HARD TISSUE ABLATION SYSTEM

• US 20070282323A1
• Filed: 05/29/2007
• Published: 12/06/2007
• Est. Priority Date: 05/30/2006
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Stalder, Kenneth R.
• Granted Patent: US 8,114,071 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• 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 2018/00166 Multiple lumina
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

An electrosurgical system and method for treating hard and soft tissues in the body comprises a shaft, a distal end section, an active electrode associated with the distal end section, a first fluid supply adapted to deliver a first electrically conductive fluid to the target site, and a second fluid supply adapted to deliver a second electrically conductive fluid to the active electrode. The system is adapted to treat a wide variety of hard tissues such as, for example, bones, calcified structures, calcified deposits, teeth, plaque, kidney-stones, gall-stones and other types of tissue by generating plasma in the vicinity of the active electrode, and applying the plasma to the tissue or structures.

Claims

1. An electrosurgical system for treating a target structure in a patient, comprising:

a device comprising a shaft, a distal end section, and an active electrode associated with the distal end section;

a first fluid supply adapted to deliver a first electrically conductive fluid in the vicinity of the target tissue; and

a second fluid supply adapted to deliver a second electrically conductive fluid to the active electrode.

2. The electrosurgical system of claim 1, wherein the first electrically conductive fluid is selected from the group consisting of:

isotonic saline, hypertonic saline, hypotonic saline, and Ringer'"'"'s lactate solution.

3. The electrosurgical system of claim 1, wherein the second electrically conductive fluid comprises sodium.

4. The electrosurgical system of claim 3, wherein the sodium bicarbonate fluid comprises a concentration of sodium bicarbonate in the range from about 0.15 normal to about 1.0 normal.

5. The electrosurgical system of claim 1, wherein a voltage supply is connected to the active electrode.

6. The electrosurgical system of claim 5, wherein plasma is generated upon application of the voltage to the active electrode.

7. The electrosurgical system of claim 1, wherein the shaft comprises an aspiration lumen adapted for removing fluids from the target site.

8. The electrosurgical system of claim 1, wherein the first and second electrically conductive fluids are delivered through a plurality of lumens on the shaft.

9. The electrosurgical system of claim 1, wherein the shaft comprises a return electrode.

10. The electrosurgical system of claim 9, wherein the second electrically conductive fluid comprises a current flow path between the active electrode and the return electrode.

11. The electrosurgical system of claim 1, wherein a valve controls the flow of the second electrically conductive fluid.

12. The system of claim 5, wherein an adjustable voltage generator regulates the voltage to cause at least one of:

molecular dissociation, heating, ablating, coagulating, cutting, removing, and modifications of the target tissue.

13. The system of claim 1, wherein the first electrically conductive fluid supply is delivered through a lumen integral with the device.

14. A method of treating a target structure in a body, comprising:

inserting an active electrode in the vicinity of the target structure in the presence of a first electrically conductive fluid, the first electrically conductive provided from outside of the body;

supplying a second electrically conductive fluid in the vicinity of the active electrode; and

applying electrical energy to the active electrode to treat the target structure.

15. The method of claim 14, wherein the step of applying electrical energy causes at least one of:

molecular dissociation, heating, ablating, coagulating, cutting, removing, and modifying of the target tissue.

16. The method of claim 14, wherein treating the target structure comprises treating a soft tissue selected from the group consisting of a ligament, a tendon, a bursa, a muscle, an intervertebral disc and cartilage.

17. The method of claim 14, wherein treating the target structure comprises treating a body structure selected from the group consisting of a bone, a calcified tissue, a mineralized tissue, a calcified deposit, kidney stones, gall stones, tartar deposits, a tooth, plaque.

18. The method of claim 14, wherein treating the target structure comprises treating a mineralized deposit in the body.

19. The method of claim 14, comprising treating a target tissue selected from the group consisting of an articular joint and an acromion.

20. The method of claim 14, comprising treating a soft tissue subsequent to treating a hard tissue.

21. The method of claim 14, wherein supplying the second electrically conductive fluid comprises supplying sodium bicarbonate solution.

22. The method of claim 14, wherein applying electrical energy generates a vapor layer from the second electrically conductive fluid.

23. The method of claim 14, wherein the first electrically conductive fluid comprises a first indicator that effects the color of the plasma from said first fluid.

24. The method of claim 14, comprising stopping the flow of the second electrically conductive fluid to the active electrode site when treating soft tissue.

26. The method of claim 23, wherein the first indicator comprises potassium chloride.

25. A method of treating a target structure in a body, comprising:

delivering to the target structure a first electrically conductive fluid supplied from outside of the body;

forming plasma from a second electrically conductive fluid; and

treating the structure with the plasma.

27. The method of claim 25, wherein the first electrically conductive fluid is selected from the group consisting of:

isotonic saline, hypertonic saline, hypotonic saline, and Ringer'"'"'s lactate solution.

28. The method of claim 25, wherein the second electrically conductive fluid comprises sodium bicarbonate.

29. The method of claim 25, wherein treating the target structure comprises treating a hard body structure selected from the group consisting of a bone, a calcified tissue, a mineralized tissue, a calcified deposit, kidney stones, gall stones, tartar deposits, a tooth, and plaque.

30. A method of modifying a structure in a body, comprising:

identifying a body structure in a patient;

delivering a first electrically conductive fluid from outside the body to the tissue;

selecting a second electrically conductive fluid effective in treating said body structure, directing the second electrically conductive fluid to an active electrode in the vicinity of the body structure; and

applying a radio-frequency voltage to the active electrode in the presence of the second electrically conductive fluid such that the body structure is modified.

31. The method of claim 30, wherein identifying the structure comprises identifying a hard body structure selected from the group consisting of a bone, a calcified tissue, a mineralized tissue, a calcified deposit, kidney stones, gall stones, tartar deposits, a tooth, plaque.

32. The method of claim 30, wherein identifying the structure comprises identifying a soft tissue selected from the group consisting of a ligament, a tendon, a muscle, cartilage, and an intervertebral disc.

33. The method of claim 30, wherein delivering first electrically conductive fluid comprises flooding the structure with an electrically conductive fluid selected from the group consisting of:

isotonic saline, hypertonic saline, hypotonic saline, and Ringer'"'"'s lactate solution.

34. The method of claim 30, wherein directing a second electrically conductive fluid comprises directing a solution of sodium bicarbonate to the active electrode.

35. An electrosurgical apparatus for treating a target structure in a patient, comprising:

a device comprising a shaft, a distal end section, and an active electrode associated with the distal end section; and

a fluid source adapted to deliver a sodium bicarbonate solution in the vicinity of the active electrode.

36. The electrosurgical system of claim 35, wherein the sodium bicarbonate solution comprises from about 0.15 normal to about 1.0 normal sodium bicarbonate.

37. The electrosurgical system of claim 35, wherein a voltage supply is connected to the active electrode.

38. The electrosurgical system of claim 37, wherein plasma is generated off the active electrode upon application of the voltage to the active electrode.

39. The electrosurgical system of claim 37, wherein the sodium bicarbonate solution is delivered through a lumen on the shaft.

40. The electrosurgical system of claim 37, wherein the shaft comprises a return electrode.

41. The electrosurgical system of claim 40, comprising a current flow path between the active electrode and the return electrode established by the presence of said sodium bicarbonate solution.