ELECTROSURGICAL METHODS AND SYSTEMS

• US 20140257269A1
• Filed: 03/07/2013
• Published: 09/11/2014
• Est. Priority Date: 03/07/2013
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Gaspredes, Jonathan, Yuan, David, Ryan, Thomas P.
• Granted Patent: US 9,713,489 B2
• Time in Patent Office: Days
• US Class Current: 606/34
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00767 Voltage
• 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 2018/00988 Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter

Abstract

Electrosurgical methods and systems. At least some of the illustrative embodiments are methods including maintaining plasma proximate to an active electrode in a first energy range, and a second energy range. During periods when plasma is proximate to the active electrode, the illustrative method may include controlling flow of fluid drawn into an aperture of an electrosurgical wand, and in some situations increasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue, and in other cases decreasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue. Further, during periods when plasma is proximate to the active electrode, the illustrative method may include providing output energy at a default energy setpoint, and then providing output energy at a second energy setpoint.

Claims

1. An electrosurgical method comprising:

maintaining plasma proximate to an active electrode of an electrosurgical wand, the plasma created based on delivery of output energy to the active electrode by an electrosurgical controller, the output energy within a predetermined first energy range, and during periods of time when output energy is being delivered within the first energy range;

providing output energy at a first default energy setpoint by the electrosurgical controller, the first default energy setpoint within the first energy range; and

then

providing output energy at a second energy setpoint by the electrosurgical controller, the second energy setpoint different than the first default energy setpoint, the second energy setpoint within the first energy range, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

2. The electrosurgical method of claim 1 further comprising, after maintaining plasma based on output energy in the first energy range, maintaining plasma proximate to the active electrode based on delivery of output energy to the active electrode within a predetermined second energy range distinct from the first energy range, and maintaining the plasma based on output energy in the second energy range responsive to the electrosurgical controller receiving a command.

3. The electrosurgical method of claim 2 wherein during periods of time when output energy is being delivered within the second energy range:

providing output energy at a default energy setpoint by the electrosurgical controller, the second default energy setpoint within the second energy range; and

then

providing output energy at a third energy setpoint by the electrosurgical controller, the third energy setpoint different than the second default energy setpoint, the third energy setpoint within the second energy range, and implementing the third energy setpoint responsive to the electrosurgical controller receiving a command.

4. The electrosurgical method of claim 2:

wherein during periods of time output energy is being delivered within the first energy range;

controlling flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate; and

increasing flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue;

wherein during periods of time output energy is being delivered within the second energy range;

controlling flow of fluid drawn into the aperture at a second flow rate; and

decreasing flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue

5. The electrosurgical method of claim 4 wherein decreasing flow of fluid drawn into the aperture further comprises decreasing a flow setpoint responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

6. The electrosurgical method of claim 4:

wherein controlling flow of fluid drawn into the aperture at the second flow rate further comprises implementing open-loop flow control; and

wherein decreasing flow of fluid drawn into the aperture further comprises implementing closed-loop control of fluid flow responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

7. The electrosurgical method of claim 1 wherein the second energy setpoint is at least one selected from the group consisting of:

a higher output energy than the first default energy setpoint; and

a lower output energy than the first default energy setpoint.

8. The electrosurgical method of claim 1 wherein the electrosurgical controller receives the command by way of at least one selected from the group consisting of:

actuation of a foot pedal;

actuation of a button on the electrosurgical wand;

actuation of a button on the electrosurgical controller; and

manipulation of a graphical user interface on the electrosurgical controller.

9. The electrosurgical method of claim 1 further comprising, after providing output energy at the first default energy setpoint and providing output energy at the second energy setpoint, providing output energy at a third energy setpoint by the electrosurgical controller, the third energy setpoint different than the first default energy setpoint and the second energy setpoint, the third energy setpoint within the first energy range, and implementing the third energy setpoint responsive to the electrosurgical controller receiving a command.

10. The electrosurgical method of claim 1 wherein maintaining plasma associated with the first energy range further comprises:

providing output energy at a first default energy setpoint by the electrosurgical controller and controlling flow of fluid at a first flow setpoint; and

then

providing output energy at a second energy setpoint and controlling flow at a second flow setpoint, the second energy setpoint being within first energy range and being different than the first default energy setpoint, the second flow setpoint different than the first flow setpoint, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

11. The electrosurgical method of claim 1 further comprising:

detecting a clog condition by;

making an initial determination of a presence of a clog based on change of first monitored parameter; and

then

verifying presence of a clog based on a second monitored parameter distinct from the first monitored parameter.

12. The electrosurgical method of claim 11 wherein the monitored parameters are each at least one selected from the group consisting of:

impedance;

electrical current flow;

temperature of a tubing member;

presence of tubing wall pulsing of the tubing member;

effectiveness of control changes;

average power delivered to an electrode circuit.

13. The electrosurgical method of claim 1 further comprising, prior to maintaining plasma, measuring impedance of an electrode circuit that comprises the active electrode.

