Instrument for optically detecting tissue attributes

A jaw assembly including first and second jaw members configured to clamp tissue therebetween. The first jaw member includes a surface opposing a surface of the second jaw member, a light source, and a light detector. The light source is configured to emit light from an opening defined in the surface of the first jaw member. The light detector is disposed within the opening and is configured to sense properties of light reflected off tissue clamped between the first and second jaw members and to generate signals indicative of the sensed properties of light. A processor is operatively associated with the light detector and is configured to receive the signals from the light detector. The processor is also configured to analyze the signals to determine an attribute of tissue clamped between the first and second jaw members and to provide feedback to a user of the attribute of the tissue.

BACKGROUND

1. Technical Field

The present disclosure relates to surgical instruments and, more specifically, to a surgical instrument for detecting attributes of tissue with optical technology.

2. Discussion of Related Art

In endoscopic surgical procedures, surgery is performed in any hollow viscus of the body through a small incision or through narrow endoscopic tubes (cannulas) inserted through a small entrance wound in the skin or through a naturally occurring orifice. Endoscopic surgical procedures performed within the interior of the abdomen are referred to as laparoscopic procedures. As used herein both laparoscopic and endoscopic procedures will be collectively referred to as endoscopic procedures. Endoscopic procedures often require the clinician to act on organs, tissues and vessels far removed from the incision

During endoscopic procedures, a surgeon may benefit from knowing attributes of tissue being manipulated to increase the effectiveness of the procedure. For example, knowing the thickness of tissue may aid a surgeon in selecting the proper size staple for the tissue. In addition, identifying the vascular properties within the surgical site the surgeon may identify the red blood cell concentration to determine whether the tissue is diseased or cancerous.

SUMMARY

Accordingly, the present disclosure relates to an endoscopic surgical instrument configured to provide intraopertive feedback of tissue properties within a surgical site.

In an aspect of the present disclosure, a jaw assembly includes first and second jaw members moveable relative to one another between an open configuration and a clamped configuration. In the clamped configuration, the first and second jaw members are configured to clamp tissue therebetween. The first jaw member includes a surface opposing a surface of the second jaw member. The first jaw member further includes an opening defined in the surface of the first jaw member. The first jaw member also includes a light source configured to emit light from the opening and a light detector disposed within the opening. The light detector is configured to sense properties of light reflected off tissue clamped between the first and second jaw members and to generate signals indicative of the sensed properties of light. The jaw assembly further includes a processor operatively associated with the light detector. The processor is configured to receive signals indicative of properties of light from the light detector, to analyze the signals to determine an attribute of tissue clamped between the first and second jaw members, and to provide auditory, haptic, or visual feedback to a user of the attribute of the tissue. The processor may be configured to determine a thickness of tissue clamped between the first and second jaw members. The light source may be configured to generate light by one of electron-stimulation, incandescent lamps, light emitting diodes, electroluminescence, gas discharge, high-intensity discharge, laser, chemoluminescence, fluorescence, or phosphorescence.

In embodiments, the second jaw member includes a second light detector disposed within a second opening defined in the surface of the second jaw member. The second light detector is configured to sense properties of light transmitted through tissue clamped between the first and second jaw members from the light source of the first jaw member and transmitted and to generate signals indicative of the sensed properties of light. The second light detector may transmit the signals to the processor.

In some embodiments, the second jaw member includes a second light source configured to emit light through a second opening defined in the surface of the second jaw member. The second jaw member further includes a second light detector disposed within the second opening configured to sense properties of light emitted from the second light source and reflected off tissue clamped between the first and second jaw members and to generate signals indicative of the sensed properties of light.

In certain embodiments, the first jaw member includes an anvil and the second jaw member includes a staple cartridge. The staple cartridge includes a plurality of staples configured to be driven through tissue clamped between the first and second jaw members.

In aspects of the present disclosure, a surgical instrument includes a handle, an elongated shaft extending from the handle, and a jaw assembly. The jaw assembly includes first and second jaw members moveable relative to one another between an open configuration and a clamped configuration. In the clamped configuration, the first and second jaw members are configured to clamp tissue therebetween. The first jaw member includes a surface opposing a surface of the second jaw member. The first jaw member further includes an opening defined in the surface of the first jaw member. The first jaw member also includes a light source configured to emit light from the opening and a light detector disposed within the opening. The light detector is configured to sense properties of light reflected off tissue clamped between the first and second jaw members and to generate signals indicative of the sensed properties of light. The jaw assembly further includes a processor operatively associated with the light detector. The processor is configured to receive signals indicative of properties of light from the light detector, to analyze the signals to determine an attribute of tissue clamped between the first and second jaw members, and to provide auditory, haptic, or visual feedback to a user of the attribute of the tissue.

