Interstitial cauterization of tissue volumes with electrosurgically deployed electrodes

• US 6,287,304 B1
• Filed: 10/15/1999
• Issued: 09/11/2001
• Est. Priority Date: 10/15/1999
• Status: Expired due to Fees

• Current Assignee: Intact Medical Corporation (Medtronic Plc)
• Original Assignee: Neothermia Corporation (Medtronic Plc)
• Inventors: Eggers, Philip E., Eggers, Eric A., Eggers, Andrew R.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US09/419,663
• Time in Patent Office: 697 Days
• Field of Search: 606/37-41, 606/45-50
• US Class Current: 606/37
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/1253 monopolar
• 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 2018/1475 Electrodes retractable in or deployable from a housing

Abstract

Apparatus system and method for cauterizing a volume of tissue wherein electrode assemblies are deployed from the forward end region of an instrument in conjunction with an electrosurgical cutting activity. Upon deployment to one or more deployed orientations, the electrodes assemblies are made biactive and the cauterization of tissue is carried out in a bipolar fashion. Following the procedure, the electrode assemblies are retracted toward the instrument and the instrument is withdrawn from the tissue region.

Claims

1. Apparatus for carrying out the cauterization of a volume of abnormal tissue of given peripheral extent utilizing the applied electrical outputs, including a return, of an electrosurgical generator, comprising:

a support member extending between a tip and a base region, having a forward end region extending along a longitudinal axis from said tip and positionable in an insertion mode into adjacency with said tissue volume peripheral extent, said forward end region having an electrode deployment portion;

a first electrode assembly, having a primary component of predetermined longitudinal dimension extending within said deployment portion in said insertion mode, deployable, in an electrosurgical cutting deployment mode, outwardly from said electrode deployment portion to a first cauterization orientation adjacent said tissue peripheral extent; and

an actuator and electrical circuit assembly extending along said support member from said base region, mechanically connected with said first electrode primary component for effecting said deployment thereof, and having a terminal assembly electrically connectable with said generator for coupling a first said applied output to said first electrode primary component providing, in operative association with a said return, electrosurgical cutting of tissue adjacent said peripheral extent during said electrosurgical cutting deployment mode, said terminal assembly conveying a second said applied output from said generator as a cauterization current to said first electrode assembly when said first electrode primary component is at said first cauterization orientation.

2. The apparatus of claim 1 including:

a second electrode assembly having a primary component of predetermined longitudinal dimension extending within said electrode deployment portion in said insertion mode, deployable in an electrosurgical cutting deployment mode, outwardly from said electrode deployment portion to a second cauterization orientation adjacent said tissue peripheral extent and spaced a cauterization distance from said first electrode assembly when at said first cauterization orientation; and

said actuator and electrical circuit assembly is mechanically connected with said second electrode assembly for effecting said deployment thereof, and said terminal assembly is configured for coupling said first applied output to said second electrode primary component during an electrosurgical cutting deployment mode.

3. The apparatus of claim 2 in which:

said actuator and electrical circuit assembly is configured for coupling said second applied output across said first and second electrode assemblies when said second electrode assembly is at said second cauterization orientation and said first electrode assembly is at said first cauterization orientation to effect passage of said cauterization current between said first and said second electrode assemblies.

4. The apparatus of claim 1 including:

a return electrode mounted upon said support member at a location for electrical coupling association with said tissue; and

said actuator and electrical circuit assembly terminal assembly is configured for coupling said return to said return electrode during said electrosurgical cutting deployment mode.

5. The apparatus of claim 4 in which said actuator and electrical circuit assembly terminal assembly is configured for coupling said second applied output across said first electrode assembly and said return electrode when said first electrode assembly is in said first cauterization orientation.

6. The apparatus of claim 5 in which said return electrode is positioned at said forward end region.

7. The apparatus of claim 1 in which:

said first electrode assembly includes a secondary electrode electrically insulated from and deployable with said first electrode assembly primary component to said first cauterization orientation and exhibiting an electrically conductive surface of area extent substantially greater than the corresponding electrically conductive surface area extent of said first electrode assembly primary component; and

said actuator and electrical circuit assembly effects deployment of said secondary electrode with said first electrode assembly primary component and said terminal assembly conveys said second applied output to said secondary electrode.

8. The apparatus of claim 1 in which:

said forward end region electrode deployment portion is outwardly open, extending along said forward end region between a forward location adjacent to said tip and a rearward location;

a first electrode primary component is thin and elongate, having a distal end connected with said support member at a connection location adjacent said forward location and extending an arch defining distance beyond said rearward location; and

said actuator and electrical circuit assembly is configured to mechanically deploy said first electrode primary component by urging it forwardly in compression to effect movement generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending between said forward location and said rearward location.

9. The apparatus of claim 8 in which said first electrode assembly comprises:

a thin membranous flexible secondary electrode support, suspended from said first electrode primary component substantially between said forward location and said rearward location and having panels defined by spaced apart slots;

a first secondary electrode provided as an electrically conductive surface supported upon said support panels and coupled with said terminal assembly for receiving said second applied output; and

said secondary electrode being foldably nested within said electrode deployment portion during said insertion mode; and

depending from said primary component toward said deployment portion when said primary component is in said first cauterization orientation.

