BR112019009914B1 - SURGICAL INSTRUMENT WITH REMOVABLE END ACTUATOR COMPONENTS - Google Patents

Abstract

A surgical instrument includes an ultrasound waveguide extending through a body assembly. An ultrasound blade connects to the ultrasound waveguide. A surgical instrument clamping arm assembly is capable of moving from an open position for receiving tissue to a closed position for squeezing tissue. The clamp arm assembly includes a clamp body and a clamp pad facing the ultrasonic blade. A surgical instrument clamping arm actuator is capable of moving from a first position to a second position to direct the clamp arm assembly from the open position to the closed position. A modular coupling of the surgical instrument connects to the pad clamp so that at least the keyboard clamp can be disconnected with respect to the ultrasonic blade for replacement thereof.

Description

PRIORITY

[0001] This application claims priority over: (1) US provisional patent application serial number 62/422,698, filed on November 16, 2016, entitled "Ultrasonic Surgical Shears with Contained Compound Lever Clamp Arm Actuator", whose disclosure is incorporated herein by reference; (2) US Provisional Patent Application Serial No. 62/508,720, filed May 19, 2017, entitled "Ultrasonic and Electrosurgical Instrument with Replaceable End Effector Features", the disclosure of which is incorporated herein by reference; and (3) US Provisional Patent Application Serial No. 62/519,482, filed June 14, 2017, entitled "Ultrasonic and Electrosurgical Instrument with Replaceable End Effector Features", the disclosure of which is incorporated herein by reference.

BACKGROUND OF THE INVENTION

[0002] A variety of surgical instruments include an end actuator that has a blade element that vibrates at ultrasonic frequencies to cut and/or seal tissue (eg, by denaturing proteins in tissue cells). These instruments include piezoelectric elements that convert electrical energy into ultrasonic vibrations which, in turn, are transmitted along an acoustic waveguide to the blade element. The accuracy of cutting and coagulation can be controlled by the surgeon's technique and by adjusting the energy level, blade edge, tissue pull and blade pressure.

[0003] Examples of ultrasonic surgical instruments include the HARMONIC ACE® ultrasonic shears, the HARMONIC WAVE® ultrasonic shears, the HARMONIC FOCUS® ultrasonic shears and the HARMONIC SYNERGY® ultrasonic blades, all produced by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio, USA. Other examples of such devices and related concepts are disclosed in US Patent No. 5,322,055 entitled "Clamp Coagulator/Cutting System for Ultrasonic Surgical Instruments", issued June 21, 1994, the disclosure of which is incorporated herein by reference; in US Patent No. 5,873,873 entitled "Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism", issued February 23, 1999, the disclosure of which is incorporated herein by reference; in US Patent No. 5,980,510, entitled "Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Arm Pivot Mount", filed October 10, 1997, the disclosure of which is incorporated herein by reference; in US Patent No. 6,325,811 entitled "Blades with Functional Balance Asymmetries for use with Ultrasonic Surgical Instruments", issued December 4, 2001, the disclosure of which is incorporated herein by reference; in US Patent No. 6,773,444 entitled "Blades with Functional Balance Asymmetries for Use with Ultrasonic Surgical Instruments", issued August 10, 2004, the disclosure of which is incorporated herein by reference; and US Patent No. 6,783,524 entitled "Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument", issued August 31, 2004, the disclosure of which is incorporated herein by reference.

[0004] Additional examples of ultrasonic surgical instruments are disclosed in US Publication No. 2006/0079874 entitled "Tissue Pad for Use with an Ultrasonic Surgical Instrument", published April 13, 2006, which disclosure is incorporated herein by reference; in US Publication No. 2007/0191713 entitled "Ultrasonic Device for Cutting and Coagulating", published August 16, 2007, the disclosure of which is incorporated herein by reference; in US Publication No. 2007/0282333 entitled "Ultrasonic Waveguide and Blade", published December 6, 2007, the disclosure of which is incorporated herein by reference; in US Publication No. 2008/0200940 entitled "Ultrasonic Device for Cutting and Coagulating", published August 21, 2008, the disclosure of which is incorporated herein by reference; in US Patent No. 8,623,027 entitled "Ergonomic Surgical Instruments", issued January 7, 2014, the disclosure of which is incorporated herein by reference; and in Patent Publication No. US 9,023,071 entitled "Ultrasonic Device for Fingertip Control", issued May 5, 2015, the disclosure of which is incorporated herein by reference; in US Patent No. 8,461,744 entitled "Rotating Transducer Mount for Ultrasonic Surgical Instruments", issued June 11, 2013, the disclosure of which is incorporated herein by reference; in US Patent No. 8,591,536 entitled "Ultrasonic Surgical Instrument Blades", issued November 26, 2013, the disclosure of which is incorporated herein by reference.

[0005] Some ultrasonic surgical instruments may include a wireless transducer such as that disclosed in US Patent No. 9,381,058, entitled "Recharge System for Medical Devices", issued on July 5, 2016, whose disclosure is incorporated herein by way of reference; in US Publication No. 2012/0116265 entitled "Surgical Instrument With Charging Devices", published May 10, 2012, the disclosure of which is incorporated herein by reference; and/or US Patent Application No. 61/410,603, filed November 5, 2010, entitled "Energy-Based Surgical Instruments", the disclosure of which is incorporated herein by reference.

[0006] Additionally, some ultrasonic surgical instruments may include a hinged drive shaft section. Examples of such ultrasonic surgical instruments are disclosed in US Patent No. 9,393,037 entitled "Surgical Instruments with Articulating Shafts", issued July 19, 2016, the disclosure of which is incorporated herein by reference; and US Patent No. 9,095,367, issued August 4, 2015, entitled "Flexible Harmonic Waveguides/Blades for Surgical Instruments", the disclosure of which is incorporated herein by reference.

[0007] Although various instruments and surgical systems have been developed and used, it is believed that no one before the inventors has developed or used the invention described in the embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Although the descriptive report concludes with embodiments that specifically indicate and distinctly claim this technology, it is believed that this technology will be better understood from the following description of certain examples, taken in conjunction with the accompanying drawings, in which numbers like reference marks identify like elements, and in which:

[0009] Figure 1A represents a perspective view of a first exemplary surgical instrument, with an instrument end actuator in an open configuration;

[0010] Figure 1B represents a perspective view of the instrument of Figure 1A, with the end actuator in a closed configuration;

[0011] Figure 2 represents an exploded perspective view of the instrument of Figure 1A;

[0012] Figure 3 represents a perspective view of a first modular assembly of the instrument of Figure 1A;

[0013] Figure 4 represents a perspective view of the first modular assembly of Figure 3, with selected portions purposely omitted for clarity;

[0014] Figure 5 represents a perspective view of a drive shaft assembly and a blade assembly of the first modular assembly of Figure 3;

[0015] Figure 6 represents a side view in cross section of the drive shaft assembly and the blade assembly of Figure 5;

[0016] Figure 7 represents a perspective view of a coupling member of the instrument of Figure 1A;

[0017] Figure 8 represents a perspective view of a second modular assembly of the instrument of Figure 1A;

[0018] Figure 9 represents an exploded perspective view of the second modular assembly of Figure 8;

[0019] Figure 10 shows an exploded perspective view of a clamping arm and a clamping block of the end actuator of Figure 8;

[0020] Figure 11 represents a perspective view of the clamping arm assembly of Figure 10;

[0021] Figure 12 is a cross-sectional side view of the clamping arm assembly of Figure 10, taken along line 12-12 of Figure 11;

[0022] Figure 13A represents a perspective view of the second modular assembly of Figure 8 aligned with the drive shaft assembly of Figure 5 to couple the modular assemblies together;

[0023] Figure 13B represents a perspective view of the second modular assembly of Figure 8 inserted on the drive shaft assembly of Figure 5;

[0024] Figure 13C represents a perspective view of the second modular assembly of Figure 8 coupled to the drive shaft assembly of Figure 5 through the coupling member of Figure 7;

[0025] Figure 14A represents a side view in cross section of the second modular assembly of Figure 8 partially inserted over the drive shaft assembly of Figure 5, taken along line 14-14 of Figure 13B;

[0026] Figure 14B represents a side view in cross section of the second modular assembly of Figure 8 more inserted in the drive shaft assembly of Figure 5, taken along line 14-14 of Figure 13B;

[0027] Figure 14C represents a side view in cross section of the second modular assembly of Figure 8 inserted into the drive shaft assembly of Figure 5 while the coupling member of Figure 7 is rotated towards a configuration to couple the set of drive shaft to the second modular assembly, taken along line 14-14 of Figure 13B;

[0028] Figure 14D represents a side view in cross section of the coupling member of Figure 7 connecting the second modular assembly of Figure 8 and the drive shaft assembly of Figure 5, taken along line 14-14 of Figure 13B ;

[0029] Figure 15A represents a front view in cross section of the second modular assembly of Figure 8 inserted in the drive shaft assembly of Figure 5, taken along line 15A-15A of Figure 14B;

[0030] Figure 15B represents a front view in cross section of the second modular assembly of Figure 8 inserted into the drive shaft assembly of Figure 5 while the coupling member of Figure 7 is rotated towards a configuration to couple the set of drive shaft to the second modular assembly, taken along line 15B-15B of Figure 14C;

[0031] Figure 15C represents a front view in cross section of the coupling member of Figure 7 connecting the second modular assembly of Figure 8 and the drive shaft assembly of Figure 5, taken along line 15C-15C of Figure 14D ;

[0032] Figure 16A represents a side view in cross section of the second modular assembly of Figure 8 coupled to the drive shaft assembly of Figure 5, in which the end actuator is in the open configuration;

[0033] Figure 16B represents a side view in cross section of the second modular assembly of Figure 8 coupled to the drive shaft assembly of Figure 5, in which the end actuator is in the closed configuration;

[0034] Figure 17 represents a perspective view of a second exemplary surgical instrument, with an instrument end actuator in an open configuration;

[0035] Figure 18 represents a partially exploded perspective view of the instrument of Figure 17;

[0036] Figure 19 represents a partial perspective view of the distal end of a clamping arm actuator of the instrument of Figure 17;

[0037] Figure 20 represents a perspective view of a set of drive shaft and ultrasonic blade of the instrument in Figure 17;

[0038] Figure 21 represents a perspective view of a removable clamping arm assembly of the instrument of Figure 17;

[0039] Figure 22 represents an exploded perspective view of the clamping arm assembly of Figure 21;

[0040] Figure 23 depicts a partial perspective view of a proximal end of a clamp arm body of the clamp arm assembly of Figure 22;

[0041] Figure 24 represents an enlarged perspective view of a third exemplary surgical instrument that has a first release coupling modular alignment release coupling associated with an end actuator, in which the end actuator is in an open configuration ;

[0042] Figure 25 represents an enlarged exploded perspective view of the surgical instrument and the modular alignment release coupling of Figure 24;

[0043] Figure 26 represents a perspective view of a gripping arm assembly of the surgical instrument of Figure 24;

[0044] Figure 27 represents an enlarged perspective view of a clamping arm actuator of the surgical instrument of Figure 24;

[0045] Figure 28A depicts the enlarged perspective view of the surgical instrument and modular alignment release coupling in the open configuration similar to Figure 24, but having several components hidden for clarity;

[0046] Figure 28B represents the enlarged perspective view of the surgical instrument and the modular alignment release coupling similar to Figure 28A, but with the surgical instrument in a release configuration;

[0047] Figure 28C represents the enlarged perspective view of the surgical instrument and the modular alignment release coupling similar to Figure 28B, but which has several components hidden for clarity;

[0048] Figure 28D shows the enlarged perspective view of the surgical instrument and the modular alignment release coupling similar to Figure 28C, but having the clamp arm assembly removed from a surgical instrument cable assembly;

[0049] Figure 29 depicts an enlarged perspective view of a fourth exemplary surgical instrument having a second release coupling modular alignment release coupling associated with an end actuator, wherein the end actuator is in an open configuration;

[0050] Figure 30 represents an enlarged exploded perspective view of the surgical instrument and the modular alignment release coupling of Figure 29;

[0051] Figure 31A represents an enlarged side view of the surgical instrument of Figure 29, in the open configuration;

[0052] Figure 31B represents the enlarged side view of the surgical instrument similar to Figure 29, but with the surgical instrument in a closed configuration;

[0053] Figure 32 represents a perspective view of a clamping arm assembly of the instrument of Figure 29;

[0054] Figure 33A represents an enlarged side view of the surgical instrument in Figure 29, in the release configuration;

[0055] Figure 33B depicts the enlarged side view of the surgical instrument similar to Figure 33A, but showing the clamp arm assembly removed from a surgical instrument handle assembly;

[0056] Figure 34 is an enlarged perspective view of a fifth exemplary surgical instrument having a first modular block coupling with a clamping block being removable from a remainder of a clamping arm assembly;

[0057] Figure 35 represents a partially exploded perspective view of the surgical instrument and modular block coupling of Figure 34;

[0058] Figure 36 represents an exploded view of the modular block coupling and clamping arm assembly of Figure 34;

[0059] Figure 37 represents a cross-sectional view of the surgical instrument of Figure 34, taken along section line 37-37 of Figure 34;

[0060] Figure 38 is an enlarged perspective view of a sixth exemplary surgical instrument having a second modular block coupling with a clamping block being removable from a remainder of a clamping arm assembly;

[0061] Figure 39 represents a partially exploded sectional view of the instrument and modular block coupling of Figure 38;

[0062] Figure 40 represents a sectional perspective view of the surgical instrument of Figure 38, taken along a center line thereof;

[0063] Figure 41 is an enlarged perspective view of a seventh exemplary surgical instrument having a third modular block with a clamping block being removable from a remainder of a clamping arm assembly;

[0064] Figure 42 represents a partially exploded perspective view of the surgical instrument and the modular block coupling of Figure 41 as well as a first modular connection tool;

[0065] Figure 43 represents a top view, in partially exploded perspective of the instrument and the modular block coupling of Figure 41;

[0066] Figure 44 is an enlarged perspective view of an exemplary eighth surgical instrument having a first modular pressure coupling;

[0067] Figure 45 depicts an enlarged side view of an exemplary ninth surgical instrument having the modular snap-fit coupling of Figure 44 associated with each of a clamp arm assembly and an electrode assembly;

[0068] Figure 46 represents an enlarged partially exploded view of the surgical instrument with the modular snap-fit couplings of Figure 45;

[0069] Figure 47A represents an enlarged side sectional view of the electrode assembly of Figure 45;

[0070] Figure 47B represents the side sectional view in enlarged cross-section of the electrode array similar to Figure 47A, but showing an inclined projection tab being pressed for removal of the electrode array from a remainder of an end actuator;

[0071] Figure 47C represents the enlarged side sectional view of the electrode assembly similar to Figure 47B, but showing the electrode assembly being removed from the rest of the end actuator;

[0072] Figure 48 represents an enlarged perspective view of the set of electrodes removed from the remainder of the end actuator of the surgical instrument of Figure 45;

[0073] Figure 49A is an enlarged side view of an exemplary tenth surgical instrument clamp arm assembly having a second modular snap-fit coupling;

[0074] Figure 49B represents the enlarged side view of the clamping arm assembly similar to Figure 49A, but showing a pair of angled projection tabs being pressed for removal of the clamping arm assembly;

[0075] Figure 49C is an enlarged side view of the clamp arm assembly similar to Figure 49B, but showing the clamp arm assembly removed from a clamp arm actuator;

[0076] Figure 50A depicts an enlarged perspective view of an exemplary eleventh surgical instrument electrode block assembly having a third modular snap-fit coupling;

[0077] Figure 50B represents the enlarged perspective view of the electrode block assembly similar to Figure 50A, but showing the electrode block assembly removed from the remainder of the end actuator;

[0078] Figure 51 is an enlarged perspective view of an exemplary twelfth surgical instrument having a fourth modular press-fit coupling associated with a clamping arm assembly;

[0079] Figure 52 is a partially exploded perspective view of the clamping arm assembly and modular press-fit coupling of Figure 51;

[0080] Figure 53 is a top view of the clamping arm assembly of Figure 51;

[0081] Figure 54 is an enlarged perspective view of an exemplary thirteenth surgical instrument having a fifth modular press-fit coupling associated with a clamping arm assembly;

[0082] Figure 55A is an enlarged perspective view of the clamping arm assembly and modular press-fit coupling of Figure 54;

[0083] Figure 55B is an enlarged side view of the clamping arm assembly and modular press-fit coupling similar to Figure 54, but showing the clamping arm assembly removed from a clamping arm actuator;

[0084] Figure 56A depicts an enlarged perspective view of an exemplary fourteenth surgical instrument having a sixth modular press-fit coupling associated with a clamping arm assembly;

[0085] Figure 56B depicts the enlarged perspective view of the surgical instrument and modular press-fit coupling similar to Figure 56A, but showing the clamp arm assembly removed from a clamp arm actuator;

[0086] Figure 57 is an enlarged perspective view of an exemplary fifteenth surgical instrument having a seventh modular press-fit coupling associated with a clamping arm assembly;

[0087] Figure 58 represents a perspective view of the clamping arm assembly of Figure 57;

[0088] Figure 59 represents an enlarged perspective view of a clamping arm actuator of the surgical instrument of Figure 57;

[0089] Figure 60A represents an enlarged cross-sectional view of the surgical instrument of Figure 57 taken along section line 60A-60A of Figure 57;

[0090] Figure 60B represents the enlarged cross-sectional view of the surgical instrument similar to Figure 60A, but representing the clamp arm assembly being removed from the clamp arm actuator;

[0091] Figure 61A represents a perspective view of a clamping arm assembly and a clamping arm actuator with an eighth modular snap-fit coupling for movable connection therebetween;

[0092] Figure 61B represents the perspective view of the clamping arm assembly, the clamping arm actuator, and pressure coupling modular similar to Figure 61A, but showing the clamping arm assembly removed from the clamping arm actuator grip;

[0093] Figure 62A represents an enlarged perspective view of a sixteenth exemplary surgical instrument having a modular threaded coupling associated with a set of electrodes;

[0094] Figure 62B represents the enlarged perspective view of the surgical instrument similar to Figure 62A, but having the electrode set removed from a remainder of the surgical instrument;

[0095] Figure 63 is an enlarged perspective view of an exemplary seventeenth surgical instrument having a modular compression coupling associated with a clamping arm assembly;

[0096] Figure 64 represents an enlarged partially exploded perspective view of a clamping arm assembly removed from a radial catch lock of a clamping arm actuator;

[0097] Figure 65A represents an enlarged side sectional view of the surgical instrument of Figure 63 taken along a center line thereof showing a radial capture lock of the modular compression coupling in a locked position and having various components hidden for greater clarity. clarity;

[0098] Figure 65B represents the enlarged side sectional view of the surgical instrument similar to Figure 65A, but showing the radial capture lock of the modular compression coupling in an unlocked position;

[0099] Figure 65C represents the enlarged side sectional view of the surgical instrument similar to Figure 65B, but showing the clamp arm assembly removed from the clamp arm actuator;

[0100] Figure 66A depicts an enlarged perspective view of an exemplary eighteenth surgical instrument having a modular bayonet-type coupling associated with a clamping arm assembly;

[0101] Figure 66B represents the enlarged perspective view of the surgical instrument similar to Figure 66A, but showing the clamp arm assembly being removed from a clamp arm actuator;

[0102] Figure 66C represents the enlarged perspective view of the surgical instrument similar to Figure 66B, but showing the clamp arm assembly removed from the clamp arm actuator;

[0103] Figure 67A depicts an enlarged perspective view of an exemplary nineteenth surgical instrument having a modular luer type coupling associated with a clamping arm assembly;

[0104] Figure 67B represents the enlarged perspective view of the surgical instrument similar to Figure 67A, but showing the clamp arm assembly removed from a clamp arm actuator;

[0105] Figure 68 is an enlarged perspective view of an exemplary twentieth surgical instrument having a modular block insertable coupling associated with a clamp arm assembly having a removable block;

[0106] Figure 69 is an enlarged partially exploded view of the surgical instrument of Figure 68 with the grip block removed from a grip body of the grip arm assembly;

[0107] Figure 70 is an enlarged perspective view of a second modular connection tool containing a replacement grip block of Figure 69;

[0108] Figure 71 represents a top view of the modular connection tool of Figure 70;

[0109] Figure 72 represents an enlarged perspective view of a twenty-first exemplary surgical instrument that has a modular lock coupling and a lock lock associated with a clamping arm assembly;

[0110] Figure 73 represents an enlarged perspective view of the surgical instrument of Figure 72 with a clamping arm actuator and clamping arm assembly in an open configuration and the locking latch in a locked position;

[0111] Figure 74A represents an enlarged perspective view of the surgical instrument of Figure 72 with the clamping arm actuator and clamping arm assembly in the open configuration and the locking latch in an unlocked position;

[0112] Figure 74B represents the enlarged perspective view of the surgical instrument similar to Figure 74A, but showing the clamp arm assembly being removed from the clamp arm actuator;

[0113] Figure 74C represents the enlarged perspective view of the surgical instrument similar to Figure 74B, but showing the clamp arm assembly removed from the clamp arm actuator;

[0114] Figure 75 is an enlarged perspective view of an exemplary twenty-second surgical instrument having a first modular multi-position coupling associated with a clamping arm assembly;

[0115] Figure 76 is an enlarged partially exploded perspective view of the surgical instrument of Figure 75 including a pair of grip blocks on the grip arm assembly and a block cover;

[0116] Figure 77 represents a perspective view of the clamping arm assembly of Figure 75 in the block cover;

[0117] Figure 78A represents an enlarged perspective view of the surgical instrument of Figure 75 with the clamping arm assembly being selectively moved from a locked position to an unlocked position and the block cover being removed;

[0118] Figure 78B represents the enlarged perspective view of the surgical instrument similar to Figure 78A, but showing the clamping arm assembly without the block cover being rotated from a first position of use to a second position of use;

[0119] Figure 78C represents the enlarged perspective view of the surgical instrument similar to Figure 78B, but showing the clamping arm assembly being selectively moved from the unlocked position to the locked position in the second position of use and reconnection of the block cover;

[0120] Figure 79A represents an enlarged perspective view of a twenty-third exemplary surgical instrument that has a second modular multi-position coupling associated with a clamping arm assembly in a closed configuration;

[0121] Figure 79B represents the enlarged perspective view of the surgical instrument similar to Figure 79A, but showing the clamp arm assembly in an open configuration and in a first use position with a lock cover being removed from a locked position ;