In embodiments, the surgical instrument may include a control interface disposed on the handle that is operatively associated with the jaw assembly. The control interface is configured to actuate the first and second jaw members between the open and clamped configurations. The control interface is operatively associated with the light source to activate the light source to emit light from the opening.

In some embodiments, the surgical instrument includes a display panel disposed on the handle. The display panel operatively associated with the processor and configured to display feedback of the attribute of the tissue.

In certain embodiments, the processor is disposed within the elongated shaft. In other embodiments, the processor is disposed within the handle.

In particular embodiments, one of jaw members includes a staple cartridge having a plurality of staples configured to fire through tissue clamped between the first and second jaw members. The processor may be configured to control the firing of staples from the surgical instrument.

In some aspects of the present disclosure, a method for detecting tissue attributes includes providing a jaw assembly, clamping tissue between first and second jaw members of the jaw assembly, emitting light from an opening in a surface of the first jaw member, sensing properties of light reflected of the tissue, transmitting signals indicative of properties of light to a processor, determining tissue attributes from the signals with the processor, and providing feedback of the tissue attributes to a user. The first and second jaw members are moveable relative to one another between an open configuration and a clamped configuration. The surface of the first jaw member opposes the second jaw member.

The method may include sensing properties of light transmitted through the tissue clamped between the first and second jaw members of the jaw assembly. The first jaw member including a light source and the second jaw member including a second light detector. Emitting light from the opening may include activating a light source of the first jaw member.

The method may include firing staples from a staple cartridge coupled to one of the first and second jaw members through tissue clamped between the first and second jaw members. Determining tissue attributes may include determining tissue thickness of tissue clamped between the jaw members and the method may include comparing the determined tissue thickness to a predetermined tissue thickness value and preventing additional functions of the surgical instrument when the determined tissue thickness is greater than the predetermined value. The method may further include inputting the predetermined tissue thickness value into a control interface operatively associated with the processor. The method may further include coupling the staple cartridge to one of the first and second jaw members. The staple cartridge may transmit the predetermined value to the processor.

Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

DETAILED DESCRIPTION

Embodiments of the present disclosure are now described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closest to the clinician and the term “distal” refers to the portion of the device or component thereof that is furthest from the clinician.

Referring toFIG. 1, a surgical instrument10is provided in accordance with the present disclosure including a handle20, an elongated shaft30extending from the handle20, and a jaw assembly40coupled to a distal end34of the elongated shaft30. The handle20includes a control interface22and a display panel28. The control interface22is operatively associated with the jaw assembly40as detailed below. The display panel28is configured to display tissue properties of tissue clamped within the jaw assembly40as detailed below.

In alternate embodiments, the display panel28is not present on the handle20but rather is or functions as a screen remote to the surgical instrument10(e.g., a surgical monitor (not shown) inside or outside an operating theater). It is contemplated that the control interface22may be integrated into the display panel28(e.g., a touch screen display panel whether the display panel28is on the handle20or remote).

In embodiments, the handle20is a powered handle and the control interface22includes a plurality of buttons or switches to manipulate the jaw assembly40. In some embodiments, the handle20is a manual handle and the control interface22includes triggers and levers (not shown) to manipulate the jaw assembly40. An exemplary example of such a handle is disclosed in commonly owned and co-pending U.S. patent application Ser. No. 13/484,975, filed May 31, 2012, published as U.S. Patent Publication No. 2012/0253329 on Oct. 4, 2012, the contents of which is hereby incorporated by reference in its entirety.

The elongated shaft30operatively associates the jaw assembly40with the handle20. A proximal end32of the elongated shaft30may be integrally formed with the handle20. In embodiments, the proximal end32releasably couples the elongated shaft30to the handle20. In some embodiments, the distal end34of the elongated shaft30includes a detachable end effector assembly36including the jaw assembly40. In embodiments, the elongated shaft30may rotate relative to the handle20. In some embodiments, the jaw assembly40articulates relative to the elongated shaft20.

With reference toFIGS. 2-4, the jaw assembly40includes an upper jaw member42, a lower jaw member44, and a detection assembly50. The upper jaw member42defines a plurality of openings43in a surface opposing the lower jaw member44. The lower jaw member44may define a plurality of openings45in a surface43opposing the upper jaw member42.

The jaw members42,44are moveable relative to one another between an open configuration (FIG. 2), wherein the jaw members42,44are spaced-apart from one another, and a clamped configuration (FIG. 3), wherein the jaw members42,44are approximated. The control interface22(FIG. 1) may be used to command a transition of the jaw members42,44between the open and clamped configurations.

