Electrosurgical system

Abstract

To provide electrosurgical systems and methods, and more specifically, electrosurgical generators and associated instruments for sealing and cutting tissue.SOLUTION: An electrosurgical system includes a bipolar electrosurgical instrument and an electrosurgical generator 10. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the instrument. The jaws include particularly positioned, shaped and / or oriented electrodes to perform the sealing of tissue. The electrosurgical generator is arranged to supply RF energy through the instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] This application generally relates to an electrosurgical system and method, and more particularly to an electrosurgical generator and related instruments for sealing and cutting tissue.

Background Art

[0005] However, even with the relatively focused surgical effects of bipolar electrosurgical instruments, surgical outcomes often depend heavily on the surgeon's skill. For example, thermal tissue damage and necrosis can occur when electrical energy is delivered over a relatively long duration, or even when relatively high-power electrical signals are delivered over a short duration. The rate at which tissue achieves the desired dissolution, sealing, or cutting effect upon application of electrical energy varies depending on the tissue type and may also vary depending on the pressure applied to the tissue by the electrosurgical device. However, it can be difficult for surgeons to assess how quickly and to what extent a composite tissue mass grasped by an electrosurgical instrument will be sealed. [Means for solving the problem]

[0006] Various embodiments provide electrosurgical instruments configured to dissolve and cut tissue. In various embodiments, the electrosurgical device or instrument includes a first jaw and a second jaw facing the first jaw, which grasps the tissue between the first and second jaws. The first jaw includes an electrode, and the second jaw also includes an electrode. The electrodes of the first and second jaws are arranged to seal the tissue between the first and second jaws using radio frequency energy.

[0007] Various embodiments provide an electrosurgical system comprising an electrosurgical instrument having a handle assembly and jaws connected to the handle assembly, and an electrosurgical generator detachably coupled to the electrosurgical instrument. The electrosurgical generator is configured to supply RF energy to the electrosurgical instrument, starting at a predetermined first voltage and increasing to a predetermined second voltage within a predetermined first period. In various embodiments, the generator is configured to regulate the voltage of the supplied RF energy to start at a predetermined third voltage after the expiration of the predetermined first period and / or after the voltage of the supplied RF energy has reached a predetermined second voltage. In various embodiments, the generator is configured to regulate the voltage of the supplied RF energy to be held constant at a predetermined voltage or at the state after the expiration of the predetermined second period and / or thereafter.

[0008] Various embodiments provide an electrosurgical system for sealing tissue. In various embodiments, the system includes an electrosurgical generator and an electrosurgical instrument or device. The generator includes an RF amplifier and a controller. The RF amplifier supplies RF energy through a removablely coupled electrosurgical instrument configured to seal tissue using only RF energy. The controller and / or RF sensor are arranged to monitor and / or measure the supplied RF energy and / or its components. In various embodiments, the controller signals the RF amplifier to adjust the voltage of the supplied RF energy at predetermined points or conditions in the sealing cycle, for example, by increasing, holding, decreasing, and / or stopping. In various embodiments, the controller signals the RF amplifier to interrupt the supplied RF energy or to initiate the termination of the supplied RF energy from the RF amplifier.

[0009] In various embodiments, an electrosurgical generator is provided, which includes an RF amplifier configured to supply RF energy having voltage spikes to an electrosurgical instrument. In various embodiments, an electrosurgical generator is provided, which is configured to supply RF energy to an electrosurgical instrument based on a control script provided by the electrosurgical instrument, and to adjust the voltage of the supplied RF energy based on predetermined conditions contained in the control script. In various embodiments, an electrosurgical instrument is provided, which is configured to house and provide a control script to an electrosurgical generator, the control script is configured to cause the electrosurgical generator to adjust the voltage of the supplied RF energy based on predetermined conditions identified within the control script.

[0010] The various features and embodiments provided throughout can be used individually or in combination with other features and / or embodiments not expressly described, and specific combinations of embodiments and features or aspects of various embodiments may not be expressly described, but such combinations are conceivable and within the scope of the present invention. Many of the incidental features of the present invention will be more readily apparent when they are considered in conjunction with the accompanying drawings and in reference to the above and below description.

[0011] This invention can be better understood when interpreted in conjunction with the accompanying drawings, in which reference numbers specify the same parts through the figures. [Brief explanation of the drawing]

[0012] [Figure 1] This is a perspective view of an electrosurgical system according to various embodiments of the present invention. [Figure 2] This is a perspective view of electrosurgical instruments according to various embodiments of the present invention. [Figure 3] This is a perspective view of electrosurgical instruments according to various embodiments of the present invention. [Figure 4] This is a perspective view of the distal end of an electrosurgical instrument according to various embodiments of the present invention. [Figure 5] This is a perspective view of the distal end of an electrosurgical instrument according to various embodiments of the present invention. [Figure 6] This figure shows a graphic representation of sample experimental data for sealing processes using electrosurgical systems according to various embodiments of the present invention. [Figure 7] This figure shows a graphic representation of sample experimental data for sealing processes using electrosurgical systems according to various embodiments of the present invention. [Figure 8] This figure shows a graphic representation of sample experimental data for sealing processes using electrosurgical systems according to various embodiments of the present invention. [Figure 9]A diagram showing a graphical representation of a sample of experimental data for a sealing process using an electrosurgical system according to various embodiments of the present invention. [Figure 10] A flowchart showing the operation of an electrosurgical system according to various embodiments of the present invention. [Figure 11] A schematic block diagram of each part of an electrosurgical system according to various embodiments of the present invention. [Figure 12] A flowchart showing the operation of an electrosurgical system according to various embodiments of the present invention.

Mode for Carrying Out the Invention

[0013] Generally, an electrosurgical system is provided that includes an electrosurgical generator configured to optimally seal or lyse tissue and an electrosurgical instrument removably coupled thereto. RF energy is supplied by an electrosurgical generator configured to provide RF energy appropriate for sealing tissue. Generators according to various embodiments determine the appropriate RF energy and the appropriate manner of delivering the RF energy for a specifically connected electrosurgical instrument, the specific tissue contacting the instrument, and / or a specific surgical procedure. Operationally, RF sealing or lysis of tissue between jaws is provided to reduce seal time and / or heat dissipation.

[0014] According to various embodiments, the electrosurgical system applies RF energy having a high voltage over a short duration to provide an RF energy spike. Thereafter, the electrosurgical system reduces the voltage of the supplied RF energy while continuing to apply the RF energy. The electrosurgical system also continuously monitors the supplied RF energy to detect short circuit or open conditions. The system also determines the shift from the high voltage RF energy spike to the reduced voltage RF energy supply, the determination of tissue or vessel lysis or sealing, and thereby the cessation or termination of the supply of RF energy.

