US20200246056A1 - Gas-enhanced energy-based surgical instrument, system, and method for minimally-invasive surgical procedures - Google Patents

Abstract

A surgical system includes a control assembly and a surgical instrument defining a gas inflow path, a gas outflow path, and an end effector configured to apply energy to tissue. The control assembly includes a gas output configured to connect to the gas inflow path, a gas input configured to connect to the gas outflow path, and an energy output configured to supply energy to the end effector. The control assembly further includes a controller to determine an amount of gas output from the gas output, determine an amount of gas withdrawn into the gas input, compare the amount of gas output and the amount of gas withdrawn, and control withdrawal of gas from the gas outflow path such that the amount of gas output and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application claims the benefit of U.S. Provisional Patent Application Nos. 62/801,151 and 62/801,153, both filed on Feb. 5, 2019, the entire contents of each of which are hereby incorporated herein by reference.
BACKGROUNDTechnical Field
• The present disclosure relates to surgical instruments, systems, and methods and, more particularly, to gas-enhanced energy-based surgical instruments, systems, and methods for use in minimally-invasive surgical procedures.
Background of Related Art
• In minimally-invasive surgical procedures, operations are carried out within an internal body cavity through small entrance openings in the body. The entrance openings may be natural passageways of the body or may be surgically created, for example, by making a small incision into which a cannula is inserted. However, the restricted access provided by minimally-invasive openings (natural passageways and/or surgically created openings) presents challenges with respect to maneuverability and visualization. Thus, in many minimally-invasive surgical procedures, the internal body cavity is insufflated with a gas to distend and separate the cavity wall from underlying tissue(s), thus improving maneuverability and visualization.
• Energy-based surgical instruments may be utilized in minimally-invasive surgical procedures to apply energy to target tissue within the internal body cavity to achieve a desired tissue effect. Gas-enhancement utilizes a gas (inert gas, energy-activated plasma, etc.) to displace fluid, disperse smoke, and/or facilitate the application of energy from the energy-based surgical instrument to tissue to achieve the desired tissue effect, and may likewise be utilized in a minimally-invasive surgical procedure.
SUMMARY
• As used herein, the term “distal” refers to the portion that is described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, any or all of the aspects described herein, to the extent consistent, may be used in conjunction with any or all of the other aspects described herein.
• Provided in accordance with aspects of the present disclosure is a surgical system including a surgical instrument and a control assembly. The surgical instrument defines a gas inflow path, a gas outflow path, and an end effector configured to apply energy to tissue. The control assembly includes a gas output configured to connect to the gas inflow path of the surgical instrument for supplying gas thereto, a gas input configured to connect to the gas outflow path of the surgical instrument to withdraw gas therefrom, and an energy output configured to supply energy to the end effector of the surgical instrument for application to tissue. The control assembly further includes a controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed, cause the processor to: determine an amount of gas output from the gas output to the gas inflow path of the surgical instrument, determine an amount of gas withdrawn into the gas input from the gas outflow path of the surgical instrument, compare the amount of gas output and the amount of gas withdrawn, and control withdrawal of gas from the gas outflow path of the surgical instrument such that the amount of gas output and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.
• In an aspect of the present disclosure, the control assembly includes a first pump configured to pump gas into the gas inflow path of the surgical instrument. Additionally or alternatively, the control assembly may include a second pump configured to withdraw gas from the gas outflow path of the surgical instrument.
• In another aspect of the present disclosure, the control assembly includes a first sensor configured to sense at least one of: an output gas flow rate, an output gas pressure, or an output gas volume. In such aspects, the processor may further be caused to determine the amount of gas output from the gas output to the gas inflow path of the surgical instrument based upon feedback from the first sensor. Additionally or alternatively, the control assembly may include a second sensor configured to sense at least one of: an input gas flow rate, an input gas pressure, or an input gas volume. In such aspects, the processor may further be caused to determine the amount of gas withdrawn into the gas input from the gas outflow path of the surgical instrument based upon feedback from the second sensor.
