Electrosurgical instrument with jaws and / or electrodes and an electrosurgical amplifier

Abstract

To provide an electrosurgical instrument having jaws and / or electrodes and an electrosurgical amplifier.SOLUTION: The electrosurgical instrument includes a jaw (102, 104) having an electrode configuration (103a, 103b, 105b) that is used to electrically alter tissue in contact with one or more electrodes. The instrument may be removably coupled to the electrosurgical unit via an electrosurgical connector extending between the instrument and a receptacle of the electrosurgical unit. The electrosurgical instrument can be rotated without breaking the electrical connections to the electrodes of the jaws. One or more of the electrodes may be retractable. The electrosurgical unit and instrument optimally seal and / or cut tissue by applying radio frequency energy based on tissue identification and monitoring of tissue modification.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 60 / 389,012, filed October 1, 2010, the entire disclosure of which is incorporated herein by reference.

[0002] FIELD OF THE INVENTION This application relates generally to electrosurgical systems and methods, and more particularly to electrosurgical instruments and connections between the instruments and electrosurgical units. [Background technology]

[0003] Surgery often requires the cutting and joining of bodily tissue, including organs, muscle tissue, connective tissue, and the vascular system. For centuries, sharp blades and sutures have been the mainstay of cutting and reconnecting procedures. During surgery, cutting bodily tissue, especially relatively highly vascularized tissue, results in bleeding. Thus, surgeons and other physicians have long sought surgical instruments and methods that would slow or reduce bleeding during surgery.

[0004] Recently, electrosurgical instruments have become available that use electrical energy to perform specific surgical tasks. Typically, electrosurgical instruments are handheld instruments such as graspers, scissors, forceps, blades, needles, and other handheld instruments that include one or more electrodes configured to receive electrical energy from an electrosurgical unit that includes a power source. The electrical energy can be used to coagulate, weld, or cut the tissue to which the instrument is applied. Advantageously, unlike typical procedures using blades, application of electrical energy to the tissue stops bleeding of the tissue.

[0005] Electrosurgical instruments are typically divided into two types: monopolar and bipolar. In monopolar instruments, electrical energy of a particular polarity is supplied to one or more electrodes of the instrument. A separate return electrode is electrically connected to the patient. While useful for certain procedures, monopolar electrosurgical instruments pose a risk of electrical burns to certain types of patients. This is due, at least in part, to the function of the return electrode. In bipolar electrosurgical instruments, one or more electrodes are electrically connected to a source of electrical energy of a first polarity and one or more other electrodes are electrically connected to a source of electrical energy of a second polarity opposite the first polarity. Thus, bipolar electrosurgical instruments, which operate without a separate return electrode, can deliver electrical signals to a concentrated area, reducing the risk of patient injury.

[0006] Although bipolar electrosurgical instruments produce a relatively concentrated surgical effect, the outcome is often highly dependent on the surgeon's skill. For example, delivery of electrical energy for a relatively long period of time or delivery of a relatively high-power electrical signal for a short period of time can result in thermal tissue damage and necrosis. The rate at which the desired coagulation or cutting effect occurs upon application of electrical energy varies depending on the type of tissue and the pressure applied to the tissue by the electrosurgical instrument. However, even highly experienced surgeons have difficulty assessing how quickly the electrosurgical instrument will heal a desired volume of tissue containing a combination of different tissue types. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] U.S. Provisional Patent Application No. 60 / 389,012 Summary of the Invention [Problem to be solved by the invention]

[0008] Various attempts have been made to reduce the risk of tissue damage during the electrosurgical process. For example, conventional electrosurgical systems include a generator that monitors ohmic resistance and tissue temperature during electrosurgical surgery and terminates electrical energy once a predetermined point is reached. However, these systems have suffered from the drawback of not providing consistent results for determining tissue coagulation, healing, or cutting endpoints for various tissue types or tissue combinations. These systems have also failed to provide consistent electrosurgical results across the use of various instruments with different instrument and electrode geometries. Typically, the electrosurgical unit must be recalibrated for each type of instrument used, even if the change is a relatively minor improvement to the instrument geometry during the product's lifespan. This is a costly and time-consuming procedure that can undesirably result in an electrosurgical unit being eliminated as an option. [Means for solving the problem]

[0009] Generally, electrosurgical instruments, units, and connections therebetween are provided. The various embodiments described with respect to the various instruments, units, and / or connections are interchangeable and applicable as described below. In one embodiment, an electrosurgical instrument is provided that includes a first jaw and a second jaw coupled to and facing the first jaw for capturing tissue therebetween. A first electrode is coupled to the first jaw. The first electrode can extend from a first location within the first jaw to a second location outside the first jaw. The first electrode is electrically connected to stationary electrodes positioned in the first and second jaws.

[0010] In another embodiment, the electrosurgical unit includes a radio frequency (RF) amplifier configured to deliver RF energy to coagulate and cut tissue, the RF amplifier delivering insufficient RF energy to tissue to fully coagulate the tissue before delivering RF energy to cut the tissue.

[0011] In another embodiment, an electrosurgical instrument is provided that includes a first jaw and a second jaw coupled to and facing the first jaw for capturing tissue therebetween, wherein first, second, third, and fourth electrodes are disposed on the first jaw and a fifth electrode is disposed on the second jaw.

[0012] In yet another embodiment, an electrosurgical instrument is provided that includes a first jaw and an opposing second jaw coupled to the first jaw for capturing tissue therebetween. A first electrode is coupled to the first jaw, and movable cutters are coupled to the first and second jaws. The instrument further includes an actuator having a stationary handle, a movable trigger coupled to at least one of the first and second jaws for moving the jaws between a spaced position and an approximated position, an elongated shaft coupled to the actuator and the first or second jaw, and a blade trigger movable along a longitudinal axis coupled to a blade shaft that is coupled to the movable cutter disposed within the elongated shaft. The instrument further includes a first stop that limits distal movement of the blade shaft along the longitudinal axis.

[0013] In one embodiment, the electrosurgical instrument includes a first jaw and an opposing second jaw coupled to the first jaw for capturing tissue therebetween, a first electrode coupled to the first jaw, an actuator including a rotatable elongate shaft coupled to the actuator and the first and second jaws, at least one conductive connector surrounding a portion of the rotatable elongate shaft within the actuator, at least one stationary contact disposed within the actuator and electrically connectable to the at least one conductive connector, and at least one conductive ring electrically connected to the first electrode. The present invention will be understood by reference to the following description taken in conjunction with the accompanying drawings, in which like reference numerals refer to like parts throughout the several views. [Brief explanation of the drawings]

[0014] [Figure 1] FIG. 1 is a perspective view of one embodiment of an electrosurgical instrument according to various embodiments of the present invention. [Figure 2A] FIG. 2A is a side view of an electrosurgical instrument with an associated coupler for connecting to an electrosurgical unit according to various embodiments of the present invention. [Figure 2B] FIG. 2B is an exploded view of an electrosurgical instrument with an associated coupler for connecting to an electrosurgical unit according to various embodiments of the present invention. [Figure 3A-1] FIG. 3A-1 is a side view of the interior of an actuator of an electrosurgical instrument according to various embodiments of the present invention. [Figure 3A-2] FIG. 3A-2 is a side view of the interior of an actuator of an electrosurgical instrument according to various embodiments of the present invention, with some components removed for ease of illustration. [Figure 3A-3] 3A-3 are perspective views of conductive connectors of electrosurgical instruments according to various embodiments of the present invention. [Figure 3A-4] 3A-4 are perspective views of the interior of an actuator of an electrosurgical instrument according to various embodiments of the present invention. [Figure 3A-5] 3A-5 are perspective views of conductive rings of electrosurgical instruments according to various embodiments of the present invention. [Figure 3A-6] 3A-6 are perspective views of the interior of an actuator of an electrosurgical instrument according to various embodiments of the present invention. [Figure 3A-7] 3A-7 are perspective views of contact brushes of electrosurgical instruments according to various embodiments of the present invention. [Figure 3A-8] 3A-8 are perspective views of exemplary single wire rotary connectors according to various embodiments of the present invention. [Figure 3B-1] 3B-1 are side views of various activation stages within an actuator of an electrosurgical instrument, according to various embodiments of the present invention. [Figure 3B-2] 3B-2 are side views of various activation stages within an actuator of an electrosurgical instrument, according to various embodiments of the present invention. [Figure 4A]FIG. 4A is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 4B] FIG. 4B is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 4C] FIG. 4C is a cross-sectional view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 5] FIG. 5 is an enlarged view of one of the jaws of an electrosurgical instrument according to various embodiments of the present invention. [Figure 6] FIG. 6 is a side view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 7] FIG. 7 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 8] FIG. 8 is an enlarged view of one of the jaws of an electrosurgical instrument according to various embodiments of the present invention. [Figure 9] FIG. 9 is a front view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 10] FIG. 10 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 11] FIG. 11 is a perspective view of an electrosurgical instrument with an associated coupler connected to an electrosurgical unit according to various embodiments of the present invention. [Figure 12] FIG. 12 is a side view of an electrosurgical instrument with an associated coupler connected to an electrosurgical unit according to various embodiments of the present invention. [Figure 13A] FIG. 13A is a side view of the interior of an actuator of an electrosurgical instrument according to various embodiments of the present invention. [Figure 13B-1] 13B-1 are side views of the interior of an actuator of an electrosurgical instrument at various stages of operation according to various embodiments of the present invention. [Figure 13B-2] 13B-2 are side views of the interior of an actuator of an electrosurgical instrument at various stages of operation according to various embodiments of the present invention. [Figure 13B-3]13B-3 are side views of the interior of an actuator of an electrosurgical instrument at various stages of operation according to various embodiments of the present invention. [Figure 13C-1] FIG. 13C-1 is a perspective view of the jaws and shaft of an electrosurgical instrument according to various embodiments of the present invention, with a portion of the shaft not shown. [Figure 13C-2] FIG. 13C-2 is a cross-sectional view of a cover tube of an electrosurgical instrument according to various embodiments of the present invention. [Figure 13C-3] FIG. 13C-3 is a perspective view of a cover tube of an electrosurgical instrument according to various embodiments of the present invention. [Figure 13C-4] 13C-4 are side views of cover tubes of electrosurgical instruments according to various embodiments of the present invention. [Figure 13C-5] FIG. 13C-5 is a perspective view of the jaws and shaft of an electrosurgical instrument according to various embodiments of the present invention, with a portion of the shaft not shown. [Figure 13C-6] 13C-6 are perspective views of the jaws and blade shaft of an electrosurgical instrument according to various embodiments of the present invention. [Figure 13C-7] 13C-7 is a side view of a blade shaft of an electrosurgical instrument according to various embodiments of the present invention. [Figure 13C-8] 13C-8 are cross-sectional views of shafts of electrosurgical instruments according to various embodiments of the present invention. [Figure 14] FIG. 14 is an exploded view of an electrosurgical instrument and coupler according to various embodiments of the present invention. [Figure 15A] FIG. 15A is a plan view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15B] FIG. 15B is a rear view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15C] FIG. 15C is a rear view of one jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15D] FIG. 15D is a plan view of the opposing jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15E]FIG. 15E is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15F] FIG. 15F is a side view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 15G] FIG. 15G is a cross-sectional view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 16] FIG. 16 is a side view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 17] FIG. 17 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 18] FIG. 18 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 19] FIG. 19 is an exploded view of an electrosurgical instrument and coupler according to various embodiments of the present invention. [Figure 20] FIG. 20 is a side view of a coupler of an electrosurgical instrument coupled to an electrosurgical unit according to various embodiments of the present invention. [Figure 21] FIG. 21 is an exploded view of a coupler of an electrosurgical instrument coupled to an electrosurgical unit according to various embodiments of the present invention. [Figure 22] FIG. 22 is an exploded view of a coupler of an electrosurgical instrument coupled to an electrosurgical unit according to various embodiments of the present invention. [Figure 23] FIG. 23 is a perspective view of a connector according to various embodiments of the present invention. [Figure 24] FIG. 24 is a perspective view of a connector according to various embodiments of the present invention. [Figure 25] FIG. 25 is an opposite perspective view of a connector according to various embodiments of the present invention. [Figure 26] FIG. 26 is a rear view of the circuitry, memory, and pin configuration of a connector according to various embodiments of the present invention. [Figure 27] FIG. 27 is a perspective view of the circuitry, memory, and pin configuration of a connector according to various embodiments of the present invention. [Figure 28]FIG. 28 is a perspective view of the circuitry, memory, and pin configuration of a connector according to various embodiments of the present invention. [Figure 29] FIG. 29 is a front view of a socket for an electrosurgical unit according to various embodiments of the present invention. [Figure 30A] FIG. 30A is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 30B] FIG. 30B is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 31] FIG. 31 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 32] FIG. 32 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 33] FIG. 33 is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 34A] FIG. 34A is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 34B] FIG. 34B is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 35A] FIG. 35A is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 35B] FIG. 35B is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 36A] FIG. 36A is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 36B] FIG. 36B is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 36C] FIG. 36C is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 36D] FIG. 36D is a perspective view of a jaw of an electrosurgical instrument according to various embodiments of the present invention. [Figure 37A] FIG. 37A is a perspective view of an electrosurgical instrument according to various embodiments of the present invention. [Figure 37B] FIG. 37B is a perspective view of an electrosurgical instrument according to various embodiments of the present invention. [Figure 38] FIG. 38 is an exemplary chart illustrating electrode placement according to various embodiments of the present invention. [Figure 39A-1] FIG. 39-1 is a perspective view of a monopolar pad and electrosurgical unit according to various embodiments of the present invention. [Figure 39A-2] FIG. 39-2 is an enlarged perspective view of a monopolar port of an electrosurgical unit according to various embodiments of the present invention. [Figure 39B] FIG. 39B is a perspective view of a monopolar pad, a monopolar and / or bipolar electrosurgical instrument, and an electrosurgical unit, according to various embodiments of the present invention. [Figure 40] FIG. 40 is a flow chart illustrating a pre-cut process for an electrosurgical instrument according to various embodiments of the present invention. [Figure 41] FIG. 41 is a block diagram of an electrosurgical unit according to various embodiments of the present invention. [Figure 42] FIG. 42 is a semi-schematic view of an electrosurgical unit according to various embodiments of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0015] An electrosurgical system, in one embodiment, includes an electrosurgical unit or generator capable of supplying radio frequency energy to one or more removably coupled electrosurgical instruments or tools. Such instruments and the connectors between the instruments and the electrosurgical unit are shown in the accompanying drawings. Each instrument is specifically designed to perform a particular clinical and / or technical operation or procedure. Furthermore, the connection or partnership between the electrosurgical unit and the instrument is such that the clinical and / or technical operation is performed, specifically enhancing the surgical capabilities of both the electrosurgical unit and the instrument.

