Electrosurgical instruments and methods of using same

Abstract

The embodiment includes an end effector including an anvil including a first end, a second end, and an anvil face positionable on a first side of the anatomical structure, and a cartridge operatively configured to house a plurality of staples and including a first end, a second end, and a cartridge face positionable on the second side of the anatomical structure. The end effector includes a blade assembly including a blade, a beam, and a nut, the blade including a first side and a second side joined at a cutting edge. The end effector includes first and second electrodes coupled to the first side of the blade, and an electrosurgical generating source in electrical communication with the first and second electrodes.

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Patent Application No. 63 / 335,955, filed April 28, 2022, and U.S. Patent Application No. 63 / 340,505, filed May 11, 2022, each of which is incorporated by reference in its entirety herein.

[0002] FIELD OF THE DISCLOSURE Embodiments of the present technology relate generally to electrosurgical techniques and, more particularly, to end effector and stapling devices and methods of using these devices in surgical procedures. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] U.S. Pat. No. 9,936,953 Summary of the Invention [Means for solving the problem]

[0004] The embodiments include an end effector for use by a surgeon to staple a patient's anatomical structure, the end effector including a first jaw having an anvil having a first end, a second end, a longitudinal axis, and an anvil face; a second jaw having a cartridge operatively configured to receive a plurality of staples and having a cartridge face; a first coupling coupling the first end of the first jaw to the first end of the second jaw; and a second coupling movably coupling 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 for retaining at least one lateral arm of the blade. In certain embodiments, the blade is translated from a first position at a distal end of the end effector to a second position at a proximal end of the end effector such that the anatomical structure is resected. Certain embodiments include multiple electrodes coupled to one side of the blade such that the multiple electrodes contact the anatomical structures during resection and achieve hemostasis by heating the tissue and blood vessels to cauterize, coagulate / dehydrate, and / or seal the tissue on this side of the blade.

[0005] In certain embodiments, the first end of the first jaw is a distal end of the first jaw and the second end of the first jaw is a proximal end of the first jaw. In certain embodiments, the first coupling includes a pin having a pin axis that is transverse to a longitudinal axis of the first jaw and a longitudinal axis of the second jaw, the pin pivotally coupling the first end of the first jaw to the first end of the second jaw. In certain embodiments, the second coupling includes a slot defined by the first jaw or the second jaw that holds a rigid link such that the rigid link is slidable within the slot. In certain embodiments, the slot has a length of 3 millimeters to 8 millimeters. Certain embodiments include a plurality of staples at least partially held by the cartridge of the second jaw. In certain embodiments, the plurality of staples at least partially held by the cartridge are positioned between the first coupling and the second coupling. Certain embodiments include a blade having a cutting surface, at least one lateral arm, and first and second electrodes coupled to one side of the blade. In certain embodiments, the first and second electrodes are in electrical communication with an electrosurgical power generating source, such as a bipolar energy source. Certain embodiments include a channel defined by the first jaw or the second jaw for holding the at least one lateral arm of the blade. In certain embodiments, the blade is transitioned from a first position at a distal end of the end effector to a second position at a proximal end of the end effector such that the anatomical structure is resected. In certain embodiments, energy to achieve hemostasis of the anatomical structure during resection is delivered by the first and second electrodes, the first electrode being an active electrode and the second electrode being a return electrode.

[0006] An embodiment of a method for stapling a patient anatomical structure having a first side and a second side to achieve hemostasis during a minimally invasive procedure includes providing an end effector including a first jaw having an anvil having a first end, a second end, a longitudinal axis, and an anvil face; a second jaw having a cartridge holding a plurality of staples and having a cartridge face; a first coupling coupling the first end of the first jaw to the first end of the second jaw; a second coupling movably coupling the second end of the first jaw to the second end of the second jaw; a knife coupled to and slidable relative to the first jaw or the second jaw; and an active electrode and a return electrode coupled to the knife. The method includes inserting an end effector through a trocar to access the anatomical structure, positioning a cartridge face on a first side of the anatomical structure, positioning an anvil face on a second side of the anatomical structure, actuating the end effector to move a rigid link such that the first jaw is urged toward the second jaw to fasten the end effector to the anatomical structure, actuating the end effector to expel a plurality of staples from the cartridge to staple the anatomical structure, actuating a knife to cut the anatomical structure, and achieving hemostasis of the anatomical structure by applying energy to the active electrode and passing it through the anatomical structure to a return electrode.

[0007] Embodiments include a surgical instrument for stapling, resecting, and sealing an anatomical structure of a patient, the surgical instrument including a first jaw having an anvil having a first end, a second end, a longitudinal axis, and an anvil face positionable on a first side of the anatomical structure, a second jaw having a first end, a second end, a longitudinal axis, and a cartridge having a cartridge face positionable on a second side of the anatomical structure operably configured to receive a plurality of staples, an end effector including a first coupling coupling the first end of the first jaw to the first end of the second jaw, a second coupling movably coupling the second end of the first jaw to the second end of the second jaw and including a rigid link connected to the first jaw and the second jaw, an elongated tube having a proximal end and a distal end coupled to the end effector, a handle having a proximal end and a distal end coupled to the proximal end of the elongated tube, and a drive assembly including a motor to actuate the end effector. In certain embodiments, the end effector includes first and second electrodes in communication with an electrosurgical power generating source, such as a bipolar energy source, that collectively function to ablate, coagulate, cauterize, seal, or otherwise treat biological tissue during a surgical procedure.

[0008] An embodiment includes a method of stapling, resecting and sealing a patient anatomical structure having a first side and a second side during a minimally invasive procedure, the method 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 10 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 10 times the width of the anvil, the cartridge holding a plurality of staples, the first end of the anvil coupled to the first end of the cartridge and the second end of the anvil movably coupled to the second end of the cartridge; and a cartridge having a distal portion and a proximal portion, wherein the second end of the anvil is moved to the second end of the cartridge. and a rigid link movably coupled thereto; inserting the end effector through a trocar to access the anatomical structure; positioning a cartridge face on a first side of the anatomical structure; positioning an anvil face on a second side of the anatomical structure; actuating the end effector to fasten the end effector to the anatomical structure and moving the rigid link such that the anvil is urged toward the cartridge; actuating the end effector to eject a plurality of staples from the cartridge to staple the anatomical structure; actuating the knife to cut the anatomical structure; and applying energy to the anatomical structure through an electrode positioned on one side of the knife during actuation of the electrode.

[0009] An embodiment includes a method of stapling, resecting and sealing a patient anatomy having a first side and a second side during a minimally invasive procedure, the method 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, the first end of the cartridge pivotally coupled to the first end of the anvil; a blade having a cutting surface, first and second electrodes coupled to only one side of the blade, and a first electrode slidably connected to the channel. the anvil face is adapted to engage the anvil blade; inserting the end effector through a trocar to access the anatomical structure; positioning a cartridge face on a first side of the anatomical structure; positioning an anvil face on a second side of the anatomical structure; fastening the end effector to the anatomical structure; actuating the end effector to eject a plurality of staples from the cartridge to staple the anatomical structure; actuating the blade to cut the anatomical structure; and applying bipolar energy to the anatomical structure through a circuit including the first and second electrodes.

[0010] Embodiments include a method of stapling, resecting and sealing a patient anatomical structure having a first side and a second side during a minimally invasive procedure, the method 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, the first end of the cartridge pivotally coupled to the first end of the anvil; a blade having a cutting surface; first and second electrodes coupled to the first side of the blade and third and fourth electrodes coupled to the second side of the blade; The method includes providing an end effector including at least one elongated arm slidably engaging a channel, inserting the end effector through a trocar to access the anatomical structure, positioning a cartridge face on a first side of the anatomical structure, positioning an anvil face on a second side of the anatomical structure, fastening the end effector to the anatomical structure, actuating the end effector to expel a plurality of staples from the cartridge to staple the anatomical structure, actuating the blade to cut the anatomical structure, and applying bipolar energy to the anatomical structure through a circuit including first, second, third, and fourth electrodes.

[0011] Embodiments include a method of stapling, resecting and sealing a patient anatomical structure having a first side and a second side during a minimally invasive procedure, the method 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, the first end of the cartridge 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 resistive heating element slidably engaging the channel. The method includes providing an end effector having an end effector and an elongated arm, inserting the end effector through a trocar to access the anatomical structure, positioning a cartridge face on a first side of the anatomical structure, positioning an anvil face on a second side of the anatomical structure, fastening the end effector to the anatomical structure, actuating the end effector to expel a plurality of staples from the cartridge to staple the anatomical structure, actuating the blade to cut the anatomical structure, and applying energy to the anatomical structure through a circuit including at least one resistive heating element to heat the anatomical structure.

[0012] Embodiments include a method of stapling, resecting and sealing a patient anatomical structure having a first side and a second side during a minimally invasive procedure, the method 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, the first end of the cartridge pivotally coupled to the first end of the anvil; a blade having a cutting surface; an electrode coupled to the blade; and at least one electrode slidably engaging the channel. The method includes providing an end effector having an end effector and an anvil face, the end effector including an electrode and two elongated arms, inserting the end effector through a trocar to access the anatomical structure, positioning a cartridge face on a first side of the anatomical structure, positioning an anvil face on a second side of the anatomical structure, fastening the end effector to the anatomical structure, actuating the end effector to expel a plurality of staples from the cartridge to staple the anatomical structure, actuating the blade to cut the anatomical structure, and applying monopolar energy to the anatomical structure through a circuit including an electrode and a return electrode attached to the patient.

[0013] An embodiment includes a surgical instrument for stapling, resecting, and sealing an anatomical structure of a patient, the surgical instrument including an anvil having a first end, a second end, and an anvil face positionable on a first side of the anatomical structure, and a cartridge operatively configured to house a plurality of staples, the cartridge including a first end, a second end, and a cartridge face positionable on the 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, the first end of the cartridge pivotally coupled to the first end of the anvil. The surgical instrument includes an end effector including a ridge, a blade having a cutting surface, at least one elongated arm slidably engaging the channel, an active electrode coupled to a first side of the blade and a return electrode coupled to the first side of the blade proximate the active electrode, an elongated tube having a proximal end and a distal end coupled to the end effector, a handle having a proximal end and a distal end coupled to the proximal end of the elongated tube, a drive assembly having a motor for actuating the end effector, and circuitry extending through the elongated tube to the active electrode and return electrode and connecting the active and inactive electrodes to a source of electrosurgical energy, such as a bipolar energy source.

[0014] An embodiment includes a method of stapling a patient anatomy having a first side and a second side during a minimally invasive procedure, the method including: a first jaw having a first end, a second end, an anvil having an anvil face, and a first channel; a second jaw having a first end, a second end, a cartridge having a cartridge face, and a second channel; a first coupling coupling the first end of the first jaw to the first end of the second jaw; a second coupling movably coupling the second end of the first jaw to the second end of the second jaw and including a rigid link; a blade portion having a cutting edge, a first side, and a second side, at least one upper lateral arm slidably positioned within the first channel, a first electrode coupled to the first side of the blade and a second electrode coupled to the first side of the blade, and a second channel. the anvil face being slidably positioned within the trocar; inserting the end effector through the trocar to access the anatomical structure; positioning a cartridge face on a first side of the anatomical structure; positioning an anvil face on a second side of the anatomical structure; actuating the end effector to fasten the end effector to the anatomical structure and moving the rigid link such that the anvil is urged toward the cartridge; actuating the end effector to expel a plurality of staples from the cartridge to staple the anatomical structure; actuating the L-shaped blade to cut the anatomical structure; and activating an electrosurgical circuit to seal the anatomical structure at the cut using the first and second electrodes.

