SURGICAL INSTRUMENTS INCORPORATING ULTRASONIC AND ELECTROSURGICAL FUNCTIONALITY

Abstract

A surgical instrument end effector assembly includes a first jaw member and a second jaw member. The second jaw member includes an ultrasonic blade body and first and second electrodes disposed on either side of the ultrasonic blade body and extending longitudinally along a majority of a length of the ultrasonic blade body. The ultrasonic blade body is adapted to receive ultrasonic energy from an ultrasonic waveguide. The first and second electrodes taper in width proximally to distally and are adapted to connect to a source of electrosurgical energy. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween.

Claims

1. An end effector assembly of a surgical instrument, comprising: first and second jaw members, the first jaw member movable relative to the second jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween; and first, second, and third electrodes, at least one of which is associated with the first jaw member and at least another of which is associated with the second jaw member, wherein the first, second, and third electrodes are configured to be energized with Radio-Frequency (RF) energy in a three-phase configuration for treating tissue grasped between the first and second jaw members.

2. The end effector assembly according to claim 1, wherein the first, second, and third electrodes are configured to be energized with RF energy waves that are 120 degrees out of phase with respect to one another.

3. The end effector assembly according to claim 1, wherein the first, second, and third electrodes are configured to be energized with RF energy waves at 50% duty cycle.

4. The end effector assembly according to claim 1, wherein the first, second, and third electrodes are configured to be energized with RF energy sine waves or RF energy square waves.

5. The end effector assembly according to claim 1, wherein the first and second electrodes are associated with the first jaw member and wherein the third electrode is associated with the second jaw member.

6. The end effector assembly according to claim 5, wherein the first and second electrodes are disposed on the first jaw member and wherein the third electrode is defined by the second jaw member.

7. The end effector assembly according to claim 1, wherein the second jaw member is an ultrasonic blade configured to be energized with ultrasonic energy.

8. The end effector assembly according to claim 7, wherein the ultrasonic blade defines one of the first, second, or third electrodes.

9. The end effector assembly according to claim 7, wherein the ultrasonic blade is configured to be energized with ultrasonic energy and the first, second, and third electrodes are configured to be energized with RF energy simultaneously.

10. The end effector assembly according to claim 7, wherein the ultrasonic blade is configured to be energized with ultrasonic energy and the first, second, and third electrodes are configured to be energized with RF energy in alternating fashion.

11. The end effector assembly according to claim 1, wherein at least one of the first, second, or third electrodes is configured to contact tissue grasped between the first and second jaw members.

12. The end effector assembly according to claim 1, wherein each of the first, second, and third electrodes is configured to contact tissue grasped between the first and second jaw members.

13. A surgical instrument, comprising: a housing; a shaft extending distally from the housing; and an end effector assembly extending distally from the shaft, the end effector assembly including: first and second jaw members, the first jaw member movable relative to the second jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween; and first, second, and third electrodes configured to be energized with Radio-Frequency (RF) energy in a three-phase configuration to treat tissue grasped between the first and second jaw members.

14. The surgical instrument according to claim 13, further comprising: a trigger selectively actuatable relative to housing to thereby move the first jaw member relative to the second jaw member between the spaced-apart position and the approximated position.

15. The surgical instrument according to claim 13, further comprising an activation switch disposed on the housing and configured to initiate the energization of the first, second, and third electrodes with RF energy upon activation thereof.

16. The surgical instrument according to claim 13, wherein at least one of the first, second, or third electrodes is associated with the first jaw member and wherein at least another one of the first, second, or third electrodes is associated with the second jaw member.

17. The surgical instrument according to claim 13, wherein the first, second, and third electrodes are configured to be energized with RF energy waves that are 120 degrees out of phase with respect to one another.

18. The surgical instrument according to claim 13, wherein the second jaw member is an ultrasonic blade configured to be energized with ultrasonic energy, the ultrasonic blade defining one of the first, second, or third electrodes.

19. The surgical instrument according to claim 18, wherein the ultrasonic blade is configured to be energized with ultrasonic energy and the first, second, and third electrodes are configured to be energized with RF energy simultaneously.

