U.S. patent application number 14/688542 was filed with the patent office on 2016-10-20 for ultrasonic surgical instrument with articulating end effector having a curved blade.
The applicant listed for this patent is Ethicon Endo-Surgery, LLC. Invention is credited to Willliam A. Olson, Foster B. Stulen, William B. Weisenburgh, II.
Application Number | 20160302819 14/688542 |
Document ID | / |
Family ID | 55806886 |
Filed Date | 2016-10-20 |
United States Patent
Application |
20160302819 |
Kind Code |
A1 |
Stulen; Foster B. ; et
al. |
October 20, 2016 |
ULTRASONIC SURGICAL INSTRUMENT WITH ARTICULATING END EFFECTOR
HAVING A CURVED BLADE
Abstract
An apparatus comprises a body assembly and a shaft extending
distally therefrom. The shaft defines a longitudinal axis. The
apparatus further comprises an acoustic waveguide and an
articulation section coupled with the shaft. A portion of the
articulation section encompasses a flexible portion of the
waveguide. The articulation section further comprises first member
and a second member that is longitudinally translatable relative to
the first member. The apparatus further comprises an end effector
including an ultrasonic blade in acoustic communication with the
waveguide. A distal portion the ultrasonic blade is disposed in a
first direction away from the longitudinal axis at a bend angle.
The end effector also includes a clamp arm that is coupled with the
first member and the second member, and an articulation drive
assembly operable to drive articulation of the articulation section
to thereby deflect the end effector from the longitudinal axis in
the first direction.
Inventors: |
Stulen; Foster B.; (Mason,
OH) ; Olson; Willliam A.; (Lebanon, OH) ;
Weisenburgh, II; William B.; (Maineville, OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon Endo-Surgery, LLC |
Guaynabo |
PR |
US |
|
|
Family ID: |
55806886 |
Appl. No.: |
14/688542 |
Filed: |
April 16, 2015 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/320094
20170801; A61B 2017/320093 20170801; A61B 2017/320095 20170801;
A61B 2017/320071 20170801; A61B 2017/2908 20130101; A61B 17/320092
20130101; A61B 2017/320089 20170801; A61B 2017/00318 20130101; A61B
2017/320069 20170801; A61B 2017/00314 20130101; A61B 2017/320075
20170801; A61B 2017/00327 20130101 |
International
Class: |
A61B 17/32 20060101
A61B017/32 |
Claims
1. An apparatus for operating on tissue, the apparatus comprising:
(a) a body assembly; (b) a shaft extending distally from the body
assembly, wherein the shaft defines a longitudinal axis; (c) an
acoustic waveguide, wherein the waveguide comprises a flexible
portion; (d) an articulation section coupled with the shaft,
wherein a portion of the articulation section encompasses the
flexible portion of the waveguide, wherein the articulation section
further comprises: (i) a first member, and (ii) a second member,
wherein the second member is longitudinally translatable relative
to the first member; (e) an end effector comprising an ultrasonic
blade in acoustic communication with the waveguide, wherein a
distal portion the ultrasonic blade is disposed in a first
direction away from the longitudinal axis at a bend angle; and (f)
an articulation drive assembly operable to drive articulation of
the articulation section to thereby deflect the end effector from
the longitudinal axis in the first direction.
2. The apparatus of claim 1, wherein the articulation section
includes a positive stop, wherein the positive stop is configured
to substantially prevent deflection of the end effector in a second
direction, wherein the second direction is opposite to the first
direction.
3. The apparatus of claim 2, wherein the articulation section
comprises a plurality of tubular members, wherein the positive stop
is disposed on at least one of the tubular members.
4. The apparatus of claim 3, wherein the positive stop comprises an
edge of at least one of the tubular members.
5. The apparatus of claim 4, wherein the edge extends perpendicular
relative to the longitudinal axis of the shaft when the
articulation section is in an unarticulated configuration.
6. The apparatus of claim 1, wherein the articulation section
comprises a flexible collar having a spine portion extending
parallel to the longitudinal axis of the shaft, wherein the collar
is configured to operably couple the shaft and the articulation
section.
7. The apparatus of claim 6, wherein the collar comprises a
plurality of legs extending transverse to the spine portion,
wherein at least one of the legs is configured to engage the shaft,
wherein at least one pair of legs is configured to engage the
articulation section.
8. The apparatus of claim 1, wherein the blade extends in the first
direction along a curved path.
9. The apparatus of claim 1, wherein the articulation section
comprises a radially inner portion, wherein the articulation
section further comprises a radially outer portion surrounding at
least part of the radially inner portion, wherein the radially
outer portion is configured to limit articulation of the
articulation section to the first direction.
10. The apparatus of claim 9, wherein the radially outer portion
comprises a plurality of adjacent, at least partially tubular
members.
11. The apparatus of claim 10, wherein at least one of the at least
partially tubular members comprises a distal edge, wherein the
distal edge includes a first portion that extends at an oblique
angle relative to a first plane extending perpendicular relative to
the longitudinal axis, wherein the distal edge includes a second
portion that extends along the first plane.
12. The apparatus of claim 11, wherein at least one of the at least
partially tubular members comprises a proximal edge, wherein the
proximal edge includes a first portion that extends at an oblique
angle relative to a second plane extending perpendicular to the
longitudinal axis, wherein the proximal edge includes a second
portion that extends along the second plane.
13. The apparatus of claim 12, wherein the second portion of the
proximal edge of one of the at least partially tubular members
substantially abuts the second portion of the distal edge of an
adjacent one of the at least partially tubular members when the
articulation section is in an unarticulated configuration.
14. The apparatus of claim 12, wherein the first portion of the
proximal edge of one of the at least partially tubular members
substantially abuts the first portion of the distal edge of an
adjacent one of the at least partially tubular members when the
articulation section is in an articulated configuration.
15. The apparatus of claim 9, wherein the radially inner portion
defines opposing channels for the first member and the second
member, respectively, wherein the first member and the second
member are each disposed between the radially inner portion and the
radially outer portion.
16. An apparatus for operating on tissue, the apparatus comprising:
(a) a body assembly; (b) a shaft extending distally from the body
assembly, wherein the shaft defines a longitudinal axis; (c) an
acoustic waveguide, wherein the waveguide comprises a flexible
portion; (d) an articulation section coupled with the shaft; (e) an
end effector coupled with the articulation section, wherein the end
effector comprises an ultrasonic blade in acoustic communication
with the waveguide; (f) an articulation drive assembly operable to
drive articulation of the articulation section to thereby deflect
the end effector from the longitudinal axis, wherein the
articulation drive assembly comprises: (i) a first member, and (ii)
a second member; wherein the first and second members are operable
to translate simultaneously in opposite directions to thereby
deflect the end effector from the longitudinal axis, wherein the
articulation section comprises a stop member configured to
substantially prevent the deflection of the end effector from the
longitudinal axis in a first direction but allow the deflection of
the end effector in a second direction from the longitudinal axis,
wherein the second direction is opposite to the first
direction.
17. The apparatus of claim 16, wherein the stop member is
configured to engage at least a portion of the shaft to prevent
deflection of the end effector in the second direction.
18. The apparatus of claim 16, wherein the stop member is disposed
perpendicularly relative to the longitudinal axis.
19. The apparatus of claim 16, wherein the end effector further
comprises a clamp arm operable to pivot toward and away from the
blade.
20. An apparatus for operating on tissue, the apparatus comprising:
(a) a body assembly; (b) a shaft extending distally from the body
assembly, wherein the shaft defines a longitudinal axis; (c) an
articulation section coupled with the shaft; (d) an end effector
coupled with the articulation section, wherein the end effector
comprises: (i) a working element configured to engage tissue,
wherein the working element includes an elongate shaft extending
through the shaft of the instrument, and (ii) a clamp arm operable
to pivot toward and away from the working element; and (e) an
articulation drive assembly operable to drive articulation of the
articulation section to thereby deflect the end effector from the
longitudinal axis, wherein the articulation drive assembly
comprises: (i) a first member, and (ii) a second member; wherein
the first and second members are operable to translate
simultaneously in opposite directions to thereby deflect the end
effector from the longitudinal axis, wherein the articulation
section comprises a plurality of pivotable members surrounding the
elongate shaft of the working element; wherein the pivotable
members include a stop on at least one side to resist pivoting in a
first direction to thereby prevent articulation of the articulation
section; wherein the pivotable members are configured to pivot in a
second direction that is opposite to the first direction in
response to translation of the first and second members to thereby
cause articulation of the articulation section.
Description
BACKGROUND
[0001] A variety of surgical instruments include an end effector
having a blade element that vibrates at ultrasonic frequencies to
cut and/or seal tissue (e.g., by denaturing proteins in tissue
cells). These instruments include piezoelectric elements that
convert electrical power into ultrasonic vibrations, which are
communicated along an acoustic waveguide to the blade element. The
precision of cutting and coagulation may be controlled by the
surgeon's technique and adjusting the power level, blade edge,
tissue traction and blade pressure.
[0002] Examples of ultrasonic surgical instruments include the
HARMONIC ACE.RTM. Ultrasonic Shears, the HARMONIC WAVE.RTM.
Ultrasonic Shears, the HARMONIC FOCUS.RTM. Ultrasonic Shears, and
the HARMONIC SYNERGY.RTM. Ultrasonic Blades, all by Ethicon
Endo-Surgery, Inc. of Cincinnati, Ohio. Further examples of such
devices and related concepts are disclosed in U.S. Pat. No.
5,322,055, entitled "Clamp Coagulator/Cutting System for Ultrasonic
Surgical Instruments," issued Jun. 21, 1994, the disclosure of
which is incorporated by reference herein; U.S. Pat. No. 5,873,873,
entitled "Ultrasonic Clamp Coagulator Apparatus Having Improved
Clamp Mechanism," issued Feb. 23, 1999, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 5,980,510, entitled
"Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Arm
Pivot Mount," filed Oct. 10, 1997, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 6,325,811, entitled
"Blades with Functional Balance Asymmetries for use with Ultrasonic
Surgical Instruments," issued Dec. 4, 2001, the disclosure of which
is incorporated by reference herein; U.S. Pat. No. 6,773,444,
entitled "Blades with Functional Balance Asymmetries for Use with
Ultrasonic Surgical Instruments," issued Aug. 10, 2004, the
disclosure of which is incorporated by reference herein; and U.S.
Pat. No. 6,783,524, entitled "Robotic Surgical Tool with Ultrasound
Cauterizing and Cutting Instrument," issued Aug. 31, 2004, the
disclosure of which is incorporated by reference herein.
[0003] Still further examples of ultrasonic surgical instruments
are disclosed in U.S. Pub. No. 2006/0079874, entitled "Tissue Pad
for Use with an Ultrasonic Surgical Instrument," published Apr. 13,
2006, the disclosure of which is incorporated by reference herein;
U.S. Pub. No. 2007/0191713, entitled "Ultrasonic Device for Cutting
and Coagulating," published Aug. 16, 2007, the disclosure of which
is incorporated by reference herein; U.S. Pub. No. 2007/0282333,
entitled "Ultrasonic Waveguide and Blade," published Dec. 6, 2007,
the disclosure of which is incorporated by reference herein; U.S.
Pub. No. 2008/0200940, entitled "Ultrasonic Device for Cutting and
Coagulating," published Aug. 21, 2008, the disclosure of which is
incorporated by reference herein; U.S. Pub. No. 2009/0105750,
entitled "Ergonomic Surgical Instruments," published Apr. 23, 2009,
the disclosure of which is incorporated by reference herein; U.S.
