Ultrasound and impedance feedback system for use with electrosurgical instruments

• US 5,733,281 A
• Filed: 03/19/1996
• Issued: 03/31/1998
• Est. Priority Date: 03/19/1996
• Status: Expired due to Term

• Current Assignee: American Cardiac Ablation Company Incorporated
• Original Assignee: American Ablation Company Incorporated
• Inventors: Nardella, Paul C.
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US08/619,829
• Time in Patent Office: 742 Days
• Field of Search: 606/12, 606/34, 606/35, 606/38, 606/41, 606/42
• US Class Current: 606/38
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00773 Sensed parameters
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 7/00 Instruments for auscultation
• CPC Class Codes: G01S 15/86 Combinations of sonar systems with lidar systems; Combinations of sonar systems with systems not using wave reflection
• CPC Class Codes: G01S 15/88 Sonar systems specially adapted for specific applications seismic or acoustic prospecting or detecting G01V1/00

Abstract

An electrosurgical feedback system for detecting the effects of electrosurgical energy on tissue. The feedback system can include an acoustical detection element that acoustically detects the effects of energy on tissue and then generates an acoustic output signal indicative of these energy effects. A power regulation element, in response to the acoustic output signal, regulates the electrosurgical energy supplied to the tissue. Alternatively, the feedback system can include an impedance determination circuit that determines the impedance of the tissue. The tissue determination stage can include a first and second differentiator circuit to determine the time-based derivative of the measured tissue impedance. The tissue determination stage generates an impedance output signal of either the first or second derivative of the tissue impedance, which is conveyed to the power regulation element. The regulation element regulates the amount of energy supplied to the tissue in response to the impedance output signal.

Claims

1. A feedback electrosurgical system for use with a surgical tool to detect the effects of energy on tissue, said system comprising

a first energy-delivering electrode to be mounted to the surgical tool and adapted to deliver electrosurgical energy from a power source to tissue disposed adjacent thereto,

a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue,

impedance measurement means in electrical communication with the surgical tool for determining the electrical impedance of the tissue, said impedance measurement means generating an impedance output signal indicative of the tissue impedance,

differentiation means in circuit with the impedance measurement means for determining the derivative of the tissue impedance in response to the impedance output signal, said differentiation means generating a derivative output signal indicative of the formation of gas created during application of energy to tissue, and

power regulation means in circuit with the differentiation means and the power source for regulating the application of electrosurgical energy by the power source to the energy-delivering electrode in response to the derivative output signal.

2. The electrosurgical system of claim 1 wherein the differentiation means includes first differentiation means in communication with the impedance measurement means for determining the first time-based derivative of the impedance output signal, said first differentiation means generating a first derivative output signal in response to the impedance output signal, and

wherein the power regulation means regulates the application of energy to the energy-delivering electrode in response to the first derivative output signal.

3. The electrosurgical system of claim 1 further comprising acoustical detection means, coupled to the surgical tool and the power regulation means, for acoustically detecting the effects of energy on tissue, said acoustical detection means generating an acoustic output signal indicative of the formation of gas created during application of energy to tissue,

wherein the power regulation means regulates the application of energy to the energy-delivering electrode in response to at least one of the derivative output signal and the acoustic output signal.

4. The electrosurgical system of claim 3 wherein said acoustical detection means includes ultrasound means for ultrasonically detecting the heating effects of energy on tissue.

5. The electrosurgical system of claim 4 wherein the ultrasound means comprises an ultrasonic transducer that is mounted on a distal end of the surgical tool.

6. The electrosurgical system of claim 5 wherein the ultrasonic transducer is mounted in close proximity to the energy-delivering electrode.

7. The electrosurgical system of claim 5 wherein the ultrasonic transducer is a piezoelectric ceramic crystal.

8. The electrosurgical system of claim 7 wherein the acoustical detection means further comprises pulse means coupled to the ultrasound means for electrically activating the ultrasound means to emit ultrasonic pulses having a selected frequency and a selected duration.

9. The electrosurgical system of claim 8 wherein the emitted ultrasonic pulses are reflected by one of the tissue and the gas formed during the application of energy to tissue, and wherein the acoustical detection means further comprises receiver means coupled to the ultrasound means for generating the acoustic output signal in response to the reflected ultrasonic pulses.

10. The electrosurgical system of claim 9 further comprising display means coupled to the receiver means for displaying the reflected ultrasonic pulses.

