JP7232328B2 - electrosurgical system - Google Patents

Description

Application of Article 30, Paragraph 2 of the Patent Act On June 4, 2018, at Sacred Heart Medical Center Hospital, Springfield, Oregon, USA, a surgical procedure for abdominal hysterectomy and bilateral salpingo-oophorectomy performed by Dr. Kathleen Yang was performed. The procedure used an electrosurgical system invented by Siazon Kevin et al.

TECHNICAL FIELD This application relates generally to electrosurgical systems and methods, and more particularly to electrosurgical generators and related instruments for sealing and cutting tissue.

Electrosurgical devices or instruments are utilized that use electrical energy to perform certain surgical tasks. Electrosurgical instruments are typically surgical instruments such as graspers, scissors, forceps, blades, or needles that include one or more electrodes configured to be supplied with electrical energy from an electrosurgical generator. be. Electrical energy can be used to coagulate, melt, or cut tissue to which it is applied.

Electrosurgical instruments typically fall into two categories: monopolar and bipolar. In monopolar devices, electrical energy is delivered to one or more electrodes on the device at high current densities, while a separate return electrode is electrically connected to the patient and often carries current densities. Designed to minimize Monopolar electrosurgical instruments can be useful for certain procedures, but often carry the risk of certain types of patient injury, such as electrical burns, due at least in part to the function of the return electrode. may contain. In a bipolar electrosurgical instrument, one or more electrodes are electrically connected to a source of electrical energy of a first polarity and one or more other electrodes are of a second polarity opposite the first polarity. is electrically connected to a source of electrical energy of opposite polarity. Bipolar electrosurgical instruments that operate without a separate return electrode are capable of delivering electrical signals to the focused tissue area with reduced risk.

US patent application Ser. No. 12/416,668 US patent application Ser. No. 12/416,751 US patent application Ser. No. 12/416,695 U.S. patent application Ser. No. 12/416,765 US patent application Ser. No. 12/416,128 U.S. Provisional Patent Application No. 61/994,215 U.S. Provisional Patent Application No. 61/944,185 U.S. Provisional Patent Application No. 61/994,415 U.S. Provisional Patent Application No. 61/994,192

However, even with the relatively focused surgical effects of bipolar electrosurgical instruments, surgical results are often highly dependent on the skill of the surgeon. For example, thermal tissue damage and necrosis can occur in cases where electrical energy is delivered for relatively long durations or relatively high power electrical signals are delivered for even short durations. The rate at which tissue achieves the desired melting, sealing, or cutting effect upon application of electrical energy varies based on tissue type and can also vary based on the pressure applied to tissue by the electrosurgical device. have a nature. However, it can be difficult for the surgeon to assess how quickly a complex tissue type mass grasped by an electrosurgical instrument will be sealed to the desired amount.

Various embodiments provide an electrosurgical instrument configured to lyse and cut tissue. In various embodiments, an electrosurgical device or instrument includes a first jaw and a second jaw opposing the first jaw to grasp tissue between the first and second jaws. The first jaw includes an electrode and the second jaw also includes an electrode. Electrodes in the first and second jaws are positioned to seal tissue between the first and second jaws using radio frequency energy.

According to various embodiments, an electrosurgical system is provided that includes an electrosurgical instrument having a handle assembly and jaws connected to the handle assembly, and an electrosurgical generator removably coupled to the electrosurgical instrument. The electrosurgical generator is configured to supply RF energy to the electrosurgical instrument starting at a first predetermined voltage and increasing to a second predetermined voltage within a first predetermined time period. be done. In various embodiments, the generator adjusts the voltage of the supplied RF energy to adjust the voltage of the supplied RF energy after expiration of a first predetermined period of time and/or after the voltage of the supplied RF energy reaches a second predetermined voltage. It is configured to start at a predetermined third voltage. In various embodiments, the generator adjusts the voltage of the supplied RF energy to be held constant at a predetermined voltage or at the expiration of and/or after a second predetermined period of time. configured as

Various embodiments provide an electrosurgical system for sealing tissue. A system in various embodiments includes an electrosurgical generator and an electrosurgical instrument or device. A generator includes an RF amplifier and a controller. The RF amplifier supplies RF energy through a removably coupled electrosurgical instrument configured to seal tissue using only RF energy. A controller and/or RF sensor is arranged to monitor and/or measure the supplied RF energy and/or its components. In various embodiments, the controller signals the RF amplifier to adjust, e.g., increase, hold, decrease, and/or stop, the voltage of the applied RF energy at predetermined points or conditions of the sealing cycle. Send. In various embodiments, the controller signals the RF amplifier to discontinue the delivered RF energy or to initiate termination of the delivered RF energy from the RF amplifier.

Various embodiments provide an electrosurgical generator that includes an RF amplifier configured to supply RF energy to an electrosurgical instrument, wherein the supplied RF energy has voltage spikes. Various embodiments provide an electrosurgical generator that supplies RF energy to an electrosurgical instrument based on a control script provided by the electrosurgical instrument and the voltage of the supplied RF energy is previously included in the control script. It is configured to adjust based on defined conditions. Various embodiments provide an electrosurgical instrument that is configured to contain and provide a control script to an electrosurgical generator, the control script identifying within the control script the voltage of the applied RF energy. configured to cause the electrosurgical generator to adjust based on predetermined conditions set.

The various features and embodiments provided throughout can be used alone or in combination with other features and/or embodiments other than those explicitly described, and specific combinations or Aspects of various embodiments may not be explicitly described, however, such combinations are contemplated and within the scope of the invention. Many of the attendant features of the present invention will be more readily appreciated when it is better understood by reference to the foregoing and following descriptions and considered in conjunction with the accompanying drawings.

The invention can be better understood when read in conjunction with the accompanying drawings, in which reference numerals designate the same parts throughout the figures.

