Combination ultrasonic and electrosurgical instrument with clamp arm electrodes

Abstract

A surgical instrument includes an ultrasonic transducer, a distally extending shaft, and an end effector at a distal end of the shaft. The end effector includes an ultrasonic blade and a clamp arm. The ultrasonic blade includes an upper treatment side, a lower treatment side, a first lateral side, and a second lateral side. The clamp arm is movable relative to the ultrasonic blade for clamping tissue therebetween, and the clamp arm provides an RF electrode operable to seal the tissue with RF energy. The RF electrode includes a first electrode side portion and a second electrode side portion. The first electrode side is spaced laterally outwardly from a first lateral side of the ultrasonic blade by a first lateral gap distance. The second electrode side is spaced apart from the first electrode side and is laterally outwardly spaced apart from a second lateral side of the ultrasonic blade by a second lateral gap distance.

Description

[0001] This application is a divisional application of International Application PCT / US2018 / 033608, titled "Combined Ultrasonic and Electrosurgical Instrument with Clamping Arm Electrodes", with Chinese Application No. 2018800337524, which entered the Chinese national phase on November 21, 2019.

[0002] This application claims the benefit of U.S. Provisional Application No. 62 / 509,351, titled "Ultrasonic Instrument With Electrosurgical Features", filed on May 22, 2017, the disclosure of which is incorporated herein by reference. Background Art

[0003] Ultrasonic surgical instruments utilize ultrasonic energy for both precise cutting and controlled coagulation of tissue. The ultrasonic energy cuts and coagulates by vibrating a blade that contacts the tissue. For example, vibrating at a frequency of approximately 50 kilohertz (kHz), the ultrasonic blade denatures proteins in the tissue to form a viscous coagulum. The pressure applied to the tissue through the blade surface collapses blood vessels and allows the coagulum to form a hemostatic seal. The precision of cutting and coagulation can be controlled by the surgeon's technique and adjustments to, for example, power level, blade edge, tissue traction, and blade pressure.

[0004] Examples of ultrasonic surgical devices include HARMONIC ultrasonic shears, HARMONIC ultrasonic shears, HARMONIC ultrasonic shears and HARMONIC Harmonic scalpels, all of which are obtained from Ethicon Endo-Surgery, Inc. (Cincinnati, Ohio). Other examples and related concepts of such devices are disclosed in the following patents: U.S. Patent No. 5,322,055, entitled "Clamp Coagulator / Cutting System for Ultrasonic Surgical Instruments," published on June 21, 1994, the disclosure of which is incorporated herein by reference; U.S. Patent No. 5,873,873, entitled "Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism," published on February 23, 1999, the disclosure of which is incorporated herein by reference; U.S. Patent No. 5,980,510, entitled "Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Arm Pivot Mount," published on November 9, 1999, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,283,981, entitled "Method of Balancing Asymmetric Ultrasonic Surgical Blades," published on September 4, 2001, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,309,400, entitled "Curved Ultrasonic Blade having a Trapezoidal Cross Section," published on October 30, 2001, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,325,811, entitled "Blades with Functional Balance Asymmetries for use with Ultrasonic Surgical Instruments," published on December 4, 2001, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,423,082, entitled "Ultrasonic Surgical Blade with Improved Cutting and Coagulation Features," published on July 23, 2002, the disclosure of which is incorporated herein by reference;U.S. Patent 6,773,444, entitled "Blades with Functional Balance Asymmetries for Use with Ultrasonic Surgical Instruments," published on August 10, 2004, the disclosure of which is incorporated herein by reference; U.S. Patent 6,783,524, entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," published on August 31, 2004, the disclosure of which is incorporated herein by reference; U.S. Patent 8,057,498, entitled "Ultrasonic Surgical Instrument Blades," published on November 15, 2011, the disclosure of which is incorporated herein by reference; U.S. Patent 8,461,744, entitled "Rotating Transducer Mount for Ultrasonic Surgical Instruments," published on June 11, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent 8,591,536, entitled "Ultrasonic Surgical Instrument Blades," published on November 26, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent 8,623,027, entitled "Ergonomic Surgical Instruments," published on January 7, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent 9,095,367, entitled "Flexible Harmonic Waveguides / Blades for Surgical Instruments," published on August 4, 2015, the disclosure of which is incorporated herein by reference; and U.S. Publication 2016 / 0022305, entitled "Ultrasonic Blade Overmold," published on January 28, 2016, the disclosure of which is incorporated herein by reference.;

[0005] Electrosurgical instruments utilize electrical energy to seal tissue and typically include a distally-mounted end effector that can be configured for bipolar or monopolar operation. During bipolar operation, current is passed through the tissue by way of an active electrode and a return electrode of the end effector. During monopolar operation, current is passed through the tissue by way of an active electrode of the end effector and a return electrode (e.g., a grounding pad) that is separately disposed on the patient's body. The heat generated by the current flowing through the tissue can form a hemostatic seal within and / or between tissues and can thus be particularly applicable, for example, to sealing blood vessels. The end effector of an electrosurgical device can also include a cutting member that is capable of moving relative to the tissue and an electrode for transecting the tissue.

[0006] The electrical energy applied by an electrosurgical device can be transferred from a generator coupled to the instrument. The electrical energy can be in the form of radiofrequency (“RF”) energy, which is a form of electrical energy typically in the frequency range of about 300 kilohertz (kHz) to 1 megahertz (MHz). In use, the electrosurgical device can pass lower-frequency RF energy through the tissue, which causes ionic oscillations or friction and effectively creates resistive heating, thereby raising the temperature of the tissue. Because a distinct boundary is formed between the affected tissue and the surrounding tissue, the surgeon can operate with high precision and control without damaging adjacent non-target tissue. The low operating temperature of RF energy can be suitable for removing soft tissue, contracting soft tissue, or shaping soft tissue while sealing blood vessels. RF energy is particularly effective for connective tissue, which is mainly composed of collagen and contracts when exposed to heat.

[0007] Examples of radiofrequency electrosurgical devices are those manufactured by Ethicon Endo-Surgery, Inc. (Cincinnati, Ohio) Tissue sealing device. Other examples of electrosurgical devices and related concepts are disclosed in the following U.S. patents: U.S. Patent No. 6,500,176, entitled "Electrosurgical Systems and Techniques for Sealing Tissue," published on December 31, 2002, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,112,201, entitled "Electrosurgical Instrument and Method of Use," published on September 26, 2006, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,125,409, entitled "Electrosurgical Working End for Controlled Energy Delivery," published on October 24, 2006, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,169,146, entitled "Electrosurgical Probe and Method of Use," published on January 30, 2007, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,186,253, entitled "Electrosurgical Jaw Structure for Controlled Energy Delivery," published on March 6, 2007, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,189,233, entitled "Electrosurgical Instrument," published on March 13, 2007, the disclosure of which is incorporated herein by reference; U.S. Patent 7,220,951, entitled "Surgical Sealing Surfaces and Methods of Use," published on May 22, 2007, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,309,849, entitled "Polymer Compositions Exhibiting a PTC Property and Methods of Fabrication," published on December 18, 2007, the disclosure of which is incorporated herein by reference; U.S. Patent No., entitled "Electrosurgical Instrument and Method of Use," published on December 25, 2007U.S. Patent No. 7,311,709, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,354,440, entitled "Electrosurgical Instrument and Method of Use", published on April 8, 2008, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,381,209, entitled "Electrosurgical Instrument", published on June 3, 2008, the disclosure of which is incorporated herein by reference.

