Combined bipolar scissor and grasper and method of forming thereof

A method of forming a combination bipolar scissors and graspers surgical instrument. The method has the steps of: providing a predetermined blade configuration of a bipolar scissors surgical instrument, the predetermined blade configuration having first and second jaw members each having a respective first and second cutting edge and first and second pivoting surfaces; defining a first grasping surface on the first jaw member, the first grasping surface being distal to the cutting edge, the first grasping surface being contained within the confines of the predetermined blade configuration; defining a second grasping surface opposing the first grasping surface on the second jaw member, the second grasping surface being contained within the confines of the predetermined blade configuration; providing a pivot pin pivotally connected to the jaw members wherein at least one jaw member is pivotable in relation to the other jaw member about the pivoting surfaces, the jaw members being capable of pivoting between an open and closed position such that the cutting edges form a scissor and the grasping surfaces form a clamp when the jaw members are in their closed position; and electrically isolating the first jaw member from the second jaw member. A further method is provided in which the cutting edges are distal to the grasping surfaces. Also provided are combination scissors/graspers having blade configurations as illustrated in FIGS. 12A-B to 14A-B.

BACKGROUND OF THE INVENTION
 1. Field of the Invention
 The field of art to which this invention relates is surgical instruments,
 in particular, electrosurgical cutting and grasping instruments.
 2. Description of the Related Art
 Surgery requires the use of surgical instruments within a restricted and
 unusually sensitive operating field. During surgery, the field becomes
 crowded if a large number of surgical instruments must be used
 simultaneously, with concomitant difficulty for the surgical team to
 maintain a clear viewing area. Under such circumstances, surgical
 instruments designed to perform more than one task are of particular
 importance.
 Two techniques used extensively in both open and endoscopic surgery are (a)
 the controlling of bleeding using electrosurgical instrumentation and (b)
 the incision or severing of tissue or vessels. The control of bleeding
 during surgery accounts for a major portion of the time involved in
 surgery. In particular, bleeding that occurs when tissue is incised or
 severed can obscure the surgeon's vision, prolong the operation, and
 adversely effect the precision of cutting. Blood loss from surgical
 cutting may require blood infusion, thereby increasing the risk of harm to
 the patient.
 Hemostatic electrosurgical techniques are known in the art for reducing
 bleeding from incised tissue prior to, during, and subsequent to incision.
 Electrosurgical cutting and coagulating instruments are used to perform
 such techniques. These instruments can be of a reusable type (which
 require cleaning and disinfecting or sterilizing before each use) or
 disposable (which are disposed of after a single use). Each type includes
 both monopolar and bipolar variations having at least one electrode. Radio
 frequency (RF) energy is conducted through this electrode to either a
 remote conductive body-plate (known as a grounding pad) in the case of
 monopolar instruments, or to a second, closely spaced conductive electrode
 in the case of bipolar instruments. In monopolar instruments electrical
 current travels from the electrode through the patient's body to the
 grounding pad. Bipolar instruments are typically connected to both poles
 of an electrosurgical generator, therefore current flow is typically
 limited to tissue adjacent to the working end of the bipolar instrument
 (where the two electrodes are located).
 Prior to the advent of electrosurgical cutting instruments, a surgeon would
 perform any cutting with a scissors and coagulate with an entirely
 different instrument. This exchange of instrumentation was time consuming.
 In response for the need to have a scissors-type instrument for cutting
 but which also incorporated the ability to coagulate blood and other body
 tissue using RF energy, electrosurgical cutting devices have been
 developed which combine mechanical cutting with electrosurgical
 cauterization, coagulation, and cutting.
 Standard shape and size scissors have evolved in the surgical arts which
 surgeons have become accustomed to. These standards have been incorporated
 into the electrosurgical cutting instruments, not only because they have
 been tested by time and found to be very functional, but mainly because
 surgeons have become accustomed with their feel and use. Examples of some
 of these standards include the Mayo, Metzenbaum, and Tenotomy scissors.
 Each standard scissor is typically available in both curved and straight
 variations.
 Grasper or forcep type instruments are also well known in the art. They
 generally consist of opposing jaws which pivot about a pivot point into an
 open or closed position. In a closed position the jaws of the grasper
 provide a means to grasp and hold, or grasp and tear, a piece of body
 organ, a vessel, or tissue.