[0015] Embodiments include a surgical instrument for stapling, resecting, and sealing a patient's anatomy, the surgical instrument including a first jaw having a first end, a second end, an anvil having an anvil face, and a first channel; a second jaw having a first end, a second end, a cartridge having a cartridge face, and a second channel; a first coupling coupling the first end of the first jaw to the first end of the second jaw; a second coupling movably coupling the second end of the first jaw to the second end of the second jaw and including a rigid link; a blade portion having a cutting edge, a first side, and a second side; at least one upper lateral arm slidably positioned within the first channel; a first coupling coupling the first end of the first jaw to the first end of the second jaw; The surgical instrument includes an end effector including an L-shaped blade including a first electrode coupled to one side and a second electrode coupled to the first side of the blade, the L-shaped blade including at least one lower lateral arm slidably positioned within the second channel, an elongated tube having a proximal end and a distal end coupled to the end effector, a handle having a proximal end and a distal end coupled to the proximal end of the elongated tube and defining a cavity, the spool being positioned within the cavity, a circuit connecting the first and second electrodes to a source of electrosurgical energy, and a drive assembly having a motor for operating the end effector, at least a portion of the circuit being wound around the spool during actuation of the end effector.An embodiment includes a surgical instrument for use by a surgeon to staple and achieve hemostasis on a patient's anatomical structure during a minimally invasive procedure, the end effector including: an anvil including a first end, a second end, and an anvil face positionable on a first side of the anatomical structure; a cartridge operably configured to accommodate a plurality of staples and including a first end, a second end, and a cartridge face positionable on the 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, the first end of the cartridge pivotally coupled to the first end of the anvil; a blade assembly including a blade, a beam, and a nut, the blade including a first side and a second side joined at a cutting edge, at least a portion of the blade assembly slidably engaging the channel; and first and second electrodes coupled to the first side of the blade. The surgical instrument includes an elongated tube having a proximal end and a distal end coupled to the end effector, a handle having a proximal end and a distal end coupled to the proximal end of the elongated tube, a drive assembly including a motor that actuates the end effector, and an electrosurgical power generating source in electrical communication with the first and second electrodes.

[0016] An embodiment includes an end effector for use by a surgeon to staple and resect a patient's anatomical structure having a first side and a second side during a minimally invasive procedure, the end effector including an anvil including a first end, a second end, and a surface positionable on the first side of the anatomical structure. The end effector further includes a cartridge configured to accommodate a plurality of staples and including a first end, a second end, and a surface positionable on the second side of the anatomical structure, and a blade assembly including a first side, a second side, and a cutting edge. The end effector further includes first and second electrodes coupled to the first side of the blade assembly, and a recess defined by the anvil that receives a first portion of the blade assembly housing. The end effector further includes a first slot defined by the anvil, opening against the anvil face and against the recess and configured to slidably receive a second portion of the blade assembly during cutting of the anatomical structure with the cutting edge, and a second slot defined by the cartridge, opening against 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 cartridge are insertable through a trocar, the end effector is remotely actuable from outside the patient's body, and at least a portion of one of the anvil and cartridge is movable toward the other to fasten the end effector to the anatomical structure.

[0017] In yet another embodiment, a method of stapling and sealing a patient anatomy having a first side and a second side during a minimally invasive procedure is disclosed that includes providing a stapler with an end effector having a plurality of electrodes positioned proximate a cutting edge, 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 housing a plurality of staples and having a cartridge face, a first coupling coupling the first jaw to the second jaw, and a second coupling movably coupling the second end of the first jaw to the second end of the second jaw, the second coupling including a link movably coupled to the first and second jaws. The method may include inserting an end effector through a trocar to access the anatomical structure, positioning a cartridge face on a first side of the anatomical structure, positioning an anvil face on a second side of the anatomical structure, remotely actuating a stapler from outside the patient's body to move the links such that at least a portion of either the anvil or the cartridge is moved toward the other to fasten the end effector to the anatomical structure, and firing the stapler and activating electrodes to simultaneously staple, cut, and seal the anatomical structure.

[0018] In another embodiment, a method of stapling a patient's anatomical structure having a first side and a second side during a minimally invasive procedure is disclosed, 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 housing a plurality of staples and including a face including a first end, a second end, and a channel extending from the second end to the first end, the second end of the anvil being movably coupled to the second end of the cartridge, positioning the cartridge face on the second side of the anatomical structure, and providing a blade having a cutting surface and an elongated arm, the elongated arm being adapted to extend from the blade positionable at least near the second end of the cartridge to the cartridge. providing a blade that extends to a first end of the anvil face and an arm that slidably engages the cartridge channel; providing an active electrode and an inactive electrode positioned on one side of the blade; providing a rigid link that movably couples the first end of the anvil to the first end of the cartridge; moving the rigid link to move at least a portion of one of the anvil and the cartridge toward the other to fasten the anatomical structure between the anvil face and the cartridge face; and drawing the blade through the anatomical structure, activating the electrodes and simultaneously cutting, stapling and sealing the anatomical structure.

[0019] The present disclosure will be more readily understood from the following detailed description of certain illustrative embodiments in conjunction with the drawings, in which: [Brief description of the drawings]

[0020] [Figure 1] FIG. 1 depicts the anatomy of the stomach. [Diagram 2] FIG. 1 is a perspective view of an electrosurgical stapling device having an end effector, an elongated tube, a handle portion, and a motor in an open position in accordance with an exemplary embodiment; [Diagram 3] FIG. 3 is a partially exploded perspective view of the end effector, elongated tube, and handle portion of the electrosurgical stapling device shown in FIG. 2; [Figure 4] FIG. 3 is a partial exploded perspective view of the motor of the electrosurgical stapling device shown in FIG. 2; [Figure 5A] FIG. 3 is a side view of the electrosurgical stapling device of FIG. 2 shown in an open position. [Figure 5B] FIG. 3 is a side view of the stapling device of FIG. 2 shown in a closed position; [Figure 6] FIG. 5B is a side cross-sectional view of the handle portion and motor shown in FIG. 5A taken along section D-. [Figure 7] FIG. 5B is a side view of the end effector shown in FIG. 5A. [Figure 8] FIG. 5C is a side cross-sectional view of the handle portion and motor shown in FIG. 5B taken along section EE. [Figure 9] FIG. 5C is a side view of the end effector shown in FIG. 5B. [Figure 10] FIG. 13 is a cross-sectional side view of a blade assembly and a drive assembly for an electrosurgical stapling device in accordance with one embodiment. [Figure 11] FIG. 1 is a perspective view of a motor controller according to one embodiment. [Figure 12] FIG. 12 is an exploded perspective view of the motor controller shown in FIG. [Figure 13] FIG. 1 depicts an exemplary beam having first and second electrodes positioned at a distal end in accordance with one embodiment. [Figure 14] 1A-1D depict an exemplary blade assembly according to various embodiments. [Figure 15] 1A-1D depict an exemplary blade assembly according to various embodiments. [Figure 16] 1A-1D depict an exemplary blade assembly according to various embodiments. [Figure 17A] 1A-1C are schematic diagrams illustrating non-limiting exemplary embodiments of electrically coupling electrodes to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 17B] 1A-1C are schematic diagrams illustrating non-limiting exemplary embodiments of electrically coupling electrodes to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 18A] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 18B] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 19] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 20] 1A-1C are schematic diagrams illustrating yet another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 21] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 22] 1A-1C are schematic diagrams illustrating yet another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 23A] 1A-1C are schematic diagrams illustrating non-limiting exemplary embodiments of electrically coupling electrodes to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 23B] 1A-1C are schematic diagrams illustrating non-limiting exemplary embodiments of electrically coupling electrodes to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 24A] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Figure 24B] 1A-1C are schematic diagrams illustrating another non-limiting exemplary embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. [Diagram 25] FIG. 1 depicts a nut with electrical contacts according to an exemplary embodiment. [Figure 26]FIG. 10 depicts another nut having electrical contacts according to another exemplary embodiment. [Figure 27] FIG. 13 is a cross-sectional side view of a handle assembly of an exemplary electrosurgical stapling device. [Figure 28] FIG. 28 is an enlarged view of the exemplary spool depicted in FIG. 27. [Figure 29] FIG. 29 is an exploded view of the spool depicted in FIG. 28. [Diagram 30] FIG. 2 is a partial view of an exemplary end effector in accordance with an exemplary embodiment; [Diagram 31] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Diagram 32] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Diagram 33] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Diagram 34] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Diagram 35] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Diagram 36] 1A-1C illustrate an exemplary blade assembly according to various embodiments. [Figure 37] FIG. 1 is a perspective view of an exemplary electrosurgical circular stapler in accordance with an exemplary embodiment. [Figure 38] FIG. 38 is an exploded perspective view of the stapling head assembly of FIG. 37; [Figure 39] 1 depicts an exemplary knife member of an electrosurgical circular stapler in accordance with an exemplary embodiment. [Diagram 40] FIG. 1 depicts an exemplary bladed electrosurgical instrument. [Diagram 41] FIG. 1 depicts an exemplary bladed electrosurgical instrument. [Diagram 42]FIG. 1 is an elevated left side view of an electrosurgical stapling and severing instrument having an open end effector (staple applying assembly) with the shaft partially cut away to expose the firing members of the proximal firing rod and distal firing bar guided by a housing ground and surrounded by a closure sleeve. [Diagram 43] 43 is a left side view of a closed end effector (staple applying assembly) having a retraction force adjustable height firing bar according to the present invention of the surgical stapling and severing instrument of FIG. 42 shown in longitudinal vertical cross section taken along section FF. [Diagram 44] FIG. 44 is a left isometric view of the firing bar of FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] Various non-limiting embodiments of the present disclosure are now described below 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 examples of these non-limiting embodiments are illustrated in the accompanying drawings. Those skilled in the art will appreciate that the systems and methods specifically described herein and illustrated in the accompanying drawings are non-limiting embodiments. Features illustrated or described with respect to one non-limiting embodiment may be combined with features of other non-limiting embodiments. Such modifications and variations are intended to be included in the present disclosure. References throughout this specification to "various embodiments," "some embodiments," "one embodiment," "some exemplary embodiments," "one exemplary embodiment," or "embodiments" mean that a particular feature, structure, or characteristic described with respect to any embodiment is included in at least one embodiment. Thus, the appearances of the phrases "various embodiments," "some embodiments," "one embodiment," "some exemplary embodiments," "one exemplary embodiment," or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Described herein are exemplary embodiments of apparatus, systems, and methods associated with surgical instruments and tools, such as electrosurgical staplers. In one exemplary embodiment, an end effector and / or endocutter stapling device (collectively referred to herein as "device") for forming a resection line during resection of an organ, tissue, or other anatomical structure is disclosed. In some embodiments, these devices can be used during minimally invasive surgical procedures. This application is related to U.S. Pat. No. 9,936,953, the entire contents of which are hereby incorporated by reference herein.

