CA2158758A1 - A piezo ultrasonic and electrosurgical handpiece - Google Patents

A piezo ultrasonic and electrosurgical handpiece

Info

Publication number
CA2158758A1
CA2158758A1 CA002158758A CA2158758A CA2158758A1 CA 2158758 A1 CA2158758 A1 CA 2158758A1 CA 002158758 A CA002158758 A CA 002158758A CA 2158758 A CA2158758 A CA 2158758A CA 2158758 A1 CA2158758 A1 CA 2158758A1
Authority
CA
Canada
Prior art keywords
stack
housing
piezo
ultrasonic
retainer
Prior art date
Legal status (The legal status 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 status listed.)
Abandoned
Application number
CA002158758A
Other languages
French (fr)
Inventor
Michael A. Beaty
Arlan J. Reschke
Jon P. Page
Bandele Jeffrey-Coker
Michael D. Olichney
Robert B. Stoddard
Emery S. Rose
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Valleylab Inc
Original Assignee
Individual
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
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=21932343&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=CA2158758(A1) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by Individual filed Critical Individual
Publication of CA2158758A1 publication Critical patent/CA2158758A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system

Abstract

An ultrasonic and electro-surgical handpiece (10) housing (11) has an axis, a distal end (12), a proximal end (13) and a passage (14) defined by an inside wall (40). A piezo stack (26) has elements (16) carried along a plane (17) generally transverse to the axis. A retainer (18) for the elements (16) has dis-tal, intermediate and proximal portions (21). The distal por-tion (19) has a fastener (22);
the proximal portion (21) has a threaded shoulder bolt (24). The stack (26) about the shoulder has an energy input (29) and a refer-ence output (30) positioned axi ally apart from one another. An insulating sleeve (31) about the bolt is between central openings of the elements (16) and the bolt.
A pair of insulators (32) about the bolt has the stack (26) there-between; one insulator (32) is between the plane (17) and the stack (26) and the other is near the threads. The intermediate portion (20) attaches to the housing (11) at the plane (17) with decoupling and sealing. An irrigation channel (44) conveys fluid. The drive energy input (29), the feedback signal and the reference outputs (30) are insulated by the sleeve (31) and pair from the bolt. A washer (34) against the insulator (32) and about the threads applies axial but not torsion to the insulator (32) when a clamping nut (35) on the threads holds components on the bolt.
The clamping nut (35) is in circuit with electrosurgical energy as the reference return for electrosurgery. A tool (36) fastens to a connector (37) for transmitting axial vibrations in the form of a predefined stroke at a tip (38) thereof.

Description

WO 94/22378 215 8 7 ~ 8 PCT/US94/00594 -A PIEZO ULTRASONIC AND ELECTROSURGICAL HANDPIECE
1. Field of the Invention A piezo ultrasonic and electrosurgical handpiece construction, with insulation between the energy inputs for ultrasonic driving and electrosurgery, permits vibration along its axis and fluid irrigation without shG- ling.
A rep~aceable structure for the umbilical cord has a cGnneclor at each end which con ugate with the handp-ece and the genera~ors.
2. Background of the Disclosure Ultrasonic and electrosurgical handpieces of various configurations to facilitate their usefulness and reliability have been used for a variety of surgical procedures. The combination of an electrosurgical and ull,ason-c handpiece pre-~enls an number of challenges and problems. The most 20 notable difficulty is the isolation of the radio frequency energy from the ultrasonic driving energy.
The handpiece requires a compact design that is facililated by a piezo driver for the ull,ason--c vibration. The use of piezo crystals such as barium titanate or lead lilanate ~;rconale to drive the tool at ultrasonic frequencies is known in an Ultra 25 product sold by Sharplan Laser and is manufactured by Fibrason:cs Inc. That product is merely an ull,asonic tool with air cooling and without electrosurgical high frequency cutting and/or coagulation.
U.S. Patent 4 674 498 has an ele~ l,osurgical system in which a blade is made to vibrate at a frequency surtic;ent to cause cavitation to take place as RF
30 energy is simultaneously applied to electrodes on the blade for effecting cutting or coagulation. U.S. Patent 4,886 060 has an ull,asol1-c knife including high frequency electric coagulation. Cardiac floating isolation for the ultrasonic aspirator enables monopolar coagulation with the handle ll,erefore as a co",p!etely passive conductor.
The insulation circuit of the ull,asonic knife has speciric dil~-ensiol1s to v~,ill.stand RF
35 energy to earth. P~ otectin~ the user with such circuitry ne~ s the prefer. ed double insulation technique for maximum proleclion and double insulation has not been disclosed in the prior patents.

