Surgical instruments

• US 20090036913A1
• Filed: 07/31/2007
• Published: 02/05/2009
• Est. Priority Date: 07/31/2007
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Madan, Ashvanl K., Stulan, Foster B., Wiener, Eitan, Houser, Kevin L., Kramer, Kenneth S.
• Granted Patent: US 8,512,365 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• 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 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320089 node location
• 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 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 2018/00791 Temperature
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A surgical device. The surgical device may comprise a transducer, an end effector, a generator and a control circuit. The transducer may be configured to provide vibrations. The end effector may be coupled to the transducer and may extend from the transducer along the longitudinal axis. The generator may provide an electrical signal to the transducer. Also, the control circuit may modify a current amplitude of the electrical signal in response to a change in a vibration frequency of the end effector. Accordingly to various embodiments, the control circuit may detect a first contribution to a vibration frequency of the end effector, the first contribution originating from tissue in contact with the end effector. Also, according to various embodiments, the control circuit may indicate a change in a vibration frequency of the end effector.

Claims

1. A surgical device comprising:

a transducer to receive an electrical signal from a generator and to provide vibrations;

an end effector coupled to the transducer and extending from the transducer along the longitudinal axis; and

a control circuit to modify a current amplitude of the electrical signal in response to a change in a vibration frequency of the end effector.

2. The surgical device of claim 1, wherein the control circuit is to reduce the current amplitude of the electrical signal in response to a reduction in the vibration frequency.

3. The surgical device of claim 1, wherein the control circuit is to calculate a displacement of the end effector considering the vibration frequency and the current amplitude.

4. The surgical device of claim 1, wherein the control circuit is to modify the current amplitude of the electrical signal to maintain a substantially constant vibration frequency of the end effector.

5. A method, comprising:

obtaining the surgical device of claim 1; and

programming the control circuit to modify a current amplitude of the electrical signal in response to a change in a vibration frequency of the end effector.

6. A computer readable medium comprising instructions that when executed by a processor cause the processor to:

monitor an electrical signal provided to a transducer of a surgical instrument, wherein the transducer is coupled to an end effector;

monitor a vibration frequency of the end effector;

modify an amplitude of the electrical signal in response to a change in the vibration frequency.

7. A surgical device comprising a processor, wherein the processor is programmed to:

monitor an electrical signal provided to a transducer of a surgical instrument, wherein the transducer is coupled to an end effector;

monitor a vibration frequency of the end effector; and

modify an amplitude of the electrical signal in response to a change in the vibration frequency.

8. The surgical device of claim 7, wherein the processor is programmed to reduce the current amplitude of the electrical signal in response to a reduction in the vibration frequency.

9. The surgical device of claim 7, wherein the processor is programmed to monitor a frequency of the current provided to the transducer.

10. A method, comprising:

obtaining the surgical device of claim 7;

programming the processor to monitor an electrical signal provided to a transducer of a surgical instrument, wherein the transducer is coupled to an end effector;

monitor a vibration frequency of the end effector; and

modify an amplitude of the electrical signal in response to a change in the vibration frequency.

11. A surgical device comprising:

a transducer to receive an electrical signal from a generator a drive frequency, the transducer to provide vibrations at the drive frequency;

an end effector coupled to the transducer and extending from the transducer along a longitudinal axis; and

a control circuit to detect a first contribution to a vibration frequency of the end effector, the first contribution originating from tissue in contact with the end effector.

12. The surgical device of claim 11, further comprising a filtering circuit to filter the drive frequency from the vibration frequency.

13. The surgical device of claim 11, further comprising a filtering circuit to filter at least one harmonic of the drive frequency from the vibration frequency.

14. The surgical device of claim 11, wherein the circuit is also to compare the vibration frequency of the device to an unloaded vibration frequency of the end effector when the end effector is not in contact with tissue.

15. A method, comprising:

obtaining the surgical device of claim 11; and

programming the control circuit detect a first contribution to a vibration frequency of the end effector, the first contribution originating from tissue in contact with the end effector.

16. A computer readable medium comprising instructions that when executed by a processor cause the processor to:

monitor a vibration frequency of an end effector of a surgical instrument; and

identify a first contribution to the vibration frequency, the first contribution originating from tissue in contact with the end effector.