Pub. No. 2010/0069940, entitled "Ultrasonic Device for Fingertip
Control," published Mar. 18, 2010, the disclosure of which is
incorporated by reference herein; and U.S. Pub. No. 2011/0015660,
entitled "Rotating Transducer Mount for Ultrasonic Surgical
Instruments," published Jan. 20, 2011, the disclosure of which is
incorporated by reference herein; and U.S. Pub. No. 2012/0029546,
entitled "Ultrasonic Surgical Instrument Blades," published Feb. 2,
2012, the disclosure of which is incorporated by reference
herein.
[0004] Some ultrasonic surgical instruments may include a cordless
transducer such as that disclosed in U.S. Pub. No. 2012/0112687,
entitled "Recharge System for Medical Devices," published May 10,
2012, the disclosure of which is incorporated by reference herein;
U.S. Pub. No. 2012/0116265, entitled "Surgical Instrument with
Charging Devices," published May 10, 2012, the disclosure of which
is incorporated by reference herein; and/or U.S. Pat. App. No.
61/410,603, filed Nov. 5, 2010, entitled "Energy-Based Surgical
Instruments," the disclosure of which is incorporated by reference
herein.
[0005] Additionally, some ultrasonic surgical instruments may
include an articulating shaft section and/or a bendable ultrasonic
waveguide. Examples of such ultrasonic surgical instruments are
disclosed in U.S. Pat. No. 5,897,523, entitled "Articulating
Ultrasonic Surgical Instrument," issued Apr. 27, 1999, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 5,989,264, entitled "Ultrasonic Polyp Snare," issued Nov. 23,
1999, the disclosure of which is incorporated by reference herein;
U.S. Pat. No. 6,063,098, entitled "Articulable Ultrasonic Surgical
Apparatus," issued May 16, 2000, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 6,090,120, entitled
"Articulating Ultrasonic Surgical Instrument," issued Jul. 18,
2000, the disclosure of which is incorporated by reference herein;
U.S. Pat. No. 6,454,782, entitled "Actuation Mechanism for Surgical
Instruments," issued Sep. 24, 2002, the disclosure of which is
incorporated by reference herein; U.S. Pat. No. 6,589,200, entitled
"Articulating Ultrasonic Surgical Shears," issued Jul. 8, 2003, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 6,752,815, entitled "Method and Waveguides for Changing the
Direction of Longitudinal Vibrations," issued Jun. 22, 2004, the
disclosure of which is incorporated by reference herein; U.S. Pat.
No. 7,135,030, entitled "Articulating Ultrasonic Surgical Shears,"
issued Nov. 14, 2006; U.S. Pat. No. 7,621,930, entitled "Ultrasound
Medical Instrument Having a Medical Ultrasonic Blade," issued Nov.
24, 2009, the disclosure of which is incorporated by reference
herein; U.S. Pub. No. 2014/0005701, published Jan. 2, 2014,
entitled "Surgical Instruments with Articulating Shafts," the
disclosure of which is incorporated by reference herein; U.S. Pub.
No. 2014/005703, entitled "Surgical Instruments with Articulating
Shafts," published Jan. 2, 2014, the disclosure of which is
incorporated by reference herein; U.S. Pub. No. 2014/0114334,
entitled "Flexible Harmonic Waveguides/Blades for Surgical
Instruments," published Apr. 24, 2014, the disclosure of which is
incorporated by reference herein; U.S. Pub. No. 2015/0080924,
entitled "Articulation Features for Ultrasonic Surgical
Instrument," published Mar. 19, 2015, the disclosure of which is
incorporated by reference herein; and U.S. patent application Ser.
No. 14/258,179, entitled Ultrasonic Surgical Device with
Articulating End Effector," filed Apr. 22, 2014, the disclosure of
which is incorporated by reference herein.
[0006] While several surgical instruments and systems have been
made and used, it is believed that no one prior to the inventors
has made or used the invention described in the appended
claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] While the specification concludes with claims which
particularly point out and distinctly claim this technology, it is
believed this technology will be better understood from the
following description of certain examples taken in conjunction with
the accompanying drawings, in which like reference numerals
identify the same elements and in which:
[0008] FIG. 1 depicts a side elevational view of an exemplary
ultrasonic surgical instrument;
[0009] FIG. 2 depicts a perspective view of an articulation section
of a shaft assembly and an end effector of the surgical instrument
of FIG. 1;
[0010] FIG. 3 depicts an exploded perspective view of an
articulation section of the shaft assembly of FIG. 2;
[0011] FIG. 4 depicts a cross-sectional side view of the shaft
assembly and end effector of FIG. 2;
[0012] FIG. 5 depicts a top plan view of the shaft assembly and end
effector of FIG. 2;
[0013] FIG. 6A depicts a cross-sectional top view of the shaft
assembly and end effector of FIG. 2 in a straight
configuration;
[0014] FIG. 6B depicts a cross-sectional top view of the shaft
assembly and end effector of FIG. 2 in an articulated
configuration;
[0015] FIG. 7 depicts a partially exploded perspective view of the
shaft assembly and end effector of FIG. 2;
[0016] FIG. 8 depicts a perspective view of a distal collar and a
drive cable of the shaft assembly of FIG. 2;
[0017] FIG. 9 depicts a partially exploded perspective view of an
articulation control assembly of the instrument of FIG. 1;
[0018] FIG. 10A depicts a side elevational view of the end effector
and the distal portion of the shaft assembly of FIG. 2, with a
clamp arm of the end effector in a closed position, and with an
outer sheath shown in cross section to reveal components within the
outer sheath;
[0019] FIG. 10B depicts a side elevational view of the shaft
assembly and end effector of FIG. 10A, with the clamp arm moved to
a partially open position;
[0020] FIG. 10C depicts a side elevational view of the shaft
assembly and end effector of FIG. 10A, with the clamp arm moved to
a fully open position;
[0021] FIG. 11 depicts a perspective view of an exemplary
alternative waveguide, including a curved blade;
[0022] FIG. 12 depicts a perspective view of a distal end of the
waveguide of FIG. 11;
[0023] FIG. 13 depicts a top view of the distal end of the
waveguide of FIG. 11, showing a bend angle of a blade of the
waveguide;
[0024] FIG. 14 depicts a perspective view of an exemplary
alternative articulation section of a shaft assembly and an end
effector incorporating the waveguide of FIG. 11, which is suitable
for incorporation into the surgical instrument of FIG. 1;
[0025] FIG. 15 depicts a perspective view of the articulation
section of the shaft assembly and the end effector of FIG. 14, with
certain parts omitted to show details;
[0026] FIG. 16 depicts an exploded perspective view of the
articulation section of the shaft assembly and the end effector of
FIG. 14;
[0027] FIG. 17 depicts a perspective view of a distal flex member
of the articulation section of FIG. 14;
[0028] FIG. 18 depicts a cross-sectional view of the distal flex
member of FIG. 17, taken along line 18-18 of FIG. 17;
[0029] FIG. 19 depicts a perspective view of a proximal flex member
of the articulation section of FIG. 14;
[0030] FIG. 20 depicts a front elevational view of the proximal
flex member of FIG. 19;
[0031] FIG. 21 depicts a perspective view of a plurality of flex
base members of the articulation section of FIG. 14, in an unflexed
configuration;
[0032] FIG. 22 depicts a front elevational view of the plurality of
flex base members of FIG. 21;
[0033] FIG. 23A depicts a top elevational view of the plurality of
flex base members of FIG. 21, in an unflexed configuration;
[0034] FIG. 23B depicts a top elevational view of the flex base
members of FIG. 21, in a flexed configuration;
[0035] FIG. 24 depicts a perspective view of a distal tube member
of the articulation section of FIG. 14;
[0036] FIG. 25 depicts a top elevational view of the distal tube
member of FIG. 24;
[0037] FIG. 26 depicts a perspective view of a proximal tube member
of the articulation section of FIG. 14;
[0038] FIG. 27 depicts a top elevational view of the proximal tube
member of FIG. 26;
[0039] FIG. 28 depicts a perspective view of a plurality of flex
rings of the articulation section of FIG. 14 in an unflexed
configuration;
[0040] FIG. 29A depicts a top elevational view of the plurality of
flex rings of FIG. 28, in an unflexed configuration;
[0041] FIG. 29B depicts a top elevational view of the set of flex
rings of FIG. 28, in a flexed configuration;
[0042] FIG. 30 depicts a perspective view of a collar of the
articulation section of FIG. 14;
[0043] FIG. 31 depicts a front elevational view of the collar of
FIG. 30;
[0044] FIG. 32A depicts a top elevational view of the articulation
section of the shaft assembly and the end effector of FIG. 14,
showing the articulation section in an unarticulated
configuration;
[0045] FIG. 32B depicts a top elevational view of the articulation
section of the shaft assembly and the end effector of FIG. 14,
showing the articulation section in an articulated
configuration;
[0046] FIG. 33A depicts a top cross-sectional view of the
articulation section of the shaft assembly and the end effector of
FIG. 14, showing the articulation section in an unarticulated
configuration; and
[0047] FIG. 33B depicts a top cross-sectional view of the
articulation section of the shaft assembly and the end effector of
FIG. 14, showing the articulation section in an articulated
configuration.
[0048] The drawings are not intended to be limiting in any way, and
it is contemplated that various embodiments of the technology may
be carried out in a variety of other ways, including those not
necessarily depicted in the drawings. The accompanying drawings
incorporated in and forming a part of the specification illustrate
several aspects of the present technology, and together with the
description serve to explain the principles of the technology; it
being understood, however, that this technology is not limited to
the precise arrangements shown.
DETAILED DESCRIPTION
[0049] The following description of certain examples of the
technology should not be used to limit its scope. Other examples,
features, aspects, embodiments, and advantages of the technology
will become apparent to those skilled in the art from the following
description, which is by way of illustration, one of the best modes
contemplated for carrying out the technology. As will be realized,
the technology described herein is capable of other different and
obvious aspects, all without departing from the technology.
Accordingly, the drawings and descriptions should be regarded as
illustrative in nature and not restrictive.
[0050] It is further understood that any one or more of the
teachings, expressions, embodiments, examples, etc. described
herein may be combined with any one or more of the other teachings,
expressions, embodiments, examples, etc. that are described herein.
The following-described teachings, expressions, embodiments,
examples, etc. should therefore not be viewed in isolation relative
to each other. Various suitable ways in which the teachings herein
may be combined will be readily apparent to those of ordinary skill
in the art in view of the teachings herein. Such modifications and
variations are intended to be included within the scope of the
claims.
[0051] For clarity of disclosure, the terms "proximal" and "distal"
are defined herein relative to a human or robotic operator of the
surgical instrument. The term "proximal" refers the position of an
element closer to the human or robotic operator of the surgical
instrument and further away from the surgical end effector of the
surgical instrument. The term "distal" refers to the position of an
element closer to the surgical end effector of the surgical
instrument and further away from the human or robotic operator of
the surgical instrument.
[0052] I. Exemplary Ultrasonic Surgical Instrument
[0053] FIG. 1 shows an exemplary ultrasonic surgical instrument
(10). At least part of instrument (10) may be constructed and
operable in accordance with at least some of the teachings of any
of the various patents, patent application publications, and patent
applications that are cited herein. As described therein and as
will be described in greater detail below, instrument (10) is
operable to cut tissue and seal or weld tissue (e.g., a blood
vessel, etc.) substantially simultaneously. It should also be
understood that instrument (10) may have various structural and
functional similarities with the HARMONIC ACE.RTM. Ultrasonic
Shears, the HARMONIC WAVE.RTM. Ultrasonic Shears, the HARMONIC
FOCUS.RTM. Ultrasonic Shears, and/or the HARMONIC SYNERGY.RTM.
