Techniques for power delivery for energy-based surgical instruments

Abstract

A system includes an energy-based surgical instrument having an end effector with two electrodes. One of the electrodes has multiple electrode portions. A generator coupled to the surgical instrument supplies radio frequency (RF) energy to the electrode portions for a tissue coagulation process, and further supplies RF energy at a higher voltage or current to the other electrode portion for a tissue transection process. Control elements monitor tissue impedance or tissue temperature. Other embodiments are described and claimed in this invention.

Description

Cross-references to related applications

[0001] This application claims the benefit and priority of U.S. Patent Application No. 63 / 740,950, filed on December 31, 2024, entitled “TECHNOLOGIES FOR OPTIMIZEDPOWER DELIVERY FOR ENERGY-BASED SURGICAL INSTRUMENTS”, the entire contents of which are incorporated herein by reference. Technical Field

[0002] This disclosure relates generally to energy-based surgical instruments, and more specifically to harmonic and / or electrosurgical instruments. Background Technology

[0003] Energy-based surgical instruments are increasingly used in surgical procedures due to their unique performance characteristics. Depending on the specific device configuration and operating parameters, energy-based surgical instruments can provide both transverse incisions of tissue and tissue hemostasis through coagulation, which can reduce or otherwise minimize patient trauma. Depending on the specific application, energy-based surgical instruments can utilize various surgical techniques, including, for example, ultrasound and / or electrosurgery (e.g., radiofrequency (RF)).

[0004] Typical ultrasonic surgical instruments may include a handheld component comprising an ultrasonic transducer and a slender shaft assembly with a distally mounted end effector for cutting and sealing tissue. For example, the end effector may include a jaw assembly with an ultrasonic scalpel and a gripping arm, the gripping arm including a non-adhesive tissue pad or similar base to receive the ultrasonic scalpel. In some cases, the slender shaft assembly may be permanently attached to the handheld component. In other cases, such as in the presence of disposable shaft assemblies or shaft assemblies interchangeable between different handheld components, the slender shaft assembly may be detached from the handheld component. In use, the end effector transmits ultrasonic energy to the tissue in contact with the ultrasonic scalpel of the end effector to achieve cutting and sealing actions. Such ultrasonic surgical devices can be configured for open surgical purposes, laparoscopic and / or endoscopic surgical procedures, including robot-assisted procedures.

[0005] Ultrasonic energy uses temperatures lower than those used in electrosurgical procedures to cut and coagulate tissue. Through high-frequency vibrations (e.g., 55,500 times per second), the ultrasonic scalpel denatures proteins in the tissue to form a viscous coagulate. The pressure applied to the tissue by the surface of the ultrasonic scalpel causes blood vessels to collapse and the coagulate to form a hemostatic seal. The surgeon can control the cutting speed and coagulation by the force applied to the tissue by the end effector, the duration of that force application, and the selected offset level of the end effector.

[0006] In electrosurgical instruments, one or more electrodes are incorporated into an end effector and configured to apply a therapeutic current to the patient's tissue to form a hemostatic seal. In electrosurgical instruments that do not include harmonic modes (i.e., do not include a harmonic scalpel), the end effector may be embodied as two gripping arms or jaws. In such embodiments, the electrosurgical instrument may include a separate mechanical blade or scalpel for cutting tissue after the hemostatic seal has been formed, which may be incorporated into an elongated shaft attached to the end effector. In bipolar embodiments, an active electrode may be attached to one of the gripping arms of the end effector and configured to introduce current into the tissue, which is received by a return electrode attached to the other gripping arm of the end effector (or, in embodiments including harmonic modes, as the scalpel itself). Conversely, in unipolar embodiments, the return electrode (e.g., a "grounding pad") may be separate from the electrosurgical instrument and located on a different part of the patient's body. In some embodiments, the electrosurgical instrument may also be configured to apply a subtherapeutic current to the patient's tissue, which may be used for sensing purposes (e.g., measuring tissue impedance).

[0007] Electrosurgery creates a hemostatic seal by generating heat in the tissue via introduced electrical energy, which is embodied in radio frequency (“RF”) energy. The specific frequency used can vary from about 100 kHz to 1 MHz depending on the intended use of the electrosurgical instrument, but higher frequencies may be used in some implementations. Additionally, in some cases, sub-therapeutic frequencies may be used for purposes other than hemostatic sealing, such as performing various electrical measurements on the tissue.