17. A surgical device comprising a processor, wherein the processor is programmed to:

monitor a vibration frequency of an end effector of a surgical instrument; and

identify a first contribution to the vibration frequency, the first contribution originating from tissue in contact with the end effector.

18. The surgical device of claim 17, wherein the processor is to filter a drive frequency of the end effector from the vibration frequency.

19. The surgical device of claim 17, wherein the processor is to compare the vibration frequency to an unloaded vibration frequency of the end effector when the end effector is not in contact with tissue.

20. A method, comprising:

obtaining the surgical device of claim 17;

programming the processor to monitor a vibration frequency of an end effector of a surgical instrument; and

to identify a first contribution to the vibration frequency, the first contribution originating from tissue in contact with the end effector.

21. A surgical device comprising:

a transducer to provide vibrations;

an end effector coupled to the transducer and extending from the transducer along the longitudinal axis; and

a control circuit to indicate a change in a vibration frequency of the end effector.

22. The surgical device of claim 21, wherein the control circuit is to indicate a reduction in a rate of reduction of the vibration frequency.

23. The surgical device of claim 21, wherein the control circuit is to indicate an increase in a reduction of the vibration frequency.

24. The surgical device of claim 21, wherein the control circuit is to detect a first contribution to the vibration frequency, the first contribution originating from tissue in contact with the end effector.

25. A method for processing a surgical device for surgery, comprising:

obtaining the surgical device of claim 21; and

programming the control circuit to indicate a change in a vibration frequency of the end effector.

26. A computer readable medium comprising instructions that when executed by a processor cause the processor to:

monitor a vibration frequency of an end effector of a surgical instrument;

identify a reduction in a rate of reduction of the vibration frequency; and

indicate an onset of coagulation in response to the reduction.

27. A surgical device comprising a processor, wherein the processor is programmed to:

monitor a vibration frequency of an end effector of a surgical instrument;

identify a reduction in a rate of reduction of the vibration frequency; and

indicate an onset of coagulation in response to the reduction.

28. The surgical device of claim 27, wherein the processor is programmed to identify a first contribution to the vibration frequency, the first contribution originating from tissue in contact with the end effector;

and indicate the onset of desiccation in response to the first contribution.

29. The surgical device of claim 28, wherein the processor is to indicate if the onset of coagulation occurs before the indicating the onset of desiccation.

30. The surgical device of claim 27, wherein the processor is to identify an increase in a rate of reduction of the vibration frequency;

and indicate an onset of desiccation in response to the increase.

31. A method for processing a surgical device for surgery, comprising:

obtaining the surgical device of claim 27;

programming the processor to monitor a vibration frequency of an end effector of a surgical instrument;

identify a reduction in a rate of reduction of the vibration frequency; and

indicate an onset of coagulation in response to the reduction.

32. A surgical device comprising:

a transducer to provide vibrations;

an end effector coupled to the transducer and extending from the transducer along a longitudinal axis;

a clamping mechanism translatable toward the end effector; and

a control circuit configured to calculate a curve representing a coefficient of collagen denaturation over time considering;

a power delivered by the end effector to a portion of tissue;

a clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

a displacement of the end effector; and

a vibration frequency of the end effector.

33. The surgical device of claim 32, wherein the coefficient of collagen denaturation is described by:

$\mathrm{CCD}~\frac{P}{\mathrm{CF}\times <br><br>D\times <br><br>f}$

where;

CCD is the coefficient of collagen denaturation;

CF is the clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

D is the displacement of the end effector; and

f is the vibration frequency of the end effector.

34. The surgical device of claim 32, wherein the control circuit is configured to:

identify a first change in a slope of the curve from a substantially negative slope to a substantially neutral slope; and

indicate a beginning of tissue coagulation in response to the first change.

35. The surgical device of claim 34, wherein the control circuit is configured to:

identify a second change in the slope of the curve from the substantially neutral slope to a substantially positive slope; and

indicate a beginning of tissue desiccation in response to the second change.

36. The surgical device of claim 33, wherein the control circuit is configured to:

identify a first region of the curve having a substantially constant slope;

calculate a region property describing the first region, wherein the region property is selected from the group consisting of a slope of the first region, a length of the first region, and a normalized value of the curve in the first region; and

derive a tissue property of the portion of tissue in contact with the end effector considering the region property, wherein the tissue property is selected from the group consisting of an outside diameter of the portion of tissue and a thickness of the portion of tissue.