20. The surgical instrument according to claim 18, wherein the ultrasonic blade is configured to be energized with ultrasonic energy and the first, second, and third electrodes are configured to be energized with RF energy in alternating fashion

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Objects and features of the present disclosure will become apparent to those of ordinary skill in the art when descriptions thereof are read with reference to the accompanying drawings, of which:

[0022] FIG. 1 is a side view of a surgical instrument exemplifying the aspects and features of the present disclosure;

[0023] FIG. 2 is a transverse, cross-sectional view of an end effector assembly configured for use with the surgical instrument of FIG. 1;

[0024] FIG. 3A is a longitudinal, cross-sectional view of yet another end effector assembly configured for use with the surgical instrument of FIG. 1;

[0025] FIG. 3B is a top view of a second jaw member of the end effector assembly of FIG. 3A;

[0026] FIG. 4A is a transverse, cross-sectional view of another end effector assembly configured for use with the surgical instrument of FIG. 1, in a seal mode;

[0027] FIG. 4B is a transverse, cross-sectional view of the end effector assembly of FIG. 4A, in a dissection mode;

[0028] FIG. 5 is a transverse, cross-sectional view of yet another end effector assembly configured for use with the surgical instrument of FIG. 1;

[0029] FIG. 6 is a transverse, cross-sectional view of still another end effector assembly configured for use with the surgical instrument of FIG. 1, shown clamping on tissue; and

[0030] FIG. 7 is a graph illustrating a three-phase configuration for energizing three electrodes in accordance with the end effector assemblies of FIGS. 1, 5, and/or 6.

DETAILED DESCRIPTION

[0031] Referring generally to FIG. 1, a combined electrosurgical, e.g., RF, and ultrasonic surgical instrument exemplifying the aspects and features of the present disclosure is shown and generally identified by reference numeral 10. For the purposes herein, surgical instrument 10 is generally described. Aspects and features of surgical instrument 10 not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail.

[0032] Surgical instrument 10 generally includes a housing 20, a handle 30, a trigger 40, an elongated shaft 50, an end effector assembly 60, a rotating assembly 70, an ultrasonic transducer 90, a cable 100 coupled to a surgical generator 110, and an activation switch 120. Activation switch 120 selectively activates a supply of electrosurgical energy from generator 110 to end effector 60 for treating tissue in an electrosurgical energy mode and selectively activates a supply of ultrasonic energy from ultrasonic transducer 90 (powered by generator 110) to end effector assembly 60 for treating tissue in an ultrasonic energy mode. To accomplish this, a switch box 122 disposed within housing 20 and coupled to activation switch 120 and/or generator 110 may be provided to determine the mode of surgical instrument 10 and enable the supply of the appropriate energy depending upon the mode. Alternatively, separate switches may be provided for each mode. Further, as an alternative to a separate generator 110, a generator and battery may be incorporated on or within housing 20 such that surgical instrument 10 operates as a cordless device.

[0033] With continued reference to FIG. 1, elongated shaft 50 of surgical instrument 10 extends distally from housing 20 and supports end effector assembly 60 at a distal end portion of elongated shaft 50. End effector assembly 60 is disposed at the distal end portion of elongated shaft 50 and includes first and second jaw members 61, 62, respectively, that cooperate to clamp and treat tissue, as described in further detail below. Rotating assembly 70 enables the selective rotation of elongated shaft 50 and, thus, end effector assembly 60 relative to housing 20.

[0034] Handle 30 is integrally associated with housing 20 for clamping and/or handling surgical instrument 10. Trigger 40 is movable relative to handle 30 from an initial position to an actuated position. Trigger 40 is operably coupled to a drive assembly (not shown) that mechanically imparts movement to end effector assembly 60. More specifically, actuation of trigger 40 causes first jaw member 61 to pivot relative to second jaw member 62 from a spaced-apart position to an approximated position to clamp tissue therebetween.

[0035] End effector assembly 60, as noted above, includes first and second jaw members 61, 62. Generally, in an ultrasonic mode, when activation switch 120 is activated, second jaw member 62 serves as an ultrasonic blade that is acoustically coupled to ultrasonic transducer 90 via a waveguide 92 to enable transmission of ultrasonic energy from ultrasonic transducer 90, along waveguide 92, to second jaw member 62 for treating tissue. In an electrosurgical mode, when activation switch 120 is activated, electrodes on one or both of the jaw members 61, 62 are energized to enable the conduction of electrosurgical energy through tissue clamped between jaw members 61, 62 to treat tissue. Various embodiments of end effector configurations suitable for use with surgical instrument 10 for the above purposes are described in detail below with reference to FIGS. 2-5. To the extent consistent, any of the aspects and features of the embodiments detailed below may be incorporated into any of the other embodiments.

