Electrosurgical systems and methods for treating tissue
First Claim
1. An electrosurgical apparatus for removing tissue from a target site, comprising:
- a probe including a first electrode type and a second electrode type, wherein the first electrode type and the second electrode type alternate between serving as an active electrode and serving as a return electrode, such that when the first electrode type serves as the active electrode the second electrode type serves as the return electrode, and when the second electrode type serves as the active electrode the first electrode type serves as the return electrode.
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Accused Products
Abstract
Electrosurgical methods and apparatus for removing tissue from a target site of a patient, the apparatus including a probe adapted for coupling to a power supply. The electrosurgical probe includes a shaft having a first electrode type and a second electrode type. The electrosurgical apparatus/probe lacks a dedicated return electrode. Instead, the first electrode type and the second electrode type alternate between serving as active electrode and serving as return electrode. The first electrode type comprises at least one ablation electrode adapted for aggressively removing tissue from a target site. The second electrode type comprises at least one digestion electrode adapted for aggressively digesting resected tissue fragments present in an aspiration stream. The apparatus may shift from a first mode of operation wherein the first electrode type serves as active electrode, to a second mode of operation wherein the second electrode type serves as active electrode, and back to the first mode of operation, without operator input. Such a shift may be determined by the presence or absence of tissue at the first and second electrode types, or by a change in electrical impedance in the milieu of the second electrode type, and such a shift may be dependent on a suitable surface area ratio of the first electrode type to the second electrode type. The probe may include an aspiration device which accommodates an aspiration stream emanating from the target site, and a fluid delivery device for delivering an extraneous electrically conductive fluid to the probe or to the target site.
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Citations
99 Claims
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1. An electrosurgical apparatus for removing tissue from a target site, comprising:
a probe including a first electrode type and a second electrode type, wherein the first electrode type and the second electrode type alternate between serving as an active electrode and serving as a return electrode, such that when the first electrode type serves as the active electrode the second electrode type serves as the return electrode, and when the second electrode type serves as the active electrode the first electrode type serves as the return electrode. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
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24. An electrosurgical system for removing tissue from a target site, comprising:
- a probe, and a high frequency power supply coupled to the probe for supplying electric power to the probe, the probe including;
a shaft having a shaft distal end portion and a shaft proximal end portion;
an ablation electrode located at the shaft distal end portion, the ablation electrode independently coupled to a first pole of the high frequency power supply;
an aspiration device including an aspiration port in communication with an aspiration lumen, the aspiration port located at the shaft distal end portion; and
a digestion electrode independently coupled to a second pole of the high frequency power supply, wherein the high frequency power supply alternates between supplying up to about 100% of the electric power to the ablation electrode and supplying up to about 100% of the electric power to the digestion electrode. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
- a probe, and a high frequency power supply coupled to the probe for supplying electric power to the probe, the probe including;
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35. An electrosurgical probe capable of removing tissue from a target site and adapted for connection to a power supply, the electrosurgical probe comprising:
a shaft having at least one ablation electrode and at least one digestion electrode, the at least one ablation electrode and the at the least one digestion electrode independently coupled to opposite poles of the power supply, wherein the at least one ablation electrode can serve as an active electrode or a return electrode, and the at the least one digestion electrode can serve as the active electrode or the return electrode. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57)
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58. A method of treating a tissue to be treated at a target site with an electrosurgical system, the electrosurgical system including a probe having an ablation electrode and a digestion electrode, the ablation electrode and the digestion electrode independently coupled to opposite poles of a power supply, and the method comprising:
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a) positioning the ablation electrode in the presence of the tissue to be treated;
b) preferentially supplying electric power from the power supply to the ablation electrode; and
c) alternatively to said step b), preferentially supplying electric power from the power supply to the digestion electrode. - View Dependent Claims (59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76)
d) prior to said steps b) and c), selecting a power level to be supplied from the power supply, wherein said step b) comprises supplying up to about 100% of the selected power level from the power supply to the ablation electrode, and said step c) comprises supplying up to about 100% of the selected power level from the power supply to the digestion electrode.
