Fluid-assisted medical devices, systems and methods

• US 20030216733A1
• Filed: 05/16/2002
• Published: 11/20/2003
• Est. Priority Date: 05/16/2002
• Status: Active Grant

• Current Assignee: Medtronic Advanced Energy LLC (Medtronic Plc)
• Original Assignee: Tissuelink Medical, Inc. (Medtronic Plc)
• Inventors: Lipson, David, McClurken, Michael E., Oyola, Arnold E.
• Granted Patent: US 6,953,461 B2
• Time in Patent Office: Days
• US Class Current: 606/51
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00809 : measured thermochromatically
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1417 : Ball
• CPC Class Codes: A61B 2018/1422 : Hook
• CPC Class Codes: A61B 2018/1455 : having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/035 : preventing further rotation
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2218/002 : Irrigation

Abstract

Surgical devices, systems and methods for treating tissue are provided. An exemplary surgical device comprises a tip portion including first and second jaws each having a tissue grasping surface, at least one of the jaws being movable toward the other jaw. The tissue grasping surface of each jaw has includes an electrically insulative surface. The device also includes first and second electrodes connectable to different terminals of an RF generator to generate electrical current flow therebetween, with each of the electrodes having an electrode surface. One of the electrode surfaces is located on one of the jaws separated from one edge of the tissue grasping surface, and the other of the electrode surfaces is located on one or the other of the jaws separated from the other edge of the tissue grasping surface. The device also includes at least one fluid passage being connectable to a fluid source.

Claims

1. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

the first jaw including a first tissue grasping surface and the second jaw including a second tissue grasping surface, the tissue grasping surface of each jaw having a length defined by proximal and distal ends, a width defined by edges and further comprising an electrically insulative surface;

first and second electrodes being connectable to different terminals of a radio frequency generator to generate electrical current flow therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage being connectable to a fluid source;

one of the first and second electrode surfaces being located on one or the other of the jaws separated from one edge of the tissue grasping surface and the other of the electrode surfaces being located on one or the other of the jaws separated from the other edge of the tissue grasping surface.

2. The tissue grasping device of claim 1 wherein:

the tip portion is configured to provide radio frequency power from a radio frequency generator with a fluid from the fluid source to tissue, the fluid provided to the tissue at a tissue surface and the radio frequency power provided to the tissue below the tissue surface.

3. The tissue grasping device of claim 1 wherein:

the tip portion is configured to provide radio frequency power to tissue at least partially through a fluid coupling located on a surface of the tissue, the fluid coupling comprising an electrically conductive fluid provided from the fluid source, the electrically conductive fluid provided from the tip portion with the radio frequency power.

4. The tissue grasping device of claim 1 further configured to:

receive radio frequency power from a radio frequency generator at a power level and an electrically conductive fluid from the fluid source at a fluid flow rate; and

deliver the electrically conductive fluid to tissue at a tissue surface and the radio frequency power to the tissue below the tissue surface.

5. The tissue grasping device of claim 1 further configured to:

receive radio frequency power from a radio frequency generator at a power level and an electrically conductive fluid from the fluid source at a fluid flow rate; and

deliver the electrically conductive fluid to tissue at a tissue surface and the radio frequency power to the tissue below the tissue surface at least partially through a fluid coupling comprising the electrically conductive fluid.

6. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a hydrophobic surface.

7. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a textured surface.

8. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a surface roughness between about 10 and 500 microns.

9. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises one or more serrations.

10. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw has a contact angle (0) with a fluid provided thereon equal to or greater than about 30 degrees and the fluid is provided from the fluid source.

11. The tissue grasping device of claim 1 wherein:

at least a portion of one of the edges defining the width of the tissue grasping surface of at least one jaw comprises a beveled edge.

12. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a material with a thermal conductivity at 300°

K (Kelvin) equal or greater than about 0.01 watt/cm°

K.

13. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw is supported by a support structure; and

the tissue grasping surface of the at least one jaw is provided at least partially by a coating overlying the support structure.

14. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw further comprises a medial portion, the medial portion supported therebeneath by a support structure comprising a material with a thermal conductivity at 300°

K (Kelvin) equal or greater than about 0.01 watt/cm°

K.

15. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw further comprises a medial portion, the medial portion supported therebeneath by a support structure which provides a heat sink for transferring heat away from the tissue grasping surface.

16. The tissue grasping device of claim 1 wherein:

the tip portion further comprises at least one fluid outlet in fluid communication with the fluid passage configured to provide a fluid from the fluid source to tissue.

17. The tissue grasping device of claim 16 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first fluid outlet and a second fluid outlet;

the first fluid outlet being located on the same jaw as the first electrode; and

the second fluid outlet being located on the same jaw as the second electrode.

18. The tissue grasping device of claim 17 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid to tissue located outside of the tissue grasping surfaces.

19. The tissue grasping device of claim 17 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid to tissue located outside of and adjacent the tissue grasping surfaces.

20. The tissue grasping device of claim 17 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid to tissue located outside of and separated from the tissue grasping surfaces.

21. The tissue grasping device of claim 17 wherein:

the first fluid outlet is configured to provide the fluid to tissue located adjacent the first electrode surface; and

the second fluid outlet is configured to provide the fluid to tissue located adjacent the second electrode surface.

22. The tissue grasping device of claim 17 wherein:

the first fluid outlet is configured to provide the fluid between the first electrode surface and tissue; and

the second fluid outlet is configured to provide the fluid between the second electrode surface and tissue.

23. The tissue grasping device of claim 17 wherein:

the first fluid outlet is configured to provide the fluid between the first electrode surface and one edge of one or the other of the tissue grasping surfaces; and

the second fluid outlet is configured to provide the fluid between the second electrode surface and the other edge of one or the other of the tissue grasping surfaces.

24. The tissue grasping device of claim 17 wherein:

the first fluid outlet is configured to provide the fluid to the first electrode surface; and

the second fluid outlet is configured to provide the fluid to the second electrode surface.

25. The tissue grasping device of claim 17 wherein:

the first fluid outlet is configured to provide the fluid to a first portion of one or the other of the jaws outside the tissue grasping surface; and

the second fluid outlet is configured to provide the fluid to a second portion of one or the other of the jaws outside the tissue grasping surface.

26. The tissue grasping device of claim 16 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first plurality of fluid outlets and a second plurality of fluid outlets, the first plurality of fluid outlets being located on the same jaw as the first electrode and the second plurality of fluids outlet being located on the same jaw as the second electrode.

27. The tissue grasping device of claim 16 wherein:

the first electrode surface is configured for the fluid to form a film at least partially thereon; and

the second electrode surface is configured for the fluid to form a film at least partially thereon.

28. The tissue grasping device of claim 1 wherein:

the fluid passage forms into a first fluid passage and a second fluid passage;

the first fluid passage being located on the same jaw as the first electrode; and

the second fluid outlet being located on the same jaw as the second electrode.

29. The tissue grasping device of claim 28 wherein:

the first electrode forms at least a portion of the first fluid passage; and

the second electrode forms at least a portion of the second fluid passage.

30. The tissue grasping device of claim 28 wherein:

the first electrode and the second electrode are each provided by an elongated structure having a cavity therein;

the first fluid passage at least partially defined by the cavity of the first electrode structure; and

the second fluid passage at least partially defined by the cavity of the second electrode structure.

31. The tissue grasping device of claim 30 wherein:

the first electrode and the second electrode each comprise metal tubing.

32. The tissue grasping device of claim 1 wherein:

each of the first and second electrode surfaces is separated from the tissue grasping surface of the jaw to which it is located by a gap.

33. The tissue grasping device of claim 32 wherein:

at least a portion of each gap separating each of the first and second electrode surfaces from the tissue grasping surface of the jaw to which it is located is configured to receive a fluid from the fluid source.

34. The tissue grasping device of claim 33 wherein:

the fluid received by each of the gaps is configured to provide a fluid coupling which removes heat from tissue located outside the tissue grasping surfaces.

35. The tissue grasping device of claim 34 wherein:

the fluid comprises an electrically conductive fluid; and

the fluid received by each of the gaps is configured to provide a fluid coupling which enhances the electrical connection of the first and second electrode surfaces and tissue located outside the tissue grasping surfaces.

