Ulllted States Patent
`
`Ryan
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`
`
`[19]
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`[11] Patent Number:
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`[45] Date of Patent:
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`6,152,923
`
`
`
`Nov. 28, 2000
`
`US006152923A
`
`
`
`[54] MULTI-CONTACT FORCEPS AND METHOD
`
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`
`
`
`OF SEALING, COAGULATING,
`
`
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`CAUTERIZING AND/OR CUTTING VESSELS
`
`
`
`
`
`4,985,030
`5,026,370
`5,116,332
`5,147,356
`
`
`
`
`
`
`1/1991 Melzer et al.
`
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`6/1991 L0tt1C1< ~
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`
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`5/1992 Lemek -
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`9/1992 Bhatta .
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`.......................... .. 606/51
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`[75]
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`.
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`Inventor: Thomas Ryan, Fort Collins, Colo.
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`.
`[73] Assignee: Sherwood Services AG, Schaffhausen,
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`Swltzerland
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`[21] Appl. No.: 09/301,270
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`[22]
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`Filed:
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`Apr. 28, 1999
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`[51]
`Int. Cl.7 ................................................... .. A61B 18/18
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`[52] U.s. Cl.
`.......... ..
`606/51; 606/42; 606/48
`[58] Field of Search ........................... 606/41, 45, 48-52,
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`606/42
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`[56]
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`References Cited
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`/1994 Canada .
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`
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`
`
`
`11/1974 U.S.S.R. .
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`
`.
`
`.
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`
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`
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`
`
`
`0 853 922 A1
`
`
`
`401367
`
`
`
`
`OTHER PUBLICATIONS
`
`
`
`
`Sigel et al., “The Mechanism of Blood Vessel Closure by
`
`
`
`
`
`
`
`
`
`
`
`
`High Frequency Eleetroeoagulatiorfi’ Surgery Gynecology
`& Obstetrlcs, 031 1965 P9 823-831;
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`Bergdahl et al. Studies on Coagulation and the Develop-
`ment of an Automatic Computerized Bipolar Coagulator”, J.
`
`
`
`
`
`
`
`
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`
`
`
`Neurosurg, vol. 75, Jul. 1991, pp. 148-151.
`International Search Re ort—PCT/US98/18640.
`
`
`
`International Search Re£ort—PCT/US98/23950.
`
`
`
`
`
`Primary Examiner—Linda C. M. Dvorak
`~
`~
`~
`
`
`
`Assistant Exammer—Roy Gibson
`
`ABSTRACT
`[57]
`
`
`
`
`
`
`Abipolar forceps for sealing, cauterizing, coagulating and/or
`
`
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`
`
`
`
`cutting vessels and vascular tissue at multiple sites includes
`
`
`
`
`
`
`
`
`
`
`
`
`
`
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`a pair of multi-pronged jaw members pivotally attached in
`
`
`
`
`
`
`
`
`opposing relation relative to one another and selectively
`movable from an 0 en osition wherein the 'aw members
`
`
`
`
`
`
`
`
`1’ d P1 t.
`1 t.
`1
`d .
`d.
`t
`t
`th
`
`
`
`
`
`
`
`are
`ispose
`in space. ‘re a ion re a 1V6. o one ano er o a
`
`
`
`
`
`
`
`
`second clamping position wherein the jaw members coop-
`
`
`
`
`
`
`
`
`erate to grasp tissue therebetween. The forcepsalso includes
`at least one electrode disposed on the inner facing surface of
`
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`each prong of the jaw members and a switch for selectively
`
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`controlling electrosurgical energy to each electrode. The
`
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`electrodes on each of the jaw members can be activated
`
`
`
`
`
`
`
`
`
`
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`
`
`simultaneously sequentially or in a multiplexed fashion
`Th
`01.
`1
`’
`1
`1
`’
`h d
`f
`1.
`‘
`isc osure a so re ates to a met 0
`sea ing,
`e
`0
`
`
`
`
`
`
`
`
`1
`.
`.
`.
`d
`1
`.
`d
`1
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`
`
`
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`
`
`cauterizing, coagu ating an /or cutting vesse s an vascu ar
`
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`tissue at multiple sites without manipulation of the forceps.
