US20030109875A1 - Open vessel sealing forceps with disposable electrodes - Google Patents
Open vessel sealing forceps with disposable electrodes Download PDFInfo
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- US20030109875A1 US20030109875A1 US10/299,650 US29965002A US2003109875A1 US 20030109875 A1 US20030109875 A1 US 20030109875A1 US 29965002 A US29965002 A US 29965002A US 2003109875 A1 US2003109875 A1 US 2003109875A1
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- electrodes
- electrode assembly
- forceps
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- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2945—Curved jaws
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- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
-
- 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
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
- A61B2018/1432—Needle curved
Abstract
A removable electrode assembly for use in combination with a forceps having opposing end effectors and a handle for effecting movement of the end effectors relative to one another. The electrode assembly includes a housing which is removably engageable with the forceps and a pair of electrodes which are attachable to a distal end of the housing. The electrodes are removably engageable with the end effectors of the forceps such that the electrodes reside in opposing relation relative to one another. The electrode assembly also includes a cover plate which is removably attachable to the housing and at least one stop member for controlling the distance the electrodes move relative to one another.
Description
- This application claims priority to U.S. application Ser. No. 09/177,950 filed Oct. 23, 1998 by Randel A. Frazier et al., and to U.S. application Ser. No. 09/178,027 filed Oct. 23, 1998 by Philip Mark Tetzlaff et al., the entire contents of each of these applications are hereby incorporated by reference.
- The present disclosure relates to electrosurgical forceps used for open surgical procedures and/or laparoscopic surgical procedures. More particularly, the present disclosure relates to a bipolar forceps having a disposable electrode assembly for sealing, cauterizing, coagulating/desiccating and/or cutting vessels and vascular tissue.
- A hemostat or forceps is a simple plier-like tool which uses mechanical action between its jaws to constrict tissue and is commonly used in open surgical procedures to grasp, dissect and/or clamp tissue. Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis by heating the tissue and blood vessels to coagulate, cauterize, cut and/or seal tissue.
- By utilizing an electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate and/or cut tissue and/or simply reduce or slow bleeding, by controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue. Generally, the electrical configuration of electrosurgical forceps can be categorized in two classifications: 1) monopolar electrosurgical forceps; and 2) bipolar electrosurgical forceps.
- Monopolar forceps utilize one active electrode associated with the clamping end effector and a remote patient return electrode or pad which is attached externally to the patient. When the electrosurgical energy is applied, the energy travels from the active electrode, to the surgical site, through the patient and to the return electrode.
- Bipolar electrosurgical forceps utilize two generally opposing electrodes which are disposed on the inner opposing surfaces of end effectors and which are both electrically coupled to an electrosurgical generator. Each electrode is charged to a different electric potential. Since tissue is a conductor of electrical energy, when the effectors are utilized to clamp or grasp tissue therebetween, the electrical energy can be selectively transferred through the tissue.
- The process of coagulating small vessels is fundamentally different than vessel sealing. For the purposes herein the term coagulation is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dried. Vessel sealing is defined as the process of liquefying the collagen in the tissue so that it cross-links and reforms into a fused mass. Thus, coagulation of small vessels is sufficient to close them, however, larger vessels need to be sealed to assure permanent closure.
- In order to effect a proper seal with larger vessels, two predominant mechanical parameters must be accurately controlled—the pressure applied to the vessel and the gap between the electrodes both of which affect thickness of the sealed vessel. More particularly, accurate application of the pressure is important to oppose the walls of the vessel, to reduce the tissue impedance to a low enough value that allows enough electrosurgical energy through the tissue, to overcome the forces of expansion during tissue heating and to contribute to the end tissue thickness which is an indication of a good seal. In some instances a fused vessel Wall is optimum between 0.001 and 0.006 inches. Below this range, the seal may shred or tear and above this range the lumens may not be properly or effectively sealed.
- Numerous bipolar electrosurgical forceps have been proposed in the past for various open surgical procedures. However, some of these designs may not provide uniformly reproducible pressure to the blood vessel and may result in an ineffective or non-uniform seal. For example, U.S. Pat. No. 2,176,479 to Willis, U.S. Pat. No. 4,005,714 to Hiltebrandt, U.S. Pat. Nos. 4,370,980, 4,552,143, 5,026,370 and 5,116,332 to Lottick, U.S. Pat. No. 5,443,463 to Stern et al., U.S. Pat. No. 5,484,436 to Eggers et al., all relate to electrosurgical instruments for coagulating, cutting and/or sealing vessels or tissue.
- These instruments rely on clamping pressure alone to procure proper sealing thickness and are not designed to take into account gap tolerances and/or parallelism and flatness requirements which are parameters which, if properly controlled, can assure a consistent and effective tissue seal. For example, it is known that it is difficult to adequately control thickness of the resulting sealed tissue by controlling clamping pressure alone for either of two reasons: 1) if too much force is applied, there is a possibility that the two poles will touch and energy will not be transferred through the tissue resulting in an ineffective seal; or 2) if too low a force is applied, a thicker less reliable seal is created.
- It has also been found that cleaning and sterilizing many of the prior art bipolar instruments is often impractical as electrodes and/or insulation can be damaged. More particularly, it is known that electrically insulative materials, such as plastics, can be damaged or compromised by repeated sterilization cycles.
- Thus, a need exists to develop a bipolar forceps which can seal vessels and tissue consistently and effectively and which will not be damaged by continued use and cleaning.
