Abstract:
A system and method for transmitting electrosurgical energy from a generator to an electrosurgical instrument are provided. The electrosurgical system includes a generator adapted to generate electrosurgical energy for treating tissue. The generator includes one or more active output terminals which supply energy to the tissue. The active output terminals are operatively connected to one or more active leads. The generator also includes one or more return output terminals which returns energy from the tissue. The return output terminals are operatively connected to at least one return lead. The system also includes an electrosurgical instrument operatively connected to the one or more active leads and one or more return electrodes operatively connected to one or more return leads. The system further includes an electrosurgical cable including one or more active leads and one or more return leads. The one or more active leads and one or more return leads are wound in a double helix fashion such that the electrical field along the cable is mitigated along the length thereof.

Description:
BACKGROUND 
     1. Technical Field 
     The present disclosure relates to an electrosurgical system and method for performing electrosurgical procedures. More particularly, the present disclosure relates to a system and method for detecting direct current (DC) properties (e.g., voltage and current) within an electrosurgical generator and controlling output of radio frequency treatment energy based on the measured DC properties. 
     2. Background of Related Art 
     Electrosurgery involves application of high radio frequency electrical current to a surgical site to cut, ablate, or coagulate tissue. In monopolar electrosurgery, a source or active electrode delivers radio frequency energy from the electrosurgical generator to the tissue and a return electrode carries the current back to the generator. In monopolar electrosurgery, the source electrode is typically part of the surgical instrument held by the surgeon and applied to the tissue to be treated. A patient return electrode is placed remotely from the active electrode to carry the current back to the generator. 
     In bipolar electrosurgery, one of the electrodes of the hand-held instrument functions as the active electrode and the other as the return electrode. The return electrode is placed in close proximity to the active electrode such that an electrical circuit is formed between the two electrodes (e.g., electrosurgical forceps). In this manner, the applied electrical current is limited to the body tissue positioned between the electrodes. When the electrodes are sufficiently separated from one another, the electrical circuit is open and thus inadvertent contact of body tissue with either of the separated electrodes prevents current flow. 
     Bipolar electrosurgery generally involves the use of forceps. A forceps is a pliers-like instrument which relies on mechanical action between its jaws to grasp, clamp and constrict vessels or tissue. So-called “open forceps” are commonly used in open surgical procedures whereas “endoscopic forceps” or “laparoscopic forceps” are, as the name implies, used for less invasive endoscopic surgical procedures. Electrosurgical forceps (open or endoscopic) utilize mechanical clamping action and electrical energy to effect hemostasis on the clamped tissue. The forceps include electrosurgical conductive surfaces which apply the electrosurgical energy to the clamped tissue. By controlling the intensity, frequency and duration of the electrosurgical energy applied through the conductive plates to the tissue, the surgeon can coagulate, cauterize and/or seal tissue. 
     Tissue or vessel sealing is a process of liquefying the collagen, elastin and ground substances in the tissue so that they reform into a fused mass with significantly-reduced demarcation between the opposing tissue structures. Cauterization involves the use of heat to destroy tissue and coagulation is a process of desiccating tissue wherein the tissue cells are ruptured and dried. 
     Tissue sealing procedures involve more than simply cauterizing or coagulating tissue to create an effective seal; the procedures involve precise control of a variety of factors. For example, in order to affect a proper seal in vessels or tissue, it has been determined that two predominant mechanical parameters must be accurately controlled: the pressure applied to the tissue; and the gap distance between the electrodes (i.e., distance between opposing jaw members or opposing sealing surfaces). In addition, electrosurgical energy must be applied to the tissue under controlled conditions to ensure creation of an effective vessel seal. 
     Electrosurgical procedures outlined above may utilize various tissue and energy parameters in a feedback-based control system. There is continual need to improve sensors as well as systems and method for processing the sense signals. 
