ELECTROSURGICAL DEVICES, SYSTEMS AND METHODS OF USING THE SAME
20180132921 ยท 2018-05-17
Inventors
Cpc classification
A61B2018/00023
HUMAN NECESSITIES
A61B18/149
HUMAN NECESSITIES
International classification
Abstract
A desiccation device for operation on a target tissue includes a handle, a shaft extending distally from the handle, and a head. The shaft defines a lumen therethrough, and the head has a loop configuration supported on a distal end of the shaft. The head is hollow and defines a lumen therethrough. The lumen of the head is in fluid communication with the lumen of the shaft. At least a portion of the head is electrically connected to a source of electrosurgical energy. A fluid is circulatable through the lumens of the shaft and the head.
Claims
1-5. (canceled)
6. A surgical device for operation on a target tissue, comprising: a handle; a first shaft extending distally from the handle; a loop having a first diverging pair of arms extending from a distal end portion of the first shaft and a first cross-bar extending between and connecting the first diverging pair of arms; and a probe including: a second shaft coupled to the handle; and a head coupled to a distal end portion of the second shaft and configured to conduct electrosurgical energy to desiccate tissue.
7. The surgical device according to claim 6, wherein the first diverging pair of arms extend transversely relative to a longitudinal axis defined by the first shaft, such that the first cross-bar is disposed below the first shaft.
8. The surgical device according to claim 6, wherein the first cross-bar is configured to conduct electrosurgical energy to cut tissue.
9. The surgical device according to claim 8, wherein the first cross-bar defines a knife-edge.
10. The surgical device according to claim 9, wherein the head has an arcuate outer surface.
11. The surgical device according to claim 6, further comprising insulative material covering the first diverging pair of arms without covering the first cross-bar.
12. The surgical device according to claim 6, further comprising an in-flow tube extending through a lumen defined in the first shaft and terminating adjacent a lumen defined in the loop, wherein the in-flow tube is configured to carry a cooling fluid to the lumen of the loop.
13. The surgical device according to claim 6, wherein the second shaft is longitudinally movable relative to the handle to adjust a longitudinal position of the head relative to the loop.
14. The surgical device according to claim 6, wherein the head is proximally spaced from the loop.
15. The surgical device according to claim 6, wherein the head includes: a second diverging pair of arms; and a second cross-bar extending between and connecting the second diverging pair of arms.
16. The surgical device according to claim 15, wherein the second diverging pair of arms are coaxially aligned with a hole defined by the loop.
17. The surgical device according to claim 6, wherein the first shaft includes spring elements configured to compress upon a threshold force being applied to the first shaft.
18. The surgical device according to claim 6, wherein the loop is one of an active electrode or a return electrode, and the head is the other of the active electrode or the return electrode.
19. The surgical device according to claim 6, wherein the first diverging pair of arms are arcuate and the first cross-bar is linear.
20. The surgical device according to claim 6, wherein the second shaft is coupled directly to the handle or is coupled to the handle via the first shaft.
21. A surgical device for operation on a target tissue, comprising: a first shaft; a loop having a first diverging pair of arms extending from a distal end portion of the first shaft and a first cross-bar extending between and connecting the first diverging pair of arms; and a probe including: a second shaft coupled to the first shaft; and a head coupled to a distal end portion of the second shaft, wherein the loop includes one of an active electrode or a return electrode, and the head includes the other of the active electrode or the return electrode, such that the loop and the head desiccate tissue.
22. The surgical device according to claim 21, wherein the first diverging pair of arms extend transversely relative to a longitudinal axis defined by the first shaft, such that the first cross-bar is disposed below the first shaft.
23. The surgical device according to claim 21, wherein the head includes a second cross-bar configured to desiccate tissue, the first cross-bar defining a knife-edge configured to cut tissue.
24. The surgical device according to claim 21, wherein the head is proximally spaced from the loop.
25. The surgical device according to claim 21, further comprising insulative material covering the first diverging pair of arms without covering the first cross-bar.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] Further features and advantages of the invention will become readily apparent from the following specification and from the drawings, in which:
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DETAILED DESCRIPTION OF EMBODIMENTS
[0041] In the drawings and in the descriptions which follow, the term proximal, as is traditional, will refer to the end which is closer to the user, while the term distal will refer to the end which is further from the user.
