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WO2025046426A1 - Détection de température tissulaire pour scellement bipolaire à l'aide d'une technologie de réseau de bragg sur fibre - Google Patents

Détection de température tissulaire pour scellement bipolaire à l'aide d'une technologie de réseau de bragg sur fibre Download PDF

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Publication number
WO2025046426A1
WO2025046426A1 PCT/IB2024/058228 IB2024058228W WO2025046426A1 WO 2025046426 A1 WO2025046426 A1 WO 2025046426A1 IB 2024058228 W IB2024058228 W IB 2024058228W WO 2025046426 A1 WO2025046426 A1 WO 2025046426A1
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WO
WIPO (PCT)
Prior art keywords
temperature
surgical device
thermal assembly
examples
tissue area
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Legal status (The legal status 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 status listed.)
Pending
Application number
PCT/IB2024/058228
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English (en)
Inventor
Nitin Goyal
Snehashis Haldar
Srimannarayana CHALLARI
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Medtronic Advanced Energy LLC
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Medtronic Advanced Energy LLC
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Publication of WO2025046426A1 publication Critical patent/WO2025046426A1/fr
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Classifications

    • 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
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • 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
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00714—Temperature
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • 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
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device

Definitions

  • the present technology is generally related to the field of medical devices, systems, and methods for use in surgical procedures. More specifically, this disclosure relates to surgical devices, units, systems, and methods that can provide for tissue temperature monitoring during procedures relating to hemostasis or sealing of bodily tissues.
  • This disclosure relates generally to the field of medical devices, systems, and methods for use in surgical procedures. More specifically, this disclosure relates to surgical devices, units, systems, and methods that can provide for hemostasis or sealing of bodily tissues, including bone, while continuously, simultaneously, or periodically monitoring the temperature of the tissue or bone.
  • the management and control of intraoperative bleeding can include the techniques of coagulation, hemostasis, or sealing of tissues and are often performed with the aid of electrodes energized from a suitable power source.
  • Typical electrosurgical devices apply an electrical potential difference or signal between an active electrode and a return electrode on a grounded body of the patient or between an active electrode and a return electrode on the device to deliver electrical energy to the area where tissue is to be affected.
  • Electrosurgical devices pass electrical energy through tissue between the electrodes to provide coagulation to control bleeding and hemostasis to seal tissue.
  • the electrosurgical devices are usually held by the surgeon and connected to the power source, such as an electrosurgical unit having a power generator, via cabling.
  • Dry-tip electrosurgical devices can adversely affect tissue and surgical procedures by desiccating or perforating tissue, causing tissue to stick to the electrodes, burning or charring tissue, and generating smoke at the surgical site. More recently, fluid-assisted electrosurgical devices have been developed that use saline to inhibit such undesirable effects as well as to control the temperature of the tissue being treated and to electrically couple the device to the tissue. Fluid- assisted electrosurgical devices have been developed which, when used in conjunction with an electrically conductive fluid such as saline, may be moved along a tissue surface without cutting the tissue to seal tissue to inhibit blood and other fluid loss during surgery.
  • an electrically conductive fluid such as saline
  • Fluid-assisted electrosurgical devices apply radiofrequency (RF) electrical energy and electrically conductive fluid to provide for sealing of soft tissues and bone in applications of orthopedics (such as total hip arthroplasty, or THA, and total knee arthroplasty, or TKA), spinal oncology, neurosurgery, thoracic surgery, and cardiac implantable electronic devices as well as others such as general surgery within the human body.
  • RF energy and the electrically conductive fluid permits the electrosurgical device to operate at approximately 100 degrees Celsius, which is nearly 200 degrees Celsius less than traditional electrosurgical devices.
  • hemostasis is performed with fluid-assisted devices having electrodes in the bipolar arrangement that are referred to as bipolar sealers. By controlling bleeding, bipolar sealers have been demonstrated to reduce the incidence of hematoma and transfusions, help maintain hemoglobin levels, and reduce surgical time in a number of procedures, and may reduce the use of hemostatic agents.
