Patent Description:
Surgical instruments and systems incorporating ultrasonic functionality utilize ultrasonic energy, i.e., ultrasonic vibrations, to treat tissue. More specifically, mechanical vibration energy transmitted at ultrasonic frequencies can be utilized to treat, e.g., seal and transect, tissue. A surgical instrument incorporating ultrasonic functionality may include, for example, an ultrasonic blade and a clamp mechanism to enable clamping of tissue against the blade. Ultrasonic energy transmitted to the blade causes the blade to vibrate at very high frequencies, which allows for heating tissue to treat tissue clamped against or otherwise in contact with the blade.

<CIT> discloses an end effector assembly having a movable jaw member and an ultrasonic blade where the movable jaw member is rotatably attached to a distal node of the waveguide.

Surgical methods are not claimed.

Provided in accordance with aspects of the disclosure is an ultrasonic surgical system including an ultrasonic transducer configured to receive an electrical drive signal and produce ultrasonic mechanical motion that is output along an ultrasonic horn of the ultrasonic transducer. The ultrasonic horn defines a cam slot. A blade extends from the ultrasonic horn. The blade receives the ultrasonic mechanical motion from the ultrasonic horn for treating tissue. A jaw member is movable relative to the blade between a spaced-apart position and an approximated position for clamping tissue. A cam pin is slidably disposed in the cam slot and is operably coupled to the jaw member. Slidably advancing the cam pin in the cam slot actuates the jaw member between the spaced-apart position and the approximated position.

According to aspects of the disclosure, at least one transverse hole is defined in the ultrasonic horn. A pivot pin is disposed in the transverse hole. The pivot pin operably couples the jaw member to the blade.

According to aspects of the disclosure, a second transverse hole is formed in the ultrasonic horn. The second transverse hole is configured to balance a transmission of the ultrasonic mechanical motion through the ultrasonic horn.

According to aspects of the disclosure, the second transverse hole is laterally offset with respect to the cam slot.

According to aspects of the disclosure, the second transverse hole is laterally offset with respect to the first transverse hole.

According to aspects of the disclosure, the ultrasonic transducer defines a central axis. The second transverse hole is laterally offset from the first transverse hole and the cam slot with respect to the central axis of the ultrasonic transducer.

According to aspects of the disclosure, the cam slot defines a proximal side and a distal side. The first transverse hole is positioned distal of the distal side of the cam slot and the second transverse hole is positioned proximal of the proximal side of the cam slot.

According to aspects of the disclosure, the first transverse hole is positioned on a first side of the central axis and the second transverse hole is positioned on a second side of the central axis opposite the first side.

According to aspects of the disclosure, an elongated assembly supports the ultrasonic transducer. The elongated assembly defines at least one articulation joint. The ultrasonic transducer is positioned at a distal side of the at least one articulation joint.

According to aspects of the disclosure, the ultrasonic generator is positioned at the distal side of the at least one articulation joint.

According to aspects of the disclosure, the ultrasonic transducer, the blade, the jaw, and the cam pin form at least a portion of an end effector assembly configured to connect to a robotic arm of a robotic surgical system.

According to aspects of the disclosure, the ultrasonic transducer includes a piezoelectric stack maintained in pre-compression against the ultrasonic horn. The piezoelectric stack may be maintained in pre-compression directly between a proximal end mass and the ultrasonic horn.

According to aspects of the disclosure, the blade extends directly from the ultrasonic horn. Alternatively, a waveguide is disposed between the ultrasonic horn and the blade.

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.

As used herein, the term "distal" refers to the portion that is being 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 an operator. Further, to the extent consistent, any of the aspects and features detailed herein may be used in conjunction with any or all of the other aspects and features detailed herein.

Descriptions of technical features or aspects of an exemplary configuration of the disclosure should typically be considered as available and applicable to other similar features or aspects in another exemplary configuration of the disclosure. Accordingly, technical features described herein according to one exemplary configuration of the disclosure may be applicable to other exemplary configurations of the disclosure, and thus duplicative descriptions may be omitted herein.

Exemplary configurations of the disclosure will be described more fully below (e.g., with reference to the accompanying drawings). Like reference numerals may refer to like elements throughout the specification and drawings.

