Instruments, systems, and methods for sealing tissue structures

Patent metadata

Field	Value
Publication number	US-9433461-B2
Application number	US-201314017572-A
Country	US
Kind code	B2
Filing date	Sep 4, 2013
Priority date	Sep 7, 2012
Publication date	Sep 6, 2016
Grant date	Sep 6, 2016

Abstract

A method of sealing bowel tissue includes grasping bowel tissue between first and second electrically-conductive surfaces, applying a clamping pressure to the grasped bowel tissue in a range of about 1 kg/cm 2 to about 2.5 kg/cm 2 , supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue to seal the grasped bowel tissue, and monitoring one or more parameters during the supplying of energy to the electrically-conductive surface(s). Instruments, end effector assemblies, generators, and systems suitable for this purpose are also provided.

First claim

What is claimed is:

1. A method of sealing bowel tissue, comprising:
grasping bowel tissue between first and second electrically-conductive surfaces;
applying a clamping pressure to the grasped bowel tissue in a range of about 1 kg/cm 2 to about 2.5 kg/cm 2 ;
supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue;
monitoring an impedance of the grasped bowel tissue as a function of time during the supplying of energy to the at least one of the first and second electrically-conductive surfaces; and
controlling the supply of energy to the at least one of the first and second electrically-conductive surfaces to maintain a target impedance ramp of the grasped bowel tissue such that the grasped bowel tissue is sealed with minimal bowel tissue denaturation, bowel tissue damage, and breakdown of bowel tissue layer architecture.

2. The method according to claim 1 , wherein the target impedance ramp is about 0.010 Ω/ms.

3. The method according to claim 1 , wherein supplying energy to the at least one of the first and second electrically-conductive surfaces includes supplying energy until bowel tissue impedance reaches a target end impedance.

4. The method according to claim 3 , wherein the target end impedance is about 200Ω.

5. A method of sealing bowel tissue, comprising:
grasping bowel tissue between first and second electrically-conductive surfaces;
applying a clamping pressure to the grasped bowel tissue in a in a range of about 1 kg/cm 2 to about 2.5 kg/cm 2 ;
supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue;
monitoring a temperature of the grasped bowel tissue during the supplying of energy to the at least one of the first and second electrically-conductive surfaces; and
controlling the supply of energy to the at least one of the first and second electrically-conductive surfaces to maintain the temperature of the grasped bowel tissue between a lower temperature limit, corresponding to a minimum temperature for sealing bowel tissue, and an upper temperature limit, corresponding to a maximum temperature prior to occurrence of bowel tissue denaturation, bowel tissue damage, and breakdown of bowel tissue layer architecture, such that the grasped bowel tissue is sealed with minimal bowel tissue denaturation, bowel tissue damage, and breakdown of bowel tissue layer architecture.

6. A method of sealing bowel tissue, comprising:
grasping bowel tissue between first and second electrically-conductive surfaces;
applying a clamping pressure to the grasped bowel tissue in a range of about 1 kg/cm 2 to about 2.5 kg/cm 2 ;
supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue;
monitoring an optical property of the grasped bowel tissue during the supplying of energy to at least one of the first and second electrically-conductive surfaces; and
stopping the supplying of energy to the at least one of the first and second electrically-conductive surfaces when the optical property of the grasped bowel tissue indicates at least one of bowel tissue denaturation, bowel tissue damage, and breakdown of bowel tissue layer architecture, such that the grasped bowel tissue is sealed with minimal bowel tissue denaturation, bowel tissue damage, and breakdown of bowel tissue layer architecture.

Assignees

• Covidien Lp

Inventors

• Arya Shobhit
• Su Lei
• Darzi Ara W
• Hanna George B

Classifications

• A61B2018/00702

  Power or energy · CPC title

• A61B2018/00494

  Stomach, intestines or bowel · CPC title

• A61B2018/0063

  Sealing · CPC title

• A61B2018/00791

  Temperature · CPC title

• A61B18/1445 Primary

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