~,~s~ls~ _ U.S. Patent 4 903 696 has a generator that powers the electrodes of electrosurgical implements and at the same time the ultrasonic transducer for imparting vibratory motion to such implements.
U.S. Patent 4 931 047 has a solution to incG,~oraling a RF coagulating and 5 RF cutting capability with a vibrating tip of an ultrasonic aspiration and fragmentation device. Switching is provided for the surgeon to use RF and/or ull-ason;c as desired and without need of changing the surgical instrument. Insulation of the piezo driver from the high frequency e!ectrosurgical energy is not known or in the devices available since the use of high Id slecl,ic alecl,ical insulators in an ultrasonic 10 transducer includes stress and structural problems he(elofore unsolved.

SUMMARY OF THE INVENTION
A piezo ull,ason-c and ale_t,G3urgical han~,riece preferably has a housing being elongaled slong its axis with a distal end, a proximal end and a passage 15 ll,erell,rough. A piezo transducer may have a plurality of ~le..,enls SUppGI led within the housing and mounted along a plane generally lrans~crse to the axis of the housing and the passage therealong.
A retainer for the piezo ele",enls most preferably has a distal portion intermediate portion and a proximal portion. The distal portion may have a fastener 20 positioned near the distal end of the housing. The proxi",al portion most preferably has an extended ",andrel in the form of a shoulder bolt with proximally disposedthreads. The intermediate portion allaches to the housing with provisions for localing the retainer axial with raspect ll,ereto with decoupling tl,erebel~lveen.
A stack of components are the piezo elements and feedback crystal wherein 25 each component most preferably has a cer,l.dll~ located hole and an energy input and a reference output positioned axially spart from one anotl~er. The stack assembles on the shoulder bolt and is pos:liol-ed with the holes thereabout.
An insulating sleeve is most preferably d;sposed about the shoulder and sar,Jwicl ,ed belvloon the central openings of the stack and the shoulder of the bolt.
30 A pair of insulators preferably may be d:sposed about the retainer with the stack pos;lioned bel-r/con the insulators as a sandwich. One of the pair of insulators is between the plane and the stack, and the other insulator is adjacent the threads and against the stack so an ultrasonic drive energy connected in circuit with the energy wo 94/22378 215 8 7 S 8 PCT/US94/00594 _ input of the elements. The feedback signal and reference output in the stack areinsulated by the sleeve and pair from the shoulder bolt.
A washer against the insulator and about the threads is most preferably in position to apply axial but not torsional loads on the insulator and stack 5 ll-ersbeneall,. A clamping nut is most preferably prox;".ally located on the threads to hold the washer axially against the componenls on the shoulder bolt. The clamp nut is most preferably for receiving an ele~l-ical source of elecl-osurgical energy for Ele~l,G3Jrgical cutting or coagu'ating and is isolaled from the piezo circuit. The plane of the retainer is most preferably e.-anged at a node point of the axial reciprocatory 1 0 motion.
A tool may connecl to the fastener with a complimenla. y conneclor and it is held ll-ereto for transmitting axial vib,alions in the form of a predefined stroke therealong to a tip thereof. The tool may include an axis aligned with the axis of the retainer for the stack. The housing passage has an inside wall and the retainer 15 includes sealing provisions with ~especl to the inside wall of the housing. The retainer most preferably has an axial passagevlay ll-erell-rough allowing fluid flow to pass without fluid commun ~li--g with the ele~t-ical conneclions of the stack.
A faslener connects to a hollow tubular tool and has a bore ll-erell-rough located along an axis ll.ereof. The bore most preferably is in fluid communication 20 with an axial passagaway through the retainer. An irrigation charlnel may be provided within the housing and is sGyfegaled from the stack for conveying irrigation fluid at the distal end of the housing. A flue con ugated with the distal end of the housing. The irrigation cha.l-nel is most p(eferably in fluid communication with the flue and may be suppGIled about the distal end of the housing concenl.ic with 25 respect to the tool. I..igalion fluid passes within an annular space around the tool but inside of the flue to l.dna...il fluid to the tool end away from the housing.
A passageway through the retainer connects to a vacuum source to provide suction at the tool end. A juncture belwe~n the tool and the faslener may preferably be in an all~r. .ale embodiment at an angle such that the axis of the passage through 30 the ~elainer and an axis of the tool are at an obtuse angle. A washer between the nut and stack may be adapted to be held against l~r~isling during tightening of the clamping to an axial preload that sl-etches the shoulder bolt so the stack is held under a predetermined compression.

