Fluid-assisted medical devices, fluid delivery systems and controllers for such devices, and methods

• US 7,115,139 B2
• Filed: 09/05/2001
• Issued: 10/03/2006
• Est. Priority Date: 03/06/2000
• Status: Expired due to Term

• Current Assignee: Medtronic Advanced Energy LLC (Medtronic Plc)
• Original Assignee: Tissuelink Medical, Inc. (Medtronic Plc)
• Inventors: Oyola, Arnold E., Charbonneau, Mark T., Luzzi, Robert, McClurken, Michael E.
• Primary Examiner(s): ROLLINS, ROSILAND STACIE
• Application Number:
  US09/947,658
• Publication Number:
  US 20020062123A1
• Time in Patent Office: 1,854 Days
• Field of Search: 606/32, 606 39- 42, 606 45- 50, 607/99, 607/101, 607/102, 607/104, 607/105, 607/106, 607/113, 607/96, 128/898
• US Class Current: 607/96
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00065 porous
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00809 measured thermochromatically
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1417 : Ball
• CPC Class Codes: A61B 2018/1422 : Hook
• CPC Class Codes: A61B 2018/1455 : having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2218/002 : Irrigation

Abstract

Medical devices, methods and systems for treating tissue are provided. An exemplary system comprises a fluid from a fluid source, a surgical device which provides energy and the fluid to the tissue and a control mechanism which changes a flow rate of fluid provided from the surgical device and changes a rate of energy provided from the surgical device. The fluid flow rate changes between at least two non-zero flow rates and the energy rate changes between at least two non-zero energy rates. An exemplary method comprises providing a fluid from a fluid source, providing a surgical device which provides energy and the fluid to the tissue, and changing a flow rate of fluid provided from the surgical device with a change in a rate of energy provided from the surgical device. Exemplary devices comprise a tip portion configured to provide energy and a fluid to a tissue.

Claims

1. A method for treating tissue comprising:

providing a monopolar electrosurgical device;

providing radio frequency power and an electrically conductive fluid to the electrosurgical device;

providing the electrically conductive fluid from the electrosurgical device at a fluid flow rate;

forming a localized fluid coupling with the electrically conductive fluid which couples the tissue and the electrosurgical device, the fluid coupling localized at a tip portion of the electrosurgical device;

providing the radio frequency power from the electrosurgical device at a power level;

applying the radio frequency power to the tissue, at least a portion of the radio frequency power applied through the fluid coupling to the tissue;

heating the tissue with the radio frequency power;

heating the fluid coupling with heat from the tissue sufficient to cause a boiling of the fluid coupling; and

using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue.

2. The method according to claim 1 wherein:

the step of using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue further comprises using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue being at about a boiling temperature of the conductive fluid.

3. The method according to claim 1 wherein:

the step of using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue further comprises at least one of using an increase and a decrease of the boiling of the fluid coupling as a visual indicator of a temperature of the tissue.

4. The method according to claim 1 wherein:

the step of using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue further comprises using an amount of boiling of the fluid coupling as a visual indicator of a temperature of the tissue.

5. The method according to claim 1 wherein:

the step of using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue further comprises using an onset of boiling of the fluid coupling as a visual indicator of a temperature of the tissue.

6. The method according to claim 1 wherein:

the step of using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue further comprises using the boiling of the fluid coupling as a visual indicator of a temperature of the tissue being at about 100°

C.

7. The method according to claim 1 wherein:

the tissue further comprises a tissue surface;

the electrosurgical device further comprises an electrode, the electrode having an electrode surface, the electrode surface comprising a spherical surface forming a distal end surface of the device;

the localized fluid coupling couples the tissue surface and the electrode; and

the step of beating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power while moving the electrode spherical surface along the tissue surface.

8. The method according to claim 1 wherein:

the tissue comprises at least one blood vessel; and

the step of heating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power sufficiently to shrink the blood vessel.

9. The method according to claim 1 wherein:

the tissue comprises collagen; and

the step of heating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power sufficiently to shrink the collagen.

10. The method according to claim 1 wherein:

the tissue comprises a tissue surface; and

using the boiling of the fluid coupling to control a temperature of the tissue surface.

11. The method according to claim 10 wherein:

the step of using the boiling of the fluid coupling to control a temperature of the tissue surface further comprises using the boiling of the fluid coupling to control a temperature of the tissue surface to about a boiling temperature of the conductive fluid.

12. The method according to claim 10 wherein:

the step of-using the boiling of the fluid coupling to control a temperature of the tissue surface further comprises at least one of using an increase and a decrease of the boiling of the fluid coupling to control a temperature of the tissue surface.

13. The method according to claim 10 wherein:

the step of using the boiling of the fluid coupling to control a temperature of the tissue surface further comprises using an amount of boiling of the fluid coupling to control a temperature of the tissue surface.

14. The method according to claim 10 wherein:

the step of using the boiling of the fluid coupling to control a temperature of the tissue surface further comprises using an onset of boiling of the fluid coupling to control a temperature of the tissue surface.

15. The method according to claim 1 wherein:

the monopolar electrosurgical device has a proximal end and a distal end and comprises;

a handle;

a tip portion provided at an ending of a shaft extending from the handle, the shaft supporting the tip portion in rigid relation to the handle;

the tip portion comprising an electrode and at least one fluid outlet opening;

a fluid passage; and

the at least one fluid outlet opening in fluid communication with the fluid passage.

16. The method according to claim 15 wherein:

the distal end of the monopolar electrosurgical device comprises a blunt distal end.