[0016] One such electrosurgical instrument is shown in Figures 1-10, which illustrate a cutting and fusing electrosurgical instrument 10 that can be connected to an electrosurgical unit in accordance with various embodiments of the present invention. As shown, the instrument includes jaws 12 for manipulating tissue and an actuator 14 for manipulating the jaws 12. A shaft 16 connects the jaws to the actuator. In one embodiment, the shaft and jaws are sized and configured to pass through a cannula for performing a laparoscopic procedure. In one embodiment, the actuator includes a barrel connected to a pivotable trigger 112, a rotatable knob 114, and a connector that provide rotational movement to the jaws for opening and closing the jaws and capturing and / or compressing tissue therebetween. The actuator also includes switches 116, 118 for activating cutting, coagulation, sealing, fusing, or other electrosurgical activity, and an indicator for indicating activation or deactivation of the activity.

[0017] The jaws 12 include a first jaw 102 and a second jaw 104. The first jaw is stationary, and the second jaw is movable by actuation by an actuator coupled to the second jaw via a shaft and / or a component within the shaft. In one embodiment, both jaws may be movable, or the mobility of the jaws may be reversed. That is, the movable jaw may be stationary and the stationary jaw may be movable. It should further be noted that the first or second jaw, being the upper or lower jaw, may be relative to the shaft and jaws if they are rotatable, thereby allowing them to assume any position. The first jaw includes four electrodes. The first and second electrodes 103a and 103b are substantially hemispherical in shape, covering or occupying a majority of the total surface area of ​​the first jaw. In one embodiment, the hemispherical shape of these electrodes and / or the corresponding interlocking shape of the second jaw cause the tissue to slide or otherwise disengage from the jaws after cutting. Additionally, the first and second electrodes are mirror images of each other, thereby forming equal halves or sides along first jaw 102 as they extend substantially along the length of second jaw 104. Disposed between the first and second electrodes are third and fourth electrodes 105a, 105b, which are substantially rectangular in shape and substantially perpendicular to first and second electrodes 103a, 103b, and which also extend along the length of the first jaw. The edges or top portions of the third and fourth electrodes may have chamfered or otherwise tapered, beveled, rounded, or curved edges to assist in the surgical procedure, such as to provide an atraumatic edge for grasping tissue, or alternatively may have defined edges to assist in cutting tissue, for example.

[0018] The third electrode 105a extends toward the second jaw, and the fourth electrode 105b extends away from the second jaw. The third electrode 105a extends and has a height somewhat greater than the height or extension of the fourth electrode 105b extending out of the first jaw. The fourth electrode 105b further includes a distally curved distal portion 105b' that extends along the tip of the first jaw 102. The longitudinal paths of the third and fourth electrodes substantially follow the longitudinal shape of the first jaw. Thus, in the illustrated embodiment, the third and fourth electrodes are somewhat curved.

[0019] When the first and second jaws 102, 104 are closed, e.g., when the jaws are in close proximity to one another, the third electrode 105a is substantially covered by the second jaw 104, thereby leaving the third electrode unexposed. However, the fourth electrode 105b remains uncovered regardless of the position of the second jaw. Each of the electrodes in the first jaw is electrically isolated from one another. Furthermore, in operation, each electrode can assume a specific electrical polarity. As such, each electrode can assist in performing a specific surgical function, such as cutting, coagulating, healing, sealing, joining, etc. In one embodiment, the second jaw also includes one or more electrodes, e.g., a fifth and a sixth electrode, which can assist in performing the desired surgical function in conjunction with the electrodes in the first jaw.

[0020] In one embodiment, when the first and second jaws 102, 104 are closed (or partially or partially closed) and a user activates a coagulation operation or coagulation state, the first and second electrodes 103a, 103b assume a particular polarity and the fifth electrode 107 assumes the opposite polarity, thereby transmitting RF energy through the tissue clamped between the first and second jaws and coagulating the tissue. Similarly, when a user activates a cutting operation and the first and second jaws are closed, the first and second electrodes 103a, 103b assume a particular polarity and the third electrode 105a of the first jaw assumes the opposite polarity, thereby first coagulating the tissue and then cutting the tissue between the first and second jaws 102, 104, specifically at the point or section where the third electrode 105a contacts the tissue between the jaws. In one particular embodiment, during a cutting operation with the first and second jaws closed, the first and second electrodes 103a, 103b are polarized opposite to that used for coagulating tissue, i.e., in a predetermined pre-cut state, until coagulation and / or before completion of coagulation. In one embodiment, after the pre-cut state is reached based on a predetermined phase value, the polarity of the first and second electrodes 103a, 103b is reversed relative to the third electrode 105a. In one embodiment, the actuator 14 includes a trigger switch. The trigger switch is in an inactive state, i.e., not energized, when the trigger is positioned away from the switch.

[0021] Furthermore, when the first and second jaws 102, 104 are not closed (fully open or partially open) and the user activates a coagulation operation or coagulation state, the first electrode 103a assumes a particular polarity and the second electrode 103b assumes the opposite polarity, thereby transmitting RF energy through the tissue between the first and second electrodes 103a, 103b and coagulating the tissue. Similarly, when the user activates a cutting operation and the first and second jaws are not closed, the first and second electrodes assume a particular polarity and the third and fourth electrodes 105a, 105b of the first jaw 102 assume opposite polarities, thereby first coagulating the tissue and then cutting the tissue between the electrodes, specifically at the point or section where the third electrode 105a contacts the tissue between the jaws. It should be understood that over-coagulated or fully coagulated tissue is more difficult to cut because the electrical conductivity of the tissue is significantly reduced. This runs counter to the trend of preventing blood loss by "hypercoagulating" the tissue (ie, sealing the tissue).

[0022] In one embodiment, the position of the trigger 112 contacts and activates the trigger switch 103 of the actuator 14. The trigger, in the illustrated embodiment, includes a flexible arm 101 coupled to or incorporated into the trigger for use in activating or deactivating the trigger switch of the actuator 14. The trigger switch 103 is internal to the actuator, i.e., housed within the actuator, and is not accessible to the surgeon. However, the trigger switch activates or enables activation of one or more external switches that are accessible to the surgeon. For example, a surgeon-accessible "cut" button or switch will not operate, i.e., apply RF energy to cut tissue, even if the surgeon presses the button, unless the internal trigger switch is activated. In one embodiment, the internal trigger switch is activated only in response to the position of the trigger and / or jaws. The internal trigger switch may also be activated via a relay based on a command or program provided by the electrosurgical unit, instrument, and / or connector. It should be understood that in various embodiments, the internal trigger switch does not by itself activate or permit activation of RF energy, thereby preventing accidental activation of the instrument without the active and deliberate participation of the surgeon. It should also be understood that in various embodiments, the surgeon-accessible switch can only be activated if the internal trigger switch is also activated, thereby preventing accidental activation of the instrument without the active and deliberate participation of the surgeon, the electrosurgical unit, the instrument, and / or the connector through active communication or deliberate programming or commands embedded in or provided by the surgeon.

[0023] Thus, it should be understood that cutting of tissue between the first and second jaws can occur with the jaws closed or with the jaws not closed. Furthermore, when the first and second jaws are not closed, cutting can occur on tissue below and / or in front of the first jaw, i.e., tissue not between the first and second jaws (cutting can occur on tissue between the fourth electrode and the first electrode, tissue between the fourth electrode and the second electrode, and / or tissue between the fourth electrode, the first electrode, and the second electrode). Furthermore, it should be understood that the electrodes, for proper polarity or connection to perform a particular task, such as cutting or coagulation, are switched on or connected to the activation circuitry of the electrosurgical unit to apply specific RF energy to cut or coagulate tissue. In one embodiment, such switching or control information is provided via script data stored on a memory chip in a plug adapter or coupler that can be connected to the electrosurgical instrument.

[0024] As described above, in one embodiment, the first jaw 102 is stationary, i.e., does not move, and includes a vertical inner electrode and a vertical outer electrode. This electrode configuration delivers energy in a predetermined direction based on the position of one jaw relative to the other. For example, this electrode configuration allows cutting to occur at the jaw tip and / or both the outer and inner surfaces of the jaw. Furthermore, this electrode configuration, located on a jaw that is stationary relative to the jaw actuation when the other jaw is opened, allows the surgeon to directly control the cutting direction or path by manipulating the actuator. This is because the jaws are stationary relative to the shaft and actuator. In one embodiment, the electrodes of both jaws can be actuated relative to each other to cut tissue captured between the jaws.

[0025] It should be understood that adding multiple electrodes to one or more jaws is a minor design choice. Particularly in laparoscopic procedures with limited field of view, it is desirable to reduce the number of electrodes to avoid short circuits, unwanted heat spread, tissue mutation, or at least tissue charring or cutting, introduced by adding electrical conductors near the energized electrodes. Accordingly, as described in the various embodiments, these electrodes are specified in their configuration, construction, and use to overcome these challenges.

[0026] In one embodiment, an electrosurgical instrument is provided that includes multiple cutting blades or surfaces, some or all of which are movable and / or electrically connected. Operatively, the instrument or components can be actuated to coagulate or coagulate tissue as needed and cut. In another embodiment, one or more of the components are stationary and / or electrically connected.

[0027] In one embodiment, electrical wires are welded to the electrodes of first jaw 102. These wires are threaded around rotary connector 27, which attaches conductive rings 24a-24d to the rotary connector within actuator 14. In one embodiment, a rotation lock is provided to hold the conductive rings in place. In one embodiment, conductive ring 24a is coupled to electrode 103a, and conductive ring 24d is coupled to electrode 103b. Conductive ring 24b is coupled to electrode 105a, and conductive ring 24c is coupled to electrode 105b. Rotary connector 27 includes one or more slots through which the electrical wires extending from the electrodes are threaded. The conductive rings are secured to the rotary connector such that each corresponding electrical wire of an associated electrode is electrically connected to its associated conductive ring. In this manner, when the rotary connector rotates, the conductive rings rotate with the associated electrical wires extending from the jaw electrodes through the shaft to the rotary connector, so that these electrical wires do not wrap around the shaft as the jaws rotate.

