Hybrid energy instrument combined with clip application capability

1 . A medical device comprising:

an elongated housing having a distal end, said housing defining a lumen channel therein;

an end effector disposed at said distal end, said end effector including an energy-based surgical instrument having an elongated treatment portion and a clamp arm assembly, wherein said clamp arm assembly is moveable relative to said treatment portion;

at least one clip disposed within said lumen channel; and

a firing bar movable through said lumen channel to advance said clip from a first position within said lumen channel to a second position external of said lumen channel.

2 . The medical device of claim 1 wherein said energy-based surgical instrument is an ultrasonic blade.

3 . The medical device of claim 2 wherein said ultrasonic blade vibrates in a longitudinal mode.

4 . The medical device of claim 2 wherein said ultrasonic blade vibrates in a torsional mode.

5 . The medical device of claim 2 wherein said ultrasonic blade vibrates in a transverse mode.

6 . The medical device of claim 1 wherein said energy-based surgical instrument is an RF blade.

7 . The medical device of claim 1 wherein said energy-based surgical instrument is a laser fiber.

8 . The medical device of claim 1 wherein said energy-based surgical instrument is an electrically resistive wire heated by electrical current passed through it.

9 . The medical device of claim 1 wherein said clamp arm assembly includes a grasping jaw adapted to grasp tissue positioned between said clamp arm assembly and said treatment portion.

10 . The medical device of claim 1 wherein said clamp arm assembly is pivotally connected to said treatment portion.

11 . The medical device of claim 1 further comprising an actuation member connected to said clamp arm assembly.

12 . The medical device of claim 8 wherein actuation of said actuation member moves said clamp arm assembly towards said treatment portion.

13 . The medical device of claim 1 further comprising an ultrasonic waveguide extending though said housing and connected to said energy-based surgical instrument.

14 . The medical device of claim 1 wherein said clip is formed from a shape memory material and is disposed within said lumen channel in an open position.

15 . The medical device of claim 14 wherein said shape memory material is a titanium/nickel alloy.

16 . The medical device of claim 1 wherein said clip includes a first leg member, a second leg member and a connection portion, said first leg member being connected to said second leg member at said connection portion.

17 . The medical device of claim 1 wherein said clip is coated with a soft, elastomeric material.

18 . The medical device of claim 16 wherein said first leg includes a distal snap adapted to engage a distal portion of said second leg.

19 . The medical device of claim 1 wherein, when said clip is in said second position, said clip is positioned between said clamp arm assembly and said treatment portion.

20 . The medical device of claim 1 wherein said end effector further includes an anvil, said anvil being positioned generally adjacent to and generally parallel with said treatment portion.

21 . The medical device of claim 15 wherein, when said clip is in said second position, said clip is positioned between said clamp arm assembly and said anvil.

22 . A medical device comprising:

an elongated housing having a distal end, said housing defining a lumen channel therein;

an end effector disposed at said distal end, said end effector including an ultrasonic blade having an elongated treatment portion and a clamp arm assembly, wherein said clamp arm assembly is moveable relative to said treatment portion to grasp tissue positioned therebetween;

an actuation member connected to said clamp arm assembly, said actuation member being adapted to move said clamp arm assembly from an open positioned to a closed position;

at least one clip disposed within said lumen channel; and

a firing bar movable through said lumen channel to advance said clip from a first position within said lumen channel to a second position between said clamp arm assembly and said ultrasonic blade.

23 . The medical device of claim 22 wherein said clamp arm assembly includes a grasping jaw adapted to grasp tissue positioned between said clamp arm assembly and said ultrasonic blade.

24 . The medical device of claim 22 wherein said end effector further includes an anvil, said anvil being positioned generally adjacent to, and generally parallel with, said treatment portion.

25 . A method for treating a target tissue comprising the steps of:

providing a hybrid medical device including a distal end having a clamp arm assembly and a energy-based surgical instrument portion disposed thereon, said energy-based surgical instrument portion including a treatment portion;

positioning said distal end of said device adjacent to said target tissue;

manipulating said distal end of said device to position said target tissue generally between said clamp arm assembly and said treatment portion;

advancing a surgical clip from said device into a space between said clamp arm assembly and said treatment portion;

crushing said clip over said target tissue; and

energizing said treatment portion to treat said target tissue.

26 . A method for treating a target tissue comprising the steps of:

providing a hybrid medical device including a distal end having a clamp arm assembly and a energy-based surgical instrument portion disposed thereon, said energy-based surgical instrument portion including a treatment portion;

positioning said distal end of said device adjacent to said target tissue;

manipulating said distal end of said device to position said target tissue generally between said clamp arm assembly and said treatment portion to capture and ligate said target tissue;

advancing a surgical clip from said device into a space between said clamp arm assembly and said treatment portion;

crushing said clip over said target tissue; and

energizing said treatment portion to treat said target tissue.