[0022] Electrosurgical instruments described herein, including but not limited to electrosurgical staplers, can involve the application of electrical and / or electromagnetic energy to cut, dissect, ablate, coagulate, cauterize, seal, or otherwise treat living tissue during a surgical procedure. Electrosurgery is typically performed with an electrosurgical generator operable to output energy and a handpiece including an end effector adapted to transfer energy to a tissue site during an electrosurgical procedure. An embodiment of these devices can be a bipolar instrument having two electrodes of opposing polarity and positioned around one another to apply a current between the faces. The bipolar electrosurgical current flows from one electrode (sometimes referred to as the active electrode) through the intervening tissue to the other electrode (sometimes referred to as the return electrode) to complete an electrical circuit.

[0023] An electrosurgical stapler according to embodiments described herein may include a handle, an actuator, and an end effector including a fastening mechanism. The fastening mechanism may include a cartridge and an anvil. During surgery, a surgeon fastens two members (e.g., an anvil and a cartridge) to an organ and compresses the organ between them. Once the organ is compressed, the surgeon may drive or fire the staples through the organ using the stapler. In one embodiment, multiple B-shaped staples may be formed with the desired compression and alignment of the fastening mechanism. In some embodiments, the stapling device may be capable of multiple fires using multiple cartridges, or in alternative embodiments, a single cartridge may be used for one fire to complete the resection of the organ. It may be advantageous to reduce the number of fires and cartridges required, as the number of cartridges used and the length of the procedure that may be associated with multiple stapler fires may increase the cost of the procedure. Similarly, it may be advantageous to enable single cartridge stapling and / or single organ resection for a reduced surgical time for the patient, which may improve clinical outcomes. For example, removing a portion of the stomach via a sleeve gastrectomy procedure using a single cartridge and one stapler firing can improve patient outcomes and reduce complications that may be associated with such procedures.

[0024] When a B-shaped staple configuration is desired, the integrity of the staple line may depend in part on the proper formation of such staples. By providing a single cartridge and single firing stapling device, improved quality of staple formation may be achieved over devices or systems that use multiple cartridges to complete the same procedure. For example, when an end effector is used multiple times to staple and resect tissue, new staples and / or cutting knives may contact previously deployed staples in subsequent applications. Allowing for a single cartridge and single staple firing can help ensure that the staple line and staple shape are proper.

[0025] Single cartridge and single-fire stapling devices can provide compression benefits compared to devices and systems requiring the use of multiple cartridges. It may be advantageous to provide a single-fire stapling device that allows for desirable compression along the length of the tissue being resected, and also provides a single staple line with properly formed staples. B-shaped staples are the standard of care in gastrointestinal, vascular, pulmonary, and hepatic applications of surgical tissue fastening devices. Self-alignment of each of the X-, Y-, and Z-axes of the fastening mechanism on both sides of the organ (e.g., anvil and cartridge alignment) can improve staple delivery and formation. It will be appreciated that any structure or mechanism suitable for providing such alignment can be incorporated into the stapling devices described herein.

[0026] An embodiment of the electrosurgical stapling device can include an anvil and a cartridge, where the cartridge can include recesses that hold a plurality of staples. The staples can be held above one or more staple drivers that can drive each of the plurality of staples upwardly through tissue into a face of the anvil during surgery. The anvil can include pockets having any suitable size, number, and dimensions that can cooperate with the cartridge driver to form, for example, a B-shape in the tissue. In one embodiment, the pockets of the anvil can be sized to provide a desired closed staple height that can be determined by the gap between the anvil and the cartridge, the depth of the pockets, and the height of the staples, and / or the staple driver and driver mechanism.

[0027] An embodiment of the electrosurgical stapling device can include electrodes positioned proximate the cutting edge of the blade assembly. In some embodiments, the electrodes are positioned on only one side of the blade assembly. Such electrodes can be configured and positioned to be in direct contact with tissue cut by the cutting edge. One of the electrodes can be an active electrode and delivers energy through the tissue to the other electrode, which can be a return electrode. Such delivery of energy can achieve hemostasis by heating the tissue and blood vessels to cauterize, coagulate / dehydrate, and / or seal the tissue.

[0028] The embodiments of the electrosurgical stapling device described herein may include inserting a stapler end effector through a trocar to perform a surgical procedure according to a laparoscopic approach. As an example, a minimally invasive surgical procedure may include a laparoscopic vertical sleeve gastrectomy. Because the spatial environment for such procedures is limited, the surgical stapling device according to the embodiments described herein may have a relatively low profile. Prior art minimally invasive devices are generally long (e.g., 35 mm to 60 mm) and thin (e.g., 5 mm to 15 mm in diameter) devices. This slender configuration may be required to fit through a trocar into a body cavity. This size limitation may present mechanical challenges, as the formation of a B-shaped staple typically requires a pressure of about 100 psi. Under these pressures, a small, less rigid stapler may deform, thus preventing proper formation of a B-shaped staple.

[0029] Prior art devices used in minimally invasive surgical procedures often have a fixed hinge at the proximal end. This hinge allows the anvil and cartridge to separate into a V-shaped configuration. Once separated, the surgeon can place the open anvil and cartridge around an organ and then collapse the V onto the organ. However, as the length of the anvil and cartridge increases, it can be difficult to maintain alignment between the anvil and cartridge over the length of the tissue. Poor alignment from such designs can be exacerbated at the distal end of such devices, which can deflect due to the force required to compress the tissue. The length of current V-shaped staplers for minimally invasive procedures is limited because of this deflection. As a result of this limitation, the anvil and cartridge are correspondingly limited in length. This length limitation requires multiple reloads and firings of staples in larger organs, such as the stomach, to complete a procedure, such as a sleeve gastrectomy. Each reload may require the surgeon to withdraw the stapler from the trocar, reload the cartridge, reinsert, and then reposition the stapler over the organ. Such systems may require longer surgical times, may be costly, may have a higher potential for adverse patient events, and may compromise the integrity of the staple line.

[0030] The examples disclosed herein are merely examples and are provided to aid in the description of the apparatus, devices, systems, and methods described herein. Unless any of the features or components illustrated in the figures and discussed below are specifically indicated as essential, none of these apparatus, devices, systems, or methods should be construed as essential to a particular implementation. For ease of reading and clarity, certain components, modules, or methods may be described only in relation to specific figures. Failure to specifically describe a combination or subcombination of components should not be understood to suggest that any combination or subcombination is not possible. Similarly, with respect to any method described, whether or not such method is described in relation to a flow diagram, unless otherwise specified or required by the context, any explicit or suggested order of any steps performed in the implementation of the method does not imply that the steps must be embodied in the order presented, but instead may be performed in a different order or in parallel.

[0031] The exemplary embodiments described herein may be used, for example, for a sleeve gastrectomy procedure or resection of the stomach. However, it will be appreciated that the above-described devices may be used for other procedures involving other anatomical structures. For example, the devices may be used for parenchymal resections, lung volume reduction procedures, or other procedures involving the lungs. Additionally, the embodiments described herein may be advantageous for anatomical resections, such as lobectomy, non-anatomical parenchymal resections, or other procedures involving the liver, or for partial nephrectomy, total nephrectomy, or other procedures involving the kidney.

[0032] Referring now to FIG. 1, the anatomy of the stomach 10 and an exemplary resection line 12 for a vertical sleeve gastrectomy are shown. Generally, the stomach 10 includes a lower end 14, an upper end 16, an anterior surface 18, and a posterior surface 20. The gastroesophageal junction 22 opens into the stomach W and is a common landmark in bariatric surgery. The fundus 24 and a section of the stomach 10 defined by the greater curvature 26 are the portions of the stomach 10 that are typically removed during a vertical sleeve gastrectomy. The remaining pouch or sleeve may generally be defined by the lesser curvature 28 and the resection line 12, providing a stomach with a significantly reduced volume. The desired location of the resection line 12 may be about 0.5 cm to about 2 cm away from the gastroesophageal junction 22 and about 2 cm to about 10 cm away from the pylorus 30. The embodiments described herein may utilize an endocutter stapling device to create a high quality, appropriate resection line during a vertical sleeve gastrectomy. These device embodiments can be advantageous because they can be easily positioned using a laparoscope, can accommodate tissue of varying thickness along the length of the resection line, can have the ability to apply uniform compressive pressure to the tissue along the resection line, and can allow for low staple firing forces. These device embodiments can utilize electrical energy to cut, dissect, ablate, coagulate, cauterize, seal, or otherwise treat the resection line during a surgical procedure.

[0033] 2 is a perspective view of an exemplary electrosurgical stapling device 100 in accordance with one embodiment. The electrosurgical stapling device 100 can include an endocutter 108 and a motor assembly 115. The electrosurgical stapling device 100 includes an end effector 121 including an anvil assembly 101, a cartridge assembly 103, a support tube 140, and a handle portion 123. The anvil assembly 101 can act as a first jaw of the end effector 121, and the cartridge assembly can act as a second jaw of the end effector 121. The end effector 121 can be connected to the handle portion 123 through the support tube 140. The handle portion 123 can include a handle 111 and a trigger 104 for actuating the electrosurgical stapling device 100.

[0034] The handle portion 123 may include a mode button 124 for switching between modes of operation. For example, in a first mode, the trigger 104 may be pressed upward to open the jaws (e.g., anvil and cartridge) or downward to close the jaws. When the jaws are in a closed position, the mode button 124 may be pressed to transition the electrosurgical stapling device 100 to a firing mode. When in the firing mode, pressing the trigger 104 may fire the electrosurgical stapling device 100 to simultaneously cut tissue while simultaneously forming a staple line comprised of one or more rows of staples. In one embodiment, pressing the trigger 104 in the firing mode may deploy a staple line including six staple rows, where a knife (not shown) may simultaneously cut tissue between the third and fourth staple rows. Immediately following the cut, electrical energy may be applied to the tissue through electrodes 170 (FIG. 3) positioned about the knife as described in more detail below.

[0035] 3 depicts an exploded perspective view of the electrosurgical stapling device 100 (FIG. 2) in accordance with at least one embodiment. The anvil assembly 101 can include an anvil frame 102 and an anvil plate 112. The anvil plate 112 can be welded to the anvil frame 102 or can be attached to another such as by gluing, brazing, sintering, machining, 3D printing, or the like. A cartridge 110 containing a plurality of staples can be attached to a cartridge frame 116 by a first cartridge pin 141 at a first end and a second cartridge pin 118 at a second end, or can be attached to the cartridge frame 116 by snap-fit, glue, or other attachment methods.

[0036] In the embodiment shown in FIG. 3, the cartridge frame 116 is insertable at its proximal end into a support tube 140 so that an end effector 121 of the endocutter 108 can be aligned and connected to a handle portion 123. The blade assembly can include a knife or blade 107 that can be coupled to a rotating member 180 by a nut 109, bushing, or other suitable connection. An electrode 170, which can be located on only one side of the knife, can achieve hemostasis by, for example, heating tissue and blood vessels to cauterize, coagulate / dehydrate, and / or seal tissue when the electrosurgical stapling device 100 is fired. The electrode 170 can be in electrical communication with an electrosurgical power generating source through a circuit (not shown).