• In another aspect of the present disclosure, the control assembly is configured to supply gas from the gas output to the gas inflow path of the surgical instrument when the energy output supplies energy to the end effector of the surgical instrument for application to tissue.
• Another surgical system provided in accordance with aspects of the present disclosure includes an electrode configured for insertion into an insufflated internal body cavity, a gas inflow path configured to extend into the insufflated internal body cavity, a gas outflow path configured to extend out of the insufflated internal body cavity, and a control assembly including an energy output configured to supply energy to the electrode, a gas output configured to supply gas along the gas inflow path into the insufflated internal body cavity when energy is supplied to the electrode, and a gas input configured to selectively withdrawn gas from the insufflated internal body cavity with the gas outflow path. The control assembly further includes a controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed, cause the processor to: determine an amount of gas supplied into the insufflated internal body cavity, determine an amount of gas withdrawn from the insufflated internal body cavity, compare the amount of gas supplied and the amount of gas withdrawn, and control the withdrawal of gas from the insufflated internal body cavity such that the amount of gas supplied and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.
• In an aspect of the present disclosure, the electrode is disposed on a surgical instrument and the gas inflow and gas outflow paths are defined through the surgical instrument.
• In another aspect of the present disclosure, the control assembly includes a first pump configured to supply gas and/or a second pump configured to withdraw gas.
• In still another aspect of the present disclosure, the control assembly includes a first sensor configured to sense at least one of: a gas flow rate, a gas pressure, or a gas volume. In such aspects, the processor may further be caused to determine the amount of gas supplied based upon feedback from the first sensor.
• In yet another aspect of the present disclosure, the control assembly includes a second sensor configured to sense at least one of: a gas flow rate, a gas pressure, or a gas volume. In such aspects, the processor may further be caused to determine the amount of gas withdrawn based upon feedback from the second sensor.
• In still yet another aspect of the present disclosure, the control assembly is housed within an enclosure.
• A method provided in accordance with aspects of the present disclosure includes inserting a surgical instrument into an insufflated internal body cavity, activating the surgical instrument to apply energy to tissue within the insufflated internal body cavity and introduce gas into the insufflated internal body cavity, determining an amount of gas that is introduced into the insufflated internal body cavity, and selectively withdrawing gas from the insufflated internal body cavity such that an amount of gas that is withdrawn is equal to or within a threshold margin of the amount of gas that is introduced.
• In an aspect of the present disclosure, gas is provided from a control assembly to the surgical instrument for introduction into the insufflated internal body cavity. In such aspects, the control assembly may include a first sensor configured to sense at least one property indicative of the amount of gas that is introduced to enable determination of the amount of gas that is introduced.
• In another aspect of the present disclosure, method according to claim14, selectively withdrawing gas includes determining an amount of gas is withdrawn, comparing the amount of gas that is withdrawn with the amount of gas that is introduced, and determining whether to withdraw gas or not based upon a result of the comparison.
• In yet another aspect of the present disclosure, gas is withdrawn from the insufflated internal body cavity into a control assembly. In such aspects, the control assembly may include a second sensor configured to sense at least one property indicative of the amount of gas that is withdrawn to enable determination of the amount of gas that is withdrawn.
• Also provided in accordance with aspects of the present disclosure is a surgical instrument including a housing, an elongated shaft assembly extending distally from the housing, and an end effector extending distally from the elongated shaft assembly. The elongated shaft assembly includes an inner shaft, an intermediate collar, and an outer sleeve. The inner shaft defines a proximal portion, a distal portion, and a lumen extending longitudinally therethrough. The proximal portion of the inner shaft inhibits passage of gas radially therethrough, while the distal portion of the inner shaft permits passage of gas radially therethrough. The intermediate collar is disposed about the inner shaft between the proximal portion and the distal portion. The outer sleeve is disposed about the inner shaft and the intermediate collar. The outer sleeve is radially spaced-apart from the inner shaft and abuts an outer periphery of the intermediate collar to define a proximal annular area between the outer sleeve and the inner shaft proximally of the intermediate collar and a distal annular area between the outer sleeve and the inner shaft distally of the intermediate collar. The outer sleeve includes a proximal portion surrounding the proximal annular area and a distal portion surrounding the distal annular area. The proximal portion of the outer sleeve permits passage of gas radially therethrough, while the distal portion of the outer sleeve inhibits passage of gas radially therethrough.
