Systems for electrosurgical dermatological treatment

• US 6,461,354 B1
• Filed: 05/18/1999
• 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., Brunell, Stephen M., Olsen, Phillip M.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/313,956
• Time in Patent Office: 1,239 Days
• Field of Search: 606/32, 606/34, 606/41, 606/45, 606/48-50, 607/99, 607/105, 607/113, 604/114
• 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. An apparatus for applying electrical energy to an external body surface of a patient comprising:

a shaft having proximal and distal ends, an electrode support, a first electrode terminal and a second electrode terminal having a larger exposed surface area than the first electrode terminal at the distal end;

a high frequency voltage source coupled to the first and second electrode terminals for applying high frequency voltage to the first and second electrode terminals in the presence of an electrically conductive fluid, the voltage being sufficient to decouple at least a portion of the epidermis from the underlying tissue and to induce contaction of the collagen fibers of a tissue structure underlying said epidermis portion; and

wherein the first electrode terminal is adapted for removing tissue and the second electrode terminal is adapted for contracting tissue underlying the removed tissue.

2. The apparatus of claim 1 wherein the electrically conductive fluid is an electrically conducting gel adapted to be placed onto the external body surface.

3. The apparatus of claim 1 wherein the electrically conductive fluid is isotonic saline adapted to be delivered onto the external body surface.

4. The apparatus of claim 1 wherein the first electrode terminal comprises an array of at least three ablation electrodes for removing tissue, and the second electrode terminal comprises first and second contraction electrodes on either side of the ablation electrodes for applying sufficient thermal energy to tissue to contract collagen fibers.

5. The apparatus of claim 1 further comprising one or more return electrodes, and means for directing electrically conductive fluid past the return electrodes to the first and second electrode terminals for generating a current path therebetween.

6. The apparatus of claim 1 wherein said high frequency voltage source has a first power setting for applying a high frequency voltage sufficient to induce molecular dissociation in the epidermal tissue, and a second power setting sufficient to induce contraction of the collagen fibers in the tissue underlying the epidermal tissue without causing molecular dissociation.

7. The apparatus of claim 1 wherein said high frequency voltage source has a power setting for applying a high frequency voltage sufficient to induce molecular dissociation in the epidermal tissue, wherein the power setting is sufficient to induce contraction of the collagen fibers in the tissue underlying the epidermal tissue without causing molecular dissociation.

8. An apparatus for applying electrical energy to an external body surface of a patient comprising:

a disposable tip having proximal and distal ends and an electrode terminal at or near the distal end;

a sterilizable housing removably coupled to the disposable tip and having a connector adapted for coupling to a high frequency voltage supply;

an electrical coupling for removably coupling the electrode terminal to the connector; and

a fluid path coupled to the disposable tip and having an opening near the electrode terminal for supplying electrically conducting fluid to said electrode terminal

wherein the sterilizable housing comprises a housing with a groove and a sleeve rotatable coupled to the housing, and the fluid path comprises a tube adapted for insertion into said groove, and wherein rotation of the sleeve relative to the housing controls fluid flow through the tube.

9. The apparatus of claim 8 further comprising a controllable valve for controlling fluid flow through the fluid path.

10. An apparatus for applying electrical energy to an epidermal tissue of a patient comprising:

a shaft having proximal and distal ends and an electrode terminal at the distal end; and

a power supply for applying high frequency voltage to the electrode terminal, the power supply having a first power setting for applying a high frequency voltage sufficient to induce molecular dissociation in at least a portion of the epidermal tissue and a second power setting sufficient to induce contraction of the collagen fibers of a tissue structure underlying the epidermal tissue without causing molecular dissociation of the tissue structure.

11. The apparatus of claim 10 further comprising an electrode support and at least a second electrode terminal coupled to the electrode support, the second electrode terminal having a larger exposed surface area than the electrode terminal, wherein the electrode terminal is adapted for removing tissue and the second electrode terminal is adapted for contracting tissue underlying the removed tissue.

12. The apparatus of claim 10 wherein the electrode terminal comprises an array of at least three ablation electrodes for removing tissue, and first and second contraction electrodes on either side of the ablation electrodes for applying sufficient thermal energy to tissue to contract collagen fibers.

13. The apparatus of claim 12 further comprising one or more return electrodes, and means for directing electrically conducting fluid past the return electrodes to the electrode terminal for generating a current path therebetween.

14. The apparatus of claim 10 further comprising a fluid source adapted to supply an electrically conductive fluid externally to an external body surface of the patient, wherein the electrically conductive fluid is an electrically conducting gel.

15. The apparatus of claim 10 further comprising a fluid source adapted to supply an electrically conductive fluid externally to an external body surface of the patient, wherein the electrically conductive fluid is isotonic saline.

16. An apparatus for applying electrical energy to an epidermal tissue of a patient comprising:

a shaft having proximal and distal ends and an electrode terminal at the distal end; and

a power supply for applying high frequency voltage to the electrode terminal, the power supply having a power setting for applying a high frequency voltage sufficient to induce molecular dissociation in at least a portion of the epidermal tissue, wherein the power setting is sufficient to induce contraction of the collagen fibers of a tissue structure underlying the epidermal tissue without causing molecular dissociation of the tissue structure.

17. The apparatus of claim 16 further comprising an electrode support and at least a second electrode terminal coupled to the electrode support, the second electrode terminal having a larger exposed surface area than the electrode terminal, wherein the electrode terminal is adapted for removing tissue and the second electrode terminal is adapted for contracting tissue underlying the removed tissue.

18. The apparatus of claim 16 wherein the electrode terminal comprises an array of at least three ablation electrodes for removing tissue, and first and second contraction electrodes on either side of the ablation electrodes for applying sufficient thermal energy to tissue to contract collagen fibers.

19. The apparatus of claim 18 further comprising one or more return electrodes, and means for directing electrically conducting fluid past the return electrodes to the electrode terminal for generating a current path therebetween.

20. The apparatus of claim 16 further comprising a fluid source adapted to supply an electrically conductive fluid externally to an external body surface of the patient, wherein the electrically conductive fluid is an electrically conducting gel.

21. The apparatus of claim 16 further comprising a fluid source adapted to supply an electrically conductive fluid externally to an external body surface of the patient, wherein the electrically conductive fluid is isotonic saline.