 Electrosurgical graspers have been developed to cauterize a portion of
 tissue. This is accomplished in one of two ways. Cauterization can be
 accomplished by using an outside surface or the tip of both jaws to
 cauterize the tissue the jaws contact. Cauterization can also be
 accomplished with a grasper by grasping down onto tissue and cauterizing
 the tissue between the jaws. It is in this way that electrosurgical
 graspers are used to coapt a vessel prior to transection with a cutting
 device. Electrosurgical graspers are also used to coapt retracted bleeders
 (severed blood vessels).
 In practice, vessels are coapted in several ways. One such way is by using
 a standard grasper not capable of cauterization and a monopolar pencil.
 The vessel is first clamped between the jaws of the grasper, and the
 pencil is used to energize the grasper with RF energy. The RF energy
 passes from the monopolar pencil, through the forceps, vessel and patients
 body to the grounding pad. This is a potentially dangerous procedure. The
 patient or surgeon can be easily injured in such a procedure.
 Another way to perform coaptation of vessels is by using a monopolar or
 bipolar scissors in which the scissors are rotated exposing the vessel to
 the side surfaces of the scissor's blades. In theory, the blade sides
 cauterize the vessel and the vessel is then severed with the scissors. In
 practice, this procedure is very difficult and can lead to complications.
 It is very easy for a surgeon to nick the vessel with the scissor blades
 before the coaptation of the vessel is complete, causing unanticipated
 bleeding and the need for further instrumentation to stop the bleeding.
 Whichever method of coaptation is used, subsequent to the coaptation, the
 vessel is severed by a cutting instrument such as an electrosurgical
 scissor. In light of the above discussion, this procedure has been most
 effectively and safely accomplished with at least two different surgical
 instruments, a grasper to grasp and coapt, and a scissor to sever the
 coapted vessel.
 Tidemand, U.S. Pat. No. 5,342,381, discloses an endoscopic combination
 bipolar scissors and forceps instrument which has blade and forceps
 portions on each of two jaws. Although the Tidemand instrument is useful
 it is subject to several disadvantages which effect the performance of the
 device, especially with regard to coaptation of vessels.
 Since the blades of the Tidemand invention are insulated (typically
 ceramic) the blades themselves only offer mechanical cutting. As discussed
 previously, an instrument which offers both mechanical and electrosurgical
 cutting is preferred over one which offers only the former. Additionally,
 certain procedures require that the scissors portion of the instrument be
 distal to the graspers. Likewise, some procedures require the grasper
 portion of the instrument to be distal to the scissor portion. Tidemand
 discloses only the latter configuration, which is inadequate in many
 surgical procedures.
 Furthermore, the shape and size of the cutting and grasping surfaces in the
 Tidemand instrument are awkward, unlike any standard scissor that surgeons
 have become accustomed to.
 With regard to surgical procedures in which coaptation of vessels is
 required, the Tidemand combination instrument could not be effectively
 utilized. Effective coaptation requires hemostasis during cutting as well
 as during grasping (or clamping) in order to cauterize the ends of the
 severed vessel.
 Like the Tidemand instrument, the single feature electrosurgical cutting
 devices and graspers of the prior art are useful and effective, but they
 too suffer from several deficiencies associated with their use. The
 instrument exchange associated with cutting, coagulating and coaptation
 requires dexterity on the part of the surgeon. The increased number of
 instruments has the disadvantage of crowding the operating field.
 Additionally, there is a greater burden on assistant personnel in the
 operating room, such as nurses, because of the exchange of instrumentation
 between them and the surgeon.
 Another disadvantage of the prior art concerns cleaning, disinfecting and
 sterilization (CDS) issues known in the surgical instrumentation art.
 Transmission of sickness and disease through contaminated instrumentation
 is a very real problem in the medical field. Typically, surgical
 instrumentation is cleaned and disinfected or sterilized after each use to
 minimize this possibility. Since effective coaptation of vessels has
 required two instruments, a graspers and a scissors, the risk of disease
 transmission is increased. The explanation for this is purely statistical,
 the probability of transmitting disease in two instruments is greater than
 for a single instrument.
