Systems and methods for electrosurgical-assisted lipectomy

• US 6,461,350 B1
• Filed: 09/28/1998
• Issued: 10/08/2002
• Est. Priority Date: 11/22/1995
• 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., Baker, Michael A., Underwood, Ronald A., Brunell, Stephen M.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/162,110
• Time in Patent Office: 1,471 Days
• Field of Search: 606/34, 606/41, 606/48, 606/49, 606/50, 606/32, 604/22, 604/35, 604/114, 607/98, 607/99, 607/101, 607/102, 607/105, 607/113
• US Class Current: 606/32
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• 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 2018/00029 open
• CPC Class Codes: A61B 2018/00148 with metal
• 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 2018/00577 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 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/0072 Current
• CPC Class Codes: A61B 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00779 : Power or energy
• 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 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• 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 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration

Abstract

Systems and methods are provided for removing adipose or fatty tissue underlying a patient'"'"'s epidermis is disclosed (e.g., liposuction, abdominoplasty, and the like). The method includes positioning one or more active electrode(s) and one or more return electrode(s) in close proximity to a target region of fatty tissue. A high frequency voltage difference is applied between the active and return electrodes, and the fatty tissue or fragments of the fatty tissue are aspirated from the target region. The high frequency voltage either softens the fatty tissue or completely removes at least a portion of the tissue. In both embodiments, the remaining fatty tissue is more readily detached from the adjacent tissue in the absence of energy, and less mechanical force is required for removal. The bipolar configuration of the present invention controls the flow of current to the immediate region around the distal end of the probe, which minimizes tissue necrosis and the conduction of current through the patient. The residual heat from the electrical energy also provides simultaneous hemostasis of severed blood vessels, which increases visualization and improves recovery time for the patient. The techniques of the present invention produce significantly less thermal energy than many conventional techniques, such as lasers and conventional RF devices, which reduces collateral tissue damage and minimizes pain and postoperative scarring.

Claims

1. A method for removing fatty tissue underlying a patient'"'"'s epidermis comprising:

positioning an electrode terminal and a return electrode in close proximity to a target region of fatty tissue;

applying a high frequency voltage difference between the electrode terminal and the return electrode to modify the fatty tissue, wherein the high frequency voltage difference is sufficient to ablate at least a portion of the fatty tissue in situ; and

during the applying voltage step, aspirating a portion of the fatty tissue from the target region.

2. The method of claim 1 wherein the high frequency voltage difference is sufficient to soften at least a portion of the fatty tissue.

3. The method of claim 1 wherein the high frequency voltage difference is sufficient to liquefy at least a portion of the fatty tissue.

4. The method of claim 1 further comprising delivering electrically conducting fluid to the target region, and contacting the electrically conducting fluid with the return electrode to provide a current flow path from the electrode terminal, through the electrically conducting fluid, and to the return electrode.

5. The method of claim 1 further comprising positioning the return electrode proximal to the electrode terminal to induce current flow from the electrode terminal away from the target region.

6. The method of claim 1 further comprising directing electrically conducting fluid along a fluid path past the electrode terminal and the return electrode to generate a current flow path between the return electrode and the electrode terminal.

7. The method of claim 1 wherein further comprising applying a sufficient high frequency voltage difference between the return electrode and the electrode terminal to remove fatty tissue through molecular dissociation or disintegration.

8. The method of claim 1 further comprising applying sufficient voltage to the electrode terminal in the presence of an electrically conducting fluid to vaporize at least a portion of the fluid between the electrode terminal and the fatty tissue.

9. The method of claim 8 further comprising accelerating charged particles from the vaporized fluid to fatty tissue to cause dissociation of the molecular bonds within the tissue structures.

10. A method for performing a lipectomy comprising:

positioning an electrode terminal in close proximity to a target region of fatty tissue underlying the epidermis;

applying a sufficient high frequency voltage to the electrode terminal to volumetrically remove fatty tissue in situ without applying suction to the fatty tissue; and

delivering electrically conducting fluid to the target region and contacting the electrically conducting fluid with a return electrode to provide a current flow path from the electrode terminal, through the electrically conducting fluid, and to the return electrode.

