Patent Description:
Examples of ultrasonic surgical instruments include the HARMONIC ACE® Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades, all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," issued August <NUM>, <CIT> <CIT>, <CIT>, and <CIT>.

Still further examples of ultrasonic surgical instruments are disclosed in <CIT>, <CIT>, <CIT>, <CIT>, <CIT>, and <CIT>.

Some ultrasonic surgical instruments may include a cordless transducer such as that disclosed in <CIT>, <CIT>, and/or <CIT>, entitled "Energy-Based Surgical Instruments". Additionally, some ultrasonic surgical instruments may include an articulating shaft section. Examples of such ultrasonic surgical instruments are disclosed in <CIT>, entitled "Surgical Instruments with Articulating Shafts," and <CIT>, entitled "Flexible Harmonic Waveguides/Blades for Surgical Instruments". <CIT> discloses an ultrasonic surgical clamp coagulator apparatus that is configured to effect cutting, coagulation, and clamping of tissue during surgical procedures. The apparatus includes an elongated portion having a pivotal clamp arm at a distal end thereof for clamping tissue against an associated ultrasonic end-effector. A clamp arm mount of the apparatus interferingly engages the pivotal clamp arm to thereby maintain the clamp arm in substantial alignment with the end-effector, while accommodating normal manufacturing tolerances of the components.

For clarity of disclosure, the terms "proximal" and "distal" are defined herein relative to a human or robotic operator of the surgical instrument. The term "proximal" refers the position of an element closer to the human or robotic operator of the surgical instrument and further away from the surgical end effector of the surgical instrument. The term "distal" refers to the position of an element closer to the surgical end effector of the surgical instrument and further away from the human or robotic operator of the surgical instrument.

<FIG> show an exemplary ultrasonic surgical instrument (<NUM>) that is configured to be used in minimally invasive surgical procedures (e.g., via a trocar or other small diameter access port, etc.). As will be described in greater detail below, instrument (<NUM>) is operable to cut tissue and seal or weld tissue (e.g., a blood vessel, etc.) substantially simultaneously. Instrument (<NUM>) of this example comprises a disposable assembly (<NUM>) and a reusable assembly (<NUM>). The distal portion of reusable assembly (<NUM>) is configured to removably receive the proximal portion of disposable assembly (<NUM>), as seen in <FIG>, to form instrument (<NUM>).

In an exemplary use, assemblies (<NUM>, <NUM>) are coupled together to form instrument (<NUM>) before a surgical procedure, the assembled instrument (<NUM>) is used to perform the surgical procedure, and then assemblies (<NUM>, <NUM>) are decoupled from each other for further processing. In some instances, after the surgical procedure is complete, disposable assembly (<NUM>) is immediately disposed of while reusable assembly (<NUM>) is sterilized and otherwise processed for re-use. By way of example only, reusable assembly (<NUM>) may be sterilized in a conventional relatively low temperature, relatively low pressure, hydrogen peroxide sterilization process. Alternatively, reusable assembly (<NUM>) may be sterilized using any other suitable systems and techniques (e.g., autoclave, etc.). In some versions, reusable assembly (<NUM>) may be sterilized and reused approximately <NUM> times. Alternatively, reusable assembly (<NUM>) may be subject to any other suitable life cycle. For instance, reusable assembly (<NUM>) may be disposed of after a single use, if desired. While disposable assembly (<NUM>) is referred to herein as being "disposable," it should be understood that, in some instances, disposable assembly (<NUM>) may also be sterilized and otherwise processed for re-use. By way of example only, disposable assembly (<NUM>) may be sterilized and reused approximately <NUM>-<NUM> times, using any suitable systems and techniques. Alternatively, disposable assembly (<NUM>) may be subject to any other suitable life cycle.

Disposable assembly (<NUM>) of the present example comprises a body portion (<NUM>), a shaft assembly (<NUM>) extending distally from body portion (<NUM>), and an end effector (<NUM>) located at the distal end of shaft assembly (<NUM>). As best seen in <FIG>, end effector (<NUM>) of this example comprises a clamp arm (<NUM>) and an ultrasonic blade (<NUM>). Clamp arm (<NUM>) includes a clamp pad (<NUM>), which faces blade (<NUM>). As shown in <FIG>, clamp arm (<NUM>) is pivotable toward and away from blade (<NUM>) to selectively compress tissue between clamp pad (<NUM>) and blade (<NUM>). As seen in <FIG>, blade (<NUM>) is an integral feature of the distal end of an acoustic waveguide (<NUM>), which extends coaxially through tubes (<NUM>, <NUM>), and which is configured to communicate ultrasonic vibrations to blade (<NUM>).

Shaft assembly (<NUM>) comprises an outer tube (<NUM>) and an inner tube (<NUM>). Outer tube (<NUM>) is operable to translate longitudinally relative to inner tube (<NUM>) to selectively pivot clamp arm (<NUM>) toward and away from blade (<NUM>). To accomplish this, and as best seen in <FIG> and <FIG>, integral pin features (<NUM>) of clamp arm (<NUM>) pivotally secure a first portion of clamp arm (<NUM>) to a distally projecting tongue (<NUM>) of outer tube (<NUM>); while an inserted pin (<NUM>) pivotally secures a second portion of clamp arm (<NUM>) to a distally projecting tongue (<NUM>) of inner tube (<NUM>). Thus, as can be seen in the transition from <FIG>, tubes (<NUM>, <NUM>) cooperate to pivot clamp arm (<NUM>) toward blade (<NUM>) when outer tube (<NUM>) is retracted proximally relative to inner tube (<NUM>). It should be understood that clamp arm (<NUM>) may be pivoted back away from blade (<NUM>) (e.g., from the position shown in <FIG> to the position shown in <FIG>) by translating outer tube (<NUM>) distally relative to inner tube (<NUM>), in reverse of the operation shown in <FIG>. In an exemplary use, clamp arm (<NUM>) may be pivoted toward blade (<NUM>) to grasp, compress, seal, and sever tissue captured between clamp pad (<NUM>) and blade (<NUM>). Clamp arm (<NUM>) may be pivoted away from blade (<NUM>) to release tissue from between clamp pad (<NUM>) and blade (<NUM>); and/or to perform blunt dissection of tissue engaging opposing outer surfaces of clamp arm (<NUM>) and blade (<NUM>). In some alternative versions, inner tube (<NUM>) is translated and outer tube (<NUM>) remains stationary to provide actuation of clamp arm (<NUM>).

