SURGICAL DEVICES HAVING CONTROLLED TISSUE CUTTING AND SEALING

• US 20150209573A1
• Filed: 01/28/2014
• Published: 07/30/2015
• Est. Priority Date: 01/28/2014
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Hibner, John, Yates, David C., Strobl, Geoffrey S., Houser, Kevin L.
• Granted Patent: US 9,802,033 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 18/1442 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 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00696 Controlled or regulated parameters
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00922 by switching or controlling the treatment energy directly within the hand-piece
• CPC Class Codes: A61B 2018/1452 including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 2560/0462 Apparatus with built-in sensors
• CPC Class Codes: A61B 2562/0261 Strain gauges
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61N 1/00 : Electrotherapy; Circuits therefor A61N2/00 takes precedence; irradiation apparatus A61N5/00

Abstract

Various surgical devices and methods are provided for monitoring and regulating tissue compression and cutting to improve tissue effect. In general, these devices include a handle portion, an elongate shaft, and an effector disposed at a distal end of the shaft and configured to engage tissue. In one embodiment, one or more sensors can be positioned at various locations on the device and can determine a force applied to tissue engaged by the end effector. When the force exceeds a threshold, a notification signal can be issued to a user. In another embodiment, a sensor can determine an amount of current moving between jaws of the end effector and a controller can slow a speed of the cutting element when the sensed current exceeds a threshold amount.

Claims

1. A surgical device, comprising:

a proximal handle portion that includes a motor;

an elongate shaft extending distally from the handle portion;

an end effector including first and second jaws disposed at a distal end of the elongate shaft and configured to engage tissue therebetween;

an actuator configured to receive an input of pressure from a user that causes the motor to provide power to cause at least one of the first and second jaws to move such that a distance between the first and second jaws is reduced and to advance the cutting element;

at least one sensor disposed on at least one of the jaws, the sensor being configured to determine a force applied to tissue disposed between the jaws when the jaws are caused to compress tissue disposed therebetween; and

a controller configured to determine when the force exceeds a predetermined threshold and, if the force is in excess of the predetermined threshold, to cause a notification signal to be issued to a user.

2. The device of claim 1, wherein the at least one sensor includes at least one strain gauge.

3. The device of claim 1, wherein the at least one sensor includes first and second strain gauges.

4. The device of claim 1, wherein the predetermined threshold force depends on at least one of tissue type and tissue thickness.

5. The device of claim 1, wherein the handle portion includes a power source that is electrically coupled to the at least one sensor.

6. The device of claim 2, wherein the at least one strain gauge is positioned parallel to a longitudinal axis of the first and second jaws.

7. The device of claim 3, wherein the first strain gauge is positioned on the first jaw and the second strain gauge is positioned on the second jaw.

8. The device of claim 3, wherein the first and second gauges are wired in parallel.

9. The device of claim 1, wherein the notification signal includes an audible signal.

10. The device of claim 1, wherein the notification signal activates a visual indicator disposed on the handle portion.

11. The device of claim 1, wherein the notification signal is configured to provide tactile sensation to a user.

12. The device of claim 11, wherein the notification signal includes a vibration.

13. The device of claim 1, wherein, when the force applied to the tissue exceeds the predetermined threshold, the actuator is configured to automatically fix a relative position of the first and second jaws.

14. A surgical device, comprising:

a proximal handle portion that includes a motor;

an elongate shaft extending distally from the handle portion;

an end effector having first and second jaws pivotably coupled to a distal end of the elongate shaft, the first and second jaws including first and second electrodes configured to apply energy to tissue disposed therebetween;

an actuator configured to receive an input of pressure from a user that causes the motor to provide power to advance a cutting element;

a sensor configured to sense current moving between the first and second electrodes; and

a controller configured to slow a speed of the cutting element when the sensed current exceeds a threshold amount.

15. The device of claim 14, wherein the actuator is configured to control opening and closing of the first and second jaws.

16. The device of claim 14, further comprising a sensor configured to determine a relative position of the first and second jaws.

17. The device of claim 14, wherein the first and second electrodes are configured to apply RF energy to tissue disposed therebetween.

18. A surgical method, comprising:

engaging a tissue between first and second jaws of an end effector of a surgical device;

applying energy to a portion of the tissue positioned between the end effector; and

causing a motor of the device to supply power to a cutting element of the device such that the cutting element advances through the tissue so as to cut the tissue; and

when the cutting element is advancing through the tissue, sensing an amount of the applied energy traveling through the portion of tissue engaged by the end effector and generating a control signal in response, the control signal modulating an amount of the power supplied to the motor so as to adjust a speed of the cutting element.

19. The method of claim 18, wherein the applied energy traveling through the tissue includes electrical current.

20. A surgical method, comprising:

engaging a tissue between first and second jaws of an end effector of a surgical device;

measuring a force applied to the tissue by the first and second jaws; and

when the measured force exceeds a predetermined threshold force, generating a notification signal to alert a user.

21. The method of claim 20, wherein the predetermined threshold force is inputted into the surgical device by a user.