U.S. patent application number 16/696284 was filed with the patent office on 2020-04-09 for ultrasonic surgical instrument with cooling conduit.
The applicant listed for this patent is Ethicon LLC. Invention is credited to Kevin Bash, Chad P. Boudreaux, Cory G. Kimball, Jeffrey D. Messerly, David A. Witt.
Application Number | 20200107853 16/696284 |
Document ID | / |
Family ID | 58745511 |
Filed Date | 2020-04-09 |
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United States Patent
Application |
20200107853 |
Kind Code |
A1 |
Boudreaux; Chad P. ; et
al. |
April 9, 2020 |
ULTRASONIC SURGICAL INSTRUMENT WITH COOLING CONDUIT
Abstract
An apparatus includes a body assembly, an acoustic waveguide, an
ultrasonic blade, and a liquid dispensing feature. The ultrasonic
blade is positioned distally relative to the body assembly. The
ultrasonic blade is in acoustic communication with the acoustic
waveguide. The liquid dispensing feature is positioned distally
relative to the body assembly. The liquid dispensing feature is
positioned adjacent to the ultrasonic blade. The liquid dispensing
feature is configured to deliver a flow of cooling liquid to the
ultrasonic blade.
Inventors: |
Boudreaux; Chad P.;
(Cincinnati, OH) ; Messerly; Jeffrey D.;
(Cincinnati, OH) ; Bash; Kevin; (Kent, WA)
; Witt; David A.; (Maineville, OH) ; Kimball; Cory
G.; (Hamilton, OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Ethicon LLC |
Guaynabo |
PR |
US |
|
|
Family ID: |
58745511 |
Appl. No.: |
16/696284 |
Filed: |
November 26, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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15163811 |
May 25, 2016 |
|
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16696284 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/1651 20130101;
A61B 2017/320075 20170801; A61B 2017/320084 20130101; A61B
2017/320098 20170801; A61B 17/1644 20130101; A61B 2017/320072
20130101; A61B 2018/00029 20130101; A61B 2217/007 20130101; A61B
17/320068 20130101 |
International
Class: |
A61B 17/32 20060101
A61B017/32; A61B 17/16 20060101 A61B017/16 |
Claims
1-20. (canceled)
21. A surgical instrument, comprising: (a) an acoustic waveguide;
(b) an ultrasonic blade in acoustic communication with the acoustic
waveguide and longitudinally extending from a proximal blade
portion to a distal blade portion; and (c) a liquid dispensing
feature positioned adjacent to the ultrasonic blade and configured
to transition from a distal position to a proximal position,
wherein the liquid dispensing feature in the distal position
longitudinally receives the proximal blade portion and at least a
portion of the distal blade portion such that the liquid dispensing
feature at least substantially encompasses the ultrasonic blade
therein, wherein the liquid dispensing feature in the proximal
position exposes the distal blade portion and at least a portion of
the proximal blade portion such that the ultrasonic blade distally
projects relative to the liquid dispensing feature, and wherein the
liquid dispensing feature is configured to deliver a flow of
cooling liquid to the ultrasonic blade.
22. The surgical instrument of claim 21, wherein the ultrasonic
blade defines a longitudinal axis, and wherein the liquid
dispensing feature is configured to translate parallel to the
longitudinal axis as the liquid dispensing feature transitions from
the distal position toward the proximal position.
23. The surgical instrument of claim 21, wherein the ultrasonic
blade is configured to be received in a hollow interior defined by
the liquid dispensing feature when the liquid dispensing feature is
in the distal position.
24. The surgical instrument of claim 21, wherein the liquid
dispensing feature is resiliently biased toward the distal
position.
25. The surgical instrument of claim 21, wherein the ultrasonic
blade has a sharp edge extending from the proximal blade portion to
the distal blade portion.
26. The surgical instrument of claim 21, wherein the liquid
dispensing feature in the distal position longitudinally receives
the proximal blade portion and the distal blade portion such that
the liquid dispensing feature fully encompasses the ultrasonic
blade therein.
27. The surgical instrument of claim 21, wherein the ultrasonic
blade longitudinally extends along an axis, and wherein the liquid
dispensing feature surrounds the axis and at least a portion of the
ultrasonic blade.
28. The surgical instrument of claim 27, wherein the ultrasonic
blade is received in a hollow interior defined by the liquid
dispensing feature.
29. The surgical instrument of claim 28, wherein the liquid
dispensing feature is configured to deliver the flow of cooling
liquid to the hollow interior.
30. The surgical instrument of claim 29, wherein the liquid
dispensing feature further defines a distal opening in fluid
communication with the hollow interior, and wherein the liquid
dispensing feature is further configured to expel at least a
portion of the flow of cooling liquid through the distal
opening.
