The present invention generally relates to surgical instruments, and more particularly, to coupling arrangements and methods for attaching a surgical tool to an ultrasonic surgical instrument.
Ultrasonic surgical instruments are used for the safe and effective treatment of many medical conditions. Such instruments commonly include a handpiece that is coupled to an ultrasonic signal generator. The instruments also include an end effector that receives the ultrasonic vibrations. Ultrasonic vibrations, when transmitted to organic tissue at suitable energy levels and using a suitable end effector, may be used to cut, dissect, elevate, cauterize tissue or to separate muscle tissue off bone. Ultrasonic instruments utilizing solid core technology are particularly advantageous because of the amount of ultrasonic energy that may be transmitted from the ultrasonic transducer, through a waveguide, to the surgical end effector. Such instruments may be used for open procedures or minimally invasive procedures, such as endoscopic or laparoscopic procedures, wherein the end effector is passed through a trocar to reach the surgical site.
Typically, ultrasonic vibration is induced in the surgical end effector by electrically exciting a transducer supported in the handpiece. The transducer may be constructed of one or more piezoelectric or magnetostrictive elements. Vibrations generated by the transducer section are transmitted to the surgical end effector via an ultrasonic waveguide that extends from the transducer section to the surgical end effector. The waveguides and end effectors are designed to resonate at the same frequency as the transducer. Therefore, when an end effector is attached to a transducer, the overall system frequency is the same frequency as the transducer itself.
Solid core ultrasonic surgical instruments may be divided into two types, single element end effector devices and multiple-element end effector. Single element end effector devices include instruments such as scalpels, and ball coagulators. The use of multiple-element end effectors such as clamping coagulators includes a mechanism to press tissue against an ultrasonic blade. Ultrasonic clamp coagulators provide an improved ultrasonic surgical instrument for cutting/coagulating tissue, particularly loose and unsupported tissue, wherein the ultrasonic blade is employed in conjunction with a clamp for applying a compressive or biasing force to the tissue, whereby faster coagulation and cutting of the tissue, with less attenuation of blade motion, are achieved. Surgical elevators are instruments used to help facilitate the elevation and removal of soft tissue during surgery. Surgical elevators are generally employed to separate muscle from bone. Cobb or curette type surgical elevators and used in spine surgery, especially to assist in posterior access in removing muscle tissue from bone.
Regardless of the type of end effector employed, the end effector must be effectively coupled to the waveguide. In some devices, the end effector is permanently coupled to the waveguide by, for example, welding. In other arrangements, the end effector is removably coupled to the waveguide by a threaded arrangement. Such end effectors are often supplied with a torque wrench that, when properly used, is designed to ensure that the end effector is attached to the waveguide by an appropriate amount of torque, while avoiding the possibility of damage or device malfunction due to the application of excessive torque to the end effector. Such wrenches may be designed to interface with a distal end or portion of the end effector. In some wrench arrangements, after the wrench is placed on the distal end of the end effector, the clinician applies torque to the wrench until an audible click is heard at which time the wrench may be removed from the end effector.
While the use of such torque wrenches can effectively ensure that an acoustically secure connection is established between the waveguide and the end effector, the torque wrenches may become lost or misplaced during the preparation of the surgical tools and the surgical suite. In addition, the torque wrenches are typically used to detach the end effector from the handpiece which requires the clinician to locate the torque wrench or other tool after the surgical procedure has been completed. Moreover, if the clinician fails to properly use the torque wrench, there is a risk that the connection between the end effector and the waveguide is insufficient to transmit the desired amount of acoustic motion to the end effector for optimum results.
It would be desirable to provide an ultrasonic surgical instrument that overcomes some of the deficiencies of the current instruments and end effector coupling arrangements. Various embodiments of the ultrasonic surgical instruments overcome these deficiencies.
In one general aspect, the various embodiments are directed to an ultrasonic surgical instrument that has a handpiece that operably supports at least one ultrasonic transducer. The surgical instrument includes a surgical tool that has a proximal end with a cavity therein. A waveguide protrudes distally from the handpiece and interacts with the at least one ultrasonic transducer. The waveguide has a distal end portion that is sized to be inserted into the cavity in the proximal end of the surgical tool and selectively expanded into retaining engagement therewith.
