Electrosurgical device

Abstract

Disclosed herein is an electrosurgical device comprising a handle at a proximal end and an elongate shaft coupled to and extending distally from the handle. The device further comprises a working distal end comprising a return electrode and an active electrode supported by an insulating spacer separating the return electrode and the active electrode. The active electrode has a planar surface facing distally and defining a maximum planar surface length. The insulating spacer is generally tapered between the return electrode and the active electrode. The insulating spacer has a planar stabilizing surface on a first side of the device having a length extending along the longitudinal axis from a distal-most end of the return electrode to a leading edge surface of the active electrode. The length is at least as long as the maximum planar surface length.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of Provisional Patent Application No. 63 / 020,852, filed on May 6, 2020, entitled “Electrosurgical Device”, which is incorporated in its entirety by reference. Technical Field

[0003] This invention relates generally to the field of electrosurgery, and more specifically to apparatus and methods for applying high-frequency voltages to treat tissues. Background Technology

[0004] Electrosurgical systems are used during surgical procedures to remove several different types of tissue. For example, surgeries involving the hip, knee, or shoulder may require the removal of portions of cartilage, meniscus, and free-floating and / or trapped tissue. In some cases, removal may be very minor, such as tissue dissection, while in others, more aggressive removal or tissue reduction is used. In some cases, removal can be performed arthroscopically. Summary of the Invention

[0005] This article describes various improvements to methods and devices for electrosurgical treatment of tissues.

[0006] This document discloses a first exemplary embodiment of an electrosurgical device including a handle at a proximal end of the device, an elongated shaft extending distally from the handle, and a longitudinal axis extending along the shaft. The elongated shaft may have an angular offset toward the distal end, or may be steerable or flexible to change the angular offset during surgery. The distal end includes a return electrode, an active electrode, and an electrically insulating spacer axially separating the return electrode and the active electrode. The active electrode is positioned along a single plane and defines a planar surface facing distally. The planar surface forms a non-orthogonal angle with respect to the longitudinal axis at the distal end. The planar surface angles with respect to the longitudinal axis to define a linear leading edge of the active electrode, the linear leading edge having a lateral extent and defining the distal edge of the electrosurgical device. The insulating spacer is tapered between the return electrode and the active electrode. The insulating spacer includes a first planar surface extending along the longitudinal axis and spanning a first side of the insulating spacer at the distal end of the electrosurgical device, which also includes the linear leading edge of the active electrode.

[0007] In some exemplary embodiments, the planar surface of the active electrode may define a planar surface length extending from the leading edge to the opposing trailing edge. A first planar surface of the insulating spacer has a first length extending from the return electrode to the leading edge of the insulating spacer, and this first length may be at least as long as the planar surface length of the active electrode. In some embodiments, the planar surface of the active electrode is oriented at an acute angle relative to the first planar surface of the spacer, the acute angle extending through the spacer. In some embodiments, the first planar surface is configured to guide the leading edge of the active electrode onto a first tissue while angulating the remaining portion of the planar surface of the active electrode away from the first tissue. In some embodiments, the insulating spacer defines a second planar surface on the side of the device opposite to the first planar surface, the second planar surface being axially longer than the first planar surface. In some embodiments, the insulating spacer defines a multifaceted outer surface, the multifaceted outer surface including at least a first planar surface, a second planar surface, and a plurality of curved surfaces separating the first planar surface and the second planar surface. In some embodiments, the insulating spacer is asymmetrically tapered between a first side and an opposing second side of the insulating spacer, the opposing second side having a larger taper angle than the first side. In some embodiments, the active electrode planar surface defines a trapezoidal boundary. In some embodiments, the spacer defines a farthest side surface that coincides with the active electrode planar surface.

[0008] Another exemplary device embodiment is disclosed, comprising a handle at a proximal end, an elongated shaft extending distally from the handle along a longitudinal axis, and a distal end. The distal end includes a return electrode, an active electrode, and an electrically insulating spacer axially separating the return electrode and the active electrode. The active electrode defines a planar surface facing distally and angled relative to the longitudinal axis to define a leading edge of the active electrode, the leading edge defining the farthest edge of the distal end. The insulating spacer is tapered between the return electrode and the active electrode. The insulating spacer defines a first planar surface extending proximally from a leading edge of the insulating spacer directly adjacent to the leading edge of the active electrode. The first planar surface extends proximally along the longitudinal axis of the device and laterally across the insulating spacer. The first planar surface is configured to engage a first tissue and stabilize the orientation of the leading edge of the active electrode relative to a target tissue.

