Ultrasonic surgical instruments

• US 8,663,220 B2
• Filed: 07/15/2009
• Issued: 03/04/2014
• Est. Priority Date: 07/15/2009
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Wiener, Eitan T., Wan, Shan, Price, Daniel W., Norvell, David K., Giordano, James R.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): VAHDAT, KHADIJEH A
• Application Number:
  US12/503,769
• Publication Number:
  US 20110015631A1
• Time in Patent Office: 1,693 Days
• Field of Search: 606 32- 52, 606/169, 606205-207
• US Class Current: 606/42
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/00393 with means for switching between functions
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

In one general aspect, various embodiments are directed to a surgical instrument that can supply mechanical energy and electrical energy to an end effector of the surgical instrument. The surgical instrument may be operated in a first operating mode in which a transducer of the surgical instrument produces mechanical energy, or vibrations, that are transmitted to the end effector and a second operating mode in which electrical energy, or current, can flow through the end effector to perform electrosurgery. In another general aspect, the surgical instrument may comprise a clamp, or jaw, which can be moved into a closed position to hold tissue against a waveguide, or blade, of the end effector. In the second operating mode of the surgical instrument, current can flow from a power source, through the waveguide, and return to the power source through a path comprising the jaw.

Claims

1. A surgical instrument, comprising:

a handpiece housing;

an acoustic assembly supported within said handpiece housing, wherein said acoustic assembly is configured to produce vibrations;

a waveguide comprising a proximal end and a distal end, wherein said proximal end is mounted to said acoustic assembly such that vibrations produced by said acoustic assembly are transmitted to said waveguide, wherein said distal end comprises a blade, and wherein said blade comprises a widest portion and a first width defined across said widest portion;

a clamp movable between an open position and a closed position relative to said waveguide, wherein said clamp comprises;

a distal end; and

an electrode comprising;

a body portion;

a first sidewall projecting from said body portion; and

a second sidewall projecting from said body portion, wherein said body portion extends between said first and second sidewalls to said distal end of said clamp, and wherein said body portion comprises a second width between said first sidewall and said second sidewall, and wherein said second width is greater than said first width;

a first conductor in electrical communication with said waveguide; and

a second conductor in electrical communication with said electrode of said clamp, wherein said first conductor and said second conductor are configured to be placed in electrical communication with a power source such that current can flow between said waveguide and said electrode of said clamp through tissue in contact with said waveguide and said electrode of said clamp.

2. The surgical instrument of claim 1, wherein said clamp is not in direct contact with said waveguide.

3. The surgical instrument of claim 1, further comprising a control unit, wherein said control unit is configured to operate said surgical instrument in a first operating mode in which said acoustic assembly produces vibrations and a second operating mode in which current flows through a circuit comprising said first conductor, said waveguide, said clamp, tissue in contact with said waveguide and said clamp, and said second conductor.

4. The surgical instrument of claim 3, further comprising a switch, wherein said switch is configured to switch said surgical instrument between said first operating mode and said second operating mode.

5. The surgical instrument of claim 1, wherein said surgical instrument further comprises a sheath at least partially surrounding said waveguide, wherein said clamp comprises a proximal end pivotably mounted to said sheath, and wherein said distal end of said clamp and said distal end of said waveguide are configured to be placed against tissue such that current can flow between said distal end of said waveguide and said distal end of said clamp through the tissue.

6. The surgical instrument of claim 1, wherein said surgical instrument further comprises a sheath at least partially surrounding said waveguide, wherein said clamp comprises a proximal end pivotably mounted to said sheath, and wherein said second conductor is at least partially embedded in said sheath.

7. The surgical instrument of claim 1, wherein said electrode of said clamp is in electrical communication with said second conductor.

8. The surgical instrument of claim 1, wherein said current can flow between said waveguide and said first sidewall through tissue positioned between said waveguide and said first sidewall.

9. The surgical instrument of claim 1, wherein a gap is defined between said waveguide and said first sidewall when said clamp is in said closed position.

