Systems and methods for electrosurgical treatment of obstructive sleep disorders

• US 7,131,969 B1
• Filed: 05/01/2000
• Issued: 11/07/2006
• Est. Priority Date: 06/07/1995
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Eggers, Philip E., Hovda, David C., Ellsberry, Maria B., Thapliyal, Hira V.
• Primary Examiner(s): RODRIGUEZ, CRIS LOIREN
• Application Number:
  US09/562,496
• Time in Patent Office: 2,381 Days
• Field of Search: 604/22, 604/35, 604/114, 606/39, 606/41, 606/46, 606/32, 606/34, 606/37, 606/45, 606/106, 606/110, 606/127, 606/38, 606/40, 607/99, 607/105, 607/113
• US Class Current: 606/45
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• 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 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00119 with metal oxide nitride
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00327 Ear, nose or throat
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00583 : Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/00678 : upper
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00827 : Current
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/124 : switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 2018/165 : Multiple indifferent electrodes
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient'"'"'s body, particularly including tissue in the ear, nose and throat. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove and/or modify the structure of tissue structures. The present invention is particularly useful for treating sleep obstructive disorders, such as sleep apnea and snoring.

Claims

1. A method for removing tissue in an oral cavity comprising:

introducing an active electrode into a patient'"'"'s mouth;

delivering an electrically conductive fluid to a target site within the patient'"'"'s mouth such that the active electrode is substantially surrounded by the electrically conductive fluid and electrically conductive fluid is present between the active electrode and target tissue at the target site;

urging said active electrode onto the surface of said target site to remove said tissue without puncturing said surface; and

applying sufficient high frequency voltage to the active electrode to effect molecular dissociation of at least a portion of the target tissue.

2. The method of claim 1 wherein said target tissue is mucosal tissue.

3. The method of claim 1 wherein said target tissue is gingival tissue.

4. A method for performing oral surgery comprising:

introducing an instrument into a patient'"'"'s oral cavity, said instrument comprising a proximal end and a distal end, said instrument further comprising an active electrode at or near said distal end and a return electrode spaced proximally from the active electrode;

providing an electrically conductive fluid between the active and return electrode; and

applying a high frequency voltage difference between the active electrode and return electrode while the distal end of the instrument is adjacent or contacting target tissue within said oral cavity such that at least a first surface layer of said tissue is removed.

5. The method of claim 4 further comprising applying a sufficient high frequency voltage difference between the active electrode and the return electrode to effect molecular dissociation of at least a portion of said target tissue.

6. The method of claim 4 further comprising applying a sufficient high frequency voltage difference to convert solid tissue cell molecules into non-condensable gases.

7. The method of claim 4 wherein the applying step includes generating a voltage gradient between the active electrode and the voltage gradient being sufficient to create an electric field that breaks down tissue through molecular dissociation.

8. The method of claim 4 further comprising delivering electrically conductive fluid to the target tissue such that the active electrode and the return electrode are in contact with the electrically conductive fluid and electrically conductive fluid is located between the active electrode and the target tissue.

9. The method of claim 8 further comprising generating a current flow path between the return electrode and the active electrode with the electrically conductive fluid.

10. The method of claim 4 further comprising applying sufficient voltage to the active electrode in the presence of electrically conducting fluid to vaporize at least a portion of the fluid between the active electrode and the target tissue at the target site to cause dissociation of the molecular bonds within the tissue structures.

11. The method of claim 4 wherein said target tissue is mucosal tissue.

12. The method of claim 11 wherein said tissue comprises a tonsil.

13. The method of claim 11 wherein said tissue comprises a soft palate tissue.

14. The method of claim 11 wherein said tissue comprises a tongue.

15. The method of claim 4 wherein said target tissue is ablated.

16. The method of claim 4 further comprising directing an electrically conductive fluid towards the active electrode.

17. The method of claim 4 wherein said applying step creates a plasma over the active electrode.

18. The method of claim 4 wherein the applying step induces the discharge of photons having a wavelength in the ultraviolet spectrum.

19. The method of claim 4 further comprising aspirating fluids and tissue fragments.

20. The method of claim 4 wherein said fluid has an electrical conductivity greater than 10 mS/cm.

21. The method of claim 4 wherein said fluid is provided via a fluid delivery element.

22. The method of claim 21 wherein said fluid delivery element is integral with said instrument.