10. The apparatus of claim 9 in which:

said secondary electrode support includes an edge region and exhibits a predetermined thickness;

said first electrode assembly primary component is provided as a tube with an internal cavity of given principal dimension and having an elongate slot therein of width corresponding with said predetermined thickness; and

said secondary electrode support edge region extends through said slot and is retained within said internal cavity.

11. The apparatus of claim 10 in which:

said secondary electrode support edge region is of border dimension less than said given principal dimension, has an edge region thickness greater than said slot width, and is slideably retained within said tube internal cavity.

12. The apparatus of claim 9 in which said secondary electrode support panels are configured with edges defined by said slots which slope toward said rearward location an amount effective to induce a wrapping thereof about said forward end region when said support member is withdrawn from adjacency with said tissue volume.

13. The apparatus of claim 8 in which said first electrode assembly is electrically insulated from said support member adjacent said forward location and adjacent said rearward location.

14. The apparatus of claim 8 in which:

said support member includes a deflector guide component located within said electrode deployment portion intermediate said forward location and said rearward location; and

said first electrode primary component is positioned in freely abutting outwardly biased relationship with said deflector guide component during said insertion mode.

15. The apparatus of claim 1 in which:

said support member electrode deployment portion comprises a guidance port defining a guidance channel having a guidance translation extending generally transversely outwardly from said longitudinal axis; and

said first electrode assembly primary component comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and actuable for deployment through said guidance port during said electrosurgical cutting deployment mode.

16. The apparatus of claim 1 in which:

said support member electrode deployment portion comprises a guidance port in communication with a guidance channel with a guidance translation extending generally forwardly from said tip; and

said first electrode assembly primary component comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable generally forwardly from said tip through said guidance port to said first cauterization position.

17. The apparatus of claim 16 in which said first electrode assembly primary component, when deployed to said first cauterization position, is upwardly angularly oriented an angle, θ

, with respect to said longitudinal axis; and

said angle, θ

, is within a range of about 5°

to 90°

.

18. A system for carrying out the cauterization of a volume of abnormal tissue, said abnormal tissue exhibiting a given peripheral extent, comprising:

an electrosurgical generator assembly having an electrosurgical return, responsive to a first control input to generate a first current defined output for carrying out electrosurgical cutting, responsive to a second control input to generate a second current defined output for carrying out cauterization and having an electrosurgical return;

a support member extending between a tip and a base region, having a forward end region extending along a longitudinal axis from said tip and positionable in an insertion mode into adjacency with said tissue volume peripheral extent, and having an electrode deployment portion adjacent said tip,

a first electrode assembly having a first primary component of predetermined longitudinal dimension, extending within said support member deployment portion during said insertion mode, deployable to move outwardly from said electrode deployment portion to a first cauterization orientation adjacent said tissue peripheral extent;

an actuator assembly extending along said support member from said base region, mechanically connected with said first electrode assembly and actuable for effecting the said deployment thereof; and

a control assembly in electrical communication with said electrosurgical generator assembly and said first electrode assembly, actuable in correspondence with said first electrode assembly deployment to effect derivation of said first control input and the application of said first current defined output to said first electrode assembly first primary component in electrical association with said electrosurgical return in correspondence with said first electrode assembly deployment toward said first cauterization orientation, subsequently actuable to effect derivation of said second control input and the application of said second current defined output to said first electrode assembly when said first electrode assembly is in said cauterization orientation.

19. The system of claim 18 including:

a second electrode assembly having a second primary component of predetermined longitudinal dimension extending within said electrode deployment portion during said insertion mode, deployable to move outwardly from said electrode deployment portion to a second cauterization orientation adjacent said tissue peripheral extent and spaced from said first electrode assembly when said first electrode assembly is at said first cauterization orientation;

said actuator assembly is mechanically connected with said second electrode assembly and actuable for effecting the said deployment thereof; and

said control assembly is in electrical communication with said second electrode assembly, actuable in the presence of said first control input to effect application of said first current defined output to said second electrode assembly second primary component in electrical association with said electrosurgical return in correspondence with said second electrode assembly deployment toward said second cauterization orientation.

20. The system of claim 19 in which:

said control assembly, in correspondence with said subsequent actuation, is configured for coupling said second current defined output across said first and second electrode assemblies to carry out cauterization of said abnormal tissue.

21. The system of claim 19 in which:

said first electrode assembly includes a first secondary electrode electrically isolated from and deployable with said first electrode assembly first primary component to said first cauterization orientation and exhibiting an electrically conductive surface of surface area extent substantially greater than the corresponding surface area extent of said first primary component;

said second electrode assembly includes a second secondary electrode electrically isolated from and deployable with said second electrode assembly second primary component to said second cauterization orientation and exhibiting an electrically conductive surface of surface area extent substantially greater than the corresponding surface area extent of said second primary component;

said actuator assembly actuator effects said first and second secondary electrode deployment; and

said control assembly, in correspondence with said subsequent actuation, is configured for coupling said second current defined output across said first and second secondary electrodes to carry out cauterization of said abnonnal tissue.

22. The system of claim 18 including:

a return electrode mounted upon said support member at a location in electrical coupling association with said tissue when said first electrode assembly is deployed toward said first cauterization orientation; and

said control assembly is responsive to apply said electrosurgical return to said return electrode when said first electrode assembly is deployed toward said first cauterization orientation.

