Instruments, systems and methods for sealing tissue structures

Patent metadata

Field	Value
Publication number	US-9924999-B2
Application number	US-201615200176-A
Country	US
Kind code	B2
Filing date	Jul 1, 2016
Priority date	Sep 7, 2012
Publication date	Mar 27, 2018
Grant date	Mar 27, 2018

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 tissue, comprising:
providing a target impedance ramp, wherein the target impedance ramp represents a change in impedance as a function of time that results in sealing of tissue while minimizing tissue denaturation, tissue damage, and breakdown of tissue layer architecture;
grasping tissue between first and second electrically-conductive surfaces;
sealing the grasped tissue by 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 tissue;
monitoring an impedance of the grasped tissue as a function of time during the supplying of energy to the at least one of the first and second electrically-conductive surfaces;
determining an actual impedance ramp, wherein the actual impedance ramp represents the monitored impedance of the grasped tissue as a function of time; and
controlling the supply of energy to the at least one of the first and second electrically-conductive surfaces based on a comparison of the actual impedance ramp with the target impedance ramp to maintain the actual impedance ramp equal to the target impedance ramp such that the grasped tissue is sealed with minimal tissue denaturation, tissue damage, and breakdown of tissue layer architecture of the grasped tissue that is being sealed to maintain viability of the tissue that is being sealed.

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 tissue impedance reaches a target end impedance.

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

5. The method according to claim 1 , wherein the tissue is bowel tissue.

6. A method of sealing tissue, comprising:
providing a lower tissue temperature limit corresponding to a minimum temperature for sealing tissue;
providing an upper tissue temperature limit corresponding to a maximum temperature prior to occurrence of tissue denaturation, tissue damage, and breakdown of tissue layer architecture;
grasping tissue between first and second electrically-conductive surfaces;
sealing the grasped tissue by 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 tissue;
monitoring a temperature of the grasped tissue during the supplying of energy to the at least one of the first and second electrically-conductive surfaces;
determining an actual tissue temperature, wherein the actual tissue temperature represents the monitored temperature of the grasped tissue;
controlling the supply of energy to the at least one of the first and second electrically-conductive surfaces based on a comparison of the actual tissue temperature of the grasped tissue with the lower and upper temperature limits; and
maintaining the actual tissue temperature of the grasped tissue between the lower temperature limit and the upper temperature limit, such that the grasped tissue is sealed with minimal tissue denaturation, tissue damage, and breakdown of tissue layer architecture of the grasped tissue that is being sealed to maintain viability of the tissue that is being sealed.

7. The method according to claim 6 , wherein the tissue is bowel tissue.

Assignees

• Covidien Lp

Inventors

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

Classifications

• A61B2018/00755

  Resistance or impedance · CPC title

• A61B2018/00702

  Power or energy · CPC title

• A61B2018/00678

  upper · CPC title

• A61B2018/00672

  lower · CPC title

• A61B2018/0063

  Sealing · CPC title