Reusable assembly (<NUM>) includes a pistol grip (<NUM>) in this example, though it should be understood that any other suitable kind of grip may be used. A trigger (<NUM>) of reusable assembly (<NUM>) is configured to pivot toward and away from pistol grip (<NUM>) to thereby translate outer tube (<NUM>), to thereby pivot clamp arm (<NUM>). Buttons (<NUM>, <NUM>) of reusable assembly (<NUM>) are operable to activate blade (<NUM>) to cause blade (<NUM>) to vibrate at ultrasonic frequencies. In some versions, at least one button (<NUM>, <NUM>) is also operable to activate end effector (<NUM>) to deliver RF electrosurgical energy to tissue. Reusable assembly (<NUM>) also includes a battery (not shown), a generator (not shown), an ultrasonic transducer assembly (not shown), and a torque wrench assembly (not shown). The battery (not shown) is operable to provide electrical power to the generator (not shown); the generator (not shown) is operable to provide electrical power to the ultrasonic transducer assembly (not shown); the ultrasonic transducer assembly is operable to convert electrical power into ultrasonic vibrations; and the torque wrench assembly (not shown) is operable to mechanically and acoustically couple waveguide (<NUM>) with the ultrasonic transducer assembly (not shown). All of these components and operabilities may be provided in accordance with at least some of the teachings of <CIT>.

When waveguide (<NUM>) is sufficiently coupled with the transducer assembly (not shown), ultrasonic vibrations that are generated by the transducer assembly (not shown) are communicated along waveguide (<NUM>) to reach blade (<NUM>). In the present example, the distal end of blade (<NUM>) is located at a position corresponding to an anti-node associated with resonant ultrasonic vibrations communicated through waveguide (<NUM>), in order to tune the acoustic assembly to a preferred resonant frequency fο when the acoustic assembly is not loaded by tissue. When the transducer assembly (not shown) is energized, the distal end of blade (<NUM>) is configured to move longitudinally in the range of, for example, approximately <NUM> to <NUM> microns peak-to-peak, and in some instances in the range of about <NUM> to about <NUM> microns at a predetermined vibratory frequency fo of, for example, <NUM>. When the transducer assembly (not shown) of the present example is activated, these mechanical oscillations are transmitted through waveguide (<NUM>) to reach blade (<NUM>), thereby providing oscillation of blade (<NUM>) at the resonant ultrasonic frequency. Thus, when tissue is secured between blade (<NUM>) and clamp pad (<NUM>), the ultrasonic oscillation of blade (<NUM>) may simultaneously sever the tissue and denature the proteins in adjacent tissue cells, thereby providing a coagulative effect with relatively little thermal spread. In some versions, an electrical current may also be provided through blade (<NUM>) and/or clamp pad (<NUM>) to also seal the tissue.

Other aspects of disposable assembly (<NUM>) and reusable assembly (<NUM>) may be provided in accordance with at least some of the teachings of <CIT> and/or any of the other references that are cited herein. Further exemplary features and operabilities for disposable assembly (<NUM>) and reusable assembly (<NUM>) will be described in greater detail below, while other variations will be apparent to those of ordinary skill in the art in view of the teachings herein.

Some operators may use blade (<NUM>) to perform back-cutting operations, where the underside of blade (<NUM>) is pressed against tissue to sever the tissue without using clamp arm (<NUM>) to compress the tissue. The resulting lateral forces on blade (<NUM>) may cause blade (<NUM>) and/or waveguide (<NUM>) to deflect slightly laterally. This may present a risk of blade (<NUM>) contacting pin (<NUM>), which may be undesirable. It may therefore be desirable to reconfigure end effector (<NUM>) such that pin (<NUM>) is not laterally adjacent to blade (<NUM>). In addition to reducing metal-to-metal contact risks associated with back-cutting, reconfiguring pin (<NUM>) may also facilitate longitudinal translation of blade (<NUM>) and waveguide (<NUM>) relative to the rest of shaft assembly (<NUM>) and end effector (<NUM>), such as when an operator wishes to clean or replace blade (<NUM>) and waveguide (<NUM>).

Those of ordinary skill in the art will also recognize that a clamp pad (<NUM>) may tend to wear after use, such that it may be desirable to replace clamp pad (<NUM>). To accomplish this, it may be beneficial to remove clamp arm (<NUM>) from tubes (<NUM>, <NUM>). In the configuration of end effector (<NUM>), some operators may have difficulty removing pin (<NUM>) in order to enable removal of clamp arm (<NUM>) from tubes (<NUM>, <NUM>). It may therefore be desirable to reconfigure end effector (<NUM>) to make it easier to remove clamp arm (<NUM>) from tubes (<NUM>, <NUM>), such as by modifying the configuration of pin (<NUM>).

The examples below relate to various alternative configurations that may be incorporated into end effector (<NUM>). At least some of these alternative configurations may reduce metal-to-metal contact risks associated with back-cutting, facilitate longitudinal translation of blade (<NUM>) and waveguide (<NUM>) relative to the rest of shaft assembly (<NUM>) and end effector (<NUM>), and/or facilitate removal of clamp arm (<NUM>) from tubes (<NUM>, <NUM>). In addition or in the alternative, the below described alternative configurations may provide other benefits. It should be understood that the following examples are merely illustrative.

<FIG> show an alternative shaft assembly (<NUM>) and alternative end effector (<NUM>) that may be readily incorporated into instrument (<NUM>) described above in place of shaft assembly (<NUM>) end effector (<NUM>). End effector (<NUM>) includes a clamp arm (<NUM>) and a clamp pad (<NUM>) that are substantially similar to clamp arm (<NUM>) and clamp pad (<NUM>) described above, with differences described in detail below. As best seen in <FIG>, shaft assembly (<NUM>) includes an outer tube (<NUM>), an inner tube (<NUM>), and an acoustic waveguide (<NUM>) extending through both outer tube (<NUM>) and inner tube (<NUM>). Outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) are substantially similar to outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) mentioned above, respectively, with differences described below.

