The present disclosure relates to surgical instruments and, more particularly, to plasma blades, electrosurgical instruments including plasma blades, and methods of manufacturing plasma blades.
A surgical forceps is a pliers-like instrument that relies on mechanical action between its jaw members to grasp, clamp, and constrict tissue. Electrosurgical forceps utilize both mechanical clamping action and energy to heat tissue to treat, e.g., coagulate, cauterize, or seal, tissue. Prior to tissue treatment, a second device or possibly the same forceps may be utilized to dissect tissue layers or otherwise separate tissue. Once the tissue is separated, the tissue may be treated and, once treated, the surgeon has to accurately sever the treated tissue.
Accordingly, many electrosurgical forceps are designed to include a tip that may be electrically activated to dissect tissue. The forceps may also include a knife that is advanced between the jaw members to cut the treated tissue. As an alternative to a mechanical knife, an energy-based tissue cutting element may be provided to cut the treated tissue using energy, e.g., thermal, electrosurgical, ultrasonic, light, or other suitable energy.
As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.
Provided in accordance with aspects of the present disclosure is an end effector for a surgical instrument that includes a pair of opposing first and second jaw members each having a jaw housing supporting an electrically conductive tissue sealing plate disposed thereon. The electrically conductive tissue sealing plates of the first and second jaw members are disposed in opposition relative to one another. One or both of the first or second jaw members is movable relative to the other jaw member to grasp tissue therebetween. The electrically conductive tissue sealing plates of the first and second jaw members are adapted to connect to opposite potentials of an electrosurgical energy source. The electrically conductive tissue sealing plates of the first jaw member has an open T-shaped configuration defining a channel along a length thereof. A plasma blade is disposed within the channel of the electrically conductive tissue sealing plate of the first jaw member and extends to a distal end portion thereof. The plasma blade electrically connects to the energy source and is independently activatable from the electrically conductive tissue sealing plates. The plasma blade includes an insulative material on either side thereof configured to focus electrical and thermal energy to an exposed edge defined along a length of the plasma blade.
In aspects according to the present disclosure, the electrically conductive tissue sealing plate of the second jaw member has an open T-shaped configuration defining a channel along a length thereof and wherein an insulative member is disposed within the channel of the electrically conductive tissue sealing plate of the second jaw member in opposing vertical registration to the plasma blade.
In aspects according to the present disclosure, the insulative member is a made from a compliant high temperature silicone. In other aspects according to the present disclosure, the insulative member is selected from the group consisting of ceramic, parylene, nylon, and PTFE.
In aspects according to the present disclosure, a bridge is disposed within the first jaw member at a proximal end thereof, the bridge configured to provide electrical continuity across the electrically conductive tissue sealing plates of the first and second jaw members.
In aspects according to the present disclosure, a sensor is operably associated with one or both jaw members and is configured to sense when the jaw members are disposed in the open configuration, the sensor communicating with the electrical energy source to configure the electrosurgical instrument for monopolar use upon activation thereof.
In aspects according to the present disclosure, a bipolar activation switch is configured to provide electrical energy to both electrically conductive tissue sealing plates upon activation thereof and a monopolar activation switch configured to provide electrical energy to the plasma blade upon activation thereof. In other aspects according to the present disclosure, a bipolar activation switch is configured to provide electrical energy to both electrically conductive tissue sealing plates upon activation thereof and a monopolar activation switch configured to provide electrical energy to the plasma blade upon activation thereof, wherein the sensor disables power to the bipolar activation switch when the jaw members are disposed in the open configuration.
Provided in accordance with another aspects of the present disclosure is an end effector for a surgical instrument that includes a pair of opposing first and second jaw members each having a jaw housing supporting an electrically conductive tissue sealing plate disposed thereon. The electrically conductive tissue sealing plates of the first and second jaw members are disposed in opposition relative to one another, one or both of the first or second jaw member is movable relative to the other jaw member to grasp tissue therebetween. The electrically conductive tissue sealing plates of the first and second jaw members are adapted to connect to opposite potentials of an electrosurgical energy source. The electrically conductive tissue sealing plates of the first and second jaw member each have an open T-shaped configuration defining a channel along a length thereof.
