Bi-polar electrosurgical endoscopic instruments

• US 5,769,849 A
• Filed: 05/23/1995
• Issued: 06/23/1998
• Est. Priority Date: 06/07/1991
• Status: Expired due to Fees

• Current Assignee: Hemostatic Surgery Corporation
• Original Assignee: Hemostatic Surgery Corporation
• Inventors: Eggers, Philip E.
• Primary Examiner(s): Shay, David M.
• Application Number:
  US08/447,628
• Time in Patent Office: 1,127 Days
• Field of Search: 606/32-52
• US Class Current: 606/48
• CPC Class Codes: A61B 17/2258 integrated in a central portion of the shock wave apparatus
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/0088 ceramic
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/0066 without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/1415 multiple blades
• CPC Class Codes: A61B 2018/146 Scissors
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: F21V 11/00 Screens not covered by groups F21V1/00, F21V3/00, F21V7/00 or F21V9/00 characterised by cooling arrangements F21V29/502
• CPC Class Codes: G02B 6/001 : the light being emitted along at least a portion of the lateral surface of the fibre
• CPC Class Codes: G02B 6/0096 : the lights guides being of the hollow type

Abstract

Endoscopic surgical instruments are provided that have bipolar electrodes on opposing movable members for passing a high frequency current through tissue for simulataneously severing or manipulating the tissue and causing hemostasis of the tissue. An electrically insulating material is interposed between the movable members so that the electrodes are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes through the tissue. Methods of endoscopically achieving hemostasis while simultaneously, manipulating and cutting tissue are also provided. Use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.

Claims

1. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

first and second blade members disposed on the distal end, the first blade member comprising a first composite of an electrically conductive material and an electrically insulative material, the first blade member having a portion defining a first shearing surface, a first cutting edge, and a first electrode extending along, and spaced apart from, the first shearing surface, the second blade member comprising a composite of an electrically conductive material and an electrically insulative material, the second blade member having a portion defining a second shearing surface, a second cutting edge, and a second electrode extending along, and spaced apart from the second shearing surface;

connection means for joining the first and second blade members to the distal end so that the first and second shearing faces oppose one another and the first cutting edge contacts the second cutting edge as the first blade member pivots relative to the second blade member in a scissors-like motion; and

actuating means connected to the proximal end of the elongated barrel for moving the first blade member relative to the second blade member,

wherein the electrically insulative material of the first and second blade members electrically isolates the first electrode from the second electrode when the first and second cutting edges contact each other.

2. An instrument as defined in claim 1 wherein the electrically insulative material of the first blade member comprises a layer having a thickness selected in the range of 0.002 to 0.050 inches.

3. An instrument as defined in claim 2 wherein the electrically insulative material of the first blade member comprises a layer having a first thickness and the electrically insulative material of the second blade member comprises a layer having a second thickness and the sum of the first and second thicknesses is selected in a range of 0.002 to 0.050 inches.

32. An instrument as defined in claim 1 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

33. An instrument as defined in claim 1 wherein the elongated barrel has a longitudinal axis, the first and second blade members have first and second tips, and the first and second blade members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

34. An instrument as defined in claim 1 wherein at least one of the first and second cutting edges is curved.

4. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

a first blade member disposed on the distal end of the elongated barrel, the first blade member having a first shearing surface including a first cutting edge, and a first non-shearing surface, the first blade member comprising a thickness of electrically insulative material extending parallel to the first shearing surface and a first thickness of electrically conductive material extending parallel to, and spaced apart from, the first shearing surface, the thickness of the electrically insulative material and the first thickness of electrically conductive material forming a portion of the non-shearing surface;

a second blade member disposed on the distal end of the elongated barrel, the second blade member having a second shearing surface including a second cutting edge, the second blade member comprising a second thickness of electrically conductive material extending parallel to the second shearing surface;

means for pivotally joining the first and second blade members together so that the first and second shearing surfaces are co-planar; and

actuating means connected to the proximal end of the elongated barrel for moving at least the first blade member relative to the second blade member in a scissors-like motion,

wherein, when the first and second thicknesses of electrically conductive material are coupled to a power source and the actuating means is operated, a current flows from the first layer of electrically conductive material to the second layer of electrically conductive material through the tissue and across the first and second cutting edges.

5. An instrument as defined in claim 4 wherein the second blade member comprises a thickness of electrically insulative material extending parallel to the second shearing surface interposed between the second shearing surface and the second thickness of electrically conductive material.

6. An instrument as defined in claim 4 wherein at least one of the first and second cutting edges is curved.

7. An instrument as defined in claim 4 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

8. An instrument as defined in claim 4 wherein the elongated barrel has a longitudinal axis, the first and second blade members have first and second tips, and the first and second blade members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

9. An instrument as defined in claim 4 wherein the electrically insulative material of the first blade member comprises a layer having a thickness selected in the range of 0.002 to 0.050 inches.

10. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

a first shearing member disposed on the distal end of the elongated barrel, the first shearing member having a first shearing surface and a first cutting edge, the first shearing member defining a first shearing plane and comprising a layer of electrically insulative material extending along the first shearing plane and a first layer of electrically conductive material extending along, and spaced apart from, the first shearing plane;

a second shearing member disposed on the distal end of the elongated barrel, the second shearing member having a second shearing surface and a second cutting edge, the second shearing member defining a second shearing plane and comprising a second layer of electrically conductive material;

means for pivotally joining the first and second shearing members together so that the first and second shearing planes are co-planar; and

actuating means connected to the proximal end of the elongated barrel for moving the first shearing member relative to the second shearing member in a scissors-like motion,

wherein, when the first and second layers of electrically conductive material are coupled to a power source and the actuating means is operated a current flows from the first layer of electrically conductive material to the second layer of electrically conductive material through the tissue and the second shearing surface.

11. An instrument as defined in claim 10 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

12. An instrument as defined in claim 10 wherein the elongated barrel has a longitudinal axis, the first and second shearing members have first and second tips, and the first and second shearing members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

13. An instrument as defined in claim 10 wherein at least one of the first and second cutting edges is curved.

14. An instrument as defined in claim 10 wherein the layer of electrically insulative material has a thickness selected in a range of 0.002 to 0.050 inches.

15. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

first and second scissor blades disposed on the distal end, the first and second scissor blades contacting one another along a cutting length;

a layer of insulative material disposed for substantially the cutting length to electrically isolate the first and second scissor blades from one another;

means for joining the first and second scissor blades to the distal end so that at least the first scissor blade moves relative to the second scissor blade in a scissors-like cutting motion, wherein the first and second scissor blades close together for shearing tissue located therebetween;

means for electrically coupling a high frequency alternating-current waveform to the first and second scissor blades; and

actuating means connected to the proximal end of the elongated barrel for moving the first scissor blade relative to the second scissor blade.

16. An instrument as defined in claim 15 wherein the layer of insulative material has a thickness in a range of 0.002 to 0.050 inches.

26. An instrument as defined in claim 15 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

27. An instrument as defined in claim 15 wherein the elongated barrel has a longitudinal axis, the first and second shearing members have first and second tips, and the first and second shearing members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

28. An instrument as defined in claim 15 wherein at least one of the first and second cutting edges is curved.

17. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

first and second blade members disposed on the distal end, the first blade member comprising a composite of an electrically conductive material and an electrically insulative material, the first blade member having a portion defining a first shearing surface, a first cutting edge and a first electrode, the second blade member comprising an electrically conductive material, the second blade member having a portion defining a second shearing surface, a second cutting edge and a second electrode, the first and second cutting edges contacting one another along a cutting length;

connection means for joining the first and second blade members to the distal end so that the first and second shearing faces face one another and the first cutting edge contacts the second cutting edge along the cutting length as the first blade member pivots relative to the second blade member in a scissors-like motion; and

actuating means connected to the proximal end of the elongated barrel for moving the first blade member relative to the second blade member,

wherein the electrically insulative material of the first blade member electrically isolates the first electrode from the second electrode along the cutting length.

18. An instrument as defined in claim 17 wherein the electrically insulative material of the first blade member comprises a layer having a thickness selected in a range of 0.002 to 0.050 inches.

19. An instrument as defined in claim 17 wherein the electrically insulative material of the first blade member comprises a layer having a first thickness and the second blade member further comprises a layer of electrically insulative material having a second thickness and the sum of the first and second thicknesses is selected in a range of 0.002 to 0.050 inches.

29. An instrument as defined in claim 17 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

30. An instrument as defined in claim 17 wherein the elongated barrel has a longitudinal axis, the first and second blade members have first and second tips, and the first and second blade members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

31. An instrument as defined in claim 17 wherein at least one of the first and second cutting edges is curved.

20. An instrument for hemostatically cutting tissue, the instrument comprising:

an elongated barrel having a proximal end and a distal end;

a first blade member disposed on the distal end, the first blade member comprising a composite of an electrically conductive material and an electrically insulative material, the first blade member having a portion defining a first shearing surface and a first cutting edge;

a second blade member disposed on the distal end, the second blade member comprising a composite of an electrically conductive material and an electrically insulative material, the second blade member having a portion defining a second shearing surface and a second cutting edge;

connection means for joining the first and second blade members to the distal end so that the first and second shearing faces oppose one another and the first cutting edge contacts the second cutting edge along a cutting length as the first blade member pivots relative to the second blade member in a scissors-like motion; and

actuating means connected to the proximal end of the elongated barrel for moving the first blade member relative to the second blade member,

wherein the electrically insulative material of the first and second blade members electrically isolate the first blade member from the second blade member along the cutting length.

21. An instrument as defined in claim 20 wherein the electrically insulative material of the first blade member comprises a layer having a thickness selected in a range of 0.002 to 0.050 inches.

22. An instrument as defined in claim 20 wherein the electrically insulative material of the first blade member comprises a first thickness and the electrically insulative material of the second blade member comprises a second thickness and the sum of the first and second thicknesses is selected in a range of 0.002 to 0.050 inches.

23. An instrument as defined in claim 20 wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.

24. An instrument as defined in claim 20 wherein the elongated barrel has a longitudinal axis, the first and second blade members have first and second tips, and the first and second blades members are curved so that the first and second tips are offset from the longitudinal axis of the elongated barrel.

25. An instrument as defined in claim 20 wherein at least one of the first and second cutting edges is curved.