Apparatus, System, and Method for Performing an Electrosurgical Procedure

[0001] This application is a continuation of U.S. patent application Ser. No. 12/248,104, filed on Oct. 9, 2008, the entire contents of which is incorporated herein by reference.

[0002] 1. Technical Field

[0003] The present disclosure relates to an apparatus, system, and method for performing an electrosurgical procedure. More particularly, the present disclosure relates to an apparatus, system, and method for performing an electrosurgical procedure that employs an electrosurgical apparatus that includes an end effector assembly configured for use with various size access ports.

[0004] 2. Description of Related Art

[0005] Electrosurgical apparatuses (e.g., electrosurgical forceps) are well known in the medical arts and typically include a handle, a shaft and an end effector assembly operatively coupled to a distal end of the shaft that is configured to manipulate tissue (e.g., grasp and seal tissue). Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis by heating the tissue and blood vessels to coagulate, cauterize, seal, cut, desiccate, and/or fulgurate tissue

[0006] As an alternative to open electrosurgical forceps for use with open surgical procedures, many modern surgeons use endoscopes and endoscopic electrosurgical apparatus (e.g., endoscopic forceps) or laparoscopic forceps for remotely accessing organs through smaller, puncture-like incisions. As a direct result thereof, patients tend to benefit from less scarring and reduced healing time. Typically, the forceps are inserted into the patient through one or more various types of cannulas or access ports (typically having an opening that ranges from about five millimeters to about twelve millimeters) that has been made with a trocar; as can be appreciated, smaller cannulas are usually preferred.

[0007] Forceps that are configured for use with small cannulas (e.g., cannulas less than five millimeters) may present design challenges for a manufacturer of electrosurgical instruments.

[0008] According to an embodiment of the present disclosure, a bipolar forceps includes a housing having a shaft extending therefrom including an end effector assembly at a distal end thereof. The end effector assembly has a wheel assembly opposing a jaw member and having a pair of opposing wheels configured to facilitate movement of the wheel assembly relative to the jaw member. A drive rod is operably coupled at a proximal end to a movable handle and at a distal end to the wheel assembly. The movable handle is movable relative to a stationary handle to move the wheel assembly relative to the jaw member. At least one electrically conductive tissue sealing plate is disposed on each of the wheel assembly and the jaw member and is adapted to connect to an electrosurgical energy source configured to deliver electrosurgical energy to tissue held between the wheel assembly and the jaw member to effect a tissue seal.

[0009] According to another embodiment of the present disclosure, a bipolar forceps includes a housing having a shaft that extends therefrom including an end effector assembly at a distal end thereof. The end effector assembly has a wheel assembly opposing a jaw member. The wheel assembly has a pair of opposing wheels configured to facilitate movement of the wheel assembly relative to the jaw member. A drive rod is operably coupled at a proximal end to a movable handle disposed within a housing and at a distal end to a mechanical interface disposed between the pair of wheels. The movable handle is movable relative to a stationary handle disposed within the housing to cause proximal and distal movement of the drive rod. The pair of wheels is configured to rotate about the mechanical interface such that proximal movement of the drive rod causes rotation of the pair of wheels in a first direction to move the wheel assembly proximally relative to the jaw member, and distal movement of the drive rod causes rotation of the pair of wheels in a second direction to move the wheel assembly distally relative to the jaw member. At least one electrically conductive tissue sealing plate is disposed on each of the wheel assembly and the jaw member. The at least one electrically conductive tissue sealing plate is adapted to connect to an electrosurgical energy source configured to deliver electrosurgical energy to tissue held between the wheel assembly and the jaw member via the at least one electrically conductive tissue sealing plate to effect a tissue seal.

[0016] Detailed embodiments of the present disclosure are disclosed herein; however, the disclosed embodiments are merely exemplary of the disclosure, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.

[0017] As noted above, it may prove useful in the arts to provide an electrosurgical apparatus that is suitable for use with various access ports, including but not limited to those that are greater than and/or less than five millimeters. With this purpose in mind, the present disclosure includes an electrosurgical forceps that includes a drive assembly operatively coupled to one or more jaw members associated with the end effector assembly of the electrosurgical forceps. The electrosurgical forceps includes a knife assembly incorporating a cutter being substantially circular in shape. The cutter is configured to assist the jaws to align during activation of the knife assembly. In embodiments, the cutter is a wire or a rod. In other embodiments, the cutter may be a tube. The drive assembly is configured to move the jaws from an open to a closed configuration that forms a closed loop electrical circuit such that a desired tissue effect (e.g., tissue seal) may be achieved.

