Grasping tool with blood coagulation function
阅读说明:本技术 带有凝血功能的抓紧工具 (Grasping tool with blood coagulation function ) 是由 A.戈瓦里 Y.阿尔加维 V.格莱纳 I.斯特尼茨基 A.C.阿尔特曼 于 2020-04-17 设计创作,主要内容包括:本发明题为“带有凝血功能的抓紧工具”。在一个实施方案中,医疗系统包括医疗器械和处理电路。医疗器械具有抓紧器头部、致动器以及接近传感器。抓紧器头部包括互补的第一抓爪和第二抓爪以及设置在第一抓爪和第二抓爪的相应远侧部分上的第一传导表面和第二传导表面,传导表面在抓紧器头部中彼此电绝缘。致动器被配置为闭合抓爪以便使传导表面与活体受检者的身体部分的组织接触。接近传感器被配置为响应于抓爪之间的位移输出至少一个接近信号。处理电路被耦合以响应于至少一个接近信号感测第一抓爪和第二抓爪之间的位移,并且当感测到的位移小于给定阈值位移时,在抓爪的第一传导表面和第二传导表面之间施加电流。(The invention provides a grasping tool with blood coagulation function. In one embodiment, a medical system includes a medical instrument and processing circuitry. The medical instrument has a grasper head, an actuator, and a proximity sensor. The grasper head includes complementary first and second grippers and first and second conductive surfaces disposed on respective distal portions of the first and second grippers, the conductive surfaces being electrically insulated from each other in the grasper head. The actuator is configured to close the gripper so as to bring the conductive surface into contact with tissue of a body part of a living subject. The proximity sensor is configured to output at least one proximity signal in response to a displacement between the grippers. The processing circuit is coupled to sense a displacement between the first gripper and the second gripper in response to the at least one proximity signal and apply a current between the first conductive surface and the second conductive surface of the gripper when the sensed displacement is less than a given threshold displacement.)
1. A medical system, comprising:
a medical device, the medical device comprising:
a grasper head, the grasper head comprising: a first gripper and a second gripper that are complementary; and first and second conductive surfaces disposed on respective distal portions of the first and second grippers, the first and second conductive surfaces being electrically insulated from each other in the gripper head;
an actuator configured to close the gripper to bring the first and second conductive surfaces into contact with tissue of a body part of a living subject; and
a proximity sensor configured to output at least one proximity signal in response to a displacement between the first gripper and the second gripper; and
processing circuitry coupled to sense a displacement between the first gripper and a second of the grippers in response to the at least one proximity signal and to apply a current between the first conductive surface and the second conductive surface of the gripper when the sensed displacement is less than a given threshold displacement.
2. The system of claim 1, wherein the proximity sensor comprises two electrical contacts disposed on the grasper head and configured to contact each other when the displacement between the first and second graspers is less than the given threshold displacement.
3. The system of claim 2, wherein the respective electrical contacts are connected to the grasper head by respective springs.
4. The system of claim 1, wherein the grasper head includes at least one position tracking transducer configured to provide a position signal indicative of a position of the grasper head, and the processing circuitry is configured to calculate the position of the grasper head in response to the position signal.
5. The system of claim 1, wherein the proximity sensor comprises two position tracking transducers disposed in the gripper head and configured to provide respective position signals indicative of respective positions of the first gripper and the second gripper included in the at least one proximity signal, and the processing circuit is configured to calculate a displacement between the first gripper and the second gripper in response to the respective position signals.
6. The system of claim 1, further comprising an irrigation pump, wherein the medical instrument comprises an irrigation tube coupled to the irrigation pump, the irrigation pump configured to pump fluid into the irrigation tube to cool the tissue.
7. The system of claim 1, wherein the grasper head comprises: two elongated members comprising the first gripper and the second gripper; and a pin connecting the two elongated members to allow angular movement between the first and second grippers.
8. The system of claim 7, wherein the proximity sensor comprises two electrical contacts disposed on two opposite sides of the two elongated members and configured to contact each other when the displacement between the first and second grippers is less than the given threshold displacement.
