JP7091355B2 - 取り外し可能なクランプアームアセンブリを有する外科用器具 - Google Patents
取り外し可能なクランプアームアセンブリを有する外科用器具 Download PDFInfo
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- JP7091355B2 JP7091355B2 JP2019547241A JP2019547241A JP7091355B2 JP 7091355 B2 JP7091355 B2 JP 7091355B2 JP 2019547241 A JP2019547241 A JP 2019547241A JP 2019547241 A JP2019547241 A JP 2019547241A JP 7091355 B2 JP7091355 B2 JP 7091355B2
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Description
本出願は、(1)その開示内容が参照により本明細書に組み込まれる、2016年11月16日出願の米国特許仮出願第62/422,698号、名称「Ultrasonic Surgical Shears with Contained Compound Lever Clamp Arm Actuator」、(2)その開示内容が参照により本明細書に組み込まれる、2017年5月19日出願の米国特許仮出願第62/508,720号、名称「Ultrasonic and Electrosurgical Instrument with Replaceable End Effector Features」、及び(3)その開示内容が参照により本明細書に組み込まれる、2017年6月14日出願の米国特許仮出願第62/519,482号、名称「Ultrasonic and Electrosurgical Instrument with Removable Features」の優先権を主張するものである。
図1A~図2及び図13A~図13Cは、第1の例示的な超音波外科用器具(10)を示す。器具(10)の少なくとも一部は、米国特許第5,322,055号、米国特許第5,873,873号、米国特許第5,980,510号、米国特許第6,325,811号、米国特許第6,773,444号、米国特許第6,783,524号、米国特許出願公開第2006/0079874号、米国特許出願公開第2007/0191713号、米国特許出願公開第2007/0282333号、米国特許出願公開第2008/0200940号、米国特許第8,623,027号、米国特許第9,023,071号、米国特許第8,461,744号、米国特許第9,381,058号、米国特許出願公開第2012/0116265号、米国特許第9,393,037号、米国特許第9,095,367号、米国特許出願第61/410,603号、及び/又は米国特許出願公開第2015/0080924号の教示の少なくとも一部に従って構成されかつ動作可能となり得る。前述の特許、特許公開、及び特許出願のそれぞれの開示は、参照により本明細書に組み込まれる。追加的にあるいは代替的に、器具(10)の少なくとも一部は、その開示内容が参照により本明細書に組み込まれる、2017年4月20日発行の米国特許出願公開第2017/0105755号、名称「Surgical Instrument with Dual Mode End Effector and Compound Lever with Detents」、及び/又は、その開示内容が参照により本明細書に組み込まれる、2016年7月18日出願の米国特許出願第62/363,411号、名称「Surgical Instrument with Dual Mode End Effector」の教示の少なくとも一部に従って構成されかつ動作可能となり得る。
図17~図18は、第2の例示的な超音波外科用器具(301)を示す。以下に特に記載しない限り、この例の器具(301)は、上述した器具(10)と同様に構成されかつ動作可能となり得る。器具(301)の特定の詳細はしたがって、以下の説明からは省略されることになり、そのような詳細は、器具(10)の説明において既に上述されていることが理解される。
