Ultrasonic surgical shears and tissue pad for same

[0001] Field of the invention [0002] The invention generally relates to surgical instruments, and more particularly to surgical instruments and ultrasonic surgical scissors overlays.

[0003] Background of the invention [0004] Ultrasonic surgical tools are known which include ultrasonic surgical scissors having an ultrasonic surgical blade, a clamping arm operating to open and close towards the blade, and a polytetrafluoroethylene tissue protective cap that is attached to the clamping arm , and which includes a clamping surface. The clamping arm exerts a clamping force on the blood vessel, which is located between the clamping surface of the tissue protector and the blade. The result of the ultrasonic-vibrating impact of the ultrasonic surgical blade and the clamping force on the blood vessel is anastomosis of the blood vessel (connecting the walls of the blood vessel), cutting (cutting) of the complex blood vessel, and coagulation (sealing) of the cut endings of the blood vessel. At the end of tissue dissection, the ultrasonic vibrating ultrasonic surgical blade contacts and cuts off a fragment of the polytetrafluoroethylene tissue protector under the influence of friction and heat of friction generated by the vibrating blade on the tissue protector. Exemplary devices are described in US Patent Nos. 5,322,055 and 6,325,811. US-A-6129735 discloses an ultrasonic treatment device comprising the distal portion of the probe formed as an integral part either independently of the probe at the distal end of the probe, the jaws opposite the distal portion of the probe, so that the jaws can open or close freely, and a thin plate placed on the jaw or the clamping side of the clamping part of the jaw, on which the clamping part is in contact with live tissue, or a flexible element arranged between the supporting part and the clamping part of the jaw.

[0005] In addition, scientists and engineers are still working on improved ultrasonic surgical scissors and improved tissue protective caps for ultrasonic surgical scissors.

Summary of the Invention [0007] The first embodiment of the tissue protector of the ultrasonic surgical scissors according to the invention comprises the body of the tissue protector of the ultrasonic surgical scissors according to claim 1, having a base material and at least one filling material which is a different material than the base material. Preferred embodiments are disclosed in the dependent claims. [0008] Many advantages and advantages are obtained from one or more embodiments of the invention. The tissue protective overlay with the base material and at least one filling material allows the selection of the base material and at least one filling material with different hardness, stiffness, lubricity, dynamic coefficient of friction, heat transfer coefficient, abrasion, heat deformation temperature, and / or melting point, to improve the wear resistance of the tissue protector, which is of great importance when high clamping forces are exerted, because the tissue protective caps wear faster at higher clamping forces than at lower clamping forces. Applicants, during one experiment, found that the 15% graphite-filled polytetrafluoroethylene tissue protector showed essentially the same wear at 3 kg (7 pounds) of clamping force as the 100% polytetrafluoroethylene tissue protector showed at 0.7 kg (1.5 pounds) clamping forces. The flexible clamping arm and / or flexible tissue protector should also improve the wear resistance of the tissue protector due to the ability of the flexible element to distribute the load more evenly over the entire surface of the tissue protector.

[0009] The invention is, without limitation, applicable to straight or curved ultrasonic surgical blades as disclosed in the patents incorporated herein by reference, and furthermore in hand tools as well as in automatic robot devices.

[0010] Brief Description of the Figures [0011] FIG. 1 is a cross-sectional view of a portion of a first embodiment of a tissue protector of an ultrasonic surgical scissors according to the invention;

[0012] FIG. 2 is a cross-sectional view of a portion of a second embodiment of a tissue protector of an ultrasonic surgical scissors according to the invention;

[0013] FIG. 3 is a plan view of the first alternative embodiment of the tissue protector of FIG. 2;

[0014] FIG. 4 is a plan view of a second alternative embodiment of the tissue protector cap of FIG. 2;

[0015] FIG. 5 is a plan view of a third additional alternative embodiment of the tissue protector cap of FIG. 2;

[0016] FIG. 6 is a schematic elevational view of a portion of an embodiment of the ultrasonic surgical scissors according to the invention;

[0017] FIG. 7 is a schematic elevational view of a portion of an alternative embodiment of the ultrasonic surgical scissors according to the invention.

[0018] Detailed description of the invention [0019] Before explaining the invention in detail, it should be noted that the invention is not limited in its application or use to the details of the structure and arrangement of the parts shown in the accompanying drawings and description. Illustrative embodiments of the invention may be implemented or incorporated into other embodiments, changes and modifications, and may be applied or implemented in various ways. In addition, unless otherwise indicated, the terms and expressions used herein have been selected only to properly describe the embodiments of the invention for the convenience of the reader and are not intended to limit the scope of the invention.