`
`18 Claims, 5 Drawing Sheets
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`ETHICON ENDO-SURGERY, INC.
`
`EX. 1016
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`1
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`

`
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`6,152,923
`Page 2
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`
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`5,527,313
`.
`6/1996 Scott et al.
`
`
`5,531,744
`7/1996 Nardella et al.
`
`5,540,684
`7/1996 Hassler, Jr.
`.
`
`
`5 549 623
`8/1996 Sharpe et al
`
`
`5,558,672
`9/1996 Edwards et al.
`
`5,562,720 10/1996 Stern et al.
`.
`
`
`10/1996 Edwardds.
`5,569,241
`
`5 5
`5 5
`ikl
`d
`“F1
`> 73» 3
`11/1996 V.
`~
`
`
`5:615:69“
`4/1997 G}‘“““° 6‘ ‘*1-
`5,626,578
`5/1997 Tihon .
`
`5,637,110
`6/1997 Pennybacker et al.
`
`5,658,281
`8/1997 Heard .
`
`5,667,526
`9/1997 LeVin .
`
`5,674,220 10/1997 Fox et al.
`
`5,683,388 11/1997 Slater.
`
`5,693,051
`12/1997 Schulze et al.
`
`12/1997 Brinkerhoff .
`5,700,261
`
`5,700,276
`12/1997 Benecke .
`
`5,702,390 12/1997 Austin et al. .
`
`
`1/1998 Lock et al.
`.
`5,709,707
`
`
`2/1998 Nardella ........................... .. 606/50
`5,713,896
`
`
`.
`2/1998 Eggleston et al.
`5,720,744
`
`
`3/1998 Draenert .
`5,728,160
`
`5,730,752
`3/1998 Alden et al.
`
`4/1998 Yates et al.
`5,735,848
`
`5/1998 Yates et al.
`5,755,717
`
`6/1998 Hooven .
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`
`5,769,849
`6/1998 Eggers .
`
`7/1998 Eggers .
`5,776,128
`
`.
`7/1998 Buysse et al.
`5,776,130
`
`
`9/1998 Panescu et al.
`.
`5,810,802
`
`
`10/1998 Nardella et al.
`.
`5,817,091
`
`
`10/1998 Williamson, IV et al.
`5,817,093
`
`5,827,281
`10/1998 Levin .
`
`.
`5,833,690 11/1998 Yates et al.
`
`
`
`.................. .. 606/51
`4/1999 Eggers et al.
`5,891,142
`
`
`
`9/1999 Richardson et al.
`.-
`5,951,549
`
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`.
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`~
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`U.S. PATENT DOCUMENTS
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`.
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`
`545 1:102
`9/1992 XaF‘11Ya“}a 6‘ ‘*1-
`~
`5,197,493
`3/1993 Gr1er—Idr1s .
`
`
`531999441
`4/1993 H0316 '
`5,217,458
`6/1993 Parins .
`
`5,217,460
`6/1993 Knoepfler .
`
`
`5,250,047 10/1993 Rydell .
`11/1993 Rydell et al.
`.
`5,258,006
`
`
`11/1993 Lyons, 1116161.
`.
`5,263,967
`
`
`
`
`5,277,201
`1/1994 Stern .
`
`5,282,800
`2/1994 Foshee et al.
`
`2/1994 Quadri.
`5,282,826
`
`5,324,289
`6/1994 Eggers .
`
`7/1994 Eggers .
`5,330,471
`
`8/1994 Anderson.
`5,336,221
`
`5,342,359
`8/1994 Rydell .
`
`8/1994 Haber et al.
`5,342,389
`
`5,352,222 10/1994 Rydell .
`
`5,356,408 10/1994 Rydell .
`
`12/1994 Davis .
`5,372,589
`
`5,389,104
`2/1995 Hahnen et al.
`
`2/1995 Eggers .
`5,391,166
`
`4/1995 Yates et al.
`.
`5,403,312
`
`
`7/1995 Basile et al.
`.
`5,431,674
`
`
`8/1995 Stern et al.
`.
`5,443,463
`
`
`8/1995 Russell et al.
`5,443,464
`
`8/1995 Bressi, Jr.
`.
`5,443,479
`
`
`.
`8/1995 Durrfeld et al.
`5,445,658
`
`
`.