[0037] The handle portion 123 may include a right handle half 120 and a left handle half 122 that may be held together in a clamshell fashion. The right handle half 120 and the left handle half 122 may be joined by, for example, ultrasonic welding, glue, screws, gripping or press-fit pins that fit into holes molded into the handles, or other assembly methods. To provide a pleasing aesthetic to the exterior of the handle portion 123, the left handle half 122 and the right handle half 120 may be covered with a left handle shell 150 and a right handle shell 152.

[0038] The control arm 151 may be driven using a drive screw 154 through a control arm nut 153. The drive screw 154 may be connected to a second drive gear coupler 145 that may engage with a motor assembly 115 (FIG. 4). The rotating member 180 may 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 may engage with the first drive gear coupler 156, which may be coupled with the motor assembly 115. In one embodiment, the second firing drive gear 169 and the first drive gear coupler 156 may be a single component or mechanism.

[0039] FIG. 4 is a perspective view of the motor assembly 115 according to one embodiment. The first electric motor 135 and the second electric motor 137 can be provided within the motor housing 113. In one embodiment, the first motor gear 163 can be coupled to the first drive gear coupler 156 (FIG. 3) and the second motor gear 165 can be coupled to the second drive gear coupler 145 (FIG. 3). The motor housing 113 can include a left motor housing half 127 and a right motor housing half 116. The motor housing 113 can include a snap 117 for coupling the motor assembly 115 with the handle portion 123 (FIG. 3). A strain relief 119 can be provided to aid in wire connection to the motor assembly 115. Between the motor assembly 115 and the electrosurgical stapling device 100, a connector 125 can allow for electrical coupling of the trigger 104 (FIG. 3) and other electrical components.

[0040] 5A is a side view of an electrosurgical stapling device 100 in accordance with one embodiment showing an end effector 121 in an open position. The end effector 121 can include a first jaw including an anvil assembly 101 and a second jaw including a cartridge assembly 103. The end effector 121 can include a main link 106 operably coupled to a motor assembly 115.

[0041] 5B is a side view of electrosurgical stapling device 100 showing end effector 121 in a closed position in which end effector 121 can be primed for a firing phase, which can include deploying staples, cutting tissue, and / or applying electrosurgical energy to tissue.

[0042] FIG. 6 depicts a cross-sectional side view of the handle portion 123 of the electrosurgical stapling device 100 in an open position (e.g., the position shown in FIG. 5A). A second drive gear coupler 145 for opening and closing the end effector 121 can be coupled to a second motor gear 165 (FIG. 4) connected to a second electric motor 137. The second drive gear coupler 145 can rotate a drive screw 154 to transition the end effector 121 between an open position and a closed position and vice versa to open and close the end effector 121. FIG. 6 shows the control arm nut 153 in a distal-most 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. In the illustrated position, the control arm nut 153 can contact a control arm distal limit switch 168 to cut off power to the second electric motor 137 when the end effector 121 is in the fully open position. The first drive gear coupler 156 can be coupled to a second motor gear 165 to deploy staples from the electrosurgical stapling device 100 and simultaneously cut tissue and then seal through hemostasis.

[0043] 6 also shows generally conductor 141 extending through support tube 140 and in electrical communication with electrode 170 (FIG. 3). In the illustrated embodiment, a spool 159 is disposed within a cavity defined by handle portion 123. Spool 159 can be configured to take up slack in conductor 141 as electrode 170 is drawn proximally toward handle portion 123 during a surgical procedure. In some embodiments, a constant force spring 161 can be coupled to spool 159 to aid in automatic winding of spool 159 during surgery.

[0044] 7 depicts a side view showing the end effector 121 of the electrosurgical stapling device 100 in an open position. The main link 106 can be attached to a first end of the anvil frame 102 by a first main link pin 120 such that the first main link pin 120 pivotally and slidably engages 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 can be angled upwardly or downwardly relative to the longitudinal axis. A second main link pin 138 can be used to pivotally couple the main link 106 to the control arm 151.

[0045] 8 depicts a cross-sectional side view showing the handle portion 123 of electrosurgical stapling device 100 in a closed position. The control arm nut 153 is illustrated in a proximal-most position on the drive screw 154 as the anvil assembly 101 is closed relative to the cartridge assembly 103. In one embodiment, as the end effector 121 is closing, the control arm nut 153 can advance proximally until it contacts a proximal limit switch 155. Upon contacting the proximal limit switch 155, the control arm nut 153 can cut off power to the second electric motor 137. The electrosurgical stapling device 100 can 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 it is in the closed position prior to firing.

[0046] 9 depicts a side view of the end effector 121 of electrosurgical stapling device 100 in a closed position. The main link 106 is illustrated partially inserted into the support tube 140 such that the anvil assembly 101 and cartridge assembly 103 are in the closed position and ready to fire.

[0047] FIG. 10 is a side view of a drive assembly 260 for stapling, cutting, and sealing tissue. The drive assembly 260 can include a blade assembly 208 including a blade 207 coupled to a beam 226. Electrodes 270 can be positioned on one side of the blade 207 such that they directly contact the tissue cut by the blade 207. The electrodes 270 can be in electrical communication with a source of electrosurgical energy through a circuit 241. The beam 226 can include a nut 209 that can be threadably engaged with a rotating member 280. The rotating member 280 can be operably coupled to a first electric motor 212 such that rotation of the rotating member 280 urges the nut 209 proximally. During surgery, activation of the first electric motor 212 can urge the nut 209 proximally such that the beam 226 and the blade assembly 208 are moved correspondingly in a proximal direction. When the blade assembly 208 is urged proximally, the cutting edge 232 on the blade 207 can transect tissue. Simultaneously, energy can be passed through the transected tissue by electrode 270 to heat the tissue and blood vessels and cauterize, coagulate / dehydrate, and / or seal tissue along one side of the incision. Blade 207 can include an upper portion 228 and a lower portion 230 that can compress the anvil and cartridge of the end effector when biased proximally.

[0048] 10 , when the blade assembly 208 is pulled to its proximal-most position, the nut 209 can engage a fired limit switch 268. When the nut 209 engages the fired limit switch 268, power to the first electric motor 212 can be cut off. 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 monolithically formed as a unitary structure with the blade assembly 208 or the beam 226.

[0049] 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 the motor controller 370 with system power, for example, 110 or 220 volt AC power from a wall outlet, or can provide battery power. The device cable connector 376 can connect multiple wires from a motor assembly of the stapling device to the motor controller 370. For example, the device cable connector 376 may provide positive and negative voltage wires to the first electric motor (e.g., first electric motor 135 shown in FIG. 4), positive and negative voltage wires to the second electric motor 137 (e.g., second electric motor 137 shown in FIG. 4), a wire to a trigger (e.g., trigger 104 shown in FIG. 3), positive and negative sensing wires to each of the fired limit switches 168 (FIG. 6), respective wires in electrical communication with the active and return electrodes (e.g., electrode 170 (FIG. 3), electrode 270 (FIG. 10)), and any other wires advantageous to the endocutter.

[0050] FIG. 12 is an exploded perspective view of the motor controller 370 according to one embodiment. A lid 373, which may be part of the controller housing 372, may contain the components inside the controller housing 372. In the embodiment shown in FIG. 11, system power may be introduced into the controller housing 372 through an electrical plug 378. A fan 380 may be included to cool the interior of the controller housing 372. A pair of speakers 382 may be provided to inform the user of the status of the stapling device, such as, for example, jaws open, jaws closed, firing complete, ready to fire, or other useful information. A display 375 may be used to provide visual indications, data, error conditions, instrument identification, or other useful data.

[0051] The motor controller board 328 can provide power to the first electric motor 135 (FIG. 4) or the second electric motor 137 (FIG. 14) as appropriate. The motor controller board 328 can control the electrosurgical energy associated with the various electrodes, such as the electrode 170 or the electrode 270 (FIG. 10). The motor controller board 328 can receive instructions from the processor board 330 to start or stop the first electric motor 135 or the second electric motor 137. The processor board 330 can contain a processor, such as an ARM processor or other processor, that is advantageous for controlling the stapling device. For example, the processor board 330 can contain software that can read the state of the limit switches 155, 168 (FIG. 6) and the trigger 104 (FIG. 6) and control the motor controller board 328 to, for example, open or close the jaws, fire the system, activate the electrosurgical energy source, or perform other advantageous functions.

[0052] In one exemplary embodiment, the ARM processor may be used to communicate with the endocutter (e.g., stapling device 100 shown in FIG. 1). For example, electrosurgical stapling device 100 may include an EEPROM or other memory holding device that may encode a serial number during manufacturing. The memory may be used to provide information to the motor controller. For example, the processor may have the capability to measure and record opening and closing motor amperage during start-up on the manufacturing line, firing motor amperage during start-up on the manufacturing line, opening and closing motor amperage during clinical use, firing motor amperage during start-up during clinical use, or other data useful to the manufacturer or operator. These data may be relayed to the motor controller 370 for storage. Such information may be displayed to the user during firing by connection of the motor controller 370 to a screen or display that may be incorporated within the electrosurgical stapling device 100 within the motor controller 370, or the data may be transmittable to a monitor used by a laparoscopic camera in minimally invasive procedures.

[0053] In one embodiment, an electrosurgical stapling device system according to embodiments described herein can have a unique serial number or other identifier that allows an operator to record the specific serial number of the instrument used in the patient's records. When the instrument is plugged into a controller, such as motor controller 370, the controller can communicate with the memory to provide the serial number on the controller's display. The memory can be used to record information regarding the use of the instrument. For example, an event log can be recorded into the memory from the controller that records motor load, number of times the instrument has been opened and closed, number of times the instrument has been fired, error codes, or other useful information on the memory for later review.

[0054] 13, an exemplary beam 426 is shown according to one non-limiting embodiment of the present disclosure. A blade assembly 408 at a distal end of the beam 426 can include a top portion 428, a bottom portion 420, and a blade 407. As with the prior embodiment, the top portion 228 and the bottom portion 230 can compress an anvil and cartridge of an end effector (not shown) when biased proximally. The blade assembly 408 has a first side 409 on which a first electrode 471 and a second electrode 473 can be coupled. As shown, the first and second electrodes 471, 473 can be positioned about the blade 407 such that the tissue to be cut is disposed in near direct contact with the first and second electrodes 471, 473. The first and second electrodes 471, 473 can be in electrical communication with a source of electrosurgical energy (not shown) through a circuit 411 extending along the beam 426. In some embodiments, the circuitry 411 may be coupled to the beam 426 using any suitable technique. For example, in some embodiments, the circuitry 411 is positioned in a slot formed in the beam 426. In other embodiments, the circuitry 411 may be molded with the beam 426.

