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US5891095A Expired / Lapsed US ⏱️ 0.0 years remaining

Electrosurgical treatment of tissue in electrically conductive fluid

Assignee: Arthrocare Corp
•
Filing: 1996-12-05
•
Granted: 1999-04-06
•
Expires: 2016-12-05
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Abstract

Abstract A method is provided for applying electrical energy to a tissue structure within a patient's body. The method includes positioning an electrosurgical probe adjacent to the tissue structure so that an electrode array including a plurality of isolated electrode terminals is brought into at least partial contact with the body structure. A high frequency voltage is then applied between each electrode terminal within the electrode array and a common, return electrode. Current flow from the electrode terminals is selectively limited to minimize low electrical impedance paths emanating from the electrode array. The present invention takes advantage of the differences in electrical properties between a target tissue and the surrounding conductive liquid (e.g. isotonic saline irrigant) in the region immediately adjacent to the electrode array to ablate the target tissue while minimizing overheating of the surrounding liquid.

Inventors

  • 👤 Philip E. Eggers
  • 👤 Hira V. Thapliyal

Bibliographic Details

Application Number —
Jurisdiction US
Data Source google_patents
Last Synchronized 2026-10-23 23:34
CPC Classifications
A; A61; A61B; A61B18/00; A61B18/04; A61B18/12; A61B18/1206; A61B18/14; A61B18/1402; A61B18/1482; A61B18/1485; A61B18/149; A61B18/1492; A61M; A61M25/00; A61M25/01; A61M25/0105; A61M25/0133; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/05; A61N1/40; A61N1/403; A61B18/148; A61B17/00; A61B2017/00017; A61B2017/00022; A61B2017/00026; A61B2017/00084; A61B2017/00092; A61B2017/00097; A61B2017/00101; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00247; A61B2017/00292; A61B2017/003; A61B17/22; A61B2017/22001; A61B2017/22038; A61B2018/00005; A61B2018/00011; A61B2018/00029; A61B2018/00053; A61B2018/0016; A61B2018/00172; A61B2018/00178; A61B2018/00184; A61B2018/00196; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00392; A61B2018/00571; A61B2018/00577; A61B2018/00583; A61B2018/00601; A61B2018/00636; A61B2018/00642; A61B2018/0066; A61B2018/00666; A61B2018/00678; A61B2018/00696; A61B2018/00726; A61B2018/00761; A61B2018/00773; A61B2018/00791; A61B2018/00797; A61B2018/00821; A61B2018/00827; A61B2018/00875; A61B2018/00886; A61B2018/1213; A61B2018/124; A61B2018/1246; A61B2018/126; A61B2018/1273; A61B2018/1405; A61B2018/1407; A61B2018/1467; A61B2018/1472; A61B18/16; A61B2018/162; A61B90/00; A61B90/36; A61B90/37; A61B2090/378; A61B2218/00; A61B2218/001; A61B2218/002; A61B2218/007; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2493; A61M25/0147; A61M25/0158