In accordance with other embodiments of the present invention, there is provided an ultrasonic surgical instrument that includes a handpiece that has a housing that operably supports at least one ultrasonic transducer therein. The ultrasonic transducers are operably coupled to an ultrasonic signal generator. A waveguide protrudes distally from the housing and interacts with the ultrasonic transducers. The waveguide has a selectively expandable distal end portion. An actuator rod is movably supported within the waveguide and is movable between a first position wherein the distal end portion is expanded and a second position wherein the distal end portion is unexpanded. The surgical instrument further includes a surgical tool that has a proximal end portion that has a cavity therein for receiving the distal end portion of the waveguide
In accordance with other embodiments of the present invention there is provided a method for removably coupling a surgical tool to a waveguide of an ultrasonic surgical instrument. In various versions, the method includes providing a cavity in a proximal end portion of the surgical tool and inserting a distal end of the waveguide into the cavity. The method further includes expanding the distal end of the waveguide to retainingly engage at least a portion of a wall of the cavity.
The novel features of the various embodiments are set forth with particularity in the appended claims. The various embodiments, however, both as to organization and methods of operation, together with further objects and advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings as follows:
Before explaining the various embodiments in detail, it should be noted that the embodiments are not limited in their application or use to the details of construction and arrangement of parts illustrated in the accompanying Drawings and Description. The illustrative embodiments may be implemented or incorporated in other embodiments, variations and modifications, and may be practiced or carried out in various ways. For example, the surgical instruments and surgical tool configurations disclosed below are illustrative only and not meant to limit the scope or application thereof. Furthermore, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments for the convenience of the reader and are not to limit the scope thereof.
The various embodiments relate, in general, to ultrasonic surgical instruments and, more particularly, to coupling arrangements for coupling a surgical tool to the source of ultrasonic energy in such instruments. Examples of ultrasonic surgical instruments are disclosed in U.S. Pat. Nos. 5,322,055 and 5,954,736 and in combination with ultrasonic blades and surgical instruments disclosed in U.S. Pat. Nos. 6,309,400 B2, 6,278,218 B1, 6,283,981 B1, and 6,325,811 B1, for example, are incorporated herein by reference in their respective entireties. Also incorporated by reference in their respective its entireties is commonly-owned, U.S. patent application Ser. No. 11/726,625, entitled ULTRASONIC SURGICAL INSTRUMENTS, filed on Mar. 22, 2007, now U.S. Publication No. 2008/0234710 A1, as well as commonly-owned U.S. patent application Ser. No. 12/469,308, entitled THERMALLY-ACTIVATED COUPLING ARRANGEMENTS AND METHODS FOR ATTACHING TOOLS TO ULTRASONIC SURGICAL INSTRUMENTS, now U.S. Publication No. 2010/0298743.
The distal end of end-bell 20 is connected to the proximal end of transduction portion 18, and the proximal end of fore-bell 22 is connected to the distal end of transduction portion 18. Fore-bell 22 and end-bell 20 have a length determined by a number of variables, including the thickness of the transduction portion 18, the density and modulus of elasticity of the material used to manufacture end-bell 20 and fore-bell 22, and the resonant frequency of the ultrasonic transducer 14.
The transducer may be constructed of one or more piezoelectric or magnetostrictive elements in the instrument handpiece 16. Ultrasonic vibration is induced in the surgical tool 100 by, for example, electrically exciting a transducer which may be constructed of one or more piezoelectric or magnetostrictive elements in the instrument hand-piece. Vibrations generated by the transducer section are transmitted to the surgical tool 100 via an ultrasonic waveguide 28 extending from the transducer section to the surgical tool 100.
In the illustrated embodiment, the transducer is constructed with piezoelectric elements 40. The piezoelectric elements 40 may be fabricated from any suitable material, such as, for example, lead zirconate-titanate, lead meta-niobate, lead titanate, or other piezoelectric crystal material. Each of the positive electrodes 42, negative electrodes 44, and piezoelectric elements 40 has a bore extending through the center. The positive and negative electrodes 42 and 44 are electrically coupled to wires 46 and 48, respectively. Wires 46 and 48 are encased within cable 50 and electrically connectable to ultrasonic signal generator 12 of ultrasonic system 10.
Ultrasonic transducer 14 of the acoustic assembly 24 converts the electrical signal from ultrasonic signal generator 12 into mechanical energy that results in primarily longitudinal vibratory motion of the ultrasonic transducer 14 and surgical tool 100 at ultrasonic frequencies. A suitable generator is available as model number GEN04, from Ethicon Endo-Surgery, Inc., Cincinnati, Ohio. When the acoustic assembly 24 is energized, a vibratory motion standing wave is generated through the acoustic assembly 24. The amplitude of the vibratory motion at any point along the acoustic assembly 24 may depend upon the location along the acoustic assembly 24 at which the vibratory motion is measured. A minimum or zero crossing in the vibratory motion standing wave is generally referred to as a node (i.e., where motion is usually minimal), and an absolute value maximum or peak in the standing wave is generally referred to as an anti-node. The distance between an anti-node and its nearest node is one-quarter wavelength (λ/4).
