Fluid-assisted medical devices, systems and methods

• US 6,953,461 B2
• Filed: 05/16/2002
• Issued: 10/11/2005
• Est. Priority Date: 05/16/2002
• Status: Expired due to Term

• Current Assignee: Medtronic Advanced Energy LLC (Medtronic Plc)
• Original Assignee: Tissuelink Medical, Inc. (Medtronic Plc)
• Inventors: Lipson, David, McClurken, Michael E., Oyola, E. Arnold
• Primary Examiner(s): Peffley, Michael
• Application Number:
  US10/147,373
• Publication Number:
  US 20030216733A1
• Time in Patent Office: 1,244 Days
• Field of Search: 606/41, 606/45, 606 48- 52, 606/206, 606/207, 607101-105
• US Class Current: 606/51
• 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 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00809 : measured thermochromatically
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1417 : Ball
• CPC Class Codes: A61B 2018/1422 : Hook
• CPC Class Codes: A61B 2018/1455 : having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/035 : preventing further rotation
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/065 : for measuring contact or contact pressure
• CPC Class Codes: A61B 2218/002 : Irrigation

Abstract

Surgical devices, systems and methods for treating tissue are provided. An exemplary surgical device comprises a tip portion including first and second jaws each having a tissue grasping surface, at least one of the jaws being movable toward the other jaw. The tissue grasping surface of each jaw has includes an electrically insulative surface. The device also includes first and second electrodes connectable to different terminals of an RF generator to generate electrical current flow therebetween, with each of the electrodes having an electrode surface. One of the electrode surfaces is located on one of the jaws separated from one edge of the tissue grasping surface, and the other of the electrode surfaces is located on one or the other of the jaws separated from the other edge of the tissue grasping surface. The device also includes at least one fluid passage being connectable to a fluid source.

Claims

1. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

the first jaw including a first jaw tissue grasping surface and the second jaw including a second jaw tissue grasping surface, the tissue grasping surface of each jaw comprising an electrically insulative surface;

a bipolar electrode configuration comprising first and second electrodes configured to be connected to a radio frequency generator to generate an electrical current therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage configured to be connected to a fluid source;

at least one fluid outlet in fluid communication with the fluid passage, the at least one fluid outlet to expel a fluid from the fluid source;

the first electrode located on a left-side portion of either the first jaw or the second jaw, the first electrode surface separated from the tissue grasping surface of the jaw on which the first electrode is located by a left-side gap for fluid; and

the second electrode located on a right-side portion of either the first jaw or the second jaw, the second electrode surface separated from the tissue grasping surface of the jaw on which the second electrode is located by a right-side gap for fluid.

2. The tissue grasping device of claim 1 wherein:

the tip portion is configured to provide radio frequency power from the radio frequency generator simultaneously with the fluid from the fluid source to treat tissue, the radio frequency power provided from the electrodes and the fluid provided from the at least one fluid outlet.

3. The tissue grasping device of claim 2 wherein:

the tip portion is further configured to provide the radio frequency power at least partially through at least one fluid coupling connecting one of the electrodes to a portion of the tissue, the at least one fluid coupling comprising the fluid from the fluid source.

4. The tissue grasping device of claim 1:

the first and second electrodes are configured to treat tissue with radio frequency power from the radio frequency generator in the presence of first and second fluid couplings connecting the first and second electrodes to first and second portions of tissue, respectively;

the first fluid coupling comprising a first portion of the fluid from the fluid source and at least partially located in the left-side gap; and

the second fluid coupling comprising a second portion of the fluid from the fluid source and at least partially located in the right-side gap.

5. The tissue grasping device of claim 1 wherein:

the left-side gap is to provide a location for at least a portion of a left-side fluid coupling connecting the first electrode to a first portion of tissue; and

the right-side gap is to provide a location for at least a portion of a right-side fluid coupling connecting the second electrode to a second portion of tissue.

6. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a hydrophobic surface.

7. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a textured surface.

8. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a surface roughness between about 10 and 500 microns.

9. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises one or more serrations.

10. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw has a contact angle (θ

) with the fluid from the fluid source when located thereon equal to or greater than about 30 degrees.

11. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw is at least partially defined by a beveled edge.

12. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw comprises a material with a thermal conductivity at 300°

K (Kelvin) equal or greater than about 0.01 watt/cm°

K.

13. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw is supported by a support structure; and

the tissue grasping surface of the at least one jaw is provided at least partially by a coating overlying the support structure.

14. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw further comprises a medial portion, the medial portion supported therebeneath by a support structure comprising a material with a thermal conductivity at 300°

K (Kelvin) equal or greater than about 0.01 watt/cm°

K.

