Bipolar electrosurgical clamp for removing and modifying tissue

• US 7,297,145 B2
• Filed: 10/11/2005
• Issued: 11/20/2007
• Est. Priority Date: 10/23/1997
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Tsuji, Craig, Ormsby, Theodore
• Primary Examiner(s): Cohen; Lee S.
• Application Number:
  US11/248,460
• Publication Number:
  US 20060129145A1
• Time in Patent Office: 770 Days
• Field of Search: 606/41, 606/48, 606 50- 52
• US Class Current: 606/41
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• 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 2018/0066 : without feedback, i.e. open loop control
• 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 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1422 : Hook
• 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 2218/003 : using a spray or a foam
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices

Abstract

The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ. The closed configuration is adapted for clamping and coagulating a target tissue while the apparatus is operating in the sub-ablation mode, while the open configuration is adapted for ablating the target tissue via molecular dissociation of tissue components. A method of the present invention comprises clamping a target tissue or organ with an electrosurgical probe. A first high frequency voltage is applied between the active electrode and the return electrode to effect coagulation of the clamped tissue. Thereafter, a second high frequency voltage is applied to effect localized molecular dissociation of the coagulated tissue.

Claims

1. An electrosurgical system for ablating or modifying tissue at a target site, comprising:

a shaft having a shaft distal end portion and a shaft proximal end portion, the shaft distal end portion having an active electrode and an opposing return electrode in pivotable relationship with said active electrode such that said electrodes have an open configuration or a closed configuration and wherein the closed configuration is adapted to clamp and hold tissue between the first and second electrode;

a voltage supply in electrical communication with said active and return electrode;

an electrically conductive fluid supply assembly containing electrically conductive fluid having an electrical conductivity equal to or greater than isotonic saline, wherein the electrically conductive fluid supply assembly is adapted to supply electrically conductive fluid to the target site such that a current flow path is present through the electrically conductive fluid between the active and the return electrode when a first high frequency voltage is applied between the active electrode and the return electrode;

a mode switch for switching the system between a coagulation mode and an ablation mode, wherein the mode switch is responsive to a shift in configuration of the shaft distal end portion.

2. The system of claim 1, wherein the closed configuration is adapted for coagulating a target tissue.

3. The system of claim 1, wherein the first high frequency voltage is sufficient to ablate the target tissue via localized molecular dissociation of target tissue components.

4. The system of claim 1 further comprising an electrode support supporting the active electrode.

5. The system of claim 4, wherein the closed configuration is adapted for coagulating a target tissue.

6. The system of claim 1 wherein the return electrode comprises a notch adapted to accommodate the active electrode.

7. The system of claim 1 wherein the active electrode comprises an elongate lateral portion.

8. The system of claim 7 wherein the active electrode comprises a distal terminal portion.

9. The system of claim 1 comprising an actuator unit adapted to force the active electrode and the return electrode toward the closed configuration.

10. The system of claim 1 wherein the active electrode is parallel to the return electrode in the closed configuration.

11. The system of claim 1 wherein the return electrode comprises a cowl.

12. The system of claim 1 wherein in the open configuration the active electrode is disposed at an angle with respect to the return electrode.

13. An electrosurgical system for ablating or modifying tissue at a target site, comprising:

a shaft having a shaft distal end portion and a shaft proximal end portion, the shaft distal end portion having an active electrode and an opposing return electrode in pivotable relationship with said active electrode such that said electrodes have an open configuration or a closed configuration and wherein the closed configuration is adapted to clamp and hold tissue between the first and second electrode;

a voltage supply in electrical communication with said active and return electrode; and

a mode switch for switching the system between a coagulation mode and an ablation mode, wherein the mode switch is responsive to a shift in configuration of the shaft distal end portion.

14. The system of claim 13, further comprising an electrode support supporting the active electrode.

15. The system of claim 13 wherein the return electrode comprises a notch adapted to accommodate the active electrode.

16. The system of claim 13 wherein the active electrode comprises an elongate lateral portion.

17. The system of claim 16 wherein the active electrode comprises a distal terminal portion.

18. The system of claim 13 comprising an actuator unit adapted to force the active electrode and the return electrode toward the closed configuration.

19. The system of claim 13 wherein the active electrode is substantially parallel to the return electrode in the closed configuration.

20. The system of claim 13 wherein the return electrode comprises a cowl.

21. The system of claim 13 wherein in the open configuration the active electrode is disposed at an angle with respect to the return electrode.