# US 12,213,717 B2 · Combination ultrasonic and electrosurgical instrument having electrical circuits with shared return path > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,213,717 B2 - Document ID: US12213717B2 - Status: Granted - Kind: B2 - Application number: 17/337,885 - Filed: 2021-06-03 - Published: 2021-11-18 - Granted: 2025-02-04 - Earliest claimed: 2017-05-22 - Assignees: Cilag GmbH International - Applicants: Cilag GmbH International - Inventors: Stephen M. Leuck; Eitan T. Wiener - Web page: https://patentgrep.com/patent/US12213717B2 ## CPC - A61B 18/00: Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body (eye surgery A61F9/007; ear surgery A61F11/00) - A61B 17/320092: {with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw} - A61B 18/1206: {Generators therefor} - A61B 18/1445: {at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod} - A61B 2017/00017: {Electrical control of surgical instruments} - A61B 2017/00137: {Details of operation mode} - A61B 2017/00738: {part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon} - A61B 2017/00929: {isolating electrical current} - A61B 2017/2929: {with a head rotatable about the longitudinal axis of the shaft} - A61B 2017/2932: {Transmission of forces to jaw members} - A61B 2017/320072: {Working tips with special features, e.g. extending parts} - A61B 2017/320074: {blade} - A61B 2017/320075: {single edge blade, e.g. for cutting} - A61B 2017/320078: {Tissue manipulating surface} - A61B 2017/320088: {with acoustic insulation, e.g. elements for damping vibrations between horn and surrounding sheath} - A61B 2017/320094: {additional movable means performing clamping operation} - A61B 2017/320095: {with sealing or cauterizing means} - A61B 2018/00077: {high, i.e. electrically conducting} - A61B 2018/00083: {low, i.e. electrically insulating} - A61B 2018/00136: {with polymer} - A61B 2018/00178: {Electrical connectors} - A61B 2018/00577: {Ablation} - A61B 2018/00607: {Coagulation and cutting with the same instrument} - A61B 2018/0063: {Sealing} - A61B 2018/00988: {Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter} - A61B 2018/00994: {combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound} - A61B 2018/126: {bipolar} - A61B 2018/142: {at least partly surrounding the target, e.g. concave, curved or in the form of a cave} - A61B 2018/1452: {including means for cutting (A61B2018/146 takes precedence)} - A61B 2018/1457: {having opposing blades cutting tissue grasped by the jaws, i.e. combined scissors and pliers} - A61B 2090/0803: {Counting the number of times an instrument is used} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A surgical instrument includes a shaft, an ultrasonic transducer, a waveguide acoustically coupled with the ultrasonic transducer and extending distally through the shaft, and an end effector arranged at a distal end of the shaft. The end effector includes an ultrasonic blade acoustically coupled with the waveguide, a clamp arm movable relative to the ultrasonic blade for clamping tissue, and an RF electrode operable to seal tissue with RF energy. The ultrasonic transducer is operable to drive the waveguide and the ultrasonic blade with ultrasonic energy. The surgical instrument further includes an ultrasonic electrical circuit operable to energize the ultrasonic transducer, and an RF electrical circuit operable to deliver RF energy to the RF electrode. A return path of the ultrasonic electrical circuit and a return path of the RF electrical circuit pass through a shared electrically conductive element. ## Claims ### Claim 1 A surgical instrument, comprising: (a) a shaft assembly including an acoustic waveguide; (b) an ultrasonic transducer, comprising: (i) a piezoelectric element, and (ii) a transducer electrode operatively coupled to the piezoelectric element; (c) an end effector distally extending from the shaft assembly including: (i) an ultrasonic blade acoustically coupled with the acoustic waveguide, wherein the ultrasonic transducer is operable to drive the acoustic waveguide and the ultrasonic blade with ultrasonic energy, (ii) at least one RF electrode configured to seal tissue with RF energy, and (iii) a clamp arm movable relative to the ultrasonic blade for clamping tissue therebetween; (d) an ultrasonic electrical circuit configured to energize the ultrasonic transducer, wherein the ultrasonic electrical circuit includes an active ultrasonic path and a return ultrasonic path; (e) an RF electrical circuit operable to deliver RF energy to the at least one RF electrode, wherein the RF electrical circuit includes an active RF path and a return RF path; and (f) an actuation assembly, including: (i) an actuation member operatively connected to the clamp arm and configured to selectively direct movement of the clamp arm, and (ii) a force-limiting assembly operatively connected between the actuation member and the clamp arm, wherein the force-limiting assembly includes a retainer, wherein the retainer includes a retaining member and a sleeve, wherein the retaining member is adjustably secured along the sleeve for adjusting a predetermined force threshold, wherein each of the return ultrasonic path and the return RF path pass through the transducer electrode. ### Claim 2 (depends on 1) The surgical instrument of claim 1, wherein each of the return ultrasonic path and the return RF path pass through an electrically conductive element. ### Claim 3 (depends on 2) The surgical instrument of claim 2, wherein each of the return ultrasonic path and the return RF path pass through the ultrasonic transducer along a common electrical return path portion. ### Claim 4 (depends on 1) The surgical instrument of claim 1, wherein each of the return ultrasonic path and the return RF path pass through the ultrasonic transducer along a common electrical return path portion. ### Claim 5 (depends on 1) The surgical instrument of claim 1, further comprising a return transducer lead extending from the transducer electrode, wherein each of the return ultrasonic path and the return RF path pass through the return transducer lead. ### Claim 6 (depends on 1) The surgical instrument