`5,456,684 10/1995 Schmidt et al.
`
`
`5,458,598 10/1995 Feinberg et al.
`.
`
`
`5,462,546
`10/1995 Rydell .
`
`.
`12/1995 Cordis et al.
`5,472,443
`
`
`12/1995 Meade et al.
`.
`5,478,351
`
`
`1/1996 Eggers et al.
`.
`5,484,436
`
`
`1/1996 Chess .
`5,486,172
`
`5,507,772
`.
`4/1996 Shutt et al.
`
`
`4/1996 Aranyi et al.
`.
`5,509,922
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`2
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`U.S. Patent
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`Nov. 28,2000
`
`Sheet 1 0f5
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`6,152,923
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`3
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`U.S. Patent
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`Nov. 28,2000
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`Sheet 2 0f5
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`6,152,923
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`5323
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`w._E_m
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`4
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`U.S. Patent
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`Nov. 28,2000
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`Sheet 3 0f5
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`6,152,923
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`5
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`U.S. Patent
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`Nov. 28, 2000
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`Sheet 4 0f5
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`6,152,923
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`6
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`U.S. Patent
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`Nov. 28,2000
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`Sheet 5 0f5
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`6,152,923
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`
`6,152,923
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`
`1
`
`MULTI-CONTACT FORCEPS AND METHOD
`
`
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`OF SEALING, COAGULATING,
`
`
`
`CAUTERIZING AND/OR CUTTING VESSELS
`
`
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`AND TISSUE
`
`
`BACKGROUND
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`The present disclosure relates to hemostats or forceps
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`used for open surgical procedures and laparoscopic surgical
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`procedures. More particularly, the present disclosure relates
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`to a multi-pronged bipolar forceps which allows a user to
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`selectively seal, cauterize, coagulate/desiccate and/or cut
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`vessels and vascular tissue at multiple sites without manipu-
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`lating the forceps.
`1. Technical Field
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`A hemostat or forceps is a simple plier-like tool which
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`uses mechanical action between its jaws to constrict tissue
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`and is commonly used in surgical procedures to grasp,
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`dissect and/or clamp tissue. Electrosurgical forceps utilize
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`both mechanical clamping action and electrical energy to
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`effect hemostasis by heating the tissue and blood vessels to
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`coagulate, cauterize, cut and/or seal tissue.
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`By controlling the intensity, frequency and duration of the
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`electrosurgical energy applied to the tissue, a surgeon can
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`either cauterize, coagulate/desiccate and/or cut tissue and/or
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`simply reduce or slow bleeding. Generally, the electrical
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`configuration of electrosurgical forceps can be categorized
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`in two classifications: 1) monopolar electrosurgical forceps;
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`and 2) bipolar electrosurgical forceps.
`Monopolar forceps utilize one active electrode associated
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`with the clamping end effector and a remote patient return
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`electrode or pad which is attached externally to the patient.
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`When electrosurgical energy is applied, the energy travels
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`from the active electrode, to the surgical site, through the
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`patient and to the return electrode.
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`Bipolar electrosurgical forceps utilize two generally
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`opposing electrodes which are disposed on the inner oppos-
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`ing surfaces of the end effectors and which are both elec-
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`trically coupled to an electrosurgical generator. Each elec-
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`trode is charged to a different electric potential. Since tissue
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`is a conductor of electrical energy, when the effectors are
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`utilized to clamp or grasp tissue therebetween, the electrical
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`energy can be selectively transferred through the tissue.
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`The process of coagulating small vessels is fundamentally
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`different from vessel sealing. For the purposes herein the
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`term coagulation is defined as a process of desiccating tissue
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`wherein the tissue cells are ruptured and dried. Vessel
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`sealing is defined as the process of liquefying the collagen
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`in the tissue so that it cross-links and reforms into a fused
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`mass. Thus, coagulation of small vessels is sufficient to close
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`them, however, larger vessels need to be sealed to assure
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`permanent closure.
