surgical instrument with removable part for easy cleaning

专利摘要:
A surgical instrument has an ultrasound blade (150) that connects to a distal end of an ultrasound waveguide. a staple arm assembly (220) is movable from an open position for receiving a fabric to a closed position for tightening the fabric. a clamp arm actuator attached to the clamp arm assembly directs the clamp arm assembly from the open position to the closed position. an outer sheath (9612) surrounds at least a portion of the ultrasound waveguide. the outer sheath includes a cap (9620) removably received against a sheath body, and a feature sheath removably capable of being capped to the sheath body such that the cap may be detached from the sheath body to access the sheath. Ultrasonic waveguide inside the outer sheath. a device (138) for molding a seal (9302) for an ultrasound waveguide (140) is also described.
公开号:BR112019009922A2
申请号:R112019009922
申请日:2017-11-16
公开日:2019-08-13
发明作者:J Mumaw Daniel；G Dezinger Kristen；L Zeckel Monica；J Minnelli Patrick；Gu Qinlin；S Holland Timothy；Guo Wei；Yu Yachuan
申请人:Ethicon Llc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for SURGICAL INSTRUMENT WITH REMOVABLE PART TO MAKE CLEANING ⁸ .
PRIORITY [0001] This application claims the priority of: (1) US provisional patent application serial number 62 / 422,698, filed on November 16, 2016, entitled Ultrasonic Surgical Shears with Contained Compound Lever Clamp Arm Actuator, the disclosure of which is here incorporated as a reference; (2) provisional patent application serial number 62 / 508,720, filed on May 19, 2017, entitled Ultrasonic and Electrosurgical Instrument with Replaceable End Effector Features, the disclosure of which is hereby incorporated by reference; and (3) provisional patent application serial number 62 / 519,482, filed on June 14, 2017, entitled Ultrasonic and Electrosurgical Instrument with Removable Features, the disclosure of which is hereby incorporated by reference. BACKGROUND OF THE INVENTION [0002] A variety of surgical instruments include an end actuator that has a blade element that vibrates at ultrasonic frequencies to cut and / or seal tissue (for example, by denaturing proteins in tissue cells). These instruments include piezoelectric elements that convert electrical energy into ultrasonic vibrations that, in turn, are transmitted along an acoustic waveguide to the blade element. The accuracy of cutting and coagulation can be controlled by the surgeon's technique and by adjusting the energy level, blade edge, tissue traction and blade pressure.
[0003] Examples of ultrasonic surgical instruments include HARMONIC ACE® ultrasonic shearers, HARMONIC WAVE® ultrasonic shearers, HARMONIC FOCUS® ultrasonic shearers and HARMONIC SYNERGY® ultrasonic blades,
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2/64 all produced by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio, USA. Other examples of such devices and related concepts are disclosed in US Patent No. 5,322,055, entitled Clamp Coagulator / Cutting System for Ultrasonic Surgical Instruments, issued June 21, 1994, the disclosure of which is incorporated herein by reference; US Patent No. 5,873,873, entitled Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism, issued February 23, 1999, the disclosure of which is hereby incorporated by reference; US Patent No. 5,980,510, entitled Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Arm Pivot Mount, filed on October 10, 1997, the disclosure of which is hereby incorporated by reference; US Patent No. 6,325,811, entitled Blades with Functional Balance Asymmetries for use with Ultrasonic Surgical Instruments, issued December 4, 2001, the disclosure of which is hereby incorporated by reference; US Patent No. 6,773,444, entitled Blades with Functional Balance Asymmetries for Use with Ultrasonic Surgical Instruments, issued on August 10, 2004, the disclosure of which is hereby incorporated by reference; and in US Patent No. 6,783,524, entitled Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument, granted on August 31, 2004, the disclosure of which is incorporated herein by reference.
[0004] Additional examples of ultrasonic surgical instruments are disclosed in US publication No. 2006/0079874, entitled Tissue Pad for Use with an Ultrasonic Surgical Instrument, published on April 13, 2006, the disclosure of which is hereby incorporated by reference; US publication No. 2007/0191713, entitled Ultrasonic Device for Cutting and Coagulating, published on August 16, 2007, the disclosure of which is hereby incorporated by reference; in US publication No. 2007/0282333, entitled Ultrasonic Waveguide and Blade, published on December 6, 2007, the disclosure of which is hereby incorporated by way of
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3/64 reference; US publication No. 2008/0200940, entitled Ultrasonic Device for Cutting and Coagulating, published on August 21, 2008, the disclosure of which is hereby incorporated by reference; US Patent No. 8,623,027, entitled Ergonomic Surgical Instruments, issued on January 7, 2014, the disclosure of which is hereby incorporated by reference; US Patent No. 9,023,071, entitled Ultrasonic Device for Fingertip Control, issued on May 5, 2015, the disclosure of which is incorporated herein by reference; and US Patent No. 8,461,744, entitled Rotating Transducer Mount for Ultrasonic Surgical Instruments, issued June 11, 2013, the disclosure of which is incorporated herein by reference; and US Patent No. 8,591,536, entitled Ultrasonic Surgical Instrument Blades, issued on November 26, 2013, the disclosure of which is hereby incorporated by reference.
[0005] Some ultrasonic surgical instruments may include a wireless transducer such as that disclosed in US Patent No. 9,381,058, entitled Recharge System for Medical Devices, granted on July 5, 2016, the disclosure of which is incorporated herein by reference; US publication No. 2012/0116265, entitled Surgical Instrument With Charging Devices, published on May 10, 2012, the disclosure of which is hereby incorporated by reference; and / or US patent application No. 61 / 410,603, filed on November 5, 2010, entitled Energy-Based Surgical Instruments, the disclosure of which is hereby incorporated by reference.
[0006] In addition, some ultrasonic surgical instruments may include an articulated drive shaft section. Examples of such ultrasonic surgical instruments are disclosed in US Patent No. 9,393,037, entitled Surgical Instruments with Articulating Shafts, issued on July 19, 2016, the disclosure of which is hereby incorporated by reference; and US Patent No. 9,095,367, entitled Flexible
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4/64
Harmonic Waveguides / Blades for Surgical Instruments ”, granted on August 4, 2015, the disclosure of which is hereby incorporated by reference.
[0007] Although various surgical instruments and systems have been developed and used, it is believed that no one before the inventors has developed or used the invention described in the attached claims.
BRIEF DESCRIPTION OF THE DRAWINGS [0008] Although the specification concludes with claims that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples, taken in conjunction with the accompanying drawings , in which like reference numbers identify like elements, and in which:
[0009] Figure 1A represents a perspective view of a first exemplary surgical instrument, with an instrument end actuator in an open configuration;
[0010] Figure 1B represents a perspective view of the instrument of Figure 1 A, with the end actuator in a closed configuration;
[0011] Figure 2 represents an exploded perspective view of the instrument of Figure 1 A;
[0012] Figure 3 represents a perspective view of a first modular set of the instrument of Figure 1 A;
[0013] Figure 4 represents a perspective view of the first modular set of Figure 3, with selected portions purposely omitted for clarity;
[0014] Figure 5 represents a perspective view of a drive shaft assembly and a blade assembly of the first modular assembly of Figure 3;
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5/64 [0015] Figure 6 represents a cross-sectional view of the drive shaft assembly and the blade assembly of Figure 5;
[0016] Figure 7 represents a perspective view of a coupling member of the instrument of Figure 1A;
[0017] Figure 8 represents a perspective view of a second modular set of the instrument of Figure 1 A;
[0018] Figure 9 represents an exploded perspective view of the second modular assembly of Figure 8;
[0019] Figure 10 shows an exploded perspective view of a clamping arm and a clamping block of the second modular assembly of Figure 8;
[0020] Figure 11 represents a perspective view of the clamping arm assembly of Figure 10;
[0021] Figure 12 represents a side view in cross section of the clamping arm assembly of Figure 10, taken along line 12-12 of Figure 11;
[0022] Figure 13A represents a perspective view of the second modular assembly of Figure 8 aligned with the drive shaft assembly of Figure 5 to couple the modular assemblies together;
[0023] Figure 13B represents a perspective view of the second modular assembly of Figure 8 inserted through the drive shaft assembly of Figure 5;
[0024] Figure 13C represents a perspective view of the second modular assembly of Figure 8 coupled to the drive shaft assembly of Figure 5 through the coupling member of Figure 7;
[0025] Figure 14A represents a cross-sectional side view of the second modular assembly of Figure 8 partially inserted on the drive shaft assembly of Figure 5, taken along line 14-14 of Figure 13B;
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6/64 [0026] Figure 14B represents a side view in cross section of the second modular set of Figure 8 inserted still on the set of drive shaft of Figure 5, taken along line 14-14 of Figure 13B;
[0027] Figure 14C represents a cross-sectional side view of the second modular assembly of Figure 8 inserted on the drive shaft assembly of Figure 5 while the coupling member of Figure 7 is rotated towards a configuration to couple the assembly drive shaft to the second modular assembly, taken along line 14-14 of Figure 13B;
[0028] Figure 14D represents a cross-sectional side view of the coupling member of Figure 7 connecting the second modular assembly of Figure 8 and the driving shaft assembly of Figure 5, taken along line 14-14 of Figure 13B ;
[0029] Figure 15A represents a front cross-sectional view of the second modular assembly of Figure 8 inserted on the drive shaft assembly of Figure 5, taken along line 15A-15A of Figure 14B;
[0030] Figure 15B represents a front cross-sectional view of the second modular assembly of Figure 8 inserted on the drive shaft assembly of Figure 5 while the coupling member of Figure 7 is rotated towards a configuration to couple the assembly drive shaft to the second modular assembly, taken along line 15B-15B of Figure 14C;
[0031] Figure 15C represents a front cross-sectional view of the coupling member of Figure 7 connecting the second modular assembly of Figure 8 and the driving shaft assembly of Figure 5, taken along line 15C-15C of Figure 14D ;
[0032] Figure 16A represents a side view in cross section of the second modular set of Figure 8 coupled to the set
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7/64 of the drive shaft of Figure 5, in which the end actuator is in an open configuration;
[0033] Figure 16B represents a cross-sectional side view of the second modular assembly of Figure 8 coupled to the drive shaft assembly of Figure 5, in which the end actuator is in a closed configuration;
[0034] Figure 17 represents a perspective view of a second exemplary surgical instrument, with an instrument end actuator in an open configuration;
[0035] Figure 18 represents a partially exploded perspective view of the instrument of Figure 17;
[0036] Figure 19 represents a partial perspective view of the distal end of a clamping actuator of the instrument of Figure 17;
[0037] Figure 20 represents a perspective view of a set of drive shaft and ultrasonic blade of the instrument of Figure 17;
[0038] Figure 21 represents a perspective view of a removable clamping arm assembly of the instrument of Figure 17;
[0039] Figure 22 represents an exploded view of the clamping arm assembly of Figure 21;
[0040] Figure 23 represents a partial perspective view of a clamping arm body of the clamping arm assembly of Figure 22;
[0041] Figure 24 represents a perspective view of a third exemplary surgical instrument, similar to the surgical instrument in Figure 1 A;
[0042] Figure 25 represents an exploded perspective view of the surgical instrument of Figure 24;
[0043] Figure 26 represents a perspective view of a guide
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8/64 waves of the surgical instrument in Figure 25;
[0044] Figure 27 represents a cross-sectional view taken along line 27-27 of Figure 26;
[0045] Figure 28A represents a cross-sectional view similar to Figure 27, with the waveguide arranged inside an exemplifying tube;
[0046] Figure 28B represents a cross-sectional view similar to Figure 28A, with an exemplary distal shape part of an exemplary shape arranged on the waveguide and an exemplary proximal shape part extended into a cavity defined by the tube and the waveguide;
[0047] Figure 28C represents a cross-sectional view similar to Figure 28B, with the distal shape part connected to the tube and cooperating with the proximal part and the tube to define a mold space in it;
[0048] Figure 28D represents a cross-sectional view similar to Figure 28C, with the proximal shape part and the distal shape part being removed from the cavity and leaving a seal disposed in the mold space;
[0049] Figure 28E represents a cross-sectional view similar to Figure 28A with the seal arranged between the tube and the waveguide;
[0050] Figure 29 represents a perspective view of a fourth exemplary surgical instrument that has a first accessible external sheath with a removable hinged cover;
[0051] Figure 30 represents a partially exploded perspective view of the surgical instrument of Figure 29;
[0052] Figure 31 represents an enlarged perspective view of the surgical instrument of Figure 30;
[0053] Figure 32 represents a perspective view of the cover
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9/64 articulated in Figure 30;
[0054] Figure 33A is an enlarged perspective view of the surgical instrument of Figure 29 with a clamping arm assembly in an open position and the hinged cover in a covered configuration; [0055] Figure 33B represents the enlarged perspective view of the surgical instrument similar to Figure 33A, but showing the clamping arm assembly in the closed position;
[0056] Figure 33C represents the enlarged perspective view of the surgical instrument similar to Figure 33A, but showing the hinged lid being separated from the covered configuration;
[0057] Figure 34A represents an enlarged perspective view of the surgical instrument of Figure 29 with the hinged lid being separated from the covered configuration;
[0058] Figure 34B represents the enlarged perspective view of the surgical instrument similar to Figure 34A with the hinged lid still separate from the covered configuration;
[0059] Figure 35A represents an enlarged cross-sectional view of the surgical instrument of Figure 34B, taken along the section line 35A-35A of Figure 34B, with the hinged lid rotated to a transverse orientation;
[0060] Figure 35B shows the enlarged cross-sectional view of the surgical instrument similar to Figure 35A, but which has the hinged lid rotated in addition to the transversal orientation to uncouple the hinged lid from it;
[0061] Figure 35C represents the enlarged cross-sectional view of the surgical instrument similar to Figure 35B, but which has the hinged cover detached from it;