[0008] It should be understood that some energy-based surgical instruments can employ dual-mode or multi-mode techniques to perform transverse incisions and / or hemostasis of patient tissue. For example, in some cases, energy-based surgical instruments may include both ultrasound and electrosurgical functions (e.g., by utilizing an ultrasonic scalpel as an electrode for the electrosurgical mode), which increases the surgical options offered to the surgeon by the surgical instrument. Summary of the Invention

[0009] According to one aspect of this disclosure, a system includes an energy-based surgical instrument and a generator coupled to the energy-based surgical instrument. The energy-based surgical instrument includes an end effector having a first electrode and a second electrode, wherein the first electrode includes a first electrode portion and a second electrode portion. The generator is configured to supply first radio frequency (RF) energy to the first electrode portion for a tissue coagulation process and to supply second RF energy to the second electrode portion for a tissue transecting process, wherein the second RF energy has a higher voltage or current than the first RF energy.

[0010] In some embodiments, the generator is configured to supply a second RF energy when the tissue impedance reaches a predetermined impedance range. In some embodiments, the predetermined impedance range includes 100 ohms to 160 ohms. In some embodiments, the predetermined impedance range includes 140 ohms to 160 ohms.

[0011] In some embodiments, the generator is configured to supply a second RF energy when the tissue temperature reaches a predetermined temperature range. In some embodiments, the predetermined temperature range includes 80°C to 160°C. In some embodiments, the predetermined temperature range includes 120°C to 140°C.

[0012] In some implementations, the generator is configured to supply a second RF energy after supplying a first RF energy.

[0013] In some embodiments, the system further includes an insulating coating coupled to the first electrode, wherein the insulating coating increases the energy density in the cutting region of the surgical instrument. In some embodiments, the insulating coating comprises polytetrafluoroethylene (PTFE).

[0014] In some embodiments, the end effector further includes a spring-biased portion coupled to the first electrode. The spring-biased portion is capable of providing a higher pressure at the second electrode portion compared to the first electrode portion. In some embodiments, the spring-biased portion also includes a movable portion to maintain a minimum predetermined cutting pressure.

[0015] According to another aspect, a method for controlling a surgical instrument includes: energizing a first electrode portion of a first electrode of an end effector of the surgical instrument with first radio frequency (RF) energy from a generator coupled to the surgical instrument for a tissue coagulation process; and energizing a second electrode portion of the first electrode with second RF energy from the generator for a tissue transecting process, wherein the second RF energy has a higher voltage or a higher current than the first RF energy.

[0016] In some embodiments, the method further includes monitoring tissue impedance by a control element of the surgical instrument. Energizing the second electrode portion with the second RF energy includes energizing the second electrode portion with the second RF energy when the tissue impedance reaches a predetermined impedance range. In some embodiments, the predetermined impedance range includes 100 ohms to 160 ohms. In some embodiments, the predetermined impedance range includes 140 ohms to 160 ohms.

[0017] In some embodiments, the method further includes monitoring tissue temperature by a control element of the surgical instrument. Energizing the second electrode portion with second RF energy includes energizing the second electrode portion with second RF energy when the tissue temperature reaches a predetermined temperature range. In some embodiments, the predetermined temperature range includes 80°C to 160°C. In some embodiments, the predetermined temperature range includes 120°C to 140°C.

[0018] In some implementations, energizing the second electrode portion includes energizing the second electrode portion after energizing the first electrode portion. Attached Figure Description

[0019] The specific implementation method refers to the following figures, in which: The specific implementation method refers to the following figures, in which: Figure 1 This is a simplified diagram of the implementation scheme for a system used to perform energy-based surgical procedures; Figure 2 yes Figure 1 A perspective view of an implementation scheme for an energy-based surgical instrument system; Figure 3 It includes an ultrasonic scalpel and is in the open position. Figure 2 A side front view of the jaw assembly of the end effector of a surgical instrument; Figure 4 It includes an ultrasonic scalpel and is in a closed state. Figure 2 A side front view of the jaw assembly of the end effector of a surgical instrument; Figure 5A yes Figure 2 A perspective view of another embodiment of an end effector for a surgical instrument, the end effector including electrodes on the lower jaw gripper of a jaw assembly; Figure 5B yes Figure 2 A perspective view of another embodiment of an end effector for a surgical instrument, the end effector comprising two jaw grippers, each jaw gripper having an electrode attached thereto; Figure 6 yes Figure 2 Exploded view of surgical instruments; Figure 7 yes Figure 2 A block diagram of the control circuit for a surgical instrument; Figure 8 yes Figure 2 A perspective view of another embodiment of an end effector for a surgical instrument, the end effector including electrodes attached thereto having a plurality of controllable portions; and Figure 9 It is used for control Figure 8A simplified flowchart of at least one method of using surgical instruments. Detailed Implementation

