Electrosurgical Tissue Fragmentation with Conductive Containment
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Solution Overview
Problem
Minimally-invasive surgical procedures face challenges in removing large tissue specimens due to restricted access and the risk of cancer cell seeding, requiring breakdown of specimens within an enclosed environment while maintaining isolation.
Innovation Solution
The use of electrosurgical systems with specific electrode configurations, including a return tissue guard and specimen bag, which are electrically-insulative and conductive, and a return electrode tenaculum with conductive and insulative jaw assemblies, to facilitate energy-based tissue breakdown and removal while ensuring electrical safety and containment.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If large tissue specimens are removed through minimally-invasive openings, then the benefits of minimally-invasive surgery are achieved, but the specimens cannot be removed intact due to size constraints
Solution Approach 1:
The tissue specimen is segmented into smaller pieces through fragmentation within the body cavity using electrosurgical energy. The generator delivers energy through the active electrode to break down the tissue into manageable fragments that can pass through the restricted minimally-invasive opening while maintaining the integrity of the containment system.
2Length of moving object
If tissue specimens are broken down into smaller pieces for removal, then size constraints are satisfied, but the risk of cancer cell seeding increases
Solution Approach 1:
A conductive containment structure (specimen bag or basket) serves as an intermediary between the tissue specimen and the body cavity. This mediator allows electrosurgical energy to pass through to fragment the tissue while simultaneously containing all tissue fragments and fluids, preventing cancer cell seeding in the body cavity during the breakdown and removal process.
Solution Approach 2:
The tissue specimen is extracted and contained within a separate containment system (specimen bag or basket) that is removed from the body cavity. All fragmentation and processing occurs within this isolated containment environment, and the entire contained system is then removed together, ensuring no contaminated material remains in the body cavity.
3Productivity
If electrosurgical energy is used for tissue breakdown, then efficient tissue removal is achieved, but electrical safety concerns arise with conductive containment structures
Solution Approach 1:
The containment structure has differentiated electrical properties in different regions: conductive portions where tissue contact is needed for energy delivery, and insulative portions for structural integrity and electrical isolation. The system selectively applies conductivity where needed for tissue fragmentation while maintaining insulation elsewhere to ensure patient safety and prevent unintended current paths.
Solution Approach 2:
The electrosurgical generator incorporates return electrode monitoring that continuously measures impedance to detect the presence and configuration of the conductive containment structure. The system provides real-time feedback to adjust energy delivery parameters, ensuring safe operation with the modified return electrode configuration while maintaining effective tissue fragmentation.
Data Source
AI summary
A tissue removal system includes an electrosurgical generator including an active electrode port and a return electrode port, an active electrode device configured to connect to the active electrode port, and a return tissue guard configured to connect to the return electrode port. Another tissue removal system includes an electrosurgical generator including an active electrode port and a return electrode port, an active electrode device configured to connect to the active electrode port, and a return specimen bag configured to connect to the return electrode port.