Electrosurgical systems and methods for facilitating unipolar and / or bipolar electrosurgical tissue treatment

Abstract

An electrosurgical system includes an electrosurgical generator configured to output electrosurgical energy to an electrosurgical device for application to tissue. The electrosurgical generator is configured to determine a condition of contact between at least one electrode of the electrosurgical device and tissue or a surgical technique using the electrosurgical device, and to control electrosurgical energy output by the electrosurgical generator based on the determined condition or surgical technique.

Description

Technical Field

[0001] The present disclosure relates to electrosurgery and, more particularly, to electrosurgical systems and methods that facilitate monopolar and / or bipolar electrosurgical tissue treatment. Background Art

[0002] Monopolar electrosurgical devices typically include an active electrode configured to deliver energy from an electrosurgical generator to tissue. Monopolar electrosurgical devices are used in conjunction with a return electrode device (e.g., a remote return pad or a local return electrode) that completes an electrical circuit between the electrosurgical generator and the patient. Such monopolar electrosurgical devices include probes, hooks, loops, and the like.

[0003] Bipolar electrosurgical devices typically include an active electrode and a return electrode that are electrically isolated from each other and charged to different potentials to enable current to flow between the active electrode and the return electrode and through intervening tissue to complete the circuit between the electrosurgical generator and the patient. Such bipolar electrosurgical devices include probes, forceps, scissors, etc.

[0004] In both monopolar and bipolar electrosurgery, electrical current is conducted through tissue to heat the tissue to achieve a desired tissue treatment, such as coagulating and / or cutting tissue. Summary of the invention

[0005] As used herein, the term "distal" refers to the portion of the description that is further away from the operator (whether a surgeon or a surgical robot), while the term "proximal" refers to the portion of the description that is closer to the operator. As used herein, terms including "generally," "about," "substantially," etc. are meant to cover up to and include variations of plus or minus 10% (e.g., manufacturing tolerances, material tolerances, usage tolerances, and environmental tolerances, measurement variations, design variations, and / or other variations). In addition, within the consistent range, any or all aspects detailed herein may be used in combination with any or all other aspects detailed herein.

[0006] According to the present disclosure, an electrosurgical system is provided, the electrosurgical system including an electrosurgical generator configured to output electrosurgical energy to at least one electrode of an electrosurgical device for application to tissue. The electrosurgical generator includes: a sensor circuit system configured to sense electrical data associated with applying energy to tissue; and a controller having a processor and a non-transitory computer-readable storage medium storing instructions, which, when executed by the processor, cause the controller to obtain the sensed electrical data, determine a contact condition between at least one electrode of the electrosurgical device and tissue based on the sensed electrical data, and control the electrosurgical energy output by the electrosurgical generator based on the determined condition.

[0007] In one aspect of the present disclosure, the contact condition is an open circuit condition.In such aspects, controlling the electrosurgical energy output may include reducing the voltage of the electrosurgical energy output.

[0008] In another aspect of the present disclosure, the contact condition is entering or exiting an open circuit condition.In such aspects, controlling the electrosurgical energy output may include reducing a voltage of the electrosurgical energy output.

[0009] In yet another aspect of the present disclosure, the contact condition is a single electrode contact condition.In such aspects, controlling the electrosurgical energy output may include stopping or pausing the electrosurgical energy output.

[0010] Another electrosurgical system provided according to aspects of the present disclosure includes an electrosurgical generator configured to output electrosurgical energy to at least one electrode of an electrosurgical device for application to tissue. The electrosurgical generator includes a sensor circuit system and a controller, the sensor circuit system configured to sense electrical data associated with applying energy to tissue or enabling data associated with enabling application of energy to tissue. The controller has a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the controller to obtain the electrical data or enabling data, determine a surgical technique to be performed using the electrosurgical device based on the electrical data or enabling data, and control the electrosurgical energy output by the electrosurgical generator based on the determined surgical technique.

[0011] In one aspect of the present disclosure, an electrosurgical generator is configured to output monopolar electrosurgical energy to a monopolar electrosurgical device.

[0012] In another aspect of the present disclosure, the surgical technique is a buzzing hemostat technique. In such aspects, controlling the electrosurgical energy output may include increasing power and / or minimizing impedance.

[0013] In yet another aspect of the present disclosure, an electrosurgical generator is configured to output bipolar electrosurgical energy to a bipolar electrosurgical device.

[0014] In yet another aspect of the present disclosure, determining the surgical technique includes performing pattern recognition on enablement data associated with enabling application of energy to tissue.

[0015] In yet another aspect of the present disclosure, the surgical technique is a spot coagulation technique.In such aspects, controlling the electrosurgical energy output may include increasing voltage and / or increasing power.