[0042] For illustrative purposes only, the electrosurgical devices described herein, will be described in terms of electrosurgical systems that include RF desiccation and/or coagulation modes. As mentioned above, the present disclosure relates to electrosurgical devices that employ RF desiccation and/or coagulation electrodes. The electrosurgical devices, as described herein, may be configured to operate in different modes of operation, e.g., ablate, desiccate, coagulate, and/or seal. Additionally, the electrosurgical devices, as described herein, may be adapted to connect to one or more different sources (e.g., electrosurgical generator) for producing a desired effect.
[0043] Referring now to the figures, in which like numerals indicate like parts, and particularly to
[0044] The specific configuration of head 106 may best be seen with reference to
[0045] Handle 102, shaft 104 and head 106 may be formed as a unitary construction of a suitably electrically conductive material. It is contemplated that at least a portion of each of handle 102, shaft 104 and head 106 may be covered with a suitably electrically insulative material or the like. In an embodiment, as best seen in
[0046] As seen in
[0047] With continued reference to
[0048] As seen in
[0049] Desiccation device 100 includes one or more hubs 128 (see
[0050] The components of dessication device 100 are not drawn to scale. Accordingly, it is envisioned that the relative sizes of the components may vary depending on the intended purpose. For example, it is contemplated that a diameter of in-flow tube 120 may be selected to maximize fluid deliver and that the diameter thereof may taper, in a distal direction, so as to form head 106. It is further contemplated that a cross-sectional diameter of the tube making up head 106 may be shaped or sized to balance the dessicating, cutting and/or debriding effect of head 106. It is further contemplated that cross-bar 110 of head 106 may have a round, transverse cross-sectional profile and/or that a diameter of cross-bar 110 of head 106 may be smaller than a diameter of in-flow tube 120.
[0051] In operation, either prior to, during or after activation of generator G, as electrosurgical energy is delivered to head 106, a cooling fluid F (e.g., water, saline, etc.) is circulated through lumen 114. Fluid F is fed, from the source of fluid FS, through in-flow tube 120 to the portion of lumen 114 defined by head 106, circulated around that portion of lumen 114, back through lumen 114 extending through shaft 104, and out through out-flow tube 120 and back to the fluid source FS.
[0052] In an embodiment, as seen in
[0053] It is further contemplated that a distal end of in-flow tube 120 and/or out-flow tube 122 (not shown), e.g., distal of hub 128, may be disposed in a support tube or respective support tubes (not shown) or the like.
[0054] Circulation of fluid F, as described above, may be established with a pump (not shown). The rate of circulation of fluid F may be increased or decreased in order to adjust the temperature of head 106 as needed. A probe (not shown) may be connected to head 106 which may sense the temperature of head 106 during the surgical procedure. The probe may be connected to generator G and/or the fluid source FS in order to provide generator G and/or the fluid source FS with feedback and thus enable generator G and/or the fluid source FS to be adjusted as needed and/or desired.
[0055] In operation, with head 106 activated and fluid F circulating therethrough, head 106 is advanced through to desiccate tissue without substantial production of eschar or the like. The desiccated tissue may then be excised (e.g., cut) as desired and/or needed.
[0056] Turning now to
[0057] As seen in
[0058] With continued reference to
[0059] As seen in
[0060] In one embodiment as seen in
[0061] Turning now to
[0062] As seen in
[0063] As seen in
[0064] It is contemplated that in an embodiment, desiccation device 100, of
[0065] Turning now to
[0066] Surgical device 200 further includes an electrode 210 operatively associated with body portion 202. Electrode 210 includes a first portion 210a which extends longitudinally along an outer surface of body portion 202 towards a distal end 202a thereof, a second portion 210b which extends around at least a portion of the periphery of body portion 202, and a third portion 210c which extends longitudinally along the outer surface of body portion 202 towards a proximal end 202b thereof.
