ULTRASONIC SURGICAL INSTRUMENT
An ultrasonic surgical instrument is provided, including a handpiece, a lever operably coupled to the handpiece and movable between first, second, and third positions, a shaft assembly extending distally from the handpiece, and an ultrasonic waveguide extending through the shaft assembly and defining a fixed jaw member at a distal end portion thereof. An outlet at the distal end of the fixed jaw member provides irrigation of fluid. The waveguide functions as an aspirator well as a transector/dissector of tissue. A movable jaw member is disposed towards a distal end portion of the shaft assembly and is operably coupled to the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between a retracted position, an extended open position, and an extended closed position.
This application is a continuation application of U.S. patent application Ser. No. 15/428,686, filed on Feb. 9, 2017, the entire contents of which is hereby incorporated herein by reference.
BACKGROUND 1. Technical FieldThe present disclosure relates to surgical instruments, and more particularly, to an ultrasonic surgical instrument
2. Discussion of Related ArtUltrasonic devices for surgical uses are well known. Ultrasonic devices convert electrical energy into high frequency mechanical impulses (ultrasonic waves) that are then used to treat tissue.
One type of commonly used ultrasonic surgical device is an ultrasonic aspirator, which typically includes a handpiece, an elongated probe, and a vibrating tip. Ultrasonic waves emanating from the vibrating tip treat tissue with high water content (e.g., tumors, liver parenchyma) while tissue with low water content (e.g., nerves, vessels, membranes) is left untreated or minimally treated. Thus, ultrasonic aspirators demonstrate inherent tissue selectivity, providing the ability to avoid critical tissue structures from damage. Ultrasonic aspirators are useful for fine dissection of soft and calcified tissues such as liver parenchyma and soft tumors. However, ultrasonic aspirators have limited hemostatic effect and little ability to dissect other tissues, such as connective tissue. As a result, ultrasonic aspirators are often used with other surgical devices, e.g., ultrasonic shears.
Ultrasonic shears provide good hemostatic effect and are capable of dissecting connective tissue. Ultrasonic shears usually include an elongated shaft attached to a handle assembly. The distal end of the elongated shaft may have a blade and clamp mechanism capable of grasping, coagulating, and cutting tissue. However, ultrasonic shears may increase the risk of inadvertently grasping, coagulating, and cutting critical tissue structures. Thus, during certain procedures, surgeons often use both devices, leveraging the strength of each device. For example, in a liver transection, a surgeon may use an ultrasonic aspirator for fine dissection of liver parenchyma and then transition to ultrasonic shears to skeletonize and seal bile ducts. Using several devices during a procedure may be expensive, cumbersome, and increase operation time and complexity.
SUMMARYProvided in accordance with aspects of the present disclosure is an ultrasonic surgical instrument including a handpiece, a lever operably coupled to the handpiece and movable between first, second, and third positions, a shaft assembly extending distally from the handpiece, and an ultrasonic waveguide extending through the shaft assembly and defining a fixed jaw member at a distal portion thereof. A movable jaw member may be disposed towards a distal portion of the shaft assembly and operably coupled to the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between a retracted position, wherein the movable jaw member is retracted relative to the fixed jaw member, an extended open position, wherein the movable jaw member opposes and is spaced-apart from the fixed jaw member, and an extended closed position, wherein the movable jaw member opposes and is approximated relative to the fixed jaw member.
In an aspect of the present disclosure, the fixed jaw member defines a first aperture adapted to emit irrigation fluid therefrom.
In another aspect of the present disclosure, the first aperture communicates with a first passageway extending through the waveguide or the shaft assembly to the handpiece.
In yet another aspect of the present disclosure, the fixed jaw member defines a second aperture for receiving aspirated material from a surgical site.
In still another aspect of the present disclosure, the second aperture communicates with a second passageway extending through the waveguide or the shaft assembly to the handpiece.
In another aspect of the present disclosure, an ultrasonic transducer is disposed within the handpiece and operably coupled to the waveguide.
In yet another aspect of the present disclosure, a dual stage button is disposed on the handpiece and coupled to the ultrasonic transducer for activating the ultrasonic transducer in each of a low power mode and a high power mode.
In still another aspect of the present disclosure, a drive assembly is operably coupled between the movable jaw member and the lever such that movement of the lever between the first, second, and third positions moves the movable jaw member relative to the fixed jaw member between the retracted, extended open, and extended closed positions.
In still yet another aspect of the present disclosure, the drive assembly includes an actuation sleeve slidably disposed within the shaft assembly, the actuation sleeve having a proximal end portion operatively connected to the lever and a distal end portion operatively connected to the movable jaw member, wherein movement of the lever translates the actuation sleeve through the shaft assembly to move the movable jaw member relative to the fixed jaw member.
In another aspect of the present disclosure, an upper pin and a lower pin are operably associated with the movable jaw member.
In yet another aspect of the present disclosure, the shaft assembly defines a dual slot arrangement including an upper slot for receipt of the upper pin, the upper slot having a proximal longitudinal portion and a distal downward sloping portion, and a lower slot for receipt of the lower pin, the lower slot having a proximal longitudinal portion and a distal downward sloping portion.
