Source: http://www.google.de/patents/US20050101965
Timestamp: 2013-05-22 10:11:28
Document Index: 49821445

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

Patent US20050101965 - Apparatus and method for sealing and cutting tissue - Google PatenteSuche Bilder Maps Play YouTube News Gmail Drive Mehr » Erweiterte Patentsuche | Webprotokoll | Anmelden Erweiterte Patentsuche PatenteAn axial elongate bipolar tissue sealer/cutter and method of use by a surgeon for electrosurgery on tissue has a handle. A chassis on the handle extends axially for axial movement. A tube may move axial relative to the chassis. An effector on a distal end of the chassis first contacts tissue with axial...http://www.google.de/patents/US20050101965?utm_source=gb-gplus-sharePatent US20050101965 - Apparatus and method for sealing and cutting tissue Ver�ffentlichungsnummerUS20050101965 A1PublikationstypAnmeldung Anmeldenummer09/992,301 Ver�ffentlichungsdatum12. Mai 2005Eingetragen14. Nov. 2001 Priorit�tsdatum9. Sept. 1997Auch ver�ffentlicht unterEP1011492A1EP1011492A4EP1011492B1EP1586279A2EP1586279A3EP1586279B1EP1586280A2EP1586280A3EP1586280B1US6267761US6932810US7270660US20060020265US20080004616WO1999012487A1 Ver�ffentlichungsnummerUS 2005/0101965 A1US2005/0101965A1 ErfinderThomas RyanUrspr�nglich Bevollm�chtigterSherwood Services Ag US-Klassifikation606/96Internationale KlassifikationA61B18/14 UnternehmensklassifikationA61B2018/00601A61B2018/00875A61B18/1442A61B2018/0063A61B2018/00702A61B2018/145 Europ�ische KlassifikationA61B18/14FReferenzen Referenziert von (2)Externe LinksUSPTO USPTO-Zuordnung EspacenetApparatus and method for sealing and cutting tissueUS 20050101965 A1 Zusammenfassung An axial elongate bipolar tissue sealer/cutter and method of use by a surgeon for electrosurgery on tissue has a handle. A chassis on the handle extends axially for axial movement. A tube may move axial relative to the chassis. An effector on a distal end of the chassis first contacts tissue with axial movement. 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 or cut through application of compression and bipolar electrosurgery between the first and second electrodes. The effector and the part have complimentary sealing or cutting 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. The partial mating complimentary surfaces may be normal or skewed relative to the axis and may be curvelinear, flat, parallel, circular, elliptical, triangular or have at least one conjugating rib and slot. A method of use has the steps of holding and manipulating the sealer/cutter, moving the chassis relative to the tube, positioning the effector and the port to contact tissue, along the axis coupling bipolar electrodes to the effector and part, electrically isolating the electrodes, selectively coupling the generator to the electrodes for supplying bipolar electrosurgery. Supporting the activator for moving axially relative to one another, the patient part and the effector so tissue therebetween is sealed or cut by applying compression and bipolar electrosurgery across the first and second electrodes are steps. Zeichnungen(8) Anspr�che
1-23. (canceled) 24. A bipolar electrosurgical instrument for sealing and cutting tissue, comprising: a chassis having a longitudinal axis defined therethrough and first and second end effectors attached thereto, one of said first and second end effectors being movable along said longitudinal axis relative to the other of said first and second end effectors from a first position for positioning tissue therebetween to a second position for grasping tissue between said first and second end effectors, wherein said first and second end effectors include complimenting vessel sealing electrodes which partially matingly engage one another, said electrodes adapted to be connected to a source of electrosurgical energy such that the electrodes are capable of sealing and cutting tissue disposed therebetween upon activation of said electrodes; an activator for moving said end effectors from the first to second positions; a sensor for measuring the impedance across the tissue held between said end effectors; and means for selectively applying electrosurgical energy from an electrosurgical energy source to said end effectors in response to the impedance measurement across the tissue from said sensor. 25. A bipolar instrument according to claim 24 wherein the activator includes a handle. 26. A bipolar instrument according to claim 24 wherein at least one of the first and second end effectors is selectively removable from the chassis. 27. A bipolar instrument according to claim 24 wherein the first and second end effectors include vessel contacting surfaces which partially matingly engage upon movement of the end effectors from the first to second positions. 28. A bipolar instrument according to claim 27 wherein the vessel contacting surface of the first end effector has a first cross section and the vessel sealing surface of the second end effector has a second cross section which compliments the first cross section to engage tissue therebetween. 29. A bipolar instrument according to claim 27 wherein the vessel contacting surfaces of the first and second end effectors cooperate to seal tissue disposed between the end effectors upon application of electrosurgical energy. 30. A bipolar instrument according to claim 27 wherein the vessel contacting surfaces of the first and second end effectors cooperate to cut tissue disposed between the end effectors upon application of electrosurgical energy. 31. A bipolar instrument according to claim 24 wherein the first end effector includes a first electrode and the second end effector includes a second electrode. 32. A bipolar instrument according to claim 31 wherein the second electrode is electrically isolated from the first electrode. 33. A method of applying electrosurgical energy to tissue comprising the steps of: providing a chassis having a longitudinal axis therethrough and first and second end effectors attached thereto, one of said end effectors being movable along said longitudinal axis relative to the other of said first and second end effectors from a first position for positioning tissue therebetween to a second position for grasping tissue between said first and second end effectors, wherein said first and second end effectors include complimenting vessel sealing electrodes which partially matingly engage one another, said electrodes adapted to be connected to a source of electrosurgical energy such that the electrodes are capable of sealing and cutting tissue disposed therebetween upon activation of said electrodes; moving said end effectors from the first to second positions to engage tissue therebetween; measuring the impedance across the tissue held between said end effectors; and selectively applying electrosurgical energy from an electrosurgical energy source to said end effectors in response to the impedance measurement across the tissue.
