Patent Publication Number: US-2022226036-A1

Title: Multi-functional surgical cautery device, system and method of use

Description:
RELATED APPLICATION 
     This application is related to, incorporates by reference, and hereby claims the priority benefit of U.S. Provisional Patent Application No. 61/661,459, filed Jun. 19, 2012 by the present inventor. 
    
    
     TECHNICAL FIELD 
     The present invention relates to a surgical device, system, and method of use and, more particularly, to an endoscopic, minimally-invasive, multi-functional, modular cautery device, system, and method of use. 
     BACKGROUND 
     Endoscopic, minimally invasive, surgery relies on instrumentation for achieving hemostasis and surgical outcomes comparable to traditional open surgery techniques via comparatively small corridors, or ports, (e.g., nostrils or keyholes) within a patient. As yet, conventionally used bipolar cautery forceps have not been effectively translated into a functional instrument for use through the smaller corridors of this minimally invasive surgery. Presently used bipolar cauterization instruments suffer from limited mobility and visualization within the smaller corridors of minimally-invasive surgery and are difficult to use due to the relatively poor depth perception and stereoscopic vision offered within those corridors. 
     SUMMARY 
     A surgical cautery device, system, and method of use are herein described. The device is a modified method of applying bipolar and/or sesquipolar electrocautery to target tissue via a pair of instruments that retain other primary surgical functions. The device may include a first and second element. The second element may be independently positionable with respect to the first element. The first and second elements include a surgical component and may be capable of forming an electrical circuit. The surgical component may be made from an electrically conductive material, such as stainless steel. Exemplary surgical components include a cutting tool, rotary blade, grasper tool, micro-grasping forceps tool, ring curette, dissector or micro-dissector, micro-scissors tool, and a suction cannula, although a wide variety of insulated surgical instruments may be incorporated into this system. The surgical components are interchangeable, and can therefore be used in any combination to provide cautery application and increase efficiency of the operation. For example, when one surgical component is a suction cannula, it may be interchangeable with a cutting tool, a rotary blade, a grasper tool, a micro-scissors tool, a micro-grasping forceps tool, a dissector, a micro-dissector, or another suction cannula. 
     In many instances, the first and second elements are configured to contact a target tissue of a patient and, upon completion of the electrical circuit, deliver electrical energy to the target tissue. Often times, the delivery of the electrical energy to the target tissue acts to cauterize the target tissue. 
     Often times, a tip of the first and second elements may be electrically conductive while a portion of the first and second elements are electrically insulated from the tip. The first element and the second element may approach the target tissue through, for example, a conventional type of surgical opening, a single port (e.g., an endoscopic or microsurgery port), or a plurality of separate ports in the patient and may be configured to be manipulated by, for example, by a human surgeon and/or a robot. 
     Another exemplary device includes an electrically conductive wire that is electrically connected to an electrically insulated element. The electrically insulated element may include an electrically conductive surgical component. The surgical component may be capable of delivering electrical energy to a target tissue of a patient via the electrically conductive wire. 
     Exemplary systems consistent with embodiments of the present invention may include a source of electrical energy electrically coupled to the first and second elements. The second element may be independently positionable with respect to the first element. The first and second elements may have a surgical component and may be capable of forming an electrical circuit and delivering electrical energy from the source to a target tissue of a patient upon completion of the electrical circuit. The systems may deliver, for example, cautery, sesquipolar cautery, and/or bipolar cautery. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention is illustrated by way of example, and not limitation, in the figures of the accompanying drawings in which: 
         FIG. 1  depicts an exemplary surgical system, consistent with embodiments of the present invention; 
         FIGS. 2A-2D  depict exemplary first and/or second elements, consistent with embodiments of the present invention; 
         FIG. 2E  depicts various exemplary surgical components, consistent with embodiments of the present invention; 
         FIGS. 3A-3C  depict various exemplary sets of surgical components, consistent with embodiments of the present invention; and 
         FIG. 4  illustrates an exemplary use of first and second elements, consistent with embodiments of the present invention. 
     
    
    