[0015] Referring to Figures 1 and 2, an exemplary embodiment of an electrosurgical system is shown, comprising an electrosurgical generator 10 and a detachably connectable electrosurgical instrument 20. The electrosurgical instrument 20 can be electrically connected to the generator via a cable connection 30 leading to a tool or device port 12 on the generator. The electrosurgical instrument 20 may include audible, tactile, and / or visual indicators to inform the user of specific predetermined statuses of the instrument, such as the start and / or end of a dissolution or cutting operation. In other embodiments, the electrosurgical instrument 20 may be reusable for another surgical procedure and / or connectable to another electrosurgical generator. In some embodiments, a manual controller, such as a hand or foot switch, may be connectable to the generator and / or instrument to enable predetermined selective control of the instrument, such as to initiate a dissolution or cutting operation.

[0016] In various embodiments, the electrosurgical generator 10 is configured to generate radio frequency (RF) electrosurgical energy and to receive data or information from an electrosurgical instrument 20 electrically connected to the generator. In one embodiment, the generator 10 outputs RF energy (e.g., 375 VA, 150 V, 5 A at 350 kHz), and in one embodiment, it is configured to measure the current and / or voltage of the RF energy and / or to calculate the power of the RF energy or the phase angle or difference between the RF output voltage and the RF output current during the activation or supply of the RF energy. The generator adjusts the voltage, current, and / or power and monitors the RF energy output (e.g., voltage, current, power, and / or phase). In one embodiment, the generator 10 stops the RF energy output under predetermined conditions such as when a device switch is asserted to stop (e.g., the dissolve button is released), a time value is satisfied, and / or when the active phase angle, current, voltage, or power and / or its change is greater than, less than, or equal to a stop value, threshold, or condition and / or change thereto.

[0017] The electrosurgical generator 10 includes at least one improved bipolar tool port 12, a standard bipolar tool port 16, and a power port 14. In other embodiments, the electrosurgical unit may include a different number of ports. For example, in some embodiments, the electrosurgical generator may include more or fewer than two improved bipolar tool ports, more or fewer standard bipolar tool ports, and more or fewer power ports. In one embodiment, the electrosurgical generator includes only two improved bipolar tool ports.

[0018] In various embodiments, each improved bipolar tool port 12 is configured to connect to an electrosurgical instrument having a mounted or integrated memory module. A standard bipolar tool port 16 is configured to accept non-dedicated bipolar electrosurgical tools different from the improved bipolar electrosurgical instruments that can be connected to the improved bipolar tool port 12. A power port 14 is configured to accept or connect to a direct current (DC) accessory device different from the non-dedicated bipolar electrosurgical tools and improved electrosurgical instruments. The power port 14 is configured to supply a DC voltage. For example, in some embodiments, the power port 14 can provide about 12 volts DC. The power port 14 can be configured to power surgical accessories such as ventilators, pumps, lights, or other surgical accessories. That is, in addition to replacing electrosurgical generators for standard or non-dedicated bipolar tools, electrosurgical generators can also replace surgical accessory power supplies. In some embodiments, replacing existing generators and power supplies with electrosurgical generators can reduce the amount of storage space required on storage rack cards or shelves in the number of trunk power cords required in the surgical workspace.

[0019] In various embodiments, the electrosurgical generator 10 may include a display 15. The display may be configured to show the status of the electrosurgical system, including, among other information, the status of one or more electrosurgical instruments and / or accessories, connectors, or connections thereto.

[0020] Electrosurgical generators in various embodiments may include a user interface such as a plurality of buttons 17. The buttons can enable user interaction with the electrosurgical generator, for example, by requesting an increase or decrease in the electrical energy supplied to one or more instruments connected to the electrosurgical generator. In other embodiments, the display 15 may be a touchscreen display, i.e., integrating data display and user interface functionality. In one embodiment, the electrosurgical tool or instrument 20 may further consist of one or more memory modules. In some embodiments, the memory contains operational data relating to the instrument and / or other instruments. For example, in some embodiments, the operational data may include information regarding electrode configuration / reconfiguration, instrument use, operating time, voltage, power, phase and / or current setpoints, and / or information relating to specific operating states, conditions, scripts, processes, or procedures. In one embodiment, the generator starts, reads from, and / or writes to the memory modules.

[0021] In various embodiments, the generator provides the ability to read the phase difference or phase angle between the voltage and current of the RF energy transmitted through the connected electrosurgical instrument while the RF energy is active. While tissue is being dissolved, the phase readings are used to detect different states during the dissolution or sealing and cutting process.

[0022] Generators in various embodiments do not monitor or control current, power, or impedance. Generators can adjust and regulate voltage. The delivered electrosurgical power is a function of the applied voltage, current, and tissue impedance. Through voltage regulation, a generator can influence the delivered electrosurgical power. However, increasing or decreasing the voltage does not necessarily increase or decrease the delivered electrosurgical power. The power response is caused by the power interacting with the tissue or tissue state without any control by the generator other than by the generator supplying power.

[0023] The generator, once it has started delivering electrosurgical power, does so continuously, for example, every 150 ms, until a failure occurs or a specific parameter is reached. In one example, the jaws of the electrosurgical instrument can be opened, i.e., compression is relieved at any point before, during, or after the application of electrosurgical power. In one embodiment, the generator also does not pause for a specific duration or wait with a predetermined time delay to initiate the termination of the electrosurgical energy.

[0024] Referring to Figures 3 to 5, a bipolar electrosurgical instrument 20 is provided in various embodiments. In the illustrated embodiments, the instrument 20 includes an actuator 24 connected to an elongated rotatable shaft 26. The elongated shaft 26 has a proximal end and a distal end, with a central longitudinal axis between them. A jaw 22 is located at the distal end of the shaft 26, and an actuator is located at the proximal end. In one embodiment, the actuator is a pistol-grip-shaped handle.

[0025] The actuator 24 includes a movable handle 23 and a stationary handle or housing 28, the movable handle 23 being connected to and movable relative to the stationary housing. In various embodiments, the movable handle 23 is slidably and pivotally connected to the stationary housing. In operation, the movable handle 23 is operated by a user, such as a surgeon, to actuate the jaws, for example, to selectively open and close the jaws.

[0026] In various embodiments, the actuator 24 includes a latch mechanism for maintaining the movable handle 23 in a second position relative to the stationary housing 28. In various embodiments, the movable handle includes a latch arm that engages with a matching latch enclosed within the stationary handle to hold the movable handle in a second or closed position. The actuator in various embodiments also includes a wire harness containing individual insulated electrical wires or leads enclosed within a single sheath. The wire harness can exit the stationary housing on its underside and can form part of a cable connection. The electrical wires within the harness can provide electrical communication between the instrument and the electrosurgical generator and / or its accessories.

[0027] In various embodiments, the switch is connected to a user-operated activation button 29 and is activated when the activation button is pressed. In one embodiment, when activated, the switch completes the circuit by electrically connecting at least two leads to each other. Thus, an electrical path is then established from the electrosurgical generator to the actuator to supply RF energy. In various embodiments, the instrument includes a posable mechanical cutting blade that can be coupled to a blade actuator such as a blade lever or trigger 25 of the actuator. The mechanical cutting blade is actuated by the blade trigger 25 to separate tissue between the jaws.

