Electrosurgical apparatus having a curved distal section

• US 7,070,596 B1
• Filed: 10/03/2000
• Issued: 07/04/2006
• Est. Priority Date: 08/09/2000
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Quackenbush, John J., Woloszko, Jean, Ormsby, Theodore C., Martini, Brian
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US09/679,394
• Time in Patent Office: 2,100 Days
• Field of Search: 606/41, 600/374, 607/99, 607/105, 607/113, 607/122
• US Class Current: 606/41
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2017/00261 Discectomy
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/0044 Spinal cord
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Apparatus and methods for advancing and retracting a medical instrument within an introducer device, wherein the instrument includes a distal tip, a distal linear portion, a first distal curve, a substantially linear inter-curve portion, and a second proximal curve. The length of the distal linear portion and the angle of the first curve determine the position of the distal tip within a lumen of the introducer device, such that the distal tip occupies a substantially central transverse location within the lumen and the distal tip avoids contact with the introducer device. The length of the inter-curve portion and the angle of the second curve determine deflection of the distal tip from a longitudinal axis of the shaft when the second curve is extended distally beyond a distal end of the introducer device. Also, methods and apparatus for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

Claims

1. A medical apparatus comprising a shaft including a shaft distal end portion and a shaft proximal end portion, the shaft distal end portion including at least one active electrode disposed thereon and having a shape comprising at least one curve proximal to the at least one active electrode, wherein the at least one curve comprises a first curve and a second curve proximal to the first curve, and the shaft distal end portion is adapted to be resilient such that upon the application of an external force the shape distorts, whereupon removal of the force the shape restores;

further including an introducer needle having a needle lumen, the needle lumen adapted for passing the shaft distal end portion therethrough, wherein the shaft distal end portion includes a distal linear portion, the active electrode includes an electrode head located terminally at a distal tip of the shaft, the first curve is characterized by a first angle and the second curve is characterized by a second angle, wherein a transverse location of the electrode head within the needle lumen is determined by the first angle and by a length of the distal linear portion.

2. The apparatus of claim 1, wherein the introducer needle includes a needle distal end, and the shaft distal end portion avoids contact with the introducer needle when the shaft distal end portion is advanced from and retracted into the needle distal end.

3. The apparatus of claim 1, wherein the apparatus is adapted for ablating tissue during an electrosurgical procedure, the at least one curve defines a specific curvature of the shaft, the specific curvature is provided during manufacture of the apparatus, and the specific curvature is at least substantially maintained during ablation of the tissue.

4. The apparatus of claim 1, wherein the at least one active electrode includes an electrode head having a spike.

5. The apparatus of claim 4, wherein the electrode head includes an apical spike and a substantially equatorial cusp.

6. The apparatus of claim 1, wherein the at least one active electrode includes a filament and an electrode head, and the apparatus further comprises a first insulating sleeve encasing the filament, and an insulating collar disposed on a distal end of the first insulating sleeve and adjacent to the electrode head.

7. The apparatus of claim 6, further comprising a cylindrical return electrode on the first insulating sleeve, the return electrode located proximal to the insulating collar.

8. The apparatus of claim 7, further comprising a second insulating sleeve encasing a proximal portion of the return electrode.

9. The apparatus of claim 8, further comprising a shaft shield encasing at least a proximal portion of the second insulating sleeve, wherein the apparatus is adapted for connection to a power supply unit via a connector cable, the connector cable includes an electrically conductive cable shield, and the shaft shield is coupled to the cable shield.

10. The apparatus of claim 6, wherein the insulating collar comprises a material selected from the group consisting of:

a glass, a ceramic, and a silicone.

11. The apparatus of claim 1, further comprising at least one depth marking located at the shaft proximal end portion.

12. The apparatus of claim 11, wherein the at least one depth marking comprises a radiopaque material.

13. The apparatus of claim 1, further comprising a tracking device located at the shaft distal end portion.

14. An electrosurgical probe and introducer needle combination for treating an intervertebral disc, comprising:

a probe including a shaft, the shaft including a shaft distal end, at least one active electrode, and at least one return electrode, wherein the shaft distal end includes a first curve and a second curve proximal to the first curve; and

an introducer needle having a lumen and a needle distal end, the introducer needle adapted for passing the shaft distal end through the lumen, and for guiding the shaft distal end distally beyond the needle distal end.

15. The combination of claim 14, wherein the shaft further includes a shaft proximal end portion, the proximal end portion being essentially linear, and the first curve and the second curve are in the same plane relative to a longitudinal axis of the proximal end portion of the shaft.

16. The combination of claim 15, wherein the first curve and the second curve are in opposite directions relative to the longitudinal axis of the proximal end portion of the shaft.

17. The combination of claim 15, wherein the second curve causes a deflection of the shaft distal end away from the longitudinal axis of the proximal end portion of the shaft when the second curve is advanced distally beyond the needle distal end.

18. The combination of claim 17, wherein the second curve is characterized by a second angle, the first curve and the second curve are separated by a substantially linear inter-curve portion, and the magnitude of the deflection is determined by the second angle and a length of the inter-curve portion.

19. The combination of claim 14, wherein the first curve and the second curve are separated by a substantially linear inter-curve portion.

20. The combination of claim 14, wherein the diameter of the lumen is from about 105% to about 500% of the diameter of the shaft distal end.