[0028] Actuator 14 further includes contact brushes 26a-26d, which are positioned in contact with associated conductive rings 24a-24d. For example, in the illustrated embodiment, contact brush 26a is positioned adjacent conductive ring 24a. Each contact brush is further connected to an electrical wire or similar connection to a connector and ultimately to an electrosurgical unit for providing and transmitting RF energy, measurement signals, diagnostic signals, or similar signals through associated electrodes in the jaws of the electrosurgical instrument. In one embodiment, slots in the actuator handle facilitate the placement of electrical wires and facilitate connection of the contact brushes to the electrosurgical unit. In this manner, the conductive rings provide a conductive or transmitting surface that is in continuous contact with the contact brushes regardless of shaft rotation. In one embodiment, the contact brushes are angled or pressed to maintain contact with the conductive rings.

[0029] A "U" shaped tube clip 25 within the actuator 14 is welded to an electrical wire, the other end of which is welded to the second jaw 104. In one embodiment, the second jaw 104 is held in place by a pull tube, which serves as the electrical connection for the second jaw 104. The conductive ring and clip provide constant electrical conductivity between the electrode and the electrosurgical unit while allowing, i.e., not preventing, a full 360° rotation of the jaws 102, 104 in any direction. For example, the electrical wires connected to the electrodes that connect to the rings or clips will follow the rotational movement of the jaws and the shafts attached to those jaws, thereby not becoming tangled in or along the shaft or actuator, restricting rotational movement, disconnecting or disengaging, and / or interfering with the operation of the actuator.

[0030] In one embodiment, individual electrical wires are welded to individual jaws of the electrosurgical instrument. The electrical wires, such as electrical wire 29, are threaded along a shaft connected to the jaws, through a rotary knob, and into slots in the rotary connector 27. In one embodiment, some electrical wires are located on one side of the connector and other electrical wires are located on the opposite side of the connector. The electrical wires are staggered along the length of the connector, which coincides with the staggered arrangement of the conductive rings. In one embodiment, the staggered arrangement prevents accidental shorting or electrical connection between the rings. The conductive rings thus, in one embodiment, slide over the connector and are located in spaced slots along the connector, engaging each conductive ring with its associated staggered electrical wire. In one embodiment, the individual electrical wires are also located in slots in the actuator handle, and associated contact brushes are located on the associated electrical wires, engaging each electrical wire with its associated contact brush. Thus, the rotary connector located in the actuator handle engages the electrical connection or conductive region of each conductive ring with the corresponding contact brush.

[0031] 11-19, which illustrate a fusion-cutting electrosurgical instrument 20 that can be coupled to an electrosurgical unit according to various embodiments of the present invention. The instrument 20 includes a jaw 22 coupled to a shaft 26. The shaft 26 is coupled to an actuator 24, which is operated to operate the jaw 22. In one embodiment, the actuator includes a floating pivot mechanism 221. The floating pivot mechanism 221 includes a pivot block coupled to a trigger 222 for opening and closing the jaws, capturing tissue between the jaws, and / or compressing tissue between the jaws. The actuator also includes a rotation knob 224 and connector for rotationally moving the jaws, in one embodiment. In one embodiment, the actuator also includes a blade trigger 225 coupled to the pusher bar or blade shaft, which is coupled to or incorporated within a distal cutting element for translating the cutting element through the jaws to sever tissue between the jaws. The actuator may further include switches 226, 227, 228 for activating cutting, coagulating, sealing, fusing, or other similar electrosurgical activity, and indicators for identifying and highlighting activated or deactivated activity.

[0032] According to various embodiments, the instrument includes a blade or cutter 191 that is movable relative to the jaws 22 of the instrument. The cutter is displaced substantially perpendicular to the surface of one or both jaws and is movable along the longitudinal axis of the instrument. In one embodiment, the cutter is positioned horizontally, i.e., parallel to, one or both jaws. In one embodiment, the cutter is movable outside the jaws or is located on the exterior, or outer surface, of one or both jaws. For example, the cutter, when operated by an actuator coupled to the cutter, can be located within one or both jaws and act as a retractable electrode or blade exposed or located outside the jaws. Cutter edges extend along the entire cutter or along a portion of the cutter, and some or all of these edges may be sharp, beveled, biased, or otherwise configured to cut tissue.

[0033] In the illustrated embodiment, the cutter 191 traverses a channel in the jaws and severs tissue between them. The channel does not extend beyond the outer periphery of the jaws, so the cutter remains within the distal boundary of the jaws. A blade shaft 196 is coupled to the cutter, i.e., is monolithically incorporated therein, and extends into the actuator. A blade trigger, when actuated, moves the cutter through the channel in the jaws. The blade shaft 196 is biased such that releasing the trigger retracts the cutter to its initial rest position. In one embodiment, a spring coupled to the blade shaft biases the cutter toward the actuator. Thus, actuation of the blade trigger, overcoming the bias of the spring, moves the cutter distally through, out of, or along the inside or outside of one or both jaws.

[0034] In one embodiment, one or more stops 195, 197 along the blade shaft 196 limit the movement of the blade shaft 196 and thus the cutter 191. In the illustrated embodiment, a stop protrusion disposed on or within the blade shaft moves with the blade shaft, and when the blade shaft is moved distally to a predetermined point, such as near the distal end of the jaw channel, the stop protrusion interacts with a corresponding stop protrusion or slot 194, preventing the stop protrusion from moving further distally beyond the stop slot. In one embodiment, a stop slot is disposed on, from, or within a cover tube 192 disposed on the blade shaft, and is positioned to contact the stop protrusion on the blade shaft when the cutter is moved distally to the predetermined point.

[0035] In one embodiment, a second stop protrusion 197 is disposed on or within the blade shaft 196. The second stop protrusion 197 is spaced apart from the first stop protrusion 195. The second stop protrusion is disposed relatively close to the actuator, i.e., away from the jaw 22. In the illustrated embodiment, the second stop protrusion 197 prevents the spring from pulling the blade proximally beyond a predetermined point, such as a point near the proximal end of the jaw channel. Thus, in various embodiments, the blade stop limits the forward and / or rearward movement of the blade or cutter as it is extended or retracted either toward or away from the distal end of the instrument. The blade stop, in one embodiment, is a crimped or deformed portion 194 of the cover tube 192. The crimped portion that interacts with the stop protrusion on the blade shaft acts as a positive stop because the inside dimension of the cover tube is narrower than the overall width of the stop protrusion on the blade shaft. To actuate and / or bias one or both jaws, a pull tube 193 connected to the jaws is positioned to surround the blade shaft 196 and, in one embodiment, includes one or more slots to expose and interact with stops on the blade shaft 196 and the cover tube 192.

[0036] The stop prevents a force applied to the cutter from exceeding a predetermined point. When activated, the cutter can continue to move distally or proximally, and the distal or proximal end of the channel or portion thereof can stop the cutter from moving further. However, if further pressure or force is applied to move the cutter distally or proximally, the jaws under pressure may come into contact with one or both jaws, damaging or dulling the cutter. The stop protrusion prevents this from occurring. In one embodiment, the second stop protrusion 197 prevents the cutter from moving further proximally, and the spring biasing the cutter proximally can hold the cutter in place. Thus, by moving the instrument along or through tissue, the cutter can be moved along and cut with the jaws open or closed without moving the blade shaft. Tissue pressed against the cutter is cut. This is because the pressure or force of the spring and its interaction with the stop protrusion hold the cutter in place.

[0037] In one embodiment, the jaws 22 include a stationary first jaw 202 and a movable second jaw 204 that moves relative to the first jaw. In one embodiment, both jaws may be movable, or the first jaw may be movable and the second jaw may be stationary. The first jaw 202 is entirely conductive and formed of a conductor. In one embodiment, the first jaw is entirely flat and includes an electrode covering or extending across the upper surface of the first jaw. The second jaw 204 includes first and second electrodes 205, 206. An insulating layer is provided between the electrodes. In one embodiment, the second electrode 206 is located on an upper portion of the second jaw 204 remote from the first jaw 202, and the first electrode 205 is located on a lower portion of the second jaw 204 closer to the first jaw 202. The second jaw 204 is pivotally attached to the first jaw or to a shaft or other component connected to the first jaw. This pivotal connection electrically connects the first jaw 202 to the second electrode 206 of the second jaw 204 in one embodiment. The second electrode 206 is generally conductive, formed of a conductor, and generally formed similarly to the first jaw. In one embodiment, the second electrode 206 is generally hemispherical in shape. In one embodiment, the first jaw 202 is generally hemispherical in shape. However, tissue clamped or captured between the first and second jaws 202, 204 is positioned between the first electrode and the second jaw. Thus, the second electrode 206 in one embodiment is not involved in or contributes to the electrical cutting or sealing of tissue grasped or captured between the first and second jaws 202, 204. When the second electrode 206 is energized or switched on, in one embodiment, it is involved in cutting and / or sealing tissue outside of the second electrode 206 or at least tissue in contact with the second electrode. In one embodiment, because of this configuration, the first and second jaws do not need to be electrically isolated and may in one embodiment be commonly connected via a jaw pin, thus facilitating manufacturing and reducing multiple or excessive electrical connections.

[0038] For example, in one embodiment, the first electrode 205 of the second jaw 204 is electrically connected to assume first and second polarities such that tissue (clamped or unclamped) positioned between and in contact with the first electrode 205 and the first jaw 202 is sealed when activated by a user. In this manner, RF energy suitable for sealing the tissue is transmitted through the tissue between the first electrode 205 and the first jaw 202, sealing the tissue. In one embodiment, a movable cutting blade may be actuated by a user to cut the tissue between the first electrode 205 and the first jaw 202. The cutting blade, in one embodiment, is electrically conductive and is activated such that RF energy suitable for cutting the tissue is transmitted between the cutting blade and the first jaw 202, the second jaw 204, or both jaws. In one embodiment, the cutting blade may be stationary. The cutting blade, in one embodiment, may be relatively dull or sharp, depending on or regardless of the electrical conductivity of the blade. There may be multiple blades, all or some of which may be conductive or connected. The cutting blades, in one embodiment, may be positioned substantially perpendicular to the first jaw 202 and / or may traverse the length or a portion of the length of the first and second jaws.

[0039] In one embodiment, tissue outside the first and second jaws 202, 204 can be cut and / or coagulated. In one embodiment, the second electrode 206 and first jaw 202 can be activated to coagulate tissue between the point or area of ​​contact of the second electrode 206 with the tissue and the point or area of ​​contact of the first jaw 202. In this manner, the sides of the jaws can drag or slide across tissue in their open or closed positions to coagulate and / or cut the tissue. Additionally, the ends or tips of the jaws (in the open or closed positions) can be positioned in contact with tissue and positioned to drag or slide across the tissue to coagulate and / or cut the tissue. In one embodiment, the first electrode 205 of the second jaw 204 and the second electrode 206 of the second jaw 204 can be electrically connected to assume first and second polarities to cut and coagulate tissue positioned between or in contact with the first and second electrodes when activated by a user for a cutting or coagulation operation, respectively.

[0040] In this manner, RF energy suitable for cutting or coagulating tissue is transmitted through the tissue between the first electrode 205 and the second electrode 206 to cut, coagulate, heal, or join the tissue. In this manner, coagulation and / or cutting of tissue may be achieved by dragging, pushing, or sliding the second jaw 204 across the tissue. In one embodiment, cutting or coagulation can only occur when the jaws 202, 204 are partially or completely spaced apart from one another. In one embodiment, a switch or sensor is activated to indicate a spaced or non-spaced relationship between the jaws so that cutting or coagulation of tissue can be activated.

[0041] In one embodiment, the first electrode 205 extends along an outer portion or tip of the distal end of the second jaw 204. The first and second electrodes 205, 206 can be energized to cut, coagulate, weld, or join tissue between or in contact with the electrodes. By confining the first electrode 205 to a particular area or configuration relative to the second electrode 206, the focal area or applicable energization area can be confined to a particular portion of the first and second electrodes 205, 206. In one embodiment, the second electrode 206 can similarly be configured to extend along a limited portion of the second jaw 204. In an exemplary embodiment, an insulator 207 disposed adjacent the first electrode 205 limits the tissue focal point of the first electrode. In one embodiment, the size, shape, and / or orientation of the first electrode, the second electrode, and / or additional electrodes can be confined to provide an appropriate or desired focal area. The first electrode extending around the periphery of the second jaw 204 is positioned generally horizontally relative to the second jaw and, in one embodiment, is relatively blunt. The orientation, size, and placement of the first electrode may vary based on the desired surgical procedure, and additional electrodes may be similarly positioned.