31. The surgical instrument of claim 30, wherein the ultrasonic
blade is configured to move relative to the liquid dispensing
feature within the distal opening.
32. The surgical instrument of claim 21, wherein the liquid
dispensing feature is configured to deliver the flow of cooling
liquid to the ultrasonic blade as the ultrasonic blade transitions
from the proximal position toward the distal position.
33. A surgical instrument comprising: (a) an acoustic waveguide;
(b) an ultrasonic blade longitudinally extending and in acoustic
communication with the acoustic waveguide, wherein the ultrasonic
blade includes a transverse opening and an edge, wherein the edge
has a substantially flat surface; and (c) a liquid dispensing
feature positioned adjacent to the ultrasonic blade, wherein the
liquid dispensing feature is configured to translate distally over
the ultrasonic blade, and wherein the liquid dispensing feature is
configured to deliver a flow of cooling liquid to the ultrasonic
blade.
34. The surgical instrument of claim 33, wherein the liquid
dispensing feature is configured to deliver the flow of cooling
liquid to a region of highest temperature of the ultrasonic
blade.
35. The apparatus of claim 33, wherein the liquid dispensing
feature is configured to deliver the flow of cooling liquid
distally along the transverse opening.
36. The apparatus of claim 33, further comprising a handle assembly
proximally positioned relative to the ultrasonic blade and
configured to be gripped by an operator.
37. The apparatus of claim 33, further comprising a body assembly
proximally positioned relative to the ultrasonic blade, and wherein
the body assembly includes a fluid port configured to enable fluid
flow from a fluid source to the liquid dispensing feature.
38. The apparatus of claim 37, wherein the body assembly further
comprises a fluid switch operable to selectively control fluid flow
to the liquid dispensing feature.
39. The apparatus of claim 33, further comprising a body assembly
proximally positioned relative to the ultrasonic blade, and wherein
the body assembly includes at activation feature operatively
connected to the ultrasonic transducer assembly such that the
ultrasonic transducer assembly is configured to be activated in
response to actuation of the activation feature.
40. A method of cooling an ultrasonic blade of a surgical
instrument, the surgical instrument including (a) an acoustic
waveguide; (b) an ultrasonic blade in acoustic communication with
the acoustic waveguide and longitudinally extending from a proximal
blade portion to a distal blade portion; and (c) a liquid
dispensing feature positioned adjacent to the ultrasonic blade and
configured to transition from a distal position to a proximal
position, wherein the liquid dispensing feature in the distal
position longitudinally receives the proximal blade portion and at
least a portion of the distal blade portion such that the liquid
dispensing feature at least substantially encompasses the
ultrasonic blade therein, wherein the liquid dispensing feature in
the proximal position exposes the distal blade portion and at least
a portion of the proximal blade portion such that the ultrasonic
blade distally projects relative to the liquid dispensing feature,
and wherein the liquid dispensing feature is configured to deliver
a flow of cooling liquid to the ultrasonic blade, the method
comprising: (a) delivering the flow the cooling liquid from the
liquid dispensing feature to the ultrasonic blade thereby cooling
the ultrasonic blade.
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. Patent Application
No. 61/410,603, filed Nov. 5, 2010, entitled "Energy-Based Surgical
Instruments," the disclosure of which is incorporated by reference
herein.
[0005] Ultrasonic surgical instruments such as those described in
the above-cited references may be primarily used to sever and/or
seal soft tissue. However, it may be desirable to use an ultrasonic
surgical instrument to cut bone, in addition to or as an
alternative to cutting/sealing soft tissue. Cutting bone with an
ultrasonic surgical instrument may generate more heat than
cutting/sealing soft tissue with an ultrasonic surgical instrument.
Unless properly addressed, this additional heat may cause
undesirable effects, such as damage (e.g., necrosis) to adjacent
bone and/or tissue; and/or damage to the ultrasonic blade.
[0006] Some conventional ultrasonic surgical instruments may be
configured to use fluid to cool an ultrasonic blade. Examples of
such instruments are described in U.S. Pub. No. 2015/0148832,
entitled "Features to Apply Fluid to an Ultrasonic Blade of a
Surgical Instrument," published May 28, 2015, the disclosure of
which is incorporated by reference herein. Other examples of
ultrasonic surgical instruments that are configured to communicate
fluid are described in U.S. Pub. No. 2013/0090576, entitled
"Surgical Instrument with Ultrasonic Waveguide Defining a Fluid
Lumen, published Apr. 11, 2013, the disclosure of which is
incorporated by reference herein; and U.S. Pat. No. 8,591,459,
entitled "Use of Biomarkers and Therapeutic Agents with Surgical
Devices," issued Nov. 26, 2013, the disclosure of which is
incorporated by reference herein.
