Tissue surface treatment apparatus and method

• US 20020120260A1
• Filed: 02/28/2001
• Published: 08/29/2002
• Est. Priority Date: 02/28/2001
• Status: Active Grant

• Current Assignee: David L. Morris
• Original Assignee: David L. Morris
• Inventors: Balbierz, Daniel J., Daniel, Steven A., Morris, David L.
• Granted Patent: US 7,422,586 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61M 2025/0085 Multiple injection needles protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence

Abstract

A tissue surface treatment apparatus includes a housing having a proximal end, a distal including a tissue contacting surface and an interior defined by the housing. A handpiece is coupled to the housing. The tissue contact surface has a plurality of apertures. An energy delivery device including at least one electrode is positionable in the housing interior. The at least one electrode includes a tissue penetrating distal end in substantial alignment with an aperture of the plurality of aperture. The at least one electrode is configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface. An advancement device is coupled to the energy delivery device. The advancement device is at least partly positionable within at least one of the housing or the handpiece. The advancement device is configured to advance the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior. A cable is coupled to one of the housing or the energy delivery device. The cable is configured to be coupled to an energy source.

Claims

1. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

2. The apparatus of claim 1, wherein the at least one electrode is an RF electrode and the energy source is an RF source.

3. The apparatus of claim 2, wherein one of the apparatus or the energy delivery device is configured to operate in a monopolar mode, a bipolar mode or is switchable between monopolar and bipolar modes.

4. The apparatus of claim 1, wherein the advancement member is substantially cylindrically shaped or substantially oval shaped.

5. The apparatus of claim 1, wherein the advancement member is configured to move reciprocally within the housing.

6. The apparatus of claim 1, wherein the advancement member is a cam member.

7. The apparatus of claim 1, wherein the advancement is configured to be advanced by a solenoid or electric motor.

8. The apparatus of claim 1, wherein the advancement member is configured to be advanced by fluid pressure, pneumatic pressure or hydraulic pressure.

9. The apparatus of claim 1, wherein at least a portion of the tissue contact surface is substantially rigid.

10. The apparatus of claim 1, further comprising:

a current and voltage measurement device coupled to the energy delivery device.

11. The apparatus of claim 10, wherein the current and voltage measurement device is configured to monitor or control a delivery of energy delivery device to the tissue site.

12. The apparatus of claim 1, wherein the energy delivery device is one of a plurality of RF electrodes, an array of RF electrodes an array of RF monopolar electrodes or an array of RF bipolar electrodes.

13. The apparatus of claim 12, further comprising:

a multiplexing device coupled to at least a portion of the plurality of RF electrodes, the multiplexing device configured to be coupled to at least one of a power supply or logic resources.

14. The apparatus of claim 12, wherein the logic resources are configured to generate a selectable RF energy vector in a tissue volume.

15. The apparatus of claim 14, wherein the tissue volume is defined by the plurality of RF electrodes, or the RF electrodes and a conductive portion of the tissue contact surface.

52. The apparatus of claim 51, wherein the fluid film is at least one of a substantially even thickness fluid, an electrically conductive film, a thermally conductive film or a cooling film.

53. The apparatus of claim 52, wherein the fluid film is configured as a return electrode and at least one electrode is an RF electrode operated in a monopolar mode.

16. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface, wherein the at least one electrode has a longitudinal axis in substantial alignment with one of a longitudinal axis of the aperture, a locus of the aperture, or a line perpendicular to a plane of the aperture;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

17. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed into a target tissue site with curvature to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery.

18. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed into a target tissue at an angle with respect to a plane of the tissue contact surface to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery.

19. The apparatus of 18, wherein the angle is one of a substantially obtuse, a perpendicular or an acute angle.

20. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed to a selectable depth into a target tissue to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery.

21. The apparatus of claim 20, wherein the selectable depth is up to about 4 cm.

22. The apparatus of claim 20, wherein one of the handpiece or an actuator coupled to the handpiece is configured to control the selectable depth.

23. The apparatus of claim 20, wherein the at least one electrode includes a first electrode and a second electrode.

24. The apparatus of claim 23, wherein the first electrode is deployable to a first depth and a second electrode is deployable to a second depth independent of the first depth.

25. The apparatus of claim 23, wherein the first electrode is deployable at first angle with respect to a plane of the tissue contact surface and the second electrode is deployable to a second angle with respect to a plane of the tissue contact surface independent of the first angle.

27. The apparatus of claim 26, wherein the bendable portion includes one of a hinged section, an articulated section, a flexible section or a pivotal coupling.

28. The apparatus of claim 26, wherein the handpiece further comprises a substantially straight portion coupled to one of the bendable portion or the curved portion.

26. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing, the handpiece including at least one of a bendable portion or a curved portion;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

29. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface having at least one of curved contour, a concave contour a convex contour or a sloping contour;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

30. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface being substantially conformable, controllably conformable or bendable;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

31. The apparatus of claim 30, wherein at least a portion of the contact surface is coupled to at least one of a handpiece, an actuator, or an actuator coupled to the handpiece and is controllably movable or deflectable responsive to movement of one the actuator or the actuator coupled to the handpiece.