- The present disclosure relates to a removable electrode assembly for use in combination with a mechanical forceps having opposed end effectors and a handle for controlling movement of the end effectors relative to one another. The electrode assembly includes a housing which is removably engageable with the mechanical forceps and a pair of electrodes which are attachable to a distal end of the housing. The electrodes are removably engageable with the end effectors of the mechanical forceps such that the electrodes reside in opposing relation relative to one another. Preferably, the electrode assembly can be employed with both open surgical procedures as well as laparoscopic surgical procedures.
- Preferably, the distal end of the housing is bifurcated forming two prongs and each of the electrodes is attached to each of the prongs. In one embodiment, the prongs are movable relative to one another to facilitate engagement of the electrodes with the end effectors of the mechanical forceps.
- Each electrode preferably includes an electrically conductive sealing surface and an insulating substrate. The substrate includes at least one mechanical interface for engaging a complimentary mechanical interface disposed on the corresponding end effector of the mechanical forceps. In one embodiment the electrodes include at least one guide pin and the corresponding end effector includes a complimentary aperture for receiving the guide pin.
- Preferably, the electrode assembly includes at least one stop member for controlling the distance between the opposing electrodes. In another embodiment of the present disclosure, the mechanical forceps includes at least one stop member for controlling the distance between the end effectors which, in turn, control the distance between the attached opposing electrodes.
- Another embodiment of the present disclosure includes a cover plate which is removably engageable with the housing member and the mechanical forceps are disposed between the housing and the cover plate when the bipolar forceps is assembled.
- Another embodiment includes a removable electrode assembly which includes a housing having at least one portion which is removably engageable with at least one portion of the forceps and a pair of electrodes attachable to a distal end of the housing. Preferably, the electrodes are removably engageable with the end effectors of the forceps such that the electrodes reside in opposing relation relative to one another. Preferably, the electrodes are electrically isolated from the handle.
- Another embodiment includes a bipolar forceps which includes a mechanical forceps having opposing end effectors and a handle for effecting movement of the end effectors relative to one another and an electrode assembly which removably engages the mechanical forceps. A pair of opposing electrodes are attached to a distal end of the electrode assembly and are removably engageable with one of the end effectors such that the electrodes reside in opposing relation relative to one another. Preferably, at least one stop member controls the distance between the opposing electrodes.
- Still yet another embodiment includes a bipolar electrosurgical instrument which includes a pair of first and second members each having an end effector attached to a distal end thereof and a handle attached to a proximal end thereof for effecting movement of the end effectors relative to one another. An electrode assembly is removably engageable with one of the first or second members and has a pair of electrodes which are removably engageable with the end effectors.
- Another embodiment includes a bipolar electrosurgical instrument having a pair of first and second members each having an end effector attached to a distal end thereof and a handle movable from a first position wherein the first and second members are disposed in spaced relation relative to one another to a second position wherein the members are closer relative to one another. A first electrode removably mounts to the first end effector and a second electrode removably mounts to the second end effector.
- Yet another embodiment includes a bipolar electrosurgical instrument having at least one stop member for maintaining a gap distance between the opposing electrodes, the gap distance being in the range of about 0.001 inches to about 0.006 inches.
- FIG. 1 is a perspective view of a bipolar forceps according to the present disclosure;
- FIG. 2 is an enlarged, perspective view of a distal end of the bipolar forceps shown in. FIG. 1;
- FIG. 3 is a perspective view with parts separated of the forceps shown in FIG. 1;
- FIG. 4 is an enlarged, side view of a disposable electrode assembly of FIG. 1 shown without a cover plate;
- FIG. 5 is an enlarged, perspective view of a distal end of the disposable electrode assembly of FIG. 4;
- FIG. 6 is a perspective view with parts separated of an upper electrode of the disposable electrode assembly of FIG. 5;
- FIG. 7 is a perspective view with parts separated of a lower electrode of the disposable electrode assembly of FIG. 5;
- FIG. 8 is a perspective view of the forceps of the present disclosure showing the operative motion of the forceps to effect sealing of a tubular vessel;
- FIG. 9 is an enlarged, partial perspective view of a sealing site of a tubular vessel;
- FIG. 10 is a longitudinal cross-section of the sealing site taken along line10-10 of FIG. 9;
- FIG. 11 is a longitudinal cross-section of the sealing site of FIG. 9 after separation of the tubular vessel;
- FIG. 12 is a perspective view of another embodiment of the present disclosure;
- FIG. 13 is an exploded view of the embodiment of FIG. 12; and
- FIG. 14 is an enlarged exploded view of a working end of the embodiment of FIGS. 12 and 13.
