Electrosurgical system

• US 9,566,108 B2
• Filed: 11/11/2013
• Issued: 02/14/2017
• Est. Priority Date: 03/31/2008
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Brustad, John R., Falkenstein, Zoran, Cappello, Christopher J., Johnson, Gary M., Gianneschi, Benjamin A., Tran, Olivia J., Wixey, Matthew A., Pravongviengkham, Kennii, Pravong, Boun, Yawata, Haruyasu, Becerra, Matthew M., Cohen, Adam J., Hilal, Nabil, Pingleton, Edward D., Hilal, Said S., Hart, Charles C, Wikoff, Chris
• Primary Examiner(s): Flick, Jason
• Application Number:
  US14/076,469
• Publication Number:
  US 20140066927A1
• Time in Patent Office: 1,191 Days
• Field of Search: 600/547, 606/32, 606/37, 606/38, 606/45
• US Class Current: 1/1
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• 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 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2018/00041 Heating, e.g. defrosting
• CPC Class Codes: A61B 2018/00077 high, i.e. electrically conducting
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• 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 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00666 : using a threshold value
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00869 : Phase
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00892 : Voltage
• CPC Class Codes: A61B 2018/00898 : Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00916 : with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/00922 : by switching or controlling the treatment energy directly within the hand-piece
• CPC Class Codes: A61B 2018/00988 : Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1266 : with DC current output
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2018/144 : Wire
• CPC Class Codes: A61B 2018/1455 : having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags

Abstract

An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

Claims

1. An electrosurgical system comprising:

an electrosurgical generator arranged to output electrosurgical energy; and

a bipolar electrosurgical tool removably coupled to the electrosurgical generator, the tool comprising;

a handle comprising;

a stationary handle; and

an actuation handle movably coupled to the stationary handle;

a rotatable elongate shaft extending distally from the handle, the elongate shaft having a proximal end and a distal end defining a central longitudinal axis therebetween;

a first jaw and a second jaw pivotably connected and positioned at the distal end of the elongate shaft, the first jaw having an inner surface, an outer surface, and at least one electrode disposed on the inner surface and the second jaw having an inner surface, an outer surface, and at least one electrode disposed on the inner surface, the first and second jaws actuatable by movement of the actuation handle from an open configuration in which the inner surface of the first jaw is spaced apart from the inner surface of the second jaw to a closed configuration in which the inner surface of the first jaw is proximate the inner surface of the second jaw and arranged to contact tissue and apply the electrosurgical energy to the tissue,

wherein the electrosurgical generator supplies electrosurgical energy from the electrosurgical generator through the at least one electrode disposed on the inner surface of the first jaw of a bipolar electrosurgical tool and the at least one electrode disposed on the inner surface of the second jaw of the bipolar electrosurgical tool, determines a first phase angle to identify a tissue type of the tissue between the inner surfaces of the first and second jaws and a predetermined phase angle based on the determined first phase angle, monitors a phase angle of the supplied electrosurgical energy, and ceases the supply of electrosurgical energy from the electrosurgical generator when the monitored phase angle reaches the predetermined phase angle indicating fusion of tissue between the inner surfaces of the first and second jaws.

2. The system of claim 1 wherein the predetermined phase angle further includes a predetermined derivative of a phase angle indicating fusion of the tissue between the first and second jaws and wherein the electrosurgical generator ceases the supply of electrosurgical energy when the derivative of the monitored phase angle reaches the derivative phase angle end point indicating fusion of tissue between the first and second jaws.

3. The system of claim 1 wherein the first and second jaws in the closed configuration compress tissue therebetween with at least one of the first and second jaws having at least two electrodes configurable to operate in a coagulation state and a cutting state and the electrosurgical generator receiving electrode configuration data indicating which of the at least two electrodes are used in the coagulation state and reconfiguring the at least two electrodes to be used in the cutting state.

4. The system of claim 1 further comprising a memory module storing tool scripts that comprises operational commands and parameters and the electrosurgical generator, receiving the operational commands and parameters, controls timing of both output of radiofrequency energy from the electrosurgical generator to the electrosurgical tool and monitoring of the phase angle.

5. The system of claim 4 wherein the operational commands includes keywords and the electrosurgical generator parses the keywords to extract commands and data to control operation of the electrosurgical tool based on events detected by the electrosurgical generator.

6. The system of claim 1 wherein the elongate shaft further comprises an actuation rod connected to one of the first and second jaws to pivot one of the first and second jaws between open and closed configurations and a pull block within the stationary handle and aligned with the actuation rod, the pull block having open top and bottom faces with the actuation handle extending through the top and bottom faces of the pull block, a distal end and a substantially closed proximal end, the distal end of the pull block being connected to the actuation rod through a plurality of threaded nuts disposed within the pull block and connected to the actuation rod, the plurality of threaded nuts being positioned between the distal end of the pull block and a portion of the actuation handle extending through the pull block.

7. The system of claim 6 wherein the electrosurgical tool further comprises a trigger movable with respect to the stationary handle, the trigger coupled to a cutting blade such that movement of the trigger moves the cutting blade longitudinally and the actuation handle moved towards the stationary handle moves the actuation rod proximally and moves the first and second jaw away from the closed configuration to the open configuration and the actuation handle moved away from the stationary handle moves the actuation rod distally and moves the first and second jaw away from the open configuration to the closed configuration.

8. The system of claim 1 wherein the electrosurgical generator identifies when the electrosurgical tool is connected to the electrosurgical generator.

9. The system of claim 8 wherein the electrosurgical generator opens a tool window on a user interface display of the electrosurgical generator and displays tool status of the identified electrosurgical tool in the tool window.

