Systems and methods for electrosurgical treatment of obstructive sleep disorders

• US 20060253117A1
• Filed: 03/09/2006
• Published: 11/09/2006
• Est. Priority Date: 01/07/1992
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Hovda, David C., Ellsberry, Maria B., Thapliyal, Hira V.
• Application Number:
  US11/373,356
• Publication Number:
  US 20060253117A1
• Time in Patent Office: Days
• US Class Current: 606/48
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00583 : Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/00678 : upper
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 2018/165 : Multiple indifferent electrodes
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient'"'"'s body, particularly including tissue in the ear, nose and throat. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove and/or modify the structure of tissue structures. The present invention is particularly useful for treating sleep obstructive disorders, such as sleep apnea and snoring.

Claims

1-24. -24. (canceled)

25. An electrosurgical system for use with a high frequency power supply and an electrically conducting fluid supply, the system comprising:

an electrosurgical probe comprising a shaft having a proximal end and a distal end, at least one active electrode disposed near the distal end and adapted to be electrically coupled to the high frequency power supply;

a passive electrode adapted to be electrically coupled to the high frequency power supply; and

a fluid delivery element defining a fluid path in electrical contact with the passive electrode and the active electrode, the fluid path having an inlet adapted to be fluidly coupled to the electrically conducting fluid supply for directing fluid along the fluid path to generate a current flow path between the passive electrode and the active electrode wherein the electrically conductive fluid has an electrical conductivity equal to or greater than 0.2 mS per cm.

26. The electrosurgical system of claim 25 wherein said electrically conductive fluid has an electrical conductivity equal to or greater than 2 mS per cm.

27. The electrosurgical system of claim 25 wherein said electrically conductive fluid has an electrical conductivity equal to or greater than 10 mS per cm.

28. The electrosurgical system of claim 25 wherein said electrically conductive fluid has an electrical conductivity about equal to 17 mS per cm.

29. The electrosurgical system of claim 25 wherein said high frequency power supply is configured to supply a voltage difference between said active electrode and said passive electrode such that said electrically conductive fluid therebetween is vaporized and forms a plasma, wherein said plasma comprises energy sufficient to modify tissue in contact with said plasma.

30. The electrosurgical system of claim 29 wherein said plasma discharges energy in the Ultraviolet range.

31. The electrosurgical system as recited in claim 25, wherein the passive electrode forms a portion of the shaft of the electrosurgical probe.

32. The electrosurgical system as recited in claim 31 further including an insulating member circumscribing the passive electrode, the passive electrode being sufficiently spaced from the active electrode to minimize direct contact between the passive electrode and a body structure at the target site when the active electrode is positioned in close proximity or in partial contact with the body structure.

33. The electrosurgical system as recited in claim 31, wherein the passive electrode is an inner tubular member and the fluid delivery element comprises an axial lumen within the passive electrode, the axial lumen directing the fluid and having an inlet in communication with the electrically conducting fluid supply and an outlet in fluid communication with the active electrode.

34. The electrosurgical system as recited in claim 31, wherein the passive electrode is an outer tubular member, the shaft further comprising an insulating member, wherein the fluid delivery element comprises an axial passage between the insulating member and the passive electrode, the axial passage for directing the fluid and having an inlet in communication with the electrically conducting fluid supply and an outlet in fluid and electrical communication with the active electrode.

35. The electrosurgical system as recited in claim 25 wherein the fluid delivery element comprises a fluid supply instrument separate from the electrosurgical probe.

36. The electrosurgical system of claim 25 wherein the active electrode is comprised of a single active electrode disposed near the distal end of the shaft.

37. The electrosurgical system of claim 25 further comprising an insulating matrix surrounding and supporting the active electrode to electrically isolate a proximal portion of the active electrode from the electrically conducting fluid, the insulating matrix comprising an inorganic material.

38. The electrosurgical system of claim 25 further comprising a fluid supply outside of the body.

39. The electrosurgical system of claim 25 wherein the active electrode and the passive electrode are configured to effect the molecular breakdown of tissue in the immediate vicinity of the active electrode when high frequency voltage is applied between the active electrode and the passive electrode in the presence of electrically conducting fluid.

40. The electrosurgical system of claim 25 wherein the electrically conducting fluid is isotonic saline.

41. The electrosurgical system of claim 25 wherein the active electrode has a distal portion configured for generating high electric field intensities sufficient to cause molecular disintegration of a body structure at the target site.

42. The electrosurgical system of claim 25 wherein the active electrode comprises a surface or edge adapted for cutting of tissue.

43. The electrosurgical system of claim 25 wherein the probe comprises a lateral surface, the active electrode being positioned on the lateral surface such that the active electrode may be brought into at least partial contact or close proximity with the tissue surfaces which are substantially tangent to the electrosurgical probe.

44. The electrosurgical system of claim 25 wherein the passive electrode is adapted to have minimal tissue effect.

45. The electrosurgical system of claim 25 wherein the passive electrode is configured to provide a low current density relative to the active electrode.

46. The electrosurgical system of claim 25 wherein the passive electrode is substantially larger than said active electrode.

47. The electrosurgical system of claim 25 wherein said passive electrode is axially spaced away from the active electrode.

48. The electrosurgical system of claim 25 wherein said passive electrode is axially spaced from the active electrode a distance between 1 mm to 10 mm.

49. The system as recited in claim 25 wherein said passive electrode has an exposed surface area 2 to 7.5 times greater than an exposed surface area of the active electrode.

50. An electrosurgical system for applying electrical energy to a target site on a structure within or on a patient'"'"'s body, the system comprising:

a high frequency power supply;

an electrosurgical probe comprising a shaft having a proximal end and a distal end, an active electrode disposed near the distal end, said active electrode being electrically coupled to the high frequency power supply;

a passive electrode electrically coupled to the high frequency power supply; and

an electrically conducting fluid supply for supplying electrically conducting fluid to the target site such that the electrically conducting fluid generates a current flow path between the passive electrode and the active electrode wherein the electrically conductive fluid has an electrical conductivity equal to or greater than 0.2 mS per cm.

51. An electrosurgical system for applying electrical energy to a target site on a structure within or on a patient'"'"'s body, the system comprising:

a high frequency power supply;

an electrosurgical probe comprising a shaft having a proximal end and a distal end, an active electrode disposed near the distal end, said active electrode being electrically coupled to the power supply;

a passive electrode electrically coupled to the power supply; and

a fluid delivery element for directing electrically conducting fluid to the target site and to substantially surround the active electrode with electrically conducting fluid and to locate electrically conducting fluid between the active electrode and the passive electrode and between the active electrode and the target site wherein the electrically conductive fluid has an electrical conductivity equal to or greater than 0.2 mS per cm.

52. An electrosurgical system for applying electrical energy to a target site on a structure within or on a patient'"'"'s body, the system comprising:

a high frequency power supply;

an electrosurgical probe comprising a shaft having a proximal end and a distal end, an active electrode disposed near the distal end, said active electrode being electrically coupled to the high frequency power supply;

a passive electrode electrically coupled to the high frequency power supply; and

an electrically conducting fluid supply for supplying electrically conducting fluid to the target site from outside of the body such that the electrically conducting fluid generates a current flow path between the passive electrode and the active electrode.