Systems and methods for electrosurgical treatment of fasciitis

• US 20060189971A1
• Filed: 11/23/2005
• Published: 08/24/2006
• Est. Priority Date: 11/22/1995
• Status: Abandoned Application

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Tasto, James P., Woloszko, Jean, Eggers, Philip E., Thapliyal, Hira V.
• Application Number:
  US11/285,927
• Publication Number:
  US 20060189971A1
• Time in Patent Office: Days
• US Class Current: 606/32
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• 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 2018/00738 Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1246 characterised by the output polarity
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1273 including multiple generators in one device
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 : located on the probe body
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of stents or stent-grafts

Abstract

Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one aspect, the invention involves canalizing or boring channels, divots, trenches or holes through an avascular connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. In one method, an active electrode is positioned in close proximity to a target site on a tendon, and a high frequency voltage difference is applied between the active electrode and a return electrode to selectively ablate tendon tissue at the target site, thereby forming a channel or void in the tendon. The active electrode(s) may be moved relative to the tendon during, or after, the application of electrical energy to damage or sculpt a void within the tendon, such as a hole, channel, crater, or the like. In another aspect of the invention, an electrosurgical probe is used to elicit a wound healing response in a target tissue, such as an injured tendon, in order to stimulate vascularization of the target tissue. The present invention may also be used for vascularization of a torn or damaged tissue in conjunction with a surgical repair procedure.

Claims

1. An electrosurgical method of treating fasciitis, comprising:

positioning an active electrode in close proximity to a target fascia, the active electrode disposed on a distal end of a shaft; and

applying a high frequency voltage across the active electrode and a return electrode, the high frequency voltage sufficient to facilitate healing of the fascia.

2. The method of claim 1, wherein the fascia comprises plantar fascia.

3. The method of claim 1, wherein an electrically conductive fluid is present between the active electrode and the fascia.

4. The method of claim 3, wherein the electrically conductive fluid comprises an electrically conductive path between the active electrode and the return electrode.

5. The method of claim 3, wherein the electrically conductive fluid comprises isotonic saline, and body fluid.

6. The method of claim 1, wherein the high frequency voltage is sufficient to generate plasma at the active electrode.

7. The method of claim 1, where the high frequency voltage is sufficient to increase fascia blood flow.

8. The method of claim 1, wherein the high frequency voltage is sufficient to regenerate fascia tissue.

9. The method of claim 1, wherein the high frequency voltage is sufficient to cause volumetric removal of fascia tissue.

10. The method of claim 9, wherein the volumetric removal of tissue is by molecular dissociation of fascia tissue.

11. The method of claim 1, wherein the return electrode is prevented from contacting the fascia.

12. The method of claim 1, wherein the return electrode is located on the shaft proximally to the active electrode.

13. The method of claim 1, including forming voids in the fascia with the active electrode.

14. The method of claim 13, wherein the voids are up to about 0.5 mm deep.

15. The method of claim 13, wherein the voids are up to about 5 mm deep.

16. The method of claim 13, wherein the diameter of voids are from about 0.5 mm to 3 mm.

17. The method of claim 13, wherein the diameter of the voids are from about 1 mm to 2 mm.

18. The method of claim 13, wherein the voids are spaced apart at approximately 5 mm intervals.

19. The method of claim 1, wherein the high frequency voltage is applied intermittingly to fascia tissue for about 0.5 second duration.

20. The method of claim 1, wherein the active electrode comprised a pointed tip.

21. The method of claim 1, wherein the active electrode is connected to a voltage regulator.

22. The method of claim 3, wherein the conductive fluid is provided by a fluid delivery lumen on the shaft.

23. An electrosurgical method of stimulating the wound healing response in fascia, comprising:

energizing an active electrode with a high frequency voltage, the active electrode disposed on the distal end of a shaft; and

transferring energy from the active electrode to the fascia sufficient to induce a healing response.

24. The method of claim 23, wherein the soft tissue comprises plantar fascia.

25. The method of claim 23, wherein the sufficient energy is transferred to stimulate collagen growth in the fascia.

26. The method of claim 23, wherein the sufficient energy is transferred from the fascia to form voids in the fascia.

27. The method of claim 23, wherein sufficient energy is transferred to heat the fascia.

28. The method of claim 23, wherein sufficient energy is transferred to volumetrically remove a portion of the fascia tissue.

29. The method of claim 23, wherein sufficient energy is transferred to damage the fascia and promote a neovascular response.

30. The method of claim 23, wherein the high frequency voltage is applied across the active electrode and a return electrode disposed on the shaft.

31. The method of claim 23, wherein an electrically conductive fluid is present between the active electrode and the fascia.

32. The method of claim 31, wherein the electrically conductive fluid comprises an electrically conductive path between the active and return electrode.

33. The method of claim 28, wherein volumetric removal of fascia tissue is plasma-induced.