1. Technical Field
The present disclosure relates generally to electrosurgical instruments and, more particularly, to an electrosurgical pencil having a plurality of hand-accessible variable controls.
2. Background of Related Art
Electrosurgical instruments have become widely used by surgeons in recent years. Accordingly, a need has developed for equipment and instruments that are easy to handle, are reliable and are safe in an operating environment. By and large, most electrosurgical instruments are hand-held instruments, e.g., an electrosurgical pencil, that transfer radio-frequency (RF) electrical or electrosurgical energy to a tissue site. The electrosurgical energy is returned to the electrosurgical source via a return electrode pad positioned under a patient (i.e., a monopolar system configuration) or a smaller return electrode positionable in bodily contact with or immediately adjacent to the surgical site (i.e., a bipolar system configuration). The waveforms produced by the RF source yield a predetermined electrosurgical effect known generally as electrosurgical cutting and fulguration.
As used herein the term “electrosurgical pencil” is intended to include instruments having a handpiece that is attached to an active electrode and is used to cauterize, coagulate and/or cut tissue. Typically, the electrosurgical pencil may be operated by a handswitch or a foot switch. The active electrode is an electrically conducting element, which is usually elongated and may be in the form of a thin flat blade with a pointed or rounded distal end. Alternatively, the active electrode may include an elongated narrow cylindrical needle that is solid or hollow with a flat, rounded, pointed or slanted distal end. Typically electrodes of this sort are known in the art as “blade”, “loop” or “snare”, “needle” or “ball” electrodes.
As mentioned above, the handpiece of the electrosurgical pencil is connected to a suitable electrosurgical energy source (i.e., generator) that produces the radio-frequency electrical energy necessary for the operation of the electrosurgical pencil. In general, when an operation is performed on a patient with an electrosurgical pencil, electrical energy from the electrosurgical generator is conducted through the active electrode to the tissue at the site of the operation and then through the patient to a return electrode. The return electrode is typically placed at a convenient place on the patient's body and is attached to the generator by a conductive material. Typically, the surgeon activates the controls on the electrosurgical pencil to select the modes/waveforms to achieve a desired surgical effect.
The power parameters are typically controlled from outside the sterile field, which requires an intermediary like a circulating nurse to make such adjustment.
A typical electrosurgical generator has numerous controls for selecting an electrosurgical output. For example, the surgeon can select various surgical “modes” to treat tissue: cut, blend (blend levels 1-3), low cut, desiccate, fulgurate, spray, etc. The surgeon also has the option of selecting a range of power settings. As can be appreciated, this gives the surgeon a great deal of variety when treating tissue. However, so many options also tend to complicate simple surgical procedures and may lead to confusion. Moreover, surgeons typically follow preset control parameters and stay within known modes, frequencies, and power settings.
The present disclosure is directed to an electrosurgical pencil having variable controls. In accordance with one aspect of the present disclosure the electrosurgical pencil includes an elongated housing and an electrocautery electrode supported within the housing and extending distally from the housing, the electrocautery electrode being connected to a source of electrosurgical energy. At least one voltage divider network (hereinafter “VDN”) is also supported on the housing and, is electrically connected to the source of electrosurgical energy for controlling a frequency, intensity, and/or mode of electrosurgical energy being delivered to the electrocautery electrode.
In another embodiment, an electrosurgical pencil is disclosed having an elongated housing and an electrocautery electrode supported within the housing and extending distally therefrom. The electrocautery electrode is operable to connect to a source of electrosurgical energy. At least one voltage divider network is supported on the housing and is operable to electrically connect to the source of electrosurgical energy for controlling the frequency, intensity, and/or mode of electrosurgical energy being delivered to the electrocautery electrode. The electrosurgical pencil further includes a frequency controller slidably supported on the housing. The frequency controller is configured to selectively actuate the voltage divider network(s) and provide a tactile feedback to a user of the electrosurgical pencil as the frequency controller is moved relative to the housing.