[0016] Yet another electrosurgical system provided according to aspects of the present disclosure includes an electrosurgical generator configured to output electrosurgical energy to an electrosurgical device for application to tissue. The electrosurgical generator includes: a sensor circuit system configured to sense electrical data associated with applying energy to tissue; and a controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the controller to obtain an enable command to initiate output of electrosurgical energy, initially control output of electrosurgical energy to achieve rapid desiccation of tissue, and subsequently control output of electrosurgical energy based on the sensed electrical data to increase power and reduce tissue impedance.

[0017] In one aspect of the disclosure, the controller is further caused to monitor the sensed electrical data for spikes during a subsequent control period.Monitoring the sensed electrical data for spikes may include monitoring for spikes in at least one of voltage or crest factor.

[0018] In another aspect of the present disclosure, the controller is further caused to reduce the power of the electrosurgical energy in response to detecting a spike in the sensed electrical data while monitoring the spike in the sensed electrical data.

[0019] In another aspect of the present disclosure, an electrosurgical generator is configured to output bipolar electrosurgical energy to a bipolar electrosurgical device including a first electrode and a second electrode configured to conduct the electrosurgical energy therebetween. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] The above and other aspects and features of the present disclosure will become more apparent when the following detailed description is considered in conjunction with the accompanying drawings, in which like reference numerals designate similar or identical elements.

[0021] Figure 1A is a schematic diagram of a monopolar electrosurgical system provided in accordance with aspects of the present disclosure shown in use treating tissue of a patient;

[0022] Figure 1B is a schematic diagram of a bipolar electrosurgical system provided in accordance with aspects of the present disclosure shown in use treating tissue of a patient;

[0023] Figure 2 yes Figure 1A and Figure 1B A front view of an electrosurgical generator of the system;

[0024] Figure 3 yes Figure 1A and Figure 1B A block diagram of an electrosurgical generator of the system;

[0025] Figures 4 to 6 is a block diagram of a method for facilitating electrosurgical tissue treatment according to aspects of the present disclosure; and

[0026] Figure 7 is a flow chart of another method of facilitating electrosurgical tissue treatment in accordance with aspects of the present disclosure. DETAILED DESCRIPTION

[0027] The present disclosure provides electrosurgical systems and methods that facilitate monopolar and / or bipolar electrosurgical tissue treatment, such as by adjusting energy delivery based on feedback to achieve a desired tissue effect while minimizing adverse reactions, such as sparking and charring of tissue. Exemplary monopolar and bipolar electrosurgical systems are described in detail below; however, it should be understood that various aspects and features of the present disclosure are equally applicable for use with any suitable monopolar and / or bipolar electrosurgical system, including multimodal systems, robotic systems, etc.

[0028] refer to Figure 1A , a monopolar electrosurgical system provided in accordance with aspects of the present disclosure is shown as generally indicated by reference numeral 100. The monopolar electrosurgical system 100 is configured to selectively apply monopolar electrosurgical energy (e.g., monopolar radiofrequency (RF) energy) to target tissue of a patient "P". More specifically, the system 100 includes a monopolar electrosurgical device 120, a return electrode device 130, and an electrosurgical generator 200. The monopolar electrosurgical device 120 includes at least one active electrode 122 configured to supply energy to tissue of the patient "P". The monopolar electrosurgical device 120 can be, for example, a monopolar electrosurgical pencil, a monopolar electrosurgical blade, a monopolar electrode ring, a monopolar electrode of a multifunctional device, a monopolar ablation device, a surgical robot monopolar end effector, or any other suitable device including an active electrode 122 configured to supply energy to tissue of the patient "P". The monopolar electrosurgical device 120 further includes an electrosurgical cable 124 having a plug (not explicitly shown) configured to connect the active electrode 122 to the active monopolar port 250 of the electrosurgical generator 200. The return electrode device 130 likewise includes an electrosurgical cable 134 having a plug (not explicitly shown) configured to connect to the return monopolar port 252 of the electrosurgical generator 200. In this manner, monopolar electrosurgical energy can be supplied from the electrosurgical generator 200 to the active electrode 122 for application to tissue and returned to the electrosurgical generator 200 via the return device 130.

[0029] The monopolar electrosurgical device 120 also includes one or more enabling controls 128 disposed thereon. Alternatively or additionally, the one or more enabling controls may be disposed on a remote enabling device (e.g., a foot switch) on the electrosurgical generator 200, or otherwise disposed to facilitate enabling and / or control of the monopolar electrosurgical device 120. Each of the one or more enabling controls 128 may be configured as a button, a slider, a toggle switch, a dial, a trigger, a virtual button, a touch screen interface, etc. Each of the one or more enabling controls 128 is configured to be connected to the electrosurgical generator 200, for example, via one or more wires extending through the cable 124, so that the surgeon can selectively enable and / or control the monopolar electrosurgical device 120. Further, each of the one or more enabling controls 128 may be configured to implement at least one of the following: enabling the supply of energy to the active electrode 122, disabling the supply of energy to the active electrode 122, selecting an operating mode, selecting a power level, etc.

