Ultrasonic surgical instrument, shears and tissue pad, method for sealing a blood vessel and method for transecting patient tissue

Abstract

An ultrasonic surgical shears has a bifurcated ultrasonic surgical blade, a clamping arm and a substantially “T”-shaped tissue pad. An alternate ultrasonic surgical shears has an ultrasonic surgical blade, a clamping arm, and a tissue pad having first and second transverse outer portions and a movable transverse central portion. An ultrasonic surgical instrument has an ultrasonic surgical clamp including an ultrasonic member adapted to ultrasonically vibrate and has a surgical cutter distinct from the ultrasonic member. A method for sealing a blood vessel of a patient includes obtaining an ultrasonic surgical clamp, sealing the blood vessel with the ultrasonic member, and transecting the sealed blood vessel using the surgical cutter. An alternate method similarly transects patient tissue and seals a blood vessel therein. An ultrasonic-surgical-shears tissue pad includes first and second transverse outer portions which are more resiliently flexible than is a transverse central portion.

1 . An ultrasonic surgical shears comprising: 
 a) a bifurcated ultrasonic surgical blade having a first distal tip portion and a second distal tip portion transversely spaced apart from the first distal tip portion creating a space therebetween;    b) a clamping arm operable to open and close toward the blade to define a clamped position and an unclamped position; and    c) a substantially “T”-shaped tissue pad attached to the clamping arm and having first and second arms and a foot each having a clamping surface, wherein, in the clamped position, the clamping surface of the first arm faces substantially toward the first distal tip portion, the clamping surface of the second arm faces substantially toward the second distal tip portion, and the clamping surface of the foot faces substantially toward the space between the first and second distal tip portions.    
   
   
       2 . The ultrasonic surgical shears of  claim 1 , wherein the first and second distal tip portions of the blade each have a substantially rectangular transverse cross section.  
   
   
       3 . The ultrasonic surgical shears of  claim 2 , wherein the clamping surface of the foot of the tissue pad has a transverse length which is substantially equal to the transverse distance between the first and second distal tip portions of the blade creating, in a fully clamped position as viewed in a transverse cross section, a first pinch point between the first arm of the tissue pad and the first distal tip portion of the blade and a second pinch point between the second arm of the tissue pad and the second distal tip portion of the blade.  
   
   
       4 . The ultrasonic surgical shears of  claim 3 , wherein, in a transverse cross section, the foot of the tissue pad has a substantially rectangular shape.  
   
   
       5 . The ultrasonic surgical shears of  claim 2 , wherein the clamping surface of the foot has a transverse length which is less than the transverse distance between the first and second distal tip portions.  
   
   
       6 . The ultrasonic surgical shears of  claim 2 , wherein the clamping surface of the foot has a transverse length which is greater than the transverse distance between the first and second distal tip portions.  
   
   
       7 . The ultrasonic surgical shears of  claim 5 , wherein, in a transverse cross section, the foot of the tissue pad has a substantially trapezoidal shape which narrows toward the clamping surface of the foot.  
   
   
       8 . A method for sealing a blood vessel of a patient comprising the steps of: 
 a) obtaining an ultrasonic surgical clamp including an ultrasonic member, a clamping arm operable to open and close toward the ultrasonic member, and a tissue pad attached to the clamping arm and having a clamping surface;    b) disposing the blood vessel between the ultrasonic member and the clamping surface;    c) operating the clamping arm to clamp the blood vessel between the ultrasonic member and the clamping surface and ultrasonically vibrating the ultrasonic member to seal but not transect the blood vessel;    d) obtaining a surgical cutter distinct from the ultrasonic member; and    e) transecting the sealed blood vessel using the surgical cutter.    
   
   
       9 . The method of  claim 8 , also including, before step e), the step of unclamping the ultrasonic surgical clamp from the blood vessel.  
   
   
       10 . The method of  claim 8 , also including, after step e), the step of unclamping the ultrasonic surgical clamp from the blood vessel.  
   
   
       11 . The method of  claim 8 , wherein the surgical cutter is a non-energy-based surgical cutter.  
   
   
       12 . The method of  claim 8 , wherein the surgical cutter is an energy-based surgical cutter.  
   
   
       13 . The method of  claim 8 , wherein the surgical cutter is a separate surgical instrument from the ultrasonic surgical clamp.  
   
   
       14 . The method of  claim 8 , wherein the surgical cutter and the ultrasonic surgical clamp are portions of a single surgical instrument.  
   
   
       15 . The method of  claim 8 , wherein the tissue pad and the ultrasonic member each have a substantially rectangular transverse cross sectional shape.  
   
