ELECTROSURGICAL DEVICE AND METHODS

• US 20070027449A1
• Filed: 07/14/2006
• Published: 02/01/2007
• Est. Priority Date: 03/05/2002
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Baylis Medical Company Inc. (Boston Scientific Corporation)
• Inventors: Godara, Neil, Hillier, Taylor
• Granted Patent: US 10,206,739 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• 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 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

A method and apparatus are disclosed for delivering energy substantially distal to an electrosurgical device. Embodiments of a device of the present invention may comprise an elongate member having one or more electrically insulated portions and a distal face comprising one or more electrically exposed conductive portions for delivering energy substantially distal to the elongate member. At least one of the one or more electrically insulated portions may extend from a proximal region of the elongate member to a distal end of the elongate member. In addition, a method is provided for creating a lesion at a target site within a body of a human or animal using an electrosurgical device. The method may comprise the steps of: inserting the electrosurgical device into the body such that the electrosurgical device is generally upstanding relative to the target site; and delivering energy from an energy source through a distal face of the electrosurgical device such that the energy is directed substantially distal to the distal face towards the target site.

Claims

1. An electrosurgical device comprising:

an elongate member having one or more electrically insulated portions and a distal face comprising one or more electrically exposed conductive portions for delivering energy substantially distal to the elongate member;

at least one of the one or more electrically insulated portions extending from a proximal region of the elongate member to the distal face.

2. The device of claim 1, wherein the distal face of the elongate member is substantially rounded.

3. The device of claim 1, wherein the distal face of the elongate member is substantially flat.

4. The device of claim 1 wherein the one or more electrically exposed conductive portions are not symmetrical about an axis of the elongate member.

5. The device of claim 1, wherein the elongate member defines at least one lumen.

6. The device of claim 1, further comprising a means for cooling at least a portion of the elongate member.

7. The device of claim 6, wherein the means for cooling comprises at least one internal tube for at least one of delivering a fluid to or removing a fluid from a distal region of the elongate member.

8. The device of claim 7, wherein the means for cooling further comprises a further internal tube for at least one of delivering a fluid to or removing a fluid from the distal region.

9. The device of claim 6, wherein the means for cooling comprises at least one thermoelectric circuit.

10. The device of claim 1, further comprising one or more temperature sensors.

11. The device of claim 10, wherein at least one of the one or more temperature sensors is at a distal region of the elongate member.

12. The device of claim 10, wherein at least one of the one or more temperature sensors extends from a distal region of the elongate member.

13. The device of claim 10, wherein at least one of the one or more temperature sensors is selected from the group consisting of a thermocouple, a thermistor, an optical fluorescence sensor and a thermometer.

14. The device of claim 1, further comprising a sensor for measuring impedance.

15. The device of claim 1, further comprising a sensor for measuring pressure.

16. The device of claim 1, wherein the elongate member comprises an electrically conductive shaft and wherein the one or more electrically insulated portions comprise electrically insulative material disposed on the surface of the shaft.

17. The device of claim 1, wherein the elongate member comprises an electrically non-conductive shaft and wherein the elongate member further comprises at least one electrical conductor for coupling the one or more electrically exposed conductive portions to an energy source.

18. A kit comprising:

an elongate member having one or more electrically insulated portions and a distal face comprising one or more electrically exposed conductive portions for delivering energy substantially distal to the elongate member, at least one of the one or more electrically insulated portions extending from a proximal region of the elongate member to the distal face; and

a cannula for facilitating insertion of the device into a patient'"'"'s body.

19. The kit of claim 18, further comprising an obturator for facilitating insertion of the cannula into the patient'"'"'s body.

20. A system comprising:

an elongate member having one or more electrically insulated portions and a distal face comprising one or more electrically exposed conductive portions for delivering energy substantially distal to the elongate member, at least one of the one or more electrically insulated portions extending from a proximal region of the elongate member to the distal face; and

an energy source for delivering energy to the one or more electrically exposed conductive portions.

21. The system of claim 20, further comprising at least one cooling source for cooling at least a portion of the elongate member.

22. A method for creating a lesion at a target site within a body of a human or animal using an electrosurgical device, the method comprising:

inserting the electrosurgical device into the body such that the electrosurgical device is generally upstanding relative to the target site; and

delivering energy from an energy source solely through a distal face of the electrosurgical device to the target site for creating the lesion at the target site.

23. The method of claim 22, wherein the electrosurgical device is inserted at an angle ranging between about 80°

to about 100°

relative to the target site.

24. The method of claim 22, wherein inserting the electrosurgical device is facilitated by visualizing the electrosurgical device along a longitudinal axis of the electrosurgical device.

25. The method of claim 24, wherein the electrosurgical device is visualized using a medical imaging modality selected from the group consisting of x-ray/radiographic imaging, ultrasound imaging and magnetic resonance imaging.

26. The method of claim 22, wherein the electrosurgical device is inserted to the target site using a gun-barrel approach.

27. The method of claim 22, wherein the electrosurgical device is inserted such that at least a portion of the target site is generally distal to the distal face of the electrosurgical device.

28. The method of claim 22, wherein at least a majority of the lesion forms substantially distal to the device.

29. The method of claim 22, further comprising, in any order, the step of cooling the distal face.

30. The method of claim 29, wherein the distal face is cooled by circulation of a fluid within the electrosurgical device.

31. The method of claim 29, wherein the step of cooling comprises cooling the distal face such that the lesion is spaced from the electrosurgical device.

32. The method of claim 22, further comprising:

delivering energy to the target site to detect the presence or absence of at least one of a motor nerve and a sensory nerve within the target site.

33. The method of claim 22, wherein the target site comprises at least one neural structure.

34. The method of claim 33, wherein the neural structure comprises one or more medial branches of one or more dorsal ramus nerves.

35. The method of claim 34, wherein at least one of the one or more medial branches is located within a cervical region of a patient'"'"'s spine.

36. The method of claim 34, wherein at least one of the one or more medial branches is located within a thoracic region of a patient'"'"'s spine.

37. The method of claim 34, wherein at least one of the one or more medial branches is located within a lumbar region of a patient'"'"'s spine.

38. The method of claim 22, wherein the target site is located within a sacroiliac region of a patient'"'"'s body.

39. The method of claim 38, wherein the target site is located adjacent to a posterior sacral foramen.

40. The method of claim 38, wherein the target site is located within a sacral neural crescent.

41. The method of claim 22, wherein the step of inserting the electrosurgical device comprises:

inserting an introducer apparatus into the body, the introducer apparatus comprising an obturator disposed within a lumen of a cannula;

positioning a distal end of the introducer apparatus at the target site;

withdrawing the obturator from the lumen of the cannula; and

inserting the electrosurgical device into the lumen of the cannula.

42. The method of claim 22, wherein energy is delivered in order to treat pain.

43. The method of claim 22, wherein the energy is electrical energy in the radiofrequency range.

44. A method for directing energy towards a target site within a body of a human or animal using an electrosurgical device having a longitudinal axis, the method comprising:

inserting the electrosurgical device into the body such that the electrosurgical device is generally upstanding relative to the target site; and

delivering energy from an energy source through a distal face of the electrosurgical device such that the energy is directed substantially distal to the distal face towards the target site.