[0028] In one embodiment, the actuator includes a rotary shaft assembly that includes a rotary knob 27 positioned on an outer cover tube of an elongated shaft 26. The rotary knob 27 allows a surgeon to rotate the shaft of the device while gripping the actuator. In various embodiments, the elongated shaft 26 includes an actuation tube that connects the jaws 22 to the actuator.

[0029] Attached to the distal end of the elongated shaft is a jaw 22, which includes a first jaw 31 and a second jaw 33. In one embodiment, a jaw pivot pin pivotally connects the first and second jaws, and allows the first jaw to be movable and pivot rotation relative to the second jaw. In various embodiments, one jaw is fixed to the elongated shaft so that the opposing jaw pivots rotation relative to a fixed jaw between an open position and a closed position. In other embodiments, both jaws can be pivotally connected to the elongated shaft so that both jaws can pivot rotation relative to each other.

[0030] The first, i.e., upper jaw 31 includes an electrode plate or pad. Similarly, the second, i.e., lower jaw 33 includes an electrode. The electrode of the upper jaw 31 and the electrode of the lower jaw 33 are electrically connected to the electrosurgical generator 10 via wires and connectors to supply RF energy to the tissue grasped between the electrodes. The electrodes are therefore arranged to have opposite polarity and to transmit RF energy between them. In various embodiments, the upper jaw also includes an upper jaw support, through which an assembly spacer is positioned between the upper jaw support and the electrode. The upper jaw also includes or is overmolded. The lower jaw includes a lower jaw support and an electrode. In the illustrated embodiment, the electrode is integrated with or incorporated into the lower jaw support, so that the lower jaw support and electrode form a monolithic structure and electrical connection. A blade channel extends longitudinally along the length of the upper jaw, the lower jaw, or both, through which the blade moves operatively. One or more conductive posts surround a portion of the blade channel. The conductive posts help reinforce the blade channels and support the tissue being cut. The conductive posts also participate in the transfer of RF energy to the tissue grasped between the jaws, thus helping to ensure that tissue adjacent to or near the blade channels being cut is dissolved. The lower jaws also include or are overmolded.

[0031] In various embodiments, the electrodes have a substantially planar sealing surface positioned to non-traumatically contact and compress the tissue trapped between the jaws. In various embodiments, the sealing surface includes uniformly spaced outcrops along the length of the jaws (e.g., four outcrops), with branches positioned between the outcrops. Thus, the overall footprint of the sealing surface or area is reduced, thereby increasing the current density applied to the tissue and reducing the current requirements for supplying RF energy as a whole. The tissue seal is thus enhanced, resulting in a high average burst pressure under both in vivo and in vitro conditions.

[0032] The electrode sealing surface also provides notches or spaces 34, 35 between the sealing surface and the jaw edges and between the exposed surfaces, allowing space for tissue to shrink or move, reducing tissue stress caused by tissue shrinkage or contraction during the sealing cycle and stress caused by tissue compression at the jaw edges. Similarly, the gradual spacing eliminates current density peaks at the electrode edges.

[0033] In various embodiments, the outcrop maintains a consistent seal width 32 while leaving space for conductive posts, and the consistent seal width of the seal surface limits the total seal area. In various embodiments, the upper jaw includes an outer seal surface profile that conforms to the lower jaw profile, preventing nonlinear current transfer through the tissue. Thus, in various embodiments, the upper jaw includes an outcrop that conforms to the outcrop of the lower jaw. Similarly, the additional area in the outcrop of the upper jaw increases the local intensity of the conductive stop landing surface. Likewise, the outcrop of the upper jaw provides a landing surface or area 37 for interaction with the conductive posts of the lower jaw that increases the local intensity of the landing surface. In various embodiments, the outcrop is conductive and includes a seal surface or inner surface through which tissue in the jaw is compressed, and RF energy is supplied to the tissue between the jaws.

[0034] In various embodiments, the upper and lower jaw electrodes have a sealing surface with a uniform width that continues along a pattern of multiple outcrops. Thus, the sealing surface has elongated portions, with curved portions spaced apart between the elongated portions, and the width of the sealing surface is uniform, constant, or remains unchanged throughout. The sealing surfaces of the upper and lower jaws have a reduced surface area relative to the total surface area body that can be formed to obtain a given overall dimension of the jaws.

[0035] In various embodiments, at least one sealing surface of the jaws includes a blade pocket or notch positioned to collect and / or clear crust, debris, or coagulated blood. This prevents the blade from locking, misaligning, or being blocked or inhibited as it returns, thereby improving the return of the blade to its initial or pre-cut position. In various embodiments, one or more blade pockets or notches 36, 39 are located at the distal end of the sealing surface and, in various embodiments, extend from the distal end of the blade channel. In various embodiments, the blade pocket is an elongated and uniformly shaped, enlarged spherical opening at the end of the blade channel. The blade pocket thus facilitates blade operation and ensures automatic blade retraction when crust accumulates on the sealing surface and within the blade channel of the jaw. In various embodiments, distal blade pockets on both the upper and lower jaws allow accumulated crust to be pushed forward and out of the blade channel. The pocket also allows older scab buildup to be pushed out of the jaws so that new scabs can be easily cleaned or more efficiently cleaned from the instrument.

[0036] In various embodiments, the jaws are curved to improve visualization and mobility of the jaws at the target surgical site and during the surgical procedure. The jaws have a proximal elongated portion that is shown or aligned to a straight line, and a curved distal portion that shows or defines a curve connected to the straight line. In various embodiments, the nearest portion of the proximal elongated portion has a diameter equal to or not exceeding the maximum outer diameter of the jaw or elongated shaft, or defines its limit. In various embodiments, the jaws have a maximum outer diameter within which the nearest portion of the jaw and the most distal portion of the jaw remain within the maximum outer diameter. The curved distal portion has a diameter smaller than the maximum outer diameter and the diameter of the nearest portion of the proximal elongated portion, or defines its limit. In various embodiments, the jaws have an internal curved notch that is deeper than the external curve, and in various embodiments, the tip of the jaw is tapered for blunt incisions. The jaws include a blade channel having a proximal elongated channel that curves to a distal curved channel, in which the proximal elongated channel is parallel and offset with respect to the longitudinal axis of the elongated shaft of the electrosurgical instrument. Therefore, visibility and mobility of the jaw can be maintained or improved without increasing jaw dimensions, which may further reduce the working area for surgical procedures or necessitate larger access devices or incisions to the patient's body.

