APPARATUS SYSTEM AND METHOD FOR COAGULATING AND CUTTING TISSUE

• US 20090125026A1
• Filed: 11/12/2008
• Published: 05/14/2009
• Est. Priority Date: 11/13/2007
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Berman, Devon, Rioux, Robert F., Kane, Kathleen
• Granted Patent: US 8,906,017 B2
• Time in Patent Office: Days
• US Class Current: 606/45
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2018/00065 porous
• 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 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/0063 Sealing
• 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: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes

Abstract

A combination tissue coagulation and cutting apparatus, system and method for coagulating and cutting tissue. A clamp element includes first and second clamp members having respective first and second porous electrodes, such as sintered metal electrodes. A portion of tissue, such as a blood vessel, is held between the porous electrodes, and fluid from a fluid source can pass through the porous electrodes. The tissue portion can be coagulated when electrical current is applied to the first and second porous electrodes, and an adjustable cutting element that is associated with the clamp members is positioned to cut a segment or all of the coagulated tissue portion. In this manner, the same surgical instrument is used to coagulate and cut tissue.

Claims

1. An electro-surgical apparatus for coagulating and cutting tissue, comprising:

a clamp element including porous electrodes configured to hold and coagulate a tissue portion when electrical current is conducted through the porous electrodes and the tissue portion; and

a cutting element associated with the clamp element, a position of the cutting element being adjustable for cutting the coagulated tissue portion when electrical current is conducted through the cutting element and the coagulated tissue portion.

2. The electro-surgical apparatus of claim 1, wherein the clamp element and the cutting element are configured to coagulate the tissue portion and subsequently cut coagulated the coagulated tissue portion.

3. The electro-surgical apparatus of claim 1, wherein the clamp element and the cutting element are configured to coagulate and cut the tissue portion and simultaneously or at about the same time.

4. The electro-surgical apparatus of claim 1, wherein the clamp element and the cutting element are configured to respectively coagulate and cut a blood vessel.

5. The electro-surgical apparatus of claim 1, wherein the clamp element includes first and second porous electrodes, the clamp element comprising:

a first clamp member having a proximal end, a distal end, an inner surface, and an outer surface, wherein the first porous electrode is attached to the inner surface of the distal end of the first clamp member, and

a second clamping member coupled to the first clamp member and having a proximal end, a distal end, an inner surface, and an outer surface, wherein the second porous electrode is attached to the inner surface of the distal end of the second clamp member.

6. The electro-surgical apparatus of claim 5, wherein the proximal ends of the first and second clamp members are handles.

7. The electro-surgical apparatus of claim 5, wherein the first and second clamp members are coupled at a pivot, and at least one of the first and second clamp members is movable about the pivot.

8. The electro-surgical apparatus of claim 5, wherein a distal end of the adjustable cutting element is positionable between the first and second clamp members.

9. The electro-surgical apparatus of claim 5, wherein a distal end of the adjustable cutting element is positionable between the first and second porous electrodes.

10. The electro-surgical apparatus of claim 5, wherein the adjustable cutting element is slidably adjustable through an aperture defined by a clamp member, or a gap defined between the first and second clamp members.

11. The electro-surgical apparatus of claim 1, wherein the porous electrodes are sintered metal electrodes.

12. The electro-surgical apparatus of claim 1, wherein the adjustable cutting element is a wire cutting element.

13. The electro-surgical apparatus of claim 1, wherein a position of the adjustable cutting element is manually adjustable by a user.

14. The electro-surgical apparatus of claim 13, wherein the adjustable cutting element is slidably adjustable.

15. The electro-surgical apparatus of claim 13, wherein the adjustable cutting element is slidably adjustable between a retracted position for coagulation of tissue and an extended position for engaging and cutting coagulated tissue.

16. The electro-surgical apparatus of claim 1, wherein the cutting element can be controlled to cut a segment of the coagulated tissue portion.

17. The electro-surgical apparatus of claim 1, wherein the cutting element can be controlled to cut the entire coagulated tissue portion.

18. A system for coagulating and cutting tissue with the same electro-surgical instrument, comprising:

a surgical apparatus for coagulating and cutting a tissue portion, the apparatus having a clamp element including porous electrodes configured to hold the tissue portion and a cutting element associated with the clamp element, a position of the cutting element being adjustable;

a current source electrically coupled to the porous electrodes and the cutting element; and

a fluid source in fluid communication with the porous electrodes, the surgical apparatus being configured to coagulate tissue held between the porous electrodes when fluid passes through the first and second porous electrodes and electrical current is conducted from current source and through the porous electrodes and the tissue, and the position of the cutting element is adjustable for cutting coagulated tissue when electrical current is conducted through the cutting element and the coagulated tissue.

19. The system of claim 18, wherein the surgical apparatus is configured to coagulate the tissue portion and subsequently cut coagulated the coagulated tissue portion.

20. The system of claim 18, wherein the surgical apparatus is configured to coagulate and cut the tissue portion and simultaneously or at about the same time.

21. The system of claim 18, wherein the clamp element and the cutting element are configured to respectively coagulate and cut a blood vessel.

22. The system of claim 18, wherein the clamp element includes first and second porous electrodes, the clamp element comprising:

a first clamp member having a proximal end, a distal end, an inner surface, and an outer surface, wherein the first porous electrode is attached to the inner surface of the distal end of the first clamp member, and

a second clamping member coupled to the first clamp member and having a proximal end, a distal end, an inner surface, and an outer surface, wherein the second porous electrode is attached to the inner surface of the distal end of the second clamp member.

23. The system of claim 22, wherein the proximal ends of the first and second clamp members are handles.

24. The system of claim 22, wherein the first and second clamp members are coupled at a pivot, and at least one of the first and second clamp members is movable about the pivot.

25. The system of claim 22, wherein a distal end of the adjustable cutting element is positionable between the first and second clamp members.

26. The system of claim 18, wherein a distal end of the adjustable cutting element is positionable between the first and second porous electrodes.

27. The system of claim 18, wherein the porous electrodes are sintered metal electrodes.

28. The system of claim 18, wherein the adjustable cutting element is a wire cutting element.

29. The system of claim 18, wherein a position of the adjustable cutting element is manually adjustable by a user.

30. The system of claim 29, wherein the adjustable cutting element is slidably adjustable.

31. The system of claim 30, wherein the adjustable cutting element is slidably adjustable between a retracted position for coagulation of tissue and an extended position for engaging and cutting coagulated tissue.

32. The system of claim 18, wherein the adjustable cutting element is slidably adjustable through an aperture defined through a clamp element or a gap between the first and second clamp elements.

33. The system of claim 18, wherein the cutting element can be controlled to cut a segment of the coagulated tissue portion.

34. The system of claim 18, wherein the cutting element can be controlled to cut the entire coagulated tissue portion.

35. A method of coagulating and cutting tissue using the same electro-surgical instrument, the method comprising:

holding tissue between first and second porous electrodes of respective first and second clamping members;

passing fluid through the porous electrodes;

applying electrical current to the porous electrodes, thereby coagulating tissue held between the porous electrodes;

cutting coagulated tissue by applying electrical current to a cutting element associated with the first and second clamp members.

36. The method of claim 35, further comprising adjusting a position of the cutting element.

37. The method of claim 36, adjusting the position further comprising slidably adjusting the cutting element.