[0008] Other examples of electrosurgical devices and related concepts are disclosed in the following U.S. patents: U.S. Patent No. 8,939,974, entitled “Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism,” published on January 27, 2015, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,161,803, entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” published on October 20, 2015, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2012 / 0078243, entitled “Control Features for Articulating Surgical Device,” published on March 29, 2012, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,402,682, entitled “Articulation Joint Features for Articulating Surgical Device,” published on August 2, 2016, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,089,327, entitled “Surgical Instrument with Multi-Phase Trigger Bias,” published on July 28, 2015, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,545,253, entitled “Surgical Instrument with Contained Dual Helix Actuator Assembly,” published on January 17, 2017, the disclosure of which is incorporated herein by reference; and U.S. Patent No. 9,572,622, entitled “Bipolar Electrosurgical Features for Targeted Hemostasis,” published on February 21, 2017, the disclosure of which is incorporated herein by reference.

[0009] Some instruments can provide ultrasonic and RF energy treatment capabilities through a single surgical device. Examples of such devices and related methods and concepts are disclosed in the following patents: U.S. Patent 8,663,220, entitled "Ultrasonic Surgical Instruments," published on March 4, 2014, the disclosure of which is incorporated herein by reference; U.S. Publication 2015 / 0141981, entitled "Ultrasonic Surgical Instrument with Electrosurgical Feature," published on May 21, 2015, the disclosure of which is incorporated herein by reference; and U.S. Publication 2017 / 0000541, entitled "Surgical Instrument with User Adaptable Techniques," published on January 5, 2017, the disclosure of which is incorporated herein by reference.

[0010] Although various types of ultrasonic surgical instruments and electrosurgical instruments have been manufactured and used, it is believed that no one has made or used the invention described herein prior to the present inventors. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The drawings incorporated in and forming a part of this specification illustrate embodiments of the invention and, together with the general description of the invention given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.

[0012] Figure 1 A perspective view of an exemplary surgical system depicting a generator and a surgical instrument operable to treat tissue with ultrasonic energy and bipolar RF energy;

[0013] Figure 2 Depicts Figure 1 A top perspective view of the end effector of the surgical instrument of , having a clamping arm providing a first electrode and an ultrasonic blade providing a second electrode;

[0014] Figure 3 Depicts Figure 2 A bottom perspective view of the end effector of ;

[0015] Figure 4 Depicts Figure 1 A partial exploded perspective view of the surgical instrument of ;

[0016] Figure 5 Depicts Figure 1 An enlarged exploded perspective view of the distal portion of the shaft assembly of the surgical instrument of and the end effector;

[0017] Figure 6 Depicts Figure 1Side elevation view of the distal portion of the inner tube of the shaft assembly of a surgical instrument;

[0018] Figure 7 Depicts Figure 1 Perspective view of the ultrasonic scalpel and the distal portion of the shaft assembly of a surgical instrument, wherein the clamping arms are hidden from view;

[0019] Figure 8 Depicts Figure 7 Top elevation view of the distal portion of the ultrasonic scalpel and the shaft assembly of;

[0020] Figure 9 Depicts a cross-section taken along Figure 8 section line 9-9 of Figure 7 ultrasonic scalpel;

[0021] Figure 10 Depicts Figure 1 Schematic cross-sectional end view of the end effector of a surgical instrument, showing clamping arms having clamping pads and first and second electrode portions on either side of the clamping pads, indicating the lateral width of each electrode portion and the side clearance distance between each electrode portion and the respective lateral sides of the ultrasonic scalpel;

[0022] Figure 11 Depicts Figure 10 Bottom elevation view of an exemplary variant of the end effector, the variant including clamping arms having first and second electrode portions, the first and second electrode portions each maintaining a uniform lateral width and a uniform side clearance distance along the tissue treatment portion of the ultrasonic scalpel;

[0023] Figure 12 Depicts Figure 10 Bottom elevation view of another exemplary variant of the end effector, the variant including clamping arms having first and second electrode portions, the first and second electrode portions each maintaining a uniform lateral width and a non-uniform side clearance distance that increases distally;

[0024] Figure 13 Depicts Figure 10 Bottom elevation view of another exemplary variant of the end effector, the variant including clamping arms having first and second electrode portions, the first and second electrode portions having a non-uniform lateral width that increases distally and a non-uniform side clearance distance that increases distally; and

[0025] Figure 14 Depicts Figure 10 Bottom elevation view of another exemplary variant of the end effector, the variant including clamping arms having first and second electrode portions, the first and second electrode portions having distally separated distal ends.

[0026] The accompanying drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the present invention may be carried out in many other ways, including those not necessarily shown in the accompanying drawings. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the present invention and, together with the description, serve to explain the principles of the present invention; however, it should be understood that the present invention is not limited to the specific arrangements shown. Detailed Description

[0027] The following description of certain examples of the present invention should not be used to limit the scope of the present invention. Other examples, features, aspects, embodiments, and advantages of the present invention will be apparent to those skilled in the art from the following description, which is presented by way of example. A best mode is contemplated for carrying out the present invention. As will be recognized, the present invention is capable of having other different and obvious aspects, all of which do not depart from the present invention. Accordingly, the drawings and description are to be regarded as illustrative in nature and not restrictive.

[0028] For the sake of clarity of disclosure, the terms "proximal" and "distal" are defined herein relative to a surgeon or other operator grasping a surgical instrument having a distal surgical end effector. The term "proximal" refers to the position of an element that is arranged closer to the surgeon, and the term "distal" refers to the position of an element that is arranged closer to the surgical end effector of the surgical instrument and farther from the surgeon. In addition, to the extent that spatial terms such as "upper", "lower", "vertical", "horizontal", etc. are used herein with reference to the accompanying drawings, it should be understood that such terms are for illustrative description purposes only and are not intended to be limiting or absolute. In this regard, it should be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions that are not limited to those shown and described herein.

[0029] I. Exemplary Surgical System

[0030] Figure 1 An exemplary surgical system (10) is depicted that includes a generator (12) and a surgical instrument (14). The surgical instrument (14) is operatively coupled to the generator (12) via a power cable (16). As described in more detail below, the generator (12) is operable to power the surgical instrument (14) to deliver ultrasonic energy for cutting tissue and electrosurgical bipolar RF energy (i.e., therapeutic level RF energy) for sealing tissue. In an exemplary configuration, the generator (12) is configured to power the surgical instrument (14) to simultaneously deliver ultrasonic energy and electrosurgical bipolar RF energy.

[0031] A. Overview of an Exemplary Surgical Instrument with Ultrasonic and Electrosurgical Features

[0032] The surgical instrument (14) of this example includes a handle assembly (18), a shaft assembly (20) extending distally from the handle assembly (18), and an end effector (22) disposed at the distal end of the shaft assembly (20). The handle assembly (18) includes a body (24) that includes a pistol grip (26) and energy control buttons (28, 30) configured to be manipulated by a surgeon. A trigger (32) is coupled to the lower portion of the body (24) and is pivotable toward and away from the pistol grip (26) to selectively actuate the end effector (22), as described in more detail below. For example, in other suitable variations of the surgical instrument (14), the handle assembly (18) may include a scissor grip configuration. As described in more detail below, an ultrasonic transducer (34) is housed within and supported by the body (24). In other configurations, the ultrasonic transducer (34) may be disposed external to the body (24).