With particular reference toFIG. 4, the detection assembly50is disposed within the jaw assembly40and includes light sources52a,52b,light detectors54a,54b,and a processor58. The upper jaw member42includes a single light source52aand a light detector54adisposed within each opening43defined by the upper jaw member42. Light from the light source52ais guided to each opening43through fiber optic cables or light pipes53such that light from light source52ais emitted from each of the openings43. It will be appreciated that having the light sources and the light detectors in a single jaw member (e.g., upper jaw member42) simplifies the routing of wiring and cables to the light sources and the light detectors. In addition, it will be appreciated that the single jaw member may be fixed relative to the elongated shaft to further simplify the routing of wiring and cables to the light sources and the light detectors.

In embodiments, the lower jaw member44includes a plurality of light sources52band light detectors54bdisposed within each opening45defined by the lower jaw member44. The light sources52bare direct light sources configured to emit light through openings45.

The light source52a,52bmay generate light by a variety of means including but not limited to electron-stimulation, incandescent lamps, electroluminescent, gas discharge, high-intensity discharge, lasers, chemoluminescence, fluorescence, and/or phosphorescence. It is contemplated that the lower jaw member44may include a single light source52bguided through fiber optic cables or light pipes (not shown), to openings45, similar to the fiber optic cables or light pipes53extending through the upper jaw member42to the openings43. It is further contemplated that the light source52amay be a plurality of light sources52adisposed within openings43of the upper jaw member42, similar to light sources52bdisposed within the openings45of the lower jaw member44.

Each light detector54a,54bis operatively associated with the processor58. Each light detector54a,54bis a sensor configured to optically sense properties of light contacting the light detector54a,54b.Each light detector54a,54bis operatively associated with the processor58. It is contemplated that each light detector54a,54bmay be wired directly to or wirelessly connected to the processor58. It is within the scope of this disclosure that light detectors54a,54bare tuned to one another to enhance the detection of light attributes. It is also within the scope of this disclosure that each light source, each light pipe, or each a group of light sources or light pipes may be associated with a specific light detector such that the light detector is configured to only detect light from the associated light source, light pipe, or group of light sources or light pipes. Further, it is within the scope of this disclosure that the light sources or light pipes may be operated sequentially to produce a clearer image of the tissue properties.

The wireless connection may be via radio frequency, optical, WIFI, Bluetooth® (an open wireless protocol for exchanging data over short distances (using short length radio waves) from fixed and mobile devices, creating personal area networks (PANs)), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 802.15.4-2003 standard for wireless personal area networks (WPANs)), etc.

The processor58may be disposed within the surgical instrument10(e.g., within the handle20, the elongate shaft30, or the jaw assembly40) or external to the surgical instrument10. The processor58is configured to receive one or more signal(s) including properties of light from the light detectors54a,54band is configured to analyze the signal(s) to determine an attribute of tissue clamped between the first and second jaw members. The processor58is operatively associated with the display panel28to display the attribute of tissue clamped within the jaw assembly40as detailed below.

Each light detector54a,54bmay be configured to detect a specific chemical or agent injected into the blood stream of a patient including but not limited to chemicals or agents cable of bioluminescence, radioluminescence, chemoluminescence, fluorescence, and/or phosphorescence. It is contemplated that each light detector54a,54bmay be configured to detect the same or different chemicals or agents than each other light detector54a,54b.It is also contemplated that each opening43,45in a respective one of the jaw members42,44may include more than one light detector54a,54bwith each light detector54a,54bconfigured to sense a different or the same attribute of light.

With reference toFIGS. 3 and 4, the detection assembly50is used to determine the attributes of tissue clamped within the jaw assembly40in accordance with the present disclosure. When tissue is clamped between the upper and lower jaw members42,44of the jaw assembly40one or more of the light sources52a,52bis activated to emit light from respective openings43,45in the jaw members42,44. The control assembly22(FIG. 1) may be used to activate the light sources52a,52b.The light emitted from the openings43,45is reflected off the surface of the tissue clamped within the jaw assembly40, backscattering some light back into respective openings43,45(e.g., light emitted from the light source52athrough an opening43reflects off the surface of tissue, travels back into the opening43and is sensed by the light detector54adisposed within the opening43). The light may also be transmitted through the tissue and into an opposing opening43,45(e.g., light emitted from the light source52athrough an opening43may be transmitted through the tissue into an opening45opposing the opening43and sensed by the light detector54bdisposed within the opening45).

In embodiments, the light sources52bor the end of the fiber optic cables53, may be positioned within opening45so as to be in direct contact with the surface of tissue to achieve a short photon path length.

The properties of the light sensed by the light detectors54a,54bare converted to electrical signals and transmitted to the processor58. The processor58analyzes the signals indicative of the properties of the sensed light to determine attributes of the tissue clamped between the jaw members42,44and displays the tissue attributes on the display panel28. For example, the intensity of the light may be used to calculate the thickness of known tissue type (i.e., lung, stomach, intestinal, muscular, etc.) clamped within the jaw assembly40and the display panel28displays the calculated thickness of the tissue.

