Patent Publication Number: US-2022211408-A1

Title: Devices, systems, and methods of manufacturing fluid-cooled ultrasonic surgical instruments

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of, and priority to, U.S. Provisional Patent Application No. 63/134,268 filed on Jan. 6, 2021, the entire contents of which are hereby incorporated herein by reference. 
    
    
     FIELD 
     The present disclosure relates to ultrasonic surgical instruments and, more particularly, to devices, systems, and methods of manufacturing fluid-cooled ultrasonic surgical instruments. 
     BACKGROUND 
     Ultrasonic surgical instruments and systems utilize ultrasonic energy, i.e., mechanical vibration energy transmitted at ultrasonic frequencies, to treat, e.g., seal and/or transect, tissue. Ultrasonic surgical instruments typically include a waveguide having a transducer coupled to a proximal end portion of the waveguide and an end effector disposed at a distal end portion of the waveguide. The waveguide transmits the ultrasonic energy produced by the transducer to the end effector for treating tissue at the end effector. The end effector may include a blade, hook, ball, etc. and/or other features such as a clamping mechanism for clamping tissue against the end effector and/or to facilitate manipulating tissue. During use, the waveguide and/or end effector of an ultrasonic surgical instrument can reach temperatures greater than 200° C. or even 300° C. 
     SUMMARY 
     As used herein, the term “distal” refers to the portion that is described which is further from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator. Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, and/or other variations, up to and including plus or minus 10 percent. Further, any or all of the aspects described herein, to the extent consistent, may be used in conjunction with any or all of the other aspects described herein. 
     Provided in accordance with aspects of the present disclosure is an ultrasonic surgical system including an ultrasonic waveguide body defining first and second longitudinal lumens extending through at least a portion of a length of the ultrasonic waveguide body. A distal transverse lumen is defined within the ultrasonic waveguide body transversely through at least a portion of the ultrasonic waveguide body to intersect and interconnect the first and second longitudinal lumens. A first proximal transverse lumen extends from a first proximal transverse aperture within the ultrasonic waveguide body transversely through a portion of the ultrasonic waveguide body to intersect the first longitudinal lumen. A second proximal transverse lumen extends from a second proximal transverse aperture within the ultrasonic waveguide body transversely through a portion of the ultrasonic waveguide body to intersect the second longitudinal lumen. Inflow and outflow conduits are fluidly coupled with the first and second proximal transverse apertures, respectively, to enable the inflow of fluid into the first longitudinal lumen and the outflow of fluid from the second longitudinal lumen, respectively. 
     In an aspect of the present disclosure, the distal transverse lumen extends from a distal transverse aperture and a distal transverse aperture plug closes the distal transverse aperture to inhibit escape of fluid therethrough. 
     In an aspect of the present disclosure, the first and second longitudinal lumens extend proximally from first and second distal face apertures defined within a distal face of the ultrasonic waveguide body. In such aspects, at least one distal face aperture plug closes the first and second distal face apertures to inhibit escape of fluid therethrough. 
     In another aspect of the present disclosure, the first and second proximal transverse apertures are defined on opposed sides of the ultrasonic waveguide body. Alternatively, the first and second proximal transverse apertures may be defined on the same side of the ultrasonic waveguide body. 
     In still another aspect of the present disclosure, first and second proximal transverse aperture plugs form a seal between the inflow and outflow conduits and the first and second proximal transverse apertures, respectively. 
     In yet another aspect of the present disclosure, the ultrasonic surgical system further includes a proximal waveguide body adapted to connect to an ultrasonic transducer. In such aspects, the ultrasonic waveguide body is a distal waveguide body including a blade and extends distally from the proximal waveguide body. The distal waveguide body may be releasably engagable with the proximal waveguide body or permanently affixed (or formed with) the proximal waveguide body. Engagement of the proximal and distal waveguide bodies, in aspects where such engagement is provided, may close proximal ends of the first and second longitudinal lumens. 
     In still yet another aspect of the present disclosure, the waveguide body includes a base and a blade extending distally from the base. The blade may define opposed narrow surfaces and opposed broad surfaces. At least a portion of the distal transverse lumen may be disposed within 10% of a length of the blade from a distal end of the blade. 
     In another aspect of the present disclosure, the ultrasonic surgical system further includes a cooling system configured to pump cooling fluid through the inflow conduit into the first longitudinal lumen and/or pump cooling fluid through the second longitudinal lumen into the outflow conduit. 
     In another aspect of the present disclosure, the ultrasonic surgical system further includes a housing supporting the cooling system and an elongated assembly extending distally from the housing. The elongated assembly includes the ultrasonic waveguide body. 
     In yet another aspect of the present disclosure, the housing further supports an ultrasonic transducer configured to produce ultrasonic energy for transmission along the ultrasonic waveguide body. The housing may further still support an ultrasonic generator configured to produce an ultrasonic drive signal for driving the ultrasonic transducer, and/or a battery configured to power the ultrasonic generator. 
     In another aspect of the present disclosure, the distal transverse lumen is at least partially formed via a distal cap defining a distal tip of the distal waveguide body. 
     A method of manufacturing an ultrasonic surgical system provided in accordance with the present disclosure includes forming first and second longitudinal lumens through at least a portion of a length of an ultrasonic waveguide body, forming a distal transverse lumen transversely through at least a portion of the ultrasonic waveguide body to intersect and interconnect the first and second longitudinal lumens, forming first and second proximal transverse lumens transversely through a portion of the ultrasonic waveguide body to intersect the first and second longitudinal lumens, respectively, plugging apertures formed from the forming of the first and second longitudinal lumens, and plugging an aperture formed from the forming of the distal transverse lumen. 
     In an aspect of the present disclosure, the method further includes fluidly connecting an inflow conduit with the first proximal transverse aperture and/or fluidly connecting an outflow conduit with the second proximal transverse aperture. 
     In another aspect of the present disclosure, the method further includes attaching the ultrasonic waveguide body, as a distal waveguide body, to a proximal waveguide body. Such attaching may close proximal ends of the first and second longitudinal lumens. The distal waveguide body may be attached to the proximal waveguide body via inertial friction welding or in any other suitable manner. 