1 is a perspective view of an electrosurgical system according to various embodiments of the present invention; FIG. 1 is a perspective view of an electrosurgical instrument according to various embodiments of the present invention; FIG. 1 is a perspective view of an electrosurgical instrument according to various embodiments of the present invention; FIG. 1 is a perspective view of a distal end of an electrosurgical instrument according to various embodiments of the present invention; FIG. 1 is a perspective view of a distal end of an electrosurgical instrument according to various embodiments of the present invention; FIG. FIG. 3 shows a graphical representation of sample experimental data for sealing using an electrosurgical system according to various embodiments of the present invention; FIG. 3 shows a graphical representation of sample experimental data for sealing using an electrosurgical system according to various embodiments of the present invention; FIG. 3 shows a graphical representation of sample experimental data for sealing using an electrosurgical system according to various embodiments of the present invention; FIG. 3 shows a graphical representation of sample experimental data for sealing using an electrosurgical system according to various embodiments of the present invention; 4 is a flowchart illustrating operation of an electrosurgical system according to various embodiments of the present invention; 1 is a schematic block diagram of portions of an electrosurgical system according to various embodiments of the present invention; FIG. 4 is a flowchart illustrating operation of an electrosurgical system according to various embodiments of the present invention;

Generally, an electrosurgical system is provided that includes an electrosurgical generator and a removably coupled electrosurgical instrument configured to optimally seal or lyse tissue. RF energy is supplied by an electrosurgical generator configured to provide adequate RF energy to seal tissue. The generator, according to various embodiments, may be suitable for the specific connected electrosurgical instrument, the specific tissue in contact with the instrument, and/or the appropriate RF energy and manner of delivering the RF energy for the specific surgical procedure. decide. Operationally, RF sealing or melting of tissue between the jaws is provided to reduce sealing time and/or heat spread.

According to various embodiments, an electrosurgical system applies RF energy having a high voltage for short durations to provide RF energy spikes. The electrosurgical system then reduces the voltage of the delivered RF energy while continuing to apply RF energy. The electrosurgical system also continuously monitors the delivered RF energy to detect short circuits or open conditions. The system also determines a shift from high voltage RF energy spikes to reduced voltage RF energy delivery, determination of tissue or vessel lysis or sealing, and thereby cessation or termination of RF energy delivery.

1-2, an exemplary embodiment of an electrosurgical system including an electrosurgical generator 10 and a removably connectable electrosurgical instrument 20 is shown. The electrosurgical instrument 20 can be electrically connected to the generator through a cabled connection 30 leading to a tool or device port 12 on the generator. Electrosurgical instrument 20 may include audio, tactile, and/or visual indicators that notify the user of certain predetermined statuses of the instrument, such as initiation and/or termination of a lysing or cutting operation, for example. In other embodiments, electrosurgical instrument 20 may be reusable for another surgical procedure and/or connectable to another electrosurgical generator. In some embodiments, a manual controller, such as a hand or foot switch, controls the generator and/or instrument to allow predetermined selective control of the instrument, such as to initiate lysing or cutting operations. connectable.

According to various embodiments, electrosurgical generator 10 is configured to generate radio frequency (RF) electrosurgical energy and to receive data or information from an electrosurgical instrument 20 electrically connected to the generator. . Generator 10, in one embodiment, outputs RF energy (eg, 375 VA, 150 V, 5 A at 350 kHz) and, in one embodiment, measures current and/or voltage of RF energy and/or RF energy. It is configured to calculate the power of the RF energy or the phase angle or difference between the RF output voltage and the RF output current during activation or delivery of the energy. The generator regulates voltage, current, and/or power and monitors RF energy output (eg, voltage, current, power, and/or phase). In one embodiment, the generator 10 detects that a device switch is deasserted (e.g., melt button is released), a time value is satisfied, and/or an active phase angle, current, voltage, or power, and/or or upon predetermined conditions such as when the change is greater than, less than or equal to a stop value, threshold, or condition and/or change thereto.

Electrosurgical generator 10 includes at least one modified bipolar tool port 12 , standard bipolar tool port 16 , and power port 14 . In other embodiments, the electrosurgical unit can include different numbers of ports. For example, in some embodiments, an electrosurgical generator may include more or less than two modified bipolar tool ports, more or less standard bipolar tool ports, and more or less power ports. In one embodiment, the electrosurgical generator includes only two modified bipolar tool ports.

According to various embodiments, each modified bipolar tool port 12 is configured to be coupled to an electrosurgical instrument having an attached or integrated memory module. Standard bipolar tool port 16 is configured to accept a non-dedicated bipolar electrosurgical tool that differs from the modified bipolar electrosurgical instruments connectable to modified bipolar tool port 12 . Power port 14 is configured to accept or connect to a direct current (DC) accessory device different from non-dedicated bipolar electrosurgical tools and advanced electrosurgical instruments. Power port 14 is configured to supply a DC voltage. For example, in some embodiments power port 14 may provide approximately 12 volts DC. Power port 14 may be configured to power surgical accessories such as a ventilator, pump, light, or other surgical accessory. That is, in addition to replacing electrosurgical generators for standard or non-dedicated bipolar tools, electrosurgical generators can also replace surgical accessory power supplies. In some embodiments, replacing an existing generator and power supply with an electrosurgical generator reduces the storage space required on storage rack cards or shelves at the number of mains power cords required for the surgical workspace. can be reduced.

According to various embodiments, electrosurgical generator 10 can include display 15 . The display can be configured to indicate, among other information, the status of the electrosurgical system including the status of one or more electrosurgical instruments and/or accessories, connectors, or connections thereto.

Electrosurgical generators according to various embodiments may include a user interface such as a plurality of buttons 17 . The button can allow user interaction with the electrosurgical generator, such as requesting an increase or decrease in electrical energy supplied to one or more instruments coupled to the electrosurgical generator. In other embodiments, display 15 may be a touch screen display, ie, integrates data display and user interface functionality. In one embodiment, electrosurgical tool or instrument 20 may further comprise one or more memory modules. In some embodiments, the memory includes operational data regarding the instrument and/or other instruments. For example, in some embodiments, the operational data may be electrode configuration/reconfiguration, instrument usage, operational time, voltage, power, phase and/or current setpoints, and/or specific operational states, conditions, scripts, processes , or may contain procedural information. In one embodiment, the generator initiates, reads from, and/or writes to the memory module.

According to various embodiments, the generator provides the ability to read the phase difference or phase angle between the voltage and current of the RF energy transmitted through the connected electrosurgical instrument while the RF energy is active. While the tissue is being fused, phase readings are used to detect different conditions during the melting or sealing and cutting process.

Generators according to various embodiments do not monitor or control current, power, or impedance. The generator regulates the voltage and can regulate the voltage. Electrosurgical power delivered is a function of applied voltage, current, and tissue impedance. Through adjustment of the voltage, the generator can influence the electrosurgical power being delivered. However, increasing or decreasing the voltage does not necessarily increase or decrease the delivered electrosurgical power. The power response is caused by power interacting with tissue or tissue conditions without any control by the generator other than by the generator supplying power.

Once the generator has started delivering electrosurgical power, it does so continuously, eg, every 150 ms, until a fault occurs or certain parameters are reached. In one example, the jaws of an electrosurgical instrument can be opened, i.e., compression is relieved any time before, during, and after application of electrosurgical power. The generator in one embodiment also does not pause for a particular duration or wait for a predetermined time delay to initiate termination of electrosurgical energy.