Various embodiments of the present disclosure are described herein with reference to the drawings wherein:
Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings. As used herein, the term “distal” refers to that portion which is further from the user while the term “proximal” refers to that portion which is closer to the user or surgeon. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.
In general, the present disclosure is directed to an electrosurgical pencil including an electrocautery electrode and at least one VDN electrically connected to a source of electrosurgical energy for controlling at least one of a frequency, an intensity, and a mode of electrosurgical energy being delivered to the electrocautery electrode.
As seen in
As shown, electrosurgical pencil 10 is coupled to a conventional electrosurgical generator “G” via a cable 12. Cable 12 includes a transmission wire 14 (see
Turning back to
In use, depending on which activation switch 24a-24c is depressed a respective switch 26a-26c is pressed into contact with VDN 27 and a characteristic signal is transmitted to electrosurgical generator “G” via control wires 16. Control wires 16a-16c are electrically connected to switches 26a-26c via a terminal 15 (see
Activation switches 24a-24c are configured and adapted to control the mode and/or “waveform duty cycle” to achieve a desired surgical intent. For example, first activation switch 24a can be set to deliver a characteristic signal to electrosurgical generator “G” that in turn transmits a duty cycle and/or waveform shape that produces a cutting and/or dissecting effect/function. Meanwhile, second activation switch 24b can be set to deliver a characteristic signal to electrosurgical generator “G” that in turn transmits a duty cycle and/or waveform shape that produces a blending effect/function (e.g., a combination of a dissecting and a hemostatic effect/function). Finally, third activation switch 24c can be set to deliver a characteristic signal to electrosurgical generator “G” that in turn transmits a duty cycle and/or waveform shape that produces a hemostatic effect/function.
Fourth control wire 16d (i.e., a return control wire) is connected to proximal end 11 of electrocautery blade 6. This prevents electrosurgical current, induced in control wires 16a-16c, from flowing through activation switches 24a-24c to electrocautery blade 6. This in turn, increases the longevity and life of switches 24a-24c.
Electrosurgical pencil 10 further includes an intensity controller 28 slidingly supported on housing 2. Intensity controller 28 includes a pair of nubs 29a, 29b, which are slidingly supported, one each, in respective guide channels 30a, 30b, formed in outer surface 7 of housing 2 on either side of activations switches 24a-24c. By providing nubs 29a, 29b on either side of activation switches 24a-24c, controller 28 can be easily manipulated by either hand of the user or the same electrosurgical pencil can be operated by a right-handed or a left-handed user.
In embodiments, intensity controller 28 may be a slide potentiometer wherein nubs 29a, 29b have a first position (e.g., proximal-most position closest to cable 12) corresponding to a relative low intensity setting, a second position (e.g., a distal-most position closest to electrocautery end effector 6) corresponding to a relative high intensity setting, and a plurality of intermediate positions corresponding to intermediate intensity settings. In embodiments, the intensity settings from proximal end to distal end may be reversed (e.g., high to low). Nubs 29a, 29b of intensity controller 28 and corresponding guide channels 30a, 30b may be provided with a series of cooperating discreet or dented positions defining a series of positions (e.g., five) to allow easy selection of the output intensity from the low intensity setting to the high intensity setting. The series of cooperating discreet or detented positions also provide the surgeon with a degree of tactile feedback. As best seen in
Intensity controller 28 is configured and adapted to adjust the power parameters (e.g., voltage, power and/or current intensity) and/or the power verses impedance curve shape to affect the perceived output intensity. For example, the greater intensity controller 28 is displaced in a distal direction the greater the level of the power parameters transmitted to electrocautery blade 6. Conceivably, current intensities can range from about 60 mA to about 240 mA when using an electrosurgical blade and having a typical tissue impedance of about 2K ohms. An intensity level of 60 mA provides very light and/or minimal cutting/dissecting/hemostatic effects. An intensity level of 240 mA provides very aggressive cutting/dissecting/hemostatic effects. Accordingly, the optimal range of current intensity is from about 100 mA to about 200 mA at 2K ohms.
