Abstract:
A control system (10) and method for the operation of neurosurgical bipolar electrodes (11) provides a source of high frequency energy (13') connected to bipolar electrodes (11). Contacting surfaces are on the bipolar electrodes (11) of highly electrically conductive material. A current transducer attached to the source of high frequency energy (13') measures (20) the RMS current applied between the contact surfaces (25). A current transducer attached to the source of high frequency energy (13') provides a signal (26) correlated to the instantaneous values of the RMS voltage between the contacts. A control connects to the source of high frequency energy (13') for initially regulating the RMS current applied by the contacting surfaces in response to the impedance until the signal (19) divided by the measure (20) which is representative of the instantaneous impedance of the load reaches a predetermined value. The control regulates the RMS power applied by the contacting surfaces in accord with the impedance until the signal (19) divided by the measure (20) reaches a predefined value. The control responds to the measure (20) and the signal (19) so that the RMS voltage applied to the load being treated between the contacting surfaces regulated while its impedance is monitored until a prescribed value is reached. The control regulates the RMS voltage applied in accord with the impedance by changing the RMS voltage to a percentage of that applied until the prescribed value is obtained so that the tissues stay moist and are coagulated without drying and carbonizing or turning to eschar.
Abstract:
A surgical system (10) has a multiple electrode electrosurgical capability in combination with a gas plasma capability for delivery of electrosurgical energy to the tissue (14) or bodily fluids (15) of a patient (16). The system includes a holder (17), a source of electrical energy (20), electrodes connected to the source of electrical energy (20), one or more passages (22) carried on the holder (17) for transporting ionizable gas (23), and a source of ionizable gas (24) of a selectable flow rate. The gas passages (22) may include at least one electrode extending toward the operative site. The gas passages (22) may include a part (28) that creates a vortex in the gas flow. The electrodes may be coaxially placed in the gas passages (22). The system may also be configured such that two electrodes are each shrouded by the ionized gas so that the electrosurgical energy is conducted to the tissue (14) or bodily fluids (15) of the operative site by passing along conductive pathways (25) in the ionized gas from each electrode. There may also be a dielectric barrier (26) between the conductive pathways (25). The system may also be configured such that one of the multiple electrodes (11) is substantially in contact with the tissue (14) or bodily fluids (15) of the operative site and another of the multiple electrodes (11) is in the circuit through the conductive pathway of the ionized gas flow so that electrosurgical energy is conducted through the tissue (14) or bodily fluids (15) of the operative site and between the electrodes. Methods of manufacture and use for the system are also claimed.
Abstract:
A neutral electrode, consisting of two parts (20, 21), is continuously monitored by an adaptive monitoring system to guarantee conditions of optimal electrical contact with the patient's skin in order to prevent burns. A special adaptive signal generator produces a signal coupled between the two parts of the return electrode by means of an insulation transformer (10). Current and applied voltage are (38) continuously monitored for phase differencies which in turn pilot a phase locked oscillator. The continuous adaption of the generated frequency by the above described feed back phase controlled loop allows to obtain an optimal testing frequency for each patient electrode combination. The optimal frequency is then obtained when the phase difference between test voltage and current is minimal.
