U.S. patent application number 14/109459 was filed with the patent office on 2014-04-17 for optical hydrology arrays and system and method for monitoring water displacement during treatment of patient tissue.
This patent application is currently assigned to COVIDIEN LP. The applicant listed for this patent is COVIDIEN LP. Invention is credited to Carine HOARAU, Ronald J. PODHAJSKY.
Application Number | 20140107443 14/109459 |
Document ID | / |
Family ID | 44761475 |
Filed Date | 2014-04-17 |
United States Patent
Application |
20140107443 |
Kind Code |
A1 |
HOARAU; Carine ; et
al. |
April 17, 2014 |
OPTICAL HYDROLOGY ARRAYS AND SYSTEM AND METHOD FOR MONITORING WATER
DISPLACEMENT DURING TREATMENT OF PATIENT TISSUE
Abstract
A system that monitors water displacement in tissue during
patient therapy includes a generator supplying electrosurgical
energy to tissue, a spectrometer operably coupled to the generator,
and a processor communicating with the generator and with the
spectrometer having a light source for exposing tissue to light and
a light sensor. The light sensor is configured to sense changes in
light through tissue in response to tissue treatment and
communicate the changes to the processor to determine tissue
hydration levels and motility. A plurality of optical fibers may be
configured in an array to communicate light between the generator
and tissue. An optical temperature monitor may communicate with the
processor and be coupled to an optical fiber. The optical fibers
may have an optic fiber distance between adjacent optical fibers.
The system may be incorporated within an electrosurgical pencil or
a forceps. A corresponding method of detecting hydration is also
disclosed.
Inventors: |
HOARAU; Carine; (Lafayette,
CA) ; PODHAJSKY; Ronald J.; (Boulder, CO) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
COVIDIEN LP |
Mansfield |
MA |
US |
|
|
Assignee: |
COVIDIEN LP
Mansfield
MA
|
Family ID: |
44761475 |
Appl. No.: |
14/109459 |
Filed: |
December 17, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
12757340 |
Apr 9, 2010 |
|
|
|
14109459 |
|
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Current U.S.
Class: |
600/342 ;
600/310; 606/41 |
Current CPC
Class: |
A61B 18/1233 20130101;
A61B 18/1477 20130101; A61B 2018/0063 20130101; A61B 18/12
20130101; A61B 5/4875 20130101; A61B 5/0084 20130101; A61B 18/1445
20130101; A61B 5/0075 20130101 |
Class at
Publication: |
600/342 ; 606/41;
600/310 |
International
Class: |
A61B 5/00 20060101
A61B005/00; A61B 18/12 20060101 A61B018/12 |
Claims
1-10. (canceled)
11. A system for monitoring water displacement in tissue during
tissue treatment, comprising: a generator configured to supply
electrosurgical energy to tissue; a spectrometer operably coupled
to the generator; and a processor in operative communication with
the generator and with the spectrometer, the spectrometer
including: at least one light source configured to expose tissue to
light; and at least one light sensor configured to sense changes in
light through tissue in response to tissue treatment and
communicate such changes to the processor to determine tissue
hydration levels.
12. The system according to claim 11, further comprising: a
plurality of optical fibers operably coupled to the generator and
configured to communicate light between the spectrometer and
tissue.
13. The system according to claim 12, wherein the plurality of
optical fibers are configured in an array.
14. (canceled)
15. A method for monitoring water displacement in tissue during
tissue treatment, comprising: providing a spectrometer including a
light source in operative communication with patient tissue;
generating light from the light source; reflecting the light
through patient tissue; and receiving the light reflected through
the patient tissue with a light sensor.
16. The method according to claim 15, further comprising: supplying
electrosurgical energy to patient tissue utilizing an energy
source; sensing changes in light through the patient tissue with
the light sensor in response to patient tissue treatment; and
determining changes in patient tissue hydration levels based on the
sensed changes in light through the patient tissue.
17. The method according to claim 16, further comprising: providing
a processor operatively coupled to at least one of the spectrometer
and energy source for analyzing the sensed changes in light through
the patient tissue.
18. The method according to claim 17, wherein the processor
operatively communicates with the spectrometer and the method
further comprises regulating the supply of electrosurgical energy
to the patient tissue based on the sensed changes in light through
the patient tissue.
19. (canceled)
20. A system for determining tissue hydration in patient tissue
during tissue treatment, comprising: a generator configured to
supply electrosurgical energy to patient tissue; a processor in
operatively coupled to the generator; a first light source
operatively coupled to the processor and configured to expose
patient tissue to light at a reference wavelength insensitive to
the moisture content of patient tissue; a second light source
operatively coupled to the processor and configured to expose
patient tissue to light at a hydration wavelength sensitive to the
moisture content of patient tissue; a first light sensor
operatively coupled to the processor and configured to sense
changes in light at the reference wavelength in response to tissue
treatment; and a second light sensor operatively coupled to the
processor and configured to sense changes in light at the hydration
wavelength in response to tissue treatment.
21. The system for determining tissue hydration in accordance with
claim 20, wherein the processor is configured to: receive sensed
changes in light at the reference wavelength; receive sensed
changes in light at the hydration wavelength; and computing tissue
hydration based at least in part upon the sensed changes in light
at the reference wavelength and the sensed changes in light at the
hydration wavelength.
22. The system for determining tissue hydration in accordance with
claim 21, wherein the processor is configured to determine the
electrosurgical energy supplied to tissue by the generator.
23. The system for determining tissue hydration in accordance with
claim 21, wherein the processor is configured to determine the
electrosurgical energy supplied to tissue by the generator based at
least in part upon the computed tissue hydration.
24. The system for determining tissue hydration in accordance with
claim 20, wherein at least one of the first light sensor and the
second light sensor are configured to sense light reflected from
patient tissue.
25. The system for determining tissue hydration in accordance with
claim 20, wherein at least one of the first light sensor and the
second light sensor are configured to sense light transmitted
through patient tissue.
26. A method for determining tissue hydration, comprising: exposing
tissue to light at a reference wavelength insensitive to the
moisture content of tissue; exposing tissue to light at a hydration
wavelength sensitive to the moisture content of tissue; sensing
changes in light at the reference wavelength; sensing changes in
light at the hydration wavelength; and comparing the sensed changes
in light at the reference wavelength to the sensed changes in light
at the hydration wavelength to determine tissue hydration.
27. The method for determining tissue hydration in accordance with
claim 26, further comprising applying electrosurgical energy to
tissue.
28. The method for determining tissue hydration in accordance with
claim 27, further comprising modifying the electrosurgical energy
in response to the determined tissue hydration.
29. The method for determining tissue hydration in accordance with
claim 26, wherein sensing changes in light includes sensing changes
in light reflected from tissue.
30. The method for determining tissue hydration in accordance with
claim 26, wherein sensing changes in light includes sensing changes
in light transmitted through tissue.
31. The method for determining tissue hydration in accordance with
claim 26, wherein sensing changes in light includes sensing changes
in light absorbed by tissue.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] The present application is a continuation application of
U.S. patent application Ser. No. 12/757,340 filed on Apr. 9, 2010,
the entire content of which is hereby incorporated by reference
herein.
BACKGROUND
[0002] 1. Technical Field
[0003] This application relates to optical spectrometry systems
and, more particularly, to optical spectrometry systems applied to
patient tissue to measure tissue hydration levels and to detect a
signal indicative of water content.
[0004] 2. Description of Related Art
[0005] Electrosurgical forceps utilize both mechanical clamping
action and electrical energy to effect hemostasis by heating the
tissue and blood vessels to coagulate, cauterize and/or seal
tissue. As an alternative to open forceps for use with open
surgical procedures, many modern surgeons use endoscopes and
endoscopic instruments 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.
[0006] Endoscopic instruments are inserted into the patient through
a cannula, or port, which has been made with a trocar. Typical
sizes for cannulas range from three millimeters (mm) to twelve
millimeters (mm). Smaller cannulas are usually preferred, which, as
can be appreciated, ultimately presents a design challenge to
instrument manufacturers who must find ways to make endoscopic
instruments that fit through the smaller cannulas.
[0007] Many endoscopic surgical procedures require cutting or
ligating blood vessels or vascular tissue. Due to the inherent
spatial considerations of the surgical cavity, surgeons often have
difficulty suturing vessels or performing other traditional methods
of controlling bleeding, e.g., clamping and/or tying-off transected
blood vessels. By utilizing an endoscopic electrosurgical forceps,
a surgeon can either cauterize, coagulate/desiccate and/or simply
reduce or slow bleeding simply by controlling the intensity,
frequency and duration of the electrosurgical energy applied
through the jaw members to the tissue. Most small blood vessels,
i.e., in the range below two millimeters in diameter, can often be
closed using standard electrosurgical instruments and techniques.
However, if a larger vessel is ligated, it may be necessary for the
surgeon to convert the endoscopic procedure into an open-surgical
procedure and thereby abandon the benefits of endoscopic surgery.
Alternatively, the surgeon can seal the larger vessel or
tissue.
[0008] It is thought that the process of coagulating vessels is
fundamentally different than electrosurgical vessel sealing. For
the purposes herein, "coagulation" is defined as a process of
desiccating tissue wherein the tissue cells are ruptured and dried.
"Vessel sealing" or "tissue sealing" is defined as the process of
liquefying the collagen in the tissue so that it reforms into a
fused mass. Coagulation of small vessels is sufficient to
permanently close them, while larger vessels need to be sealed to
assure permanent closure.
[0009] Thus, medical devices that apply electro-thermal energy for
vessel sealing, ablation, coagulation are known in the art. Tissue
conductance and permittivity are significant factors in the
therapeutic effect of such medical devices that apply the
electro-thermal energy to patient tissue. Displacement of water is
correlated with changes in tissue conductance and permittivity and
lack of control over such changes in tissue conductance and
permittivity can lead to overdessication during vessel sealing
procedures.
SUMMARY
[0010] To advance the state of the art with respect to application
of electro-thermal energy to patient tissue, the present disclosure
relates to a system and a method for monitoring water displacement
during treatment of patient tissue.
[0011] In one embodiment, the system for monitoring water
displacement in tissue during patient therapy includes a generator
configured to supply electrosurgical energy to tissue, a
spectrometer operably coupled to the generator, and a processor in
operative communication with the generator and with the
spectrometer. The spectrometer includes a light source for exposing
tissue to light and a light sensor. The light sensor is configured
to sense changes in light through tissue in response to tissue
treatment and communicate such changes to the processor to
determine tissue hydration levels. A plurality of optical fibers
may be operably coupled to the generator and configured to
communicate light between the generator and tissue. The plurality
of optical fibers may be configured in an array. The spectrometer
may be a near infra-red spectrometer providing light in the near
infrared wavelength range as the light source.
[0012] In one embodiment, the system may also include an optical
temperature monitor. The optical temperature monitor may be in
operative communication with the processor, and include at least
one optical fiber operatively coupled to the optical temperature
monitor. The one or more optical fibers are configured to enable
the optical temperature monitor to monitor the temperature of the
tissue where water displacement is optically monitored. The one or
more optical fibers may be configured within a plurality of optical
fibers wherein at least one optical fiber is operatively coupled to
the light source to enable transmitting light towards the tissue
and at least one optical fiber is configured to receive light
reflected from the tissue and to transport the light to the light
sensor. The plurality of optical fibers may be configured in an
optical array. The plurality of optical fibers of the optical array
may be configured to have an optic fiber distance between adjacent
optical fibers. The optical fiber distance is within the range of
about 0.25 millimeters (mm) to about 4.0 mm to optimize the
transmission of light through tissue to determine hydration
levels.
[0013] In one embodiment, the processor is configured to record
and/or analyze changes in hydration of the tissue sensed by the
spectrometer across the optic fiber distance. In addition, the
processor may be configured to record and/or analyze changes in
temperature of the tissue sensed by the optical temperature
monitor. The sensed temperature may be used to calculate
compensation for the temperature effect on hydration measured by
the spectrometer.
[0014] In one embodiment, the system is incorporated in an
electrosurgical pencil that includes a housing having proximal and
distal ends, and a blade receptacle defined at a distal end of the
housing for supporting an electrosurgical blade therein. The
electrosurgical blade is disposed in optical communication with the
light source and light sensor for monitoring hydration levels in
tissue during operation of the electrosurgical pencil.
[0015] In one embodiment, the system is incorporated in an
electrosurgical forceps that includes a pair of first and second
jaw members disposed in pivotal relationship with respect to one
another and attached to a distal end of at least one shaft. Each
jaw member supports an electrically conductive surface thereon, at
least one of the jaw members is disposed in optical communication
with the light source and the other of the jaw members is disposed
in optical communication with the light sensor for monitoring
hydration levels in tissue during operation of the electrosurgical
forceps.
[0016] The present disclosure relates also to a method for
monitoring water displacement in tissue during patient therapy. The
method includes the steps of providing a spectrometer including a
light source in operative communication with patient tissue,
generating light from the light source, reflecting the light
through the patient tissue; and receiving the light reflected
through the patient tissue with a light sensor. The method may
include supplying electrosurgical energy to patient or subject
tissue utilizing an energy source, sensing changes in light through
the tissue in response to tissue treatment, and determining changes
in tissue hydration levels based on the sensed changes in light
through the tissue. In addition, the method may include providing a
processor for analyzing the sensed changes in light through the
tissue, and determining the changes in hydration levels in the
tissue based on the sensed changes in light through the tissue. The
processor may operatively communicate with the spectrometer to
regulate the supply of electrosurgical energy to the tissue. The
method may also include configuring a plurality of optical fibers
in an array, wherein the array enables at least one of the
plurality of optical fibers operatively coupled to the light source
and enables at least one optical fiber of the plurality of optical
fibers to be configured to enable transporting light reflected from
the tissue to be separated to effect an optic fiber distance within
the tissue. That is, the processor may be operatively coupled to
the spectrometer and/or the supply of electrosurgical energy.
[0017] In one embodiment, the method includes providing an optical
temperature monitor, providing at least one optical fiber
operatively coupled to the optical temperature monitor, and
monitoring the temperature of the tissue where water displacement
is optically monitored. Knowledge of the temperature of the tissue
can be used to provide more accurate measurement of tissue
hydration.
