ELECTROSURGICAL APPARATUS AND METHODS FOR LAPAROSCOPY

• US 20080132890A1
• Filed: 02/15/2008
• Published: 06/05/2008
• Est. Priority Date: 01/07/1992
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Ellsberry, Maria B.
• Granted Patent: US 7,824,405 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• 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 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 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/144 Wire
• 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 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

Electrosurgical methods and apparatus for treating tissue at a target site of a patient. An electrosurgical instrument includes a shaft, having a shaft distal end and a shaft proximal end, and an electrode assembly disposed at the shaft distal end. The electrode assembly includes at least one active electrode disposed on an electrode support. The instrument is adapted for coupling to a high frequency power supply or electrosurgical generator. Each active electrode is adapted for removing tissue from a target site and/or for localized coagulation of the target tissue. In one embodiment, the instrument is adapted for laparoscopic procedures.

Claims

1. An electrosurgical apparatus for treating tissue at a target site, comprising:

a shaft having a shaft distal end and a shaft proximal end;

an electrically insulating electrode support disposed at the shaft distal end; and

a plurality of active electrodes arranged substantially parallel to each other on the electrode support, wherein the shaft comprises an inner shaft and an outer shaft, wherein a proximal portion of the inner shaft lies within the outer shaft, and a distal portion of the inner shaft extends distally from the outer shaft.

2. The apparatus of claim 1, wherein the inner shaft comprises a metal tube.

3. The apparatus of claim 2, wherein the metal tube comprises stainless steel.

4. The apparatus of claim 2, wherein the metal tube has a curved distal end.

5. The apparatus of claim 1, wherein the outer shaft comprises an electrically insulating tube.

6. The apparatus of claim 5, wherein the outer shaft comprises a composite material, the composite material including a resin.

7. The apparatus of claim 6, wherein the composite material further includes a fibrous material.

8. The apparatus of claim 1, further comprising an electrically insulating sleeve ensheathing a length of the inner shaft, wherein the inner shaft includes at least one longitudinal, external groove.

9. The apparatus of claim 1, further comprising a return electrode.

10. The apparatus of claim 9, wherein the return electrode comprises an exposed, distal portion of the inner shaft.

11. The apparatus of claim 1, further comprising a fluid delivery unit.

12. The apparatus of claim 11, wherein the fluid delivery unit comprises a plurality of fluid delivery channels, each fluid delivery channel defined jointly by an external groove in the inner shaft and an inner surface of an electrically insulating sleeve, the sleeve ensheathing a length of the inner shaft.

13. The apparatus of claim 1, wherein each of the plurality of active electrodes comprises a first filament, a second filament, and a bridge portion suspended between the first filament and the second filament.

14. The apparatus of claim 1, wherein each of the plurality of active electrodes including a distal edge, wherein the distal edge is characterized by an acute angle in the range of from about 25°

to 85°

.

15. The apparatus of claim 13, wherein the electrode support includes a substantially planar treatment surface, and wherein each bridge portion is spaced from the treatment surface by a minimum distance in the range of from about 0.05 mm to 3 mm.

16. The apparatus of claim 13, wherein the electrode support includes a treatment surface and a recess within the treatment surface, and each bridge portion spans the recess.

17. The apparatus of claim 16, wherein the treatment surface is bisected by the recess.

18. The apparatus of claim 1, wherein the electrode support comprises a ceramic.

19. The apparatus of claim 16, further comprising an aspiration unit adapted for aspirating excess or unwanted materials from a working end of the apparatus or from a surgical site.

20. The apparatus of claim 19, wherein the aspiration unit includes an aspiration port, and wherein the aspiration port lies within the recess.

21. The apparatus of claim 1, further comprising a connection block adapted for coupling the plurality of active electrodes to a high frequency power supply, wherein each of the plurality of active electrodes comprises a bridge portion, a first filament, and a second filament, and wherein at least one of the first filament and the second filament is coupled to the connection block.

22. An electrosurgical instrument, comprising:

a shaft having a shaft distal end, the shaft distal end having a plurality of longitudinal, external grooves;

an electrode assembly disposed at the shaft distal end; and

an electrically insulating sheath external to the shaft distal end, the sheath and the plurality of grooves jointly defining a corresponding plurality of fluid delivery channels external to the shaft distal end, each of the plurality of fluid delivery channels adapted as a fluid conduit.

23. The instrument of claim 22, wherein the electrically insulating sheath comprises a heat shrink tube.

24. The instrument of claim 22, wherein the electrode assembly comprises an electrically insulating electrode support having a treatment surface, and at least one active electrode disposed on the treatment surface.

25. The instrument of claim 24, wherein each active electrode includes a distal edge, each distal edge characterized as having an acute angle.

26. The instrument of claim 22, wherein the shaft distal end is curved.

27. A method of electrosurgically removing ectopic endometrial tissue of a patient, the method comprising:

a) providing an electrosurgical probe, the probe including an electrode assembly having at least one active electrode;

b) positioning the electrode assembly in at least close proximity to a target endometrial implant; and

c) applying a high frequency voltage between a return electrode and the at least one active electrode, wherein the voltage is effective in removing the endometrial implant with little or no damage to tissue underlying the endometrial implant.

28. The method of claim 27, wherein the electrode assembly includes a plurality of active electrodes, and wherein said step b) comprises positioning at least one of the plurality of active electrodes in at least close proximity to the endometrial implant.

29. The method of claim 27, wherein said step b) comprises advancing a working end of the probe towards the endometrial implant via a laparoscope.

30. The method of claim 27, wherein said step b) comprises advancing a working end of the probe towards the bowel, the ureter, the urinary bladder, or the ovaries of the patient.

31. The method of claim 28, wherein each of the plurality of active electrodes includes a bridge portion, the electrode assembly configured such that each of the bridge portions are substantially parallel to each other, and wherein the electrode assembly is adapted for the removal of soft tissue in a controlled manner.

32. The method of claim 27, wherein the voltage applied in said step c) is effective in vaporizing the endometrial implant to form gaseous ablation by-products.

33. The method of claim 32, wherein the probe provided in said step a) includes an integral aspiration unit, and the method further comprises:

d) aspirating the gaseous ablation by-products from the vicinity of the target endometrial implant via the aspiration unit.