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`In order to effect a proper seal with larger vessels, two
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`predominant mechanical parameters must be accurately
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`controlled—the pressure applied to the vessel and the gap
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`between the electrodes both of which affect thickness of the
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`sealed vessel. More particularly, accurate application of the
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`pressure is important to oppose the walls of the vessel, to
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`reduce the tissue impedance to a low enough value that
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`allows enough electrosurgical energy through the tissue, to
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`overcome the forces of expansion during tissue heating and
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`to contribute to the end tissue thickness which is an indica-
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`tion of a good seal. In some instances a fused vessel wall is
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`optimum between 0.015 and 0.060 millimeters (0.006 to
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`0.020 inches).
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`As mentioned above, electrosurgical energy may be
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`applied through the tissue to halt or prevent bleeding.
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`10
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`15
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`20
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`25
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`30
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`35
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`40
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`2
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`Traditionally, forceps are used to create a single seal per
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`application of electrosurgical energy. Additional seals are
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`made by moving/manipulating the forceps to a second
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`sealing site and applying more electrosurgical energy. For
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`example, when vessels need to be sealed and cut, a surgeon
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`typically makes two seals and cuts between the seals or the
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`surgeon makes three seals and cuts along the centerline of
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`the middle seal. To make these two or three seals,
`the
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`surgeon manipulates the forceps two or three times and
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`applies electrosurgical energy after each manipulation. This
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`process can be time consuming especially when cutting
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`multiple vessels.
`Numerous bipolar electrosurgical forceps have been pro-
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`posed in the past for various surgical procedures. However,
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`none of these forceps are designed to seal vessels at multiple
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`sealing sites without manipulating the forceps. For example:
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`U.S. Pat. Nos. 2,176,479 to Willis; 4,005,714 to Hiltebrandt;
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`4,370,980, 4,552,143, 5,026,370 and 5,116,332 to Lottick;
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`5,443,463 to Stern et al.; 5,702,390 to Austin et al.; and
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`5,484,436 to Eggers et al., all relate to electrosurgical
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`instruments for coagulating, cutting and/or sealing vessels or
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`tissue.
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`Stern et al. relates to a coagulating device which utilizes
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`a series of electrodes disposed on an inner facing surface of
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`one end effector with a corresponding pair of temperature
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`sensors disposed on the opposite end effector for sensing the
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`temperature rise in the tissue and providing feedback to an
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`electrosurgical generator to control the rate of coagulation of
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`the tissue.
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`Austin relates to a bipolar instrument which utilizes a
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`triangularly-shaped electrode pivotally disposed between
`two parallel electrodes. The triangularly-shaped electrode
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`can be positioned such that in the closed configuration the
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`base of the triangle coagulates tissue between the two
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`parallel electrodes or the triangularly-shaped electrode can
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`be positioned such that
`in the closed configuration the
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`triangle apex cuts tissue between the two parallel electrodes.
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`Thus, there exists a need to develop a bipolar forceps
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`which can effectively seal, cauterize, coagulate and/or cut
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`vessels and tissue at multiple tissue sites without manipu-
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`lating the forceps.
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`SUMMARY
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`The present disclosure relates to a bipolar forceps which
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`includes a pair of multi-pronged jaw members pivotally
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`attached in opposing relation relative to one another which
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`are selectively movable from a first open position wherein
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`the jaw members are disposed in spaced relation relative to
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`one another to a second clamping position wherein the jaw
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`members cooperate to grasp and apply pressure to tissue
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`therebetween. At least one electrode is disposed on the inner
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`facing surface of each prong of the jaw members. A switch
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`selectively controls electrosurgical energy to each electrode.
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`Preferably,
`the jaw members are bifurcated and each
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`prong/tine of the first jaw member aligns with a correspond-
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`ing prong of the second jaw member. Jaw members having
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`three, four, five, etc. prongs are also contemplated.
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`In one embodiment, the inner facing surface of at least
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`one electrode has a shaped or formed cross-section, e.g.,
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`V-shaped, corrugated and/or notched, so as to enhance
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`sealing, coagulating, and/or cutting the tissue.
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`Other embodiments of the present disclosure relate to a
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`method of applying electrosurgical energy to tissue to effec-
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`tively seal, coagulate, cauterize and/or cut
`tissue. The
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`method includes the steps of: 1) providing a bipolar forceps
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`as described above; 2) grasping tissue between the jaw
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`8
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`

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`6,152,923
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`3
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`members; 3) selectively activating a first electrode on a first
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`of the prongs of the first jaw member; and selectively
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`activating a second electrode on a first of the prongs of the
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`second jaw member. Other methods of the present disclosure
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`include selectively activating additional electrodes on addi-
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`tional prongs of the first and second jaw members to create
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`multiple seals without manipulating the forceps.
