Source: http://www.google.com/patents/US6267761?dq=6,891,551
Timestamp: 2017-10-19 07:46:37
Document Index: 628850190

Matched Legal Cases: ['art 25', 'art 25', 'art 49', 'art 50', 'art 35', 'art 36', 'art 48', 'art 25']

Patent US6267761 - Apparatus and method for sealing and cutting tissue - Google Patents
An axial elongate bipolar tissue sealer and method of use by a surgeon for electrosurgery on tissue has a handle. A tube may move axially relative to a chassis on the handle. The effector provides bipolar electrosurgery. A member extending from the distal end is opposite the patient end of the tube....http://www.google.com/patents/US6267761?utm_source=gb-gplus-sharePatent US6267761 - Apparatus and method for sealing and cutting tissue
Publication number US6267761 B1
Application number US 08/925,805
Also published as DE69832391D1, DE69832391T2, DE69841834D1, EP1011492A1, EP1011492A4, EP1011492B1, EP1586279A2, EP1586279A3, EP1586279B1, EP1586280A2, EP1586280A3, EP1586280B1, US6932810, US7270660, US20050101965, US20060020265, US20080004616, WO1999012487A1
Publication number 08925805, 925805, US 6267761 B1, US 6267761B1, US-B1-6267761, US6267761 B1, US6267761B1
Inventors Thomas Patrick Ryan
Patent Citations (86), Non-Patent Citations (7), Referenced by (427), Classifications (11), Legal Events (6)
Apparatus and method for sealing and cutting tissue
US 6267761 B1
An axial elongate bipolar tissue sealer and method of use by a surgeon for electrosurgery on tissue has a handle. A tube may move axially relative to a chassis on the handle. The effector provides bipolar electrosurgery. A member extending from the distal end is opposite the patient end of the tube. A part on the member is transverse to the axis to conduct electrosurgery. First and second bipolar electrodes on the effector and part are electrically isolated. A generator for bipolar electrosurgery supplies the electrodes. An activator is movably supported on the handle connects to the tube and/or chassis to axially move the patient end and its effector relative to the part. Tissue and bodily fluid therebetween are sealed through application of compression and bipolar electrosurgery between the first and second electrodes. The effector and the part have complimentary sealing surfaces for partial mating engagement upon axial movement toward one another. The effector and the part can be removably attached to the distal end or member, respectively.
1. An elongate bipolar tissue sealer for application by a surgeon of electrosurgical energy to the tissue and bodily fluids of a patient, the sealer comprising:
a handle for holding and manipulation by the surgeon;
a chassis carried on the handle extending distally relative to the handle, the chassis having a handle end and a distal end disposed along the axis;
a tube carried for axial movement relative to and along the chassis and the handle, the tube elongate relative to the chassis, the tube having a surgeon end and a patient end disposed along the axis thereof;
an effector on the patient end in position to first contact tissue upon movement of the tube relative to the chassis and axially away from the handle by the surgeon, the effector of a material for conducting electrosurgical energy;
a member supported by the distal end of the chassis extending past the patient end of the tube;
a part on the member at the distal end thereof, the part transversely located relative to the axis in position opposite the patient end, the part of a material for conducting electrosurgical energy;
a first bipolar electrosurgical electrode electrically connected to the effector of the patient end;
a second bipolar electrosurgical electrode electrically connected to the part, the second bipolar electrosurgical electrode electrically isolated from the first bipolar electrosurgical electrode;
an electrosurgical generator electrically coupled to the first and second electrosurgical electrodes, the electrosurgical generator for selectively supplying bipolar electrosurgical energy to the first and second bipolar electrosurgical electrodes;
a mechanical activator movably supported on the handle for use by the surgeon, the activator connected to the tube, the activator for axially moving the patient end and the effector thereof toward from the part so that tissue and bodily fluid therebetween may be sealed between the effector and the part through the application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes.
