WO2006101661A2 - Ultrasonic wound debrider probe and method of use - Google Patents

Ultrasonic wound debrider probe and method of use Download PDF

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Publication number
WO2006101661A2
WO2006101661A2 PCT/US2006/006490 US2006006490W WO2006101661A2 WO 2006101661 A2 WO2006101661 A2 WO 2006101661A2 US 2006006490 W US2006006490 W US 2006006490W WO 2006101661 A2 WO2006101661 A2 WO 2006101661A2
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WO
WIPO (PCT)
Prior art keywords
probe
face
bore
lateral surface
head portion
Prior art date
Application number
PCT/US2006/006490
Other languages
French (fr)
Other versions
WO2006101661A3 (en
Inventor
Theodore A. D. Novak
Ronald R. Manna
Dan Voic
Scott Isola
Original Assignee
Misonix Incorporated
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Misonix Incorporated filed Critical Misonix Incorporated
Priority to JP2008502995A priority Critical patent/JP2008538299A/en
Priority to CA2602485A priority patent/CA2602485C/en
Publication of WO2006101661A2 publication Critical patent/WO2006101661A2/en
Publication of WO2006101661A3 publication Critical patent/WO2006101661A3/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/54Chiropodists' instruments, e.g. pedicure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00747Dermatology
    • A61B2017/00761Removing layer of skin tissue, e.g. wrinkles, scars or cancerous tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005Effects, e.g. on tissue
    • A61B2017/22007Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing
    • A61B2017/22008Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing used or promoted
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/32007Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072Working tips with special features, e.g. extending parts
    • A61B2017/320078Tissue manipulating surface

