Method and apparatus for ultrasonic surgical fragmentation and removal of tissue
AssigneeCooper LaserSonics, Inc.
InventorsAlan Broadwin, Alexander Kreizman, Chana Puiam, Vaclav O. Podany, Leonard M. Emery
Life of this patent
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Abstract
A method and apparatus for periodically interrupting ultrasonic power applied to a ultrasonically vibrating tip to control its amplitude between high and low or zero amplitudes with a selectible duty cycle and repetition rate provides enhanced fragmentation and improves surgical control. The duty cycle may also vary as a function of a remotely sensed parameter such as tissue temperature.
Claims64
An ultrasonic surgical apparatus comprising:
- a surgical handpiece,
- an ultrasonic tissue fragmenting tool adapted for ultrasonically fragmenting tissue at a surgical site of a patient,
- said tool being supported by said handpiece,
- said tool having an ultrasonically-vibratable tool tip,
- a supplying means for supplying ultrasonic vibrations to said tool tip,
- a switching means for automatically and repeatedly switching the amplitude of the ultrasonic vibrations of said tool, during a tissue fragmenting procedure at the surgical site, back and forth between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude,
- an aspirating means connected to said handpiece for aspirating, from the surgical site, fluid and tissue fragmented by said ultrasonically-vibrating tool tip, and
- an irrigating means connected to said handpiece for supplying an irrigating solution to the area of the surgical site for suspending the tissue particles fragmented by said tool tip.
The apparatus of claim I further comprising an adjusting means for adjusting said high amplitude.
An ultrasonic surgical apparatus for removing tumorous tissue from a patient with minimal resulting damage to the healthy tissue adjacent to the tumorous tissue comprising:
- an ultrasonic tissue fragmenting tool,
- a pulsing means for pulsing said tool with ultrasonic vibrations during the ultrasonic tumorous tissue fragmenting procedures at a rapid pulse rate between a working high amplitude for a first period of time and a standby low amplitude which is lower than said high amplitude for a second period of time,
- a cycle time defined by said first period of time plus said second period of time,
- a duty cycle defined by said first period of time divided by said cycle time,
- a sensing means for sensing the temperature of the adjacent healthy tissue while the tumorous tissue is being fragmented during a fragmenting procedure, and
- an adjusting means for automatically varying, as a function of the temperature sensed by said sensing means, said duty cycle.
A method for the controlled fragmenting of unwanted tissue at a surgical site with reduced resulting heat damage comprising:
- during an ultrasonic tissue fragmenting procedure at the surgical site using a vibratable tool of an ultrasonic fragmenting device, automatically and periodically interrupting at a rapid rate the amplitude of the ultrasonic vibrations delivered to the tool between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude.
The method of claim 62 wherein said periodically interrupting is characterized in that the duty cycle thereof is between about 15% and less than 100%.
The method of claim 62 wherein said low amplitude is a zero amplitude.
The method of claim 62 further comprising sequentially varying the repetition rate with which the stroke amplitude of said tool is varied between said high and low amplitudes according to a predetermined sequence.
An ultrasonic surgical apparatus comprising:
- an ultrasonic tissue fragmenting tool adapted for ultrasonically fragmenting tissue at a surgical site of patient,
- a supplying means for supplying ultrasonic vibrations to said tool,
- a switching means for switching the amplitude of the ultrasonic vibrations of said tool, during a tissue fragmenting procedure at the surgical site, back and forth between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude, and
- said supplying means further includes a low amplitude adjust potentiometer means which provides a reference signal for said closed loop generator feed-back system for setting said low amplitude.
An ultrasonic surgical apparatus comprising:
- an ultrasonic tissue fragmenting tool adapted for ultrasonically fragmenting tissue at a surgical site of patient,
- a supplying means for supplying ultrasonic vibrations to said tool,
- a switching means for switching the amplitude of the ultrasonic vibrations of said tool, during a tissue fragmenting procedure at the surgical site, back and forth between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude,
- said switching means including a duty cycle control means for providing a variable preselected duty cycle for said high and said low amplitude vibrations,
- said duty cycle control means being responsive to a remotely sensed parameter, and
- said remotely-sensed parameter being temperature.
An ultrasonic surgical apparatus comprising:
- an ultrasonic tissue fragmenting tool adapted for ultrasonically fragmenting tissue at a surgical site of a patient,
- a supplying means for supplying ultrasonic vibrations to said tool,
- a switching means for switching the amplitude of the ultrasonic vibrations of said tool, during a tissue fragmenting procedure at the surgical site, back and forth between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude,
- said switching means including a duty cycle control means for providing a variable preselected duty cycle for said high and said low amplitude vibrations,
- said duty cycle control means being responsive to a remotely-sensed parameter, and
- said remotely-sensed parameter being vapor generation at the surgical site.
An ultrasonic surgical apparatus comprising:
- an ultrasonic tissue fragmenting tool adapted for ultrasonically fragmenting tissue at a surgical site of a patient,
- a supplying means for supplying ultrasonic vibrations to said tool,
- a switching means for switching the amplitude of the ultrasonic vibrations of said tool, during a tissue fragmenting procedure at the surgical site, back and forth between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude,
- a temperature sensing means for sensing the temperature of tissue adjacent to the tissue to which said tool is being applied while applied thereto, and
- said switching means being responsive to said temperature sensing means to vary the amplitude of the stroke of said tool with a duty cycle that is a function of the adjacent tissue temperature.
An ultrasonic surgical apparatus comprising:
- an ultrasonic tissue fragmenting tool,
- a pulsing means for pulsing said tool with ultrasonic vibrations at a rapid pulse rate during an ultrasonic tissue fragmenting procedure between a working high amplitude for a first period of time and a standby low amplitude which is lower than said high amplitude for a second period of time,
- a cycle time defined by said first period of time plus said second period of time,
- duty cycle defined by said first period of time divided by said cycle time,
- a controlling means for controlling said duty cycle,
- said controlling means controlling said duty cycle continuously based upon a remotely-sensed parameter in the operative field of said tool to yield a closed loop system, and
- said remotely-sensed parameter comprising temperature of tissue of a patient.
A method for the controlled fragmenting of unwanted tissue at a surgical site with reduced resulting heat damage comprising:
- during an ultrasonic tissue fragmenting procedure at the surgical site using a vibratable tool of an ultrasonic fragmenting device, periodically interrupting at a rapid rate the amplitude of the ultrasonic vibrations delivered to the tool between a working high amplitude and a standby low amplitude which is a lower amplitude than said high amplitude,
- sensing a remote parameter, and varying the duty cycle of said interrupting step as a function of said remotely-sensed parameter, and
- said remotely-sensed parameter being temperature.
Dependencies are inferred from the claim text.