Vessel sealing system

• US 8,287,528 B2
• Filed: 03/28/2008
• Issued: 10/16/2012
• Est. Priority Date: 10/23/1998
• Status: Expired due to Fees

• Current Assignee: Covidien AG (Medtronic Plc)
• Original Assignee: Covidien AG (Medtronic Plc)
• Inventors: Wham, Robert H., Buysse, Steven P., Orszulak, James H.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US12/057,557
• Publication Number:
  US 20090259224A1
• Time in Patent Office: 1,663 Days
• Field of Search: 606 32- 35, 606 38- 42
• US Class Current: 606/34
• 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 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00428 Severing
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00684 using lookup tables
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe

Abstract

A method for electrosurgically sealing a tissue includes steps of: (A) applying a first pulse of RF energy to the tissue; and (B) applying at least one subsequent RF energy pulse to the tissue and keeping constant or varying RF energy parameters of individual pulses of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs during the individual RF energy pulses. The method terminates the generation of the at least one subsequent RF pulse upon a determination that the electrical transient is absent.

Claims

1. A method for electrosurgically sealing tissue, comprising the steps of:

applying a first pulse of RF energy to the tissue having a duration of less than about 200 milliseconds to limit excessively heating tissue;

measuring a value of an electrical characteristic of tissue in response to the first pulse of RF energy; and

applying at least one subsequent RF energy pulse to the tissue based on the value of an electrical characteristic of tissue and regulating RF energy parameters of individual pulses of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs during at least one subsequent RF energy pulse.

2. A method as in claim 1, wherein the pulse duration of the first pulse is about 100 milliseconds.

3. A method as in claim 1, wherein the step of applying the first pulse comprises the steps of:

continuously measuring at least one characteristic of a response of the tissue to the applied first pulse; and

in accordance with the measured characteristic, determining whether to change at least one characteristic of the first pulse of RF energy.

4. A method as in claim 3, further comprising the step of modifying predetermined parameters of the set of RF energy parameters in accordance with a control input from an operator.

5. A method as in claim 3, wherein the at least one characteristic is at least one RF energy parameters selected from the group consisting of a magnitude of a starting power, a magnitude of a starting voltage, a magnitude of a starting current, and pulse width.

6. A method as in claim 1, wherein said at least one characteristic of an electrical transient is selected from the group consisting of an electric current transient and tissue impedance.

7. A method as in claim 1, wherein said at least one characteristic of an electrical transient is selected from the group consisting of a rate of change of an electric current transient, a rate of change of the tissue impedance, and phase rotation of voltage and current.

8. A method as in claim 1, wherein the at least one of the RF energy parameters is selected from the group consisting of a current value, a voltage value, a current phase angle, and a tissue impedance value.

9. A method as in claim 1, wherein the RF energy parameters that are varied for individual pulses of the subsequent RF energy pulses are selected from the group consisting of RF power output, current, voltage, pulse width and duty cycle.

10. A method as in claim 1, further comprising the step of determining if the tissue responded to the first pulse of RF energy prior to the step of applying at least one subsequent RF energy pulse.

11. A method as in claim 10, wherein the step of applying at least one subsequent RF energy pulse includes the step of varying at least one of RF starting power, a magnitude of starting current, pulse width, and a magnitude of starting voltage for the at least one subsequent RF energy pulse.

12. A method as in claim 1, further comprising the steps of:

measuring the at least one characteristic of the electrical transient that occurs at the end of at least the first pulse and the at least one subsequent RF energy pulse;

in accordance with the measured characteristic, determining whether to terminate the method for electrosurgically sealing tissue, or using the measured characteristic to determine a set of RF energy parameters for a subsequent RF energy pulse and repeating the applying step.

13. A method as in claim 12, wherein the set of RF energy parameters for the subsequent RF energy pulse comprise a magnitude of a starting RF power, a magnitude of a starting current, a magnitude of a starting pulse width, a magnitude of a starting voltage, and a duty cycle.

14. A method as in claim 12, wherein the electrical transient is an electrical impedance of the tissue.

15. A method as in claim 14, wherein the step of using the measured characteristic to determine the set of RF energy parameters for a subsequent RF energy pulse comprises the a step of using the measured impedance value to readout at least two or more RF energy parameters from an entry in one of a plurality of lookup tables.