     In still another aspect of the present disclosure, the method further includes coupling the first and second proximal transverse lumens with inflow and outflow conduits, respectively, associated with a cooling system. 
     In another aspect of the present disclosure, forming the distal transverse lumen includes securing a cap to a distal end of the ultrasonic waveguide body to define a distal tip of the ultrasonic waveguide body. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other aspects and features of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements. 
         FIG. 1  is a perspective view of an ultrasonic surgical instrument provided in accordance with the present disclosure; 
         FIG. 2  is a side, cut-away view of a proximal portion of the ultrasonic surgical instrument of  FIG. 1 ; 
         FIG. 3  is a schematic illustration of a robotic surgical system provided in accordance with the present disclosure; 
         FIG. 4A  is an enlarged, perspective view of a distal portion of a waveguide of the ultrasonic surgical instrument of  FIG. 1 ; 
         FIG. 4B  is a longitudinal, cross-sectional view of a distal body of the waveguide of  FIG. 4A  illustrating an internal flow path formed therein; 
         FIG. 5  is a perspective view of the distal portion of the waveguide of  FIG. 4A  assembled with inflow and return conduits connected thereto and the fluid flow path sealed closed; 
         FIGS. 6A and 6B  are perspective and longitudinal, cross-sectional views, respectively, of a distal portion of another waveguide provided in accordance with the present disclosure; 
         FIG. 7  is a longitudinal, cross-sectional view of a distal portion of still another waveguide provided in accordance with the present disclosure; 
         FIGS. 8A and 8B  are perspective and longitudinal, cross-sectional views, respectively, of a distal portion of yet another waveguide provided in accordance with the present disclosure; and 
         FIGS. 9 and 10  are longitudinal, cross-sectional views of proximal portions of still yet other waveguides provided in accordance with the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Turning to  FIGS. 1 and 2 , an ultrasonic surgical instrument provided in accordance with aspects of the present disclosure is generally identified by reference numeral  10 . Instrument  10  is a fully cordless instrument that incorporates an on-board cooling system in addition to an on-board power source, e.g., battery, and an ultrasonic generator and transducer. However, it is also contemplated that instrument  10  be configured as a corded instrument, e.g., wherein instrument  10  is configured to connect to a remote cooling system by way of one or more fluid lines and to a remote ultrasonic generator (separate from or integrated with the remote cooling system) by way of a cable; or as a partially-corded instrument, e.g., wherein instrument  10  includes an on-board power source and ultrasonic generator and is configured to connect to a remote cooling system by way of one or more fluid lines, or wherein instrument  10  incorporates an on-board cooling system and is configured to connect to a remote ultrasonic generator. Likewise, other style ultrasonic instruments are also contemplated such as, for example, pencil-style instruments, hemostat-style instruments, etc. Thus, although particular aspects and features of instrument  10  are detailed below, it is understood that the aspects and features of the present disclosure are equally applicable for use with any other suitable ultrasonic surgical instrument or system, e.g., robotic surgical system  1000  ( FIG. 3 ). Other suitable instruments for use in accordance with the present disclosure including remote or on-board cooling systems are described, for example, in Patent Application Pub. No. US 2019/0247073, titled “REMOVABLE FLUID RESERVOIR AND ULTRASONIC SURGICAL INSTRUMENT INCLUDING THE SAME” and filed on Feb. 13, 2018, and Patent Application Pub. No. US 2017/0281215, titled “DEVICES, SYSTEMS, AND METHODS FOR COOLING A SURGICAL INSTRUMENT” and filed on Mar. 18, 2017, the entire contents of each of which are hereby incorporated herein by reference. 
     Instrument  10  generally includes a handle assembly  100 , an elongated assembly  200  that extends distally from handle assembly  100 , a transducer and generator assembly (“TAG”)  300  configured for releasable engagement with handle assembly  100 , and a battery  400  configured for removable receipt within handle assembly  100 . Elongated assembly  200  may be integral with handle assembly  100  or may be releasably engagable with handle assembly  100 . 
     Handle assembly  100  includes a housing  110 , a cooling system  120 , a switch assembly  140 , a generator dock  150 , a battery dock  160 , a flex circuit assembly  170  (including flex circuit portions  182 ,  184 ), and a clamp trigger  190 . 
     Housing  110  of handle assembly  100  defines a body portion  112  defining a longitudinal axis and a fixed handle portion  114  extending from body portion  112  at an oblique angle relative to the longitudinal axis of body portion  112  (although fixed handle potion  114  may alternatively extend perpendicularly relative to the longitudinal axis of body portion  112 ). Body portion  112  of housing  110  is configured to receive a proximal portion of elongated assembly  200  in operable engagement with clamp trigger  190  such that actuation of clamp trigger  190  manipulates end effector assembly  280  of elongated assembly  200 . When engaged with body portion  112  of housing  110 , elongated assembly  200  is aligned on the longitudinal axis of body portion  112 . Body portion  112  of housing  110  is also configured to support TAG  300  thereon with transducer  320  of TAG  300  mechanically coupled with waveguide  230  of elongated assembly  200 , e.g., via a threaded connection, latching, or in any other suitable manner, and both aligned on the longitudinal axis of body portion  112  of housing  110 . Generator  340  of TAG  300  is electrically coupled with generator dock  150  of housing  110  when TAG  300  is engaged with body portion  112  of housing  110 . Fixed handle portion  114  of housing  110  defines an internal compartment  116  configured to removably receive battery  400  therein and a hinged door  118  configured to enclose battery  400  within internal component  116 . 
     Cooling system  120  includes one or more fluid pumps  122  and, in some aspects, a fluid reservoir  124 , although fluid reservoir  124  may be omitted in other configurations. Cooling system  120  further includes associated tubing  126  operably interconnecting fluid pump  122 , fluid reservoir  124 , and inflow and return conduits  128   a,    128   b  (or interconnecting fluid pump  122  and inflow and return conduits  128   a,    128   b,  in aspects where fluid reservoir  124  is omitted) for pumping cooling fluid to and returning cooling fluid from elongated assembly  200 . Inflow and return conduits  128   a,    128   b  may extend along and/or through elongated assembly  200 , ultimately entering waveguide  230  thereof to permit circulation of cooling fluid through blade  282  of end effector assembly  280  of elongated assembly  200 , as described in greater detail below. 
