Method for operating an electrical surgical instrument with optimal tissue compression

• US 8,286,846 B2
• Filed: 04/14/2008
• Issued: 10/16/2012
• Est. Priority Date: 05/19/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Smith, Kevin W., Bales, Thomas, Deville, Derek Dee, Rivera, Carlos, Palmer, Matthew A.
• Primary Examiner(s): Tawfik, Sameh H.
• Assistant Examiner(s): CHUKWURAH, NATHANIEL C
• Application Number:
  US12/102,464
• Publication Number:
  US 20080245841A1
• Time in Patent Office: 1,646 Days
• Field of Search: 227/19, 227/175.1, 227/179.1, 227/180.1, 227/176.1, 606/1, 606/33, 606/219
• US Class Current: 227/175.1
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/07257 characterised by its anvil
• CPC Class Codes: A61B 2017/07271 characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2090/032 pressure limiting, e.g. hydrostatic
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 90/03 Automatic limiting or abutting means, e.g. for safety

Abstract

A method for effecting a tissue-compressing surgery at a user-selected compression force provides an electrical switch having switching states changed solely by mechanical movements. The switch is mechanically coupled with an adjustable biasing device retaining the switch in one state until a force greater than the bias device is imparted to the switch. The switch is in line with a tissue-compressing device to place a proportional amount of compression force on the switch as imparted upon the tissue. The biasing device is set to a desired state-changing tissue compression force so that the switch changes its state when the force on the switch is at least the desired force. Tissue compresses until a force imparted on the switch at least equals the desired state-changing tissue compression force and, at such time, the switching state changes and, thereafter, a surgical procedure is carried out on the compressed tissue.

Claims

1. A method for effecting a tissue compressing, cutting, and stapling surgical procedure at a user-selected tissue compression force, which comprises:

providing a mechanical binary-output OTC electrical switch having OTC-off and OTC-reached electrical states initiated and changed solely by mechanical movements;

disposing the switch in line with an electrically controlled surgical endocutter to cause a force that is proportional to a force that is placed upon compressed tissue within jaws thereof to be placed upon the switch;

mechanically coupling the switch with an adjustable biasing device that is set to an amount of force that is proportional to an optimal tissue compression force of the compressed tissue within the jaws and retains the switch in the OTC-off switching state until a force at least as great as the optimal tissue compression force is imparted to the switch; and

permitting a surgical cutting and stapling procedure to be carried out on the tissue compressed within the jaws only after the switch changes to the OTC-reached state.

2. A method of configuring a surgical instrument having a surgical tissue-compressing device including a pair of opposing compression surfaces with a tissue compression-measuring device, the method comprising:

providing a mechanical binary-output electrical switch having open and closed electrical switching states initiated and changed solely by mechanical movements;

mechanically coupling the switch with an adjustable biasing device retaining the switch in one of the switching states until a force at least as great as a force imposed by the biasing device is imparted to the switch;

disposing the switch in line with the surgical tissue-compressing device to cause a proportional amount of force that is placed upon compressed tissue disposed between the opposing compression surfaces to be placed upon the switch; and

setting the biasing device to an amount of force that is proportional to an optimal tissue compression force of the compressed tissue when disposed between the opposing compression surfaces.

3. The method according to claim 2, which further comprises disposing the switch to cause substantially the same force that is placed upon the compressed tissue disposed between the opposing compression surfaces to be placed upon the switch.

4. The method according to claim 3, wherein setting the biasing device to an amount of force that is proportional to the optimal tissue compression force of the compressed tissue when disposed between the opposing compression surfaces causes a change of the switching state when a compression force placed on tissue by the opposing compression surfaces of the tissue-compressing device is at least as great as the optimal tissue compression force.

5. The method according to claim 2, which further comprises providing an indicator operable to indicate when the switching state is changed.

6. The method according to claim 2, which further comprises providing the switch with a switch actuation gap that is between approximately 25 micrometers and 200 micrometers in width.

7. The method according to claim 6, which further comprises orienting the switch actuation gap to span along a compression axis of the tissue-compressing device and cause a change of the switching state dependent upon a force expanding along the compression axis.

8. A method of configuring a surgical instrument having a surgical tissue-compressing device including a pair of opposing compression surfaces with an adjustable tissue compression-measuring device, the method comprising:

providing a mechanical binary-output electrical switch having open and closed electrical switching states initiated and changed solely by mechanical movements;

mechanically coupling the switch with an adjustable biasing device retaining the switch in one of the switching states until a force at least as great as a force imposed by the biasing device is imparted to the switch;

disposing the switch in line with the surgical tissue-compressing device to cause a proportional amount of force that is placed upon compressed tissue disposed between the opposing compression surfaces to be placed upon the switch; and

setting the biasing device to an amount of force that is proportional to an optimal tissue compression force of the compressed tissue when disposed between the opposing compression surfaces to cause a change of the switching state to occur when the switch experiences a force at least as great as the force imposed by the biasing device.

