Surgical vessel sealing instruments

Abstract

Vessel sealing instruments are provided that comprise an ultrasonic transducer having a reduced longitudinal length distal of the articulation wrist of the instrument to improve the maneuverability of the instrument within a tight surgical area, such as encountered during a laparoscopic procedure. The vessel sealing instruments may be particularly useful as part of a robotic-assisted surgical system. A vessel sealing instrument comprises a blade having a distal portion with a smaller sectional density than a proximal portion. This design minimizes the length of the blade, allowing the blade to be located distal of an articulation wrist, which avoids generating ultrasonic transducer vibrations through the wrist, thereby reducing the wear and tear on the instrument components.

Description

SURGICAL VESSEL SEALING INSTRUMENTSCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Application Serial No. 63 / 665,964 filed on June 28, 2024, the complete disclosure of which is incorporated herein by reference for all purposesBACKGROUND

[0002] The field generally relates to surgical vessel sealing instruments, and more particularly to miniaturized ultrasonic scalpels that may be particularly useful with instruments having an articulated wrist.

[0003] Minimally invasive medical techniques are intended to reduce the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. One effect of minimally invasive surgery, for example, is reduced post-operative hospital recovery times. The average hospital stay for a standard open surgery is typically significantly longer than the average stay for an analogous minimally invasive surgery (MIS). Thus, increased use of MIS could save millions of dollars in hospital costs each year. While many of the surgeries performed each year in the United States could potentially be performed in a minimally invasive manner, only a portion of the current surgeries uses these advantageous techniques due to limitations in minimally invasive surgical instruments and the additional surgical training involved in mastering them.

[0004] Improved surgical instruments such as tissue access, navigation, dissection and sealing instruments have enabled MIS to redefine the field of surgery. These instruments allow surgeries and diagnostic procedures to be performed with reduced trauma to the patient. A common form of minimally invasive surgery is endoscopy, and a common form of endoscopyis laparoscopy, which is minimally invasive inspection and surgery inside the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately one-half inch or less) incisions to provide entry ports for laparoscopic instruments.

[0005] Laparoscopic surgical instruments generally include an endoscope (e.g., laparoscope) for viewing the surgical field and tools for working at the surgical site. The working tools differ from those used in conventional (open) surgery, for example, in that the working end or end effector of each laparoscopic tool may be separated from its handle by an extension tube (also known as, e.g., an instrument shaft or a main shaft). The end effector can include, for example, a clamp, grasper, scissor, stapler, cautery tool, linear cutter, or needle holder, among others.

[0006] To perform surgical procedures, the surgeon passes working tools through cannula sleeves to an internal surgical site and manipulates them from outside the abdomen. The surgeon views the procedure from a monitor that displays an image of the surgical site taken from the endoscope. Similar endoscopic techniques are employed in, for example, arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cisternoscopy, sinoscopy, hysteroscopy, urethroscopy, and the like.

[0007] Minimally invasive telesurgical robotic systems have been being developed to increase a surgeon's dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location (outside the sterile field). In a telesurgery system, the surgeon is often provided with an image, e.g., a three dimensional image of the surgical site at a control console. While viewing, e.g., a three dimensional, image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the control console, which in turn control the motion of the servo-mechanically operated slave instruments.

[0008] The servomechanism used for telesurgery will often accept input from two master controllers (one for each of the surgeon's hands) and may include two or more robotic arms. A surgical instrument is mounted on each of the robotic arms. Operative communication between master controllers and associated robotic arm and instrument assemblies is typically achieved through a control system. The control system typically includes at least one processor that relays input commands from the master controllers to the associated robotic arm and instrument assemblies and back in the case of, for example, force feedback or the like. One example of a robotic surgical system is the DA VINCI™ system commercialized by Intuitive Surgical, Inc. of Sunnyvale, California.

[0009] A variety of structural arrangements have been used to support the surgical instrument at the surgical site during robotic surgery. The driven linkage or "slave" is often called a robotic surgical manipulator, and exemplary linkage arrangements for use as a robotic surgical manipulator during minimally invasive robotic surgery are described, for example, in U.S. Pat. Nos. 7,594,912, 6,758,843, 6,702,805, 6,676,669, 6,246,200, 5,855,583, 5,808,665, 5,800,423, 5,445,166, and 5,184,601, the disclosures of which are fully incorporated herein by reference in their entirety for all purposes.

[0010] During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors that perform various functions for the surgeon, for example, holding or driving a needle, grasping a blood vessel, dissecting tissue, or the like, in response to manipulation of the master input devices. One type of surgical instrument that may be employed is a vessel sealer, which performs the function of clamping and sealing tissue, e.g., blood vessels. Vessel sealers have been employed in many different surgical procedures.

[0011] Vessel sealing instruments, e.g., a bipolar vessel sealer, can seal a blood vessel by simultaneously clamping the vessel closed and directing an electrical current through thevessel tissue to cauterize the vessel tissue and thereby seal the vessel. Another type of vessel sealing instruments is an ultrasonic vessel sealer, which employs ultrasonic vibrations to heat and seal the tissue. Such vessel sealers generally have jaws that apply clamping pressure sufficient for sealing of the vessel.

