Tissue monitoring electrosurgical instruments and methods of use thereof

Abstract

An electrosurgical instrument comprising: an end effector and a tissue monitoring system, the end effector comprising: an anvil; a cartridge operably configured to receive a plurality of staples; a blade assembly, the blade assembly comprising a blade; at least one electrode coupled to the blade, where the at least one electrode is in electrical communication with an electrosurgical power source generated by a controller; a surgical instrument includes a blade, a tissue monitoring system coupled to the blade, and at least one tissue sensor coupled to the blade, the tissue monitoring system in electrical communication with the at least one tissue sensor, where the at least one tissue sensor provides a feedback signal indicative of a tissue characteristic to the controller, and wherein the controller signals the electrosurgical power supply to adjust an operating parameter of the electrosurgical instrument based on the feedback signal.

Description

Technical Field

[0001] Embodiments of the disclosed technology generally relate to electrosurgical techniques and, more particularly, to an end effector and stapling device and methods of using such devices in a surgical procedure to deliver energy to tissue and receive signals from a tissue sensor based on a real-time state of the tissue. Summary of the Invention

[0002] An overview of certain example embodiments of the disclosed technology is provided below. This overview is not an extensive review and is not intended to identify key or critical aspects or elements of the disclosed technology or to delineate its scope. However, it should be understood that the use of the indefinite article in the language used to describe and claim the disclosed technology is not intended to limit the described technology in any way. Instead, the use of "a / an" should be construed to mean "at least one" or "one or more".

[0003] One embodiment of the disclosed technology provides an electrosurgical instrument. The surgical instrument includes: an end effector and a tissue monitoring system, the end effector including: an anvil including a first end, a second end, and an anvil face locatable on a first side of an anatomical structure; a cartridge operably configured to receive a plurality of staples, the cartridge including a first end, a second end, and a face locatable on a second side of the anatomical structure; a blade assembly including a blade, wherein the blade includes a first side and a second side joined at a cutting edge; at least one electrode coupled to the blade, wherein the at least one electrode is in electrical communication with an electrosurgical power source generated by a controller; and at least one tissue sensor coupled to the blade, the tissue monitoring system in electrical communication with the at least one tissue sensor, wherein the at least one tissue sensor provides a feedback signal to the controller indicative of a characteristic of the tissue, and wherein the controller signals the electrosurgical power source based on the feedback signal to adjust an operating parameter of the electrosurgical instrument.

[0004] When the blade is advanced from a first position at a distal end of the cartridge to a second position at a proximal end of the cartridge, an incision is formed in the anatomical structure and the at least one electrode and the at least one tissue sensor contact the anatomical structure and translate along the anatomical structure. The controller may include analog or logic circuitry for processing the feedback signal received from the at least one tissue sensor and determining a signal to send to the electrosurgical power source. The circuitry may connect the at least one electrode to the electrosurgical power source and the at least one tissue sensor to the tissue monitoring system. The feedback signal may be related to the tissue temperature of the anatomical structure. Once the tissue temperature rises above a predetermined threshold, the electrosurgical power source is terminated. The predetermined threshold of the tissue temperature may be between 80 - 120 °C. If the tissue temperature at a predetermined tissue location of the anatomical structure has not reached a target temperature, the firing speed of the electrosurgical instrument is reduced. The target temperature of the predetermined tissue location may be between 60 - 100 °C. The feedback signal may be related to the tissue impedance of the anatomical structure. If the tissue impedance at a predetermined tissue location of the anatomical structure has not reached a target impedance (such as, for example, 200 ohms), the electrosurgical power source is terminated. If the tissue impedance rises above a predetermined threshold (such as, for example, 600 ohms), the firing speed of the electrosurgical instrument is reduced.

[0005] Another embodiment of the disclosed technology provides an electrosurgical instrument for stapling, excising, and sealing a patient's anatomical structure. The surgical instrument includes: an end effector and a tissue monitoring system, the end effector including: an anvil including a first end, a second end, and an anvil face locatable on a first side of the anatomical structure; a cartridge operably configured to receive a plurality of staples, the cartridge including a first end, a second end, and a face locatable on a second side of the anatomical structure; a blade assembly including a blade and a beam, wherein the blade includes a first side and a second side joined at a cutting edge; at least one electrode coupled to the blade, wherein the at least one electrode is in electrical communication with an electrosurgical power source generated by a controller; and at least one tissue sensor coupled to the blade, the tissue monitoring system in electrical communication with the at least one tissue sensor, wherein when the blade is advanced from a first position at a distal end of the cartridge to a second position at a proximal end of the cartridge, the at least one tissue sensor provides a tissue impedance feedback signal to the controller, and wherein the controller signals the electrosurgical power source based on the tissue impedance feedback signal to adjust the firing speed of the electrosurgical instrument.

[0006] When the blade is advanced from the first position at the distal end of the cartridge to the second position at the proximal end of the cartridge, an incision is formed in the anatomical structure and the at least one electrode and the at least one tissue sensor contact the anatomical structure and translate along the anatomical structure. The controller may include analog or logic circuitry for processing the feedback signal received from the at least one tissue sensor and for determining the signal to send to the electrosurgical power supply. If the tissue impedance at a predetermined tissue location of the anatomical structure has not reached a target impedance (such as, for example, 200 ohms), the electrosurgical power supply is terminated. If the tissue impedance rises above a predetermined threshold (such as, for example, 600 ohms), the firing speed of the electrosurgical instrument is reduced. The at least one tissue sensor may further provide a tissue temperature feedback signal to the controller. If the tissue temperature at a predetermined tissue location of the anatomical structure has not reached a target temperature, the firing speed of the electrosurgical instrument is reduced. The target temperature for the predetermined tissue location may be between 60-100 °C. Once the tissue temperature rises above a predetermined threshold (such as, for example, between 80-120 °C), the electrosurgical power supply is terminated.

[0007] Certain embodiments of the disclosed technology include an end effector for a surgeon to staple a patient's anatomical structure, the end effector including a first jaw having a first end, a second end, a longitudinal axis, and an anvil having an anvil face; a second jaw having a first end, a second end, a longitudinal axis, and a cartridge operably configured to receive a plurality of staples, the cartridge having a cartridge face; a first coupling that couples the first end of the first jaw to the first end of the second jaw; and a second coupling that movably couples the second end of the first jaw to the second end of the second jaw. Certain embodiments include a blade having a cutting surface and at least one lateral arm. Certain embodiments include a channel defined by the first jaw or the second jaw to hold at least one lateral arm of the blade. In certain embodiments, the blade is transferred from a first position at the distal end of the end effector to a second position at the proximal end of the end effector such that the anatomical structure is excised. Certain embodiments include a plurality of electrodes coupled to one side of the blade such that the plurality of electrodes contact the anatomical structure during excision to effect hemostasis by heating the tissue and blood vessels to cauterize, coagulate / dry, and / or seal the tissue on one side of the blade. Certain embodiments further include at least one tissue sensor coupled to the blade near the electrodes.

[0008] In some embodiments, the first end of the first jaw is the distal end of the first jaw, and the second end of the first jaw is the proximal end of the first jaw. In some embodiments, the first coupling includes a pin having a pin axis that is transverse to the longitudinal axis of the first jaw and the longitudinal axis of the second jaw, wherein the pin pivotally couples the first end of the first jaw to the first end of the second jaw. In some embodiments, the second coupling includes a slot defined by the first jaw or the second jaw, the slot retaining a rigid link such that the rigid link is slidable within the slot. In some embodiments, the length of the slot is from 3 millimeters to 8 millimeters. Some embodiments include a plurality of staples at least partially held by a cartridge of the second jaw. In some embodiments, the plurality of staples at least partially held by the cartridge are positioned between the first coupling and the second coupling. Some embodiments include a blade having a cutting surface, at least one lateral arm, a first electrode and a second electrode, and a tissue sensor coupled to one side of the blade. In some embodiments, the first electrode and the second electrode are in electrical communication with an electrosurgical power source such as a bipolar energy source, and the tissue sensor is in electrical communication with a tissue monitoring system. Some embodiments include a channel defined by the first jaw or the second jaw to retain at least one lateral arm of the blade. In some embodiments, the blade is transferred from a first position at the distal end of the end effector to a second position at the proximal end of the end effector such that an anatomical structure is excised. In some embodiments, energy is delivered by the first electrode and the second electrode to effect hemostasis of the anatomical structure during excision, wherein the first electrode is the active electrode and the second electrode is the return electrode. Operating parameters, including the firing speed of the electrosurgical device, can be altered based on real-time signals received from the tissue sensor.

[0009] Certain embodiments of the disclosed technology provide a method for stapling a patient's anatomical structure and achieving hemostasis of the anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including a first jaw having a first end, a second end, a longitudinal axis, and an anvil having an anvil face; a second jaw having a first end, a second end, a longitudinal axis, and a cartridge holding a plurality of staples, the cartridge having a cartridge face; a first linkage coupling the first end of the first jaw to the first end of the second jaw; a second linkage movably coupling the second end of the first jaw to the second end of the second jaw; a blade coupled to and slidable relative to the first jaw or the second jaw; an active electrode and a return electrode coupled to the blade; and at least one tissue sensor coupled to the blade; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure; operating the end effector to move a rigid link such that the first jaw is advanced toward the second jaw to clamp the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; achieving hemostasis of the anatomical structure by applying energy to the active electrode to pass through the anatomical structure and reach the return electrode; and monitoring the state of the tissue at the hemostasis site with the tissue sensor.

[0010] Certain embodiments of the disclosed technology provide a surgical instrument for stapling, excising, and sealing a patient's anatomical structure, the surgical instrument including an end effector that includes a first jaw having a first end, a second end, a longitudinal axis, and an anvil having an anvil face locatable on a first side of the anatomical structure; a second jaw having a first end, a second end, a longitudinal axis, and a cartridge operably configured to receive a plurality of staples, the cartridge having a cartridge face locatable on a second side of the anatomical structure; a first linkage that couples the first end of the first jaw to the first end of the second jaw; and a second linkage that movably couples the second end of the first jaw to the second end of the second jaw, wherein the second linkage includes a rigid link connected to the first jaw and the second jaw; an elongate tube having a proximal end and a distal end, wherein the distal end is coupled to the end effector; a handle having a proximal end and a distal end, wherein the distal end of the handle is coupled to the proximal end of the elongate tube; and a drive assembly that includes a motor for actuating the end effector. In certain embodiments, the end effector includes a first electrode and a second electrode in communication with an electrosurgical power source such as a bipolar energy source. The first electrode and the second electrode are for co-ablation, coagulation, cauterization, sealing, or otherwise treating biological tissue during a surgical procedure. In certain embodiments, the end effector includes a tissue sensor in communication with a tissue monitoring system.

[0011] Certain embodiments of the disclosed technology provide a method for stapling, excising, and sealing a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including an anvil having a first end, a second end, an anvil face, a length, and a width, wherein the length of the anvil is at least ten times the width of the anvil; a cartridge having a first end, a second end, a cartridge face, a length, and a width, wherein the length of the cartridge is at least ten times the width of the anvil, the cartridge holding a plurality of staples, wherein the first end of the anvil is coupled to the first end of the cartridge, and the second end of the anvil is movably coupled to the second end of the cartridge; and a rigid link having a distal portion and a proximal portion, wherein the rigid link movably couples the second end of the anvil to the second end of the cartridge; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure; operating the end effector to move the rigid link such that the anvil is advanced toward the cartridge to clamp the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating a knife to cut the anatomical structure; applying energy to the anatomical structure through an electrode positioned on one side of the knife during electrode activation; and electronically monitoring at least one parameter of the anatomical structure as the anatomical structure is cut.

[0012] Certain embodiments of the disclosed technology provide a method for stapling, excising, and sealing a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including an anvil having a first end, a second end, and an anvil face; a cartridge holding a plurality of staples, the cartridge having a first end, a second end, and a cartridge face including a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade having a cutting surface, a first electrode and a second electrode, and a tissue sensor coupled to only one side of the blade, and at least one elongate arm, wherein the at least one elongate arm slidably engages the channel; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure, clamping the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; applying bipolar energy to the anatomical structure through a circuit system including the first electrode and the second electrode; and monitoring the temperature of the anatomical structure through the tissue sensor.

[0013] Certain embodiments of the disclosed technology provide a method for stapling, excising, and sealing a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including an anvil having a first end, a second end, and an anvil face; a cartridge holding a plurality of staples, the cartridge having a first end, a second end, and a cartridge face, the cartridge face including a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade having a cutting surface, a first electrode and a second electrode coupled to a first side of the blade, and a third electrode and a fourth electrode coupled to a second side of the blade, and at least one elongate arm, at least one tissue sensor coupled to the blade, wherein the at least one elongate arm slidably engages the channel; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure; clamping the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; applying bipolar energy to the anatomical structure through a circuit system including the first electrode, the second electrode, the third electrode, and the fourth electrode; and monitoring the temperature of the anatomical structure through the at least one tissue sensor.

[0014] Certain embodiments of the disclosed technology provide a method for stapling, excising, and sealing a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including an anvil having a first end, a second end, and an anvil face; a cartridge holding a plurality of staples, the cartridge having a first end, a second end, and a cartridge face, the cartridge face including a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade having a cutting surface, at least one resistive heating element coupled to the blade, and at least one elongate arm, wherein the at least one elongate arm slidably engages the channel; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure, clamping the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; applying energy to the anatomical structure through a circuit system including the at least one resistive heating element to heat the anatomical structure.

[0015] Certain embodiments of the disclosed technology provide a method of stapling, excising, and sealing a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including an anvil having a first end, a second end, and an anvil face; a cartridge holding a plurality of staples, the cartridge having a first end, a second end, and a cartridge face, the cartridge face including a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade having a cutting surface, one electrode coupled to the blade, a tissue sensor coupled to the blade, and at least one elongate arm, wherein the at least one elongate arm slidably engages the channel; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure; clamping the end effector onto the anatomical structure; operating the end effector to drive the plurality of staples in the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; applying monopolar energy to the anatomical structure through a circuit system including the one electrode attached to the patient and a return electrode; and monitoring the temperature of the anatomical structure through the tissue sensor.