Ultrasonic Blades. Furthermore, instrument (10) may have various
structural and functional similarities with the devices taught in
any of the other references that are cited and incorporated by
reference herein.
[0054] To the extent that there is some degree of overlap between
the teachings of the references cited herein, the HARMONIC ACE.RTM.
Ultrasonic Shears, the HARMONIC WAVE.RTM. Ultrasonic Shears, the
HARMONIC FOCUS.RTM. Ultrasonic Shears, and/or the HARMONIC
SYNERGY.RTM. Ultrasonic Blades, and the following teachings
relating to instrument (10), there is no intent for any of the
description herein to be presumed as admitted prior art. Several
teachings herein will in fact go beyond the scope of the teachings
of the references cited herein and the HARMONIC ACE.RTM. Ultrasonic
Shears, the HARMONIC WAVE.RTM. Ultrasonic Shears, the HARMONIC
FOCUS.RTM. Ultrasonic Shears, and the HARMONIC SYNERGY.RTM.
Ultrasonic Blades.
[0055] Instrument (10) of the present example comprises a handle
assembly (20), a shaft assembly (30), and an end effector (40).
Handle assembly (20) comprises a body (22) including a pistol grip
(24) and a pair of buttons (26). Handle assembly (20) also includes
a trigger (28) that is pivotable toward and away from pistol grip
(24). It should be understood, however, that various other suitable
configurations may be used, including but not limited to a scissor
grip configuration. End effector (40) includes an ultrasonic blade
(160) and a pivoting clamp arm (44). Clamp arm (44) is coupled with
trigger (28) such that clamp arm (44) is pivotable toward
ultrasonic blade (160) in response to pivoting of trigger (28)
toward pistol grip (24); and such that clamp arm (44) is pivotable
away from ultrasonic blade (160) in response to pivoting of trigger
(28) away from pistol grip (24). Various suitable ways in which
clamp arm (44) may be coupled with trigger (28) will be apparent to
those of ordinary skill in the art in view of the teachings herein.
In some versions, one or more resilient members are used to bias
clamp arm (44) and/or trigger (28) to the open position shown in
FIG. 1.
[0056] An ultrasonic transducer assembly (12) extends proximally
from body (22) of handle assembly (20). Transducer assembly (12) is
coupled with a generator (16) via a cable (14), such that
transducer assembly (12) receives electrical power from generator
(16). Piezoelectric elements in transducer assembly (12) convert
that electrical power into ultrasonic vibrations. Generator (16)
may include a power source and control module that is configured to
provide a power profile to transducer assembly (12) that is
particularly suited for the generation of ultrasonic vibrations
through transducer assembly (12). By way of example only, generator
(16) may comprise a GEN 300 sold by Ethicon Endo-Surgery, Inc. of
Cincinnati, Ohio. In addition or in the alternative, generator (16)
may be constructed in accordance with at least some of the
teachings of U.S. Pub. No. 2011/0087212, entitled "Surgical
Generator for Ultrasonic and Electrosurgical Devices," published
Apr. 14, 2011, the disclosure of which is incorporated by reference
herein. It should also be understood that at least some of the
functionality of generator (16) may be integrated into handle
assembly (20), and that handle assembly (20) may even include a
battery or other on-board power source such that cable (14) is
omitted. Still other suitable forms that generator (16) may take,
as well as various features and operabilities that generator (16)
may provide, will be apparent to those of ordinary skill in the art
in view of the teachings herein.
[0057] A. Exemplary End Effector and Acoustic Drivetrain
[0058] As best seen in FIGS. 2-4, end effector (40) of the present
example comprises clamp arm (44) and ultrasonic blade (160). Clamp
arm (44) includes a clamp pad (46) that is secured to the underside
of clamp arm (44), facing blade (160). Clamp pad (46) may comprise
polytetrafluoroethylene (PTFE) and/or any other suitable
material(s). Clamp arm (44) is pivotally secured to a distally
projecting tongue (43) of an upper distal shaft element (172),
which is fixedly secured within a distal portion of a distal outer
sheath (33). Clamp arm (44) is operable to selectively pivot toward
and away from blade (160) to selectively clamp tissue between clamp
arm (44) and blade (160). A pair of arms (156) extend transversely
from clamp arm (44) and are pivotally secured to a lower distal
shaft element (170), which is slidably disposed within the distal
portion of distal outer sheath (33).
[0059] As best seen in FIGS. 7-8, a cable (174) is secured to lower
distal shaft element (170). Cable (174) is operable to translate
longitudinally relative to an articulation section (130) of shaft
assembly (30) to selectively pivot clamp arm (44) toward and away
from blade (160). In particular, cable (174) is coupled with
trigger (28) such that cable (174) translates proximally in
response to pivoting of trigger (28) toward pistol grip (24), and
such that clamp arm (44) thereby pivots toward blade (160) in
response to pivoting of trigger (28) toward pistol grip (24). In
addition, cable (174) translates distally in response to pivoting
of trigger (28) away from pistol grip (24), such that clamp arm
(44) pivots away from blade (160) in response to pivoting of
trigger (28) away from pistol grip (24). Clamp arm (44) may be
biased toward the open position, such that (at least in some
instances) the operator may effectively open clamp arm (44) by
releasing a grip on trigger (28).
[0060] As shown in FIGS. 7-8, cable (174) is secured to a proximal
end of lower distal shaft element (170). Lower distal shaft element
(170) comprises a pair of distal flanges (171, 173) extending from
a semi-circular base (168). Flanges (171, 173) each comprise a
respective opening (175, 177). Clamp arm (44) is rotatably coupled
to lower distal shaft element (170) via a pair of inwardly
extending integral pins (41, 45). Pins (41, 45) extend inwardly
from arms (156) of clamp arm (44) and are rotatably disposed within
respective openings (175, 177) of lower distal shaft element (170).
As shown in FIGS. 10A-10C, longitudinal translation of cable (174)
causes longitudinal translation of lower distal shaft element (170)
between a proximal position (FIG. 10A) and a distal position (FIG.
10C). Longitudinal translation of lower distal shaft element (170)
causes rotation of clamp arm (44) between a closed position (FIG.
10A) and an open position (FIG. 10C).
[0061] Blade (160) of the present example is operable to vibrate at
ultrasonic frequencies in order to effectively cut through and seal
tissue, particularly when the tissue is being compressed between
clamp pad (46) and blade (160). Blade (160) is positioned at the
distal end of an acoustic drivetrain. This acoustic drivetrain
includes transducer assembly (12) and an acoustic waveguide (180).
Acoustic waveguide (180) comprises a flexible portion (166).
Transducer assembly (12) includes a set of piezoelectric discs (not
shown) located proximal to a horn (not shown) of waveguide (180).
The piezoelectric discs are operable to convert electrical power
into ultrasonic vibrations, which are then transmitted along
waveguide (180), including flexible portion (166) of waveguide
(180) to blade (160) in accordance with known configurations and
techniques. By way of example only, this portion of the acoustic
drivetrain may be configured in accordance with various teachings
of various references that are cited herein.
[0062] As best seen in FIG. 3, flexible portion (166) of waveguide
(180) includes a distal flange (136), a proximal flange (138), and
a narrowed section (164) located between flanges (136, 138). In the
present example, flanges (136, 138) are located at positions
corresponding to nodes associated with resonant ultrasonic
vibrations communicated through flexible portion (166) of waveguide
(180). Narrowed section (164) is configured to allow flexible
portion (166) of waveguide (180) to flex without significantly
affecting the ability of flexible portion (166) of waveguide (180)
to transmit ultrasonic vibrations. By way of example only, narrowed
section (164) may be configured in accordance with one or more
teachings of U.S. Pub. No. 2014/0005701 and/or U.S. Pub. No.
2014/0114334, the disclosures of which are incorporated by
reference herein. It should be understood that waveguide (180) may
be configured to amplify mechanical vibrations transmitted through
waveguide (180). Furthermore, waveguide (180) may include features
operable to control the gain of the longitudinal vibrations along
waveguide (180) and/or features to tune waveguide (180) to the
resonant frequency of the system. Various suitable ways in which
waveguide (180) may be mechanically and acoustically coupled with
transducer assembly (12) will be apparent to those of ordinary
skill in the art in view of the teachings herein.
[0063] In the present example, the distal end of blade (160) is
located at a position corresponding to an anti-node associated with
resonant ultrasonic vibrations communicated through flexible
portion (166) of waveguide (180), in order to tune the acoustic
assembly to a preferred resonant frequency f.sub.o when the
acoustic assembly is not loaded by tissue. When transducer assembly
(12) is energized, the distal end of blade (160) is configured to
move longitudinally in the range of, for example, approximately 10
to 500 microns peak-to-peak, and in some instances in the range of
about 20 to about 200 microns at a predetermined vibratory
frequency f.sub.o of, for example, 55.5 kHz. When transducer
assembly (12) of the present example is activated, these mechanical
oscillations are transmitted through waveguide (180) to reach blade
(160), thereby providing oscillation of blade (160) at the resonant
ultrasonic frequency. Thus, when tissue is secured between blade
(160) and clamp pad (46), the ultrasonic oscillation of blade (160)
may simultaneously sever the tissue and denature the proteins in
adjacent tissue cells, thereby providing a coagulative effect with
relatively little thermal spread. In some versions, an electrical
current may also be provided through blade (160) and clamp arm (44)
to also cauterize the tissue. While some configurations for an
acoustic transmission assembly and transducer assembly (12) have
been described, still other suitable configurations for an acoustic
transmission assembly and transducer assembly (12) will be apparent
to one or ordinary skill in the art in view of the teachings
herein. Similarly, other suitable configurations for end effector
(40) will be apparent to those of ordinary skill in the art in view
of the teachings herein.
[0064] B. Exemplary Shaft Assembly and Articulation Section
[0065] Shaft assembly (30) of the present example extends distally
from handle assembly (20). As shown in FIGS. 2-7, shaft assembly
(30) includes distal outer sheath (33) and a proximal outer sheath
(32) that enclose clamp arm (44) drive features and the
above-described acoustic transmission features. Shaft assembly (30)
further includes an articulation section (130), which is located at
a distal portion of shaft assembly (30), with end effector (40)
being located distal to articulation section (130). As shown in
FIG. 1, a knob (31) is secured to a proximal portion of proximal
outer sheath (32). Knob (31) is rotatable relative to body (22),
such that shaft assembly (30) is rotatable about the longitudinal
axis defined by outer sheath (32), relative to handle assembly
(20). Such rotation may provide rotation of end effector (40),
articulation section (130), and shaft assembly (30) unitarily. Of
course, rotatable features may simply be omitted if desired.
[0066] Articulation section (130) is operable to selectively
position end effector (40) at various lateral deflection angles
relative to a longitudinal axis defined by outer sheath (32).
Articulation section (130) may take a variety of forms. By way of
example only, articulation section (130) may be configured in
accordance with one or more teachings of U.S. Pub. No.
2012/0078247, the disclosure of which is incorporated by reference
herein. As another merely illustrative example, articulation
section (130) may be configured in accordance with one or more
teachings of U.S. Pub. No. 2014/0005701 and/or U.S. Pub. No.
2014/0114334, the disclosures of which are incorporated by
reference herein. Various other suitable forms that articulation
section (130) may take will be apparent to those of ordinary skill
in the art in view of the teachings herein.
