Patent Description:
Ultrasonic surgical instruments and systems utilize ultrasonic energy, i.e., ultrasonic vibrations, to treat tissue. More specifically, a typical ultrasonic surgical instrument or system includes a transducer configured to produce mechanical vibration energy at ultrasonic frequencies that is transmitted along a waveguide to an ultrasonic end effector configured to treat, e.g., coagulate, cauterize, fuse, seal, cut, desiccate, or otherwise treat tissue.

Some ultrasonic surgical instruments and systems incorporate rotation features, thus enabling rotation of the ultrasonic end effector to a desired orientation within the surgical site. However, even in such instruments and systems, the ability to navigate within the surgical site via rotation and manipulation alone is limited. For example, <CIT> discloses an ultrasonic instrument with a distally positioned end effector and flexible ultrasonic transducer assembly which comprises a distal transducer portion and a proximal transducer portion coupled by a bendable intermediate portion.

As used herein, the term "distal" refers to the portion that is being described which is further from a user, while the term "proximal" refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.

No surgical methods are claimed. Provided in accordance with the present disclosure is an ultrasonic surgical instrument including a housing, an elongated shaft extending distally from the housing, an end effector extending distally from the elongated shaft, and a transducer assembly disposed at least partially within the elongated shaft. The end effector includes a jaw and an ultrasonic blade. The jaw is configured to pivot relative to the ultrasonic blade from an open position to a clamping position for clamping tissue therebetween. The transducer assembly is disposed at least partially within the elongated shaft, is distally-spaced from the housing, and includes proximal and distal transducers interconnected by a connector. The ultrasonic blade is connected to the distal transducer such that ultrasonic energy produced by the proximal transducer is transmitted along the connector and the distal transducer to the ultrasonic blade and such that ultrasonic energy produced by the distal transducer is transmitted to the ultrasonic blade.

The connector is a flexible connector configured to articulate in at least one direction. The elongated shaft includes an articulating portion and the flexible connector may extend through the articulating portion such that the proximal transducer is disposed proximally of the articulating portion and such that the distal transducer is disposed distally of the articulating portion. The flexible connector may be formed as a band of material.

In another aspect of the present disclosure, the elongated shaft defines an outer diameter of 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>; in aspects, between about <NUM> and about <NUM>. Alternatively or additionally, each of the proximal and distal transducers may define an outer diameter of less than <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, or less than about <NUM>; in aspects, between about <NUM> and about <NUM>.

In still another aspect of the present disclosure, each of the proximal and distal transducers includes a proximal mass, a distal mass, a stack of piezoelectric elements held under pre-compression between the proximal and distal masses, and first and second electrodes electrically coupled to the stack of piezoelectric elements.

In yet another aspect of the present disclosure, the ultrasonic blade defines a cylindrical configuration. In such aspects, the jaw may be configured to rotate about the ultrasonic blade such that the jaw is capable of clamping tissue between the jaw and blade at any rotational orientation of the jaw relative to the blade.

In still yet another aspect of the present disclosure, the first and second transducers are disposed around vibration node points.

In another aspect of the present disclosure, the housing is adapted to connect to a robotic arm of a robotic surgical system. Alternatively or additionally, the housing includes at least one manual control.

In yet another aspect of the present disclosure, the proximal and distal transducers are driven by independent electrical drive signals. In such aspects, in a first mode of operation, both of the proximal and distal transducers may be activated while, in a second mode of operation, only one of the proximal or distal transducers may be activated.

In still another aspect of the present disclosure, an ultrasonic horn connects the distal transducer with the ultrasonic blade.

Other features, objects, and advantages of the instruments and techniques described in this disclosure will be apparent from the description and drawings, and from the claims.

Referring generally to <FIG> and <FIG>, an illustrative hand-held ultrasonic surgical instrument exemplifying the aspects and features of the present disclosure is shown generally identified by reference numeral <NUM>. For the purposes herein, hand-held ultrasonic surgical instrument <NUM> is generally described. Aspects and features of hand-held ultrasonic surgical instrument <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.