[0122] Figure 79C represents the enlarged perspective view of the surgical instrument similar to Figure 79B, but showing the lock cover removed and the clamp arm assembly in an unlocked position;

[0123] Figure 79D represents the enlarged perspective view of the surgical instrument similar to Figure 79C, but showing the clamping arm assembly being rotated from the first position of use to a second position of use;

[0124] Figure 79E represents the enlarged perspective view of the surgical instrument similar to Figure 79D, but showing the lock cover reconnected to the locked position to secure the clamping arm assembly in the second position of use;

[0125] Figure 80 is a bottom view of the clamping arm assembly of Figure 79A;

[0126] Figure 81 is a top view of the clamping arm assembly of Figure 79A;

[0127] Figure 82 represents an enlarged side view of a twenty-fourth exemplary surgical instrument that has a modular internal release coupling associated with a clamping arm assembly;

[0128] Figure 83 represents a partially exploded perspective view of the surgical instrument of Figure 82;

[0129] Figure 84 represents a perspective view of a third modular connection tool configured to connect the clamping arm assembly of Figure 82 from a clamping arm actuator;

[0130] Figure 85 represents a perspective view of the clamping arm assembly of Figure 82;

[0131] Figure 86 is a cross-sectional view of the clamping arm assembly of Figure 85, taken along section line 86-86 of Figure 85;

[0132] Figure 87 represents a cross-sectional view of the clamping arm assembly of Figure 85, taken along section line 87-87 of Figure 85;

[0133] Figure 88 is a perspective view of the surgical instrument of Figure 82 receiving the modular connection tool of Figure 84 to disconnect the clamp arm assembly;

[0134] Figure 89A represents an enlarged cross-sectional view of the clamping arm actuator and clamping arm assembly of Figure 88 taken along section line 89A-89A of Figure 88;

[0135] Figure 89B represents the enlarged cross-sectional view of the clamping arm actuator and clamping arm assembly similar to Figure 89A, but showing the clamping arm assembly being disconnected from the clamping arm actuator and removed from the same;

[0136] Figure 90A depicts an enlarged perspective view of an exemplary twenty-fifth surgical instrument having a modular helical coupling associated with a clamping arm assembly;

[0137] Figure 90B represents the enlarged perspective view of the surgical instrument similar to Figure 90A, but showing the clamp arm assembly being removed from a clamp arm actuator in a closed configuration;

[0138] Figure 91 represents a view of the distal end of the clamping arm actuator of Figure 90B;

[0139] Figure 92 depicts a fourth modular connection tool containing a replacement clamping arm assembly to replace the clamping arm assembly of Figure 90B;

[0140] Figure 93 represents a view of the proximal end of the modular connection tool with the replacement clamp arm assembly of Figure 92;

[0141] Figure 94A represents an enlarged side view of the 90A surgical instrument with the clamping arm actuator in an open configuration to connect the replacement clamping arm assembly to it with the modular connection tool of Figure 92;

[0142] Figure 94B represents the enlarged side view of the surgical instrument and the modular connection tool of Figure 94A, but showing the modular connection tool with the replacement clamping arm assembly on it being rotatably connected to the actuator of the clamping arm;

[0143] Figure 94C represents the enlarged side view of the surgical instrument and the modular connection tool of Figure 94B, but showing the modular connection tool being removed after connecting the replacement clamp arm assembly to the clamp arm actuator ;

[0144] Figure 95 depicts an enlarged perspective view of an exemplary twenty-sixth surgical instrument having a modular body insert coupling associated with a clamping arm assembly;

[0145] Figure 96 is an enlarged partially exploded perspective view of the surgical instrument of Figure 95 showing the clamp arm assembly and a clamp arm actuator;

[0146] Figure 97 represents a view of the distal end of the clamping arm actuator of Figure 96;

[0147] Figure 98 represents a top view of the clamping arm actuator of Figure 96 having an electromechanical connection;

[0148] Figure 99 represents a perspective view of the clamping arm assembly of Figure 96;

[0149] Figure 100 depicts an overmolding process for forming at least a portion of the clamp arm assembly of Figure 95;

[0150] Figure 101 represents a side view of a twenty-seventh surgical instrument that has a flat compression mechanism with an alternative cable assembly and an alternative clamping arm actuator;

[0151] Figure 102 depicts an enlarged, partially exploded perspective view of a gripping arm assembly of the surgical instrument of Figure 101 with a first modular side load coupling;

[0152] Figure 103 depicts an enlarged, partially exploded, sectional perspective view of a gripping arm assembly of the surgical instrument of Figure 101 with a second modular side load coupling;

[0153] Figure 104 depicts an enlarged, partially exploded sectional perspective view of a gripping arm assembly of the surgical instrument of Figure 101 with a third modular side load coupling;

[0154] Figure 105 depicts an enlarged, partially exploded sectional perspective view of a gripping arm assembly of the surgical instrument of Figure 101 with a fourth modular side load coupling;

[0155] Figure 106 depicts an enlarged, partially exploded, sectional perspective view of a gripping arm assembly of the surgical instrument of Figure 101 with a modular transverse load coupling;

[0156] Figure 107 represents a perspective view of a modular connection tool;

[0157] Figure 108 represents a perspective view of another modular connection tool similar to the modular connection tool of Figure 107;

[0158] Figure 109 is a side view of the modular connection tool of Figure 107 being received by an exemplary twenty-ninth surgical instrument that has a clamping arm assembly and an ultrasonic blade;

[0159] Figure 110 is an enlarged side view of the modular connection tool similar to Figure 109, but showing the modular connection tool compressed between the clamping arm assembly and the ultrasonic blade to connect a modular clamping block;

[0160] Figure 111A represents an enlarged sectional view of a clamping body of the clamping arm assembly of Figure 110 receiving the clamping block;

[0161] Figure 111B represents an enlarged sectional view of the clamping body similar to Figure 111A, but showing the modular clamping block connected to the clamping body;

[0162] Figure 112 represents a perspective view of an exemplary cover spacer, in a disengaged position with a surgical instrument;

[0163] Figure 113 represents a perspective view of the cover spacer of Figure 112;

[0164] Figure 114A represents a side elevation view of the cover spacer of Figure 112, in a position engaged with the surgical instrument, in which the surgical instrument includes an end actuator in an open position;

[0165] Figure 114B represents a side elevation view of the cover spacer of Figure 112, in a position engaged with the surgical instrument and the end actuator in an intermediate position;

[0166] Figure 115 represents a perspective view of an exemplary clamping block assembly, similar to the clamping block assembly of Figure 1A, with an exemplary block liner disposed thereon and an exemplary blank block for use with the clamping block;

[0167] Figure 116 is a top plan view of an exemplary top portion of an exemplary way for coupling the blank block to the clamping block assembly of Figure 115;

[0168] Figure 117 represents a top plan view of a bottom portion exemplifying the way for coupling the blank block to the clamping block assembly of Figure 115;

[0169] Figure 118 represents a perspective view of an exemplary form using the top portion of Figure 116 and the bottom portion of Figure 117;

[0170] Figure 119 represents a cross-sectional view taken along line 119-119 of Figure 118;

[0171] Figure 120 represents a perspective view of a twenty-eighth surgical instrument that has a three-point alignment feature;

[0172] Figure 121 represents a partial perspective view of a distal portion of the surgical instrument of Figure 120;

[0173] Figure 122 represents a partial top view of a distal portion of the surgical instrument of Figure 120; It is

[0174] Figure 123 represents a partial perspective view of a distal portion of a handle assembly of the surgical instrument of Figure 120, with some portions removed to reveal the internal features.

[0175] The drawings are not intended to be limiting in any way and it is contemplated that various embodiments of the technology may be performed in a variety of other ways, including those not necessarily represented in the drawings. The drawings incorporated in the annex and forming a part of the specification illustrate various aspects of the present technology and, together with the description, serve to explain the principles of the technology; it is understood, however, that this technology is not limited precisely to the arrangements shown.

DETAILED DESCRIPTION

[0176] The following description of certain examples of the technology should not be used to limit its scope. Other examples, resources, aspects, modalities and advantages of the technology will become evident to those skilled in the art from the following description, which is given by way of illustration, one of the best contemplated ways to execute the technology. As will be understood, the technology described here is capable of other different and obvious aspects, all without disregarding the technology. Consequently, the drawings and descriptions are to be considered as illustrative and not restrictive in nature.

[0177] It is further understood that any one or more of the teachings, expressions, modalities, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. which are described in the present invention. The teachings, expressions, modalities, examples, etc. described below should not be viewed in isolation from one another. Various suitable ways in which the teachings of the present invention may be combined will become readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included within the scope of the embodiments.

[0178] For clarity of disclosure, the terms "proximal" and "distal" are defined herein in relation to a human or robotic operator of the surgical instrument. The term "proximal" refers to the position of an element closest to the human or robotic operator of the surgical instrument and furthest away from the surgical end actuator of the surgical instrument. The term "distal" refers to the position of an element closest to the surgical end actuator of the surgical instrument and furthest away from the human or robotic operator of the surgical instrument. In addition, the terms "top", "bottom", "side", "transverse", "bottom" and "top" are relative terms to provide additional clarity to the figure descriptions provided below. The terms "top", "bottom", "side", "cross", "bottom" and "top" are therefore not intended to unnecessarily limit the invention described herein.

I. Exemplary Ultrasonic Surgical Instrument for Open Surgical Procedures

[0179] Figures 1A to 2 and Figures 13A to 13C illustrate an exemplary first ultrasonic surgical instrument 10. At least part of the instrument 10 can be constructed and operable in accordance with at least some of the teachings of US patent No. 5,322,055 ; US Patent No. 5,873,873; US Patent No. 5,980,510; US Patent No. 6,325,811; US Patent No. 6,773,444; US Patent No. 6,783,524; in US Publication No. 2006/0079874; in US Publication No. 2007/0191713; in US Publication No. 2007/0282333; in US Publication No. 2008/0200940; US Patent No. 8,623,027; US Patent No. 9,023,071; US Patent No. 8,461,744; US Patent No. 9,381,058; in US Publication No. 2012/0116265; US Patent No. 9,393,037; US Patent No. 9,095,367; US Patent Application No. 61/410,603; and/or US Publication No. 2015/0080924. The disclosures of each of the foregoing patents, publications and applications are incorporated herein by reference. Additionally or alternatively, at least part of instrument 10 can be constructed and operable in accordance with at least some of the teachings of US Publication No. 2017/0105755, entitled "Surgical Instrument with Dual Mode End Effector and Compound Lever with Detents", published on April 20, 2017, which disclosure is incorporated herein by reference; and/or US Patent Application No. 62/363,411, entitled "Surgical Instrument with Dual Mode End Effector", filed July 18, 2016, the disclosure of which is incorporated herein by reference.

[0180] As will be described in more detail below, the instrument 10 is operable to cut tissue and seal or weld tissue (e.g., a blood vessel, etc.) substantially simultaneously. It should be understood that the instrument 10 may have several structural and functional similarities to the HARMONIC ACE® Ultrasonic Scissors, the HARMONIC WAVE® Ultrasonic Scissors, the HARMONIC FOCUS® Ultrasonic Scissors and/or the HARMONIC SYNERGY® Ultrasonic Blades. Furthermore, instrument 10 may have various structural and functional similarities to the devices taught in any of the other references cited and incorporated by reference to the present invention.

[0181] The instrument 10 in the present example includes a first modular assembly 100, a second modular assembly 200, and a coupling member 300. As will be described in more detail below, the coupling member 300 can selectively attach the first modular assembly 100 to the second modular assembly 200 to form the instrument 10 with an end actuator 12. As best seen in Figures 1A and 1B, the end actuator 12 comprises an ultrasonic blade 150 and a gripping block 222 from a squeeze 220.

[0182] Additionally, as will be described in more detail below, selected portions of the second modular assembly 200 can act in relation to the first modular assembly 100, when properly attached to each other, in order to actuate the end actuator 12 from a open configuration (Figures 1A and 16A), to a closed configuration (Figures 1B and 16B). The ability to selectively connect and disconnect the second building block 200 to/from the first building block 100 can provide additional reuse benefits of any building block 100, 200. For example, different types of first building blocks 100 can be used with the second set modular 200 to provide different types of surgical instruments. Similarly, different types of second modular sets 200 can be used with the first modular set 100 to provide different types of surgical instruments. Additionally, moving components of the second modular assembly 200 can be housed within the static components of the second modular assembly 200, which can provide additional advantages, some of which are described below while others will be apparent to a person commonly skilled in the art in view of the teachings of the present invention.

[0183] The first modular assembly 100 includes a handle assembly 110, a drive shaft assembly 130 extending distally from the handle assembly 110, and an ultrasonic blade 150 extending distally from the drive shaft assembly drive 130. The handle assembly 110 includes a body 112, a finger grip ring 124, a pair of buttons 126 distal to the finger grip ring 124, and an ultrasonic transducer assembly 30 housed in the body 112.

[0184] The driveshaft assembly 130 includes a proximal outer sheath 132 extending distally from the body 112, a tube 138 extending distally from the proximal outer sheath 132, and a waveguide 140 extending into and through the proximal outer sheath 132 and tube 138. The proximal outer sheath 132 includes a pair of protrusions 136. Additionally, the proximal outer sheath 132 defines a pair of recesses 134. As will be described in more detail below, the recesses 134 are sized to mate with a portion of the distal outer sheath 230 while the protuberances 136 are configured to pivotally couple the proximal outer sheath 132 to the coupling member 300. Both the recesses 134 and the protuberances 136 may assist in coupling the first set modular 100 to coupling member 300.

[0185] The proximal outer sheath 132 can be fixed in relation to the body 112, while the tube 138 can be fixed in relation to the proximal outer sheath 132. As will be described in more detail below, the waveguide 140 can be attached to the assembly transducer 30 and supported by portions of the proximal outer sheath 132 and tube 138. The ultrasonic blade 150 may be unitarily connected to the waveguide 140, and also extend distally from the waveguide 140. As will be described in more detail. below, waveguide 140 is operable to connect to ultrasonic transducer assembly 30 to provide acoustic communication between ultrasonic blade 150 and transducer assembly 30.

[0186] With reference to Figure 4, an ultrasonic transducer assembly 30 is housed inside the body 112 of the cable assembly 110. As seen in Figures 1A and 1B, the transducer assembly 30 is coupled to a generator 5 through a plug 11. The transducer assembly 30 receives electrical energy from the generator 5 and converts this energy into ultrasonic vibrations using piezoelectric principles. Generator 5 can include a power source and a control module that is configured to provide an energy profile to transducer assembly 30 that is particularly suitable for generating ultrasonic vibrations through transducer assembly 30. Generator 5 can also be configured to provide a power profile that allows the tip actuator 12 to deliver RF electrosurgical energy to tissue.

[0187] By way of example only, generator 5 may comprise a GEN 300, sold by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio, USA. Additionally or alternatively, the generator (not shown) can be constructed in accordance with at least some of the teachings of U.S. Patent No. 8,986,302, entitled "Surgical Generator for Ultrasonic and Electrosurgical Devices", issued March 24, 2015, the disclosure of which is incorporated into the present invention by way of reference. It should also be understood that at least some of the functionality of the generator 5 can be integrated into the cable assembly 110, and that the cable assembly 110 can even include a battery or other on-board power source, so that the plug 11 is omitted. Yet other suitable forms that generator 5 can assume, as well as various features and operabilities that generator 5 can provide, will be apparent to those commonly skilled in the art in view of the teachings of the present invention.

[0188] The ultrasonic vibrations that are generated by the transducer assembly 30 are communicated along an acoustic waveguide 140 when properly coupled. Waveguide 140 is mechanically and acoustically coupled to transducer assembly 30. Waveguide 140 extends through drive shaft assembly 130 to reach ultrasonic blade 150. Waveguide 140 can be attached to the proximal outer sheath 132 and/or to the body 112 via a pin 135 that extends through the waveguide 140 and the proximal outer sheath 132. The pin 135 can help ensure that the waveguide 140 remains longitudinally and rotationally fixed relative to the remainder of the driveshaft assembly 130 140 when the waveguide is in a deactivated state (i.e., not ultrasonically vibrating).

[0189] Additionally, the waveguide 140 can be supported by the tube 138 through seals 142 located between an inside of the tube 138 and an outside of the waveguide 140. The seals 142 can also prevent unwanted matter and fluid from entering portions of the tube 138 that houses the waveguide 140. The pins 135 and seals 142 are located at positions along the length of the waveguide 140 that correspond to nodes associated with the resonant ultrasonic vibrations communicated through the waveguide 140. Therefore, the contact between waveguide 140 and pin 135, as well as contact between waveguide 140 and seals 142 may not affect the ultrasonic vibrations communicated through waveguide 154.

[0190] When the ultrasonic blade 150 is in an activated state (i.e., vibrating ultrasonically), the ultrasonic blade 150 is operable to effectively cut through tissue and seal tissue, particularly when tissue is being clamped between the clamping block 222 and the ultrasonic blade 150. It should be understood that the waveguide 140 may be configured to amplify mechanical vibrations transmitted through the waveguide 140. Furthermore, the waveguide 140 may include features that may be operable to control the gain of longitudinal vibrations along the waveguide 140 and/or means for tuning the waveguide 140 to the resonant frequency of the system.

[0191] In the present example, the distal end of the ultrasonic blade 150 is located in a position that corresponds to an antinode associated with resonant ultrasonic vibrations, communicated through the waveguide 140, to tune the acoustic assembly to a preferred resonant frequency fo when the acoustic set is not loaded by tissue. When the transducer assembly 30 is energized, the distal end of the ultrasonic blade 150 is configured to move longitudinally in the range of, for example, approximately 10 to 500 microns peak-to-peak and, in some cases, in the range of about 20 at about 200 microns at a predetermined vibrational frequency of, for example, 55.5 kHz. When the transducer assembly 30 of the present example is activated, these mechanical oscillations are transmitted through the waveguide 140 to reach the ultrasonic blade 150, thereby causing the ultrasonic blade 150 to oscillate at the ultrasonic resonant frequency. Therefore, when tissue is clamped between the ultrasonic blade 150 and the clamping block 222, the ultrasonic oscillation of the ultrasonic blade 150 can simultaneously cut the tissue and denature the proteins in the adjacent tissue cells, thereby providing a relatively low clotting effect. little thermal propagation.

[0192] In some versions, an electric current can also be supplied through the ultrasonic blade 150 and/or the clamping block 222 to also seal the tissue. It should therefore be understood that instrument 10 may also be configured to deliver RF radiofrequency energy to a surgical site via tip actuator 12. By way of example only, an operator may rely primarily on the use of ultrasonic energy from blade 150 to cut the tissue that is captured between the ultrasonic blade 150 and the gripping block 222. The operator can further rely on the use of RF energy from the end actuator 12 to seal the cut tissue. Of course, it will be recognized that the ultrasonic energy from blade 150 can seal tissue to some degree, so the RF energy from tip actuator 12 can supplement the seal that would already be achieved using ultrasonic energy. It should also be understood that there may be cases where the operator may wish to simply use the tip actuator 12 to apply only RF energy to the tissue, without also applying ultrasonic energy to the tissue. As will be understood from the description of the present invention, some versions of the instrument 10 are capable of providing all of the above-mentioned types of functionality. Various ways in which the instrument 10 can be configured and operable to provide electrosurgical modes of operation by ultrasound as well as by radiofrequency are described in various references cited in the present invention; however, other ways in which the instrument 10 can be configured and operable to provide ultrasound and radiofrequency electrosurgical modes of operation will be apparent to those of ordinary skill in the art in view of the teachings of the present invention.

[0193] An operator can activate buttons 126 to selectively activate the transducer assembly 30 to thereby activate the ultrasonic blade 150. In the present example, two buttons 126 are provided. In some versions, a button 126 is provided to activate the ultrasonic blade 150 in a first power profile (for example, a first frequency and/or first amplitude), and another button 126 is provided to activate the ultrasonic blade 150 in a second power profile (eg a second frequency and/or second amplitude). In some other versions, a button 126 is provided to activate the ultrasonic blade 150 with ultrasonic energy, and the other button 126 is provided to activate the end actuator 12 with RF energy. In some other versions, a button 126 is operable to activate the ultrasonic blade 150 with ultrasonic energy, while simultaneously activating the end actuator 12 with RF energy; while the other button 126 is only operable to activate the ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate the ultrasonic blade 150 with ultrasonic energy, then based on one or more other conditions (e.g., time, measured impedance, etc.) while button 126 remains activated , finally activating the end actuator 12 with RF energy and at the same time activating the ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate the ultrasonic blade 150 with ultrasonic energy, then based on one or more other conditions (e.g., time, measured impedance, etc.) while button 126 remains activated , finally activating end actuator 12 with RF energy and at the same time ceasing activation of ultrasonic blade 150 with ultrasonic energy. In some other versions, at least one button 126 is operable to initially activate end actuator 12 with RF energy, then based on one or more other conditions (e.g., time, measured impedance, etc.) while button 126 remains activated, finally activating ultrasonic blade 150 with ultrasonic energy and at the same time ceasing activation of end actuator 12 with RF energy.

[0194] It should be understood that any other suitable number of buttons and/or otherwise selectable energy levels and/or energy modalities may be provided. For example, a footswitch may be provided to selectively activate the transducer assembly 30.

[0195] The buttons 126 of the present example are positioned so that an operator can readily and completely operate the instrument 10 with a single hand. For example, when the first and second modular assemblies 100, 200 are attached, the operator can position his thumb on the thumb grip ring 214, position his ring finger on the finger grip ring 124, position his middle finger over the body 112 and manipulate the buttons 126 using your index finger. Of course, any other suitable techniques can be used to hold and operate the instrument 10; and buttons 126 may be located in any other suitable positions.

[0196] As mentioned above, and as will be described below, the coupling member 300 is configured to selectively couple the first modular assembly 100 to the second modular assembly 200. As best seen in Figure 7, the coupling member 300 comprises a body 302, a pair of resilient arms 304 extending from body 302, and a pair of handles 305 extending from body 302. Each resilient arm 304 defines a respective pivot hole 306 and a locking assembly 308. resilient arms 304 are spaced apart from each other to receive the proximal outer sheath 132 and to press fit the pivot holes 306 with the respective protuberances 136. Therefore, as shown between Figures 13B and 13C and 14B and 14C, the coupling member 300 is configured to pivotally connect the proximal outer sheath 132 through the pivot holes 306 and the protrusions 136. Although in the actual example the coupling member 300 and the proximal outer sheath 132 are pivotally coupled via a press fit, any other type of suitable connection can be used as would be apparent to the person ordinarily skilled in the art in view of the teachings of the present invention. For example, the protrusions 136 can be extensible relative to the proximal outer sheath 132 to pivotally engage the pivot hole 306 of the coupling member 300. The handles 305 can be positioned on the body 302 so that an operator can easily rotate the coupling member 300 relative to outer sheath 132 via handles 305.