[0042] In one embodiment, the first electrode 205, first jaw 202, and / or second electrode 206 are continuous or monolithic electrodes and include a continuous or monolithic sealing surface. In one embodiment, the monolithic sealing surface includes spaced or interrupted portions to provide multiple sealing paths or surfaces. For example, the first electrode 205 includes first and second sealing paths 217a, 217b. These first and second sealing paths surround and are adjacent to the jaw blade or cutting channel, through which the blade or cutting electrode is disposed and traverses. In the illustrated embodiment, the monolithic sealing surface further includes spacers or cavities 215a, 215b and third and fourth sealing paths 219a, 219b. The third and fourth sealing paths are positioned adjacent to but spaced apart from the first and second sealing paths. In one embodiment, the first and second sealing paths are inner paths, as opposed to the third and fourth sealing paths being outer paths. The interrupted or spaced multiple paths provide excess sealing area or portions of the tissue where sealing is performed, separated by portions of the tissue that are not electrically or otherwise manipulated by the jaws. This spacing or unaffected tissue between the sealing paths enhances the overall sealing of the tissue and reduces thermal diffusion and tissue manipulation along the tissue. In the illustrated embodiment, the tissue between the first and fourth sealing paths remains unaffected by energy transmitted to the electrodes, while the tissue along the first and third sealing paths is electrically sealed. Similarly, the tissue between the second and fourth sealing paths is electrically sealed, while the tissue between these paths or within or along the cavity remains unaffected. Furthermore, the tissue along the cavity is not compressed or mechanically manipulated compared to the tissue along the sealing paths.

[0043] In one embodiment, a user can energize the first electrode 205 to cut, coagulate, heal, or join tissue in contact with or between the first electrode 205 and first jaw 202, and / or the second electrode 206. In one embodiment, the second electrode 206 and the first jaw 202 have a common electrical contact and / or a common polarity to allow RF energy to be transferred between the first electrode 205 and the first jaw 202 and / or between the first electrode 205, the second electrode 206, and the first jaw 202.

[0044] In one embodiment, tissue positioned between the jaws 202, 204 can be welded when the jaws are not fully open or fully closed, i.e., in a state between the open and closed states. However, in one embodiment, automatic interruption of RF energy is not used, nor is it activated or deactivated, because the conditions suitable for automatic interruption of RF energy are not met or reached. Additionally, cutting can be prevented (mechanically and / or electrically). In one embodiment, intermediate states are determined based on the activation or deactivation of switches and / or sensors located on the instrument adjacent the trigger and / or jaws, or based on detecting the position of the trigger or jaws relative to one another.

[0045] According to various embodiments, electrosurgical RF energy uses both an active electrode and a return electrode to cut and / or coagulate tissue in a bipolar manner, typically in gynecological laparoscopic procedures, for example. In such configurations, the desired surgical effect (e.g., cutting, coagulation, etc.) is based on the current density ratio between the electrodes, the electrode geometry, and the current and voltage applied to the electrodes. In one embodiment, tissue cutting uses a voltage output of 200 V or more, while coagulation uses a voltage less than 200 V. Current density is measured as (delivered current) / (electrode surface area). As such, the active electrode and return electrode can be evaluated using the following current density ratio: Electrode / Return Electrode = (High Current Density) / (Low Current Density). It should be understood that one electrode may act as either an active or return electrode relative to another electrode, or may switch between active and return electrode roles, based on the current density, electrode geometry, and / or the current and voltage supplied to the electrode. Typically, the active and return electrodes are electrically isolated from each other.

[0046] Various electrode configurations for the jaws of electrosurgical instruments according to various embodiments of the present invention are shown in Figures 30-38. In various embodiments, at least one electrode or only one electrode is located on one jaw. For example, in one embodiment, the electrode is located on the upper jaw and is oriented horizontally relative to the jaw. It should be understood that the electrode may be located on the jaw opposite the jaw shown, and the upper and lower jaws are relative to each other. Thus, any reference to the upper jaw also refers to the lower jaw, and any reference to the movable jaw also refers to the stationary jaw.

[0047] In Figures 30A and 30B, the movable jaw 602 includes an outer vertical electrode 605. With this electrode configuration, cutting occurs at the tip of the articulated jaw and / or along the length of the jaw. In one embodiment, cutting occurs in an articulated manner and / or along a path relative to the instrument shaft and actuator. For example, the electrodes on the jaw are parallel to or aligned with the path of jaw movement (e.g., paths 601 and / or 603 (bidirectional or unidirectional)), allowing tissue to be cut upon opening of the upper jaw. In the illustrated embodiment, the electrode 605 is associated with a relatively large conductive portion 606 or second electrode 607 surrounding the jaw electrode to conduct RF energy therebetween and form the cutting path.

[0048] In one embodiment, the stationary jaw 704 includes an outer vertical electrode 705, as shown in FIG. 31. This electrode configuration allows cutting at the tip of the stationary jaw 704 and / or along the length of the outer portion of the jaw. The electrode 705 operates in conjunction with either the inner or outer electrode, which in one embodiment acts as another electrode, conducting RF energy therebetween. In one embodiment, the movable jaw 702 does not include an electrode or is insulated from the electrode 705 in some manner. In operation, the surgeon can manipulate the cutting direction or path by manipulating the actuator while the jaw remains stationary relative to the instrument shaft.

[0049] Referring now to FIG. 32 , in one embodiment, one jaw 802 includes a horizontal electrode 803 and a vertical electrode 805. This electrode configuration delivers energy directly based on the position of the jaws relative to one another. Furthermore, this configuration does not require electrically isolating the upper jaw actuation member from the lower jaw. When the jaws are closed, the horizontal electrode 807 of the lower jaw 804 can be used to cut tissue, using the lower jaw 804 as a return electrode. When the jaws are open, the vertical electrode 805 can cut tissue at the tip of the upper jaw 802 and along the length of the upper jaw, articulating with the shaft and the instrument handpiece. Tissue can be cut with the upper jaw open because the active electrode is parallel to the path the upper jaw travels. The active electrode uses the upper jaw actuation member as a return electrode. The orientation of both electrodes can be switched, for example, from vertical to horizontal and from horizontal to vertical, to achieve a similar effect.

[0050] In one embodiment, a cutting electrode 811 of the electrosurgical instrument can be used to separate tissue, as shown in FIG. 33. A mechanical cutting blade 812 is used to divide tissue captured in the jaws 815, 816 of the instrument along the length of the jaws by actuating a lever located on the actuator of the instrument. It should be understood that the mechanical and electrical blades can be reversed. In one embodiment, a first cutting electrode 811 can be used to separate tissue. A second cutting electrode 812 can be used to divide tissue captured in the jaws of the device by using the lower jaw 816 as a return electrode. This second electrode can be moved along the length of the jaws of the instrument by actuating a lever located on the actuator of the instrument.

[0051] In various embodiments, the electrodes (and the portions to which they are attached) may be used to physically probe and / or manipulate tissue when not electrically energized. In various embodiments, a retractable electrode provides an atraumatic jaw assembly for contacting tissue and moving through a trocar seal. In one embodiment, the cutting electrode can be retracted into the body of either jaw of the instrument to facilitate removal or cleaning of eschar that has formed on the electrode.

[0052] In one embodiment, the electrode 91 can be retracted by moving the actuator relative to the trigger (see FIGS. 34A and 34B). For example, retraction occurs relative to jaw movement. Such actuation can indicate which position of the electrode is available for cutting tissue. In one embodiment, the electrode can be activated when extended and deactivated when retracted. Retractable electrodes can be located in either jaw or both jaws. In one embodiment, retraction of the electrode 91 can be achieved by a lever or similar actuator that is separate from the trigger or actuator (see FIGS. 35A and 35B). In this way, the electrode can be extended or retracted regardless of the jaw position. The electrodes can also be independently activated in the extended position.

[0053] The retractable electrodes described above and shown in Figures 36A-36d may be rounded 95, pointed, L-hook 93, or J-hook 94. In various embodiments where the electrodes are L-hook shaped, J-hook shaped, or similarly shaped and are retractable, such electrodes can be used to capture tissue between the jaws of the instrument and / or in the hook portion of the electrode.

[0054] In one embodiment, the electrodes on one jaw can be separate or can be two adjacent electrodes (e.g., a distal electrode and a proximal electrode). The electrodes can be energized simultaneously or individually. Furthermore, one electrode can treat a different type of tissue than the other electrode (e.g., one cuts and the other coagulates, one treats one type of tissue and the other is used for another type of tissue). These separate electrodes can also provide tissue type comparison or phase monitoring to ensure proper treatment (e.g., cutting, coagulation, etc.) of the tissue or multiple types of tissue in contact with the separate electrodes. In one embodiment, the other jaw or another portion of the same jaw can act as an electrode to exchange RF energy between the electrodes.

[0055] 20-29, an electrosurgical instrument can be connected to an electrosurgical unit through a coupler 50 according to various embodiments of the present invention. Coupler 50 includes a plug 502 attached to a cable 501 that is attached to and extends from the connecting instrument. Plug 502 has attached connector 503 that can be connected to an electrosurgical unit. In one embodiment, plug 502 cannot be connected to an electrosurgical unit without connector 503.

[0056] In one embodiment, plug 502 is removably attached to a connector 503 that is connectable directly to an electrosurgical unit. Connector 503 provides a conduit for RF energy to be delivered from the electrosurgical unit through a cable to the instrument. Additionally, communication back to the electrosurgical unit is transmitted from the instrument through the cable and connector. For example, the instrument transmits a signal via a switch or by activating a handle or trigger to close a circuit that delivers RF energy as required by the instrument.

[0057] Connector 503, in one embodiment, includes a memory circuit 503b' and a pin arrangement 503b" that is specifically configured to couple to a corresponding pin arrangement 501d of a cable 501 associated with an electrosurgical instrument. The other end of the cable has contacts 501a, 501b, and 501c disposed thereon that are configured to connect to corresponding contact points for switches, indicators, and / or sensors as appropriate for the associated electrosurgical instrument. Thus, the pin arrangement may be varied to couple the cable to connector 503, and contacts 501a, 501b, 501c, 501d, and 501f may be varied to couple the cable to a corresponding electrosurgical instrument.

[0058] The memory circuit, in one embodiment, contains instrument or tool data outlining the operation of the instrument in conjunction with the electrosurgical unit. In one embodiment, the tool data is transmitted from the chip to the electrosurgical unit. The unit analyzes the tool data to recognize and validate the electrosurgical instrument to which its connector is attached. The tool data also includes script information describing the manner in which the attached electrosurgical instrument operates. For example, the script information may include the total number of electrodes provided on the electrosurgical instrument and the state in which one or more of the electrodes are in use, or software to be transmitted to the electrosurgical unit when the instrument is successfully electrically connected to the electrosurgical unit. The tool data may also include data regarding various electrosurgical procedures to be performed by the instrument and the corresponding energy level ranges and durations of these procedures, data regarding the electrode configuration of the instrument, and / or data regarding switching between electrodes to perform various electrosurgical procedures. Similarly, customized data, such as settings preferred by a particular surgeon or settings for a surgical procedure to be performed, may be included in the tool data and used, for example, to configure the electrosurgical unit in a predetermined mode or to a particular configuration preferred by the surgeon, such as a particular power setting or user interface appearance or control.

[0059] In one embodiment, the electrosurgical unit has limited capabilities for supplying or terminating RF energy. Additionally, the electrosurgical unit can gradually increase or decrease the amount or intensity of RF energy supplied. However, the control or regulation of RF energy is not contained or built into the electrosurgical unit, but instead resides as script information in a memory circuit. The script information provides control data that directs the supply of RF energy so that, when a user presses a button or turns on a switch, RF energy is directed to the corresponding electrode as indicated by the control electrode. Similarly, the control data further includes information for verifying and recognizing that a button has been pressed. After an initial connection is made between the electrosurgical instrument and the unit when the instrument is connected to the unit, the script information is communicated to the electrosurgical unit. In one embodiment, to prevent reuse of connector 503, subsequent or further access or requests to send script information to the unit are not provided or permitted.

[0060] The connector, in one embodiment, is a non-sterile connector, and the cable and the electrosurgical instrument to which it is connected are sterilized. It is noted that the non-sterile feature of the connector is not typically used in other electrosurgical systems. However, due to the electrical components within the connector, such as memory circuits, the connector is typically not easily sterilizable. Therefore, such components are not typically embedded or otherwise provided in electrosurgical instruments that must be sterilized. However, by providing a separately attachable connector, electrosurgical systems can be customized and / or configured where sterility concerns are addressed.