[0062] Figure 36 represents a perspective view of a fifth exemplary surgical instrument that has a second accessible external sheath with a removable magnetic cover;
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10/64 [0063] Figure 37 represents an enlarged perspective view of the surgical instrument of Figure 36 with the magnetic cap detached from it;
[0064] Figure 38 represents a perspective view of the magnetic cover of Figure 36;
[0065] Figure 39A represents an enlarged perspective view of the surgical instrument of Figure. 36 with the magnetic cover hidden for clarity of various features;
[0066] Figure 39B represents the enlarged perspective view of the surgical instrument similar to Figure 39A, but showing the magnetic cap being detached from it;
[0067] Figure 40 represents a perspective view of a sixth exemplary surgical instrument that has a third external sheath accessible with a removable pin cover;
[0068] Figure 41 represents a partially enlarged exploded perspective view of the surgical instrument of Figure 40 that includes the pin cover, which has a cover body and a plurality of pins;
[0069] Figure 42 represents a perspective view of a seventh exemplary surgical instrument that has a fourth external sheath accessible with a first removable snap-on lid;
[0070] Figure 43 represents an exploded perspective view partially enlarged of the surgical instrument of Figure 42;
[0071] Figure 44 represents an external perspective view of the snap-fit lid of Figure 43;
[0072] Figure 45 shows an interior perspective view of the snap-fit lid of Figure 43;
[0073] Figure 46 represents an enlarged perspective view of the surgical instrument of Figure 42 with the snap cap removed from it;
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11/64 [0074] Figure 47 represents a perspective view of an eighth exemplary surgical instrument that has a fifth external sheath accessible with a second removable snap-on lid;
[0075] Figure 48 represents an exploded perspective view partially enlarged of the surgical instrument of Figure 47;
[0076] Figure 49 represents an external perspective view of the snap-fit lid of Figure 48;
[0077] Figure 50 represents an interior perspective view of the snap-fit lid of Figure 48; and [0078] Figure 51 represents an enlarged perspective view of the surgical instrument of Figure 47 with the snap-on lid removed from it.
[0079] The drawings are not intended to be limiting in any way and it is contemplated that various modalities of technology can be performed in a variety of other ways, including those not necessarily represented in the drawings. The drawings incorporated in the annex and forming part of the specification illustrate various aspects of the present technology and, together with the description, serve to explain the principles of the technology; it is understood, however, that this technology is not limited precisely to the provisions shown. DETAILED DESCRIPTION [0080] The following description of certain examples of the technology should not be used to limit its scope. Other examples, resources, aspects, modalities and advantages of the technology will become evident to those versed in the technique from the following description, which is given by way of illustration, one of the best ways contemplated to execute the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without disregarding the technology. Consequently, drawings and descriptions
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12/64 should be considered as illustrative and not restrictive. [0081] It is understood that any one or more of the teachings, expressions, modalities, examples etc. described here can be combined with any one or more of the other teachings, expressions, modalities, examples etc. that are described in the present invention. The teachings, expressions, modalities, examples etc. described below should not be seen in isolation from each other. Various suitable ways in which the teachings of the present invention can be combined will become readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included in the scope of the attached claims.
[0082] For clarity of disclosure, the terms proximal and distal are defined here in relation to a human or robotic operator of the surgical instrument. The term proximal refers to the position of an element closer to the human or robotic operator of the surgical instrument and further away from the surgical end actuator of the surgical instrument. The term distal refers to the position of an element closer to the surgical end actuator of the surgical instrument and further away from the human or robotic operator of the surgical instrument. In addition, the terms top, bottom, side, cross, bottom and top are relative terms to provide additional clarity to the Figure descriptions provided below. The terms top, bottom, side, cross, bottom and top are therefore not intended to unnecessarily limit the invention described herein. I. First Exemplifying Ultrasonic Surgical Instrument for Open Surgical Procedures [0083] Figures 1A to 2 and Figures 13A to 13C illustrate a first example ultrasonic surgical instrument 10. At least part of instrument 10 can be constructed and operable according to
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13/64 at least some of the teachings of US Patent No. 5,322,055; US patent No. 5,873,873; US patent no ^. 5,980,510; US patent No. 6,325,811; US patent No. 6,773,444; US patent No. 6,783,524; US publication No. 2006/0079874; in US publication No. 2007/0191713; in US publication No. 2007/0282333; in US publication No. 2008/0200940; US patent No. 8,623,027; US patent No. 9,023,071; US patent No. 8,461,744; US patent No. 9,381,058; in US publication No. 2012/0116265; US patent No. 9,393,037; US patent No. 9,095,367; US patent application No. 61 / 410,603. and / or US publication No. 2015/0080924. The disclosures of each of the aforementioned patents, publications and applications are hereby incorporated by reference. In addition or alternatively, at least part of instrument 10 can be constructed and operable in accordance with at least some of the teachings of US publication No. 2017/0105755, entitled Surgical Instrument with Dual Mode End Effector and Compound Lever with Detents, published in April 20, 2017, the description of which is incorporated herein by way of reference; and / or US Patent Application No. 62 / 363,411, entitled Surgical Instrument with Dual Mode End Effector, filed on July 18, 2016, the description of which is incorporated herein by reference.
[0084] As described in more detail below, instrument 10 is operable to cut tissue and seal or weld tissue (e.g., a blood vessel, etc.) substantially simultaneously. It should be understood that instrument 10 can have several structural and functional similarities with HARMONIC ACE® ultrasonic scissors, HARMONIC WAVE® ultrasonic scissors, HARMONIC FOCUS® ultrasonic scissors and / or with HARMONIC SYNERGY® ultrasonic sheets. Furthermore, instrument 10 may have several structural and functional similarities with the devices taught in any of the other references cited and incorporated by reference to the present invention.
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14/64 [0085] Instrument 10 in the present example includes a first modular assembly 100, a second modular assembly 200, and a coupling member 300. As will be described in more detail below, coupling member 300 can selectively clamp the first modular assembly 100 to the second modular assembly 200 to form instrument 10 with an end actuator 12. As can best be seen in Figures 1A and 1B, end actuator 12 comprises an ultrasonic blade 150 and a clamping block 222 of an assembly clamping block 220.
[0086] Still, as will be described in more detail below, selected portions of the second modular set 200 can act in relation to the first modular set 100, when properly attached to each other, in order to actuate the end actuator 12 from a open configuration (Figures 1A and 16A), for a closed configuration (Figures 1B and 16B). The ability to selectively connect and disconnect the second modular set 200 with the first modular set 100 can provide additional reuse benefits of any modular set 100, 200. For example, different types of first modular sets 100 can be used with the second modular set 200 to provide different types of surgical instruments. Similarly, different types of second modular sets 200 can be used with the first modular set 100 to provide different types of surgical instruments. In addition, moving components of the second modular assembly 200 can be housed within the static components of the second modular assembly 200, which can provide additional advantages, some of which are described below while others will be apparent to a person skilled in the art in view of the teachings of the present invention.
[0087] The first modular set 100 includes a set of cable
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110, a drive shaft assembly 130 extending distally from cable assembly 110, and an ultrasonic blade 150 extending distally from drive shaft assembly 130. Cable assembly 110 includes a body 112, a finger grip ring 124, a pair of buttons 126 distal to the finger grip ring 124, and an ultrasonic transducer assembly 30 housed within the body 112.
[0088] The drive shaft assembly 130 includes a proximal outer sheath 132 that extends distally from body 112, a tube 138 that extends distally from proximal outer sheath 132, and a waveguide 140 extending to in and through both the proximal outer sheath 132 and the tube 138. The proximal outer sheath 132 includes a pair of protrusions 136. In addition, the proximal outer sheath 132 defines a pair of recesses 134. As will be described in more detail below, the recesses 134 are dimensioned to couple with a part of the distal outer sheath 230 while protrusions 136 are configured to pivot proximally outer sheath 132 to the coupling member 300. Both recesses 134 and protrusions 136 can help couple the first set modular 100 to the coupling member 300.
[0089] The proximal external sheath 132 can be fixed in relation to the body 112, while the tube 138 can be fixed in relation to the proximal external sheath 132. As will be described in more detail below, the waveguide 140 can be fixed to the set transducer 30 and be supported by portions of the proximal outer sheath 132 and tube 138. The ultrasonic blade 150 can be connected uniquely to the waveguide 140, and also extends distally from the waveguide 140. As will be described in more detail details below, waveguide 140 is operable to connect to the ultrasonic transducer assembly
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16/64 in order to provide acoustic communication between the ultrasonic blade 150 and the transducer set 30.
[0090] With reference to Figure 4, an ultrasonic transducer assembly 30 is housed within the body 112 of the cable assembly 110. As seen in Figures 1A and 1 Β, the transducer assembly 30 is coupled to a generator 5 via a plug 11.0 transducer set 30 receives electrical energy from generator 5 and converts that energy into ultrasonic vibrations using piezoelectric principles. The generator 5 can include a power source and a control module that is configured to provide a power profile to the transducer assembly 30, which is particularly suitable for generating ultrasonic vibrations through the transducer assembly 30. The generator 5 can also be configured to provide a power profile that allows end-12 actuator to apply RF electrosurgical energy to the tissue. [0091] For example only, generator 5 may comprise a GEN 300, sold by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio, USA. In addition, or alternatively, the generator (not shown) can be built according to at least some of the teachings of US Patent No. 8,986,302, entitled Surgical Generator for Ultrasonic and Electrosurgical Devices, published on April 14, 2011, whose disclosure is incorporated by reference into the present invention. It should also be understood that at least some of the features of generator 5 can be integrated into cable assembly 110, and that cable assembly 110 may even include a battery or other built-in power source, so that plug 11 is omitted. Still other suitable forms that the generator 5 can take, as well as various features and operabilities that the generator 5 can provide, will be evident to those skilled in the art in view of the teachings of the present invention.
[0092] Ultrasonic vibrations that are generated by the set of
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17/64 transducer 30 are communicated along an acoustic waveguide 140 when properly coupled. The waveguide 140 is mechanically and acoustically coupled to the transducer assembly 30. The waveguide 140 extends through the drive shaft assembly 130 to reach the ultrasonic blade 150. The waveguide 140 can be attached to the proximal outer sheath 132 and / or body 112 by means of a pin 135 that extends through the waveguide 140 and the proximal outer sheath 132. Pin 135 can help to ensure that the waveguide 140 remains longitudinally and rotationally fixed in relation to the rest of the drive shaft assembly 130 when the waveguide 140 is in a deactivated state (i.e., not ultrasonically vibrating).
[0093] In addition, the waveguide 140 can be supported by the tube 138 through seals 142 located between an interior of the tube 138 and an exterior of the waveguide 140. The seals 142 can also prevent unwanted matter and fluid from entering the portions of the tube 138 that houses the waveguide 140. The pin 135 and the seals 142 are located in positions along the length of the waveguide 140 which corresponds to a knot associated with the resonant ultrasonic vibrations communicated through the waveguide 140. Therefore , the contact between the waveguide 140 and the pin 135, as well as the contact between the waveguide 140 and the seals 142 may not affect the ultrasonic vibrations communicated through the waveguide 154.
[0094] When the ultrasonic blade 150 is in an activated state (i.e., ultrasonically vibrating), the ultrasonic blade 150 is operable to effectively cut through the fabric and seal it, particularly when the fabric is being trapped between the clamping block 222 and the ultrasonic blade 150. It should be understood that the waveguide 140 can be configured to amplify mechanical vibrations transmitted through the waveguide 140. In addition, the waveguide 140
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18/64 may include features that can be operable to control the gain of longitudinal vibrations along the waveguide 140 and / or features to tune the waveguide 140 to the system's resonant frequency. [0095] In the present example, the distal end of the ultrasonic blade 150 is located in a position that corresponds to an antino associated with resonant ultrasonic vibrations, communicated through the waveguide 140, to tune the acoustic set to a preferred resonant frequency f ₀ when the acoustic set is not loaded by fabric. When the transducer assembly 30 is energized, the distal end of the ultrasonic blade 150 is configured to move longitudinally in the range of, for example, approximately 10 to 500 microns from peak to peak and, in some cases, in the range of about 20 to about 200 microns at a predetermined vibratory frequency f ₀ , for example, 55.5 kHz. When the transducer assembly 30 of the present example is activated, these mechanical oscillations are transmitted through the waveguide 140 to reach the ultrasonic blade 150, thereby causing the ultrasonic blade 150 to oscillate at the resonant ultrasonic frequency. Therefore, when the tissue is trapped between the ultrasonic blade 150 and the clamping block 222, the ultrasonic oscillation of the ultrasonic blade 150 can simultaneously cut the tissue and denature proteins in the cells of the adjacent tissue, thus providing a relatively coagulating effect. little thermal spread.
