Method and apparatus for applying thermal energy to tissue using a clamp

• US 5,336,221 A
• Filed: 11/06/1992
• Issued: 08/09/1994
• Est. Priority Date: 10/14/1992
• Status: Expired due to Fees

• Current Assignee: PLS Liquidating LLC
• Original Assignee: Premier Laser Systems, Inc.
• Inventors: Anderson, Dallas W.
• Primary Examiner(s): ASCHENBRENNER, PETER
• Application Number:
  US07/972,530
• Time in Patent Office: 641 Days
• Field of Search: 606/27, 606/3, 606/2, 606/8, 606/9, 606/15, 606/16, 606/40, 606/51, 606/52, 606/49, 606/205, 606/208, 606/209, 606/150
• US Class Current: 606/27
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2018/2211 Plurality of fibres

Abstract

A method and apparatus for applying optical or other thermal energy to tissue using a clamp. The energy is supplied at a frequency which biologically welds or fuses tissue. A material that is transmissive to the energy treatment frequency is embedded in one or more jaws of the clamp and engage the tissue during the tissue fusion process. The transmissive material has a thickness selected to insure that the energy source is spaced at the proper distance from the tissue so that the tissue receives the proper amount of energy for sealing. The transmissive material holds the tissue in the jaw to maintain the edges of the tissue in tight approximation. The energy may be coupled to the clamp by one or more optical fibers. These fibers are recessed in or placed adjacent to the jaw at a specified distance from the surface of the transmissive material and directs treatment energy through the transmissive material to weld the edges of the tissue together.

Claims

1. An apparatus for causing the formation of a proteinaceous framework from denatured protein in the vicinity of biological tissue to be reconstructed, the apparatus comprising:

an energy source for providing energy which is capable of heating the tissue to form an adhesive denatured proteinaceous substance;

a clamp having a first jaw having a concave surface for engaging with the tissue, sad surface being formed of a layer of transmissive material which is substantially transparent to the energy being emitted by the source, said surface of the transmissive material being selected to have a thickness for maintaining a predetermined spacing between said delivering means and the tissue;

means for delivering said energy from the source through said transmissive material to an area on the biological tissue to be reconstructed when said jaw engages the tissue, said delivery means including a plurality of optical fibers each having one end placed adjacent to the transmissive material, said plurality of fibers being positioned in said first and second jaws to direct energy at a plurality of areas that circumscribe said tissue when said tissue is engaged by said jaws; and

means for controlling substantially all of the energy directed at the area to be within a nondestructive range bonded by a minimum rate at which tissue forms a denatured proteinaceous substance and a maximum rate at which water in the tissue would boil so that anatomical continuity of the tissue is restored after energy is delivered to the tissue.

2. An apparatus for occluding any organ having a lumen by causing the formation of a proteinaceous framework from denatured protein within the walls of the lumen being occluded, the apparatus comprising:

a clamp having a plurality of apertures and having a surface of concave curvature shaped to compress the organ and to tightly close off the lumen when the surface of the clamp engages with the organ;

an optical energy source for providing energy which is capable of heating tissue to form an adhesive proteinaceous substance; and

means for sealing and thereby occluding the lumen by directing energy from the source through the compressed organ engaged with the scamp to heat the organ to a nondestructive range bounded by a minimum temperature at which tissue forms a denatured proteinaceous substance and a maximum temperature at which water in the tissue would boil, said sealing means including means for delivering the optical energy through the plurality of apertures int he clamp and through said tissue being occluded.

3. A method for reconstructing tissue by causing the formation of a proteinaceous framework from denatured protein in the vicinity of biological tissue, the method comprising the steps of:

providing an energy source which is capable of heating the tissue to form an adhesive proteinaceous substance;

providing a layer of material which is transmissive to the provided energy;

engaging the tissue to be welded with the transmissive material;

delivering the energy from the source through the engaged transmissive material to a area on the biological tissue to be reconstructed;

controlling the energy directed at the area to be within a nondestructive range bounded by a minimum rate at which tissue forms a denatured proteinaceous substance and a maximum rate at which water in the tissue would boil;

delivering the energy from the source by feeding the energy into on end of an optical fiber media ad directing the energy exiting the other end of the media through the material and at the area;

placing the other end of the media adjacent the material; and

selecting the thickness of the transmissive material to ensure that the distance between one end of the fiber optic cable and the tissue to be reconstructed is maintained at a predetermined distance.

4. A method for anastomosing biological tissue, by causing the formation of a proteinaceous framework from denatured protein on adjacent edges of the tissue being joined, the method comprising the steps of:

providing a clamp having a first jaw that rotates about a pivot towards a second jaw;

placing adjacent edges of a the tissue in close proximity to each other in between the jaws;

actuating the clamp to pivot the first jaw toward the second jaw to engage the tissue with sufficient pressure to force the edges of the tissue to contact;

providing energy which is capable of heating tissue to form an adhesive proteinaceous substance;

directing the energy at the edges of the tissue to heat the contacting edges of the tissue to a temperature within a nondestructive range bounded by a minimum temperature at which tissue forms a denatured proteinaceous substance and a maximum temperature at which water in the tissue would boil;

forming the tissue engaging surface of the jaws in a concave or circular shape;

extending a protrusion along an edge of the tissue engaging surface to form a ledge which forces the edges of the tissue to contact when the surface of the jaw engages the tissue;

contacting the tissue with the ledge when the jaws are activated; and

directing the energy at the tissue approximation while the edges of the tissue are in contact.