Hand-held ultrasonic surgical instrument <NUM> generally includes a handle assembly <NUM> and an elongated assembly <NUM> extending distally from handle assembly <NUM>. Handle assembly <NUM> includes a housing <NUM> defining a body portion <NUM> and a fixed handle portion <NUM>. Handle assembly <NUM> further includes an activation button <NUM> and a clamp trigger <NUM>.

Body portion <NUM> of housing <NUM> is configured to support a generator assembly <NUM> including generator electronics <NUM> disposed within an outer housing. Generator assembly <NUM> may be permanently engaged with body portion <NUM> of housing <NUM> or removable therefrom. Alternatively, generator assembly <NUM> may be remotely disposed and coupled to ultrasonic surgical instrument <NUM> by way of a cable.

Fixed handle portion <NUM> of housing <NUM> defines a compartment <NUM> configured to receive a battery assembly <NUM> and a door <NUM> configured to enclose compartment <NUM>. An electrical connection assembly (not shown) is disposed within housing <NUM> of handle assembly <NUM> and serves to electrically couple activation button <NUM>, generator assembly <NUM>, and battery assembly <NUM> with one another when generator assembly <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 ultrasonic surgical instrument <NUM> in response to depression of activation button <NUM>. In configurations where generator assembly <NUM> is remote from ultrasonic surgical instrument <NUM>, battery assembly <NUM> and the configuration of fixed handle portion <NUM> for receiving battery assembly <NUM> need not be provided, as the remote generator assembly <NUM> may be powered by a standard wall outlet or other remote power source.

Elongated assembly <NUM> of ultrasonic surgical instrument <NUM> includes an elongated shaft <NUM> having one or more articulating portions <NUM>, a transducer assembly <NUM>, a drive assembly (not shown), an articulation assembly (not shown), a rotation knob <NUM>, an articulation knob <NUM>, and an end effector <NUM> including a blade <NUM>, a jaw <NUM>, and a support shaft <NUM>.

Elongated shaft <NUM> extends distally from body portion <NUM> of housing <NUM>. The one or more articulating portions <NUM> are defined along at least a portion of elongated shaft <NUM>. More specifically, articulating portion <NUM> is shown in <FIG> and <FIG> disposed at a distal end portion of elongated shaft <NUM> and coupled to support shaft <NUM> of end effector <NUM> such that articulation of articulating portion <NUM> relative to a longitudinal axis of elongated shaft <NUM> articulates end effector <NUM> relative to the longitudinal axis of elongated shaft <NUM>. However, it is also contemplated that additional or alternative articulating portion(s) <NUM> 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>). Articulating portion(s) <NUM> may include one or more articulation components <NUM>, e.g., articulation joint(s), articulation linkage(s), flexible portion(s), malleable portion(s), etc., to enable articulation of end effector <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, articulating portion(s) <NUM> is configured to enable both pitch articulation and yaw articulation; in other configurations, unlimited articulation in any direction is enabled.

Jaw <NUM> is pivotably mounted on a distal end portion of support shaft <NUM> and the drive assembly operably couples clamp trigger <NUM> of handle assembly <NUM> with jaw <NUM> of end effector <NUM> such that clamp trigger <NUM> is selectively actuatable to pivot jaw <NUM> relative to support shaft <NUM> and blade <NUM> of end effector <NUM> from a spaced-apart position to an approximated position for clamping tissue between jaw <NUM> and blade <NUM>. The drive assembly may include a drive shaft, drive sleeve, drive cables, and/or other suitable components extending through handle assembly <NUM>, elongated shaft <NUM> (including articulating portion <NUM> thereof), and support shaft <NUM> to operably couple clamp trigger <NUM> with jaw <NUM> and enable pivoting of jaw <NUM> between the spaced-apart and approximated positions regardless of the articulation of articulating portion <NUM>. Jaw <NUM> includes a more-rigid structural body which is pivotably mounted on a distal end portion of support shaft <NUM>, and a more-compliant jaw liner secured to the more-rigid structural body and positioned to oppose blade <NUM> to enable clamping of tissue therebetween.