     The one or more fluid pumps  122  of cooling system  120  are supported within body portion  112  of housing  110 . For example, a fluid pump  122  may be supported on either or both sides of body portion  112  of housing  110  at radially-spaced positions relative to the longitudinal axis of body portion  112  of housing  110 . In such a configuration, fluid pumps  122  may define relatively thin, elongate configurations such that sufficient space is defined between the pumps  122  and/or the pump  122  and housing  110  to permit passage of transducer  320  of TAG  300  therebetween (in alignment on the longitudinal axis) while requiring minimal, if any, increase in the overall with dimension of body portion  112  of housing  110  to accommodate pump(s)  122 . 
     A connection interface  130  of cooling system  120  for enabling power and/or control signals to be transmitted to pump(s)  122  is positioned so as not to interfere with TAG  300 . Further, a connector  132 , e.g., lead wire, cable, flex circuit, or other suitable connector, extends through body portion  112  of housing  110  to couple the connection interface  130  with flex circuit assembly  170  of handle assembly  100  to permit communication of power and control signals between pump(s)  122 , generator  340 , switch assembly  140 , and/or battery  400 . More specifically, pump(s) of cooling system  120  may be controlled via a controller of generator  340 , battery  400 , or a separate controller of cooling system  120 , e.g., within control box  130 . Regardless of the location and/or configuration, the controller is configured to control pump(s)  122  so as to maintain a flow of cooling fluid sufficient to cool blade  282  of end effector  280 , to activate and deactivate cooling in response to manual inputs, and/or to implement automatic cooling (for example, upon deactivation of the supply of energy). The one or more fluid pumps  122  may be piezoelectric microfluidic pumps or other microfluidic pumps such as micro-peristaltic pumps, syringe pumps, etc. Regardless of the particular pump configuration utilized, the one or more fluid pumps  122  may, in aspects, be configured to generate sufficient flow rate of cooling fluid so as to cool waveguide  230  of elongated assembly  200  from an initial temperature of about 300° C. to about 100° C. (or about 120° C.) to a cooled temperature of about 70° C. to about 0° C. (or less than about 60° C.) in from about 0.5 seconds to about 2.5 seconds (or in less than about 2 seconds). However, other temperatures and/or cooling times are also contemplated. 
     Continuing with reference to  FIGS. 1 and 2 , fluid reservoir  124  is disposed within housing  110  of handle assembly  100 . More specifically, fluid reservoir  124  is disposed within fixed handle portion  114  of housing  110  and is positioned between internal compartment  116  of fixed handle portion  114  and body portion  112  of housing  110 . Fluid reservoir  124  may define a cut-out  134  within which at least a portion of clamp trigger  190  extends upon actuation thereof. As such, fluid reservoir  124  does not interfere with actuation of clamp trigger  190 . It is also contemplated that fluid reservoir  124  be positioned in other locations, e.g., at a free end of fixed handle portion  114  such that battery  400  is disposed between fluid reservoir  124  and body portion  112 . 
     Fluid reservoir  124  further includes a port  136  having an input  137   a  and an output  137   b.  Tubing  126  of cooling system  120  is coupled to input  137   a  and output  137   b  of fluid reservoir  124  to couple fluid reservoir  124  with fluid pump(s)  122  and inflow and return conduits  128   a,    128   b.  More specifically, either or both of the ends  138   a,    138   b  of the tubes of tubing  126  may extend through input  137   a  and output  137   b  and into fluid reservoir  124  such that the ends  138   a,    138   b  of the tubes of tubing  126  are disposed at opposite sides, ends, or portions of fluid reservoir  124 , thereby maximizing the spacing therebetween. This configuration inhibits the hotter, returned cooling fluid from being immediately pumped back out of fluid reservoir  124 . Further, the ends  138   a,    138   b  of the tubes of tubing  126  are positioned within fluid reservoir  124  relative to one another such that, regardless of the orientation of handle assembly  100 , any air in fluid reservoir  124  is inhibited from entering inflow conduit  128   a.    
     Switch assembly  140  of handle assembly  100  includes an energy activation button  142  operably positioned to electrically couple to flex circuit assembly  170 . Flex circuit assembly  170  electrically couples switch assembly  140 , battery  400 , and TAG  300  with one another. Thus, when energy activation button  142  is activated in an appropriate manner, power is supplied from battery  400  to TAG  300 . Energy activation button  142  may be configured for dual-mode activation such that, a first activation of energy activation button  142  drives TAG  300  in a “LOW” power mode, while a second, different activation of energy activation button  142  drives TAG  300  in a “HIGH” power mode. Other suitable activation configurations are also contemplated. 
     Switch assembly  140  of handle assembly  100  further includes, in aspects, a pair of cooling activation buttons  144  operably positioned on either side of housing  110 . Flex circuit assembly  170  electrically couples connection interface  130  of cooling system  120  with switch assembly  140 , battery  400 , and TAG  300 . Thus, activation of either or both of cooling activation buttons  144  initiates cooling. In aspects, multiple activations and/or particular activation patterns of cooling activation button(s)  144  may subsequently terminate cooling, switch between different cooling modes or programs, etc. 
     Generator dock  150  is disposed on body portion  112  of housing  110  and is positioned to electrically couple to generator  340  of TAG  300  upon engagement of TAG  300  with housing  110 . Battery dock  160  is disposed within internal compartment  116  of fixed handle portion  114  of housing  110  and is positioned to electrically couple to battery  400  upon receipt of battery  400  within internal compartment  116 . Docks  150 ,  160 , flex circuit assembly  170  (including flex circuit portions  182 ,  184  thereof), and connector  132  of cooling system  120  electrically couple TAG  300 , switch assembly  140 , control box  130  of cooling system  120 , and battery  400  with one another to enable communication of power and/or control signals therebetween. Flex circuit portion  182 , more specifically, interconnects battery dock  160  with flex circuit assembly  170 . The flexible configuration of flex circuit portion  182  enables routing of flex circuit  182  about fluid reservoir  124 , which is disposed between flex circuit assembly  170  and battery dock  160 . Flex circuit portion  184 , on the other hand, electrically couples flex circuit assembly  170  with generator dock  150 . 
