CN110418617A - 具有纹理钳口的电外科器械 - Google Patents

具有纹理钳口的电外科器械 Download PDF

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CN110418617A
CN110418617A CN201880018622.3A CN201880018622A CN110418617A CN 110418617 A CN110418617 A CN 110418617A CN 201880018622 A CN201880018622 A CN 201880018622A CN 110418617 A CN110418617 A CN 110418617A
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jaw
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E·M·伦纳
K·A·巴什
J·M·巴斯勒
C·Q·萧
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Ethicon LLC
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Abstract

本发明公开的电外科系统包括RF电流发生器、柄部主体和端部执行器，该端部执行器与该柄部主体以机械方式连通。该端部执行器具有包括第一电极的第一钳口，该第一电极具有与该发生器的第一端子电连通的第一电极表面。该端部执行器也包括第二钳口，该第二钳口包括第二电极，该第二电极具有与该发生器的第二端子电连通的基本上平坦的第二电极表面。该第一钳口包括至少一个特征部，该至少一个特征部被构造成能够向压缩在该至少一个特征部与该第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小不同于当该第一钳口放置于邻近该第二钳口的位置时施加到压缩在该第一电极表面与该第二电极表面之间的组织的压缩力的大小。

Description

具有纹理钳口的电外科器械
背景技术
电外科装置用于许多外科手术中。电外科装置向组织施加电能以便对组织进行处理。电外科装置可包括具有安装在远侧的端部执行器的器械，端部执行器包括一个或多个电极。端部执行器可抵靠组织定位，由此使得电流被引入到组织中。电外科装置可被构造成能够用于双极操作。在双极操作期间，电流分别通过端部执行器的有源电极和回流电极被引入到组织中并从组织回流。双极装置也可具有由两个或更多个钳口组成的端部执行器，每个钳口具有有源电极和/或回流电极中的至少一个。钳口中的至少一个从与相对钳口间隔开以用于接纳组织的位置到钳口之间的空间小于第一位置的空间的位置是可动的。可动的钳口的移动压缩保持在两者间的组织。由流过组织的电流所产生的热结合通过钳口移动实现的压缩可以在组织内和/或在组织之间形成止血密封并因此可尤其适用于例如密封血管。电外科装置的端部执行器有时也包括切割构件，其相对于组织和电极是可动的，以横切组织。
电外科装置也可包括将组织夹持在一起的机构，诸如缝合装置，以及/或者切断组织的机构诸如组织刀。电外科装置可包括轴，其用于将端部执行器邻近接受治疗的组织放置。轴可为直的或弯曲的、可弯曲的或不可弯曲的。在包括直的和可弯曲轴的电外科装置中，轴可具有一个或多个关节运动接头以允许轴的受控弯曲。当使用具有直的非弯曲轴的电外科装置不容易接近待处理的组织时，此类接头可允许电外科装置的使用者以与轴成角度的方式将端部执行器放置于与组织接触。
由电外科装置施加的电能可通过发生器传递至器械。电能可为射频(“RF”)能量的形式。电能可以是射频(“RF”)能量的形式，RF能量可在EN60601-2-2:2009+A11:2011,Definition 201.3.218–HIGH FREQUENCY(EN60601-2-2:2009+A11:2011，定义201.3.218-高频率)中所述的频率范围内。例如，单极RF应用中的频率通常被限制为小于5MHz。然而，在双极RF应用中，频率几乎可为任何值。单极应用通常使用200kHz以上的频率，以避免由于使用低频电流而应当导致不希望的对神经和肌肉的刺激。如果风险分析显示神经肌肉刺激的可能性已减轻至可接受的水平，则双极技术可使用较低频率。通常，不使用高于5MHz的频率以使与高频渗漏电流相关联的问题最小化。然而，就双极技术而言可使用较高频率。通常认为，10mA是组织热效应的下限阈值。
电外科装置在其操作期间可通过在两个或更多个钳口之间压缩的组织传递RF能量。此类RF能量可以引起组织中的离子振荡，实际上造成电阻性加热，并由此增加组织的温度。增加的组织温度可能导致组织烧灼。RF能量可尤其良好地适用于结缔组织，结缔组织主要由胶原构成，并在接触热时收缩。由于可在受影响的组织与周围组织之间形成尖锐边界，因此外科医生能够以高精确度水平进行操作，并在不损伤相邻的非目标组织的情况下进行控制。在一些外科手术中，RF能量可用于密封血管。
在组织的手术切除期间，血管可以作为规程的一部分或切除所关注的组织的辅助切断。一旦血管被切断，血液就可能流入手术部位，潜在地使部位模糊，从而使外科手术变得更加困难。如果切断的血管为主要血管，诸如动脉或静脉，则患者在手术过程中可能遭受大量失血，从而显著损害患者的健康。
许多血管具有三层结构。最内层即内膜层(或腹膜内部)可使血管的内腔进行排列。中间层(中膜)可包括平滑肌细胞，其可收缩以协助血液流动。最外层即动脉外膜(或外膜)是一种复杂结构，可能包括多种细胞类型，诸如白细胞、成纤维细胞和肌成纤维细胞，嵌入细胞外基质中，可能包括各种胶原纤维、纤粘蛋白和各种蛋白聚糖。
可以理解，血管的成功烧灼需要施加足够的压缩力以关闭血管，以及施加RF能量以加热并在压缩下烧灼组织。为了将足够的压缩力施加到血管，电外科装置的端部执行器钳口必须牢固地抓持血管的动脉外膜并施加足够的压力，以克服由平滑肌以及其内的血流产生的力。可以认识到，动脉外膜的结构和组成可能使端部执行器钳口难以牢固地抓持血管，以允许压缩力和RF能量被递送以进行适当的烧灼。因此，设计具有特征或纹理的电外科装置的端部执行器可能是有用的，以确保端部执行器钳口可在烧灼之前和期间牢固地抓持血管。
发明内容
在一个方面，电外科系统可包括RF电流发生器、柄部主体和端部执行器，端部执行器与柄部主体以机械方式连通。端部执行器可包括第一钳口和第二钳口，第一钳口包括具有第一电极表面的第一电极，其中第一电极与RF电流发生器的第一端子电连通，第二钳口包括具有第二电极表面的第二电极，其中第二电极与RF电流发生器的第二端子电连通，并且其中第一钳口包括至少一个特征部，特征部被构造成能够向在至少一个特征部与第二电极表面之间压缩的组织施加一定量的压缩力，该压缩力的大小不同于当第一钳口放置于邻近第二钳口的位置时，施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。另外，第二电极为平坦表面。
在电外科系统的一个方面，至少一个特征部包括设置在第一电极中的至少一个纵向通道。
在电外科系统的一个方面，至少一个特征部包括设置在第一电极中的至少一个横向通道。
在电外科系统的一个方面，第二电极设置在绝缘层上。
在一个方面，电外科系统还包括多个绝缘垫，其中，多个绝缘垫中的每个具有与第二电极表面共面的表面，其中至少一个特征部包括从第一电极延伸并与第一电极电连通的多个凸起的凸台，并且其中，当第一钳口放置于邻近第二钳口的位置时，多个凸起的凸台中的至少一个被构造成能够接合多个绝缘垫中的至少一个。
在电外科系统的一个方面，至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个纵向脊部，并且其中多个凸起的凸台从至少一个纵向脊部的表面延伸。
在电外科系统的一个方面，至少一个特征部还包括设置在第一电极中的至少一个纵向通道。
在电外科系统的一个方面，至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个横向脊部，并且其中多个凸起的凸台从至少一个横向脊部的表面延伸。
在电外科系统的一个方面，至少一个特征部还包括设置在第一电极中的至少一个横向通道。
在电外科系统的一个方面，当将力施加到端部执行器时，第二钳口能够相对于第一钳口运动。
在电外科系统的一个方面，当将力施加到端部执行器时，第一钳口能够相对于第二钳口运动。
在一个方面，用于电外科装置的端部执行器可包括第一钳口和第二钳口，第一钳口包括具有第一电极表面的第一电极，其中第一电极被构造成能够与RF电流发生器的第一端子电连通，并且第二钳口包括具有第二电极表面的第二电极，其中第二电极被构造成能够与RF电流发生器的第二端子电连通。还根据该方面，其中第一钳口包括至少一个特征部，至少一个特征部被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小不同于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小，并且第二电极为平坦表面。
在端部执行器的一个方面，至少一个特征部被构造成能够向压缩在至少一个特征部与第二钳口之间的组织施加一定量的压缩力，该压缩力的大小大于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。
在端部执行器的一个方面，至少一个特征部包括从第一电极延伸并且与第一电极电连通的至少一个纵向脊部。
在端部执行器的一个方面，至少一个特征部包括从第一电极延伸并且与第一电极电连通的至少一个横向脊部。
在端部执行器的一个方面，至少一个特征部被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小小于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。
在端部执行器的一个方面，至少一个特征部包括设置在第一电极中的至少一个纵向通道。
在端部执行器的一个方面，至少一个特征部包括设置在第一电极中的至少一个横向通道。
在端部执行器的一个方面，至少一个特征部被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小大于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小，并且至少第二特征部被构造成能够向压缩在至少第二特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小小于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。
在端部执行器的一个方面，第二电极设置在绝缘层上。
在一个方面，端部执行器还包括至少一个绝缘垫，其中至少一个绝缘垫具有与第二电极共面的表面，其中至少一个特征部具有至少一个从第一电极延伸并与第一电极电连通的凸起的凸台，并且其中当第一钳口放置于邻近第二钳口的位置时，至少一个凸起的凸台被构造成能够接合至少一个绝缘垫。
在端部执行器的一个方面，至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个纵向脊部，并且其中至少一个凸起的凸台从至少一个纵向脊部的表面延伸。
在端部执行器的一个方面，至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个横向脊部，并且其中至少一个凸起的凸台从至少一个横向脊部的表面延伸。
在端部执行器的一个方面，第二钳口能够相对于第一钳口运动。
在端部执行器的一个方面，第一钳口能够相对于第二钳口运动。
附图说明
各个方面的特征在所附权利要求书中进行了具体描述。然而，通过结合如下附图参考以下说明可最好地理解关于组织和操作的方法的各个方面及其优点：
图1A示出了根据本公开内容的一个方面的与能量源电连通的外科器械。
图1B为根据本公开的一个方面的图1A所示的外科器械的端部执行器的详细视图。
图2示出了图1A和图1B的电外科器械的端部执行器的一个方面的透视图，其中钳口打开。
图3示出了图2中所示的端部执行器的非可动的钳口的一个方面的透视图。
图4A示出了图3中所示的非可动的钳口的钳口构件框架的一个方面的透视图。
图4B示出了图3中所示的非可动的钳口的电极组件的一个方面的透视图。
图4C示出了图3中所示的非可动的钳口的方面的分解图。
图5示出了图2中所示的端部执行器的可动的钳口的一个方面的透视图。