2. The bipolar tissue sealer of claim 1 wherein the mechanical activator is connected to the chassis for relative movement of the tube and chassis.
holding and manipulating a handle;
a tube extending axially along an axis and carried on a chassis supported by the handle;
moving the tube relative to the handle along the axis, the chassis having a handle end and a distal end;
carrying the tube telescopically with the chassis for axial movement relative thereto and along the axis, the tube elongate relative to the chassis, the tube having a surgeon end and a patient end disposed along the axis thereof;
contacting tissue upon movement axially of an effector on the patient end with movement away from the handle and controlled by the surgeon, the chassis having a member extending from the distal end having a part in position opposite the patient end of the tube and transverse relative to the axis and on the member;
providing a first bipolar electrosurgical electrode coupled to the effector of the patient end and a second bipolar electrosurgical electrode coupled to the part;
electrically isolating the first bipolar electrosurgical electrode from the second bipolar electrode;
coupling electrically to an electrosurgical generator, the first and second bipolar electrosurgical electrodes;
providing movement of the patient end and the effector relative to the part thus sealing tissue and bodily fluid therebetween the effector and the part through the application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes during use by the surgeon of a mechanical activator connected for relative movement of the tube or chassis.
14. The method of claim 13 wherein the first and second electrosurgical electrodes include complimentary sealing surfaces and the method further comprises the step of mating and engaging the complimentary sealing surfaces about tissue upon axially moving the first and second electrodes toward one another along the axis.
This relates to an apparatus and method for cutting and sealing blood vessels or tissue using a bipolar linear travel device that compresses the tissue or vessel and then RF power is applied to seal the tissue and cut the tissue.
In order to seal blood vessels during surgery, for the purpose of defunctionalizing the vessels or to halt or prevent bleeding, radiofrequency (RF) energy can be applied to the vessel structure instead of staples or clips. Traditionally, forceps are used to create a single seal per application with bipolar RF energy. Normally, forceps that have a hinge between the tines that press against either side of the vessel are clamped about tissue and power is applied. Problems are sometimes encountered with this technique because of the forceps bending or the lack of parallelism between the tines thus affecting how the tissue or vessel is compressed and sealed.
An axially elongate bipolar tissue sealer or cutter for application of electrosurgical energy by a surgeon to the tissue and bodily fluids of a patient preferably has a handle for holding and manipulation by the surgeon. A chassis carried on the handle may extend axially relative to the handle and away from the surgeon. The chassis may be moveable to and from the handle along the axis. The chassis may have a handle end and a distal end. A tube could be carried for axial movement relative to or along the chassis. The tube is elongate relative to the chassis and has a surgeon end and a patient end disposed along its axis in the preferred embodiment.
FIG. 1 is a perspective view of an elongated tubular bipolar tissue sealer or cutter for application by a surgeon of electrosurgical energy to the tissue, the sealer or cutter slides along its axis with an internal, concentric sliding portion for axially bring together the end effectors.
FIG. 2 is a view in cross section as would be seen along lines 2—2 in FIG. 1.
FIG. 1 is a perspective view of an elongate tubular bipolar tissue sealer or cutter 10 for application by a surgeon of electrosurgical energy to tissue. A handle 11, for holding and manipulation by the surgeon, is on a proximal end 12 of the elongate bipolar tissue sealer or cutter 10. The handle 11 has both first and second handle grips 13 and 14, respectively. A chassis 15, carried on the handle 11 by mechanical connection with the first handle grip 13, extends axially along axis “A” relative to the handle 11 and away from the surgeon a distance adequate to reach the patient's operative site. The chassis 15 is comprised of at least two parts. The first is an outer tube 16 which extends from the handle 11 along the axis “A.” The outer tube 16 is fixed on the chassis 15. The second part is a member or chassis extension 17 extending from a patient end 18 of the outer tube 16, also along the axis “A.” An inner tube 19 is moveable to and from the handle 11 in the preferred embodiment. The inner tube 19 is guided along the axis “A.” The inner tube 19 connects to the second handle grip 14 for surgeon access. A distal end 20 is on the inner tube 19 and faces the operative site. The elongate tubular sealer or cutter 10 thus in part slides along its axis “A” with inner tube 19 which is an internal, concentric slider to axially bring together end effectors 21 and 22. Inner tube 19 is telescopically carried, in the preferred embodiment, on the chassis 15 for axial movement relative to and therealong. The inner tube 19 moves relative to the chassis 15, a surgeon end 23 and the distal end 20 which are disposed along the axis “A” thereof as shown in FIGS. 1 and 3. FIG. 2 is a view of the inner and outer tubes 19 and 16 in cross section as would be seen along lines 2—2 in FIG. 1. The preferred outer and inner tubes 16 and 19 are metallic and thus should be insulated from each other and from the user by a coating 19′ as seen in FIG. 2.