[0018] In one embodiment, the present disclosure relates to an
electrically conductive member for use with an electrosurgical
instrument. The electrically conductive member includes a surface
configured to engage patient tissue and adapted to connect to a
source of electrosurgical energy. The electrically conductive
member also includes at least one optical transmitter that is
configured to propagate light through patient tissue and at least
one corresponding optical sensor configured to sense changes in
reflected light propagating through patient tissue during operation
of the electrosurgical instrument and relating the changes in
reflected light through patient tissue to hydration levels in
tissue.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] Various embodiments are described herein with reference to
the drawings:
[0020] FIG. 1 is a perspective view of an electrode assembly of an
electrosurgical pencil according to the present disclosure
illustrating one embodiment of an end effector assembly having an
optical transmitter positioned to propagate light through patient
tissue and optical sensors positioned to sense at least a portion
of the light propagating through patient tissue for monitoring
hydration levels in tissue during operation of the electrosurgical
pencil;
[0021] FIG. 2A is a perspective view an ES pencil blade of the end
effector assembly of FIG. 1;
[0022] FIG. 2B is a cross-sectional view of the pencil blade of the
end effector assembly taken along section line 2B-2B of FIG.
2A;
[0023] FIG. 2C is a perspective view of another embodiment of the
pencil blade of the electrocautery end effector assembly of FIG. 1
having an optical transmitter and an optical sensor;
[0024] FIG. 2D is a cross-sectional view of the pencil blade of the
electrocautery end effector assembly taken along section line 2D-2D
of FIG. 2C
[0025] FIG. 3A is a schematic view of one embodiment of an optical
transmitter wherein light is reflected by a prism;
[0026] FIG. 3B is a schematic view of one embodiment of an optical
sensor wherein light is reflected by a prism;
[0027] FIG. 3C is a schematic view of one embodiment of a
dual-function optical transmitter and optical sensor wherein light
is reflected by a prism;
[0028] FIG. 4A is a schematic view of one embodiment of an optical
transmitter wherein light is transmitted by a light emitting
diode;
[0029] FIG. 4B is a schematic view of one embodiment of an optical
sensor wherein light is sensed by a light emitting diode;
[0030] FIG. 5A is a perspective view of another embodiment of the
pencil blade of the end effector assembly of FIG. 1 having an
optical transmitter and an optical sensor;
[0031] FIG. 5B is a cross-sectional view of the pencil blade of the
end effector assembly taken along section line 5B-5B of FIG.
5A;
[0032] FIG. 6A is a perspective view of another embodiment of the
pencil blade of the end effector assembly of FIG. 1 having an
optical transmitter and an optical sensor;
[0033] FIG. 6B is a cross-sectional view of the pencil blade of the
electrocautery end effector assembly taken along section line 6B-6B
of FIG. 6A;
[0034] FIG. 7 is a schematic view of one embodiment of an
electrically conductive member for use with an electrosurgical
instrument according to the present disclosure in which one optical
transmitter and two optical sources are disposed substantially
linearly on a surface of the electrically conductive member;
[0035] FIG. 7A is a schematic view of the electrically conductive
member of FIG. 7 taken along section line 7A-7A;
[0036] FIG. 8 is a schematic view of another embodiment of an
electrically conductive member for use with an electrosurgical
instrument according to the present disclosure in which one optical
transmitter and two optical sources are disposed substantially
linearly on a surface of the electrically conductive member;
[0037] FIG. 9 is a schematic view of yet another embodiment of an
electrically conductive member for use with an electrosurgical
instrument according to the present disclosure having a circular
array of optical sensors and an optical transmitter disposed on a
surface of the electrically conductive member;
[0038] FIG. 10 is a schematic view of still another embodiment of
an electrically conductive member for use with an electrosurgical
instrument according to the present disclosure having a circular
array of optical transmitters and an optical sensor disposed on a
surface of the electrically conductive member;
[0039] FIG. 11 is a schematic view of another embodiment of an
electrically conductive member for use with an electrosurgical
instrument according to the present disclosure having two circular
arrays of optical transmitters and optical sensors disposed on a
surface of the electrically conductive member;
[0040] FIG. 12A is a schematic view of a surface of an electrically
conductive member for use with an electrosurgical instrument
according to the present disclosure having an array of optical
transmitters and optical sensors disposed in channels on the suface
of the electrically conductive member;
[0041] FIG. 12B is an end view of the electrically conductive
member of FIG. 12A for an electrosurgical pencil;
[0042] FIG. 12B' is an end view of the electrically conductive
member of FIG. 12A for a bipolar electrosurgical forceps;
[0043] FIG. 12C is a schematic view of the electrically conductive
member of FIG. 12B taken along section line 12C-12C;
[0044] FIG. 12C' is a view of the electrically conductive member of
FIG. 12B' taken along section line 12C'-12C';
[0045] FIG. 13 is an enlarged view of an end of an optical fiber
illustrated in FIG. 12C';
[0046] FIG. 14 is a perspective view of a bipolar electrosurgical
forceps according to the present disclosure illustrating one
embodiment of an end effector assembly having an optical
transmitter positioned to propagate light through patient tissue
and optical sensors positioned to sense light propagating through
patient tissue for monitoring hydration levels in tissue during
operation of the bipolar forceps;
[0047] FIG. 14A is an enlarged perspective view of the embodiment
of the jaw members of the end effector assembly of FIG. 14;
[0048] FIG. 14B is a profile view of another embodiment of the jaw
members of the end effector assembly of FIG. 14;
[0049] FIG. 14C is an enlarged perspective view of another
embodiment of the jaw members of the end effector assembly of FIG.
14;
[0050] FIG. 15A is a schematic, side view of another embodiment of
the jaw members of the end effector assembly of FIG. 14;
[0051] FIG. 15B is a schematic, view of the lower jaw member of the
end effector assembly of FIG. 15A taken along section line
15B-15B;
[0052] FIG. 15C is a schematic, side view of another embodiment of
the jaw members of the end effector assembly of FIG. 14;
[0053] FIG. 15D is a schematic view of the lower jaw member of the
end effector assembly of FIG. 15C taken along section line
15D-15D;
[0054] FIG. 16 is a schematic, side view of another embodiment of
an end effector assembly according to the present disclosure for a
parallel jaw type bipolar electrosurgical forceps assembly having
an optical transmitter positioned to propagate light through
patient tissue and optical sensors positioned to sense light
propagating through patient tissue for monitoring hydration levels
in tissue during operation of the bipolar forceps;
[0055] FIG. 16A is an enlarged view of the area of detail 16A
illustrated in FIG. 16;
[0056] FIG. 17 is a schematic, side view of another embodiment of
the parallel jaw type bipolar electrosurgical forceps assembly of
FIG. 16 having an optical transmitter positioned to propagate light
through patient tissue and optical sensors positioned to sense
light propagating through patient tissue for monitoring hydration
levels in tissue during operation of the bipolar forceps;
[0057] FIG. 18 is a schematic, side view of yet another embodiment
of the parallel jaw type bipolar electrosurgical forceps assembly
of FIG. 16 having an optical transmitter positioned to propagate
light through patient tissue and optical sensors positioned to
sense light propagating through patient tissue for monitoring
hydration levels in tissue during operation of the bipolar
forceps;
[0058] FIG. 19 is a schematic view of a system for monitoring water
displacement during treatment of patient tissue according to the
present disclosure;
[0059] FIG. 20 is a schematic view of one embodiment of the
mechanical-optical multiplexer switch included within the system
for monitoring water displacement of FIG. 19 as configured with
respect to the array of optical transmitters and optical sensors
illustrated in FIG. 11; and
[0060] FIG. 21 is a view of an optical alignment member included
within the mechanical-optical multiplexer switch taken along
section line 21-21 illustrated in FIG. 20.
DETAILED DESCRIPTION
[0061] The present disclosure relates to a system and method for
detecting water displacement and/or water hydration levels in
tissue by arranging optic fibers in an array on the tissue
contacting surfaces. Optic fibers are configured at one end to
connect the fibers to a light source and at an opposite end to
terminate in an array such that the light is transmitted into the
tissue may be measured and/or monitored. Several light sensing
optic fibers may also be included in the array and disposed in
close proximity to the lens of the fiber optic that is the source.
The end of the sensing optic fiber opposite the array is connected
to a spectrometer. The configuration of the array can be designed
into many different configurations and is not necessarily limited
in this disclosure. The configuration may be dependent on the type
of tissue and the geometry of the application. Applications include
by are not limited to medical devices that use electro-thermal
energy. The spacing and placement of the optical fiber elements of
the optical array are specified such that discrete changes in
hydration of the tissue over time can be recorded. These recorded
discrete hydration changes together with the known array geometry
can be analyzed (for example, by computer) to provide information
on the displacement of water in the tissue. The source and detected
wavelengths are selected to optimize the detection of water.
[0062] One application of this type of optical array is the
placement of the array in close proximity to a thermal ablation
probe. The displacement of water is correlated with changes in
tissue conductance and permittivity. Tissue conductance and
permittivity are significant factors in the therapeutic effect of
medical devices that use electro-thermal energy.
[0063] A series of probes measures the hydration of a multitude of
tissues. A probe or probes are placed in an array at a location
where the sensors receiving the reflected signal are placed in the
array so that changes in hydration can be monitored. Dynamic
changes of hydration during energy treatment of tissue can be
recorded, analyzed, and utilized to control delivery of
electrosurgical energy during the course of tissue treatment.
[0064] Turning now to FIG. 1, there is illustrated a partial view
of electrosurgical pencil 100 that includes a housing 102 defining
an open distal end 103a for selectively receiving proximal end 108
of electrocautery blade 106 therein. Open distal end 103a defines a
blade receptacle 105 for blade 106. (The proximal end 103b of the
housing 103 is not entirely shown).
[0065] In one embodiment, electrocautery blade 106 is supported in
a collar 120. Collar 120 is positioned between distal end 110 and
proximal end 108 of electrocautery blade 106. Collar 120 has a
shaped outer surface 120a configured and dimensioned to complement
the inner profile of receptacle 105 of open distal end 103a. In one
embodiment, the open distal end 103a of housing 102 defines a
hexagonally-shaped inner profile of receptacle 105 and collar 120
defines a hexagonal outer surface 120a. The blade 106 and the
collar 120 define an electrocautery end effector assembly 112 that
is operatively connectable to the blade receptacle 105.
[0066] Such an electrosurgical pencil is disclosed in commonly
owned US Patent Application Publication No. 2006/0178667, U.S.
patent application Ser. No. 11/337,990 by Sartor et al., entitled
"ELECTROSURGICAL PENCIL WITH ADVANCED ES CONTROLS," the entire
contents of which is incorporated by reference herein.
[0067] Blade receptacle 105 is defined at the distal end 103a of
the housing for supporting the electrosurgical blade 106 therein.
The electrosurgical blade 106 is configured to be connected to a
source of electrosurgical energy, e.g., an electrosurgical
generator, not shown.
[0068] Turning initially to FIGS. 3A through 4B, there are various
illustrated embodiments of optical transmitters and optical sensors
for use with end effector assembly 112. As defined herein, an
optical transmitter includes, but is not limited to, small diameter
optical fibers, e.g., having a diameter ranging up to about 1
millimeter (mm); large diameter optical fibers, e.g. having a
diameter ranging up to about 2 mm; prisms that reflect at least a
portion of light propagating therethrough, optical fibers having at
least one end with a tapered configuration to function as a prism,
light-emitting electronic devices such as a light-emitting diodes
(LED), or electrical cable s that transmit electrical signals that
provide optical information from a light source. As defined herein,
an electrical cable is capable of providing optical communication
between a light source and a light-emitting electronic device.
Photo-electric detectors convert photonic signals to electrical
signals, and light-emitting electronic devices such as
light-emitting diodes convert electrical signals to photonic
signals.
[0069] Such optical transmitters may be configured as single
members or in an assembly of one or more members of the same
category in optical communication with one another or in an
assembly of one or more members of different categories in optical
communication with one another.
[0070] As defined herein, an optical sensor includes, but is not
limited to, small diameter optical fibers, e.g., having a diameter
ranging up to about one (1) millimeter (mm); large diameter optical
fibers, e.g. having a diameter ranging up to about two (2) mm;
prisms that reflect at least a portion of light propagating
therethrough, optical fibers having at least one end with a tapered
configuration that functions as a prism, light-sensing electronic
devices such a photo-electric detector or photosensor, or
electrical cables that transmit electrical signals that provide
optical information from a photo-electric detector. Such
photoelectric detectors may be made from, for example, gallium
arsenide (GaAs), indium phosphide (InP), gallium phosphide (GaP),
indium gallium arsenide (InGaAs), silicon germanium (SiGe),
germanium (Ge), germanium tin (GeSn), sulfur germanium tin (SGeSn)
and the like. As defined herein, an electrical cable is capable of
providing optical communication between a photo-electric detector
and a light-emitting electronic device. Photo-electric detectors
convert photonic signal to electrical signals, and light-emitting
electronic devices such as light-emitting diodes convert the
electrical signals to photonic signals.
[0071] Similarly, such optical sensors may be configured as single
members or in an assembly of one or more members of the same
category in optical communication with one another or in an
assembly of one or more members of different categories in optical
communication with one another.
[0072] Optical sensors include, but are not limited to, optical
detectors that are mostly quantum devices in which an individual
photon produces a discrete effect; photoresistors or light
dependent resistors in which resistance is a function of light
intensity; photodiodes operating in a photovoltaic mode or in a
photoconductive mode; photovoltaic cells or solar cells producing a
voltage and an electric current when illuminated; photomultiplier
tubes containing a photocathode that emits electrons when
illuminated and wherein the electrons may be amplified by a chain
of dynodes; phototubes containing a photocathode that emits
electrons when illuminated wherein the tube conducts a current
proportional to the light intensity; light-emitting devices (LEDs)
that are reverse-biased to act as photodiodes; phototransistors
that function as amplifying photodiodes; optical detectors that
function as thermometers converting heat of incoming radiation to
an electrical current, such as pyroelectric detectors, Golay cells,
thermocouples and thermistors
[0073] Additionally, as defined herein, an optical transmitter may
also function alternately as an optical sensor to serve as a dual
function optical transmitter and optical receiver. A dual function
optical transmitter and optical receiver may include a multiplexer
device.
