Electrosurgical instrument with an ablation mode and a coagulation mode

• US 8,361,065 B2
• Filed: 07/10/2008
• Issued: 01/29/2013
• Est. Priority Date: 07/10/2008
• Status: Active Grant

• Current Assignee: HS West Investments, LLC
• Original Assignee: HS West Investments, LLC
• Inventors: West, Hugh S. Jr.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US12/171,150
• Publication Number:
  US 20100010485A1
• Time in Patent Office: 1,664 Days
• Field of Search: 606/37, 606/39, 606/40, 606/42, 600/393, 607/148
• US Class Current: 606/37
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2017/00973 pedal-operated
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe

Abstract

The electrosurgical instrument is configured to selectively perform ablation or coagulation as desired. The electrosurgical instrument includes at least two electrodes on the electrode probe that can be activated using an RF generator. The electrosurgical instrument is selectively switchable between an ablation mode and a coagulation mode by changing the amount of active surface area. In particular, in the ablation mode, a relatively small surface area is active. Thus, for a given power input, the current density is relatively high. In the coagulation mode, the active surface area is increased, thereby reducing the current density in the coagulation mode for the given power input.

Claims

1. An electrosurgical instrument or system for selectively ablating or coagulating tissue at a surgical site during a surgical procedure, the electrosurgical instrument or system being switchable between an ablation mode and a coagulation mode, the electrosurgical instrument or system comprising:

an elongate probe having a proximal end portion and a distal end portion;

a first electrode positioned at the distal end portion of the elongate probe, the first electrode having a first surface area so as to generate a first current density sufficient to ablate tissue when a first amount of power is delivered to the first electrode during operation in an ablation mode;

a coagulation electrode positioned at the distal end portion and electrically isolated from the first electrode, the coagulation electrode having a second surface area that is at least 10% greater than the first surface area so as to generate a second current density that is less than the first current density so as to coagulate tissue when a second amount of power greater than the first amount of power is delivered to the coagulation electrode during operation in a coagulation mode; and

a user operable switch electrically coupled to the first electrode and to the coagulation electrode for selectively delivering power from a power generator to one or both of the first electrode or coagulation electrode, the user operable switch providing user selectable switching between the ablation mode and the coagulation mode, wherein;

when the electrosurgical instrument or system operates in the ablation mode, the switch selectively causes the first amount of power to be delivered only to the first electrode and not to the coagulation electrode so as to generate the first current density at the first electrode sufficient to ablate tissue, and

when the electrosurgical instrument or system operates in the coagulation mode, the switch selectively causes the second amount of power to be delivered to at least the coagulation electrode so as to generate the second current density at the coagulation electrode and optionally also at the first electrode sufficient to coagulate tissue.

2. An electrosurgical instrument or system as in claim 1, wherein, in the coagulation mode, the switch causes a first portion of the second amount of power to be delivered to the first electrode and a second portion of the second amount of power to be delivered to the coagulation electrode, thereby configuring the first electrode for coagulation instead of ablation as a result of increased total electrode surface area.

3. An electrosurgical instrument or system as in claim 1, wherein the first electrode and the coagulation electrode comprise concentric surfaces separated by an insulating material.

4. An electrosurgical instrument or system as in claim 3, further comprising an aspiration lumen in the distal portion, the aspiration lumen having an opening surrounded by the coagulation electrode.

5. An electrosurgical instrument or system as in claim 1, wherein at least one of the first electrode and the coagulation electrode comprises a plurality of distinct surface areas each separated by an insulating material.

6. An electrosurgical instrument or system as in claim 1, wherein the total electrode surface area that is activated when operating in the coagulation mode is at least 15% larger than when operating in the ablation mode.

7. An electrosurgical instrument or system as in claim 1, wherein the second electrode surface area that is activated when operating in the coagulation mode is at least 25% larger than when operating in the ablation mode.

