Managing tissue treatment

• US 10,321,950 B2
• Filed: 03/17/2015
• Issued: 06/18/2019
• Est. Priority Date: 03/17/2015
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Yates, David C., Strobl, Geoffrey S.
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US14/660,620
• Publication Number:
  US 20160270840A1
• Time in Patent Office: 1,554 Days
• CPC Class Codes: A61B 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• 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 2017/0003 of parts of the instruments
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00994 combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Various embodiments are directed to systems and methods for providing segmented power curves to tissue. A surgical generator may receive an indication of a first impedance of tissue to be treated by a surgical end effector. The generator may determine that the first impedance is within an impedance range corresponding to a first power curve segment of the segmented power curve and provide a drive signal to the end effector according to a first power curve. The generator may further receive an indication of a second impedance of the tissue to be treated by the end effector, determine that the second impedance is within an impedance range corresponding to a second power curve segment of the segmented power curve, and provide the drive signal to the end effector according to a second power curve.

Claims

1. A surgical system, the surgical system comprising:

an end effector of a surgical instrument, wherein the end effector is configured to grasp tissue;

a generator communicatively coupled to the end effector, the generator capable of delivering energy to the tissue grasped by the end effector according to a first and second power curve stored in memory, wherein the first power curve defines a first range of power levels that is greater than a second range of power levels defined by the second power curve, wherein the generator is configured to;

receive a tissue impedance value corresponding to an impedance of the tissue grasped by the end effector; and

wherein when the tissue impedance value is within a first range of tissue impedance, the generator is further configured to;

deliver energy to the end effector according to the first power curve; and

wherein when the tissue impedance value is within a second range of tissue impedance, the generator is further configured to alternately apply segments of the first and second power curve to reduce a rate of increase of tissue impedance within the second range of tissue impedance by;

generating a segment of the second power curve to deliver energy to the end effector according to the segment of the second power curve while the tissue impedance value is within a first subrange of the second range of tissue impedance; and

generating a segment of the first power curve to deliver energy to the end effector according to the segment of the first power curve while the tissue impedance value is within a second subrange of the second range of tissue impedance.

2. The surgical system of claim 1, wherein the generator is further configured to alternate between energy to be delivered to the end effector according to the segment of the second power curve and energy to be delivered to the end effector according to the segment of the first power curve.

3. The surgical system of claim 1, wherein the energy to be delivered to the end effector according to the segment of the second power curve is less than the energy to be delivered to the end effector according to the segment of the first power curve.

4. The surgical system of claim 1, wherein a total energy to be delivered to the end effector according to the second power curve is less than a total energy to be delivered to the end effector according to the first power curve.

5. The surgical system of claim 1, wherein the second power curve defines a constant power.

6. The surgical system of claim 5, wherein the second power curve defines a constant power between 0 Watts and 5 Watts.

7. The surgical system of claim 1, wherein a ratio of a width of the segment of the first power curve to a width of the segment of the second power curve is between 1/10 and 10, wherein the width defines a difference between a minimum value and a maximum value of a subrange.

8. The surgical system of claim 1, wherein a ratio of a width of the segment of the first power curve to a width of the segment of the second power curves between ⅓

and 3, wherein the width defines a difference between a minimum value and a maximum value of a subrange.

9. The surgical system of claim 1, wherein a ratio of a width of the segment of the first power curve to a width of the segment of the second power curve is about 1, wherein the width defines a difference between a minimum value and a maximum value of a subrange.

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

receive a request for an energy cycle routine to be delivered to the end effector;

determine that at least one jaw member of the end effector has not been in an open position since a conclusion of a previous energy cycle; and

deliver a modified energy cycle routine to the end effector, wherein delivering the modified energy cycle routine delivers less energy than delivering the energy cycle routine.