36. The tissue grasping device of claim 35 wherein:

at least a portion of the electrical current flow between the first and second electrode surfaces may be caused to flow at least partially through at least one fluid coupling as opposed to tissue located outside the tissue grasping surfaces, whereby the amount of current flow through tissue located outside the tissue grasping surfaces may be correspondingly reduced.

37. The tissue grasping device of claim 32 further comprising:

the tissue grasping surface of each jaw having a length; and

each gap further comprises an elongated gap separating each of the first and second electrode surfaces from the tissue grasping surface of the jaw to which it is located along the length of the tissue grasping surface.

38. The tissue grasping device of claim 37 wherein:

at least a portion of each elongated gap separating each of the first and second electrode surfaces from the tissue grasping surface of the jaw to which it is located is configured to receive a fluid from the fluid source and provide a fluid flow channel for the fluid along the length of the tissue grasping surface.

39. The tissue grasping device of claim 1 wherein:

at least one jaw comprises at least one stand-off configured to keep tissue from physically contacting at least one of the first electrode surface and the second electrode surface.

40. The tissue grasping device of claim 1 further comprising:

at least one jaw further comprises at least one obstruction configured to inhibit a fluid shunt from forming between the first electrode and the second electrode.

41. The tissue grasping device of claim 1 further comprising:

a tissue treatment indicator which provides an output related to the level of treatment of tissue.

42. The tissue grasping device of claim 41 wherein:

the tissue treatment indicator is located on the tip portion.

43. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

each jaw including a tissue grasping surface, the tissue grasping surface of each jaw further comprising an electrically insulative surface;

a portion of each tissue grasping surface being located on each side of a center plane, the center plane orientated longitudinal and perpendicular to the tissue grasping surface;

first and second electrodes being connectable to different terminals of a radio frequency generator to generate electrical current flow therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage being connectable to a fluid source;

one of the first and second electrodes being located on one or the other of the jaws on one side of the center plane and the other of the electrodes being located on one or the other of the jaws on the other side of the center plane; and

each of the first and second electrode surfaces being separated from the tissue grasping surface of the jaw to which it is located.

44. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

each jaw including a tissue grasping surface, the tissue grasping surface of each jaw further comprising an electrically insulative surface;

a portion of each tissue grasping surface being located on two opposing sides of a cutting mechanism, the cutting mechanism comprising a blade;

first and second electrodes being connectable to different terminals of a radio frequency generator to generate electrical current flow therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage being connectable to a fluid source;

one of the first and second electrodes being located on one or the other of the jaws on one side of the cutting mechanism and the other of the electrodes being located on one or the other of the jaws on the other side of the cutting mechanism; and

each the first and second electrode surfaces being separated from the tissue grasping surface of the jaw to which it is located.

45. A method for treating tissue comprising:

providing tissue;

providing electrical current;

providing a fluid;

providing a first tissue grasping surface and a second tissue grasping surface;

grasping a first portion of tissue, the first portion of tissue located between the tissue grasping surfaces;

providing the fluid to a second portion of tissue, the second portion of tissue located outside the tissue grasping surfaces;

providing the electric current to the tissue; and

directing the electric current in the first portion of tissue to flow across the tissue grasping surfaces.

46. The method for treating tissue of claim 45 comprising the additional step of:

cooling the second portion of tissue with the fluid.

47. The method for treating tissue of claim 45 wherein:

the step of providing a fluid further comprises providing an electrically conductive fluid, and the additional step of;

reducing the electrical current in the second portion of tissue with the fluid.

48. A method for treating tissue comprising:

providing tissue;

providing electrical current;

providing a fluid;

providing a first tissue grasping surface and a second tissue grasping surface;

grasping a first portion of tissue, the first portion of tissue located between the tissue grasping surfaces;

providing the fluid to a second portion of tissue, the second portion of tissue located outside the tissue grasping surfaces;

providing the electric current to the tissue; and

directing the electric current in the first portion of tissue to flow substantially parallel to the tissue grasping surfaces.

49. The method for treating tissue of claim 48 comprising the additional step of:

cooling the second portion of tissue with the fluid.

50. The method for treating tissue of claim 48 wherein:

the step of providing a fluid further comprises providing an electrically conductive fluid, and the additional step of;

reducing the electrical current in the second portion of tissue with the fluid.