[0067] As best seen in FIGS. 2-6B articulation section (130) of
this example comprises a set of three retention collars (133) and a
pair of ribbed body portions (132, 134), with a pair of
articulation bands (140, 142) extending along respective channels
(135, 137) defined between interior surfaces of retention collars
(133) and exterior surfaces of ribbed body portions (132, 134).
Ribbed body portions (132, 134) are longitudinally positioned
between flanges (136, 138) of flexible portion (166) of waveguide
(180). In some versions, ribbed body portions (132, 134) snap
together about flexible portion (166) of waveguide (180). Ribbed
body portions (132, 134) are configured to flex with flexible
portion (166) of waveguide (180) when articulation section (130)
bends to achieve an articulated state.
[0068] FIG. 3 shows ribbed body portions (132, 134) in greater
detail. In the present example, ribbed body portions (132, 134) are
formed of a flexible plastic material, though it should be
understood that any other suitable material may be used. Ribbed
body portion (132) comprises a set of three ribs (150) that are
configured to promote lateral flexing of ribbed body portion (132).
Of course, any other suitable number of ribs (150) may be provided.
Ribbed body portion (132) also defines a channel (135) that is
configured to receive articulation band (140) while allowing
articulation band (140) to slide relative to ribbed body portion
(132). Similarly, ribbed body portion (134) comprises a set of
three ribs (152) that are configured to promote lateral flexing of
ribbed body portion (134). Of course, any other suitable number of
ribs (152) may be provided. Ribbed body portion (134) also defines
a channel (137) that is configured to receive articulation band
(142) while allowing articulation band (142) to slide relative to
ribbed body portion (137).
[0069] As best seen in FIG. 5, ribbed body portions (132, 134) are
laterally interposed between articulation bands (140, 142) and
flexible portion (166) of waveguide (180). Ribbed body portions
(132, 134) mate with each other such that they together define an
internal passage sized to accommodate flexible portion (166) of
waveguide (180) without contacting waveguide (180). In addition,
when ribbed body portions (132, 134) are coupled together, a pair
of complementary distal notches (131A, 131B) formed in ribbed body
portions (132, 134) align to receive a pair of inwardly projecting
resilient tabs (38) of distal outer sheath (33). This engagement
between tabs (38) and notches (131A, 131B) longitudinally secures
ribbed body portions (132, 134) relative to distal outer sheath
(33). Similarly, when ribbed body portions (132, 134) are coupled
together, a pair of complementary proximal notches (139A, 139B)
formed in ribbed body portions (132, 134) align to receive a pair
of inwardly projecting resilient tabs (37) of proximal outer sheath
(32). This engagement between tabs (37) and notches (139A, 139B)
longitudinally secures ribbed body portions (132, 134) relative to
proximal outer sheath (32). Of course, any other suitable kinds of
features may be used to couple ribbed body portions (132, 134) with
proximal outer sheath (32) and/or distal outer sheath (33).
[0070] The distal ends of articulation bands (140, 142) are
unitarily secured to upper distal shaft element (172). When
articulation bands (140, 142) translate longitudinally in an
opposing fashion, this will cause articulation section (130) to
bend, thereby laterally deflecting end effector (40) away from the
longitudinal axis of shaft assembly (30) from a straight
configuration as shown in FIG. 6A to an articulated configuration
as shown in FIG. 6B. In particular, end effector (40) will be
articulated toward the articulation band (140, 142) that is being
pulled proximally. During such articulation, the other articulation
band (140, 142) may be pulled distally by upper distal shaft
element (172). Alternatively, the other articulation band (140,
142) may be driven distally by an articulation control. Ribbed body
portions (132, 134) and narrowed section (164) are all sufficiently
flexible to accommodate the above-described articulation of end
effector (40). Furthermore, flexible acoustic waveguide (166) is
configured to effectively communicate ultrasonic vibrations from
waveguide (180) to blade (160) even when articulation section (130)
is in an articulated state as shown in FIG. 6B.
[0071] As best seen in FIG. 3, each flange (136, 138) of waveguide
(180) includes a respective pair of opposing flats (192, 196).
Flats (192, 196) are oriented along vertical planes that are
parallel to a vertical plane extending through narrowed section
(164) of flexible portion (166). Flats (192, 196) are configured to
provide clearance for articulation bands (140, 142). In particular,
flats (196) of proximal flange (138) accommodate articulation bands
(140, 142) between proximal flange (138) and the inner diameter of
proximal outer sheath (32): while flats (192) of distal flange
(136) accommodate articulation bands (140, 142) between distal
flange (136) and the inner diameter of distal outer sheath (33). Of
course, flats (192, 196) could be substituted with a variety of
features, including but not limited to slots, channels, etc., with
any suitable kind of profile (e.g., square, flat, round, etc.). In
the present example, flats (192, 196) are formed in a milling
process, though it should be understood that any other suitable
process(es) may be used. Various suitable alternative
configurations and methods of forming flats (192, 196) will be
apparent to those of ordinary skill in the art in view of the
teachings herein. It should also be understood that waveguide (180)
may include flats formed in accordance with at least some of the
teachings of U.S. patent application Ser. No. 13/868,336, entitled
"Ultrasonic Device for Cutting and Coagulating," filed Apr. 23,
2013, the disclosure of which is incorporated by reference
herein.
[0072] In the present example, outer rings (133) are located at
longitudinal positions corresponding to ribs (150, 152), such that
three rings (133) are provided for three ribs (150, 152).
Articulation band (140) is laterally interposed within channel
(135) between rings (133) and ribbed body portion (132); while
articulation band (142) is laterally interposed within channel
(137) between rings (133) and ribbed body portion (134). Rings
(133) are configured to keep articulation bands (140, 142) in a
parallel relationship, particularly when articulation section (130)
is in a bent configuration (e.g., similar to the configuration
shown in FIG. 6B). In other words, when articulation band (140) is
on the inner diameter of a curved configuration presented by a bent
articulation section (130), rings (133) may retain articulation
band (140) such that articulation band (140) follows a curved path
that complements the curved path followed by articulation band
(142). It should be understood that channels (135, 137) are sized
to accommodate respective articulation bands (140, 142) in such a
way that articulation bands (140, 142) may still freely slide
through articulation section (130), even with rings (133) being
secured to ribbed body portions (150, 152). It should also be
understood that rings (133) may be secured to ribbed body portions
(132, 134) in various ways, including but not limited to
interference fitting, adhesives, welding, etc.
[0073] When articulation bands (140, 142) are translated
longitudinally in an opposing fashion, a moment is created and
applied to a distal end of distal outer sheath (33) via upper
distal shaft element (172). This causes articulation section (130)
and narrowed section (164) of flexible portion (166) of waveguide
(180) to articulate, without transferring axial forces in
articulation bands (140, 142) to waveguide (180). It should be
understood that one articulation band (140, 142) may be actively
driven distally while the other articulation band (140, 142) is
passively permitted to retract proximally. As another merely
illustrative example, one articulation band (140, 142) may be
actively driven proximally while the other articulation band (140,
142) is passively permitted to advance distally. As yet another
merely illustrative example, one articulation band (140, 142) may
be actively driven distally while the other articulation band (140,
142) is actively driven proximally. Various suitable ways in which
articulation bands (140, 142) may be driven will be apparent to
those of ordinary skill in the art in view of the teachings
herein.
[0074] As best seen in FIG. 9, an articulation control assembly
(100) is secured to a proximal portion of outer sheath (32).
Articulation control assembly (100) comprises a housing (110) and a
rotatable knob (120). Housing (110) comprises a pair of
perpendicularly intersecting cylindrical portions (112, 114). Knob
(120) is rotatably disposed within a first hollow cylindrical
portion (112) of housing (110) such that knob (120) is operable to
rotate within cylindrical portion (112) of housing (110). Shaft
assembly (30) is slidably and rotatably disposed within a second
cylindrical portion (114). Shaft assembly (30) comprises a pair of
translatable members (161, 162), both of which extend slidably and
longitudinally through the proximal portion of outer sheath (32).
Translatable members (161, 162) are longitudinally translatable
within second cylindrical portion (114) between a distal position
and a proximal position. Translatable members (161, 162) are
mechanically coupled with respective articulation bands (140, 142)
such that longitudinal translation of translatable member (161)
causes longitudinal translation of articulation band (140), and
such that longitudinal translation of translatable member (162)
causes longitudinal translation of articulation band (142).
[0075] Knob (120) comprises a pair of pins (122, 124) extending
downwardly from a bottom surface of knob (120). Pins (122, 124)
extend into second cylindrical portion (114) of housing (110) and
are rotatably and slidably disposed within a respective pair of
channels (163, 164) formed in top surfaces of translatable members
(161, 162). Channels (163, 164) are positioned on opposite sides of
an axis of rotation of knob (120), such that rotation of knob (120)
about that axis causes opposing longitudinal translation of
translatable members (161, 162). For instance, rotation of knob
(120) in a first direction causes distal longitudinal translation
of translatable member (161) and articulation band (140), and
proximal longitudinal translation of translatable member (162) and
articulation band (142); and rotation of knob (120) in a second
direction causes proximal longitudinal translation of translatable
member (161) and articulation band (140), and distal longitudinal
translation of translatable member (162) and articulation band
(142). Thus, it should be understood that rotation of rotation knob
(120) causes articulation of articulation section (130).
[0076] Housing (110) of articulation control assembly (100)
comprises a pair of set screws (111, 113) extending inwardly from
an interior surface of first cylindrical portion (112). With knob
(120) rotatably disposed within first cylindrical portion (112) of
housing (110), set screws (111, 113) are slidably disposed within a
pair of arcuate channels (121, 123) formed in knob (120). Thus, it
should be understood that rotation of knob (120) will be limited by
movement of set screws (111, 113) within channels (121, 123). Set
screws (111, 113) also retain knob (120) in housing (110),
preventing knob (120) from traveling vertically within first
cylindrical portion (112) of housing (110).
[0077] An interior surface of first cylindrical portion (112) of
housing (110) comprises a first angular array of teeth (116) and a
second angular array of teeth (118) formed in an interior surface
of first cylindrical portion (112). Rotation knob (120) comprises a
pair of outwardly extending engagement members (126, 128) that are
configured to engage teeth (116, 118) of first cylindrical portion
(112) in a detent relationship to thereby selectively lock knob
(120) in a particular rotational position. The engagement of
engagement members (126, 128) with teeth (116, 118) may be overcome
by a user applying sufficient rotational force to knob (120); but
absent such force, the engagement will suffice to maintain the
straight or articulated configuration of articulation section
(130). It should therefore be understood that the ability to
selectively lock knob (120) in a particular rotational position
lock will enable an operator to selectively lock articulation
section (130) in a particular deflected position relative to the
longitudinal axis defined by outer sheath (32).
[0078] In some versions of instrument (10), articulation section
(130) of shaft assembly (30) is operable to achieve articulation
angles up to between approximately 15.degree. and approximately
30.degree., both relative to the longitudinal axis of shaft
assembly (30) when shaft assembly (30) is in a straight
(non-articulated) configuration. Alternatively, articulation
section (130) may be operable to achieve any other suitable
articulation angles.
[0079] In some versions of instrument (10), narrowed section (164)
of waveguide (180) has a thickness between approximately 0.01
inches and approximately 0.02 inches. Alternatively, narrowed
section (164) may have any other suitable thickness. Also in some
versions, narrowed section (164) has a length of between
approximately 0.4 inches and approximately 0.65 inches.