15. The tissue grasping device of claim 1 wherein:

the tissue grasping surface of at least one jaw further comprises a medial portion, the medial portion supported therebeneath by a support structure which provides a heat sink for transferring heat away from the tissue grasping surface.

16. The tissue grasping device of claim 1 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first fluid outlet and a second fluid outlet;

the first fluid outlet being located on the same jaw as the first electrode; and

the second fluid outlet being located on the same jaw as the second electrode.

17. The tissue grasping device of claim 16 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid from the fluid source to tissue located outside of the tissue grasping surfaces.

18. The tissue grasping device of claim 16 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid from the fluid source to tissue located outside of and adjacent the tissue grasping surfaces.

19. The tissue grasping device of claim 16 wherein:

the first fluid outlet and the second fluid outlet are configured to provide the fluid from the fluid source to tissue located outside of and separated from the tissue grasping surfaces.

20. The tissue grasping device of claim 16 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source to tissue located adjacent the first electrode surface; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source to tissue located adjacent the second electrode surface.

21. The tissue grasping device of claim 16 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source between the first electrode surface and a first portion of tissue; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source between the second electrode surface and a second portion of tissue.

22. The tissue grasping device of claim 16 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source between the first electrode surface and the tissue grasping surface of the jaw on which the first electrode is located; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source between the second electrode surface and the tissue grasping surface of the jaw on which the second electrode is located.

23. The tissue grasping device of claim 16 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source to the first electrode surface; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source to the second electrode surface.

24. The tissue grasping device of claim 16 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source to a first portion of one or the other of the jaws outside the tissue grasping surface; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source to a second portion of one or the other of the jaws outside the tissue grasping surface.

25. The tissue grasping device of claim 1 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first plurality of fluid outlets and a second plurality of fluid outlets, the first plurality of fluid outlets being located on the same jaw as the first electrode and the second plurality of fluids outlet being located on the same jaw as the second electrode.

26. The tissue grasping device of claim 1 wherein:

the first electrode surface is configured for a first portion of the fluid from the fluid source to form a film at least partially thereon; and

the second electrode surface is configured for a second portion of the fluid from the fluid source to form a film at least partially thereon.

27. The tissue grasping device of claim 1 wherein:

the at least one fluid passage further comprises a first fluid passage and a second fluid passage;

the first fluid passage being located on the same jaw as the first electrode; and

the second fluid passage being located on the same jaw as the second electrode.

28. The tissue grasping device of claim 27 wherein:

the first electrode defines at least a portion of the first fluid passage; and

the second electrode defines at least a portion of the second fluid passage.

29. The tissue grasping device of claim 27 wherein:

the first electrode and the second electrode are each provided by an elongated structure having a cavity therein;

the first fluid passage at least partially defined by the cavity of the first electrode structure; and

the second fluid passage at least partially defined by the cavity of the second electrode structure.

30. The tissue grasping device of claim 29 wherein:

the first electrode and the second electrode each comprise metal tubing.

31. The tissue grasping device of claim 1 wherein:

at least a portion of each gap is configured to receive a portion of the fluid expelled from the fluid outlet therein.

32. The tissue grasping device of claim 31 wherein:

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to remove heat generated during use of the device from at least one of tissue and the device.

33. The tissue grasping device of claim 31 wherein:

the fluid from the fluid source comprises an electrically conductive fluid; and

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to provide an electrical path for an electrical current.

34. The tissue grasping device of claim 33 wherein:

the portion of each gap configured to receive a portion of the fluid from the fluid expelled from the fluid outlet therein is further positioned for the fluid therein to provide an electrical path outside the tissue grasping surfaces, whereby the heating of tissue located outside the tissue grasping surfaces may be reduced.

35. The tissue grasping device of claim 1 wherein:

each gap further comprises an elongated gap.

36. The tissue grasping device of claim 35 wherein:

each elongated gap is configured to provide a fluid trough.

37. The tissue grasping device of claim 1 wherein:

at least one jaw comprises at least one stand-off configured to keep tissue from physically contacting at least one of the first electrode surface and the second electrode surface.

38. The tissue grasping device of claim 1 further comprising:

at least one jaw further comprises at least one obstruction configured to inhibit a fluid shunt from forming between the first electrode and the second electrode.

39. The tissue grasping device of claim 1 further comprising:

a tissue treatment indicator which provides an output related to the level of treatment of tissue.

40. The tissue grasping device of claim 39 wherein:

the tissue treatment indicator is located on the tip portion.

41. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

each jaw including a tissue grasping surface, the tissue grasping surface of each jaw further comprising an electrically insulative surface;

a portion of each tissue grasping surface being located on each side of a center plane, the center plane orientated longitudinal and perpendicular to the tissue grasping surface;

a bipolar electrode configuration comprising first and second electrodes configured to be connected to a radio frequency generator to generate an electrical current therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage configured to be connected to a fluid source;

at least one fluid outlet in fluid communication with the fluid passage, the at least one fluid outlet to expel a fluid from the fluid source;

one of the first and second electrodes being located on one or the other of the jaws on one side of the center plane and the other of the electrodes being located on one or the other of the jaws on the other side of the center plane; and

each of the first and second electrode surfaces being separated from the tissue grasping surface of the jaw to which it is located by first and second gaps for fluid, respectively.

42. The tissue grasping device of claim 41 wherein:

the tissue grasping surface of at least one jaw has a contact angle (θ

) with the fluid from the fluid source when located thereon equal to or greater than about 30 degrees.

43. The tissue grasping device of claim 41 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first fluid outlet and a second fluid outlet;

the first fluid outlet being located on the same jaw as the first electrode; and

the second fluid outlet being located on the same jaw as the second electrode.

44. The tissue grasping device of claim 43 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source between the first electrode surface and a first portion of tissue; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source between the second electrode surface and a second portion of tissue.

45. The tissue grasping device of claim 41 wherein:

at least a portion of each gap is configured to receive a portion of the fluid expelled from the fluid outlet therein.

46. The tissue grasping device of claim 45 wherein:

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to remove heat generated during use of the device from at least one of tissue and the device.

47. The tissue grasping device of claim 45 wherein:

the fluid from the fluid source comprises an electrically conductive fluid; and

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to provide an electrical path for an electrical current.

48. The tissue grasping device of claim 41 wherein:

each gap further comprises an elongated gap.

49. The tissue grasping device of claim 41 further comprising:

at least one jaw further comprises at least one obstruction configured to inhibit a fluid shunt from forming between the first electrode and the second electrode.

50. A tissue grasping device comprising:

a tip portion including a first jaw and a second jaw, at least one of the jaws being movable toward the other jaw;

each jaw including a tissue grasping surface, the tissue grasping surface of each jaw further comprising an electrically insulative surface;

a portion of each tissue grasping surface being located on two opposing sides of a cutting mechanism, the cutting mechanism comprising a blade;

a bipolar electrode configuration comprising first and second electrodes configured to be connected to a radio frequency generator to generate an electrical current therebetween, the first electrode having a first electrode surface and the second electrode having a second electrode surface;

at least one fluid passage configured to be connected to a fluid source;

at least one fluid outlet in fluid communication with the fluid passage, the at least one fluid outlet to expel a fluid from the fluid source;

one of the first and second electrodes being located on one or the other of the jaws on one side of the cutting mechanism and the other of the electrodes being located on one or the other of the jaws on the other side of the cutting mechanism; and

each the first and second electrode surfaces being separated from the tissue grasping surface of the jaw to which it is located by first and second gaps for fluid, respectively.

51. The tissue grasping device of claim 50 wherein:

the tissue grasping surface of at least one jaw has a contact angle (θ

) with the fluid from the fluid source when located thereon equal to or greater than about 30 degrees.

52. The tissue grasping device of claim 50 wherein:

the at least one fluid outlet in fluid communication with the fluid passage further comprises a first fluid outlet and a second fluid outlet;

the first fluid outlet being located on the same jaw as the first electrode; and

the second fluid outlet being located on the same jaw as the second electrode.

53. The tissue grasping device of claim 52 wherein:

the first fluid outlet is configured to provide a first portion of the fluid from the fluid source between the first electrode surface and a first portion of tissue; and

the second fluid outlet is configured to provide a second portion of the fluid from the fluid source between the second electrode surface and a second portion of tissue.

54. The tissue grasping device of claim 50 wherein:

at least a portion of each gap is configured to receive a portion of the fluid expelled from the fluid outlet therein.

55. The tissue grasping device of claim 54 wherein:

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to remove heat generated during use of the device from at least one of tissue and the device.

56. The tissue grasping device of claim 54 wherein:

the fluid from the fluid source comprises an electrically conductive fluid; and

the portion of each gap configured to receive a portion of the fluid expelled from the fluid outlet therein is positioned for the fluid therein to provide an electrical path for an electrical current.

57. The tissue grasping device of claim 50 wherein:

each gap further comprises an elongated gap.

58. The tissue grasping device of claim 50 further comprising:

at least one jaw further comprises at least one obstruction configured to inhibit a fluid shunt from forming between the first electrode and the second electrode.