Ultrasonic surgical instrument with removable shaft assembly portion
11547431 · 2023-01-10
Assignee
Inventors
Cpc classification
A61B2017/0046
HUMAN NECESSITIES
A61B2090/0806
HUMAN NECESSITIES
B25B27/02
PERFORMING OPERATIONS; TRANSPORTING
A61B2017/2902
HUMAN NECESSITIES
B23P19/04
PERFORMING OPERATIONS; TRANSPORTING
A61B2017/320072
HUMAN NECESSITIES
A61B2017/320093
HUMAN NECESSITIES
A61B17/320092
HUMAN NECESSITIES
A61B17/320068
HUMAN NECESSITIES
B23P19/02
PERFORMING OPERATIONS; TRANSPORTING
International classification
B23P19/04
PERFORMING OPERATIONS; TRANSPORTING
B23P19/02
PERFORMING OPERATIONS; TRANSPORTING
Abstract
An apparatus includes a body, a shaft assembly, and an end effector. The shaft assembly includes an outer tube, an inner tube, and an acoustic waveguide. The end effector includes an ultrasonic blade and a clamp arm. The ultrasonic blade is acoustically coupled with the acoustic waveguide. A first portion of the clamp arm is pivotably coupled with a distal end of the outer tube. A second portion of the clamp arm is pivotably coupled with a distal end of the inner tube. The outer tube and the inner tube are configured to removably couple with the body such that the outer tube, the inner tube, and the clamp arm are configured to removably couple with the body and the remainder of the shaft assembly and end effector as a unit.
Claims
1. A clamp pad loader assembly, comprising: (a) a clamp arm guide defining a plurality of openings, wherein each of the plurality of openings is dimensioned to receive a clamp arm of an ultrasonic instrument; (b) a clamp pad cartridge coupled with the clamp arm guide, wherein the clamp pad cartridge comprises: (i) a plurality of clamp pad retention members respectively aligned with the plurality of openings, wherein the plurality of clamp pad retention members includes a first clamp pad retention member, and (ii) a clamp pad housed within the first clamp pad retention member of the plurality of clamp pad retention members, wherein the clamp pad cartridge and the clamp arm guide are configured to actuate relative to each other between an open position and a closed position while the clamp arm of the ultrasonic instrument is within a first opening of the plurality of openings in order to couple the clamp arm with the first clamp pad housed within the first clamp pad retention member of the plurality of clamp pad retention members; and (c) a biasing member disposed between the clamp arm guide and the clamp pad cartridge, wherein the biasing member biases the clamp arm guide and the clamp pad cartridge toward the open position.
2. The clamp pad loader assembly of claim 1, wherein the biasing member comprises a wave spring.
3. The clamp pad loader assembly of claim 2, wherein the clamp pad cartridge comprises a split post, and wherein the wave spring is disposed on the split post.
4. The clamp pad loader assembly of claim 3, wherein the clamp arm guide defines a bore, and wherein the split post extends within the bore.
5. The clamp pad loader assembly of claim 1, wherein the clamp pad cartridge comprises a plurality of guide posts, and wherein the clamp arm guide comprises a plurality of cylindrical members dimensioned to slidably receive the plurality of guide posts, respectively.
6. The clamp pad loader assembly of claim 1, wherein the clamp arm guide comprises a plurality of tube support sections extending respectively from the plurality of openings, and wherein the plurality of tube support sections are configured to support a shaft assembly of the ultrasonic instrument.
7. The clamp pad loader assembly of claim 1, wherein the first clamp pad retention member of the plurality of clamp pad retention members comprises a pair of grasping arms configured to releasably hold the clamp pad.
8. The clamp pad loader assembly of claim 7, wherein each of the pair of grasping arms comprises a chamfered surface configured to release the clamp pad from the pair of grasping arms in response to the clamp pad cartridge and the clamp arm guide actuating relative to each other between the open position and the closed position while the clamp arm of the ultrasonic instrument is within the first opening of the plurality of openings.
9. The clamp pad loader assembly of claim 1, wherein the first clamp pad retention member of the plurality of clamp pad retention members comprises a plurality of studs configured to engage the clamp pad to thereby longitudinally align the clamp pad with the first clamp pad retention member.
10. The clamp pad loader assembly of claim 1, wherein the clamp pad comprises a boss configured to fit within the first opening of the clamp arm of the ultrasonic instrument.
11. The clamp pad loader assembly of claim 10, wherein the boss defines a first groove configured to receive a tension wire of the clamp arm of the ultrasonic instrument.
12. The clamp pad loader assembly of claim 11, wherein the boss comprises a chamfer configured to deflect the tension wire into engagement with the first groove as the clamp arm couples with the clamp pad.
13. The clamp pad loader assembly of claim 12, wherein the clamp pad comprise a pair of studs configured to engage with a pair of grooves defined by the clamp arm to thereby longitudinally align the clamp pad with the clamp arm, respectively.