[0096] In some versions, an electric current can also be supplied through the ultrasonic blade 150 and / or the clamping block 222 to also seal the fabric. Therefore, it should be understood that instrument 10 can also be configured to deliver RF radio frequency energy to a surgical site via end actuator 12. Only by way of example, an operator can rely primarily on the use of ultrasonic energy from blade 150 to cut the
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19/64 tissue that is captured between the ultrasonic blade 150 and the clamping block 222. The operator can also count on the use of RF energy from the end actuator 12 to seal the cut tissue. Obviously, it will be recognized that the ultrasonic energy of the blade 150 can seal the tissue to a certain degree, so that the RF energy from the end actuator 12 can supplement the seal that would already be obtained with the use of the ultrasonic energy. It should also be understood that there may be cases where the operator may simply wish to use the end actuator 12 to apply only RF energy to the tissue, without also applying ultrasonic energy to the tissue. As will be understood from the description of the present invention, some versions of the instrument 10 are capable of providing all types of functionality mentioned above. Various ways in which the instrument 10 can be configured and operable to provide both ultrasonic and RF electrosurgical energy modes of operation are described in various references cited in the present invention; although other ways in which the instrument 10 can be configured and operable to provide both ultrasonic and RF electrosurgical modes of operation, will be apparent to those skilled in the art in view of the teachings of the present invention.
[0097] An operator can activate buttons 126 to selectively activate transducer set 30 to thereby activate ultrasonic blade 150. In the present example, two buttons 126 are provided. In some versions, a button 126 is provided to activate the ultrasonic blade 150 in a first power profile (for example, a first frequency and / or first amplitude), and another button 126 is provided to activate the ultrasonic blade 150 in a second power profile (for example, a second frequency and / or second amplitude). In some other versions, a button 126 is provided to activate the blade
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20/64 ultrasonic 150 with ultrasonic energy, and the other button 126 is provided to activate end actuator 12 with RF energy. In some other versions, a button 126 is operable to activate the ultrasonic blade 150 with ultrasonic energy while simultaneously activating the end actuator 12 with RF energy; while the other button 126 is operable only to activate the ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate the ultrasonic blade 150 with ultrasonic energy, then based on one or more other conditions (eg time, measured impedance, etc.) while the button 126 remains on , eventually activate the end actuator 12 with RF energy while still activating the ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate the ultrasonic blade 150 with ultrasonic energy, then based on one or more other conditions (eg time, measured impedance, etc.) while the button 126 remains on , eventually activate the end actuator 12 with RF energy and at the same time stop the activation of the ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate end actuator 12 with RF energy, then based on one or more other conditions (eg time, measured impedance, etc.) while button 126 remains activated, eventually activate the ultrasonic blade 150 with ultrasonic energy and at the same time cease activating the a 12 with RF energy.
[0098] It should be understood that any other suitable number of buttons and / or, otherwise, selectable energy levels and / or energy modalities can be provided. For example, a pedal can be provided to selectively activate transducer set 30. [0099] The buttons 126 in this example are positioned
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21/64 so that an operator can readily and completely operate instrument 10 with a single hand. For example, when the first and second modular assemblies 100, 200 are coupled, the operator can position his thumb on the thumb grip ring 214, position his ring finger on the finger grip ring 124, position his middle finger on the body 112 and manipulate the buttons 126 using your index finger. Obviously, any other suitable techniques can be used to hold and operate the instrument 10; and buttons 126 can be located in any other suitable positions.
[0100] As mentioned above, and as will be described below, the coupling member 300 is configured to selectively couple the first modular assembly 100 to the second modular assembly 200. As can be seen better in Figure 7, the coupling member 300 comprises a body 302, a pair of resilient arms 304 extending from body 302, and a pair of handles 305 extending from body 302. Resilient arms 304 each define a respective pivot hole 306 and assembly locking 308. The resilient arms 304 are spaced apart from each other in order to receive the proximal outer sheath 132 and to press fit the pivot holes 306 to the respective protrusions 136. Therefore, as shown between Figures 13B to 13C and 14B to 14C, the coupling member 300 is configured to pivotally connect to the proximal outer sheath 132 through pivot holes 306 and protrusions 136. Although in the exe The coupling member 300 and the proximal outer sheath 132 are currently pivotally coupled by pressure fitting, any other suitable connection type can be used as would be evident to the person skilled in the art in view of the teachings of the present invention. For example, protrusions 136 may be extensible in relation to the proximal outer sheath 132 in order to pivotably engage the pivot hole
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306 of the coupling member 300. The handles 305 can be positioned on the body 302 so that an operator can easily rotate the coupling member 300 with respect to the outer sheath 132 through handles 305.
[0101] Each locking set 308 includes an inner contact wall 310 facing each other and a coupling recess 312. As will be described in more detail below, locking set 308 is configured to rotate around the pivot 306 and protrusions 136 and in order to selectively couple to the portions of the second modular set 200.
[0102] Although coupling member 300 in the current example is used to connect the first modular assembly 100 to the second modular assembly 200, it should be understood that the coupling member 300 can be incorporated into any suitable type of modular assembly that would be evident from a person skilled in the art in view of the teachings of the present invention. For example, coupling assembly 300 can be modified to couple different different modular clamping arm assemblies to the first modular assembly 100 where different modular clamping arm assemblies include clamping arm assemblies like those taught in US publication No. 2017 / 0105788, entitled Surgical Instrument with Dual Mode End Effector and Modular Clamp Arm Assembly, published on April 20, 2017, the description of which is hereby incorporated by reference. In this way, a modular clamping arm assembly that can be coupled to the first modular assembly 100 can provide pivoting movement of a clamping arm on one side of the ultrasonic blade 150 while the other modular clamping arm assembly that can be coupled to the first modular assembly 100 can provide pivoting movement of a clamping arm on the other side of the ultrasonic blade 150. Other suitable types of clamping arm assemblies
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23/64 that can be used to provide different types of second modular assemblies 200 will become apparent to those skilled in the art in view of the teachings of the present invention.
[0103] The second modular assembly 200 includes a clamp arm assembly 210, a clamp block assembly 220, and a distal outer sheath 230. As will be described in more detail below, the distal outer sheath 230 is configured to couple both the coupling member 300 and the proximal outer sheath 132 in order to selectively couple the first modular set 100 to the second modular set 200. In other words, when properly coupled, the proximal outer sheath 132 and the distal outer sheath 230 can be attached one in relation to the other. As will be described in more detail below, the clamping arm assembly 210 and the clamping block assembly 220 are both pivotally coupled to the distal outer sheath 230. In addition, the clamping arm assembly 210 and the clamping block assembly clamping 220 are dimensioned to mesh with each other so that the rotation of one set 210, 220 with respect to the outer sheath 230 causes the rotation of the other set 210, 220 with respect to the outer sheath 230. In other words, the clamping arm assembly 210 and the clamping block assembly 220 have the ability to rotate one with respect to the outer sheath 230. [0104] The outer sheath 230 includes a U-shaped body 232 extending from a distal face 235 and ends in a pair of proximally presented projections 234. The proximally displayed protuberances 234 each include a lateral protuberance 238 extending in the opposite direction to the body in force. U-shape 232. The U-shaped body 232 defines a longitudinal path 236 and a plurality of holes 240. The U-shaped body 232 and the longitudinal path 236 are dimensioned to receive the tube 138 and rotate a set clamping arm 210 and the set
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24/64 of clamping block 220. In particular, as is best seen between Figures 13A and 13B, the U-shaped body 232 can be inserted over the ultrasonic blade 150 and tube 138 so that tube 138 rests under clamping arm assembly 210 and clamping block assembly 220. Tube 138 can protect the waveguide 140 so that clamping arm assembly 210 and clamping block assembly 220 do not come into contact with adjacent portions of waveguide 140. [0105] As shown between Figures 13A to 13B and between Figures 14A to 14B, the proximally displayed projections 234 are configured to be inserted into the recesses 134 defined by the proximal outer sheath 132. When proximally projected shown 234 are inserted in the recesses 134, the distal outer sheath 230 may not rotate in relation to the proximal outer sheath 132 around a longitudinal geometric axis defined by tube 138. Therefore, the projections pr oximally presented 234 can be coupled to the recesses 134 to swivel the distal outer sheath 230 in relation to the proximal outer sheath 132.
[0106] As shown between Figures 13B to 13C, between Figures 14B to 14D, and between Figures 15A to 15C, since the distal outer sheath 230 is swiveled in relation to the proximal outer sheath 132 , an operator can rotate the coupling member 300 so that the locking assembly 308 snaps to the side protrusions 238. In particular, an operator can rotate the coupling member 300 around the protrusion 136 so that the lateral protrusions 238 move against the contact walls 310 of the resilient arms 304. As a result, as can be seen best in Figure 15B, the contact between the contact with the side walls 310 and the side protrusions 238 flexes the resilient arms 304 outwardly to the projections proximally presented 234. An operator can still rotate the
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25/64 coupling member 300 around the protrusions 136 so that the lateral protrusions 238 are no longer in a boundary position against the contact wall 310, as shown in Figures 13C, 14C and 15C. The resilient nature of the resilient arms 304 allows the resilient arms 304 to return to a relaxed position so that the lateral protrusions 238 rest within the coupling recess 312 of the locking assembly 308. With the locking assembly 308 of the coupling member 300 fully fixed, and shown in Figures 13C, 14D and 15C, the distal outer sheath 230 is longitudinally fixed in relation to the proximal outer sheath 132, thus coupling the first modular set 100 to the second modular set 200.
[0107] If an operator wishes to decouple the first modular assembly 100 from the second modular assembly 200, an operator can hold the handles 305 to rotate the coupling member 300 in the opposite direction around the protrusions 136 to flex the resilient arms 304 to exit the lateral protrusions 238 from the coupling recess 312.
[0108] As mentioned in, the clamping arm assembly 210 and the clamping block assembly 220 are both pivotally coupled to the outer sheath 230 so that the rotation of an assembly 210, 220 relative to the outer sheath 230 causes the other assembly 210, 220 to rotate in relation to the outer sheath 230.
[0109] The clamping arm assembly 210 includes an elongated arm 212, a thumb grip ring 214, a flesh protrusion 216 and a pivot coupling 218. The thumb grip ring 214 and the elongated arm 212 provide together a scissor-handled configuration in combination with body 112 and finger grip ring 124. Pivot coupling 218
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26/64 pivoting the clamping arm assembly 210 to the outer sheath 230 by means of pins 202. As will be described in more detail below, the meat protuberance 216 interacts with the clamping block assembly 220 in order to rotate the assembly clamping block 220 in response to rotation of the clamping arm assembly 210.
[0110] The clamping block set 220 includes a protrusion 222 facing the ultrasonic sheet 150, a pair of tissue blocks 223 located adjacent to the ultrasonic sheet 150 and proximal to the clamping block 222, an arm 224 that defines both a recess cam 226 as a spring recess 221, a pivot coupling 228 and a molar beam 225 housed within spring recess 221. In some versions, the clamping block assembly 220 also includes one or more electrodes that are operable for apply RF electrosurgical energy to the tissue. Various references in the present invention provide examples of how a clamping block assembly can incorporate one or more electrodes that are operable to apply RF electrosurgical energy to the tissue, while other examples of how clamping block assembly 220 can incorporate one or more electrodes that are operable to apply RF electrosurgical energy to the tissue will be apparent to those skilled in the art in view of the teachings of the present invention.
[0111] In the current example, the tissue locks 223 align longitudinally to the distal face 235 when the end actuator 12 is in the closed position. The tissue locks 223 and the distal face 235 can cooperate to prevent the tissue from consistently reaching a proximal position within the end actuator 12 where the ultrasonic energy of the blade 150 may not cut or seal the tissue in a consistent and simple manner. By providing this prevention, the 223 tissue block can eliminate the need for an operator
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27/64 view the proximal region of the end actuator 12 to determine if the tissue has reached an undesirably proximal position within the end actuator 12.