[0074] Returning specifically to FIG. 3A, optical transmitter 202
includes one or more optical fibers e.g., optical fibers 204a,
204b, and 204c and/or one or more light reflecting prisms 206 in
optical communication with corresponding optical fibers 204a, 204b
and/or 204c. The optical transmitter 202 may include a large
diameter single optical fiber 208 in optical communication with
patient tissue (not shown). The diameter of optical fiber 208
ranges up to about 3 mm. Light 10 is illustrated propagating
through the optical fibers 204a, 204b and 204c to prism 206 wherein
the light 10 is reflected by the prism 306 to a large diameter
single optical fiber 208 propagates the light to patient
tissue.
[0075] FIG. 3B illustrates an optical sensor 202' that also
includes one or more optical fibers e.g., optical fibers 204a,
204b, and 204c and/or one or more light reflecting prisms 206 in
optical communication with corresponding optical fibers 204a', 204
b' and/or 204c'. The optical sensor 202 may include a large
diameter single optical fiber 208 in optical communication with
patient tissue (not shown). Optical sensor 202' differs from
optical transmitter 202 in that light 10' travels in the reverse
direction as compared to light 10. More particularly, light 10' is
illustrated propagating from the patient tissue (again not shown)
through the large diameter optical fiber 208 to prism 206 wherein
the light 10' is reflected by the prism 206 to optical fibers
204a', 204b' and 204c'. Additionally, optical fibers 204a', 204b'
and 204c' may have diameters which differ from one another so as to
propagate differing wavelengths of light. The diameters of optical
fibers 204a', 204b' and 204c' may also differ from the diameters of
optical fibers 204a, 204b and 204c of optical transmitter 202
described with respect to FIG. 3A.
[0076] FIG. 3C illustrates one embodiment of a dual function
optical transmitter and optical sensor 202'' wherein light 10'' may
propagate to patient tissue (again not shown) and alternately
propagate from patient tissue. More particularly, dual-function
optical transmitter and optical sensor 202'' is substantially
identical to optical transmitter 202 and optical sensor 202' except
for the inclusion of optical multiplexer 210 in the path of optical
fibers 204a, 204b and 204c. The optical multiplexer (MUX) 210 is in
optical communication with proximal optical fibers 214a, 214b and
214c and with distal optical fibers 204a, 204b and 204c
[0077] In the transmission phase of operation, light 10''
propagates from the proximal side of MUX 210 through the proximal
optical fibers 214a, 214b and 214c through the MUX 210 to the
distal optical fibers 204a, 204b and 204c. As is the case for
optical transmitter 202, light 10'' is reflected by the prism 206
to propagate through the large optical fiber 208 to pass through
patient tissue.
[0078] In the sensing phase of operation, light 10'' propagates
from patient tissue where the light 10'' is detected by the large
diameter optical fiber 208 and propagates to the prism 206 wherein
the light 10'' is reflected by the prism 206 to distal optical
fibers 204a, 204b and 204c. The light 10'' propagates to the MUX
210 where the light is selectively propagated by switching to at
least one or more of the proximal optical fibers 214a, 214b and
214c.
[0079] FIG. 4A illustrates an alternate embodiment of an optical
transmitter 2510. More particularly, optical transmitter 2510
includes electrical cable 2541 that is capable of providing optical
communication between a light source (to be described below with
respect to FIGS. 18-20), and a light-emitting electronic device
2561 such as a light-emitting diode. A photo-electric detector (not
shown) converts a photonic signal to an electrical signal. The
light-emitting electronic device 256 converts the electrical signal
to a photonic signal resulting in light 101 being emitted from the
light-emitting electronic device 256 to propagate through large
diameter optical fiber 208 to patient tissue (also not shown).
[0080] FIG. 4B illustrates an alternate embodiment of an optical
sensor 2520. More particularly, optical sensor 2520 includes
electrical cable 2542 that is capable of providing optical
communication between photo-electric detector 2562 and a light
detector (to be described below with respect to FIGS. 18-20). Light
102 propagating through patient tissue (not shown) propagates to
large diameter optical fiber 208 in contact with patient tissue.
The photo-electric detector 2520 detects the light 102 propagating
through the large diameter optical fiber 208 and converts the
photonic signal to an electrical signal. The electrical signal
communicates with the light detector (to be described below).
[0081] Returning to FIGS. 2A and 2B, one embodiment of
electrocautery blade 106 is shown. More particularly,
electrocautery blade 106a defines a proximal end 150a and a distal
end 150b. The blade 106a has a substantially planar configuration
having a generally convex lateral cross-section defining one or
more peripheral edges 120 and one or more lateral surfaces, e.g.,
first surface 1301a and second surface 1301b. The blade 106a
includes a cylindrical shaft 140 defining a hollow central region
140' therewithin and extending to a proximal end 144 of
substantially planar region 152 of the blade 106a. The hollow shaft
140 extends to the substantially planar region 152 to define a
circumferential recess 142 around the outer surface of the hollow
shaft 140.
[0082] The electrosurgical blade 106a is configured with one or
more optical transmitters 202 positioned to propagate light 10
through patient tissue and one or more optical sensors 202'
positioned to sense at least a portion of the light 10' propagating
through patient tissue for monitoring hydration levels in tissue
during operation of the electrosurgical pencil 100.
[0083] More particularly, the electrosurgical blade 106a is
configured wherein optical transmitters 2021a and 2022a (shown
partially) propagate light through patient tissue via the first
lateral surface 1301a while optical transmitters 2021b (2022b, not
shown) propagate light through patient tissue via the second
lateral surface 1301b. Optical transmitters 2021a, 2022a, 2021b
(and 2022b, not shown) are configured with prism 206 and the
optical fibers described with respect to optical transmitter 202 in
FIG. 3A.
[0084] Similarly, the electrosurgical blade 106a is configured
wherein optical sensors 2021a' and 2022a' (shown partially) sense
at least a portion of the light propagating through the patient
tissue via the first lateral surface. 1301a while optical sensors
2021b' (and corresponding optical sensors not shown) sense at least
a portion of the light propagating through the patient tissue via
the second lateral surface 1301b. Optical sensors 2021a', 2022a',
2021b' (and corresponding optical sensors not shown) are also
configured with prism 206 and the optical fibers described with
respect to the optical sensor 202' in FIG. 3B. As indicated, the
diameters of the sensing optical fibers 204a', 204b', 204c' may
differ from one another. The optical sensors 2021a' and 2021b' may
be positioned proximally on the electrosurgical blade 106a with
respect to the optical transmitters 2021a and 2021b.
[0085] The transmission optical fibers 204a, 204b, 204c and the
sensing optical fibers 204a', 204b', 204c' are routed through the
hollow central region 140' of the shaft 140 and further through the
housing 102.
[0086] Turning now to FIGS. 2C and 2D, there is illustrated another
embodiment of electrocautery blade 106. More particularly,
electrocautery blade 106b again defines proximal end 150a and
distal end 150b. The blade 106b has a substantially planar
configuration having a generally convex lateral cross-section
defining at least one peripheral edge 1202 and at least one lateral
surface, e.g., first surface 1302a and second surface 1302b (not
explicitly shown on the opposing side of first surface 1302a). The
blade 106b includes cylindrical shaft 140 defining hollow central
region 140' therewithin and extending to proximal end 144 of
substantially planar region 152 of the blade 106b. The hollow shaft
140 extends to the substantially planar region 152 to define a
circumferential recess 142 around the outer surface of the hollow
shaft 140.
[0087] The electrosurgical blade 106b is again configured with at
least one optical transmitter 202 positioned to propagate light 10
through patient tissue and at least one optical sensor 202'
positioned to sense at least a portion of the light 10' propagating
through the patient tissue for monitoring hydration levels in
tissue during operation of the electrosurgical pencil 100.
[0088] More particularly, the electrosurgical blade 106b is
configured wherein optical transmitters 2023a and 2023b propagate
light through the patient tissue via first and second lateral
portions 1202a and 1202b, respectively, of peripheral edge 1202.
Additionally, the electrosurgical blade 106b is configured wherein
optical sensors 2023a' and 2023b' sense at least a portion of the
light propagating through the patient tissue via first and second
lateral portions 1202a and 1202b, respectively, of peripheral edge
1202.
[0089] Optical transmitters 2023a and 2023b are configured with
prism 206 and the optical fibers described with respect to optical
transmitter 202 in FIG. 3A. Optical sensors 2023a' and 2023b' are
also configured with prism 206 and the optical fibers described
with respect to the optical sensor 202' in FIG. 3B, except that
large diameter single optical fiber 208 is replaced by more than
one smaller diameter optical fibers similar to 204a', 204b', 204c'.
As indicated, the diameters of the sensing optical fibers 204a',
204b', 204c' may differ from one another. The optical sensors
2023a' and 2023b' may be positioned on the electrosurgical blade
106b proximally with respect to optical transmitters 2023a and
2023b.
[0090] The transmission optical fibers 204a, 204b, 204c and the
sensing optical fibers 204a', 204b', 204c' are routed through the
hollow central region 140' of the shaft 140 and further through the
housing 102.
[0091] Turning now to FIGS. 5A and 5B, there is illustrated still
another embodiment of electrocautery blade 106. More particularly,
electrocautery blade 106c again defines proximal end 150a and
distal end 150b. The blade 106c again has a substantially planar
configuration having a generally convex lateral cross-section
defining at least one peripheral edge 1203 and at least one lateral
surface, e.g., first surface 1303a and a second surface not
explicitly shown on the opposing side of first surface 1303a. The
blade 106c again includes cylindrical shaft 140 defining hollow
central region 140' therewithin and extending to proximal end 144
of substantially planar region 152 of the blade 106c. The hollow
shaft 140 extends to the substantially planar region 152 to define
a circumferential recess 142 around the outer surface of the hollow
shaft 140.
[0092] In contrast to electrosurgical blades 106a and 106b, the
electrosurgical blade 106c is configured with at least one optical
transmitter 2510 positioned to propagate light 1001 through patient
tissue, but, in a similar manner as with respect to electrosurgical
blades 106a and 106b, with at least one optical sensor 202'
positioned to sense at least a portion of the light 10' propagating
through the patient tissue for monitoring hydration levels in
tissue during operation of the electrosurgical pencil 100.
[0093] More particularly, the electrosurgical blade 106c is
configured wherein optical transmitters 2511a and 2511b propagate
light through the patient tissue via first and second lateral
portions 1203a and 1203b, respectively, of peripheral edge 1203.
Thus, the optical transmitters 2511a and 2511b include electrical
cables 2541a and 2541b and light-emitting electronic devices 2561a
and 2561b and large diameter optical fibers 2081a and 2081b,
respectively, as described with respect to optical transmitter 2510
in FIG. 4A. Additionally, the electrosurgical blade 106c is
configured wherein optical sensors 2024a' and 2024b' sense at least
a portion of the light propagating through the patient tissue via
first and second lateral portions 1203a and 1203b, respectively, of
peripheral edge 1203.
[0094] Optical sensors 2024a' and 2024b' are also configured with
prism 206 and the optical fibers described with respect to the
optical sensor 202' in FIG. 3B, except that large diameter single
optical fiber 208 is replaced by more than one smaller diameter
optical fibers similar to 204a', 204b', 204c'. As indicated, the
diameters of the sensing optical fibers 204a', 204b', 204c' may
differ from one another.
[0095] The transmitting electrical cables 2541a and 2541b and the
sensing optical fibers 204a', 204b', 204c' are again routed through
the hollow central region 140' of the shaft 140 and further through
the housing 102.
[0096] FIGS. 6A and 6B illustrate yet another embodiment of
electrocautery blade 106. More particularly, electrocautery blade
106d again defines proximal end 150a and distal end 150b. The blade
106d has a substantially planar configuration having a generally
convex lateral cross-section defining at least one peripheral edge
1204 and at least one lateral surface, e.g., first surface 1304a
and a second surface not explicitly shown on the opposing side of
first surface 1304a. The blade 106d includes cylindrical shaft 140
defining hollow central region 140' therewithin and extending to
proximal end 144 of substantially planar region 152 of the blade
106c. The hollow shaft 140 extends to the substantially planar
region 152 to define a circumferential recess 142 around the outer
surface of the hollow shaft 140.
[0097] In contrast to electrosurgical blades 106a, 106b or 106c,
the electrosurgical blade 106d is configured with at least one
optical transmitter 202 positioned to propagate light 10 through
patient tissue, but, with at least one optical sensor 2520
positioned to sense at least a portion of the light 1002
propagating through the patient tissue for monitoring hydration
levels in tissue during operation of the electrosurgical pencil
100.
[0098] More particularly, the electrosurgical blade 106d is
configured wherein optical transmitters 2025a and 2025b propagate
light through the patient tissue via first and second lateral
portions 1204a and 1204b, respectively, of peripheral edge 1204.
Thus, the optical transmitters 2025a and 2025b include large
diameter optical fibers 2082a and 2082b, respectively, as described
with respect to optical transmitter 202 in FIG. 3A.
[0099] Optical sensors 2025a and 2025b are also configured with
prism 206 and the optical fibers described with respect to the
optical sensor 202' in FIG. 3A.
[0100] Additionally, the electrosurgical blade 106d is configured
wherein optical sensors 2521a' and 2521b' sense at least a portion
of the light propagating through the patient tissue also via first
and second lateral portions 1204a and 1204b, respectively, of
peripheral edge 1204. The optical sensors 2521a' and 2521b' include
the electrical cables 2542a' and 2542b' and photo-electric
detectors 2562a' and 2562b' and each with a plurality of optical
fibers similar to optical fibers 204a', 204b' and 204c' on the
first and second portions 1204a and 1204b, respectively, of the
lateral edge 1204. as described with respect to optical sensor 2520
in FIG. 4B, thereby sensing at least a portion of the light
propagating through the patient tissue.
[0101] Additionally, the electrosurgical blade 106d is configured
wherein optical sensors 2521a' and 2521b' may be positioned
proximally on the electrosurgical blade 106d with respect to the
optical transmitters 2025a and 2025b.
[0102] The transmitting optical fibers 204a, 204b, 204c and the
sensing electrical cables 2542a and 2542b are routed through the
hollow central region 140' of the shaft 140 and further through the
housing 102.