上述の外科用器具(10、301)は、それぞれのモジュール式アセンブリ及び他の取り外し可能に接続された特徴部に関する関連する接続部を含めて、様々な連結機構を有する。そのような連結機構は、外科手技の前、最中、又は後の多くの状況において有用となり得るが、一例では、外科用器具(10、301)の残りの部分から外科用器具の交換可能な部分を取り外すことによって、交換可能な部分の交換及び外科用器具(10、301)の残りの部分の再使用を可能にする。そのような交換可能な部分の1つがクランプパッド(222、432)であり、クランプパッドは、使用により摩耗する傾向があり、また所望に応じて操作者によって交換され得る。しかしながら、エンドエフェクタ(12)の更なる交換可能な部分には、限定するものではないが、クランプアームアセンブリ(210、400)、及び上記で簡潔に議論した電極(図示せず)などの電極アセンブリが挙げられる。
図24~図30Fは、ハンドルアセンブリ(311)と、シャフトアセンブリ(330)と、クランプアームアクチュエータ(512)と、クランプアームアセンブリ(514)と、第1のモジュール式整合解除連結部(516)とを有する第3の例示的な外科用器具(510)を示す。図24~図25に関して言えば、クランプアームアセンブリ(514)は、モジュール式整合解除連結部(516)を有するクランプアームアクチュエータ(512)に取り外し可能に接続され、モジュール式整合解除連結部は、クランプアームアセンブリ(514)から延在するクランプ本体接続部(518)と、クランプアームアクチュエータ(512)から延在するクランプアクチュエータ接続部(520)とを含む。クランプアームアセンブリ(514)は、クランプ本体(522)とクランプパッド(524)とを含む。クランプパッド(524)は、クランプパッド(524)が超音波ブレード(350)に面してそれらの間に組織を受容及びクランプするように、クランプ本体(522)に接続される。開放構成から閉鎖構成へとハンドルアセンブリ(311)に対してクランプアームアクチュエータ(512)が選択的に移動することは、組織を受容するように構成された開放位置から、組織をクランプするように構成された閉鎖位置へと、それぞれにクランプアームアセンブリ(514)を移動させることになる。本例では、クランプアームアクチュエータ(512)が解除構成へと選択的に移動することにより、クランプアクチュエータ接続部(520)はクランプ本体接続部(518)に対して整列し、クランプアームアセンブリ(514)の取り外し及び交換のためにクランプアームアセンブリ(514)をクランプアームアクチュエータ(512)から分離する。外科用器具(510)に関して示されていないが、クランプアームアセンブリ(514)は、使用中に血管を凝固させることなど、組織に影響を与えるためにRFエネルギーを組織に送達するように構成された1つ又は2つ以上の電極を更に含んでもよい。
図36~図38は、器具(10)と同様の第4の例示的な外科用器具(9100)を示し、同様の要素は同様の参照符号を有している。図16Bに示すように、エンドエフェクタ(12)のいくつかの変形例では、カム突出部(216)は、アーム(224)に直接接続するように細長アーム(212)から遠位に延在する。図36~図38に示されるように、器具(9100)のいくつかの変形例では、突出部(216)ではなく、器具(9100)が、それらの間に配設されたリンク(9106)を使用してクランプアーム(9104)に接続された作動アーム(9102)を含んでもよい。リンク(9106)は第1の端部(9108)から第2の端部(9110)へと延在する。第1の端部(9108)は、枢動連結部(218)の周りで枢動するように構成された作動アーム(9102)にピン留めされるか、ないしは別の方法で回転可能に取り付けられる。リンク(9106)の第2の端部(9110)は、枢動連結部(228)の周りで枢動するクランプアーム(9104)にピン留めされるか、ないしは別の方法で回転可能に取り付けられる。
図1A~図1B及び図16A~図16Bに示されるように、操作者が、枢動連結部(218)を中心として細長アーム(212)を遠位外部シース(230)に向かって回転させると、カム突出部(216)は、枢動連結部(218)の周りで遠位外部シース(230)から離れる方向に回転する。細長アーム(212)と枢動連結部(218)との間の公差が厳しいことにより、細長アーム(212)の移動は、枢動連結部(218)の軸線の周りでの回転のみに制限される。