[0033] As Figure 2 and Figure 3 shown, the end effector (22) includes an ultrasonic blade (36) and clamping arms (38) configured to selectively pivot toward and away from the ultrasonic blade (36) for clamping tissue therebetween. The ultrasonic blade (36) is acoustically coupled to an ultrasonic transducer (34) configured to drive (i.e., vibrate) the ultrasonic blade (36) at an ultrasonic frequency for cutting and / or sealing tissue positioned in contact with the ultrasonic blade (36). The clamping arms (38) are operatively coupled to the trigger (32) such that the clamping arms (38) are configured to pivot toward the ultrasonic blade (36) to a closed position in response to pivoting of the trigger (32) toward the pistol grip (26). Additionally, the clamping arms (38) are configured to pivot away from the ultrasonic blade (36) to an open position in response to pivoting of the trigger (32) away from the pistol grip (26) (see, for example Figures 1-3 ). Various suitable ways of coupling the clamping arms (38) to the trigger (32) will be apparent to those of ordinary skill in the art in light of the teachings provided herein. In some variations, one or more resilient members may be incorporated to bias the clamping arms (38) and / or the trigger (32) toward the open position.

[0034] The clamping pad (40) is fixed to the clamping side of the clamping arm (38) and extends distally along the clamping side so as to face the ultrasonic scalpel (36). The clamping pad (40) is configured to engage and clamp tissue against the corresponding tissue treatment portion of the ultrasonic scalpel (36) when the clamping arm (38) is actuated to its closed position. At least the clamping side of the clamping arm (38) provides a first electrode (42), herein referred to as the clamping arm electrode (42). Additionally, at least the clamping side of the ultrasonic scalpel (36) provides a second electrode (44), herein referred to as the blade electrode (44). As described in more detail below, the electrodes (42, 44) are configured to apply electrosurgical bipolar RF energy provided by the generator (12) to tissue that is electrically coupled to the electrodes (42, 44). The clamping arm electrode (42) can be used as the active electrode while the blade electrode (44) serves as the return electrode, or vice versa. The surgical instrument (14) can be configured to apply electrosurgical bipolar RF energy through the electrodes (42, 44) before and / or after vibrating the ultrasonic scalpel (36) at an ultrasonic frequency while vibrating the ultrasonic scalpel (36) at an ultrasonic frequency.

[0035] As Figures 1-5 shown, the shaft assembly (20) extends along a longitudinal axis and includes an outer tube (46), an inner tube (48) received within the outer tube (46), and an ultrasonic waveguide (50) supported within the inner tube (48). As Figures 2-5 best seen therein, the clamping arm (38) is coupled to the distal ends of the outer and inner tubes (46, 48). Specifically, the clamping arm (38) includes a pair of proximally extending connecting fork arms (52) that receive therebetween the distal end (54) of the inner tube (48) and are pivotally coupled to the distal end (54), where a pivot pin (56) is received within through holes formed in the connecting fork arms (52) and the distal end (54) of the inner tube (48). First and second connecting fork fingers (58) depend from the connecting fork arms (52) and are pivotally coupled to the distal end (60) of the outer tube (46). Specifically, each connecting fork finger (58) includes a protrusion (62) that is rotatably received within a corresponding opening (64) formed in the sidewall of the distal end (60) of the outer tube (46).

[0036] In this example, the inner tube (48) is longitudinally fixed relative to the handle assembly (18), and the outer tube (46) is configured to translate relative to the inner tube (48) and the handle assembly (18) along the longitudinal axis of the shaft assembly (20). When the outer tube (46) translates distally, the clamping arms (38) pivot about the pivot pin (56) toward their open positions. When the outer tube (46) translates proximally, the clamping arms (38) pivot in the opposite direction toward their closed positions. The proximal end of the outer tube (46) is operatively coupled to the trigger (32) via, for example, a linkage assembly such that actuation of the trigger (32) causes the outer tube (46) to translate relative to the inner tube (48), thereby opening or closing the clamping arms (38). In other suitable configurations not shown herein, the outer tube (46) may be longitudinally fixed and the inner tube (48) may be configured to translate for moving the clamping arms (38) between their open and closed positions.

[0037] The shaft assembly (20) and the end effector (22) may be configured to rotate together about the longitudinal axis relative to the handle assembly (18). As Figure 4 shown, the retaining pin (66) extends transversely through the proximal portions of the outer tube (46), the inner tube (48), and the waveguide (50), thereby rotatably coupling these components relative to each other. In this example, a rotation knob (68) is provided at the proximal end portion of the shaft assembly (20) to facilitate rotation of the shaft assembly (20) and the end effector (22) relative to the handle assembly (18). The rotation knob (68) is rotatably fixed to the shaft assembly (20) using the retaining pin (66) that extends through a proximal collar of the rotation knob (68). It should be understood that in other suitable configurations, the rotation knob (68) may be omitted or replaced with an alternative rotational actuation structure.

[0038] The ultrasonic waveguide (50) is acoustically coupled to the ultrasonic transducer (34) at its proximal end via, for example, a threaded connection, and is coupled to the ultrasonic scalpel (36) at its distal end, as Figure 5As shown. The ultrasonic knife (36) is shown integrally formed with the waveguide (50) such that the knife (36) extends distally directly from the distal end of the waveguide (50). In this way, the waveguide (50) acoustically couples the ultrasonic transducer (34) to the ultrasonic knife (36) and is used to transmit ultrasonic mechanical vibrations from the transducer (34) to the knife (36). Thus, the ultrasonic transducer (34), the waveguide (50), and the ultrasonic knife (36) together define an acoustic assembly (100). During use, the ultrasonic knife (36) can be positioned in direct contact with tissue and apply ultrasonic vibration energy to the tissue with or without an auxiliary clamping force provided by the clamping arm (38), and thereby cut and / or seal the tissue. For example, the knife (36) can cut through tissue clamped between the clamping arm (38) and the first processing side (204) of the knife (36), or the knife (36) can cut through tissue positioned in contact with the relatively arranged second processing side (206) of the knife (36), such as during a "back cut" movement. In some variations, the waveguide (50) can amplify the ultrasonic vibrations delivered to the knife (36). Additionally, the waveguide (50) can include various features capable of operating to control the gain of the vibrations and / or features adapted to tune the waveguide (50) to a selected resonant frequency. Additional exemplary features of the ultrasonic knife (36) and the waveguide (50) are described in more detail below.

[0039] The waveguide (50) is supported within the inner tube (48) by a plurality of nodal support elements (70) positioned along the length of the waveguide (50), as Figure 4 and Figure 5 shown. Specifically, the nodal support elements (70) are longitudinally positioned along the waveguide (50) at positions corresponding to the acoustic nodes defined by the resonant ultrasonic vibrations transmitted through the waveguide (50). The nodal support elements (70) can provide structural support to the waveguide (50) and provide acoustic isolation between the waveguide (50) and the inner and outer tubes (46, 48) of the shaft assembly (20). In an exemplary variation, the nodal support elements (70) can include O-rings. The waveguide (50) is supported at its most distal acoustic node by a nodal support element in the form of an overmolded member (72), as Figure 5 shown. For example, the waveguide (50) is longitudinally and rotationally fixed within the shaft assembly (20) by a retaining pin (66) that passes through a transverse through-hole (74) formed at an acoustic node (such as the most proximal acoustic node) disposed proximally on the waveguide (50).