[0012] One challenge with minimally invasive surgery arises when these vessel sealing instruments are articulated within a patient’s body. Articulation of the vessel sealing instrument within the body is highly advantageous in order to position the instrument in hard- to-reach locations within the patient and / or to navigate the instrument around the other anatomical features within the surgical space inside the patient. The length of the instrument distal of the articulation wrist, however, can exacerbate this challenge, e.g., the longer the length of the instrument distal of the articulation wrist, the harder it is to navigate that instrument within the surgical space.

[0013] Another challenge with vessel sealing instruments is that they employ ultrasonic vibrations in order to generate the heat to cauterize the tissue to be sealed. These vibrations are most effective when transverse vibrations are minimized, as these transverse vibrations contribute to undesirable wear and tear on the clamping blades of the vessel sealing instrument. Placing the ultrasonic transducer proximal to the articulation wrist results in an increase in these transverse vibrations, since the ultrasonic vibrations travel through and / or around the angle created by the articulation wrist.

[0014] U.S. Patent Publication No. US2006 / 0058825 to Ogura sought to alleviate this challenge by placing the ultrasonic vibration transducer distal to the articulation wrist. However, Ogura suffers from the drawbacks described above, in that the length of the ultrasonic transducer, in combination with the length of the vessel sealing jaws, makes the instrument difficult to maneuver within the tight anatomical spaces within a patient’s body.SUMMARY

[0013] The following presents a simplified summary of the claimed subject matter in order to provide a basic understanding of some aspects of the claimed subject matter. This summary is not an extensive overview of the claimed subject matter. It is intended to neither identify key or critical elements of the claimed subject matter nor delineate the scope of the claimed subject matter. Its sole purpose is to present some concepts of the claimed subject matter in a simplified form as a prelude to the more detailed description that is presented later.

[0014] Vessel sealing instruments are provided that comprise an ultrasonic transducer having a reduced longitudinal length to improve the maneuverability of the instrument within a tight surgical area, such as encountered during a laparoscopic procedure. The vessel sealing instruments may be particularly useful as part of a robotic-assisted surgical system.

[0015] In one aspect, a vessel sealing instrument comprises first and second jaws pivotally coupled to each other and an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw. The first jaw comprises a blade having a first sectional density (i.e., mass per cross-sectional area) at a proximal portion of the blade, and a second sectional density at a distal portion of the blade. The second sectional density is less than the first sectional density which amplifies the vibrations of the standing ultrasonic wave as it travels distally through the blade.

[0016] In embodiments, the vessel sealing instrument comprises an articulation wrist for providing at least two degrees of freedom of movement in the pitch and yaw directions. The blade of the instrument is disposed distal to the articulation wrist which avoids generating the ultrasonic transducer vibrations through the wrist, thereby minimizing transverse vibrations and reducing the wear and tear on the jaws of the instrument.

[0017] In embodiments, the sectional density of the blade tapers in a distal direction along a length of the blade. In certain embodiments, the cross-sectional profile of the blade isselected from the group consisting of exponential, catenoidal, cosine, conic, Gaussian, stepped horn. Alternatively, the cross-sectional profile of the blade comprises an optimized Non- Uniform Rational B-Spline or NURBS-based profile, which also minimizes the amount of stress concentration along the blade.

[0018] In embodiments, the blade comprises a series of patterned holes and / or horizontal / helical slots disposed therein. In such an embodiment, the patterned holes and / or slots can have a consistent depth or their depths can deepen towards the distal tip of the transducer. Still further, coring out the components from their proximal side to their distal side may also provide the same amplification effect.

[0019] In another aspect, there is provided herein various embodiments for an improved ultrasonic articulating, e.g., robotically, vessel sealing system. In one such embodiment, a vessel sealing instrument comprises a first jaw having a blade configured as an ultrasonic waveguide and a second jaw pivotably mounted relative to the first jaw. The vessel sealing instrument further comprises an actuating mechanism coupled to the first and second jaws and operable to pivot the second jaw relative to the first jaw so as to apply sealing pressure to tissue between the first and second jaw; The vessel sealing instrument comprises an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw, wherein the blade of the instrument has a first sectional density at a proximal location along its blade length, and a second sectional density at a more distal location along its blade length, wherein the second sectional density is less than the first sectional density.

[0020] In embodiments, the sectional density of the blade tapers in a distal direction along a length of the blade. In certain embodiments, the cross-sectional profile of the blade is selected from the group consisting of exponential, catenoidal, cosine, conic, Gaussian, stepped horn. Alternatively, the cross-sectional profile of the blade comprises an optimized Non-Uniform Rational B-Spline or NURBS-based profile, which also minimizes the amount of stress concentration along the blade.

[0021] Additionally, or alternatively, the blade may have a gradual reduction of its mass per cross-sectional area by having a plurality of holes or slots, wherein the plurality of slots may be one of horizontal and helical. Still further, the plurality of holes or slots may have a consistent depth or they may deepen towards the distal tip of the transducer.

[0022] In certain embodiments, the vessel sealing instrument comprises a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist. The ultrasonic transducer is disposed in the second portion of the robotic control arm distal to the articulation wrist. The articulation wrist may provide at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm. The ultrasonic transducer may, in various embodiments, generate ultrasonic vibrations with a half wavelength at resonance frequency of about 40 kHz to about 80 kHz, or about 55.6 kHz, although other frequencies are contemplated.