[0112] The flesh protrusion 216 is sized to rotate within the cam recess 226 while also coming into contact with the cam recess 226. The cam protrusion 216 and the cam recess 226 are positioned within the outer sheath 230 of so that both are located between pivot couplings 218, 228 while clamping arm assembly 210 and clamping block assembly 220 are pivotally coupled to the distal outer sheath 230. Therefore, as shown between Figures 1A to 1B and from 16A to 16B, when an operator rotates the elongated arm 212 around the pivot coupling 218 towards the distal outer sheath 230, the cam protrusion 216 rotates in the opposite direction to the distal outer sheath 230 around the pivot coupling 218 Due to the fact that cam protrusion 216 is housed within cam recess 226, upward movement of cam protrusion 216 around pivot coupling 218 causes the upward movement of the cam recess 226 around the pivot coupling 228. The upward movement of the cam recess 226 around the pivot coupling 228 rotates the arm 224 so that the clamping block 222 rotates towards the ultrasonic blade 150 Therefore, closing the elongated arm 212 of the clamping arm assembly 210 towards the cable assembly 110 leads to closing the clamping block 222 towards the ultrasonic blade 150. It should therefore be understood that when a first assembly modular 100 and the second modular set 200 are connected, the operator can tighten the thumb snap ring 214 towards the body 112 to thereby secure the fabric between the tightening block assembly 220 and the ultrasonic blade 150 to
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28/64 priming the tissue against the ultrasonic sheet 150. When the ultrasonic sheet 150 is activated during this compression, the clamping block assembly 220 and the ultrasonic sheet 150 cooperate to transect and / or seal the compressed tissue.
[0113] As mentioned above, the spring bundle 225 is housed within the spring recess 221. As best seen in Figure 225, the spring bundle 225 is sized so that a part of the spring bundle 221 extends to out of the recess of the spring 138 to make contact with the tube 12 to provide electrical continuity between the one or more RF electrodes of the end actuator 12 and the electrical power source. It should be understood that the spring beam 225 maintains this electrical continuity throughout the movement range of the clamping block assembly 220. It should also be understood that other suitable types of resources can be used to provide electrical continuity between the one or more RF electrodes of the end 12 actuator and the electrical power source.
[0114] In some versions, one or more resilient members are used to tilt the clamping block assembly 220 towards the open position shown in Figures 1A and 16A. Of course, any other type of suitable resilient member can be used as will be apparent to those skilled in the art in view of the teachings of the present invention. Alternatively, the clamping block assembly 220 need not necessarily be forced into the open position.
[0115] Pivot couplings 218, 228 of the clamping arm assembly 210 and clamping block assembly 220 that lie within the longitudinal route 236 of the distal outer sheath 230 can provide certain desirable advantages over the clamping arm assembly clamping 210 and clamping block assembly 220 which pivotably attach to an outer part of the outer sheath 230. For
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For example, there may be a reduction in the likelihood of inadvertently pinching the fabric due to rotation of the clamp arm assembly 210 and clamp block assembly 220 with the pivot couplings 218, 228 being housed in the U-shaped body 232. In other words, the U-shaped body 232 can prevent the fabric from being inadvertently pinched by rotating the clamping arm assembly 210 and clamping block assembly 220 with respect to the outer sheath 230. Also, the width of the second modular assembly 200 can be reduced due to the fact that the pivot couplings 218, 228 are housed within the longitudinal path 236 of the distal outer sheath 230. It may also be easier to manufacture the desired components due to the simplified shapes of the arm assembly clamping 210 and clamping block assembly 220. A reduction in the tolerance stack can also be an advantage for storing pivot couplings 218, 228 in the inner outer sheath 230.
[0116] The aforementioned components and functionalities of instrument 10 are merely illustrative. The instrument 10 can be configured in several other ways, as will become apparent to those skilled in the art in view of the teachings of the present invention. By way of example only, at least part of the instrument 10 can be constructed and / or operable in accordance with at least some of the teachings of any of the following documents, the disclosures of which are all incorporated into the present invention for reference purposes: US patent n 5,322,055; US patent No. 5,873,873; US patent No. 5,980,510; US patent No. 6,325,811; US patent No. 6,783,524; US publication No. 2006/0079874; in US publication No. 2007/0191713; in US publication No. 2007/0282333; in US publication No. 2008/0200940; ^c US Patent 9,023,071; US patent No. 8,461,744; US patent No. 9,381,058; in US publication No. 2012/0116265; US patent No. 9,393,037; US patent No. 9,095,367; and / or US publication no.
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2015/0080925, entitled Alignment Features for Ultrasonic Surgical Instrument, published on March 19, 2015, the disclosure of which is hereby incorporated by reference,
II. Second Exemplifying Ultrasonic Surgical Instrument for Open Surgical Procedures [0117] Figures 17 to 18 show a second exemplifying ultrasonic surgical instrument 301. Except as described below, instrument 301 in this example can be constructed and is operable in the same way as the instrument 10 described above. Certain details of instrument 301 will therefore be omitted from the following description, it being understood that such details have already been provided above in the description of instrument 10.
[0118] The instrument 301 of the present example comprises a cable assembly 320, a clamp arm assembly 320, a drive shaft assembly 330 and a clamp arm assembly 400. The cable assembly 311 of this example is configured and operable exactly as cable assembly 110 described above, so details of cable assembly 311 will not be reiterated here.
[0119] The clamping arm actuator 320 is pivotally coupled to the outer sheath 330. In the present example, the clamping arm actuator 320 is not removable from the drive shaft assembly 330. The clamping arm actuator 320 of the The present example comprises a drive shaft 322. A thumb ring 324 is positioned at the proximal end of the drive shaft 322. As best seen in Figures 18 and 19, the pair of projections 326 extends distally from the drive shaft 322. The projections 326 are laterally spaced from one another and extend parallel to each other. As can best be seen in Figure 19, the distal end of each projection 326 includes a protuberance of flesh 328. The
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31/64 cam protrusions 328 are configured to cooperate with the clamping arm assembly 400, in a similar manner to the cam protrusions 216, as will be described below. As can also be seen better in Figure 19, projections 326 also define a pair of pin openings 327, which are configured to receive pin 338. Pin 338 provides a pivoting coupling between the clamping arm actuator 320 and the assembly drive shaft 330.
[0120] The drive shaft assembly 330 extends distally from the cable assembly 311 and is substantially identical to the drive shaft assembly 130 described above except for the differences described below. An ultrasonic blade 350, which is identical to the ultrasonic blade 150 described above, is positioned at the distal end of the drive shaft assembly 130. As can be seen best in Figure 20, the drive shaft assembly 330 defines an opening 332 which is configured to receive pin 338 to thereby provide a pivoting coupling between the actuator of the clamping arm 320 and the drive shaft assembly 330. As also shown in Figure. 20, the drive shaft assembly 330 includes an inclined latch protrusion 334, which is configured to engage the clamp arm assembly 400 as will be described in greater detail below.
[0121] As shown in Figures 21 and 22, the clamping arm assembly 400 of the present example comprises a pair of wraps 402, 404 partially surrounding a clamping arm body 430, which is pivotally coupled to a stationary body 410 Each wrap includes a distally presented fabric locking edge 408. Stationary body 410 also includes a pair of distally displayed fabric locking edges 418. Edges 408, 418 are configured to consistently cooperate and restrict proximal positioning of the fabric like 223 fabric locks and the face
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32/64 distal 235 described above. The casing 404 of the present example also includes a protection member projecting 406 distally.
[0122] The stationary body 410 of the present example further includes a pin opening 411 and a proximally projecting locking member 412. Locking member 412 defines a locking opening 414 and a ramp 416. Locking member 412 is configured to cooperate with the locking protrusion 334 of the drive shaft assembly 330 to selectively secure the clamp arm assembly 400 to the drive shaft assembly 330. In particular, when the clamp arm assembly 400 is initially supplied separately from the drive shaft assembly 330, an operator can align the clamping arm assembly 400 to the drive shaft assembly 330 along a common geometry axis and then insert blade 350 and the remaining distal portion of the drive shaft assembly 330 on the clamping arm assembly 400. The ramp 416 will eventually engage the latch protrusion 334, which will provide a cam action that causes the latch member 412 to svie in the opposite direction to the longitudinal geometric axis. As the operator continues to insert the drive shaft assembly 330 through the clamping arm assembly 400, the lock protrusion 334 eventually reaches the lock opening 414, at which point the locking member 412 resiliently returns to a state not deflected straight. In this phase, the locking protrusion 334 is arranged in the locking opening 414 and thus fixes the clamping arm assembly 400 to the drive shaft assembly 330. When the operator wants to remove the clamping arm assembly 400 from the shaft assembly actuation 330, the operator can simply engage the ramp 416 and thereby propel lock member 412 into a deflected state where lock member 412 can unblock lock latch 334; then pull the set of
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33/64 clamping arm 400 in the opposite direction to the drive shaft assembly 330. Other suitable structures and techniques that can be used to secure the clamping arm assembly 400 to the driving shaft assembly 330, and to remove the clamping arm 400 of the drive shaft assembly 330, will be apparent to those skilled in the art in view of the teachings of the present invention.
[0123] The clamping arm body 430 of the present example comprises a clamping block 432 and a pair of proximal projections 434. Clamping block 432 is positioned and configured to compress the tissue against the ultrasonic blade 350 when the arm assembly clamp 400 is attached to the drive shaft assembly 330. Said protective member 406 of wrapper 404 is configured to extend over the outer end of the distal end of the clamping arm body 430, without covering the clamping block 432. The protective member 406 thus allows the clamping block 432 to directly contact the fabric. The projections 438 each comprise a respective proximally shown recess 436 and a pair of pin openings 438. A pin 440 is positioned in the pin openings 411,438 to thus pivotably engage the clamping arm body 430 with the body stationary 410. Wraps 402, 404 are fixedly attached to the body of the clamping arm 430 so that the envelopes 402, 404 rotate with the body of the clamping arm 430 in relation to the stationary body 410.
[0124] As shown in Figure 23, the recesses 436 have a generally U-shaped configuration. The recesses 436 are configured to receive flesh protrusions 328 from the clamping block actuator 320. In other words, when the axle assembly drive 330 is inserted into the clamping arm assembly 400 as described above, the meat protrusions 328 will enter recesses 436 when lock member 412 reaches the point at which
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34/64 lock member 412 secures the clamping arm assembly 400 to the drive shaft assembly 330. When the operator removes the clamping arm assembly 400 from the drive shaft assembly 330, the meat protrusions 328 can come out freely of the recesses 436, as the actuator of the clamping arm 320 remains attached to the drive shaft assembly 330. As can be seen better in Figure 17, the casings 402, 404 are configured to cover the interfaces between the recesses 436 and the cam protrusions 328. It is to be understood that the relationship between the recesses 436 and the cam protrusions 328 is substantially identical to the relationship between the cam protrusion 216 and the cam recess 226 described above. In this way, the recesses 436 and the cam protrusions 328 provide a pivot coupling between the clamping arm body 430 and the clamping arm actuator 320.
[0125] As noted above, the actuator of the clamping arm 320 is pivotally coupled to the drive shaft assembly 330 through pin 338; and the clamping arm assembly 430 is pivotally coupled to the stationary body 410 through a pin 440; while stationary body 410 is fixedly attached to the drive shaft assembly 330. The pivoting interface between the recesses 436 and the cam protrusions 328 is longitudinally positioned between the longitudinal positions of the pins 338, 440. Therefore, it should be understood that the clamping arm actuator 320 and clamping body 430 cooperate to provide a composite lever assembly. When an operator rotates the thumb ring 324 towards the cable assembly 311, the action of the composite lever provides the corresponding pivoting movement of the clamping block 432 towards the ultrasonic blade 350.
[0126] In the present example, a resilient beam 313 is attached to the actuator of the clamping arm 320 and is slidably supported against the
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35/64 drive shaft assembly 330, so that the resilient beam 313 resiliently pushes the actuator of the clamping arm 320 in the opposite direction to the cable assembly 311. This way, when an operator relaxes his clamping or thumb ring 324 , the resilient beam 313 will propel the thumb ring 324 in the opposite direction to the cable assembly 311, thus driving the clamping block 432 in the opposite direction to the ultrasonic blade 350. Obviously, any other suitable components and arrangements can be used to provide an inclination resilient to the actuator of the clamping arm 320. Alternatively, such a resilient slope can simply be omitted.
III. Sealing interface between the tube and the waveguide [0127] As shown in Figure 6, the waveguide 140 can be supported by the tube 138 through seals 142 located between an interior of the tube 138 and an exterior of the waveguide 140 The seals 142 can also prevent unwanted matter and fluid from entering the portions of the tube 138 that houses the waveguide 140. In these versions of the instrument 10 shown in Figure 6, the most distal seal 142 is manually placed on the waveguide 140 as by rolling seal 142 on the waveguide 140 after the passage of the ultrasonic blade 15 through the seal 142. This manual manipulation and placement of the seal 142 can degrade the material of the seal 142, leading to an early degradation of the seal 142 or even an adjustment unsealed between waveguide 140 and seal 142.
[0128] Figures 24 to 28E illustrate a third exemplary surgical instrument 9300, similar to instrument 10, with similar elements having similar numbering. In some versions of the 9300 instrument, instead of physically applying an O-ring seal, such as a seal 142 on the waveguide 140, the 9300 instrument includes a 9302 seal molded directly on the waveguide 140. In some versions of the 9300 instrument, the 9302 seal
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36/64 is overmoulded on the waveguide 140 locally to allow the sealing material 9302 to connect both to the outside of the waveguide 140 and to the inside of the tube 138, thus creating a tight fit seal between them to prevent material unwanted fluid and fluid enter tube 138.