Referring to <FIG>, a surgical system provided in accordance with aspects of the present disclosure is shown generally identified by reference numeral <NUM> including a surgical instrument <NUM>, a surgical generator <NUM>, and, in some aspects, a return electrode device <NUM>, e.g., including a return pad <NUM>. Surgical instrument <NUM> includes a handle assembly <NUM>, an elongated assembly <NUM> extending distally from handle assembly <NUM>, an end effector assembly <NUM> disposed at a distal end of elongated assembly <NUM>, and a cable assembly <NUM> operably coupled with handle assembly <NUM> and extending therefrom for connection to surgical generator <NUM>.

Surgical generator <NUM> includes a display <NUM>, a plurality user interface features <NUM>, e.g., buttons, touch screens, switches, etc., an ultrasonic plug port <NUM>, a bipolar electrosurgical plug port <NUM>, and active and return monopolar electrosurgical plug ports <NUM>, <NUM>, respectively. As an alternative to plural dedicated ports <NUM>-<NUM>, one or more common ports (not shown) may be configured to act as any two or more of ports <NUM>-<NUM>.

Surgical instrument <NUM> is configured to operate in one or more electrosurgical modes supplying Radio Frequency (RF) energy to tissue to treat tissue, e.g., a monopolar configuration and/or a bipolar configuration, and an ultrasonic mode supplying ultrasonic energy to tissue to treat tissue. The modes may operate simultaneously, sequentially, or in any other suitable manner. Surgical generator <NUM> is configured to produce ultrasonic drive signals for output through ultrasonic plug port <NUM> to surgical instrument <NUM> to activate surgical instrument <NUM> in the ultrasonic mode and to provide electrosurgical energy, e.g., RF bipolar energy for output through bipolar electrosurgical plug port <NUM> and/or RF monopolar energy for output through active monopolar electrosurgical port <NUM> to surgical instrument <NUM> to activate surgical instrument <NUM> in the one or more electrosurgical modes. Plug <NUM> of return electrode device <NUM> is configured to connect to return monopolar electrosurgical plug port <NUM> to return monopolar electrosurgical energy from surgical instrument <NUM> in the monopolar electrosurgical mode. In other aspects, the electrosurgical functionality (and associated components and configurations) of surgical instrument <NUM> may be omitted such that surgical instrument <NUM> operates only in an ultrasonic mode.

Continuing with reference to <FIG>, handle assembly <NUM> includes a housing <NUM>, an activation button <NUM>, and a clamp trigger <NUM>. Housing <NUM> is configured to support an ultrasonic transducer <NUM>. Ultrasonic transducer <NUM> may be permanently engaged within housing <NUM> or removable therefrom. Ultrasonic transducer <NUM> includes a piezoelectric stack or other suitable ultrasonic transducer components electrically coupled to surgical generator <NUM>, e.g., via one or more of first electrical lead wires <NUM>, to enable communication of ultrasonic drive signals to ultrasonic transducer <NUM> to drive ultrasonic transducer <NUM> to produce ultrasonic vibration energy that is transmitted along a waveguide <NUM> of elongated assembly <NUM> to blade <NUM> of end effector assembly <NUM> of elongated assembly <NUM>, as detailed below. Feedback and/or control signals may likewise be communicated between ultrasonic transducer <NUM> and surgical generator <NUM>. Ultrasonic transducer <NUM>, more specifically, and as detailed below, may include a stack of piezoelectric elements secured, under pre-compression between proximal and distal end masses or a proximal end mass and an ultrasonic horn with first and second electrodes electrically coupled between piezoelectric elements of the stack of piezoelectric elements to enable energization thereof to produce ultrasonic energy. However, other suitable ultrasonic transducer configurations, including plural transducers and/or non-longitudinal, e.g., torsional, transducers are also contemplated.

An activation button <NUM> is disposed on housing <NUM> and coupled to or between ultrasonic transducer <NUM> and/or surgical generator <NUM>, e.g., via one or more of first electrical lead wires <NUM>, to enable activation of ultrasonic transducer <NUM> in response to depression of activation button <NUM>. In some configurations, activation button <NUM> may include an ON/OFF switch. In other configurations, activation button <NUM> may include multiple actuation switches to enable activation from an OFF position to different actuated positions corresponding to different activation settings, e.g., a first actuated position corresponding to a first activation setting (such as a LOW power or tissue sealing setting) and a second actuated position corresponding to a second activation setting (such as a HIGH power or tissue transection setting). In still other configurations, separate activation buttons may be provided, e.g., a first actuation button for activating a first activation setting and a second activation button for activating a second activation setting. Additional activation buttons, sliders, wheels, etc. are also contemplated to enable control of various different activation settings from housing <NUM>.

