U.S. patent application number 12/241565 was filed with the patent office on 2009-01-29 for ultrasonic curved blade.
This patent application is currently assigned to United States Surgical Corporation. Invention is credited to Dominick L. Mastri, Corbett W. Stone.
Application Number | 20090030440 12/241565 |
Document ID | / |
Family ID | 25429903 |
Filed Date | 2009-01-29 |
United States Patent
Application |
20090030440 |
Kind Code |
A1 |
Mastri; Dominick L. ; et
al. |
January 29, 2009 |
ULTRASONIC CURVED BLADE
Abstract
An ultrasonic dissection and coagulation system for surgical use
is provided. The system includes an ultrasonic instrument, a
control module, and a remote actuator. The ultrasonic instrument
has a housing and an elongated body portion extending from the
housing. An ultrasonic transducer supported within the housing is
operatively connected to a cutting jaw by a vibration coupler. The
vibration coupler conducts high frequency vibration from the
ultrasonic transducer to the cutting jaw. The cutting jaw has a
blade surface which is curved downwardly and outwardly in the
distal direction with respect to the longitudinal axis of the
elongated body portion along its length such that an angle defined
by a line drawn tangent to the blade surface and the longitudinal
axis of the elongated body portion varies between 5 degrees and 75
degrees. A clamp member having a tissue contact surface is
positioned adjacent to the cutting jaw and is movable from an open
position in which the tissue contact surface is spaced form the
blade surface to a clamped position in which the tissue contact
surface is in close juxtaposed alignment with the blade surface to
clamp tissue therebetween. The clamp member and the curved cutting
jaw combine to enhance contact between tissue and the blade surface
of the cutting jaw during cutting. Further, the continuously
varying angle of the blade surface with respect to the longitudinal
axis of the elongated body portion facilitates selective user
control over the application of force on tissue during a cutting or
dissecting procedure.
Inventors: |
Mastri; Dominick L.;
(Bridgeport, CT) ; Stone; Corbett W.; (San Diego,
CA) |
Correspondence
Address: |
Tyco Healthcare Group LP
60 MIDDLETOWN AVENUE
NORTH HAVEN
CT
06473
US
|
Assignee: |
United States Surgical
Corporation
|
Family ID: |
25429903 |
Appl. No.: |
12/241565 |
Filed: |
September 30, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11305706 |
Dec 16, 2005 |
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12241565 |
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10737414 |
Dec 16, 2003 |
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11305706 |
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10241936 |
Sep 11, 2002 |
6682544 |
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10737414 |
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09604877 |
Jun 28, 2000 |
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10241936 |
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09420640 |
Oct 20, 1999 |
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09604877 |
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08911205 |
Aug 14, 1997 |
6024750 |
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09420640 |
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Current U.S.
Class: |
606/169 |
Current CPC
Class: |
A61B 17/29 20130101;
A61B 2017/320094 20170801; A61B 17/320092 20130101; A61B 2017/2825
20130101; A61B 17/295 20130101; A61B 2017/320095 20170801; A61B
2017/320075 20170801 |
Class at
Publication: |
606/169 |
International
Class: |
A61B 17/32 20060101
A61B017/32 |
Claims
1. A system for performing ultrasonic surgical procedures
comprising: an ultrasonic instrument including a housing, an
elongated body portion, and a jaw assembly supported adjacent a
distal end of the elongated body portion, the housing being
configured to removably receive an ultrasonic transducer; and a
trocar assembly including a cannula dimensioned to slidably receive
the elongated body portion of the ultrasonic instrument.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] This application is a continuation of U.S. patent
application Ser. No. 10/241,936, filed Sep. 11, 2002, which is a
continuation of U.S. patent application Ser. No. 09/604,877, filed
Jun. 28, 2000, which is a continuation of U.S. patent application
Ser. No. 09/420,640, filed Oct. 20, 1999, which is a continuation
of U.S. patent application Ser. No. 08/911,205, filed Aug. 14,
1997, now U.S. Pat. No. 6,024,750, all of which are incorporated
herein by reference.
BACKGROUND
[0002] 1. Technical Field
[0003] The present disclosure relates to an ultrasonic dissection
and coagulation system for surgical use. More specifically, the
present disclosure relates to an ultrasonic instrument including a
curved blade and a clamp member particularly suited for performing
dissection and coagulation of tissue.