以下の実施例は、本明細書の教示を組み合わせるか又は適用することができる、様々な非網羅的な方法に関する。以下の実施例は、本出願における又は本出願の後の出願におけるどの時点でも提示され得る、いずれの特許請求の範囲の適用範囲をも限定することを目的としたものではないと理解されよう。一切の棄権を意図するものではない。以下の実施例は、単なる例示の目的で与えられるものにすぎない。本明細書の様々な教示は、他の多くの方法で構成及び適用が可能であると考えられる。また、いくつかの変形では、以下の実施例において言及される特定の特徴を省略してよいことも考えられる。したがって、本発明者又は本発明者の利益の継承者により、後日、そうである旨が明示的に示されない限り、以下に言及される態様又は特徴のいずれも重要なものとして見なされるべきではない。以下に言及される特徴以外の更なる特徴を含むいかなる特許請求の範囲が本出願において、又は本出願に関連する後の出願において示される場合、それらの更なる特徴は、特許性に関連するいかなる理由によっても追加されたものとして仮定されるべきではない。
外科用器具であって、(a)第1のモジュール式アセンブリであって、(i)本体、(ii)超音波トランスデューサと連結するように構成された超音波導波管、(iii)超音波導波管の遠位端に接続された超音波ブレード、及び(iv)本体と移動可能に連結するように構成された連結部材を含む第1のモジュール式アセンブリと、(b)第2のモジュール式アセンブリであって、(i)第1の枢動連結部を含むクランプアームアセンブリ、(ii)第2の枢動連結部を含むクランプパッドアセンブリ、並びに(iii)連結部材を介して第1のモジュール式アセンブリの本体に選択的に連結するように構成された遠位外部シースであって、遠位外部シースが、超音波導波管の一部分を収容するように構成された内面を含み、遠位外部シースの内面が、第1の枢動連結部及び第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。
遠位外部シースがU字型本体を含む、実施例1に記載の外科用器具。
本体は凹部を含み、遠位外部シースが、凹部内に挿入されるように構成された近位突出部を含む、実施例1又は2のいずれか1つ又は2つ以上に記載の外科用器具。
近位突出部が側方突出部を含み、連結部材が、側方突出部と嵌合して遠位外部シースを第1のモジュール式アセンブリの本体と連結するように構成されている、実施例3に記載の外科用器具。
連結部材が、ロックアセンブリを画定する弾性アームを含み、ロックアセンブリが、側方突出部と連結するように構成されている、実施例4に記載の外科用器具。
連結部材が本体と枢動可能に連結されている、実施例1~5のいずれか1つ又は2つ以上に記載の外科用器具。
クランプアームアセンブリがカム突出部を含む、実施例1~6のいずれか1つ又は2つ以上に記載の外科用器具。
クランプパッドアセンブリがカム凹部を含み、カム突出部及びカム凹部が、互いに嵌合するように構成されている、実施例7に記載の外科用器具。
カム凹部及びカム突出部が、第1の枢動連結部と第2の枢動連結部との間に位置する、実施例8に記載の外科用器具。
クランプパッドが組織停止部を含む、実施例1~9のいずれか1つ又は2つ以上に記載の外科用器具。
クランプパッドアセンブリが、クランプパッドを開放構成へと付勢するように構成された弾性部材を含む、実施例1~10のいずれか1つ又は2つ以上に記載の外科用器具。
クランプアームアセンブリが親指リンググリップを含む、実施例1~11のいずれか1つ又は2つ以上に記載の外科用器具。
本体が指リンググリップを含む、実施例1~12のいずれか1つ又は2つ以上に記載の外科用器具。
第1のモジュール式アセンブリが、本体から延在する管を更に含む、実施例1~13のいずれか1つ又は2つ以上に記載の外科用器具。
導波管が管内に収容されている、実施例14に記載の外科用器具。
導波管と管との間に位置する封止部を更に含む、実施例15に記載の外科用器具。
超音波ブレードが管から遠位に延在する、実施例1~16のいずれか1つ又は2つ以上に記載の外科用器具。
本体内に少なくとも部分的に収容された超音波トランスデューサを更に含み、超音波導波管が超音波トランスデューサと連結されている、実施例1~17のいずれか1つ又は2つ以上に記載の外科用器具。
外科用器具であって、(a)第1のモジュール式アセンブリであって、(i)本体、(ii)超音波導波管、及び(iii)超音波導波管の遠位端に接続された超音波ブレードを含む、第1のモジュール式アセンブリと、(b)第2のモジュール式アセンブリであって、(i)第1の枢動連結部を含むクランプアームアセンブリ、(ii)第2の枢動連結部を含むクランプパッドアセンブリ、並びに(iii)第2のモジュール式アセンブリを第1のモジュール式アセンブリの本体に固定するように構成された遠位外部シースであって、遠位外部シースが、超音波導波管の一部分を収容するように構成された内面を含み、遠位外部シースの内面が、第1の枢動連結部及び第2の枢動連結部を収容するように構成されている、第2のモジュール式アセンブリ、を含む、外科用器具。