37. The surgical device of claim 36, wherein the control circuit is configured to derive the tissue property of the portion of tissue by consulting a look-up table correlating the region property and the tissue property.

38. A method for processing a surgical device for surgery, comprising:

obtaining the surgical device of claim 32; and

programming the control circuit to calculate a curve representing a coefficient of collagen denaturation over time considering;

a power delivered by the end effector to a portion of tissue;

a clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

a displacement of the end effector; and

a vibration frequency of the end effector.

39. A computer readable medium comprising instructions that when executed by a processor cause the processor to:

monitor a power delivered by an end effector of a surgical device to a portion of tissue;

monitor a clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

monitor a displacement of the end effector;

monitor a vibration frequency of the end effector; and

calculate a curve representing a coefficient of collagen denaturation over time considering;

the power delivered by the end effector to the portion of tissue;

the clamp force applied to the portion of tissue; and

the displacement of the end effector; and

the vibration frequency of the end effector.

40. A surgical device comprising a processor, wherein the processor is programmed to:

monitor a power delivered by an end effector of a surgical device to a portion of tissue;

monitor a clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

monitor a displacement of the end effector;

monitor a vibration frequency of the end effector; and

calculate a curve representing a coefficient of collagen denaturation over time considering;

the power delivered by the end effector to the portion of tissue;

the clamp force applied to the portion of tissue; and

the displacement of the end effector; and

the vibration frequency of the end effector.

41. The surgical device of claim 40, wherein the coefficient of collagen denaturation is described by:

$\mathrm{CCD}~\frac{P}{\mathrm{CF}\times <br><br>D\times <br><br>f}$

Where;

CCD is the coefficient of collagen denaturation;

CF is the clamp force applied to the portion of tissue between the end effector and the clamping mechanism;

D is the displacement of the end effector; and

f is the vibration frequency of the end effector.

42. The surgical device of claim 40, wherein the processor is programmed to:

identify a first change in a slope of the curve from a substantially negative slope to a substantially neutral slope; and

indicate a beginning of tissue coagulation in response to the first change.

43. The surgical device of claim 42, wherein the processor is programmed to:

identify a second change in the slope of the curve from the substantially neutral slope to a substantially positive slope; and

indicate a beginning of tissue desiccation in response to the second change.

44. The surgical device of claim 40, wherein the processor is programmed to:

identify a first region of the curve having a substantially constant slope;

calculate a region property describing the first region, wherein the region property is selected from the group consisting of a slope of the first region, a length of the first region, and a normalized value of the curve in the first region; and

derive a tissue property of the portion of tissue in contact with the end effector considering the region property, wherein the tissue property is selected from the group consisting of an outside diameter of the portion of tissue and a thickness of the portion of tissue.

45. The surgical device of claim 44, wherein the processor is to derive consult a look-up table correlating the region property and the tissue property.

46. A method, comprising:

obtaining the surgical device of claim 40; and

a processor to calculate a curve representing a coefficient of collagen denaturation over time considering;

the power delivered by the end effector to the portion of tissue;

the clamp force applied to the portion of tissue; and

the displacement of the end effector; and

the vibration frequency of the end effector.

47. A surgical device comprising an end effector, the end effector comprising:

a central member extending longitudinally through the end effector; and

a plurality of radial mode transducers positioned around the central member, wherein the plurality of radial mode transducers are configured to respond to an electrical signal by vibrating in a direction perpendicular to the longitudinal axis.

48. The surgical device of claim 47, comprising a clamp arm pivotable toward the plurality of radial mode transducers along the longuditinal axis.

49. The surgical device of claim 47, wherein the central guide is flexible.

50. The surgical device of claim 47, wherein at least one of the plurality of radial mode transducers defines a concavity having a face perpendicular to the longitudinal axis.

51. The surgical device of claim 50, wherein the concavity encircles the at least one of the plurality of radial mode transducers about the longitudinal axis.

52. The surgical device of claim 47, wherein the end effector is configured to articulate.

53. A method for processing a surgical device for surgery, comprising:

obtaining the surgical device of claim 47; and

replacing at least one of the plurality of radial mode transducers positioned around the central member, wherein the plurality of radial mode transducers are configured to respond to an electrical signal by vibrating in a direction perpendicular to the longitudinal axis. sterilizing the surgical device.