[0129] As shown in Figures 24 to 28E, inside instrument 9300, tube 138 and waveguide 140 define a cavity 9304 between them. A form 9306 is mounted within cavity 9304 to overmould seal 9302 locally to tube 138 and waveguide 140. Form 9306 includes a proximal form part 9308 and a distal form part 9310 that can be placed together to define a 9312 mold space between them.
[0130] The proximal shaped part 9308 is an elongated breach-style device that enters cavity 9304 from the proximal end of tube 138. Proximally shaped part 9308 includes an interruption part 9314 that generally corresponds to the space between tube 138 and the waveguide 140 in order to prevent the seal forming material from expanding beyond the proximal shape part 9308. The proximal shape part 9308 further includes a sleeve part 9316 which can be flexible to fit the contours or tube angles 138. In operation, a user or machine extends the part proximally 9308 into cavity 9304 in the direction of Arrow 9300A by manipulating the glove part 9316 to extend the interruption part 9314 for proper positioning within the tube 138. As positioned, the break part 9314 is configured to prevent any seal forming material from moving beyond the break part 9314 ep within the proximal area of the tube 138.
[0131] Distal shape potion 9310 is a capping style device, part of which is configured to enter cavity 9304 from the distal end of tube 138. The distal shape part
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9310 includes an inner part 9318 and an outer part 9320. The inner part 9318 is configured to extend into cavity 9304, while outer part 9320 is configured to be in a boundary position with the outermost end of tube 138. A the distal shape 9310 also defines an internal channel 9322, which is sized to fit the waveguide 140 inside it. In operation, a user or machine extends the part distally 9310 over the waveguide 140 in the direction of the Arrow 9300B, with the waveguide 140 disposed within the inner channel 9322 and until the outer part 9320 is in contiguity with the outer end of tube 138. This guides inner part 9318 in cavity 9304, partly distal to proximal 9308. As distal part 9310 is pressed against tube 138, form 9306 is created and the mold space 9312 is defined.
[0132] As shown in Figure 28B, the distal shape part 9310 defines a material channel 9324. The material channel 9324 extends from the outside of the outer part 9320 to the outside of the inner part 9322. The material channel 9324 allows the material used in the sealing formation 9302 to travel through the distal shape part 9310 in the direction of the Arrow 9300C and into the mold space 9312 while the distal shape part 9310 is held against the tube 138. This allows the sealing 9302 is formed through the distal shape part 9310 while the distal shape part 9310 is coupled to the tube 138.
[0133] With specific reference to Figures 28A to 28E, since the material used to create the seal 9302 is poured into the form 9306, the seal 9302 is allowed to harden and / or cure. After the seal is sufficiently cured 9302, both the proximal shaped part 9308 and the distal shaped part 9310 are removed from tube 138, leaving seal 9302 adhered to both tube 138 and waveguide 140 to prevent liquid and debris enter cavity 9304.
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38/64 [0134] In some versions of the 9300 instrument, the seal 9302 is located in a position along the length of the waveguide 140 which corresponds to a knot associated with the resonant ultrasonic vibrations communicated through the waveguide 140. Therefore, contact between waveguide 140 and seal 9302 may not affect ultrasonic vibrations communicated through waveguide 140.
IV. Surgical Instrument with an Accessible External Sheath [0135] As discussed above in relation to Figures 1A and 16B, the distal external sheath 230 is configured to reduce the likelihood of inadvertently pinching tissue due to rotation of the clamping arm assembly 210 and the assembly clamping block 220 and can thereby protect the fabric. Although such protection may be beneficial to the patient in some cases, the distal outer sheath 230 also inhibits access to the interior of a surgical instrument 10 and, more particularly, to the tome of tube 138 and ultrasonic blade 150. In some uses, blood and other body fluids and tissues can move proximally along the ultrasonic sheet and around the tube 138, thus making it difficult to clean and effectively sterilize one or more portions of the surgical instrument 10 for reuse.
[0136] Thus, it may be desirable, in some cases, to provide the surgical instrument 10, or any instrument like those described here, with an accessible outer sheath 9612, 9712, 9812, 9912, 10012 configured to provide access within the surgical instrument 10 for cleaning and, more particularly, sterilizing the surgical instrument 10. Obviously, alternative access for different cleaning uses can be similarly performed. The invention, therefore, is not intended to be unnecessarily limited to use for cleaning. In addition, although the following accessible outer sheaths 9612, 9712, 9812, 9912, 10012 are shown in different positions with different fixings 9620, 9720, 9820, 9920, 10020, it will be understood that
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39/64 the accessible outer sheaths 9612, 9712, 9812, 9912, 10012 with one or more fixings 9620, 9720, 9820, 9920, 10020 can be incorporated into any surgical instrument described herein, exchanged, or moved so as to take one or more portions of external sheaths removable from a remainder of the surgical instrument. For this purpose, similar reference numbers indicate similar features.
A. A Hinged Cover for a First Accessible External Sheath [0137] Figures 29 to 35C illustrate a fourth exemplary surgical instrument 9610 that includes a 9611 drive shaft assembly with a first accessible 9612 external sheath. The 9610 surgical instrument further includes the cable assembly 110, the clamping arm assembly 210 with the clamping block assembly 220, the clamping arm actuator 220, and the tube 320 through which the waveguide 138 extends to the ultrasonic blade 140 150 along the longitudinal geometric axis. With reference to Figures 29 and 30, the accessible outer sheath 9612 radially surrounds at least part of the waveguide 140 around the longitudinal axis and includes a sheath body 9616, a hinged cover 9618 and a sheath fixture 9620. O sheath body 9616 removably receives the hinged lid 9618 against it to define a generally U-shaped opening, and the sheath fixture 9620 separately separates the hinged lid 9618 against the sheath body 9616. During treatment, hinge cover 9618 generally remains in a covered configuration, as shown in Figure 29. The physician selectively separates hinge cover 9618 from sheath body 9616 as shown in Figures 30 and 31 to access an inner portion 9622 of surgical instrument 9610 around the tube 138 as desired, as to more easily clean and / or sterilize the inner 9622 after treating the patient.
[0138] Figure 31 and Figure 32 show 9616 sheath body,
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40/64 hinged cover 9618 and sheath fixing 9620 in greater detail. For this purpose, sheath fixture 9620 includes a distal fixture 9624 that has a snap-fit coupling 9625 and a proximal fixture 9626 that has a hinge coupling 9627. The snap-fit coupling 9625 includes a pair of elongated resilient flaps displaced 9628 configured to releasably engage a pair of 9630 shoulders, respectively. In the present example, each elongated flap 9628 extends from hinged lid 9618, while shoulders 9630 are positioned in the body of sheath 9616. In order to accommodate resilient inward deflection for selective disengagement of the 9630 shoulders, elongated flaps 9628 extend unevenly with respect to a laterally extending reinforcement 9632, which provides structural support through the hinged cover 9618.
[0139] The articulation coupling 9627 of proximal fixing 9626 includes a pair of laterally extending and opposing pins 9634 configured to be pivotally received within a pair of holes 9636, respectively. In the present example, each pin 9635 extends outwardly laterally from the sheath body 9616, while each hole 9636 extends through the hinge cover 9618. The hinge cover 9618 generally rotates around the pins 9635 in relation to the sheath body 9616, but it is also completely removable from the 9616 sheath body by excessive rotation of the hinged cover 9618 in the proximal direction. More particularly, a slot 9638 extends through an inner surface of the hinged lid 9618 to cover each hole 9636. Thus, while each pin 9634 is generally captured in each hole 9636, each slot 9638 is configured to provide each pin 9634 with a trajectory through which it moves for selective removal as discussed in more detail below.
[0140] In addition, a distal 9640 support and a proximal support
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9642 extend upwards from each side of the body of sheath 9612 adjacent to the tube 138 inside the inner part 9622. The distal and proximal supports 9640, 9642 each have a lateral hole 9644 which extends through them in order of pivoting the clamping arm assembly 210 and the clamping arm actuator 320 to it. Hinge cover 9618 has a pair of 9646 recesses and a pair of proximal support recesses 9648 configured to provide clearance for distal and proximal supports 9640, 9642 along an inner surface of hinge cover 9618.
[0141] Figures 33A and 33B show a distal tissue block 9650 configured to prevent tissue from being proximally inserted into the inner part 9622 of the surgical instrument 9610 in addition to the distal tissue block 9650. In the present example, an upper part 9652 of the distal tissue lock 9650 is a distal face of the hinged lid 9618, while a bottom part 9654 of the distal tissue lock 9650 is a distal face of the sheath body 9616. The clamping block assembly 220 is movably received within a clamping channel 9656 between lateral portions of the distal tissue lock 9660 to thereby provide ample clearance for moving the clamping block assembly 220 between the open and closed positions, as discussed in more detail above.
[0142] In use, in relation to Figures 33A to 35C, the physician accesses the inner part 9622 of the surgical instrument 9610 by separating the hinged lid 9618 from the body of the 9616 sheath. More particularly, the physician selectively manipulates the elongated flaps 9628 to inside, as shown in Figure 33C through the clamping channel 9656 until it is transversely unobstructed and disengaged from the shoulders 9630. Once the proximal fixture 9626 is thus disengaged, the hinged lid 9618 rotates proximally from an orientation
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42/64 longitudinal for a transverse orientation as shown in Figures 34A and 34B. The 9634 pins generally remain inside the 9636 holes when rotating from the longitudinal orientation of the covered configuration to the transverse orientation. However, as shown in Figures 35A to 35C, excessive rotation of the hinge cover 9618 proximally beyond the transverse orientation aligns the slots 9638 respectively with the pins 9634 so that the hinge cover 9618 can be selectively removed from the sheath body 9616 to access the internal part 9622. The physician cleans the 9610 surgical instrument using any one or more known cleaning methods for such instruments. After the desired cleaning, the doctor fixes the hinged lid 9618 again in the reverse order of separation of the hinged lid 9618 as described above.
B. A Magnetic Cap for a Second Accessible External Sheath [0143] Figures 36 to 39B illustrate a fifth exemplary surgical instrument 9710 that includes a drive shaft assembly 9711 with a second accessible external sheath 9712. Regarding Figures 36 a 37, the accessible outer sheath 9712 radially surrounds at least part of the waveguide 140 around the longitudinal geometry axis and includes a sheath body 9716, a magnetic cover 9718 and a sheath fixture 9720. Sheath body 9716 receives from the magnetic cover 9718 removably against it to define a generally U-shaped opening, and the 9720 sheath attachment separably couples the magnetic cover 9718 against the 9716 sheath body. During treatment, the magnetic cover 9718 generally remains in a covered configuration, as shown in Figure 36. The physician selectively separates the magnetic cap 9718 from the sheath body 9716 as per shown in Figure 37 to access an internal part 9722 of surgical instrument 9710 around tube 138 as desired, such as to clean and / or sterilize more
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43/64 easily the internal 9722 after the treatment of the patient.
[0144] Figures 36 to 38 show sheath body 9716, magnetic cover 9718 and sheath fixation 9720 in greater detail. For this purpose, sheath fixture 9720 includes a distal fixture 9724 that has a magnetic coupling 9725 and a proximal fixture 9726 that has a magnetic coupling 9727. The magnetic coupling 9725 includes a magnetically attractive base 9728 attached to the arm assembly clamp 210 and a magnetic coupler, such as a 9730 disk magnet, configured to be positioned opposite the 9728 base. Thus, the 9730 disk magnet, although magnetically attracted to the 9728 base in the vicinity of the 9728 base, presses the 9718 magnetic cover between the same. The magnetic cap 9718 also includes a cylindrical recess 9732 configured to receive the disc magnet 9730 both to increase the magnetic attraction of the disc magnet 9730 to the base 9728 and to position the disc magnet 9730 relatively flush with an outer surface thereof. In the present example, disk magnet 9730 is fixed within cylindrical recess 9732 and base 9728 is a metallic material configured to attract disk magnet 9730. Alternatively, base 9728 can be magnetic for increased attachment with disk magnet 9730 .
[0145] The proximal magnetic coupling 9727 of the proximal fixture 9726 includes an internal magnet 9734 attached to an internal surface of the magnetic cover 9718 and extending inwardly towards tube 138. Tube 138 is magnetically attractive so that the internal magnet 9734 is configured to engage tube 138 to removably couple magnetic cap 9718 to tube 138. In the present example, tube 138 is a metallic material configured to attract internal magnet 9734. Alternatively, tube 138 can be magnetic or
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44/64 have a magnet on it for increased fixation with the internal magnet 9734.
[0146] In addition, the distal support 9640 (see Figure 31) and ο proximal support 9642 (see Figure 31) extend upward from sheath body 9712 adjacent to tube 138 and opposite to magnetic cap 9718. The proximal and distal supports 9640, 9642 (see Figure 31) are generally similar to those discussed above. However, instead of having such brackets 9640, 9642 (see Figure 31) on each side, the brackets 9640, 9642 (see Figure 31) are on one side opposite the magnetic cover 9718 to thus pivotally support the assembly clamp arm 210 and clamping arm actuator 320 for use.
[0147] Figure 39A shows a distal tissue block 9750 configured to prevent tissue from being proximally introduced into the inside 9722 of the surgical instrument 9710 in addition to the distal tissue block 9750. In the present example, the distal tissue block 9750 is a distal face of sheath body 9716. Clamping block assembly 220 is movably received within a clamping channel 9756 between side portions of the distal 9760 fabric lock to thereby provide ample clearance for moving clamping block assembly 220 between open and closed positions, as discussed above in more detail.
