U.S. patent application number 17/410368 was filed with the patent office on 2022-02-10 for ultrasonic surgical instrument with sliding blade sheath.
The applicant listed for this patent is Cilag GmbH International. Invention is credited to Cory G. Kimball, Jeffrey D. Messerly, Matthew C. Miller, Tony C. Siebel, William B. Weisenburgh, II.
Application Number | 20220039826 17/410368 |
Document ID | / |
Family ID | 1000005925523 |
Filed Date | 2022-02-10 |
United States Patent
Application |
20220039826 |
Kind Code |
A1 |
Siebel; Tony C. ; et
al. |
February 10, 2022 |
ULTRASONIC SURGICAL INSTRUMENT WITH SLIDING BLADE SHEATH
Abstract
A surgical instrument includes a gripping assembly, a shaft
assembly, an end effector, and a pivoting member. The gripping
assembly defines a first opening for receiving a finger or a thumb
of a user. The gripping assembly includes a first deformable
feature that is configured to be moved in order to increase or
decrease a cross-sectional area of the first opening. The shaft
assembly extends distally from the gripping assembly. The end
effector is positioned at a distal end of the shaft assembly and
includes a first member. The pivoting member is pivotably coupled
with the shaft assembly. The pivoting member is pivotable with
respect to the first member of the end effector between an open
position and a closed position to thereby clamp tissue between the
first member and the pivoting member.
Inventors: |
Siebel; Tony C.;
(Cincinnati, OH) ; Weisenburgh, II; William B.;
(Maineville, OH) ; Messerly; Jeffrey D.;
(Cincinnati, OH) ; Miller; Matthew C.;
(Cincinnati, OH) ; Kimball; Cory G.; (Hamilton,
OH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Cilag GmbH International |
Zug |
|
CH |
|
|
Family ID: |
1000005925523 |
Appl. No.: |
17/410368 |
Filed: |
August 24, 2021 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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16380238 |
Apr 10, 2019 |
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17410368 |
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15097630 |
Apr 13, 2016 |
10433864 |
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16380238 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/00858
20130101; A61B 2017/320095 20170801; A61B 2017/00207 20130101; A61B
2017/320044 20130101; A61B 2017/2911 20130101; A61B 2017/320094
20170801; A61B 2017/00017 20130101; A61B 2017/00367 20130101; A61B
17/2841 20130101; A61B 2017/320078 20170801; A61B 2017/00424
20130101; A61B 2017/00946 20130101; A61B 17/2812 20130101; A61B
17/320092 20130101; A61B 17/3201 20130101; A61B 2017/0042
20130101 |
International
Class: |
A61B 17/32 20060101
A61B017/32; A61B 17/28 20060101 A61B017/28; A61B 17/3201 20060101
A61B017/3201 |
Claims
1.-20. (canceled)
21. A surgical instrument comprising: (a) a body; (b) a shaft
assembly extending distally from the body; (c) an end effector at a
distal end of the shaft assembly, wherein the end effector
comprises: (i) an ultrasonic blade, and (ii) a clamp arm comprising
a first surface, wherein the clamp arm is pivotable relative to the
ultrasonic blade from an open position to a closed position to
thereby clamp tissue between the ultrasonic blade and the clamp
arm; and (d) a sheath that angularly envelops the ultrasonic blade,
wherein the sheath is a movable between a retracted position and an
extended position relative to the end effector without touching the
ultrasonic blade, wherein the sheath comprises a second surface
that faces away from the first surface of the clamp arm in the
extended position, wherein the second surface of the sheath and the
first surface of the clamp arm are configured to bluntly dissect
tissue in response to pivoting the clamp arm toward the open
position while the sheath is in the extended position.
22. The surgical instrument of claim 21, wherein the first surface
comprises a textured surface.
23. The surgical instrument of claim 22, wherein the textured
surface comprises a knurled surface.
24. The surgical instrument of claim 21, wherein the body comprises
a switch configured to transition the sheath between the retracted
position and the extended position.
25. The surgical instrument of claim 24, wherein the switch is
slidably between a proximal position and a distal position.
26. The surgical instrument of claim 25, wherein the proximal
position of the switch corresponds to the retracted position of the
sheath, wherein the distal position of the switch corresponds to
the extended position of the sheath.
27. The surgical instrument of claim 26, wherein a mechanical
linkage extends between the sheath and the switch.
28. The surgical instrument of claim 21, wherein the body comprises
a gripping assembly comprising a thumb grip and a finger grip.
29. The surgical instrument of claim 28, wherein the thumb grip in
connected with the clamp arm such that movement of the thumb grip
drives movement of the clamp arm.
30. The surgical instrument of claim 29, wherein the finger grip in
connected with the ultrasonic blade such that movement of the
finger grip drives movement of the ultrasonic blade.
31. The surgical instrument of claim 30, wherein the finger grip
and the thumb grip are pivotally coupled to each other.
32. The surgical instrument of claim 21, wherein the body further
comprises an activation button configured to ultrasonically
activate the ultrasonic blade.
33. The surgical instrument of claim 21, wherein the body further
comprises a transducer assembly in ultrasonic communication with
the ultrasonic blade.
34. The surgical instrument of claim 33, wherein the ultrasonic
transducer assembly is configured to selectively couple with a
generator.
35. The surgical instrument of claim 21, where the sheath partially
envelopes the ultrasonic blade in the extended position such that
the ultrasonic blade and the clamp arm are configured to grasp and
sever tissue while the sheath is in the extended position.
36. A surgical instrument comprising: (a) a body; (b) a shaft
assembly extending distally from the body; (c) an end effector at a
distal end of the shaft assembly, wherein the end effector
comprises: (i) an ultrasonic blade, and (ii) a clamp arm, wherein
the clamp arm is pivotable relative to the ultrasonic blade from an
open position to a closed position to thereby clamp tissue between
the ultrasonic blade and the clamp arm, wherein the end effector
defines a first cross sectional area when the clamp arm is in the
closed position; and (d) a sheath at least partially covering the
ultrasonic blade and movable between a first position and a second
position relative to the end effector without touching the end
effector, wherein the end effector defines a second cross sectional
area when the sheath is in the second position and the clamp arm is
in the closed position.
37. The surgical instrument of claim 36, wherein the sheath
comprises a first knurled surface facing away from the clamp arm in
the second position.
38. The surgical instrument of claim 37, wherein the clamp arm
comprises a second knurled surface facing away from the first
knurled surface.
39. The surgical instrument of claim 38, further comprising a
mechanical link extending between the sheath and the body.
40. A surgical instrument comprising: (a) a body; (b) a shaft
assembly extending distally from the body; (c) an end effector at a
distal end of the shaft assembly, wherein the end effector
comprises: (i) an ultrasonic blade, and (ii) a clamp arm comprising
a first textured surface, wherein the clamp arm is pivotable
relative to the ultrasonic blade from an open position to a closed
position to thereby clamp tissue between the ultrasonic blade and
the clamp arm, wherein the end effector defines a first cross
sectional area when the clamp arm is in the closed position; and
(d) a sheath comprising a second textured surface, wherein the
sheath at least partially covers the ultrasonic blade such that the
second textured surface faces away from the first textured surface
of the clamp arm, wherein the sheath is configured to move between
a first position and a second position relative to the end effector
without touching the end effector, wherein the end effector defines
a second cross sectional area when the sheath is in the second
position and the clamp arm is in the closed position.
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 one or more 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 angle, 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.
[0004] 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.
[0005] 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.
[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. 2 depicts a perspective view of an exemplary ultrasonic
surgical instrument;
[0009] FIG. 2 depicts an exploded perspective view of the
instrument FIG. 1;
[0010] FIG. 3 depicts a side elevational view of the distal end of
the instrument of FIG. 1;
[0011] FIG. 4 depicts a top plan view of an end effector instrument
of FIG. 1;
[0012] FIG. 5 depicts a perspective view of an exemplary
alternative ultrasonic surgical instrument;
[0013] FIG. 6 depicts a side elevational view of the instrument of
FIG. 5, with a slidable sheath the instrument in a retracted
position;
[0014] FIG. 7 depicts a detailed side elevational view of a portion
of a gripping assembly of the instrument of FIG. 5;
[0015] FIG. 8 depicts a detailed side elevational view of an end
effector of the instrument of FIG. 5, showing the slidable sheath
in an extended position;
[0016] FIG. 9A depicts a cross-sectional view of the end effector
taken along line 9A-9A of FIG. 6;
[0017] FIG. 9B depicts a cross-sectional view of the end effector
of FIG. 8, taken along line 9B-9B of FIG. 8;
[0018] FIG. 10A depicts a side elevational view of a distal end of
the end effector of FIG. 8, positioned between layers of tissue,
showing the sheath in an extended position and the end effector in
a closed position;
[0019] FIG. 10B depicts a side elevational view of a distal end of
the end effector of FIG. 8, positioned between layers of tissue,
showing the sheath in the extended position and the end effector in
an open position to separate the layers of tissue;
[0020] FIG. 11A depicts a top plan view of tissue forming an
anatomical passageway;
[0021] FIG. 11B depicts a top plan view of the end effector of FIG.