     SUMMARY 
     In one embodiment, the present disclosure provides for an electrosurgical system. The system includes a direct current power supply configured to supply direct current; a radio frequency output stage electrically coupled to the direct current power supply, the radio frequency output stage configured to transform direct current into a radio frequency waveform; a direct current voltage sensor coupled to the direct current power supply and configured to measure direct current voltage; a direct current current sensor coupled to the direct current power supply and configured to measure direct current; and a controller coupled to the direct current voltage and current sensors, the controller configured to determine at least one of voltage and current of the radio frequency waveform based on the measured voltage and current of the direct current. 
     In another embodiment, the present disclosure provides for a method for delivering radio frequency energy to tissue. The method includes generating direct current at a direct current power supply; transforming direct current into a radio frequency waveform at a radio frequency output stage electrically coupled to the direct current power supply; measuring voltage and current of the direct current supplied to the radio frequency output stage; and determining at least one of voltage and current of the radio frequency waveform based on the measured voltage and current of the direct current. 
     In further embodiments, an electrosurgical system is disclosed. The system includes an electrosurgical generator having a direct current power supply configured to supply direct current; a direct current voltage sensor coupled to the direct current power supply and configured to measure direct current voltage; a direct current current sensor coupled to the direct current power supply and configured to measure direct current; and a controller coupled to the direct current voltage and current sensors. The system also includes an electrosurgical instrument coupled to the electrosurgical generator, the electrosurgical instrument including a radio frequency output stage electrically coupled to the direct current power supply, the radio frequency output stage configured to transform direct current into a radio frequency waveform, wherein the controller is configured to determine at least one of voltage and current of the radio frequency waveform based on the measured voltage and current of the direct current. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various embodiments of the present disclosure are described herein with reference to the drawings wherein: 
         FIG. 1  is a schematic block diagram of an embodiment of an electrosurgical system according to the present disclosure; 
         FIG. 2  is a front view of an electrosurgical generator according to the present disclosure; 
         FIG. 3  is a schematic block diagram of the electrosurgical generator of  FIG. 2  according to the present disclosure; 
         FIG. 4  is a flow chart of a method according to the present disclosure; and 
         FIG. 5  is a schematic block diagram of an embodiment of an electrosurgical system according to the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. 
     A generator according to the present disclosure can perform monopolar and/or bipolar electrosurgical procedures, including vessel sealing procedures. The generator may include a plurality of outputs for interfacing with various electrosurgical instruments (e.g., a monopolar instrument, return electrode, bipolar electrosurgical forceps, footswitch, etc.). Further, the generator includes electronic circuitry configured to generate radio frequency energy specifically suited for various electrosurgical modes (e.g., cutting, blending, division, etc.) and procedures (e.g., monopolar, bipolar, vessel sealing). In embodiments, the generator may be embedded, integrated or otherwise coupled to the electrosurgical instruments providing for an all-in-one electro surgical apparatus. 
       FIG. 1  is a schematic illustration of a bipolar and monopolar electrosurgical system  1  according to the present disclosure. The system  1  may include one or more monopolar electrosurgical instruments  2  having one or more electrodes (e.g., electrosurgical cutting probe, ablation electrode(s), etc.) for treating tissue of a patient. Electrosurgical energy is supplied to the instrument  2  by a generator  200  via a supply line  4  that is connected to an active terminal  230  ( FIG. 3 ) of the generator  200 , allowing the instrument  2  to coagulate, ablate and/or otherwise treat tissue. The energy is returned to the generator  200  through a return electrode  6  via a return line  8  at a return terminal  32  ( FIG. 3 ) of the generator  200 . The system  1  may include a plurality of return electrodes  6  that are disposed on a patient to minimize the chances of tissue damage by maximizing the overall contact area with the patient. In addition, the generator  200  and the return electrode  6  may be configured for monitoring so-called “tissue-to-patient” contact to insure that sufficient contact exists therebetween to further minimize chances of tissue damage. 