DETAILED DESCRIPTION OF THE INVENTION 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 has 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 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. A first bipolar electrosurgical electrode 26 for contact with the patient's tissue or bodily fluids is electrically coupled to the effector 22 beyond the patient end 18. A second bipolar electrosurgical electrode 27 is electrically coupled to the effectors 21 and 22 for contact with the patient's tissue or bodily fluids. The second bipolar electrosurgical electrode 27 is electrically isolated from the first bipolar electrosurgical electrode 26 but is in position to deliver bipolar electrosurgical energy across tissue held therebetween. An electrosurgical generator 28, in FIG. 3, is electrically coupled to the first and second electrosurgical electrodes 26 and 27 through terminals 29 and 30, respectively. The electrosurgical generator 28 can be arranged for selectively supplying bipolar electrosurgical energy to the first and second bipolar electrosurgical electrodes 26 and 27. Selective application of electrosurgical energy is in response to the surgeons control and/or a sensor 31 in the electrosurgical generator 28. Sensor 31 may measure impedance across the tissue between the electrodes 26 and 27. A mechanical activator 32, in FIG. 3, is preferably movably supported on the handle 11 for use by the surgeon. The mechanical activator 32 connects to the inner tube 19 for axially moving the end effector 21 thereof toward or away from the end effector 22 in the preferred embodiment. The tissue and bodily fluid therebetween may be sealed or cut between the end effectors 21 and 22 through the combined application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes 26 and 27. 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 nibs 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 nib 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 nibs 41 and complimentary opposed kerf 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 nibs 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 of using has a first bipolar electrosurgical electrode 26 coupled to the end effector 22 extending from the patient end 18 and a second bipolar electrosurgical electrode 27 coupled to the end effector 21. Electrically isolating the second bipolar electrosurgical electrode 27 from the first bipolar electrosurgical electrode 26 is another preferred method step for using. The method preferably has the step of selectively coupling electrically an electrosurgical generator 28 to the first and second electrosurgical electrodes to supply bipolar electrosurgical energy from the electrosurgical generator to the first and second bipolar electrosurgical electrodes 26 and 27. The method most preferably has the step of a surgeon using a mechanical activator 32 movably supported on the handle 11. Moving axially with the mechanical activator 32 the inner tube 19 and the end effector 21 thereof toward or away from the end effector 22 so that tissue and bodily fluid therebetween may be sealed or cut between the end effectors 21 and 22 the application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes 26 and 27 is a preferred step. 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 method has the step of using the partially mating complimentary flat surfaces 33 and 34 that are perhaps along the planes of the flat surfaces. The method has the step of using the partially mating complimentary circular surfaces 33 and 34 that might be along the arcs of the circular surfaces. The method has the step of using the partially mating complimentary elliptical surfaces 33 and 34 which are preferably along the curves of the ellipses. The method has the step of using the partially mating complimentary triangular surfaces 33 and 34 that can be along edges of the triangles. The method has the step of using the partially mating complimentary surfaces 33 and 34 by engaging at least one conjugating rib and slot. The method has the step of using the partially mating complimentary surfaces 33 and 34 that include one or more ribs. As a result of laboratory testing of a model of the bipolar tissue sealer or cutter results have shown excellent performance in sealing a range of vessels of various sizes. The bipolar tissue sealer or cutter with linear travel was tested on freshly excised porcine splenic arteries ranging from 1.8 to 3.3 mm. A single activation of power (14 W, 500 kHz) was used on each vessel firmly clamped between the end effector bipolar electrodes. FIG. 17 shows the voltage, current impedance, power, and energy during activation on a 2.6 mm porcine splenic artery with the bipolar device shown in FIG. 15. The voltage ranges from 18-23 volts until the impedance rises at about 14 sec. At this point, the vessel is sealed and the power is manually switched off. The impedance curve shows an initial decrease as the vessel is heated with radiofequency energy, down to about 20 ohms. The rapid increase to about 200 ohms signals that the vessel is desiccated and sealing process is over. Data, shown in the graphs of FIG. 17, display the voltage, current, impedance, power and energy during the activation of 17 sec. achieved with an elongated tubular bipolar tissue sealer or cutter as shown in FIG. 15. Activation times ranged from 12-28 sec. Energy applied ranged from 170-400 joules. Contact impedance ranged from 20-80 ohms, depending on vessel size and shape of end effectors. If the end effectors of FIG. 5 were used, the contact impedance would decrease due to the larger contact area with the vessel. Vessel size affects impedance as well. The vessels were closely examined after each sealing and found to have no charring. In 2 out of 13 trials, the vessel was adherent to one of the end effectors. Histological analysis showed that the vessel walls were completely welded with the integrity of the intima, adventitia, and media completely lost. The proteins were melted and a semi-translucent weld resulted. Adjacent to the weld site, the vessel wall was relatively normal. 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. Referenziert von Zitiert von PatentEingetragen Ver�ffentlichungsdatum Antragsteller TitelUS823601728. M�rz 20087. Aug. 2012Olympus Medical Systems Corp.Ultrasonic therapeutic apparatusWO2007120063A219. Juni 200725. Okt. 2007Kukwa, AndrzejMultifunctional surgical instrument for precise operations, particularly for laryngologic and neurosurgical operationsDrehenOriginalbildGoogle-Startseite - Sitemap - USPTO-Bulk-Downloads - Datenschutzerkl�rung - Nutzungsbedingungen - �ber Google Patente - Feedback gebenDaten bereitgestellt von IFI CLAIMS Patent Services.© 2012 Google