- Referring now to FIGS.1-3, a
bipolar forceps 10 for use with open and/or laparoscopic surgical procedures includes amechanical forceps 20 and anelectrode assembly 21. In the drawings and in the description which follows, the term “proximal”, as is traditional, will refer to the end of theforceps 10 which is closer to the user, while the term “distal” will refer to the end which is further from the user. -
Mechanical forceps 20 includes first andsecond members shaft Shafts proximal end distal end proximal end shaft portion handle member shaft portions distal end shaft portion end effectors end effectors handle members - Preferably,
shaft portions end effectors pivot 25 such that movement of thehandles end effectors end effectors end effectors tubular vessel 150 therebetween (see FIG. 8). It is envisioned thatpivot 25 has a large surface area to resist twisting and movement offorceps 10 during operation. Clearly, theforceps 10 can be designed such that movement of one or both of thehandles - As best seen in FIG. 3,
end effector 24 includes an upper orfirst jaw member 44 which has an inner facingsurface 45 and a plurality of mechanical interfaces disposed thereon which are dimensioned to releasable engage a portion of adisposable electrode assembly 21 which will be described in greater detail below. Preferably, the mechanical interfaces includesockets 41 which are disposed at least partially through inner facingsurface 45 ofjaw member 44 and which are dimensioned to receive a complimentary detent attached toupper electrode 120 of thedisposable electrode assembly 21. While the term socket is used herein, it is contemplated that either a male or female mechanical interface may be used onjaw member 44 with a mating mechanical interface disposed on thedisposable electrode assembly 21. - In some cases, it may be preferable to manufacture
mechanical interfaces 41 along another side ofjaw member 44 to engage a complimentary mechanical interface of thedisposable electrode assembly 21 in a different manner, e.g., from the side.Jaw member 44 also includes anaperture 67 disposed at least partially throughinner face 45 ofend effector 24 which is dimensioned to receive acomplimentary guide pin 124 disposed onelectrode 120 of thedisposable electrode assembly 21. -
End effector 22 includes a second orlower jaw member 42 which has an inner facingsurface 47 which opposes inner facingsurface 45. Preferably,jaw members jaw members jaw member 44,jaw member 42 also includes a plurality of mechanical interfaces orsockets 43 disposed thereon which are dimensioned to releasable engage a complimentary portion disposed on anelectrode 110 of thedisposable electrode assembly 21 as described below. Likewise,jaw member 42 also includes an aperture 65 disposed at least partially throughinner face 47 which is dimensioned to receive a complimentary guide pin 126 (see FIG. 4) disposed onelectrode 110 of thedisposable electrode assembly 21. - Preferably,
shaft members mechanical forceps 20 are designed to transmit a particular desired force to the opposing inner facing surfaces 47 and 45 of the of thejaw members shaft members shaft members jaw members jaw members shaft members shaft members jaw members - Each
shaft member ratchet portion proximal end 13 of itsrespective shaft member 12 towards theother ratchet 34 in a generally vertically aligned manner such that the inner facing surfaces of eachratchet end effectors ratchet flanges ratchet ratchets ratchets shaft members end effectors electrodes jaw members handles - In some cases it may be preferable to include other mechanisms to control and/or limit the movement of the
jaw members jaw members - Preferably, at least one of the shaft members, e.g.,14, includes a
tang 99 which facilitates manipulation of theforceps 20 during surgical conditions as well as facilitates attachment ofelectrode assembly 21 onmechanical forceps 20 as will be described in greater detail below. - As best seen in FIGS. 2, 3 and5,
disposable electrode assembly 21 is designed to work in combination withmechanical forceps 20. Preferably,electrode assembly 21 includeshousing 71 which has aproximal end 77, adistal end 76 and anelongated shaft plate 78 disposed therebetween. Ahandle plate 72 is disposed near theproximal end 77 ofhousing 71 and is sufficiently dimensioned to releasably engage and/or encompasshandle 18 ofmechanical forceps 20. Likewise,shaft plate 78 is dimensioned to encompass and/or releasably engageshaft 14 andpivot plate 74 disposed near thedistal end 76 ofhousing 71 is dimensioned to encompasspivot 25 and at least a portion ofdistal end 19 ofmechanical forceps 20. It is contemplated that theelectrode assembly 21 can be manufactured to engage either the first orsecond members mechanical forceps 20 and theirrespective component parts - In the embodiment shown in FIG. 2, handle18,
shaft 14,pivot 25 and a portion ofdistal end 19 are all dimensioned to fit into corresponding channels located inhousing 71. For example, achannel 139 is dimensioned to receivehandle 18, achannel 137 is dimensioned to receiveshaft 14 and achannel 133 is dimensioned to receivepivot 25 and a portion ofdistal end 19. -
Electrode assembly 21 also includes acover plate 80 which is also designed to encompass and/or engagemechanical forceps 20 in a similar manner as described with respect to thehousing 71. More particularly,cover plate 80 includes aproximal end 85, adistal end 86 and anelongated shaft plate 88 disposed therebetween. Ahandle plate 82 is disposed near theproximal end 85 and is preferably dimensioned to releasable engage and/or encompasshandle 18 ofmechanical forceps 20. Likewise,shaft plate 88 is dimensioned to encompass and/or releasable engageshaft 14 and apivot plate 94 disposed neardistal end 86 is designed to encompasspivot 25 anddistal end 19 ofmechanical forceps 20. Preferably, handle 18,shaft 14,pivot 25 anddistal end 19 are all dimensioned to fit into corresponding channels (not shown) located incover plate 80 in a similar manner as described above with respect to thehousing 71. - As best seen with respect to FIGS. 3 and 4,