3-5, according to various embodiments, a bipolar electrosurgical instrument 20 is provided. In the illustrated embodiment, instrument 20 includes actuator 24 coupled to elongated rotatable shaft 26 . Elongated shaft 26 has proximal and distal ends and defines a central longitudinal axis therebetween. At the distal end of shaft 26 is jaw 22 and at the proximal end is the actuator. In one embodiment, the actuator is a pistol-grip handle.

Actuator 24 includes a movable handle 23 and a stationary handle or housing 28, with movable handle 23 coupled to and movable relative to the stationary housing. According to various embodiments, movable handle 23 is slidably and pivotally coupled to the stationary housing. In operation, movable handle 23 is manipulated by a user, eg, a surgeon, to actuate the jaws, eg, to selectively open and close the jaws.

According to various embodiments, actuator 24 includes a latch mechanism that maintains movable handle 23 in a second position relative to stationary housing 28 . In various embodiments, the movable handle includes latch arms that engage matching latches confined within the stationary handle to retain the movable handle in the second or closed position. Actuators in various embodiments also include wire harnesses that include individual insulated electrical wires or leads confined within a single sheath. The wire harness can exit the stationary housing on its underside and form part of the cable connection. Electrical wires within the harness can provide electrical communication between the instrument and the electrosurgical generator and/or its accessories.

In various embodiments, the switch is connected to a user-operable activation button 29 and is activated when the activation button is pressed. In one aspect, when activated, the switch completes a circuit by electrically connecting at least two leads together. Accordingly, an electrical path is then established from the electrosurgical generator to the actuator to supply RF energy. In various embodiments, the instrument includes a translatable mechanical cutting blade that can be coupled to a blade actuator such as a blade lever or trigger 25 of the actuator. A mechanical cutting blade is actuated by a blade trigger 25 to divide the tissue between the jaws.

In one embodiment, the actuator includes a rotating shaft assembly including a rotating knob 27 disposed on the outer cover tube of elongated shaft 26 . A rotation knob 27 allows the surgeon to rotate the shaft of the device while holding the actuator. According to various embodiments, elongated shaft 26 includes an actuation tube that couples jaws 22 with an actuator.

Attached to the distal end of the elongated shaft are jaws 22 including first jaw 31 and second jaw 33 . In one embodiment, a jaw pivot pin pivotally connects the first and second jaws and allows the first jaw to be movable and pivotable relative to the second jaw. In various embodiments, one jaw is fixed relative to the elongated shaft such that the opposing jaw pivots relative to the fixed jaw between open and closed positions. In other embodiments, both jaws can be pivotally connected to the elongated shaft such that both jaws can pivot relative to each other.

The first or upper jaw 31 contains electrode plates or pads. Similarly, the second or lower jaw 33 contains electrodes. The electrodes of the upper jaw 31 and the electrodes of the lower jaw 33 are electrically connected to the electrosurgical generator 10 through wires and connectors to deliver RF energy to the tissue grasped between the electrodes. The electrodes are thus arranged to have opposite polarities and to transmit RF energy therebetween. The upper jaw in various embodiments also includes an upper jaw support with an assembly spacer positioned between the upper jaw support and the electrode. The upper jaw also includes or is overmolded. The lower jaw includes a lower jaw support and an electrode. In the illustrated embodiment, the electrodes are integrated or incorporated into the lower jaw support, thus the lower jaw support and electrodes form a monolithic structure and electrical connection. A blade channel extends longitudinally along the length of the upper jaw, the lower jaw, or both, through which the blade operatively moves. Surrounding a portion of the blade channel are one or more conductive posts. The conductive posts help strengthen the blade channel and support the tissue being cut. The conductive posts also help ensure that tissue being cut adjacent or close to the blade channel is lysed, as the conductive posts also participate in the transmission of RF energy to the tissue grasped between the jaws. do. The lower jaw also includes or is overmolded.

According to various embodiments, the electrodes have substantially planar sealing surfaces arranged to atraumatically contact and compress tissue captured between the jaws. The sealing surface in various embodiments includes outcrops (eg, four outcrops) evenly spaced along the length of the jaws, with branches disposed between the outcrops. Accordingly, the overall footprint of the sealing surface or area is reduced, thereby increasing the current density applied to the tissue and reducing the current requirement for delivery of RF energy as a whole. The tissue seal is thus enhanced, resulting in high average burst pressures in both in vivo and ex vivo conditions.

The electrode sealing face also provides notches or spaces 34, 35 between the sealing face and the edges of the jaws and between the outcrops to allow space for tissue to contract or migrate, allowing tissue to move during the sealing cycle. reduces tissue stresses due to contraction or contraction of the jaws and stresses caused by tissue compression at the edges of the jaws. Similarly, the graduated spacing eliminates current density peaks at the edges of the electrodes.

In various embodiments, the outcrop keeps the seal width 32 consistent while leaving space for the conductive posts, and the consistent seal width of the seal face limits the total seal area. In various embodiments, the upper jaw includes an outer sealing surface profile that matches the lower jaw profile to prevent non-linear current transfer through tissue. Accordingly, the upper jaw in various embodiments includes an outcrop that matches the outcrop of the lower jaw. Also, the additional area at the outcrop of the upper jaw increases the local strength of the conductive stop landing surface. Similarly, the outcrop of the upper jaw provides a landing surface or area 37 for interaction of the conductive posts of the lower jaw which increases the local strength of the landing surface. In various embodiments, the outcrop is electrically conductive and includes a sealing or inner surface through which tissue in the jaws is compressed and RF energy is delivered to the tissue between the jaws.

The maxillary and mandibular electrodes in various embodiments have sealing surfaces that are uniform in width and that continue along a pattern of multiple outcrops. Thus, the sealing surface has elongated portions, curved portions are spaced between the elongated portions, and the width of the sealing surface remains uniform, constant, or unchanged throughout. The sealing surfaces of the upper and lower jaws are minimized and therefore have a reduced surface area relative to the total surface area body that can be formed for a given overall jaw size.