[0040] In this example, the distal end (76) of the ultrasonic knife (36) is located at a position corresponding to an antinode associated with the resonant ultrasonic vibrations transmitted through the waveguide (50). Such a configuration enables the acoustic assembly (100) of the instrument (14) to be tuned to a preferred resonant frequency f when the ultrasonic knife (36) is not loaded with tissue. oWhen the ultrasonic transducer (34) is functioned by the generator (12) to transmit mechanical vibrations through the waveguide (50) to the blade (36), the distal end (76) of the blade (36) oscillates longitudinally, for example, at a vibration frequency f of approximately 50 kHz that is pre-determined, within a peak-to-peak range of approximately 20 microns to 120 microns, and in some cases, within a range of approximately 20 microns to 50 microns. When the ultrasonic blade (36) is positioned in contact with tissue, the ultrasonic oscillations of the blade (36) can simultaneously cut the tissue and denature proteins in adjacent tissue cells, thereby providing a coagulation effect with minimal heat dissipation. o As shown, the distal end (54) of the inner tube (48) can be radially offset outward relative to the remaining proximal portion of the inner tube (48). This configuration allows the pivot pin hole (78) that receives the clamping arm pivot pin (56) to be spaced further from the longitudinal axis of the shaft assembly (20) compared to a situation where the distal end (54) is flush with the remaining proximal portion of the inner tube (48). Advantageously, this provides an increased gap between the proximal portions of the clamping arm electrode (42) and the blade electrode (44), thereby reducing the risk of an undesired "short circuit" between the electrodes (42, 44) and their corresponding active and return circuit paths during a re-cut when the ultrasonic blade (36) flexes towards the clamping arm (38) and the pivot pin (56) in response to a normal force applied to the blade (36) by the tissue. In other words, when the ultrasonic blade (36) is used for a re-cut operation, the ultrasonic blade (36) can tend to deflect slightly away from the longitudinal axis of the shaft assembly (20) towards the pin (56). By spacing the pivot pin hole (78) further from the longitudinal axis compared to a situation where the distal end (54) of this example does not provide the radial offset, the distal end (54) provides additional lateral clearance between the pivot pin (56) and the ultrasonic blade (36), thereby reducing or eliminating the risk of contact between the ultrasonic blade (36) and the pivot pin (56) when the ultrasonic blade (36) deflects laterally during a re-cut operation. In addition to preventing a circuit short that would otherwise be caused by contact between the ultrasonic blade (36) and the pivot pin (56) when the end effector (22) is actuated to apply RF electrosurgical energy, the additional clearance prevents mechanical damage that would otherwise be caused by contact between the ultrasonic blade (36) and the pivot pin (56) when the ultrasonic blade (36) is ultrasonically vibrating.

[0041] As Figure 6 shown

[0042] B. Exemplary Ultrasonic Knife

[0043] Figures 7-9Additional details of the ultrasonic knife (36) of the surgical instrument (14) are shown. The ultrasonic knife (36) includes a tissue treatment portion that extends distally beyond the distal ends (54, 60) of the inner and outer tubes and terminates at a distal tip (76) having a rounded edge. The tissue treatment portion of the knife (36) is configured to contact and treat tissue using ultrasonic energy received through the ultrasonic waveguide (50). As Figure 8 shown, the tissue treatment portion of the knife (36) includes a proximal linear knife region (202) and a distal curved knife region (204) that extends distally from the linear knife region (202). The linear knife region (202) extends parallel to the longitudinal axis along which the waveguide (50) defined by the shaft assembly (20) extends. The curved knife region (204) extends along a curved path that laterally deflects away from the longitudinal axis in the distal direction. As Figure 8 best shown, the lateral dimension of the curved knife region (204) tapers distally towards the distal tip (76). As Figure 2 and Figure 3 shown, the shape of the clamping arm (38) may be similar to the treatment portion of the ultrasonic knife (36) in that the clamping arm (38) includes a proximal linear clamping portion and a distal curved clamping portion. In an alternative configuration, the ultrasonic knife (36) and the clamping arm (38) may be completely linear and extend parallel to the longitudinal axis.

[0044] The tissue treatment portion of the ultrasonic knife (36) includes an upper primary treatment side (206) that faces the clamping arm (38) (hidden from view) and is configured to compress tissue against the clamping arm (38). The tissue treatment portion also includes a lower secondary treatment side having a cutting edge (208) arranged opposite and away from the primary treatment side (206) from the clamping arm (38). The cutting edge (208) is configured to cut tissue during a back-cutting procedure. A first lateral knife side and a second lateral knife side (210, 212) extend between the primary treatment side (206) and the cutting edge (208). As Figure 9 The cross-sectional view of best shows that the primary treatment side (206) is convex and rounded. Additionally, each of the first lateral side and the second lateral side (210, 212) includes a swept side surface (214) that extends distally along its curved path through the distal portion of the linear knife region (202) and the entire curved knife region (204). As Figure 9 shown, the swept side surface (214) hangs down from the rounded treatment surface of the primary treatment side (206) and defines a profile of the ultrasonic knife (36) having lateral side edges that are generally parallel to each other.

[0045] The height of the ultrasonic blade (36) at a selected longitudinal position is defined by the maximum lateral distance measured between the processing side (206) and the cutting edge (208) at the selected position. The width of the ultrasonic blade (36) at a selected longitudinal position is defined by the maximum lateral distance measured between the first lateral side and the second lateral side (210, 212) at the selected position. As Figure 7 and Figure 8 shown, the shape of the curved blade region (204) is configured such that at its various longitudinal positions, including at the blade tip (76), the blade height is greater than the corresponding blade width. In other configurations, the blade height may be less than or equal to the blade width.

[0046] C. Exemplary Configuration of the Clamping Arm Electrode

[0047] Figure 10 A schematic cross-sectional end view of a tissue treatment portion of an end effector (22) of a surgical instrument (14) is shown, the tissue treatment portion including an ultrasonic blade (36) and a clamping arm (38) having a clamping pad (40). The clamping pad (40) extends distally along a centerline region of the clamping side of the clamping arm (38) and provides a clamping arm electrode (42). The clamping arm electrode (42) includes a first electrode side portion (280) extending distally along the first lateral side of the clamping pad (40) and a second electrode side portion (282) extending along the opposite second lateral side of the clamping pad (40). As Figure 10 shown, each clamping arm electrode side portion (280, 282) is formed to have a lateral electrode width (W) measured from the outer lateral edge to the inner lateral edge of the electrode side portion (280, 282), showing the corresponding lateral side adjacent to the clamping pad (40). The clamping pad (40) is formed to have a lateral pad width greater than the lateral width of the ultrasonic blade (36) so as to define a lateral clearance distance (G1) between the inner lateral edge of each clamping arm electrode side portion (280, 282) and the corresponding lateral side (210, 212) of the blade (36). The clamping pad (40) projects beyond the electrode side portions (280, 282) in the direction of the primary processing side (266) towards the blade (36). This configuration defines a vertical clearance distance (G2) between each electrode side portion (280, 282) and the clamping surface of the clamping pad (40) and thus the primary processing side (266) of the blade (36).

[0048] The optimal size of the lateral electrode width (W) provides sufficient electrode surface area for delivering bipolar RF energy sufficient to seal tissue, while preventing unwanted electrical sparks or arcs due to the electrode width (W) being too small. The optimal size of the gap distances (G1, G2) enables peak efficiency of the end effector (22). For example, the optimal size of the gap distances (G1, G2) prevents an unwanted short circuit between the ultrasonic blade (36) and the clamping arm (38) due to the gap distances (G1, G2) being too small, and further prevents unwanted electrical sparks or arcs and resulting inefficient RF energy transfer due to the gap distances (G1, G2) being too large. In an exemplary configuration, the lateral electrode width (W) of each clamping arm electrode side (280, 282) can be in the range of from about 0.007 inches to about 0.018 inches, such as, for example, about 0.018 inches. The lateral gap distance (G1) corresponding to each electrode side (280, 282) can be in the range of from about 0.002 inches to about 0.012 inches, such as, for example, about 0.007 inches or about 0.012 inches. Additionally, in various examples, the vertical gap distance (G2) corresponding to the electrode sides (280, 282) is greater than 0 and can be uniform and equal to each other along the entire length of the electrode sides (280, 290).