[0007] 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
[0008] 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:
[0009] FIG. 1 depicts a perspective view of an exemplary ultrasonic
surgical instrument;
[0010] FIG. 2 depicts a top plan view of a working end of the
instrument of FIG. 1;
[0011] FIG. 3 depicts a side elevational view of the working end of
FIG. 2;
[0012] FIG. 4 depicts a cross-sectional side view of the working
end of FIG. 2, taken along line 4-4 of FIG. 2;
[0013] FIG. 5 depicts a perspective view of the working end of FIG.
2 cutting into bone and dispensing a cooling liquid to the cut
site;
[0014] FIG. 6 depicts a cross-sectional side view of the working
end of FIG. 2 disposed in bone and dispensing a cooling liquid to
the cut site;
[0015] FIG. 7 depicts a perspective view of another exemplary
ultrasonic surgical instrument;
[0016] FIG. 8 depicts a perspective view of the instrument of FIG.
7, with a housing portion omitted to reveal internal
components;
[0017] FIG. 9A depicts a perspective view of a working end of the
instrument of FIG. 7, with a cooling sheath in a distal
position;
[0018] FIG. 9B depicts a perspective view of the working end of
FIG. 9A, with the cooling sheath in a proximal position;
[0019] FIG. 10 depicts a cross-sectional side view of the working
end of FIG. 9A, with the cooling sheath in the distal position;
[0020] FIG. 11A depicts a side elevational view of the working end
of FIG. 9A, with the cooling sheath in the distal position, and
with the working end in an initial state of engagement with a bone
surface;
[0021] FIG. 11B depicts a side elevational view of the working end
of FIG. 9A, with the cooling sheath in the proximal position, and
with a blade of the working end disposed in bone;
[0022] FIG. 12 depicts a perspective view of another exemplary
ultrasonic surgical instrument;
[0023] FIG. 13A depicts a perspective view of a working end of the
instrument of FIG. 12, with a cooling sheath in a distal
position;
[0024] FIG. 13B depicts a perspective view of the working end of
FIG. 13A, with the cooling sheath in a proximal position; and
[0025] FIG. 14 depicts a cross-sectional perspective view of the
working end of FIG. 13A, with the cooling sheath in the distal
position.
[0026] 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
[0027] 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.
[0028] 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.
[0029] 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.
[0030] I. Exemplary Ultrasonic Surgical Instrument with Fixed
Position Liquid Cooling Feature
[0031] 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.
[0032] Instrument (10) of the present example comprises a handle
assembly (20), an ultrasonic transducer assembly (30), an
ultrasonic blade (40), and a liquid dispensing feature (50). Handle
assembly (20) is configured to be grasped using a pencil grip,
though some operators may choose to grasp handle assembly (20) in
some other fashion (e.g., using a power grip, etc.). Handle
assembly (20) includes a fluid port (22), a fluid switch (26), and
a plurality of activation buttons (28).
[0033] Fluid port (22) is configured to couple with a fluid conduit
(18), which is further in communication with a fluid source (16).
Fluid conduit (18) may comprise a flexible tube and/or any other
kind of conduit (18). By way of example only, fluid conduit (18)
may be coupled with fluid port (22) via a luer fitting and/or any
other suitable kind(s) of connection features. Fluid source (16)
may comprise a soft container (e.g., a bag), a hard container
(e.g., a box or canister), or have any other suitable
configuration. In some versions, fluid source (16) is not
pressurized, such that fluid flows from fluid source (16) to port
under the influence of gravity. In some other versions, fluid
source (16) is pressurized. For instance, fluid source (16) may
comprise a pump or other pressurizing assembly. As another merely
illustrative example, fluid source (16) may contain a
pre-pressurized fluid.
[0034] In any of the foregoing versions, fluid switch (26) is
operable to selectively control the flow of fluid from fluid source
(16) to liquid dispensing feature (50). For instance, fluid switch
(26) may be operable to actuate a valve to transition the valve
between an open state and a closed state. In some other versions,
fluid switch (26) is omitted and the flow of fluid from fluid
source (16) to liquid dispensing feature (50) is either constant or
is regulated automatically. Various components and configurations
that may be used to selectively restrict the flow of fluid from
fluid source (16) to liquid dispensing feature (50) will be
apparent to those of ordinary skill in the art in view of the
teachings herein. It should also be understood that any suitable
fluids may be communicated from fluid source (16) to liquid
dispensing feature (50) to cool a surgical site, including but not
limited to saline.