[0103] FIGS. 7-11 and 12A, 12B, 12C and 13 illustrate various
embodiments of an electrically conductive member 300 for use with
an electrosurgical instrument. The electrically conductive member
300 has a surface 302 that is configured to be in contact with
patient tissue (not shown) and to be connected to a source of
electrosurgical energy (not shown),
[0104] As described in more detail below, the electrically
conductive member 300 is configured with one or more optical
transmitters positioned in an array to propagate light through
patient tissue and one or more optical sensors positioned in an
array to sense via reflectance by the patient tissue at least a
portion of the light propagating through the patient tissue for
monitoring hydration levels in tissue during operation of the
electrosurgical pencil.
[0105] Turning particularly to FIGS. 7 and 7A, and in conjunction
with FIGS. 4A and 4B, electrically conductive member 300a has
surface 302a that is configured to be in contact with, or to engage
with, patient tissue (not shown) and adapted to connect to a source
of electrosurgical energy (not shown), The surface 302a is
configured with one more optical transmitters 2512 positioned in an
array to propagate light through patient tissue and at least one
optical sensor, e.g., two optical sensors 2522 and 2523 positioned
in an array, configured to sense changes in reflected light, e.g.,
via reflectance by the patient tissue, at least a portion of the
light propagating through the patient tissue during operation of
the electrosurgical instrument and relating the changes in
reflected light to hydration levels in tissue during operation of
the electrosurgical pencil.
[0106] The optical sensors 2522' and 2523' may include first
optical fibers 2522a' and 2523a', second optical fibers 2522b' and
2523b', and third optical fibers 2522c' and 2523c', respectively,
wherein the diameter of the first optical fibers 2522a' and 2523a'
differs from the diameter of the second optical fibers 2522b' and
2523b', and the diameter of the third optical fibers 2522c' and
2523c' differs from the diameters of the first and second optical
fibers.
[0107] The optical transmitters 2512 are disposed substantially
linearly to form on the surface a single line of optical fibers
2512a that is disposed distally from the two optical sensors 2522'
and 2523. The optical fibers of optical sensors 2522' and 2523' are
disposed substantially linearly to form first and second lines of
optical fibers 2522a', 2522b', 2522c' and 2523a', 2523b', 2523c',
respectively. The optical transmitters 2512 may be disposed
substantially linearly relative to one another along an axis "A"
defined through the electrically conductive member 300a from a
proximal end to a distal end thereof. The optical transmitters 2512
may be disposed distally relative to the optical sensors 2522' and
2523'. The optical sensors 2522' and 2523' may correspond to the
optical transmitters 2512.
[0108] As illustrated in FIG. 7A, in a similar manner as with
respect to the optical transmitter 2510 described with respect to
FIG. 4A, the optical transmitter 2512 includes electrical cable
2541, light-emitting electronic device 2561 and the single line of
optical fibers 2512a. In addition, in a similar manner as with
respect to the optical sensor 2520 described with respect to FIG.
4B, optical sensors 2522' and 2523' include electrical cables 2542'
and 2543', photo-electric detector 2562' and 2563', and the optical
fibers 2522a', 2522b', 2522c' and 2523a', 2523b', 2523c',
respectively.
[0109] Upon emission of light from the light-emitting electronic
device 2561, light path 301 propagates from the single line of
optical fibers 2512a to first line of optical fibers 2522a',
2522b', 2522c' of first optical sensor 2522'. Similarly, light path
311 propagates from the single line of optical fibers 2512a to
second line of optical fibers 2523a', 2523b', 2523c' of second
optical sensor 2523'.
[0110] As explained below in more detail with respect to FIGS.
19-20, the different diameters of the optical fibers of the optical
sensors 2522' and 2523' enable monitoring of water motility within
the patient tissue during the electrosurgical procedure.
[0111] FIG. 8 illustrates an alternate embodiment of the
electrically conductive member 300 having surface 302. More
particularly, electrically conductive member 300b is an alternate
embodiment of the electrically conductive member 300a described
above with respect to FIGS. 7 and 7A. Again, the electrically
conductive member 300b includes the at least two optical sensors
2522' and 2523'. The optical fibers 2522a', 2522b', 2522c' and
2523a', 2523b' 2523c' of the optical sensors 2522' and 2523',
respectively are disposed substantially linearly to form on surface
302b first and second lines. The first line 2522' is distal from
the second line 2523'.
[0112] Electrically conductive member 300b differs from
electrically conductive member 300a in that the optical fibers
2512a of the optical transmitter 2512 are disposed substantially
linearly to form a single line disposed between the first and
second lines of the two or more optical sensors 2522' and 2523'.
That is, the plurality of optical sensors 2522' and 2523' may be
disposed substantially linearly along an axis "B" defined through
the electrically conductive member 300b. The optical sensors 2522'
and 2523' may be disposed substantially linearly relative to one
another to form first and second lines of optical sensors on the
surface 302b. The second line of optical sensors 2522' may be
distal from the first line of optical sensors 2523'.
[0113] As illustrated in FIG. 7A, the optical transmitter 2512
forms a first light path in patient tissue. The first light
propagates by reflectance in the patient tissue to the first
optical sensor 2522' while the optical transmitter 2512 also forms
a second light path in patient tissue, wherein the second light
path propagates by reflectance in the patient tissue to the second
optical sensor 2523'. The diameters of the optical fibers 2522a',
2522b', 2522c' may differ from one another. Similarly, the
diameters of the optical fibers 2523a', 2523b', 2523c' may differ
from one another to allow propagation of light of differing
wavelengths.
[0114] The optical transmitter 2512 may also include the
light-emitting electronic device 2561 and electrical cable 2541
described previously with respect to FIG. 4A while the optical
sensors 2522', 2523' include the photo-electric detector 2562 and
electrical cable 2542 described previously with respect to FIG.
4B.
[0115] FIG. 9 illustrates yet another embodiment of the
electrically conductive member 300 having surface 302. More
particularly, electrically conductive member 300c includes one or
more optical transmitters 2513 and two or more optical sensors,
e.g., first optical sensor 2524' and second optical sensor 2525'.
The optical transmitter 2513 and the first and second optical
sensors 2524', 2525' are disposed in a pattern on surface 302c that
includes at least a first plurality of optical fibers 2524a',
2524b', 2524c' of optical sensor 2524' in a circumferential
arrangement and a second plurality of optical fibers 2525a',
2525b', 2525c' of optical sensor 2525' in a circumferentially
substantially concentric arrangement with respect to the first
plurality of optical fibers 2524a', 2524b', 2524c' of optical
sensor 2524'. That is, the first plurality of optical sensors 2524'
may be disposed in a first circumferential pattern on the surface
302c and the second plurality of optical sensors 2525' may be
disposed in a second circumferential pattern on the surface 302c
that is concentric to the first circumferential pattern of the
first plurality of optical sensors 2524'.
[0116] Optical fibers 2513a, 2513b, 2513c, 2513c, 2513d, 2513e of
optical transmitter 2513 are disposed substantially at the center
of the substantially concentric arrangement of the first and second
plurality of optical fibers 2524a', 2524b', 2524c' and 2525a',
2525b', 2525c' of the optical sensors 2524' and 2525',
respectively. That is, the optical transmitter 2513 may be disposed
substantially at the center of the concentric arrangement of the
first and second circumferential patterns of the optical sensors
2524' and 2525', respectively.
[0117] In view of the light paths 301 and 311 illustrated in FIG.
7A, the optical transmitter 2513 forms multiple light paths in
patient tissue distributed substantially radially away from the
optical fibers 2513a, 2513b, 2513c, 2513c, 2513d, 2513e. The light
propagates by reflectance in the patient tissue to the
substantially concentric arrangement of the first and second
plurality of optical fibers 2524a', 2524b', 2524c' and 2525a',
2525b', 2525c' of the optical sensors 2524' and 2525',
respectively. The diameters of the plurality of optical fibers
2524a', 2524b', 2524c' and 2525a', 2525b', 2525c' may again differ
from one another as explained above
[0118] In addition, the optical transmitter 2513 may include the
light-emitting electronic device 2561 and electrical cable 2541
described previously with respect to FIG. 4A while the optical
sensors 2524', 2525' include the photo-electric detector 2562 and
electrical cable 2542 described previously with respect to FIG.
4B.
[0119] FIG. 10 illustrates still another embodiment of the
electrically conductive member 300 having surface 302. More
particularly, electrically conductive member 300d includes two or
more optical transmitters, e.g., first optical transmitter 2514 and
second optical transmitter 2515. The optical transmitters 2514,
2515 are disposed in a pattern on surface 302d that includes at
least a first plurality of optical fibers 2514a, 2514b . . . 2514n
of optical transmitter 2514 in a circumferential arrangement and a
second plurality of optical fibers 2515a, 2515b . . . 2515n of
optical transmitter 2515 in a circumferential substantially
concentric arrangement with respect to the first plurality of
optical fibers 2514a, 2514b . . . 2514n. That is, the first
plurality of optical transmitters 2514 may be disposed in a first
circumferential pattern on the surface 302d and the second
plurality of optical transmitters 2515 may be disposed in a second
circumferential pattern on the surface 302d that is concentric to
the first circumferential pattern of the first plurality of optical
transmitters 2514.
[0120] Optical fibers 2526a', 2526b' and 2526c' of one or more
optical sensors 2526' are disposed substantially at the center of
the substantially concentric arrangement of the first and second
plurality of optical fibers 2514a, 2514b . . . 2514n and 2515a,
2515b . . . 2515n of optical transmitters 2514 and 2515,
respectively. That is, the optical sensor 2526' may be disposed
substantially at the center of the concentric arrangement of the
first and second circumferential patterns of the optical
transmitters 2514 and 2515, respectively.
[0121] In view of the light paths 301 and 311 illustrated in FIG.
7A, the optical transmitters 2514, 2515 form multiple light paths
in patient tissue distributed substantially radially towards the
optical fibers 2526a', 2526b', 2526c' of optical sensor 2526'. The
light propagates by reflectance in the patient tissue from the
substantially concentric arrangement of the first and second
plurality of optical fibers 2514a, 2514b . . . 2514n and 2515a,
2515b . . . 2515n of optical transmitters 2514 and 2515,
respectively. The diameters of the optical fibers 2526a', 2526b',
2526c' of optical sensor 2526' may again differ from one another to
allow propagation and sensing of light of different wavelengths.
The light-emitting electronic devices and photo-electric detectors
and electrical cables may be configured as described previously
with respect to FIGS. 4A and 4B.
[0122] FIG. 11 illustrates yet another embodiment of the
electrically conductive member 300 having surface 302. More
particularly, electrically conductive member 300e includes two or
more optical transmitters, e.g., first optical transmitter 2516 and
second optical transmitter 2517, and two or more optical sensors,
e.g., first optical sensor 2527' and second optical sensor 2528'.
The optical transmitters 2516, 2517 and the optical sensors 2527',
2528' are disposed in a pattern on surface 302e. At least a first
plurality of optical fibers 2516a, 2516b . . . 2516n and 2517a,
2517b . . . 2517n form at least a portion of the optical
transmitters 2516 and 2517, respectively, and are disposed in a
substantially circumferential arrangement.
[0123] At least a first plurality of optical fibers 2527a', 2527b',
2527c' and at least a second plurality of optical fibers 2528a',
2528b', 2528c' form at least a portion of the optical sensors 2527'
and 2528', respectively. The first and second plurality of optical
fibers 2527a', 2527b', 2527c' and 2528a', 2528b', 2528c' of optical
sensors 2527' and 2528', respectively, are disposed substantially
at the center of the substantially circumferential arrangement of
the first and second plurality of optical fibers 2516a, 2516b . . .
2516n and 2517a, 2517b . . . 2517n that form at least a portion of
the optical transmitters 2516 and 2517, respectively, to form a
first array of optical transmitting and sensing fibers. The first
array of optical transmitter 2516 and optical sensor 2527' is
disposed distally with respect to the second array of optical
transmitter 2517 and optical sensor 2528'. That is, the first
optical sensor 2527' may include fibers 2527a', 2527b', 2527c' that
form a first circumferential arrangement and the first optical
transmitter 2516 may be disposed substantially at the center of the
first circumferential arrangement of the fibers 2527a', 2527b',
2527c'. The second optical sensor 2528' may include fibers 2528a',
2528b', 2528c' that form a second circumferential arrangement and
the second optical transmitter 2517 may be disposed substantially
at the center of the second circumferential arrangement of the
fibers 2528a', 2528b', 2528c'. The second circumferential
arrangement may be disposed distally relative to the first
circumferential arrangement, along an axis "C" defined through the
electrically conductive member 302e.
[0124] In view of the light paths 301 and 311 illustrated in FIG.
7A, the optical transmitters 2516, 2517 form multiple light paths
in patient tissue distributed substantially radially towards the
respective optical fibers 2527a', 2527b', 2527c' of optical sensor
2527' and 2528a', 2528b', 2528c' of optical sensor 2528' in the
first and second arrays, respectively. Again, the light propagates
by reflectance in the patient tissue. The diameters of the optical
fibers 2527a', 2527b', 2527c' of optical sensor 2527' and of
optical fibers 2528a', 2528b', 2528c' of optical sensor 2528' may
again differ from one another to allow propagation and sensing of
light of different wavelengths.
[0125] First and second arrays of optical transmitters and optical
sensors may also be formed by replacing the concentrically arranged
optical fibers 2516a, 2516b . . . 2516n and 2517a, 2517b . . .
2517n of optical transmitters 2516 and 2517, respectively, with
optical sensors and by replacing the first and second plurality of
optical fibers 2527a', 2527b', 2527c' and 2528a', 2528b', 2528c' of
optical sensors 2527' and 2528', respectively, that are disposed
substantially at the center of the substantially circumferential
arrangement of the first and second plurality of optical fibers
2516a, 2516b . . . 2516n and 2517a, 2517b . . . 2517n with optical
transmitters.
[0126] FIGS. 12A, 12B, 12B', 12C, 12C' and 13 illustrate different
embodiments of yet another electrically conductive member 300 for
use with an electrosurgical instrument having a surface 302
according to the present disclosure. More particularly, FIGS. 12A,
12B, 12C and 13 illustrate an electrically conductive member 300f
having at least a first lateral surface 3021f and a second lateral
surface 3022f on an opposing side of the electrically conductive
member 300f.