图6A、图6B和图6C分别是图5中所示的可动的钳口的方面的顶部、侧面和底部的平面图。
图7是沿图6C中所示的可动的钳口的方面的线7-7截取的纵切面视图。
图8是沿图6C中所示的可动的钳口的方面的线8-8截取的横切面视图。
图9示出了图2中所示的端部执行器的可动的钳口的第二方面的透视图。
图10A、图10B和图10C分别是图9中所示的可动的钳口的方面的顶部、侧面和底部的平面图。
图11是沿图10C中所示的可动的钳口的方面的线11-11截取的纵切面视图。
图12是沿图10C中所示的可动的钳口的方面的线12-12截取的横切面视图。
图13示出了图2中所示的端部执行器的可动的钳口的第三方面的透视图。
图14示出了图2中所示的端部执行器的可动的钳口的第四方面的透视图。
图15A、图15B和图15C分别是图14中所示的可动的钳口的方面的顶部、侧面和底部的平面图。
图16是沿图15C中所示的可动的钳口的方面的线16-16截取的纵切面视图。
图17是沿图15C中所示的可动的钳口的方面的线17-17截取的横切面视图。
图18示出了图2中所示的端部执行器的可动的钳口的第五方面的透视图。
图19A、图19B和图19C分别是图18中所示的可动的钳口的方面的顶部、侧面和底部的平面图。
图20是沿图19C中所示的可动的钳口的方面的线20-20截取的纵切面视图。
图21A是沿图19C中所示的可动的钳口的方面的线21A-21A截取的横切面视图。
图21B是沿图19C中所示的可动的钳口的方面的线21B-21B截取的横切面视图。
图21C是沿图19C中所示的可动的钳口的方面的线21C-21C截取的横切面视图。
图22是图1A和图1B的电外科器械的端部执行器的一个方面的剖视图，其中钳口闭合并压缩两者间的血管。
图23是在通过图1A和图1B的电外科器械施加密封操作之后血管的一个方面的剖视图。
图24是图1A和图1B的电外科器械的端部执行器的剖视图，其中第一钳口和第二钳口包括内部锥形部分和外部凹面部分。
图25是在图24中所示的端部执行器的第一钳口与第二钳口之间压缩的血管的第二方面的剖视图。
具体实施方式
下面对本技术的某些示例的说明不应当用于限制本技术的范围。根据下面的描述，本技术的其他示例、特征、方面、各方面和优点对本领域技术人员来说将变得显而易见。正如将意识到的，本文所述的技术能够具有其它不同的和明显的方面，所有这些方面均不脱离本技术。因此，附图和说明应当被视为实质上是例示性的而非限制性的。
还应当理解，本文所述的教导内容、表达、方面、示例等中的任一个或多个可与本文所述的其它教导内容、表达、方面、示例等中的任一个或多个组合。因此，下述教导内容、表达、方面、示例等不应当被视为彼此孤立。参考本文的教导内容，本文的教导内容可进行组合的各种合适方式对于本领域的普通技术人员而言将显而易见。此类修改和变型旨在包括在权利要求书的范围内。
而且，在以下说明中，应当理解，诸如前、后、内部、外部、上部、下部、顶部、底部等术语是方便的言语，并且不应当理解为限制性术语。本文所用的术语并非意在限制在本文所述装置或其部分的范围内，而是可以按照其它取向附接或利用。将参照附图更详细地描述各种方面。在整个公开内容中，术语“近侧”用于描述部件例如轴、柄部组件等的更接近于操作外科器械的使用者例如外科医生的侧面，并且术语“远侧”用于描述部件的距离操作外科器械的使用者更远的侧面。
本公开的各方面呈现用于单个电外科装置，单个电外科装置被构造成能够用于抓持组织并使用电和/或其他能量执行密封规程。电外科装置的端部执行器可包括以各种构型布置的多个构件，以共同执行上述功能。如本文所用，端部执行器可被称为钳口组件或夹钳组件，其包括上钳口构件和下钳口构件，其中，上钳口构件和下钳口构件中的至少一者能够相对于另一者运动。钳口构件可适于连接到电外科能量源。钳口构件可结合电极。电极可以是正电极或负电极。在双极电外科装置中，电极可适于连接到电外科能量源的相对端子，诸如双极射频(RF)发生器，以便在它们之间产生电流。电外科能量可选择性地通过夹持在钳口构件之间的组织传输，以实现组织密封和/或治疗。组织可以因在钳口构件上的相反极性电极之间流动的电流而凝结。
至少一个钳口构件可包括限定在其中的刀通道，刀通道被构造成能够使刀仅沿其往复地运动，以用于切断夹持在钳口构件之间的组织。刀通道可以是钳口构件中的延伸狭槽。刀可设置在与至少一个钳口构件相关联的凹陷部内。电外科装置可具有凝结功能和切割功能两者。这可消除或减少手术期间的器械互换。可仅使用机械力或机械力和电外科能量的组合来实现切割。电外科能量可选择性地用于凝结和/或切割。刀可以由导电材料制成，导电材料适于连接到电外科源，并且可选择性地激活以分离设置在钳口构件之间的组织。刀可以是弹簧偏置的，由此使得一旦切断组织，刀就可以自动返回刀通道内的未接合位置或凹陷部中的回缩位置。
在一些方面，钳口构件能够相对于彼此运动。在操作电外科装置期间，钳口构件中的至少一个可以从第一打开位置移动到第二闭合位置，在第一打开位置，钳口构件可围绕大量组织设置，在第二闭合位置，钳口构件抓持组织。因此，钳口构件可移动通过类似于传统钳子的抓紧器类的运动范围。在第二位置，电流在钳口构件之间流动，以实现对两者间捕获的组织止血。钳口构件可被构造成能够具有相对厚的近侧部分以抵抗弯曲。钳口构件中的至少一个可具有三维构型，其具有D形横截面。具有D形横截面的三维构型可抵抗弯曲。可包括锁定机构以将钳口构件锁定在闭合位置。锁定机构可设定钳口构件之间的夹持压力。可在钳口构件之间设置至少一个导电间隙设定构件，以在双极电外科装置中的电极之间建立所需的间隙。
电外科装置可包括在端部执行器的钳口之间设置间隙的部件，经由端部执行器抓持组织的部件、经由一个或多个电极向组织递送能量的部件和经由解剖装置诸如组织刀切割组织的部件。电外科装置的任何方面的结构能力可被设计用于多种外科规程中的一种或多种中。在一些外科规程中，附连到相对直的且不可弯曲的轴的端部执行器可容易地接近经治疗的组织。在一些另选的外科规程中，在此类轴上，端部执行器可能不容易地接近组织。在此类规程中，电外科装置可包括被设计成弯曲的轴，以使得端部执行器可接触需要治疗的组织。在此类装置中，轴可包括一个或多个关节运动接头，其可允许轴在使用者的控制下弯曲。滑动刀可包括向滑动刀提供致动力的特征部。刀致动器可以可操作地联接到轴以用于选择性地使刀通过刀通道往复地运动。
前部组件可被设计用于特定的外科规程，而被构造成能够可释放地附接到前部组件的可重复使用的柄部组件可被设计成控制每个前部组件共有的外科功能，诸如组织抓持、烧灼和切割。因此，可减少手术所需的装置的数量和类型。可重复使用的柄部组件可被设计成使电外科装置的常见功能自动化。装置智能可由位于可重复使用的柄部组件中的控制器提供，控制器被构造成能够从前部组件接收信息。此类信息可包括关于前部组件的类型和用途的数据。另选地，信息可包括指示控制部件(诸如可操纵的按钮或滑片)的位置和/或激活的数据，其可指示应当激活哪些系统功能以及以何种方式激活。
在一些非限制性示例中，当能量激活控制被使用者置于激活位置时，控制器可供应RF电流。在一些另选的非限制性示例中，一旦能量激活控制被置于激活位置，控制器就可供应RF电流预先确定的时间段。在又一个非限制性示例中，控制器可接收与钳口构件的位置有关的数据，并且如果钳口构件未处于闭合位置，则防止RF电流被供应到一个或多个组织烧灼功率接触件。
在一些方面，所提到的示例中的任一个也可被构造成能够通过各种部件沿至少一个轴线进行关节运动，部件包括例如一系列接头、一个或多个铰链或挠性轴承和一个或多个凸轮或滑轮系统。其它特征部可包括联接到端部执行器的构件中的一个或多个的相机或灯，以及用于外科装置的各种能量选项。
电外科装置可被构造成能够以各种形式获取能量，能量包括但不限于电能、单极和/或双极RF能量、微波能量、可逆和/或不可逆电穿孔能量、以及/或者超声能量、热能或它们的任何组合，以独立地或同时地输送到患者的组织。能量可通过与电外科装置电连通的功率源传递到电外科装置。功率源可以是发生器。功率源可经由合适的传输介质(诸如缆线)连接到电外科装置。功率源可与电外科装置分离，或者可与电外科装置整体地制成，以形成一体的电外科系统。在一个非限制性示例中，功率源可包括位于电外科装置的一部分内的一个或多个电池。可以理解，功率源可获取用于患者的组织上以及其它装置的任何其它电气用途的能量，装置包括但不限于灯、传感器、通信系统、指示器和显示器，它们与电外科装置有关地和/或与电外科装置一起操作，以形成电外科系统。
如上所述，电外科装置可被构造成能够以RF能量的形式获取电能。电外科装置可通过在两个或更多个钳口构件之间压缩的组织传递RF能量。在一些外科规程中，RF能量可适用于在密封血管的同时移除、收缩软组织或对软组织塑型。RF能量可尤其良好地适用于结缔组织，结缔组织主要由胶原构成，并在接触热时收缩。由于可在受影响的组织与周围组织之间形成尖锐边界，因此外科医生能够以高精确度水平进行操作，并在不损伤相邻的非目标组织的情况下进行控制。
RF能量可在EN 60601-2-2:2009+A11:2011,Definition 201.3.218-HIGHFREQUENCY(EN 60601-2-2:2009+A11:2011，定义201.3.218-高频率)中所述的频率范围内。例如，单极RF应用中的频率通常可被限制为小于5MHz。然而，在双极RF应用中，频率几乎可为任何值。单极应用通常可使用高于200kHz的频率，以便避免由于使用低频电流而应当导致不希望的对神经和肌肉的刺激。如果风险分析显示神经肌肉刺激的可能性已减轻至可接受的水平，则双极应用可使用较低频率。通常，不使用高于5MHz的频率以使与高频渗漏电流相关联的问题最小化。然而，在双极应用的情况下，可使用较高的频率。通常认为，10mA是组织热效应的下限阈值。
如上所述，电外科装置可与发生器结合使用。发生器可以是电外科发生器，其特征在于固定的内部阻抗和固定的工作频率，其向外部负载(例如，组织)递送最大功率，具有的电阻抗为在约50欧姆至150欧姆范围内。在这种类型的双极电外科发生器中，当负载阻抗增加到数万欧姆或更高的水平时，随着负载阻抗朝着最大“开放电路”电压增加，施加的电压可单调增加。另外，电外科装置可与双极电外科发生器一起使用，双极电外科发生器具有固定的工作频率和输出电压，输出电压可在数十欧姆到数万欧姆的负载阻抗范围内基本上恒定，包括“开放电路”状态。电外科装置可有利地与可变电压设计或基本上恒定电压设计的双极电外科发生器一起使用，其中，当递送电流降低到预先确定的水平以下时可中断施加的电压。此类双极发生器可被称为自动发生器，因为它们可感测凝结过程的完成并终止电压的施加，常常伴有可听指示，其形式是停止“电压施加”音调或通知独特的“凝结完成”音调。此外，电外科装置可与电外科发生器一起使用，电外科发生器的工作频率可随负载阻抗而变化，以作为随着负载阻抗的改变而调制施加的电压的部件。
电外科装置的各种方面使用治疗和/或亚治疗电能来治疗组织。一些方面可用在机器人应用中。一些方面可适用于手动操作的方式。在一个非限制性示例中，电外科装置可包括近侧柄部、远侧工作端部或端部执行器和设置在它们之间的导引器或细长轴。
在一些非限制性医疗规程中，电外科装置可用于在组织切除之前焊接或密封血管。此类血管也可作为切除其他组织诸如囊肿、肿瘤或感染的材料的规程的一部分移除。血管密封可减少出血，从而降低切除规程过程中的潜在有害影响。在此类规程中，可在烧灼位置处切割血管。可以理解，在切割位点处可能需要完全密封以防止出血。因此，具有可防止切割血管直至确保完全密封的电外科装置是有用的。
为了适当地密封血管，可精确地控制影响密封的血管的厚度的两个机械参数：施加到血管的压力和电极之间的间隙。适当的密封可能需要在血管上施加足够的压力，以确保血管壁彼此邻近并且两者间不存在居间间隙。可将血管压缩至预定范围内的压力。合适压力的典型范围可为介于约30磅每平方英寸(约0.2MPa)和约250磅每平方英寸(约1.7MPa)之间。此外，适当的密封可能需要提供足够的功率以确保血管壁接收足够的热量以将壁焊接在一起。因此，可能需要组织压缩和组织烧灼两者以形成适当的密封。这些可通过端部执行器的钳口构件来实现。如上所述，钳口构件可抓持、压缩并将能量递送至组织。
为了有效地进行止血，钳口构件应当有效地传导适当的电流流动穿过抓持的组织。当该电流不足时，组织或血管的凝结作用可能受到损害。当电流过大时，可能发生相应的过度加热，从而有可能产生破坏性的电弧。过度加热可导致组织和血液凝结物粘附到钳口构件的表面上的现象。这可导致装置的电极与随后可为了治疗目的而被抓持的组织之间的电阻抗增大。此类粘附组织可引起凝固表面的破坏，其本身可损害预期的止血效果。端部执行器可结合高度抛光的电极表面，用于减小组织粘附的程度以及在发生粘附时有利于它们的清洁的目的。
