ELECTROSURGICAL INSTRUMENT FOR ABLATION AND RESECTION

Abstract

An electrosurgical instrument which is capable of simultaneously ablating an area of tissue with microwave energy and performing resection with RF energy. The instrument comprises a structure for conveying both RF and microwave energy to an instrument tip that is configured to emit the microwave energy in a manner suitable for ablation (e.g. as a substantially spherical field) and to emit the RF energy in a more focussed manner to enable accurate and controllable resection to be performed. The energy conveying structure comprises a coaxial transmission line for conveying microwave energy. The coaxial transmission line has a hollow inner conductor that defines a passage that supports a second transmission line for conveying radiofrequency energy.

Claims

1. An electrosurgical instrument for delivering radiofrequency (RF) electromagnetic (EM) energy and microwave EM energy for resection and ablation of biological tissue, the instrument comprising: an energy conveying cable structure comprising: a coaxial transmission line for conveying microwave energy, the coaxial transmission line comprising an inner conductive layer, an outer conductive layer and a dielectric layer separating the inner conductive layer from the outer conductive layer, wherein the inner conductive layer is formed around a hollow longitudinal passage along the cable structure; and a transmission line for conveying radiofrequency energy along the hollow longitudinal passage; and an instrument tip at a distal end of the energy conveying cable structure, the instrument tip comprising: a dielectric tip element extending longitudinally beyond a distal end of the outer conductor, wherein the inner conductor extends longitudinally beyond the distal end of the outer conductor within the dielectric tip element to form a microwave radiator; and an active electrode and a return electrode mounted at a distal end of the dielectric tip, wherein the active electrode and the return electrode are connected to the transmission line to support an RF field therebetween at the distal end of the dielectric tip element.

2. An electrosurgical instrument according to claim 1, wherein the coaxial transmission line for conveying the microwave energy is a first coaxial transmission line, and the transmission line for conveying the radiofrequency energy is a second coaxial transmission line, wherein the second coaxial transmission line comprises an innermost conductive element extending through the longitudinal passage, the inner conductive layer, and an innermost dielectric layer separating the inner conductive layer from the innermost conductive element, wherein the active electrode is electrically connected to the inner conductive layer and the return electrode is electrically connected to the innermost conductive element, and wherein the innermost conductive element and the outer conductive layer are electrically grounded.

3. An electrosurgical instrument according to claim 2, wherein the innermost conductive element is a conductive wire.

4. An electrosurgical instrument according to claim 2, wherein the innermost conductive element includes a control wire for manipulating the instrument tip.

5. An electrosurgical instrument according to claim 1, wherein the transmission line for conveying the radiofrequency energy is ;,a pair of wires extending through the hollow longitudinal passage.

6. An electrosurgical instrument according to claim 5, wherein the pair of wires are encased in an electrically insulating sheath.

7. An electrosurgical instrument according to claim 1, wherein the energy conveying cable structure is insertable through a flexible insertion tube of a surgical mscoping device.

8. An electrosurgical instrument according to claim 1, wherein the energy conveying cable structure has a outer diameter equal to or less than 3 mm.

9. An electrosurgical instrument according to claim 1, wherein the longitudinal passage extends through the dielectric tip element to provide a fluid flow path through the instrument.

10. An electrosurgical instrument according to claim 1, wherein the dielectric tip is ceramic.

11. An electrosurgical instrument according to claim 1 having a diplexer connected at a proximal end of the energy conveying cable structure.

12. An electrosurgical apparatus comprising: an electrosurgical generator arranged to supply radiofrequency energy and microwave energy; and an electrosurgical instrument according to claim 1 connected to the electrosurgical generator, wherein the energy conveying cable structure is arranged to convey the microwave energy via the coaxial transmission line for conveying microwave energy and the radiofrequency energy via the transmission line for conveying radiofrequency energy.

13. An electrosurgical instrument for delivering radiofrequency (RF) electromagnetic (EM) energy and microwave EM energy for resection and ablation of biological tissue, the instrument comprising: a coaxial transmission line for conveying the RF EM energy and the microwave EM energy, the coaxial transmission line comprising an inner conductive layer, an outer conductive layer and a dielectric layer separating the inner conductive layer from the outer conductive layer; and a ball-shaped instrument tip at a distal end of the energy conveying cable structure, instrument tip comprising: a first conductive hemisphere electrically connected to the inner conductive layer; a second conductive hemisphere electrically connected to the outer conductive layer; and a planar dielectric layer located in a physical separation gap between the first conductive hemisphere and the second conductive hemisphere, wherein the first conductive hemisphere and the second conductive hemisphere are configured to: radiate the microwave EM energy as a substantially spherical field, and provide respectively an active electrode and a return electrode on opposing sides of the separation gap for delivering the RF EM energy.

14. An electrosurgical instrument according to claim 13, wherein the ball-shaped instrument tip has a diameter equal to or less than 3 mm.

