WO1995031938A1 - Tissue connecting apparatus - Google Patents

Tissue connecting apparatus Download PDF

Info

Publication number
WO1995031938A1
WO1995031938A1 PCT/GB1995/001200 GB9501200W WO9531938A1 WO 1995031938 A1 WO1995031938 A1 WO 1995031938A1 GB 9501200 W GB9501200 W GB 9501200W WO 9531938 A1 WO9531938 A1 WO 9531938A1
Authority
WO
WIPO (PCT)
Prior art keywords
tip portion
tissue
portions
microwave
microwave energy
Prior art date
Application number
PCT/GB1995/001200
Other languages
French (fr)
Inventor
William John Hoskin
Original Assignee
Microsurgical Equipment Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Microsurgical Equipment Ltd. filed Critical Microsurgical Equipment Ltd.
Publication of WO1995031938A1 publication Critical patent/WO1995031938A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00491—Surgical glue applicators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00132—Setting operation time of a device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00491—Surgical glue applicators
    • A61B2017/00504—Tissue welding

Definitions

  • the present invention relates to tissue connecting apparatus.
  • the two end portions of the blood vessels are turned back to form two radially outwardly directed flanges. These flanges can be brought into abutment with each other and locked together with a series of circu ferentially spaced stitches using sutures or metal staples.
  • tissue connecting apparatus comprising two cooperating members which can be urged together to clamp two portions of tissue into close abutment with each other and microwave means operable to inject sufficient microwave energy into the abutting portions of the tissue to create forces which will hold the two portions at least temporarily in tight engagement with each other even after release from between the two members.
  • the two cooperating members comprise the two arms of a pair of forceps.
  • a coaxial cable runs along one said arm to direct microwave energy from one tip portion of the pair of forceps towards the other tip portion.
  • the said other tip portion carries a microwave reflector to reflect microwave energy received from the direction of said one tip portion towards the other tip portion.
  • a microwave generator is connected to said coaxial cable to deliver power in the range of from 2 to 10 watts.
  • a timer may be provided to limit the duration of the supply of energy to the tip on each energisation to a predetermined period in the range of from 1 to 30 milliseconds.
  • the power and timing of each burst of energy delivered by the generator is set so that the temperature generated in the abutting tissue portions rises to a temperature in the range of from 63°C to 75°C.
  • Said one tip may support an arcuate cavity tube coupled to the coaxial cable to receive microwave energy and deliver it to the tissue portions over an arcuate band.
  • Figure 1 is a side elevation of two blood vessels configured into abutting relationship to be coupled together;
  • Figure 2 is a perspective view of a pair of forceps for welding the pair of blood vessels together;
  • Figure 3 is a side elevation of the tips of the forceps of Figure 2 to an enlarged scale
  • Figure 4 is a block diagram of the energising circuit
  • Figure 5 is a perspective view of a modified probe for the forceps.
  • Figure 1 shows a pair of blood vessels 2 and 4 to be coupled together.
  • the end portion of the vessel 2 is folded outwardly to form a radially outwardly extending flange 2A.
  • the end portion of the vessel 4 is folded outwardly to form a radially outwardly extending flange 4A.
  • the two flanges 2A and 4A are brought into abutting relationship and a series of circumferentially spaced "spot welds" are performed using a spacial pair of forceps to lock the two flanges together.
  • Each "spot weld” is produced by clamping the two abutting flanges together at a particular spot and injecting microwave energy.
  • the microwave energy will heat the tissue up to around 68°C and in doing so cause the abutting tissues to partially dehydrate.
  • the action of dehydration will cause the abutting tissues to try to draw fluid from one another and this is sufficient for the two tissues to be temporarily bonded together.
  • the healing properties available cause the two tissues to start to knit together in a relatively short time and so, as the bond holding the tissues together as a result of dehydration diminishes, the knitting action increases until the tissues become permanently locked together.
  • This method is preferable to suturing and stapling since there is no foreign body which needs to be removed or left behind.
  • the microwave energy is preferably delivered using a pair of forceps (see Figure 2) .
  • the forceps comprise a shank 6 having a pair of arms 8 and 14.
  • a coaxial cable 22 is coupled to the shank 6 to feed microwave energy from a source 30.
  • a coaxial link 16 runs along a slot 18 on the inner face of the arm 14 and terminates in a small probe 20 directed towards the other arm 14 (se Figure 3) and located in an opening 24 in the tip 14A of the arm 14.
  • the tip 8A of the other arm 8 carries a reflector 26 to reflect back any energy received from the probe 20.
  • the reflector 26 is preferably concave.
  • the tips 8A and 14A are bent with respect to the longitudinal axis of the arms 8 and 14 to allow for easier visibility when in use.
  • the circuit supplying the microwave energy includes a generator 30 (see Figure 4) operating at a frequency of 2450 megahertz having a variable power output of 2 to 10 watts.
  • the power output may be continuous, pulsed or interrupted.
  • a timer 32 is interposed between the generator 30 and the probe 20.
  • the timer has a push button 34 which when operated, passes power for a predetermined period of time. The period may be adjusted over the range of 1 to 30 milliseconds.
  • the push button 34 is preferably located in the forceps to allow easy access for the operator.
  • an arcuate cavity, channel or tube 38 can be used to inject microwave energy over an arcuate band around the abutting tissues.
  • the energy burst may be discontinued by a temperature sensor mounted on the forceps to detect when the temperature in the clamped bits of the tissue exceed a temperature of 68°C or any other selected temperature in the range of from 63°C to 75 ⁇ C.