当抓持组织时，钳口构件可相互接触，从而导致短路。例如，当小组织部件在钳口构件之间被抓持并且/或者当钳口构件被用力压缩时，电极可在被抓持的组织附近彼此接触，从而导致短路。钳口构件可包括绝缘涂层，其可以某种几何结构接触。
在各个方面，导电间隙设置构件可设置在钳口构件之间。导电间隙设置构件可固定在一个钳口构件上并且/或者与一个钳口构件成一整体并延伸至其他钳口构件。导电间隙设置构件可突出穿过钳口构件。导电间隙设置构件可限定钳口构件之间的间隙。导电间隙设置构件可以是导电的。间隙设置构件可由导电材料制成，并且也是刚性的，以抵抗响应于所施加的力的变形。导电间隙设置构件可被定尺寸和被构造成能够避免相对电极之间的短路并且/或者确保电极在电极之间不存在组织的情况下不应当靠近到足以形成电弧。
根据各种方面，端部执行器可包括钳口构件之间的电绝缘构件。电绝缘构件可设置在钳口构件中的至少一个上。钳口构件可具有表面。电绝缘构件可具有与钳口构件的表面共面的表面。至少一个电绝缘构件的顶部表面可以是圆形、正方形、矩形、椭圆形或任何其他合适的形状。在存在多于一个电绝缘构件的一些方面，电绝缘构件可各自具有与各种形状的任何组合相同的形状或不同的形状。
在各个方面，可存在多于一个电绝缘构件。电绝缘构件可具有不同的形状和/或尺寸。电绝缘构件中的全部或一些可沿电极的长度改变形状和/或尺寸。电绝缘构件可沿电极的长度具有增大或减小的尺寸。电绝缘构件可以规则的方式或随机地改变形状和/或尺寸。
在各个方面，钳口构件的表面上的电极可由金属制成。钳口构件的表面的暴露部分可具有平滑表面以使对组织或凝结物的粘附最小化，并且当组织碎屑或凝结物累积时有利于它们的清洁。钳口构件的表面可包括导热部件诸如铜、银、铝、钨、镍，或本领域的技术人员可能想到的任何其他导热材料。涂覆有生物相容性金属涂层的层压复合物可施加到表面上。钳口构件可包括导热铜和机械强度更强的材料，尤其是更高模量的不锈钢的层压复合物。可通过电沉积的生物相容性金属涂层(诸如铬)保持钳口构件的生物相容性，金属涂层涂覆有不锈钢和铜层压体两者同时不影响电绝缘构件。在一些非限制性示例中，对于具有小钳口构件的端部执行器(例如，在其尖端处具有的宽度为约0.039"(1mm))，可提供具有厚度为约0.011"的304不锈钢层和厚度为约0.052"的对应铜层的层压复合物。对于较大的钳口构件，可提供具有厚度为约0.015"的304不锈钢层和厚度为约0.075"至约0.085"的对应铜层的层压复合物。例如，可提供生物相容性涂层作为电沉积铬涂层，例如，由俄亥俄州克利夫兰市电解公司(Electrolyzing Corporation of Ohio,Cleveland,Ohio 44112)销售的MED-COAT 2000。此生物相容性涂层被描述为符合或超过USP类VI级认证。
至少一个电绝缘构件可由电绝缘材料制成。电绝缘材料可以是氧化铝、陶瓷、尼龙、聚邻苯二甲酰胺(PPA)、特氟隆、聚酰亚胺、聚对二甲苯、任何其他合适的材料和/或它们的任何组合。在各个方面，可在钳口构件的表面上提供平滑的金属表面，以减少组织或凝结物的粘附，并且这些表面可涂覆有导电不粘涂层。至少一个电绝缘构件的顶部表面可涂覆有电绝缘性不粘涂层材料。
在各个方面，钳口构件的长度可被设置用于外科手术中的特定应用。例如，长度为约0.4"或0.5"至约0.75"诸如约0.47"(12mm)的钳口构件可用于较小解剖结构或精细工作。对于较大解剖结构，钳口构件的长度可为约1"或更大，例如约1.57"(40mm)。
至少一个电绝缘构件可具有适当的直径，由此使得电绝缘构件既不太小以致不刺穿组织，也不太大以致不能占据太多的电极表面。电绝缘构件的最小直径可以为约0.03125"(1/32")，因为此直径的构件可不刺穿组织，除非从构件上施加到组织上的压力非常高。如果太多电极表面被电绝缘构件带走，则电极表面可能太少，因此，与一个电绝缘构件/多个构件相邻的导电区域太少，并且电外科装置和/或电极可能无法获得所需的性能。在一些方面，存在多于一个电绝缘构件或多个构件，并且可具有相同或不同的任何组合的直径。
在以下详细说明中，参考构成其一部分的附图。在附图中，除非上下文另外指出，否则类似的符号和参考字符通常在几个视图中标识类似的部件。
图1A示出了根据本公开的一个方面的与发生器101电连通的电外科器械100。根据各个方面，利用柔性电路102，电外科器械100可为可构造的。电外科器械100可包括细长构件103，诸如轴104，其具有联接到柄部组件106的近侧部分105。细长构件103的远侧部分107可包括联接到轴104的远侧端部的端部执行器108(参见1B图)。在一些方面，端部执行器108可包括第一钳口构件109a和第二钳口构件109b，每个钳口构件均具有外部部分或表面110a、110b。第一钳口构件109a和第二钳口构件109b中的至少一者能够相对于轴104运动。仅有一个钳口能够相对于轴104运动，并且另一个钳口可相对于轴104固定。第一钳口构件109a和第二钳口构件109b中的至少一者能够相对于另一者沿箭头J所示的路径可为可旋转地运动，以使第一钳口构件109a和第二钳口构件109b在打开位置与闭合位置之间转换。在操作中，第一钳口构件109a和第二钳口构件109b可从打开位置转换到闭合位置以捕获两者之间的组织。捕获的组织可接触钳口组111a、111b的一个或多个工作部分，这些一个或多个工作部分被构造成能够施加能量以治疗定位在端部执行器108处或附近的目标组织。
能量的类型可采取各种形式，并且包括但不限于单极性和/或双极性RF能量、微波能量、可逆和/或不可逆电穿孔能量和/或超声能量或它们的任何组合。柄部组件106可包括限定夹持件113的外壳112。在各个方面，被构造成能够向端部执行器108提供操作指令的柄部包括一个或多个控制界面114a-c(例如，按钮或开关114a)、沿箭头R为可旋转的旋钮114b和相对于夹持件113沿箭头T为可动的触发器114c。多个按钮、旋钮或触发器也可被包括为外壳112的一部分，以便操纵在端部执行器108处的一个或多个功能构件。在一些方面，柄部组件106还可被构造成能够电联接到发生器101，以向电外科器械100提供能量。
发生器101可经由合适的传输介质诸如缆线115连接到电外科器械100。在一个示例中，发生器101可联接到控制器，例如控制单元116。在各个方面，控制单元116可与发生器101整体地形成或者可作为电联接到发生器101(以虚线显示以示出此选项)的独立电路模块或装置而提供。控制单元116可包括自动或手动操作的控件，以控制由发生器101递送到电外科器械100的电流量。尽管如目前所公开的，发生器101被显示为与电外科器械100分开，但在一些方面，发生器101(和/或控制单元116)可与电外科器械100整体地制成，以形成一体的电外科系统，其中位于电外科器械100内的电池可以是能量源，而联接到电池的电路产生合适的电能、超声能量或热能。虽然发生器101通常被示出为联接到柄部组件106(例如，用细绳)，但应当理解在一些方面，发生器101可定位在细长构件103和/或柄部组件106内。例如，在一个方面，发生器101包括定位在柄部组件106、轴104或其一部分中的一个或多个直流电池。
在一个方面，发生器101可包括位于发生器101的前面板上的输入装置。输入装置可包括生成适用于对发生器101的操作进行编程的信号的任何合适的装置，例如诸如键盘或输入端口。在一个示例中，第一钳口109a中的一个或多个电极以及第二钳口109b中的一个或多个电极可联接到发生器101。缆线115可包括多个电导体以用于将电能施加到电外科器械100的第一电极(其可被指定为+电极)和第二电极(其可被指定为-电极)。可以认识到，+和-标记仅仅是为了方便而不是指示电极性。导体中的每个的端部可被放置于与发生器101的端子电连通。发生器101可具有多个端子，每个端子被构造成能够接触导体中的一个或多个。控制单元116可用于激活发生器101，发生器101可用作电源。在各个方面，发生器101可包括例如可被独立地或同时地激活的RF源、超声波源、直流电源和/或任何其他合适类型的电能量源。在各个方面，缆线115可包括至少一个供流导体117和至少一个回流导体118，其中，电流能够经由至少一个供流导体117供应至电外科器械100，并且其中，电流能够经由至少一个回流导体118流回发生器101。在各个方面，至少一个供流导体117和至少一个回流导体118可包括绝缘导线和/或任何其他合适类型的导体。如下文所述，至少一个供流导体117和至少一个回流导体118可包括在缆线115内并且/或者可包括：在发生器101与电外科器械100的端部执行器108之间或至少部分地在它们之间延伸的缆线。发生器101可被构造成能够在供流导体117与回流导体118之间施加足够的电压差，由此使得可将足够的电流供应到端部执行器108，以执行预期的电外科操作。
在一个示例中，发生器101可实施为电外科单元(ESU)，电外科单元能够提供足以利用RF能量来执行双极电外科手术的功率。在一个示例中，ESU可为由科罗拉多州博尔德市的美敦力公司(Medtronic of Boulder Colorado)出售的Force TriadTMEnergy Platform(Force TriadTM能量平台)。在一些方面，诸如对于双极性电外科应用而言，可利用具有有源电极和回流电极的电外科器械100，其中有源电极和回流电极可抵靠、邻近待处理的组织来定位并且/或者与待处理的组织电连通，由此使得电流可以从有源电极流过PTC主体并通过组织流到回流电极。因此，在各个方面，电外科系统可包括供流路径和回流路径，其中正被处理的所捕获组织完成或闭合电路。在其他方面，发生器101可提供亚治疗RF能级以用于在电外科系统中评估组织状态以及提供反馈的目的。可使用此类反馈来控制电外科器械100的治疗性RF能量输出。如果风险分析显示神经肌肉刺激的可能性已减轻至可接受的水平，则双极外科手术可使用亚治疗RF能级。在某些情况下，可不使用高于5MHz的频率以使与高频渗漏电流相关联的问题最小化。然而，就双极技术而言可使用较高频率。通常认为，10mA是组织热效应的下限阈值。
在电外科器械100的操作过程中，使用者通常抓持组织，向抓持的组织提供能量以形成焊接或密封(例如，通过致动按钮和/或踏板)，然后驱动电外科器械的远侧端部处的组织切割元件穿过抓持的组织。根据各个方面，可提供钳口闭合构件，并且钳口闭合构件的轴向运动的平移可为有节奏的或以其他方式受控制的，以有助于以合适的行进速率来驱动钳口闭合构件。通过控制行进速率，所捕获组织在经切割元件横切之前已被适当地和功能性地密封的可能性可能增加。
图2为外科器械系统100的端部执行器108的一个示例的透视图。端部执行器108可包括第一钳口构件109a和第二钳口构件109b。如图2所示，第一钳口构件109a可被构造成能够相对于第二钳口构件109b运动，并且第二钳口构件109b能够相对于轴104有效地保持固定的几何结构。可以理解，在另选示例中，第二钳口构件109b可以被构造成能够相对于第一钳口构件109a运动，并且第一钳口构件109a可以相对于轴104有效地保持固定的几何结构。
图2还示出了第一钳口构件109a的工作部分111a的至少一部分和第二钳口构件109b的工作部分111b的至少一部分。第一钳口构件109a的工作部分111a可包括至少第一电极220a。第二钳口构件109b的工作部分111b可以包括至少一个分层结构，其可以包括但不限于绝缘层210和第二电极220b。
电极220a、b可包括导电材料。在各个方面，钳口构件109a、b的电极220a、b分别可以由金属制成。钳口构件109a、b的表面可包括导热部件诸如铜、银、铝、钨、镍或本领域的技术人员可能想到的任何其他导热材料。涂覆有生物相容性金属涂层的层压复合物可施加到表面上。钳口构件109a、b可包括导热铜和机械强度更强的材料，尤其是更高模量的不锈钢的层压复合物。可通过电沉积的生物相容性金属涂层(诸如铬)保持钳口构件109a、b的生物相容性，金属涂层涂覆有不锈钢和铜层压体两者。在一些非限制性示例中，对于具有小钳口构件109a、b的端部执行器108(例如，在其尖端具有的宽度为约0.039"(1mm))，可提供具有厚度为约0.011"的304不锈钢层和厚度为约0.052"的对应铜层的层压复合物。对于较大的钳口构件109a、b，可提供具有厚度为约0.015"的304不锈钢层和厚度为约0.075"至约0.085"的对应铜层的层压复合物。例如，可提供生物相容性涂层作为电沉积铬涂层，例如，由俄亥俄州克利夫兰市电解公司(Electrolyzing Corporation of Ohio,Cleveland,Ohio44112)销售的MED-COAT 2000。此生物相容性涂层被描述为符合或超过USP类VI级认证。