As best seen in <FIG>, outer tube (<NUM>) is operable to translate longitudinally relative to inner tube (<NUM>) to selectively pivot clamp arm (<NUM>) toward and away from blade (<NUM>). To accomplish this, and as best seen in <FIG>, integral pin features (<NUM>) of clamp arm (<NUM>), which are substantially similar to integral pin features (<NUM>) mentioned above, pivotally secure a first portion of clamp arm (<NUM>) to pin slot (<NUM>) of a distally projecting tongue (<NUM>) of outer tube (<NUM>); while integral pin features (<NUM>) pivotally secure a second portion of clamp arm (<NUM>) to angled distal prongs (<NUM>) of inner tube (<NUM>) via pin holes (<NUM>). It should be understood that integral pin features (<NUM>) may vertically translate within pin slot (<NUM>). Therefore, longitudinal translation of outer tube (<NUM>) rotates the first portion of clamp arm (<NUM>) about the second portion of clamp arm (<NUM>). Thus, as can be seen in the transition from <FIG>, tubes (<NUM>, <NUM>) cooperate to pivot clamp arm (<NUM>) toward blade (<NUM>) when outer tube (<NUM>) is retracted proximally relative to inner tube (<NUM>). It should be understood that clamp arm (<NUM>) may be pivoted back away from blade (<NUM>) (e.g., from the position shown in <FIG> to the position shown in <FIG>) by translating outer tube (<NUM>) distally relative to inner tube (<NUM>), in reverse of the operation shown in <FIG>. In an exemplary use, clamp arm (<NUM>) may be pivoted toward blade (<NUM>) to grasp, compress, seal, and sever tissue captured between clamp pad (<NUM>) and blade (<NUM>). Clamp arm (<NUM>) may be pivoted away from blade (<NUM>) to release tissue from between clamp pad (<NUM>) and blade (<NUM>); and/or to perform blunt dissection of tissue engaging opposing outer surface of clamp arm (<NUM>) and blade (<NUM>).

While inner tube (<NUM>) includes distally projecting tongue (<NUM>), inner tube (<NUM>) of the present example includes a pair of angled distal prongs (<NUM>) defining a longitudinal channel (<NUM>). Angled distal prongs (<NUM>) each have a flat surface (<NUM>) extending from prongs (<NUM>). Together, each angled distal prong (<NUM>) and corresponding flat surface (<NUM>) define a pin hole (<NUM>). As will be described in greater detail below, pin holes (<NUM>) are dimensioned to receive integral pins (<NUM>) of clamp arm (<NUM>). As also seen in <FIG>, end effector (<NUM>) further includes a cap (<NUM>). Cap (<NUM>) includes a spacer (<NUM>) and a pair of flanges (<NUM>). Spacer (<NUM>) is dimensioned with fit within longitudinal channel (<NUM>) while flanges (<NUM>) are dimensioned to rest on top of angled distal prongs (<NUM>). As will be described in further detail below, cap (<NUM>) is configured to fix integral pins (<NUM>) within pin holes (<NUM>) once clamp arm (<NUM>) is assembled to inner tube (<NUM>).

<FIG> show an exemplary assembly of clamp arm (<NUM>) and inner tube (<NUM>). As best seen in <FIG>, clamp arm (<NUM>) is placed over angled distal prongs (<NUM>) such that integral pins (<NUM>) are laterally aligned with angled distal prongs (<NUM>). It should be understood that inner tube (<NUM>) is made out of a resilient material, such that angled distal prongs (<NUM>) may flex relative to one another within longitudinal channel (<NUM>). Therefore, as seen in <FIG>, a user may pinch angled distal prongs (<NUM>) or flats (<NUM>) together, such that angled distal prongs (<NUM>) flex toward each other within longitudinal channel (<NUM>). Integral pins (<NUM>) and angled distal prongs (<NUM>) are then no longer laterally aligned, but both angled distal prongs (<NUM>) are laterally between integral pins (<NUM>).

With angled distal prongs (<NUM>) deflected inwardly, and as seen in <FIG>, the operator may place clamp arm (<NUM>) over inner tube (<NUM>) such that integral pins (<NUM>) slide past angled distal prongs (<NUM>) within pin holes (<NUM>). Integral pins (<NUM>) abut against flats (<NUM>). At this stage, integral pins (<NUM>) are within pin holes (<NUM>). As seen in <FIG>, the operator may now release angled distal prongs (<NUM>) and/or flats (<NUM>). Due to the resilient nature of angled distal prongs (<NUM>) and flats (<NUM>), both angled distal prongs (<NUM>) and flats (<NUM>) return to their natural position, as shown in <FIG>. Additionally, integral pins (<NUM>) abut against both angled distal prongs (<NUM>) and flats (<NUM>). Integral pins (<NUM>) are now fixed within pin holes (<NUM>) at this stage.

With integral pins (<NUM>) located in pin holes (<NUM>), and as shown in <FIG>, cap (<NUM>) is then placed on top of inner tube (<NUM>) such that spacer (<NUM>) lies within longitudinal channel (<NUM>) while abutting against both angled distal prongs (<NUM>). Additionally, flanges (<NUM>) rest on top angled distal prongs (<NUM>). With cap (<NUM>) in place, angled distal prongs (<NUM>) and/or flats (<NUM>) are no longer capable of deflecting inwardly toward one another within longitudinal channel (<NUM>) to release integral pins (<NUM>) from pin holes (<NUM>). At this point, cap (<NUM>) may be welded to angled distal prongs (<NUM>) to fix cap (<NUM>) to inner tube (<NUM>), and therefore fix clamp arm (<NUM>) to inner tube (<NUM>). Of course, any other suitable method of fixing cap (<NUM>) to angled distal prongs (<NUM>) may be used as would be apparent to one having ordinary skill in the art in view of the teachings herein. It should be understood that integral pins (<NUM>) do not extend laterally across the width of inner tube (<NUM>). Additionally, integral pins (<NUM>) are dimensioned to not extend across the lateral width of blade (<NUM>). Therefore, the chances of blade (<NUM>) making contact with integral pins (<NUM>) are reduced or eliminated.

While an operator flexes angled distal prongs (<NUM>) and/or flats (<NUM>) toward one another as a separate step of the process in the present example, it should be understood that this is merely optional. In some alternative versions, the operator may force integral pins (<NUM>) on top of angled distal prongs (<NUM>), and contact between integral pins (<NUM>) and angled distal prongs (<NUM>) may provide a camming action that flexes distal prongs (<NUM>) and flats (<NUM>) toward each other. In some such versions, integral pins (<NUM>) may have angled surfaces that cooperate with angled distal prongs (<NUM>) to further promote this camming action. Other ways that angled distal prongs (<NUM>) and flats (<NUM>) may flex toward each other to create the appropriate gap for insertion of integral pins (<NUM>) into pin holes (<NUM>) will be apparent to one having ordinary skill in the art in view of the teachings herein.

