PRESSURE RELIEF VENT FOR SURGICAL SEALING DEVICES

Abstract

A blood vessel puncturing means within the internal cavity of the sealing jaws of an electrosurgical instrument. A forceps type electrosurgical device provided with jaws having electrically conductive sealing plates on the inner surfaces that is used to seal a blood vessel during will usually have an inner cavity of the jaws between the jaws within which a blood vessel is received and may expand during electrosurgical sealing. To prevent a blood vessel expanding during electrosurgical sealing to a dangerous size, the inner cavity is provided with a means to puncture the blood vessel in a controlled fashion, and thereby relieve the pressure within the blood vessel. The puncturing means may comprise one or more relief vents. The relief vents may provide channels to allow pressure to be vented to the external of the jaws, thus relieving the internal pressure on the jaws during coagulation.

Claims

1. A jaw-type end effector for an electrosurgical instrument, comprising: upper and lower jaw members provided with tissue sealing electrodes thereon, arranged in use to receive a blood vessel to be sealed, to clamp the blood vessel between the upper and lower jaw members, and to apply an RF coagulating signal thereto via the tissue sealing electrodes to seal the blood vessel, the end effector further comprising blood vessel pressure relief means positioned within the jaw members such that when the jaw members are closed about a blood vessel to be sealed the blood vessel pressure relief means relieve expansionary pressure in the blood vessel should the blood vessel expand when being sealed to a critical size that affects the efficacy of the end effector in forming a seal.

2. A jaw-type end effector according to claim 1, wherein the blood vessel pressure relief means are positioned within an interior cavity of the jaw members such that they relieve the pressure in the blood vessel if the blood vessel expands to or above a predetermined size.

3. A jaw-type end effector according to claim 1, wherein the blood vessel pressure relief means are positioned within an interior cavity of the jaw members such that they relieve the pressure in the blood vessel prior to the blood vessel expanding to a size such that any of the following would occur: a) the end effector would not otherwise remain clamped on the blood vessel; b) the blood vessel would uncontrollably burst; or c) a defective blood vessel seal would be formed.

4. A jaw-type end effector according to claim 1, wherein multiple blood vessel pressure relief means are provided at different positions within an interior cavity of the jaw members.

5. A jaw-type end effector according to claim 1, wherein respective blood vessel pressure relief means are provided on both the upper and lower jaw members.

6. A jaw-type end effector according to claim 1, wherein the pressure relief means are hollow and provide a channel from the interior of the jaw member or members to the exterior thereof.

7. A jaw type end-effector according to claim 6, wherein the channel is sufficiently large to permit the egress of tissue debris from the coagulation operation from within the interior cavity of the jaw members.

8. A jaw-type end effector according to claim 1, wherein the pressure relief means are solid, and the jaw members are arranged to provide a sufficiently large interior volume when closed to contain tissue debris from the coagulation operation.

9. A jaw-type end effector according to claim 1, wherein the pressure relief means are arranged to be deployable from within the walls of the jaw members.

10. A jaw-type end effector according to claim 9, wherein the pressure relief means are retractable back into the walls of the jaw members, wherein the pressure relief means are deployed when a sealing procedure is being undertaken and are then retracted once a sealing procedure is completed.

11. A jaw type end effector according to claim 1, wherein the pressure relief means are fixed in place within the interior of the jaw members.

12. A jaw type end effector according to claim 1, wherein the pressure relief means comprises a blood vessel puncturing means arranged to puncture the blood vessel if the blood vessel expands to or above a predetermined size.

13. A jaw type end effector according to claim 12, wherein the blood vessel puncturing means comprise one or more needle type structures.

14. A jaw-type end effector according to claim 12, wherein the puncturing means has a tissue puncturing point, operatively deployed in a position just above the plane of the sealing electrodes.

15. A jaw type end effector according to claim 1, and further comprising a pressure relieving channel venting from the interior of the jaws to the exterior, the channel having a mesh or guard over the exterior exit thereof.

16. A jaw-type end effector according to claim 14, wherein the pressure relieving channel is part of the blood vessel pressure relief means.

17. An electrosurgical instrument comprising: a jaw-type end effector, comprising upper and lower jaw members provided with tissue sealing electrodes thereon, arranged in use to receive a blood vessel to be sealed, to clamp the blood vessel between the upper and lower jaw members, and to apply an RF coagulating signal thereto via the tissue sealing electrodes to seal the blood vessel; the jaw-type end effector further comprising blood vessel pressure relief means positioned within the jaw members such that when the jaw members are closed about a blood vessel to be sealed the blood vessel pressure relief means relieve expansionary pressure in the blood vessel should the blood vessel expand when being sealed to a critical size that affects the efficacy of the end effector in forming a seal; and a handpiece mounting the jaw-type end effector and including one or more activation switches, buttons or handles to allow a user to operate the instrument to open and close the jaw members and to provide an RF electrosurgical signal to the tissue sealing electrodes.