[0023] In another aspect, a robotic surgical system comprises a robotic console having a user interface, and a robotic control arm configured to be controlled by the user interface. The robotic control arm comprises an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist. The robotic surgical system further comprises a vessel sealing instrument configured for coupling to the second portion of the robotic control arm. The vessel sealing instrument comprises a first jaw having a blade configured as an ultrasonic waveguide and a second jaw pivotably mounted relative to the first arm so as, upon actuation,to apply sealing pressure to tissue between the first and second jaw. The vessel sealing instrument comprises an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw. The ultrasonic transducer is located distal to the articulation wrist.

[0024] In embodiments, the articulation wrist may provide at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm. The blade of the instrument may have a first sectional density at a proximal location along its blade length, and may have a second sectional density at a more distal location along its blade length, wherein the second sectional density is less than the first sectional density. In embodiments, the sectional density of the blade tapers in a distal direction along a length of the blade. In certain embodiments, the cross-sectional profile of the blade is selected from the group consisting of exponential, catenoidal, cosine, conic, Gaussian, stepped horn. Alternatively, the cross-sectional profile of the blade comprises an optimized Non-Uniform Rational B-Spline or NURBS-based profile, which also minimizes the amount of stress concentration along the blade.

[0025] Additionally, or alternatively, the blade may have a gradual reduction of its cross-sectional by having a plurality of holes or slots. The plurality of slots may be one of horizontal and helical. Still further, the plurality of holes or slots may have a consistent depth or may deepen towards the distal tip of the transducer. The ultrasonic transducer may generate ultrasonic vibrations with a half wavelength at resonance frequency of about 55.6 kHz, although other frequencies are also contemplated.

[0026] In another aspect, a vessel sealing instrument comprises a first jaw having a blade configured as an ultrasonic waveguide and a second jaw pivotably mounted relative to the first jaw. The vessel sealing instrument further comprises an actuating mechanism coupledto the first and second jaws and operable to pivot the second jaw relative to the first jaw so as to apply sealing pressure to tissue between the first and second jaw. The vessel sealing instrument comprises an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw. The transducer comprises a vibration amplifier in the form of a horn. The horn comprises a first folded horn portion that extends distally.

[0027] In embodiments,, the horn comprises a second folded horn portion which extends proximally from a distalmost end of the first folded horn portion.

[0028] In embodiments, the vessel sealing instrument comprises a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist. The ultrasonic transducer is located in the second portion of the robotic control arm distal to the articulation wrist. The articulation wrist may provide at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm. The ultrasonic transducer generates ultrasonic vibrations with a half wavelength at resonance frequency of about 40 kHz to about 80 kHz, or about 55.6 kHz, although other frequencies are also contemplated.

[0029] In another aspect, an articulating robotic vessel sealing instrument comprises a first jaw having a blade configured as an ultrasonic waveguide and a second jaw pivotably mounted relative to the first jaw. The articulating robotic vessel sealing instrument further comprises an actuating mechanism coupled to the first and second jaws and operable to pivot the second jaw relative to the first jaw so as to apply sealing pressure to tissue between the first and second jaw. The articulating robotic vessel sealing instrument comprises an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations alongthe first jaw. The transducer is at least partially supported by a spring having a first stiffness in a first direction and a second stiffness in a second direction, wherein the first stiffness is greater than the second stiffness.

[0030] In various embodiments, the spring comprises a slotted disc spring. Alternatively, the spring comprises a tangential linear flexure bearing.

[0031] In embodiments, the vessel sealing instrument comprises a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist, wherein the ultrasonic transducer may be located in the second portion of the robotic control arm distal to the articulation wrist. The articulation wrist provides at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm. In embodiments, the ultrasonic transducer may generate ultrasonic vibrations with a half wavelength at resonance frequency of about 40 kHz to about 80 kHz, or about 55.6 kHz, although other frequencies are also contemplated.BRIEF DESCRIPTION OF THE DRAWINGS

[0032] The above and other aspects, features, and advantages of the device described herein will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:

[0033] Fig. 1A is a perspective view of an example surgical instrument, according to various embodiments;

[0034] Fig. IB is a perspective view of illustrative surgical instrument with a robotically controlled backend mechanism;

[0035] Fig. 1C is a top view of an operating room employing a robotic surgical system;

[0036] Fig. 2A is a perspective view of a surgical vessel sealing instrument;

[0037] Fig. 2B is a perspective view of a transducer for a surgical vessel sealing instrument;

[0038] Fig. 2C is a perspective view of a waveguide for a transducer of a surgical vessel sealing instrument;

[0039] Fig. 3A is a perspective view of a transducer for a surgical vessel sealing instrument that includes a plurality of holes therein;

[0040] Fig. 3B is a perspective view of a transducer for a surgical vessel sealing instrument that includes an alternative arrangement of holes therein;

[0041] Fig. 3C is a perspective view of a transducer for a surgical vessel sealing instrument that includes a plurality of helical slots therein;

[0042] Fig. 3D is a perspective view of a transducer for a surgical vessel sealing instrument that includes a plurality of straight slots therein that deepen in depth as they progress towards the distal end of the instrument;

[0043] Fig. 4A is a side schematic view of a transducer for a surgical vessel sealing instrument having a single-folded horn arrangement;

[0044] Fig. 4B is a side schematic view of a transducer for a surgical vessel sealing instrument having a double-folded horn arrangement;

[0045] Fig. 5 A illustrates a slotted disc spring configured for supporting the transducer; and

[0046] Fig. 5B illustrates a tangential linear flexure bearing configured for supporting the transducer.DETAILED DESCRIPTION

[0047] Particular embodiments are described hereinbelow with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely exemplary and may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ this disclosure in virtually any appropriately detailed structure. Well-known functions or constructions are not described in detail so as to avoid obscuring the device described here in any unnecessary detail.

