Electrosurgical treatment in conjunction with monitoring

• US 20060030845A1
• Filed: 08/04/2005
• Published: 02/09/2006
• Est. Priority Date: 08/04/2004
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Baylis Medical Company Inc. (Boston Scientific Corporation)
• Inventors: Godara, Neil, Leung, Mark, Lifshitz, Nir, Conquergood, Laura
• Granted Patent: US 7,799,021 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor

Abstract

An electrosurgical apparatus comprising an energy source operable to concurrently provide a first signal and a second signal, said first and second signals having different frequencies; and a signal processor operable to receive a third signal from a patient'"'"'s body, to process said third signal, and to produce an output based on a processing of said third signal; wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to a delivery of said second signal to said patient'"'"'s body.

Claims

1. An electrosurgical apparatus comprising:

at least one energy source operable to at least partly concurrently provide a first signal and a second signal, said first and second signals having different frequencies; and

at least one signal processor operable to receive a third signal from a patient'"'"'s body, to process said third signal, and to produce an output based on a processing of said third signal;

wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to a delivery of said second signal to said patient'"'"'s body.

2. The apparatus of claim 1, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz.

3. The apparatus of claim 1, wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

4. The apparatus of claim 1, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz and wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

5. The apparatus of claim 1, wherein said evoked potential is a somatosensory evoked potential.

6. The apparatus of claim 1, wherein said evoked potential is a motor evoked potential.

7. The apparatus of claim 1, further comprising a display.

8. The apparatus of claim 1, further comprising a storage element.

9. The apparatus of claim 1, further comprising a controller.

10. The apparatus of claim 9, wherein said controller is operable to alter the operation of said at least one energy source.

11. The apparatus of claim 10, wherein said controller is operable to perform at least one operation selected from the group consisting of modulating a power output of said at least one energy source, disabling one or more operations of said at least one energy source and otherwise altering a parameter controllable by said at least one energy source.

12. The apparatus of claim 9, wherein said controller is operable to control said at least one signal processor.

13. The apparatus of claim 12, wherein said controller is operable to perform at least one operation selected from the group consisting of altering filtering parameters, increasing or decreasing a level of amplification, and changing a predetermined or previously measured waveform or value to which a signal is compared.

14. The apparatus of claim 9, wherein said controller is operable to output an informational message.

15. An electrosurgical system comprising:

an electrosurgical apparatus comprising at least one energy source operable to at least partly concurrently provide a first signal and a second signal, said first and second signals having different frequencies, and at least one signal processor operable to receive a third signal from a patient'"'"'s body, to process said third signal, and to produce an output based on the processing of said third signal, wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to the application of said second signal to said patient'"'"'s body;

at least one electrically conductive component operable to deliver said first signal to a patient'"'"'s body;

at least one electrically conductive component operable to deliver said second signal to a patient'"'"'s body;

at least one electrically conductive component operable to convey said evoked potential from said patient'"'"'s body to said signal processor; and

at least one electrically conductive component operable to provide a return path for at least one of said first signal and said second signal.

16. The system of claim 15, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz.

17. The system of claim 15, wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

18. The system of claim 15, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz and wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

19. The system of claim 15, further comprising a display.

20. The system of claim 15, further comprising a storage element.

21. The system of claim 15, further comprising a controller.

22. The system of claim 21, wherein said controller is operable to alter the operation of said at least one energy source.

23. The system of claim 22, wherein said controller is operable to perform at least one operation selected from the group consisting of modulating power output of said at least one energy source, disabling one or more operations of said at least one energy source and otherwise altering a parameter controllable by said at least one energy source.

24. The system of claim 21, wherein said controller is operable to control said at least one signal processor.

25. The system of claim 24, wherein said controller is operable to perform at least one operation selected from the group consisting of altering filtering parameters, increasing or decreasing a level of amplification, and changing a predetermined or previously measured waveform or value to which a signal is compared.

26. The system of claim 21, wherein said controller is operable to output an informational message.

27. The system of claim 15, further comprising at least one means for cooling.

28. The system of claim 27, wherein said means for cooling comprises at least one fluid circulation apparatus.

29. The system of claim 27, further comprising a controller.

30. The system of claim 29, wherein said controller is operable to alter an operation of said means for cooling.

31. The system of claim 30, wherein said controller is operable to perform at least one operation selected from the group consisting of modulating an output of said at least one means for cooling, disabling one or more operations of said at least one means for cooling and otherwise altering a parameter controllable by said at least one means for cooling.