Elongated assembly <NUM> of surgical instrument <NUM> includes an outer drive sleeve <NUM>, a waveguide <NUM>, a rotation knob <NUM>, and an end effector assembly <NUM> including a blade <NUM> and a jaw member <NUM>. Rotation knob <NUM> is rotatable in either direction to rotate elongated assembly <NUM> in either direction relative to handle assembly <NUM>. The drive assembly operably couples a proximal portion of outer drive sleeve <NUM> to clamp trigger <NUM> of handle assembly <NUM>. A distal portion of outer drive sleeve <NUM> is operably coupled to jaw member <NUM>. Advancing the outer drive sleeve <NUM> actuates the jaw member <NUM> between open and clamped configurations. Other suitable drive structures as opposed to a sleeve are also contemplated such as, for example, drive rods, drive cables, drive screws, etc..

Referring still to <FIG>, the drive assembly may be tuned to provide a jaw clamping force, or jaw clamping force within a jaw clamping force range, to tissue clamped between jaw member <NUM> and blade <NUM> or may include a force limiting feature whereby the clamping force applied to tissue clamped between jaw member <NUM> and blade <NUM> is limited to a particular jaw clamping force or a jaw clamping force within a jaw clamping force range.

Waveguide <NUM> includes blade <NUM> disposed at a distal end thereof. Blade <NUM> may be integrally formed with waveguide <NUM>, separately formed and subsequently attached (permanently or removably) to waveguide <NUM>, or otherwise operably coupled with waveguide <NUM>. Waveguide <NUM> and/or blade <NUM> may be formed from titanium, a titanium alloy, or other suitable electrically conductive material(s), although non-conductive materials are also contemplated. Waveguide <NUM> includes a proximal connector (not shown), e.g., a threaded male connector, configured for engagement, e.g., threaded engagement within a threaded female receiver, of ultrasonic transducer <NUM> such that ultrasonic motion produced by ultrasonic transducer <NUM> is transmitted along waveguide <NUM> to blade <NUM> for treating tissue clamped between blade <NUM> and jaw member <NUM> or positioned adjacent to blade <NUM>.

Cable assembly <NUM> of surgical instrument <NUM> includes a cable <NUM>, an ultrasonic plug <NUM>, and an electrosurgical plug <NUM>. Ultrasonic plug <NUM> is configured for connection with ultrasonic plug port <NUM> of surgical generator <NUM> while electrosurgical plug <NUM> is configured for connection with bipolar electrosurgical plug port <NUM> of surgical generator <NUM> and/or active monopolar electrosurgical plug port <NUM> of surgical generator <NUM>. In configurations where generator <NUM> includes a common port, cable assembly <NUM> may include a common plug (not shown) configured to act as both the ultrasonic plug <NUM> and the electrosurgical plug <NUM>. In configurations where surgical instrument <NUM> is only configured for ultrasonic operation, electrosurgical plug <NUM> and associated components are omitted.

Plural first electrical lead wires <NUM> electrically coupled to ultrasonic plug <NUM> extend through cable <NUM> and into handle assembly <NUM> for electrical connection to ultrasonic transducer <NUM> and/or activation button <NUM> to enable the selective supply of ultrasonic drive signals from surgical generator <NUM> to ultrasonic transducer <NUM> upon activation of activation button <NUM> in an ultrasonic mode. In addition, and where electrosurgical functionality is provided, plural second electrical lead wires <NUM> are electrically coupled to electrosurgical plug <NUM> and extend through cable <NUM> into handle assembly <NUM>. In bipolar configurations, separate second electrical lead wires <NUM> are electrically coupled to waveguide <NUM> and jaw member <NUM> (and/or different portions of jaw member <NUM>) such that bipolar electrosurgical energy may be conducted between blade <NUM> and jaw member <NUM> (and/or between different portions of jaw member <NUM>). In monopolar configurations, a second electrical lead wire <NUM> is electrically coupled to waveguide <NUM> such that monopolar electrosurgical energy may be supplied to tissue from blade <NUM>. Alternatively, or additionally, a second electrical lead wire <NUM> may electrically couple to jaw member <NUM> in the monopolar configuration to enable monopolar electrosurgical energy to be supplied to tissue from jaw member <NUM>. In configurations where both bipolar and monopolar functionality are enabled, one or more of the second electrical lead wires <NUM> may be used for both the delivery of bipolar energy and monopolar energy; alternatively, bipolar and monopolar energy delivery may be provided by separate second electrical lead wires <NUM>. One or more other second electrical lead wires <NUM> is electrically coupled to activation button <NUM> to enable the selective supply of electrosurgical energy from surgical generator <NUM> to waveguide <NUM> and/or jaw member <NUM> upon activation of activation button <NUM> in an electrosurgical mode.