[0016] Certain embodiments of the disclosed technology provide a surgical instrument for stapling, excising, and sealing a patient's anatomical structure, the surgical instrument including an end effector that includes an anvil having a first end, a second end, and an anvil face locatable on a first side of the anatomical structure; a cartridge operably configured to receive a plurality of staples, the cartridge having a first end, a second end, and a cartridge face locatable on a second side of the anatomical structure, the cartridge face including a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade having a cutting surface and at least one elongate arm, wherein the at least one elongate arm is slidably engaged with the channel; an active electrode and a return electrode, the active electrode being coupled to a first side of the blade and the return electrode being coupled to the first side of the blade adjacent the active electrode; a tissue sensor coupled to the blade; an elongate tube having a proximal end and a distal end, wherein the distal end is coupled to the end effector; a handle having a proximal end and a distal end, wherein the distal end of the handle is coupled to the proximal end of the elongate tube; a drive assembly having a motor for actuating the end effector; and a circuitry extending through the elongate tube to the active electrode and the return electrode, wherein the circuitry connects the active electrode and the return electrode to an electrosurgical energy source, such as a bipolar energy source.

[0017] Certain embodiments of the disclosed technology provide a method of stapling a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the method comprising the steps of: providing an end effector including a first jaw having a first end, a second end, an anvil having an anvil surface, and a first passageway; a second jaw having a first end, a second end, a cartridge having a cartridge surface, and a second passageway; a first coupling that couples the first end of the first jaw to the first end of the second jaw; a second coupling that movably couples the second end of the first jaw to the second end of the second jaw, wherein the second coupling includes a rigid link; and an I-shaped blade including a blade portion having a cutting edge, a first side, and a second side, at least one upper side arm, a first electrode coupled to the first side of the blade, a second electrode coupled to the first side of the blade, a tissue sensor coupled to the blade, and at least one lower side arm, wherein the at least one upper side arm is slidably positioned in the first passageway and the at least one lower side arm is slidably positioned in the second passageway; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge surface on the first side of the anatomical structure; positioning the anvil surface on the second side of the anatomical structure; operating the end effector to move the rigid link such that the anvil is advanced toward the cartridge to clamp the end effector onto the anatomical structure; operating the end effector to push the plurality of staples in the cartridge to staple the anatomical structure; actuating the I-shaped blade to cut the anatomical structure, and activating an electrosurgical circuit using the first electrode and the second electrode to seal the anatomical structure at the incision site.

[0018] Certain embodiments of the disclosed technology provide a surgical instrument for stapling, excising, and sealing a patient's anatomical structure. The surgical instrument includes an end effector that includes a first jaw having a first end, a second end, an anvil having an anvil surface, and a first channel; a second jaw having a first end, a second end, a cartridge having a cartridge surface, and a second channel; a first linkage that couples the first end of the first jaw to the first end of the second jaw; a second linkage that movably couples the second end of the first jaw to the second end of the second jaw, wherein the second linkage includes a rigid link; and an I-shaped blade that includes a blade portion having a cutting edge, a first side, and a second side, at least one upper side arm, a first electrode coupled to the first side of the blade, a second electrode coupled to the first side of the blade, a tissue sensor coupled to the first side of the blade, and at least one lower side arm, wherein the at least one upper side arm is slidably positioned within the first channel, wherein the at least one lower side arm is slidably positioned within the second channel; and an elongate tube having a proximal end and a distal end, wherein the distal end is coupled to the end effector; a handle having a proximal end and a distal end, wherein the distal end of the handle is coupled to the proximal end of the elongate tube, wherein the handle defines a cavity and a spool is positioned within the cavity; a circuitry that couples the first electrode and the second electrode to an electrosurgical energy source, and a drive assembly having a motor for actuating the end effector, and wherein during actuation of the end effector, at least a portion of the circuitry winds around the spool.

[0019] Certain embodiments of the disclosed technology provide a surgical instrument for use by a surgeon to staple anatomical structures of a patient and effect hemostasis during minimally invasive surgery. The end effector includes an anvil having a first end, a second end, and an anvil face that can be positioned on a first side of the anatomical structure; a cartridge operably configured to receive a plurality of staples, the cartridge having a first end, a second end, and a cartridge face that can be positioned on a second side of the anatomical structure, the cartridge face defining a channel extending from the first end of the cartridge to the second end of the cartridge, wherein the first end of the cartridge is pivotally coupled to the first end of the anvil; a blade assembly including a blade, a beam, and a nut, the blade having a first side and a second side joined at a cutting edge, wherein at least a portion of the blade assembly is slidably engaged with the channel; and a first electrode and a second electrode coupled to the first side of the blade. A tissue sensor is coupled to the first side of the blade. The surgical instrument includes an elongate tube having a proximal end and a distal end, wherein the distal end is coupled to the end effector; a handle having a proximal end and a distal end, wherein the distal end of the handle is coupled to the proximal end of the elongate tube; a drive assembly including a motor for actuating the end effector; and an electrosurgical power source in electrical communication with the first electrode and the second electrode.

[0020] Certain embodiments of the disclosed technology provide an end effector for use by a surgeon to staple and excise a patient's anatomical structure during minimally invasive surgery, the anatomical structure having a first side and a second side, the end effector including an anvil including a first end, a second end, and a face locatable on the first side of the anatomical structure. The end effector further includes a cartridge and blade assembly, the cartridge configured to receive a plurality of staples and including a first end, a second end, and a face locatable on the second side of the anatomical structure, the blade assembly including a first side, a second side, and a cutting edge. The end effector further includes a first electrode and a second electrode coupled to the first side of the blade assembly and a tissue sensor, and a recess defined by the anvil that receives a first portion of the blade assembly. The end effector further includes a first slot defined by the anvil and a second slot defined by the cartridge, the first slot opening to the anvil face and the recess and configured to slidably receive a second portion of the blade assembly during cutting of the anatomical structure with the cutting edge, the second slot opening to the cartridge face and configured to slidably receive a third portion of the blade assembly during cutting of the anatomical structure with the cutting edge. The second end of the anvil is movably coupled to the second end of the cartridge, each of the anvil and the cartridge being insertable through a trocar, and the end effector being remotely operable from outside the patient's body, wherein at least a portion of one of the anvil and the cartridge is movable toward the other to clamp the end effector to the anatomical structure.

[0021] Certain embodiments of the disclosed technology provide a method of stapling and sealing a patient's anatomical structure during minimally invasive surgery, wherein the anatomical structure has a first side and a second side. The method may include the steps of: providing a stapler having an end effector, the end effector having a plurality of electrodes and a tissue sensor positioned proximate a cutting blade; a first jaw having a first end, a second end, and an anvil having an anvil face; a second jaw having a first end, a second end, and a cartridge that houses a plurality of staples, the cartridge having a cartridge face; a first linkage that couples the first jaw to the second jaw; and a second linkage that movably couples the second end of the first jaw to the second end of the second jaw, wherein the second linkage includes a linkage movably coupled to the first jaw and the second jaw; inserting the end effector through a trocar to access the anatomical structure; positioning the cartridge face on the first side of the anatomical structure; positioning the anvil face on the second side of the anatomical structure; remotely operating the stapler from outside the patient's body to move the linkage such that at least a portion of one of the anvil or the cartridge moves toward the other to clamp the end effector onto the anatomical structure; firing the stapler and activating the electrodes to simultaneously staple, cut, and seal the anatomical structure; and monitoring tissue temperature through the tissue sensor.

[0022] Certain embodiments of the disclosed technology provide a method of stapling a patient's anatomical structure during a minimally invasive procedure, wherein the anatomical structure has a first side and a second side. The method includes the steps of: providing an anvil including a first end, a second end, and a face; positioning the anvil face on the first side of the anatomical structure; providing a cartridge that houses a plurality of staples, the cartridge including a first end, a second end, and a face, the face including a channel extending from the second end to the first end, wherein the second end of the anvil is movably coupled to the second end of the cartridge; positioning the cartridge face on the second side of the anatomical structure; providing a blade having a cutting surface and an elongate arm that extends at least from the blade, which can be positioned near the second end of the cartridge, to the first end of the cartridge, the arm being slidably engaged with the cartridge channel; providing an active electrode and a passive electrode positioned on one side of the blade; providing a tissue sensor on one side of the blade; providing a rigid link movably coupling the first end of the anvil to the first end of the cartridge; moving the rigid link so that at least a portion of one of the anvil and the cartridge moves toward the other to clamp the anatomical structure between the anvil face and the cartridge face; and pulling the blade through the anatomical structure, activating the electrodes, and simultaneously cutting, stapling, sealing the anatomical structure and monitoring the temperature of the anatomical structure.

[0023] It should be understood that all combinations of the foregoing concepts and additional concepts discussed in greater detail below (provided such concepts are not mutually inconsistent) are contemplated as part of the technology disclosed herein and can be implemented to achieve the benefits described herein. After reading and understanding the detailed description of the following exemplary embodiments, additional features and aspects of the disclosed systems, devices, and methods will become apparent to those of ordinary skill in the art. As will be appreciated by those skilled in the art, additional embodiments are possible without departing from the scope and spirit disclosed herein. Accordingly, the description provided herein is considered to be illustrative in nature and not restrictive. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] The drawings incorporated in and forming a part of this specification schematically illustrate one or more example embodiments of the disclosed technology and, together with the general description given above and the detailed description given below, serve to explain the principles of the disclosed subject matter, and in the drawings:

[0025] Figure 1 depicts the anatomy of the stomach;

[0026] Figure 2Depicts a perspective view of an electrosurgical stapling device shown in an open position, the electrosurgical stapling device having an end effector, an elongate tube, a handle portion, and a motor;

[0027] Figure 3 Is Figure 2 A partial exploded perspective view of the end effector, elongate tube, and handle portion of the electrosurgical stapling device shown in

[0028] Figure 4 Is Figure 2 A partial exploded perspective view of the motor of the electrosurgical stapling device shown in

[0029] Figure 5A Depicts an Figure 2 Electrosurgical stapling device shown in a side view in an open position;

[0030] Figure 5B Depicts an Figure 2 Stapling device shown in a side view in a closed position;

[0031] Figure 6 Depicts Figure 5A A side cross-sectional view taken along section D-D of the handle portion and motor shown in

[0032] Figure 7 Depicts Figure 5A A side view of the end effector shown in

[0033] Figure 8 Depicts Figure 5B A side cross-sectional view taken along section E-E of the handle portion and motor shown in

[0034] Figure 9 Depicts Figure 5B A side view of the end effector shown in

[0035] Figure 10 Is a cross-sectional side view of a blade assembly and a drive assembly for an electrosurgical stapling device according to one embodiment;

[0036] Figure 11 Is a perspective view of a motor controller according to one embodiment;

[0037] Figure 12 Is Figure 11 An exploded perspective view of the motor controller shown in

[0038] Figure 13 Depicts an exemplary beam according to one embodiment having a first electrode and a second electrode positioned at its distal end;

[0039] Figures 14 - 16Depicts an example blade assembly according to various embodiments;

[0040] Figures 17A - 17B Schematically depicts a non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0041] Figures 18A - 18B Schematically depicts another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0042] Figure 19 Schematically depicts another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0043] Figure 20 Schematically depicts yet another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0044] Figure 21 Schematically depicts another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0045] Figure 22 Schematically depicts yet another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0046] Figures 23A - 23B Schematically depicts a non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0047] Figures 24A - 24B Schematically depicts another non - limiting example embodiment of electrically coupling an electrode to an electrosurgical energy source and maintaining such coupling during operation;

[0048] Figure 25 Depicts a nut having electrical contacts according to an example embodiment;

[0049] Figure 26 Depicts another nut having electrical contacts according to another example embodiment;

[0050] Figure 27 Is a cross - sectional side view of a handle assembly of an example electrosurgical stapling device;

[0051] Figure 28 Is Figure 27 An enlarged view of the example spool depicted in;

[0052] Figure 29 IsFigure 28 An exploded view of the spool depicted therein;

[0053] Figure 30 is a partial view of an exemplary end effector according to an exemplary embodiment;

[0054] Figures 31 - 36 is an exemplary blade assembly according to various embodiments;

[0055] Figure 37 is a perspective view of an exemplary electrosurgical circular stapler according to an exemplary embodiment;

[0056] Figure 38 depicts Figure 37 an exploded perspective view of the stapling head assembly of;

[0057] Figure 39 depicts an exemplary knife member of an electrosurgical circular stapler according to an exemplary embodiment;

[0058] Figures 40 - 41 depicts an exemplary electrosurgical instrument with a blade;

[0059] Figure 42 is a left side view of an electrosurgical stapling and cutting instrument having an open end effector (staple delivery assembly), wherein the shaft is partially cut away to expose the firing members of the proximal and distal firing rods guided by the frame base and surrounded by the closing sleeve;

[0060] Figure 43 is Figure 42 a left side view of a closed end effector (staple delivery assembly) of a surgical stapling and cutting instrument according to the present invention, the closed end effector having a firing rod with a retraction force adjustment height, the left side view being taken in a longitudinal vertical cross-section taken along section F-F; and

[0061] Figure 44 is Figure 43 a left isometric view of the firing rod of. DETAILED DESCRIPTION

[0062] Various non - limiting embodiments of the present disclosure will now be described to provide a comprehensive understanding of the structure, function, and principles of use of the devices, systems, methods, and processes disclosed herein. One or more instances of these non - limiting embodiments are shown in the accompanying drawings. Those of ordinary skill in the art will understand that the systems and methods specifically described and shown in the drawings are non - limiting embodiments. Features described or illustrated in connection with one non - limiting embodiment may be combined with features of other non - limiting embodiments. Such modifications and variations are intended to be included within the scope of the present disclosure. Throughout the specification, references to "each embodiment", "certain embodiments", "one embodiment", "some example embodiments", "one example embodiment", or "an embodiment" mean that a particular feature, structure, or characteristic described in connection with any embodiment is included in at least one embodiment. Thus, the phrases "in various embodiments", "in some embodiments", "in one embodiment", "in some example embodiments", "in one example embodiment", or "in an embodiment" that appear throughout the specification do not necessarily all refer to the same embodiment. Additionally, a particular feature, structure, or characteristic may be combined in any suitable manner in one or more embodiments. Example embodiments of devices, systems, and methods for surgical instruments and tools, such as electrosurgical staplers, are described herein. In one example embodiment, an end effector and / or an inner cutter stapling device (collectively referred to herein as the "device") is disclosed for forming a resection line during the excision of an organ, tissue, or other anatomical structure. In some embodiments, the device may be used during minimally invasive surgery. This application is related to U.S. Patent No. 9,936,953, which is hereby incorporated by reference in its entirety.

