The present disclosure relates to surgical instruments and, more particularly, to electrosurgical end effector assemblies and electrosurgical forceps configured to reduce thermal spread to surrounding tissue.
A surgical forceps is a plier-like device which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue. Electrosurgical forceps utilize both mechanical clamping action and energy to treat, e.g., coagulate, cauterize, and/or seal, tissue. Generally, electrosurgical forceps can be categorized as monopolar electrosurgical forceps or bipolar electrosurgical forceps.
Bipolar electrosurgical forceps generally employ opposing electrodes that are charged to different electric potentials, thus enabling the conduction of energy therebetween and through tissue disposed between the electrodes to treat tissue. Although suitable energy is required to effectively treat tissue, the application of energy to tissue should be targeted to the specific region of tissue to be treated. Thermal spread, defined as heat transfer (heat conduction, heat convection, or electrical current dissipation) to adjacent tissue outside the targeted region, should be minimized, as such may result in collateral damage to adjacent tissue.
As used herein, the term “distal” refers to a component or portion thereof that is being described which is further from a user, while the term “proximal” refers to a component or portion thereof that is being described which is closer to a user. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.
An end effector assembly of an electrosurgical forceps provided in accordance with aspects of the present disclosure includes first and second jaw members, one or both of which is movable relative to the other between a spaced-apart position and an approximated position. One or both of the jaw members includes an electrically-conductive inner member defining an outer surface, a first electrically-insulative layer disposed on at least a first portion of the outer surface of the electrically-conductive inner member, a second electrically-insulative layer disposed on at least a second portion of the outer surface of the electrically-conductive inner member, and an electrode disposed on the second electrically-insulative layer and electrically coupled to the electrically-conductive inner member. The first electrically-insulative layer has a thermal conductivity greater than a thermal conductivity of the second electrically-insulative layer. The electrode defines a tissue-treating surface of the corresponding jaw member.
In an aspect of the present disclosure, the first electrically-insulative layer includes diamond-like carbon. Additionally or alternatively, the second electrically-insulative layer may include titanium dioxide.
In another aspect of the present disclosure, the second electrically-insulative layer has a thermal conductivity value less than 50 W/(m K).
In still another aspect of the present disclosure, the first electrically-insulative layer has a thermal conductivity value greater than 500 W/(m K).
In yet another aspect of the present disclosure, the electrically-conductive inner member includes a proximal flange and a distal body. In such aspects, the first electrically-insulative layer is disposed on a first portion of the distal body, and the second electrically-insulative layer is disposed on the proximal flange and a second portion of the distal body.
In still yet another aspect of the present disclosure, the second electrically-insulative layer defines a window and the electrode is electrically coupled to the electrically-conductive inner member through the window.
An electrosurgical forceps provided in accordance with aspects of the present disclosure includes an end effector assembly including first and second jaw members each defining a tissue-treating surface. One or both of the jaw members is movable relative to the other between a spaced-apart position and an approximated position. One or both of the jaw members includes a first electrically-insulative layer disposed on at least a first portion of the jaw members. The first electrically-insulative layer has a thermal conductivity value greater than about 50 W/(m K). The one or both of the jaw members further includes an electrode disposed on the jaw member and defining the tissue-treating surface thereof.
In an aspect of the present disclosure, the first electrically-insulative layer has a thermal conductivity value greater than about 200 W/(m K). In another aspect of the present disclosure, the first electrically-insulative layer has a thermal conductivity value greater than about 500 W/(m K).
In another aspect of the present disclosure, the first electrically-insulative layer is disposed on an opposite side of the jaw member as compared to the electrode.
In still another aspect of the present disclosure, a second electrically-insulative layer is disposed on a second portion of one or both of the jaw members. The second electrically-insulative layer having a thermal conductivity value less than about 50 W/(m K).
In yet another aspect of the present disclosure, the first and/or second jaw member further includes an electrically-conductive inner member defining an outer surface. The first electrically-insulative layer is disposed on at least a portion of the outer surface of the electrically-conductive inner member.