9. The system of claim 8, wherein respective ones of the electrical contacts are connected to the elongated member by respective springs.
Technical Field
The present invention relates to medical tools and in particular, but not exclusively, to grasping tools.
Background
Graspers may be used in medical applications to grasp, remove, and/or cut tissue, which often results in significant bleeding. Coagulation in surgery may be performed by applying an electric current to bleeding tissue.
For example, U.S. patent 5,810,809 to Rydell describes an arthroscopic instrument for debriding tissue that includes electrocautery electrodes for achieving hemostasis at a surgical site. The drive motor of the debridement instrument is located remotely from the handle of the instrument and provides a means of electrically isolating the handle from the drive motor and associated power source even if the arthroscopic surgery is performed under saline.
U.S. patent 8,702,702 to Edwards et al describes a mechanical cutting device that utilizes mechanical (rotational) motion and suction to engage tissue and also applies cutting energy sufficient to vaporize the tissue. Rotation and suction are used to engage tissue (tissue is drawn into the cutting windows of the inner and outer blades when they are aligned), and the cutting member then functions as an electrode by applying an electrical cutting signal thereto such that the cutting member electrically cuts tissue as the cutting members are relatively rotated. The electrical cutting signal is only applied when the windows are aligned until the tissue cutting is complete. The cutting signal preferably stops after the cutting window becomes misaligned. When the cutting window is misaligned, a coagulation signal may be provided to the cutting member, causing the device to function as an electrocautery device.
U.S. patent publication 2014/0148729 to Schmitz et al describes a method for removing at least a portion of a brain tumor and may first include contacting a forward tissue cutter disposed at a distal end of a tissue removal device with the brain tumor. The tissue removal device can include a shaft having a diameter of no greater than about 10mm, and in some embodiments, the tissue cutter does not extend laterally beyond the diameter of the shaft. The method may next involve cutting tissue from the brain tumor using a tissue cutter. The method may then involve moving the cut tissue through the channel of the shaft in a direction from the distal end of the tissue removal device toward the proximal end of the device.
European patent publication EP0913126 to Kese et al describes an open surgical and endoscopic version of a combination bipolar electrosurgical cutting and grasping instrument in which the grasping surface is contained within the shape of a standard surgical scissors. This unique arrangement creates a combined scissors and grasper that has the appearance of a standard scissors, but allows the surgeon to cauterize tissue and blood vessels while cutting and grasping, making the instrument well suited for performing vascular anastomosis.
Disclosure of Invention
According to an embodiment of the present disclosure, a medical system is provided that includes a medical instrument and a processing circuit. The medical instrument includes a grasper head, an actuator, and a proximity sensor. The grasper head includes complementary first and second grippers and first and second conductive surfaces disposed on respective distal portions of the first and second grippers, the first and second conductive surfaces being electrically insulated from each other in the grasper head. The actuator is configured to close the gripper to bring the first conductive surface and the second conductive surface into contact with tissue of a body part of a living subject. The proximity sensor is configured to output at least one proximity signal in response to a displacement between the first gripper and the second gripper. The processing circuit is coupled to sense a displacement between the first gripper and the second gripper in response to the at least one proximity signal and apply a current between the first conductive surface and the second conductive surface of the gripper when the sensed displacement is less than a given threshold displacement.
Further, according to an embodiment of the present disclosure, the proximity sensor comprises two electrical contacts disposed on the grasper head and configured to contact each other when the displacement between the first and second graspers is less than a given threshold displacement.
Still further in accordance with an embodiment of the present disclosure, the respective electrical contacts are connected to the grasper head by respective springs.
Further, in accordance with an embodiment of the present disclosure, the grasper head includes at least one position tracking transducer configured to provide a position signal indicative of a position of the grasper head, and the processing circuitry is configured to calculate the position of the grasper head in response to the position signal.
Further, according to an embodiment of the invention, the proximity sensor comprises two position tracking transducers arranged in the gripper head and configured to provide respective position signals comprised in the at least one proximity signal, the position signals being indicative of respective positions of the first gripper and the second gripper, and the processing circuit is configured to calculate the displacement between the first gripper and the second gripper in response to the respective position signals.