[0063] The electrosurgical instruments described herein, including but not limited to electrosurgical staplers, may involve the application of electrical and / or electromagnetic energy during surgery to cut, dissect, ablate, coagulate, cauterize, seal, or otherwise treat biological tissue. Electrosurgical procedures are typically performed using an electrosurgical generator and a handpiece operable to output energy, the handpiece including an end effector adapted to transfer energy to a tissue site during electrosurgical procedures. Embodiments of the device may be bipolar instruments having two electrodes of opposite polarity positioned close to each other such that a current is applied between their surfaces. The bipolar electrosurgical current flows from one electrode (sometimes referred to as the active electrode) through intervening tissue to the other electrode (sometimes referred to as the return electrode) to complete the circuit.

[0064] One of the problems that can be caused by electrosurgery is unwanted tissue damage due to the thermal effect, where otherwise healthy tissue surrounding the tissue to which the electrosurgical energy is applied is thermally damaged due to an effect known in the art as "thermal diffusion". During thermal diffusion, excessive heat from the surgical site may conduct directly to adjacent tissue, and / or steam released from the tissue being treated at the surgical site may cause damage to the surrounding tissue. According to the present disclosure, one or more sensors may be configured to supply a feedback signal indicative of a characteristic of the tissue, such as the temperature or impedance of the tissue. Such feedback signals may be collected in real time while energy is supplied to the tissue through one or more electrodes. The one or more sensors may be positioned very close to the electrodes and may translate through the tissue as the tissue is excised, thereby providing signal conduction along the excision site.

[0065] An electrosurgical stapler according to an embodiment described herein may include a handle, an actuator, and an end effector including a clamping mechanism. The clamping mechanism may include a cartridge and an anvil. During operation, a surgeon may clamp two members (e.g., the anvil and the cartridge) onto an organ and compress the organ therebetween. Once the organ is compressed, the surgeon may use the stapler to drive or fire staples through the organ. In one embodiment, a plurality of B-shaped staples may be formed through the desired compression and alignment of the clamping mechanism. In some embodiments, a plurality of cartridges may be used to fire the stapling device multiple times, or in alternative embodiments, a single cartridge may be used to complete the excision of the organ with a single firing. Reducing the number of firings and cartridges required may be advantageous because the cost of the surgery may increase with the use of cartridges and longer surgeries associated with multiple stapler firings. Providing single-cartridge stapling and / or excision of the organ to reduce the surgical time of the patient may also be advantageous, which can improve clinical outcomes. For example, according to a sleeve gastrectomy procedure using a single cartridge and a stapler firing, excising a portion of the stomach may improve the patient's outcome and reduce complications associated with such a procedure.

[0066] When such staple configurations are desired, the integrity of the staple line depends in part on the proper formation of the B-shaped staples. Providing a single cartridge and a single-fire stapling device can improve staple formation quality compared to devices or systems that use multiple cartridges to perform the same surgery. For example, when the end effector is used multiple times to staple and excise tissue, in subsequent applications, new staples and / or cutting blades may contact previously placed staples. Providing a single cartridge and staple firing can help ensure that the staple line is consistent with the shape of the staples.

[0067] Single cartridge and single-fire stapling devices can also provide compression benefits relative to devices and systems that require the use of multiple cartridges. It may be advantageous to provide a single-fire stapling device that provides a desired compression along the length of the tissue to be excised while also providing a single staple line with properly formed staples. B-shaped staples are standard of care for gastrointestinal, vascular, pulmonary, and hepatic applications of surgical tissue fastening devices. Alignment of each of the X, Y, and Z axes of the clamping mechanism with itself on each side of the organ (e.g., anvil aligned with the cartridge) can improve staple delivery and formation. It should be understood that any suitable structure, staple form, staple shape, staple format, or other suitable mechanism can be incorporated into the stapling devices described herein to provide such alignment.

[0068] Embodiments of an electrosurgical stapling device can include an anvil and a cartridge, where the cartridge can include recesses that hold multiple staples. The staples can be held above one or more staple drivers that, during operation, can push each of the multiple staples upward through tissue into the face of the anvil. The anvil can include cavities of any suitable size, number, and dimensions that can cooperate with a cartridge driver to form, for example, a B shape within the tissue. In one embodiment, the dimensions of the cavities of the anvil can be set to provide a desired closed staple height that can be determined by the gap between the anvil and the cartridge, the depth of the cavities, and the height of the staples, and / or the staple drivers and driver mechanisms.

[0069] Embodiments of an electrosurgical stapling device can include an electrode and a tissue sensor that are positioned adjacent to the cutting edge of a blade assembly. In some embodiments, the tissue sensor and the electrode are located only on one side of the blade assembly. Such an electrode and tissue sensor can be configured and positioned such that they are in direct contact with the tissue that has been cut by the cutting edge. One of the electrodes can be an active electrode that delivers energy through the tissue to another electrode, which can be a return electrode. Delivery of such energy can affect hemostasis by heating the tissue and blood vessels to cauterize, coagulate / dry, and / or seal the tissue. The tissue sensor can move along the excision site very close to the electrode to provide feedback on the state of the tissue as it is being cut.

[0070] According to laparoscopic methods, embodiments of the electrosurgical stapling devices described herein may include inserting the end effector of the stapler through a trocar to perform a surgical procedure. For example, minimally invasive surgery may include laparoscopic vertical sleeve gastrectomy. Because the spatial environment for such procedures is limited, the surgical stapling devices according to the embodiments described herein may have a relatively low profile. Minimally invasive devices in the prior art are typically long (e.g., 35 mm to 60 mm) and thin (e.g., 5 mm to 15 mm in diameter) devices. Such an elongated configuration may be necessary to fit through a trocar into the body cavity. Since staple forming typically requires about 100 psi of pressure, the limited size may present mechanical problems. At these pressures, smaller, less rigid staplers may deform and thus impede proper staple forming.

[0071] Prior art devices for minimally invasive surgery typically have a fixed hinge at the proximal end. This hinge allows the anvil and the cartridge to separate into a V-shaped configuration. Once separated, the surgeon can place the open anvil and cartridge around an organ and then fold the V-shaped piece onto the organ. However, as the length of the anvil and cartridge increases, it may be more difficult to maintain alignment between the anvil and the cartridge across the tissue length. Poor alignment of such designs may be exacerbated at the most distal end of such devices because the force required to compress the tissue can deflect such devices. Due to this deflection, the length of the V-shaped staplers currently used for minimally invasive surgery is limited. Due to this limitation, the length of the anvil and cartridge is also correspondingly limited. For larger organs such as the stomach, this limitation on length requires multiple staple reloads and firings to complete a procedure such as sleeve gastrectomy. Each reload may require the surgeon to remove the stapler from the trocar, reload the cartridge, reinsert it, and then reposition the stapler on the organ. Such systems may require more surgical time, may be more expensive, may increase the likelihood of adverse patient events, and may result in poor staple line integrity.

[0072] The examples discussed herein are merely examples and are provided to assist in explaining the devices, apparatuses, systems, and methods described herein. Unless specifically designated as mandatory, features or components shown in the figures or discussed below should not be considered mandatory for any particular implementation of any of these devices, apparatuses, systems, or methods. For ease of reading and clarity, certain components, modules, or methods may be described only in conjunction with specific figures. Failure to specifically describe combinations or sub - combinations of components should not be construed as indicating that any combination or sub - combination is not possible. Further, for any method described, whether the method is described in conjunction with a flowchart or not, it should be understood that, unless the context otherwise specifies or requires, any explicit or implicit ordering of steps executed during the execution of the method does not mean that the steps must be executed in the order presented, but may be executed in a different order or in parallel.

[0073] The example embodiments described herein can be used, for example, in sleeve gastrectomy surgery or gastrectomy. However, it should be understood that the device can be used in other surgeries involving other anatomical structures. For example, the device can be used in parenchymal resection, lung volume reduction surgery, or other surgeries involving the lungs. Further, the embodiments described herein can be used in anatomical resections, such as lobectomy, non - anatomical parenchymal resection, or other surgeries involving the liver, or in partial nephrectomy, total nephrectomy, or other surgeries involving the kidneys.

[0074] Now referring to Figure 1 , the anatomy of the stomach 10 and an example resection line 12 for vertical sleeve gastrectomy are shown. The stomach 10 generally includes a lower end 14, an upper end 16, an anterior side 18, and a posterior side 20. The gastroesophageal junction 22 leads to the stomach 10 and is a common landmark in bariatric surgery. The fundus 24 of the stomach 10 and the section of the stomach 10 defined by the greater curvature 26 are generally the portions of the stomach 10 that are resected during vertical sleeve gastrectomy. The remaining pouch or sleeve can generally be defined by the lesser curvature 28 and the resection line 12, which presents a stomach with a significantly reduced volume. The desired location of the resection line 12 can be about 0.5 cm to about 2 cm from the gastroesophageal junction 22 and about 2 cm to about 10 cm from the pylorus 30. According to the embodiments described herein, during vertical sleeve gastrectomy, an endocutter stapling device can be used to form a high - quality, consistent resection line. Embodiments of the device may be advantageous because they can be easily positioned laparoscopically, can accommodate tissues of different thicknesses along the length of the resection line, can be capable of providing uniform compression pressure on the tissues along the resection line, and can achieve low staple - firing force. Embodiments of the device can utilize electrical energy during surgery to cut, dissect, ablate, coagulate, cauterize, seal, or otherwise treat the resection line.

[0075] Figure 2Is a perspective view of an exemplary electrosurgical stapling device 100 according to one embodiment. The electrosurgical stapling device 100 may include an inner cutter 108 and a motor assembly 115. The electrosurgical stapling device 100 includes an end effector 121, a support tube 140, and a handle portion 123. The end effector includes an anvil assembly 101 and a cartridge assembly 103. The anvil assembly 101 may act as a first jaw of the end effector 121, and the cartridge assembly may act as a second jaw of the end effector 121. The end effector 121 may be connected to the handle portion 123 through the support tube 140. The handle portion 123 may include a handle 111 and a trigger 104 for actuating the electrosurgical stapling device 100.

[0076] The handle portion 123 may include a mode button 124 for switching between operating modes. For example, in a first mode, the trigger 104 may be pressed upward to open the jaws (e.g., the anvil and the cartridge), or pressed downward to close the jaws. When the jaws are in the closed position, the mode button 124 may be depressed to switch the electrosurgical stapling device 100 to the firing mode. When in the firing mode, depressing the trigger 104 may fire the electrosurgical stapling device 100 to form a staple line containing one or more rows of staples while cutting tissue. In one embodiment, depressing the trigger 104 in the firing mode may deploy a staple line including six rows of staples, where a knife (not shown) may cut the tissue between the third and fourth rows of staples simultaneously. Immediately after being cut, electrical energy may be applied to the tissue through an electrode 170 ( Figure 3 ) positioned close to the knife, as described in more detail below.

[0077] Figure 3 Depicts an exploded perspective view of an electrosurgical stapling device 100 ( Figure 2 ) according to at least one embodiment. The anvil assembly 101 may include an anvil frame 102 and an anvil plate 112. The anvil plate 112 may be welded to the anvil frame 102, or may be attached in other ways such as by gluing, brazing, sintering, machining, 3D printing, etc. A cartridge 110 containing a plurality of staples may be attached to a cartridge frame 116 through a first cartridge pin 143 at a first end and a second cartridge pin 118 at a second end, or alternatively, the cartridge 110 may be attached to the cartridge frame 116 by snap fit, gluing, or other attachment methods.

[0078] In Figure 3In the illustrated embodiment, the cartridge frame 116 can be inserted at its proximal end into the support tube 140 to align the end effector 121 of the inner cutter 108 with the handle portion 123 and to connect the end effector to the handle portion. The blade assembly can include a knife or blade 107 that can be coupled to the rotating member 180 by a nut 109, a bushing, or other suitable connection. For example, an electrode 170 that can be positioned on only one side of the knife can heat tissue and blood vessels to cauterize, coagulate / dry, and / or seal the tissue when the electrosurgical stapling device 100 is fired to effect hemostasis. The electrode 170 can be in electrical communication with an electrosurgical power source through a circuit system (not shown). The tissue sensor 177 can be positioned adjacent to the knife 107. In some embodiments, the tissue sensor is coupled to the knife 107 and is positioned distal to the electrode 170. Although Figure 3 a single tissue sensor 177 is shown, the present disclosure is not limited thereto, as any suitable number of tissue sensors 177 can be deployed in the end effector 121. The tissue sensor 177 can be, for example, a resistance temperature device (RTD) that functions as a temperature sensor. The RTD can be a component of a temperature measurement circuit that includes a current source for passing current through the RTD and a voltage reading device for reading the voltage drop generated across the RTD. Based on the current and voltage, a resistance value can be obtained that indicates the sensed temperature.

[0079] The handle portion 123 can include a right handle half 120 and a left handle half 122 that can be held together in a clamshell manner. The right handle half 120 and the left handle half 122 can be connected by, for example, ultrasonic welding, glue, screws, clamping pins, or press-fit pins that fit into holes molded in the handle or other assembly methods. The left handle housing 150 and the right handle housing 152 can be used to provide an aesthetically pleasing exterior appearance for the outside of the handle portion 123 by covering the left handle half 122 and the right handle half 120.

[0080] The drive screw 154 can be used to drive the control arm 151 through the control arm nut 153. The drive screw 154 can be connected to a second drive gear coupler 145 that can engage the motor assembly 115 ( Figure 4 ). The rotating member 180 can be coupled to the motor assembly 115 through a firing drive gear 166 and a second firing drive gear 169, where the second firing drive gear 169 can engage a first drive gear coupler 156 that can be coupled to the motor assembly 115. In one embodiment, the second firing drive gear 169 and the first drive gear coupler 156 can be a single component or feature.

[0081] Figure 4is a perspective view of a motor assembly 115 according to one embodiment. A first motor 135 and a second motor 137 may be disposed within a motor housing 113. In one embodiment, a first motor gear 163 may be coupled to a first drive gear coupler 156( Figure 3 ), and a second coupling gear 165 may be coupled to a second drive gear coupler 145( Figure 3 ). The motor housing 113 may include a left motor housing half 127 and a right motor housing half 116. The motor housing 113 may include a snap 117 to couple the motor assembly 115 to a handle portion 123( Figure 3 ). A strain relief 119 may be provided to support wiring to the motor assembly 115. A connector 125 may provide electrical coupling of a trigger 104( Figure 3 ) and other electrical components between the motor assembly 115 and the electrosurgical stapling device 100.