11. The electrosurgical system of claim 3 wherein the acoustical detection means includes microphone means for detecting sounds associated with the application of energy to tissue, and for generating an electrical output signal corresponding to the detected sounds.

12. The electrosurgical system of claim 11 wherein the acoustical detection means further includes speaker means coupled to the microphone means for producing an audible output signal in response to the electrical output signal.

13. The electrosurgical system of claim 1 wherein the power source is one of an RF generator, a laser and an ultrasonic energy source.

14. A feedback electrosurgical system for use with a surgical tool to detect the effects of energy on tissue, said system comprising

a first energy-delivering electrode to be mounted to the surgical tool and adapted to deliver electrosurgical energy from a power source to tissue disposed adjacent thereto,

a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue,

impedance measurement means in electrical communication with the surgical tool for determining the electrical impedance of the tissue, said impedance measurement means generating an impedance output signal indicative of the tissue impedance,

differentiation means in circuit with the impedance measurement means for determining the derivative of the tissue impedance in response to the impedance output signal, said differentiation means generating a derivative output signal indicative of the time-based derivative of the impedance output, wherein the differentiation means comprises:

first differentiation means in communication with the impedance measurement means for determining the first time-based derivative of the impedance output signal, said first differentiation means generating a first derivative output signal in response to the impedance output signal, and second differentiation means in circuit with the first differentiation means for determining the second time-based derivative of the impedance output signal, said second differentiation means generating a second derivative output signal in response to the first derivative output signal, and

power regulation means in circuit with the differentiation means and the power source for regulating the application of electrosurgical energy by the power source to the energy-delivering electrode in response to the derivative output signal, the power regulation means regulating the application of energy to the energy-delivering electrode in response to the second derivative output signal.

15. An electrosurgical feedback system for use with a surgical tool to detect the effects of energy on tissue, said system comprising

a first energy-delivering electrode to be mounted to the surgical tool and adapted to receive electrosurgical energy from a power source and deliver energy to the tissue,

a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue,

acoustical detection means coupled to the surgical tool for detecting acoustically the effects of energy on the tissue, said acoustical detection means generating an acoustic output signal indicative of the formation of gas created during application of energy to the tissue, and

power regulation means in circuit with the surgical tool and the acoustical detection means for regulating the energy supplied to the energy delivering electrode in response to the acoustic output signal.

16. The electrosurgical system of claim 15 wherein the acoustical detection means includes an ultrasonic transducer.

17. The electrosurgical system of claim 16 wherein the acoustical detection means further includes pulsing means coupled to the ultrasonic transducer for applying an electrical current thereto to induce the transducer to generate ultrasonic pulses.

18. The electrosurgical system of claim 17 wherein the acoustical detection means further comprises processor means coupled to the ultrasonic transducer for receiving and processing electrical signals generated by the ultrasonic transducer that are indicative of reflected ultrasonic pulses, said processor means generating the acoustic output signal.

19. The electrosurgical system of claim 18 further including display means in circuit with the processor means for displaying the reflected ultrasonic pulses.

20. The electrosurgical system of claim 15 further comprising impedance measurement means coupled to the surgical tool for determining the impedance of the tissue disposed between the energy receiving electrode and the second electrode, said impedance measurement means generating an impedance output signal indicative of the impedance of the tissue.

21. The electrosurgical system of claim 20 further comprising first derivative means coupled to the impedance measurement means for determining the first time-based derivative of the impedance output signal, said first derivative means generating a first derivative output signal indicative of the first derivative of the tissue impedance.

22. The electrosurgical system of claim 21 further including means for communicating the first derivative output signal to said power regulation means, said power regulation means regulating the power supplied to the energy-delivering electrode in response to at least one of the first derivative output signal and the acoustic output signal.

23. The electrosurgical system of claim 15 wherein the acoustical detection means includes microphone means for detecting the effect of energy on the tissue, said microphone means generating an electrical output signal indicative of sounds associated with the heating of tissue.

24. The electrosurgical system of claim 23 further comprising speaker means in communication with the microphone means for converting said electrical output signal of said microphone means into an audible output signal.