  • the techniques of this disclosure generally relate to the field of medical devices, systems, and methods for use in surgical procedures. More specifically, this disclosure relates to surgical devices, units, systems, and methods that can provide for hemostasis or sealing of bodily tissues, including bone, while continuously, simultaneously, or periodically monitoring the temperature of the tissue or bone.
  • the present disclosure provides a surgical device, comprising a handle including at least one user input mechanism and a shaft extending distally from the handle, the shaft including a distal end.
  • a thermal assembly can be operably coupled to the distal end of the shaft, including a heating element, wherein the thermal assembly includes at least one heating element and is electrically coupled to the at least one user input mechanism.
  • a temperature monitoring mechanism can in coupled to the handle, wherein the temperature monitoring mechanism includes temperature monitoring technology such that a temperature of the thermal assembly or a targeted tissue area of a patient is monitored during a procedure with the surgical device, wherein the temperature monitoring technology includes Fiber Bragg Grating technology.
  • the present disclosure provides a method for operating a surgical device, comprising providing hemostatic sealing of tissue, at a targeted area of a patient, with a thermal assembly operably coupled to a distal end of a shaft, the thermal assembly including a heating element, wherein the heating element is electrically coupled to at least one user input mechanism.
  • the method further comprising coupling the user input mechanism to a handle, wherein the shaft extends distally and monitoring and determining the temperature of the targeted tissue area or the thermal assembly during hemostatic sealing.
  • FIG. 1 is a schematic view illustrating a surgical system, according to examples.
  • FIG. 2 is a side view illustrating an example of a surgical device of the system of FIG. 1 , including a thermal assembly with an internal temperature monitoring mechanism, according to examples.
  • FIG. 3 is a side view illustrating an alternative example of a surgical device including a thermal assembly that can be used in conjunction with an external temperature monitoring mechanism, according to examples.
  • FIG. 4 is a schematic view illustrating the temperature monitoring technology, according to examples.
  • FIG. 5 illustrates an example wavelength shift seen by gratings during temperature monitoring, according to examples.
  • FIG. 6 illustrates an example block diagram method for temperature detection and monitoring during homeostatic or sealing procedures, according to examples.
  • FIG. 1 is a side view illustrating an example surgical system 10 that can include a handheld surgical device to deliver thermal energy to provide hemostasis or sealing of body tissues, including bone, with or without the constant (e.g., having a consistent, adjustable flow rate) or periodic use of fluid dispersal.
  • periodic use of fluid dispersal can include dispersing fluid at a given interval of time, every ‘C’ seconds/minutes/etc., on demand of a clinician (e.g., via a user input), etc.
  • system 10 can be included within a handheld surgical device.
  • system 10 can include a selectively dispersed fluid, e.g., a fluid can be dispersed at the discretion of the clinician or operator of the system 10.
  • the dispersed fluid can be implemented to be constantly dispersed while the device is activated.
  • the fluid can disburse constant fluid at a flow rate selectively determined by the clinician or operator.
  • the fluid can be water, saline, or other fluidlike substance that can cool or otherwise reduce the temperature of the area that is undergoing hemostasis or sealing procedures.
  • System 10 can include a source of thermal energy 12 coupled to a heating element 14.
  • the source of thermal energy 12 can include a source of electrical energy electrically coupled to the heating element 14.
  • heating element 14 can be configured as part of heating assembly on a distal tip of a surgical device, e.g., handheld surgical device 100 of FIG. 2.
  • Heating element 14 can include a resistive material that is configured to rise in temperature when an electrical current is passed through heating element 14.
  • the source of thermal energy 12 can be selectively activated via a switch, button, lever, directional pad, or any other input mechanisms to apply the electrical current to the heating element 14.
  • Activation of the thermal assembly can quickly heat heating element 14 into the temperature range of about 80 degrees Celsius to about 110 degrees Celsius, such as to a preselected temperature within that range.