Abstract

Human tissue connecting apparatus comprises a set of forceps having two cooperating arms (8, 14) which can be urged together to clamp two portions (2, 4) of tissue into close abutment with each other. A microwave generator feeds microwave energy to the tips of the forceps to inject sufficient microwave energy into the abutting portions (2, 14) of the tissue to create forces which will hold the two portions (2, 4) at least temporarily in tight engagement with each other even after release from between the two tips.

Description

TISSUE CONNECTING APPARATUS
The present invention relates to tissue connecting apparatus.
In the field of surgery there is often a requirement to connect together several blood vessels. In one method of connection, the two end portions of the blood vessels are turned back to form two radially outwardly directed flanges. These flanges can be brought into abutment with each other and locked together with a series of circu ferentially spaced stitches using sutures or metal staples.
In due course, the abutting tissues knit together and the sutures or staples are either removed or left in situ as foreign bodies. To remove the sutures or staples requires further surgical procedures and to leave them in place is generally considered undesirable. Either way, the arrangement is disadvantageous. Also, the application of sutures or staples consumes both materials and time. It is an object of the invention to provide improved apparatus for connecting tissues.
According to the present invention, there is provided tissue connecting apparatus comprising two cooperating members which can be urged together to clamp two portions of tissue into close abutment with each other and microwave means operable to inject sufficient microwave energy into the abutting portions of the tissue to create forces which will hold the two portions at least temporarily in tight engagement with each other even after release from between the two members.
Preferably, the two cooperating members comprise the two arms of a pair of forceps.
Advantageously, a coaxial cable runs along one said arm to direct microwave energy from one tip portion of the pair of forceps towards the other tip portion. Preferably the said other tip portion carries a microwave reflector to reflect microwave energy received from the direction of said one tip portion towards the other tip portion. A microwave generator is connected to said coaxial cable to deliver power in the range of from 2 to 10 watts.
A timer may be provided to limit the duration of the supply of energy to the tip on each energisation to a predetermined period in the range of from 1 to 30 milliseconds.
The power and timing of each burst of energy delivered by the generator is set so that the temperature generated in the abutting tissue portions rises to a temperature in the range of from 63°C to 75°C. Said one tip may support an arcuate cavity tube coupled to the coaxial cable to receive microwave energy and deliver it to the tissue portions over an arcuate band.
Tissue connecting apparatus in the form of a pair of forceps and embodying the present invention will now be described, by way of example, with reference to the accompanying drawings, in which:
Figure 1 is a side elevation of two blood vessels configured into abutting relationship to be coupled together;
Figure 2 is a perspective view of a pair of forceps for welding the pair of blood vessels together;