Rotation knob <NUM> is rotatable in either direction to rotate at least a portion of elongated assembly <NUM> in either direction relative to handle assembly <NUM>. More specifically, in some configurations, elongated shaft <NUM>, transducer assembly <NUM>, and an end effector <NUM> are configured to rotate together with one another relative to handle assembly <NUM>. In other configurations, elongated shaft <NUM>, jaw <NUM> of end effector <NUM>, and support shaft <NUM> of end effector <NUM> are configured to rotate together with one another relative to handle assembly <NUM>, transducer assembly <NUM>, and blade <NUM> of end effector <NUM>. In this configuration, jaw <NUM> is rotatable about blade <NUM> to enable orientation of jaw <NUM> in any suitable radial position about blade <NUM>. Thus, jaw <NUM> is capable of being pivoted relative to blade <NUM> between the spaced-apart and approximated positions to clamp tissue between jaw <NUM> and blade <NUM> at any suitable radial position about blade <NUM>.

The articulation assembly may include gears, pulleys, sleeves, tension cables, etc. that operably couple articulation knob <NUM> with the one or more articulation components <NUM> of articulating portion <NUM> such that rotation of articulation knob <NUM> manipulates articulating portion <NUM> to thereby articulate end effector <NUM> and support shaft <NUM> relative to the longitudinal axis of elongated shaft <NUM>. Alternatively, articulation knob <NUM> may be operably coupled to support shaft <NUM> to induce the above-described articulating motion. Additional articulation actuators and/or other suitable articulation actuators (manual or powered) are also contemplated.

With additional reference to <FIG>, transducer assembly <NUM> includes proximal and distal transducers <NUM>, <NUM>, respectively, a flexible connector <NUM> extending between proximal and distal transducers <NUM>, <NUM>, respectively, a distal horn <NUM> extending distally from distal transducer <NUM>, and ultrasonic blade <NUM> which serves as the blade of end effector <NUM> extending distally from distal horn <NUM>.

Transducer assembly <NUM> extends at least partially through elongated shaft <NUM>, including articulating portion <NUM> thereof. More specifically, proximal transducer <NUM> is positioned proximally of an articulating portion <NUM> of elongated shaft <NUM> (e.g., the distal-most articulating portion <NUM> where multiple articulating portions <NUM> are provided), distal transducer <NUM> is positioned within support shaft <NUM> distally of the articulating portion <NUM> of elongated shaft <NUM>, and flexible connector <NUM> extends through the articulating portion <NUM> of elongated shaft <NUM> such that, in response to articulation of articulating portion <NUM>, flexible connector <NUM> is similarly articulated to thereby articulate distal transducer <NUM>, ultrasonic horn <NUM>, and ultrasonic blade <NUM> relative to proximal transducer <NUM>. Transducer assembly <NUM> further extends through and distally from support shaft <NUM> of end effector <NUM> such that blade <NUM> is positioned to oppose jaw <NUM> to enable clamping of tissue therebetween. Transducer assembly <NUM> is described in greater detail below with reference to <FIG>.

It is contemplated that at least the portions of elongated shaft <NUM> and support shaft <NUM> that include transducer assembly <NUM> extending therethrough and, in some configurations, the entireties of elongated shaft <NUM> and support shaft <NUM>, define outer diameters less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, less than about <NUM>, or between about <NUM> and about <NUM>, wherein "about" and similar terms as utilized herein account for material, manufacturing, use, measurement, environment, etc. tolerances; industry conventions and customs; etc., and may encompass differences of up to <NUM>%. As such, transducer assembly <NUM> may define a sufficiently small diameter so as to enable operable receipt within elongated shaft <NUM> and support shaft <NUM> that is at most smaller than, for example, <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, or <NUM>; transducer assembly <NUM> my define a diameter of between about <NUM> and about <NUM>, in some configurations. By providing a configuration with the above-noted outer diameters, ultrasonic surgical instrument <NUM> may be utilized minimally-invasively through access devices, e.g., trocars, having diameters of about <NUM>, about <NUM>, about <NUM>, about <NUM>, about <NUM>, or about <NUM>, respectively.

