Surgical instrument with nerve detection feature

Abstract

A surgical apparatus comprises an instrument body, an end effector, and a control module. The end effector is in communication with the handle assembly. The end effector is operable for use in a surgical procedure. The control module is in communication with the end effector. The end effector with the control module is able to deliver surgical energy as well as nerve excitation energy to a surgical site. A surgeon may detect stimulation of nervous tissue by visually observing the tissue twitch, and may adjust surgical technique accordingly. A sensor may be used to detect excitation of nervous tissue based on excitation caused by the nerve excitation energy.

I/We claim: 
     
         1 . An apparatus comprising:
 (a) an instrument body;   (b) an end effector in communication with the instrument body, wherein the end effector is operable to perform a surgical operation at a surgical site, wherein the end effector is further operable to deliver nerve excitation energy to tissue at the surgical site; and   (c) a control module in communication with the end effector, wherein the control module is operable to drive the end effector to deliver surgical energy to the surgical site, wherein the control module is further operable to drive the end effector to deliver nerve excitation energy to the surgical site.   
     
     
         2 . The apparatus of  claim 1 , further comprising a sensor in communication with the control module, wherein the sensor is configured to detect excitation of nervous tissue based on excitation caused by the nerve excitation energy. 
     
     
         3 . The apparatus of  claim 2 , wherein the sensor is positioned on a distal end of the end effector. 
     
     
         4 . The apparatus of  claim 2 , wherein the sensor comprises an impedance sensor. 
     
     
         5 . The apparatus of  claim 2 , wherein the sensor comprises a plurality of current sensing electrodes. 
     
     
         6 . The apparatus of  claim 2 , wherein the end effector comprises a blade and a clamp arm. 
     
     
         7 . The apparatus of  claim 6 , wherein the sensor is positioned on the clamp arm. 
     
     
         8 . The apparatus of  claim 6 , wherein the blade is configured to deliver energy operable to excite nervous tissue. 
     
     
         9 . The apparatus of  claim 2 , further comprising an indicator in communication with the sensor, wherein the indicator is configured convey whether the sensor detects a biological response to the nerve excitation energy. 
     
     
         10 . The apparatus of  claim 9 , wherein the indicator comprises a visual indicator. 
     
     
         11 . The apparatus of  claim 9 , wherein the indicator comprises an audio indicator. 
     
     
         12 . The apparatus of  claim 1 , further comprising a transducer configured to convert electrical power into ultrasonic vibration energy, wherein the surgical energy comprises the ultrasonic vibration energy. 
     
     
         13 . The apparatus of  claim 12 , wherein the control module is operable to drive the transducer with pulses of electrical power to create the ultrasonic vibration energy. 
     
     
         14 . The apparatus of  claim 13 , wherein the control module is further operable to deliver the nerve excitation energy between the pulses of electrical power used to create the ultrasonic vibration energy. 
     
     
         15 . The apparatus of  claim 1 , wherein the nerve excitation energy comprises pulsatile electrical current. 
     
     
         16 . An apparatus comprising:
 (a) an instrument body;   (b) an end effector in communication with the instrument body, wherein the end effector comprises an ultrasonic blade operable to deliver ultrasonic energy to tissue at a surgical site; and   (c) a control module in communication with the end effector, wherein the control module is operable to selectively activate the ultrasonic blade to deliver ultrasonic energy to tissue at a surgical site, wherein the control module is further operable to activate the end effector to deliver nerve excitation energy through the end effector to tissue at the surgical site.   
     
     
         17 . The apparatus of  claim 16 , wherein the end effector further comprises a clamp arm operable to selectively pivot toward and away from the ultrasonic blade. 
     
     
         18 . The apparatus of  claim 17 , wherein the control module is operable to deliver nerve excitation energy through the clamp arm to tissue at the surgical site. 
     
     
         19 . The apparatus of  claim 16 , wherein the nerve excitation energy comprises AC electrical current. 
     
     
         20 . A method of detecting nervous tissue during a surgical procedure with a surgical instrument having an end effector, the method comprising:
 (a) positioning the end effector at a surgical site in the body of a patient;   (b) activating the end effector to perform a surgical function on tissue at the surgical site;   (c) activating the end effector to excite nervous tissue at or near the surgical site; and   (d) detecting the excitation of nervous tissue.