15527results about "Surgical instruments for heating" patented technology

Surgical instruments are disclosed that are couplable to or have an end effector or a disposable loading unit with an end effector, and at least one micro-electromechanical system (MEMS) device operatively connected to the surgical instrument for at least one of sensing a condition, measuring a parameter and controlling the condition and / or parameter.

A working end of a surgical instrument that carries first and second jaws for delivering energy to tissue. In a preferred embodiment, at least one jaw of the working end defines a tissue-engagement plane that contacts the targeted tissue. The cross-section of the engagement plane reveals that it defines (i) a first surface conductive portion or a variably resistive matrix of a temperature-sensitive resistive material or a pressure-sensitive resistive material, and (ii) a second surface portion coupled to a fixed resistive material that coupled in series or parallel to a voltage source together with the first portion. In use, the engagement plane will apply active Rf energy to ohmically heat the captured tissue until the point in time that a controller senses an electrical parameter of the tissue such as impedance. Thereafter, the controller switches energy delivery to the second surface portion that is resistively heated to thereby apply energy to tissue by conductive heat transfer.

An electrosurgical stapling apparatus is provided which uses thermogenic energy as well as surgical fasteners or staples for strengthening tissue, providing hemostasis, tissue joining or welding. The thermogenic energy also strengthens tissue in proximity to a staple line and knife cut line and provides hemostasis along the staple and cut lines formed by the staples and a knife blade during surgical stapling. The use thermogenic energy provides short-term hemostasis and sealing, and reduces or prevents staple line and cut line bleeding, while the stapling features provide short and long-term tissue strength and hemostasis. The stapling apparatus further substantially reduces or prevents knife cut line bleeding by energizing a knife blade for cauterizing tissue while it is being cut. In one embodiment, energy is applied to the anvil to energize the staples as they make contact with the anvil.

An electrosurgical medical device and method for creating thermal welds in engaged tissue that carries the electrosurgical components in a disposable cartridge. The instrument also can carry a blade member in a disposable cartridge, thus making the instrument system inexpensive to use. In another embodiment, the electrical leads of the cartridge have a surface coating of a thermochromic material to provide the physician with a visual indicator of operational parameters when applying energy to tissue.

A working end of a surgical instrument that carries first and second jaws for delivering energy to tissue. In a preferred embodiment, at least one jaw of the working end defines a tissue-engagement plane that contacts the targeted tissue. The cross-section of the engagement plane reveals that it defines a surface conductive portion that overlies a variably resistive matrix of a temperature-sensitive resistive material or a pressure-sensitive resistive material. An interior of the jaw carries a conductive material or electrode that is coupled to an Rf source and controller. In an exemplary embodiment, the variably resistive matrix can comprise a positive temperature coefficient (PTC) material, such as a ceramic, that is engineered to exhibit a dramatically increasing resistance (i.e., several orders of magnitude) above a specific temperature of the material. In use, the engagement plane will apply active Rf energy to captured tissue until the point in time that the variably resistive matrix is heated to its selected switching range. Thereafter, current flow from the conductive electrode through the engagement surface will be terminated due to the exponential increase in the resistance of variably resistive matrix to provide instant and automatic reduction of Rf energy application. Further, the variably resistive matrix can effectively function as a resistive electrode to thereafter conduct thermal energy to the engaged tissue volume. Thus, the jaw structure can automatically modulate the application of energy to tissue between active Rf heating and passive conductive heating of captured tissue to maintain a target temperature level.

An electrosurgical medical device and technique for creating thermal welds in engaged tissue that provides very high compressive forces. In one exemplary embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying first and second surface portions that comprise (i) an electrically conductive material and (ii) a positive temperature coefficient (PTC) material having a selected increased resistance that differs at each selected increased temperature over a targeted treatment range. One type of PTC material is a doped ceramic that can be engineered to exhibit a selected positively sloped temperature-resistance curve over about 37° C. to 100° C. The 70° C. to 100° C. range can bracket a targeted “thermal treatment range” at which tissue welded can be accomplished. The engineered resistance of the PTC matrix at the upper end of the temperature range will terminate current flow through the matrix. In one mode of operation, the engagement plane cause ohmic heating within tissue from Rf energy delivery tissue PTC matrix is heated to exceed the treatment range. Thereafter, energy density in the engaged tissue will be modulated as the conductivity of the second portion hovers within the targeted treatment range to thereby provide optical tissue heating for purposes of tissue welding.