14. The clamp pad loader assembly of claim 1, wherein the clamp pad comprises a polytetrafluoroethylene material.
15. A clamp pad loader assembly, comprising: (a) a clamp arm guide defining a plurality of openings, wherein each of the plurality of openings is dimensioned to receive a clamp arm of an ultrasonic instrument; (b) a clamp pad cartridge coupled with the clamp arm guide, wherein the clamp pad cartridge comprises a plurality of clamp pad retention members respectively aligned with the plurality of openings; and (c) a plurality of clamp pads, wherein the plurality of clamp pads are respectively housed within the plurality of clamp pad retention members, wherein the clamp pad cartridge and the clamp arm guide are configured to actuate relative to each other between an open position and a closed position while the clamp arm of the ultrasonic instrument is within an opening of the plurality of openings in order to couple the clamp arm with the clamp pad respectively housed within the clamp pad retention member; and (d) a biasing member disposed between the clamp arm guide and the clamp pad cartridge, wherein the biasing member biases the clamp arm guide and the clamp pad cartridge toward the open position.
16. The clamp pad loader assembly of claim 15, wherein the clamp arm guide defining the opening is configured to drive the clamp arm toward the clamp pad.
17. The clamp pad loader assembly of claim 15, wherein the clamp pad cartridge is slidably coupled with the clamp arm guide.
18. The clamp pad loader assembly of claim 15, wherein each of the plurality of clamp arm retention members comprises a base configured to support the clamp pad, respectively.
19. A clamp pad loader assembly, comprising: (a) a clamp arm guide defining a first opening dimensioned to receive a clamp arm of an ultrasonic instrument; (b) a clamp pad cartridge coupled with the clamp arm guide, wherein the clamp pad cartridge comprises a first clamp pad retention member aligned with the first opening; (c) a first clamp pad housed within the first clamp pad retention member, wherein the clamp pad cartridge and the clamp arm guide are configured to actuate relative to each other between an open position and a closed position while the clamp arm of the ultrasonic instrument is within the first opening in order to couple the clamp arm with the first clamp pad housed within the first clamp pad retention member; and (d) a biasing member disposed between the clamp arm guide and the clamp pad cartridge, wherein the biasing member biases the clamp arm guide and the clamp pad cartridge toward the open position.
20. The clamp pad loader assembly of claim 19, further comprising a second clamp pad retention member and a second clamp pad, wherein the clamp arm further defines a second opening, wherein the second clamp pad retention member is aligned with the second opening, and wherein the second clamp pad is housed within the second clamp pad retention member.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) While the specification concludes with claims which particularly point out and distinctly claim this technology, it is believed this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
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(48) The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.
DETAILED DESCRIPTION
(49) The following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
(50) It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
(51) For clarity of disclosure, the terms “proximal” and “distal” are defined herein relative to a human or robotic operator of the surgical instrument. The term “proximal” refers the position of an element closer to the human or robotic operator of the surgical instrument and further away from the surgical end effector of the surgical instrument. The term “distal” refers to the position of an element closer to the surgical end effector of the surgical instrument and further away from the human or robotic operator of the surgical instrument.
I. Overview of Exemplary Ultrasonic Surgical Instrument
(52)
(53) In an exemplary use, assemblies (100, 200) are coupled together to form instrument (10) before a surgical procedure, the assembled instrument (10) is used to perform the surgical procedure, and then assemblies (100, 200) are decoupled from each other for further processing. In some instances, after the surgical procedure is complete, disposable assembly (100) is immediately disposed of while reusable assembly (200) is sterilized and otherwise processed for re-use. By way of example only, reusable assembly (200) may be sterilized in a conventional relatively low temperature, relatively low pressure, hydrogen peroxide sterilization process. Alternatively, reusable assembly (200) may be sterilized using any other suitable systems and techniques (e.g., autoclave, etc.). In some versions, reusable assembly (200) may be sterilized and reused approximately 100 times. Alternatively, reusable assembly (200) may be subject to any other suitable life cycle. For instance, reusable assembly (200) may be disposed of after a single use, if desired. While disposable assembly (100) is referred to herein as being “disposable,” it should be understood that, in some instances, disposable assembly (100) may also be sterilized and otherwise processed for re-use. By way of example only, disposable assembly (100) may be sterilized and reused approximately 2-30 times, using any suitable systems and techniques. Alternatively, disposable assembly (100) may be subject to any other suitable life cycle.
(54) In some versions, disposable assembly (100) and/or reusable assembly (200) includes one or more features that are operable to track usage of the corresponding assembly (100, 200), and selectively restrict operability of the corresponding assembly (100, 200) based on use. For instance, disposable assembly (100) and/or reusable assembly (200) may include one or more counting sensors and a control logic (e.g., microprocessor, etc.) that is in communication with the counting sensor(s). The counting sensor(s) may be able to detect the number of times the ultrasonic transducer of instrument (10) is activated, the number of surgical procedures the corresponding assembly (100, 200) is used in, the number of trigger closures, and/or any other suitable conditions associated with use. The control logic may track data from the counting sensor(s) and compare the data to one or more threshold values. When the control logic determines that one or more threshold values have been exceeded, the control logic may execute a control algorithm to disable operability of one or more components in the corresponding assembly (100, 200). In instances where the control logic stores two or more threshold values (e.g., a first threshold for number of activations and a second threshold for number of surgical procedures, etc.), the control logic may disable operability of one or more components in the corresponding assembly (100, 200) the first time one of those thresholds is exceeded, or on some other basis.