  • the heating element 14 can include a low thermal mass or heat capacity so that heating element 14 can heat to the preselected temperature or temperature range within a predetermine or set period of time (e.g., between one or two seconds of activation) and can cool to a safe temperature (e.g., below a threshold temperature) within a predetermined or set period of time (e.g., between one or two seconds) of deactivation.
  • System 10 can include a temperature monitoring mechanism 16 operably coupled to detect the temperature of heating element 14 and/or bodily tissue that is subject to the hemostasis or sealing of the patient described in greater detail below.
  • the temperature monitoring mechanism 16 can indirectly (i.e., non-contact) determine the temperature of the heating element 14 or bodily tissue of the patient, which is described in greater detail below.
  • the temperature monitoring mechanism 16 is operably coupled to a controller 18 to monitor the temperature of the heating element 14 and the temperature of the tissue of the patient.
  • Controller 18 can include a processor 19 and memory 20 to receive signals, information, data etc. transmitted by the temperature monitoring mechanism 16 and to execute a set of instructions in an application to monitor the temperature of the heating element 14 and the temperature of the tissue of the patient.
  • system 10 can include a display or a data output couplable to an external monitor to provide graphical or indications of temperature or other information as determined by the controller 18.
  • display or output can be external to or couple with the surgical device, e.g., handheld surgical device 100.
  • temperature monitoring can be done in parallel with the use of the heating element 14 during hemostasis or sealing procedures.
  • system 10 can include an alerting mechanism coupled to the system 100 (e.g., LED light, internal speaker, display, etc.) that can produce an alert, such as a visual or audio alert (e.g., activating a light, a continuous flashing light, produce a sound, such as an alarm or alert indication, etc.) when the controller detects the temperature of the heating element 14 or tissue of the patient exceeding a threshold temperature.
  • a visual or audio alert e.g., activating a light, a continuous flashing light, produce a sound, such as an alarm or alert indication, etc.
  • the threshold temperature can be shown via a display electrically or wirelessly coupled to the alerting mechanism. If the threshold temperature is reached or exceeded, the alert can be seen or heard by the clinician during hemostasis or sealing procedures and be prompted to stop, at least temporarily, the procedure.
  • the clinician can stop the procedure, based on the alert, or apply additional fluid to the treatment area to allow the temperature of the heating element 14 or the tissue of the patient to cool down to an acceptable temperature level, prior to continuing hemostasis or sealing procedures.
  • the threshold temperature can be modified, either dynamically or automatically, depending on the type of tissue and the location of the procedure being performed within the patient.
  • system 10 may provide for a selective application of fluid if desired by a surgeon.
  • Fluid may be provided from a fluid source that can include a bag of fluid through a drip chamber to delivery tubing and to a handheld surgical device.
  • the fluid includes saline and can include physiologic saline such as sodium chloride (NaCl) 0.9% weight/volume solution.
  • Saline is an electrically conductive fluid, and other suitable electrically conductive fluids can be used.
  • the fluid may include a nonconductive fluid, such as deionized water.
  • Fig. 2 illustrates an example of a surgical device 100 having thermal assembly 102 that can be used in conjunction with system 10.
  • Thermal assembly 102 can include an exposed conductive surface configured to be electrically coupled to a source of electrical energy supplied from a power source that is not necessarily in the RF range.
  • thermal assembly 102 can be electrically coupled to the power source via one or more power cables 104.
  • Thermal assembly 102 can be configured to provide for an electrode/tissue interface of a patient.
  • Thermal assembly 102 can be formed to optimize hemostatic sealing of tissue, including bone, without fluid, or in conjunction with selected or constant delivery of fluid,
  • Surgical device 100 can include a handpiece 106.
  • Handpiece 106 includes a handle 106 that can include a finger or hand grip portion (e.g., with ridges) on the lower surface or bottom portion of the surgical device 100 and intended to be held in the hand of the surgeon or clinician.
