公开(公告)号：US07041102B2

公开(公告)日：2006-05-09

申请号：US10443974

申请日：2003-05-22

申请人： Csaba Truckai ,  James A. Baker ,  Gabor Gran ,  John H. Shadduck

发明人： Csaba Truckai ,  James A. Baker ,  Gabor Gran ,  John H. Shadduck

IPC分类号： A61B18/12

CPC分类号： A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063 ,  A61B2018/00809

摘要： An electrosurgical medical device and method for creating thermal welds in engaged tissue that carries the electrosurgical components in a disposable cartridge. The instrument also can carry a blade member in a disposable cartridge, thus making the instrument system inexpensive to use. In another embodiment, the electrical leads of the cartridge have a surface coating of a thermochromic material to provide the physician with a visual indicator of operational parameters when applying energy to tissue.

公开(公告)号：US06905497B2

公开(公告)日：2005-06-14

申请号：US10453086

申请日：2003-05-31

申请人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

发明人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

IPC分类号： A61B18/14 ,  A61B18/12

CPC分类号： A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063

摘要： An electrosurgical medical device for creating thermal welds in engaged tissue that provides general grasping and dissecting functionality. In an exemplary embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying electrosurgical energy delivery means. The jaw assembly, in one mode of operation, can be used for general grasping and dissecting purposes wherein the jaws close in a non-parallel manner so that the distalmost jaw tip only engage tissue with little movement of the actuator lever in the handle of the instrument. In another mode of operation, the jaw assembly closes close in a parallel manner under very high compression to enable tissue welding.

摘要翻译： 一种用于在接合组织中产生热焊缝的电外科医疗装置，其提供一般的抓握和解剖功能。 在示例性实施例中，器械的至少一个钳口限定了携带电外科能量输送装置的组织接合平面。 钳口组件在一种操作模式中可用于一般的抓取和解剖目的，其中钳口以不平行的方式闭合，使得最远端的钳口尖端仅接合组织，致动器杠杆在手柄中几乎没有移动 仪器。 在另一种操作模式中，钳夹组件在非常高的压缩下以平行的方式闭合以实现组织焊接。

公开(公告)号：US07112201B2

公开(公告)日：2006-09-26

申请号：US10351449

申请日：2003-01-22

申请人： Csaba Truckai ,  John H. Shadduck ,  James A. Baker

发明人： Csaba Truckai ,  John H. Shadduck ,  James A. Baker

IPC分类号： A61B18/12

CPC分类号： A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00125 ,  A61B2018/00148 ,  A61B2018/0063

摘要： An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying a conductive-resistive matrix of a conductively-doped non-conductive elastomer. The engagement surface portions thus can be described as a positive temperature coefficient material that has a unique selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The conductive-resistive matrix can be engineered to bracket a targeted thermal treatment range, for example about 60° C. to 80° C., at which tissue welding can be accomplished. In one mode of operation, the engagement plane will automatically modulate and spatially localize ohmic heating within the engaged tissue from Rf energy application—across micron-scale portions of the engagement surface. In another mode of operation, a conductive-resistive matrix can induce a “wave” of Rf energy density to sweep across the tissue to thereby weld tissue.

公开(公告)号：US07011657B2

公开(公告)日：2006-03-14

申请号：US10340144

申请日：2003-01-10

申请人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

发明人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

IPC分类号： A61B18/12

CPC分类号： A61B18/1445 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063 ,  A61B2018/1455

摘要： An electrosurgical medical device and technique for creating thermal welds in engaged tissue that provides very high compressive forces. In one exemplary embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying first and second surface portions that comprise (i) an electrically conductive material and (ii) a positive temperature coefficient (PTC) material having a selected increased resistance that differs at each selected increased temperature over a targeted treatment range. One type of PTC material is a doped ceramic that can be engineered to exhibit a selected positively sloped temperature-resistance curve over about 37° C. to 100° C. The 70° C. to 100° C. range can bracket a targeted “thermal treatment range” at which tissue welded can be accomplished. The engineered resistance of the PTC matrix at the upper end of the temperature range will terminate current flow through the matrix. In one mode of operation, the engagement plane cause ohmic heating within tissue from Rf energy delivery tissue PTC matrix is heated to exceed the treatment range. Thereafter, energy density in the engaged tissue will be modulated as the conductivity of the second portion hovers within the targeted treatment range to thereby provide optical tissue heating for purposes of tissue welding.