18. An electrosurgical system, comprising an electrosurgical instrument according to claim 17, and an electrosurgical generator to generate the RF coagulating signal and supply it to the electrosurgical instrument.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Embodiments of the invention will now be further described by way of example only and with reference to the accompanying drawings, wherein like reference numerals refer to like parts, and wherein:

[0029] FIG. 1 is a drawing of a prior art electrosurgical sealing forceps arrangement;

[0030] FIGS. 2a to 2d are a series of drawings illustrating how a blood vessel can burst during electrosurgical sealing in a jaw based type sealing device;

[0031] FIG. 3 is a drawing of a first embodiment of the present invention;

[0032] FIG. 4 is a drawing of a further embodiment of the present invention;

[0033] FIG. 5 is a drawing of a yet further embodiment of the present invention;

[0034] FIG. 6 is a drawing of a part of the embodiment of FIG. 5;

[0035] FIG. 7 is drawing of a modification that can be applied to the embodiments of the invention; and

[0036] FIG. 8 is a drawing of an electrosurgical system having a forceps type electrosurgical device to which the concepts of the present invention may be applied.

DETAILED DESCRIPTION OF THE EMBODIMENTS

[0037] Embodiments of the present invention provide an end effector for an electrosurgical instrument in the form of a jaw-based clamping, sealing and cutting device, for example arranged as a pair of forceps. Typically embodiments of the present invention provide upper and lower jaws in opposed relation to each other, the opposing inner surfaces of the jaws being provided with electrically conductive sealing plates, which are electrically connected in use to an electrosurgical generator. In use a blood vessel to be sealed is seized and held within the jaws, and an electrosurgical coagulation signal applied to the conductive sealing plates to seal the blood vessel.

[0038] In some jaw arrangements there is an internal cavity between two sets of opposing sealing plates on the upper and lower jaws respectively. As the blood vessel is sealed between the two sets of sealing plates the part of the blood vessel within the inner cavity of the jaws can expand, in some ways in a balloon-like fashion, due to the increasing temperature and pressure caused by the RF coagulation signal heating the tissue. If the blood vessel expands excessively to the point where it uncontrollably bursts then tissue fragments can foul the electrosurgical instrument, and in addition a defective blood vessel seal can be formed, which may post-operatively bleed, with attendant deleterious consequences for the patient. In order to prevent this from occurring, a blood vessel pressure relief means is provided within the jaw cavity, positioned to relieve the pressure in the blood vessel held between the jaws should it expand to a size where it might burst. The blood vessel pressure relief means may take the form of blood vessel puncturing means, such as, for example, fixed relief vents placed on the inside of the blade track positioned just above the electrodes. Relief vents are placed above electrodes to ensure the device jaws remains atraumatic during manipulation.

[0039] During coagulation the heat/pressure build-up in the vessel will push the expanding walls of the vessel onto the relief vents. The multiple relief vents will puncture the vessel in a controlled manner, thus reducing the pressure build-up and avoiding the vessel bursting inside of the blade track. This would eliminate the build-up of coagulated vessel fragments in the blade track which, can hinder deployment/retraction of mechanical cut blade.

[0040] In addition, and as a one of the main benefits, by relieving the pressure build-up, the blood vessel pressure relief means will avoid situations whereby the pressure overcomes the jaw force and expels pressure/steam back through the portions of the vessel that are being sealed between the electrodes which, could be detrimental to seal quality without it being recognised by the generator/user. Thus, the positioning of the blood vessel puncturing means with respect to the sealing plates is such that the puncturing means operates to puncture a blood vessel as it grows in size within the clamped jaws before it reaches a size that would cause the jaw clamping force to be momentarily overcome, releasing pressure back through a newly formed seal. As noted above positioning the blood pressure puncturing means just above the sealing plates reliably achieves this, although other positions may be possible depending on the precise design of the jaws.