Referring generally to <FIG>, an illustrative robotic surgical system exemplifying 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>. 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 or other suitable 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, to which may be attached, for example, a surgical tool "ST" supporting an end effector assembly <NUM>, <NUM>. End effector assembly <NUM> may be configured as an articulating ultrasonic surgical instrument similarly as detailed above with respect to instrument <NUM> (<FIG> and <FIG>) except that housing <NUM> of handle assembly <NUM> (<FIG> and <FIG>) is configured to connect to robot arm <NUM> and any manual controls or features of instrument <NUM> (<FIG> and <FIG>) are modified appropriately such that manipulation, actuation, and the other functions of instrument <NUM> (<FIG> and <FIG>) are effected by robot arm <NUM> rather than manually by a user. End effector <NUM> may be any other suitable surgical end effector, 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>, and, thus, the surgical tools "ST" (including end effectors <NUM>, <NUM>) 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.

Turning to <FIG>, transducer assembly <NUM> is shown in non-articulated (e.g., linear) and articulated conditions, respectively. As noted above, transducer assembly <NUM> includes proximal and distal transducers <NUM>, <NUM>, respectively, flexible connector <NUM> extending between proximal and distal transducers <NUM>, <NUM>, respectively, ultrasonic horn <NUM> extending distally from distal transducer <NUM>, and ultrasonic blade <NUM> (which serves as the blade of end effector <NUM>) extending distally from ultrasonic horn <NUM>.

Proximal transducer <NUM> may be supported within elongated shaft <NUM> (<FIG>) in substantially fixed position relative thereto and includes a proximal end mass 233a, a distal end mass 233b, and a stack of piezoelectric elements 233c disposed between proximal and distal end masses 233a, 233b, respectively. Proximal transducer <NUM> further includes a stress rod 233d engaged with the distal end mass 233b, e.g., via a threaded, welded, or other suitable engagement, and extending proximally through the stack of piezoelectric elements 233c and proximal end mass 233a. A bolt 233e engaged with the stress rod 233d proximally of the proximal end mass 233a maintains the stack of piezoelectric elements 233c under a longitudinal pre-compression between proximal and distal end masses 233a, 233b, respectively, although other suitable configurations for pre-compressing the stack of piezoelectric elements 233c are also contemplated. Proximal transducer <NUM> additionally includes first and second electrodes 233f, <NUM> electrically coupled between piezoelectric elements of the stack of piezoelectric elements 233c to enable energization thereof to produce ultrasonic energy. Electrical lead wires (not shown) connect first and second electrodes 233f, <NUM> with generator assembly <NUM> (<FIG>) to enable an electrical drive signal generated by generator assembly <NUM> (<FIG>) to be imparted to the stack of piezoelectric elements 233c of proximal transducer assembly <NUM> to energize the stack of piezoelectric elements 233c to produce ultrasonic energy.

Distal transducer <NUM> includes a proximal end mass 235a, a distal end mass 235b, and a stack of piezoelectric elements 235c disposed between proximal and distal end masses 235a, 235b, respectively. A stress rod (not shown) extend between proximal end mass 235a, a distal end mass 235b and through the stack of piezoelectric elements 235c to maintain the stack of piezoelectric elements 235c under a longitudinal pre-compression between proximal and distal end masses 235a, 235b, respectively. Distal transducer <NUM> additionally includes first and second electrodes 235f, <NUM> electrically coupled between piezoelectric elements of the stack of piezoelectric elements 235c to enable energization thereof to produce ultrasonic energy. Electrical lead wires (not shown) connect first and second electrodes 235f, <NUM> with generator assembly <NUM> (<FIG>) to enable an electrical drive signal generated by generator assembly <NUM> (<FIG>) to be imparted to the stack of piezoelectric elements 235c of distal transducer assembly <NUM> to energize the stack of piezoelectric elements 235c to produce ultrasonic energy. The first and second electrodes 235f, <NUM> of distal transducer <NUM> may be energized via a commonly controlled and output electrical drive signal (via common or separate leads) as the first and second electrodes 233f, <NUM> of proximal transducer <NUM>, respectively. Alternatively, proximal and distal transducers <NUM>, <NUM>, respectively, may be energized via independently controlled and output electrical drive signals from generator assembly <NUM> (<FIG>).