公开(公告)号：US06770072B1

公开(公告)日：2004-08-03

申请号：US10308362

申请日：2002-12-03

申请人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

发明人： Csaba Truckai ,  James A. Baker ,  John H. Shadduck

IPC分类号： A61B1814

CPC分类号： A61B18/1445 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063 ,  A61B2018/1455

摘要： A working end of a surgical instrument that carries first and second jaws for delivering energy to tissue. In a preferred embodiment, at least one jaw of the working end defines a tissue-engagement plane that contacts the targeted tissue. The cross-section of the engagement plane reveals that it defines a surface conductive portion and an elastomeric body portion. The elastomeric body portion is adapted to flex, deflect and extend laterally when engaging tissue to atraumatically engage tissue at the edges of the working end to create a smooth transition between welded tissue and undamaged tissue. The jaws can further carry a variably resistive matrix of a temperature-sensitive resistive material or a pressure-sensitive resistive material. An interior of the jaw carries a conductive material or electrode that is coupled to an Rf source and controller. In an exemplary embodiment, the variably resistive matrix can comprise a positive temperature coefficient (PTC) material, such as a ceramic, that is engineered to exhibit a dramatically increasing resistance (i.e., several orders of magnitude) above a specific temperature of the material. In use, the engagement plane will apply active Rf energy to captured tissue until the point in time that the variably resistive matrix is heated to its selected switching range. Thereafter, current flow from the conductive electrode through the engagement surface will be terminated due to the exponential increase in the resistance of variably resistive matrix to provide instant and automatic reduction of Rf energy application. Thus, the jaw structure can automatically modulate the application of energy to tissue between active Rf heating and passive conductive heating of captured tissue to maintain a target temperature level.

摘要翻译： 手术器械的工作端，其携带用于将能量递送至组织的第一和第二钳口。 在优选实施例中，工作端的至少一个钳口限定了接触目标组织的组织接合平面。 接合平面的横截面显示其限定表面导电部分和弹性体主体部分。 弹性体主体部分适于在接合组织时在横向上弯曲，偏转和延伸，以在工作端的边缘处不可靠地接合组织，以在焊接的组织和未损坏的组织之间形成平滑过渡。 钳口可以进一步携带温度敏感的电阻材料或压敏电阻材料的可变电阻矩阵。 钳口的内部承载耦合到Rf源和控制器的导电材料或电极。 在示例性实施例中，可变电阻矩阵可以包括正温度系数（PTC）材料，例如陶瓷，其被工程化以显示高于材料的特定温度的显着增加的电阻（即几个数量级）。 在使用中，接合平面将对被捕获的组织施加活性的Rf能量，直到可变电阻矩阵被加热到其选择的开关范围的时间点为止。 此后，由于可变电阻矩阵的电阻的指数增加，导电电极通过接合表面的电流将终止，以提供即时和自动降低Rf能量应用。 因此，钳口结构可以自动调节被捕获组织的活性Rf加热和被动导电加热之间的能量对组织的应用以保持目标温度水平。

公开(公告)号：US20130317492A1

公开(公告)日：2013-11-28

申请号：US13676249

申请日：2012-11-14

申请人： Csaba Truckai ,  Aaron Germain ,  John H. Shadduck

发明人： Csaba Truckai ,  Aaron Germain ,  John H. Shadduck

IPC分类号： A61B18/08

CPC分类号： A61B18/1445 ,  A61B18/08 ,  A61B18/085 ,  A61B2018/00172 ,  A61B2018/00589 ,  A61B2018/00601 ,  A61B2018/146

摘要： A medical for removing tissue from a patient includes an elongated probe with a working end. A pair of jaws is provided at the working end. The jaws may be closed for cutting and treatment of the tissue. Cutting may be effective through a sharpened cutting blade, and RF cutting blade, and similar cutting edges. The tissue may be remodeled using heat generated from passive heating elements on the jaws, active heating elements on the jaws, a PTCR heating element carried by the jaws, or resistive heaters on the jaws.