In embodiments, the intensity settings are preset and selected from a look-up table based on a choice of electrosurgical instruments/attachments, desired surgical effect, surgical specialty and/or surgeon preference. The selection may be made automatically or selected manually by the user. The intensity values may be predetermined or adjusted by the user.
Electrosurgical pencil 10 further includes a frequency controller 35 slidingly supported on housing 2. Frequency controller 35 includes a nub 36 that is slidingly supported in a guide channel 37 formed in outer surface 7 of housing 2 proximal to activation switches 24a-24c.
In embodiments, frequency controller 35 may be a slide potentiometer wherein nub 36 has a first position (e.g., a proximal-most position closest to cable 12) corresponding to a relative low frequency setting, a second position (e.g., a distal-most position closest to electrocautery end effector 6) corresponding to a relatively high frequency setting, and a plurality of intermediate positions corresponding to intermediate frequency settings. Any one of the plurality of intermediate positions may correspond to the “park” position, as discussed above, that corresponds to a standard and/or pre-determined frequency setting.
In embodiments, nub 36 of frequency controller 35 and corresponding guide channel 37 may be provided with a series of cooperating discreet or dented positions defining a series of positions (e.g., five positions) to allow easy selection of the output frequency from the low frequency setting to the high frequency setting. The series of cooperating discreet or detented positions also provide the surgeon with a degree of tactile feedback. As best seen in
Frequency controller 35 is configured and adapted to adjust the frequency parameter to affect the perceived RF output of generator “G.” By way of example, the greater frequency controller 35 is displaced in a distal direction the greater the level of the frequency parameter of the energy transmitted to electrocautery blade 6. As frequency is increased from about 470 kHz to about 1 MHz, thermal penetration decreases and arc length increases. Thus, a frequency level of 470 kHz provides for deep thermal penetration and a relatively short arc length while a frequency level of 1 MHz provides for superficial thermal penetration and a relatively long arc length. Accordingly, the user would utilize the frequency controller 35 to select the lower 470 kHz level of frequency if deep thermal penetration is required to provide the desired surgical effect without the need for a long arc length. Conversely, the user would utilize the frequency controller 35 to select the higher 1 MHz level of frequency if superficial thermal penetration and a longer arc length are required to provide the desired surgical effect.
In embodiments, the frequency settings may be preset and selected from a look-up table based on a choice of electrosurgical instruments/attachments, desired surgical effect, surgical specialty and/or surgeon preference. The selection may be made automatically or selected manually by the user. The frequency values may be predetermined or adjusted by the user.
With reference to
In the illustrated embodiment, VDN 27 includes a plurality of resistors “R1” (e.g., 6 resistors), connected in a first series between transmission line 27d and transmission line 27e. In embodiments, resistors “R1” may combine to total about 1000 ohms of resistance. The first series of resistors “R1” is selectively actuatable by intensity controller 28 at a plurality of locations along the length thereof. These locations along the length of the first series of resistors “R1” are represented as a first set of switches “S1a-S1e.” In operation, as intensity controller 28 is moved along the first series of resistors “R1,” the value of the resistance of the first series of resistors “R1” is changed. The change of the resistance value of the first series of resistors “R1” is represented in
When intensity controller 28 is moved to a third of middle position along the first series of resistors “R1,” corresponding to switch “S1c,” a “park position” is established in which no resistance is present. Accordingly, electrosurgical generator “G” measures a maximum voltage value of zero volts.
VDN 27 further includes a plurality of resistors “R2” (e.g., four resistors), connected in a second series between transmission line 27d and transmission line 27e. In embodiments, resistors “R2” may combine to total about 1000 ohms of resistance. The second series of resistors “R2” is selectively actuatable by any one of activation buttons 24a-24c. The location where the second series of resistors “R2” is actuated is represented by as a second set of switches “S2a-S2c.” In operation, depending which switch “S2a-S2c” is closed, by actuation of a particular activation switch 24a-24c, the value of the resistance of the second series of resistors “R2” is changed. The change of the resistance value of the second series of resistors “R2” causes a change in voltage that is measured by electrosurgical generator “G” that, in turn, activates and transmits a different mode of operation to electrosurgical pencil 10.