     WRITTEN DESCRIPTION 
     Electrosurgical devices apply a high-frequency electric current to biological target tissue to cut, coagulate, or desiccate the target tissue or at least a portion of the target tissue. Electrosurgical devices use a generator (e.g., power supply or waveform generator) and a hand piece including one or several electrodes. Electrosurgery techniques are used in, for example, dermatological, gynecological, cardiac, plastic, ocular, spine, ear, nose, and throat (ENT), maxillofacial, orthopedic, urological, neuro- and general surgical procedures as well as certain dental procedures. 
     One of the benefits of modern endoscopic surgery is the ability to work through two or more ports, via a bimanual and/or robotic approach. Rather than constrain the size and mobility of a cautery device to one port, one embodiment of the current surgical system proposes a novel electrocautery technique, in which two separate “electrodes” of the system are also independently insulated modular devices with their own functional purpose (e.g., micro-grasping forceps, suction cannula, micro-scissors, dissectors, micro-dissectors, etc.). These dually-functioning components of the cautery system can manipulate target tissue with much greater mobility and visualization, and independently transmit opposing current from one electrode to another in order to achieve a sesquipolar or bipolar cautery effect (depending on, for example, the size and surface area of the conducting electrode surfaces) from one electrode to the other. Rather than functionally diverge near the tip of the forceps, as current models for endoscopic bipolar forceps propose, the current invention has two separate electrodes with dual function as another surgical device. The two electrodes diverge outside of the patient rather than within the surgical cavity, and are connected to each other and a power supply via wiring in order to appropriately transmit opposing high-frequency current to contacted target tissue. Each functional electrode/element of the electrocautery device may be insulated with respect to the surgical component, so that current will only be transmitted selectively from one surgical component to the other. The modular devices can be connected and disconnected to, for example, standard wires used with power supplies, such as bipolar electro cautery generators, and may be used in various combinations (e.g., suction cannula and micro-scissors or micro-grasping forceps and micro-scissors). Current may be activated via any conventionally available means, such as with a foot pedal in a manner similar to existing bipolar devices. 
     The present invention provides increased mobility and visualization in cauterizing the surgical target when compared with conventional techniques, by, for example, allowing two or more elements with surgical components to approach target tissue from different depths, angles, and/or ports. Each surgical component may have independent, interchangeable, and/or functional properties (i.e., cutting, grasping, dissection, sucking, probing, etc.), thus allowing a surgeon to manipulate delicate surgical target tissue as it is cauterized in an efficient manner. In addition, according to the present invention, the size of a surgical opening within a patient (i.e., port) need only accommodate one surgical component, which, in many cases, is smaller than traditionally used cauterizing forceps. 
     The present invention further allows a surgeon to perform surgical operations and cauterize with the same surgical components, thereby reducing the need to remove surgical devices from the patient and subsequently insert a separate cauterization device. Thus, utilization of the present invention increases surgical efficiency and potentially reduces the risk of infection or damage to surrounding anatomical structures that may be caused by repeatedly removing and inserting devices. 
     The present invention is more particularly described with regard to the exemplary embodiments depicted in the figures that accompany the instant patent application. For example,  FIG. 1  depicts an exemplary surgical system  100  consistent with some embodiments of the present invention. Surgical system  100  may include a power supply  150 , a power cord  155 , and an activation device  160 . Power supply  150  may be coupled to a first element  110  and a second element  120  via an electrical connector  145  (e.g., banana clip) electrically coupled to an electrically conductive wire  130 . Power supply  150  may be any device capable of supplying electrical power, or current, to first and second elements  110  and  120  upon user selection of activation device  160 . Activation device  160  may be any conventionally available means for initiating the delivery of electricity to first element  110  and/or second element  120  including, but not limited to, a foot petal, a button, or a dial. In some embodiments, an amount of power delivered to first and/or second elements  110  and  120  may be controlled by manipulation of activation device  160  (e.g., twisting a dial) in order to deliver a maximum level of power, or a fraction thereof, to first and/or second elements  110  and  120 . 
     First and second elements  110  and  120  may be configured to deliver electrical energy  165  from power supply  150  to a contacted, or target, portion of tissue within a patient via surgical components  115  and/ 125 . Exemplary target tissue includes a small blood vessel in need of cauterization, tumor, or other undesirable tissue to be removed from the patient. First and second elements  110  and  120  may be configured to be manipulated by a human surgeon and/or a robot and, on some occasions, may be configured to be used in microscopic or endoscopic single or multiple port surgery. In some embodiments, a portion of first and second elements  110  and  120 , with the exception of a first and second surgical components  115  and  125 , respectively, may be covered in electrical insulation  135  or may be otherwise insulated. In this way, only surgical components  115  and/or  125  may deliver electrical energy from power supply  150  to contacted tissue. Electrical insulation  135  may be any appropriate electrically insulating material including, but not limited to, plastic, vinyl, epoxy, parylene, or ceramic and may enable a surgeon to grasp and/or hold first and second elements  110  and  120  via, for example, graspers  140 . First and/or second elements  110  and  120  as well as surgical components  115  and/or  125  may be disposable (i.e., one time use), or reusable (i.e., capable of being used multiple times). 