[0020] It is clear that any one or more of the following embodiments, forms, etc. can be combined with one or more of the embodiments, forms, etc. described below.

[0021] Referring to the figures in which like reference numerals indicate like elements, FIG. 1 shows a first embodiment of a tissue protector 10 of the ultrasonic surgical scissors according to the invention. The tissue protector 10 of the ultrasonic surgical scissors has a body 12 of the tissue protector the ultrasonic surgical scissors 12 comprising a base material 14 and at least one filling material 16 which is a different material than the base material 14.

[0022] In one example according to an embodiment of the tissue protector 10 of the ultrasonic surgical scissors of FIG. 1, at least one filling material 16 has at least one property that has a different value from at least one property of the base material 14, wherein at least one property is selected from the group consisting of: hardness, stiffness, lubricity, dynamic coefficient of friction , heat transfer coefficient, abrasion, thermal deformation temperature, and melting point. In one variation, at least two or more or all of the properties have different values ​​for the base material 14 and at least one filling material 16.

[0023] In one representation of the tissue protector 10 of the ultrasonic surgical scissors of FIG. 1, the base material 14 has a thermal deformation temperature greater than 500 K (500 degrees Fahrenheit). In the same or another representation, the base material 14 has a melting point greater than 600K (700 degrees Fahrenheit). In the same or another representation, the base material 14 has a dynamic coefficient of friction of less than 0.3 at velocity and pressure values ​​greater than 4000 kilograms per second (30,000 foot pounds per second). In one choice of materials, the protective cap material 10 of the ultrasonic surgical scissors of FIG. 1, the base material 14 consists essentially of thermosetting plastic. In one embodiment, the base material 14 consists essentially of a polyimide material.

In one example of the invention, the at least one filling material 16 has a hardness that is different from that of the base material 14. In the same or different example, at least one filling material 16 has a stiffness that is different from that of base material 14. In the same or different example, at least one filler material 16 has a lubricity that is different from that of base material 14. In the same or different example, at least one filler material 16 has a dynamic coefficient of friction that is different from that of the base material 14. In the same or different example, at least one filler material 16 has a heat transfer coefficient that is different from the one for the base material 14. In the same or another example, the at least one filler material 16 has an abrasion that is different from that for the base material 14. In the same or different example, the at least one filling material 16 has a heat deformation temperature that is different from that of the base material 14. In the same or different example, at least one filling material 16 has a melting point that is different from that for base material 14.

[0025] In one example of the invention, the at least one filler material 16 is selected from the group consisting of glass, carbon fiber, graphite, metal particles, molybdenum disulphide, lubricating liquid, solid material that changes at a higher temperature to be more lubricious powder, solid that turns into a liquid at elevated temperature, carbon nanotubes, polyphenylene sulfone, polyphenylene sulfide, Sumifine powder, boron nitride, polytetrafluoroethylene powder, silicone oil and airgel.

[0026] In the same or another example according to the invention, the base material 14 is selected from the group consisting of plastic, porous ceramics, polished ceramics, nanocomposite with an ordered structure (a material that is a combination of two or more materials which, after curing , form a predefined matrix), highly cross-linked polytetrafluoroethylene, a metal having at least as hard as tantalum, a fluorinated polyimide, polymer with clay forming nanocomposite (these are materials that are filled with a small amount of clay material, whereby the clay material is combined with the polymer molecule to obtain a material with improved properties relative to the original polymer material such as a composite nylon with clay that exhibits deformation temperature heat by at least 300 K (100 degrees Fahrenheit) higher than that of regular nylon material), and polyimide material. In one embodiment, the plastic is selected from the group consisting of polytetrafluoroethylene and polyimide. In one modification, essentially 85% of the body of the ultrasound tissue protector of the surgical blade consists essentially of base material 14 and substantially 15% of the body of the ultrasonic tissue protector of the blade consists essentially of at least one filling material 16, wherein the base material 14 is essentially polytetrafluoroethylene, and wherein the at least one filler material 16 is substantially graphite.

[0027] In one embodiment of the invention, the body 12 of the protective tissue cover of the ultrasonic surgical scissors comprises a base material 14 and at least one filling material 16, wherein the base material 14 is selected from the group consisting of plastic, porous ceramics, polished ceramics, strength-increasing nanocomposite, highly cross-linked polytetrafluoroethylene, a metal having a hardness at least as low as tantalum, fluorinated polyimide, clay polymer forming nanocomposite, and polyamide.

In one configuration not shown according to the invention, the body of the protective cap of the tissue of the ultrasonic surgical scissors consists essentially of a material selected from the group consisting of porous ceramics, polished ceramics, strength-increasing nanocomposite, highly cross-linked polytetrafluoroethylene, a metal having a hardness at least low as tantalum, fluorinated polyimide, clay polymer forming nanocomposite, and polyamide.