• In an aspect of the present disclosure, a distal cap encloses a distal end of the outer sleeve. In such aspects, the end effector may extend distally through the distal cap.
• In another aspect of the present disclosure, the distal cap defines a plurality of openings in communication with the distal annular area to permit passage of gas from the distal annular area through the openings.
• In still another aspect of the present disclosure, the plurality of openings are disposed radially about the end effector in a distally-oriented direction such that gas passing from the distal annular area through the openings is directed distally about the end effector.
• In yet another aspect of the present disclosure, the distal portion of the inner shaft defines a plurality of transverse apertures therethrough to permit passage of gas radially therethrough from the lumen to the distal annular area.
• In still yet another aspect of the present disclosure, the proximal portion of the outer sleeve defines a plurality of slots therethrough to permit passage of gas from an exterior of the outer sleeve radially therethrough into the proximal annular area.
• In another aspect of the present disclosure, the end effector is engaged with the inner shaft at a distal end of the inner shaft and encloses the distal end of the inner shaft.
• In yet another aspect of the present disclosure, the end effector includes an electrode adapted to connect to a source of energy for applying energy to tissue.
• In another aspect of the present disclosure, the inner shaft is at least partially formed from an electrically-conductive material, disposed in electrical communication with the electrode, and adapted to deliver energy from a source of energy to the electrode for applying energy to tissue.
• In still yet another aspect of the present disclosure, an inflow tube is disposed in communication with the lumen for supplying gas thereto and an outflow tube is disposed in communication with the proximal annular space for withdrawing gas therefrom.
• Another surgical instrument provided in accordance with aspects of the present disclosure includes a housing, an elongated shaft assembly extending distally from the housing, and an end effector extending distally from the elongated shaft assembly. The elongated shaft assembly includes an inner shaft defining a lumen extending longitudinally therethrough, an outer sleeve disposed about and radially spaced-apart from the inner shaft to define an annular area therebetween, and an intermediate collar disposed between the inner shaft and the outer sleeve and dividing the annular area into a proximal annular area portion and a distal annular area portion. An inflow path is defined through the lumen, through openings defined within the inner shaft distally of the intermediate collar, through the distal annular area portion of the annular area, and through a distal end of the outer sleeve. An outflow path is defined through the proximal annular area portion and through openings defined within the outer sleeve proximally of the intermediate collar.
• In an aspect of the present disclosure, the openings defined within the inner shaft distally of the intermediate collar are transverse apertures. Additionally or alternatively, the openings defined within the outer sleeve proximally of the intermediate collar may be longitudinally-extending slots.
• In another aspect of the present disclosure, the elongated shaft assembly further includes a distal cap disposed at distal ends of the inner shaft and outer sleeve. In such aspects, the inflow path through the distal end of the outer sleeve may extend through openings defined within the distal cap.
• In yet another aspect of the present disclosure, the end effector includes an electrode adapted to connect to a source of energy for applying energy to tissue.
• In still another aspect of the present disclosure, the inner shaft is at least partially formed from an electrically-conductive material, disposed in electrical communication with the electrode, and adapted to deliver energy from a source of energy to the electrode for applying energy to tissue.
• In still yet another aspect of the present disclosure, the outer sleeve is electrically-insulative.
• In another aspect of the present disclosure, an inflow tube is disposed in communication with the inflow path for supplying gas thereto and an outflow tube is disposed in communication with the outflow path for withdrawing gas therefrom.
• In another aspect of the present disclosure, at least one membrane is disposed about the openings defined within the outer sleeve proximally of the intermediate collar. The at least one membrane is configured to permit passage of gas therethrough and inhibit passage of liquid therethrough.
BRIEF DESCRIPTION OF THE DRAWINGS
• The above and other aspects and features of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements and:
• FIG. 1 is an illustration of a minimally-invasive, gas-enhanced, energy-based surgical system provided in accordance with the present disclosure shown in a surgical environment;
• FIG. 2 is a perspective view of a surgical instrument of the system ofFIG. 1;
• FIG. 3 is a perspective view of a distal portion of the instrument ofFIG. 2;
• FIG. 4 is a perspective view of the distal portion of the instrument ofFIG. 2 with the outer sleeve and distal cap removed;
• FIG. 5 is an enlarged, perspective, longitudinal cross-sectional view of the area of detail indicated as “5” inFIG. 3;
• FIG. 6 is an enlarged, perspective, longitudinal cross-sectional view of the area of detail indicated as “6” inFIG. 3;
• FIG. 7 is a perspective view of a control assembly of the system ofFIG. 1;
• FIG. 8 is a schematic diagram of the control assembly ofFIG. 7; and
• FIG. 9 is a perspective, partial cross-sectional view of the distal portion of the instrument ofFIG. 2 in use within an internal body cavity.
DETAILED DESCRIPTION
• The present disclosure provides gas-enhanced energy-based surgical instruments, systems, and methods for use in minimally-invasive surgical procedures. Although the instruments, systems, and methods of the present disclosure are detailed herein configured for use in conjunction with one another, it is understood that the instruments, systems, and methods of the present disclosure also have applicability independently of one another and/or with other instruments, systems, and methods.
• Referring toFIG. 1, a gas-enhanced energy-based surgical system provided in accordance with the present disclosure is shown generally identified byreference numeral10.System10 includes asurgical instrument100 and acontrol assembly200 and is configured for use in minimally-invasive surgical procedures on a patient “P” within an insufflated internal body cavity “C” (FIG. 9) of the patient “P.”Surgical instrument100 is configured to supply energy, e.g., RF energy (although other energy modalities such as, for example, microwave, ultrasonic, laser, thermal, etc., are also contemplated), to tissue to achieve a desired tissue effect.Surgical instrument100 is further configured to supply a gas, e.g., an inert gas, an energy-activated plasma, etc., at the site of energy application to facilitate achieving the desired tissue effect by, for example, displacing fluid, dispersing smoke, and/or facilitating the application of energy to tissue.Surgical instrument100 is also configured to withdraw gas from the insufflated internal body cavity “C” (FIG. 9) to maintain an appropriate insufflation pressure within the insufflated internal body cavity “C” (FIG. 9).Surgical instrument100 is described in greater detail below.
• Control assembly200 ofsystem10 may be configured as a single unit housed within an enclosure210 (as illustrated inFIG. 1) or may include several sub-units operably coupled to one another (in close proximity or remote from one another).Control assembly200 is coupled tosurgical instrument100 and is configured to supply and control the supply of energy to tissue viasurgical instrument100, supply and control the supply of gas to the site of energy application viasurgical instrument100, and withdraw and control the withdrawal of gas from the insufflated internal body cavity “C” (FIG. 9) viasurgical instrument100.Control assembly200 is described in greater detail below.
• Turning toFIGS. 2-6, and initially toFIG. 2,surgical instrument100 generally includes ahousing120, anelongated shaft assembly140 extending distally fromhousing120, anend effector160 extending distally fromelongated shaft assembly140, and aconnection assembly180 operably coupled tohousing120 and configured to operably connectsurgical instrument100 to control assembly200 (FIG. 1).Surgical instrument100 may be configured as a disposable, single-use instrument; a reusable, multi-use instrument capable of being sterilized for repeated use; or a reposable instrument wherein some portions are capable of being sterilized for repeated use and other portions are disposable, single-use portions that are replaced after each use.
• Continuing with reference toFIG. 2,housing120 includes abody portion122 an a fixedhandle portion124 extending perpendicularly or obliquely frombody portion122 to provide an ergonomic pistol-grip configuration facilitating grasping and manipulatinghousing120, although other suitable configurations, e.g., a pencil-grip configuration, are also contemplated.Housing120 further includes anenergy activation button126, a gassupply activation button128, and arotation wheel130, although additional or alternative controls are also contemplated.
• With reference toFIGS. 3-6,elongated shaft assembly140, as noted above, extends distally from housing120 (FIG. 2). A proximal portion (not shown) ofelongated shaft assembly140 is disposed withinhousing120 and operably coupled to rotation wheel130 (FIG. 2) withinhousing120 to enable rotation ofelongated shaft assembly140 relative tohousing120 in response to rotation ofrotation wheel130 relative tohousing120.Elongated shaft assembly140 extends from the proximal portion thereof, distally fromhousing120, to endeffector160.