Alternatively, narrowed section (164) may have any other suitable
length. It should also be understood that the transition regions of
waveguide (180) leading into and out of narrowed section (164) may
be quarter rounded, tapered, or have any other suitable
configuration.
[0080] In some versions of instrument (10), flanges (136, 138) each
have a length between approximately 0.1 inches and approximately
0.2 inches. Alternatively, flanges (136, 138) may have any other
suitable length. It should also be understood that the length of
flange (136) may differ from the length of flange (138). Also in
some versions, flanges (136, 138) each have a diameter between
approximately 0.175 inches and approximately 0.2 inches.
Alternatively, flanges (136, 138) may have any other suitable outer
diameter. It should also be understood that the outer diameter of
flange (136) may differ from the outer diameter of flange
(138).
[0081] While the foregoing exemplary dimensions are provided in the
context of instrument (10) as described above, it should be
understood that the same dimensions may be used in any of the other
examples described herein. It should also be understood that the
foregoing exemplary dimensions are merely optional. Any other
suitable dimensions may be used.
[0082] C. Exemplary Alternative Acoustic Waveguide with Curved
Blade
[0083] FIGS. 11-13 show an exemplary alternative waveguide (280)
that may be readily incorporated into instrument (10),
particularly, into an acoustic drivetrain of instrument (10).
Waveguide (280) of the present example includes a blade (260),
which is operable to vibrate at ultrasonic frequencies in order to
effectively cut through and seal tissue, particularly when the
tissue is being compressed between blade (260) and another portion
of an end effector, such as a curved version of clamp pad (46) of
end effector (40). As best shown in FIG. 13, blade (260) is curved
at a bend angle ".theta." relative to a longitudinal axis of
waveguide (280).
[0084] In one example, the acoustic drivetrain includes transducer
assembly (12) and acoustic waveguide (280). Acoustic waveguide
(280) comprises a flexible portion (266). Transducer assembly (12)
includes a set of piezoelectric discs (not shown) located proximal
to a horn (not shown) of waveguide (280). The piezoelectric discs
are operable to convert electrical power into ultrasonic
vibrations, which are then transmitted along waveguide (280),
including flexible portion (266) of waveguide (280), to blade (260)
in accordance with known configurations and techniques. By way of
example only, this portion of the acoustic drivetrain may be
configured in accordance with various teachings of various
references that are cited herein.
[0085] Flexible portion (266) of waveguide (280) includes a distal
flange (236), a proximal flange (238), and a narrowed section (264)
located between flanges (236, 238). Waveguide (280) includes
longitudinally extending notches that are formed in the waveguide
flanges to accommodate cable (274), which is discussed in more
detail below. Cable is received in the lower notches (not shown);
and the upper notches (237, 239) are formed to provide balance
(i.e., to compensate for the presence of the lower notches).
Waveguide (280) includes a tapered region (239) between distal
flange (236) and blade (260). In the present example, flanges (236,
238) are located at positions corresponding to nodes associated
with resonant ultrasonic vibrations communicated through waveguide
(280). Narrowed section (264) is configured to allow flexible
portion (266) of waveguide (280) to flex without significantly
affecting the ability of flexible portion (266) of waveguide (280)
to transmit ultrasonic vibrations. By way of example only, narrowed
section (264) may be configured in accordance with one or more
teachings of U.S. Pub. No. 2014/0005701 and/or U.S. Pub. No.
2014/0114334, the disclosures of which are incorporated by
reference herein.
[0086] It should be understood that waveguide (280) may be
configured to amplify mechanical vibrations transmitted through
waveguide (280). Furthermore, waveguide (280) may include features
operable to control the gain of the longitudinal vibrations along
waveguide (280) and/or features to tune waveguide (280) to the
resonant frequency of the system. For example, as shown in FIG. 11,
waveguide (280) includes a plurality of opposing pairs of
longitudinally spaced, laterally presented notches (282a, 282b). In
the present example, each notch (282a) of the three most proximal
pairs of notches (282a) has a longer length than each notch (282b)
of the two most distal pairs of notches (282b). Notches (282a,
282b) are provided, at least in part, to assist in controlling the
vibratory properties of the waveguide (280), which are different in
waveguide (280) than in waveguide (180) due in part to the curved
configuration of blade (260). Various suitable ways in which
waveguide (280) may be mechanically and acoustically coupled with
transducer assembly (12) will be apparent to those of ordinary
skill in the art in view of the teachings herein.
[0087] Each flange (236, 238) of waveguide (280) includes a
respective pair of opposing, laterally presented flats (292, 296).
Flats (292, 296) are oriented along vertical planes that are
parallel to a vertical plane extending through narrowed section
(264) of flexible portion (266). Flats (296) are configured to
provide clearance for articulation bands (212, 214). In particular,
flats (296) of proximal flange (238) accommodate articulation bands
(214) between proximal flange (138) and the inner diameter of
proximal outer sheath (204). Notably, articulation bands (212, 214)
are coupled to waveguide (280) at a point proximal to distal flange
(236). Of course, flats (292, 296) could be substituted with a
variety of features, including but not limited to slots, channels,
etc., with any suitable kind of profile (e.g., square, flat, round,
etc.). In the present example, flats (292, 296) are formed in a
milling process, though it should be understood that any other
suitable process(es) may be used. Various suitable alternative
configurations and methods of forming flats (292, 296) will be
apparent to those of ordinary skill in the art in view of the
teachings herein. It should also be understood that waveguide (280)
may include flats formed in accordance with at least some of the
teachings of U.S. Pub. No. 2013/0289592, entitled "Ultrasonic
Device for Cutting and Coagulating," published Oct. 31, 2013, the
disclosure of which is incorporated by reference herein.
[0088] In the present example, the distal end of blade (260) is
located at a position corresponding to an anti-node associated with
resonant ultrasonic vibrations communicated through flexible
portion (266) of waveguide (280), in order to tune the acoustic
assembly to a preferred resonant frequency f.sub.o when the
acoustic assembly is not loaded by tissue. When transducer assembly
(12) is energized, the distal end of blade (260) is configured to
move longitudinally in the range of, for example, approximately 10
to 500 microns peak-to-peak, and in some instances in the range of
about 20 to about 200 microns at a predetermined vibratory
frequency f.sub.o of, for example, 55.5 kHz. When transducer
assembly (12) of the present example is activated, these mechanical
oscillations are transmitted through waveguide (280) to reach blade
(260), thereby providing oscillation of blade (260) at the resonant
ultrasonic frequency. Thus, when tissue is secured between blade
(260) and a curved version of clamp pad (46), for example, the
ultrasonic oscillation of blade (260) may simultaneously sever the
tissue and denature the proteins in adjacent tissue cells, thereby
providing a coagulative effect with relatively little thermal
spread. In some versions, an electrical current may also be
provided through blade (260) and clamp arm (44) to also cauterize
the tissue. While some configurations for an acoustic transmission
assembly and transducer assembly (12) have been described, still
other suitable configurations for an acoustic transmission assembly
and transducer assembly (12) will be apparent to one or ordinary
skill in the art in view of the teachings herein. Similarly,
various suitable ways in which waveguide (280) may be configured
will be apparent to those of ordinary skill in the art in view of
the teachings herein.
[0089] D. Exemplary Alternative End Effector and Shaft Assembly
with One-Way Articulation
[0090] FIGS. 14-16 and 32A-33B show an exemplary alternative shaft
assembly (200) and end effector (240) that may be readily
incorporated into instrument (10). In the example shown, shaft
assembly (200) and end effector are configured to accommodate for
the properties of curved blade (260), as discussed in more detail
below. Shaft assembly (200) of this example comprises a distal
outer sheath (202), a proximal outer sheath (204), and a plurality
of flex rings (206) that form a portion of an articulation section
(210). While articulation section (130) is configured to articulate
in two lateral directions relative to the longitudinal axis of
shaft assembly (30), articulation section (210) of the present
example is configured to articulate in only one direction relative
to a longitudinal axis of shaft assembly (200). Particularly, in
the present example, articulation section (210) is allowed to
articulate in one lateral direction, but is substantially prevented
from articulating in the opposite lateral direction.
[0091] Articulation section (210) is operable to selectively
position end effector (240) at various lateral deflection angles,
in one direction, relative to a longitudinal axis defined by
proximal outer sheath (204). In the present example, the direction
in which articulation section (210) is permitted to articulate is
the same direction which curved blade (260) bends away from the
axis (at bend angle (.theta.)). End effector (240) includes blade
(260) and a pivoting clamp arm (244) having a clamp pad (245). In
the present example, clamp arm (244) and clamp pad (245) are curved
at a bend angle that is substantially similar to the bend angle
(.theta.) of blade (260). End effector (240) is configured to
operate substantially similar to end effector (40) discussed above
except for the differences discussed below. In particular, clamp
arm (244) of end effector (240) is operable to compress tissue
against blade (260). When blade (260) is activated while clamp arm
(244) compresses tissue against blade (260), end effector (240)
simultaneously severs the tissue and denatures the proteins in
adjacent tissue cells, thereby providing a coagulative effect.
[0092] Clamp arm (244) is operable to selectively pivot toward and
away from blade (242) to selectively clamp tissue between clamp pad
(245) and blade (260), in a manner substantially similar to clamp
arm (44). Clamp arm (244) is coupled to a trigger (e.g., trigger
(28)) such that clamp arm (244) is pivotable toward ultrasonic
blade (260) in response to pivoting of trigger (28) toward pistol
grip (24); and such that clamp arm (244) is pivotable away from
ultrasonic blade (260) in response to pivoting of trigger (28) away
from pistol grip (24). As best seen in FIGS. 15-16, a cable (274)
is secured to a lower distal shaft element (270). Cable (274) is
operable to translate longitudinally relative to an articulation
section (210) of shaft assembly (200) to selectively pivot clamp
arm (244) toward and away from blade (260). In particular, cable
(274) is coupled with trigger (28) such that cable (274) translates
proximally in response to pivoting of trigger (28) toward pistol
grip (24), and such that clamp arm (244) thereby pivots toward
blade (260) in response to pivoting of trigger (28) toward pistol
grip (24). In addition, cable (274) translates distally in response
to pivoting of trigger (28) away from pistol grip (24), such that
clamp arm (244) pivots away from blade (260) in response to
pivoting of trigger (28) away from pistol grip (24). Clamp arm
(244) may be biased toward the open position, such that (at least
in some instances) the operator may effectively open clamp arm
(244) by releasing a grip on trigger (28). Various suitable ways in
which clamp arm (244) may be coupled with trigger (28) will be
apparent to those of ordinary skill in the art in view of the
teachings herein.
[0093] In the example shown, cable (274) is secured to a proximal
end of a lower distal shaft element (270), which is configured in a
manner substantially similar to lower distal shaft element (170).
In that regard, lower distal shaft element (270) comprises a pair
of distal flanges (not shown) extending from a semi-circular base.
The flanges each comprise a respective opening (not shown). Clamp
arm (244) is rotatably coupled to lower distal shaft element (270)
via a pair of inwardly extending integral pins (not shown). The
pins extend inwardly from arms (256) of clamp arm (244) and are
rotatably disposed within respective openings of lower distal shaft
element (270). In a manner similar to that shown in FIGS. 10A-C,
longitudinal translation of cable (274) causes longitudinal
translation of lower distal shaft element (270) between a proximal
position and a distal position. Longitudinal translation of lower
distal shaft element (270) causes rotation of clamp arm (244)
between a closed position and an open position.