[0036] Referring now to FIG. 2, in conjunction with FIG. 1, another end effector assembly 400 of the present disclosure is shown. End effector assembly 400 generally includes a first jaw member 410 and a second jaw member 420. First jaw member 410 includes a jaw body 412 having a jaw liner 414 and first and second electrodes 416, 418, disposed thereon. Jaw liner 414 may be formed from an insulative, compliant material, e.g., polytetraflouroethylene (P T F E), and is positioned to oppose jaw member 420, which is an ultrasonic blade body 422. First and second electrodes 416, 418 are positioned transversely on first jaw member 410 with jaw liner 414 disposed therebetween and are electrically isolated to enable conduction of electrosurgical energy therebetween, transversely between jaw members 410, 420. First and second electrodes 416, 418 may each be electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50.

[0037] In use, electrosurgical energy delivery and ultrasonic energy delivery are activated simultaneously, in staggered but overlapping temporal relation, or consecutively. More specifically, first and second electrodes 416, 418 are energized to different potentials to conduct electrosurgical energy transversely therebetween and through tissue clamped between jaw members 410, 420, while ultrasonic energy is transmitted to ultrasonic blade body 422, which remains electrically neutral so as not to interfere with the conduction of energy between electrodes 416, 418, via waveguide 92 for transmission to tissue clamped between ultrasonic blade body 422 and jaw liner 414.

[0038] Referring now to FIGS. 3A-3B, in conjunction with FIG. 1, in accordance with another embodiment of the present disclosure, an end effector assembly is shown identified by reference numeral 500. End effector assembly 500 generally includes first and second jaw members 510, 520. First jaw member 510 may be configured similarly as first jaw member 410 of end effector assembly 400 (FIG. 2), including a jaw body (not shown) having a jaw liner (not shown) and first and second electrically-conductive tissue-contacting surfaces (not shown) disposed on either side of the jaw liner, although other configurations are also contemplated, e.g., jaw member may define an insulated tissue-contacting surface. The electrically-conductive tissue-contacting surfaces may be electrically coupled to one another or electrically isolated from one another, and may be energizable to the same or different potentials.

[0039] Second jaw member 520 includes an ultrasonic blade body 522 acoustically coupled to waveguide 92 and positioned to oppose the jaw liner of the first jaw member 510, and a pair of electrodes 524, 526 electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50. Electrodes 524, 526 extend along the majority of ultrasonic blade body 522 on opposing sides thereof and taper in thickness in the proximal to distal direction. Electrodes 524, 526 may be electrically isolated from one another to enable electrodes 524, 526 to be energized to different potentials and conduct energy therebetween, or may be electrically coupled to be energizable to the same potential for conducting energy to jaw member 510. The proximal portions of electrodes 524, 526, having relatively larger widths, conduct greater amounts of electrosurgical energy therebetween as compared to the distal portions of electrodes 524, 526, which have relatively smaller widths.

[0040] In use, electrosurgical energy delivery and ultrasonic energy delivery are activated simultaneously, in staggered but overlapping temporal relation, or consecutively. The ultrasonic energy is delivered from ultrasonic blade body 522 to tissue positioned between ultrasonic blade body 522 and the jaw liner of jaw member 510. The electrosurgical energy may be conducted transversely, wherein electrode 524 and the electrically-conductive tissue-contacting surface of jaw member 510 on the same side are energized to a first potential and electrode 526 and the electrically-conductive tissue-contacting surface of jaw member 510 on the same side are energized to a second, different potential, or may be conducted between jaw members 510, 520, wherein electrodes 524, 526 are energized to a first potential and the electrically-conductive tissue-contacting surfaces of jaw member 510 are energized to a second, different potential. In either configuration, due to the tapered configuration of electrodes 524, 526, upon activation, relatively more electrosurgical tissue treatment is effected in a proximal, electrosurgical treatment region E of jaw member 520, relatively more ultrasonic tissue treatment is effected in a distal, ultrasonic treatment region U, and a blended treatment region B is disposed therebetween. As such, a clinician may position tissue within the electrosurgical treatment region E, the ultrasonic treatment region U, and/or the blended treatment region B to realize a desired result. The electrosurgical treatment region E may provide more robust sealing of tissue and greater seal widths which also improves seal quality, while the ultrasonic treatment region U may provide faster dissection of tissue. The blended treatment region B may provide moderate sealing and dissecting capabilities.