2~15~ -A voltage potential bel~rJeen the feedback signal and the reference output indicates the particular feedback crystal in the handF ece. An adjustable resistance is most preferably located in series with the feedback signal being calibrated to a preset value so that the stack can be used with any source of ultrasonic energy.A
5 tool may be selected to be interchangeable with other tools of dirrerenl lengths and configurations and the operation will be maintained. Specirically, the adjustable ras;;,lance most preferably is capable of calibrating dirrerenl tools so the stack and source of energy acco"""odates the tools. The stroke at the tip of the tool is most preferably uniform.
A stack acting as a capacitor and bleed res;slors are most preferably connecled in parallel across and in circuit with the energy input of the elements, feedback signal and fefefence output, respectively, to provide elecl-ical discharge.
Controls may be on an outside surface of the housing for controlling ele~t-osurgical energy, ull.ason-c drive energy, and irrigation. A flat ribbon of wires 15 most preferably connects the energy input of the elements, feedback signal and reference output. These are sur~l sd to the handpiece by an insulated three wireribbon cable with the feference output amid the energy input and feedback output.
The insulated three wire ribbon cables may have a strain relief where it is connecled to a connector block. A removable allach,nent to an ull.ason-c gene-dlor 20 and the wires terminate at the conneclor block. A first slotted keeper preferably retains a serpentine length of ribbon cable and a second keeper retains the first keeper. The conneclor block to terminate the wires is in circuit with the controls.
The ul~.asonie drive energy and the reference output and feedback signal connect to an ull-ason,c generdlor and an e'ect-osurgical generator by a cable from the 25 connector block to the electrosurgical gene, alor when the connec~or block is plugged into a receiving terminal on the ull-ason c generalor.
A --anir~'d inlerconnecls with the proximal end and a floating fitting disposedll ,ereb~lween preferably per"~ils movement of the fitting to center and seal fluid flow to the irrigation channel.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a perspe~ /e view of a piezo ull,ason;c and ~le~,l,Gsurgical handpiece shown with its umbilical cord sepa~ated as in an exploded view.

-Figure 2 is a perapeclive view similar to Figure 1 but the separated umbilical cord is shown with the switch control in position for attachment to the housing of the piezo ull-asonic and electrosurgical handpiece.
Figure 3 is a side view in cross section as would be seen if taken along line 3-3 of Figure 2 and if the exploded umbilical cord and switch thereof were full assembled to the piezo ull,asonic and electrosurgical handpiece.
Figure 4 is an enlarged partial view of the tool end of the piezo ultrasonic andele_l,Gsurgical l,andp ece shown in cross section and provided to illustrate themounting of an angled tool.
Figure 5 is a perspecl;~e view similar to Figure 2 but showing only the umbilical cord for the piezo ull~asoni~ and elecl-osurgical handpiece and the conneclions to the electrosurgical and ultrasonic generdlors.
Figure 6 is a pe.specli~e view shown exploded of the strain relief used to hold the flat ribbon cable.
Figure 7 is a schematic circuit diagra,-, showing the relationship of the components in the piezo drive circuitry of the handpiece.

DETAILED DESCRIPTION OF THE INVENTION

A piezo ulllbsonic and electrosurgical handpiece 10 is illustrated in perspecli~e in Figures 1 snd 2. The handp ece 10 has a housing 11 made of an insulating plastic into an elongaled hollow shell. The longer dimension of the housing 11 aligns along its axis ~A~ with a distal end 12 and a prox;.l~al end 13. A piezo transducer 15 formed of crystals includes a plurality 16 of elements SUppGI led within the housing 1 1 and carried in a plane 17 generally transverse to the axis "A" of the housing 11 and the passage 14 therealong.
A fetai"er 18 in Figure 3, a cross section along lines 3-3 in Figure 2, for the piezo crystal ele.-,enla 16 has a distal portion 19, inler",ed;ale portion 20 and a proximal portion 21. The distal portion 19 may have a faslener 22 (not speci~ically shown but typically fine threads) positioned near the distal end 12 of the housing 1 1 .
The proximal portion 21 has an e,clended mandrel 23 in the form of a shoulder bolt 24 with proximally disposed threads ~not shown to avoid cluttering the Figure with unnecessary detail). The intermediate portion 20 alldches to the housing 11 at the 2~S~