In still yet another aspect of the present disclosure, in the retracted position of the movable jaw member, the upper and lower pins are disposed at proximal end portions of the proximal longitudinal portions of the respective upper and lower slots.
In still another aspect of the present disclosure, in the extended open position of the movable jaw member, the upper pin is disposed at a transition between the proximal longitudinal portion and the distal downward sloping portion of the upper slot, and the lower pin is disposed at a distal end of the distal downward sloping portion of the lower slot.
In another aspect of the present disclosure, in the extended closed position of the movable jaw member, the upper and lower pins are disposed at distal end portions of the distal downward sloping portions of the respective upper and lower slots.
In yet another aspect of the present disclosure, a dial is disposed at a distal end portion of the handpiece and operably coupled to the shaft assembly for selectively rotating the shaft assembly and the end effector assembly relative to the handpiece.
In still yet another aspect of the present disclosure, the handpiece includes a fluid inlet port configured to operably couple to a fluid source.
In still another aspect of the present disclosure, the handpiece includes a suction port configured to operably couple to a source of vacuum.
In another aspect of the present disclosure, the movable jaw member includes a clamp pad disposed thereon.
In yet another aspect of the present disclosure, the clamp pad further includes teeth configured to facilitate grasping tissue between the movable jaw member and the fixed jaw member.
Objects and features of the present disclosure will become apparent to those of ordinary skill in the art when descriptions thereof are read with reference to the accompanying drawings, of which:
The ultrasonic surgical instrument of the present disclosure incorporates the features of ultrasonic aspirators and ultrasonic shears into a single device. In the ultrasonic aspiration mode, the device allows for fine dissection of tissue, for example, around critical structures. In the ultrasonic shears mode, the device provides the ability to clamp, coagulate, and/or dissect tissue. These and other aspects and features of the present disclosure are detailed hereinbelow.
Referring generally to
Referring to
Dual stage button 15 may be used to activate ultrasonic surgical instrument 10 in both an ultrasonic aspiration mode “A” (
An irrigation and aspiration fluid housing 38 is disposed towards the proximal end portion of handpiece 12. A fluid inlet 42 communicates with an annular fluid line 44 defined between an inner surface of inner tube 76 of shaft assembly 75 and an outer surface of waveguide 20. Fluid line 44 ultimately communicates with an irrigation channel 82b (
An aspiration channel 81b extends longitudinally from a distal opening 81c defined within body portion 81a of fixed jaw member 83 to an axial passage 58 defined within waveguide 20. An outlet conduit 62 communicates with axial passage 58 to enable the aspiration of irrigation fluid and emulsified tissue adjacent to end effector assembly 80. Fluid inlet 42 and outlet conduit 62 may be coupled separately to a pump source (not shown) and a vacuum source (not shown), respectively, for enabling irrigation and aspiration, or may be coupled to a combined pump/vacuum source (not shown). Thus, emulsified tissue and irrigation fluid may be aspirated, e.g., vacuumed or pumped, as indicated by arrow “AS” (
Shaft assembly 75 extends distally from handpiece 12 and includes end effector assembly 80 (
Movable jaw member 84 defines a jaw member body 84a and two pins disposed thereon: an upper pin 84b and a lower pin 84c. Upper pin 84b and lower pin 84c, in relation to each other, may be configured in a longitudinally offset arrangement. Movable jaw member 84 is slidably and pivotably mounted relative to fixed jaw member 83 and shaft assembly 75 via receipt of pins 84b, 84c within slot arrangement 120 of shaft assembly 75. As will be described below, in addition to the ultrasonic aspiration mode “A” (
Movable jaw member 84 may include a clamp pad 85 (
Referring to
With particular reference to
Lever 90 extends into and is pivotably coupled within handpiece 12 to enable lever 90 to pivot upon a fixed point within handpiece 12 between the three positions described above (“D,” “P1,” and “P2,” (
Referring back to
Referring now to
In ultrasonic aspiration mode “A,” jaw member 84 is in a retracted position “R” such that it does not obstruct the surgeon's view during a procedure or interfere with fine dissection of tissue. Suction and/or irrigation are operable in the ultrasonic aspiration mode “A.” For example, irrigation fluid is ejected from distal opening 82c of irrigation channel 82b to wash the transection plane and tissue particles from the surgical site such that the surgeon's view remains unobstructed. Additionally, irrigation fluid from distal opening 82c of irrigation channel 82b may cool fixed jaw member 83 to prevent burning or charring of tissue. Fluid flowing into and through ultrasonic surgical instrument 10 may also prevent ultrasonic surgical instrument 10 from failure caused by overheating. Likewise, fragmented bits of tissue as well as irrigation fluid and other fluids are aspirated from the surgical site through distal opening 81c of aspiration channel 81b. Distal openings 81c, 82c may have a substantially teardrop shape to facilitate, e.g., the aspiration and irrigation of tissue.