Further in accordance with an embodiment of the present disclosure, the system includes an irrigation pump, wherein the medical instrument includes an irrigation tube coupled to the irrigation pump, the irrigation pump configured to pump fluid into the irrigation tube to cool the tissue.
Still further in accordance with an embodiment of the present disclosure, the grasper head includes two elongated members having a first gripper and a second gripper, and a pin connecting the two elongated members to allow angular movement between the first gripper and the second gripper.
Further, according to an embodiment of the present disclosure, the proximity sensor comprises two electrical contacts disposed on two opposite sides of the two elongated members and configured to contact each other when the displacement between the first gripper and the second gripper is smaller than a given threshold displacement.
Further, according to embodiments of the present disclosure, the respective electrical contacts are connected to the elongated member by respective springs.
There is also provided, in accordance with another embodiment of the present disclosure, a medical method, including: closing the first and second jaws of the grasper head of the medical instrument to bring the first and second conductive surfaces disposed on the respective distal portions of the first and second jaws into contact with tissue of the body portion of the living subject, the first and second conductive surfaces being electrically insulated from each other in the grasper head; outputting at least one proximity signal in response to a displacement between the first gripper and the second gripper; sensing a displacement between the first gripper and the second gripper in response to the at least one proximity signal; and applying a current between the first and second conductive surfaces of the gripper when the sensed displacement is less than a given threshold displacement.
Further, according to an embodiment of the present disclosure, the method includes that the two electrical contacts are in contact with each other when the displacement between the first gripper and the second gripper is smaller than a given threshold displacement.
Still further in accordance with an embodiment of the present disclosure, the respective electrical contacts are connected to the grasper head by respective springs.
Additionally, in accordance with an embodiment of the present disclosure, the method includes providing a position signal indicative of a position of the grasper head and calculating the position of the grasper head in response to the position signal.
Further, in accordance with an embodiment of the present disclosure, the method includes providing two position tracking transducers disposed in the gripper head, providing respective position signals included in the at least one proximity signal indicative of respective positions of the first gripper and the second gripper, and calculating a displacement between the first gripper and the second gripper in response to the respective position signals.
Further, according to an embodiment of the present disclosure, the method includes pumping a fluid into an irrigation tube of the medical instrument to cool the tissue.
Technical solution 1. a medical treatment method, comprising:
closing first and second grippers of a grasper head of a medical instrument to bring first and second conductive surfaces disposed on respective distal portions of the first and second grippers into contact with tissue of a body portion of a living subject, the first and second conductive surfaces being electrically insulated from each other in the grasper head;
outputting at least one proximity signal in response to a displacement between the first gripper and the second gripper;
sensing the displacement between the first gripper and the second gripper in response to the at least one proximity signal; and
applying a current between the first conductive surface and the second conductive surface of the gripper when the sensed displacement is less than a given threshold displacement.
Solution 2. the method according to solution 1, further comprising bringing two electrical contacts into contact with each other when the displacement between the first gripper and the second gripper is less than the given threshold displacement.
Solution 3. the method of solution 2, wherein respective ones of the electrical contacts are connected to the grasper head by respective springs.
Technical solution 5. the method according to technical solution 1, further comprising: two position tracking transducers disposed in the gripper head providing respective position signals indicative of respective positions of the first gripper and the second gripper included in the at least one proximity signal; and calculating a displacement between the first gripper and the second gripper in response to the respective position signal.
The method of claim 1, further comprising pumping a fluid into an irrigation tube of the medical device to cool the tissue.
Drawings
The present invention will be understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
FIG. 1 is a schematic view of a medical surgical system according to an embodiment of the present invention;
FIG. 2 is a schematic view of a magnetic field radiation assembly for use in a medical surgical system, according to an embodiment of the present invention;
FIG. 3 is a schematic view of a medical device according to an embodiment of the present invention;
FIGS. 4-6 are various schematic views of the distal end of the medical device shown in FIG. 3;
figure 7 is a schematic view of a grasper head according to a first alternate embodiment of the present invention;
figure 8 is a schematic view of a grasper head according to a second alternate embodiment of the present invention; and
FIG. 9 is a flow chart including exemplary steps in a method of operation of the system of FIG. 1.