[0030] The system 100 can be used to supply monopolar electrosurgical energy to tissue, for example to coagulate or cut tissue, although other tissue treatments are also contemplated. Further, the monopolar electrosurgical device 120 can be configured to operate in a variety of different modes corresponding to different power levels, different tissue treatments, different types of tissue to be treated, different surgical techniques utilized, different surgical conditions, etc.

[0031] Go to Figure 1B, a bipolar electrosurgical system provided in accordance with aspects of the present disclosure is shown as generally indicated by reference numeral 150. The bipolar electrosurgical system 150 is configured to selectively apply bipolar electrosurgical energy to tissue of a patient "P". The system 150 includes a bipolar electrosurgical device 160 and an electrosurgical generator 200. The bipolar electrosurgical device 160 may be, for example, a bipolar electrosurgical forceps (as described in detail herein), but other suitable bipolar electrosurgical devices are also contemplated, such as bipolar electrosurgical forceps, bipolar electrosurgical probes, bipolar electrosurgical resection loops, bipolar electrosurgical scissors, surgical robotic bipolar end effectors, and the like. The bipolar electrosurgical device 160 includes opposing first and second jaw members 162, 164, which include first and second electrodes 163, 165, respectively. The first electrode 163 and the second electrode 165 are configured to be connected to the bipolar port 258 of the electrosurgical generator 200 via a cable 170 having a plug (not explicitly shown) and including a first electrode lead 172 and a second electrode lead 174 connected to the respective first electrode 163 and the second electrode 165. The first electrode lead 172 and the second electrode lead 174 are electrically isolated from each other and connected to different pins of the plug of the cable 170, thereby connecting to the active terminal and the return terminal of the bipolar port 258 of the electrosurgical generator 200. In this way, bipolar electrosurgical energy is supplied from the electrosurgical generator 200 to the bipolar electrosurgical device 160 via the cable 170, conducted between the first electrode 163 and the second electrode 165 and through tissue (e.g., tissue grasped between the first jaw member 162 and the second jaw member 164), and returned to the electrosurgical generator 200 via the cable 170.

[0032] The bipolar electrosurgical device 160 also includes one or more enabling controls 178 disposed thereon. Alternatively or additionally, the one or more enabling controls may be disposed on a remote enabling device (e.g., a foot switch) on the electrosurgical generator 200, or otherwise disposed to facilitate enabling and / or control of the bipolar electrosurgical device 160. Each of the one or more enabling controls 178 may be configured as a button, a slider, a toggle switch, a dial, a trigger, a virtual button, a touch screen interface, etc. Each of the one or more enabling controls 178 is configured to be connected to the electrosurgical generator 200, for example, via one or more wires extending through the cable 170, so that the surgeon can selectively enable and / or control the bipolar electrosurgical device 160. Further, each of the one or more enabling controls 178 may be configured to implement at least one of the following: enabling the supply of energy to the bipolar electrosurgical device 160, disabling the supply of energy to the bipolar electrosurgical device 160, selecting an operating mode, selecting a power level, etc.

[0033] The system 150 can be used to supply bipolar electrosurgical energy to tissue, for example to coagulate or cut tissue, although other tissue treatments are also contemplated. Further, the bipolar electrosurgical device 160 can be configured to operate in a variety of different modes corresponding to different power levels, different tissue treatments, different types of tissue to be treated, different surgical techniques utilized, different surgical conditions, etc.

[0034] Go to Figure 2 , showing a front side 240 of an electrosurgical generator 200. The electrosurgical generator 200 may include a plurality of ports 250-262 to accommodate a variety of types of electrosurgical devices (e.g., monopolar electrosurgical device 120, bipolar electrosurgical device 160, etc.) and / or accessories (e.g., foot switches, remote user interfaces (UIs), communication hubs, robotic systems, etc.). One or more of the ports 250-262 may include a detection device configured to read a detection signal stored or otherwise encoded in a plug of a device connected to the port (e.g., devices 120, 150 (respectively)). Figure 1A and Figure 1B ) on the plug of the cable 130, 170 to obtain identification information, authentication information, usage information and / or operating parameters of the device connected to the electrosurgical generator 200, thereby enabling the electrosurgical generator 200 to selectively start and configure energy delivery and energy delivery settings based on information related to the connected device. Such a detection device can be configured to read information from a bar code, an electrical component (e.g., a resistor, a capacitor, etc.), an RFID chip, a magnet, a non-transitory storage device (e.g., a non-volatile memory, an EEPROM, etc.), etc. that can be connected to the plug of the device or integrated into the plug of the device. Suitable detection devices include, for example, a bar code reader, an electrical sensor, an RFID reader, a Hall effect sensor, a memory reader, and / or any other suitable decoder configured to read information.