[0041] The fixed relief vents can be designed like hypodermic needles (i.e. are hollow), allowing the pressure to be relieved externally through the cross-section of the jaw assembly. Moreover, the relief vents can also be made to be deployable on activation of the hand/foot switch for the electrosurgical generator. Moreover, when pressure has been expelled to the outside of the jaw, evidence of the pressure relief can be seen from the outside. A surgeon is then able to see this and understand that a possible ‘Popping’ event may have taken place within the jaws which can lead them to make another seal downstream to be extra sure that the vessel has been securely sealed.

[0042] Alternatively, in some devices which have larger jaws, there should be enough internal capacity within internal cavity of the jaws that contains the blade track for the pressure to be relieved internally within the device jaws. In this case, the blood vessel puncturing means do not need to vent the blood vessel to the exterior of the jaws, and can instead for example be blind needles (i.e. solid, not hollow), or any other sharp shape that simply impinge against and puncture any growing blood vessel, with the contents of the blood vessel then being contained within the interior of the closed jaws.

[0043] The effect of embodiments in relieving the pressure build-up in a blood vessel that is being sealed is to enable the clamp force to remain consistent and allow the electrodes to coagulate the tissue in between without being affected by the pressure build-up.

[0044] In another embodiment one option is to have deployable relief vent(s) that are only deployed when the coagulation hand-switch/foot-switch is activated. These vents then project from the body of jaws into the interior cavity therein when the electrosurgical generator is activated, but otherwise are contained within the jaw body. Once activation has ceased, then the relief vent would return to a fully shrouded safe position. This would guarantee that the device would remain atraumatic when being used for tissue manipulation

[0045] If it is possible to relieve the pressure externally, then the jaws can be provided with a vent from the interior of the jaws to the exterior to help dissipate the expulsion of pressure without causing any harm to patient or user. Such a vent may be covered with grid bars or a mesh design which can help to prevent material re-entering into the interior of the jaws, and to prevent foreign objects from blocking the vent.

[0046] Further features and benefits of embodiments of the disclosure will become apparent from the following description of embodiments thereof with respect to the Figures.

[0047] Turning first to FIG. 3, a jaw- based clamping and sealing device according to a first embodiment comprises an upper jaw member 20 and a lower jaw member 22. The upper jaw member 20 has formed on lower sealing surfaces thereof respective electrodes 26a and 26b. Correspondingly, the lower jaw member 22 has formed on upper sealing surfaces thereof respective electrodes 26c and 26d. The lower sealing surface of upper jaw 20 and the upper sealing surface of lower jaw 22 are in opposed relation thereto, such that the respective sealing surfaces formed thereon are also in opposing relation. Thus, when the members 20 and 22 are closed and the respective sealing surfaces brought together, blood vessel 24 placed within the jaws will be seized and clamped within the jaws, and an electrosurgical coagulating signal can then be applied to electrodes 26 in order to seal the blood vessel.

[0048] As shown in FIG. 3, when a blood vessel is being sealed the heat and resulting temperature of the blood vessel can rise, thus increasing the pressure within the vessel, and causing it to balloon upwards and downwards within the interior cavity of the jaws device. In order to prevent the ballooning blood vessel from either bursting uncontrollably or forcing the jaw members apart, blood vessel puncturing means 30a-30d are provided on the surface of the interior cavity of the jaws, located just above each of the sealing electrodes 26a to 26d. That is, in this embodiment a respective puncturing means is provided for each sealing electrode. However, in other embodiments, fewer or more puncturing means may be provided. For example, in another embodiment, only one or two puncturing means may be provided to puncture the blood vessel.

[0049] In this embodiment, the puncturing means take the form of a hypodermic needle, with a channel running therethrough from the interior of the jaws to the exterior surface thereof. This allows blood and other tissue from within the punctured blood vessel to be evacuated from within the interior of the jaws to the exterior. However, in other embodiments these channels may not be necessary, and in particular if the interior cavity of the jaws is sufficient to accept the material from within the punctured blood vessel. That is, if the interior cavity of the jaws is large enough to accept the material from within the punctured blood vessel without forcing the jaws open, then it may not be necessary to provide the channels running from the interior cavity of the jaws to the exterior.

[0050] In embodiments of the invention the puncturing means 30a to 30d may take the form of hypodermic needles with hollow channels therein, or, where it is not necessary to provide such channels, as described above, solid blind needles or other sharp devices. The puncturing means should be provided positioned within the interior cavity of the jaws just above the electrodes such that the blood vessel cannot expand to a sufficient extent to force the jaws open without impinging upon one of the puncturing means, and being punctured. The precise positioning of the puncturing means within the jaws within this constraint will depend on the size and shape of the interior cavity.