[0197] Each locking assembly 308 includes an inner contact wall 310 facing toward each other and a coupling recess 312. As will be described in more detail below, the locking assembly 308 is configured to rotate around the locking hole pivot 306 and protrusions 136 for selectively engaging portions of the second modular assembly 200.

[0198] Although the coupling member 300 in the current example is used to connect the first modular assembly 100 to the second modular assembly 200, it should be understood that the coupling member 300 can be incorporated into any suitable type of modular assembly that would be apparent to a person skilled in the art in view of the teachings of the present invention. For example, the coupling assembly 300 can be modified to couple different modular clamp arm assemblies to the first modular clamp assembly 100 wherein the different modular clamp arm assemblies include clamp arm assemblies such as those taught in U.S. Publication No. 2017 /0105788, entitled "Surgical Instrument with Dual Mode End Effector and Modular Clamp Arm Assembly", published April 20, 2017, which disclosure is incorporated herein by reference. In this way, one modular clamping arm assembly that can be attached to the first modular assembly 100 can provide pivotal movement of one clamping arm on one side of the ultrasonic blade 150 while the other modular clamping arm assembly that can be attached to the first Modular assembly 100 can provide pivotal movement of a clamping arm on the other side of the ultrasonic blade 150. Other suitable clamping arm assemblies that can be used to provide different types of second modular assemblies 200 will be apparent to those of ordinary skill in the art. in view of the teachings of the present invention.

[0199] The second modular assembly 200 includes a clamping arm assembly 210, a clamping block assembly 220, and a distal outer sheath 230. As will be described in more detail below, the distal outer sheath 230 is configured to mate to the coupling member 300 and the proximal outer sheath 132 in order to selectively couple the first modular assembly 100 to the second modular assembly 200. In other words, when properly coupled, the proximal outer sheath 132 and distal outer sheath 230 can be fixed in relation to each other. each other. As will also be described in more detail below, the clamping arm assembly 210 and the clamping block assembly 220 are both pivotally coupled to the distal outer sheath 230. Additionally, the clamping arm assembly 210 and the clamping block assembly grips 220 are sized to interlock with each other such that rotation of one set 210, 220 with respect to distal outer sheath 230 causes rotation of the other set 210, 220 with respect to distal outer sheath 230. In other words , the clamping arm assembly 210 and the clamping block assembly 220 are capable of rotating each other relative to the distal outer sheath 230.

[0200] The distal outer sheath 230 includes a U-shaped body 232 extending from a distal face 235 and terminating in a pair of proximally presented projections 234. Each proximally presented projection 234 includes a lateral protrusion 238 that extends away from the U-shaped body 232. The U-shaped body 232 defines a longitudinal path 236 and a plurality of holes 240. The U-shaped body 232 and longitudinal path 236 are sized to receive tube 138 and to rotatably house a portion of clamp arm assembly 210 and clamp block assembly 220. In particular, as best shown between Figures 13A and 13B, the U-shaped body 232 can be inserted into ultrasonic blade 150 and tube 138 so that tube 138 will rest under clamp arm assembly 210 and clamp block assembly 220. Tube 138 can protect guide from waves 140 such that the clamping arm assembly 210 and clamping block assembly 220 do not contact adjacent portions of the waveguide 140.

[0201] As shown between Figures 13A and 13B and between Figures 14A and 14B, the proximally presented projections 234 are configured to be inserted into the recesses 134 defined by the proximal outer sheath 132. When the proximally presented projections 234 are inserted into the recesses 134 , the distal outer sheath 230 may not rotate with respect to the proximal outer sheath 132 about a longitudinal axis defined by the tube 138. Therefore, the proximally presented projections 234 may correspond with the recesses 134 to pivotally secure the distal outer sheath 230 relative to the proximal outer sheath 132.

[0202] As shown between Figures 13B and 13C, between Figures 14B to 14D, and between Figures 15A to 15C, when the distal outer sheath 230 is pivotally attached to the proximal outer sheath 132, an operator can rotate the limb coupling member 300 so that the locking assembly 308 presses into the side protrusions 238. In particular, an operator can rotate the coupling member 300 about the protrusion 136 so that the protrusions 238 slide against contact walls 310 of the resilient arms 304. As a result, as best seen in Figure 15B, the contact between the contact walls 310 and the side protrusions 238 flexes the resilient arms 304 outwardly away from the proximally displayed projections 234. An operator may additionally rotating coupling member 300 around protrusions 136 so that side protrusions 238 no longer rest against contact wall 310 as shown in Figures 13C, 14C and 15C. The resilient nature of the resilient arms 304 allows the resilient arms 304 to return to a relaxed position so that the side protrusions 238 rest within the coupling recess 312 of the locking assembly 308. With the locking assembly 308 of the coupling member 300 fully Attached, and shown in Figures 13C, 14D, and 15C, the distal outer sheath 230 is fixed longitudinally with respect to the proximal outer sheath 132, thereby coupling the first modular assembly 100 to the second modular assembly 200.

[0203] If an operator wishes to decouple the first modular assembly 100 from the second modular assembly 200, the operator can grasp the handles 305 to rotate the coupling member 300 in the opposite direction around the protrusions 136 to flex the resilient arms 304 and release the lateral protrusions 238 of the coupling recess 312.

[0204] As mentioned above, the clamp arm assembly 210 and clamp block assembly 220 are both pivotally coupled to the distal outer sheath 230 such that rotation of one assembly 210, 220 relative to the distal outer sheath 230 causes the other set 210, 220 to rotate relative to the distal outer sheath 230.

[0205] The clamping arm assembly 210 includes an elongate arm 212, a thumb clamping ring 214, a cam boss 216, and a pivot coupling 218. The thumb clamping ring 214 and the elongating arm 212 provide a scissor grip type configuration in combination with body 112 and finger grip ring 124. Pivot coupling 218 pivotally couples grip arm assembly 210 to distal outer sheath assembly 230 via of pins 202. As will be described in more detail below, the cam protrusion 216 interacts with the clamp block assembly 220 to rotate the clamp block assembly 220 in response to rotation of the clamp arm assembly 210.

[0206] The grip block assembly 220 includes a grip block 222 facing the ultrasonic blade 150, a pair of tissue locks 223 positioned adjacent to the ultrasonic blade 150 and proximal to the grip block 222, an arm 224 defining a cam recess 226 and a spring recess 221, a pivot coupling 228, and a spring bundle 225 housed within spring recess 221. In some versions, the clamp block assembly 220 additionally includes one or more electrodes which is /are operable to apply RF electrosurgical energy to tissue. Various references in the present invention provide examples of how a grip block assembly can incorporate one or more electrodes that is/are operable to apply RF electrosurgical energy to tissue, while other examples of how the grip block assembly 220 can incorporate a or more electrodes that is/are operable to apply RF electrosurgical energy to tissue will be apparent to those of ordinary skill in the art in view of the teachings of the present invention.

[0207] In the current example, the tissue locks 223 align longitudinally with the distal face 235 when the end actuator 12 is in the closed position. The tissue stops 223 and the distal face 235 can cooperate to consistently and simply prevent the tissue from inadvertently reaching a proximal position within the end actuator 12 where the ultrasonic energy from the blade 150 may not properly cut or seal the tissue. By providing such prevention, tissue block 223 can eliminate the operator's need to view the proximal region of end actuator 12 to determine if tissue has reached an undesirably proximal position within end actuator 12.

[0208] The cam protuberance 216 is sized to rotate within the cam recess 226 and also be in contact with the cam recess 226. The cam protuberance 216 and the cam recess 226 are positioned within the distal outer sheath 230 of so that both are located between pivotal couplings 218, 228 while clamping arm assembly 210 and clamping block assembly 220 are pivotally coupled to distal outer sheath 230. Therefore, as shown between Figures 1A and 1B and 16A and 16B, when an operator rotates the elongate arm 212 around the pivot coupling 218 toward the distal outer sheath 230, the cam protuberance 216 rotates away from the distal outer sheath 230 about the coupling pivot 218. the cam protrusion 216 is housed within the cam recess 226, upward movement of the cam protrusion 216 about pivot coupling 218 causes upward movement of cam recess 226 about pivot coupling 228. Upward movement of cam recess 226 around pivot coupling 228 rotates arm 224 so that clamping block 222 pivots toward ultrasonic blade 150. Therefore, closing of elongated arm 212 of clamping arm assembly 210 towards the handle assembly 110 leads to the closure of the clamping block 222 towards the ultrasonic blade 150. It should be understood, therefore, that when the first modular assembly 100 and the second modular assembly 200 are connected, an operator can tighten the thumb grip ring 214 toward body 112 to thereby clamp tissue between grip block assembly 220 and ultrasonic blade 150 to compress tissue against ultrasonic blade 150. When ultrasonic blade 150 is activated during Upon such compression, the clamping block assembly 220 and the ultrasonic blade 150 cooperate to transversely cut and/or seal the compressed tissue.

[0209] As mentioned above, the spring bundle 225 is housed within the spring recess 221. As best seen in Figures 16A to 16B, the spring bundle 225 is sized so that a portion of the spring bundle 225 extends extend out of spring recess 221 to make contact with tube 138 to provide electrical continuity between the one or more RF electrodes of end actuator 12 and the electrical power source. It should be understood that the spring bundle 225 maintains this electrical continuity throughout the entire range of motion of the clamp block assembly 220. It should also be understood that other suitable types of devices may be used to provide electrical continuity between the one or more end actuator RF electrodes 12 and the electrical power source.

[0210] In some versions, one or more resilient members are used to bias the clamp block assembly 220 to the open position shown in Figures 1A and 16A. Of course, any other suitable type of resilient member can be used as will become apparent to those skilled in the art in view of the teachings of the present invention. Alternatively, the clamp block assembly 220 need not necessarily be tilted towards the open position.

[0211] The pivot couplings 218, 228 of the clamping arm assembly 210 and clamping block assembly 220 being located in the longitudinal path 236 of the distal outer sheath 230 can provide certain desirable advantages compared to the clamping arm assembly 210 and the clamping block assembly 220 that pivotally engage an outer portion of the distal outer sheath 230. For example, there may be a reduced likelihood of inadvertently squeezing tissue due to rotation of the clamping arm assembly 210 and the clamping assembly. clamping block 220 with pivotal couplings 218, 228 being housed in U-shaped body 232. In other words, U-shaped body 232 can protect tissue from being inadvertently clamped by rotation of clamping arm assembly 210 and of the clamping block assembly 220 relative to the distal outer sheath 230. Additionally, the width of the second modular assembly 200 can be reduced due to the pivot couplings 218, 228 being housed within the longitudinal path 236 of the distal outer sheath 230. It can also be easier to manufacture the desired components due to the simplified shapes of the clamping arm assembly 210 and clamping block assembly 220. A reduced tolerance stack can also be an advantage for storing pivot couplings 218, 228 within the sheath distal outer 230.

[0212] The aforementioned components and features of instrument 10 are merely illustrative. Instrument 10 can be configured in a variety of other ways, as will become apparent to those skilled in the art in view of the teachings of the present invention. By way of example only, at least part of the instrument 10 may be constructed and/or operable in accordance with at least some of the teachings of any of the following documents, the disclosures of which are all incorporated by reference herein by reference: US patent no. 5,322,055; US Patent No. 5,873,873; US Patent No. 5,980,510; US Patent No. 6,325,811; US Patent No. 6,783,524; in US Publication No. 2006/0079874; in US Publication No. 2007/0191713; in US Publication No. 2007/0282333; in US Publication No. 2008/0200940; US Patent No. 9,023,071; US Patent No. 8,461,744; US Patent No. 9,381,058; in US Publication No. 2012/0116265; US Patent No. 9,393,037; US Patent No. 9,095,367; and/or US Publication No. 2015/0080925, entitled "Alignment Features for Ultrasonic Surgical Instrument", published March 19, 2015, which disclosure is incorporated herein by reference.

II. Second Exemplary Ultrasonic Surgical Instrument for Open Surgical Procedures

[0213] Figures 17 and 18 show a second exemplary ultrasonic surgical instrument 301. Except as described below, the instrument 301 of this example can be constructed and operable exactly as the instrument 10 described above. Certain details of instrument 301 will therefore be omitted from the description below, it being understood that such details have already been provided above in the description of instrument 10.

[0214] The instrument 301 of the present example comprises a cable assembly 311, a clamping arm actuator 320, a drive shaft assembly 330 and a clamping arm assembly 400. The cable assembly 311 of the present example is configured and operable just like cable assembly 110 described above, so details of cable assembly 311 will not be reiterated here.

[0215] The clamp arm actuator 320 is pivotally coupled to the drive shaft assembly 330. In the present example, the clamp arm actuator 320 is not removable from the drive shaft assembly 330. The clamp arm actuator grip 320 of the present example comprises a drive shaft 322. A thumb ring 324 is positioned at the proximal end of drive shaft 322. As best seen in Figures 18 and 19, the pair of projections 326 extend distally from of the drive shaft 322. The projections 326 are laterally spaced from one another and extend parallel to one another. As best seen in Figure 19, the distal end of each projection 326 includes a cam boss 328. The cam bosses 328 are configured to cooperate with the clamp arm assembly 400, in a similar manner to the cam bosses 216 , as will be described below. As also best seen in Figure 19, the projections 326 also define a pair of pin openings 327 which are configured to receive the pin 338. The pin 338 provides a pivotable coupling between the clamp arm actuator 320 and the clamp assembly. drive shaft 330.

[0216] The drive shaft assembly 330 extends distally from the cable assembly 311 and is substantially identical to the drive shaft assembly 130 described above except for the differences described below. An ultrasonic blade 350, which is identical to the ultrasonic blade 150 described above, is positioned at the distal end of the drive shaft assembly 130. As best seen in Figure 20, the drive shaft assembly 330 defines an opening 332 which is configured to receive pin 338 to thereby provide a pivotable coupling between the clamp arm actuator 320 and the drive shaft assembly 330. As also shown in Figure 20, the drive shaft assembly 330 includes an angled locking protrusion 334, which is configured to engage clamp arm assembly 400 as will be described in greater detail below.

[0217] As shown in Figures 21 to 22, the clamp arm assembly 400 of the present example comprises a pair of housings 402, 404 that partially surround a clamp arm body 430, which is pivotally coupled to a stationary body 410. Each wrap includes a distally presented tissue locking edge 408. The stationary body 410 also includes a pair of distally presented tissue locking edges 418. The edges 408, 418 are configured to consistently cooperate and constrain proximal positioning of tissue such as tissue blocks 223 and distal face 235 described above. The housing 404 of the present example also includes a distally projecting shield member 406.

[0218] The stationary body 410 of the present example further includes a pin opening 411 and a proximally projecting latch member 412. The latch member 412 defines a latch opening 414 and 416 of a ramp. The lock member 412 is configured to cooperate with the lock protrusion 334 of the driveshaft assembly 330 to selectively secure the clamping arm assembly 400 to the driveshaft shaft assembly 330. In particular, when the arm assembly clamp 400 is initially supplied separately from the drive shaft assembly 330, an operator can align the clamp arm assembly 400 with the drive shaft assembly 330 along a common axis and then insert the blade 350 and the remaining distal portion of drive shaft assembly 330 on clamping arm assembly 400. Ramp 416 will engage lock protrusion 334, which will provide a cam action that causes lock member 412 to deviate from the longitudinal axis . As the operator continues to insert drive shaft assembly 330 through clamping arm assembly 400, latch protrusion 334 finally reaches latch opening 414, at which point latch member 412 resiliently returns to a state not deflected, straight. At this stage, the lock protrusion 334 is disposed in the lock opening 414 and thereby secures the clamp arm assembly 400 to the drive shaft assembly 330. When the operator wishes to remove the clamp arm assembly 400 from the shaft assembly of drive 330, the operator can simply engage ramp 416 and thereby urge latch member 412 into a deflected state where latch member 412 can release latch protrusion 334; then pull the clamp arm assembly 400 away from the drive shaft assembly 330. Other suitable structures and techniques that may be used to secure the clamp arm assembly 400 to the drive shaft assembly 330, and to remove the clamp arm assembly 400 of the drive shaft assembly 330, will be apparent to those of ordinary skill in the art in view of the teachings of the present invention.

[0219] The clamp arm body 430 of the present example comprises a clamp block 432 and a pair of proximal projections 434. The clamp block 432 is positioned and configured to compress tissue against the ultrasonic blade 350 when the arm assembly clamp 400 is attached to drive shaft assembly 330. Guard member 406 of housing 404 is configured to extend over the outside of the distal end of clamp arm body 430, without covering clamp block 432. shield member 406 thus allows clamping block 432 to contact tissue directly. Each projection 438 comprises a respective proximally presented recess 436 and a pair of pin openings 438. A pin 440 is positioned in the pin openings 411, 438 to thereby pivotally couple the clamp arm body 430 to the stationary body 410. Wraps 402, 404 are fixedly attached to grip arm body 430 such that wraps 402, 404 rotate with grip arm body 430 relative to stationary body 410.

[0220] As shown in Figure 23, the recesses 436 have a generally U-shaped configuration. The recesses 436 are configured to receive the cam protuberances 328 of the actuator of the clamping arm 320. In other words, when the shaft assembly drive 330 is inserted into clamping arm assembly 400 as described above, cam protrusions 328 will enter recesses 436 when latch member 412 reaches the point at which latch member 412 secures clamp arm assembly 400 to the assembly of drive shaft assembly 330. When the operator removes clamp arm assembly 400 from drive shaft assembly 330, cam protrusions 328 can freely exit recesses 436 while clamp arm actuator 320 remains attached to clamp assembly. shaft 330. As best seen in Figure 17, the housings 402, 404 are configured to cover the interfaces between recesses 436 and cam protrusions 328. It should be understood that the relationship between recesses 436 and cam protrusions 328 is substantially identical to the relationship between the cam protrusion 216 and the recess 226 described above. In this way, recesses 436 and cam protrusions 328 provide pivotal coupling between clamping arm body 430 and clamping arm actuator 320.

[0221] As noted above, the clamping arm actuator 320 is pivotally coupled to the drive shaft assembly 330 through pin 338; and the clamp arm body 430 is pivotally coupled to the stationary body 410 through a pin 440; while stationary body 410 is fixedly attached to drive shaft assembly 330. The pivotal interface between recesses 436 and cam projections 328 is longitudinally positioned between the longitudinal positions of pins 338, 440. that the clamp arm actuator 320 and clamp arm body 430 cooperate to provide a composite lever assembly. When an operator rotates the thumb ring 324 toward the handle assembly 311, the compound lever action provides corresponding pivotal motion of the grip block 432 toward the ultrasonic blade 350.

[0222] In the present example, a resilient beam 313 is attached to the clamp arm actuator 320 and slides against the drive shaft assembly 330, so that the resilient beam 313 resiliently urges the clamp arm actuator 320 away from the handle assembly 311. Thus, when an operator relaxes his grip on the thumb ring 324, the resilient beam 313 forces the thumb ring 324 away from the handle set 311, thereby propelling the block of thumb. grip 432 in the opposite direction of the ultrasonic blade 350. Obviously, any other suitable components and arrangements can be used to provide a resilient bias to the clamp arm actuator 320. Alternatively, such resilient bias can simply be omitted.

III. Exemplary Ultrasonic Surgical Instruments and Multiple Replaceable Tip Actuator Features

[0223] The surgical instruments 10, 301 described above have a variety of coupling mechanisms including associated connections for the respective sets and other removablely connected features. While such coupling mechanisms can be useful in many circumstances before, during or after a surgical procedure, in one example, removing a replaceable portion of the surgical instrument from a remainder of the surgical instrument 10, 301 allows replacement of the replaceable portion and reusing the remainder of the surgical instrument 10, 301. One such replaceable portion is the grip block 222, 432, which tends to wear out with use, and can be replaced by the operator as desired. However, additional replacement portions for end actuator 12 include, but are not limited to, clamp arm assemblies 210, 400, and electrode assemblies, such as the electrodes (not shown) briefly discussed above.

[0224] The operator disconnects removable portions of the end actuator 12 for replacement by manipulating the modular couplings 616, 716, 816, 916, 1016, 1116, 1316, 1416, 1516, 1616, 1716, 1816, 1916, 2016, 2116, 2216, 2316, 2416, 2516, 2616, 2716, 2816, 2916, 3016, 3116, 3216, 3316, 3416, 3533, 9516, directly or indirectly, as described in more detail below. Although the following modular couplings 616, 716, 816, 916, 1016, 1116, 1316, 1416, 1516, 1616, 1716, 1816, 1916, 2016, 2116, 2216, 2316, 2416, 2516, 2616 , 2716, 2816, 2916 , 3016, 3116, 3216, 3316, 3416, 3533, 9516 are shown in distinct positions among reusable and replaceable features for removable connection, for any of the following modular couplings 616, 716, 816, 916, 1016, 1116, 1316, 1416, 1516, 1616, 1716, 1816, 1916, 2016, 2116, 2216, 2316, 2416, 2516, 2616, 2716, 2816, 2916, 3016, 3116, 3216, 3316, 3416, 353 3, 9516, it will be understood that modular couplings 616, 716, 816, 916, 1016, 1116, 1316, 1416, 1516, 1616, 1716, 1816, 1916, 2016, 2116, 2216, 2316, 2416, 2516, 2616, 2716, 2816, 2916, 3016, 3116, 3216, 3316, 3416, 3533, 9516 can be incorporated into any surgical instrument described herein, replaced, or moved in such a way as to render one or more portions of a surgical instrument removable from a remainder of the surgical instrument. To this end, other suitable types of clamp arm assemblies that can be used to provide different types of modular assemblies will be apparent to those commonly skilled in the art in view of the teachings in the present invention.

[0225] Similar reference numbers described above indicate similar features below. Additionally, the following will provide removal descriptions for Modular Couplings 616, 716, 816, 916, 1016, 1116, 1316, 1416, 1516, 1616, 1716, 1816, 1916, 2016, 2116, 2216, 2316, 2416, 2516, 2616, 2716, 2816, 2916, 3016, 3116, 3216, 3316, 3416, 3533, 9516, but except where otherwise specified, replacement of a replaceable portion, such as a clamp arm assembly replacement, is performed in motion and steps in reverse for reassembly. The following applies to the removal and replacement of various end actuator replaceable features and is not intended to be limited to the removal thereof only.