[0041] Referring now to FIGS. 4A and 4B, in conjunction with FIG. 1, an end effector assembly 700 in accordance with the present disclosure is shown. End effector assembly 700 generally includes a first jaw member 710 and a second jaw member 720. First jaw member 710 includes a jaw body 712 defining an arcuate configuration having first and second electrodes 714a, 714b arranged in a pair towards a first side of jaw body 712 and third and fourth electrodes 716a, 716b arranged in a pair towards a second, opposite side of jaw body 712. Electrodes 714a, 714b, 716a, 716b are electrically isolated from one another and each is electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50. Electrodes 714a, 714b, 716a, 716b are selectively energizable to various different potentials to achieve a desired configuration. For example, as shown in FIG. 4A, in a tissue sealing mode, electrodes 714a, 716a may be energized to a first potential and electrodes 714b, 716b to a second, different potential such that two tissue seals may be formed on clamped tissue, one towards each side of jaw body 712. The middle, substantially unsealed portion of the clamped tissue is configured to receive ultrasonic energy (simultaneously, overlapping, or consecutively with the supply of electrosurgical energy) from jaw member 720, serving as an ultrasonic blade body 722, to dissect the tissue between the two seals.

[0042] As another example, as shown in FIG. 4B, in a tissue dissecting mode, electrodes 714a, 714b may be energized to a first potential and electrodes 716a, 716b to a second, different potential such that currently flows transversely across jaw member 710 to facilitate dissection of tissue while ultrasonic energy (simultaneously, overlapping, or consecutively with the supply of electrosurgical energy) from jaw member 720 likewise effects dissection of tissue clamped between jaw members 710, 720. Other configurations are also contemplated.

[0043] Referring now to FIG. 5, in conjunction with FIG. 1, in accordance with another embodiment of the present disclosure, an end effector assembly 800 is shown. End effector assembly 800 generally includes first and second jaw members 810, 820. First jaw member 810 includes a jaw liner body 812 formed from or coated with an electrically-insulative material, which may be compliant, e.g., PTFE, and first and second electrodes 814, 816 disposed on jaw liner body 812. Jaw member 810, more specifically, defines a wedge-shaped configuration with an inwardly-facing tissue-contacting arcuate surface 813b, formed by jaw liner body 812, and an outwardly-facing arcuate surface 813a having a greater radius of curvature as compared to surface 813b. Electrodes 814, 816 define the end portions of outwardly-facing arcuate surface 813b, while jaw liner body 812 forms the middle portion of surface 813a. Jaw liner body 812 electrically isolates electrodes 814, 816 from one another, each of which are electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50.

[0044] Jaw member 820 serves as an ultrasonic blade body 822 and is also electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50. Ultrasonic blade body 822 may define an arcuate tissue-contacting surface 824 that is complementary to inwardly-facing tissue-contacting arcuate surface 813b of jaw member 810 to facilitate clamping tissue therebetween while maximizing surface area.

[0045] In operation, end effector assembly 800 may be activated in a first configuration, wherein ultrasonic energy is transmitted along waveguide 92 to jaw member 820 while electrodes 814, 816 are not energized, to enable treating tissue clamped between ultrasonic blade body 822 of jaw member 820 and jaw liner body 812 of jaw member 810. In a second configuration, end effector assembly 800 may be activated such that electrodes 814, 816 are energized to a first potential and jaw member 820 is energized to a second, different potential, such that electrosurgical energy is conducted through tissue clamped between jaw members 810, 820 to treat tissue. In a third configuration, electrodes 814, 816 are energized to different potentials and jaw member 820 remains electrically neutral such that electrosurgical energy is conducted transversely through tissue clamped between jaw members 810, 820 between electrodes 814, 816.

