Electrosurgical cutting tool

• US 5,665,085 A
• Filed: 08/03/1994
• Issued: 09/09/1997
• Est. Priority Date: 11/01/1991
• Status: Expired due to Term

• Current Assignee: Medical Scientific Incorporated
• Original Assignee: Medical Scientific Incorporated
• Inventors: Nardella, Paul C.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/285,413
• Time in Patent Office: 1,133 Days
• Field of Search: 606/32, 606/37, 606/39, 606/40, 606/41, 606/142, 606/143, 606/167, 606/171, 606/172, 606/45-50, 227/175.1, 227/176.1, 227/180.1, 227/901, 227/902
• US Class Current: 606/41
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• 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 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1447 wherein sliding surfaces cause opening/closing of the end effectors
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00973 pedal-operated
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/0066 without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/00738 Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/126 bipolar

Abstract

An electrosurgical tool comprises a retractable cutting element moveable along a linear cutting path and an electrical energy supply source which communicates electrical energy (e.g., radio frequency energy) through the cutting element and to tissue adjacent the cutting element. The cutting element may be formed of a sharp or non-sharpened material. During surgical procedures the electrosurgical cutting device is able to simultaneously cut tissue and cauterize, or fuse, the tissue in areas adjacent the incision through the application of electrical energy. The effect is a reduced amount of bleeding associated with surgical procedures and an enhanced ability to control and eliminate bleeding. Optionally, the electrosurgical cutting device may also include a supply of surgical staples which are deployed simultaneously with the cutting action and delivery of electrosurgical energy to adjacent tissue.

Claims

1. An electrosurgical device, comprising:

a proximal handle region;

a distal, tissue affecting portion including opposed first and second tissue engaging surfaces;

a tissue contacting, electrically isolated energy delivering electrode provided on one of the first or second tissue engaging surfaces;

a tissue contacting return electrode provided on one of the first or second tissue engaging surfaces, the return electrode being electrically isolated from the energy delivering electrode;

one or more surgical staples, provided on one of the first or second tissue engaging surfaces of the tissue affecting portion;

a driver means for deploying the staples;

means for effecting closure of one or more of the surgical staples, the means for effecting closure being provided on one of the first or second tissue engaging surfaces opposite the surgical staples; and

electrosurgical current delivery means for communicating electrical energy through the energy delivering electrode to tissue to effect cutting and/or cauterization of tissue.

2. The device of claim 1 further comprising a cutting element provided on one of the first or second tissue engaging surfaces.

3. The device of claim 2 wherein the cutting element is a cutting blade that is adapted to be manipulated to sever tissue.

4. The device of claim 2 wherein the cutting element is the energy delivering electrode.

5. The device of claim 1 wherein the surgical staples are disposed within a cartridge means for housing the surgical staples, the cartridge means being provided on one of the first or second tissue engaging surfaces of the tissue affecting portion.

6. The device of claim 1 wherein the return electrode is the means for effecting closure of the surgical staples.

7. The device of claim 6 wherein the energy delivering electrode is provided on the cartridge means and is in electrical communication with the surgical staples to be deployed.

8. The device of claim 1 wherein the energy delivering electrode is the driver means.

9. The device of claim 1 wherein the voltage of the electrosurgical energy delivered to the tissue from the cutting blade is in the range of about 50 to 100 volts RMS.

10. An electrosurgical cutting device, comprising:

a tool housing including a handle portion;

a cutting portion, adjacent the handle portion, having substantially parallel first and second elongate tyne elements which define a tissue engaging space therebetween;

a pathway within the first tyne member which defines a cutting path;

a moveable curing element, electrically isolated from the remainder of the tool, said cutting element being adapted to move from a retracted position through the pathway in the first tyne to sever tissue;

means for moving the cutting element through the pathway to effect cutting of tissue;

selectively operable electrosurgical current supply means for communicating electrical energy through the cutting element to tissue to cauterize tissue simultaneous with the cutting action of the element; and

a tissue contacting return electrode in electrical communication with the second tyne element and electrically isolated from the cutting element, forming a bipolar electrosurgical cutting device.

11. The device of claim 10 wherein the cutting element is a cutting blade.

12. The device of claim 10 wherein the cutting element comprises an electrode wire.

13. The device of claim 10 wherein the cutting element is selected from the group consisting of conductive metals, conductive polymers and conductive ceramics.

14. The device of claim 10 wherein the cutting element comprises a non-conductive substrate coated with a conductive material selected from the group consisting of metals, polymers and ceramics.

