US20110166483A1 - Ultrasonic curved blade - Google Patents
Ultrasonic curved bladeDownload PDFInfo
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- US20110166483A1 US20110166483A1US13/048,462US201113048462AUS2011166483A1US 20110166483 A1US20110166483 A1US 20110166483A1US 201113048462 AUS201113048462 AUS 201113048462AUS 2011166483 A1US2011166483 A1US 2011166483A1
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- tissue
- ultrasonic
- blade surface
- body portion
- elongated body
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Classifications
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320074—Working tips with special features, e.g. extending parts blade
- A61B2017/320075—Working tips with special features, e.g. extending parts blade single edge blade, e.g. for cutting
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
Definitions
- the present disclosurerelates to an ultrasonic dissection and coagulation system for surgical use. More specifically, the present disclosure relates to an ultrasonic instrument including a curved blade and a clamp member particularly suited for performing dissection and coagulation of tissue.
- Ultrasonic instruments for surgical use and the benefits associated therewithare well known.
- the use of an ultrasonic generator in conjunction with a surgical scalpelfacilitates faster and easier cutting of organic tissue and accelerates blood vessel clotting in the area of the cut, i.e., accelerated coagulation.
- Improved cuttingresults from increased body tissue to scalpel contact caused by the high frequency of vibration of the scalpel blade with respect to body tissue.
- Improved coagulationresults from heat generated by contact between the scalpel blade and the body tissue as the scalpel blade is vibrated at a high frequency.
- U.S. Pat. No. 3,862,630(“Balamuth”) discloses an ultrasonic system including an ultrasonic motor, a tool member having a working surface oriented normal to the direction of mechanical vibration generated by the ultrasonic motor, and a clamp member extending parallel to the tool member for compressing tissue against the tool member.
- U.S. Pat. No. 5,322,055(“Davison”) discloses an ultrasonic surgical instrument adapted for endoscopic use having a blade and a clamp movable in relation to the blade to capture tissue therebetween. The blade and the clamp define a clamping region having a plane which is parallel to the longitudinal axis of the surgical instrument. During an endoscopic procedure, movement of the instrument is limited to movement along an axis parallel to the plane of the clamping region. Thus, no additional blade force is imposed on the body tissue as a result of movement of the instrument.
- an ultrasonic systemfor dissection and coagulation of tissue.
- the systemincludes an ultrasonic instrument, a control module, and a remote actuator.
- the ultrasonic instrumenthas a housing and an elongated body portion extending from the housing.
- An ultrasonic transducer supported within the housingis operatively connected to a cutting jaw by a vibration coupler.
- the vibration couplerconducts high frequency vibration from the ultrasonic transducer to the cutting jaw.
- the cutting jawhas a blade surface which is curved outwardly and downwardly along its surface and thus, curved with respect to the axis of vibration.
- the curved blade surfaceis preferably configured such that the angle defined between a line tangent to the blade surface and the longitudinal axis of the elongated body portion vanes from about 5 degrees to about 45 degrees along the length of the blade surface.
- a clamp member having a tissue contact surfaceis positioned adjacent to the cutting jaw and is movable from an open position in which the tissue contact surface is spaced from the blade surface to a clamped position in which the tissue contact surface is in close juxtaposed alignment with the blade surface to clamp tissue therebetween.
- the clamp member and the angled bladecombine to enhance contact between tissue and the blade surface of the blade member.
- FIG. 1is a perspective view of the ultrasonic dissection and coagulation system with the ultrasonic instrument inserted partially through a cannula;
- FIG. 2is a perspective view of the ultrasonic instrument of FIG. 1 ;
- FIG. 3is a perspective view with parts separated of the clamp of the ultrasonic instrument of FIG. 1 ;
- FIG. 4is a perspective view with parts separated of the elongated body portion of the ultrasonic instrument of FIG. 1 ;
- FIG. 5is a perspective view with parts separated of the ultrasonic instrument of FIG. 1 ;
- FIG. 6is a perspective view with parts separated of the rotation assembly of the ultrasonic instrument of FIG. 1 ;
- FIG. 7is a side partial cutaway view of the ultrasonic instrument of FIG. 1 in the open position
- FIG. 8is an enlarged view of the indicated area of detail of FIG. 7 illustrating the clamp in the open position
- FIG. 9is a perspective view of the distal end of the elongated body portion of the ultrasonic instrument of FIG. 1 with the clamp in the open position;
- FIG. 10is a perspective partial cutaway view of the distal end of the elongated body portion of the ultrasonic instrument of FIG. 1 with the clamp in the open position;
- FIG. 11is a front perspective, partial cutaway view of the distal end of the elongated body portion of the ultrasonic instrument of FIG. 1 with the clamp in the open position;
- FIG. 12is a side partial cutaway view of the ultrasonic instrument of FIG. 1 with the clamp in the clamped (closed) position;
- FIG. 13is an enlarged view of the indicated area of detail of FIG. 12 illustrating the clamp in the closed position
- FIG. 14is a side cross-sectional view of the distal end of the elongated body portion of the ultrasonic instrument of FIG. 1 in the clamped position;
- FIG. 15is a perspective view of the ultrasonic instrument of FIG. 1 with the elongated body portion partially rotated;
- FIG. 16Ais a side view of an alternate embodiment of the ultrasonic transducer of FIG. 1 ;
- FIG. 16Bis a side cross-sectional view taken along section line 16 B- 16 B of FIG. 16A .
- FIG. 16Cis a perspective view with parts separated of the ultrasonic transducer of FIG. 16A ;
- FIG. 17Ais a side view of a torque wrench assembly in engagement with the ultrasonic transducer of FIG. 16A ;
- FIG. 17Bis a side cross-sectional view taken along section line 17 B- 17 B of FIG. 17A .
- FIG. 1illustrates the ultrasonic dissection and coagulation system shown generally as 10 .