housing 71 andcover plate 80 are designed to engage one another overfirst member 11 ofmechanical forceps 20 such thatfirst member 11 and its respective component parts, e.g., handle 18,shaft 14,distal end 19 andpivot 25, are disposed therebetween. Preferably,housing 71 andcover plate 80 include a plurality of mechanical interfaces disposed at various positions along the interior ofhousing 71 andcover plate 80 to effect mechanical engagement with one another. More particularly, a plurality ofsockets 73 are disposedproximate handle plate 72,shaft plate 78 andpivot plate 74 ofhousing 71 and are dimensioned to releasably engage a corresponding plurality ofdetents 83 extending fromcover plate 80. It is envisioned that either male or female mechanical interfaces or a combination of mechanical interfaces may be disposed withinhousing 71 with mating mechanical interfaces disposed on or withincover plate 80. - As best seen with respect to FIGS.5-7, the
distal end 76 ofelectrode assembly 21 is bifurcated such that two prong-like members electrode electrode 120 is affixed at anend 90 ofprong 105 andelectrode 110 is affixed at anend 91 ofprong 103. It is envisioned that theelectrodes ends - A pair of
wires electrodes wires wire bundle 28 which runs from a terminal connector 30 (see FIG. 3), to theproximal end 77 ofhousing 71, along the interior ofhousing 71, todistal end 76.Wire bundle 28 is separated intowires distal end 76 and thewires electrode wires wire bundle 28 at various pinch points along the inner cavity of theelectrode assembly 21 and enclosing thewires electrode assembly 21 by attaching thecover plate 80. - This arrangement of
wires bipolar forceps 10. As mentioned above, the proximal end of thewire bundle 28 is connected to aterminal connector 30, however, in some cases it may be preferable to extendwires wires second members - As best seen in FIG. 6,
electrode 120 includes an electricallyconductive seal surface 126 and an electricallyinsulative substrate 121 which are attached to one another by snap-fit engagement or some other method of assembly, e.g.,substrate 121 is overmolded to capture the electricallyconductive seal surface 126. Preferably,substrate 121 is made from an injection molded plastic material and is shaped to mechanically engage a correspondingsocket 41 located injaw member 44 ofend effector 24. Thesubstrate 121 not only insulates the electric current but it also alignselectrode 120 both of which contribute to the seal quality and consistency. For example, by overmolding theconductive surface 126 to thesubstrate 121, the alignment and thickness of theelectrode 120 can be controlled. - Preferably,
substrate 121 includes a plurality ofbifurcated detents 122 which are shaped to, compress during insertion intosockets 41 and expand and releasably engagesockets 41 after insertion. It is envisioned that snap-fit engagement of theelectrode 120 and thejaw member 44 will accommodate a broader range of manufacturing tolerances.Substrate 121 also includes an alignment orguide pin 124 which is dimensioned to engageaperture 67 ofjaw member 44. -
Conductive seal surface 126 includes anwire crimp 145 designed to engage thedistal end 90 ofprong 105 ofelectrode assembly 21 and electrically engage a corresponding wire connector affixed to wire 60 located within electrode assembly.Seal surface 126 also includes an opposingface 125 which is designed to conduct an electrosurgical current to a tubular vessel ortissue 150 when it is held thereagainst. -
Electrode 110 includes similar elements for insulating and conducting electrosurgical current totissue 150. More particularly,electrode 110 includes an electricallyconductive seal surface 116 and an electricallyinsulative substrate 111 which are attached to one another by snap-fit engagement or some other method of assembly.Substrate 111 includes a plurality ofbifurcated detents 112 and an alignment pin 126 (see FIG. 4) which are dimensioned to engage a corresponding plurality ofsockets 43 and aperture 65 located injaw member 42.Conductive seal surface 116 includes anextension 155 having awire crimp 119 which engages thedistal end 91 ofprong 103 and electrically engages a corresponding wire connector affixed to wire 62 located inhousing 71.Seal surface 116 also includes an opposingface 115 which conducts an electrosurgical current to a tubular vessel ortissue 150 when it is held thereagainst. Alternatively,electrodes 110 and/or 120 can be formed as one piece and include similar components for insulating and conducting electrical energy. - As best seen in FIG. 7,
substrate 111 also includes anextension 108 and astop member 106 which is designed to engagecorresponding extension 155 and aninterface 107 located onconductive seal 116. To assembleelectrode 110,stop member 106 andextension 108 are overmolded ontointerface 107 andextension 155 ofconductive seal 116. After assembly,wire crimp 119 is then inserted intoend 91 ofprong member 103 and connected to wire 62. - It is known that as the tissue is compressed and electrosurgical energy is applied to the tissue, the impedance of the tissue decreases as the moisture level decreases. As a result, two mechanical factors play an important role in determining seal thickness and effectiveness, i.e., the pressure applied between opposing faces47 and 45 and the gap distance between the opposing
electrodes 110 and 120 (see FIG. 5).Jaw members electrodes electrode assembly 21 and themechanical forceps 20 are configured to fall within specific manufacturing tolerances to assure that the gap between electrodes will not vary outside the desired range. - It is also known that tissue thickness is very difficult to control by force alone, i.e., too much force and the two poles would touch and the little energy would travel through the tissue resulting in a bad seal or too little force and the seal would be too thick. Applying the correct force is important for other reasons: to oppose the vessel lumens; reduce the tissue impedance to a low enough value that allows enough current through the tissue; and to overcome the forces of expansion during tissue heating in addition to contributing towards creating the required end tissue thickness which is an indication of a good seal.