[0094] Shaft assembly (200) further comprises a pair of
articulation bands (212, 214). Distal ends of articulation bands
(212, 214) are secured to distal flex member (302) of articulation
section (210). Articulation bands (212, 214) are configured to
operate substantially similar to articulation bands (140, 142)
discussed above except for the differences discussed below. In
particular, as shown best in FIGS. 32A-33B, articulation bands
(212, 214) are permitted to cause articulation of articulation
section (210) in substantially only one direction, as discussed in
more detailed below. When articulation bands (212, 214) are
translated longitudinally in an opposing fashion, a moment is
created and applied to distal flex member (302) and also distal
outer sheath (202), and also to other components of the
articulation section (210) due to the operable coupling among the
distal flex member (302), distal outer sheath (202), and other
components of articulation section (210). This causes articulation
section (210) and narrowed section (249) of flexible portion (248)
of waveguide (280) to articulate, without transferring axial forces
in articulation bands (212, 214) to waveguide (246).
[0095] As shown in FIGS. 14-16, articulation section (210)
comprises a distal flex member (302), a proximal flex member (304),
and a plurality of flex base members (306a-c). Articulation section
(210) further comprises distal outer sheath (202), a proximal outer
sheath (204), and flex rings (206a-c). Articulation section (210)
also includes a flexible collar (300) that is configured to
operably couple certain components of the articulation section
(210) to one another, as discussed in more detail below. Distal
flex member (302) t is operably coupled to the distal ends of a
respective articulation band (212, 214). Flex base members (304a-c)
are positioned proximally relative to the distal flex member (302),
and proximal flex member (304) positioned proximal of flex base
members (306a-c). Distal flex member (302), proximal flex member
(304), and flex base members (306a-c) collectively define opposing
channels (308, 310) for receiving articulation bands (212, 214),
respectively.
[0096] FIGS. 17-18 show distal flex member (302) of the present
example in more detail. As shown, distal flex member (302) includes
a proximal end (314), a distal end (316), and a generally U-shaped
body (318) that defines a space (319) configured for receiving at
least a portion of waveguide (280). A bottom portion of distal flex
member (302) includes a longitudinally extending recess (320) that
is configured to receive cable (274). Each side of distal flex
member (302) includes a channel (322) that is shaped and configured
for receiving a distal end of a respective articulation band (212,
214). Each channel (322) includes an aperture (324) that is
configured to receive a portion of a fastener (325) (FIG. 15) for
coupling a respective articulation band (212, 214) to a side of the
distal flex member (302). By way of example only, fastener (325)
may comprise a pin, a rivet, and/or any other suitable kind of
structure.
[0097] Space (319) for receiving waveguide (280) includes a first
dimensioned portion (326) that receives a distal portion of
waveguide and a second dimensioned portion (328), which includes a
smaller dimension than first dimensioned portion (326). Second
dimensioned portion (328) is configured to receive narrowed section
(264) of waveguide (280). Notably, however, distal flex member
(302) does not contact waveguide (280). Second dimensioned portion
(326) is defined by a pair of opposing angled flanges (330) which
extend radially inwardly toward a central longitudinal axis of
distal flex member (302). Angled flanges (330) define a tapered
transition portion between the first dimensioned portion (326) and
second dimensioned portion (328). Second dimensioned portion (328)
is further defined by a pair of flanges (332), which also extend
radially inwardly toward the central longitudinal axis of distal
flex member (302), at the proximal end (314) of distal flex member
(302). Flanges (330, 332) define a pair of opposing slots (334)
that extend along a plane that is parallel to the longitudinal axis
of distal flex member. Each slot (334) includes an aperture (336).
Various suitable ways in which distal flex member (302) may be
configured will be apparent to those of ordinary skill in the art
in view of the teachings herein.
[0098] FIGS. 19-20 show proximal flex member (304) of the present
example in more detail. As shown, proximal flex member (304)
includes a proximal end (338), a distal end (340) and a generally
U-shaped body (342) that defines a space (343) configured for
receiving at least a portion of waveguide (280). A bottom portion
of proximal flex member (302) includes a longitudinal recess (344)
that is configured to receive cable (274). Each side of proximal
flex member (304) includes a channel (346) that is shaped and
configured for receiving portion of a respective articulation band
(212, 214) (and which forms a portion of channels (308, 310)). Each
channel (346) is defined in part by an upper, shelf (348) and a
lower shelf (350).
[0099] The space (343) of proximal flex member (304) for receiving
waveguide (280) includes a first dimensioned portion (352) that
receives a portion of waveguide (280) and a second dimensioned
portion (354), which includes a smaller dimension than first
dimensioned portion (326). Second dimensioned portion (354) is
configured to receive narrowed section (264) of waveguide (280),
though proximal flex member (304) does not contact waveguide (280).
Second dimensioned portion (354) is defined by a pair of opposing
angled flanges (356) which extend radially inwardly toward a
central longitudinal axis of proximal flex member (304). Angled
flanges (356) define a tapered transition portion between the first
dimensioned portion (352) and second dimensioned portion (354).
Second dimensioned portion (354) is further defined by a pair of
flanges (358), which also extend radially inwardly toward the
central longitudinal axis of proximal flex member (304), at the
distal end (340) of proximal flex member (304). Flanges (356, 358)
define a pair of opposing slots (360). Each slot (360) includes a
generally rectangular aperture (362). Various suitable ways in
which proximal flex member (304) may be configured will be apparent
to those of ordinary skill in the art in view of the teachings
herein.
[0100] Flex base members (306a-c), as shown in more detail in FIGS.
21-23B, define a single, unitary body (364) comprising three
members (306a-c), with living hinges (366) between adjoining
members (306a-c). However, in other examples, flex base members
(306a-c) may be separate, individual members. In the example shown,
body (364) is generally U-shaped and defines a space (368)
configured for receiving at least a portion of waveguide (280).
However, body (364) does not contact waveguide (280). A bottom
portion of each flex base member (306a-c) includes a longitudinal
recess (370) configured to receive cable (274). Each side of each
base member (306a-c) includes a radially outwardly extending shelf
(372), each of which defines a boundary on each side of the base
members (306a-c) for receiving a portion of a respective
articulation band (212, 214). Each base member (306a-c) includes a
respective pair of opposing distal flanges (374) and a respective
pair of opposing proximal flanges (376) extending radially inwardly
toward a central longitudinal axis of body (364). The distal and
proximal flanges (374, 376) in each pair of flanges (374, 376)
define a slot (378) therebetween. Each slot (378) includes a
generally rectangular aperture (380).
[0101] Each base member (306a-c) includes a respective first distal
face portion (382a), a second distal face portion (382b), a first
proximal face portion (384a), and a second proximal face portion
(384b). As shown best in FIG. 23B, base members (306a-c) are
configured to transition to a flexed position from an unflexed
position (FIG. 23A) when, for example, articulation bands (212,
214) are moved longitudinally relative to one another. In the
unflexed position, there is a gap between adjacent first proximal
and distal faces (384a, 382a); and between second proximal and
distal faces (384b, 382b). First distal faces (382a) and second
distal faces (382b) are disposed at an oblique angle
(.theta..sub.23A-1) relative to an imaginary plane that is
perpendicular to the longitudinal axis of base members (306a-c).
First proximal edges (384a) and first proximal edges (384b) are
disposed at an oblique angle (.theta..sub.23A-2) relative to an
imaginary plane that is perpendicular to the longitudinal axis of
base members (306a-c). In the present example, angle
(.theta..sub.23A-1) and angle (.theta..sub.23A-2) are substantially
equal. Thus, the angle between adjacent first proximal and distal
edges (384a, 382a) in an unflexed position; and between adjacent
second proximal and distal edges (384b, 382b) in an unflexed
position, is .theta..sub.23A-1+.theta..sub.23A-2.
[0102] As shown in FIG. 23B, base members (306a-c) are in a flexed
position after pivoting in one direction relative to a central
longitudinal axis about living hinges (366), such that first
proximal faces (384a) substantially abut respective first distal
faces (382a) of an adjoining base member (306a-c). It will be
understood that in some versions, base members (306a-c) may pivot
in an opposite direction, for example, such that second proximal
faces (382b) substantially abut respective second distal faces
(382b) of an adjoining base member (306a-c). However, in the
present example, as will be understood from the discussion below,
other components of articulation section (210) may effectively
allow base members (306a-c) to pivot in only one direction. Various
suitable ways in which flex base members (306a-c) may be configured
will be apparent to those of ordinary skill in the art in view of
the teachings herein.
[0103] Still referring to FIGS. 14-16, articulation section (210)
of the present example also includes a distal outer sheath (202), a
proximal outer sheath (204), and flex rings (206a-c) that at least
partially surround other components of articulation section (210).
Referring also to FIGS. 24-25 and 33A-34B, distal outer sheath
(202) of the present example more particularly comprises a proximal
end (386), a distal end (388), and a lumen (390) extending
therebetween. At least a first portion (392) of a proximal edge of
distal outer sheath (202) extends along an imaginary plane (393)
that is perpendicular to the longitudinal axis of distal outer
sheath (202), while a second portion (394) of proximal edge extends
at angle (.theta..sub.25) relative to plane (393). Distal outer
sheath (202) of the present example further comprises a
longitudinal channel (396) extending from the proximal edge (392)
in a direction parallel to a longitudinal axis of distal outer
sheath (202). Longitudinal channel (396) terminates at a transverse
channel (398). Transverse channel (398) of the present example
extends parallel to the plane (393) but perpendicular to
longitudinal channel (396).
[0104] Distal outer sheath (202) is coupled to waveguide (280) via
an elastomeric ring (403), which is positioned about distal flange
(236) of waveguide (280). Thus, as discussed in more detail below,
when distal outer sheath (202) is laterally deflected by the
articulation of articulation section (210), distal outer sheath
(202) transfers that lateral deflection to waveguide (280), thereby
articulating end effector (240).
[0105] Distal outer sheath (202) of the present example further
comprises a pair of apertures (400), which are generally
rectangular in shape, and spaced laterally from one another and
from longitudinal cutout (396). Distal outer sheath (202) further
includes a plurality of circumferentially spaced obround apertures
(402). As shown, in the present example, there are six obround
apertures (402), but in other examples, there may be more or less
than six obround apertures (402). Longitudinally between obround
apertures (402) and proximal end (386), distal tube member includes
a pair of angularly spaced, generally rectangular apertures (404).
Various suitable ways in which distal outer sheath (202) may be
configured will be apparent to those of ordinary skill in the art
in view of the teachings herein.
[0106] Proximal outer sheath (204) of the present example,
referring to FIGS. 14-16 and 26-27, is suitable for incorporation
into instrument (10) in a manner substantially similar to outer
sheath (32). Proximal outer sheath (204) is substantially similar
to outer sheath (32), except for the differences discussed herein.
Particularly, proximal outer sheath (204) includes a proximal end
(not shown), a distal end (406), and a lumen (408) extending
therebetween. As best seen in FIG. 27, a first portion (410) of
distal edge extends along an imaginary plane (411) that is
perpendicular to the longitudinal axis of proximal outer sheath
(204), while a second portion (412) of distal edge (410) extends at
an oblique angle (.theta..sub.27) relative to plane (412). Proximal
outer sheath (204) further comprises a longitudinal channel (414)
extending from distal edge (410) in a direction parallel to a
longitudinal axis of proximal outer sheath (204). Longitudinal
channel (414) terminates at a transverse channel (416). Transverse
channel (416) of the present example extends parallel to plane
(412) but perpendicular relative to longitudinal channel (414).
