System and method for tissue sealing

• US 8,216,223 B2
• Filed: 02/23/2009
• Issued: 07/10/2012
• Est. Priority Date: 01/24/2006
• Status: Active Grant

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Covidien AG (Medtronic Plc)
• Inventors: Wham, Roberth H., Coulson, Rebecca, Riegner, Kari L., Schechter, David A., McKenna, Nicole, Bastian, Barbara R., Harper, Jennifer S.
• Primary Examiner(s): Desanto, Matthew F
• Application Number:
  US12/390,981
• Publication Number:
  US 20090157072A1
• Time in Patent Office: 1,233 Days
• Field of Search: 606 32- 51
• US Class Current: 606/38
• CPC Class Codes: A61B 18/1206 Generators 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 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00875 Resistance or impedance

Abstract

An electrosurgical system is disclosed. The electrosurgical system includes an electrosurgical generator adapted to supply electrosurgical energy to tissue. The electrosurgical generator includes impedance sensing circuitry which measures impedance of tissue, a processor configured to determine whether a tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance, wherein tissue reaction corresponds to a boiling point of tissue fluid, and an electrosurgical instrument including at least one active electrode adapted to apply electrosurgical energy to tissue. A tissue cooling period is provided to enhance operative outcomes.

Claims

1. An electrosurgical generator for tissue fusion, comprising:

an RF output stage adapted to supply electrosurgical energy to tissue to an electrosurgical instrument, wherein the electrosurgical instrument includes at least one active electrode adapted to apply electrosurgical energy to tissue;

impedance sensing circuitry configured to measure impedance of tissue; and

a processor configured to;

determine whether tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance, wherein tissue reaction corresponds to a boiling point of tissue fluid;

generate a target impedance trajectory as a function of measured impedance and desired rate of change based on the tissue reaction determination, wherein the target impedance trajectory includes a plurality of target impedance values;

detect a negative deviation between the measured tissue impedance and a corresponding target impedance value associated with an unexpected drop in tissue impedance, wherein if the negative deviation is detected for more than a predetermined time period the processor recalculates and generates a subsequent reset impedance trajectory to compensate for the negative deviation, the reset impedance trajectory configured to mirror the target impedance trajectory;

interrupt the supply of electrosurgical energy to tissue to effectuate a cooling period; and

indicate expiration of the cooling period.

2. An electrosurgical generator for tissue fusion according to claim 1, wherein the processor is adapted to generate a threshold impedance value as a function of an offset impedance value and an ending impedance value, wherein the offset impedance value is obtained after an initial impedance measurement.

3. An electrosurgical generator for tissue fusion according to claim 2, wherein the processor is further configured to determine whether tissue impedance is at least equal to the threshold impedance for a predetermined shutoff period.

4. An electrosurgical generator for tissue fusion according to claim 3, wherein the processor is configured to adjust output of the electrosurgical generator in response to the determination whether tissue impedance is at least equal to the threshold impedance for a predetermined shutoff period.

5. An electrosurgical generator for tissue fusion according to claim 1, wherein the processor is configured to determine the cooling period in response to parameters relating to a tissue fusion process.

6. An electrosurgical generator for tissue fusion according to claim 5, wherein the parameters relating to a tissue fusion process are selected from a group consisting of tissue temperature, tissue impedance, tissue mass, electrosurgical energy delivery, fluid presence, jaw angle, and characteristics of the at least one active electrode.

7. An electrosurgical generator for tissue fusion according to claim 1, wherein the processor verifies the negative deviation is stable.

8. An electrosurgical generator for tissue fusion according to claim 7, wherein in response to detection of the negative deviation, the processor is configured to determine whether a subsequent tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance, wherein tissue reaction corresponds to a boiling point of tissue fluid.

9. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes;

a pair of jaw members configured to grasp tissue; and

a ratchet mechanism configured to selectively apply pressure to the jaws in response to the processor wherein the processor is further configured to vary jaw pressure in response to a determination that tissue reaction has occurred.

10. An electrosurgical generator for tissue fusion according to claim 9 wherein jaw pressure is increased in response to a determination that tissue reaction has occurred.

11. An electrosurgical generator for tissue fusion according to claim 1, wherein the cooling period is a fixed period of time.

12. An electrosurgical generator for tissue fusion according to claim 1, wherein the cooling period ranges from about zero seconds to about ten seconds.

13. An electrosurgical generator for tissue fusion according to claim 1, wherein the processor is configured to drive tissue impedance along the target impedance trajectory by adjusting the output level to substantially match tissue impedance to a corresponding target impedance value.

14. An electrosurgical generator for tissue fusion according to claim 1, wherein the indication is selected from the group consisting of an audible indication and a visual indication.

15. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes;

a pair of jaw members configured to grasp tissue; and

a ratchet mechanism configured to selectively apply pressure to the jaws in response to the processor wherein the processor is further configured to increase jaw pressure upon activation of the electrosurgical energy.

16. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes;

a pair of jaw members configured to grasp tissue; and

a ratchet mechanism configured to selectively apply pressure to the jaws in response to the processor wherein the processor is further configured to vary jaw pressure in response to tissue impedance.

17. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes;

a pair of jaw members configured to grasp tissue; and

a ratchet mechanism configured to selectively apply pressure to the jaws in response to the processor wherein the processor is further configured to release jaw pressure upon expiration of the cooling period.

18. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes a temperature sensor in operable communication with the electrosurgical generator wherein the processor is further configured to receive a signal from the temperature sensor and adjust the cooling period in response thereto.

19. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes a fluid sensor in operable communication with the electrosurgical generator; and

the processor is further configured to receive a signal from the fluid sensor and adjust the cooling period in response thereto.

20. An electrosurgical generator for tissue fusion according to claim 1 wherein:

the electrosurgical instrument further includes an angle sensor adapted to sense the included angle between the jaws and in operable communication with the electrosurgical generator; and

the processor is further configured to receive a signal from the angle sensor and adjust at least one of the impedance trajectory and the cooling period in response thereto.