[0035] Ultrasonic transducer assembly (30) extends proximally from
handle assembly (20) and is coupled with a generator (12) via a
cable (14), such that transducer assembly (30) receives electrical
power from generator (12). Piezoelectric elements in transducer
assembly (30) convert that electrical power into ultrasonic
vibrations. Generator (12) may include a power source and control
module that is configured to provide a power profile to transducer
assembly (30) that is particularly suited for the generation of
ultrasonic vibrations through transducer assembly (30). By way of
example only, generator (12) may comprise a GEN04 or GEN11 sold by
Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. In addition or in
the alternative, generator (12) 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. In versions where generator (12)
is capable of driving various different kinds of ultrasonic
surgical instruments (e.g., with different resonant frequencies),
handle assembly (20) may include an EEPROM or some other feature
that identifies the type of ultrasonic surgical instrument (10) for
generator (12), such that generator (12) may automatically select
and deliver the appropriate power profile based on the identified
type of ultrasonic surgical instrument (10).
[0036] It should also be understood that at least some of the
functionality of generator (12) 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 (12) may take,
as well as various features and operabilities that generator (12)
may provide, will be apparent to those of ordinary skill in the art
in view of the teachings herein.
[0037] In the present example, transducer assembly (30) is
activated in response to the operator actuating at least one button
(28) of handle assembly (20). Buttons (28) are provided in an
angularly spaced array about the longitudinal axis defined by
handle assembly (20). The configuration and arrangement of buttons
(28) in the present example enables an operator to easily access
and actuate at least one button (28) regardless of the angular
orientation of handle assembly (20) in the operator's hand. In
other words, the operator will be able to easily actuate at least
one button (28) with the thumb or index finger of the operator's
hand that is grasping handle assembly (20) using a pencil grip. By
way of example only, buttons (28) may be configured and operable in
accordance with at least some of the teachings of U.S. patent
application Ser. No. 14/515,129, entitled "Activation Features for
Ultrasonic Surgical Instrument," filed Oct. 15, 2014, the
disclosure of which is incorporated by reference herein.
Alternatively, handle assembly (20) may have any other suitable
user input features that are operable to selectively activate
transducer assembly (30). As yet another merely illustrative
alternative, transducer assembly (30) may be selectively activated
using some other kind of user input (e.g., footswitch, etc.).
[0038] As best seen in FIGS. 2-4, ultrasonic blade (40) of the
present example includes a sharp edge (42) extending around the
outer perimeter of blade (40). Ultrasonic blade (40) also defines
an oblong transverse opening (44). Ultrasonic blade (40) thus has
an elongate "O" shape or hollow elliptical shape in this example,
similar to the head of a sewing needle (with opening (44) being
similar to the eye of a sewing needle). Ultrasonic blade (40) is
acoustically coupled with ultrasonic transducer assembly (30) via a
waveguide (32), which extends through handle assembly (20) to join
transducer assembly (30) with blade (40). Thus, ultrasonic
vibrations that are generated by transducer assembly (30) are
communicated along waveguide (32) to blade (40), such that blade
(40) will vibrate ultrasonically when transducer assembly (30) is
activated. Those of ordinary skill in the art will understand that,
as a matter of physics, the distal end of blade (40) is located at
a position corresponding to an anti-node associated with resonant
ultrasonic vibrations communicated through waveguide (32) (i.e., at
an acoustic anti-node).
[0039] When transducer assembly (30) is energized, the distal end
of blade (40) 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.0 of, for example,
approximately 21 kHz to approximately 31 kHz. In some other
versions, the vibratory frequency is up to approximately 50 kHz or
even up to approximately 55 kHz. At any such frequencies, when
blade (40) is pressed against bone as described in greater detail
below, the ultrasonic oscillation of blade (40) will work in
concert with sharp edge (42) to break up the bone to promote
cutting of the bone by blade (40).
[0040] Liquid dispensing feature (50) of the present example
comprises a first longitudinally extending portion (52), an
obliquely extending portion (54), and a second longitudinally
extending portion (56). Portions (52, 54, 56) together defined a
dogleg configuration. First longitudinally extending portion (52)
is in fluid communication with fluid port (22), as selectively
restricted by fluid switch (26). First longitudinally extending
portion (52) is parallel to and offset from waveguide (32).
[0041] As best seen in FIG. 4, obliquely extending portion (54) is
sized and configured to provide a transition whereby second
longitudinally extending portion (56) is located within opening
(44) defined by blade (40). Second longitudinally extending portion
(56) extends along the same longitudinal axis as waveguide (32) in
this example, though other configurations may be used if desired.
Second longitudinally extending portion (56) defines a plurality of
openings (58) that are in fluid communication with the interior of
liquid dispensing feature (50). Openings (58) are discretely
positioned in an array that extends along the length of second
longitudinally extending portion (56) and about the longitudinal
axis of second longitudinally extending portion (56). In the
present example, openings (58) are formed as circular holes; though
in other versions openings (58) may be in the form of elongate
slots and/or have any other suitable configuration.
