ENHANCED CONTROL SYSTEMS INCLUDING FLEXIBLE SHIELDING AND SUPPORT SYSTEMS FOR ELECTROSURGICAL APPLICATIONS

• US 20100042097A1
• Filed: 08/18/2009
• Published: 02/18/2010
• Est. Priority Date: 08/18/2008
• Status: Active Grant

• Current Assignee: Encision Inc.
• Original Assignee: Encision Inc.
• Inventors: Newton, David, Taylor, Warren
• Granted Patent: US 8,500,728 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3449 whereby the instrument channels merge into one single channel
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61B 2018/167 Passive electrodes capacitively coupled to the skin
• CPC Class Codes: A61B 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 2090/0436 Shielding
• CPC Class Codes: A61B 2090/0481 against EM radiation, e.g. microwave
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders

Abstract

A surgical system comprises a device adapted to deliver a plurality of surgical instruments to a site within a patient'"'"'s body, a first surgical instrument comprising an active electrode probe, a second surgical instrument for performing a non-electrosurgical procedure, a conductive shield surrounding the active electrode probe of the first surgical instrument and connected to a reference potential, and a cold instrument monitor connected to the second surgical instrument and to the reference potential.

Claims

1. A surgical system, comprising:

an introducer device adapted to deliver a plurality of surgical instruments to a site within a patient'"'"'s body;

a first surgical instrument comprising an active electrode probe having a tip and being adapted for connection to an electrosurgical generator for effecting at the tip thereof an electrosurgical procedure within the patient'"'"'s body, the first surgical instrument adapted to be deployed through the introducer device;

a second surgical instrument for performing a non-electrosurgical procedure, the second surgical instrument adapted to be deployed through the introducer device;

a conductive shield surrounding the active electrode probe of the first surgical instrument and connected to a reference potential; and

a cold instrument monitor connected to the second surgical instrument and to the reference potential, whereby any current which flows from the active electrode probe to the second surgical instrument is conducted to the reference potential.

2. The surgical system of claim 1, further comprising a monitoring system for determining whether any current is present in the second surgical instrument.

3. The surgical system of claim 1, wherein the second surgical instrument is selected from the group consisting of a grasper, an irrigation tube, an optical scope, a scissor, and an ablation device.

4. The surgical system of claim 1 further comprising:

a third surgical instrument for performing a non-electrosurgical procedure, the third surgical instrument adapted to be deployed through the introducer device;

a second cold instrument monitor connected to the third surgical instrument and to the reference potential, whereby any current which flows from the active electrode probe to the third surgical instrument is conducted to the reference potential.

5. The surgical system of claim 1, wherein the cold instrument monitor is adapted to detect current emanating from the active electrode probe of the first surgical instrument by direct contact with the active electrode probe.

6. The surgical system of claim 1, wherein the cold instrument monitor is adapted to detect current emanating from the active electrode probe of the first surgical instrument by capacitive coupling with the active electrode probe.

7. The surgical system of claim 1 wherein the cold instrument monitor comprises:

a sensing tube surrounding at least a portion of the second surgical instrument;

first and second contact monitors connected to the second surgical instrument, the first and second contact monitors electrically coupled to a connection monitor, the connection monitor adapted to determine one or more of the voltage, current, impedance and resistance generated at the first and second contact monitors.

8. The surgical system of claim 7, further comprising a voltage sensor coupled to the sensing tube, wherein the connection monitor and the voltage sensor are coupled to a processor adapted to determine whether a fault condition exists at the second surgical instrument.

9. The surgical system of claim 1, wherein the second surgical instrument includes a conductive exterior.

10. The surgical system of claim 1, wherein the second surgical instrument includes a non-conductive exterior.

11. The surgical system of claim 1, wherein the cold instrument monitor comprises a RF monitoring tag clamped on to a portion of the second surgical instrument.

12. The surgical system of claim 1, wherein the cold instrument monitor comprises an RF monitoring tag adhered to a portion of the second surgical instrument.

13. The surgical system of claim 1, wherein the introducer device is a trocar.

14. A surgical system, comprising:

a surgical control mechanism for delivering a plurality of surgical instruments to a site within a patient'"'"'s body, the surgical control mechanism comprising a control arm for maneuvering at least one of the plurality of surgical instruments;

a first surgical instrument comprising an active electrode probe having a tip and being adapted for connection to an electrosurgical generator for effecting at the tip thereof an electrosurgical procedure within a patient'"'"'s body;

a second surgical instrument for performing a non-electrosurgical procedure;

a conductive shield surrounding the active electrode probe and connected to a reference potential; and

a cold instrument monitor connected to the second surgical instrument and to the reference potential, whereby any current which flows from the active electrode probe to the second surgical instrument is conducted to the reference potential;

wherein at least one of the first and second surgical instruments is disposed on a distal end of the control arm.