[0035] Continue to refer to Figure 2, the electrosurgical generator 200 includes one or more display screens 242, 244, 246 for providing various output information to the user (e.g., enable settings, mode settings, intensity settings, treatment completion indicators, feedback information (e.g., tissue impedance), etc.). Each of the screens 242, 244, 246 can be associated with a corresponding port 250-262 or ports 250-262. The electrosurgical generator 200 further includes suitable enable controls (e.g., buttons, enablers, switches, touch screens, etc.) for controlling the electrosurgical generator 200 and / or devices connected thereto. The display screens 242, 244, 246 can be further configured as touch screens that display corresponding menus for electrosurgical devices connected to the electrosurgical generator, thereby facilitating selection of settings and / or operating modes for those particular devices.

[0036] The ports 250-262 may include, for example, one or more active monopolar device ports 250, 256 each configured to receive a monopolar electrosurgical device (e.g., monopolar electrosurgical device 120 ( Figure 1A )) of the plug; return monopolar device port 252, the return monopolar device port is configured to receive a monopolar electrosurgical return device (eg, return device 130 ( Figure 1A )) plug; input device port 254, such as for a foot switch; bipolar device port 258, the bipolar device port is configured to receive a bipolar electrosurgical device (e.g., bipolar electrosurgical device 160 ( Figure 1B ))'s plug; a first container sealing port 260 and a second container sealing port 262, each of which is configured to receive a plug of a container sealing device; and / or any other suitable port.

[0037] Go to Figure 3 , the electrosurgical generator 200 includes a sensor circuit system 272, a controller 274, a high voltage DC power supply ("HVPS") 277, and an RF output stage 278. The HVPS 277 provides high voltage DC power to the RF output stage 278, which converts the high voltage DC power into RF energy for delivery to a connected device, such as the monopolar electrosurgical device 120 ( Figure 1A ) and / or bipolar electrosurgical device 160 ( Figure 1B ). In particular, the RF output stage 278 generates a waveform of high frequency RF energy. The RF output stage 278 is configured to generate a plurality of waveforms having various duty cycles, peak voltages, crest factors, and other parameters depending on the particular settings and / or operating mode. With respect to outputting monopolar energy to, for example, the active electrode 122 ( Figure 1A), the RF output stage 278 is configured to output high frequency RF energy to the cable 124 for delivery to the active electrode 122 (see Figure 1A ), while the energy is returned via the cable 134 of the device 130 ( Figure 1A ) Return. With respect to outputting bipolar energy to, for example, electrodes 163, 165 of a bipolar electrosurgical device 160 ( Figure 1B ), the RF output stage 278 is configured to output high frequency RF energy to the leads 172, 174 of the cable 170 of the bipolar electrosurgical device 160 ( Figure 1B ).

[0038] The controller 274 includes a microprocessor 275 (or other suitable processor, such as a digital signal processor, an ASIC, a graphics processing unit (GPU), a field programmable gate array (FPGA), or a central processing unit (CPU)) operably connected to a memory 276, which may be a volatile type memory (e.g., RAM) and / or a non-volatile type memory (e.g., flash media, disk media, etc.). The microprocessor 275 is operably connected to the HVPS 277 and / or the RF output stage 278, thereby allowing the microprocessor 275 to control the output of the electrosurgical generator 200, for example, based on feedback received from the sensor circuit system 272. The sensor circuit system 272 is operably coupled to energy supply leads that supply energy to / from tissue, for example, to / from the monopolar electrosurgical device 120 and the return device 130 in a monopolar configuration ( Figure 1A ), and supplying energy to / from electrodes 163, 165 of a bipolar electrosurgical device 160 in a bipolar configuration ( Figure 1B ). Based on these leads and more specifically on the signals transmitted along them, the sensor circuit system 272 can determine one or more parameters, such as tissue impedance, current, voltage (rms voltage and / or peak voltage), power, crest factor, and / or phase. The sensor circuit system 272 provides feedback based on the sensed parameters, for example, to the controller 274, which in turn selects an energy delivery algorithm, modifies the energy delivery algorithm, and / or adjusts the energy delivery parameters based on the feedback. More specifically, the controller 274 can be configured to control the power, voltage (rms voltage and / or peak voltage), current, tissue impedance, crest factor, and / or phase of the output electrosurgical energy based on the feedback received from the sensor circuit system 272 and based on one or more implemented energy delivery algorithms. As described above, the electrosurgical generator 200 can also read information from a connected device to enable control based on the type, configuration, and / or setting of the connected device.

[0039] Sensor circuit system 272 and / or controller 274 can also monitor the activation of a control (e.g., activation control 128 ( Figure 1A )) and / or enable control 178( Figure 1B ) and / or other inputs connected to the wires of the electrosurgical generator 200 to determine activation, deactivation, settings, modes, and / or other operational inputs and control the electrosurgical generator 200 based thereon. Alternatively or additionally, the sensor circuit system 272 and / or the controller 274 can be configured to monitor other sensors associated with the monopolar electrosurgical device 120, the bipolar electrosurgical device 160, the electrosurgical generator 200, and / or other devices. For example, an accelerometer associated with one or more of the devices can provide feedback regarding the movement of the device, from which usage, technique, and / or intent can be determined.

