Inductively heated multi-mode bipolar surgical tool

• US 8,491,578 B2
• Filed: 12/24/2009
• Issued: 07/23/2013
• Est. Priority Date: 04/17/2009
• Status: Active Grant

• Current Assignee: Domain Surgical, Inc (OmniGuide Holdings, Inc.)
• Original Assignee: Domain Surgical, Inc (OmniGuide Holdings, Inc.)
• Inventors: Manwaring, Kim, McNally, David
• Primary Examiner(s): Dvorak, Linda
• Assistant Examiner(s): DELLA, JAYMI E
• Application Number:
  US12/647,374
• Publication Number:
  US 20100268211A1
• Time in Patent Office: 1,307 Days
• Field of Search: 606/47, 606/113, 607/103
• US Class Current: 606/31
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/085 Forceps, scissors
• CPC Class Codes: A61B 18/10 Power sources therefor
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00141 continuous, e.g. wave
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00973 pedal-operated
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320082 for incising tissue
• CPC Class Codes: A61B 2018/00077 high, i.e. electrically conducting
• CPC Class Codes: A61B 2018/00095 high, i.e. heat conducting
• CPC Class Codes: A61B 2018/00107 Coatings on the energy applicator
• CPC Class Codes: A61B 2018/0013 non-sticking
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/00619 : Welding
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00714 : Temperature
• CPC Class Codes: A61B 2018/00755 : Resistance or impedance
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00803 : with temperature prediction
• CPC Class Codes: A61B 2018/00958 : for switching between different working modes of the main function
• CPC Class Codes: A61B 2018/128 : generating two or more frequencies
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61M 25/00 : Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• CPC Class Codes: Y10T 29/49124 : On flat or curved insulated base, e.g., printed circuit, etc.

Abstract

Thermal, electrosurgical and mechanical modalities may be combined in a surgical tool. Potentially damaging effects in a first modality may be minimized by using a secondary modality. In one example, thermal hemostasis may thus help electrosurgical applications avoid the adverse tissue effects associated with hemostatic monopolar electrosurgical waveforms while retaining the benefits of using monopolar incising waveforms.

Claims

1. A multi-mode surgical tool comprising:

an electrosurgical electrode and

a thermal element comprising a conductor and a ferromagnetic layer covering at least a portion of the conductor, the ferromagnetic layer forming a ferromagnetic region disposed along the conductor, the conductor extending from a position prior to the ferromagnetic layer, through the ferromagnetic region and to a position beyond the ferromagnetic layer, the ferromagnetic layer being sufficiently thin that the ferromagnetic layer will not fracture when the ferromagnetic layer is heated in air and then immersed in liquid while the ferromagnetic layer is heated;

wherein passage of electrical energy from a conductor location prior to the ferromagnetic region to a conductor location beyond the ferromagnetic region causes heating of the ferromagnetic layer.

2. The multi-mode surgical tool of claim 1, wherein the ferromagnetic layer is disposed circumferentially about the conductor.

3. The multi-mode surgical tool of claim 2 further comprising a catheter, wherein the electrosurgical electrode and the thermal element are disposed upon the catheter.

4. The multi-mode surgical tool of claim 3, wherein the catheter is rigid.

5. The multi-mode surgical tool of claim 3, wherein the catheter is flexible.

6. The multi-mode surgical tool of claim 3, wherein the catheter is configured for aspiration.

7. The multi-mode surgical tool of claim 3, wherein the catheter is configured for substance delivery.

8. The multi-mode surgical tool of claim 3, wherein the catheter is configured for irrigation.

9. The multi-mode surgical tool of claim 3, wherein the catheter has a meltable substance disposed therein which can be released from the catheter by generating heat in the thermal element.

10. The multi-mode surgical tool of claim 3, wherein the catheter has at least one sensor disposed therein.

11. The multi-mode surgical tool of claim 3, wherein the catheter comprises a visualization device.

12. The multi-mode surgical tool of claim 1, wherein the thermal element and the electrosurgical electrode are configured to be independently activated.

13. The multi-mode surgical tool of claim 1, wherein the thermal element is configured to function as the electrosurgical electrode.

14. The multi-mode surgical tool of claim 13, further comprising a signal generator for producing a multiplexed signal.

15. The multi-mode surgical tool of claim 14, wherein the electrosurgical electrode and the thermal element are configured to receive the multiplexed signal from a single channel.

16. The multi-mode surgical tool of claim 14, wherein the multiplexed signal further comprises an electrosurgical signal and a ferromagnetic heating signal.