摘要翻译： 用于从患者去除组织的医学包括具有工作端的细长探针。 工作端设有一对钳口。 钳口可以关闭以切割和处理组织。 切割可以通过锋利的切割刀片和RF切割刀片以及类似的切削刃而有效。 可以使用由钳口上的被动加热元件，钳口上的主动加热元件，由钳口承载的PTCR加热元件或钳口上的电阻加热器产生的热量来重组组织。

公开(公告)号：US08556910B2

公开(公告)日：2013-10-15

申请号：US12062345

申请日：2008-04-03

申请人： Csaba Truckai ,  Robert Luzzi ,  John H. Shadduck

发明人： Csaba Truckai ,  Robert Luzzi ,  John H. Shadduck

IPC分类号： A61B17/58 ,  A61B17/60 ,  A61F2/00

CPC分类号： A61B17/8836 ,  A61B17/8822 ,  A61B2017/00022

摘要： Systems and methods for delivering bone cement into a bone can include a handle body defining a flow path, a thermal emitter in the handle body to apply energy to bone cement passing through the flow path, a source of bone cement and an injection cannula. The cannula can be in communication with the flow path such that inserting the cannula into a bone can allow a flow of bone cement therethrough to an opening at a distal end of the cannula. Other systems and methods for delivering bone cement into a bone can include an injector body with a handle portion, and a cannula, a bone cement container, a low pressure drive mechanism configured to effect a flow of bone cement from said container to the injector body and a high pressure drive mechanism configured to effect a flow of bone cement through the injector body into the bone.

摘要翻译： 用于将骨水泥输送到骨中的系统和方法可以包括限定流路的手柄主体，手柄主体中的热发射器，以将能量施加到通过流路的骨水泥，骨水泥源和注射套管。 套管可以与流动路径连通，使得将套管插入骨头可以允许骨水泥通过其穿过套管远端的开口。 用于将骨水泥输送到骨头中的其它系统和方法可以包括具有手柄部分的注射器主体和套管，骨水泥容器，低压驱动机构，其被配置为实现骨粘固剂从所述容器流到喷射器主体 以及高压驱动机构，其构造成使得骨水泥通过所述注射器主体流入所述骨中。

公开(公告)号：US08512326B2

公开(公告)日：2013-08-20

申请号：US13277913

申请日：2011-10-20

申请人： John H. Shadduck ,  Aaron Germain ,  Kyle Klein ,  Michael D. Walker ,  Csaba Truckai

发明人： John H. Shadduck ,  Aaron Germain ,  Kyle Klein ,  Michael D. Walker ,  Csaba Truckai

IPC分类号： A61B18/18

CPC分类号： A61B18/1482 ,  A61B1/015 ,  A61B1/05 ,  A61B17/32002 ,  A61B17/3205 ,  A61B18/00 ,  A61B18/1206 ,  A61B18/18 ,  A61B2017/320028 ,  A61B2018/00196 ,  A61B2018/00202 ,  A61B2018/00559 ,  A61B2018/00589 ,  A61B2018/00601 ,  A61B2018/00625 ,  A61B2018/048 ,  A61B2018/126 ,  A61B2018/1437 ,  A61B2218/002 ,  A61B2218/007

摘要： Tissue may be cut and extracted from an interior location in a patient's body using a probe or tool which both effects cutting and causes vaporization of a liquid or other fluid to propel the cut tissue through an extraction lumen of the cutting device. The cutting may be achieved using an electrosurgical electrode assembly, including a first electrode on a cutting member and a second electrode within a cutting probe or tool. Thus, over a first cutting portion, radio frequency current may help cut the tissue and over a second or over transition region, the RF current may initiate vaporization of the fluid or other liquid to propel the tissue from the cutting device.