[0020] While the concepts of this disclosure are readily available in various modifications and alternatives, specific exemplary embodiments thereof have been shown by way of example in the accompanying drawings and will be described in detail herein. However, it should be understood that this disclosure is not intended to limit the concepts to the specific forms disclosed, but rather, the object of the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.

[0021] Throughout this specification, when referring to the surgical instruments described herein and the natural anatomical structures of patients, terms indicating anatomical reference, such as anterior, posterior, medial, lateral, superior, inferior, distal, proximal, etc., may be used. These terms have well-known meanings in anatomical studies and surgery. Unless otherwise stated, these anatomical reference terms used in the written details and claims are intended to be consistent with their well-known meanings.

[0022] References to "an embodiment," "an embodiment," "an exemplary embodiment," etc., in this specification mean that the embodiment may include a particular feature, structure, or characteristic, but each embodiment may or may not include that particular feature, structure, or characteristic. Furthermore, these phrases do not necessarily refer to the same embodiment. Additionally, when a particular feature, structure, or characteristic is described in connection with an embodiment, whether or not it is explicitly described, it should be assumed that implementing such a particular feature, structure, or characteristic in combination with other embodiments is within the knowledge of a person skilled in the art. Furthermore, it should be understood that items included in a list in the form of "at least one of A, B, and C" may mean (A); (B); (C); (A and B); (A and C); (B and C); or (A, B, and C). Similarly, items listed in the form of "at least one of A, B, or C" may mean (A); (B); (C); (A and B); (A and C); (B and C); or (A, B, and C).

[0023] In some cases, the disclosed embodiments may be implemented in hardware, firmware, software, or any combination thereof. The disclosed embodiments may also be implemented as instructions carried or stored on a transient or non-transitory machine-readable (e.g., computer-readable) storage medium, which may be read and executed by one or more processors. The machine-readable storage medium may be embodied in any storage device, mechanism, or other physical structure (e.g., volatile or non-volatile memory, media disk, or other media device) for storing or transmitting information in a machine-readable form.

[0024] In the accompanying drawings, some structural or methodological features may be shown in a specific arrangement and / or order. However, it should be understood that such a specific arrangement and / or order may not be necessary. Instead, in some embodiments, such features may be arranged in a different manner and / or order than those shown in the illustrative drawings. Furthermore, the inclusion of structural or methodological features in a particular drawing does not imply that such features are necessary in all embodiments, and in some embodiments, these features may be omitted or may be combined with other features.

[0025] See now Figure 1 and Figure 2 In an exemplary embodiment, system 100 for performing energy-based surgical procedures includes a surgical instrument 102, a transducer 104, and a generator 106. The surgical instrument 102 is exemplarily embodied as an ultrasound surgical instrument, but in other embodiments may be embodied as an electrosurgical surgical instrument or a multimodal ultrasound / electrosurgical surgical instrument. In use, the surgical instrument 102 can be used to perform various surgical procedures, including laparoscopic, endoscopic, or conventional open surgical procedures. In doing so, the surgeon may selectively activate an ultrasound mode (and / or an electrosurgical / RF mode) of the surgical instrument 102. In ultrasound mode, the generator 106 drives the transducer 104 to cause the ultrasonic scalpel 130 of the jaw assembly 122 of the end effector 120 of the surgical instrument 102 to vibrate at a reference frequency, which facilitates simultaneous cutting of patient tissue and hemostatic sealing. Additionally or alternatively, in some embodiments, the surgeon may selectively activate an electrosurgical mode of the surgical instrument 102 to deliver a therapeutic RF energy to the patient tissue to achieve hemostatic sealing. In such embodiments, the blade 130 may be embodied as an ultrasonic blade 130 or a mechanical blade designed to use mechanical force to cut tissue (e.g., in those embodiments that do not employ ultrasonic technology). Furthermore, in some embodiments, the surgical instrument 102 may be configured to have only an electrosurgical / RF mode, and in such embodiments, the jaw assembly 122 of the end effector 120 may not include the ultrasonic blade 130, as described below. Figure 5B To be discussed in more detail.