An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane that carries a recessed central portion. In another embodiment, the controller coupled to the Rf source is adapted to switch from a power control operational mode to a voltage controlled operational mode at a selected transition impedance level.

An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying a conductive-resistive matrix of a conductively-doped non-conductive elastomer. The engagement surface portions thus can be described as a positive temperature coefficient material that has a unique selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The conductive-resistive matrix can be engineered to bracket a targeted thermal treatment range, for example about 60° C. to 80° C., at which tissue welding can be accomplished. In one mode of operation, the engagement plane will automatically modulate and spatially localize ohmic heating within the engaged tissue from Rf energy application—across micron-scale portions of the engagement surface.

An electrosurgical working end for automatic modulation of active Rf density in a targeted tissue volume. The working end of the probe of the present invention defines a tissue-engagement surface of an elastomeric material with conductive elements that extend therethrough. In one embodiment, the expansion of the elastomeric material can de-couple the conductive elements from an interior electrode based temperature to modulate current flow. In another embodiment, the elastomeric material can couple and de-couple the conductive elements from an interior electrode based engagement pressure to modulate current flow.

A surgical stapler utilizing plastic staples and ultrasonic welding to secure the staples in body tissue. The stapler includes a pair of jaws movable between open and closed positions, a handle and trigger assembly for controlling operation of the jaws, and an elongated tubular structure connecting the handle and trigger assembly to the jaws. The stapler also includes an ejection assembly for ejecting at least one staple from one of the jaws against the other of the jaws. An anvil and a horn are positioned in the other of the jaws and are arranged to receive ends of the ejected staple such that the ends overlap between the anvil and the horn. The horn is for melting and bonding at least a portion of the overlapping ends of the staple upon being energized by a predetermined form of energy, and one of the anvil and the horn is movable from within the bonded staple to allow the jaws to be moved to an open position.

An electrosurgical working end and method for sealing and transecting tissue are provided. An exemplary electrosurgical working end has openable-closeable first and second jaws for progressively clamping a selected tissue volume. A method of the invention comprises applying electrosurgical energy to the tissue in either a first mode or a second mode based on the degree of jaw closure.

The present invention provides robotic surgical instruments and systems that include electrosurgical cutting / shearing tools and methods of performing a robotic surgical procedure. The surgical instruments can advantageously be used in robotically controlled minimally invasive surgical operations. A surgical instrument generally comprises an elongate shaft having a proximal end and a distal end. An end effector, for performing a surgical operation such as cutting, shearing, grasping, engaging, or contacting tissue adjacent a surgical site, is coupleable to a distal end of the shaft. Preferably, the end effector comprises a pair of scissor-like blades for cooperatively shearing the tissue. A conductor electrically communicating with at least one blade delivers electrical energy to tissue engaged by the blades. An interface coupled to the proximal end of the shaft and removably connectable to the robotic surgical system is also included.

An electro-mechanical surgical device, system and / or method may include a housing, at least two opposing jaw, and at least one electrical contact associated with at least one of the jaws. The electrical contact may include at least one of a bipolar electrical contact and an ultrasonic electrical contact. The electrical contact may be a row of electrodes located on one or all of the jaws. A sensor may also be associated with any tissue located between the jaws to sense and report the temperature of that tissue. A piercable ampulla containing fluid may also be placed on at least one of the jaws so that the fluid is releasable when the jaws are in closed position and the electrode(s) pass through the tissue into the piercable ampulla.

Methods for heating tissue completely, thoroughly, and uniformly comprise delivering radio frequency energy through a bipolar surgical instrument having first and second jaws with first and second electrode members within the treatment region. Tissue is grasped between the first and second jaws of the bipolar instrument. The electrode members are energized at a power level to deliver electrical energy to and heat tissue between the first and second electrode members. The power level is increased at a predetermined rate from an initial level. The initial level and predetermined rate are selected to avoid creating a vapor layer and to permit an impedance increase to occur as a result of complete tissue desiccation. A tissue impedance may also be measured and compared to a preset impedance limit for terminating the power delivery when the measured impedance exceeds the impedance limit.

An electrosurgical instrument for scoring, welding and transecting tissue is provided. The electrosurgical instrument comprises first and second openable-closeable jaws and at least one scoring electrode extending from a distal end of at least one of the first and second openable-closeable jaws. The first and second openable-closeable jaws comprises first and second conductive tissue engaging surfaces, respectively, and first and second insulating members, respectively. The scoring electrode is coupled with at least one of the first and second insulating members. The at least one scoring electrode can be activated independently from the first and second openable-closeable jaws so that the electrosurgical instrument can independent score tissue and weld tissue.