In various embodiments, the sealing surface of at least one of the jaws includes blade pockets or notches arranged to collect and/or clear crusts, debris, or clotted blood. Thus, locking, misalignment, or blocking or inhibition of blade return is avoided, thereby enhancing return of the blade to its initial or pre-cut position. In various embodiments, one or more blade pockets or notches 36, 39 are located at the distal end of the sealing surface and, in various embodiments, extend from the distal end of the blade channel. In various embodiments, the blade pocket is an enlarged spherical opening at the end of the blade channel that is elongated and uniform. The blade pocket thus facilitates blade actuation and ensures automatic blade retraction when crust builds up on the sealing surfaces and within the blade channels of the jaws. In various embodiments, distal blade pockets on both the upper and lower jaws allow accumulated eschar to be pushed forward and out of the blade channel. The pockets also allow older crust build-up to be pushed out of the jaws so that new crust facilitates instrument cleaning or more efficient cleaning.

In various embodiments, the jaws are curved to improve visualization and mobility of the jaws at the target surgical site and during the surgical procedure. The jaws have a proximal elongated portion that exhibits or aligns with a straight line, and a curved distal portion that exhibits or defines a straight connected curve. In various embodiments, the proximal-most portion of the proximal elongated portion has a diameter equal to or delimits the maximum outer diameter of the jaws or elongated shaft. In various embodiments, the jaws have a maximum outer diameter such that the most proximal portion of the jaws and the most distal portion of the jaws remain within the maximum outer diameter. The curved distal portion has or defines a diameter less than the maximum outer diameter and a diameter of the proximal-most portion of the proximal elongated portion. In various embodiments, the jaws have an inner curve notch that is deeper than the outer curve, and in various embodiments the jaw tips are tapered for blunt dissection. The jaw includes a blade channel having a proximal elongated channel that curves to a distal curved channel, where the proximal elongated channel is parallel and offset with respect to the longitudinal axis of the elongated shaft of the electrosurgical instrument. there is Therefore, visibility and mobility at the jaws are maintained or enhanced without increasing jaw size, which further reduces the working area for surgical procedures or provides greater access to the patient's body. or may require incision.

In some embodiments, the electrode geometry of the conductive pads of the jaw assembly ensures that the sealing area or surface completely surrounds the distal portion of the cutting path. According to various embodiments, the dimensions of the jaw surface are such that it is properly distributed with respect to the optimum pressure applied to the tissue between the jaws to obtain the potential force that the force mechanism can generate. be. Its surface area is also electrically significant relative to the surface area that contacts tissue. This ratio of tissue surface area and thickness has been optimized in relation to the relative electrical properties of the tissue.

In various embodiments, the lower jaw 33 and associated conductive pads have an upper outer surface positioned to contact tissue. The upper surfaces are slanted or beveled and are mirror images of each other, such positioning or orientation facilitating focused current density and tissue fixation. In various embodiments, the lower jaw is made of stainless steel and is as stiff or stiffer than the conductive pads. In various embodiments, the lower jaw includes a rigid insulator made of non-conductive material and is as stiff or stiffer than the lower jaw or conductive pads. In various embodiments, the mandible and conductive pads are made of the same material.

According to various embodiments, an RF energy control process, script, or system for sealing or melting tissue is divided into one or more control sections. In the illustrated embodiment, the control process, script, or system includes four sections: voltage spike, voltage sag and ramp, ramp stop, and RF termination. In various embodiments, a control process, script, or system includes one or more sections in various combinations or orders thereof. Processing ends when an error or unexpected result occurs from or between sections. In various embodiments, such errors include detection of shorts or opens. In one embodiment, a short circuit detection error is determined by the generator when the measured phase angle of the RF energy supplied by the generator equals or exceeds a predetermined value, eg, 60°. In one embodiment, an open detection error is determined by the generator when the measured current of the delivered RF energy equals or exceeds a predetermined value, eg, 2 or 4 Amp. Completion of the control process without errors indicates a successful tissue seal. In various embodiments, a successful tissue seal is recognized as the ability of the tissue seal to withstand a predetermined range of burst pressures or a certain threshold pressure.

Various embodiments have identified that tissue seal formation is dependent on denaturation and cross-linking of native collagen present in the vascular extracellular matrix starting at about 60°C. It has also been identified that the strength of this matrix is highly dependent on drying of the seal site through evaporation of water present in the seal tissue. Furthermore, a temperature of at least 80° C. can produce a bond between denatured collagen and other living tissue. Furthermore, it has been identified that collagen degrades over time under elevated temperatures rather than the peak temperature of exposure. Therefore, exposing the tissue to high temperature conditions, eg, 100° C., for relatively short durations of the sealing cycle has no effect on collagen structure and allows evaporation of water. According to various embodiments, the total time to seal the tissue is to subject the structure to a high temperature, e.g., to allow water to distill so that the denatured collagen crosslinks and connects to the tissue and to limit hydrogen bonding of collagen and water. Depends on heating up to 100°C. Therefore, it has been found desirable to achieve 100°C in the grasped tissue as quickly as possible to initiate the drying process in order to optimize the sealing time.

Thus, according to various embodiments, the generator uses high voltage spikes or pulses through the supplied RF energy after RF energy is initiated and/or after various device tests are performed. In various embodiments, the RF energy potential applied to the tissue is spike driven by the proxy tissue temperature such that a high amount of power is applied at the beginning of the sealing cycle to maximize energy transfer.

With various embodiments of electrosurgical generators and removable instruments, rapid heating is desirable to vaporize the latent fluid as quickly as possible for optimal seal time, but vaporization that occurs too quickly may result in excess vapor. It has been identified that this can cause the seal structure to fail while trying to escape. Such identification in some cases may only be observable through burst pressure testing. With the voltage spike completed, the system reduces the voltage to a predetermined level and slowly increases the voltage of the delivered RF energy. In various embodiments, sufficient power is applied to the tissue to maintain a sufficient temperature for desiccation while the increase occurs. Continuous evaporation is thereby possible at a rate that does not cause seal structure failure, enhancing vessel sealing performance.

In various embodiments, high peak voltages provide sealing in a shorter amount of time due to higher energy transfer. It has been experimentally shown that the application of high pressure levels can cause sealing tissue to adhere to the active electrode. Thus, it has been found that by ending the voltage ramp at a lower peak voltage and holding the voltage output constant at the end, continuous energy application is possible while reducing the likelihood of tissue adhesion. . According to various embodiments, the determination of when to terminate this ramp is made by monitoring the phase and current of the supplied RF energy. When the tissue dries, the phase becomes capacitive and draws less current. By terminating the ramp at a fixed current value when the current value falls and when the phase is capacitive, the dryness level of the tissue can be classified. This variable voltage setting allows the sealing cycle to adjust energy application based on electrical and structural differences in the tissue being sealed.