11. The method of claim 10 wherein contacting the electrically conducting fluid with the return electrode comprises directing electrically conducting fluid along a fluid path past the electrode terminal and the return electrode to generate the current flow path between the return electrode and the electrode terminal.

12. The method of claim 10 wherein further comprising applying a sufficient high frequency voltage to the electrode terminal to remove tissue through molecular dissociation or disintegration.

13. An apparatus for removing fatty tissue underlying the epidermis at a target site comprising:

a shaft having proximal and distal end portions and an electrode terminal on the distal end portion, the distal end portion being sized for introduction through a percutaneous penetration in the patient'"'"'s epidermis;

a return electrode on the shaft spaced from the electrode terminal;

a power supply coupled to the electrode terminal and the return electrode for applying a sufficient high frequency voltage difference between the electrode terminal and the return electrode to modify fatty tissue underlying the epidermis;

a suction lumen positioned adjacent the electrode terminal for aspirating the modified fatty tissue from the patient, wherein the suction lumen comprises a distal opening; and

an aspiration electrode positioned across the distal opening of the suction lumen and electrically coupled to the power supply.

14. The apparatus of claim 13 wherein the suction lumen is coupled to the shaft.

15. The apparatus of claim 14 wherein the aspiration electrode is positioned within the suction lumen proximal to the distal opening.

16. The apparatus of claim 14 wherein the aspiration electrode comprises a loop electrode extending across the distal opening of the suction lumen.

17. The apparatus of claim 13 wherein the aspiration electrode comprises two or more loop electrodes.

18. The apparatus of claim 13 wherein the aspiration electrode comprises one or more coiled electrodes.

19. The apparatus of claim 13 wherein the electrode terminal is electrically isolated from the aspiration electrode and the return electrode is spaced proximally from the electrode terminal.

20. The apparatus of claim 13 further comprising an electrode array of electrically isolated electrode terminals, the electrode terminals being electrically isolated from the aspiration electrode.

21. The apparatus of claim 13 further comprising a fluid delivery element defining a fluid path in electrical contact with the return electrode and the electrode terminal to generate a current flow path between the return electrode and the electrode terminal.

22. The apparatus of claim 21 further including an insulating member positioned between the return electrode and the electrode terminal, the return electrode being sufficiently spaced from the electrode terminal to minimize direct contact between the return electrode and a body structure at the target site when the electrode terminal is positioned in close proximity or in partial contact with the body structure.

23. A method for removing fatty tissue comprising:

positioning an electrode terminal and a return electrode in close proximity to a target region of fatty tissue;

applying a high frequency voltage difference between the electrode terminal and the return electrode to remove a portion of the fatty tissue through molecular dissociation or disintegration; and

during the applying voltage step, aspirating a portion of the fatty tissue from the target region.

24. The method of claim 23 wherein the high frequency voltage difference is sufficient to soften at least a portion of the fatty tissue.

25. The method of claim 23 wherein the high frequency voltage difference is sufficient to liquefy at least a portion of the fatty tissue.

26. The method of claim 23 wherein the high frequency voltage difference is sufficient to ablate at least a portion of the fatty tissue in situ.

27. The method of claim 23 further comprising delivering electrically conducting fluid to the target region, and contacting the electrically conducting fluid with the return electrode to provide a current flow path from the electrode terminal, through the electrically conducting fluid, and to the return electrode.

28. The method of claim 23 further comprising positioning the return electrode proximal to the electrode terminal to induce current flow from the electrode terminal away from the target region.

29. The method of claim 23 further comprising directing electrically conducting fluid along a fluid path past the electrode terminal and the return electrode to generate a current flow path between the return electrode and the electrode terminal.

30. The method of claim 23 further comprising applying sufficient voltage to the electrode terminal in the presence of an electrically conducting fluid to vaporize at least a portion of the fluid between the electrode terminal and the fatty tissue.

31. The method of claim 30 further comprising accelerating charged particles from the vaporized fluid to fatty tissue to cause dissociation of the molecular bonds