Conmed Corporation

C. R. Bard, Inc.

Francis T McGreevy

Katherine R Pavlovsky

Karl W Hahn

Carol A Bertrand

Alison Rogers

Pieces of tissue are fused together and simultaneously cut by compressing the pieces together at an interface, delivering an impulse of electrical power which is converted into sufficient thermal energy to fuse the pieces together at the interface and simultaneously cut the fused tissue pieces along a well-defined linear path. The impulse, and the fusion and the simultaneous cutting, occur within a preferable time of 1.5-2.0 seconds but no greater than 4.0 seconds. The temperature of the thermal energy is regulated between 220&#xb0; C.-320&#xb0; C. The force applied on the tissue pieces is sufficient to fuse the tissue at the interface followed by further compression to cut the fused tissue along the linear path as a result of the thermal energy and a zero distance gap between jaws which compress the tissue pieces. The jaws have smooth working surfaces with an Ra of 0.15 or less microns up to 0.40 microns.

Apparatus and method for rapid reliable electrothermal tissue fusion and simultaneous cutting

Pieces of tissue are fused together by compressing the pieces together at an interface, delivering an impulse of electrical power which is converted into sufficient thermal energy to fuse the pieces together at the interface. The impulse and the fusion occur within a preferable time of 0.5-2.0 seconds but no greater than 4.0 seconds. The temperature of the thermal energy is regulated between 150&#xb0; C.-200&#xb0; C. The tissue pieces are compressed to a thickness of 0.05-0.10 mm. Jaws which compress the tissue and transfer the energy have smooth working surfaces with an Ra of 0.15 or less microns to 0.40 microns.

Apparatus and method for rapid reliable electrothermal tissue fusion

Biological tissue is sealed or fused to occlude an opening by compressing apposite sidewall portions of the tissue and applying sufficient energy to cause the fibers of the compressed apposed sidewall portions to intertwine and fuse with one another to form a permanent seal. The energy application is controlled by detecting a precursor fusion condition while applying the energy and before sufficient energy has been applied to achieve a permanent seal. The application of energy is terminated in a time-delayed relationship to the detection of the precursor fusion condition. The precursor fusion condition is detected from derivative values of an envelope established by peak values of cycles of high-frequency current conducted through the tissue.

Coaptive tissue fusion method and apparatus with current derivative precursive energy termination control

Biological tissue is sealed or fused to occlude an opening by compressing apposite sidewall portions of the tissue and applying sufficient energy to cause the fibers of the compressed apposed sidewall portions to intertwine and fuse with one another to form a permanent seal. The energy application is controlled by detecting a precursor fusion condition while applying the energy and before sufficient energy has been applied to achieve a permanent seal. The application of energy is terminated in a time-delayed relationship to the detection of the precursor fusion condition. The precursor fusion condition is detected from derivative values of the total accumulated amount of high-frequency energy conducted through the tissue.

Coaptive tissue fusion method and apparatus with energy derivative precursive energy termination control

A sidewall of biological tissue which surrounds and defines an opening in the tissue is sealed or fused to occlude the opening by compressing apposite sidewall portions and applying sufficient energy to cause the fibers of the compressed apposed sidewall portions to intertwine and fuse with one another to form a permanent seal. The energy application is controlled by detecting a precursor fusion condition while applying the energy and before sufficient energy has been applied to achieve an adequate seal. The application of energy is terminated in a time-delayed relationship to the detection of the precursor fusion condition such that sufficient energy has been applied to achieve an effective seal. The precursor fusion condition is detected upon the peak RF current delivered to the tissue remaining below a threshold value for a threshold time.

Method and apparatus for precursively controlling energy during coaptive tissue fusion

A virtual control panel controls the functionality of an electrosurgical generator in response to interrogating, preferably optically, an object, such as a user's finger, interacting with a control panel image as an act of control input over the functionality of the generator. The control panel image is presented, preferably by optical projection, on a display surface of a display surface structure. The control panel image may include, in addition to a contact control area where interaction with the object is interrogated, a display area where information describing the functionality of the generator is presented, preferably by optical projection. A virtual pad can be used with the virtual control panel to divide and separate control and display functionality.

Virtual control of electrosurgical generator functions

A virtual control system for an operating room establishes virtual control devices to control surgical equipment and patient monitoring equipment and to display control, status and functionality information concerning the surgical equipment and condition information of the patient. The virtual control devices permit direct interaction by the surgeon while maintaining a sterile field, and avoid the use of actual physical devices and electrical cables connecting them to the surgical equipment.

Virtual operating room integration

An electrosurgical technique of achieving coagulation involves conducting a predetermined ionizable gas in a jet to the tissue at a predetermined flow rate sufficient to clear natural fluids from the tissue and to substantially expose the tissue stroma. Electrical radio frequency energy is conducted to the tissue in ionized conductive pathways in the gas jet. To achieve fulguration, the electrical energy is conducted as arcs in the ionized conductive pathways. To achieve a non-contact type of electrosurgical desiccation, the electrical energy is conducted as a non-arcing diffuse current in the ionized conductive pathways.

Electrosurgical conductive gas stream technique of achieving improved

A stent for the anastomosis of a vessel comprises an integral solid of biologically compatible material which is adapted to melt from a solid into a fluid in response to heat energy or body temperature into the fluid which flows through the vessel. Preferably the stent is formed of frozen material, and has a temperature which is substantially less than the temperature of the vessel upon insertion. Upon melting, the biologically compatible material naturally integrates with the fluid normally conducted by the vessel. The stent may be advantageously formed of frozen blood plasma or other blood fluid which is compatible with the blood normally conducted by an artery or a vein. When used in conjunction with thermal bonding techniques, the stent aligns the ends of the vessel for thermal bonding without the necessity for taking the time-consuming circumferentially-spaced stay sutures. The thermal mass and temperature of the stent protects the inner coating, the tuncia intima, from substantial damage from the heat applied during thermal bonding.

Vessel anastomosis using meltable stent

Meltable stent for anastomosis

A solid-state electrosurgical generator is disclosed which provides output waveforms that are optimized for electrosurgical fulguration. The fulguration output circuitry consists of a radio-frequency tank circuit which is periodically pulsed to produce a periodic damped-sinusoidal output waveform. However, the damping factor is sufficiently low so that many cycles of the waveform occur between periodic input pulses. Although the duty cycle is relatively high compared to prior art devices, cutting and burning effects are prevented by a high impedance output which internally limits fulguration arc current. The fulgurating arc developed by the device is longer and more consistent than that developed by previous devices thereby resulting in superior fulguration.

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Aurora, CO, United States of America

Francis T McGreevy