15. An electrosurgical instrument according to claim 13, wherein the first conductive hemisphere and the second conductive hemisphere are symmetrically mounted on the planar dielectric layer.

16. An electrosurgical instrument according to claim 13 including: a first electrical connector mounted on a first surface of the planar dielectric layer, the first electrical connector electrically connecting the inner conductive layer to the first conductive hemisphere; and a second electrical connector mounted on a second surface of the planar dielectric layer opposite to the first surface, the second electrical connector electrically connecting the outer conductive layer to the second conductive hemisphere.

17. An electrosurgical instrument according to claim 13, wherein the coaxial transmission line includes a fluid flow passage for conveying a fluid to the instrument tip.

18. An electrosurgical instrument according to claim 17, wherein the instrument tip includes a fluid flow outlet connected to the fluid flow passage.

19. An electrosurgical instrument according to claim 18, wherein the fluid passage is through the planar dielectric layer.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0032] Embodiments of the invention will now be described by way of example with reference to the accompanying drawings in which:

[0033] FIG. 1 is a schematic cross-sectional view of an energy conveying structure for a combined microwave ablation and RF resection electrosurgical instrument that is an embodiment of the invention;

[0034] FIG. 2 is a schematic view of an alternative tip structure for a combined microwave ablation and RF resection electrosurgical instrument that is an embodiment of the invention; and

[0035] FIGS. 3A and 3B comprise a side view, a front and an axial cross-sectional of a tip structure for a combined microwave ablation and RF resection electrosurgical instrument that is another embodiment of the invention.

DETAILED DESCRIPTION; FURTHER OPTIONS AND PREFERENCES

[0036] FIG. 1 shows a schematic cross-sectional view of an energy conveying structure 100 according to the present invention. The energy conveying structure 100 is insertable in a flexible insertion tube of a surgical scoping device for invasive electrosurgery. The energy conveying structure 100 comprises a triaxial layered structure multiple layers arranged coaxially relative to a longitudinal instrument axis that extends along the insertion tube.

[0037] The multi-layer coaxial structure may comprise an innermost dielectric layer (omitted from FIG. 1 for clarity) which is hollow to form an instrument channel 102 of the scoping device. An inner conductive layer 104 is formed on the innermost dielectric layer. An outer conductive layer 106 is formed coaxially with the inner conductive layer 104, with an intermediate dielectric layer 108 separating the inner conductive layer 104 and the outer conductive layer 106. The inner conductive layer 104, intermediate dielectric layer 108 and the outer conductive layer 106 form a first coaxial transmission line. According to an embodiment of the invention, within the instrument channel 102 there is an innermost conductive element 110, which in this embodiment is a thin metal wire or filament. The inner conductive layer 104, the innermost dielectric layer and the innermost conductive element 110 form a second coaxial transmission line.

[0038] At a proximal end of the energy conveying structure 100 there is a connector 112 for connecting the structure 100 to a generator (not shown). There may be an intermediate coaxial cable between the connector and the generator. The generator may be configured to generate radiofrequency (RF) and/or microwave energy which is conveyed by the multi-layer structure to a distal end of the energy conveying structure 100.

[0039] The first coaxial transmission line (e.g. formed by the inner conductive layer 104, the outer conductive layer 106 and the outer dielectric layer 108) may be arranged to convey microwave energy 114. The second coaxial transmission line (formed by the inner conductive layer 104, the innermost conductive element 110 and the innermost dielectric layer) may be arranged to convey conveying RF energy. The outer conductive layer 106 and the innermost conductive layer 110 are grounded, whereby the inner conductive layer is the signal conductor for both the first and second transmission lines. The second transmission line is thus inverted from a conventional coaxial structure, where the grounded conductor is normally outermost.

[0040] At the proximal end of the energy conveying structure 100 there is a diplexer 116 which acts both to connect the RF and microwave energy from the generator on to their respective transmission lines and also to prevent leakage over the signals between the transmission lines.

[0041] A radiator tip 118 made of ceramic material is positioned at the distalmost end of the energy conveying structure 100. The radiator tip 118 is a hollow cylinder which is positioned to be collinear with the outer dielectric later 108, and has the same inner and outer dimensions as the outer dielectric layer 108. The innermost conductive element 110, inner conductive layer 104 and inner dielectric layer are thereby able to extend through the radiator tip 118, but the outer conductive layer 106 terminates at or around the end of the outer dielectric layer 108. Due to this configuration, when microwave energy is conveyed along the structure 100, microwave energy is radiated from the tip 118 in a generally spherical pattern. This may produce microwave ablation in a generally spherical region of tissue.

