Tissue sealing method

Abstract

An improved method and equipment for tissue/vessel sealing is disclosed for the sealing, coagulation and transection of tissue during surgical procedures. The improvement is accomplished through better management of heat and moisture present during tissue treatment by having tissue grasping surfaces comprised of an outer non-conducting region and an inner conductive region, and including channels in the jaw assembly to direct steam and moisture away from surrounding tissue. The outer region follows the perimeter each jaw, isolating the treatment zone and preventing steam and excess heat from leaving the tissue treatment zone, reducing thermal margins and unintended patient burns. The outer region also prevents surrounding moisture from affecting the treatment zone and allowing more consistent results.

I claim: 
     
         1 . An electrosurgical instrument for treatment of tissue with distal end effectors comprising of:
 i. a jaw assembly of paired first and second opposing jaw members which are moveable between an open and closed position for grasping and delivering energy to target tissue, and   ii. at least one jaw member having an inner area of its grasping surface that is conductive for the sealing of tissue, and   iii. contains an outer region on the entire perimeter of the jaw's grasping surface that is non-conductive and configured to prevent escape of heat from the tissue treatment site during application of electrical energy, and   iv. said jaw assembly containing at least one feature to provide pressure relief by directing escaping heat and moisture back within the jaw, and   v. exhausting said heat and moisture away from the tissue treatment site and nearby tissue.   
     
     
         2 . The jaw assembly of  claim 1  where the pressure directing feature comprises at least one channel in at least one of jaw. 
     
     
         3 . The jaw assembly  2 , wherein the pressure directing feature is located at the interface of the conductive and non-conductive portions of the grasping surface of at least one jaw, following the perimeter shape of the jaw. 
     
     
         4 . The jaw assembly  2 , wherein the pressure directing feature is located in the conductive grasping region of at least one jaw. 
     
     
         5 . The jaw assembly  2 , wherein the pressure directing feature comprises a pattern in the form of channels or openings traveling from the non-conducting grasping surface of the jaws inward, through the conductive portion of the jaws. 
     
     
         6 . The jaw assembly of  claim 1  configured so that excess heat and pressure are directed to exhaust out the back region of the jaw assembly. 
     
     
         7 . The jaw assembly of  claim 1  configured so that excess heat and pressure are directed to exhaust through the shaft or body of the instrument. 
     
     
         8 . The jaw assembly of  claim 1  configured so that excess heat and pressure are directed to exhaust out the outer middle surface of at least one jaw. 
     
     
         9 . The jaw assembly of  claim 1  where the outer, non-conductive grasping surface is configured to come into tissue contact prior to the inner, conductive region of the grasping surface and provide sufficient pressure to prevent steam and other hot moisture from escaping the outer perimeter of jaws. 
     
     
         10 . The jaw assembly of  claim 1  where the outer, non-conductive grasping surface is configured to come into tissue contact at the same time as the inner, conductive region of the grasping surface and provide sufficient pressure to prevent steam and other hot moisture from escaping the outer perimeter of jaws. 
     
     
         11 . The jaw assembly of  claim 1  where the outer, non-conductive grasping surface is configured to come into tissue contact after the inner, conductive region of the grasping surface and provide sufficient pressure to prevent steam and other hot moisture from escaping the outer perimeter of jaws. 
     
     
         12 . The jaw assembly of  claim 1  where the outer, non-conductive region of the grasping surface is configured to provide an inside to out tensioning of tissue being grasped. 
     
     
         13 . The jaw assembly of  claim 1  where the outer, non-conductive region of the grasping surface is moveable in relation to the inner, conductive region. 
     
     
         14 . The jaw assembly of  claim 1  where the outer, non-conductive region of the grasping surface is in the form of an elastomeric material. 
     
     
         15 . The jaw assembly of  claim 1  where the outer, non-conductive region of the grasping surface provides a physical and electrical barrier to conductive fluids outside of the tissue grasp region. 
     
     
         16 . The jaw assembly of  claim 1  where the outer, non-conductive regions of the grasping surfaces contain surface features to aid in tissue retraction. 
     
     
         17 . The jaw assembly of  claim 1  where the outer, non-conductive region of the grasping surface is configured to aid in the release of treated tissue. 
     
     
         18 . A method for controlled application energy to tissue consisting of:
 i. engaging target tissue between an assembly of two jaws, each containing a non-conductive outer grasping region and a conductive inner grasping region, and   ii. delivering energy to heat the grasped tissue and where the outer grasping region prevents the escape of heat and moisture from the outer perimeter of the grasping surface, and   iii. excess heat and moisture is directed back through jaw assembly, and   iv. is exhausted away from tissue treatment region and surrounding tissue.   
     
     
         19 . A method for controlled application energy to tissue consisting of:
 i. engaging target tissue between an assembly of two jaws, each containing a non-conductive outer grasping region and a conductive inner grasping region, and   ii. where the outer grasping region provides outward tensioning of grasped tissue, and   iii. delivering energy to heat the grasped tissue, and   iv. where the outer grasping region prevents the escape of heat and moisture from the outer perimeter of the grasping surface, and   v. excess heat and moisture is directed back through jaw assembly, and   vi. is exhausted away from tissue treatment region and adjacent tissue, and   vii. the treated tissue is then transected.