[0018] Turning now to FIG. 1, an embodiment of an endoscopic bipolar forceps 10 is shown for use with various surgical procedures and generally includes a housing 20, a handle assembly 30, a rotating assembly 80, a trigger assembly 70, and an end effector assembly 100 that mutually cooperate to grasp, seal, and divide tubular vessels and vascular tissue. Although the majority of the figure drawings depict a bipolar forceps 10 for use in connection with endoscopic surgical procedures, the present disclosure may be used for more traditional open surgical procedures. For the purposes herein, the forceps 10 is described in terms of a laparoscopic instrument; however, it is contemplated that an open version of the forceps may also include the same or similar operating components and features as described below.

[0019] Forceps 10 includes a shaft 12 that has a distal end 14 dimensioned to mechanically engage the end effector assembly 100 and a proximal end 16 that mechanically engages the housing 20. In the drawings and in the descriptions that follow, the term “proximal”, as is traditional, will refer to the end of the forceps 10 that is closer to the user, while the term “distal” will refer to the end that is further from the user.

[0020] Forceps 10 includes an electrosurgical cable 310 that connects the forceps 10 to a source of eleetrosurgical energy, e.g., a generator (not shown). One such source of electrosurgical energy is described in commonly-owned U.S. Pat. No. 6,033,399 entitled “ELECTROSURGICAL GENERATOR WITH ADAPTIVE POWER CONTROL”. Cable 310 is internally divided into cable leads 310a, 310b, and 310c, that are designed to transmit electrical potentials through their respective feed paths through the forceps 10 to the end effector assembly 100.

[0021] For a more detailed description of handle assembly 30, movable handle 40, rotating assembly 80, and electrosurgical cable 310 (including line-feed configurations and/or connections) reference is made to commonly owned Patent Publication No., 2003-0229344, filed on Feb. 20, 2003, entitled VESSEL SEALER AND DIVIDER AND METHOD OF MANUFACTURING THE SAME.

[0022] Handle assembly 30 includes a fixed handle 50 and a movable handle 40. Fixed handle 50 is integrally associated with housing 20 and handle 40 is movable relative to fixed handle 50 as explained in more detail below with respect to the operation of the forceps 10. Rotating assembly 80 is operatively connected to the housing 20 and is rotatable approximately 180 degrees in either direction about a longitudinal axis “A-A” (See FIG. 1).

[0023] As mentioned above, end effector assembly 100 is attached at the distal end 14 of shaft 12 and includes a pair of opposing jaw members 110 and 120. Movable handle 40 of handle assembly 30 is operatively connected to a drive assembly 150 (shown in phantom) that, together, mechanically cooperate to impart movement of the jaw members 110 and 120 from an open position wherein the jaw members 110 and 120 are disposed in spaced relation relative to one another, to a clamping or closed position wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween. With this purpose in mind, drive assembly 150 may include any suitable number of electrical connections, configurations, and/or components (e.g., resistors, capacitors, inductors, rheostats, etc.), mechanical connections, configurations, and/or components (e.g., gears, links, springs, rods, etc.), and/or electro-mechanical connections, configurations, and/or components such that forceps 10 may function as intended.

[0024] As shown best in FIGS. 2, 3A, and 3B, the end effector assembly 100 includes opposing jaw members 110 and 120 that cooperate to effectively grasp tissue for sealing purposes. The end effector assembly 100 may be designed as a unilateral assembly, i.e., jaw member 120 is fixed relative to the shaft 12 and jaw member 110 pivots about a pivot pin 103 relative to jaw member 120 to grasp tissue, or as a bilateral assembly, i.e., jaw members 110 and 120 pivot about pivot pin 103 relative to each other to grasp tissue. In some embodiments and as will be discussed in further detail below, jaw members 110, 120 are operably coupled to each other via pivot pin 103 about which pivoting jaw member 110 pivots relative to stationary jaw member 120.

[0025] As best shown in FIGS. 3A and 3B, mechanical interface 105 is operable by the drive assembly 150 such that drive assembly 150 urges mechanical interface 105 in the distal and proximal directions, as indicated by directional arrows “D” and “P”, respectively. The pivoting jaw member 110 is actuated by the drive assembly 150 such that the pivoting jaw member 110 pivots about pivot pin 103 between open and closed positions. Pulling the mechanical interface 105 proximally closes the jaw members 110 and 120 about tissue grasped therebetween and pushing the mechanical interface 105 distally opens the jaw members 110 and 120 for grasping purposes. In another embodiment, illustrated in FIG. 3C, pivot pin 103 is configured to slide within a cam slot to pivot jaw member 110 between open and closed positions.