In various embodiments, the phase angle, current, and/or power of the applied RF energy are measured, calculated, and/or monitored to achieve the appropriate tissue temperature to induce the relevant tissue effect. be. 6-9 show diagrams showing graphical representations of exemplary sealing cycles according to various embodiments. As shown, voltage 111a is shown versus other RF output readings or indicators such as power 111b, impedance 111c, energy 111d, current 111f, and phase 111g. Additionally, and as shown in FIGS. 6-9, in various embodiments the generator may include indicators or readings to reduce operating and power costs and consumption, and/or the number of generator parts. are configured not to measure or calculate temperature. Additional information or readings are generally supplied or indicated for contextual purposes. Further, in various embodiments, imprecise or impractical impedance or temperature readings are not used or measured.

As shown, the voltage of RF energy 111a is high at the initial instant of the sealing cycle and for a relatively short period of time compared to the total sealing time in the sealing cycle to produce a voltage spike in RF energy 122,122. is increased to During this voltage spike or pulse, energy transfer is maximized, as illustrated by the power 111b and current 111f of the applied RF energy increasing to peaks in the sealing cycle. Thereafter, the voltage of RF energy 111a is reduced 123 and slowly increased 124, 125 for voltage spikes. In various embodiments, a gradual voltage ramp through the system seeks to maintain the tissue between the jaws near 100° C., thereby controlling the boiling rate of water in the tissue. According to various embodiments, the phase angle, current, and power of the applied RF energy are monitored to achieve the proper tissue effect to seal the tissue. When the phase angle of the applied RF energy crosses zero or becomes negative and/or the current is less than 60%, the applicable current is less than, for example, 3000 mA, which makes the tissue between the jaws more capacitive. , thereby drawing less current 131, 132 as the water boils or otherwise evaporates from the tissue being sealed. The RF energy voltage is then held constant 126, 133 to reduce the likelihood of tissue sticking. At seal complete 141, for example, within a time frame or period of time predetermined by the system, the RF energy supplied by the system is terminated, or the RF energy supply is interrupted, discontinued, or stopped. In various embodiments, the system determines seal complete when the power of the supplied RF energy falls below a predetermined power threshold 142, such as 4% of maximum power or 15 volt-amps. In various embodiments, the ramp of RF energy is terminated and, after a period of time predetermined by the system, the RF energy delivered by the system is terminated, or the RF energy delivery is interrupted, stopped, or stopped.

In various embodiments, the period during which the generator produces a voltage spike of RF energy is shorter than the overall seal cycle and/or the period during which the generator decreases the voltage of RF energy and slowly increases. In various embodiments, the period for which the generator holds the voltage of RF energy constant is shorter than the entire seal cycle and/or longer than the period for which the generator produces voltage spikes of RF energy.

In various embodiments, the system identifies, for example, an unexpected current draw provided to some tissue bundles that draw the maximum current or power that can be supplied by the generator. While the system is under such current conditions, the supply of RF energy required to seal tissue may not be sufficient or may not be efficiently supplied by the system. In various embodiments, to address such conditions, the system determines whether the current of the RF energy output is greater than 95% of the maximum allowable current, eg, 4750mA. If so, the system waits or further delays to ensure that the current has dropped sufficiently to indicate that sufficient desiccation of the tissue has occurred. After such a delay, if the current has not dropped sufficiently, an error is indicated and/or the RF energy being delivered is discontinued. According to various embodiments, the system determines or confirms that the current has dropped sufficiently when the current drops below 90% of the maximum value, eg, 4500mA. Accordingly, the system determines that the current condition has ended and/or the tissue has begun to boil.

In one embodiment, as shown in FIG. 10, an electrosurgical procedure, such as a tissue lysing or sealing procedure, is initiated by pressing a switch or moving an actuator over the tool (51) and an initial test positive. Based on the results, the generator delivers RF energy having a predetermined voltage from the generator to the electrosurgical tool and ultimately to the tissue (52). The generator monitors the supplied RF energy (53) from the time the RF power is turned on and continuously supplied by the generator. Upon or when a predetermined or predetermined point in time, condition or threshold is reached or exceeded, the supply voltage of the RF energy and the predetermined point in time are adjusted or newly selected (55) and the generator , continue to monitor the supplied RF energy (52). If a predetermined condition indicates the end of a lysis or sealing cycle, e.g., tissue sealing is complete and such condition is reached or exceeded, the generator releases RF energy (57). Terminate or interrupt the supply. In various embodiments, tissue has been fused or sealed (or an error has occurred (e.g., electrode short circuit) and/or an unexpected condition has occurred (e.g., acceptable but unexpected An audible and/or visual signal is provided to indicate switch release. According to various embodiments, predetermined time points, conditions, or thresholds and/or initialization tests are determined based on provided tool algorithms or scripts for connected electrosurgical tools, procedures, or priorities. be.

Referring now to FIG. 11, in one embodiment electrosurgical generator 10 is connected to an AC mains input and power supply 41 converts an AC voltage from the AC mains input to a DC voltage for powering the various circuits of the generator. Convert to The power supply also provides a DC voltage to RF amplifier 42 which generates RF energy. In one embodiment, RF amplifier 42 converts 100 VDC from the power supply into a sinusoidal waveform at a frequency of 350 kHz that is delivered through the connected electrosurgical instrument. RF sensor circuitry 43 measures/calculates voltage, current, power, and phase at the output of the generator that supplies RF energy to the connected electrosurgical instrument 20 . The measured/calculated information is provided to controller 44 .

In one embodiment, the RF sensor analyzes the AC voltage and current measured from the RF amplifier for control signals including voltage, current, power, and phase that are sent to the controller for power and further processing. to generate a DC signal of In one embodiment, the RF sensor 43 measures the output voltage and current, the root mean square (RMS) of the voltage and current, the apparent power of the RF output energy, and the power of the RF energy delivered through the connected electrosurgical instrument. Calculate the phase angle between voltage and current. In particular, the voltage and current of the output RF energy are processed by analog circuitry of the RF sensor to produce real and imaginary components of both voltage and current. These signals are processed by a Field Programmable Gate Array (FPGA) to provide different measurements related to voltage and current, including an AC signal, a phase shift between voltage and current, and an RMS measurement of power. Therefore, in one embodiment, the output voltage and current are measured in analog, converted to digital, and processed by an FPGA to calculate the RMS voltage and current, the apparent power, and the phase angle between voltage and current, It is then converted back to analog for the controller.