外科用器具であって、(a)第1のモジュール式アセンブリであって、(i)本体、(ii)超音波導波管、及び(iii)超音波導波管の遠位端に接続された超音波ブレードを含む、第1のモジュール式アセンブリと、(b)第2のモジュール式アセンブリであって、(i)第1の枢動連結部を含むクランプアームアセンブリ、(ii)第2の枢動連結部を含むクランプパッドアセンブリであって、クランプパッドアセンブリの近位端が、第3の枢動連結部を介してクランプアームアセンブリの遠位端と枢動可能に連結され、第3の枢動連結部が、第1の枢動連結部と第2の枢動連結部との間に長手方向に配置されている、クランプアームアセンブリ、並びに(iii)第2のモジュール式アセンブリを第1のモジュール式アセンブリの本体に固定するように構成された遠位外部シースであって、遠位外部シースが、超音波導波管の一部分を収容するように構成された内面を含み、遠位外部シースの内面が、第1の枢動連結部及び第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。
外科用器具であって、(a)エンドエフェクタであって、(i)第1の電極を含む超音波ブレード、及び(ii)超音波ブレードに対して移動するように構成されたクランプアームを含むエンドエフェクタと、(b)クランプアームを作動させるための細長アームと、を含み、クランプアーム及び細長アームが間接的に接続されている、外科用器具。
第1の端部と第2の端部とを有するリンクを更に含み、リンクの第1の端部がクランプアームに連結され、リンクの第2の端部が細長アームに連結されている、実施例21に記載の外科用器具。
外科用器具であって、(a)エンドエフェクタであって、(i)第1の電極を含む超音波ブレード、及び(ii)超音波ブレードに対して移動するように構成されたクランプアームを含むエンドエフェクタと、(b)クランプアームを作動させるための細長アームであって、細長アームによって画定されたスロットを通じて延在する枢動連結部の周りで移動可能である、細長アームと、を含む、外科用器具。
本明細書の様々な例は、互いに解除可能に連結されている2つ以上のモジュール式構成要素を説明しているが、いくつかの変形例は、そのようなモジュール性及び解除可能な連結を排除し得ることを理解されたい。例えば、器具(10)のいくつかの変形形態は、第2のモジュール式アセンブリ(200)が第1のモジュール式アセンブリ(100)から取り外されることを可能にしない単一の組合わせユニットとして、第1のモジュール式アセンブリ(100)及び第2のモジュール式アセンブリ(200)を提供し得る。いくつかのそのような変形例では、連結部材(300)は、省略されるか(いくつかの他の特徴部が、第1のモジュール式アセンブリ(100)と第2のモジュール式アセンブリ(200)との間の恒久的連結を提供するために使用されている)、あるいは、連結部材(300)は、第1のモジュール式アセンブリ(100)から第2のモジュール式アセンブリ(200)を連結解除するように連結部材(300)が操作され得ないように修正されてもよい。同様に、器具(301)のいくつかの変形形態は、クランプアームアセンブリ(400)がシャフトアセンブリ(330)から取り外されることを防止し得る。例えば、ラッチ部材(412)は省略されてもよく、クランプアームアセンブリ(400)は、シャフトアセンブリ(330)と恒久的に連結されてもよい。
(1) 外科用器具であって、
(a)第1のモジュール式アセンブリであって、
(i)本体、
(ii)超音波トランスデューサと連結するように構成された超音波導波管、
(iii)前記超音波導波管の遠位端に接続された超音波ブレード、及び
(iv)前記本体に移動可能に連結するように構成された連結部材、を含む、第1のモジュール式アセンブリと、
(b)第2のモジュール式アセンブリであって、
(i)第1の枢動連結部を含むクランプアームアセンブリ、
(ii)第2の枢動連結部を含むクランプパッドアセンブリ、並びに
(iii)前記連結部材を介して前記第1のモジュール式アセンブリの前記本体に選択的に連結するように構成された遠位外部シースであって、前記遠位外部シースが、前記超音波導波管の一部分を収容するように構成された内面を含み、前記遠位外部シースの前記内面が、前記第1の枢動連結部及び前記第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。