[0082] Figure 5A is a side view of an electrosurgical stapling device 100 according to one embodiment, showing the end effector 121 in an open position. The end effector 121 may include a first jaw containing an anvil assembly 101 and a second jaw containing a cartridge assembly 103. The end effector 121 may include a main link 106 operably coupled to the motor assembly 115.

[0083] Figure 5B is a side view of the electrosurgical stapling device 100 showing the end effector 121 in a closed position. The end effector 121 in the closed position may be ready to fire, which may include deploying staples, cutting, and / or applying electrosurgical energy to tissue.

[0084] Figure 6 depicts a cross-sectional side view of a handle portion 123 of the electrosurgical stapling device 100 in an open position (e.g., the position shown in Figure 5A ). A second drive gear coupler 145 for opening and closing the end effector 121 may be coupled to a second motor gear 165 associated with the second motor 137( Figure 4 ). The second drive gear coupler 145 may rotate a drive screw 154 to open and close the end effector 121, thereby transitioning the end effector 121 between the open position and the closed position, and vice versa. In Figure 6In [the figure], the control arm nut 153 is shown in the outermost position on the drive screw 154 such that the main link 106 is fully extended and the end effector 121 is in the open position. When the end effector 121 is in the fully open position, the control arm distal limit switch 168 can be contacted by the control arm nut 153 in the position shown to interrupt the power to the second motor 137. The first drive gear coupler 156 can be coupled to the second motor gear 165 to deploy staples from the electrosurgical stapling device 100 while cutting and subsequently sealing tissue with a hemostatic seal.

[0085] Figure 6 Also schematically depicted is a conductor 141 that extends through the support tube 140 and is in electrical communication with the electrode 170( Figure 3 )). In the embodiment shown, the spool 159 is positioned within a cavity defined by the handle portion 123. The conductor 141 can include, for example, conductors 141A - 141D as shown in cross-section A - A. For example, conductors 141A and 141B can be components of a circuit having the electrode 170, and conductors 141C and 141D can be components of a circuit having the tissue sensor 177. The spool 159 can be configured to gather slack from the conductor 141 during surgery when the electrode 170 and the tissue sensor 177 are pulled proximally towards the handle portion 123. In some embodiments, a constant force spring 161 can be coupled to the spool 159 to assist in the automatic winding of the spool 159 during operation.

[0086] Figure 7 A side view of the end effector 121 of the electrosurgical stapling device 100 shown in the open position is depicted. The main link 106 can be attached to the first end of the anvil frame 102 by the first main link pin 120 such that the first main link pin 120 can pivotally and slidably engage the main link slot 105. The main link slot 105 can be a channel parallel to the longitudinal axis of the anvil assembly 101, or the main link slot 105 can be inclined upward or downward relative to this longitudinal axis. The second main link pin 138 can be used to pivotally couple the main link 106 to the control arm 151.

[0087] Figure 8Depicts a cross-sectional side view of the handle portion 123 of an electrosurgical stapling device 100 shown in a closed position. The control arm nut 153 is shown in its most proximal position on the drive screw 154 such that the anvil assembly 101 is closed relative to the cartridge assembly 103. In one embodiment, when the end effector 121 is closed, the control arm nut 153 may travel proximally until it contacts the proximal limit switch 155. When the control arm nut 153 contacts the proximal limit switch 155, it may interrupt the power to the second motor 137. The electrosurgical stapling device 100 may be configured such that it cannot transition to a firing mode until the control arm nut 153 engages the proximal limit switch 155 to ensure that the electrosurgical stapling device 100 is in a closed position prior to firing.

[0088] Figure 9 Depicts a side view of the end effector 121 of an electrosurgical stapling device 100 shown in a closed position. The main link 106 is shown partially inserted into the support tube 140 such that the anvil assembly 101 and the cartridge assembly 103 are in a closed position ready for firing.

[0089] Figure 10 Is a side view of a drive assembly 260 for simultaneously stapling, cutting, and sealing tissue. The drive assembly 260 may include a blade assembly 208 that includes a blade 207 coupled to a beam 226. An electrode 270 and a tissue sensor 277 may be positioned on one side of the blade 207 such that they directly contact the tissue being cut by the blade 207. The electrode 270 may be in electrical communication with an electrosurgical energy source through a circuitry 241. The beam 226 may include a nut 209 that may threadedly engage a rotating member 280. The rotating member 280 may be operably coupled to a first motor 212 such that rotation of the rotating member 280 pushes the nut 209 proximally. During operation, activating the first motor 212 may push the nut 209 proximally such that the beam 226 and the blade assembly 208 move in the proximal direction accordingly. When the blade assembly 208 is pushed proximally, a cutting edge 232 on the blade 207 may transect the tissue. Simultaneously, energy may pass through the transected tissue via the electrode 270 to heat the tissue and blood vessels, thereby cauterizing, coagulating / drying, and / or sealing the tissue along one side of the incision. The tissue sensor 277 may simultaneously provide real-time feedback regarding the state of the tissue near the cutting site. The blade 207 may include a top portion 228 and a lower portion 230 that may compress the anvil and cartridge of the end effector when pushed proximally.

[0090] Still referring to Figure 10, when the blade assembly 208 is pulled to its proximal most position, the nut 209 can engage the firing complete limit switch 268. When the nut 209 engages the firing complete limit switch 268, the power to the first motor 212 can be interrupted. It is contemplated that the nut 209 can be attached to the blade assembly 208 or the beam 226 in any suitable manner (such as by pins, spot welding, or other attachment methods). Alternatively, the nut 209 can be integrally formed with the blade assembly 208 or the beam 226 as a single structure.

[0091] Figure 11 is a perspective view of a motor controller 370 according to one embodiment. The motor controller 370 can include a controller housing 372 having an on / off switch 374, a display 375, and a device cable connector 376. The on / off switch 374 can provide wall power, such as 110 volts or 220 volts AC power from a wall outlet, or can provide battery power to the motor controller 370. The device cable connector 376 can connect multiple wires from the motor assembly of the stapling device to the motor controller 370. For example, the device cable connector 376 can provide a positive voltage line and a negative voltage line to a first motor (e.g., Figure 4 the first motor 135 shown in Figure 4 ), a positive voltage line and a negative voltage line to a second motor 137 (e.g., Figure 3 the second motor 137 shown in Figure 6 ), wires to a trigger (e.g., Figure 3 the trigger 104 shown in Figure 6 ), a positive sense line and a negative sense line to each firing complete limit switch 168 ( Figure 6 ), wires in electrical communication with the active electrode and wires in electrical communication with a return electrode (e.g., electrode 170 ( Figure 3 ), electrode 270 ( Figure 10 )), wires in electrical communication with one or more tissue sensors (e.g., tissue sensor 177 ( Figure 3 )), and any other wires for the inner cutter.

[0092] Figure 12 is an exploded perspective view of a motor controller 370 according to one embodiment. A cover 373, which can be part of the controller housing 372, can contain the components inside the controller housing 372. In the Figure 11 embodiment shown, wall power can be introduced into the controller housing 372 through an electrical inlet 378. A fan 380 can also be included to cool the interior of the controller housing 372. A pair of speakers 382 can be provided to notify the user of the status of the stapling device, such as for example jaw open, jaw closed, firing complete, ready to fire, or other useful information. The display 375 can be used to provide visual directions, data, error conditions, instrument identification, or other useful data.

[0093] The motor controller board 328 can provide power to the first motor 135 ( Figure 4 ) or the second motor 137 ( Figure 4 ) when appropriate. The motor controller board 328 can also control electrosurgical energy associated with various electrodes, such as electrode 170 or electrode 270 ( Figure 10 ). The motor controller board 328 can also receive signals indicating the tissue state provided, for example, by tissue sensor 177 or tissue sensor 277. The motor controller board 328 can be directed by the processor board 330 to turn on or off the first motor 135 or the second motor 137. The processor board 330 can contain a processor for controlling the stapling device, such as an ARM processor or other processor. For example, the processor board 330 can contain software that reads the status of limit switches 155, 168 ( Figure 6 ) and trigger 104 ( Figure 6 ) and can control the motor controller board 328 to, for example, open and close the jaws, fire the system, activate the electrosurgical energy source, or perform other useful functions.

[0094] In one example embodiment, an ARM processor can be used to communicate with the inner cutter (e.g., Figure 1 the stapling device 100 shown in ). For example, the electrosurgical stapling device 100 can include an EEPROM or other memory holding device that can be encoded with a serial number during manufacturing. The memory can be used to provide information to the motor controller. For example, the processor may be able to measure and record the open and close motor amperage during startup on the production line; data on the tissue condition along the resection site; the firing generator amperage during startup on the production line; the open and close motor amperage during clinical use; the firing generator amperage during startup during clinical use, or other data useful to the manufacturer or operator. This data can also be relayed to and stored in the motor controller 370. Such information can also be displayed to the user during firing by connecting the motor controller 370 to a screen or display, which can be incorporated into the electrosurgical stapling device 100, in the motor controller 370, or the data can be transmitted to a monitor used by a laparoscopic camera in minimally invasive surgery.

[0095] In one embodiment, an electrosurgical stapling device system according to the embodiments described herein can have a unique serial number or other identifier to allow an operator to record the specific serial number of the instrument used in a patient record. When the instrument is inserted into a controller, such as motor controller 370, the controller can communicate with a memory and provide the serial number on a display of the controller. The memory can also be used to record information regarding the use of the instrument. For example, an event log can be recorded from the controller to the memory, where the controller logs motor load, number of times the instrument is opened or closed, number of times the instrument is fired, error codes, or other useful information into the memory for later viewing.

[0096] Now referring Figure 13 , an example beam 426 in accordance with a non-limiting embodiment of the present disclosure is shown. A blade assembly 408 located at the distal end of the beam 426 can include a top portion 428, a bottom portion 420, and a blade 407. Similar to the previous embodiments, the top portion 228 and the lower portion 230 can compress the anvil and cartridge of the end effector (not shown) when pushed proximally. The blade assembly 408 has a first side surface 409, on which a first electrode 471, a second electrode 473, and a tissue sensor 477 can be coupled. As shown, the first electrode 471, the second electrode 473, and the tissue sensor 477 can be positioned adjacent to the blade 407 such that the tissue being cut is placed in almost direct contact with the first electrode 471, the second electrode 473, and the tissue sensor 477. The first electrode 471 and the second electrode 473 can be in electrical communication with an electrosurgical energy source (not shown) through a circuitry 411 extending along the beam 426. In some embodiments, the circuitry 411 can be coupled to the beam 426 using any suitable technique. For example, in some embodiments, the circuitry 411 is placed within a slot formed in the beam 426. In other embodiments, the circuitry 411 can be cast with the beam 426. The tissue sensor 477 can also deliver signals through the circuitry 411 extending along the beam 426.

[0097] The electrosurgical energy source can provide a bipolar electrosurgical current that travels from the first electrode 471 through the intervening tissue to the second electrode 473 to complete the circuit. More specifically, when the blade assembly 408 is pushed proximally, the blade 407 transects the tissue along an excision line 12 ( Figure 1 ), and energy can be delivered to the excised tissue simultaneously. Such energy can thereby heat the tissue and blood vessels along the excision line 12 to cauterize, coagulate / dry, and / or seal the tissue along the excision line 12. The tissue sensor 477 can provide a feedback signal indicative of one or more tissue parameters such as tissue impedance, tissue temperature, output current, and / or voltage.

[0098] The tissue will be separated along resection line 12 such that the incision has a first side and a second side. Since the first electrode 471 and the second electrode 473 are coupled to one side of the blade assembly 408, during transection, only one side of the incision (i.e., the first side) will contact the first electrode 471 and the second electrode 473. In some embodiments, additional electrodes and one or more tissue sensors may be positioned on the other side of the blade assembly 408 such that both sides of the incision will contact a pair of electrodes and tissue sensors. For example, as shown, a pair of electrodes 471, 473 and a tissue sensor 477 may be coupled to one side of the blade assembly 408, and another pair of electrodes (not shown) may be disposed on the opposite side of the blade assembly 408. The other pair of electrodes may also be in electrical communication with an electrosurgical energy source (not shown) through circuitry 411 extending along the beam 426. In this arrangement, during transection, both sides of the incision may contact a pair of electrodes while the tissue condition along both sides of the incision is also monitored. Thus, according to various embodiments, the electrodes on both sides of the blade assembly 408 may be used to simultaneously cauterize, coagulate / dry, and / or seal both sides of the incision formed by the blade assembly 408.

[0099] While Figure 13 an example arrangement of electrodes and tissue sensors is depicted, the present disclosure is not limited thereto. In fact, various different electrode layouts as well as different electrode shapes, configurations, placement and positioning of electrodes and tissue sensors, and total numbers of electrodes and sensors may be used without departing from the scope of the present disclosure. Figures 14 - 15 Each depicts an example electrode and tissue sensor layout according to various embodiments. Additionally, although Figures 14 - 15 for illustrative purposes electrodes and one or more tissue sensors positioned on the first side of the blade assembly are depicted, it should be understood that the electrodes and / or one or more tissue sensors may alternatively or additionally be disposed on the second side of the blade assembly without departing from the scope of the present disclosure.

[0100] First refer to Figure 14, depicts a blade assembly 508 coupled to a beam 526. A first electrode 571 and a second electrode 573 are coupled to one side of the blade assembly 508 and are in electrical communication with an electrosurgical energy source (not shown) through a circuitry 511. A tissue sensor 577 is also coupled to one side of the blade assembly 508 to provide feedback to a tissue monitoring system (not shown) through the circuitry 511. In this embodiment, the first electrode 571 and the second electrode 573 are placed along the longitudinal axis of the beam 526. In one embodiment, the first electrode 571 is the active electrode and the second electrode 573 is the return electrode. In another embodiment, the first electrode 571 is the return electrode and the second electrode 573 is the active electrode. Each of the first electrode 571 and the second electrode 573 may have a curved outer surface, which may facilitate contact between the first electrode 571 and the second electrode 573 and the tissue during resection. In some embodiments, the first electrode 571 and the second electrode 573 may each be a frustum of a cylinder (as shown). In other embodiments, the first electrode 571 and the second electrode 573 may each be hemispherical, rectangular block, or any of a variety of other suitable shapes. As Figure 14 shown, the tissue sensor 577 may have a shape factor similar to that of the electrodes 571, 573, or may have a different shape factor without departing from the scope of the present disclosure.

