TRANSLATABLE OUTER TUBE FOR SEALING USING SHIELDED LAP CHOLE DISSECTOR

• US 20170000512A1
• Filed: 06/30/2015
• Published: 01/05/2017
• Est. Priority Date: 06/30/2015
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Gallmeyer, Thomas C., Conlon, Sean P., Schulte, John B., Denzinger, Kristen G., Kirk, Jeffery T.
• Granted Patent: US 10,357,303 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• 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 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320078 Tissue manipulating surface
• CPC Class Codes: A61B 2017/320082 for incising tissue
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument

Abstract

Aspects of the present disclosure are presented for a surgical instrument for cutting and sealing tissue. In some embodiments, the surgical instrument includes a handle assembly, a shaft, and an end effector. The end effector may include: a blade that vibrates at an ultrasonic frequency, a shielded portion enclosing a back edge of the blade, a high-friction surface coupled to the shielded portion and positioned between the shielded portion and the back edge of the blade. A space is defined between the high-friction surface and the back edge of the blade when the end effector is in a cutting configuration. In a sealing configuration, the high-friction surface contacts the back edge of the blade, which generates heat based on ultrasonic vibrations of the blade rubbing against the high-friction surface. The shielded portion can coagulate bleeding tissue based on heat transfer from the high-friction surface to the shielded portion.

Claims

1. An end effector, comprising:

a blade having a cutting edge configured to dissect and coagulate tissue and a back edge, the blade is configured to couple to an ultrasonic waveguide and configured to vibrate at ultrasonic frequency to dissect and coagulate the tissue;

a shielded portion enclosing the back edge of the blade; and

a high-friction surface coupled to the shielded portion and positioned between the shielded portion and the back edge of the blade, wherein a space is defined between the high-friction surface and the back edge of the blade when the end effector is configured into a dissecting configuration;

wherein, when the end effector is configured into a sealing configuration, the high-friction surface contacts the back edge of the blade and is configured to generate heat by frictionally coupling the ultrasonic vibrations of the blade to the high-friction surface, and wherein the shielded portion is configured to coagulate tissue by coupling heat from the high-friction surface to the tissue.

2. The end effector of claim 1, further comprising at least one low-friction surface coupled to the shielded portion and positioned alongside a lateral edge of the blade, the low-friction surface configured to permit ultrasonic vibration of the blade upon contacting the low-friction surface based on a lateral movement of the blade.

3. The end effector of claim 1, further comprising a shaft including a fulcrum component configured to couple to the ultrasonic waveguide positioned within the shaft.

4. The end effector of claim 3, wherein the fulcrum is positioned at a node based on a frequency of the ultrasonic vibrations.

5. The end effector of claim 1, further comprising a protective hood coupled to the shielded portion and covering at least a portion of the distal end of the blade.

6. The end effector of claim 1, further comprising an indentation grooved into a proximal end of the shielded portion and configured to flexibly enable the shielded portion to bend upon applying a force against the side of the shielded portion opposite the position of the blade.

7. The end effector of claim 1, further comprising a sliding mechanism configured to slide the shielded portion and the blade in and out of the end effector.

8. The end effector of claim 1, wherein the shielded portion is further configured to rotate around the blade such that the high-friction surface is configured to touch the back edge of the blade in a first rotational configuration and the high-friction surface is configured to touch the cutting edge of the blade in a second rotational configuration.

9. A surgical instrument, comprising:

a handle assembly;

an ultrasonic transducer configured to produce ultrasonic vibrations;

a shaft coupled to the handle assembly, the shaft comprising;

an ultrasonic waveguide coupled to the ultrasonic transducer and configured to vibrate at an ultrasonic frequency; and

a slidable lever configured to slide back and forth within the shaft; and

an end effector comprising;

a blade having a cutting edge configured to cut tissue and a back edge, the blade coupled to the ultrasonic waveguide and configured to vibrate at the ultrasonic frequency to cut the tissue;

a heating pad comprising a high-friction surface enclosing a portion of the blade or the ultrasonic waveguide and coupled to the slidable lever, wherein a space is defined between the high-friction surface and the blade or the ultrasonic waveguide when the end effector is configured into a cutting configuration;

wherein, when the end effector is configured into a sealing configuration, the slidable lever is configured to slide proximally toward the handle assembly, causing the high-friction surface to contact the blade or the ultrasonic waveguide , wherein the high-friction surface is configured to generate heat by frictionally coupling ultrasonic vibrations from the blade or the ultrasonic waveguide contacting the high-friction surface, and wherein the back edge of the blade is configured to coagulate tissue based on heat transfer from the high-friction surface to the back edge.