Definitions

  • This invention relates to ultrasonic surgical instruments and associated methods of use.
  • this invention relates to high-efficiency medical treatment probes for ultrasonic surgical aspirators. These probes increase the ability to fragment and emulsify hard and soft tissue in a clinical environment while reducing unwanted heat and collateral tissue damage.
  • these surgical devices include a blunt tip hollow probe that vibrates at frequencies between 20 kc and 100 kc, with amplitudes up to 300 microns or more.
  • Such devices ablate tissue by either producing cavitation bubbles which implode and disrupt cells, tissue compression and relaxation stresses (sometimes called the jackhammer effect) or by other forces such as micro streaming of bubbles in the tissue matrix.
  • the effect is that the tissue becomes liquefied and separated. It then becomes emulsified with the irrigant solution. The resulting emulsion is then aspirated from the site. Bulk excision of tissue is possible by applying the energy around and under an unwanted tumor to separate it from the surrounding structure. The surgeon can then lift the tissue out using common tools such as forceps.
  • the probe or tube is excited by a transducer of either the piezoelectric or magnetostrictive type that transforms an alternating electrical signal within the frequencies indicated into a longitudinal or transverse vibration.
  • a transducer of either the piezoelectric or magnetostrictive type that transforms an alternating electrical signal within the frequencies indicated into a longitudinal or transverse vibration.
  • the two become a single element with series and parallel resonances.
  • the designer will try to tailor the mechanical and electrical characteristics of these elements to provide the proper frequency of operation.
  • the elements will have a long axis that is straight and has the tip truncated in a plane perpendicular to the long axis, as shown in Fig 1. This is done for simplicity and economic considerations. In almost all applications, whether medical or industrial, such an embodiment is practical and useful.
  • the blunt straight probe has been shown to be less effective in removing the hard eschar buildup that occurs when the wound is healing. This eschar buildup must be removed so that the healthy tissue is exposed and allowed to close the wound to provide complete healing with minimal scar tissue formation.
  • the small diameter tip since it is cannulated, has a small annular area with limits energy transmission into the wound. This extends the length of the procedure and causes operator fatigue and patient discomfort.
  • the present invention aims to provide an improved ultrasonic surgical instrument for use in debridement of wounds, particularly which may be used in conjunction with ultrasonic surgical aspirators to debride wounds.
  • the present invention further aims to provide an improved ultrasonic surgical instrument with a form that enhances surgical efficiency and reduces the time required to complete at least some kinds of debridement procedures.
  • such an improved ultrasonic surgical instrument has irrigation or suction capability arid may be used in debriding deep wounds such as cuts and puncture wounds.
  • the present invention seeks to provide an improved ultrasonic surgical instrument that has liquid directing channels for greater heat reduction at the distal face and to prevent liquid jetting or spraying from the tissue probe interface.
  • a probe for use as an ultrasonically vibrating tool is disclosed with a central bore coincident with the longitudinal axis.
  • the proximal end of said bore communicates with a bore in the ultrasonic handpiece using methods well known to the art, such as a male/female thread
  • the probe is shaped such as to provide both a resonant frequency of operation in the range for which the electronic generator was designed and an amplitude of vibration at the distal face which is desired for proper tissue ablation.
  • Such amplitudes have generally been shown to be in the range of 30 to 300 microns. Again, the technique needed for calculating said shapes is well known to the art and outside the scope of this disclosure.
  • Probe heads or ends in accordance with the present invention incorporate either a substantially symmetrical distal end or a distal end with a pronounced asymmetry. Each end has attributes that increase its effectiveness on varying tissue pathologies.
  • Probe ends pursuant to the present invention are further modified to improve the liquid flow to the probe/tissue interface such as to reduce the bulk temperature rise of the tissue and prevent clogging of the liquid passageway.
  • Probe ends are further modified to produce energy directors that impart energy from the sides of the probes instead of only at the distal face of the probe. Such energy directors, when contacting skin or tissue, will increase volume of tissue treated per unit time and thereby reduce the operating time of the procedure.
  • an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the shaft is provided with an internal longitudinal channel or bore extending to the end face.
  • the end face is formed with an indentation communicating with the channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
  • the head portion may be enlarged in a transverse direction relative to the shaft.
  • the end face has an elongated shape, while the indentation is elongate and forms a groove in the end face of the head portion. This groove may extend parallel to or in a length dimension of the end face .
  • the end face is inclined or beveled relative to the longitudinal axis of the probe.
  • an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the head portion also has a lateral surface extending substantially parallel to the longitudinal axis of the probe.
  • the lateral surface is provided with at least one outwardly or radially extending projection. The projection enables the application of ultrasonic cavitation energy to a tissue surface that is in contact with the lateral or side surface of the probe head.
  • the projection is one of a plurality of projections extending from the lateral surface.
  • the projections may be identical to one another and staggered from one another along the lateral surface of the probe head.
  • the projections may have a shape that is pyramidal, semi-cylindrical, wedge-shaped, or plate-like.
  • the projections may lie down against the lateral surface of the probe head, in the nature of fish scales, flaps, or flattened plates.
  • the projections may take the form of ridges.
  • the projections or ridges may extend perimetrally or circumferentially about the probe head. Preferably, however, the projections or ridges are disposed only along one side (or possibly two sides, in some applications) of the probe head.
  • the probe head may take a prismatic form, with the energy-directing projections or ridges formed along one (or two) lateral surfaces thereof. This placement of the energy- directing projections facilitates use of the probe in surgical procedures, inasmuch as it is
  • M24-139 easier for the surgeon to keep track of the location of the projections to ensure that the projections come into contact only with target debridement tissues.
  • the projections may be finely distributed over a lateral face of the probe head so as to form a knurled surface.
  • a knurled surface is similar to that found on a metal filing tool.
  • the shaft and the probe head may be provided with an internal longitudinal channel or bore extending to the end face of the probe head, with the end face being formed with an indentation communicating with the channel or bore at a distal end thereof.
  • the indentation extends laterally relative to the channel or bore, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
  • the indentation may be elongate and form a groove in the end face of the head portion. Where the head portion has an elongated shape, the groove may extend parallel to a length dimension of the end face.
  • a surgical method in accordance with the present invention utilizes a probe vibratable at at least one ultrasonic frequency, the probe having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the method comprises bringing the distal end face into contact with organic tissues of a patient, energizing the probe to vibrate the end face at the ultrasonic frequency during the contacting of the tissues with the distal end face, and channeling liquid between the contacted tissues and a longitudinal bore in the probe, during the contacting of the tissues with the distal end face, via an indentation in the end face communicating with the bore.
  • the channeling of liquid includes guiding liquid from the contacted tissues to the bore.
  • the channeling of liquid comprises guiding liquid to the contacted tissues from the bore.
  • a surgical method in accordance with another feature of the present invention utilizes a probe vibratable at at least one ultrasonic frequency, where the probe has a distal end face oriented at least partially transversely to a longitudinal axis of the shaft, a lateral surface extending substantially perpendicularly to the end face and substantially parallel to the longitudinal axis, and at least one outwardly or radially extending projection extending out from the lateral surface.
  • the method comprises bringing the lateral surface together with the projection into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projection, energizing the probe to vibrate the lateral surface and the projection at the ultrasonic frequency.
  • the bringing of the lateral surface together with the projection into contact with organic tissues of a patient includes inserting a distal end portion of the probe into a fissure or recess in an organ of the patient and moving the probe so that the lateral surface and the projection contact a wall of the fissure or recess.
  • the bringing the lateral surface together with the projection into contact with organic tissues of a patient includes manipulating the probe so that the lateral surface is oriented substantially parallel to the organic tissues and so that the end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface and the projection.
  • an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the shaft is provided with an internal longitudinal channel or bore extending to the end face.
  • the end face is formed with an indentation communicating with the channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
  • the head portion may be enlarged in a transverse direction relative to the shaft.
  • the end face has an elongated shape, while the indentation is elongate and forms a groove in the end face of the head portion. This groove may extend parallel to or in a length dimension of the end face.
  • an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the head portion also has a lateral surface extending substantially parallel to the longitudinal axis of the probe.
  • the lateral surface is provided with at least one outwardly or radially extending projection.
  • the projection enables the application of ultrasonic cavitation energy to a tissue surface that is in contact with the lateral or side surface of the probe head.
  • the projection is one of a plurality of projections extending from the lateral surface.
  • the projections may be identical to one another and staggered from one another along the lateral surface of the probe head.
  • the projections may have a shape that is pyramidal, semi-cylindrical, wedge-shaped, or plate-like.
  • the projections may lie down against the lateral surface of the probe head, in the nature of fish scales, flaps, or flattened plates.
  • the projections may take the form of ridges or knurls.
  • the projections are disposed along only a portion of the lateral surface area of the probe head.
  • the probe head is prismatic with three or more planar lateral faces, the energy-direting
  • M24-139 projections are disposed along less than all of the lateral faces of the probe head. More preferably, the projections are disposed along only one or two lateral faces of the probe head.
  • the shaft and the probe head may be provided with an internal longitudinal channel or bore extending to the end face of the probe head, with the end face being formed with an indentation communicating with the channel or bore at a distal end thereof.
  • the indentation extends laterally relative to the channel or bore, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
  • the indentation may be elongate and form a groove in the end face of the head portion. Where the head portion has an elongated shape, the groove may extend parallel to a length dimension of the end face.
  • a surgical method in accordance with the present invention utilizes a probe vibratable at at least one ultrasonic frequency, the probe having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft.
  • the method comprises bringing the distal end face into contact with organic tissues of a patient, energizing the probe to vibrate the end face at the ultrasonic frequency during the contacting of the tissues with the distal end face, and channeling liquid between the contacted tissues and a longitudinal bore in the probe, during the contacting of the tissues with the distal end face, via an indentation in the end face communicating with the bore.
  • the channeling of liquid includes guiding liquid from the contacted tissues to the bore.
  • the channeling of liquid comprises guiding liquid to the contacted tissues from the bore.
  • a surgical method in accordance with another feature of the present invention utilizes a probe vibratable at at least one ultrasonic frequency, where the probe has a distal end face oriented at least partially transversely to a longitudinal axis of the shaft, a lateral surface
  • the method comprises bringing the lateral surface together with the projection into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projection, energizing the probe to vibrate the lateral surface and the projection at the ultrasonic frequency.
  • the bringing of the lateral surface together with the projection into contact with organic tissues of a patient includes inserting a distal end portion of the probe into a fissure or recess in an organ of the patient and moving the probe so that the lateral surface and the projection contact a wall of the fissure or recess.
  • the bringing the lateral surface together with the projection into contact with organic tissues of a patient includes manipulating the probe so that the lateral surface is oriented substantially parallel to the organic tissues and so that the end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface and the projection.
  • Fig. 1 is a cross sectional view of a prior art ultrasonic probe for use with an ultrasonic aspirator.
  • Fig. 2A is partially a side elevational view and partially a cross-sectional view of an ultrasonic probe in accordance with the present invention.
  • Fig. 2B is a distal end elevational view of the probe of Fig. 2A.
  • Fig. 2C is partially a top elevational view and partially a cross-sectional view of the probe of Fig. 2A.
  • Fig. 3 A is partially a side elevational view and partially a cross-sectional view of another ultrasonic probe in accordance with the present invention.
  • Fig. 3B is a distal end elevational view of the probe of Fig. 3 A, showing a modification in the form of an elongate groove in a distal end face of the probe head.
  • Fig. 3 C is a view similar to Fig. 3 A showing the groove of Fig. 3B.
  • Fig. 3D is a partial cross-sectional view taken along line III-III in Fig. 3C.
  • Fig. 4 is partially a side elevational view and partially a cross-sectional view of a further ultrasonic probe in accordance with the present invention.
  • Fig. 4 A is partial view, on a larger scale, of a lateral surface of a head of the probe of Fig. 4, taken in region IV-IV of Fig. 4.
  • Figs. 4B-4D are side elevational views of the probe head of Fig. 4, showing respective modifications of formations along the lateral surface thereof.
  • Fig. 4E is a perspective view of the probe head depicted in Fig. 4D.
  • Fig. 5 is partially a side elevational view and partially a cross-sectional view of yet another ultrasonic probe in accordance with the present invention.
  • Fig. 1 shows a probe 10 which is known to the art and is currently manufactured for use with an ultrasonic aspirator.
  • This probe 10 is basically shaped with an exponential or Gaussian taper.
  • Probe 10 is cannulated and has an integral male thread (not shown) at the proximal end (proximate the operator). This thread communicates with a female threaded bore (not illustrated) in the transducer 12.
  • the probe 10 is generally constructed of an acoustically efficient metal or ceramic. Titanium is the most commonly used material, but other material has been employed with success. Material choice does not have a significant impact upon the embodiments of this disclosure.
  • the distal end of the prior art probe 10 is truncated in a plane Pl perpendicular to the longitudinal axis 14 of the resonant body (probe and transducer). Since the probe 10 is cannulated, a distal end face 16 takes the form of an annular surface with a small cross sectional area.
  • the shape of the probe 10 allows the probe to become a velocity transformer, i.e., the probe will amplify the input vibrations from the transducer 12 by a fixed value, called a gain factor, determined by the geometry of the probe.
  • the probe 10 had a gain factor of 10
  • the probe would multiply the input vibration of the transducer, for example 30 microns, to a final amplitude at the distal end of the probe of 300 microns.
  • This phenomenon is well known to the art.
  • the tissue will be disrupted through cavitation and mechanical effects.
  • saline or water By adding saline or water to the tissue-probe interface, cooling of the tissue is achieved and the tissue is emulsified into the liquid and is more easily aspirated either through the center of the probe 10, if the center bore is connected to the aspirator or by separate suction cannulae if the center bore is connected to the irrigant source.
  • Figs. 2A-2C show a probe 18 with a shaft 19 and an enlarged distal head 20. More particularly, probe head 20 may be asymmetrical such that the cross sectional shape is rectangular or oval (see Fig. 2B). This asymmetry allows the probe 18 to maintain a higher gain factor and be more able to be inserted into smaller wounds.
  • the surface area of a distal end face 22 of probe head 20 is greatly increased over the prior art probe (Fig. 1) and will naturally ablate tissue at a
  • the shape of the probe head 20 allows access to irregularly shaped wound beds, such as cuts or fissures with slit openings.
  • FIG. 3A depicts a probe 24 having a shaft 25 and an asymmetrically enlarged head 26 with a truncated or beveled distal end face 28 located in a plane P2 that is not perpendicular to a longitudinal axis 30 of the probe.
  • This probe 24 has been shown to improve performance in removing the hard eschar buildup of bum wounds, which must be removed in order to expose healthy tissue.
  • the bore opening 32 or 34 may become blocked with tissue. This blockage prevents aspiration of the emulsified tissue, if the respective bore 36 or 38 is connected to a vacuum source (not shown) or blocks the flow of cooling fluid out of the probe, if the bore is attached to a pressurized liquid source (not shown). Because of the pressure buildup, the liquid has a tendency to jet or stream from the probe tissue interface, causing the irrigant to be sprayed around the room instead of onto the wound bed. Also, if the distal end face of the probe is very large, the liquid may not cover the entire face, even if the opening 32, 34 at the end of the probe is not blocked.
  • a channel, groove, indentation, or notch 40 is provided in the face 28 of the probe, as shown in Fig. 3B, 3C and 3D.
  • This channel 40 reduces the likelihood of blockage of an output opening 42 of the probe bore 38 by locating this opening or outlet proximally from the distal end face 28 of the probe head 26, while allowing the liquid to fill the channel 40 and cover the remaining distal surface area more fully.
  • Many alternative shapes of channels may be employed in the distal end faces of ultrasonic probes without changing the concepts outlined herein.
  • channel or groove 40 extend parallel to or in a length dimension of the end face 28,
  • the probes are limited in their ability to ablate tissue by the fact the only area where this ablation can occur is at the distal end face.
  • the sides or lateral surfaces of the probes are generally disposed parallel to the longitudinal axes and parallel to the direction of ultrasonic compression wave transmission. When tissue touches these lateral surfaces, no ablation occurs since the motion is a sliding or rubbing action, which does not transmit sufficient energy into the tissue to cause emulsion or ablation. It is therefore desired to improve ultrasonic tissue ablation probes so that energy may be transmitted from one or more lateral faces or side surfaces of the probe heads so that more tissue may be ablated per unit time. Figs.
  • probe head 50 has a prismatic shape with four planar lateral surfaces or faces 48, projections 46 being disposed only along one or two of the lateral surfaces.
  • energy-directing projections 46 are disposed only along two opposing lateral surfaces 48. Where projections occur along only one or at most two lateral surfaces 48, it is easier for the user to avoid contact with non-target tissues.
  • Probe head 50 may be integrally formed with a shaft portion 49 of probe 44. Alternatively, probe head 50 may be formed as a separate piece that is firmly attached to shaft 49,
  • M24-139 e.g., via mating screw threads (not shown) or a force or friction fit. These same alternatives also apply to probe heads 20, 26, 66.
  • Projections 46 may have a fine geometrical configuration and distribution so as to form the respective lateral surface 48 into a knurled surface as one would find, for example, on a metal file.
  • projections 46 may be a series of ridges or knurls on probe head 50.
  • projections or energy directors 46 may be pyramidal sections fashioned from the base metal of the probe 44 that project out in a substantially perpendicular direction from a longitudinal axis 51 of the probe. More specifically, projections or energy directors 46 are a series of parallel ridges or knurls each of triangular cross-section extending transversely to a direction of ultrasonic wave propagation.
  • Projections or energy directors 46 may include a first set of parallel ridges 46a and a second set of ridges 46b that is staggered relative to the first set.
  • Each set of wedge- or triangle-shaped projections or ridges 46a, 46b defines a corresponding set of grooves (not separately designated) each of triangular cross-section extending transversely to a direction of ultrasonic wave propagation.
  • the resulting faceted surfaces of projections or ridges 46a, 46b impart a vector force on the target tissue when the probe 44 vibrates, which will cause cavitation and emulsif ⁇ cation of the tissue when it contacts the faceted surfaces.
  • lateral surface 48 may be provided with energy-directing projections or ridges 52, 54, 56 of different geometrical shapes.
  • Projections or ridges 52 are convex, for instance, semi-cylindrical.
  • Projections or ridges 54 define concave grooves or recesses 58.
  • Projections 56 are flattened plates or flaps that lie against lateral surface 48 in the natural offish scales.
  • Fig. 5 shows a probe 60 in the configuration of
  • Probe 60 is provided circumferentially along a cylindrical lateral or side surface 64 or probe head 62 with a plurality of pyramidal energy-directing projections 66.
  • Projections 66 may be small such as that which occurs in a knurled surface, for example, on a metal file.
  • the energy directors 66 will impart vector forces on the tissue when in contact with the wound bed such that emulsion and ablation will occur around the probe as well as in front of it.
  • Such probes have been shown to increase the speed of ablation and thereby significantly reduce the time of operation. Again, such energy directors may be purely pyramidal, or have concave or convex faces.
  • an operator assembles the ultrasonic surgical aspirator with the probes, connects the central bore to a pressurized liquid source which can be adjusted to provide a controlled flow at the probe tip, turn on the system to provide between 30 and 350 microns of probe tip displacement, and touches the tip and the energy directors to the tissue to be ablated, causing cavitational and mechanical forces to be imparted to said tissue which ablates the tissue, thereby debriding and cleansing the wound bed.
  • Aspiration may be accomplished simultaneously or separately from ultrasonic ablation by connecting a flue or sheath around said probe, as in Fig. 6, that is in turn connected to a vacuum source and then the emulsified tissue is aspirated through this annular space. Conversely, the flue or sheath may be eliminated and the aspirate removed via separate suction cannulae.
  • a surgical method utilizing probe 24 or 44 or another probe provided in an end face with a channel, groove, indentation, or notch such as channel 40 is operated to vibrate at an ultrasonic frequency.
  • the distal end face 22, 28 of the probe is brought into contact with organic tissues of a patient.
  • the probe is energized to ultrasonically vibrate the end face 22,
  • M24-139 28 during the contacting of the tissues with the distal end face, and liquid is channeled between the contacted tissues and longitudinal bore 36, 38, during the contacting of the tissues with the distal end face, via indentation or channel 40.
  • a surgical method utilizing probe 44 or 60 comprises bringing the lateral surface 48 or 64 together with projections, ridges, or knurls 46, 66 into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projections, energizing the probe to vibrate the lateral surface 48, 64 and the projections 46, 66 at a predetermined ultrasonic frequency.
  • This method may include inserting a distal end portion of the probe into a cut, fissure or recess in an organ of the patient and moving the probe so that the lateral surface 48, 64 and the projections 46, 66 contact a wall of the fissure or recess.
  • the probe is manipulating so that the lateral surface 48, 64 is oriented substantially parallel to the organic tissues and so that the distal end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface 48, 64 and the projections 46, 66.

