Devices and techniques for cutting and coagulating tissue

{
  "publication_number": "US10022568B2",
  "country": "US",
  "kind": "B2",
  "title": "Devices and techniques for cutting and coagulating tissue",
  "abstract": "Various embodiments are directed to a method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument. In accordance with the method, a generator is configured to generate at least one time varying electrical signal having a resonant frequency, monitor the resonant frequency of the at least one electrical signal, calculate a frequency slope between frequency data points of the time varying electrical signal, where the frequency slope is the change in resonant frequency over time, compare the frequency slope to a threshold frequency slope, and trigger a first response of the generator when the frequency slope crosses the threshold frequency slope.",
  "claims": [
    "1. A method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument, the method comprising: generating, by a generator, at least one time-varying electrical signal having a resonant frequency; monitoring, by the generator, the resonant frequency of the at least one time-varying electrical signal; calculating, by the generator, a frequency slope between frequency data points of the time varying electrical signal, where the frequency slope is a change in resonant frequency over time; comparing, by the generator, the frequency slope to a frequency slope threshold; and triggering, by the generator, a first response of the generator when the frequency slope crosses the frequency slope threshold.",
    "2. The method of claim 1, comprising: comparing, by the generator, the frequency slope to the frequency slope threshold; and triggering, by the generator, a second response of the generator when the frequency slope crosses the frequency slope threshold.",
    "3. The method of claim 2, comprising: determining, by the generator, when the frequency slope is less than the frequency slope threshold; incrementing, by the generator, a timer when the frequency slope is less than the frequency slope threshold; determining, by the generator, when the timer is greater than a required trigger time; and setting a logic condition when the timer is greater than the required trigger time.",
    "4. The method of claim 3, comprising: incrementing, by the generator, the timer when the resonant frequency is less than a resonant frequency threshold and the frequency slope is less than the frequency slope threshold.",
    "5. The method of claim 2, comprising: comparing, by the generator, the frequency slope to a cross-back frequency slope threshold, wherein the cross-back frequency slope threshold is the frequency slope threshold above which a triggered response stops.",
    "6. A method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument, the method comprising: receiving, by a generator, a frequency slope threshold; monitoring, by the generator, a frequency slope of the ultrasonic drive system; comparing, by the generator, the frequency slope of the ultrasonic drive system with the frequency slope threshold; and incrementing, by the generator, a timer when the frequency slope is less than the frequency slope threshold.",
    "7. The method of claim 6, further comprising: receiving, by the generator, a required time before trigger parameter; receiving, by the generator, a timer value from the timer; comparing, by the generator, the required time before trigger parameter and the timer value; setting, by the generator, a condition set latch when the timer value is greater than the required time before trigger parameter and indicating that a predetermined condition has set been met; or resetting, by the generator, the condition set latch when the timer value is less than or equal to the required time before trigger parameter.",
    "8. The method of claim 6 further comprising: resetting, by the generator, the timer when the frequency slope is greater than the frequency slope threshold.",
    "9. The method of claim 8, further comprising: determining, by the generator, when a cross-back frequency slope latch is set; and indicating that a predetermined condition set has not been met when the cross-back frequency slope latch is not set.",
    "10. The method of claim 9, further comprising: receiving, by the generator, a minimum latch time parameter for a condition set latch; receiving, by the generator, a cross-back frequency slope threshold parameter; receiving, by the generator, an indication that at least one of the condition set latch or the cross-back frequency slope latch is set; comparing, by the generator, a latched time of the condition set latch with the minimum latch time parameter for the condition set latch; comparing, by the generator, the frequency slope with the cross-back frequency slope threshold parameter; and indicating, by the generator, that a predetermined condition set has been met when the frequency slope is less than the cross-back frequency slope threshold parameter.",
    "11. The method of claim 10, further comprising: resetting, by the generator, a timer latch; and indicating, by the generator, that a predetermined condition set has not been met when the frequency slope is greater than the cross-back frequency slope threshold parameter.",