- dissection and coagulation system 10includes ultrasonic instrument 12 , control module 14 , and remote actuator 16 .
- Control module 14is operatively connected to ultrasonic instrument 12 by electrically conductive cable 18 and functions to control the power and frequency of current supplied to ultrasonic instrument 12 . Any suitable controller capable of delivering power to ultrasonic instrument 12 can be used. Control module 14 does not form part of the invention and will not be further discussed herein.
- Remote actuator 16e.g., pedal actuator, is operatively connected to control module 14 by electrically conductive cable 20 and can be actuated to initiate the supply of power to ultrasonic instrument 12 via control module 14 to effect vibratory motion of ultrasonic instrument 12 to cut and coagulate tissue.
- ultrasonic instrument 12includes housing 22 and elongated body portion 24 extending distally therefrom.
- Housing 22is preferably formed from molded housing half-sections 22 a and 22 b and includes a barrel portion 26 having a longitudinal axis aligned with the longitudinal axis of body portion 24 and a stationary handle portion 28 extending obliquely from barrel portion 26 .
- Ultrasonic transducer 30is supported within and extends from the proximal end of housing 22 and is connected to control module 14 via cable 18 .
- Jaw assembly 32is disposed adjacent the distal end of elongated body portion 24 and is actuated by moving movable handle 36 with respect to stationary handle portion 28 .
- Movable handle 36 and stationary handle portion 28include openings 38 and 40 , respectively, to facilitate gripping and actuation of ultrasonic instrument 12 .
- Elongated body portion 24is supported within rotatable knob 34 and may be selectively rotated by rotating knob 34 with respect to housing 22 to change the orientation of jaw assembly 32 .
- FIGS. 3 and 4illustrate elongated body portion 24 with parts separated.
- Elongated body portion 24includes an outer tube 42 which is preferably cylindrical and has a proximally located annular flange 44 dimensioned to engage rotatable knob 34 ( FIG. 2 ) as described below.
- An elongated actuator tube 46which is also preferably cylindrical, is configured to be slidably received within outer tube 42 and includes a proximally located annular flange 48 dimensioned to engage coupling member 98 ( FIG. 5 ) which is supported within housing 22 ( FIG. 2 ) and will be described in detail below.
- Vibration coupler 50is dimensioned to extend through elongated actuator tube 46 and includes a proximal end 52 having a reduced diameter portion 54 configured to operatively engage ultrasonic transducer 30 ( FIG. 5 ) and a distal end 56 adapted to be operatively connected to cutting jaw 58 .
- a plurality of silicon rings 51can be molded or otherwise attached to the nodal points along vibration coupler 50 to seal between vibration coupler 50 and actuator tube 46 .
- cutting jaw 58includes an internal proximal threaded bore (not shown) which is dimensioned to receive threaded distal end 56 of vibration coupler 50 .
- cutting jaw 58can be formed integrally with vibration coupler 50 , cutting jaw 58 may include a threaded proximal end configured to be received within a threaded bore formed in vibration coupler 50 , or other attachment devices can be used.
- a clamp 60having a clamp body 62 and a tissue contact member 64 removably secured to clamp body 62 is operatively connected to the distal end of actuator tube 46 .
- Clamp body 62includes a pair of tissue receiving stops 71 that define the proximal end of the exposed blade surface 59 .
- Tissue contact member 64is preferably composed of teflon and is preferably removably fastened to clamp body 62 by a tongue and groove fastening assembly (reference numerals 61 and 65 , respectively), although other fastening assemblies are also envisioned.
- Tissue contact member 64functions to isolate clamp 60 , which is preferably metallic, from jaw 58 which is also preferably metallic to prevent metal to metal contact.
- Tissue contact member 50also functions to grip tissue to prevent movement of the tissue with vibrating cutting jaw 58 .
- at least one row of teethmay be positioned on clamp 60 to grip tissue, such as disclosed in U.S. patent application Ser. No. 08/911,207, which is incorporated herein by reference.
- Pivot members (pins) 66 located at the proximal end of clamp body 62are configured to be received within openings 68 formed in the distal end of outer tube 42 .
- a guide slot 70 formed in the distal end of actuator tube 46permits relative movement between actuator tube 46 and clamp body 62 by allowing pins 66 to move in guide slot 70 .
- a pair of camming members 72are also formed on clamp body 62 and are positioned to be received within cam slots 74 formed in the distal end of actuator tube 46 . Movement of actuator tube 46 and clamp 60 will be described in detail below.
- Cutting jaw 58includes a curved blade surface 59 that slopes downwardly and outwardly in the distal direction.
- the entire blade surface 59 exposed to tissuei.e., the portion of blade surface 59 between tissue receiving stops 71 and the distal end of blade surface 59 , has a tangent which defines an angle with respect to the longitudinal axis of elongated body portion 24 that varies along the length of blade surface 59 from about 5 degrees to about 75 degrees.
- the angle defined by a line tangent to the blade surface and the longitudinal axis of elongated body portion 24varies from about 5 degrees to about 45 degrees along the length of the blade surface.
- the curved blade surfaceprovides better visibility at the surgical site.
- Clamp 60is movable from an open position in which tissue contact member 64 is spaced apart from blade surface 59 ( FIGS. 7 and 8 ) to a clamped position in which tissue contact member is in juxtaposed close alignment with blade surface 59 ( FIGS. 11-13 ) to clamp tissue therebetween.
- the interior surface of tissue contact member 64is curved to correspond to blade surface 59 .
- the clamped positionnote the positioning of tissue contact member 64 with respect to blade surface 59 . Actuation of clamp 60 from the open position to the clamped position will be described in detail below.
- Housing half-sections 22 a and 22 bdefine a chamber 76 configured to receive a portion of ultrasonic transducer 30 .
- Chamber 76has an opening 78 communicating with the interior of housing 22 .
