Vessel sealing system

• US 6,398,779 B1
• Filed: 09/30/1999
• Issued: 06/04/2002
• Est. Priority Date: 10/23/1998
• Status: Expired due to Term

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Sherwood Services AG
• Inventors: Wham, Robert H., Buysse, Steven P., Orszulak, James H.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US09/408,944
• Time in Patent Office: 978 Days
• Field of Search: 606/32-42
• US Class Current: 606/34
• 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 2017/2945 Curved jaws
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1432 curved

Abstract

A method for electrosurgically sealing a tissue includes steps of: (A) applying an initial pulse of RF energy to the tissue, the pulse having characteristics selected so as not to appreciably heat the tissue; (B) measuring a value of an impedance of the tissue in response to the applied pulse; (C) in accordance with the measured impedance value, determining an initial set of pulse parameters for use during a first RF energy pulse that is applied to the tissue; and (D) varying the pulse parameters of individual ones of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs during subsequent RF energy pulses. The method terminates the generation of subsequent RF energy pulses upon a determination that the electrical transient is absent or that a minimum output voltage has been reached.

Claims

1. A system for electrosurgically sealing tissue, comprising an electrosurgical generator comprising an RF energy source and a controller for controlling the operation of electrosurgical generator, said electrosurgical generator having an output for coupling to a surgical instrument comprising electrodes for coupling RF energy generated by said electrosurgical generator to tissue to be sealed;

said system further comprising a circuit that is coupled to said output of said electrosurgical generator for protecting said output against an overvoltage condition, said circuit comprising a suppressor that detunes a tuned resonant circuit at said output for reducing a magnitude of a voltage appearing at said output.

2. A system as in claim 1, wherein said circuit comprises a capacitance network in parallel with an inductance, and a voltage actuated switch for coupling an additional capacitance across said network upon an occurrence of an overvoltage condition.

36. A method as in claim 1, and further comprising a step of terminating a generation of subsequent RF energy pulses upon a determination that the current transient is absent.

3. A system for electrosurgically sealing tissue, comprising an electrosurgical generator comprising an RF energy source and a controller for controlling the operation of the electrosurgical generator, said electrosurgical generator having an output for coupling to a surgical instrument comprising electrodes for coupling RF energy generated by said electrosurgical generator to tissue to be sealed;

said controller being operable for causing said electrosurgical generator to apply an initial pulse of RF energy to the tissue and for measuring a value of an electrical characteristic of the tissue in response to the applied initial pulse, said controller being responsive to the measured electrical characteristic for determining an initial set of pulse parameters for a subsequent pulse and for then varying the pulse parameters of individual pulses of further subsequent RF energy pulses in accordance with a change in the electrical characteristic;

said system further comprising an operator-actuated seal intensity control, wherein said controller is coupled to an output of said seal intensity control and is responsive thereto, when determining said initial set of pulse parameters, for modifying predetermined ones of said initial set of pulse parameters.

4. A system as in claim 3, wherein said predetermined pulses of the pulse parameters that are modified comprise a pulse power, a pulse starting voltage level, a pulse voltage decay scale factor, and a pulse dwell time.

6. A system as in claim 3, wherein the electrical characteristic is comprised of an electrical impedance.

7. A system as in claim 3, wherein the electrical characteristic is comprised of a current-voltage phase angle.

9. A system as in claim 3, wherein the electrical characteristic is comprised of an electrical impedance, and wherein said controller varies the pulse parameters of individual pulses of the subsequent RF energy pulses in accordance with a change in the electrical impedance as determined from at least one characteristic of an electrical transient that occurs at the beginning of each individual pulse of the subsequent RF energy pulses.

10. A system as in claim 9, wherein the at least one characteristic of the electrical transient is a width of the electrical transient.

11. A system as in claim 9, wherein the at least one characteristic of the electrical transient is the rate of change of the electrical transient.

12. A system as in claim 3, wherein said initial set of pulse parameters comprise a magnitude of a starting power and a magnitude of a starting voltage.

13. A system as in claim 3, wherein said pulse parameters that are varied comprise a pulse duty cycle and a pulse amplitude.

14. A system as in claim 3, wherein said subsequent RF energy pulses are each reduced in amplitude by a controlled amount from a previous RF energy pulse.

15. A system as in claim 6, and further comprising one of a plurality of pulse parameter lookup tables that is readably coupled to said controller, and wherein said controller, when determining said initial set of pulse parameters, uses said impedance value to readout said initial set of pulse parameters from said one of a plurality of pulse parameter lookup tables.