[0026] Surgical instrument 102 is illustratively embodied as ultrasonic surgical scissors, but in other embodiments may be embodied as other types of surgical instruments having an ultrasonic mode and / or an electrosurgical mode. In an illustrative embodiment, surgical instrument 102 includes a handle assembly 110 and an elongated shaft assembly 112 extending distally away from the handle assembly 110 and, in some embodiments, removably attached to the handle assembly 110. The elongated shaft assembly 112 includes an end effector 120 located at a distal end remote from the handle assembly 110. The end effector 120 includes a jaw assembly 122, which illustratively includes an ultrasonic scalpel 130 and a corresponding jaw clamp 132 (but in those embodiments having only an electrosurgical / RF mode, two jaw clamps may be included). Figure 3 and Figure 4 As shown, the jaw assembly 122 can be in the open state ( Figure 3 ) and closed state ( Figure 4 The jaw assembly 122 moves between the open and closed states. In the open state, the jaw clamp 132 is positioned away from the ultrasonic scalpel 130, and in the closed state, the jaw clamp 132 is positioned near or otherwise in contact with the ultrasonic scalpel 130. Actuation of the jaw assembly 122 from the open to the closed state allows for grasping, cutting, and coagulating blood vessels and / or tissues. It should be understood that the open state may correspond to a degree of opening less than the fully open position of the jaw assembly 122, and the closed state may correspond to a degree of closure less than the fully closed position. That is, the closed state may, for example, correspond to the minimum distance between the distal end of the jaw clamp 132 and the ultrasonic scalpel 130, and the open state may correspond to the maximum distance between the distal end of the jaw clamp 132 and the ultrasonic scalpel 130. However, in other embodiments, the open state may correspond to the fully open position of the jaw assembly 122, and the closed state may correspond to the fully closed position of the jaw assembly 122.

[0027] In those embodiments where the surgical instrument 102 includes both ultrasound mode and electrosurgical / RF mode, the end effector 120 may include one or more RF electrodes 500 coupled to the jaw clamp 132, such as Figure 5A As shown. Although in Figure 5AIn some embodiments, the exemplary end effector 120 includes only a single electrode 500, but it should be understood that in other embodiments, the end effector 120 may include additional electrodes 500 (e.g., multiple electrode pads 500). Electrode 500 may be embodied as an active electrode configured to deliver RF energy or a return electrode configured to “absorb” the applied RF energy. In those embodiments utilizing bipolar RF, the ultrasonic scalpel 130 may embody an active electrode or a return electrode, wherein electrode 500 embodies another active electrode or return electrode. Alternatively, other active electrodes or return electrodes may be incorporated into the ultrasonic scalpel 130 or into another portion of the jaw assembly 122 of the end effector 120. In monopolar embodiments, the RF electrode 500 may be embodied as an active electrode, and the return electrode may be attached to a portion of the patient's body.

[0028] In those embodiments where the surgical instrument 102 includes only the electrosurgical / RF mode, the jaw assembly 122 of the end effector 120 includes a jaw clamping member 532, which replaces the ultrasonic scalpel 130, such as Figure 5B As shown. In such embodiments, electrode 500 may be attached to or otherwise incorporated into each jaw clamp 132, 532 and embodied as an active electrode or a return electrode to facilitate the application of RF energy to tissue captured between jaw clamps 132, 532. In such embodiments, surgical instrument 102 may include a blade incorporated into an elongated shaft assembly 112, the blade being configured to eject outward after the tissue has been sealed with RF energy to cut the patient's tissue.

[0029] See again Figure 1 and Figure 2 In embodiments that include ultrasound capability, the handle assembly 110 includes a receiver 140 configured to receive a transducer 104 to facilitate connection of the transducer 104 to the handle assembly 110 and the elongated shaft assembly 112. The handle assembly 110 also includes a trigger assembly 150 comprising a master trigger 152 and a switch assembly 154. The master trigger 152 is operable by a surgeon to move the jaw assembly 122 of the end effector 120 between an open and closed state. The switch assembly 154 includes one or more buttons operable by a surgeon to activate (and in some embodiments, configure) an ultrasound mode and / or an electrosurgical mode of the surgical instrument 102.