     The system  1  may also include a bipolar electrosurgical forceps  10  having one or more electrodes for treating tissue of a patient. The electrosurgical forceps  10  includes a housing  11  and opposing jaw members  13  and  15  disposed at a distal end of a shaft  12 . The jaw members  13  and  15  have one or more active electrodes  14  and a return electrode  16  disposed therein, respectively. The active electrode  14  and the return electrode  16  are connected to the generator  200  through cable  18  that includes the supply and return lines  4 ,  8  coupled to the active and return terminals  230 ,  232 , respectively ( FIG. 3 ). The electrosurgical forceps  10  is coupled to the generator  200  at a connector having connections to the active and return terminals  230  and  232  (e.g., pins) via a plug disposed at the end of the cable  18 , wherein the plug includes contacts from the supply and return lines  4 ,  8  as discussed in more detail below. 
     With reference to  FIG. 2 , a front face  240  of the generator  200  is shown. The generator  200  may be any suitable type (e.g., electrosurgical, microwave, etc.) and may include a plurality of connectors  250 - 262  to accommodate various types of electrosurgical instruments (e.g., electrosurgical forceps  10 , etc.). The connectors  250 - 262  may include various detection devices that can read (e.g., scan, decode, etc.) identifying information encoded or otherwise recorded on or within the plugs or cables of the instruments. The connectors  250 - 262  are configured to decode the information encoded on the plugs corresponding to the operating parameters of particular instruments allowing the generator  200  to preset energy delivery settings based on the connected instrument. In embodiments, data may be encoded in bar codes, electrical components (e.g., resistors, capacitors, etc.), RFID chips, magnets, non-transitory storage (e.g., non-volatile memory, EEPROM, etc.), which may then be coupled to or integrated into the plug. Corresponding detection devices may include, but are not limited to, bar code readers, electrical sensors, RFID readers, Hall Effect sensors, memory readers, etc. and any other suitable decoders configured to decode data. 
     The generator  200  includes one or more display screens  242 ,  244 ,  246  for providing the user with variety of output information (e.g., intensity settings, treatment complete indicators, etc.). Each of the screens  242 ,  244 ,  246  is associated with corresponding connector  250 - 262 . The generator  200  includes suitable input controls (e.g., buttons, activators, switches, touch screen, etc.) for controlling the generator  200 . The display screens  242 ,  244 ,  246  are also configured as touch screens that display a corresponding menu for the electrosurgical instruments (e.g., electrosurgical forceps  10 , etc.). The user then makes inputs by simply touching corresponding menu options. 
     Screen  242  controls monopolar output and the devices connected to the connectors  250  and  252 . Connector  250  is configured to couple to monopolar electrosurgical instrument (e.g., electrosurgical pencil) and connector  252  is configured to couple to a foot switch (not shown). The foot switch provides for additional inputs (e.g., replicating inputs of the generator  200 ). Screen  244  controls monopolar and bipolar output and the devices connected to the connectors  256  and  258 . Connector  256  is configured to couple to other monopolar instruments. Connector  258  is configured to couple to a bipolar instrument (not shown). 
     Screen  246  controls bipolar sealing procedures performed by the forceps  10  that may be plugged into the connectors  260  and  262 . The generator  200  outputs energy through the connectors  260  and  262  suitable for sealing tissue grasped by the forceps  10 . In particular, screen  246  outputs a user interface that allows the user to input a user-defined intensity setting. The user-defined setting may be any setting that allows the user to adjust one or more energy delivery parameters, such as power, current, voltage, energy, etc. or sealing parameters, such as pressure, sealing duration, etc. The user-defined setting is transmitted to the controller  224  where the setting may be saved in memory  226 . In embodiments, the intensity setting may be a number scale, such as from one to ten or one to five. In embodiments, the intensity setting may be associated with an output curve of the generator  200 . The intensity settings may be specific for each forceps  10  being utilized, such that various instruments provide the user with a specific intensity scale corresponding to the forceps  10 . 