8, with the sliding sheath in a retracted position, being used to
transect the anatomical passageway of FIG. 11A;
[0022] FIG. 11C depicts a top plan view of the anatomical
passageway of FIG. 11A after being transected by the end effector
of FIG. 8;
[0023] FIG. 12 depicts a perspective view of another exemplary
alternative ultrasonic surgical instrument;
[0024] FIG. 13 depicts a cross-sectional view of the instrument of
FIG. 12, taken along line 13-13 of FIG. 12;
[0025] FIG. 14 depicts a side elevational view of an exemplary
alternative handle assembly that is suitable for incorporation into
an ultrasonic surgical instrument, showing one exemplary
configuration of an activation area on the handle assembly;
[0026] FIG. 15 depicts a side elevational view of another exemplary
alternative handle assembly that is suitable for incorporation into
an ultrasonic surgical instrument, showing another exemplary
configuration of an activation area on the handle assembly;
[0027] FIG. 16A depicts a side elevational view of another
exemplary alternative ultrasonic instrument, showing the instrument
being manipulated by an operator using a first exemplary grip
configuration;
[0028] FIG. 16B depicts a perspective view of the instrument of
FIG. 16A, showing the instrument being manipulated by an operator
using a second exemplary grip configuration;
[0029] FIG. 16C depicts an alternative perspective view of the
instrument of FIG. 16A, showing the instrument being manipulated by
an operator using a third exemplary grip configuration;
[0030] FIG. 17 depicts a side elevational view of an exemplary
alternative handle assembly that is suitable for incorporation into
an ultrasonic surgical instrument, showing an exemplary alert
feature in an illuminated state.
[0031] FIG. 18 depicts a flowchart showing steps of an exemplary
method for programming a control scheme of a surgical
instrument;
[0032] FIG. 19 depicts a flowchart showing steps of an exemplary
method for changing the control scheme of a surgical instrument;
and
[0033] FIG. 20 depicts a flowchart showing steps of an exemplary
method for updating control settings of a surgical instrument.
[0034] 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
[0035] 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.
[0036] 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.
[0037] For clarity of disclosure, the terms "proximal," "distal,"
"upper," and "lower" 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. The terms
"proximal," "distal," "upper," and "lower" are thus relative terms
and not intended to unnecessarily limit the invention described
herein.
I. Exemplary Ultrasonic Surgical Instrument
[0038] 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.
[0039] 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 finger grip
(24) and a pair of buttons (26). Instrument (10) also includes a
clamp arm assembly (50) that is pivotable toward and away from body
(22). A proximal portion of clamp arm assembly (50) comprises a
thumb grip (52). Thumb grip (52) and finger grip (24) together
provide a scissor grip type of configuration. It should be
understood, however, that various other suitable configurations may
be used, including but not limited to a pistol grip
configuration.
[0040] End effector (40) includes an ultrasonic blade (42)
extending distally from shaft assembly (30); and a pivoting clamp
arm (54), which is an integral feature of clamp arm assembly (50).
Clamp arm assembly (50) is pivotably coupled to a projection (34)
extending laterally from shaft assembly (30) via a pivot member
(36) (e.g., a pin, bearing, shaft, etc.) such that clamp arm (54)
is pivotable toward and away from ultrasonic blade (42) to thereby
clamp tissue between a clamp pad (55) of clamp arm (54) and
ultrasonic blade (42). As best seen in FIG. 3, clamp arm assembly
(50) is pivotably coupled to projection (34) such that clamp arm
assembly (50) pivots about an axis that is offset from a
longitudinal axis (LA1). It should be understood that such rotation
about an offset axis may allow for a narrower shaft assembly (30)
profile. It should be understood that shaft assembly (30) passes
through a portion of clamp arm assembly (50) such that as clamp arm
assembly (50) rotates, clamp arm (54) rotates about a portion of
shaft assembly (30). In particular, a first member (53A) and a
second member (53B) of clamp arm assembly (50) are disposed about a
distal portion of shaft assembly (30).
[0041] Clamp arm assembly (50) is configured such that clamp arm
(54) is pivotable toward ultrasonic blade (42) in response to
pivoting of thumb grip (52) of clamp arm assembly (50) toward body
(22); and such that clamp arm (54) is pivotable away from
ultrasonic blade (42) in response to pivoting of thumb grip (52) of
clamp arm assembly (50) away from body (22). As best seen in FIG.
2, a proximal end of clamp arm (54) is disposed within a distal
recess (56) of a shank portion (51) of clamp arm assembly (50); and
is secured therein by a pin (58). Various other suitable ways in
which clamp arm (54) may be integrated into clamp arm assembly (50)
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 (54) and/or trigger (28) to an
open position. By way of example only, such a resilient member may
comprise a leaf spring, a torsion spring, and/or any other suitable
kind of resilient member.
[0042] FIG. 4 shows a top view of end effector (40). The distal end
of ultrasonic blade (42) has a width (W1). The distal end of clamp
arm (54) has a width (W2). In the present example, the width (W2)
of clamp arm (54) is greater than the width (W1) of ultrasonic
blade (42). In some other versions, the width (W1) of ultrasonic
blade (42) is greater than the width (W2) of clamp arm (54). In
still other versions, the width (W1) of ultrasonic blade (42) is
equal to the width (W2) of clamp arm (54). By way of further
example only, end effector (40) may be constructed and operable in
accordance with at least some of the teachings of U.S. Pub. No.
2015/0080925, entitled "Alignment Features for Ultrasonic Surgical
Instrument," published Mar. 19, 2015, the disclosure of which is
incorporated herein by reference, in its entirety.
[0043] As shown in FIG. 1, 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). Transducer assembly (12) receives electrical power from
generator (16) and converts that power into ultrasonic vibrations
through piezoelectric principles. 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 GEN04, GEN11, or 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.
[0044] Ultrasonic vibrations that are generated by transducer
assembly (12) are communicated along an acoustic waveguide (80),
which extends through shaft assembly (30) to reach ultrasonic blade
(42) as shown in FIG. 2. Waveguide (80) is secured within shaft
assembly (30) via a pin (32), which passes through waveguide (80)
and shaft assembly (30). Pin (32) is located at a position along
the length of waveguide (80) corresponding to a node associated
with resonant ultrasonic vibrations communicated through waveguide
(80). As noted above, when ultrasonic blade (42) is in an activated
state (i.e., vibrating ultrasonically), ultrasonic blade (42) is
operable to effectively cut through and seal tissue, particularly
when the tissue is being clamped between clamp arm (54) and
ultrasonic blade (42).
[0045] In the present example, the distal end of ultrasonic blade
(42) is located at a position corresponding to an anti-node
associated with resonant ultrasonic vibrations communicated through
waveguide (80), 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 ultrasonic blade (42) 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 the waveguide to reach
ultrasonic blade (42), thereby providing oscillation of ultrasonic
blade (42) at the resonant ultrasonic frequency. Thus, when tissue
is secured between ultrasonic blade (42) and clamp arm (54), the
ultrasonic oscillation of ultrasonic blade (42) may simultaneously
sever the tissue and denature the proteins in adjacent tissue
cells, thereby providing a coagulative effect with relatively
little thermal spread.
[0046] In some versions, end effector (40) is operable to apply
radiofrequency (RF) electrosurgical energy to tissue in addition to
applying ultrasonic energy to tissue. By way of example only, end
effector (40) may be configured and operable in accordance with at
least some of the teachings of U.S. Pub. No. 2015/0141981, entitled
"Ultrasonic Surgical Instrument with Electrosurgical Feature,"
published May 21, 2015, the disclosure of which is incorporated by
reference herein; and/or U.S. Pat. No. 8,663,220, entitled
"Ultrasonic Electrosurgical Instruments," issued Mar. 4, 2014, the
disclosure of which is incorporated by reference herein. Other
suitable configurations for end effector (40) will be apparent to
those of ordinary skill in the art in view of the teachings
herein.