[0067] As seen in
[0068] Body portion 202 may be fabricated from any suitable rigid material, including and not limited to, stainless steel, titanium, polycarbonate, polyvinylchloride and the like. Electrode 210 is fabricated from any suitable electrically conductive material, including and not limited to stainless steel, titanium and the like. It is envisioned that at least first portion 210a and third portion 210c of electrode 210 is covered with a suitable insulative material thereby leaving second portion 210b thereof exposed.
[0069] Electrode 210 may be hollow thereby defining a circulation path for fluid to flow therethrough. It is envisioned that a proximal end of first portion 210a and second portion 210b of electrode 210 are each fluidly connected or connectable to fluid source FS. It is further envisioned that electrode 210 is electrically connected or connectable to an electrosurgical generator G. Body portion 202 of surgical device 200 may be connected to a vacuum source VS for creating a suction through lumen 204 thereof.
[0070] In operation, with fluid circulating through electrode 210 and with electrode 210 activated, the distal end of surgical device 200 may be approximated toward a target tissue such that second portion 210b may be contacted with the target tissue and thereby desiccate the same. As the target tissue is desiccated and/or debridded, any smoke and/or loose tissue generated as a result thereof may be aspirated into body portion 202. A selective coating 206 in side shaft 202 may be employed to prevent RF flow through aspirated tissue reducing occlusion of lumen 204 by tissue chard to the inside surface.
[0071] Turning now to
[0072] Turning now to
[0073] Turning now to
[0074] While first and third portions 210a, 210c, respectively, of electrode 210 is shown disposed externally of body portion 202, it is envisioned and within the scope of the present disclosure for first and third portions 210a, 210c, respectively, to be disposed within lumen 204 of body portion 202.
[0075] As seen throughout
[0076] Turning now to
[0077] Surgical device 300 includes a shaft 302 having an electrode 310 supported on, formed at or extending from a distal end 302b thereof and a suction lumen 304 operatively connected thereto and extending from a proximal end 302a to distal end 302b of shaft 302. A selective coating may be applied to the inside of shaft 304 to reduce clogging. Surgical device 300 is adapted to operatively connect to a generator G and a vacuum source VS. A surgical device 400 may also be adapted to operatively connect to a fluid source FS, to be described in greater detail below.
[0078] Shaft 302 may have a generally tubular structure defining a longitudinal axis X therethrough. Shaft 302 may be configured to serve as a handle for grasping thereof, or shaft 302 may be adapted to attach to a handle, not shown. Shaft 302 includes proximal end 302a and distal end 302b. Proximal end 302a of shaft 302a may be adapted to connect to generator G, vacuum source VS and/or fluid source FS. Shaft 302 may have a sheathing or insulative coating (not shown) extending over at least a portion of a length thereof, or at least a portion of shaft 302 may be made from a suitable non-conductive material.
[0079] Surgical device 300 includes a suction lumen 304 extending from or selectively extending from distal end 302b of shaft.
[0080] Suction lumen 304 may be oriented substantially orthogonal to the longitudinal X axis. Alternatively, suction lumen 304 may be oriented at any suitable angle with respect to the longitudinal X axis, as best seen in
[0081] In one embodiment, suction lumen 304 may be a separate member attached to shaft 302 via any suitable attaching means. Alternatively, suction lumen 304 may be defined by shaft 302 or portion thereof.
[0082] As mentioned above, surgical device 300 includes an electrode 310 located at distal end 302b of shaft 302 and selectively extendable therefrom. Electrode 310 may include one or more arms 312 (one arm is shown) that extends therefrom in a generally transverse orientation relative to an axis thereof. Each arm 312 may be formed of a suitable electrically conductive material that may be at least partially coated with a suitable insulative material. Alternatively, each arm 312 may include an inner conductor surface and an outer non-conductive sheath (not shown). Surgical device 300 includes one or more fingers 314 (one finger is shown) extending from arm 312.
[0083] When viewing at surgical device 300 from the front, finger 314 and arm 312 of electrode 310 appear generally L shaped.
