Electrosurgical methods and systems

• US 9,713,489 B2
• Filed: 03/07/2013
• Issued: 07/25/2017
• Est. Priority Date: 03/07/2013
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Woloszko, Jean, Ryan, Thomas P., Yuan, David, Gaspredes, Jonathan
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US13/787,973
• Publication Number:
  US 20140257269A1
• Time in Patent Office: 1,601 Days
• Field of Search: 606 34, 606 41
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00744 Fluid flow
• CPC Class Codes: A61B 2018/00767 Voltage
• 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 2018/00988 Means for storing information, e.g. calibration constants, or for preventing excessive use, e.g. usage, service life counter

Abstract

Electrosurgical methods and systems. At least some of the illustrative embodiments are methods including maintaining plasma proximate to an active electrode in a first energy range, and a second energy range. During periods when plasma is proximate to the active electrode, the illustrative method may include controlling flow of fluid drawn into an aperture of an electrosurgical wand, and in some situations increasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue, and in other cases decreasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue. Further, during periods when plasma is proximate to the active electrode, the illustrative method may include providing output energy at a default energy setpoint, and then providing output energy at a second energy setpoint.

Claims

1. An electrosurgical method comprising:

maintaining plasma proximate to an active electrode of an electrosurgical wand, the plasma created based on delivery of output energy to the active electrode by an electrosurgical controller, the output energy within a predetermined first energy range, and during periods of time when output energy is being delivered within the first energy range;

controlling an aspirating flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate; and

increasing the aspirating flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue; and

maintaining plasma proximate to the active electrode, the plasma created based on delivery of output energy to the active electrode within a predetermined second energy range, the second energy range distinct from the first energy range, and during periods of time output energy is being delivered within the second energy range;

controlling the aspirating flow of fluid drawn into the aperture at a second flow rate; and

decreasing the aspirating flow of fluid drawn into the aperture responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

2. The electrosurgical method of claim 1 wherein decreasing flow of fluid drawn into the aperture further comprises decreasing a flow setpoint responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

3. The electrosurgical method of claim 1:

wherein controlling flow of fluid drawn into the aperture at the second flow rate further comprises implementing open-loop flow control; and

wherein decreasing flow of fluid drawn into the aperture further comprises implementing closed-loop flow control responsive to the electrosurgical controller detecting the active electrode is in operational relationship with tissue.

4. The electrosurgical method of claim 1 wherein maintaining plasma associated with the first energy range further comprises:

providing output energy at a default energy setpoint by the electrosurgical controller, the default energy setpoint within the first energy range; and

then

providing output energy at a second energy setpoint by the electrosurgical controller, the second energy setpoint different than the default energy setpoint, the second energy setpoint within the first energy range, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

5. The electrosurgical method of claim 4 wherein the second energy setpoint is at least one selected from the group consisting of:

a higher output energy than the default energy setpoint;

and a lower output energy than the default energy setpoint.

6. The electrosurgical method of claim 4 wherein the controller receives the command by way of at least one selected from the group consisting of:

actuation of a foot pedal;

actuation of a button on the electrosurgical wand;

actuation of a button on the electrosurgical controller; and

manipulation of a graphical user interface on the electrosurgical controller.

7. The electrosurgical method of claim 4 further comprising, after providing output energy at the default energy setpoint and providing output energy at the second energy setpoint, providing output energy at a third energy setpoint by the electrosurgical controller, the third energy setpoint different than the default energy setpoint and the second energy setpoint, the third energy setpoint within the first energy range, and implementing the third energy setpoint responsive to the electrosurgical controller receiving a command.

8. The electrosurgical method of claim 1 wherein maintaining plasma associated with the first energy range further comprises:

providing output energy at a default energy setpoint by the electrosurgical controller and controlling aspiration of fluid at a first flow setpoint; and

then

providing output energy at a second energy setpoint and controlling aspiration at a second flow setpoint, the second energy setpoint being within first energy range and being different than the default energy setpoint, the second flow setpoint different than the first flow setpoint, and implementing the second energy setpoint responsive to the electrosurgical controller receiving a command.

9. The electrosurgical method of claim 1 further comprising delaying the delivery of output energy to the active electrode until at least the first flow rate of flow of fluid drawn into an aperture of the electrosurgical wand is established.

10. The electrosurgical method of claim 1 further comprising, prior to at least one step of maintaining plasma, measuring impedance of an electrode circuit that comprises the active electrode.

11. The method of claim 1, wherein during periods of time when output energy is being delivered, adjusting the output energy so as to maintain plasma proximate the active electrode.

12. The electrosurgical method of claim 1 further comprising detecting a clog condition that alters the flow of fluid through the aperture based on an increase of temperature of tubing associated with the aperture.

13. The electrosurgical method of claim 12, wherein the temperature is sensed by a temperature measurement device abutting an outer surface of the tubing.

14. An electrosurgical method comprising:

maintaining plasma proximate to an active electrode of an electrosurgical wand, the plasma created based on delivery of output energy to the active electrode by an electrosurgical controller, the output energy within a predetermined first energy range, and during periods of time when output energy is being delivered within the first energy range;

measuring at least one electrical parameter presented by of an electrode circuit impedance comprising the plasma and active electrode;

controlling an aspirating flow of fluid drawn into an aperture of the electrosurgical wand at a first flow rate; and

increasing the aspirating flow of fluid drawn into the aperture in response to an increase in the electrode circuit impedance; and

maintaining plasma proximate to the active electrode, the plasma created based on delivery of output energy to the active electrode within a predetermined second energy range, the second energy range distinct from the first energy range, and during periods of time output energy is being delivered within the second energy range;

measuring the at least one electrical parameter indicative of an electrode circuit impedance comprising the plasma and active electrode;

controlling the aspirating flow of fluid drawn into the aperture at a second flow rate; and

decreasing the aspirating flow of fluid drawn into the aperture responsive to an increase in electrode circuit impedance.