Method and apparatus for precursively controlling energy during coaptive tissue fusion

• US 7,678,105 B2
• Filed: 09/16/2005
• Issued: 03/16/2010
• Est. Priority Date: 09/16/2005
• Status: Active Grant

• Current Assignee: Conmed Corporation (Jefferies Financial Group, Inc.)
• Original Assignee: Conmed Corporation (Jefferies Financial Group, Inc.)
• Inventors: Pavlovsky, Katherine R., McGreevy, Francis T.
• Primary Examiner(s): Peffley; Michael
• Assistant Examiner(s): HUPCZEY, JR, RONALD JAMES
• Application Number:
  US11/228,891
• Publication Number:
  US 20070066969A1
• Time in Patent Office: 1,642 Days
• Field of Search: 606 32- 52
• US Class Current: 606/32
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00827 Current

Abstract

A sidewall of biological tissue which surrounds and defines an opening in the tissue is sealed or fused to occlude the opening by compressing apposite sidewall portions and applying sufficient energy to cause the fibers of the compressed apposed sidewall portions to intertwine and fuse with one another to form a permanent seal. The energy application is controlled by detecting a precursor fusion condition while applying the energy and before sufficient energy has been applied to achieve an adequate seal. The application of energy is terminated in a time-delayed relationship to the detection of the precursor fusion condition such that sufficient energy has been applied to achieve an effective seal. The precursor fusion condition is detected upon the peak RF current delivered to the tissue remaining below a threshold value for a threshold time.

Claims

1. A tissue sealing apparatus for coaptively sealing a sidewall of biological tissue which surrounds and defines an opening in the tissue to occlude the opening permanently, comprising:

a handpiece having movable jaws to compress apposed portions of the sidewall with sufficient pressure for sealing the opening;

an electrical energy generator connected to the handpiece and operative to conduct sufficient electrical energy to the jaws and through the compressed apposed portions of the sidewall during a treatment cycle to fuse together permanently the apposed sidewall portions and permanently occlude the opening, the energy delivered from the generator includes RF current delivered in RF cycles, each RF cycle of the RF current having a peak current value, the treatment cycle having an initial heating phase during which the peak current values of the RF current cycles have initial peak current values and also having a reduction phase during which the peak current values of the RF current cycles diminish from the initial peak current values due to the desiccation of the tissue and an increase in the impedance of the tissue;

a controller connected to control the duration of the electrical energy conducted from the generator to the handpiece and through the compressed apposed sidewall portions to avoid inadequate and excessive energy application for coaptively sealing the tissue, the controller including;

a switch which is movable from a closed position to an opened position in response to a termination signal asserted to the switch, the closed position conducting the energy including the RF current from the generator to the handpiece, the opened position terminating the conduction of the energy from the generator to the handpiece;

a detector which includes a threshold circuit, a comparator and a threshold timer, the threshold circuit developing a threshold value which is less than the initial peak current values of RF current cycles during the initial heating phase, the comparator connected to the threshold circuit and comparing the peak current values of RF current cycles to the threshold value, the threshold timer establishing a predetermined threshold time duration, and wherein the detector delivers a trigger signal upon the peak current values of the RF current cycles not exceeding the threshold value for the predetermined threshold time; and

an energy completion timer receptive of the trigger signal and operative to assert the termination signal to the switch upon expiration of a predetermined energy completion time measured from assertion of the trigger signal.

2. A tissue sealing apparatus as defined in claim 1, wherein:

the switch normally occupies the closed position.

3. A tissue sealing apparatus as defined in claim 1, wherein:

the initial heating phase comprises a multiple number of RF current cycles of substantially constant initial peak current values which heat the tissue; and

the reduction phase comprises a multiple number of RF current cycles of generally decreasing peak current values.

4. A tissue sealing apparatus as defined in claim 3, wherein:

the increase in tissue impedance during the reduction phase causes arcing of the electrical energy between the jaws; and

the threshold value and the predetermined threshold time duration cause the detector to deliver the trigger signal before arcing occurs.

5. A tissue sealing apparatus as defined in claim 3, wherein:

the increase in tissue impedance during the reduction phase causes arcing of the electrical energy between the jaws; and

the predetermined energy completion time causes assertion of the termination signal after arcing occurs.

6. A tissue sealing apparatus as defined in claim 1, wherein:

each RF current cycle has positive and negative peak current values;

the threshold circuit establishes a positive threshold value and a negative threshold value;

the comparator compares positive and negative peak current values of each RF current cycle to the positive and negative threshold values to determine whether the positive and negative peak current values of each RF current cycle exceed the positive and negative threshold values in a positive and negative sense, respectively; and

the detector delivers the trigger signal upon none of the positive and negative peak current values of the RF current cycles respectively exceeding the positive and negative threshold values in the positive and negative sense for the predetermined threshold time duration.

7. A tissue sealing apparatus as defined in claim 1, wherein:

the detector reinitiates use of the predetermined threshold time duration to determine the delivery of the trigger signal whenever the peak current value of one RF current cycle exceeds the threshold value.

