Managing tissue treatment

• US 10,194,972 B2
• Filed: 08/26/2014
• Issued: 02/05/2019
• Est. Priority Date: 08/26/2014
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Yates, David C., Wiener, Eitan T., Davison, Mark A.
• Primary Examiner(s): Flory, Christopher A
• Application Number:
  US14/469,093
• Publication Number:
  US 20160058492A1
• Time in Patent Office: 1,624 Days
• Field of Search: 606 34
• CPC Class Codes: A61B 18/085 Forceps, scissors
• CPC Class Codes: A61B 18/10 Power sources therefor
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61N 2007/025 interstitial

Abstract

Various embodiments are directed to systems and methods for providing a drive signal to a surgical device for treating tissue. A surgical generator may deliver the drive signal according to a first composite load curve. The surgical generator may receive a first tissue measurement indicating a property of the tissue at a first time during the delivery of the drive signal, receive a second tissue measurement indicating the property of the tissue at a second time during the delivery of the drive signal after the first time, and based on the first and second tissue measurements, determine a difference in the property of the tissue between the first time and the second time. When the difference in the property of the tissue exceeds a difference threshold, the generator may deliver the drive signal according to a second composite load curve that is more aggressive than the first composite load curve.

Claims

1. A surgical system for providing a drive signal to a surgical device for treating tissue, the surgical system comprising:

a surgical generator, wherein the surgical generator is programmed to;

deliver the drive signal according to a first composite load curve, wherein the first composite load curve defines a first level of power to be delivered to the tissue as a function of at least one measured property of the tissue, and wherein the first composite load curve defines a plurality of pulses to be sequentially applied to the tissue;

receive a first tissue measurement over a period of a pulse of the plurality of pulses of the drive signal indicating a property of the tissue at a first time during the delivery of the pulse of the plurality of pulses of the drive signal;

receive a second tissue measurement over the period of the pulse indicating the property of the tissue at a second time during the delivery of the pulse of the plurality of pulses of the drive signal, wherein the second time is after the first time;

determine, prior to completion of the delivery of the pulse, a difference in the property of the tissue between the first time and the second time based on the first and second tissue measurements;

prior to completion of the first composite load curve, when the difference in the property of the tissue exceeds a difference threshold of the property of the tissue, deliver the drive signal according to a second composite load curve, wherein the second composite load curve defines a second level of power, and wherein the second level of power is greater than the first level of power.

2. The surgical system of claim 1, wherein the property of the tissue is selected from the group consisting of:

an impedance of the tissue;

a temperature of the tissue; and

a pressure exerted on the tissue.

3. The surgical system of claim 1, wherein the property of the tissue is an impedance of the tissue.

4. The surgical system of claim 3, wherein the surgical generator is further programmed to determine the period of the pulse.

5. The surgical system of claim 3, wherein the difference threshold is at least one property selected from the group consisting of:

a predetermined impedance value;

a percentage of the first tissue measurement; and

a multiple of the first tissue measurement.

6. The surgical system of claim 1, further comprising:

receiving a third tissue measurement indicating the property of the tissue at a third time during delivery of the drive signal;

receiving a fourth tissue measurement indicating the property of the tissue at a fourth time during delivery of the drive signal; and

based on the third and fourth tissue measurements, determine a second change in the property between the third time and the fourth time;

when the second change in the property is greater than a second change threshold, deliver the drive signal according to a third composite load curve, wherein the third composite load curve defines a third level of power, and wherein the third level of power is greater than the second level of power.

7. The surgical system of claim 1, further comprising:

receiving a third tissue measurement indicating the property of the tissue at a third time during delivery of the drive signal;

receiving a fourth tissue measurement indicating the property of the tissue at a fourth time during delivery of the drive signal; and

based on the third and fourth tissue measurements, determine a second change in the property between the third time and the fourth time;

when the second change in the property is not greater than a second difference threshold, continue to deliver the drive signal according to the second composite load curve.

8. The surgical system of claim 7, further comprising, when the second change in the property is not greater than the second difference threshold, continue to deliver the drive signal according to the second composite load curve until a termination of the second composite load curve.

9. The surgical system of claim 1, wherein relative to the first composite load curve, the second composite load curve has a higher delivered power over a range of potential tissue impedances.

10. The surgical system of claim 1, wherein the surgical generator is further programmed to:

before delivering the drive signal according to the first composite load curve, receive a starting tissue measurement indicating a starting property of the tissue; and

prior to treatment, select the first composite load curve based on the property of the tissue.

11. A surgical system for providing a drive signal to a surgical device for treating tissue, the surgical system comprising:

a surgical generator, wherein the surgical generator is programmed to;

deliver the drive signal according to a first composite load curve, wherein the first composite load curve defines a first level of power to be delivered to the tissue as a function of at least one measured property of the tissue, and wherein the first composite load curve defines a plurality of pulses to be sequentially applied to the tissue;

receive a first tissue measurement over a period of a pulse of the plurality of pulses of the drive signal indicating a property of the tissue at a first time during the delivery of the pulse of the plurality of pulses of the drive signal;

receive a second tissue measurement over the period of the pulse indicating the property of the drive signal at a second time during the delivery of the pulse of the plurality of pulses of the drive signal, wherein the second time is after the first time;

determine, prior to completion of the delivery of the pulse of the drive signal, a difference in the property of the drive signal between the first time and the second time based on the first and second tissue measurements;

prior to completion of the first composite load curve, when the difference in the property of the drive signal exceeds a difference threshold of the property of the tissue, deliver the drive signal according to a second composite load curve, wherein the second composite load curve defines a second level of power, and wherein the second level of power is greater than the first level of power.

12. The surgical system of claim 11, wherein the property of the drive signal is a power provided to the tissue, and wherein determining a change in the power provided to the tissue between the first time and the second time comprises determining a change in an average power provided to the tissue during a first pulse of the plurality of pulses and an average power provided to the tissue during a second pulse of the plurality of pulses.

13. The surgical system of claim 11, wherein the property of the drive signal is selected from the group consisting of a current of the drive signal, a voltage of the drive signal a reflectivity of the drive signal, and a force applied to the tissue.

14. A method of providing a drive signal to a surgical device for treating tissue, the method comprising:

delivering the drive signal to a surgical device according to a first composite load curve, wherein the first composite load curve defines a first level of power to be delivered to the tissue as a function of at least one measured property of the tissue, and wherein the first composite load curve defines a plurality of pulses to be sequentially applied to the drive signal;

receiving a first tissue measurement over a period of a pulse of the plurality of pulses of the drive signal indicating a property of the tissue at a first time during the delivery of the pulse of the plurality of pulses of the drive signal;

receiving a second tissue measurement over the period of the pulse indicating the property of the tissue at a second time during the delivery of the pulse of the plurality of pulses of the drive signal, wherein the second time is after the first time;

determining, prior to completion of the delivery of the pulse, a difference in the property of the tissue between the first time and the second time based on the first and second tissue measurements;

prior to completion of the first composite load curve, when the difference in the property of the tissue exceeds a difference threshold of the property of the tissue, delivering the drive signal according to a second composite load curve, wherein the second composite load curve defines a second level of power, and wherein the second level of power is greater than the first level of power.