A. Exemplary Third Ultrasonic Surgical Instrument with a First Modular Alignment Release Coupling

[0226] Figures 24 to 28D illustrate a third exemplary surgical instrument 610 that has a handle assembly 311, a drive shaft assembly 330, a grip arm actuator 612, a grip arm assembly 614, and a fourth modular alignment release coupling 616. Referring to Figures 24 and 25, the clamp arm assembly 614 is releasably connected to the clamp arm actuator 612, with the modular alignment release coupling 616, which includes a connection of the clamping body 618 extending from the clamping arm assembly 614 and a clamping actuator connection 620 extending from the clamping arm actuator 612. The clamping arm assembly 614 includes a clamping body 622 and a block clamping block 624. The clamping block 624 is connected to the clamping body 622 such that the clamping block 624 faces the ultrasonic blade 350 for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 612 relative to the cable assembly 311 from an open configuration to a closed configuration respectively moves the clamp arm assembly 614 from an open position, configured to receive tissue, to a closed position. closed set to hold the fabric. In the present example, selectively moving the 612 clamping arm actuator to a release configuration aligns the 620 clamping actuator connection with the 618 clamping body connection to disconnect the 614 clamping arm assembly from the 614 clamping arm actuator. grip 612 for removing and replacing grip arm assembly 614. While not shown with respect to surgical instrument 610, grip arm assembly 614 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue tissue, how to coagulate the vessels in use.

[0227] Figure 25 illustrates the drive shaft assembly 330 configured to receive the clamping arm actuator 612 and the clamping arm assembly 614 for use. Driveshaft assembly 311 has a pair of opposing cylindrical pins 628 of a modular alignment release coupling 616 extending laterally from opposite sides thereof. Each cylindrical pin 628 has a transverse slot 630 extending linearly across one face thereof. The outer radial surfaces of the cylindrical pins 628 are configured to releasably receive a distal portion of the actuator from the clamp arm 612, while the transverse slots 630 of the cylindrical pins 628 are configured to receive a proximal portion of the clamp arm assembly 614 shown. in Figures 26 and 27 in more detail. For this purpose, the proximal portion of the clamping arm assembly 614 has internal clamping shields 632 connecting the clamping body 618 that define a pair of opposing pockets 634, while the distal portion of the clamping arm actuator 612 has a pair of elongated flanges with respective mounting holes 638 connecting the pinch actuator 620. As shown in Figure 28A, the mounting holes 638 rotatably receive the cylindrical pins 628 while the inner shields 632 surround the cylindrical pins 628 within a portion elongated mounting holes 638. In this way, the clamping arm assembly 614 is releasably connected to the actuator clamping arm 612 via the cylindrical pins 628 of the modular alignment release coupling 616. However, the alignment of the internal baffles 632, transverse slot 630, and elongated portions of mounting holes 638 to the release configuration releases clamp arm assembly 6140 for removal. In the present example, the movement of the clamp arm actuator 612 about the pins 628 is below the longitudinal axis, but the movement of the clamp arm assembly 614 is above the longitudinal axis, because the pins 628 laterally cross the longitudinal axis.

[0228] In use, Figures 28A to 28D illustrate the clamping arm actuator 612 and clamping arm assembly 614 collectively in closed and release configurations. Referring to Figure 28C, the operator aligns inner baffles 632, transverse slot 630, and elongated portions of mounting holes 638 to the release configuration shown in Figure 28C. The operator then translates the clamp arm assembly 614 away from the clamp arm actuator 612 until it is removed from it, as shown in Figure 28D. Furthermore, the clamp arm actuator 612 is removable from the pins 628 by manipulating the flanges 636 laterally outward and away from the driveshaft assembly 330.

B. Exemplary Fourth Ultrasonic Surgical Instrument with a Second Modular Alignment Release Coupling

[0229] Figures 29 to 33B illustrate a fourth exemplary surgical instrument 710 that has a handle assembly 311, a drive shaft assembly 330, a grip arm actuator 712, a grip arm assembly 714, and a second modular alignment release coupling 716. Referring to Figures 29 and 30, the clamp arm assembly 714 is releasably connected to the clamp arm actuator 712, with the modular alignment release coupling 716, which includes a connection of the clamping body 718 extending from the clamping arm assembly 714 and a clamping actuator connection 720 extending from the clamping arm actuator 712. The clamping arm assembly 714 includes a clamping body 722 and a block clamping block 724. The clamping block 724 is connected to the clamping body 722 such that the clamping block 724 faces the ultrasonic blade 350 for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 712 relative to the cable assembly 311 from an open configuration to a closed configuration respectively moves the clamp arm assembly 714 from an open position, configured to receive tissue, to a closed position. closed set to hold the fabric. In the present example, selectively moving the clamp arm actuator 712 to a release configuration aligns the clamp actuator connection 720 relative to the clamp body connection 718 to disconnect the clamp arm assembly 714 from the clamp arm actuator. grip 712 for removal and replacement of grip arm assembly 714. Although not shown with respect to surgical instrument 710, grip arm assembly 714 may additionally include one or more electrodes configured to apply RF energy to tissue to affect the tissue, how to coagulate the vessels in use.

[0230] Figure 30 illustrates the drive shaft assembly 330 configured to receive the clamping arm actuator 712 and the clamping arm assembly 714 for use. Driveshaft assembly 311 has a pair of opposing cylindrical pins 728 extending laterally from opposite sides thereof. The cylindrical pins 728 are configured to be respectively received in a pair of holes of a distal portion of the clamp arm actuator 712 so that the clamp arm actuator 712 is pivotally connected to the drive shaft assembly 330. Similarly, the driveshaft assembly 330 further includes a pair of opposing shields 729 extending laterally therefrom and positioned distally from the pins 728. The shields 729 are configured to be received within the transverse slot 730 of the cylindrical pins 731 pivotally mounted to clamp arm assembly 714 to pivotally connect clamp arm assembly 714 to shaft assembly 330. In the present example, movement of clamp arm actuator 712 728 around the pins is generally above the longitudinal axis, but the releasable connection to the clamp arm assembly 714 is below the longitudinal axis. However, clamping body 722 encircles the longitudinal axis so that movement of clamping block 724 is above the longitudinal axis.

[0231] In addition to the cylindrical pins 728, the slotted cylindrical pins 731, and the shields 729, the modular alignment release coupling 716 also has a tightening body connection 718, which includes a pair of opposing arm pins 732 and a pinch actuator connection 718, which includes a pair of elongated slots 734. Arm pins 732 extend laterally outward from the longitudinal axis, while elongated slots 734 face the longitudinal axis to receive the respective pins 31A to 32. In the open configuration of Figure 31A, each arm pin 732 is positioned relatively distal in the elongated slot 734. However, in the closed configuration of Figure 31B, each arm pin 732 is positioned relatively proximal in the elongated slot 734. In the present example, the movement of the actuator of the clamp arm 712 about the pins 728 is below the longitudinal axis, but the movement of the clamp arm assembly 714 is above the longitudinal axis, because the pins 728 cross laterally the longitudinal axis.

[0232] In use, Figure 33A illustrates the 712 clamp arm actuator and the 714 clamp arm assembly collectively in the released configuration, which is pivoted beyond the open configuration (see Figure 31A). In the released configuration, the arm pins 732 slide distally of the elongated slot 734 until they exit each elongated slot 734. After the arm pins 732 exit the elongated slots 734, the operator removes the clamp arm assembly 714 from the pads 729 with their distal translation.

C. Exemplary Fifth Ultrasonic Surgical Instrument with a First Modular Block Coupling

[0233] Figures 34 to 37 illustrate a fifth exemplary surgical instrument 810 having a clamp arm actuator 812, a clamp arm assembly 814 with a clamp block cover 815, and a first modular compression coupling 816. Referring to Figures 34 through 36, the clamp arm assembly 814 further includes a clamp block 818 and a clamp body 820 that is configured to releasably receive the clamp block 815 and clamp block cover 818 For this purpose, the clamping body 820 of the present example rigidly extends from the clamping arm actuator 812 with the clamping block coupling 816 between the clamping block cover 815 and the clamping body 812 to detachably connect the clamping block 818 into the clamping body 820.

[0234] The modular block coupling 816 includes a clamping block connection 822, a cap connection 824 and a pair of clamping body connections 826, 828. As shown in more detail in Figures 36 and 37, the connection of the clamping block 822 includes a pair of elongated block shields 830, while cap connection 824 includes a resilient outer rim 832. One of the clamping body connections 826 has a plurality of resilient clips 834, while the other clamping body connection Grip 828 has a rigid outer lip 836. Each resilient clip 834 engages an upper surface of elongated block pads 830 to releasably secure the grip block 818 within the grip body 820. Further, the resilient outer lip 832 on the lid of the clamping block 815 engages the rigid outer rim 836 to releasably secure the clamping block cover 815 to the clamping body 820 thereby capturing the clamping block 818 therebetween. In the present example, a portion of the clamping block 818 extends through an elongated hole 838 in the clamping block cap 815. This portion may include a low friction coating, such as polytetrafluoroethylene, to inhibit tissue adhesion during use. The grip block cap 815 is also electrically connected during connection with the grip body 820 to an RF energy source such that the grip block cap 815 is also an RF electrode, although the grip block cap 815 grip 815 may not be an RF electrode in alternate examples.

[0235] In use, the operator lifts the clamping block cover 815 from the clamping body 820, overcoming the engagement force between the resilient outer rim 832 and the rigid outer rim 836. The operator then lifts the gripping block 818 from the body clamping block 820 similarly overcomes the engagement force between the elongated block pads 830 and the clamps 834 and can discard the used clamping block 818. A replacement grip block 818 fits onto the grip body 820 followed by snapping the grip block cover 815 onto the grip body 820 to capture the replacement grip block 818 for use.

D. Exemplary Sixth Ultrasonic Surgical Instrument with a Second Modular Block Coupling

[0236] Figures 38 to 40 illustrate a sixth exemplary surgical instrument 910 having a clamp arm actuator 912, a clamp arm assembly 914 with a clamp block cover 915, and a second modular compression coupling 916. The clamping arm assembly 914 further includes a clamping block 918 and a clamping body 920, which is configured to releasably receive the clamping block 915 and the clamping block cap 918. Clamping 920 of the present example rigidly extends from the clamping arm actuator 912 with the clamping block coupling 916 between the clamping block cover 915 and the clamping body 912 for releasably connecting the clamping block 918 inside clamp body 920.

[0237] The modular block coupling 916 includes a cap connection 924 and a clamp body connection 926. The cap connection 924 includes a resilient outer rim 932, while the clamp body connection 926 has a plurality of clips 934. Each resilient clip 934 extending upwardly from clamping body 920 engages resilient outer rim 932 on clamping block cover 915 to releasably secure clamping block cover 915 to clamping body 920. In this way, the grip block cover 915 compresses and releasably captures the grip block 918 against a support surface 936 of the grip body 920. In the present example, a portion of the grip block 918 extends through a hole elongated 938 on the grip block cap 915. The grip block cap 915 is also electrically connected during connection with the grip body 920 to an RF power source such that the grip block cap 915 is also a RF electrode, although the grip block cap 915 may not be an RF electrode in alternate examples.

[0238] In use, the operator lifts the clamping block cover 915 from the clamping body 920 overcoming the engagement force between the resilient outer rim 932 and the plurality of resilient clips 934. The operator then simply removes and can discard the grip block 918 from the grip body 920. A replacement grip block 918 is positioned on the support surface 936 and the grip block cover 915 engages the grip body 920 to capture the replacement grip block 918 for use.

E. Exemplary Seventh Ultrasonic Surgical Instrument with a Third Modular Block Coupling

[0239] Figures 41 to 43 illustrate a seventh exemplary surgical instrument 1010 that has a clamping arm actuator 1012, a clamping arm assembly 1014 with a separable clamping arm assembly 1015, and a third modular compression coupling 1016 The clamping arm assembly 1014 further includes a clamping block assembly 1015 with a clamping block 1018 and a block housing 1019, as well as a clamping body 1020 that is configured to releasably receive the clamping block assembly. clamping body 1015. For this purpose, clamping body 1020 of the present example rigidly extends from clamping arm actuator 1012 with modular block coupling 1016 between clamping block assembly 1040 and clamping body 1012 for releasably connecting the block housing 1019 within the clamping body 1020.

[0240] The modular block coupling 1016 includes a clamp block connection 1024 and a clamp body connection 1026. The clamp block connection 1024 includes a pair of resilient clips 1032 extending proximally from the block compartment 1019, while the clamping body connection 1026 includes a pair of side openings 1034 that extend through a proximal portion of the clamping body 1020. The side openings 1034 are configured to receive, respectively, resilient clips 1032 for securely fastening removable block housing 1019 in clamping body 1020. Clamping arm assembly 1014 further includes a plurality of resilient gusset members 1035 that project distally within clamping body 1020 and are configured to further grip block housing 1019 on the gripper body 1020, as shown in Figures 42 and 43. Although not shown with respect to the surgical instrument 1010, the gripper arm assembly 1014 can further include one or more electrodes configured to apply RF energy to tissue to affect the tissue, how to coagulate the vessels in use.

[0241] In use, the operator forces the resilient clips 1032 laterally inward towards the longitudinal axis and out of the side openings 1034. In one example, a modular connection tool 1080 is provided to assist in disconnecting the block assembly from clamping 1015 of clamping body 1020. U-shaped modular connecting tool 1080 has integral projections 1082 at respective ends that are configured to be inserted into side opening 1034 to urge resilient clips 1032 laterally inward. After disconnection, the operator lifts the clamp block assembly 1015 past the resilient gusset members 1035 for removal. A replacement grip block 1018 with a replacement grip block assembly 1015 is positioned in and fitted to grip body 1020 in order to capture the replacement grip block 1018 for use.

F. Exemplary Eighth Ultrasonic Surgical Instrument with a First Modular Snap-On Coupling

[0242] Figure 44 illustrates an exemplary ninth surgical instrument 1110 having a drive shaft assembly 330, a grip arm actuator 1112, a grip arm assembly 1114, and a first modular press-fit coupling 1116. Clamping arm assembly 1114 is releasably connected to clamping arm actuator 1112 with modular press fit coupling 1116, which includes a clamping body fitting 1118 on clamping arm assembly 1114 and an actuator fitting clamp 1120 on the clamp arm actuator 1112. The clamp arm assembly 1114 includes a clamp body 1122 and a clamp block 1124. The clamp block 1124 is connected to the clamp body 1122 so that the clamp block 1124 faces the ultrasonic blade 350 for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 1112 relative to the drive shaft assembly 330 from an open configuration to a closed configuration respectively moves the clamp arm assembly 1114 from an open position, configured to receive tissue, to a closed position configured to secure the fabric. Although not shown with respect to surgical instrument 1110, clamp arm assembly 1114 may further include one or more electrodes configured to apply RF energy to tissue to affect the tissue, such as coagulating vessels in use.

[0243] Although the surgical instrument 1110 has an ultrasonic blade 350 as shown and described above in relation to Figure 44, an alternative example, such as a tenth exemplary surgical instrument 1210 (see Figures 45 to 48), has a set of electrodes 1252 positioned opposite the clamp arm assembly 1114. For this purpose, the modular snap fit coupling 1116 will be described in conjunction with the electrode assembly 1252 (see Figures 45 to 48) of the surgical instrument 1210 (see Figures 45 to 48). The additional description regarding modular press fit coupling 1116 provided below similarly applies to surgical instrument 1110 above.

G. Ninth Sample Ultrasonic Surgical Instrument with a First Modular Snap-On Coupling

[0244] Figures 45 to 48 illustrate an exemplary ninth surgical instrument 1210 having a clamp arm actuator 1212, a clamp arm assembly 1214, and a modular press fit coupling 1116 discussed briefly above. Clamp arm assembly 1214 is releasably connected to clamp arm actuator 1212 with modular press fit coupling 1116, which includes a clamp body connection 1118 on clamp arm assembly 1214 and an actuator connection clamp 1120 on the clamp arm actuator 1212. The clamp arm assembly 1214 includes a clamp body 1222 and a clamp block 1224. The clamp block 1224 is connected to the clamp body 1222 so that the clamp block 1224 faces an electrode 1250 of an electrode assembly 1252 for receiving and clamping tissue therebetween. Modular snap-fit coupling 1116 is also incorporated into electrode assembly 1252 for releasably connecting electrode 1250 to electrode actuator 1254. Selective movement of clamp arm actuator 1212 relative to electrode actuator 1254 from from an open configuration to a closed configuration respectively move the clamp arm assembly 1214 from an open position configured to receive tissue to a closed position configured to grip tissue. Electrode 1250 of the present example is an RF electrode operatively connected to an RF energy source and configured to deliver RF energy to tissue.

[0245] Although the surgical instrument 1110 has an ultrasonic blade 350 as shown and described above in relation to Figure 44, an alternative example, such as a ninth exemplary surgical instrument 1210 (see Figures 45 to 48), has a set of electrodes 1250 positioned opposite the clamp arm assembly 1114. For this purpose, the modular snap fit coupling 1116 will be described in conjunction with the electrode assembly 1252 (see Figures 45 to 48) of the surgical instrument 1210 (see Figures 45 to 48). The additional description regarding modular press fit coupling 1116 provided below similarly applies to surgical instrument 1110 above.

[0246] Referring to Figure 46, the modular press-fit coupling 1116 has a clamp body connection 1118 with an inclined projection tab 1126 extending proximally from a proximal portion of the clamp arm assembly 1214. The modular press-fit coupling 1116 also has a pinch actuator connection 1120 with a bottom opening 1128 that extends transversely through an actuator bottom surface of the pinch arm 1212. The bottom opening 1128 receives the angled projection tab 1126 and releasably capturing the inclined projection tab 1126 to thereby releasably connect the clamp arm assembly 1214 to the clamp arm actuator 1212.

[0247] In addition, Figures 46 to 47A illustrate a modular snap-fit coupling 1116 that has an electrode assembly connection 1256 with an inclined projection tab 1126 extending proximally from a proximal portion of the electrode assembly 1252. The modular press-fit coupling 1116 also has an electrode actuator connection 1258 with an upper opening 1128 that extends transversely across an upper surface of the electrode actuator 1254. The upper opening 1128 receives the angled projection tab 1126 and releasably capturing the inclined projection tab 1126 to thereby releasably connect the electrode assembly 1252 to the electrode actuator 1254.

[0248] In use, in relation to Figures 47A to 48, the operator transversely presses the inclined projection tab 1126 until longitudinally releasing the upper opening 1128 in the electrode actuator 1254. Once free, the operator distally translates the electrode assembly 1252 with respect to the electrode actuator 1254. A replacement electrode assembly 1252 is positioned in the electrode actuator 1254 and press fit thereto to capture the replacement electrode assembly 1252 for use. A replacement clamp arm assembly 1214 may also be removed and replaced via modular press fit coupling 1116, as discussed in connection with electrode assembly 1252.

H. Exemplary Tenth Ultrasonic Surgical Instrument with a Second Modular Snap-On Coupling

[0249] Figures 49A to 49C illustrate an exemplary eleventh surgical instrument 1310 having a clamp arm actuator 1312, a clamp arm assembly 1314, and a second modular press-fit coupling 1316. The clamp arm assembly Clamp 1314 is releasably connected to clamp arm actuator 1312, with the modular snap fit coupling 1316, which includes a clamp body connection 1318 on clamp arm assembly 1314 and a clamp actuator connection 1320 on clamp arm assembly 1314. clamp arm actuator 1312. The clamp arm assembly 1314 includes a clamp body 1322 and a clamp block 1324. The clamp block 1324 is connected to the clamp body 1322 so that the clamp block 1324 faces toward the ultrasonic blade (not shown) to receive and clamp the tissue therebetween. Selective movement of the clamp arm actuator 1312 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1314 from an open position configured to receive tissue, to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 1310, clamp arm assembly 1314 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulating vessels in use.

[0250] The clamping body connection 1318 includes a pair of upper and lower inclined projection tabs 1326 extending proximally from the proximal portion of the clamping arm assembly 1314, while the clamping actuator connection 1320 includes a pair of upper and lower openings 1328 extending transversely across the upper and lower surfaces of the actuator of the clamping arm 1312. The upper and lower openings 1328 respectively receive the upper and lower angled projection tabs 1326 and capture the angled projection tabs 1326 to thereby releasably connecting the clamping arm assembly 1314 to the clamping arm actuator 1312. In addition, the upper and lower angled projection wings 1326 are relatively oversized and project transversely beyond the upper and lower surfaces of the arm actuator. tightening nut 1312 for more direct access by the operator in use.

[0251] In use, the operator presses transversely and simultaneously the upper and lower inclined projection tabs 1326 until longitudinally releasing the upper and lower openings 1328 in the actuator of the clamping arm 1312. Once free, the operator distally translates the arm assembly of clamping arm 1314 relative to clamping arm actuator 1312. A replacement clamping arm assembly 1314 is positioned on clamping arm actuator 1312 and engaged therein in order to capture the replacement clamping arm assembly 1314 for use.

I. Eleventh Sample Ultrasonic Surgical Instrument with a Third Modular Pressure Fit Coupling

[0252] Figures 50A to 50B illustrate an exemplary eleventh surgical instrument 1410 having a clamp arm actuator 1412, a clamp arm assembly 1414, and a second modular press fit coupling 1416. clamp arm actuator 1412 and clamp arm assembly 1414 with modular snap fit coupling 1416 operate similarly to the modular snap fit coupling 1316 discussed above with angled projection tab and opening 1328 (see Figures 49A to 49C). However, a single angled projection tab 1426 cooperates with the opening 1428 of the present example so that the tab 1426 is relatively undersized and flush with the actuator top surface of the clamping arm 1412 to inhibit the operator from inadvertently manipulating the projection tab. slant 1426 and remove clamp arm assembly 1414 from clamp arm actuator 1412 in use.

J. Twelfth Sample Ultrasonic Surgical Instrument with a Fourth Modular Pressure Fit Coupling

[0253] Figures 51 to 53 illustrate a twelfth exemplary surgical instrument 1510 that has a clamp arm actuator 1512, a clamp arm assembly 1514, and a fourth modular press-fit coupling 1516. The clamp arm assembly Clamp 1514 is releasably connected to the clamp arm actuator 1512 with the Modular Snap Fit Coupling 1516, which includes a clamp body connection 1518 on the clamp arm assembly 1514 and a clamp actuator connection 1520 on the actuator of the clamping arm 1512. The clamping arm assembly 1514 includes a clamping body 1522 and a clamping block 1524. The clamping block 1524 is connected to the clamping body 1522 so that the clamping block 1524 faces the ultrasonic blade (not shown) for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 1512 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1514 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 1510, clamp arm assembly 1514 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulating vessels in use.

