US 11,446,052 B2Granted

Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue

AssigneeCilag GmbH International

InventorsFrederick E. Shelton, IV, David C. Yates

Life of this patent

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Abstract

Surgical instruments and system and methods for using surgical instruments are disclosed. A surgical instrument comprises an end effector comprising an ultrasonic blade and clamp arm, an electrode, an ultrasonic transducer, and a sensor coupled to a control circuit. The electrode receives electrosurgical energy from a generator and applies the electrosurgical energy to the end effector to weld tissue based on the generator generating a drive signal. The ultrasonic transducer ultrasonically oscillates the ultrasonic blade in response to the drive signal. The control circuit receives a signal from the sensor indicative of a surgical parameter, determines a weld time of a surgical operation based on the sensor signal, and varies one or more of a clamp arm pressure applied by the clamp arm and a power level of the electrosurgical energy to maintain one or more of a predefined heat flux or power applied to tissue loaded in the end effector.

Claims20

Dependent claims

A surgical instrument comprising:

an end effector comprising:
an ultrasonic blade configured to ultrasonically oscillate against tissue;
and
a clamp arm configured to pivot relative to the ultrasonic blade;
an electrode configured to receive electrosurgical energy from a generator and apply the received electrosurgical energy to the end effector to weld tissue based on the generator generating a drive signal;
an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer configured to ultrasonically oscillate the ultrasonic blade in response to the drive signal;
a sensor coupled to a control circuit, wherein the sensor is configured to output a signal indicative of a surgical parameter to the control circuit;
and
the control circuit coupled to the end effector, wherein the control circuit is configured to:
receive the sensor signal;
determine a cutting and coagulation focal point along the length of the ultrasonic blade, wherein the cutting and coagulation focal point shifts between the proximal and distal end of the ultrasonic blade;
determine a weld time of a surgical operation performed by the surgical instrument based on the sensor signal;
and
vary one or more of a clamp arm pressure applied by the clamp arm and a power level of the electrosurgical energy to maintain one or more of a predefined heat flux or power applied to tissue loaded in the end effector, wherein the clamp arm pressure and power level are based in part on the location of the cutting and coagulation focal point, and wherein the predefined heat flux is constant along the length of the ultrasonic blade.

11 more elements

A surgical system comprising:

a surgical hub configured to receive an impedance rate algorithm transmitted from a cloud computing system, wherein the surgical hub is communicatively coupled to the cloud computing system;
and
a surgical instrument communicatively coupled to the surgical hub, wherein the surgical instrument comprises:
an end effector comprising:
an ultrasonic blade configured to ultrasonically oscillate against tissue;
and
a clamp arm configured to pivot relative to the ultrasonic blade;
an electrode configured to receive electrosurgical energy from a generator and apply the received electrosurgical energy to the end effector to weld tissue based on the generator generating a drive signal;
an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer configured to ultrasonically oscillate the ultrasonic blade in response to the drive signal;
a control circuit coupled to the end effector, wherein the control circuit is configured to perform the impedance rate algorithm to:
receive a first tissue impedance point of a series of sequential impedance points;
determine a first power level of the electrosurgical energy that corresponds to the first tissue impedance point;
control the generator to deliver the electrosurgical energy at the first power level;
determine a second tissue impedance point of the series of sequential impedance points;
adjust the first power level to a second power level of the electrosurgical energy based on a time interval to reach the second tissue impedance point, where the adjustment from the first power level to the second power level is determined based on the time interval to reach the second tissue impedance point and the second power level to mimic a predicted impedance rise corresponding to the time interval;
and
control the generator to deliver the electrosurgical energy at the second power level.

14 more elements

A method of using a surgical instrument to deliver electrosurgical energy according to a target impedance rise rate, wherein the surgical instrument comprises:

an end effector comprising:
an ultrasonic blade configured to ultrasonically oscillate against tissue;
and a clamp arm configured to pivot relative to the ultrasonic blade;
a generator configured to deliver electrosurgical energy to the end effector based on generating a drive signal;
an electrode configured to deliver the electrosurgical energy to the end effector;
an ultrasonic transducer acoustically coupled to the ultrasonic blade, the ultrasonic transducer configured to ultrasonically oscillate the ultrasonic blade in response to the drive signal generated by the generator;
and a control circuit coupled to the end effector and wherein the method comprises:
controlling, by the control circuit, the generator to apply power according to a tissue impedance algorithm, wherein the tissue impedance algorithm is configured to achieve a constant heat flux by adjusting power over a series of sequential impedance points, comprising the steps of:
applying, by the generator, a first power level to reach a first tissue impedance point of the series of sequential impedance points;
terminating, by the generator, application of the first power level for a first dwell time, wherein power is not applied during the first dwell time, and wherein the first power level is determined based on the first dwell time;
determining, by the control circuit, a second tissue impedance point of the series of sequential impedance points:
applying, by the generator, a second power level to reach the second tissue impedance point;
terminating, by the generator, application of the second power level for a second dwell time, wherein power is not applied during the second dwell time, and wherein the second power level is determined based on the second dwell time;
determining, by the control circuit, a third tissue impedance point of the series of sequential impedance points;
and
applying, by the generator, a third power level to reach the third tissue impedance point to achieve the target impedance rise rate.

13 more elements

Dependencies are inferred from the claim text.

Facts

Application: 16/182,235Filed 6 Nov 2018 · us provisional application
Priority: 28 Dec 2017
Published: US 2019/0201044 A14 Jul 2019
Granted: 20 Sep 2022
Term ends: Not estimatedThe source records don’t support an estimate.

Classification42 codes

A61B 17/320092
Using mechanical vibrations, e.g. ultrasonic: with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
A61B 17/320068
Surgical cutting instruments: using mechanical vibrations, e.g. ultrasonic
A61B 18/1206
By passing a current through the tissue to be heated, e.g. high-frequency current: generators therefor
A61B 18/1445
Probes having pivoting end effectors, e.g. forceps: at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod

Family

Application62/611,341Us provisional application · filed 28 Dec 2017
Application62/611,339Us provisional application · filed 28 Dec 2017
Application62/611,340Us provisional application · filed 28 Dec 2017
Application62/640,415Us provisional application · filed 8 Mar 2018
Application62/640,417Us provisional application · filed 8 Mar 2018
Application62/650,898Us provisional application · filed 30 Mar 2018
Application62/650,887Us provisional application · filed 30 Mar 2018
Application62/650,877Us provisional application · filed 30 Mar 2018
Application62/650,882Us provisional application · filed 30 Mar 2018
Application62/659,900Us provisional application · filed 19 Apr 2018
Application62/692,748Us provisional application · filed 30 Jun 2018
Application62/692,768Us provisional application · filed 30 Jun 2018
Application62/692,747Us provisional application · filed 30 Jun 2018
Application62/729,195Us provisional application · filed 10 Sep 2018
US 2019/0201044 A1Pre-grant publication · published 4 Jul 2019
US 11,446,052 B2This patent

From the US filing history. Foreign family members aren’t listed.