[0048] Vessel sealing instruments are provided that comprise an ultrasonic transducer having a reduced longitudinal length distal of the articulation wrist of the instrument to improve the maneuverability of the instrument within a tight surgical area, such as encountered during a laparoscopic procedure.

[0049] Traditionally, an ultrasonically activated scalpel consists of a vibration generator (often a Langevin piezoceramic) sandwiched between a back mass and a front mass. Since piezoceramic transducers can only generate a few microns of vibration amplitude (typically 0.1 % of their length), the device is tuned to resonate at a certain ultrasonic frequency. Therefore, its overall length may be a half-wavelength or a multiple of the half-wavelength at the driving frequency. A vibration amplifier (horn) is also usually employed as part of the front mass to amplify the delivered vibration amplitude. Designing a piezoelectric transducer is generally a complicated task, since its overall performance is dependent on many factors, such as dimensions and material properties of various parts, the number of piezoelectric elements, the mode and frequency of driving the system, etc. Depending on the application, multiple objective functions can be defined that are usually contradictory. Limiting the overall length of the transducer to one half-wavelength and designing it to resonate at 40-80 kHz, the transducer can be designed to be about 1.25-2.5 inch long. Miniaturizing the cross-sectionalprofile is not, however, as straight forward, since gradual cross-sectional reduction is necessary to amplify the vibration amplitude. This has been achieved herein by optimizing the blade profile for a maximum vibration amplitude gain and a minimum amount of stress concentration.

[0050] In an embodiment, Fig. 1 A is a perspective view of a surgical vessel sealing instrument 100, in accordance with various embodiments. The surgical vessel sealing instrument 100 includes a first portion 105a and a second portion 105b. The first portion 105a of the vessel sealing instrument 100 is located distally of an articulation wrist 104, while the second portion 105b of the vessel sealing instrument 100 is located proximally of the articulation wrist 104. The articulation wrist 104 provides structure that enables, e.g., at least two degrees of freedom of movement in the pitch and yaw directions of the first portion 105a relative to the second portion 105b.

[0051] The first portion 105a of the surgical vessel sealing instrument 100, as shown, includes a pair of jaws. Specifically, as shown, the first portion 105a has a first jaw 101 and a second jaw 102. The first jaw 101 comprises a blade configured as an ultrasonic waveguide, as will be described in additional detail below. The second jaw 102 is pivotably mounted relative to the first arm 101. An outer sleeve 103 extends from the jaws distally to the articulation wrist 104. An actuating mechanism (hidden in this view) is coupled to the first and second jaws 101, 102 and is operable to pivot the second jaw 102 relative to the first jaw 101 so as to apply sealing pressure to tissue when such tissue is placed between the first and second jaw 101, 102.

[0015] Housed within the outer sleeve 103 is an ultrasonic transducer 106. The ultrasonic transducer 106 is internal to the outer sleeve 103 and is therefore shown in this view of FIG. 1A in dotted line format. The ultrasonic transducer 106 is configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw 101. The ultrasonictransducer 106 is located distal to the articulation wrist 104, such that the transverse vibrations are not amplified or exacerbated by travelling through and / or around the angle created by the articulation wrist 104. Additional details of the vessel sealing instrument are discussed below.

[0052] The features of the described surgical vessel sealing instruments may be readily adapted for use in surgical instruments that are activated using any technique within the purview of those skilled in the art, such as, for example, manually activated surgical instruments, powered surgical instruments (e.g., electro-mechanically powered instruments), robotic surgical instruments as described herein, and the like.

[0053] In certain embodiments, the surgical vessel sealing instrument 100 may be operated as part of a robotic surgical system. Fig. IB illustrates a robotic backend mechanism 107 that is selectively connectable by a user to the second portion 105b of the vessel sealing instrument 100. Backend mechanism 107 typically provides a mechanical coupling between the drive tendons, bands or cables of the instrument and the motorized axes of the mechanical interface of a drive system. Further details of known backend mechanisms and surgical systems are described, for example, in U.S. Pat. No. 8,597,280, U.S. Pat. No. 7,048,745, and U.S. Pat No. 10,016,244. Each of these patents is hereby incorporated by reference in its entirety.