  • the device 100 can be wired (e.g., power cables 104) or can be wireless and include the features of a thermal control system within handpiece 104.
  • Handpiece 104 can include a proximal end 108 for balance and to receive electrical communication from power source 12, via power cables 104 or wirelessly (e.g., batteries).
  • handpiece 104 can comprise a sterilizable, rigid, electrically insulative material, such as a synthetic polymer (e.g., polycarbonate, acrylonitrile-butadiene-styrene).
  • Handle 106 can include an upper surface that is opposite the lower surface.
  • a controller 110 can include one or more input operating mechanisms, such as one or more buttons, switches, etc. (not shown) and can be coupled to circuitry such as on a printed circuit board, in examples, input operating mechanisms can be disposed on the upper or lower surface and configured to be operated by the user (e.g., via the thumb or finger of the user to control one or more functions of the surgical device 100).
  • input operating mechanisms can provide binary activation (on/off) control for each function and can be configured as a pushbutton, switch lever, etc.
  • user input mechanisms can be pushed or switched to activate thermal assembly 102 and released or re -pushed to deactivate thermal assembly 102.
  • an additional switch or input (not shown) can be used selectively activate fluid dispersal.
  • surgical system 100 can include temperature monitoring technology 112 (e.g., reflecting the same or similar capabilities to temperature monitoring mechanism 16), such that the temperature of thermal assembly 102 and the temperature of the tissue under hemostasis or sealing can be determined and monitored during surgical procedures (e.g., hemostasis or sealing of tissue, including bone).
  • temperature monitoring technology 112 can include Fiber Bragg Grating technology, described in greater detail below.
  • additional or alternative user input mechanism can be used to selectively control temperature monitoring technology 112.
  • temperature monitoring technology 112 can be activated and can continuously monitor and detect the temperature of thermal assembly 102 or tissue under sealing 114 while the surgical device 100 is activated.
  • monitoring and detecting of thermal assembly 102 or tissue under sealing 114 can be deactivated upon deactivation of surgical device 100.
  • temperature monitoring technology 112 can be activated and periodically monitor and detect the temperature of thermal assembly 102 or tissue under sealing 114 while the surgical device 100 is activated.
  • periodic monitoring can include, manually activating and deactivating the monitoring, activating monitoring ‘X’ number of times within a certain time period, or activate monitoring every ‘Y’ seconds/minutes, etc.
  • the temperature monitoring technology 112 can include a field of view 116 that can monitor the temperature of the (targeted) tissue area 114.
  • the temperature monitoring technology 112 can monitor the temperature of the tissue area of a patient, which can include the target tissue subject to hemostasis or sealing and a portion of the tissue area surrounding the targeted tissue area, via field of view 116.
  • the temperature monitoring technology 112 can include a field of view 116 that can monitor the temperature of the thermal assembly 102. It should be understood that other functions and control of surgical device 100 and temperature monitoring technology 112 are contemplated.
  • surgical device 100 can include a probe assembly 122 extending distally from the handpiece 104.
  • Probe assembly 122 can include a shaft 122.
  • the shaft 122, or other portions of device 100 can include one or more elements forming a subassembly to be generally one or more of rigid, bendable, fixed-length, variable-length (including telescoping or having an axially- extendable or axially-retractable length) or other configuration.
  • Shaft 122 can be configured to communicate a source of thermal energy to the thermal assembly 102.
  • Shaft 122 carries one or more electrical conductors to a distal end 124 including the thermal assembly 102.
  • Electrical pathways of the handpiece 104 and probe assembly 120 can be formed as conductive arms, wires, traces, other conductive elements, and other electrical pathways formed from electrically conductive material (e.g., metal, stainless steel, titanium, gold, silver, platinum or any other suitable material).
  • surgical device 100 can selectively disperse fluid via at least one fluid lumen coupled within shaft 122 and can extend into the handpiece 104 to delivery tubing in a cable extending from proximal end 108.