25. An electrosurgical feedback system for use with a surgical tool to detect the effects of energy on tissue, said system comprising

a first energy-delivering electrode to be mounted to the surgical tool and adapted to receive electrosurgical energy from a power source and deliver energy to the tissue,

a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue,

acoustical detection means coupled to the surgical tool for detecting acoustically the effects of energy on the tissue, said acoustical detection means generating an acoustic output signal indicative of the heating effects on the tissue, and

power regulation means in circuit with the surgical tool and the acoustical detection means for regulating the energy supplied to the energy delivering electrode in response to the acoustic output signal,

impedance measurement means coupled to the surgical tool for determining the impedance of the tissue disposed between the energy receiving electrode and the second electrode, said impedance measurement means generating an impedance output signal indicative of the impedance of the tissue,

first derivative means coupled to the impedance measurement means for determining the first time-based derivative of the impedance output signal, said first derivative means generating a first derivative output signal indicative of the first derivative of the tissue impedance,

second derivative means in communication with the first derivative means and the power regulation means for determining the derivative of the first derivative output signal, said second derivative means generating a second derivative output signal indicative of the second derivative of the impedance output signal.

26. The electrosurgical system of claim 25 including means for communicating the second derivative output signal to said power regulation means, said power regulation means regulating the power supplied to the energy-delivering electrode in response to at least one of the second derivative output signal and the acoustic output signal.

27. The electrosurgical system of claim 26 further including display means for displaying at least one of the first derivative output signal, the second derivative output signal and the acoustic output signal.

28. An electrosurgical feedback system for use with a surgical tool to detect the effects of energy on tissue, said system comprising

a first energy-delivering electrode to be mounted to the surgical tool and adapted to receive electrosurgical energy from a power source and deliver energy to the tissue,

a second electrode adapted to receive the power delivered by the first electrode and passing through the tissue,

acoustical detection means associated with a surgical tool and remotely located relative thereto for detecting acoustically the effects of energy on the tissue, said acoustical detection means generating an acoustic output signal indicative of the formation of gas created during application of energy to the tissue, and

power regulation means in circuit with the acoustical detection means for regulating the power supplied to the tool in response to the acoustic output signal.

29. The electrosurgical system of claim 28 wherein the acoustical detection means further includes an ultrasonic transducer and pulsing means coupled to the ultrasonic transducer for applying an electrical current thereto to induce the transducer to generate ultrasonic pulses.

30. The electrosurgical system of claim 29 wherein the acoustical detection means further comprises processor means coupled to the ultrasonic transducer for receiving and processing electrical signals generated by the ultrasonic transducer that are indicative of reflected ultrasonic pulses, said processor means generating the acoustic output signal.

31. The electrosurgical system of claim 28 wherein the acoustical detection means includes microphone means for detecting the effect of energy on the tissue, said microphone means generating an electrical output signal indicative of sounds associated with the heating of tissue.

32. The electrosurgical system of claim 31 further comprising speaker means in communication with the microphone means for converting said electrical output signal of said microphone means into an audible output signal.

33. A feedback electrosurgical system for detecting the effects of energy on tissue and for use with a surgical tool comprising a first energy-delivering electrode to be mounted to the surgical tool and adapted to deliver electrosurgical energy from a power source to tissue disposed adjacent thereto and a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue, the system comprising:

impedance measurement means in electrical communication with the surgical tool for determining the electrical impedance of the tissue, said impedance measurement means generating an impedance output signal indicative of the tissue impedance,

differentiation means in circuit with the impedance measurement means for determining the derivative of the tissue impedance in response to the impedance output signal, said differentiation means generating a derivative output signal indicative of the formation of gas created during application of energy to tissue, and

power regulation means in circuit with the differentiation means and the power source for regulating the application of electrosurgical energy by the power source to the energy-delivering electrode in response to the derivative output signal.

34. An electrosurgical feedback system for detecting the effects of energy on tissue and for use with a surgical tool comprising a first energy-delivering electrode to be mounted to the surgical tool and adapted to receive electrosurgical energy from a power source and deliver energy to the tissue and a second electrode adapted to receive the energy delivered by the first electrode and passing through the tissue, the system comprising:

acoustical detection means coupled to the surgical tool for detecting acoustically the effects of energy on the tissue, said acoustical detection means generating an acoustic output signal indicative of the formation of gas created during application of energy to the tissue, and

power regulation means in circuit with the surgical tool and the acoustical detection means for regulating the energy supplied to the energy delivering electrode in response to the acoustic output signal.