[0037] In some embodiments, the electrode shape of the conductive pads of the jaw assembly ensures that the sealing area or surface completely encloses the distal portion of the cutting path. In various embodiments, the dimensions of the jaw surface are such that they are appropriately distributed with respect to the optimal pressure applied to the tissue between the jaws so that the potential force that the force mechanism can generate is obtained. Its surface area is also electrically significant with respect to the surface area in contact with the tissue. This ratio of tissue surface area to thickness is optimized with respect to the relative electrical properties of the tissue.

[0038] In various embodiments, the lower jaw 33 and associated conductive pad have an upper outer surface positioned to contact tissue. This upper surface is inclined or sloped and mirror-image of one another, and such positioning or orientation facilitates focused current density and tissue fixation. In various embodiments, the lower jaw is made of stainless steel and is as rigid as or more rigid than the conductive pad. In various embodiments, the mandible includes a rigid insulator made of a non-conductive material and is as rigid as or more rigid than the lower jaw or conductive pad. In various embodiments, the mandible and conductive pad are made of the same material.

[0039] In various embodiments, an RF energy control process, script, or system for sealing or dissolving tissue is divided into one or more control sections. In the illustrated embodiment, the control process, script, or system includes four sections: voltage spike, voltage drop and ramp, ramp stop, and RF termination. In various embodiments, the control process, script, or system includes one or more sections in various combinations or sequences. The process terminates if an error or unexpected result occurs in or between sections. In various embodiments, such errors include short-circuit or open-circuit detection. In one embodiment, a short-circuit detection error is determined by the generator when the measured phase angle of the RF energy supplied by the generator is equal to or exceeds a predetermined value, e.g., 60°. In one embodiment, an open-circuit detection error is determined by the generator when the measured current of the supplied RF energy is equal to or exceeds a predetermined value, e.g., 2 or 4 amp. Completion of the control process without errors indicates a successful tissue seal. In various embodiments, a successful tissue seal is recognized as the tissue seal being able to withstand a predetermined range of burst pressure or a specific threshold pressure.

[0040] Through various embodiments, it has been identified that tissue seal formation depends on the denaturation and crosslinking of native collagen present in the extracellular matrix of vascular systems, which begins at approximately 60°C. It has also been identified that the strength of this matrix is ​​highly dependent on the drying of the sealing site through the evaporation of water present in the sealing tissue. Furthermore, at temperatures of at least 80°C, bonding between denatured collagen and other biological tissues can be formed. Moreover, it has been identified that collagen decomposes over time at higher temperatures rather than at the peak exposure temperature. Therefore, exposure of the tissue to high-temperature conditions, e.g., 100°C, over a relatively short sealing cycle duration does not affect the structure of the collagen, and water evaporation is possible. Through various embodiments, the total time for sealing the tissue depends on heating the structure to a high temperature, e.g., 100°C, to allow water to distill so that the denatured collagen crosslinks and binds to the tissue, and to limit hydrogen bonding between collagen and water. Therefore, to optimize the sealing time, it has been found that it is desirable to achieve 100°C within the grasped tissue as quickly as possible to initiate the drying process.

[0041] Accordingly, in various embodiments, after the RF energy has been initiated and / or after various device tests have been performed, the generator uses a high voltage spike or pulse through the supplied RF energy. In various embodiments, the potential of the RF energy applied to the tissue is driven as a spike by the proxy tissue temperature and is applied at the start of the seal cycle to maximize energy transfer, with a high power quantity applied.

[0042] In various embodiments of electrosurgical generators and removable devices, rapid heating is desirable to evaporate the latent fluid as quickly as possible to optimize seal time. However, it has been identified that evaporation occurring too rapidly can cause the seal structure to break as excess vapor tries to escape. In some cases, such identification can only be observed through burst pressure testing. Once the voltage spike is complete, the system reduces the voltage to a predetermined level and slowly increases the voltage of the supplied RF energy. In various embodiments, while the increase occurs, sufficient power is applied to the tissue to maintain a temperature sufficient for drying. This allows for continuous evaporation at a rate that does not cause seal structure failure, thereby improving vascular sealing performance.

[0043] In various embodiments, a higher peak voltage provides a shorter sealing time due to higher energy transfer. Experimental studies have shown that applying high voltage levels may cause the sealing tissue to adhere to the active electrode. Therefore, it has been found that terminating the voltage ramp at a lower peak voltage and maintaining the voltage output constant at termination reduces the possibility of tissue adhesion while allowing continuous energy application. In various embodiments, the decision of when to terminate this ramp is made by monitoring the phase and current of the supplied RF energy. As the tissue dries, the phase becomes capacitive and the drawn current decreases. By terminating the ramp at a fixed current value when the current value drops and the phase is capacitive, the level of tissue dryness can be classified. This variable voltage setting allows the sealing cycle to adjust the energy application based on the electrical and structural differences of the tissue being sealed.

[0044] In various embodiments, the phase angle, current, and / or power of the applied RF energy are measured, calculated, and / or monitored to achieve a suitable tissue temperature for causing the relevant tissue effects. Figures 6–9 show diagrams illustrating illustrative seal cycles according to various embodiments. As shown, voltage 111a is shown relative to other RF output readings or indicators such as power 111b, impedance 111c, energy 111d, current 111f, and phase 111g. In addition, although shown in Figures 6–9, in various embodiments the generator is configured not to measure or calculate one or more indicators or readings, such as temperature, in order to reduce operating and power costs and consumption, and / or the number of components in the generator. Additional information or readings are generally supplied or shown for contextual purposes. Furthermore, in various embodiments, inaccurate or impractical impedance or temperature readings are not used or measured.

[0045] As shown in the figure, the voltage of RF energy 111a is increased to a high point at the initial moment of the seal cycle and over a relatively short period compared to the total seal time in order to generate a voltage spike of RF energy 122, 122. During this voltage spike or pulse, energy transfer is maximized, as exemplified by the increase of the power 111b and current 111f of the applied RF energy to their highest points in the seal cycle. Subsequently, the voltage of RF energy 111a is reduced 123 and slowly increased relative to the voltage spike 124, 125. In various embodiments, the gradual voltage ramp by the system is intended to maintain the tissue between the jaws near 100°C, thereby controlling the boiling rate of water within the tissue. In various embodiments, the phase angle, current, and power of the applied RF energy are monitored to achieve a suitable tissue effect for sealing the tissue. The phase angle of the applied RF energy crosses zero or becomes negative, and / or the current falls below 60%, and the applicable current falls below, for example, 3000mA, which indicates that the tissue between the jaws has become more capacitive, thereby drawing less current as water boils or evaporates from the sealed tissue 131, 132. The RF energy voltage is then kept constant to reduce the possibility of tissue adhesion 126, 133. Upon seal completion 141, for example, within a predetermined time frame or period by the system, the RF energy supplied by the system is terminated, or the RF energy supply is interrupted, stopped, or terminated. In various embodiments, the system determines seal completion when the power of the supplied RF energy has fallen below a predetermined power threshold 142, such as 4% of the maximum power or 15 volt-amperes. In various embodiments, the RF energy ramp is terminated, and after a predetermined period by the system, the RF energy supplied by the system is terminated, or the RF energy supply is interrupted, stopped, or terminated.