As shown in
Referring now to
In order to move movable jaw member 84 from the retracted position “R” (
Referring to
The travel distance of jaw member 84 between the retracted position “R,” open position “O,” and/or closed position “C” may be relatively small. To give a user appropriate tactile feedback between the actuation of lever 90 and the resulting travel of jaw member 84 within slot arrangement 120, the boomerang-shape-like configuration of cross bar 103 allows for maximum travel of lever 90, such that the travel of lever 90 from each position (e.g., “D” to “P1” or “D to “P2,” “P1” to “D” or “P1” to “P2,” “P2” to “D” or “P2” to “P1”) is amplified versus the actual travel distance of jaw member 84, resulting in an appropriate level of tactile feedback.
It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications, and variances. The embodiments described with reference to the attached drawings are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods, and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.
Claims
1-20. (canceled)
21. An ultrasonic surgical instrument, comprising:
- a handpiece;
- a shaft assembly extending distally from the handpiece; and
- an ultrasonic waveguide extending through the shaft assembly and including a fixed jaw member at a distal portion thereon, the fixed jaw member defining a first aperture adapted to emit irrigation fluid into a surgical site and a second aperture, independent of the first aperture, adapted to receive aspirated material from a surgical site.
22. The ultrasonic surgical instrument according to claim 21, wherein the first aperture communicates with a first passageway extending through the waveguide.
23. The ultrasonic surgical according to claim 21, wherein the second aperture communicates with a second passageway extending through the waveguide.
24. The ultrasonic surgical instrument according to claim 21, wherein the first aperture communicates with a first passageway extending through the waveguide and the second aperture communicates with a second passageway extending through the waveguide independent of the first passageway.
25. The ultrasonic surgical instrument according to claim 21, wherein the second aperture is positioned more-distally relative to the first aperture.
26. The ultrasonic surgical instrument according to claim 21, wherein the first and second apertures are oriented in a distally-facing direction.
27. The ultrasonic surgical instrument according to claim 21, wherein the handpiece further includes a fluid inlet port communicating with the first aperture and configured to operably couple to a fluid source.
28. The ultrasonic surgical instrument according to claim 21, wherein the handpiece further includes a suction port communicating with the second aperture and configured to operably couple to a source of vacuum.
29. The ultrasonic surgical instrument according to claim 21, wherein at least one of the first or second apertures defines a substantially teardrop shape.
30. The ultrasonic surgical instrument according to claim 21, wherein both of the first and second apertures define substantially teardrop shapes.
31. An ultrasonic surgical instrument, comprising:
- a handpiece;
- a shaft assembly extending distally from the handpiece;
- a lever extending from the handpiece and operably coupled to the shaft assembly;
- an ultrasonic waveguide extending through the shaft assembly and including a fixed jaw member at a distal portion thereon, the fixed jaw member defining a first aperture adapted to emit irrigation fluid into a surgical site and a second aperture, independent of the first aperture, adapted to receive aspirated material from a surgical site; and
- a movable jaw member disposed towards a distal portion of the shaft assembly and operably coupled to the lever such that actuation of the lever moves the movable jaw member relative to the fixed jaw member at least between an open position, wherein the movable jaw member is spaced-apart from the fixed jaw member, and a closed position, wherein the movable jaw member is approximated relative to the fixed jaw member.
32. The ultrasonic surgical instrument according to claim 31, wherein the first aperture communicates with a first passageway extending through the waveguide and the second aperture communicates with a second passageway extending through the waveguide independent of the first passageway.
33. The ultrasonic surgical instrument according to claim 32, wherein the handpiece further includes:
- a fluid inlet port communicating with the first passageway and configured to operably couple to a fluid source; and
- a suction port communicating with the second passageway and configured to operably couple to a source of vacuum.
34. The ultrasonic surgical instrument according to claim 31, wherein the second aperture is positioned more-distally relative to the first aperture.
35. The ultrasonic surgical instrument according to claim 31, wherein the first and second apertures are oriented in a distally-facing direction.
36. The ultrasonic surgical instrument according to claim 31, wherein at least one of the first or second apertures defines a substantially teardrop shape.
37. The ultrasonic surgical instrument according to claim 31, wherein both of the first and second apertures define substantially teardrop shapes.
38. The ultrasonic surgical instrument according to claim 31, further including an ultrasonic transducer disposed within the handpiece and operably coupled to the waveguide.
39. The ultrasonic surgical instrument according to claim 31, wherein actuation of the lever moves the movable jaw member relative to the fixed jaw member between a retracted position, wherein the movable jaw member is positioned proximally of the fixed jaw member, the open position, and the closed position.
Type: Application
Filed: Jul 23, 2019
Publication Date: Nov 14, 2019
Inventors: SCOTT D. UHLRICH (FORT COLLINS, CO), ANTHONY B. ROSS (BOULDER, CO), ROBERT B. STODDARD (STEAMBOAT SPRINGS, CO), ERIC R. LARSON (BOULDER, CO)
Application Number: 16/520,064