- Ultrasonic transducer 30includes a bore 80 configured to receive proximal end 54 of vibration coupler 50 . In the assembled condition, proximal end 54 extends through opening 78 into bore 80 .
- Ultrasonic transducer 30may be secured within housing 22 to vibration coupler 50 using any known attachment apparatus.
- a torque wrenchsuch as disclosed in copending U.S. patent application Ser. No. 08/911,207, now U.S. Pat. No.
- 6,036,667can be used to secure ultrasonic transducer 30 to vibration coupler 50 .
- the proximal end of transducer 30may be configured to engage the torque wrench.
- Movable handle 36is pivotally connected between housing half-sections 22 a and 22 b about pivot pin 82 which extends through holes 84 formed in legs 86 of movable handle 36 .
- a cam slot 88 formed in each leg 86is configured to receive a protrusion 90 projecting outwardly from coupling member 98 ( FIG. 6 ).
- coupling member 98operatively connects movable handle 36 to actuator tube 46 and is preferably formed from molded half-sections 98 a and 98 b to define a throughbore 100 dimensioned to slidably receive the proximal end of vibration coupler 50 .
- Coupling member 98has an inner distally located annular groove 102 dimensioned to receive annular flange 48 of actuator tube 46 and an outer proximally located annular groove 104 .
- Groove 104is positioned to receive an annular rib 106 formed on the internal wall of a swivel member 108 ( FIG. 5 ).
- Swivel member 108is preferably formed from molded half-sections 108 a and 108 b and permits rotation of coupling member 98 relative to movable handle 36 .
- Protrusions 90project outwardly from sidewalls of swivel member 108 and extend through cam slots 88 of movable handle 36 ( FIG. 5 ).
- rotation knob 34is preferably formed from molded half-sections 34 a and 34 b and includes a proximal cavity 110 for slidably supporting coupling member 98 and a distal bore 112 dimensioned to receive outer tube 42 .
- An annular groove 114 formed in bore 112is positioned to receive annular flange 44 of outer tube 42 .
- the outer wall of knob 34has a proximally located annular ring 116 dimensioned to be rotatably received within annular slot 118 formed in opening 120 of housing 22 .
- the outer wall of knob 34also includes scalloped surface 122 to facilitate gripping of rotatable knob 34 .
- Annular ring 116permits rotation of knob 34 with respect to housing 22 while preventing axial movement with respect thereto.
- A. pair of cylindrical rods 124extend between half-sections 34 a and 34 b through a rectangular opening 126 formed in coupling member 98 .
- Rods 124engage a pair of concave recesses 128 formed in fitting 130 which is fastened about vibration coupler 50 , such that rotation of knob 34 causes rotation of vibration coupler 50 and thus rotation of blade 58 and clamp 60 .
- recesses 128can be monolithically formed with vibration coupler 50 .
- FIGS. 7-10illustrate ultrasonic instrument 12 with clamp 60 in the open position.
- the elongated body 24 which includes clamp 60 and blade 58 , and housing 22 which includes handles 28 and 36are packaged as an integral unit, e.g., non-detachably connected, that requires no assembly by the user prior to use. That is, the user needs only to attach transducer 30 to housing 22 to ready instrument 12 for use.
- movable handle 36In the open position, movable handle 36 is spaced rearwardly from stationary handle portion 28 and protrusions 90 are positioned in the lower proximal portion of cam slots 88 .
- tissue contact member 64 of clamp 60is spaced from blade surface 59 to define a tissue receiving area 132 .
- the proximal end of tissue receiving area 132is defined by tissue receiving stops 71 which are preferably integrally formed with clamp body 62 and extend below blade surface 59 .
- tissue contact surface 64is also preferably formed with a longitudinally extending concavity 67 to receive tissue therein.
- distal end of blade 58may be formed in any shape which may be suitable to a particular surgical application, i.e., pointed, flat, etc.
- tissue contact surface 64need not be formed with a concavity but may be flat, angled, etc.
- cam slot 88engages protrusion 90 of swivel member 108 to advance coupling member 98 distally within cavity 110 of rotation knob 34 .
- actuator tube 46is attached to coupling member 98 by an annular flange 48 , actuator tube 46 is also advanced distally in the direction indicated by arrow “B” in FIG. 12 . Movement of actuator tube 46 distally causes cam slots 74 to move into engagement with camming members 72 to pivot clamp body 62 about pivot members 66 , in the direction indicated by arrow “C” in FIG.
- protrusions 90are located in a central portion of cam slots 88
- pivot members 66are located near the proximal end of guide slots 70
- camming members 72are located in the proximal lower portion of cam slots 74 .
- Elongated body portion 24can be freely rotated with respect to housing 22 by rotating rotation knob 34 .
- rotation of knob 34 in the direction indicated by arrow “D”causes rotation of jaw assembly 32 in the direction indicated by arrow “E”.
- Knob 34is positioned adjacent housing 22 to facilitate one handed operation of both movable handle 36 and rotation knob 34 .
- elongated body portion 24is dimensioned to extend through a trocar assembly 140 , and is preferably dimensioned to extend through a 5 mm trocar assembly.
- elongated body portion 24is slid through trocar assembly 140 with jaw assembly 32 in the clamped or closed position to a position adjacent tissue (not shown) to be dissected and/or coagulated.
- An optical unit(not shown) can also be positioned adjacent the surgical site to facilitate viewing of the procedure.
- Jaw assembly 32is opened and tissue to be dissected and/or coagulated is positioned within tissue receiving area 132 (See also FIG. 9 ). Tissue receiving stops 71 prevent tissue from moving past the proximal end of blade surface 59 .
- jaw assembly 32is closed to clamp tissue between tissue contact member 64 and blade surface 59 .