plane 17 with provisions for locating the retainer 18 axial with respect thereto with decoupling therebetween. In particular and as shown in Figure 3 a view of the side in cross section resilient rings 25 between the housing 11 and the retainer 18 allow relative movement between them so the distal portion 19 can vibrate axially without 5 i"lerrerence from the housing 11 this is decoupling.
The piezo transducer 15 has a stack 26 of componenls which are the piezo ele."enls 16 and a feedback crystal 27; wl,erein each co",ponent most preferablyhas a centrally localed hole 28 and an energy input 29 and a reference output 30electrically connecled and posilioned axially apart from one another. The stack 26 10 assembles on the shoulder bolt 24 and is positioned with the holes 28 of each element 16 about the shoulder bolt 24.
An insulating sleeve 31 is d;sposed about the shoulder bolt 24 to prevent energy in the stack 26 from grounding in the bolt 24. The sleeve 31 is sandwiched between the central holes 28 of the stack 26 and the shoulder of the bolt 24. A pair 15 of insulators 32 d;sposed about the retainer 18 have the stack 26 positioned therebetween to further insulate the driving ele_t,ical energy for ull-ason-c vibration.
One of the pair of insulators 32 is located between the plane 17 and the stack 26 and the other insulator 32 is positioned adjacent the threads and against the stack 26 so the source of ull,ason;c drive energy in the form of a wire 33 connects in a 20 circuit to provide the energy input for stimulating the elements 16 see Figures 3 and 7. The feedback crystal 27 offers a signal picked up by anoll,er wire shown also in Figures 3 and 7. The reference output 30 from the stack 26 is a still further wire and all the wires, Gle."enls 16 and the feedback crystal 27 are insulated by thesleeve 31 and the pair 32 from the shoulder bolt 24. In Figure 3 the routing of the 25 wires and the positioning of the elements 16 and feedback crystal 27 are shown relative the shoulder bolt 24 and the housing 11.
A washer 34 against the insulator 32 and about the threads is in position to apply axial but not torsional loads on the insulator 32 and stack 26 therebeneath.
A clamping nut 35 is prox;",ally localed on the ll,reads to hold the washer 34 axially 30 and tightly against the componeols on the shoulder bolt 24. Washer 34 between the clamping nut 35 and insulator 32 is adapted to be held against twisting during ligl)leo ~9 of the cla,np-ng nut 35 to an axial preload that sl,elches the shoulder bolt 24 so the stack 26 is held under a predeter",ined compression.

W0941~78 21 5 8 ~ 5 ~ PCT~S94/00594 UlL,asonic energy vibrations resulting from driving the elements 16 with is provided to the distal portion 19 and through the faslaner 22 in the form of axial strokes for having excursions of about 330 ",i..rG",eters and at a frequency of 23,000 hertz or 178 ",icrG",eters at 36,000 hertz at the patient contacting end of 5 the ull,ason:c electrosurgical handpiece 10. For electrosurgery the clamping nut 35 receives a source of elecl,osurgical energy at up to 500,000 hertz so that cutting or coagulating can be perrGr",ed with the l-and -ece 10. Electrical conneclions to the stack drive piezo elements 16 are independer,l of the ele~l,Gsurgical energy since there is insulation 31 and 32 bel~//ccn the bolt 24 and the stack 26. Current flow 10 through the piezo ele "enls 16 and signals from the feedback crystal 27 causeco"l,~llad axial reciproc~ motion to be transmitted to the distal end 12 of the retainer 18 for conveyance to the raslener 22 ll-ereal. The plane 17 of the retainer 18 iS most preferably arranged at a node point of the axial reciprocat~"~ motion so that the driving force of the stack 26 is not diminished.
A tool 36 as shown in Figures 1 2,3 and 4 connect to the raslener 22 with a complimentary connector 37 and it is held lherelo for l,dns",illing axial vibrations in the form of a prederined stroke therealong to a tip 38 ll,ereof. The prefer,ed ~aslener 22 and connector 37 are fine threads which are not specifically shown in Figures 3 Or 4. The tool 36 includes an axis that may be aligned with the axis "A"
of the retainer 18 as is CGIllllloll or at an angle to the axis "A" as is shown in the Figures 3 and 4. Angling the tool 36 allows it to reach difficult areas for ull,ason-c and/or elecl,osurgery. The handpiece 10 and tool 36 are capahle of either ele~l,G3urgery ull,ason:c surgery or a corr~ alion of both and sv~ hes 39 are provided for that purpose.
The housing passage 14 has an inside wail 40 and the retainer 18 includes sealing provisions 41 with respect to the inside wall 40 of the housing, as shown in Figures 3 and 4. The retainer 18 most preferably has an axial passageway 42 ll,erell,rough allowing fluid flow to pass without any fluid communicating with the elecl,ical conneclions of the stack 26.
The tool 36 iS hollow and tubular with a bore 43 ll-erell-rough located along an axis "B" tl-ereof so the bore 43 can be in fluid communication with the axialpassage 42 through the retainer 18. An i-,i~alion channel 44 provided within thehousing 1 1 is segregated from the stack 26 for conveying irrigation fluid to the distal ~,~5~