In one embodiment, controller 44 controls or signals RF amplifier 42 to affect the output RF energy. For example, the controller utilizes information provided by RF sensor 43 to determine whether RF energy should be output, adjusted, or terminated. In one embodiment, the controller determines when or if predetermined current, power, and/or phase thresholds have been reached or exceeded to determine when to terminate the output of RF energy. decide. In various embodiments, the controller performs the melting or sealing process described in more detail herein, and in some embodiments, the controller performs the sealing process from data sent from the electrosurgical instrument. receive instructions and settings or script data for Thus, in various embodiments, the controller initiates, holds and/or terminates the RF amplifier at a predetermined voltage and/or for a predetermined period of time and/or based on a predetermined threshold. to induce RF energy or adjust the voltage of the RF energy being supplied.

The RF amplifier 42 generates high power RF energy that passes through the connected electrosurgical instruments and, in one example, through the electrosurgical instruments to lyse or seal tissue. In various embodiments, the RF amplifier delivers RF energy to the electrosurgical instrument starting at a first predetermined voltage and increasing to a second predetermined voltage within a first predetermined time period. or feed through it. In various embodiments, the RF amplifier is configured to convert the 100 VDC power delivered to the connected electrosurgical device into a high power sinusoidal waveform having a frequency of 350 kHz. RF sensor 43 interprets the measured AC voltage and current from RF amplifier 42 and produces a DC control signal including voltage, current, power and phase, which is interpreted by controller 44 .

A generator, including a controller and/or RF sensor, monitors and/or measures whether the RF energy being delivered is as expected. In various embodiments, the system, eg, controller and/or RF sensor, monitors the voltage and/or current of the RF energy to ensure that the voltage and current are above predetermined thresholds. The system, eg, controller and/or RF sensor, also monitors, measures, and/or calculates the phase and/or power of the supplied RF energy. A system, e.g., a controller and/or an RF sensor, ensures that the voltage, current, phase, and/or power of the supplied RF energy is within a predetermined voltage, current, phase, and/or power window or range. do. In one embodiment, the voltage, current, phase and/or power windows are predetermined maximum voltage, current, phase and/or power and predetermined minimum voltage, current, phase and/or power have predetermined limits for each. An error is indicated when the RF energy voltage, current, phase, and/or power falls outside its respective window. In one embodiment, each window slides or is adjusted by the system when RF energy is applied to seal the tissue between the jaws of the instrument. Each window adjustment is to ensure that the delivered RF energy is as expected. In various embodiments, the system measures the phase and/or current of the delivered RF energy to determine whether the phase and/or current has reached or exceeded a predetermined phase and/or current threshold. or monitor phase and/or current velocity, and if phase and/or current excess occurs, RF energy is delivered for a predetermined period of time before terminating.

According to various embodiments, the actuation engine of the controller 44 is configurable such that the generator is different and receives different actuation scenarios including, but not limited to, many electrosurgical tools, surgical procedures, and priorities. enable. The actuation engine receives and interprets data from external sources and specifically configures the actuation of the generator based on the received data.

The actuation engine receives configuration data from a database script file read from the memory device of the electrosurgical instrument. Scripts define the state logic used by the generator. Based on the determined conditions and measurements made by the generator, the script can define or set power levels and shutoff criteria. In one embodiment, the script includes trigger events including indication of a short circuit condition, eg, when the measured phase is greater than 60°, or an open condition, eg, when the measured current is less than 2 Amp.

An exemplary RF energy control process, script, or system for an electrosurgical generator and associated electrosurgical tools that lyse or seal tissue according to various embodiments is shown in FIG. In various embodiments, as shown in FIG. 12, for example, the RF energy is applied to a connected electrosurgical tool that sets the voltage of the applied RF energy such that the generator produces RF energy and has voltage spikes (72). (71) by the generator. The generator continues to supply RF energy (72) and monitors or waits (73) for a predetermined period or spike duration. When the spike duration 121 expires or elapses, the generator adjusts the voltage of the applied RF energy to a predetermined minimum value 123 and the generator gradually increases the voltage of the RF energy to a predetermined voltage level 125. or increase 124 (74). The generator also monitors (75) at least the phase, voltage, current, power, and/or its change/rate of the supplied RF energy. the voltage is held constant 126 when the phase and current conditions are reached or equal to, exceed or fall below a predetermined threshold or value (75); and/or The ramp is terminated 133 (77). In various embodiments, a phase condition or threshold is reached or below a predetermined phase threshold 132 and/or a current condition or value is reached or below a predetermined current threshold 131 (75 ), the generator adjusts the voltage of the delivered RF energy to be constant (77). If the phase and current conditions or thresholds are not reached or exceeded, the generator either monitors a predetermined time period or lamp duration or continues to supply RF energy (74) to meet the phase and current conditions. Wait for this period or duration while monitoring (75). When the lamp duration expires or has elapsed, the generator adjusts the voltage of the delivered RF energy to remain constant (77). With the RF energy held constant, the generator continues to supply RF energy (77) and monitors or waits (78) for a predetermined period or hold duration. When the hold duration expires or elapses, the generator monitors or waits (79) for a predetermined period or termination duration while continuing to supply RF energy. Once the termination duration expires or has elapsed, processing is performed or a termination procedure is initiated and/or RF energy supplied by the generator is stopped (81). If the termination duration has not expired or has elapsed, the generator determines (80) whether a power condition or threshold has been reached or is less than a predetermined power threshold or value 142. If a power condition or threshold is reached or exceeded, action is taken or a termination procedure is initiated and/or RF energy supplied by the generator is stopped (81). If the power condition or threshold is not reached or exceeded, the generator continues to supply RF energy while monitoring the power condition and termination duration period.

In various embodiments, impedance is measured to determine short or open conditions through a low voltage measurement signal delivered to a connected electrosurgical tool prior to initiation of treatment. In one embodiment, passive impedance is measured to determine if the grasped tissue is within the operating range (2-200Ω) of the electrosurgical tool. If the initial impedance test is passed, RF energy is delivered to the electrosurgical tool. After that, the impedance/resistance is either not measured or ignored.

In various embodiments, the voltage of the RF energy is applied in a ramp manner (74) starting at 35-45% and up to 65-100% of the global voltage setting, or at a user-selected level in one embodiment. In various embodiments, the voltage of the RF energy ranges from 35-40 volts, eg, starting at a predetermined third voltage, to 65-90 volts, eg, 1.5-4 volts, to a predetermined fourth voltage. Seconds, for example, is applied in a ramp fashion over a second predetermined period of time. In various embodiments, the voltage is held constant at a voltage less than and/or equal to a predetermined voltage equal to and/or less than the end of the ramp voltage and/or for a predetermined period of time. be. In various embodiments, this time period is longer than the time period for voltage spikes and/or for voltage ramps. In various embodiments, the voltage of RF energy is applied as a voltage spike (72) starting at 30-40% and up to 75-100% of the global voltage setting or at a user-selected level. In various embodiments, the voltage of the RF energy is 35-40 volts, eg, 50 as voltage spikes starting from a predetermined first voltage to 75-90 volts, eg, a predetermined second voltage. ˜300 ms, for example, applied for a predetermined first period.