Detailed Description
SUMMARY
As described above, graspers may be used in medical applications to grasp, remove, and/or cut tissue, which often results in excessive bleeding. Coagulation in surgery may be performed by applying an electric current to bleeding tissue.
The geometry and mechanical structure of the medical device may complicate coagulation using the medical device. For example, if the medical device includes many conductive surfaces, the applied current may be limited due to short circuits caused by the metal surfaces.
Embodiments of the present invention include a system including a medical instrument for grasping tissue and automatically applying an electrical current to the grasped tissue in response to the tissue being grasped, thereby performing coagulation when the tissue may bleed. The electrical current is automatically applied in response to grasping tissue based on sensing a displacement between complementary grippers of a grasper head of the medical instrument. The automatic application of current prevents the physician from forgetting to coagulate each time the physician grasps tissue, and also allows the physician to concentrate on other tasks at hand.
The gripper includes a conductive surface through which an electrical current is applied to the tissue. The conductive surfaces are electrically connected to the processing circuitry, but the conductive surfaces are electrically insulated from each other in the gripper head. Such electrical insulation may be achieved by forming at least a portion of the grasper head or at least a portion of the grasper from an insulating material, such as a biocompatible plastic. In some embodiments, the grasper head and/or the grasper may be formed of a conductive material coated with an insulating material, such as a biocompatible plastic.
In some embodiments, the grasper head includes two elongated members having grippers, and a pin connecting the two elongated members to allow angular movement between the grippers.
The medical device includes an actuator to close the gripper to bring the conductive surface into contact with tissue of a body part of a living subject.
The grasper head also includes at least one position tracking transducer that provides a position signal indicative of the position of the grasper head. The processing circuitry calculates the position of the grasper head from the position signal. Based on the calculated position, a representation of the grasper head in the body part may be displayed on the display screen. The physician may then guide the grasper head within the body part according to the displayed representation of the grasper head.
The grasper head includes a proximity sensor that outputs one or more proximity signals in response to displacement between the grippers.
In some embodiments, the proximity sensor includes two electrical contacts disposed on the grasper head. The electrical contacts are in contact with each other when the displacement between the grippers is less than a given threshold displacement, for example about 2mm or in the range 1mm-4 mm. The electrical contacts may be connected to the grasper head by respective springs.
In some embodiments, the proximity sensor includes two electrical contacts disposed on two opposing sides of two elongated members. When the displacement between the grippers is less than a given threshold displacement, the electrical contacts are in contact with each other. The electrical contacts may be connected to the elongate member by respective springs.
In some embodiments, the proximity sensor includes two position tracking transducers disposed at the head of the grasper. A position tracking transducer provides a position signal indicative of the position of the gripper. The processing circuit calculates a displacement between the grippers in response to the position signal.
The processing circuit is coupled to sense a displacement between the grippers in response to the proximity signal. Sensing the displacement may be based on the two electrical contacts being in contact with each other. Alternatively, sensing the displacement may be performed by calculating the displacement between the grippers.
When the sensed displacement is less than a given threshold displacement, the processing circuitry applies a current between the conductive surfaces of the gripper. As a result of the two electrical contacts contacting each other, the processing circuitry may apply an electrical current between the conductive surfaces, thereby closing the electrical circuit, resulting in a flow of electrical current. Alternatively, the processing circuitry may apply the current in response to the calculated displacement being less than a given threshold displacement.
The system may also include an irrigation pump and an irrigation tube disposed in the medical instrument. The flush tube is coupled to a flush pump. The irrigation pump pumps fluid into the irrigation tube to cool the tissue heated by the application of the electrical current.