17. The multi-mode surgical tool of claim 16, wherein the electrosurgical signal is between about 200 kHz and 2 MHz and the ferromagnetic heating signal is between about 5 MHz and 24 GHz.

18. The multi-mode surgical tool of claim 16, wherein the electrosurgical signal is between about 350 kHz and 800 kHz and the ferromagnetic heating signal is between about 40 MHz and 928 MHz.

19. The multi-mode surgical tool of claim 16, wherein the electrosurgical signal is between about 350 kHz and 800 kHz and wherein the ferromagnetic heating signal is between about 5 MHz and 24 GHz.

20. The multi-mode surgical tool of claim 16, wherein the electrosurgical signal is between about 200 kHz and 2 MHz and wherein the ferromagnetic heating signal is between about 40 MHz and 928 MHz.

21. The multi-mode surgical tool of claim 1, wherein the ferromagnetic layer has a Curie temperature and heating of the ferromagnetic region is regulated at or below the Curie temperature of the ferromagnetic layer.

22. The multi-mode surgical tool of claim 1, further comprising a power supply for providing an energy waveform to the electrosurgical electrode to treat tissue and a different energy waveform to cause sufficient heating of the ferromagnetic layer to treat tissue.

23. The multi-mode surgical tool of claim 1, further comprising a second conductor for providing energy to the electrosurgical electrode and the thermal element and a signal generator for providing a multiplexed signal in the second conductor.

24. The multi-mode surgical tool of claim 1, further comprising a power supply and a control for selectively activating the electrosurgical electrode and the thermal element individually or in combination.

25. The multi-mode surgical tool of claim 1, wherein the thermal element is disposed on the electrosurgical electrode.

26. The multi-mode surgical tool of claim 1, further comprising a nonstick coating disposed on at least one of the bipolar electrode and the thermal element.

27. The multi-mode tool of claim 1, further comprising a biocompatible coating disposed over at least a portion of the thermal element.

28. The multi-mode surgical tool of claim 1, wherein the thermal element is self cleaning.

29. The multi-mode surgical tool of claim 1, wherein the ferromagnetic layer is configured to be heated to a temperature of at least 37 degrees Centigrade.

34. The multi-mode surgical forceps of claim 28, wherein the second signal is configured to pass from a conductor location prior to the ferromagnetic layer to a conductor location beyond the ferromagnetic layer to cause the ferromagnetic layer to heat to the temperature of between about 37 and 600 degrees Centigrade.

35. The multi-mode surgical forceps of claim 28, wherein the bipolar signal is between about 350 kHz and 800 kHz and the second signal is between about 40 MHz and 928 MHz.

30. Multi-mode surgical forceps comprising:

at least two tips;

a bipolar electrode disposed on at least one of the at least two tips, the bipolar electrode including a channel for receiving a bipolar signal; and

a thermal element comprising a conductor and a ferromagnetic layer covering at least a portion of the conductor disposed on at least one of the at least two tips, the thermal element configured for receiving a second signal other than a bipolar signal, the ferromagnetic layer being sufficiently thin to not fracture when exposed to a temperature differential sufficiently large to cause a ferrite bead to fracture;

wherein the second signal is configured to cause direct heating of the thermal element to a temperature between about 37 and 600 degrees Centigrade.

31. The multi-mode surgical forceps of claim 30, wherein the thermal element and the bipolar electrode are disposed on the same tip.

32. The multi-mode surgical forceps of claim 30, wherein the thermal element and the bipolar electrode are disposed on separate tips.

33. The multi-mode surgical forceps of claim 30, further comprising a non-stick coating disposed on at least one of the at least two tips.

36. Multi-mode surgical forceps comprising:

at least two arms;

a bipolar electrode disposed on one of the at least two arms;

a return bipolar electrode disposed upon one of the at least two arms; and

at least one conductor having a ferromagnetic coating which will not fracture when repeatedly heated and immersed in liquid while still hot, the conductor being disposed upon at least one of the at least two arms.

37. The multi-mode surgical forceps of claim 36, wherein ferromagnetic coating forms a ferromagnetic region disposed along the at least one conductor, the at least one conductor extending from a position prior to the ferromagnetic coating, through the ferromagnetic region and to a position beyond the ferromagnetic coating.

38. The multi-mode surgical forceps of claim 37, further comprising a sensor disposed on one of the at least two arms.

39. The multi-mode surgical forceps of claim 38, wherein the sensor is configured to measure tissue effects.

40. The multi-mode surgical forceps of claim 39, wherein the sensor is configured to measure temperature.

41. The multi-mode surgical forceps of claim 38, further comprising a power supply and wherein the power supply is configured to adjust a power output in response to a measurement of the sensor.