[0046] In various embodiments, the period during which the generator generates RF energy voltage spikes is shorter than the overall seal cycle and / or the period during which the generator reduces and slowly increases the RF energy voltage. In various embodiments, the period during which the generator maintains a constant RF energy voltage is shorter than the overall seal cycle and / or longer than the period during which the generator generates RF energy voltage spikes.

[0047] In various embodiments, the system identifies, for example, an unexpected current draw provided to a tissue bundle that draws the maximum current or power that the generator can supply. While the system is under such current conditions, the supply of RF energy required to seal the tissue may be insufficient or not efficiently supplied by the system. In various embodiments, to address such conditions, the system determines whether the current of the RF energy output is greater than 95% of the maximum allowable current, e.g., 4750mA. If so, the system waits or further delays to ensure that the current has dropped sufficiently, indicating that the tissue has been sufficiently dried. If, after such a delay, the current has not dropped sufficiently, an error is displayed and / or the supplied RF energy is interrupted. In various embodiments, the system determines or confirms that the current has dropped sufficiently when it has dropped below 90% of the maximum value, e.g., 4500mA. Thus, the system determines that the current condition has ended and / or the tissue has begun to boil.

[0048] In one embodiment, as shown in Figure 10, an electrosurgical procedure such as tissue dissolution or sealing is initiated by pressing a switch or moving an actuator over a tool (51), and based on a positive result of an initial check, the generator supplies RF energy with a predetermined voltage from the generator to the electrosurgical tool and ultimately to the tissue (52). From the time the RF power is turned on and continuously supplied by the generator, the generator monitors the supplied RF energy (53). When a predetermined or predetermined time, condition, or threshold is reached or exceeded, or at that time, the supply voltage of the RF energy and the predetermined time are adjusted or newly selected (55), and the generator continues to monitor the supplied RF energy (52). If a predetermined condition indicates the end of the dissolution or sealing cycle, for example, when tissue sealing is complete and such condition has been reached or exceeded, the generator terminates or interrupts the supply of RF energy (57). In various embodiments, acoustic and / or visual signals are supplied to indicate that tissue has been dissolved or sealed (or that an error has occurred (e.g., a short circuit in the electrodes), and / or that an unexpected condition has occurred (e.g., an acceptable but unexpected switch deactivation)). In various embodiments, predetermined time points, conditions, or thresholds, and / or initialization checks are determined based on a provided tool algorithm or script with respect to the connected electrosurgical tools, procedures, or priorities.

[0049] Referring here to Figure 11, in one embodiment, the electrosurgical generator 10 is connected to the AC main input, and the power supply 41 converts the AC voltage from the AC main input to a DC voltage to power the various circuits of the generator. The power supply also supplies a DC voltage to an RF amplifier 42 that generates RF energy. In one embodiment, the RF amplifier 42 converts 100VDC from the power supply into a sinusoidal waveform at a frequency of 350kHz, which is transmitted through the connected electrosurgical instrument. An RF sensor circuit 43 measures / calculates voltage, current, power, and phase at the output of the generator that supplies RF energy to the connected electrosurgical instrument 20. The measured / calculated information is supplied to the controller 44.

[0050] In one embodiment, the RF sensor analyzes the AC voltage and current measured from the RF amplifier and generates a DC signal for a control signal including power and voltage, current, power, and phase, which are sent to the controller for further processing. In one embodiment, the RF sensor 43 measures the output voltage and current and calculates the root mean square (RMS) of the voltage and current, the apparent power of the RF output energy, and the phase angle between the voltage and current of the RF energy supplied through the connected electrosurgical instrument. In particular, the voltage and current of the output RF energy are processed by the analog circuitry of the RF sensor to generate real and imaginary components of both the voltage and current. These signals are processed by a field-programmable gate array (FPGA) to give different measurements related to voltage and current, including the AC signal, the phase shift between voltage and current, and the RMS measurement of power. Thus, in one embodiment, the output voltage and current are measured analogously, converted to digital, processed by the FPGA to calculate the RMS voltage and current, apparent power, and the phase angle between voltage and current, and then converted back to analog for the controller.

[0051] In one embodiment, the controller 44 controls or signals the RF amplifier 42 to affect the output RF energy. For example, the controller uses information supplied by the RF sensor 43 to determine whether it is necessary to output, regulate, or terminate the RF energy. In one embodiment, the controller determines when predetermined current, power, and / or phase thresholds have been reached or exceeded in order to determine when the output of the RF energy should be terminated. In various embodiments, the controller performs a dissolution or sealing process, which is described in more detail herein, and in some embodiments, the controller receives instruction and setting or script data to perform the sealing process from data sent from an electrosurgical instrument. Thus, in various embodiments, the controller induces RF energy by starting the RF amplifier, at a predetermined voltage and / or for a predetermined period of time and / or holding and / or terminating it based on a predetermined threshold, or by regulating the voltage of the supplied RF energy.

[0052] The RF amplifier 42 generates high-power RF energy that passes through the connected electrosurgical instrument and, in an example, through the electrosurgical instrument that dissolves or seals tissue. In various embodiments, the RF amplifier supplies RF energy to or through the electrosurgical instrument, starting at a predetermined first voltage and increasing to a predetermined second voltage within a predetermined first period. In various embodiments, the RF amplifier is configured to convert a 100VDC power supply delivered to the connected electrosurgical device into a high-power sinusoidal waveform having a frequency of 350kHz. The RF sensor 43 interprets the measured AC voltage and current from the RF amplifier 42 and generates a DC control signal including voltage, current, power, and phase, which is interpreted by the controller 44.

[0053] A generator including a controller and / or RF sensor monitors and / or measures whether the supplied RF energy is as expected. In various embodiments, the system, e.g., the controller and / or RF sensor, monitors the voltage and / or current of the RF energy to ensure that the voltage and current are above predetermined thresholds. The system, e.g., the controller and / or RF sensor, also monitors, measures, and / or calculates the phase and / or power of the supplied RF energy. The system, e.g., the controller and / or RF sensor, ensures that the voltage, current, phase, and / or power of the supplied RF energy are within predetermined voltage, current, phase, and / or power windows or ranges. In one embodiment, the voltage, current, phase, and / or power windows are each limited by predetermined maximum voltage, current, phase, and / or power, and predetermined minimum voltage, current, phase, and / or power. An error is displayed if the voltage, current, phase, and / or power of the RF energy falls outside their respective windows. In one embodiment, each window slides or is adjusted by the system when RF energy is supplied to seal the tissue between the jaws of the instrument. The adjustment of each window is to ensure that the supplied RF energy is as expected. In various embodiments, the system monitors the phase and / or current, or the rate of the phase and / or current, of the supplied RF energy to determine whether the phase and / or current has reached or exceeded a predetermined phase and / or current threshold, and if a phase and / or current overload occurs, the RF energy is supplied for a predetermined period before termination.