[0047] An operator may activate buttons (26) to selectively close
switches (27) (see FIG. 2), thereby selectively activating
transducer assembly (12) to activate ultrasonic blade (42). In the
present example, two buttons (26) are provided--one for activating
ultrasonic blade (42) at a low power and another for activating
ultrasonic blade (42) at a high power. However, it should be
understood that any other suitable number of buttons and/or
otherwise selectable power levels may be provided. For instance, a
foot pedal may be provided to selectively activate transducer
assembly (12). Buttons (26) of the present example are positioned
such that an operator may readily fully operate instrument (10)
with a single hand. For instance, the operator may position their
thumb in the ring formed by thumb grip (52), position their middle
or ring finger in the ring formed by finger grip (24), and
manipulate buttons (26) using their index finger. Of course, any
other suitable techniques may be used to grip and operate
instrument (10); and buttons (26) may be located at any other
suitable positions.
[0048] The foregoing components and operabilities of instrument
(10) are merely illustrative. Instrument (10) may be configured in
numerous other ways as will be apparent to those of ordinary skill
in the art in view of the teachings herein. By way of example only,
at least part of instrument (10) may be constructed and/or operable
in accordance with at least some of the teachings of any of the
references cited herein. Additional merely illustrative variations
for instrument (10) will be described in greater detail below. It
should be understood that the below described variations may be
readily applied to instrument (10) described above and any of the
instruments referred to in any of the references that are cited
herein, among others.
II. Exemplary Alternative Ultrasonic Surgical Instrument Including
Blunt Dissection and Adjustable Handle Features
[0049] As discussed above, end effector (40) is operable to
transect and seal tissue (or just seal tissue) by compressing the
tissue between clamp pad (55) of clamp arm (54) and ultrasonic
blade (42), while activating blade (42) with ultrasonic energy. It
may be desirable to provide the end effector (40) with features
that facilitate the use of end effector (40) in performing blunt
dissections (e.g., by selectively increasing the effective width of
end effector (40), by providing surface features to end effector
(40) that enhance tissue gripping, etc.), in addition to allowing
end effector (40) to also be used to transect and seal tissue
ultrasonically. By way of example only, such versatility may be
desirable in thoracic surgical procedures where the pulmonary
artery, pulmonary vein, and/or bronchus need to be transected.
[0050] Furthermore, while instrument (10) is suitable for use by
operators having differently sized hands, it may be desirable in
some instances to allow an operator to customize or adjust aspects
of instrument (10). For example, it may be desirable to provide
adjustable features on handle assembly (20) to accommodate the
operator's comfort in grasping instrument (10) and/or to improve
overall ergonomics of instrument (10). Similarly, it may be
desirable to provide gripping features on handle assembly (20) that
facilitate grasping of instrument (10) using two or more different
kinds of gripping styles.
[0051] The following description relates to examples of instrument
(10) that include end effector (40) variations and handle assembly
(20) variations that may provide the above-noted enhanced
functionality. Other variations will be apparent to those of
ordinary skill in the art in view of the teachings herein. It
should be understood that the following teachings may be readily
incorporated into instrument (10), such that structural and
functional details that are omitted from the following discussion
may simply be provided in accordance with the above discussion, in
accordance with the teachings of the various references that are
cited herein, and/or otherwise as will be apparent to those of
ordinary skill in the art in view of the teachings herein.
A. Overview of Exemplary Ultrasonic Instrument with Translating
Blade Sheath and Enhanced Gripping Features
[0052] FIGS. 5-11B illustrate an exemplary ultrasonic surgical
instrument (110) including an exemplary alternative end effector
(140) that includes features to aid in blunt dissection; and an
exemplary alternative gripping assembly (170) that includes
adjustable features that aid an operator in grasping instrument
(110). End effector (140) and gripping assembly (170) are discussed
in further detail below. Although end effector (140) and/or handle
assembly (120) may be readily incorporated into instrument (10) or
other suitable instruments, each of these features are described
herein with respect to instrument (110). Instrument (110) is
substantially similar to instrument (10), except for the
differences described below. Aside from the features described
below, at least part of instrument (110) may be constructed and
operable in accordance with any of the references that are cited
herein.
[0053] Instrument (110) of the present example comprises a shaft
assembly (130) that extends between end effector (140) and gripping
assembly (170). Gripping assembly (170) includes a handle assembly
(120) and clamp arm assembly (150) that an operator may grasp and
manipulate in order to operate instrument (110), as discussed in
further detail below. Handle assembly (120) comprises a body (122)
including a finger grip (124) and a button (126). Clamp arm
assembly (150) that is pivotable toward and away from body (122). A
proximal portion of clamp arm assembly (150) comprises a thumb grip
(152). Thumb grip (152) and finger grip (124) together provide a
scissor grip type of configuration. It should be understood,
however, that various other suitable configurations may be used,
including but not limited to a pistol grip configuration. Moreover,
many suitable grasping configurations by an operator are possible.
For example, thumb grip (152) and finger grip (124) each may
accommodate any of the thumb and/or fingers of an operator.
[0054] End effector (140) includes an ultrasonic blade (142)
extending distally from shaft assembly (130); and a pivoting clamp
arm (154), which is an integral feature of clamp arm assembly
(150). Clamp arm assembly (150) is pivotably coupled to shaft
assembly (130) via a pivot member (136) (e.g., a pin, bearing,
shaft, etc.) such that clamp arm (154) is pivotable toward and away
from ultrasonic blade (142) to thereby clamp tissue between a clamp
pad (155) of clamp arm (154) and ultrasonic blade (142). As best
seen in FIG. 5, clamp arm assembly includes a proximal portion
(156), a distal portion (158), and a middle portion (160). As
shown, middle portion (160) comprises a bifurcation defining first
and second arms (162). Clamp arm assembly (150) is pivotably
coupled to shaft assembly (130) due to first and second arms (162)
being pivotally coupled about pivot member (136). Various other
suitable ways in which clamp arm assembly (150) may be pivotally
coupled to shaft assembly (130) will be apparent to persons skilled
in the art in view of the teachings herein.
[0055] Clamp arm assembly (150) is configured such that clamp arm
(154) is pivotable toward ultrasonic blade (142) in response to
pivoting of thumb grip (152) of clamp arm assembly (150) toward
body (122); and such that clamp arm (154) is pivotable away from
ultrasonic blade (142) in response to pivoting of thumb grip (152)
of clamp arm assembly (150) away from body (122). In some versions,
one or more resilient members are used to bias clamp arm (154) to
an open position. By way of example only, such a resilient member
may comprise a leaf spring, a torsion spring, and/or any other
suitable kind of resilient member.
[0056] As shown in FIG. 5, an ultrasonic transducer assembly (112)
is positioned within body (122) of handle assembly (120).
Transducer assembly (112) may be configured to operate
substantially similar to transducer assembly (12). Other suitable
forms and configurations that transducer assembly (112) may assume
will be apparent to persons skilled in the art in view of the
teachings herein. As shown, transducer assembly (112) is coupled
with a generator (16) via a cable (14). While an acoustic waveguide
is not shown in FIGS. 5-11B, it will be understood that an acoustic
waveguide of instrument (110) extends through shaft assembly (130)
and is configured substantially in accordance with waveguide (80)
described above. Accordingly, when transducer assembly (112) is
energized, ultrasonic mechanical oscillations of the waveguide are
transmitted through the waveguide to reach ultrasonic blade (142),
thereby providing oscillation of ultrasonic blade (142) at the
resonant ultrasonic frequency. Thus, when tissue is secured between
ultrasonic blade (142) and clamp arm (154), the ultrasonic
oscillation of ultrasonic blade (142) 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, end effector (140) is also operable to
apply RF electrosurgical energy to tissue (e.g., in accordance with
the teachings of references cited herein).
[0057] An operator may activate button (126) to thereby selectively
activating transducer assembly (112) to activate ultrasonic blade
(142). It will be understood that instrument (110) includes
components similar to those described with respect to instrument
(10) that cause the activation of transducer assembly (112) upon
activation of button (126). In the present example, one button
(126) is provided; however, in other examples, there may be
multiple buttons (126), such as one for activating ultrasonic blade
(142) at a low power level and another for activating ultrasonic
blade (142) at a high power level. It should be understood that any
other suitable number of buttons and/or otherwise selectable power
levels may be provided. For instance, a foot pedal may be provided
to selectively activate transducer assembly (112). Button (126) of
the present example positioned such that an operator may readily
fully operate instrument (110) with a single hand. For instance,
the operator may position their thumb in the ring formed by thumb
grip (152), position their middle or ring finger in the ring formed
by finger grip (124), and manipulate button (126) using their index
finger. Of course, any other suitable techniques may be used to
grip and operate instrument (110); and button (26) may be located
at any other suitable positions. In alternative examples,
instrument (110) may include controls similar to other instruments
described herein, in order to activate transducer assembly
(112).