[0004] 2. Background of Related Art
[0005] Ultrasonic instruments for surgical use and the benefits
associated therewith are well known. For example, the use of an
ultrasonic generator in conjunction with a surgical scalpel
facilitates faster and easier cutting of organic tissue and
accelerates blood vessel clotting in the area of the cut, i.e.,
accelerated coagulation. Improved cutting results from increased
body tissue to scalpel contact caused by the high frequency of
vibration of the scalpel blade with respect to body tissue.
Improved coagulation results from heat generated by contact between
the scalpel blade and the body tissue as the scalpel blade is
vibrated at a high frequency. Thus, in order to reap the advantages
associated with ultrasonic energy, good blade to tissue contact is
important.
[0006] U.S. Pat. No. 3,862,630 ("Balamuth") discloses an ultrasonic
system including an ultrasonic motor, a tool member having a
working surface oriented normal to the direction of mechanical
vibration generated by the ultrasonic motor, and a clamp member
extending parallel to the tool member for compressing tissue
against the tool member. U.S. Pat. No. 5,322,055 ("Davison")
discloses an ultrasonic surgical instrument adapted for endoscopic
use having a blade and a clamp movable in relation to the blade to
capture tissue therebetween. The blade and the clamp define a
clamping region having a plane which is parallel to the
longitudinal axis of the surgical instrument. During an endoscopic
procedure, movement of the instrument is limited to movement along
an axis parallel to the plane of the clamping region. Thus, no
additional blade force is imposed on the body tissue as a result of
movement of the instrument.
[0007] Accordingly, a need exists for an improved ultrasonic
surgical instrument which is easy to use and provides fast and easy
cutting and improved coagulation.
SUMMARY
[0008] In accordance with the present disclosure, an ultrasonic
system for dissection and coagulation of tissue is provided. The
system includes an ultrasonic instrument, a control module, and a
remote actuator. The ultrasonic instrument has a housing and an
elongated body portion extending from the housing. An ultrasonic
transducer supported within the housing is operatively connected to
a cutting jaw by a vibration coupler. The vibration coupler
conducts high frequency vibration from the ultrasonic transducer to
the cutting jaw. The cutting jaw has a blade surface which is
curved outwardly and downwardly along its surface and thus, curved
with respect to the axis of vibration. The curved blade surface is
preferably configured such that the angle defined between a line
tangent to the blade surface and the longitudinal axis of the
elongated body portion varies from about 5 degrees to about 45
degrees along the length of the blade surface. A clamp member
having a tissue contact surface is positioned adjacent to the
cutting jaw and is movable from an open position in which the
tissue contact surface is spaced from the blade surface to a
clamped position in which the tissue contact surface is in close
juxtaposed alignment with the blade surface to clamp tissue
therebetween. The clamp member and the angled blade combine to
enhance contact between tissue and the blade surface of the blade
member.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIG. 1 is a perspective view of the ultrasonic dissection
and coagulation system with the ultrasonic instrument inserted
partially through a cannula;
[0010] FIG. 2 is a perspective view of the ultrasonic instrument of
FIG. 1;
[0011] FIG. 3 is a perspective view with parts separated of the
clamp of the ultrasonic instrument of FIG. 1;
[0012] FIG. 4 is a perspective view with parts separated of the
elongated body portion of the ultrasonic instrument of FIG. 1;
[0013] FIG. 5 is a perspective view with parts separated of the
ultrasonic instrument of FIG. 1;
[0014] FIG. 6 is a perspective view with parts separated of the
rotation assembly of the ultrasonic instrument of FIG. 1;
[0015] FIG. 7 is a side partial cutaway view of the ultrasonic
instrument of FIG. 1 in the open position;
[0016] FIG. 8 is an enlarged view of the indicated area of detail
of FIG. 7 illustrating the clamp in the open position;
[0017] FIG. 9 is a perspective view of the distal end of the
elongated body portion of the ultrasonic instrument of FIG. 1 with
the clamp in the open position;
[0018] FIG. 10 is a perspective partial cutaway view of the distal
end of the elongated body portion of the ultrasonic instrument of
FIG. 1 with the clamp in the open position;
[0019] FIG. 11 is a front perspective, partial cutaway view of the
distal end of the elongated body portion of the ultrasonic
instrument of FIG. 1 with the clamp in the open position;
[0020] FIG. 12 is a side partial cutaway view of the ultrasonic
instrument of FIG. 1 with the clamp in the clamped (closed)
position;
[0021] FIG. 13 is an enlarged view of the indicated area of detail
of FIG. 12 illustrating the clamp in the closed position;
[0022] FIG. 14 is a side cross-sectional view of the distal end of
the elongated body portion of the ultrasonic instrument of FIG. 1
in the clamped position;
[0023] FIG. 15 is a perspective view of the ultrasonic instrument
of FIG. 1 with the elongated body portion partially rotated;
[0024] FIG. 16A is a side view of an alternate embodiment of the
ultrasonic transducer of FIG. 1;
[0025] FIG. 16B is a side cross-sectional view taken along section
line 16B-16B of FIG. 16A.