[0055] The electrosurgical energy source can provide a bipolar electrosurgical current that flows from the first electrode 471 through the intervening tissue to the second electrode 473 to complete an electrical circuit. More specifically, when the blade assembly 408 is biased proximally, the blade 407 can transect the tissue along the resection line 12 (FIG. 1) and simultaneously deliver energy to the resected tissue. Such energy can thereby heat the tissue and blood vessels along the resection line 12 and cauterize, coagulate / dehydrate, and / or seal the tissue along the resection line 12. The tissue will be divided along the resection line 12, such that the incision has a first side and a second side. Because the first and second electrodes 471, 473 are coupled to one side of the blade assembly 408, only one side of the incision (i.e., the first side) will be in contact with the first and second electrodes 471, 473 during the transsection. In some embodiments, additional electrodes may be positioned on the other side of the blade assembly 408 such that both sides of the incision are in contact with a pair of electrodes. For example, as shown, one pair of electrodes 471, 473 may be coupled to one side of the blade assembly 408, and another pair of electrodes (not shown) may be positioned on the other side of the blade assembly 408. The other pair of electrodes may also be in electrical communication with a source of electrosurgical energy (not shown) through a circuit 411 extending along the beam 426. In this arrangement, both sides of the incision may be in contact with a pair of electrodes during transection. Thus, electrodes on both sides of the blade assembly 408 may be used to cauterize, coagulate / dehydrate, and / or seal both sides of the incision made by the blade assembly 408 according to various embodiments.

[0056] FIG. 13 illustrates one exemplary electrode arrangement, however the present disclosure is not limited to such arrangement. Indeed, a variety of different electrode layouts, as well as a variety of electrode shapes, electrode configurations, and electrode placement locations, as well as total electrode numbers, may be used without departing from the scope of the present disclosure. Each of FIGS. 14-15 depicts an exemplary electrode layout according to various embodiments. Additionally, while FIGS. 14-15 show electrodes positioned on a first side of the blade assembly for illustrative purposes, it will be appreciated that the electrodes may additionally or alternatively be positioned on a second side of the blade assembly without departing from the scope of the present disclosure.

[0057] 14, a blade assembly 508 is shown coupled to a beam 526. First and second electrodes 571, 573 are coupled to one side of the blade assembly 508 and are in electrical communication with a source of electrosurgical energy (not shown) through a circuit 511. In this embodiment, the first and second electrodes 571, 573 are disposed 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 and second electrodes 571, 573 can have a curved outer surface that can help bring the first and second electrodes 571, 573 into contact with tissue during ablation. In some embodiments, each of the first and second electrodes 571, 573 can be truncated cylindrical (as shown). In other embodiments, each of the first and second electrodes 571, 573 can be a hemispherical block, a rectangular block, or any of a variety of other suitable shapes.

[0058] 15, there is shown a blade assembly 608 coupled to a beam 626. First and second electrodes 671, 673 are coupled to one side of the blade assembly 608 and are in electrical communication with a source of electrosurgical energy (not shown) through a circuit 611. In this embodiment, the first and second electrodes 671, 673 are disposed along an axis perpendicular to the longitudinal axis of the beam 626. In one embodiment, the first electrode 671 is an active electrode and the second electrode 673 is a return electrode. In another embodiment, the first electrode 671 is a return electrode and the second electrode 673 is an active electrode. Although the first and second electrodes 671, 673 are shown as generally rectangular, each of the electrodes may be any of a variety of other suitable shapes.

[0059] 16, there is shown a blade assembly 708 coupled to a beam 726. First and second electrodes 771, 773 are coupled to one side of the blade assembly 708 and are in electrical communication with a source of electrosurgical energy (not shown) through a circuit 711. In this embodiment, the blade assembly includes a distal extension 709 that helps provide a desired placement of the electrodes. Such a distal extension 709 can be used, for example, to accommodate larger sized electrodes and / or to accommodate additional lateral separation between the electrodes.

[0060] 17A-17B are schematic diagrams illustrating one exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. Referring initially to FIG. 17A, a blade assembly 808 is shown coupled to a beam 826 extending into a support tube 840 shown in cross section. As shown, first and second electrodes 871, 873 may be coupled to the blade assembly 808. Similar to the arrangement shown in FIG. 10, a nut 809 may be threadedly coupled to a rotating member 880 such that rotation of the rotating member 880 results in longitudinal movement of the nut 809 along the length of the rotating member 880. The proximal end of the beam 826 may be coupled or otherwise engaged to the nut 809 such that proximal movement of the nut 809 along the rotating member 880 results in movement of the beam 826 in the same direction.

[0061] 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 a first electrode 871 through a conductor 849 routed along the beam 826. The second contact 847 can be in electrical contact with a second electrode 873 through a conductor 851 routed along the beam 826.

[0062] A first conductive strip 841 can be positioned on an inner surface of the support tube 840. The first conductive strip 841 can be in electrical communication with an electrosurgical energy source, such as a bipolar energy source 860, through a conductor 861. Additionally, a second conductive strip 843 can be positioned on an inner surface of the support tube 840. The second conductive strip 841 can be in electrical communication with an electrosurgical energy source, such as a bipolar energy source 860, through a conductor 863. The first contact 845 can be in physical contact with the first conductive strip 841 and maintain such contact while the first contact 845 translates relative to the first conductive strip 841. The second contact 847 can be in physical contact with the second conductive strip 843 and maintain such contact while the second contact 847 translates relative to the second conductive strip 843. Each of the contacts 845, 847 may include a brush, a leaf spring, or any other suitable connection that enables the transfer of electrical current between the contact and the respective conductive strip as the beam 826 translates relative to the support tube 840.

[0063] FIG. 17B illustrates, in schematic form, the delivery of energy to tissue (not shown) during surgery. During surgery, the nut 809 is translated in the direction indicated by arrow A by rotation of the rotating member 880. An energy supply path to the tissue being ablated by the blade assembly 808 can be provided continuously. More specifically, a path including conductor 861, first conductive strip 841, first contact 845, and conductor 849 provides an energy supply path from the bipolar energy source 860 to the first electrode 871. A path including conductor 851, second contact 847, second conductive strip 843, and conductor 863 can provide a continuous energy return path from the second electrode 873 to the bipolar energy source 860. As with other embodiments described herein, the firing rate of the blade assembly 808 through the tissue can determine the duration of energy (e.g., heat) provided to a particular tissue location.

[0064] 18A-18B generally depict another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. Referring initially to FIG. 18A, there is shown a blade assembly 908 coupled to a beam 926 extending into a support tube 940 shown in cross section. As shown, first and second electrodes 971, 973 can be coupled to the blade assembly 998. A nut 909 can be threadedly engaged to a rotating member 980 such that rotation of the rotating member 980 results in longitudinal movement of the nut 909 along the length of the rotating member 980. The proximal end of the beam 926 can be coupled or otherwise engaged to the nut 909 such that proximal movement of the nut 909 along the rotating member 980 results in movement of the beam 926 in the same direction.

[0065] The nut 909 may include a first contact 945 and a second contact 947. The first contact 945 may be in electrical contact with a first electrode 971 through a conductor 949 routed from the nut 909 along the beam 926. The second contact 947 may be in electrical contact with a second electrode 973 through a conductor 951 routed from the nut 909 along the beam 926.

[0066] Similar to FIGS. 17A-17B, a first conductive strip 941 can be positioned on an inner surface of the support tube 940. The first conductive strip 941 can be in electrical communication with a source of electrosurgical energy, such as a bipolar energy source 960, through a conductor 961. Additionally, a second conductive strip 943 can be positioned on an inner surface of the support tube 940. The second conductive strip 941 can be in electrical communication with a source of electrosurgical energy, such as a bipolar energy source 960, through a conductor 963. A first contact 945 can be in physical contact with the first conductive strip 941 and maintain such contact while the first contact 945 translates relative to the first conductive strip 941. A second contact 947 can be in physical contact with the second conductive strip 943 and maintain such contact while the second contact 947 translates relative to the second conductive strip 943. Each of the contacts 945, 947 may include a brush, a leaf spring, or any other suitable connection that enables the transfer of electrical current between the contact and the respective conductive strip as the nut 909 translates relative to the support tube 940.

[0067] 18B illustrates, in a schematic manner, the delivery of energy to tissue (not shown) during surgery. During surgery, the nut 909 is translated in the direction indicated by arrow A by rotation of the rotating member 980. An energy supply path may be continuously provided to the tissue being resected by the blade assembly 908. More specifically, a path including the conductor 961, the first conductive strip 941, the first contact 945, and the conductor 949 provides an energy supply path from the bipolar energy source 960 to the first electrode 971. A path including the conductor 951, the second contact 947, the second conductive strip 943, and the conductor 963 may continuously provide an energy return path from the second electrode 973 to the bipolar energy source 960.

[0068] 19 generally depicts another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1008 is shown coupled to a beam 1026 that extends into a support tube 1040, shown in cross section. As shown, first and second electrodes 1071, 1073 may be coupled to the blade assembly 1008. A nut 1009 may be threadedly engaged to a rotating member 1080 such that rotation of the rotating member 1080 results in longitudinal movement of the nut 1009 along the length of the rotating member 1080. The proximal end of the beam 1026 may be coupled or otherwise engaged to the nut 1009 such that proximal movement of the nut 1009 along the rotating member 1080 results in movement of the beam 1026 in the same direction.

[0069] The distal end of the beam can include a first contact 1045 and a second contact 1047. The first contact 1045 can be in electrical contact with a first electrode 1071 through a conductor 1049 routed along the beam 1026. The second contact 1047 can be in electrical contact with a second electrode 1073 through a conductor 1051 routed along the beam 1026.

[0070] A first conductor 1041 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1060, may be routed within the support tube 1040 and connected to the first contact 1045. Additionally, a second conductor 1043 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1060, may be routed within the support tube 1040 and connected to the first contact 1047. The first and second conductors 1041, 1043 may be wound around a spool 1059, which may be similar to spool 159 of FIG.

[0071] During surgery, the nut 1009 is translated in the direction indicated by arrow A by rotation of the rotating member 1080. An energy supply path can be continuously provided to tissue being resected by the blade assembly 1008. More specifically, a path including the conductor 1041, the first contact 1045, and the conductor 1049 forms an energy supply path from the bipolar energy source 1060 to the first electrode 1071. A path including the conductor 1051, the second contact 1047, and the second conductor 1043 can continuously provide an energy return path from the second electrode 1073 to the bipolar energy source 1060. As the nut 1009 is translated in the direction indicated by arrow A, rotation of the spool 1059 can take up excess slack in the first and second conductors 1041, 1043.

[0072] 20 generally depicts another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1108 is shown coupled to a beam 1126 that extends into a support tube 1140, shown in cross section. As shown, first and second electrodes 1171, 1173 may be coupled to the blade assembly 1108. A nut 1109 may be threadedly engaged to a rotating member 1180 such that rotation of the rotating member 1180 results in longitudinal movement of the nut 1109 along the length of the rotating member 1180. The proximal end of the beam 1126 may be coupled or otherwise engaged to the nut 1109 such that proximal movement of the nut 1109 along the rotating member 1180 results in movement of the beam 1126 in the same direction.

[0073] The distal end of the beam can include a flexible circuit connection 1045. The flexible circuit connection 1145 can be in electrical contact with a first electrode 1171 through a conductor 1149 routed along the beam 1126. The flexible circuit connection 1145 can be in electrical contact with a second electrode 1173 through a conductor 1151 routed along the beam 1126.