Abstract

An ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The shaft is provided with an internal longitudinal channel or bore extending to the end face. The end face is foπned with an indentation communicating with the channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of the end face relative to the channel or bore. The head portion also has a lateral surface extending substantially parallel to the longitudinal axis of the probe. The lateral surface is provided with at least one outwardly or radially extending projection. The projection enables the application of ultrasonic cavitation energy to a tissue surface that is in contact with the lateral or side surface of the probe head.

Description

ULTRASONIC WOUND DEBRIDER PROBE AND METHOD OF USE
BACKGROUND OF THE INVENTION This invention relates to ultrasonic surgical instruments and associated methods of use.
More particularly, this invention relates to high-efficiency medical treatment probes for ultrasonic surgical aspirators. These probes increase the ability to fragment and emulsify hard and soft tissue in a clinical environment while reducing unwanted heat and collateral tissue damage.
Over the past 30 years, several ultrasonic tools have been invented which can be used to ablate or cut tissue in surgery. Such devices are disclosed by Wuchinich et al. in U.S. Patent No. 4,223,676 and Idemoto et al in U.S. Patent No. 5,188,102.
In practice, these surgical devices include a blunt tip hollow probe that vibrates at frequencies between 20 kc and 100 kc, with amplitudes up to 300 microns or more. Such devices ablate tissue by either producing cavitation bubbles which implode and disrupt cells, tissue compression and relaxation stresses (sometimes called the jackhammer effect) or by other forces such as micro streaming of bubbles in the tissue matrix. The effect is that the tissue becomes liquefied and separated. It then becomes emulsified with the irrigant solution. The resulting emulsion is then aspirated from the site. Bulk excision of tissue is possible by applying the energy around and under an unwanted tumor to separate it from the surrounding structure. The surgeon can then lift the tissue out using common tools such as forceps.
The probe or tube is excited by a transducer of either the piezoelectric or magnetostrictive type that transforms an alternating electrical signal within the frequencies indicated into a longitudinal or transverse vibration. When the probe is attached to the transducer, the two become a single element with series and parallel resonances. The designer will try to tailor the mechanical and electrical characteristics of these elements to provide the proper frequency of operation. Most of the time, the elements will have a long axis that is straight and has the tip truncated in a plane perpendicular to the long axis, as shown in Fig 1. This is done for simplicity and economic considerations. In almost all applications, whether medical or industrial, such an embodiment is practical and useful. However, in applications such as the debridement of burns, wounds, diabetic ulcers or ulcers induced by radiation treatments, the blunt straight probe has been shown to be less effective in removing the hard eschar buildup that occurs when the wound is healing. This eschar buildup must be removed so that the healthy tissue is exposed and allowed to close the wound to provide complete healing with minimal scar tissue formation. Also, the small diameter tip, since it is cannulated, has a small annular area with limits energy transmission into the wound. This extends the length of the procedure and causes operator fatigue and patient discomfort.
Therefore, it is desired to provide a probe that can be mated to an ultrasonic surgical aspirator which increases the efficiency of emulsification, does not heat up the operative site and lowers the time of operation.
SUMMARY OF THE INVENTION
The present invention aims to provide an improved ultrasonic surgical instrument for use in debridement of wounds, particularly which may be used in conjunction with ultrasonic surgical aspirators to debride wounds. The present invention further aims to provide an improved ultrasonic surgical instrument with a form that enhances surgical efficiency and reduces the time required to complete at least some kinds of debridement procedures. Preferably, such an improved ultrasonic surgical instrument has irrigation or suction capability arid may be used in debriding deep wounds such as cuts and puncture wounds. The present invention seeks to provide an improved ultrasonic surgical instrument that has liquid directing channels for greater heat reduction at the distal face and to prevent liquid jetting or spraying from the tissue probe interface.
A probe for use as an ultrasonically vibrating tool is disclosed with a central bore coincident with the longitudinal axis. The proximal end of said bore communicates with a bore in the ultrasonic handpiece using methods well known to the art, such as a male/female thread
M24-139 combination. The probe is shaped such as to provide both a resonant frequency of operation in the range for which the electronic generator was designed and an amplitude of vibration at the distal face which is desired for proper tissue ablation. Such amplitudes have generally been shown to be in the range of 30 to 300 microns. Again, the technique needed for calculating said shapes is well known to the art and outside the scope of this disclosure.
Probe heads or ends in accordance with the present invention incorporate either a substantially symmetrical distal end or a distal end with a pronounced asymmetry. Each end has attributes that increase its effectiveness on varying tissue pathologies.
Probe ends pursuant to the present invention are further modified to improve the liquid flow to the probe/tissue interface such as to reduce the bulk temperature rise of the tissue and prevent clogging of the liquid passageway. Probe ends are further modified to produce energy directors that impart energy from the sides of the probes instead of only at the distal face of the probe. Such energy directors, when contacting skin or tissue, will increase volume of tissue treated per unit time and thereby reduce the operating time of the procedure.
In one embodiment of the present invention, an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The shaft is provided with an internal longitudinal channel or bore extending to the end face. The end face is formed with an indentation communicating with the channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
The head portion may be enlarged in a transverse direction relative to the shaft. In that event, the end face has an elongated shape, while the indentation is elongate and forms a groove in the end face of the head portion. This groove may extend parallel to or in a length dimension of the end face .
M24-139 When the channel or bore is connected to a suction source, fluid in the indentation flows toward the channel or bore. When the channel or bore is connected to a source of irrigation liquid, liquid in the indentation flows away from the channel or bore.
Pursuant to a feature of the present invention, the end face is inclined or beveled relative to the longitudinal axis of the probe.
In another embodiment of the present invention, an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The head portion also has a lateral surface extending substantially parallel to the longitudinal axis of the probe. The lateral surface is provided with at least one outwardly or radially extending projection. The projection enables the application of ultrasonic cavitation energy to a tissue surface that is in contact with the lateral or side surface of the probe head.
Pursuant to a feature of the present invention, the projection is one of a plurality of projections extending from the lateral surface. The projections may be identical to one another and staggered from one another along the lateral surface of the probe head. The projections may have a shape that is pyramidal, semi-cylindrical, wedge-shaped, or plate-like. The projections may lie down against the lateral surface of the probe head, in the nature of fish scales, flaps, or flattened plates.
The projections may take the form of ridges. The projections or ridges may extend perimetrally or circumferentially about the probe head. Preferably, however, the projections or ridges are disposed only along one side (or possibly two sides, in some applications) of the probe head. The probe head may take a prismatic form, with the energy-directing projections or ridges formed along one (or two) lateral surfaces thereof. This placement of the energy- directing projections facilitates use of the probe in surgical procedures, inasmuch as it is
M24-139 easier for the surgeon to keep track of the location of the projections to ensure that the projections come into contact only with target debridement tissues.
It is contemplated that the projections may be finely distributed over a lateral face of the probe head so as to form a knurled surface. Such a knurled surface is similar to that found on a metal filing tool.
As discussed above, the shaft and the probe head may be provided with an internal longitudinal channel or bore extending to the end face of the probe head, with the end face being formed with an indentation communicating with the channel or bore at a distal end thereof. The indentation extends laterally relative to the channel or bore, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
The indentation may be elongate and form a groove in the end face of the head portion. Where the head portion has an elongated shape, the groove may extend parallel to a length dimension of the end face.
A surgical method in accordance with the present invention utilizes a probe vibratable at at least one ultrasonic frequency, the probe having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The method comprises bringing the distal end face into contact with organic tissues of a patient, energizing the probe to vibrate the end face at the ultrasonic frequency during the contacting of the tissues with the distal end face, and channeling liquid between the contacted tissues and a longitudinal bore in the probe, during the contacting of the tissues with the distal end face, via an indentation in the end face communicating with the bore.
Where the bore is connected to a suction source, the channeling of liquid includes guiding liquid from the contacted tissues to the bore.
Where the bore is connected to a source of irrigation liquid, the channeling of liquid comprises guiding liquid to the contacted tissues from the bore.
M24-139 A surgical method in accordance with another feature of the present invention utilizes a probe vibratable at at least one ultrasonic frequency, where the probe has a distal end face oriented at least partially transversely to a longitudinal axis of the shaft, a lateral surface extending substantially perpendicularly to the end face and substantially parallel to the longitudinal axis, and at least one outwardly or radially extending projection extending out from the lateral surface. The method comprises bringing the lateral surface together with the projection into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projection, energizing the probe to vibrate the lateral surface and the projection at the ultrasonic frequency. Pursuant to another feature of the present invention, the bringing of the lateral surface together with the projection into contact with organic tissues of a patient includes inserting a distal end portion of the probe into a fissure or recess in an organ of the patient and moving the probe so that the lateral surface and the projection contact a wall of the fissure or recess. According to another feature of the present invention, the bringing the lateral surface together with the projection into contact with organic tissues of a patient includes manipulating the probe so that the lateral surface is oriented substantially parallel to the organic tissues and so that the end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface and the projection. In one embodiment of the present invention, an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The shaft is provided with an internal longitudinal channel or bore extending to the end face. The end face is formed with an indentation communicating with the channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
M24-139 The head portion may be enlarged in a transverse direction relative to the shaft. In that event, the end face has an elongated shape, while the indentation is elongate and forms a groove in the end face of the head portion. This groove may extend parallel to or in a length dimension of the end face. When the channel or bore is connected to a suction source, fluid in the indentation flows toward the channel or bore. When the channel or bore is connected to a source of irrigation liquid, liquid in the indentation flows away from the channel or bore.
Pursuant to a feature of the present invention, the end face is inclined or beveled relative to the longitudinal axis of the probe. In another embodiment of the present invention, an ultrasonic medical probe comprises an elongate shaft formed integrally with a head portion having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The head portion also has a lateral surface extending substantially parallel to the longitudinal axis of the probe.
The lateral surface is provided with at least one outwardly or radially extending projection. The projection enables the application of ultrasonic cavitation energy to a tissue surface that is in contact with the lateral or side surface of the probe head.
Pursuant to a feature of the present invention, the projection is one of a plurality of projections extending from the lateral surface. The projections may be identical to one another and staggered from one another along the lateral surface of the probe head. The projections may have a shape that is pyramidal, semi-cylindrical, wedge-shaped, or plate-like.
The projections may lie down against the lateral surface of the probe head, in the nature of fish scales, flaps, or flattened plates.
The projections may take the form of ridges or knurls. Preferably, the projections are disposed along only a portion of the lateral surface area of the probe head. For example, where the probe head is prismatic with three or more planar lateral faces, the energy-direting
M24-139 projections are disposed along less than all of the lateral faces of the probe head. More preferably, the projections are disposed along only one or two lateral faces of the probe head.
As discussed above, the shaft and the probe head may be provided with an internal longitudinal channel or bore extending to the end face of the probe head, with the end face being formed with an indentation communicating with the channel or bore at a distal end thereof. The indentation extends laterally relative to the channel or bore, whereby liquid is guided over an extended surface of the end face relative to the channel or bore.
The indentation may be elongate and form a groove in the end face of the head portion. Where the head portion has an elongated shape, the groove may extend parallel to a length dimension of the end face.
A surgical method in accordance with the present invention utilizes a probe vibratable at at least one ultrasonic frequency, the probe having a distal end face oriented at least partially transversely to a longitudinal axis of the shaft. The method comprises bringing the distal end face into contact with organic tissues of a patient, energizing the probe to vibrate the end face at the ultrasonic frequency during the contacting of the tissues with the distal end face, and channeling liquid between the contacted tissues and a longitudinal bore in the probe, during the contacting of the tissues with the distal end face, via an indentation in the end face communicating with the bore.
Where the bore is connected to a suction source, the channeling of liquid includes guiding liquid from the contacted tissues to the bore.
Where the bore is connected to a source of irrigation liquid, the channeling of liquid comprises guiding liquid to the contacted tissues from the bore.
A surgical method in accordance with another feature of the present invention utilizes a probe vibratable at at least one ultrasonic frequency, where the probe has a distal end face oriented at least partially transversely to a longitudinal axis of the shaft, a lateral surface
