Electrosurgical system for resection and ablation of tissue in electrically conductive fluids

• US 5,888,198 A
• Filed: 12/05/1996
• Issued: 03/30/1999
• Est. Priority Date: 01/07/1992
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Thapliyal, Hira V., Eggers, Philip E.
• Primary Examiner(s): Yasko, John D.
• Assistant Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/766,382
• Time in Patent Office: 845 Days
• Field of Search: 604/20-22, 604/113, 604/114, 604/27, 604/29, 604/30, 604/32, 604/35, 604/38, 606/28, 606/31, 606/41, 606/194
• US Class Current: 604/114
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00097 one of the thermometric elements being an electrode or the heating element
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00196 : reciprocating lengthwise
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• 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 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/0066 : without feedback, i.e. open loop control
• CPC Class Codes: A61B 2018/00678 : upper
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00821 : measured by a thermocouple
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00886 : Duration
• CPC Class Codes: A61B 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/1407 : Loop
• 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 2018/162 : located on the probe body
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61M 25/0133 : Tip steering devices
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0158 : with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia

Abstract

An electrosurgical system comprises an electrosurgical probe and an electrosurgical power supply for ablation and resection of soft tissue in the presence of electrically conductive fluids, such as isotonic saline. In one embodiment, the probe includes a shaft having an electrode array with a plurality of electrically isolated electrode terminals and a return electrode spaced proximally from the electrode array. The power supply includes a plurality of current limiting elements for limiting current based on impedance between the electrode terminals and the return electrode. By applying high frequency voltage to the electrode array, target tissue may be cut or ablated while heat dissipation through low impedance paths, such as saline, is minimized. The power supply has an operating frequency less than 400 kHz, usually about 100 kHz, for limiting current penetration into the tissue.

Claims

1. An electrosurgical system comprising an electrosurgical probe and an electrosurgical power supply, wherein the electrosurgical probe comprises:

a shaft having a proximal end and a distal end;

an electrode array disposed near the distal end of the shaft, said array including a plurality of electrically isolated electrode terminals disposed over a contact surface; and

a connector near the proximal end of the shaft for electrically coupling the electrode terminals individually to the electrosurgical power supply;

and wherein the electrosurgical power supply comprises;

a multiplicity of current limiting elements for independently limiting power to each of the electrode terminals based on impedance at the electrode terminals; and

a connector which mates with the shaft connector to electrically couple individual ones of said current limiting elements to individual ones of said electrode terminals.

2. An electrosurgical system as in claim 1, wherein the shaft is generally rigid over at least a portion of its length.

3. An electrosurgical system as in claim 1, further comprising a return electrode on the shaft and having an exposed surface area subtantially larger than an exposed surface area of each of the electrode terminals.

4. An electrosurgical system as in claim 3, wherein the return electrode is mounted over the exterior of the shaft and spaced proximally from the electrode array.

5. An electrosurgical system as in claim 1, wherein the electrode array is disposed over the distal tip of the shaft.

6. An electrosurgical system as in claim 1, wherein the electrode array is disposed over a lateral surface of the shaft.

7. An electrosurgical system as in claim 1, wherein the electrode array is arranged in a linear pattern to act as cutting blade.

8. An electrosurgical system as in claim 1, wherein the electrode array includes at least 6 electrode terminals.

9. An electrosurgical system as in claim 1, further comprising a temperature sensor located in the electrode array wherein the connector also electrically couples the temperature sensor to the high frequency voltage source.

10. An electrosurgical system as in claim 1, wherein the current limiting elements comprise current limiting resistors in parallel with each other and in series with a common voltage source.

11. An electrosurgical system as in claim 1, further comprising a temperature controller which adjusts output of the voltage source in response to a temperature set point and a measured temperature value received from the electrosurgical probe through the connector.

20. The system of claim 1 wherein the current limiting elements comprise a resonant circuit structure.

21. The system of claim 20 further comprising a return electrode, wherein the resonant circuit structure comprises a capacitor in series with each electrode terminal, and an inductor between each electrode terminal and the return electrode.

22. The system of claim 1 wherein the current limiting elements comprise inductors in series with each of the electrode terminals.

23. The system of claim 1 wherein the current limiting elements comprise capacitors in series with each of the electrode terminals.

12. An electrosurgical apparatus for applying high frequency electrical energy to a tissue structure within or on a patient'"'"'s body comprising:

an electrosurgical probe comprising a shaft with a proximal end, a distal end and at least one electrode terminal at or near the distal end;

an electrosurgical power supply coupled to the electrode terminal for applying a high frequency voltage to the electrode terminal, the power supply having an operating frequency of about 50 kHz to about 300 kHz; and

a connector coupling the electrode terminal to the power supply for applying voltage to a tissue structure at the operating frequency.

13. The system of claim 12 wherein the power supply has an operating frequency of about 100 kHz.

14. The system of claim 12 wherein the voltage is about 10 to 500 volts rms.

15. The system of claim 12 wherein the probe further comprises an array of electrically isolated electrode terminals.

16. The system of claim 12 further comprising a return electrode positioned on the shaft of the probe proximal to the electrode terminal.

17. The system of claim 15 further comprising a plurality of power limiting elements each coupled between one of the electrode terminals and the power supply, wherein the power limiting elements independently limit power applied to the electrode terminals based on impedance between the electrode terminals and a return electrode.

18. The system of claim 12 further comprising a source of electrically conducting fluid for delivering electrically conducting fluid to the target site.

19. The system of claim 18 wherein the electrically conducting fluid is isotonic saline.

24. An electrosurgical system for applying high frequency electrical energy to a tissue structure within or on a patient'"'"'s body comprising:

an electrosurgical probe comprising a shaft with a proximal end, a distal end and at least one electrode terminal at or near the distal end;

a return electrode;

an electrosurgical power supply coupled to the electrode terminal and the return electrode; and

means for applying a high frequency voltage difference between the electrode terminal and the return electrode in the presence of electrically conductive fluid such that electric current flows from the electrode terminal, through the electrically conductive fluid, to the return electrode.

25. The system of claim 24 wherein the electrode terminal comprises a single electrode disposed near the distal end of an instrument shaft.

26. The system of claim 24 wherein the electrode terminal includes an array of electrically isolated electrode terminals disposed near the distal end of an instrument shaft.

27. The system of claim 24 wherein the electrically conductive fluid is selected from the group consisting essentially of blood and electrolytic irrigants.

28. The system of claim 24 wherein the return electrode is spaced from the electrode terminal such that when the electrode terminal is brought adjacent a tissue structure immersed in electrically conductive fluid, the return electrode is spaced from the tissue structure and the electrically conductive fluid completes a conduction path between the electrode terminal and the return electrode.

29. The system of claim 24 further comprising an electrically insulating support at the distal tip of the probe, the electrode terminal being substantially surrounded by the insulating support, the insulating support comprising an inorganic material.

30. The system of claim 29 wherein the inorganic material is selected from the group consisting essentially of ceramic, glass and glass/ceramic compositions.

31. The system of claim 24 wherein the power supply has an operating frequency of less than 400 kHz.

32. The system of claim 24 wherein the power supply has an operating frequency of about 100 kHz.