[0054] Still further, in such an arrangement, input couplers may interface with, and be driven by, corresponding output couplers (not shown) of a telesurgical surgery system, such as the system disclosed in U.S Pub. No. 2014 / 0183244A1, the entire disclosure of which is incorporated by reference herein. The input couplers are drivingly coupled with one or more input members (not shown) that are disposed within the second portion 105b of the vessel sealing instrument 100. The input members are drivingly coupled with the vessel sealing instrument 100. Suitable input couplers can be adapted to mate with various types of motor packs (not shown), such as the universal motor packs disclosed in U.S. Pat. No. 8,529,582, the disclosure of which is incorporated by reference herein in their entirety. Further details ofknown input couplers and surgical systems are described, for example, in U.S. Pat. No. 8,597,280, U.S. Pat. No. 7,048,745, and U.S. Pat No. 10,016,244. Each of these patents is hereby incorporated by reference in its entirety for all purposes.

[0055] Actuation mechanisms of surgical instrument 100 may employ drive cables, rods or bands that are used in conjunction with a system of motors and pulleys. Powered surgical systems, including robotic surgical systems that utilize drive cables or bands connected to a system of motors and pulleys for various functions including opening and closing of jaws, as well as for movement and actuation of end effectors are well known. Further details of known drive cable and band surgical systems are described, for example, in U.S. Pat. Nos. 7,666,191, 8,271,230 and 9,050,119 and Publication No. WO 2020 / 252184, all of which are hereby incorporated by reference in their entireties. While described herein with respect to a vessel sealing instrument configured for use with a robotic surgical system, it should be understood that the actuation and drive assemblies described herein may be incorporated into manually actuated instruments, electro-mechanical powered instruments, or instruments actuated in any other way.

[0056] Fig. 1C illustrates an example robotic surgical system in which a surgical vessel sealing instrument may be employed. Specifically, Fig. 1C illustrates a top view of an operating room employing a robotic surgical system 300. The robotic surgical system 300 including a Console (“C”) utilized by a Surgeon (“S”) while performing a minimally invasive diagnostic or surgical procedure, usually with assistance from one or more Assistants (“A”), on a Patient (“P”) who is lying down on an Operating table (“O”).

[0057] The Console includes a monitor 304 for displaying an image of a surgical site to the Surgeon, left and right manipulatable control devices 308 and 309, a foot pedal 305, and a processor 302. The control devices 308 and 309 may include any one or more of a variety of input devices such as joysticks, gloves, trigger-guns, hand-operated controllers, or the like. Theprocessor 302 may be a dedicated computer that may be integrated into the Console or positioned next to it.

[0058] The Surgeon performs, e.g., a minimally invasive surgical procedure, by manipulating the control devices 308, 309 so that the processor 302 causes their respectively associated robotic arm assemblies 328 and 329 to manipulate their respective removably coupled surgical instruments 100a and 100b accordingly, while the Surgeon views the surgical site in 3-D on the Console monitor 304 as it is captured by a stereoscopic endoscope 340.

[0059] Each of the surgical instruments 100a, 100b, as well as the endoscope 340, may be inserted through a cannula or other tool guide (not shown) into the Patient so as to extend down to the surgical site through corresponding minimally invasive incisions 366. Each of the robotic arms is conventionally formed of links, such as link 362, which are coupled together and manipulated through motor controlled or active joints, such as joint 363.

[0060] The number of surgical instruments used at one time, and consequently the number of robotic arms being used in the system 300, will generally depend on the diagnostic or surgical procedure and the space constraints within the operating room, among other factors. If it is necessary to change one or more of the surgical instruments 100a, 100b being used during a procedure, the Assistant may remove the surgical instrument no longer being used from its robotic arm, and replace it with another surgical instrument.

[0061] The monitor 304 may be positioned near the Surgeon's hands so that it will display a projected image that is oriented so that the Surgeon feels that he or she is actually looking directly down onto the operating site. To that end, images of the surgical instruments 100a, 100b may appear to be located substantially where the Surgeon's hands are located.

[0062] The processor 302 may perform various functions in the system 300. One function that it may perform is to translate and transfer the mechanical motion of control devices 308 and 309 to their respective robotic arms 328 and 329 through control signals overa bus 310 so that the Surgeon can effectively manipulate their respective surgical instruments 100a, 100b. Another function that the processor 302 may perform is implementing various control system processes as described herein.

[0063] Although described as a processor, it is to be appreciated that the processor 302 may be implemented in practice by any combination of hardware, software and firmware. Also, its functions as described herein may be performed by one unit, or divided up among different components, each of which may be implemented in turn by any combination of hardware, software and firmware. Additional details on robotic surgical systems, can be found in, e.g., commonly owned U.S. Pat. No. 6,493,608 and International Application WO 2017 / 132611, the entire disclosures of each being fully incorporated by reference herein.

[0064] Returning now to FIG. 1 A and as mentioned above, in the embodiment shown, the ultrasonic transducer 106 is located distal to the articulation wrist 104, such that transverse vibrations are not increased by the ultrasonic vibrations travelling through and / or around the angle created by the articulation wrist 104. In order to achieve optimized vibrational performance, the blade 101 of the vessel sealing instrument 100 may have a particular profile. Advantageously, the blade 101 may have a first sectional density or mass per cross-sectional area at a proximal location along its blade length, and a second sectional density at a more distal location along its blade length, wherein the second sectional density is less than the first mass sectional density. In the embodiment shown, this reduction in sectional density area along the distal length of the blade 101 is achieved by an optimized curved profile that provides the blade 101 with a smaller diameter at its distal end and a relatively larger diameter closer to its proximal end. This gradual reduction of the blade’s sectional density may be achieved by having, e.g., a profile that is exponential, catenoidal, cosine, conic, Gaussian, or stepped horn. Advantageously, the gradual reduction of the blade’s sectional density is optimized by having the profile of the blade 101 be a non-uniform rational B-spline (NURBS) profile.