[0040] In various aspects, the memory 276 can be separate from the controller 274 and communicate with the microprocessor 275 through a communication bus of a circuit board, through a communication cable (such as a serial ATA cable or other type of cable), and / or via a suitable wireless communication protocol. Regardless of the location of the memory 276 and / or the microprocessor 275, the memory 276 includes computer readable instructions that can be executed by the microprocessor 275 to operate the controller 274, for example, to execute a variety of algorithms, such as fixed algorithms, machine learning algorithms, etc. The controller 274 can further include a network interface (not shown) to communicate with other computers or servers. In various aspects, a storage device (not shown) of the controller 274 or a storage device separate therefrom can be used to store data.

[0041] Although illustrated as being part of the electrosurgical generator 200, it is also contemplated that the controller 274 is remote from the electrosurgical generator 200, such as located on a remote server and accessible via a wired or wireless connection by the electrosurgical generator 200. In configurations where the controller 274 is remote, it is contemplated that the controller 274 may be accessible by and connected to multiple electrosurgical generators 200.

[0042] Go to Figures 4 to 7 , electrosurgical methods that facilitate monopolar and / or bipolar electrosurgical tissue treatment are described. To the extent consistent, any method detailed herein with respect to monopolar electrosurgery may also be used with respect to bipolar electrosurgery, and vice versa. Further, the electrosurgical methods detailed herein are not mutually exclusive; rather, to the extent consistent, any or all of the electrosurgical methods detailed herein may be utilized in any suitable combination implemented simultaneously, sequentially, alternatingly, in overlapping temporal relationships, or in any other suitable manner. The electrosurgical methods detailed herein may be implemented by the monopolar electrosurgical system 100 ( Figure 1A), bipolar electrosurgical system 150 ( Figure 1B ), and / or any other suitable electrosurgical system. In particular, in various aspects, the processing and control described in detail below can be performed by the controller 274 ( Figure 3 )implement.

[0043] refer to Figure 4 , method 400 is configured for use during application of energy (e.g., monopolar or bipolar electrosurgical energy) to tissue. Method 400 includes obtaining sensed data 410 and obtaining stored data 420 in multiple aspects, and providing data 410, 420 to one or more algorithms 430 to determine conditions associated with application of energy 440. Energy delivery settings 450 can then be adjusted as needed based on the determined conditions.

[0044] In various aspects, the sensor data 410 includes, for example, data from the sensor circuit system 272 ( Figure 3 ) electrical feedback data, such as power, voltage (rms voltage and / or peak voltage), current, tissue impedance, crest factor, and / or phase of the output electrosurgical energy. Other suitable sensed data 410 are also contemplated.

[0045] The stored data 420 may include information related to the device in use (e.g., from the electrosurgical generator 200 ( Figure 2 ) information obtained by one of the detection devices of the present invention, previous electrical feedback data, and / or previous activation data. The stored data 420 may additionally or alternatively include information to be utilized by one or more algorithms, such as: operating thresholds, operating ranges, coefficients, formulas, tables, etc.

[0046] The one or more algorithms 430 may include: an algorithm that compares the sensed data 410 and / or the stored data 420 to a set point or range; an algorithm that retrieves information from one or more lookup tables based on the sensed data 410 and / or the stored data 420; an algorithm configured as one or more functions (e.g., linear, polynomial, piecewise, or other suitable functions) that receive the sensed data 410 and / or the stored data 420 as input variables; a machine learning algorithm, etc.

[0047] With respect to machine learning algorithms, these algorithms can be trained using training data obtained experimentally via mathematical simulations, using machine learning, using theoretical formulas, combinations thereof, and the like. The machine learning algorithms can be trained and then deployed for use, or can be continuously trained and updated based on local and / or remote (from other systems) data. In various aspects, training the machine learning algorithms can be performed by the electrosurgical generator or can be performed by one or more computing devices separate from the electrosurgical generator, and the resulting algorithms can then be communicated to the electrosurgical generator.

[0048] In various aspects, the one or more machine learning algorithms may include classification machine learning, and / or one or more neural networks, such as long short-term memory networks, convolutional neural networks (CNNs), recursive adversarial networks (RANs), generative adversarial networks (GANs), and / or other suitable neural networks. In lieu of or in addition to neural networks, other suitable machine learning systems (e.g., support vector machines (SVMs)) may be utilized, and / or may be implemented: Bayesian regression, naive Bayes, nearest neighbor, least squares, mean, and support vector regression, as well as other data science and artificial science techniques. Other suitable machine learning algorithms are also contemplated.