[0127] The electrically conductive member 300f includes on first
and second lateral surfaces 3021f and 3022f one or more optical
transmitters, e.g., optical transmitters 3011a, 3011b, 3011c, 3011d
and 3012a, 3012b, 3012c, 3012d. The electrically conductive member
300f also includes on first and second lateral surfaces 3021f and
3022f one or more optical sensors, e.g., optical sensors 3011a',
3011b', 3011c' and 3012a', 3012b', 3012c'. The optical transmitters
3011a, 3011b, 3011c, 3011d and 3012a, 3012b, 3012c, 3012d and
optical sensors 3011a', 3011b', 3011c' and 3012a', 3012b', 3012c'
each may include an optical fiber having at least one end 3010 with
a tapered configuration to function as a prism. That is, the
optical transmitters 3011a, 3011b, 3011c, 3011d and 3012a, 3012b,
3012c, 3012d may each have tapered end 3010 that forms a prism.
[0128] As illustrated in FIGS. 12B and 12C, the optical sensors
3011a', 3011b', 3011c' and 3012a', 3012b', 3012c' are each
positioned in channels (for simplicity, the channels are not
separately numbered) in the respective surfaces 3021f and 3022f
having a depth within the electrically conductive member 300f that
is greater than the depth of channels (for simplicity, the channels
are not separately numbered) within which optical transmitters
3011a, 3011b, 3011c, 3011d and 3012a, 3012b, 3012c, 3012d are
positioned.
[0129] The tapered configuration ends 3010 of the optical
transmitters 3011a, 3011b, 3011c, 3011d and 3012a, 3012b, 3012c,
3012d are positioned within the respective surfaces 3021f and 3022f
to transmit light through patient tissue via the tapered
configuration ends 3010. Similarly, the tapered configuration ends
3010 of the optical sensors 3011a', 3011b', 3011c' and 3012a',
3012b', 3012c' are positioned within the respective surfaces 3021f
and 3022f to sense light propagating by reflectance, through
patient tissue via the tapered configuration ends 3010. For
simplicity, light 321 is identified in FIG. 13 as reflecting in
either direction to represent the two different functions of
transmission into the patient tissue and sensing by reflectance
from the patient tissue. The light 321 propagates and reflects
through patient tissue. The first and second lateral surfaces
3021f, 3022f may each include translucent heat-insulating layers
3031f and 3032f to cover the respective channels and the optical
fibers positioned therewithin.
[0130] The electrically conductive member 300f illustrated in FIGS.
12A, 12B, 12C and 13, which includes the optical transmitters and
optical sensors in both the first and second lateral surfaces
3021f, 3022f may be adapted as a blade for an electrosurgical
pencil in a similar manner as described previously with respect to
FIGS. 1 through 6b.
[0131] The electrically conductive member 300f' illustrated in
FIGS. 12A, 12B', 12C' and 13 is configured identically to the
electrically conductive member 300f except that only the optical
transmitters 3012a, 3012b, 3012c, 3012d and optical sensors 3012a',
3012b', 3012c' associated with second lateral surface 3022f and
their respective channels (again not numbered for simplicity) are
illustrated. The electrically conductive member 300f' may be
adapted as a jaw member of a bipolar electrosurgical forceps, as
described in more detail below with respect to FIG. 14.
[0132] FIG. 14 illustrates a bipolar electrosurgical forceps 400
according to the present disclosure illustrating one embodiment of
an end effector assembly 405 having an optical transmitter
positioned to propagate light through patient tissue and optical
sensors positioned to sense at least a portion of the light
propagating through the patient tissue for monitoring hydration
levels in tissue during operation of the bipolar forceps.
[0133] One embodiment of a bipolar forceps 400 is shown for use
with various surgical procedures and generally includes a housing
402, a handle assembly 430, a rotating assembly 480, a trigger
assembly 470 and an end effector assembly 405 which mutually
cooperate to grasp, seal and divide tubular vessels and vascular
tissue.
[0134] End effector assembly 405 is attached to distal end 414 of
shaft 412 and includes a pair of opposing jaw members 410 and 420.
Movable handle 440 of handle assembly 430 is ultimately connected
to a drive rod (not shown) disposed within the shaft 412 which,
together, mechanically cooperate to impart movement of the jaw
members 410 and 420 from an open position wherein the jaw members
410 and 420 are disposed in spaced relation relative to one
another, to a clamping or closed position wherein the jaw members
410 and 420 cooperate to grasp tissue.
[0135] Forceps 400 also includes an electrical interface or plug
450 which connects the forceps 400 to a source of electrosurgical
energy, e.g., a generator (not shown). Plug 450 includes a pair of
prong members 452a and 452b that are dimensioned to mechanically
and electrically connect the forceps 400 to the source of
electrosurgical energy. An electrical cable 455 extends from the
plug 450 to a sleeve 456 which securely connects the cable 455 to
the forceps 400.
[0136] The first and second jaw members 410 and 420 each have
respective inwardly facing surfaces 410' and 420' associated
therewith. As defined herein, the inwardly facing surfaces 410' and
420' may be formed partially of an electrically conductive material
and partially of an electrically insulating material. The
electrically conductive material is in electrical communication
with the source of electrosurgical energy. Consequently, the
inwardly facing surfaces 410' and 420' may be referred to as
electrically conductive surfaces 410', 420' and as electrically
insulating surfaces 410', 420'.
[0137] The first and second jaw members 410 and 420 respectively
are each adapted for relative movement between an open position to
receive tissue and a closed position engaging tissue between the
inwardly facing surfaces 410' and 410'. That is, first and second
jaw members 410 and 420 are disposed in pivotal relationship with
respect to one another and attached to distal end 414 of at least
one shaft, e.g., shaft 412. Each jaw member 410 and 420 supports an
electrically conductive surface 410' and 420', respectively,
thereon. Jaw member 410 and/or jaw member 420 is configured to be
connected to the source of electrosurgical energy (via the plug
450), One of the jaw members, e.g., lower jaw member 410, may be in
a fixed position with respect to the shaft 412. The jaw members 410
and 420 of end effector assembly 405 are configured to effect
optical transmission of light through patient tissue.
[0138] FIG. 14A illustrates one embodiment of end effector assembly
405. More particularly, end effector assembly 405a includes one of
the jaw members 410 and/or 420, e.g., upper jaw member 420a,
configured with one or more optical transmitters, e.g., optical
transmitter 2510, as described previously with respect to FIG. 4A,
that is positioned in the surface 420' to propagate light through
patient tissue.
[0139] One or both of the jaw members, e.g., lower jaw member 410a,
may be configured with one or more optical sensors, e.g., optical
sensor 202', as described previously with respect to FIG. 2B with
the exception that the large diameter single optical fiber 208 is
replaced by a plurality of optical fibers such as optical fibers
204a', 204b', 204c' having diameters that differ from one another.
Optical sensor 202' is positioned to sense at least a portion of
the light (not shown) propagating through the patient tissue. The
light is transmitted by the optical transmitter 2510 positioned in
the upper jaw member 420a, for monitoring hydration levels in the
patient tissue during operation of the electrosurgical forceps
400.
[0140] As described below with respect to FIGS. 19-20, one or both
of the jaw members 410 and 420 is disposed in optical communication
with a light source 7321, 7322 and/or 7323 and the other of the jaw
members 410 and 420 is disposed in optical communication with a
light sensor 7341 and/or 7342 for monitoring hydration levels in
the tissue 2 during operation of the electrosurgical forceps
400.
[0141] FIG. 14B illustrates another embodiment of the end effector
assembly 405 of FIG. 14. More particularly, end effector assembly
405b includes one of the jaw members 410 and/or 420, e.g., upper
jaw member 420b, configured with one or more optical transmitters,
e.g., optical transmitter 2510 that includes a light-emitting
electronic device (as described previously with respect to FIG. 4A)
that is positioned in the surface 420' to propagate light through
patient tissue.
[0142] One or both of the jaw members, e.g., lower jaw member 410b,
is configured with one or more optical sensors, e.g., optical
sensor 2520 that includes a photo-electric detector (as described
previously with respect to FIG. 4B) that is positioned to sense at
least a portion of light 331 propagating through the patient
tissue. The light 331 is transmitted by the optical transmitter
2510 positioned in the upper jaw member 420, for monitoring
hydration levels in the patient tissue during operation of the
electrosurgical forceps 400.
[0143] As described below with respect to FIGS. 19-20, one or both
of the jaw members 410 and 420 is disposed in optical communication
with a light source 7321, 7322 and/or 7323 and the other of the jaw
members 410 and 420 is disposed in optical communication with a
light sensor 7341 and/or 7342 for monitoring hydration levels in
the tissue 2 during operation of the electrosurgical forceps
400.
[0144] FIG. 14C illustrates still another embodiment of the end
effector assembly 405 of FIG. 14. More particularly, end effector
assembly 405c includes one or more jaw members 410 and/or 420,
e.g., upper jaw member 420c, configured with one or more optical
transmitters, e.g., optical transmitter 202, as described
previously with respect to FIG. 4A with the exception that the
large diameter single optical fiber 208 is replaced by a plurality
of optical fibers such as optical fibers 204a, 204b, 204c having
diameters that differ from one another. The optical transmitter 202
is positioned in the surface 420' to propagate light through
patient tissue.
[0145] One or both of the jaw members, e.g., lower jaw member 410b,
is configured with one or more optical sensors, e.g., optical
sensor 202', as described previously with respect to FIG. 3B with
the exception that the large diameter single optical fiber 208 is
replaced by a plurality of optical fibers such as optical fibers
204a', 204b', 204c' having diameters that differ from one another.
The optical sensor 202' is positioned to sense at least a portion
of light propagating through the patient tissue. The light has been
transmitted by the optical transmitter 202 positioned in the upper
jaw member 420, for monitoring hydration levels in the patient
tissue during operation of the electrosurgical forceps 400.
[0146] Again, as described below with respect to FIGS. 19-20, at
least one of the jaw members 410 and 420 is disposed in optical
communication with a light source 7321, 7322 and/or 7323 and the
other of the jaw members 410 and 420 is disposed in optical
communication with a light sensor 7341 and/or 7342 for monitoring
hydration levels in the tissue 2 during operation of the
electrosurgical forceps 400.
[0147] FIGS. 15A and 15B illustrate yet another embodiment of the
end effector assembly 405 of FIG. 14. More particularly, end
effector assembly 405d includes the jaw members 410 and/or 420,
e.g., upper jaw member 420d, configured with one or more optical
transmitters 2026, e.g., optical transmitter 202, as described
previously with respect to FIG. 3A with the exception that the
large diameter single optical fiber 208 is omitted and one surface
2061 of prism 206 is exposed directly on inwardly facing surface
420' to reflect light from a common light source 1220 via the prism
206 to patient tissue (not shown). Thus, optical transmitter 2026
is positioned in the inwardly facing surface 420' to propagate
light in different paths, e.g., light paths 341a, 341b, 341c,
through patient tissue.
[0148] One or both of the jaw members, e.g., lower jaw member 410d,
is configured with one or more optical sensors, e.g., first, second
and third optical sensors 2026a', 2026b', 2026c', respectively,
that are similar to optical sensor 202', as described previously
with respect to FIG. 3B with the exception that the large diameter
single optical fiber 208 is again omitted and one surface 2061a',
2061b', 2061c' of prisms 206a', 206b', 206c', respectively, is
exposed directly on inwardly facing surface 410' to reflect light
via the prism 206 from patient tissue (not shown) through a
plurality of optical fibers 204a', 204b', 204c' that are routed
through individual channels in channel groups 2040a', 2040b',
2040c', respectively.
[0149] The optical sensors 2026a', 2026b', 2026c' are each
positioned to sense at least a portion of the light propagating in
light paths 341a, 341b, 341c, respectively, through the patient
tissue. The light is transmitted by the optical transmitter 2026
positioned in the upper jaw member 420, for monitoring hydration
levels in the patient tissue during operation of the
electrosurgical forceps 400. To enable routing of the optical
fibers 204a', 204b', 204c' in channel groups 2040a', 2040b',
2040c', the channel groups 2040a', 2040b', 2040c' are formed
laterally offset from one another within the lower jaw member 410d.
More particularly, as indicated above, the first, second and third
optical sensors 2026a', 2026b', 2026c' each have a prism associated
therewith, e.g., prisms 206a', 206b', 206c', respectively, mounted
on the fixed jaw member 410d. The first prism 206a' is mounted
distally of the second prism 206b' and the second prism 206b' is
mounted distally of the third prism 206c'. The first prism 206a' is
mounted proximal to first lateral edge 430a of the surface 410d.
The second prism 206b' is laterally offset with respect to the
first prism 206a' and is further laterally offset with respect to
the lateral edge 430a. The third prism 206c' is laterally offset
with respect to both first and second prisms 206a' and 206b',
respectively, and may be proximal to second lateral edge 430b of
the surface 410d.
[0150] Correspondingly, the first channel group 2040a' is laterally
offset from the second channel group 2040b' and both the first and
second channel groups 2040a' and 2040b are laterally offset from
third channel group 2040c'.
[0151] As described below with respect to FIGS. 19-20, one or both
of the jaw members 410 and 420 may be disposed in optical
communication with a light source 7321, 7322 and/or 7323 and the
other of the jaw members 410 and 420 may be disposed in optical
communication with a light sensor 7341 and/or 7342 for monitoring
hydration levels in the tissue 2 during operation of the
electrosurgical forceps 400.
[0152] FIGS. 15C and 15D illustrate yet another embodiment of the
end effector assembly 405 of FIG. 14 having lower and upper jaw
members 410 and 420, respectively. More particularly, end effector
assembly 405e includes upper jaw member 420e that is identical to
upper jaw member 420d as described above with respect to FIGS. 15A
and 15D. The jaw members, e.g., lower jaw member 410e, may be
substantially identical to lower jaw member 410d described above
with respect to FIGS. 15A and 15B. Lower jaw member 410e is also
configured with one or more optical sensors, e.g., first, second
and third optical sensors 2026a', 2026b', 2026c', respectively,
that are again similar to optical sensor 202', as described
previously with respect to FIG. 4B with the exception that the
large diameter single optical fiber 208 is now included.
[0153] As illustrated in FIGS. 15C and 15D, one end 2080a, 2080b,
2080c of each large diameter single optical fiber 208a, 208b, 208c,
respectively, is exposed directly on inwardly facing surface 410'
to sense light propagating in light paths 341a, 341b, 341c,
respectively, from patient tissue (not shown) and to communicate
the light to be reflected via the respective prisms 206a', 206b',
206c' again through a plurality of optical fibers 204a', 204b',
204c' that are routed through individual channels in channel groups
2040a', 2040b', 2040c', respectively.