As an alternative to a remote generator <NUM>, surgical system <NUM> may be at least partially cordless in that it incorporates an ultrasonic generator, an electrosurgical generator, and/or a power source, e.g., a battery, thereon or therein. In this manner, the connections from surgical instrument <NUM> to external devices, e.g., generator(s) and/or power source(s), is reduced or eliminated. More specifically, with reference to <FIG>, another surgical system in accordance with the present disclosure is shown illustrated as a surgical instrument <NUM> supporting an ultrasonic generator <NUM>, a power source (e.g., battery assembly <NUM>), and an electrosurgical generator <NUM> thereon or therein. Surgical instrument <NUM> is similar to surgical instrument <NUM> (<FIG>) and may include any of the features thereof except as explicitly contradicted below. Accordingly, only differences between surgical instrument <NUM> and surgical instrument <NUM> (<FIG>) are described in detail below while similarities are omitted or summarily described.

Housing <NUM> of surgical instrument <NUM> includes a body portion <NUM> and a fixed handle portion <NUM> depending from body portion <NUM>. Body portion <NUM> of housing <NUM> is configured to support an ultrasonic transducer and generator assembly ("TAG") <NUM> including ultrasonic generator <NUM> and ultrasonic transducer <NUM>. TAG <NUM> may be permanently engaged with body portion <NUM> of housing <NUM> or removable therefrom.

Fixed handle portion <NUM> of housing <NUM> defines a compartment <NUM> configured to receive battery assembly <NUM> and electrosurgical generator <NUM> and a door <NUM> configured to enclose compartment <NUM>. An electrical connection assembly (not shown) is disposed within housing <NUM> and serves to electrically couple activation button <NUM>, ultrasonic generator <NUM> of TAG <NUM>, and battery assembly <NUM> with one another when TAG <NUM> is supported on or in body portion <NUM> of housing <NUM> and battery assembly <NUM> is disposed within compartment <NUM> of fixed handle portion <NUM> of housing <NUM>, thus enabling activation of surgical instrument <NUM> in an ultrasonic mode in response to appropriate actuation of activation button <NUM>. Further, the electrical connection assembly or a different electrical connection assembly disposed within housing <NUM> serves to electrically couple activation button <NUM>, electrosurgical generator <NUM>, battery assembly <NUM>, and end effector assembly <NUM> (e.g., blade <NUM> and jaw member <NUM> and/or different portions of jaw member <NUM>) with one another when electrosurgical generator <NUM> and battery assembly <NUM> are disposed within compartment <NUM> of fixed handle portion <NUM> of housing <NUM>, thus enabling activation of surgical instrument <NUM> in an electrosurgical mode, e.g., bipolar RF, in response to appropriate actuation of activation button <NUM>. For a monopolar electrosurgical mode, return electrode device <NUM> (<FIG>) may be configured to connect to surgical instrument <NUM> (electrosurgical generator <NUM> thereof, more specifically), to complete a monopolar circuit through tissue and between surgical instrument <NUM> (e.g., blade <NUM> and/or jaw member <NUM>) and return electrode device <NUM> (<FIG>).

With reference to <FIG>, a distal portion of another surgical instrument <NUM> provided in accordance with the present disclosure is shown. Surgical instrument <NUM> may be configured similar to and include any of the features of surgical instrument <NUM> (for use with a remote generator <NUM> as part of system <NUM>) (<FIG>) or surgical instrument <NUM> (including ultrasonic and electrosurgical generators <NUM>, <NUM> and a battery assembly <NUM> thereon or therein) (<FIG>), except as explicitly contradicted below. Accordingly, only differences between surgical instrument <NUM> and surgical instruments <NUM>, <NUM> (<FIG> and <FIG>, respectively) are described in detail below while similarities are omitted or summarily described.