- It is also known that the size of the gap effects the tissue seal. For example, if a gap is too great, i.e., the jaws do not compress the tissue enough, the tissue does not properly liquefy the collagen for effective sealing. If, on the other hand, the gap is too small, i.e., the jaws compress the tissue too much, the electrosurgical energy effectively severs the tissue which is also undesirous. It has been found that in order to effectively seal tissue and overcome the shortcomings described above, the gap distance (range)151 (See FIG. 8) between the opposing
electrodes - In order to assure that the desired gap range is achieved after assembly and that the correct force is applied to seal the tissue,
substrate 111 includes at least one stop member, 106, which is designed to restrict and/or regulate movement of the twoelectrodes forceps 20 also includes at least one stop member, e.g., 101 (see FIG. 3), for restricting and/or regulating the distance betweenend effectors end effectors electrodes stop 106 is part of thedisposable electrode assembly 21, this stop has the added benefit of being dependent on the material of thedisposable electrode assembly 21. Preferably, a “step” stop is utilized due to its ease of manufacture and simplicity. - It is contemplated that the stop member can be positioned at various points along the disposable electrode assembly to achieve the aforedescribed desired gap range and/or the stop member can be positioned on other parts of the instrument, e.g., handles16, 18,
jaws shafts - Preferably, the seal surfaces115 and 125 are relatively flat to avoid current concentrations at sharp edges and to avoid arcing between high points. In addition and due to the reaction force of the
tissue 150 when engaged,jaw members jaw members electrodes tissue 150. The tapered shape of the electrode, e.g., 110, is determined by calculating the mechanical advantage variation from the distal to proximal end of theelectrode 110 and adjusting the width of theelectrode 110 accordingly. - Preferably, at least one of the prong members, e.g.,105, is resilient or includes a
flex relief portion 53 which permits movement of the twoprong members electrodes electrode assembly 21 is removably attached to themechanical forceps 20 by initially movingprong 105 towardsprong 103 by bendingprong 105 atflex relief portion 53. Theelectrodes jaw members detents pins socket aperture 65 and 67, respectively.Housing 71 is also positioned accordingly such thatshaft 14, handle 18 andpivot 25 are all positioned proximate theircorresponding channels housing 71. - When
flex relief portion 53 is released, eachelectrode jaw member detents sockets housing 71 is engaged withmechanical forceps 20. Thecover plate 80 is then attached tohousing 71 in the manner described above. Thebipolar forceps 10 is now ready for operation. - In one embodiment, the
electrode assembly 21 is attached to themechanical forceps 20 in a different manner. For example and as best illustrated in FIG. 3, theelectrode assembly 21 can be engaged with themechanical forceps 20 in the following four-step manner: 1)electrode assembly 21 andcover plate 80 are pivoted backward such thattang 99 engages aslot 100 inelectrode assembly 21; 2)electrode assembly 21 andcover plate 80 are then pivoted forward to engageshaft 14 ofmechanical forceps 20 therebetween; 3)detents 112 ofelectrode 110 are then engaged withsockets 43 ofjaw member 22; and 4)detents 122 ofelectrode 120 are engaged withsockets 41 ofjaw member 24. - FIG. 8 shows the
bipolar forceps 10 during use wherein thehandle members tubular tissue 150 to effect aseal 152 as shown in FIGS. 9 and 10. Once sealed, thetubular vessel 150 can be cut alongseal 152 to separate thetissue 150 andform gap 154 therebetween as shown in FIG. 11. - After the
bipolar forceps 10 is used or if theelectrode assembly 21 is damaged, theelectrode assembly 21 can be easily removed and/or replaced by reversing the above attachment procedure and anew electrode assembly 21 can be engaged with themechanical forceps 20 in the same manner. For example, theelectrode assembly 21 can be disengaged from themechanical forceps 20 in the following four-step manner: 1) thedetents 122 ofelectrode 120 are disengaged from thesockets 41 ofjaw member 24; 2) thedetents 112 ofelectrode 110 are disengaged from thesockets 43 ofjaw member 22; 3) theelectrode assembly 21 andcover plate 80 are disengaged fromshaft 14 ofmechanical forceps 20; and 4) theelectrode assembly 21 andcover plate 80 are pivoted such thattang 99 disengages fromslot 100 inelectrode assembly 21. - It is envisioned that by making the
electrode assembly 21 disposable, theelectrode assembly 21 is less likely to become damaged since it is only intended for a single use and, therefore, does not require cleaning or sterilization. As a result, the functionality and consistency of the vital sealing components, e.g., theconductive surface surface - FIGS.12-14 show another embodiment of the present disclosure for use with endoscopic surgical procedures and includes a bipolar forceps 210 having a
drive rod assembly 211 coupled to ahandle assembly 218. Thedrive rod assembly 211 includes an elongatedhollow shaft portion 212 having aproximal end 216 and adistal end 214. Anend effector assembly 222 is attached to thedistal end 214 ofshaft 212 and includes a pair of opposingjaw members assembly 218 is attached to theproximal end 216 ofshaft 212 and includes anactivator 220 for imparting movement of thejaw members jaw members jaw members tissue 150 therebetween. - As best seen in FIG. 13,
activator 220 includes amovable handle 226 having anaperture 234 defined therein for receiving at least one of the operator's fingers and a fixed handle 228 having anaperture 232 defined therein for receiving an operator's thumb.Movable handle 226 is selectively moveable from a first position relative to fixed handle 228 to a second position in closer proximity to the fixed handle 228 to closejaw members channel 227 which extends proximally for receiving aratchet 230 which is coupled tomovable handle 226. This structure allows for progressive closure ofend effector assembly 222 as well as locking engagement of opposingjaw members handle 226 relative to handle 228 such as, e.g., hydraulic, semi-hydraulic and/or gearing systems. - Fixed handle228 includes a