[0254] The clamping body connection 1518 includes a pair of opposite, inclined lateral projection tabs 1526 that extend proximally and laterally from the proximal portion of the clamping arm assembly 1514, while the clamping actuator connection 1520 includes a pair of side openings 1528 extending transversely through the actuator side walls of the clamping arm 1512. The side openings 1528 receive respective angled side projection tabs 1526 and capture the angled side projection tabs 1526 to thereby releasably connect the clamp arm assembly 1514 to clamp arm actuator 1512.

[0255] In addition, the clamp body connection 1518 further includes a clamp 1529 that extends proximally from the proximal portion of the clamp arm assembly 1514 towards a support hole 1530, which extends proximally through a distal end clamp arm actuator 1512. Support hole 1530 is configured to receive clamp 1529 with angled lateral projection tabs 1526 engaged in side openings 1528. Clamp 1529 and clamp arm actuator 1512 are thereby configured to provide additional structural support while tightening the fabric in use to inhibit bending or tearing. A connection switch 1532 is further included with the present example and positioned in at least one of the side openings 1528. The connection switch 1532 is configured to detect the presence of the angled lateral projection tabs 1526 in the openings 1528 and communicate that connected state to a controller (not shown) for indicating that the clamp arm assembly 1514 is connected to the clamp arm actuator 1512 for use in the surgical procedure.

[0256] In use, the operator simultaneously and laterally presses the inclined lateral projection tabs 1626 until longitudinally releasing the side openings 1528 in the clamping arm actuator 1512. Once free, the operator distally translates the clamping arm assembly 1514 into relationship to actuator clamp arm 1512. Connection switch 1532 further communicates to the operator through the controller (not shown) that clamp arm assembly 1514 is removed from clamp arm actuator 1512. A replacement clamp arm assembly 1514 is positioned on and engaged in the clamping arm actuator 1512 in order to capture the replacement clamping arm assembly 1514 for use and indicates such connection to the operator via a connection key 1532.

K. Exemplary Thirteenth Ultrasonic Surgical Instrument with a Fifth Modular Pressure Fit Coupling

[0257] Figures 54 to 55B illustrate an exemplary thirteenth surgical instrument 1610 that has a clamp arm actuator 1612, a clamp arm assembly 1614, and a fifth modular snap-fit coupling 1616. The clamp arm assembly Clamp 1614 is releasably connected to the clamp arm actuator 1612 with the Modular Snap Fit Coupling 1616, which includes a clamp body connection 1618 on the clamp arm assembly 1614 and a clamp actuator connection 1620 on the actuator of the clamping arm 1612. The clamping arm assembly 1614 includes a clamping body 1622 and a clamping block 1624. The clamping block 1624 is connected to the clamping body 1622 so that the clamping block 1624 faces the ultrasonic blade (not shown) for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 1612 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1614 from an open position configured to receive tissue to a closed position configured to grip tissue. The clamp arm assembly of the present example further includes at least one RF electrode 1625 operatively connected to an RF energy source and configured to apply RF energy to tissue to affect tissue , how to coagulate the vessels in use.

[0258] The clamp body connection 1618 includes a pair of angled laterally projecting tabs 1626 that extend proximally and laterally over a body clamp 1629 of the clamp arm assembly 1614 discussed in more detail below. The clamping actuator connection 1620 includes a pair of side openings 1628 that extend laterally through the side walls of the clamping arm actuator 1612. The side openings 1628 receive the respective angled side projection tabs 1626 and capture the side projection tabs angles 1626 to thereby releasably connect clamp arm assembly 1614 to clamp arm actuator 1612.

[0259] Furthermore, the clamp body connection 1618 further includes a body clamp 1629 extending proximally from the proximal portion of the clamp arm assembly 1614 towards a support hole 1630, which extends proximally through a actuator distal end of clamp arm 1612. Support hole 1630 is configured to receive body clamp 1629 with angled lateral projection tabs 1626 fitted into side openings 1628. Body clamp 1629 and clamp arm actuator 1612 are thus configured to provide structural support while at the same time tightening the fabric in use to inhibit bending or tearing. A connection switch 1632 is further included with the present example and positioned in at least one of the support hole 1630. The connection switch 1632 is configured to detect the presence of the body clamp 1629 operatively connected to the support hole 1630 and communicate this connected state to a controller (not shown) to indicate that the clamp arm assembly 1614 is connected to the clamp arm actuator 1612 for use in the surgical procedure.

[0260] The modular snap-fit coupling 1616 additionally includes an electrical connection 1634, which includes a male electrical coupling 1636 and a female electrical coupling 1638. The male and female electrical couplings 1636, 1638 are configured to connect removablely to communicate electrical signals and RF energy to the RF electrode 1625, but allow removal and replacement of the clamp arm assembly 1614.

[0261] In use, the operator simultaneously and laterally presses the inclined lateral projection tabs 1626 until longitudinally releasing the lateral openings 1628 in the actuator of the clamping arm 1612. Once free, the operator distally translates the clamping arm assembly 1614 in clamp arm actuator 1612 and disconnects male and female electrical couplings 1636, 1638. Connection switch 1632 further communicates to operator via controller (not shown) that clamp arm assembly 1614 is removed from arm actuator clamping arm 1612. A replacement clamping arm assembly 1614 is positioned on the clamping arm actuator 1612 and engaged therewith in order to capture the replacement clamping arm assembly 1614 for use and indicates such connection to the operator through a connection key 1632.

L. Fourteenth Sample Ultrasonic Surgical Instrument with a Sixth Modular Pressure Fit Coupling

[0262] Figures 56A to 56B illustrate an exemplary fourteenth surgical instrument 1710 that has a clamp arm actuator 1712, a clamp arm assembly 1714, and a sixth modular press-fit coupling 1716. The clamp arm assembly Clamp 1714 is releasably connected to the clamp arm actuator 1712 with the Modular Snap Fit Coupling 1716, which includes a clamp body connection 1718 on the clamp arm assembly 1714 and a clamp actuator connection 1720 on the actuator of the clamping arm 1712. The clamping arm assembly 1714 includes a clamping body 1722 and a clamping block 1724. The clamping block 1724 is connected to the clamping body 1722 so that the clamping block 1724 faces the ultrasonic blade (not shown) for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 1712 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1714 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 1710, clamp arm assembly 1714 may additionally include one or more electrodes configured to apply RF energy to tissue to affect the tissue, such as coagulating vessels in use.

[0263] The clamping body connection 1718 includes a pair of opposite, angled lateral projection tabs 1726 that extend laterally from a proximal portion of the clamping arm assembly 1714, while the clamping actuator connection 1720 includes a pair of side openings 1728 extending transversely through the side walls of the clamping arm actuator 1712. The side openings 1728 receive respective angled lateral projection tabs 1726 and capture the angled lateral projection tabs 1726 to thereby releasably connect the assembly from clamping arm 1714 to clamping arm actuator 1712.

[0264] The clamp arm assembly 1714 of the present example is received transversely in the clamp arm actuator 1712 so that a distal portion of the clamp arm actuator 1712 supports the clamp body 1722 therein. Clamping arm actuator 1712 and clamping body 1722 are thus configured to provide additional structural support while at the same time clamping the tissue in use to inhibit bending or tearing. The distal portion of the clamp arm actuator 1712 also includes an end slot 1729 configured to receive a portion of the clamp arm assembly 1714 so that the clamp block 1724 is approximately flush with a bottom surface of the clamp arm actuator. 1712.

[0265] In use, the operator simultaneously and laterally presses the inclined lateral projection tabs 1726 until longitudinally releasing the side openings 1728 in the clamping arm actuator 1712. Once free, the operator distally translates the clamping arm assembly 1714 into with respect to the actuator clamp arm 1712. A replacement clamp arm assembly 1714 is positioned and supported on the clamp arm actuator 1712 and engaged therein in order to capture the replacement clamp arm assembly 1714 for use.

M. Fifteenth Sample Ultrasonic Surgical Instrument with a Seventh Modular Pressure Fit Coupling

[0266] Figures 57 to 60B illustrate an exemplary fifteenth surgical instrument 1810 that has a clamping arm actuator 1812, a clamping arm assembly 1814, and a seventh modular press-fit coupling 1816. The clamping arm assembly Clamp 1814 is releasably connected to the clamp arm actuator 1812 with the Modular Snap Fit Coupling 1816, which includes a clamp body connection 1818 on the clamp arm assembly 1814 and a clamp actuator connection 1820 on the actuator of the clamping arm 1812. The clamping arm assembly 1814 includes a clamping body 1822 and a clamping block 1824. The clamping block 1824 is connected to the clamping body 1822 so that the clamping block 1824 faces the ultrasonic blade (not shown) for receiving and clamping tissue therebetween. Selective movement of the clamp arm actuator 1812 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1814 from an open position configured to receive tissue, to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 1810, clamp arm assembly 1814 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulating vessels in use.

[0267] The clamping body connection 1818 includes a transverse lateral projection tab 1826 that extends transversely from the proximal portion of the clamping arm assembly 1814, while the clamping actuator connection 1820 includes a transverse opening 1828 that extends transversely through clamp arm actuator 1812. Transverse opening 1828 receives transverse slanted projection tab 1826 and captures slanted projection tab 1826 to thereby releasably connect clamp arm assembly 1814 to clamp arm actuator 1812 .

[0268] The modular press-fit coupling 1816 further cooperates with a proximal portion of the clamping body 1822 to further connect the clamping arm assembly 1814 to the clamping arm actuator 1812. For this purpose, with reference to Figures 58 and 59, the clamp arm actuator has a distal transverse hole 1830 extending therethrough and is positioned distally from the transverse opening 1828. The distal transverse hole 1830 is configured to receive the proximal portion of the clamp body 1822 through the even in a transverse direction and rotated with respect to the longitudinal direction for alignment with the clamp arm actuator 1812. The clamp arm actuator 1812 further includes a distal nose 1832 configured to be received within a nasal canal 1834 on a lower surface of the grip body 1822. The grip body 1822 is thus configured to be rotated about the distal nose 1832 and further supported by the distal nose 1832 for use.

[0269] In use, in relation to Figures 60A and 60B, the transverse operator longitudinally presses the inclined projection tab 1826 until transversely releasing the opening 1828 in the clamping arm actuator 1812. Once free, the operator rotates the arm assembly clamp arm 1814 relative to clamp arm actuator 1812 around distal nose 1832 and transversely removes clamp body 1822 from distal transverse hole 1830. A replacement clamp arm assembly 1814 is positioned on clamp arm actuator 1812 and snapped onto it in order to capture the Replacement Grip Arm Assembly 1814 for use.

N. One Eighth Exemplary Modular Snap Fit Coupling

[0270] Figures 61A and 61B illustrate an eighth modular press-fit coupling 9516 for a clamp arm actuator 9512 and a clamp arm assembly 9514. The clamp arm assembly 9514 is removablely connected to the clamp actuator 9512 clamp arm with 9516 modular press fit coupling, which includes a 9518 clamp body connection on the 9514 clamp arm assembly and a 9520 clamp actuator connection on the 9512 clamp arm actuator. clamp 9514 includes a clamp body 9522 and a clamp block 9524. The clamp block 9524 is connected to the clamp body 9522 such that the clamp block 9524 faces the ultrasonic blade (not shown) to receive and clamp the fabric between them. Selective movement of clamp arm actuator 9512 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves clamp arm assembly 9514 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown, clamp arm assembly 9514 can further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulate vessels and/or otherwise seal tissue.

[0271] The clamp body connection 9518 includes an internal hole 9526a that extends distally from the proximal portion of the clamp arm assembly 9514 and is configured to receive a distal portion of the clamp arm actuator 9512. The clamp body connection grip 9518 further includes an inner shield 9526b and a pair of side slots 9526c that extend through, respectively, the side walls of the grip body 9522 to the inner hole 9526a. In the present example, inner bulkhead 9526b is positioned with respect to side slots 526c, which extend proximally to a proximal face of clamping body 9522. The clamping actuator connection 9520 includes a distally extending hook 9528a and a pair of opposing laterally extending flaps 9528b. Internal hole 9526 is configured to receive hook 9528a so that hook 9528a releasably engages inner shoulder 9526b and side flaps 9528b releasably engage side walls within side slots 9526c. More particularly, the hook 9528a resiliently cooperates with the inner bulkhead 9526b while the side tabs 9528b resiliently cooperates within the side slots 9526c of the side walls so that the distal end portion of the pinch actuator 9512 resiliently engages the removable connection with the clamping portion 9526c. proximal end of clamping body 9522.

[0272] In use, the operator withdraws the clamp actuator assembly 9514 distally in relation to the fastener actuator 9512 with sufficient force to overcome the resilient engagement between the hook 9528a and the internal bulkhead 9526b as well as the side flaps 9528b and side slots 9526c of the side walls. Once resilient engagement is overcome, the operator further distally withdraws the pinch actuator assembly 9514 until the pinch actuator 9512 is removed from the internal bore 9526a. A 9514 Replacement Pinch Arm Assembly is positioned on and engaged in the 9512 Pinch Arm Actuator to capture the 9514 Replacement Pinch Arm Assembly for use.

O. Sixteenth Sample Ultrasonic Surgical Instrument with a Modular Threaded Coupling

[0273] Figures 62A and 62B illustrate an exemplary sixteenth surgical instrument 1910 that has a grip arm actuator 1912, a grip arm assembly 1914, and a modular threaded coupling 1916. The grip arm assembly 1914 is connected removable to the 1912 clamping arm actuator with the 1916 modular threaded coupling, which includes a 1918 clamping body connection on the 1914 clamping arm assembly and a 1920 clamping actuator connection on the 1912 clamping arm actuator. clamp arm assembly 1914 includes a clamp body 1922 and a clamp block 1924. The clamp block 1924 is connected to the clamp body 1922 so that the clamp block 1924 faces the ultrasonic blade (not shown) to receive and secure the fabric between them. Selective movement of the clamp arm actuator 1912 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 1914 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 1910, clamp arm assembly 1914 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as clotting vessels in use.

[0274] The clamping body connection 1918 includes a threaded pin 1926 that extends proximally from a proximal portion of the clamping arm assembly 1914, while the clamping actuator connection 1920 includes a threaded opening 1928 that extends proximally through a distal end of the clamp arm actuator 1912. The threaded opening 1928 rotatably receives the threaded pin 1926 and tightens it 1926 to thereby removablely connect the clamp arm assembly 1914 to the clamp arm actuator 1912.

[0275] In use, the operator pivotally loosens the threaded pin 1926 from the threaded opening 1928 until it releases it from the threaded opening 1928 in the actuator of the clamping arm 1912. Once free, the operator distally removes the clamping arm assembly 1914 in relation to the 1912 actuator clamp arm. A 1914 replacement clamp arm assembly is positioned on the 1912 clamp arm actuator and rotatably threaded into it to tighten and capture the 1914 replacement clamp arm assembly. For use.

P. Seventeenth Sample Ultrasonic Surgical Instrument with a Modular Compression Coupling

[0276] Figures 63 to 65C illustrate an exemplary seventeenth surgical instrument 2010 that has a clamping arm actuator 2012, a clamping arm assembly 2014, and a modular compression coupling 2016. With respect to Figures 63 and 64, the 2014 clamp arm assembly is releasably connected to the 2012 clamp arm actuator, with the 2016 modular compressive coupling, which includes a 2018 clamp body connection on the 2014 clamp arm assembly and a clamp actuator connection 2020 on the 2012 clamp arm actuator. The 2014 clamp arm assembly includes a clamp body 2022 and a clamp block 2024. The clamp block 2024 is connected to the clamp body 2022 so that the clamp block 2024 is facing the ultrasonic blade (not shown) to receive and clamp the tissue therebetween. Selective movement of the clamp arm actuator 2012 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 2014 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 2010, clamp arm assembly 2014 may additionally include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulation vessels in use.

[0277] The clamping body connection 2018 includes an outer surface 2026 of the clamping body 2022, while the clamping actuator connection 2020 includes a radial catch latch 2028 configured to frictionally engage the outer surface 2026 of the clamping body 2022 for removable connection. In the present example, the radial catch latch 2028 includes a spring-like biasing member 2030 and a latch 2032 configured to be selectively moved from a latched configuration to a non-latched configuration. Spring 2030 is generally in compression and forced toward the latched configuration such that spring 2030 has a relatively small diameter and engages radially with outer surface 2026. Furthermore, pulling distal arm assembly 2014 distally effectively constricts the spring 2030 radially inward to further frictionally engage outer surface 2026. However, selective manipulation of latch 2032 in the proximal direction compresses spring 2030 so that spring 2030 has a relatively large diameter and radially disengages outer surface 2026. radial catch latch 2028 thereby releases grip arm assembly 2014 for removal in the unlocked configuration.

[0278] In use, in relation to Figures 65A to 65C, the operator proximally pushes the latch 2032 from the locked configuration to the unlocked configuration so that the spring 2030 disengages from the outer surface 2026 of the clamp arm assembly 2014. The operator then distally translates the 2014 clamp arm assembly from the 2030 spring until it releases the 2030 spring and removes it from the 2012 clamp arm actuator. A replacement 2014 clamp arm assembly is positioned on the 2012 clamp arm actuator and the 2032 lock returns distally to the locked configuration to capture the 2014 Replacement Grip Arm Assembly for use.

Q. Eighteenth Sample Ultrasonic Surgical Instrument with a Modular Bayonet-Type Coupling

[0279] Figures 66A to 66C illustrate an exemplary eighteenth surgical instrument 2110 that has a clamp arm actuator 2112, a clamp arm assembly 2114, and a modular bayonet-type coupling 2116. The clamp arm assembly 2114 is Removably connected to the 2112 clamp arm actuator with the 2116 Modular Bayonet Coupling, which includes a 2118 clamp body connection to the 2114 clamp arm assembly and a 2120 clamp actuator connection to the 2112 clamp arm actuator The clamping arm assembly 2114 includes a clamping body 2122 and a clamping block 2124. The clamping block 2124 is connected to the clamping body 2122 so that the clamping block 2124 faces the ultrasonic blade (not shown ) to receive and hold the fabric therebetween. Selective movement of the clamp arm actuator 2112 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 2114 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 2110, clamp arm assembly 2114 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as clotting vessels in use.

[0280] The clamping body connection 2118 includes a bayonet-like tab 2126 extending radially outward from a proximal portion thereof, while the gripper actuator connection 2120 includes a bayonet slot 2128 configured to receive in a manner sliding bayonet tab 2126 for removable connection. In the present example, bayonet slot 2128 extends proximally through a distal end side wall along a longitudinal portion of bayonet slot 2128 and an intersecting transverse portion of bayonet slot 2128. Bayonet tab 2126 generally remains captured in the transverse portion of the bayonet slot 2128 during use, but is rotated so that the bayonet tab 2126 is in the longitudinal portion for proximal removal. To aid in removal, the clamp arm assembly 2114 further includes a proximal resilient cap 2130 in upward compression within the clamp arm actuator 2112 against a seat 2132. In this way, the resilient cap 2130 resiliently extends from of compression to push the clamp body 2122 and clamp block 2124 distally from the clamp arm actuator 2112 for removal.

[0281] In use, in relation to Figures 66A to 66C, the operator rotates the bayonet flap 2126 through the transverse portion of the bayonet slot 2128 with the remainder of the clamping arm assembly 2114 and the resilient cover 2130 pushes the assembly of clamping arm 2113 distally. The operator then distally translates the bayonet tab 2126 distally through the longitudinal portion of the bayonet slot 2128 until the clamp arm assembly 2114 is removed from the clamp arm actuator 2112. A replacement clamp arm assembly 2114 is positioned on the clamp arm actuator 2112 and rotated to capture bayonet tab 2126 in transverse portion of bayonet slot 2118 for use.

R. Nineteenth Sample Ultrasonic Surgical Instrument with a Modular Luer Coupling

[0282] Figures 67A and 67B illustrate an exemplary nineteenth surgical instrument 2210 that has a clamp arm actuator 2212, a clamp arm assembly 2214, and a modular luer coupling 2216. The clamp arm assembly 2214 is connected removable to the 2212 clamp arm actuator with the 2216 modular luer coupling, which includes a 2218 clamp body connection to the 2214 clamp arm assembly and a 2220 grip actuator connection to the 2212 clamp arm actuator. clamp arm assembly 2214 includes a clamp body 2222 and a clamp block 2224. The clamp block 2224 is connected to the clamp body 2222 so that the clamp block 2224 faces the ultrasonic blade (not shown) to receive and secure the fabric between them. Selective movement of the clamp arm actuator 2212 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 2214 from an open position configured to receive tissue to a closed position configured to clamp the fabric. Although not shown with respect to surgical instrument 2210, clamp arm assembly 2214 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulation vessels in use.

[0283] The clamp body connection 2218 includes a male luer lock 2226 extending proximally from a proximal portion thereof, while the clamp actuator connection 2220 includes a female luer lock 2228 within a distal portion thereof . Female luer lock 2228 is configured to rotatably receive male luer lock 2226 to releasably connect clamp arm assembly 2214 to clamp arm actuator 2212.

[0284] In use, the operator rotates the clamp arm assembly 2214 with the male luer lock 226 relative to the clamp arm actuator 2212 to release and withdraw the clamp arm assembly 2214 in the distal direction. The operator then distally translates the clamp arm assembly 2214 until the clamp arm assembly 2214 is removed from the clamp arm actuator 2212. A replacement clamp arm assembly 2214 is positioned on the clamp arm actuator 2212 and rotated In order to capture the male luer lock 2226 into the female luer lock 2218 for use.

S.Twentieth Exemplary Ultrasonic Surgical Instrument with a Modular Block Insertable Element Coupling

[0285] Figures 68 to 71 illustrate an exemplary twentieth surgical instrument 2310 that has a clamping arm actuator 2312, a clamping arm assembly 2314 with a separable clamping block assembly 2315, and a block insertable element coupling 2316. Clamping arm assembly 2314 further includes a clamping block assembly 2315 with a clamping block 2118 and a clamping block 2319, as well as a clamping body 2320 that is configured to removablely receive the assembly. clamping block assembly 2315. For this purpose, the clamping body 2320 of the present example rigidly extends from the clamping arm actuator 2312 with the coupling of the modular block insert element 2316 between the clamping block assembly 2340 and clamping body 2312 for releasably connecting block housing 2319 within clamping body 2320.