(2) 前記遠位外部シースがU字型本体を含む、実施態様1に記載の外科用器具。
(3) 前記本体が凹部を含み、前記遠位外部シースが、前記凹部内に挿入されるように構成された近位突出部を含む、実施態様1に記載の外科用器具。
(4) 前記近位突出部が側方突出部を含み、前記連結部材が、前記側方突出部と嵌合して前記遠位外部シースを前記第1のモジュール式アセンブリの前記本体と連結するように構成されている、実施態様3に記載の外科用器具。
(5) 前記連結部材が、ロックアセンブリを画定する弾性アームを含み、前記ロックアセンブリが、前記側方突出部と連結するように構成されている、実施態様4に記載の外科用器具。
(7) 前記クランプアームアセンブリがカム突出部を含む、実施態様1に記載の外科用器具。
(8) 前記クランプパッドアセンブリがカム凹部を含み、前記カム突出部及び前記カム凹部が、互いに嵌合するように構成されている、実施態様7に記載の外科用器具。
(9) 前記カム凹部及び前記カム突出部が、前記第1の枢動連結部と前記第2の枢動連結部との間に位置する、実施態様8に記載の外科用器具。
(10) 前記クランプパッドアセンブリが組織停止部を含む、実施態様1に記載の外科用器具。
(12) 前記クランプアームアセンブリが親指リンググリップを含む、実施態様1に記載の外科用器具。
(13) 前記本体が指リンググリップを含む、実施態様1に記載の外科用器具。
(14) 前記第1のモジュール式アセンブリが、前記本体から延在する管を更に含む、実施態様1に記載の外科用器具。
(15) 前記導波管が前記管内に収容されている、実施態様14に記載の外科用器具。
(17) 前記超音波ブレードが前記管から遠位に延在する、実施態様14に記載の外科用器具。
(18) 前記本体内に少なくとも部分的に収容された超音波トランスデューサを更に含み、前記超音波導波管が前記超音波トランスデューサと連結されている、実施態様1に記載の外科用器具。
(19) 外科用器具であって、
(a)第1のモジュール式アセンブリであって、
(i)本体、
(ii)超音波導波管、及び
(iii)前記超音波導波管の遠位端に接続された超音波ブレード、を含む、第1のモジュール式アセンブリと、
(b)第2のモジュール式アセンブリであって、
(i)第1の枢動連結部を含むクランプアームアセンブリ、
(ii)第2の枢動連結部を含むクランプパッドアセンブリ、並びに
(iii)前記第2のモジュール式アセンブリを前記第1のモジュール式アセンブリの前記本体に固定するように構成された遠位外部シースであって、前記遠位外部シースが、前記超音波導波管の一部分を収容するように構成された内面を含み、前記遠位外部シースの前記内面が、前記第1の枢動連結部及び前記第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。
(20) 外科用器具であって、
(a)第1のモジュール式アセンブリであって、
(i)本体、
(ii)超音波導波管、及び
(iii)前記超音波導波管の遠位端に接続された超音波ブレード、を含む、第1のモジュール式アセンブリと、
(b)第2のモジュール式アセンブリであって、
(i)第1の枢動連結部を含むクランプアームアセンブリ、
(ii)第2の枢動連結部を含むクランプパッドアセンブリであって、前記クランプパッドアセンブリの近位端が、第3の枢動連結部を介して前記クランプアームアセンブリの遠位端と枢動可能に連結され、前記第3の枢動連結部が、前記第1の枢動連結部と前記第2の枢動連結部との間に長手方向に配置されている、クランプパッドアセンブリ、並びに
(iii)前記第2のモジュール式アセンブリを前記第1のモジュール式アセンブリの前記本体に固定するように構成された遠位外部シースであって、前記遠位外部シースが、前記超音波導波管の一部分を収容するように構成された内面を含み、前記遠位外部シースの前記内面が、前記第1の枢動連結部及び前記第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。
Claims (19)
- 外科用器具であって、
(a)第1のモジュール式アセンブリであって、
(i)本体、
(ii)超音波トランスデューサと連結するように構成された中実の超音波導波管、
(iii)前記超音波導波管の遠位端に接続された超音波ブレード、及び
(iv)前記本体に移動可能に連結するように構成された連結部材、を含む、第1のモジュール式アセンブリと、
(b)第2のモジュール式アセンブリであって、
(i)第1の枢動連結部を含むクランプアームアセンブリ、