[0030] Transducer 104 is illustratively connected to generator 106 via cable assembly 108. As described above, generator 106 is configured to drive transducer 104 at a reference frequency or resonant frequency, thereby causing ultrasonic scalpel 130 to vibrate. For example, in one exemplary embodiment, generator 106 may supply an electrical signal to transducer 104 to cause ultrasonic scalpel 130 of jaw assembly 122 to vibrate longitudinally in, for example, a range of approximately 20 kHz to 250 kHz. In a specific embodiment, for example, ultrasonic scalpel 130 may vibrate in a range of approximately 54 kHz to 56 kHz (e.g., at approximately 55.5 kHz). In other embodiments, ultrasonic scalpel 130 may vibrate at other frequencies, including, for example, approximately 31 kHz or approximately 80 kHz. The vibration offset of ultrasonic scalpel 130 can be controlled, for example, by controlling the amplitude of the electrical signal applied to transducer 104 by generator 106. Generator 106 may be activated such that electrical energy can be supplied to transducer 104 continuously or intermittently. The generator 106 also has a power cord (not shown) for plugging into an electrosurgical unit or a conventional power outlet. Alternatively, the generator 106 can be powered by a direct current (DC) source such as a battery.

[0031] In some embodiments, generator 106 may be configured to operate in different modes. In such embodiments, generator 106 may include an ultrasound generator module 162 for controlling an ultrasound mode, an electrosurgical / radiofrequency (RF) generator module 164 for controlling an electrosurgical mode, and / or other generator modules (e.g., a thermal generator module) for controlling other operating modes. In some embodiments, the various modes of generator 106 may operate independently of each other. For example, generator 106 may activate the ultrasound mode of ultrasound generator module 162 to apply ultrasound energy to jaw assembly 122, and subsequently, therapeutic or subtherapeutic RF energy may be applied to jaw assembly 122 via electrosurgical generator module 164. Alternatively, the activation modes of generator 106 may operate simultaneously or concurrently with each other.

[0032] In electrosurgical mode, the electrosurgical generator module 164 is configured to generate RF energy at frequencies ranging from approximately 100 kHz (100 kHz) to approximately 1 MHz (1 MHz). The generated RF energy is supplied to the patient's tissue via electrodes 500 of the end effector 120, as described above with respect to Figure 5. In some embodiments, the electrosurgical generator module 164 may also be configured to selectively provide subtherapeutic levels of RF energy to perform various electrical measurements of the patient's tissue. For example, the electrosurgical generator module 164 may be configured to measure the impedance of the patient's tissue using electrodes 500 and an appropriate level of RF energy.

[0033] See now Figure 6As described above, the exemplary surgical instrument 102 includes a handle assembly 110 and an elongated shaft assembly 112 extending distally away from the handle assembly 110. The handle assembly 110 includes a housing 600, which includes a right half-housing 602 and a left half-housing 604. The half-housings 602 and 604 are configured to mate with each other to form the housing 600. To facilitate such mating, each of the half-housings 602 and 604 may include various interfaces sized to be mechanically aligned and engaged with each other to form the housing 600 and enclose the internal working parts of the surgical instrument 102.

[0034] The main trigger 152 of the trigger assembly 150 is coupled to a linkage mechanism to convert the rotational motion of the main trigger 152 into axial motion of the bracket 610, which is then configured to move the jaw assembly 122 of the end effector 120 between an open and closed state via the elongated shaft assembly 112. The main trigger 152 includes a first set of flanges 620 having openings formed therein to receive a first bracket pin 630 extending through the bracket 610. The main trigger 152 also includes a second set of flanges 622 configured to receive a first end portion of the connector 624. A trigger pin 626 is received within the openings formed in the first end portion and the second set of flanges 622 of the connector 624. The trigger pin 626 forms a trigger pivot point for the main trigger 152. The second end portion of the connector 624, opposite the first end portion, is received within a slot formed in the proximal end portion of the bracket 610 and retained therein by the second bracket pin 632. As the master trigger 152 rotates about the pivot point formed by the trigger pin 626, the carriage 610 translates horizontally. The spring 634 is used to bias the carriage forward, such that the jaw assembly 122 of the end effector 120 is biased to the open (or fully open) state.

