Endoscopic surgical instrument

• US 5,662,680 A
• Filed: 10/28/1994
• Issued: 09/02/1997
• Est. Priority Date: 10/18/1991
• Status: Expired due to Fees

• Current Assignee: Ashvin H. Desai
• Original Assignee: Ashvin H. Desai
• Inventors: Desai, Ashvin H.
• Primary Examiner(s): Brown, Michael A.
• Application Number:
  US08/331,046
• Time in Patent Office: 1,040 Days
• Field of Search: 606/210, 606/39-41, 606/45-46, 604/21, 604/27-30, 604/32, 604/33, 604/34, 604/35, 604/404, 604/167, 604/294, 600/120, 600/10
• US Class Current: 606/210
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 2018/0091 Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• 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 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61M 1/772 operating alternately
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 Photodynamic therapy, i.e. excitation of an agent

Abstract

An improved electrode apparatus for use with an endoscopic surgical instrument provides an adjustable volume of tissue ablation and may be used with an RF energy source in either monopolar or bipolar output mode. The electrode apparatus may be used in any endoscopic surgical application, and provides a new method for any endoscopic treatment involving soft tissue ablation, including hysteroscopic and laparoscopic treatment of uterine fibroids/myomas.

Claims

1. An endoscopic surgical instrument comprising:

a) a housing;

b) a single access conduit being disposed within said housing, and having a proximal conduit end and a distal conduit end;

c) an irrigation port formed in said housing;

d) an evacuation port formed in said housing, each of said irrigation and said evacuation ports being in fluid communication, through independent valves, with said proximal conduit end of said single access conduit;

e) an aperture and a closure therefor, said aperture being formed in said housing, and said closure being openable to allow the ingress of microsurgical instrumentation into said proximal conduit end of said single access conduit; and

f) RF electrode means insertable into said aperture and into said single access conduit and having a length so as to protrude beyond said distal conduit end of said single access conduit, said RF electrode means for engaging a body tissue portion, and for simultaneously ablating said body tissue portion and measuring an impedance value associated with said body tissue portion, said RF electrode means including at least three electrodes in a non-linear pattern.

2. An endoscopic surgical instrument as recited in claim 1, wherein said RF electrode means includes electrode movement means for extending and retracting one or more of said electrodes beyond said distal end.

3. An endoscopic surgical instrument as recited in claim 2, wherein each of said electrodes has a distal electrode end, and wherein said electrode means further includes electrode diverting means for causing said distal electrode end of one or more of said electrodes to move away from one or more of the other said electrodes.

4. An endoscopic surgical instrument as recited in claim 3 wherein said diverting means includes a conically tapered guide for deflecting said electrodes as said electrodes are extended by said movement means, whereby as said electrodes are extended, said distal electrode ends of said electrodes are spaced further apart.

5. An endoscopic surgical instrument as recited in claim 3 wherein said diverting means includes

a) one or more of said electrodes being memory electrodes constructed of memory wire and preconfigured in a non-linear shape;

and

b) electrode casing means having one or more guiding passageways with a proximal opening and a distal opening for guiding said memory electrodes;

whereby when one of said memory electrodes has a portion extended by said movement means beyond said distal opening of said casing means, said portion returns to the pre-configured shape.

6. An endoscopic surgical instrument as recited in claim 1 wherein said RF electrode means further includes

a) casing means for guiding said electrodes, said casing means with a proximal opening and a distal opening;

b) insulation means for electrically insulating portions of said electrodes; and

c) said electrodes including two usage categories including one or more first type electrodes, and one or more second type electrodes, where active RF energy is passed on one type of electrodes and the other type is used for an electrical return path.

7. An endoscopic instrument as recited in claim 6 wherein said RF electrode means further includes electrode diverting means for causing a portion of one or more of said first type electrodes to move away from one or more of said second type electrodes.

8. An endoscopic surgical instrument as recited in claim 7 wherein said electrode diverting means includes

said casing means having a tapered extension protruding from said distal end,

whereby said portions of one or more of said first type electrodes protruding from said distal end are deflected.