rotating assembly 223 for controlling the rotational movement ofend effector assembly 222 about a longitudinal axis “A” of theelongated shaft 212. Preferably, rotatingassembly 223 includes upper andlower knob portions 224 a and 224 b, respectively, which releasably engage one another about agear 252 which is attached toshaft 212. A pair ofhandle sections 228 a and 2228 b engage one another by way of a plurality of mechanical interfaces to form fixed handle 228. As best seen in FIG. 13, eachhandle section 228 a and 228 b is generally hollow such that acavity 250 is formed therein for housing various internal components which make up the forceps 210. For example,cavity 250 houses aPC board 258 which controls the electrosurgical energy being transmitted from an electrosurgical generator (not shown) to eachjaw member cable 260 which attached through awire port 229 disposed in the proximal end ofhandle assembly 218. ThePC board 258 converts the electrosurgical energy from the generator into two different electrical potentials which are transmitted to eachjaw member terminal clip - Referring to FIG. 14,
rod assembly 211 includes adrive rod 270 which has aproximal end 271 and adistal end 272. Apiston 238 is attached to theproximal end 271 ofdrive rod 270 and includes a generally roundedhead portion 239 and anotch 241 located between thehead portion 239 and the proximal end ofpiston 238. Preferably, clevisflanges arm 240 are dimensioned to receivehead 239 therebetween whenarm 240 is assembled betweenhandle sections 228 a and 228 b (see FIG. 6). Movement of thehandle 226 towards fixed handle 228 imparts pivotal movement of theupper end 245 ofarm 240 at apivot point 255 which, in turn, imparts movement of thepiston 238 from a first position wherein thepiston 238 is disposed further fromend effector assembly 222 to a second position whereinpiston 238 is in closer proximity to endeffector assembly 222. As explained in greater detail below, movement of thepiston 238 between first and second positions imparts linear movement to driverod 270 which, in turn, movesjaw members - Seating the generally rounded
head 239 betweenclevis flanges rotating assembly 223 effectively without interfering with the linear movement of thepiston 238. - The
end effector assembly 222 includesfirst jaw 280,second jaw 282 and an electrically insulatingyoke 284 disposed therebetween. Preferably,jaw member 280 andjaw member 282 are movable from an open position to a closed position by movement of thehandle assembly 218 as described above. It is contemplated that either both or one of thejaw members First jaw member 280 has afirst flange 281 which extends therefrom and acam slot 86 located therethrough. Likewise,second jaw 282 has asecond flange 283 which extends therefrom and acam slot 288 located therethrough. - The
end effector assembly 222 also includes anouter nose portion 294 and aninner nose portion 296 which engagejaw members first pivot 305 is located onouter nose portion 294 and is dimensioned to engage acorresponding pivot hole 289 located onflange 283. Asecond pivot 303 is located oninner nose portion 296 and is dimensioned to engage acorresponding pivot hole 287 located onflange 281. The center of rotation forfirst jaw member 280 is at afirst pivot hole 287 and the center of rotation forsecond jaw member 282 is at asecond pivot hole 289. Preferably, eachnose portion respective jaw member - As mentioned above with respect to FIG. 13, electrosurgical energy is transmitted from the electrosurgical generator to an
connector assembly 315 which includes thePC board 258 which converts the energy into first and second poles. A pair ofterminal clips PC board 258 and transfer the first and second poles of alternating potential, respectively, to thedrive rod assembly 211. Clip 264 a connects toshaft 212 and conducts the first pole tojaw member 282 andclip 264 b connects topiston 238 which is, in turn, connected to driverod 270. The second pole is conducted alongdrive rod 270 tojaw member 280. Both thedrive rod 270 and theshaft 212 are made from an electrically conductive material and preferably aninsulation sleeve 275 is disposed betweendrive rod 270 andshaft 212 to prevent the forceps 210 from short circuiting. - As best seen in FIG. 14, the
inner nose portion 296 is electrically connected withdrive rod 270 and theouter nose portion 294 is electrically connected toshaft 212. The inner andouter nose portions capture yoke 284 along withflanges Yoke 284 moves axially along axis “A” in a space between inner andouter portions spacer stake 319 maintains the separation of thenose portions Stake 319 is dimensioned to engage and lock the inner andouter nose portions jaw members yoke 284. In some cases it may be preferable todimension stake 319 such thatstake 319 acts as a stop member and controls the gap distance between the opposingjaw members stake 319 is formed from an electrically insulative material such as plastic. Thenose portions flanges detents cam slots -
End effector assembly 222 also includes aninner insulator 302 and anouter insulator 300 for maintaining electrical insulation between poles.Outer insulator 300 insulatesouter nose portion 294 frominner nose portion 296 and driverod 270 which conduct the second pole of electrical energy.Inner insulator 302 insulatesinner nose portion 296 fromouter nose portion 294 andshaft 212 which conduct the first pole of electrical energy. In this manner,outer nose portion 294 can provide electrical continuity betweenshaft 212 andjaw member 282, whileinner nose portion 296 can provide electrical continuity betweendrive rod 270 andjaw member 280. - Preferably, a
spring contact 298 is utilized to maintain the electrical connection betweendrive rod 270 andinner nose portion 296 during axial motion of thedrive rod 270. A donut-shapedspacer 308 can also be utilized to assure linear motion of thedrive rod 270 withinsleeve 275 and to prevent accidental short circuiting of the forceps 210. - Referring back to FIG. 14,
yoke 284 is preferably formed from an electrically insulative material such as plastic. Afirst side 291 ofyoke 284 facesfirst flange 281 and asecond side 293 ofyoke 284 facessecond flange 283. When yoke 84 is positioned betweenflanges yoke 284 electrically insulatesfirst jaw member 80 fromsecond jaw member 282. In this manner, bipolar electrosurgical current can be conducted through tissue 350 which is grasped betweenjaws flanges - In order to achieve a desired gap range (e.g., about 0.001 to about 0.006 inches) and apply a desired force to seal the tissue, at least one