Abstract:
An insulating switch base (16) with a top (17), bottom (18) and an edge (19) has configured openings (20) through the top (17) and one edge (19) for a conductor. A conductive switch (10) lead frame (22) has proximal ends (24) with insulation displacement connectors (25) bent in the openings. A resilient member (26) on the frame has a moveable contact and is conductively associated with a connector. A contoured arm (27) on the frame is distal of but conductive with another connector. The arm is spaced from the member as an open contact capable of momentary engagement. A frangible area (28) on each frame is between the member and the arm. Recesses (30) in the top (17) support (41) and retain the frame. A slot (35) and barbs (36) on each connector receive one conductor and secure in an opening after aligned installation in an opening, seating of the frame in its recess and severing the area over a passage in the base. A membrane attaches over the frame and a molding is applied about the membrane leaving the member open. A method of assembling the switch (10) having a cable (13) with conductors with a base. Driving conductors into the openings to bend into sections (21) and pressing the cable (13) into a channel on the base are steps. Forming and installing a frame with contacts (12) and connectors in recesses (30) to hold the frame with contacts (12) normally open but capable of closing are steps. Displacing the insulation on the conductors with connectors while separating the contacts (12) by severing areas of the frame and attaching a membrane over the frame and base are steps. Trimming excess conductors to prevent protruding from the base and encasing the assembled switch (10) in an insulator are steps. A tool for the assembly of base and frame has a support (41) to position and retain the bottom (18) aligned with the frame. An inserter (42) and a holder (43) force and bend each conductor in its section (21). A carrier locates the frame relative to and in alignment with recesses (30) in the top (17). Lugs (45) engage connector apertures (34) to drive each into an opening and chisels (46) cut areas over passages (37) on the base. Preset protuberances engage and set the arm when seating the frame so the dimple (31) engages and sets the switch (10) gap.
Abstract:
A handpiece (11) with a moveable switchable electrode (12) delivers high frequency electrosurgery. The electrode switches (28) from a first monopolar mode with an active electrode (14) extending from the handpice (11) and a patient (13) return electrodes (15a and 15b) to a second bipolar mode with the active and return electrodes (15a and 15b) extending. Electrosurgical generator (16) outputs supply energy to the electrodes. Bipolar terminals (18) supply energy to the electrodes for use in the second mode. An active lead (19a) selectively connects the active output and the active electrode (14). A return lead (20a and 20b) selectively connects the return electrode (15a and 15b) and the return output in the first mode or the return terminal when in the second mode. Terminals connect with wiring to the electrodes in the handpiece (11) to complete the circuit for the second mode. One terminal is on the generator and the other is in the handpiece (11) to connect to the electrodes and complete the circuit for the second mode. The electrode has a control (12') on the handpiece (11) for the surgeon to change circuitry and to position the electrode for each mode. The control (12') and return electrode (15a and 15b) are moveably supported by the handpiece (11). The return electrode (15a and 15b) in the first mode is positioned inside the handpiece (11) disconnected from its terminal. The return electrode (15a and 15b) connects to its terminal when extended from the handpiece (11). The return electrode (15a and 15b) when used in the first mode, has a pair of pads (21) attached to the patient (13) and connected to a monitoring circuit (22) for testing continuity between each pad and the patient (13). The handpiece (11) has an elongated support extending distally. A method of use has steps including providing the handpiece (11) and electrode, switching the electrode from the first mode to the second mode, providing the generator with outputs for supplying energy to the electrodes, having terminals for the electrodes when used in the second mode, including an active lead (19a) selectively in circuit between the active output and electrode and including a return lead (20a and 20b) selectively in circuit between the return electrode (15a and 15b) and output when in the first mode or the terminal when in the second mode.
Abstract:
A minimally invasive retractor and dissector (10) for internal surgical use on a patient has a tubular support (11) for passing into the body; the tubular support (11) has a passage (16) for access along an axis "A" thereof during operative procedures on the patient's internal tissue. A proximal end (12) on the tubular support (11) is located outside the patient in position to be accessed by the surgeon when a distal end (13) is inside. One or more jointed articulated members (15) are movably positioned and capable of holding and pulling tissue disposed beyond the distal end (13) and each member has a distal tip (17) to hold tissue. An instrument capable of moving independent of any member functions cooperatively on the tissue and passes through the passage (16) from the proximal end (12) to beyond the distal end (13) as the members position the tissue. The instrument is a surgical tool and the tissue is maneuvered by the members within the body into a position relative to the tool. A control (19) at the proximal end (12) manipulates the members relative to the axis "A" permitting holding and pulling tissue disposed beyond the distal end (13); the control (19) is capable of moving the instrument independent of the members for operating on the held and maneuvered tissue. A grip (34) manipulates the members and positions the instrument. A method for using the minimally invasive retractor and dissector (10) has the steps of making an opening for a tubular support (11) to pass into the body, leaving the proximal end (12) on the tubular support (11) outside the body, positioning the distal end (13) thereof inside, and moving members carried on the tubular support (11). Holding and pulling tissue disposed beyond the distal end (13) and using the passage (16) for access along the axis thereof for operating on internal tissue are added steps. Another step is moving an instrument in the passage (16) independent of the members.
