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    Electrosurgical jaw structure for controlled energy delivery
    1.
    发明授权
    Electrosurgical jaw structure for controlled energy delivery 有权
    用于受控能量输送的电外科钳口结构

    公开(公告)号：US06929644B2

    公开(公告)日：2005-08-16

    申请号：US10032867

    申请日：2001-10-22

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

    发明人： Csaba Truckai ,  James A. Baker ,  Bruno Strul ,  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 ,  A61B2018/00809

    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 that overlies 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. Further, the variably resistive matrix can effectively function as a resistive electrode to thereafter conduct thermal energy to the engaged tissue volume. 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它限定了覆盖在温度敏感电阻材料或压敏电阻材料的可变电阻矩阵上的表面导电部分。 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。 此外，可变电阻矩阵可以有效地用作电阻电极，之后将热能传导到被接合的组织体积。 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。

    Electrosurgical jaw structure for controlled energy delivery
    2.
    发明授权
    Electrosurgical jaw structure for controlled energy delivery 有权
    用于受控能量输送的电外科钳口结构

    公开(公告)号：US07186253B2

    公开(公告)日：2007-03-06

    申请号：US11118881

    申请日：2005-04-29

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

    发明人： Csaba Truckai ,  James Baker ,  Bruno Strul ,  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 ,  A61B2018/00809

    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 that overlies 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.

    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它限定了覆盖在温度敏感电阻材料或压敏电阻材料的可变电阻矩阵上的表面导电部分。 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）。

    Surgical system for applying ultrasonic energy to tissue
    4.
    发明授权
    Surgical system for applying ultrasonic energy to tissue 有权
    将超声能量应用于组织的手术系统

    公开(公告)号：US06773409B2

    公开(公告)日：2004-08-10

    申请号：US09957529

    申请日：2001-09-19

    申请人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

    发明人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

    IPC分类号： A61B1804

    CPC分类号： A61B17/320092 ,  A61B18/1442 ,  A61B18/18 ,  A61B18/1815 ,  A61B18/20 ,  A61B18/22 ,  A61B2018/1455 ,  A61B2018/1876

    摘要： A surgical system for controlled application of ultrasound energy to engaged tissue volumes for creating effective biological welds or seals in tissue. The invention provides an ultrasound transmission assembly including piezoelectric elements coupled to an elongate waveguide that is reciprocatable in an interior of an introducer. The reciprocatable waveguide assembly of the invention is adapted to have multiple functionality: (i) to couple ultrasound energy to both opposing jaws to thereby deliver energy to both sides of engaged tissues to create uniform thermal weld effects; (ii) to apply very high compressive forces to captured tissues over the length of elongate jaws by engaging substantially the entire length of the jaws, and (iii) to transect the captured tissues contemporaneous with the delivery of energy to create the thermal weld. The invention further provides for use of other energy sources to deliver thermal energy to tissue, for example microwave energy, Rf energy and laser energy, either in combination with ultrasound energy or independently.

    摘要翻译： 一种外科系统，用于将受控的超声能量应用于接合的组织体积，以在组织中产生有效的生物学焊缝或密封。 本发明提供了一种超声波传输组件，其包括耦合到细长波导的压电元件，其可在导引器的内部中往复运动。 本发明的可往复波导组件适于具有多个功能：（i）将超声能量耦合到两个相对的钳口，从而将能量传递到啮合组织的两侧以产生均匀的热焊接效应; （ii）通过接合基本上整个长度的钳口，在延长的钳口的长度上对捕获的组织施加非常高的压缩力，并且（iii）在同时产生能量的同时延伸捕获的组织以产生热焊接。 本发明进一步提供了使用其他能量来组合超声能量或独立地将热能传递给组织，例如微波能量，Rf能量和激光能量。

    Pressure-assisted biopsy needle apparatus and technique
    5.
    发明授权
    Pressure-assisted biopsy needle apparatus and technique 有权
    压力辅助活检针装置及技术

    公开(公告)号：US06485436B1

    公开(公告)日：2002-11-26

    申请号：US09637463

    申请日：2000-08-10

    申请人： Csaba Truckai ,  Bruno Strul ,  John H. Shadduck

    发明人： Csaba Truckai ,  Bruno Strul ,  John H. Shadduck

    IPC分类号： A61B500

    CPC分类号： A61B10/0275 ,  A61B10/0283 ,  A61B18/1477 ,  A61B2010/0225 ,  A61B2018/0063 ,  A61B2018/1425

    摘要： An improved biopsy needle assembly for efficient removal of multiple biopsy cores from a single needle penetration. The needle apparatus comprises an elongate assembly of paired sleeves with an open notch in the wall of the outer sleeve for engaging a tissue volume in the bore of that sleeve. An inner sleeve or blade member with a sharp blade edge is moveable from a retracted position to an extended position to both (i) excise the tissue volume, and (ii) function as valve means to alter the open notch between an open position and a closed position. The invention provides a looped inflow-outflow passageway system for using high-pressure fluid flows to push or expel the excised tissue from the bore in working end where the excised tissue is captured. The looped passageway system is coupled to a remote pressurization source.