Figure 3 is a side elevation of the tips of the forceps of Figure 2 to an enlarged scale; Figure 4 is a block diagram of the energising circuit; and
Figure 5 is a perspective view of a modified probe for the forceps.
Figure 1 shows a pair of blood vessels 2 and 4 to be coupled together. As shown the end portion of the vessel 2 is folded outwardly to form a radially outwardly extending flange 2A. Similarly, the end portion of the vessel 4 is folded outwardly to form a radially outwardly extending flange 4A. The two flanges 2A and 4A are brought into abutting relationship and a series of circumferentially spaced "spot welds" are performed using a spacial pair of forceps to lock the two flanges together. Each "spot weld" is produced by clamping the two abutting flanges together at a particular spot and injecting microwave energy. The microwave energy will heat the tissue up to around 68°C and in doing so cause the abutting tissues to partially dehydrate. Upon release of the clamping action the action of dehydration will cause the abutting tissues to try to draw fluid from one another and this is sufficient for the two tissues to be temporarily bonded together. During this period the healing properties available cause the two tissues to start to knit together in a relatively short time and so, as the bond holding the tissues together as a result of dehydration diminishes, the knitting action increases until the tissues become permanently locked together.
This method is preferable to suturing and stapling since there is no foreign body which needs to be removed or left behind.
The microwave energy is preferably delivered using a pair of forceps (see Figure 2) . The forceps comprise a shank 6 having a pair of arms 8 and 14. A coaxial cable 22 is coupled to the shank 6 to feed microwave energy from a source 30. A coaxial link 16 runs along a slot 18 on the inner face of the arm 14 and terminates in a small probe 20 directed towards the other arm 14 (se Figure 3) and located in an opening 24 in the tip 14A of the arm 14. The tip 8A of the other arm 8 carries a reflector 26 to reflect back any energy received from the probe 20. The reflector 26 is preferably concave.
As can be seen, the tips 8A and 14A are bent with respect to the longitudinal axis of the arms 8 and 14 to allow for easier visibility when in use.
The circuit supplying the microwave energy includes a generator 30 (see Figure 4) operating at a frequency of 2450 megahertz having a variable power output of 2 to 10 watts. The power output may be continuous, pulsed or interrupted. A timer 32 is interposed between the generator 30 and the probe 20. The timer has a push button 34 which when operated, passes power for a predetermined period of time. The period may be adjusted over the range of 1 to 30 milliseconds. The push button 34 is preferably located in the forceps to allow easy access for the operator.
In a modification shown in Figure 5, instead of a probe 20, an arcuate cavity, channel or tube 38 can be used to inject microwave energy over an arcuate band around the abutting tissues.
It will be appreciated that instead of forceps other clamping arrangements can be used.
Instead of using a timer, the energy burst may be discontinued by a temperature sensor mounted on the forceps to detect when the temperature in the clamped bits of the tissue exceed a temperature of 68°C or any other selected temperature in the range of from 63°C to 75βC.
While the frequency of 2450 megahertz has been suggested any other frequency may be used provided the energy produced can be absorbed by water.