[0049] Exemplary variations of the clamping arm (38) and their dimensional configurations are described below, each of which is configured to operate in a manner similar to the clamping arm (38) and is adapted to be used with the surgical instrument (14). Additionally, the lateral electrode width (W) and gap distances (G1, G2) of the additional clamping arm configurations described below can fall within the exemplary ranges described above. Those skilled in the art will appreciate that various additional variations of the clamping arm (38) incorporating any one or more of the exemplary clamping arm electrode features described below can be used in combination with the surgical instrument (14).

[0050] Figure 11 Shown in accordance with Figure 10The end effector (290) including the ultrasonic scalpel (36) and the clamping arm (292) of the first exemplary variant of the clamping arm (38). The clamping arm (292) is similar to the clamping arm (38) in that the clamping arm (292) includes a centrally positioned clamping pad (294) and a first clamping arm electrode side portion and a second clamping arm electrode side portion (296, 298) extending distally along the respective lateral sides of the clamping pad (294). The distal ends of the clamping arm electrode side portions (296, 298) are joined together by a distal electrode bridge portion (299). As shown, the lateral electrode width (W) of each electrode side portion (296, 298) is uniform along the entire length of the treatment portion of the ultrasonic scalpel (36) and is equal to the other. Similarly, the lateral gap distance (G1) corresponding to each electrode side portion (296, 298) is uniform along the entire length of the tissue treatment portion of the ultrasonic scalpel (36) and is equal to the other. The lateral electrode width W and the lateral gap distance G can fall within the ranges described above.

[0051] Figure 12 Shows according to Figure 10 The end effector (300) including the ultrasonic scalpel (36) and the clamping arm (302) of the second exemplary variant of the clamping arm (38). The clamping arm (302) is similar to Figure 11 the clamping arm (292) in that the clamping arm (302) includes a centrally positioned clamping pad (304) and a first clamping arm electrode side portion and a second clamping arm electrode side portion (306, 308) extending distally along the respective lateral sides of the clamping pad (304), and are joined at their distal ends by an electrode bridge portion (309). The clamping arm (302) is further similar to the clamping arm (292) in that the lateral electrode width (W) of each electrode side portion (306, 308) is uniform along the entire length of the tissue treatment portion of the ultrasonic scalpel (36) and is equal to the other.

[0052] The clamping arm (302) differs from the clamping arm (292) in that the lateral clearance distance (G1) of each electrode side (306, 308) is non-uniform along the length of the tissue treatment portion of the blade (36). Specifically, the lateral clearance distance (G1) flares or increases distally along the distal portion of the curved region (204) of the blade (36). In the present example, the lateral clearance distance (G1) of the electrode side (308) increases distally at a greater rate than the lateral clearance distance (G1) of the electrode side (306). Thus, the lateral clearance distances (G1) of the electrode sides (306, 308) are not equal to each other throughout the distal portion of the curved region (204) of the blade (36). Specifically, at various longitudinal positions along the curved region (204) of the blade (36), the lateral clearance distance (G1) of the electrode side (308) is greater than the lateral clearance distance (G1) of the electrode side (306). In other variations of the clamping arm (302), the lateral clearance distances (G1) of the electrode sides (306, 308) may increase distally at the same rate such that the clearance distances (G1) remain equal to each other throughout the curved blade region (204).

[0053] As Figure 12 shown, the configuration of the clamping arm (302) described above can be achieved by providing the clamping pad (304) with a width that flares or increases laterally outward through the distal portion of the curved blade region (204). The increased clearance distance (G1) (where the lateral deflection of the ultrasonic blade (36) is greatest) at the distal portion of the end effector (300) allows for greater lateral misalignment between the ultrasonic blade (36) and the clamping arm (302) while maintaining an electrical connection therebetween through the clamped tissue. To maintain a uniform lateral electrode width (W) throughout the flared region of the clamping pad (304), the lateral width of the clamping arm (302) increases or flares distally simultaneously with the lateral width of the clamping pad (304).

[0054] Figure 13 Shown is an end effector (310) including an ultrasonic blade (36) and a clamping arm (312) of a third exemplary variation of the clamping arm (38) according to Figure 10 . The clamping arm (312) is the same as Figure 12The clamping arms (302) are similar in that the clamping arm (312) includes a centrally located clamping pad (314) and first and second clamping arm electrode sides (316, 318) that extend distally along respective lateral sides of the clamping pad (314), and are joined at their distal ends by an electrode bridge portion (319). The clamping arm (312) is further similar to the clamping arm (302) in that the lateral gap distance (G1) of each electrode side (316, 318) increases distally along the distal portion of the curved blade region (204), and the gap distances (G1) are not equal to each other at all longitudinal positions throughout the curved blade region (204).

[0055] The clamping arm (312) differs from the clamping arm (302) in that the lateral electrode width (W) of each electrode side (316, 318) is non-uniform along the length of the tissue treatment portion of the blade (36). Specifically, the lateral electrode width (W) tapers or decreases distally along the distal portion of the curved blade region (204). In other words, as the lateral gap distance (G1) increases, the lateral electrode width (W) decreases. The rates of increase and decrease may be similar to each other. Additionally, the lateral electrode widths (W) of the electrode sides (316, 318) may be substantially equal to each other at any given longitudinal position along the clamping arm (312). The narrower electrode sides (316, 318) of the clamping arm (302) deliver a concentrated level of bipolar RF energy at the clamping arm section having an increased gap distance (G1). This enables effective delivery of electrosurgical bipolar RF energy to tissue at the larger gap section, which accommodates a greater degree of lateral deflection of the ultrasonic blade (36) as described above, without causing the lateral width of the clamping arm (312) to flare outwards like Figure 12 the clamping arm (302). Accordingly, the clamping arm (312) can generally provide the same performance benefits as the clamping arm (302) while maintaining a thinner profile.

[0056] Figure 14 illustrates an end effector (320) including an ultrasonic blade (36) and a clamping arm (322) of a fourth exemplary variant of the clamping arm (38) according to Figure 10 The clamping arm (322) is similar to the clamping arms (292, 302, 312) described above in that the clamping arm (322) includes a centrally located clamping pad (324) and first and second clamping arm electrode sides (326, 328) that extend distally along respective lateral sides of the clamping pad (324). Additionally, the lateral electrode width (W) of each electrode side (326, 328) is uniform and equal to the other along the entire length of the tissue treatment portion of the ultrasonic blade (36).

[0057] The clamping arm (322) differs from the clamping arms (292, 302, 312) in that the clamping arm (322) omits the distal electrode bridge portions that join the distal ends (327, 329) of the engaging electrode sides (326, 328). Instead, in this example, the electrode distal ends (327, 329) are laterally separated from each other by a clamping pad (324) that extends to the distal end of the clamping arm (322). Additionally, the electrode distal ends (327, 329) are aligned with the distal knife end (76), but it should be understood that in other examples, the distal ends (327, 329) may terminate proximal or distal to the knife end (76). Although not shown, a variation of any of the clamping arms (292, 302, 312) described above may be provided where the distal electrode bridge portions (299, 309, 319) are omitted to provide electrode distal ends similar to those of the clamping arm (322).