`Preferably, the electrodes can be activated simultaneously,
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`sequentially and/or multiplexed depending upon a particular
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`purpose and/or to promulgate a particular electrosurgical
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`result.
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`Another method according the present disclosure relates
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`to a method of sealing vessels which includes the steps of:
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`1) providing a bipolar forceps having: a pair of multi-
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`pronged jaw members pivotally attached in opposing rela-
`tion relative to one another and movable from a first open
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`position to a second clamping position to grasp tissue
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`therebetween, at least one pair of opposing electrodes dis-
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`posed on each opposing pair of prongs of the jaw members,
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`and a switch for selectively controlling electrosurgical
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`energy to each electrode; 2) grasping tissue between the jaw
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`members; and 3) selectively activating each of the pairs of
`opposing electrodes to form a seal between each pair of
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`opposing electrodes.
`BRIEF DESCRIPTION OF THE DRAWINGS
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`FIG. 1A is a perspective view of a multi-pronged bipolar
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`forceps according to the present disclosure;
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`FIG. 1B is an enlarged, perspective view of an end
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`effector of the bipolar forceps shown in the closed configu-
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`ration;
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`FIG. 1C is an enlarged, perspective view of the end
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`effector shown in the open configuration;
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`FIG. 2 is an enlarged, fragmentarily-illustrated perspec-
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`tive view of the individual prongs of a trifurcated end
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`effector shown coupled to a switching mechanism;
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`FIG. 3 is front view of an alternate embodiment of the end
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`effector wherein the inner facing surfaces of the middle
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`opposing electrodes form a V-shaped mechanical interface;
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`FIG. 4 is front view of an alternate embodiment of the end
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`effector wherein the inner facing surfaces of the middle
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`opposing electrodes form a notch-like mechanical interface;
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`FIG. 5 is an enlarged, fragmentarily-illustrated perspec-
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`tive view of the individual prongs of a bifurcated end
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`effector shown coupled to a switching mechanism;
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`FIG. 6 is a perspective view showing the forceps of FIG.
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`1 in the open configuration prior to engagement about a
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`tubular vessel;
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`FIG. 7 is a perspective view showing the forceps of FIG.
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`1 in the closed configuration compressing a tubular vessel;
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`FIGS. 8A and 8B are front views of the forceps showing
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`one particular electrode pair activation sequence for sealing
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`tissue at multiple sealing sites;
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`FIGS. 9A—9C are front views of the forceps showing
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`another electrode pair activation sequence for sealing tissue
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`at multiple sealing sites;
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`FIG. 10 is a front view of the forceps showing simulta-
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`neous activation of the electrode pairs;
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`FIGS. 11A and 11B are front views of the forceps showing
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`another electrode pair activation sequence wherein verti-
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`cally off-set pairs of electrodes are activated to form an
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`X-shaped cross-seal;
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`FIG. 12 is a front view of the forceps showing simulta-
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`neous activation of one lower electrode forming two cross-
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`seals with two upper, vertically off-set electrodes; and
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`10
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`15
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`20
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`25
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`30
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`35
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`60
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`4
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`FIGS. 13A and 13B are front views of the forceps
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`showing another electrode activation sequence for cross-
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`sealing tissue at multiple sealing sites.
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`DETAILED DESCRIPTION OF THE
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`PREFERRED EMBODIMENTS
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`Referring now to FIG. 1A, a forceps 10 for use with open
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`and/or laparoscopic surgical procedures includes an elon-
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`gated shaft portion 12 having a proximal end 16 and a distal
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`end 14. In the drawings and in the description which follows,
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`the term “proximal”, as is traditional, will refer to the end of
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`the forceps 10 which is closer to the user, while the term
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`“distal” will refer to the end which is further from the user.
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`An end effector assembly 22 is attached to the distal end
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`14 of shaft 12 and includes a pair of opposing multi-pronged
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`jaw members 40 and 42. Preferably, end effector assembly
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`22 is trifurcated and includes a middle or central pair of
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`opposing prongs 40b and 42b and two pair of outer opposing
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`prongs 40a, 42a and 40c, 42c (see FIGS. 1B and 1C).