<FIG> show a shaft assembly (<NUM>) and an end effector (<NUM>) in accordance with the present invention that may be readily incorporated into instrument (<NUM>) described above in place of shaft assembly (<NUM>) end effector (<NUM>). End effector (<NUM>) includes a clamp arm (<NUM>) and clamp pad (<NUM>) that are substantially similar to clamp arm (<NUM>) and clamp pad (<NUM>) described above, with difference described in detail below. Shaft assembly (<NUM>) includes an outer tube (<NUM>), an inner tube (<NUM>), and an acoustic waveguide (<NUM>) extending through both outer tube (<NUM>) and inner tube (<NUM>). Outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) are substantially similar to outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) mentioned above, respectively, with differences described below.

As best seen in <FIG>, outer tube (<NUM>) is operable to translate longitudinally relative to inner tube (<NUM>) to selectively pivot clamp arm (<NUM>) toward and away from blade (<NUM>). To accomplish this, integral pin features (<NUM>) of clamp arm (<NUM>), which are substantially similar to integral pin features (<NUM>) mentioned above, pivotally secure a first portion of clamp arm (<NUM>) to pin slot (<NUM>) of a distally projecting tongue (<NUM>) of outer tube (<NUM>); while integral pin features (<NUM>) pivotally secure a second portion of clamp arm (<NUM>) to angled distal prongs (<NUM>) of inner tube (<NUM>) via pin holes (<NUM>). It should be understood that integral pin features (<NUM>) may vertically translate within pin slot (<NUM>). Therefore, longitudinal translation of outer tube (<NUM>) rotates the first portion of clamp arm (<NUM>) about the second portion of clamp arm (<NUM>). Thus, as can be seen in the transition from <FIG>, tubes (<NUM>, <NUM>) cooperate to pivot clamp arm (<NUM>) toward blade (<NUM>) when outer tube (<NUM>) is retracted proximally relative to inner tube (<NUM>). It should be understood that clamp arm (<NUM>) may be pivoted back away from blade (<NUM>) (e.g., from the position shown in <FIG> to the position shown in <FIG>) by translating outer tube (<NUM>) distally relative to inner tube (<NUM>), in reverse of the operation shown in <FIG>. In an exemplary use, clamp arm (<NUM>) may be pivoted toward blade (<NUM>) to grasp, compress, seal, and sever tissue captured between clamp pad (<NUM>) and blade (<NUM>). Clamp arm (<NUM>) may be pivoted away from blade (<NUM>) to release tissue from between clamp pad (<NUM>) and blade (<NUM>); and/or to perform blunt dissection of tissue engaging opposing outer surface of clamp arm (<NUM>) and blade (<NUM>).

While inner tube (<NUM>) includes distally projecting tongue (<NUM>), inner tube (<NUM>) of the present example includes a pair of angled distal prongs (<NUM>) defining a longitudinal channel (<NUM>). Angled distal prongs (<NUM>) each have a flat surface (<NUM>) extending from prongs (<NUM>). Together, each angled distal prong (<NUM>) and corresponding flat surface (<NUM>) define a pin hole (<NUM>). As will be described in greater detail below, pin holes (<NUM>) are dimensioned to receive integral pins (<NUM>) of clamp arm (<NUM>). As also seen in <FIG>, a tab (<NUM>) is integrally fixed on one angled distal prong (<NUM>), and extends across longitudinal channel (<NUM>) above the other angled distal prong (<NUM>).

<FIG> show an exemplary assembly of clamp arm (<NUM>) and inner tube (<NUM>). <FIG> shows shaft assembly (<NUM>) and end effector (<NUM>) without clamp arm (<NUM>) attached. Similar to clamp arm (<NUM>) in <FIG>, clamp arm (<NUM>) may be placed over angled distal prongs (<NUM>) such that integral pins (<NUM>) are laterally aligned with angled distal prongs (<NUM>). It should be understood that inner tube (<NUM>) is made out of a resilient material, such that angled distal prongs (<NUM>) may flex relative to one another within longitudinal channel (<NUM>). Therefore, as seen in <FIG>, an operator may pinch angled distal prongs (<NUM>) or flats (<NUM>) together, such that angled distal prongs (<NUM>) flex toward each other within longitudinal channel (<NUM>). As seen in <FIG>, angled distal prongs (<NUM>) are then spaced such that integral pins (<NUM>) may slide within pin holes (<NUM>) and abut against the portion of pin holes (<NUM>) defined by flats (<NUM>). At this stage, integral pins (<NUM>) are within pin holes (<NUM>).

With integral pins (<NUM>) are within pin holes (<NUM>), and as seen in <FIG>, the operator may now release angled distal prongs (<NUM>) and/or flats (<NUM>). Due to the resilient nature of angled distal prongs (<NUM>) and flats (<NUM>), both angled distal prongs (<NUM>) and flats (<NUM>) return to their natural position, as shown in <FIG>. Additionally, integral pins (<NUM>) abut against both angled distal prongs (<NUM>) and flats (<NUM>). Integral pins (<NUM>) are now fixed within pin holes (<NUM>) at this stage. With pins (<NUM>) fixed within pin holes (<NUM>), and as shown in <FIG>, the operator may fix or secure tab (<NUM>) to the other angled distal prong (<NUM>) that tab (<NUM>) is not already integrally fixed to. End (<NUM>) of tab (<NUM>) may be fixed to the other angled distal prong (<NUM>) through welding or any other suitable method known to one having ordinary skill in the art in view of the teachings herein. With tab (<NUM>) fixed to both angled distal prongs (<NUM>), angled distal prongs (<NUM>) and/or flats (<NUM>) are no longer capable of deflecting inwardly toward one another to release integral pins (<NUM>) from pin holes (<NUM>). It should be understood that integral pins (<NUM>) do not extend laterally across the width of inner tube (<NUM>). Additionally, integral pins (<NUM>) are dimensioned to not extend across the lateral width of blade (<NUM>). Therefore, chances of blade (<NUM>) making contact with integral pins (<NUM>) are reduced or eliminated.

