CA1085253A - Surgical instrument having self-regulating dielectric heating of its cutting edge and method of using the same - Google Patents

Surgical instrument having self-regulating dielectric heating of its cutting edge and method of using the same

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Publication number
CA1085253A
CA1085253A CA246,551A CA246551A CA1085253A CA 1085253 A CA1085253 A CA 1085253A CA 246551 A CA246551 A CA 246551A CA 1085253 A CA1085253 A CA 1085253A
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CA
Canada
Prior art keywords
blade
dielectric
cutting edge
temperature
electric field
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA246,551A
Other languages
French (fr)
Inventor
Robert F. Shaw
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Individual
Original Assignee
Individual
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Filing date
Publication date
Priority claimed from US05/558,333 external-priority patent/US4207896A/en
Application filed by Individual filed Critical Individual
Application granted granted Critical
Publication of CA1085253A publication Critical patent/CA1085253A/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00107Coatings on the energy applicator

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

Abstract

Abstract of the Disclosure The cutting edge of a scalpel blade is heated to an elevated preselected constant operating temperature for cutting tissue with simultaneous hemostasis by dielectric heating of the internal structure of the blade in the region along the cutting edge. Selective heating of regions of the cutting edge that are locally cooled by contact with tissues during surgical cutting is provided for by constructing the heating elements of the blade of ferroelectric materials that have a Curie point in the operating temperature range and that provide large increases in loss factor (the product of relative di-electric constant times the ratio of loss current to charging current) for temperature decrements below the Curie point.

Description

$~$i3 SURGIC~L INSTRUMENT HAVING SELF-REGULATING
DIELECTRIC HEATING OF ITS CUTTING EDGE ;
AND ~THOD OF USING THE SAME

Background of the Invention The control of bleeding during surgery accounts for a major portion of the total time involved in an operation. The bleeding that occurs from the plethora of small blood vessels that pervade all tissues whenever tissues are incised obscures the surgeon's vision, reduces his precision, and often dictates slow and elaborate procedures in surgical operations. It is `~
well known to heat the tissues to minimize bleeding from in-cisions, and surgical scalpels which are designed to elevate tissue temperatures and minimize bleeding axe also well known.
One such scalpel transmits high frequency, high energy sparks from a small electrode held in the surgeon's hand to the tissues, where they are converted to heat. Typically, substantial elec-trical currents pass through the patient's body to a large electrode beneath the patient, which completes the electrical :~0155ZS3 circuit. Discharge of sparks and temperature conversion in the tissue are poorly controlled in distribution and intensity, and erratic muscular contractions in the patient are produced so that this apparatus cannot be used to perform precise surgery.
Further, apparatus of this type frequently produce severe tissue damage and debris in the form of charred and dead tissue, which materially interfere with wound healing.
Another well-known surgical scalpel employs a blade with a resistive heating element which cuts the tissue and provides simultaneous hemostasis. Although these resistive elements can be readily brought to a suitably high and constant temperature in air prior to contacting tissues, as soon as portions of the blade come in contact with tissues, they are rapidly cooled.
During surgery, non-predictable and continuously varying portions of the blade contact the tissues as they are being cut. As the blade cools, the tissue cutting and hemostasis become markedly less effective and tissue tends to adhere to the blade. If additional power is applied by conventional means to counteract this cooling, this additional power is selectively delivered to the uncooled portions of the blade, frequently resulting in excessive temperatures which may result in tissue damage and blade destruction. This results from the fact that in certain known resistively heated scalpels, the heating is a function of the current squared times the resistance (I R). In conventional metallic blades of this type, the higher the temperature of any blade portion, the greater its electrical resistance, and con-sequently the greater the incremental heating resulting from incremental power input.
It is generally recognized that to seal tissues and effect hemostasis it is desirable to operate at a temperature ,, ,:, : .:: .

5~53 between 300C. and 1000C. And for reasons noted above, it is desirable that electrothermal hemostatic surgical cutting instruments include a mechanism by which power is selective-ly delivered to those portions of the blade that are cooled by tissue contact so that the cutting edge may be maintained at a substantially uniform operating temperature within the desired optimal range. Recently, hemostatic scalpels have been described (see, for example, U. S. Patents 3,768,482 and 3,826,263) in which the temperature-controlling mechanisms include resistive heating elements disposed on the surface of the scalpel blade. However, such instruments require precision in fabricating the dimensions of the heat-ing elements to obtain the desired resistances. And such resistive heating elements may be subjected to variations in resistance-during use, as tissue juices and proteins become deposited upon the surface of the blade.
Summary of the Invention In accordance with one aspect of this invention there is provided a blade comprising: a cutting means including a cutting edge having a dielectric means disposed in the region along said cutting edge; and electrode means disposed adjacent said dielectric means for establishing an electric field through said dielectric means to dissipate power in said dielectric means in response to an alternating electrical signal appearing on said electrode means.
In accordance with another aspect of this inven-tion there is provided the method of heating the cutting edge of a dielectric means operating at an elevated tempera-ture and having a cutting edge, the method comprising the steps of: establishing an alternating electric field in the region of the cutting edge of the dielectric means; and ~ -3-: "'. i.(;