of claim 1, wherein the ultrasonic transducer further includes: (i) a proximal end element, and (ii) a distal end element, wherein the piezoelectric element is disposed between the proximal and distal end elements. ### Claim 7 (depends on 1) The surgical instrument of claim 1, wherein the end effector further includes a clamp arm movable relative to the ultrasonic blade for clamping tissue therebetween. ### Claim 8 (depends on 7) The surgical instrument of claim 7, wherein the shaft assembly includes a first shaft portion operatively connected to the clamp arm and a second shaft portion, and wherein the second shaft portion is selectively movable relative to the first shaft portion to thereby selectively move the clamp arm relative to the ultrasonic blade, wherein the clamp arm includes a first pin, a second pin, and a gap defined therebetween, wherein the first and second pins are connected to the first shaft portion of the shaft assembly, and wherein the ultrasonic blade is configured to be received within the gap. ### Claim 9 (depends on 7) The surgical instrument of claim 7, wherein the shaft assembly further includes an elongate member pivotally connected to the clamp arm, wherein the actuation assembly further includes a yoke operatively connected to the actuation member and configured to move in response to movement of the actuation member. ### Claim 10 A surgical instrument, comprising: (a) a shaft assembly including an acoustic waveguide, wherein the shaft assembly has a first shaft portion and a second shaft portion and the first shaft portion is selectively movable relative to the second shaft portion, wherein the first shaft portion includes an inner tube and the second shaft portion includes an outer tube, wherein the inner tube extends along a longitudinal axis, wherein a distal end of the inner tube is offset radially outwardly relative to the longitudinal axis; and (b) an end effector distally extending form the shaft assembly including: (i) an ultrasonic blade acoustically coupled with the acoustic waveguide, and (ii) a clamp arm movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the second shaft portion is selectively movable relative to the first shaft portion to thereby selectively move the clamp arm relative to the ultrasonic blade, wherein the clamp arm includes: (A) a first pin, (B) a second pin, (C) a gap defined between the first and second pins, wherein the first and second pins are connected to the first shaft portion of the shaft assembly, and wherein the ultrasonic blade is configured to be received within the gap. ### Claim 11 (depends on 10) The surgical instrument of claim 10, wherein the first, the second pin, and the gap therebetween extend along a first pivot axis. ### Claim 12 (depends on 11) The surgical instrument of claim 11, wherein the clamp arm includes a first protrusion and a second protrusion connected to the second shaft portion, wherein the first and second protrusion extend along a second pivot axis. ### Claim 13 (depends on 10) The surgical instrument of claim 10, wherein the inner tube includes a distal end and a proximal portion, wherein the clamp arm is spaced further away from the shaft assembly than if the distal end of the inner tube were flush with the proximal portion of the inner tube. ### Claim 14 (depends on 13) The surgical instrument of claim 13, wherein the distal end of the inner tube provides additional lateral clearance between the ultrasonic blade and the first pin. ### Claim 15 (depends on 14) The surgical instrument of claim 14, wherein the additional lateral clearance between the ultrasonic blade and first pin is configured to inhibit contact between the ultrasonic blade and first pin when the ultrasonic blade deflects laterally during back-cutting operations. ### Claim 16 A surgical instrument, comprising: (a) a shaft assembly including an acoustic waveguide and an elongate member; (b) an end effector distally extending form the shaft assembly including: (i) an ultrasonic blade acoustically coupled with the acoustic waveguide, and (ii) a clamp arm movable relative to the ultrasonic blade for clamping tissue therebetween, wherein the clamp arm is pivotally connected to the elongate member; and (c) an actuation assembly including: (i) an actuation member operatively connected to the clamp arm and configured to selectively direct movement of the clamp arm, and (ii) a force-limiting assembly operatively connected between the actuation member and the clamp arm, wherein the force-limiting assembly is configured to limit a clamp force of the clamp arm to a predetermined force threshold, wherein the force-limiting assembly includes a retainer secured relative to the elongate member, wherein the retainer includes a sleeve that has at least one leg radially received within the elongate member to secure the retainer to the elongate member. ### Claim 17 (depends on 16) The surgical instrument of claim 16, wherein the actuation assembly further includes a yoke operatively connected to the actuation member and configured to move in response to movement of the actuation member. ### Claim 18 (depends on 17) The surgical instrument of claim 17, wherein the force-limiting assembly further includes a resilient feature captured between the yoke and the retainer, wherein the resilient feature is configured to transmit force from the yoke to the retainer up to the predetermined force threshold such that the yoke and the retainer move together, and wherein the resilient feature is configured to compress at the predetermined force threshold such that the yoke moves relative to the retainer for limiting force at the clamp arm. ### Claim 19 (depends on 18) The surgical instrument of claim 18, wherein the resilient feature includes a spring stack, and wherein the retainer includes a retaining member secured to the sleeve, wherein the spring stack is received on the sleeve and captured between the retaining member and the yoke. ### Claim 20 (depends on 19) The surgical instrument of claim 19, wherein the retaining member is adjustably secured along the sleeve for adjusting a predetermined force threshold.