Devices and techniques for cutting and coagulating tissue

• US 9,237,921 B2
• Filed: 03/15/2013
• Issued: 01/19/2016
• Est. Priority Date: 04/09/2012
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Messerly, Jeffrey D., Bertke, Brian D., Tellio, Karalyn R., Wiener, Eitan T., Yates, David C., Aldridge, Jeffrey L., Giordano, James R.
• Primary Examiner(s): Stigell, Theodore
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US13/839,014
• Publication Number:
  US 20130282003A1
• Time in Patent Office: 1,040 Days
• Field of Search: 606/27, 606/39, 606/40, 606/38
• US Class Current: 1/1
• 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 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/0003 of parts of the instruments
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/00176 Two pulses, e.g. second pulse having an effect different from the first one
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00994 combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound

Abstract

Various forms are directed to systems and methods for driving an end effector coupled to an ultrasonic drive system of a surgical instrument. A generator may generate at least one electrical signal. The at least one electrical signal may be monitored against a first set of logic conditions. When an ultrasonic impedance of the surgical instrument exceeds a threshold impedance, a resonant frequency of the at least one electrical signal may be stored as a baseline frequency. A first response of the generator may be triggered upon the occurrence of either the first set of logic conditions being met or the resonant frequency of the at least one electrical signal differing from the baseline frequency by a baseline deviation threshold.

Claims

1. A method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument, the method comprising:

generating, by a surgical generator, at least one electrical signal;

comparing, by the surgical generator, an ultrasonic impedance of the surgical instrument to an impedance threshold;

determining, by the surgical generator, that the ultrasonic impedance of the surgical instrument has exceeded the impedance threshold;

determining, by the surgical generator, that a present resonant frequency slope of the at least one electrical signal differs from a past resonant frequency slope of the at least one electrical signal by more than a frequency slope threshold; and

triggering, by the surgical generator, a first response.

2. The method of claim 1, wherein triggering the first response comprises triggering at least one response selected from the group consisting of an audible response, a visual response, and a pulsing response.

3. The method of claim 1, wherein triggering the first response comprises:

generating, by the surgical generator, a first pulse amplitude for a first pulse time, where the first pulse time is a period over which the first pulse amplitude is driven by the surgical generator; and

generating, by the surgical generator, a second pulse amplitude for a second pulse time, where the second pulse time is a period over which the second pulse amplitude is driven by the surgical generator.

4. The method of claim 3, wherein the first pulse amplitude is equal to the second pulse amplitude and the first pulse time is about one minute.

5. The method of claim 1, comprising:

detecting, by the surgical generator, that the at least one electrical signal meets a set of logic conditions; and

triggering, by the surgical generator, a second response.

6. The method of claim 5, comprising determining the triggering of the first or the second response on a hierarchical basis.

7. The method of claim 5, wherein the set of logic conditions comprises at least one condition selected from the group consisting of:

a resonant frequency of the at least one electrical signal being less than a frequency threshold; and

the present resonant frequency slope of the at least one electrical signal being less than a frequency slope parameter.

8. A surgical system, comprising:

a surgical instrument, comprising;

an ultrasonic transducer; and

an ultrasonic end effector coupled to the ultrasonic transducer; and

a surgical generator, the surgical generator comprising;

at least one processor programmed to;

receive data describing an electrical signal provided by the surgical generator to the surgical instrument;

compare an ultrasonic impedance of the surgical instrument to an impedance threshold;

determine that the ultrasonic impedance of the surgical instrument is greater than an impedance threshold;

determine that a present resonant frequency slope of at least one electrical signal generated by the surgical generator differs from a past resonant frequency slope by more than a frequency slope threshold; and

trigger a first response.

9. A method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument, the method comprising:

generating, by a surgical generator, at least one electrical signal;

monitoring, by the surgical generator, the at least one electrical signal against a first set of logic conditions;

detecting, by the surgical generator, a load event at the end effector by comparing an ultrasonic impedance of the surgical instrument to an impedance threshold, wherein the load event is detected when an ultrasonic impedance of the surgical instrument exceeds an impedance threshold and a present resonant frequency slope differs from a past resonant frequency slope by more than a frequency slope threshold parameter;

determining, by the surgical generator, that the first set of logic conditions are met; and

triggering, by the surgical generator, a first response.

10. The method of claim 9, wherein detecting the load event comprises:

comparing the present resonant frequency slope of the at least one electrical signal with the past resonant frequency slope of the at least one electrical signal offset from a present resonant frequency of the at least one electrical signal by a window offset time.

11. The method of claim 9, wherein the load event is detected when the ultrasonic impedance of the surgical instrument exceeds the impedance threshold for at least a threshold time above impedance and the present resonant frequency slope differs from the past resonant frequency slope by more than the frequency slope threshold parameter.

12. The method of claim 9, wherein the load event is detected until the ultrasonic impedance of the surgical instrument drops below an impedance reset threshold.

13. The method of claim 9, wherein triggering the first response comprises:

generating, by the surgical generator, a first pulse amplitude for a first pulse time, where the first pulse time is a period over which the first pulse amplitude is driven by the surgical generator; and

generating, by the surgical generator, a second pulse amplitude for a second pulse time, where the second pulse time is a period over which the second pulse amplitude is driven by the surgical generator.

14. The method of claim 13, wherein the first pulse amplitude is equal to the second pulse amplitude, and wherein the first pulse time is about one minute.

15. The method of claim 9, comprising:

monitoring, by the surgical generator, the at least one electrical signal against a second set of logic conditions; and

triggering, by the surgical generator, a second response when the second set of logic conditions is met.

16. The method of claim 9, wherein the first set of logic conditions comprises at least one condition selected from the group consisting of:

a present resonant frequency being less than a frequency threshold;

or

the present resonant frequency slope being less than a frequency slope parameter.

18. The method of claim 13 , wherein the first pulse amplitude is equal to the second pulse amplitude.

19. The method of claim 13, wherein the first pulse amplitude is greater than the second pulse amplitude.

20. The method of claim 13, wherein the first pulse amplitude is less than the second pulse amplitude.

21. The method of claim 13, wherein the first pulse time is about one minute.

17. A surgical system, comprising:

a surgical generator, the surgical generator comprising;

an amplifier;

a transformer; and

at least one processor, wherein the at least one processor is programmed to;

monitor at least one electrical signal generated by the surgical generator against a first set of logic conditions, wherein the at least one electrical signal is provided to a surgical instrument to drive an end effector of the surgical instrument;

detect a load event at the end effector by comparing an ultrasonic impedance of the surgical instrument to an impedance threshold, wherein a load event is detected when an ultrasonic impedance of the surgical instrument exceeds an impedance threshold, and a present resonant frequency slope differs from a past resonant frequency slope by more than a frequency slope threshold parameter;

determine that the first set of logic conditions is met; and

trigger a first response of the surgical generator.

22. A method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument, the method comprising:

generating, by a surgical generator, at least one electrical signal;

monitoring, by the surgical generator, the at least one electrical signal against a first set of logic conditions;

detecting, by the surgical generator, a load event at the end effector, wherein detecting the load event comprises comparing an ultrasonic impedance of the surgical instrument to an impedance threshold, and wherein the load event is detected when the ultrasonic impedance of the surgical instrument exceeds the impedance threshold for at least a threshold time and a present resonant frequency slope differs from a past frequency slope by more than a frequency slope parameter;

determining that the first set of logic conditions is met; and

triggering a first response of the surgical generator.