[0154] In a similar manner as with respect to end effector assembly
405d described with respect to FIGS. 15A and 15C, the optical
sensors 2026a', 2026b', 2026c' are each positioned to sense at
least a portion of the light propagating in light paths 341a, 341b,
341c, respectively, through the patient tissue. The light is
transmitted by the optical transmitter 2026 positioned in the upper
jaw member 420, for monitoring hydration levels in the patient
tissue during operation of the electrosurgical forceps 400. To
enable routing of the optical fibers 204a', 204b', 204c' in channel
groups 2040a', 2040b', 2040c', the channel groups 2040a', 2040b',
2040c' are formed laterally offset from one another within the
lower jaw member 410d. More particularly, as indicated above, the
first, second and third optical sensors 2026a', 2026b', 2026c' each
have a large diameter single optical fiber 208a, 208b, 208c
associated with prisms 206a', 206b', 206c', respectively, that are
mounted within the fixed jaw member 410e. The first large diameter
single optical fiber 208a and associated prism 206a' are mounted
distally of the second large diameter single optical fiber 208b and
associated second prism 206b', and the second large diameter single
optical fiber 208b and associated second prism 206b' are mounted
distally of the third large diameter single optical fiber 208c and
associated prism 206c'.
[0155] The first optical fiber 208a and associated first prism
206a' may be mounted in proximity to first lateral edge 440a of the
surface 410e. The second optical fiber 208b and associated first
prism 206b' may be laterally offset with respect to the first
optical fiber 208a and associated first prism 206a' and may be
further laterally offset with respect to the first lateral edge
440a. The third optical fiber 208c and associated third prism 206c'
may be laterally offset with respect to both first and second
optical fiber 208a, 208b and associated prisms 206a' and 206b',
respectively, and may be in proximity to second lateral edge 440b
of the surface 410e.
[0156] Correspondingly, the first channel group 2040a' is laterally
offset from the second channel group 2040b' and both the first and
second channel groups 2040a' and 2040b are laterally offset from
third channel group 2040c'.
[0157] The first jaw member 410e is thus a compound jaw member in
which the first, second and third optical fibers 208a, 208b, 208c,
respectively, extend partially into a secondary region 410e'
defined within the first jaw member 410e away from the surface
410'. Additionally, the first, second and third prisms 206a',
206b', 206c' and the optical fibers 204a', 204b', 204c' and channel
groups 2040a', 2040b', 2040c' are mounted predominantly, if not
entirely, within the secondary region 410e'.
[0158] FIGS. 16, 16A, 17 and 18 illustrate various embodiments of
an end effector assembly 505 according to the present disclosure
for a parallel jaw type bipolar electrosurgical forceps (not shown)
having first and second jaw members 510 and 520 having one or more
optical transmitters positioned to propagate light through patient
tissue and one or more optical sensors positioned to sense at least
a portion of the light propagating through the patient tissue for
monitoring hydration levels in tissue during operation of the
bipolar forceps. The end effector assembly 505 ay be configured
such that the jaw members 510 and 520 remain substantially parallel
to one another during the relative movement between the open
position to the closed position and vice versa. One of the jaw
members 510 or 520 may be in a fixed position with respect to a
shaft (not shown). Alternatively, both of the jaw members 510 and
520 may be movable with respect to a shaft (not shown).
[0159] More particularly, referring first to FIGS. 16 and 16A, end
effector assembly 505a includes first jaw member 510a and second
jaw member 520a having respective inwardly facing surfaces 510a'
and 520a' associated therewith. The jaw members 510a and 520a are
adapted for relative movement between an open position to receive
tissue and a closed position engaging tissue between the inwardly
facing surfaces 510a' and 520a'.
[0160] In a similar manner as with respect to jaw members 410 and
420 discussed previously with respect to FIGS. 14A to 15D, the
inwardly facing surfaces 510a' and 520a' of each jaw member 510a
and 520a, respectively, is formed partially of an electrically
conductive surface and of an electrically insulating surface. One
or both of the jaw members 510a and/or 520a is configured to be
connected to a source of electrosurgical energy (not shown). One of
the jaw members may be in a fixed position with respect to a shaft
(not shown).
[0161] One or both of the jaw members, e.g., jaw member 520a, may
be configured with one or more optical transmitters, e.g., optical
transmitter 2027a that is similar to optical transmitter 202
described previously with respect to FIG. 3A, except that optical
transmitter 2027a does not include large diameter optical fiber
208. The optical transmitter 2027a includes prism 2060a having
surface 2061 that is exposed on inwardly facing surface 520a'. The
optical transmitter 2027 and associated prism 2060a and surface
2061 are positioned to propagate light through patient tissue (not
shown) in a light path 351a.
[0162] Similarly, one of the jaw members, e.g., jaw member 510a,
may be configured with one or more optical sensors, e.g., optical
sensor 2027a' that is similar to optical sensor 202' described
previously with respect to FIG. 3B, except that optical sensor
2027a' also does not include large diameter optical fiber 208. The
optical sensor 2027a' includes prism 2060a' having surface 2061'
that is exposed on inwardly facing surface 510a'. The optical
sensor 2027a' and associated prism 2060a' and surface 2061' are
positioned to sense at least a portion of the light propagating via
light path 351a through the patient tissue for monitoring hydration
levels in tissue during operation of the electrosurgical
forceps.
[0163] The light reflected via the respective prisms 2027a and
2027a' propagates through plurality of optical fibers 204a, 204b,
204c and 204a', 204b', 204c' that are routed through individual
channels in channel groups 2040a and 2040a' in jaw members 520a and
510a, respectively. The optical fibers 204a, 204b, 204c and 204a',
204b', 204c' again have diameters that differ from one another. The
optical fibers 204a, 204b, 204c and 204a', 204b', 204c' are routed
in individual channels to reduce interference between one
another.
[0164] The optical transmitter 2027a receives light propagating
through channel group 2040a from a light source 602 that is in
optical-electrical communication therewith, while optical sensor
2027a' propagates light through channel group 2040a' that is in
optical-electrical communication with a light detector 602'.
[0165] As illustrated in more detail in FIG. 16A, the prisms 2027a
and 2027a' may include angled surfaces 2062 and 2062' with
reflective coatings 2070 and 2070', respectively, to increase the
efficiency of the reflection of light via the prisms.
[0166] FIG. 17 illustrates another embodiment of end effector
assembly 505 according to the present disclosure for a parallel jaw
type bipolar electrosurgical forceps (not shown) having first and
second jaw members 510 and 520.
[0167] In a similar manner as with respect to end effector assembly
505a described above with respect to FIGS. 16 and 16A, jaw members
510b and 520b of end effector assembly 505b include, respectively,
inwardly facing surfaces 510b' and 520b'.
[0168] Jaw members 510b and 520b differ from jaw members 510a and
520a in that in place of optical transmitter 2027a and optical
sensor 2027a, respectively, second jaw member 520b includes optical
transmitter 2510b that is similar to optical transmitter 2510
having light-emitting electronic device 2561 and electric cable
2541 described above with respect to FIG. 4A, except that optical
transmitter 2510b does not include large diameter optical fiber
208. Optical transmitter 2027b is in electrical communication with
a processor 600.
[0169] Similarly, first jaw member 510b includes optical sensor
2520b that is similar to optical sensor 2520 having photo-electric
detector 2562 and electrical cable 2542 described above with
respect to FIG. 4B, except that optical sensor 2520b also does not
include large diameter optical fiber 208.
[0170] The optical transmitter 2510b and optical sensor 2520b are
in electrical communication, via electrical cables 2541 and 2542,
respectively, with a processor 604.
[0171] Optical transmitter 2027b may propagate light from second
surface 520b' in a path 351b through patient tissue (not shown) to
optical sensor 2027b' and that the propagation and intensity of the
light may be controlled by the processor 604.
[0172] FIG. 18 illustrates yet another embodiment of end effector
assembly 505 according to the present disclosure for a parallel jaw
type bipolar electrosurgical forceps (not shown) having first and
second jaw members 510 and 520.
[0173] In a similar manner as with respect to end effector
assemblies 505a and 505b described above with respect to FIGS. 16,
16A and 17, jaw members 510c and 520c of end effector assembly 505c
include, respectively, inwardly facing surfaces 510c' and 520c'.
Second jaw member 520c includes optical transmitter 2510c that is
identical to optical transmitter 2510b illustrated in FIG. 17 and
includes light-emitting electronic device 2561 and electrical cable
2541.
[0174] However, in contrast to first jaw member 510b illustrated in
FIG. 16, first jaw member 510c includes optical sensor 2027c' which
is similar to optical sensor 202' described above with respect to
FIG. 3B, and which includes large diameter optical fiber 208 having
one end 2081 exposed on surface 510c' and which is in optical
communication with prism 206 that is included in optical sensor
2027c'. Additionally, optical sensor 2027c' differs from optical
sensor 2027a' illustrated in FIGS. 16 and 16A in that in place of
the plurality of optical fibers 204a', 204b', 204c' in optical
communication with the prism 2060a', optical sensor 2027c' includes
a large diameter optical fiber 2083 that is in optical
communication with the prism 206 such that light emitted by optical
transmitter 2510c propagates in light path 351c to be sensed at end
2081 of optical fiber 208 exposed on surface 510c'. The light
propagates in light path 351c through large diameter optical fiber
208 to prism 206 where it is reflected to propagate through large
diameter optical fiber 2083 to a photo-detector 606'.
[0175] The photo-detector 606' is in communication with the
processor 604. Similarly, the processor 604 is in communication
with the light-emitting electronic device 2510c of optical
transmitter 2510c via the electrical cable 2541. Optical
transmitter 2510c may propagate light from second surface 520c' in
path 351c through patient tissue (not shown) to optical sensor
2520b and that the propagation and intensity of the light may be
controlled by the processor 604.
[0176] Turning now to FIGS. 19-20, there is illustrated one
embodiment of an optical hydrology system 700 according to the
present disclosure that includes schematically an exemplary
embodiment of an optical hydrology array 710 according to the
present disclosure. Optical hydrology array 710 is formed, in one
embodiment, in a flat rectangular plate type arrangement. The array
710 includes a first or lower surface 712a that is configured in a
generally flat shape suitable to be disposed in proximity to
patient tissue 2 (see FIG. 19). A second or upper surface 712b is
disposed in a position opposite to the first or lower surface 712a.
First and second side walls 718 and 720, respectively, straddle
between the first and second surfaces 712a and 712b, respectively
to form the generally box-like flat rectangular plate type
configuration of the array 710 for housing the optical components
therein.
[0177] The array 710 further includes a plurality of apertures 722
that extend from the first surface 712a to the second surface 712b.
The plurality of apertures 722 penetrate through the first and
second surfaces 712a and 712b, respectively, and are configured in
a matrix-like arrangement. The optical hydrology system 700 further
includes a plurality of optical fibers 724 disposed in a
corresponding number of apertures 722 disposed in the first and
second surfaces 712a and 712b, respectively.
[0178] In one embodiment, the system 700 includes a generator 714
that is configured to supply electrosurgical energy to patient
tissue 2. An optical spectrometer 716 is operably coupled to the
generator 714. The electrosurgical generator 710 is operably
coupled to the hydrology array 710. In addition, a processor 730 is
disposed in operative communication with the generator 714 and with
the spectrometer 716. The spectrometer 720 may include a light
source 732 for transmitting light to expose the tissue 2 to light;
and a light detector 734. The light detector 734 is configured to
sense changes in light through the tissue 2 in response to tissue
treatment and communicate such changes to the processor 730 to
determine tissue hydration levels.
[0179] The plurality of optical fibers 724 are operably coupled to
the generator 714 and are configured to communicate light between
the generator 714 and the tissue 2. In one embodiment, the
spectrometer 716 is a near infra-red spectrometer providing light
in the near infrared wavelength range as the light source 722. More
particularly, at least one of the optical fibers 724a of the array
710 is configured to operatively communicate light 755 originating
from the light source 732 to enable transmitting the light 755
towards the tissue 2. In addition, one or more of the optical
fibers 724b of the array 710 is configured to receive light
reflected from the tissue 2 and to transport the light 755 to the
light detector 734.
[0180] The light 755, originating from the light source 732,
travels in a generally U-shaped path 760 from ends 726 of the
optical fibers 724a to ends 728 of optical fibers 724b and then to
the light detector 734. Thus, an optic fiber distance d is defined
between adjacent optical fibers 724 and particularly between ends
726 of the optical fibers 724a to ends 728 of optical fibers 724b.
The optical fiber distance d is within a range of about four (4) mm
to about ten (10) mm to optimize and/or enable the transmission of
light 755 through the tissue 2 to determine hydration levels in the
tissue 2. In one embodiment, range of the distance d extends from
about three (3) mm to about twelve (12) mm. The processor 730 is
configured to at least record and/or analyze changes in hydration
of the tissue 2 sensed by the spectrometer 716 across the optic
fiber distance d. The "banana-shaped" path of light 755 is that
portion of the light emitted at the end 726 of optical fiber 724a
that can be detected by the end 728 of the optical fiber 724b and
does not define the limits of the light distribution within the
tissue 2.
[0181] In one embodiment, the system 700 includes a temperature
monitor 702. The temperature monitor 702 may be an optical
temperature monitor and operatively communicates with the processor
730 and may be operably coupled to one or more fibers 724c. The
temperature monitor 702 is described as an optical temperature
monitor although other type of temperature monitors such as
thermo-electrical or chemical or thermo-mechanical monitors may be
used. The optical fiber(s) 724c is/are configured to enable the
temperature monitor 702 to monitor the temperature of the light 755
reflected through the tissue 2 originating from the light source
732. End 727 of the optical fiber 724c that is configured to enable
the temperature monitor 702 to monitor the temperature of the light
755 is positioned in interfacing relationship with the generally
U-shaped path 760 of the light 755 that travels from the end 726 of
the optical fiber 724a to end 728 of optical fiber 724b. The
processor 730 is configured to record and/or analyze changes in
temperature of the tissue 2 sensed by the temperature monitor
702.