Claims Analysis

Total Claims: 67
Claim 1
Independent Claim 103 words
A method for applying electrical energy to a target site on a structure on or within a patient's body, the method comprising: positioning an electrode terminal into at least close proximity with the target site in the presence of an electrically conducting fluid; positioning a return electrode within the electrically conducting fluid to generate a current flow path between the electrode terminal and the return electrode; and applying high frequency voltage to the electrode terminal and the return electrode such that an electrical current flows from the electrode terminal, through the target site, and to the return electrode through the current flow path.
Claim 2
Independent Claim 103 words
A method for applying electrical energy to a target site on a structure on or within a patient's body, the method comprising: positioning an electrode terminal into at least close proximity with the target site in the presence of an electrically conducting fluid; positioning a return electrode within the electrically conducting fluid to generate a current flow path between the electrode terminal and the return electrode; and applying high frequency voltage to the electrode terminal and the return electrode such that an electrical current flows from the electrode terminal, through the target site, and to the return electrode through the current flow path.
Claim 3
Dependent Claim 26 words
The method of claim 1 wherein the electric current flows substantially through the electrically conducting fluid while minimizing electric current flow passing through the body structure.
Claim 4
Dependent Claim 19 words
The method of claim 1 wherein at least a portion of the electric current passes through the body structure.
Claim 5
Dependent Claim 45 words
The method of claim 1 further comprising immersing the target site within a volume of the electrically conductive fluid and positioning the return electrode within the volume of electrically conductive fluid to generate the current flow path between the target site and the return electrode.
Claim 6
Dependent Claim 24 words
The method of claim 4 wherein the electrode terminal is introduced into a cavity in the patient's body flooded with the electrically conducting fluid.
Claim 7
Dependent Claim 28 words
The method of claim 5 wherein the body cavity is selected from the group consisting essentially of the knee, shoulder, wrist, ankle, elbow, hip, foot, hand and spine.
Claim 8
Dependent Claim 22 words
The method of claim 1 wherein the electrode terminal comprises a single electrode disposed near the distal end of an instrument shaft.
Claim 9
Dependent Claim 26 words
The method of claim 1 wherein the electrode terminal includes an array of electrically isolated electrode terminals disposed near the distal end of an instrument shaft.
Claim 10
Dependent Claim 22 words
The method of claim 1 wherein the electrically conductive fluid is selected from the group consisting essentially of blood and electrolytic irrigants.
Claim 11
Dependent Claim 13 words
The method of claim 1 wherein the electrically conductive fluid comprises isotonic saline.
Claim 12
Dependent Claim 30 words
The method of claim 8 including independently controlling current flow from at least two of the electrode terminals based on electrical impedance between each electrode terminal and the return electrode.
Claim 13
Dependent Claim 58 words
The method of claim 1 wherein the return electrode is spaced from the electrode terminal such that when the electrode terminal is brought adjacent a tissue structure immersed in electrically conductive fluid, the return electrode is spaced from the tissue structure and the electrically conductive fluid completes a conduction path between the electrode terminal and the return electrode.
Claim 14
Dependent Claim 23 words
A method as in claim 1, further including maintaining a space between the electrode terminal and the body structure during the applying step.
Claim 15
Dependent Claim 19 words
The method of claim 13 wherein the maintaining step comprises moving the electrode terminal transversely across the body structure.
Claim 16
Dependent Claim 35 words
The method of claim 1 wherein the electrically conducting fluid is directed through a cannula into the body cavity, the electrode terminal and the return electrode being submerged in the fluid within the body cavity.
Claim 17
Dependent Claim 27 words
The method of claim 15 wherein the body cavity is selected from the group consisting essentially of the knee, shoulder, wrist, ankle, elbow, foot, hand and spine.
Claim 18
Dependent Claim 42 words
The method of claim 1 wherein the current flow between the electrode terminal and the return electrode has an inherent capacitance, the method further comprising delivering high frequency current across at least one current limiting element in series with the electrode terminal.
Claim 19
Dependent Claim 45 words
The method of claim 17 further comprising selecting the current limiting element such that the inherent capacitance associated with tissue and the electrically conducting fluid between the return electrode and the electrode terminal and the current limiting element together form a series resonant output circuit.
Claim 20
Dependent Claim 37 words
The method of claim 1 further comprising providing one or more electrode terminals surrounded by an insulating matrix at the distal tip of the probe to electrically isolate each terminal, the insulating matrix comprising an inorganic material.
Claim 21
Dependent Claim 22 words
The method of claim 19 wherein the inorganic material is selected from the group consisting essentially of ceramic, glass and glass/ceramic compositions.