A plasma blade is disposed within the channel of the electrically conductive tissue sealing plate of the first jaw member and extends to a distal end portion thereof. The plasma blade electrically connects to the energy source and is independently activatable from the electrically conductive tissue sealing plates. An insulative member is disposed within the channel of the electrically conductive tissue sealing plate of the second jaw member in opposing vertical registration to the plasma blade.
In aspects according to the present disclosure, the plasma blade includes an insulative material on either side thereof configured to focus electrical and thermal energy to an exposed edge defined along a length of the plasma blade. In other aspects according to the present disclosure, the insulative member is a made from a compliant high temperature silicone. In still other aspects according to the present disclosure, the insulative member is selected from the group consisting of ceramic, parylene, nylon, and PTFE.
In aspects according to the present disclosure, a bridge disposed within the first jaw member at a proximal end thereof, the bridge configured to provide electrical continuity across the electrically conductive tissue sealing plates of the first and second jaw members.
In aspects according to the present disclosure, a sensor is operably associated with one or both jaw members and is configured to sense when the jaw members are disposed in the open configuration, the sensor communicating with the electrical energy source to configure the electrosurgical instrument for monopolar use upon activation thereof.
In aspects according to the present disclosure, a bipolar activation switch is configured to provide electrical energy to both electrically conductive tissue sealing plates upon activation thereof and a monopolar activation switch configured to provide electrical energy to the plasma blade upon activation thereof. In other aspects according to the present disclosure, a bipolar activation switch is configured to provide electrical energy to both electrically conductive tissue sealing plates upon activation thereof and a monopolar activation switch configured to provide electrical energy to the plasma blade upon activation thereof, wherein the sensor disables power to the bipolar activation switch when the jaw members are disposed in the open configuration.
The above and other aspects and features of the present disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements.
Referring to
Forceps 10 includes a housing 20, a handle assembly 30, a rotating assembly 70, a first activation switch 80, a second activation switch 90, and an end effector assembly 100. Forceps 10 further includes a shaft 12 having a distal end portion 14 configured to (directly or indirectly) engage end effector assembly 100 and a proximal end portion 16 that (directly or indirectly) engages housing 20. Forceps 10 also includes cable “C” that connects forceps 10 to an energy source, e.g., an electrosurgical generator 500 (
As can be appreciated, after sealing, a vessel or tissue may be separated either by the use of a central cutting electrode that is elevated to a high temperature (e.g., a resistively heated element) or by using an electrosurgical electrode that is polarized opposite of the patient return pad (REM pad) during a so-called “cut” mode or cycle. The electrosurgical electrode used for cutting may either be a traditional uncoated electrode or, according to the present disclosure, employ a plasma blade 130.
A plasma blade 130 is configured to direct a majority of the electrosurgical energy to an exposed cutting edge, e.g., cutting edge 130b (
The cut cycle of a plasma blade 130 also differs from convention electrode cut modes or cut cycles as a result of the plasma blade's 130 particular configuration and the tendency to direct the electrical energy to and out from the cutting edge 130b requiring less energy to effectively cut the tissue. Typically, the energy waveform includes a maximum peak-to-peak voltage of up to about 1000V and a root mean squared voltage (VRms) of up to about 360V. The waveform is typically unpulsed but may be pulsed depending upon a particular purpose.