[0026] FIG. 16C is a perspective view with parts separated of the
ultrasonic transducer of FIG. 16A;
[0027] FIG. 17A is a side view of a torque wrench assembly in
engagement with the ultrasonic transducer of FIG. 16A; and
[0028] FIG. 17B is a side cross-sectional view taken along section
line 17B-17B of FIG. 17A.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0029] Preferred embodiments of the presently disclosed ultrasonic
dissection and coagulation system will now be described in detail
with reference to the drawings, in which like reference numerals
designate identical or corresponding elements in each of the
several views.
[0030] FIG. 1 illustrates the ultrasonic dissection and coagulation
system shown generally as 10. Briefly, dissection and coagulation
system 10 includes ultrasonic instrument 12, control module 14, and
remote actuator 16. Control module 14 is operatively connected to
ultrasonic instrument 12 by electrically conductive cable 18 and
functions to control the power and frequency of current supplied to
ultrasonic instrument 12. Any suitable controller capable of
delivering power to ultrasonic instrument 12 can be used. Control
module 14 does not form part of the invention and will not be
further discussed herein. Remote actuator 16, e.g., pedal actuator,
is operatively connected to control module 14 by electrically
conductive cable 20 and can be actuated to initiate the supply of
power to ultrasonic instrument 12 via control module 14 to effect
vibratory motion of ultrasonic instrument 12 to cut and coagulate
tissue.
[0031] As illustrated in FIG. 2, ultrasonic instrument 12 includes
housing 22 and elongated body portion 24 extending distally
therefrom. Housing 22 is preferably formed from molded housing
half-sections 22a and 22b and includes a barrel portion 26 having a
longitudinal axis aligned with the longitudinal axis of body
portion 24 and a stationary handle portion 28 extending obliquely
from barrel portion 26. Ultrasonic transducer 30 is supported
within and extends from the proximal end of housing 22 and is
connected to control module 14 via cable 18. Jaw assembly 32 is
disposed adjacent the distal end of elongated body portion 24 and
is actuated by moving movable handle 36 with respect to stationary
handle portion 28. Movable handle 36 and stationary handle portion
28 include openings 38 and 40, respectively, to facilitate gripping
and actuation of ultrasonic instrument 12. Elongated body portion
24 is supported within rotatable knob 34 and may be selectively
rotated by rotating knob 34 with respect to housing 22 to change
the orientation of jaw assembly 32.
