Tissue resection control systems and methods
A method for removing tissues may comprise disposing a tissue resection device at a target tissue site, causing the tissue resection device to resect a core of tissue from the target tissue site, removing the core of tissue from the body, wherein the removing the core of tissue from the body creates a core cavity at the target tissue site.
1 . A surgical instrument system for coring tissue from a target tissue site, the system comprising:
a tissue resection device configured for coring tissue, wherein the device comprises:
a first clamping element comprising a helical coil, the helical coil including first electrode,
a second clamping element comprising a second electrode, the second clamping element being positioned to oppose at least a portion of the first clamping element;
a cutting element configured for the transection of tissue; and
a handle assembly configured to facilitate interaction between tissue and at least one of the first clamping element, the second clamping element, or the cutting element, the handle assembly comprising:
a rotational control assembly configured to rotate to cause rotation of the helical coil into the tissue;
a linear actuator, the linear actuator including actuator arms configured to be translated to cause a portion of the tissue to be clamped between the helical coil and the second electrode, the first electrode and the second electrode configured to deliver energy to seal the portion of the tissue clamped between the helical coil and the second electrode,
the linear actuator configured to be deactivated, after the first electrode and the second electrode deliver the energy, to unclamp the portion of the tissue from between the first clamping element and the second clamping element.
2 . The system of claim 1 , wherein the handle assembly facilitates connection of at least one of the first electrode and the second electrode to a generator.
3 . The system of claim 1 , wherein the handle assembly facilitates connection of at least one of the first electrode and the second electrode to a computing device.
4 . The system of claim 1 , wherein the handle assembly facilitates connection of at least one of the first electrode and the second electrode to a robotic system.
5 . The system of claim 1 , wherein the handle assembly is configured to automate advancement of at least one of the first electrode and the second electrode.
6 . The system of claim 1 , wherein the handle assembly is configured to automate delivery of energy to at least one of the first electrode and the second electrode.
7 . The system of claim 1 , further comprising a ligation and amputation system including a knob and a machinal line, the machinal line configured to lasso a distal end of the target tissue site for amputation of the distal end of the target tissue site.
8 . The system of claim 1 , wherein the first clamping element includes an outer tube, the helical coil is coupled to a distal end of the outer tube.
9 . The system of claim 8 , wherein the second clamping element includes a central tube slidably disposed in the outer tube, the second electrode embedded within a surface segment of the central tube.
10 . The system of claim 9 , wherein the cutting element is configured to be moved through the central tube to cut the sealed portion of the tissue.
11 . The system of claim 1 , further comprising an anchor configured to anchor to the target tissue site.
12 . The system of claim 11 , wherein the helical coil is configured to track along the anchor towards the target tissue site.
13 . The system of claim 1 , wherein the rotational control assembly is configured to allow bi-directional rotation of the helical coil.
14 . The system of claim 1 , wherein the rotational control assembly is configured to allow the helical coil to rotate a predetermined rotational distance such that fluid vessels are caught in a helix section of the helical coil and moved to a flat portion of the helical coil.
15 . The system of claim 14 , wherein the linear actuator is configured to be activated after the rotational control assembly rotates the helical coil the predetermined rotational distance.
16 . The system of claim 7 , wherein the ligation and amputation system is configured to deploy the machinal line to amputate the distal end of the target tissue site when the target tissue site is disposed within the cutting element.
17 . The system of claim 7 , wherein the ligation and amputation system includes a spring configured to be actuated to expose the machinal line.
18 . The system of claim 1 , further comprising a controller coupled to at least one of the tissue resection device and the handle assembly.
19 . The system of claim 18 , wherein the controller is in communication with a generator, wherein the controller is configured to control the generator to provide radiofrequency energy to at least one of the first electrode and the second electrode, the radiofrequency energy sufficient to seal vessels in the portion of the tissue clamped between the first clamping element and the second clamping element.
20 . The system of claim 18 , wherein the controller is configured to sense an interaction of tissue with the tissue resection device.
21 . The system of claim 18 , wherein the energy is a first energy modality, wherein the controller is configured to:
deliver a first drive signal to cause the first electrode and the second electrode to deliver the first energy modality;
determine a tissue parameter of tissue interacting with the tissue resection device; and
deliver a second drive signal to cause a second energy modality to be delivered via the tissue resection device based on the tissue parameter determined, wherein the first energy modality is different from the second energy modality.