10. The surgical instrument of claim 1, wherein said waveguide comprises a first side and a second side, wherein said first sidewall extends laterally with respect to said first side of said waveguide when said clamp is in said closed position, wherein said second sidewall extends laterally with respect to said second side of said waveguide when said clamp is in said closed position.

11. The surgical instrument of claim 10, wherein said current can flow between said waveguide and said first and second sidewalls through tissue positioned between said waveguide and said first and second sidewalls.

12. The surgical instrument of claim 10, wherein a first gap is defined between said waveguide and said first sidewall and a second gap is defined between said waveguide and said second sidewall.

13. The surgical instrument of claim 1, wherein said clamp comprises a tissue-contacting surface.

14. The surgical instrument of claim 13, wherein a gap is defined between said clamp tissue-contacting surface and said waveguide when said clamp is in said closed position.

15. The surgical instrument of claim 13, wherein said first and second sidewalls extend beyond said clamp tissue-contacting surface when said clamp is in said closed position.

16. The surgical instrument of claim 13, wherein said clamp further comprises a non-conductive tissue-contacting pad secured to said clamp tissue contacting surface.

17. The surgical instrument of claim 1, wherein said waveguide further comprises a tissue-contacting surface.

18. The surgical instrument of claim 17, wherein said first and second sidewalls extend beyond said waveguide tissue-contacting surface when said clamp is in said closed position.

19. The surgical instrument of claim 1, wherein said current is a radio frequency (RF) current.

20. The surgical instrument of claim 19, wherein said RF current is a therapeutic RF current.

21. The surgical instrument of claim 19, wherein said RF current is a subtherapeutic RF current.

22. A surgical instrument, comprising:

a handpiece housing;

an acoustic assembly supported within said handpiece housing, wherein said acoustic assembly is configured to produce vibrations;

a waveguide comprising a proximal end and a distal end, wherein said proximal end is mounted to said acoustic assembly such that vibrations produced by said acoustic assembly are transmitted to said waveguide, wherein said waveguide further comprises a waveguide tissue-contacting surface, wherein said distal end comprises a blade, and wherein said blade comprises a widest portion and a first width measured across said widest portion; and

a clamp movable between an open position and a closed position relative to said waveguide, wherein said clamp comprises;

a distal end;

a clamp tissue-contacting surface, wherein said clamp tissue-contacting surface is positioned at least one of against or adjacent to said waveguide tissue-contacting surface when said clamp is in said closed position; and

an electrode, wherein said electrode comprises;

a first sidewall extending beyond said clamp tissue-contacting surface, wherein said first sidewall also extends beyond said waveguide tissue-contacting surface when said clamp is in said closed position;

a second sidewall extending beyond said clamp tissue-contacting surface, wherein said second sidewall also extends beyond said waveguide tissue-contacting surface when said clamp is in said closed position; and

a body portion extending between said first and second sidewalls to said distal end of said clamp, wherein said body portion comprises a second width measured between said first sidewall and said second sidewall, and wherein said second width is greater than said first width.

23. The surgical instrument of claim 22, wherein said waveguide comprises a first side and a second side, wherein said first sidewall extends laterally with respect to said first side of said waveguide when said clamp is in said closed position, and wherein said second sidewall extends laterally with respect to said second side of said waveguide when said clamp is in said closed position.

24. The surgical instrument of claim 22, further comprising:

a first conductor in electrical communication with said waveguide; and

a second conductor in electrical communication with said electrode of said clamp, wherein said first conductor and said second conductor are configured to be placed in electrical communication with a power source such that current can flow between said waveguide and said electrode of said clamp through tissue in contact with said waveguide and said electrode of said clamp.

25. The surgical instrument of claim 22, wherein said clamp tissue-contacting surface defines a first plane, wherein said waveguide tissue-contacting surface defines a second plane, and wherein said first and second sidewalls extend though said first plane and said second plane when said clamp is in said closed position.

26. The surgical instrument of claim 25, wherein said first and second sidewalls extend through said first plane and said second plane when said clamp is in a partially-closed position.

27. The surgical instrument of claim 26, wherein said first and second sidewalls do not extend through said second plane when said clamp is in said open position.