[0054] Various embodiments allow the actuation engine of the controller 44 to be configured to receive different actuation scenarios, including but not limited to different and numerous electrosurgical tools, surgical procedures, and priorities, for the generator. The actuation engine receives and interprets data from an external source and specifically configures the operation of the generator based on the received data.

[0055] The operating engine receives configuration data from a database script file read from the memory device of the electrosurgical instrument. The script defines the state logic used by the generator. Based on the determined state and measurements made by the generator, the script can define or set the output level and shut-off criteria. In one embodiment, the script includes trigger events that include, for example, an indication of a short-circuit condition when the measured phase is greater than 60°, or an open-circuit condition when the measured current is less than 2 amp.

[0056] Exemplary RF energy control processes, scripts, or systems for electrosurgical generators and associated electrosurgical tools for dissolving or sealing tissue by various embodiments are shown in Figure 12. In various embodiments, as shown in Figure 12, for example, RF energy is supplied by the generator through a connected electrosurgical tool (71) which sets the voltage of the supplied RF energy so that the generator generates RF energy and has a voltage spike (72). The generator monitors or waits (73) for a predetermined period or spike duration while continuing to supply RF energy (72). When the spike duration 121 ends or has elapsed, the generator adjusts the voltage of the supplied RF energy to a predetermined minimum value 123, and the generator gradually increases or increases the voltage of the RF energy to a predetermined voltage level 125 (74). The generator also monitors at least the phase, voltage, current, power, and / or the rate of change (75) of the supplied RF energy. When the phase and current conditions are reached, or when the voltage is equal to, exceeds, or falls below a predetermined threshold or value (75), the voltage is kept constant 126 and / or the ramp is terminated 133 (77). In various embodiments, when the phase conditions or threshold are reached, or when the voltage falls below a predetermined phase threshold 132, and / or when the current conditions or value are reached, or when the voltage falls below a predetermined current threshold 131 (75), the generator adjusts the voltage of the supplied RF energy to be constant (77). If the phase and current conditions or thresholds are not reached or exceeded, the generator monitors a predetermined period or ramp duration, or waits for this period or duration while continuing to supply RF energy (74) and monitoring the phase and current conditions (75). When the ramp duration has ended or elapsed, the generator adjusts the voltage of the supplied RF energy to be constant (77). With the RF energy maintained at a constant level, the generator continues to supply RF energy (77) while monitoring or waiting for a predetermined period or duration of maintenance (78). When the duration of maintenance ends or elapses, the generator continues to supply RF energy while monitoring or waiting for a predetermined period or duration of maintenance (79).When the termination duration ends or elapses, processing is performed or the termination procedure is initiated and / or the RF energy supplied by the generator is stopped (81). If the termination duration has not ended or elapsed, the generator determines whether a power condition or threshold has been reached or whether it is less than a predetermined power threshold or value 142 (80). If the power condition or threshold has been reached or exceeded, processing is performed or the termination procedure is initiated and / or the RF energy supplied by the generator is stopped (81). If the power condition or threshold has not been reached or exceeded, the generator continues to supply RF energy while monitoring the power condition and the termination duration.

[0057] In various embodiments, before processing begins, impedance is measured via a low-voltage measurement signal sent to the connected electrosurgical tool to determine short-circuit or open conditions. In one embodiment, passive impedance is measured to determine whether the grasped tissue is within the operating range (2–200Ω) of the electrosurgical tool. If the initial impedance check passes, RF energy is supplied to the electrosurgical tool. Thereafter, impedance / resistance is not measured or is ignored.

[0058] In various embodiments, the RF energy voltage is applied in a ramp-like manner (74) starting from 35-45% of the global voltage setting and up to a maximum of 65-100%, or in one embodiment, at a user-selectable level. In various embodiments, the RF energy voltage is applied in a ramp-like manner over 1.5-4 seconds, for example, a predetermined second period, starting from 35-40 volts, for example, a predetermined third voltage, and up to 65-90 volts, for example, a predetermined fourth voltage. In various embodiments, the voltage is held constant for a predetermined period at a voltage lower than and / or equal to a predetermined voltage equal to and / or lower than the end of the ramp voltage. In various embodiments, this period is longer than the period for the voltage spike and / or the period for the voltage ramp. In various embodiments, the RF energy voltage is applied as a voltage spike (72) starting from 30-40% of the global voltage setting and up to a maximum of 75-100%, or at a user-selectable level. In various embodiments, the RF energy voltage is applied as a voltage spike over 50 to 300 ms, for example, a predetermined first period, starting from 35 to 40 volts, for example, a predetermined first voltage, up to 75 to 90 volts, for example, a predetermined second voltage.

[0059] In various embodiments, the phase is monitored along with the current with respect to open and short-circuit events while RF energy is applied and, in one embodiment, after the phase and / or phase change stop or termination point is reached, in order to evaluate or determine whether a pseudo-indication of dissolution (caused by an open or short circuit) has been reached.

[0060] In various embodiments, the generator is configured to make additional adjustments to various parameters or functions related to the output, voltage, current, power, and / or phase of the RF energy, and the actuating engine is configured to adjust the output of the RF energy using various parameters or functions. In one exemplary embodiment, the control circuit provides additional adjustment controls for direct phase adjustment, which are expected to adjust the voltage, current, and / or power output to satisfy a specified phase adjustment setpoint provided by the actuating engine.

[0061] In various embodiments, the generator utilizes monitors, measurements, and / or calculated values ​​of voltage, power, current, and / or phase, e.g., control indicators, to recognize, act upon, or perform operating conditions. In various embodiments, additional measurements or calculations based on measurements related to the RF output adjustment circuit are provided by a script or actuation engine to recognize and act upon additional or different events related to, or triggered by, additional measurements or calculations against other measurements or thresholds. In one embodiment, the additional measurements include error signals combined with pulse-width modulation (PWM) load cycles used to adjust the output of voltage, current, and / or power, or other similar adjustment parameters. In various embodiments, different or additional events or indicators that can be identified and triggered may be transitions from one adjustment control to another (e.g., from current adjustment to power adjustment). In various embodiments, subsequent impedance or temperature checks or measurements are not performed because they are inaccurate and / or impractical.

[0062] In various embodiments, the generator utilizes multiple states, control points, or checks to identify phase, current, or power values, and with respect to positive or negative trends, respectively. An error is signaled if the generator fails to identify the expected trend. Multi-state checks increase or enhance the generator resolution when identifying expected RF output trends across different types of structures.