[0065]

[0066] Additionally, or alternatively, the reduction in sectional density along the distal length of the blade 101 may be achieved by different methods. For example, in embodiments, the reduction in sectional density along the distal length of the blade 101 may be achieved by the transducer having a gradual reduction of its sectional density by having a plurality of holes or slots disposed therein.

[0067] FIG. 3A illustrates a transducer 400 for which a reduction in mass per cross- sectional area along the distal length of the blade is achieved by the transducer having a plurality of holes 401 along its length. While these holes 401 are shown in FIG. 3 A as being generally circular in shape, of relatively equal size and in a substantially longitudinally oriented pattern, such holes can take a variety of different shapes, sizes and patterns so as to achieve the reduction in mass per cross-sectional area along the distal length of the blade. For example, FIG. 3B illustrates a transducer 500 for which the reduction in mass per cross-sectional area along the distal length of the blade is achieved by the transducer having a plurality of different sized holes 501, in a different pattern along its length. In some embodiments, such holes can have consistent depths along the length of the blade. However, still other embodiments, the depths of the holes may deepen from the proximal end of the transducer towards the distal end of the transducer, thereby increasing the rate of reduction in mass per cross-sectional area along the distal length of the blade. Other arrangements of such holes, in different shapes, patterns and sizes, are also contemplated herein.

[0068] Additionally, or alternatively to holes, the reduction in mass per cross-sectional area along the distal length of the blade can also be achieved by the transducer having a plurality of different sized slots therein. Such slots could also have a variety of different shapes, sizes and patterns. For example, FIG. 3C illustrates a transducer 600 for which the reduction in mass per cross-sectional area along the distal length of the blade is achieved by thetransducer having a plurality of helical slots 601 arranged along its length. Other arrangements of such slots, in different shapes, patterns and sizes, are also contemplated herein.

[0069] For example, FIG. 3D illustrates a transducer 700 for which the reduction in mass per cross-sectional area along the distal length of the blade is achieved by the transducer having a plurality of relatively straight, e.g., horizontal, slots 701 arranged along its length. In some embodiments, such slots 701 can have consistent depths along their individual lengths. However, in the embodiment shown in FIG. 3D, the slots 701 may have depths that deepen from the proximal end of the transducer 700 towards the distal end of the transducer 700, thereby increasing the rate of reduction in mass per cross-sectional area along the distal length of the blade.

[0070] Unlike previous designs, the embodiment shown in FIG. 1A has a relatively shorter longitudinal length than conventional transducers, and thus does not suffer from the drawbacks of these conventional transducers mentioned hereinabove. For example, a primary drawback of conventional designs is that the length of the vessel sealing instrument that is distal relative to the articulation wrist is undesirably long and therefore difficult to maneuver within the tight anatomical spaces within a minimally invasive surgical space inside a patient’s body. This drawback is alleviated by the shorter longitudinal length achieved via optimized transducer performance described herein.

[0071] In the embodiment of FIG. 1A, the optimized transducer 106 and blade 101 configuration may provide a length of about 40 mm to about 44 mm, or about 42 mm, from the articulation wrist 104 to the distalmost tip of the blade 101. In addition, the transducer 106 may have an outer diameter of less than about 8 mm, or about 5 mm, enabling it to fit within an outer sleeve 103 having an outer diameter of about 8mm, thereby ensuring that the vessel sealing instrument 100 is compatible with standard laparoscopic trocars (not shown).

[0072] FIGS. 2A-C illustrate another embodiment. Specifically, Fig. 2A is aperspective view of a surgical vessel sealing instrument 200, in accordance with various embodiments. Like the previously described embodiment, the surgical vessel sealing instrument 200 includes a first portion 205a and a second portion 205b. The first portion 205a of the vessel sealing instrument 200 is located distally of an articulation wrist 204, while the second portion 205b of the vessel sealing instrument 200 is located proximally of the articulation wrist 204. The articulation wrist 204 provides structure that enables, e.g., at least two degrees of freedom of movement in the pitch and yaw directions of the first portion 205a relative to the second portion 205b.

[0073] The first portion 205a of the surgical vessel sealing instrument 200, as shown, also includes a pair of jaws. Specifically, as shown, the first portion 205a has a first jaw 201 and a second jaw 202. The first jaw 201 comprises a blade 201 configured as an ultrasonic waveguide. The second jaw 202 is pivotably mounted relative to the first arm 201. An outer sleeve 203 extends distal of the articulation wrist 204. An actuating mechanism (hidden in this view) is coupled to the first and second jaws 201, 202 and is operable to pivot the second jaw 202 relative to the first jaw 201 so as to apply sealing pressure to tissue when such tissue is placed between the first and second jaw 201, 202.