15. The device of claim 14 wherein the non-conductive substrate is selected from the group consisting of a non-conductive polymer or ceramic.

16. The device of claim 10, further comprising:

a cartridge means for housing a plurality of surgical staples, said cartridge means disposed on the first tyne member, on a side thereof facing the second tyne member and having a longitudinal groove therein to accommodate passage of the cutting element;

a means for deploying the staples substantially simultaneously with the cutting action of the element; and

anvil means for effecting closure of the staples, the anvil means being disposed on a side of the second tyne member facing the first tyne member.

17. The device of claim 16 wherein the return electrode is in electrical communication with the anvil means, forming a bipolar electrosurgical device.

18. A method of conducting electrosurgical procedures, comprising the steps of:

providing a bipolar electrosurgical cutting tool having as an active, energy delivering electrode a retractable cutting element selectively moveable along a predetermined cutting path, said cutting element being connected to one pole of a bipolar generator and being electrically isolated from a tissue contacting return electrode disposed on a cutting portion of the tool and adjacent the cutting element;

placing tissue in the cutting path of the cutting element;

activating the cutting element such that it passes through and severs the tissue;

providing electrosurgical energy through the cutting element to tissue adjacent the incision simultaneously with the severing of tissue by the element such that the affected tissue is cauterized and bleeding associated with the incision is essentially eliminated; and

deploying a plurality of surgical staples adjacent the incision, simultaneous with the steps of activating the cutting element and providing electrosurgical energy through the element to the tissue.

19. The method of claim 18, further comprising the step of deploying a plurality of surgical staples adjacent the incision, simultaneous with the steps of activating the cutting element and providing electrosurgical energy through the element to the tissue.

20. The method of claim 18 wherein the current of the electrosurgical energy delivered to tissue through the cutting element is in the range of 0.5 to 2.0 amps.

21. The method of claim 18 wherein the voltage of the electrosurgical energy delivered to tissue through the cutting element is in the range of about 50 to 100 volts RMS.

22. The method of claim 18 wherein the time required for the cutting element to traverse, cut and cauterize tissue is about 1.5 to 4.5 seconds.

23. A bipolar electrosurgical cutting device, comprising:

a handle means for grasping and manipulating the device;

a cutting portion, adjacent to the handle means, having substantially parallel first and second elements that define a tissue engaging space therebetween;

a cutting element disposed within the cutting portion of the device and adapted to be manipulated to sever tissue, the cutting element being electrically isolated from the remainder of the device and being in electrical communication with a remote generator which provides electrosurgical energy to the cutting element for delivery to tissue contacted by the cutting element;

a tissue contacting return electrode provided on a tissue-contacting region of the cutting portion electrically isolated from the cutting element, forming a bipolar electrosurgical device;

means for effecting the movement of the cutting element within the cutting portion of the device to sever tissue; and

power control means for activating and regulating the electrosurgical energy supplied to the tool.

24. The device of claim 23 further comprising a pathway disposed within one of the first or second elements which defines a cutting path.

25. The device of claim 23 wherein the first element houses the cutting element and the second element serves as the return electrode.

26. The device of claim 25 further comprising a cartridge means for housing a supply of surgical staples which is disposed within the first element.

27. The device of claim 26 wherein the means for effecting the movement further controls the action of a staple ejecting mechanism such that surgical staples are deployed substantially simultaneously with the cutting movement of the cutting element.

28. The device of claim 27 wherein a means for closing the surgical staples is disposed on the second element.

29. An electrosurgical cutting device, comprising:

a tool housing including a handle portion;

a cutting element, adjacent the handle portion, having substantially parallel first and second elongate tyne elements which define a tissue engaging space therebetween;

a pathway within the first tyne member which defines a cutting path;

a moveable cutting element, electrically isolated from the remainder of the tool, said cutting element being adapted to move from a retracted position through the pathway in the first tyne to sever tissue;

means for moving the cutting element through the pathway to effect cutting of tissue;

a cartridge means for housing a plurality of surgical staples, said cartridge means disposed on the first tyne member, on a side thereof facing the second tyne member and having a longitudinal groove therein to accommodate passage of the cutting element;

a means for deploying the staples substantially simultaneously with the cutting action of the cutting element;

anvil means for effecting closure of the staples, the mandrel means being disposed on a side of the second tyne member facing the first tyne member; and

selectively operable electrosurgical current supply means for communicating electrical energy through the cutting element to tissue to cauterize tissue simultaneous with the cutting action of the cutting element.