[0035] As described above, the trigger assembly 150 also includes a switch assembly 154. The switch assembly 154 illustratively includes a toggle switch 640 selectable to activate one or more switches 642. Activation of switch 642 energizes an electrical element 644, which energizes the ultrasonic transducer 104 to induce an ultrasonic mode of the surgical instrument 102.

[0036] The elongated shaft assembly 112 includes an outer tubular sheath 650 and a knob 652 coupled to the outer tubular sheath 650. The knob 652 is operable to rotate the outer tubular sheath 650 about an axis defined by the outer tubular sheath 650. A reciprocating tubular actuator 654 is located within the outer tubular sheath 650 and is mechanically engaged at its distal end with an end effector 120. The reciprocating tubular actuator 654 is also mechanically engaged at its proximal end with a bracket 610 within the shank assembly 110 via a coupling element 656. In an embodiment including an ultrasonic mode, an ultrasonic waveguide 670 is located within the reciprocating tubular actuator 654. The distal end of the ultrasonic waveguide 670 is acoustically coupled (e.g., directly or indirectly mechanically coupled) to an ultrasonic scalpel 130, and the proximal end is acoustically coupled to a transducer 104. The ultrasonic waveguide 670 is isolated from the other components of the elongated shaft assembly 112 by a protective sheath 672 and multiple isolation elements 674. The outer tubular sheath 650, the reciprocating tubular actuator 654, and the ultrasonic waveguide 670 are mechanically engaged together via pins 658.

[0037] See now Figure 7 In an exemplary embodiment, the surgical instrument 102 includes control circuitry 700. Control circuitry 700 includes a controller 702 and a trigger assembly 150, which cooperate to provide ultrasonic energy to the harmonic scalpel 130 of the jaw assembly 122 of the end effector 120 and / or to the RF electrode 500 of the jaw assembly 122, according to the operating modes of the surgical instrument 102 as described above. However, in other embodiments, control circuitry 700 may include additional or other electronic devices and / or circuitry.

[0038] Controller 702 may be embodied as any type of controller, function block, digital logic or other component, device, circuit or combination thereof capable of performing the functions described herein. In an exemplary embodiment, controller 702 includes processor 704, memory 706 and input / output (I / O) subsystem 708. Processor 704 may be embodied as any type of processor capable of performing the functions described herein. For example, processor 704 may be embodied as a single-core or multi-core processor, digital signal processor, microcontroller or other processor or processing / control circuitry. Similarly, memory 706 may be embodied as any type of volatile and / or non-volatile memory or data storage device capable of performing the functions described herein. In operation, memory 706 may store various data and software used during the operation of control circuitry 700, such as executable firmware or software, programs, libraries and drivers that may be executed by processor 704 or otherwise used.

[0039] Processor 704 and memory 706 are communicatively coupled to other components of control circuitry 700 via I / O subsystem 708, which may be embodied as circuitry and / or components to facilitate input / output operations between controller 702 (e.g., processor 704 and / or memory 706) and other components of control circuitry 700. For example, I / O subsystem 708 may be embodied as or otherwise include a memory controller hub, input / output control hub, firmware devices, communication links (i.e., point-to-point links, bus links, wires, cables, optical fibers, printed circuit board traces, etc.) and / or other components and subsystems facilitating input / output operations. In some embodiments, I / O subsystem 708 may form part of a system-on-a-chip (SoC) and be integrated onto a single integrated circuit chip along with processor 704, memory 706, and other components of surgical instrument 102. Additionally, in some embodiments, memory 706 or a portion thereof may be integrated into processor 704.

[0040] During operation, as described above, the controller 702 is configured to control the activation of the ultrasound mode and / or electrosurgical / RF mode of the surgical instrument 102. For this purpose, the controller 702 can monitor the activation of the main trigger 152 and / or one or more activation switches 154 of the trigger assembly 150. In response to the activation of the appropriate trigger 152 or switch 154, the controller 702 controls the transducer 104 to generate ultrasound energy, which is propagated to the harmonic scalpel 130 via the ultrasonic waveguide 670. Additionally or alternatively, in response to the activation of the corresponding switch 154 of the trigger assembly 150, the controller 702 can be configured to supply a certain amount of RF energy to the RF electrode 500 via the interconnect 710 through the electrosurgical generator module 164. It should be understood that although the transducer 104 and generator 106 are in... Figure 1 and Figure 7 The transducer 104 is shown as a separate component from the energy-based surgical instrument 102, but in other embodiments, the transducer 104 and / or generator 106 may be incorporated into the surgical instrument 102.