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`Handle portion 18 is attached to the proximal end 16 of shaft
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`12 and includes an activator assembly 20 for imparting
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`movement of the jaw members 40 and 42 from an open
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`position wherein the jaw members 40, 42 are disposed in
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`spaced relation relative to one another,
`to a clamping or
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`closed position wherein the jaw members 40, 42 cooperate
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`to compress tissue 51 therebetween (see FIGS. 6 and 7).
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`Activator assembly 20 includes a movable handle 26
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`having an aperture 34 defined therein for receiving at least
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`one of the operator’s fingers and a fixed handle 28 having an
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`aperture 32 defined therein for receiving an operator’s
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`thumb. Movable handle 26 is selectively moveable from a
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`first position relative to fixed handle 28 to a second position
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`in closer proximity to the fixed handle 28 to approximate jaw
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`members 40, 42. Preferably, fixed handle 28 includes a
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`channel 27 which extends proximally for receiving a ratchet
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`30 which is coupled to movable handle 26. This structure
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`allows for progressive closure of end effector assembly 22 as
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`well as locking the juxtaposed position of opposing jaw
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`members 40, 42.
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`In some cases it may be preferable to include other
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`mechanisms to control and/or limit the movement of handle
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`26 relative to handle 28 such as, e.g., hydraulic, semi-
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`hydraulic and/or gearing systems.
`Handle portion 18 may also include a rotation knob 24 for
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`controlling the rotational movement of the end effector
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`assembly 22 about a longitudinal axis “A” of the elongated
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`shaft 12. Preferably, the ratio of rotation of the knob 24 to
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`the end effector assembly 22 is 1:1, however, it is contem-
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`plated that gearing structure may be incorporated to increase
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`or decrease the rotational ratio depending upon a particular
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`purpose.
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`FIGS. 1B and 1C show enlarged views of the trifurcated
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`end effector 22 which includes a first or upper multi-pronged
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`jaw member 40 and a second or lower multi-pronged jaw
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`member 42 which are disposed in opposing relation about
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`pivot assembly 45. Preferably, each prong 40a, 40b, 40c and
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`42a, 42b, 42c of each jaw member 40 and 42, respectively,
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`includes an electrode 41a, 41b, 41c and 43a, 43b, 43c,
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`respectively, disposed on the inner facing surface thereof
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`(FIG. 2). FIG. 1B shows the end effector 22 in a closed
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`configuration and FIG. 1C shows the end effector 22 in open
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`configuration. For the purposes herein, the term “closed”
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`when referring to the position of the jaw members relative
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`to one another means to bring the jaw members together in
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`close proximity relative to one another without the elec-
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`trodes actually contacting one another.
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`9
`
`

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`6,152,923
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`5
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`As best seen in FIG. 2, each electrode 41a, 41b, 41c and
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`43a, 43b, 43c is electrically coupled to a switch 71 by a cable
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`45a, 45b, 45c and 46a, 46b, 46c, respectively. The switch 71
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`is electrically coupled to an electrosurgical generator 70 by
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`cable 73. Preferably, switch 71 selectively imparts different
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`electrical potentials to specific electrodes 41a, 41b, 41c and
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`43a, 43b, 43c, respectively. Since tissue 51 is a conductor of
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`electrical energy, when the upper and lower jaw members,
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`40, 42, respectively, grasp tissue 51 therebetween, the elec-
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`trical energy is transferred through the tissue 51.
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`FIGS. 3 and 4 show alternate embodiments of an end
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`effector assembly 122 wherein at least one of the opposing
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`electrode pairs, e.g., 141b, 143b, is shaped to enhance a
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`particular electrosurgical procedure or, when activated with
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`the other electrodes, performs a dual electrosurgical
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`purpose, e.g., cutting and sealing. More particularly and
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`with respect to FIG. 3, electrode 141b has a V-shaped outer
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`surface and electrode 143b has a corresponding V-shaped
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`recess. It is contemplated that shaping the electrodes 141b,
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`143b in this fashion will enhance the cutting characteristics
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`of the forceps 10. For example, during an operation a
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`surgeon can elect to either: 1) initially seal the tissue 51 on
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`either side of electrodes 141b, 143b by activating electrode
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`pairs 141C, 143c and 141a, 143a and then activating the
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`middle electrodes 141b, 143b to cut the tissue; or 2) the
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`surgeon can activate all of the electrodes 141a,b,c and
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`143a,b,c simultaneously to cut and weld the tissue 51 with
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`a single discharge of electrosurgical energy. It may be that
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`the cutting is done by pulsing a high voltage pulse between
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`electrodes 141b and 143b. The pulse may be at the RF
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`frequency or alternately at DC levels.