jaw member 280 and/or 282 includes astop member 339 which limits the movement of the two opposingjaw members dimension stake 319 such that it acts like a stop member and limits the movement of the two opposingjaw members stop member 339 and/orstake 319 is made from an insulative material and is dimensioned to limit opposing movement of thejaw members - From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the present disclosure. For example, although it is preferable that
electrodes electrodes handles - Although it is preferable to vertically align
electrodes electrodes - Although it is preferable that the
electrode assembly 21 includehousing 71 andcover plate 80 to engagemechanical forceps 20 therebetween, in some cases it may be preferable to manufacture thedisposable electrode assembly 21 such that only one piece, e.g.,housing 71 is required to engagemechanical forceps 20. - While only one embodiment of the disclosure has been described, 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 a preferred embodiment. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Claims (34)
1. A removable electrode assembly for use with a forceps having opposing end effectors and a handle for effecting relative movement of the end effectors with respect to one another, the electrode assembly comprising:
a housing having at least one portion which is removably engageable with at least a portion of the forceps;
a pair of electrodes attachable to a distal end of the housing, the electrodes being removably engageable with the end effectors of the forceps such that the electrodes are disposed in opposing relation to one another; and
at least one stop member for controlling the distance between the opposing electrodes.
2. A removable electrode assembly according to claim 1 wherein each of the electrodes includes an electrically conductive sealing surface and an insulating substrate.
3. A removable electrode assembly according to claim 2 wherein the stop member is attached to the insulating substrate.
4. A removable electrode assembly according to claim 1 wherein the distal end of the housing is bifurcated forming two prongs and each of the electrodes is attached to one of the prongs.
5. A removable electrode assembly according to claim 4 wherein the prongs of the housing are movable relative to one another to facilitate engagement of the electrodes with the end effectors of the forceps.
6. A removable electrode assembly according to claim 5 wherein the insulating substrate of each of the electrodes includes at least one mechanical interface for engaging a complimentary mechanical interface disposed on the corresponding end effector of the forceps.
7. A removable electrode assembly according to claim 6 wherein the mechanical interface of at least one of the substrates includes at least one detent and the mechanical interface of the corresponding end effector includes at least one complimentary socket for receiving the detent.
8. A removable electrode assembly according to claim 6 wherein the substrate of at least one of the electrodes includes at least one guide pin and the corresponding end effector includes at least one complimentary aperture for receiving the guide pin.
9. A removable electrode assembly according to claim 1 wherein the stop member is attached to at least one of the end effectors.
10. A removable electrode assembly according to claim 1 wherein the stop member is attached to at least one of the electrodes.
11. A removable electrode assembly according to claim 1 wherein the electrodes are tapered.
12. A removable electrode assembly according to claim 1 wherein each of the electrodes includes an electrical connector for coupling to a wire.
13. A removable electrode assembly according to claim 1 wherein the housing is removably engageable with the handle of the forceps.
14. A removable electrode assembly according to claim 1 further comprising a cover plate which is removably engageable with the housing.
15. A removable electrode assembly according to claim 14 wherein both the housing and the cover plate are engageable with the forceps.
16. A removable electrode assembly according to claim 15 wherein the forceps are disposed between the housing and the cover plate.
17. A removable electrode assembly according to claim 1 wherein the housing includes a bifurcated distal end which forms two prongs and each electrode is removably attachable to one of the prongs.
18. A removable electrode assembly according to claim 17 wherein the prongs of the housing are movable relative to one another to facilitate engagement of the electrodes with the end effectors of the forceps.
19. A removable electrode assembly according to claim 1 further comprising at least one ratchet which engages at least one complementary mechanical interface to maintain a desired closure force between opposing electrodes.
20. A removable electrode assembly according to claim 1 further comprising a pair of opposing ratchets which interlock in at least one position for maintaining a desired closure force between opposing electrodes.
21. A removable electrode assembly for use with a forceps having opposing end effectors and a handle for effecting relative movement of the end effectors with respect to one another, the electrode assembly comprising:
a housing having a portion which is removably engageable with a portion of the forceps; and
a pair of electrodes attachable to a distal end of the housing, the electrodes being removably engageable with the end effectors of the forceps such that the electrodes are disposed in opposing relation to one another.
22. A removable electrode assembly according to claim 21 wherein the distal end of the housing is bifurcated forming two prongs and each of the electrodes is removably engageable with one of the prongs.
23. A removable electrode assembly according to claim 22 wherein the prongs are movable relative to one another to facilitate engagement of the electrodes with the end effectors of the forceps.
24. A removable electrode assembly according to claim 21 wherein the electrodes are electrically isolated from the handle.