14. The electrosurgical method of claim 1 further comprising, during the maintaining, estimating remaining plasma time of the electrode circuit based on continued use in the first energy range.

15. An electrosurgical method comprising:

maintaining plasma proximate to an active electrode of an electrosurgical wand, the plasma created based on delivery of output energy to the active electrode by an electrosurgical controller, the output energy within a predetermined first energy range, and during periods of time when output energy is being delivered within the first energy range;

controlling flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate; and

increasing flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue;

maintaining plasma proximate to the active electrode, the plasma created based on delivery of output energy to the active electrode within a predetermined second energy range, the second energy range distinct from the first energy range, and during periods of time output energy is being delivered within the second energy range;

controlling flow of fluid drawn into the aperture at a second flow rate; and

decreasing flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

16. The electrosurgical method of claim 15 wherein decreasing flow of fluid drawn into the aperture further comprises decreasing a flow setpoint responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

17. The electrosurgical method of claim 15:

wherein controlling flow of fluid drawn into the aperture at the second flow rate further comprises implementing open-loop flow control; and

wherein decreasing flow of fluid drawn into the aperture further comprises implementing closed-loop flow control responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

18. The electrosurgical method of claim 15 wherein maintaining plasma associated with the first energy range further comprises:

providing output energy at a default energy setpoint by the electrosurgical controller, the default energy setpoint within the first energy range; and

then

providing output energy at a second energy setpoint by the electrosurgical controller, the second energy setpoint different than the default energy setpoint, the second energy setpoint within the first energy range, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

19. The electrosurgical method of claim 18 wherein the second energy setpoint is at least one selected from the group consisting of:

a higher output energy than the default energy setpoint; and

a lower output energy than the default energy setpoint.

20. The electrosurgical method of claim 18 wherein the controller receives the command by way of at least one selected from the group consisting of:

actuation of a foot pedal;

actuation of a button on the electrosurgical wand;

actuation of a button on the electrosurgical controller; and

manipulation of a graphical user interface on the electrosurgical controller.

21. The electrosurgical method of claim 18 further comprising, after providing output energy at the default energy setpoint and providing output energy at the second energy setpoint, providing output energy at a third energy setpoint by the electrosurgical controller, the third energy setpoint different than the default energy setpoint and the second energy setpoint, the third energy setpoint within the first energy range, and implementing the third energy setpoint responsive to the electrosurgical controller receiving a command.

22. The electrosurgical method of claim 15 wherein maintaining plasma associated with the first energy range further comprises:

providing output energy at a default energy setpoint by the electrosurgical controller and controlling flow of fluid at a first flow setpoint; and

then

providing output energy at a second energy setpoint and controlling flow at a second flow setpoint, the second energy setpoint being within first energy range and being different than the default energy setpoint, the second flow setpoint different than the first flow setpoint, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

23. The electrosurgical method of claim 15 further comprising delaying the delivery of output energy to the active electrode until at least the first flow rate of flow of fluid drawn into an aperture of the electrosurgical wand is established.

24. The electrosurgical method of claim 15 further comprising, prior to maintaining plasma, measuring impedance of an electrode circuit that comprises the active electrode.

25. An electrosurgical controller comprising:

a processor;

a memory coupled to the processor;

a voltage generator operatively coupled to the processor, the voltage generator comprising an active terminal;

a wand connector configured to couple to a connector of an electrosurgical wand, at least one electrical pin of the wand connector coupled to the active terminal of the voltage generator;

a peristaltic pump comprising a rotor coupled to an electric motor, the electric motor operatively coupled to the processor;

wherein the memory storing a program that, when executed by the processor, causes the processor to

command the voltage generator to deliver output energy to the active electrode of the electrosurgical wand, the output energy within a predetermined first energy range, and during periods of time when output energy is being delivered within the first energy range the program causes the processor to;

control flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate by control of the peristaltic pump;

detect periods of time when the active electrode is in operational relationship with tissue; and

increase speed of the peristaltic pump responsive to detection that the active electrode is in operational relationship with tissue;

command the voltage generator to deliver output energy to the active electrode within a predetermined second energy range, and during periods of time when output energy is being delivered within the second energy range the program causes the processor to;

control flow of fluid drawn into the aperture of the electrosurgical wand at a second flow rate by control of the peristaltic pump;

detect periods of time when the active electrode is in operational relationship with tissue; and

decrease speed of the peristaltic pump responsive to detection that the active electrode is in operational relationship with tissue.

26. The electrosurgical controller of claim 25 wherein when the processor decreases speed of the peristaltic pump, the program causes the processor to decrease a flow setpoint for the peristaltic pump responsive to detection that active electrode is in operational relationship with tissue.

27. The electrosurgical controller of claim 25:

wherein when the processor controls flow fluid drawn into the aperture at the second flow rate, the program causes the processor to implement open-loop flow control of peristaltic pump speed; and

wherein when the processor decreases speed of the peristaltic pump, the program causes the processor to implement closed-loop control of the peristaltic pump.