[0042] By way of example only, liquid dispensing feature (50) may
be formed by a conventional hypotube that is bent to provide the
dogleg configuration defined by portions (52, 54, 56). In some such
versions, second longitudinally extending portion (56) is at least
partially flattened along the same plane along which blade (40)
extends. Other suitable ways in which liquid dispensing feature
(50) may be formed will be apparent to those of ordinary skill in
the art in view of the teachings herein. It should also be
understood that no portions of liquid dispensing feature (50)
contact blade (40) in this example. Moreover, liquid dispensing
feature (50) has sufficient rigidity in this example such that
liquid dispensing feature (50) will not contact blade (40) even if
liquid dispensing feature (50) is pressed against bone or other
structures during normal operation of instrument (10).
[0043] As noted above, when an ultrasonic blade is used to cut
through bone, the friction caused by the blade vibrating against
the bone may generate substantial heat, which may be undesirable.
Thus, liquid dispensing feature (50) may be used to dispense fluid
at a bone cut site in order to avoid having excess heat generated
by blade (40). In particular, as shown in FIGS. 5-6, cooling liquid
(90) may be dispensed via openings (58) in order to fill a cut site
(82) with cooling liquid (90) as blade (40) cuts through bone (80).
The dispensed cooling liquid (90) may directly contact blade (40)
and the bone (80) at the cut site (82), thereby cooling blade (40)
and the bone (80) at the cut site (82). It should be understood
that the configuration of liquid dispensing feature (50) will
dispense cooling liquid (90) at the distal end of blade (40) rather
than simply dispensing the fluid proximal to blade (40). This may
advantageously provide cooling at the region of blade (40) where
the temperature is the highest. In addition or in the alternative,
the distal location at which liquid dispensing feature (50)
dispenses cooling liquid (90) may minimize the reduction of
visibility of the surgical site that might otherwise be caused by
cooling liquid (90).
[0044] As can be seen in FIGS. 3-6, second longitudinally extending
portion (56) has a maximum thickness that is less than or equal to
the maximum thickness of blade (40). As seen in FIGS. 5-6, this
enables second longitudinally extending portion (56) to enter the
cut (82) with blade (40). In other words, second longitudinally
extending portion (56) and blade (40) can enter bone (80) together,
without second longitudinally extending portion (56) getting
snagged on bone (80) or otherwise interfering with entry of blade
(40) into bone (80).
[0045] II. Exemplary Ultrasonic Surgical Instrument with
Translating Liquid Cooling Feature having Blade Cooling Chamber
[0046] When a cooling liquid (90) is delivered to a site where an
ultrasonic blade (40) is vibrating, the vibrations of blade (40)
may cause splashing of the cooling liquid (90). This may result in
undesirable dispersal of the cooling liquid (90), which may
adversely affect the cooling efficiency of the cooling liquid (90).
It may therefore be desirable to provide a feature that minimizes
splashing and keeps the cooling liquid (90) as close to blade (40)
as possible. Moreover, it may be desirable to provide this same
effect regardless of the degree to which blade (40) is disposed in
bone (80).
[0047] FIGS. 7 shows an exemplary alternative ultrasonic surgical
instrument (100) that is configured to minimize splashing of
cleaning fluid (90). Instrument (100) of this example comprises a
handle assembly (120), an ultrasonic blade (140), and a liquid
dispensing feature (150). Handle assembly (120) of this example
includes housings (122) and a distal nose portion (124). As shown
in FIG. 8, housings (122) contain a transducer assembly (130) and
an acoustic waveguide (132), which is in acoustic communication
with transducer assembly (130). Referring back to FIG. 7,
transducer assembly (130) may be coupled with a generator (112) via
a cable (114). It should be understood that generator (112),
transducer assembly (130), and waveguide (132) may be configured
and operable substantially similarly to generator (12), transducer
assembly (30), and waveguide (32) described above. Thus, further
details of these components will not be repeated here. While not
shown in FIGS. 7-8, it should be understood that handle assembly
(120) may also include activation buttons similar to buttons (28)
described above. Alternatively, instrument (100) may rely on any
other kind of user input feature(s) to selectively activate
transducer assembly (130).
[0048] As best seen in FIG. 9B, ultrasonic blade (140) of the
present example comprises a sharp cutting edge (142) and an oblong
transverse opening (144). In the present example, transverse
opening (144) passes completely through ultrasonic blade (140),
from one transverse surface to an opposite transverse surface.