16. A system as in claim 15, wherein said one of a plurality of pulse parameter lookup tables is selected manually or automatically, based on a choice of an electrosurgical tool or instrument.

17. A system as in claim 6, wherein said controller is responsive to a control input from an operator for modifying any one of said pulse parameters.

18. A system as in claim 17, wherein said any one of said pulse parameters comprise a pulse power, a pulse starting voltage level, a pulse voltage decay scale factor, and a pulse dwell time.

19. A system as in claim 10, wherein said controller is responsive to a determination that said electrical transient is absent for terminating a generation of subsequent RF energy pulses.

20. A system as in claim 3, and further comprising a circuit that is coupled to said output of said electrosurgical generator for protecting said output against an overvoltage condition, said circuit comprising a suppressor that detunes a tuned resonant circuit at said output for reducing a magnitude of a voltage appearing at said output.

21. A system as in claim 14, wherein said circuit comprises a capacitance network in parallel with an inductance, and a voltage actuated switch for coupling an additional capacitance across said network upon an occurrence of an overvoltage condition.

22. A system as in claim 20, wherein the circuit for protecting said output against an overvoltage condition provides automatic detuning of the RF energy independent of the tissue response to the application of RF energy.

5. A system for electrosurgically sealing tissue, comprising an electrosurgical generator comprising an RF energy source and a controller for controlling the operation of an electrosurgical generator, said electrosurgical generator having an output for coupling to a surgical instrument comprising electrodes for coupling RF energy generated by said electrosurgical generator to tissue to be sealed;

said controller being operable for causing said electrosurgical generator to apply an initial pulse of RF energy to the tissue and for measuring a value of an electrical characteristic of the tissue in response to the applied initial pulse, said controller being responsive to the measured electrical characteristic for determining an initial set of pulse parameters for a subsequent pulse and for then varying the pulse parameters of individual pulses of further subsequent RF energy pulses in accordance with a change in the electrical characteristic of the tissue.

8. A system as in claim 5, wherein the electrical characteristic is comprised of a magnitude of an output current.

23. A method for electrosurgically sealing tissue, comprising steps of:

applying a first pulse of RF energy to the tissue; and

applying at least one subsequent RF energy pulse to the tissue and varying RF energy parameters of individual pulses of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs at the beginning of individual pulses of the subsequent RF energy pulses.

24. A method as in claim 23, wherein the step of applying the first pulse includes a step of selecting characteristics of the first pulse so as not to appreciably heat the tissue.

25. A method as in claim 23, wherein the step of applying the first pulse comprises steps of:

measuring at least one characteristic of a response of the tissue to the applied first pulse; and

in accordance with the measured characteristic, determining an initial set of RF energy parameters.

26. A method as in claim 23, wherein the electrical transient is an electric current transient.

27. A method as in claim 26, wherein the at least one characteristic of said electrical transient is a width of the electric current transient.

28. A method as in claim 26, wherein the at least one characteristic of said electrical transient is a rate of change of the electric current transient.

29. A method as in claim 25, wherein the initial set of RF energy parameters comprise a magnitude of a starting power and a magnitude of a starting voltage.

30. A method as in claim 23, wherein the RF energy parameters that are varied comprise a pulse duty cycle and a pulse amplitude.

31. A method as in claim 23, wherein the subsequent RF energy pulses are each reduced in amplitude by a controlled amount from a previous RF energy pulse.

32. A method as in claim 25, wherein the at least one characteristic of the response of the tissue that is measured is a value of an electrical impedance of the tissue, and wherein the step of determining the initial set of RF energy parameters comprises a step of using the measured impedance value to readout the initial set of RF energy parameters from an entry in one of a plurality of lookup tables.

33. A method as in claim 32, wherein said one of a plurality of lookup tables is selected manually or automatically, based on a choice of an electrosurgical tool or instrument.

34. A method as in claim 23, and further comprising a step of modifying predetermined pulses of the initial set of RF energy parameters in accordance with a control input from an operator.

35. A method as in claim 33, wherein the predetermined pulses of the RF energy parameters that are modified comprise a pulse power, a pulse starting voltage level, a pulse voltage decay scale factor, and a pulse dwell time.