M24-139 extending substantially perpendicularly to the end face and substantially parallel to the longitudinal axis, and at least one outwardly or radially extending projection extending out from the lateral surface. The method comprises bringing the lateral surface together with the projection into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projection, energizing the probe to vibrate the lateral surface and the projection at the ultrasonic frequency.
Pursuant to another feature of the present invention, the bringing of the lateral surface together with the projection into contact with organic tissues of a patient includes inserting a distal end portion of the probe into a fissure or recess in an organ of the patient and moving the probe so that the lateral surface and the projection contact a wall of the fissure or recess. According to another feature of the present invention, the bringing the lateral surface together with the projection into contact with organic tissues of a patient includes manipulating the probe so that the lateral surface is oriented substantially parallel to the organic tissues and so that the end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface and the projection.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 is a cross sectional view of a prior art ultrasonic probe for use with an ultrasonic aspirator.
Fig. 2A is partially a side elevational view and partially a cross-sectional view of an ultrasonic probe in accordance with the present invention.
Fig. 2B is a distal end elevational view of the probe of Fig. 2A.
Fig. 2C is partially a top elevational view and partially a cross-sectional view of the probe of Fig. 2A.
Fig. 3 A is partially a side elevational view and partially a cross-sectional view of another ultrasonic probe in accordance with the present invention.
M24-139 Fig. 3B is a distal end elevational view of the probe of Fig. 3 A, showing a modification in the form of an elongate groove in a distal end face of the probe head.
Fig. 3 C is a view similar to Fig. 3 A showing the groove of Fig. 3B. Fig. 3D is a partial cross-sectional view taken along line III-III in Fig. 3C. Fig. 4 is partially a side elevational view and partially a cross-sectional view of a further ultrasonic probe in accordance with the present invention.
Fig. 4 A is partial view, on a larger scale, of a lateral surface of a head of the probe of Fig. 4, taken in region IV-IV of Fig. 4.
Figs. 4B-4D are side elevational views of the probe head of Fig. 4, showing respective modifications of formations along the lateral surface thereof.
Fig. 4E is a perspective view of the probe head depicted in Fig. 4D. Fig. 5 is partially a side elevational view and partially a cross-sectional view of yet another ultrasonic probe in accordance with the present invention.
DETAILED DESCRIPTION Several probes are disclosed which embody the improvements described herein.
Fig. 1 shows a probe 10 which is known to the art and is currently manufactured for use with an ultrasonic aspirator. This probe 10 is basically shaped with an exponential or Gaussian taper. Probe 10 is cannulated and has an integral male thread (not shown) at the proximal end (proximate the operator). This thread communicates with a female threaded bore (not illustrated) in the transducer 12. By tightening the probe 10 onto the transducer 12 and using standard wrenches for final torquing, the transducer and probe essentially become one resonant body. Bores of the probe 10 and transducer 12 communicate with one another. The probe 10 is generally constructed of an acoustically efficient metal or ceramic. Titanium is the most commonly used material, but other material has been employed with success. Material choice does not have a significant impact upon the embodiments of this disclosure.
M24-139 The distal end of the prior art probe 10 is truncated in a plane Pl perpendicular to the longitudinal axis 14 of the resonant body (probe and transducer). Since the probe 10 is cannulated, a distal end face 16 takes the form of an annular surface with a small cross sectional area. The shape of the probe 10 allows the probe to become a velocity transformer, i.e., the probe will amplify the input vibrations from the transducer 12 by a fixed value, called a gain factor, determined by the geometry of the probe. For example, if the probe 10 had a gain factor of 10, the probe would multiply the input vibration of the transducer, for example 30 microns, to a final amplitude at the distal end of the probe of 300 microns. This phenomenon is well known to the art. By placing the distal end face 16 of probe 10 against organic tissue of a patient, the tissue will be disrupted through cavitation and mechanical effects. By adding saline or water to the tissue-probe interface, cooling of the tissue is achieved and the tissue is emulsified into the liquid and is more easily aspirated either through the center of the probe 10, if the center bore is connected to the aspirator or by separate suction cannulae if the center bore is connected to the irrigant source. However, the distal end of probe 10 in its conventional configuration is not conducive to ablating large volumes of tissue in short periods of time. By increasing the surface area of distal end face 16, a probe can be constructed which will ablate tissue faster and allow for a shorter operation. This is especially advantageous when debriding wounds such as bedsores, diabetic ulcers, burn wounds, etc. Figs. 2A-2C show a probe 18 with a shaft 19 and an enlarged distal head 20. More particularly, probe head 20 may be asymmetrical such that the cross sectional shape is rectangular or oval (see Fig. 2B). This asymmetry allows the probe 18 to maintain a higher gain factor and be more able to be inserted into smaller wounds. The surface area of a distal end face 22 of probe head 20 is greatly increased over the prior art probe (Fig. 1) and will naturally ablate tissue at a
M24-139 higher rate. The shape of the probe head 20 allows access to irregularly shaped wound beds, such as cuts or fissures with slit openings.
Although the probe of Figs. 2A-2C has been shown to have higher performance over prior art, further improvements may be made. Fig. 3A depicts a probe 24 having a shaft 25 and an asymmetrically enlarged head 26 with a truncated or beveled distal end face 28 located in a plane P2 that is not perpendicular to a longitudinal axis 30 of the probe. This probe 24 has been shown to improve performance in removing the hard eschar buildup of bum wounds, which must be removed in order to expose healthy tissue.
One problem that is encountered in such probe designs, whether the probe head is truncated in a perpendicular plane Pl such as head 20 or in a plane P2 inclined relative to the instrument axis 30 such as probe head 26, is the bore opening 32 or 34 may become blocked with tissue. This blockage prevents aspiration of the emulsified tissue, if the respective bore 36 or 38 is connected to a vacuum source (not shown) or blocks the flow of cooling fluid out of the probe, if the bore is attached to a pressurized liquid source (not shown). Because of the pressure buildup, the liquid has a tendency to jet or stream from the probe tissue interface, causing the irrigant to be sprayed around the room instead of onto the wound bed. Also, if the distal end face of the probe is very large, the liquid may not cover the entire face, even if the opening 32, 34 at the end of the probe is not blocked.
In order to improve the performance of the probe 24 in this regard, a channel, groove, indentation, or notch 40 is provided in the face 28 of the probe, as shown in Fig. 3B, 3C and 3D. This channel 40 reduces the likelihood of blockage of an output opening 42 of the probe bore 38 by locating this opening or outlet proximally from the distal end face 28 of the probe head 26, while allowing the liquid to fill the channel 40 and cover the remaining distal surface area more fully. Many alternative shapes of channels may be employed in the distal end faces of ultrasonic probes without changing the concepts outlined herein. In the
M24-139 illustrated example, channel or groove 40 extend parallel to or in a length dimension of the end face 28,
When bore 38 is connected to a suction source (not shown), fluid in the channel 40 flows toward the bore 38. When the channel or bore 38 is connected to a source of irrigation liquid (not shown), liquid in the channel 40 flows away from the bore 38.
Regardless of the shape of the distal surface or end faces of the probes as discussed hereinabove, the probes are limited in their ability to ablate tissue by the fact the only area where this ablation can occur is at the distal end face. The sides or lateral surfaces of the probes are generally disposed parallel to the longitudinal axes and parallel to the direction of ultrasonic compression wave transmission. When tissue touches these lateral surfaces, no ablation occurs since the motion is a sliding or rubbing action, which does not transmit sufficient energy into the tissue to cause emulsion or ablation. It is therefore desired to improve ultrasonic tissue ablation probes so that energy may be transmitted from one or more lateral faces or side surfaces of the probe heads so that more tissue may be ablated per unit time. Figs. 4 and 4 A show a probe 44 which is identical to probe 24 of Figs. 3B-3D with the addition of outwardly or radially extending projections 46 serving as energy guides or directors disposed along at least one lateral or side surface 48 of a probe head 50. Preferably, probe head 50 has a prismatic shape with four planar lateral surfaces or faces 48, projections 46 being disposed only along one or two of the lateral surfaces. As depicted in Fig. 4, energy-directing projections 46 are disposed only along two opposing lateral surfaces 48. Where projections occur along only one or at most two lateral surfaces 48, it is easier for the user to avoid contact with non-target tissues.
Probe head 50 may be integrally formed with a shaft portion 49 of probe 44. Alternatively, probe head 50 may be formed as a separate piece that is firmly attached to shaft 49,
M24-139 e.g., via mating screw threads (not shown) or a force or friction fit. These same alternatives also apply to probe heads 20, 26, 66.
Projections 46 may have a fine geometrical configuration and distribution so as to form the respective lateral surface 48 into a knurled surface as one would find, for example, on a metal file. Or projections 46 may be a series of ridges or knurls on probe head 50. Alternatively, as shown in Fig. 4B, projections or energy directors 46 may be pyramidal sections fashioned from the base metal of the probe 44 that project out in a substantially perpendicular direction from a longitudinal axis 51 of the probe. More specifically, projections or energy directors 46 are a series of parallel ridges or knurls each of triangular cross-section extending transversely to a direction of ultrasonic wave propagation. Projections or energy directors 46 may include a first set of parallel ridges 46a and a second set of ridges 46b that is staggered relative to the first set. Each set of wedge- or triangle-shaped projections or ridges 46a, 46b defines a corresponding set of grooves (not separately designated) each of triangular cross-section extending transversely to a direction of ultrasonic wave propagation. The resulting faceted surfaces of projections or ridges 46a, 46b impart a vector force on the target tissue when the probe 44 vibrates, which will cause cavitation and emulsifϊcation of the tissue when it contacts the faceted surfaces.
As illustrated in Figs. 4B-4E, lateral surface 48 may be provided with energy-directing projections or ridges 52, 54, 56 of different geometrical shapes. Projections or ridges 52 are convex, for instance, semi-cylindrical. Projections or ridges 54 define concave grooves or recesses 58. Projections 56 are flattened plates or flaps that lie against lateral surface 48 in the natural offish scales. These energy directors or projections 52, 54, 56 allow faster tissue ablation by creating a much larger active surface area at the distal end of the probe 44.
In cases where a probe tip must be smaller than that allowed by the described embodiment, such as when small and/or deep bedsores or wounds must be debrided, the probe tip may be improved to allow faster ablation as well. Fig. 5 shows a probe 60 in the configuration of
M24-139 a tubular end or head 62. Probe 60 is provided circumferentially along a cylindrical lateral or side surface 64 or probe head 62 with a plurality of pyramidal energy-directing projections 66. Projections 66 may be small such as that which occurs in a knurled surface, for example, on a metal file. The energy directors 66 will impart vector forces on the tissue when in contact with the wound bed such that emulsion and ablation will occur around the probe as well as in front of it. Such probes have been shown to increase the speed of ablation and thereby significantly reduce the time of operation. Again, such energy directors may be purely pyramidal, or have concave or convex faces.
All said probes in this embodiment might be designed by those skilled in the art using known tools and techniques.
In a method of using the above-described probes for debriding and cleaning wounds, sores and ulcers with ultrasound energy, an operator assembles the ultrasonic surgical aspirator with the probes, connects the central bore to a pressurized liquid source which can be adjusted to provide a controlled flow at the probe tip, turn on the system to provide between 30 and 350 microns of probe tip displacement, and touches the tip and the energy directors to the tissue to be ablated, causing cavitational and mechanical forces to be imparted to said tissue which ablates the tissue, thereby debriding and cleansing the wound bed. Aspiration may be accomplished simultaneously or separately from ultrasonic ablation by connecting a flue or sheath around said probe, as in Fig. 6, that is in turn connected to a vacuum source and then the emulsified tissue is aspirated through this annular space. Conversely, the flue or sheath may be eliminated and the aspirate removed via separate suction cannulae.
A surgical method utilizing probe 24 or 44 or another probe provided in an end face with a channel, groove, indentation, or notch such as channel 40 is operated to vibrate at an ultrasonic frequency. The distal end face 22, 28 of the probe is brought into contact with organic tissues of a patient. The probe is energized to ultrasonically vibrate the end face 22,
M24-139 28 during the contacting of the tissues with the distal end face, and liquid is channeled between the contacted tissues and longitudinal bore 36, 38, during the contacting of the tissues with the distal end face, via indentation or channel 40.
A surgical method utilizing probe 44 or 60 comprises bringing the lateral surface 48 or 64 together with projections, ridges, or knurls 46, 66 into contact with organic tissues of a patient and, during the contacting of the tissues with the lateral surface and the projections, energizing the probe to vibrate the lateral surface 48, 64 and the projections 46, 66 at a predetermined ultrasonic frequency. This method may include inserting a distal end portion of the probe into a cut, fissure or recess in an organ of the patient and moving the probe so that the lateral surface 48, 64 and the projections 46, 66 contact a wall of the fissure or recess.
Altneratively or additionally, the probe is manipulating so that the lateral surface 48, 64 is oriented substantially parallel to the organic tissues and so that the distal end face is oriented substantially perpendicularly to the organic tissues immediately prior to an engaging of the organic tissues with the lateral surface 48, 64 and the projections 46, 66. Although the invention has been described in terms of particular embodiments and applications, one of ordinary skill in the art, in light of this teaching, can generate additional embodiments and modifications without departing from the spirit of or exceeding the scope of the claimed invention. Accordingly, it is to be understood that the drawings and descriptions herein are proffered by way of example to facilitate comprehension of the invention and should not be construed to limit the scope thereof.
M24-139