(55) In versions where a control logic is operable to disable instrument (10) based on the amount of use, the control logic may also determine whether instrument (10) is currently being used in a surgical procedure, and refrain from disabling instrument (10) until that particular surgical procedure is complete. In other words, the control logic may allow the operator to complete the current surgical procedure but prevent instrument (10) from being used in a subsequent surgical procedure. Various suitable forms that counters or other sensors may take will be apparent to those of ordinary skill in the art in view of the teachings herein. Various suitable forms that a control logic may take will also be apparent to those of ordinary skill in the art in view of the teachings herein. Similarly, various suitable control algorithms that may be used to restrict usage of instrument (10) will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, some versions of instrument (10) may simply omit features that track and/or restrict the amount of usage of instrument (10).
(56) Disposable assembly (100) of the present example comprises a body portion (110), a shaft assembly (150) extending distally from body portion (110), and an end effector (180) located at the distal end of shaft assembly (150). As best seen in
(57) Shaft assembly (150) comprises an outer tube (152) and an inner tube (170). Outer tube (152) is operable to translate longitudinally relative to inner tube (170) to selectively pivot clamp arm (182) toward and away from blade (190). To accomplish this, and as best seen in
(58) Reusable assembly (200) comprises various features that are operable to activate blade, including a battery and an ultrasonic transducer. Reusable assembly (200) further includes features that are operable to couple the ultrasonic transducer with waveguide to thereby couple the ultrasonic transducer with blade (190). In the present example, the distal end of blade (190) is located at a position corresponding to an anti-node associated with resonant ultrasonic vibrations communicated through waveguide (192), in order to tune the acoustic assembly to a preferred resonant frequency f.sub.o when the acoustic assembly is not loaded by tissue. When the transducer assembly is energized, the distal end of blade (190) is configured to move longitudinally in the range of, for example, approximately 10 to 500 microns peak-to-peak, and in some instances in the range of about 20 to about 200 microns at a predetermined vibratory frequency f.sub.o of, for example, 55.5 kHz. When the transducer assembly of the present example is activated, these mechanical oscillations are transmitted through waveguide (192) to reach blade (190), thereby providing oscillation of blade (190) at the resonant ultrasonic frequency. Thus, when tissue is secured between blade (190) and clamp pad (184), the ultrasonic oscillation of blade (190) may simultaneously sever the tissue and denature the proteins in adjacent tissue cells, thereby providing a coagulative effect with relatively little thermal spread. In some versions, an electrical current may also be provided through blade (190) and/or clamp pad (184) to also seal the tissue.
(59) In addition to the foregoing, disposable assembly (100) and/or reusable assembly (200) may be constructed and operable in accordance with at least some of the teachings of U.S. Pub. No. 2015/0245850, entitled “Ultrasonic Surgical Instrument with Removable Handle Assembly,” published Sep. 3, 2015, issued as U.S. Pat. No. 10,010,340 on Jul. 3, 2018, the disclosure of which is incorporated by reference herein. In addition, or in the alternative, disposable assembly (100) and/or reusable assembly (200) may be constructed and operable in accordance with at least some of the teachings of U.S. Pub. No. 2016/0015419, entitled “Ultrasonic Surgical Instrument with Removable Handle Assembly,” published Jan. 21, 2016, issued as U.S. Pat. No. 10,349,967 on Jul. 16, 2019, the disclosure of which is incorporated by reference herein. Other suitable components, features, and operabilities that may be incorporated into disposable assembly (100) and/or reusable assembly (200) and variations thereof will be apparent to those of ordinary skill in the art in view of the teachings herein.
II. Further Exemplary Alternative Disposable Assembly for Ultrasonic Surgical Instrument with Removable Acoustic Waveguide
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(61) Disposable assembly (1500) of the present example comprises a first disposable sub-assembly (1502) and a second disposable sub-assembly (1504). A disposable clamp pad (1800) connects with and is separable from components of first disposable sub-assembly (1502) as will be described further below. Sub-assemblies (1502, 1504) are configured to be coupled together in order to form disposable assembly (1500), which may then be coupled with a variation of reusable assembly (200) to form a complete ultrasonic surgical instrument. After the ultrasonic surgical instrument is used in a surgical procedure, disposable assembly (1500) may be removed from the variation of reusable assembly (200); and then first disposable sub-assembly (1502) may be removed from second disposable sub-assembly (1504). In some such instances, the variation of reusable assembly (200) may be cleaned, sterilized, and re-used up to 100 times (by way of example only). First disposable sub-assembly (1502) may be cleaned, sterilized, and re-used up to 5 times (by way of example only). Clamp pad (1800) may be disposed of, such that clamp pad (1800) is only used one single time. Second disposable sub-assembly (1504) may be cleaned, sterilized, and re-used between 5 to 10 times (by way of example only). Still in some other versions, clamp pad (1800) may be non-removable and flush port (1700), as will be discussed in greater detail below, may be omitted such that first disposable sub-assembly (1502) is used only one time. Of course, these re-use scenarios are merely illustrative examples. It should nevertheless be understood that the configuration of disposable assembly (1500) may minimize the amount of single-use material that is disposed of after each surgical procedure. This may reduce cost and overall waste as compared to conventional instrumentation.