Handle assembly 30 of forceps 10 includes a fixed handle 50 and a movable handle 40. Fixed handle 50 is integrally associated with housing 20 and handle 40 is movable relative to fixed handle 50. Movable handle 40 of handle assembly 30 is operably coupled to a drive assembly (not shown) that, together, mechanically cooperate to impart movement of one or both of jaw members 110, 120 of end effector assembly 100 about a pivot 103 between a spaced-apart position and an approximated position to grasp tissue between tissue-treating surfaces 114, 124 of jaw members 110, 120. As shown in
Referring to
Forceps 210 includes two elongated shaft members 212a, 212b, each having a proximal end portion 216a, 216b, and a distal end portion 214a, 214b, respectively. Forceps 210 is configured for use with an end effector assembly 100′ similar to end effector assembly 100. More specifically, end effector assembly 100′ includes first and second jaw members 110′, 120′ attached to respective distal end portions 214a, 214b of shaft members 212a, 212b. Jaw members 110′, 120′ are pivotably connected about a pivot 103′. Each shaft member 212a, 212b includes a handle 217a, 217b disposed at the proximal end portion 216a, 216b thereof. Each handle 217a, 217b defines a finger hole 218a, 218b therethrough for receiving a finger of the user. As can be appreciated, finger holes 218a, 218b facilitate movement of the shaft members 212a, 212b relative to one another to, in turn, pivot jaw members 110′, 120′ from the spaced-apart position, wherein jaw members 110′, 120′ are disposed in spaced relation relative to one another, to the approximated position, wherein jaw members 110′, 120′ cooperate to grasp tissue therebetween.
One of the shaft members 212a, 212b of forceps 210, e.g., shaft member 212b, includes a proximal shaft connector 219 configured to connect forceps 210 to a source of energy, e.g., electrosurgical generator 500 (
Jaw members 110′, 120′ define a curved configuration wherein each jaw member is similarly curved laterally off of a longitudinal axis of end effector assembly 100′. However, other suitable curved configurations including curvature towards one of the jaw members 110, 120′ (and thus away from the other), multiple curves with the same plane, and/or multiple curves within different planes are also contemplated. Jaw members 110, 120 of end effector assembly 100 (
Referring to
Robotic surgical instrument 2000 includes a plurality of robot arms 2002, 2003; a control device 2004; and an operating console 2005 coupled with control device 2004. Operating console 2005 may include a display device 2006, which may be set up in particular to display three-dimensional images; and manual input devices 2007, 2008, by means of which a surgeon may be able to telemanipulate robot arms 2002, 2003 in a first operating mode. Robotic surgical instrument 2000 may be configured for use on a patient 2013 lying on a patient table 2012 to be treated in a minimally invasive manner. Robotic surgical instrument 2000 may further include a database 21014, in particular coupled to control device 2004, in which are stored, for example, pre-operative data from patient 2013 and/or anatomical atlases.
Each of the robot arms 2002, 2003 may include a plurality of members, which are connected through joints, and an attaching device 2009, 2011, to which may be attached, for example, an end effector assembly 2100, 2200, respectively. End effector assembly 2100 is similar to end effector assembly 100, although other suitable end effector assemblies for coupling to attaching device 2009 are also contemplated. End effector assembly 2200 may be any end effector assembly, e.g., an endoscopic camera, other surgical tool, etc. Robot arms 2002, 2003 and end effector assemblies 2100, 2200 may be driven by electric drives, e.g., motors, that are connected to control device 2004. Control device 2004 (e.g., a computer) may be configured to activate the motors, in particular by means of a computer program, in such a way that robot arms 2002, 2003, their attaching devices 2009, 2011, and end effector assemblies 2100, 2200 execute a desired movement and/or function according to a corresponding input from manual input devices 2007, 2008, respectively. Control device 2004 may also be configured in such a way that it regulates the movement of robot arms 2002, 2003 and/or of the motors.
Turning to
In embodiments, tissue-treating plates 113, 123 may be deposited onto jaw housings 112, 122 or jaw inserts (not shown) disposed within jaw housings 112, 122, e.g., via sputtering. Alternatively, tissue-treating plates 113, 123 may be pre-formed and engaged with jaw housings 112, 122 and/or jaw inserts (not shown) disposed within jaw housings 112, 122 via, for example, overmolding, adhesion, mechanical engagement, etc.