23. The system of claim 22 in which said control assembly is responsive to apply said second current defined output across said first electrode assemblies and said return electrode.

24. The system of claim 23 in which said return electrode is located in proximity to said forward end region.

25. The system of claim 18 in which:

said first electrode assembly includes a first secondary electrode electrically isolated from and deployable with said first electrode assembly first primary component to said cauterization orientation and exhibiting an electrically conductive surface of surface area extent substantially greater than the corresponding surface area extent of said first primary component;

said actuator assembly actuation effects said first secondary electrode deployment; and

said control assembly subsequent actuation effects application of said second current defined output to said first secondary electrode.

26. The system of claim 18 in which:

said support member electrode deployment portion is outwardly open, extending along said forward end region between a forward location adjacent to said tip and a rearward location;

said first electrode assembly first primary component is thin, elongate and resilient, having a distal end connected with said support member at a connection location adjacent said forward location and extending an arch defining distance beyond said rearward location; and

said actuator assembly is configured to deploy said first electrode first primary component by urging it forwardly in compression to effect movement thereof generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending between said forward location and said rearward location.

27. The system of claim 26 in which said first electrode assembly first primary component is electrically insulated from said support member adjacent said forward location and adjacent said rearward location.

28. The system of claim 26 in which:

said support member includes a deflector guide component located within said electrode deployment portion intermediate said forward location and said rearward location; and

said first electrode assembly first primary component is positioned in freely abutting outwardly biased relationship with said deflector guide component during said insertion mode.

29. The system of claim 26 in which:

said first electrode assembly includes an array of electrically conductive flat panel shaped first secondary electrodes, each having an outwardly disposed edge connected in electrically isolative association with said first electrode first primary component, said first secondary electrodes depending from said first electrode first primary component toward said deployment portion when said first electrode first primary component is in said first cauterization orientation, and being nestably retained within said support member electrode deployment portion during said insertion mode.

30. The system of claim 26 in which:

said first electrode assembly comprises;

a thin membranous flexible polymeric first secondary electrode support, suspended from said first primary component substantially between said forward location and said rearward location and having slot defined panels;

a first secondary electrode provided as an electrically conductive surface supported upon said first secondary electrode support panels; and

said first secondary electrode being foldably nested with said first secondary electrode support within said electrode deployment portion during said insertion mode, and depending from said first primary component toward said deployment portion when said first primary component is in said first cauterization orientation.

31. The system of claim 30 in which:

said first secondary electrode support includes an edge region and exhibits a predetermined thickness;

said first primary component is provided as a tube with an internal cavity of given principal dimension, and having an elongate slot therein of width corresponding with said predetermined thickness; and

said secondary electrode support edge region extends through said slot and is retained within said internal cavity.

32. The system of claim 31 in which:

said first secondary electrode support edge region is of border dimension less than said given principal dimension, has an edge region thickness greater than said slot width, and is slidably retained within said tube internal cavity.

33. The system of claim 30 in which said first secondary electrode support panels extend along said first primary component substantially from said forward location to said rearward location when said first primary component is within said deployment portion in said insertion mode.

34. The system of claim 30 in which said slot defined panels are configured with slot defined edges sloping toward said rearward location an amount effective to induce a wrapping thereof about said forward end region when said support member is withdrawn from adjacency with said tissue volume peripheral extent.

35. The system of claim 26 in which:

said first electrode assembly includes an array of thin, flexible electrically conductive first secondary electrodes each having an outer end connected in electrically isolative association with the first electrode first primary component and having an inner end connected within said deployment portion, said first secondary electrodes extending from said first electrode first primary component into said deployment portion when said first electrode first primary component is in said first cauterization orientation, and being retained within said support member electrode deployment portion during said insertion mode.

36. The system of claim 26 in which:

said support member includes an elongate mandrel mounted for rotation within said electrode deployment portion;

said first electrode assembly including a thin sheet-form electrically conductive secondary electrode having an arcuately shaped outer edge and inward edge connected with said mandrel, said secondary electrode being wound about said mandrel and retained within said electrode deployment portion during said insertion mode; and

said actuator assembly is mechanically connected with said mandrel and is actuable to rotate said mandrel to deploy said secondary electrode from said deployment portion.

37. The system of claim 26 in which:

said first electrode assembly includes a thin, elongate secondary electrode having a distal end connected with said support member at a connection location adjacent said forward location and extending a secondary arch defining distance less than said first electrode arch defining distance beyond said rearward location;

said actuation assembly is configured to deploy said secondary electrode by urging it forwardly in compression to effect movement thereof generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending substantially between said forward location and said rearward location; and

said control assembly is electrically coupled with said secondary electrode and is responsive to effect application of said second current defined output thereto.

38. The system of claim 18 in which:

said support member electrode deployment portion comprises a guidance port and a guidance channel having a guidance translation extending generally transversely outwardly from said longitudinal axis; and

said first electrode assembly first primary component comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable through said guidance port to said first cauterization orientation adjacent said tissue peripheral extent.

39. The apparatus of claim 18 in which:

said support member electrode deployment portion comprises a guidance port in communication with a guidance channel with a guidance translation extending generally forwardly from said tip; and

said first electrode assembly first primary component comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable generally forwardly from said tip through said guidance port to said first cauterization position.