(62) A. Exemplary First Disposable Sub-Assembly and Clamp Pad
(63) As shown in
(64) As shown in
(65) As shown in
(66) Clamp arm (1570) comprises tension wire (1578) that extends generally longitudinally along clamp arm (1570). Clamp arm (1570) further comprises opening (1579). Tension wire (1578) is positioned within opening (1579) of clamp arm (1570). Clamp pad (1800) is selectively received within opening (1579) from an underside of clamp arm (1570) as shown by the up/down arrows in
(67) Multiple cooperating features between clamp arm (1570) and clamp pad (1800) provide secure yet removable connection between clamp arm (1570) and clamp pad (1800). First, clamp pad (1800) comprises a groove (1802) configured to receive tension wire (1578) of clamp arm (1570). Second, clamp pad (1800) comprises a pair of studs (1804) on each side of clamp pad (1800) that are configured to engage with corresponding grooves (1574) in clamp arm (1570) to ensure appropriate longitudinal alignment and positioning of clamp pad (1800) relative to clamp arm (1570). In the present example, clamp pad (1800) comprises a boss (1806) projecting upwardly from the remainder of clamp pad (1800), and boss (1806) contains groove (1802) and grooves (1804). Boss (1806) also comprises chamfer (1808) that contacts tension wire (1578) during loading and unloading of clamp pad (1800) within clamp arm (1570). For instance, during the process of loading clamp pad (1800), tension wire (1578) is deflected laterally in a resilient fashion such that clamp pad (1800) can be seated within opening (1579). Once clamp pad (1800) is fully seated within opening (1579), chamfer (1808) is above tension wire (1578) and tension wire (1578) is located within groove (1802). Similarly, when removing or unloading clamp pad (1800) from clamp arm (1570), chamfer (1808) again deflects tension wire (1578) laterally and out from groove (1802). While tension wire (1578) is used to removably secure clamp pad (1800) to clamp arm (1570) in the present example, it should be understood that various other kinds of deformable members may be used to removably secure clamp pad (1800) to clamp arm (1570).
(68) At a proximal end of clamp arm (1570) and clamp pad (1800) are additional cooperating features. Clamp arm (1570) comprises a pair of projections (1573) and clamp pad (1800) comprises a pair of slots (1810) whereby projections (1573) are configured to be received within respective slots (1810) when clamp pad (1800) is installed on clamp arm (1570).
(69) As shown in
(70) As shown in
(71) In the present example, cap (1704) includes a strap (1708) having an opening (1710) that is configured to fit around luer fitting (1702) as shown in
(72) As shown in
(73) Guide slot (1620) includes a first portion (1622), a second portion (1624), and a third portion (1626). First portion (1622) extends longitudinally, while second portion (1624) extends helically, while third portion (1626) extends laterally. First and third portions (1622, 1626) are angularly offset from each other by approximately 90° about the longitudinal axis of inner tube (1600). Other suitable forms that guide slot (1620) may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
(74) As will be described in further detail below, outer tube (1580) is configured to couple with a tube actuator (1650) of second disposable sub-assembly (1504) when first disposable sub-assembly (1502) is coupled with second disposable sub-assembly (1504). Tube actuator (1650) is configured to drive outer tube (1580) longitudinally in response to pivotal movement of trigger (1512), to thereby drive clamp arm (1570) toward and away from blade (1560) as described above.
(75) B. Exemplary Second Disposable Sub-Assembly
(76) As shown in
(77) In the present example, guide pin (1526) extends through waveguide (1562), thereby connecting waveguide (1562) with knob member (1520) as shown in
(78) Trigger (1512) is operable to drive tube actuator (1650) longitudinally, to thereby drive outer tube (1580) longitudinally, to thereby drive clamp arm (1570) toward and away from blade (1560), when first disposable sub-assembly (1502) is coupled with second disposable sub-assembly (1504). Structural features of tube actuator (1650) will be described in greater detail below. Various suitable components that may be used to provide longitudinal movement of tube actuator (1650) in response to pivotal movement of trigger (1512) will be apparent to those of ordinary skill in the art in view of the teachings herein. By way of example only, trigger (1512) may be operatively coupled with tube actuator (1650) in accordance with at least some of the teachings of U.S. Pub. No. 2015/0245850, entitled “Ultrasonic Surgical Instrument with Removable Handle Assembly,” published Sep. 3, 2015, issued as U.S. Pat. No. 10,010,340 on Jul. 3, 2018, the disclosure of which is incorporated by reference herein. In addition, or in the alternative, trigger (1512) may be operatively coupled with tube actuator (1650) in accordance with at least some of the teachings of U.S. Pub. No. 2016/0015419, entitled “Ultrasonic Surgical Instrument with Removable Handle Assembly,” filed Sep. 29, 2015, issued as U.S. Pat. No. 10,349,967 on Jul. 16, 2019, the disclosure of which is incorporated by reference herein.