[0101] Embodiments of the disclosed technology that include a tissue monitoring system (see, for example, Figures 17A - 23B ) may include a closed-loop control scheme that includes a feedback control loop, where one or more tissue sensors (e.g., tissue sensors 477 and 577) provide feedback to a motor controller (e.g., motor controller 370). The tissue sensor may provide information obtained from one or more sensing mechanisms for sensing various tissue parameters such as tissue impedance, tissue temperature, output current, and / or voltage. The motor controller may then signal an electrosurgical power source through a motor controller board (e.g., motor controller board 238), and the electrosurgical power source may then adjust various operating parameters such as the firing speed of an electrosurgical stapling device. The motor controller may include analog and / or logic circuitry for processing sensed values from the tissue sensor and determining control signals sent to the electrosurgical power source. The tissue sensor may be provided with leads (or wireless) to transmit information to the controller while the tissue sensor translates along the tissue during a resection procedure.

[0102] In a non - limiting example, one or more tissue sensors provide measured tissue temperature feedback to a motor controller to adjust the firing speed of an electrosurgical stapling device. Once the tissue temperature rises above a predetermined threshold, the energy from the electrosurgical power source is terminated and deactivated, thereby stopping the firing of the electrosurgical stapling device. In one embodiment, the predetermined threshold is between 80 - 120 °C. Further, if the tissue temperature at a predetermined location along the resection line 12 ( Figure 1 as shown) has not reached a predetermined target temperature, the firing speed of the electrosurgical stapling device is reduced. In one embodiment, the predetermined target temperature of the tissue is between 60 - 100 °C.

[0103] In another non - limiting example, one or more tissue sensors provide measured tissue impedance feedback to a motor controller to adjust the firing speed of an electrosurgical stapling device. As the tissue is cauterized along the resection line 12, the impedance within the tissue increases. Thus, if the tissue impedance at a predetermined location along the resection line 12 has not reached a predetermined target impedance, the energy from the electrosurgical power source is terminated and deactivated. Further, if the tissue impedance rises above a predetermined threshold, the firing speed of the electrosurgical stapling device is reduced, thereby stopping the firing of the electrosurgical stapling device. In one embodiment, the target impedance required to maintain a temperature between 90 - 100 °C is between 200 - 600 ohms (Ω). If the tissue impedance is greater than 600 Ω, the firing speed of the electrosurgical stapling device is reduced, and if the tissue impedance is below 200 Ω, the energy from the electrosurgical power source is deactivated.

[0104] Now referring to Figure 15 , a blade assembly 608 coupled to a beam 626 is depicted. A first electrode 671 and a second electrode 673 are coupled to one side of the blade assembly 608 and are in electrical communication with an electrosurgical energy source (not shown) through a circuitry 611. A tissue sensor 677 is also coupled to one side of the blade assembly 608 to provide feedback to a tissue monitoring system through the circuitry 611. In this embodiment, the first electrode 671 and the second electrode 673 are placed along an axis orthogonal to the longitudinal axis of the beam 626. In one embodiment, the first electrode 671 is the active electrode and the second electrode 673 is the return electrode. In another embodiment, the first electrode 671 is the return electrode and the second electrode 673 is the active electrode. Although the first electrode 671 and the second electrode 673 are schematically shown as being generally rectangular, the electrodes can each be of any of a variety of other suitable shapes.

[0105] Now referring to Figure 16, depicts a blade assembly 708 coupled to a beam 726. A first electrode 771 and a second electrode 773 are coupled to one side of the blade assembly 708 and are in electrical communication with an electrosurgical energy source (not shown) via an electrical circuit system 711. A tissue sensor 777 is also coupled to one side of the blade assembly 708 to provide feedback to a tissue monitoring system via the electrical circuit system 711. In this embodiment, the blade assembly includes a distal extension 709 that facilitates the desired placement of the electrodes. For example, such a distal extension 709 can be used to accommodate larger-sized electrodes and / or to accommodate further lateral separation between the electrodes.

[0106] Figures 17A - 17B Schematically depicts one example non-limiting embodiment of electrically coupling the electrodes to an electrosurgical energy source, coupling the tissue sensor to a tissue monitoring system, and maintaining such coupling during operation. First referring to Figure 17A , a blade assembly 808 coupled to a beam 826 extending into a support tube 840 is shown, which is shown in cross-sectional view. As shown, a first electrode 871, a second electrode 873, and a tissue sensor 877 can be coupled to the blade assembly 808. Similar to the arrangement shown in Figure 10 , a nut 809 can be threaded onto a rotating member 880 such that rotation of the rotating member 880 causes the nut 809 to traverse longitudinally along the length of the rotating member 880. The proximal end of the beam 826 can be coupled to the nut 809 or otherwise engaged therewith such that traversal of the nut 809 along the rotating member 880 in the proximal direction causes the beam 826 to traverse in the same direction.

[0107] The distal end of the beam can include a first contact 845 and a second contact 847. The first contact 845 can be in electrical contact with the first electrode 871 via a conductor 849 routed along the beam 826. The second contact 847 can be in electrical contact with the second electrode 873 via a conductor 851 routed along the beam 826. The distal end of the beam can also include a third contact 846 and a fourth contact 848. The third contact 846 can be in electrical contact with the tissue sensor 877 via a conductor 850 routed along the beam 826. The fourth contact 848 can be in electrical contact with the tissue sensor 877 via a conductor 852 routed along the beam 826.

[0108] The first conductive band 841 can be positioned on the inner surface of the support tube 840. The first conductive band 841 can be in electrical communication with an electrosurgical energy source, such as a bipolar energy source 860, through a conductor 861. The second conductive band 843 can also be positioned on the inner surface of the support tube 840. The second conductive band 841 can be in electrical communication with an electrosurgical energy source (such as a bipolar energy source 860) through a conductor 863. When the first contact 845 translates relative to the first conductive band 841, the first contact 845 can physically contact the first conductive band 841 and maintain such contact. When the second contact 847 translates relative to the second conductive band 843, the second contact 847 can physically contact the second conductive band 843 and maintain such contact.

[0109] The third conductive band 842 can be positioned on the inner surface of the support tube 840. The third conductive band 842 can be in electrical communication with a tissue monitoring system 862. The fourth conductive band 844 can also be positioned on the inner surface of the support tube 840. The fourth conductive band 844 can be in electrical communication with a tissue monitoring system 862. When the third contact 846 translates relative to the third conductive band 842, the third contact 846 can physically contact the third conductive band 842 and maintain such contact. When the fourth contact 848 translates relative to the fourth conductive band 844, the fourth contact 848 can physically contact the fourth conductive band 844 and maintain such contact.

[0110] Each of the contacts 845, 846, 847, and 848 can include a brush, a leaf spring, or any other suitable connection that allows current to transfer between the contact and the corresponding conductive band when the beam 826 translates relative to the support tube 840.

[0111] Figure 17B Energy delivery to tissue (not shown) during operation is schematically depicted. During operation, the nut 809 translates in the direction indicated by arrow A by rotation of the rotating member 880. An energy supply path can be continuously provided to the tissue excised by the blade assembly 808. More specifically, an energy supply path is formed from the bipolar energy source 860 to the first electrode 871 through a path including the conductor 861, the first conductive band 841, the first contact 845, and the conductor 849. An energy return path can be continuously provided from the second electrode 873 to the bipolar energy source 860 through a path including the conductor 851, the second contact 847, the second conductive band 843, and the conductor 863. Additionally, the tissue monitoring system 862 can receive a continuous signal from the tissue excised by the blade assembly 808. More specifically, the circuit from the tissue monitoring system 862 to the tissue sensor 877 includes the third conductive band 842, the third contact 846, and the conductor 850 on one leg and the fourth conductive band 844, the fourth contact 848, and the conductor 852 on the other leg.

[0112] Figures 18A - 18B Schematically depicts another example non - limiting embodiment of electrically coupling an electrode to an electrosurgical energy source, coupling a tissue sensor to a tissue monitoring system, and maintaining such couplings during operation. First referring to Figure 18A , a blade assembly 908 coupled to a beam 926 is shown extending into a support tube 940, which is shown in cross - sectional view. As shown, a first electrode 971 and a second electrode 973, as well as a tissue sensor 977, may be coupled to the blade assembly 998. A nut 909 may be threadedly coupled to a rotating member 980 such that rotation of the rotating member 980 causes the nut 909 to traverse longitudinally along the length of the rotating member 980. The proximal end of the beam 926 may be coupled to or otherwise engaged with the nut 909 such that traversal of the nut 909 along the rotating member 980 in the proximal direction causes the beam 926 to traverse in the same direction.

[0113] The nut 909 may include a first contact 945 and a second contact 947. The first contact 945 may be in electrical contact with the first electrode 971 through a conductor 949 that starts at the nut 909 and then routes along the beam 926. The second contact 947 may be in electrical contact with the second electrode 973 through a conductor 951 that starts at the nut 909 and then routes along the beam 926. The nut 909 may also include a third contact 946 and a fourth contact 948. The third contact 946 may be in electrical contact with the tissue sensor 977 through a conductor 950 that routes along the beam 926. The fourth contact 948 may be in electrical contact with the tissue sensor 977 through a conductor 952 that routes along the beam 926.

[0114] Similar to Figures 17A - 17B, the first conductive band 941 can be positioned on the inner surface of the support tube 940. The first conductive band 941 can be electrically connected to an electrosurgical energy source, such as a bipolar energy source 960, through a conductor 961. The second conductive band 943 can also be positioned on the inner surface of the support tube 940. The second conductive band 941 can be electrically connected to an electrosurgical energy source (such as a bipolar energy source 960) through a conductor 963. When the first contact 945 translates relative to the first conductive band 941, the first contact 945 can physically contact the first conductive band 941 and maintain such contact. When the second contact 947 translates relative to the second conductive band 943, the second contact 947 can physically contact the second conductive band 943 and maintain such contact. The third conductive band 942 can be positioned on the inner surface of the support tube 940. The third conductive band 942 can be electrically connected to the tissue monitoring system 962. The fourth conductive band 944 can also be positioned on the inner surface of the support tube 940. The fourth conductive band 944 can be electrically connected to the tissue monitoring system 962. When the third contact 946 translates relative to the third conductive band 942, the third contact 946 can physically contact the third conductive band 942 and maintain such contact. When the fourth contact 948 translates relative to the fourth conductive band 944, the fourth contact 948 can physically contact the fourth conductive band 944 and maintain such contact.

[0115] Each of the contacts 945, 946, 947, and 948 can include a brush, a leaf spring, or any other suitable connection that allows current to transfer between the contact and the corresponding conductive band when the nut 909 translates relative to the support tube 940.

[0116] Figure 18B Energy delivery to tissue (not shown) during operation is schematically depicted. During operation, the nut 909 translates in the direction indicated by arrow A by rotation of the rotating member 980. An energy supply path can be continuously provided to the tissue excised by the blade assembly 908. More specifically, an energy supply path is formed from the bipolar energy source 960 to the first electrode 971 through a path including the conductor 961, the first conductive band 941, the first contact 945, and the conductor 949. An energy return path can be continuously provided from the second electrode 973 to the bipolar energy source 960 through a path including the conductor 951, the second contact 947, the second conductive band 943, and the conductor 963. Additionally, the tissue monitoring system 962 can receive a continuous signal from the tissue excised by the blade assembly 908. More specifically, the circuit from the tissue monitoring system 962 to the tissue sensor 977 includes the third conductive band 942, the third contact 946, and the conductor 950 on one leg and the fourth conductive band 944, the fourth contact 948, and the conductor 952 on the other leg.

[0117] Figure 19Schematically depicts another example non - limiting embodiment of electrically coupling an electrode to an electrosurgical energy source, coupling a tissue sensor to a tissue monitoring system, and maintaining such couplings during operation. A blade assembly 1008 coupled to a beam 1026 is shown extending into a support tube 1040, which is shown in cross - sectional view. As shown, a first electrode 1071, a second electrode 1073, and a tissue sensor 1077 may be coupled to the blade assembly 1008. A nut 1009 may be threadedly coupled to a rotating member 1080 such that rotation of the rotating member 1080 causes the nut 1009 to traverse longitudinally along the length of the rotating member 1080. The proximal end of the beam 1026 may be coupled to or otherwise engaged with the nut 1009 such that traversal of the nut 1009 along the rotating member 1080 in the proximal direction causes the beam 1026 to traverse in the same direction.

[0118] The distal end of the beam 1026 may include a first contact 1045 and a second contact 1047. The first contact 1045 may be in electrical contact with the first electrode 1071 via a conductor 1049 routed along the beam 1026. The second contact 1047 may be in electrical contact with the second electrode 1073 via a conductor 1051 routed along the beam 1026. The distal end of the beam 1026 may further include a third contact 1046 and a fourth contact 1048. The third contact 1046 may be in electrical contact with the tissue sensor 1077 via a conductor 1050 routed along the beam 1026. The fourth contact 1048 may be in electrical contact with the tissue sensor 1077 via a conductor 1052 routed along the beam 1026.

[0119] A first conductor 1041A in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1060, may be routed into the support tube 1040 and connected to the first contact 1045. A second conductor 1041B in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1060, may also be routed into the support tube 1040 and connected to the second contact 1047. A third conductor 1043A in electrical communication with the tissue monitoring system 1062 may be routed into the support tube 1040 and connected to the third contact 1046. A fourth conductor 1043B in electrical communication with the tissue monitoring system 1062 may also be routed into the support tube 1040 and connected to the fourth contact 1048. The first conductor 1041A and the second conductor 1041B may be wound around a spool 1059, which may be similar to, for example Figure 8 the spool 159. For example, the third conductor 1043A and the fourth conductor 1043B may be wound around a spool 1061.

