Systems and methods for electrosurgical skin resurfacing

• US 6,309,387 B1
• Filed: 05/18/1999
• Issued: 10/30/2001
• Est. Priority Date: 11/22/1995
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Thapliyal, Hira V.
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): Kearney, R.
• Application Number:
  US09/313,957
• Time in Patent Office: 896 Days
• Field of Search: 606/27-29, 606/32, 606/34, 606/36, 606/39, 606/40, 606/41-50, 606/9, 607/98, 607/99, 607/100, 607/101, 607/104, 607/108, 128/898
• US Class Current: 606/41
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• 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 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/00148 : with metal
• 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 2018/00327 : Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00404 : Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/0047 : Upper parts of the skin, e.g. skin peeling or treatment of wrinkles
• CPC Class Codes: A61B 2018/00476 : Hair follicles
• CPC Class Codes: A61B 2018/00505 : Urinary tract
• 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 2018/00625 : Vaporization
• 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 2018/00702 : Power or energy
• 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 2018/00815 : measured by a thermistor
• 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 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• 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 2018/1253 : 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 2018/1467 : 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 2018/165 : Multiple indifferent electrodes
• 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

Abstract

Systems and methods are provided for selectively applying electrical energy to a target location on an external body surface, such as skin tissue removal and/or collagen shrinkage in the epidermis or dermis, e.g., the removal of pigmentations, vascular lesions (e.g., leg veins), scars, tattoos, etc., and for other surgical procedures on the skin, such as tissue rejuvenation, cosmetic surgery, wrinkle removal, hair removal and/or transplant procedures. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals adjacent an external body surface, such as the outer surface of the skin, to remove and/or modify the structure of tissue structures within the skin. Depending on the specific cosmetic procedure, the present invention may be used to: (1) volumetrically remove tissue or hair (i.e., ablate or effect molecular dissociation of the tissue structure); (2) separate a tissue layer from an underlying tissue layer so that the tissue layer can be removed; (3) shrink or contract collagen connective tissue; and/or (4) coagulate blood vessels underlying the surface of the skin.

Claims

1. A method for dermatological treatment of an external body surface comprising:

applying high frequency voltage to an electrode terminal in close proximity to a target site on the epidermis of the patient; and

removing a layer of the epidermis at the target site.

2. The method of claim 1 wherein the removing step comprises applying sufficient high frequency voltage to the electrode terminal to remove the epidermis layer through molecular dissociation or disintegration.

3. The method of claim 1 further comprising applying thermal energy to a tissue layer underlying said epidermis layer to effect contraction of the collagen fibers within the tissue layer.

4. The method of claim 3 wherein the collagen fibers in the tissue layer underlying the epidermis are heated to a temperature in the range of about 55°

C. to about 70°

C.

5. The method of claim 1 wherein the electrode terminal comprises an electrode array including a plurality of electrically isolated electrode terminals.

6. The method of claim 1 wherein the applying high frequency voltage comprises:

positioning the electrode terminal into at least close proximity with the target site in the presence of an electrically conducting fluid;

positioning a return electrode within the electrically conducting fluid to generate a current flow path between the target site and the return electrode; and

applying high frequency voltage to the electrode terminal and the return electrode such that an electrical current flows from the electrode terminal, through the target site, and to the return electrode through the current flow path.

7. The method of claim 6 further comprising applying sufficient voltage to the electrode terminal in the presence of the electrically conducting fluid to vaporize at least a portion of the fluid between the electrode terminal and the epidermis.

8. The method of claim 7 further comprising accelerating charged particles from the vaporized fluid to said portion of the epidermis to cause dissociation of the molecular bonds within the tissue structures of said portion of the epidermis.

9. The method of claim 1 wherein the electrode terminal comprises a substantially elongate tissue treatment surface, the method further comprising traversing the electrode terminal across external body surface in a direction substantially perpendicular to the longitudinal axis of the elongate tissue treatment surface.

10. A method for dermatological treatment of a patient body surface comprising:

positioning an electrode terminal in close proximity to a target site on the epidermis of the patient;

directing an electrically conducting fluid to provide a current flow path between the electrode terminal and a return electrode; and

applying high frequency voltage between the electrode terminal and the return electrode to impart sufficient energy into the target site to volumetrically remove at least several cells layers of the epidermis.

11. The method of claim 10 wherein the applying step comprises:

vaporizing the electrically conducting fluid in a thin layer over at least a portion of the electrode terminal.

12. The method of claim 11 further comprising the step of inducing the discharge of energy to the target site, wherein the energy is in the form of ultraviolet energy.

13. The method of claim 11 further comprising the step of inducing the discharge of energy to the target site, wherein the energy is in the form of energetic electrons.

14. The method of claim 10 wherein the electrode terminal comprises an electrode array including a plurality of isolated electrode terminals, the method further comprising independently limiting power to the electrode terminals.

15. The method of claim 14 wherein the electrode terminals are substantially flush with an electrically insulating matrix on the distal tip of the probe.

16. The method of claim 14 wherein the electrode terminals are proximally recessed a distance of 0.0 to 0.005 inches from an electrically insulating matrix on the distal tip of the probe.

17. The method of claim 14 wherein the electrode terminals distally extend a distance of 0.0 to 0.005 inches from an electrically insulating matrix on the distal tip of the probe.

18. The method of claim 10 wherein the high frequency voltage is in the range from 300 to 1400 volts peak to peak.

19. The method of claim 10 further comprising translating the electrode terminal transversely across a layer of epidermal tissue.

20. The method of claim 10 further comprising generating a high electric field intensity at a distal portion of the electrode terminal, the electric field intensity being sufficient to cause molecular disintegration or dissociation of tissue structure on the target site.

21. The method of claim 10 wherein the depth of tissue removal is about 10 to 200 microns.

22. A method for dermatological treatment of an external body surface comprising:

positioning an electrode terminal in close proximity to a target site on the epidermis of the patient; and

applying high frequency electrical energy to the electrode terminal, the electrical energy being selected to volumetrically remove a portion of the epidermis.

23. The method of claim 22 further comprising providing an electrically conducting fluid at the target site, and positioning the electrode terminal within the electrically conducting fluid.

24. The method of claim 23 further comprising positioning a return electrode within the electrically conducting fluid so that a current flow path is generated within the fluid from the electrode terminal to the return electrode.

25. The method of claim 23 further comprising directing electrically conducting fluid along a fluid supply path past the return electrode to the target site.

26. The method of claim 22 further comprising immersing the target site within a volume of the electrically conducting fluid and positioning the return electrode and the electrode terminal within said volume.

27. The method of claim 22 further comprising volumetrically removing surface layers of the epidermis.

28. The method of claim 22 further comprising removing tissue abnormalities from the patient'"'"'s skin.

29. The method of claim 22 further comprising rejuvenating tissue layers below the removed cell layers.

30. The method of claim 22 further comprising rejuvenating tissue layers below the removed portion of the epidermis.

31. A method for resurfacing an external body surface comprising:

positioning an electrode terminal in close proximity to a target site on an outer surface of the patient'"'"'s skin; and

applying high frequency electrical energy to the electrode terminal, the electrical energy being selected to remove wrinkles in the patient'"'"'s skin.

32. The method of claim 31 wherein the electrical energy is selected to volumetrically remove a portion of the epidermis.

33. The method of claim 31 further comprising providing an electrically conducting fluid at the target site, and positioning the electrode terminal within the electrically conducting fluid.

34. The method of claim 33 further comprising positioning a return electrode within the electrically conducting fluid so that a current flow path is generated within the fluid from the electrode terminal to the return electrode.