[0051] FIG. 4 shows an alternative arrangement for the puncturing means. Here the puncturing means comprises a sharp, triangular flag shaped member, which is rotatably mounted with a hinge (not shown) within a slot formed in the wall of the jaw members 20 and 22. When the device is unclamped the flag shaped member is retained within the slot, as shown in position 40, meaning the jaws are atraumatic. However, when required to be used to puncture a blood vessel, and the jaws are in a clamped state ready for sealing, the sharp flag shaped member is rotated so as to be deployed outwards from its slot passing through position 42, and coming to rest in position 44, as shown in FIG. 4. In a further embodiment, the sharp flag-shaped member is deployed when both the jaws are clamped shut, and the coagulation signal is being applied to the sealing electrodes. Howsoever the sharp flag-shaped member is deployed, once in the deployed position the sharp point of the triangular flag shape member is pointing downwards (in the case of the upper jaw member), such that if the blood vessel increases in size it will impinge upon the sharp point, and be punctured. It will be understood that the corresponding arrangement can be provided in the lower jaw member, where the triangular flag shaped member rotates upwards.

[0052] FIGS. 5 and 6 show a yet further alternative embodiment. Here, instead of multiple fixed puncturing means being provided, a single, retractable, puncturing means in the form of a hypodermic needle 50 is provided within the wall of the upper jaw member 20. More particularly, a hypodermic needle 50 having a channel formed therethrough is mounted within the wall of the upper jaw member 20 diagonally pointing downwards through the wall, towards the sealing plane of the jaw member where the blood vessel would normally be when clamped. When in use, the hypodermic needle 50 is deployed from within the wall of the upper jaw member 20 to a position just above the sealing electrodes 26a and b, such that if the blood vessel expands to an unwanted extent, it will impinge the point of the needle 50, and be punctured. When not required i.e. when sealing is not taking place, the hypodermic needle 50 may be retracted back into its own channel within the wall of the upper jaw member 20.

[0053] In variations of the above multiple needles 50 may be provided extending from the upper and lower jaw members, to provide multiple puncturing means in the same manner as for example in the embodiment of FIG. 3.

[0054] FIG. 7 shows a modification that may be applied to any of the above-described embodiments where the puncturing means are provided with vents through the walls of the jaw members. In particular, a grid mesh or bar members 72 may be provided over the outer opening 70 of any such vents to prevent the ingress of foreign material into the vents from the outside of the jaw members, and thus causing them to be blocked.

[0055] FIG. 8 shows an electrosurgical system that makes use of the embodiments of the invention described herein. More particularly, electrosurgical instrument 1 having an end effector having a blood vessel puncturing means as described in the previous embodiment is connected to an electrosurgical generator 4500 having a controllable radiofrequency (RF) source therein (not shown) that in use produces RF coagulation energy that coagulates or seals tissue when applied thereto via the electrodes of the end-effector of the instrument 1. Electrosurgical generator 4500 includes control input switches 4504 and 4502, to respectively allow the generator to be turned on and off, and to allow the power of the RF coagulation energy fed to the instrument 1 to be controlled. In these respects, the electrosurgical generator 4500 is conventional.

[0056] The instrument 1 is connected in use to generator 4500 by control and power line 4506, which contains separate electrical lines to allow RF energy to be fed to the end-effector of the instrument 1 via internal wiring, and also to allow a control signal to be received from the switch of the instrument 1, to command the electrosurgical generator to output RF coagulation energy to the instrument 1. In use the surgeon activates the generator via on-off switch 4504, and selects the coagulation or sealing energy strength to be generated by the internal RF source using buttons 4502. During a surgical procedure with the instrument when sealing or coagulation RF energy is required at the end-effector, the surgeon controls the generator to produce such a signal by pressing an activation switch on the instrument or generator, or using a footswitch (not shown), the generated RF signal then being passed via the electrical lines 4506 to the end-effector. That is, activation of the generator in use causes RF coagulation or sealing energy to be supplied to the sealing plates 26a-d (see FIG. 3) contained within the end-effector.

[0057] If during sealing the blood vessels expand sufficiently to impinge upon the puncturing means, then the puncturing means will act to puncture the blood vessels in a controlled manner. As such, pressure is then relieved within the blood vessels and the coagulation and vessel sealing procedure can proceed as intended, with the result that a more reliable blood vessel seal is obtained.

[0058] Various further modifications to the above described embodiments, whether by way of addition, deletion or substitution, will be apparent to the skilled person to provide additional embodiments, any and all of which are intended to be encompassed by the appended claims.