     Referring still to  FIGS. 1 and 2 , clamp trigger  190  of handle assembly  100  of instrument  10  extends from body portion  112  of housing  110  in opposing relation relative to fixed handle portion  114  of housing  110 . Clamp trigger  190  is pivotably coupled to body portion  112  of housing  110  and operably associated with elongated assembly  200  such that pivoting of clamp trigger  190  towards fixed handle portion  114  of housing  110  pivots jaw  284  of end effector assembly  280  of elongated assembly  200  from an open position to a clamping position for clamping tissue between jaw  284  and blade  282 , which extends distally from waveguide  230  of elongated assembly  200 . 
     Elongated assembly  200  generally includes a sleeve assembly having an outer sleeve  210  and an inner sleeve (not shown) disposed within outer sleeve  210 , waveguide  230  extending through the inner sleeve (not shown), a drive assembly  250 , a rotation assembly  270  operably disposed about outer sleeve  210 , and end effector assembly  280  disposed at the distal end of the sleeve assembly. End effector assembly  280  includes, as noted above, blade  282  and jaw  284 , which is operably coupled to outer sleeve  210  such that translation of outer sleeve  210  pivots jaw  284  relative to blade  282  between the open and clamping positions. Drive assembly  250  operably couples a proximal portion of outer sleeve  210  with clamp trigger  190  such that actuation of clamp trigger  190  pivots jaw  284  relative to blade  282  between the open and clamping positions. In the above-detailed configuration, the inner sleeve is a support sleeve and the outer sleeve is a drive sleeve, although the opposite configuration is also contemplated, as are other suitable drive mechanisms for pivoting jaw  284  relative to blade  282 . 
     Jaw  284  of end effector assembly  280  includes a more-rigid structural body  285   a  and a more-compliant jaw liner  285   b.  Structural body  285   a  is pivotably coupled to the inner sleeve of elongated assembly  200  and operably coupled with outer sleeve  210  of elongated assembly  200  to enable the above-detailed translation of outer sleeve  210  to impart pivotal motion of jaw  284  relative to blade  282  to clamp tissue between jaw liner  285   b  of jaw  284  and blade  282 . Jaw liner  285   b  is positioned to oppose blade  282  in the clamping position of jaw  284 . 
     Waveguide  230  extends through the inner sleeve (not shown), includes blade  282  extending from the distal end thereof and includes a proximal end portion that is configured to operably couple to transducer  320 , e.g., via a threaded connection, latching, or in any other suitable manner. Inflow and return conduits  128   a,    128   b,  in aspects, may extend from housing  110  at least partially along and/or through elongated assembly  200  before fluidly coupling with an interior flow path defined within waveguide  230  or may fluidly couple with waveguide  230  within housing  110 . Waveguide  230 , the interior flow path defined within waveguide  230 , and the connection of inflow and return conduits  128   a,    128   b  to waveguide  230  are described in greater detail below. 
     TAG  300  and battery  400  are each removable from handle assembly  100  to facilitate disposal of handle assembly  100  or to enable sterilization of handle assembly  100 . TAG  300  may be configured to withstand sterilization such that TAG  300  may be sterilized for repeated use. Battery  400 , on the other hand, is configured to be aseptically transferred and retained within compartment  116  of fixed handle portion  114  of housing  110  of handle assembly  100  such that battery  400  may be repeatedly used without requiring sterilization thereof. Alternatively or additionally, battery  400  may be sterilized. In some configurations, TAG  300  (or a portion thereof, e.g., generator  340  or transducer  320 ) may be integral with housing  110 . 
     TAG  300  includes ultrasonic transducer  320  and generator  340 . A set of connectors  362  and corresponding rotational contacts  364  associated with generator  340  and ultrasonic transducer  320 , respectively, enable data and drive signals to be communicated from generator  340  to transducer  320 , e.g., the piezoelectric stack of transducer  320 , to drive transducer  320 . Battery  400  powers generator  340  to produce a drive signal, e.g., a high voltage AC signal, that is communicated to transducer  320 . Transducer  320  converts the signal into mechanical motion that is output along waveguide  230  to blade  282  of end effector assembly  280 . Transducer  320  further includes a rotation knob  380  disposed at a proximal end thereof to enable rotation of transducer  320  relative to generator  340  and handle assembly  100 . Rotation knob  380  may also facilitates operable coupling of transducer  320  with elongated assembly  200 . 
     With reference to  FIG. 3 , a robotic surgical system in accordance with the aspects and features of the present disclosure is shown generally identified by reference numeral  1000 . For the purposes herein, robotic surgical system  1000  is generally described. Aspects and features of robotic surgical system  1000  not germane to the understanding of the present disclosure are omitted to avoid obscuring the aspects and features of the present disclosure in unnecessary detail. 
     Robotic surgical system  1000  generally includes a plurality of robot arms  1002 ,  1003 ; a control device  1004 ; and an operating console  1005  coupled with control device  1004 . Operating console  1005  may include a display device  1006 , which may be set up in particular to display three-dimensional images; and manual input devices  1007 ,  1008 , by means of which a surgeon, may be able to telemanipulate robot arms  1002 ,  1003  in a first operating mode. Robotic surgical system  1000  may be configured for use on a patient  1013  lying on a patient table  1012  to be treated in a minimally invasive manner. Robotic surgical system  1000  may further include a database  1014 , in particular coupled to control device  1004 , in which are stored, for example, pre-operative data from patient  1013  and/or anatomical atlases. 