• Elongated shaft assembly140 includes aninner shaft142, anouter sleeve144, and adistal cap146. Referring toFIGS. 4 and 5,inner shaft142 is formed at least partially from an electrically-conductive material, includes aproximal portion148 and a distal portion150 (of similar or different length), and defines a longitudinally-extendinglumen152 therethrough. Anintermediate collar154 is disposed aboutinner shaft142 betweenproximal portion148 and adistal portion150 thereof.Proximal portion148 ofinner shaft142 defines a solid outer annular surface; that is,proximal portion148 ofinner shaft142 is configured to inhibit the passage of gas betweenlumen152 and the radial exterior ofproximal portion148 ofinner shaft142.Distal portion150 ofinner shaft142, defines a plurality oftransverse apertures151 therethrough arranged annularly about and longitudinally along at least a portion thereof in any suitable arrangement and/or pattern.Apertures151 enable the passage of gas radially betweenlumen152 and the exterior ofdistal portion150 ofinner shaft142.
• Referring toFIGS. 3, 5, and 6,outer sleeve144 ofelongated shaft assembly140 is formed from an electrically-insulative material, coated with an electrically-insulated material, or otherwise configured to inhibit the conduction of electrical energy therethrough. In embodiments,outer sleeve144 is formed from, for example, woven carbon fiber or a biocompatible polymer.Outer sleeve144 is disposed about and radially-spaced frominner shaft142 ofelongated shaft assembly140 to define a proximalannular space156abetweenouter sleeve144 andproximal portion148 ofinner shaft142 and a distalannular space156bbetweenouter sleeve144 anddistal portion150 ofinner shaft142.Outer sleeve144 abuts the outer radial surface ofintermediate collar154 to establish a seal therebetween to inhibit gas exchange between proximalannular space156aand distalannular space156b. The abutment ofouter sleeve144 withintermediate collar154 also serves to maintaininner shaft142 in concentric position withinouter sleeve144, thus maintaining proximal and distalannular spaces156a,156b, respectively, betweeninner shaft142 andouter sleeve144.
• Outer sleeve144 includes aproximal portion158asurrounding proximalannular space156aand adistal portion158bsurrounding distalannular space156b.Proximal portion158aofouter sleeve144 defines a plurality of longitudinally-extendingslots159atherethrough arranged annularly about and longitudinally along at least a portion thereof in any suitable arrangement and/or pattern.Slots159aenable the passage of gas radially between proximalannular space156aand the exterior ofproximal portion158aofouter sleeve144.Distal portion158bofouter sleeve144, on the other hand, defines a solid outer annular surface; that is,distal portion158bofouter sleeve144 is configured to inhibit the passage of gas between distalannular space156band the radial exterior ofdistal portion158bofouter sleeve144.
• Outer sleeve144, in embodiments, may further include one ormore membranes159bdisposed at least aboutslots159a. Eachmembrane159bmay be a hydrophobic membrane or other suitable membrane that enables the exchange of gas therethrough but inhibits the exchange of liquids therethrough. Suitable membranes include, for example, microporous PTFE and GOR-TEX®, available from W.L. Gore & Associates GmbH.
• Referring toFIGS. 3 and 5,distal cap146 ofelongated shaft assembly140 is disposed at the distal ends ofinner shaft142 andouter sleeve144 and may define a semi-spherical configuration (as illustrated), a frustoconical configuration, or other suitable configuration.Distal cap146 encloses the distal end of distalannular space156band defines a plurality of radially-arrangedapertures147 defined therethrough and oriented in a generally distally-facing direction.Apertures147 thus enable gas disposed within distalannular space156bto exitsurgical instrument100 throughapertures147 in a distal direction radially aboutend effector160, as detailed below.
• Continuing with reference toFIGS. 3 and 5,end effector160 includes ahub162 and anelectrode164 extending distally fromhub162.Hub162 is engaged, e.g., welded, withdistal portion150 ofinner shaft142 at the distal end ofdistal portion150 to seal off the distal end oflumen152.Hub162 is formed at least partially from an electrically-conductive material and is electrically coupled toinner shaft142, e.g., via direct mechanical contact therebetween.Electrode164 is likewise formed at least partially from an electrically-conductive material and extends distally fromhub162.Electrode164 may be engaged with, monolithically formed with, or otherwise coupled tohub162 in electrical communication therewith.End effector160 is fixed relative toelongated shaft assembly140 such thatend effector160 is rotated in conjunction withelongated shaft assembly140 and relative to housing120 (FIG. 2), e.g., in response to rotation ofrotation wheel130 relative to housing120 (seeFIG. 2).
• Electrode164, as noted above, extends distally fromhub162. More specifically,electrode164 extends distally through a central opening defined throughdistal cap146 and distally ofelongated shaft assembly140.Electrode164 fully occupies the central opening ofdistal cap146 or is otherwise sealed therein to inhibit the passage of gas through the central opening betweenelectrode164 anddistal cap146.Electrode164 is also radially surrounded by and extends distally fromapertures147 ofdistal cap146. As such, gas exitingelongated shaft assembly140 distally throughapertures147 is directed radially aboutelectrode164 and distally towards the distal-most end ofelectrode164.Electrode164 may define adistal portion166 having any suitable configuration to facilitate communicating energy to tissue such as, for example, a hook-shape (as illustrated) or other suitable shape.