An electrosurgical working end and method for obtaining a tissue sample for biopsy purposes, for example, from a patient's lung or a liver. The working end provides curved jaw members that are positioned on opposing sides of the targeted anatomic structure. The working end carries a slidable extension member that is laterally flexible with inner surfaced that slide over the jaw members to clamp tissue therebetween. As the extension member advances, the jaws compress the tissue just ahead of the advancing extension member to allow the laterally-outward portion of the extension member to ramp over the tissue while a cutting element contemporaneously cuts the tissue. By this means, the transected tissue margin is captured under high compression. The working end carries a bi-polar electrode arrangement that engages the just-transected medial tissue layers as well as surface layers to provides Rf current flow for tissue welding purposes that is described as a medial-to-surface bi-polar approach.

A qualifying connection for an instrument attaches to a source of electrosurgery energy to and the instrument and has first and second parts coupled to the instrument and the source, respectively. Optical couplings on the connection transmit invisible energy to identify the instrument and are proximate on the first and second parts. A light modifier on the first part is proximal to the second part for modification of radiation in the infrared wavelengths so infrared transmitters encode signals and non contact coded proximity detectors on the second part are the coupled detectors. Non contact coded proximity detectors respond to modified infrared light establishing an Nth bit identification code. An infrared light supply in the source pass from the transmitters across the communicating couplings for encoding signals by modification of the infrared light with a light modifier. Mechanical attachments include conjugating male and female portions physically extending between the parts for mating engagement. The attachments juxtaposition the parts when the attachments geometrically conjugate to geographically positioning the couplings proximate for communicating. The attachments have one or more conductors for delivery of high frequency energy from the source to the instrument. A cable fits between the first part of the connection and the instrument and has electrical conductors for carrying energy passing through the first part of the connection from the source to the instrument. An identifying circuit couples to the second part and responds to invisible light optically communicated across the couplings for verifying the type of instrument connected by the cable to the source.

An electrosurgical bipolar forceps for sealing is disclosed. The forceps includes one or more shaft members having an end effector assembly disposed at the distal end. The end effector assembly includes two jaw members movable from a first position to a closed position wherein the jaw members cooperate to grasp tissue at constant pressure. Each of the jaw members includes an electrically conductive sealing plate connected to a first energy source which communicates electrosurgical energy through the tissue held therebetween. The electrosurgical energy is communicated at constant voltage. The electrically conductive sealing plates are operably connected to sensor circuitry which is configured to measure initial tissue impedance and transmit an initial impedance value to a controller. The controller determines the constant pressure and the constant voltage to be applied to the tissue based on the initial impedance value.

An electrosurgical cutting blade (1) comprises a first electrode (2), a second electrode (3), and an electrical insulator (4) separating the first and second electrodes. The first and second electrodes have dissimilar characteristics (cross-sectional area, thermal conductivity etc.) such that the first electrode (2) is encouraged to become an active electrode and the second electrode (3) is encouraged to become a return electrode. The spacing between the first and second electrodes (between 0.25 mm and 3.0 mm) and the peak voltage supplied to the electrodes (2 and 3) are both selected such that arcing does not occur directly between the electrodes, but between the first electrode and the tissue at the target site. The arrangement is such that, in use, a thermal differential of at least 50° C. is established between the first and second electrodes (2 and 3), such that the second electrode is maintained below a temperature of 70° C. This is achieved either by thermally insulating the second electrode from the first electrode, and / or by transferring heat away from the second electrode, e.g. by conduction, forced cooling, or by means of a heat pipe (27).

An electrosurgical system has an electrosurgical generator and a bipolar electrosurgical instrument, the generator being arranged to perform a treatment cycle in which radio frequency energy is delivered to the instrument as an amplitude-modulated radio frequency power signal in the form of a succession of pulses characterized by successive pulses of progressively increasing pulse width and progressively decreasing pulse amplitude. There are periods of at least 100 milliseconds between successive pulses, and the treatment cycle begins with a predetermined pulse mark-to-space ratio. Energy delivery between pulses is substantially zero. Each burst is of sufficiently high power to form vapor bubbles within tissue being treated and the time between successive pulses is sufficiently long to permit condensation of the vapor.