40. The apparatus of claim 39 in which said first electrode assembly, when deployed to said first cauterization position, is upwardly angularly oriented an angle, θ

, with respect to said longitudinal axis; and

said angle, θ

, is within a range of about 5°

to 90°

.

41. The system of claim 18 in which:

said first electrode assembly first primary component is configured having predetermined length and principal cross sectional dimension;

said control assembly includes an electrical coding component mounted with said support member and exhibiting an electrical parameter corresponding with said predetermined dimension;

said electrosurgical generator includes a decoding circuit electrically coupled with said control assembly, responsive to electrically interrogate said electrical coding component to derive a corresponding selection signal, and is responsive to said selection signal to generate predetermined said first current defined output and second current defined output corresponding with said predetermined dimensions.

42. The system of claim 18 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined first temperature value condition to derive a first control condition, said electrosurgical generator further including a control logic circuit responsive to said first control condition to modulate said first current defined output in correspondence therewith.

43. The system of claim 18 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined second temperature value condition to derive a second control condition, to modulate said second current defined output in correspondence therewith.

44. The system of claim 18 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined third temperature value condition corresponding with the necrosis of said abnormal tissue to derive a third control condition, said generator including a control logic circuit responsive to said third control condition to terminate generation of said second current defined output.

45. The system of claim 18 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it;

said electrosurgical generator includes;

a display assembly responsive to a display input signal to provide a perceptible output cueing a procedure termination,

a temperature logic circuit responsive to said temperature output condition and a predetermined third temperature value condition corresponding with the necrosis of said abnormal tissue to derive a third control condition, and

a control logic circuit responsive to said third control condition to derive said display input signal.

46. A method for cauterizing targeted abnormal tissue of a patient, said tissue having a given volume and peripheral extent, comprising the steps of:

(a) providing an electrosurgical generator assembly having an electrosurgical return, controllable to generate a first current defined output for carrying out electrosurgical cutting of tissue, and to generate a second current defined output for carrying out the cauterization of said abnormal tissue;

(b) providing an instrument electrically coupled with said electrosurgical generator, having a support member extending between a tip and a base region, having a forward end region with first and second electrode assemblies having a nested orientation for movement of said forward end region with respect to said tissue, actuable for outward, spaced apart deployment from said forward end region to corresponding first and second deployed orientations and futher actuable to retract toward said nested orientation;

(c) positioning said instrument forward end region in adjacency with said tissue peripheral extent, with said first and second electrodes assemblies in said nested orientation;

(d) actuating said instrument to deploy said first electrode assembly outwardly to a first cauterizing orientation in adjacency with said tissue peripheral extent;

(e) simultaneously with said step (d) controlling said electrosurgical generator assembly to apply said first current defined output to said first electrode in electrical association with said return during said first electrode assembly deployment;

(f) actuating said instrument to deploy said second electrode assembly outwardly to a second cauterizing orientation spaced from said first cauterizing orientation and in adjacency with said tissue peripheral extent;

(g) simultaneously with said step (f), controlling said electrosurgical generator assembly to apply said first current defined output to said second electrode assembly in electrical association with said return during said second electrode assembly deployment;

(h) controlling said electrosurgical generator assembly to apply said second current defined output across said first and second electrode assemblies, for an interval effective to cauterize said abnormal tissue;

(i) actuating said instrument to retract said first electrode assembly toward said nested orientation;

(j) actuating said instrument to retract said second electrode assembly into said nested orientation; and

(k) removing said instrument forward end region from adjacency with said tissue peripheral extent.

47. The method of claim 46 wherein said steps (d) through (g) are carried out substantially simultaneously.

48. The method of claim 46 in which:

said electrosurgical return is provided as a patient return electrode having an extended surface area for atraumatic contact with tissue at a location remote from said targeted abnormal tissue;

including the step of;

positioning said patient return electrode in a skin contacting relationship with said patient, and

said steps (e) and (g) are carried out in electrosurgically monopolar fashion.

49. The method of claim 46 in which:

said electrosurgical return is provided comprising a return electrode mounted upon said support member at a location in electrical coupling association with said tissue when said forward end region is positioned in adjacency with said tissue peripheral extent; and

said steps (e) and (g) are carried out in electrosurgically monopolar fashion.

50. The method of claim 49 in which said step (h) is carried out by applying said second current defined output across said first electrode assembly and said return electrode and across said second electrode assembly and said return electrode.

51. The method of claim 50 in which said second current defined output is applied simultaneously across said first and second electrode assemblies and said return electrode.

52. The method of claim 46 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said step (h) application of said second current defined output is carried out until said temperature output condition corresponds with an effective cauterization of said abnormal tissue.

53. The method of claim 46 in which:

said steps (d) and (f) are carried out by deploying respective said first and second electrode assemblies to a sequence of incrementally outward said first and second cauterizing orientations from first to last; and

said step (h) is carried out following movement of said first and second electrode assemblies to each said incrementally outward orientation from first to last.

54. The method of claim 46 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said steps (e) and (g) include the steps of monitoring said temperature output condition and controlling said electrosurgical generator to maintain the temperature of tissue in contact with said first and second electrodes during said deployment thereof below about 75°

C.