8. A tissue sealing apparatus as defined in claim 1, wherein the controller further comprises:

a maximum duration timer which measures a delivery time that electrical energy is delivered from the generator to the handpiece and which asserts a control signal to the switch upon the delivery time exceeding a predetermined maximum time duration which is longer than an expected time duration of a normal treatment cycle; and

wherein;

the switch moves to the opened position in response to the asserted control signal.

9. A tissue sealing apparatus as defined in claim 1, wherein the predetermined threshold time duration is in the range of 100 to 200 milliseconds.

10. A tissue sealing apparatus as defined in claim 1, wherein the predetermined threshold time duration is in the range of 125 to 175 milliseconds.

11. A tissue sealing apparatus as defined in claim 1, wherein the predetermined threshold time duration is approximately 150 milliseconds.

12. A tissue sealing apparatus as defined in claim 1, wherein the predetermined energy completion time is in the range of 900 to 1200 milliseconds.

13. A tissue sealing apparatus as defined in claim 1, wherein the predetermined energy completion time is approximately 980 milliseconds.

14. A controller which controls the duration of electrical energy conducted from an electrical energy generator to a handpiece and through compressed apposed sidewall portions of biological tissue to seal the sidewall portions and permanently occlude an opening previously defined by the sidewall portions while avoiding inadequate and excessive energy application for coaptively sealing the tissue, the handpiece having movable jaws which compress apposed sidewall portions with sufficient pressure for sealing the opening, the generator conducting RF current delivered in RF cycles to the jaws and through the compressed apposed sidewall portions during a treatment cycle, the RF current of each RF cycle having a peak current value, the treatment cycle having an initial heating phase during which the peak current values of the RF current cycles have initial peak current values and also having a reduction phase during which the peak current values of the RF current cycles diminish from the initial peak current values due to the desiccation of the tissue and an increase in the impedance of the tissue;

the controller comprising;

a switch which is movable from a closed position to an opened position in response to a termination signal asserted to the switch, the closed position conducting the RF current from the generator to the handpiece, the opened position terminating the conduction of the RF current from the generator to the handpiece;

a detector which includes a threshold circuit, a comparator and a threshold timer, the threshold circuit developing a threshold value which is less than the initial peak current values of RF current cycles during the initial heating phase, the comparator connected to the threshold circuit and comparing the peak current values of RF current cycles to the threshold value, the threshold timer establishing a predetermined threshold time duration, and wherein the detector delivers a trigger signal upon the peak current values of the RF current cycles not exceeding the threshold value for the predetermined threshold time; and

an energy completion timer receptive of the trigger signal and operative to assert the termination signal to the switch upon expiration of a predetermined energy completion time measured from assertion of the trigger signal.

15. A controller as defined in claim 14, wherein:

the switch normally occupies the closed position.

16. A controller as defined in claim 14, wherein:

the initial heating phase comprises a multiple number of RF current cycles of substantially constant initial peak current values which heat the tissue; and

the reduction phase comprises a multiple number of RF current cycles of generally decreasing peak current values.

17. A controller as defined in claim 16, wherein:

the increase in tissue impedance during the reduction phase causes arcing of the electrical energy between the jaws; and

the threshold value and the predetermined threshold time duration cause the detector to deliver the trigger signal before arcing occurs.

18. A controller as defined in claim 16, wherein:

the increase in tissue impedance during the reduction phase causes arcing of the electrical energy between the jaws; and

the predetermined energy completion time causes assertion of the termination signal after arcing occurs.

19. A controller as defined in claim 14, wherein:

each RF current cycle has positive and negative peak current values;

the threshold circuit establishes a positive threshold value and a negative threshold value;

the comparator compares positive and negative peak current values of each RF current cycle to the positive and negative threshold values to determine whether the positive and negative peak current values of each RF current cycle exceed the positive and negative threshold values in a positive and negative sense, respectively; and

the detector delivers the trigger signal upon none of the positive and negative peak current values of the RF current cycles respectively exceeding the positive and negative threshold values in the positive and negative sense for the predetermined threshold time duration.

20. A controller as defined in claim 14, wherein:

the detector reinitiates use of the predetermined threshold time duration to determine the delivery of the trigger signal whenever the peak current value of one RF current cycle exceeds the threshold value.

21. A controller as defined in claim 14, wherein the controller further comprises:

a maximum duration timer which measures a delivery time that electrical energy is delivered from the generator to the handpiece and which asserts a control signal to the switch upon the delivery time exceeding a predetermined maximum time duration which is longer than an expected time duration of a normal treatment cycle; and

wherein;

the switch moves to the opened position in response to the asserted control signal.

22. A controller as defined in claim 14, wherein the predetermined threshold time duration is in the range of 100 to 200 milliseconds.

23. A controller as defined in claim 14, wherein the predetermined threshold time duration is in the range of 125 to 175 milliseconds.

24. A controller as defined in claim 14, wherein the predetermined threshold time duration is approximately 150 milliseconds.

25. A controller as defined in claim 14, wherein the energy completion time is in the range of 900 to 1200 milliseconds.

26. A controller as defined in claim 14, wherein the energy completion time is approximately 980 milliseconds.