While in the current example, a user flexes angled distal prongs (<NUM>) and/or flats (<NUM>) towards one another in the present example, it should be understood that this is merely optional. In some alternative versions, the operator may force integral pins (<NUM>) on top of angled distal prongs (<NUM>), and contact between integral pins (<NUM>) and angled distal prongs (<NUM>) may provide a camming action that flexes angled distal prongs (<NUM>) and flats (<NUM>) toward each other. In some such versions, integral pins (<NUM>) may have angled surfaces that cooperate with angled distal prongs (<NUM>) to further promote this camming action. Other ways that angled distal prongs (<NUM>) and flats (<NUM>) may flex toward each other to create the appropriate gap for insertion of integral pins (<NUM>) into pin holes (<NUM>) will be apparent to one having ordinary skill in the art in view of the teachings herein.

<FIG> show another shaft assembly (<NUM>) and end effector (<NUM>) in accordance with the present invention that may be readily incorporated into instrument (<NUM>) described above in place of shaft assembly (<NUM>) end effector (<NUM>). End effector (<NUM>) includes a clamp arm (<NUM>) and clamp pad (<NUM>) that are substantially similar to clamp arm (<NUM>) and clamp pad (<NUM>) described above, with difference described in detail below. As best seen in <FIG>, shaft assembly (<NUM>) includes an outer tube (<NUM>), an inner tube (<NUM>), and an acoustic waveguide (<NUM>) extending through both outer tube (<NUM>) and inner tube (<NUM>). Outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) are substantially similar to outer tube (<NUM>), inner tube (<NUM>), and acoustic waveguide (<NUM>) mentioned above, respectively, with differences described below.

Similar to inner tube (<NUM>), inner tube (<NUM>) of the present example includes a pair of angled distal prongs (<NUM>) defining a longitudinal channel (<NUM>). Angled distal prongs (<NUM>) each have a flat surface (<NUM>) extending from prongs (<NUM>). Together, each angled distal prong (<NUM>) and corresponding flat surface (<NUM>) define a pin hole (<NUM>). Clamp arm (<NUM>) may be attached to inner tube (<NUM>) in substantially the same manner as described above for coupling clamp arm (<NUM>) with inner tube (<NUM>), with the difference of inserting removable cap (<NUM>) as will be describe below. It should therefore be understood that inner tube (<NUM>) is made out of a resilient material, such that angled distal prongs (<NUM>) may flex relative to one another within longitudinal channel (<NUM>). Pin holes (<NUM>) are dimensioned to receive integral pins (<NUM>) of clamp arm (<NUM>) when angled distal prongs (<NUM>) and flats (<NUM>) are flexed toward each other within longitudinal channel (<NUM>). With integral pins (<NUM>) inserted into pin holes (<NUM>), angled distal prongs (<NUM>) and flats (<NUM>) may return to their natural position such that integral pins (<NUM>) abut against portions of angled distal prongs (<NUM>) and flats (<NUM>) defining pin holes (<NUM>).

When pins (<NUM>) are disposed in corresponding pin holes (<NUM>), and as best seen in <FIG>, removable cap (<NUM>) may be inserted into longitudinal channel (<NUM>) to prevent angled distal prongs (<NUM>) and/or flats (<NUM>) from deflecting inwardly toward one another to release integral pins (<NUM>) from pin holes (<NUM>). Removable cap (<NUM>) includes a spacer portion (<NUM>), a resilient portion (<NUM>) extending from spacer portion (<NUM>), and a tab (<NUM>) extending from resilient portion (<NUM>). Additionally, longitudinal channel (<NUM>) includes an access channel (<NUM>) and a locking channel (<NUM>). Access channel (<NUM>) is sized so an operator may insert an object or their finger within access channel (<NUM>) to selectively remove removable cap (<NUM>) by sliding removable cap (<NUM>) distally. Locking channel (<NUM>) is sized to receive tab (<NUM>) when removable cap (<NUM>) is fully inserted, thereby longitudinally locking removable cap (<NUM>) relative to inner tube (<NUM>).

Spacer portion (<NUM>) defines a pair of longitudinal slots (<NUM>). Longitudinal slots (<NUM>) are sized to receive the inner edges of angled distal prongs (<NUM>) when removable cap (<NUM>) is installed. As best seen in <FIG>, the operator may vertically align longitudinal slots (<NUM>) with the edges of angled distal prongs (<NUM>) so that longitudinal slots (<NUM>) house the edges of angled distal prongs (<NUM>). Resilient member is capable of bending, such that tab (<NUM>) may vertically move relative to spacer portion (<NUM>). Thus, as shown in <FIG>, when spacer portion (<NUM>) initially engages angled distal prongs (<NUM>), tab (<NUM>) may slide on top of longitudinal channel (<NUM>) and angled distal prongs (<NUM>).

As best seen in <FIG>, when spacer portion (<NUM>) slides a sufficient distance proximally toward inner tube (<NUM>), tab (<NUM>) may fit within locking channel (<NUM>). With tab (<NUM>) no longer forced above longitudinal channel (<NUM>) through engagement with angled distal prongs (<NUM>), the resilient nature of resilient portion (<NUM>) moves tab (<NUM>) within locking channel (<NUM>). Tab (<NUM>) is thereby vertically aligned with spacer portion (<NUM>) at this stage. As described above, spacer portion (<NUM>) is located between angled distal prongs (<NUM>) such that angled distal prongs (<NUM>) and/or flats (<NUM>) are no longer capable of deflecting inwardly toward one another to release integral pins (<NUM>) from pin holes (<NUM>). Additionally, tab (<NUM>) resting within locking channel (<NUM>) prevents unintentional longitudinal movement of removable cap (<NUM>) relative to inner tube (<NUM>). If an operator desires to remove removable cap (<NUM>) (e.g. to remove clamp arm (<NUM>)), the operator may push tab (<NUM>) downwardly so tab (<NUM>) no longer engages locking channel (<NUM>), then slide removable cap (<NUM>) in the distal direction. Alternatively, an operator user may insert an object or their finger into access channel (<NUM>) in order to lift tab (<NUM>) above locking channel (<NUM>), then slide removable cap (<NUM>) in the distal direction.