VDN 27 further includes a plurality of resistors “R3” (e.g., six resistors), connected in a third series between transmission line 27d and transmission line 27e. In embodiments, resistors “R3” may combine to total about 1000 ohms of resistance. The third series of resistors “R3” is selectively actuatable by frequency controller 35 at a plurality of locations along the length thereof. These locations along the length of the third series of resistors “R3” are represented as a third set of switches “S3a-S3e.” In operation, as frequency controller 35 is moved along the third series of resistors “R3,” the value of the resistance of the third series of resistors “R3” is changed. The change of the resistance value of the third series of resistors “R3” is represented in
When frequency controller 35 is moved to a third of middle position along the third series of resistors “R3,” corresponding to switch “S3c,” a “park position” is established in which no resistance is present. Accordingly, electrosurgical generator “G” measures a maximum voltage value of zero volts. In embodiments, electrosurgical generator “G” may interpret a measured voltage value of zero volts as a signal to transmit RF energy at a standard and/or predetermined level to electrosurgical pencil 10.
In operation, if more than one activation button 24a-24c is actuated simultaneously (i.e., a “multi-key activation” scenario), electrosurgical generator “G” will measure a unique voltage that does not correspond to any preset known voltage stored therein and thus does not activate or transmit any mode of operation to electrosurgical pencil 10.
In use, depending on which activation button 24a-24c is depressed a respective switch 26a-26c is pressed into contact with VDN 27. The depressed activation button 24a-24c electrically engages juxtaposed electrical contacts of VDN 27 thereby changing the value of the second series of resistors “R2.” Depending on the value of the resistance of the second series of resistors “R2” a characteristic voltage is generated and measured by electrosurgical generator “G” via transmission line 27b and one of control wires 16a-16d. (See
In order to vary the intensity of the power parameters of electrosurgical pencil 10, the surgeon displaces intensity controller 28 as described above, thereby changing the value of the first series of resistors “R1.” Depending on the value of the resistance of the first series of resistors “R1,” a characteristic voltage is generated and measured by electrosurgical generator “G” via third transmission line 27c and one of control wires 16a-16d. (See
In embodiments, a VDN (not explicitly shown) separate from VDN 27 may be provided for any one of the first series, second series, and third series of resistors “R1,” “R2,” and “R3” or any combination thereof. In this configuration, an independent voltage comparator circuit (not explicitly shown) may be provided to permit bi-directional communication between two or more VDNs. In this manner, each VDN may reference the voltage and, thus, the unique mode/frequency/duty cycle of the RF energy being transmitted to electrocautery blade 6.
Also as depicted in
The hemostatic effect/function may be defined as having waveforms with a duty cycle from about 1% to about 12%. The blending effect/function may be defined as having waveforms with a duty cycle from about 12% to about 75%. The cutting and/or dissecting effect/function may be defined as having waveforms with a duty cycle from about 75% to about 100%. It is important to note that these percentages are approximated and may be customized to deliver the desired surgical effect for various tissue types and characteristics.
In operation and depending on the particular electrosurgical function desired, the surgeon depresses one of activation switches 24a-24c, in the direction indicated by arrow “Y” (see
In order to vary the intensity of the power parameters of electrosurgical pencil 10, the surgeon displaces intensity controller 28 in the direction indicated by double-headed arrow “X”. As mentioned above, the intensity can be varied from approximately 60 mA for a light effect to approximately 240 mA for a more aggressive effect. For example, by positioning nubs 29a, 29b of intensity controller 28 closer to the proximal-most end of guide channels 30a, 30b (i.e., closer to cable 12) a lower intensity level is produced and by positioning nubs 29a, 29b of intensity controller 28 closer to the distal-most end of guide channels 30a, 30b (i.e., closer to electrocautery end effector 6) a larger intensity level is produced resulting in a more aggressive effect being produced. In embodiments, when nubs 29a, 29b of intensity controller 28 are positioned at the proximal-most end of guide channels 30a, 30b, VDN 27 is set to a null and/or open position. Electrosurgical pencil 10 may be shipped with intensity controller 28 set to the null and/or open positions. In embodiments, the frequency settings from proximal end to distal end may be reversed (e.g., high to low).