在一个示例中，第二电极220b可具有围绕刀通道230的U形形状，其中刀可被设置用于往复地运动。第二电极220b可以具有平坦表面222，当使钳口构件109a、b进入近侧位置时，平坦表面222可以抵靠组织设置。
绝缘层210可包括电绝缘材料。非限制地，电绝缘材料可以由氧化铝、陶瓷、尼龙、聚邻苯二甲酰胺(PPA)、特氟隆材料、聚酰亚胺、聚对二甲苯、任何其他合适的电绝缘材料和/或任何组合或它们的组合构成。
如图2中所示，第二电极220b可以沉积在绝缘层210上或以其他方式放置于与绝缘层210直接物理连通。绝缘垫215a-f可以形成在第二电极220b的顶表面上。另选地，绝缘垫215a-f中的每个可以具有与第二电极220b的表面222共面的顶表面。例如，绝缘垫215a-f可以包括绝缘层210的一部分，并且第二电极220b可以制成覆盖绝缘层210的顶表面并且至少部分地围绕绝缘垫215a-f中的每个的至少一侧。在一些示例中，可以制成第二电极220b，以使得包括第二电极220b的材料完全围绕绝缘垫215a-f的侧面，以使得仅暴露绝缘垫215中的每个的顶表面。
可以存在单个绝缘垫215或者可以存在多个绝缘垫215a-f。绝缘垫215a-f可以沿第二电极220b的单侧(例如，沿U形第二电极220b的内侧的绝缘垫215a-f)或沿第二电极220b的多个侧面(例如，沿U形第二电极220b的内侧并沿外侧)放置。多个绝缘垫215a-f可以具有相同的维度(例如长度和/或宽度)或者可以具有不同的维度。在一个非限制性示例中，第二电极220b的靠近端部执行器108中的接头的一对绝缘垫215a、d可以比位于第二电极220b的中间节段中的一对绝缘垫215b、e更长和/或更宽。类似地，第二电极220b的中间节段中的一对绝缘垫215b、e可以比位于第二电极220b的远侧节段中的一对绝缘垫215c、f更长和/或更宽。可以理解，关于多个绝缘垫215a-f之间的相对维度没有暗示限制。多个绝缘垫215a-f可以沿第二电极220b的侧面相等间隔开，或者可以沿第二电极220b的侧面可变地间隔开。绝缘垫215a-f可以具有适合于绝缘垫215a-f的功能的任何形状，包括但不限于圆形或部分圆形、椭圆形或部分椭圆形、卵形或部分卵形、方形或矩形。绝缘垫215a-f可以全部具有相同的形状或者可以具有不同的形状。
图3示出了图2中所示的端部执行器108的示例的第二钳口构件109b的透视图。第二钳口构件109b可以包括电极组件层307，其可以与钳口框架319以机械方式连通。电极组件层307可附连到钳口框架319(不可从其移除)。另选地，电极组件层307可与钳口框架319可移除地相关联。可移除电极组件层307可用于允许可移除电极组件层307被移除，以用于替换目的(如果损坏)或用于清洁目的(如果发生结垢)。健康专业人员也可以根据特定外科手术的要求在可移除电极组件层307的各种构型中进行选择。
图4A-C示出了第二钳口构件109b的多个视图及其部件的各方面。图4A示出了钳口框架319的一个方面，其可以形成第二钳口构件109b的部件。钳口框架319可以与电极组件层307以机械方式连通，如图4B所示。在一个方面，当钳口构件109a、b放置于靠近构型中时，例如当压缩和烧灼一块组织时，钳口框架319可以被构造成能够使第二钳口构件109b的电极组件层307稳定抵靠第一钳口构件109a。电极组件层307可包括第二电极220b，其有与绝缘层210以机械方式连通的第二电极表面222。图4C是图3中所示的第二钳口构件109b的分解图。图4C示出了第二钳口构件109b的一个方面，其包括具有第二电极表面222的第二电极220b、绝缘层210和钳口框架319。在一个示例中，绝缘层210可以包括一个或多个绝缘垫215a-f。第二电极220b可以具有切口226a-f，每个切口226被构造成能够接纳绝缘垫215，以使得绝缘垫215a-f中的每个的表面与第二电极220b的表面222共面。
图5是第一钳口构件509的第一示例的透视图，第一钳口构件509可以结合到电外科器械100(参见图1)的端部执行器108(参见图2)中。第一钳口构件509的工作部分可包括第一钳口组件519，其包括第一电极520，第一电极520具有被构造成当使第一钳口构件509相对于第二钳口构件(例如，参见图2的109b)进入近侧位置时能够接触组织的一部分的表面522。如图5所示，示例性第一钳口构件509的表面522可包括主要平坦表面。第一钳口构件509也可包括刀通道530，组织切割刀可通过其往复地运动。另外，第一电极520可以结合包括一个或多个凸起的凸台515a-f的特征部。
可以存在单个凸起的凸台515或者可以存在多个凸起的凸台515a-f。凸起的凸台515a-f可沿第一电极520的单侧(例如，沿U形第一电极520的内侧的凸起的凸台515a-f)或沿第一电极520的多个侧面(例如，沿U形第一电极520的内侧并沿外侧)放置。多个凸起的凸台515a-f可以具有相同的维度(例如长度和/或宽度)或者可以具有不同的维度。在一个非限制性示例中，第一电极520的靠近端部执行器中的近侧接头的一对凸起的凸台515a、d可以比位于第一电极520的中间节段中的一对凸起的凸台515b、e更长和/或更宽。类似地，第一电极520的中间节段中的一对凸起的凸台515b、e可以比位于第一电极520的远侧节段中的一对凸起的凸台515c、f更长和/或更宽。可以理解，关于多个凸起的凸台515a-f之间的相对维度没有暗示限制。多个凸起的凸台515a-f可以沿第一电极520的侧面相等间隔开，或者可以沿第一电极520的侧面可变地间隔开。凸起的凸台515a-f可以具有适合于凸起的凸台515a-f的功能的任何形状，包括但不限于圆形或部分圆形、椭圆形或部分椭圆形、卵形或部分卵形、方形或矩形。凸起的凸台515a-f可以全部具有相同的形状或者可以具有不同的形状。凸起的凸台515a-f可以是导电的或非导电的。导电的凸起的凸台515a-f可以与第一电极520电连通，并且可以具有与第一电极520相同的电极性。另选地，非导电的凸起的凸台515a-f可以不与第一电极520电连通，并且可以相对于第一电极520或第二电极(例如图4A-C中的220b)缺少电极性。
当第一钳口109a靠近第二钳口109b移动时，凸起的凸台515a-f中的每个可以被构造成能够接合多个绝缘垫215a-f中的一个(参见图2)。可以理解，在此上下文中，术语“接合”可以包括在凸起的凸台515的表面与配合绝缘垫215的表面之间形成直接物理接触。然而，在此上下文中，术语“接合”也可以包括凸起的凸台515和被带入接近位置但非接触的位置的配合的绝缘垫215，例如，当第一钳口109a靠近第二钳口109b移动时，一块组织在凸起的凸台515与配合的绝缘垫215的表面之间被压缩。
图6A-C分别是图5中所示的第一钳口构件509的示例的顶部、侧面和底部平面视图。图7是沿线7-7截取的图6C中所示的第一钳口构件509的示例的纵向剖视图。图7中所示的纵向剖视图特别示出了刀通道530以及第一钳口构件509的凸起的凸台515d、e、f的剖视图。图8是沿线8-8截取的图6C中所示的第一钳口构件509的示例的横向剖视图。图8的横向剖视图具体示出了刀通道530、凸起的凸台515c、f和第一钳口构件509的第一电极的基本平坦的表面522的横向剖视图。
图9是第一钳口构件909的第一示例的透视图，第一钳口构件909可以结合到电外科器械100(参见图1)的端部执行器108(参见图2)中。第一钳口构件909的工作部分可包括第一钳口组件919，第一钳口组件919包括具有表面922的第一电极920。如图9中所示，示例性第一电极920的表面922的至少一部分可包括平坦表面。第一钳口构件909也可包括刀通道530，组织切割刀可通过其往复地运动。
另外，第一电极920可以结合特征部，例如一个或多个凸起的脊923。在图9所示的方面，第一电极920包括在表面922上方垂直突出并且可围绕刀通道530的单个U形凸起的脊923。另选地，第一电极920可包括一个或多个凸起的脊923。凸起的脊923可沿第一电极920的单侧或沿第一电极920的多个侧面放置。多个凸起的脊923可具有相同的维度(例如，电极表面922上方的垂直范围)或可具有不同的维度。一个或多个凸起的脊923可彼此平行并且可平行于刀通道530并且位于刀通道530的相对侧上。可以认识到，图9中的一个或多个凸起的脊923的描绘不被认为限制一个或多个凸起的脊923的数量、形状、长度、高度或宽度，或者它们关于第一电极920的设置。因此，可存在一个、两个、三个或任意数目的此类凸起的脊923。一个或多个凸起的脊923可具有相同的长度、宽度或高度，或者在它们的任何组合中具有独立不同的长度、宽度或高度。此外，一个或多个凸起的脊923可以设置在刀通道530的相对侧上，或者设置在刀通道530的任何一侧上。多个一个或多个凸起的脊923可围绕刀通道530对称地或非对称地设置。多个一个或多个凸起的脊923可以彼此平行的取向设置，或者可以不彼此平行的取向设置。虽然图9中所示的一个或多个凸起的脊923被示出为线性脊，但此类形状不是限制性的。因此，一个或多个凸起的脊923的另选方面可包括线性脊、弯曲脊、线性和弯曲脊的组合，或者包括多个线性和/或弯曲段的脊。此外，多个一个或多个凸起的脊923可具有相同的形状或不同的形状。
附加特征部可包括一个或多个凸起的凸台915a-f，其中凸起的凸台915a-f中的每个从一个或多个凸起的脊923的表面垂直延伸。可以理解，第一电极920、电极表面922、一个或多个凸起的脊923和凸起的凸台915a-f可以全部相互电连通。因此，施加到第一电极920的电压可以同等地施加到第一电极表面922、一个或多个凸起的脊923以及凸起的凸台915a-f中的每个。另选地，第一电极表面922、一个或多个凸起的脊923和凸起的凸台915a-f中的一个或多个可以与第一钳口组件919的任何其他部件电绝缘。也可以理解，第一钳口组件919的部件可被构造成当使第一钳口构件909相对于第二钳口构件(例如，参见图2的109b)进入近侧位置时能够接触组织的一部分。可被构造成能够接触组织的一部分的第一钳口组件919的部件可包括第一电极表面922、一个或多个凸起的脊923和凸起的凸台915a-f中的任一个或多个。
可以存在单个凸起的凸台915或者可以存在多个凸起的凸台915a-f。凸起的凸台915a-f可沿第一电极920的单侧(例如，沿U形第一电极920的内侧的凸起的凸台915a-f)或沿第一电极920的多个侧面(例如，沿U形第一电极920的内侧并沿外侧)放置。多个凸起的凸台915a-f可以具有相同的维度(例如长度和/或宽度)或者可以具有不同的维度。在一个非限制性示例中，第二电极920的靠近端部执行器中的近侧关节的一对凸起的凸台915a、d可以比位于第一电极920的中间节段中的一对凸起的凸台915b、e更长和/或更宽。类似地，第一电极920的中间节段中的一对凸起的凸台915b、e可以比位于第一电极920的远侧节段中的一对凸起的凸台915c、f更长和/或更宽。可以理解，关于多个凸起的凸台915a-f之间的相对维度没有暗示限制。多个凸起的凸台915a-f可以沿第一电极920的侧面相等间隔开，或者可以沿第一电极920的侧面可变地间隔开。凸起的凸台915a-f可以具有适合于凸起的凸台915a-f的功能的任何形状，包括但不限于圆形或部分圆形、椭圆形或部分椭圆形、卵形或部分卵形、方形或矩形。凸起的凸台515a-f可以全部具有相同的形状或者可以具有不同的形状。
当第一钳口构件909靠近第二钳口109b移动时，凸起的凸台915a-f中的每个可以被构造成能够接合多个绝缘垫215a-f中的一个(参见图2)。可以理解，在此上下文中，术语“接合”可以包括在凸起的凸台915的表面与配合绝缘垫215的表面之间形成直接物理接触。然而，在此上下文中，术语“接合”也可以包括凸起的凸台915和被带入接近位置但非接触的位置的配合的绝缘垫215，例如，当第一钳口构件909靠近第二钳口109b移动时，一块组织在凸起的凸台915与配合的绝缘垫215的表面之间被压缩。