     Each of the robot arms  1002 ,  1003  may include a plurality of members, which are connected through joints, and an attaching device  1009 ,  1011 , to which may be attached, for example, a surgical tool “ST” supporting an end effector  1050 ,  1060 . One of the surgical tools “ST” may be ultrasonic surgical instrument  10  ( FIG. 1 ), wherein manual manipulation and actuation features are replaced with robotic inputs. In such configurations, robotic surgical system  1000  may include or be configured to connect to an ultrasonic generator, a power source, and cooling system. The other surgical tool “ST” may include any other suitable surgical instrument, e.g., an endoscopic camera, other surgical tool, etc. Robot arms  1002 ,  1003  may be driven by electric drives, e.g., motors, that are connected to control device  1004 . Control device  1004  (e.g., a computer) may be configured to activate the motors, in particular by means of a computer program, in such a way that robot arms  1002 ,  1003 , their attaching devices  1009 ,  1011 , and, thus, the surgical tools “ST” execute a desired movement and/or function according to a corresponding input from manual input devices  1007 ,  1008 , respectively. Control device  1004  may also be configured in such a way that it regulates the movement of robot arms  1002 ,  1003  and/or of the motors. 
     Referring to  FIGS. 1, 2, 4A, 4B , waveguide  230 , as noted above, includes blade  282  disposed at a distal end thereof. Waveguide  230 , more specifically, includes a proximal body  232  ( FIGS. 2 and 4A ) and a distal body  234  ( FIGS. 4A and 4B ) that includes blade  282 . In aspects, proximal body  232  and distal body  234  may be integrally formed from a single piece of material or may be separately formed and subsequently attached to one another (permanently or removably). Proximal body  232  and distal body  234  may, in aspects where proximal and distal body  232 ,  234  are separately formed and subsequently attached, be attached via threaded engagement, e.g., via receipt of a threaded plug  233  ( FIG. 4A ) of proximal body  232  within a threaded bore  236  ( FIGS. 4A and 4B ) defined within a proximal end of distal body  234 . Other methods of attachment are also contemplated, such as various types of welding (e.g., inertial friction welding), brazing, soldering, diffusion bonding, etc. Proximal body  232  and/or distal body  234  may be formed from aluminum, aluminum alloy, titanium, a titanium alloy, or other suitable similar or different material(s). 
     Proximal body  232  of waveguide  230  extends from housing  110  through at least a portion of the inner support sleeve of elongated assembly  200  to distal body  234 . Proximal body  232  is configured to operable engage ultrasonic transducer  320  such that ultrasonic motion produced by ultrasonic transducer  320  is transmitted along proximal body  232  to distal body  234  and, ultimately, blade  282  for treating tissue clamped between blade  282  and jaw  284  or positioned adjacent to blade  282 . Proximal body  232  may define a generally cylindrical-shaped configuration and may be solid, although hollow or semi-hollow configurations are also contemplated. 
     With particular reference to  FIGS. 4A and 4B , distal body  234  includes a base  238  and blade  282  extending distally from base  238 . Base  238  and blade  282  may be integrally formed from a single piece of material or may be separately formed and subsequently attached to one another (permanently or removably). Base  238  defines a generally cylindrical-shaped configuration, although other configurations are also contemplated. Blade  282  extends distally from base  282 . Blade  282  may define a substantially linear configuration (as shown), may define a curved configuration, or may define any other suitable configuration, e.g., straight and/or curved surfaces, portions, and/or sections; one or more convex and/or concave surfaces, portions, and/or sections; etc. With respect to curved configurations, blade  282 , more specifically, may be curved in any direction relative to jaw  284  ( FIG. 1 ), for example, such that the distal tip of blade  282  is curved towards jaw  284  ( FIG. 1 ), away from jaw  284  ( FIG. 1 ), or laterally (in either direction) relative to jaw  284  ( FIG. 1 ). Further, blade  282  may be formed to include multiple curves in similar directions, multiple curves in different directions within a single plane, and/or multiple curves in different directions in different planes. In addition, although one configuration of blade  282  is described and illustrated herein, it is contemplated that blade  282  may additionally or alternatively be formed to include any suitable features, e.g., a tapered configuration, various different cross-sectional configurations along its length, cut-outs, indents, edges, protrusions, straight surfaces, curved surfaces, angled surfaces, wide edges, narrow edges, and/or other features. In aspects, blade  282  defines a pair of relatively narrow generally convex opposed surfaces and a pair of relatively broad generally planar opposed surfaces, although other configurations are also contemplated. One of the narrow surfaces may be positioned to oppose jaw  284  ( FIG. 1 ), one of the broad surfaces may be positioned to oppose jaw  284  ( FIG. 1 ), or blade  282  and/or jaw  284  ( FIG. 1 ) may be relatively rotatable to position a desired surface in opposition to jaw  284  ( FIG. 1 ). A transition region  240  defining a gradual (or more gradual) transition between base  238  and blade  282  may also be provided. 
     Distal body  234  may be formed from a solid material into which the various lumens detailed below are formed, although other configurations are also contemplated. Distal body  234 , more specifically, includes first and second longitudinal lumens  242 ,  244  extending in substantially parallel, spaced-apart relation relative to one another through at least a portion of base  238  and blade  282 . Longitudinal lumens  242 ,  244  communicate with distal apertures  243 ,  245 , respectively, defined through a distal face of blade  282 . Longitudinal lumens  242 ,  244  may be formed within distal body  234  during manufacture of distal body  234  (e.g., as part of an extrusion process or other suitable formation process) or may be formed subsequent to manufacture of distal body  234  (e.g., via drilling). In either configuration, longitudinal lumens  242 ,  244  extend through the distal face of blade  282  proximally through blade  282  and at least a portion of base  238  to closed or open proximal ends. Alternatively, in configurations where distal body  234  is removable from proximal body  232  ( FIG. 4A ), longitudinal lumens  242 ,  244  may be formed within distal body  234  through a proximal end portion of base  238  (or of waveguide  230 ) to or through the distal face of blade  282 . In aspects, threaded bore  236  of base  238  communicates with open proximal ends of longitudinal lumens  242 ,  244 . In such aspects, threaded engagement of threaded plug  233  of proximal body  232  (see  FIG. 4A ) within threaded bore  236  of base  238  of distal body  234  to attach proximal and distal bodies  232 ,  234  with one another also serves to seal the proximal ends of longitudinal lumens  242 ,  244  closed (either by itself or with a seal, e.g., a grommet, o-ring, gasket, sealant, overmold, etc., disposed between proximal and distal bodies  232 ,  234 , e.g., pressed distally to bottom out within threaded bore  236 ). In other configurations, longitudinal lumens  242 ,  244  communicate with one or more internal lumens (e.g., a single lumen or dedicated lumens corresponding to each longitudinal lumen  242 ,  244 ) defined within proximal body  232  and extending at least partially therethrough to closed or closable proximal ends of the internal lumen(s) of proximal body  232 . In aspects, such internal lumens of proximal body  232  extend to the proximal end of proximal body  232  and are sealed closed (themselves or with a seal) via engagement of proximal body  232  of waveguide  230  with transducer  320  ( FIG. 2 ), e.g., via the threaded engagement therebetween. 