Claims

CLAIMS:
1. An ultrasonic medical probe comprising an elongate shaft provided with a head portion, said head portion having a distal end face oriented at least partially transversely to a longitudinal axis of said shaft, said shaft being provided with an internal longitudinal channel or bore extending to said end face, said end face being formed with an indentation communicating with said channel or bore at a distal end thereof, whereby liquid is guided over an extended surface of said end face relative to said channel or bore.
2. The probe defined in claim 1 wherein said head portion has a lateral surface extending generally parallel to said longitudinal axis, said lateral surface being provided with at least one outwardly or radially extending projection.
3. The probe defined in claim 2 wherein said projection is one of a plurality of substantially identical projections extending from said lateral surface.
4. The probe defined in claim 3 wherein said projections have a shape taken from the group consisting of pyramids, semi-cylinders, wedges, plates, and flaps or flattened plates.
5. The probe defined in claim 3 wherein said projections are taken from the group consisting of ridges and knurls.
6. The probe defined in claim 3 wherein said lateral surface is a perimetral surface, said projections extending circumferentially.
M24-139
7. The probe defined in claim 1 wherein said head portion is enlarged in a transverse direction relative to said shaft.
8. The probe defined in claim 7 wherein said end face has an elongated shape.
9. The probe defined in claim 8 wherein said indentation is elongate and forms a groove in said end face of said head portion.
10. The probe defined in claim 1 wherein said indentation is elongate and forms a groove in said end face of said head portion.
11. The probe defined in claim 10 wherein said head portion has an elongated shape, said groove extending parallel to a length dimension of said end face.
12. The probe defined in claim 1 wherein said channel or bore is connectable to a suction source, fluid in said indentation flowing toward said channel or bore.
13. The probe defined in claim 1 wherein said channel or bore is connectable to a source of irrigation liquid, liquid in said indentation flowing away from said channel or bore.
14. The probe defined in claim 1 wherein said head portion forms a distal end portion of said shaft.
15. The probe defined in claim 1 wherein said end face is inclined or beveled relative to said longitudinal axis.
M24-139
16. The probe defined in claim 1 wherein said probe head is formed separately from said elongate shaft and attached thereto.
17. An ultrasonic medical probe comprising an elongate shaft provided with a head portion, said head portion having a distal end face oriented at least partially transversely to a longitudinal axis of said shaft, said head portion having a lateral surface extending substantially parallel to said longitudinal axis, said lateral surface being provided with at least one outwardly or radially extending projection.
18. The probe defined in claim 17 wherein said projection is one of a plurality of projections extending from said lateral surface.
19. The probe defined in claim 18 wherein said projections have a shape taken from the group consisting of pyramids, semi-cylinders, wedges, plates, and flaps or flattened plates.
20. The probe defined in claim 18 wherein said projections arefinely configured and distributed so as to form a knurled surface on said head portion.
21. The probe defined in claim 18 wherein said head portion has a plurality of planar lateral faces, said projections being disposed along less than all of said lateral faces.
22. The probe defined in claim 21 wherein said projections are disposed along only one of said lateral faces.
M24-139
23. The probe defined in claim 17 wherein said shaft is provided with an internal longitudinal channel or bore extending to said end face, said end face being formed with an indentation communicating with said channel or bore at a distal end thereof, said indentation extending laterally relative to said channel or bore, whereby liquid is guided over an extended surface of said end face relative to said channel or bore.
24. The probe defined in claim 23 wherein said indentation is elongate and forms a groove in said end face of said head portion.
25. The probe defined in claim 24 wherein said head portion has an elongated shape, said groove extending parallel to a length dimension of said end face.
26. The probe defined in claim 17 wherein said head portion is enlarged in a transverse direction relative to said shaft.
27. The probe defined in claim 26 wherein said end face has an elongated shape.
28. The probe defined in claim 27 wherein said indentation is elongate and forms a groove in said end face of said head portion.
29. The probe defined in claim 17 wherein said end face is inclined or beveled relative to said longitudinal axis.
30. A surgical method comprising:
M24-139 providing a probe vibratable at at least one ultrasonic frequency, said probe having a distal end face oriented at least partially transversely to a longitudinal axis of said shaft; bringing said distal end face into contact with organic tissues of a patient; during the contacting of said tissues with said distal end face, energizing said probe to vibrate said end face at said ultrasonic frequency; and during the contacting of said tissues with said distal end face, channeling liquid between the contacted tissues and a longitudinal bore in said probe via an indentation in said end face communicating with said bore.
31. The method defined in claim 30, further comprising connecting said bore to a suction source, the channeling of liquid comprising guiding liquid from the contacted tissues to said bore.
32. The method defined in claim 30, further comprising connecting said bore to a source of irrigation liquid, the channeling of liquid comprising guiding liquid to the contacted tissues from said bore.
33. A surgical method comprising: providing a probe vibratable at at least one ultrasonic frequency, said probe having a distal end face oriented at least partially transversely to a longitudinal axis of said shaft, said probe also having a lateral surface extending substantially perpendicularly to said end face and substantially parallel to said longitudinal axis, said lateral surface being provided with at least one outwardly or radially extending projection; bringing said lateral surface together with said projection into contact with organic tissues of a patient; and
M24-139 during the contacting of said tissues with said lateral surface and said projection, energizing said probe to vibrate said lateral surface and said projection at said ultrasonic frequency.
34. The method defined in claim 33 wherein the bringing said lateral surface together with said projection into contact with organic tissues of a patient includes inserting a distal end portion of said probe into a fissure or recess in an organ of the patient and moving said probe so that said lateral surface and said projection contact a wall of said fissure or recess.
35. The method defined in claim 33 wherein the bringing said lateral surface together with said projection into contact with organic tissues of a patient includes manipulating said probe so that said lateral surface is oriented substantially parallel to said organic tissues and so that said end face is oriented substantially perpendicularly to said organic tissues immediately prior to an engaging of said organic tissues with said lateral surface and said projection.
36. The method defined in claim 33 wherein said projection is one of a plurality of projections along said lateral surface, said projections having a shape taken from the group consisting of knurls, pyramids, semi-cylinders, wedges, plates, and flaps or flattened plates.
M24-139
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Cited By (76)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011504792A (en) * 2007-11-28 2011-02-17 ダッドソン マニュファクチャリング シーオーアールピー. Dermatome with ultrasonic cutting blade
EP2178448A4 (en) * 2007-07-27 2015-07-08 Ethicon Endo Surgery Inc Ultrasonic surgical instruments
US9283045B2 (en) 2012-06-29 2016-03-15 Ethicon Endo-Surgery, Llc Surgical instruments with fluid management system
US9339289B2 (en) 2007-11-30 2016-05-17 Ehticon Endo-Surgery, LLC Ultrasonic surgical instrument blades
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9414853B2 (en) 2007-07-27 2016-08-16 Ethicon Endo-Surgery, Llc Ultrasonic end effectors with increased active length
US9427249B2 (en) 2010-02-11 2016-08-30 Ethicon Endo-Surgery, Llc Rotatable cutting implements with friction reducing material for ultrasonic surgical instruments
US9504855B2 (en) 2008-08-06 2016-11-29 Ethicon Surgery, LLC Devices and techniques for cutting and coagulating tissue
US9510850B2 (en) 2010-02-11 2016-12-06 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments
US9623237B2 (en) 2009-10-09 2017-04-18 Ethicon Endo-Surgery, Llc Surgical generator for ultrasonic and electrosurgical devices
US9636135B2 (en) 2007-07-27 2017-05-02 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments
US9642644B2 (en) 2007-07-27 2017-05-09 Ethicon Endo-Surgery, Llc Surgical instruments
US9649126B2 (en) 2010-02-11 2017-05-16 Ethicon Endo-Surgery, Llc Seal arrangements for ultrasonically powered surgical instruments
US9700339B2 (en) 2009-05-20 2017-07-11 Ethicon Endo-Surgery, Inc. Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments
US9700343B2 (en) 2012-04-09 2017-07-11 Ethicon Endo-Surgery, Llc Devices and techniques for cutting and coagulating tissue
US9713507B2 (en) 2012-06-29 2017-07-25 Ethicon Endo-Surgery, Llc Closed feedback control for electrosurgical device
US9724118B2 (en) 2012-04-09 2017-08-08 Ethicon Endo-Surgery, Llc Techniques for cutting and coagulating tissue for ultrasonic surgical instruments
US9737326B2 (en) 2012-06-29 2017-08-22 Ethicon Endo-Surgery, Llc Haptic feedback devices for surgical robot
US9743947B2 (en) 2013-03-15 2017-08-29 Ethicon Endo-Surgery, Llc End effector with a clamp arm assembly and blade
US9764164B2 (en) 2009-07-15 2017-09-19 Ethicon Llc Ultrasonic surgical instruments
US9795405B2 (en) 2012-10-22 2017-10-24 Ethicon Llc Surgical instrument
US9801648B2 (en) 2007-03-22 2017-10-31 Ethicon Llc Surgical instruments
US9848901B2 (en) 2010-02-11 2017-12-26 Ethicon Llc Dual purpose surgical instrument for cutting and coagulating tissue
US9848902B2 (en) 2007-10-05 2017-12-26 Ethicon Llc Ergonomic surgical instruments
US9883884B2 (en) 2007-03-22 2018-02-06 Ethicon Llc Ultrasonic surgical instruments
US9925003B2 (en) 2012-02-10 2018-03-27 Ethicon Endo-Surgery, Llc Robotically controlled surgical instrument
US9962182B2 (en) 2010-02-11 2018-05-08 Ethicon Llc Ultrasonic surgical instruments with moving cutting implement
US10010339B2 (en) 2007-11-30 2018-07-03 Ethicon Llc Ultrasonic surgical blades
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US10034684B2 (en) 2015-06-15 2018-07-31 Ethicon Llc Apparatus and method for dissecting and coagulating tissue
US10154852B2 (en) 2015-07-01 2018-12-18 Ethicon Llc Ultrasonic surgical blade with improved cutting and coagulation features
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10194973B2 (en) 2015-09-30 2019-02-05 Ethicon Llc Generator for digitally generating electrical signal waveforms for electrosurgical and ultrasonic surgical instruments
US10201382B2 (en) 2009-10-09 2019-02-12 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10226273B2 (en) 2013-03-14 2019-03-12 Ethicon Llc Mechanical fasteners for use with surgical energy devices
US10245064B2 (en) 2016-07-12 2019-04-02 Ethicon Llc Ultrasonic surgical instrument with piezoelectric central lumen transducer
US10251664B2 (en) 2016-01-15 2019-04-09 Ethicon Llc Modular battery powered handheld surgical instrument with multi-function motor via shifting gear assembly
USD847990S1 (en) 2016-08-16 2019-05-07 Ethicon Llc Surgical instrument
US10278721B2 (en) 2010-07-22 2019-05-07 Ethicon Llc Electrosurgical instrument with separate closure and cutting members
US10285723B2 (en) 2016-08-09 2019-05-14 Ethicon Llc Ultrasonic surgical blade with improved heel portion
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10335182B2 (en) 2012-06-29 2019-07-02 Ethicon Llc Surgical instruments with articulating shafts
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10349999B2 (en) 2014-03-31 2019-07-16 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US10357303B2 (en) 2015-06-30 2019-07-23 Ethicon Llc Translatable outer tube for sealing using shielded lap chole dissector
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US10398497B2 (en) 2012-06-29 2019-09-03 Ethicon Llc Lockout mechanism for use with robotic electrosurgical device
US10420579B2 (en) 2007-07-31 2019-09-24 Ethicon Llc Surgical instruments
US10420580B2 (en) 2016-08-25 2019-09-24 Ethicon Llc Ultrasonic transducer for surgical instrument
US10426507B2 (en) 2007-07-31 2019-10-01 Ethicon Llc Ultrasonic surgical instruments
US10433900B2 (en) 2011-07-22 2019-10-08 Ethicon Llc Surgical instruments for tensioning tissue
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10517627B2 (en) 2012-04-09 2019-12-31 Ethicon Llc Switch arrangements for ultrasonic surgical instruments
US10524854B2 (en) 2010-07-23 2020-01-07 Ethicon Llc Surgical instrument
US10537352B2 (en) 2004-10-08 2020-01-21 Ethicon Llc Tissue pads for use with surgical instruments
US10543008B2 (en) 2012-06-29 2020-01-28 Ethicon Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
USRE47996E1 (en) 2009-10-09 2020-05-19 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10842522B2 (en) 2016-07-15 2020-11-24 Ethicon Llc Ultrasonic surgical instruments having offset blades
US10881449B2 (en) 2012-09-28 2021-01-05 Ethicon Llc Multi-function bi-polar forceps
US10893883B2 (en) 2016-07-13 2021-01-19 Ethicon Llc Ultrasonic assembly for use with ultrasonic surgical instruments
US11020140B2 (en) 2015-06-17 2021-06-01 Cilag Gmbh International Ultrasonic surgical blade for use with ultrasonic surgical instruments
US11058447B2 (en) 2007-07-31 2021-07-13 Cilag Gmbh International Temperature controlled ultrasonic surgical instruments
US11266430B2 (en) 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
US11324527B2 (en) 2012-11-15 2022-05-10 Cilag Gmbh International Ultrasonic and electrosurgical devices
USD974558S1 (en) 2020-12-18 2023-01-03 Stryker European Operations Limited Ultrasonic knife