[0074] Housed within the outer sleeve 203 is an ultrasonic transducer 206. The ultrasonic transducer 206 is internal to the outer sleeve 203 and is therefore shown in FIG. 2A in dotted line format, additional details being shown in FIGS. 2B and 2C. Like the ultrasonic transducer described above, the ultrasonic transducer 206 is configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw 201. The ultrasonic transducer 206 is located distally relative to the articulation wrist 204, such that the transverse vibrations are not amplified or exacerbated by travelling through and / or around the angle created by the articulation wrist 204. FIGS. 2B and 2C illustrates the transducer 206 removed from the outer sleeve 203 and the waveguide 206a removed from the transducer 206, and shows the blade 201connected at its proximal end to a flange 208, and a proximal rod 207 extending proximally from the flange 208. FIG. 2C shows this same transducer 206 with an ultrasonic body 209 mounted onto the proximal rod 207.

[0075] The embodiment shown in FIGS. 2A-C has the additional advantage of providing a still shorter longitudinal length of the vessel sealing instrument 200. This is achieved, e.g., by increasing the relative spacing between the flange 208 of the transducer 206 and the pivot point 210 (see FIG. 2A) of the first and second jaws 201, 202. More specifically, the second jaw 202 is shortened (relative to other designs) such that the pivot point 210 of the first and second jaws 201, 202 is located more distally along the first jaw 201.

[0076] While the above-described embodiments achieve the reduction in mass per cross-sectional area along the distal length of the blade by the transducer having optimized blade profiles and / or by employing various different sizes, shapes and patterns of holes and / or slots, there is also contemplated arrangements which employ flexural design as a way to achieve the desired length and frequency requirements. An example of such a flexural design is a single-folded horn design, such as shown schematically in FIG. 4A. FIG. 4A illustrates a transducer 1406 having a blade 1401 connected at its proximal end to a flange 1408, and a proximal rod 1407 extending proximally from the flange 1408. FIG. 4 A shows a horn 1420 mounted thereon, the horn 1420 having a first folded horn portion 1420a, which extends distally from the horn 1420. The other components of the transducer 1406 (not labelled) include the well-known features of a transducer, e.g., back mass etc.

[0077] FIG. 4B illustrates an alternative transducer design having a double-folded horn configuration. Specifically, FIG. 4B illustrates a portion of a transducer 1506 (certain components not being shown) having a blade 1501 connected at its proximal end to a flange 1508. FIG. 4B shows a horn 1520 mounted thereto, the horn 1520 having a first folded horn portion 1520a, which extends distally from the horn 1520. In addition, FIG. 4B shows that thefirst folded horn portion 1520a has a fold at the distalmost end thereof, forming a second folded horn portion 1520b which extends proximally from the distalmost end of the first folded horn portion 1520a. Again, the other components of the transducer 1506 (not labelled) include the well-known features of a transducer, e.g., back mass etc.

[0078] According to various embodiments, and as mentioned previously, the ultrasonic transducer arrangements set forth herein employ a half-wavelength design. When using a halfwavelength design, there is typically a single node location where the transducer can be supported. However, supporting the transducer at a different location - so as to enable configurations such as those described hereinabove - can be achieved by using a spring that has less stiffness in one direction, e.g., a horizontal direction, than it has in a different direction, e.g., a lateral direction. One such example of a spring that has less stiffness in one direction, e.g., a horizontal direction, than it has in a different direction, e.g., a lateral direction, is a slotted disc spring 1001 such as shown in FIG. 5 A. Another such example of a spring that has less stiffness in one direction, e.g., a horizontal direction, than it has in a different direction, e.g., a lateral direction, is a tangential linear flexure bearing 1002, such as shown in FIG. 5B and which is described in additional detail in U.S. Patent No. 5,492,313, the entire contents of which are incorporated by reference herein. Of course, it should be recognized that the slotted disc spring 1001 shown in FIG. 5 A and the tangential linear flexure bearing 1002 shown in FIG. 5B are merely two examples of springs that have less stiffness in one direction than in a different direction, and that many other examples of such a spring may be employed for enabling the transducer to be supported at optimal locations other than the single node location.

[0079] While several embodiments have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. For example, the device described herein is not limited to only the mechanisms described herein, as other suitabledevices or mechanisms are also contemplated. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Thus, the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.

[0080] Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Various alternatives and modifications can be devised by those skilled in the art without departing therefrom. Accordingly, it is intended to embrace all such alternatives, modifications and variances. As well, one skilled in the art will appreciate further features and advantages based on the above-described embodiments. Accordingly, it is not intended to be limited by what has been particularly shown and described, except as indicated by the appended claims.

Claims

CLAIMSWhat is claimed is:

1. A vessel sealing instrument, comprising: a first jaw having a blade configured as an ultrasonic waveguide; a second jaw pivotably mounted to the first jaw; an actuating mechanism coupled to the first and second jaws and operable to pivot the second jaw relative to the first jaw; and an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw, wherein the blade has a first sectional density at a proximal portion of the blade and a second sectional density at a distal portion of the blade, wherein the second sectional density is less than the first sectional density.

2. The vessel sealing instrument of claim 1, wherein a sectional density of the blade tapers in a distal direction along a length of the blade.

3. The vessel sealing instrument of claim 1, wherein the blade comprises a cross-sectional profile selected from the group consisting of exponential, catenoidal, cosine, conic, Gaussian, and stepped horn.

4. The vessel sealing instrument of claim 1, wherein the blade comprises a Non-Uniform Rational B-Spline (NURBS-based) cross-sectional profile.