     Continuing with reference to  FIGS. 4A and 4B , a distal transverse lumen  246  is defined at least partially through blade  282  at a distal end portion of blade  282 , e.g., within approximately 15% of a length of blade  282  from the distal end thereof, in other aspects within approximately 10%, and in still other aspects, within approximately 5%. Distal transverse lumen  246  may be formed within blade  282  via drilling, e.g., forming a distal transverse aperture  247  disposed on one side of blade  282 , or in any other suitable manner. Distal transverse lumen  246  extends transversely across one of the longitudinal lumens  242 ,  244  into communication with the other longitudinal lumen  242 ,  244 . In this manner, distal transverse lumen  246  establishes communication between longitudinal lumens  242 ,  244  within the distal end portion of blade  282 . Distal transverse lumen  246  may not extend completely through blade  282 , e.g., such that a single distal transverse aperture  247  is formed, or may extend completely therethrough, e.g., such that a pair of opposed distal transverse apertures  247  is formed. Distal transverse lumen  246  may extend in substantially perpendicular orientation relative to longitudinal lumens  242 ,  244  or at an angle relative thereto. 
     Base  238  of distal body  234  of waveguide  230  defines a pair of proximal transverse lumens  248   a,    248   b  therethrough, although it is also contemplated that proximal transverse lumens  248   a,    248   b  be defined within proximal body  232  of waveguide  230  (in configuration wherein longitudinal lumens  242 ,  244  communicate with corresponding lumens defined through at least a portion of proximal body  232 ). Proximal transverse lumens  248   a,    248   b  extend from transverse apertures  249   a,    249   b  on opposing sides of base  238  into communication with longitudinal lumens  242 ,  244 , respectively, or may be disposed on the same side of base  238  and extend into communication with respective longitudinal lumens  242 ,  244 . Longitudinal lumens  242 ,  244  may terminate at proximal transverse lumens  248   a,    248   b  or may extend proximally therebeyond. Proximal transverse lumens  248   a,    248   b  may be formed via drilling through base  238  or in any other suitable manner. Proximal transverse lumens  248   a,    248   b  may extend only partially through base  238  so as to maintain isolation between longitudinal lumens  242 ,  244  within base  238 , or may extend completely through base  238  whereby the undesired apertures formed thereby are sealed closed during manufacturing, e.g., according to any of the aspects detailed herein. Whether by initial formation or subsequent sealed closure, proximal transverse lumens  248   a,    248   b  each communicate with one of the longitudinal lumens  242 ,  244  but not the other longitudinal lumen  242 ,  244 . Proximal transverse lumens  248   a,    248   b  may be transversely aligned with one another or longitudinally offset relative to one another and either or both may extend in substantially perpendicular orientation relative to longitudinal lumens  242 ,  244  or at angles relative thereto. 
     Referring also to  FIG. 5 , during manufacturing, in order to define a closed fluid circuit from cooling system  120 , through waveguide  230 , and back to cooling system  120  (see  FIG. 2 ), inflow and return conduits  128   a,    128   b  are coupled, in fluid communication, with longitudinal lumens  242 ,  244 , respectively, and the various apertures  243 ,  245 ,  247 ,  249   a,    249   b  defined through waveguide  230  are sealed to inhibit escape of fluid from the closed fluid circuit. Although the fluid circuit from cooling system  120  through waveguide  230  and back to cooling system  120  is closed, cooling system  120  may itself define an open-loop configuration (e.g., wherein supply fluid and return fluid are separate and return fluid is not re-circulated), a closed-loop configuration (e.g., wherein return fluid is re-circulated as supply fluid), or a semi-closed loop configuration (e.g., wherein some return fluid is re-circulated while other return fluid is not re-circulated). Further still, in other configurations, one or more apertures  243 ,  245 ,  247 ,  249   a,    249   b  defined through waveguide  230  are sealed closed while one or more other apertures  243 ,  245 ,  247 ,  249   a,    249   b  defined through waveguide  230  remain open to enable the direction of fluid from waveguide  230  in a particular manner or manners in an open-loop system, e.g., to function as an aspirator and/or suction device. 
     Inflow and return conduits  128   a,    128   b  may extend to or at least partially through transverse apertures  249   a,    249   b  to enable the delivery of inflow fluid through proximal transverse aperture  249   a,  proximal transverse lumen  248   a,  and into longitudinal lumen  242 , from longitudinal lumen  242  to longitudinal lumen  244  at the distal end portion of blade  282  via distal transverse lumen  246 , and to enable the return of return fluid from longitudinal lumen  244 , through proximal transverse lumen  248   b  and transverse aperture  249   b  to return conduit  128   b.  Inflow conduit  128   a  and/or return conduit  128   b  may, interiorly and/or exteriorly relative to waveguide  230 , be oriented substantially perpendicularly relative to longitudinal lumens  242 ,  244 , respectively, or may be angled relative thereto. Additionally or alternatively, as noted above, proximal transverse lumens  248   a,    248   b  may be angled or substantially perpendicular relative to longitudinal lumens  242 ,  244 . Angling inflow conduit  128   a  and/or return conduit  128   b  and/or angling either or both proximal transverse lumens  248   a,  e.g., in a proximally-angled manner, may facilitate inflow and outflow of fluid to and from longitudinal lumens  242 ,  244 , respectively, although other configurations are also contemplated. In configurations where inflow and return conduits  128   a,    128   b  extend at least partially into proximal transverse lumens  248   a,    248   b,  respectively, the ends of inflow and return conduits  128   a,    128   b  may be cut at an angled, chamfered, or otherwise asymmetrically configured to facilitate fluid flow in a desired manner, e.g., distally from inflow conduit  128   a  through longitudinal lumen  242  and/or proximally through longitudinal lumen  244  into return conduit  128   b.    