[0148] In use, in relation to Figures 39A and 39B, the doctor accesses the internal part 9722 of the surgical instrument 9710 by separating the magnetic cover 9718 from the body of the 9716 sheath. More particularly, the doctor pulls out the magnetic cover 9718 with sufficient strength to overcome the magnetic attraction between magnet 9730 and base 9728 as well as between internal magnet 9734 and tube 138. Once the distal and proximal fixings 9724, 9726 are thus disengaged, the magnetic cap 9718 is simply removed from the sheath body 9716
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45/64 to access the inside 9722. The physician cleans the 9710 surgical instrument using any one or more known cleaning methods for such instruments. After the desired cleaning, the doctor fixes the magnetic cover 9718 again in the reverse order of separation of the magnetic cover 9718 as described above. In addition, the doctor sterilizes the surgical instrument 9710 after re-attaching the magnetic cap 9718.
C. A Pin Cover for a Third Accessible External Sheath [0149] Figures 40 and 41 illustrate a sixth exemplary surgical instrument 9810 including a drive shaft assembly 9811 with a third accessible outer sheath 9812. The accessible outer sheath 9812 radially encircles at least part of the waveguide 140 around the longitudinal axis and includes a sheath body 9816, a pin cover 9818 and a sheath fixture 9820. Sheath body 9816 removably receives the pin cover 9818 against the same for defining a generally U-shaped opening, and the 9818 sheath fixation separably couples the 9818 pin cover against the 9816 sheath body. During treatment, the 9818 pin cover generally remains in a covered configuration, as shown in Figure 40. The physician selectively separates the 9818 pin cover from the 9816 sheath body as shown in Figure 41 to access an internal part 9822 d the surgical instrument 9810 around the tube 138 as desired, as to more easily clean and / or sterilize the internal part 9822 after treatment of the patient.
[0150] Sheath fixture 9820 includes a distal fixture 9824 that has a lower pin coupling 9825 and a proximal fixture 9826 that has another lower pin coupling 9825 and an upper pin coupling 9827. Each of the lower pin coupling and
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Upper 46/64 9825, 9827 includes a pin hole 9828 that extends laterally through a mounting flange 9829 and a pin 9830. More particularly, the sheath body 9816 and the pin cover 9818 have a pair of pin holes 9828 through mounting flange 9829 for each coupling lower and upper pin 9825, 9827. Pin 9838 is configured to be received in the cooperating pair of pin holes
9828 while coaxially aligned to removably secure pin cover 9818 to sheath body 9816. In the present example, pin 9838 is configured to friction the mounting flange
9829 into the 9828 pin hole for attachment. Obviously, the coupling, like other closures, can be used in a similar way. Therefore, the invention is not intended to be unnecessarily limited to friction hooks 9830.
[0151] In addition, distal support 9640 (see Figure 31) and proximal support 9642 (see Figure 31) extend upwardly from sheath body 9812 adjacent to tube 138 and opposite pin cover 9818. The proximal and distal supports 9640, 9642 (see Figure 31) are generally similar to those discussed above. However, instead of having such brackets 9640, 9642 (see Figure 31) on each side, the brackets 9640, 9642 (see Figure 31) are on the side opposite the pin cover 9818 to thus pivotally support the clamping arm assembly 210 and clamping arm actuator 320 for use.
[0152] The accessible outer sheath 9812 also has a distal tissue lock 9850 configured to prevent tissue from being proximally inserted into the inner part 9822 of the surgical instrument 9810 in addition to the distal tissue lock 9850. In the present example, a side part Distal tissue lock 9852 9850 is a distal face of pin cover 9818, while another lateral part 9854 of distal tissue lock 9850 is a distal face of sheath body 9816.
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The clamping block assembly 220 is movably received within a clamping channel 9856 between side portions 9852, 9854 of the distal tissue lock 9860 to thereby provide ample clearance for moving the clamping block assembly 220 between the open and closed, as discussed above in more detail.
[0153] In use, in relation to Figures 40 and 41, the doctor accesses the internal part 9822 of the surgical instrument 9810 by separating the 9818 pin cover from the 9816 sheath body. More particularly, the doctor selectively removes the 9830 pins from each pin hole 9828 for each of the distal and proximal fixings 9824, 9826. Once the distal and proximal fixings 9825, 9826 are thus disengaged, the pin cover 9818 is simply removed from the sheath body 9816 to access the inner part 9822 The physician cleans the 9810 surgical instrument using any one or more known cleaning methods for such instruments. After the desirable cleaning, the doctor fixes the 9818 pin cover again, usually in the reverse order of the 9818 pin cover separation as described above. In addition, the doctor sterilizes the 9810 surgical instrument after re-attaching the 9818 pin cover.
D. A first snap-on cover for a fourth accessible outer sheath [0154] Figures 42 to 46 illustrate a seventh exemplary surgical instrument 9910 including a drive shaft assembly 9911 with a fourth accessible outer sheath 9912. Regarding Figure 42 and Figure 43, the accessible outer sheath 9912 radially surrounds at least part of the waveguide 140 around the longitudinal geometry axis and includes a sheath body 9916, a first snap-on cover 9918 and a sheath fixture. 9920. The 9916 sheath body removably receives the plug-in cover
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48/64 by pressing 9918 against it to define a generally U-shaped opening, and the sheath fixture 9920 separately separates the snap-on cover 9918 against the sheath body 9916. During treatment, the Snap-on 9918 generally remains in a covered configuration, as shown in Figure 42. The physician selectively separates the snap-on lid 9918 from the sheath body 9916 as shown in Figure 43 to access an inner portion 9922 of the surgical instrument 9910 around of tube 138 as desired, as to more easily clean and / or sterilize the inner part 9922 after treating the patient.
[0155] Sheath fixture 9920 includes a distal fixture 9924 that has a snap fit coupling 9925 and a proximal fixture 9926 that has another snap fit coupling 9925 and a snap fit coupling 9927. Each of the bottom and top snap-fit couplings 9925, 9927 include a snap-fit hole 9928 that extends through the sheath body 9916 to define at least one adjacent shoulder 9929 on it and a resilient flap 9930 that extends to from the snap-on cover 9918. Each resilient flap 9930 is configured to extend through the snap-in hole 9928 to releasably engage the shoulder 9929. As shown in Figures 43 to 45, the snap-in hole Distal fixation 9928 9924 extends transversely through sheath body 9916 to receive the resilient flap 9930 from distal fixation 9924, which extends transversely upward from an inner surface of the snap-fit lid 9918. In contrast, the top and bottom snap-fit holes 9928 of the proximal fixture 9926 extend laterally through the sheath body
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9916 to receive respectively the upper and lower resilient flaps 9930 of the proximal fixture 9926, which extend laterally outward from an external surface of the snap-on cover 9918. [0156] In use, in relation to Figure 46, the physician accesses the inner part 9922 of surgical instrument 9910 by separating the snap-cap 9918 from the sheath body 9916. More particularly, the physician selectively rotates a distal portion of the snap-cap 9918 sideways outwardly to overcome the resilient engagement between the flap resilient 9930 and distal fixing shoulder 9929 9924. Once the distal fixation is disengaged, the physician distally removes the snap-on cover 9918 to overcome the resilient engagement between the resilient flap 9930 and the proximal fixing shoulder 9929 for removal of the snap-on cover 9918 and access to the internal part 9922. The doctor cleans the surgical instrument 9910 using any have one or more known cleaning methods for such instruments. After the desirable cleaning, the doctor fixes the 9918 snap-on lid again, usually in the reverse order of the 9918 snap-on lid separation as described above.
E. A Second Pressure Snap Cap for a Fifth Accessible External Sheath [0157] Figures 47 to 51 illustrate an eighth exemplary surgical instrument 10010 including a drive shaft assembly 10011 with an accessible fifth external sheath 10012. Regarding Fig. 47 and Fig. 48, accessible outer sheath 10012 radially surrounds at least part of the waveguide 140 around the longitudinal axis and includes a sheath body 10016, a second snap-on cover 10018 and a sheath fixture 10020 In addition to the differences noted below, the 10018 snap-in cap is similar to the 9918 snap-in cap
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50/64 (see Figure 46) discussed above to access the internal part 9922 of surgical instrument 10010.
[0158] For this purpose, sheath fixation 10020 includes a distal fixation 9924 discussed above, but has a proximal fixation 10026 having an upper tubular coupling 10028 and a lower tubular coupling 10030. Each of the upper and lower tubular couplings 10028, 10030 includes an outer tube 10032 that extends longitudinally along an inner surface of the snap-fit lid 10018 and an inner tube 10034 that extends longitudinally along an inner surface of sheath body 10016. As shown in Figures 48 at 50, the outer tubes 10032 in the snap-on cover 10018 are configured to align and slide the inner tubes 10034 respectively. The proximal fixation 10026 thus inhibits the movement of the snap-in cap 10018 in relation to the body. sheath 10016, but distal movement, which is inhibited by distal fixation 9924.
[0159] In use, in relation to Figure 51, the physician accesses the inner part 9922 of the surgical instrument 10010 by separating the snap-on lid 10018 from the body of the sheath 10016. More particularly, the physician selectively rotates a distal portion of the lid snap-fit 10018 outwardly to overcome the resilient engagement between the resilient flap 9930 and the distal fixing shoulder 9929 9924. Once the distal fixation is disengaged, the doctor removes the press-fit cap 10018 distally to the tubes internal 10034 to be removed from external tubes 10032 for the removal of the pressure cap 10018 and access to the internal part 9922. The physician cleans surgical instrument 10010 using any one or more known cleaning methods for such instruments. After the desired cleaning, the doctor fixes the snap cap again
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51/64 by pressure 10018 generally the reverse order of separation of the snap-on cover 10018 as described above.
V. Exemplifying Combinations [0160] The following examples refer to several non-exhaustive ways in which the teachings of the present invention can be combined or applied. It should be understood that the following examples are not intended to restrict coverage of any claims that may be made at any time in this application or in deposits subsequent to this application. No rights waiver is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of the present invention can be arranged and applied in several other ways. It is also contemplated that some variations may omit certain features referred to in the examples below. Therefore, none of the aspects or resources referred to below should be considered critical, unless explicitly stated otherwise at a later date by the inventors or by a successor of interest to the inventors. If any claims are made in this application or in subsequent filings related to this application that include additional features in addition to those listed below, it is not assumed that these additional features have been added for any reason related to patentability.
Example 1 [0161] Device comprising: (b) an ultrasonic waveguide arranged in a tube; (b) a part proximally; and (c) a distal portion.
Example 2 [0162] Device, according to Example 1, in which the part proximally defines an internal channel.
Example 3
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52/64 [0163] Device, according to Example 1, in which the proximal part includes a closing part and a sleeve part extending therefrom.
Example 4 [0164] Method of forming a seal between a tube and a waveguide, wherein the method comprises: (a) extending a closing part of a part proximally to a defined cavity between the tube and the guide waves; (b) coupling a distal part to the tube, where the waveguide extends through the distal part, where the proximal part, the distal part, and the tube define a mold space between the same; (c) transferring a sealing material through the part distally and into the mold space; and (d) allowing the material in the mold space to cure and form a seal.
Example 5 [0165] Method of forming a seal between a tube and a waveguide, wherein the method comprises: (a) building a shape within a defined cavity between the tube and the waveguide, wherein the shape defines a mold space; (b) transferring a sealing material through the form and into the mold space; and (c) allowing the material in the mold space to heal and form a seal between the tube and the waveguide.
Example 6 [0166] Surgical instrument, which comprises: (a) a body assembly; (b) an ultrasonic waveguide extending through the body assembly along a longitudinal geometric axis; (c) an ultrasonic blade connected to a distal end of the ultrasonic waveguide; (d) a clamping arm assembly configured to move from an open position to receive a fabric towards
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53/64 a closed position to hold the tissue relative to the ultrasonic blade, where the clamping arm assembly includes: (i) a clamping body, and (ii) a clamping block connected to the clamping body facing the ultrasonic sheet; (e) a clamping arm actuator operationally connected to the clamping arm assembly and configured to move selectively from a first position towards a second position in relation to the body, thereby directing the clamping arm assembly of the open position to closed position; and (f) an outer sheath that radially surrounds at least part of the ultrasonic waveguide around the longitudinal geometric axis, in which the outer sheath includes: (i) a sheath body operably connected to the body assembly and affixed in relation to the ultrasonic waveguide (ii) a cover removably received against the sheath body and (iii) a sheath clamping feature configured to removably attach the cover to the sheath body so that the cover is configured to be selectively separated from the sheath body to access the ultrasonic waveguide inside the outer sheath.
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Example 7 [0167] Surgical instrument, according to Example 6, in which the outer sheath is generally U-shaped.
Example 8 [0168] Surgical instrument according to Example 7, in which the outer sheath further includes a distal tissue block configured to prevent the tissue from being proximally introduced in addition to the distal tissue block.
Example 9 [0169] Surgical instrument, according to Example 8, in which the distal tissue block has a first blocking part and a second blocking part, and in which the first and second blocking portions of the tissue blocking distal are respectively positioned on the sheath body and the cover.
Example 10 [0170] Surgical instrument, according to Example 9, in which the sheath clamping feature includes a hinge coupling so that the cover is pivotal in relation to the sheath body. Example 11 [0171] Surgical instrument according to Example 10, in which the articulation coupling includes a pin extending from the cover or sheath body and a hole extending through the other between the cover or the sheath body, in which the hole is configured to pivot the pin in it.
