Methods for electrosurgical tendon vascularization

• US 6,763,836 B2
• Filed: 06/18/2002
• Issued: 07/20/2004
• Est. Priority Date: 06/02/1998
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Pacek, James L., Tasto, James P., Woloszko, Jean, Eggers, Philip E., Thapliyal, Hira V., Baker, Michael A.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US10/174,266
• Publication Number:
  US 20030055418A1
• Time in Patent Office: 763 Days
• Field of Search: 606/41, 606/42, 606/45, 606/48, 607/101, 607/102, 607/104, 607/105, 604/22, 604/114, 128/898
• US Class Current: 128/898
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00738 Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1273 including multiple generators in one device
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument

Abstract

Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one variation, the invention involves creating a pattern of voids in connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. This also includes using a template device to assist in the creation of the pattern of voids. Also included is an electrosurgical device with a self-contained fluid supply for providing conductive fluid to the target tissue or to active electrodes of the device.

Claims

1. A method of inducing a controlled inflammatory response in tissue, the method comprising:

selecting a target tissue from an area of soft tissue;

applying energy to the target tissue; and

forming at least one pattern of voids by repeating the applying act.

2. The method of claim 1 comprising:

selecting a target tissue from an area of soft tissue;

positioning an active electrode in at least close proximity to the target tissue;

removing a void in the tissue by applying a high frequency voltage to the active electrode, the high frequency voltage being sufficient to volumetrically remove a portion of the target tissue; and

forming at least one pattern of voids by repeating the positioning and applying acts.

3. The method of claim 2, wherein selecting the target tissue comprises selecting target tissue from a group consisting of a tendon, a ligament, and a meniscus.

4. The method of claim 2, wherein the pattern comprises a pattern selected from a group consisting of a grid, a circle, at least two circles, at least two concentric circles, a helical pattern, a linear pattern, a non-linear pattern, a random pattern, and a combination thereof.

5. The method of claim 4, wherein a spacing between voids ranges between 0.5 mm and 10 mm.

6. The method of claim 4, wherein a spacing between voids is constant.

7. The method of claim 4, wherein a spacing between voids varies.

8. The method of claim 4, further comprising placing a template adjacent to the target tissue prior to the positioning step, wherein the template comprises a plurality of holes arranged in a layout similar to the pattern.

9. The method of claim 8, wherein the forming step comprises using the template as a guide for positioning the active electrode.

10. The method of claim 8 wherein the template further serves to separate tissue adjacent to the target tissue.

11. The method of claim 2, wherein the void has a lateral dimension in the range of from about 0.5 mm to about 2.0 mm.

12. The method of claim 2, wherein the void has a depth in the range of from about 0.5 mm to about 4.0 cm.

13. The method of claim 2, wherein the void comprises an opening in tissue selected from the group consisting of a channel, a hole, a furrow, a crater, a divot, and a combination thereof.

14. The method of claim 13, wherein the act of removing the void comprises applying the high frequency voltage between the active electrode and a return electrode.

15. The method of claim 13, wherein the return electrode is located on an external surface of a patient'"'"'s body.

16. The method of claim 13, wherein the return electrode and the active electrode are both located on an electrosurgical probe.

17. The method of claim 13, further comprising placing an electrically conductive fluid between the active electrode and the return electrode, the electrically conductive fluid providing a current flow path between the active electrode and the return electrode.

18. The method of claim 16, wherein the electrically conductive fluid comprises isotonic saline.

19. The method of claim 2, wherein the active electrode comprises a single electrode adjacent to a distal end of an electrosurgical probe.

20. The method of claim 19, wherein the active electrode comprises an electrode array comprising a plurality of electrically isolated active electrodes, and wherein said applying step comprises applying the high frequency voltage to the electrode array.

21. The method of claim 2, further comprising providing an electrically conductive fluid between the active electrode and the target tissue.

22. The method of claim 2, further comprising introducing at least a distal end of an electrosurgical probe into a patient'"'"'s knee, shoulder, or elbow;

wherein said positioning step comprises positioning the distal end of the probe in at least close proximity to the tendon within the knee, the shoulder, or the elbow.

23. A method of treating soft tissue comprising:

selecting a target tissue from the group consisting of a tendon, ligament, and meniscus;

applying energy to the target tissue; and

forming at least one pattern of voids by repeating the applying act.

24. A method of treating soft tissue comprising inducing a healing response in said tissue by creating at least one void in said tissue with an elongate apparatus, said apparatus comprising at least one active electrode arranged on a distal end of said apparatus, said electrode being electrically connected with a high frequency voltage source, wherein said at least one void is created by positioning said active electrode in at least close proximity to the tissue and activating said electrode with a selected voltage.