[0120] During operation, upon rotation of the rotatable member 1080, the nut 1009 translates in the direction indicated by arrow A. An energy supply path can be continuously provided to tissue excised by the blade assembly 1008. More specifically, an energy supply path is formed from the bipolar energy source 1060 to the first electrode 1071 through a path including the conductor 1041A, the first contact 1045, and the conductor 1049. An energy return path can be continuously provided from the second electrode 1073 to the bipolar energy source 1060 through a path including the conductor 1051, the second contact 1047, and the second conductor 1041B. As the nut 1009 translates in the direction indicated by arrow A, rotation of the spool 1059 can gather excess slack in the first conductor 1041A and the second conductor 1041B. Additionally, the tissue monitoring system 1062 can receive a continuous signal from tissue excised by the blade assembly 1008. More specifically, the circuitry from the tissue monitoring system 1062 to the tissue sensor 1077 includes the third conductor 1043A, the third contact 1046, and the conductor 1050 on one leg, and the fourth conductor 1043B, the fourth contact 1048, and the conductor 1052 on the other leg. As the nut 1009 translates in the direction indicated by arrow A, rotation of the spool 1061 can gather excess slack in the third conductor 1043A and the fourth conductor 1043B.

[0121] Figure 20 Another exemplary non-limiting embodiment is schematically depicted of electrically coupling electrodes to an electrosurgical energy source, coupling a tissue sensor to a tissue monitoring system, and maintaining such couplings during operation. A blade assembly 1108 coupled to a beam 1126 is shown extending into a support tube 1140, which is shown in cross-sectional view. As shown, a first electrode 1171, a second electrode 1173, and a tissue sensor 1177 can be coupled to the blade assembly 1108. A nut 1109 can be threadedly coupled to a rotatable member 1180 such that rotation of the rotatable member 1180 causes the nut 1109 to traverse longitudinally along the length of the rotatable member 1180. The proximal end of the beam 1126 can be coupled to or otherwise engaged with the nut 1109 such that traversal of the nut 1109 along the rotatable member 1180 in the proximal direction causes the beam 1126 to traverse in the same direction.

[0122] The distal end of the beam can include a flexible circuit connection 1045. The flexible circuit connection 1145 can be in electrical contact with the first electrode 1171 through a conductor 1149 routed along the beam 1126. The flexible circuit connection 1145 can also be in electrical contact with the second electrode 1173 through a conductor 1151 routed along the beam 1126. The flexible circuit connection 1145 can also be in electrical contact with the tissue sensor 1177 through conductors 1150, 1152 routed along the beam 1126.

[0123] A flexible circuit 1141 (sometimes referred to as a flexible printed circuit or flexible circuit) that is electrically connected to an electrosurgical energy source, such as bipolar energy source 1160, can be routed to support tube 1140 and connected to flexible circuit connection 1145. Flexible circuit 1141 can be in electrical communication with slip ring 1159, which can be coupled to a spool, for example. Flexible circuit 1141 can house a plurality of conductors (i.e., traces) incorporated into a substrate. For example, flexible circuit 1141 can include a first trace and a second trace each in electrical communication with bipolar energy source 1160 and a trace in electrical communication with tissue monitoring system 1162.

[0124] During operation, nut 1109 translates in the direction indicated by arrow A by rotation of rotating member 1180. An energy supply path can be continuously provided to the tissue excised by blade assembly 1108. More specifically, an energy supply path is formed from bipolar energy source 1160 to first electrode 1171 through a path including flexible circuit 1141, flexible circuit connection 1145, and conductor 1149. An energy return path can be continuously provided from second electrode 1173 to bipolar energy source 1160 through a path including conductor 1151, flexible circuit connection 1145, and flexible circuit 1141. Additionally, tissue monitoring system 1062 can receive a continuous signal from the tissue excised by blade assembly 1008.

[0125] Figure 21 Another example non-limiting embodiment is schematically depicted that electrically couples electrodes to an electrosurgical energy source, couples a tissue sensor to a tissue monitoring system, and maintains such couplings during operation. Blade assembly 1208 coupled to beam 1226 is shown extending into support tube 1240, which is shown in cross-sectional view. As shown, first electrode 1271, second electrode 1273, and tissue sensor 1277 can be coupled to blade assembly 1208. Nut 1209 can be threadedly coupled to rotating member 1280 such that rotation of rotating member 1280 causes nut 1209 to traverse longitudinally along the length of rotating member 1280. The proximal end of beam 1226 can be coupled to or otherwise engaged with nut 1209 such that traversal of nut 1209 along rotating member 1280 in the proximal direction causes beam 1226 to traverse in the same direction.

[0126] The nut 1209 may include a first contact 1245 and a second contact 1247. The first contact 1245 may be in electrical contact with the first electrode 1271 through a conductor 1249 that starts from the nut 1209 and then routes along the beam 1226. The second contact 1247 may be in electrical contact with the second electrode 1273 through a conductor 1251 that starts from the nut 1209 and then routes along the beam 1226. The nut 1209 may further include a third contact 1246 and a fourth contact 1248. The third contact 1246 may be in electrical contact with the tissue sensor 1277 through a conductor 1250 that routes along the beam 1226. The fourth contact 1248 may be in electrical contact with the tissue sensor 1277 through a conductor 1252 that routes along the beam 1226.

[0127] A first conductor 1241A in electrical communication with an electrosurgical energy source, such as the bipolar energy source 1260, may be routed into the support tube 1240 and connected to the first contact 1245. A second conductor 1241B in electrical communication with an electrosurgical energy source, such as the bipolar energy source 1260, may also be routed into the support tube 1240 and connected to the second contact 1247. A third conductor 1243A in electrical communication with the tissue monitoring system 1262 may be routed into the support tube 1240 and connected to the third contact 1246. A fourth conductor 1243B in electrical communication with the tissue monitoring system 1262 may also be routed into the support tube 1240 and connected to the fourth contact 1248. The first conductor 1241A and the second conductor 1241B may be wound around a spool 1259, which may be similar to, for example Figure 8 the spool 159. For example, the third conductor 1243A and the fourth conductor 1243B may be wound around a spool 1261.

[0128] During operation, upon rotation of the rotatable member 1280, the nut 1209 translates in the direction indicated by arrow A. An energy supply path can be continuously provided to the tissue excised by the blade assembly 1208. More specifically, an energy supply path is formed from the bipolar energy source 1260 to the first electrode 1271 through a path including the conductor 1241A, the first contact 1245, and the conductor 1249. An energy return path can be continuously provided from the second electrode 1273 to the bipolar energy source 1260 through a path including the conductor 1251, the second contact 1247, and the second conductor 1241B. As the nut 1209 translates in the direction indicated by arrow A, rotation of the spool 1259 can gather excess slack in the first conductor 1241A and the second conductor 1241B. Additionally, the tissue monitoring system 1262 can receive a continuous signal from the tissue excised by the blade assembly 1208. More specifically, the circuitry from the tissue monitoring system 1262 to the tissue sensor 1277 includes a third conductor 1243A, a third contact 1246, and a conductor 1250 on one leg and a fourth conductor 1243B, a fourth contact 1248, and a conductor 1252 on the other leg. As the nut 1209 translates in the direction indicated by arrow A, rotation of the spool 1261 can gather excess slack in the third conductor 1243A and the fourth conductor 1243B.

[0129] Figure 22 Another exemplary non - limiting embodiment is schematically depicted of electrically coupling electrodes to an electrosurgical energy source, coupling a tissue sensor to a tissue monitoring system, and maintaining such couplings during operation. The blade assembly 1308 coupled to the beam 1326 is shown extending into the support tube 1340, which is shown in cross - sectional view. As shown, the first electrode 1371, the second electrode 1373, and the tissue sensor 1177 can be coupled to the blade assembly 1308. The nut 1309 can be threadedly coupled to the rotatable member 1380 such that rotation of the rotatable member 1380 causes the nut 1309 to traverse longitudinally along the length of the rotatable member 1380. The proximal end of the beam 1326 can be coupled to or otherwise engaged with the nut 1309 such that traversing of the nut 1309 along the rotatable member 1380 in the proximal direction causes the beam 1326 to traverse in the same direction.

[0130] The nut 1309 may include a flexible circuit connection 1345. The flexible circuit connection 1345 may be in electrical contact with the first electrode 1371 through a conductor 1349 that starts from the nut 1309 and then routes along the beam 1326. The flexible circuit connection 1345 may also be in electrical contact with the second electrode 1373 through a conductor 1351 that starts from the nut 1309 and then routes along the beam 1326. The flexible circuit connection 1345 may also be in electrical contact with the tissue sensor 1377 through conductors 1350, 1352 that route along the beam 1326.

[0131] A flexible circuit 1341 (sometimes referred to as a flexible printed circuit or flexible circuit) that is in electrical communication with an electrosurgical energy source, such as the bipolar energy source 1360, may be routed to the support tube 1340 and connected to the flexible circuit connection 1345. The flexible circuit 1341 may be in electrical communication with a slip ring 1359, which may be coupled to a spool, for example. The flexible circuit 1341 may house a plurality of conductors (i.e., traces) that are bonded to a substrate. For example, the flexible circuit 1341 may include a first trace and a second trace that are each in electrical communication with the bipolar energy source 1360 and a trace that is in electrical communication with the tissue monitoring system 1362.

[0132] During operation, the nut 1309 translates in the direction indicated by arrow A by rotation of the rotating member 1380. An energy supply path may be continuously provided to the tissue excised by the blade assembly 1308. More specifically, an energy supply path is formed from the bipolar energy source 1360 to the first electrode 1371 through a path that includes the flexible circuit 1341, the flexible circuit connection 1345, and the conductor 1349. An energy return path may be continuously provided from the second electrode 1373 to the bipolar energy source 1360 through a path that includes the conductor 1351, the flexible circuit connection 1345, and the flexible circuit 1341. Additionally, the tissue monitoring system 1362 may receive a continuous signal from the tissue excised by the blade assembly 1308.

[0133] Figures 23A - 23B Another exemplary non-limiting embodiment is schematically depicted that electrically couples an electrode to an electrosurgical energy source and maintains such coupling during operation. A blade assembly 1408 coupled to a beam 1426 is shown extending into a support tube 1440, which is shown in cross-sectional view. As shown, a first electrode 1471 and a second electrode 1473 may be coupled to the blade assembly 1408. A nut 1409 may be threadedly coupled to a rotating member 1480 such that rotation of the rotating member 1480 causes the nut 1409 to traverse longitudinally along the length of the rotating member 1480. The proximal end of the beam 1426 may be coupled to or otherwise engaged with the nut 1409 such that traversal of the nut 1409 along the rotating member 1480 in the proximal direction causes the beam 1426 to traverse in the same direction.

[0134] The driven nut 1411 can be positioned distally of the nut 1409. As shown, the driven nut 1411 can be threadedly coupled to the rotating member 1480, or can be threadedly coupled to a different rotating member. The driven nut 1411 can be configured such that it traverses proximally at a slower rate than the proximal traverse of the nut 1409. If the driven nut 1411 is threadedly coupled to the rotating member 1480, the driven nut 1411 can have a different thread pattern than the nut 1409 to achieve the speed differential. The driven nut 1411 can include one or more pins, shown as pins 1413 and 1415.

[0135] The distal end of the beam can include a first contact 1445 and a second contact 1447. The first contact 1445 can be in electrical contact with the first electrode 1471 via a conductor 1449 routed along the beam 1426. The second contact 1447 can be in electrical contact with the second electrode 1473 via a conductor 1451 routed along the beam 1426.

[0136] A first conductor 1441 in electrical communication with an electrosurgical energy source, such as the bipolar energy source 1460, can be routed into the support tube 1440, looped around the pin 1413, and then connected to the first contact 1445. A second conductor 1443 also in electrical communication with an electrosurgical energy source, such as the bipolar energy source 1460, can be routed into the support tube 1440, looped around the pin 1415, and then connected to the second contact 1447.

[0137] During operation, an energy supply path can be continuously provided to the tissue excised by the blade assembly 1408. More specifically, an energy supply path is formed from the bipolar energy source 1460 to the first electrode 1471 through a path including the conductor 1441, the first contact 1445, and the conductor 1449. An energy return path can be continuously provided from the second electrode 1473 to the bipolar energy source 1460 through a path including the conductor 1451, the second contact 1447, and the second conductor 1443.

[0138] The nut 1409 can initially be longitudinally spaced from the driven nut 1411 by a distance D1( Figure 23A ). By rotation of the rotating member 1480, the two nuts can be translated in the direction indicated by arrow A. The nut 1409 can travel a greater distance, thereby increasing the distance between the nut 1409 and the driven nut 1411 to a distance D2( Figure 23B)。Since conductors 1441 and 1443 respectively surround pins 1413 and 1415, the increase in such spacing during operation helps manage the slack formed in conductors 1441 and 1443 when nut 1409 is translated in the direction indicated by arrow a. Additionally, in some embodiments, a tissue sensor may be coupled to the blade assembly. Conductors associated with the tissue sensor may be routed similarly to conductors 1441 and 1443 to help manage their slack during operation.

[0139] Figures 24A - 24B Another exemplary non - limiting embodiment is schematically depicted that electrically couples an electrode to an electrosurgical energy source and maintains such coupling during operation. A blade assembly 1508 coupled to a beam 1526 is shown extending into a support tube 1540, which is shown in cross - section. As shown, a first electrode 1571 and a second electrode 1573 may be coupled to the blade assembly 1508. A nut 1509 may be threadedly coupled to a rotating member 1580 such that rotation of the rotating member 1580 causes the nut 1509 to longitudinally traverse along the length of the rotating member 1580. The proximal end of the beam 1526 may be coupled to or otherwise engaged with the nut 1509 such that traversing of the nut 1509 in the proximal direction along the rotating member 1580 causes the beam 1526 to traverse in the same direction.

[0140] A follower nut 1511 may be positioned distally of the nut 1509. As shown, the follower nut 1511 may be threadedly coupled to the rotating member 1580 or may be threadedly coupled to a different rotating member. The follower nut 1511 may be configured such that it traverses proximally at a slower rate than the proximal traversing of the nut 1509. If the follower nut 1511 is threadedly coupled to the rotating member 1580, the follower nut 1511 may have a different thread pattern than the nut 1509 to achieve the speed differential. The follower nut 1511 may include one or more pins, shown as pins 1513 and 1515.

[0141] The nut 1509 includes a first contact 1545 and a second contact 1547. The first contact 1545 may be in electrical contact with the first electrode 1571 through a conductor 1549 that starts at the nut 1509 and then routes along the beam 1526. The second contact 1547 may be in electrical contact with the second electrode 1573 through a conductor 1551 that starts at the nut 1509 and then routes along the beam 1526.