- Poweris supplied to ultrasonic instrument 12 via control module 14 to initiate vibration of blade 58 to effect dissection and/or coagulation of tissue. Because of the curve of blade surface 59 , the force applied by blade surface 59 to the tissue being dissected can be selectively increased or decreased as instrument 12 is moved forward through trocar assembly 140 by adjusting the location of the tissue on blade surface 59 and thus changing the angle of the force applied to the tissue being dissected.
- FIGS. 16A-16Cillustrate an alternate embodiment of the ultrasonic transducer shown generally as 230 .
- Ultrasonic transducer 230includes a housing 231 having a proximal housing portion 232 and a distal housing portion 234 .
- Proximal housing portion 232has a scalloped section 236 adjacent its proximal end.
- Transducer horn 238is supported within housing 231 by support collar 240 and annular ring 242 .
- the distal end of transducer horn 238includes a threaded bore 244 dimensioned to engage reduced diameter portion 54 of vibration coupler 50 ( FIG. 4 ). As best illustrated in FIG.
- transducer horn 238is formed with annular flange 246 , about which annular ring 242 is received.
- the proximal end of support collar 240also includes an annular flange 248 which, in an assembled condition, is clamped between proximal and distal housing portions 232 and 234 to fixedly retain support collar 240 in position within housing 231 .
- the distal end of support collar 240engages annular ring 242 to retain annular ring 242 and thus horn 238 in a longitudinally fixed position within housing 231 .
- torque wrench assembly 250is configured and dimensioned to engage scalloped section 236 of ultrasonic transducer 230 to facilitate assembly of transducer assembly 230 with the remaining portion of ultrasonic instrument 12 .
- Torque wrench assembly 250assures that horn 238 and vibration coupler 50 ( FIG. 4 ) are properly connected, i.e., properly torqued.
- vibration coupler 50 and blade 58may be monolithically formed or attached using structure other than screw threads.
- Different actuator assembliesother than the actuator tube having a camming surface can be used to pivot the clamp member to the clamped position.
- the elongated body portion of the instrumentcan be dimensioned to extend through other than 5 mm trocar assemblies, e.g., 10 mm, 12 mm, etc. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
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Abstract
Description
- This application is a continuation of U.S. patent application Ser. No. 12/241,565, filed Sep. 30, 2008, which is a continuation of U.S. patent application Ser. No. 11/305,706 filed Dec. 16, 2005, now abandoned, which is a continuation of U.S. patent application Ser. No. 10/737,414, filed Dec. 16, 2003, now abandoned, which is a continuation of U.S. patent application Ser. No. 10/241,936, filed Sep. 11, 2002, now U.S. Pat. No. 6,682,544, which is a continuation of U.S. patent application Ser. No. 09/604,877, filed Jun. 28, 2000, now abandoned, which is a continuation of U.S. patent application Ser. No. 09/420,640, filed Oct. 20, 1999, now abandoned, which is a continuation of U.S. patent application Ser. No. 08/911,205, filed Aug. 14, 1997, now U.S. Pat. No. 6,024,750, all of which are incorporated herein by reference in their entirety.
- 1. Technical Field
- The present disclosure relates to an ultrasonic dissection and coagulation system for surgical use. More specifically, the present disclosure relates to an ultrasonic instrument including a curved blade and a clamp member particularly suited for performing dissection and coagulation of tissue.
- 2. Background of Related Art
- Ultrasonic instruments for surgical use and the benefits associated therewith are well known. For example, the use of an ultrasonic generator in conjunction with a surgical scalpel facilitates faster and easier cutting of organic tissue and accelerates blood vessel clotting in the area of the cut, i.e., accelerated coagulation. Improved cutting results from increased body tissue to scalpel contact caused by the high frequency of vibration of the scalpel blade with respect to body tissue. Improved coagulation results from heat generated by contact between the scalpel blade and the body tissue as the scalpel blade is vibrated at a high frequency. Thus, in order to reap the advantages associated with ultrasonic energy, good blade to tissue contact is important.
- U.S. Pat. No. 3,862,630 (“Balamuth”) discloses an ultrasonic system including an ultrasonic motor, a tool member having a working surface oriented normal to the direction of mechanical vibration generated by the ultrasonic motor, and a clamp member extending parallel to the tool member for compressing tissue against the tool member. U.S. Pat. No. 5,322,055 (“Davison”) discloses an ultrasonic surgical instrument adapted for endoscopic use having a blade and a clamp movable in relation to the blade to capture tissue therebetween. The blade and the clamp define a clamping region having a plane which is parallel to the longitudinal axis of the surgical instrument. During an endoscopic procedure, movement of the instrument is limited to movement along an axis parallel to the plane of the clamping region. Thus, no additional blade force is imposed on the body tissue as a result of movement of the instrument.
- Accordingly, a need exists for an improved ultrasonic surgical instrument which is easy to use and provides fast and easy cutting and improved coagulation.
- In accordance with the present disclosure, an ultrasonic system for dissection and coagulation of tissue is provided. The system includes an ultrasonic instrument, a control module, and a remote actuator. The ultrasonic instrument has a housing and an elongated body portion extending from the housing. An ultrasonic transducer supported within the housing is operatively connected to a cutting jaw by a vibration coupler. The vibration coupler conducts high frequency vibration from the ultrasonic transducer to the cutting jaw. The cutting jaw has a blade surface which is curved outwardly and downwardly along its surface and thus, curved with respect to the axis of vibration. The curved blade surface is preferably configured such that the angle defined between a line tangent to the blade surface and the longitudinal axis of the elongated body portion vanes from about 5 degrees to about 45 degrees along the length of the blade surface. A clamp member having a tissue contact surface is positioned adjacent to the cutting jaw and is movable from an open position in which the tissue contact surface is spaced from the blade surface to a clamped position in which the tissue contact surface is in close juxtaposed alignment with the blade surface to clamp tissue therebetween. The clamp member and the angled blade combine to enhance contact between tissue and the blade surface of the blade member.