~ . . , , . , ,-1~ 5'~i3 dissipating power in the region of the cutting edge to heat the cutting edge by dielectric losses associated with the applied alternating electric field.
By way of added explanation, the present inven-tion provides a surgical cutting instrument in which the cutting portion of the blade is brought to an elevated temperature by dielectric heating of a scalpel constructed of a non-conducting material. Dielectric heating depends on the heat generated by dipole rotation in a dielectric material caused by an alternating electric field.
All materials can be characterized from an electromagnetic consideration with respect to two para-meters, namely, the magnetic permeability ~ , and the di-electric constant ~, Most dielectric materials are non-magnetic and the permeability is equal to that of free space.
Therefore, the controlling parameter in such materials is the dielectric constant, which may be very large relative to free space. To incorporate both a lost current and a charging current, the dielectric constant of a material is -3a-. .

10~52~i3 generally written in complex form ~ '' where ~' is the real dielectric constant and ~'' is the loss factor. The di-electric constant is also often written in relative form k =
k' - jk'' where k = ~/~O and eO is t:he constant of free space.
The power generated in a dielectric is given by p = 0 55 (1o-12) E2 f k' tan ~

in watts/cm3, where E is the electric field in volts per centimeter, f is the frequency in hertz, k' is the relative dielectric constant, and tan ~ is the ratio of loss current to charging current or k''/k'. The power generated in a dielectric is therefore dependent upon the voltage applied to it, the fre-quency, and the complex dielectric constant of the material.
In the present invention, the tissue-cutting edge of a blade-shaped structure including a dielectric element is heated by the application thereto of a high frequency electrical signal.
The electrodes are disposed on the surfaces of the dielectric element in a manner which establishes a high frequency electric field within the element in a region thereof near the tissue-cutting edge.
Further, selective heating of those portions of the cutting edge that are cooled by tissue contact in order to main-tain cutting temperature sufficiently constant (i.e., temperature self-regulation) may be accomplished by fabricating the element of a dielectric material in which the loss factor k'' (i.e., the product of the re:Lative dielectric and the tan ~ [ratio of loss current to charging current, or k''/k']) increases with de-creasing temperature. Since each local region of the dielectri-cally heated material is directly affected by the high ~requency 29 electric field, each local region may have its operating ~1)8~ S3 temperatures regulated independently of the operating temperatures of adjacent regions. Thus, even in the presence of unpredictable and substantial variations in cooling of the various regions of the heated edge resulting from the edge being manipulated to cut tissues, the heated tissue-cutting edge can be maintained within a suitably constant temperature range.
Ferroelectric materials are examples of dielectrics that have this property near their Curie points. The Curie point of a ferroelectric material is the temperature at which, from an electro-magnetic standpoint, the real dielectric constant experiences a sharp peak and the loss tangent experiences a sharp increase with decreasing temperature. Figure 3 shows these properties for the ferroelectric barium titanate. It can be seen that there is approximately a 5 to 1 increase in k'' tk' x tan ~) as the temperature drops ~rom 170C. to 120C.
Therefore, if this material were used to heat the cutting edge of a scalpel blade in accordance with the present invention, and i a constant frequency and voltage were assumed, there would be a 5 to 1 heating increase as the temperature dropped from 170C.
to 120C. To obtain self-regulation in the 300C. to 1000C.
range, as is desirable in surgical procedures, it is desirable to have a material with a Curie point within this latter temper-ature range. There are ferroelectric materials available with a wide range of Curie points. Figure 4 shows the effect on the real dielectric constant of the addition of lead titanate to barium titanate. The Curie point is moved upward in temperature as the percentage of lead titanate increases. Lead zirconate titanate is an example of a commercially available material with - a Curie point in the 400C. range.
The ferroelectric materials, in addition to having a Curie point that dielectric materials in general do not possess, . . : . :.: : :, ~L~8~ 3 have large values of k'. This permits generating the desired power in the small volume of material that i5 present in the scalpel at voltages that are attainable with standard oscillators and that are small enough to prevent breakdown in small diameter coaxial transmission lines. The following tabulation illustrates the difference in power generated within the volume that is typically to be expected between the electrodes on a scalpel blade. Two dielectrics are illustrated, one a ferroelectric and one a more conventional dielectric such as glass.