[0049] Continue to refer to Figure 4 , the determined condition 440 can be, for example, an open circuit condition. For example, in monopolar surgery, an open circuit condition exists in which the device is enabled without contact between the active electrode and the tissue (e.g., before contact between the active electrode and the tissue). Alternative or additional determined conditions 440 can be entering or exiting an open circuit condition. For example, in monopolar surgery, entering or exiting an open circuit condition occurs when the device is enabled with minimal or reduced contact (e.g., initiating contact or removing contact) between the active electrode and the tissue. With respect to these open circuit or entering / exiting open circuit conditions 440, adjusting the settings 450 based on the determined conditions can include, for example, reducing (e.g., ramping down) the voltage of the supplied energy so that sparks into the tissue are eliminated or minimized upon entering / exiting (e.g., upon initiating contact with the tissue and / or removing contact from the tissue).

[0050] In the event that the determined condition 440 is a normal operating condition (e.g., not an open circuit condition or entering / exiting an open circuit condition), adjusting the setting 450 based on the determined condition can include maintaining power to facilitate tissue treatment, such as tissue dissection. As long as the normal operating condition persists, power can be safely maintained (e.g., via increasing voltage as needed), even in high impedance tissue, to achieve the desired tissue treatment. For example, this configuration enables efficient and effective tissue cutting even through high impedance tissue.

[0051] Continue to refer to Figure 4 , in multiple aspects, the determined condition 440 is a single electrode contact condition. For example, in bipolar surgery, a single electrode contact condition exists where the device is enabled with only one of the electrodes maintaining full contact with the tissue. It has been found that the single electrode contact condition results in a higher and more unstable impedance during the application of energy to the tissue, while a relatively smooth and consistent voltage and current graph and a lower impedance are achieved for a normal operating condition (where both electrodes are in full contact with the tissue prior to enabling). The sensed data 410 for detecting the single electrode contact condition may include impedance data sampled within a predetermined time period (e.g., 0.02s) once a predetermined power threshold (e.g., 1W) has been reached. One or more algorithms 430 may be configured to perform a time integration on the impedance data, and based on the result, determine whether a single electrode contact condition exists by comparing the result with a threshold (which may be the stored data 420). Other suitable algorithms 430 are also contemplated.

[0052] In the event that a single electrode contact condition is determined to exist, adjusting settings 450 based on the determined condition may include temporarily pausing the supply of energy, disabling the supply of energy (thus requiring re-enabling), and / or outputting a warning to a user, for example, from the electrosurgical generator 200.

[0053] Still reference Figure 4 In various aspects, the determined condition 440 can be an impedance condition of the tissue. For example, in a monopolar procedure, tissue in contact with the active electrode can be classified as low impedance tissue or not low impedance tissue, although additional or alternative impedance classifications are also contemplated. In the event that the active electrode is determined to be in contact with low impedance tissue, adjusting the setting 450 based on the determined condition can include reducing the voltage to eliminate or minimize sparking and / or charring of the tissue. This configuration enables precise tissue treatment (e.g., dissection) even in low impedance tissue.

[0054] Go to Figure 5 , the method 500 is configured for use during application of energy (e.g., monopolar or bipolar electrosurgical energy) to tissue. The method 500 includes obtaining sensing data 510 and storing the data in multiple aspects 520, and providing the data 510, 520 to one or more algorithms 530 to determine the surgical technique being performed 540. The energy delivery settings 550 can then be adjusted as needed based on the determined technique.

[0055] In various aspects, the sensor data 510 includes, for example, data from the sensor circuit system 272 ( Figure 3), such as power, voltage (rms voltage and / or peak voltage), current, tissue impedance, crest factor, and / or phase of the output electrosurgical energy. Other suitable sensed data 510 is also contemplated, such as sensed data from other sensors and / or devices. More specifically, in various aspects, accelerometers or other motion data from one or more devices can be utilized. In various aspects, video and / or audio data from corresponding cameras and / or microphones incorporated into or separate from one or more of these devices can be utilized. This additional sensed data can be used to facilitate determinations of use, technique, intent, tissue type, tissue condition, environmental conditions, and the like.

[0056] The stored data 520 may include information related to the device in use (e.g., from the electrosurgical generator 200 ( Figure 2 ) information obtained by one of the detection devices of the present invention, previous electrical feedback data, and / or previous activation data. The stored data 520 may additionally or alternatively include information to be utilized by one or more algorithms, such as: operating thresholds, operating ranges, coefficients, formulas, tables, etc.

[0057] The one or more algorithms 530 may include: an algorithm that compares the sensed data 510 with the stored data 520; an algorithm that retrieves information from one or more lookup tables based on the sensed data 510; an algorithm configured as one or more functions (e.g., linear, polynomial, piecewise, or other suitable functions) that receive the sensed data 510 and / or the stored data 520 as input variables; a pattern recognition algorithm, a machine learning algorithm (such as those described in detail above or other suitable machine learning algorithms), etc.