8. An electrosurgical instrument or system as in claim 1, wherein the elongate probe is monopolar.

9. An electrosurgical instrument or system as in claim 8, further comprising a return electrode that is sized and configured to be attached to an external part of the body of a patient.

10. An electrosurgical instrument or system as in claim 1, wherein the elongate probe is bipolar, the elongate probe comprising a return electrode positioned on the distal end portion thereof.

11. An electrosurgical instrument or system as in claim 1, further comprising an RF generator, wherein the user operable switch comprises a foot pedal electrically coupled to the RF generator.

12. An electrosurgical instrument or system as in claim 1, wherein the user operable switch is incorporated into the proximal end portion of the elongate probe.

13. A method for operating an electrosurgical instrument at a surgical site, comprising:

(i) providing an electrosurgical instrument or system as in claim 1;

(ii) coupling the electrosurgical instrument to an RF generator, the RF generator providing a total quantity of power to the electrosurgical instrument;

(iii) selecting the ablation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the ablation mode, wherein in the ablation mode, a part of the total quantity of power is delivered only to the first electrode and not to the coagulation electrode so as to cause ablation of tissue at the surgical site; and

(iv) selecting the coagulation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the coagulation mode, wherein in the coagulation mode, a greater part of the total quantity of power is delivered to the coagulation electrode and optionally also to the first electrode while causing coagulation of tissue at the surgical site, and wherein when operating in the coagulation mode a lower electrode current density is generated while delivering the greater part of the total quantity of power as compared to when operating in the ablation mode.

14. A method as in claim 13, wherein operating the electrosurgical instrument in the coagulation mode comprises delivering a portion of the total quantity of power from the RF generator to the first electrode and delivering a second portion of the total quantity of power to the coagulation electrode to further increase total electrode surface area.

15. A method as in claim 13, wherein the total quantity of power of the RF generator is in a range from 150 W to 600 W.

16. A method as in claim 13, wherein the total quantity of power of the RF generator is in a range from about 200 W to about 400 W.

17. A method as in claim 13, wherein step (iii) is performed prior to step (iv).

18. A method as in claim 13, wherein step (iv) is performed prior to step (iii).

19. A method as in claim 13, further comprising aspirating fluids through a lumen in the elongate probe while operating the electrosurgical instrument in the ablation mode.

20. An electrosurgical instrument for selectively ablating or coagulating tissue at a surgical site during a surgical procedure, comprising:

an elongate probe having a proximal end portion and a distal end portion;

a first electrode positioned at the distal end portion of the elongate probe, the first electrode having a first surface area so as to generate a first current density sufficient to ablate tissue when a first amount of power is delivered to the first electrode during operation in an ablation mode;

a coagulation electrode positioned at the distal end portion and electrically isolated from the first electrode, the coagulation electrode and the first electrode providing a combined surface area greater than the first surface area so as to generate a second current density that is less than the first current density when a second amount of power that is the same or greater than the first amount of power is simultaneously delivered to both the coagulation electrode and the first electrode in order for the coagulation electrode and first electrode to coagulate tissue during operation in a coagulation mode; and

a user operable switch electrically coupled to the first electrode and to the coagulation electrode for selectively delivering power from a power generator to only the first electrode during operation of the electrosurgical instrument in the ablation mode and power to both the coagulation electrode and the first electrode during operation of the electrosurgical instrument in the coagulation mode, wherein

when the electrosurgical instrument operates in the ablation mode, the switch selectively causes the first amount of power to be delivered only to the first electrode and not the coagulation electrode so as to generate the first current density at the first electrode sufficient to ablate tissue, and

when the electrosurgical instrument operates in the coagulation mode, the switch selectively causes the second amount of power to be simultaneously delivered to both the coagulation electrode and the first electrode so as to generate the second current density at the coagulation electrode and the first electrode that is less than the first current density and that is sufficient to coagulate tissue.

21. An electrosurgical instrument as in claim 20, wherein the coagulation electrode has a larger surface area than the first surface area of the first electrode.