[0286] The modular block insert coupling 2316 includes a clamp block connection 2324 and a clamp body connection 2326. The clamp block connection 2324 includes a longitudinal flange 2332 that extends along an upper surface of the block housing 2319 and a pair of side wings 2333 extending from the respective side of the block housing 2319, while the clamping body connection 2326 includes a longitudinal slot 2334 extending along one surface of the clamping body 2320 and a pair of side openings 2335 through respective sides of the clamping body 2320. The longitudinal slot 2334 is configured to receive the longitudinal tab 2332 for releasably securing the block housing 2319 to the clamping body 2320. In the present example, longitudinal tab 2332 is inserted distally into a proximal end of longitudinal slot 2332 until a distal end of longitudinal tab 2332 is flush with a distal end of longitudinal slot 2334.

[0287] In use, the operator pushes the clamping block assembly 2315 proximally so that the longitudinal tab 2332 moves proximally through the longitudinal slot 2334 until it is removed from the longitudinal slot 2334. Such manipulation of the clamping block assembly 2315 is aided with a modular connection tool 2350 shown in Figures 70 and 71. The modular connection tool 2350 has an unloaded cavity 2352 in which the used grip block assembly 2314 is deposited and a loaded cavity 2354 from which a replacement clamping block assembly 2314. More particularly, the no-load cavity 2352 has an internal surface configured to push the side tabs 2333 of the side slots 2335 and the clamping block assembly 2318 of the longitudinal slot 2334 for the deposition of the clamping block assembly 2314. tightening block 2318 in it. Replacement clamp block assembly 2318 is suspended in load cavity 2352 such that the operator inserts longitudinal slot 2334 into clamp body 2320 past replacement clamp block assembly 2318 and then withdraws clamp body 2320 from load cavity 2354. Thus, the longitudinal tab 2332 is pulled through the longitudinal slot 2334 until it is connected for use and the modular connection tool 2350 can be discarded.

T. Twenty-First Exemplary Ultrasonic Surgical Instrument with a Modular Latch Coupling

[0288] Figures 72 to 74C illustrate a twenty-first exemplary surgical instrument 2410 that has a clamping arm actuator 2412, a clamping arm assembly 2414, and a modular lock coupling 2416. With respect to Figures 72 to 74A, the 2414 clamp arm assembly is releasably connected to the 2412 clamp arm actuator with the 2416 modular lock coupling, which includes a 2418 clamp body connection to the 2414 clamp arm assembly and a 2420 clamp actuator connection on the clamp arm actuator 2412. The clamp arm assembly 2414 includes a clamp body 2422 and a clamp block 2424. The clamp block 2424 is connected to the clamp body 2422 so that the clamp block 2424 faces for the 350 ultrasonic blade to receive and clamp the tissue between them. Selective movement of clamp arm actuator 2412 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2414 from an open position configured to receive tissue to a position closed loop configured to grip tissue. Although not shown with respect to surgical instrument 2410, clamp arm assembly 2414 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as clotting vessels in use.

[0289] The clamp body connection 2418 includes a capture member, such as a bulbous capture member 2426, extending proximally from the clamp body 2422, while the clamp actuator connection 2420 includes capture grooves 2428 in a distal end portion thereof. Capture groove 2428 is configured to support and retain bulbous capture member 2426. Modular latch coupling 2416 further includes a latch 2430 configured to be selectively moved from a latched configuration to a non-latched configuration. In the latched configuration, the latch 2430 covers and captures the bulbous capture member 2426 in the capture groove 2428 groove so that the clamp arm assembly 2414 is releasably connected to the clamp arm actuator 2412. However, in the unlocked configuration, latch 2430 discovers and releases capture bulb member 2426 such that capture bulb member 2426 is removable from capture groove 2428. In the present example, capture bulb member 2426 is oblong and capture groove 2428 is hooked so that the bulbous capture member 2426 is generally captured within the hooked capture groove 2428 unless pivoted for removal.

[0290] In use, in relation to Figures 74A to 74C, the operator proximally pushes the lock 2430 from the locked configuration to the unlocked configuration and pivots the clamp arm assembly 2414 transversely upwards. The operator then transversely translates the pinch arm assembly 2414 until it is clear of the hooked catch groove 2428 hooked groove and removed from the pinch arm actuator 2412. A replacement pinch arm assembly 2414 is positioned on the actuator of clamp arm 2412 and latch 2430 is directed back to the latched configuration in order to capture the replacement clamp arm assembly 2414 for use.

U. Twenty-second Exemplary Ultrasonic Surgical Instrument with First Modular Multi-Position Coupling

[0291] Figures 75 to 78C illustrate a twenty-second exemplary surgical instrument 2510 that has a clamp arm actuator 2512, a clamp arm assembly 2514, and a modular multi-position coupling 2516. With respect to Figures 75-77 , the clamping arm assembly 2514 is movably connected to the clamping arm actuator 2512 with the modular multi-position coupling 2516, which includes a clamping body connection 2518 on the clamping arm assembly 2514 and an actuator connection of the clamp 2520 on actuator of clamping arm 2512. Clamping arm assembly 2514 includes clamping arm body 2522 and clamping block 2524. Clamping blocks 2524 are connected to opposite upper and lower surfaces of clamping body 2522 such that each clamping block 2524 respectively faces the ultrasonic blade 350 in a first use position or a second use position for receiving and clamping tissue therebetween. Selective movement of clamp arm actuator 2512 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2514 from an open position configured to receive tissue to a position closed set to hold the fabric. Although not shown with respect to surgical instrument 2510, clamp arm assembly 2514 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulation vessels in use.

[0292] The clamp body connection 2518 includes a longitudinal pin 2526 with a lock 2527 extending proximally from the clamp body 2522, while the clamp actuator connection 2520 includes a pin hole 2528 extending proximally through a portion of the distal end thereof. Pin hole 2528 is configured to slideably receive longitudinal pin 2526 such that longitudinal pin 2526 selectively slides between a proximal, locked position and a distal, unlocked position. Lock 2527 engages an actuator distal wall of clamp arm 2512 in the unlocked position to further inhibit distal translation so that clamp arm assembly 2514 remains at least somewhat movable without being removed from pin hole 2528. an alternative example, longitudinal pin 2526 may be removable from pin hole 2528 without lock 2527. In the present example, clamp arm assembly 2514 further includes a bottom block cover 2529 configured to cover the remaining clamp block 2524 facing inward. opposite direction of ultrasonic blade 350. Grip body 2522 and lower block cover 2529 each have respective ridges 2530 configured to overlap transversely for selective engagement between grip body 2522 and lower block cover 2529.

[0293] The modular multi-position coupling 2516 further includes a proximally extending tab 2532 configured to be received within a pair of tab holes 2534 that respectively correspond to the first wear position and the second wear position. With tab 2532 in upper tab hole 2534, a first of grip blocks 2524 faces ultrasonic blade 350 for use. With tab 2532 in lower tab hole 2534, a second of grip blocks 2524 faces ultrasonic blade 350 for use. In any case, tab holes 2534 with tab 2532 received therein are configured to inhibit rotation of clamp arm assembly 2514.

[0294] In use, with respect to Figures 78A to 78C, the operator distally removes the lower block cover 2529 from the grip body 2522 and also distally translates the grip body 2522 along a longitudinal axis from the first position of use by the disengagement of tab 2532 from tab hole 2534 so that clamping body 2522 with dual clamping blocks 2522 is freely rotatable. The operator then rotates the clamping body 2522 around the longitudinal axis with dual clamping blocks 2522 from the first use position towards the second use position to face the second clamping block 2524 towards the blade. 350. Once aligned, the operator translates the grip body 2522 proximally and engages the tab 2532 with the tab hole 2534 in the second use position and reattaches the lower block cover 2529 for another use.

V. Twenty-third Exemplary Ultrasonic Surgical Instrument with a Second Modular Multi-Position Coupling

[0295] Figures 79A to 81 illustrate a twenty-third exemplary surgical instrument 2610 that has a clamp arm actuator 2612, a clamp arm assembly 2614, and a second modular multi-position coupling 2616. With respect to Figures 79A and 79B, clamp arm assembly 2614 is movably connected to clamp arm actuator 2612 with modular multi-position coupling 2616, which includes a clamp body connection 2618 on clamp arm assembly 2614 and an actuator connection of grip 2620 on actuator of clamp arm 2612. Clamp arm assembly 2614 includes a clamp body 2622 and a clamp block 2624. The clamp blocks 2624 are connected to opposing upper and lower surfaces of clamp body 2622 in such that each clamping block 2624 respectively faces the ultrasonic blade 350 in a first use position or a second use position for receiving and clamping tissue therebetween. Selective movement of clamp arm actuator 2612 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2614 from an open position configured to receive tissue to a position closed set to hold the fabric. Furthermore, referring to Figures 80 and 81, the clamp arm assembly 2614 further includes a plurality of RF electrodes 2625 extending along each clamp block 2624. Each RF electrode 2625 is operatively connected to an RF energy source and configured to apply RF energy to tissue to affect tissue such as coagulating vessels in use.

[0296] The clamping body connection 2618 shown in more detail in Figures 79C and 79D includes a transverse pin 2626 that extends transversely through a central portion of the clamping body 2622, while the clamping actuator connection 2620 includes a hole pin 2630 extending transversely through a distal bifurcated portion thereof along a gap 2627. Pin hole 2630 is configured to rotatably receive cross pin 2626 so that cross pin 2626 and pin arm assembly grip 2614 selectively rotates between a first wear position and a second wear position. Alternatively or additionally, cross pin 2626 may be configured to slide transversely between a locked position and an unlocked position such that cross pin 2626 inhibits selective rotation of clamp arm assembly 2614 in the locked position and allows selective rotation of the clamp arm assembly 2614 in unlocked position.

[0297] The modular multi-position coupling 2616 additionally includes an upper lock cover 2628 and a lower lock cover 2629 removablely connected and configured to releasably hold the clamping arm assembly 2614 in the first position of use or in the second position of use. More particularly, the upper and lower locking covers 2628, 2629 engaged with the clamp arm actuator 2612 collectively inhibit selective rotation of the clamp arm assembly 2614 from the first wear portion or the second wear position for use in the surgical procedure. However, with the upper and lower latch covers 2628, 2629 disengaged from the clamp arm actuator 2612, the clamp arm assembly 2614 is selectively rotatable about the cross pin 2626. In this way, the operator rotates the clamp arm assembly. grip 2614 from the first gripping position in use when a first gripping block is used for the second gripping position such that a second gripping block faces the ultrasonic blade 350 for another usage.

[0298] In use, in relation to Figures 79A to 79E, the operator disengages the upper and lower lock covers 2628, 2629 from the distal bifurcated portion of the clamping arm actuator 2612 so that the clamping arm assembly is selectively rotatable about a transverse axis along cross pin 2626. The operator then rotates clamp arm assembly 2614 from the first use position to a second use position and engages the upper and lower latch covers 2628, 2629 to the clamp arm actuator 2612 for securing clamp arm assembly 2614 in the second use position for another use. To position the second gripping block 2624 in a position similar to the first gripping block 2624, the gripping body 2622 is U-shaped and symmetrical about the transverse axis shown in Figures 80 and 81.

W. Twenty-Fourth Ultrasonic Surgical Instrument Assembly with Modular Internal Release Coupling

[0299] Figures 82 to 89B illustrate a twenty-fourth exemplary surgical instrument 2710 that has a cable assembly 311, a drive shaft assembly 330, a clamping arm actuator 2712, a clamping arm assembly 2714, and a modular internal release coupling 2716. Referring to Figures 82 and 83, the clamp arm assembly 2714 is releasably connected to the clamp arm actuator 2712, with the modular internal release coupling 2716, which includes a body connection clamping block 2718 on clamping arm assembly 2714 and a clamping actuator connection 2720 on clamping arm actuator 2712. Clamping arm assembly 2714 includes a clamping body 2722 and clamping block 2724. 2724 is connected to clamping body 2722 such that clamping block 2724 faces ultrasonic blade 350 for receiving and clamping tissue therebetween. Selective movement of clamp arm actuator 2712 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2714 from an open position configured to receive tissue to a position closed set to hold the fabric. Although not shown with respect to surgical instrument 2710, clamp arm assembly 2714 may additionally include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulating vessels in use.

[0300] The modular internal release coupling 2716 of the present example is generally contained in the actuator of the clamping arm 2712 while connected to the clamping arm assembly 2714 to inhibit inadvertent removal of the removable clamping arm assembly 2714. Figure 95 represents a 2750 modular connection tool configured to access the 2716 modular internal release coupling for removal of the 2714 clamp arm assembly discussed below in more detail. In the present example, the modular connection tool 2750 has a handle body 2752 configured to be manipulated by the operator and a release key 2754 rigidly extending therefrom. An end portion of the release key 2754 is configured to manipulate at least a portion of the modular inner release coupling 2716 for removal. More particularly, in the present example, release key 2754 has an upper wedge 2756 and an opposing lower wedge 2756 configured to manipulate the clamp body connection 2718 for removal of clamp arm assembly 2714 from clamp actuator arm 2712. In addition, the 2750 Modular Connection Tool may also include an integrated circuit and/or memory, such as a programmable and electrically erasable read-only memory (EEPROM), configured to pair with the 2710 surgical instrument to verify proper installation of the 2714 clamp arm, 2750 modular connection tool authentication, and acquire diagnostic and output drive parameters. In another example, a variety of modular connection tools 2750 may be provided with the surgical instrument 2710 with each respective modular connection tool 2750 being configured for a specific use, such as use with an ultrasonic instrument and/or a bipolar instrument of RF.

[0301] With respect to Figures 85 to 89A, the clamping body connection 2718 includes a pair of upper and lower inclined projection tabs 2726 that extend proximally from the proximal portion of the clamping arm assembly 2714, while the The pinch actuator connection 2720 includes an elongated longitudinal opening 2727 having a pair of upper and lower shields 2728 that extend transversely across the upper and lower surfaces of the clamp arm actuator 2712. The upper and lower shields 2728 respectively receive the clamping tabs. upper and lower slanted projection 2726 against them to thereby removablely connect the clamp arm assembly 2714 to the clamp arm actuator 2712.

[0302] In use, in relation to Figures 89A and 89B, the operator distally inserts the release key 2754 through a proximal portion of the longitudinal opening 2727 so that the upper and lower wedges 2756 engage the upper inclined projection tabs respectively and lower 2726. Upper and lower wedges 2756 drive upper and lower angled projection flaps 2726 toward each other until each flap is transversely released from upper and lower shields 2728, respectively. Once free, the operator distally translates the clamp arm assembly 2714 relative to the clamp arm actuator 2712 from a distal portion of the longitudinal opening 2727. A replacement clamp arm assembly 2714 is positioned on the clamp arm actuator 2712 and snapped onto it to capture the replacement grip arm assembly 2714 for use.

X. Twenty-fifth Exemplary Ultrasonic Surgical Instrument with a Modular Helical Coupling

[0303] Figures 90A to 94C illustrate an exemplary twenty-fifth surgical instrument 2810 that has a clamping arm actuator 2812, a clamping arm assembly 2814, and a modular helical coupling 2816. With respect to Figures 90A and 90B, the clamp arm assembly 2814 is detachably connected to clamp arm actuator 2812 with modular helical coupling 2816, which includes a clamp body connection 2818 on the clamp arm assembly 2814 and a clamp actuator connection 2820 on the actuator of the clamp arm 2812. The clamp arm assembly 2814 includes a clamp body 2822 and a clamp block 2824. The clamp block 2824 is connected to the clamp body 2822 so that the clamp block 2824 faces the ultrasonic blade 350 to receive and hold the tissue between them. Selective movement of clamp arm actuator 2812 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2814 from an open position configured to receive tissue to a position closed set to hold the fabric. Although not shown with respect to surgical instrument 2810, clamp arm assembly 2814 may additionally include one or more electrodes configured to apply RF energy to tissue to affect the tissue, such as coagulating vessels in use.

[0304] With respect to Figures 90B and 91, the clamping body connection 2818 includes a helical connector 2826 extending proximally from a proximal portion thereof, while the clamping actuator connection 2820 includes a helical hole 2828 inside of a distal portion thereof. The helical hole 2828 is configured to rotatably receive the helical connector 2826 in order to removablely connect the clamping arm assembly 2814 to the clamping arm actuator 2812. The helical connector 2826 also includes a keyed end 2829 configured to be received into a keyed hole distal 2830 of helical hole 2828 for proper alignment while inserting helical connector 2826 into helical hole 2828. For removal, the operator rotates the clamp arm assembly 2814 relative to the clamp arm actuator 2812 until the clamp arm assembly 2814 is removed from it.

[0305] Figures 92 and 93 show a modular connection tool 2850 containing a replacement clamp arm assembly 2814. The modular connection tool 2850 includes a tool compartment 2852 that has a proximal access hole 2854. The keyed end 2829 is positioned in access hole 2854 so the operator is facing proximal access hole 2854 toward the 2812 clamp arm actuator for connecting the 2814 replacement clamp arm assembly to the 2812 clamp arm actuator.

[0306] In use, as shown in Figures 94A to 94C, the operator inserts the helical connector 2826 into the helical hole 2828 and rotates the modular connection tool 2850 containing the clamping arm assembly 2814 in relation to the clamping arm actuator 2812 Such rotation effectively withdraws clamp arm assembly 2814 through access hole 2854 until connected to clamp arm actuator 2812 and tool compartment 2852 for use. The used clamp arm assembly 2814 as well as the modular connection tool 2850 can thus be discarded.

Y. Twenty-sixth Exemplary Ultrasonic Surgical Instrument with a Modular Body Insertable Element Coupling

[0307] Figures 95 to 100 illustrate an exemplary twenty-sixth surgical instrument 2910 that has a drive shaft assembly 330, a clamping arm actuator 2912, a clamping arm assembly 2914, and a body insertable element coupling 2916 Clamp Arm Assembly. The 2914 Clamp Arm Assembly is releasably connected to the 2912 Clamp Arm Actuator with the 2916 Modular Insert Coupling, which includes a 2918 Clamp Body Fitting on the 2914 Clamping Arm Assembly and a 2914 Clamping Arm Assembly fitting. of the grip actuator 2920 on the actuator of the clamp arm 2912. The clamp arm assembly 2914 includes a clamp body 2922 and a clamp block 2924. The clamp block 2924 is connected to the clamp body 2922 so that the clamp clamp 2924 faces the ultrasonic blade 350 to receive and clamp tissue therebetween. Selective movement of clamp arm actuator 2912 relative to drive shaft assembly 330 from an open configuration to a closed configuration respectively moves clamp arm assembly 2914 from an open position configured to receive tissue to a position closed set to hold the fabric. Furthermore, the clamp arm assembly 2914 further includes an RF electrode 2925 that extends across the clamp block 2924. The RF electrode 2925 is operatively connected to an RF power source and configured to deliver energy of RF to the tissue to affect the tissue, such as coagulating the vessels in use.

[0308] The clamping body connection 2918 includes a lower longitudinal flange 2926, which extends longitudinally along a lower surface of the clamping body 2922, and a proximal opening 2927 that extends through a portion of the proximal end of the body clamp 2922. The clamp actuator connection 2920 includes an upper longitudinal slot 2928, which extends along an upper surface of the clamp arm actuator 2912, and a distal pin 2929, which extends distally from a distal portion of the clamp arm actuator 2912. The upper longitudinal slot 2928 and the proximal opening 2927 are configured to proximally and respectively receive the lower longitudinal flange 2926 and the distal pin 2929 to releasably capture the clamp arm assembly 2914 to the clamp arm actuator. clamp arm 2912. In one example, such releasable capture of clamp arm assembly 2914 is an annular slot 2930 around distal pin 2929 that receives a resiliently deflectable portion of clamp body 2922 for releasably connecting the arm assembly clamping arm 2914 to clamping arm actuator 2912.

[0309] Furthermore, in the present example, the distal pin 2929 and the proximal opening 2927 collectively define an electrical connection 2930. The distal pin 2929 is electrically connected to the RF power source and configured to transmit electrical signals through the proximal opening 2927 , which is electrically connected to the RF electrode 2925.

[0310] In use, the operator distally translates the clamping arm assembly 2914 with sufficient force to overcome the resilient capture of the deflectable portion of the clamping body 2922 in the annular slot 2930. The operator continues this distal translation until the clamping arm assembly Used grip 2914 is removed from the 2912 grip arm actuator. A 2914 replacement grip arm assembly is positioned on the 2912 grip arm actuator and snapped onto it to capture the 2914 replacement grip arm assembly for use.

[0311] An exemplary method of manufacturing a clamp arm assembly 2914 is shown in Figure 100. First, the clamp block 2924 is positioned against the RF electrode 2925. Second, the clamp body 2922 is overmolded , as in plastic, to the clamping block 2924 and the RF electrode 2925. The overlap molding continues until the lower longitudinal flange 2926 is further formed with the clamping body 2922. Thus, the overlap molded plastic forms the lower longitudinal flange 2926, clamp body 2922, and attach clamp block 2924 to RF electrode 2925 to manufacture clamp arm assembly 2914. Of course, alternative methods of manufacturing clamp arm assembly 2914 can be used. The invention, then, is not intended to be unnecessarily limited to the overlay molded clamp arm assembly 2914.

Z. Seventeenth Ultrasonic Surgical Instrument with Plane Compression and a Variety of Modular Couplings

[0312] Figures 101 and 102 illustrate a twenty-seventh exemplary surgical instrument 3010 that has a cable assembly 3002, a drive shaft assembly 3004, an ultrasonic blade 3006, a clamping arm actuator 3012, a clamping arm assembly clamp 3014, and a first modular side load coupling 3016. The clamp arm assembly 3014 is releasably connected to the clamp arm actuator 3012 with the modular side load coupling 3016, which includes a clamp body connection 3018 on the 3014 clamping arm assembly and a 3020 clamping actuator connection on the 3012 clamping arm actuator. The 3014 clamping arm assembly includes a clamping body 3022 and a clamping block 3024. The clamping block 3024 is connected to the clamping body 3022 so that the clamping block 3024 faces the ultrasonic blade 3006 for receiving and clamping tissue therebetween. Selective movement of clamp arm actuator 3012 relative to drive shaft assembly 3004 from an open configuration to a closed configuration respectively moves clamp arm assembly 3014 from an open position configured to receive tissue to a position closed set to hold the fabric. More particularly, the cable assembly 3002 is connected to the clamping arm actuator 3012 such that selective pivotal movement therebetween results in transverse motion between the clamping arm assembly 3014 and the ultrasonic blade 3006. Grip 3014 and ultrasonic blade 3006 thus remain in parallel planes throughout the movement for a generally equal compression distribution along relatively flat layers of fabric compressed therebetween during use. Although not shown with respect to surgical instrument 3010, clamp arm assembly 3014 may further include one or more electrodes configured to apply RF energy to tissue to affect tissue, such as coagulating vessels in use.