 Additionally, the cost of processing (cleaning, disinfecting or
 sterilizing) two reusable instruments and purchasing two reusable
 instruments is greater than the costs associated with a single combined
 instrument.
 To combat the CDS problems associated with reusable instruments, disposable
 instruments have been developed which are disposed after a single use.
 While they have their advantages, disposable instruments suffer from the
 disadvantage of contributing to the amount of medical waste generated.
 The prior art disposable scissors and graspers suffer the disadvantage of
 contributing twice the medical waste as a single disposable instrument
 combining both features. Likewise, the cost of two disposable surgical
 instruments is greater than the cost of a combined disposable instrument.
 Accordingly, there is a need in the art for an improved electrosurgical
 instrument having mechanical grasping and cauterization capabilities to
 coapt vessels combined with capabilities to mechanically transect and
 cauterize the vessel, contained within a standard scissors shape and size.
 SUMMARY OF THE INVENTION
 Therefore, it is an object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which is
 capable of performing the functions of both a bipolar forceps and a
 bipolar scissors.
 It is yet a further object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 combines a bipolar scissors and bipolar grasper with the grasping portions
 contained within a standard scissor shape and size.
 It is yet a further object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof to
 eliminate the need to energize a standard grasper with a monopolar pencil.
 It is yet a further object of the present invention a single bipolar
 electrosurgical instrument and method for forming thereof to eliminate the
 need to rotate a monopolar or bipolar scissors to coapt a vessel.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 provides for improved cauterization and coagulation.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 reduces the amount of instrumentation necessary for surgical procedures in
 which both electrosurgical cutting and grasping is required.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 reduces the burden on assistant personnel in an operating room in which a
 surgical procedure is being performed that requires both electrosurgical
 cutting and grasping.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 reduces the amount of dexterity needed by a surgeon performing a surgical
 procedure in which both electrosurgical cutting and grasping is required.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 reduces the costs associated with surgical procedures in which both
 electrosurgical cutting and grasping is required.
 It is yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 decreases the probability of transmission of disease due to contaminated
 instrumentation in surgical procedures in which both electrosurgical
 cutting and grasping is required.
 It is still yet another object of the present invention to provide a single
 bipolar electrosurgical instrument and method for forming thereof which
 decreases the amount of medical waste generated in surgical procedures in
 which both electrosurgical cutting and grasping is required.
 Accordingly, a method of forming a combination bipolar scissors and
 graspers surgical instrument is provided. The method comprises the steps
 of: providing a predetermined blade configuration of a bipolar scissors
 surgical instrument, the predetermined blade configuration having first
 and second jaw members each having a respective first and second cutting
 edge and first and second pivoting surfaces; defining a first grasping
 surface on the first jaw member, the first grasping surface being distal
 to the cutting edge, the first grasping surface being contained within the
 confines of the predetermined blade configuration; defining a second
 grasping surface opposing the first grasping surface on the second jaw
 member, the second grasping surface being contained within the confines of
 the predetermined blade configuration; providing a pivot pin pivotally
 connected to the jaw members wherein at least one jaw member is pivotable
 in relation to the other jaw member about the pivoting surfaces, the jaw
 members being capable of pivoting between an open and closed position such
 that the cutting edges form a scissor and the grasping surfaces form a
 clamp when the jaw members are in their closed position; and electrically
 isolating the first jaw member from the second jaw member.
 In another embodiment of the methods of the present invention, the cutting
 edges are distal to the grasping surfaces.
 In yet other embodiments of the present invention bipolar electrosurgical
 instruments are provided having a combined scissor and grasper, wherein
 the scissor and grasper are formed within the shape of the standard
 scissors illustrated in FIGS. 12A, 12B; 13A, 13B; and 14A, 14B.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
 Referring now in detail to FIGS. 1A and 1B there is illustrated the
 operating (or distal) end of the inventive combined bipolar scissors and
 grasper instrument 10 which includes first and second jaw members 12,14.
 Each jaw member having a cutting edge 16,18, a cutting surface 17,19, and
 a grasping surface 20,22. The cutting edges 16,18 and grasping surfaces
 20,22 generally being formed of a conductive material, preferably
 stainless steel. The first cutting edge 16 opposes the second cutting edge
 18 and the first grasping surface 20 opposes the second grasping surface
 22.