[0026] As best shown in FIG. 2, jaw member 110 also includes a jaw housing 116 which has an insulative substrate or insulator 114 and an electrically conducive surface 112. insulator 114 is configured to securely engage the electrically conductive sealing surface 112. This may be accomplished by stamping, by overmolding, by overmolding a stamped electrically conductive sealing plate and/or by overmolding a metal injection molded seal plate.

[0027] All of these manufacturing techniques produce jaw member 110 having an electrically conductive surface 112 which is substantially surrounded by an insulating substrate 114. The insulator 114, electrically conductive sealing surface 112 and the outer, non-conductive jaw housing 116 are configured to limit and/or reduce many of the known undesirable effects related to tissue sealing, e.g., flashover, thermal spread and stray current dissipation. In other embodiments, the jaw members 110 and 120 may be manufactured from a ceramic-like material and the electrically conductive surface(s) 112 are coated onto the ceramic-like jaw members 110 and 120.

[0028] Jaw member 120 includes similar elements to jaw member 110 such as jaw housing 126 having an insulator 124 and an electrically conductive sealing surface 122 that is dimensioned to securely engage the insulator 124.

[0029] As best shown in FIG. 2, jaw member 120 may include a series of stop members 750 disposed on the inner facing surfaces of the electrically conductive sealing surface 122 to facilitate gripping and manipulation of tissue and to define a gap “G” (FIG. 4) between opposing jaw members 110 and 120 during sealing and cutting of tissue. As best shown in FIGS. 3A and 3B, pivoting jaw member 110 pivots about pivot pin 103 to the closed position such that conductive sealing surface 112 engages stop members 750. The flexible nature of jaw member 110 allows an operator to generate additional sealing pressure on tissue grasped between the jaw members 110 and 120. More specifically, once end effector assembly 100 is in the closed position and pivoting jaw member 110 is engaged with stop members 750 (FIG. 3B), movable handle 40 may be squeezed relative to stationary handle 50 to utilize the flexibility of jaw member 110 to vary and/or generate additional closure pressure between jaw member 110 and stop members 750 for purposes of sealing tissue. The series of stop members 750 may be employed on one or both jaw members 110 and 120 depending upon a particular purpose or to achieve a desired result. A detailed discussion of stop members 750 as well as various manufacturing and assembling processes for attaching and/or affixing the stop members 750 to the electrically conductive sealing surfaces 112, 122 are described in commonly owned, co-pending U.S. Patent Publication Application No. 20040122423 entitled “VESSEL SEALER AND DIVIDER WITH NON-CONDUCTIVE STOP MEMBERS” by Dycus et al.

[0030] In some embodiments, as illustrated in FIGS. 3B and 3C, forceps 10 includes a camming member 130 disposed within shaft 12 and positioned to engage pivoting jaw member 110 at flange 118 when pivoting jaw member 110 is pivoted to the closed position. More specifically, as pivoting jaw member 110 pivots about pivot pin 103 from the open position to the closed position, i.e., in a clock-wise direction, camming member 130 cams a surface of flange 118 to prevent further pivoting of jaw member 110 about pivot pin 103 in the clock-wise direction. Once end effector assembly 100 is in the closed position, and camming member 130 is engaged with flange 118, movable handle 40 may be squeezed relative to stationary handle 50 to utilize the flexibility of jaw member 110 to vary and/or generate additional closure pressure between jaw members 110 and 120 and/or between jaw member 110 and stop members 750, as discussed hereinabove.

[0031] In some embodiments, as illustrated in FIG. 3D, the end effector assembly 100 may be designed as a bilateral assembly, i.e., each of jaw members 110 and 120 pivot about pivot pin 103 relative to each other to grasp tissue.

[0032] In the illustrated embodiment, the unilateral end effector assembly 100 includes one stationary or fixed jaw member 120 mounted in fixed relation to the shaft 12 and a pivoting jaw member 110 mounted about a pivot pin 103 attached to the stationary jaw member 120. In some embodiments, fixed jaw member 120 may be monolithically formed with shaft 12, e.g., stationary jaw member 120 may be defined by the distal end 14 of shaft 12.

[0033] As best shown in FIG. 4, a knife channel 115 runs through the center of jaw member 120 such that a blade 122 may cut tissue grasped between wheel assembly 110 and jaw member 120. More specifically, the blade 122 advances through knife channel 115 when activated (e.g., via the trigger assembly 70) to progressively and selectively divide tissue along an ideal tissue plane in a precise manner to effectively and reliably divide the tissue. In embodiments, forceps 10 may be configured such that blade 122 may only be advanced through knife channel 115 to cut tissue when wheel assembly 110 is positioned at certain locations along jaw member 120 (e.g., in a grasping position, a distal most position, a proximal most position, etc.) thus preventing accidental or premature activation of the blade 122 through tissue.

[0034] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.