55. A method for cauterizing targeted abnormal tissue of a patient, said tissue having a given volume and peripheral extent, comprising the steps of:

(a) providing an electrosurgical generator assembly having an electrosurgical return, controllable to generate a first current defined output for carrying out electrosurgical cutting of tissue, and to generate a second current defined output for carrying out the cauterization of said abnormal tissue;

(b) providing an instrument electrically coupled with said electrosurgical generator assembly, having a support member extending between a tip and a base region, having a forward end region with a deployable first electrode assembly having a nested orientation for movement of said forward end region with respect to said tissue, actuable for outward deployment from said forward end region to a cauterizing orientation and futher actuable to retract toward said nested orientation, and having a surface mounted electrode in electrical communication with said electrosurgical return mounted upon said support member at a location for electrical coupling association with said tissue;

(c) positioning said instrument forward end region in adjacency with said abnormal tissue peripheral extent, with said first electrode assembly in said nested orientation and said surface mounted electrode in said electrical coupling association with said tissue peripheral extent;

(d) actuating said instrument to deploy said first electrode assembly outwardly to said cauterizing orientation in adjacency with said abnormal tissue peripheral extent;

(e) simultaneously with said step (d), controlling said electrosurgical generator assembly to apply said first current defined output to said first electrode in electrical association with said electrosurgical return through said second electrode during said deployment;

(f) controlling said electrosurgical generator assembly to apply said second current defined output across said first electrode assembly and said surface mounted electrode for an interval effective to cauterize said abnormal tissue;

(g) actuating said instrument to retract said first electrode toward said nested orientation; and

(h) removing said instrument forward portion from adjacency with said tissue peripheral extent.

56. The method of claim 55 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said step (f) application of said second current defined output is carried out until said temperature output condition corresponds with an effective cauterization of said abnormal tissue.

57. The method of claim 55 in which:

said step (d) is carried out by deploying said first electrode assembly to a sequence of incrementally outward cauterizing orientations from first to last; and

said step (f) is carried out following movement of said first electrode assembly to each said incrementally outward orientation from first to last.

58. The method of claim 55 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said steps (e) includes the step of monitoring said temperature output condition and controlling said electrosurgical generator to maintain the temperature of said electrode below about 75°

C. during said deployment thereof.

59. Apparatus for carrying out the cauterization of a volume of tissue utilizing the applied electrical output, including a return, of an electrosurgical generator, comprising:

a support member extending between a tip and a rear region, having a forward end region extending along a longitudinal axis from said tip and positionable in an insertion mode at a location for the electrosurgical cutting of tissue, said forward end region having a first deployment assembly;

a first electrode of predetermined longitudinal dimension extending within said first deployment assembly in said insertion mode, deployable, in an electrosurgical cutting mode, outwardly from said electrode first deployment assembly to a first cauterization orientation for effecting cauterization of said volume of tissue; and

an actuator and electrical circuit assembly extending along said support member from said rear region, mechanically connected with said first electrode for effecting said deployment thereof, and having a terminal assembly connectable with said generator for coupling a first said applied output to said first electrode providing, in operative association with said return, localized electrosurgical cutting of said tissue in contact with said first electrode during said electrosurgical cutting mode, said terminal assembly conveying a second said applied output from said generator as a cauterization current to said first electrode when said first electrode is at said first cauterization orientation.

60. The apparatus of claim 59 including:

a second electrode of predetermined longitudinal dimension extending, during said insertion mode, within a second electrode deployment assembly of said forward end region spaced from said first electrode deployment assembly, the said second electrode being deployable in an electrosurgical cutting mode outwardly from said second electrode deployment assembly to a second cauterization orientation spaced a cauterization distance from said first electrode when at said first cauterization orientation; and

said actuator and electrical circuit assembly is mechanically connected with said second electrode for effecting said deployment thereof, and said terminal assembly is configured for coupling said first applied output to said second electrode during an electrosurgical cutting mode.

61. The apparatus of claim 60 in which:

said actuator and electrical circuit assembly is configured for coupling said second applied output across said first and second electrodes when said second electrode is at said second cauterization orientation and said first electrode is at said first cauterization orientation.

62. The apparatus of claim 61 including:

a third electrode of predetermined longitudinal dimension extending, during said insertion mode within a third electrode deployment assembly of said forward end region, spaced from said first and second electrode deployment assemblies, said third electrode being deployable in an electrosurgical cutting mode outwardly from said third electrode deployment assembly to a third cauterization orientation;

a fourth electrode of predetermined longitudinal dimension extending, during said insertion mode, within a fourth electrode deployment assembly of said forward end region, said fourth electrode deployment assembly being spaced from said third electrode deployment assembly, said fourth electrode being deployable in an electrosurgical cutting mode outwardly from said fourth electrode deployment assembly to a fourth cauterization orientation spaced a cauterization distance from said third electrode when at said third cauterization orientation; and

said actuator and electrical circuit assembly is mechanically connected with said third and fourth electrodes for effecting said deployment thereof, and said terminal assembly is configured for coupling said first applied output to said third and fourth electrodes during an electrosurgical cutting mode.

63. The apparatus of claim 62 in which:

said actuator and electrical circuit assembly is configured for coupling said second applied output across said third and fourth electrodes when said third electrode is at said third cauterization orientation and said fourth electrode is at said fourth cauterization orientation.