  • the fluid lumen can include an outlet port disposed on or proximate the thermal assembly 102 for selectively dispersing fluid at or near the targeted tissue area.
  • temperature monitoring technology 112 can be coupled within the probe assembly 122, such that field of view 116 is sufficient to the clinician for monitoring the temperature of thermal assembly 102 or tissue under sealing 114 accurately with near precision.
  • FIG. 3 is an alternative example of a surgical device 100 having thermal assembly 102 that can be used in conjunction with an external temperature monitoring technology 112, according to examples.
  • surgical device 100 can include one or more components as described in FIG. 2, such that hemostasis or sealing procedures of bodily tissue can be performed.
  • temperature monitoring technology 112 can be coupled to an external element, e.g., an external nozzle 130.
  • External nozzle 130 can be coupled to a power source to facilitate operations of the temperature monitoring technology 112.
  • temperature monitoring technology can be coupled to the distal tip 132 of the nozzle 130 such that the temperature monitoring technology 112 can be positioned next to or near the thermal assembly 102 or targeted tissue area 114 for precise temperature monitoring during procedures.
  • temperature monitoring technology 112 can monitor the temperature of thermal assembly 102 and the temperature of the tissue under hemostasis or sealing procedures.
  • temperature monitoring technology 112 can include Fiber Bragg Grating technology, described in greater detail below.
  • additional or alternative user input mechanism can be used to selectively control temperature monitoring technology 112.
  • temperature monitoring technology 112 can include an optical fiber with a single grating on its tip to monitor temperature of thermal assembly 102 or targeted tissue area 114.
  • temperature monitoring technology 112 can be activated and positioned near the thermal assembly 102 or targeted tissue area 114 individually to monitor temperature.
  • temperature monitoring technology 112 can be activated and positioned near the thermal assembly 102 or targeted tissue area 114 simultaneously during hemostasis or sealing procedures (i.e., while the surgical device 100 is activated). In examples, monitoring and detecting of thermal assembly 102 or tissue under sealing 114 can be deactivated individually upon deactivation of surgical device 100. In examples, temperature monitoring technology 112 can be linked, whether wirelessly or via electrical communication, to activate or periodically monitor and detect the temperature of thermal assembly 102 or tissue under sealing 114 while the surgical device 100 is activated. In examples, the external nozzle 130 can be operated by a clinician individually or in parallel with the surgical device 100.
  • the nozzle 130 can be electrically coupled to a power source (not show), via wiring or portable power source, to provide power to the temperature monitoring technology 112.
  • nozzle 130 e.g., temperature monitoring technology 112
  • the temperature monitoring technology 112 can include its own field of view 134, such that a narrower, more precise area is monitored during activation of the temperature monitoring technology 112.
  • the nozzle can be electrically coupled to a display, either coupled to the nozzle 130 or communicatively couple externally.
  • nozzle 130 can include an alerting mechanism (e.g., LED light, internal speaker, etc.) that can produce an alert, such as a visual or audio alert (e.g., continuous flashing light, produce a sound, such as an alarm or alert indication, etc.) when the temperature monitoring technology 112 detects the temperature of the thermal assembly 102 or targeted tissue area 114 exceeds a threshold temperature.
  • the threshold temperature can be shown via the display electrically or wirelessly coupled to the alerting mechanism.
  • the alert can be seen or heard by the clinician during hemostasis or sealing procedures and be prompted to stop, at least temporarily, the procedure.
  • fluid may be automatically activated to initiate flow or additional flow to the thermal assembly 102 or the target tissue area 114 for cooling.
  • power to the thermal assembly 102 can be reduced or ceased.
  • the threshold temperature can be modified, either dynamically or automatically, depending on the type of tissue and the location of the procedure being performed within the patient. It should be understood that other functions and control of surgical device 100 and nozzle 130, including temperature monitoring technology 112, are contemplated.
  • FIG. 4 is an illustration of an example of temperature monitoring technology 112.