 The first jaw member 12 further has a first pivoting surface 30. The second
 jaw member 14 further has a second pivoting surface 32. The pivoting
 surfaces 30,32 slidably contact each other at a point where the jaw
 members 12,14 intersect.
 The jaw members 12,14 are pivotally connected by way of a rivet, screw, or
 pin 24 at their point of intersection such that they are capable of
 pivoting between an open and closed position. The point of intersection is
 configured with a conventional surgical scissors pivot.
 As shown in FIGS. 1C and 1D, a conventional bipolar surgical scissor is
 shown having a predetermined blade configuration and referred to generally
 as reference numeral 1, wherein a first blade member 12a pivots about a
 second blade member 14a whereby they are retained into a pivoting
 relationship by a rivet, pin or screw 24a. The predetermined blade
 configuration can be any of those previously discussed, such as those
 having a Mayo, Metzenbaum, or Tenotomy configuration, or any other blade
 configuration now know or later developed.
 Each blade member has a cutting edge 16a,18a and a cutting surface 17a,19a.
 A first electrically insulating coating 26a is applied to the first
 cutting surface 17a and a second insulating coating 36a is applied to the
 pin 24a for electrically isolating the first blade member 12a from the
 second blade member 14a. Therefore, electrical conduction is prevented
 from the first jaw member 12a to the second jaw member 14a through the
 rivet, pin or screw 24a.
 Referring back to FIGS. 1A and 1B, when in the closed position, the first
 cutting edge 16 engages the second cutting edge 18 in a shearing motion.
 Similarly, the first grasping surface 20 substantially meets the second
 grasping surface 22 to form a clamp for grasping and clamping tissue or
 vessels therewithin.
 Electrically insulating material is provided to electrically isolate the
 first jaw member 12 from the second jaw member 14. A first electrically
 insulating coating 26 is secured to the first cutting surface 17 thereby
 insulating the first cutting surface 17 from the second cutting surface 19
 when the jaw members 12,14 are in their closed position but which allows
 electrical conduction between the first and second cutting edges 16,18
 when tissue is present between the cutting edges 16,18.
 Furthermore, a second insulating coating 28 is secured to the second
 grasping surface 22 thereby insulating the first grasping surface 20 from
 the second grasping surface 22. A third insulating coating 34 is supplied
 at the first pivoting surface 30. Lastly, a fourth insulating coating 36
 is provided on the rivet, pin, or screw 24, to prevent electrical
 conduction from the first jaw member 12 to the second jaw member 14
 through the pivot rivet, screw, or pin 24.
 The insulating coatings 26, 28, and 34 are preferably aluminum oxide,
 plasma deposited on the instrument surfaces. The thickness of the aluminum
 oxide coatings can be between 0.003 and 0.010 inches thick, preferably
 between 0.005 and 0.007 inches thick to withstand a voltage of
 approximately 1,500 volts.
 Preferably, the pivot pin, screw, or rivet 24 is similarly coated, but also
 can be fabricated from a high strength polymer, a glass-filled polymer, a
 ceramic-filled polymer, or fabricated entirely from a ceramic. If
 fabricated from a ceramic, it can be further impregnated with a polymer,
 such as PTFE, to improve its lubricity. Additionally, the pin, screw or
 rivet is typically epoxied in place with any suitable medical grade epoxy.
 As shown in FIGS. 3A through 3D, the second insulating coating 28
 preferably covers only a portion of the second grasping surface 22. When
 tissue is grasped between the first grasping surface 20 and second
 grasping surface 22, RF energy from one jaw member will be conducted to
 the other in the portions of the second grasping surface 22 which are
 uncoated, thereby cauterizing the tissue between the grasping surfaces
 20,22 in the region of the uncoated portions.
 Since the second insulating coating 28 covers only a portion of the second
 grasping surface 22 it can therefore take on a variety of shapes and
 sizes. FIG. 3A shows the second insulating coating 28a applied as a
 semi-circle across the width of the second grasping surface 22. The second
 insulating coating 28a is preferably raised above the second grasping
 surface 22, as shown in FIG. 3B, such that an insulating gap is maintained
 between the first grasping surface 20 and the second grasping surface 22
 when the jaw members 12,14 are in their closed position. The insulating
 gap prevents electricity from being conducted from the first grasping
 surface 20 to the second grasping surface 22 when the jaw members 12,14
 are in their closed position and tissue is not present between them.