摘要翻译： 可以使用探针或工具从患者体内的内部位置切割并提取组织，所述探针或工具都会影响切割并引起液体或其它流体的蒸发，以将切割的组织推动通过切割装置的提取腔。 可以使用电外科电极组件来实现切割，所述电外科电极组件包括切割构件上的第一电极和切割探针或工具内的第二电极。 因此，在第一切割部分上，射频电流可以帮助切割组织并且在第二或过渡过渡区域上，RF电流可以引发流体或其它液体的蒸发，以推动来自切割装置的组织。

公开(公告)号：US20120197248A1

公开(公告)日：2012-08-02

申请号：US13445532

申请日：2012-04-12

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/18 ,  A61B18/14

CPC分类号： A61B18/1442 ,  A61B18/1445 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00125 ,  A61B2018/00148 ,  A61B2018/0016 ,  A61B2018/00404 ,  A61B2018/00601 ,  A61B2018/0063 ,  A61B2018/1412 ,  A61B2018/1455

摘要： Embodiments of the invention provide an electrosurgical jaw structure comprising first and second opposing jaws one or both of which include 3D variable resistance bodies. The jaw structure can be part of the working end of a surgical instrument. In one embodiment, the jaws can comprise first and second energy-delivery jaw surfaces having first and second 3D variable resistance bodies, with the jaw surface configured to be coupled to an Rf source. The 3D variable resistance bodies can define different temperature-resistance curves. The 3D bodies can be configured to control ohmic heating of tissue by modulating the delivery of Rf energy to tissue. Jaw structures having the 3D bodies can be used to engage and produce high strength tissue welds in targeted tissue including tissue volumes having varying tissue types. Such jaw structures can be configured to simultaneously apply different energy levels to each tissue type within the tissue volume.

摘要翻译： 本发明的实施例提供一种电外科钳口结构，其包括第一和第二相对的钳口，其中一个或两个包括3D可变电阻体。 钳口结构可以是外科器械的工作端的一部分。 在一个实施例中，夹爪可以包括具有第一和第二3D可变电阻体的第一和第二能量输送钳口表面，其中钳口表面被配置为耦合到Rf源。 3D可变电阻体可以定义不同的耐温曲线。 3D体可以被配置成通过调节Rf能量递送到组织来控制组织的欧姆加热。 可以使用具有3D体的颚结构来接合和产生包括具有不同组织类型的组织体积的靶组织中的高强度组织焊接。 这种钳口结构可以被配置为同时对组织体积内的每种组织类型施加不同的能量水平。

公开(公告)号：US20120136352A1

公开(公告)日：2012-05-31

申请号：US13323032

申请日：2011-12-12

申请人： Csaba Truckai ,  John H. Shadduck

发明人： Csaba Truckai ,  John H. Shadduck

IPC分类号： A61B18/14 ,  A61B17/295

CPC分类号： A61B18/1445 ,  A61B17/320016 ,  A61B17/3201 ,  A61B18/08 ,  A61B18/085 ,  A61B18/1442 ,  A61B18/1815 ,  A61B2017/00084 ,  A61B2017/2933 ,  A61B2017/2934 ,  A61B2017/2945 ,  A61B2017/320064 ,  A61B2018/00107 ,  A61B2018/00619 ,  A61B2018/0063 ,  A61B2018/00702 ,  A61B2018/00791 ,  A61B2018/1432

摘要： An electrosurgical working end and method for sealing and transecting tissue. An exemplary working end provides curved jaw members that are positioned on opposing sides of the targeted anatomic structure. The working end carries a slidable extension member having flange portions with inner surfaces that slide over the jaw members to clamp tissue therebetween. The working end carries an independent slidable cutting member that is flexible to follow the curved axis of the jaws. The electrosurgical surfaces of the jaws include partially-resistive bodies for carrying a current or load which modulates ohmic heating in the engaged tissue to prevent charring and desiccation of tissue to create a high strength thermal seal.

摘要翻译： 电外科工作端及组织密封和横切方法。 示例性工作端提供定位在目标解剖结构的相对侧上的弯曲钳口构件。 工作端承载有可滑动的延伸构件，其具有凸缘部分，其内表面在钳口构件上滑动以在其间夹紧组织。 工作端具有独立的可滑动切割构件，其可挠曲地沿着夹爪的弯曲轴线。 钳口的电外科表面包括用于承载电流或负载的部分电阻体，其调节接合组织中的欧姆加热，以防止组织的烧焦和干燥以产生高强度热密封。