Referring in particular to
Regardless of the particular configuration of jaw member 110, jaw member 110 may include a longitudinally-extending insulative member 115 extending along at least a portion of the length of tissue-treating surface 114. Insulative member 115 may be transversely centered on tissue-treating surface 114 or may be offset relative thereto. Further, insulative member 115 may be disposed, e.g., deposited, coated, etc., on tissue-treating surface 114, may be positioned within a channel or recess defined within tissue-treating surface 114, or may define any other suitable configuration. Additionally, insulative member 115 may be substantially (within manufacturing, material, and/or use tolerances) coplanar with tissue-treating surface 114, may protrude from tissue-treating surface 114, may be recessed relative to tissue-treating surface 114, or may include different portions that are coplanar, protruding, and/or recessed relative to tissue-treating surface 114. Insulative member 115 may be formed from, for example, compliant high temperature silicone, ceramic, parylene, nylon, PTFE, or other suitable material(s) (including combinations of insulative and non-insulative materials). The insulative member 115 may also be formed from polybenzimidazole or similar materials.
With reference to
Jaw housing 122 of jaw member 120 is disposed about the distal body portion of structural frame 121, e.g., via overmolding, adhesion, mechanical engagement, etc., and supports tissue-treating plate 123 thereon, e.g., via overmolding, adhesion, mechanical engagement, depositing (such as, for example, via sputtering), etc.
As shown in
Plasma blade 130 is partially covered on either side with an insulative material 128a, 128b along a length thereof to direct the energy (electrical and thermal) to exposed surfaces, e.g., a top surface 130b of the plasma blade 130. In embodiments, insulative material 128a, 128b (glass, ceramic, etc.) covers the entire surface of the plasma blade 130 except the exposed top surface or cutting edge 130b. Plasma blade 130 may be configured to contact insulative member 115 (
As mentioned above, plasma blade 130 is surrounded by an insulative material 128a, 128b disposed within slot 125 or attached to the plasma blade 130 to both electrically the isolate plasma blade 130 from tissue-treating plate 123 and to direct energy to the exposed edge or top surface 130b for cutting tissue. Plasma blade 130 and insulative material 128a, 128b may similarly or differently be substantially (within manufacturing, material, and/or use tolerances) coplanar with tissue-treating surface 124, may protrude from tissue-treating surface 124, may be recessed relative to tissue-treating surface 124, or may include different portions that are coplanar, protruding, and/or recessed relative to tissue-treating surface 124. The insulative materials 128a, 128b may be directed deposited onto the plasma blade 130, may be taped onto the plasma blade 130, may be configured to encapsulated or cover the plasma blade 130, may form a pocket for receiving the plasma blade 130, may be molded to the plasma blade 130 or in any other fashion known in the art.
As can be appreciated, configuring seal plate 123 in an open T-shape simplifies electrical connections as only a single point of electrical connection is required with the integral, yet un-bisected design. The open T-shaped configuration allows the plasma blade 130 to extend beyond the distal end of the jaw member 120 for dissection purposes, if desired. A bridge 122b may be disposed at the proximal end of the jaw member 120 to provide electrical continuity across the seal plate 123 and simplify manufacturing, electrical connection and assembly. The bridge 122b allows the seal plate 123 to remain split along the entire length of the jaw member 120 (
Jaw member 110 also includes seal plate 113 affixed thereto in opposing relation to jaw member 120. Similarly, seal plate 113 is generally open T-shaped along a length thereof and includes a channel 117 defined therealong that is configured to house insulative member 115 therein. Insulative member 115 is disposed in vertical registration with plasma blade 130.
During bipolar sealing, the generator 500 provides electrical energy to seal plates 113, 123 to seal tissue “T” disposed therebetween according to one or more known sealing algorithms. As a result thereof, during activation, a tissue seal “S” is created between sealing plates 113, 123 on either side of channels 117 and 125 respectively. Once sealed, the algorithm may be configured to automatically activate the plasma blade 130 to transect the tissue “T” substantially along the center of the opposing seal plates 113, 123. As mentioned above, the upper surface or edge 130b of the plasmas blade 130 is the only portion thereof that is exposed thereby eliminating any arc effect (to other conductors) and focusing the electrical and thermal energy along a defined cutting path. During activation of the plasma blade 130 and one or more of the sealing plates 113, 123 may remain electrically energized, e.g., sealing plate 113, to act as an electrical return to generator 500. Alternatively, a return pad 600 (e.g., REM system) may be electrically energized and act as the electrical return for the plasma blade 130.