 It should be noted that the second insulating coating 28 is used to
 maintain an insulating gap between the first grasping surface 20 and the
 second grasping surface 22 equal to the thickness of the coating 28. The
 second insulating coating 28 can be eliminated and an insulating air gap
 used to isolate the first grasping surface 20 from the second grasping
 surface 22.
 It should also be noted that the second insulating coating 28, as well as
 the first insulating coating 26, are not essential to the functioning of
 the instrument. They are provided for safety reasons to eliminate the
 possibility of electrical shorting between the jaw members 12,14 in the
 situation where the instrument is accidentally energized with RF energy
 while the jaw members 12,14 are in their closed position and tissue is not
 present between them. Such a situation where electrical shorting occurs
 between the jaw members 12,14 can be potentially dangerous to both the
 surgeon and patient.
 Similarly, FIG. 3C shows an alternatively shaped second insulating coating
 28b applied as a strip across the length of the first grasping surface 20.
 FIG. 3D shows that the second insulating coating 28b is likewise raised
 above the second grasping surface 22 such that an insulating gap is
 maintained between the first grasping surface 20 and the second grasping
 surface 22 when the jaw members 12, 14 are in their closed position.
 Referring back to FIGS. 1A and 1B, as shown clearly in a comparison of
 FIGS. 1C and 1D, the shape of the instrument's distal end does not vary
 from the shape of the predetermined blade configuration of the standard
 scissor's blades 12a,14a even though grasping surfaces 20,22 have been
 formed therein. Since the grasping surfaces 20,22 follow the contours of a
 standard scissor shape, the feel and use of the standard scissor is
 maintained for the combined instrument. The grasping surfaces are formed
 into the jaw members of the scissors by any methods known in the art, such
 as grinding, machining, or casting of the jaw members having both the
 cutting edges and grasping surfaces formed therein. Thus, the grasping
 surfaces do not necessarily have to be formed after the formation of the
 jaw members having the cutting edges. As in the case where the jaw members
 are formed by casting, the cutting edges and grasping surfaces of the jaw
 members may be formed simultaneously. Of course, secondary operations may
 be necessary, such as sharpening the cutting edges and machining a knurled
 pattern on the grasping surfaces.
 FIGS. 1A and 1B illustrate an embodiment of the present invention 10
 configured to have the cutting edges 16,18 distal to the grasping surfaces
 20,22. FIGS. 2A and 2B illustrate a similar embodiment of the present
 invention 40 in which all components similar to or identical with those in
 FIGS. 1A and 1B are designated by the same reference numerals, and is
 merely modified with regard to the previous embodiment, in that the jaw
 members 12,14 are configured to have the grasping surfaces 20,22 distal to
 the cutting edges 16,18. Similarly, FIGS. 4A through 4D illustrate two
 variations of the second insulating surface 28a,28b similar to those
 previously discussed and shown in FIGS. 3A through 3D.
 As shown clearly in FIG. 2B, the shape of the instrument's distal end does
 not vary from the shape of a standard scissor, even though grasping
 surfaces 20,22 have been formed therein. Since the grasping surfaces 20,22
 follow the contours of a standard scissor shape, the feel and use of the
 standard scissor is maintained for the combined instrument. Since the
 width of the scissor tapers down toward the distal tip, less grasping
 surface is available in this configuration than in the configuration shown
 in FIGS. 1A and 1B. However, each configuration is useful and more
 effective in certain surgical procedures depending upon the cutting and
 grasping requirements for the procedure. As discussed previously with
 regard to the embodiments shown in FIGS. 1A and 1B, the grasping surfaces
 can be formed by any method known in the art and do not have to be formed
 after the formation of the jaw members having the cutting edges, but may
 be formed simultaneously therewith.