[0061] In one embodiment, connector 503 allows the electrosurgical instrument to be customized and / or configured to accommodate or accommodate various electrosurgical instruments connectable to the electrosurgical unit. Thus, as the electrosurgical instrument changes or improves over time and / or surgical procedures, i.e., surgical procedures, updated information can be provided to the electrosurgical unit from a connector custom-made for the electrosurgical instrument attached to the connector. Thus, changes to instruments or tools and periodic updates to tools can be made quickly without downtime to the electrosurgical unit. This is because the software for operating the instruments is contained within the electrosurgical instrument itself, rather than the electrosurgical unit. Thus, updates can be made during the manufacture of the instrument, thereby eliminating the potentially time-consuming and expensive act of removing and replacing an electrosurgical unit from a hospital operating room to perform an update to the electrosurgical unit, for example.

[0062] Additionally, connector 503 securely connects the electrosurgical instrument to the electrosurgical unit. In one embodiment, the script information stored in the connector is compatible only with the associated electrosurgical instrument and not with other instruments. For example, if a user couples a vessel sealer to the provided connector, the script information stored in the memory circuit only contains information about that particular vessel sealer. Thus, if a user couples the same connector to another instrument, such as an electrosurgical scalpel (setting aside mechanical and electrical characteristics that would prevent such attachment), the electrosurgical unit will not have the script information to recognize and / or power such an instrument. Thus, even if a user activates the scalpel, an electrosurgical unit that does not have any script information for such an instrument will not supply RF energy to the instrument. In this example, the provided script information is for a vessel sealer. Using this script information, the electrosurgical unit can verify that the attached device is not a vessel sealer, and more specifically, that it is not an appropriate instrument for the provided script information. In one embodiment, this is recognized during the initial handshake between the attached instrument and the electrosurgical unit, whereby the script information provides additional assurance of proper use of the instrument.

[0063] Connector 503, in one embodiment, also provides a uniform configuration on one side or end for connection to an electrosurgical unit and a plug for an electrosurgical instrument on the other end. Pin or recess formations 503a, 503b'' mate or interlock uniformly and predictably with corresponding pin or recess formations on the instrument port of the electrosurgical unit. Similarly, plug 501d includes a recess or pin formation that interlocks with corresponding pin or recess formation 503b'' on connector 503. Covers 502a, 502b, and 502c cover or enclose the associated components of plug 502 or connector 503. Connector 503 thus provides a uniform mechanical connection between the electrosurgical unit and the associated electrosurgical instrument, thereby facilitating ease of manufacture and use in surgery. However, circuitry provided in connector 503 may provide customized or non-uniform electrical connections between the unit and the instrument and / or provide scripting information about the instrument to the unit, thereby enhancing upgrade flexibility and instrument customization.

[0064] It should be understood that there are a variety of RF electrosurgical units that provide RF energy, and similarly, a variety of electrosurgical instruments or tools that can be connected to such electrosurgical units to receive the provided RF energy for use in a variety of procedures. However, certain electrosurgical instruments are required and function optimally when RF energy is delivered within specific specifications or methods. In some cases, such instruments or electrosurgical units simply do not work, leaving the surgical team surprised that the instrument or electrosurgical unit has malfunctioned. As a result, surgical devices are mistakenly discarded and surgical procedures are delayed while the cause of the problem is investigated and identified.

[0065] In other cases, the instrument and electrosurgical unit do not work together, in the sense that the electrosurgical unit supplies RF energy to the instrument. However, an instrument or electrosurgical unit that anticipates a particular application of such energy may damage the device or cause the instrument to operate improperly, for example, the instrument may not adequately cut tissue or the blood vessel may not seal after the instrument applies RF energy. Thus, in some cases, certain electrosurgical instruments should not be connected to certain RF electrosurgical units, and vice versa.

[0066] Furthermore, in particular cases, surgical teams expect specific operational qualities and performance from electrosurgical instruments or electrosurgical units for use in a particular surgical procedure. However, such operational performance can only be achieved when a particular electrosurgical instrument is used with a particular electrosurgical unit. Therefore, pairing of such specific devices is required to provide the expected operational quality and performance. Therefore, ensuring proper connections between the electrosurgical instrument and the electrosurgical unit is necessary to ensure operational quality and performance and to prevent unexpected operational failure or damage to the device.

[0067] In one embodiment, a system and method are provided for ensuring proper connection of a specific or specified electrosurgical instrument to a specific or corresponding specific socket on an electrosurgical unit, thereby preventing improper connection of an unspecified electrosurgical instrument to a specific socket, thus, among other things, ensuring that only electrosurgical instruments of specific quality and performance that are compatible with the specific quality and performance of the electrosurgical unit are used.

[0068] In one embodiment, the tool connector 503 mates with the tool connector socket 302 of the tool port of the electrosurgical unit. A recess in the connector and a groove or channel 303 in the tool socket ensure proper orientation during insertion of the instrument or tool. The recess in the connector and the groove in the socket ensure that the correct and expected instrument is plugged into the corresponding instrument port, e.g., the DC port, relative to the dedicated instrument port. In one embodiment, upon insertion, a latching mechanism including a latch arm on the instrument plug and a corresponding latch shelf 301 on the socket locks the connection, resulting in flat-surface contact pads on the connector engaging a series of extension pins 304, e.g., spring-loaded pogo pins, on the socket of the electrosurgical unit. In one embodiment, a series of pins extending from the socket of the electrosurgical unit are removably electrically connected to the flat-surface pads on the connector. As such, the flat-surface pads do not include a mechanical connector for interacting with or interlocking the pins with the associated pads. Furthermore, in one embodiment, the connector or plug does not include a mechanical connection or interlock that couples the pins of the socket to the connector. In the illustrated embodiment, the contact pads are recessed within respective cavities in the plug, which do not interlock with associated pins that extend to contact the associated contact pads when the plug is inserted into the socket. In one embodiment, the socket further includes a switch 305 that is recessed within the socket and operatively activated by the plug, specifically an interlocking pin or protrusion 504 extending from the plug, and inserted into the socket. In one embodiment, the socket, along with the corresponding plug, is circular or similarly shaped, thereby reducing the overall surface area or working area along the electrosurgical unit. In one embodiment, pins extend from the plug or connector, and flat surface pads are arrayed along the socket of the electrosurgical unit.

[0069] In various embodiments, the opposite side of the tool connector plug contact pads is shown. In this view, a printed circuit board (PCB) is provided with a tool connector head that provides connection to the instrument and circuitry containing the encrypted tool memory chip. The tool connector head, in various embodiments, connects the instrument electrodes (up to five), functional instrument switches (cut, coagulate, and heal), instrument position switches (instrument fully open and instrument fully closed), and the electrosurgical instrument's tri-color LED to the electrosurgical unit. In this way, the pin / socket alignment of the instrument socket corresponds to the pin / socket alignment of the tool connector plug.

[0070] In one embodiment, script-based or instrument-specific generator intelligence is stored in a non-volatile memory section of a memory chip in the tool connector that communicates with the electrosurgical unit. A script parser in the electrosurgical unit's central processing unit (CPU) reads and processes tool script information, including, but not limited to, expiration authentication (ensuring use of the original manufacturer), disposable warranty, instrument expiration date, instrument recognition, user interface controls (electrosurgical unit display and / or tone), instrument interface settings (flat, instrument-mounted LEDs), electrode segment and electrosurgical unit settings (voltage and current) that may be based on jaw element position (fully open or fully clamped), time-based power deactivation timeout limits, and socket feedback activation endpoints (e.g., coagulation endpoint based on the phase between voltage and current) and switch points (e.g., switching from coagulation to cut, coagulation to cut, etc., based on the phase between voltage and current).

[0071] The memory chip, in one embodiment, is written by the electrosurgical unit's CPU to store procedure-specific data, including, but not limited to, the serial number of the electrosurgical unit used, a timestamp of the instrument connection, the number of the instrument used, the power setting used during each use, tissue feedback data before, during, and after instrument use, the instrument use state (cut, coagulate, heal), the duration of instrument use, the stop point (automatic stop, failure, manual stop, etc.), and the failure event and nature (instrument short, expired, or unidentified instrument, etc.).

[0072] In one embodiment of the pinout for a dedicated RF instrument socket, pin contacts 1 through 8 are reserved for the tool memory circuit, pins 9 through 17 are reserved for the instrument switch and LEDs (cut, coag, heal, instrument open, instrument close, red, blue, green LEDs, and return), and pins 18 through 22 are reserved for the five instrument electrodes. In another embodiment, the pinout for a dedicated DC instrument socket is reserved for pin contacts 1 through 8 for the memory circuit, pins 9 through 17 are reserved for the instrument switch and LEDs (on 1, on 2, on 3, instrument position 1, instrument position 2, red, blue, green LEDs, and return), and pins 20 and 21 are reserved for providing power to the DC.

[0073] In various embodiments, electrosurgical systems and processes apply monopolar or bipolar radio frequency electrical energy to a patient during surgery. Such systems and processes are particularly suited for laparoscopic and endoscopic procedures where spatial access is limited, easy handling is required for visibility, and they are used for fusion of blood vessels and other biological tissues, as well as for cutting and separating tissue / vessels. In certain embodiments, the systems and processes fuse, join, coagulate, seal, or cut tissue by applying RF energy to mechanically compressed tissue. In various embodiments, determination of the endpoint of the electrosurgical process is provided by monitoring and verifying the phase shift of the voltage and current during the process. In one embodiment, when the tissue is desiccated and the fusion process is complete, the phase shift changes more significantly than the impedance, thus providing more sensitive control than using impedance. Therefore, RF energy is applied via the electrosurgical unit in conjunction with measuring and monitoring the phase shift via the electrosurgical control device to fuse, join, coagulate, seal, cut, or perform other electrical transformations of blood vessels and tissue according to various embodiments of the electrosurgical system.

[0074] In one embodiment, measuring the tissue's dielectric properties and controlling and feeding back the phase difference provides an accurate control-feedback mechanism for various types of tissue, regardless of tissue size. For example, a controller for an electrosurgical unit is configured to monitor and control the electrosurgical process on tissue by determining the product of the dielectric constant and conductivity and the phase difference between the applied voltage and current. Specifically, the control-feedback circuit of the controller determines when the phase difference reaches a phase shift value determined by the dielectric constant and / or conductivity measurements. When such a threshold is reached, the electrosurgical process is terminated, another action is initiated, or another state is activated. Indicators, such as visual or audio indicators, are provided to signal termination or a change in state / action. In one aspect, the controller limits electrical energy delivered through the electrodes (totally, nearly totally, or to a predetermined minimum value). In one embodiment, an electrosurgical instrument, in conjunction with the controller, thereby atraumatically contacts connective tissue and applies sufficient burst pressure, tensile strength, or break strength within the tissue.

[0075] In one embodiment, instead of the tissue quickly reaching a predetermined phase (e.g., in the range of 40° to 60° depending on the tissue type), the measured phase shift gradually approaches the decoupling threshold. This gradual approach requires a significant amount of time to reach the final phase threshold. Thus, instead of using the phase value to reach a constant value, a phase derivation may additionally be used to avoid the gradual approach to the final phase value. Furthermore, the determined phase value may overshoot without detection or before the processor can recognize that the final phase stop has been reached. Thus, instead of using only the phase value to reach a constant value, a phase derivation may be used.

[0076] As described above and throughout this application, the electrosurgical unit ultimately supplies RF energy to a connected electrosurgical instrument. The electrosurgical unit ensures that the supplied RF energy does not exceed certain parameters and detects fault and error conditions. However, in various embodiments, the electrosurgical instrument provides the commands or logic used to properly apply RF energy to perform a surgical procedure. The electrosurgical instrument includes a memory with the commands and parameters required to operate the instrument in conjunction with the electrosurgical unit.

[0077] In various embodiments, continuous and / or periodic monitoring of the phase value of the contacted tissue can be correlated with the transition from one tissue state or type to the next, or from one tissue state or type to no contact. In one exemplary embodiment, the obturator 41 includes two electrodes 44a, 44b used to monitor the phase of the contacted tissue (see FIGS. 37A and 37B). When the obturator 41 is inserted into the abdominal cavity, the phase value can be used to indicate the point at which the tip of the obturator 41 is within or through the abdominal wall, at which point the surgeon can begin insufflation. This entry point can be indicated by a visual, audible, or tactile alarm. It should be understood that an insufflation needle, probe, or similar device can be configured similarly to an obturator to confirm a particular entry point or entry state as appropriate for a particular surgical procedure. Similar applications can be applied to stent placement to ensure proper contact with ground pads, etc. Furthermore, the phase value, tissue confirmation, or state can be used to help eliminate the need for tactile feedback. For example, in robotic surgery and the instruments used therein, confirmation monitoring can eliminate the need to "feel" when tissue is being cut, sealed, or grasped, and can eliminate the need to exert specific pressures to perform such tasks.