5. The vessel sealing instrument of claim 1, wherein the blade comprises a plurality of holes or slots.

6. The vessel sealing instrument of claim 5, wherein the plurality of holes or slots are horizontal.

7. The vessel sealing instrument of claim 5, wherein the plurality of holes or slots are helical.

8. The vessel sealing instrument of claim 5, wherein the plurality of holes or slots each have substantially the same depth.

9. The vessel sealing instrument of claim 5, wherein the plurality of holes or slots each have a depth, wherein the depth of the holes or slots increases in a distal direction.

10. The vessel sealing instrument of claim 1, further comprising: a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist, wherein the ultrasonic transducer is located in the second portion of the robotic control arm distal to the articulation wrist.

11. The vessel sealing instrument of claim 10, wherein the articulation wrist provides at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm.

12. The vessel sealing instrument of claim 1, wherein the ultrasonic transducer generates ultrasonic vibrations at a resonance frequency of about 40 kHz to about 80 kHz.

13. The vessel sealing instrument of claim 12, wherein the resonance frequency is about 55.6.

14. A robotic surgical system comprising: a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist, a vessel sealing instrument configured for coupling to the second portion of the robotic control arm, the vessel sealing instrument comprising: a first jaw having a blade configured as an ultrasonic waveguide; a second jaw pivotably mounted relative to the first jaw; and an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw, the ultrasonic transducer located distal to the articulation wrist.

15. The robotic surgical system of claim 14, wherein the articulation wrist provides at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm.

16. The robotic surgical system of claim 14, wherein the blade of the instrument has a first sectional density at a proximal portion of the blade, and a second sectional density at a distal portion of the blade, wherein the second sectional density is less than the first sectional density.

17. The robotic surgical system of claim 14, wherein a sectional density of the blade tapers in a distal direction along a length of the blade.

18. The robotic surgical system of claim 14, wherein the blade comprises a cross-sectional profile selected from the group consisting of exponential, catenoidal, cosine, conic, Gaussian, and stepped horn.

19. The robotic surgical system of claim 14, wherein the blade comprises a Non-Uniform Rational B-Spline (NURBS-based) cross-sectional profile.

20. The robotic surgical system of claim 14, wherein the blade comprises a plurality of holes or slots.

21. The robotic surgical system of claim 20, wherein the plurality of holes or slots are one of horizontal and helical.

22. The robotic surgical system of claim 20, wherein the plurality of holes or slots each have substantially the same depth.

23. The robotic surgical system of claim 20, wherein the plurality of holes or slots each have a depth, wherein the depth of the holes or slots increases in a distal direction.

24. The robotic surgical system of claim 14, wherein the ultrasonic transducer generates ultrasonic vibrations at a resonance frequency of about 40 kHz to about 80 kHz.

25. The robotic surgical system of claim 24, wherein the half wavelength at resonance frequency is about 55.6.

26. A vessel sealing instrument, comprising: a first jaw having a blade configured as an ultrasonic waveguide; a second jaw pivotably mounted relative to the first jaw;an actuating mechanism coupled to the first and second jaws and operable to pivot the second jaw relative to the first jaw; and an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw, wherein the transducer comprises a vibration amplifier in the form of a horn, the horn including a first folded horn portion that extends distally.

27. The vessel sealing instrument of claim 26, wherein the horn includes a second folded horn portion which extends proximally from a distalmost end of the first folded horn portion.

28. The vessel sealing instrument of claim 26, further comprising: a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist, wherein the ultrasonic transducer is located in the second portion of the robotic control arm distal to the articulation wrist.

29. The vessel sealing instrument of claim 26, wherein the articulation wrist provides at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm.

30. The vessel sealing instrument of claim 25, wherein the ultrasonic transducer generates ultrasonic vibrations at a resonance frequency of about 40 kHz to about 80 kHz.

31. An articulating robotic vessel sealing instrument, comprising: a first jaw having a blade configured as an ultrasonic waveguide; a second jaw pivotably mounted relative to the first jaw; an actuating mechanism coupled to the first and second jaws and operable to pivot the second jaw relative to the first; and an ultrasonic transducer configured to receive an electrical signal and to generate ultrasonic vibrations along the first jaw,the transducer being at least partially supported by a spring that has a first stiffness in a first direction and a second stiffness in a second direction, the first stiffness less than the second stiffness.

32. The articulating robotic vessel sealing instrument of claim 31, wherein the spring is a slotted disc spring.

33. The articulating robotic vessel sealing instrument of claim 31, wherein the spring is a tangential linear flexure bearing.

34. The vessel sealing instrument of claim 31, further comprising: a robotic control arm having an articulation wrist, a first portion of the robotic control arm being proximal to the articulation wrist and a second portion of the robotic control arm being distal to the articulation wrist, wherein the ultrasonic transducer is located in the second portion of the robotic control arm distal to the articulation wrist.

35. The articulating robotic vessel sealing instrument of claim 34, wherein the articulation wrist provides at least two degrees of freedom of movement in the pitch and yaw directions of the first portion of the robotic control arm relative to the second portion of the robotic control arm.

36. The articulating robotic vessel sealing instrument of claim 31, wherein the ultrasonic transducer generates ultrasonic vibrations at a resonance frequency of about 40 kHz to about 80 kHz.

Images