FIG. 1 is a perspective view of the ultrasonic dissection and coagulation system with the ultrasonic instrument inserted partially through a cannula;FIG. 2 is a perspective view of the ultrasonic instrument ofFIG. 1 ;FIG. 3 is a perspective view with parts separated of the clamp of the ultrasonic instrument ofFIG. 1 ;FIG. 4 is a perspective view with parts separated of the elongated body portion of the ultrasonic instrument ofFIG. 1 ;FIG. 5 is a perspective view with parts separated of the ultrasonic instrument ofFIG. 1 ;FIG. 6 is a perspective view with parts separated of the rotation assembly of the ultrasonic instrument ofFIG. 1 ;FIG. 7 is a side partial cutaway view of the ultrasonic instrument ofFIG. 1 in the open position;FIG. 8 is an enlarged view of the indicated area of detail ofFIG. 7 illustrating the clamp in the open position;FIG. 9 is a perspective view of the distal end of the elongated body portion of the ultrasonic instrument ofFIG. 1 with the clamp in the open position;FIG. 10 is a perspective partial cutaway view of the distal end of the elongated body portion of the ultrasonic instrument ofFIG. 1 with the clamp in the open position;FIG. 11 is a front perspective, partial cutaway view of the distal end of the elongated body portion of the ultrasonic instrument ofFIG. 1 with the clamp in the open position;FIG. 12 is a side partial cutaway view of the ultrasonic instrument ofFIG. 1 with the clamp in the clamped (closed) position;FIG. 13 is an enlarged view of the indicated area of detail ofFIG. 12 illustrating the clamp in the closed position;FIG. 14 is a side cross-sectional view of the distal end of the elongated body portion of the ultrasonic instrument ofFIG. 1 in the clamped position;FIG. 15 is a perspective view of the ultrasonic instrument ofFIG. 1 with the elongated body portion partially rotated;FIG. 16A is a side view of an alternate embodiment of the ultrasonic transducer ofFIG. 1 ;FIG. 16B is a side cross-sectional view taken alongsection line 16B-16B ofFIG. 16A .FIG. 16C is a perspective view with parts separated of the ultrasonic transducer ofFIG. 16A ;FIG. 17A is a side view of a torque wrench assembly in engagement with the ultrasonic transducer ofFIG. 16A ; andFIG. 17B is a side cross-sectional view taken alongsection line 17B-17B ofFIG. 17A .- Preferred embodiments of the presently disclosed ultrasonic dissection and coagulation system will now be described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views.
FIG. 1 illustrates the ultrasonic dissection and coagulation system shown generally as10. Briefly, dissection andcoagulation system 10 includesultrasonic instrument 12,control module 14, andremote actuator 16.Control module 14 is operatively connected toultrasonic instrument 12 by electricallyconductive cable 18 and functions to control the power and frequency of current supplied toultrasonic instrument 12. Any suitable controller capable of delivering power toultrasonic instrument 12 can be used.Control module 14 does not form part of the invention and will not be further discussed herein.Remote actuator 16, e.g., pedal actuator, is operatively connected to controlmodule 14 by electricallyconductive cable 20 and can be actuated to initiate the supply of power toultrasonic instrument 12 viacontrol module 14 to effect vibratory motion ofultrasonic instrument 12 to cut and coagulate tissue.- As illustrated in
FIG. 2 ,ultrasonic instrument 12 includeshousing 22 andelongated body portion 24 extending distally therefrom.Housing 22 is preferably formed from molded housing half-sections 22aand22band includes abarrel portion 26 having a longitudinal axis aligned with the longitudinal axis ofbody portion 24 and astationary handle portion 28 extending obliquely frombarrel portion 26.Ultrasonic transducer 30 is supported within and extends from the proximal end ofhousing 22 and is connected to controlmodule 14 viacable 18.Jaw assembly 32 is disposed adjacent the distal end ofelongated body portion 24 and is actuated by movingmovable handle 36 with respect tostationary handle portion 28.Movable handle 36 andstationary handle portion 28 includeopenings ultrasonic instrument 12.Elongated body portion 24 is supported withinrotatable knob 34 and may be selectively rotated by rotatingknob 34 with respect tohousing 22 to change the orientation ofjaw assembly 32. FIGS. 3 and 4 illustrateelongated body portion 24 with parts separated.Elongated body portion 24 includes anouter tube 42 which is preferably cylindrical and has a proximally locatedannular flange 44 dimensioned to engage rotatable knob34 (FIG. 2 ) as described below. Anelongated actuator tube 46, which is also preferably cylindrical, is configured to be slidably received withinouter tube 42 and includes a proximally locatedannular flange 48 dimensioned to engage coupling member98 (FIG. 5 ) which is supported within housing22 (FIG. 2 ) and will be described in detail below.Vibration coupler 50 is dimensioned to extend throughelongated actuator tube 46 and includes aproximal end 52 having a reduceddiameter portion 54 configured to operatively engage ultrasonic transducer30 (FIG. 5 ) and adistal end 56 adapted to be operatively connected to cuttingjaw 58. A plurality of silicon rings51 can be molded or otherwise attached to the nodal points alongvibration coupler 50 to seal betweenvibration coupler 50 andactuator tube 46. Preferably, cuttingjaw 58 includes an internal proximal threaded bore (not shown) which is dimensioned to receive threadeddistal end 56 ofvibration coupler 50. Alternately, cuttingjaw 58 can be formed integrally withvibration coupler 50, cuttingjaw 58 may include a threaded proximal end configured to be received within a threaded bore formed invibration coupler 50, or other attachment devices can be used. Aclamp 60 having aclamp body 62 and atissue contact member 64 removably secured to clampbody 62 is operatively connected to the distal end ofactuator tube 46.Clamp body 62 includes a pair of tissue receiving stops71 that define the proximal end of the exposedblade surface 59.Tissue contact member 64 is