22. An electrosurgical instrument as in claim 20, wherein the coagulation electrode has a smaller surface area than the first surface area of the first electrode.

23. An electrosurgical instrument as in claim 20, wherein the coagulation electrode has a surface area equal to the first surface area of the first electrode.

24. A method for operating an electrosurgical instrument at a surgical site, comprising:

(i) providing an electrosurgical instrument as in claim 20;

(ii) coupling the electrosurgical instrument to an RF generator, the RF generator providing a total quantity of power to the electrosurgical instrument;

(iii) selecting the ablation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the ablation mode, wherein in the ablation mode, the total quantity of power is delivered only to the first electrode and not to the coagulation electrode so as to cause ablation of tissue at the surgical site; and

(iv) selecting the coagulation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the coagulation mode, wherein in the coagulation mode, a same or greater total quantity of power is delivered to both the coagulation electrode and the first electrode while causing coagulation of tissue at the surgical site, and wherein when operating in the coagulation mode a lower electrode current density is generated at the coagulation electrode and the first electrode while delivering the same or greater total quantity of power as compared to when operating in the ablation mode.

25. An electrosurgical instrument for selectively ablating or coagulating tissue at a surgical site, the electrosurgical instrument being switchable between an ablation mode and a coagulation mode, the electrosurgical instrument comprising:

an elongate probe having a proximal end portion and a distal end portion;

a dedicated ablation electrode positioned at the distal end portion of the elongate probe, the dedicated ablation electrode having a first surface area so as to generate a first current density sufficient to ablate tissue when a first amount of power is delivered to the dedicated ablation electrode during operation in an ablation mode;

a dedicated coagulation electrode positioned at the distal end portion and electrically isolated from the dedicated ablation electrode, the dedicated coagulation electrode having a second surface area that is at least 10% greater than the first surface area of the ablation electrode so as to generate a second current density sufficient to only coagulate tissue when a second amount of power greater than the first amount of power is delivered to the dedicated coagulation electrode; and

a user operable switch electrically coupled to the ablation electrode and to the coagulation electrode for selectively delivering power from a power generator to the ablation or coagulation electrode, the user operable switch providing user selectable switching between the ablation electrode and the coagulation electrode, wherein,

when the electrosurgical instrument operates in the ablation mode, the switch selectively causes the first amount of power to be delivered only to the dedicated ablation electrode and not to the dedicated coagulation electrode so as to generate the first current density at the dedicated ablation electrode sufficient to ablate tissue, and

when the electrosurgical instrument operates in the coagulation mode, the switch selectively causes the second amount of power to be delivered only to the dedicated coagulation electrode and not to the dedicated ablation electrode so as to generate the second current density at the dedicated coagulation electrode sufficient to coagulate tissue.

26. An electrosurgical instrument as in claim 25, wherein the second surface area is at least 15% larger than the first surface area.

27. An electrosurgical instrument as in claim 25, wherein the second surface area is at least 25% larger than the first surface area.

28. A method for operating an electrosurgical instrument at a surgical site, comprising:

(i) providing an electrosurgical instrument as in claim 25;

(ii) coupling the electrosurgical instrument to an RF generator, the RF generator providing a total quantity of power to the electrosurgical instrument;

(iii) selecting the ablation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the ablation mode, wherein in the ablation mode, the total quantity of power is delivered only to the first electrode and not to the coagulation electrode so as to cause ablation of tissue at the surgical site; and

(iv) selecting the coagulation mode for the electrosurgical instrument using the user operable switch and operating the electrosurgical instrument in the coagulation mode, wherein in the coagulation mode, a greater total quantity of power is delivered to the coagulation electrode while causing coagulation of tissue at the surgical site, and wherein when operating in the coagulation mode a lower electrode current density is generated at the coagulation electrode while delivering the greater total quantity of power as compared to when operating in the ablation mode.