The subject invention is directed to electrosurgical instruments, and more particularly, to a bi-polar vessel sealer having a jaw assembly that has opposed sealing surfaces with a varying tissue gap height.
Laparoscopic or “minimally invasive” surgical techniques are becoming commonplace in the performance of procedures such as cholecystectomies, appendectomies, hernia repair and nephrectomies. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.
Electrosurgical instruments for sealing blood vessels are often used in laparoscopic and other endoscopic surgical procedures. These instruments utilize both the mechanical clamping action of a pair of jaws and electrical energy to cauterize and seal blood vessels during a surgical procedure. Existing vessel sealing devices use non-conductive stops to create a gap between the sealing surfaces (electrodes) of the jaws without allowing current to transfer through the stops. This gap allows for energy to transfer through tissue, between the sealing surfaces (one side acting as the anode and the other as the cathode) and is a critical feature in providing effective sealing. The prior art describes the stops added to opposing sealing surfaces as being designed with a uniform gap between the surfaces. An example of such a prior art device is disclosed in U.S. Pat. No. 10,568,682.
In addition to controlling the gap between electrodes, tissue grasping is also a crucial aspect of jaw design, especially when dividing tissue. In bi-polar sealers, tissue is typically divided with a cutting blade that runs through the center of the jaws that creates an axial force on the tissue when deployed. If there isn't sufficient grasping of the tissue, the tissue will be forced out of the jaws during use. It would be beneficial therefore to provide an electrosurgical vessel sealing instrument that uses non-conductive stops on opposing sealing surfaces to provide gap control but also includes a non-uniform separation between the sealing surfaces to aid in tissue grasping.
The subject invention is directed to a new and useful electrosurgical instrument for use in endoscopic and laparoscopic surgical procedures to cauterize and seal blood vessels using electrical energy, which has enhanced tissue grasping characteristics. The electrosurgical instrument includes a proximal handle portion, an elongated tubular body portion that extends distally from the proximal handle portion and a jaw assembly that is operatively associated with a distal end of the tubular body portion.
The jaw assembly includes a pair of cooperating jaw members that are adapted and configured for movement between an open position and a closed position. Each jaw member includes a conductive sealing plate upon which a sealing surface of the jaw member is defined. The two sealing surfaces of the jaw members define a vessel sealing gap therebetween when the jaw members are in the closed position. Preferably, the vessel sealing gap has a height that varies along an axial extent of the jaw assembly between a proximal end portion of the jaw assembly and a distal end portion of the jaw assembly. This varying height vessel sealing gap enhances the tissue grasping characteristics of the jaw assembly.
More particularly, the vessel sealing gap of the jaw assembly includes a proximal gap area, a medial gap area and a distal gap area. The height of the medial gap area is greater than the height of the proximal gap area and the height of the distal gap area. It is envisioned that at least one of the jaw members includes a proximal sealing surface, a medial sealing surface and a distal sealing surface, and the height of the medial sealing surface is less than the height of the proximal sealing surface and the height of the distal sealing surface.
At least a portion of the sealing surface of each jaw member has a plurality of spaced apart coining features formed therein for enhancing the tissue grasping characteristics of the jaw assembly. In addition, at least a portion of the sealing surface of each jaw member has a plurality of spaced apart non-conductive protuberances formed thereon for grasping tissue. The protuberances act as stops to help define the vessel sealing gap and to further enhance the tissue grasping characteristics of the jaw assembly.
Preferably, the non-conductive protuberances are formed on the sealing surface of each jaw member from a ceramic material in an additive manufacturing process, and they are preferably located in the proximal gap area, the medial gap area and the distal gap area. It is envisioned that the location, spacing, size and shape of non-conductive protuberances or stops could vary by design to enhance or otherwise change the tissue grasping characteristics of the jaw assembly.
A conductive wire extends from the proximal handle assembly, through the elongated body to the jaw assembly for connecting with each of the conductive sealing plates to supply energy thereto for sealing a blood vessel. The sealing surface on each jaw member includes a recessed track for accommodating a translating cutting blade that is used to divide a sealed blood vessel. The proximal handle portion includes a deployment trigger operatively connected to the jaw assembly through the elongated body portion for moving the cutting blade through the jaw assembly within the recessed track formed in in each sealing surface.
The proximal handle portion further includes an actuation handle operatively connected to the jaw assembly through the elongated body portion for moving the jaw members between the open and closed positons. The proximal handle portion also includes a rotation knob operatively associated with the elongated body portion for rotating the elongated body portion about a longitudinal axis thereof relative to the proximal handle portion.
Each jaw member includes a proximal yoke portion having an angled cam slot formed therein for accommodating a transverse cam pin that is operatively connected to the actuation handle through the elongated body portion, and an aperture for accommodating a transverse pivot pin.
The subject invention is also directed to an electrosurgical instrument for use in endoscopic and laparoscopic surgical procedure to seal and divide a blood vessel, which includes a proximal handle portion, an elongated tubular body portion extending distally from the proximal handle portion, a jaw assembly operatively associated with a distal end of the body portion and including a pair of cooperating jaw members mounted for movement between an open position and a closed position for grasping and sealing a blood vessel, and a cutting blade operatively associated with the jaw assembly for dividing the sealed blood vessel.