10. The surgical instrument of claim 9, wherein the handle assembly further comprises a power button configured to control a time duration of the sealing configuration that limits an amount of time that the high-friction surface generates heat via the ultrasonic vibrations of the blade or the ultrasonic waveguide.

11. The surgical instrument of claim 10, wherein the power button is communicably coupled to the slidable lever and is further configured to slide the slidable lever proximally toward the handle assembly when the power button is pressed.

12. The surgical instrument of claim 10, wherein the handle assembly further comprises:

an activation sled coupled to the power button and configured to slide proximally, perpendicular to the direction of the power button as the power button is pressed down;

an activation magnet coupled to the activation end;

a processor; and

a sensor communicably coupled to the processor and positioned near the activation magnet;

wherein when the activation sled is slid proximally based on the power button being pressed, the activation magnet is configured to move sufficiently close to the sensor to activate the sensor and cause the sensor to trigger a timing procedure in the processor that limits the amount of time that the high-friction surface generates heat.

13. The surgical instrument of claim 10, wherein the handle assembly comprises a second button communicably coupled to the slidable lever and configured to slide the slidable lever when the second button is pressed down.

14. The surgical instrument of claim 9, wherein the shaft further comprises a fulcrum component coupled to the ultrasonic waveguide and positioned within the shaft, wherein the ultrasonic waveguide is fastened within the shaft by the fulcrum at a distal end from the handle assembly and is otherwise suspended within the shaft.

15. The surgical instrument of claim 14, wherein the fulcrum is positioned at a distance away from the handle assembly equal to a harmonic node based on a frequency of the ultrasonic vibrations of the ultrasonic waveguide.

16. The surgical instrument of claim 9, wherein:

the handle assembly further comprises a sliding mechanism;

the slidable lever is coupled to the sliding mechanism on a proximal end of the slidable lever and coupled to the shielded portion on a distal end of the slidable lever;

a proximal end of the shielded portion is fastened to a base at a proximal end of the blade via a rotatable hinge; and

the shielded portion is configured to be controlled based on manipulation of the sliding mechanism via the slideable lever and a pivot caused by the fastening of the rotatable hinge.

17. A surgical instrument, comprising:

a handle assembly;

an ultrasonic transducer;

a shaft coupled to the handle assembly, the shaft comprising;

an ultrasonic waveguide configured to vibrate at an ultrasonic frequency; and

a rotatable inner tube configured to rotate within the shaft; and

an end effector comprising;

a blade having a cutting edge configured to cut tissue and a back edge, the blade coupled to the ultrasonic waveguide and configured to vibrate at the ultrasonic frequency to cut the tissue;

a rotatable member coupled to the rotatable inner tube;

a shielded portion coupled to the rotatable member and enclosing the back edge of the blade;

a high-friction surface coupled to the shielded portion and positioned between the shielded portion and the back edge of the blade, wherein there is a space between the high-friction surface and the back edge of the blade when the end effector is configured into a cutting configuration;

wherein, when the end effector is configured into a sealing configuration, the shielded portion is rotated onto the blade based on rotation of the rotatable inner tube, such that the high-friction surface touches the back edge of the blade and is configured to generate heat based on ultrasonic vibrations of the blade rubbing against the high-friction surface, and wherein the shielded portion is configured to coagulate tissue based on heat transfer from the high-friction surface to the shielded portion.

18. The surgical device of claim 17, wherein the end effector is configured to slide into and out of a trocar when the end effector is configured into the sealing configuration, and the end effector is configured to not slide into or out of the trocar when the end effector is configured into the cutting configuration, based on the rotatable member being rotated beyond the shape of the end effector.

19. The surgical device of claim 17, wherein:

the rotatable inner tube comprises a cam positioned at a distal end of the rotatable inner tube; and

the rotatable member comprises a knob positioned at a proximal end of the rotatable member such that the knob fastens into the cam of the rotatable inner tube.

20. The surgical device of claim 19, wherein the rotatable member comprises an axle positioned at an outer edge of the rotatable member, wherein the axle is coupled to an anchor affixed to an outer edge of the end effector, such that the rotatable member is configured to rotate based on rotational movement of the cam, using the position of the axle as a center axis of rotation for the rotatable member.