64. The apparatus of claim 63 in which:

said first, second, third and fourth electrode deployment assemblies are outwardly open, extending along said forward end region between a forward location adjacent said tip and a rearward location;

each said first, second, third and fourth electrodes is thin and elongate, having a distal end connected with said support member at a connection location adjacent said forward location and extending an arch defining distance beyond said rearward location; and

said actuator and electrical circuit assembly is configured to deploy each said first, second, third and fourth electrode by urging it forwardly in compression to effect movement generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending between said forward location and said rearward location.

65. The apparatus of claim 64 in which each said first, second, third and fourth electrode is electrically insulated from said support member adjacent said forward location and said rearward location.

66. The apparatus of claim 64 including:

a deflector guide component mounted within said support member forward end region and providing a component of said first, second, third and fourth deployment assemblies; and

each said first, second, third and fourth electrode is positioned in freely abutting outwardly biased relationship with said deflector guide component during said insertion mode.

67. The apparatus of claim 59 including:

a return electrode mounted upon said support member at a location for electrical coupling association with said tissue; and

said actuator and electrical circuit assembly terminal assembly is configured for coupling said return to said return electrode during said electrosurgical cutting mode.

68. The apparatus of claim 67 in which said actuator and electrical circuit assembly terminal assembly is configured for coupling said second applied output across said first electrode and said return electrode when said first electrode is in said first cauterization orientation.

69. The apparatus of claim 68 in which said return electrode is positioned at said forward end region.

70. The apparatus of claim 59 in which:

said first electrode deployment assembly comprises a guidance port defining a guidance channel having a guidance translation extending generally transversely outwardly from said longitudinal axis; and

said first electrode comprises a resilient wire extending within said first electrode deployment assembly, having a distal end aligned during said insertion mode for deployment through said guidance port, and actuable for deployment through said guidance port during said electrosurgical cutting mode.

71. The apparatus of claim 59 in which:

said first electrode deployment assembly comprises a guidance port in communication with a guidance channel with a guidance translation extending generally forwardly from said tip; and

said first electrode comprises a resilient wire extending within said first electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable generally forwardly from said tip through said guidance port to said first cauterization position.

72. The apparatus of claim 71 in which said first electrode, when deployed to said first cauterization position, is upwardly angularly oriented an angle, θ

, with respect to said longitudinal axis; and

said angle, θ

, is within a range of about 5°

to 90°

.

73. A system for carrying out the cauterization of a volume of tissue, comprising;

an electrosurgical generator assembly responsive to a first control input to generate a first current defined output for carrying out electrosurgical cutting, responsive to a second control input to generate a second current defined output for carrying out cauterization and having an electrosurgical return;

a support member extending between a tip and a rear region, having a forward end region extending along a longitudinal axis from said tip and positionable in an insertion mode at a select location within said tissue and having an electrode deployment portion adjacent said tip,

a first electrode of predetermined longitudinal dimension, extending within said deployment portion during said insertion mode, deployable to move outwardly from said electrode deployment portion to a first cauterization orientation within said tissue;

an actuator assembly extending along said support member from said rear region, mechanically connected with said first electrode and actuable for effecting the said deployment thereof; and

a control assembly in electrical communication with said electrosurgical generator assembly and said first electrode, actuable in correspondence with said first electrode deployment to effect derivation of said first control input and the application of said first current defined output to said first electrode in electrical association with said electrosurgical return simultaneously with said first electrode deployment toward said first cauterization orientation, subsequently actuable to effect derivation of said second control input and the application of said second current defined output to said first electrode when said first electrode is in said cauterization orientation.

74. The system of claim 73 including:

a second electrode of predetermined longitudinal dimension extending within said electrde deployment portion during said insertion mode, deployable to move outwardly from said electrode deployment portion to a second cauterization orientation within said tissue and spaced from said first electrode when said first electrode is at said first cauterization orientation;

said actuator assembly is mechanically connected with said second electrode and actuable for effecting the said deployment thereof; and

said control assembly is in electrical communication with said second electrode, actuable in the presence of said first control input to effect application of said first current defined output to said second electrode in electrical association with said electrosurgical return simultaneously with said second electrode deployment toward said second cauterization orientation.

75. The system of claim 74 in which:

said control assembly, in correspondence with said subsequent actuation, is configured for coupling said second current defined output across said first and second electrodes to carry out cauterization of said tissue.

76. The system of claim 75 including:

a third electrode of predetermined longitudinal dimension extending, during said insertion mode, within said electrode deployment portion, spaced from said first and second electrodes and deployable to move outwardly from said electrode deployment portion to a third cauterization orientation;

a fourth electrode of predetermined longitudinal dimension extending, during said insertion mode within said electrode deployment portion, spaced from said third electrode and deployable to move outwardly from said electrode deployment portion to a fourth cauterization orientation spaced a cauterization distance from said third electrode when at said third cauterization orientation; and

said control assembly is in electrical communication with said third and fourth electrodes, actuable in the presence of said first control input to effect application of said first current defined output to said third and fourth electrodes in electrical association with said electrosurgical return simultaneously with said third and fourth electrode deployment toward respective said third and fourth cauterization orientations.