Transverse opening (144) is configured to promote the communication
of cooling liquid (90) through blade (140). In some other versions,
transverse opening (144) is replaced with a recess or gutter. In
such versions, recesses or gutters may be formed on both sides of
ultrasonic blade (140). Such recesses or gutters may be configured
to promote the communication of cooling liquid (90) along blade
(140). Still other variations of blade (140) may include a
combination of a transverse opening (144) and recesses or gutters,
etc. Other suitable features and configurations that may be used to
promote the communication of cooling liquid (90) through and/or
along blade (140) will be apparent to those of ordinary skill in
the art in view of the teachings herein.
[0049] Liquid dispensing feature (150) of the present example is
configured to transition between a distal position (as shown in
FIGS. 9A, 10, and 11A) and a proximal position (as shown in FIGS.
7-8, 9B, and 11B). When liquid dispensing feature (150) is in the
distal position, liquid dispensing feature (150) fully encompasses
(or at least substantially encompasses) blade (140). When liquid
dispensing feature (150) is in the proximal position, blade (140)
is fully exposed (or at least substantially exposed) relative to
liquid dispensing feature (150). In the present example, liquid
dispensing feature (150) is resiliently biased toward the distal
position (e.g., by a coil spring, by a leaf spring, or by some
other resilient feature). Liquid dispensing feature (150) will thus
remain in the distal position unless and until the distal end of
liquid dispensing feature (150) is acted upon by some other
structure, such as a surface of bone (80) as described in greater
detail below.
[0050] Liquid dispensing feature (150) is coupled with a pair of
fluid conduits (118), which are further coupled with fluid sources
(116). Fluid sources (116) and conduits (118) may be configured and
operable just like fluid source (16) and conduit (18) described
above. While two fluid sources (116) are shown in FIG. 7, it should
be understood that both conduits (118) may instead be coupled with
a single, shared fluid source (116). It should also be understood
that conduits (118) are configured to translate with liquid
dispensing feature (150) as liquid dispensing feature (150)
translates between the distal and proximal positions. As best seen
in FIG. 10, conduits (118) are in fluid communication with a hollow
interior (154) defined by liquid dispensing feature (150). Thus, as
fluid is communicated from fluid source (116) through conduits
(118), this fluid will flood hollow interior (154). As also shown
in FIG. 10, blade (140) is positioned in hollow interior (154) when
liquid dispensing feature (150) is in the distal position. Blade
(140) will thus be bathed in the cooling liquid within hollow
interior (154) when liquid dispensing feature (150) is in the
distal position as cooling liquid is communicated through conduits
(118).
[0051] As shown in FIG. 9A, liquid dispensing feature (150) also
includes a transverse opening (156) in this example. Transverse
opening (156) is configured to allow some cooling liquid to escape
from hollow interior (154). In some versions, more than one
transverse opening (156) is included. In some other versions,
transverse opening (156) is omitted.
[0052] In the present example, and as shown in FIG. 10, a seal
(134) is positioned between waveguide (124) and distal nose portion
(124). Seal (134) is configured to prevent the cooling liquid from
traveling proximally along waveguide (132) into interior regions of
handle assembly (120). Seal (134) may be positioned at a position
corresponding to a node associated with ultrasonic vibrations
communicated along waveguide (132). Various suitable ways in which
seal (134) may be configured will be apparent to those of ordinary
skill in the art in view of the teachings herein.
[0053] As best seen in FIGS. 9A-10, liquid dispensing feature (150)
further includes a distal opening (152) that is sized to
accommodate blade (140). In particular, distal opening (152) is
large enough such that liquid dispensing feature (150) does not
contact blade (140) throughout the longitudinal range of travel of
liquid dispensing feature (150) relative to blade (140). Distal
opening (152) is also large enough to allow cooling liquid to pass
through distal opening (152) even while blade (140) is disposed in
distal opening (152). Liquid dispensing feature (150) also has
sufficient rigidity and support such that liquid dispensing feature
(150) will not bend or otherwise deflect into contact with blade
(140) even as transversely oriented forces impinge against liquid
dispensing feature (150) (e.g., by liquid dispensing feature (150)
being pressed against an anatomical structure) during normal
operation of instrument (100).