As mentioned above, the plasma blade 130 may be utilized for monopolar dissection, e.g., open jaw dissection. More particularly, with the jaw members 110, 120 disposed in an open configuration, the plasma blade 130 may be activated via switch 90 with a first electrical potential which is directed through the tissue and to a return pad 600 (e.g., REM system) having a second electrical potential. Tissue may be dissected as jaw member 120 is moved into contact therewith.
Generally referring to
Plasma blade 130, on the other hand, is configured to connect to electrosurgical generator 500 (
A sensor 700 (
Tissue sealing plate 1123 is generally open T-shaped to define a longitudinally-extending slot 1125 therealong for housing the plasma blade 1130 therein. Longitudinally-extending slot 1125 is defined through tissue-treating plate 1123 and is positioned to oppose insulative member 1115 of jaw member 1110 in the approximated position. Slot 1125 may extend through a portion of jaw housing 1122 and/or other components of jaw member 1120 to enable receipt of the plasma blade 1130 at least partially within slot 1125.
Plasma blade 1130 is partially covered on either side with an insulative material 1128 along a length thereof to direct the energy (electrical and thermal) to exposed surfaces, e.g., a top surface 1130b of the plasma blade 1130. In embodiments or methods, the plasma blade 1130 may be encapsulated in glass via a so-called dip and cure method or alternatively the glass may be screen printed thereon. In other embodiments or methods, a ceramic may be sprayed onto the sides of the plasma blade 1130 leaving the edge 1130b exposed. The ceramic may be deposited onto the plasma blade 1130 via electrolytic oxidation.
In yet other embodiments or methods, a polyamide such as the polyamide sold under the trademark Kapton® may be taped or film coated onto the sides of the plasma blade 1130 leaving edge 1130b exposed. In other embodiments or methods, molded engineering plastics may be disposed on either side of the plasma blade 1130, e.g., plastics such as polyphthalamide (PPA) such as that sold under the trademark Amodel®, polyetheretherketone (PEEK), polybenzimidazole (PBI), etc. A synthetic fluoropolymer such as polytetrafluoroethylene (PTFE) may also be disposed on either side of the plasma blade 1130. In still other embodiments, silicone may be molded on either side of the plasma blade 1130. In some of the above applications or methods, post grinding may be necessary reveal the exposed edge 1130b. In other instances, one or more techniques may be utilized to automatically expose the edge 1130b during the process of insulating the sides of the plasma blade 1130.
Plasma blade 1130 may be configured to contact insulative member 1115 in the approximated position and may be configured to regulate (or contribute to the regulation of) a gap distance between tissue-treating surfaces 1114, 1124 in the approximated position. In addition to using a return pad or REM pad (not shown), the insulative member 1115 may be configured to direct electrical energy away from the sealed tissue. For example, a return electrode 1175 may be embedded into the insulative member 1115 and connected to the electrical return. As such, the embedded electrode 1175 directs electrical energy from the plasma blade 1130 away from the seal plates and tissue. Other configurations and methods of directing electrical energy may also be employed, e.g., utilizing a monolithic opposing jaw, e.g., jaw member 1110, to act as the electrical return or the opposing seal plate, e.g., seal plate 1113.
In other aspects according to the present disclosure, a coating 1177 may be applied to the inner peripheral edges of the seal plates 1113, 1123 to impede electrical energy towards the tissue. For example, a high temperature silicone such as SiO2 may be employed for this purpose.
Referring back to
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. For example, the plasma blade 130 may be segmented along the length of the jaw members 110, 120 and independently activatable depending upon a particular purpose. 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 U.S. Provisional Application Ser. No. 63/279,612 filed Nov. 15, 2021, the entire contents of which being incorporated by reference herein.
Number | Date | Country | |
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63279612 | Nov 2021 | US |