Fluid-assisted medical devices, systems and methods

• US 8,568,409 B2
• Filed: 10/31/2007
• Issued: 10/29/2013
• Est. Priority Date: 03/06/2000
• Status: Active Grant

• Current Assignee: Medtronic Advanced Energy LLC (Medtronic Plc)
• Original Assignee: Medtronic Advanced Energy LLC (Medtronic Plc)
• Inventors: O'Brien, Scott D., McClurken, Michael F., Luzzi, Robert
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US11/931,312
• Publication Number:
  US 20080058796A1
• Time in Patent Office: 2,190 Days
• Field of Search: 128/898, 606/41, 606/45, 606/46, 606 48- 50, 607/96, 607/104
• US Class Current: 606/49
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2018/00029 open
• 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 2018/00601 Cutting
• CPC Class Codes: A61B 2018/0063 Sealing
• CPC Class Codes: A61B 2018/00702 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 2018/1417 Ball
• CPC Class Codes: A61B 2018/1422 Hook
• 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

Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

Claims

1. A surgical method for treating tissue comprising:

providing tissue having a tissue surface;

providing radio frequency power and an electrically conductive fluid to an electrosurgical device having a tip portion which simultaneously provides the radio frequency power and the electrically conductive fluid to a tissue treatment site, the tip portion comprising at least one fluid outlet opening and a non-porous blunt distal end provided by an exposed electrode;

providing an 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 surface and the electrode, the fluid coupling localized at the tip portion of the electrosurgical device;

providing the radiofrequency power to the tissue;

moving the tip portion of the electrosurgical device along the tissue;

coagulating the tissue with the electrosurgical device without cutting the tissue; and

blunt dissecting the tissue with the tip portion of electrosurgical device after coagulating the tissue.

2. The method according to claim 1 wherein:

the tissue comprises parenchymal tissue.

3. The method according to claim 1 wherein:

the tissue comprises collagen.

4. The method according to claim 1 wherein:

the tissue comprises organ tissue.

5. The method according to claim 1 wherein:

the electrically conductive fluid comprises saline solution.

6. The method according to claim 1 wherein:

the exposed electrode comprises a domed portion.

7. The method according to claim 6 wherein:

the at least one fluid outlet opening is located proximal to the domed portion of the exposed electrode.

8. The method according to claim 6 wherein:

the exposed electrode further comprises a cylindrical portion proximal to the domed portion.

9. The method according to claim 8 wherein:

the at least one fluid outlet opening is arranged to provide fluid to the cylindrical portion of the exposed electrode.

10. The method according to claim 1 wherein:

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

11. The method according to claim 1 further comprising:

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

12. A surgical method comprising:

providing tissue;

providing an electrically conductive fluid and radiofrequency power to an electrosurgical device having a tip portion to treat the tissue, the tip portion comprising a sintered metal electrode;

placing the electrode on the tissue;

providing the electrically conductive fluid and the radiofrequency power simultaneously from the device to treat the tissue; and

blunt dissecting the tissue with the electrosurgical device.

13. The method of claim 12 wherein:

blunt dissecting the tissue is performed during a resection procedure.

14. The method of claim 13 wherein:

the resection procedure is to remove a portion of tissue, the portion of tissue removed comprising a tumor.

15. The method of claim 12 further comprising:

forming a localized fluid coupling with the electrically conductive fluid which couples the tissue and the electrode,

the fluid coupling localized at the tip portion of the device.

16. The method of claim 12 further comprising:

moving the electrode along the tissue.

17. The method of claim 12 further comprising:

moving the electrode along a line of resection.

18. The method of claim 12 further comprising:

treating the tissue along a line of resection.

19. The method of claim 12 further comprising:

treating the tissue within a crevice.

20. The method of claim 12 further comprising:

treating the tissue sufficiently to provide coagulation.

21. The method of claim 20 wherein:

blunt dissecting the tissue is performed at the same time as coagulation.

22. The method of claim 20 wherein:

blunt dissecting the tissue is performed after coagulation.

23. The method of claim 12 wherein:

the tissue comprises a blood vessel.

24. The method of claim 23 further comprising:

identifying the blood vessel in the tissue from blunt dissecting.

25. The method of claim 24 further comprising:

treating the tissue sufficiently to shrink the blood vessel.

26. The method of claim 12 wherein:

the tissue comprises collagen.

27. The method of claim 26 further comprising:

treating the tissue sufficiently to shrink the collagen.

28. The method of claim 12 further comprising:

removing a portion of tissue, the portion of tissue removed comprising a tumor.

29. The method of claim 12 wherein:

the tissue comprises organ tissue.

30. The method of claim 12 wherein:

the tissue comprises parenchymal tissue.

31. The method of claim 12 wherein:

the tissue comprises liver tissue.

32. The method of claim 12 wherein:

the tissue comprises at least one of lung, pancreas and kidney tissue.

33. The method of claim 12 wherein:

the electrically conductive fluid comprises saline.

34. The method of claim 32 wherein:

the saline is normal saline.

35. The method of claim 12 wherein:

the electrically conductive fluid comprises an electrolyte solution.

36. The method of claim 32 wherein:

the electrically conductive fluid is provided from a fluid source, the fluid source comprising a bag of saline.

37. The method of claim 12 wherein:

the electrosurgical device comprises;

a handle;

a rigid shaft extending distally beyond the handle, the shaft having a distal end;

the electrode extends distally beyond the distal end of the shaft,

a fluid delivery lumen; and

the electrode in fluid communication with the fluid delivery lumen.

38. The method of claim 12 wherein:

the sintered metal electrode is porous.

39. The method of claim 38 wherein:

the porous sintered metal electrode comprises a plurality of pores.

40. The method of claim 39 wherein:

the pores have a pore size in a range of 2.5 micrometers to 500 micrometers.

41. The method of claim 39 wherein:

the pores have a pore size in a range of 10 micrometers to 120 micrometers.

42. The method of claim 39 wherein:

the pores have a pore size and a range of 20 micrometers to 80 micrometers.

43. The method of claim 12 wherein:

the sintered metal electrode is pervious to the passage of the fluid.

44. The method of claim 12 wherein:

the sintered metal electrode at least partially defines a fluid outlet.

45. The method of claim 12 wherein:

the electrosurgical device has fluid flow adjustment mechanism.

46. The method of claim 12 wherein:

the electrosurgical device has a switch to activate the radiofrequency power.

47. The method of claim 12 wherein:

the electrosurgical device is a monopolar device.

48. The method of claim 12 wherein:

the electrosurgical device is a laparoscopic surgery device.

49. The method of claim 12 wherein:

the electrosurgical device is an open surgery device.

50. A surgical method comprising:

providing tissue;

providing an electrically conductive fluid and radiofrequency power to an electrosurgical device having a tip portion to treat the tissue, the tip portion comprising a metal electrode wherein the metal electrode comprises a porous structure and bonded metal particles;

placing the electrode on the tissue;

providing the electrically conductive fluid in the radiofrequency power simultaneously from the device to treat the tissue;

blunt dissecting the tissue with the electrosurgical device.