9. The method according to claim 8, which further comprises providing an indicator operable to indicate when the switching state is changed.

10. The method according to claim 8, which further comprises providing the switch with a switch actuation gap that is between approximately 25 micrometers and 200 micrometers in width.

11. The method according to claim 10, which further comprises orienting the switch actuation gap to span along a compression axis of the tissue-compressing device and cause a change of the switching state dependent upon a force expanding along the compression axis.

12. A method for effecting a tissue-compressing surgical procedure at a user-selected tissue compression force, the method comprising:

providing a mechanical binary-output electrical switch having open and closed electrical switching states initiated and changed solely by mechanical movements;

mechanically coupling the switch with an adjustable biasing device retaining the switch in one of the switching states until a force at least as great as a force imposed by the biasing device is imparted to the switch;

disposing the switch in line with a surgical tissue-compressing device including a pair of opposing compression surfaces to cause a proportional amount of force that is placed upon compressed tissue disposed between the opposing compression surfaces to be placed upon the switch;

setting the biasing device to an amount of force that is proportional to an optimal tissue compression force of the compressed tissue when disposed between the opposing compression surfaces;

compressing tissue between the opposing compression surfaces of the tissue-compressing device until a force imparted on the switch is at least as great as the optimal tissue compression force and, at such time, changing the switching state; and

after changing the switching state, effecting a surgical procedure on the compressed tissue.

13. The method according to claim 12, which further comprises providing an indicator operable to indicate when the switching state is changed.

14. The method according to claim 12, which further comprises providing the switch with a switch actuation gap that is between approximately 25 micrometers and 200 micrometers in width.

15. The method according to claim 14, which further comprises orienting the switch actuation gap to span along a compression axis of the tissue-compressing device and cause a change of the switching state dependent upon a force expanding along the compression axis.

16. The method according to claim 12, which further comprises:

providing the tissue-compressing device as an electrically powered surgical endocutter having an end effector with jaws, a knife assembly for cutting tissue compressed between the jaws, and a stapling assembly for stapling the tissue compressed between the jaws; and

effecting the surgical procedure by electrically powering the knife and stapling assemblies at the compressed tissue only after the switching state is changed.

17. A method for effecting a tissue-compressing surgical procedure at a user-selected tissue compression force, which comprises:

providing a mechanical binary-output electrical switch having open and closed electrical switching states initiated and changed solely by mechanical movements;

mechanically coupling the switch with an adjustable biasing device retaining the switch in one of the switching states until a force at least as great as a force imposed by the biasing device is imparted to the switch;

disposing the switch in line with an electrically controlled surgical tissue-compressing device including a pair of opposing compression surfaces to cause a proportional amount of force that is placed upon compressed tissue disposed between the opposing compression surfaces to be placed upon the switch, the tissue-compressing device having an electrically operated tissue-compressing assembly and a feedback controller communicatively connected to the tissue-compressing assembly;

setting the biasing device to an optimal tissue compression force;

electrically connecting the switch to the feedback controller; and

compressing tissue between the opposing compression surfaces of the tissue-compressing device until a force imparted on the switch is at least as great as the optimal tissue compression force and, at such time, changing the switching state, which state change communicates to the feedback controller that tissue is being compressed with the optimal tissue compression force.

18. The method according to claim 17, which further comprises permitting a surgical procedure to be carried out on the compressed tissue only after the feedback controller has received a state change signal from the switch.

19. The method according to claim 18, which further comprises communicatively connecting the tissue-compressing device to the feedback controller and operating the tissue-compressing device dependent upon a signal from the feedback controller to maintain the optimal tissue compression force on the tissue.

20. The method according to claim 18, which further comprises:

providing the tissue-compressing device as an electrically powered surgical endocutter having an end effector with jaws, a knife assembly for cutting tissue compressed between the jaws, and a stapling assembly for stapling cut tissue compressed between the jaws; and

operating the feedback controller to permit electrically powered cutting and stapling of the compressed tissue only after the feedback controller has received the state change signal from the switch.

21. The method according to claim 17, which further comprises permitting a surgical procedure to be carried out on the compressed tissue only while the feedback controller is receiving a state change signal from the switch.

22. The method according to claim 21, which further comprises:

providing the tissue-compressing device as an electrically powered surgical endocutter having an end effector with jaws, a knife assembly for cutting tissue compressed between the jaws, and a stapling assembly for stapling cut tissue compressed between the jaws; and

operating the feedback controller to permit electrically powered cutting and stapling of the compressed tissue only while the feedback controller is receiving the state change signal from the switch.

23. The method according to claim 17, which further comprises connecting an indicator to the feedback controller to indicate when the switching state is changed, the indicator being one of a tactile, an audible, and a visual indicator.

24. The method according to claim 17, which further comprises providing the switch with a switch actuation gap that is between approximately 25 micrometers and 200 micrometers in width.

25. The method according to claim 24, which further comprises orienting the switch actuation gap to span along a compression axis of the tissue-compressing device and cause a change of the switching state dependent upon a force expanding along the compression axis.