Fluid-assisted medical devices, systems and methods

• US 20050010212A1
• Filed: 08/09/2004
• Published: 01/13/2005
• Est. Priority Date: 03/06/2000
• 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 7,604,635 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. 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 first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

the first jaw comprising a first jaw tissue grasping surface and the second jaw comprising a second jaw tissue grasping surface, the tissue grasping surface of each jaw comprising an electrically insulative surface;

a first electrode and a second electrode, the first and second electrodes configured to have opposite polarity when electrically coupled to a radio frequency power source and positioned for an electrical current from the first and second electrodes to flow in tissue grasped between the tissue grasping surfaces substantially parallel to the tissue grasping surfaces;

at least one fluid delivery passage; and

a first fluid outlet and a second fluid outlet, at least one of the first fluid outlet and the second fluid outlet in fluid communication with the at least one fluid delivery passage.

2. The device of claim 1 wherein:

at least one of the first fluid outlet to provide a fluid onto the first electrode and the second fluid outlet to provide a fluid onto the second electrode.

3. The device of claim 1 wherein:

at least one of the first fluid outlet at least partially defined by the first electrode and the second fluid outlet at least partially defined by the second electrode.

4. The device of claim 1 wherein:

at least one of the first fluid outlet at least partially defined by an opening in the first electrode and the second fluid outlet at least partially defined by an opening in the second electrode.

5. The device of claim 1 wherein:

at least one of the first fluid outlet at least partially defined by a hole in the first electrode and the second fluid outlet at least partially defined by a hole in the second electrode.

6. The device of claim 1 wherein:

at least one of the first fluid outlet to provide a fluid to wet a surface portion of the first electrode and the second fluid outlet to provide a fluid to wet a surface portion of the second electrode.

7. The device of claim 1 wherein:

the first jaw tissue grasping surface has a first edge opposite a second edge; and

at least one of the first fluid outlet to provide a fluid between the first electrode and the first edge of the first jaw tissue grasping surface and the second fluid outlet to provide a fluid between the second electrode and the second edge of the first jaw tissue grasping surface.

8. The device of claim 1 wherein:

at least one of the first fluid outlet to provide a fluid into a first reservoir and the second fluid outlet to provide a fluid into a second reservoir.

9. The device of claim 8 wherein:

at least one of the first reservoir being along the first electrode and the second reservoir being along the second electrode.

10. The device of claim 8 wherein:

at least one of the first reservoir being adjacent the first electrode and the second reservoir being adjacent the second electrode.

11. The device of claim 8 wherein:

the first jaw tissue grasping surface has a first edge opposite a second edge; and

at least one of a portion of the first reservoir being between the first electrode and the first edge of the first jaw tissue grasping surface and a portion of the second reservoir being between the second electrode and the second edge of the first jaw tissue grasping surface.

12. The device of claim 8 wherein:

at least one of a portion of the first reservoir being defined by the first electrode and a portion of the second reservoir being defined by the second electrode.

13. The device of claim 8 wherein:

at least one of the first reservoir comprising a first elongated channel and the second reservoir comprising a second elongated channel.

14. The device of claim 8 wherein:

the first jaw tissue grasping surface has a first edge opposite a second edge; and

at least one of the first reservoir being along the first edge of the first jaw tissue grasping surface and the second reservoir being along the second edge of the first jaw tissue grasping surface.

15. The device of claim 1 wherein:

the first jaw tissue grasping surface has a first edge opposite a second edge; and

at least one of the first electrode being spaced along the first edge of the first jaw tissue grasping surface and the second electrode being spaced along the second edge of the first jaw tissue grasping surface.

16. The device of claim 15 wherein:

at least one of the first electrode being spaced along the first edge of the first jaw tissue grasping surface by a first reservoir and the second electrode being spaced along the second edge of the first jaw tissue grasping surface by a second reservoir.

17. The device of claim 16 wherein:

at least one of the first reservoir being along the first electrode and the second reservoir being along the second electrode.

18. The device of claim 16 wherein:

at least one of the first reservoir being adjacent the first electrode and the second reservoir being adjacent the second electrode.

19. The device of claim 16 wherein:

at least one of a portion of the first reservoir being between the first electrode and the first edge of the first jaw tissue grasping surface and a portion of the second reservoir being between the second electrode and the second edge of the first jaw tissue grasping surface.

20. The device of claim 16 wherein:

at least one of a portion of the first reservoir being defined by the first electrode and a portion of the second reservoir being defined by the second electrode.

21. The device of claim 16 wherein:

at least one of the first reservoir comprising a first elongated channel and the second reservoir comprising a second elongated channel.

22. The device of claim 15 wherein:

the first edge of the first jaw tissue grasping surface comprises a left edge of the first jaw tissue grasping surface; and

the second edge of the first jaw tissue grasping surface comprises a right edge of the first jaw tissue grasping surface.

23. The device of claim 22 wherein:

at least one of the first electrode being spaced along the left edge of the first jaw tissue grasping surface by a first reservoir and the second electrode being spaced along the right edge of the first jaw tissue grasping surface by a second reservoir.

24. The device of claim 23 wherein:

at least one of the first reservoir being along the first electrode and the second reservoir being along the second electrode.

25. The device of claim 23 wherein:

at least one of the first reservoir being adjacent the first electrode and the second reservoir being adjacent the second electrode.

26. The device of claim 23 wherein:

at least one of a portion of the first reservoir being between the first electrode and the left edge of the first jaw tissue grasping surface and a portion of the second reservoir being between the second electrode and the right edge of the first jaw tissue grasping surface.