     Referring still to  FIGS. 4A-5 , apertures  243 ,  245 ,  247 ,  249   a,    249   b  may be closed via corresponding plugs  260 . Plugs  260  may be similar or different from one another and may sealingly close apertures  243 ,  245 ,  247 ,  249   a,    249   b  in similar or different manners. One or more of plugs  260  may be configured, for example, as a rod, e.g., a titanium rod or other rod of similar of different material from distal body  234  of waveguide  230 , that is inserted into the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b  and welded therein to sealingly close the aperture  243 ,  245 ,  247 ,  249   a,    249   b.  In such aspects, lost wax, depth gauge, or other suitable fixturing may be utilized to retain the rod in pace during welding. In aspects, one or more of plugs  260  may be formed from, for example, a high temperature polymer, rubber, or metal and, in these or other aspects, may be welded, thermally interference fit, soldered (wherein the plugs are formed wholly from the solder material or wherein a plug of different material is soldered), brazed, or otherwise secured in position within the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b  to sealingly close the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b.    
     The plug  260  configured to sealingly close apertures  243 ,  245 , in aspects, may be joined via a connector such that plugs  260  are together inserted into corresponding apertures  243 ,  245  and secured therein (in any manner detailed herein or any other suitable manner, and with plugs  260  formed from any suitable material such as any of those detailed herein). Such a plug  260  may define a substantially U-shaped configuration and be inserted from the exterior of waveguide  230 . Alternatively, such a plug  260  may include an O-ring (itself or together with plug portions extending therefrom) or other seal connector, e.g., a gasket, that is inserted distally through lumen  242 ,  244  to seal apertures  243 ,  245  (and, in some aspects, also aperture  247 ) closed. 
     One or more of plugs  260  may be overmolded from the interior or exterior of the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b  to sealingly close the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b.  One or more of plugs  260  may be separately formed and then inserted (from the interior or exterior) and sealed within the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b,  or may be formed within the corresponding aperture  243 ,  245 ,  247 ,  249   a,    249   b,  e.g., via filling the corresponding aperture with material via overmolding, casting, brazing, soldering, etc. from the interior or exterior thereof. One or more of plugs  260  may be configured as a set screw or other threaded element and/or one or more of apertures  243 ,  245 ,  247 ,  249   a,    249   b  may include threading to enable sealed engagement via threading (itself (e.g., via pipe thread sealing) or with an additional seal or seal material) of the one or more plugs  260  within the corresponding aperture(s)  243 ,  245 ,  247 ,  249   a,    249   b,  from the interior or exterior thereof. 
     In configurations wherein longitudinal lumens  242 ,  244  define open proximal ends, the open proximal ends may be collectively or individually plugged according to any of the aspects detailed above or in any other suitable manner. Further, with respect to the plugs  260  for apertures  249   a,    249   b,  inflow and outflow conduits  128   a,    128   b,  respectively, may extend through the plugs  260 , be defined within the plugs  260 , form the plugs  260 , be surrounded by the plugs  260 , or be otherwise configured relative to the plugs  260  such that the plugs  260  seal apertures  249   a,    249   b  and inflow and outflow conduits  128   a,    128   b,  respectively, to inhibit escape of fluid from the system while allowing fluid flow between waveguide  230  and inflow and outflow conduits  128   a,    128   b.  Combinations of any two or more of the above-noted plug configurations are also contemplated as are other configurations to facilitate sealed closure of some or all apertures  243 ,  245 ,  247 ,  249   a,    249   b.    
     With general reference to  FIGS. 1-5 , in use, upon activation of cooling, cooling system  120  is configured to pump fluid, using the one or more fluid pumps  122 , from fluid reservoir  124 , through inflow conduit  128   a,  proximal transverse lumen  248   a,  distally through longitudinal lumen  242 , from longitudinal lumen  242  to longitudinal lumen  244  at the distal end portion of blade  282  via distal transverse lumen  246 , proximally through longitudinal lumen  244 , through transverse lumen  248   b,  through outflow conduit  128   b,  and back to fluid reservoir  124 . In this manner, cooling fluid is circulated substantially entirely along the length of blade  282  to facilitate cooling blade  282 . The cooling fluid may be saline, water, or other suitable fluid. 
     Turning to  FIGS. 6A-6B , a distal body  1234  including a blade  1282  of another waveguide  1230  provided in accordance with aspects of the present disclosure is shown. Except as explicitly contradicted below, waveguide  1230  may be configured similarly to and include any of the features of waveguide  230  ( FIGS. 1, 2, 4A, and 4B ). Thus, the following description will focus on differences between waveguide  1230  and waveguide  230  ( FIGS. 1, 2, 4A, and 4B ) while similarities are only summarily described or omitted entirely. 
     Distal body  1234  of waveguide  1230  includes a base  1238  and blade  1282  extending distally from base  1238 . Distal body  1234  further includes first and second longitudinal lumens  1242 ,  1244  extending in substantially parallel, spaced-apart relation relative to one another through at least a portion of base  1238  and blade  1282  to open distal ends. A cap  1250  defining a connector lumen  1252  is welded, soldered, or otherwise secured to the distal end of blade  1282  to thereby define a distal tip of blade  1282 . Cap  1250  may be formed from the same material as blade  1282  or a different material. Upon securing cap  1250  to the distal end of blade  1282 , connector lumen  1252  establishes communication between the open distal ends of longitudinal lumens  1242 ,  1244  and otherwise seals off the fluid flow path, inhibiting the escape of fluid from within distal body  1234 . Thus, cooling fluid can be pumped distally through distal body  1234  via one of longitudinal lumens  1242 ,  1244  and can return proximally through distal body  1234  via connector lumen  1252  and the other longitudinal lumen  1242 ,  1244  to thereby cool distal body  1234  of waveguide  1230 . With respect to distal body  1234 , a transverse lumen need not be provided towards distal ends of longitudinal lumens  1242 ,  1244 . 