In order to vary the frequency of the energy transmitted by electrosurgical generator “G” to pencil 10, the surgeon displaces frequency controller 35 in the direction indicated by double headed arrow “X.” As mentioned above, the frequency may be varied from about 1 MHz for superficial thermal penetration and a long arc length and 470 kHz for deep thermal penetration and a short are length. For example, by positioning nub 36 of frequency controller 35 closer to the distal-most end of guide channel 37 (i.e., closer to electrocautery end effector 6) a higher frequency level is produced and by positioning nub 36 of frequency controller 35 closer to the distal-most end of guide channel 37 (i.e., closer to cable 12) a lower frequency level is produced resulting in deeper thermal penetration. In embodiments, when nub 36 of frequency controller 35 is positioned at the proximal-most end of guide channel 37, VDN 27 is set to a null and/or open position. Electrosurgical pencil 10 may be shipped with frequency controller 35 set to the null and/or open position.
In embodiments, intensity controller 28 may control the intensity level of the electrosurgical energy transmitted by all three activation switches 24a-24c, simultaneously. That is, as nubs 29a, 29b of intensity controller 28 are positioned relative to guide channels 30a, 30b, the intensity level of the electrosurgical energy transmitted to all three activation switches 24a-24c is set to the same value of slide potentiometer or intensity controller 28. Similarly, frequency controller 35 may control the frequency level of the electrosurgical energy transmitted by all three activation switches 24a-24c, simultaneously. That is, as nub 36 of frequency controller 35 is positioned relative to guide channel 37, the frequency level of the electrosurgical energy transmitted to all three activation switches 24a-24c is set to the same value of slide potentiometer or frequency controller 35.
As a safety precaution, when electrosurgical pencil 10 is changed from one mode to another, intensity controller 28 and frequency controller 35 may be configured such that each must be reset (i.e., nubs 29a, 29b, 36 re-positioned to the proximal-most end of guide channels 30a, 30b, 37, thus setting VDN 27 to the null and/or open position). After being reset, intensity controller 28 and frequency controller 35 may be adjusted as needed to the desired and/or necessary intensity level and frequency level respectively, for the mode selected.
In embodiments, VDN 27 may also include an algorithm that stores the last intensity level and/or frequency level setting for each mode. In this manner, intensity controller 28 and frequency controller 35 do not have to be reset to the last operative value when the particular mode is re-selected.
The combination of placing VDN 27 and fourth control wire 16d in electrosurgical pencil 10 essentially places the entire resistor network of the electrosurgical system (e.g., electrosurgical pencil 10 and the source of electrosurgical energy “G”) within electrosurgical pencil 10. Conventional electrosurgical systems typically include a current limiting resistor disposed within the electrosurgical pencil, for activating the electrosurgical pencil, and a second resistor network disposed in the source of electrosurgical energy, for controlling the intensity of the electrosurgical energy transmitted. In accordance with the present disclosure, all three resistor networks are disposed within electrosurgical pencil 10, namely, the first resistor network as evidenced by frequency controller 35, the second resistor network as evidenced by activation switches 24a-24c, and the third resistor network as evidenced by intensity controller 28.
As described above, intensity controller 28 and frequency controller 35 can be configured and adapted to provide a degree of tactile feedback. Alternatively, audible feedback can be produced from intensity controller 28 (e.g., a “click”), from electrosurgical energy source “G” (e.g., a “tone”) and/or from an auxiliary sound-producing device such as a buzzer (not explicitly shown).