Proximal outer sheath (204) of the present example further
comprises a pair of apertures (419), which are generally
rectangular in shape, and spaced laterally from one another and
from longitudinal cutout (414). Various suitable ways in which
proximal outer sheath (204) may be configured will be apparent to
those of ordinary skill in the art in view of the teachings
herein.
[0107] As shown in FIGS. 14-16, distal, middle, and proximal flex
rings (206a-c) are positioned between distal outer sheath (202) and
proximal outer sheath (204) such that flex rings (206a-c), distal
outer sheath (202), and proximal outer sheath (204) define at least
a portion of a radially outward boundary of shaft assembly (200).
Flex rings (206a-c) define a single, unitary body (364) comprising
three members (306a-c), with living hinges (366) between adjoining
flex rings (206a-c). However, in other examples, flex rings
(206a-c) may be separate, individual members. Referring also to
FIGS. 28-29B, three flex rings (206a-c) are shown, but it will be
understood that there may be more or less than three flex rings
(206a-c). In the present example, each flex ring (206a-c) includes
a first portion (418) that is partially circular in cross-section
and a pair of flanges (420). The flanges (420) of each pair of
flanges (420) extend radially inwardly from each end of the first
portion (418) toward one another, and along a plane extending
parallel to a longitudinal axis of each flex ring (206). Each
flange (420) includes a generally rectangular aperture (421)
extending therethrough.
[0108] Each flex ring (206a-c) includes a first distal edge portion
(422a), second distal edge portion (422b), first proximal edge
portion (424a), and second proximal edge portion (424b). In the
present example, first distal edge portion (422a) extends at an
oblique angle relative to second distal edge portion (422b). Second
distal edge portion (422b) of each flex ring (206a-c) extends along
a first plane (426) that is perpendicular to the longitudinal axis
of each flex ring (206a-c). Thus, the first distal edge portion
(422a) extends at an oblique angle (.theta..sub.29A-1) relative to
a first plane (426) that is perpendicular to the longitudinal axis
of each flex ring (206). Similarly, first proximal edge portion
(424a) extends at an oblique angle relative to second proximal edge
portion (424b). Second proximal edge portion (424b) extends along a
second plane (428) that is perpendicular to the longitudinal axis
of each flex ring (206a-c). Thus, the first proximal edge portion
(424a) of each flex ring (206a-c) extends at an oblique angle
(.theta..sub.29A-2) relative to its second proximal edge portion
(424b).
[0109] When assembled as shown in FIGS. 14-15, the distal most flex
ring (206a) is substantially abutted distally by distal outer
sheath (202) (force represented by arrow (430) in FIG. 29A), while
the proximal most flex ring (206c) is substantially abutted
proximally by proximal outer sheath (204) (force represented by
arrow (432) in FIG. 29A). Flex rings (206a-c) are configured to
transition to a flexed position (FIG. 29B) from an unflexed
position (FIG. 29A) when, for example, articulation bands (212,
214) are moved longitudinally relative to one another, as discussed
in more detail below. However, second distal edge portions (424a)
and second proximal edge portions (424b) interact with one another
and with distal outer sheath (202) and proximal outer sheath (204)
to act as positive stops to restrict pivoting of flex rings
(206a-c) to a single direction. As shown, longitudinal axis (425)
intersects the points of each flex ring (206a-c) where the
respective first and second distal portions (422a, 422b) meet, and
where the respective first and second proximal portions (424a,
424b) meet. Because adjacent second distal and proximal portions
(422b, 424b) act as a positive stop against one another (and also
with adjacent distal and proximal tube members (202a, 202b)), flex
rings are substantially prevented from pivoting along a path that
is above axis (425) ("above" direction represented by arrow (435)).
Therefore, in the present example, due to the operative coupling of
flex rings (206a-c) to other components of articulation mechanism
(210), articulation mechanism (210) is permitted to articulate in
only one direction (opposite to arrow (435)) and may only pivot
about axes (427, 429)).
[0110] Flex rings (206a-c) are rigid in the present example such
that any attempted articulation in the opposite direction does not
substantially occur due to the material properties of flex rings
(206a-c). That is, where articulation bands (212, 214) are moved in
a manner that causes a moment in the opposite direction, the
material properties (rigidity, stiffness, etc.) of flex rings
(206a-c) are configured to prevent bending, buckling, compression,
etc., of the flex rings (206a-c) that may cause a certain amount of
articulation in the direction of arrow (435). Various suitable ways
in which flex rings (206a-c) may be configured will be apparent to
those of ordinary skill in the art in view of the teachings
herein.
[0111] FIGS. 14-16 and 30-33B show collar (300) of the present
example. As noted above, collar (300) is configured to operably
couple certain components of the articulation section (210) to one
another. Collar (300) of the present example is further configured
to couple distal outer sheath (202) with proximal outer sheath
(204). As best shown in FIGS. 30-31, collar (434) includes a
proximal end (436), and a distal end (438), and a body (440)
extending therebetween. In the present example, collar (300)
includes a spine portion (442) extending along a longitudinal axis
and five pairs of opposing legs (444a-e) extending from the spine
portion (442). Collar (300) also includes an elongate rib (443)
extending along the axis of the collar (300). Each of the five
pairs of legs (444a-e) are spaced apart equally along a
longitudinal axis of the collar (300). As shown, there are five
pairs of opposing legs, but there may be more or less than five
pairs of legs, and the pairs of opposing legs may or may not be
equally spaced longitudinally. In the present example, each pair of
legs includes a first leg that extends away from the spine (442) in
a first direction and a second leg extending away from the spine in
second direction. Each of the first and second legs of each pair
include curvilinear portions and are configured such that the first
and second legs of each pair eventually extend parallel to one
another. Each of the legs (444a-e) includes a respective snap-fit
feature (446a-e) defining respective angled portions (448a-e) and
lip portions (450a-e). In some examples, angled portions (448a-e)
are configured to act as cam members, in order to assist the collar
(300) to be coupled with other components of the articulation
section. More particularly, angled portions (448a-e) may act as cam
members when being directed into respective slots and apertures,
and legs (444a-e) may flex inwardly temporarily as collar (300) is
being directed into engagement with certain components to provide a
snap fit engagement. Various suitable ways in which collar (300)
may be configured will be apparent to those of ordinary skill in
the art in view of the teachings herein
[0112] The operable coupling of components of the articulation
section (210) allows the articulation section (210) to articulate
when a moment is applied directly to one or more components of the
articulation section (210). Referring to FIGS. 14-16, 32A and 33A,
in the present example, in the unarticulated configuration,
proximal end (314) of distal flex member (302) substantially abuts
flex base member (306a), particularly at the point where first
distal portion (382a) meets second distal portion (382b). Distal
end (340) of proximal flex member (304) substantially abuts flex
base member (306c), particularly where first proximal portion
(384a) meets second proximal portion (384b). As discussed above,
flex base member (306b) is between flex base member (306a) and flex
base member (306c).
[0113] In the present example, lumen (390) of distal tube member
(302) coaxially receives distal flex member (302) such that slots
(334) of distal flex member (302) generally align with apertures
(400) of distal outer sheath (202). Legs (444a) extend into
apertures (400) and along slots (334) such that lip portion (450a)
engages a portion of aperture (336) and thereby secures collar
(300), distal flex member (302), and distal outer sheath (202) to
one another. Lumen (408) of proximal outer sheath (204) receives
proximal flex member (304) such that slots (360) of proximal flex
member (304) generally align with apertures (419) of proximal tube
member. Legs (444e) extend into apertures (419) and along slots
(360) such that lip portion (450e) engages a portion of aperture
(362) and thereby secures collar (300), proximal flex member (304),
and proximal outer sheath (204) to one another.
[0114] Flex base members (306a-c) of the present example are
coaxially received in flex rings (206a-c) such that flex base
member (306a) is coincident with flex ring (206a), flex base member
(306b) is coincident with flex ring (206b), and flex base member
(306c) is coincident with flex ring (206c). Therefore, in such a
configuration, apertures (421) of each flex ring (206a-c) generally
align with slots (378) of a respective flex base member (306a-c).
Legs (444b) extend into apertures (421) of flex ring (206a) and
along slots (378) of flex base member (306a) such that lip portions
(450b) engage a portion of a respective aperture (380). Similarly,
legs (444c) extend into apertures (421) of flex ring (206b) and
along slots (378) of flex base member (306b) such that lip portions
(450c) engage a portion of a respective aperture (380). Similarly,
legs (444d) extend into apertures of flex ring (206b) and along
slots (378) of flex base member (306c) such that lip portions
(450d) engage a portion of a respective aperture (380).
[0115] Still referring to FIGS. 14-16, 32A, and 33A, in the present
example, in the unarticulated configuration, first portion (392) of
proximal edge of distal outer sheath (202) substantially abuts
second distal portion (422b) of flex ring (206a). Second proximal
portion (424b) of flex ring (206a) substantially abuts second
distal portion (422b) of flex ring (206b). Similarly, second
proximal portion (424b) of flex ring (206b) substantially abuts
second distal portion (422b) of flex ring (206c). Second proximal
portion (424b) of flex ring (206b) substantially abuts first
portion (210) of distal edge of proximal outer sheath (204).
Various suitable ways in which articulation section (210) may be
configured will be apparent to those of ordinary skill in the art
in view of the teachings herein.
[0116] In the present example, as articulation bands (212, 214) are
moved longitudinally relative to one another, a moment is initially
applied to distal flex member (302). Due to the distal flex member
(302), flex base members (306a-c), proximal flex member (304),
distal outer sheath (202), flex rings (206a-c), and proximal outer
sheath (304) being operably coupled via collar (300) in the manner
described herein, the moment applied to distal flex member (302) is
transferred to the collar (300), distal flex member (302), flex
base members (306a-c), proximal flex member (304), distal outer
sheath (202), flex rings (206a-c), and proximal outer sheath (204).
Thus, articulation section transitions (210) to an articulated
configuration, as best shown in FIGS. 32B, 33B. In the articulated
configuration, articulation section (210) articulates in the same
direction away from the longitudinal axis of instrument (10) as the
direction of the bend angle (.theta.) of blade (260).
[0117] As shown in FIGS. 32B and 33B, as a result of the moment
applied onto the components of articulation section (210), distal
outer sheath (202) is pivoted relative to flex ring (206a) such
that second portion (394) of distal edge of distal outer sheath
(202) substantially abuts first distal portion (422a) of flex ring
(206a). Flex ring (206a) is shown to be pivoted relative to flex
ring (206b) such that first proximal portion (424a) of flex ring
(206b) substantially abuts first distal portion (422a) of flex ring
(206b). Flex ring (206b) is shown pivoted relative to flex ring
(206c) such that first proximal portion (424a) of flex ring (206b)
substantially abuts first distal portion (422a) of flex ring
(206c). Flex ring (206c) is shown to be pivoted such that first
proximal portion (424a) of flex ring (206c) substantially abuts
second portion (412) of distal edge of proximal outer sheath (204).
Thus, in the present example, the maximum articulation angle (as
measured between a central axis of distal outer sheath (202)
relative to a central axis of proximal outer sheath (204)) due to
the abutment of such structures is .theta..sub..DELTA., where
.theta..sub..DELTA.=3*(.theta..sub.29A-1+.theta..sub.29A-2)-.theta..sub.2-
7-.theta..sub.25.
[0118] Once the articulation bands (212, 214) move relative to one
another in a manner opposite to that which caused the articulation,
articulation section (210) may return to the unarticulated
configuration shown in FIGS. 32A and 33A. However, even if the
operator somehow attempts to continue opposingly move articulation
bands (212, 214) once articulation section (210) reaches the
unarticulated configuration shown in FIGS. 32A and 33A, engagement
between adjacent edge portions (422b, 424b) will prevent
articulation section (210) from articulating past longitudinal axis
(425) in the direction of arrow (435).
