Integrated systems for electrosurgical steam or smoke control

• US 9,861,428 B2
• Filed: 09/16/2013
• Issued: 01/09/2018
• Est. Priority Date: 09/16/2013
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Trees, Gregory A., Arshonsky, Susan G., Batross, Jonathan T., Boudreaux, Chad P., Chekan, Edward G., Corbett, Catherine A., Davis, Craig T., Kiturkes, Alex W., McFarland, Terry A., Monroe, David A., Sarley, John M., Shelton, IV, Frederick E., Schulte, John B., Stulen, Foster B., Voegele, Aaron C., Weisenburgh, II, William B., Widenhouse, Tamara, Witt, David A.
• Primary Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US14/028,176
• Publication Number:
  US 20150080879A1
• Time in Patent Office: 1,576 Days
• 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 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/008 for smoke evacuation

Abstract

A medical device includes an end effector configured to apply bipolar energy to target tissue along a working portion thereof and a fluid control system to control the flow of a fluid produced when the end effector applies the bipolar energy to heat the target tissue. The fluid control system includes a fluid path element defining a fluid path, a distal fluid port configured to intake the fluid adjacent to the working portion of an end effector for transport through the fluid path, and a proximal fluid port configured to intake the fluid transported through the fluid path and to exhaust the transported fluid.

Claims

1. A medical device, comprising:

an end effector, comprising;

a first jaw comprising an inner surface and an outer surface;

a second jaw comprising an inner surface and an outer surface, wherein at least one of the first jaw or the second jaw is rotatably movable to capture target tissue between the inner surface of the first jaw and the inner surface of the second jaw; and

a working portion that extends from a proximal end to a distal end of at least one of the inner surface of the first jaw or the inner surface of the second jaw, wherein the working portion comprises an electrode to apply energy to the target tissue in contact with the working portion at a target tissue site;

a fluid control system, comprising;

a fluid path element defining one or more than one fluid path to transport a fluid, wherein at least one of the one or more than one fluid path is defined by a lumen that defines a plurality of distal fluid ports to at least one of deliver the fluid to or intake the fluid from the target tissue site, wherein the at least one fluid path is situated on and extends along the outer surface of the first jaw or the outer surface of the second jaw adjacent to the working portion, and wherein the plurality of distal fluid ports are positioned along and external to the working portion between the proximal end and the distal end of the working portion; and

a proximal fluid port fluidically coupled to the one or more than one fluid path;

a transport component coupled to the proximal fluid port, wherein the transport component is configured to cause the fluid to move through the one or more than one fluid path; and

an activation element to control activation of the transport component based on at least one operation of the end effector, wherein the activation element is configured to activate the transport component to cause the fluid to move through the plurality of distal fluid ports of the at least one fluid path sequential to the application of energy to the target tissue by the electrode.

2. The medical device of claim 1, wherein the transport component comprises a pressure differential.

3. The medical device of claim 2, wherein the transport component is fluidically coupled to a pump that provides the pressure differential.

4. The medical device of claim 1, further comprising a supply component coupled to the proximal fluid port, wherein the supply component comprises one of a fluid source to supply the fluid to the plurality of distal fluid ports or a fluid reservoir to receive the fluid from the plurality of distal fluid ports.

5. The medical device of claim 1, wherein the sequential activation comprises activating the transport component before or after the application of the energy by the electrode.

6. The medical device of claim 1, wherein the sequential activation comprises activating the transport component before and either during or after the application of the energy by the electrode.

7. The medical device of claim 1, wherein the activation element is configured to activate the transport component to cause the fluid to move through the plurality of distal fluid ports of the at least one fluid path at a time defined with respect to an operation of the end effector.

8. The medical device of claim 1, wherein the sequential activation is controlled via one or more than one sequence preprogrammed in a memory module.

9. The medical device of claim 1, wherein the activation element is configured to activate the transport component to deliver a first fluid through the plurality of distal fluid ports of the at least one fluid path to at least one of disperse steam or absorb heat from the steam after the application of the energy to the target tissue by the electrode.

10. The medical device of claim 9, wherein the first fluid comprises a biologically compatible gas.

11. The medical device of claim 9, wherein the transport component is further configured to deliver the first fluid at one or more than one of a temperature, a rate, and a pattern to disperse the steam or absorb the heat from the steam.

12. The medical device of claim 1, wherein the activation element is configured to activate the transport component to deliver a first fluid through the plurality of distal fluid ports of the at least one fluid path to at least one of cool the target tissue or condense steam after the application of the energy to the target tissue by the electrode.

