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08/16/07 - USPTO Class 600 |  192 views | #20070191713 | Prev - Next | About this Page  600 rss/xml feed  monitor keywords

Ultrasonic device for cutting and coagulating

USPTO Application #: 20070191713
Title: Ultrasonic device for cutting and coagulating
Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation, and fine dissection required in fine and delicate surgical procedures. The assembly includes a clamping mechanism, including a clamp arm cam-mounted at the distal portion of the instrument, which is specifically configured to create a desired level of tissue clamping forces. The balanced blade provides a functional asymmetry for improved visibility at the blade tip and a multitude of edges and surfaces, designed to provide a multitude of tissue effects: clamped coagulation, clamped cutting, grasping, back-cutting, dissection, spot coagulation, tip penetration and tip scoring. The assembly also features hand activation configured to provide an ergonomical grip and operation for the surgeon. Hand switches are placed in the range of the natural axial motion of the user's index or middle fingers, whether gripping the surgical instrument right-handed or left handed. (end of abstract)



Agent: Philip S. Johnson Johnson & Johnson - New Brunswick, NJ, US
Inventors: Stephen E. Eichmann, Karen Kowalski Isaacs, Kenneth S. Kramer, Michael R. Lamping, Ashvani K. Madan, Matthew C. Miller, Aaron C. Voegele, Eitan T. Wiener, Joseph E. Young
USPTO Applicaton #: 20070191713 - Class: 600471000 (USPTO)

Related Patent Categories: Surgery, Diagnostic Testing, Detecting Nuclear, Electromagnetic, Or Ultrasonic Radiation, Ultrasonic, Structure Of Transducer Or Probe Assembly, Probe Placed In Vascular System Or Body Orifice, Catheter,

Ultrasonic device for cutting and coagulating description/claims


The Patent Description & Claims data below is from USPTO Patent Application 20070191713, Ultrasonic device for cutting and coagulating.

Brief Patent Description - Full Patent Description - Patent Application Claims
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REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims the priority benefit of U.S. provisional patent application Ser. No. 60/726,625, filed on Oct. 14, 2005.

FIELD OF THE INVENTION

[0002] The present invention generally relates to ultrasonic surgical systems and, more particularly, to an ultrasonic device that is optimized to allow surgeons to perform cutting, coagulation, and fine dissection required in fine and delicate surgical procedures such as a thyroidectomy.

BACKGROUND OF THE INVENTION

[0003] Ultrasonic surgical instruments are finding increasingly widespread applications in surgical procedures by virtue of the unique performance characteristics of such instruments. Depending upon specific instrument configurations and operational parameters, ultrasonic surgical instruments can provide substantially simultaneous cutting of tissue and homeostasis by coagulation, desirably minimizing patient trauma. The cutting action is typically effected by an end-effector at the distal end of the instrument, which transmits ultrasonic energy to tissue brought into contact with the end-effector. Ultrasonic instruments of this nature can be configured for open surgical use, laparoscopic or endoscopic surgical procedures including robotic-assisted procedures.

[0004] Ultrasonic surgical instruments have been developed that include a clamp mechanism to press tissue against the blade of the end-effector in order to couple ultrasonic energy to the tissue of a patient. Such an arrangement (sometimes referred to as a clamp coagulator shears or an ultrasonic transector) is disclosed in U.S. Pat. Nos. 5,322,055; 5,873,873 and 6,325,811. The surgeon activates the clamp arm to press the clamp pad against the blade by squeezing on the handgrip or handle.

[0005] Some current designs of clamp coagulator shears utilize a foot pedal to energize the surgical instrument. The surgeon operates the foot pedal while simultaneously applying pressure to the handle to press tissue between the jaw and blade to activate a generator that provides energy that is transmitted to the cutting blade for cutting and coagulating tissue. Key drawbacks with this type of instrument activation include the loss of focus on the surgical field while the surgeon searches for the foot pedal, the foot pedal getting in the way of the surgeon's movement during a procedure and surgeon leg fatigue during long cases.

[0006] Various methods have been disclosed for curved end effector balancing, which include repositioning the mass along the end effector. The drawbacks of such methods are i) high stresses in the curved region, which makes the end effector more prone to fracture if it comes in contact with metal during surgery; ii) a shorter active length, which limits the vessel size that can be operated on, (the active length is defined as the length from the distal end of the blade to where the displacement is one half of the displacement at its distal end); and/or iii) the inability to separately balance orthogonal displacements.