 Referring now to FIGS. 5A and 5B there is illustrated the embodiments of
 FIGS. 1A and 2A, respectively, in which the standard scissor pivot
 configuration is replaced by a box-lock pivot configuration. FIG. 5A
 illustrates an instrument 10a of the present invention configured with the
 scissors portion distal to the grasping portion. In the box-lock
 configuration shown, the first jaw member 12 is retained within, and
 pivots within a slot 50 disposed in the second jaw member 14. In addition,
 the first member 12 has a first and second pivoting surface 52,54 and the
 second member 14 has a third and fourth pivoting surface 56,58. The first
 pivoting surface 52 being in sliding contact with the third pivoting
 surface 56 and the second pivoting surface 54 being in sliding contact
 with the fourth pivoting surface 58. Third and fourth insulating coatings
 60,62 are needed on the first and second pivoting surfaces 52,54 on the
 first jaw member 12 in order to isolate the first jaw member 12 from the
 second jaw member 14. A fifth insulating coating 64 is disposed around the
 pin, rivet, or screw 24 to complete the electrical isolation of the first
 jaw member 12 from the second jaw member 14. Otherwise, all components are
 similar to, or identical with, those in FIG. 1A and are designated with
 the same reference numerals.
 Referring now to FIG. 5B, there is illustrated an instrument of the present
 invention configured with the graspers portion distal to the scissors
 portion, similar to the instrument shown in FIG. 2A. The instrument
 illustrated in FIG. 5B differs in that it replaces the conventional
 scissor pivoting means with a box-lock pivot means. This embodiment is
 similar to the embodiment shown in FIG. 5A except for the grasper portion
 being distal to the scissor portion. In a variation of this configuration,
 the first insulating coating 26 can be extended to the first pivoting
 surface 52, thereby eliminating the need for a separate fourth insulating
 coating 60. Otherwise, all components are similar to, or identical with,
 those in FIG. 2A and are designated with the same reference numerals.
 The embodiment as configured in FIGS. 1A and 1B with the scissors portion
 distal to the grasping portion is preferred for procedures that require
 cauterization of larger vessels, or groups of vessels. It is particularly
 suited for procedures requiring cauterization of vessels larger than three
 millimeter in diameter. The coagulation of ovarian vessels in an
 "Oophorectomy" is representative of such a procedure.
 The embodiment as configured in FIGS. 2A and 2B with the graspers portion
 distal to the scissors portion is preferred for those procedures requiring
 extensive blunt dissection. Procedures requiring separation of connective
 tissue to free vein and artery, such as "Pericardiectomy for Constrictive
 Pericarditis" and "Harvesting for a Free Greater Omentum Transfer" are
 examples of such procedures.
 Furthermore, there are procedures where either configuration could be used,
 and the surgeon would want a choice of either instrument.
 Mayo, Metzenbaum, and Tenotomy predetermined blade configurations have been
 discussed in relation to the present invention. However, it should be
 understood that any standard shape scissor employing a predetermined blade
 configuration now known or later developed can be employed in the present
 invention. A point of novelty, among others, thereof being the formation
 of grasping surfaces in a standard scissor shape whereby the contours,
 shape, and size of the scissor is maintained, thus preserving the same
 feel and use as the standard scissor. It should also be understood that
 any standard scissor shape used in the present invention can be configured
 in either a straight blade or curved blade configuration.
 Referring now to FIG. 6, the operating (or distal) end of the present
 invention as shown in FIGS. 1A and 1B is integral with an actuation means
 for opening and closing the jaw members 12,14 relative to each other
 resulting in an embodiment of the present invention 100a useful for open
 surgical procedures. In a preferred implementation, the actuation means
 comprises first and second conductive elongated members 102,104. Each
 elongated member having a distal end 106,108 and a proximal end 110,112.
 The first jaw member 12 being integral with the distal end 106 of the
 first elongated member 102. The second jaw member 14 being disposed on the
 distal end 108 of the second elongated member 104.
 The first elongated member 102 pivots about the second elongated member 104
 about the pivot pin, screw or rivet 24. First and second finger loops
 114,116 are provided at the proximal ends 110,112 of the elongated members
 102,104 for insertion of fingers for actuation of the jaw members 12,14
 between an open position as shown in FIG. 6 and a closed position as shown
 in FIG. 8.
 Referring back to FIG. 6, a means for supplying RF energy to the first jaw
 member 12 and RF energy of the opposite polarity to the second jaw member
 14 is accomplished by first and second conductive connectors 118,120
 disposed at the proximal ends 110,112 of the elongated members 102,104 for
 connection to a power cord (not shown).