[0042] The innermost conductive element 110 extends through the hollow interior of the radiator tip 118, and terminates at a return electrode 124 that is exposed at a distal end of the radiator tip 118. The return electrode may be radially displaced from the longitudinal axis of the device, whereby there is a step in the innermost conductive element 110 to make the necessary electrical connection. In one example, the return electrode is mounted on an inner surface of the passage through the radiator tip 118. The inner conductive layer 104 may include a distal extension that extends through the hollow interior of the radiator tip 118 to form an active electrode 126 that lies opposite the return electrode 124 at the distal end of the radiator tip. When RF energy is conveyed through the structure 100, an RF electric field is set up between the active electrode 126 and the return electrode 124 that enables cutting or resection may take place in a region 122 at the distal end of the radiator tip.

[0043] FIG. 2 is a schematic view of an alternative tip structure 200 for a combined microwave ablation and RF resection electrosurgical instrument that is an embodiment of the invention. The tip structure 200 comprises a substantially spherical radiator having a first hemisphere 202 and a second hemisphere 204, wherein the first hemisphere 202 and the second hemisphere 204 are each made of a conductive material. For example, each hemisphere may be made from a metallic material or shell. The first hemisphere 202 and the second hemisphere 204 are separated by a dielectric material 206 such that the first hemisphere 202, second hemisphere 204 and dielectric material 206 form a substantially spherical structure. The layer of dielectric material 206 may be less than 0.5 mm in thickness. A first electrode 208 is connected to an inner surface of the first hemisphere 202, and a second electrode 210 is connected to an inner surface of the second hemisphere 204. In this way, the first electrode 208 and the second electrode 210 oppose each other across the layer of dielectric material 206. The first electrode 208 and second electrode 210 cover at least a portion of the base of each respective hemisphere. In some embodiments, the first electrode 208 and second electrode 210 may cover substantially all of the base of each respective hemisphere.

[0044] The electrodes 208, 210 are respectively connected to the inner and outer conductors of a coaxial feed cable (not shown). In other embodiments, the electrodes 208, 210 may be omitted, and each hemisphere directed connected to a respective one of the inner and outer conductors. The coaxial feed cable is arranged to convey RF and microwave energy from a generator in the manner described above. The spherical tip structure shown in FIG. 2 may be dimensioned to fit within the instrument channel of a surgical scoping device.

[0045] The tip structure 200 is dimensioned to deliver the RF and microwave energy from the coaxial cable in different ways. At microwave frequencies, the separate hemispheres appear electrically like a single sphere. Microwave energy delivered to the tip structure 200 may thus be radiated by the first hemisphere 202 and the second hemisphere 204 in a substantially spherical pattern. In this way, the tip structure 200 is able to ablate a generally spherical region of tissue.

[0046] However, at radiofrequencies, the tip structure 200 appears electrically like a parallel plate capacitor. In this case, RF energy delivered to hemispheres sets up an RF field across the gap formed by the dielectric layer 206 that is capable of performing cutting or resection. Thus, the tip structure 200 is able to perform RF cutting and resection, where the resection is performed in the plane of the dielectric layer 206 and so can be controlled by movement of the instrument. For example, the instrument may be rotatable so that cutting is performed in a different plane.

[0047] The tip structure 200 may also be arranged to deliver fluid (e.g. saline or gas, e.g. to form a plasma for treatment). A fluid flow outlet 212 may be formed in the planar dielectric layer 206 to introduce fluid at the treatment site. The fluid flow outlet 212 may be in fluid communication with a fluid passageway in the coaxial feed cable. In some examples, the coaxial feed cable may comprise a hollow coaxial transmission line, i.e. a coaxial transmission line with a hollow inner conductor. The fluid passageway may be within the hollow inner conductor.

[0048] FIG. 3A shows a side view and front view of an electrosurgical instrument tip 300 that is another embodiment of the invention. FIG. 3B is a schematic cross-sectional view thereof. The instrument is configured as a coaxial transmission line comprises a hollow inner conductor 310 separated from an outer conductor 308 by an electrically insulating dielectric material 304. At a distal portion of the tip, the inner conductor 310 and dielectric material 304 protrude beyond a distal end of the outer conductor and a protective sleeve 302 to form a microwave antenna. Microwave energy delivered from a generator (not shown) at a proximal end of the coaxial cable can thus be emitted at the distal portion of the tip.

[0049] The hollow inner conductor 31 provides a channel 312 through which a pair of conductive wires 314 extend. The wires 314 terminate at their distal ends in a pair of electrodes 306 formed on the distal end face of the dielectric material 304. The wires 314 may form any suitable transmission line structure for conveyed radiofrequency (RF) energy, e.g. a twisted pair or the like. The wires may be embedded or encased in an electrically insulating sheath 316 that is conveyed through the channel 312. The pair of electrodes 306 are each connected to a respective wire 314 to form active and return electrodes for delivering RF energy. The electrodes 306 encourage a preferential current path for the RF energy across the distal face of the instrument tip to facilitate RF resection as the instrument is inserted through tissue.