32. The system of claim 15, further comprising at least one tissue monitoring device.

33. The system of claim 32, wherein said tissue monitoring device comprises a temperature sensor.

34. The system of claim 33, wherein said temperature sensor is selected from the group consisting of a thermocouple, a thermistor and a thermometer.

35. The system of claim 32, wherein said tissue monitoring device comprises an impedance monitor.

36. The system of claim 32, further comprising a controller.

37. The system of claim 36, wherein said controller is operable to alter an operation of a component of said system based on an output from said at least one tissue monitoring device.

38. The system of claim 15, wherein the at least one component operable to deliver said first signal comprises a probe.

39. The system of claim 15 wherein the at least one component operable to deliver said first signal comprises a bipolar apparatus.

40. The system of claim 15, wherein the at least one component operable to deliver said second signal is selected from the group consisting of a needle electrode and a surface electrode.

41. The system of claim 15, wherein the at least one component operable to convey said evoked potential is selected from the group consisting of a needle electrode and a surface electrode.

42. The system of claim 15, wherein the at least one component operable to provide a return path comprises a grounding pad.

43. A method of electrosurgery comprising the steps of:

conveying a first signal having a first frequency to a patient'"'"'s body;

conveying a second signal having a second frequency to a patient'"'"'s body; and

receiving an evoked potential generated by said patient'"'"'s body, wherein said evoked potential is generated in response to a delivery of said second signal to said patient'"'"'s body;

wherein the steps of conveying a first signal and conveying a second signal occur at least partly concurrently.

44. The method of claim 43, further comprising a step of processing said evoked potential and providing an output based on said processing of said evoked potential.

45. The method of claim 44, wherein the step of processing said evoked potential comprises performing at least one operation selected from the group consisting of amplifying said evoked potential, filtering said evoked potential, averaging said evoked potential and comparing said evoked potential to pre-determined data.

46. The method of claim 43, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz.

47. The method of claim 46, wherein said first signal is conveyed to perform at least one treatment procedure selected from the group consisting of lesioning, ablation and denervation.

48. The method of claim 43, wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

49. The method of claim 48, wherein said second signal is conveyed to stimulate a sensory nerve.

50. The method of claim 49, wherein said evoked potential is a somatosensory evoked potential.

51. The method of claim 48, wherein said second signal is conveyed to stimulate a motor nerve.

52. The method of claim 51, wherein said evoked potential is a motor evoked potential.

53. The method of claim 43, wherein said first signal has a frequency from about 260 kHz to about 1.5 MHz and wherein said second signal has a frequency from about 1 Hz to about 100 Hz.

54. The method of claim 44, further comprising a step of altering said first signal based on said output.

55. The method of claim 43, further comprising a step of altering the processing of said evoked potential.

56. The method of claim 43, further comprising a step of outputting an informational message.

57. The method of claim 43, wherein said method further comprises a step of providing cooling.

58. The method of claim 57, further comprising a step of altering the cooling.

59. The method of claim 43, further comprising a step of monitoring at least one characteristic of a tissue of said patient'"'"'s body.

60. The method of claim 59, further comprising a step of altering said first signal based on the monitoring of the at least one tissue characteristic.

61. The method of claim 59, further comprising the steps of providing cooling and altering the cooling based on the monitoring of the at least one tissue characteristic.

62. An electrosurgical apparatus comprising:

a first energy source operable to provide a first signal having a first frequency;

a second energy source operable to provide a second signal having a second frequency;

a signal processor operable to receive a third signal from a patient'"'"'s body, to process said third signal, and to produce an output based on the processing of said third signal; and

a controller operable to control said first signal based on said output;

wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to the application of said second signal to said patient'"'"'s body.

63. The apparatus of claim 62, further comprising a display.

64. An electrosurgical apparatus comprising:

means for at least partly concurrently providing at least a first signal and a second signal, said first and second signals having different frequencies; and

means for receiving a third signal from a patient'"'"'s body, for processing said third signal, and for producing an output based on the processing of said third signal;

wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to the application of said second signal to said patient'"'"'s body.

65. The apparatus of claim 64, further comprising means for displaying information.

66. The apparatus of claim 64, further comprising means for controlling said first signal based on said output.

67. An electrosurgical apparatus comprising:

means for providing a first signal having a first frequency;

means for providing a second signal having a second frequency;

means for receiving a third signal from a patient'"'"'s body, processing said third signal, and producing an output based on the processing of said third signal; and

means for controlling said first signal based on said output;

wherein said third signal is an evoked potential generated by said patient'"'"'s body in response to the application of said second signal to said patient'"'"'s body.

68. The apparatus of claim 67, further comprising means for displaying information.