[0078] In various embodiments, continuous and / or periodic monitoring of the tissue phase value being treated can be correlated to either a change in tissue type or a change in tissue properties due to the delivery of energy. In one embodiment, based on the monitoring of the tissue phase value, the current and voltage output to the instrument can be varied (increased or decreased based on the desired tissue effect (cut, coagulation, or healing)), electrodes can be activated or deactivated, and energy delivery to active attachments can be initiated or terminated.

[0079] Electrosurgical modality transitions based on tissue phase values ​​for electrosurgical instruments according to various embodiments of the present invention may include the following features: 1.Coagulation-cutting 2. Coagulation-Cut-Coagulation (Automatic Shut-Off - Shuts off RF energy when phase value is reached or exceeded) 3. Coagulation-Cut-Coagulation (User Shutoff - shuts off RF energy when surgeon releases energy delivery) 4. Cutting-coagulation (automatic shutoff) 5. Cutting-Coagulation (User Blocking)

[0080] In one embodiment, upon contact with tissue at a particular phase value, an active instrument modality (cutting, coagulation, and welding) can be activated or deactivated. In another embodiment, upon contact with tissue at a particular phase value, the instrument can automatically provide energy to the tissue (cutting, coagulation, welding, welding, or any combination thereof and / or modality described above) until a predetermined phase value is reached.

[0081] In one embodiment, a visual, audio, and / or tactile indication can be used to indicate the type of tissue that the active instrument has contacted, allowing the electrosurgical instrument to seek out specific tissue types. When used in combination with multiple electrodes of an active electrosurgical instrument, a combination of tissue types can be visually, audio, and / or tactilely indicated, allowing specific electrodes to be activated and energy to be provided to portions of the device as desired to perform a specific surgical procedure based on the specific tissue.

[0082] In one embodiment, because bipolar RF energy is used to cut the tissue, the treated tissue cannot dry or dehydrate to the point where only a collagen seal remains. At this point, the "seal" cannot conduct electricity to cut the tissue as needed or safely using bipolar energy delivery (e.g., the tissue resistance is too high). Similarly, at this point, cutting the seal or tissue surrounding the seal using a mechanical (unenergized) blade or cutting instrument is difficult, for example, due to tissue calcification. Therefore, when using phase values ​​to identify the "pre-cut" or "partial seal" transition, the tissue can be coagulated to a known phase that is lower than the predetermined phase value that indicates complete coagulation of the tissue. The cut is then made (mechanically or electrically). After the cut, energy delivery continues until the predetermined phase value that indicates complete sealing of the tissue is reached.

[0083] It should be understood that, so that the tissue being electrically cut is conductive, minimal thermal damage or desiccation must be applied to the tissue to be cut. In one embodiment, the electrosurgical instrument creates approximately 1 mm to 2 mm of lateral thermal damage outside the jaws of the device at a 45° phase shift. The spacing between the coagulation electrodes of the electrosurgical instrument is approximately 0.040 inches, or 1 mm, and a phase shift greater than 45° desiccates the tissue to the point where it cannot be cut effectively. Thus, in one embodiment, the greater the spacing between the electrodes, the higher the pre-cut transition point or condition, and a lower pre-cut transition point corresponds to a closer electrode spacing. A lower pre-cut transition represents a phase value where coagulation is less likely to occur, as opposed to complete coagulation of the tissue. Furthermore, RF energy, e.g., voltage, is applied at a faster or more abrupt rate to electrodes that are relatively closely spaced. This is because the pre-cut transition is lower than the pre-cut transition when the electrodes are spaced farther apart. Similarly, RF energy is applied at a slower or less abrupt rate to electrodes that are relatively far apart. Furthermore, when tissue is clamped between the jaws, the tissue within the jaws is subjected to a higher temperature than the outer edges of the jaws, thus reducing thermal damage to tissue not clamped between the jaws or exposed to a lower temperature, thereby allowing the use of a relatively high pre-cut transition point.

[0084] Referring to Figures 40, 41, and 42, one embodiment illustrates a pre-cut process. The process begins by receiving a cut command (601) generated by activating a pressure button or switch. The press of the cut button is communicated to and recognized by an electrosurgical unit connected to the electrosurgical instrument. In one embodiment, a processor within the electrosurgical unit commands or initiates the output or delivery of RF energy to the electrosurgical instrument (603). However, the delivered RF energy is insufficient to cut tissue placed in the jaws of the electrosurgical instrument. Instead, the delivered RF energy is less than sufficient to cut the tissue and is used for coagulation. The processor monitors (605) the phase between the current and voltage of the RF energy being delivered to the tissue. In one embodiment, the phase between the current and voltage of the RF energy is monitored by current and voltage monitoring circuitry and filters. A comparison is made to a pre-cut phase state or switch (607). In one embodiment, the pre-cut phase state is a predetermined value or range of values ​​specific to the particular electrosurgical instrument and tissue type. The tissue may be one for which the instrument is intended to be used or one for which the instrument is specifically intended to be used or treated. In other embodiments, the pre-cut phase state may be determined based on or dynamically relative to an initial or periodic determination of tissue type, e.g., by measuring the tissue's permittivity and / or conductivity, to identify various predetermined values ​​or ranges of values ​​for a given tissue type. For example, the initial determination of tissue type may be used and compared to a value, e.g., a table of pre-cut phase values, that has been empirically or otherwise determined to be an optimal or specific phase value for identifying the pre-cut phase state.

[0085] As described above, the pre-cut phase state is identified as a point or state where the tissue to which RF energy is applied is nearly coagulated but not fully coagulated, e.g., the tissue is nearly completely desiccated, dehydrated, and / or calcified. If the pre-cut phase switch is not identified as having been reached or exceeded, the process continues, continuing to apply RF energy and monitor the phase. After the pre-cut phase state is identified as having been reached, the process transitions to cutting the tissue. In one embodiment, the processor commands or initiates (609) a ramp-up or initiation of RF energy appropriate to cut the tissue at the jaws of the electrosurgical instrument. In one embodiment, the application of RF energy for cutting after pre-cutting the tissue is rapid, accelerating the rate at which the electrosurgical unit reaches and delivers maximum output voltage. If the voltage increases according to a long ramp-up cycle or step function, the tissue being cut will be coagulated. Thus, depending on the time it takes the electrosurgical unit to reach the cutting voltage level, the tissue may become too dry to be properly cut.

[0086] In one embodiment, the process continues as the phase between the applied current and voltage is measured and / or monitored to confirm that the tissue has been properly cut. Additionally, in one embodiment, after the tissue has been cut, RF energy to effect coagulation is again applied to the tissue so that complete coagulation of the tissue can be effected or initiated and confirm that the tissue has been coagulated.

[0087] The pre-cutting and subsequent cutting of tissue are the same or nearly the same, but the tissue is first coagulated to a pre-cut state with respect to surrounding tissue, and then cut between the nearly coagulated tissue. Note that the application of coagulation RF energy and / or cutting RF energy is determined by the electrode delivering the associated RF energy. Thus, the affected tissue may be based on the location of RF energy application from the electrode locations to be pre-cut and then cut using different sets of electrodes. For example, when a cut command is initiated, one or more electrodes are activated to apply RF energy to coagulate tissue in contact with one or more electrodes, and once the pre-cut state is reached, one or more additional electrodes are activated to apply RF energy to cut the tissue in contact with those different electrodes. Thus, in one embodiment, pressing the cut button on the electrosurgical instrument applies RF energy to tissue in one region to bring it from a coagulated state to a pre-cut state, and then applies RF energy to tissue in another region to cut the other tissue. In one embodiment, one or more electrodes are used to deliver RF energy to perform coagulation and one or more electrodes other than the electrodes used for coagulation are used to deliver RF energy to perform cutting. Additionally, one or more electrodes may be used as common electrodes used to deliver RF energy for both coagulation and cutting.

[0088] In one embodiment, the electrosurgical unit 420 may include an input / output circuit 422, an RF delivery circuit 424, a phase discriminator 426, and a processor 428. One or more circuits may be included in the input / output circuit 422. The input / output circuit 422 receives RF energy from the RF delivery circuit 424 and transmits it to the electrosurgical unit 420 and a connected electrosurgical instrument (not shown). The input / output circuit 422 also receives tool data and / or tissue data from the electrosurgical instrument and / or through a connector therebetween. In one embodiment, the phase discriminator calculates the phase difference between the voltage and current delivered by the RF delivery circuit 424. In one embodiment, the applied voltage and current are rectified, compared, or combined, for example, through an XOR logic gate, to generate a pulse-width modulated signal. The duty cycle of the generated signal represents the phase difference between the applied voltage and current. The determined phase difference is then provided to the processor, which compares it to a predetermined phase threshold based on the particular tissue in contact with the electrosurgical instrument. In one embodiment, the processor provides the above-described process for determining a pre-disconnect condition in order to complete the disconnect.

[0089] In one embodiment, the electrosurgical generator includes an RF amplifier 633, an RF amplifier controller and monitor 634, an energy monitor 642, and a relay and tissue measurement device 635. The electrosurgical generator is connected to a 120 Hz voltage mains input. The mains input is isolated by a low leakage transformer in the power supply 631. The power supply provides the operating voltage for the control processor 637 and the RF amplifier 633. The power supply also includes two 50 VDC output modules connected in series to provide a total output of 100 VDC and 8 A (amperes). The RF amplifier generates the RF power. For example, a switched mode low impedance RF generator generates the RF output voltage. In one embodiment, it generates 500 peak cut voltage for cutting and 7 A for coagulation / healing.

[0090] In one embodiment, tissue healing involves applying RF current to a relatively large piece of tissue. Because of the potentially large tool contact area, tissue impedance is very low. Therefore, to deliver an effective amount of RF power, the current capacity of the RF amplifier is large. Thus, while a typical generator can generate a current of 2 A to 3 A, the generator's RF amplifier can deliver 5 A or more RMS into a low-impedance load. This results in rapid tissue healing with minimal damage to adjacent tissue.

[0091] The RF amplifier circuitry monitors both voltage and current. A set of voltage and current sensors are connected to the RF amplifier controller and monitor 634, which uses these sensors for servo control. The voltage and current can also be read by the processor 637 using an analog-to-digital converter (ADC) located in the RF amplifier controller and monitor. The RF amplifier controller and monitor also has an analog multiplier that calculates power by multiplying the voltage and current. The RF amplifier controller and monitor uses the average values ​​of the voltage and current, does not include the phase angle, and thus effectively calculates volt-ampere reactive power (VAR) rather than actual power. A second set of voltage and current sensors is connected to the energy monitor 642. The signals are connected to the ADC for redundant voltage and current monitoring. The processor multiplies the voltage and current readings to ensure the power output does not exceed 400 W (watts). The energy monitor has monitoring circuitry that is completely separate from the RF amplifier controller and monitor. This includes an ADC with an independent voltage reference.

[0092] The RF amplifier, in one embodiment, is a switching class D push-pull circuit. In this way, the amplifier can generate large RF voltages in high-impedance tissue and large RF currents in low-impedance tissue. The output level of the RF amplifier is controlled by pulse-width modulation (PWM). This high-voltage PWM output signal is sinusoidalized by a low-pass filter in the RF amplifier. The output of the filter is the coagulation output of the RF amplifier. An output transformer further steps up the output voltage to obtain the disconnect output of the RF amplifier. Only one output at a time is connected to the control servo of the RF amplifier controller and monitor, and is selected so that only one output is used at a time.

[0093] An RF amplifier controller and monitor 634 is connected to the RF amplifier. In one embodiment, the RF amplifier controller and monitor 634 receives voltage and current setpoints. These setpoints are entered by a user through a user interface to set the output power level of the RF amplifier. The user setpoints are translated into operating levels by an analog-to-digital converter in the RF amplifier controller and monitor 634. The user setpoints are translated into operating levels by an analog-to-digital converter in the RF amplifier controller and monitor 634. In one embodiment, the setpoints include maximum voltage output, maximum current output, maximum power output, and phase stop. A servo circuit in the RF amplifier controller and monitor 634 controls the RF output power based on the three setpoints. The servo circuit thus controls the output voltage of the RF amplifier so that the voltage, current, and power setpoints are not exceeded. For example, the output power of the ESG is limited to less than 400 W. The individual voltage and current setpoints can be set above 400 W depending on tissue impedance. Thus, the power servo limits the power output to less than 400 W.

[0094] The RF output voltage and current are regulated by a feedback control system that compares the output voltage and current to setpoint values ​​and adjusts the output voltage to maintain the commanded power. RF power is limited to 400 W. Two tool connections are supported by using a relay 635 to multiplex the RF power and control signals. An EMI line filter 636 limits RF leakage voltage by using an RF isolation transformer and coupling capacitors.

