Electrosurgery with infiltration anesthesia
First Claim
1. The method for carrying out a surgical procedure wherein an electrode is electrosurgically excited to create an arc for cutting tissue of an animal, comprising the steps of:
- determining an anticipated range of resistance values exhibited by said tissue when confronted by said electrode from a low value to a high value;
providing a said electrosurgical cutting electrode;
providing an electrosurgical generator connectable in electrical excitation relationship with said cutting electrode and having a resistance load verses power characteristic effective to sustain creation of said arc at said electrode when confronting said tissue throughout said range of resistance values;
anesthetizing said animal by parenterally administering a solution of a local anesthetic agent and biocompatible diluent at the site of said tissue, said solution exhibiting a resistivity of value effective to maintain at least said low value of resistance when infiltrated within said tissue; and
then carrying out said procedure while electrosurgically exciting said electrode from said electrosurgical generator.
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Accused Products
Abstract
Method for carrying out the recovery of an intact volume of tissue wherein a delivery cannula tip is positioned in confronting adjacency with the volume of tissue to be recovered. The electrosurgical generator employed to form an arc at a capture component extending from the tip is configured having a resistance-power profile which permits recovery of the specimen without excessive thermal artifact while providing sufficient power to sustain a cutting arc. For the recovery procedure, a local anesthetic employing a diluent which exhibits a higher resistivity is utilized and the method for deploying the capture component involves an intermittent formation of a cutting arc with capture component actuation interspersed with pauses of duration effective to evacuate any accumulation or pockets of local anesthetic solution encountered by the cutting electrodes.
107 Citations
45 Claims
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1. The method for carrying out a surgical procedure wherein an electrode is electrosurgically excited to create an arc for cutting tissue of an animal, comprising the steps of:
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determining an anticipated range of resistance values exhibited by said tissue when confronted by said electrode from a low value to a high value;
providing a said electrosurgical cutting electrode;
providing an electrosurgical generator connectable in electrical excitation relationship with said cutting electrode and having a resistance load verses power characteristic effective to sustain creation of said arc at said electrode when confronting said tissue throughout said range of resistance values;
anesthetizing said animal by parenterally administering a solution of a local anesthetic agent and biocompatible diluent at the site of said tissue, said solution exhibiting a resistivity of value effective to maintain at least said low value of resistance when infiltrated within said tissue; and
then carrying out said procedure while electrosurgically exciting said electrode from said electrosurgical generator. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. The method for accessing subcutaneous target tissue of an animal comprising the steps of:
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providing an electrosurgical system including an electrosurgical generator and an operatively associated cutting electrode assembly energizable to provide a tissue cutting arc;
anesthetizing said animal by parenterally administering at the site of said tissue a solution of a local anesthetic agent and biocompatible diluent exhibiting an electrical conductivity of value effective for providing an electrical resistance at tissue confronting said electrode sustaining said tissue cutting arc when said solution is infiltrated within the tissue of said animal;
positioning said electrode subcutaneously at said site;
energizing said cutting electrode to provide said tissue cutting arc; and
maneuvering said electrode with respect to said target tissue. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. The method for carrying out a surgical procedure wherein an electrode is electrosurgically excited to create an arc for cutting at a tissue site of an animal, comprising the steps of:
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determining the lowest value of resistivity of tissue for such an animal;
providing an electrosurgical system including an electrosurgical generator and an operatively associated cutting electrode assembly energizable to provide a tissue cutting arc;
providing a local anesthetic as a solution of a local anesthetic agent and a biocompatible diluent exhibiting a resistivity substantially corresponding with or greater than said determined lowest value of resistivity;
anesthetizing said animal by parenternally administering said local anesthetic to effect its infiltration about said tissue site; and
then carrying out said procedure while electrosurgically energizing said electrode assembly. - View Dependent Claims (24, 25, 26, 27)
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28. The method for isolating and retrieving a tissue volume of given peripheral extent within adjacent tissue of a patient, comprising the steps of:
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(a) providing an electrosurgical generator controllable to derive an electrosurgical cutting output at a cutting voltage level;
(b) providing a tissue retrieval instrument having a delivery cannula and extending from a proximal end portion along a longitudinal axis to a forward region having a tip, said instrument having a capture component positioned within said delivery cannula internal channel having a forward portion extending to a forwardly disposed cutting electrode assembly energizable to define an electrosurgical cutting arc supporting leading edge, said capture component being actuable to cause said leading edge to extend from said delivery cannula laterally outwardly and forwardly toward a maximum peripheral extent selected to correspond with said given peripheral extent and subsequently extendable while being drawn toward said axis to a capture orientation, and said instrument further comprising a controllable motor drive assembly;
(c) providing a control assembly electrically coupled with said electrosurgical generator and said instrument and actuable between a capture mode effecting the energization of said cutting electrode and actuation of said capture component, and a pause mode effecting the de-actuation of said capture component and de-energization of said cutting electrode. (d) providing a local anesthetic as a solution of a local anesthetic agent and a biocompatible diluent exhibiting a resistivity of value effective for supporting the presence of said cutting arc when infiltrated within said adjacent tissue;
(e) anesthetizing said patient by parenterally administering said local anesthetic to effect said infiltration of said solution;
(f) positioning said delivery cannula within said adjacent tissue in a manner wherein said tip is in confronting adjacency with said tissue volume;
(g) actuating said control assembly to derive said capture mode to effect an isolation and envelopment of said tissue volume; and
(h) removing said delivery cannula with the capture component retained isolated tissue volume from said adjacent tissue. - View Dependent Claims (29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39)
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40. The method for surgically accessing a target tissue volume of a patient comprising the steps of:
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(a) providing an accessing instrument having an electrosurgical cutting assembly at its distal end which is energizable to form an electrosurgical cutting arc;
(b) providing a fluid evacuation assembly having a fluid intake port adjacent said electrosurgical cutting assembly and actuable to effect a fluid suction condition at said fluid intake port;
(c) anesthetizing said patient by parenterally administering a solution of a local anesthetic agent and biocompatible diluent about the site of said target tissue volume;
(d) forming an opening of limited depth in the skin of said patient using a cutting instrument;
(e) positioning said distal end of said instrument within said opening;
(f) energizing said electrosurgical cutting assembly to effect creation of said cutting arc;
(g) actuating said fluid evacuation assembly; and
(h) maneuvering said accessing instrument with respect to said target tissue volume with a motion effective to cause the aspiration through said intake port of accumulations of said solution within the tissue of said patient to an extent wherein said cutting arc is maintained effective to cut tissue. - View Dependent Claims (41, 42, 43, 44)
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45. The method for carrying out a surgical procedure upon a patient comprising the steps of:
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(a) providing an accessing instrument having an electrosurgical cutting assembly which is energizable to form an electrosurgical cutting arc;
(b) anesthetizing said patient by parenterally administering a solution of a local anesthetic agent and biocompatible into tissue of said patient;
(c) energizing said electrosurgical cutting assembly to effect creation of said cutting arc;
(d) maneuvering said accessing instrument borne electrosurgical cutting assembly to carry out a surgical procedure within the tissue of said patient; and
(e) simultaneously with said step (d) aspirating any accumulation of said solution within the path of said maneuvering to an extent effective to maintain the presence of said cutting arc to cut tissue.
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Specification