27. The device of claim 23 wherein:

at least one a portion of the first reservoir being defined by the first electrode and a portion of the second reservoir being defined by the second electrode.

28. The device of claim 23 wherein:

at least one of the first reservoir comprising a first elongated channel and the second reservoir comprising a second elongated channel.

29. The device of claim 1 wherein:

the first jaw tissue grasping surface has a first edge opposite a second edge; and

at least one of the first electrode being along the first edge of the first jaw tissue grasping surface and the second electrode being along the second edge of the first jaw tissue grasping surface.

30. The device of claim 29 wherein:

the first edge of the first jaw tissue grasping surface comprises a left edge of the first jaw tissue grasping surface; and

the second edge of the first jaw tissue grasping surface comprises a right edge of the first jaw tissue grasping surface.

31. The device of claim 1 wherein:

the first jaw has a first side portion opposite a second side portion;

the first electrode being on the first side portion of the first jaw; and

the second electrode being on the second side portion of the first jaw.

32. The device of claim 31 wherein:

the first fluid outlet is on the same side portion of the first jaw as the first electrode; and

the second fluid outlet is on the same side portion of the first jaw as the second electrode.

33. The device of claim 31 wherein:

the first side portion of the first jaw comprises a left side portion of the first jaw; and

the second side portion of the first jaw comprises a right side portion of the first jaw.

34. The device of claim 33 wherein:

the first fluid outlet is on the same side portion of the first jaw as the first electrode; and

the second fluid outlet is on the same side portion of the first jaw as the second electrode.

35. The device of claim 1 wherein:

the first jaw comprises a first jaw support structure beneath the first jaw tissue grasping surface, the first jaw support structure having a first side portion opposite a second side portion;

the first electrode being along the first side portion of the first jaw support structure; and

the second electrode being along the second side portion of the first jaw support structure.

36. The device of claim 35 wherein:

the first side portion of the first jaw support structure comprises a left side portion of the first jaw support structure; and

the second side portion of the first jaw support structure comprises a right side portion of the first jaw support structure.

37. The device of claim 1 wherein:

the at least one fluid delivery passage comprises a first fluid delivery passage and a second fluid delivery passage;

the first fluid outlet in fluid communication with the first fluid delivery passage; and

the second fluid outlet in fluid communication with the second fluid delivery passage.

38. The device of claim 37 wherein:

at least one of a portion of the first fluid delivery passage being defined by the first electrode and a portion of the second fluid delivery passage being defined by the second electrode.

39. The device of claim 37 wherein:

at least one of a portion of the first fluid delivery passage being defined by a cavity in the first electrode and a portion of the second fluid delivery passage being defined by a cavity in the second electrode.

40. The device of claim 37 wherein:

at least one of a portion of the first fluid delivery passage being defined by a lumen in the first electrode and a portion of the second fluid delivery passage being defined by a lumen in the second electrode.

41. The device of claim 1 wherein:

at least one of the first electrode and the second electrode comprises metal tubing.

42. The device of claim 41 wherein:

the first electrode comprises metal tubing; and

the second electrode comprises metal tubing.

43. The device of claim 1 wherein:

at least one of the first electrode and the second electrode comprises a hollow structure.

44. The device of claim 43 wherein:

the first electrode comprises a hollow structure; and

the second electrode comprises a hollow structure.

45. The device of claim 1 wherein:

at least one of the first electrode and the second electrode comprises a tubular structure.

46. The device of claim 45 wherein:

the first electrode comprises a tubular structure; and

the second electrode comprises a tubular structure.

47. The device of claim 1 wherein:

at least one of the first electrode and the second electrode comprises a cylindrical structure.

48. The device of claim 47 wherein:

the first electrode comprises a cylindrical structure; and

the second electrode comprises a cylindrical structure.

49. The device of claim 1 wherein:

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

50. The device of claim 1 wherein:

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

51. The device of claim 1 wherein:

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

52. The device of claim 1 wherein:

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

53. The device of claim 1 wherein:

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

54. The device of claim 1 wherein:

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

55. The device of claim 1 wherein:

the tissue grasping surface of at least one jaw having a beveled edge.

56. The device of claim 1 wherein:

at least one jaw comprises a support structure beneath the tissue grasping surface; and

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

57. The device of claim 1 wherein:

at least one jaw comprises a support structure beneath the tissue grasping surface; and

the support structure comprises a material with a thermal conductivity at 300°

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

K.

58. The device of claim 1 wherein:

at least one jaw comprises a support structure beneath the tissue grasping surface; and

the support structure provides a heat sink for transferring heat away from the tissue grasping surface.

59. The device of claim 1 further comprising:

at least one stand-off overlying at least a portion of one of the first electrode and the second electrode, the stand-off to keep tissue from physically contacting the electrode.

60. The device of claim 59 wherein:

the at least one stand-off comprises a coil.

61. The device of claim 60 wherein:

the coil comprises an electrically insulative material.

62. The device of claim 59 wherein:

the at least one stand-off comprises a porous structure.

63. The device of claim 1 further comprising:

at least one obstruction configured to inhibit a fluid shunt from forming between the at least two electrodes.

64. The device of claim 63 wherein:

the at least one obstruction comprises a portion of one of the jaws.

65. The device of claim 63 wherein:

the at least one obstruction comprises a drip edge.

66. The device of claim 1 further comprising:

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

67. The device of claim 66 wherein:

the tissue treatment indicator comprises a lamp.

68. The device of claim 1 further comprising:

a cutting mechanism.

69. The device of claim 68 wherein:

the cutting mechanism comprises a blade.