10. The system of claim 8 wherein the electrosurgical generator measures capacitance and impedance of the connected electrosurgical tool and the predetermined phase angle is adjusted based on the measured capacitance and impedance of the electrosurgical tool.

11. The system of claim 10 wherein the electrosurgical generator measures capacitance and impedance of the connected electrosurgical tool and the determined first phase angle is adjusted based on the measured capacitance and impedance of the electrosurgical tool.

12. The system of claim 1 wherein the electrosurgical generator ceases the supply of electrosurgical energy from the electrosurgical generator by restricting further delivery of electrosurgical energy to a predetermined minimum.

13. The system of claim 5 wherein the memory module is mounted on a printed circuit board (PCB) and disposed in the stationary handle of the electrosurgical tool.

14. The system of claim 5 wherein the memory module is integrated within a plug of a wiring harness exiting from the stationary handle and the plug is removably connected to the electrosurgical generator.

15. The system of claim 6 wherein the plurality of threaded nuts are adjustable relative to each other to adjust a length between the pull block and the actuation rod and wherein the rotatable shaft and the first and second jaws are rotatable relative to the stationary handle, the rotatable shaft and the first and second jaws rotatable about a longitudinal axis while the stationary handle remains stationary.

16. An electrosurgical system comprising:

an electrosurgical generator arranged to output electrosurgical energy; and

a bipolar electrosurgical tool removably coupled to the electrosurgical generator, the tool comprising a first jaw and a second jaw pivotably connected to each other, the first jaw having an inner surface, an outer surface, and at least one electrode disposed on the inner surface and the second jaw having an inner surface, an outer surface, and at least one electrode disposed on the inner surface, the first and second jaws actuatable from an open configuration in which the inner surface of the first jaw is spaced apart from the inner surface of the second jaw to a closed configuration in which the inner surface of the first jaw is proximate the inner surface of the second jaw and arranged to contact tissue and apply the electrosurgical energy to the tissue,

wherein the electrosurgical generator supplies electrosurgical energy from the electrosurgical generator through the at least one electrode disposed on the inner surface of the first jaw of the bipolar electrosurgical tool and the at least one electrode disposed on the inner surface of the second jaw of the bipolar electrosurgical tool to fuse tissue between the at least one electrode of the first jaw and the at least one electrode of the second jaw, monitors a phase angle of the supplied electrosurgical energy, and ceases the supply of electrosurgical energy from the electrosurgical generator when a derivative of the monitored phase angle reaches a predetermined derivative phase angle end point indicating fusion of tissue between the first and second jaws.

17. The system of claim 16 wherein the electrosurgical generator ceases delivery of the electrosurgical energy to the tissue when the derivative of the monitored phase angle exceeds the predetermined derivative phase angle end point even if the monitored phase angle has not exceeded a predetermined phase angle endpoint indicating fusion of tissue between the first and second jaws.

18. The system of claim 17 wherein the electrosurgical generator measures at least one of a capacitance and impedance of the connected electrosurgical tool and the predetermined derivative phase angle end point is adjusted based on the at least one of the measured capacitance and impedance of the electro surgical tool.

19. The system of claim 16 wherein the electrosurgical generator measures the impedance of the connected electrosurgical tool and decreases the predetermined derivative phase angle end point based on an increase in the measured impedance of the electrosurgical tool.

20. The system of claim 19 wherein the electrosurgical generator measures the capacitance of the connected electrosurgical tool and decreases the predetermined derivative phase angle end point based on an increase in the measured capacitance of the electrosurgical tool.

21. The system of claim 17 wherein the electrosurgical generator ceases the supply of electrosurgical energy from the electrosurgical generator by restricting further supply of the electrosurgical energy to a predetermined minimum.

22. An electrosurgical system comprising:

an electrosurgical generator arranged to output electrosurgical energy; and

a bipolar electrosurgical tool removably coupled to the electrosurgical generator, the tool comprising a first jaw and a second jaw pivotably connected to each other, the first jaw having an inner surface, an outer surface, and an electrode disposed on the inner surface and the second jaw having an inner surface, an outer surface, and an electrode disposed on the inner surface, the first and second jaws actuatable from an open configuration in which the inner surface of the first jaw is spaced apart from the inner surface of the second jaw to a closed configuration in which the inner surface of the first jaw is proximate the inner surface of the second jaw and arranged to contact tissue and apply the electrosurgical energy to the tissue,

wherein the electrosurgical generator supplies electrosurgical energy from the electrosurgical generator through the electrode disposed on the inner surface of the first jaw of the bipolar electrosurgical tool and the electrode disposed on the inner surface of the second jaw of the bipolar electrosurgical tool to fuse tissue therebetween, monitors a phase angle of the supplied electrosurgical energy and determines when fusion of tissue between the inner surfaces of the first and second jaws has occurred when a derivative of the monitored phase angle reaches a predetermined derivative phase angle end point indicating fusion of tissue between the inner surfaces of the first and second jaws.

23. The system of claim 22 further comprising a second electrode positioned on the second jaw, the second electrode having a contact area ten percent as large as a contact area of the electrode disposed on the inner surface of the second jaw.

24. The system of claim 22 further comprising a second electrode positioned on the second jaw, the electrosurgical generator arranged to supply electrosurgical energy between the electrode on the inner surface of the second jaw and the second electrode of the second jaw when the monitored phase angle reaches a cutting switching level.

25. The system of claim 24 wherein the cutting switching level is a phase angle between 10 degrees and 40 degrees.