B. Exemplary Translating Blade Sheath
[0058] As noted above, end effector (140) includes features that
aid in blunt dissection of tissue. As shown in FIGS. 6, 8, 9A-9B,
10B, and 11A-11B, end effector (140) includes a sheath (144) that
is axially movable between a retracted position (FIGS. 6, 9A, and
10B) and an extended position (FIGS. 8, 9B, and 11A-11B). As shown
in the present example, sheath (144) partially angularly envelops
ultrasonic blade (142) such that tissue may be clamped between
blade (142) and clamp arm (154) and subjected to mechanical
oscillations of blade (142), without being impeded by sheath (144).
In other words, blade (142) does not contact sheath (144). It
should therefore be understood that end effector (140) may still be
used to ultrasonically seal and sever tissue regardless of the
position of sheath (144). However, in other examples, sheath (144)
may fully envelop blade (142) such that when sheath (144) is in the
extended position, end effector (140) may not be used to sever
tissue using mechanical oscillations of blade (144).
[0059] As shown, sheath (144) in the extended position increases
the effective cross-sectional area of distal end of end effector
(140) (e.g., taken along line 9B-9B of FIG. 8). Because the
effective cross-sectional area of end effector (140) is increased,
an operator may be less likely to pierce tissue during blunt
dissection of tissue using end effector (140). In the present
example, sheath (144) and clamp arm (154) include a textured
surface to further aid in blunt dissection of tissue. Particularly,
as best seen in FIGS. 8 and 11A-11B, sheath (144) and underside
(156) of clamp arm (154) (i.e., the portion opposing clamp pad
(155)) each include a knurled surface (149, 159), respectively.
Knurled surfaces (148, 159) may enhance a grip between sheath (144)
and tissue, and between clamp arm (154) and tissue, when end
effector (140) is used to perform blunt dissection as shown in
FIGS. 10A-10B and as will be described in greater detail below.
[0060] In the present example, knurled surfaces (149, 159) are
machined onto sheath (144) and clamp arm (154). However, in other
examples, knurled surfaces (149, 159) may be added to sheath (144)
and clamp arm (154) in other suitable manners that will be apparent
to persons skilled in the art in view of teachings herein.
Moreover, rather than knurling, sheath (144) and/or clamp arm (154)
may include other types of suitable textured surfaces, surface
treatments, coatings, etc., that will be apparent to persons
skilled in the art in view of the teachings herein.
[0061] In the present example, sheath (144) is operably connected
to a slidable switch (146) via a mechanical link (148). As shown,
moving switch (146) in the proximal direction moves link (148) and
sheath (144) proximally, while moving switch (146) in the distal
direction moves link (148) and sheath (144) distally. In other
examples, sheath (144) may be axially movable by switch (146) in
other suitable manners. In some variations, sheath (144) may move
proximally in response to distal movement of switch (146), and
distally in response to proximal movement of switch (146). In some
other variations, switch (146) may comprise a push button or other
mechanism, the depression of which mechanically or electronically
causes movement of sheath (144). Other suitable manners of
advancing and retracting sheath (144) will be apparent to persons
skilled in the art in view of the teachings herein.
C. Exemplary Alternative Gripping Assembly with Adjustability
Features
[0062] Some instruments having scissor grip configurations like
that of instrument (10) include finger and thumb grips that are
rigid. Such instruments may not allow the operator to customize the
size and shape of the eyelets according to the operator's hand
size, comfort level, and other preferences. In instrument (110),
gripping assembly (170) includes a handle assembly (120) having an
adjustable finger grip (124), and clamp arm assembly (150) having
an adjustable thumb grip (152). Finger grip (124) and thumb grip
(152) are each adjustable in order to accommodate operator hand
size differences and gripping preferences.
[0063] In particular, finger grip (124) defines an eyelet (172)
having an adjustable member (174) that is movable relative to other
portions of eyelet (172). As shown in FIG. 7, a portion of
adjustable portion (174) may be directed inwardly toward the
longitudinal axis of instrument (110) to effectively decrease the
cross-sectional area of eyelet (172). Alternatively, a portion of
adjustable member (174) may be directed outwardly away from the
longitudinal axis of instrument (110) to effectively increase the
cross-sectional area of eyelet (172). In some examples, some
portions of adjustable member (174) may be moved toward the
longitudinal axis while other portions of adjustable member (174)
are simultaneously moved away from the longitudinal axis of
instrument (110). As shown, adjustable member (174) encompasses
only a certain portion of thumb grip (124) and eyelet (172). In
other words, thumb grip (124) and eyelet (172) are adjustable as
described above along only a portion of the perimeters thereof.
However, adjustable member (174) may extend along a greater or
lesser portion of such perimeters than the amount shown. Moreover,
adjustable member (174) is shown to be a single continuous portion
in the present example. However, in other examples, there may
multiple adjustable members (174).
[0064] Finger grip (124) includes additional features that aid in
the user gripping the gripping assembly (170). As shown, distal
portion of eyelet (172) includes a first tapered section (176) and
proximal portion of eyelet (172) includes a second tapered section
(178). Inner surface (180) of eyelet (172) in the present example
includes a surface with sufficient pliability to provide comfort to
the operator but not so much pliability that could reduce the
operator's control and responsiveness of instrument (110).
Moreover, in the present example, inner surface (180) of eyelet
(172) provides a coefficient of friction that is sufficient to
assist in maintaining the position of operator's finger or thumb
within eyelet (172) when movement of such is not desired, but also
that allows the operator to move his or her finger or thumb within
eyelet (172) when desired. As shown, clamp arm assembly (150)
further includes a projection (179) extending distally from finger
grip (152) that defines a space (181) for another finger of the
operator. Thus, eyelet (172) is configured for an operator to
suitably position a thumb or finger according to the operator's
anatomical considerations and comfort preferences, among other
things.
[0065] Similarly, thumb grip (152) defines an eyelet (182) having
an adjustable member (184) that is movable relative to other
portions of eyelet (182). Similar to adjustable portion (174) shown
in FIG. 7, a portion of adjustable member (184) may be directed
inwardly toward the longitudinal axis of instrument (110) to
effectively decrease the cross-sectional area of eyelet (182).
Alternatively, a portion of adjustable member (184) may be directed
outwardly away from the longitudinal axis of instrument (110) to
effectively increase the cross-sectional area of eyelet (182). In
some examples, some portions of adjustable member (184) may be
moved toward the longitudinal axis while other portions of
adjustable member (184) are simultaneously moved away from the
longitudinal axis of instrument (110). As shown, adjustable member
(184) encompasses only a certain portion of thumb grip (124) and
eyelet (182). In other words, thumb grip (124) and eyelet (182) are
adjustable as described above along only a portion of the
perimeters thereof. However, adjustable member (184) may extend
along a greater or lesser portion of such perimeters than the
amount shown. Moreover, adjustable member (184) is shown to be a
single continuous portion in the present example. However, in other
examples, there may multiple adjustable members (184).
[0066] Finger grip includes additional features that aid in the
user gripping the gripping assembly (170). As shown, distal portion
of eyelet (182) includes a first tapered section (186) and proximal
portion of eyelet (182) includes a second tapered section (188).
Inner surface (190) of eyelet (192) in the present example includes
a surface with sufficient pliability to provide comfort to the
operator but not so much pliability that could reduce the
operator's control and responsiveness of instrument (110).
Moreover, in the present example, inner surface (190) of eyelet
(182) provides a coefficient of friction that is sufficient to
assist in maintaining the position of operator's finger or thumb
within eyelet (182) when movement of such is not desired, but also
that allows the operator to move his or her finger or thumb within
eyelet (182) when desired. Thus, eyelet (182) is configured for an
operator to suitably position a thumb or finger according to the
operator's anatomical considerations and comfort preferences, among
other things.
[0067] In the present example, each adjustable member (174, 184) is
deformable. By way of example only, adjustable member (184) may be
malleably deformable. For instance, adjustable members (174, 184)
may be configured to maintain their adjusted positions absent a
sufficient adjustment force. Adjustment members (174, 184) may thus
be configured to provide an amount of resistance that maintains the
positions of adjustment members (174, 184) during use and
manipulation of instrument (110). However, upon being subjected to
such a sufficient adjustment force, adjustment members (174, 184)
are configured to move in the direction of such force. In some
other versions, adjustable members (174, 184) are resiliently
deformable, plastically deformable, or otherwise deformable.