16. A method as in claim 15, wherein said one of the plurality of lookup tables is selected manually or automatically, based on a choice of an electrosurgical tool or instrument.

17. A method as in claim 1, further comprising the step of combining an RF energy pulse with the at least one subsequent RF energy pulse.

18. A method as in claim 1, further comprising the step of terminating a generation of the at least one subsequent RF energy pulse upon a determination that the electrical transient is absent.

19. A system for electrosurgically sealing tissue comprising:

means for applying a first pulse of RF energy with a pulse duration of less than about 200 milliseconds to the tissue wherein the characteristics of the first pulse are selected as to not excessively heat the tissue; and

means for applying at least one subsequent RF energy pulse to the tissue and keeping constant or varying RF energy parameters of individual pulses in accordance with at least one characteristic of an electrical transient that occurs during RF energy pulse.

20. A system as in claim 19, wherein the pulse duration of the first pulse is about 100 milliseconds.

21. A system as in claim 19, wherein the means for applying the first pulse comprises:

means for continuously measuring at least one characteristic of a response of the tissue to the applied first pulse; and

means for determining whether to change a set of RF energy parameters, in accordance with the measured characteristic.

22. A system as in claim 21, wherein the default set of RF energy parameters includes parameters selected from the group consisting of a magnitude of a starting power, a magnitude of a starting voltage, a magnitude of a starting current, and pulse width.

23. A system as in claim 21, further comprising means for modifying predetermined parameters of the set of RF energy parameters in accordance with a control input from an operator.

24. A system as in claim 19, wherein the electrical transient is selected from the group consisting of an electric current transient and tissue impedance.

25. A system as in claim 19, wherein the at least one characteristic of the electrical transient is selected from the group consisting of a rate of change of an electric current transient, a rate of change of the tissue impedance, and phase rotation of voltage and current.

26. A system as in claim 19, wherein the at least one characteristic is selected from the group consisting of a current value, a voltage value, a current phase angle, and a tissue impedance value.

27. A system as in claim 19, wherein the RF energy parameters that are varied for individual pulses of the RF energy pulses are selected from the group consisting of RF power output, current, voltage, pulse width and duty cycle.

28. A system as in claim 19, further comprising means for determining if the tissue responded to the first pulse of RF energy prior to activating the means for applying at least one subsequent RF energy pulse.

29. A system as in claim 28, wherein the means for applying at least one subsequent RF energy pulse includes means for varying at least one of RF starting power, a magnitude of starting current, pulse width, and a magnitude of starting voltage for the at least one subsequent RF energy pulse.

30. A system as in claim 19, further comprising:

means for measuring the at least one characteristic of the electrical transient that occurs at the end of the first pulse and subsequent RF energy pulses;

means for determining whether to terminate the system for electrosurgically sealing tissue, in accordance with the measured characteristic; and

means for using the measured characteristic to determine a set of RF energy parameters for a subsequent RF energy pulse if the means for determining determines not to terminate the system for electrosurgically sealing tissue.

31. A system as in claim 30, wherein the set of RF energy parameters for the subsequent RF energy pulse comprise a magnitude of a starting RF power, a magnitude of a starting current, a magnitude of a starting pulse width, a magnitude of a starting voltage, and a duty cycle.

32. A system as in claim 30, wherein the electrical transient is an electrical impedance of the tissue.

33. A system as in claim 32, wherein the means for using the measured characteristic to determine the set of RF energy parameters for a subsequent RF energy pulse comprises means for using the measured impedance value to readout at least two or more RF energy parameters from an entry in one of a plurality of lookup tables.

34. A system as in claim 33, wherein said one of the plurality of lookup tables is selected manually or automatically, based on a choice of an electrosurgical tool or instrument.

35. A system as in claim 19, further comprising means for combining an RF energy pulse with at least one subsequent RF energy pulse.

36. A system as in claim 19, further comprising means for terminating a generation of subsequent RF energy pulses upon a determination that the electrical transient is absent.