Methods and systems for advanced harmonic energy

Patent metadata

Field	Value
Publication number	US-2025090220-A1
Application number	US-202418894131-A
Country	US
Kind code	A1
Filing date	Sep 24, 2024
Priority date	Aug 5, 2016
Publication date	Mar 20, 2025
Grant date	—

Abstract

Aspects of the present disclosure are presented for a medical instrument configured to adjust the power level for sealing procedures to account for changes in tissue impedance levels over time. In some aspects, a medical instrument may be configured to apply power according to a power algorithm to seal tissue by applying a gradually lower amount of power over to time as the tissue impedance level begins to rise out of the “bathtub region,” which is the time period during energy application where the tissue impedance is low enough for electrosurgical energy to be effective for sealing tissue. In some aspects, the power is then cut once the tissue impedance level exceeds the “bathtub region.” By gradually reducing the power, a balance is achieved between still applying an effective level of power for sealing and prolonging the time in which the tissue impedance remains in the “bathtub region.”

First claim

1 . A surgical system comprising:
an end effector comprising at least one energy delivery component configured to transmit electrosurgical energy to a tissue at a surgical site; and a control circuit communicatively coupled to the at least one energy delivery component and programmed to:
for a first application period, cause the at least one energy delivery component to transmit the electrosurgical energy at a first power level, the first application period comprising a point in time where impedance of the tissue reaches a minimum impedance value; and
for a second application period after the first application period, cause the at least one energy delivery component to transmit the electrosurgical energy starting from a predetermined proportion of a transition impedance threshold level and decreasing the electrosurgical energy at a steady rate from the first power level until a second power level is reached, wherein the second power level is lower than the first power level and the second application period comprises a point in time where the impedance of the tissue rises above the minimum impedance value.

2 . The surgical system of claim 1 , wherein the first application period and the second application period combined comprise a time period where the electrosurgical energy is delivered at a higher rate and causes sealing of the tissue at the surgical site.

3 . The surgical system of claim 21 , wherein the third application period further comprises a time period where the impedance of the tissue rises to a level such that the electrosurgical energy is delivered at a lower rate and no longer causes sealing of the tissue at the surgical site.

4 . The surgical system of claim 1 , further comprising at least one sensor configured to measure an initial level of impedance in the tissue and the minimum impedance value in the tissue.

5 . The surgical system of claim 21 , wherein the control circuit is further programmed to determine a beginning of the third application period based on a measured initial level of impedance in the tissue.

6 . The surgical system of claim 21 , wherein the control circuit is further programmed to determine a beginning of the third application period based on a measured minimum level of impedance in the tissue.

7 . The surgical system of claim 1 , wherein the first application period and the second application period combined comprise a continuous time period where the impedance of the tissue impedance remains below an initial level of impedance in the tissue.

8 . The surgical system of claim 1 , wherein the at least one energy delivery component is configured to transmit RF and ultrasonic energy.

9 . A method for transmitting electrosurgical energy to a tissue at a surgical site by a surgical system, the method comprising:
causing, by an energy delivery component of the surgical system, the electrosurgical energy to be applied to the tissue; measuring, by at least one sensor of the surgical system, a benchmark level of impedance of the tissue; determining, among a plurality of power load curve algorithms, a power load curve algorithm to be applied to the energy delivery component, based on the measured benchmark level of impedance of the tissue; based on the determined power load curve algorithm:
for a first application period, causing the energy delivery component to transmit the electrosurgical energy at a first power level, the first application period comprising a point in time where impedance of the tissue reaches a minimum impedance value; and
for a second application period after the first application period, causing the energy delivery component to transmit the electrosurgical energy, starting from a predetermined proportion of a transition impedance threshold level and decreasing the electrosurgical energy at a steady rate from the first power level until a second power level is reached, wherein the second power level is lower than the first power level and the second application period comprises a point in time where the impedance of the tissue rises above the minimum impedance value.

10 . The method of claim 9 , wherein determining the power load curve algorithm comprises determining whether the benchmark level of impedance is less than a first threshold impedance value, whether the benchmark level of impedance is greater than the first threshold impedance value and less than a second threshold impedance value, and whether the benchmark level of impedance is greater than the second threshold impedance value.

11 . The method of claim 9 , wherein the first application period and the second application period combined comprise a time period where the electrosurgical energy is delivered at a higher rate and causes sealing of the tissue at the surgical site.

12 . The method of claim 23 , wherein the third application period further comprises a time period where the impedance of the tissue rises to a level such that the electrosurgical energy is delivered at a lower rate and no longer causes sealing of the tissue at the surgical site.

13 . The method of claim 9 , wherein the benchmark level of impedance is the minimum impedance value or an initial level of impedance of the tissue.

14 . The method of claim 23 , wherein a beginning of the third application period is based on the measured benchmark level of impedance.

15 . The method of claim 9 , wherein the first application period and the second application period combined comprise a continuous time period where the tissue impedance remains below an initial level of impedance in the tissue.

16 . The method of claim 9 , wherein the energy delivery component is configured to transmit RF and ultrasonic energy.

17 . A surgical instrument comprising:
a handle assembly; a shaft coupled to the handle assembly; an end effector coupled to the shaft and comprising at least one energy delivery component configured to transmit electrosurgical energy to a tissue at a surgical site; and a control circuit communicatively coupled to the energy delivery component and programmed to:
for a first application period, cause the at least one energy delivery component to transmit the electrosurgical energy at a first power level, the first application period comprising a point in time where impedance of the tissue reaches a minimum impedance value; and
for a second application period after the first application period, cause the at least one energy delivery component to transmit the electrosurgical energy, starting from a predetermined proportion of a transition impedance threshold level and decreasing the electrosurgical energy at a steady rate from the first power level until a second power level is reached, wherein the second power level is lower than the first power level and the second application period comprises a point in time where the impedance of the tissue rises above the minimum impedance value.

18 . The surgical instrument of claim 17 , wherein the first application period and the second application period combined comprise a time period where the electrosurgical energy is delivered at a higher rate and causes sealing of the tissue at the surgical site.

19 . The surgical instrument of claim 25 , wherein the third application period further comprises a time period where the impedance of the tissue rises to a level such that the electrosurgical energy is delivered at a lower rate and no longer causes sealing of the tissue at the surgical site.

20 . The surgical instrument of claim 17 , further comprising at least one s

Assignees

• Cilag Gmbh Int

Inventors

• Yates David C
• Krumm Amy M
• Davison Mark A

Classifications

• A61B2018/00875

  Resistance or impedance · CPC title

• A61B2018/00702

  Power or energy · CPC title

• A61B2018/00678

  upper · CPC title

• A61B2018/00642

  with feedback, i.e. closed loop control · CPC title

• A61B2018/0063

  Sealing · CPC title