[0054] FIGS. 11A-11B illustrate a sequence of an exemplary use of
instrument (100). As shown in FIG. 11A, instrument (100) is
initially positioned such that the distal end of liquid dispensing
feature (150) is in contact with the outer surface of bone (80). At
this stage, liquid dispensing feature (150) is in a distal position
relative to blade (140). Blade (140) is thus fully recessed (or at
least substantially recessed) relative to the distal end of liquid
dispensing feature (150). The operator then activates blade (140)
and begins communicating cooling liquid (90) to liquid dispensing
feature (150), while simultaneously urging blade (140) distally
into bone (80). As shown in FIG. 11B, sharp edge (142) of blade
(140) and the ultrasonic vibration of blade (140) cooperate to form
a cut (82) in bone (80). The distal end of liquid dispensing
feature (150) remains in contact with the outer surface of bone
(80), such that liquid dispensing feature (150) is now in a
proximal position relative to blade (140). During the transition
from the state shown in FIG. 11A to the state shown in FIG. 11B,
cooling liquid (90) is communicated through liquid dispensing
feature (150) in order to provide cooling to blade (140) and bone
(80). As seen in FIG. 11B, cooling liquid (90) flows along blade
(140) and along the cut (82) of the bone (80), reaching the distal
end of blade (140). When the operator retracts instrument (100)
proximally relative to bone (80) after forming cut (82), the bias
of the resilient member (not shown) that acts against liquid
dispensing feature (150) will return liquid dispensing feature
(150) back to the distal position shown in FIG. 11A.
[0055] It should be understood from the foregoing that the
translation of liquid dispensing feature (150) relative to blade
(140) may assist in substantially containing cooling liquid (90) to
thereby minimize splashing of cooling liquid, while still allowing
blade (140) to enter bone (80). While liquid dispensing feature
(150) translates relative to blade (140) in this example, some
variations may provide a fixed version of liquid dispensing feature
(150). For instance, in some alternative versions, liquid
dispensing feature (150) may be fixedly secured to distal nose
portion (124), such that liquid dispensing feature (150) does not
translate relative to blade (140). In such alternative versions,
liquid dispensing feature (150) may still dispense cooling liquid
(90); and such cooling liquid (90) may still travel along blade
(140) and into cut (82) to provide the cooling effects noted above.
However, such versions may provide more splashing of cooling liquid
(90) than the version described above with reference to FIGS.
7-11B.
[0056] III. Exemplary Ultrasonic Surgical Instrument with
Translating Liquid Cooling Feature having Distal Cooling Jets
[0057] FIGS. 12 shows another exemplary alternative ultrasonic
surgical instrument (200) that is configured to provide liquid
cooling. Instrument (200) of this example is substantially
identical to instrument (100) described above, with the exception
of the fact that instrument (200) has an alternative liquid
dispensing feature (250) instead of having liquid dispensing
feature (150). Otherwise, the same reference numbers are used in
FIGS. 12-14 to indicate components that are identical to similarly
numbered components from FIGS. 7-11B. The details of these
identical components will therefore not be repeated here.
[0058] Like liquid dispensing feature (150) described above, liquid
dispensing feature (250) of the present example is configured to
translate relative to blade (140) between a distal position (FIG.
13A) and a proximal position (FIG. 13B). Also as described above
with respect to liquid dispensing feature (150), alternative
versions of liquid dispensing feature (250) may be fixedly secured
to distal nose portion (124), such that liquid dispensing feature
(250) does not translate relative to blade (140). Unlike liquid
dispensing feature (150) described above, liquid dispensing feature
(250) of the present example includes a pair of cooling jet
openings (258) located near distal opening (252). As best seen in
FIG. 14, conduits (118) are in fluid communication with cooling jet
openings (258). Thus, cooling liquid that is communicated from
fluid sources (116) via conduits (118) will be further communicated
through cooling jet openings (258). It should be understood that,
cooling liquid (90) expelled through cooling jet openings (258) may
provide a cooling effect to blade (140) and the bone (80) that is
cut by blade (140), similar to the cooling effect described above.
In some variations of liquid dispensing feature (250), liquid
dispensing feature (250) is further configured to communicate
cooling liquid to a hollow interior region of liquid dispensing
feature (250), to thereby further cool a portion of blade (140)
that is disposed in the hollow interior region. It should be
understood that the cooling liquid may be communicated to this
hollow interior region in addition to being communicated through
cooling jet openings (258).
[0059] IV. Exemplary Combinations
[0060] 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
[0061] An apparatus comprising: (a) a body assembly; (b) an
acoustic waveguide; (c) an ultrasonic blade positioned distally
relative to the body assembly, wherein the ultrasonic blade is in
acoustic communication with the acoustic waveguide; and (d) a
liquid dispensing feature positioned distally relative to the body
assembly, wherein the liquid dispensing feature is positioned
adjacent to the ultrasonic blade, wherein the liquid dispensing
feature is configured to deliver a flow of cooling liquid to the
ultrasonic blade.
EXAMPLE 2
[0062] The apparatus of Example 1, wherein the ultrasonic blade
defines a longitudinal axis, wherein at least a portion of the
liquid dispensing feature extends along a path that is parallel to
the longitudinal axis.
