Medical device with a bilateral jaw configuration for nerve stimulation
Aspects of the present disclosure are presented for a single surgical instrument configured to grasp, seal, and/or cut tissue through application of therapeutic energy, and also detect nerves through application of non-therapeutic electrical energy. A medical device may include two jaws at an end effector, used to apply therapeutic energy and to perform surgical procedures. The therapeutic energy may be in the form of ultrasonic vibrations or higher voltage electrosurgical energy. One of the jaws may be configured to cut tissue through application of the blade. In addition, one or both of the two jaws may be configured to apply nontherapeutic energy for nerve stimulation probing. The application of therapeutic energy may be disabled while the nontherapeutic nerve stimulation energy is applied, and vice versa. The nontherapeutic nerve stimulation energy may be applied to the use of one or more probes positioned near one or both of the jaws.
1 . A method of operating a surgical instrument, the method comprising:
moving (i) a first jaw coupled to a distal end of a first jaw arm and (ii) a second jaw coupled to a distal end of a second jaw arm of the surgical instrument from an open configuration to a closed configuration to capture tissue positioned between the first jaw and the second jaw, wherein a proximal end of the first jaw arm is coupled to a first jaw handle and a proximal end of the second jaw arm is coupled to a second jaw handle, and wherein moving the first and second jaws comprises rotating each of the first and second jaws about a pivot joint located between the respective distal and proximal ends;
energizing an electrode of the surgical instrument to deliver a first energy to tissue positioned between the first jaw and the second jaw;
moving a probe of the surgical instrument from a retracted configuration in which the probe is retracted into a housing of the first jaw arm or a housing of the second jaw arm to an extended configuration; and
energizing the probe to deliver a second energy to the tissue.
2 . The method of claim 1 , wherein the second energy comprises nontherapeutic energy for providing electrical stimulation to the tissue.
3 . The method of claim 1 , wherein moving the probe of the surgical instrument from the retracted configuration to the extended configuration comprises:
moving a first probe of the surgical instrument from a retracted configuration in which the first probe is retracted into the housing of the first jaw arm or the housing of the second jaw arm to an extended configuration, and
moving a second probe of the surgical instrument from a retracted configuration in which the second probe is retracted into the housing of the first jaw arm or the housing of the second jaw arm to an extended configuration.
4 . The method of claim 3 , wherein moving the first probe and moving the second probe comprises moving the first probe and the second probe to define a gap between a distal end of the first probe and a distal end of the second probe.
5 . The method of claim 3 , wherein moving the first probe and moving the second probe comprises moving the first probe and the second probe to define a gap between a distal end of the first probe that is contoured toward the gap and a distal end of the second probe that is contoured toward the gap.
6 . The method of claim 1 , wherein moving the probe of the surgical instrument comprises moving a probe of the surgical instrument that is positioned adjacent the first jaw and the second jaw.
7 . The method of claim 1 , wherein moving the probe of the surgical instrument comprises operating a retraction mechanism of the surgical instrument to move the probe between the extended configuration and the retracted configuration.
8 . The method of claim 7 , wherein operating the retraction mechanism comprises operating a wheel retraction mechanism.
9 . The method of claim 7 , wherein operating the retraction mechanism comprises operating a slide retraction mechanism.
10 . The method of claim 1 , wherein moving the probe of the surgical instrument comprises moving a probe formed from a shape memory material.
11 . The method of claim 1 , wherein energizing the probe comprises operating a switch to control an amount of the second energy delivered to the probe from an energy source.
12 . The method of claim 1 , wherein energizing the electrode of the surgical instrument to deliver the first energy to tissue positioned between the first jaw and the second jaw comprises energizing the electrode of the surgical instrument to deliver therapeutic energy to the tissue configured for sealing or cutting of the tissue.
13 . A nerve stimulation system of a surgical instrument, the nerve stimulation system comprising: a radio frequency (RF) generator circuit including an RF source, a first electrode, a second electrode, and a first amplifier electrically coupled to the RF source and each of the first and second electrodes; and a nerve stimulation circuit including a bi-phasic source, a second amplifier, and a third amplifier, wherein each of the second and third amplifiers is electrically coupled to the bi-phasic source, further wherein the second amplifier and the third amplifier are out of phase relative to each other.
14 . The nerve stimulation system of claim 13 , wherein the second amplifier is electrically coupled to the first electrode of the RF generator circuit and wherein the third amplifier is electrically coupled to the second electrode of the RF generator circuit.
15 . The nerve stimulation system of claim 13 , wherein the RF generator circuit further includes an electrically conductive element, and wherein each of the second and third amplifier is electrically coupled to the electrically conductive element.
16 . The nerve stimulation system of claim 15 , wherein the electrically conductive element comprises a electrically conductive pad.
17 . The nerve stimulation system of claim 15 , wherein the electrically conductive element comprises a electrically conductive needle.
18 . The nerve stimulation system of claim 13 , wherein the RF generator circuit further comprises an isolation transformer electrically coupled to the first amplifier, a first blocking capacitor electrically coupled to the isolation transformer and the first electrode, and a second blocking capacitor electrically coupled to the isolation transformer and to the second electrode.
19 . The nerve stimulation system of claim 13 , wherein the nerve stimulation circuit further comprises (i) a first RF blocking circuit electrically coupled to the second amplifier and to the first electrode of the RF generator circuit and (ii) a second RF blocking circuit electrically coupled to the third amplifier and to the second electrode of the RF generator circuit.