[0068] Adjustable members (174, 184) may comprise an internal
deformable member, such as a metal wire, embedded within a flexible
outer material. In other examples, adjustable members (174, 184)
may comprise a plurality of interlocking members that are
configured to provide deformability. For example, adjustable
members (174, 184) may comprise one or more ratchet joints that may
pivot and lock in certain positions. In some other examples,
adjustable members (174, 184) may include pivotally connected
members that are configured lock in particular rotational positions
relative to one another (e.g., similar to a gooseneck
configuration). Other suitable configurations and manners of
imparting deformability to adjustable members (174, 184) will be
apparent to persons skilled in the art in view of the teachings
herein.
D. Exemplary Operation
[0069] In an exemplary use for blunt dissection of tissue, sheath
(144) may be advanced to the extended position as described above.
End effector (140) may then be positioned between apposed layers of
tissue (T1, T2) as shown in FIG. 10A. Due to the increased
effective cross-sectional area of distal end of end effector (140)
with sheath (144) in the extended position, the likelihood of blade
(142) piercing tissue (T1, T2) may be reduced. To bluntly dissect
or separate tissue layers (T1, T2), clamp arm (154) is pivoted away
from ultrasonic blade (142) and sheath (144), as shown in FIG. 10B.
Referring now to FIGS. 11A-11C, in some instances, instrument (110)
is then used to transect tissue (T). Ultrasonic blade (142) and
clamp arm (154) may be positioned around two layers of tissue.
Clamp arm (154) is then closed relative to blade (142) to capture
the layers of tissue between blade (142) and clamp pad (155) of
clamp arm (154). Ultrasonic blade (142) may then be ultrasonically
activated, such as in the manner discussed above, so that end
effector (140) cuts and seals tissue (T). While sheath (144) is
shown to be in a retracted position in FIG. 11B, in other examples,
sheath (144) may be in the extended position (e.g., FIGS. 8, 9B,
and 11A-11B) when blade (142) is activated. Blade (142) is
activated for a sufficient amount of time such that tissue (T) is
transected or severed, as shown in FIG. 11C.
[0070] In some instances, instrument (110) is used only to perform
blunt dissection of tissue (T1, T2). In some other instances,
instrument (110) is used only to sever tissue (T). In still other
instances, instrument (110) is used to perform blunt dissection of
tissue (T1, T2) before and/or after severing tissue (T), in the
same surgical procedure. It should be understood that the diverse
functionalities of instrument (110) may reduce the total number of
different kinds of instruments that are needed to perform a
surgical procedure.
III. Exemplary Alternative Ultrasonic Surgical Instrument with
Touch Activation Sensor
[0071] In addition to (or as an alternative to) providing enhanced
ergonomics through the configuration of grips (124, 152) as
described above, variations of instrument (10, 110) may provide
enhanced ergonomics by providing alternatives to buttons (26, 126).
In particular, it may be desirable to provide one or more features
that are operable to ultrasonically activate blade (42, 142) and
that are readily accessible by the operator's hand regardless of
whether the operator chooses to grasp instrument (10, 110) using
one particular gripping configuration or another particular
gripping configuration. In other words, it may be desirable to
enable the operator to easily activate blade (42, 142) regardless
of how the operator chooses to grasp instrument (10, 110). The
below discussion provides several examples of variations that may
be used to provide alternatives to buttons (26, 126). Still other
examples will be apparent to those of ordinary skill in the art in
view of the teachings herein.
A. Ultrasonic Surgical Instrument with Activation Area on Handle
Assembly
[0072] FIG. 12 shows another exemplary alternative ultrasonic
surgical instrument (210). Instrument (210) is similar to
instrument (10, 110), except for the differences discussed below.
In the present example, instrument (210) is configured to be
activated by a user activating an activation area (244), as
discussed in further detail below, rather than by button(s) (26,
126). While activation area (244) is shown and described in the
context of instrument (210), it should be understood that
activation area (244) and variations thereof may be readily
incorporated into instruments (10, 210) above, for example, to
activate transducer (12, 112). Aside from the features described
below, at least part of instrument (210) may be constructed and
operable in accordance with any of the references that are cited
herein.
[0073] Instrument (210) of the present example comprises a shaft
assembly (230) and an end effector (240) that are operably coupled
to a gripping assembly (270). Gripping assembly (270) includes a
handle assembly (220) and clamp arm assembly (250) that an operator
may grasp and manipulate in order to operate instrument (210), as
discussed in further detail below. Handle assembly (220) comprises
a body (222) including a finger grip (224). Clamp arm assembly
(250) is pivotable toward and away from body (222). A proximal
portion of clamp arm assembly (250) comprises a thumb grip (252).
Thumb grip (252) and finger grip (224) together provide a scissor
grip type of configuration. It should be understood, however, that
various other suitable configurations may be used, including but
not limited to a pistol grip configuration. Moreover, many suitable
grasping configurations by an operator are possible. For example,
thumb grip (252) and finger grip (242) each may accommodate any of
the thumb and/or fingers of an operator.
[0074] End effector (240) includes an ultrasonic blade (242)
extending distally from shaft assembly (230); and a pivoting clamp
arm (254), which is an integral feature of clamp arm assembly
(250). Clamp arm assembly (250) is pivotably coupled to shaft
assembly (230) via a pivot member (236) (e.g., a pin, bearing,
shaft, etc.) such that clamp arm (254) is pivotable toward and away
from ultrasonic blade (242) to thereby clamp tissue between a clamp
pad (e.g., like clamp pad (155)) of clamp arm (154) and ultrasonic
blade (242). Various other suitable ways in which clamp arm
assembly (250) may be pivotally coupled to shaft assembly (230)
will be apparent to persons skilled in the art in view of the
teachings herein.
[0075] Clamp arm assembly (250) is configured such that clamp arm
(254) is pivotable toward ultrasonic blade (242) in response to
pivoting of thumb grip (252) of clamp arm assembly (250) toward
body (222); and such that clamp arm (254) is pivotable away from
ultrasonic blade (242) in response to pivoting of thumb grip (252)
of clamp arm assembly (250) away from body (222). In some versions,
one or more resilient members are used to bias clamp arm (254) to
an open position. By way of example only, such a resilient member
may comprise a leaf spring, a torsion spring, and/or any other
suitable kind of resilient member.
[0076] An ultrasonic transducer assembly (212) is positioned within
body (222) of handle assembly (220). Transducer assembly (212) may
be configured to operate substantially similar to transducer
assembly (12, 112). Other suitable forms and configurations that
transducer assembly may assume will be apparent to persons skilled
in the art in view of the teachings herein. As shown, transducer
assembly (212) is coupled with a generator (16) via a cable (14).
While an acoustic waveguide is not shown in FIGS. 12-13, it will be
understood that an acoustic waveguide of instrument (210) extends
through shaft assembly (230) and is configured substantially in
accordance with waveguide (80) described above. Accordingly, when
transducer assembly (212) is energized, ultrasonic mechanical
oscillations of the waveguide are transmitted through the waveguide
to reach ultrasonic blade (242), thereby providing oscillation of
ultrasonic blade (242) at the resonant ultrasonic frequency. Thus,
when tissue is secured between ultrasonic blade (242) and clamp arm
(254), the ultrasonic oscillation of ultrasonic blade (242) 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, end effector
(240) is also operable to apply RF electrosurgical energy to tissue
(e.g., in accordance with the teachings of references cited
herein).
[0077] As noted above, handle assembly (220) of the present example
further comprises an activation area (244), which is configured to
activate transducer assembly (212) upon receiving a suitable input
gesture (e.g., touch gesture) from an operator. Activation area
(244) in the present example comprises a touch sensor (245) which,
as seen best in FIG. 13, takes the form of film (246) extending
from one side of handle assembly (220) to the other side of handle
assembly (220). By way of example only, film (246) may comprise a
capacitive touch sensitive film. Film (246) is in communication
with printed circuit board (248), which includes components that
are operable to convert touches/gestures sensed by sensor (245)
into control signals that activate transducer (212). Thus, upon
sensor (245) sensing a suitable touch gesture, circuit board (248)
communicates such information to transducer (212) to thereby
activate transducer (212). As shown in the present example,
activation area (244) is shown to only be positioned a particular
portion of handle assembly (220). However, in other examples,
activation area (244) may cover a larger portion of the surface
area of handle assembly (220). Additionally or alternatively, there
may be additional activation areas (244) positioned on the handle
assembly (220) or on other components of instrument (210). For
example, activation area(s) (244) may encompass substantially all
of the surface area of instrument (210) such that an operator can
essentially provide an input gesture to any portion of instrument
(210) in order to activate transducer assembly (212).
