WO2012139085A4 - System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue - Google Patents

System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue Download PDF

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Publication number
WO2012139085A4
WO2012139085A4 PCT/US2012/032659 US2012032659W WO2012139085A4 WO 2012139085 A4 WO2012139085 A4 WO 2012139085A4 US 2012032659 W US2012032659 W US 2012032659W WO 2012139085 A4 WO2012139085 A4 WO 2012139085A4
Authority
WO
WIPO (PCT)
Prior art keywords
surgical instrument
thermal
tip
fluid
surgical
Prior art date
Application number
PCT/US2012/032659
Other languages
French (fr)
Other versions
WO2012139085A3 (en
WO2012139085A2 (en
Inventor
Mark Stringham
Preston Manwaring
Kim Manwaring
Philip Eggers
Original Assignee
Domain Surgical, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Domain Surgical, Inc. filed Critical Domain Surgical, Inc.
Priority to CA2868737A priority Critical patent/CA2868737A1/en
Priority to EP12767458.8A priority patent/EP2704656B1/en
Publication of WO2012139085A2 publication Critical patent/WO2012139085A2/en
Publication of WO2012139085A3 publication Critical patent/WO2012139085A3/en
Publication of WO2012139085A4 publication Critical patent/WO2012139085A4/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00023—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A61B2018/00035—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open with return means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/20—Holders specially adapted for surgical or diagnostic appliances or instruments

Abstract

A cooling system for a surgical handpiece may provide fluid flow to the surgical tip and to the internal electronic components to prevent temperatures that may damage or make the patient or surgeon uncomfortable. Tip directed gas further controls the tip-tissue interface by displacing blood or serum from the incision point, increasing precision and diminishing coagulum build-up. In the alternative, cooling fluid may be used to quench tissue being treated.