[0142] A first conductor 1541 in electrical communication with an electrosurgical energy source, such as bipolar energy source 1560, may be routed into support tube 1540, loop around pin 1513, and then connected to first contact 1545. A second conductor 1543 in electrical communication with an electrosurgical energy source, such as bipolar energy source 1560, may also be routed into support tube 1540, loop around pin 1515, and then connected to second contact 1547.

[0143] During operation, an energy supply path may be continuously provided to tissue excised by blade assembly 1508. More specifically, an energy supply path is formed from bipolar energy source 1560 to first electrode 1571 through a path including conductor 1541, first contact 1545, and conductor 1549. An energy return path may be continuously provided from second electrode 1573 to bipolar energy source 1560 through a path including conductor 1551, second contact 1547, and second conductor 1543.

[0144] Nut 1509 may initially be longitudinally spaced from follower nut 1511 by a distance D1 ( Figure 24A ). By rotation of rotatable member 1580, the two nuts may be translated in the direction indicated by arrow A. Nut 1509 may travel a greater distance, thereby increasing the distance between nut 1509 and follower nut 1511 to a distance D2 ( Figure 24B ). Because conductors 1541 and 1543 loop around pins 1513 and 1515 respectively, an increase in such spacing during operation helps manage slack formed in conductors 1541 and 1543 as nut 1509 is translated in the direction indicated by arrow a. Additionally, in some embodiments, a tissue sensor may be coupled to the blade assembly. Conductors associated with the tissue sensor may be routed similar to conductors 1541 and 1543 to help manage their slack during operation.

[0145] Now referring to Figure 25 , an example nut 1609 is shown in accordance with a non - limiting embodiment. Nut 1609 may be similar to, for example, nut 909 ( Figures 18A - 18B ). Nut 1609 may include threads 1611 configured to engage a rotatable member. Nut 1609 may also include a first contact 1645, a second contact 1646, a third contact 1647, and a fourth contact 1648. In Figure 25 , contacts 1645, 1646, 1647, and 1648 are shown as leaf springs configured to contact conductive bands, such as conductive bands 941, 942, 943, and 944 ( Figures 18A - 18B ). Nut 1609 may also include conductors 1649, 1650, 1651, and 1652 that are coupled to circuitry (not shown) on a beam.

[0146] Now refer to Figure 26 , which shows another exemplary nut 1709 according to a non - limiting embodiment. Nut 1709 can be similar to, for example, nut 909( Figures 18A - 18B ). Nut 1709 can include threads 1711 that are configured to engage a rotating member. Nut 1709 can also include a first contact 1745, a second contact 1746, a third contact 1747, and a fourth contact 1748. In Figure 26 , contacts 1745, 1746, 1747, and 1748 are shown as brush contacts that are configured to contact conductive bands, such as conductive bands 941, 942, 943, and 944( Figures 18A - 18B ). Nut 1709 can also include conductors 1649, 1650, 1651, and 1652 that are coupled to a circuit (system) (not shown) on a beam.

[0147] Now refer to Figure 27 , a cross - sectional view of an exemplary electrosurgical stapling device 1900. Electrosurgical stapling device 1900 can be similar to electrosurgical stapling device 100( Figures 1 - 2 ). In this regard, electrosurgical stapling device 1900 can include a nut 1909 that translates along a rotating member 1980 during rotation of the rotating member 1980. In the illustrated embodiment, a flexible circuit 1941 is connected to nut 1909, for example, similar to the arrangement in Figure 22 . The spool assembly 1959 can be configured to house the flexible circuit 1941 when nut 1909 translates in the direction indicated by arrow A during operation.

[0148] Figure 28 An enlarged view of the spool assembly 1959 is provided, and Figure 29 a disassembled view of the spool assembly 1959 is provided. The spool assembly 1959 can include a housing 1912 that defines a slot 1914 through which the flexible circuit 1941 passes and wraps around a spool 1910. When nut 1909 translates toward the spool assembly 1959 to gather the flexible circuit 1941, the spool 1910 can rotate about its axis of rotation 1920. Thus, during operation, the spool 1910 can rotate relative to the housing 1912 to pull the flexible circuit 1941 into the spool assembly 1959.

[0149] The spool assembly 1959 may also include a slip ring assembly 1957 to deliver energy to the flexible circuit 1941. The slip ring assembly 1957 may include a first contact 1902 and a second contact 1906 positioned on the outer surface of the bobbin 1910. The contacts 1902, 1906, 1922, and 1926 may be in electrical communication with the flexible circuit 1941 through any suitable connection. The first contact 1902 may be configured to maintain constant contact with the first circular electrode 1904 during rotation of the bobbin 1910. The second contact 1906 may be configured to maintain constant contact with the second circular electrode 1908 during rotation of the bobbin 1910. Each of the first electrode 1904 and the second electrode 1908 may be in electrical communication with a bipolar energy source 1960( Figure 29 ). The third contact 1922 may be configured to maintain constant contact with the third circular electrode 1928 during rotation of the bobbin 1910. The fourth contact 1926 may be configured to maintain constant contact with the fourth circular electrode 1924 during rotation of the bobbin 1910. The third electrode 1928 and the fourth electrode 1924 may be in electrical communication with the tissue monitoring system 1962.

[0150] Although some embodiments described herein describe using circuitry along a beam to deliver electrosurgical energy to electrodes positioned on a blade assembly, the present disclosure is not limited thereto. For example, referring to Figures 30 - 31 , an example embodiment is shown in which a first conductive band 2041 is positioned inside the anvil assembly 2001 and a second conductive band 2043 is positioned inside the cartridge assembly 2003. Each of the conductive bands 2041, 2043 may be in electrical communication with a suitable electrosurgical energy source (not shown). Figure 30 An example blade assembly 2008 having a first electrode 2071 and a second electrode 2073 is depicted, which may generally be similar to the foregoing embodiments. The example blade assembly 2008 also has a first pick-up electrode 2045 in electrical communication with the first electrode 2071. The first pick-up electrode 2045 is configured to contact the first conductive band 2041 positioned inside the anvil assembly 2001. The example blade assembly 2008 also has a second pick-up electrode 2047 in electrical communication with the second electrode 2073. The second pick-up electrode 2047 is configured to contact the second conductive band 2043 positioned inside the cartridge assembly 2003. Thus, when the blade assembly 2008 passes through the anvil assembly 2001 and the cartridge assembly 2003 during an operative strike, the pick-up electrodes 2045, 2047 may maintain contact with the conductive bands 2041, 2043.

[0151] Figure 32Depicts another example blade assembly 3008 having a first electrode 3071 and a second electrode 3073, which may generally be similar to the foregoing embodiments. The example blade assembly 3008 also has a first pick-up electrode 3045 in electrical communication with the first electrode 3071. The first pick-up electrode 3045 is configured to contact a first conductive band positioned inside the anvil assembly. The example blade assembly 3008 also has a second pick-up electrode 3047 in electrical communication with the second electrode 3073. The second pick-up electrode 3047 is configured to contact a second conductive band positioned inside the anvil assembly. Figure 32 The configuration may allow the construction bands in the anvil assembly to be further embedded and thus further away from the patient's tissue during operation. It can be appreciated that a method similar to the method depicted in Figures 30 - 32 can be used to implement a tissue sensor on the blade assembly using the conductive bands positioned in the anvil assembly 2001 and the cartridge assembly 2003.

[0152] While many embodiments of the present invention depict the use of electrodes, it should be understood that any suitable technique can be used to cauterize, coagulate / dry, and / or seal tissue. For example, in some embodiments, one or more resistive heating elements may be coupled to the blade assembly. When energized, one or more resistive heating elements can deliver heat directly to the tissue along the incision. In some embodiments, one or more resistive heating elements may be placed only on one side of the blade assembly such that the heat is directed to one side of the incision. Alternatively, one or more resistive heating elements may be placed on both sides of the blade assembly. Additionally, in some embodiments, the blade assembly may include a heating assembly that includes a resistive heating element and, for example, a heating pad or other suitable heat dissipation structure. Such structures can be positioned very close to the resistive heating element and are configured to directly contact the tissue. For example, during cross-cutting, the heat dissipation structure can help dissipate the heat from the resistive heating element into the tissue.

[0153] Figure 33 Depicts an example blade assembly 3108 including an example resistive heating element 3171. The example blade assembly 3108 also has a heating pad 3172 that covers the resistive heating element 3171 and is configured to help dissipate the heat generated by the resistive heating element 3171 during operation. The resistive heating element 3171 can be energized through a circuitry 3111 that extends along a beam 3126. While Figure 33 depicts a resistive heating element 3171 placed only on the first side of the blade assembly 3108, it should be understood that other embodiments may also have similar resistive heating elements placed on the other side. Additionally, according to the present disclosure, one or more tissue sensors may be incorporated into the blade assembly 3108.

[0154] Figure 34 depicts an exemplary blade assembly 3208 that includes another exemplary resistive heating element 3271. The resistive heating element 3271 can be energized by a circuitry 3211 that extends along a beam 3226. Although Figure 34 depicts the resistive heating element 3271 disposed only on a first side of the blade assembly 3208, it should be understood that other embodiments may also have a similar resistive heating element disposed on the other side. As shown, the resistive heating element 3271 can include a curved outer surface that helps to bring the resistive heating element 3271 into contact with tissue during resection. Additionally, according to the present disclosure, one or more tissue sensors can be incorporated into the blade assembly 3208.

[0155] Figure 35 depicts an exemplary blade assembly 3308 that includes a plurality of resistive heating elements 3371. The resistive heating elements 3371 can be energized by a circuitry 3311 that extends along a beam 3326. Although Figure 35 depicts the resistive heating elements 3371 disposed only on a first side of the blade assembly 3308, it should be understood that other embodiments may also have a similar resistive heating element disposed on the other side. As shown, the resistive heating elements 3371 include a curved outer surface, although the present disclosure is not limited thereto. In the illustrated embodiment, the resistive heating elements 3371 are linearly arranged in a travel direction of the beam 3326 with gaps therebetween. A specific spacing between adjacent resistive heating elements 3371 and the size of the resistive heating elements 3371 can be selected based on various operating parameters. For example, during operation, the spacing between adjacent resistive heating elements 3371 can help reduce the likelihood of tissue being burned. Further, in some embodiments, each resistive heating element 3371 can be configured to heat to substantially the same temperature when energized. In other embodiments, for example, the operating temperature of each of the various resistive heating elements 3371 can vary in order to achieve a desired temperature distribution. Finally, although Figure 35 shows three resistive heating elements 3371, it should be understood that the present disclosure is not limited thereto, as some embodiments can utilize fewer than three resistive heating elements 3371 while other embodiments can use more than three resistive heating elements 3371. Additionally, according to the present disclosure, one or more tissue sensors can be incorporated into the blade assembly 3308.

[0156] In other embodiments, instead of using bipolar electrosurgical methods or resistive heating elements to cauterize and seal tissue, some surgical devices can utilize monopolar electrosurgical techniques to deliver energy to tissue. For example, Figure 36Depicts an example blade assembly 3408 including an example active electrode 3471. The active electrode 3471 can be energized by a circuitry 3411 extending along a beam 3426. During operation, a return electrode (not shown) can be attached to a patient such that current flows from a generator to the active electrode 3471, through the target tissue, and then to the return electrode and back to the generator. Thus, the active electrode 3471 can be used to cauterize tissue along an incision by delivering energy to the tissue. Additionally, according to the present disclosure, one or more tissue sensors can be incorporated into the blade assembly 3408.

[0157] Although various embodiments are described herein in the context of an endocutter, it should be understood that the present disclosure is not limited thereto. Instead, the bipolar electrode arrangements according to the present disclosure can be incorporated into a variety of surgical tools and systems having cutting edges. More specifically, the electrodes according to the present disclosure can be incorporated into tools and systems proximal to the cutting edge, which can be configured to cauterize, coagulate / dry, and / or seal tissue cut by such cutting edges.

[0158] First referring to Figures 37 - 39 , an example electrosurgical circular stapler 4000 according to the present disclosure is shown. The example electrosurgical circular stapler 4000 can be used to provide end-to-end, side-to-side, or end-to-side anastomosis between two segments of an anatomical lumen such as a portion of a patient's digestive tract. The electrosurgical circular stapler 4000 can include a handle assembly 4100, a shaft assembly 4200, a stapling head assembly 4300, and an anvil 4400.

[0159] The electrosurgical circular stapler 4000 can further include a connection 4120 to a bipolar energy source 4060 and a tissue monitoring system 4062. The bipolar energy source 4060 can be configured to deliver electrosurgical energy to electrodes positioned within the stapling head assembly 4300. The stapling head assembly 4300 is positioned at a distal end of the shaft assembly 4200. The anvil 4400 is configured to be removably coupled to the shaft assembly 4200, adjacent to the stapling head assembly 4300. The anvil 4400 and the stapling head assembly 4300 can cooperate to grip tissue, cut tissue, staple tissue, and seal tissue. A knob 4130 at a proximal end of the handle assembly 4100 can be rotated relative to a housing 4110 to provide precise gripping of tissue between the anvil 4400 and the stapling head assembly 4300. When a safety trigger 4140 of the handle assembly 4100 pivots away from a firing trigger 4150 of the handle assembly 4100, the firing trigger 4150 can be actuated to thereby provide cutting, stapling, and sealing of tissue.

[0160] Figure 38A exploded view of the stapling head assembly 4300 is provided. The stapling head assembly 4300 may include a body member 4310 and a slidable staple driver member 4350. The body member 4310 includes a cylindrical inner core member 4312 that extends distally. The body member 4310 is fixedly secured to the outer sheath 4210 of the shaft assembly 4200( Figure 37 ).

[0161] As Figure 38 shown, the stapling head assembly 4300 may further include a trocar 4330 and a circular knife member 4340, which is coaxially positioned within the staple driver member 4350. The knife member 4340 includes a sharp circular cutting edge 4342 that faces distally. The knife member 4340 is sized such that the outer diameter defined by the knife member 4340 is less than the diameter defined by the inner annular array of the staple driver 4352. The knife member 4340 has a cylindrical wall 4360, on which a first electrode 4071 and a second electrode 4073 are positioned. One or more tissue sensors 4077 may also be positioned on the cylindrical wall 4360. Given the teachings herein, other suitable structural relationships between the knife member 4340 and the staple driver member 4350 will be apparent to those of ordinary skill in the art.