图10A-C分别是图9中所示的第一钳口构件909的示例的顶部、侧面和底部平面视图。图11是沿线11-11截取的图10C中所示的第一钳口构件909的示例的纵向剖视图。图11中所示的纵向剖视图特别示出了刀通道530以及第一钳口构件909的凸起的凸台915d、e、f的剖视图。图12是沿线12-12截取的图10C中所示的第一钳口构件509的示例的横向剖视图。图12的横向剖视图具体示出了刀通道530、凸起的凸台915c、f、第一钳口构件909的第一电极的基本平坦的表面522以及一个或多个凸起的脊923的表面的横向剖视图。
图13示出了图9中所示的第一钳口构件的另选实施方案的透视图。类似于如图9所示的第一钳口构件909的工作部分，示例性第一电极920的表面922的至少一部分可包括平坦表面。第一钳口构件909也可包括刀通道530，组织切割刀可通过其往复地运动。另外，第一电极920可以结合特征部，例如一个或多个凸起的脊923，类似于图9中所示的那些。例如，第一电极920可包括在表面922上方垂直突出并且可围绕刀通道530的单个U形凸起的脊923。另选地，第一电极920可包括多个凸起的脊923。凸起的脊923可沿第一电极920的单侧或沿第一电极920的多个侧面放置。多个凸起的脊923可具有相同的维度(例如，电极表面922上方的垂直范围)或可具有不同的维度。然而，如图13所示的第一电极920不含从一个或多个凸起的脊923的表面垂直延伸的一个或多个凸起的凸台915a-f，如图9所示。可以理解，第一电极920、电极表面922和一个或多个凸起的脊923可以全部相互电连通。
图14是第一钳口构件1409的第一示例的透视图，第一钳口构件1409可以结合到电外科器械100(参见图1)的端部执行器108(参见图2)中。第一钳口构件1409的工作部分可包括第一钳口组件1419，其包括第一电极1420，第一电极1420具有被构造成当使第一钳口构件1409相对于第二钳口构件(例如，参见图2的109b)进入近侧位置时能够接触组织的一部分的表面1422。如图14所示，示例性第一钳口构件1409的表面1422可包括主要平坦表面。第一钳口构件1409也可包括刀通道530，组织切割刀可通过其往复地运动。
另外，第一电极1420可以包含特征部，例如可以在第一电极1420的表面1422中制成的一个或多个纵向通道1423a、b。在图14所示的方面，第一电极1420包括在表面1422内垂直制成的多个纵向通道1423a、b。图14中所示的纵向通道1423a、b被示出为沿第一电极1420的纵向范围延伸的线性纵向通道1423a、b。线性纵向通道1423a、b可彼此平行并且可平行于刀通道530并且位于刀通道530的相对侧上。可以认识到，图14中的纵向通道1423a、b的描绘不被认为限制纵向通道1423的数量、形状、长度、深度或宽度，或者它们关于第一电极1420的设置。因此，可存在一个、两个、三个或任意数目的此类纵向通道1423。纵向通道1423可具有相同的长度、宽度或深度，或者在它们的任何组合中具有独立不同的长度、宽度或深度。此外，纵向通道1423可以设置在刀通道530的相对侧上，或者设置在刀通道530的任何一侧上。多个纵向通道1423可围绕刀通道530对称地或非对称地设置。多个纵向通道1423可以彼此平行的取向设置，或者可以不彼此平行的取向设置。虽然图14中所示的纵向通道1423被示出为线性通道，但此类形状不是限制性的。因此，纵向通道1423的另选方面可包括线性通道、弯曲通道、线性和弯曲通道的组合，或者包括多个线性和/或弯曲段的通道。此外，多个纵向通道1423可具有相同的形状或不同的形状。
另外，第一电极1420可以结合包括一个或多个凸起的凸台515a-f的特征部。可以存在单个凸起的凸台515或者可以存在多个凸起的凸台515a-f。凸起的凸台515a-f可沿第一电极1420的单侧(例如，沿U形第一电极1420的内侧的凸起的凸台515a-f)或沿第一电极1420的多个侧面(例如，沿U形第一电极1420的内侧并沿外侧)放置。多个凸起的凸台515a-f可以具有相同的维度(例如长度和/或宽度)或者可以具有不同的维度。在一个非限制性示例中，第一电极1420的靠近端部执行器中的近侧接头的一对凸起的凸台515a、d可以比位于第一电极1420的中间节段中的一对凸起的凸台515b、e更长和/或更宽。类似地，第一电极1420的中间节段中的一对凸起的凸台515b、e可以比位于第一电极1420的远侧节段中的一对凸起的凸台515c、f更长和/或更宽。可以理解，关于多个凸起的凸台515a-f之间的相对维度没有暗示限制。多个凸起的凸台515a-f可以沿第一电极1420的侧面相等间隔开，或者可以沿第一电极1420的侧面可变地间隔开。凸起的凸台515a-f可以具有适合于凸起的凸台515a-f的功能的任何形状，包括但不限于圆形或部分圆形、椭圆形或部分椭圆形、卵形或部分卵形、方形或矩形。凸起的凸台515a-f可以全部具有相同的形状或者可以具有不同的形状。
当第一钳口109a靠近第二钳口109b移动时，凸起的凸台515a-f中的每个可以被构造成能够接合多个绝缘垫215a-f中的一个(参见图2)。可以理解，在此上下文中，术语“接合”可以包括在凸起的凸台515的表面与配合绝缘垫215的表面之间形成直接物理接触。然而，在此上下文中，术语“接合”也可以包括凸起的凸台515和被带入接近位置但非接触的位置的配合的绝缘垫215，例如，当第一钳口109a靠近第二钳口109b移动时，一块组织在凸起的凸台515与配合的绝缘垫215的表面之间被压缩。
图15A-C分别是图14中所示的第一钳口构件1409的示例的顶部、侧面和底部平面视图。图16是沿线16-16截取的图15C中所示的第一钳口构件1409的示例的纵向剖视图。图16中所示的纵向剖视图特别示出了刀通道530以及第一钳口构件1409的凸起的凸台515d、e、f的剖视图。图17是沿线17-17截取的图15C中所示的第一钳口构件1409的示例的横向剖视图。图17的横向剖视图具体示出了刀通道530、凸起的凸台515b、e、第一钳口构件1409的第一电极1420的基本平坦的表面1422以及一个或多个纵向通道1423a、b的表面的横向剖视图。
图18是第一钳口构件1809的第一示例的透视图，第一钳口构件1809可以结合到电外科器械100(参见图1)的端部执行器108(参见图2)中。第一钳口构件1809的工作部分可包括第一钳口组件1819，其包括第一电极1820，第一电极1820具有被构造成当使第一钳口构件1809相对于第二钳口构件(例如，参见图2的109b)进入近侧位置时能够接触组织的一部分的表面1822。如图18所示，示例性第一钳口构件1809的表面1822可包括主要平坦表面。第一钳口构件1809也可包括刀通道530，组织切割刀可通过其往复地运动。
另外，第一电极1820可以包含特征部，例如可以在第一电极1820的表面1822中制成的一个或多个横向通道1823。为了清楚起见，并非所有横向通道1823均在图18中标记。然而，可以理解，图18中所示的所有此类横向通道(标记或未标记)均包括在本公开中。在图18所示的方面，第一电极1820包括在表面1822内垂直制成的多个横向通道1823。图18中所示的横向通道1823被示出为沿第一电极1820的横向范围延伸的线性横向通道1823。线性横向通道1823可彼此平行并且可正交于刀通道530。可以认识到，图18中的横向通道1823的描绘不被认为限制横向通道1823的数量、形状、长度、深度或宽度，或者它们关于第一电极1820的设置。因此，可存在一个、两个、三个或任意数目的此类横向通道1823。横向通道1823可具有相同的长度、宽度或深度，或者在它们的任何组合中具有独立不同的长度、宽度或深度。此外，横向通道1823可以设置在刀通道530的相对侧上，或者设置在刀通道530的任何一侧上。多个横向通道1823可围绕刀通道530对称地或非对称地设置。多个横向通道1823可以彼此平行的取向设置，或者可以不彼此平行的取向设置。虽然图18中所示的横向通道1823被示出为线性通道，但此类形状不是限制性的。因此，横向通道1823的另选方面可包括线性通道、弯曲通道、线性和弯曲通道的组合，或者包括多个线性和/或弯曲段的通道。此外，多个横向通道1823可具有相同的形状或不同的形状。
另外，第一电极1820可以结合包括一个或多个凸起的凸台515a-f的特征部。可以存在单个凸起的凸台515或者可以存在多个凸起的凸台515a-f。凸起的凸台515a-f可沿第一电极1820的单侧(例如，沿U形第一电极1820的内侧的凸起的凸台515a-f)或沿第一电极1820的多个侧面(例如，沿U形第一电极1820的内侧并沿外侧)放置。多个凸起的凸台515a-f可以具有相同的维度(例如长度和/或宽度)或者可以具有不同的维度。在一个非限制性示例中，第一电极1820的靠近端部执行器中的近侧接头的一对凸起的凸台515a、d可以比位于第一电极1420的中间节段中的一对凸起的凸台515b、e更长和/或更宽。类似地，第一电极1820的中间节段中的一对凸起的凸台515b、e可以比位于第一电极1820的远侧节段中的一对凸起的凸台515c、f更长和/或更宽。可以理解，关于多个凸起的凸台515a-f之间的相对维度没有暗示限制。多个凸起的凸台515a-f可以沿第一电极1820的侧面相等间隔开，或者可以沿第一电极1820的侧面可变地间隔开。凸起的凸台515a-f可以具有适合于凸起的凸台515a-f的功能的任何形状，包括但不限于圆形或部分圆形、椭圆形或部分椭圆形、卵形或部分卵形、方形或矩形。凸起的凸台515a-f可以全部具有相同的形状或者可以具有不同的形状。
当第一钳口109a靠近第二钳口109b移动时，凸起的凸台515a-f中的每个可以被构造成能够接合多个绝缘垫215a-f中的一个(参见图2)。可以理解，在此上下文中，术语“接合”可以包括在凸起的凸台515的表面与配合绝缘垫215的表面之间形成直接物理接触。然而，在此上下文中，术语“接合”也可以包括凸起的凸台515和被带入接近位置但非接触的位置的配合的绝缘垫215，例如，当第一钳口109a靠近第二钳口109b移动时，一块组织在凸起的凸台515与配合的绝缘垫215的表面之间被压缩。
图19A-C分别是图18中所示的第一钳口构件1809的示例的顶部、侧面和底部平面视图。图20是沿线20-20截取的图19C中所示的第一钳口构件1809的示例的纵向剖视图。图20中所示的纵向剖视图特别示出了刀通道530以及第一钳口构件1809的凸起的凸台515d、e、f的剖视图。此外，图20也以剖视图示出了多个横向通道1823连同第一电极1820的表面1822的视图。图21A-C分别示出了沿线21A-21A、21B-21B和21C-21C截取的图19C中所示的第一钳口构件1809的示例的各种横向剖视图。图21A的横向剖视图具体示出了刀通道530和第一钳口构件1809的第一电极1820的基本平坦的表面1822。图21B的横向剖视图具体示出了刀通道530、第一钳口构件1809的第一电极1820的基本平坦的表面1822和凸起的凸台515b、e。图21C的横向剖视图具体示出了刀通道530和横向通道1823的凹面相对于第一钳口构件1809的第一电极1820的基本平坦的表面1822。
图5-21C及其如上所述的描述呈现了包括多个特征部的第一钳口构件109a的多个方面，这些特征部被构造成在第一钳口构件109a和/或其相应的第一电极220a的表面中能够形成多个纹理。虽然本文已公开了此类特征部的多个方面，但此类方面不应理解为限制性的。因此，特征部可包括任何合适的特征部，这些特征部可被构造成在钳口构件或电极的表面上能够形成纹理。这些特征部通常可包括垂直于电极表面上方延伸的凸起或升高特征部，或者垂直于电极表面下方延伸的凹陷特征部。本文不对制成特征部的方法施加任何明示或暗示的限制。
特征部可包括单个特征部或多个特征部。单个特征部或多个特征部可具有有限的范围，诸如凸台(凸起特征部)或凹坑(凹陷特征部)。单个特征部或多个特征部可具有更延伸的范围，诸如脊(凸起特征部)或通道(凹陷特征部)。单个特征部或多个特征部—具有有限范围或延伸范围—不限于其各自的形状、尺寸或维度。单个特征部或多个特征部—具有有限范围或延伸范围—不限于它们各自关于电极表面的设置。因此，例如，脊或通道(具有延伸范围的特征部)可以沿基本上平行于第一电极的纵向轴线的轴线延伸，从而分别包括纵向脊或纵向通道。另选地，脊或通道(具有延伸范围的特征部)可以沿基本上垂直于第一电极的纵向轴线的轴线延伸，从而分别包括横向脊或横向通道。在又一另选示例中，脊或通道(具有延伸范围的特征部)可沿轴线延伸，既不基本上平行于第一电极的纵向轴线也不基本上垂直于第一电极的纵向轴线，从而分别包括倾斜脊或倾斜通道。