Claims

AMENDED CLAIMS received by the International Bureau on 23 January 2013 (23.01 .13) CLAIMS What is claimed is:
1. A thermal surgical instrument comprising:
a body comprising a body housing, a first conduit disposed in the housing, and a fluid connection site disposed in fluid communication with the first conduit;
a surgical tip comprising a tip housing and a thermal element extending from the tip housing;
wherein the surgical tip is in communication with the body housing such that at least a portion of the surgical tip is in fluid communication with the first conduit; and
wherein the first conduit, the body housing, and the tip housing form an coolant flow pathway for cooling the thermal surgical instrument.
2. The thermal surgical instrument according to claim 1 , wherein the surgical tip is removably engageable with the body.
3. The thermal surgical instrument according to claim 1 , wherein the surgical tip further comprises a second conduit, and wherein the surgical tip engages the body such that the second conduit is in fluid communication with the first conduit.
4. The thermal surgical instrument according to claim 2, wherein the body housing further comprises a recess having a shape and wherein the tip housing has a shape complimentary to the shape of the recess, wherein the shape of the recess and the shape of the tip housing facilitate alignment and engagement of the surgical tip to the body.
5. The thermal surgical instrument according to claim 2, wherein the body further comprises at least one alignment member to facilitate alignment and engagement of the surgical tip to the body.
6. The thermal surgical instrument according to claim 1 , wherein the surgical tip further comprises at least one aperture in the surgical tip for creating a coolant flow pathway directed toward the thermal element.
7. The thermal surgical instrument according to claim 1 , wherein the surgical tip further comprises an elongate tube having a distal end and a proximal end, wherein the distal end of the elongated tube is connected to the tip housing and wherein the thermal element is attached at the proximal end of the elongate tube.
47
8. The thermal surgical instrument according to claim 7, wherein the elongate tube comprises two concentric tubes having a void therethrough.
9. The thermal surgical instrument according to claim 8, wherein the two concentric tubes are comprised of an electrically conductive material.
10. The thermal surgical instrument according to claim 7, wherein the elongate tube further comprises an insulating material disposed between the two concentric tubes.
11. The thermal surgical instrument according to claim 7, wherein the elongate tube further comprises an outer tube, wherein the outer tube is disposed around the two concentric tubes such that there is a space between the outer tube and the two concentric tubes.
12. The thermal surgical instrument according to claim 11, wherein the space between the outer tube and the two concentric tubes and the void through the two concentric tubes form part of the airflow pathway.
13. The thermal surgical instrument according to claim 11, further comprising a spline disposed between the outer tube and the two concentric tubes.
14. The thermal surgical instrument of claim 1, wherein the surgical tip housing is formed integrally with the body housing.
15. A thermal surgical instrument comprising:
a primary section having a housing defining a void;
a secondary section connected to the primary section, the secondary section comprising a housing defining a void;
a fluid connection site disposed on at least one of the primary section and the secondary section; and
a thermal element attached to the primary section;
wherein the void in the housing of the primary section and the void in the housing of the secondary section form a coolant flow pathway in the thermal surgical instrument;
and wherein the fluid connection site is in fluid communication with the coolant flow pathway.
16. The thermal surgical instrument according to claim 15, wherein the primary section is a removably connectable surgical tip.
17. The thermal surgical instrument according to claim 15, wherein the coolant flow pathway further comprises at least one conduit connected to the fluid connection site.
48
18. The thermal surgical instrument according to claim 15, wherein the thermal element is hollow.
19. The thermal surgical instrument according to claim 18, wherein the hollow thermal element further comprises at least one aperture disposed thereon.
20. The thermal surgical instrument according to claim 15, wherein the primary section further comprises a heat sink.
21. The thermal surgical instrument according to claim 15, further comprising a tube, wherein the tube is attachable to the surgical instrument, and wherein the instrument is connectable to a suction source.
22. A method of cooling a thermal surgical instrument comprising the steps of:
selecting a thermal surgical instrument comprising a thermal element, a housing having a coolant flow pathway, and a fluid connection site;
connecting the fluid connection site to a device to provide a cooling fluid to the thermal surgical instrument; and
directing cooling fluid through the coolant flow pathway to remove heat from the thermal surgical instrument.
23. The method according to claim 22, wherein cooling fluid is directed into the thermal surgical instrument through the fluid connection site.
24. The method according to claim 23, wherein device connected to the fluid connection site is a suction device, and wherein cooling fluid drawn into the coolant flow pathway and exits through the fluid connection site.
25. The method according to claim 23, further comprising disposing at least one aperture on the thermal surgical tool, wherein the at least one aperture is in fluid communication with the coolant flow pathway so that at least a portion of the cooling fluid is released from the thermal surgical tool through the aperture.
26. The method according to claim 23, wherein cooling fluid released from the at least one aperture is directed toward the thermal element.
27. The method according to claim 25, wherein the cooling fluid is liquid, and wherein at least a portion of the liquid released from the at least one aperture is a heated surgical instrument having a first structure for receiving the tubing of the fluid drip line and a second structure for directing fluid to a thermal element of the heated surgical instrument; and
directed into a surgical site to quench tissue which has been contacted by the thermal element.
28. The method according to claim 23, wherein the thermal element is hollow, and wherein the hollow thermal element is in fluid communication with the airflow pathway so as to direct cooling fluid through the hollow element.
29. The method according to claim 23, wherein the hollow thermal element further comprises at least one aperture so that at least a portion of the cooling fluid is released from the at least one aperture in hollow thermal element and directed toward a tissue being treated.
30. A method of cooling a surgical handpiece comprising:
causing a coolant to flow through an inside first portion of a tip;
reversing the direction of the coolant flow adjacent the first portion of the tip and causing coolant flow tip: and
causing the coolant to flow through an inside second portion of the tip.
31. The method of claim 30, further comprising the step of directing coolant flow from the tip to a secondary section.
32. The method of claim 30, further comprising the step of directing a portion of the coolant flow at the end of the tip through the tip onto an active element.
33. The method of claim 30, further comprising the step of directing a portion of the coolant flow at the end of the tip through the tip onto a surgical site.
34. A tip for a heated surgical instrument comprising a first structure for receiving the tubing of a coolant line and a second structure for directing fluid toward a thermal element of the heated surgical instrument.
35. The tip of claim 34, wherein the first structure for receiving the tubing of a coolant line is an intake and the second structure for directing fluid to a thermal element of the heated surgical instrument is at least one aperture disposed in the heated surgical instrument adjacent the thermal element.
36. The tip of claim 35, wherein the at least one aperture comprises a plurality of apertures.
37. A system for cooling a heated surgical instrument comprising: a fluid drip line comprising a bag of fluid and tubing;
wherein the rate of fluid flow to the thermal element of the heated surgical instrument can be controlled.
38. The system for cooling a heated surgical instrument of claim 37, wherein the first structure for receiving the tubing of a fluid drip line is an intake and the second structure for directing fluid to a thermal element of the heated surgical instrument is a port.
39. The system for cooling a heated surgical instrument of claim 38, wherein the port comprises a plurality of ports.
40. The system for cooling a heated surgical instrument of claim 39, wherein the intake is disposed on the tip of the heated surgical instrument.
41. The system for cooling a heated surgical instrument of claim 37, wherein the heated surgical instrument is designed for use in a surgical field and the bag of fluid is hung at a height relative to the surgical field, and wherein the fluid flow rate to the thermal element is controlled by adjusting the height of the bag of fluid relative to the surgical field.
PCT/US2012/032659 2011-04-08 2012-04-07 System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue WO2012139085A2 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CA2868737A CA2868737A1 (en) 2011-04-08 2012-04-07 System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue
EP12767458.8A EP2704656B1 (en) 2011-04-08 2012-04-07 System for cooling of a heated surgical instrument and/or surgical site and treating tissue

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
US201161473725P 2011-04-08 2011-04-08
US61/473,725 2011-04-08
US201161505059P 2011-07-06 2011-07-06
US61/505,059 2011-07-06
US13/441,823 2012-04-06
US13/441,823 US8932279B2 (en) 2011-04-08 2012-04-06 System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue

Publications (3)

Publication Number Publication Date
WO2012139085A2 WO2012139085A2 (en) 2012-10-11
WO2012139085A3 WO2012139085A3 (en) 2013-02-28
WO2012139085A4 true WO2012139085A4 (en) 2013-07-04

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PCT/US2012/032659 WO2012139085A2 (en) 2011-04-08 2012-04-07 System and method for cooling of a heated surgical instrument and/or surgical site and treating tissue

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US (2) US8932279B2 (en)
EP (1) EP2704656B1 (en)
CA (1) CA2868737A1 (en)
WO (1) WO2012139085A2 (en)

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US8932279B2 (en) 2015-01-13
US20130023866A1 (en) 2013-01-24
WO2012139085A3 (en) 2013-02-28
EP2704656A2 (en) 2014-03-12
US20150088114A1 (en) 2015-03-26
WO2012139085A2 (en) 2012-10-11
EP2704656A4 (en) 2015-08-05
EP2704656B1 (en) 2019-08-28
CA2868737A1 (en) 2012-10-11
US9149321B2 (en) 2015-10-06

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