EXAMPLE 3
[0063] The apparatus of Example 2, wherein the liquid dispensing
feature comprises: (i) a first portion extending parallel to the
longitudinal axis of the ultrasonic blade, wherein the first
portion is offset from the longitudinal axis of the ultrasonic
blade, (ii) a second portion extending along the longitudinal axis
of the ultrasonic blade, and (iii) a third portion joining the
first portion with the second portion.
EXAMPLE 4
[0064] The apparatus of Example 3, wherein the third portion
extends along a path that is obliquely oriented relative to the
longitudinal axis of the ultrasonic blade.
EXAMPLE 5
[0065] The apparatus of any one or more of Examples 3 through 4,
wherein the ultrasonic blade defines an opening, wherein the second
portion is positioned in the opening.
EXAMPLE 6
[0066] The apparatus of any one or more of Examples 3 through 5,
wherein the second portion defines a plurality of openings, wherein
the openings are configured to expel the cooling liquid.
EXAMPLE 7
[0067] The apparatus of any one or more of Examples 3 through 6,
wherein the ultrasonic blade has a maximum thickness, wherein the
second portion has a maximum thickness, wherein the maximum
thickness of the second portion is less than or equal to the
maximum thickness of the ultrasonic blade.
EXAMPLE 8
[0068] The apparatus of any one or more of Examples 1 through 7,
wherein the ultrasonic blade has a sharp edge extending from a
proximal region to a distal region and back to the proximal
region.
EXAMPLE 9
[0069] The apparatus of Example 8, wherein the liquid dispensing
feature has a distal end, wherein the distal end is proximal to the
distal region of the ultrasonic blade.
EXAMPLE 10
[0070] The apparatus of any one or more of Examples 1 through 9,
wherein the liquid dispensing feature is configured to surround at
least a portion of the ultrasonic blade.
EXAMPLE 11
[0071] The apparatus of Example 10, wherein the liquid dispensing
feature is configured to translate relative to the body assembly
between a distal position and a proximal position.
EXAMPLE 12
[0072] The apparatus of Example 11, wherein the ultrasonic blade is
configured to be contained in a hollow interior defined by the
liquid dispensing feature when the liquid dispensing feature is in
the distal position, wherein the ultrasonic blade is configured to
be exposed distally relative to the liquid dispensing feature when
the liquid dispensing feature is in the proximal position.
EXAMPLE 13
[0073] The apparatus of any one or more of Examples 11 through 12,
wherein the liquid dispensing feature is resiliently biased toward
the distal position.
EXAMPLE 14
[0074] The apparatus of any one or more of Examples 10 through 13,
wherein at least a portion of the ultrasonic blade is disposed in a
hollow interior defined by the liquid dispensing feature.
EXAMPLE 15
[0075] The apparatus of Example 14, wherein the liquid dispensing
feature is configured to deliver a flow of cooling liquid to the
hollow interior.
EXAMPLE 16
[0076] The apparatus of Example 15, wherein the liquid dispensing
feature further defines a distal opening in fluid communication
with the hollow interior, wherein the liquid dispensing feature is
further configured to expel cooling liquid through the distal
opening.
EXAMPLE 17
[0077] The apparatus of Example 16, wherein the ultrasonic blade is
configured to pass through the distal opening.
EXAMPLE 18
[0078] The apparatus of any one or more of Examples 1 through 17,
wherein the liquid dispensing feature comprises at least two
cooling jet openings configured to expel a flow of cooling liquid
to the ultrasonic blade.
EXAMPLE 19
[0079] An apparatus comprising: (a) a body assembly; (b) an
acoustic waveguide; (c) an ultrasonic blade positioned distally
relative to the body assembly, wherein the ultrasonic blade is in
acoustic communication with the acoustic waveguide; and (d) a
liquid dispensing feature configured to translate relative to the
ultrasonic blade, wherein the liquid dispensing feature is
configured to deliver a flow of cooling liquid to the ultrasonic
blade while translating relative to the blade.
EXAMPLE 20
[0080] A method of using an ultrasonic surgical instrument to cut
bone, the method comprising: (a) urging a sharp edge of an
ultrasonic blade of the ultrasonic surgical instrument against bone
while the ultrasonic blade is vibrating ultrasonically, thereby
forming a cut in the bone; and (b) communicating a cooling liquid
via a liquid dispensing feature of the ultrasonic surgical
instrument, wherein the act of communicating a cooling liquid
comprises: (i) cooling a distal end of the ultrasonic blade, and
(ii) cooling the cut bone.
[0081] V. Miscellaneous
[0082] 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.
[0083] 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.
[0084] 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.
[0085] 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.
[0086] 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.
[0087] 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.
* * * * *