22 . The system of claim 21 , wherein the tissue parameter is tissue impedance, the controller is configured to calculate the tissue impedance based on electrical parameters associated with the first energy modality.
23 . The system of claim 21 , wherein properties of the first energy modality and the second energy modality correspond to a type of interaction between the tissue resection device and the tissue interacting with the tissue resection device.
24 . The system of claim 21 , wherein the controller is configured to cease delivery of the first drive signal when a termination parameter is met.
25 . The system of claim 1 , wherein the energy is radiofrequency (RF).
26 . The system of claim 1 , wherein the energy is ultrasonic energy.
27 . The system of claim 21 , wherein the controller is further configured to determine a state of the tissue interacting with the tissue resection device based on the tissue parameter, the state of the tissue includes coagulated, sealed, or cut.
28 . The system of claim 21 , wherein the controller is configured to measure a rate of change of the tissue parameter.
29 . The system of claim 18 , wherein the controller is configured to determine that the tissue interacting with the tissue resection device is sealed based on at least one of initial tissue impedance, initial aperture defined by the first clamping element and the second clamping element, current tissue impedance, rate of change of tissue impedance, ultrasonic energy driven into the tissue, radio frequency (RF) energy driven into the tissue, or transaction time.
30 . The system of claim 21 , wherein the first drive signal incudes a first energy signal, the controller is configured to modulate delivery of the first energy signal based on a measured tissue impedance by modifying an output power of a generator configured to deliver energy to at least one of the first electrode and the second electrode, modifying an output waveform of the generator, selecting a second energy signal to deliver to the tissue resection device, or modifying a termination parameter.
31 . The system of claim 18 , wherein the controller is configured to sense and control a position of the cutting element relative to at least one of the first or second clamping elements of the tissue resection device.
32 . The system of claim 19 , wherein the controller is configured to control the generator to provide a continuous amount of radiofrequency energy.
33 . The system of claim 19 , wherein the controller is configured to control the generator to automatically provide an increase or decrease in an amount of radiofrequency energy delivered to at least one of the first electrode or the second electrode.
34 . The system of claim 18 , wherein the controller is configured to control a position of the first clamping element relative to the second clamping element.
35 . The system of claim 19 , wherein the tissue resection device and the generator are at least one of mechanically or electrically connected to the handle assembly.
36 . The system of claim 18 , wherein the controller is configured to sense an amount of force applied to at least one of the first or second clamping elements to detect the interaction of tissue with the tissue resection device.
37 . The system of claim 1 , further comprising a computing logic configured to automate use of one or more functions of the tissue resection device, the computing logic configured to receive one or more inputs relating to the tissue resection device.
38 . The system of claim 37 , wherein the computing logic is disposed in the handle assembly associated with the tissue resection device.
39 . The system of claim 38 , wherein the computing logic is disposed in a generator in communication with the tissue resection device.
40 . The system of claim 1 , wherein the handle assembly is configured to repeat a cycle of rotating the helical coil, clamping tissue between the first clamping element and the second clamping element, and applying the energy to seal vessels.
41 . The system of claim 21 , wherein the tissue parameter is based on dividing a voltage measurement of radio frequency (RF) energy by a current measurement of the RF energy.
42 . The system of claim 37 , wherein the computing logic is configured to determine an energy distribution provided via the tissue resection device.
43 . A surgical instrument system for coring tissue from a target tissue site, the system comprising:
a first clamping element comprising a helical coil and a first electrode;
a second clamping element comprising a second electrode;
a cutting element configured for the transection of tissue; and
a handle assembly configured to facilitate interaction between tissue and at least one of the first clamping element, the second clamping element, or the cutting element, the handle assembly comprising:
a rotational control assembly configured to rotate to cause rotation of the helical coil into the tissue;
a linear actuator, the linear actuator including actuator arms configured to be translated to control a position of the first clamping element and the second clamping element relative to one another along a longitudinal axis thereof to clamp a portion of tissue between the first clamping element and the second clamping element, the first electrode and the second electrode configured to deliver energy to seal the portion of the tissue clamped between the first clamping element and the second clamping element,
the linear actuator configured to, after the first electrode and the second electrode deliver the energy, unclamp the portion of the tissue from between the first clamping element and the second clamping element.