Electrosurgical medical system and method

• US 9,408,664 B2
• Filed: 03/15/2013
• Issued: 08/09/2016
• Est. Priority Date: 12/28/2000
• Status: Active Grant

• Current Assignee: Senorx Incorporated (Becton, Dickinson & Co)
• Original Assignee: Senorx Incorporated (Becton, Dickinson & Co)
• Inventors: Daw, Derek, Dabney, James Huntington
• Primary Examiner(s): Fowler, Daniel
• Application Number:
  US13/841,928
• Publication Number:
  US 20130211398A1
• Time in Patent Office: 1,243 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00726 Duty cycle
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/0094 Types of switches or controllers
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/1266 with DC current output
• CPC Class Codes: A61B 2018/1286 having a specific transformer
• CPC Class Codes: A61B 2018/162 located on the probe body

Abstract

A medical device system and method provide an RF electrosurgical generator coupled to an electrosurgical electrode via a patient box disposed in close proximity to the patient. An RF signal is delivered from the generator to the patient box where signal power is increased and the RF signal delivered to the electrosurgical electrode. The patient box is coupled to the electrosurgical electrode by a short cable capable of carrying an HV, high frequency 5 MHz signal without leakage. An electrical characteristic associated with the electrosurgical electrode is monitored and a desired RF power output and duty cycle maintained by adjusting DC input voltage applied to an RF amplifier, responsive to the monitoring. The system determines when the electrosurgical cutting electrode has started cutting and switches from a start mode to a run mode having a different RF duty cycle and a reduced RF power output controlled by a servo system.

Claims

1. A medical device comprising:

an electrosurgical tissue cutting electrode;

a return electrode;

a patient box electrically connected to the electrosurgical tissue cutting electrode;

an RF transformer in the patient box, the RF transformer being configured to measure a first stream of RF telemetry signals;

an RF electrosurgical generator electrically coupled to the electrosurgical tissue cutting electrode and the return electrode, the RF electrosurgical generator being configured to provide an RF signal, wherein the RF electrosurgical generator being configured to measure a second stream of RF telemetry signals at an RF combiner housed within the RF electrosurgical generator, and wherein the RF electrosurgical generator being configured to provide a start mode with a first RF power output and a first RF duty cycle and a run mode with a second RF power output and a second RF duty cycle, wherein each of the first RF duty cycle and the second RF duty cycle is a ratio of a pulse duration to a pulse period;

a shielded transmission line electrically connecting the RF electrosurgical generator to the RF transformer in the patient box, whereby the patient box being configured to receive the RF signal from the RF electrosurgical generator and the patient box being configured to supply each of the first RF power output and the second RF power output to the electrosurgical tissue cutting electrode;

a determining device configured to determine when the electrosurgical tissue cutting electrode has started cutting a tissue; and

a control device configured to switch the RF electrosurgical generator from the start mode to the run mode in response to the determining device when the electrosurgical tissue cutting electrode has started to cut the tissue.

2. The medical device of claim 1, wherein the start mode is controlled by the RF electrosurgical generator via a matching unit and includes the first RF power output and the first RF duty cycle, and the run mode is controlled by the RF electrosurgical generator via a servo system and having the second RF duty cycle and the second RF power output.

3. The medical device of claim 1, wherein the determining device is configured to monitor electrical characteristics between the electrosurgical tissue cutting electrode and tissue that is in contact with the return electrode, the electrical characteristics monitored include a DC voltage that appears across the electrosurgical tissue cutting electrode and the return electrode as a result of plasma forming on the electrosurgical tissue cutting electrode.

4. The medical device of claim 3, wherein the RF electrosurgical generator is configured to operate in the start mode when the DC voltage is less than a predetermined limit that designates tissue cutting and operates in the run mode when the DC voltage is at or exceeds the predetermined limit that designates tissue cutting.

5. The medical device of claim 4, wherein the RF electrosurgical generator further comprises a servo system being configured such that a DC voltage level of the DC voltage is established to ensure that plasma has formed on the electrosurgical tissue cutting electrode.

6. The medical device of claim 4, wherein the DC voltage between the electrosurgical tissue cutting electrode and an adjacent tissue exceeds the predetermined limit, wherein the predetermined limit is associated with a formation of plasma at a location between the electrosurgical tissue cutting electrode and the adjacent tissue.

7. The medical device of claim 4, wherein in the start mode the DC voltage is less than the predetermined limit, and in the run mode the DC voltage is at or exceeds the predetermined limit.

8. The medical device of claim 1, wherein the patient box is configured to calculate an actual RF output energy from the first stream of RF telemetry signals, and the RF electrosurgical generator is configured to compare the actual RF output energy from the patient box with an RF combiner RF output energy determined from the second stream of RF telemetry signals;

wherein the RF electrosurgical generator is configured to generate an error when the actual RF output energy does not match the RF combiner RF output energy.

9. The medical device of claim 1, wherein the RF electrosurgical generator further comprises:

an RF amplifier; and

an RF combiner, wherein the RF amplifier is electronically coupled to the RF combiner, wherein the RF combiner is configured to receive the second stream of RF telemetry signals.

10. The medical device of claim 1, wherein the first RF duty cycle is 50 to 100% and wherein the second RF duty cycle is 15 to 40%.