Bipolar electrosurgical instruments

Patent metadata

Field	Value
Publication number	US-11786293-B2
Application number	US-201916438693-A
Country	US
Kind code	B2
Filing date	Jun 12, 2019
Priority date	Jun 13, 2018
Publication date	Oct 17, 2023
Grant date	Oct 17, 2023

Abstract

A bipolar surgical instrument comprises a body first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to determine a boiling point for tissue between the jaws using a measure of impedance therebetween.

First claim

The invention claimed is:

1. An electrosurgical system comprising:
a bipolar electrosurgical instrument comprising:
a body;
an elongate shaft (i) attached to the body and (ii) having a distal end;
first and second elongate jaw members at the distal end of the elongate shaft, the first elongate jaw member carrying a first electrode and the second elongate jaw member carrying a second electrode, the first and second elongate jaw members being movable relative to one another between an open position in which the first and second electrodes are spaced apart from one another and a closed position in which the first electrode is adjacent the second electrode; and
a power cable having (i) a pair of electrically conductive elements, (ii) a first end for connection with a source of radio frequency electromagnetic energy, and (iii) a second end for connection to the first and second electrodes; and

a waveform generator that is the source of radio frequency electromagnetic energy and comprising:
a radio frequency signal generator operable to supply a radio frequency signal to the first and second electrodes via the power cable; and
a controller operable to control operation of the radio frequency signal generator, in dependence upon a received control input,

wherein the controller is operable:
in a tissue heating stage after a preheating stage and prior to a tissue sealing stage:
to control the radio frequency signal generator to supply the radio frequency signal at a controlled voltage level to the first and second electrodes, the controlled voltage level starting at a starting voltage at a heating start time, increasing during the heating stage and ending at a final voltage at a heating end time that is larger than the starting voltage;
to measure an impedance between the first and second electrodes during the supply of the controlled voltage level;
to detect a minimum measured impedance between the first and second electrodes during the supply of the controlled voltage; and
to determine the heating end time as that time when a measured impedance is greater than the minimum measured impedance by a first predetermined amount;
in the tissue sealing stage:
to supply the radio frequency signal at a constant predetermined sealing voltage level to the first and second electrodes for a predetermined sealing time period having a sealing end time, the constant predetermined sealing voltage level being greater than the final voltage;
to measure an impedance level between the first and second electrodes at the sealing end time;
to compare a measured sealing impedance at the sealing end time with a predetermined reference impedance;
to end the tissue sealing stage when the measured sealing impedance at the sealing end time is greater than or equal to the predetermined reference impedance; and
when the measure sealing impedance at the sealing end time is less than the predetermined reference impedance, to repeat the tissue heating and tissue sealing stages until the measured sealing impedance at the sealing end time is greater than or equal to the predetermined reference impedance.

2. An electrosurgical system as claimed in claim 1 , wherein the controller is operable, in an initialisation stage prior to the tissue heating stage:
to control the radio frequency signal generator to supply the radio frequency signal of a predetermined initial power level to the first and second electrodes for a predetermined initial time period having an end time;
to measure a voltage level between the first and second electrodes at the end time; and
to store such a measured voltage as the starting voltage for the tissue heating stage.

3. An electrosurgical system as claimed in claim 1 , wherein the controller is operable, in a completion stage subsequent to the tissue sealing stage, and when the comparison signal is indicative of the measured sealing impedance being greater than or equal to the predetermined reference impedance:
to control the radio frequency signal generator to apply the radio frequency signal at a predetermined completion voltage level, lower than the predetermined sealing voltage, for a predetermined completion time period; and
to end supply of the radio frequency signal.

4. An electrosurgical system as claimed in claim 1 , wherein the controller is operable to measure electrical current supplied to the first and second electrodes to generate a measured current signal, and to detect a short circuit between the first and second electrodes if the measured current signal indicates electrical current supplied to the first and second electrodes exceeds a first predetermined value for at least a predetermined time period.

5. A method of operating an electrosurgical system comprising a bipolar electrosurgical instrument comprising a body; an elongate shaft (i) attached to the body and (ii) having a distal end; first and second elongate jaw members at the distal end of the elongate shaft, the first elongate jaw carrying a first electrode and the second elongate jaw carrying the second electrode, the first and second elongate jaw members being movable relative to one another between an open position in which the first and second electrodes are spaced apart from one another and a closed position in which the first electrode is adjacent the second electrode; and a power cable having (i) a pair of electrically conductive elements, (ii) a first end for connection with a source of radio frequency electromagnetic energy, and (iii) a second end for connection to the first and second electrodes; and a waveform generator that is the source of radio frequency electromagnetic energy and comprising a radio frequency signal generator operable to supply a radio frequency signal to the first and second electrodes via the power cable; and a controller operable to control operation of the radio frequency signal generator, in dependence upon a received control input, wherein the method comprises:
a tissue heating stage comprising:
controlling the radio frequency signal generator to supply the radio frequency signal at a controlled voltage level to the first and second electrodes, the controlled voltage level starting at a starting voltage at an heating start time, increasing during the heating stage and ending at a final voltage at an heating end time that is larger than the starting voltage;
measuring an impedance between the first and second electrodes during the supply of the controlled voltage level;
detecting a minimum measured impedance between the first and second electrodes during the supply of the controlled voltage; and
determining the heating end time as that time when a measured impedance is greater than the minimum measured impedance by a first predetermined amount;

a tissue sealing stage comprising:
supplying the radio frequency signal at a predetermined sealing voltage level to the first and second electrodes for a predetermined sealing time period having a sealing end time, the predetermined voltage level being greater than the final voltage;
measuring an impedance level between the first and second electrodes at the sealing end time;
comparing a measured sealing impedance at the sealing end time with a predetermined reference impedance;
ending the tissue sealing stage when the measured sealing impedance at the sealing end time is greater than or equal to the predetermined reference impedance at the sealing end time; and
when the measured sealing impedance at the sealing end time is less than the predetermined reference impedance level, repeating the tissue heating and tissue sealing stages until the measured sealing impedance at the sealing end time is greater than or equal to the predetermined reference impedance.

6. A method as claimed in claim 5 , further comprising, in advance of

Assignees

• Gyrus Medical Ltd

Inventors

• Williams Wayne
• Jones Lewis

Classifications

• A61B18/1445 Primary

  at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod · CPC title

• A61B18/1206 Primary

  Generators therefor · CPC title

• A61B18/1442

  Probes having pivoting end effectors, e.g. forceps · CPC title

• A61B17/2909

  Handles · CPC title

• A61B2018/0063

  Sealing · CPC title