[0041] See now Figure 8 In another exemplary embodiment, the end effector 120 for a surgical instrument includes a jaw assembly 122, which includes electrodes 500 attached to each of the jaw grippers 132, 532, similar to... Figure 5B The end effector 120 shown and described above. In Figure 8 In the exemplary end effector 120 shown, the electrode 500 attached to the jaw clamp 132 includes a plurality of portions 800, 802, which are surrounded by and / or embedded in a non-conductive tissue pad 804.

[0042] During the cutting operation or in the cutting area of ​​the electrodes, each of the electrode portions 800, 802 may be supplied with a separate amount or waveform of energy. This separate bipolar energy may have a higher voltage or current than the energy supplied to the main solidification portion of the electrode group 500. Of course, different numbers and / or arrangements of electrode portions 800, 802 may be used in other embodiments.

[0043] Alternatively, each individual electrode 500 may have an insulating coating on a portion of the electrode 500, which will further concentrate the energy density within the cutting area into a more constrained form. For example, a portion of the cutting electrode 500 may be coated with a thick layer of polytetrafluoroethylene (PTFE), thereby creating a finer focusing area for delivering energy to the tissue, while further creating a suppressed adhesion portion of the electrode 500 retainer, which minimizes the accumulation of charred material or debris.

[0044] Alternatively, the cutting electrode may have a geometry integral with the conductive portion, which creates a small, thin energy focusing region relative to the rest of the cutting electrode. The portion of the geometry outside this thin focusing region may have an insulating coating to further minimize the energy density area and also prevent tissue buildup.

[0045] See now Figure 9 This illustrates a method 900 for controlling an energy-based surgical instrument 102. Method 900 may be performed by a controller 702, a generator 106, and / or one or more other microcontrollers or other control elements of the system 100. Method 900 begins at block 902, where the control element determines whether to energize a cutting portion of the electrode 500 of the surgical instrument 102. The cutting portion may be implemented as described above. Figure 8 The central portion 800 of the electrode 500 shown, or another electrode portion located in the cutting region. The cutting electrode portion may be energized, for example, as part of the main solidification cycle (e.g., after the start of the solidification cycle but before the end of the cycle), or the cutting electrode portion may be energized after the solidification cycle is completed.

[0046] In some embodiments, in block 904, the control element may monitor tissue impedance to determine whether to energize the cutting electrode portion. For example, if the cutting operation is completed as part of a main coagulation cycle, the energization of the individual electrode portion may be activated based on tissue impedance, such as when the measured tissue impedance is between 100 Ω and 160 Ω, or, as another example, when the measured tissue impedance is between 140 Ω and 160 Ω. In some embodiments, in block 906, the control element may monitor temperature (e.g., tissue temperature or instrument temperature) to determine whether to energize the cutting electrode portion. For example, if the cutting operation is completed as part of a main coagulation cycle, the energization of the individual electrode portion may be activated based on temperature (e.g., tissue temperature or instrument temperature), such as when the measured temperature is between 80°C and 160°C, or, as another example, when the measured temperature is between 120°C and 140°C. In some embodiments, in block 908, the control element may monitor the coagulation process in other ways. For example, when the solidification cycle is complete, the control element can energize the cutting section, which can be determined based on the actual time elapsed, changes in the operating mode, or other indications of the solidification process.

[0047] In block 910, the control element checks whether the cutting electrode portion is energized. If not, the method loops back to block 902 to continue determining whether the cutting electrode portion is energized. If yes, method 900 proceeds to block 912. In block 912, the control element energizes the cutting portion of the electrode. As described above, the cutting electrode portion can be energized with a separate bipolar energy, which can have a higher voltage or current than the energy supplied to the main solidification portion of the electrode group 500. This higher cutting energy can be further focused or concentrated through one or more insulating coatings or other non-conductive features. After energizing the cutting electrode portion, method 900 loops back to block 902 to continue determining whether the cutting electrode portion is energized.

