EP0727964A1 - Apparatus for simultaneously holding and sealing tissue - Google Patents
Apparatus for simultaneously holding and sealing tissueInfo
- Publication number
- EP0727964A1 EP0727964A1 EP94902263A EP94902263A EP0727964A1 EP 0727964 A1 EP0727964 A1 EP 0727964A1 EP 94902263 A EP94902263 A EP 94902263A EP 94902263 A EP94902263 A EP 94902263A EP 0727964 A1 EP0727964 A1 EP 0727964A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- tissue
- seam
- edges
- energy
- clamp
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
- A61B2017/0488—Instruments for applying suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/0063—Sealing
Definitions
- This invention relates to a method and apparatus for sealing incisions on skin or other organ surfaces by drawing and holding the edges of the incision in tight proximity to form a seam while directing thermal energy onto the seam to denature the protein substance therein.
- Optical energy transformed to thermal energy has been used to convert biological tissue into a denatured proteinaceous substance for facilitating healing and wound closure.
- This healing technique is referred to generally as laser tissue welding.
- laser tissue welding methods are described in U.S. Patent No. 's 4,672,969, 4,854,320, 5,002,051, and 5,140,984. These methods deliver optical energy to tightly approximated tissue in the vicinity of a wound.
- This application of thermal energy results in the denaturation of tissue protein including collagen, with disruption of the cell walls which allows the intra- and intercellular fluids to mix. Additional heat further denatures this protein soup which binds together creating something akin to a "biological glue".
- thermal energy is delivered through an optical fiber to the tissue being reconstructed.
- one end of the fiber is connected to a laser that supplies optical energy to the wound site.
- Another end of the fiber is typically spaced a predetermined distance from the tissue, the distance depending on the tissue type.
- a foot pedal or hand held device activates and deactivates the laser.
- the parameters such as intensity and duration of the optical energy are controlled so that substantially all of the tissue being heated is raised to a predetermined non-destructive temperature.
- the minimum predetermined temperature is one at which tissue is converted to a denatured proteinaceous substance.
- the maximum predetermined temperature is one at which water in the tissue boils.
- Critical to tissue welding methods is the necessity to place edges of tissue being repaired in tight approximation. Placing the tissue edges in close or tight proximity allows the denatured tissue constituents to form an intercellular matrix resulting in tissue fusion. Certain skin tissue types require precision when applying the optical energy to seal the edges. A drawback to a current skin tissue welding procedures is that to ensure precision, the optical energy must be applied slowly and carefully thereby increasing the application time.
- An object of this invention is to provide an improved method and apparatus for reconstructing tissue.
- Another object of this invention is to provide an apparatus through which laser welding energy passes and is directed at the tissue that is to be sealed or fused.
- An energy source provides energy which is capable of heating the tissue to form an adhesive proteinaceous substance.
- the source is optically coupled to a layer of material that is supported by at least one of the members and that is transmissive to the energy that heats tissue.
- a delivering device directs energy from the source through the layer of material or through portholes that allow the energy source to be recessed from the tissue at the tissue seam when the edges are pulled into close or tight approximation.
- the layer of material has a thickness that maintains a predetermined distance between the directing device and the tissue seam when energy from the source is directed at the tissue.
- Figs. 1 and 2 are perspective views of the apparatus for simultaneously sealing and holding tissue, where Fig. 1 is a view of the apparatus holding tissue, and where Fig. 2 is a view of the apparatus prior to grasping the tissue;
- Fig. 3 is a front sectioned view along line 3-3 of Fig. 1, and
- Fig. 4 is a top view of the apparatus shown in Fig. 1.
- an apparatus 10 for tissue welding having an energy source 12 optically connected to a proximal end of a delivery device 14. A distal end of delivery device 14 is connected to clamp 16. Clamp 16 engages with tissue 18 to pull edges 20 and 22 of lesion or incision 24 together in tight contact to form a seam 26. Once engaged, optical energy from source 12 is fed through device 14 and clamp 16 to seam 26. The optical energy is applied with sufficient amplitude and duration to heat tissue 18 to an adhesive proteinaceous substance to seal the seam 26.
- clamp 16 includes a first elongated member 28 pivotally connected with rod 30 to second elongated member 32.
- a spring (not shown) may be attached to rod 30 and members 28 and 32 to close clamp.
- First and second elongated members 28 and 32 have edges 34 and 36 respectively which engage the surface of tissue 18. Edges 34 and 36 extend parallel to each other and seam 26.
- Connected to one end of members 28 and 32 are handles 40 and 42 which permit a user to rotate members 28 and 32 on rod 30.
- Connected to and extending parallel to rod 30 between members 28 and 32 is transmissive material 44. Material 44 is transparent to energy being emitted through delivery device 14 to seal seam 26. Material 44 has two functions.
- tissue 18 contacts material 44 and its edges are held in alignment.
- material 44 prevents tissue edges 20 and 22 from becoming overly everted or inverted.