Surgical instrument <NUM> includes a housing (not shown, for manual manipulation or attachment to a surgical robot) and an elongated assembly <NUM> extending distally from the housing. Elongated assembly <NUM> of surgical instrument <NUM> includes an elongated shaft <NUM> having one or more articulating portions <NUM>, an ultrasonic transducer <NUM>, and an end effector assembly <NUM> including a blade <NUM>, a jaw member <NUM>, and a distal housing <NUM>.

Elongated shaft <NUM>, as noted above, extends distally from the housing. The one or more articulating portions <NUM> are disposed along at least a portion of elongated shaft <NUM>. More specifically, an articulating portion <NUM> is shown in <FIG> in the form of an articulating joint disposed at a distal end portion of elongated shaft <NUM> and coupled to distal housing <NUM> of end effector assembly <NUM> such that articulation of articulating portion <NUM> relative to a longitudinal axis of elongated shaft <NUM> articulates end effector assembly <NUM> relative to the longitudinal axis of elongated shaft <NUM>. However, it is also contemplated that additional or alternative articulating portions may be disposed along some or all of elongated shaft <NUM> periodically, intermittently, or continuously (for a portion or the entirety of elongated shaft <NUM>). Each articulating portion <NUM> may include one or more articulation joints, linkages, flexible portions, malleable portions, and/or other suitable articulating structures to enable articulation of end effector assembly <NUM> relative to the longitudinal axis of elongated shaft <NUM> in at least one direction, e.g., pitch articulation and/or yaw articulation. In configurations, the one or more articulating portions <NUM> are configured to enable both pitch articulation and yaw articulation; in other configurations, unlimited articulation in any direction is enabled.

Jaw member <NUM> is pivotably mounted on and extends distally from distal housing <NUM>. A drive assembly (not shown) of surgical instrument <NUM> operably couples the actuator, e.g., clamp trigger <NUM> (<FIG>), with jaw member <NUM> of end effector assembly <NUM> by way of a jaw drive (not shown) such that the actuator is selectively actuatable to pivot jaw member <NUM> relative to distal housing <NUM> and blade <NUM> of end effector assembly <NUM> from an open position to a clamping position for clamping tissue between jaw member <NUM> and blade <NUM>. The jaw drive may include one or more drive shafts, drive sleeves, drive cables, gears, cams, and/or other suitable components. Jaw member <NUM> includes a more-rigid structural body 785a, which is pivotably mounted on a distal end portion of distal housing <NUM>, and a more-compliant jaw liner 785b, which is captured by the more-rigid structural body 785b and positioned to oppose blade <NUM> to enable clamping of tissue therebetween.

In configurations where surgical instrument <NUM> also includes electrosurgical functionality (e.g., bipolar RF and/or monopolar RF), electrical lead wires (not shown) extend through elongated shaft <NUM> and articulating portion <NUM> to electrically coupled to ultrasonic horn <NUM> or blade <NUM>, and/or to jaw member <NUM> such that bipolar electrosurgical energy may be conducted between blade <NUM> and jaw member <NUM> (and/or between different portions of jaw member <NUM>) and/or such that monopolar electrosurgical energy may be supplied to tissue from blade <NUM> and/or jaw member <NUM>.

An articulation assembly (not shown) including gears, pulleys, sleeves, cables, etc. operably couples a proximal articulation actuator (not shown) with articulating portion <NUM> such that actuation of the proximal articulation actuator manipulates articulating portion <NUM> to thereby articulate end effector assembly <NUM> relative to the longitudinal axis of elongated shaft <NUM>.

Continuing with reference to <FIG>, an ultrasonic transducer <NUM> is disposed within distal housing <NUM> and positioned distally of articulating portion <NUM>, an ultrasonic horn <NUM> extends distally from ultrasonic transducer <NUM>, and blade <NUM> extends distally from ultrasonic horn <NUM>. Thus, in contrast to surgical instruments <NUM>, <NUM> (<FIG> and <FIG>, respectively), ultrasonic transducer <NUM> is disposed within distal housing <NUM> distally of articulating portion <NUM> rather than proximally in the housing of the instrument. Alternatively, ultrasonic transducer <NUM> may be positioned proximally of articulating portion <NUM> (in the housing or otherwise positioned), and a waveguide (not shown) including one or more articulating portions, e.g., flexible portions, joint portions, linkage portions, etc., may extend through articulating portion <NUM> and interconnect ultrasonic transducer <NUM> with blade <NUM> such that ultrasonic energy produced by ultrasonic transducer <NUM> can be transmitted along the waveguide to blade <NUM> regardless of the articulation of articulating portion <NUM>.