(79) Buttons (1514, 1516) are operable to activate ultrasonic blade (1560). In particular, buttons (1514, 1516) are operable to activate the ultrasonic transducer assembly in the variation of reusable assembly (200), which in turn generates ultrasonic vibrations, which are communicated along waveguide (1562) to reach blade (1560). In some versions, button (1514) activates ultrasonic blade (1560) with ultrasonic energy at a first set of parameters (e.g., high power); while button (1516) activates ultrasonic blade (1560) with ultrasonic energy at a second set of parameters (e.g., low power). As another merely illustrative alternative, button (1514) may activate ultrasonic blade (1560) with ultrasonic energy; while button (1516) activates end effector (1550) to apply RF electrosurgical energy. Various suitable ways in which this may be carried out, as well as various other suitable ways in which buttons (1514, 1516) may be configured, arranged, and operable will be apparent to those of ordinary skill in the art in view of the teachings herein.
(80) Coupling feature (1518) is operable to couple with one or more complementary coupling features in the variation of reusable assembly (200) in accordance with at least some of the teachings of U.S. Pub. No. 2015/0245850, issued as U.S. Pat. No. 10,010,340, and/or in accordance with at least some of the teachings of U.S. Pub. No. 2016/0015419, issued as U.S. Pat. No. 10,349,967. In addition, or in the alternative, coupling feature (1518) may be actuated to transition disposable assembly (1500) into a cleaning mode in accordance with at least some of the teachings of U.S. Pub. No. 2015/0245850, issued as U.S. Pat. No. 10,010,340 and/or in accordance with at least some of the teachings of U.S. Pub. No. 2016/0015419, issued as U.S. Pat. No. 10,349,967. Various suitable components, features, and operabilities that may be incorporated into and/or otherwise associated with coupling feature (1518) will be apparent to those of ordinary skill in the art in view of the teachings herein.
(81) Communication feature (1519) is operable to couple with one or more complementary coupling features in the variation of reusable assembly (200) in accordance with at least some of the teachings of U.S. Pub. No. 2015/0245850, issued as U.S. Pat. No. 10,010,340, and/or in accordance with at least some of the teachings of U.S. Pub. No. 2016/0015419 issued as U.S. Pat. No. 10,349,967. By way of example only, communication feature (1519) may comprise one or more electrical contacts that are operable to provide data communication and/or other electrical related operability when coupled with one or more complementary coupling features in the variation of reusable assembly (200). By way of example only, partial handle assembly (1510) may include sensors and/or various other kinds of features from which data may be provided to the variation of reusable assembly (200) via communication feature (1519). Various suitable components, features, and operabilities that may be incorporated into and/or otherwise associated with communication feature (1519) will be apparent to those of ordinary skill in the art in view of the teachings herein.
(82) As best seen in
(83) Knob member (1520) is operable to rotate the shaft assembly that is formed by waveguide (1562), inner tube (1600), outer tube (1580), and end effector (1550) when first disposable sub-assembly (1502) is coupled with second disposable sub-assembly (1504). In particular, this shaft assembly is rotatable relative to housing (1511) of partial handle assembly (1510). As best seen in
(84) As shown in
(85) As noted above, tube actuator (1650) is configured to removably couple with outer tube (1580) and thereby drive outer tube (1580) longitudinally in response to pivotal motion of trigger (1512). As best seen in
(86) C. Exemplary Assembly of First Disposable Sub-Assembly with Second Disposable Sub-Assembly
(87)
(88) Beginning with
(89) To ensure proper alignment of curved clamp arm (1570) with curved blade (1560), boss (1530) is sized to match first slot opening (1621) of guide slot (1620). With this configuration, boss (1530) is too large compared to second slot opening (1623) to fit within second slot opening (1623). Therefore, installing first disposable sub-assembly (1502) onto second disposable sub-assembly (1504) will only occur when boss (1530) is angularly aligned with the correct slot opening—first slot opening (1621) in the present example. Referring to
(90) As shown in
(91) In between the assembly stages shown in
(92)
(93)
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(95) During the transition from the state shown in
(96) With assembly completed as shown in
(97) In the series shown in
(98) D. Exemplary Disassembly of First Disposable Sub-Assembly from Second Disposable Sub-Assembly
(99) As noted above, first disposable sub-assembly (1502) may be configured for 5 uses while second disposable sub-assembly (1504) may be configured for 5 to 10 uses (or any other suitable number of uses). It may therefore be desirable to enable an operator to disassemble first disposable sub-assembly (1502) from second disposable sub-assembly (1504) without destroying second disposable sub-assembly (1504). To that end,
(100) As shown in
(101) In order to initiate disassembly, the operator may need to first actuate trigger (1512) in a fashion that extends outer tube (1580) distally to open clamp arm (1570).
(102) Once in the position shown in
(103) It should be understood that during the process of disassembly shown in
(104) E. Clamp Pad Removal and Reloading
(105)
(106) In use, clamp pad loader assembly (1900) is actuated by moving clamp arm guide (1902) and pad cartridge (1904) toward each other, thereby compressing wave spring assembly (1906).
(107) As shown in
(108) Still referring to
(109) To replace clamp pad (1800) installed on clamp arm (1570), first an operator removes any existing clamp pad (1800) from clamp arm (1570). As noted above, to remove clamp pad (1800) the operator may use a tool or instrument to push clamp pad (1800) down and through opening (1579) of clamp arm (1570) such that pad (1800) is freed from its connection with tension wire (1578). When loading or installing a new clamp pad (1800) onto clamp arm (1570), clamp arm (1570) is moved to an open position so as to not damage blade (1560) when using clamp pad loader assembly (1900). Next clamp arm (1570) is inserted through one of openings (1916) in clamp arm guide (1902) such that clamp arm (1570) is positioned above a loaded clamp pad (1800) retained within pad cartridge (1904).