  • temperature monitoring technology 112 can include Fiber Bragg Grating technology that can be incorporated in a surgical device, for example, surgical device 100 or nozzle 130.
  • Temperature monitoring technology 112 can include an optical fiber 202 (e.g., a strand of fiber optics) including a core 203, a transmitter 204 and a receiver 206.
  • temperature monitoring technology 112 can also include an optics controller 208 (e.g., a processor to process information or signals transmitted and received).
  • additional gratings 212 can be implemented, for example, as intermediate gratings between gratings 212A and 212B, which can provide further differentiation between the different wavelengths or additional wavelengths of electromagnetic radiation to be deflected.
  • incoming reflected electromagnetic radiation of a location or device being monitored e.g., reflected from the targeted tissue area 114 or the thermal assembly 102
  • the gratings 212 configured to receive all wavelengths of electromagnetic radiation and pass through the entire fiber.
  • each grating 212 can deflect the specific electromagnetic radiation wavelength by some degree. This deflection of electromagnetic radiation along with the identification of the grating 212, the location of the grating 212, previous wavelength, current or changed wavelength, etc. which has deflected the phase of the wavelength can be transmitted by transmitter 204.
  • the optical controller can receive the transmitted information, via circulator 210. In embodiments, the optical controller can process the information for detection and determination of the temperature change based on the deflected wavelength shift reflected from one or more gratings 212.
  • the grating 212 near to the exposed grating can receive the reflected electromagnetic radiation and pass through the gratings 212.
  • the change in temperature of the targeted tissue area 114 or thermal assembly 102 can result in a variation in electromagnetic radiation received by the respective gratings 212, resulting in a shift of the wavelength from ambient or previously monitored temperatures.
  • the detected and determined information based on the electromagnetic radiation passed through deflected in gratings 212 can be transmitted by transmitter 204 to circulator 210 and processed by optic controller 208.
  • the deflected electromagnetic radiation through grating 212 can create a significant variation in the phase of the optical signal of the electromagnetic wavelength for which the respective grating 212 is configured for. Such variation can be correlated with a specific change in temperature (e.g., thermal deviation).
  • the precise or near precise value of the deflected electrosurgical radiation for each grating 212 can be processed by optic controller 208 and an accurate measure of the temperature of the monitored targeted tissue area 114 or thermal assembly 102 can be determined.
  • the shift in wavelength can be detected by the optical controller 208 communicatively coupled to the optical receiver 206.
  • the optical controller 208 can receive the electromagnetic radiation of various wavelength as per the gratings 212 as transmitted optical signals, via circulator 210.
  • the transmission can occur periodically.
  • the optical signal received can include the original optical signal or a deflected signal.
  • the information included among the signal, forwarded to other optical to digital convertors can include the number of the wavelengths transmitted over time, the number of signals received, the details of all the deflected signals, the location and identification of the gratings which had deflected these signals, etc.
  • the optical controller 208 can determine, based on the wavelength filtered through one or more of gratings 212, a phase of the shifted wavelength of electromagnetic radiation.
  • the temperature and wavelength phase deflection can be mapped using a predefined lookup table. Based on the phase of the shifted wavelength, the phase shift can correlate to a specific amount of shift in temperature of the monitored area. In examples, each shift in the deflection by 0.001 degrees or radians can be related to a 0.01 degree temperature shift.
  • the lookup table can be stored in a memory (not shown) communicatively coupled with optic controller 208. In examples, based on the temperature shift, according to the lookup table, the temperature of the monitored area or component can be determined. In examples, the determined temperature, list of grating 212 deflections, etc. (e.g., final or completed set of information to initiate an alert or action) can be transmitted to the receiver 206. It is to be understood that other information and data determined and transmitted is contemplated.
  • a precise control system can be designed to control the temperature by controlling the rate of flow of the saline.
  • optical controller 208 can create an alert for the clinician.