In still yet another aspect of the present disclosure, the forceps further includes a housing and a shaft extending distally from the housing. The shaft defines a distal end and includes the end effector assembly disposed at the distal end thereof.
In another aspect of the present disclosure, the forceps further includes first and second shaft members each defining a distal end. The first shaft member has the first jaw member attached at the distal end thereof and the second shaft member has the second jaw member attached at the distal end thereof.
Another electrosurgical forceps provided in accordance with aspects of the present disclosure includes first and second electrically-conductive inner members each including a shaft member, a jaw member at a distal end of the shaft member, and a handle at a proximal end of the shaft member. The first and second inner members are coupled to one another such that movement of the handles between an open position and a closed position moves the jaw members between a spaced-apart position and an approximated position. One or both of the electrically-conductive inner members includes a first electrically-insulative layer disposed on a portion of the jaw member thereof, a second electrically-insulative layer disposed on another portion of the jaw member thereof and also disposed on a portion of the shaft member and the handle thereof, and an electrode disposed on a portion of the second electrically-insulative layer at the corresponding jaw member. The first electrically-insulative layer has a thermal conductivity greater than a thermal conductivity of the second electrically-insulative layer.
In an aspect of the present disclosure, the first electrically-insulative layer has a thermal conductivity value greater 200 W/(m K).
In another aspect of the present disclosure, the second electrically-insulative layer defines a first window at the corresponding jaw member and the electrode is electrically coupled to that jaw member through the first window.
In yet another aspect of the present disclosure, the second electrically-insulative layer defines a second window at the corresponding handle and the handle is adapted to connect to a source of energy through the second window.
In still another aspect of the present disclosure, at the jaw member of the first and/or second electrically-conductive inner members, the first electrically-insulative layer is disposed on an opposite side of the jaw member as compared to the second electrically-insulative layer and the electrode.
Various aspects and features of the present disclosure described herein with reference to the drawings wherein:
Turning to
Referring to
Each jaw member 110, 120 of end effector assembly 100 includes an electrically-conductive inner member 115, 125 (
Referring to
Handle assembly 30 includes a fixed handle 50 and a movable handle 40. Fixed handle 50 is integrally associated with housing 20 and movable handle 40 is movable relative to fixed handle 50. More specifically, movable handle 40 is pivotably coupled to housing 20 within housing 20 and operably coupled to a drive assembly (not shown) disposed within housing 20 such that movable handle 40 and the drive assembly (not shown), together, mechanically cooperate to impart movement of one or both of jaw members 210, 220 between a spaced-apart position and an approximated position to grasp tissue therebetween. As shown in
Similarly as with end effector assembly 100 (
Turning to
Referring to
First outer layers 116, 126 may be formed via coating an electrically-insulative material onto distal bodies 112, 122 of inner members 115, 125 using any suitable technique. In some embodiments, first outer layers 116, 126 are made of a material that has a thermal conductivity value greater than about 50 W/(m K), in some other embodiments, greater than about 200 W/(m K), and in still yet some other embodiments, greater than about 500 W/(m K). First outer layers 116, 126 may each have a thickness of from about 1 μm to about 50 μm in some embodiments, and in some other embodiments from about 5 μm to about 20 μm. In some embodiments, first outer layers 116, 126 are made of diamond-like carbon. In such embodiments, first outer layers 116, 126 may be applied using chemical vapor deposition or physical vapor deposition, for example.
With continued reference to
Second outer layers 117, 127 define windows 131, 132 extending therethrough. As detailed below, windows 131, 132 are provided to enable electrical connection between inner members 115, 125 and electrodes 118, 128. In some embodiments, first and second outer layers 116, 126 and 117, 127 cooperate to fully surround and cover the exterior of inner members 115, 125 except for windows 131, 132.