In some configurations, distal housing <NUM>, including ultrasonic transducer <NUM> therein, defines an outer diameter less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, or less than about <NUM>. As such, ultrasonic transducer <NUM>, in such configurations, may define a sufficiently small diameter (for example, <NUM>% less than the diameters above) so as to enable operable receipt within distal housings <NUM> of the above-noted dimensions, respectively. By providing a configuration with the above-noted outer diameters, surgical instrument <NUM> may be utilized minimally-invasively through standard sizes of access devices. Ultrasonic transducer <NUM>, other than its overall size, may be configured similar to ultrasonic transducer <NUM> (<FIG>) or any other suitable ultrasonic transducer. For example, ultrasonic transducer <NUM> may include a stack of piezoelectric elements secured, under pre-compression between a proximal end mass and ultrasonic horn <NUM> with first and second electrodes electrically coupled between piezoelectric elements of the stack of piezoelectric elements to enable energization thereof to produce ultrasonic energy. Electrical lead wires (not shown) connect the electrodes of ultrasonic transducer <NUM> with an ultrasonic generator (not shown) to enable an electrical drive signal generated by the ultrasonic generator to be imparted to the stack of piezoelectric elements of ultrasonic transducer <NUM> to energize the stack of piezoelectric elements to produce ultrasonic energy for transmission to blade <NUM> via ultrasonic horn <NUM>.

Turning to <FIG>, a robotic surgical system in accordance with the aspects and features of the present disclosure is shown generally identified by reference numeral <NUM>. For the purposes herein, robotic surgical system <NUM> is generally described. Aspects and features of robotic surgical system <NUM> 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 <NUM> generally includes a plurality of robot arms <NUM>, <NUM>; a control device <NUM>; and an operating console <NUM> coupled with control device <NUM>. Operating console <NUM> may include a display device <NUM>, which may be set up in particular to display three dimensional images; and manual input devices <NUM>, <NUM>, by means of which a person (not shown), for example a surgeon, may be able to telemanipulate robot arms <NUM>, <NUM> in a first operating mode. Robotic surgical system <NUM> may be configured for use on a patient <NUM> lying on a patient table <NUM> to be treated in a minimally invasive manner. Robotic surgical system <NUM> may further include a database <NUM>, in particular coupled to control device <NUM>, in which are stored, for example, pre-operative data from patient <NUM> and/or anatomical atlases.

Each of the robot arms <NUM>, <NUM> may include a plurality of members, which are connected through joints, and an attaching device <NUM>, <NUM>, to which may be attached, for example, a surgical tool "ST" supporting an end effector <NUM>, <NUM>. One of the surgical tools "ST" may be surgical instrument <NUM> (<FIG>), surgical instrument <NUM> (<FIG>), or surgical instrument <NUM> (<FIG>), e.g., configured for use in both an ultrasonic mode and one or more electrosurgical (bipolar and/or monopolar) modes, wherein manual actuation features, e.g., actuation button <NUM> (<FIG>), clamp lever <NUM> (<FIG>), the proximal articulation actuator, etc., are replaced with robotic inputs. In such configurations, robotic surgical system <NUM> may include or be configured to connect to an ultrasonic generator, an electrosurgical generator, and/or a power source. The other surgical tool "ST" may include any other suitable surgical instrument, e.g., an endoscopic camera, other surgical tool, etc. Robot arms <NUM>, <NUM> may be driven by electric drives, e.g., motors, that are connected to control device <NUM>. Control device <NUM> (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 <NUM>, <NUM>, their attaching devices <NUM>, <NUM>, and, thus, the surgical tools "ST" execute a desired movement and/or function according to a corresponding input from manual input devices <NUM>, <NUM>, respectively. Control device <NUM> may also be configured in such a way that it regulates the movement of robot arms <NUM>, <NUM> and/or of the motors.