 The power cord typically connects to an electrosurgical generator 123 which
 energizes each of the electrical connectors 118,120 with RF energy used to
 cauterize tissue. In a bipolar configuration, the first electrical
 connector 118 is supplied with RF energy having a certain polarity, while
 the second electrical connector 120 is supplied with RF energy of the
 opposite polarity.
 Since the electrical connectors 118,120, the elongated members 102,104, and
 the jaw members 12,14 are typically conductive, the RF energy is
 transported from the electrical connectors 118,120, through the elongated
 members 102,104, to the jaw members 12,14. To protect and insulate a user
 from shock, the elongated members 102,104 along with the finger loops
 114,116 are coated with an electrically insulating material 122,
 preferably nylon to prevent electrical conduction from portions of the
 instrument other than those intended. Typically, the insulating coating
 122 extends just past the pivot pin, rivet, or screw 24 leaving only the
 electrical is connectors 118,120 and most of the jaw members 12,14
 exposed. Since the first jaw member 12 is electrically isolated from the
 second jaw member 14 the RF energy supplied at electrical connector 118
 will not short with the opposite polarity RF energy supplied at electrical
 connector 120 unless tissue is present between the jaw members 12,14 to
 complete their circuit.
 Referring now to FIGS. 7A and 7B, FIG. 7A is taken along the line 7A--7A in
 FIG. 6 illustrating a sectional view of cutting edges 16,18 and the
 insulated coating 26 secured to the first cutting edge 16. Similarly, FIG.
 7B is taken along the line 7B--7B in FIG. 6 illustrating a sectional view
 of grasping surfaces 20,22 and the insulated coating 28 secured to the
 second grasping surface 22.
 The embodiment shown in FIGS. 6, 7A, 7B, and 8 can also be configured in
 the box-lock configuration shown in FIG. 5A and in any standard scissor
 configuration now known or later developed in the surgical arts.
 Furthermore, any of these configurations can be of a reusable or
 disposable nature.
 The embodiment illustrated in FIGS. 9, 10A, 10B, and 11, generally referred
 to by reference numeral 100b, in which all components similar to or
 identical with those in FIGS. 6, 7A, 7B, and 8 are designated with the
 same reference numerals, is merely modified with regard to the previous
 embodiment, in that the configuration of jaw members 12,14 is as shown in
 FIGS. 2A and 2B where the grasping surfaces 20,22 are distal to the
 cutting edges 16,18.
 The embodiment shown in FIGS. 9, 10A, 10B, and 11 can also be configured in
 the box-lock configuration shown in FIG. 5B or in any standard scissor
 configuration now known or later developed in the surgical arts.
 Furthermore, any of these configurations can be of a reusable or
 disposable nature.
 Referring now to FIGS. 12A-B to 14A-B there are illustrated plan and side
 views of three standard shaped surgical scissors, the shape of which are
 well known in the art to surgeons and others skilled in the surgical arts.
 While these well known surgical scissors have distinctive shapes, they can
 vary somewhat in scale.
 FIGS. 12A and 12B illustrate a plan and side view, respectively, of a Mayo
 surgical scissor, FIGS. 13A and 13B illustrate a plan and side view,
 respectively, of a Metzenbaum surgical scissor, and FIGS. 14A and 14B
 illustrate a plan and side view, respectively, of a Tenotomy surgical
 scissor. While the methods of the present invention are applicable to any
 standard shaped scissor having a predetermined blade configuration, they
 have been found particularly useful with the Mayo, Metzenbaum, and
 Tenotomy scissor blade configurations illustrated in FIGS. 12A-B to 14A-B.
 From the foregoing, it becomes readily apparent to one skilled in the art
 that the novel combination bipolar scissors/graspers instrument offers
 improved coaptation of vessels and decreases the number of instruments
 required in surgical procedures in which both cutting and grasping is
 required, which renders the instrument much more effective in certain
 surgical procedures and much less expensive to purchase, and to process in
 comparison with currently employed instruments. It should also be readily
 apparent that the present invention, although shown with regard to an open
 surgical instrument, it equally applicable to endoscopic versions thereof.
 Although this invention has been shown and described with respect to
 detailed embodiments thereof, it will be understood by those skilled in
 the art that various changes in form and detail thereof may be made
 without departing from the spirit and scope of the claimed invention.