多个特征部可包括升高和/或凹陷特征部的任何组合或组合。可以组合多个特征部。例如，参考图9，脊诸如纵向脊923可包括附加特征部，诸如垂直于纵向脊923的表面延伸的凸起的凸台915a-f。可以认识到，基本上垂直于电极的纵向轴线(一个或多个横向脊)的一个或多个脊也可以包括附加特征部，诸如垂直于横向脊的表面延伸的凸起的凸台。也可以认识到，既不基本垂直于电极的纵向轴线也不平行于电极的纵向轴线(一个或多个倾斜脊)的一个或多个脊也可以包括附加特征部，诸如垂直于倾斜脊的表面延伸的凸起的凸台。类似地，具有第一深度的通道(例如纵向通道、横向通道或倾斜通道)也可以在内表面上包括具有第二深度的第二通道。此外，多个特征部可关于电极的表面对称地设置，或者它们可关于电极的表面不对称地设置。多个特征部—具有有限范围或扩展范围—不限于它们关于电极相对于彼此的表面的设置。
如上所述，并且如图1至图21C所示，端部执行器可包括第一钳口构件和第二钳口构件。在上面公开的方面，第一钳口构件可以是上钳口构件，其被构造成当力施加到端部执行器时能够相对于包括下钳口构件的第二钳口构件移动，其中第二钳口构件相对于细长轴处于相对固定的几何结构。上面公开的方面包括被构造成能够向与上钳口构件和可动的第一钳口构件相关联的表面(诸如电极表面)提供纹理的特征部。另外，上面公开的方面包括基本上平坦的电极，其包括与下钳口构件和相对固定的第二钳口构件相关联的电极组件层。可以理解，另选方面包括钳口组件，其中上钳口构件相对于细长轴相对固定，并且下钳口构件可被构造成当力施加到端部执行器时能够相对于固定的上钳口构件运动。还可以理解，上面公开的多个特征部可以与固定钳口构件相关联，而不是与可动的钳口构件相关联。类似地，可以理解，电极组件层可以与可动的钳口构件相关联，而不是与固定钳口构件相关联。
如上所述，并且如图1至图21C所示，端部执行器可包括第一钳口构件和第二钳口构件，其中第一钳口构件可包括具有第一电极表面的第一电极，并且第二钳口构件可包括具有第二电极表面的第二电极。第一电极可以放置于与RF电流发生器的第一端子电连通，并且第二电极可以放置于与RF电流发生器的第二端子电连通。可以理解，第一电极、第一电极表面和任一个或多个特征部—包括但不限于一个或多个凸起的脊、一个或多个通道和一个或多个凸起的凸台—可以全部与RF电流发生器的第一端子进行相互电通信和电通信。因此，施加到第一电极的电压可以均等地施加到第一电极表面中的每个以及一个或多个特征部中的每个，包括一个或多个凸起的脊、一个或多个通道和一个或多个凸起的凸台。
图22和图23示出了在示例性血管上使用具有纹理钳口的外科器械的效果的方面。图22示出了夹持在外科器械的第一钳口组件109a与第二钳口组件109b之间的血管2260的剖视图。血管2260可包括由内膜2264、平滑肌层或中膜以及外层或动脉外膜2266界定的内腔2262。第一钳口组件109a相对于第二钳口组件109b移动到近侧位置，并且血管2260在两者间被压缩。在图22中，第一钳口组件109a包括类似于图14中所示的第一电极1420和包括类似于图3中所示的电极109b的第二钳口组件109b。因此，图22示出了第一电极的表面1422a、b、c、d以及纵向通道1423a、b的凹面。图22也示出了第二电极220b的表面。另外，图22示出了与第一电极109a相关联的刀通道530和与第二电极109b相关联的刀通道230的相对位置。为清楚起见，图22省略了第一电极1420的凸起的凸台515或第二钳口组件109b的绝缘垫215。
如图22所示，夹持在第一钳口组件109a与第二钳口组件109b之间的血管2260的一部分可能变形，以使得内腔2262的一部分可处于压缩状态但仍然是明显的，例如血管2260的设置在第一钳口组件109a的通道1423a、b与第二电极220b的表面之间的部分。另选地，内腔2262可以完全密封2268，例如在第一电极的表面1422b、c与第二电极220b的表面之间的血管2260的部分中。
如果血管2260被认为是可变形的胡克定律固体，则由第一钳口组件109a和第二钳口组件109b赋予其的压缩力与血管2260的物理变形量成比例。继而，血管2260的变形量可以与第一电极220a或其任何特征部与第二电极220b之间的距离有关。例如，如图22所示，通道1423a的底表面与第二电极220b的表面之间的距离2280大于第一电极1422b的表面与第二电极220b的表面之间的距离2282。因此，由通道1423a的表面压缩的血管2260的变形量小于由第一电极1422b的表面压缩的血管2260的变形量，因此在通道1423a处产生的压缩力小于在第一电极1422b处产生的压缩力。可以理解，图22中示出的血管2260的变形具体可以由电极1420的特定形状及其特征部(例如纵向通道1423a、b)产生。
然而，应当认识到，夹持在具有另选特征部的第一钳口组件109a与第二钳口组件109b之间的血管2260可以包括由第一电极的那些另选特征部的几何结构引起的另选变形。例如，如图9所示的第一钳口组件909包括脊923和凸起的凸台915a-f。可以理解，在第一钳口组件909与第二钳口组件109b之间压缩的血管的一部分可以在第一电极920的表面922与第二电极220b之间比在脊923和/或凸起的凸台915a-f与第二电极220b之间经受更大的压缩力。因为凸起特征部(脊923和/或凸起的凸台915a-f)与第二电极220b的表面之间的距离小于第一电极920的表面922与第二电极220B的表面之间的距离，因此可能出现这种更大的压缩力。
图23示出了外科器械在血管2260上的应用结果。可以观察到内腔2262通常是明显的并且内膜2264、平滑肌层或中膜2263和外层或动脉外膜2266都具有正常血管2260的大致圆形横截面几何结构。不受理论的约束，可以在封闭血管壁2260的动脉外膜密封件2267中观察到外科器械的应用结果。内膜2264也可以包括由密封过程产生的结构2265，其可以用于机械地加强外膜密封件2267抵抗在心脏收缩泵送运动期间产生的血液横向力(箭头A)。
图24示出了端部执行器的一个方面的剖视图，其中第一钳口构件109a和第二钳口构件109b都可以包括互补特征部，这些互补特征部被构造成在压缩和烧灼期间能够模制血管的形状。第一钳口构件109a可包括刀通道530，组织切割刀可通过其往复地运动。类似地，第二钳口构件109b可包括刀通道230，组织切割刀可通过其往复地运动。
在图24所示的方面，第一电极的至少一部分可包括一个或多个第一锥形部分2422a、b。第一锥形部分2422a、b可以设置在第一钳口构件109a的一个或多个内部节段中，例如靠近刀通道530。在图24所示的方面，第二电极的至少一部分可包括一个或多个第二锥形部分2420a、b。第二锥形部分2420a、b可以设置在第二钳口构件109b的一个或多个内部节段中，例如靠近刀通道230。当第一钳口构件109a和第二钳口构件109b放置于近侧位置时，例如当在两者间压缩血管时，可以形成包括第一锥形空间2424a和第二锥形空间2424b的压缩区。第一锥形空间2424a可以由第一锥形部分2422a和第二锥形部分2420a界定，并且第二锥形空间2424b可以由第一锥形部分2422b和第二锥形部分2420b界定。第一锥形空间2424a可朝向钳口构件109a、b的外部具有比朝向钳口构件109a、b的内部的间隔更宽的间隔。类似地，第二锥形空间2424b可朝向钳口构件109a、b的外部具有比朝向钳口构件109a、b的内部的间隔更宽的间隔。第一锥形部分2422a、b可以与向第一钳口构件109a提供电能的导体电连通，并且第二锥形部分2420a、b可以与向第二钳口构件109b提供电能的导体电连通。
图24中所示的锥形部分2422a、b可以沿第一钳口构件109a的整个长度延伸或仅沿第一钳口构件109a的长度的一部分延伸。此外，第一钳口构件109a可包括多个锥形部分，每个锥形部分沿第一钳口构件109a的部分长度延伸。尽管图24中所示的锥形部分2422a、b可以具有线性锥形，但锥形部分2422a、b可以包括另选的锥形，诸如弯曲的锥形。另外，图24中所示的锥形部分2420a、b可以沿第二钳口构件109b的整个长度延伸或仅沿第二钳口构件109b的长度的一部分延伸。此外，第二钳口构件109b可包括多个锥形部分，每个锥形部分沿第二钳口构件109b的部分长度延伸。尽管图24中所示的锥形部分2420a、b可以具有线性锥形，但锥形部分2420a、b可以包括另选的锥形，诸如弯曲的锥形。
在图24所示的方面，第一电极的至少一部分还可包括一个或多个第一凹面部分2423a、b。第一凹面部分2423a、b可以邻近第一钳口构件109a的外部节段设置，例如靠近第一钳口构件109a的外边缘。在一些方面，第一凹面部分2423a可以靠近第一锥形部分2422a；类似地，第一凹面部分2423b可以靠近第一锥形部分2422b。在图24所示的方面，第二电极的至少一部分可包括一个或多个第二凹面部分2421a、b。第二凹面部分2421a、b可以邻近第二钳口构件109b的外部节段设置，例如靠近第二钳口构件109b的外边缘。在一些方面，第二凹面部分2421a可以靠近第二锥形部分2420a；类似地，第二凹面部分2421b可以靠近第二锥形部分2420b。
当第一钳口构件109a和第二钳口构件109b放置于近侧位置时，例如当在两者间压缩血管时，可以形成第一模具区2425a和第二模具区2425b。第一模具区2425a可以由第一凹面部分2423a和第二凹面部分2421a界定，并且第二模具区2425b可以由第一凹面部分2423b和第二凹面部分2421b界定。第一凹面部分2423a、b可以与向第一钳口构件109a提供电能的导体电连通，并且第二凹面部分2421a、b可以与向第二钳口构件109b提供电能的导体电连通。另选地，第一凹面部分2423a、b可以不与向第一钳口构件109a提供电能的导体电连通。另外，第二凹面部分2421a、b可以不与向第一钳口构件109b提供电能的导体电连通。凹面部分2423a、b和/或凹面部分2421a、b与不向第一钳口构件109a和/或第二钳口构件109b提供电能的导体电连通，但仍可与它们各自的锥形部分热连通(分别为2422a、b和2420a、b)。因此，凹面部分2423a可以与锥形部分2422a热连通，凹面部分2423b可以与锥形部分2422b热连通，凹面部分2421a可以与锥形部分2420a热连通，并且凹面部分2421b可以与锥形部分2420b热连通。
图24中所示的凹面部分2423a、b可以沿第一钳口构件109a的整个长度延伸或仅沿第一钳口构件109a的长度的一部分延伸。此外，第一钳口构件109a可包括多个凹面部分，每个凹面部分沿第一钳口构件109a的部分长度延伸。尽管图24中所示的凹面部分2423a、b可以具有弯曲的几何结构，但凹面部分2423a、b可以包括几何结构，诸如线性几何结构。另外，图24中所示的凹面部分2421a、b可以沿第二钳口构件109b的整个长度延伸或仅沿第二钳口构件109b的长度的一部分延伸。此外，第二钳口构件109b可包括多个凹面部分，每个凹面部分沿第二钳口构件109b的部分长度延伸。尽管图24中所示的凹面部分2421a、b可以具有弯曲的几何结构，但凹面部分2421a、b可以包括另选的几何结构，诸如线性几何结构。
图25示出了在图24中所示的钳口构件之间压缩和烧灼血管2560的结果。在图25所示的方面，血管2560可包括内腔2562、中膜2563和动脉外膜2566。当血管2560在第一钳口构件与第二钳口构件之间被压缩时，在钳口构件之间的内部空间中形成压缩区R。压缩区R可包括第一锥形空间2424a和第二锥形空间2424b的组合，如图24所示。在将电能施加到钳口构件时，可以加热脉管2560的组织以形成凝结物。不受理论的约束，凝结物可受到由压缩区R内的钳口构件的锥形2520引导的塑性流力。因此，凝结物连同中膜2563可以从压缩区R流入模具区2525a、b。可以注意到，图25中的模具区2525a、b对应于图24中的模具区2425a、b。因为作为凝结物的过量组织可能积聚在模具区2525a、b中，所以模具区2525a、b中的动脉外膜厚度T可以大于血管2560的动脉外膜的正常厚度S。密封血管2560可以通过在刀通道530和230内操作的往复刀切割。所得的密封件可包括由凝结物形成的血管2560的增厚部分，其在模具区2525a、b中模制。这样，血管密封件可被制造成具有更大再现性、一致性和可预测性。
