Energy-based medical treatment system and method

• US 7,854,735 B2
• Filed: 02/16/2006
• Issued: 12/21/2010
• Est. Priority Date: 02/16/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Noschang, Sarah A., Gutierrez, Jorge N., Houser, Kevin L.
• Primary Examiner(s): Dvorak; Linda C
• Assistant Examiner(s): SCOTT, AMANDA L
• Application Number:
  US11/355,463
• Publication Number:
  US 20070191828A1
• Time in Patent Office: 1,769 Days
• Field of Search: 606 32- 34, 606/49, 606 50- 52, 606/169, 606205-209
• US Class Current: 606/40
• CPC Class Codes: A61B 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension

Abstract

A method for medical treatment includes beginning coagulating patient tissue using an energy-based clamp coagulator, determining the clamping force, and measuring the acoustic impedance of the patient tissue. The method also includes compensating the measured acoustic impedance for clamp pressure and monitoring the coagulation using at least the compensated measured acoustic impedance. A first medical treatment system includes an energy-based clamp coagulator, an acoustic-impedance measurer, and a force measurer. A second system includes an energy-based clamp coagulator having a clamping member which includes, or is adapted to function as, an electrical-impedance-measuring electrode for measuring an electrical impedance of the clamped patient tissue. A third system includes an energy-based clamp coagulator having a clamping member which includes, or is adapted to function as, a temperature sensor for measuring a temperature of the clamped patient tissue.

Claims

1. An energy-based medical treatment system comprising:

a) an energy-based clamp coagulator adapted to clamp patient tissue;

b) an acoustic-impedance measurer operatively connected to the energy-based clamp coagulator to measure an acoustic impedance of the clamped patient tissue;

c) a force measurer operatively connected to the energy-based clamp coagulator to measure a clamp force on the clamped patient tissue; and

d) a controller which compensates the measured acoustic impedance of the patient tissue for clamp pressure using at least the measured clamp force.

2. The energy-based medical treatment system of claim 1, wherein the controller also monitors a coagulation of the patient tissue using at least the compensated measured acoustic impedance.

3. The energy-based medical treatment system of claim 2, wherein the controller controls a power output of a generator based on the monitored coagulation of the patient tissue, wherein the power output powers the energy-based clamp coagulator.

4. The energy-based medical treatment system of claim 3, wherein the controlled power output is adjusted lower by the controller as the monitored coagulation of the patient tissue nears completion.

5. The energy-based medical treatment system of claim 3, wherein the controlled power output is turned off by the controller when the monitored coagulation of the patient tissue is completed.

6. The energy-based medical treatment system of claim 2, wherein the controller controls a visual and/or audio indicator which indicates, to a user of the energy-based clamp coagulator, the monitored coagulation of the patient tissue.

7. The energy-based medical treatment system of claim 6, wherein the energy-based clamp coagulator is an ultrasonic surgical shears having an ultrasonic blade and a clamp arm.

8. The energy-based medical treatment system of claim 7, wherein the force measurer is adapted to measure a force applied to the clamp arm.

9. An energy-based medical treatment system comprising:

a) an energy-based clamp coagulator adapted to clamp patient tissue;

b) an acoustic-impedance measurer operatively connected to the energy-based clamp coagulator, the acoustic-impedance measurer determining a value of acoustic impedance based on a generator output power;

c) a force measurer operatively connected to the energy-based clamp coagulator, the force measurer determining a value of clamping force based on a force transducer output; and

d) a controller generating a value of compensated acoustic impedance from the value of acoustic impedance based on at least the value of clamping force, wherein the value of compensated acoustic impedance is corrected to a value less than the value of acoustic impedance with increasing values of clamping force.

10. The energy-based medical treatment system of claim 9, wherein the controller monitors a coagulation of the patient tissue using at least the value of compensated acoustic impedance.

11. The energy-based medical treatment system of claim 10, wherein the controller controls the generator output power based on the monitored coagulation of the patient tissue, wherein the generator output power powers the energy-based clamp coagulator.

12. The energy-based medical treatment system of claim 11 wherein the controller reduces generator power output as the value of compensated acoustic impedance nears a predetermined upper limit.

13. The energy-based medical treatment system of claim 11 wherein the controller stops generator power output when the value of compensated acoustic impedance reaches a predetermined upper limit.

14. The energy-based medical treatment system of claim 11 wherein the controller reduces generator power output as the state of an acoustic impedance versus time relationship nears a predetermined state.

15. The energy-based medical treatment system of claim 11 wherein the controller stops generator power output as the state of an acoustic impedance versus time relationship reaches a predetermined state.

16. The energy-based medical treatment system of claim 11, wherein the controller controls a visual and/or audio indicator which indicates, to a user of the energy-based clamp coagulator, the monitored coagulation of the patient tissue.

17. The energy-based medical treatment system of claim 16, wherein the energy-based clamp coagulator is an ultrasonic surgical shears having an ultrasonic blade and a clamp arm.

18. The energy-based medical treatment system of claim 17, wherein the force transducer is adapted to measure a force applied to the clamp arm.