[0058] Each clamping arm (292, 302, 312, 322) as described above has a first electrode side and a second electrode side with widths (W) that are equal to each other along the entire length of the electrode sides. However, an alternative variation of the clamping arms (292, 302, 312, 322) may have electrode sides with widths (W) that are not equal along one or more of their longitudinal extension portions (e.g., along the portion corresponding to the curved knife region (204)). Such variations in the electrode width (W) may be provided to accommodate performance differences exhibited by the knife (36) and / or the clamping arms (292, 302, 312, 322) between their concave curved lateral side corresponding to the first lateral knife side (210) and their corresponding convex curved lateral side corresponding to the second lateral knife side (212). For example, during use, the concave curved lateral side of the knife (36) and the clamping arms (292, 302, 312, 322) may provide a first degree of cutting and sealing treatment to the tissue, while the convex curved lateral side of the knife (36) and the clamping arms (292, 302, 312, 322) may provide a second degree of cutting and sealing treatment to the tissue.

[0059] II. Exemplary Combinations

[0060] The following embodiments relate to various non-exhaustive ways in which the teachings herein can be combined or applied. It should be understood that the following embodiments are not intended to limit the scope of any claims that may be provided at any time in this patent application or in subsequent filings of this patent application. No disclaimer is intended. The following embodiments are provided merely for illustrative purposes. It is contemplated that the various teachings herein can be arranged and applied in many other ways. It is also contemplated that some variations may omit certain features mentioned in the following embodiments. Accordingly, none of the aspects or features mentioned below should be considered decisive, unless expressly so indicated otherwise, for example, by the inventors or their successors in interest at a later date. If any claims presented in this patent application or in subsequent filings related to this patent application include additional features other than those mentioned below, such additional features should not be assumed to have been added for any reason related to patentability.

[0061] Example 1

[0062] A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft that extends distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector includes: (i) an ultrasonic blade configured to be driven by the ultrasonic transducer with ultrasonic energy, wherein the ultrasonic blade includes: (A) an upper processing side, (B) a lower processing side disposed opposite the upper processing side, (C) a first lateral side, and (D) a second lateral side disposed opposite the first lateral side, and (ii) a clamping arm movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the clamping arm provides an RF electrode operable to seal tissue with RF energy, wherein the RF electrode includes: (A) a first electrode side portion that is laterally outwardly spaced from the first lateral side of the ultrasonic blade by a first lateral gap distance; and (B) a second electrode side portion spaced from the first electrode side portion, wherein the second electrode side portion is laterally outwardly spaced from the second lateral side of the ultrasonic blade by a second lateral gap distance.

[0063] Example 2

[0064] The surgical instrument according to Embodiment 1, wherein the end effector further includes a clamping pad coupled to the clamping arm, wherein the first electrode side portion extends along a first lateral side of the clamping pad, and wherein the second electrode side portion extends along a second lateral side of the clamping pad.

[0065] Example 3

[0066] The surgical instrument according to any one of the foregoing embodiments, wherein the first lateral clearance distance is equal to the second lateral clearance distance along the curved distal portion of the ultrasonic scalpel.

[0067] Example 4

[0068] The surgical instrument according to any one of the foregoing embodiments, wherein at least one of the first lateral clearance distance and the second lateral clearance distance is uniform along the curved distal portion of the ultrasonic scalpel.

[0069] Example 5

[0070] The surgical instrument according to any one of the foregoing embodiments, wherein at least one of the first lateral clearance distance and the second lateral clearance distance is non-uniform along the curved distal portion of the ultrasonic scalpel.

[0071] Example 6

[0072] The surgical instrument according to any one of the foregoing embodiments, wherein each of the first lateral clearance distance and the second lateral clearance distance is in the range of 0.002 inches to 0.012 inches along the curved distal portion of the ultrasonic scalpel.

[0073] Example 7

[0074] The surgical instrument according to any one of the foregoing embodiments, wherein the lateral width of at least one of the first electrode side portion and the second electrode side portion is uniform along the length of at least the distal portion of the clamping arm.

[0075] Example 8

[0076] The surgical instrument according to any one of the foregoing embodiments, wherein the lateral width of at least one of the first electrode side portion and the second electrode side portion is non-uniform along the length of at least the distal portion of the clamping arm.

[0077] Example 9

[0078] The surgical instrument according to Embodiment 8, wherein the lateral width of at least one of the first electrode side portion and the second electrode side portion increases distally.

[0079] Example 10

[0080] The surgical instrument according to any one of Embodiments 8 to 9, wherein the lateral width of at least one of the first electrode side portion and the second electrode side portion decreases distally.

[0081] Example 11

[0082] The surgical instrument according to any one of the foregoing embodiments, wherein a lateral width of each of the first electrode side portion and the second electrode side portion is in a range of 0.007 inches to 0.018 inches along a length of at least a distal portion of the clamping arm.

[0083] Example 12

[0084] The surgical instrument according to any one of the foregoing embodiments, wherein the RF electrode extends distally beyond a distal end of the ultrasonic scalpel and defines an electrode bridge portion that electrically couples a distal end of the first electrode side portion to a distal end of the second electrode side portion.

[0085] Example 13

[0086] The surgical instrument according to any one of the foregoing embodiments, wherein the ultrasonic scalpel includes a linear proximal portion and a curved distal portion, and wherein the first electrode side portion and the second electrode side portion extend beside the curved distal portion.

[0087] Example 14

[0088] The surgical instrument according to any one of the foregoing embodiments, wherein the RF electrode includes a first RF electrode, and wherein the ultrasonic scalpel provides a second RF electrode, and wherein the first RF electrode and the second RF electrode are operable to seal tissue using bipolar RF energy.

[0089] Example 15

[0090] The surgical instrument according to any one of the foregoing embodiments, wherein the upper processing side of the ultrasonic scalpel includes a convex curved surface that provides the second RF electrode.

[0091] Example 16

[0092] A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft extending distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector includes: (i) an ultrasonic blade configured to be driven by the ultrasonic transducer with ultrasonic energy, wherein the ultrasonic blade includes: (A) an upper processing side, (B) a lower processing side disposed opposite to the upper processing side, (C) a first lateral side, and (D) a second lateral side disposed opposite to the first lateral side, and (ii) a clamping arm movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the clamping arm provides an RF electrode operable to seal tissue with RF energy, wherein the RF electrode includes: (A) a first electrode side having a first width and laterally outwardly spaced from the first lateral side of the ultrasonic blade by a first lateral gap distance; and (B) a second electrode side spaced from the first electrode side, wherein the second electrode side has a second width and is laterally outwardly spaced from the second lateral side of the ultrasonic blade by a second lateral gap distance, wherein at least one of the first width or the second width is non-uniform along the length of at least the distal portion of the clamping arm, and wherein at least one of the first lateral gap distance or the second lateral gap distance is non-uniform along the length of at least the distal portion of the clamping arm.

[0093] Example 17

[0094] The surgical instrument according to embodiment 16, wherein each of the first width and the second width decreases distally.

[0095] Example 18

[0096] The surgical instrument according to any one of embodiments 16 to 17, wherein each of the first lateral gap distance and the second lateral gap distance increases distally.

