Electrosurgical device for coagulating and for making incisions, a method of severing blood vessels and a method of coagulating and for making incisions in or severing tissue

• US 6,679,882 B1
• Filed: 11/17/2000
• Issued: 01/20/2004
• Est. Priority Date: 06/22/1998
• Status: Expired due to Term

• Current Assignee: LiNA Medical International Operations AG (LiNA WW Holding AG)
• Original Assignee: LiNA Medical ApS
• Inventors: Kornerup, Niels
• Primary Examiner(s): Peffley, Michael
• Application Number:
  US09/715,666
• Time in Patent Office: 1,159 Days
• Field of Search: 606/41, 606/42, 606/45, 606/46, 606/48-52, 606/205, 606/206
• US Class Current: 606/51
• 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

Abstract

An electrosurgical device for coagulating and for making incisions in or severing tissue such as blood vessels, the device comprising forceps jaws (6, 7) for immobilizing a tissue portion to be coagulated and incised, the forceps jaws (6, 7) being connected to means for applying an electrical tension between said forceps jaws for coagulating the tissue portion, the device further comprising a member (22) for being displaced between said forceps jaws (6, 7) to incise a tissue portion held between the forceps jaws and coagulated thereby, the member (22) being connected to means for applying an electrical voltage to said member for performing an incision in said tissue by means of said electrical voltage applied to said member (22) the member (22) preferably being blunt such that the incision substantially exclusively is achieved by means of the voltage applied to the member (22). For preventing the generation of smoke through charring of the tissue portion, a tube is provided for supplying an electrically non-conductive, cooling liquid to the tissue portion.

Claims

1. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising:

at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

first electrical means for applying electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

at least one blunt incision means for making incisions in at least part of said tissue portion, and

the immobilizing means comprising adjustable spring loading means for applying an adjustable spring load for immobilizing the tissue portion.

2. A device according to claim 1 wherein the spring load is manually adjustable depending on the characteristics of the tissue portion to be immobilized by the immobilizing means.

3. A device according to claim 1 wherein the immobilizing means comprise first and second moveable forceps jaws and moving means for opening and closing the first and second jaws relative to one another for holding the tissue portion therebetween.

4. A device according to claim 3 wherein the moving means comprise adjustable spring loading means for applying an adjustable spring load for closing the first and second jaws relative to one another.

5. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising:

at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

first electrical means for applying a first electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

at least one second electrical me for applying a second electric power to at least part of said tissue portion for making incisions in said tissue portion

at least one tubular element for supplying an electrically non-conductive, cooling liquid to said tissue portion, and

the second electrical means is configured such, by being blunt, that the incision or severing is substantially exclusively achieved by means of said second electric power.

6. A device according to claim 5 wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a combination thereof.

7. A device according to claim 6 wherein the signal is a DC or AC signal such as a LF, an BF or an RF signal for instance a VHF, a UHF or a microwave signal.

8. A device according to claim 5 wherein the first and second electric powers are obtained by means of substantially identical electric current or voltage signals.

9. A device according to claim 5 wherein the immobilizing means comprise first and second moveable forceps jaws and moving means for opening and closing the first and second jaws relative to one another for holding and/or clamping the tissue portion therebetween.

10. A device according to claim 9 wherein the moving means comprise adjustable spring loading means for applying a specific or an adjustable spring load for closing the first and second jaws relative to one another.

11. A device according to claim 10 wherein the spring load is manually adjustable depending on the characteristics of the tissue portion to be held between said jaws.

12. A device according to claim 5 and further comprising electrical switching means for applying the first and second electric powers independently of one another and preferably sequentially.

13. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising

at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

first electrical means for applying a first electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

at least one second electrical means for applying a second electric power to at least part of said tissue portion for making incisions in said tissue portion,

at least one tubular element for supplying an electrically non-conductive, cooling liquid to said tissue portion, and

the second electrical means is configured such, by being blunt, that the incision or severing is substantially exclusively achieved by means of said second electric power.

14. A device according to claim 13 wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a combination thereof.

15. A device according to claim 14 wherein the signal is a DC or AC signal such as a LF, an HF or an RF signal for instance a VHF, a UHF or a microwave signal.

16. A device according to claim 13 wherein the first and second electric powers are obtained by means of substantially identical electric current or voltage signals.

17. A device according to claim 13 wherein the immobilizing means comprise first and second moveable forceps jaws and moving means for opening and closing the first and second jaws relative to one another for holding and/or clamping the tissue portion therebetween.

18. A device according to claim 17 wherein the moving means comprise adjustable spring loading means for applying a specific or an adjustable sprig load for closing the first and second jaws relative to one another.

19. A device according to claim 18 wherein the spring load is manually adjustable depending on the characteristics of the tissue portion to be held between said jaws.

20. A device according to claim 13 and further comprising electrical switching means for applying the first and second electric powers independently of one another and preferably sequentially.

21. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising:

an elongated tubular member having a proximal and a distal end and a lumen extending therethrough,

first and second moveable forceps jaws extending from said distal end,

opening and closing means for opening and closing the first and second forceps jaws relative to one another,

first electrical means for applying a first electric voltage across the first and second forceps jaws,

a blunt electric power application means extending from said distal end and arranged for being improved through a tissue portion held between the first and second forceps jaws, and

second electrical means for applying a second electric voltage to the electric power application means relative to the first and/or the second forceps jaws.

22. A device according to claim 21 wherein the first electric voltage is substantially equal to the second electric voltage.

23. A device according to claim 21 and further comprising a handle fixed to said proximal end of the tubular member.

24. A device according to claim 23 wherein the opening and closing means comprise adjustable spring loading means for applying a specific or an adjustable spring load for closing the first and second jaws relative to one another.

25. A device according to claim 24 wherein the handle comprises spring load adjusting means for manually adjusting the spring load of the spring loading means.

26. A device according to claim 23 wherein the handle comprises forceps activating means for manually activating the opening and closing means.

27. A device according to claim 23 wherein the handle comprises incision activating means for manually activating the movement of the electric power application means through the tissue portion.

28. A device according to claim 23 wherein the handle comprises switching means for activating the first and second electrical means for applying said first and second electric voltages.

29. A device according to claim 28 wherein the switching means are adapted to cooperate with the incision activating means such that the first electric voltage is applied in the deactivated condition of said incision activating means while the second electric voltage is applied in the activated condition of said incision activating means.

30. A device according to claim 21 wherein the blunt electric power application means comprise a plate member having a blunt leading edge.

31. A device according to claim 30 wherein the plate member except the leading edge portion is electrically insulated from the surroundings such that electric power only may be supplied to the tissue portion through said leading edge portion.

32. A device according to claim 21 wherein the blunt electric power application means comprise a wire member arranged for being moved through the tissue portion and for supplying electric power to the tissue portion.

33. A method of severing blood vessels, the method comprising the following steps:

applying a first electric power to a portion of the blood vessel adjacent the intended severing location for coagulating the blood and tissue in said region, and

applying a second electric power to said region at said severing location by means of a blunt electric power application means for severing the blood vessel.

34. A method according to claim 33 wherein said portion of the blood vessel is compressed prior to and/or during the application of the first electric power, the degree of compression being such that the flow of blood through the blood vessel is such that the blood and tissue for coagulates to form a permanent coagulation clot in the blood vessel adjacent said severing location for allowing severing of the blood vessel without bleeding.

35. A method according to claim 33 wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a it combination thereof.

36. A method according to claim 33 wherein the signal is a DC or AC signal such as a LF, an HF or an RF signal for instance a VHF, a UHF or a microwave signal.

37. A method according to claim 33 wherein the first and second electric powers are obtained by means of substantially identical electric current or voltage signals.

38. A method according to claim 36 wherein the first and/or second electric powers are delivered by a 60 Watt 500 kHz generator.

39. A method of coagulating and for making incisions in or severing tissue such as for instance blood vessels, the method comprising the following steps:

providing at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

providing first electrical means for applying a first electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

providing at least one electric power application means for applying a second electric power to at least part of said tissue portion,

immobilizing said tissue portion by applying said immobilizing means to the tissue portion,

applying the first electric power to the tissue portion for coagulating at least part of the tissue portion, and

applying the second electric power to at least part of said tissue portion by means of a blunt incision means for at least assisting in performing an incision in or severing the tissue portion.

40. A method according to claim 39 wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a combination thereof.

41. A method according to claim 40, wherein the signal is a DC or AC signal such as a LF, an HF or an RF signal for instance a VHF, a UHF or a microwave signal.

42. A method according to claim 40 wherein the signal is a DC or AC signal such as a LF, an BY or an RF signal for instance a VHF, a UHF or a microwave signal.

43. A method according to claim 39 wherein the first and second electric powers are obtained by means of substantially identical electric current or voltage signals.

44. A method according to claim 39 wherein the first and/or second electric powers are delivered by a 60 Watt 500 kHz generator.

45. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising:

an elongated tubular member having a proximal and a distal end and a lumen extending therethrough,

first and second moveable forceps jaws extending from said distal end,

opening and closing means for opening and closing the first and second forceps jaws relative to one another,

first electrical means for applying a first electric voltage across the first and second forceps jaws,

a blunt electric power application means extending from said distal end and arranged for being moved through a tissue portion held between the first and second forceps jaws, at least one tubular element for supplying an electrically non-conductive, cooling liquid to said tissue portion, and

second electrical means for applying a second electric voltage to the electric power application means relative to the first and/or the second forceps jaws.

46. A device according to claim 45 wherein the first electric voltage is substantially equal to the second electric voltage.

47. A device according to claim 45 and further comprising a handle fixed to said proximal end of the tubular member.

48. A device according to claim 47 wherein the opening and closing means comprise adjustable spring loading means for applying a specific or an adjustable spring load for closing the first and second jaws relative to one another.