15. The surgical system of claim 14, wherein the surgical control mechanism is a robotic surgical system.

16. The surgical system of claim 14, wherein surgical control mechanism is adapted to be controlled from a location remote from the patient.

17. The surgical system of claim 14, wherein the control arm comprises a plurality of interconnected and articulating segments and is capable of positioning the at least one of the first and second surgical instruments within a three dimensional location in the patient'"'"'s body.

18. The surgical system of claim 14, further comprising a second control arm for maneuvering at least one of the plurality of surgical instruments.

19. The surgical system of claim 14, wherein the cold instrument monitor comprises:

a sensing tube surrounding at least a portion of the second surgical instrument; and

first and second contact monitors connected to the second surgical instrument, the first and second contact monitors electrically coupled to a connection monitor, the connection monitor adapted to determine one or more of the voltage, current, impedance and resistance generated at the first and second contact monitors.

20. The surgical system of claim 14, wherein the cold instrument monitor comprises a wireless radio frequency sensor coupled to the second surgical instrument.

21. The surgical system of claim 14, further comprising a second cold instrument monitor, wherein the second cold instrument monitor is coupled to a surface other than that of a surgical instrument.

22. The surgical system of claim 21, wherein the second cold instrument monitor is adapted to couple to an operating room table.

23. The surgical system of claim 21, wherein the second cold instrument monitor is adapted to couple to a person.

24. An enhanced control surgery system for aiding in the performance of a surgical procedure, comprising:

a surgical tool control arm having one or more interconnected and articulated members;

a controller adapted to maneuver the surgical tool control arm;

an active electrode probe having a tip and extending through the surgical tool control arm, the active electrode probe being adapted for connection to an electrosurgical generator;

a conductive shield surrounding the active electrode probe; and

an electrical terminal connected to the shield and adapted to connect the shield to a reference potential;

wherein both the active electrode probe and the conductive shield are adapted to substantially conform to the movements of the surgical tool control arm.

25. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from a conductive cloth.

26. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from a wire mesh.

27. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from a wire braid.

28. The enhanced control surgery system of claim 24, wherein the conductive shield comprises a polymer tubing and a conductive material disposed over the polymer tubing.

29. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from a wire embedded in a flexible polymer.

30. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from a flexible circuit.

31. The enhanced control surgery system of claim 24, wherein the conductive shield comprises:

an insulating woven matrix;

a flexible conductor; and

an insulative coating.

32. The enhanced control surgery system of claim 24, wherein the conductive shield is formed from flexible micro-coaxial cable.

33. An active electrode probe for an enhanced control surgery system, comprising:

a flexible conductor for delivering electrosurgical energy during an electrosurgical procedure, the conductor being adapted for connection to an electrosurgical generator;

a flexible substrate surrounding the conductor;

a flexible conductive shield disposed on an outer surface of the substrate and electrically connected to a reference potential, whereby any current which flows in the conductive shield from the conductor is conducted to the reference potential;

wherein the flexible conductive shield is formed from a conductive wire mesh applied to a non-conductive base material.

34. A method of monitoring and referencing a cold surgical instrument during an electrosurgical procedure utilizing more than one surgical instrument, wherein at least one of the surgical instruments is an electrosurgical instrument adapted to deliver electrosurgical energy, the method comprising:

providing a sensor proximate to the cold surgical instrument;

detecting a voltage in the cold surgical instrument through the sensor;

setting a first voltage threshold in a connection monitoring device;

comparing the detected voltage with the first threshold voltage;

determining whether the voltage represents a safe patient condition;

altering the delivery of power to the electrosurgical instrument based on the comparison between the detected voltage and the first voltage threshold.

35. The method of claim 34 further comprising coupling the cold surgical instrument to a reference voltage

36. The method of claim 34, further comprising providing an audible alert if the detected voltage is greater than the first voltage threshold.

37. The method of claim 34, further comprising setting a second voltage threshold in the connection monitoring device and comparing the detected voltage with the second threshold voltage.

38. The method of claim 34, further comprising providing a detector proximate to the cold surgical instrument that identifies the cold surgical instrument.