preferably composed of teflon and is preferably removably fastened to clampbody 62 by a tongue and groove fastening assembly (reference numerals Tissue contact member 64 functions to isolateclamp 60, which is preferably metallic, fromjaw 58 which is also preferably metallic to prevent metal to metal contact.Tissue contact member 50 also functions to grip tissue to prevent movement of the tissue with vibrating cuttingjaw 58. Alternately, at least one row of teeth may be positioned onclamp 60 to grip tissue, such as disclosed in U.S. patent application Ser. No. 08/911,207, which is incorporated herein by reference. Pivot members (pins)66 located at the proximal end ofclamp body 62 are configured to be received withinopenings 68 formed in the distal end ofouter tube 42. Aguide slot 70 formed in the distal end ofactuator tube 46 permits relative movement betweenactuator tube 46 and clampbody 62 by allowingpins 66 to move inguide slot 70. A pair ofcamming members 72 are also formed onclamp body 62 and are positioned to be received withincam slots 74 formed in the distal end ofactuator tube 46. Movement ofactuator tube 46 and clamp60 will be described in detail below.- Cutting
jaw 58 includes acurved blade surface 59 that slopes downwardly and outwardly in the distal direction. Preferably, theentire blade surface 59 exposed to tissue, i.e., the portion ofblade surface 59 between tissue receiving stops71 and the distal end ofblade surface 59, has a tangent which defines an angle with respect to the longitudinal axis ofelongated body portion 24 that varies along the length ofblade surface 59 from about 5 degrees to about 75 degrees. Ideally, the angle defined by a line tangent to the blade surface and the longitudinal axis ofelongated body portion 24 varies from about 5 degrees to about 45 degrees along the length of the blade surface. The curved blade surface provides better visibility at the surgical site.Clamp 60 is movable from an open position in whichtissue contact member 64 is spaced apart from blade surface59 (FIGS. 7 and 8 ) to a clamped position in which tissue contact member is in juxtaposed close alignment with blade surface59 (FIGS. 11-13 ) to clamp tissue therebetween. The interior surface oftissue contact member 64 is curved to correspond toblade surface 59. In.the clamped position, note the positioning oftissue contact member 64 with respect toblade surface 59. Actuation ofclamp 60 from the open position to the clamped position will be described in detail below. - Referring now to
FIGS. 5 and 6 , the handle assembly and the rotation assembly will now be discussed. Housing half-sections 22aand22bdefine achamber 76 configured to receive a portion ofultrasonic transducer 30.Chamber 76 has anopening 78 communicating with the interior ofhousing 22.Ultrasonic transducer 30 includes abore 80 configured to receiveproximal end 54 ofvibration coupler 50. In the assembled condition,proximal end 54 extends through opening78 intobore 80.Ultrasonic transducer 30 may be secured withinhousing 22 tovibration coupler 50 using any known attachment apparatus. Preferably, a torque wrench, such as disclosed in copending U.S. patent application Ser. No. 08/911,207, now U.S. Pat. No. 6,036,667, incorporated herein by reference above, can be used to secureultrasonic transducer 30 tovibration coupler 50. As disclosed therein, the proximal end oftransducer 30 may be configured to engage the torque wrench.Movable handle 36 is pivotally connected between housing half-sections 22aand22baboutpivot pin 82 which extends throughholes 84 formed inlegs 86 ofmovable handle 36. Acam slot 88 formed in eachleg 86 is configured to receive aprotrusion 90 projecting outwardly from coupling member98 (FIG. 6 ). - As illustrated in
FIG. 6 ,coupling member 98 operatively connectsmovable handle 36 toactuator tube 46 and is preferably formed from molded half-sections 98aand98bto define athroughbore 100 dimensioned to slidably receive the proximal end ofvibration coupler 50. Couplingmember 98 has an inner distally locatedannular groove 102 dimensioned to receiveannular flange 48 ofactuator tube 46 and an outer proximally locatedannular groove 104.Groove 104 is positioned to receive anannular rib 106 formed on the internal wall of a swivel member108 (FIG. 5 ).Swivel member 108 is preferably formed from molded half-sections 108aand108band permits rotation of couplingmember 98 relative tomovable handle 36.Protrusions 90 project outwardly from sidewalls ofswivel member 108 and extend throughcam slots 88 of movable handle36 (FIG. 5 ). - Referring to
FIGS. 5 and 6 ,rotation knob 34 is preferably formed from molded half-sections 34aand34band includes aproximal cavity 110 for slidably supportingcoupling member 98 and adistal bore 112 dimensioned to receiveouter tube 42. Anannular groove 114 formed inbore 112 is positioned to receiveannular flange 44 ofouter tube 42. The outer wall ofknob 34 has a proximally locatedannular ring 116 dimensioned to be rotatably received withinannular slot 118 formed in opening120 ofhousing 22. The outer wall ofknob 34 also includes scallopedsurface 122 to facilitate gripping ofrotatable knob 34.Annular ring 116 permits rotation ofknob 34 with respect tohousing 22 while preventing axial movement with respect thereto. A. pair ofcylindrical rods 124 extend between half-sections 34aand34bthrough arectangular opening 126 formed incoupling member 98.Rods 124 engage a pair ofconcave recesses 128 formed in fitting130 which is fastened aboutvibration coupler 50, such that rotation ofknob 34 causes rotation ofvibration coupler 50 and thus rotation ofblade 58 andclamp 60. Alternately, recesses128 can be monolithically formed withvibration coupler 50. FIGS. 7-10 illustrateultrasonic instrument 12 withclamp 60 in the open position. Theelongated body 24 which includesclamp 60 andblade 58, andhousing 22 which includeshandles transducer 30 tohousing 22 toready instrument 12 for use. In the open position,movable handle 36 is spaced rearwardly fromstationary handle portion 28 andprotrusions 90 are positioned in the lower proximal portion