25. A bipolar electrosurgical instrument, comprising:
a forceps having opposing end effectors and a handle for effecting relative movement of the end effectors with respect to one another, an electrode assembly removably attachable to the forceps, the electrode assembly including a pair of opposing electrodes attached to a distal end thereof, each of the electrodes being removably engageable with one of the end effectors such that the electrodes reside in opposing relation to one another, and at least one stop member for controlling the distance between the opposing electrodes.
26. A bipolar electrosurgical instrument comprising:
a pair of first and second members each having an end effector extending from a distal end thereof and a handle attached to a proximal end thereof for effecting relative movement of the end effectors with respect to one another; and
an electrode assembly which is removably engageable with the first member, the electrode assembly having a pair of electrodes, each electrode being removably engageable with one of the end effectors.
27. A bipolar electrosurgical instrument according to claim 26 wherein the electrode assembly is bifurcated such that two prong-like members extend outwardly to support an electrode which is removably engaged with one of the end effectors.
28. A bipolar electrosurgical instrument comprising:
a pair of first and second members each having an end effector extending from a distal end thereof and a handle movable from a first position wherein the first and second members are disposed in spaced relation relative to one another to a second position wherein the members are closer relative to one another; and
a first electrode removably mounted to the first end effector and a second electrode removably mounted to the second end effector.
29. A bipolar electrosurgical instrument for sealing vessels, comprising:
first and second opposing end effectors, each end effector has an inner surface and an outer surface;
a handle disposed proximal of the first and second end effectors, the handle being movable from a first position wherein the first and second end effectors are disposed in spaced relation to one another to a second position wherein the end effectors are closer relative to one another such that the end effectors hold tissue therebetween for application of electrosurgical energy, the handle including at least one gripping portion to be gripped by a user to move the handle between the first position and the second position;
a first electrode disposed on the first end effector and a second electrode disposed on the second end effector such that movement of the handle from the first position to the second position results in the first and second electrodes being closer relative to each other, the electrodes residing in substantially opposing relation to one another and each electrode having a tissue contacting surface to engage tissue between the tissue contacting surfaces of the first and second electrodes and to enable the supply of electrosurgical energy to the tissue engaged therebetween to effect sealing;
a connector for electrically connecting the first and second electrodes to a source for supplying electrosurgical energy to each of the electrodes such that one of the electrodes has a first electrical potential and the other electrode has a second electrical potential such that the substantially opposing electrodes are capable of conducting bipolar energy through tissue held therebetween; and
at least one stop member for maintaining a gap distance between the first and second electrodes when handle is moved to the second position such that the end effectors and the electrodes are closer relative to one another, the gap distance being in the range of about 0.001 inches to about 0.006 inches.
30. A bipolar electrosurgical instrument according to claim 29 wherein the gap distance is in the range of about 0.002 inches to about 0.005 inches.
31. A bipolar electrosurgical instrument comprising:
a handle;
a drive rod assembly comprising:
an outer shaft having an end effector assembly attached to a distal end thereof, the end effector assembly including a pair of opposing first and second electrodes attached at a distal end thereof, the end effector assembly having an inner nose portion electrically coupled to the first electrode and an outer nose portion electrically coupled to the second electrode;
a drive rod disposed within the outer shaft, the drive rod movable by the handle from a first position wherein the first and second electrodes are disposed in spaced relation to one another to a second position wherein the first and second electrodes are closer relative to one another such that the electrodes hold tissue therebetween for application of electrosurgical energy; and
a connector for electrically connecting the first and second electrodes to a source for supplying electrosurgical energy to each of the electrodes such that the first electrode has a first electrical potential and the second electrode has a second electrical potential.
32. A bipolar electrosurgical instrument according to claim 31 wherein the connector includes a PC board having first and second clips, the first clip transmits the first electrical potential to the shaft which conducts the first electrical potential to the outer nose portion and the first electrode and the second clip transmits the second electrical potential to the drive rod which conducts the second electrical potential to the inner nose portion and the second electrode.
33. A bipolar electrosurgical instrument according to claim 31 wherein the drive rod is electrically isolated from the outer shaft.
34. A bipolar electrosurgical instrument according to claim 31 wherein the inner nose portion and the outer nose portion are electrically isolated from each other.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/299,650 US20030109875A1 (en) | 1999-10-22 | 2002-11-19 | Open vessel sealing forceps with disposable electrodes |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/425,696 US6511480B1 (en) | 1998-10-23 | 1999-10-22 | Open vessel sealing forceps with disposable electrodes |
US10/299,650 US20030109875A1 (en) | 1999-10-22 | 2002-11-19 | Open vessel sealing forceps with disposable electrodes |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/425,696 Division US6511480B1 (en) | 1998-10-23 | 1999-10-22 | Open vessel sealing forceps with disposable electrodes |
Publications (1)
Publication Number | Publication Date |
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US20030109875A1 true US20030109875A1 (en) | 2003-06-12 |
Family
ID=23687655
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/299,650 Abandoned US20030109875A1 (en) | 1999-10-22 | 2002-11-19 | Open vessel sealing forceps with disposable electrodes |
US12/200,682 Expired - Fee Related US8361071B2 (en) | 1999-10-22 | 2008-08-28 | Vessel sealing forceps with disposable electrodes |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/200,682 Expired - Fee Related US8361071B2 (en) | 1999-10-22 | 2008-08-28 | Vessel sealing forceps with disposable electrodes |
Country Status (1)
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US (2) | US20030109875A1 (en) |
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