[0029] In one embodiment of the invention, the tissue protector body 12 of the ultrasonic surgical scissors includes a base material 14 and at least one filling material 16, wherein the base material 14 consists essentially of a porous polymer, and wherein at least one filling material 16 is selected from the group consisting essentially of grease, lubricating liquid, and grease, which turns into a lubricating liquid at elevated temperatures.

[0030] In one system according to the invention, not shown, the body of the protective cover of the ultrasonic surgical scissors consists essentially of a porous absorbent material which, on contact, absorbs the patient's body fluids in the body of the protective cover of the ultrasonic surgical scissors or absorbs water after immersion in water containing solution such as saline. These materials improve the temperature performance of the tissue protector body by absorbing some of the heat energy to evaporate the water trapped in the tissue protector body.

[0031] FIG. 2 shows a second embodiment of a tissue protector 18 of the ultrasonic surgical scissors according to the invention. The tissue protector of the ultrasonic surgical scissors 18 has a body 20 of the tissue protector of the ultrasonic surgical scissors having an adjacent first and second area 24 and 26, wherein the first area 24 includes the first material 28 and the second area 26 includes the second material 30, which is another material than the first material 28. The above description of the tissue protector 18 of FIG. 2 has the same use in the tissue protective caps of FIG. 3-5, as is apparent to those skilled in the art from the discussion of tissue protector caps of FIG. 3-5. In one embodiment, the tissue protector 18 of FIG. 2, the first area 24 consists essentially of the first material 28 and the second area 26 consists essentially of the second material 30. In a further embodiment, the first area 24 comprises a base material and at least one filling material, wherein the base material is the first material 28. In the same or different variant, the second area 26 comprises a base material and at least one filling material, wherein the base material is a second material 30.

[0032] In one structure of the tissue protector 18 of FIG. 2, the interface between the first and second areas 24 and 26 of the tissue protector body 20 is substantially perpendicular to the clamping surface 22 of the tissue protector body 20 as shown in the figures. In another construction, not shown, the interface between the first and second areas is substantially parallel to the clamping surface (this can be visualized by turning the tissue protector 18 of FIG. 2 by ninety degrees). In an additional design, not shown, the contact surface is inclined relative to the clamping surface at an angle between substantially 1 and 89 degrees, as will be apparent to those skilled in the art.

[0033] It should be noted that the forms, material choices, etc. described for embodiments of the tissue protector 10 of the ultrasonic surgical scissors of FIG. 1 have the same use in the embodiments of the protective cover 18 of the tissue of the ultrasonic surgical scissors of FIG. 2, wherein "first material 28" replaces "base material 14" and "second material 30" replaces "at least one filling material 16".

[0034] FIG. 3 is an external plan view of the tissue protector 118, which is the first alternative embodiment of the tissue protector 18 of FIG. 2. The tissue protector 118 includes a tissue protector body 120 having an adjacent first and second area 124 and 126 as shown in the figures. The first area 124 includes the first material 128, and the second area 126 includes the second material 130, which is a different material from the first material. In one embodiment, the clamping surface 122 of the body 120 of the tissue protector 120 consists essentially of a first material 128, which extends from the clamping surface 122 toward the second of the areas 126. In one example, the transverse material between the second area 126 is the first material

128 first area 124.

In another example, not shown, the third area with the third material is positioned transversely between the second areas.

[0035] FIG. 4 is an external plan view of the tissue protector 218, which is a second alternative embodiment of the tissue protector 18 of FIG. 2.

The tissue protective cap 218 includes a tissue protective cap body 220 having adjacent first and second regions 224 and 226 as shown in the figures. The first area 224 includes the first material 228, and the second area 226 includes the second material 230, which is a different material from the first material. In one embodiment, the clamping surface 222 of the tissue protector body 220 consists essentially of a first material 228 that extends from the clamping surface 222 toward the second of areas 226. In one example, the material transversely positioned between the second of areas 226 is the first material 228 first area 224. In a further example, not shown, the third area with the third material is positioned transversely between the second areas.

[0036] FIG. 5 is an external plan view of the tissue protector 318, which is a third alternative embodiment of the tissue protector 18 of FIG. 2. The tissue protector 318 includes a tissue protector body 320 having adjacent first and second regions 324 and 326 as shown in the figures. The first area 324 includes the first material 328, and the second area 326 includes the second material 330, which is a different material from the first material. In one embodiment, the clamping surface 322 of the body 320 of the tissue protective pad consists essentially of a first material 328 that extends from the clamping surface 322 toward the second of the areas 326. In one application, the tissue protective pad 318 improves the durability of the pad by that the first area 324 is protective and abrasive or melted fairly quickly, but has certain properties, such as lubricity, that are desired. Ultrasonic surgical blade, not shown in FIG. 5, travels through the first material 318 and then contacts the second material 330. The second material 330 is selected such that its properties cause it to wear or melt less than the first material 318.