end 12 of the housing 11. A flue 45 conjugates with the distal end 12 of the housing 11 so the irrigation channel 44 is in fluid communication with the flue 45 which is supported about the distal end 12 of the housing 11 concenl- ic with respect to the tool 36. Irrigation fluid thus passes within an annular space 46 around the 5 tool 36 but inside of the flue 45 to transmit fluid away from the housing 11 to the tool tip 38. The fluid is typically saline used to cool and remove debris from the surgical site.
A port 47 in Figures 2, 3 and 5 through the retainer 18 connects to a vacuum source (not shown) to provide suction at the tool tip 38 and the suction draws the 10 coolanl and debris up through the bore 43 and port 47 cooling the piezo transducer 15 thereabout in the stack 26 of elements 16. The angled juncture between the tool 36 and about the faslsner 22 is at an obtuse angle so the flow of coolanl and debris is free to pass ll.efell,rough.
A voltage potenlial belwoon the feedback signal and the ~efe-ence output 15 indicates the cha.a~ rislics of the stack 26 including the feedback crystal 27 in the handpiece 10. An adjustab'e resistance is located in series with the feedback signal and may be c~' braled to a preset value so that the stack 26 can be used with any source of ull-ason c energy. Any tool 36 selected and desig,.ed to be inlerchangeably used with other tools of dir~ere,-l lenyll.s and configurations can be 20 attached to the piezo ull.ason-~ and elecltosurgical handp ece 10. Specifically, the adjustable res;s~ance is adequate to c~'~brale for dirre(en~ tools so the stack 26 and source of energy may acco"-,--odate all the such in~erchangeable tools. The stroke at the tip 38 of the tool 36 is uniform, nol~;ll.slanding a .lirrerent tool 36.
In Figure 7 the stack 26 acts as a capacitor and bleed res;slo(s are shown 25 connec~ed in parallel across and in circuit with the energy input of the elements, feedback signal and reference output, respecli~ely, prevent accidental electrical discha(ge. Controls, in for exd--,ple the form of switches 39, may be on an outside surface 48 of the housing 11 for "-anag;ng the electrosurgical energy, the ull.asonic drive energy, and/or the irrigation. A flat ribbon of wires 49 connecls the switches 30 39 and anotl-er ribbon of wires 49 conne.:t the energy input of the elernents, feedback signal and reference output. In particular, these are supp' ed to the handpiece 10 by two separate insulated three wire ribbon cables 49 best shown inFigure 6. In one flat ribbon cable 49 the feference output is positioned amid the WO 94/22378 21 ~ 8 7 ~ ~ PCTIUS94/00594 energy input and feedback output so that the capacitive coupling of the energy input and feedback output are minimized.
The insulated three wire ribbon cable 49 has a strain relief 50 in Figures 5 and6 where it is connecled to a connector block 51. A removable attachment receiving 5 terminal 52 to an ultrasonic generator 53 has the wires of the ribbon cable 49ten"inaling at the connector block 51. A first slotted keeper 54 in Figure 6 retains a ser~eriline length 55 of ribbon cable 49 when slid lalerall-/ over the se-,uer,line length 55 and a second keeper 56 retains the first keeper 55. Specifically the first and second keepers 55 and 56 conjLgate with each other and conneclor block 51.
10 The conneclor block 51 to terminate the wires is in circuit with the control s.//ilches 39. The ull,ason:c drive energy and the reference output and feedback signal connecttothe ul~.ason-c generator 53 and an sle~t-osurgical generalor 57 by a cable 58 from the connector block 51 to the standard foolsvJicll, jack on electrosurgical ger,eralor 57 when the connector block 51 is plugged into the receiv;ng ter",inal 52 15 on the ull-ason~c generdlor 53.
As shown in Figures 1,2 and 5 a manir~l~ 59 inlerconnects into the prox;,..al end 13 and a rloaling fitting 60 d:sposad thereb~l~aen. The floating fitting 60 per---ils lateral movement of the fitting 60 to center and seal fluid flow to the irrigation channel 44 as best seen in Figure 3. In Figure 5 a single wire 61 is shown 20 connected to the elect~Gsurgical generator 57 to provide radio frequency energy to the hand~ ece 10 for El~_l-osurgery at the tip 38.