9. An endoscopic surgical instrument as recited in claim 7 wherein said electrode diverting means includes

one or more of said first type electrodes being memory electrodes constructed of memory wire and preconfigured in a non-linear shape, whereby when a said memory electrode has a portion extended by said movement means beyond said distal end of said casing means, said portion returns to said non-linear shape and said electrode is deflected.

10. An endoscopic surgical instrument as recited in claim 8 wherein

said diverting means is a conically tapered section having a central axis and extending from said casing means so as to deflect said electrodes of said first type outward and away from said central axis when said electrodes are extended by said movement means, and said conically tapered section having a said passageway therethrough along said central axis for passage of an electrode of said second type,

whereby as said electrodes are extended by said movement means an increasingly larger area of ablation is achievable when RF energy is applied to said electrodes, passing from said electrodes of said first type, through body tissue and to said electrode of said second type.

11. An RF electrode assembly as recited in claim 7 wherein

said diverting means is a conically tapered section having a central axis and extending from said casing means so as to deflect said electrodes of said first type outward and away from said central axis when said electrodes are extended by said movement means, and said conically tapered section having a passageway therethrough along said central axis for passage of an electrode of said second type,

whereby as said electrodes are extended by said movement means an increasingly larger area of ablation is achievable when RF energy is applied to said electrodes, passing from said electrodes of said first type, through body tissue and to said electrode of said second type.

12. An RF electrode assembly for ablating a body tissue portion, comprising:

a) at least three electrodes arranged in a non-linear pattern; and

b) electrode movement means for extending and retracting one or more of said electrodes.

13. An RF electrode assembly as recited in claim 12 wherein each of said electrodes has a proximal electrode end and a distal electrode end, and said RF electrode assembly further comprising:

electrode diverting means for causing said distal electrode end of one or more of said electrodes to move away from one or more of the other said electrodes.

14. An RF electrode assembly as recited in claim 13 wherein said diverting means includes a conically tapered guide for deflecting said electrodes as said electrodes are extended by said movement means, whereby as said electrodes are extended, tips of said electrodes are spaced further apart.

15. An RF electrode assembly as recited in claim 13 wherein said diverting means includes

a) one or more of said electrodes being memory electrodes constructed of memory wire and preconfigured in a non-linear shape;

and

b) electrode casing means having one or more guiding passageways with a proximal opening and a distal opening for guiding said memory electrodes,

whereby when one of said memory electrodes has a portion extended by said movement means beyond said distal end of said casing means, said portion returns to the pre-configured shape.

16. An RF electrode assembly as recited in claim 12 wherein said RF electrode means further includes

a) casing means for guiding said electrodes, said casing means with a proximal opening and a distal opening;

b) insulation means for electrically insulating portions of said electrodes; and

c) said electrodes including two usage categories including one or more type A electrodes, and one or more type B electrodes, where active RF energy is passed on one of the types and the other type is used for an electrical return path.

17. An RF electrode assembly as recited in claim 16 wherein said electrode means further includes electrode diverting means for causing a portion of one or more of said electrodes to move away from one or more of the other electrodes.

18. An RF electrode assembly as recited in claim 17 wherein said electrode diverting means includes

said casing means having a tapered extension protruding from said distal end,

whereby said portion of one or more of said electrodes protruding from said distal end are deflected.

19. An RF electrode assembly as recited in claim 17 wherein said electrode diverting means includes

one or more of said electrodes being memory electrodes constructed of memory wire and preconfigured in a non-linear shape,

whereby said memory electrode has a portion extended by said movement means beyond said distal end of said casing means, said portion returns to said non-linear shape and said electrode is deflected.

20. A method for soft tissue ablation/removal, comprising:

(a) directing an endoscopic instrument including RF electrode means to the target tissue;

(b) advancing said RF electrode means into said tissue, said electrode means comprising at least three electrodes arranged in a non-linear pattern to engage a volume of tissue between said electrodes;

(c) providing RF energy to said electrodes, thereby ablating/removing said tissue.