Surgical resection apparatus

• US 9,707,037 B2
• Filed: 06/24/2014
• Issued: 07/18/2017
• Est. Priority Date: 09/25/2007
• Status: Active Grant

• Current Assignee: Creo Medical Ltd.
• Original Assignee: Creo Medical Ltd.
• Inventors: Hancock, Christopher Paul
• Primary Examiner(s): Ram, Jocelyn D
• Application Number:
  US14/313,771
• Publication Number:
  US 20140330265A1
• Time in Patent Office: 1,120 Days
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00708 switching the power on or off
• CPC Class Codes: A61B 2018/00732 Frequency
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00785 Reflected power
• CPC Class Codes: A61B 2018/1823 Generators therefor
• CPC Class Codes: A61B 2018/183 characterised by the type of antenna
• CPC Class Codes: A61B 2018/1876 with multiple frequencies

Abstract

Surgical cutting apparatus having a treatment channel and a measurement channel for conveying microwave energy from a source to an antenna at a cutting edge. The measurement channel operates at lower power than the treatment channel for determining when higher energy can be safely applied. The apparatus may deliver microwave radiation at differing frequencies to one or more antennas at the cutting edge, e.g. to provide different treatment effects. The source may generate an output for an antenna whose frequency can be selected e.g. for most efficient operation. Selection may be automatic based on detected magnitude and phase of reflected signals during a frequency sweep of a forward signal. Power delivered to tissue via the cutting element may be manually boosted to deal with large blood vessels. The apparatus may include a reflected power monitor for recognizing behavior in reflected signals received from the antenna to trigger automatic pre-emptive action.

Claims

1. A surgical cutting apparatus comprising:

a microwave radiation source arranged to generate a microwave radiation signal;

a surgical instrument having;

a cutting element comprising a blade with an edge for cutting biological tissue, and

an antenna connected to the microwave radiation source by a microwave feed structure and arranged to emit a substantially uniform microwave radiation field at the edge of the blade of the cutting element; and

a reflected radiation detector arranged to receive a reflected signal reflected back from the antenna,

wherein the microwave feed structure comprises;

a first channel for conveying the microwave radiation signal at a first power level for treatment, and

a second channel for conveying the microwave radiation signal at a second power level for measurement;

wherein the antenna is selectively connectable to the microwave radiation source via either the first channel or the second channel,

wherein the antenna is connected to the reflected radiation detector via a signal transfer unit which is arranged to receive the reflected signal along the first channel if the antenna is connected to the microwave radiation source via the first channel or along the second channel if the antenna is connected to the microwave radiation source via the second channel,

wherein the signal transfer unit is arranged to route the reflected signal received along the second channel directly to the reflected radiation detector, and

wherein the first channel includes an amplifier connected between the microwave radiation source and the antenna to amplify the microwave radiation signal generated by the microwave radiation source to the first power level, and wherein the second channel bypasses the amplifier.

2. The surgical cutting apparatus according to claim 1, wherein the reflected radiation detector includes a low power transceiver on the second channel, the low power transceiver being arranged to measure a power level of the reflected signal routed through the signal transfer unit.

3. The surgical cutting apparatus according to claim 1, wherein the first power level is two or more orders of magnitude greater than the second power level.

4. The surgical cutting apparatus according to claim 1, wherein the signal transfer unit includes a circulator on the second channel, the circulator having a first portion connected to the microwave radiation source, a second port connected to the antenna, and a third port connected to the reflected radiation detector, the circulator being arranged to direct the microwave radiation signal from the microwave radiation source to the antenna and to direct the reflected radiation signal from the antenna to the reflected radiation detector.

5. The surgical cutting apparatus according to claim 4, wherein the signal transfer unit includes a carrier cancellation circuit connected to the circulator.

7. The surgical cutting apparatus according to claim 1 including a switch arranged to selectively connect the antenna to either the first channel or the second channel.

8. The surgical cutting apparatus according to claim 7, wherein the switch comprises a filtering arrangement having two selectable configurations.

9. The surgical cutting apparatus according to claim 1, wherein the edge of the blade of the cutting element comprises a radiating portion of the antenna.