49. A device according to claim 48 wherein the handle comprises spring load adjusting means for manually adjusting the spring load of the spring loading means.

50. A device according to claim 47 wherein the handle comprises forceps activating means for manually activating the opening and closing means.

51. A device according to claim 47 wherein the handle comprises incision activating means for manually activating the movement of the electric power application means through the tissue portion.

52. A device according to claim 47 wherein the handle comprises switching means for activating the first and second electrical means for applying said first and second electric voltages.

53. A device according to claim 47, wherein said at least one tubular element extends from said handle through said elongated tubular member and communicates through a fiber tubular element with an external source for the supply of said electrically non-conductive, cooling liquid.

54. A device according to claim 53, wherein said at least one tubular element is exposed at said distal end of said tubular member.

55. A device according to claim 53, wherein said further tubular element comprises a pump for controlling the supply of said electrically non-conductive, cooling liquid.

56. A device according to claim 47, wherein the switching means are adapted to cooperate with the incision activating means such that the first electric voltage is applied in the deactivated condition of said incision activating means while the second electric voltage is applied in the activated condition of said incision activating means.

57. A device according to claim 45, wherein the electric power application means comprise a plate member having a blunt leading edge.

58. A device according to claim 47, wherein the plate member except the leading edge portion is electrically insulated from the surroundings such that electric power only may be supplied to the tissue portion through said leading edge portion.

59. A device according to claim 45, wherein the electric power application means comprise a wire member arranged for being moved through the tissue portion and for supplying electric power to the tissue portion.

60. A device according to claim 45, said electrically non-conductive, cooling liquid being Glycin®

.

61. An electrosurgical device for coagulating and for making incisions in or severing tissue such as for instance blood vessels, said device comprising

at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

first electrical means for applying electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

at least one blunt incision means for making incisions in at least part of said tissue portion, and

at least one tubular element for supplying an electrically non-conductive, cooling liquid to said tissue portion,

the immobilizing means comprising adjustable spring loading means for applying an adjustable spring load for immobilizing the tissue portion.

62. A device according to claim 61, wherein the spring load is manually adjustable depending on the characteristics of the tissue portion to be immobilized by the immobilizing means.

63. A device according to claim 61, wherein the immobilizing means comprise first and second moveable forceps jaws and moving means for opening and closing the first and second jaws relative to one another for holding the tissue portion therebetween.

64. A device according to claim 63, wherein the moving means comprise adjustable spring loading means for applying an adjustable spring load for closing the first and second jaws relative to one another.

65. A method of severing blood vessels, the method comprising the following steps:

applying a first electric power to a portion of the blood vessel adjacent the intended severing location for coagulating the blood and tissue in said region,

applying a second electric power to said region at said severing location by means of a blunt electric power application means for severing the blood vessel, and

supplying an electrically non-conductive, cooling liquid to said portion of said blood vessel and/or to said region while applying said first and/or said second electric power, respectively.

66. A method according to claim 65, wherein said portion of the blood vessel is compressed prior to and/or during the application of the first electric power, the degree of compression being such that the flow of blood through the blood vessel is such that the blood and tissue for coagulates to form a permanent coagulation clot in the blood vessel adjacent said severing location for allowing severing of the blood vessel without bleeding.

67. A method according to claim 65, wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a combination thereof.

68. A method according to claim 65, wherein the signal is a DC or AC signal such as a LF, an HF or an RF signal for instance a VHF, a UHF or a microwave signal.

69. A method according to claim 65, wherein the first and second electric powers are obtained by means of substantially identical electric current or voltage signals.

70. A method according to claim 68, wherein the first and/or second electric powers are delivered by a 60 Watt 500 kHz generator.

71. A method of coagulating and for making incisions in or severing tissue such as for instance blood vessels, the method comprising the following steps:

providing at least one immobilizing means for immobilizing a tissue portion to be coagulated and incised,

providing first electrical means for applying a first electric power to the tissue portion immobilized by the immobilizing means for coagulating at least part of said tissue portion,

providing at least one electric power application means for applying a second electric power to at least part of said tissue portion,

immobilizing said tissue portion by applying said immobilizing means to the tissue portion,

applying the first electric power to the tissue portion for coagulating at least part of the tissue portion, and

applying the second electric power to at least part of said tissue portion by means of a blunt incision means for at least assisting in performing an incision in or severing the tissue portion,

supplying an electrically non-conductive, cooling liquid to said tissue portion while applying said first and/or said second electric power to said tissue portion.

72. A method according to claim 71, wherein the first and/or the second electrical power is constituted by an electric current signal, an electric voltage signal or a combination thereof.

73. A method according to claim 71, said electrically non-conductive, cooling liquid being Glycin®

.

74. A method according to claim 71, wherein the first and second electric powers are obtained by means of substantially identical cleric current or voltage signals.