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63. The method of claim 58, further comprising
repeatedly alternating between said step b) and said step c). -
64. The method of claim 63, wherein repeatedly alternating between said steps b) and c) is inherent in the electrosurgical system and is dependent on the presence or absence of tissue at the ablation electrode and the digestion electrode.
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65. The method of claim 64, wherein repeatedly alternating between said steps b) and c) is dependent on a change in electrical impedance in the vicinity of the ablation electrode or the digestion electrode.
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66. The method of claim 58, wherein a switch from said step b) to said step c) is induced by the presence of tissue in an electrically conductive fluid in the vicinity of the digestion electrode.
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67. The method of claim 58, wherein a switch from said step c) to said step b) is induced by the absence of tissue in an electrically conductive fluid in the vicinity of the digestion electrode while the ablation electrode is in the presence of tissue.
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68. The method of claim 58, wherein the ratio of the surface area of the ablation electrode to the surface area of the digestion electrode is in the range of from about 2.5:
- 1 to about 1.5;
1.
- 1 to about 1.5;
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69. The method of claim 58, wherein said step b) results in generation of a plasma in the vicinity of the ablation electrode and removal of at least a portion of the tissue from the target site in a cool ablation process, wherein the tissue at the target site is exposed to a temperature in the range of from about 45°
- C. to about 90°
C.
- C. to about 90°
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70. The method of claim 58, wherein said step c) results in generation of a plasma in the vicinity of the digestion electrode and the plasma induces molecular dissociation of tissue components of at least one tissue fragment in the vicinity of the digestion electrode to yield low molecular weight ablation by-products.
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71. The method of claim 58, wherein at any given time point said step b) and said step c) are mutually exclusive.
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72. The method of claim 58, wherein said step b) defines an ablation mode, and said step c) defines an alternative digestion mode.
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73. The method of claim 58, wherein said step a) comprises positioning the ablation electrode adjacent to, or in contact with, cartilage tissue, and said step b) results in removal of at least a portion of the cartilage tissue.
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74. The method of claim 58, further comprising the step of delivering an electrically conductive fluid to the ablation electrode or to the tissue at the target site.
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75. The method of claim 58, further comprising the step of aspirating resected tissue from the target site in an aspiration stream, wherein the aspiration stream contacts the digestion electrode.
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76. The method of claim 58, wherein the electric power supplied to the ablation electrode and to the digestion electrode is characterized by a peak-to-peak voltage in the range of from about 10 to 2000 volts, and a RMS voltage in the range of from about 5 volts to 1000 volts.
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77. A method of removing tissue from a target site with an electrosurgical probe, the method comprising:
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a) coupling the electrosurgical probe to a power supply, wherein the electrosurgical probe includes a first electrode type and a second electrode type, and the first electrode type and the second electrode type are independently coupled to opposite poles of the power supply;
b) preferentially supplying power from the power supply to the first electrode type; and
c) in response to a change in electrical impedance experienced by the first electrode type or the second electrode type, preferentially supplying power from the power supply to the second electrode type. - View Dependent Claims (78, 79, 80, 81, 82, 83)
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84. An electrosurgical system for treating tissue at a target site, comprising:
an electrosurgical probe including a first electrode type and a second electrode type, wherein both the first electrode type and the second electrode type are adapted for having an electrically-induced tissue-altering effect, and the electrosurgical probe is configured such that the first electrode type can be brought into contact with the tissue at the target site while the second electrode type does not contact the tissue at the target site. - View Dependent Claims (85, 86, 87, 88, 89, 90, 91)
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92. An electrosurgical system, comprising:
a probe including a first electrode type and a second electrode type, wherein both the first electrode type and the second electrode type are adapted for having a tissue-altering effect, and wherein during a first mode of operation of the electrosurgical system the first electrode type functions as an active electrode while the second electrode type functions as a return electrode, and during a second mode of operation of the electrosurgical system the second electrode type functions as the active electrode while the first electrode type functions as the return electrode. - View Dependent Claims (93, 94, 95, 96, 97, 98, 99)
Specification