10. The surgical cutting apparatus according to claim 1 including an impedance adjustor on the first channel,

wherein the reflected radiation detector is arranged to detect the magnitude and phase of the reflected signal, and

wherein the impedance adjustor has an adjustable complex impedance that is controllable based on the detected magnitude and phase.

6. A surgical cutting apparatus, comprising:

a microwave radiation source arranged to generate a microwave radiation signal;

a surgical instrument having;

a cutting element comprising a blade with an edge for cutting biological tissue, and

an antenna connected to the microwave radiation source by a microwave feed structure and arranged to emit a substantially uniform microwave radiation field at the edge of the blade of the cutting element; and

a reflected radiation detector arranged to receive a reflected signal reflected back from the antenna,

wherein the microwave feed structure comprises;

a first channel for conveying the microwave radiation signal at a first power level for treatment, and

a second channel for conveying the microwave radiation signal at a second power level for measurement;

wherein the antenna is selectively connectable to the microwave radiation source via either the first channel or the second channel,

wherein the antenna is connected to the reflected radiation detector via a signal transfer unit which is arranged to receive the reflected signal along the first channel if the antenna is connected to the microwave radiation source via the first channel or along the second channel if the antenna is connected to the microwave radiation source via the second channel,

wherein the signal transfer unit is arranged to route the reflected signal received along the second channel directly to the reflected radiation detector, and

wherein the signal transfer unit includes a forward directional coupler and a backward directional coupler on the first channel, the forward directional coupler and the backward directional coupler being respectively arranged to couple the microwave radiation signal generated by the microwave radiation source and the reflected signal from the antenna when present on the first channel.

11. A surgical cutting apparatus, comprising:

a microwave radiation source arranged to generate a microwave radiation signal;

a surgical instrument having;

a cutting element comprising a blade with an edge for cutting biological tissue, and

an antenna connected to the microwave radiation source by a microwave feed structure and arranged to emit a substantially uniform microwave radiation field at the edge of the blade of the cutting element; and

a reflected radiation detector arranged to receive a reflected signal reflected back from the antenna;

a reflected power monitor arranged to detect a signature event in the reflected signal detected by the reflected radiation detector; and

a power level adjuster connected between the microwave radiation source and the antenna, the power level adjuster being arranged to automatically adjust a power level of the microwave radiation signal received by the antenna if the monitor detects the signature event,

wherein the microwave feed structure comprises;

a first channel for conveying the microwave radiation signal at a first power level for treatment, and

a second channel for conveying the microwave radiation signal at a second power level for measurement;

wherein the antenna is selectively connectable to the microwave radiation source via either the first channel or the second channel,

wherein the antenna is connected to the reflected radiation detector via a signal transfer unit which is arranged to receive the reflected signal along the first channel if the antenna is connected to the microwave radiation source via the first channel or along the second channel if the antenna is connected to the microwave radiation source via the second channel,

wherein the signal transfer unit is arranged to route the reflected signal received along the second channel directly to the reflected radiation detector.

12. The surgical cutting apparatus according to claim 11, wherein the signature event is either:

(i) a predetermined rate of change of reflected power or a constant level of reflected power detected during a certain time slot or for a certain duration;

or

(ii) a certain change in the impedance of the tissue derived from changes in the behaviour of the reflected power.

13. The surgical cutting apparatus according to claim 11, wherein the reflected power monitor includes a differentiator arranged to:

measure a value of dv/dt (change of voltage with time) for the reflected signals, and

compare the measured value to a threshold value, whereby the signature event is a value of dv/dt that is higher than the threshold value.

14. The surgical cutting apparatus according to claim 11, wherein the power level adjuster is arranged to:

reduce the power level as soon as the signature event is detected, and

ramp the power level back up in a recovery time period after the power level has been reduced.

15. The surgical cutting apparatus according to claim 11, wherein the reflected power monitor is arranged to emit an audible or visual signal when the signature event is detected.

16. The surgical cutting apparatus according to claim 15, wherein the audible or visual signal is representative of a type of the signature event detected.