       FIG. 3  shows a schematic block diagram of the generator  200  configured to output electrosurgical energy. The generator  200  includes a controller  224 , a power supply  227 , and an output stage  228 . The power supply  227  may be a direct current high voltage power supply and is connected to an AC source (e.g., line voltage) and provides high voltage DC power to an output stage  228 , which then converts high voltage DC power into treatment energy (e.g., ultrasonic, electrosurgical or microwave) and delivers the energy to the active terminal  230 . The energy is returned thereto via the return terminal  232 . The output stage  228  is configured to operate in a plurality of modes, during which the generator  200  outputs corresponding waveforms having specific duty cycles, peak voltages, crest factors, etc. In another embodiment, the generator  200  may be based on other types of suitable power supply topologies. 
     The controller  224  includes a microprocessor  225  operably connected to a memory  226 , which may include transitory type memory (e.g., RAM) and/or non-transitory type memory (e.g., flash media, disk media, etc.). The microprocessor  225  includes an output port that is operably connected to the power supply  227  and/or output stage  228  allowing the microprocessor  225  to control the output of the generator  200  according to either open and/or closed control loop schemes. Those skilled in the art will appreciate that the microprocessor  225  may be substituted by any logic processor (e.g., control circuit) adapted to perform the calculations discussed herein. 
     A closed loop control scheme is a feedback control loop, in which a plurality of sensors measure a variety of tissue and energy properties (e.g., tissue impedance, tissue temperature, output power, current and/or voltage, etc.), and provide feedback to the controller  224 . The controller  224  then signals the power supply  227  and/or output stage  228 , which then adjusts the DC and/or power supply, respectively. The controller  224  also receives input signals from the input controls of the generator  200 , the instrument  2  and/or forceps  10 . The controller  224  utilizes the input signals to adjust power outputted by the generator  200  and/or performs other control functions thereon. 
     The generator  200  according to the present disclosure includes an RF voltage sensor  300  and an RF current sensor  302 . The RF voltage sensor  300  is coupled to the active and return terminals  230  and  232  provides measurements of the RF voltage supplied by the output stage  228 . The RF current sensor  302  is coupled to the active terminal  230  and provides measurements of the RF current supplied by the output stage  228 . The RF voltage and current sensors  230  and  232  may be any suitable RF voltage/current sensor including, but not limited to, sense transformers, sense resistors, sense capacitors, and combinations thereof. The RF voltage and current sensors  300  and  302  provide the sensed RF voltage and current signals, respectively, to the controller  224 , which then may adjust output of the power supply  227  and/or the output stage  228  in response to the sensed RF voltage and current signals. 
     The generator  200  according to the present disclosure also includes a DC voltage sensor  304  and a DC current sensor  306 . For simplicity, the power supply  227  is shown schematically being coupled to the output stage  228  via a connection  301 . Those skilled in the art will appreciate that the power supply  227  is connected with its positive and negative terminals (not shown) to the output stage  228 . The DC voltage and current sensors  304  and  306  are coupled to the connection  301  and provide measurements of the DC voltage and current supplied to the output stage  228  by the power supply  227 . The DC voltage and current sensors  304  and  306  may be any suitable DC voltage/current sensor including, but not limited to, Hall Effect sensors, sense resistors, and combinations thereof. The DC voltage and current sensors  304  and  306  provide the sensed DC voltage and current signals, respectively, to the controller  224 , which then may adjust output of the power supply  227  and/or the output stage  228  in response to the sensed DC voltage and current signals. 
     The output stage  228  may be embodied as any suitable RF inverter power supply topology including, but not limited to, half bridge, full bridge, push pull, and combinations thereof. In embodiments, the output of the output stage  228  may be any amplitude-modulated RF waveform generated by varying DC voltage of the power supply  227 . The generator  200  adjusts the RF output of the output stage  228  based on the sensed signals as measured by either the DC voltage and current sensors  304  and  306  and/or the RF voltage and current sensors  300  and  302 . 