(110) With clamp arm (1570) within clamp pad loader assembly (1900), clamp pad loader assembly is actuated to the position shown in
(111) As shown in
III. Exemplary Tray for Simple Life Cycle Determination
(112) In some instances, a disposable sub-assembly designed to have multiple uses may be configured to stop operating after a predetermined amount of re-uses. Therefore, after a predetermined amount of re-uses is counted by a disposable sub-assembly, that sub-assembly may no longer work to form a complete surgical instrument. In such instances, it may be desirable to determine how many uses remain for a specific disposable sub-assembly that is configured to be cleaned, sterilized and re-used. This may allow an operator to discard a completely used disposable sub-assembly without accidentally cleaning, sterilizing, and attempting to reuse disposable sub-assembly.
(113)
(114) As mentioned above, tray (1404) stores four first disposable sub-assemblies (702). An operator may couple one first disposable sub-assembly (702) to second disposable sub-assembly (704), use disposable assembly (700) in a surgical procedure, decouple first disposable sub-assembly (702) from second disposable sub-assembly (704), discard first disposable sub-assembly, clean and sterilize second disposable sub-assembly (704), and return second disposable sub-assembly (704) to tray (1404). An operator may repeat this process until there are no longer any first disposable sub-assemblies (702) associated with tray (1404). This may indicate to an operator that second disposable sub-assembly (704) has no more remaining uses and should also be discarded.
(115) Therefore, tray (1404) provides a means for storing, transporting, and tracking the number of reloads an operator has left.
(116) While in the current example, four first disposable sub-assemblies (702) are used, it should be understood any suitable number of first disposable sub-assemblies (702) may be used as would be apparent to one having ordinary skill in the art in view of the teachings herein.
IV. Exemplary Combinations
(117) The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to restrict the coverage of any claims that may be presented at any time in this application or in subsequent filings of this application. No disclaimer is intended. The following examples are being provided for nothing more than merely illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in numerous other ways. It is also contemplated that some variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a successor in interest to the inventors. If any claims are presented in this application or in subsequent filings related to this application that include additional features beyond those referred to below, those additional features shall not be presumed to have been added for any reason relating to patentability.
Example 1
(118) A surgical instrument comprising: (a) a reusable assembly comprising an ultrasonic transducer; (b) a first disposable sub-assembly comprising a clamp arm; (c) a second disposable sub-assembly comprising: (i) a pivotable trigger, and (ii) an ultrasonic waveguide, wherein the second disposable sub-assembly is configured to removably coupled with the reusable assembly; wherein the first disposable sub-assembly is configured to removably coupled with the second disposable sub-assembly, wherein the pivotable trigger is configured to rotate the clamp arm relative to the ultrasonic waveguide when the first disposable sub-assembly is coupled to the second disposable sub-assembly.
Example 2
(119) The surgical instrument of Example 1, wherein the first disposable sub-assembly comprises a first inner tube and a first outer tube, wherein the first outer tube is pivotally coupled to the clamp arm, wherein the first inner tube is pivotally coupled to the clamp arm.
Example 3
(120) The surgical instrument of Example 2, wherein the second disposable sub-assembly comprises a second inner tube having a proximal end and a distal end, wherein the second inner tube is configured to removably couple with the first inner tube at the distal end of the second inner tube.
Example 4
(121) The surgical instrument of any one or more of Example 2 through 3, wherein the second disposable assembly comprises a knob member configured to rotate the ultrasonic waveguide about a longitudinal axis defined by the ultrasonic waveguide, wherein knob member houses a tube actuator, wherein the first outer tube is removable coupled to the tube actuator.
Example 5
(122) The surgical instrument of Example 4, wherein the knob member defines a keyway and a rotation path, wherein the keyway and rotation path are configured to align the first disposable sub-assembly when coupled to the second sub-assembly.
Example 6
(123) The surgical instrument of any one or more of Examples 1 through 5, wherein the second disposable sub-assembly has a counting mechanism to determine how many times the second disposable sub-assembly has been used.
Example 7
(124) An assembly tool for use with any of the surgical instruments of Examples 1 through 6, where the assembly tool comprises a torque wrench configured to properly couple the reusable assembly with the second sub-assembly.
Example 8
(125) The assembly tool of Example 7, wherein the assembly tool also comprises a spanner wrench configured to rotate the first sub-assembly relative to the second sub-assembly.
Example 9
(126) The assembly tool of Example 7, wherein the assembly tool is configured to fix the first sub-assembly relative to the assembly tool.
Example 10
(127) The assembly tool of Example 9, wherein the assembly tool comprises a base member and a top member, wherein the top member is configured to pivot relative to the base member from an open position to a closed position, wherein the assembly tool is configured to fix the first sub-assembly relative to the assembly tool when the top member is in the closed position.