[0182] In one embodiment, the system 700 may include a light source
732' that is independent of the spectrometer 716. The independent
light source 732' is in optical communication with the optical
fiber 724a to propagate light 755 through the optical hydrology
array and with the processor 730. Additionally, a
mechanical-optical multiplexer switch 740 may be included in the
path of optical fiber 724b to enable the light 755 propagating
through optical fiber 724b to be transferred from the light
detector 734 housed in the spectrometer 716 to the independent
detector 734'.
[0183] FIG. 20 is a schematic view of one embodiment of the
mechanical-optical multiplexer switch 740 included within the
system 700 for monitoring water displacement of FIG. 19 as
configured with respect to the array of optical transmitters and
optical sensors illustrated in FIG. 11.
[0184] FIG. 21 is a view of optical alignment member 742 included
within the mechanical-optical multiplexer switch 742.
[0185] The multiplexer switch 742 provides mechanical-optical
alignment between one or more light sources 732, e.g., light source
7321 emitting in a wavelength range of about 200 nanometers (nm) to
about 2000 nm, light source 7322 emitting in a wavelength range of
about 400 nm to about 2000 nm, and light source 7323 emitting in a
wavelength range of about 600 nm to about 2000 nm and patient
tissue 2 (see also FIG. 19) and between patient tissue 2 and one or
more light detectors, e.g., light detector 7341 detecting in a
wavelength range of about 300 nm to about 900 nm and light detector
7342 detecting in a wavelength range of about 850 nm to about 2500
nm. The wavelength ranges disclosed herein represent exemplary
embodiments of the present disclosure and are not intended to be
limiting.
[0186] The switch 740 includes a first optical fiber alignment
member 742 (an "instrument side" optical alignment member) that is
configured with at least first and second surfaces 742a and 742b,
respectively, on opposing sides of the alignment member 742. The
first and second surfaces 742a and 742b each include a plurality of
ports disposed thereupon, e.g., ports d1, s1, d2, s2, d3, s3 on
first surface 742a and ports d1', s1', d2', s2', d3', s3' on second
surface 742b.
[0187] Two or more corresponding ports on the first surface, e.g.,
ports s1, s2, s3 on first surface 742a, are configured to enable
optical communication between one or more light sources, e.g.,
first light source 7321, second light source 7322, and third light
source 7323, and the optical alignment member 742.
[0188] Additionally, two or more corresponding ports on the first
surface, e.g., ports d1, d2, d3 on first surface 742a are
configured to enable optical communication between the optical
alignment member 742 and one or more light detectors, e.g., light
detector 7341 and light detector 7342.
[0189] Two or more corresponding ports on the second surface, e.g.,
ports s1', s2', s3' on surface 742b, are configured to enable
optical communication between two or more corresponding ports on
the first surface, e.g., ports s1, s2, s3, respectively, that are
configured to enable optical communication between the one or more
light sources, e.g., first light source 7321, second light source
7322, and third light source 7323, and the optical alignment member
742 via corresponding channels 762 disposed therebetween,
[0190] Similarly, two or more corresponding ports on the second
surface, e.g., ports d1', d2', d3', are configured to enable
optical communication between two or more corresponding ports on
the first surface, e.g., ports d1, d2, d3, respectively, that are
configured to enable optical communication between the optical
alignment member 742 and at least one light detector, e.g., light
detector 7341 and light detector 7342, via corresponding channels
764 disposed therebetween.
[0191] As indicated in FIG. 20, ports s1 and s1' are aligned with
first light source 7321, ports s2 and s2' are aligned with second
light source 7322 and ports s3 and s3' are aligned with light
source 7323. Ports d1 and d1' are aligned with first light detector
7341 and ports d2 and d2' and d3 and d3' are aligned with the
second light detector 7342.
[0192] The switch 740 also includes a second optical fiber
alignment member 752a (a first "tissue-side" optical alignment
member) configured with the first and second surfaces 754a and
754b, respectively. In a similar manner, the first and second
surfaces 754a and 754b each include a plurality of ports 1d1',
1s1', 1d2', 1s2', 1d3', 1s3' and 1d1, 1s1, 1d2, 1s2, 1d3, 1s3,
respectively, disposed thereupon,
[0193] Two or more corresponding ports on the first surface, e.g.,
ports 1s1', 1s2', 1s3', are configured to enable optical
communication between corresponding optical ports on the optical
member 752, e.g., ports s1', s2', s3' on the surface 742b of the
first optical member 742, via corresponding channels 762 disposed
therebetween,
[0194] Two or more corresponding ports on the second surface, e.g.,
ports 1d1, 1d2, 1d3, of the second optical alignment member 752 are
configured to enable optical communication between corresponding
optical ports 1d1', 1d2', 1d3' on the first surface 752a of the
second optical alignment member 752a via corresponding channels 764
disposed therebetween and patient tissue 2.
[0195] Similarly, at least a third optical fiber alignment member,
e.g., optical alignment members 752b, 752c . . . 752n (or second,
third . . . nth "tissue-side" optical alignment members) are also
configured with at least the first and second surfaces 754a and
754b, respectively. Again, the first and second surfaces 754a and
754b each include a plurality of ports 1 disposed thereupon, e.g.,
ports 2s1', 2s2', 2s3', 2d1', 2d2', 2d3' and 2s1, 2s2, 2s3, 2d1,
2d2, 2d3 on surfaces 752a and 752b of third optical alignment
member 752b, ports 3s1', 3s2', 3s3', 3d1', 3d2', 3d3' and 3s1, 3s2,
3s3, 3d1, 3d2, 3d3 on surfaces 754a and 754b of fourth optical
alignment member 752c, up through ports ns1', ns2', ns3', nd1',
nd2', nd3' and ns1, ns2, ns3, nd1, nd2, nd3 on surfaces 754a and
754b of nth optical alignment member 752n, respectively.
[0196] In view of the foregoing description of optical alignment
members 742 and 752a, optical alignment is provided via the
channels 762 and 764 and aforementioned ports of the third through
nth optical alignment members 752b through 754n. As defined herein,
the nth optical alignment member represents at least the third
optical alignment member and may include a greater number within
the limits of practicality.
[0197] As illustrated in FIG. 20, the first optical alignment
member 742 is movable, as indicated via the arrows "A" and "B" in a
linear direction, with respect to the second and at least the third
optical alignment members, e.g., 752a, 752b, 752c . . . 752n to
enable the optical alignment between the light sources 7321, 7322
and 7323 and patient tissue 2 and between patient tissue 2 and the
light detectors 7341 and 7342.
[0198] The optical alignment occurs when the first optical
alignment member 742 has been moved to a position with respect to,
for example, fourth optical alignment member 752c such that ports
s1', s2', s3' on the second surface 742b of the first optical
alignment member 742 are aligned with the ports 3s1', 3s2', 3s3',
respectively, on the first surface 754a of the fourth optical
alignment member 752c, and when the ports d1', d2', d3' on the
second surface 742b of the first optical alignment member 742 are
aligned with the ports 3d1', 3d2', 3d3' of the fourth optical
alignment member 752c.
[0199] For clarity, optical fibers are not shown in the channels
762 and 764 or separately numbered. The result of the optical
alignment is that light from first light source 7321 propagates
through the optical fibers in the first optical alignment member
742 ("instrument side") to interface with the corresponding optical
fibers in the fourth optical alignment member 752c ("tissue side")
to form a first light path 7551 in patient tissue 2 between first
light source 7321 emitting at a wavelength of about 200 nm to 2000
nm to first light detector 7341 detecting at wavelengths of about
300 nm to about 900 nm.
[0200] Similarly, light from second light source 7322 propagates
through the optical fibers in the first optical alignment member
742 ("instrument side") to interface with the corresponding optical
fibers in the fourth optical alignment member 752c ("tissue side")
to form a second light path 7552 in patient tissue 2 between second
light source 7322 emitting at a wavelength of about 400 nm to 2000
nm to second light detector 7342 detecting at wavelengths of about
850 nm to about 2500 nm.
[0201] Additionally, light from third light source 7323 propagates
through the optical fibers in the first optical alignment member
742 ("instrument side") to interface with the corresponding optical
fibers in the fourth optical alignment member 752c ("tissue side")
to form a third light path 7553 in patient tissue 2 between third
light source 7323 emitting at a wavelength of about 600 nm to 2000
nm to second light detector 7342 detecting at wavelengths of about
850 nm to about 2500 nm.
[0202] For simplicity, the same optical hydrology array 710
illustrated in FIG. 19 is positioned between the "tissue-side"
optical alignment members 752a . . . 752n and the patient tissue 2.
It should be noted that the same optical hydrology array 710 is
associated with the differing "tissue-side" optical alignment
members 752a . . . 752n. That is, different groups of the optical
fibers associated with the optical hydrology array 710 are routed
to and from through the array 10 and separate to be associated with
corresponding "tissue-side" optical alignment members 752a . . .
752n to provide differing details of water motility information
with respect to the patient tissue 2.
[0203] Although FIG. 20 is a schematic view of one embodiment of
the mechanical-optical multiplexer switch 740 included within the
system 700 for monitoring water displacement of FIG. 19 as
configured with respect to the array of optical transmitters and
optical sensors illustrated in FIG. 11, that is, the switch 740 is
configured wherein one sensing (detecting) optical fiber is
associated with a corresponding transmitting (source or emitting)
optical fiber, system 700 may further be modified to include
optical splitters (not shown) in the paths between the patient
tissue 2 and the "tissue-side" optical alignment members 752a, 752b
to 752n to accommodate situations where there is a mis-match in the
number of transmitting or source fibers with respect to the number
of sensing or detecting fibers.
[0204] Similarly, system 700 may further be modified to include
optical splitters (not shown) in the paths between the "instrument
side" optical alignment member 742 and the light sources 7321,
7322, 7323 and light detectors 7341, 7342 also to accommodate
situations where there is a mismatch in the number of transmitting
or source fibers with respect to the number of sensing or detecting
fibers.
[0205] The "instrument-side" optical alignment member 742 and the
"tissue-side" optical alignment members 752a . . . 752n may be
configured to be substantially identical, and are illustrated as
mirror images of one another. Also, the number of ports d1, s1, d2,
s2, d3, s3 and d1', s1', d2', s2', d3', s3' etc. and channels 762
and 764 may be varied as necessary or advantageous. Additionally,
the mechanical-optical multiplexer switch 740 may be configured
wherein the second and at least a third optical alignment members
752a . . . 752n ("tissue-side" members) are movable with respect to
the first optical alignment member 742 ("instrument-side" member)
to enable the optical alignment between the at least one light
source, e.g., light sources 7321, 7322, 7323, and patient tissue 2
and between patient tissue 2 and the at least one light detector,
e.g., light detectors 7341, 7342. Although such motion would also
be linear as indicated by the arrows "A" and "B", other
configurations of the "tissue-side" optical alignment members 752a
. . . 752n may be devised, such as wherein the optical alignment
member 742 rotates around the optical alignment members 752a . . .
752b or vice versa. The embodiments are not limited with respect to
the direction and type of motion of the optical alignment
members.
[0206] The mechanical-optical multiplexer switch 740 has been
described with respect to the electrically conductive member 300d
illustrated in FIG. 11, which in FIGS. 19-20 is equivalent to the
optical hydrology array 710. The mechanical-optical multiplexer
switch 740 is configured for the embodiment of FIG. 11 wherein the
optical fibers are routed entirely to and from the patient tissue 2
as opposed to electrically conductive member 300a illustrated in
FIGS. 7 and 7A wherein light-emitting electronic devices 2561' and
photo-electric detectors 2562' and 2563' and associated electrical
cables 2541 and 2542 are employed.
[0207] The mechanical-optical multiplexer switch 740 may be made
from an opaque material such as a metal or metal alloy, a plastic
or a ceramic or suitable combinations thereof to prevent
interference by light transmission between the optical fibers in
the various channels 762 and 764. Dashed box 770 represents a
common housing within which the processor 730, spectrometer 716,
and the generator 714 may be incorporated therein. Additionally,
temperature monitor 702 may be incorporated within the housing 770
or may be located elsewhere such as on or in the electrosurgical
instrument. Supporting structure (not shown) for the optical
alignment members 742 and 752a . . . 752n may be provided by the
switch housing. Also, the motion of the optical alignment members
742 and 752a . . . 752n with respect to each other may be effected
by electrical, mechanical, chemical, pneumatic or other movers
suitable for the application.
[0208] In view of the previous descriptions of electrosurgical
pencil blades 106a to 106d described with respect to FIGS. 1-6B, of
electrically conductive members 300a to 300f and 300f' described
with respect to FIGS. 7 to 13, of end effector assemblies 405a to
405e described with respect to FIGS. 14 to 15D, and of end effector
assemblies 505a to 505c described with respect to FIGS. 16 to 18,
the electrosurgical pencil blades 106a to 106d, the electrically
conductive members 300a to 300f and 300f', the end effector
assemblies 405a to 405e, and the end effector assemblies 505a to
505c may be substituted for the optical hydrology array 710 in FIG.
19 for either light reflectance or light transmission applications,
as applicable to the particular blade or assembly.
[0209] Referring to FIG. 19, the near Infrared (IR) wavelength
optical spectrometer 716 and optical fibers 724 sense changes
across the array 710 and correlate the changes with movement of
water through the tissue. Light reflected by the tissue enables
detecting water content and transmitted light.
[0210] As described above with respect to FIG. 20, first light
source 7321 emits light at a wavelength of about 200 nm to 2000 nm
to first light detector 7341 detecting at wavelengths of about 300
nm to about 900 nm. Second light source 7322 emits light at a
wavelength of about 400 nm to 2000 nm to second light detector 7342
detecting at wavelengths of about 850 nm to about 2500 nm.
Additionally, third light source 7323 emits light at a wavelength
of about 600 nm to 2000 nm to second light detector 7342 detecting
at wavelengths of about 850 nm to about 2500 nm.
[0211] The values of the electrical, thermal and hydraulic
conductivities of the tissue all depend on the quantity and
location of the water content within the tissue. The analysis of
the quantity and location of the water content within the tissue
may be determined by comparing intensities of the light passing
through the patient tissue both spatially and temporally, that is
by comparing the measured intensities to the spatial location and
to the time at which the measurements have been made.