[0119] II. Exemplary Combinations
[0120] The following examples relate to various non-exhaustive ways
in which the teachings herein may be combined or applied. It should
be understood that the following examples are not intended to
restrict the coverage of any claims that may be presented at any
time in this application or in subsequent filings of this
application. No disclaimer is intended. The following examples are
being provided for nothing more than merely illustrative purposes.
It is contemplated that the various teachings herein may be
arranged and applied in numerous other ways. It is also
contemplated that some variations may omit certain features
referred to in the below examples. Therefore, none of the aspects
or features referred to below should be deemed critical unless
otherwise explicitly indicated as such at a later date by the
inventors or by a successor in interest to the inventors. If any
claims are presented in this application or in subsequent filings
related to this application that include additional features beyond
those referred to below, those additional features shall not be
presumed to have been added for any reason relating to
patentability.
Example 1
[0121] An apparatus for operating on tissue, the apparatus
comprising: (a) a body assembly; (b) a shaft extending distally
from the body assembly, wherein the shaft defines a longitudinal
axis; (c) an acoustic waveguide, wherein the waveguide comprises a
flexible portion; (d) an articulation section coupled with the
shaft, wherein a portion of the articulation section encompasses
the flexible portion of the waveguide, wherein the articulation
section further comprises: (i) a first member, and (ii) a second
member, wherein the second member is longitudinally translatable
relative to the first member; (e) an end effector comprising an
ultrasonic blade in acoustic communication with the waveguide,
wherein a distal portion the ultrasonic blade is disposed in a
first direction away from the longitudinal axis at a bend angle;
and (f) an articulation drive assembly operable to drive
articulation of the articulation section to thereby deflect the end
effector from the longitudinal axis in the first direction.
Example 2
[0122] The apparatus of Example 1 or any of the following examples,
wherein the articulation section includes a positive stop, wherein
the positive stop is configured to substantially prevent deflection
of the end effector in a second direction, wherein the second
direction is opposite to the first direction.
Example 3
[0123] The apparatus of Example 2, wherein the articulation section
comprises a plurality of tubular members, wherein the positive stop
is disposed on at least one of the tubular members.
Example 4
[0124] The apparatus Example 3, wherein the positive stop comprises
an edge of at least one of the tubular members.
Example 5
[0125] The apparatus of Example 4, wherein the edge extends
perpendicular relative to the longitudinal axis of the shaft when
the articulation section is in an unarticulated configuration.
Example 6
[0126] The apparatus of any of the preceding or following Examples,
wherein the articulation section comprises a flexible collar having
a spine portion extending parallel to the longitudinal axis of the
shaft, wherein the collar is configured to operably couple the
shaft and the articulation section.
Example 7
[0127] The apparatus of Example 6, wherein the collar comprises a
plurality of legs extending transverse to the spine portion,
wherein at least one of the legs is configured to engage the shaft,
wherein at least one pair of legs is configured to engage the
articulation section.
Example 8
[0128] The apparatus of any of the preceding or following Examples,
wherein the blade extends in a first direction along a curved
path.
Example 9
[0129] The apparatus of any of the preceding or following Examples,
wherein the articulation section comprises a radially inner
portion, wherein the articulation section further comprises a
radially outer portion surrounding at least part of the radially
inner portion, wherein the radially outer portion is configured to
limit articulation of the articulation section to the first
direction.
Example 10
[0130] The apparatus of Example 9, wherein the radially outer
portion comprises a plurality of adjacent, at least partially
tubular members.
Example 11
[0131] The apparatus of Example 10, wherein at least one of the at
least partially tubular members comprises a distal edge, wherein
the distal edge includes a first portion that extends at an oblique
angle relative to a first plane extending perpendicular relative to
the longitudinal axis, wherein the distal edge includes a second
portion that extends along the first plane.
Example 12
[0132] The apparatus of Example 11, wherein at least one of the at
least partially tubular members comprises a proximal edge, wherein
the proximal edge includes a first portion that extends at an
oblique angle relative to a second plane extending perpendicular to
the longitudinal axis, wherein the proximal edge includes a second
portion that extends along the second plane.
Example 13
[0133] The apparatus of any of Example 12, wherein the second
portion of the proximal edge of one of the at least partially
tubular members substantially abuts the second portion of the
distal edge of an adjacent one of the at least partially tubular
members when the articulation section is in an unarticulated
configuration.
Example 14
[0134] The apparatus of Example 12, wherein the first portion of
the proximal edge of one of the at least partially tubular members
substantially abuts the first portion of the distal edge of an
adjacent one of the at least partially tubular members when the
articulation section is in an articulated configuration.
Example 15
[0135] The apparatus of Example 9, wherein the radially inner
portion defines opposing channels for the first member and the
second member, respectively, wherein the first member and the
second member are each disposed between the radially inner portion
and the radially outer portion.
Example 16
[0136] An apparatus for operating on tissue, the apparatus
comprising: (a) a body assembly; (b) a shaft extending distally
from the body assembly, wherein the shaft defines a longitudinal
axis; (c) an acoustic waveguide, wherein the waveguide comprises a
flexible portion; (d) an articulation section coupled with the
shaft; (e) an end effector coupled with the articulation section,
wherein the end effector comprises an ultrasonic blade in acoustic
communication with the waveguide; (f) an articulation drive
assembly operable to drive articulation of the articulation section
to thereby deflect the end effector from the longitudinal axis,
wherein the articulation drive assembly comprises: (i) a first
member, and (ii) a second member; wherein the first and second
members are operable to translate simultaneously in opposite
directions to thereby deflect the end effector from the
longitudinal axis, wherein the articulation section comprises a
stop member configured to substantially prevent the deflection of
the end effector from the longitudinal axis in a first direction
but allow the deflection of the end effector in a second direction
from the longitudinal axis, wherein the second direction is
opposite to the first direction.
Example 17
[0137] The apparatus of Example 16 or any of the following
examples, wherein the stop member is configured to engage at least
a portion of the shaft to prevent deflection of the end effector in
the second direction.
Example 18
[0138] The apparatus of Example 16 or any of the following
examples, wherein the stop member is disposed perpendicularly
relative to the longitudinal axis.
Example 19
[0139] The apparatus of Example 16 or any of the following
examples, wherein the end effector further comprises a clamp arm
operable to pivot toward and away from the blade.
Example 20
[0140] An apparatus for operating on tissue, the apparatus
comprising: (a) a body assembly; (b) a shaft extending distally
from the body assembly, wherein the shaft defines a longitudinal
axis; (c) an articulation section coupled with the shaft; (d) an
end effector coupled with the articulation section, wherein the end
effector comprises: (i) a working element configured to engage
tissue, wherein the working element includes an elongate shaft
extending through the shaft of the instrument, and (ii) a clamp arm
operable to pivot toward and away from the working element; and (e)
an articulation drive assembly operable to drive articulation of
the articulation section to thereby deflect the end effector from
the longitudinal axis, wherein the articulation drive assembly
comprises: (i) a first member, and (ii) a second member; wherein
the first and second members are operable to translate
simultaneously in opposite directions to thereby deflect the end
effector from the longitudinal axis, wherein the articulation
section comprises a plurality of pivotable members surrounding the
elongate shaft of the working element; wherein the pivotable
members are include a stop on one side to resist pivoting in a
first direction to thereby prevent articulation of the articulation
section; wherein the pivotable members are configured to pivot in a
second direction that is opposite to the first direction in
response to translation of the first and second members to thereby
cause articulation of the articulation section.
[0141] III. Miscellaneous
[0142] It should be understood that any of the versions of
instruments described herein may include various other features in
addition to or in lieu of those described above. By way of example
only, any of the instruments described herein may also include one
or more of the various features disclosed in any of the various
references that are incorporated by reference herein. It should
also be understood that the teachings herein may be readily applied
to any of the instruments described in any of the other references
cited herein, such that the teachings herein may be readily
combined with the teachings of any of the references cited herein
in numerous ways. Moreover, those of ordinary skill in the art will
recognize that various teachings herein may be readily applied to
electrosurgical instruments, stapling instruments, and other kinds
of surgical instruments. Other types of instruments into which the
teachings herein may be incorporated will be apparent to those of
ordinary skill in the art.
[0143] It should be appreciated that any patent, publication, or
other disclosure material, in whole or in part, that is said to be
incorporated by reference herein is incorporated herein only to the
extent that the incorporated material does not conflict with
existing definitions, statements, or other disclosure material set
forth in this disclosure. As such, and to the extent necessary, the
disclosure as explicitly set forth herein supersedes any
conflicting material incorporated herein by reference. Any
material, or portion thereof, that is said to be incorporated by
reference herein, but which conflicts with existing definitions,
statements, or other disclosure material set forth herein will only
be incorporated to the extent that no conflict arises between that
incorporated material and the existing disclosure material.
[0144] Versions of the devices described above may have application
in conventional medical treatments and procedures conducted by a
medical professional, as well as application in robotic-assisted
medical treatments and procedures. By way of example only, various
teachings herein may be readily incorporated into a robotic
surgical system such as the DAVINCI.TM. system by Intuitive
Surgical, Inc., of Sunnyvale, Calif. Similarly, those of ordinary
skill in the art will recognize that various teachings herein may
be readily combined with various teachings of U.S. Pat. No.
6,783,524, entitled "Robotic Surgical Tool with Ultrasound
Cauterizing and Cutting Instrument," published Aug. 31, 2004, the
disclosure of which is incorporated by reference herein.
[0145] Versions described above may be designed to be disposed of
after a single use, or they can be designed to be used multiple
times. Versions may, in either or both cases, be reconditioned for
reuse after at least one use. Reconditioning may include any
combination of the steps of disassembly of the device, followed by
cleaning or replacement of particular pieces, and subsequent
reassembly. In particular, some versions of the device may be
disassembled, and any number of the particular pieces or parts of
the device may be selectively replaced or removed in any
combination. Upon cleaning and/or replacement of particular parts,
some versions of the device may be reassembled for subsequent use
either at a reconditioning facility, or by a user immediately prior
to a procedure. Those skilled in the art will appreciate that
reconditioning of a device may utilize a variety of techniques for
disassembly, cleaning/replacement, and reassembly. Use of such
techniques, and the resulting reconditioned device, are all within
the scope of the present application.
[0146] By way of example only, versions described herein may be
sterilized before and/or after a procedure. In one sterilization
technique, the device is placed in a closed and sealed container,
such as a plastic or TYVEK bag. The container and device may then
be placed in a field of radiation that can penetrate the container,
such as gamma radiation, x-rays, or high-energy electrons. The
radiation may kill bacteria on the device and in the container. The
sterilized device may then be stored in the sterile container for
later use. A device may also be sterilized using any other
technique known in the art, including but not limited to beta or
gamma radiation, ethylene oxide, or steam.
[0147] Having shown and described various embodiments of the
present invention, further adaptations of the methods and systems
described herein may be accomplished by appropriate modifications
by one of ordinary skill in the art without departing from the
scope of the present invention. Several of such potential
modifications have been mentioned, and others will be apparent to
those skilled in the art. For instance, the examples, embodiments,
geometrics, materials, dimensions, ratios, steps, and the like
discussed above are illustrative and are not required. Accordingly,
the scope of the present invention should be considered in terms of
the following claims and is understood not to be limited to the
details of structure and operation shown and described in the
specification and drawings.
* * * * *