77. The system of claim 76 in which:

said control assembly, in correspondence with said subsequent actuation, is configured for coupling said second current defined output across said third and fourth electrodes to carry out cauterization of said tissue.

78. The system of claim 73 including:

a return electrode mounted upon said support member at a location in electrical coupling association with said tissue when said first electrode is deployed toward said first cauterization orientation; and

said control assembly is responsive to apply said electrosurgical return to said return electrode when said first electrode is deployed toward said first cauterization orientation.

79. The system of claim 78 in which said control assembly is responsive to apply said second current defined output across said first and return electrodes.

80. The system of claim 79 in which said return electrode is located in proximity to said forward end region.

81. The system of claim 73 in which:

said support member electrode deployment portion is outwardly open, extending along said forward end region between a forward location adjacent to said tip and a rearward location;

said first electrode is thin, elongate and resilient, having a distal end connected with said support member at a connection location adjacent said forward location and extending an arch defining distance beyond said rearward location; and

said actuator assembly is configured to deploy said first electrode by urging it forwardly in compression to effect movement thereof generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending between said forward location and said rearward location.

82. The system of claim 81 in which said first electrode is electrically insulated from said support member adjacent said forward location and adjacent said rearward location.

83. The system of claim 81 in which:

said support member includes a deflector guide component located within said electrode deployment portion intermediate said forward location and said rearward location; and

said first electrode is positioned in freely abutting outwardly biased relationship with said deflector guide component during said insertion mode.

84. The system of claim 81 in which:

said first electrode includes an array of electrically conductive flat panel shaped secondary electrodes, each having an outwardly disposed edge connected in electrically conductive association with said first electrode, said secondary electrodes depending from said first electrode toward said deployment portion when said first electrode is in said first cauterization orientation, and being nestably retained within said support member electrode deployment portion during said insertion mode.

85. The system of claim 81 in which:

said first electrode includes an array of thin, flexible electrically conductive secondary electrodes each having an outer end connected in electrically conductive association with the first electrode and having an inner end connected within said deployment portion, said secondary electrodes extending from said first electrode into said deployment portion when said first electrode is in said first cauterization orientation, and being retained within said support member electrode deployment portion during said insertion mode.

86. The system of claim 81 in which:

said first electrode includes a thin, elongate secondary electrode having a distal end connected with said support member at a connection location adjacent said forward location and extending a secondary arch defining distance less than said first electrode arch defining distance beyond said rearward location;

said actuation assembly is configured to deploy said secondary electrode by urging it forwardly in compression to effect movement thereof generally transversely to said longitudinal axis to an extent curving it into an outwardly depending arch formation extending substantially between said forward location and said rearward location; and

said control assembly is electrically coupled with said secondary electrode and is responsive to effect application of said second current defined output thereto.

87. The system of claim 73 in which:

said support member electrode deployment portion comprises a guidance port and a guidance channel having a guidance translation extending generally transversely outwardly from said longitudinal axis; and

said first electrode comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable through said guidance port to said first cauterization orientation adjacent said tissue peripheral extent.

88. The apparatus of claim 73 in which:

said support member electrode deployment portion comprises a guidance port in communication with a guidance channel with a guidance translation extending generally forwardly from said tip; and

said first electrode comprises a resilient wire extending within said electrode deployment portion, having a distal end aligned during said insertion mode for deployment through said guidance port, and deployable generally forwardly from said tip through said guidance port to said first cauterization position.

89. The apparatus of claim 88 in which said first electrode, when deployed to said first cauterization position, is upwardly angularly oriented an angle, θ

, with respect to said longitudinal axis; and

said angle, θ

, is within a range of about 5°

to 90°

.

90. The system of claim 73 in which:

said first electrode is configured having predetermined length and principal cross sectional dimension;

said control assembly includes an electrical coding component mounted with said support member and exhibiting an electrical parameter corresponding with said predetermined dimension;

said electrosurgical generator includes a decoding circuit electrically coupled with said control assembly, responsive to electrically interrogate said electrical coding component to derive a corresponding selection signal, and is responsive to said selection signal to generate predetermined said first current defined output and second current defined output corresponding with said predetermined dimension.

91. The system of claim 73 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined first temperature value condition to derive a first control condition, said electrosurgical generator further including a control logic circuit responsive to said first control condition to modulate said first current defined output in correspondence therewith.

92. The system of claim 73 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined second temperature value condition to derive a second control condition, to modulate said second current defined output in correspondence therewith.

93. The system of claim 73 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said electrosurgical generator includes a temperature logic circuit responsive to said temperature output condition and a predetermined third temperature value condition corresponding with the necrosis of said abnormal tissue to derive a third control condition, said generator including a control logic circuit responsive to said third control condition to terminate generation of said second current defined output.

94. The system of claim 73 in which:

said control assembly includes a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it;

said electrosurgical generator includes;

a display assembly responsive to a display input signal to provide a perceptible output a procedure termination,

a temperature logic circuit responsive to said temperature output condition and a predetermined third temperature value condition corresponding with the necrosis of said abnormal tissue to derive a third control condition, and

a control logic circuit responsive to said third control condition to derive said display input signal.