[0313] The clamping body connection 3018 includes a side opening 3026 that extends laterally through the proximal portion of the clamping arm assembly 3014, while the clamping actuator connection 3020 includes a dowel pin 3028 that extends transversely from a distal portion of the clamp arm actuator 3012. The side opening 3026 receives the dowel pin 3028 so that the clamp arm actuator 3014 releasably connects the clamp arm assembly 3014.

[0314] In use, the operator laterally removes the clamp body 3022 from the clamp arm actuator 3014 until the clamp body 3022 is clear of the pin pin 3028. A replacement clamp arm assembly 3014 is positioned on the clamp pin 3012 clamp arm actuator pin 3028 and connected to it to capture the 3014 replacement clamp arm assembly for use.

[0315] Figure 103 shows the 3012 grip actuator with a second 3116 modular side load coupling similar to the 3014 first modular side load coupling (see Figure 102). However, instead of the clamp arm assembly 3014 (see Figure 102) as discussed above, an alternative clamp arm assembly 3114 has a unitary construction of a clamp block 3124 with a clamp block connection 3118 configured to removable connection to clamp actuator connection 3020. More particularly, the clamp block connection includes a pair of side openings 3126 configured to receive dowel pin 3028 for removable connection, as discussed above. Furthermore, the operator can select a desirable side opening 3126 through which to position the dowel pin 3028 to adjust an operable length of the clamp arm assembly 3114 in use.

[0316] Figure 104 shows the 3012 pinch actuator with a third modular side load coupling 3216 similar to the first modular side load coupling 3014 (see Figure 102). However, instead of the clamping arm assembly 3014 (see Figure 102) as discussed above, another alternative clamping arm assembly 3214 has a clamping block 3124 at least partially surrounded by a clamping body 3222, as in a U-shaped cross-section. A clamping body connection 3218 has a transversely extending dowel pin 3226 with a rivet head 3227, while a clamping actuator connection 3220 has a side opening 3228 that extends laterally through of the same. Side opening 3228 is configured to receive dowel pin 3226 so that rivet head 3227 resiliently fits to releasably connect clamp arm actuator 3012 to clamp arm assembly 3214 for use.

[0317] Figure 105 shows the 3012 pinch actuator with a fourth modular side load coupling 3316 similar to the third modular side load coupling 3216 (see Figure 104). However, instead of a 3214 clamp arm assembly (see Figure 104) with a 3218 clamp body connection, a 3314 clamp arm assembly has an external clamp block 3324 laterally connected to an internal clamp body 3322. A clamp block connection 3318 has a dowel pin 3226 with a rivet head 3227 configured to releasably connect to the side opening 3328 for use.

[0318] With respect to Figure 106, additional alternatives of a clamping arm actuator 3412 and a clamping arm assembly 3414 cooperate with a modular transverse load coupling 3416 to releasably connect the clamping arm assembly 3414 to the actuator of the 3412 clamping arm. The 3416 modular cross load coupling, which includes a 3418 clamping body connection on the 3414 clamping arm assembly and a 3420 clamping actuator connection on the 3412 clamping arm actuator. The clamping block 3414 includes a clamping body 3422 and a clamping block 3424. The clamping block 3424 is connected to the clamping body 3422 so that the clamping block 3024 faces the ultrasonic blade 3006 to receive and clamp the tissue between the same. Selective movement of the clamp arm actuator 3012 relative to the cable assembly (not shown) from an open configuration to a closed configuration respectively moves the clamp arm assembly 3014 from an open position configured to receive tissue to a closed position configured to clamp the fabric.

[0319] The clamping body connection 3418 includes a U-shaped outer surface 3426 of the clamping body 3422, while the clamping actuator connection 3420 includes a longitudinal channel 3428 that extends along the clamping arm actuator 3412 Longitudinal channel 3428 transversely receives outer surface 3426 of clamping body 3422 with a friction fit so that clamping arm assembly 3414 releasably connects clamping arm actuator 3412.

[0320] In use, the operator transversely removes the clamping body 3422 from the longitudinal channel 3428 in the clamping arm actuator 3014 until the clamping body 3422 is free of the longitudinal channel 3428. A replacement clamping arm assembly 3414 is positioned transversely into the longitudinal channel 3428 of the 3012 clamping arm actuator and frictionally connected therein to capture the 3414 replacement clamping arm assembly for use.

AA. Alternative Modular Connection Tools and Transverse Grip Block Connection

[0321] Figures 107 and 108 respectively show alternative modular connection tools 3510, 3510' having handle bodies 3512, 3512'. Each handle body 3512, 3512' includes a storage bracket 3514, 3514' configured to receive and hold at least one replacement grip block 3516 and, in some examples, additional replacement components of a grip arm assembly. In addition, the 3510 Modular Connection Tool also includes an electrical connection 3518 configured to communicate with a controller (not shown) of a 3520 surgical instrument (see Figure 109) where the 3510 Modular Connection Tool is precisely positioned relative to to the 3510 Surgical Instrument (see Figure 109) to connect the 3516 Squeeze Block to a 3522 Squeeze Arm Actuator (see Figure 109).

[0322] The surgical instrument 3520 shown in Figure 109 includes a cable assembly 3524, a drive shaft assembly 3526, and an ultrasonic blade 3528 in addition to the grip actuator arm 3522. With the grip actuator arm 3522 in one open position relative to the ultrasonic blade 3528, the modular connection tool 3510 is inserted therebetween with a clamp block connection 3530 as shown in Figure 109 and Figure 111A. The operator selectively squeezes the 3510 Modular Connection Tool between the 3522 Pinch Actuator Arm and the 3528 Ultrasonic Blade as shown in Figure 110 in order to compress the 3530 Pinch Block connection against a 3532 Pinch Actuator connection as shown in Figure 110. Figure 111B for removable connection as a fourth modular block coupling 3533. In the present example, the clamping block connection 3530 has a T-shaped tab 3534 and the clamping actuator connection 3532 has a T-shaped opening 3536. The T-shaped opening 3536 is configured to receive the T-shaped tab 3534 which resiliently deflects for insertion and connection into the T-shaped opening 3536. For removal, the operator can move the T-shaped lid 3534 from the T-shaped opening 3536. T-shape 3536 or apply one of the modular connecting tools 3510, 3510' shown in Figures 107 and 108, to the grip block 3516 to remove the T-flap 3534 from the T-shape opening 3536.

IV. Exemplary Ultrasonic Surgical Instrument with Optimum Span Adjustment Mechanism

[0323] In some cases, it may be beneficial for an ultrasonic surgical instrument to provide the operator with an indication that a predetermined gap has been established between the ultrasonic blade 150 and the grip block 222 of the end actuator 12 during point coagulation. Improve the capability of ultrasonic surgical instruments such as surgical instrument 10, 301, 610, 710, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510, 1610, 1710, 1810, 1910, 2010, 2110, 22 10, 2310, 2410, 2510, 2610, 2710, 2810, 2910, 3010 discussed above, to form the predetermined span in end actuator 12 may be desirable when delivering ultrasonic and/or RF energy to a patient's tissue, how to accomplish a punctual clotting in a patient's tissue. Furthermore, it may be desirable for ultrasonic surgical instruments to be able to maintain the predetermined gap between ultrasonic blade 150 and gripping block 222 for an extended period. Providing this capability can enhance an operator's ability to move the grip block 222 towards the ultrasonic blade 150 to an intermediate position with the predetermined gap formed in the end actuator 12. This can be beneficial in ensuring that the end actuator 12 is not excessively driven into a closed position or unproductively driven towards the middle position but remains in an open position. Providing a surgical instrument that is capable of achieving and maintaining the gap and maintaining the predetermined gap in the end actuator 12 can prove the operator's ability to properly perform a point coagulation of a patient's tissue.

[0324] In ultrasonic surgical instruments, such as instrument 10, 301, 610, 710, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510, 1610, 1710, 1810, 1910, 2010, 2110, 2 210, 2310 , 2410, 2510, 2610, 2710, 2810, 2910, 3010 described above, it may be beneficial to include a spacer, whether a physical or electrical component, that is attached or removablely inserted into the cable assembly 110, clamp arm assembly 210, and/or drive shaft assembly 330 to thereby inhibit movement of clamp arm assembly 210 to maintain the predetermined gap in use and/or provide an indication to the operator that the predetermined gap has been formed in the end actuator 12. It may be desirable to provide the spacer in a manner that allows the operator to freely transition the spacer from a non-actuated position, where the spacer is not actively operative to define the predetermined gap in the end actuator 12, to a position actuated that the spacer is actively operable to form the predetermined gap between the ultrasonic blade and the gripping block 150 222 as per the ultrasonic surgical instrument 10, 301, 610, 710, 810, 910, 1010, 1110, 1210, 1310, 1410 , 1510, 1610, 1710, 1810, 1910, 2010, 2110, 2210, 2310, 2410, 2510, 2610, 2710, 2810, 2910, 3010 is engaged. This can provide the operator with the ability selectively to activate the spacer when the predetermined gap in the end actuator 12 is desired. It may be additionally desirable for the spacer to inhibit the ultrasonic blade 150 and clamping block 222 from the closed position. The following description provides several examples of an ultrasonic surgical instrument cooperatively configured to provide a predetermined span on an end actuator.

[0325] It should be understood that the spacers and thrust mechanisms described below can be readily incorporated into any of the various surgical instruments 10, 301, 610, 710, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510 , 1610, 1710, 1810, 1910, 2010, 2110, 2210, 2310, 2410, 2510, 2610, 2710, 2810, 2910, 3010 described above and in any of the various surgical procedures described in the various references described herein. Other suitable ways in which the surgical instruments described below, spacers and thrust mechanisms can be used will become apparent to those of ordinary skill in the art based on the teachings of the present invention. It should be understood that the handle body, drive shaft assembly, and clamp arm actuator may be configured and operable in accordance with those assemblies on the surgical instrument 10, 301, 610, 710, 810, 910, 1010, 1110, 1210, 1310, 1410, 1510, 1610, 1710, 1810, 1910, 2010, 2110, 2210, 2310, 2410, 2510, 2610, 2710, 2810, 2910, 3010 above except for the differences explicitly noted above. Similar reference numerals described above indicate similar features described below.

A. Exemplary Surgical Instrument with Spacer Mechanism i. Cover Spacer with Sliding Adjuster

[0326] Figure 112 shows an exemplary cover spacer 5050 and a surgical instrument 5000, which is similar in operation to the surgical instrument 3010 (see Figure 101) discussed above in more detail. Cover spacer 5050 includes an adjuster body 5052, a stopper 5054, and a pair of ports 5056, 5058. Adjuster body 5052 is configured to be selectively manipulated toward surgical instrument 5000 to move cover spacer 5050 from one position disengaged, as seen in Figure 112, to an engaged position, as shown in Figure 114A. Apertures 5056, 5058 are sized and configured to receive a clamping arm 5044 and an ultrasonic blade 5042 therein, respectively, 5050 when the cover spacer is in the engaged position.

[0327] With the cover spacer 5050 in the disengaged position, an end actuator 5040 of the surgical instrument 5000 is configured to move an ultrasonic blade 5042 and a clamping arm 5044 to a closed position. In other words, End Actuator 5040 is able to move to the closed position with Cover Spacer 5050 disengaged from Surgical Instrument 5000. However, with Cover Spacer 5050 in the engaged position, Clamp Arm 5044 and ultrasonic blade 5042 are received within the openings 5056, 5058 and the blocker 5054 is positioned between the ultrasonic blade and the clamping arm 5042 5044, as seen in Figure 114A. In this case, the blocker 5054 is configured to inhibit the actuation of the clamping arm actuator 5030 towards the handle body 5010 for a closed configuration by blocking the clamping arm 5044 from moving relative to the ultrasonic blade 5042 to the position closed.

[0328] In the present example, as seen in Figures 114A and 114B, the adjuster body 5052 is configured to be slidably translated proximally over a distal end 5001 of the surgical instrument 5000 to thus engage the cover spacer 5050 in the surgical instrument 5000. With shroud spacer 5050 in the engaged position, openings 5056, 5058 slidingly receive clamping arm 5044 and ultrasonic blade 5042, respectively, to position blocker 5054 between ultrasonic blade 5042 and clamping arm 5044 In this case, blocker 5054 is configured to inhibit clamp arm actuator 5030 from moving relative to cable body 5010 for the closed configuration. As best seen in Figure 113, the blocker 5054 is an intermediate wall that separates the openings 5056, 5058 and is configured to have a thickness 5055 that corresponds to a predetermined gap 5060 to be formed between the ultrasonic blade 5042 and the grip 5044. With the cover spacer 5050 in the engaged position, the cover spacer 5050 is configured to maintain the predetermined gap 5060 between the ultrasonic blade 5042 and the clamp arm 5044. Alternatively, the adjuster body 5052 is further configured to be translated slidably moved distally from distal end 5001 of surgical instrument 5000 to thereby disengage cover spacer 5050 from surgical instrument 5000. Cover spacer 5050 in the disengaged position, clamp arm 5044 and ultrasonic blade 5042 are not contained inside openings 5056, 5058 and the interlock 5054 is not positioned between end actuator 5040.

V. Formation of the Block Ceiling

[0329] Figures 115 to 119 illustrate an instrument 9000, similar to instrument 10, with similar elements having similar numbering. In some versions of the instrument 9000, the clamping block assembly 220 includes a block liner 9002 applied to an outer surface 9004 of the clamping block 222. The block liner 9002 can be formed using a hydrophobic type of material or "non-adherent" such as Teflon® or another polytetrafluoroethylene PTFE formula or any other type of material. When coupled with the grip block 222, the grip block 9002 has an outer block surface 9006 oriented to press against the tissue when the grip block 222 is secured to the ultrasonic blade 150.

[0330] The block liner 9002 can be applied to the clamping block 222 by pressing a blank block 9008 onto the clamping block 222 with sufficient pressure to couple the blank block 9008 to the clamping block 222. The coupling can be performed by means of insert molding or overmolding or any other molding mechanism or connection of the blank block 9008 to the clamping block 222.

[0331] As shown in Figures 115 to 119, in some versions, the blank block 9008 can be coupled to the clamping block 222 using a form 9010. The form 9010 includes a top portion 9012 that defines a first cavity 9014 and a bottom portion 9016 defining a second cavity 9018. In some versions of the form 9010, the first cavity 9014 is sized to receive a portion of the clamping block 222 and the second cavity is sized to receive the blank block 9008. portion of the clamping block 222 received within the first cavity 9014 may be an electrode 9020. The electrode 9020 of the clamping block 222 may include undercuts or dovetail features that may receive the blank block material 9008 when the block in blank 9008 is pressed together with electrode 9020. When top portion 9012 and top portion 9016 are combined and pressed at the same time in the direction of Arrow 9000A and 9000B (Figure 118), electrode 9020 into the first cavity 9014 and the 9008 blank block in the second 9018 cavity are pressed together to mold or mate the 9008 blank block to the 9020 electrode. The 9008 blank block material flows into any undercuts or notches or other features of the 9020 electrode to provide a robust connection between the same.

[0332] High definition features can be machined into the 9020 electrode to allow a robust connection between the 9008 blank block material and the 9020 electrode. As shown in Figure 119, the top portion 9012 can include one or more columns 9022 extending to be in abutting position with electrode 9020 when electrode 9020 is disposed within first cavity 9014. Columns 9022 cooperate with electrode 9020 to define one or more pockets 9024 for receiving blank block material 9008 therein when top portion 9012 is pressed together with bottom portion 9016. Similarly, electrode 9020 may include one or more undercuts 9026 for receiving blank block material 9008 therein when top portion 9012 is pressed along with the bottom portion 9016. The pockets 9024 and undercuts 9026 help to facilitate a robust connection between the 9008 block blank material and the 9020 electrode and allow the use of alternative or non-traditional block blank geometries 9008 to increase fixation and stability.

SAW. Sample Surgical Instrument with Multi-Point Alignment Features

[0333] Figures 120 to 123 illustrate an exemplary ultrasonic surgical instrument 10010. The instrument 10010 in the present example includes a first modular assembly 10100 and a second modular assembly 10200 that are configured to connect to form the instrument 10010 with an actuator end actuator 10012. End actuator 10012 comprises an ultrasonic blade 10150 and a gripping block 10222 of a gripping block assembly 10220. Selected portions of the second modular assembly 10200 can act with respect to the first modular assembly 10100 to drive the actuator endpoint 10012 from an open configuration to a closed configuration. The ability to selectively connect and disconnect the second modular assembly 10200 to the first modular assembly 10100 can provide reuse benefits of any modular assembly 10100, 10200. Additionally, moving components of the second modular assembly 10200 can be housed within the static components of the second assembly modular 10200, which may provide additional advantages, some of which are described herein while others will be apparent to a person skilled in the art in view of the teachings of the present invention.

[0334] The first modular assembly 10100 includes a handle assembly 10110, a body assembly 10130 extending distally from the handle assembly 10110, and an ultrasonic blade 10150 extending distally from the body assembly 10130. handle assembly 10110 includes a body 10112, a finger grip ring 10124, a pair of buttons 10126 distal to finger grip ring 10124, and an ultrasonic transducer assembly 30 housed in body 10112. The body assembly 10130 includes an outer sheath 10132 extending distally from the body 10112, and a waveguide 10140 extending into and through the outer sheath 10132. The waveguide 10140 can attach to the transducer assembly 30 and be supported by the outer sheath portions 10132 in the same or similar manner as described above with respect to the instrument 10. The ultrasonic blade 10150 may be unitarily connected 10140 to the waveguide, and also extend distally from the waveguide 10140. The waveguide 10140 is operable to connect to the ultrasonic transducer assembly 30 in order to provide acoustic communication between the ultrasonic blade 10150 and the transducer assembly 30 in the same or similar manner as described above with respect to the instrument 10.

[0335] Furthermore, in the same or similar manner as described above with respect to instrument 10, the end actuator 10012 is configurable to also deliver RF energy to tissue in addition to or instead of ultrasonic energy. Various ways in which the instrument 10010 can be configured and operable to provide electrosurgical modes of operation by ultrasound as well as by radiofrequency are described in various references cited in the present invention; however, other ways in which instrument 10010 can be configured and operable to provide ultrasound and radiofrequency electrosurgical modes of operation will be apparent to those skilled in the art in view of the teachings of the present invention.

[0336] The second modular assembly 10200 includes a clamping arm assembly 10210 and a clamping block assembly 10220. The clamping arm assembly 10210 and the clamping block assembly 10220 are sized to intertwine with each other in a such that rotation of one assembly 10210, 10220 causes rotation of the other assembly 10210, 10220. Clamp arm assembly 10210 includes an elongate arm 10212, a thumb grip ring 10214, and a cam boss 10216. Thumb Grip Assembly 10214 and Elongated Arm 10212 together provide a scissor grip type configuration in combination with Body 10112 and Finger Grip Ring 10124. Cam Bump 10216 interacts with Grip Block Assembly 10220 in order to rotate the clamp block assembly 10220 in response to rotation of the clamp arm assembly 10210.

[0337] The grip block assembly 10220 includes a grip block 10222 facing the ultrasonic blade 10150, a pair of tissue locks 10223 located adjacent to the ultrasonic blade 10150 and proximal to the grip block 10222, and the grip body 10224 defining a cam recess 10226. In some versions, the grip block assembly 10220 further includes one or more electrodes that is/are operable to apply RF electrosurgical energy to tissue. Various references in the present invention provide examples of how a grip block assembly can incorporate one or more electrodes that is/are operable to apply RF electrosurgical energy to tissue, while other examples of how the grip block assembly 10220 can incorporate a or more electrodes that is/are operable to deliver RF electrosurgical energy to tissue will be apparent to those skilled in the art in view of the teachings of the present invention.

[0338] The cam protrusion 10216 is sized to rotate within the cam recess 10226 and also be in contact with the cam recess 10226. The cam protrusion 10216 and the cam recess 10226 are located between the pivotal couplings 10218, 10228 , which respectively connect clamping arm assembly 10210 and clamping block assembly 10220 with body assembly 10130. In use, when an operator rotates elongated arm 10212 around pivot coupling 10218, cam boss 10216 rotates away from body assembly 10130 about pivot coupling 10218. Because cam boss 10216 is housed within cam recess 10226, upward movement of cam boss 10216 about pivot coupling 10218 causes the upward movement of cam recess 10226 about pivot coupling 10228. Upward movement of cam recess 10226 about pivot coupling 10228 rotates clamp arm 10224 so clamp block 10222 rotates toward ultrasonic blade 10150. Therefore, the closing of the elongated arm 10212 of the clamping arm assembly 10210 towards the handle assembly 10110 leads to the closing of the clamping block 10222 towards the ultrasonic blade 10150. the first modular assembly 10100 and the second modular assembly 10200 are connected, an operator can squeeze the thumb grip ring 10214 towards the body 10112 to thereby clamp the tissue between the grip block assembly 10220 and the ultrasonic blade 10150 to compress the tissue against the ultrasonic blade 10150. When the ultrasonic blade 10150 is activated during this compression, the grip block assembly 10220 and the ultrasonic blade 10150 cooperate to transect and/or seal the compressed tissue.

[0339] With reference to Figures 122 and 123, the instrument 10010 further comprises alignment features 10300. In the present example, the instrument 10010 includes multiple alignment features 10300. The alignment features 10300 are configured to connect with an inner surface 10302 of the outer sheath 10132 of the body assembly 10130 as shown in Figure 123. The alignment feature 10300 is further configured to contact the clamp body 10224 of the clamp arm assembly 10210. An additional alignment feature 10304 is located in the pivot coupling 10228 in the form of an adjustable spacer 10306. Spacer 10306 is configured to also contact clamp body 10224 and guide clamp body 10224 into contact with alignment features 10300 on the opposite side of clamp body 10224 Spacer 10306 can be adjusted to a desired position to thereby control the degree of impact or contact between grip body 10224 and alignment features 10300 on one side and grip body 10224 and spacer 10306 on the other side. Once the alignment feature 10304 in the form of spacer 10306 is in its desired position, it can be secured in place by spot welding or other fastening features as will be apparent to those commonly skilled in the art in view of the teachings of the present invention. In some instances where the 10010 instrument is configured for multi-use, the 10304 alignment feature is secured using a selective attachment feature such as a release button, thumb screw, or other structure that will be apparent to those skilled in the art. in view of the teachings of the present invention which allows to attach and remove portions of the clamp arm assembly 10210 and/or the clamp block assembly 10220.