[0046] With reference to FIG. 6, in conjunction with FIG. 1, in accordance with another embodiment of the present disclosure, an end effector assembly 900 is shown. End effector assembly 900 generally includes a first jaw member 910 and a second jaw member 920. First jaw member 910 is bifurcated into jaw components 912, 914 that are spaced-apart and electrically isolated from one another. Jaw components 912, 914 are electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50, and may be energized to similar or different potentials.

[0047] Jaw member 920 is an ultrasonic blade body 922 that is acoustically coupled to waveguide 92 to enable transmission of ultrasonic energy from ultrasonic transducer 90, along waveguide 92, to ultrasonic blade body 922. Ultrasonic blade body 922 is also electrically coupled to generator 110 and activation switch 120, e.g., via one or more lead wires (not shown) extending through cable 100, housing 20, and elongated shaft 50, to enable ultrasonic blade body 922 to be energized with electrosurgical energy.

[0048] Ultrasonic blade body 922 defines a generally circular configuration. Jaw components 912, 914 define radiused tissue-contacting surfaces 913, 915, respectively, that generally conform to the curvature of ultrasonic blade body 922 of second jaw member 920, e.g., the radii of curvature of tissue-contacting surfaces 913, 915 generally approximate the radius of ultrasonic blade body 922 (wherein generally takes into account manufacturing, material, and other tolerances). However, other configurations are also contemplated.

[0049] In operation, trigger 40 is actuated to move jaw members 910, 920 to the approximated position to clamp tissue therebetween. With jaw members 910, 920 in the approximated position clamping tissue therebetween, jaw component 912, jaw component 914, and ultrasonic blade body 922 may define any suitable electrical configuration to achieve a desired tissue effect. For example, end effector assembly 900 may be activated: in a first configuration, wherein ultrasonic energy is transmitted along waveguide 92 to ultrasonic blade body 922 while jaw components 912, 914 are not energized; in a second configuration, wherein jaw components 912, 914 are energized to a first potential and ultrasonic blade body 922 is energized to a second, different potential; in a third configuration, wherein jaw components 912, 914 are energized to different potentials and ultrasonic blade body 922 remains electrically neutral; in a fourth configuration, wherein jaw components 912, 914 are energized to different potentials and ultrasonic blade body 922 is energized with ultrasonic energy but is otherwise electrically neutral; in a fifth configuration, wherein jaw components 912, 914 are energized to the same potential and ultrasonic blade body 922 is energized with ultrasonic energy and to a different electrical potential; etc.

[0050] Referring to FIG. 7, in conjunction with FIGS. 1, 5, and 6, end effector assemblies 800, 900 (or any other suitable end effector assembly with at least three independently-energizable electrodes) are advantageous in that they allow for various different electrical configurations. In some electrical configuration, the three electrodes A, B, and C (corresponding to the three independently-energizable electrodes of a suitable end effector assembly) may be energized to a three-phase configuration, wherein each of the electrodes A, B, and C is energized with waves that are 120 degrees out of phase relative to each other such as, for example, as illustrated in FIG. 7. Although square waves are illustrated in FIG. 7, it is also contemplated that sine waves or other suitable waves that are 120 degrees out of phase relative to each other may also be provided.

[0051] A three-phase configuration such as that detailed above enables energy excitation between all three electrodes A, B, and C. Further, the amount of energy supplied may be controlled such as, for example, by using square waves of less than 50% duty cycle. Additionally or alternatively, the amplitudes of any or all of the three phases may be controlled to produce more or less energy excitation in certain directions, e.g., between different combinations of electrodes A, B, and C.

[0052] Regardless of the three-phase configuration utilized, ultrasonic energy may be supplied simultaneously, before/after, overlapping, alternating, during only portions of three-phase energy application, or in any other suitable manner, or may not be supplied during three-phase energy application. Likewise, the three-phase energy may be supplied simultaneously, before/after, overlapping, alternating, during only portions of ultrasonic energy application, or in any other suitable manner, or may not be supplied during ultrasonic energy application.

[0053] Although embodiments have been described in detail with reference to the accompanying drawings for the purpose of illustration and description, it is to be understood that the inventive processes and apparatus are not to be construed as limited thereby. It will be apparent to those of ordinary skill in the art that various modifications to the foregoing embodiments may be made without departing from the scope of the disclosure.