[0058] The determined technique 540 can be, for example, buzzing a hemostat. Buzzing a hemostat is a surgical technique in which tissue is grasped with a grasping hemostat or forceps and an active electrode of a monopolar electrosurgical device is moved into contact with the bare metal of the hemostat or forceps to energize the hemostat or forceps and enable coagulation of the grasped tissue. However, settings associated with the monopolar electrosurgical device may affect the effectiveness of buzzing the hemostat. By employing one or more algorithms 530, the method 500 enables determination of whether a surgeon is using the buzzing hemostat technique and, based thereon, adjusting settings to facilitate treatment using the buzzing hemostat technique.

[0059] A relatively low impedance and a relatively clean current waveform may indicate that the surgeon is utilizing the buzzing hemostat technique, whereas a relatively high impedance and a relatively noisy current waveform may indicate that the surgeon is directly treating tissue with a monopolar electrosurgical device. These implementations may be used, for example, to establish one or more algorithms 530 configured to detect whether the buzzing hemostat technique is being used.

[0060] In the event that a buzzing hemostat technique is determined, adjusting the settings 550 based on the determined technique may include implementing and / or tightening safety thresholds (e.g., of power, impedance, voltage, and / or current). Alternatively or additionally, adjusting the settings 550 based on the determined technique may include monitoring electrical data and adjusting power to maximize power and minimize impedance. This may also include monitoring for spikes in voltage or crest factor that would indicate sparking and / or charring of tissue. In the event that a buzzing hemostat technique is not determined (or is no longer determined), the energy delivery settings may revert to default settings.

[0061] Reference Figure 6 , the method 600 is configured for use during application of energy (e.g., monopolar or bipolar electrosurgical energy) to tissue. The method 600 includes obtaining enabling data 610 and storing the data in multiple aspects 620, and providing the data 610, 620 to one or more algorithms 630 to determine the surgical technique being performed 640. The energy delivery settings 650 can then be adjusted as needed based on the determined technique.

[0062] In various aspects, the enablement data 610 includes one or more enablement controls (eg, the enablement controls 128 ( Figure 1A ) and / or enable control 178 ( Figure 1B ))’s activation frequency, order, and / or pattern.

[0063] The stored data 620 may include information related to the device in use (e.g., from the electrosurgical generator 200 ( Figure 2 ) information obtained by one of the detection devices of the present invention, previous electrical feedback data, and / or previous activation data. The stored data 620 may additionally or alternatively include information to be utilized by one or more algorithms, such as: operating thresholds, operating ranges, coefficients, formulas, tables, etc.

[0064] The one or more algorithms 630 may include: an algorithm that compares the sensed data 610 with the stored data 620; an algorithm that retrieves information from one or more lookup tables based on the sensed data 610; an algorithm configured as one or more functions (e.g., linear, polynomial, piecewise, or other suitable functions) that receive the sensed data 610 and / or the stored data 620 as input variables; a pattern recognition algorithm, a machine learning algorithm (such as those described in detail above or other suitable machine learning algorithms), etc.

[0065] Continue to refer to Figure 6 In various aspects, the determined technology 640 is spot coagulation. The spot coagulation technology (as reflected in the enablement data 610 via repeated activation and deactivation) can be determined based on pattern recognition (based on machine learning or based on traditional algorithms) of a repeating pattern of short bursts of energy. When the spot coagulation technology is detected, adjusting the settings 650 based on the determined technology can include increasing the voltage and power output to promote spot coagulation. In the event that the spot coagulation technology is not detected or is no longer detected, the settings can remain unchanged or can be restored to the default settings. This configuration enables effective and efficient spot coagulation.

[0066] Go to Figure 7 , another method provided in accordance with the present disclosure is shown as generally indicated by method 700. Method 700 can be configured for use during application of energy to tissue. For example, method 700 can be implemented with respect to bipolar electrosurgical energy delivery in a coagulation mode, but other embodiments of method 700 are also contemplated. With respect to bipolar coagulation, performance is enhanced at lower impedances (e.g., approximately 50 ohms to 125 ohms). However, optimal power settings are difficult to preset because tissue effects are slow to begin with, and after the tissue has been dried to a certain extent, the tissue effects may be undesirable, such as causing over-drying, scorching, and / or sparking. Therefore, instead of predefined power settings, method 700 controls power to efficiently and effectively achieve desired tissue effects, such as coagulation.

[0067] Initially, at 710, a request is received, for example, from an enable control (such as enable control 178 ( Figure 1B)) is provided to initiate the supply of energy to the tissue. In response, energy is applied to the tissue, thereby controlling the power to promote rapid drying of the tissue, as indicated at 720. This can be accomplished, for example, by monitoring sensed data (e.g., monitoring current, rms voltage, peak voltage, crest factor, impedance, phase, and / or its time component (such as the rate of change of voltage or current)) as indicated at 730 to achieve rapid drying of the tissue, thereby accelerating the initial tissue effect. Once drying is achieved, the sensed data is continuously monitored, and the output is adjusted to achieve and maintain high power and low impedance, as indicated at 740. At the same time, the voltage or crest factor of the sensed data is monitored, as indicated at 750. A spike in the voltage or crest factor can indicate sparking, and thus in response to detecting such a spike, the power can be reduced and / or other energy settings can be adjusted to suppress or minimize sparking and charring of the tissue. Monitoring and controlling as indicated at 730-750 continues until tissue treatment is complete, as indicated at 760, for example, until energy application is deactivated.