Dielectric Constant, Frequency, Watts in k' - jk'' Hertz Volts/cm 0.01 cm 4-j 0.01 4(107) 2(103) 1o~2 1700-j 34 4(107) 2(103) 30 Description of the Drawings Figure 1 is a partial side ~iew of a surgical cutting instrument according to one embodiment of the present invention;
Figure 2 is an end sectional view of one embodiment of a blade-shaped portion of an instrument as shown in Figure l;
Figure 3 is a graph showing the temperature dependence of dielectric constant and loss tangent of barium titanate ceramic; and Figure 4 is a graph showing dielectric constant as a function of temperature, with the percent of lead titanate in barium titanate as a variable.
Description of the Preferred Embodiment Referring now to Figure 1, there is shown in cutaway side view a surgical cutting instrument which has a blade-shaped 28 element 9 that is suitably attached to a handle 11. An electrode 5~S3 13 is disposed on one major face o~ the element 9 near the periphery thereof and another similar electrode 15 (not shown) is disposed on the opposite major face in approximate registration with electrode 13 on the one major face. These electrodes 13, 15 may be connected, respectively, to the terminals of a source 17 of radio frequency signal in such a manner that a radio frequency electric field is established within the element 9 between the electrodes 13, 15 in response to the radio frequency signal applied thereto. This causes local heating near the peripheral edges of the element 9 in the manner as previously described. And since ;' the radio frequency electric ~ield established between electrodes 13 and 15 independently affects the local regions of the dielectric, the operating temperatures of local regions may be regulated independently of the oper~ting temperatures of adjacent regions.
With a material which has the desirable characteristics previously discussed in connection with the graphs of Figures 3 and 4, and at the selected operating temperatures, the entire cutting edge can be maintained within a suitably constant temperature range despite the irregular and unpredictable manner in which the various regions of the cutting edge are used.
The sectional view of Figure 2 shows the arrangement of electrodes 13 and 15 disposed on opposite faces of the element 9 in approximate pattern registration adjacent the tissue-cutting edge of the element 9. An insulating material 21 such as silicon dioxide may be deposited on the major surfaces of element 9 and over the respective electrodes 13 and 15 to insulate the body of a patient from electrical signals appearing on these electrodes.
The radio frequency signal source 19 may be adjustable in signal amplitude or in frequency, or both, to adjust the ambient operating temperature of the cutting edge in air.

Claims (24)