[0048] In addition or alternatively, in some embodiments, the end effector 120 may include a pressure control system, such as a spring-biased support, which can be positioned at... Figure 8 Below part or all of the electrode portions 800, 802 and / or tissue pad 804 shown. Therefore, in those embodiments, the support surface for concentrating the cutting energy density region has a spring-biased portion that provides increased pressure over the remainder of the coagulation electrode region. Additionally, the support surface may also have deflectable, deformable, or movable portions, ensuring a higher pressure region without preventing variations in the remaining portion of the electrode gap due to differences in tissue thickness within the cutting portion. When the tissue softens, thins, or is damaged, the spring bias returns the support to a position closer to the cutting electrode to maintain a minimum predetermined cutting pressure.

[0049] Although the present disclosure has been illustrated and described in detail in the accompanying drawings and the foregoing description, such illustrations and descriptions should be regarded as exemplary rather than restrictive in nature, and it should be understood that only exemplary embodiments are shown and described, and all changes and modifications made within the substance of the present disclosure should be protected.

[0050] The methods, apparatus, and systems described herein possess numerous advantages due to their various features. It should be noted that alternative embodiments of the methods, apparatus, and systems of this disclosure may exclude all described features, but may still benefit from at least some of the advantages of such features. Those skilled in the art will readily conceive of their own implementations of the methods, apparatus, and systems described above, which may incorporate one or more features of the invention and fall within the spirit and scope of this disclosure as defined by the appended claims.

Claims

1. A system comprising: An energy-based surgical instrument, the energy-based surgical instrument comprising an end effector having a first electrode and a second electrode, wherein the first electrode includes a first electrode portion and a second electrode portion; and A generator coupled to the energy-based surgical instrument, wherein the generator is configured to supply a first radio frequency (RF) energy to the first electrode portion for a tissue coagulation process and to supply a second RF energy to the second electrode portion for a tissue transecting process, wherein the second RF energy has a higher voltage or a higher current than the first RF energy.

2. The system according to claim 1, wherein, The generator is configured to supply the second RF energy when the tissue impedance reaches a predetermined impedance range.

3. The system according to claim 2, wherein, The predetermined impedance range includes 100 ohms to 160 ohms.

4. The system according to claim 2, wherein, The predetermined impedance range includes 140 ohms to 160 ohms.

5. The system according to claim 1, wherein, The generator is configured to supply the second RF energy when the tissue temperature reaches a predetermined temperature range.

6. The system according to claim 5, wherein, The predetermined temperature range includes 80°C to 160°C.

7. The system according to claim 5, wherein, The predetermined temperature range includes 120°C to 140°C.

8. The system according to claim 1, wherein, The generator is configured to supply the second RF energy after supplying the first RF energy.

9. The system of claim 1, further comprising an insulating coating coupled to the first electrode, wherein, The insulating coating increases the energy density in the cutting area of ​​the surgical instrument.

10. The system according to claim 9, wherein, The insulating coating contains polytetrafluoroethylene (PTFE).

11. The system according to claim 1, wherein, The end effector further includes a spring-biased portion coupled to the first electrode, wherein the spring-biased portion is capable of providing a higher pressure at the second electrode portion compared to the first electrode portion.

12. The system according to claim 11, wherein, The spring biasing portion also includes a movable portion to maintain a minimum predetermined cutting pressure.

13. A method for controlling a surgical instrument, the method comprising: A generator connected to the surgical instrument energizes a first electrode portion of a first electrode of a first electrode of an end effector of the surgical instrument with first radio frequency (RF) energy for a tissue coagulation process. as well as The second electrode portion of the first electrode is energized by the generator with second RF energy for use in tissue transecting processes, wherein the second RF energy has a higher voltage or a higher current than the first RF energy.

14. The method according to claim 13, further comprising: Tissue impedance is monitored by the control elements of the surgical instrument; The second RF energy is used to energize the second electrode portion, which includes energizing the second electrode portion with the second RF energy when the tissue impedance reaches a predetermined impedance range.

15. The method according to claim 14, wherein, The predetermined impedance range includes 100 ohms to 160 ohms.

16. The method of claim 14, wherein, The predetermined impedance range includes 140 ohms to 160 ohms.

17. The method according to claim 13, further comprising: Tissue temperature is monitored by the control elements of the surgical instrument; The second electrode portion is energized with the second RF energy when the tissue temperature reaches a predetermined temperature range.

18. The method according to claim 17, wherein, The predetermined temperature range includes 80°C to 160°C.

19. The method of claim 17, wherein, The predetermined temperature range includes 120°C to 140°C.

20. The method according to claim 13, wherein, Energizing the second electrode portion includes energizing the second electrode portion after energizing the first electrode portion.

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