Medical device with a bilateral jaw configuration for nerve stimulation

• US 10,456,193 B2
• Filed: 04/20/2017
• Issued: 10/29/2019
• Est. Priority Date: 05/03/2016
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Yates, David C., Messerly, Jeffrey D., McLain, Cameron D., Shires, Peter K., Estera, Frederick, Nott, Cameron R., Stulen, Foster B., Papa, Christopher A.
• Primary Examiner(s): Kim, Eun Hwa
• Assistant Examiner(s): Premraj, Cathy
• Application Number:
  US15/493,122
• Publication Number:
  US 20170319265A1
• Time in Patent Office: 922 Days
• 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 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/295 combined with cutting implements
• 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 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00958 for switching between different working modes of the main function
• 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
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61N 1/04 : Electrodes electrosurgical electrodes A61B18/14
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/3605 : Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36057 : adapted for stimulating afferent nerves
• CPC Class Codes: A61N 1/36146 : specified by the stimulation parameters

Abstract

Aspects of the present disclosure are presented for a single surgical instrument configured to grasp, seal, and/or cut tissue through application of therapeutic energy, and also detect nerves through application of non-therapeutic electrical energy. A medical device may include two jaws at an end effector, used to apply therapeutic energy and to perform surgical procedures. The therapeutic energy may be in the form of ultrasonic vibrations or higher voltage electrosurgical energy. One of the jaws may be configured to cut tissue through application of the blade. In addition, one or both of the two jaws may be configured to apply nontherapeutic energy for nerve stimulation probing. The application of therapeutic energy may be disabled while the nontherapeutic nerve stimulation energy is applied, and vice versa. The nontherapeutic nerve stimulation energy may be applied to the use of one or more probes positioned near one or both of the jaws.

Claims

1. A surgical instrument, comprising:

a first jaw handle and a second jaw handle pivotally coupled about a joint;

the first jaw handle comprising a first jaw at a distal end of the first jaw handle;

the second jaw handle comprising a second jaw at a distal end of the second jaw handle;

the first and second jaws configured to grasp tissue therebetween when the first and second jaw handles are pivotally rotated about the joint into a closed position;

an electrical stimulation probe physically coupled to a proximal portion of either the first jaw handle or the second jaw handle and positioned physically separate from the first and second jaws such that a distal end of the electrical stimulation probe does not touch the first and the second jaws;

at least one of the first and second jaws configured to deliver therapeutic energy at a higher energy level for sealing or cutting tissue at a surgical site; and

at least one of the first and second jaws configured to deliver nontherapeutic energy at a lower energy level for providing electrical stimulation to nerve tissue at the surgical site.

2. The surgical instrument of claim 1, wherein the therapeutic energy comprises ultrasonic energy.

3. The surgical instrument of claim 1, wherein the therapeutic energy comprises high frequency electrosurgical energy.

4. The surgical instrument of claim 1, wherein both the first and second jaws are configured to deliver the nontherapeutic energy to the tissue at the surgical site, and wherein the nontherapeutic energy delivered at both the first and second jaws are at the same electrical potential.

5. The surgical instrument of claim 1, wherein at least one of the first and second jaws comprises an insulating material on an inside portion of the jaw such that the first jaw contacts the second jaw in the closed position by way of touching the insulating material.

6. A surgical instrument, comprising:

a handle assembly; and

an end effector communicatively coupled to the handle assembly and comprising;

a first and second jaw; and

an electrical stimulation probe physically coupled to a proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the electrical stimulation probe does not touch the first and the second jaws;

the handle assembly configured to manipulate the first and second jaws to define an open position and a closed position; and

the end effector configured to;

deliver, through the first and second laws, therapeutic energy at a higher energy level for sealing or cutting tissue at a surgical site; and

deliver, through the electrical stimulation probe, nontherapeutic energy at a lower energy level for providing electrical stimulation to nerve tissue at the surgical site.

7. The surgical instrument of claim 6, wherein the end effector further comprises a slot, and wherein the electrical stimulation probe is retractable and is further configured to retract in a proximal direction toward the handle assembly and into the slot of the end effector, and to protract in a distal direction away from the handle assembly and out of the slot of the end effector.