As seen in
As seen in
As seen in
Activation switches 124a-124c are configured and adapted to control the mode and/or “waveform duty cycle” to achieve a desired surgical intent in the same manner as activation switches 24a-24c of electrosurgical pencil 10 described above.
In operation and depending on the particular electrosurgical function desired, the surgeon depresses one of activation switches 124a-124c, in the direction indicated by arrow “Y” thereby closing a corresponding switch 126a-126c and closing and/or completing control loop 116. For example, the surgeon can depress activation switch 124a to perform a cutting or dissecting function, activation switch 124b to perform a dissecting/hemostatic function, or activation switch 124c to perform a hemostatic function. In turn, generator “G” transmits an appropriate waveform output to electrocautery blade 106 via transmission wire 114.
In an alternative embodiment, as seen in
In alternative embodiments, sliding intensity controllers 128a, 128b may be replaced with dial-like VDNs (not explicitly shown). In this configuration, sliding frequency controller 135 may be configured in either a “single-nub” or “double-nub” configuration and slidably supported in a guide channel (not explicitly shown) proximal or distal to activation switches 124a-124c.
Since the surgeon has a number of controls at his finger tips, the surgeon is able to create a pallet of varying therapeutic effects ranging from a pure “cutting” effect to a pure “coagulating” effect and a number of effects in between at a number of intensities and/or frequencies. Moreover, with some pre-setting of the electrosurgical energy source “G”, electrosurgical pencil 100 will have all the useful settings available to the surgeon within the sterile field. Accordingly, it is not necessary that the surgeon interact with hardware outside the sterile field (e.g., electrosurgical energy source “G”) once the surgical procedure begins thus allowing the surgeon to focus attention on the surgical procedure.
While embodiments of electrosurgical pencils according to the present disclosure have been described herein, it is not intended that the disclosure be limited there and the above description should be construed as merely exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.
For example, as seen in
Accordingly, electrosurgical pencil 200 can be configured such that each activation switch 24a-24c is a separate mode, such as, for example, activation switch 24a can be set such that electrosurgical pencil 200 performs “division” when depressed, activation switch 24b can be set such that electrosurgical pencil 200 performs “division with hemostasis” when depressed, and activation switch 24c can be set such that electrosurgical pencil 200 performs “hemostasis” when depressed. In addition, each of nubs 229a-229c is in operative engagement with a corresponding activation switch 24a-24c such that the power/frequency for each mode of operation of electrosurgical pencil 200 can be independently adjusted.
As seen in
Turning now to
As seen in
As seen in
In embodiments, electrosurgical pencil 100 may include a smart recognition technology that communicates with the generator to identify the electrosurgical pencil and communicate various surgical parameters that relate to treating tissue with electrosurgical pencil 100. For example, the electrosurgical pencil 100 may be equipped with a bar code or Aztec code that is readable by the generator and presets the generator to default parameters associated with treating tissue with electrosurgical pencils. The bar code or Aztec code may also include programmable data that is readable by the generator and programs the generator to specific electrical parameters prior to use.
Other smart recognition technology may be included that enables the generator to determine the type of instrument being utilized or to insure proper attachment of the instrument to the generator as a safety mechanism. One such safety connector is identified in U.S. Pat. No. 7,131,860, the entire contents of which are incorporated herein by reference. For example, in addition to the smart recognition technology described above, such a safety connector can include a plug or male portion operatively associated with the electrosurgical pencil and a complementary socket or female portion operatively associated with the electrosurgical generator. Socket portion is “backward compatible” to receive connector portions of electrosurgical pencils disclosed therein and to receive connector portions of prior electrosurgical instruments.
While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, 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.
This application claims the benefit of priority to U.S. Provisional Application Ser. No. 60/992,413 entitled “THERMAL PENETRATION AND ARC LENGTH CONTROLLABLE ELECTROSURGICAL PENCIL” filed Dec. 5, 2007 by Jason L. Craig, which is incorporated by reference herein.
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