13. The medical device of claim 12, wherein the first fluid comprises a biologically compatible liquid.

14. The medical device of claim 12, wherein the first fluid is delivered at one or more than one of a volume, a rate, and a location to form a thermal barrier between the steam and surrounding tissue at the target tissue site.

15. The medical device of claim 1, wherein the plurality of distal fluid ports of the at least one fluid path are positioned where the fluid is produced or released during the application of the energy to the target tissue by the electrode.

16. A medical device, comprising:

an end effector, comprising;

a proximal end;

a distal end;

a first jaw comprising an interior surface and an exterior surface that extend between the proximal end and the distal end;

a second jaw comprising an interior surface and an exterior surface that extend between the proximal end and the distal end, wherein the end effector is configured to capture target tissue between the interior surface of the first jaw and the interior surface of the second jaw; and

a working portion defined by at least one of the interior surface of the first jaw or the interior surface of the second jaw, wherein the working portion comprising an electrode to apply energy to the target tissue captured between the interior surface of the first jaw and the interior surface of the second jaw at a target tissue site;

a fluid control system, comprising;

at least one fluid path element, wherein each fluid path element defines one or more than one fluid path to transport a fluid, wherein at least one of the one or more than one fluid path of each fluid path element is defined by a tube which defines a plurality of distal fluid ports to at least one of deliver the fluid to or intake the fluid from the target tissue site, wherein the at least one fluid path of each fluid path element is coupled to and extends along the exterior surface of the first jaw or the exterior surface of the second jaw proximate to the working portion, and wherein the plurality of distal fluid ports are positioned along and peripheral to the working portion between the proximal end and the distal end of the end effector;

a transport component configured to cause the fluid to move through the one or more than one fluid path of each fluid path element; and

an activation element to control activation of the transport component based on at least one operation of the end effector, wherein the activation element is configured to activate the transport component to cause the fluid to move through the plurality of distal fluid ports of the at least one fluid path of each fluid path element sequential to the application of energy to the target tissue by the electrode.

17. The medical device of claim 16, wherein the sequential activation comprises activating the transport component before or after the application of the energy by the electrode.

18. The medical device of claim 16, wherein the sequential activation is controlled via one or more than one sequence preprogrammed in a memory module.

19. A medical device, comprising:

an end effector, comprising;

a first jaw comprising an inner surface and an outer surface, wherein the inner surface of the first jaw defines a first plane;

a second jaw comprising an inner surface and an outer surface, wherein the inner surface of the second jaw defines a second plane, and wherein the end effector is configured to capture target tissue between the inner surface of the first jaw and the inner surface of the second jaw; and

a working portion defined by the inner surface of the first jaw and the inner surface of the second jaw, wherein the working portion comprises an electrode to apply energy to the target tissue at a target tissue site;

a fluid control system to transport a fluid, the fluid control system comprising;

a first fluid path defined by tubing attached to and extending along the outer surface of the first jaw adjacent to a longitudinal edge of the inner surface of the first jaw, wherein the tubing of the first fluid path defines a first plurality of laterally-facing fluid ports arranged in a plane parallel to the first plane to at least one of deliver the fluid to or intake the fluid from the target tissue site, and wherein the first plurality of laterally-facing fluid ports are positioned external to the working portion along the first jaw;

a second fluid path defined by tubing attached to and extending along the outer surface of the second jaw adjacent to a longitudinal edge of the inner surface of the second jaw, wherein the tubing of the second fluid path defines a second plurality of laterally-facing fluid ports arranged in a plane parallel to the second plane to at least one of deliver the fluid to or intake the fluid from the target tissue site, and wherein the second plurality of laterally-facing fluid ports are positioned external to the working portion along the second jaw; and

a proximal fluid port fluidically coupled to the first fluid path and the second fluid path;

a transport component coupled to the proximal fluid port, wherein the transport component is configured to cause the fluid to move through the first fluid path and the second fluid path; and

an activation element to control activation of the transport component based on at least one operation of the end effector, wherein the activation element is configured to activate the transport component to cause the fluid to move through the first plurality of laterally-facing fluid ports of the first fluid path and the second plurality of laterally-facing fluid ports of the second fluid path at sequential to the application of energy to the target tissue by the electrode.

20. The medical device of claim 19, wherein the fluid control system further comprises a third fluid path defined by tubing positioned external to the end effector, wherein the third fluid path branches into the first fluid path and the second fluid path.