Electrosurgery with improved control apparatus and method

• US 6,740,081 B2
• Filed: 01/25/2002
• Issued: 05/25/2004
• Est. Priority Date: 01/25/2002
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Hilal, Said
• Primary Examiner(s): Gibson, Roy D.
• Assistant Examiner(s): Vrettakos, Peter J
• Application Number:
  US10/057,227
• Publication Number:
  US 20030144654A1
• Time in Patent Office: 851 Days
• Field of Search: 606/1-2, 606/7-17, 606/27-52
• US Class Current: 606/34
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 18/20 using laser
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00238 porous

Abstract

In electrosurgical system includes an electrosurgical generator providing power through an electrode, and a laser providing laser energy through an optical fiber. The electrode optical fiber and a source of environmental gas can all be included in a handpiece, catheter or other delivery device. In operation, the environmental gas can be released into the vicinity of an operative site and the laser activated to energize atoms along a pathway. Electrosurgical power can then be applied to ionize the items of the atoms of the pathway and create a path of least resistance for an electrosurgical arc. A reduction in the laser power required can be achieved by matching the photon frequency of the laser with the excitation frequency of the environmental gas. In a laparoscopic procedure, the insufflation gas may be used as the environmental gas.

Claims

1. An electrosurgical apparatus adapted to perform electrosurgery through a handpiece at an operative site on a patient, comprising:

a source of environmental gas providing gas molecules having properties for being energized at a particular frequency to an excited state;

first delivery apparatus disposed in the handpiece and coupled to the source of gas, the first delivery apparatus being adapted to deliver the gas molecules into proximity with the operative site;

a laser disposed in the hand piece and adapted to produce a laser beam providing laser energy at a frequency equal to about an integer multiple of the particular frequency of the environmental gas, and at a power generally sufficient to excite but not ionize the gas molecules;

second delivery apparatus coupled to the laser in the handpiece for delivering the laser beam along a pathway leading toward the operative site;

an electrosurgery generator providing electrosurgical power; and

third delivery apparatus disposed in the handpiece and coupled to the electrosurgery generator, the third delivery apparatus being adapted to deliver the electrosurgical power along the pathway toward the operative site.

2. The electrosurgical apparatus recited in claim 1, wherein the laser energy is provided in an amount generally insufficient to ionize the gas molecules along the pathway.

3. The electrosurgical apparatus recited in claim 2, wherein the electrosurgical power is provided in an amount generally sufficient to ionize the gas molecules excited by the laser.

4. The electrosurgical apparatus recited in claim 1, wherein:

the source of gas provides molecules of a first gas; and

the laser has properties for generating the laser energy in an environment containing molecules of a second gas.

5. The electrosurgical apparatus recited in claim 4, wherein the first gas contains molecules of the second gas.

6. The electrosurgical apparatus recited in claim 4, wherein the first gas and the second gas contain molecules of at least one of carbon dioxide, argon, and helium.

7. The electrosurgical apparatus recited in claim 1 wherein the laser is a first laser and the laser beam is a first laser beam, and the apparatus further comprises:

a second laser having a second laser beam which converges with the first laser beam in proximity to the operative site on the patient.

8. The electrosurgical apparatus recited in claim 7, wherein:

the first laser beam has properties including power, temperature, frequency, and cross sectional configuration; and

the second laser beam has properties including power, temperature, frequency, and cross sectional configuration, respectively; and

at least one of the properties of the first laser beam differs from the respective property of the second laser beam.

9. The electrosurgical apparatus recited in claim 1, wherein:

the electrosurgical apparatus includes a handpiece with a housing; and

at least portions of the first delivery apparatus, second delivery apparatus, and third delivery apparatus are disposed within the housing of the hand piece.

10. The electrosurgical apparatus recited in claim 1, wherein the second delivery apparatus moves the laser beam to provide the pathway with a planar configuration.