Description of the System
Turning now to the drawings, reference is now made to fig. 1, which is a schematic illustration of a medical surgical system 20, and to fig. 2, which is a schematic illustration of a magnetic field radiation
For this procedure, the magnetic
The alternating magnetic field induces signals in
The position of the distal end of medical instrument 28 and the position of
In some embodiments, the medical instrument 28 is attached to the robotic arm 40 and held by the robotic arm 40, which is configured to manipulate the medical instrument 28. The robotic arm 40 includes a plurality of robotic joints configured to control movement of the robotic arm 40 and manipulate the medical instrument 28. In other embodiments, the medical instrument 28 is held and manipulated by the physician 54.
As described in more detail below, the
Similarly, determination of the position and orientation of position tracking transducer 36 enables tracking of the position and orientation of a portion (e.g., the head) of
A system for tracking an entity inserted in a patient using a magnetic field radiator, such as
The robotic arm 40 typically has its own robot coordinate system. The robot coordinate system is registered with the magnetic coordinate system of the
The elements of the system 20, including the
In some embodiments, a CT image of
In implementation, some or all of these functions of
The system 20 may also include a flush pump 64 disposed in the console 50. The flush pump 64 is described in more detail with reference to fig. 3-6.
Reference is now made to fig. 3 to 6. Fig. 3 is a schematic illustration of a medical device 28 according to an embodiment of the present invention. Fig. 4-6 are various schematic views of the distal end 34 of the medical device 28 shown in fig. 3.
The medical instrument 28 includes a grasper head 68 having complementary graspers 66 (referenced 66-1 and 66-2, respectively, in the figures) and conductive surfaces 70 (referenced 70-1 and 70-2, respectively) disposed on respective distal portions of the graspers 66, the conductive surface 70-1 being disposed on the grasper 66-1 and the conductive surface 70-2 being disposed on the grasper 66-2. The gripper 66 may optionally include one or more cutting edges (not shown). The conductive surface 70 may be formed of any suitable conductive material, such as, but not limited to, platinum iridium. The cutting edge may be formed of any suitable material, such as, but not limited to, stainless steel. The dimensions of the grasper head 68 are on the order of millimeters.
The conductive surface 70 provides an area on the gripper 66 through which to apply an electrical current to the grasped tissue. The conductive surfaces 70 are electrically isolated from each other in the grasper head 68. Such electrical isolation may be achieved by forming at least a portion of the grasper head 68 or at least a portion of the grasper 66 from an insulating material, such as a biocompatible plastic. In some embodiments, the grasper head 68 and/or the grasper 66 may be formed of a conductive material coated with an insulating material, such as a biocompatible plastic.
In some embodiments, the grasper head 68 includes two
The medical instrument 28 also includes an actuator 76 configured to close the gripper 66 so as to bring the conductive surface 70-1 and the conductive surface 70-2 into contact with tissue of a body part of a living subject. In fig. 3, the actuator 76 is shown to include a wheel handle 78 with a wire 80 connected to the proximal end of one of the
The grasper head 68 includes at least one
The grasper head 68 includes a
In some embodiments, the
In some embodiments, the
The
In embodiments where the
In embodiments where the
The
The medical device 28 includes an irrigation tube 90 disposed therein and connected to the irrigation pump 64. The irrigation pump 64 is configured to pump fluid into the irrigation tube 90 to cool the tissue. The flush pump 64 may be activated in response to an electrical current flowing between the conductive surfaces 70.
Reference is now made to fig. 7, which is a schematic illustration of a grasper head 68B, according to a first alternative embodiment of the present invention. The grasper head 68B is substantially identical to the grasper head 68 of fig. 3-6, except that the
Reference is now made to fig. 8, which is a schematic illustration of a
Reference is now made to fig. 9, which is a
The actuator 76 is configured to close (block 94) the gripper 66 so as to bring the conductive surfaces 70-1, 70-2 into contact with tissue of a body part of a living subject.
The
When the
When the
The
As previously described, when the
When the
The
Various features of the invention which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination.
The embodiments described above are cited by way of example, and the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not disclosed in the prior art.
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