    "12. A generator configured to drive an end effector coupled to an ultrasonic drive system of a surgical instrument, the generator comprising: a processor; a timer circuit coupled to the processor; a timer latch coupled to the processor; a condition set latch coupled to the processor; and a memory coupled to the processor, wherein the memory includes machine executable instructions that when executed by the processor cause the processor to: receive a frequency slope threshold; monitor a frequency slope of the ultrasonic drive system; compare the frequency slope of the ultrasonic drive system with the frequency slope threshold; and increment the timer circuit when the frequency slope is less than the frequency slope threshold.",
    "13. The generator of claim 12, wherein the machine executable instructions, when executed by the processor, cause the processor to: receive a required time before trigger parameter; receive a timer value from the timer circuit; compare the required time before trigger parameter and the timer value; set the condition set latch when the timer value is greater than the required time before trigger parameter and indicate that a predetermined condition has not been met; or reset the condition set latch when the timer value is less than or equal to the required time before trigger parameter.",
    "14. The generator of claim 12, wherein the machine executable instructions, when executed by the processor, cause the processor to: reset the timer circuit when the frequency slope is greater than the frequency slope threshold.",
    "15. The generator of claim 14, wherein the machine executable instructions, when executed by the processor, cause the processor to: indicate a cross-back frequency slope latch is set; and indicate that a predetermined condition set has not been met when the cross-back frequency slope latch is not set.",
    "16. The generator of claim 15, wherein the machine executable instructions, when executed by the processor, cause the processor to: receive a minimum latch time parameter for the condition set latch; receive a cross-back frequency slope threshold parameter; receive an indication that the cross-back frequency slope latch is set; compare the frequency slope with the cross-back frequency slope threshold parameter; and indicate that a predetermined condition set has been met when the frequency slope is less than the cross-back frequency slope threshold parameter.",
    "17. The generator of claim 15, wherein the machine executable instructions, when executed by the processor, cause the processor to: reset the timer latch; and indicate that the predetermined condition set has not been met when the frequency slope is greater than the cross-back frequency slope threshold parameter."
  ],
  "description_excerpt": "The present disclosure generally relates to ultrasonic surgical systems and, more particularly, to an ultrasonic system that allows surgeons to perform cutting and coagulation.\n\nUltrasonic surgical instruments are finding increasingly widespread applications in surgical procedures by virtue of the unique performance characteristics of such instruments. Depending upon specific instrument configurations and operational parameters, ultrasonic surgical instruments can provide substantially simultaneous cutting of tissue and hemostasis by coagulation, desirably minimizing patient trauma. The cutting action is typically realized by an-end effector, or blade tip, at the distal end of the instrument, which transmits ultrasonic energy to tissue brought into contact with the end effector. Ultrasonic instruments of this nature can be configured for open surgical use, laparoscopic, or endoscopic surgical procedures including robotic-assisted procedures.\n\nSome surgical instruments utilize ultrasonic energy for both precise cutting and controlled coagulation. Ultrasonic energy cuts and coagulates by using lower temperatures than those used by electrosurgery. Vibrating at high frequencies (e.g., 55,500 times per second), the ultrasonic blade denatures protein in the tissue to form a sticky coagulum. Pressure exerted on tissue with the blade surface collapses blood vessels and allows the coagulum to form a hemostatic seal. The precision of cutting and coagulation is controlled by the surgeon's technique and adjusting the power level, blade edge, tissue traction, and blade pressure.",
  "cpc": [
    "A61N 7/00",
    "A61B 17/320068",
    "A61B 17/320092",
    "A61B 18/1206",
    "A61B 18/14",
    "A61B 18/1445",
    "A61B 2017/00026",
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  ],
  "ipc": [
    "A61B 17/32",
    "A61N 7/00",
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    "B06B 1/02",
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  ],
  "assignees": [
    "Ethicon LLC"
  ],
  "inventors": [
    "Jeffrey D. Messerly",
    "Eitan T. Wiener",
    "Brian T. Noyes",
    "Jeffrey L. Aldridge",
    "James R. Giordano",
    "Robert J. Beetel, III",
    "Daniel J. Abbott",
    "Foster B. Stulen",
    "Matthew C. Miller",
    "Aaron C. Voegele",
    "Jeffrey P. Wiley",
    "Nathan J. Price",
    "Daniel W. Price",
    "Robert L. Koch, Jr."
  ],
  "filing_date": "2015-07-27",
  "publication_date": "2018-07-17",
  "grant_date": "2018-07-17",
  "priority_date": "2008-08-06",
  "application_number": "US-201514810318-A",
  "family_id": "44786107",
  "cited_by_count": 475,
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