[0074] A flexible circuit 1141 (sometimes referred to as a flexible printed circuit or flex circuit), in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1160, can be routed within the support tube 1140 and connected to a flexible circuit connection 1145. The flexible circuit 1141 can be in electrical communication with a slip ring 1159, which can be coupled to a spool, for example. The flexible circuit 1141 can contain multiple conductors (i.e., traces) adhered to a substrate. For example, the flexible circuit 1141 can include first and second traces, each in electrical communication with a bipolar energy source 1160.

[0075] During surgery, the nut 1109 is translated in the direction indicated by arrow A by rotation of the rotating member 1180. An energy delivery path may be continuously provided to tissue being resected by the blade assembly 1108. More specifically, a path including the flexible circuit 1141, the flexible circuit connection 1145, and the conductor 1149 forms an energy delivery path from the bipolar energy source 1160 to the first electrode 1171. A path including the conductor 1151, the flexible circuit connection 1145, and the flexible circuit 1141 may be continuously provided to provide an energy return path from the second electrode 1173 to the bipolar energy source 1160.

[0076] 21 diagrammatically illustrates another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1208 is shown coupled to a beam 1226 that extends into a support tube 1240, shown in cross section. As shown, first and second electrodes 1271, 1273 may be coupled to the blade assembly 1208. A nut 1209 may be threadedly engaged to a rotating member 1280 such that rotation of the rotating member 1280 results in longitudinal movement of the nut 1209 along the length of the rotating member 1280. The proximal end of the beam 1226 may be coupled or otherwise engaged to the nut 1209 such that proximal movement of the nut 1209 along the rotating member 1280 results in movement of the beam 1226 in the same direction.

[0077] The nut 1209 can include a first contact 1245 and a second contact 1247. The first contact 1245 can be in electrical contact with a first electrode 1271 through a conductor 1249 routed from the nut 1209 along the beam 1226. The second contact 1247 can be in electrical contact with a second electrode 1273 through a conductor 1251 routed from the nut 1209 along the beam 1226.

[0078] A first conductor 1241 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1260, may be routed within the support tube 1240 and connected to a first contact 1245. Additionally, a second conductor 1243 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1260, may be routed within the support tube 1240 and connected to a second contact 1247. The first and second conductors 1241, 1243 may be wound around a spool 1259, which may be similar to spool 159 of FIG.

[0079] During surgery, the nut 1209 is translated in the direction indicated by arrow A by rotation of the rotating member 1280. An energy supply path can be continuously provided to tissue being resected by the blade assembly 1208. More specifically, a path including the conductor 1241, the first contact 1245, and the conductor 1249 forms an energy supply path from the bipolar energy source 1260 to the first electrode 1271. A path including the conductor 1251, the second contact 1247, and the second conductor 1243 can continuously provide an energy return path from the second electrode 1273 to the bipolar energy source 1260. As the nut 1209 is translated in the direction indicated by arrow A, rotation of the spool 1259 can take up excess slack in the first and second conductors 1241, 1243.

[0080] 22 generally depicts another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1308 is shown coupled to a beam 1326 that extends into a support tube 1340, shown in cross section. As shown, first and second electrodes 1371, 1373 may be coupled to the blade assembly 1308. A nut 1309 may be threadedly engaged to a rotating member 1380 such that rotation of the rotating member 1380 results in longitudinal movement of the nut 1309 along the length of the rotating member 1380. The proximal end of the beam 1326 may be coupled or otherwise engaged to the nut 1309 such that proximal movement of the nut 1309 along the rotating member 1380 results in movement of the beam 1326 in the same direction.

[0081] The nut 1309 can include a flexible circuit connection 1345. The flexible circuit connection 1345 can be in electrical contact with a first electrode 1371 through a conductor 1349 routed from the nut 1309 along the beam 1326. The flexible circuit connection 1345 can be in electrical contact with a second electrode 1373 through a conductor 1351 routed from the nut 1309 along the beam 1326.

[0082] A flexible circuit 1341 (sometimes referred to as a flexible printed circuit or flex circuit), in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1360, can be routed within the support tube 1340 and connected to a flexible circuit connection 1345. The flexible circuit 1341 can be in electrical communication with a slip ring 1359, which can be coupled to a spool, for example. The flexible circuit 1341 can contain multiple conductors (i.e., traces) adhered to a substrate. For example, the flexible circuit 1341 can include first and second traces, each in electrical communication with a bipolar energy source 1360.

[0083] During surgery, the nut 1309 is translated in the direction indicated by arrow A by rotation of the rotating member 1380. An energy supply path may be continuously provided to tissue being resected by the blade assembly 1308. More specifically, a path including the flexible circuit 1341, the flexible circuit connection 1345, and the conductor 1349 provides an energy supply path from the bipolar energy source 1360 to the first electrode 1371. A path including the conductor 1351, the flexible circuit connection 1345, and the flexible circuit 1341 may continuously provide an energy return path from the second electrode 1373 to the bipolar energy source 1360.

[0084] 23A-23B generally depict another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1408 is shown coupled to a beam 1426 extending into a support tube 1440 shown in cross section. As shown, first and second electrodes 1471, 1473 may be coupled to the blade assembly 1408. A nut 1409 may be threadedly engaged to a rotating member 1480 such that rotation of the rotating member 1480 results in longitudinal movement of the nut 1409 along the length of the rotating member 1480. The proximal end of the beam 1426 may be coupled or otherwise engaged to the nut 1409 such that proximal movement of the nut 1409 along the rotating member 1480 results in movement of the beam 1426 in the same direction.

[0085] A tracking nut 1411 can be positioned distal to the nut 1409. The tracking nut 1411 can be threaded onto the rotating member 1480 as shown, or can be threaded onto a different rotating member. The tracking nut 1411 can be configured to move proximally at a slower rate than the proximal movement of the nut 1409. To accommodate this speed differential when the tracking nut 1411 is threaded onto the rotating member 1480, the tracking nut 1411 can have a different thread pattern than the nut 1409. The tracking nut 1411 can include one or more pins, shown as pin 1413 and pin 1415.

[0086] 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 a first electrode 1471 through a conductor 1449 routed along the beam 1426. The second contact 1447 can be in electrical contact with a second electrode 1473 through a conductor 1451 routed along the beam 1426.

[0087] A first conductor 1441 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1460, can be routed within the support tube 1440, looped around the pin 1413, and then connected to a first contact 1445. Additionally, a second conductor 1443 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1460, can be routed within the support tube 1440, looped around the pin 1415, and then connected to a second contact 1447.

[0088] During surgery, an energy delivery path can be continuously provided to tissue being resected by blade assembly 1408. More specifically, a path including conductor 1441, first contact 1445, and conductor 1449 forms an energy delivery path from bipolar energy source 1460 to first electrode 1471. A path including conductor 1451, second contact 1447, and second conductor 1443 can be continuously provided to provide an energy return path from second electrode 1473 to bipolar energy source 1460.

[0089] Nut 1409 may initially be longitudinally separated from trailing nut 1411 by a distance D1 (FIG. 23A). Both nuts may be translated in the direction indicated by arrow A by rotation of rotating member 1480. Nut 1409 may advance an additional distance, thereby increasing the distance between nut 1409 and trailing nut 1411 to a distance D2 (FIG. 23B). Because conductors 1441 and 1443 are looped around pins 1413 and 1415, respectively, such an increase in separation during operation may help manage slack formed in conductors 1441 and 1443 as nut 1409 is translated in the direction indicated by arrow A.

[0090] 24A-B generally depict another exemplary, non-limiting embodiment for electrically coupling an electrode to a source of electrosurgical energy and maintaining such coupling during surgery. A blade assembly 1508 is shown coupled to a beam 1526 extending into a support tube 1540 shown in cross section. As shown, first and second electrodes 1571, 1573 may be coupled to the blade assembly 1508. A nut 1509 may be threadedly engaged to a rotating member 1580 such that rotation of the rotating member 1580 results in longitudinal movement of the nut 1509 along the length of the rotating member 1580. The proximal end of the beam 1526 may be coupled or otherwise engaged to the nut 1509 such that proximal movement of the nut 1509 along the rotating member 1580 results in movement of the beam 1526 in the same direction.

[0091] A tracking nut 1511 can be positioned distal to the nut 1509. The tracking nut 1511 can be threaded onto the rotating member 1580 as shown, or can be threaded onto a different rotating member. The tracking nut 1511 can be configured to move proximally slower than the proximal movement of the nut 1509. To accommodate this speed differential when the tracking nut 1511 is threaded onto the rotating member 1580, the tracking nut 1511 can have a different thread pattern than the nut 1509. The tracking nut 1511 can include one or more pins, shown as pin 1513 and pin 1515.

[0092] The nut 1509 can include a first contact 1545 and a second contact 1547. The first contact 1545 can be in electrical contact with a first electrode 1571 through a conductor 1549 routed from the nut 1509 along the beam 1526. The second contact 1547 can be in electrical contact with a second electrode 1573 through a conductor 1551 routed from the nut 1509 along the beam 1526.

[0093] A first conductor 1541 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1560, can be routed within the support tube 1540, looped around the pin 1513, and then connected to a first contact 1545. Additionally, a second conductor 1543 in electrical communication with an electrosurgical energy source, such as a bipolar energy source 1560, can be routed within the support tube 1540, looped around the pin 1515, and then connected to a second contact 1547.

[0094] During surgery, an energy delivery path can be continuously provided to tissue being resected by blade assembly 1508. More specifically, a path including conductor 1541, first contact 1545, and conductor 1549 forms an energy delivery path from bipolar energy source 1560 to first electrode 1571. A path including conductor 1551, second contact 1547, and second conductor 1543 can be continuously provided to provide an energy return path from second electrode 1573 to bipolar energy source 1560.

[0095] Nut 1509 may initially be longitudinally separated from trailing nut 1511 by a distance D1 (FIG. 24A). Both nuts may be translated in the direction indicated by arrow A by rotation of rotating member 1580. Nut 1509 may advance an additional distance, thereby increasing the distance between nut 1509 and trailing nut 1511 to a distance D2 (FIG. 24B). Because conductors 1541 and 1543 are looped around pins 1513 and 1515, respectively, such increased separation during surgery may help manage slack formed in conductors 1541 and 1543 as nut 1509 is translated in the direction indicated by arrow A.

[0096] 25, an exemplary nut 1609 is shown according to one non-limiting embodiment. The nut 1609 can be similar to, for example, nut 909 (FIGS. 18A-18B). The nut 1609 can include threads 1611 configured to engage a rotating member. The nut 1609 can further include a first contact 1645 and a second contact 1647. In FIG. 25, the first contact 1645 and the second contact 1647 are illustrated as leaf springs configured to contact conductive strips, such as conductive strips 941 and 943 (FIGS. 18A-18B). The nut 1609 can further include conductors 1649 and 1651 that are coupled to a circuit on a beam (not shown).

[0097] 26, another exemplary nut 1709 is shown according to one non-limiting embodiment. The nut 1709 can be similar to, for example, nut 909 (FIGS. 18A-18B). The nut 1709 can include threads 1711 configured to engage a rotating member. The nut 1709 can further include a first contact 1745 and a second contact 1747. In FIG. 25, the first contact 1745 and the second contact 1747 are illustrated as brushes configured to contact conductive strips such as conductive strips 941 and 943 (FIGS. 18A-18B). The nut 1709 can further include conductors 1649 and 1651 that are coupled to a circuit on a beam (not shown).