In some configurations, activation button <NUM> (<FIG>) itself or an additional activation button (not shown) enable activation at different levels, e.g., a first activation corresponding to a LOW power mode (producing a relatively low velocity of ultrasonic blade <NUM>) and a HIGH power mode (producing a relatively high velocity of ultrasonic blade <NUM>). In such configurations, only one of the transducers <NUM>, <NUM> may be activated in the LOW power mode while both of the transducers <NUM>, <NUM> are activated in the HIGH power moved. Alternatively, both transducers <NUM>, <NUM> may be activated in both modes (with one or both of the transducers <NUM>, <NUM> being activated to a different power level in the different modes).

Flexible connector <NUM> includes a proximal hub 237a, a distal hub 237b, and a body 237c extending between the proximal and distal hubs 237a, 237b, respectively. Proximal hub 237a is unitarily formed with or engaged to distal mass 233b of proximal transducer <NUM> while distal hub 237b is unitarily formed with or engaged to proximal mass 235a of distal transducer <NUM>. Body 237c is flexible in at least one direction. In some configurations, as illustrated, body 237c is formed as a band of material capable of flexing in directions perpendicular to the broad side surfaces of the band of material. In other configurations, body 237c may include, for example, one or more reduced-dimension portions (to increase flexibility in one or more directions), flexure hinge sections, ball-and-socket joints, pinned joints, combinations thereof, and/or other suitable articulation features to enable articulation of flexible connector <NUM> in one or more directions.

Ultrasonic horn <NUM> is unitarily formed with or engaged to distal mass 235b of distal transducer <NUM> and extends distally therefrom. Blade <NUM> is unitarily formed with or engaged with ultrasonic horn <NUM> and extend distally therefrom. In some configurations, ultrasonic horn <NUM> is omitted and blade <NUM> is directly formed with or engaged to distal mass 235b.

Blade <NUM>, as illustrated, defines a straight, cylindrical configuration. As detailed above, this configuration enables clamping of tissue between blade <NUM> and jaw <NUM> (<FIG>) at any rotational orientation of jaw <NUM> (<FIG>) relative to blade <NUM> (in embodiments where jaw <NUM> (<FIG>) is rotatable about blade <NUM>). Blade <NUM> may alternatively define other suitable cross-sectional configurations, e.g., polygonal configurations, and/or may include tapers along the length thereof. Further, as an alternative to defining a straight configuration, blade <NUM> may define a curved and/or angled configuration including one or more curved/angled portions curved/angled in similar or different directions.

Continuing with reference to <FIG>, as detailed above, transducer assembly <NUM> must define a sufficiently small diameter so as to enable operable receipt within elongated shaft <NUM> and support shaft <NUM>. More specifically, proximal and distal transducers <NUM>, <NUM>, respectively, in some configurations, define outer diameters less than about <NUM>, less than about <NUM>, or less than about <NUM>. As a result, the diameters of the piezoelectric elements (or largest cross-sectional dimension for non-circular elements) of the stacks of piezoelectric elements 233c, 235c are limited which, in turn, limits the ultrasonic energy capable of being generated by the proximal and distal transducers <NUM>, <NUM>, respectively. Further, the physics of longitudinal standing waves renders the increased energy produced by increasing the number of the piezoelectric elements in the stack relatively minimal.