In some instances, ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) may be removable from the rest of shaft assembly (<NUM>, <NUM>, <NUM>, <NUM>) and end effector (<NUM>, <NUM>, <NUM>, <NUM>). This may enable cleaning and/or other processing of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>). In such cases, it may be desirable to have a locking and locating feature associated with instrument (<NUM>) such that ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) are oriented in the same angular position relative to shaft assembly (<NUM>, <NUM>, <NUM>, <NUM>) and end effector (<NUM>, <NUM>, <NUM>, <NUM>) every time a user reassembles ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) within end effector (<NUM>, <NUM>, <NUM>, <NUM>) and shaft assembly (<NUM>, <NUM>, <NUM>, <NUM>). This consistency in the angular orientation of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) may be desirable in order to ensure that the proper region of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) is facing clamp pad (<NUM>, <NUM>, <NUM>, <NUM>). Having consistency in the angular orientation of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) may also be particularly desirable in contexts where ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) extends along a curve, to ensure that the curve of a complimentarily curved clamp arm (<NUM>, <NUM>, <NUM>, <NUM>) is aligned with the curve of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>).

The following examples provide various features that may be used to provide consistent angular orientation of ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) as ultrasonic blade (<NUM>, <NUM>, <NUM>, <NUM>) and waveguide (<NUM>, <NUM>, <NUM>, <NUM>) are inserted into shaft assembly (<NUM>, <NUM>, <NUM>, <NUM>). Further examples are described in <CIT>. It should be understood that the teachings below may be readily combined with any of the teachings above, such that the examples below are not intended to be exclusive of the examples above. It should also be understood that the teachings below may be readily applied to other versions of instrument (<NUM>), not just the versions of instrument (<NUM>) that are described herein.

<FIG> show an alternative shaft assembly (<NUM>) and an alternative body portion (<NUM>) that may be readily incorporated into instrument (<NUM>) described above. Shaft assembly (<NUM>) includes a rotation assembly (<NUM>) that is operable to rotate shaft assembly (<NUM>) relative to body portion (<NUM>). Rotation assembly (<NUM>) includes a rotation knob (<NUM>) unitarily attached to a sleeve (<NUM>) extending into body portion (<NUM>). Shaft assembly further includes an outer tube (<NUM>), an inner tube (<NUM>), and a waveguide (<NUM>) extending through inner tube (<NUM>) and outer tube (<NUM>). Outer tube (<NUM>), inner tube (<NUM>) and waveguide (<NUM>) are substantially similar to outer tube (<NUM>), inner tube (<NUM>), and waveguide (<NUM>) described above, respectively, with differences described below. As best seen in <FIG>, a portion of outer tube (<NUM>), inner tube (<NUM>) and waveguide (<NUM>) extend through rotation knob (<NUM>) and sleeve (<NUM>).

Body portion (<NUM>) also houses a spring loaded key lock assembly (<NUM>). As will be described in greater detail below, spring loaded key lock assembly (<NUM>) is capable of selectively locking the longitudinal position of waveguide (<NUM>) relative to inner tube (<NUM>). Additionally, as will be described in greater detail below, spring loaded key lock assembly (<NUM>) is also capable of unlocking waveguide (<NUM>) relative to inner tube (<NUM>) and outer tube (<NUM>), such that waveguide (<NUM>) may be removed from body portion (<NUM>) for cleaning or other reasons.

Spring loaded key lock (<NUM>) includes a handle (<NUM>) that is connected to a pair of locking forks (<NUM>). Lock (<NUM>) further includes a biasing member (<NUM>) that is fixed to sleeve (<NUM>) of rotation assembly (<NUM>) and handle (<NUM>). Locking forks (<NUM>) extend from handle (<NUM>) toward sleeve (<NUM>). As best seen in <FIG>, biasing member (<NUM>) biases handle (<NUM>) toward sleeve (<NUM>). However, as best seen in <FIG>, an operator may pull handle (<NUM>) away from sleeve (<NUM>) to stretch biasing member (<NUM>). However, as soon as a user releases handle (<NUM>), biasing member (<NUM>) will resiliently actuate handle (<NUM>) toward sleeve (<NUM>).

As can be seen in <FIG>, sleeve (<NUM>), outer tube (<NUM>), and inner tube (<NUM>) define a pair of key slots (<NUM>) that are dimensioned to receive locking forks (<NUM>). Locking forks (<NUM>) may also actuate within key slots (<NUM>). Additionally, waveguide (<NUM>) defines a pair of keyed flats (<NUM>) and a pair of faces (<NUM>). Faces (<NUM>) are adjacent and perpendicular to keyed flats (<NUM>). As best seen in <FIG>, keyed flats (<NUM>) are dimensioned with a substantially similar, if not exact, width of locking forks (<NUM>). Therefore, when key lock assembly (<NUM>) engages waveguide (<NUM>), faces (<NUM>) prevent waveguide (<NUM>) from traveling in the longitudinal direction due to interaction of faces (<NUM>) and locking forks (<NUM>). Additionally, as best seen in <FIG>, locking forks (<NUM>) are spaced apart from one another so that each locking fork (<NUM>) makes contact with its respective keyed flat (<NUM>) when locking forks (<NUM>) are located within keyed slots (<NUM>). Therefore, keyed flats (<NUM>) prevent waveguide (<NUM>) from lateral movement or rotating about its own longitudinal axis due to interaction of keyed flats (<NUM>) and locking forks (<NUM>).

Additionally, as best seen in <FIG> and <FIG>, an operator may pull handle (<NUM>) away from sleeve (<NUM>) so that locking forks (<NUM>) travel along key slots (<NUM>). Locking forks (<NUM>) may travel along key slots (<NUM>) until locking forks (<NUM>) no longer make contact with faces (<NUM>) or keyed flats (<NUM>). An operator may thus pull waveguide (<NUM>) in the proximal direction until waveguide (<NUM>) is sufficiently removed from inner tube (<NUM>) and outer tube (<NUM>). If the operator desires to place waveguide (<NUM>) back into inner tube (<NUM>) and outer tube (<NUM>), the operator may pull handle (<NUM>) away from sleeve (<NUM>), insert waveguide (<NUM>) into inner tube (<NUM>) and outer tube (<NUM>) until locking forks (<NUM>) align with keyed flats (<NUM>), and then allow biasing member (<NUM>) to force locking forks (<NUM>) within key slots (<NUM>).

