Method and system for heating tissue with a bipolar instrument

• US 6,682,527 B2
• Filed: 03/13/2001
• Issued: 01/27/2004
• Est. Priority Date: 03/13/2001
• Status: Expired due to Term

• Current Assignee: Perfect Surgical Techniques Incorporated
• Original Assignee: Perfect Surgical Techniques Incorporated
• Inventors: Strul, Bruno
• Primary Examiner(s): Paik, Sang Y.
• Assistant Examiner(s): DAHBOUR, HENRY
• Application Number:
  US09/808,096
• Publication Number:
  US 20020133152A1
• Time in Patent Office: 1,050 Days
• Field of Search: 606/51, 606/33, 606/45, 606/52, 606/34, 606/41, 606/48, 606/49, 606/50, 606/37, 606/38
• US Class Current: 606/51
• CPC Class Codes: A61B 18/1206 Generators 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00761 Duration
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00886 Duration

Abstract

Methods for heating tissue completely, thoroughly, and uniformly comprise delivering radio frequency energy through a bipolar surgical instrument having first and second jaws with first and second electrode members within the treatment region. Tissue is grasped between the first and second jaws of the bipolar instrument. The electrode members are energized at a power level to deliver electrical energy to and heat tissue between the first and second electrode members. The power level is increased at a predetermined rate from an initial level. The initial level and predetermined rate are selected to avoid creating a vapor layer and to permit an impedance increase to occur as a result of complete tissue desiccation. A tissue impedance may also be measured and compared to a preset impedance limit for terminating the power delivery when the measured impedance exceeds the impedance limit.

Claims

1. A method for heating a treatment region of tissue, said method comprising:

introducing a bipolar surgical instrument having first and second jaws with first and second electrode members within the treatment region;

grasping tissue between the first and second jaws;

energizing the electrode members at a power level to deliver electrical energy to and heat tissue between the first and second electrode members; and

increasing the power level at a predetermined rate from an initial level, wherein the initial level and predetermined rate are selected to avoid creating a vapor layer and to permit an impedance increase to occur as a result of complete tissue desiccation.

2. A method as in claim 1, further comprising measuring tissue impedance.

3. A method as in claim 2, further comprising comparing the measured impedance to an impedance limit, and automatically terminating power delivery if the measured impedance exceeds the impedance limit.

4. A method as in claim 3, wherein the impedance limit is selected to indicate the impedance increase due to complete tissue desiccation.

5. A method as in claim 3, wherein the impedance limit is in the range from 50 ohms to 1000 ohms.

6. A method as in claim 3, further comprising repeating the energizing and increasing steps at least once after termination until all the tissue between the first and second electrodes is completely desiccated without charring the treatment tissue.

7. A method as in claim 1, further comprising terminating power delivery automatically after a preset amount of time.

8. A method as in claim 1, wherein the electrode members are energized with radio frequency current.

9. A method as in claim 8, wherein the radio frequency current is supplied with a controlled voltage power supply.

10. A method as in claim 1, wherein at least one of the electrode members comprises a plurality of tissue penetrating elements, the tissue penetrating elements engaging the tissue before the electrode members are energized.

11. A method as in claim 1, wherein the power level is in a range from 5 W to 150 W.

12. A method as in claim 1, wherein the predetermined rate of power increase is in the range from 1 W/sec to 100 W/sec.

13. A method as in claim 1, wherein the electrode members are energized for a time less than 5 minutes.

14. A method as in claim 1, wherein the tissue comprises tissue of or surrounding the liver, kidney, lung, bowel, stomach, pancreas, breast, uterus, prostate, muscle, membrane, appendix, other abdominal organs, or other thoracic organs.

15. A system comprising:

a radio frequency generator; and

instructions setting forth the method of claim 1.

16. A computer program embodied in a tangible medium, wherein the program sets forth a method according to claim 1.

17. A radio frequency generator comprising:

a radio frequency power source having a controlled voltage output and a bipolar connection for bipolar forceps having first and second jaws with first and second electrode members; and

means for automatically increasing power delivered to the bipolar forceps;

wherein the increasing means increases the power at a predetermined rate from an initial level, the initial level and predetermined rate avoiding formation of a vapor layer while permitting an impedance increase to occur as a result of complete tissue dessication.

18. A radio frequency generator as in claim 17, wherein the increasing means initiates a cycle where it measures an impedance of tissue, compares the measured impedance to an impedance limit, and increases the power level based on the predetermined rate if the measured impedance does not exceed the impedance limit.

19. A radio frequency generator as in claim 18, wherein the impedance limit is selected to indicate the impedance increase due to complete tissue desiccation.

20. A radio frequency generator as in claim 18, wherein the impedance limit is in the range from 50 ohms to 1000 ohms.

21. A radio frequency generator as in claim 18, wherein the increasing means repeats the cycle.

22. A radio frequency generator as in claim 18, wherein the increasing means is activated only once for continual cycling.

23. A radio frequency generator as in claim 17, further comprising a user interface for inputting the rate of power increase, the initial power level, and an impedance limit.

24. A radio frequency generator as in claim 23, wherein the user interface further comprises a front panel display that displays at least one of real-time impedance, total energy delivered, and instantaneous power delivered.

25. A radio frequency generator as in claim 23, wherein the user interface further comprises an audible alarm which indicates the delivery of power.

26. A radio frequency generator as in claim 17, wherein the predetermined rate of power increase is in the range from 1 W/sec to 100 W/sec.

27. A radio frequency generator as in claim 17, wherein a time of power delivery is less than 5 minutes.

28. A radio frequency generator as in claim 17, wherein the power source operates at a frequency in the range from 100 kHz to 2 MHz and a power level in the range from 5 W to 150 W.

29. A radio frequency generator as in claim 17, wherein the increasing means comprises a programmable digital controller.

30. A radio frequency generator as in claim 17, wherein the increasing means comprises a control program embodied in a tangible medium.