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`FIG. 4 shows another embodiment of the end effector 222
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`wherein electrode 241b includes a notch and electrode 243b
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`includes a corresponding recess which is dimensioned to
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`receive the notch to enhance electrosurgical sealing.
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`It is contemplated that electrodes 241a,b,c and 243a,b,c
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`may be shaped with a variety of mechanically complimen-
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`tary surfaces to enhance electrosurgical sealing, coagulating,
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`cauterizing and/or cutting. Moreover, it is also envisioned
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`that one electrode pair, 241b, 243b, may be vertically offset
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`from another electrode pair 241a, 243a (and/or 241C, 243C)
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`which may also enhance a particular electrosurgical proce-
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`dure. Moreover,
`is also envisioned that end effector
`it
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`assembly 22 can have more or less prongs depending upon
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`a particular purpose. For example, FIG. 5 depicts an end
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`effector assembly 922 which includes two pair of opposing
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`prongs 940a, 942a and 940b, 942b with opposing electrodes
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`941a, 943a and 941b, 943b, respectively disposed thereon.
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`In use and as best seen in FIGS. 6 and 7, the surgeon
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`manipulates handle 26 (FIG. 1A) to advance the activator
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`assembly 20 and move jaw members 40, 42 (FIG. 1C) to the
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`open position wherein the jaw members 40, 42 are disposed
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`in spaced relation relative to one another to receive tissue 51
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`therebetween (FIG. 6). The surgeon then manipulates handle
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`26 to impart movement of the jaw members 40, 42 about
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`pivot 45 (FIG. 1B) to close the inner facing surfaces of the
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`jaw members 40, 42 about tissue 51 (FIG. 7). By controlling
`the intensity, frequency and duration of the electrosurgical
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`energy applied to the tissue 51, and, to a certain extent, by
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`controlling the mechanical clamping pressure applied to the
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`tissue 51, the surgeon can either seal, cauterize, coagulate/
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`desiccate and/or cut tissue and/or simply reduce or slow
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`bleeding. The mating electrodes may also have complimen-
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`tary surfaces that are rounded, notched or triangular for the
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`purpose of increasing their surface area and thus increasing
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`the seal width.
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`It is contemplated that various electrosurgical generators
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`can be employed to seal, cauterize, coagulate/desiccate
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`10
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`15
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`25
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`10
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`6
`and/or cut tissue and/or simply reduce or slow bleeding, e.g.,
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`those generators described in U.S. Pat. Nos. 4,658,819,
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`4,658,820, 4,827,927 and 5,514,129 the contents of which
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`are incorporated herein by reference.
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`It is contemplated that switch 71 (FIG. 2) selectively
`controls each individual electrode and can activate the
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`electrodes 41a, 41b, 41c, 43a, 43b, 43c simultaneously,
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`sequentially, in pairs, and/or in various combinations. For
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`example, FIGS. 8A—13B show several electrode activation
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`schemes for sealing, cauterizing, coagulating and/or cutting
`tissue 51. In particular, FIGS. 8A and 8B show one particular
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`electrode activation sequence wherein opposing electrodes
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`341b and 343b are initially activated such that electrosur-
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`gical current flows between electrodes 341b, 343b and
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`through tissue 51 to form a seal 360b therebetween (see FIG.
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`8A). After seal 360b is formed, electrodes pairs 341a, 343a
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`and 341c, 343c are activated to form seals 360a and 360C
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`(FIG. 8B) on either side of seal 360b. As can be appreciated
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`from the present disclosure, the surgeon can easily create
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`multiple seals without having to physically manipulate and/
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`or re-position the f