Electrosurgical method and system for treating foot ulcer

• US 7,691,101 B2
• Filed: 01/06/2006
• Issued: 04/06/2010
• Est. Priority Date: 01/06/2006
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Davison, Terry S., Warne, Brian
• Primary Examiner(s): DVORAK, LINDA C
• Assistant Examiner(s): DVORAK, LINDA C
• Application Number:
  US11/327,089
• Publication Number:
  US 20070213700A1
• Time in Patent Office: 1,551 Days
• Field of Search: 128/898, 606/41, 606/45, 606 49- 50
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 2018/00452 Skin
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

An electrosurgical method for treating foot ulcer, including diabetic foot ulcer, comprising: positioning an active electrode in close proximity to the ulcer, the active electrode being disposed on a distal end of an electrosurgical shaft; applying a high-frequency voltage potential difference across the active electrode and a return electrode in the presence of an electrically conductive fluid, the voltage potential being sufficient to generate plasma at the active electrode; and stimulating the ulcer with the active electrode to increase blood flow, remove unhealthy tissue and induce the body'"'"'s natural healing response.

Claims

1. An electrosurgical method of treating ulcer tissue to promote healing, comprising:

positioning an active electrode in close proximity to the ulcer tissue, the active electrode disposed on a distal end of a shaft; and

applying a high-frequency voltage potential difference across the active electrode and a return electrode sufficient to generate plasma at the active electrode,

whereby the active electrode modifies the ulcer tissue, and wherein modifying the ulcer tissue comprises debriding, perforating, inducing blood-flow to, coagulating, and volumetrically removing ulcer tissue.

2. The method of claim 1, wherein an electrically conductive fluid is provided on the active electrode.

3. The method of claim 1, wherein the ulcer tissue comprises a skin ulcer.

4. The method of claim 1, whereby modifying the ulcer tissue comprises directing plasma to the ulcer tissue.

5. The method of claim 1, wherein modifying the ulcer tissue comprises passing an electric current through the ulcer tissue.

6. The method of claim 1, whereby positioning the active electrode comprises translating the active electrode axially and radially over tissue in the proximity of the ulcer tissue.

7. The method of claim 1, wherein the active and the return electrode are disposed on the shaft.

8. The method of claim 1, wherein the return electrode is prevented from contacting tissue in the vicinity of the ulcer tissue.

9. The method of claim 2, wherein the electrically conductive fluid comprises a conductive layer disposed on the active electrode.

10. The method of claim 2, where plasma is generated from the electrically conductive fluid.

11. The method of claim 2, wherein the electrically conductive fluid comprises a conductive bridge disposed between the active and return electrodes.

12. The method of claim 2, wherein the electrically conductive fluid comprises, body fluid, a conductive gel, isotonic saline and Ringer'"'"'s lactate solution.

13. The method of claim 1, including contacting the ulcer tissue with the active electrode.

14. The method of claim 1, including flooding the ulcer tissue with conductive fluid.

15. The method of claim 1, including directing plasma intermittingly to contact tissue in the vicinity of the ulcer tissue for about 0.5 seconds on each instance.

16. The method of claim 1, wherein perforating the tissue comprises forming perforations at about 2 to 5 mm apart in the ulcer tissue and in the vicinity of the ulcer tissue.

17. The method of claim 1, wherein perforating the tissue comprises forming perforations with diameters of up to about 3 mm in the ulcer tissue and in the vicinity of the ulcer tissue.

18. The method of claim 1, wherein perforating the tissue comprises forming perforations up to about 3 mm deep in the ulcer tissue and in the vicinity of the ulcer tissue.

19. The method of claim 1, wherein perforating the tissue comprises forming perforations up to about 5 mm deep in the ulcer tissue and in the vicinity of the ulcer tissue.

20. The method of claim 1, including adjusting the voltage to cause coagulation of tissue in the vicinity of the ulcer tissue.

21. The method of claim 1, wherein the active electrode is attached to a voltage regulator and a conductive fluid supply.

22. The method of claim 1, wherein the active electrode is selected from the group consisting of an electrode having a pointed tip, a wire electrode, a screen electrode, and a suction electrode.

23. The method of claim 1, wherein the shaft comprises a suction lumen adapted for suctioning tissue from the vicinity of the ulcer tissue.

24. The method of claim 1, wherein the shaft comprises a fluid discharge lumen adapted for delivering conductive fluid in the vicinity of the active electrode.

25. The method of claim 1, wherein the ulcer tissue comprises a mucus membrane ulcer.

26. The method of claim 1, wherein the ulcer tissue comprises a foot ulcer.

27. The method of claim 1, wherein the ulcer tissue comprises a diabetic foot ulcer.

28. The method of claim 1, wherein the ulcer tissue comprises cellulitic tissue.

29. The method of claim 1, wherein modifying the ulcer tissue further comprises debriding, perforating, inducing blood-flow to, coagulating, and volumetrically removing tissue in the vicinity of the ulcer tissue.