[0095] The cut and coagulation output voltages of the RF amplifier are coupled to a relay and tissue measurement circuit 635. In one embodiment, the relay and tissue measurement circuit 635 includes a relay matrix that routes the RF amplifier output to one of three output ports of the electrosurgical unit. The relay matrix also selects the form of the tool voltage. The RF output is always switched off before switching on a relay to prevent damage to the relay contacts. To alleviate stuck relays and route RF to an idle output port, each output port has a leakage current sensor. The sensor looks for RF current imbalances, such as current exiting one tool port and returning through another tool port. The current sensor is located on the relay PCB, and the detector and ADC are located on the energy monitor PCB. The CPU monitors the ADC for leakage current. If a fault is detected, an alarm condition is triggered, which turns off the RF power.

[0096] The relay and tissue measurement circuitry also includes a low-voltage network analysis circuit used to measure the tool impedance before turning on RF power. The circuit measures impedance and tissue phase angle, and in one embodiment uses a 10V signal operating at 100 Hz. The processor 637 uses the impedance measurement to determine if the tools are shorted. If tool A or B is shorted, the system will warn the user and prevent RF power from being turned on. The RF amplifier is fully short-circuit protected. Depending on the servo settings, the system may enter a short circuit but not cause a fault condition. In one embodiment, the initial impedance and / or phase measurements can determine if the jaws are open and / or there is no tissue in contact with the jaws and / or if the jaws are dirty, e.g., have excessive eschar that is in the way.

[0097] The use of an isolation transformer provides voltage and current feedback to ensure low leakage current. A processor 637 calculates the power output of the RF amplifier and compares it to a power setpoint, which, in one embodiment, is input by the user. The processor 637 also monitors the phase lag, or difference between current and voltage. Furthermore, in one embodiment, the processor matches various phase settings, depending on the tissue type, to the monitored phase difference. Such a processor measures the tissue phase shift before applying RF energy. As described in more detail below, the phase measurement is proportional to the tissue's permittivity and / or conductivity, thereby uniquely identifying the tissue type. Once the tissue type is identified, the phase angle associated with endpoint determination for that tissue type can be determined. The generator, in one embodiment, has three RF output ports (Tool A, Tool B, and Generic Bipolar). Tool A and B ports 639 are used for connecting smart tools, while the Generic Bipolar port 640 supports standard electrosurgical tools. An audible tone is emitted when the RF output is active or if an alarm condition exists.

[0098] The hand and foot controls are also isolated to limit leakage current. The control processor checks the inputs for valid selection before enabling the RF output. When two control inputs from the switches are simultaneously activated, the RF output is turned off and an alarm is generated. A digital-to-analog converter is used to convert the control output into a signal usable by the analog servo control. The control set points are output voltage and current. An analog-to-digital converter is used to process analog phase angle measurements. Additionally, voltage RMS and power RMS information from the control is converted into a form usable for presentation to the user. A digital I / O bus interface 638 digitally communicates between the user, the control, and the hand / foot switches. Isolation circuitry is used to eliminate possible leakage paths from the electrosurgical generator. It also communicates between the user and the generator through a data channel protocol.

[0099] In one embodiment, the unit has four tool interface circuits. These circuits are used to electrically isolate the user input switches from the main power supply inside the system. All four tool interface circuits are identical and have an onboard microprocessor to read the user switch inputs, as well as tool crypto and script memories. Switch closure resistance is measured by an ADC to prevent dirty switch contacts from being read as closed. A switch closure of 300 ohms or less is valid, while a reading of 1000 ohms or greater is an open. A reading between 300 ohms and 1000 ohms is considered a faulty input.

[0100] The four tool interface circuits communicate with the processor using an RS485 network. Each tool interface circuit has jumpers to select its address and location on the unit. The RS485 interface is isolated to eliminate potential leakage current paths. One tool interface circuit connects to each of the Tool A and B ports. A third tool interface circuit connects to the DC output port, and a fourth circuit connects to the rear panel footswitch input. The processor is the master of the network, and the four circuits are slaves to the network. The processor polls each circuit for input. The tool interface circuits only respond to commands. This makes the network deterministic and prevents any deadlocks. Each tool interface circuit is connected to a System OK logic signal. If a system error is detected by the tool interface circuit, this signal is asserted true. The processor monitors this signal and indicates a fault. This signal also has a hardware connection to the RF amplifier controller and monitor 634, which disables the RF amplifier if asserted true. System errors can occur due to two input switches being activated simultaneously or due to loss of communication with the processor. The Tool A and B ports and the DC port have microswitches that detect when a tool is plugged into the socket. Until this switch is pressed, the front panel connections of the tool interface circuit are configured in the off state to prevent leakage current from flowing from the front panel connections. When the switch is pressed, the tool interface allows the processor to begin reading from and writing to the tool cryptographic memory and script memory. After a tool is detected, a window on the user interface display opens, indicating the type and status of the connected tool. The generic bipolar port supports legacy tools that do not have configuration memory. The tissue measurement circuitry is used to monitor the contacts of the bipolar connections.When a bipolar tool is connected, the tool's capacitance is detected and the processor opens a bipolar tool window on the user interface display, indicating the bipolar tool's status. The DC port is used to interface with custom surgical tools to which 12V DC is applied. When a tool is plugged into this port, a window on the user interface display opens, indicating the type and status of the connected tool. When the DC tool script command is activated, the processor closes a relay in the Power Control and Isolation circuitry 643, turning on the isolated 12V tool power.

[0101] The power control isolation circuit 643 has two other features. The power control isolation circuit 643 controls the 100V power supply that drives the RF amplifier. This power supply is turned on by a relay controlled from the RF amplifier controller and monitor. The processor provides commands to this power supply via the RF amplifier controller and monitor. If the RF amplifier controller and monitor is reset or detects a fault condition, the relay will not activate, leaving the 100V power supply in an off state. Additionally, the power control isolation circuit has an RS485 isolation circuit located in it. This adds an extra layer of insulation.

[0102] A front panel interface circuit 641 is used to connect the front panel control switches and LCD display to the processor. The front panel interface circuit also contains a microprocessor powered by an isolated standby power supply that is on whenever the main power is on. When the power button on the front panel is pressed, the microprocessor turns on the main logic power supply using a relay in the power control isolation circuit. When the button is pressed to turn off the power, the microprocessor sends a power off request signal to the processor. When the processor is ready to turn off the power, it sends a power off signal to the microprocessor. The power control relay then opens, turning off the main power supply.

[0103] In one embodiment, the generator accepts only one switch input command. When RF is inactive, for example, RF energy is applied, multiple switch closures, and the footswitch, tool, or combination of footswitch and tool are ignored. When RF is active, two closures terminate the alarm and RF. The footswitch, in one embodiment, includes a momentary switch that activates the application of RF energy. The switch, when actuated, initiates the activation of RF energy, for example, coagulation, cutting, and / or coagulation or cutting sequentially. A two-position push button on the foot pedal switch allows for toggling between different tools. The generator display and hand tool LED indicate the active port.

[0104] In one embodiment, all RF activation results in RF ON Tone. The activation tone volume is adjustable from 40 dBA (minimum) to 65 dBA (maximum) with a control knob mounted on the rear panel. However, the volume control does not affect the audible volume for the alarm. Additionally, in one embodiment, a universal input power supply is connected to the generator, allowing it to operate over a range of input voltages and frequencies without the use of switches or settings. In one embodiment, a programming port is used to download code to the generator and to upload operational data.

[0105] In one embodiment, the generator provides 12V DC output power at 3A. Examples of such tools that use DC power include, but are not limited to, aspiration / irrigation pumps, staplers, and morcellators (tools for breaking tumors into small pieces for removal). The DC connector has an intuitive one-way connection. Similar to other tool sockets, a non-sterile electronic chip module attaches to the connector of an appropriate DC hand tool using a conventional one-way locking mechanism. Tool-specific engravings on both the connector and the chip module ensure that the chip module is compatible only with the type of tool for which it is programmed. The chip connector allows tool recognition and uses tool data storage. The DC connector is further configured to prevent improper insertion. The generator is also configured to recognize the attached DC tool. The generator reads morphological data from the tool connector, allowing the tool to recognize and store data for use by the tool.

[0106] In one embodiment, the phase measurement is a relative measurement between two sinusoidal signals. One signal is used as a reference and the phase shift relative to that reference is measured. Because the signals are time-varying, the measurement cannot be made instantaneously. The signals must be monitored for a long enough period of time that the difference between the signals can be determined. Typically, the time difference between two known points (where the sine waves cross zero) is measured to determine the phase angle. In the case of a phase controller, the device generates an output sine wave using a precision quartz clock. Using the same precision clock, input samples are read with an analog-to-digital converter. In this way, the output of the phased controller is exactly in phase with the output of the phase controller. In one embodiment, the phase controller compares the input sine wave signal to a reference sine wave to determine the amount of phase shift.

[0107] The phase control device performs this comparison using a mathematical calculation known as the Discrete Fourier Transform (DFT). In this particular case, 1024 samples of the input signal are correlated, one by one, with both a sine and a cosine function. By convention, the cosine portion is called the real part and the sine portion is called the imaginary part. If there is no phase shift in the input signal, the result of the DFT is 100% real. If there is a 90° phase shift in the input signal, the result of the DFT is 100% imaginary. If the result of the DFT contains both a real and an imaginary part, the phase angle can be calculated as the arctangent of the imaginary and real values.

[0108] It should be understood that the calculation of phase angle is independent of real and imaginary units. Only ratios matter. The phase result of the phase controller is also independent of gain, and no impedance calculations are made in the phase angle calculation process. By performing a DFT, the phase controller encodes the phase measurement as a pair of numbers.

[0109] According to various embodiments, precise knowledge of the phase endpoints prior to energy delivery allows for trigger control and the delivery of more current (7 A, 400 W) than other electrosurgical units. According to various embodiments, memory capabilities in the instrument key portion of each instrument connector allow for read and write access between the electrosurgical unit and the instrument key or connector. Information may include treatment record data (energy profile, tissue type, etc.) or data to prevent the device from being reused. In one embodiment, the use-by date (UBD), number of uses, device serial number, and expiration after the first use value are encrypted to prevent the instrument key from being reprocessed and reused. In one example, to aid in inventory control, information includes the electrosurgical unit serial number, which can be retrieved and stored in memory when an instrument is connected to the unit. Information such as the serial number can then be used in tandem with lot and sales data to identify the location of the electrosurgical unit and / or track its movement. Similarly, locators or trackers using GPS, RFID, IP addresses, cellular triangulation may be incorporated into the instrument and / or electrosurgical unit to locate and track the location of the electrosurgical unit or instrument.

[0110] In one embodiment, the information may include metrics such as a record of the types of tissue encountered during a procedure and / or tracking performance of the instrument or electrosurgical unit (frequency of use, number of procedures, etc.). Pre-customized surgeon settings may include data output parameters (e.g., voltage, current, and power) that are stored on the connector or instrument key and loaded into the electrosurgical unit upon connection. Specific settings may be programmed or stored prior to shipping of the instrument / connector. Additionally, instrument / electrosurgical unit diagnostic information may be included. For example, calibration and output verification information may be stored on the electrosurgical unit and then downloaded to the instrument key upon connection. In one embodiment, software upgrades may be delivered via the memory and instrument port of the electrosurgical unit.

[0111] In one embodiment, the electrosurgical generator or unit can automatically sense or confirm insertion / connection of a standard bipolar instrument. In one embodiment, the electrosurgical unit can compensate for standard bipolar instruments and phase monitor and / or confirm tissue or its condition. For example, the tissue measurement circuitry may be included in the electrosurgical unit or may be an intermediate connector between the instrument and the electrosurgical unit. The circuitry and / or programming may provide the functionality for phase monitoring and / or confirming tissue type or condition. The tissue measurement circuitry, in one embodiment, may include a phase measurement adjustment circuit or programming that accounts for the impedance of the circuitry and the cable extending between the tissue and the tool port. The circuitry may also include temperature compensation, since the actual change in phase value due to the instrument is less than the potential change due to temperature fluctuations.

[0112] It will be shown in detail that the phase difference between voltage and current is used as a control value in the healing or joining process, rather than impedance when electrically characterizing tissue. If the vessel and tissue have time-dependent ohmic resistance R and capacitance C in parallel (both of which depend on the size and type of tissue), the phase difference can be given by the following equation: R=(ρ d) / A where R is the ohmic resistance, ρ is the resistivity, A is the area, and d is the thickness of the fusion tissue. X C =1 / (ω C) where Xc is the capacitive impedance, ω is the frequency, and C is the capacitance of the tissue. C=(ε·ε0·A) / d where ε and ε0 are the relative and absolute permittivity. The phase difference φ can be expressed as follows: φ=arctan(X C / R)=arctan〔(ω·ε·ε0·ρ) -1 〕 where ρ is equal to the reciprocal of the conductivity.