End effector 21 on the distal end 20 is in position to contact tissue upon movement axially away from the handle 11 by the surgeon's manipulation of second handle grip 14. FIG. 3 is a side view of the reusable elongate tubular structure of FIG. 1 with both of the various end effectors 21 and 22 shown from the side. The effector 21 and 22 are made of materials for conducting electrosurgical energy such as metal, conductive polymer or ceramic. The end effector 22 has member (jaw member) 24 supported by the chassis extension 17 normal thereto in position opposite the patient end 20 of the inner tube 19. A part 25 on the member 24 thereof is transversely located relative to the axis “A” in FIG. 1. The end effectors 21 and 22 are thus opposed for engagement upon relative axial displacement of the inner tube 19 and/or chassis 15. FIG. 4 is a side view of a disposable elongate tubular structure of FIG. 1 with one of the various end effectors 21 and 22 shown from the side in FIG. 3. As shown in FIG. 3 the chassis extension 17, member 24, and part 25 are made for conducting electrosurgical energy. Of course, insulation can be added as needed to direct the bipolar electrosurgery to the space between the end effectors 21 and 22.
The end effectors 21 and 22 include complimentary sealing or cutting surfaces 33 and 34 for partial mating engagement upon their axial movement toward one another along the axis “A.” FIG. 13 illustrates end effectors 21 and 22 or the conjugating jaws of FIG. 5 with a vessel therebetween prior to sealing. Similarly, FIG. 14 illustrates end effectors 21 and 22 or the conjugating jaws of FIG. 5 with a vessel therebetween during sealing. The end effectors 21 and 22 could be removably attached to the member 24 and/or the inner tube 19, respectively. FIG. 15 is a partial enlarged view of the end effectors 21 and 22 of FIG. 1 viewed from the side with an open vessel clamped therebetween during the method or process of sealing. The partial mating complimentary surfaces 33 and 34 in FIG. 8 are curvelinear for providing more tissue contacting area than flat surfaces of the same width would. In FIG. 8 the end effectors 21 and 22 have conjugating complimentary surfaces 33 and 34 that nest configured with a pedistaled male part 49 and a mating U shaped female part 50 for the jaws. FIG. 9 is an enlarged top view of end effectors 21 and 22 showing conjugating surfaces that nest with a male part 35 terraced and a female part 36 shaped to fit as jaws. FIG. 10 is an enlarged top view of end effectors 21 and 22 showing conjugating surfaces that nest with a pair of upstanding ribs 38 and a complimentary pair of kerfs 37 as the jaws. FIG. 11 is an enlarged top view of the end effectors 21 and 22 showing conjugating surfaces that nest with a single upstanding rib 39 and a complimentary kerf 40 as the jaws. FIG. 12 is an enlarged top view of end effectors 21 and 22 showing conjugating surfaces that nest with a pair of upstanding opposite ribs 41 and complimentary opposed kerfs 42 wherein therein one rib 41 is on each of the end effectors 21 and 22 across from its complimentary kerf 42 on the opposite end effectors either 21 or 22.
Any complimentary mating curvelinear jaws even “S” shaped or those shown in FIG. 1 could be arranged to provide more surface area for contact than the flat surfaces defined by the cords thereacross. FIG. 5 is an enlarged top view end effectors 21 and 22 showing conjugating surfaces 33 and 34 that nest with V shaped complimentary jaws 43 and 44. FIG. 6 is an enlarged top view of end effectors 21 and 22 showing conjugating surfaces 33 and 34 that nest with a rib 45 and a channel 46 as complimentary jaws. FIG. 7 is an enlarged top view of end effectors 22 and 23 showing conjugating surfaces 33 and 34 that nest with a male part pedistaled 47 and V shaped female part 48 as complimentary jaws.