[0098] 27, a cutaway view of electrosurgical stapling device 1900 is shown. Electrosurgical stapling device 1900 can be similar to electrosurgical stapling device 100 (FIGS. 1-2). In this regard, electrosurgical stapling device 1900 can include a nut 1909 that translates along rotatable member 1980 during rotation of rotatable member 1980. In the illustrated embodiment, nut 1909 has a flexible circuit 1941 connected thereto, for example, similar to the arrangement in FIG. 22. Spool assembly 1959 can be configured to receive flexible circuit 1941 as nut 1909 translates in the direction indicated by arrow A during surgery.

[0099] FIG. 28 provides a close-up view of the spool assembly 1959, and FIG. 29 provides an exploded view of the spool assembly 1959. The spool assembly 1959 can include a shell 1912 that defines a slot 1914 through which the flexible circuit 1941 passes before being wound around the bobbin 1910. The bobbin 1910 can be rotated about a rotation axis 1920 as the nut 1909 translates towards the spool assembly 1959 to retrieve the flexible circuit 1941. Thus, during operation, the bobbin 1910 can be rotated relative to the shell 1912 to retract the flexible circuit 1941 into the spool assembly 1959.

[0100] The spool assembly 1959 may further include a slip ring assembly 1957 for delivering energy to the flexible circuit 1941. The slip ring assembly 1957 may include first and second contacts 1902, 1906 disposed on an outer surface of the bobbin 1910. The first and second contacts 1902, 1906 may be in electrical communication with the flexible circuit 1941 through any suitable connection. The first contact 1902 may be configured to remain in constant contact with the first circular electrode 1904 during rotation of the bobbin 1910. The second contact 1906 may be configured to remain in constant contact with the second circular electrode 1908 during rotation of the bobbin 1910. Each of the first and second electrodes 1904, 1908 may be in electrical communication with a bipolar energy source 1906 (FIG. 29).

[0101] While certain embodiments described herein describe the use of circuits along the beam to deliver electrosurgical energy to electrodes positioned on the blade assembly, the present disclosure is not limited to such use. For example, with reference to FIGS. 30-31, an exemplary embodiment is shown in which a first conductive strip 2041 is positioned within the anvil assembly 2001 and a second conductive strip 2043 is positioned within the cartridge assembly 2003. Each of the conductive strips 2041, 2043 can be in electrical communication with a suitable source of electrosurgical energy (not shown). FIG. 30 depicts an exemplary blade assembly 2008 having first and second electrodes 2071, 2073 that can be generally similar to conventional embodiments. The exemplary blade assembly 2008 further includes 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 strip 2041 positioned within the anvil assembly 2001. The exemplary blade assembly 2008 further includes a second pick-up electrode 2047 in electrical communication with the second electrode 2073. The second pick-up electrode 2047 is configured to contact a second conductive strip 2043 positioned within the cartridge assembly 2003. Thus, the pick-up electrodes 2045, 2047 can remain in contact with the conductive strips 2041, 2043 during a surgical impulse as the blade assembly 2008 passes through the anvil assembly 2001 and the cartridge assembly 2003.

[0102] FIG. 32 depicts another exemplary blade assembly 3008 having first and second electrodes 3071, 3073 that may be generally similar to the prior art embodiment. The exemplary blade assembly 3008 further includes 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 strip positioned within the anvil assembly. The exemplary blade assembly 3008 further includes 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 strip positioned within the anvil assembly. The configuration of FIG. 32 may allow the configuration strip to be embedded deeper within the anvil assembly and thus further away from the patient's tissue during surgery.

[0103] While many of these embodiments show the use of electrodes, it will be appreciated that any suitable technique for cauterizing, coagulating / dehydrating, and / or sealing tissue can be used. For example, in some implementations, one or more resistive heating elements can be coupled to the blade assembly. When energized, the one or more resistive heating elements can deliver heat directly to the tissue along the incision. In some implementations, the one or more resistive heating elements can be located only on one side of the blade assembly such that heat is directed to one side of the incision. Alternatively, the one or more resistive heating elements can be located on both sides of the blade assembly. Additionally, in some embodiments, the blade assembly can include a heating assembly including the resistive heating element and, for example, a heating pad or other suitable heat dissipation structure. Such a structure can be positioned in close proximity to the resistive heating element and configured to directly contact the tissue. The heat dissipation structure can help dissipate heat from the resistive heating element into the tissue, for example, during a transection.

[0104] FIG. 33 depicts an example blade assembly 3108 including an example resistive heating element 3171. The example blade assembly 3108 further includes a heating pad 3172 configured to cover the resistive heating element 3171 and help dissipate heat generated by the resistive heating element 3171 during surgery. The resistive heating element 3171 may be energized by a circuit 3111 that extends along the beam 3126. Although FIG. 33 shows the resistive heating element 3171 located only on a first side of the blade assembly 3108, it will be appreciated that other embodiments may have a similar resistive heating element located on the other side as well.

[0105] 34 depicts an example blade assembly 3208 including another example resistive heating element 3271. The resistive heating element 3271 may be energized by a circuit 3211 that extends along the beam 3226. It will be appreciated that while FIG. 34 shows the resistive heating element 3271 located only on a first side of the blade assembly 3208, other embodiments may have a similar resistive heating element located on the other side as well. As shown, the resistive heating element 3271 may include a curved outer surface that may aid in bringing it into contact with tissue during ablation.

[0106] FIG. 35 illustrates an exemplary blade assembly 3308 including multiple resistive heating elements 3371. The resistive heating elements 3371 can be energized by a circuit 3311 that extends along the beam 3326. It will be appreciated that while FIG. 35 shows the resistive heating elements 3371 located only on a first side of the blade assembly 3308, other embodiments can have similar resistive heating elements located on the other side as well. As shown, the resistive heating elements 3371 include a curved outer surface, but the present disclosure is not limited to that shape. In the illustrated embodiment, the resistive heating elements 3371 are linearly positioned in the direction of travel of the beam 3326 with gaps between them. The particular spacing between adjacent resistive heating elements 3371, as well as the size of the resistive heating elements 3371, can be selected based on various operating parameters. As an example, the spacing between adjacent resistive heating elements 3371 can help reduce the likelihood of tissue becoming burned during surgery. Further, in some embodiments, each resistive heating element 3371 can be configured to heat to substantially the same temperature when energized. In other embodiments, the operating temperature of each of the various resistive heating elements 3371 can be varied to achieve a desired temperature profile, for example. Finally, although three resistive heating elements 3371 are shown in FIG. 35, it is to be appreciated that the present disclosure is not limited to three resistive heating elements 3371, as some embodiments can utilize fewer than three resistive heating elements 3371, while other embodiments can utilize more than three resistive heating elements 3371.

[0107] In other embodiments, instead of utilizing bipolar electrosurgical techniques or resistive heating elements to cauterize and seal tissue, some surgical devices may utilize monopolar electrosurgical techniques to deliver energy to tissue. FIG. 36, for example, illustrates an exemplary blade assembly 3408 including an exemplary active electrode 3471. The active electrode 3471 may be energized by a circuit 3411 that extends along the beam 3426. During surgery, a return electrode (not shown) may be attached to the patient such that current flows from the generator to the active electrode 3471, then through the target tissue to the return electrode, and back to the generator. In this manner, tissue along the incision may be cauterized by delivering energy into the tissue using the active electrode 3471.

[0108] Although various embodiments are described herein in the context of endocutters, it is to be appreciated that the present disclosure is not limited to the context of endocutters. Rather, bipolar electrode arrangements according to the present disclosure can be incorporated into a wide variety of surgical tools and systems having cutting edges. More specifically, electrodes according to the present disclosure can be incorporated into tools and systems that can be configured to cauterize, coagulate / dehydrate, and / or seal tissue cut by such cutting edges in proximity to the cutting edges.

[0109] 37-39, an exemplary electrosurgical circular stapler 4000 in accordance with the present disclosure is illustrated. The exemplary electrosurgical circular stapler 4000 can be used to provide an end-to-end, side-to-side, or end-to-side anastomosis between two sections 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.

[0110] The electrosurgical circular stapler 4000 can further include a connection 4120 to a bipolar energy source 4060. The bipolar energy source 4060 can be configured to deliver electrosurgical energy to electrodes positioned on 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 releasably couple to the shaft assembly 4200 at a location adjacent the stapling head assembly 4300. The anvil 4400 and the stapling head assembly 4300 can cooperate to fasten tissue, cut tissue, staple tissue, and seal tissue. A knob 4130 at a proximal end of the handle assembly 4100 can be rotatable relative to the casing 4110 to enable precise fastening of tissue between the anvil 4400 and the stapling head assembly 4300. When the safety trigger 4140 of the handle assembly 4100 is pivoted away from the firing trigger 4150 of the handle assembly 4100, the firing trigger 4150 can be actuated, thereby providing tissue cutting, stapling, and sealing.

[0111] 38 provides an exploded view of the stapling head assembly 4300. The stapling head assembly 4300 can include a body member 4310 and a slidable staple driver member 4350. The body member 4310 includes a distally extending cylindrical inner core member 4312. The body member 4310 is fixedly secured to an outer sheath 4210 of the shaft assembly 4200 (FIG. 37).

[0112] As shown in FIG. 38 , the stapling head assembly 4300 can further include a trocar 4330 and a circular knife member 4340 coaxially positioned within the staple driver member 4350. The knife member 4340 includes a sharp circular cutting edge 4342 directed distally. The knife member 4340 is sized such that it defines an outer diameter that is smaller than the diameter defined by the inner annular array of staple drivers 4352. The knife member 4340 has a cylindrical wall 4360 having first and second electrodes 4071, 4073 positioned thereon. 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 in light of the teachings herein.

[0113] As shown in the close-up view of the knife member 4340 in FIG. 38, the first and second electrodes 4071, 4073 can be in electrical communication with the first and second contacts 4045, 4047, respectively. The flexible circuit 4041 can be in electrical communication with the first and second contacts 4045, 4047, and with the bipolar energy source 4059, for example. Although FIG. 38 depicts the first and second electrodes 4071, 4073 as being approximately rings surrounding the knife member 4340, the present disclosure is not limited to that shape. For example, FIG. 39 depicts a knife member 5340 having a plurality of laterally spaced electrodes 5071, 5073 positioned in an alternating manner about an outer surface 5075. The electrodes 5071, 5073 can be in communication with the bipolar energy source 5059, for example, through the flexible circuit 5041. In this embodiment, electrode 5071 is shown as the “active” electrode and is in contact with the bipolar energy source 5059 through contact 5045. Electrode 5073 is shown as the “inactive” electrode and is in contact with the bipolar energy source 5059 through contact 5047.

[0114] Additionally, the systems and methods described herein can be used with a variety of different types of bladed medical tools and instruments, some non-limiting examples of which are illustrated in Figures 40-41. Referring first to Figure 40, an electrosurgical scalpel 6000 is shown in electrical communication with a bipolar energy source 6059. The electrosurgical scalpel 6000 can include two electrodes 6071, 6073 positioned proximate a cutting edge 6007 at a distal end. The electrodes 6071, 6073 can be in electrical communication with the bipolar energy source 6059 through a flexible circuit 6041, among other suitable connection techniques. Referring now to Figure 41, an electrosurgical scissors 7000 is shown in electrical communication with a bipolar energy source 6059. The electrosurgical scissors 7000 can include two electrodes 7071, 7073 positioned proximate a cutting edge 7007 of the electrosurgical scissors. The electrodes 7071, 7073 may be in electrical communication with the bipolar energy source 7059 through a flexible circuit 7041, among other suitable connection techniques.

