System and method for tissue sealing

• US 8,147,485 B2
• Filed: 02/23/2009
• Issued: 04/03/2012
• Est. Priority Date: 01/24/2006
• Status: Active Grant

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Covidien AG (Medtronic Plc)
• Inventors: Coulson, Rebecca, Riegner, Kari L., Schechter, David A., McKenna, Nicole, Bastian, Barbara R., Harper, Jennifer S., Wham, Roberth H.
• Primary Examiner(s): DeSanto, Matthew F
• Application Number:
  US12/391,036
• Publication Number:
  US 20090157075A1
• Time in Patent Office: 1,135 Days
• Field of Search: 606 32- 52
• US Class Current: 606/34
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00875 Resistance or impedance

Abstract

An electrosurgical system is disclosed. The electrosurgical system includes an electrosurgical generator adapted to supply electrosurgical energy to tissue. The electrosurgical generator includes impedance sensing circuitry which measures impedance of tissue, a processor configured to determine whether a tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance, wherein tissue reaction corresponds to a boiling point of tissue fluid, and an electrosurgical instrument including at least one active electrode adapted to apply electrosurgical energy to tissue. A tissue cooling period is provided to enhance operative outcomes.

Claims

1. A method for performing electrosurgical tissue fusion comprising the steps of:

closing a pair of jaw members of an electrosurgical instrument about tissue;

applying electrosurgical energy at an output level to tissue from an electrosurgical generator;

determining whether tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance, wherein tissue reaction corresponds to a boiling point of tissue fluid;

generating a target impedance trajectory as a function of measured impedance and desired rate of change based on the tissue reaction determination, the target impedance trajectory including a plurality of target impedance values;

determining whether a negative deviation between the measured tissue impedance and a corresponding target impedance value associated with an unexpected drop in tissue impedance has occurred for more than a predetermined amount of time, wherein if the negative deviation is detected for more than the predetermined amount of time the processor recalculates and generates a subsequent target impedance trajectory to compensate for the negative deviation;

interrupting the application of electrosurgical energy to tissue;

cooling the tissue; and

releasing the jaw members of the electrosurgical instrument from tissue.

2. A method according to claim 1, further comprising the step of:

generating a threshold impedance value as a function of an offset impedance value and an ending impedance value, wherein the offset impedance value is obtained after an initial impedance measurement.

3. A method according to claim 2, further comprising the step of:

determining whether tissue impedance is at least equal to the threshold impedance for a predetermined shutoff period.

4. A method according to claim 3, further comprising the step of:

adjusting output of the electrosurgical generator in response to the determination whether tissue impedance is at least equal to the threshold impedance for a predetermined shutoff period.

5. A method according to claim 1, further including the steps of sensing at least one property relating to the tissue fusion;

and determining the duration for the cooling step in response to the at least one sensed tissue fusion property.

6. A method according to claim 5, wherein the at least one sensed tissue fusion property is selected from the group consisting of tissue temperature, tissue impedance, tissue mass, electrosurgical energy delivery, fluid presence, jaw angle, and electrode characteristics.

7. A method according to claim 1, further including the step of indicating the completion of the cooling step.

8. A method according to claim 7, wherein the indication is selected from the group consisting of an audible indication and a visual indication.

9. A method according to claim 1, further comprising the step of identifying at least one property of the electrosurgical instrument.

10. A method according to claim 9, wherein the duration of the cooling step is adjusted in accordance with the at least one identified property of the electrosurgical instrument.

11. A method according to claim 1, wherein the duration of the cooling step is about zero seconds to about ten seconds.

12. A method according to claim 1, further comprising the step of:

driving tissue impedance along the target impedance trajectory by adjusting the output level to substantially match tissue impedance to a corresponding target impedance value.

13. A method according to claim 1, detecting a hysteresis artifact identifier to determine whether the tissue reaction is stable.

14. A method for fusing biologic tissue comprising the steps of:

providing an electrosurgical instrument including;

at least one active electrode adapted to apply electrosurgical energy to tissue; and

a pair of jaw members configured to grasp tissue;

providing an electrosurgical instrument adapted to supply electrosurgical energy to the at least one active electrode, the electrosurgical generator including;

impedance sensing circuitry configured to measure impedance of tissue;

providing a processor in operable communication with the electrosurgical instrument;

closing a pair of jaw members of an electrosurgical instrument about tissue;

applying electrosurgical energy to tissue from an electrosurgical generator;

determining whether tissue reaction has occurred as a function of a minimum impedance value and a predetermined rise in impedance;

generating a target impedance trajectory as a function of measured impedance and desired rate of change based on the tissue reaction determination, the target impedance trajectory including a plurality of target impedance values;

determining whether a final tissue impedance value was reached;

responding to a determination that a final tissue impedance value was reached by;

determining a cooling period in response to the tissue reaction;

interrupting the application of electrosurgical energy to tissue to effectuate a cooling period;

cooling the tissue during a cooling period; and

indicating tissue fusing was successful;

responding to a determination that a final tissue impedance value was not reached by;

interrupting the application of electrosurgical energy to tissue;

indicating tissue fusing was unsuccessful; and

releasing the jaw members from tissue.

15. A method according to claim 14, wherein the provided electrosurgical instrument further includes an identification module configured to identify a characteristic of the electrosurgical instrument.

16. A method according to claim 15, wherein the duration of the cooling period is determined in accordance with an identified characteristic of the electrosurgical instrument.

17. A method according to claim 14, wherein the duration of the cooling period is determined in accordance with a sensed tissue impedance.

18. A method according to claim 14, wherein the closing step is initiated by the processor.

19. A method according to claim 14, wherein the releasing step is initiated by the processor.

20. A method according to claim 14, wherein the duration of the cooling period ranges from about zero seconds to about ten seconds.

21. A method according to claim 14, further comprising the steps of:

sensing the jaw angle of the instrument; and

adjusting at least one of the impedance trajectory and the cooling period in response to the sensed jaw angle.