In addition, the light detectors54a,54bmay be configured to sense properties of light associated with a specific chemical or agent injected into the blood stream of a patient. Further, the light detectors54a,54bmay be configured to sense properties of light indicating foreign bodies, diseased tissue, or non-tissue within tissue clamped within the jaw assembly40.

In embodiments, the processor58may compare the tissue thickness of tissue clamped within the jaw assembly40to a predetermined value and provide the clinician with indicia that the tissue thickness is greater than or less than the predetermined value. When the tissue thickness is greater than the predetermined value the processor58may provide audible, haptic, or visual indicia to the clinician to alert the clinician that the tissue thickness is greater than the predetermined value (e.g., a red light, a failure tone, a stop icon, an alert light pattern, an audible alert pattern, etc.). When the tissue thickness is less than or equal to the predetermined value, the processor58may provide audible, haptic, or visual indicia to the clinician to alert the clinician that the tissue thickness is less than or equal to the predetermined value (e.g., a green light, a go ahead tone, a go icon, a go light pattern, an audible go pattern, etc.). With a thickness of the tissue determined, a clinician may select an appropriately configured surgical instrument to complete a particular surgical task (e.g., a surgical stapler loaded with an appropriately sized plurality of surgical staples).

Referring toFIGS. 5-8, a surgical instrument100is provided in accordance with the present disclosure including a handle20, an elongated shaft30extending from the handle20, a detachable end effector assembly36including a jaw assembly140. The jaw assembly140includes an upper jaw member142, a lower jaw member144, and a detection assembly150. The upper jaw member142includes an anvil162having a plurality of staple pockets164. The anvil162may be releasably coupled to the upper jaw member142. An opening143is defined in the anvil162between each of the staple pockets164.

The lower jaw member144includes a staple cartridge166having a plurality of staples168configured to be fired through tissue clamped between the upper and lower jaw members142,144. Each staple168is associated with a staple pusher169that is configured to urge the staple168from the staple cartridge166, through tissue clamped between the jaw members142,144, and towards the anvil162. When each staple168contacts the anvil162, legs of each staple168are formed to secure the staple168within the tissue clamped between the jaw members142,144. The staple cartridge166may be releasably coupled to the lower jaw member144.

The detection assembly150includes a plurality of light sources52a,a plurality of light detectors54a,and a processor158. The light sources52aand light detectors54aare disposed within the openings143defined in the anvil162of the upper jaw member142. The processor158is disposed within the handle20and is operatively associated with the light detectors54a.The light sources52a,the light detectors54a,and the processor158of surgical instrument100operate substantially similar to the light sources52a,the light detectors54a,and the processor58of surgical instrument10detailed above, as such only the differences are detailed below.

The processor158may be configured to lock out additional functions of the jaw assembly140when the tissue thickness of tissue clamped within the jaw assembly140is greater than a predetermined value (e.g., prevents the staples168from firing from the staple cartridge166).

The clinician may input the predetermined value into a control assembly22. The control assembly22may be disposed on the handle20or remote to the surgical instrument100. The staple cartridge166may be replaceable with a plurality of staple cartridges having varying sized staples168. The size of the staples168within the staple cartridge166coupled to the lower jaw member144may determine the predetermined value. The staple cartridge166may be operatively associated with the processor158such that when the staple cartridge166is coupled to the lower jaw member144the predetermined value associated with the staple cartridge166is transmitted to the processor158. It is also contemplated that the predetermined value includes an upper limit and a lower limit associated with a suitable thicknesses of tissue for the staple cartridge166and the processor158is configured to prevent the staples168from firing if the tissue thickness is not between the upper and lower limits.

The tissue thickness may be determined by the red blood cell density within the tissue. For example, if there is too much blood occlusion the reduced density of the red blood cells indicates that the staples168within the staple cartridge166are too small for the tissue clamped within the jaw assembly140.

The attributes of tissue clamped within the jaw member assembly40,140may also be detected by detecting abnormal blood flow. For example, abnormal blood flow may indicate that cancerous or tumorous tissue is clamped within the jaw assembly40,140informing the clinician that a resection margin (i.e., the amount of tissue being removed containing cancerous or tumorous tissue) should be increased.

As mentioned above, the detection assembly50may be provided as a standalone instrument or as part of a multifunction surgical instrument including but not limited to a surgical stapler, a grasper, or an electrosurgical device.

The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery”. Such systems employ various robotic elements to assist the surgeon in the operating theatre and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include, remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein (e.g., the jaw assembly40) while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions (e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc.). As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.