     The controller  224  includes a transfer function that correlates the sensed DC voltage and current signals to the sensed RF voltage and current signals. In particular, the operating parameters of the output stage  228  may be expressed as a transfer function, which may be used to calculate output RF voltage and current based on the sensed DC voltage and current signals. The transfer function may be used to compensate for the loss and/or distortion introduced between the output stage  228  and the load. These non-ideal behaviors can be impacted by many different factors including input voltage, input current, output voltage, output current and load impedance. One way to characterize these behaviors may include analysis of the generator  200  at different open loop operating points while monitoring the input and/or output characteristics, namely, DC voltage and current and RF output voltage and current. This data may then be used to generate a polynomial curve fit and/or piecewise linear curve. The curves are then transposed to a transfer function that describes the relationship between the DC voltage and current and the output RF voltage and current thus providing the transfer function. The process to obtain the transfer function may be performed during initial setup of the generator  200  on a unit-by-unit basis or for any specific lot and then preprogrammed and stored in memory  226 . 
     Thus, the controller  224  determines the output RF voltage and current based on the sensed DC voltage and current signals. The calculated output RF voltage and current may then be compared with actual sensed RF voltage and current as a redundant measurement (e.g., to verify functionality of the sensors  300 ,  302 ,  304 , and  306 ). 
       FIG. 4  illustrates a method in accordance with the present disclosure. In step  400 , DC voltage and current outputted by the power supply  227  are measured by the DC voltage and current sensors  304  and  306 , respectively. The measured sensor signals are transmitted to the controller  224 . In step  402 , the controller  224  calculates the output RF voltage and current based on the sensed DC voltage and current values. In particular, the controller  224  (e.g., the microprocessor  225 ) utilizes a transfer function that correlates the sensed output DC values with output RF values. 
     In step  401 , RF voltage and current outputted by the output stage  228  are measured by the RF voltage and current sensors  300  and  302 , respectively. The measured sensor signals are transmitted to the controller  224 . In step  403 , the controller  224  compares measured RF output values with the calculated the RF voltage and current based on the sensed DC voltage and current values. The difference between calculated RF values and measured RF values may be used to determine functionality of the generator  200 , such that if the difference between the measured and calculated RF values varies by a predetermined amount an error is issued resulting in stoppage and/or adjustment of the power output. The difference between calculated and measured RF values which triggers an error condition may be from about 10% and above, in embodiments, from about 20% and above. 
     In step  405 , the controller  224  may utilize the comparison to determine dosage error in delivery of output power. The term “dosage error” as used herein denotes a difference between preset output power (e.g., user or generator selected) and delivered output power. The difference may be due to a variety of factors (e.g., malfunctioning power generating components, sensors, etc.). The dosage error, e.g., difference between preset power and calculated RF values based on measured DC values and/or actual measured RF values may be from about 10% and above, in embodiments, from about 20% and above. The dosage error calculation determines the functionality (or malfunction) of the sensors  300 ,  302 ,  304 , and  306 . Thus, if the dosage error is outside a desired limit, in step  405 , the controller  224  may issue an alarm and/or terminate the output of the generator  200 . 
     In step  404 , the controller  224  signals the power supply  227  and/or the output stage  228  to adjust its output in response to an algorithm or other instructions for controlling the output of the generator  200  including differences calculated in steps  403  and  405 . 
       FIG. 5  illustrates another embodiment of an electrosurgical system  500 . The system  500  includes a generator  502 , which is similar to the generator  200  described above with respect to  FIGS. 2 and 3 . The generator  502  is coupled to the forceps  10 , which is shown for illustrative purposes only, and any other electrosurgical instrument may be utilized. The system  500  decouples the output stage  228  from the generator  502 . The output stage  228  is instead disposed in the housing  11  of the forceps  10 . The generator  502  also does not include RF voltage and current sensors  300  and  302 , which allows for significant miniaturization of the output stage  228  and repositioning thereof into the housing  11 . This significantly simplifies the hardware design for the electrosurgical system  500 . 
     Calculation of output RF values based on measured DC signals also simplifies hardware and software requirements of electrosurgical generators, which usually perform intensive root mean square calculations. Further, this configuration obviates the need to include sensors at the high voltage side of the generator, allowing for use of components with a lower voltage rating. 
     While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.