Preferably, each jaw member of the jaw assembly includes a conductive sealing plate upon which a sealing surface of the jaw member is defined, and the opposed sealing surfaces of the jaw members define a vessel sealing gap therebetween when the jaw members are in the closed position. The vessel sealing gap includes a proximal gap area, a medial gap area and a distal gap area, wherein the height of the medial gap area is greater than the height of the proximal gap area and the height of the distal gap area so as to provide the jaw assembly with enhanced tissue grasping characteristics, particularly when the sealed blood vessel is being divided by the cutting blade.
These and other features of the electrosurgical instrument of the subject invention will become more readily apparent to those having ordinary skill in the art to which the subject invention appertains from the detailed description of the preferred embodiments taken in conjunction with the following brief description of the drawings.
So that those skilled in the art will readily understand how to make and use the electrosurgical instrument of the subject invention without undue experimentation, preferred embodiments thereof will be described in detail herein below with reference to the figures wherein:
Referring now to the drawings wherein like reference numerals identify like or similar structural elements or features of the subject invention, there is illustrated in
The electrosurgical instrument 10 of the subject invention includes a proximal handle assembly 12, an elongated tubular body portion 14 that extends distally from the proximal handle assembly 12 and a bi-polar jaw assembly 16 that is operatively associated with a distal end of the tubular body portion 14. More particularly, the tubular body portion 14 includes a bifurcated distal end section 15 that accommodates the bi-polar jaw assembly 16.
The proximal handle assembly 12 is preferably formed in two-parts from a high strength, light weight medical grade plastic material, such as Lexan or the like, and it includes an upper body portion 18 and a lower fixed grasping portion 20. A U-shaped pivoting actuation handle 22 is operatively associated with the upper body portion 18 of the handle assembly 12 for actuating the jaw assembly 16, as will be discussed in more detail below with further reference to
A deployment trigger 24 is also operatively associated with the body portion 18 of the handle assembly 12 for actuating a cutting knife that translates through the jaw assembly 16 to divide a sealed blood vessel, which will also be discussed in more detail below with further reference to
With continuing reference to
Referring now to
As best seen in
The vessel sealing gap G of the jaw assembly 16 includes a distal gap area that is best seen in
By way of illustrative example, as best seen in
Referring now to
The proximal yoke portion 64 of jaw member 32 has a longitudinal bore hole 70 for accommodating passage of the electrical conductor 58, an angled cam slot 72 for accommodating a transverse camming pin 75 (see
Those having ordinary skill in the art will readily appreciate that the structure of the lower jaw member 34 of jaw assembly 16 is substantially similar to the structure of the upper jaw member 32 of jaw assembly 16 described above, except that the angled cam slot in the proximal yoke of the lower jaw member 34 would be oppositely oriented so that longitudinal movement of the camming pin 75 relative to the two oppositely angled cam slots would effectuate the opening and closing of the two jaw members 32, 34. Also, note the paired conductors 58a, 58b in shown
More particularly, with reference to
Once closed, the bi-polar jaw assembly 16 is energized to seal and cauterize a blood vessel grasped between the conductive sealing surfaces 40, 42. Those skilled in the art will readily appreciate that the control of electrical power to the instrument 10 by way of power cable 30 can be achieved through actuation of a foot peddle or other mechanism connected to the power cable 30. Thereafter, upon the release of actuation handle 22, the actuation shaft 78 will be pulled in a proximal direction under the influence of the coiled spring 108 associated with the coupling 106 of the rocker arm 102.
Referring again to
In addition, at least a portion of the sealing surface 40, 42 of each jaw member 32, 34 has a plurality of spaced apart non-conductive protuberances formed thereon for further enhancing the tissue grasping characteristics of the jaw assembly 16. More particularly, a section of the sealing surface 40 of the upper jaw member 32 includes a set of spaced apart rounded protuberances 84, while a mirrored section of the sealing surface 42 of the lower jaw member 34 includes a corresponding set of spaced apart rounded protuberances 86. The protuberances also act as stops to maintain the gap spacing between the conductive sealing surfaces 40, 42 of the jaw members 32, 34.
The geometry of the non-conductive protuberances 84, 86 is best seen in
The protuberances 84, 86 are preferably, but not necessarily located in the proximal gap area, the medial gap area and the distal gap area defined between the two jaw members 32, 34. It is envisioned that the location, spacing, size and shape of non-conductive protuberances 84, 86 could vary by design to enhance or otherwise change the tissue grasping characteristics of the jaw assembly.
Referring now to
In use, upon pressing the trigger lock 26 to displace the pivoting lock link 23, manual actuation of the trigger 24 against the bias of the coiled spring 100 that surrounds the drive shaft 96, causes the drive shaft 96 to advance in a distal direction. This drives the cutting blade 90 through the jaw assembly 16 within the recessed tracks 92, 94 in jaw members 32, 34 to divide a sealed blood vessel, as best seen in
While the electrosurgical instrument of the subject disclosure has been shown and described with reference to preferred embodiments, those skilled in the art will readily appreciate that changes and/or modifications may be made thereto without departing from the scope of the subject disclosure.
This application is a U.S. National Phase Application filed under 35 U.S.C. § 371, based on International Patent Application No. PCT/US202/030551, filed Apr. 29, 2020, which claims priority to U.S. Provisional Patent Application Ser. No. 62/840,437 filed Apr. 30, 2019, the disclosures of which are herein incorporated by reference in their entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2020/030551 | 4/29/2020 | WO | 00 |
Number | Date | Country | |
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62840437 | Apr 2019 | US |