Surgery – Instruments – Cutting – puncturing or piercing
Reexamination Certificate
2000-02-08
2001-12-11
Thaler, Michael H. (Department: 3731)
Surgery
Instruments
Cutting, puncturing or piercing
Reexamination Certificate
active
06328751
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates, in general, to curved ultrasonic blades for use in surgical instruments and, more particularly, to balanced curved ultrasonic blades including two or more balance asymmetries.
BACKGROUND OF THE INVENTION
Ultrasonic instruments are often used in surgery to cut and coagulate tissue. Exciting the end effector (e.g. cutting blades) of such instruments at ultrasonic frequencies induces longitudinal vibratory movement which generates localized heat within adjacent tissue, facilitating both cutting and coagulation. Because of the nature of ultrasonic instruments, a particular ultrasonically actuated end effector may be designed to perform numerous functions, including, for example, cutting and coagulation. The structural stress induced in such end effectors by vibrating the blade at ultrasonic frequencies may have a number of undesirable effects. Such undesirable effects may include, for example, substantial transverse motion in the instrument waveguide which may lead to, for example, excess heat generation in the waveguide or premature stress failure. The undesirable effects of vibrating a surgical end effector at ultrasonic frequencies are compounded where the end effector is not symmetrical, that is, where the mass of the end effector is not distributed symmetrically about a line extending through the central axis of the transmission waveguide. Therefore, one way to improve the performance of ultrasonically actuated end effectors is to design end effectors which are substantially symmetric about the central axis of the transmission waveguide. Alternatively, the surgical end effector may be small and short, in which case the end effector will act like a small lumped mass at the end of the transmission waveguide and will not induce substantial transverse motion in the waveguide. Where it is desirable to design end effectors which are not symmetric, performance may be improved by designing the end effector such that the center of mass of the end effector is located along a line which extends through the central axis of the waveguide. One known method of moving the center of mass is to add or subtract mass opposite or close to the asymmetric region until the center of mass lies along a central axis. As a further alternative, longitudinal vibratory motion in the waveguide may be reduced or eliminated by using thicker, more robust waveguides which are not as subject to transverse vibratory motion. However, the use of thick waveguides may not be an acceptable alternative where the ultrasonic surgical instrument is being designed for use in minimally invasive surgery such as endoscopic or laparoscopic surgery. In such instruments it is generally desirable to reduce the diameter of the ultrasonic waveguide in order to fit the instrument through the tiny surgical incisions, narrow body orifices and through trocars presently being used and being designed for future procedures. Long thin ultrasonic waveguides, such as those used in instruments for minimally invasive surgery, are particularly susceptible to transverse vibrations introduced by imbalances in the end effector.
For certain applications, it is desirable to include one or more axially asymmetrical features, (e.g. blade curvature) to enhance performance of the end effector. It may also be desirable to design such end effectors to be relatively long, in order to facilitate certain surgical procedures. In such end effectors, it is not always possible or desirable to include opposed balancing features in the treatment portion in order to balance the end effector by aligning the center of mass with the central axis of the transmission waveguide. It would, therefore, be desirable to design an ultrasonic surgical instrument including a waveguide and an ultrasonic end effector wherein undesirable transverse vibrations resulting from the inclusion of beneficial asymmetrical features (e.g. a long curved blade) in the working portion of the end effector have been reduced or eliminated. It would further be advantageous to design such an instrument wherein the undesirable transverse vibrations have been reduced or eliminated without adding balancing features to the treatment portion of the end effector. It would further be advantageous to design an end effector wherein undesirable transverse vibrations resulting from the inclusion of beneficial asymmetrical features in the treatment portion of the end effector have been reduced or eliminated by adding asymmetrical balancing features proximal to the treatment portion of the end effector. It would further be advantageous to design an asymmetric end effector with a center of mass which is not on the central axis of the transmission wave guide wherein significant transverse motion is not induced in the waveguide by the asymmetric end effector.
SUMMARY OF THE INVENTION
A balanced ultrasonic surgical instrument including an ultrasonic transmission rod and an ultrasonically actuated blade attached to the distal end of the ultrasonic transmission rod. According to the present invention, the ultrasonically actuated blade includes a treatment portion and a balance portion. The treatment portion has a functional feature such as, for example, a curved blade which makes the treatment portion asymmetric. Such a functional feature may be referred to as a functional asymmetry. The balance portion includes at least first and second asymmetric features designed and positioned to balance out any undesirable torque generated by the treatment portion. Such balance features may be referred to as balance asymmetries and may include asymmetric features such as, for example, notches, flats, bumps or raised regions. In an ultrasonic instrument according to the present invention, the balance portion generally extends from a node point on the ultrasonic transmission rod to the proximal end of the treatment portion. In an ultrasonic surgical instrument according to the present invention, the first and second balance asymmetries are positioned such that transverse vibrations in the ultrasonic transmission rod are substantially reduced and may be reduced to approximately zero. Further, in an ultrasonic surgical instrument according to the present invention, the balance ratio of the transmission waveguide may be reduced to less than 1:10 and may be further reduced to less than 1:200.
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International standard IEC 61847, First edition 1998-01, Ultrasoni
Ethicon Endo-Surgery Inc.
Shay Bernard
Thaler Michael H.
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