    摘要翻译： 一种改进的活检针组件，用于从单针穿透有效地去除多个活检芯。 针装置包括成对的套筒的细长组件，其在外套筒的壁中具有开口的凹口，用于接合该套筒的孔中的组织体积。 具有锋利刀片边缘的内套筒或刀片构件可从缩回位置移动到延伸位置，以便（i）切除组织体积，和（ii）用作阀装置，以改变打开位置和打开位置之间的打开凹口 关闭位置。 本发明提供了一种循环的流入 - 流出通道系统，用于使用高压流体流在被切除的组织被捕获的工作端中从所述孔中推动或排出切除的组织。 环形通道系统联接到远程加压源。

    Polymer embolic elements with metallic coatings for occlusion of vascular malformations
    9.
    发明授权
    Polymer embolic elements with metallic coatings for occlusion of vascular malformations 有权
    具有用于阻塞血管畸形的金属涂层的聚合物栓塞元件

    公开(公告)号：US06458127B1

    公开(公告)日：2002-10-01

    申请号：US09721812

    申请日：2000-11-24

    申请人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

    发明人： Csaba Truckai ,  John H. Shadduck ,  Bruno Strul

    IPC分类号： A61B1700

    CPC分类号： A61B17/12022 ,  A61B17/12113 ,  A61B17/12168 ,  A61B2017/12068

    摘要： A system for occlusion of aneurysms comprising a class of polymer embolic elements that carry a conductive material to provide the element with a specified resistivity. The embolic element is introduced into a targeted vascular malformation from a catheter sleeve that carries an electrode arrangement at its distal terminus. After introducing any selected length of the embolic element into the vascular malformation to mechanically occlude the malformation, the physician delivers electrical current within a first selected power range to the electrode at the catheter terminus. The electrical current flows to the embolic element wherein the specified resistivity of the element controllably causes a selected thickness of coagulum to form about the surface of the embolic element to more fully occupy the volume of the malformation with occlusive material. A controller and feedback circuitry allow the embolic element to be maintained at a selected temperature to insure even build-up of the desired coagulative layer about the electrode, without risk of creating hot-spots within the aneurysm. Thereafter, the physician delivers electrical current at second higher power level to electrode arrangement to cause the embolic element to act as a fuse at the catheter terminus to divide any selected length of deployed embolic element from the remainder of the embolic element still within the catheter sleeve.

    摘要翻译： 一种用于闭塞动脉瘤的系统，其包括一类聚合物栓塞元件，所述聚合物栓塞元件携带导电材料以提供具有指定电阻率的元件。 栓塞元件从导管套管引入目标血管畸形，导管套管在其远端终端带有电极装置。 在将任何选定长度的栓塞元件引入血管畸形以机械地堵塞畸形之后，医生在导管终端处将电流在第一选定的功率范围内传送到电极。 电流流向栓塞元件，其中该元件的规定电阻率可控制地导致凝块的选定厚度围绕栓塞元件的表面形成，以更充分地占据闭塞材料的畸形体积。 控制器和反馈电路允许栓塞元件保持在选定的温度，以确保围绕电极均匀地堆积所需的凝固层，而不会在动脉​​瘤内产生热点。 此后，医生将第二较高功率电平的电流传送到电极装置，以使栓塞元件作为导管终端处的保险丝，将任何选定长度的展开的栓塞元件与仍在导管套筒内的栓塞元件的其余部分分开 。

    Electrosurgical instrument and method of use
    10.
    发明授权
    Electrosurgical instrument and method of use 有权
    电外科仪器及使用方法

    公开(公告)号：US07311709B2

    公开(公告)日：2007-12-25

    申请号：US10448478

    申请日：2003-05-30

    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： A61B18/1442 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/0063 ,  A61B2018/00654 ,  A61B2018/00791 ,  A61B2018/00797 ,  A61B2018/00809 ,  A61B2018/1467

    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 variable resistive body of a positive temperature coefficient material that has a selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The variable resistive body 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 variable resistive body will focus conductive heating in a selected portion of the engagement surface.

    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和方法。 在一个实施例中，仪器的至少一个钳口限定了携带正温度系数材料的可变电阻体的组织接合平面，其在目标治疗范围内的每个选定的升高温度下具有选定的降低的电导率。 可变电阻体可以被设计成支撑目标热处理范围，例如约60℃至80℃，在该热处理范围内可以实现组织焊接。 在一种操作模式中，接合平面将自动地调节并且在接合表面的微米级部分的Rf能量施加之间空间地定位所接合组织内的欧姆加热。 在另一种操作模式中，可变电阻体将导电加热聚焦在接合表面的选定部分中。