8. The surgical instrument of claim 6, wherein the end effector further comprises a return probe coupled to the proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the return probe does not touch the first and the second jaws, wherein the electrical stimulation probe and the return probe complete a circuit when both the return probe and the electrical stimulation probe contact tissue at the surgical site, and wherein the return probe acts as an electrical return for the nontherapeutic energy.

9. The surgical instrument of claim 6, wherein the distal end of the electrical stimulation probe is configured to contour substantially near a first side of the end effector, the first side of the end effector including a first portion of a distal tip of the end effector defined by the first and second jaws.

10. The surgical instrument of claim 9, wherein the end effector further comprises a return probe coupled to the proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the return probe does not touch the first and the second jaws, and the distal end of the return probe is configured to contour substantially near a second side of the end effector opposite to the first side and toward the distal end of the electrical stimulation probe, the second side of the end effector including a second portion of the distal tip of the end effector defined by the first and second jaws, wherein the electrical stimulation probe and the return probe complete a circuit when both the return probe and the electrical stimulation probe contact tissue at the surgical site.

11. The surgical instrument of claim 6, wherein the end effector further comprises a first electrical protrusion probe coupled to a distal end of the first or second jaw and configured to deliver the nontherapeutic energy to stimulate the nerve tissue at the surgical site.

12. The surgical instrument of claim 11, wherein the end effector further comprises a second electrical protrusion return probe coupled to the distal end of the first or second jaw and configured to complete a circuit with the first electrical protrusion probe when both the first electrical protrusion probe and the second electrical protrusion return probe contact tissue at the surgical site.

13. The surgical instrument of claim 6, further comprising a shaft coupled to a distal end of the handle assembly and a proximal end of the end effector, the shaft configured to electrically couple the end effector to the handle assembly.

14. A surgical system, comprising:

a handle assembly;

a power generator electrically coupled to the handle assembly; and

an end effector communicatively coupled to the handle assembly and electrically coupled to the power generator and comprising;

a first and second jaw; and

an electrical stimulation probe physically coupled to a proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the electrical stimulation probe does not touch the first and the second jaws;

the handle assembly configured to manipulate the first and second jaws to define an open position and a closed position;

the end effector configured to;

selectively deliver, through the first and second jaws, therapeutic energy at a higher energy level for sealing or cutting tissue at a surgical site; and

selectively deliver, through the electrical stimulation probe, nontherapeutic energy at a lower energy level for providing electrical stimulation to nerve tissue at the surgical site;

the power generator configured to;

generate the therapeutic energy at the higher energy level to be transmitted to the end effector; and

generate the nontherapeutic energy at the lower energy level to be transmitted to the end effector.

15. The surgical system of claim 14, wherein the end effector further comprises a slot;

and wherein the electrical stimulation probe is retractable and is further configured to retract in a proximal direction toward the handle assembly and into the slot of the end effector, and to protract in a distal direction away from the handle assembly and out of the slot of the end effector.

16. The surgical system of claim 14, wherein the end effector further comprises a return probe coupled to the proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the return probe does not touch the first and the second jaws, wherein the electrical stimulation probe and the return probe complete a circuit when both the return probe and the electrical stimulation probe contact tissue at the surgical site, and wherein the return probe acts as an electrical return for the nontherapeutic energy.

17. The surgical system of claim 14, wherein the distal end of the electrical stimulation probe is configured to contour substantially near a first side of the end effector, the first side of the end effector including a first portion of a distal tip of the end effector defined by the first and second jaws.

18. The surgical system of claim 17, wherein the end effector further comprises a return probe coupled to the proximal portion of the end effector and positioned physically separate from the first and second jaws such that a distal end of the return probe does not touch the first and the second jaws, and the distal end of the return probe is configured to contour substantially near a second side of the end effector opposite to the first side and toward the distal end of the electrical stimulation probe, the second side of the end effector including a second portion of the distal tip of the end effector defined by the first and second jaws, wherein the electrical stimulation probe and the return probe complete a circuit when both the return probe and the electrical stimulation probe contact tissue at the surgical site.

19. The surgical system of claim 16, wherein the therapeutic energy is monopolar and the return probe further acts as an electrical return for the therapeutic energy.