[0063] In various embodiments, the generator also monitors the phase or current and / or the rate of the phase or current to determine whether the connected electrosurgical tool has received an electrically open or short-circuit condition. In one example, the generator identifies an electrically short-circuit condition of the connected electrosurgical instrument by monitoring the phase of the applied or supplied RF energy, and the electrically short-circuit condition is identified when the monitored phase is greater than a predetermined maximum phase value. Similarly, in one example, the generator identifies an electrically open condition of the connected electrosurgical instrument by monitoring the current of the applied or supplied RF energy, and the electrically open condition is identified when the monitored current is less than a predetermined minimum current. In either or both cases, the generator displays an error when it finds an open and / or short-circuit condition, and the supplied RF energy is interrupted.

[0064] In various embodiments, predetermined processes, as described throughout this application, are loaded into a memory module embedded in a connector detachably connected to a plug and / or cable-type connection leading to an electrosurgical instrument. In various embodiments, the device script or process is programmed on an adapter PCBA enclosed within the device connector or wired into the circuitry within the device connector during manufacturing / assembly. The script source file is written in a custom text-based language and then compiled by a script compiler into a script database file that is readable only by the generator. The script file contains parameters specifically selected to configure the generator to output a particular voltage (e.g., 100V (RMS)), current (e.g., 5000mA (RMS)), and power level (e.g., 300VA). In various embodiments, a device key programmer device reads the script database file and then programs it into the memory of the adapter PCBA.

[0065] Moving now to some of the operating modes of the electrosurgical tools or instruments described herein in various embodiments, the first and second jaws 31, 33 are placed around the tissue with a blood vessel or tissue bundle identified for dissolution. The handle 21 is squeezed, thereby pivoting the jaws relative to each other to substantially grasp the tissue. The actuator has a first or initial position with the jaws 22 in an open position, and the handle 23 is positioned away from or separated from the housing 28.

[0066] Pressing the dissolve button 29 by the surgeon triggers the application of radiofrequency energy to the tissue between the jaws. With the tissue dissolved, the actuator can be opened again by releasing the handle and separated from the stationary housing 28. To cut the tissue between the jaws, the user can activate the blade trigger 25. When the blade trigger is moved proximal, the cutting blade moves distally to divide the tissue between the jaws. When the surgeon releases the blade trigger, the blade spring resets the cutting blade to its original position. In various embodiments, the actuator has a cutting position where the jaws 22 are in the closed position, the movable handle is closed and latched, the blade trigger is already pressed, and the cutting blade has advanced to its distal position.

[0067] In various embodiments, an intermediate or unlocked position is provided in which the jaws are in a closed or close position, but the handle is unlocked. Thus, when the handle is unlocked, it returns to its original or initial position. In one embodiment, the blade trigger may not be activated to cut tissue between the jaws, and a melt button or switch can be activated to melt tissue between the jaws. In various embodiments, a latched position is provided in which the jaws are in a closed or close position, and the handle is latched. Thus, when the handle is unlocked, it does not return to its original or initial position. In one embodiment, a melt button or switch can be activated to melt tissue between closed jaws, and / or the blade trigger can be activated to cut tissue between the jaws.

[0068] As described above, in various embodiments, the electrosurgical instrument has a first (open) state in which the jaws are separated from each other, and therefore the handle is also separated from the stationary housing. Thus, the instrument is positioned to grasp tissue between the jaws. In the second (intermediate) state of the instrument, the jaws are close to each other to grasp tissue between the jaws, and similarly, the handle and housing are close to each other. The surgeon can return to the first state by opening the jaws and therefore positioning the jaws again to grasp tissue or other tissue. In the third (closed) state of the instrument, the handle is brought further closer to the stationary housing and latches to the stationary housing. Moving to the third state, the tissue grasped between the jaws can be cut through the activation of the blade lever. Moving to the third state in which the handle is latched to the housing reduces the possibility of accidentally releasing the tissue. Likewise, accidental cutting of tissue or accidental cutting along the wrong tissue line is avoided. Furthermore, this state allows for the application of a constant, continuous, and predetermined range of compression on the tissue between the jaws before, during, and after the activation of RF energy, thereby enhancing the sealing or dissolution of the tissue between the jaws. In various embodiments, the application of RF energy can be performed when the handle and jaws are in at least the second state and the dissolution button has been activated by the surgeon.

[0069] In various embodiments, it should be noted that, to avoid erroneous readings, the electrosurgical generator does not measure the resistance or impedance of the tissue while supplying RF energy to the tissue. Various embodiments provide an electrosurgical system that reduces heat diffusion and provides efficient power delivery to seal blood vessels or tissues in contact with bipolar electrosurgical instruments through a controlled and efficient supply of RF energy.

[0070] As described above throughout this application, the electrosurgical generator ultimately supplies RF energy to the connected electrosurgical instrument. The electrosurgical generator ensures that the supplied RF energy does not exceed specified parameters and detects fault or error conditions. In various embodiments, the electrosurgical instrument provides commands or logic circuits used to appropriately apply RF energy to the surgical procedure. For example, the electrosurgical instrument includes a memory having commands and parameters that instruct the operation of the instrument in relation to the electrosurgical generator. For example, in a simple case, the generator can supply RF energy, but the connected instrument determines how much energy is applied or for how long. However, the generator does not allow the supply of RF energy to exceed a set threshold, even if instructed by the connected instrument, thereby providing inspection or assurance against incorrect instrument commands.

[0071] As described above and in more detail below, electrosurgical instruments, tools, or devices can be used in the electrosurgical systems described herein. For example, electrosurgical grippers, scissors, forceps, probes, needles, and other instruments incorporating one, some, or all of the embodiments described herein can provide various advantages to the electrosurgical system. Various embodiments and combinations thereof of electrosurgical instruments and generators are discussed throughout this specification. One, some, or all of the features described throughout this specification are intended to be included in any embodiment of the instruments, generators, and combinations thereof described herein. For example, each of the described instruments may preferably include a memory for interaction with a generator, as described above, and vice versa. However, in other embodiments, the described instruments and / or generators may be configured to interact with a standard bipolar radio frequency power source without the need for instrument memory interaction. Furthermore, various embodiments can be described in terms of modules and / or blocks for the sake of clarity, and such modules and / or blocks can be executed by one or more hardware components, such as processors, digital signal processors (DSPs), programmable logic devices (PLDs), application-specific integrated circuits (ASICs), circuits, registers, and / or software components, such as programs, subroutines, logic circuits, and / or combinations of hardware and software components. Similarly, such software components can be interchanged with hardware components or combinations thereof, and vice versa.