<FIG> show another alternative shaft assembly (<NUM>) that may be readily incorporated into instrument (<NUM>) described above. Shaft assembly (<NUM>) includes an ultrasonic waveguide (<NUM>), an inner tube (<NUM>), an outer tube (<NUM>), and a rotation assembly (<NUM>); which are substantially similar to ultrasonic waveguide (<NUM>), inner tube (<NUM>), outer tube (<NUM>), and rotation assembly (<NUM>), respectively, except for the differences described below.

As best seen in <FIG>, ultrasonic waveguide (<NUM>) includes a seal (<NUM>), a cam pin (<NUM>) and a threaded stud (<NUM>) that is configured to couple with an ultrasonic transducer (not shown). Inner tube (<NUM>) includes a cam slot (<NUM>) extending from the proximal end of inner tube (<NUM>) and terminating at a placement hole (<NUM>). Outer tube (<NUM>) includes a cam slot (<NUM>) extending from the proximal end of outer tube (<NUM>) and terminating in a translation slot (<NUM>). Rotation assembly (<NUM>) includes a rotation knob (<NUM>) defining a channel (<NUM>) and a locking feature (<NUM>). Locking feature (<NUM>) may actuate relative to the rest of rotation assembly (<NUM>). It should be understood that cam pin (<NUM>) may fit within both cam slots (<NUM>, <NUM>) and radially extend from the rest of ultrasonic waveguide (<NUM>) as to extend beyond the dimensions of inner tube (<NUM>) and outer tube (<NUM>).

<FIG> show how waveguide (<NUM>) may be assembled within outer tube (<NUM>), inner tube (<NUM>), and rotation knob (<NUM>). Outer tube (<NUM>) and inner tube (<NUM>) are partially disposed within channel (<NUM>) of rotation knob (<NUM>). An operator may insert the distal end of waveguide (<NUM>) into the proximal openings of inner tube (<NUM>) and outer tube (<NUM>) such that cam pin (<NUM>) is aligned with cam slots (<NUM>, <NUM>). As mentioned above, camp pin (<NUM>) extends radially outwardly from the rest of ultrasonic waveguide (<NUM>) such that cam pin (<NUM>) extends beyond the dimensions of inner tube (<NUM>) and outer tube (<NUM>). Therefore, when cam pin (<NUM>) is aligned with cam slots (<NUM>, <NUM>), cam pin (<NUM>) extends through inner tube (<NUM>) and outer tube (<NUM>) via cam slots (<NUM>, <NUM>). It should be understood that cam slots (<NUM>, <NUM>) are aligned when outer tube (<NUM>) is actuated to its most distal position relative to inner tube (<NUM>). However, cam slots (<NUM>, <NUM>) may be dimensioned to align at any other longitudinal location of outer tube (<NUM>) relative to inner tube (<NUM>) as would be apparent to one having ordinary skill in the art in view of the teachings herein.

As shown in <FIG>, the operator push ultrasonic waveguide (<NUM>) in the distal direction. As waveguide (<NUM>) travels distally, cam slots (<NUM>, <NUM>) force waveguide (<NUM>) to rotate via cam pin (<NUM>). Waveguide (<NUM>) may travel distally within inner tube (<NUM>) and outer tube (<NUM>) until cam pin (<NUM>) reaches placement hole (<NUM>) as shown in <FIG>. Because cam pin (<NUM>) is located at the same location relative to the rest of waveguide (<NUM>), and because cam slots (<NUM>, <NUM>) are located at the same location when aligned, waveguide (<NUM>) will uniformly locate in the same longitudinal and rotational position every time waveguide (<NUM>) is inserted into inner tube (<NUM>) and outer tube (<NUM>). Placement hole (<NUM>) is located directly adjacent to locking feature (<NUM>). As described above, locking feature (<NUM>) is capable of actuating relative to the rest of rotation assembly (<NUM>). Additionally, locking feature (<NUM>) is dimensioned for a snap fit with cam pin (<NUM>) when locking feature (<NUM>) is actuated toward cam pin (<NUM>) as shown in <FIG>. Waveguide (<NUM>) is thereby rotationally and longitudinally fixed relative to rotation assembly (<NUM>). While locking feature (<NUM>) uses a snap fit to lock with cam pin (<NUM>) in the current example, any other suitable method of fixing cam pin (<NUM>) to locking feature (<NUM>) may be utilized as would be apparent to one having ordinary skill in the art in view of the teachings herein.

If an operator wishes to remove waveguide (<NUM>) for cleaning or other purposes, the operator may actuate locking feature (<NUM>) in the upward direction so that locking feature (<NUM>) is no longer fixed to cam pin (<NUM>). The operator may then pull waveguide (<NUM>) in the proximal direction to further remove waveguide (<NUM>) from inner tube (<NUM>) and outer tube (<NUM>).

It should be understood that translation slot (<NUM>) of outer tube (<NUM>) is dimensioned to allow outer tube (<NUM>) to longitudinally travel relative to inner tube (<NUM>) such that outer tube (<NUM>) does not interfere with cam pin (<NUM>) when waveguide (<NUM>) is assembled in place and secured by locking feature (<NUM>). Therefore, the operator may still open and close a clamp arm relative to a blade. It should also be understood that while one cam pin (<NUM>) and one pair of cam slots (<NUM>, <NUM>) are utilized in the current example, any suitable number of cam pins (<NUM>) and cam slots (<NUM>, <NUM>) may be utilized.

<FIG> shows an ultrasonic blade (<NUM>) and body portion (<NUM>) that may be readily incorporated into instrument (<NUM>) described above. As best seen in <FIG>, body portion (<NUM>) includes a shroud (<NUM>) defining a pair of rotating recesses (<NUM>). As will be described in greater detail below, rotating recesses (<NUM>) of shroud (<NUM>) are configured to rotationally and longitudinally align ultrasonic blade (<NUM>) relative to the rest of body portion (<NUM>).

As best seen in <FIG>, waveguide (<NUM>) includes a threaded recess (<NUM>) that is configured to couple waveguide (<NUM>) with an ultrasonic transducer (not shown), a silicone portion (<NUM>) defining a pin hole (<NUM>), and a clocking pin (<NUM>) that is configured to fit within pin hole (<NUM>) of silicone portion (<NUM>). Clocking pin (<NUM>) includes a pin (<NUM>) surrounded by a silicone overmold (<NUM>). Clocking pin (<NUM>) further includes a pair of clocking blocks (<NUM>) located at the ends of pin (<NUM>). Clocking blocks (<NUM>) may be made out of a plastic material or contain a plastic overmold. Silicone portion (<NUM>) and silicone overmold (<NUM>) help isolate ultrasonic waveguide (<NUM>) from clocking pin (<NUM>). This may help prevent clocking pin (<NUM>) from transmitting acoustic vibrations that are transmitted through waveguide (<NUM>) to an ultrasonic blade. Clocking pin (<NUM>) fits within pin hole (<NUM>) in such a way that clocking pin (<NUM>) is fixed relative to ultrasonic waveguide (<NUM>).