Claim 22
Dependent Claim 30 words
The method of claim 8 further comprising actively limiting current to at least two of the electrode terminals based on electrical impedance between the electrode terminals and the return electrode.
Claim 23
Dependent Claim 15 words
The method of claim 21 further comprising measuring current flow for a given applied voltage.
Claim 24
Dependent Claim 35 words
The method of claim 21 further comprising changing the resonant frequency of a series resonant output circuit with changes in the inherent capacitance associated with the tissue and electrically conducting fluid between the electrode terminals.
Claim 25
Dependent Claim 32 words
The method of claim 21 further comprising interrupting or limiting current between the electrode terminals and the return electrode when the impedance sensor indicates an electrical impedance less than a threshold level.
Claim 26
Dependent Claim 30 words
The method of claim 8 further comprising passively limiting or interrupting current flow to the electrode terminals based on the electrical impedance between the electrode terminals and the return electrode.
Claim 27
Dependent Claim 20 words
The method of claim 1 wherein the frequency of the applied voltage is about 20 kHz to about 20 MHz.
Claim 28
Dependent Claim 20 words
The method of claim 1 wherein the high frequency voltage is greater than 10 volts and less than 1000 volts.
Claim 29
Dependent Claim 29 words
The method of claim 8 wherein the electrode array is disposed over a lateral surface of an electrode array support member near the distal end of the instrument shaft.
Claim 30
Dependent Claim 27 words
The method of claim 21 wherein the actively limiting current step is carried out by measuring current flow to the electrode terminals for a given applied voltage.
Claim 31
Dependent Claim 34 words
The method of claim 25 wherein the passive limiting current flow step is carried out with a passive current limiting element selected from the group consisting essentially of inductors, capacitors, resistors and combinations thereof.
Claim 32
Independent Claim 30 words
The method of 1 further comprising an electrical connector for coupling the electrode terminal to a high frequency voltage supply and a current limiting element located distal to the connector.
Claim 33
Independent Claim 30 words
The method of 1 further comprising an electrical connector for coupling the electrode terminal to a high frequency voltage supply and a current limiting element located distal to the connector.
Claim 34
Dependent Claim 24 words
The method of claim 7 further comprising a proximal handle coupled to the instrument shaft, and a current limiting element located in the handle.
Claim 35
Dependent Claim 44 words
The method of claim 1 further comprising an electrical connector for coupling the electrode terminal to a high frequency voltage supply and a current limiting element located within a high frequency power supply, the connector being adapted for coupling to the current limiting element.
Claim 36
Dependent Claim 30 words
The method of claim 1 further comprising an electrical connector for coupling the electrode terminal to a high frequency voltage supply and a current limiting element located within the connector.
Claim 37
Dependent Claim 51 words
The method of claim 1 wherein the electrode terminal and the return electrode are configured to effect the electrical breakdown of tissue in the immediate vicinity of the electrode terminal when high frequency voltage is applied between the electrode terminal and the return electrode in the presence of electrically conducting fluid.
Claim 38
Dependent Claim 21 words
The method of claim 8 further comprising generating a high electric field intensity at a distal portion of the electrode terminal.
Claim 39
Dependent Claim 31 words
The method of claim 1 wherein the distal surface of the electrode terminal has a shape selected from the group consisting essentially of flat, concave, convex, hemispherical, pyramidal, conical and cylindrical.
Claim 40
Dependent Claim 27 words
The method of claim 1 wherein the power to the electrode terminal is controlled based on the electrical impedance between the electrode terminal and the return electrode.
Claim 41
Dependent Claim 23 words
The method of claim 38 further comprising limiting power to the electrode terminal when the electrical impedance is less than a threshold value.
Claim 42
Dependent Claim 50 words
The method of claim 1 wherein temperature at the target site is measured by a temperature sensor adjacent to the electrode terminal which is electrically coupled to the high frequency voltage source such that power delivery to the electrode terminal is limited if the measured temperature exceeds a threshold value.
Claim 43
Dependent Claim 15 words
The method of claim 40 wherein the temperature sensor is integral with the electrode terminal.
Claim 44
Independent Claim 50 words
The method of claims 8 wherein temperature at the target site is measured by a temperature sensor adjacent to the electrode terminal which is electrically coupled to the high frequency voltage source such that power delivery to the electrode terminal is limited if the measured temperature exceeds a threshold value.
Claim 45
Dependent Claim 56 words
The method of claim 8 wherein the electrode array and the return electrode are configured to effect the electrical breakdown of tissue in the immediate vicinity of the electrode array when high frequency voltage is applied between the electrode terminals of the electrode array and the return electrode in the presence of an electrically conductive fluid.
Claim 46
Independent Claim 92 words