[0072] Further examples of electrosurgical units, instruments, and the connections between them, and their operation and / or functionality are described in U.S. Patent Application No. 12 / 416,668, “Electrosurgical System,” filed April 1, 2009; U.S. Patent Application No. 12 / 416,751, “Electrosurgical System,” filed April 1, 2009; U.S. Patent Application No. 12 / 416,695, “Electrosurgical System,” filed April 1, 2009; U.S. Patent Application No. 12 / 416,765, “Electrosurgical System,” filed April 1, 2009; and U.S. Patent Application No. 12 / 416,128, “Electrosurgical System,” filed March 31, 2009, the entirety of these disclosures is incorporated by reference as if it were incorporated in whole herein. Certain aspects of these electrosurgical generators, tools, and systems are discussed herein, and further details and examples relating to various embodiments are described in U.S. Provisional Patent Application No. 61 / 994,215, “Electrosurgical Dissolution Device,” filed May 16, 2014, U.S. Provisional Patent Application No. 61 / 944,185, “Electrosurgical Generator with Synchronization Detector,” filed May 16, 2014, U.S. Provisional Patent Application No. 61 / 994,415, “Electrosurgical System,” and U.S. Provisional Patent Application No. 61 / 994,192, filed May 16, 2014, and the entirety of these disclosures is incorporated by reference as if it were incorporated in whole herein.

[0073] The above description is provided to enable any person skilled in the art to construct and use an electrosurgical device or system and to perform the methods described herein, and enumerates the best modes considered by the inventors practicing the present invention. However, various modifications will still be obvious to those skilled in the art. These modifications are considered to be within the scope of the disclosure of the present invention. In addition, different embodiments or aspects of such embodiments are considered to be illustrated and described in various figures throughout this specification. However, it should be noted that each embodiment and its aspects, although illustrated or described separately, can be combined with one or more of the other embodiments and their aspects unless explicitly stated otherwise. Each combination is not explicitly described simply for the sake of readability of this specification. Likewise, the embodiments of the present invention should be considered illustrative and not restrictive in all respects.

Claims

1. It is an electrosurgical generator, The system comprises an RF amplifier configured to supply RF energy to an electrosurgical instrument connected to the electrosurgical generator, and a controller, The aforementioned controller, A step of using a voltage spike through RF energy to heat a portion of the tissue in contact with the electrosurgical instrument for a predetermined period of time so that the voltage level of the RF energy can dry it out. The steps include adjusting the voltage level of the RF energy to maintain the temperature for drying, The steps include monitoring the phase and current of the RF energy supplied to the electrosurgical instrument, A controller configured to perform a sealing cycle by the step of terminating the supply of RF energy from the RF amplifier when the phase and current of the RF energy supplied to the electrosurgical instrument meet one or two or more predetermined thresholds or conditions. An electrosurgical generator characterized by the following features.

2. The aforementioned temperature is 100 degrees Celsius. The electrosurgical generator according to claim 1.

3. The step of adjusting the voltage level includes the steps of lowering the voltage level to a predetermined minimum value and raising the voltage level from the predetermined minimum value at a predetermined rate slower than the rate of the voltage spike. The electrosurgical generator according to claim 1.

4. The step of adjusting the voltage level further comprises the step of setting the voltage level to a predetermined voltage maintenance level, wherein the predetermined voltage maintenance level is between a predetermined minimum value and a predetermined maximum voltage level used between the voltage spikes. The electrosurgical generator according to claim 3.

5. One of one or more predetermined thresholds for terminating the supply of the RF energy is when the current of the monitored RF energy is detected to be a predetermined current value when the phase of the monitored RF energy is determined to be capacitive. The electrosurgical generator according to any one of claims 1 to 4.

6. The monitored current is less than 60% of the applicable current or less than 3000 mA. The electrosurgical generator according to claim 5.

7. One of the one or more predetermined thresholds or conditions is based on elapsed time. The electrosurgical generator according to claim 6.

8. One of one or more predetermined thresholds for terminating the supply of RF energy includes the steps of detecting that the sealing cycle is complete based on a measurement of the power of the RF energy, and detecting that the measured power has decreased to less than 4% or less than 15 volt-amperes of the maximum amount of power used during the sealing cycle. The electrosurgical generator according to claim 6.

9. The aforementioned controller further, The system detects that the monitored current exceeds 95% of the maximum allowable current or 4750mA. Initiate a predetermined delay period such that the monitored current decreases. By determining whether the monitored current has dropped to 90% of the maximum allowable current or to less than 4500mA, During the sealing cycle, the system is configured to detect unintended current draws and eliminate them. The electrosurgical generator according to claim 6.

10. The controller is configured to determine that a portion of the tissue in contact with the electrosurgical instrument is beginning to dry out when the monitored current drops below 90% of the maximum allowable current or below 4500 mA. The electrosurgical generator according to claim 9.

11. The controller is configured to detect an error after the delay in which the monitored current has not fallen to less than 90%. The controller is configured to instruct the RF amplifier to stop supplying RF energy to the electrosurgical instrument. The electrosurgical generator according to claim 9.

12. The aforementioned controller further, When the phase of the monitored RF energy becomes greater than 60 degrees, The RF amplifier is configured to detect and resolve a short circuit by instructing it to terminate the supply of RF energy to the electrosurgical instrument. The electrosurgical generator according to any one of claims 1 to 4.

13. The aforementioned controller further, When the monitored current falls below 2 amps, By instructing the RF amplifier to terminate the supply of RF energy to the electrosurgical instrument, It is configured to detect and resolve open conditions. The electrosurgical generator according to any one of claims 1 to 4.

14. The aforementioned voltage spike has an initial voltage ramp starting at 30-40% of the global voltage setting and progressing to 75-100%. The electrosurgical generator according to any one of claims 1 to 4.

15. The increase in voltage level from the predetermined minimum value at a predetermined rate lower than the rate of the voltage spike starts at 35-45% of the global voltage setting and increases to 65-100%. The electrosurgical generator according to claim 3.

16. The increase in voltage level from the predetermined minimum value begins at 35 to 45 volts. The increase in the voltage level at the predetermined rate, which is lower than the rate of the voltage spike, increases to 65 to 90 volts. The electrosurgical generator according to claim 3 or 15.

17. The time it takes for the voltage level to increase from the predetermined minimum value at a predetermined rate lower than the rate of the voltage spike is 1.5 to 4 seconds. The electrosurgical generator according to claim 3 or 15.

18. The step of adjusting the voltage level further comprises the step of setting the voltage level to a predetermined voltage maintenance level, wherein the predetermined voltage maintenance level is higher than a predetermined maximum voltage level used during the voltage spike. The electrosurgical generator according to any one of claims 1 to 3.

19. The controller is configured to measure the impedance of the tissue portion that the electrosurgical instrument will contact before using the voltage spike through the RF energy, and if the measured impedance is within a predetermined operating range of the electrosurgical instrument or 2-200 ohms, the RF energy is supplied to the electrosurgical instrument. The electrosurgical generator according to any one of claims 1 to 4.

20. The duration of the voltage level set to the predetermined voltage maintenance level is longer than the duration of the voltage spike and shorter than the duration of the seal cycle corresponding to the voltage level decreasing to a predetermined minimum value, and the voltage level is increased from the predetermined minimum value at a predetermined rate. The electrosurgical generator according to claim 18.

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