CUT AND SEAL INSTRUMENT

• US 20100292691A1
• Filed: 07/22/2010
• Published: 11/18/2010
• Est. Priority Date: 03/05/2009
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: BROGNA, SALVATORE
• Granted Patent: US 8,858,547 B2
• Time in Patent Office: Days
• US Class Current: 606/45
• 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 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/0088 ceramic
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00773 Sensed parameters
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00988 Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter
• 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 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 2090/0803 Counting the number of times an instrument is used

Abstract

A combined electrical tissue sealing and mechanical tissue cutting instrument. The instrument has two opposing jaw members. A removable cartridge is positioned in one of the jaw members. The cartridge includes a tissue sealing electrode and a tissue cutter. As either the tissue sealing electrode or the cutter deteriorates with use, the cartridge is replaced with a new cartridge. Cartridges are configured with various electrode geometries to accommodate various associated electro-surgical units. One or more pressure sensors in the cartridge or in the instrument jaw that supports the cartridge provide an indication that a required clamping pressure exists between the jaw members to carry out the tissue sealing. A cut and seal controller allows various actions to be carried out when particular clamping pressures are sensed, or when an indication that tissue sealing is complete is sensed.

Claims

1. A combined cutting and sealing surgical instrument comprising:

a first tissue sealing electrode; and

a removable cartridge;

wherein the removable cartridge comprises a second tissue sealing electrode and a tissue cutter; and

wherein the second tissue sealing electrode is positioned to oppose the first tissue sealing electrode when the cartridge is inserted in the instrument.

2. The instrument of claim 1:

wherein the instrument further comprises a moveable jaw member; and

wherein the first tissue sealing electrode is mounted on the movable jaw member.

3. The instrument of claim 1:

wherein the tissue cutter comprises a movable blade.

4. The instrument of claim 3:

wherein the instrument comprises a motor that drives the movable blade from a start position to an end position so as to cut tissue a first time, and from the end position to the start position so as to reset the movable blade to cut tissue a second time.

5. The instrument of claim 1:

wherein the tissue cutter comprises an electrode.

6. The instrument of claim 1:

wherein at least one of the first or second tissue sealing electrodes comprises a surface on which a ceramic is overlaid.

7. The instrument of claim 1:

wherein only the second tissue sealing electrode comprises a surface on which a ceramic is overlaid.

8. The instrument of claim 1:

wherein a top surface of the removable cartridge comprises an enhanced tissue grasping feature.

9. The instrument of claim 1:

wherein the instrument comprises a jaw that receives the removable cartridge; and

wherein a top surface of the jaw comprises an enhanced tissue grasping feature.

10. The instrument of claim 1:

wherein the removable cartridge comprises at least one pressure sensor positioned to sense a clamping pressure against tissue positioned between the first and second tissue sealing electrodes.

11. The instrument of claim 1:

wherein the instrument comprises a jaw that receives the removable cartridge; and

wherein the jaw comprises at least one pressure sensor positioned to sense a clamping pressure against tissue positioned between the first and second tissue sealing electrodes.

12. The instrument of claim 1:

wherein the cartridge further comprises an electronic encryption device; and

wherein the electronic encryption device stores information that is used to manage a number of allowable cartridge uses.

13. The instrument of claim 1:

wherein the instrument further comprises a wrist mechanism that provides at least a pitch or yaw degree of freedom for the opposing first and second tissue sealing electrodes.

14. A surgical system comprising:

a cartridge, wherein the cartridge comprises a first tissue sealing electrode;

a surgical instrument, wherein the surgical instrument comprises a first jaw and a second jaw, wherein the first jaw comprises a second tissue sealing electrode facing the second jaw, and wherein the second jaw is configured to removably receive the cartridge in a position where the first tissue sealing electrode is opposite the second tissue sealing electrode; and

a cut and seal controller, wherein the cut and seal controller automatically generates a command to the surgical instrument to reduce a clamping force between the first and the second jaws after sensing that tissue sealing is complete.

15. A surgical tissue sealing system comprising:

a first cartridge, wherein the first cartridge comprises an electrode having a first geometry;

a second cartridge, wherein the second cartridge comprises an electrode having a second geometry different from the first geometry; and

a surgical instrument, wherein the surgical instrument comprises a first jaw and a second jaw, wherein the first jaw comprises an electrode that faces the second jaw, and wherein the second jaw is configured to interchangeably receive the first cartridge or the second cartridge.

16. The system of claim 15 further comprising:

a first electro-surgical unit, wherein the first electro-surgical unit is associated with the electrode having the first geometry; and

a second electro-surgical unit, wherein the second electro-surgical unit is associated with the electrode having the first geometry;

wherein the first electrosurgical unit is coupled to provide tissue sealing energy to the electrode on the first jaw and the electrode having the first geometry when the first cartridge is positioned in the second jaw; and

wherein the second electrosurgical unit is coupled to provide tissue sealing energy to the electrode on the first jaw and the electrode having the second geometry when the second cartridge is positioned in the second jaw.

a first electro-surgical unit, wherein the first electro-surgical unit is associated with the electrode having the first geometry; and

a second electro-surgical unit, wherein the second electro-surgical unit is associated with the electrode having the first geometry;

wherein the first electrosurgical unit is coupled to provide tissue sealing energy to the electrode on the first jaw and the electrode having the first geometry when the first cartridge is positioned in the second jaw; and

wherein the second electrosurgical unit is coupled to provide tissue sealing energy to the electrode on the first jaw and the electrode having the second geometry when the second cartridge is positioned in the second jaw.

17. A surgical tissue sealing system comprising:

a surgical instrument, wherein the surgical instrument comprises a first jaw, a second jaw, and a pressure sensor, wherein the first jaw comprises a first tissue sealing electrode, wherein the second jaw comprises a second tissue sealing electrode, and wherein the pressure sensor senses a clamping pressure against tissue clamped between the first and second tissue sealing electrodes; and

a surgeon'"'"'s console, wherein the surgeon'"'"'s console receives an indication of the pressure sensed by the pressure sensor, and wherein the surgeon'"'"'s console outputs an indication that a pressure required for an effective tissue sealing operation exists between the first and the second tissue sealing electrodes.

18. A method of operating a combined cut and seal surgical instrument, comprising:

inserting a removable cartridge into the instrument, wherein the cartridge comprises a tissue sealing electrode and a tissue cutter;

generating a command to direct tissue sealing energy to the tissue sealing electrode in response to a surgeon'"'"'s input;

automatically generating a second command to cut tissue with the tissue cutter after sensing that tissue sealing is complete.

19. The method of claim 18 further comprising:

automatically generating a third command to move the tissue cutter to a start position to allow the tissue cutter to cut tissue again.

20. The method of claim 18 further comprising:

automatically generating a third command to release tissue clamping pressure after sensing that tissue sealing is complete.

21. The method of claim 18 further comprising:

automatically generating a third command to release tissue clamping pressure after sensing that tissue cutting is complete.