Electrosurgical Tissue Sealer and Cutter

• US 20130030433A1
• Filed: 10/01/2012
• Published: 01/31/2013
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Heard, David N.
• Granted Patent: US 8,668,691 B2
• Time in Patent Office: Days
• US Class Current: 606/45
• CPC Class Codes: A61B 17/3205 Excision instruments
• 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 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• 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 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Abstract

A surgical instrument comprises an end effector including a pair of jaw members configured to move with respect to one another between an open configuration and a closed configuration for clamping tissue. At least one jaw member includes an elongate cam slot extending in a longitudinal direction over a substantial a length a tissue clamping surface of the at least one jaw member. A plurality of electrically isolated, and longitudinally spaced electrodes is supported by the tissue clamping surface and is configured to deliver electrosurgical energy to tissue. A reciprocating member engages the elongate cam slot and is extendable to a sealing position with respect to each of the electrodes to define a predetermined gap distance between a particular electrode and an opposing tissue clamping surface.

Claims

1. A surgical instrument, comprising:

an end effector including a pair of jaw members having opposing tissue clamping surfaces, at least one of the jaw members configured to move with respect to the other jaw member from an open configuration for receiving tissue and a closed configuration for clamping tissue between the opposing tissue clamping surfaces, at least one jaw member including an elongated cam slot defined therein and extending longitudinally therealong over a substantial a length of the tissue clamping surfaces;

a plurality of electrically isolated and independently activatable electrodes supported by at least one of the tissue clamping surfaces of one of the jaw members, each of the plurality of electrically insulated electrodes longitudinally spaced along at least one respective tissue clamping surface and configured to selectively deliver electrosurgical energy to tissue; and

a reciprocating member selectively extendable through the elongated cam slot to a distal end thereof to cam the jaw members to the closed configuration, each of the plurality of electrodes activatable at a longitudinal sealing position as the reciprocating member extends through the elongated cam slot.

2. The surgical instrument according to claim 1, further comprising an interruption mechanism to interrupt advancement of the reciprocating member at sequential longitudinal sealing positions along the elongated cam slot to allow selective application of electrosurgical energy.

3. The surgical instrument according to claim 2, wherein the interruption mechanism includes a handle movable with respect to a grip member, wherein the reciprocating member is operatively coupled to the movable handle such that the reciprocating member is advanced upon approximation of the movable handle with the grip member and advancement of the reciprocating member is interrupted upon separation of the movable handle from the grip member.

4. The surgical instrument according to claim 2, wherein the interruption mechanism includes a motor and a controller, the motor operatively associated with the reciprocating member to advance the reciprocating member upon activation of the motor and interrupt advancement upon deactivation of the motor, the controller operatively associated with the motor to activate and deactivate the motor.

5. The surgical instrument according to claim 4, further comprising a sensor array in electrical communication with the controller, the sensor array adapted to detect the position of the reciprocating member with the elongated cam slot with respect to at least one longitudinal sealing position.

6. The surgical instrument according to claim 1, further comprising a controller for providing electrical energy to a particular electrically isolated electrode while maintaining other electrically isolated electrodes in an electrically inactive state.

7. The surgical instrument according to claim 6, further comprising a sensor array in electrical communication with the controller, the sensor array adapted to detect a characteristic of the tissue indicative of a completed electrosurgical treatment.

8. The surgical instrument according to claim 7, wherein the sensor array includes at least one of a temperature sensor, an impedance sensor and an optical sensor.

9. The surgical instrument according to claim 1, wherein the reciprocating member includes a blade for transecting tissue.

10. The surgical instrument according to claim 9, wherein the reciprocating member includes a cam driver configured to engage the elongated cam slot and the blade is disposed proximally with respect to a cam driver.

11. The surgical instrument according to claim 10, wherein the blade is disposed sufficiently proximally relative to the cam driver such that when the reciprocating member is in a sealing position associated with a particular electrically isolated electrode, the blade is disposed proximally of the particular electrically isolated electrode.

12. The surgical instrument according to claim 1, wherein the reciprocating member generally exhibits an I-beam geometry including a pair of opposed flanges connected by an intermediate web.

13. The surgical instrument according to claim 12, wherein one of the pair of opposed flanges engages the elongated cam slot defined within one of the jaw members and the other of the pair of opposed flanged engages a second cam slot defined within the other of the jaw members.

14. The surgical instrument according to claim 1, wherein the elongated cam slot is angled such that advancement of the reciprocating member therethrough urges the end effector to the closed configuration.

15. The surgical instrument according to claim 1, wherein the plurality of electrically isolated electrodes includes a plurality of electrode sets, each electrode set including at least two electrically isolated electrodes of opposite polarity supported on respective tissue clamping surfaces such that the electrically isolated electrodes of opposite polarity cooperate to induce electrosurgical current flow through tissue positioned between the tissue clamping surfaces.

16. A surgical instrument comprising:

an end effector including a pair of jaw members having opposing tissue clamping surfaces, at least one of the jaw members configured to move with respect to the other jaw member from an open configuration for receiving tissue and a closed configuration for clamping tissue between the opposing tissue clamping surfaces, at least one of the jaw members having a cam slot formed therein;

a plurality of electrically isolated and independently activatable electrodes supported by at least one of the tissue clamping surfaces of one of the jaw members, each of the plurality of electrically isolated electrodes longitudinally spaced along at least one respective clamping surface and configured to deliver electrosurgical energy the tissue;

a reciprocating member including a blade, the reciprocating member selectively extendable through the elongated cam slot to a distal end thereof to cam the jaw members to the closed configuration, each of the plurality of electrodes activatable at a longitudinal sealing position as the reciprocating member extends through the elongated cam slot.

17. A method for electrosurgically treating tissue, the method comprising the steps of:

providing an instrument including a plurality of electrically isolated and independently activatable electrodes spaced longitudinally along at least one of a pair of tissue clamping surfaces of a pair of jaw members having a cam slot defined therein, the instrument also including a reciprocating member selectively extendable through the elongated cam slot to a distal end thereof to cam the jaw members to a closed configuration, each of the plurality of electrically isolated electrodes activatable at a longitudinal sealing position as the reciprocating member extends through the elongated cam slot;

positioning tissue between the opposing clamping surfaces such that at least a first pair of electrically isolated electrodes of the plurality of electrically isolated electrodes contacts the tissue;

advancing the reciprocating member through the cam slot to clamp proximate the pair of electrically isolated electrodes;

selectively activating the pair of electrically isolated electrodes to treat tissue and create a tissue seal; and

advancing the reciprocating member to the next pair of electrically isolated electrodes.

18. The method of claim 17, further comprising interrupting advancement of the reciprocating member to maintain the reciprocating member at the closed configuration with respect to the first pair of electrodes while providing electrosurgical energy to the first pair of electrodes.

19. The method of claim 17, wherein the reciprocating member includes a blade for transecting tissue.

20. The surgical instrument according to claim 19, wherein the reciprocating member includes a cam driver configured to engage the elongated cam slot and the blade is disposed proximally with respect to a cam driver.