(ii)第2の枢動連結部を含むクランプパッドアセンブリであって、前記クランプパッドアセンブリの近位端が、第3の枢動連結部を介して前記クランプアームアセンブリの遠位端と枢動可能に連結され、前記第3の枢動連結部が、前記第1の枢動連結部と前記第2の枢動連結部との間に長手方向に配置されている、クランプパッドアセンブリ、並びに
(iii)前記連結部材を介して前記第1のモジュール式アセンブリの前記本体に選択的に連結するように構成された遠位外部シースであって、前記遠位外部シースが、前記超音波導波管の一部分を収容するように構成された内面を含み、前記遠位外部シースの前記内面が、前記第1の枢動連結部及び前記第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含む、外科用器具。 - 前記遠位外部シースがU字型本体を含む、請求項1に記載の外科用器具。
- 前記本体が凹部を含み、前記遠位外部シースが、前記凹部内に挿入されるように構成された近位突出部を含む、請求項1に記載の外科用器具。
- 前記近位突出部が側方突出部を含み、前記連結部材が、前記側方突出部と嵌合して前記遠位外部シースを前記第1のモジュール式アセンブリの前記本体と連結するように構成されている、請求項3に記載の外科用器具。
- 前記連結部材が、ロックアセンブリを画定する弾性アームを含み、前記ロックアセンブリが、前記側方突出部と連結するように構成されている、請求項4に記載の外科用器具。
- 前記連結部材が前記本体と枢動可能に連結されている、請求項1に記載の外科用器具。
- 前記クランプアームアセンブリがカム突出部を含む、請求項1に記載の外科用器具。
- 前記クランプパッドアセンブリがカム凹部を含み、前記カム突出部及び前記カム凹部が、互いに嵌合するように構成されている、請求項7に記載の外科用器具。
- 前記カム凹部及び前記カム突出部が、前記第1の枢動連結部と前記第2の枢動連結部との間に位置する、請求項8に記載の外科用器具。
- 前記クランプパッドアセンブリが組織停止部を含む、請求項1に記載の外科用器具。
- 前記クランプパッドアセンブリが、前記クランプパッドアセンブリを開放構成へと付勢するように構成された弾性部材を含む、請求項1に記載の外科用器具。
- 前記クランプアームアセンブリが親指リンググリップを含む、請求項1に記載の外科用器具。
- 前記本体が指リンググリップを含む、請求項1に記載の外科用器具。
- 前記第1のモジュール式アセンブリが、前記本体から延在する管を更に含む、請求項1に記載の外科用器具。
- 前記超音波導波管が前記管内に収容されている、請求項14に記載の外科用器具。
- 前記超音波導波管と前記管との間に位置する封止部を更に含む、請求項15に記載の外科用器具。
- 前記超音波ブレードが前記管から遠位に延在する、請求項14に記載の外科用器具。
- 前記本体内に少なくとも部分的に収容された超音波トランスデューサを更に含み、前記超音波導波管が前記超音波トランスデューサと連結されている、請求項1に記載の外科用器具。
- 外科用器具であって、
(a)第1のモジュール式アセンブリであって、
(i)本体、
(ii)中実の超音波導波管、
(iii)前記超音波導波管の遠位端に接続された超音波ブレード、及び
(iv)前記本体に移動可能に連結するように構成された連結部材、を含む、第1のモジュール式アセンブリと、
(b)第2のモジュール式アセンブリであって、
(i)第1の枢動連結部を含むクランプアームアセンブリ、
(ii)第2の枢動連結部を含むクランプパッドアセンブリであって、前記クランプパッドアセンブリの近位端が、第3の枢動連結部を介して前記クランプアームアセンブリの遠位端と枢動可能に連結され、前記第3の枢動連結部が、前記第1の枢動連結部と前記第2の枢動連結部との間に長手方向に配置されている、クランプパッドアセンブリ、並びに
(iii)前記第2のモジュール式アセンブリを前記第1のモジュール式アセンブリの前記本体に固定するように構成された遠位外部シースであって、前記遠位外部シースが、前記超音波導波管の一部分を収容するように構成された内面を含み、前記遠位外部シースの前記内面が、前記第1の枢動連結部及び前記第2の枢動連結部を収容するように構成されている、遠位外部シース、を含む、第2のモジュール式アセンブリと、を含み、
前記遠位外部シースは、前記連結部材を介して前記第1のモジュール式アセンブリの前記本体に選択的に連結するように構成されている、外科用器具。
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