Example 12 [0172] Surgical instrument, according to Example 11, in which the articulation coupling also includes a slot in communication with the hole, in which the pin is configured to be removed from the hole through the slot in order to uncouple the cover of the sheath body.
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Example 13 [0173] Surgical instrument, according to any of Examples 6 to 12, in which the sheath fixing feature includes a pressure coupling that has a resilient flap configured to be releasably engaged with a shoulder.
Example 14 [0174] Surgical instrument, according to any of Examples 6 to 13, in which the sheath fixation feature includes a protrusion and a channel, in which the channel is configured to receive the protuberance in a sliding manner.
Example 15 [0175] Surgical instrument, according to any of Examples 6 to 14, in which the sheath clamping feature includes a magnetic coupler configured to magnetically couple the cover in relation to the sheath body.
Example 16 [0176] Surgical instrument, according to Example 15, in which the magnetic coupler is configured to magnetically engage at least one of the clamping arm assembly, the clamping arm actuator or a tube around the ultrasonic waveguide. Example 17 [0177] Surgical instrument, according to any of Examples 6 to 16, in which the sheath fixing feature includes a pin hole and a pin, in which the pin hole is configured to receive removably the pin.
Example 18 [0178] Surgical instrument, according to Example 17, in which the pin is configured to have a friction fit within the pin hole.
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Example 19 [0179] Surgical instrument, according to any of Examples 6 to 18, in which the sheath fixation feature has a proximal fixation part and a distal fixation part, and in which each of the fixation portions proximal and distal is configured to separately connect the cover to the sheath body.
Example 20 [0180] Surgical instrument, according to any of Examples 6 to 19, which further comprises a seal radially interposed between the ultrasonic waveguide and the outer sheath, in which the seal is configured to prevent fluid communication through a gap similar to a cylinder defined between the ultrasonic waveguide and the outer sheath.
Example 21 [0181] Method for accessing an internal part of an ultrasonic instrument, where the ultrasonic instrument includes: (a) a body assembly; (b) an ultrasonic waveguide extending through the body assembly along a longitudinal geometric axis; (c) an ultrasonic blade connected to a distal end of the ultrasonic waveguide; (d) a clamping arm assembly configured to move from an open position to receive a tissue towards a closed position to clamp the tissue relative to the ultrasonic blade, wherein the clamping arm assembly includes: (i) a clamping body, and (ii) a clamping block connected to the clamping body facing the ultrasonic blade; (e) a clamping arm actuator operationally connected to the clamping arm assembly and configured to move selectively from a first position towards a second position in relation to the body, thereby directing the clamping arm assembly of the open position to closed position; and (f) an outer sheath that radially surrounds at least
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57/64 a portion of the ultrasonic waveguide around the longitudinal geometric axis, in which the outer sheath includes: (i) a sheath body operatively connected to the body assembly and affixed to the ultrasonic waveguide, ( il) a cover removably received against the sheath body, and (iii) a sheath clamping feature configured to separably attach the cover to the sheath body, so that the cover is configured to be selectively separated from the body the sheath, in which the method comprises: (a) uncoupling the cover from the sheath body to reveal an internal part of the ultrasonic instrument through an access space; and (b) access the inside of the ultrasonic instrument through the access space.
Example 22 [0182] Method, according to Example 21, which further comprises cleaning the inside of the ultrasonic instrument while accessing the inside through the access space.
Example 23 [0183] Method, according to any of Examples 21 to
22, in which the act of uncoupling further comprises pivoting the lid in relation to the sheath body.
Example 24 [0184] Method, according to any of Examples 21 to
23, in which the act of uncoupling further comprises sliding the cover in relation to the sheath body.
Example 25 [0185] Method, according to any of Examples 21 to
24, in which the act of uncoupling further comprises sliding the cover in relation to the sheath body.
Example 26 [0186] Method, according to Example 25, in which the cap includes
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58/64 still deflect one part of the lid in relation to another part of the lid. Example 27 [0187] Device, which comprises: (a) a tube; (b) an ultrasonic waveguide arranged on the tube; (c) an ultrasonic blade that extends distally from the ultrasonic waveguide; (d) a proximally shaped part, wherein the proximally shaped part includes: (i) a part of an interrupting device, and (ii) a glove part extending from the closing part; and (e) distal shaped part, where the proximal shaped part, the distal shaped part, and the tube together define a mold space between them, where the mold space is configured to receive a sealing material through the distal part that forms a seal between the tube and the ultrasonic waveguide.
SAW. Miscellaneous [0188] Although several examples of the present invention describe two or more modular components being releasably coupled together, it should be understood that some variations can eliminate such modularity and removable couplings. For example, some versions of instrument 10 may provide the first modular set 100 and the second modular set 200 as a single combined unit that does not allow the second modular set 200 to be removed from the first modular set 100. In some of these versions, the member coupling 300 would either be omitted or I (with some other feature being used to provide permanent coupling between the first modular set 100 and the second modular set 200); or the coupling member 300 may be modified so that the coupling member 300 may not be manipulated to decouple the second modular assembly 200 from the first modular assembly 100. Similarly, some versions of the instrument 301 may prevent the arm assembly clamp 400 is removed from the
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59/64 drive 330. For example, lock member 412 can be omitted and clamping arm assembly 400 can be permanently coupled to drive shaft assembly 330.
[0189] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US publication No. 2017/0105754, entitled Surgical Instrument with Dual Mode End Effector and Side-Loaded Clamp Arm Assembly, published in April 20, 2017, the description of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US publication No. 2017/0105754 will become apparent to those skilled in the art.
[0190] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US publication No. 2017/0105755, entitled Surgical Instrument with Dual Mode End Effector and Side-Loaded Clamp Arm Assembly, published in April 20, 2017, the description of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US publication No. 2017/0105755 will become apparent to those skilled in the art.
[0191] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US publication No. 2017/0105788, entitled Surgical Instrument with Dual Mode End Effector and Modular Clamp Arm Assembly, published on 20 April 2017, the description of which is incorporated herein by way of reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US publication No. 2017/0105788 will become apparent to those skilled in the art.
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60/64 [0192] The various instruments described above can be used in a variety of types of surgical procedures. As an example only, the instruments described above can be used to perform liver resection, colorectal surgical procedures, gynecological surgical procedures and / or various other types of surgical procedures. Various other types of procedures and ways in which the instruments described above can be used will be apparent to those skilled in the art in accordance with the teachings of the present invention.
[0193] It should be understood that any of the versions of the instruments described here may include several other resources in addition to or instead of those described above. By way of example only, any of the instruments described here may also include one or more of the various resources disclosed in any of the various references that are incorporated herein by way of reference. It should also be understood that the teachings of the present invention can be readily applied to any of the instruments described in any of the other references cited in the present invention, so that the teachings of the present invention can be readily combined with the teachings of any one. of the references cited in the present invention in various ways. Other types of instruments to which the teachings of the present invention can be incorporated will be apparent to those skilled in the art.
[0194] In addition to the previously mentioned, the teachings of the present invention can readily be combined with various teachings of US patent application No. [attorney document number END8130USNP.0652942], entitled Surgical Instrument with Removable Clamp Arm Assembly, deposited in same date as the present application, the disclosure of which is incorporated by reference into the present invention.
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Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8130USNP.0652942] will be apparent to those skilled in the art in view of the teachings of the present invention.
[0195] In addition to the previously mentioned, the teachings of the present invention can readily be combined with various teachings of US patent application serial number [attorney document number END8130USNP1.0652944], entitled Surgical Instrument with Removable End Effector Components, filed on the same date as the present application, the description of which is incorporated by reference into the present invention. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8130USNP1.0652944] will be apparent to those skilled in the art in view of the teachings of the present invention.
[0196] In addition to the aforementioned, the teachings of the present invention can readily be combined with various teachings of US patent application No. [Attorney document No. END8130USNP2.0652948], entitled Surgical Instrument with Selectively Actuated Gap-Setting Features for End Effector, filed on the same date as this application, the description of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8130USNP2.0652948] will be apparent to those skilled in the art in view of the teachings of the present invention.
[0197] In addition to the aforementioned, the teachings of the present invention can readily be combined with various teachings of US patent application No. [attorney document number]
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END8130USNP3.0652950], entitled Surgical Instrument with Spot Coagulation Control Algorithm, filed on the same date as this application, whose description is incorporated into the present invention by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application No. [attorney document number END8130 USNP3.0652950] will be apparent to those skilled in the art in view of the teachings of the present invention.
[0198] It should also be understood that any ranges of values mentioned here should be read as including the upper and lower limits of such ranges. For example, a strip expressed as in the range between approximately 2.5 cm and approximately 3.8 cm approximately 1.0 inch and approximately 1.5 inches should read as including approximately 2.5 cm and approximately 3.8 cm approximately 1 , 0 inches and approximately 1.5 inches, in addition to including values between those upper and lower limits.
[0199] It should be understood that any patent, publication, or other disclosure material taken as incorporated by reference in this invention for reference, in whole or in part, is incorporated into the present invention only insofar as the incorporated material does not conflict with the definitions, statements or other material disclosed in this disclosure. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or part of it, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials contained herein, will be incorporated here only insofar as there is no conflict between the material embedded and the development material
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Existing 63/64.
[0200] 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 medical treatments and procedures assisted by robotics. As an example only, several teachings of the present invention can readily be incorporated into a robotic surgical system such as the DAVINCI ™ system by Intuitive Surgical, Inc., of Sunnyvale, California, USA. Similarly, persons skilled in the art will recognize that various teachings of the present invention can be easily combined with various teachings from US Patent No. 6,783,524, entitled Robotic Surgical Tool With Ultrasound Cauterizing And Cutting Instrument, published August 31, 2004 , the disclosure of which is hereby incorporated by reference.
[0201] The versions described above can be designed to be discarded after a single use or can be designed to be used multiple times. The versions can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing specific parts and subsequent reassembly. Specifically, some versions of the device can be disassembled into any number of particular parts or parts of the device can be selectively replaced or removed in any combination. By cleaning and / or replacing specific parts, some versions of the device can be reassembled for subsequent use in a reconditioning facility or by an operator immediately before a surgical procedure. Those skilled in the art will understand that the reconditioning of a device can use
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64/64 a variety of disassembly, cleaning / replacement and reassembly techniques. The use of these techniques, as well as the resulting refurbished device, are all within the scope of this application. [0202] Just as an example, the versions described here can be sterilized before and / or after a procedure. In a sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the device can then be placed in a radiation field, such as gamma radiation, X-rays or high-energy electrons, which can penetrate the container. Radiation can kill bacteria on the device and the container. The sterile device can then be stored in a sterile container for later use. The device can also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.
[0203] Having shown and described various modalities of the present invention, further adaptations of the methods and systems described in the present invention can be made by means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications have been mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, stages and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention should be considered in accordance with the terms of the following claims and it is understood that it is not limited to the details of the structure and operation shown and described in the specification and drawings.

