Radio-frequency tissue welder two stage pressure application

Abstract

There are disclosed methods and apparatus for attachment and welding of tissue. In an embodiment, the apparatus includes an energy applicator configured to apply energy to generate heat within a target tissue to evaporate water to create dried tissue, and a thermally conductive material disposed adjacent the first tissue contacting surface or the second tissue contacting surface. The thermally conductive material may be configured for direct contact with the target tissue heated by the energy applicator. The thermally conductive material provides a high coefficient of thermal conductivity so as to evenly distribute heat within the targeted tissue area. Other embodiments are also disclosed.

1 - 32 . (canceled) 
     
     
         33 . Apparatus for attachment and welding of tissue, the apparatus comprising:
 an energy applicator positioned adjacent at least one of a first tissue contacting surface and a second tissue contacting surface, the energy applicator positioned on a grasping mechanism, the energy applicator configured to apply an amount of energy to generate heat within a target tissue so as to evaporate intracellular and extracellular water from the target tissue to create dried tissue, and denature at least one of collagen and elastin within the target tissue to attach portions of the target tissue together; and   a pressure controller in operable connection with the grasping mechanism, the pressure controller having a low pressure setting and a high pressure setting, the low pressure setting configured to allow the grasping mechanism to apply a low amount of pressure so as to grasp and approximate tissue without excessive damage to the tissue, the high pressure setting configured to allow the grasping mechanism to apply a high amount of pressure so as to clamp the tissue for welding with the energy applicator, and the high amount of pressure for the high pressure setting exceeding the low amount of pressure for the low pressure setting.   
     
     
         34 . Apparatus in accordance with  claim 33 , wherein the low pressure setting is configured to allow energy delivery to ablate and shrink tissue. 
     
     
         35 . Apparatus in accordance with  claim 33 , wherein the high pressure setting is configured to allow optimized tissue welding during energy delivery. 
     
     
         36 . Apparatus in accordance with  claim 33 , wherein the grasping mechanism includes a set of jaws in operable connection with the pressure controller. 
     
     
         37 . Apparatus in accordance with  claim 33 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 5 to 10 kgf/cm 2 . 
     
     
         38 . Apparatus in accordance with  claim 33 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 10 kgf/cm 2 . 
     
     
         39 . Apparatus in accordance with  claim 33 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 15 kgf/cm 2 . 
     
     
         40 . Apparatus in accordance with  claim 33 , wherein a clamping force of the low pressure setting is distributed over substantially an entire portion of the tissue contacting surface, and wherein a clamping force of the high pressure setting is distributed over substantially an entire portion of the tissue contacting surface. 
     
     
         41 . Apparatus for attachment and welding of tissue, the apparatus comprising:
 an energy applicator positioned on at least one of a first tissue contacting surface and a second tissue contacting surface, the energy applicator positioned on a grasping mechanism, the energy applicator configured to apply an amount of energy to generate heat within a target tissue so as to evaporate intracellular and extracellular water from the target tissue to create dried tissue, and denature at least one of collagen and elastin within the target tissue to attach portions of the target tissue together; and   a pressure controller in operable connection with the grasping mechanism, the pressure controller having a low pressure setting and a high pressure setting, the low pressure setting configured to allow the grasping mechanism to apply a low amount of pressure so as to grasp and approximate tissue without excessive damage to the tissue, the high pressure setting configured to allow the grasping mechanism to apply a high amount of pressure so as to clamp the tissue for welding with the energy applicator, and the high amount of pressure for the high pressure setting exceeding the low amount of pressure for the low pressure setting.   
     
     
         42 . Apparatus in accordance with  claim 41 , wherein the low pressure setting is configured to allow energy delivery to ablate and shrink tissue. 
     
     
         43 . Apparatus in accordance with  claim 41 , wherein the high pressure setting is configured to allow optimized tissue welding during energy delivery. 
     
     
         44 . Apparatus in accordance with  claim 41 , wherein the grasping mechanism includes a set of jaws in operable connection with the pressure controller. 
     
     
         45 . Apparatus in accordance with  claim 41 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 5 to 10 kgf/cm 2 . 
     
     
         46 . Apparatus in accordance with  claim 41 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 10 kgf/cm 2 . 
     
     
         47 . Apparatus in accordance with  claim 41 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 15 kgf/cm 2 . 
     
     
         48 . Apparatus in accordance with  claim 41 , wherein a clamping force of the low pressure setting is distributed over substantially an entire portion of the tissue contacting surface, and wherein a clamping force of the high pressure setting is distributed over substantially an entire portion of the tissue contacting surface. 
     
     
         49 . A method of attaching and reinforcing tissue, the method comprising:
 selecting a low pressure setting on a pressure controller in operable connection with a grasping mechanism;   at the low pressure setting, applying energy adjacent to tissue surfaces with an energy applicator positioned on the grasping mechanism, wherein the application of the energy is configured to generate an amount of heat within a target tissue so as to evaporate intracellular and extracellular water from a target tissue to create dried tissue and so as to grasp and approximate tissue without excessive damage to the tissue;   subsequent to applying energy at the low pressure setting, selecting a high pressure setting on the pressure controller in operable connection with a grasping mechanism, the high amount of pressure for the high pressure setting exceeding the low amount of pressure for the low pressure setting; and   at the high pressure setting, applying energy adjacent to tissue surfaces with the energy applicator positioned on the grasping mechanism, wherein the application of the energy is configured to generate an amount of heat within a target tissue so as to allow optimized tissue welding during energy delivery.   
     
     
         50 . A method in accordance with  claim 49 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 5 to 10 kgf/cm 2 . 
     
     
         51 . A method in accordance with  claim 49 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 10 kgf/cm 2 . 
     
     
         52 . A method in accordance with  claim 49 , wherein the low pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of less than 1 kgf/cm 2  and the high pressure setting for the pressure controller is configured to allow the grasping mechanism to apply a clamping force of about 1 to 15 kgf/cm 2 .