• With reference back toFIGS. 1 and 2,connection assembly180 ofsurgical instrument100 includes acable182, andinflow tube184, and anoutflow tube186 disposed within anouter sheath188, althoughcable182,inflow tube184, and/oroutflow tube186 may alternatively be connected to one another without an outer cable sheath, may be separate from one another, or may be configured in any other suitable manner.Cable182 includes aplug183 at the proximal end thereof configured to connectsurgical instrument100 to anenergy output202 ofcontrol assembly200.Cable182 extends distally throughouter sheath188 intohousing120, wherein a lead wire (not explicitly show) extending throughcable182 is electrically connected toinner shaft142 ofelongated shaft assembly140, e.g., via a slip-ring connection (not shown). Thus, energy, e.g., RF energy, may be delivered fromcontrol assembly200 toelectrode164 via the lead wire ofcable182 andinner shaft142 for application to tissue to achieve a desired tissue effect.Cable182 may additionally house one or more control wires (not explicitly shown) configured to connectenergy activation button126 and/or gassupply activation button128 to controlassembly200 to enable the selective activation of energy and/or gas supply fromcontrol assembly200 tosurgical instrument100.
• Inflow tube184 ofconnection assembly180 includes aplug185 at the proximal end thereof configured to connectsurgical instrument100 to agas output204 ofcontrol assembly200.Inflow tube184 extends distally throughouter sheath188 intohousing120, wherein the distal end ofinflow tube184 is disposed in communication withlumen152 ofinner shaft142 in sealed relation. Thus, gas, e.g., an inert gas such as CO₂, may be delivered fromcontrol assembly200 to lumen152 viainflow tube184. More specifically, gas may be pumped throughinflow tube184 andlumen152, exitinglumen152 and entering distalannular space156bviatransverse apertures151 defined withindistal portion150 ofinner shaft142, and exiting distalannular space156bthroughapertures147 ofdistal cap146 such that the gas is expelled distally into the internal body cavity “C” (FIG. 9) aboutelectrode164 to facilitate achieving the desired tissue effect, e.g., via displacing fluid, dispersing smoke, and/or facilitating the application of energy fromelectrode164 to tissue.
• Outflow tube186 ofconnection assembly180 includes aplug187 at the proximal end thereof configured to connectsurgical instrument100 to agas input206 ofcontrol assembly200.Outflow tube186 extends distally throughouter sheath188 intohousing120, wherein the distal end ofoutflow tube184 is disposed in communication with proximalannular space156adefined betweeninner shaft142 andouter sleeve144, in sealed relation. Thus, gas may be draw from the internal body cavity “C” (FIG. 9) into proximalannular space156aviaslots159a(and through membrane(s)159b) ofouter sleeve144, proximally through proximalannular space156a, into and throughoutflow tube186, and, ultimately, to controlassembly200 for collection, recycling, exhausting, etc.
• Referring generally toFIGS. 1-6 and 9,end effector160 andelongated shaft assembly140 ofsurgical instrument100 are configured for minimally-invasive insertion into an insufflated internal body cavity “C,” e.g., through an access port “A,” whilehousing120 ofsurgical instrument100 remains externally disposed to enable manipulation and/or activation ofsurgical instrument100. Once inserted in this manner,surgical instrument100 may be activated to supply energy to tissue “T” viaelectrode164, supply a gas aboutelectrode164 adjacent tissue “T” to facilitate achieving a desired tissue effect, and withdraw gas from the insufflated internal body cavity “C” (while, in embodiments, also inhibiting the withdrawal of liquids from the insufflated internal body cavity “C”) at positions proximally-spaced fromelectrode164 and tissue “T” so as not to interfere with the application of energy to tissue and/or the supplied input gas.
• Turning toFIGS. 1 and 7-9,control assembly200, as noted above, includesenergy output202 configured to supply energy tosurgical instrument100, agas output204 configured to supply gas tosurgical instrument100, and agas input206 configured to withdraw gas fromsurgical instrument100.Control assembly200, as also noted above, may be housed within a single enclosure210 (as shown) or may be a combination of sub-assemblies coupled to one another. Enclosure210 (and/or one or more of the sub-assemblies, in embodiments where provided) may further include adisplay screen220, which may be a touch-screen display to enable input as well as to provide a visual output. Other input and/or output components are also contemplated such as, for example, speakers, LEDs, keypads, etc.
