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

• US 20020002379A1
• Filed: 06/25/2001
• Published: 01/03/2002
• Est. Priority Date: 06/30/2000
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Bishop, Gregory D.
• Granted Patent: US 6,558,376 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• 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 2017/00504 Tissue welding
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2090/08021 of the patient or his organs

Abstract

A surgical method for increasing the size of a tissue weld in clamped tissue is disclosed. The method includes providing an end effector for an ultrasonic surgical instrument. The end effector includes an ultrasonic blade having a proximal and a distal end and a clamping mechanism having a clamping surface positioned opposite the ultrasonic blade. The clamping mechanism is adapted to clamp tissue against a side of the ultrasonic blade. A first and a second support surface are positioned laterally on two sides of the ultrasonic blade. Both support surfaces are ultrasonically isolated from the blade and positioned opposite at least a portion of the clamping surface. The method includes actuating the clamping mechanism to clamp tissue between the clamping surface and the ultrasonic blade and between the clamping surface and the first and second tissue support surfaces to define a substantially continuous pressure region. Finally, ultrasonic energy is applied to the ultrasonic blade for the creation of a tissue weld in the substantially continuous pressure region. The tissue weld spreading from tissue clamped between the clamping surface and the ultrasonic blade and into tissue clamped between the clamping surface and the first and second tissue support surfaces.

Claims

1. A surgical method for increasing the size of a tissue weld in clamped 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 a side of 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; 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;

b) actuating said clamping mechanism to clamp tissue between said clamping surface and said ultrasonic blade, and between said clamping surface and said first and second tissue support surfaces, the clamped tissue defining a substantially continuous pressure region; and

c) applying ultrasonic energy to said ultrasonic blade for the creation of a tissue weld in the substantially continuous pressure region, the tissue weld spreading from tissue clamped between said clamping surface and said ultrasonic blade and into tissue clamped between said clamping surface and said first and second tissue support surfaces.

2. The method of claim 1, the method further comprising cutting said tissue weld.

3. The method of claim 1 wherein said ultrasonic energy is applied at a frequency between 20 kHz to 250 kHz

4. The method of claim 3 wherein said ultrasonic energy is applied at a frequency of 55 kHz.

5. The method of claim 1 wherein said ultrasonic energy is applied with a side of said ultrasonic blade, said side located between said proximal and distal end of said ultrasonic blade.

6. 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.

7. The method of claim 6, the method further comprising cutting said tissue weld.

8. The method of claim 6 wherein said ultrasonic energy is applied at a frequency between 20 kHz to 250 kHz

9. The method of claim 8 wherein said ultrasonic energy is applied at a frequency of 55 kHz.

10. The method of claim 6 wherein said ultrasonic energy is applied with a side of said ultrasonic blade, said side between said proximal and distal end.

11. The method of claim 10 wherein said support surface angle is between about one degree and sixty degrees.

12. The method of claim 11 wherein said support surface angle is preferably ten degrees.

13. 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.

14. The method of claim 13, the method further comprising cutting said tissue weld.

15. The method of claim 13 wherein said ultrasonic energy is applied at a frequency between 20 kHz to 250 kHz

16. The method of claim 15 wherein said ultrasonic energy is applied at a frequency of 55 kHz.

17. The method of claim 13 wherein said ultrasonic energy is applied with a side of said ultrasonic blade, said side between said proximal and distal end.

18. The method of claim 13 wherein said support surface angle is between about one degree and sixty degrees.

19. The method of claim 18 wherein said support surface angle is preferably ten degrees.