95. A method for cauterizing tissue of a patient, comprising the steps of:

(a) providing an electrosurgical generator assembly having an electrosurgical return, controllable to generate a first current defined output for carrying out electrosurgical cutting of tissue, and to generate a second current defined output for carrying out the cauterization of said tissue;

(b) providing an instrument electrically coupled with said electrosurgical generator assembly, having a support member extending between a tip and a rear region, having a forward end region with first and second electrode assemblies having a nested orientation for movement of said forward end region with respect to said tissue, actuable for outward, spaced apart deployment from said forward end region to corresponding first and second deployed orientations and further actuable to retract toward said nested orientation;

(c) positioning said instrument forward end region in said tissue with said first and second electrodes in said nested orientation;

(d) actuating said instrument to deploy said first electrode assembly outwardly to a first cauterizing orientation;

(e) simultaneously with said step (d) controlling said electrosurgical generator assembly to apply said first current defined output to said first electrode assembly in electrical association with said return during said first electrode deployment;

(f) actuating said instrument to deploy said second electrode outwardly to a second cauterizing orientation spaced from said first cauterizing orientation;

(g) simultaneously with said step (f), controlling said electrosurgical generator assembly to apply said first current defined output to said second electrode assembly in electrical association with said return during said second electrode assembly deployment;

(h) controlling said electrosurgical generator assembly to apply said second current defined output across said first and second electrode assemblies, for an interval effective to cauterize tissue located substantially therebetween;

(i) actuating said instrument to retract said first electrode assembly toward said nested orientation;

(j) actuating said instrument to retract said second electrode assembly toward said nested orientation; and

(k) removing said instrument forward end region from said tissue.

96. The method of claim 95 wherein said steps (d) through (g) are carried out substantially simultaneously.

97. The method of claim 95 in which:

said electrosurgical return is provided as a patient return electrode having an extended surface area for atraumatic contact with tissue at a location remote from said first and second electrodes;

including the step of;

positioning said patient return electrode in a skin contacting relationship with said patient, and

said steps (e) and (g) are carried out in electrosurgically monopolar fashion.

98. The method of claim 95 in which:

said electrosurgical return is provided comprising a return electrode mounted upon said support member at a location in electrical coupling association with said tissue when said forward end region is positioned in said tissue; and

said steps (e) and (g) are carried out in electrosurgically monopolar fashion.

101. The method of claim 95 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said step (h) application of said second current defined output is carried out until said temperature output condition corresponds with an effective cauterization of said tissue.

102. The method of claim 95 in which:

said steps (d) and (f) are carried out by deploying respective said first and second electrodes to a sequence of incrementally outward said first and second cauterizing orientations from first to last; and

said step (h) is carried out following movement of said first and second electrode assemblies to each said incrementally outward orientation from first to last.

103. The method of claim 95 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said steps (e) and (g) include the steps of monitoring said temperature output condition and controlling said electrosurgical generator to maintain the temperature of tissue in contact with said first and second electrodes during said deployment thereof below about 75°

C.

99. The method of clain 98 in which said step (h) is carried out by applying said second current defined output across said first electrode assembly and said return electrode and across said second electrode and said return electrode.

100. The method of claim 99 in which said second current defined output is applied simultaneously across said first and second electrode assemblies and said return electrode.

104. A method for cauterizing tissue of a patient, comprising the steps of:

(a) providing an electrosurgical generator assembly having an electrosurgical return, controllable to generate a first current defined output for carrying out electrosurgical cutting of tissue, and to generate a second current defined output for carrying out the cauterization of tissue;

(b) providing an instrument electrically coupled with said electrosurgical generator assembly, having a support member extending between a tip and a rear region, having a forward end region with a deployable first electrode assembly having a nested orientation for movement of said forward end region with respect to said tissue, actuable for outward deployment from said forward end region to a cauterizing orientation and further actuable to retract toward said nested orientation, and having a surface mounted electrode in electrical communication with said electrosurgical return mounted upon said support member at a location for electrical coupling association with said tissue;

(c) positioning said instrument forward end region in said tissue with said first electrode assembly in said nested orientation and said surface mounted electrode in said electrical coupling association with said tissue;

(d) actuating said instrument to deploy said first electrode assembly outwardly to said cauterizing orientation;

(e) simultaneously with said step (d), controlling said electrosurgical generator assembly to apply said first current defined output to said first electrode in electrical association with said electrosurgical return through said second electrode during said deployment;

(f) controlling said electrosurgical generator assembly to apply said second current defined output across said first electrode and said surface mounted electrode for an interval effective to cauterize said abnormal tissue;

(g) actuating said instrument to retract said first electrode assembly toward said nested orientation; and

(h) removing said instrument forward portion from said tissue.

105. The method of claim 104 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said step (f) application of said second current defined output is carried out until said temperature output condition corresponds with an effective cauterization of said abnormal tissue.

106. The method of claim 104 in which:

said step (d) is carried out by deploying said first electrode assembly to a sequence of incrementally outward cauterizing orientations from first to last; and

said step (f) is carried out following movement of said first electrode assembly to each said incrementally outward orientation from first to last.

107. The method of claim 104 in which:

said instrument is provided having a temperature sensor mounted upon said support member at said forward end region and having a temperature output condition corresponding with the temperature of tissue in adjacency with it; and

said steps (e) includes the step of monitoring said temperature output condition and controlling said electrosurgical generator assembly to maintain the temperature of said electrode below about 75°

C. during said deployment thereof.