[0340] With the configuration described above for the instrument 10010, the alignment features 10300, 10304 work together to provide the ability to control the grip displacement and the cross grip between the grip body 10224 and the blade 10150. In some versions, one or more alignment features 10300, 10304 are comprised of conductive material and are electrically connected to an RF source to provide RF energy to the grip body 10224 through contact of the grip body 10224 with the alignment features 10300 , 10304. In this way, the need to directly connect the clamping body 10224 is reduced or avoided entirely. On a version of the 10010 assembly tool that has the 10300, 10304 alignment features, the 10300 alignment features can be machined into the housing and mounted on the 10010 instrument based on the position of a hole for the 10150 blade.

[0341] The aforementioned components and functionalities of instrument 10010 are merely illustrative. Instrument 10010 can be configured in a variety of other ways, as will become apparent to those skilled in the art in view of the teachings of the present invention. By way of example only, at least part of instrument 10010 can be constructed and/or operable in accordance with at least some of the teachings of any one of the following documents, the disclosures of which are all incorporated by reference herein by reference: US Patent No. ° 5,322,055; US Patent No. 5,873,873; US Patent No. 5,980,510; US Patent No. 6,325,811; US Patent No. 6,783,524; in US Publication No. 2006/0079874; in US Publication No. 2007/0191713; in US Publication No. 2007/0282333; in US Publication No. 2008/0200940; US Patent No. 9,023,071; US Patent No. 8,461,744; US Patent No. 9,381,058; in US Publication No. 2012/0116265; US Patent No. 9,393,037; US Patent No. 9,095,367; and/or US Publication No. 2015/0080925, entitled "Alignment Features for Ultrasonic Surgical Instrument", published March 19, 2015, which disclosure is incorporated herein by reference.

VII. Exemplary combinations

[0342] The following examples refer to various non-exhaustive ways in which the teachings of the present invention can be combined or applied. It is to be understood that the examples below are not intended to restrict the coverage of any embodiments that may be presented at any time in this application or in subsequent filings to this application. No waiver of rights is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of the present invention may be arranged and applied in various other ways. It is also contemplated that some variations may omit certain features referred to in the examples below. Therefore, none of the aspects or features referred to below should be considered critical, unless explicitly stated otherwise at a later date by the inventors or a successor of interest to the inventors. If any embodiments are presented in the present application or in subsequent filings relating to this application that include additional features in addition to those referenced below, it is not presumed that those additional features have been added for any reason related to patentability.

Example 1

[0343] Surgical instrument characterized by the fact that it comprises: (a) a body assembly; (b) an ultrasonic waveguide extending through the body assembly; (c) an ultrasonic blade connected to a distal end of the ultrasonic waveguide; (d) a clamp arm assembly configured to move from an open position for receiving tissue to a closed position for clamping tissue relative to the ultrasonic blade, the clamp arm assembly including: (i) a body clamping, and (ii) clamping block connected to the clamping body facing the ultrasonic blade; (e) a clamp arm actuator operatively connected to the clamp arm assembly and configured to selectively move from a first position towards a second position relative to the body to thereby respectively direct the clamp arm assembly from the open position to closed position; and (f) a modular coupling operatively connected to the clamping arm assembly such that at least the clamping block of the clamping arm assembly is configured to be disconnected from the ultrasonic blade for replacement thereof.

Example 2

[0344] The surgical instrument of Example 1 in which the modular coupling includes a clamping actuator connection positioned on the clamping arm actuator and a clamping body connection positioned on the clamping body, in which the clamping actuator connection is configured to releasably connect to the clamping body connection so that the clamping arm assembly is removable from the clamping arm actuator for clamping arm assembly replacement.

Example 3

[0345] The surgical instrument of Example 2 in which the clamping actuator connection comprises an inclined projection tab or an aperture and the clamping body connection comprises the other of the inclined projection tab or the aperture, wherein the aperture is configured to removablely receive the inclined projection flap for removable connection between them.

Example 4

[0346] The surgical instrument of Example 3 in which the clamping body connection is the inclined projection tab extending from the clamping body and the clamping actuator connection is the opening extending through at least one portion of the clamp arm actuator.

Example 5

[0347] The surgical instrument of Example 2 in which the clamping actuator connection comprises one of a threaded pin or a threaded opening and the clamping body connection comprises the other of the threaded pin or the threaded opening, in which the opening threaded pin is configured to threadably receive the threaded pin for removable connection therebetween.

Example 6

[0348] The surgical instrument of Example 5 in which the clamping body connection is the threaded pin that extends from the clamping body and the clamping actuator connection is the threaded opening that extends through at least a portion of the actuator grip arm.

Example 7

[0349] The surgical instrument of Example 2 in which the grip actuator connection comprises one of a male luer lock or a female luer lock and the grip body connection comprises the other of a male luer lock or a female luer lock, wherein the female luer lock is configured to removablely receive the male luer lock for removable connection therebetween.

Example 8

[0350] The surgical instrument of Example 7 in which the clamping body connection is the male luer lock that extends from the clamping body and the clamping actuator connection is the female luer lock that extends through at least one portion of the clamp arm actuator.

Example 9

[0351] The surgical instrument of Example 2 in which the clamp actuator connection comprises one of a bayonet tab or bayonet slot and the clamp body connection comprises the other of the bayonet tab or bayonet slot, wherein the bayonet slot is configured to removablely receive the bayonet tab for removable connection therebetween.

Example 10

[0352] The surgical instrument of Example 9 in which the clamping body connection is the bayonet-type tab that extends from the clamping body and the clamping actuator connection is the bayonet-type slot that extends through at least a portion of the clamp arm actuator.

Example 11

[0353] The surgical instrument of Example 2 in which the grip actuator connection comprises a radial catch lock and the grip body connection comprises an outer surface of the grip body, where the radial catch lock is configured to move selectively from a latched configuration to a non-latched configuration, wherein the radial catch latch in the latched configuration is radially inwardly angled against the outer surface of the grip body for removable connection therebetween, and wherein the catch latch radial in the unlocked configuration is directed radially outward from the outer surface of the clamp body for removal of the clamp body therefrom.

Example 12

[0354] The surgical instrument of Example 2 in which the clamping actuator connection comprises one of a helical projection or a helical opening and the clamping body connection comprises the other of the helical projection or helical opening, in which the opening helical projection is configured to removablely receive the helical projection for removable connection between them.

Example 13

[0355] The surgical instrument of Example 12 in which the clamping body connection is the helical projection extending from the clamping body and the clamping actuator connection is the helical opening extending through at least a portion of the actuator grip arm.

Example 14

[0356] The surgical instrument of Example 2 in which the clamping actuator connection comprises one of a longitudinal flap or a longitudinal slot and the clamping body connection comprises the other of the longitudinal flap or the longitudinal slot, in which the slot longitudinal is configured to removablely receive the longitudinal flap for removable connection therebetween.

Example 15

[0357] The surgical instrument of Example 14 in which the clamping body connection is the longitudinal tab that extends from the clamping body and the clamping actuator connection is the longitudinal slot that extends through at least a portion of the actuator grip arm.

Example 16

[0358] The surgical instrument of Example 2 in which the clamp actuator connection comprises one of a pin tab or an opening and the clamp body connection comprises the other of a pin tab or the aperture, in which the aperture is configured to removablely receive the pin tab for removable connection therebetween.

Example 17

[0359] The surgical instrument of Example 16 in which the clamping actuator connection is the pin tab that extends from the clamping arm actuator and the clamping body connection is the opening that extends through at least one tightening body portion.

Example 18

[0360] The surgical instrument of Example 2 in which the modular connection additionally includes a lock configured to selectively move from a locked configuration to a non-locked configuration, in which the pinch actuator connection comprises one of a capture groove or a catching member and the connection of the clamping body comprises the other one of the catching groove or the catching member, wherein the catching groove is configured to releasably receive the catching member for removable connection therebetween with the latch in the latched configuration, and wherein the latch is configured to release the catching member in the non-latched configuration for removal from the catching groove.

Example 19

[0361] The surgical instrument of Example 18 in which the grip body connection is the capture member extending from the grip body and the grip actuator connection is the grip groove extending through at least one portion of the clamp arm actuator.

Example 20

[0362] The surgical instrument of Example 19 in which the locking latch is slidably connected to the grip arm actuator to selectively move from the locked configuration to the unlocked configuration.

Example 21

[0363] The surgical instrument of Example 1 in which the clamping arm assembly includes another clamping block, in which the modular coupling includes a clamping actuator connection positioned on the clamping arm actuator and a clamping body connection positioned on the clamping body, wherein the clamping actuator connection is configured to releasably connect the clamping body connection so that the clamping arm assembly is selectively movable relative to the clamping arm actuator of a first use position for a second use position, where one of the grip blocks faces the ultrasonic blade in the first use position for use, and where the other of the grip blocks faces the ultrasonic blade in the second position from use to use.

Example 22

[0364] The surgical instrument of example 21 in which the clamping arm assembly is configured to be selectively movable along a longitudinal axis and around the longitudinal axis from the first position of use to the second position of use.

Example 23

[0365] The surgical instrument of Example 21 in which the clamping arm assembly is configured to rotate around a longitudinal axis from the first position of use to the second position of use.

Example 24

[0366] The surgical instrument of Example 1 in which the clamping arm assembly further includes a clamping block cover, in which the modular coupling includes a clamping actuator connection positioned on the clamping block cover and a body connection clamp positioned on the clamp body, wherein the clamp block connection is configured to releasably connect to the clamp body connection such that the clamp block is releasably secured between the clamp block cover and the clamping body for clamping arm assembly replacement.

Example 25

[0367] The surgical instrument of Example 24 in which the clamping body of the clamping arm assembly extends from the clamping arm actuator with the clamping block and clamping cap being removable therefrom by disconnecting the clamping cap grip body grip.

Example 26

[0368] The surgical instrument of Example 1 in which the modular coupling includes a longitudinal tab and a longitudinal slit, wherein the clamping block has the longitudinal tab or the longitudinal slit positioned thereon and the clamping body has the other one of the longitudinal tab or the longitudinal slot positioned thereon, and wherein the longitudinal slot is configured to releasably receive the longitudinal tab for removable connection therebetween.

Example 27

[0369] The surgical instrument of Example 26 wherein the longitudinal flap extends from the grip block and the longitudinal slit extends through at least a portion of the grip body.

Example 28

[0370] The surgical instrument of Example 27 in which the clamping body of the clamping arm assembly extends from the clamping arm actuator with the clamping block being removable therefrom by disconnecting the clamping block from the clamping body .

Example 29

[0371] The surgical instrument of Example 1 in which the clamping arm assembly and the clamping arm actuator are configured to be selectively moved to a release configuration, in which the modular coupling is configured to release the clamping arm assembly tightening relative to the clamping arm actuator in the release configuration for clamping arm assembly replacement.

Example 30

[0372] The surgical instrument of any of Example 1 to Example 29 in which the clamp arm actuator is releasably connected to the body assembly.

Example 31

[0373] The surgical instrument of any of Example 1 to Example 30 further comprising a modular connection tool configured to engage at least a portion of the clamp arm assembly or at least a portion of the modular coupling to thereby connect or disconnect o at least a portion of the clamp arm assembly relative to the ultrasonic blade.

Example 32

[0374] The surgical instrument of any of Example 1 to Example 31 in which the clamp arm actuator additionally includes an RF electrode.

Example 33

[0375] The surgical instrument of any of Example 1 to Example 32 in which the modular coupling additionally includes an electronic connection configured to communicate electrical signals along it.

Example 34

[0376] A method of forming a surgical instrument comprising attaching a block liner and an electrode of a surgical instrument together to couple the block liner to the electrode.

Example 35

[0377] The method of Example 34 in which the tightening is performed using a form.

Example 36

[0378] The method of Example 34 in which the electrode includes an undercut for receiving a portion of the block lining therein.

Example 37

[0379] Surgical instrument characterized by the fact that it comprises: (a) a body assembly; (b) an ultrasonic waveguide extending through the body assembly; (c) an ultrasonic blade connected to a distal end of the ultrasonic waveguide; (d) a clamp arm assembly configured to move from an open position for receiving tissue to a closed position for clamping tissue relative to the ultrasonic blade, the clamp arm assembly including: (i) a body clamping, and (ii) clamping block connected to the clamping body facing the ultrasonic blade; (e) a clamp arm actuator operatively connected to the clamp arm assembly and configured to selectively move from a first position towards a second position relative to the body to thereby respectively direct the clamp arm assembly from the open position to closed position; (f) at least one alignment feature connected to the body assembly and in contact with the clamping arm assembly, wherein the at least one alignment feature is configured to control displacement of the gripper and the cross jaw between the gripper body grip and the ultrasonic blade.

Example 38

[0380] Surgical instrument characterized by the fact that it comprises: (a) a body assembly; (b) an ultrasonic waveguide extending through the body assembly; (c) an ultrasonic blade connected to a distal end of the ultrasonic waveguide; (d) a clamp arm assembly configured to move from an open position for receiving tissue to a closed position for clamping tissue relative to the ultrasonic blade, the clamp arm assembly including: (i) a body clamp, (ii) a clamp block connected to the clamp body facing the ultrasonic blade, and (iii) an electrode, wherein the electrode is operable to apply electrical energy to the tissue; (e) a clamp arm actuator operatively connected to the clamp arm assembly and configured to selectively move from a first position towards a second position relative to the body to thereby respectively direct the clamp arm assembly from the open position to closed position; and (f) a modular coupling operatively connected to the clamping arm assembly such that at least one of the clamping block or the clamping arm assembly electrode is configured to be modularly disconnected from the clamping block.

VIII. Several

[0381] Although several examples of the present invention describe two or more modular components being releasably coupled together, it should be understood that some variations may eliminate such modularity and removable couplings. For example, some versions of the instrument 10 may provide the first modular assembly 100 and the second modular assembly 200 as a single combined unit that does not allow the second modular assembly 200 to be removed from the first modular assembly 100. In some of these versions, the member of coupling 300 would be omitted with some other feature being used to provide permanent coupling between the first modular assembly 100 and the second modular assembly 200; or the coupling member 300 can be modified so that the coupling member 300 cannot be manipulated to decouple the second modular assembly 200 from the first modular assembly 100. Similarly, some versions of the instrument 301 can prevent the arm assembly from clamping arm 400 is removed from driveshaft assembly 330. For example, latch member 412 can be omitted and clamping arm assembly 400 can be permanently coupled to driveshaft assembly 330.

[0382] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US publication No. 2017/0105754, entitled "Surgical Instrument with Dual Mode End Effector and Side-Loaded Clamp Arm Assembly", filed on April 20, 2017, the disclosure of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Publication No. 2017/0105754 will be apparent to those of ordinary skill in the art.

[0383] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US Publication No. 2017/0105755, entitled "Surgical Instrument with Dual Mode End Effector and Compound Lever with Detents", published in April 20, 2017, which disclosure is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Publication No. 2017/0105755 will be apparent to those skilled in the art.

[0384] It should also be understood that the various teachings of the present invention can be readily combined with the various teachings of US publication No. 2017/0105788, entitled "Surgical Instrument with Dual Mode End Effector and Modular Clamp Arm Assembly", published in April 20, 2017, which disclosure is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Publication No. 2017/0105788 will be apparent to those skilled in the art.

[0385] The various instruments described above can be used in a variety of types of surgical procedures. By way of example only, the instruments described above may be used to perform liver resection, colorectal surgical procedures, gynecological surgical procedures, and/or various other types of surgical procedures. Various other types of procedures and ways in which the instruments described above can be used will become apparent to those skilled in the art in accordance with the teachings of the present invention.

[0386] It should be understood that any of the versions of the instruments described herein may include various other features in addition to or instead of those described above. By way of example only, any of the instruments described herein may also include one or more of the various features disclosed in any of the various references which are incorporated herein by reference. It should also be understood that the teachings of the present invention can be readily applied to any of the instruments described in any of the other references cited in the present invention, so that the teachings of the present invention can be readily combined with the teachings of any one. of references cited in the present invention in various ways. Other types of instruments into which the teachings of the present invention can be incorporated will be apparent to those skilled in the art.

[0387] In addition to those mentioned above, the teachings shown here can be readily combined with the teachings of US patent application No. [attorney document No. END8130USNP.0652942], entitled "Surgical Instrument with Removable Clamp Arm Assembly", filed on the same date as the present application, the disclosure of which is incorporated by reference into the present invention. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [Act.

[0388] In addition to those mentioned above, the teachings shown herein can be readily combined with the teachings of US patent application No. [Attorney document No. END8130USNP2.0652948], entitled "Surgical Instrument with Selectively Actuated Gap-Setting Features for End Effector", filed on the same date as this application, the disclosure of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application no. [attorney docket no. END8130USNP2.0652948] will be apparent to those skilled in the art in view of the teachings of the present invention.

[0389] In addition to those mentioned above, the teachings shown here can be readily combined with the teachings of US patent application serial number [attorney document number END8130USNP3.0652950], entitled "Surgical Instrument with Spot Coagulation Control Algorithm" , filed on the same date as the present application, the disclosure of which is incorporated herein by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US patent application no. [attorney doc no. END8130USNP3.0652950] will be apparent to those skilled in the art in view of the teachings of the present invention.

[0390] In addition to those mentioned above, the teachings shown herein can be readily combined with the teachings of US patent application serial number [attorney document number END8130USNP4.0652946], entitled "Surgical Instrument with Removable Portion to Facilitate Cleaning ", filed on the same date as the present application, the disclosure of which is incorporated into the present invention by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [Attorney's Document No. END8130USNP4.0652946] will be apparent to those skilled in the art in view of the teachings of the present invention.

[0391] It should also be understood that any ranges of values mentioned herein should be read as including the upper and lower limits of such ranges. For example, a range expressed as in the range "between approximately 2.5 cm and approximately 3.8 cm (approximately 1.0 inch and approximately 1.5 inches)" should be read as including approximately 2.5 cm and approximately 3, 8 cm (approximately 1.0 inch and approximately 1.5 inches), in addition to including the values between those upper and lower limits.

[0392] It should be understood that any patent, publication, or other disclosure material incorporated into the present invention by way of reference, in whole or in part, are incorporated into the present invention only to the extent that the incorporated material does not conflict with the definitions, statements or other disclosed material presented in this disclosure. Accordingly, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated by reference into the present invention. Any material, or portion thereof, incorporated herein by reference but which conflicts with existing definitions, statements, or other disclosure materials set forth herein, is incorporated herein only to the extent that there is no conflict between the material incorporated and existing disclosure material.

[0393] Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings of the present invention can be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, California, USA. Similarly, those skilled in the art will recognize that various teachings of the present invention can be easily combined with various teachings of U.S. Patent No. 6,783,524 entitled "Robotic Surgical Tool With Ultrasound Cauterizing And Cutting Instrument", issued Aug. 2004, the disclosure of which is incorporated herein by reference.

[0394] The versions described above can be designed to be discarded after a single use or can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembling the device, followed by cleaning or replacing specific parts, and subsequent reassembly. Specifically, some versions of the device can be disassembled into any number of particular parts, or device parts can be selectively replaced or removed in any combination. By cleaning and/or replacing specific parts, some versions of the device can be reassembled for subsequent use in an overhaul facility or by an operator immediately prior to a surgical procedure. Those skilled in the art will understand that refurbishing a device can use a variety of disassembly, cleaning/replacement, and reassembly techniques. Use of these techniques, as well as the resulting refurbished device, are all within the scope of this application.

[0395] Just as an example, the versions described here can be sterilized before and/or after a procedure. In a sterilization technique, the device is placed in a closed, sealed container, such as a plastic or TYVEK bag. The container and device can then be placed in a field of radiation, such as gamma radiation, X-rays or high-energy electrons, which can penetrate the container. Radiation can kill bacteria in the device and container. The sterilized device can then be stored in a sterile container for later use. The device may also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.

[0396] Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described in the present invention can be carried out through suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and others will be apparent to those skilled in the art. For example, the examples, modalities, geometry, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not binding. Consequently, the scope of the present invention is to be considered in accordance with the terms of the embodiments and it is understood that the same is not limited to the details of structure and operation shown and described in the specification and drawings.

Claims (3)

1. Surgical instrument (10), comprising: a body assembly (100); an ultrasonic waveguide (140) extending through the body assembly (100); an ultrasonic blade (150) connected to a distal end of the ultrasonic waveguide (140); a clamp arm assembly (614) configured to move from an open position for receiving tissue toward a closed position for clamping tissue relative to the ultrasonic blade (150), wherein the clamp arm assembly (614) includes: a clamping body (622), and a clamping block (624) connected to the clamping body (622) facing the ultrasonic blade (150); a clamp arm actuator (612) operatively connected to the clamp arm assembly (614) and configured to selectively move from a first position to a second position relative to the body (100) to thereby respectively direct the clamping arm assembly (614) from the open position to the closed position; and characterized in that it further comprises a modular coupling (616) operatively connected to the clamping arm assembly (614) such that at least the clamping block (624) of the clamping arm assembly (614) is configured to be disconnected with respect to the ultrasonic blade (150) for replacement thereof, and wherein the clamp arm assembly (614) and clamp arm actuator (612) are configured to be selectively moved to a release configuration, wherein the modular coupling (616) is configured to release the clamp arm assembly (614) from the clamp arm actuator (612) in the release configuration for clamp arm assembly replacement (614). 2. Surgical instrument (10), according to claim 1, characterized in that the modular coupling (616) additionally includes an electronic connection configured to communicate electrical signals along it. 3. Surgical instrument (10), according to claim 1, characterized in that the clamping arm assembly (614) further comprises an electrode, wherein the electrode is operable to apply electrical energy to a tissue, and in that the modular coupling is operatively connected to the clamp arm assembly (614) such that at least one of the clamp block (624) or clamp arm assembly electrode (614) is configured to be modularly disconnected from the block clamp (624).