Referring to <FIG>, an exemplary ultrasonic transducer <NUM> is provided which may be used as ultrasonic transducer <NUM> (<FIG> and <FIG>), ultrasonic transducer <NUM> (<FIG>), or the ultrasonic transducer of any other suitable surgical instrument. Ultrasonic transducer <NUM> include a piezoelectric stack <NUM>, ultrasonic horn <NUM>, a proximal end mass 547a, in some aspects a distal end mass 547b (although in other aspects distal end mass 547b is excluded), and a rod <NUM> securing piezoelectric stack <NUM> between proximal and distal end masses 547a, 547b, respectively, and to horn <NUM> under compression. Rod <NUM> may be secured via a proximal nut <NUM> threaded or otherwise engaged about rod <NUM> at a proximal end portion thereof and may be secured distally within a cavity defined within horn <NUM> via welding, threaded engagement, or in any other suitable manner. The pre-compression of piezoelectric stack <NUM> against horn <NUM> (directly or indirectly), enables efficient and effective transmission of ultrasonic energy from piezoelectric stack <NUM> to horn <NUM> for transmission along a waveguide to a blade (see <FIG> and <FIG>, for example) or directly from horn <NUM> to a blade (see <FIG>, for example). In some configurations, distal end mass 547a is omitted and horn <NUM> acts as the distal end mass against which piezoelectric stack <NUM> is directly compressed.

Ultrasonic transducer <NUM> further includes electrode assembly <NUM> having at least one electrode disposed in contact with a surface of at least one piezoelectric element <NUM> of piezoelectric stack <NUM> and at least one electrode disposed in contact with an opposed surface of the at least one piezoelectric element <NUM> of piezoelectric stack <NUM> to, as noted above, enable an electrical input drive signal, e.g., a drive signal voltage, to be applied across piezoelectric stack <NUM>.

In aspects of the present disclosure, a cooling system <NUM>, e.g., including one or more passive cooling devices (such as heat sinks) and/or one or more active cooling devices (such as cooling fluid circulation systems, Peltier coolers, etc.), may be provided to reduce the temperature of piezoelectric elements <NUM> during operation.

In an ultrasonic surgical instrument (e.g., instrument <NUM> (<FIG>)), as described herein, ultrasonic transducer <NUM> is configured to receive an electrical drive signal and produce ultrasonic mechanical motion that is output along ultrasonic horn <NUM> of the ultrasonic transducer <NUM>. The ultrasonic horn <NUM> defines a transverse cam slot <NUM> and at least one transverse hole <NUM>. A blade (e.g., blade <NUM> (not shown in <FIG>, see <FIG>)) extends from the ultrasonic horn <NUM>. The blade <NUM> (<FIG>) receives the ultrasonic mechanical motion from the ultrasonic horn <NUM> for treating tissue. A jaw member (e.g., jaw member <NUM>) is movable relative to the blade <NUM> (<FIG>) between a spaced-apart position and an approximated position for clamping tissue. A cam pin <NUM> is slidably disposed in the cam slot <NUM> of ultrasonic horn <NUM> and in a corresponding cam slot <NUM> defined in a proximal support portion of the jaw member <NUM>. Slidably advancing the cam pin <NUM> in the cam slots <NUM>, <NUM> actuates the jaw member <NUM> between the spaced-apart position and the approximated position, depending upon the direction of sliding. In aspects, a suitable drive structure, e.g., a drive bar <NUM>, is engaged with or otherwise coupled to cam pin <NUM> to enable the selective sliding of cam pin <NUM> upon translation of the drive bar <NUM>. A pivot pin <NUM> is disposed in the transverse hole <NUM> and a corresponding transverse hole <NUM> defined in jaw member <NUM>. The pivot pin <NUM> thus pivotably couples the jaw member <NUM> to the ultrasonic horn <NUM> and, thus, relative to the blade <NUM> (<FIG>).

Forming of the cam slot <NUM> and the transverse hole <NUM> in the ultrasonic horn <NUM> reduces an amount of space needed to house the ultrasonic transducer <NUM> while still supporting the blade <NUM> and jaw member <NUM> (see <FIG>) when the ultrasonic transducer <NUM> is supported at a distal end portion of an elongated member (e.g., elongated member <NUM>). This arrangement is particularly useful when an ultrasonic surgical instrument is robotically operated without a handle assembly. As an example, the ultrasonic transducer <NUM> may be housed distal of an articulating portion <NUM> of elongated member <NUM>, such as in distal housing <NUM> (see, e.g., <FIG>). In aspects where the ultrasonic transducer <NUM> is disposed within a proximal housing, the cam slots and transverse holes detailed above may be defined through the waveguide or proximal portion of the blade rather than the ultrasonic horn <NUM> of the ultrasonic transducer <NUM>.