[0162] As Figure 38 shown in the enlarged view of the knife member 4340 in Figure 38 , the first electrode 4071 and the second electrode 4073 may be in electrical communication with a first contact 4045 and a second contact 4047, respectively. For example, a flexible circuit 4041 may be in electrical communication with the first contact 4045, the second contact 4047, and a bipolar energy source 4059. Although Figure 39 depicts the first electrode 4071 and the second electrode 4073 generally as a ring around the knife member 4340, the present disclosure is not limited thereto. For example,

[0163] depicts a knife member 5340 having a plurality of laterally spaced electrodes 5071, 5073 that are positioned around its outer surface 5075 in an alternating manner. For example, the electrodes 5071, 5073 may be in communication with a bipolar energy source 5059 through a flexible circuit 5041. In this embodiment, the electrode 5071 is shown as an "active" electrode and is in communication with the bipolar energy source 5059 through a contact 5045. The electrode 5073 is shown as a "passive" electrode and is in communication with the bipolar energy source 5059 through a contact 5047. One or more tissue sensors 5077 may also be positioned on the knife member 4340, which is in communication with a tissue monitoring system 5062.

[0163] In addition, the systems and methods described herein may be used with a variety of different types of blade-bearing medical tools and instruments, Figures 40 - 41Schematically shows some of these non - limiting examples. First, referring to Figure 40 , an electrosurgical scalpel 6000 electrically connected to a bipolar energy source 6059 is shown. The electrosurgical scalpel 6000 can include two electrodes 6071, 6073, which are positioned near a cutting edge 6007 at the distal end. The electrodes 6071, 6073 can be electrically connected to the bipolar energy source 6059 through a flexible circuit 6041 and various other suitable connection techniques. Next, referring to Figure 41 , an electrosurgical scissor 7000 electrically connected to a bipolar energy source 6059 is shown. The electrosurgical scissor 7000 can include two electrodes 7071, 7073, which are positioned near the cutting edge 7007 of the scissor. The electrodes 7071, 7073 can be electrically connected to the bipolar energy source 7059 through a flexible circuit 7041 and various other suitable connection techniques. Additionally, according to the present disclosure, one or more tissue sensors can be incorporated into the electrosurgical scalpel 6000 and / or the electrosurgical scissor 7000.

[0164] Figures 42 - 44 Depicts an electrosurgical stapling and cutting instrument according to various non - limiting embodiments, where Figure 43 shows a cross - sectional view of the end effector, and Figure 44 shows the firing rod. First, referring to Figure 42 , the electrosurgical stapling and cutting instrument 8010 includes a handle portion 8012, which is manipulated to position an implementation portion 8014 including a fastening end effector, and the end effector is depicted as a staple delivery assembly 8016 distally attached to an elongate shaft 8018. The dimensions of the implementation portion 8014 are set for insertion through the cannula of a trocar (not shown) for endoscopic or laparoscopic surgery, where the upper jaw (anvil) 8020 and the lower jaw 8022 of the staple delivery assembly 8016 are closed by depressing a closure trigger 8024 towards a pistol grip 8026 of the handle portion 8012, which advances an outer closure sleeve 8028 of the elongate shaft 8018 to pivotally close the anvil 8020.

[0165] Once inserted into a body cavity or lumen infused with gas, the surgeon can rotate a knob 8030 by twisting a shaft, and the shaft rotates the knob engaging across the distal end of the handle 8012 and the proximal end of the elongate shaft 8018 to rotate the implementation portion 8014 about its longitudinal axis. After being positioned in this way, the closure trigger 8024 can be released to open the anvil 8020 so that tissue can be grasped and positioned. Once satisfied with the tissue held in the staple delivery assembly 8016, the surgeon depresses the closure trigger 8024 until it locks against the pistol grip 8026, thereby clamping the tissue inside the staple delivery assembly 8016.

[0166] Then, the firing trigger 8032 is depressed and pulled towards the closing trigger 8024 and the pistol grip 8026, thereby applying a firing force or movement thereto to advance the firing member distally from the non-fired position. The firing member is depicted as including a proximal firing lever 8034 attached to a distal firing lever 8036, the distal firing lever being supported within a frame base 8038 that connects the handle portion 8012 to the staple delivery assembly 8016. During the staple firing movement, the firing lever 8036 engages an elongate staple channel 8040 and actuates a staple magazine 8042 contained therein, both the elongate staple channel and the staple magazine forming a lower jaw 8022. The firing lever 8036 also engages a closed anvil 8020. After releasing the firing trigger 8032 to apply a retracting force or movement to the firing lever 8036, depressing the closing release button 8044 releases the closing trigger 8024 such that the closing sleeve 8028 can retract to pivot and open the anvil 8020, thereby releasing the cut and stapled tissue from the staple delivery assembly 8016.

[0167] In Figure 43 it, the staple delivery assembly 8016 closes over the compressed tissue 8046. In Figure 43 and 44 it, the firing lever 8036 has a proximal portion 8048 attached to a distal E-beam 8060 that translates within the staple delivery assembly 8016. As depicted, with the firing lever 8036 retracted, the vertical portion 8052 of the E-beam 8060 is substantially located at the rear of the staple magazine 8042, as after a new staple magazine 8042 has been inserted into the elongate staple channel 8040. An upper pin 8054 that laterally extends from an upper portion of the vertical portion 8052 of the E-beam 8060 is initially located within a recessed anvil cavity 8056 near the proximal pivot end of the anvil 8020. As the E-beam 8060 is advanced distally during the staple firing movement, the vertical portion 8052 passes through a narrow longitudinal anvil slot 8058 formed in the staple-forming lower surface 8050 of the anvil 8020, a proximal open vertical slot 8062 formed in the magazine 8042, and a lower longitudinal channel slot 8064 formed in the elongate staple channel 8040.

[0168] The narrow longitudinal anvil slot 8058 communicates upwardly with a laterally widened longitudinal anvil passage 8066 sized to slidably receive the upper pin 8054. The longitudinal channel slot 8064 communicates downwardly with a laterally widened longitudinal channel track 8068 that receives the lower leg 8070 sized to slide therein and attached at the bottom of the vertical portion 8052 of the E-beam 8060. The laterally widened intermediate pin 8072 extending from the vertical portion 8052 of the E-beam 8060 is positioned to slide along the top surface of the bottom tray 8074 of the staple cartridge 8042, which in turn rests on the elongate staple channel 8040. The longitudinal firing recess 8075 formed in the staple cartridge 8042 above the bottom tray 8074 is sized to permit the intermediate pin 8072 to translate through the staple cartridge 8042.

[0169] The distal drive surface 8076 of the vertical portion 8052 of the E-beam 8060 is positioned to translate through the proximal opening vertical slot 8062 of the staple cartridge 8042 and drive distally the wedge slider 8078 proximally positioned in the staple cartridge 8042. The vertical portion 8052 of the E-beam 8060 includes a cutting surface 8080 along the distal edge above the distal drive surface 8076 and below the upper pin 8054 that cuts the tissue 8046 being clamped during stapling.

[0170] The first electrode 8071 and the second electrode 8073 may be positioned on the E-beam 8060. The first electrode 8071 and the second electrode 8073 may be in electrical communication with a bipolar energy source 8059 via the circuitry 8041 and may be activated during distal advancement of the E-beam 8060 through the tissue 8046. Although the first electrode 8071 and the second electrode 8073 are shown positioned only on the first side of the E-beam 8060, the present disclosure is not so limited. Instead, one or more electrodes may be disposed on either side of the E-beam 8060 to cauterize, coagulate / dry, and / or seal the tissue 8046 by heating the tissue 8046 and blood vessels to effect hemostasis. Additionally, one or more tissue sensors 8077 may be positioned on the E-beam 8060 in communication with a tissue monitoring system 8062.

[0171] In various embodiments disclosed herein, a single component may be replaced by multiple components and multiple components may be replaced by a single component to perform a given one or more functions. Such replacements are within the contemplation of the embodiments except where such replacements would not function. For example, staple leg height, staple manufacturing material, anvil cavity depth, anvil cavity shape, and anvil cavity asymmetry may all vary in any combination.

[0172] The foregoing description of the embodiments and examples has been presented for purposes of illustration and description. It is not intended to be exhaustive or limited to the forms described. Many modifications are possible in light of the above teachings. Some of these modifications have been discussed, and others will be understood by those skilled in the art. The embodiments were chosen and described in order to best illustrate the principles of the various embodiments as applied to a particular use contemplated. Of course, the scope is not limited to the examples set forth herein, but may be used in any number of applications and equivalent devices by those of ordinary skill in the art. On the contrary, the scope of the present invention is hereby intended to be defined by the appended claims.

Claims

1. An electrosurgical instrument, the surgical instrument comprising: (a) An end effector, the end effector comprising: (i) An anvil, the anvil including a first end, a second end, and an anvil face capable of being positioned on a first side of an anatomical structure; (ii) A cartridge, the cartridge being operably configured to receive a plurality of staples, the cartridge including a first end, a second end, and a face capable of being positioned on a second side of the anatomical structure; (iii) A blade assembly, the blade assembly including a blade, wherein the blade includes a first side and a second side joined at a cutting edge; (iv) At least one electrode, the at least one electrode being coupled to the blade, wherein the at least one electrode is in electrical communication with an electrosurgical power supply generated by a controller; And (v) At least one tissue sensor, the at least one tissue sensor being coupled to the blade; And (b) A tissue monitoring system, the tissue monitoring system being in electrical communication with the at least one tissue sensor, wherein the at least one tissue sensor provides a feedback signal indicative of a tissue characteristic to the controller, and wherein the controller signals the electrosurgical power supply to adjust an operating parameter of the electrosurgical instrument based on the feedback signal.

2. The electrosurgical instrument according to claim 1, wherein when the blade is advanced from a first position at a distal end of the cartridge to a second position at a proximal end of the cartridge: (a) An incision is formed in the anatomical structure; and (b) The at least one electrode and the at least one tissue sensor contact the anatomical structure and translate along the anatomical structure.

3. The electrosurgical instrument according to claim 1, wherein the controller includes analog or logic circuitry for: (a) Processing the feedback signal received from the at least one tissue sensor; and (b) Determining a signal to be sent to the electrosurgical power supply.

4. The electrosurgical instrument according to claim 1, wherein the circuitry connects the at least one electrode to the electrosurgical power supply and connects the at least one tissue sensor to the tissue monitoring system.

5. The electrosurgical instrument according to claim 1, wherein the feedback signal is related to the tissue temperature of the anatomical structure.

6. The electrosurgical instrument according to claim 5, wherein once the tissue temperature rises above a predetermined threshold, the electrosurgical power supply is terminated.

7. The electrosurgical instrument according to claim 6, wherein the predetermined threshold of the tissue temperature is between 80 - 120 °C.

8. The electrosurgical instrument according to claim 5, wherein if the tissue temperature at a predetermined tissue location of the anatomical structure has not reached a target temperature, the firing speed of the electrosurgical instrument is reduced.

9. The electrosurgical instrument according to claim 8, wherein the target temperature of the predetermined tissue location is between 60 - 100 °C.

10. The electrosurgical instrument according to claim 1, wherein the feedback signal is related to the tissue impedance of the anatomical structure.

11. The electrosurgical instrument according to claim 10, wherein if the tissue impedance at a predetermined tissue location of the anatomical structure has not reached a target impedance of 200 ohms, the electrosurgical power supply is terminated.

12. The electrosurgical instrument according to claim 10, wherein if the tissue impedance rises above a predetermined threshold of 600 ohms, the firing speed of the electrosurgical instrument is slowed down.

13. An electrosurgical instrument for stapling, excising, and sealing a patient's anatomical structure, the surgical instrument comprising: (a) An end effector, the end effector comprising: (i) An anvil, the anvil including a first end, a second end, and an anvil face that can be positioned on a first side of the anatomical structure; (ii) A cartridge, the cartridge being operably configured to receive a plurality of staples, the cartridge including a first end, a second end, and a face that can be positioned on a second side of the anatomical structure; (iii) A blade assembly, the blade assembly including a blade and a beam, wherein the blade includes a first side and a second side joined at a cutting edge; (iv) At least one electrode, the at least one electrode being coupled to the blade, wherein the at least one electrode is in electrical communication with an electrosurgical power supply generated by a controller; And (v) At least one tissue sensor, the at least one tissue sensor being coupled to the blade; And (b) A tissue monitoring system, the tissue monitoring system being in electrical communication with the at least one tissue sensor, wherein when the blade is advanced from a first position at a distal end of the cartridge to a second position at a proximal end of the cartridge, the at least one tissue sensor provides a tissue impedance feedback signal to the controller, and wherein the controller signals the electrosurgical power supply to adjust the firing speed of the electrosurgical instrument based on the tissue impedance feedback signal.

14. The electrosurgical instrument according to claim 13, wherein when the blade is advanced from the first position at the distal end of the cartridge to the second position at the proximal end of the cartridge: (a) An incision is formed in the anatomical structure; and (b) The at least one electrode and the at least one tissue sensor contact the anatomical structure and translate along the anatomical structure.

15. The electrosurgical instrument according to claim 13, wherein the controller includes an analog or logic circuitry for: (a) Processing the feedback signal received from the at least one tissue sensor; and (b) Determining the signal sent to the electrosurgical power supply.

16. The electrosurgical instrument according to claim 13, wherein if the tissue impedance at a predetermined tissue location of the anatomical structure has not reached a target impedance of 200 ohms, the electrosurgical power supply is terminated.

17. The electrosurgical instrument according to claim 13, wherein if the tissue impedance rises above a predetermined threshold of 600 ohms, the firing speed of the electrosurgical instrument is slowed down.

18. The electrosurgical instrument according to claim 13, wherein the at least one tissue sensor further provides a tissue temperature feedback signal to the controller.

19. The electrosurgical instrument according to claim 18, wherein if the tissue temperature at a predetermined tissue location of the anatomical structure has not reached a target temperature between 60-100 °C, the firing speed of the electrosurgical instrument is slowed down.

20. The electrosurgical instrument according to claim 18, wherein once the tissue temperature rises above a predetermined threshold between 80-120 °C, the electrosurgical power supply is terminated.

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