17. The method according to claim 16 wherein:

the blunt distal end of the monopolar electrosurgical device is provided by a spherically shaped portion of the electrode.

18. The method according to claim 17 wherein:

the electrode of the monopolar electrosurgical device comprises a cylindrically shaped portion proximal to the spherically shaped portion.

19. The method according to claim 17 wherein:

the at least one fluid outlet opening of the monopolar electrosurgical device is proximal to the spherically shaped portion of the electrode.

20. The method according to claim 15 wherein:

the shaft of the monopolar electrosurgical device comprises a rigid hollow shaft; and

a portion of the fluid passage of the monopolar electrosurgical device is contained within the shaft.

21. The method according to claim 15 wherein:

the at least one fluid outlet opening is at least partially defined by the electrode.

22. The method according to claim 1 wherein:

the tissue comprises at least one of soft tissue and vascular tissue.

23. The method according to claim 1 wherein:

the tissue comprises tumor tissue.

24. The method according to claim 1 wherein:

the tissue comprises at least one of hard tissue, bone tissue and cancellous tissue.

25. The method according to claim 1 wherein:

the tissue comprises at least one of organ tissue, liver tissue, lung tissue, spleen tissue, gallbladder tissue, kidney tissue and pancreas tissue.

26. The method according to claim 1 wherein:

the electrically conductive fluid comprises at least one of saline solution and electrolyte solution.

27. A method for treating tissue, the method comprising:

providing a monopolar electrosurgical device;

providing radio frequency power and an electrically conductive fluid to the electrosurgical device;

providing the electrically conductive fluid from the electrosurgical device at a fluid flow rate;

forming a localized fluid coupling with the electrically conductive fluid which couples the tissue and the electrosurgical device, the fluid coupling localized at a tip portion of the electrosurgical device;

providing the radio frequency power from the electrosurgical device at a power level;

applying the radio frequency power to the tissue, at least a portion of the radio frequency power applied through the fluid coupling to the tissue;

heating the tissue with the radio frequency power;

heating the fluid coupling with heat from the tissue;

visually observing the fluid coupling for a boiling of the fluid coupling; and

adjusting the fluid flaw rate based on visually observing the fluid coupling for a boiling of the fluid coupling.

28. The method according to claim 27 wherein:

the step of adjusting the fluid flow rate based on visually observing the fluid coupling for a boiling of the fluid coupling further comprises decreasing the fluid flow rate based on visually observing a lack of boiling of the fluid coupling.

29. The method according to claim 27 wherein:

the step of adjusting the fluid flow rate based on visually observing the fluid coupling for a boiling of the fluid coupling further comprises increasing the fluid flow rate based on visually observing a boiling of the fluid coupling.

30. The method according to claim 27 wherein:

the step of adjusting the fluid flow rate based on visually observing the fluid coupling for a boiling of the fluid coupling further comprises decreasing the fluid flow rate based on visually observing a boiling of the fluid coupling.

31. The method according to claim 27 wherein:

the tissue comprises at least one blood vessel; and

the step of beating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power sufficiently to shrink the blood vessel.

32. The method according to claim 27 wherein:

the tissue comprises collagen; and

the step of heating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power sufficiently to shrink the collagen.

33. The method according to claim 27 wherein:

the monopolar electrosurgical device has a proximal end and a distal end and comprises;

a handle;

a tip portion provided at an ending of a shaft extending from the handle, the shaft supporting the tip portion in rigid relation to the handle;

the tip portion comprising an electrode and at least one fluid outlet opening;

a fluid passage; and

the at least one fluid outlet opening in fluid communication with the fluid passage.

34. The method according to claim 33 wherein:

the distal end of the monopolar electrosurgical device comprises a blunt distal end.

35. The method according to claim 34 wherein:

the blunt distal end of the monopolar electrosurgical device is provided by a spherically shaped portion of the electrode.

36. The method according to claim 35 wherein:

the electrode of the monopolar electrosurgical device comprises a cylindrically shaped portion proximal to the spherically shaped portion.

37. The method according to claim 35 wherein:

the at least one fluid outlet opening of the monopolar electrosurgical device is proximal to the spherically shaped portion of the electrode.

38. The method according to claim 33 wherein:

the shaft of the monopolar electrosurgical device comprises a rigid hollow shaft; and

a portion of the fluid passage of the monopolar electrosurgical device is contained within the shaft.

39. The method according to claim 33 wherein:

the at least one fluid outlet opening is at least partially defined by the electrode.

40. The method according to claim 27 wherein:

the tissue comprises at least one of soft tissue and vascular tissue.

41. The method according to claim 27 wherein:

the tissue comprises tumor tissue.

42. The method according to claim 27 wherein:

the tissue comprises at least one of hard tissue, bone tissue and cancellous tissue.

43. The method according to claim 27 wherein:

the tissue comprises at least one of organ tissue, liver tissue, lung tissue, spleen tissue, gallbladder tissue, kidney tissue and pancreas tissue.

44. The method according to claim 27 wherein:

the electrically conductive fluid comprises at least one of saline solution and electrolyte solution.

45. The method according to claim 27 wherein:

the tissue further comprises a tissue surface;

the electrosurgical device further comprises an electrode, the electrode having an electrode surface, the electrode surface comprising a spherical surface forming a distal end surface of the device;

the localized fluid coupling couples the tissue surface and the electrode; and

the step of heating the tissue with the radio frequency power further comprises heating the tissue with the radio frequency power while moving the electrode spherical surface along the tissue surface.