ofcam slots 88. At the distal end ofultrasonic instrument 12,pivot members 66 are positioned near the distal end ofguide slots 70 and caromingmembers 72 are positioned in the upper distal portion ofcam slots 74.Tissue contact member 64 ofclamp 60 is spaced fromblade surface 59 to define atissue receiving area 132. The proximal end oftissue receiving area 132 is defined by tissue receiving stops71 which are preferably integrally formed withclamp body 62 and extend belowblade surface 59. Preferably, the distal end ofblade 58 is rounded to prevent inadvertent damage to tissue during use ofinstrument 12 andtissue contact surface 64 is also preferably formed with alongitudinally extending concavity 67 to receive tissue therein. Alternately, the distal end ofblade 58 may be formed in any shape which may be suitable to a particular surgical application, i.e., pointed, flat, etc. Moreover,tissue contact surface 64 need not be formed with a concavity but may be flat, angled, etc.- Referring to
FIGS. 11-15 , whenmovable handle 36 is pivoted clockwise aboutpivot member 82 towardsstationary handle portion 28, in the direction indicated by arrow “A” inFIG. 11 ,cam slot 88 engagesprotrusion 90 ofswivel member 108 to advance couplingmember 98 distally withincavity 110 ofrotation knob 34. Sinceactuator tube 46 is attached to couplingmember 98 by anannular flange 48,actuator tube 46 is also advanced distally in the direction indicated by arrow “B” inFIG. 12 . Movement ofactuator tube 46 distally causescam slots 74 to move into engagement withcamming members 72 to pivotclamp body 62 aboutpivot members 66, in the direction indicated by arrow “C” inFIG. 13 , to moveclamp member 62 andtissue contact member 64 into the clamped position. In the clamped position, protrusions90 are located in a central portion ofcam slots 88,pivot members 66 are located near the proximal end ofguide slots 70, andcamming members 72 are located in the proximal lower portion ofcam slots 74. Elongated body portion 24 can be freely rotated with respect tohousing 22 by rotatingrotation knob 34. As illustrated inFIG. 15 , rotation ofknob 34 in the direction indicated by arrow “D” causes rotation ofjaw assembly 32 in the direction indicated by arrow “E”.Knob 34 is positionedadjacent housing 22 to facilitate one handed operation of bothmovable handle 36 androtation knob 34.- Referring again to
FIG. 1 ,elongated body portion 24 is dimensioned to extend through atrocar assembly 140, and is preferably dimensioned to extend through a 5 mm trocar assembly. During use,elongated body portion 24 is slid throughtrocar assembly 140 withjaw assembly 32 in the clamped or closed position to a position adjacent tissue (not shown) to be dissected and/or coagulated. An optical unit (not shown) can also be positioned adjacent the surgical site to facilitate viewing of the procedure.Jaw assembly 32 is opened and tissue to be dissected and/or coagulated is positioned within tissue receiving area132 (See alsoFIG. 9 ). Tissue receiving stops71 prevent tissue from moving past the proximal end ofblade surface 59. Next,jaw assembly 32 is closed to clamp tissue betweentissue contact member 64 andblade surface 59. Power is supplied toultrasonic instrument 12 viacontrol module 14 to initiate vibration ofblade 58 to effect dissection and/or coagulation of tissue. Because of the curve ofblade surface 59, the force applied byblade surface 59 to the tissue being dissected can be selectively increased or decreased asinstrument 12 is moved forward throughtrocar assembly 140 by adjusting the location of the tissue onblade surface 59 and thus changing the angle of the force applied to the tissue being dissected. FIGS. 16A-16C illustrate an alternate embodiment of the ultrasonic transducer shown generally as230.Ultrasonic transducer 230 includes ahousing 231 having aproximal housing portion 232 and adistal housing portion 234.Proximal housing portion 232 has a scallopedsection 236 adjacent its proximal end.Transducer horn 238 is supported withinhousing 231 bysupport collar 240 andannular ring 242. The distal end oftransducer horn 238 includes a threadedbore 244 dimensioned to engage reduceddiameter portion 54 of vibration coupler50 (FIG. 4 ). As best illustrated inFIG. 16B ,transducer horn 238 is formed withannular flange 246, about whichannular ring 242 is received. The proximal end ofsupport collar 240 also includes anannular flange 248 which, in an assembled condition, is clamped between proximal anddistal housing portions support collar 240 in position withinhousing 231. The distal end ofsupport collar 240 engagesannular ring 242 to retainannular ring 242 and thus horn238 in a longitudinally fixed position withinhousing 231.- Referring to
FIGS. 17A-17B ,torque wrench assembly 250 is configured and dimensioned to engagescalloped section 236 ofultrasonic transducer 230 to facilitate assembly oftransducer assembly 230 with the remaining portion ofultrasonic instrument 12.Torque wrench assembly 250 assures thathorn 238 and vibration coupler50 (FIG. 4 ) are properly connected, i.e., properly torqued. - It will be understood that various modifications may be made to the embodiments herein. For example,
vibration coupler 50 andblade 58 may be monolithically formed or attached using structure other than screw threads. Different actuator assemblies other than the actuator tube having a camming surface can be used to pivot the clamp member to the clamped position. Further, the elongated body portion of the instrument can be dimensioned to extend through other than 5 mm trocar assemblies, e.g., 10 mm, 12 mm, etc. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Claims (1)
1. A system for performing ultrasonic surgical procedures comprising:
an ultrasonic instrument including a housing, an elongated body portion, and a jaw assembly supported adjacent a distal end of the elongated body portion, the housing being configured to removably receive an ultrasonic transducer, and
a trocar assembly including a cannula dimensioned to slidably receive the elongated body portion of the ultrasonic instrument.