[0115] 42-44 depict an electrosurgical stapling and severing instrument according to various non-limiting embodiments, with FIG 43 showing a cross-sectional view of the end effector and FIG 44 illustrating a firing bar. With reference to FIG 42, the electrosurgical stapling and severing instrument 8010 includes a handle portion 8012 that is manipulated to position an implement portion 8014 that includes a fastening end effector shown as a staple applying assembly 8016 attached distally to an elongated shaft 8018. The implementation portion 8014 is sized to be inserted through a cannula of a trocar (not shown) in an endoscopic or laparoscopic surgical procedure by depressing the closure trigger 8024 toward the pistol grip 8026 of the handle portion 8012, thereby advancing the outer closure sleeve 8028 of the elongated shaft 8018 and pivoting the anvil 8020 closed, thereby causing the upper jaw (anvil) 8020 and lower jaw 8022 of the staple applying assembly 8016 to be inserted in a closed position.

[0116] Once inserted into a body cavity or lumen in an aspirated state, the surgeon can rotate the implement portion 8014 about its longitudinal axis by twisting a shaft rotation knob 8030 engaged between the distal end of the handle 8012 and the proximal end of the elongated shaft 8018. Once so positioned, the closure trigger 8024 can be released, opening the anvil 8020 so that tissue can be grasped and positioned. With tissue sufficiently held within the staple applying assembly 8016, the surgeon depresses the closure trigger 8024 until it locks against the pistol grip 8026, fastening the tissue inside the staple applying assembly 8016.

[0117] The firing trigger 8032 is then depressed and drawn toward the closure trigger 8024 and pistol grip 8026, thereby applying a firing force or motion to the firing trigger 8032 that advances the firing member distally from an unfired position. The firing member is illustrated as being supported within a housing ground 8038 that connects the handle portion 8012 to the staple applying assembly 8016 and including a proximal firing rod 8034 attached to a distal firing bar 8036. During the staple firing motion, the firing bar 8036 actuates a staple cartridge 8042 that engages and is trapped within an elongated staple channel 8040 that together form the lower jaw 8022. The firing bar 8036 also engages the anvil 8020. After releasing the firing trigger 8032 and applying a retraction force or movement to the firing bar 8036, the closure trigger 8024 is unclamped by depressing the closure release button 8044, thereby retracting the closure sleeve 8028 to pivot and open the anvil 8020 and release the severed and stapled tissue from the staple applying assembly 8016.

[0118] In FIG. 43 , the staple applying assembly 8016 is closed to compress tissue 8046. In FIGS. 43 and 44 , the firing bar 8036 has a proximal portion 8048 attached to a distal E-beam 8050 that translates within the staple applying assembly 8016. As shown with the firing bar 8036 retracted, the vertical portion 8052 of the E-beam 8050 resides substantially rearward of the staple cartridge 8042, as it will after a new staple cartridge 8042 has been inserted into the elongated staple channel 8040. An upper pin 8054 extending laterally from an upper portion of the vertical portion 8052 of the E-beam 8050 initially resides in an invaginated anvil pocket 8056 near the pivot end of the anvil 8020. As the E-beam 8050 advances during the staple firing movement, the vertical portion 8052 passes through a narrow longitudinal anvil slot 8058 formed in the staple forming underside 8060 of the anvil 8020, a proximally opening vertical slot 8062 formed in the cartridge 8042, and an underlying longitudinal channel slot 8064 formed in the elongated staple channel 8040.

[0119] The narrow longitudinal anvil slot 8058 communicates upwardly to a laterally wide longitudinal anvil channel 8066 sized to slidably receive the upper pin 8054. The longitudinal channel slot 8064 communicates downwardly to a laterally wide longitudinal channel track 8068 which receives a lower foot 8070 sized to slide within the laterally wide longitudinal channel track 8068 and attached to the bottom of the vertical portion 8052 of the E-beam 8050. A laterally wide central pin 8072 extending from the vertical portion 8052 of the E-beam 8050 is positioned to slide along an upper surface of a bottom tray 8074 of the staple cartridge 8042 which subsequently abuts on the elongated staple channel 8040. A longitudinal firing recess 8075 formed within the staple cartridge 8042 above the bottom tray 74 is sized to allow the laterally wide central pin 8072 to translate through the staple cartridge 8042 .

[0120] A distal drive surface 8076 of the vertical portion 8052 of the E-beam 8050 is positioned to translate through the proximally-opening vertical slot 8062 of the staple cartridge 8042 and to distally drive a wedge sled 8078 disposed proximally within the staple cartridge 8042. The vertical portion 8052 of the E-beam 8050 includes a cutting surface 8080 along its distal edge above the distal drive surface 8076 and below the upper pin 8054 which simultaneously severs the fastened tissue 8046 as it is stapled.

[0121] First and second electrodes 8071, 8073 can be positioned on the E-beam 8050. The first and second electrodes 8071, 8073 can be in electrical communication with a bipolar energy source 8059 through circuitry 8041 and can be activated during distal advancement of the E-beam 8050 through the tissue 8046. Although the first and second electrodes 8071, 8073 are shown positioned only on a first side of the E-beam 8050, the present disclosure is not so limited. Instead, one or more electrodes can be placed on either side of the E-beam 8050 to achieve hemostasis by heating the tissue 8046 and blood vessels to cauterize, coagulate / dehydrate, and / or seal the tissue 8046.

[0122] In various embodiments disclosed herein, multiple components may be substituted for single components and multiple components may be substituted for single components to perform a given function or functions. Except where such substitutions are not considered to be effective, such substitutions are within the contemplated scope of these embodiments. For example, the height of the staple legs, the materials from which the staples are made, the depth of the anvil pockets, the shape of the anvil pockets, and the asymmetry of the anvil pockets may all be varied in any combination.

[0123] The above description of the embodiments and examples has been presented for purposes of illustration and description. This description is not intended to be exhaustive or limited to the form described. Many modifications are possible in light of the above teachings. Some of these modifications have been discussed, while others will be apparent to those skilled in the art. The embodiments have been chosen and described in order to best illustrate the principles of the various embodiments as suited to the particular use contemplated. The scope is, of course, not limited to the examples set forth herein, and those skilled in the art can employ this scope in any number of applications and equivalent devices. Rather, the scope of the invention is hereby intended to be defined by the claims appended hereto. [Explanation of symbols]

[0124] 10 Stomach 12 Resection line 22 Gastroesophageal Junction 26 Greater curvature of the stomach 30 Pylorus

Claims

1. An electrosurgical instrument for stapling, excising, and sealing the anatomical structures of a patient, (a) (i) An anvil including a first end, a second end, and an anvil surface that can be positioned on the first side of the anatomical structure, (ii) A cartridge configured to be operable to accommodate a plurality of staples, comprising a first end, a second end, and a cartridge surface positionable on the second side of the anatomical structure, wherein the cartridge surface defines a channel extending from the first end of the cartridge to the second end of the cartridge, and the first end of the cartridge pivotally coupled to the first end of the anvil, (iii) A blade assembly comprising a blade, a beam, and a nut, wherein the blade includes a first side and a second side joined at the cutting edge, and at least a portion of the blade assembly slidably engages with the channel, (iv) First and second electrodes coupled to the first side of the blade, End effectors including, (b) An elongated tube having a proximal end and a distal end connected to the end effector, (c) A handle having a proximal end and a distal end connected to the proximal end of the elongated tube, (d) A drive assembly including a motor that operates the end effector, (e) an electrosurgical power source electrically connected to the first and second electrodes, Surgical instruments including those mentioned.

2. The electrosurgical instrument according to claim 1, wherein the blade assembly includes at least one elongated arm that pushes each of the plurality of staples out of the cartridge when the blade is advanced from a first position at the distal end of the cartridge to a second position at the proximal end of the cartridge.

3. The electrosurgical instrument according to claim 1, wherein the blade assembly is L-shaped so as to compress the anvil and the cartridge during use.

4. Further comprising a first conductive strip and a second conductive strip, The anvil defines a channel, the first conductive strip is positioned in the channel defined by the anvil, and the second conductive strip is positioned in the channel defined by the cartridge. The blade assembly includes a first contact that engages with the first conductive strip and a second contact that engages with the second conductive strip. The first contact is electrically connected to the first electrode, and the second contact is electrically connected to the second electrode. The electrosurgical instrument according to claim 3.

5. The electrosurgical instrument according to claim 4, wherein the first electrode is electrically connected to the electrosurgical power source through the first conductive strip, and the second electrode is electrically connected to the electrosurgical power source through the second conductive strip.

6. The electrosurgical instrument according to claim 1, wherein when the blade is advanced from a first position at the distal end of the cartridge to a second position at the proximal end of the cartridge, an incision portion having a first side and a second side is formed in the anatomical structure.

7. The electrosurgical instrument according to claim 1, wherein the first and second electrodes come into contact with the anatomical structure when the blade is advanced from a first position at the distal end of the cartridge to a second position at the proximal end of the cartridge.

8. The electrosurgical instrument according to claim 1, further comprising a circuit connecting each of the first and second electrodes to the electrosurgical power source.

9. The electrosurgical instrument according to claim 8, wherein the circuit comprises a first conductive strip coupled to the inner surface of the elongated tube and a second conductive strip coupled to the inner surface of the elongated tube.

10. The electrosurgical instrument according to claim 9, wherein the nut includes a first contact electrically communicating with the first conductive strip and a second contact electrically communicating with the second conductive strip.

11. The electrosurgical instrument according to claim 10, wherein each of the first contact and the second contact is either a brush contact or a spring contact.

12. The electrosurgical instrument according to claim 9, wherein the beam includes a first contact electrically communicating with the first conductive strip and a second contact electrically communicating with the second conductive strip.

13. The electrosurgical instrument according to claim 1, further comprising a beam circuit extending along the length of the beam.

14. The electrosurgical instrument according to claim 13, wherein the beam defines a longitudinal slot, and at least a portion of the beam circuit is positioned within the longitudinal slot.

15. The electrosurgical instrument according to claim 1, wherein the first and second electrodes each have substantially planar outer surfaces.

16. The electrosurgical instrument according to claim 1, wherein the first and second electrodes each have a curved outer surface.

17. Further including a circuit board, The aforementioned handle defines the cavity, The circuit board is positioned inside the cavity. The electrosurgical instrument according to claim 1.

18. Further including a follow-up nut containing at least one pin, The circuit includes at least one conductor, The distal end of the at least one conductor is coupled to the beam, and the proximal end of the at least one conductor is coupled to the circuit board. A portion of the at least one conductor between the proximal end and the distal end is wrapped around the pin. The electrosurgical instrument according to claim 17.

19. The blade further includes third and fourth electrodes coupled to the second side of the blade, The electrosurgical power source is electrically connected to the third and fourth electrodes. The electrosurgical instrument according to claim 1.

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