[0113] Thus, the difference between monitoring the phase difference φ rather than the (ohmic) resistance R depends only on the frequency ω at which φ is applied and the material properties (i.e., permittivity and conductivity), and is independent of the tissue dimensions (i.e., the area A of the compressed tissue and the tissue thickness d). Furthermore, the relative change in phase difference is much larger than the change in tissue resistance at the end of the healing process, making the measurement easier and more accurate.

[0114] Furthermore, by measuring the initial dielectric properties (dielectric constant ε and conductivity) of the tissue at a particular frequency, the tissue type can be determined. Figure 30 shows the dielectric properties at 350 kHz (which is within the frequency range of a typical electrosurgical generator) of various types of biological tissue with increasing values ​​of the product of the dielectric constant ε and conductivity. By measuring the product of the tissue's dielectric constant ε and conductivity (which are material properties and are independent of tissue dimensions) prior to actually fusing the tissue or prior to the joining process, the phase shift required to properly heal or seal a particular biological tissue can be determined. The phase shift required to reliably heal or seal each type of tissue is measured as a function of the product of the tissue's dielectric constant ε and conductivity. Furthermore, endpoint determination can be shown as a function of the initial phase reading of the tissue determination, and similarly, endpoint determination can be shown as a function of the tissue's properties (conductivity x dielectric constant).

[0115] As a result, (a) measuring the dielectric properties of the tissue and (b) controlling and feeding back the phase difference can provide an accurate control-feedback mechanism for various types of tissue, regardless of tissue size, and standard electrosurgical generators can be used (these generators individually operate over very narrow frequency ranges). However, it should be noted that the natural frequency of the tissue property measurement may or may not be the same as the natural frequency of the phase. However, if the tissue measurement is based on the generator's drive frequency and different generators are used (all operating over very similar power ranges), the endpoints will be different. Therefore, in such cases, it is preferable to use either (1) an external measurement signal (which is a signal of the same frequency) or (b) a stand-alone generator.

[0116] In this manner, the controller is configured to determine the product of the permittivity and conductivity, as well as the phase difference between the applied voltage and current, to monitor and control the tissue healing or joining process. Specifically, a control-feedback circuit in the controller determines when the phase difference reaches a phase shift value determined by the permittivity and conductivity measurements. When this threshold is reached, the healing or joining process is terminated. An indicator, such as a visual or audible indicator, is provided to indicate this termination, and in one aspect, the controller limits further delivery of electrical energy through the electrodes (totally, nearly completely, or to a predetermined minimum value). In this manner, the tissue sealing, joining, or joining tool atraumatically contacts the connective tissue and provides sufficient burst pressure, tensile strength, or break strength within the tissue.

[0117] In one embodiment, a single bipolar / monopolar connector plug is provided that can connect a monopolar instrument to an electrosurgical unit. In one embodiment, the connector includes a ground pad port 310 that turns the electrosurgical unit 420 on and off with an internal relay of the electrosurgical unit acting as another electrode (e.g., sixth electrode (F)) (see FIGS. 38 and 39). Based on a relay / electrode configuration program or instrument pattern (e.g., stored in the connector's memory), the electrosurgical instrument 450 can cut and coagulate either bipolarly, monopolarly, or both. In one embodiment, in bipolar mode, the electrosurgical unit 420 uses two or more electrodes, e.g., electrode B and electrode C, to form active and return paths, and in monopolar mode, the electrosurgical unit uses one or more of the electrodes, e.g., electrode A through electrode E, as the active electrode and uses the ground pad 315 as the return-only electrode 310, e.g., electrode F. In one embodiment, a switch, connector, and / or port internal or external to the electrosurgical instrument is used to identify and notify the electrosurgical unit that monopolar operation is being used. Additionally, in one embodiment, a phase measurement of the applied RF energy can be used to identify if the monopolar pads have been removed and do not provide sufficient contact with the patient and / or conductivity to the electrosurgical instrument.

[0118] Other examples of electrosurgical units, instruments, and connections therebetween, their operation and / or functionality are described in U.S. patent application Ser. No. 12 / 416,668, entitled "Electrosurgical System," filed April 1, 2009; U.S. patent application Ser. No. 12 / 416,751, entitled "Electrosurgical System," filed April 1, 2009; U.S. patent application Ser. No. 12 / 416,765, entitled "Electrosurgical System," filed April 1, 2009; and U.S. patent application Ser. No. 12 / 416,128, entitled "Electrosurgical System," filed March 31, 2009. The entire disclosures of these applications are incorporated herein by reference.

[0119] While the present application discloses certain preferred embodiments and examples, those skilled in the art will recognize that the present invention encompasses other variations and / or uses of the invention beyond the specifically disclosed embodiments, and obvious modifications and equivalents thereof. Moreover, various features of these inventions may be used alone or in combination with other features of these inventions other than those expressly described above. Thus, the scope of the invention disclosed herein is not limited by the particular disclosed embodiments described above, but should be determined solely by a proper reading of the following claims. [Explanation of symbols]

[0120] 10. Electrosurgical instruments for fusion and cutting 12 Joe 14 Actuators 16 shaft 112 Trigger 116, 118 Switch 102 First Joe 103a 1st electrode 103b 2nd electrode 104 Second Joe 105a 3rd electrode 105b 4th electrode

Claims

1. In electrosurgical instruments, First Joe and a second jaw coupled to and facing the first jaw for capturing tissue therebetween; a first electrode connected to the first jaw and extendable from a first location within the first jaw to a second location outside the jaw, the first electrode electrically connected to a stationary electrode positioned in the first or second jaw.

2. 10. The device of claim 1, The first electrode is curvilinear.

3. 10. The device of claim 1, The first electrode is blunt.

4. 10. The device of claim 1, The first electrode is pointed.

5. In an electrosurgical unit, 1. An electrosurgical unit comprising: a radio frequency (RF) amplifier configured to deliver RF energy to coagulate and cut tissue, the RF amplifier delivering RF energy to tissue insufficient to completely coagulate the tissue before delivering RF energy to cut the tissue.

6. 6. The electrosurgical unit of claim 5, the RF amplifier is configured to supply RF energy between the first electrode and the second electrode until the identified phase value equals or exceeds a first predetermined phase value, the first predetermined phase value being less than a second predetermined phase value identified to coagulate tissue.

7. 7. The electrosurgical unit of claim 6, The electrosurgical unit, wherein the RF amplifier is configured to provide RF between the first and second electrodes to cut tissue disposed between the first and second electrodes.

8. 6. The electrosurgical unit of claim 5, The electrosurgical unit, wherein the RF amplifier is configured to supply RF energy between the first electrode and the second electrode to pre-cut tissue disposed between the first and second electrodes.

9. 9. The electrosurgical unit of claim 8, The electrosurgical unit, wherein the RF amplifier is configured to supply RF energy between the first and third electrodes to cut tissue disposed between the first and third electrodes.

10. 7. The electrosurgical unit of claim 6, The electrosurgical unit, wherein the first predetermined phase value is based on a spacing between electrodes of the first and second jaws.

11. 7. The electrosurgical unit of claim 6, The electrosurgical unit, wherein the delivered RF energy is a first amount based on the first predetermined phase value.

12. In electrosurgical instruments, First Joe and a second jaw coupled to and facing the first jaw for capturing tissue therebetween; a first electrode disposed on the first jaw; a second electrode disposed on the first jaw; a third electrode disposed on the first jaw; a fourth electrode disposed on the first jaw; and a fifth electrode disposed in the second jaw.

13. 13. The electrosurgical instrument of claim 12, the first electrode is positioned on the first jaw perpendicular to the fifth electrode, and the first and fifth electrodes are electrically connected to cut tissue disposed between the first and second jaws when the first and second jaws are in close proximity to one another.

14. 13. The electrosurgical instrument of claim 12, an electrosurgical instrument, wherein the first, second, and third electrodes are electrically connected and the second and third electrodes are disposed on opposite sides of an outer surface of the first jaw to cut tissue disposed between the first and second jaws when the first and second jaws are positioned adjacent to one another.

15. 13. The electrosurgical instrument of claim 12, the second, third, and fifth electrodes are electrically connected, and the second and third electrodes are disposed on opposite sides of the outer surface of the first jaw to cut tissue disposed between the first and second jaws when the first and second jaws are in close proximity to each other.

16. 13. The electrosurgical instrument of claim 12, an electrosurgical instrument, wherein the first, second, and third electrodes are electrically connected and the second and third electrodes are disposed on opposite sides of an outer surface of the first jaw to cut tissue disposed between the first and second jaws when the first and second jaws are in a spaced apart position.

17. 13. The electrosurgical instrument of claim 12, the second, third, and fourth electrodes are electrically connected to each other to cut tissue disposed outside the first and second jaws when the first and second jaws are in a spaced-apart position, the second and third electrodes are disposed on opposite sides of the outer surface of the first jaw, and the fourth electrode is disposed on the first jaw perpendicular to the fifth electrode and extends in a direction away from the first and second jaws.

18. 13. The electrosurgical instrument of claim 12, an electrosurgical instrument, wherein the second and third electrodes are electrically connected and positioned on opposite sides of the outer surface of the first jaw to coagulate tissue positioned outside the first and second jaws when the first and second jaws are in a spaced-apart position.

19. In electrosurgical instruments, First Joe and a second jaw coupled to and facing the first jaw for capturing tissue therebetween; a first electrode connected to the first jaw; a movable cutter coupled to the first and second jaws; an actuator, the actuator comprising: a stationary handle and a movable trigger coupled to at least one of the first and second jaws for moving the jaws between a spaced apart position and an adjacent position; an elongated shaft coupled to the actuator and the first or second jaw; a blade trigger connected to a blade shaft and movable along a longitudinal axis, the blade trigger being connected to the movable cutter disposed within the elongated shaft; a first stop that limits distal movement of the blade shaft along a longitudinal axis.

20. 20. The electrosurgical instrument of claim 19, further comprising: and a second stop limiting proximal movement of the blade shaft along the longitudinal axis.

21. In electrosurgical instruments, First Joe and a second jaw coupled to and facing the first jaw for capturing tissue therebetween; a first electrode connected to the first jaw; an actuator, the actuator comprising: a rotatable elongate shaft coupled to the actuator and the first or second jaw; and at least one electrically conductive connector surrounding a portion of the rotatable elongate shaft within the actuator. and at least one stationary contact disposed within the actuator and electrically connectable to the at least one conductive connection, wherein the at least one conductive ring is electrically connected to the first electrode.

22. 22. The electrosurgical instrument of claim 21, The actuator further comprises: a stationary handle and a movable trigger coupled to at least one of the first and second jaws for moving the jaws between a spaced apart position and an adjacent position; and an internal switch disposed within the actuator that is not externally accessible and that is actuated by the movable trigger contacting the internal switch; An electrosurgical instrument comprising: at least one external switch disposed on an actuator; and electrical connections for activating the at least one external switch and the internal switch.

23. In electrosurgical instruments, First Joe and a second jaw coupled to and facing the first jaw for capturing tissue therebetween; a first electrode connected to the first jaw.

24. 25. The device of claim 24, The first electrode is disposed at a tip of the second jaw.

25. 25. The device of claim 24, the first electrode is exposed along a peripheral distal portion of the first jaw and is not exposed along a remaining peripheral portion of the first electrode extending toward a proximal portion of the first jaw.

26. In an electrosurgical unit, an RF amplifier configured to supply RF energy; a phase discriminator connected to said RF amplifier configured to measure a tissue property based on a phase difference between the voltage and current of delivered RF energy.

27. 27. The electrosurgical unit of claim 26, further comprising: An electrosurgical unit including a monopolar electrode removably coupled to said electrosurgical unit.

28. 27. The electrosurgical unit of claim 26, The electrosurgical unit is configured to record the type of tissue contacted by electrodes of the electrosurgical instrument.

29. 27. The electrosurgical unit of claim 26, The electrosurgical unit further includes a connector positioned between the electrosurgical instrument and the electrosurgical unit, the connector including a memory for storing operational data.

30. In electrosurgical instruments, A long, slender shaft and at least one electrode disposed at a distal end of said elongate shaft, said at least one electrode configured to identify the type of tissue contacted.

31. 31. The device of claim 30, The identification of tissue type is based on the phase difference between the applied voltage and current.

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