Systems and methods for electrosurgical treatment of tissue in the brain and spinal cord

• US 6,322,549 B1
• Filed: 01/06/2000
• Issued: 11/27/2001
• Est. Priority Date: 02/20/1998
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Thapliyal, Hira V.
• Primary Examiner(s): Seidel, Richard K.
• Assistant Examiner(s): Sirmons, Kevin C.
• Application Number:
  US09/478,729
• Time in Patent Office: 691 Days
• Field of Search: 604/28, 604/43, 604/114, 604/500, 604/518, 604/522, 604/22, 606/35-42
• US Class Current: 604/500
• CPC Class Codes: A61B 18/14 Probes or electrodes 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 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• 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: A61N 1/06 for high-frequency therapy

Abstract

The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient'"'"'s brain and spinal cord. The systems and methods of the present invention are particularly useful for treating cerebrovascular diseases, such as vessel occlusion, or for the volumetric removal or ablation of intracranial tumors or Arteriovenous Malformations (AVMs). The method of the present invention comprises positioning an electrosurgical probe or catheter adjacent the target site so that one or more electrode terminal(s) are brought into at least partial contact or close proximity with a body structure within the patient'"'"'s head or neck, such as tumor tissue or an occlusion within a blood vessel. High frequency voltage is then applied between the electrode terminal(s) and one or more return electrode(s) to volumetrically remove or ablate at least a portion of the body structure in situ. In specific embodiments, the high frequency voltage is sufficient to effect the dissociation or disintegration of organic molecules into non-viable atoms and molecules. Specifically, the present invention converts the solid tissue cells into non-condensable gases that are no longer intact or viable, and thus, not capable of spreading viral or bacterial particles to other portions of the body structure.

Claims

1. A method for treating a tumor located in the head and neck comprising:

positioning an electrode terminal and a return electrode adjacent a body structure at a target site within a patient'"'"'s head or neck;

applying a sufficient high frequency voltage difference between the electrode terminal and the return electrode to volumetrically remove a portion of the body structure;

effecting molecular dissociation of at least a portion of the cells within the tumor; and

converting at least a portion of the tumor cells into non-viable gases to minimize the spread of the tumor.

2. The method of claim 1 wherein the body structure comprises an occlusive media disposed within a body vessel.

3. The method of claim 2 wherein the occlusive media is selected from the group comprising atheromatous occlusions, thrombotic occlusions, plaque and emboli.

4. The method of claim 2 further comprising applying high frequency voltage to the electrode terminal and a return electrode positioned within the blood vessel and spaced from the occlusive media such that an electrical current flows from the electrode terminal, through the region of the occlusive media, and to the return electrode.

5. The method of claim 4 wherein the high frequency voltage is applied in the presence of electrically conducting fluid, the method further comprising generating a current flow path through the electrically conducting fluid between the return electrode and the electrode terminal to selectively ablate the occlusive media.

6. The method of claim 1 further comprising:

before the applying step, fluidly isolating a region around the occlusive media within the body passage to confine products of ablation within said region; and

aspirating said ablation products from the body passage.

7. The method of claim 1 wherein the body structure comprises an arteriovenous malformation.

8. The method of claim 1 wherein the positioning step comprises advancing an electrosurgical instrument through a percutaneous penetration in the patient'"'"'s head.

9. The method of claim 1 wherein the positioning step comprises advancing an electrosurgical catheter transluminally into the patient'"'"'s head.

10. The method of claim 1 wherein the positioning step comprises the step of guiding the electrode terminal to the target site in the head.

11. The method of claim 10 further comprising an electrode array including a plurality of electrically isolated electrode terminals.

12. The method of claim 11 wherein the guiding step comprises detecting electrical properties of body structures adjacent each of the electrode terminals and guiding the electrode array to the target site based on the electrical properties.

13. The method of claim 12 wherein the electrical properties comprises impedance between each of the electrode terminals and the return electrode.

14. The method of claim 11 further comprising independently controlling current flow from at least two of the electrode terminals based on impedance between the electrode terminal and a return electrode.

15. The method of claim 1 wherein the electrode terminal comprises a single electrode at or near a distal end of an electrosurgical instrument.

16. The method of claim 1 wherein the return electrode and the electrode terminal are both located on an electrosurgical instrument.

17. The method of claim 1 further comprising positioning the electrode terminal and the return electrode within electrically conductive fluid.

18. The method of claim 17 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 tissue structure.

19. The method of claim 18 further comprising accelerating charged particles from the vaporized fluid to the tissue structure to cause dissociation of the molecular bonds within the tissue structure.

20. The method of claim 17 further comprising positioning the electrode terminal and the return electrode within electrically conductive fluid to generate a current flow path between the return electrode and the electrode terminal.

21. A method for treating tissue in the head and neck comprising:

positioning an electrode array including a plurality of electrically isolated electrode terminals and a return electrode adjacent a body structure at a target site within a patient'"'"'s head or neck;

applying a sufficient high frequency voltage difference between the electrode terminals and the return electrode to volumetrically remove a portion of the body structure; and

detecting electrical properties of body structures adjacent each of the electrode terminals and guiding the electrode array to the target site based on the electrical properties.

22. The method of claim 21 wherein the body structure comprises an occlusive media disposed within a body vessel.

23. The method of claim 22 wherein the occlusive media is selected from the group comprising atheromatous occlusions, thrombotic occlusions, plaque and emboli.

24. The method of claim 21 further comprising applying high frequency voltage to the electrode terminals and the return electrode positioned within the blood vessel and spaced from the occlusive media such that an electrical current flows from the electrode terminals, through the region of the occlusive media, and to the return electrode.

25. The method of claim 21 wherein the high frequency voltage is applied in the presence of electrically conducting fluid, the method further comprising generating a current flow path through the electrically conducting fluid between the return electrode and the electrode terminals to selectively ablate the occlusive media.

26. The method of claim 21 wherein the positioning step comprises advancing an electrosurgical instrument through a percutaneous penetration in the patient'"'"'s head.

27. The method of claim 21 wherein the positioning step comprises advancing an electrosurgical catheter transluminally into the patient'"'"'s head.

28. The method of claim 21 wherein the electrical properties comprises impedance between each of the electrode terminals and the return electrode.

29. The method of claim 21 wherein the return electrode and the electrode terminals are both located on an electrosurgical instrument.