According to various embodiments, the phase is measured while the RF energy is being applied and in one embodiment the phase and /or monitored with current for open and short events after reaching a phase change stop or endpoint.

According to various embodiments, the generator is configured to make additional adjustments to various parameters or functions related to power, voltage, current, power, and/or phase of RF energy, and the actuation engine is configured to make various parameters or configured to adjust the output of RF energy using the function. In one exemplary embodiment, the control circuit provides a phase direct control wherein the voltage, current, and/or power output will be adjusted to satisfy specified phase adjustment settings provided by the operating engine. Provides additional tuning controls for tuning.

According to various embodiments, the generator monitors, measures, and/or calculates values of voltage, power, current, and/or phase, e.g., control indicators, to recognize, act on, or enforce operating conditions. take advantage of In various embodiments, the additional measurements or calculations based on the measurements associated with the RF power conditioning circuit are additional or different events associated with or triggered by other measurements or thresholds. provided by a script or actuation engine to recognize and act on An additional measurement in one embodiment is an error signal combined with a pulse width modulated (PWM) duty cycle used to adjust the output of voltage, current, and/or power, or other similar adjustment parameter. include. In various embodiments, a different or additional event or indicator that can be identified and triggered can be a transition from one regulation control to another regulation control (e.g., current regulation to power regulation). . In various embodiments, no subsequent impedance or temperature inspections or measurements are performed because they are inaccurate and/or impractical.

In various embodiments, the generator utilizes many states, control points, or tests to identify phase, current, or power values and for positive or negative trends, respectively. An error is signaled if the generator did not identify the expected trend. Multi-state testing increases or enhances generator resolution in identifying expected RF output trends across different types of tissue.

In various embodiments, the generator also monitors the phase or current and/or the speed of the phase or current to determine if the connected electrosurgical tool has experienced an electrical open or short condition. In one example, the generator identifies an electrical short condition in a connected electrosurgical instrument by monitoring the phase of the applied or delivered RF energy, and if the monitored phase is greater than a predetermined maximum phase value, the electrical A short circuit condition is identified. Similarly, in one example, the generator identifies an electrical opening condition of the connected electrosurgical instrument by monitoring the current of the applied or delivered RF energy, and if the monitored current is less than a predetermined minimum current, the generator An electrical open condition is identified. In either or both cases, the generator will indicate an error if it finds an open and/or short condition and the RF energy being delivered will be discontinued.

In various embodiments, predetermined processes as described throughout this application are loaded into memory modules embedded in connectors removably connected to plugs and/or cable connections leading to electrosurgical instruments. be In various embodiments, the device script or process is programmed onto an adapter PCBA encapsulated within the device connector or hardwired into circuitry within the device connector during manufacturing/assembly. Script source files are written in a custom text-based language and then compiled by a script compiler into script database files that are readable only by the generator. The script file contains parameters specifically selected to configure the generator to output a specific voltage (e.g. 100v (RMS)), current (e.g. 5000mA (RMS)), and power level (e.g. 300VA). including. In various embodiments, the device key programmer device reads the script database file and then programs it into the memory of the adapter PCBA.

Turning now to some aspects of the operation of the electrosurgical tools or instruments described herein according to various embodiments, with the vessel or tissue bundle identified for lysis, the first and second jaws are 31, 33 are placed around the tissue. Handle 21 is squeezed thereby pivoting the jaws relative to each other to substantially grasp tissue. The actuator has a first or initial position in which the jaws 22 are in the open position and the handle 23 is positioned away or spaced apart from the housing 28 .

Depressing the melt button 29 by the surgeon causes the application of radio frequency energy to the tissue between the jaws. With the tissue lysed, the actuator can be reopened and moved away from the stationary housing 28 by releasing the handle. A user can actuate the blade trigger 25 to cut tissue between the jaws. When the blade trigger is moved proximally, the cutting blade moves distally to divide the tissue between the jaws. The blade spring resets the cutting blade to its original position when the surgeon releases the blade trigger. According to various embodiments, the actuator has a cutting position in which the jaws 22 are in the closed position, the movable handle is closed and latched, the blade trigger is already depressed, and the cutting blade is in its distal-most position. Move forward to position.

Various embodiments provide an intermediate or unlatched position in which the jaws are in the closed or approximated position but the handle is unlatched. Thus, when the handle is released, it will return to its original or initial position. In one embodiment, the blade trigger may not be activated to cut the tissue between the jaws, and the melt button or switch may be activated to melt the tissue between the jaws. Various embodiments provide a latched position in which the jaws are in a closed or approximated position and the handle is latched. Therefore, when the handle is released, the handle does not return to its original or initial position. In one embodiment, a melt button or switch can be activated to melt tissue between the closed jaws and/or a blade trigger can be activated to cut tissue between the jaws.

As noted above, according to various embodiments, the electrosurgical instrument has a first (open) state in which the jaws are spaced apart from each other and thus the handle is also spaced apart from the stationary housing. The instrument is thus positioned to grasp tissue between the jaws. In the second (intermediate) state of the instrument, the jaws are close together to grasp tissue between the jaws, and the handle and housing are close together as well. The surgeon can return to the first state by opening the jaws and thus repositioning the jaws to grasp tissue or other tissue. In the third (closed) state of the instrument, the handle is brought closer to and latches to the stationary housing. Moving to the third state, tissue grasped between the jaws can be cut through actuation of the blade lever. Movement to the third state in which the handle is latched to the housing reduces the likelihood of accidental release of tissue. Also, inadvertent cutting of tissue or inadvertent cutting along the wrong tissue line is avoided. In addition, this condition allows for the application or range of constant and continuous predetermined compression on the tissue between the jaws before, during, and after the RF energy is activated, thereby tissue sealing or dissolution. According to various embodiments, the application of RF energy can occur with the handle and jaws in at least the second state and with the lyse button activated by the surgeon.

Note that in various embodiments, the electrosurgical generator does not measure tissue resistance or impedance while delivering RF energy to the tissue to avoid erroneous readings. Various embodiments provide an electrosurgical system that reduces heat spread and provides efficient power delivery to seal vessels or tissue in contact with bipolar electrosurgical instruments through controlled and efficient delivery of RF energy. offer.