[0007] Some current designs of clamp coagulator shears. utilize handles that are either of a pistol or scissors grips design. The scissor grip designs may have one thumb or finger grip that is immovable and fixed to the housing and one movable thumb or finger grip. This type of grip may not be entirely familiar to surgeons who use other open-type surgical instruments, such as hemostats, where both thumb and finger grips move in opposition to one another. Current designs have scissor arms that rotate around a fixed pivot or rotation point that is perpendicular to the longitudinal axis of the working element. This approach is limited since the relative motion between the two arms is completely rotational. This feature limits the ability to control the pressure profile between the two working ends when fully closed.

[0008] Some current designs of clamp coagulator shears are not specifically designed for delicate procedures where precise dissection, cutting and coagulation are required. An exemplary procedure is a thyroidectomy where precise dissection, cutting and coagulation is required to avoid critical blood vessels and nerve bundles.

[0009] It would be desirable to provide an ultrasonic surgical instrument that overcomes some of the deficiencies of current instruments. The ultrasonic surgical instrument described herein overcomes those deficiencies.

BRIEF SUMMARY OF THE INVENTION

[0010] An ultrasonic clamp coagulator assembly embodying the principles of the present invention is configured to permit selective dissection, cutting, coagulation and clamping of tissue during surgical procedures.

[0011] A first expression of a first embodiment of the invention is for an ultrasonic waveguide including an ultrasonically actuated blade attached to the distal end of the waveguide; a tissue pad having a tissue engaging surface having a first width and a second width less than the first width; and a clamp member defining a distal portion and a proximal portion and moveable with respect to the blade and having an open position in which at least a portion of the clamp member is spaced from the blade and a closed position in which the clamp member is adjacent to the blade for clamping tissue between the tissue pad and the blade.

[0012] A second expression of a first embodiment includes a clamp member defining a first dimension and a second dimension in a first plane and the first dimension is greater than the second dimension and further defining a first dimension and a second dimension in a second plane and the first dimension is greater than the second dimension.

[0013] A first expression of a third embodiment includes a method of assembling a sterilized ultrasonic clamp coagulator apparatus including the steps of providing an ultrasonic waveguide having a proximal end and a distal end and an ultrasonically actuated blade attached to the distal end of the waveguide; a tissue pad having a flange and a tissue engaging surface having a first width and a second width less than the first width; a clamp member moveable with respect to said end-effector and having an open position in which at least a portion of the clamp member is spaced from the blade and a closed position in which the clamp member is adjacent to the blade for clamping tissue between the tissue pad and the blade, and where the clamp member includes a slot for slidably receiving the flange and slidably engaging the flange within the slot and then sterilizing the clamp coagulator apparatus.

[0014] A first expression of a fourth embodiment of an ultrasonic surgical instrument is for a housing configured to accept a transducer and further defining a longitudinal axis; a first switch positioned on the housing for actuation by one or more fingers of a user in a direction parallel to the longitudinal axis and further electrically connected to a generator for providing an electrical signal to the generator for controlling a first level of ultrasonic energy delivered by the transducer.

[0015] A second expression of a fourth embodiment of an ultrasonic surgical instrument is for a second switch positioned on the housing for actuation by one or more fingers of a user in a direction parallel to the longitudinal axis and further electrically connected to a generator for providing an electrical signal to the generator for controlling a second level of ultrasonic energy delivered by the transducer.

[0016] A first expression of a fifth embodiment of an ultrasonic surgical instrument is for an ultrasonic waveguide defining a longitudinal axis, having a proximal end, a most distal node and a distal end and an ultrasonically actuated blade positioned at the distal end of the waveguide and which defines a functional asymmetry within a first plane, a first balance asymmetry distal to the most distal node and proximal to the blade; and a second balance asymmetry proximal to the most distal node.

[0017] A first expression of a sixth embodiment of an ultrasonic surgical instrument is for a housing, an outer shroud having a proximal end joined to the housing, an ultrasonic waveguide positioned within the outer tube, an ultrasonically actuated blade positioned at the distal end of the waveguide, and an actuating lever for operating a clamp arm located at the distal end of the lever. The actuating lever has camming members, which operatively engage the outer tube such that movement of the actuating lever positions the clamp arm between open and clamped positions relative to the blade.

[0018] A second expression of a sixth embodiment of an ultrasonic instrument is for stationary finger ring that defines an opening having a length L and the housing and a transducer are sized to position a center of gravity of the surgical instrument at the housing within the dimension of length L.

[0019] A first expression of a first embodiment of a torque wrench for use with an ultrasonic clamp coagulator apparatus is for a hand wrench body, a cantilever arm movably attached to said wrench body, at least one tooth located at the cantilever arm's distal end, and an adaptor rotatably attached to the hand wrench and comprising a cam for operatively engaging the tooth.

BRIEF DESCRIPTION OF THE FIGURES

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