[0032] FIGS. 3 and 4 illustrate elongated body portion 24 with
parts separated. Elongated body portion 24 includes an outer tube
42 which is preferably cylindrical and has a proximally located
annular flange 44 dimensioned to engage rotatable knob 34 (FIG. 2)
as described below. An elongated actuator tube 46, which is also
preferably cylindrical, is configured to be slidably received
within outer tube 42 and includes a proximally located annular
flange 48 dimensioned to engage coupling member 98 (FIG. 5) which
is supported within housing 22 (FIG. 2) and will be described in
detail below. Vibration coupler 50 is dimensioned to extend through
elongated actuator tube 46 and includes a proximal end 52 having a
reduced diameter portion 54 configured to operatively engage
ultrasonic transducer 30 (FIG. 5) and a distal end 56 adapted to be
operatively connected to cutting jaw 58. A plurality of silicon
rings 51 can be molded or otherwise attached to the nodal points
along vibration coupler 50 to seal between vibration coupler 50 and
actuator tube 46. Preferably, cutting jaw 58 includes an internal
proximal threaded bore (not shown) which is dimensioned to receive
threaded distal end 56 of vibration coupler 50. Alternately,
cutting jaw 58 can be formed integrally with vibration coupler 50,
cutting jaw 58 may include a threaded proximal end configured to be
received within a threaded bore formed in vibration coupler 50, or
other attachment devices can be used. A clamp 60 having a clamp
body 62 and a tissue contact member 64 removably secured to clamp
body 62 is operatively connected to the distal end of actuator tube
46. Clamp body 62 includes a pair of tissue receiving stops 71 that
define the proximal end of the exposed blade surface 59. Tissue
contact member 64 is preferably composed of teflon and is
preferably removably fastened to clamp body 62 by a tongue and
groove fastening assembly (reference numerals 61 and 65,
respectively), although other fastening assemblies are also
envisioned. Tissue contact member 64 functions to isolate clamp 60,
which is preferably metallic, from jaw 58 which is also preferably
metallic to prevent metal to metal contact. Tissue contact member
50 also functions to grip tissue to prevent movement of the tissue
with vibrating cutting jaw 58. Alternately, at least one row of
teeth may be positioned on clamp 60 to grip tissue, such as
disclosed in U.S. patent application Ser. No. 08/911,207, which is
incorporated herein by reference. Pivot members (pins) 66 located
at the proximal end of clamp body 62 are configured to be received
within openings 68 formed in the distal end of outer tube 42. A
guide slot 70 formed in the distal end of actuator tube 46 permits
relative movement between actuator tube 46 and clamp body 62 by
allowing pins 66 to move in guide slot 70. A pair of camming
members 72 are also formed on clamp body 62 and are positioned to
be received within cam slots 74 formed in the distal end of
actuator tube 46. Movement of actuator tube 46 and clamp 60 will be
described in detail below.
[0033] Cutting jaw 58 includes a curved blade surface 59 that
slopes downwardly and outwardly in the distal direction.
Preferably, the entire blade surface 59 exposed to tissue, i.e.,
the portion of blade surface 59 between tissue receiving stops 71
and the distal end of blade surface 59, has a tangent which defines
an angle with respect to the longitudinal axis of elongated body
portion 24 that varies along the length of blade surface 59 from
about 5 degrees to about 75 degrees. Ideally, the angle defined by
a line tangent to the blade surface and the longitudinal axis of
elongated body portion 24 varies from about 5 degrees to about 45
degrees along the length of the blade surface. The curved blade
surface provides better visibility at the surgical site. Clamp 60
is movable from an open position in which tissue contact member 64
is spaced apart from blade surface 59 (FIGS. 7 and 8) to a clamped
position in which tissue contact member is in juxtaposed close
alignment with blade surface 59 (FIGS. 11-13) to clamp tissue
therebetween. The interior surface of tissue contact member 64 is
curved to correspond to blade surface 59. In the clamped position,
note the positioning of tissue contact member 64 with respect to
blade surface 59. Actuation of clamp 60 from the open position to
the clamped position will be described in detail below.
[0034] Referring now to FIGS. 5 and 6, the handle assembly and the
rotation assembly will now be discussed. Housing half-sections 22a
and 22b define a chamber 76 configured to receive a portion of
ultrasonic transducer 30. Chamber 76 has an opening 78
communicating with the interior of housing 22. Ultrasonic
transducer 30 includes a bore 80 configured to receive proximal end
54 of vibration coupler 50. In the assembled condition, proximal
end 54 extends through opening 78 into bore 80. Ultrasonic
transducer 30 may be secured within housing 22 to vibration coupler
50 using any known attachment apparatus. Preferably, a torque
wrench, such as disclosed in copending U.S. patent application Ser.
No. 08/911,207, now U.S. Pat. No. 6,036,667, incorporated herein by
reference above, can be used to secure ultrasonic transducer 30 to
vibration coupler 50. As disclosed therein, the proximal end of
transducer 30 may be configured to engage the torque wrench.