A method for removing a tissue structure within a patient's body comprising: introducing an electrically conductive fluid into the patient's body to immerse the tissue structure within the electrically conductive fluid; positioning an electrode terminal and return electrode into at least close proximity with the target site in the presence of the electrically conducting fluid; and applying high frequency voltage to the electrode terminal and the return electrode such that an electrical current flows from the electrode terminal, through the target site, and to the return electrode through the electrically conductive fluid.
Claim 47
Independent Claim 92 words
A method for removing a tissue structure within a patient's body comprising: introducing an electrically conductive fluid into the patient's body to immerse the tissue structure within the electrically conductive fluid; positioning an electrode terminal and return electrode into at least close proximity with the target site in the presence of the electrically conducting fluid; and applying high frequency voltage to the electrode terminal and the return electrode such that an electrical current flows from the electrode terminal, through the target site, and to the return electrode through the electrically conductive fluid.
Claim 48
Dependent Claim 22 words
The method of claim 44 wherein the electric current flows substantially through the electrically conducting fluid without passing through the body structure.
Claim 49
Dependent Claim 19 words
The method of claim 44 wherein at least a portion of the electric current passes through the body structure.
Claim 50
Dependent Claim 21 words
The method of claim 44 wherein the tissue structure is selected from the group consisting essentially of fibrocartilage and articular cartilage.
Claim 51
Dependent Claim 22 words
The method of claim 44 wherein the electrode terminal comprises a single electrode disposed near the distal end of an instrument shaft.
Claim 52
Dependent Claim 13 words
The method of claim 44 wherein the electrically conductive fluid comprises isotonic saline.
Claim 53
Dependent Claim 43 words
The method of claim 44 wherein the electrode terminal comprises an array of electrode terminals, the method further comprising independently controlling current flow from at least two of the electrode terminals based on electrical impedance between each electrode terminal and the return electrode.
Claim 54
Dependent Claim 31 words
The method of claim 44 further comprising a plurality of current limiting circuit structures in parallel with each other and in series with a return voltage supply within a power supply.
Claim 55
Dependent Claim 25 words
The method of claim 44 further comprising limiting current flow to electrode terminals in contact with low impedance current path back to the return electrode.
Claim 56
Dependent Claim 21 words
The method of claim 44 wherein the return electrode is disposed proximally of the single electrode terminal on the instrument shaft.
Claim 57
Dependent Claim 23 words
A method as in claim 44, further including maintaining a space between the electrode array and the body structure during the applying step.
Claim 58
Dependent Claim 38 words
The method of claim 44 further comprising providing one or more electrode terminals surrounded by an insulating matrix at the distal tip of the probe to electrically isolate each electrode terminal, the insulating matrix comprising an inorganic material.
Claim 59
Dependent Claim 22 words
The method of claim 55 wherein the inorganic material is selected from the group consisting essentially of ceramic, glass and glass/ceramic compositions.
Claim 60
Dependent Claim 30 words
The method of claim 44 further comprising passively limiting or interrupting current flow to the electrode terminal based on the electrical impedance between the electrode terminal and the return electrode.
Claim 61
Dependent Claim 27 words
The method of claim 44 wherein the electrode terminal disposed over a lateral surface of an electrode support member near the distal end of an instrument shaft.
Claim 62
Dependent Claim 27 words
The method of claim 44 wherein the power to the electrode terminal is controlled based on the electrical impedance between the electrode terminal and the return electrode.
Claim 63
Dependent Claim 23 words
The method of claim 59 further comprising limiting power to the electrode terminal when the electrical impedance is less than a threshold value.
Claim 64
Dependent Claim 49 words
The method of claim 44 wherein temperature at the target site is measured by a temperature sensor adjacent to the electrode terminal which is electrically coupled to high frequency voltage source such that power delivery to the electrode terminal is limited if the measured temperature exceeds a threshold value.
Claim 65
Dependent Claim 15 words
The method of claim 61 wherein the temperature sensor is integral with the active electrode.
Claim 66
Dependent Claim 51 words
The method of claim 44 wherein the electrode terminal and return electrode are configured to effect the electrical breakdown of tissue in the immediate vicinity of the electrode terminal when high frequency voltage is applied between the active electrode and the return electrode in the presence of an electrically conductive fluid.
Claim 67
Dependent Claim 29 words
The method of claim 44 wherein the distal surface of the electrode terminal has a shape from the group consisting essentially of flat, concave, convex, hemispherical, pyramidal, and/or cylindrical.

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3.5 Years (Year 4) 2002-04-05 2002-10-05 2003-04-06 $2000.00 Window Closed / Lapsed
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