Claims (26)

What is claimed is:
1. A piezo ultrasonic and electrosurgical handpiece 10 comprising:
a housing 11 being elongated along its axis and having a distal end 12 and a proximal end 13 and a passage 14 therethrough;
a piezo transducer 15 having a plurality of elements 16 supported within the housing 11 and mounted along a plane 17 generally transverse to the axis of the housing 11 and the passage 14 therealong;
a retainer 18 for the piezo elements 16, the retainer 18 having a distal portion 19, intermediate portion 20 and a proximal portion 21, the distal portion 19 having fastener 22 positioned near the distal end 12 of the housing 11, the proximal portion 21 having an extended mandrel 23 in the form of a shoulder bolt 24 with proximally disposed threads, the intermediate portion 20 attached to the housing 11 with provisions for locating the retainer 18 axial with respect thereto with decoupling therebetween;
the piezo elements 16 and a feedback crystal 27 arranged in a stack of components, each component having a centrally located hole 28 and an energy input 29 and a reference output 30 positioned axially apart from one another, the stack 26 assembled on the shoulder bolt 24 and positioned with the holes 28 thereabout;
an insulating sleeve 31 disposed about the shoulder and sandwiched between the central openings of the stack 26 and the shoulder of the bolt;
a pair of insulators 32 disposed about the retainer 18 with the stack 26 positioned between the insulators 32 as a sandwich, one of the pair of insulators 32 between the plane 17 and the stack 26 and the other insulator 32 adjacent thethreads and against the stack 26 so an ultrasonic drive energy connected in circuit with the energy input 29 of the elements 16, feedback signal and reference output 30 in the stack 26 are insulated by the sleeve 31 and pair from the shoulder bolt 24;
a washer 34 located against the insulator 32 and about the threads in position to apply axial but not torsional loads on the insulator 32 and stack 26therebeneath;
a clamping nut 35 proximally located on the threads to hold the washer 34 axially against the components on the shoulder bolt 24, the clamping nut 35 including means for receiving an electrical source of electrosurgical energy, and electric connections to the stack 26 the electrical connections 26 for driving piezo elements for driving piezo elements 16 for receiving current flow through the piezo elements 16 and for transmitting signals from the feedback crystal 27 to cause controlled axial reciprocatory motion to be transmitted to the distal end 12 of the retainer 18 for conveyance to the fastener 22 thereat and the plane 17 of the retainer 18 arranged at a node point of the axial reciprocatory motion.
2. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein a tool 36 is connected to the fastener 22 with complimentary connector 37 and is held thereto for transmitting axial vibrations in the form of a predefined stroke therealong to a tip 38 thereof.
3. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein the tool 36 has an axis which is aligned with the axis of the retainer 18 for the stack 26.
4. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein the housing 11 passage 14 has an inside wall 40 and the retainer 18 includes sealing provisions 41 with respect to the inside wall 40 of the housing 11 the retainer 18 has an axial passageway 42 therethrough allowing fluid flow to pass without fluid communicating with the electrical connections or the stack 26.
5. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein the fastener 22 connects to a hollow tubular tool 36 and having a 43 therethrough located along an axis thereof the 43 in fluid communication with anaxial passageway 42 through the retainer 18.
6. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 5 wherein an irrigation channel 44 is provided within the housing 11 and is segregated from the stack 26 for conveying irrigation fluid at the distal end 12 of the housing 11.
7. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 6 wherein a flue 45 conjugates with the distal end 12 of the housing 11 with the irrigation channel 44 in fluid communication with the flue 45 which is supportedabout the distal end 12 of the housing 11 concentric with respect to the tool 36 for permitting irrigation fluid to pass within an annular space 46 around the tool 36 but inside of the flue 45 to transmit fluid to the tool tip 38 away from the housing 11.
8. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 7 wherein the passageway 42 through the retainer 18 is connected to a vacuum source to provide suction at the tool tip 38.
9. The piezo ultrasonic and electrosurgical handpiece 10 1 wherein the juncture between the tool 36 and the fastener 22 is at an angle such that the axis of the passage 14 through the retainer 18 and an axis of the tool 36 are at an obtuse angle.
10. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein washer 34 is adapted to be held against comprising during tightening of the clamping nut 35 to an axial preload that stretches the shoulder bolt 24 so the stack 26 is held under a predetermined compression.
11. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 2 wherein a voltage potential between the feedback signal and the reference output30 is indicative of the particular feedback crystal 27 in the handpiece 10 and an adjustable resistance located in series with the feedback signal may be calibrated to a preset value so that the stack 26 can be used with any source of ultrasonic energy.
12. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 11 wherein the tool 36 selected is interchangeable with other tools of different lengths and configurations and the adjustable resistance is capable of calibrating for those different tools so the stack 26 and source of energy accommodate the tools and the stroke at the tip 38 of the tool 36 is uniform.
13. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 2 wherein the stack 26 acts as a capacitor and bleed resistors are connected in parallel across and in circuit with the energy input 29 of the elements 16, feedback signal and reference output 30 respectively to provide electrical discharge.
14. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 2 wherein controls are provided on an outside surface 48 of the housing 11 for containing electrosurgical energy ultrasonic drive energy, and irrigation.
15. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 14 wherein the energy input 29 of the elements 16, feedback signal and reference output 30 are supplied to the handpiece 10 by an insulated three wire 33 ribbon cable 58 with reference output 30 amid the energy input 29 and feedback output 30.
16. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 15 wherein the insulated three wire 33 ribbon cable 58 has a strain relief 50 for where it is connected to a connector block 51 for removable attachment 52 to an ultrasonic generator 53 and the wires 49 terminate at the connector block 51 a first slotted keeper 54 for retaining a serpentine length 55 of ribbon cable 58 and a second keeper 56 for retaining the first keeper 54.
17. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 16 wherein the connector block 51 to terminate the wires 49 in circuit with the controls, with the ultrasonic drive energy, with the reference output 30 and feedback signal is connected to an ultrasonic generator 53 and an electrosurgical generator 57 by a cable from the connector block 51 to the electrosurgical generator 57 when the connector block 51 is plugged into a receiving terminal on the ultrasonic generator 53.
18. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 1 wherein a manifold 59 interconnects with the proximal end 13 and a floating fitting 60 disposed therebetween permits movement of the fitting to center and seal fluid flow to the irrigation channel 44.
19. A piezo ultrasonic and electrosurgical handpiece 10 comprising:
a housing 11 being elongated along its axis and having a distal end 12 and a proximal end 13 and a passage 14 therethrough, the housing 11 passage 14 has an inside wall 40;
a piezo transducer 15 having a plurality of elements 16 supported within the housing 11 and mounted along a plane 17 generally transverse to the axis of the housing 11 and the passage 14 therealong;
a retainer 18 for the piezo elements 16, the retainer 18 having a distal portion 19, intermediate portion 20 and a proximal portion 21 the distal portion 19 having fastener 22 positioned near the distal end 12 of the housing 11, the proximal portion 21 having an extended mandrel 23 in the form of a shoulder bolt 24 with proximally disposed threads, the intermediate portion 20 attached to the housing 11 with provisions for locating the retainer 18 axial with respect thereto with decoupling therebetween, the retainer 18 includes sealing provisions 41 with respect to theinside wall 40 of the housing 11;