Families Citing this family (103)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6050943A (en) 1997-10-14 2000-04-18 Guided Therapy Systems, Inc. Imaging, therapy, and temperature monitoring ultrasonic system
US7914453B2 (en) 2000-12-28 2011-03-29 Ardent Sound, Inc. Visual imaging system for ultrasonic probe
US10835307B2 (en) 2001-06-12 2020-11-17 Ethicon Llc Modular battery powered handheld surgical instrument containing elongated multi-layered shaft
US20040030254A1 (en) * 2002-08-07 2004-02-12 Eilaz Babaev Device and method for ultrasound wound debridement
US8182501B2 (en) 2004-02-27 2012-05-22 Ethicon Endo-Surgery, Inc. Ultrasonic surgical shears and method for sealing a blood vessel using same
US7824348B2 (en) 2004-09-16 2010-11-02 Guided Therapy Systems, L.L.C. System and method for variable depth ultrasound treatment
US9011336B2 (en) 2004-09-16 2015-04-21 Guided Therapy Systems, Llc Method and system for combined energy therapy profile
US7393325B2 (en) 2004-09-16 2008-07-01 Guided Therapy Systems, L.L.C. Method and system for ultrasound treatment with a multi-directional transducer
US8444562B2 (en) 2004-10-06 2013-05-21 Guided Therapy Systems, Llc System and method for treating muscle, tendon, ligament and cartilage tissue
US10864385B2 (en) 2004-09-24 2020-12-15 Guided Therapy Systems, Llc Rejuvenating skin by heating tissue for cosmetic treatment of the face and body
US8535228B2 (en) 2004-10-06 2013-09-17 Guided Therapy Systems, Llc Method and system for noninvasive face lifts and deep tissue tightening
US9827449B2 (en) 2004-10-06 2017-11-28 Guided Therapy Systems, L.L.C. Systems for treating skin laxity
JP2008522642A (en) 2004-10-06 2008-07-03 ガイデッド セラピー システムズ, エル.エル.シー. Method and system for beauty enhancement
DE202005022028U1 (en) 2004-10-06 2012-07-09 Guided Therapy Systems, Llc Ultrasonic tissue treatment system
US8133180B2 (en) 2004-10-06 2012-03-13 Guided Therapy Systems, L.L.C. Method and system for treating cellulite
US7758524B2 (en) 2004-10-06 2010-07-20 Guided Therapy Systems, L.L.C. Method and system for ultra-high frequency ultrasound treatment
US8690778B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Energy-based tissue tightening
US20060111744A1 (en) 2004-10-13 2006-05-25 Guided Therapy Systems, L.L.C. Method and system for treatment of sweat glands
US9694212B2 (en) 2004-10-06 2017-07-04 Guided Therapy Systems, Llc Method and system for ultrasound treatment of skin
US8663112B2 (en) 2004-10-06 2014-03-04 Guided Therapy Systems, Llc Methods and systems for fat reduction and/or cellulite treatment
US11235179B2 (en) 2004-10-06 2022-02-01 Guided Therapy Systems, Llc Energy based skin gland treatment
US11883688B2 (en) 2004-10-06 2024-01-30 Guided Therapy Systems, Llc Energy based fat reduction
US11207548B2 (en) 2004-10-07 2021-12-28 Guided Therapy Systems, L.L.C. Ultrasound probe for treating skin laxity
US11724133B2 (en) 2004-10-07 2023-08-15 Guided Therapy Systems, Llc Ultrasound probe for treatment of skin
EP1875327A2 (en) 2005-04-25 2008-01-09 Guided Therapy Systems, L.L.C. Method and system for enhancing computer peripheral saftey
US20070191713A1 (en) 2005-10-14 2007-08-16 Eichmann Stephen E Ultrasonic device for cutting and coagulating
US7621930B2 (en) 2006-01-20 2009-11-24 Ethicon Endo-Surgery, Inc. Ultrasound medical instrument having a medical ultrasonic blade
US8562547B2 (en) 2006-06-07 2013-10-22 Eliaz Babaev Method for debriding wounds
US7431704B2 (en) * 2006-06-07 2008-10-07 Bacoustics, Llc Apparatus and method for the treatment of tissue with ultrasound energy by direct contact
AU2007286660A1 (en) * 2006-08-25 2008-02-28 Eilaz Babaev Portable ultrasound device for the treatment of wounds
US8430897B2 (en) * 2006-08-29 2013-04-30 Misonix Incorporated Ultrasonic wound debrider probe and method of use
US9566454B2 (en) 2006-09-18 2017-02-14 Guided Therapy Systems, Llc Method and sysem for non-ablative acne treatment and prevention
US8050752B2 (en) * 2006-09-29 2011-11-01 Bacoustics, Llc Method of treating lumens, cavities, and tissues of the body with an ultrasound delivered liquid
JP2008119250A (en) * 2006-11-13 2008-05-29 Miwatec:Kk Handpiece for ultrasonic surgical instrument, and horn
US7714481B2 (en) * 2006-11-30 2010-05-11 Olympus Medical Systems Corp. Ultrasonic treatment apparatus
JP2010526589A (en) 2007-05-07 2010-08-05 ガイデッド セラピー システムズ, エル.エル.シー. Method and system for modulating a mediant using acoustic energy
US20150174388A1 (en) 2007-05-07 2015-06-25 Guided Therapy Systems, Llc Methods and Systems for Ultrasound Assisted Delivery of a Medicant to Tissue
WO2009088390A1 (en) * 2008-01-11 2009-07-16 Misonix Incorporated Ultrasonic debrider probe
EP2234556B1 (en) * 2008-01-11 2015-11-11 Misonix Incorporated Ultrasonic wound debrider probe
US20090216157A1 (en) * 2008-02-22 2009-08-27 Norihiro Yamada Ultrasonic operating apparatus
US20090254005A1 (en) * 2008-04-03 2009-10-08 Eilaz Babaev Ultrasound assisted tissue welding device
KR102147455B1 (en) 2008-06-06 2020-08-24 얼테라, 인크 Ultrasound treatment system
US8118823B2 (en) 2008-06-12 2012-02-21 Integra Lifesciences (Ireland) Ltd. Shear stress ultrasonic horn for ultrasonic surgical aspiration
US20100168741A1 (en) * 2008-12-29 2010-07-01 Hideo Sanai Surgical operation apparatus
US11090104B2 (en) 2009-10-09 2021-08-17 Cilag Gmbh International Surgical generator for ultrasonic and electrosurgical devices
US8715186B2 (en) 2009-11-24 2014-05-06 Guided Therapy Systems, Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
US9229031B2 (en) 2010-05-12 2016-01-05 Stmicroelectronics S.R.L. Probes for testing integrated electronic circuits and corresponding production method
EP2600937B8 (en) 2010-08-02 2024-03-06 Guided Therapy Systems, L.L.C. Systems for treating acute and/or chronic injuries in soft tissue
US9504446B2 (en) 2010-08-02 2016-11-29 Guided Therapy Systems, Llc Systems and methods for coupling an ultrasound source to tissue
US8857438B2 (en) 2010-11-08 2014-10-14 Ulthera, Inc. Devices and methods for acoustic shielding
CN103458815B (en) * 2011-02-23 2016-08-10 奥林巴斯株式会社 Ultrasound probe and ultrasonic treatment unit
US8858471B2 (en) 2011-07-10 2014-10-14 Guided Therapy Systems, Llc Methods and systems for ultrasound treatment
KR20190080967A (en) 2011-07-11 2019-07-08 가이디드 테라피 시스템스, 엘.엘.씨. Systems and methods for coupling an ultrasound source to tissue
US9263663B2 (en) 2012-04-13 2016-02-16 Ardent Sound, Inc. Method of making thick film transducer arrays
US11406415B2 (en) 2012-06-11 2022-08-09 Tenex Health, Inc. Systems and methods for tissue treatment
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
US9820768B2 (en) 2012-06-29 2017-11-21 Ethicon Llc Ultrasonic surgical instruments with control mechanisms
US20140005702A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with distally positioned transducers
US9510802B2 (en) 2012-09-21 2016-12-06 Guided Therapy Systems, Llc Reflective ultrasound technology for dermatological treatments
CN204637350U (en) 2013-03-08 2015-09-16 奥赛拉公司 Aesthstic imaging and processing system, multifocal processing system and perform the system of aesthetic procedure
WO2014146022A2 (en) 2013-03-15 2014-09-18 Guided Therapy Systems Llc Ultrasound treatment device and methods of use
US9320528B2 (en) * 2013-06-26 2016-04-26 Misonix, Incorporated Ultrasonic cutting blade with cooling liquid conduction
US9211137B2 (en) * 2013-06-28 2015-12-15 Misonix, Incorporated Ultrasonic cutting blade with cooling liquid conduction
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
GB2521228A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
GB2521229A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
US9795436B2 (en) 2014-01-07 2017-10-24 Ethicon Llc Harvesting energy from a surgical generator
US9949751B2 (en) 2014-02-04 2018-04-24 Misonix, Inc. Ultrasonic debrider probe
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
US10092310B2 (en) 2014-03-27 2018-10-09 Ethicon Llc Electrosurgical devices
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
BR112016023889B1 (en) 2014-04-18 2023-02-07 Ulthera, Inc ULTRASOUND TRANSDUCTION SYSTEM FOR LINEAR FOCUSING ULTRASOUND
US10398465B2 (en) 2014-04-29 2019-09-03 Misonix Incorporated Ultrasonic surgical instrument assembly, related accessory, and associated surgical method
US9962181B2 (en) 2014-09-02 2018-05-08 Tenex Health, Inc. Subcutaneous wound debridement
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
US10765470B2 (en) 2015-06-30 2020-09-08 Ethicon Llc Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters
US11129669B2 (en) 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US11051873B2 (en) 2015-06-30 2021-07-06 Cilag Gmbh International Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
US9872697B2 (en) 2015-07-13 2018-01-23 Misonix, Incorporated Ultrasonic wound treatment apparatus and associated method
US11229471B2 (en) 2016-01-15 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization
US11129670B2 (en) 2016-01-15 2021-09-28 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization
US10716615B2 (en) 2016-01-15 2020-07-21 Ethicon Llc Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade
PT3405294T (en) 2016-01-18 2023-03-03 Ulthera Inc Compact ultrasound device having annular ultrasound array peripherally electrically connected to flexible printed circuit board and method of assembly thereof
US10213225B2 (en) 2016-06-29 2019-02-26 Elwha Llc Robotic debridement apparatuses, and related systems and methods
US10226307B2 (en) 2016-06-29 2019-03-12 Elwha Llc Robotic debridement apparatuses, and related systems and methods
KR20230149878A (en) 2016-08-16 2023-10-27 얼테라, 인크 Systems and methods for cosmetic ultrasound treatment of skin
US10952759B2 (en) 2016-08-25 2021-03-23 Ethicon Llc Tissue loading of a surgical instrument
US10603064B2 (en) 2016-11-28 2020-03-31 Ethicon Llc Ultrasonic transducer
US10820920B2 (en) 2017-07-05 2020-11-03 Ethicon Llc Reusable ultrasonic medical devices and methods of their use
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
US20210196358A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instrument with electrodes biasing support
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US11707318B2 (en) 2019-12-30 2023-07-25 Cilag Gmbh International Surgical instrument with jaw alignment features
US11911063B2 (en) 2019-12-30 2024-02-27 Cilag Gmbh International Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade
US11779387B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Clamp arm jaw to minimize tissue sticking and improve tissue control
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution system
US11759251B2 (en) 2019-12-30 2023-09-19 Cilag Gmbh International Control program adaptation based on device status and user input
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US20210196359A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instruments with electrodes having energy focusing features
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030023193A1 (en) * 2000-11-20 2003-01-30 Holger Soring System for antiseptic surgery
US20040030254A1 (en) * 2002-08-07 2004-02-12 Eilaz Babaev Device and method for ultrasound wound debridement