<FIG> show an exemplary assembly of waveguide (<NUM>). First, as shown in <FIG> and <FIG>, the proximal end of ultrasonic waveguide (<NUM>) is inserted into the distal end of shroud (<NUM>). Clocking blocks (<NUM>) of clocking pin (<NUM>) are thereby inserted into the origin of rotating recesses (<NUM>). Rotating recesses (<NUM>) define respective helical paths within shroud (<NUM>). Therefore, as shown in <FIG> and <FIG>, as waveguide (<NUM>) is rotated, clocking blocks (<NUM>), and therefore waveguide (<NUM>), travel proximally within shroud (<NUM>) while rotating to a predetermined angular orientation. Eventually, as shown in <FIG> and <FIG>, clocking blocks (<NUM>) reach the termination of rotating recesses (<NUM>). At this point, waveguide (<NUM>) cannot further rotate or travel proximally relative to shroud (<NUM>). Because shroud (<NUM>) is fixed relative to the rest of body (<NUM>), waveguide (<NUM>) will be uniformly placed in the same longitudinal and angular position every time waveguide (<NUM>) is "clocked" within shroud (<NUM>). An operator may remove waveguide (<NUM>) for cleaning and reinsert waveguide (<NUM>) back into shroud (<NUM>) at the exact location for subsequent use.

While the present example has waveguide (<NUM>) being inserted at the distal end of shroud (<NUM>), alternatively waveguide (<NUM>) may also be configured to be inserted in the proximal end of shroud (<NUM>).

<FIG> show an alternative body (<NUM>), shaft assembly (<NUM>), and end effector (<NUM>) that may be readily incorporated into instrument (<NUM>) described above. Shaft assembly (<NUM>) and end effector (<NUM>) are substantially similar to shaft assembly (<NUM>) and end effector (<NUM>) described above, with differences described below. Shaft assembly (<NUM>) includes an outer tube (<NUM>), an inner tube (not shown), a waveguide (<NUM>) and a rotation assembly (<NUM>); which are substantially similar to outer tube (<NUM>), inner tube (<NUM>), waveguide (<NUM>) and rotation assembly (<NUM>) described above. Rotation assembly (<NUM>) includes a rotation knob (<NUM>) substantially similar to rotation knob (<NUM>) described above. Waveguide (<NUM>) defines a pin hole (<NUM>) that is configured to be used in coupling waveguide (<NUM>) to body (<NUM>). End effector (<NUM>) includes a clamp arm (<NUM>) and an acoustic blade (<NUM>) substantially similar to clamp arm (<NUM>) and acoustic blade (<NUM>) mentioned above.

Body (<NUM>) includes a trigger (<NUM>), a tether (<NUM>) connected to waveguide (<NUM>) at a connection point (<NUM>), and a tether housing (<NUM>) that stores a coiled portion (<NUM>) of tether (<NUM>). Tether (<NUM>) extends from coiled portion (<NUM>) in such a way that portions of tether (<NUM>) may extend out of coiled portion (<NUM>), as shown in <FIG>. Coiled portion (<NUM>) may have recoil function, such that tugging on the portion of tether (<NUM>) extending from coiled portion (<NUM>) encourages coiled portion (<NUM>) to recoil excess lengths of tether (<NUM>). As shown in <FIG>, connection point (<NUM>) couples tether (<NUM>) with waveguide (<NUM>) such that waveguide (<NUM>) can be removed relative to the rest of shaft assembly (<NUM>), but cannot be removed entirely relative to body (<NUM>). In other words, even if waveguide (<NUM>) is removed from shaft assembly (<NUM>) for cleaning, waveguide (<NUM>) cannot be completely detached from body (<NUM>) due to tether (<NUM>). Connection point (<NUM>) may consist of a groove on waveguide (<NUM>) in which tether (<NUM>) is tied around. Alternatively, connection point (<NUM>) may comprise an overmold of silicone on the portion of tether (<NUM>) in contact with waveguide (<NUM>). Various other suitable ways in which tether (<NUM>) may be secured to waveguide (<NUM>) will be apparent to one having ordinary skill in the art in view of the teachings herein.

It should also be understood that any ranges of values referred to herein should be read to include the upper and lower boundaries of such ranges. For instance, a range expressed as ranging "between approximately <NUM> (<NUM> inches) and approximately <NUM> (<NUM> inches) should be read to include approximately <NUM> (<NUM> inches) and approximately <NUM> (<NUM> inches), in addition to including the values between those upper and lower boundaries.

Similarly, those of ordinary skill in the art will recognize that various teachings herein may be readily combined with various teachings of <CIT>.

Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by an operator immediately prior to a procedure.

Claim 1:
An apparatus comprising:
(a) a shaft assembly defining a longitudinal axis, wherein the shaft assembly comprises:
(i) a first coupling member (<NUM>), and
(ii) a second coupling member (<NUM>), wherein the first coupling member (<NUM>) and the second coupling member (<NUM>) are configured to flex toward each other from a first position to a second position, wherein the first coupling member (<NUM>) and the second coupling member (<NUM>) define a pivot axis in the first position, wherein the first coupling member (<NUM>) and the second coupling member (<NUM>) define a longitudinal channel (<NUM>), wherein the longitudinal channel (<NUM>) is wider in the first position than the second position; and
(b) an end effector (<NUM>) comprising:
(i) an ultrasonic blade (<NUM>) extending from the shaft assembly,
(ii) a clamp arm (<NUM>) configured to couple or decouple with the shaft assembly when the first coupling member and the second coupling member (<NUM>) are in the second position, wherein the clamp arm (<NUM>) is configured to pivot toward and away from the ultrasonic blade (<NUM>) about the pivot axis when the first coupling member and the second coupling member (<NUM>) are in the first position;
characterized in that
the first coupling member (<NUM>) comprises a tab (<NUM>), wherein the tab (<NUM>) extends over the longitudinal channel (<NUM>) toward the second coupling member (<NUM>).