32. The apparatus of claim 31, wherein at least a portion of the contact surface is mechanically coupled to connecting member coupled to one of the actuator, the handpiece, or the actuator coupled to the handpiece.

33. The apparatus of claim 30, the tissue contact surface has one of a curved contour, a concave contour or a convex contour.

34. The apparatus of claim 30, wherein the conformable portion includes at least one of an articulated portion, a hinged portion a flexible portion or an elastomeric portion.

35. The apparatus of claim 34, wherein at least a portion of the conformable surface is coupled to a connecting member coupled to an actuator positioned on the handpiece, wherein the conformable surface is movable responsive to movement of the actuator.

37. The apparatus of claim 30, wherein the tissue contacting surface is substantially circular shaped or substantially oval shaped.

38. The apparatus of claim 30, wherein the tissue contacting surface has a substantially radiused or tapered edge.

39. The apparatus of claim 30, wherein at least a portion of the tissue contact surface includes an insulative layer or coating.

36. The apparatus of 30, wherein at least a portion of the conformable surface is inflatable, expandable, or an expandable balloon.

40. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface including a movable or detachable insulative layer;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

41. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;

a switching device coupled to at least one of the at least one electrode, a power supply coupled to the at least one electrode or a ground pad electrode coupled to the power supply;

impedance measurement circuitry coupled to the at least one of at least one electrode or the ground pad electrode;

logic resources coupled to at least one of the impedance measurement circuitry or the switching device, the logic resources configured to redirect at least a portion of a current flow going to the ground pad electrode responsive to an impedance change measured by the impedance measurement circuitry; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to the power supply.

42. The apparatus of 41, wherein one of the logic resources or the switching device are configured to switch an RF mode of the least one electrode from a RF monopolar mode to an RF bipolar mode responsive to an impedance change measured by the impedance measurement circuitry.

43. The apparatus of claim 42, wherein the switching device is a multiplexing device.

44. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;

a multiplexing device coupled to the at least one electrode, a power supply coupled to the at least one electrode or a ground pad electrode coupled to the power supply; and

a cable coupled to at least one of the housing, the multiplexing device or the energy delivery device, the cable being configured to be coupled to a power supply.

46. The apparatus of claim 45, wherein at least a portion of the conductive contact surface is configurable as a return electrode.

47. The apparatus of claim 46, wherein the at least one electrode is an RF electrode configured to operate in a monopolar or a bipolar mode.

48. The apparatus of claim 45, further comprising:

a switching device coupled to at least one of the conductive contact surface, the at least one electrode, a power supply coupled to the at least one electrode or a ground pad electrode coupled to the power supply;

impedance measurement circuitry coupled to at least one of the at least one electrode or the ground pad electrode; and

logic resources coupled to at least one of the impedance measurement circuitry or the switching device, the logic resources configured to redirect at least a portion of a current flow going to the ground pad electrode to the conductive contact surface responsive to an impedance change measured by the impedance measurement circuitry.

49. The apparatus of claim 48, wherein the switching device is a multiplexing device.

45. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, at least a portion of the tissue contact surface being a conductive contact surface, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to at least one of the housing ,the energy delivery device, or the conductive surface, the cable being configured to be coupled to an energy source.

50. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, at least a portion of the tissue contact surface being a porous portion comprising a porous material, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

51. The apparatus of claim 50, wherein the porous portion is configured to deliver one of a fluid, a fluid film or a vacuum to the tissue surface.

54. The apparatus of claim 51, wherein the fluid is electrically conductive, thermally conductive or a cooling fluid.

55. The apparatus of claim 51, wherein one of the fluid or the fluid film is configured as an RF electrode or electrically coupled to one of the at least one RF electrode or an RF power supply.

56. The apparatus of claim 51, wherein the porous portion is configured to deliver a vacuum sufficient to fixedly position at least a portion of the contact surface on the tissue surface.

57. The apparatus of claim 51, wherein the porous portion is configured to deliver a vacuum sufficient to at least partially conform at least a portion of the contact surface to the tissue surface.

58. The apparatus of claim 51, further comprising:

a fluid source coupled the tissue contact surface, wherein the fluid source includes at least one a conductive fluid, an electrolytic solution, a saline solution, a thermally conductive fluid, a cooling fluid or a chemotherapeutic fluid.

59. The apparatus of claim 51, further comprising

a vacuum source coupled the tissue contact surface.

60. A tissue surface treatment apparatus , comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

at least a portion of the tissue contacting surface having a lubricous coating;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

61. The apparatus of claim 60, wherein the lubricous coating is one of a non-stick coating, a hydrophobic coating, a polymer coating, a fluoro-polymer coating or a silicone coating.

62. The apparatus of claim 60, wherein the lubricous coating is configured to reduce a tissue adhesion to at least a portion of the tissue contact surface.

63. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

at least a portion of the tissue contacting surface having a textured surface;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

64. The apparatus of claim 63, where the textured surface increases a coefficient of friction between the tissue contact surface and the tissue surface.

65. The apparatus of claim 63, where the textured surface improves one of a stability or a lateral stability of the tissue contact surface on the tissue surface.

66. The apparatus of claim 63, wherein the tissue contacting surface is substantially circular shaped or substantially oval shaped.

67. The apparatus of claim 63, wherein the tissue contacting surface has a substantially radiused edge or a substantially tapered edge.

70. The apparatus of claim 69, wherein the stop is positionable.

71. The apparatus of claim 69, wherein the stop comprises one of an indexing device or an indexing mechanism.

72. The apparatus of claim 69, wherein the movement is a linear movement with respect to a longitudinal axis of the advancement member.

73. The apparatus of claim 69, wherein the stop controls a depth of penetration of the at least one electrode.

68. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, tissue contacting surface having a substantially radiused edge or a substantially tapered edge, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

69. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;

at least one stop coupled to one of the housing or the advancement member the stop configured to limit a movement of at least one of the advancement member or the at least one electrode; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

74. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface, the at least one electrode including an insulator positioned in a surrounding relationship to the electrode;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

75. The apparatus of claim 74, wherein the insulator is slidably positionable over the at least one electrode to produce a selectable energy delivery surface.

76. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a sensor coupled to at least one of the housing, the tissue contact surface, the energy delivery device, the at least one electrode or the advancement member; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

77. The apparatus of claim 76, wherein the sensor is a thermal sensor, a thermocouple, a pressure sensor, a force sensor, a strain gauge, a positional sensor, an LVDT, an optical sensor, a current sensor, voltage sensor or a pH sensor.

78. The apparatus of claim 76, the sensor is configured to sense one of an electrode position, an electrode deployment depth or a fully withdrawn position of the electrode.

79. The apparatus of claim 78, wherein the sensor is one an LVDT, a resister, a resistance strip or a potentiometer

80. The apparatus of 76, further comprising:

feedback control resources coupled to at least one of the sensor, the first RF electrode or a fluid delivery device coupled to at least one infusion port positioned on one of the tissue contact surface or the energy delivery device.

81. The apparatus of claim 80, wherein the feedback control resources includes at least one of a microprocessor, a controller, a software module, a software program set forth in a tangible media, a power control circuit, a voltage and current monitor, a user interface or a display.

82. The apparatus of claim 80, wherein the feedback control resources are configured to control process variables to reduce one of a tissue desiccation in proximity to the energy delivery device or an impedance rise.

83. The apparatus of claim 82, wherein the process variables include at least one of a power level, a duty cycle, an energy delivery, an RF energy delivery, a rate of RF energy delivery to the tissue site, a fluid delivery, a fluid flow rate or a fluid pressure.

84. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;

at least one infusion port coupled to at least one of the tissue contact surface, the energy delivery device, or the at least one electrode; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

85. The apparatus of claim 84, wherein the at least one infusion port includes a plurality of infusion ports.

86. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface, the housing defining an interior;

an fluid delivery device positionable in the housing interior, the fluid delivery device including at least one hollow non conducting infusion member with at least one infusion aperture and a tissue penetrating distal end, the at least one infusion member configured to be advanced from the housing interior and into a target tissue site to infuse a fluid into tissue and define a tissue infusion volume, the fluid delivery device configured to be coupled to a fluid source;

a handpiece coupled to the housing;

an advancement device coupled to the fluid delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one infusion member from the housing interior into the target tissue site and completely withdrawal the at least one infusion member into the housing interior; and

a conductor coupled to at least one of the fluid delivery device or the infusion member, the conductor being configured to be coupled to an energy source.

87. A tissue surface treatment apparatus, comprising:

a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures and a tissue access port, the housing defining an interior;

an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece coupled to the housing;

an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior; and

a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

88. The apparatus of claim 87, wherein the tissue access port includes a tissue anchoring member or a helical member.

89. The apparatus of claim 87, wherein the tissue access port is adapted to provide access to the tissue surface by a surgical instrument, a forceps, a biopsy device or a catheter device.

90. A tissue surface treatment apparatus, comprising:

a housing means having a proximal end, a distal end including a tissue contacting surface means having a plurality of apertures means, the housing means defining an interior;

an energy delivery device means positionable in the housing means interior, the energy delivery device means including at least one electrode means with a tissue penetrating distal end in substantial alignment with an aperture means of the plurality of apertures means, the at least one electrode means configured to be advanced from the housing means interior through the aperture means and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;

a handpiece means coupled to the housing means;

an advancement device means coupled to the energy delivery device means, the advancement device means being at least partly positionable within at least one of the housing means or the handpiece means, the advancement device means configured to advance at least a portion of the at least one electrode means from the housing means interior into the target tissue site and completely withdrawal the at least one electrode means into the housing means interior; and

a cable means coupled to one of the housing means or the energy delivery device means, the cable means being configured to be coupled to an energy source means.