Movable handle 36 is pivotally connected between housing
half-sections 22a and 22b about pivot pin 82 which extends through
holes 84 formed in legs 86 of movable handle 36. A cam slot 88
formed in each leg 86 is configured to receive a protrusion 90
projecting outwardly from coupling member 98 (FIG. 6).
[0035] As illustrated in FIG. 6, coupling member 98 operatively
connects movable handle 36 to actuator tube 46 and is preferably
formed from molded half-sections 98a and 98b to define a
throughbore 100 dimensioned to slidably receive the proximal end of
vibration coupler 50. Coupling member 98 has an inner distally
located annular groove 102 dimensioned to receive annular flange 48
of actuator tube 46 and an outer proximally located annular groove
104. Groove 104 is positioned to receive an annular rib 106 formed
on the internal wall of a swivel member 108 (FIG. 5). Swivel member
108 is preferably formed from molded half-sections 108a and 108b
and permits rotation of coupling member 98 relative to movable
handle 36. Protrusions 90 project outwardly from sidewalls of
swivel member 108 and extend through cam slots 88 of movable handle
36 (FIG. 5).
[0036] Referring to FIGS. 5 and 6, rotation knob 34 is preferably
formed from molded half-sections 34a and 34b and includes a
proximal cavity 110 for slidably supporting coupling member 98 and
a distal bore 112 dimensioned to receive outer tube 42. An annular
groove 114 formed in bore 112 is positioned to receive annular
flange 44 of outer tube 42. The outer wall of knob 34 has a
proximally located annular ring 116 dimensioned to be rotatably
received within annular slot 118 formed in opening 120 of housing
22. The outer wall of knob 34 also includes scalloped surface 122
to facilitate gripping of rotatable knob 34. Annular ring 116
permits rotation of knob 34 with respect to housing 22 while
preventing axial movement with respect thereto. A pair of
cylindrical rods 124 extend between half-sections 34a and 34b
through a rectangular opening 126 formed in coupling member 98.
Rods 124 engage a pair of concave recesses 128 formed in fitting
130 which is fastened about vibration coupler 50, such that
rotation of knob 34 causes rotation of vibration coupler 50 and
thus rotation of blade 58 and clamp 60. Alternately, recesses 128
can be monolithically formed with vibration coupler 50.
[0037] FIGS. 7-10 illustrate ultrasonic instrument 12 with clamp 60
in the open position. The elongated body 24 which includes clamp 60
and blade 58, and housing 22 which includes handles 28 and 36, are
packaged as an integral unit, e.g., non-detachably connected, that
requires no assembly by the user prior to use. That is, the user
needs only to attach transducer 30 to housing 22 to ready
instrument 12 for use. In the open position, movable handle 36 is
spaced rearwardly from stationary handle portion 28 and protrusions
90 are positioned in the lower proximal portion of cam slots 88. At
the distal end of ultrasonic instrument 12, pivot members 66 are
positioned near the distal end of guide slots 70 and camming
members 72 are positioned in the upper distal portion of cam slots
74. Tissue contact member 64 of clamp 60 is spaced from blade
surface 59 to define a tissue receiving area 132. The proximal end
of tissue receiving area 132 is defined by tissue receiving stops
71 which are preferably integrally formed with clamp body 62 and
extend below blade surface 59. Preferably, the distal end of blade
58 is rounded to prevent inadvertent damage to tissue during use of
instrument 12 and tissue contact surface 64 is also preferably
formed with a longitudinally extending concavity 67 to receive
tissue therein. Alternately, the distal end of blade 58 may be
formed in any shape which may be suitable to a particular surgical
application, i.e., pointed, flat, etc. Moreover, tissue contact
surface 64 need not be formed with a concavity but may be flat,
angled, etc.
[0038] Referring to FIGS. 11-15, when movable handle 36 is pivoted
clockwise about pivot member 82 towards stationary handle portion
28, in the direction indicated by arrow "A" in FIG. 11, cam slot 88
engages protrusion 90 of swivel member 108 to advance coupling
member 98 distally within cavity 110 of rotation knob 34. Since
actuator tube 46 is attached to coupling member 98 by an annular
flange 48, actuator tube 46 is also advanced distally in the
direction indicated by arrow "B" in FIG. 12. Movement of actuator
tube 46 distally causes cam slots 74 to move into engagement with
camming members 72 to pivot clamp body 62 about pivot members 66,
in the direction indicated by arrow "C" in FIG. 13, to move clamp
member 62 and tissue contact member 64 into the clamped position.