[0212] First, a reference wavelength .lamda.r may be defined as a
measured wavelength of light that is insensitive to the moisture
content of the tissue. Reference wavelength .lamda.r is a function
of x, y and t, where x and y define a two-dimensional location of
the measurement within the patient tissue with respect to a
reference set of x-y coordinate axes and t defines the time of the
measurement. For any given tissue, there are multiple wavelengths
.lamda.r that are insensitive to the moisture content of the
tissue. The reference wavelength .lamda.r is then defined as
follows:
.lamda.r=f(x,y,t) Eq. 1
[0213] A reference intensity Ir may be defined as the intensity of
light passing through patient tissue as measured at a selected
particular reference wavelength .lamda.r that is a measured
wavelength of light that is insensitive to the moisture content of
the tissue. Since .lamda.r is a function of x, y and t, then Ir is
also a function of .lamda.r, x, y and t, as follows:
Ir=f[.lamda.r(x,y,t)] Eq. 2
[0214] Reference intensity Ir is measured at a wavelength that is
known not to be sensitive to the presence of water.
[0215] Next, hydration wavelength .lamda.h may be defined as a
measured wavelength of light at which the intensity of light
passing through the tissue varies depending on the moisture content
of the tissue. Hydration wavelength .lamda.h is a function of x, y
and t, where x and y define a two-dimensional location of the
measurement within the patient tissue with respect to a reference
set of x-y coordinate axes and t defines the time of the
measurement. The hydration wavelength .lamda.h is then defined as
follows:
.lamda.h=f(x,y,t) Eq. 3
[0216] For any given tissue sample, there are a range of multiple,
discrete hydration wavelengths .lamda.h at which the intensity of
light passing through patient tissue is sensitive to the moisture
content of the tissue. The particular hydration wavelength .lamda.h
at which the intensity of the light passing through patient tissue
is measured during the electrosurgical procedure may be selected as
that wavelength that exhibits the greatest level of gain with
respect to the moisture content of the tissue.
[0217] A hydration intensity Ih may be defined as a function of
.lamda.h, x, y and t, where Ah defines the measured wavelength of
light that is dependent on the moisture content of the tissue, x
and y define a two-dimensional location of the measurement within
the patient tissue with respect to a reference set of x-y
coordinate axes and t defines the time of the measurement.
Therefore, the hydration intensity Ih is defined as follows:
Ih=f[.lamda.h(x,y,t)] Eq. 4
[0218] The intensities Ir and Ih may be measured in counts of
photon emissions per unit of time. Alternatively, other units of
measurement may be applied such as the candela (cd, the Standards
International SI unit of measurement for light intensity) or the
lumen (Im, the SI unit for measuring the flux of light being
produced by a light source or received by a surface) or the lumen
hour (Im h, the SI unit for a quantity of light, equal to one lumen
of light flux continued for one hour). The analysis of the moisture
content is performed by calculating the ratio R of the hydration
intensity Ih to the reference intensity Ir as follows:
R={Ih[.lamda.h(x,y,t)]/Ir[.lamda.r(x,y,t)]} Eq. 5
[0219] At location x1, y1 at time t1, Ir is determined as a
function of [.lamda.r(x1, y1, t1)]. Ih is determined as a function
of [.lamda.h (x1, y1, t1)]. The ratio R is then calculated:
R(111/111)={Ih[.lamda.h(x1,y1,t1)]/Ir[.lamda.r(x1,y1,t1)]} Eq.
6
[0220] where .lamda.h(x1, y1, t1) is the hydration wavelength
measured at location x1, y1 at time t1 and .lamda.r(x1, y1, t1) is
the reference wavelength measured at location x1, y1 at time
t1.
[0221] A subsequent measurement of the reference wavelength
.lamda.r, reference intensity Ir, hydration wavelength .lamda.h and
hydration intensity Ih may be taken at the same location but at a
different time and a new ratio of intensities calculated as
follows:
R(112/112)={Ih[.lamda.h(x1,y1,t2)]/Ir[.lamda.r(x1,y1,t12]} Eq.
7
where .lamda.h(x1, y1, t2) is the hydration wavelength measured at
location x1, y1 at time t2 and .lamda.r(x1, y1, t2) is the
reference wavelength measured at location x1, y1 at time t2.
[0222] Alternatively, another measurement of the reference
wavelength .lamda.r, reference intensity Ir, hydration wavelength
.lamda.h and hydration intensity Ih may be taken at a different
location but at the same time and another ratio of intensities
calculated as follows:
R(221/221)={Ih[.lamda.h(x2,y2,t1)]/Ir[.lamda.r(x2,y2,t1]} Eq. 8
where .lamda.h(x2, y2, t1) is the hydration wavelength measured at
location x2, y2 at time t1 and .lamda.r(x2, y2, t1) is the
reference wavelength measured at location x2, y2 at time t1.
[0223] Yet another measurement of the reference wavelength
.lamda.r, reference intensity Ir, hydration wavelength .lamda.h and
hydration intensity Ih may be taken at a different location and a
different time as follows:
R(222/222)={Ih[.lamda.h(x2,y2,t2)]/Ir[.lamda.r(x2,y2,t2]} Eq. 9
where .lamda.h(x2, y2, t2) is the hydration wavelength measured at
location x2, y2 at time t2 and .lamda.r(x2, y2, t2) is the
reference wavelength measured at location x2, y2 at time t2.
[0224] As can be understood from the foregoing, the ratio R may be
calculated at numerous desired locations and times. The location
and time of the reference wavelength .lamda.r and reference
intensity Ir need not correspond to the location and time of the
hydration wavelength .lamda.h and hydration intensity Ih. In such
an exemplary case, the ratio R may be calculated as follows:
R(221/112)={Ih[.lamda.h(x2,y2,t1)]/Ir[.lamda.r(x1,y1,t12]} Eq.
10
where .lamda.h(x2, y2, t1) is the hydration wavelength measured at
location x2, y2 at time t1 and .lamda.r(x1, y1, t2) is the
reference wavelength measured at location x1, y1 at time t2.
[0225] The ratio R corrects for inconsistencies not related to the
hydration level of the tissue. Such inconsistencies may include
variation of the intensity of the light source or variations in the
tissue that are not related to hydration content. The numerical
values of the ratio R are dependent on the particular tissue
undergoing the electrosurgical procedure and on the particular
spectrometer. Wavelengths in the range of about 900 nm generally
represent wavelengths at which the light intensity is generally not
sensitive to hydration content and thus does not vary with
hydration content. Such wavelengths may be selected as reference
wavelengths .lamda.r. Wavelengths in the range of about 1500 nm
generally represent wavelengths at which the light intensity is
sensitive to hydration content, and thus do vary with hydration
content. Such wavelengths may be selected as hydration wavelengths
.lamda.h.
[0226] While the measurements of the ratio R may be calculated at a
fixed value of the hydration wavelength .lamda.h during an
electrosurgical procedure, for further validation of the results,
the measurements of the ratio R may be calculated at one or more
other values of the hydration wavelength .lamda.h during the
electrosurgical procedure.
[0227] A refinement of the intensity measurements may be performed
to further remove spurious factors to give a more accurate reading
of tissue moisture content by various mathematical operations such
as addition, subtraction, multiplication and division as
follows:
Addition: R(111/111)+R(221/221) Eq. 11
or
Subtraction: R(112/112)-R(111/111) Eq. 12
or
Multiplication: R(111/221)*R(212/211) Eq. 13
or
Division: R(222/212)/R(221/112),etc. Eq. 14
[0228] If determined to be advantageous, the above calculated ratio
values of intensities may also be raised exponentially, for
example, as follows:
Multiplication: R(111/221).sup.n*R(221/112).sup.n, Eq. 15
where n is a positive or negative number other than zero (and which
may differ for each ratio reading such as R(111/221) or R(221/112),
etc.)
[0229] The mechanical-optical multiplexer switch 740 in FIGS. 19-20
allows different wavelength intensities to be measured with respect
to space and time, e.g., with respect to x-y coordinates and with
respect to time t.
[0230] The array 710 provides a differential in water content and
in water movement. Water movement could be in an elliptical pattern
rather than a circular pattern. Based on any of the foregoing
measurements, either with intensity ratio measurements alone or
further refined by additional mathematical operations such as
addition, subtraction, multiplication, division, etc., a
Monte-Carlo analysis may be performed to determine the most
probable location of the greatest moisture content within the
tissue.
[0231] Movement of the mechanical-optical multiplexer switch 740
during the electrosurgical process enables acquisition of numerous
intensity measurements at different locations and at different
times from various locations within the array 710.
[0232] In view of the foregoing description of the optical
hydrology array monitoring system 700 and electrosurgical pencil
100 and electrosurgical forceps 400, the present disclosure relates
also to a method for monitoring water displacement in tissue during
patient therapy. The method includes providing a spectrometer,
e.g., spectrometer 716 that includes light source 732 and light
detector 734. The method includes generating light 755 from the
light source 732 that is reflected through the patient or subject
tissue 2 and receiving the light 755 reflected through the tissue 2
wherein the light 755 reflected through the tissue 2 is received by
the light detector 734.
[0233] The method may further include supplying electrosurgical
energy to the tissue 2, e.g., via the electrosurgical generator 714
utilizing an energy source (not shown), sensing changes in light
through the tissue 2 in response to tissue treatment, e.g. via the
optical array 710, and determining changes in tissue hydration
levels based on the sensed changes in light 755 through the tissue
2, e.g., via the optical spectrometer 716. The method may also
include providing a processor such as the processor 730 to which
the sensed changes in light 755 through the tissue 2 are
communicated wherein the processor 730 determines the changes in
tissue hydration levels based on the sensed changes in light 755
through the tissue 2. The processor 730 is operably coupled to the
spectrometer 716 and/or the electrosurgical generator 714 and/or
the energy source.
[0234] Additionally, in one embodiment, the method includes
providing a plurality of optical fibers 724 arranged wherein at
least one of the optical fibers 724a is configured to operatively
communicate light 755 originating from the light source 732 to
enable transmitting light towards the tissue 2 and at least one of
the optical fibers 724b is configured to enable transporting light
755 reflected from the tissue 2.
[0235] The method may also include interfacing the one or more
optical fibers 724a to the light source 732 and the one or more
optical fibers 724b to the light detector 734. The method may also
include configuring the plurality of optical fibers 724 in the
array 710 to be separated to effect an optimal optic fiber distance
d within the tissue 2, as described above.
[0236] In one embodiment, the method further includes providing
light 755 in the near infrared wavelength range as the light source
732. Additionally, the method may be implemented by further
including the steps of providing optical temperature monitor 702,
providing one or more optical fibers 724c that operatively couple
to the optical temperature monitor 702, and monitoring the
temperature of light 755 reflected through the tissue 2 originating
from the light source 732.
[0237] The method may be implemented wherein the one or more
optical fibers 724c operatively coupled to the optical temperature
monitor 702 is configured within the array 710.
[0238] In one embodiment, the method is implemented via a processor
such as the processor 730 for recording and/or analyzing changes in
hydration of the tissue 2 in time and/or space sensed by the
spectrometer 716 based on the fiber optic distance d. Additionally,
the method may be implemented wherein the processor 730 records
and/or analyzes changes in temperature of the tissue 2 sensed by
the optical temperature monitor 702.
[0239] Referring again to FIG. 1 and FIG. 19, the method is
implemented wherein the array 710 and/or system 700 is incorporated
in the electrosurgical pencil 100 including the housing 102 having
proximal and distal ends 108 and 110, respectively, and the blade
receptacle 105 defined at the distal end 110 of the housing 102 for
supporting the electrosurgical blade 106 therein. The
electrosurgical blade 106 is disposed in optical communication with
the light source 732 and the light detector 734 and the method
includes monitoring hydration levels in the tissue 2 during
operation of the electrosurgical pencil 100.
[0240] Referring again to FIG. 14, the method is implemented
wherein the arrays 710 and 710' are incorporated in the
electrosurgical forceps 400 including the pair of first and second
jaw members 410 and 420, respectively, disposed in pivotal
relationship with respect to one another and attached to the distal
end 414 of at least one shaft 412. Each jaw member 410 and 420
supports the electrically conductive surfaces 410' and 420',
respectively, thereon. At least one of the jaw members 410 and/or
420 is disposed in optical communication with the light source 732,
via the optical fibers 724 of the respective arrays 710 and/or
710', and the other of the jaw members 420 and/or 410, respectively
being disposed in optical communication with the light detector
734, also via the optical fibers 724 of the respective arrays 710
and/or 710'. The method includes monitoring hydration levels in
tissue 2 during operation of the electrosurgical forceps 400.
[0241] Again, the near Infrared (IR) wavelength optical
spectrometer 716 and optical fibers 724 sense changes across the
array 710 and correlate the changes with movement of water through
the tissue. Light reflected by the tissue enables detecting water
content and transmitted light.
[0242] Whether the optical hydrology system with the array is
applied to RF therapy or to microwave therapy, the water content is
a solvent. The dissolved ions travel through the solvent and their
optical characteristics enable the spectrometer to sense the
presence and movement of water in the tissue. The electrosurgical
generator thus may be driven to control the flow of water through
the tissue to optimize the delivery of energy to the tissue and
thus to enhance the therapeutic effect of the particular energy
treatment being applied.
[0243] As described previously, such as with respect to FIGS. 7 to
13, the array of optical fibers may be arranged in various
geometries to track the motility of water through the tissue.
During tissue dessication, water must be displaced to other
locations within the tissue. The system array can track movement of
water and then control algorithms can optimize energy induction.
Again, the near Infrared (IR) wavelength optical spectrometer 716
and optical fibers 724 sense changes across the array 710 and/or
710' and correlate the changes with movement of water through the
tissue. Light reflected by the tissue enables detecting water
content and transmitted light.
[0244] Differences in fiber optic geometries enable detection and
tracking of the manner in which water is moving through the tissue.
The induction of energy can be slowly ramped up or the induction
can be applied to immediately reach a steady peak value.
Alternatively, the induction of energy can be applied in pulses.
The energy induction process can be applied to force water out of
tissue and control pulsing time and operation can be controlled to
effect such forcing of water out of patient tissue.
[0245] Although the subject disclosure has been described with
respect to exemplary embodiments, it will be readily apparent to
those having ordinary skill in the art to which it appertains that
changes and modifications may be made thereto without departing
from the spirit or scope of the subject disclosure as defined by
the appended claims.
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