Bipolar electrosurgical instruments
A bipolar surgical instrument ( 1 ) comprises a body ( 2 ), first and second opposed jaws ( 18, 20 ) located at the distal end of a shaft ( 10 ), the first jaw ( 18 ) being movable with respect to the second jaw ( 20 ) between an open position in which the first and second jaws ( 18, 20 ) are spaced apart from one another, and a closed position in which the first and second jaws ( 18, 20 ) are adjacent one another. The first and second elongate jaw members ( 18, 20 ) have respective first and second electrodes. A controller is operable to determine a mode of operation depending upon a measurement of impedance between the first and second jaws.
1. An electrosurgical system comprising:
a bipolar electrosurgical instrument comprising:
a body;
an elongate shaft attached to the body, the elongate shaft extending to a distal end;
a first elongate jaw member and a second elongate jaw member provided at the distal end of the elongate shaft, the first elongate jaw member carrying a first electrode and the second elongate jaw member carrying a second electrode, the first elongate jaw member and the second elongate jaw member being movable relative to one another between an open position in which the first electrode and the second electrode are spaced apart from one another, and a closed position in which the first electrode is adjacent the second electrode; and
a power cable having (1) a pair of electrically conductive elements, (2) a first end and (3) a second end for connection to the first electrode and the second electrode; and
a waveform generator connected with the first end of the power cable of the bipolar electrosurgical instrument and comprising:
a radio frequency signal generator operable to supply a radio frequency signal to the first electrode and the second electrode via the power cable; and
a controller operable to control operation of the radio frequency signal generator, in dependence upon a received control input,
wherein the controller is operable, in a sealing stage following, in seratium, a tissue impedance measurement stage and a heating stage:
to control the radio frequency signal generator to supply a radio frequency signal at a predetermined sealing voltage level to the first electrode and the second electrode for a sealing time period of a predetermined length having a sealing end time, the predetermined sealing voltage level being a voltage increase during the sealing time period such that the controller is configured to increase the voltage at a faster rate in the heating stage than in the tissue impedance measurement stage;
to measure an impedance level between the first electrode and the second electrode at the sealing end time;
to compare the measured impedance with a predetermined reference impedance to produce a comparison signal; and
to determine whether to repeat the heating and sealing stages or proceed to a different stage in dependence upon the comparison signal.
2. The electrosurgical system as claimed in claim 1 , wherein the controller is operable, subsequent to the sealing stage, and when the comparison signal is indicative of the measured impedance level being less than the predetermined reference impedance;
to repeat the heating and sealing stages until the comparison signal is indicative of the measured impedance level being greater than or equal to the predetermined reference impedance.
3. The electrosurgical system as claimed in claim 1 , wherein the controller is operable, in a completion stage subsequent to the sealing stage, and when the comparison signal is indicative of the measured impedance level being greater than or equal to the predetermined reference impedance;
to control the radio frequency signal generator to apply a radio frequency signal at a predetermined completion voltage level, lower than the predetermined sealing voltage level, for a predetermined completion time period; and
to end supply of the radio frequency signal at the predetermined completion voltage level at the end of the predetermined completion time period.
4. A method of operating an electrosurgical system comprising a bipolar electrosurgical instrument comprising a body; an elongate shaft attached to the body, the elongate shaft extending to a distal end; a first elongate jaw member and a second elongate jaw member located at the distal end of the elongate shaft, the first elongate jaw member carrying a first electrode and the second elongate jaw carrying a second electrode, the first elongate jaw member and the second elongate jaw member being movable relative to one another between an open position in which the first electrode and the second electrode are spaced apart from one another, and a closed position in which the first electrode is adjacent the second electrode; and a power cable having (1) a pair of electrically conductive elements, (2) a first end and (3) a second end for connection to the first electrode and the second electrode; and a waveform generator connected with the first end of the power cable of the bipolar electrosurgical instrument and comprising a radio frequency signal generator operable to supply a radio frequency signal to the first electrode and the second electrode via the power cable; and a controller operable to control operation of the radio frequency signal generator, in dependence upon a received control input, wherein the method comprises in a sealing stage following, in seriatum, a tissue impedance measurement stage and a heating stage:
supplying a radio frequency signal of a predetermined power level to the first electrode and the second electrode for a predetermined time period having an end time, the predetermined power level resulting in a voltage increase during the predetermined time period, and increasing the voltage at a faster rate in the heating stage than in the tissue impedance measurement stage;
measuring an impedance level between the first electrode and the second electrode at the end time;
comparing the measured impedance with a predetermined reference impedance to produce a comparison signal; and
determining whether to repeat the heating and sealing stages or proceed to a different stage in dependence upon the comparison signal.
5. The method as claimed in claim 4 , further comprising, subsequent to the sealing stage, and when the comparison signal is indicative of the measured impedance level being less than the predetermined reference impedance; repeating the heating and sealing stages until the comparison signal is indicative of the measured impedance level being greater than or equal to the predetermined reference impedance.
6. The method as claimed in claim 4 , further comprising, subsequent to the sealing stage, and when the comparison signal is indicative of the measured impedance level being greater than or equal to the predetermined reference impedance:
a completion stage comprising:
controlling the radio frequency signal generator to apply a radio frequency signal at a predetermined completion voltage level, lower than the predetermined sealing voltage level, for a predetermined completion time period; and
ending supply of the radio frequency signal at the predetermined completion voltage level at the end of the predetermined completion time period.
7. An electrosurgical system comprising:
a bipolar electrosurgical instrument comprising:
a body;
an elongate shaft attached to the body, the elongate shaft extending to a distal end;
first elongate jaw member and a second elongate jaw member at the distal end of the elongate shaft, the first elongate jaw member carrying a first electrode and the second elongate jaw member carrying a second electrode, the first elongate jaw member and the second elongate jaw member being movable relative to one another between an open position in which the first and second electrodes are spaced apart from one another, and a closed position in which the first electrode is adjacent the second electrode; and
a power cable having (1) a pair of electrically conductive elements, (2) a first end and (3) a second end for connection to the first electrode and the second electrode; and
a waveform generator connected with the first end of the power cable of the bipolar electrosurgical instrument and comprising:
a radio frequency signal generator operable to supply a radio frequency signal to the first electrode and the second electrode via the power cable; and
a controller operable to control operation of the radio frequency signal generator, in dependence upon a received control input,
wherein:
the controller is operable, in a sealing stage following, in seratium, a tissue impedance measurement stage and a heating stage:
to control the radio frequency signal generator to supply a radio frequency signal at a predetermined sealing voltage level to the first electrode and the second electrode for a sealing time period of a predetermined length having a sealing end time;
to measure an impedance level between the first electrode and the second electrode at the sealing end time;
to compare the measured impedance with a predetermined reference impedance to produce a comparison signal;
to determine a relative size of a vessel based on the comparison signal;
to determine whether to repeat the heating and sealing stages or proceed to a different stage in dependence upon the relative size of the vessel; and
when the comparison signal indicates that the measured impedance is greater than the predetermined reference impedance, the controller:
determines that the relative size of the vessel is small, and
commences supplying a radio frequency signal at a voltage level that increases to a maximum value.
8. The electrosurgical system as claimed in claim 7 , wherein
when the comparison signal indicates that the measured impedance is less than the predetermined reference impedance, the controller:
determines that the relative size of the vessel is large, and
commences a stage of reducing the voltage for a fixed period and subsequently repeats the heating and sealing stages.