In the clamped position, protrusions 90 are located in a central
portion of cam slots 88, pivot members 66 are located near the
proximal end of guide slots 70, and camming members 72 are located
in the proximal lower portion of cam slots 74.
[0039] Elongated body portion 24 can be freely rotated with respect
to housing 22 by rotating rotation knob 34. As illustrated in FIG.
15, rotation of knob 34 in the direction indicated by arrow "D"
causes rotation of jaw assembly 32 in the direction indicated by
arrow "E". Knob 34 is positioned adjacent housing 22 to facilitate
one handed operation of both movable handle 36 and rotation knob
34.
[0040] Referring again to FIG. 1, elongated body portion 24 is
dimensioned to extend through a trocar assembly 140, and is
preferably dimensioned to extend through a 5 mm trocar assembly.
During use, elongated body portion 24 is slid through trocar
assembly 140 with jaw assembly 32 in the clamped or closed position
to a position adjacent tissue (not shown) to be dissected and/or
coagulated. An optical unit (not shown) can also be positioned
adjacent the surgical site to facilitate viewing of the procedure.
Jaw assembly 32 is opened and tissue to be dissected and/or
coagulated is positioned within tissue receiving area 132 (See also
FIG. 9). Tissue receiving stops 71 prevent tissue from moving past
the proximal end of blade surface 59. Next, jaw assembly 32 is
closed to clamp tissue between tissue contact member 64 and blade
surface 59. Power is supplied to ultrasonic instrument 12 via
control module 14 to initiate vibration of blade 58 to effect
dissection and/or coagulation of tissue. Because of the curve of
blade surface 59, the force applied by blade surface 59 to the
tissue being dissected can be selectively increased or decreased as
instrument 12 is moved forward through trocar assembly 140 by
adjusting the location of the tissue on blade surface 59 and thus
changing the angle of the force applied to the tissue being
dissected.
[0041] FIGS. 16A-16C illustrate an alternate embodiment of the
ultrasonic transducer shown generally as 230. Ultrasonic transducer
230 includes a housing 231 having a proximal housing portion 232
and a distal housing portion 234. Proximal housing portion 232 has
a scalloped section 236 adjacent its proximal end. Transducer horn
238 is supported within housing 231 by support collar 240 and
annular ring 242. The distal end of transducer horn 238 includes a
threaded bore 244 dimensioned to engage reduced diameter portion 54
of vibration coupler 50 (FIG. 4). As best illustrated in FIG. 16B,
transducer horn 238 is formed with annular flange 246, about which
annular ring 242 is received. The proximal end of support collar
240 also includes an annular flange 248 which, in an assembled
condition, is clamped between proximal and distal housing portions
232 and 234 to fixedly retain support collar 240 in position within
housing 231. The distal end of support collar 240 engages annular
ring 242 to retain annular ring 242 and thus horn 238 in a
longitudinally fixed position within housing 231.
[0042] Referring to FIGS. 17A-17B, torque wrench assembly 250 is
configured and dimensioned to engage scalloped section 236 of
ultrasonic transducer 230 to facilitate assembly of transducer
assembly 230 with the remaining portion of ultrasonic instrument
12. Torque wrench assembly 250 assures that horn 238 and vibration
coupler 50 (FIG. 4) are properly connected, i.e., properly
torqued.
[0043] It will be understood that various modifications may be made
to the embodiments herein. For example, vibration coupler 50 and
blade 58 may be monolithically formed or attached using structure
other than screw threads. Different actuator assemblies other than
the actuator tube having a camming surface can be used to pivot the
clamp member to the clamped position. Further, the elongated body
portion of the instrument can be dimensioned to extend through
other than 5 mm trocar assemblies, e.g., 10 mm, 12 mm, etc.
Therefore, the above description should not be construed as
limiting, but merely as exemplifications of preferred embodiments.
Those skilled in the art will envision other modifications within
the scope and spirit of the claims appended hereto.
* * * * *