     With reference to  FIG. 7 , a distal body  2234  including a blade  2282  of another waveguide  2230  provided in accordance with aspects of the present disclosure is shown. Distal body  2234  is similar to and may include any of the features of distal body  1234  ( FIGS. 6A and 6B ) except as explicitly contradicted below. 
     Distal body  2234  of waveguide  2230  includes a base  2238  and blade  2282  extending distally from base  2238 . Distal body  2234  further includes first and second longitudinal lumens  2242 ,  2244  extending in substantially parallel, spaced-apart relation relative to one another through at least a portion of base  2238  and blade  2282 . Longitudinal lumens  2242 ,  2244  terminate at and communicate with a transverse lumen  2246  disposed at the distal end of blade  2282  and in communication with an open distal end thereof. Thus, lumens  2242 ,  2244 ,  2246  all communicate with the open distal end of blade  2282 . 
     A cap  2250  including a base  2252  and a head  2254  is welded, soldered, or otherwise secured to the distal end of blade  2282  to thereby define a distal tip of blade  2282  with base  2252  extending at least partially into the open distal end of blade  2282  and head  2254  abutting the distal face(s) of blade  2282 . Upon securing cap  2250  to the distal end of blade  2282  in this manner, the open distal end of blade  2282  is sealed closed while still maintaining a fluid flow path between longitudinal lumens  2242 ,  2244  via transverse lumen  2246 . Thus, cooling fluid can be pumped distally through distal body  2234  via one of longitudinal lumens  2242 ,  2244  and can return proximally through distal body  2234  via transverse lumen  2246  and the other longitudinal lumen  2242 ,  2244  to thereby cool distal body  2234  of waveguide  2230 . Base  2252  of cap  2250  facilitates proper alignment and orientation of cap  2250  relative to blade  2282  upon welding or otherwise securing cap  2250  to blade  2282 . 
     Referring to  FIGS. 8A and 8B , a distal body  3234  including a blade  3282  of another waveguide  3230  provided in accordance with aspects of the present disclosure is shown. Distal body  3234  is similar to and may include any of the features of distal body  1234  ( FIGS. 6A and 6B ) except as explicitly contradicted below. 
     Rather than providing a cap  1250  as detailed above with respect to distal body  1234  (see  FIGS. 6A and 6B ), distal body  3234  includes a bent pipe  3250  (curved, angled, and/or otherwise bent) defining a lumen  3252  therethrough secured, e.g., welded, soldered, or otherwise secured, to the distal end of blade  3282  such that lumen  3252  establishes communication between the open distal ends of longitudinal lumens  3242 ,  3244  and otherwise seals off the fluid flow path, inhibiting the escape of fluid from distal body  3234 . Thus, cooling fluid can be pumped distally through distal body  3234  via one of longitudinal lumens  3242 ,  3244  and can return proximally through distal body  3234  via lumen  3252  and the other longitudinal lumen  3242 ,  3244  to thereby cool distal body  3234  of waveguide  3230 . 
     With general reference to  FIGS. 6A-8B , in aspects, cap  1250 , cap  2250 , and/or pipe  3250  may define features to facilitate tissue treatment. For example, cap  1250 , cap  2250 , and/or pipe  3250  may define angled, rounded, curved, and/or other suitable configurations to facilitate, for example, performing otomies, blunt dissection, and/or other surgical tasks with or without ultrasonic energy. 
     Turning to  FIGS. 9 and 10 , proximal end portions of the distal bodies  4234 ,  5234  of still other waveguides  4230 ,  5230  provided in accordance with aspects of the present disclosure are shown. Except as explicitly contradicted below, waveguides  4230 ,  5230  may be configured similarly to and include any of the features of waveguide  230  ( FIGS. 1, 2, 4A, and 4B ), any of the other waveguides detailed herein, and/or any other suitable waveguide. Thus, the following description will focus on differences between waveguides  4230 ,  5230  and the above-detailed waveguides, e.g., waveguide  230  ( FIGS. 1, 2, 4A, and 4B ), while similarities are only summarily described or omitted entirely. 
     Referring to  FIG. 9 , distal body  4234  of waveguide  4230  defines longitudinal lumens  4242 ,  4244  extending at least partially therethrough. Longitudinal lumens  4242 ,  4244  define open proximal ends open to the proximal end of distal body  4234 . Distal body  4234  of waveguide  4230  further includes a connector body  4250  secured, e.g., welded, soldered, or otherwise secured, to the proximal end of distal body  4234 . Connector body  4250  may be formed from the same or a different material as distal body  4234  and, upon securing connector body  4250  to the proximal end of distal body  4234 , seals closed the proximal ends of longitudinal lumens  4242 ,  4244 . Connector body  4250  may further include a proximal bore  4236  to enable threaded or other suitable engagement of the proximal body (not shown, see proximal body  232  ( FIG. 4A )) of waveguide  4230  within proximal bore  4236  to thereby secure the proximal body and distal body  4234  with one another (via connector body  4250  therebetween) to enable ultrasonic energy transmission therealong. 
     With reference to  FIG. 10 , distal body  5234  of waveguide  5230  defines longitudinal lumens  5242 ,  5244  extending at least partially therethrough and a proximal bore  5236  defined therein at the proximal end thereof. The proximal ends of longitudinal lumens  5242 ,  5244  communicate with proximal bore  5236 . A plug  5250  is secured within proximal bore  5236  at the open proximal ends of longitudinal lumens  5242 ,  5244  to seal off the proximal ends of longitudinal lumens  5242 ,  5244 . Plug  5250  may be formed from any suitable material similar or different from that of waveguide  5230  and may be welded, soldered, adhered, molded, compression-fit (such as where plug  5250  is formed from a resilient material), threaded, or otherwise secured within proximal bore  5236 . Plug  5250  occupies only a portion of proximal bore  5236  to enable threaded or other suitable engagement of the proximal body (not shown, see proximal body  232  ( FIG. 4A )) of waveguide  5230  within proximal bore  5236  to thereby secure the proximal body and distal body  5234  with one another to enable ultrasonic energy transmission therealong. 
     While several aspects and features of the disclosure are detailed above and shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description and accompanying drawings should not be construed as limiting, but merely as exemplifications of particular configurations. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.