Abstract:
An electrosurgical control (10) for a trocar (11) has a trocar (11) with a cannula (12) with a stylet (13) coaxially fit therein. The stylet (13) is movable relative to the cannula (12) along a common axis. The trocar (11) is shaped for insertion in a direction generally along the axis through tissue in a puncture procedure with its stylet (13). A distal end (15) and a proximal end (16) on the elongate cannula (12) so the distal end (15) enters the tissue while the proximal end (16) remains outside. A tip (17) on the stylet (13) end, near the distal end (15) of the cannula (12), normally extends therebeyond in position to puncture the tissue. The stylet (13) has an energy supply (18) passing from the tip (17) to its opposite end (19) and moves reciprocally relative to the cannula (12) so the tip (17) extends or is fully within the cannula (12). An electrosurgical generator (20) provides energy to the opposite end (19) of the stylet (13) and an electrosurgically active device is a part of the tip (17) and connects to the energy supply (18). A sampling circuit (21) is connected to the electrosurgically active device and responds to changes in energy passing through the energy supply (18) as a function of tissue cut by the electrosurgically active device. The sampling circuit (21) provides a signal relative to the energy supplied and a measuring circuit (22) analyzes the signal to instantly isolate a specific signal therefrom indicative of a significant change in the energy when the tip (17) is not in tissue. A comparator (23) has a settable predetermined threshold amount of energy at which the electrosurgical generator (20) no longer supplies energy. A peak energy level is set by a knob (24) and is compared to the varying signals from the sampling circuit (21). A switch (25) responds to the comparator (23) to disconnect the energy when the threshold is exceeded.
Abstract:
An improved devices for delivering RF current to the operating tool (6) of an ultrasonic surgical apparatus which comprises a switch module for selecting said RF current, an electrically conducting metal band (18) connected to the switch module and an electrically conductive O-ring (19) in electrical contact with the metal band and located around the acoustic connecting member (5) of the apparatus.
Abstract:
A design and method of manufacture are disclosed for an electrosurgical electrode (10) with a silicone coating. The coating resists the build-up of eschar. The silicone material is thick enough in the flat area of the blade to withstand the electrosurgical voltage without breakdown. The electrosurgical current path is primarily through the blade edges (15) and tip. The flat of the blade remains insulated under most conditions. The relatively thick coating also provides high tear strength and added durability. The composition of the electrode (10) coatings may include silicone elastomers (11) in the form of adhesives, dispersions, or liquid rubbers. The coating composition may also contain adhesion promoters, heat stabilizers, plasticizers, release enhancers, cross-linking agents, and colorants. Several methods of manufacture are illustrated by way of examples.
Abstract:
A constant power control circuit (107) for an electrosurgical generator (101) and a method for maintaining the electrical power output of an electrosurgical generator (101) at a generally constant value throughout a given tissue impedance range are disclosed. The constant power control circuit (107) and the method recognize and use the unique and simple linear characteristics associated with certain electrosurgical generator (101) designs to monitor and control the electrical power output without having to calculate or monitor the actual output power. The constant power control circuit (107) includes a current sampling circuit (115), a linear conversion circuit (117), and a feedback correction circuit (119). The constant power control circuit (107) may also include protection circuitry that prevents the electrosurgical generator (101) from being over-driven during high and/or low impedance loading (121), and reduces the severity of exit sparking by providing a quick response to high impedance indications while nonetheless maintaining increased power levels throughout a preset, nominal impedance range. The constant power control circuit (107) and method may be included as an integral part of the overall electrosurgical generator's (101) circuitry, or may be embodied as a separate unit that connects to, and controls, an electrosurgical generator (101). The constant power control circuit (107) and method may be embodied through a variety of analog and/or digital circuit components or arrangements, including software running on computational and memory circuitry.