[0068] Although several aspects of the disclosure have been shown in the accompanying drawings, it is not intended that the disclosure be limited thereto, as it is intended that the scope of the disclosure be as broad as the art will allow, and the specification should be read in the same manner. Therefore, the above description should not be construed as limiting, but merely as an illustration of a particular configuration. Those skilled in the art will envision other modifications within the scope and spirit of the appended claims.

Claims

1. An electrosurgical system, comprising: An electrosurgical generator configured to output electrosurgical energy to at least one electrode of an electrosurgical device for application to tissue, the electrosurgical generator comprising: sensor circuitry configured to sense electrical data associated with applying energy to the tissue; and A controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the controller to: obtaining sensed electrical data; determining a contact condition between the at least one electrode of the electrosurgical device and tissue based on the sensed electrical data; and The electrosurgical energy output by the electrosurgical generator is controlled based on the determined condition.

2. The electrosurgical system of claim 1, wherein: The contact condition is an open circuit condition.

3. The electrosurgical system of claim 2, wherein: Controlling the electrosurgical energy output includes reducing a voltage of the electrosurgical energy output.

4. The electrosurgical system of claim 1, wherein: The contact condition is entering or exiting an open circuit condition.

5. The electrosurgical system of claim 5, wherein: Controlling the electrosurgical energy output includes reducing a voltage of the electrosurgical energy output.

6. The electrosurgical system of claim 1, wherein: The contact condition is a single-electrode contact condition.

7. An electrosurgical system according to claim 6, wherein: Controlling the electrosurgical energy output includes stopping or pausing the electrosurgical energy output.

8. An electrosurgical system comprising: An electrosurgical generator configured to output electrosurgical energy to at least one electrode of an electrosurgical device for application to tissue, the electrosurgical generator comprising: sensor circuitry configured to sense electrical data associated with applying energy to tissue or enablement data associated with enabling application of energy to tissue; and A controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the controller to: obtaining the electrical data or the activation data; determining a surgical technique to be performed using the electrosurgical device based on the electrical data or the activation data; and The electrosurgical energy output by the electrosurgical generator is controlled based on the determined surgical technique.

9. An electrosurgical system according to claim 8, wherein: The electrosurgical generator is configured to output monopolar electrosurgical energy to a monopolar electrosurgical device, and wherein the sensor circuitry is configured to sense the electrical data associated with applying energy to tissue.

10. An electrosurgical system according to claim 9, wherein: The surgical technique described is the buzzing hemostat technique.

11. An electrosurgical system according to claim 10, wherein: Controlling the electrosurgical energy output includes at least one of increasing power or minimizing impedance.

12. The electrosurgical system of claim 8, wherein: The electrosurgical generator is configured to output bipolar electrosurgical energy to a bipolar electrosurgical device, and wherein the sensor circuitry is configured to sense activation data associated with enabling application of energy to tissue.

13. An electrosurgical system according to claim 12, wherein: Determining the surgical technique includes performing pattern recognition on the enabling data associated with enabling application of energy to tissue.

14. The electrosurgical system of claim 12, wherein: The surgical technique is the spot coagulation technique.

15. An electrosurgical system according to claim 14, wherein: Controlling the electrosurgical energy output includes at least one of increasing voltage or increasing power.

16. An electrosurgical system comprising: An electrosurgical generator configured to output electrosurgical energy to an electrosurgical device for application to tissue, the electrosurgical generator comprising: sensor circuitry configured to sense electrical data associated with applying energy to the tissue; and A controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the controller to: obtaining an enable command to initiate output of the electrosurgical energy; initially controlling the output of the electrosurgical energy to achieve rapid desiccation of tissue; and The output of the electrosurgical energy is then controlled based on the sensed electrical data to increase power and reduce tissue impedance.

17. An electrosurgical system according to claim 16, wherein: The controller is further caused to monitor for spikes in the sensed electrical data during a subsequent control period.

18. An electrosurgical system according to claim 17, wherein: Monitoring the sensed electrical data for spikes includes monitoring for spikes in at least one of voltage or crest factor.

19. The electrosurgical system of claim 17, wherein: The controller is further caused to reduce the power of the electrosurgical energy in response to detecting a spike in the sensed electrical data while monitoring the spike in the sensed electrical data.

20. The electrosurgical system of claim 16, wherein: The electrosurgical generator is configured to output bipolar electrosurgical energy to a bipolar electrosurgical device including a first electrode and a second electrode configured to conduct electrosurgical energy therebetween.

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