Electrosurgical tissue sealer and cutter

• US 8,277,446 B2
• Filed: 04/24/2009
• Issued: 10/02/2012
• Est. Priority Date: 04/24/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Heard, David N.
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): Gilbert, Andrew
• Application Number:
  US12/429,533
• Publication Number:
  US 20100274244A1
• Time in Patent Office: 1,257 Days
• Field of Search: 606 45- 52
• US Class Current: 606/51
• CPC Class Codes: A61B 17/3205 Excision instruments
• 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 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Abstract

A surgical instrument comprises an end effector including a pair of jaw members configured to move with respect to one another between an open configuration and a closed configuration for clamping tissue. At least one jaw member includes an elongate cam slot extending in a longitudinal direction over a substantial a length a tissue clamping surface of the at least one jaw member. A plurality of electrically isolated, and longitudinally spaced electrodes is supported by the tissue clamping surface and is configured to deliver electrosurgical energy to tissue. A reciprocating member engages the elongate cam slot and is extendable to a sealing position with respect to each of the electrodes to define a predetermined gap distance between a particular electrode and an opposing tissue clamping surface.

Claims

1. A surgical instrument, comprising:

an end effector including a pair of jaw members having opposing tissue clamping surfaces, at least one of the jaw members configured to move with respect to the other jaw member to move the end effector between an open configuration for receiving tissue and a closed configuration for clamping tissue between the opposing tissue clamping surfaces, the at least one jaw member including an elongate cam slot extending longitudinally along the at least one jaw member over a substantial a length of the tissue clamping surfaces;

a plurality of electrically isolated electrodes supported by at least one of the tissue clamping surfaces of one of the jaw members, each of the plurality of electrodes longitudinally spaced along the at least one tissue clamping surface and configured to deliver electrosurgical energy to tissue; and

a reciprocating member extendable through the elongate cam slot to a longitudinal sealing position with respect to each of the electrodes, wherein when the reciprocating member is in the sealing position with respect to a particular electrode, the reciprocating member defines a predetermined gap distance between the particular electrode and the opposing tissue clamping surface; and

an interruption mechanism to interrupt advancement of the reciprocating member at each of the longitudinal sealing positions.

2. The surgical instrument according to claim 1, wherein the interruption mechanism includes a handle movable with respect to a grip member, wherein the reciprocating member is operatively coupled to the movable handle such that the reciprocating member is advanced upon approximation of the movable handle with the grip member and advancement of the reciprocating member is interrupted upon separation of the movable handle from the grip member.

3. The surgical instrument according to claim 1, wherein the interruption mechanism includes a motor and a controller, the motor operatively associated with the reciprocating member to advance the reciprocating member upon activation of the motor and interrupt advancement upon deactivation of the motor, the controller operatively associated with the motor to activate and deactivate the motor.

4. The surgical instrument according to claim 3, further comprising a sensor array in electrical communication with the controller, the sensor array adapted to detect the position of the reciprocating member with respect to at least one longitudinal sealing position.

5. The surgical instrument according to claim 1, further comprising a controller for providing electrical energy to a particular electrode while maintaining other electrodes in an electrically inactive state.

6. The surgical instrument according to claim 5, further comprising a sensor array in electrical communication with the controller, the sensor array adapted to detect a characteristic of the tissue indicative of a completed electrosurgical treatment.

7. The surgical instrument according to claim 6, wherein the sensor array includes at least one of a temperature sensor, an impedance sensor and an optical sensor.

8. The surgical instrument according to claim 1, wherein the reciprocating member includes a blade for transecting tissue.

9. The surgical instrument according to claim 8, wherein the reciprocating member includes a cam driver configured to engage the elongate cam slot and the blade is disposed proximally with respect to a cam driver.

10. The surgical instrument according to claim 9, wherein the blade is disposed sufficiently proximally with respect to the cam driver such that when the reciprocating member is in a sealing position associated with a particular electrode, the blade is disposed proximally of the particular electrode.

11. The surgical instrument according to claim 1, wherein the reciprocating member generally exhibits an I-beam geometry including a pair of opposed flanges connected by an intermediate web.

12. The surgical instrument according to claim 11, wherein one of the pair of opposed flanges engages the elongate cam slot defined in one of the jaw members and the other of the pair of opposed flanged engages a second cam slot defined in the other of the jaw members.

13. The surgical instrument according to claim 1, wherein the elongate cam slot includes a proximal portion curved such that advancement of the reciprocating member therethrough urges the end effector to the closed configuration.

14. The surgical instrument according to claim 1, wherein the plurality of electrodes includes a plurality of electrode sets, each electrode set including at least two electrodes of opposite polarity supported respective tissue clamping surfaces such that the electrodes of opposite polarity may cooperate to induce an electrosurgical current to flow through tissue positioned between the tissue clamping surfaces.

15. A surgical instrument comprising:

an end effector including a pair of jaw members having opposing tissue clamping surfaces, at least one of the jaw members configured to move with respect to the other jaw member to move the end effector between an open configuration for receiving tissue and a closed configuration for clamping tissue between the opposing tissue clamping surfaces;

a plurality of electrically isolated electrodes supported by at least one of the tissue clamping surfaces of one of the jaw members, each of the plurality of electrodes longitudinally spaced along the at least one clamping surface and configured to deliver electrosurgical energy the tissue;

a reciprocating member including a blade, the reciprocating member extendable to a longitudinal sealing position with respect to each of the electrodes, wherein when the reciprocating member is in the sealing position with respect to a particular electrode the forward blade is disposed immediately proximally of the particular electrode; and

an interruption mechanism configured to interrupt advancement of the reciprocating member at each of the sealing positions.

16. A method for electrosurgically treating tissue, the method comprising the steps of:

providing an instrument including a plurality of electrically isolated electrodes being spaced longitudinally along at least one of a pair of tissue clamping surfaces of a pair of jaw members, the instrument also including a reciprocating member longitudinally movable to a sealing position with respect to each of the plurality of electrodes;

positioning tissue between the opposing clamping surfaces such that at least a first proximal electrode and a second distal electrode of the plurality of electrodes contacts the tissue;

advancing the reciprocating member to the sealing position with respect to the first proximal electrode to clamp the tissue between the first proximal electrode and the opposing tissue clamping surface at a predetermined gap distance;

interrupting advancement of the reciprocating member to maintain the reciprocating member at the sealing position with respect to the first proximal electrode while providing electrosurgical energy to the first proximal electrode and maintaining the second distal electrode in an electrically inactive state;

further advancing the reciprocating member to the sealing position with respect to the second distal electrode to clamp the tissue between the second distal electrode and the opposing tissue clamping surface at the predetermined gap distance; and

interrupting advancement of the reciprocating member to maintain the reciprocating member at the sealing position with respect to the second distal electrode while providing electrosurgical energy to the second distal electrode and maintaining the first proximal electrode in an electrically inactive state.