     On some occasions, first and second surgical components  115  and  125  may be similarly configured to one another with regard to shape and size and, in some instances, may comprise a matched pair of components. On other occasions, first surgical component  115  may be configured to perform a first function in addition to the conduction of electricity and second surgical component  125  may be configured to perform a second function in addition to the conduction of electricity. For example, first surgical component  115  may be configured to be operable by a robot while second surgical component  125  may be configured to be operable by a human surgeon. Additionally, one or both surgical components  115  and/or  125  may include one or more controls (not shown) that enable a manipulator of the surgical component (e.g., human surgeon or robot) to control the operation of the surgical component. 
     First and second elements  110  and  120  and/or first and second surgical components  115  and  125  may configured to be independently positionable by a human surgeon and/or a robot. In this way movement of, for example, first element  110  does not impact the position of second element  120 . Likewise, on some occasions, movement of first surgical component  115  may not impact the position or functioning of second surgical component  125 . In this manner, first and second elements  110  and  120  and/or first and second surgical components  115  and  125  may be moved independently within a patient and/or prior to entry into a patient to, for example, contact target tissue from different angles or enter different ports within a patient and/or perform different functions (in addition to the delivery of electricity) within the patient with regard to the target tissue. 
     In some embodiments, first and second elements  115  and  125  may be interchangeable with other elements via any known method. For example, first and/or second element  115  and/or  125  may be interchangeable at power supply  150  via extraction of electrical connector  145  coupled to first or second element  115  or  125  from power supply  150  and insertion of another electrical connector compatible with power supply  150  (not shown) electrically coupled to another element (not shown) into power supply  150 . In this way, for example, micro-scissors element  115 / 125  as depicted in  FIG. 2A  (described below) may be interchanged with suction cannula element  115 / 125  as depicted in  FIG. 2D  (described below). Additionally or alternatively, surgical components  115  and/or  125  may be interchangeable with other surgical components via any conventionally available means, including, but not limited to, unscrewing or otherwise decoupling surgical component  115  and/or  125  from first and/or second elements  110  and  120 . For example, a surgical component  115  or  125  may be removed from element  110  or  120 , respectively, and another surgical element may be attached to the first or second element  110  or  120 . 
       FIGS. 2A-2D  depict exemplary first and/or second elements  110 / 120 . In  FIG. 2A , first and/or second element  110 / 120  is configured as a micro-scissors tool, wherein graspers  140  are embodied as scissor handles, the shaft of the micro-scissors tool is encased in insulation  135  and surgical component  115 / 125  is an electrically conductive set of micro-scissors. In  FIG. 2B , first and/or second element  110 / 120  is also configured as a micro-scissors tool, wherein the entire first and/or second element  110 / 120 , with the exception of surgical component  115 / 125 , is covered with insulation  135 . In  FIG. 2C , first and/or second element  110 / 120  is configured as a probe, wherein surgical component  115 / 125  is a surgical probe. In  FIG. 2D , first and/or second element  110 / 120  is configured as a suction tool, wherein surgical component  115 / 125  is a suction cannula.  FIG. 2E  depicts various exemplary surgical components  115 / 125 , wherein surgical component  115 A/ 125 A is a suction cannula, surgical component  115 B/ 125 B is a grasper, surgical component  115 C/ 125 C is a set of micro-scissors, and surgical component  115 D/ 125 D is a probe. 
     In some embodiments, first and second surgical components may be similar to, or different from, one another. For example,  FIGS. 3A-3C  depict various exemplary sets of surgical components  115  and  125  as provided by various embodiments of the present invention. As depicted in  FIG. 3A , first and second surgical components  115 B and  125 B are configured as grasping elements that enable a surgeon to grasp and manipulate target tissue as well as cauterize the target tissue. As depicted in  FIGS. 3B and 3C , surgical components  115  and  125  are configured differently from one another. In the embodiment depicted in  FIG. 3B , surgical component  115 A is configured as a suction device and surgical component  115 B is configured as a grasping component. A surgeon utilizing first and second elements  110  and  120  of this embodiment would thus be enabled to grasp target tissue, suck material (e.g., blood, bone, and/or target tissue) from the patient, and cauterize target tissue while, for example, suctioning smoke resulting from cauterization to improve visualization. In the embodiment depicted in  FIG. 3C , surgical component  115 B is configured as a grasping tool and surgical component  115 C is configured as a micro-scissors tool. A surgeon utilizing first and second elements  110  and  120  of this embodiment would thus be enabled to grasp, cut, and cauterize target tissue without requiring removal or insertion of any additional devices. 
       FIG. 4  illustrates an exemplary use of first and second elements  110  and  120  following insertion into two ports of a patient to contact target tissue  405 . In this embodiment, first element  110  is inserted into a first port within the right nostril of a patient and second element  120  is inserted into a second port within the left nostril of the patient. In this way, first and second elements may approach target tissue  405  from different angles and may move independently of one another. Following insertion of first and second elements  110  and  120  into the first and second ports within the patient, the delivery of electricity may be initiated via user selection of activation device  160  of power supply  150  thereby forming an electrical circuit. Following activation, electrical power may be delivered to first and/or second elements  110  and/or  120  and, upon contact of surgical components  115  and  125  with target tissue, electrical energy  165  may be delivered to the target tissue, thereby cauterizing the target tissue. The same application could be used for multi-port surgery in the abdomen, thorax, or any other surgical site where one or multiple access ports or corridors are utilized. 
     Hence, an endoscopic multi-port bipolar cautery device, system, and method of use have been herein described.