An electrosurgical system has an electrosurgical generator and a bipolar electrosurgical instrument, the generator being arranged to perform a treatment cycle in which radio frequency energy is delivered to the instrument as an amplitude-modulated radio frequency power signal in the form of a succession of pulses characterized by periods of a least 100 milliseconds between successive pulses and by a predetermined pulse mark-to-space ratio. Energy delivery between pulses is substantially zero and the mark-to-space ratio is typically 1:4 or less. Each burst is of sufficiently high power to form vapor bubbles within tissue being treated and the time between successive pulses is sufficiently long to permit condensation of the vapor. The treatment cycles may each include an initial period and a subsequent period, the pulse duty cycle being increased or energy being delivered continuously in the subsequent period in order that tissue coagulation can be achieved quickly despite increasing tissue impedance.

An ablation device for creating a lesion within a body is provided. The ablation device includes a shaft having a proximal end and a distal end, wherein at least a portion of the shaft is bendable to form a desired configuration. A clamp assembly is secured to the distal end of the shaft. The clamp assembly has a first jaw and a second jaw, the second jaw moveable relative to the first jaw to open or close the clamp assembly. The ablation device also includes a first electrode secured to the first jaw of the clamp assembly, a second electrode secured to the second jaw of the clamp assembly, and a handle connected to the proximal end of the shaft.

Surgical devices, systems and methods for treating tissue are provided. An exemplary surgical device comprises a tip portion including first and second jaws each having a tissue grasping surface, at least one of the jaws being movable toward the other jaw. The tissue grasping surface of each jaw has includes an electrically insulative surface. The device also includes first and second electrodes connectable to different terminals of an RF generator to generate electrical current flow therebetween, with each of the electrodes having an electrode surface. One of the electrode surfaces is located on one of the jaws separated from one edge of the tissue grasping surface, and the other of the electrode surfaces is located on one or the other of the jaws separated from the other edge of the tissue grasping surface. The device also includes at least one fluid passage being connectable to a fluid source.

An embodiment of the invention provides a method for detecting and treating a tumor using tissue localized volumetric impedance measurement. The method includes providing an impedance measurement apparatus having a plurality of resilient members deployable with curvature and configured to sample tissue impedance through a plurality of conductive pathways. The apparatus is configured to be coupled to at least one of an energy delivery device, a power supply, a switching device or logic resources. The apparatus is then positioned at a selected tissue site and the impedance array deployed to define a sample volume. The impedance array is then utilized to make impedance measurements through a plurality of conductive pathways. Information from the impedance measurements is then utilized to determine a tissue condition of the sample volume. Energy is then delivered from the energy delivery device to ablate or necrose at least a portion of the tumor.

A surgical fastener applying apparatus including an anvil half-section having a distal end and a longitudinal axis; a cartridge receiving half-section having a distal end and operatively couplable with the anvil half-section such that the distal ends of the half-sections are in juxtaposed relation; and a deflection control system operatively engaged with and reinforcing the distal end of the anvil half-section when a force is applied to the distal end of the anvil half-section in a direction transverse to the longitudinal axis.

A hemostat-type device for ablative treatment of tissue, particularly for treatment of atrial fibrillation, is constructed with features that provide easy and effective treatment. A swiveling head assembly can allow the jaws to be adjusted in pitch and roll. Malleable jaws can permit curved lesion shapes. A locking detent can secure the jaws in a closed position during the procedure. An illuminated indicator provides confirmation that the device is operating. A fluid delivery system simplifies irrigated ablation procedures.

A material comprising a matrix or a buttress is impregnated with an adhesive initiator and is used with a surgical stapling device and an adhesive. The tissue and material are stapled together, and a knife in the surgical stapling device cuts the tissue and the material. The adhesive is applied across the cut and sets up or polymerizes to seals the cut when the adhesive contacts the adhesive initiator. The surgical stapling device can place the staples in a linear, arcuate, or circular array, and can anastomose luminal tissue. The methods of use can include stapling luminal tissue end to end, stapling two portions of material onto ether side of tissue, and stapling two portions of tissue onto a portion of material. Additionally, a portion of adhesive filed material can be stapled onto one side of portion of tissue and the adhesive initiator impregnated material can be stapled onto the other. Cutting the material and tissue provides a path for the adhesive across the cut, and catalyzes the adhesive from contact with the adhesive initiator.