[0037] It will be appreciated that the examples, forms, material selections, etc. described in the embodiments of the tissue protector 18 of FIG. 2 can be used in the same way in the embodiments of the tissue protector 118, 218 and 318 of the tissue of FIG. 3-5. Other alternative embodiments of the tissue protective cover 18 are left to the skilled person. [0038] FIG. 6 shows a first embodiment of an ultrasonic surgical scissors 32 according to the invention. The ultrasonic surgical shears 32 include an ultrasonic surgical blade 34 and a clamping arm 36 operating to open and close towards the blade 34 and having a laterally and elastically flexible distal end 38. By "resiliently flexible distal end" is meant that distal end 38 resiliently bends when clamping the clamping arm 36 for example when ultrasonic surgical shears 32 are used to cut and seal a blood vessel positioned between clamping surface 42 and ultrasonic surgical blade 34, whose walls have been joined by the clamping force exerted by the clamping arm 36. In one implementation of the first example, the ultrasonic surgical scissors 32 also include a tissue protector 40 attached to the clamping arm 36 and having a clamping surface 42, the tissue protective covering being resiliently flexible in a direction substantially perpendicular to the clamping surface 42. In one representation of the embodiment of the ultrasonic surgical scissors 32, the tissue protective cover 40 includes the base material and at least one filling material as described above for the tissue protective cover 10 of FIG.

1. In another representation of the ultrasonic surgical scissors 32, the tissue protective cover 40 includes a first material and a second material as described above for the tissue protective cover 18, 118, 218 or 318 of FIG. 2-5. [0039] FIG. 7 shows a second embodiment of an ultrasonic surgical scissors 44 according to the invention. Ultrasonic surgical scissors 44 include an ultrasonic surgical blade 46, a clamping arm 48 operating to open and close towards the blade 46, and a tissue protective cover 50. The tissue protective cover 50 is attached to the clamping arm 48 and has a clamping surface 52. At least a portion of the tissue protective cover 50 is resiliently flexible in a direction substantially perpendicular to the clamping surface 52. By "elastically flexible" it is meant that the tissue protective cover 50 flexibly flexes when clamping the clamping arm 48, for example, when ultrasonic surgical scissors 44 are used to cut and seal a blood vessel located between the clamping surface 52 and the ultrasonic surgical blade 46, which the walls are joined by the clamping force exerted by the clamping arm 48. In one representation of an embodiment of the ultrasonic surgical scissors 44, the tissue protector 50 includes the base material and at least one filler material as described above for the tissue protector 10 of FIG. 1. In a further representation of the ultrasonic surgical scissors 44, the tissue protective cover 40 includes the first material and the second material as described above for the protective cover 18, 118, 218 or 318 of the tissue of FIG. 2-5.

[0040] Many advantages and advantages are obtained from one or more embodiments of the invention. The tissue protective overlay with the base material and at least one filling material allows the selection of the base material and at least one filling material with different hardness, stiffness, lubricity, dynamic coefficient of friction, heat transfer coefficient, abrasion, heat deformation temperature, and / or melting point, to improve the wear resistance of the tissue protector, which is of great importance when high clamping forces are exerted, because the tissue protective caps wear faster at higher clamping forces than at lower clamping forces. Applicants, during one experiment, found that the 15% graphite-filled polytetrafluoroethylene tissue protector showed essentially the same wear at 3 kg (7 pounds) of clamping force as the 100% polytetrafluoroethylene tissue protector showed at 0.7 kg (1.5 pounds) clamping forces. The flexible clamping arm and / or flexible tissue protector should also improve the wear resistance of the tissue protector due to the ability of the flexible element to distribute the load more evenly over the entire surface of the tissue protector.

[0041] Although the invention has been presented by describing several embodiments, it is not the intention of the applicants to limit or narrow the scope of the appended claims to these details. Numerous other variants, changes and equivalents will be apparent to those skilled in the art without departing from the scope of the invention. For example, the ultrasonic surgical scissors and tissue protector of the invention are applicable to robot-based surgery taking into account obvious modifications to these systems, components and methods compatible with such a robot system. It is clear that the above description is given by way of example and that other modifications are apparent to those skilled in the art without departing from the scope of the appended claims.

23971 / EP / 14

EP 1 729 656