[0078] In versions of instrument (210) where more than one sensor
(245) is provided, the different sensors (245) may provide
different responses. For instance, one sensor (245) may provide
ultrasonic activation of blade (242) at a first power level while
another sensor (245) may provide ultrasonic activation of blade
(242) at a second power level. In addition or in the alternative,
one sensor (245) may provide RF electrosurgical activation of end
effector (240) while another one or more sensors (245) may provide
ultrasonic activation of blade (242). Regardless of the number of
sensors (245), sensor (245) may provide different responses based
on how the operator touches sensor (245). For instance, as will be
described in greater detail below, sensor (245) may provide one
response when an operator taps sensor (245), and a different
response when the operator slides a finger along sensor (245),
and/or another different response when the operator maintains
contact with sensor (245).
[0079] FIGS. 14 and 15 show another exemplary alternative
ultrasonic instrument (310) having a pistol grip configuration. As
discussed below, similar to instrument (210), instrument (310) may
be activated in response to a suitable input gesture on an
activation area (344), rather than utilizing buttons (26, 126). At
least part of instrument (310) may be constructed and operable in
accordance with any of the references that are cited herein.
[0080] Instrument (310) of the present example comprises a handle
assembly (320) and a shaft assembly (330). While an end effector is
not shown, it will be understood that end effector includes an
ultrasonic blade and a pivoting clamp arm, which may be configured
and operable in accordance with the teachings of various references
cited herein. Instrument (310) further includes a transducer
assembly (312) that generates ultrasonic vibrations that are
communicated to ultrasonic blade of instrument (310) in the same
manner as described above with respect to transducer assembly (12,
112, 212) and ultrasonic blade (42, 142, 242). Moreover, it will be
understood that transducer assembly (312) may be coupled to a
generator via a cable.
[0081] Handle assembly (320) comprises a body (322) including a
pistol grip (324) and a trigger (328) that is pivotable toward and
away from pistol grip (324) to pivot the clamp arm relative to the
ultrasonic blade. However, rather than including buttons,
instrument (310) includes an activation area (344) which, upon
receiving a suitable touch gesture from an operator, is configured
to activate transducer assembly (312). By way of example only,
activation area (344) may comprise one or more sensors such as a
capacitive touch sensitive film. Other suitable components and
features that may be used to form activation area (344) will be
apparent to those of ordinary skill in the art in view of the
teachings herein.
[0082] FIG. 14 shows one exemplary form that activation area (344)
may take. In this example, activation area (344) encompasses a
substantial portion of body (322) of handle assembly (320).
Particularly, activation area (344) extends from a proximal portion
of body (322), around distal portion of body, and substantially
from trigger (328) to an upper portion of body (322). In this
configuration, an operator may activate activation area (344) using
a finger and/or thumb of the same hand that grasps pistol grip
(324); or using the operator's other hand. FIG. 15 shows another
exemplary form that activation area (344) may take. In this
example, activation area (344) covers less surface area of body
(322) than in the example of FIG. 14. In the example of FIG. 15,
activation area (344) encompasses the distal portion of body (322),
as well as upper and lower lateral portions of body (322). In still
other examples, activation area (344) may encompass different or
additional parts of handle assembly (320). For example, in some
examples, activation area (344) may encompass the entire body (322)
or entire handle assembly (320). Other suitable forms that
activation area (344) may take will be apparent to persons skilled
in the art in view of the teachings herein.
[0083] In the present example, an operator may activate transducer
(212, 312) of instrument by performing any suitable touch gesture
on activation area (244, 344), using one or more fingers of an
operator. Alternative, rather than using the fingers of an
operator, a sufficient input device (e.g., a stylus), may be
utilized in addition or in the alternative to the operator's
fingers. Such suitable touch gestures may include tapping,
sliding/swiping, pressing and holding, any other suitable touch
gestures that will be understood by persons skilled in the art in
view of the teachings herein, as well as any variations and/or
combinations of such touch gestures. Thus, in the example shown,
activation area (244, 344) is configured to detect a touch gesture
and activate transducer (212, 312) or otherwise activate end
effector (240) based on such touch gesture.
[0084] In some examples, activation area (244, 344) is configured
to detect different touch gestures, and to communicate such
different inputs so that transducer assembly (212, 312) is
activated in different activation modes. By way of example only,
tapping activation area (244, 344) may toggle power levels (e.g.,
within the ultrasonic modality) or toggle modalities (e.g., RF
versus ultrasonic) or simply trigger activation of blade (242)/end
effector (240). By way of further example, sliding a finger along
activation area (244, 344) may provide variable selection of a
power level (e.g., within the ultrasonic modality). For instance,
upon receiving one type of touch gesture (e.g., proximal swipe),
transducer assembly (212, 312) may be activated in a first
activation mode, (e.g., an activation mode associated with a
"minimum" ultrasonic energy level that results in only the sealing
of tissue). Similarly, upon receiving a second type of touch
gesture (e.g., distal swipe), transducer assembly (212) may be
activated in a second activation mode (e.g., an activation mode
associated with a "maximum" ultrasonic energy level that results in
the sealing and cutting of tissue). In the examples shown in FIGS.
12-15, activation area (244, 344) is configured to detect and
resolve a single touch gesture, such as a tapping, sliding/swiping,
or pressing and holding of a single finger. However, in other
examples, activation area (244, 344) may be configured to detect
and resolve other types of input touch gestures, including single
touch with gesture (also known as "two-finger gestures," "dual
touch," "dual control," and "gesture touch"), two touch, and
multi-touch. Other suitable kinds of gestures that may be sensed by
activation area (244, 344), and various different ways in which
instrument (210, 310) may respond to such different gestures, will
be apparent to those of ordinary skill in the art in view of the
teachings herein. Moreover, it should be understood that instrument
(210, 310) may be configured to allow the operator to program
instrument (210, 310) such that the operator may select particular
gestures that are available and corresponding responses to selected
gestures.
[0085] It should also be understood that various kinds of touch
sensitive features may be used to sense touching of activation
areas (244, 344). By way of example only, activation areas (244,
344) may comprise projected capacitive touch sensors, bending wave
sensors, infrared sensors, optical sensors, resistive sensors,
surface acoustic wave sensors, surface capacitive sensors, or other
suitable types of sensors. In examples utilizing multiple sensors
(245), instrument (210) may utilize a single type of sensor, or
multiple types of sensors. Other suitable forms and configurations
that sensor (245) may take will be apparent to persons skilled in
the art in view of the teachings herein.
B. Ultrasonic Surgical Instrument with Adaptable Activation
Area
[0086] FIGS. 16A-16C show another exemplary alternative surgical
instrument (410).
[0087] Instrument (410) is similar to instrument (10, 110, 210),
except for the differences discussed below. In the present example,
instrument (410) is configured to be activated by a user activating
an activation area (444), as discussed in further detail below,
rather than by button(s) (26, 126). Aside from the features
described below, at least part of instrument (410) may be
constructed and operable in accordance with any of the references
that are cited herein.
[0088] Instrument (410) of the present example comprises a shaft
assembly (430) and an end effector (440) that are operably coupled
to a gripping assembly (470). Gripping assembly (470) includes a
handle assembly (420) and clamp arm assembly (450) that an operator
may grasp and manipulate in order to operate instrument (410), as
discussed in further detail below. Handle assembly (420) comprises
a body (422) including a thumb grip (424). Clamp arm assembly (450)
is pivotable toward and away from body (422). A proximal portion of
clamp arm assembly (450) comprises a finger grip (452). Finger grip
(452) and thumb grip (424) together provide a scissor grip type of
configuration. It should be understood, however, that various other
suitable configurations may be used, including but not limited to a
pistol grip configuration. Moreover, many suitable grasping
configurations by an operator are possible. For example, thumb grip
(452) and finger grip (442) each may accommodate any of the thumb
and/or fingers of an operator.
[0089] End effector (440) includes an ultrasonic blade (442)
extending distally from shaft assembly (430); and a pivoting clamp
arm (454), which is an integral feature of clamp arm assembly
(450). Clamp arm assembly (450) is pivotably coupled to shaft
assembly (430) via a pivot member (436) (e.g., a pin, bearing,
shaft, etc.) such that clamp arm (454) is pivotable toward and away
from ultrasonic blade (442) to thereby clamp tissue between a clamp
pad (e.g., like clamp pad (155)) of clamp arm (154) and ultrasonic
blade (442). Various other suitable ways in which clamp arm
assembly (450) may be pivotally coupled to shaft assembly (430)
will be apparent to persons skilled in the art in view of the
teachings herein.
[0090] An ultrasonic transducer assembly (not shown) may be is
positioned within body (422) of handle assembly (420). The
transducer assembly may be configured to operate substantially
similar to transducer assembly (12, 112, 212) described above.
