System and method for tissue sealing

• US 8,685,016 B2
• Filed: 02/23/2009
• Issued: 04/01/2014
• 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:
  US12/390,944
• Publication Number:
  US 20090157071A1
• Time in Patent Office: 1,863 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 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• 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 2018/00761 Duration
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00886 Duration
• CPC Class Codes: A61B 90/96 using barcodes
• CPC Class Codes: A61B 90/98 using electromagnetic means, e.g. transponders

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 tissue fusion system comprising:

an electrosurgical instrument including at least one active electrode adapted to apply electrosurgical energy to tissue; and

an electrosurgical generator adapted to supply electrosurgical energy to the at least one active electrode, the electrosurgical generator including;

impedance sensing circuitry configured to measure impedance of tissue; and

a processor configured to;

regulate the supply of electrosurgical energy to tissue;

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 wherein a timer is associated with the rise in impedance, an expiration of the timer setting off an alarm by the generator, the alarm prompting a re-grasp of tissue, whereas non-expiration of the timer triggers the generator to generate a ramping of current in an outer loop and a constant current in an inner loop of a current control curve;

determine a cooling period in response to the tissue reaction;

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

indicate expiration of the cooling period.

2. An electrosurgical tissue fusion system 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.

3. An electrosurgical tissue fusion system according to claim 2 wherein the processor is further configured to vary jaw pressure in response to a determination that tissue reaction has occurred.

4. An electrosurgical tissue fusion system according to claim 3 wherein jaw pressure is increased in response to a determination that tissue reaction has occurred.

5. An electrosurgical tissue fusion system according to claim 2 wherein the processor is further configured to increase jaw pressure upon activation of the electrosurgical energy.

6. An electrosurgical tissue fusion system according to claim 2 wherein the processor is further configured to vary jaw pressure in response to tissue impedance.

7. An electrosurgical tissue fusion system according to claim 2, wherein the processor is further configured to release jaw pressure upon expiration of the cooling period.

8. An electrosurgical tissue fusion system 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.

9. An electrosurgical tissue fusion system according to claim 8, wherein the processor is configured to determine whether tissue impedance is at least equal to the threshold impedance for a predetermined shutoff period.

10. An electrosurgical tissue fusion system according to claim 9, 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.

11. An electrosurgical tissue fusion system according to claim 1, wherein the electrosurgical instrument further includes an identification module.

12. An electrosurgical tissue fusion system according to claim 11, wherein the identification module includes at least one of a resistor, a barcode, an RFID tag, and computer memory.

13. An electrosurgical tissue fusion system according to claim 11, wherein electrode characteristics are encoded within the identification module.

14. An electrosurgical tissue fusion system according to claim 11, wherein the identification module is in operable communication with the processor.

15. An electrosurgical tissue fusion system according to claim 1, wherein the processor is configured to generate a target impedance trajectory as a function of measured impedance and desired rate of change based on the tissue reaction determination, the target impedance trajectory including a plurality of target impedance values.

16. An electrosurgical tissue fusion system according to claim 15, wherein the processor is configured to drive tissue impedance along the target impedance trajectory by adjusting the output level of the electrosurgical generator to substantially match tissue impedance to a corresponding target impedance value.

17. An electrosurgical tissue fusion system according to claim 1, wherein the cooling period is a fixed period of time.

18. An electrosurgical tissue fusion system according to claim 1, 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 electrode characteristics.

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

20. An electrosurgical tissue fusion system according to claim 1, wherein the cooling period ranges from about 0.5 seconds to about 2 seconds.

21. An electrosurgical tissue fusion system according to claim 1, wherein the processor is further configured to detect a hysteresis indicator to determine whether the tissue reaction is stable.

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

23. An electrosurgical tissue fusion system according to claim 1 wherein:

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

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

24. An electrosurgical tissue fusion system according to claim 1 wherein:

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

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

25. An electrosurgical tissue fusion system according to claim 1 wherein:

the electrosurgical instrument further includes a fluid sensor, configured to sense fluid at a surgical site, in operable communication with the electrosurgical generator; and

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