  • an alert can include generating a sound, activating a visual indicator (e.g., blinking light optionally coupled with or to surgical device 100) and other alerting mechanisms such that the clinician is notified to perform an action (e.g., introduce additional saline to the monitored area) or to cease an action (e.g., halt, at least temporarily, surgical procedures).
  • measured or calculated temperature data can be sent or displayed to the clinician (e.g., via a user interface), such as the previous temperature of the monitored area, the new temperature of the monitored area, the change in temperature of the monitored area, and other temperature data. It should be understood that additional alerting mechanisms and data associated with surgical procedures are contemplated.
  • FIG. 5 illustrates an example wavelength shift seen by gratings 212, in which temperature is directly proportional.
  • the ambient or previously detected wavelength filtered by one grating 212) at an ambient or previously determined temperature is indicated at 302.
  • the wavelengths of electromagnetic radiation change illustrated at 304.
  • a resulting wavelength shift 306 occurs in which additional or alternative gratings 212 filter the new reflected wavelength of electromagnetic radiation.
  • the amount of wavelength shift between the ambient or previously detected wavelength (e.g., filtered by one grating 212) and the shift in reflected wavelengths of electromagnetic radiation (e.g., captured by an alternative grating) is directly proportional to the resulting change in temperature.
  • the comparisons between shifts in wavelengths can thus be used to calculate near correct computations of the temperature at the gratings 212.
  • FIG. 6 illustrates an example block diagram method for temperature detection and monitoring during homeostatic or sealing procedures, according to examples.
  • the surgical device 100 can be available and used during a homeostasis or sealing procedures.
  • the clinician can initiate homeostasis or sealing of tissue procedures and activate the surgical device 100 at 404.
  • homeostasis or sealing of tissue, including bone is commenced at or near a target tissue area.
  • the temperature at or near the target area or the thermal assembly can be monitored by temperature monitoring technology.
  • temperature monitoring technology receives and processes incoming electromagnetic radiation reflected from at or near the target area for homeostasis or sealing procedures.
  • the incoming electromagnetic radiation can be refracted through gratings and a change or shift in wavelength can be realized though the gratings.
  • the change or shift in wavelength is processed and a change in temperature at or near the target area can be determined based on the change or shift in wavelength.
  • the change in temperature can be determined using a lookup table.
  • the lookup table can include associating temperatures associated with corresponding changes in wavelength.
  • the amount of change or shift in wavelength can be directly proportional to the change in temperature, resulting in a correct or near correct calculated or determination of the temperature at the gratings.
  • an alert can be activated.
  • an alert can be any one of a visual or audio activation, such that the alert gains the attention of the clinician or others in the vicinity of the homeostasis or sealing procedure.
  • the alert can indicate the clinician to cease, at least temporarily, the homeostasis or sealing procedure.
  • the alert can automatically distribute additional fluid, such as saline, to the target area.
  • the alert can automatically deactivate the surgical device or reduce power, such that temperature of the thermal assembly is reduced.
  • Example 11 includes the method of example 10, further comprising using monitoring the temperature using Fiber Bragg Grating technology, wherein the Fiber Bragg Grating technology is coupled to the surgical device.
  • Example 12 includes the method of example 11, further comprising the Fiber Bragg Grating technology including a plurality a plurality of exposed fiber optic gratings, wherein each fiber optic grating is configured to pass through a signal with a wavelength within a range of wavelengths; and accepting, by each fiber optic grating, distinct ranges of wavelengths compared to other corresponding fiber optic gratings.
  • Example 13 includes the method of example 11, further comprising monitoring and determining the temperature of the targeted tissue area or the thermal assembly based on a shift in wavelength received by the Fiber Bragg Grating technology.
  • Example 14 includes the method of example 11, further comprising determining the temperature of the targeted tissue area or the thermal assembly based on a lookup table, wherein the lookup table includes associated pairs of temperatures and shifts in wavelengths determined based on one or more signals passed through Fiber Bragg Grating technology.
  • Example 16 includes the method of example 10, further comprising periodically monitoring and determining the temperature of at least one of the targeted tissue area or the thermal assembly.