The above-detailed configuration of transducer assembly <NUM>, regardless of whether transducer assembly <NUM> is disposed in an unarticulated condition (<FIG>) or an articulated condition (<FIG>), enables ultrasonic energy produced by proximal transducer <NUM> to be transmitted along flexible connector <NUM>, distal transducer <NUM>, and ultrasonic horn <NUM> to blade <NUM> and also enables ultrasonic energy produced by distal transducer <NUM> to be transmitted along ultrasonic horn <NUM> to blade <NUM>. Thus, by providing two transducers <NUM>, <NUM> producing ultrasonic energy that is transmitted to blade <NUM>, the overall amount of ultrasonic energy provided at blade <NUM> can be increased without requiring an increase in the overall diameter of the system. In some devices, proximal and distal transducers <NUM>, <NUM> are disposed at or near node points of the system.

Referring to <FIG>, the above-detailed configuration of transducer assembly <NUM> (<FIG>) is merely exemplary; the present disclosure is not limited to two transducers connected by a flexible connector. Rather, any suitable configuration of transducers and connectors may be provided to enable a suitable amount of ultrasonic energy to be transmitted to the blade while maintaining the overall diameter of the system below a threshold diameter. For example, as illustrated in <FIG>, first, second, and third transducers <NUM> may be provided with first and second flexible connectors <NUM> disposed therebetween and an ultrasonic horn <NUM> and blade <NUM> extending distally from the distal-most transducer <NUM>.

As illustrated in <FIG>, as another example, first, second, third, and fourth transducers <NUM> may be provided with first and second flexible connectors <NUM> connecting the first and second transducers <NUM> and third and fourth transducers <NUM>, respectively, a rigid connector <NUM>' connecting the second and third transducers <NUM> with one another, and with one another and a with one another, and an ultrasonic horn <NUM> and blade <NUM> extending distally from the distal-most transducer <NUM>.

<FIG> illustrates still another example, wherein first and second transducers <NUM> are connected by a flexible connector <NUM>, an ultrasonic horn <NUM> extends distally from the distal-most transducer <NUM>, a waveguide <NUM>' extends distally from the ultrasonic horn <NUM>, and a blade <NUM> is defined at or engaged to a distal end of the waveguide <NUM>'.

First, second, and third transducers <NUM> are illustrated in <FIG>, wherein the first and second transducers <NUM> are connected via a rigid connector <NUM>' and the second and third transducers <NUM> are connected by a flexible connector <NUM>. An ultrasonic horn <NUM> and blade <NUM> extend distally from the distal-most transducer <NUM>. Other configurations including combinations of the above component or any other suitable components interconnecting multiple transducers with an ultrasonic blade are also contemplated.

The transducers, flexible connectors, ultrasonic horns, and blade of the configurations of <FIG> may be similar to and include any of the features of transducer assembly <NUM> (<FIG>) as detailed above. Further, the multiple flexible connectors may be oriented to allow articulation in the same plane to allow a greater degree of flexibility or in different planes to allow multidimensional articulation.

Claim 1:
An ultrasonic surgical instrument, comprising:
a housing (<NUM>);
an elongated shaft (<NUM>) extending distally from the housing;
an end effector (<NUM>) extending distally from the elongated shaft, the end effector including a jaw (<NUM>) and an ultrasonic blade (<NUM>), wherein the jaw is configured to pivot relative to the ultrasonic blade from an open position to a clamping position for clamping tissue therebetween; and
a transducer assembly (<NUM>) disposed at least partially within the elongated shaft, the transducer assembly distally-spaced from the housing and including proximal and distal transducers (<NUM>,<NUM>) interconnected by a connector (<NUM>),
wherein the ultrasonic blade is connected to the distal transducer such that ultrasonic energy produced by the proximal transducer is transmitted along the connector and the distal transducer to the ultrasonic blade and such that ultrasonic energy produced by the distal transducer is transmitted to the ultrasonic blade
wherein the connector is a flexible connector (<NUM>) configured to articulate in at least one direction characterised in that the elongated shaft includes an articulating portion (<NUM>) configured to articulate the end effector relative to the longitudinal axis of the elongated shaft and
wherein the flexible connector extends through the articulating portion such that the proximal transducer is disposed proximally of the articulating portion and such that the distal transducer is disposed distally of the articulating portion.