如图22、图23和图25所示，可以使用如本文所述的具有钳口构件的外科器械进行烧灼规程的血管可以具有包括多层的复杂结构。如上文所公开的，此类血管可包括动脉和静脉，其包括内膜、中膜和动脉外膜(连同静脉瓣)。然而，应当认识到，可使用上文所公开的钳口构件来压缩和密封任何尺寸和结构的血管。此类血管可包括但不限于小动脉、毛细管和小静脉。此外，非血管组织(包括皮组织、肌肉组织、胃肠组织和泌尿组织)也可使用具有本文公开的此类钳口构件的外科器械适当地烧灼和切割。
虽然已经通过描述若干方面示出了本文的各种方面，并且虽然已经相当详细地描述了示例性实施例，但申请人的意图不在于将所附权利要求的范围约束或以任何方式限制到这些细节中。本领域的技术人员可容易看出另外的优点和修改形式。例如，公认的是，内窥镜式手术比腹腔镜式手术更常见。因此，本发明对内窥镜式手术和设备进行了讨论。然而，本文使用的诸如“内窥镜式”的术语不应当被理解为将本发明限于仅结合内窥镜式管(例如，套管针)使用的器械。与此相反，本发明据认为可用于进入受限于小切口的任何手术中，包括(但不限于)腹腔镜式手术以及开腹手术。
此外，尽管已举例说明和描述了多个形式，但申请人的意图并非将所附权利要求的范围约束或限制在此类细节中。在不脱离本公开的范围的情况下，可实现对这些形式的许多修改、变化、改变、替换、组合和等同物，并且本领域技术人员将想到这些形式的许多修改、变化、改变、替换、组合和等同物。此外，另选地，可将与所描述的形式相关联的每个元件的结构描述为用于提供由该元件执行的功能的器具。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。因此，应当理解，上述具体实施方式和随附权利要求旨在涵盖属于本发明所公开的形式范围内的所有此类修改形式、组合和变型形式。所附权利要求旨在涵盖所有此类修改、变化、改变、替换、修改和等同物。
为了公开的简洁和清楚，已经以框图形式而不是详细地示出了前述公开的所选方面。本文所提供的详细描述的一些部分可根据对存储在一个或多个计算机存储器或一个或多个数据存储设备(例如软盘、硬盘驱动器、光盘(CD)、数字视频磁盘(DVD)或数字磁带)中的数据进行操作的指令来呈现。本领域的技术人员用此类描述和表达向本领域的其它技术人员描述和传达他们的工作要旨。通常，算法是指导致所需结果的有条理的步骤序列，其中“步骤”是指物理量和/或逻辑状态的操纵，物理量和/或逻辑状态可以(但不一定)采用能被存储、转移、组合、比较和以其他方式操纵的电或磁信号的形式。常用于指这些信号，如位、值、元素、符号、字符、术语、数字等。这些和类似的术语可与适当的物理量相关联并且仅仅是应用于这些量和/或状态的方便的标签。
除非上述公开中另外明确指明，否则可以理解的是，在上述公开中，使用术语如“处理”或“估算”或“计算”或“确定”或“显示”的讨论是指计算机系统或类似的电子计算设备的动作和进程，其操纵表示为计算机系统的寄存器和存储器内的物理(电子)量的数据并将其转换成相似地表示为计算机系统存储器或寄存器或其它此类信息存储、传输或显示设备内的物理量的其它数据。
在一般意义上，本领域的技术人员将认识到，可以用多种硬件、软件、固件或它们的任何组合单独和/或共同实施的本文所述的多个方面可以被看作是由多种类型的“电子电路系统”组成。因此，如本文所用，“电子电路系统”包括但不限于具有至少一个离散电路的电子电路系统、具有至少一个集成电路的电子电路系统、具有至少一个专用集成电路的电子电路系统、形成由计算机程序配置的通用计算设备的电子电路系统(如，至少部分地实施本文所述的方法和/或设备的由计算机程序配置的通用计算机，或者至少部分地实施本文所述的方法和/或设备的由计算机程序配置的微处理器)、形成存储器设备(如，形成随机存取存储器)的电子电路系统，以及/或者形成通信设备(如，调制解调器、通信开关或光电设备)的电子电路系统。本领域的技术人员将认识到，可以模拟或数字方式或它们的一些组合实施本文所述的主题。
上述具体实施方式已通过使用框图、流程图和/或示例阐述了装置和/或方法的各种形式。只要此类框图、流程图和/或示例包含一个或多个功能和/或操作，本领域的技术人员就要将其理解为此类框图、流程图和/或示例中的每个功能和/或操作都可以单独和/或共同地通过多种硬件、软件、固件或实际上它们的任何组合来实施。在一种形式中，本文所述的主题的若干部分可以通过专用集成电路(ASIC)、现场可编程门阵列(FPGA)、数字信号处理器(DSP)或其他集成格式来实施。然而，本领域的技术人员将认识到，本文所公开的形式的一些方面可以作为在一台或多台计算机上运行的一个或多个计算机程序(如，作为在一个或多个计算机系统上运行的一个或多个程序)，作为在一个或多个处理器上运行的一个或多个程序(如，作为在一个或多个微处理器上运行的一个或多个程序)，作为固件，或者作为实际上它们的任何组合全部或部分地在集成电路中等效地实现，并且根据本发明，设计电子电路系统和/或编写软件和/或硬件的代码应当在本领域技术人员的技术范围内。另外，本领域的技术人员将认识到，本文所述主题的机制能够作为多种形式的一个或多个程序产品进行分布，并且本文所述主题的示例性形式适用，而不管用于实际进行分布的信号承载介质的具体类型是什么。信号承载介质的示例包括但不限于如下：可录式媒体，诸如软盘、硬盘驱动器、光盘(CD)、数字视频光盘(DVD)、数字磁带、计算机存储器等；以及传输式介质，诸如数字和/或模拟通信介质(例如，光纤缆线、波导、有线通信链路、无线通信链路(例如，发射器、接收器、传输逻辑、接收逻辑等)等)。
在一些情况下，一个或多个元件可使用表达“耦接”和“连接”连同其衍生词来描述。应当理解，并不希望这些术语彼此同义。例如，某些方面可使用术语“连接”来描述，以表示两个或更多个元件彼此直接物理接触或电接触。在另一个示例中，一些方面可使用术语“联接”来描述，以表示两个或更多个元件直接物理接触或电接触。然而，术语“联接”也可指两个或更多个元件彼此不是直接接触，而是彼此配合或相互作用。应当理解，包含在不同的其他部件内或与不同的其他部件连接的不同部件的所描绘的架构仅仅是示例，并且实际上可实现许多其他架构以实现相同的功能。在概念意义上，获得相同功能性的组件的任何布局都是有效“相关联的”，由此使得获得所需的功能性。因此，本文中为获得特定功能性而结合在一起的任何两个组件都可被视为彼此“相关联”，由此使得获得所需的功能性，而不论结构或中间组件如何。同样，如此相关联的任何两个部件也可视为彼此“操作地连接”或“操作地联接”，以实现所需的功能性，并且能够如此相关联的任何两个部件都可视为彼此“可操作地联接”，以实现所需的功能性。可操作耦接的具体示例包括但不限于物理上可匹配和/或物理上相互作用的部件，以及/或者可无线交互的，以及/或者无线相互作用的部件，以及/或者逻辑上相互作用的，以及/或者可在逻辑上相互作用的部件，以及/或者电气相互作用的部件，以及/或者可电气相互作用的部件，以及/或者光学相互作用的部件，以及/或者可光学相互作用的部件。
在其他情况下，一个或多个部件在本文中可被称为“被构造成能够”、“可被构造成能够”、“可操作/可操作地”、“适于/可适于”、“能够”、“可适形/适形于”等。本领域的技术人员将认识到，除非上下文另有所指，否则“被构造成能够”通常可涵盖活动状态的部件和/或未活动状态的部件和/或待机状态的部件。
虽然已经示出并描述了本公开的特定方面，但对本领域的技术人员将显而易见的是，基于本文的教导，可在不脱离本文所述的主题的情况下作出改变和变型，并且如在本文所述的主题的真实范围内，其更广泛的方面并因此所附权利要求将所有此类改变和变型包括在其范围内。本领域的技术人员应当理解，一般而言，本文和特别是所附权利要求(例如，所附权利要求的正文)中所使用的术语通常旨在为“开放”术语(例如，术语“包括”应当解释为“包括但不限于”，术语“具有”应当解释为“至少具有”，术语“包含”应当解释为“包含但不限于”等)。本领域的技术人员还应当理解，如果所引入权利要求叙述的具体数目为预期的，则这样的意图将在权利要求中明确叙述，并且在不存在这样的叙述的情况下，不存在这样的意图。例如，为有助于理解，下述所附权利要求可含有对介绍性短语“至少一个”和“一个或多个”的使用以引入权利要求。然而，对此类短语的使用不应当视为暗示通过不定冠词“一个”或“一种”引入权利要求表述将含有此类引入权利要求表述的任何特定权利要求限制在含有仅一个这样的表述的权利要求中，甚至当同一权利要求包括介绍性短语“一个或多个”或“至少一个”和诸如“一个”或“一种”(例如，“一个”和/或“一种”通常应当解释为意指“至少一个”或“一个或多个”)的不定冠词时；这也适用于对用于引入权利要求表述的定冠词的使用。
另外，即使明确叙述引入权利要求叙述的特定数目，本领域的技术人员应当认识到，此种叙述通常应当解释为意指至少所叙述的数目(例如，在没有其它修饰语的情况下，对“两个叙述”的裸叙述通常意指至少两个叙述、或两个或更多个叙述)。此外，在其中使用类似于“A、B和C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员应当理解该惯例的意义(例如，“具有A、B和C中的至少一者的系统”应当包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。在其中使用类似于“A、B或C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员应当理解该惯例的意义(例如，“具有A、B或C中的至少一者的系统”应当包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。本领域的技术人员还应当理解，通常，除非上下文另有指示，否则无论在具体实施方式、权利要求或附图中呈现两个或更多个替代术语的转折性词语和/或短语应当理解为涵盖包括该术语中的一者、该术语中的任一个或这两个术语的可能性。例如，短语“A或B”通常将被理解为包括“A”或“B”或“A和B”的可能性。
对于所附的权利要求，本领域的技术人员将理解，其中表述的操作通常可以任何顺序进行。另外，尽管以一定顺序列出了多个操作流程，但应当理解，可以不同于所示顺序的其它顺序进行该多个操作，或者可以同时进行该多个操作。除非上下文另有规定，否则此类替代排序的示例可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向，或其它改变的排序。此外，除非上下文另有规定，否则像“响应于”、“相关”这样的术语或其它过去式的形容词通常不旨在排除此类变体。
值得一提的是，任何对“一个方面”、“方面”、“一种形式”、“形式”的提及均意指结合该方面所述的具体特征、结构或特性包括在至少一个方面。因此，出现在整篇说明书中的不同位置的短语“在一个方面”、“在一方面”、“在一种形式中”或“在一形式中”不一定都是指同一方面。此外，具体特征、结构或特性可在一个或多个方面以任何合适的方式组合。
对于本文中使用的基本上任何复数和/或单数术语，本领域技术人员可从复数转换成单数和/或从单数转换成复数，只要适合于上下文和/或应用即可。为清楚起见，各种单数/复数置换在本文中没有明确表述。
在某些情况下，对系统或方法的使用可发生在一个地区中，即使部件位于该地区外部。例如，在分布式计算上下文中，对分布式计算系统的使用可发生在一个地区中，即使该系统的部件可能位于该地区外部(例如，位于该地区外部的继电器、服务器、处理器、信号承载介质、传输计算机、接收计算机等)。
系统或方法的销售同样可发生一个地区中，即使该系统或方法的部件位于和/或用于该地区外部。此外，在一个地区中实施用于执行方法的系统的至少一部分不排除在另一个地区中使用该系统。
上述美国专利、美国专利申请公开、美国专利申请、国外专利、国外专利申请、本说明书中所提及和/或任何应用数据表中所列出的非专利申请或任何其它公开材料均在不与其相抵触的程度上以引用方式并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
概括地说，已经描述了由采用本文所述的概念产生的许多有益效果。为了举例说明和描述的目的，已经提供了一个或多个形式的上述具体实施方式。这些具体实施方式并非意图为详尽的或限定到本发明所公开的精确形式。可以按照上述教导内容对本发明进行修改或变型。选择和描述的一个或多个形式是为了说明原理和实际应用，从而使本领域的普通技术人员能够利用适用于预期的特定用途的该多个形式和多种修改形式。与此一同提交的权利要求书旨在限定完整范围。
本文所述主题的各个方面在以下编号的实施例中陈述：
实施例1.一种电外科系统，包括：
RF电流发生器；柄部主体；和
端部执行器，其与柄部主体以机械方式连通，端部执行器包括：