28. The electrosurgical controller of claim 25 wherein when the processor commands the voltage generator to deliver output energy in the first energy range, the program causes the processor to:

command delivery of output energy at a default energy setpoint, the default energy setpoint within the first energy range; and

then

command delivery of output energy at a second energy setpoint, the second energy setpoint different than the default energy setpoint, the second energy setpoint within the first energy range, and implementation responsive to the electrosurgical controller receiving a command.

29. The electrosurgical controller of claim 28 wherein the second energy setpoint is at least one selected from the group consisting of:

a higher output energy than the default energy setpoint; and

a lower output energy than the default energy setpoint.

30. The electrosurgical controller of claim 28 wherein after commanding delivery of output energy at the default energy setpoint and commanding delivery of output energy at the second energy setpoint, the program further causes the processor to command delivery of output energy at a third energy setpoint different than the default energy setpoint and the second energy setpoint, the third energy setpoint within the first energy range, and the commanding regarding the third energy setpoint responsive to the electrosurgical controller receiving a command.

31. The electrosurgical controller of claim 25 further comprising the memory storing a program that, when executed by the processor causes the processor to, prior commanding the voltage generator to deliver output energy within first or second energy range:

command the voltage generator to deliver output energy in a test energy range, the test energy range lower that the first and second energy ranges, and the test energy range insufficient to cause plasma formation at the active electrode; and

measure an indication of active electrode wear.

32. The electrosurgical controller of claim 31 wherein when the processor measures an indication of active electrode wear, the program causes the processor to measure impedance of a wand circuit comprising the active electrode.

33. The electrosurgical controller of claim 31 wherein the program further causes the processor to, during periods of time when the voltage generator provides output energy in the first or second energy range, estimate active electrode wear.

34. An electrosurgical controller comprising:

a processor;

a memory coupled to the processor;

a voltage generator operatively coupled to the processor, the voltage generator comprising an active terminal;

a wand connector configured to couple to a connector of an electrosurgical wand, at least one electrical pin of the wand connector coupled to the active terminal of the voltage generator;

a peristaltic pump comprising a rotor coupled to an electric motor, the electric motor operatively coupled to the processor;

wherein the memory storing a program that, when executed by the processor, causes the processor to;

command the voltage generator to provide output energy to the active terminal at a first default energy setpoint, the first default energy setpoint within a first energy range; and

then

command the voltage generator to provide output energy to the active terminal at a second energy setpoint, the second energy setpoint different than the first default energy setpoint, the second energy setpoint within the first energy range, and transitioning to the second energy setpoint responsive to the electrosurgical controller receiving a command.

35. The electrosurgical system of claim 34 wherein the program further causes the processor to:

detect a clog condition by causing the processor to;

make an initial determination of a presence of a clog based on change of first monitored parameter; and

then

verify presence of a clog based on a second monitored parameter distinct from the first monitored parameter.

36. The electrosurgical system of claim 35 wherein the monitored parameters are each at least one selected from the group consisting of:

impedance;

electrical current flow;

temperature of a tubing member;

presence of tubing wall pulsing of the tubing member;

effectiveness of control changes;

average power delivered to an electrode circuit.

37. The electrosurgical controller of claim 34 wherein after the processor commands the voltage generator to provide output energy in the first energy range, the program further causes the processor to command the voltage generator to provide output energy to the active electrode within a predetermined second energy range distinct from the first energy range.

38. The electrosurgical controller of claim 37 wherein during periods of time when the voltage generator provides output energy in the second energy range, the program further causes the processor to:

command the voltage generator to provide output energy at a second default energy setpoint, the second default energy setpoint within the second energy range; and

then

command the voltage generator to provide output energy at a third energy, the third energy setpoint different than the second default energy setpoint, and the third energy setpoint within the second energy range.

39. The electrosurgical controller of claim 37:

wherein during periods of time when the voltage generator provides output energy in the first energy range, the program causes the processor to;

control flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate by control of the peristaltic pump;

detect periods of time when the active electrode is in operational relationship with tissue; and

increase speed of the peristaltic pump responsive to detection that the active electrode is in operational relationship with tissue;

wherein during periods of time when the voltage generator provides output energy within the second energy range;

control flow of fluid drawn into the aperture of the electrosurgical wand at a second flow rate by control of the peristaltic pump;

detect periods of time when the active electrode is in operational relationship with tissue; and

decrease speed of the peristaltic pump responsive to detection that the active electrode is in operational relationship with tissue.

40. The electrosurgical controller of claim 39 wherein when the processor decreases speed of the peristaltic pump, the program causes the processor to decrease a flow setpoint responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

41. The electrosurgical controller of claim 39:

wherein when the processor controls flow fluid drawn into the aperture at the second flow rate, the program causes the processor to implement open-loop flow control of peristaltic pump speed; and

wherein when the processor decreases speed of the peristaltic pump, the program causes the processor to implement closed-loop control of the peristaltic pump.

42. The electrosurgical controller of claim 34 wherein the second energy setpoint is at least one selected from the group consisting of:

a higher output energy than the first default energy setpoint; and

a lower output energy than the first default energy setpoint.