As described above throughout this application, the electrosurgical generator ultimately provides RF energy to the connected electrosurgical instruments. The electrosurgical generator ensures that delivered RF energy does not exceed specified parameters and detects fault or error conditions. In various embodiments, the electrosurgical instrument provides commands or logic circuitry used to properly apply RF energy to the surgical procedure. For example, an electrosurgical instrument includes a memory having commands and parameters that direct operation of the instrument in relation to an electrosurgical generator. For example, in the simple case, a generator can supply RF energy, but the connected instrument determines how much or how long the energy is applied. However, the generator does not allow the delivery of RF energy to be greater than a set threshold, even if directed by a connected instrument, thereby providing a check or warranty against erroneous instrument commands.

As described generally above and in more detail below, electrosurgical instruments, tools, or devices can be used in the electrosurgical systems described herein. For example, electrosurgical graspers, scissors, forceps, probes, needles, and other instruments incorporating one, some, or all of the aspects described herein provide various advantages to electrosurgical systems. can do. Various electrosurgical instrument and generator embodiments and combinations thereof are discussed throughout the specification. It is contemplated that one, some, or all of the features described generally throughout this specification can be included in any of the embodiments of instruments, generators, and combinations thereof described herein. there is For example, each of the described instruments may desirably include memory for interaction with the generator as described above, and vice versa. However, in other embodiments, the described instruments and/or generators can be configured to interact with standard bipolar radio frequency power sources without instrument memory interaction. Additionally, while various embodiments may be described in terms of modules and/or blocks for ease of description, such modules and/or blocks may comprise one or more hardware components; processors, digital signal processors (DSPs), programmable logic devices (PLDs), application specific integrated circuits (ASICs), circuits, registers, and/or software components such as programs, subroutines, logic circuits, and/or or can be implemented by a combination of hardware and software components. Likewise, such software components may be interchanged with hardware components or combinations thereof, and vice versa.

Further examples of electrosurgical units, instruments, and connections therebetween and operation and/or functionality thereof are described in U.S. patent application Ser. , 668, U.S. patent application Ser. U.S. patent application Ser. No. 12/416,695, filed Apr. 1, 2009, U.S. patent application Ser. No. 12/416,128 entitled "Electrosurgical System" of the application, the entire disclosures of which are hereby incorporated by reference in their entireties. incorporated by Certain aspects of these electrosurgical generators, tools, and systems are discussed herein, and additional details and examples regarding various embodiments can be found in "Electrosurgical Dissolution", filed May 16, 2014. U.S. Provisional Patent Application No. 61/994,215 entitled "Device", U.S. Provisional Patent Application No. 61/944,185 entitled "Electrosurgical Generator with Synchronization Detector", filed May 16, 2014. No. 61/994,415, filed May 16, 2014, entitled "Electrosurgical System," and entitled "Electrosurgical Generator," filed May 16, 2014; US Provisional Patent Application No. 61/994,192, the entire disclosures of which are hereby incorporated by reference as if incorporated herein in their entirety.

The foregoing description is provided to enable any person skilled in the art to make and use an electrosurgical device or system and to perform the methods described herein, and to implement the present invention. It enumerates the best modes considered by authors. Various modifications, however, will still be apparent to those skilled in the art. These modifications are considered to be within the scope of this disclosure. In addition, different embodiments or aspects of such embodiments may be considered shown and described in various figures throughout this specification. Note, however, that although shown or described separately, each embodiment and aspect thereof can be combined with one or more of the other embodiments and aspects thereof, unless expressly stated otherwise. There must be. Each combination is not explicitly described merely to facilitate readability of the specification. Likewise, embodiments of the present invention are to be considered in all respects as illustrative rather than restrictive.

Claims (15)

An electrosurgical system comprising:
an electrosurgical instrument having a handle assembly and jaws connected to the handle assembly;
an electrosurgical generator removably coupled to the electrosurgical instrument;
a voltage level of RF energy applied by the electrosurgical generator to an area of tissue in contact with the jaws of the electrosurgical instrument;
generating an initial voltage spike over a first predetermined time period;
after the first predetermined period of time has elapsed, decreasing the voltage level followed by increasing the voltage level, the decreasing and increasing for a second predetermined period longer than the first predetermined period;
holding the voltage level at a post-increase voltage level when a measured current of RF energy in a region of tissue in contact with the electrosurgical instrument falls below a predetermined current threshold;
managing the voltage level by terminating RF energy delivery to the electrosurgical instrument after holding the voltage level at the elevated voltage level for a third predetermined period of time;
An electrosurgical system characterized by: the raised voltage level and the raised voltage level are equal;
The electrosurgical system of claim 1. wherein the boosted voltage level is higher than the boosted voltage level;
The electrosurgical system of claim 1. the third predetermined period is longer than the second predetermined period,
The electrosurgical system of claim 1. the jaw of the electrosurgical instrument includes at least one electrode having a plurality of outcrops;
The electrosurgical system of claim 1. The jaws are curved, and the electrosurgical instrument further comprises a blade movable through the curved jaws between the plurality of outcrops.
An electrosurgical system according to claim 5. When the measurement phase of RF energy equals or falls below a predetermined phase threshold for said second predetermined time period, said subsequent ramp-up is terminated and said RF energy voltage level is reduced to said post-rise voltage. keep at the level of
The electrosurgical system of claim 1. terminating delivery of RF energy to the electrosurgical system when the measured power of the RF energy equals or falls below a predetermined power threshold for the third predetermined time period;
The electrosurgical system of claim 1. terminating the delivery of RF energy to the electrosurgery when the measured current of the delivered RF energy is greater than a predetermined percentage of the maximum allowable current that the electrosurgical generator can deliver for a fixed period of time. ,
The electrosurgical system of claim 1. upon detecting one or more errors, the electrosurgical generator terminates delivery of RF energy to the electrosurgical instrument;
The electrosurgical system of claim 1. wherein the one or more errors are short circuit errors or open circuit errors;
11. The electrosurgical system of claim 10. the short circuit error is detected by the electrosurgical generator when a measured phase of delivered RF energy from the electrosurgical generator equals or exceeds a predetermined phase error value;
12. The electrosurgical system of claim 11. wherein the predetermined phase error value is 60 degrees;
13. The electrosurgical system of claim 12. the open circuit error is detected by the electrosurgical generator when a measured current of the delivered RF energy equals or exceeds a predetermined current error value;
12. The electrosurgical system of claim 11. wherein the predetermined current error value is 2 or 4 Amps;
15. The electrosurgical system of claim 14.

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