Method of use of an ultrasonic clamp and coagulation apparatus with tissue support surface

A surgical method for increasing the size of a tissue weld in compressed tissue comprising the steps of:

• a) providing an end effector for an ultrasonic surgical instrument, said end effector including;
• i) an ultrasonic blade having a proximal and a distal and;
• ii) a clamping mechanism having a clamping surface positioned opposite said ultrasonic blade, wherein said clamping mechanism is adapted to clamp tissue against said ultrasonic blade;
• iii) a first support surface positioned laterally on a first side of said ultrasonic blade, said first support surface being ultrasonically isolated from said blade and positioned opposite at least a portion of said clamping surface, said first support surface having a support surface angle relative to the longitudinal axis of said ultrasonic blade;
• and
• iv) a second support surface positioned laterally on a second side of said ultrasonic blade, said second support surface being ultrasonically isolated from said blade and positioned opposite at least a portion of said clamping surface, said second support surface having generally the same support surface angle as said first support surface;
• b) moving said clamping mechanism to a first position to clamp tissue between said clamping surface and said first and second support surface said clamped tissue spaced away from said ultrasonic blade and having an uncompressed tissue region positioned opposite said blade;
• c) moving said clamping mechanism to a second position to clamp the uncompressed tissue region against said ultrasonic blade to create a substantially continuous pressure region within the tissue clamped within said end effector;
• and
• d) applying ultrasonic energy to the clamped tissue in contact with said ultrasonic blade to create a tissue weld, the tissue weld spreading away from the clamped tissue in contact with said ultrasonic blade and into clamped tissue adjacent to and spaced away from said ultrasonic blade.

A surgical method for increasing the size of a tissue weld in compressed tissue, comprising the steps of:

• a) providing an end effector for an ultrasonic surgical instrument, said end effector including;
• i) an ultrasonic blade having a proximal and a distal end;
• ii) a clamping mechanism having a clamping surface positioned opposite said ultrasonic blade, wherein said clamping mechanism is adapted to clamp tissue against said ultrasonic blade;
• iii) a first support surface positioned laterally on a first side of said ultrasonic blade, said first support surface being ultrasonically isolated from said blade and positioned opposite at least a portion of said clamping surface, said first support surface having a support surface angle relative to the longitudinal axis of said ultrasonic blade;
• and
• iv) a second support surface positioned laterally on a second side of said ultrasonic blade, said second support surface being ultrasonically isolated from said blade and positioned opposite at least a portion of said clamping surface, said second support surface having generally the same support surface angle as said first support surface;
• b) moving said clamping mechanism to a first position to clamp tissue between said clamping surface and said first and second support surfaces, the clamped tissue spaced away from said ultrasonic blade and the tissue having an uncompressed tissue region opposite said blade,
• c) activating said ultrasonic blade;
• and
• d) moving said clamping mechanism to a second position to clamp tissue against said active ultrasonic blade to create a tissue weld within the substantially continuous pressure region.