第一钳口，其包括具有第一电极表面的第一电极，其中第一电极与RF电流发生器的第一端子电连通；和
第二钳口，其包括具有第二电极表面的第二电极，其中第二电极与RF电流发生器的第二端子电连通；
其中第一钳口包括至少一个特征部，其被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小不同于当第一钳口放置于邻近第二钳口的位置时施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小，并且
其中，第二电极为平坦表面。
实施例2.根据实施例1所述的电外科系统，其中至少一个特征部包括设置在第一电极中的至少一个纵向通道。
实施例3.根据实施例1至2中任一项所述的电外科系统，其中至少一个特征部包括设置在第一电极中的至少一个横向通道。
实施例4.根据实施例1至3中任一项所述的电外科系统，其中第二电极设置在绝缘层上。
实施例5.根据实施例4所述的电外科系统，还包括多个绝缘垫，其中多个绝缘垫中的每个具有与第二电极表面共面的表面；
其中至少一个特征部包括从第一电极延伸并与第一电极电连通的多个凸起的凸台；并且
其中当第一钳口放置于邻近第二钳口的位置时，多个凸起的凸台中的至少一个被构造成能够接合多个绝缘垫中的至少一个。
实施例6.根据实施例5所述的电外科系统，其中至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个纵向脊部，并且其中多个凸起的凸台从至少一个纵向脊部的表面延伸。
实施例7.根据实施例6所述的电外科系统，其中至少一个特征部还包括设置在第一电极中的至少一个纵向通道。
实施例8.根据实施例5所述的电外科系统，其中至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个横向脊部，并且其中多个凸起的凸台从至少一个横向脊部的表面延伸。
实施例9.根据实施例8所述的电外科系统，其中至少一个特征部还包括设置在第一电极中的至少一个横向通道。
实施例10.根据实施例1至9中任一项所述的电外科系统，其中当将力施加到端部执行器时，第二钳口能够相对于第一钳口是运动。
实施例11.根据实施例1至10中任一项所述的电外科系统，其中当将力施加到端部执行器时，第一钳口能够相对于第二钳口是运动。
实施例12.一种用于电外科装置的端部执行器，该端部执行器包括：
第一钳口，其包括具有第一电极表面的第一电极，其中第一电极被构造成能够与RF电流发生器的第一端子电连通；和
第二钳口，其包括具有第二电极表面的第二电极，其中第二电极被构造成能够与RF电流发生器的第二端子电连通；
其中第一钳口包括至少一个特征部，其被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小不同于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小，并且
其中，第二电极为平坦表面。
实施例13.根据实施例12所述的端部执行器，其中至少一个特征部被构造成能够向压缩在至少一个特征部与第二钳口之间的组织施加一定量的压缩力，该压缩力的大小大于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间压缩的组织的压缩力的大小。
实施例14.根据实施例12至13中任一项所述的端部执行器，其中至少一个特征部包括从第一电极延伸并且与第一电极电连通的至少一个纵向脊部。
实施例15.根据实施例12至14中任一项所述的端部执行器，其中至少一个特征部包括从第一电极延伸并且与第一电极电连通的至少一个横向向脊部。
实施例16.根据实施例12至15中任一项所述的端部执行器，其中至少一个特征部被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小小于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。
实施例17.根据实施例16所述的端部执行器，其中至少一个特征部包括设置在第一电极中的至少一个纵向通道。
实施例18.根据实施例16所述的端部执行器，其中至少一个特征部包括设置在第一电极中的至少一个横向通道。
实施例19.其中至少一个特征部被构造成能够向压缩在至少一个特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力的大小大于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小，并且
其中至少第二特征部被构造成能够向压缩在至少第二特征部与第二电极表面之间的组织施加一定量的压缩力，该压缩力大小小于当第一钳口放置于邻近第二钳口的位置时由第一电极施加到压缩在第一电极表面与第二电极表面之间的组织的压缩力的大小。
实施例20.根据实施例12至19中任一项所述的端部执行器，其中第二电极设置在绝缘层上。
实施例21.根据实施例20所述的端部执行器，还包括至少一个绝缘垫，其中至少一个绝缘垫具有与第二电极共面的表面；
其中至少一个特征部包括从第一电极延伸并与第一电极电连通的至少一个凸起的凸台；并且
其中当第一钳口放置于邻近第二钳口的位置时，至少一个凸起的凸台被构造成能够接合至少一个绝缘垫。
实施例22.根据实施例21所述的端部执行器，其中至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个纵向脊部，并且其中至少一个凸起的凸台从至少一个纵向脊部的表面延伸。
实施例23.根据实施例21至22中任一项所述的端部执行器，其中至少一个特征部还包括从第一电极延伸并与第一电极电连通的至少一个横向脊部，并且其中至少一个凸起的凸台从至少一个横向脊部的表面延伸。
实施例24.根据实施例12至23中任一项所述的端部执行器，其中第二钳口能够相对于第一钳口运动。
实施例25.根据实施例1至11中任一项所述的端部执行器，其中第一钳口相对于第二钳口运动。

Claims (25)

1.一种电外科系统，包括：
RF电流发生器；
柄部主体；和
端部执行器，所述端部执行器与所述柄部主体以机械方式连通，所述端部执行器包括：
第一钳口，所述第一钳口包括具有第一电极表面的第一电极，其中所述第一电极与所述RF电流发生器的第一端子电连通；和
第二钳口，所述第二钳口包括具有第二电极表面的第二电极，其中所述第二电极与所述RF电流发生器的第二端子电连通；
其中，所述第一钳口包括至少一个特征部，所述至少一个特征部被构造成能够向压缩在所述至少一个特征部与所述第二电极表面之间的组织施加一定量的压缩力，所述压缩力的大小不同于当所述第一钳口放置于邻近所述第二钳口的位置时施加到压缩在所述第一电极表面与所述第二电极表面之间的组织的压缩力的大小，并且
其中，所述第二电极为平坦表面。
2.根据权利要求1所述的电外科系统，其中，所述至少一个特征部包括设置在所述第一电极中的至少一个纵向通道。
3.根据权利要求1所述的电外科系统，其中，所述至少一个特征部包括设置在所述第一电极中的至少一个横向通道。
4.根据权利要求1所述的电外科系统，其中，所述第二电极设置在绝缘层上。
5.根据权利要求4所述的电外科系统，还包括多个绝缘垫，其中，所述多个绝缘垫中的每个具有与所述第二电极表面共面的表面；
其中，所述至少一个特征部包括从所述第一电极延伸并与所述第一电极电连通的多个凸起的凸台；并且
其中，当所述第一钳口放置于邻近所述第二钳口的所述位置时，所述多个凸起的凸台中的至少一个被构造成能够接合所述多个绝缘垫中的至少一个。
6.根据权利要求5所述的电外科系统，其中，所述至少一个特征部还包括从所述第一电极延伸并与所述第一电极电连通的至少一个纵向脊部，并且其中所述多个凸起的凸台从所述至少一个纵向脊部的表面延伸。
7.根据权利要求6所述的电外科系统，其中，所述至少一个特征部还包括设置在所述第一电极中的至少一个纵向通道。
8.根据权利要求5所述的电外科系统，其中，所述至少一个特征部还包括从所述第一电极延伸并与所述第一电极电连通的至少一个横向脊部，并且其中所述多个凸起的凸台从所述至少一个横向脊部的表面延伸。
9.根据权利要求8所述的电外科系统，其中，所述至少一个特征部还包括设置在所述第一电极中的至少一个横向通道。
10.根据权利要求1所述的电外科系统，其中，当将力施加到所述端部执行器时，所述第二钳口能够相对于所述第一钳口运动。
11.根据权利要求1所述的电外科系统，其中，当将力施加到所述端部执行器时，所述第一钳口能够相对于所述第二钳口运动。
12.一种用于电外科装置的端部执行器，所述端部执行器包括：
第一钳口，所述第一钳口包括具有第一电极表面的第一电极，其中所述第一电极被构造成能够与RF电流发生器的第一端子电连通；和
第二钳口，所述第二钳口包括具有第二电极表面的第二电极，其中所述第二电极被构造成能够与所述RF电流发生器的第二端子电连通；
其中，所述第一钳口包括至少一个特征部，所述至少一个特征部被构造成能够向压缩在所述至少一个特征部与所述第二电极表面之间的组织施加一定量的压缩力，所述压缩力的大小不同于当所述第一钳口放置于邻近所述第二钳口的位置时由所述第一电极施加到压缩在所述第一电极表面与所述第二电极表面之间的组织的压缩力的大小，并且
其中，所述第二电极为平坦表面。
13.根据权利要求12所述的端部执行器，其中，所述至少一个特征部被构造成能够向压缩在所述至少一个特征部与所述第二钳口之间的所述组织施加一定量的压缩力，该压缩力的大小大于当所述第一钳口放置于邻近所述第二钳口的所述位置时由所述第一电极施加到压缩在所述第一电极表面与所述第二电极表面之间的所述组织的压缩力的大小。
14.根据权利要求13所述的端部执行器，其中，所述至少一个特征部包括从所述第一电极延伸并且与所述第一电极电连通的至少一个纵向脊部。
15.根据权利要求13所述的端部执行器，其中，所述至少一个特征部包括从所述第一电极延伸并且与所述第一电极电连通的至少一个横向脊部。
16.根据权利要求12所述的端部执行器，其中，所述至少一个特征部被构造成能够向压缩在所述至少一个特征部与所述第二电极表面之间的所述组织施加一定量的压缩力，该压缩力的大小小于当所述第一钳口放置于邻近所述第二钳口的所述位置时由所述第一电极施加到压缩在所述第一电极表面与所述第二电极表面之间的所述组织的压缩力的大小。
17.根据权利要求16所述的端部执行器，其中，所述至少一个特征部包括设置在所述第一电极中的至少一个纵向通道。
18.根据权利要求16所述的端部执行器，其中，所述至少一个特征部包括设置在所述第一电极中的至少一个横向通道。
19.根据权利要求12所述的端部执行器，其中，至少一个特征部被构造成能够向压缩在所述至少一个特征部与所述第二电极表面之间的所述组织施加一定量的压缩力，该压缩力的大小大于当所述第一钳口放置于邻近所述第二钳口的所述位置时由所述第一电极施加到压缩在所述第一电极表面与所述第二电极表面之间的所述组织的压缩力的大小，并且其中，至少第二特征部被构造成能够向压缩在所述至少第二特征部与所述第二电极表面之间的所述组织施加一定量的压缩力，该压缩力的大小小于当所述第一钳口放置于邻近所述第二钳口的所述位置时由所述第一电极施加到压缩在所述第一电极表面与所述第二电极表面之间的所述组织的压缩力的大小。
20.根据权利要求12所述的端部执行器，其中，所述第二电极设置在绝缘层上。
21.根据权利要求20所述的端部执行器，还包括至少一个绝缘垫，其中，所述至少一个绝缘垫具有与所述第二电极表面共面的表面；
其中，所述至少一个特征部包括从所述第一电极延伸并与所述第一电极电连通的至少一个凸起的凸台；并且
其中，当所述第一钳口放置于邻近所述第二钳口的所述位置时，所述至少一个凸起的凸台被构造成能够接合所述至少一个绝缘垫。
22.根据权利要求21所述的端部执行器，其中，所述至少一个特征部还包括从所述第一电极延伸并与所述第一电极电连通的至少一个纵向脊部，并且其中所述至少一个凸起的凸台从所述至少一个纵向脊部的表面延伸。
23.根据权利要求21所述的端部执行器，其中，所述至少一个特征部还包括从所述第一电极延伸并与所述第一电极电连通的至少一个横向脊部，并且其中所述至少一个凸起的凸台从所述至少一个横向脊部的表面延伸。
24.根据权利要求12所述的端部执行器，其中，所述第二钳口能够相对于所述第一钳口运动。
25.根据权利要求1所述的端部执行器，其中，所述第一钳口能够相对于所述第二钳口运动。
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