Integrated grounding electrodes for eletrocautery vessel harvester

Patent metadata

Field	Value
Publication number	US-2020008866-A1
Application number	US-201816026156-A
Country	US
Kind code	A1
Filing date	Jul 3, 2018
Priority date	Jul 3, 2018
Publication date	Jan 9, 2020
Grant date	—

Abstract

An endoscopic vessel harvester cuts and cauterizes side branches from a target vessel using a cutter member that extends at a distal end of an insertion member. The cutter member has a plate defining a slit for receiving a side branch. A cutting electrode is disposed at a base of the slit and a pair of grounding electrodes are each mounted to an outer surface of the plate on opposite sides of the slit. Each grounding electrode has a raised longitudinal ridge adjoining a portion of the slit including the base of the slit and has a spot cautery wing extending laterally away from the slit with a surface configured to engage a surface of the tunnel. The longitudinal ridges each have an upright jamb surface configured to contact the side branch remotely from the cutting electrode so that it is unnecessary to make a grounding contact on the tunnel.

First claim

What is claimed is:

1 . An endoscopic vessel harvester comprising:
a longitudinal insertion member having a distal end adapted for insertion into a tunnel dissected along a target vessel within a body of a patient; a vessel keeper extendably mounted at the distal end of the insertion member comprising a capture frame with an opened position to admit the target vessel and having a closed position to slidably capture the target vessel; and a cutter member extendably mounted at the distal end of the insertion member comprising a plate defining a slit for receiving a side branch to the target vessel, a cutting electrode disposed at a base of the slit, and a pair of grounding electrodes each mounted to an outer surface of the plate on opposite sides of the slit, wherein each grounding electrode has a raised longitudinal ridge adjoining a portion of the slit including the base of the slit and has a spot cautery wing extending laterally away from the slit with a surface configured to engage a surface of the tunnel, wherein the longitudinal ridges each have an upright jamb surface configured to contact the side branch remotely from the cutting electrode.

2 . The harvester of claim 1 wherein each upright jamb surface has a height of 0.5 mm or greater.

3 . The harvester of claim 1 wherein each upright jamb surface is located within 0.3 mm of an upright profile of the slit.

4 . The harvester of claim 1 wherein an upper edge of each upright jamb surface has a radius of at least 0.1 mm.

5 . The harvester of claim 1 wherein each longitudinal ridge has a ramped leading edge and a ramped trailing edge.

6 . The harvester of claim 1 wherein the electrodes are comprised of stainless steel.

7 . The harvester of claim 1 further comprising:
electrode extensions welded to the grounding electrodes and extending through the insertion member for connecting to a bipolar power source.

8 . The harvester of claim 1 wherein the surface of each spot cautery wing defines a curved planar surface for contacting the tunnel.

9 . A method of severing branches from a target vessel during harvesting from a body by an endoscopic vessel harvester having an elongated sleeve member and a cutter, wherein the cutter is longitudinally extendable from the sleeve member toward a cutting position for cutting the branches, wherein the cutter comprises a V-tip and a longitudinal slit for receiving the branch to be cut, and wherein the cutter further comprises a cutting electrode disposed at a base of the slit and a pair of grounding electrodes each mounted to an outer surface of the V-tip on opposite sides of the slit, wherein each grounding electrode has a raised longitudinal ridge adjoining a portion of the slit including the base of the slit and has a spot cautery wing extending laterally away from the slit with a surface configured to engage a surface of a tunnel that is dissected from the vessel, wherein the longitudinal ridges each have an upright jamb surface configured to contact the branches remotely from the cutting electrode, the method comprising the steps of:
exposing the target vessel by blunt dissection to open a tunnel surrounding the target vessel; advancing the sleeve member and extending the cutter to capture a respective branch in the longitudinal slit so that the cutting electrode pushes against the respective branch; pivoting the sleeve member so that at least one of the grounding electrodes contacts the respective branch without the grounding electrodes contacting the tunnel; and activating a high-frequency current between the cutting electrode and the grounding electrodes to cut and cauterize the respective branch.

10 . The method of claim 9 further comprising the steps of:
identifying a spot on the tunnel wherein bleeding occurs;
pressing the spot cautery wings against the tunnel so that at least one spot cautery wing contacts the spot where bleeding occurs; and
activating the high-frequency current between the grounding electrodes to cauterize the spot.

Assignees

• Terumo Cardiovascular Sys Corp

Inventors

• Fujii Tatsunori
• Siddiqui Safi
• Kadykowski Randal J

Classifications

• A61B2018/00601

  Cutting · CPC title

• A61B2018/00607

  Coagulation and cutting with the same instrument · CPC title

• A61B2018/162

  located on the probe body · CPC title

• A61B2018/00428

  Severing · CPC title

• A61B2018/00982

  combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes · CPC title