Systems and methods for tissue resection, ablation and aspiration

• US 6,482,201 B1
• Filed: 07/27/2000
• Issued: 11/19/2002
• Est. Priority Date: 06/07/1995
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Hovda, David C., Ellsberry, Maria B., Thapliyal, Hira V., Olsen, Phillip M.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/629,251
• Time in Patent Office: 845 Days
• Field of Search: 606/32, 606/34, 606/41, 606/45, 606/46, 606/49, 607/99, 607/105, 607/113, 604/35, 604/114, 128/898
• US Class Current: 606/41
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00101 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 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 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• 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 2018/00666 : 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 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• 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 2018/1467 : 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 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

The present invention provides systems and methods for selectively applying electrical energy to a target location within or on a patient'"'"'s body. In particular, methods and apparatus are provided for resecting, cutting, partially ablating, aspirating or otherwise removing tissue from a target site, and ablating the tissue in situ. The systems and methods of the present invention are particularly useful for ablation and hemostasis of tissue in sinus surgery (e.g., chronic sinusitis and/or removal of polypectomies) and for resecting and ablating soft tissue structures, such as the meniscus and synovial tissue within a joint.

Claims

1. A method for treating tissue comprising:

positioning a resection electrode adjacent tissue at a target site on or within a patient'"'"'s body;

applying high frequency voltage between the resection electrode and a return electrode and moving the resection electrode relative to the tissue to resect a tissue fragment from the tissue; and

applying high frequency voltage between an ablation electrode and a return electrode, the voltage being sufficient to ablate the tissue fragment in situ.

2. The method of claim 1 wherein the ablation electrode and the resection electrode are the same electrode.

3. The method of claim 1 wherein the ablation electrode and the resection electrode are separate electrodes.

4. The method of claim 1 wherein the resection electrode comprises a loop extending distally from a distal end of an instrument shaft.

5. The method of claim 1 wherein the ablation electrode comprises a plurality of electrically independent electrodes on an instrument shaft spaced proximally from the resection electrode.

6. An apparatus for applying electrical energy to a tissue structure at a target site comprising:

an electrosurgical instrument having a shaft with a proximal end portion and a distal end portion;

a loop electrode extending from the distal end portion of the shaft;

an ablation electrode on the shaft spaced from the loop electrode;

one or more return electrodes located on the shaft and adapted for coupling to a high frequency power supply; and

one or more connectors near the proximal end portion of the shaft for electrically coupling the loop and ablation electrodes to a high frequency power supply.

7. The apparatus of claim 6 further comprising an electrode array of electrically isolated ablation electrode terminals, the ablation electrode terminals being electrically isolated from the loop electrode.

8. The apparatus of claim 6 further comprising a fluid delivery element defining a fluid path in electrical contact with the return electrode and the ablation electrode to generate a current flow path between the return electrode and the ablation electrode.

9. The apparatus of claim 6 wherein at least one of the one or more return electrodes forms a portion of the shaft, and is spaced proximally from the loop electrode and the ablation electrode.