- Material 44 maintains the proper . spacing between the distal end of device 14 and the surface of tissue 18. By maintaining the proper spacing, the tissue 18 is precisely heated to a predetermined temperature range bounded by a minimum temperature at which tissue denatures, and a maximum temperature at which water in tissue boils.
- delivery device 14 may optionally direct energy through a porthole 52 (FIG. 3) in material 44 that allows the distal end of device 14 to be recessed from tissue 18. In another embodiment, delivery device 14 can be positioned in material 44 to directly contact tissue 18.
- Energy s ' virce 12 is preferably a Laser energy source emittir... coherent light energy from about 1.2 to 1.4 micrometers.
- Energy source 12 is preferably enabled and disabled by a foot activator 50 or a switch (not shown) positioned on handle 40 or 42.
- the distal end of delivery device 14 is positioned between material 44 and rod 30.
- the delivery device 14 which source 12 is connected is preferably a fiber optic cable which is capable of side firing at its distal end (See Fig. 4). Although a side firing optic cable is shown as delivery device 14, cables which have end firing may be used as well.
- clamp 16 is positioned over incision 24 so that delivery device 14 distal end aligns with the incision 24.
- handles 40 and 42 are rotated by the user so that edges of members 28 and 32 engage the surface of tissue 18.
- Handles 40 and 42 continue to be rotated to draw tissue edges 20 and 22 in tight proximity and in contact with material 44.
- foot activator 50 is depressed to enable source 12.
- Thermal energy from source 12 is delivered through device 14, material 44 to seam 26 of tissue 18.
- Device 14 preferably delivers energy through material 44 and along the entire length of seam 26.
- device 14 delivers thermal energy to a portion of seam 25 and then clamp 16 is opened, moved to a new location over seam 26. Once positioned over the new location, the clamp 16 would be closed to tightly approximate the edges 20 and 22 of the tissue 18 at the new location, and then thermal energy would be delivered to the new seam 26 location to seal the incision 24.
- the thermal energy from source is delivered with sufficient amplitude and duration to heat tissue 18 to a predetermined non-destructive temperature range. This range is bounded by a minimum rate at which tissue forms a denatured proteinaceous substance and a maximum rate at which water in tissue boils. The preferred maximum temperature at which the tissue 18 is heated is slightly less than the temperature tissue shrinkage occurs.
Abstract
Description
Claims
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/US1993/011094 WO1995013747A1 (en) | 1992-11-06 | 1993-11-16 | Apparatus for simultaneously holding and sealing tissue |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0727964A1 true EP0727964A1 (en) | 1996-08-28 |
EP0727964A4 EP0727964A4 (en) | 1999-06-16 |
Family
ID=22237186
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP94902263A Withdrawn EP0727964A4 (en) | 1993-11-16 | 1993-11-16 | Apparatus for simultaneously holding and sealing tissue |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP0727964A4 (en) |
JP (1) | JPH09509070A (en) |
KR (1) | KR960705505A (en) |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4597379A (en) * | 1979-05-16 | 1986-07-01 | Cabot Medical Corporation | Method of coagulating muscle tissue |
EP0480293A1 (en) * | 1990-10-11 | 1992-04-15 | LaserSurge, Inc. | Clamp for approximating tissue sections |
WO1994008526A1 (en) * | 1992-10-14 | 1994-04-28 | Premier Laser Systems, Inc. | Clamp and method for applying thermal energy |
-
1993
- 1993-11-16 JP JP7514402A patent/JPH09509070A/en active Pending
- 1993-11-16 EP EP94902263A patent/EP0727964A4/en not_active Withdrawn
-
1996
- 1996-05-16 KR KR1019960702590A patent/KR960705505A/en not_active Application Discontinuation
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4597379A (en) * | 1979-05-16 | 1986-07-01 | Cabot Medical Corporation | Method of coagulating muscle tissue |
EP0480293A1 (en) * | 1990-10-11 | 1992-04-15 | LaserSurge, Inc. | Clamp for approximating tissue sections |
WO1994008526A1 (en) * | 1992-10-14 | 1994-04-28 | Premier Laser Systems, Inc. | Clamp and method for applying thermal energy |
Non-Patent Citations (1)
Title |
---|
See also references of WO9513747A1 * |
Also Published As
Publication number | Publication date |
---|---|
JPH09509070A (en) | 1997-09-16 |
EP0727964A4 (en) | 1999-06-16 |
KR960705505A (en) | 1996-11-08 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
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17P | Request for examination filed |
Effective date: 19960613 |
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AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): AT CH DE ES FR GB IT LI |
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A4 | Supplementary search report drawn up and despatched |
Effective date: 19990504 |
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AK | Designated contracting states |
Kind code of ref document: A4 Designated state(s): AT CH DE ES FR GB IT LI |
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17Q | First examination report despatched |
Effective date: 20010418 |
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STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN |
|
18D | Application deemed to be withdrawn |
Effective date: 20010829 |