37. A method for electrosurgically desiccating tissue, comprising steps of:

applying a first pulse of RF energy to the tissue;

measuring an electrical characteristic of the tissue in response to the applied first pulse of RF energy; and

,

in accordance with the measured electrical characteristic, determining an initial set of electrosurgical parameters for use during an electrosurgical desiccation procedure.

38. A method as in claim 37, further comprising a step of subsequently applying at least one pulse of RF energy to the tissue for desiccating and sealing individual vessels and tissue bundles, in accordance with the measured tissue electrical characteristics.

39. A method as in claim 38, wherein the electrical characteristic is comprised of an electrical impedance.

40. A method as in claim 37, wherein the electrical characteristic is comprised of a current-voltage phase angle.

41. A method as in claim 37, wherein the electrical characteristic is comprised of a magnitude selected from the group of an output current, a voltage, and a power.

42. A method as in claim 37, wherein the initial set of electrosurgical parameters are comprised of power, a maximum voltage, a starting voltage, a voltage decay factor, a voltage ramp factor, a maximum RF on time, a pulse dwell time, a pulse off time, and a desired pulse width.

43. A method as in claim 42, wherein the initial set of electrosurgical parameters are further comprised of a minimum voltage, a maximum cool scale factor, and a pulse width minimum.

44. A method as in claim 38, and further comprising a step of varying parameters of subsequently applied RF energy pulses in accordance with an observed electrical response of the tissue to the subsequent RF energy pulses.

45. A method as in claim 38, and further comprising a step of applying a subsequent RF energy pulse in accordance with at least one characteristic of an electrical transient that occurs at a beginning of the subsequent RF energy pulse.

48. A method as in claim 40, wherein the electrical characteristic is comprised of an electrical impedance.

49. A method as in claim 40, wherein the electrical characteristic is comprised of a current-voltage phase angle.

50. A method as in claim 40, wherein the electrical characteristic is comprised of a magnitude selected from the group of an output current, a voltage, and a power.

51. A method as in claim 44, wherein the initial set of electrosurgical parameters are comprised of power, a maximum voltage, a starting voltage, a voltage decay factor, a voltage ramp factor, a maximum RF on time, a pulse dwell time, a pulse off time, and a desired pulse width.

52. A method as in claim 51, wherein the initial set of electrosurgical parameters are further comprised of a minimum voltage, a maximum cool scale factor, and a pulse width minimum.

46. A method for electrosurgically sealing tissue, comprising steps of:

applying a first pulse of RF energy to the tissue, the tissue being held between opposing jaws of a surgical instrument; and

applying a plurality of subsequent RF energy pulses to the tissue while controllably decreasing an amplitude of individual ones of the subsequent RF energy pulses, the amplitude being controllably decreased in order to compensate for a decrease in distance between the opposing jaws due to a thermally-induced shrinkage of the tissue.

47. A method for electrosurgically desiccating tissue, comprising steps of:

applying a first pulse of RF energy to the tissue;

measuring an electrical characteristic of the tissue in response to the applied first pulse of RF energy;

in accordance with the measured electrical characteristic, determining an initial set of electrosurgical parameters for use during an electrosurgical desiccation procedure;

applying at least one subsequent pulse of RF energy to the tissue for desiccating and sealing individual vessels and tissue bundles, in accordance with the measured tissue electrical characteristics;

measuring the actual pulse width of the at least one subsequent pulse of RF energy applied;

determining a fixed voltage reduction factor from the measured actual pulse width of the RF energy applied and the measured electrical characteristic of the tissue;

determining a fixed number of additional pulses of RF energy to be applied, from the measured actual pulse width of the RF energy applied and the measured electrical characteristic of the tissue; and

,

applying said determined number of fixed pulses to the tissue, decreasing each subsequent pulse by the voltage reduction factor.

53. A system for electrosurgically sealing tissue, comprising an electrosurgical generator comprising an RF energy source and a controller for controlling the operation of electrosurgical generator, said electrosurgical generator having an output for coupling to a surgical instrument comprising electrodes for coupling RF energy generated by said electrosurgical generator to tissue to be sealed;

said controller being operable for causing said electrosurgical generator to apply an initial pulse of RF energy to the tissue that is adapted to be between opposing jaws of the surgical instrument, and for applying a plurality of subsequent RF energy pulses to the tissue while controllably decreasing an amplitude of individual pulses of the subsequent RF energy pulses, said controller controllably decreasing amplitude in order to compensate for a decrease in distance between the opposing jaws due to a thermally-induced shrinkage of the tissue.