Family Cites Families (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3937236A (en) 1974-10-07 1976-02-10 Mdt Chemical Company Ultrasonic cleaning device
US4223676A (en) 1977-12-19 1980-09-23 Cavitron Corporation Ultrasonic aspirator
JPS62282914A (en) 1986-05-31 1987-12-08 Shinshin Shokai:Kk Ultrasonic welding pattern
US5167231A (en) 1986-12-24 1992-12-01 Kabushiki Kaisha Toshiba Ultrasonic probe
US4872353A (en) 1987-11-25 1989-10-10 Micromeritics Instrument Corp. Automatic sample feeder for suspended samples
JP2671135B2 (en) 1988-08-01 1997-10-29 東湘電機株式会社 Ultrasonic disruption device for cells
US4989583A (en) * 1988-10-21 1991-02-05 Nestle S.A. Ultrasonic cutting tip assembly
US4930532A (en) 1989-02-17 1990-06-05 Ipco Corporation Beaker holder for use with ultrasonic cleaning device
US5180363A (en) * 1989-04-27 1993-01-19 Sumitomo Bakelite Company Company Limited Operation device
US5171387A (en) 1990-01-19 1992-12-15 Sonokinetics Group Ultrasonic comb horn and methods for using same
US5112300A (en) * 1990-04-03 1992-05-12 Alcon Surgical, Inc. Method and apparatus for controlling ultrasonic fragmentation of body tissue
CA2042006C (en) 1990-05-11 1995-08-29 Morito Idemoto Surgical ultrasonic horn
US5095188A (en) 1990-07-26 1992-03-10 Branson Ultrasonics Corporation Manufacture of high frequency horns
US5185728A (en) 1990-10-31 1993-02-09 Cyber Scientific Omnidirectional ultrasonic transducer
US5459699A (en) 1992-08-25 1995-10-17 Industrial Sound Technologies Method and apparatus for generating high energy acoustic pulses
US5512335A (en) 1994-06-27 1996-04-30 International Business Machines Corporation Fluid treatment device with vibrational energy means
US5495699A (en) * 1994-11-09 1996-03-05 Weldun International, Inc. Method and apparatus for pressure filling and sealing a vessel
WO1996018349A2 (en) * 1994-12-13 1996-06-20 Torben Lorentzen An electrosurgical instrument for tissue ablation, an apparatus, and a method for providing a lesion in damaged and diseased tissue from a mammal
US6071480A (en) 1994-12-22 2000-06-06 Abbott Laboratories Method for generating a standing sonic wave, methods of sonication with a standing sonic wave, and a standing sonic wave sonicator
US5779985A (en) 1995-12-18 1998-07-14 Solid Phase Sciences Corporation Reaction plenum
US6277332B1 (en) 1995-12-18 2001-08-21 Solid Phase Sciences Corporation Reaction plenum with magnetic separation and/or ultrasonic agitation
JPH09222424A (en) 1996-02-16 1997-08-26 Toshiba Corp Ultrasonic probe
US5931847A (en) * 1997-01-09 1999-08-03 Ethicon Endo-Surgery, Inc. Surgical cutting instrument with improved cutting edge
DE69818908T2 (en) 1997-05-30 2004-07-22 Yazaki Corp. Connection structure between a wire and a terminal, connection method therefor and a terminal
GB9805569D0 (en) 1998-03-16 1998-05-13 Nestle Sa Cutting system
US6524251B2 (en) * 1999-10-05 2003-02-25 Omnisonics Medical Technologies, Inc. Ultrasonic device for tissue ablation and sheath for use therewith
GB9926998D0 (en) 1999-11-15 2000-01-12 Nestle Sa Ultrasonic cutting system
US6152383A (en) 1999-11-22 2000-11-28 King Ultrasonic Co., Ltd. Ultrasonic nebulizer
US6638238B1 (en) * 1999-12-09 2003-10-28 The Regents Of The University Of California Liposuction cannula device and method
US6578659B2 (en) 2000-12-01 2003-06-17 Misonix Incorporated Ultrasonic horn assembly
US20030203491A1 (en) 2002-04-26 2003-10-30 Andrevski Zygmunt M. Gravitational flow purification system
US20040030349A1 (en) * 2002-08-08 2004-02-12 Mikhail Boukhny Liquefaction handpiece tip
US7611473B2 (en) * 2003-09-11 2009-11-03 Ethicon, Inc. Tissue extraction and maceration device
US20050177184A1 (en) * 2004-02-09 2005-08-11 Easley James C. Torsional dissection tip