CLAIMS:
1. A blade comprising: a cutting means including a cutting edge having a dielectric means disposed in the region along said cutting edge; and electrode means disposed adjacent said dielectric means for establishing an electric field through said dielectric means to dissipate power in said dielectric means in response to an alternating electrical signal appear-ing on said electrode means.
2. A blade as in claim 1 wherein said dielectric means exhibits increased power dissipation in response to decrease in temperature over a portion of a temperature range.
3. A blade as in claim 1 wherein said dielectric means exhibits a Curie point about which a transition in loss factor with temperature occurs.
4. A blade as in claim 3 wherein said dielectric means includes ferroelectric material.
5. A blade comprising: a cutting means including a cutting edge having a dielectric means disposed in the region along said cutting edge, wherein said dielectric means includes a titanate composition; and electrode means disposed adjacent said dielectric means for establishing an electric field through said dielectric means to dissipate power in said di-electric means in response to an alternating electrical signal appearing on said electrode means.
6. A blade as in claim 5 wherein said titanate composition is at least one of lead and barium.
7. A blade as in claim 6 wherein said dielectric means includes lead zirconate titanate.
8. A blade as in claim 1 comprising a layer of insulating material disposed over the electrode means.
9. A blade as in claim 1 wherein the dielectric means has an electrical parameter that varies as a function of tempera-ture to increase power dissipation on applied electrical signal in the regions of said cutting edge which are selec-tively cooled.
10. A blade as in claim 1 wherein the dielectric means has a loss factor which varies inversely with temperature.
11. A blade as in claim 1 for hemostatic surgery wherein the dielectric means exhibits a Curie point transition in loss factor within the range of temperature between about 300°C.
and about 1000°C.
12. A blade as in claim 1 comprising source means of alter-nating electrical signal coupled to the electrode means of the blade for establishing said alternating electric field within the dielectric means.
13. A blade as in claim 12 comprising: means responsive to the temperature of a region along said cutting edge for producing a representative control signal; and means respon-sive to said control signal for altering a selected parameter of an alternating signal applied to said electrode means from the source means.
14. A blade as in claim 13 wherein the means responsive to the control signal alters one of the amplitude and frequency of an alternating signal applied to said electrodes from said source means.
15. A blade as in claim 5 including a layer of insulating material disposed over said electrode means to electrically insulate tissue being cut from electrical shock.
16. The method of heating the cutting edge of a dielectric means operating at an elevated temperature and having a cutting edge, the method comprising the steps of: establish-ing an alternating electric field in the region of the cutting edge of the dielectric means; and dissipating power in the region of the cutting edge by dielectric losses associated with the applied alternating electric field.
17. The method of heating as in claim 16 wherein in the step of establishing an alternating electric field, the power dis-sipation is increased in the regions of the cutting edge which are selectively cooled in response to variations with temperature of an electric parameter of the dielectric material of the dielectric means.
18. The method of heating as in claim 17 wherein in the step of establishing an alternating electric field, the electrical parameter which varies with temperature is the loss factor of the dielectric material.
19. The method of heating as in claim 18 wherein in the step of establishing an alternating electric field, the dielectric material exhibits a Curie point about which a transition in loss factor with temperature occurs.
20. The method of heating as in claim 19 for use in hemo-static surgery wherein in the step of establishing an alter-nating electric field, the dielectric material exhibits a Curie point transition in loss factor within the range of temperatures from about 300°C. to about 1000°C.
21. The method of heating as in claim 16 wherein in the step of establishing an alternating electric field, at least one of the frequency and amplitude of an alternating electrical signal is altered in response to changes in temperature along the cutting edge.
22. The blade claimed in claim 1 wherein said dielectric means exhibits increased power dissipation in response to decrease in temperature over a portion of the temperature range between approximately 300°C. and 1000°C.
23. The blade claimed in claim 22 wherein said dielectric means exhibits an increase in loss factor at Curie point transition within said temperature range.
24. The blade claimed in claim 23 wherein said dielectric means includes ferroelectric material.
CA246,551A 1975-03-14 1976-02-25 Surgical instrument having self-regulating dielectric heating of its cutting edge and method of using the same Expired CA1085253A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US558,333 1975-03-14
US05/558,333 US4207896A (en) 1970-08-13 1975-03-14 Surgical instrument having self-regulating dielectric heating of its cutting edge

Publications (1)

Publication Number Publication Date
CA1085253A true CA1085253A (en) 1980-09-09

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA246,551A Expired CA1085253A (en) 1975-03-14 1976-02-25 Surgical instrument having self-regulating dielectric heating of its cutting edge and method of using the same

Country Status (6)

Country Link
JP (1) JPS51122986A (en)
BR (1) BR7601564A (en)
CA (1) CA1085253A (en)
DE (1) DE2609439C3 (en)
FR (1) FR2303517A1 (en)
GB (1) GB1546626A (en)

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4248231A (en) * 1978-11-16 1981-02-03 Corning Glass Works Surgical cutting instrument
US4232676A (en) * 1978-11-16 1980-11-11 Corning Glass Works Surgical cutting instrument
DE2944730A1 (en) * 1978-11-16 1980-05-29 Corning Glass Works SURGICAL INSTRUMENT
CA1161326A (en) * 1979-09-10 1984-01-31 Robert F. Shaw Abherent surgical instrument and method
US4700716A (en) * 1986-02-27 1987-10-20 Kasevich Associates, Inc. Collinear antenna array applicator
US4793346A (en) * 1986-09-04 1988-12-27 Bruce Mindich Process and apparatus for harvesting vein
EP0280798B1 (en) * 1987-03-02 1993-01-27 Everest Medical Corporation Electrosurgery surgical instrument
JPH0322944U (en) * 1989-07-12 1991-03-11
US8377052B2 (en) * 2009-04-17 2013-02-19 Domain Surgical, Inc. Surgical tool with inductively heated regions
AU2020253261B2 (en) * 2019-03-29 2023-04-13 Conmed Corporation High permittivity electrosurgical electrode coating

Also Published As

Publication number Publication date
DE2609439B2 (en) 1978-11-16
JPS51122986A (en) 1976-10-27
FR2303517A1 (en) 1976-10-08
DE2609439A1 (en) 1976-09-16
DE2609439C3 (en) 1979-07-12
BR7601564A (en) 1976-09-14
GB1546626A (en) 1979-05-23
FR2303517B3 (en) 1979-06-29

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