Electrosurgical generator method

• US 6,293,942 B1
• Filed: 05/02/1996
• Issued: 09/25/2001
• Est. Priority Date: 06/23/1995
• Status: Expired due to Term

• Current Assignee: Gyrus Medical Incorporated (Olympus Corporation)
• Original Assignee: Gyrus Medical Incorporated (Olympus Corporation)
• Inventors: Goble, Nigel Mark, Goble, Colin Charles Owen
• Primary Examiner(s): Shay, David M.
• Application Number:
  US08/642,121
• Time in Patent Office: 1,972 Days
• Field of Search: 606/32-52, 604/20, 604/27
• US Class Current: 606/38
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes 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 2017/00482 with a code
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00625 Vaporization
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• 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
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/143 : multiple needles
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2018/1435 : Spiral
• 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 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61M 2205/6018 : providing set-up signals for the apparatus configuration
• CPC Class Codes: A61M 2205/6027 : Electric-conductive bridges closing detection circuits, with or without identifying elements, e.g. resistances, zener-diodes

Abstract

An electrosurgical system including an electrode assembly having two electrodes for use immersed in an electrically conductive fluid has a generator with control circuitry for rapidly reducing the delivered radio frequency output power by at least 50% within at most a few cycles of the peak radio frequency output voltage reaching a predetermined threshold limit. In this way, tissue coagulation can be performed in, for example, saline without significant steam generation. The same peak voltage limitation technique is used in a tissue vaporization or cutting mode to limit the size of the steam pocket at the electrodes and to avoid electrode burning.

Claims

1. A method of operating an electrosurgical system which has a generator with an output coupled to an electrode assembly having an electrode for operation in a conductive liquid, wherein the method comprises:

applying radio frequency power to the electrode, and

automatically adjusting the radio frequency power applied to the electrode to maintain the conductive liquid adjacent the electrode at its boiling point for tissue desiccation, so that vapour bubbles form on the electrode'"'"'s surface without forming a vapor pocket surrounding the electrode.

2. A method according to claim 1, wherein the electrosurgical system has at least a tissue desiccation mode and a tissue cutting or vaporization mode, and wherein the method comprises:

selecting one of the said modes;

when the desiccation mode is selected, automatically adjusting the radio frequency power supplied to the electrode assembly to maintain the conductive liquid adjacent the electrode at its boiling point for tissue desiccation without creating a vapour pocket surrounding the electrode; and

when the cutting or vaporization mode is selected, automatically adjusting the radio frequency power supplied to the electrode to maintain a vapor pocket surrounding the electrode.

3. A method according to claim 2, wherein, in the cutting or vaporisation mode, the radio frequency power supplied to the electrode is automatically limited to prevent overheating of the electrode.

4. A method according to claim 3, wherein the radio frequency power supplied to the electrode is automatically adjusted by limiting the output voltage applied to the electrode to predetermined first and second voltage values, the first voltage value being used in the desiccation mode, and the second voltage value, which is higher than the first voltage value, being used in the cutting or vaporisation mode.

5. A method according to claim 4, wherein the first and second voltage values are in the ranges of from 150V to 200V and from 250V to 600V respectively, the voltages being peak voltages.

6. A method of operating an electrosurgical system which has a generator with an output coupled to an electrode assembly having an electrode for operation in a conductive liquid, wherein the method comprises:

applying radio frequency power to the electrode,

monitoring an electrical signal related to the voltage developed at the output of the generator, and

reducing the applied power when said signal reaches a predetermined threshold value associated with an increased load impedance,

whereby only sufficient radio frequency power is applied to the electrode to maintain the conductive liquid adjacent the electrode at its boiling point for tissue desiccation, so that vapour bubbles are formed on the electrode'"'"'s surface without forming a vapour pocket surrounding the electrode.

7. A method according to claim 6, wherein the monitored electrical signal is the peak output voltage applied to the electrode.

8. A method according to claim 6, wherein the applied power is reduced by at least 50% within 100 μ

s of the peak output voltage exceeding the predetermined threshold.

9. A method according to claim 6, wherein the applied power is reduced by reducing the conduction period of a radio frequency output power device of the generator during individual radio frequency cycles.

10. A method according to claim 9, further including reducing the supply voltage supplied to the output power device simultaneously with said reduction in the conduction period, and then progressively increasing the conduction period at a rate which is less than the rate at which the conduction period is reduced.

11. A method according to claim 10, wherein the generator has a switched mode power supply and the supply voltage reduction is achieved by disabling the output of a supply current switching device of the power supply for a whole number n of the power supply switching cycles, where n is greater than or equal to 1, until said monitored electrical signal no longer reaches the predetermined threshold value.

12. An electrosurgical tissue desiccation method comprising:

providing an electrosurgical system comprising an electrosurgical radio frequency generator coupled to an electrode assembly having a treatment electrode;

introducing the electrode assembly into a selected operation site with the treatment electrode contacting the tissue to be treated and with the tissue and the treatment electrode immersed in a conductive liquid;

actuating the generator to apply radio frequency power to the treatment electrode; and

automatically adjusting the radio frequency power during its application to the treatment electrode by the generator to maintain the conductive liquid adjacent the treatment electrode at its boiling point, so that vapour bubbles are formed on the electrode'"'"' surface without creating a vapour pocket surrounding the electrode.

13. A method according to claim 12, wherein the controlling step comprises automatically reducing the applied radio frequency power in response to the peak output voltage applied to the treatment electrode reaching a predetermined value.

14. A method according to claim 12, wherein the treatment electrode is a distal tissue contact electrode and the electrode assembly further comprises a liquid contact electrode spaced proximally with respect to the treatment electrode, and wherein the electrode assembly is introduced into the operation site such that the treatment electrode is in contact with the tissue to be treated and the liquid contact electrode is immersed in the conductive liquid, the electrode assembly being manipulated to cause heating and desiccation of the tissue in a required region adjacent the treatment electrode.

15. An electrosurgical tissue desiccation method comprising:

providing an electrosurgical system comprising an electrosurgical radio frequency generator coupled to an electrode assembly having an active electrode and a return electrode,

introducing the electrode assembly into a selected operation site with the tissue and said electrodes immersed in a conductive liquid;

actuating the generator to apply electrosurgical power to the active electrode and thereby to locally apply heat to the tissue; and

while the generator is actuated, automatically adjusting the radio frequency power applied to the active electrode by the generator to maintain the conductive liquid adjacent the active electrode at its boiling point so that vapour bubbles are formed on the electrode'"'"'s surface without forming a vapour pocket surrounding the active electrode.

16. A method according to claim 15, wherein the adjusting step comprises automatically reducing the applied radio frequency power in response to the peak output voltage applied to the active electrode reaching a predetermined value.

17. A method according to claim 15, wherein the active electrode is a distal tissue treatment electrode and the return electrode is spaced proximally with respect to the active electrode, and wherein the electrode assembly is introduced into the operation site and manipulated to cause heating and desiccation of the tissue in a required region next to the treatment electrode whilst the generator is actuated.