21. The combination of claim 14, wherein the shaft distal end remains substantially centrally located within the lumen when the shaft distal end is passed within the lumen.

22. The combination of claim 14, wherein the shaft distal end is located substantially centrally within the lumen when the shaft distal end is retracted into the needle distal end.

23. The combination of claim 14, wherein the shaft has a length in the range of from about 10 cm to about 25 cm, and a diameter in the range of from about 0.5 mm to about 2.5 mm, and the introducer needle has a length in the range of from about 10 cm to about 20 cm, and the lumen has a diameter in the range of from about 1.0 mm to about 3.0 mm.

24. The combination of claim 14, wherein the at least one active electrode is disposed at a distal tip of the shaft, the shaft distal end includes a distal linear portion, and a transverse location of the at least one active electrode within the lumen is determined by a length of the distal linear portion.

25. The combination of claim 14, wherein the at least one active electrode is disposed at a distal tip of the shaft, the first curve is characterized by a first angle, and the first angle determines a transverse location of the at least one active electrode within the lumen.

26. The combination of claim 14, wherein the shaft includes a mechanical stop, and the mechanical stop limits distal movement of the shaft within the lumen of the introducer needle.

27. A medical apparatus, comprising:

a shaft including a shaft distal tip, a shaft distal end portion, and a shaft proximal end portion, the shaft distal end portion having a first curve and a second curve proximal to the first curve, wherein the first curve and the second curve are in the same plane relative to a longitudinal axis of the proximal end portion of the shaft, and the first curve and the second curve are in opposite directions, and an introducer device having a lumen and an introducer distal end, the introducer device adapted for passing the shaft distal end portion through the lumen, wherein the shaft distal tip occupies a substantially central transverse location within the lumen when the shaft distal end portion is passed within the lumen.

28. The medical apparatus of claim 27, wherein the shaft distal tip occupies a substantially central transverse location within the lumen when the shaft distal end portion is advanced from and retracted into the introducer distal end.

29. The medical apparatus of claim 27, wherein the shaft distal end portion avoids contact with the introducer device when the shaft distal end portion is advanced from and retracted into the introducer distal end.

30. The medical apparatus of claim 27, wherein the shaft includes a distal linear portion, and a transverse location of the shaft distal tip within the lumen is determined by an angle of the first curve and by a length of the distal linear portion.

31. The medical apparatus of claim 27, wherein the second curve causes a deflection of the shaft distal tip away from a longitudinal axis of the shaft when the second curve is advanced distally beyond the introducer distal end.

32. The medical apparatus of claim 27, further comprising an electrosurgical probe, wherein the electrosurgical probe includes the shaft.

33. The medical apparatus of claim 27, comprising a medical instrument selected from the group consisting of:

a catheter, a cannula, an endoscope, and a hypodermic needle.

34. The apparatus of claim 27, further comprising a tracking device located at the shaft distal end portion, and wherein said tracking device comprises a material selected from the group consisting of tungsten, stainless steel alloys, platinum, platinum alloys, titanium, titanium alloys, molybdenum, molybdenum alloys, nickel, and nickel alloys.

35. A medical apparatus, comprising:

a shaft including a shaft distal tip, a shaft distal end portion, and a shaft proximal end portion, the shaft distal end portion having a first curve and a second curve proximal to the first curve, wherein the first curve and the second curve are in the same plane relative to a longitudinal axis of the proximal end portion of the shaft, and the first curve and the second curve are in opposite directions, and where the shaft distal end portion is adapted to be resilient such that upon the application of an external force the at least one curve distorts, whereupon removal of the force the at least one curve restores, further comprising an introducer device having a lumen and an introducer distal end, the introducer device adapted for passing the shaft distal end portion through the lumen, wherein the shaft distal tip occupies a substantially central transverse location within the lumen when the shaft distal end portion is passed within the lumen.

36. The medical apparatus of claim 35, wherein the shaft distal tip occupies a substantially central transverse location within the lumen when the shaft distal end portion is advanced from and retracted into the introducer distal end.

37. The medical apparatus of claim 35, wherein the shaft distal end portion avoids contact with the introducer device when the shaft distal end portion is advanced from and retracted into the introducer distal end.

38. The medical apparatus of claim 35, wherein the shaft includes a distal linear portion, and a transverse location of the shaft distal tip within the lumen is determined by an angle of the first curve and by a length of the distal linear portion.

39. The medical apparatus of claim 35, wherein the second curve causes a deflection of the shaft distal tip away from a longitudinal axis of the shaft when the second curve is advanced distally beyond the introducer distal end.

40. The medical apparatus of claim 35, further comprising an electrosurgical probe, wherein the electrosurgical probe includes the shaft.

41. The medical apparatus of claim 35, comprising a medical instrument selected from the group consisting of:

a catheter, a cannula, an endoscope, and a hypodermic needle.

42. The apparatus of claim 35, wherein the proximal end portion is essentially linear, and the first curve and the second curve arc in the same plane relative to the longitudinal axis of the proximal end portion of the shaft, and the first curve and the second curve arc in opposite directions relative to the longitudinal axis of the proximal end portion of the shaft.

43. The apparatus of claim 35, further comprising a tracking device located at the shaft distal end portion and comprising a material selected from the group consisting of titanium alloys and nickel alloys.