• With particular reference toFIG. 8,control assembly200 further includes anRF generator212 configured to convert power, e.g., from a wall outlet (not shown), into electrosurgical RF energy for output toenergy output202 such that RF energy may be delivered fromcontrol assembly200 toelectrode164 of surgical instrument100 (seeFIG. 1) for application to tissue “T” (FIG. 9).Control assembly200 also includes or is coupled to a gas source214 and apump224 coupled between gas source214 andgas output204 to enable gas to be pumped from gas source214 throughsurgical instrument100 and into the internal body cavity “C” about end effector160 (seeFIG. 9), as detailed above.Control assembly200 additionally includes or is coupled to agas reservoir216 and apump226 coupled betweengas reservoir216 andgas input206 to enable gas to be withdrawn, e.g., suctioned, from the internal body cavity “C” via instrument100 (seeFIG. 9), as detailed above, for depositing ingas reservoir216.
• Referring again toFIGS. 1 and 7-9,control assembly200 also includes acontroller230 including, for example, a microcontroller and a storage medium storing instructions to be executed by the microcontroller.Controller230 is configured to receive input information fromsurgical instrument100, e.g., activation signals fromenergy activation button126 and/or gassupply activation button128, and direct an appropriate output, e.g., the supply of energy to electrode164 or the output of gas tosurgical instrument100.Controller230 may be configured to automatically output gas tosurgical instrument100 when energy is supplied to surgical instrument100 (concurrently or delayed relative thereto) and/or may be configured to output gas tosurgical instrument100 in response to activation of gassupply activation button128.
• Controller230 is further configured to monitor the amount, e.g., volume, of gas output tosurgical instrument100 and, thus, the amount of gas input into the internal body cavity “C.” This may be accomplished using asensor234 configured to sense a flow rate of gas output via pump224 (or at any other suitable location) such that, knowing the dimensions of the components within the gas output flow path,controller230 can determine the amount of gas input into the internal body cavity “C.” Alternatively,sensor234 may be configured to sense a pressure and/or volume difference within gas source214 such thatcontroller230 can correlate the same to the amount of gas pumped into the internal body cavity “C.” As another alternative,sensor234 may be configured to monitor the power consumption, torque, impedance, and/or other suitable parameter(s) ofpump224 and correlate the same to an amount to enablecontroller230 to determine the amount of gas pumped tosurgical instrument100 and, thus, the amount of gas input into the internal body cavity “C.” As still another alternative,sensor234 may be configured to monitor the “ON” time ofpump224 such thatcontroller230, knowing the output ofpump224, can determine the amount of gas input into the internal body cavity “C.” Other suitable configurations ofsensor234 for determining the amount of gas input into the internal body cavity “C” are also contemplated. The amount of gas input into the internal body cavity “C” is stored in a memory ofcontroller230 and updated continuously or periodically.
• Continuing with reference toFIGS. 1 and 7-9,controller230 is also configured to controlpump226, thereby controlling the withdrawal of gas from the internal body cavity “C” viainstrument100, for ultimate depositing ingas reservoir216. More specifically,controller230 is configured to control the withdrawal of gas from the internal body cavity “C” in accordance with the determined amount of gas input into the internal body cavity “C” such that the amount of gas withdrawn is equal to or within a threshold margin of the amount of gas input. The threshold margin may be an absolute value, e.g., a numerical volume, or a relative value, e.g., a percentage of the input volume. As such, the amount of gas within the insufflated internal body cavity “C” (absent other factors contributing to the addition or loss of gas) is maintained constant or within a threshold range throughout use ofsurgical instrument100. Thus, the pressure within the insufflated internal body cavity “C” (absent other factors contributing to the addition or loss of pressure) is also maintained constant or within a threshold range throughout use ofsurgical instrument100.
• Controller230 controls the withdrawal of gas from the internal body cavity “C,” in embodiments, by monitoring the amount of gas withdrawn from the internal body cavity “C,” comparing the amount of gas withdrawn to the amount of gas input (stored in the memory of controller230), and selectively operatingpump226 to ensure the amount of gas withdrawn is equal to or within a threshold margin of the amount of gas input.Controller230 may utilize asensor236 such as, for example, a flow rate sensor, a pressure and/or volume sensor, a pump parameter sensor, an “ON” time sensor, etc. (similarly as detailed above with respect to sensor234), to determine the amount of gas withdraw from the internal body cavity “C.”Controller230 may compare the determined input and withdrawn amounts continuously or periodically, and automatically control activation (and deactivation) ofpump226 to withdraw gas as necessary to ensure that the amount of gas and/or pressure within the insufflated internal body cavity “C” (absent other factors) is maintained constant or within a threshold range throughout use ofsurgical instrument100.
• From the foregoing and with reference to the various drawings, those skilled in the art will appreciate that certain modifications can be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims (17)