Wires 46 and 48 transmit the electrical signal from the ultrasonic signal generator 12 to positive electrodes 42 and negative electrodes 44. The piezoelectric elements 40 are energized by an electrical signal supplied from the ultrasonic signal generator 12 in response to a foot switch 60 to produce an acoustic standing wave in the acoustic assembly 24. The electrical signal causes disturbances in the piezoelectric elements 40 in the form of repeated small displacements resulting in large compression forces within the material. The repeated small displacements cause the piezoelectric elements 40 to expand and contract in a continuous manner along the axis of the voltage gradient, producing longitudinal waves of ultrasonic energy. The ultrasonic energy is transmitted through the acoustic assembly 24 to the surgical tool 100.
In order for the acoustic assembly 24 to deliver energy to the surgical tool 100, all components of acoustic assembly 24 must be acoustically coupled to the surgical tool 100. The components of the acoustic assembly 24 are preferably acoustically tuned such that the length of any assembly is an integral number of one-half wavelengths (nλ/2), where the wavelength λ is the wavelength of a pre-selected or operating longitudinal vibration drive frequency fd of the acoustic assembly 24, and where n is any positive integer. It is also contemplated that the acoustic assembly 24 may incorporate any suitable arrangement of acoustic elements. As the present Detailed Description proceeds, those of ordinary skill in the art will readily understand that the system 10 described above is but one example of a myriad of ultrasonic surgical systems that may employ various unique and novel advantages of the embodiments of the present invention.
In the embodiment depicted in
CET2<CET1
The distal end portion 29 of the waveguide 28 is sized and shaped relative to the cavity 114 in the proximal end portion 112 of the surgical tool 100 such that a slip fit or an amount of clearance “C” is created between the distal end portion 29 of the waveguide 28 and the cavity 114 when the waveguide 28 and the surgical tool 100 are at approximately the same temperature.
In various embodiments, the waveguide 28, or at least the distal end portion 29 of the waveguide 28, may be fabricated from, for example, aluminum which has a coefficient of thermal expansion of 13.7×10−6 in/in/degree F. and the proximal end portion 112 of the surgical tool 100 may be fabricated from, for example, titanium which has a coefficient of thermal expansion of 4.34×10−6 in/in/degree F. In such embodiment, clearance “C” may be approximately 0.0005 inches.
To couple the surgical tool 100 to the waveguide 28, the clinician positions the distal end portion 29 of the waveguide 28 into the cavity 114 of the surgical tool 100 as illustrated in
In the embodiment of
CET2>CET1
To couple the surgical tool 100″ to the waveguide 28″, the clinician positions the proximal end portion 112″ of the surgical tool 100″ in the cavity 114″ in the distal end portion 29″ of the waveguide 28″ as illustrated in
To initiate the coupling process, the distal end portion 418 of the handpiece is inserted into the cavity 530 in the shroud 520 of the surgical tool 500 as shown in
Another coupling arrangement 710 is illustrated in
As illustrated in
A method for coupling a surgical tool 700 to a handpiece 616 will now be described.
Turning to
To detach the surgical tool from the handpiece 616, the clinician moves the release ring 640 to activate the activation switch 689 or contact which causes the transducers to start the vibration process and begin the heating cycle. As the heat generating/cooling units 660 begin to heat up, the locking ring 652 begins to expand to enable the clinician to pull the surgical tool apart from the handpiece 616. When the parts have been separated, the power activation switch discontinues the power to the transducers after the power actuation switch is no longer activated by the distal end 721 of the tool shroud 720. Those of ordinary skill in the art will appreciate that a variety of known switches and switching arrangements, microprocessor controlled contacts, etc. may be used to activate and deactivate the transducers during the tool coupling process without departing from the spirit and scope of the present invention. For example, the power activation switches may comprise proximity sensing switches or contacts that are coupled to a microprocessor housed in or mounted adjacent to the generator.
Various embodiments may include an axially movable actuator rod 850 that is movably supported within a slot 840 in the waveguide 826. The actuator rod 850 may be fabricated from, for example, ultem, PEI and have a distal end 852 that is sized to extend between lugs 830 and, when advanced distally between the lugs 830, causes the lugs 830 to move radially. As can be seen in
Thus, to couple the surgical tool 900 to the handpiece 816, the clinician inserts the lugs 830 into the cavity 930 while the actuator rod 850 is in an unactuated position (
Various devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device may be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the various embodiments described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
It is preferred that the device is sterilized. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide or steam.
Although various embodiments have been described herein, many modifications and variations to those embodiments may be implemented. For example, different types of end effectors may be employed. Also, where materials are disclosed for certain components, other materials may be used. The foregoing description and following claims are intended to cover all such modification and variations.
Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
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Number | Date | Country | |
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20100298851 A1 | Nov 2010 | US |