11. An electrosurgical apparatus adapted to perform electrosurgery at an operative site on a patient, comprising:

a source of environmental gas providing gas molecules having properties for being energized at a particular frequency to an excited state;

first delivery apparatus coupled to the source of gas and adapted to deliver the gas molecules into proximity with the operative site;

a laser adapted to produce a laser beam providing laser energy at a frequency equal to about an integer multiple of the particular frequency of the environmental gas, and at a power generally sufficient to excite the gas molecules;

second delivery apparatus coupled to the laser for delivering the laser beam along a pathway leading toward the operative site;

an electrosurgery generator providing eleotrosurgical power;

third delivery apparatus coupled to the electrosurgery generator and adapted to deliver the electrosurgical power along the pathway toward the operative site;

a first jaw and an opposing second jaw;

the first delivery apparatus being disposed in the first jaw;

the second delivery apparatus being disposed in one of the first jaw and the second jaw; and

the third delivery apparatus being disposed in one of the first jaw and the second jaw.

12. The eleotrosurgical apparatus recited in claim 11, wherein the second delivery apparatus is disposed in the first jaw and the third delivery apparatus is disposed in the opposing second jaw.

13. The electrosurgical apparatus recited in claim 11 wherein the second delivery apparatus includes a plurality of optical fibers.

14. The electrosurgical apparatus recited in claim 11, wherein the electrosurgery generator includes a first pole coupled to the first jaw and a second pole coupled to the second jaw.

15. An electrosurgical apparatus for performing laparoscopic electrosurgery at an operative site in the abdominal cavity of a patient, comprising:

a handpiece;

a source of environmental shielding gas providing gas molecules having properties for being energized at a particular frequency to an excited state;

first delivery apparatus carried by the handpiece and coupled to the source of gas, the first delivery apparatus being adapted to deliver the gas molecules into proximity with the operative site;

a laser carried by the handpiece and adapted to produce a laser beam providing laser energy at a frequency equal to about an integer multiple of the particular frequency of the environmental gas, and at a power generally sufficient to excite but not ionize the gas molecules;

second delivery apparatus coupled to the laser for establishing a pathway of excited gas molecules leading toward the operative site;

an electrosurgery generator providing electrosurgical power;

third delivery apparatus coupled to the electrosurgery generator and adapted to ionized the excited gas molecules along the pathway, and to deliver the electrosurgical power along the ionized pathway to the operative site;

a handpiece including a housing and an elongate probe extending from the housing; and

at least the third delivery apparatus extending through the probe of the handpiece.

16. The eleotrosurgery apparatus recited in claim 15, wherein:

the second delivery apparatus extends through the probe of the handpiece.

17. The electrosurgery apparatus recited in claim 16, wherein:

the first delivery apparatus extends through the probe of the handpiece.

18. The electrosurgery apparatus recited in claim 15, wherein the source of gas is disposed in the housing of the hand piece.

19. The electrosurgery apparatus recited in claim 15, wherein the laser is disposed in the housing of the handpiece.

20. The electrosurgery apparatus recited in claim 19, wherein the source of gas is included in the housing of the handpiece.

21. The electrosurgery apparatus recited in claim 15, wherein the laser includes a battery and a laser generator powered by the battery.

22. The electrosurgery apparatus recited in claim 21, wherein the battery is rechargeable.

23. A catheter having a proximal end and a distal end, the catheter being adapted to perform electrosurgery within a body conduit, comprising:

an elongate shaft extending to the distal end of the catheter;

a balloon carried by the shaft and being disposed generally at the distal end of the catheter, the balloon having a wall and being inflatable by an inflation gas having molecules excitable by a laser;

portions of the balloon defining at least one hole providing for a controlled release of the inflation gas from the balloon;

inflation apparatus for inflating the balloon with the inflation gas and for releasing a portion of the inflation gas through the at least one hole in the balloon;

laser apparatus including a light fiber disposed along the wall of the balloon, the fiber being adapted to release laser energy into the inflation gas to excite the molecules of the gas along a pathway; and

electrosurgical apparatus including an electrode disposed along the wall of the balloon, the electrode being adapted to release electrosurgical energy along the pathway and to perform the electrosurgery within the body conduit.

24. The catheter recited in claim 23, wherein the wall of the balloon has an inner surface, and the light fiber is disposed along the inner surface of the balloon wall.

25. The catheter recited in claim 24, wherein the light fiber is a side-light fiber.

26. The catheter recited in claim 23, wherein the wall of the balloon has an outer surface and the electrosurgical electrode is disposed along the outer surface of the balloon wall.

27. The catheter recited in claim 26, wherein the light fiber of the laser apparatus is disposed along the outer surface of the balloon wall.

