Ultrasonic surgical system

• US 20080300611A1
• Filed: 05/29/2007
• Published: 12/04/2008
• Est. Priority Date: 05/29/2007
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Stulen, Foster B., Houser, Kevin L., Muir, Stephanie J.
• Granted Patent: US 9,271,751 B2
• Time in Patent Office: Days
• US Class Current: 606/167
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320075 single edge blade, e.g. for cutting
• CPC Class Codes: A61B 2017/320084 Irrigation sleeves
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61B 2217/005 with suction drainage system

Abstract

An ultrasonic surgical system includes an ultrasonic transmission member having a proximal end and a distal end. An ultrasonically actuated end-effector is attached at the distal end of the transmission member. A pressurized fluid delivery system includes a fluid nozzle in communication with at least one fluid source. The fluid nozzle is arranged and configured to deliver pressurized fluid to soft tissue at a rate to move the soft tissue away from the end-effector during use.

Claims

1. An ultrasonic surgical system, comprising:

an ultrasonic transmission member having a proximal end and a distal end;

an ultrasonically actuated end-effector attached at the distal end of the transmission member; and

a pressurized fluid delivery system including a fluid nozzle in communication with at least one fluid source, the fluid nozzle arranged and configured to deliver pressurized fluid to soft tissue at a rate to move the soft tissue away from the end-effector during use.

2. The ultrasonic surgical system of claim 1 further comprising:

an inner sheath disposed about the ultrasonic transmission member; and

an outer sheath disposed about the inner sheath and spaced radially therefrom to define a fluid passageway for directing the pressurized fluid to the fluid nozzle.

3. The ultrasonic surgical system of claim 2 further comprising a hand piece that is graspable by a user, the hand piece including an ultrasonic transducer operatively connected to the waveguide, the hand piece including a user control located thereon that allows for user control of pressurized fluid delivery.

4. The ultrasonic surgical system of claim 1 further comprising an outer sheath disposed about the ultrasonic transmission member to define a fluid passageway for directing the pressurized fluid to the fluid nozzle.

5. The ultrasonic surgical system of claim 1 configured to deliver fluid from the fluid nozzle at a rate of at least about 20 ml/sec.

6. The ultrasonic system of claim 1, wherein the pressurized fluid delivery system includes multiple fluid sources.

7. The ultrasonic system of claim 6, wherein the multiple fluid sources include a first fluid source including a first fluid and a second fluid source including a second fluid that is different from the first fluid.

8. The ultrasonic system of claim 6, wherein the multiple fluid sources include a first fluid source configured to provide a fluid at a first pressure and a second fluid source configured to provide a fluid at a second pressure different from the first pressure.

9. The ultrasonic surgical system of claim 1, wherein the end-effector is a composite end-effector comprising

a first portion comprising a first material having a first thermal conductivity;

and

a second portion comprising a second material having a second thermal conductivity that is higher than the first thermal conductivity.

10. The ultrasonic surgical system of claim 1, wherein the end-effector is a composite end-effector comprising:

a first portion comprising a lossy material that self-heats to provide heat to tissue during use; and

a second portion comprising a non-lossy material that limits heat provided to tissue during use.

11. The ultrasonic surgical system of claim 1, wherein the end-effector is a composite end-effector comprising diamond particles disposed in a matrix of metal material, the diamond particles being exposed at a surface of the end-effector for contact with tissue during use.

12. An ultrasonic surgical system, comprising:

an ultrasonic transmission member;

an ultrasonically actuated end-effector attached to the transmission member; and

a sheath that is moveable relative to the end-effector, the sheath having a first configuration in which the sheath covers the end-effector to inhibit interaction with tissue by the end-effector and a second configuration in which the end-effector is exposed beyond the sheath to interact with tissue.

13. The ultrasonic surgical system of claim 12 further comprising a biasing member operatively connected to the sheath such that the sheath is biased toward the first configuration.

14. The ultrasonic surgical system of claim 13 further comprising:

a connector member fixedly connected to the transmission member, the connector member including an axial portion and a radial portion extending outwardly from the axial portion, the biasing member being located between the connector member and the sheath to bias the sheath toward the first configuration.

15. The ultrasonic surgical system of claim 14, wherein the biasing member is a spring.

16. The ultrasonic surgical system of claim 12 further comprising a fluid delivery system, a distal end of the sheath defining a fluid nozzle for delivering pressurized fluid to tissue during use.

17. The ultrasonic surgical system of claim 12, wherein the end-effector is a composite end-effector comprising

a first portion comprising a first material having a first thermal conductivity;

and

a second portion comprising a second material having a second thermal conductivity that is higher than the first thermal conductivity.

18. A method of treating tissue using an ultrasonic surgical system, the method comprising:

locating an ultrasonically actuated end-effector attached at a distal end of an ultrasonic transmission member in proximity to tissue; and

directing pressurized fluid onto soft tissue at a rate to move the soft tissue away from the end-effector using a pressurized fluid delivery system including a fluid nozzle in communication with at least one fluid source.

19. The method of claim 18, wherein the fluid nozzle is defined by a sheath that surrounds the ultrasonic transmission member.

20. The method of claim 19 further comprising moving the sheath from a first configuration in which the sheath covers the end-effector to inhibit interaction with tissue by the end-effector and a second configuration in which the end-effector is exposed beyond the sheath to interact with tissue.

21. The method of claim 20 further comprising biasing the sheath toward the first configuration.

22. An ultrasonic surgical system, comprising

a surgical instrument having a distal end adapted to perform a surgical procedure on a patient and a proximal end adapted to be controllable by an operator, the instrument including a pressure lumen having sufficient burst strength to conduct a high pressure liquid towards the distal end of the instrument, the pressure lumen including at least one nozzle providing a jet opening, the nozzle being shaped to form a liquid jet as a liquid at high pressure flows therethrough;

an evacuation lumen, including a jet-receiving opening having a cross-sectional area and locatable opposite the jet opening at a predetermined distance therefrom to receive a liquid jet when the instrument is in operation and to deliver the liquid from the surgical site in the form of a liquid column; and

an ultrasonic system configured to impart ultrasonic energy to one or more of the pressure lumen, liquid jet, evacuation lumen and liquid column.

23. The ultrasonic system of claim 22, wherein the ultrasonic system comprises an ultrasonic transducer connected to the pressure lumen, the ultrasonic transducer configured to impart longitudinal vibratory motion to the pressure lumen while high pressure liquid flows therethrough.

24. The ultrasonic system of claim 22, wherein the ultrasonic system comprises an ultrasonic transducer connected to the pressure lumen, the ultrasonic transducer configured to decrease a diameter of the pressure lumen in multiple vibratory pulses while high pressure liquid flows therethrough.

25. The ultrasonic system of claim 22, wherein the ultrasonic system comprises an ultrasonic transducer connected to the evacuation lumen, the ultrasonic transducer configured to impart longitudinal vibratory motion to the pressure lumen while high pressure liquid flows therethrough.

26. The ultrasonic system of claim 22, wherein the ultrasonic system comprises an ultrasonic transducer connected to the evacuation lumen, the ultrasonic transducer configured to decrease a diameter of the evacuation lumen in multiple vibratory pulses while the liquid column flows therethrough.

27. An ultrasonic surgical system, comprising:

an ultrasonic transmission member having a proximal end and a distal end; and

an ultrasonically actuated end-effector attached at the distal end of the transmission member, the end-effector being a composite end-effector comprising diamond particles disposed in a matrix of metal material, the diamond particles being exposed at a surface of the end-effector for contact with tissue during use.