Accordingly, when the transducer assembly is energized, the
resulting ultrasonic mechanical oscillations may be transmitted
through an acoustic waveguide to reach ultrasonic blade (442),
thereby providing oscillation of ultrasonic blade (442) at the
resonant ultrasonic frequency. Thus, when tissue is secured between
ultrasonic blade (442) and clamp arm (454), the ultrasonic
oscillation of ultrasonic blade (442) 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, end effector (440) is also operable to
apply RF electrosurgical energy to tissue (e.g., in accordance with
the teachings of references cited herein).
[0091] As noted above, instrument (410) of the present example
further includes a plurality of activation areas (444), rather than
including button(s) (e.g., buttons (26, 126), for activating the
transducer assembly. Upon receiving a suitable touch gesture from
an operator, an activation area (444) is configured to activate the
transducer assembly in a manner that is substantially identical to
that described above with respect to activation areas (244, 344).
In versions where a plurality of activation areas (444) are
substantially contiguous with each other, such activation areas
(444) may be considered as a single activation area (444). For
example, where instrument includes a series of substantially
contiguous activation areas (444), instrument (410) may be
considered to include a single activation area (444).
[0092] Different activation areas (444) or portions of activation
areas (444) may be active depending on the orientation of
instrument (410) and/or the position of the operator's hand
relative to instrument (410). "Active," as described herein with
respect to an activation area (444), is meant to refer to a state
where inputting a sufficient input gesture to such activation area
(444) results in the activation of transducer assembly (412). In
other words, an active activation area (444) will be responsive to
operator input, such that blade (442) will be activated in response
to the operator touching the active activation area (444). When one
activation area (444) of instrument (410) is active, the other
activation areas (444) may be rendered inactive. An inactive
activation area (444) may be non-responsive to operator input, such
that blade (442) will not be activated in response to the operator
touching the inactive activation area (444). It should be
understood that an active activation area (444) may be configured
and operable just like activation areas (244, 344) described
above.
[0093] In the example shown, instrument (410) includes a sensor
(480) that is configured to sense the position and/or orientation
of instrument (410). As shown, sensor (480) is positioned on handle
assembly (420) of instrument (410). However, in other examples,
sensor (480) may be positioned on other portions of instrument
(410). Moreover, in other examples, there may be more than one
sensor (480). In the present example, sensor (480) comprises a
gyroscopic sensor. However, in other examples, sensor (480) may
comprise an accelerometer and/or any other suitable type of sensor.
In some examples where instrument includes multiple sensors (480),
instrument (410) may include a combination of different types of
sensors (480), such as both gyroscopic sensors and
accelerometers.
[0094] In the present example, referring also to FIG. 18, in
response to sensing a particular position and/or orientation of
instrument (410) (block 502), one of the plurality of activation
areas (444) may be rendered active (block 504). For example, when
sensor (480) senses that instrument (410) is in the position and
orientation shown in FIG. 16A, an activation area (444) positioned
on an intermediate region of clamp arm assembly (450) may be
rendered active while other activation areas (444) are rendered
inactive. Similarly, when sensor (480) senses that instrument (410)
is in the position and orientation shown in FIG. 16B, an activation
area (444) on body (422) of handle assembly (420) may be rendered
active while other activation areas (444) are rendered inactive.
Further, when sensor (480) senses that instrument (410) is in the
position and orientation shown in FIG. 16C, an activation area
(444) positioned on a proximal-most region and on an intermediate
region of clamp arm assembly (450) may be rendered active while
other activation areas (444) are rendered inactive. The activation
areas (444) shown in FIGS. 16A-16C that are rendered active in
response to the particular positions shown are merely exemplary.
Thus, it will be understood that alternative or additional
activation areas (444) may be rendered active in response to
instrument (410) being oriented and grasped in such positions.
Moreover, it will be understood that instrument (410) may be
grasped and oriented in positions other than those shown, and that
various activation areas (444) may be rendered active in response
to instrument (410) being grasped and oriented in such
positions.
[0095] In addition or in the alternative to sensing the position
and/or orientation of instrument (410), instrument (410) may
include sensors that are configured to sense the position of an
operator's hand, fingers, or thumb relative to instrument (410).
For example, as discussed above, activation areas (444) comprise
one or more sensors, that upon receiving a suitable touch gesture
from an operator, communicate a signal to activate the transducer
assembly. These same sensors may also be utilized to sense the
positioning of an operator's hand, fingers, or thumb. For example,
sensors may sense the presence of the operator's finger, thumb, or
other portion of the operator's hand, and may render one or more
particular activation areas (444) active based at least in part on
the sensed grip of the operator's hand on instrument (410). In
other examples, however, a different sensor or set of sensors may
be utilized for detecting the position of an operator's hand,
fingers, or thumb.
[0096] In some examples, instrument (410) is configured to alert a
user of the location of an activation area (444) (FIG. 18, block
506). For instance, in the example shown in FIG. 17, a portion of
body (322) of instrument (310) may illuminate to alert the operator
of the position of the active activation area (344). In addition or
in the alternative to illumination, instrument (310) may alert an
operator with one or more of sound, haptic feedback, or other
suitable notification methods. In addition to alerting an operator
of the location of activation area (444), in some examples,
instrument (410) may be configured to alert the operator of a
particular input gesture. For example, where the input gesture for
a particular activation mode includes a tapping of an operator's
finger or thumb, the alert may be a blinking or pulsing of light
that occurs. For example, such light may blink or pulse
intermittently or continuously. In examples where the input gesture
includes pressing and holding, the alert may comprise a point of
light that shines at a center point initially and that travels
radially outwardly in all directions therefrom as it dissipates in
the center. In examples where the input gesture comprises swiping
or sliding, the alert may comprise progressive illumination of
linearly aligned lights. Additionally or alternatively, the
linearly aligned lights may blink successively to indicate a
particular direction of swiping (e.g., similar to a traffic sign
indicating to get into another lane). In such examples, the lights
may take the form of arrows that point in a particular direction.
In some examples, such illuminating alerts may include non-blinking
or flashing lights. Rather, such illuminating alerts may comprise a
continuously illuminated light or lights. Other suitable manners of
alerting an operator will be apparent to persons skilled in the art
in view of the teachings herein.
[0097] Referring to FIG. 19, instrument (410) may allow for an
operator to customize or program a specific input gesture according
to a specific function of instrument (410). Additionally or
alternatively, instrument (410) may allow for an operator to
specify a location or locations where activation area (444) should
be positioned. In such examples, instrument (410) may include a
programming mode (block 602) which the operator can activate at any
time during use of instrument (410). In some examples, the operator
may activate the programming mode (block 602) prior to utilizing
instrument (410) during a surgical procedure. However, in some
examples, the programming mode may be activated (block 602) during
a surgical procedure in the event the operator desires to change
the controls of instrument (410) during the surgical procedure.
Instrument (410) may then receive the user gesture and user input
location(s) preferences for a first function (blocks 604, 606)
which then may be applied to instrument (410) (block 608). Next, if
applicable, instrument (410) receives the user gesture and user
input location(s) preferences for a second function (blocks 610,
612), which may then be applied to instrument (410) (block 614). In
some instances, instrument (410) receives the user gesture and user
input location(s) preferences for one or more additional functions
(block 616).
[0098] In the present example, the first function may be associated
with delivering a first, "minimum" ultrasonic energy level, while
the second function may be associated with delivering a second,
"maximum" ultrasonic energy level. However, in other examples, the
first and second functions may be associated with other functions
that may be performed of instrument (410) (e.g., application of RF
electrosurgical energy, etc.). In the present example, the steps of
receiving the user's preferences (e.g., blocks 604, 606, 610, 612)
may take place with the user providing such desired gesture inputs
and locations of activation areas on instrument (410) itself. For
example, instrument (410) in the programming mode may prompt a user
to specify the input gestures and locations. In such an example,
the user may perform his or her preferred input gesture on the
instrument (410). By way of example, in order to program a
"proximal 2 cm swipe" as the input gesture for the first function,
the user may perform such an input gesture on an aspect of
instrument (410) during the programming mode. In the present
example, the location of the input gesture as performed during the
programming mode also serves as the activation area for such an
input gesture. However, in some examples, the user may opt to
select one or more different activation areas, or may opt to have
the entire instrument (410), or entire portions of instrument
(e.g., entire handle assembly (420)), act as an activation
area.