Priority Applications (4)
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| US13/048,462US20110166483A1 (en) | 1997-08-14 | 2011-03-15 | Ultrasonic curved blade |
| US13/312,069US20120179182A1 (en) | 1997-08-14 | 2011-12-06 | Ultrasonic curved blade |
| US13/890,404US20130245658A1 (en) | 1997-08-14 | 2013-05-09 | Ultrasonic curved blade |
| US15/355,398US20170065292A1 (en) | 1997-08-14 | 2016-11-18 | Ultrasonic curved blade |
Applications Claiming Priority (8)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/911,205US6024750A (en) | 1997-08-14 | 1997-08-14 | Ultrasonic curved blade |
| US42064099A | 1999-10-20 | 1999-10-20 | |
| US60487700A | 2000-06-28 | 2000-06-28 | |
| US10/241,936US6682544B2 (en) | 1997-08-14 | 2002-09-11 | Ultrasonic curved blade |
| US10/737,414US20040147946A1 (en) | 1997-08-14 | 2003-12-16 | Ultrasonic curved blade |
| US11/305,706US20060122639A1 (en) | 1997-08-14 | 2005-12-16 | Ultrasonic curved blade |
| US12/241,565US20090030440A1 (en) | 1997-08-14 | 2008-09-30 | Ultrasonic curved blade |
| US13/048,462US20110166483A1 (en) | 1997-08-14 | 2011-03-15 | Ultrasonic curved blade |
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| US12/241,565ContinuationUS20090030440A1 (en) | 1997-08-14 | 2008-09-30 | Ultrasonic curved blade |
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| US13/312,069ContinuationUS20120179182A1 (en) | 1997-08-14 | 2011-12-06 | Ultrasonic curved blade |
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| US20110166483A1true US20110166483A1 (en) | 2011-07-07 |
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| US09/948,014Expired - LifetimeUS6468286B2 (en) | 1997-08-14 | 2001-09-06 | Ultrasonic curved blade |
| US10/241,936Expired - LifetimeUS6682544B2 (en) | 1997-08-14 | 2002-09-11 | Ultrasonic curved blade |
| US10/737,414AbandonedUS20040147946A1 (en) | 1997-08-14 | 2003-12-16 | Ultrasonic curved blade |
| US11/305,706AbandonedUS20060122639A1 (en) | 1997-08-14 | 2005-12-16 | Ultrasonic curved blade |
| US12/241,565AbandonedUS20090030440A1 (en) | 1997-08-14 | 2008-09-30 | Ultrasonic curved blade |
| US13/048,462AbandonedUS20110166483A1 (en) | 1997-08-14 | 2011-03-15 | Ultrasonic curved blade |
Family Applications Before (6)
| Application Number | Title | Priority Date | Filing Date |
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| US08/911,205Expired - LifetimeUS6024750A (en) | 1997-08-14 | 1997-08-14 | Ultrasonic curved blade |
| US09/948,014Expired - LifetimeUS6468286B2 (en) | 1997-08-14 | 2001-09-06 | Ultrasonic curved blade |
| US10/241,936Expired - LifetimeUS6682544B2 (en) | 1997-08-14 | 2002-09-11 | Ultrasonic curved blade |
| US10/737,414AbandonedUS20040147946A1 (en) | 1997-08-14 | 2003-12-16 | Ultrasonic curved blade |
| US11/305,706AbandonedUS20060122639A1 (en) | 1997-08-14 | 2005-12-16 | Ultrasonic curved blade |
| US12/241,565AbandonedUS20090030440A1 (en) | 1997-08-14 | 2008-09-30 | Ultrasonic curved blade |
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| US11179176B2 (en) | 2016-07-13 | 2021-11-23 | Olympus Corporation | Grasping treatment instrument and manufacturing method of grasping treatment instrument |
Also Published As
| Publication number | Publication date |
|---|---|
| US6468286B2 (en) | 2002-10-22 |
| US20030009186A1 (en) | 2003-01-09 |
| US6024750A (en) | 2000-02-15 |
| US20060122639A1 (en) | 2006-06-08 |
| US6682544B2 (en) | 2004-01-27 |
| US20020019646A1 (en) | 2002-02-14 |
| US20040147946A1 (en) | 2004-07-29 |
| US20090030440A1 (en) | 2009-01-29 |
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| Date | Code | Title | Description |
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| AS | Assignment | Owner name:TYCO HEALTHCARE GROUP LP, CONNECTICUT Free format text:ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MASTRI, DOMINIC L.;STONE, CORBETT W.;SIGNING DATES FROM 19980130 TO 19980216;REEL/FRAME:025964/0977 | |
| STCB | Information on status: application discontinuation | Free format text:ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION | |
| AS | Assignment | Owner name:UNITED STATES SURGICAL CORPORATION, CONNECTICUT Free format text:CORRECTIVE ASSIGNMENT TO CORRECT THE FIRST ASSIGNOR'S NAME AND THE ASSIGNEE'S NAME AND ADDRESS PREVIOUSLY RECORDED ON REEL 025964 FRAME 0977. ASSIGNOR(S) HEREBY CONFIRMS THE CORRECT INFORMATION IS DOMINICK AND UNITED STATES SURGICAL CORPORATION, 150 GLOVER AVENUE, NORWALK, CT 06856;ASSIGNORS:MASTRI, DOMINICK L.;STONE, CORBETT W.;SIGNING DATES FROM 19980130 TO 19980216;REEL/FRAME:027919/0697 Owner name:THE KENDALL COMPANY LP, MASSACHUSETTS Free format text:ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:UNITED STATES SURGICAL CORPORATION;REEL/FRAME:027917/0548 Effective date:19990401 Owner name:TYCO HEALTHCARE GROUP LP, MASSACHUSETTS Free format text:ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:UNITED STATES SURGICAL CORPORATION;REEL/FRAME:027917/0627 Effective date:20100111 Owner name:TYCO HEALTHCARE GROUP LP, MASSACHUSETTS Free format text:CHANGE OF NAME;ASSIGNOR:THE KENDALL COMPANY LP;REEL/FRAME:027921/0587 Effective date:19990408 |