   
       16 . A method for transecting patient tissue and sealing a blood vessel therein comprising the steps of: 
 a) obtaining an ultrasonic surgical clamp including an ultrasonic member, a clamping arm operable to open and close toward the ultrasonic member, and a tissue pad attached to the clamping arm and having a clamping surface;    b) disposing the patient tissue between the ultrasonic member and the clamping surface;    c) operating the clamping arm to clamp the patient tissue between the ultrasonic member and the clamping surface and ultrasonically vibrating the ultrasonic member to seal the blood vessel but not transect the patient tissue including the blood vessel;    d) obtaining a surgical cutter distinct from the ultrasonic member; and    e) transecting the patient tissue including the sealed blood vessel using the surgical cutter.    
   
   
       17 . An ultrasonic surgical instrument comprising: 
 a) an ultrasonic surgical clamp including an ultrasonic member, a clamping arm operable to open and close toward the ultrasonic member, and a tissue pad attached to the clamping arm and having a clamping surface, wherein the ultrasonic surgical clamp is adapted to ultrasonically seal a blood vessel clamped between the clamping surface of the tissue pad and the ultrasonic member by ultrasonically vibrating the ultrasonic member; and    b) a surgical cutter distinct from the ultrasonic member, connected to the ultrasonic surgical clamp, and adapted to transect a blood vessel which has been sealed by the ultrasonic surgical clamp.    
   
   
       18 . The ultrasonic surgical instrument of  claim 17 , wherein the surgical cutter is a non-energy-based surgical cutter.  
   
   
       19 . The ultrasonic surgical instrument of  claim 17 , wherein the surgical cutter is an energy-based surgical cutter.  
   
   
       20 . The ultrasonic surgical instrument of  claim 17 , wherein the tissue pad and the ultrasonic member each have a substantially rectangular transverse cross sectional shape.  
   
   
       21 . An ultrasonic surgical shears comprising: 
 a) an ultrasonic surgical blade;    b) a clamping arm operable to open and close toward the blade to define a clamped position and an unclamped position; and    c) a tissue pad attached to the clamping arm and having first and second transverse outer portions and a transverse central portion disposed between the first and second transverse outer portions, wherein the transverse central portion is movable, with respect to the first and second transverse outer portions, toward the blade.    
   
   
       22 . The ultrasonic surgical shears of  claim 21 , wherein the ultrasonic surgical blade is a bifurcated ultrasonic surgical blade having a first distal tip portion and a second distal tip portion transversely spaced apart from the first distal tip portion creating a space therebetween, wherein the transverse central portion is movable into the space between the first and second distal tip portions.  
   
   
       23 . The ultrasonic surgical shears of  claim 21 , wherein each of the first and second transverse outer portions is movable, with respect to the transverse central portion, away from the blade.  
   
   
       24 . The ultrasonic surgical shears of  claim 21 , wherein the blade has a substantially rectangular transverse cross sectional shape.  
   
   
       25 . The ultrasonic surgical shears of  claim 24 , wherein the transverse central portion and the first and second transverse outer portions each have a substantially rectangular transverse cross sectional shape.  
   
   
       26 . An ultrasonic-surgical-shears tissue pad comprising an ultrasonic-surgical-shears tissue pad body having a top surface attachable to a clamping arm of an ultrasonic surgical shears, having a bottom surface including a clamping surface, having a clamping direction, having first and second transverse outer portions each extending from the top to the bottom surface, and having a transverse central portion disposed between the first and second transverse outer portions and extending from the top to the bottom surface, wherein the first and second transverse outer portions are more resiliently flexible along the clamping direction than is the transverse central portion.  
   
   
       27 . The ultrasonic-surgical-shears tissue pad of  claim 26 , wherein the tissue pad body has a substantially rectangular transverse cross section and has a “T”-shaped segment having first and second arms and a central stem, wherein the transverse central portion includes the entire central stem and none of the first and second arms, and wherein the central stem projects away from the first and second arms along the clamping direction.  
   
   
       28 . The ultrasonic-surgical-shears tissue pad of  claim 26 , wherein the tissue pad body has an inverse “T”-shaped segment having first and second arms and a central stem, wherein the transverse central portion includes the entire central stem and none of the first and second arms, and wherein the central stem projects away from the first and second arms along a direction opposite to the clamping direction.  
   
   
       29 . The ultrasonic-surgical-shears tissue pad of  claim 28 , wherein the tissue pad body has a substantially inverse “T”-shaped transverse cross section.  
   
   
       30 . The ultrasonic-surgical-shears tissue pad of  claim 28 , wherein the tissue pad body has a substantially rectangular transverse cross section.