28. The catheter recited in claim 23, wherein:

the hole portions of the balloon, the light fiber of the laser system, and the electrode of the electrosurgery system are disposed generally longitudinally of the shaft of the catheter.

29. The catheter recited in claim 23, wherein the inflation gas has a excitation frequency and the laser energy of the laser apparatus has a discharge frequency equal to about an integer multiple of the excitation frequency.

30. An electrosurgical apparatus adapted to perform electrosurgery at an operative site on a patient, comprising;

a hand piece;

a source of environmental gas coupled to the handpiece and having gas molecules with properties for being energized at an excitation frequency;

a laser disposed in the handpiece to introduce a laser beam into the environmental gas to excite but not ionize the environmental gas along a pathway leading to the operative site on the patient;

the laser beam having a discharge frequency equal to about an integer multiple of the excitation frequency of the environmental gas; and

an electrosurgical generator coupled to the handpiece and disposed to create an electrosurgical arc along the pathway to perform the electrosurgery at the operative site on the patient.

31. The electrosurgical apparatus recited in claim 30, wherein the laser has an active medium with the discharge frequency.

32. The electrosurgical apparatus recited in claim 31, wherein the laser is a gas laser and the active medium is a gas.

33. The electrosurgical apparatus recited in claim 32, wherein the gas is carbon dioxide.

34. The electrosurgical apparatus recited in claim 31, wherein the laser is a solid state laser and the active medium is a crystal.

35. The electrosurgical apparatus recited in claim 34, wherein the crystal is ruby.

36. The eleotrosurgical apparatus recited in claim 31, wherein the discharge frequency of the laser is tunable.

37. A catheter adapted for operation with a laser end an electrosurgical generator, and in proximity to an environmental gas, comprising:

a catheter body extending along an axis between a proximal end and a distal end;

a hub disposed at the proximal end of the catheter body;

a delivery device disposed at the distal end of the catheter body;

an optical fiber included in the delivery device and adapted for connection to the laser to excite the environmental gas along a pathway leading to an operative site; and

an electrosurgical lead included in the delivery device and adapted for connection to the electrosurgical generator for delivering electrosurgical power along the pathway.

38. The catheter recited in claim 37, wherein the delivery device includes a balloon.

39. The catheter recited in claim 38, wherein the balloon is inflatable with the environmental gas.

40. The catheter recited in claim 38, wherein:

the optical fiber is disposed relative to the balloon; and

the electrosurgical lead is disposed externally of the balloon.

41. The catheter recited in claim 40, wherein the optical fiber is disposed interiorly of the balloon.

42. The Catheter recited in claim 37, wherein the electrosurgical lead is terminated distally at an electrode.

43. The catheter recited in claim 37, wherein the optical fiber is terminated at a refractive index coating.

44. The catheter recited in claim 43, wherein portions of the coating define a window permitting the escape of laser energy along the pathway.

45. An electrosurgical handpiece adapted for use with a source of environmental gas and an electrosurgical generator to perform an electrosurgical operation at an operative site, the handpiece comprising:

a housing;

a laser disposed in the housing;

at least one optical fiber coupled to the laser in the housing;

at least one electrosurgical electrode carried by the housing and adapted to be coupled to the electrosurgical generator;

a sheath enclosing the optical fiber and the electrode and defining a gas channel interiorly of the sheath and exteriorly of the optical fiber and the electrode;

the sheath being adapted for coupling the gas channel to the source of the environmental gas to direct the environmental gas toward the operative site;

the optical fiber being adapted for coupling to the laser to create a pathway of energized molecules of the environmental gas between the handpiece and the operative site; and

the electrode being adapted for coupling to the electrosurgical generator for delivering electrosurgical power along the pathway.

46. The handpiece recited in claim 45 wherein the optical fiber is a first optical fiber and the pathway is a first pathway, the handpiece further comprises:

a second optical fiber disposed in the sheath and being coupled to the laser to create a pathway from energized molecules of the environmental gas between the handpiece and the operative site.

47. The handpiece recited in claim 46, further comprising:

a first lens for converging the pathway of the energized molecules from the first fiber toward the optical site and;

a second lens for converging the pathway of energized molecules from the second fiber toward the optical site.

48. The hand piece recited in claim 45, wherein the electrode is adapted for use in a bipolar electrosurgical configuration.