[0099] In some examples, the steps of receiving the user's
preferences (e.g., blocks 604, 606, 610, 612) may take place with
the user providing such desired gesture inputs and locations of
activation areas on a graphical user interface. In such examples,
instrument (410) may be in communication with a user interface that
allows a user to select input gesture and location preferences for
one or more functions. In other examples, the user may select the
particular instrument from a list on the user interface. Other
suitable manners of identifying instrument (410) on interface will
be apparent to persons skilled in the art in view of the teachings
herein. In the examples utilizing a GUI, a user may be presented
with a model or graphical representation of instrument (410) on the
user interface. In some examples, user may be able to select input
gestures by performing the input gesture on the model or graphical
representation of the instrument on the user interface,
particularly where the user interface comprises a touch screen. In
other examples, the user may select from a menu of input gestures
and locations of activation areas associated therewith from a
predefined list, such as from a drop down menu. Other suitable
methods and manners of programming particular input gestures and
activation areas will be apparent to persons skilled in the art.
Once the input gestures and locations of activation areas are
applied, the programming mode may be deactivated (block 618) and
operation mode may be activated (block 620). In some examples, the
user may be alerted of the location of an activation area and/or of
a particular input gesture (block 622), in a similar manner as
described above with respect to block (506).
[0100] In some instances, instrument (410) may define a default
input gesture for a particular function. It may be desirable to
change or update such an input gesture in accordance with unifying
controls of older and newer generation devices, for example. In
such an event, referring to FIG. 20, instrument (410) may be
switched to a programming mode (block 702) and then connected to a
centralized system (block 704). The system may investigate and
determine whether settings of instrument (410), such as particular
input gesture(s) are the most recent input gestures programmed onto
instrument (410) (blocks 706, 708). If such settings are up to date
the system ends the investigation (block 710). However, if the
settings are not up to date, the system may prompt a user with the
option of updating the settings to the most up to date settings
(block 712), or to maintain the current settings. If the user
declines to updates the settings, the process ends (block 710).
However, if the user desires to updates the settings, the system
updates the settings with the most up to date settings, such as the
most up to date input gesture(s).
[0101] It will be understood that some or all of the steps of the
methods described herein, such as those shown in FIGS. 18, 19, and
20 may be incorporated into any of the methods described herein,
such as those embodied in flowcharts of FIGS. 18, 19, and 20, or
into other suitable or appropriate methods. Moreover, while the
foregoing teachings have been described with respect to particular
examples of instruments (e.g., instruments (10, 110, 210, 310,
410)), it will be understood that such teachings may be performed
with respect to, or incorporated into other instruments described
herein, or other suitable instruments.
[0102] It will be further understood that using activation areas
comprising sensors (245) in order to activate instruments, such as
those described herein, instead of using mechanical parts such as
buttons, may increase reliability and durability for reusable
devices. Moreover, the physical continuity of body (222) that comes
with a lesser amount of moving parts allows for easier cleaning and
prevents fluid and debris from ingressing into internal portions of
instrument (210) during use and during sterilization. Furthermore,
there are a variety of sensors that may be utilized in particular
instruments. For example, sensors that are programmable (e.g., as
described above) could be utilized in some instruments, while more
limited capability sensors that may only perform a single or a few
functions may be utilized in other instances, such as in more cost
sensitive situations. Moreover, while a sensor or sensors may be
applied to an entire instrument, thus making an entire instrument
an activation area, it is also possible to strategically place such
sensor(s) on smaller regions or portions of instruments. Moreover,
such sensors, particularly projected capacitance sensors, can
assume a variety of characteristics depending on the substrate to
which it is bonded. For example, such sensors may be applied to
substrates including, but not limited to, plastic film, glass, and
others; and can also be over-molded and formed onto substrates.
Other suitable methods of incorporating such sensors onto
substrates and into or onto instruments will be apparent to persons
skilled in the art in view of the teachings herein.
IV. Exemplary Combinations
[0103] 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
[0104] A surgical instrument comprising: (a) a gripping assembly
defining a first opening for receiving a finger or a thumb of a
user, wherein the gripping assembly comprises a first deformable
feature, wherein the first deformable feature is configured to be
moved in order to increase or decrease a cross-sectional area of
the first opening; (b) a shaft assembly extending distally from the
gripping assembly; (c) an end effector, wherein the end effector is
positioned at a distal end of the shaft assembly, wherein the end
effector comprises a first member; and (d) a pivoting member,
wherein the pivoting member is pivotably coupled with the shaft
assembly, wherein the pivoting member is pivotable with respect to
the first member of the end effector between an open position and a
closed position to thereby clamp tissue between the first member
and the pivoting member.
EXAMPLE 2
[0105] The surgical instrument of Example 1, wherein the gripping
assembly defines a second opening for receiving another finger or
thumb of the user, wherein the gripping assembly comprises a second
deformable feature, wherein the second deformable feature is
configured to be moved in order to increase or decrease a
cross-sectional area of the second opening.
EXAMPLE 3
[0106] The surgical instrument of any one or more of Examples 1
through 2, wherein the first deformable feature comprises a
malleable member.
EXAMPLE 4
[0107] The surgical instrument of any one or more of Examples 1
through 3, wherein the first deformable feature comprises a
plurality of movable linkages.
EXAMPLE 5
[0108] The surgical instrument of any one or more of Examples 1
through 4, wherein the gripping assembly and the pivoting member
cooperate to provide a scissor grip configuration.
EXAMPLE 6
[0109] The surgical instrument of any one or more of Examples 1
through 5, wherein the first opening includes a tapered
portion.
EXAMPLE 7
[0110] The surgical instrument of any one or more of Examples 1
through 6, wherein the first member of the end effector comprises
an ultrasonic blade.
EXAMPLE 8
[0111] The surgical instrument of Example 7, wherein the pivoting
member comprises a clamp arm including a clamp pad, Example the
clamp arm is member is pivotable with respect to the blade to
thereby clamp tissue between the ultrasonic blade and the clamp
pad.
EXAMPLE 9
[0112] The surgical instrument of Example 8, further comprising a
movable sheath configured to selectively envelop a portion of the
ultrasonic blade.
EXAMPLE 10
[0113] The surgical instrument of Example 9, wherein the gripping
member further comprises an actuating member, wherein the sheath is
configured to move relative to the ultrasonic blade in response to
actuation of the actuating member.
EXAMPLE 11
[0114] The surgical instrument of any one or more of Examples 9
through 10, wherein the sheath is slidable between a proximal
position and a distal position along the ultrasonic blade, wherein
the sheath in the distal position is configured to increase the
effective cross sectional area of a distal portion of the end
effector.
EXAMPLE 12
[0115] The surgical instrument of any one or more of Examples 9
through 11, wherein the sheath comprises a textured outer
surface.
EXAMPLE 13
[0116] The surgical instrument of Example 12, wherein the textured
outer surface comprises knurling.
EXAMPLE 14
[0117] The surgical instrument of any one or more of Examples 7
through 13, further comprising an ultrasonic transducer assembly,
wherein the ultrasonic transducer assembly is in acoustic
communication with the ultrasonic blade.
EXAMPLE 15
[0118] The surgical instrument of Example 14, wherein the
ultrasonic transducer assembly is integral with at least part of
the gripping portion.
EXAMPLE 16
[0119] A surgical instrument comprising: (a) a body; (b) a shaft
assembly extending distally from the body; (c) an end effector at a
distal end of the shaft assembly, wherein the end effector
comprises: (i) a first member, and (ii) a second member, wherein
the second member is pivotable relative to the first member from an
open position to a closed position to thereby clamp tissue between
the first member and the second member, wherein the end effector
defines a first cross sectional area when the second member is in
the closed position; and (d) a sheath movable between a first
position and a second position relative to the end effector,
wherein the end effector defines a second cross sectional area when
the sheath is in the second position and the second member is in
the closed position.
EXAMPLE 17
[0120] A surgical instrument comprising: (a) a body; (b) a shaft
assembly extending distally from the body; (c) an end effector at a
distal end of the shaft assembly, wherein the end effector has an
active element; and (d) a touch sensitive activation area
positioned on at least one of the body or the shaft assembly,
wherein the touch sensitive activation area comprises a sensor
configured to receive a touch input, wherein the touch sensitive
activation area is configured to activate the active element of the
end effector in response to the sensor receiving a touch input.
EXAMPLE 18
[0121] The surgical instrument of Example 17, wherein the sensor
comprises a projected capacitive sensor.
EXAMPLE 19
[0122] The surgical instrument of any one or more of Examples 17
through 18, wherein the touch sensitive activation area is movable
based on a position of the body and/or the shaft assembly.
EXAMPLE 20
[0123] The surgical instrument of any one or more of Examples 17
through 19, wherein a position of the touch sensitive activation
area is movable based on an input from a user.
V. Miscellaneous
[0124] 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. Other types of instruments into which the
teachings herein may be incorporated will be apparent to those of
ordinary skill in the art.
[0125] 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.
[0126] 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.
[0127] 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.
[0128] 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.
[0129] 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.
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