What is claimed is:

1. A surgical system, comprising:

a surgical instrument defining a gas inflow path, a gas outflow path, and an end effector configured to apply energy to tissue; and

a control assembly including a gas output configured to connect to the gas inflow path of the surgical instrument for supplying gas thereto, a gas input configured to connect to the gas outflow path of the surgical instrument to withdraw gas therefrom, and an energy output configured to supply energy to the end effector of the surgical instrument for application to tissue, the control assembly further including a controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed, cause the processor to:

determine an amount of gas output from the gas output to the gas inflow path of the surgical instrument;

determine an amount of gas withdrawn into the gas input from the gas outflow path of the surgical instrument;

compare the amount of gas output and the amount of gas withdrawn; and

control withdrawal of gas from the gas outflow path of the surgical instrument such that the amount of gas output and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.

2. The surgical system according toclaim 1, wherein the control assembly includes a first pump configured to pump gas into the gas inflow path of the surgical instrument.

3. The surgical system according toclaim 1, wherein the control assembly includes a second pump configured to withdraw gas from the gas outflow path of the surgical instrument.

4. The surgical system according toclaim 1, wherein the control assembly includes a first sensor configured to sense at least one of: an output gas flow rate, an output gas pressure, or an output gas volume, and wherein the processor is further caused to determine the amount of gas output from the gas output to the gas inflow path of the surgical instrument based upon feedback from the first sensor.

5. The surgical system according toclaim 1, wherein the control assembly includes a second sensor configured to sense at least one of: an input gas flow rate, an input gas pressure, or an input gas volume, and wherein the processor is further caused to determine the amount of gas withdrawn into the gas input from the gas outflow path of the surgical instrument based upon feedback from the second sensor.

6. The surgical system according toclaim 1, wherein the control assembly is configured to supply gas from the gas output to the gas inflow path of the surgical instrument when the energy output supplies energy to the end effector of the surgical instrument for application to tissue.

7. A surgical system, comprising:

an electrode configured for insertion into an insufflated internal body cavity;

a gas inflow path configured to extend into the insufflated internal body cavity;

a gas outflow path configured to extend out of the insufflated internal body cavity; and

a control assembly including an energy output configured to supply energy to the electrode, a gas output configured to supply gas along the gas inflow path into the insufflated internal body cavity when energy is supplied to the electrode, and a gas input configured to selectively withdrawn gas from the insufflated internal body cavity with the gas outflow path, the control assembly further including a controller having a processor and a non-transitory computer-readable storage medium storing instructions that, when executed, cause the processor to:

determine an amount of gas supplied into the insufflated internal body cavity;

determine an amount of gas withdrawn from the insufflated internal body cavity;

compare the amount of gas supplied and the amount of gas withdrawn; and

control the withdrawal of gas from the insufflated internal body cavity such that the amount of gas supplied and the amount of gas withdrawn are equal to one another or within a threshold margin of one another.

8. The surgical system according toclaim 7, wherein the electrode is disposed on a surgical instrument, and wherein the gas inflow and gas outflow paths are defined through the surgical instrument.

9. The surgical system according toclaim 7, wherein the control assembly includes a first pump configured to supply gas.

10. The surgical system according toclaim 7, wherein the control assembly includes a second pump configured to withdraw gas.

11. The surgical system according toclaim 7, wherein the control assembly includes a first sensor configured to sense at least one of: a gas flow rate, a gas pressure, or a gas volume, and wherein the processor is further caused to determine the amount of gas supplied based upon feedback from the first sensor.

12. The surgical system according toclaim 7, wherein the control assembly includes a second sensor configured to sense at least one of: a gas flow rate, a gas pressure, or a gas volume, and wherein the processor is further caused to determine the amount of gas withdrawn based upon feedback from the second sensor.

13. The surgical system according toclaim 7, wherein the control assembly is housed within an enclosure.

14. A method, comprising;

inserting a surgical instrument into an insufflated internal body cavity;

activating the surgical instrument to apply energy to tissue within the insufflated internal body cavity and introduce gas into the insufflated internal body cavity;

determining an amount of gas that is introduced into the insufflated internal body cavity; and

selectively withdrawing gas from the insufflated internal body cavity such that an amount of gas that is withdrawn is equal to or within a threshold margin of the amount of gas that is introduced.

15. The method according toclaim 14, wherein gas is provided from a control assembly to the surgical instrument for introduction into the insufflated internal body cavity, and wherein the control assembly includes a first sensor configured to sense at least one property indicative of the amount of gas that is introduced to enable determination of the amount of gas that is introduced.

16. The method according toclaim 14, wherein selectively withdrawing gas includes determining an amount of gas is withdrawn, comparing the amount of gas that is withdrawn with the amount of gas that is introduced, and determining whether to withdraw gas or not based upon a result of the comparison.

17. The method according toclaim 16, wherein gas is withdrawn from the insufflated internal body cavity into a control assembly, and wherein the control assembly includes a second sensor configured to sense at least one property indicative of the amount of gas that is withdrawn to enable determination of the amount of gas that is withdrawn.

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