[0084] Finger 314 may extend from arm 312 in any suitable direction. Finger 314 may have a variety of different geometric shapes and/or configurations to include a leading conductive distal edge 314a and a trailing non-conductive proximal edge 314b. As seen in
[0085] Finger 314 may include a conductive surface 314a in electrical communication with the generator G, and a non-conductive surface 314b isolated from conductive surface 314a. Conductive surface 314a may extend distally from an intermediate plane of finger 314 at an angle that is between about 0 and 90 (
[0086] Distal edge 314a may be configured to have a generally dull edge. In an embodiment, edge 314a and a proximal scraping edge 314b of finger 314 may each be angled or straight.
[0087] Scraping edge 314b may be formed of non-conductive material, such as, for example, ceramic or high temperature plastic, e.g., liquid crystal polymer. Alternatively, scraping edge 314b, or any portion thereof, may be coated with an insulative material. Scraping edge 314b may be configured to have a minimal sharpness. That is, proximal edge 314b should be sharp enough to scrap or slough tissue that has been coagulated, and pass over tissue that has not been coagulated.
[0088] Scraping edge 314b may be in a fixed spaced apart relation relative to suction lumen 304. In particular, scraping edge 314b is spaced apart from suction lumen 304 at a distance d such that suction lumen 304 may aspirate coagulated and/or desiccated tissue and aspirate fluids in the proximity of tissue being treated. As seen in
[0089] For example, as seen in
[0090] The following steps are illustrative of one mode in which surgical apparatus 300 may be employed. In operation, with distal edge 314a of electrode 310 activated, distal edge 314a is advanced over a desired tissue to coagulate and/or desiccate the tissue. Subsequently, a layer of the coagulated and/or desiccated tissue may be scrapped off via the scrapping edge 314b of electrode 310 and aspirated by suction lumen 304. If additional layers of tissue have to be removed, they may be removed employing the same or similar steps as herein described.
[0091] Turning now to
[0092] Surgical device 400 includes a shaft 402 having an electrode 410 supported on or formed at a distal end 402b thereof and a suction lumen 404 operatively connected thereto and extending from a proximal end 402a to distal end 402b.
[0093] Surgical device 400 further includes an inflow conduit 420 and an outflow conduit 422 each operatively fluid interfacing electrode 410 with a fluid source FS. In an embodiment, inflow conduit 420 and outflow conduit 422 may be defined by shaft 402 and may extend along a longitudinal length thereof.
[0094] While electrode 410 is illustrated as having the same or similar configuration to electrode 310, electrode 410 may have a loop configuration the same as or similar to the loop configuration described with reference to cutting head 106. Electrode 410 is hollow and defines a lumen 416 in fluid communication with inflow conduit 420 and outflow conduit 422 of shaft 402. In use, a fluid is circulatable through inflow conduit 420 and outflow conduit 422 of shaft 402 to cool electrode 410.
[0095] Inflow conduit 422 and outflow conduit 422 of shaft 402 may be configured the same as or similarly to in-flow tube 120 and out-flow tube 122 as described hereinabove.
[0096] The following steps are illustrative of one mode in which surgical apparatus 400 may be employed. In operation, with distal edge 414a of electrode 410 activated, distal edge 414a is advanced over a desired tissue to coagulate and/or desiccate the tissue. Subsequently, a layer of the coagulated and/or desiccated tissue may be scrapped off via the scrapping edge 414b of electrode 410 and aspirated by suction lumen 404. As mentioned above, if additional layers of tissue have to be removed, they may be removed employing the same or similar steps as herein described. However, if numerous advancements of electrode 410 over tissue are made, electrode 410 and/or any portion thereof may become too hot, and for at least the same or similar reasons stated above, it may be useful to circulate fluid into electrode 410 or a portion thereof, via inflow and outflow conduits, 420 and 422, respectively, to cool electrode 410.
[0097] From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, surgical devices 300 and 400 may include a sensor, not shown, operatively connected thereto and in operative communication with suction lumens 304 and 404 and/or electrodes 310 and 410. The sensor may be configured to detect the direction that surgical devices 300 and 400 are moving. The sensor may also be configured to detect pressure changes at electrodes 310 and 410.
[0098] With reference to
[0099] Although the subject devices, systems and methods have been described with respect to preferred embodiments, it will be readily apparent, to those having ordinary skill in the art to which it appertains, that changes and modifications may be made thereto without departing from the spirit or scope of the subject of the present disclosure.