Optical energy-based methods and apparatus for tissue sealing

• US 9,113,934 B2
• Filed: 05/16/2011
• Issued: 08/25/2015
• Est. Priority Date: 05/16/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Chernov, Boris, Misuchenko, Igoris, Martsinovskiy, Georgy, Verbitsky, Mikhail
• Primary Examiner(s): Roane, Aaron
• Application Number:
  US13/108,093
• Publication Number:
  US 20120296317A1
• Time in Patent Office: 1,562 Days
• Field of Search: 606 7- 10, 607 88- 94, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 17/2812 with a single pivotal connection A61B17/29 takes precedence
• CPC Class Codes: A61B 17/285 combined with cutting implements
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/00508 using laser
• 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 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00732 Frequency
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1452 including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 2018/207 mixing two wavelengths
• CPC Class Codes: A61B 2018/2261 with scattering, diffusion or dispersion of light
• CPC Class Codes: A61B 2018/2266 with a lens, e.g. ball tipped
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence

Abstract

Optical energy-based methods and apparatus for sealing vascular tissue involves deforming vascular tissue to bring different layers of the vascular tissue into contact each other and illuminating the vascular tissue with a light beam having at least one portion of its spectrum overlapping with the absorption spectrum of the vascular tissue. The apparatus may include two deforming members configured to deform the vascular tissue placed between the deforming members. The apparatus may also include an optical system that has a light source configured to generate light, a light distribution element configured to distribute the light across the vascular tissue, and a light guide configured to guide the light from the light source to the light distribution element. The apparatus may further include a cutting member configured to cut the vascular tissue and to illuminate the vascular tissue with light to seal at least one cut surface of the vascular tissue.

Claims

1. A method of sealing vascular tissue using a deforming member, comprising:

deforming the vascular tissue to cause different layers of the vascular tissue to contact each other by using the deforming member;

cutting the vascular tissue using a blade including a cutting edge and opposing side surfaces; and

distributing first light through at least one of the opposing side surfaces to illuminate and seal at least one cross-sectional surface of the cut vascular tissue with the first light having at least one portion of the first light'"'"'s spectrum overlapping with an absorption spectrum of the vascular tissue,

wherein an incident angle of second light with respect to an axis normal to the surface of the deforming member is selected so as to create total internal reflection of the second light within the deforming member so that the second light is reflected off of a boundary between the deforming member and air outside of the deforming member before the surface of deforming member is sufficiently close to the vascular tissue to create frustrated total internal reflection to cause the second light to pass through the surface of the deforming member to the vascular tissue.

2. The method of claim 1, wherein the second light includes at least a first light wave having a first wavelength and a second light wave having a second, different wavelength, wherein the first light wave changes optical parameters of the vascular tissue or a component of blood within the vascular tissue to increase the absorption of the second light wave by the vascular tissue or the component of blood within the vascular tissue.

3. The method of claim 1, further comprising forming the second light into at least one light beam.

4. The method of claim 1, further comprising forming the second light into at least two light beams that propagate at different angles with respect to the deformed vascular tissue.

5. The method of claim 1, wherein the second light is configured to penetrate the vascular tissue through a surface of the vascular tissue while maintaining the original integrity of the surface of the vascular tissue.

6. The method of claim 1, wherein the second light is configured to penetrate the vascular tissue through a cut in the vascular tissue formed prior to or during sealing of the vascular tissue.

7. The method of claim 1, wherein distributing the first light includes illuminating the at least one cross-sectional surface of the cut vascular tissue with the second light all at one time.

8. The method of claim 1, wherein distributing the first light includes:

forming the first light into at least one light spot; and

scanning the at least one light spot over the at least one cross-sectional surface of the cut vascular tissue.

9. The method of claim 1, further comprising:

monitoring at least one parameter of the vascular tissue; and

controlling at least one parameter of the second light based on the at least one parameter of the vascular tissue.

10. The method of claim 9, wherein the at least one parameter of the second light is one or more of intensity, frequency, polarization, phase, pulse width, pulse frequency, duty cycle, repetition rate, wave shape, duration of illumination, total exposure of tissue to the second light, or the spectra of the second light.

11. The method of claim 9, wherein the at least one parameter of the vascular tissue is electrical impedance of a volume of the vascular tissue.

12. The method of claim 9, wherein the at least one parameter of the vascular tissue is optical transparency of the vascular tissue.

13. The method of claim 9, wherein the at least one parameter of the vascular tissue is the degree of optical anisotropy of the vascular tissue.

14. The method of claim 9, wherein the at least one tissue parameter is the polarization-dependent optical loss in the vascular tissue.

15. The method of claim 1, further comprising:

sensing temperature of the vascular tissue; and

controlling at least one parameter of the second light based on the temperature of the vascular tissue.

16. The method of claim 1, wherein deforming the vascular tissue includes stretching the vascular tissue along a longitudinal axis of a vessel within the vascular tissue.

17. The method of claim 1, wherein deforming the vascular tissue includes compressing the vascular tissue.