Claims

1. Tissue connecting apparatus comprising two cooperating members which can be urged together to clamp two portions of tissue into close abutment with each other and microwave means operable to inject sufficient microwave energy into the abutting portions of the tissue to create forces which will hold the two portions at least temporarily in tight engagement with each other even after release from between the two members.
2. Apparatus according to Claim 1, wherein the two cooperating members comprise the two arms of a pair of forceps.
3. Apparatus accord to Claim 2, including a coaxial cable running along one said arm to direct microwave energy from one tip portion of the pair of forceps towards the other tip portion.
4. Apparatus according to Claim 3, wherein the said other tip portion carries a microwave reflector to reflect microwave energy received from the direction of said one tip portion back towards said one tip portion.
5. Apparatus according to Claim 3 or to Claim 4, including a microwave generator connected to said coaxial cable to deliver power in the range of from 2 to 10 watts.
6. Apparatus according to any one of Claims 3 to 5, including a timer actuable to limit the duration of the supply of energy to said one tip portion on each energisation to a predetermined period in the range of from 1 to 30 milliseconds.
7. Apparatus according to Claim 5, including control means for controlling the power and timing of each burst of energy delivered by the generator in a manner such that the temperature generated in the abutting tissue portions rises to a temperature in the range of from 63°C to 75°C.
8. Apparatus according to any one of Claims 3 to 7, wherein said one tip portion supports an arcuate cavity tube coupled to the coaxial cable to receive microwave energy and deliver it to the tissue portions over an arcuate band.
PCT/GB1995/001200 1994-05-25 1995-05-25 Tissue connecting apparatus WO1995031938A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9410505A GB9410505D0 (en) 1994-05-25 1994-05-25 Tissue connecting apparatus
GB9410505.3 1994-05-25

Publications (1)

Publication Number Publication Date
WO1995031938A1 true WO1995031938A1 (en) 1995-11-30

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1995/001200 WO1995031938A1 (en) 1994-05-25 1995-05-25 Tissue connecting apparatus

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GB (1) GB9410505D0 (en)
WO (1) WO1995031938A1 (en)

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3831607A (en) * 1973-02-10 1974-08-27 H Lindemann Electrocoagulation grasping forceps for tube sterilization by means of bipolar high frequency heat radiation
US4315510A (en) * 1979-05-16 1982-02-16 Cooper Medical Devices Corporation Method of performing male sterilization
EP0119967A1 (en) * 1983-03-11 1984-09-26 Carlo Rebuffat New purse-string instrument
EP0150253A2 (en) * 1983-04-08 1985-08-07 Research Corporation Technologies, Inc. Microwave scalpel
EP0330135A2 (en) * 1988-02-25 1989-08-30 LaserSurge, Inc. Tubular tissue welding device without moving parts
WO1993022977A2 (en) * 1992-05-18 1993-11-25 Baxter International Inc. Improved percutaneous transluminal catheter and transmitter therefor
US5295955A (en) * 1992-02-14 1994-03-22 Amt, Inc. Method and apparatus for microwave aided liposuction
WO1994008526A1 (en) * 1992-10-14 1994-04-28 Premier Laser Systems, Inc. Clamp and method for applying thermal energy

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3831607A (en) * 1973-02-10 1974-08-27 H Lindemann Electrocoagulation grasping forceps for tube sterilization by means of bipolar high frequency heat radiation
US4315510A (en) * 1979-05-16 1982-02-16 Cooper Medical Devices Corporation Method of performing male sterilization
EP0119967A1 (en) * 1983-03-11 1984-09-26 Carlo Rebuffat New purse-string instrument
EP0150253A2 (en) * 1983-04-08 1985-08-07 Research Corporation Technologies, Inc. Microwave scalpel
EP0330135A2 (en) * 1988-02-25 1989-08-30 LaserSurge, Inc. Tubular tissue welding device without moving parts
US5295955A (en) * 1992-02-14 1994-03-22 Amt, Inc. Method and apparatus for microwave aided liposuction
WO1993022977A2 (en) * 1992-05-18 1993-11-25 Baxter International Inc. Improved percutaneous transluminal catheter and transmitter therefor
WO1994008526A1 (en) * 1992-10-14 1994-04-28 Premier Laser Systems, Inc. Clamp and method for applying thermal energy

Also Published As

Publication number Publication date
GB9410505D0 (en) 1994-07-13

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