Surgery – Instruments – Electrical application
Reexamination Certificate
1999-01-13
2001-05-01
Leubecker, John P. (Department: 3739)
Surgery
Instruments
Electrical application
C606S033000, C606S213000, C606S049000, C607S101000
Reexamination Certificate
active
06224593
ABSTRACT:
1. TECHNICAL FIELD
The present disclosure relates generally to apparatus and methods for thermally treating tissue and more particularly, to an apparatus for applying microwave frequency energy to seal a body vessel or tissue.
2. BACKGROUND OF THE DISCLOSURE
In many surgical procedures, body vessels, e.g., blood vessels, ducts, adhesions, fallopian tubes, etc. . . . are sealed to defunctionalize or close the vessel. Traditionally, staples, clips or sutures have been used to close a body vessel. However, these traditional procedures often leave foreign body material inside a patient. In an effort to reduce foreign body material left within the patient and to more effectively seal the body vessel, energy techniques that seal by heat processes have been employed. The present disclosure include apparatus and methods that combine applying a force to greatly compress the target tissue as well as applying energy such that collagen will melt and reform in a permanently compressed state.
Current vessel sealing procedures utilize heat treatment in the form of radio frequency (RF) energy in the frequency range of 200 to 1000 kHz to heat and desiccate tissue causing closure and sealing of the body vessel. For example, U.S. Pat. No. 5,258,006 discloses electrosurgical bipolar RF forceps which cauterize blood vessels during a percutaneous laparoscopic cholecystectomy procedure.
Accordingly, there is a need for an apparatus which provides a uniform, controllable seal and that is capable of providing such a seal with minimum collateral damage to body tissue.
SUMMARY
Accordingly, the present disclosure is directed to apparatus for thermal treatment of tissue. The apparatus has particular application in sealing of body tissue, including vessels such as blood vessels, fallopian tubes, bundled tissue incl. vein, artery and/or nerves, ducts, adhesions, etc. The apparatus advantageously compresses the tissue and provides a non-stick application of microwave frequency electrosurgical energy thereby avoiding sticking of tissue to the apparatus and providing a more controllable seal. The apparatus can also seal body tissue without undesired collateral damage. It is contemplated that at least a portion of the apparatus may be constructed from flexible material. It is further contemplated that at least a portion of the apparatus may be constructed from a deformable material.
The apparatus includes an elongated member having proximal and distal ends and having a tissue capturing portion for capturing tissue. The apparatus further includes a microwave conductor operatively mounted with the elongated member and having a forward conductor end. The microwave conductor is adapted for reciprocal axial movement relative to the elongated member between an unadvanced position where the forward conductor end is displaced from the tissue capturing portion and an advanced position where the forward conductor end is adjacent to the tissue capturing portion to direct microwave energy toward the body tissue portion supported therein. A source of microwave energy in electrical communication with the microwave conductor supplies microwave energy having a frequency ranging from about 400 MHz to about 2500 MHz.
In a preferred embodiment, the microwave conductor includes an active or inner conductor and a return or outer conductor mounted in coaxial arrangement. The forward conductor end of the microwave conductor is uninsulated to expose the active conductor and the return conductor to permit direct contact with the body tissue portion. Preferably, the tissue capturing portion defines a tissue capturing surface whereby the tissue capturing surface comprises a dielectric material. It is also envisioned that an insulator can be mounted to the forward conductor end to prevent direct contact between the body tissue and the forward conductor end to limit collateral tissue damage and inhibit eschar buildup and sticking to the apparatus.
In one preferred embodiment, the active conductor of the microwave conductor is dimensioned to extend distally beyond the return conductor. Desirably, an insulating material is disposed about a portion of the active conductor extending distally beyond the return conductor.
In another preferred embodiment, the microwave conductor includes at least one ground plane in electrical contact with the outer conductor. Preferably, an insulating material is disposed on a tissue contacting surface of the one ground plane.
In yet another preferred embodiment, the return conductor of the microwave conductor is dimensioned to extend distally beyond the active conductor.
In a most preferred embodiment, the apparatus includes a handle connected to the elongated member. The handle includes a manual actuator operatively connected to the microwave conductor. The actuator is movable to cause corresponding movement of the microwave conductor between the unadvanced and the advanced positions.
A method is disclosed for sealing body tissue and including the steps of: positioning a surgical instrument adjacent body tissue; and supplying microwave energy having a frequency ranging from about 400 MHz to about 2500 MHz to the surgical instrument to cause desiccation of the body tissue portion to thereby substantially seal a portion of the body tissue.
In a preferred embodiment, the surgical instrument includes a microwave conductor, and the step of positioning includes placing the microwave conductor in direct contact with the body tissue. Preferably, the surgical instrument includes an elongated member having a tissue capturing portion at a distal end, and the step of positioning includes arranging the surgical instrument such that the body vessel portion is disposed between the microwave conductor and the tissue capturing portion. Most preferably, the step of positioning includes clamping the body vessel portion between the microwave conductor and the tissue capturing portion. Desirably, the microwave conductor includes an active conductor and a return conductor mounted in coaxial arrangement, the forward conductor end of the microwave conductor being uninsulated to expose the active conductor and the return conductor, and wherein the step of positioning includes directly contacting the vessel portion with the forward conductor end.
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Ryan Thomas Patrick
Trembly B. Stuart
Farah Ahmed
Leubecker John P.
Sherwood Services AG
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