权利要求:
Claims (20)
[1]
1. Surgical instrument, characterized by the fact that it comprises:
(a) a body assembly;
(b) an ultrasonic waveguide extending through the body assembly along a longitudinal geometric axis;
(c) an ultrasonic blade positioned at a distal end of the ultrasonic waveguide;
(d) a clamping arm assembly configured to move from an open position to receive a tissue towards a closed position to clamp the tissue relative to the ultrasonic blade, wherein the clamping arm assembly includes:
(i) a clamping body, and (ii) a clamping block connected to the clamping body facing the ultrasonic blade;
(e) a clamping arm actuator operationally connected to the clamping arm assembly and configured to move selectively from a first position towards a second position in relation to the body, thereby directing the clamping arm assembly respectively. tightening from the open to the closed position; and (f) an outer sheath that radially surrounds at least part of the ultrasonic waveguide around the longitudinal geometric axis, in which the outer sheath includes:
(i) a sheath body operatively connected to the body assembly and affixed to the ultrasonic waveguide, (ii) a cover removably received against the sheath body, and (iii) a sheath clamping feature configured to separably attach the cover to the sheath body so that the
Petition 870190054536, of 06/13/2019, p. 126/132
[2]
2/6 cover is configured to be selectively separated from the sheath body to access the ultrasonic waveguide inside the outer sheath.
2. Surgical instrument, according to claim 1, characterized by the fact that the external sheath is generally U-shaped.
[3]
3. Surgical instrument according to claim 1, characterized by the fact that the outer sheath also includes a distal tissue stop configured to prevent the tissue from being proximally introduced beyond the distal tissue stop.
[4]
4. Surgical instrument according to claim 3, characterized in that the distal tissue stop has a first blocking part and a second blocking part, and in which the first and second blocking portions of the tissue stop distal are respectively positioned on the sheath body and the cover.
[5]
5. Surgical instrument, according to claim 1, characterized by the fact that the sheath fixing feature includes an articulation coupling so that the cover is pivotal in relation to the sheath body.
[6]
6. Surgical instrument, according to claim 5, characterized in that the articulation coupling includes a pin extending from the cover or the sheath body and a hole extending through the other between the cover or the sheath body, in which the hole is configured to pivot the pin in it.
[7]
7. Surgical instrument, according to claim 6, characterized by the fact that the articulation coupling also includes a slot in communication with the hole, in which the pin is configured to be removed from the hole through the slot in order to uncouple the cover of the sheath body.
Petition 870190054536, of 06/13/2019, p. 127/132
3/6
[8]
8. Surgical instrument according to claim 1, characterized by the fact that the sheath fixing feature includes a pressure coupling that has a resilient flap configured to be releasably engaged with a shoulder.
[9]
9. Surgical instrument, according to claim 1, characterized by the fact that the sheath fixation feature includes a protrusion and a channel, in which the channel is configured to receive the protrusion in a sliding way.
[10]
10. Surgical instrument, according to claim 1, characterized by the fact that the sheath fixing feature includes a magnetic coupler configured to magnetically couple the cover in relation to the sheath body.
[11]
11. Surgical instrument according to claim 10, characterized by the fact that the magnetic coupler is configured to magnetically engage at least one of the clamping arm assembly, the clamping arm actuator or a tube around the ultrasonic waveguide.
[12]
12. Surgical instrument, according to claim 1, characterized by the fact that the sheath fixing feature includes a pin hole and a pin, in which the pin hole is configured to receive the pin removably.
[13]
13. Surgical instrument, according to claim 12, characterized by the fact that the pin is configured to have a friction fit within the pin hole.
[14]
14. Surgical instrument, according to claim 1, characterized by the fact that the sheath fixation feature has a proximal fixation part and a distal fixation part, and in which each of the proximal and distal fixation portions is configured for separably coupling the cover to the sheath body.
[15]
15. Surgical instrument, according to claim 1,
Petition 870190054536, of 06/13/2019, p. 128/132
4/6 characterized by the fact that it also comprises a seal radially interposed between the ultrasonic waveguide and the outer sheath, in which the seal is configured to prevent fluid communication through a gap similar to a cylinder defined between the waveguide ultrasonic and the outer sheath.
[16]
16. Device, characterized by the fact that it comprises:
(a) a tube;
(b) an ultrasonic waveguide arranged on the tube;
(c) an ultrasonic blade that extends distally from the ultrasonic waveguide;
(d) a proximally shaped part, where the proximally shaped part includes:
(i) a first interruption part, and (ii) a glove part that extends from the interruption part; and (e) distal shaped part, where the proximal shaped part, the distal shaped part, and the tube together define a mold space between them, where the mold space is configured to receive a sealing material through the distal part that forms a seal between the tube and the ultrasonic waveguide.
[17]
17. Method for accessing an internal part of an ultrasonic instrument that includes:
(a) a body assembly;
(b) an ultrasonic waveguide extending through the body assembly along a longitudinal geometric axis;
(c) an ultrasonic blade positioned at a distal end of the ultrasonic waveguide;
(d) a clamping arm assembly configured to move from an open position to receive a tissue towards a closed position to secure the tissue in relation to the ultrasonic sheet,
Petition 870190054536, of 06/13/2019, p. 129/132
5/6 where the clamping arm assembly includes:
(i) a clamping body, and (ii) a clamping block connected to the clamping body facing the ultrasonic blade;
(e) a clamping arm actuator operationally connected to the clamping arm assembly and configured to move selectively from a first position towards a second position in relation to the body, thereby directing the clamping arm assembly of the open position to closed position; and (f) an outer sheath that radially surrounds at least part of the ultrasonic waveguide around the longitudinal geometric axis, in which the outer sheath includes:
(i) a sheath body operatively connected to the body assembly and affixed to the ultrasonic waveguide, (ii) a cover removably received against the sheath body, and (iii) a sheath clamping feature configured to separably coupling the cover to the sheath body so that the cover is configured to be selectively separated from the sheath body to access the ultrasonic waveguide inside the outer sheath, in which the method is characterized by comprising:
(a) uncouple the cover from the sheath body to reveal an internal part of the ultrasonic instrument through an access space; and (b) access the inside of the ultrasonic instrument through the access space.
[18]
18. Method, according to claim 17, characterized by the fact that it also comprises cleaning the inside of the ultrasonic instrument while accessing the inside through the space of
Petition 870190054536, of 06/13/2019, p. 130/132
6/6 access,
[19]
19. Method, according to claim 17, characterized by the fact that the act of uncoupling further comprises pivoting the cover in relation to the sheath body.
[20]
20. Method, according to claim 17, characterized by the fact that the act of uncoupling further comprises sliding the cover in relation to the sheath body.

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法律状态:
2021-10-05| B350| Update of information on the portal [chapter 15.35 patent gazette]|

---

2022-02-15| B06W| Patent application suspended after preliminary examination (for patents with searches from other patent authorities) chapter 6.23 patent gazette]|

优先权:

---

申请号 | 申请日 | 专利标题

---

US201662422698P| true| 2016-11-16|2016-11-16|

---

US201762508720P| true| 2017-05-19|2017-05-19|

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US201762519482P| true| 2017-06-14|2017-06-14|

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US15/798,902|US10736648B2|2016-11-16|2017-10-31|Surgical instrument with removable portion to facilitate cleaning|

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PCT/US2017/062025|WO2018106425A1|2016-11-16|2017-11-16|Surgical instrument with removable portion to facilitate cleaning|

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