  • Example 17 includes the method of example 10, further comprising issuing an alert when the temperature of at least one of the targeted tissue area or thermal assembly exceeds a determined threshold temperature.
  • Example 18 includes the method of example 17, further comprising exceeding the determined threshold temperature of 110 degrees Celsius.
  • Example 19 includes the method of example 10, further comprising automatically reducing power delivered to the surgical device when at least one of the targeted tissue area or the thermal assembly exceeds a determined threshold temperature.
  • Example 20 includes the method of example 10, further comprising automatically expelling fluid to the targeted tissue area when at least one of the targeted tissue area or the thermal assembly exceeds a determined threshold temperature.
  • Computer-readable media may include non-transitory computer- readable media, which corresponds to a tangible medium such as data storage media (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer).
  • data storage media e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer.
  • processors such as one or more digital signal processors (DSPs), general purpose microprocessors, application specific integrated circuits (ASICs), field programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuitry.
  • DSPs digital signal processors
  • ASICs application specific integrated circuits
  • FPGAs field programmable logic arrays
  • processors may refer to any of the foregoing structure or any other physical structure suitable for implementation of the described techniques. Also, the techniques could be fully implemented in one or more circuits or logic elements.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif chirurgical, comprenant une poignée comprenant au moins un mécanisme d'entrée d'utilisateur et un arbre s'étendant de manière distale à partir de la poignée, l'arbre comprenant une extrémité distale. Dans des exemples, un ensemble thermique peut être couplé de manière fonctionnelle à l'extrémité distale de l'arbre, comprenant un élément chauffant, l'ensemble thermique comprenant au moins un élément chauffant et étant électriquement couplé à l'au moins un mécanisme d'entrée d'utilisateur. Dans des exemples, un mécanisme de surveillance de température peut être couplé à la poignée, le mécanisme de surveillance de température comprenant une technologie de surveillance de température de telle sorte qu'une température d'au moins l'un de l'ensemble thermique et une zone de tissu ciblée d'un patient est surveillée pendant une procédure avec le dispositif chirurgical, la technologie de surveillance de température comprenant une technologie de réseau de Bragg sur fibre.
PCT/IB2024/058228 2023-08-25 2024-08-23 Détection de température tissulaire pour scellement bipolaire à l'aide d'une technologie de réseau de bragg sur fibre Pending WO2025046426A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202363578723P 2023-08-25 2023-08-25
US63/578,723 2023-08-25

Publications (1)

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WO2025046426A1 true WO2025046426A1 (fr) 2025-03-06

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PCT/IB2024/058228 Pending WO2025046426A1 (fr) 2023-08-25 2024-08-23 Détection de température tissulaire pour scellement bipolaire à l'aide d'une technologie de réseau de bragg sur fibre

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050251128A1 (en) * 2004-04-28 2005-11-10 Gyrus Medical Limited Electrosurgical method and apparatus
US20140025060A1 (en) * 2012-07-19 2014-01-23 Covidien Lp Electrosurgical device including an optical sensor
US20150327915A1 (en) * 2012-07-19 2015-11-19 Covidien Lp Surgical instrument with fiber bragg grating
US20230149080A1 (en) * 2020-04-10 2023-05-18 Intuitive Surgical Operations, Inc. Flexible instruments with patterned antenna assemblies having variable recoverable flexibility

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050251128A1 (en) * 2004-04-28 2005-11-10 Gyrus Medical Limited Electrosurgical method and apparatus
US20140025060A1 (en) * 2012-07-19 2014-01-23 Covidien Lp Electrosurgical device including an optical sensor
US20150327915A1 (en) * 2012-07-19 2015-11-19 Covidien Lp Surgical instrument with fiber bragg grating
US20230149080A1 (en) * 2020-04-10 2023-05-18 Intuitive Surgical Operations, Inc. Flexible instruments with patterned antenna assemblies having variable recoverable flexibility

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