As an example, the cam slot <NUM> (or cam slot <NUM>) may have a curved profile when viewed in longitudinal cross section. The curved profile can be used to facilitate smooth pivoting of the jaw member <NUM> between spaced-apart and approximated positions as the cam pin <NUM> is longitudinally advanced therethrough, and to inhibit binding. The curved cam profile can also allow the jaw force to be tuned/optimized throughout the moving jaw/blade range of the cam slot <NUM>.

While the ultrasonic horn <NUM> is shown and described as having both a cam slot <NUM> and a transverse hole <NUM>, the cam slot <NUM> may be omitted, and the jaw member <NUM> may be actuated by an external sleeve, such as drive sleeve <NUM> (<FIG>). In this arrangement the transverse hole(s) described herein would still be formed in the ultrasonic horn <NUM>.

Referring to <FIG>, in ultrasonic transducer <NUM> a second transverse hole <NUM> is formed in the ultrasonic horn <NUM>. The second transverse hole <NUM> is configured to mechanically balance a transmission of the ultrasonic mechanical motion through the ultrasonic horn <NUM>. As an example, undesired asymmetric vibration may be reduced or eliminated by the second transverse hole <NUM>. Asymmetric vibration is more likely to occur when a cam slot (e.g., <NUM> or <NUM>) is off-center. Thus, balancing features described herein may be omitted when the cam slot is centered (e.g., with respect to a central axis (X-X) of the ultrasonic transducer <NUM>. While transverse holes are described below, other balancing features such as adding or removing material from an ultrasonic horn (e.g., indents, recesses, slots and/or protrusions) may be employed to balance vibrations, such as longitudinal vibrations in an ultrasonic horn of ultrasonic transducer <NUM> or the other ultrasonic transducers described herein.

The second transverse hole <NUM> may be longitudinally aligned with the cam slot <NUM>. The second transverse hole <NUM> may also be longitudinally aligned with the first transverse hole <NUM>. For example, the ultrasonic transducer <NUM> defines a central axis (e.g., axis X-X). The second transverse hole <NUM> is longitudinally aligned with the first transverse hole <NUM> and the cam slot <NUM> along the central axis X-X of the ultrasonic transducer <NUM>.

Referring to <FIG>, in ultrasonic transducer <NUM> the cam slot <NUM> defines a proximal side <NUM> and a distal side <NUM>. The first transverse hole <NUM> is positioned distal of the distal side <NUM> of the cam slot <NUM> and a second transverse hole <NUM> is positioned proximal of the proximal side <NUM> of the cam slot <NUM>. The first transverse hole <NUM> and the second transverse hole <NUM> may be symmetrically spaced apart from the opposite sides (<NUM>, <NUM>, respectively) of the cam slot <NUM>.

Referring to <FIG>, in ultrasonic transducer <NUM> a first transverse hole <NUM> including pivot pin <NUM> is positioned on a first side of the central axis X-X and a second transverse hole <NUM> is positioned on a second side of the central axis X-X opposite the first side. The first transverse hole <NUM> and the second transverse hole <NUM> may be symmetrically positioned with respect the central axis X-X. The first transverse hole <NUM> and/or the second transverse hole <NUM> may be laterally offset with respect to the central axis X-X. The first transverse hole <NUM> and/or the second transverse hole <NUM> may be laterally offset with respect to cam slot <NUM>.

Other positionings and/or number of transverse holes and/or slots to facilitate balance are also contemplated.

Claim 1:
An ultrasonic surgical system, comprising:
an ultrasonic transducer configured to receive an electrical drive signal and, in response thereto, to produce ultrasonic mechanical motion that is output along an ultrasonic horn (<NUM>) of the ultrasonic transducer, the ultrasonic horn defining a cam slot (<NUM>) therein;
a blade (<NUM>) extending from the ultrasonic horn and configured to receive the ultrasonic mechanical motion from the ultrasonic horn for treating tissue in contact therewith;
a jaw member (<NUM>) movable relative to the blade between a spaced-apart position and an approximated position for clamping tissue therebetween; and
a cam pin (<NUM>) slidably disposed in the cam slot and operably coupled to the jaw member, wherein slidably advancing the cam pin in the cam slot pivots the jaw member relative to the blade between the spaced-apart position and the approximated position.