Example 11
(128) The assembly tool of Example 10, wherein the assembly tool is configured to selectively lock when the top member is in the closed position
Example 12
(129) The assembly tool of any one or more of Examples 9 through 11, wherein the assembly tool further has a locator feature configured to fix the first disposable sub-assembly in the same position relative to the assembly tool.
Example 13
(130) The assembly tool of Example 12, wherein the locator feature comprises a locator pin.
Example 14
(131) The assembly tool of Example 13, wherein the locator pin is biased to a first position, wherein the locator pin is configured to translate from the first position to the a second position in response to the top member pivoting from the open position to the closed position.
Example 15
(132) The assembly tool of any one or more of Example 9 through 14, wherein the first inner tube comprises a first alignment hole, wherein the first outer tube each comprises a second alignment hole, wherein the locator pin is configured to insert through the first alignment hole and the second alignment hole.
Example 16
(133) The assembly tool of Example 15, wherein the locator pin and the first inner tube define a gap configured to receive the ultrasonic waveguide when the locator pin is in the second position.
Example 17
(134) The assembly tool of any one or more of Example 9 through 16, wherein the assembly tool comprises a tubular surface configured to conform to at least a portion of first outer tube.
Example 18
(135) The assembly tool of any one or more of Example 9 through 16, wherein the assembly tool is pivotable via a living hinge.
Example 19
(136) The surgical instrument of Example 6, wherein the second disposable sub-assembly further comprises an indicator, wherein the indicator is configured to show whether the second disposable sub-assembly has been used a predetermined number of times.
Example 20
(137) The surgical instrument of Example 19, wherein the indicator is activated by a button.
Example 21
(138) An apparatus, comprising: (a) a body; (b) a shaft assembly, wherein the shaft assembly comprises: (i) an outer tube, (ii) an inner tube, and (iii) an acoustic waveguide; and (c) an end effector, wherein the end effector comprises: (i) an ultrasonic blade acoustically coupled with the acoustic waveguide, and (ii) a clamp arm, wherein a first portion of the clamp arm is pivotably coupled with a distal end of the outer tube, wherein a second portion of the clamp arm is pivotably coupled with a distal end of the inner tube; wherein the outer tube and the inner tube are configured to removably couple with the body such that the outer tube, the inner tube, and the clamp arm are configured to removably couple with the body and the remainder of the shaft assembly and end effector as a unit.
Example 22
(139) The apparatus of Example 21, wherein the outer tube proximally terminates in a proximal end, wherein the inner tube proximally terminates in a proximal end, wherein the proximal end of the inner tube is proximal to the proximal end of the outer tube.
Example 23
(140) The apparatus of any one or more of Examples 21 through 22, wherein the outer tube is configured to translate relative to the body and relative to the inner tube while the inner tube remains stationary relative to the body.
Example 24
(141) The apparatus of any one or more of Examples 21 through 23, wherein the inner tube proximally terminates in a proximal end, wherein the proximal end of the inner tube defines a guide slot, wherein the body includes a guide feature configured to fit in the guide slot, wherein the guide feature and the guide slot are configured to cooperate with each other to thereby govern angular positioning of the inner tube relative to the acoustic waveguide.
Example 25
(142) The apparatus of Example 24, wherein the guide slot comprises a first portion and a second portion, wherein the first portion is oriented parallel to a longitudinal axis of the shaft assembly, wherein the second portion is non-parallel with the longitudinal axis of the shaft assembly.
Example 26
(143) The apparatus of any one or more of Examples 21 through 25, wherein the body includes a latch, wherein the latch is configured to cooperate with the outer tube to thereby secure longitudinal positioning of the outer tube relative to the body.
Example 27
(144) The apparatus of Example 26, wherein the body comprises: (i) a housing, and (ii) a knob member, wherein the knob member is operable to rotate the shaft assembly relative to the housing.
Example 28
(145) The apparatus of Example 27, wherein the knob member includes a cantilevered button, wherein the cantilevered button is operable to disengage the latch from the outer tube.
Example 29
(146) The apparatus of any one or more of Examples 26 through 28, wherein the outer tube proximally terminates at a proximal end, wherein the proximal end has a lateral opening, wherein the latch is configured to cooperate with the lateral opening to thereby secure longitudinal positioning of the outer tube relative to the body.
Example 30
(147) The apparatus of Example 29, wherein the latch comprises a prong, wherein the lateral opening is configured to receive the prong.
Example 31
(148) The apparatus of any one or more of Examples 21 through 30, wherein the outer tube includes a laterally oriented flush port, wherein the flush port is in fluid communication with a space defined between the inner tube and the outer tube.
Example 32
(149) The apparatus of any one or more of Examples 21 through 31, wherein the clamp arm comprises a clamp arm body and a clamp pad, wherein the clamp arm body is configured to removably receive the clamp pad.
Example 33
(150) The apparatus of Example 32, wherein the clamp arm body defines an opening, wherein the clamp arm further comprises a tension wire extending through the opening, wherein the tension wire is configured to removably retain the clamp pad relative to the clamp arm body.
Example 34
(151) The apparatus of Example 33, wherein the clamp pad includes a boss defining a groove, wherein the groove is configured to receive the tension wire.