[0097] Example 19

[0098] A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft extending distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector comprises: (i) an ultrasonic blade configured to be driven by the ultrasonic transducer with ultrasonic energy, wherein the ultrasonic blade comprises: (A) a linear proximal blade portion, (B) a curved distal blade portion, (C) a first lateral side, and (D) a second lateral side, the second lateral side being disposed opposite the first lateral side; and (ii) a clamping arm movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the clamping arm provides an RF electrode operable to seal tissue with RF energy, wherein the RF electrode comprises: (A) a first electrode side portion, wherein the first electrode side portion is laterally outwardly spaced from the first lateral side of the ultrasonic blade by a first lateral gap distance; and (B) a second electrode side portion spaced from the first electrode side portion, wherein the second electrode side portion is laterally outwardly spaced from the second lateral side of the ultrasonic blade by a second lateral gap distance, wherein at least one of the first lateral gap distance or the second lateral gap distance is in the range of 0.002 inches to 0.012 inches along the curved distal blade portion.

[0099] Example 20

[0100] The surgical instrument according to embodiment 19, wherein the lateral width of at least one of the first electrode side portion or the second electrode side portion is in the range of 0.007 inches to 0.018 inches along the curved distal blade portion.

[0101] III. Miscellaneous

[0102] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Accordingly, the above teachings, expressions, embodiments, examples, etc. should not be regarded as isolated from one another. With reference to the teachings herein, various suitable ways in which the teachings herein may be combined will be apparent to those of ordinary skill in the art. Such modifications and variations are intended to be included within the scope of the claims.

[0103] Additionally, any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the teachings, expressions, embodiments, examples, etc. described in the following patent applications: U.S. Patent Application [Attorney Docket No. END8245USNP] entitled "Combination Ultrasonic and Electrosurgical Instrument Having Electrical Circuits With Shared Return Path" filed on the same date; U.S. Patent Application [Attorney Docket No. END8245USNP1] entitled "Combination Ultrasonic and Electrosurgical Instrument Having Slip Ring Electrical Contact Assembly" filed on the same date; U.S. Patent Application [Attorney Docket No. END8245USNP2] entitled "Combination Ultrasonic and Electrosurgical Instrument Having Electrically Insulating Features" filed on the same date; U.S. Patent Application [Attorney Docket No. END8245USNP3] entitled "Combination Ultrasonic and Electrosurgical Instrument Having Curved Ultrasonic Blade" filed on the same date; U.S. Patent Application [Attorney Docket No. END8245USNP5] entitled "Combination Ultrasonic and Electrosurgical Instrument Having Ultrasonic Waveguide With Distal Overmold Member" filed on the same date; U.S. Patent Application [Attorney Docket No. END8245USNP6] entitled "Combination Ultrasonic and Electrosurgical System Having Generator Filter Circuitry" filed on the same date;and / or U.S. Patent Application No. [Attorney Docket No. END8245USNP7] entitled "Combination Ultrasonic and Electrosurgical System Having EEPROM and ASIC Components" filed on the same date as this application. The disclosure of each of these applications is hereby incorporated by reference herein.;

[0104] Additionally, any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the teachings, expressions, embodiments, examples, etc. described in the following patent applications: U.S. Patent Application [Attorney Docket No. END8146USNP] titled "Combination Ultrasonic and Electrosurgical Instrument with Clamp Arm Position Input and Method for Identifying Tissue State" filed on the same date; U.S. Patent Application Attorney Docket No. [END8146USNP1] titled "Combination Ultrasonic and Electrosurgical Instrument with Adjustable Energy Modalities and Method for Sealing Tissue and Inhibiting Tissue Resection" filed on the same date; U.S. Patent Application [Attorney Docket No. END8146USNP2] titled "Combination Ultrasonic and Electrosurgical Instrument with Adjustable Clamp Force and Related Methods" filed on the same date; U.S. Patent Application [Attorney Docket No. END8146USNP3] titled "Combination Ultrasonic and Electrosurgical Instrument with Adjustable Energy Modalities and Method for Limiting Blade Temperature" filed on the same date; U.S. Patent Application Attorney Docket No. END8146USNP4] titled "Combination Ultrasonic and Electrosurgical Instrument and Method for Sealing Tissue with Various Termination Parameters" filed on the same date;and / or the U.S. patent application entitled "Combination Ultrasonic and Electrosurgical Instrument and Method for Sealing Tissue in Successive Phases" filed on the same date therewith [Attorney Docket No. END8146USNP5]. The disclosure of each of these applications is incorporated herein by reference.

[0105] It should be understood that any patent, patent publication, or other published material that is alleged to be incorporated herein by reference, whether in its entirety or in part, is incorporated herein only to the extent that such incorporated material does not conflict with the existing definitions, statements, or other published material set forth in this disclosure. Accordingly, and to the extent necessary, the disclosure set forth herein explicitly supersedes any conflicting material incorporated herein by reference. Any material or portion thereof that is alleged to be incorporated herein by reference but conflicts with the existing definitions, statements, or other published material set forth herein will be incorporated only to the extent that there is no conflict between the incorporated material and the existing published material.

[0106] The above-described types of devices can be applied to traditional medical treatments and surgeries performed by medical professionals, as well as robot-assisted medical treatments and surgeries. By way of example only, the various teachings herein can be readily incorporated into robotic surgical systems, such as the DAVINCI of Intuitive Surgical, Inc. (Sunnyvale, California) TMSystems. Similarly, those of ordinary skill in the art will recognize that the various teachings herein can be readily combined with the various teachings of any of the following patents: U.S. Patent No. 5,792,135, entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity," published on August 11, 1998, the disclosure of which is incorporated herein by reference; U.S. Patent No. 5,817,084, entitled "Remote Center Positioning Device with Flexible Drive," published on October 6, 1998, the disclosure of which is incorporated herein by reference; U.S. Patent No. 5,878,193, entitled "Automated Endoscope System for Optimal Positioning," published on March 2, 1999, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,231,565, entitled "Robotic Arm DLUS for Performing Surgical Tasks," published on May 15, 2001, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,783,524, entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument," published on August 31, 2004, the disclosure of which is incorporated herein by reference; U.S. Patent No. 6,364,888, entitled "Alignment of Master and Slave in a Minimally Invasive Surgical Apparatus," published on April 2, 2002, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,524,320, entitled "Mechanical Actuator Interface System for Robotic Surgical Tools," published on April 28, 2009, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,691,098, entitled "Platform Link Wrist Mechanism," published on April 6, 2010, the disclosure of which is incorporated herein by reference;U.S. Patent No. 7,806,891, entitled "Repositioning and Reorientation of Master / Slave Relationship in Minimally Invasive Telesurgery," published on October 5, 2010, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,844,789, entitled "Automated End Effector Component Reloading System for Use with a Robotic System," published on September 30, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,820,605, entitled "Robotically-Controlled Surgical Instruments," published on September 2, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,616,431, entitled "Shiftable Drive Interface for Robotically-Controlled Surgical Tool," published on December 31, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,573,461, entitled "Surgical Stapling Instruments with Cam-Driven Staple Deployment Arrangements," published on November 5, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,602,288, entitled "Robotically-Controlled Motorized Surgical End Effector System with Rotary Actuated Closure Systems Having Variable Actuation Speeds," published on December 10, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,301,759, entitled "Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector," published on April 5, 2016, the disclosure of which is incorporated herein by reference;U.S. Patent No. 8,783,541, entitled "Robotically-Controlled Surgical End Effector System," published on July 22, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,479,969, entitled "Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot," published on July 9, 2013, the disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 8,800,838, entitled "Robotically-Controlled Cable-Based Surgical End Effectors," published on August 12, 2014, the disclosure of which is incorporated herein by reference; and / or U.S. Patent No. 8,573,465, entitled "Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems," published on November 5, 2013, the disclosure of which is incorporated herein by reference.;

[0107] Devices of the type described above can be designed to be discarded after a single use, or they can be designed to be reusable multiple times. In either case or both cases, these types can be repaired to be reused after at least one use. Repair can include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts and subsequently reassembling. Specifically, some types of devices can be disassembled, and any number of specific parts or portions of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific components, some types of the device can be reassembled at a repair facility or by the user immediately prior to surgery for subsequent use. Those skilled in the art will appreciate that the repair of the device can be carried out for disassembly, cleaning / replacement, and reassembly using a variety of techniques. The use of such techniques and the resulting repaired device are all within the scope of this application.