The partial mating complimentary surfaces 33 and 34 might be parallel but skewed to axis “A” as in FIG. 15 to provide elongate contact with axial movement between the inner tube 19 and chassis 15 thus keeping the size of the laparoscopic portal through which the end effectors 21 and 22 must pass to a minimum transverse dimension. The partial mating complimentary surfaces 33 and 34 could be substantially flat as in FIGS. 3 and 4. The partial mating complimentary surfaces 33 and 34 may be circular sections such as appear in FIGS. 1 and 8. The partial mating complimentary surfaces 33 and 34 might be elliptical and thus similar to FIGS. 1 and 8 with the curvatures being a part of an ellipse instead of a circle. Because of the perspective showing in FIG. 1, the observable differences in such an illustration between a circle and an ellipse can not be perceived. The partial mating complimentary surfaces 33 and 34 could also be triangular as in FIGS. 5, 7, 13 and 14. The partial mating complimentary surfaces 33 and 34 may include at least one conjugating rib and slot as in FIGS. 6 and 11. The partial mating complimentary surfaces 33 and 34 could include several ribs as in FIGS. 10 and 12.
A method of applying the elongate tubular bipolar tissue sealer or cutter 10 along an axis “A” includes use by a surgeon to deliver bipolar electrosurgical energy to the tissue and bodily fluids of a patient. The method has the steps of holding and manipulating the handle 11 by the surgeon. Extending axially inner tube 19 and/or the chassis 15 carried on the handle 11 away from the surgeon is a step. The method can have the step moving the inner tube 19 relative to the chassis 15 along the axis “A.” Carrying inner tube 19 for axial movement relative to and along the chassis 15 is a step of the preferred method. The method step includes positioning end effector 22 on the patient end 18 to first contact tissue upon movement axially of the inner tube 19 by the surgeon. Using a supported member 24 the chassis 15 is a step of the method. The method may have the step of using a part 25 located transversely relative to the axis “A” and on the member 24.
The method may have the steps of applying the provided end effectors with partially complimentary sealing or cutting surfaces 33 and 34, and partially mating engagement of the complimentary sealing or cutting surfaces 33 and 34 upon axial movement toward one another along the axis “A.” FIG. 16 is a perspective illustration of a sealed vessel 51 as a consequence of performing the method to form seal 52. The method might use the step of choosing to removably attach the end effectors 26 and 27, inner tube 19 and the chassis 15, respectively. The method has the step of using partially mating the complimentary surfaces 33 and 34 engagable along curvelinear paths for providing more tissue contacting area than between flat surfaces. The method has the step of using the partially mating the complimentary surfaces 33 and 34 preferably parallel along a plane skewed to the axis “A” to provide elongate contact with axial movement between the inner tube 19 and chassis 15.
The preferred elongate tubular bipolar tissue sealer or cutter 10 for application of electrosurgical energy to tissue by a surgeon as covered in the claims that follow has structure that slides along its axis “A” with an internal, concentric sliding portion. The inner or inside sliding tube 19 is attached to the proximal end effector 21 and the external fixed tube or chassis 15 connects to the distal end effector 22 in the preferred embodiment. The two end effectors 21 and 22 are matched so that the distal end effector 22 fits snugly against the proximal end effector 21. These end effectors 21 and 22 can be any of a number of conjugating shaped pairs including triangular, spherical, rectangular, with or without a notch. The notch is not just for alignment but also may define a sharp edge to sever the tissue or vessel by application of a pulse of high-power RF to the clamped site of tissue in between the end effectors 21 and 22. In the preferred embodiment, the handle 11 is squeezed so the inner tube 19 slides away the user and the chassis 15 is fix in relation to the inner tube 19 as the end effectors 21 and 22 act on the tissue therebetween. Of course it can be reversed so the chassis 15 moves and the inner tube 19 is fixed.
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U.S. Classification 606/50, 606/41, 606/32
Cooperative Classification A61B2018/0063, A61B2018/00601, A61B2018/00702, A61B2018/145, A61B2018/00875, A61B18/1442
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:RYAN, THOMAS PATRICK;REEL/FRAME:008790/0588