an irrigation channel 44 within the housing 11 and segregated from the stack 26 for conveying irrigation fluid at the distal end 12 of the housing 11;
the peizo elements 16 and a feedback crystal 27 arranged in a stack 26 of components each component having a centrally located hole 28 and an energyinput 29 and a reference output 30 positioned axially apart from one another thestack 26 assembled on the shoulder bolt 24 and positioned with the holes 28 thereabout;
an insulating sleeve 31 disposed about the shoulder and sandwiched between the central openings of the stack 26 and the shoulder of the bolt;
a pair of insulators 32 disposed about the retainer 18 with the stack 26 positioned between the insulators 32 as a sandwich, one of the pair of insulators 32 between the plane 17 and the stack 26 and the other insulator 32 adjacent thethreads and against the stack 26 so an ultrasonic drive energy connected in circuit with the energy input 29 of the elements 16, feedback signal and reference output 30 in the stack 26 are insulated by the sleeve 31 and pair from the shoulder bolt 24;
a washer 34 located against the insulator 32 and about the threads in position to apply axial but not torsional loads on the insulator 32 and stack 26therebeneath;
a clamping nut 35 proximally located on the threads to hold the washer 34 axially against the components on the shoulder bolt 24 the clamping nut 35 including means for receiving an electrical source of electrosurgical energy, and electric connections to the stack 26 the electrical connections 26 including means for driving piezo elements, for receiving current flow through the piezo elements 16 and for transmitting signals from the feedback crystal 27 to cause controlled axial reciprocatory motion to be transmitted to the distal end 12 of the retainer 18 for conveyance to the fastener 22 thereat and the plane 17 of the retainer 18 arranged at a node point of the axial reciprocatory motion and a tool 36 is connected to the fastener 22 with complimentary connector 37 and is held thereto for transmitting axial vibrations in the form of a predefined stroke therealong to a tip 38 thereof the fastener 22 connected to a hollow tubular tool 36 and having a therethrough located along an axis thereof the 43 in fluid communication with anaxial passageway 42 through the retainer 18 having a passageway 42 therethrough allowing fluid flow to pass without fluid communicating with the electrical connections or the stack 26.
20. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 19 wherein a flue 45 conjugates with the distal end 12 of the housing 11 with the irrigation channel 44 in fluid communication with the flue 45 which is supportedabout the distal end 12 of the housing 11 concentric with respect to the tool 36 for permitting irrigation fluid to pass within an annular space 46 around the tool 36 but inside of the flue 45 to transmit fluid to the tool tip 38 away from the housing 11.
21. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 20 wherein the passageway 42 through the retainer 18 is connected to a vacuum source to provide suction at the tool tip 38.
22. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 19 wherein the juncture between the tool 36 and the fastener 22 is at an angle suchthat the axis of the passage 14 through the retainer 18 and an axis of the tool 36 are at an obtuse angle.
23. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 19 wherein a voltage potential between the feedback signal and the reference output30 is indicative of the particular feedback crystal 27 in the handpiece 10 and an adjustable resistance located in series with the feedback signal may be calibrated to a preset valve so that the stack 26 can be used with any source of ultrasonic energy.
24. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 23 wherein the tool 36 selected is interchangeable with other tools of different lengths and configurations and the adjustable resistance is capable of calibrating for those different tools so the stack 26 and source of energy accommodate the tools and the stroke at the tip 38 of the tool 36 is uniform.
25. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 19 wherein controls are provided on an outside surface 48 of the housing 11 for controlling electrosurgical energy, ultrasonic drive energy and irrigation.
26. The piezo ultrasonic and electrosurgical handpiece 10 of Claim 25 wherein the energy input 29 of the elements 16, feedback signal and reference output 30 are supplied to the handpiece 10 by an insulated three wire 33 ribbon cable 58 with reference output 30 amid the energy input 29 and feedback output 30.
CA002158758A 1993-04-07 1994-01-28 A piezo ultrasonic and electrosurgical handpiece Abandoned CA2158758A1 (en)

Applications Claiming Priority (2)

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US08/044,430 US5312329A (en) 1993-04-07 1993-04-07 Piezo ultrasonic and electrosurgical handpiece
US08/044,430 1993-04-07

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EP (1) EP0692950A1 (en)
JP (1) JP2608692B2 (en)
AU (1) AU672284B2 (en)
CA (1) CA2158758A1 (en)
FI (1) FI941573A (en)
NO (1) NO953991L (en)
WO (1) WO1994022378A1 (en)

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EP0692950A1 (en) 1996-01-24
AU6030194A (en) 1994-10-24
AU672284B2 (en) 1996-09-26
JP2608692B2 (en) 1997-05-07
WO1994022378A1 (en) 1994-10-13
US5312329A (en) 1994-05-17
NO953991D0 (en) 1995-10-06
FI941573A (en) 1994-10-08
NO953991L (en) 1995-10-09
FI941573A0 (en) 1994-04-06
JPH08504643A (en) 1996-05-21

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