Example 35
(152) The apparatus of Example 34, wherein the boss further comprises a chamfer, wherein the chamfer is configured to deflect the tension wire as the clamp pad is secured to the clamp arm body.
Example 36
(153) An apparatus, comprising: (a) a body; (b) a shaft assembly, wherein the shaft assembly comprises: (i) an outer tube, (ii) an inner tube, and (iii) an acoustic waveguide; and (c) an end effector, wherein the end effector comprises: (i) an ultrasonic blade acoustically coupled with the acoustic waveguide, and (ii) a clamp arm, comprising: (A) a clamp arm body, wherein a first portion of the clamp arm body is pivotably coupled with a distal end of the outer tube, wherein a second portion of the clamp arm body is pivotably coupled with a distal end of the inner tube, wherein the clamp arm body defines an opening, (B) a tension wire extending through the opening, and (C) a clamp pad, wherein the tension wire is configured to removably secure the clamp pad to the clamp arm body.
Example 37
(154) The apparatus of Example 36, further comprising a clamp pad loader assembly, wherein the clamp pad loader assembly is configured to receive the clamp arm body, wherein the clamp pad loader assembly is further configured to removably retain at least one clamp pad, wherein the damp pad loader assembly is further configured to load the retained at least one clamp pad onto the clamp arm body.
Example 38
(155) The apparatus of Example 37, wherein the clamp pad loader assembly further comprises: (i) a body, (ii) a latch, wherein the latch is configured to removably secure the at least one clamp pad to the body, and (iii) an actuator, wherein the actuator is configured to disengage the latch to thereby release the at least one clamp pad from the body of the clamp pad loader.
Example 39
(156) A method of assembling an instrument, the method comprising: (a) grasping an instrument body, wherein an acoustic waveguide extends distally from the instrument body, wherein the acoustic waveguide has a distal end including an ultrasonic blade; (b) grasping a shaft assembly, wherein the shaft assembly comprises: (i) an inner tube, wherein the inner tube distally terminates in a distal end, wherein the inner tube proximally terminates in a proximal end, (ii) an outer tube, wherein the outer tube distally terminates in a distal end, wherein the outer tube proximally terminates in a proximal end, and (iii) a clamp arm, wherein the clamp arm is pivotably coupled with the distal end of the inner tube, wherein the clamp arm is further pivotably coupled with the distal end of the outer tube; (c) inserting the proximal ends of the inner and outer tubes into the instrument body, wherein the proximal ends of the inner and outer tubes are inserted into the instrument body as a unit; (d) securing the proximal ends of the inner and outer tubes in the instrument body, wherein the clamp arm and the ultrasonic blade cooperate to define an end effector after the proximal ends of the inner and outer tubes are secured in the instrument body.
Example 40
(157) The method of Example 39, further comprising pressing a clamp pad into engagement with a clamp arm body to thereby form the clamp arm, wherein the act of pressing a clamp pad into engagement with a clamp arm body comprises deflecting a resilient feature secured to the clamp arm body.
V. Miscellaneous
(158) It should be understood that any of the versions of instruments described herein may include various other features in addition to or in lieu of those described above. By way of example only, in addition to the teachings above, it should be understood that the instruments described herein may be constructed and operable in accordance with at least some of the teachings of U.S. Pat. Nos. 5,322,055; 5,873,873; 5,980,510; 6,325,811; 6,773,444; 6,783,524; 9,095,367; U.S. Pub. No. 2006/0079874, now abandoned; U.S. Pub. No. 2007/0191713, now abandoned; U.S. Pub. No. 2007/0282333, now abandoned; U.S. Pub. No. 2008/0200940, now abandoned; U.S. Pub. No. 2009/0105750, issued as U.S. Pat. No. 8,623,027 on Jan. 7, 2014; U.S. Pub. No. 2010/0069940, issued as U.S. Pat. No. 9,023,071; U.S. Pub. No. 2011/0015660, issued as U.S. Pat. No. 8,461,744 on Jun. 11, 2013; U.S. Pub. No. 2012/0112687, issued as U.S. Pat. No. 9,381,058; U.S. Pub. No. 2012/0116265, now abandoned; U.S. Pub. No. 2014/0005701, issued as U.S. Pat. No. 9,393,037; U.S. Pub. No. 2015/0080924, issued as U.S. Pat. No. 10,172,636; and/or U.S. Pat. App. No. 61/410,603. The disclosures of each of the foregoing patents, publications, and applications are incorporated by reference herein. It should also be understood that the instruments described herein may have various structural and functional similarities with the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and/or the HARMONIC SYNERGY® Ultrasonic Blades. Furthermore, the instruments described herein may have various structural and functional similarities with the devices taught in any of the other references that are cited and incorporated by reference herein.
(159) To the extent that there is some degree of overlap between the teachings of the references cited herein, the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the teachings herein relating to the instruments described herein, there is no intent for any of the description herein to be presumed as admitted prior art. Several teachings herein will in fact go beyond the scope of the teachings of the references cited herein and the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades.
(160) It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
(161) Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings herein may be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif. Similarly, those of ordinary skill in the art will recognize that various teachings herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004, the disclosure of which is incorporated by reference herein.
(162) Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
(163) By way of example only, versions described herein may be sterilized before and/or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
(164) Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.