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030023193A1 (en) * 2000-11-20 2003-01-30 Holger Soring System for antiseptic surgery
US20040030254A1 (en) * 2002-08-07 2004-02-12 Eilaz Babaev Device and method for ultrasound wound debridement

Cited By (105)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10537352B2 (en) 2004-10-08 2020-01-21 Ethicon Llc Tissue pads for use with surgical instruments
US9801648B2 (en) 2007-03-22 2017-10-31 Ethicon Llc Surgical instruments
US9987033B2 (en) 2007-03-22 2018-06-05 Ethicon Llc Ultrasonic surgical instruments
US9883884B2 (en) 2007-03-22 2018-02-06 Ethicon Llc Ultrasonic surgical instruments
US9642644B2 (en) 2007-07-27 2017-05-09 Ethicon Endo-Surgery, Llc Surgical instruments
EP2178448A4 (en) * 2007-07-27 2015-07-08 Ethicon Endo Surgery Inc Ultrasonic surgical instruments
US9707004B2 (en) 2007-07-27 2017-07-18 Ethicon Llc Surgical instruments
US10398466B2 (en) 2007-07-27 2019-09-03 Ethicon Llc Ultrasonic end effectors with increased active length
US9414853B2 (en) 2007-07-27 2016-08-16 Ethicon Endo-Surgery, Llc Ultrasonic end effectors with increased active length
US9913656B2 (en) 2007-07-27 2018-03-13 Ethicon Llc Ultrasonic surgical instruments
US9636135B2 (en) 2007-07-27 2017-05-02 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments
US10420579B2 (en) 2007-07-31 2019-09-24 Ethicon Llc Surgical instruments
US10426507B2 (en) 2007-07-31 2019-10-01 Ethicon Llc Ultrasonic surgical instruments
US11058447B2 (en) 2007-07-31 2021-07-13 Cilag Gmbh International Temperature controlled ultrasonic surgical instruments
US9848902B2 (en) 2007-10-05 2017-12-26 Ethicon Llc Ergonomic surgical instruments
JP2011504792A (en) * 2007-11-28 2011-02-17 ダッドソン マニュファクチャリング シーオーアールピー. Dermatome with ultrasonic cutting blade
US10433865B2 (en) 2007-11-30 2019-10-08 Ethicon Llc Ultrasonic surgical blades
US10245065B2 (en) 2007-11-30 2019-04-02 Ethicon Llc Ultrasonic surgical blades
US9339289B2 (en) 2007-11-30 2016-05-17 Ehticon Endo-Surgery, LLC Ultrasonic surgical instrument blades
US10888347B2 (en) 2007-11-30 2021-01-12 Ethicon Llc Ultrasonic surgical blades
US10265094B2 (en) 2007-11-30 2019-04-23 Ethicon Llc Ultrasonic surgical blades
US10433866B2 (en) 2007-11-30 2019-10-08 Ethicon Llc Ultrasonic surgical blades
US10441308B2 (en) 2007-11-30 2019-10-15 Ethicon Llc Ultrasonic surgical instrument blades
US10045794B2 (en) 2007-11-30 2018-08-14 Ethicon Llc Ultrasonic surgical blades
US10463887B2 (en) 2007-11-30 2019-11-05 Ethicon Llc Ultrasonic surgical blades
US10010339B2 (en) 2007-11-30 2018-07-03 Ethicon Llc Ultrasonic surgical blades
US9795808B2 (en) 2008-08-06 2017-10-24 Ethicon Llc Devices and techniques for cutting and coagulating tissue
US10335614B2 (en) 2008-08-06 2019-07-02 Ethicon Llc Devices and techniques for cutting and coagulating tissue
US10022568B2 (en) 2008-08-06 2018-07-17 Ethicon Llc Devices and techniques for cutting and coagulating tissue
US10022567B2 (en) 2008-08-06 2018-07-17 Ethicon Llc Devices and techniques for cutting and coagulating tissue
US9504855B2 (en) 2008-08-06 2016-11-29 Ethicon Surgery, LLC Devices and techniques for cutting and coagulating tissue
US9700339B2 (en) 2009-05-20 2017-07-11 Ethicon Endo-Surgery, Inc. Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments
US9764164B2 (en) 2009-07-15 2017-09-19 Ethicon Llc Ultrasonic surgical instruments
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10263171B2 (en) 2009-10-09 2019-04-16 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10201382B2 (en) 2009-10-09 2019-02-12 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US9623237B2 (en) 2009-10-09 2017-04-18 Ethicon Endo-Surgery, Llc Surgical generator for ultrasonic and electrosurgical devices
USRE47996E1 (en) 2009-10-09 2020-05-19 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US10265117B2 (en) 2009-10-09 2019-04-23 Ethicon Llc Surgical generator method for controlling and ultrasonic transducer waveform for ultrasonic and electrosurgical devices
US9510850B2 (en) 2010-02-11 2016-12-06 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments
US9649126B2 (en) 2010-02-11 2017-05-16 Ethicon Endo-Surgery, Llc Seal arrangements for ultrasonically powered surgical instruments
US9848901B2 (en) 2010-02-11 2017-12-26 Ethicon Llc Dual purpose surgical instrument for cutting and coagulating tissue
US10117667B2 (en) 2010-02-11 2018-11-06 Ethicon Llc Control systems for ultrasonically powered surgical instruments
US9427249B2 (en) 2010-02-11 2016-08-30 Ethicon Endo-Surgery, Llc Rotatable cutting implements with friction reducing material for ultrasonic surgical instruments
US9962182B2 (en) 2010-02-11 2018-05-08 Ethicon Llc Ultrasonic surgical instruments with moving cutting implement
US10299810B2 (en) 2010-02-11 2019-05-28 Ethicon Llc Rotatable cutting implements with friction reducing material for ultrasonic surgical instruments
US10278721B2 (en) 2010-07-22 2019-05-07 Ethicon Llc Electrosurgical instrument with separate closure and cutting members
US10524854B2 (en) 2010-07-23 2020-01-07 Ethicon Llc Surgical instrument
US10433900B2 (en) 2011-07-22 2019-10-08 Ethicon Llc Surgical instruments for tensioning tissue
US9925003B2 (en) 2012-02-10 2018-03-27 Ethicon Endo-Surgery, Llc Robotically controlled surgical instrument
US9724118B2 (en) 2012-04-09 2017-08-08 Ethicon Endo-Surgery, Llc Techniques for cutting and coagulating tissue for ultrasonic surgical instruments
US9700343B2 (en) 2012-04-09 2017-07-11 Ethicon Endo-Surgery, Llc Devices and techniques for cutting and coagulating tissue
US10517627B2 (en) 2012-04-09 2019-12-31 Ethicon Llc Switch arrangements for ultrasonic surgical instruments
US10524872B2 (en) 2012-06-29 2020-01-07 Ethicon Llc Closed feedback control for electrosurgical device
US10398497B2 (en) 2012-06-29 2019-09-03 Ethicon Llc Lockout mechanism for use with robotic electrosurgical device
US9713507B2 (en) 2012-06-29 2017-07-25 Ethicon Endo-Surgery, Llc Closed feedback control for electrosurgical device
US10335183B2 (en) 2012-06-29 2019-07-02 Ethicon Llc Feedback devices for surgical control systems
US10335182B2 (en) 2012-06-29 2019-07-02 Ethicon Llc Surgical instruments with articulating shafts
US9737326B2 (en) 2012-06-29 2017-08-22 Ethicon Endo-Surgery, Llc Haptic feedback devices for surgical robot
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US10441310B2 (en) 2012-06-29 2019-10-15 Ethicon Llc Surgical instruments with curved section
US10543008B2 (en) 2012-06-29 2020-01-28 Ethicon Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
US9283045B2 (en) 2012-06-29 2016-03-15 Ethicon Endo-Surgery, Llc Surgical instruments with fluid management system
US10881449B2 (en) 2012-09-28 2021-01-05 Ethicon Llc Multi-function bi-polar forceps
US9795405B2 (en) 2012-10-22 2017-10-24 Ethicon Llc Surgical instrument
US11324527B2 (en) 2012-11-15 2022-05-10 Cilag Gmbh International Ultrasonic and electrosurgical devices
US10226273B2 (en) 2013-03-14 2019-03-12 Ethicon Llc Mechanical fasteners for use with surgical energy devices
US9743947B2 (en) 2013-03-15 2017-08-29 Ethicon Endo-Surgery, Llc End effector with a clamp arm assembly and blade
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US10349999B2 (en) 2014-03-31 2019-07-16 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10034684B2 (en) 2015-06-15 2018-07-31 Ethicon Llc Apparatus and method for dissecting and coagulating tissue
US11020140B2 (en) 2015-06-17 2021-06-01 Cilag Gmbh International Ultrasonic surgical blade for use with ultrasonic surgical instruments
US10357303B2 (en) 2015-06-30 2019-07-23 Ethicon Llc Translatable outer tube for sealing using shielded lap chole dissector
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US10154852B2 (en) 2015-07-01 2018-12-18 Ethicon Llc Ultrasonic surgical blade with improved cutting and coagulation features
US10624691B2 (en) 2015-09-30 2020-04-21 Ethicon Llc Techniques for operating generator for digitally generating electrical signal waveforms and surgical instruments
US11033322B2 (en) 2015-09-30 2021-06-15 Ethicon Llc Circuit topologies for combined generator
US10687884B2 (en) 2015-09-30 2020-06-23 Ethicon Llc Circuits for supplying isolated direct current (DC) voltage to surgical instruments
US10194973B2 (en) 2015-09-30 2019-02-05 Ethicon Llc Generator for digitally generating electrical signal waveforms for electrosurgical and ultrasonic surgical instruments
US10610286B2 (en) 2015-09-30 2020-04-07 Ethicon Llc Techniques for circuit topologies for combined generator
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
US10299821B2 (en) 2016-01-15 2019-05-28 Ethicon Llc Modular battery powered handheld surgical instrument with motor control limit profile
US10251664B2 (en) 2016-01-15 2019-04-09 Ethicon Llc Modular battery powered handheld surgical instrument with multi-function motor via shifting gear assembly
US10537351B2 (en) 2016-01-15 2020-01-21 Ethicon Llc Modular battery powered handheld surgical instrument with variable motor control limits
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
US10245064B2 (en) 2016-07-12 2019-04-02 Ethicon Llc Ultrasonic surgical instrument with piezoelectric central lumen transducer
US10893883B2 (en) 2016-07-13 2021-01-19 Ethicon Llc Ultrasonic assembly for use with ultrasonic surgical instruments
US10842522B2 (en) 2016-07-15 2020-11-24 Ethicon Llc Ultrasonic surgical instruments having offset blades
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US10285723B2 (en) 2016-08-09 2019-05-14 Ethicon Llc Ultrasonic surgical blade with improved heel portion
USD847990S1 (en) 2016-08-16 2019-05-07 Ethicon Llc Surgical instrument
US10420580B2 (en) 2016-08-25 2019-09-24 Ethicon Llc Ultrasonic transducer for surgical instrument
US11266430B2 (en) 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
USD974558S1 (en) 2020-12-18 2023-01-03 Stryker European Operations Limited Ultrasonic knife

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