Prior to application of second outer layers 117, 127, inner members 115, 125 may be pre-treated to improve adhesion of second outer layers 117, 127 thereon. In some embodiments, the portions of inner members 115, 125 to which second outer layers 117, 127 are to be applied are subjected to micro-arc oxidation (MAO) treatment to facilitate subsequent adhesion of second outer layers 117, 127, as detailed below.
Referring still to
Electrodes 118, 128 are formed from an electrically-conductive material applied to second outer layers 117, 127. Electrodes 118, 128 extend over windows 131, 132 defined within respective second outer layers 117, 127 such that electrodes 118, 128 are electrically connected to respective inner member 115, 125 via windows 131, 132. Electrodes 118, 128 may at least partially fill windows 131, 132 to establish such connection, inner members 115, 125 may protrude into windows 131, 132 to establish such connection, and/or a conductive material may be disposed within windows 131, 132 to establish such a connection.
Electrodes 118, 128 are shown in
Referring additionally to
With additional reference to
Referring generally to
Still referring to
Once tissue is positioned as desired, shaft members 12a, 12b may be moved towards one another, e.g., to a closed position, to pivot jaw members 110, 120 about pivot pin 103 toward the approximated position to grasp tissue between tissue-treating surfaces 114, 124. With shaft members 12a, 12b sufficiently approximated and, thus, with tissue grasped between tissue-treating surfaces 114, 124 of jaw members 110, 120 under suitable closure pressure, protrusion 13 of shaft member 12b contacts connection member 6, thereby establishing electrical connection between cable 2 and shaft member 12b, with shaft member 12a already connected to cable 2 via proximal shaft connector 19. In embodiments where separate shaft connectors (not shown) connect cable 2 to shaft members 12a, 12b, such connection upon sufficient approximation of shaft members 12a, 12b is not required as shaft members 12a, 12b, in such embodiments, are already electrically connected to cable 2.
With tissue grasped between tissue-treating surfaces 114, 124 and electrical connection established, if required, the user may selectively apply electrosurgical energy to electrodes 118, 128 via shaft members 12a, 12b and inner members 115, 125, respectively, by actuating activation switch 8. Upon such actuation, energy is conducted between electrodes 118, 128 and through tissue grasped between tissue-treating surfaces 114, 124 defined by electrodes 118, 128 to thereby treat the grasped tissue. Once tissue has been sufficiently treated, shaft members 12a, 12b may be returned to the open position to return jaw members 110, 120 to the spaced-apart position to release the treated tissue. In some embodiments, forceps 10 may further incorporate mechanical and/or electrical features to enable tissue cutting along the treatment area after tissue treatment (or where only tissue cutting is desired).
During tissue treatment, heat generated via the conduction of energy between electrodes 118, 128 and through tissue is dissipated along the lengths of distal bodies 112, 122 of jaw members 110, 120 due to the relatively high thermal conductivity of first outer layers 116, 126. Further, heat is conducted away from electrodes 118, 128 due to the fact that first outer layers 116, 126 are disposed on an opposite side of jaw members 110, 120 as compared to electrodes 118, 128 and do to the relatively high thermal conductivity of first outer layers 116, 126 as compared to second outer layers 117, 127. Second outer layers 117, 127, having a relatively low thermal conductivity, inhibit the conduction of heat laterally from electrodes 118, 128 and proximally to proximal flanges 111, 121 of jaw members 110, 120. Thus, via the above-detailed configuration of jaw members 110, 120, thermal spread from electrodes 118, 128 is reduced and collateral damage to surrounding tissue caused by thermal spread is inhibited.
Referring to
The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
Turning to
Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
Robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 1002, 1003, their attaching devices 1009, 1011 and thus the surgical tool (including end effector 1100) execute a desired movement according to a movement defined by means of manual input devices 1007, 1008. Control device 1004 may also be set up in such a way that it regulates the movement of robot arms 1002, 1003 and/or of the drives.
Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to with control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Filing Document | Filing Date | Country | Kind |
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PCT/CN2015/088088 | 8/26/2015 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2017/031712 | 3/2/2017 | WO | A |
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Entry |
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