Surgical instruments including sensors

Patent metadata

Field	Value
Publication number	US-11253257-B2
Application number	US-202016890135-A
Country	US
Kind code	B2
Filing date	Jun 2, 2020
Priority date	Mar 8, 2017
Publication date	Feb 22, 2022
Grant date	Feb 22, 2022

Abstract

A surgical instrument includes a handle portion, a shaft coupled to the handle portion, a pair of jaw members operably coupled to the shaft, an inflatable member, and a sensor. The inflatable member is associated with one of the jaw members and is configured to apply pressure to tissue disposed between the pair of jaw members. The sensor is associated with one of the jaw members and is configured to measure local perfusion pressure in the tissue disposed between the pair of jaw members.

First claim

What is claimed is:

1. A method of performing a surgical procedure, comprising:
clamping tissue of a patient between a first jaw member of a surgical instrument and an inflatable member that is attached to a second jaw member of the surgical instrument;
measuring local perfusion in the tissue using a perfusion sensor associated with at least one of the first or second jaw members;
measuring a pressure within the inflatable member;
determining a local perfusion pressure in the tissue using the measured local perfusion and the measured pressure within the inflatable member; and
determining, using the determined local perfusion pressure of the tissue, whether the tissue is in condition for stapling.

2. The method according to claim 1 , further comprising stapling the tissue in response to determining that the tissue is in condition for stapling.

3. The method according to claim 2 , wherein stapling the tissue severs a fastener that attaches the inflatable member to the second jaw member, thereby releasing the inflatable member from the second jaw member.

4. The method according to claim 1 , further comprising passing the first and second jaw members through an access port toward the tissue while the inflatable member is in a collapsed state.

5. The method according to claim 1 , further comprising displaying on a display an image of blood flow or a number representative of the measured local perfusion in the tissue after measuring the local perfusion in the tissue.

6. The method according to claim 5 , further comprising displaying on the display the measured pressure within the inflatable member.

7. The method according to claim 1 , further comprising increasing a clamping pressure between the first and second jaw members until the perfusion sensor determines a lack of local perfusion in the tissue.

8. The method according to claim 7 , wherein increasing the clamping pressure includes at least one of expanding the inflatable member or approximating the first and second jaw members.

9. The method according to claim 7 , further comprising:
decreasing the clamping pressure on the tissue after determining the lack of local perfusion in the tissue;
ceasing the decreasing of the clamping pressure in response to the perfusion sensor deter raining that the local perfusion has returned to the tissue; and
determining the pressure in the inflatable member at the moment the local perfusion has returned to the tissue, wherein the pressure in the inflatable member at the moment the local perfusion has returned to the tissue is the local perfusion pressure.

10. The method according to claim 1 , wherein determining whether the tissue is in condition for stapling includes comparing the determined local perfusion pressure with a known local perfusion pressure associated with healthy or viable tissue.

11. The method according to claim 1 , wherein determining whether the tissue is in condition for stapling includes:
determining a systemic blood pressure of the patient;
calculating a ratio of the determined local perfusion pressure and the determined systemic blood pressure; and
comparing the calculated ratio to a known ratio that is associated with healthy or viable tissue.

12. A method of performing an anastomotic procedure, comprising:
positioning tissue of a patient between a pair of jaw members of a surgical stapling instrument;
inflating an inflatable member associated with at least one of the pair of jaw members, thereby applying pressure on the tissue with the inflatable member;
measuring local perfusion in the tissue using a perfusion sensor associated with at least one of the pair of jaw members;
measuring a pressure within the inflatable member;
determining a local perfusion pressure of the tissue using the measured local perfusion and the measured pressure within the inflatable member;
determining, using the determined local perfusion pressure of the tissue, whether the tissue is healthy or viable; and
stapling the tissue in response to determining that the tissue is healthy or viable.

13. The method according to claim 12 , wherein stapling the tissue severs a fastener that attaches the inflatable member to the at least one of the pair of jaw members, thereby releasing the inflatable member from the at least one of the pair of jaw members.

14. The method according to claim 12 , further comprising:
increasing a clamping pressure between the pair of jaw members;
decreasing the clamping pressure in response to determining a lack of local perfusion in the tissue; and
displaying the pressure in the inflatable member at the moment the local perfusion has returned to the tissue, wherein the pressure in the inflatable member at the moment the local perfusion has returned to the tissue is the local perfusion pressure.

15. The method according to claim 12 , wherein determining whether the tissue is healthy or viable includes comparing the determined local perfusion pressure with a known local perfusion pressure associated with healthy or viable tissue.

16. The method according to claim 12 , further comprising:
determining a systemic blood pressure of the patient; and
calculating a ratio of the determined local perfusion pressure and the determined systemic blood pressure.

17. The method according to claim 16 , wherein determining whether the tissue is healthy or viable includes comparing the calculated ratio to a known ratio that is associated with healthy or viable tissue.

Assignees

• Covidien Lp

Inventors

• Evans Christopher K
• Eschbach Matthew

Classifications

• A61B2017/00022

  Sensing or detecting at the treatment site · CPC title

• A61B2562/0247

  Pressure sensors · CPC title

• A61B5/0215

  by means inserted into the body · CPC title

• A61B2017/2926

  Details of heads or jaws · CPC title

• A61B17/068

  Surgical staplers {, e.g. containing multiple staples or clamps}({staplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105;} for performing anastomosis A61B17/115; {staplers in general B25C5/00}) · CPC title