[0108] By way of example only, the forms described herein may be sterilized before and / or after surgery. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or TYVEK bag. The container and device may then be placed in a radiation field that penetrates the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in a sterile container for later use. Any other technique known in the art may also be used to sterilize the device, including but not limited to beta radiation or gamma radiation, ethylene oxide, or steam.

[0109] Various embodiments of the invention have been shown and described, and further improvements to the methods and systems described herein may be achieved by appropriate modification by those of ordinary skill in the art without departing from the scope of the invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not required. Accordingly, the scope of the invention should be considered in light of the following claims and should be understood to be not limited to the details of the structures and operations shown and described in the specification and drawings.

Claims

1. A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft that extends distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector comprises: (i) an ultrasonic blade configured to be driven by the ultrasonic transducer with ultrasonic energy, wherein the ultrasonic blade comprises: (A) an upper processing side, (B) a lower processing side disposed opposite the upper processing side, (C) a first lateral side, and (D) a second lateral side disposed opposite the first lateral side, and (ii) clamping arms movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the clamping arms provide RF electrodes operable to seal tissue with RF energy, wherein the RF electrodes comprise: (A) a first electrode side portion that is laterally outwardly spaced from the first lateral side of the ultrasonic blade by a first lateral gap distance; and (B) a second electrode side portion spaced from the first electrode side portion, wherein the second electrode side portion is laterally outwardly spaced from the second lateral side of the ultrasonic blade by a second lateral gap distance.

2. The surgical instrument according to claim 1, wherein, The end effector further comprises a clamping pad coupled to the clamping arms, wherein the first electrode side portion extends along a first lateral side of the clamping pad, and wherein the second electrode side portion extends along a second lateral side of the clamping pad.

3. The surgical instrument according to claim 1, wherein, The first lateral gap distance is equal to the second lateral gap distance along a curved distal portion of the ultrasonic blade.

4. The surgical instrument according to claim 1, wherein At least one of the first lateral gap distance or the second lateral gap distance is uniform along a curved distal portion of the ultrasonic blade.

5. The surgical instrument according to claim 1, wherein, At least one of the first lateral gap distance or the second lateral gap distance is non-uniform along a curved distal portion of the ultrasonic blade.

6. The surgical instrument according to claim 1, wherein, Each of the first lateral gap distance and the second lateral gap distance is in the range of 0.002 inches to 0.012 inches along a curved distal portion of the ultrasonic blade.

7. The surgical instrument according to claim 1, wherein, The lateral width of at least one of the first electrode side portion or the second electrode side portion is uniform along at least the length of the distal portion of the clamping arm.

8. The surgical instrument according to claim 1, wherein, The lateral width of at least one of the first electrode side portion or the second electrode side portion is non-uniform along at least the length of the distal portion of the clamping arm.

9. The surgical instrument according to claim 8, wherein, The lateral width of at least one of the first electrode side portion or the second electrode side portion increases distally.

10. The surgical instrument according to claim 8, wherein, The lateral width of at least one of the first electrode side portion or the second electrode side portion decreases distally.

11. The surgical instrument according to claim 1, wherein, The lateral width of each of the first electrode side portion and the second electrode side portion is in the range of 0.007 inches to 0.018 inches along at least the length of the distal portion of the clamping arm.

12. The surgical instrument according to claim 1, wherein, The RF electrodes extend distally beyond the distal end of the ultrasonic blade and define an electrode bridge portion that electrically couples the distal end of the first electrode side portion to the distal end of the second electrode side portion.

13. The surgical instrument according to claim 1, wherein, The ultrasonic scalpel includes a linear proximal portion and a curved distal portion, wherein the first electrode side portion and the second electrode side portion extend beside the curved distal portion.

14. The surgical instrument according to claim 1, wherein, The RF electrode includes a first RF electrode, wherein the ultrasonic scalpel provides a second RF electrode, and wherein the first RF electrode and the second RF electrode are operable to seal tissue using bipolar RF energy.

15. The surgical instrument according to claim 14, wherein, The upper processing side of the ultrasonic scalpel includes a convex curved surface that provides the second RF electrode.

16. A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft that extends distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector includes: (i) an ultrasonic scalpel configured to be driven by the ultrasonic transducer using ultrasonic energy, wherein the ultrasonic scalpel includes: (A) an upper processing side, (B) a lower processing side disposed opposite the upper processing side, (C) a first lateral side, and (D) a second lateral side disposed opposite the first lateral side, and (ii) clamping arms movable relative to the ultrasonic scalpel for clamping tissue therebetween, wherein the clamping arms provide RF electrodes operable to seal tissue using RF energy, wherein the RF electrodes include: (A) a first electrode side portion having a first width and laterally outwardly spaced from the first lateral side of the ultrasonic scalpel by a first lateral gap distance; and (B) a second electrode side portion spaced from the first electrode side portion, wherein the second electrode side portion has a second width and is laterally outwardly spaced from the second lateral side of the ultrasonic scalpel by a second lateral gap distance, wherein at least one of the first width or the second width is non-uniform along the length of at least the distal portion of the clamping arm, wherein at least one of the first lateral gap distance or the second lateral gap distance is non-uniform along the length of at least the distal portion of the clamping arm.

17. The surgical instrument according to claim 16, wherein Each of the first width and the second width decreases distally.

18. The surgical instrument according to claim 16, wherein, Each of the first lateral gap distance and the second lateral gap distance increases distally.

19. A surgical instrument, comprising: (a) an ultrasonic transducer; (b) a shaft that extends distally relative to the ultrasonic transducer; and (c) an end effector disposed at the distal end of the shaft, wherein the end effector includes: (i) an ultrasonic scalpel configured to be driven by the ultrasonic transducer using ultrasonic energy, wherein the ultrasonic scalpel includes: (A) a linear proximal knife portion, (B) a curved distal knife portion, (C) a first lateral side, and (D) a second lateral side disposed opposite the first lateral side, and (ii) A clamping arm that is movable relative to the ultrasonic scalpel for clamping tissue therebetween, wherein the clamping arm provides an RF electrode that is operable to seal tissue using RF energy, and wherein the RF electrode includes: (A) A first electrode side portion that is laterally outwardly spaced from the first lateral side of the ultrasonic scalpel by a first lateral gap distance; and (B) A second electrode side portion that is spaced from the first electrode side portion, wherein the second electrode side portion is laterally outwardly spaced from the second lateral side of the ultrasonic scalpel by a second lateral gap distance, wherein at least one of the first lateral gap distance or the second lateral gap distance is in the range of 0.002 inches to 0.012 inches along the curved distal knife portion.

20. The surgical instrument according to claim 19, wherein, The lateral width of at least one of the first electrode side portion or the second electrode side portion is in the range of 0.007 inches to 0.018 inches along the curved distal knife portion.

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