[0009] In some embodiments, the active electrode defines a main planar surface length and the first planar surface of the insulating spacer has a linear length at least as long as the main planar surface length. The linear length may be defined as a length extending along the longitudinal axis. In some embodiments, the planar surface of the active electrode is oriented at an acute angle relative to the first planar surface of the insulating spacer, the acute angle extending through the spacer. In some embodiments, the insulating spacer defines a second planar surface on the side of the electrosurgical device opposite to the first planar surface. The second planar surface may be axially longer than the first planar surface. In some embodiments, the insulating spacer defines a multifaceted outer surface, the multifaceted outer surface including at least the first planar surface and the second planar surface. In some embodiments, the insulating spacer may be asymmetrically tapered between a first side and an opposite second side, the opposite second side having a larger taper angle than the first side. In some embodiments, the planar surface of the active electrode defines a trapezoidal boundary. In some embodiments, the insulating spacer defines a farthest side surface, the farthest side surface facing distally and coinciding with the planar surface of the active electrode.

[0010] An exemplary method for treating target tissue with an electrosurgical device is also disclosed, comprising engaging a large portion of the planar surface of an insulating spacer of the electrosurgical device onto a first tissue. An active electrode of the device is then moved toward the target tissue while maintaining engagement of the planar surface onto the first tissue. The planar surface of the spacer may be oriented relative to the active electrode to preferentially place the leading edge of the active electrode onto the target tissue while angularly distancing the planar surface of the active electrode away from the target tissue. The leading edge of the active electrode may then be moved along the target tissue while electrosurgical energy is applied to treat the target tissue while maintaining engagement of the planar surface onto the first tissue.

[0011] In some exemplary methods, the planar surface is configured to define an inert side of the device, such that the leading edge of the active electrode is moved along the target tissue to treat the target tissue while applying electrosurgical energy, simultaneously protecting the first tissue from the electrosurgical energy. Some exemplary methods may also include adjusting the orientation of the device so that a majority of the planar surface of the active electrode engages with the second tissue while observing the trailing edge surface of the active electrode. Applying electrosurgical energy to this adjusted orientation can then reduce the volume of the second tissue. The insulating spacer defines a tapered surface extending from the trailing edge surface of the active electrode, the tapered surface being configured to provide visibility of the trailing edge surface while reducing the volume of the second tissue.

[0012] These and other features and advantages will become apparent from reading the following detailed description and viewing the accompanying drawings. It should be understood that the foregoing general description and the following detailed description are illustrative only and not intended to limit the claimed aspects.

[0013] definition

[0014] Various terms are used to refer to specific system components. Different companies may use different names to refer to a component—this document is not intended to distinguish between components with different names but the same function. In the following discussion and claims, the terms "comprising" and "including" are used in an open-ended manner and should therefore be interpreted as "including but not limited to...". Furthermore, the terms "connected" or "coupled" are intended to indicate indirect or direct connection. Thus, if a first device is connected to a second device, the connection can be either a direct connection or an indirect connection via other devices and connections.

[0015] References to singular items include the possibility that multiple identical items exist. More specifically, as used herein and in the appended claims, the singular forms “a,” “an,” “the,” and “the” include the plural forms unless the context clearly specifies otherwise. It should also be noted that the claims may be written to exclude any optional elements. Thus, this statement serves as a prior basis for the use of proprietary terms such as “merely,” “only,” or the use of “negative” limitations associated with the recitation of the claim elements. Finally, it should be understood that, unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention pertains.

[0016] "Ablation" should refer to the removal of tissue based on the interaction between tissue and plasma.

[0017] "Plasma" should refer to a low-temperature gas formed by vapor bubbles or vapor layers capable of ionizing and discharging.

[0018] "Active electrode" refers to the electrode of an electrosurgical device that produces an electrically induced tissue-altering effect when it comes into contact with or near the target tissue.

[0019] "Return electrode" should refer to the electrode of an electrosurgical device used to provide a current path of charge relative to the active electrode, and / or the electrode of an electrosurgical device that does not itself produce an electrically induced tissue-altering effect on the target tissue being treated.

[0020] Where a range of values ​​is provided, it should be understood that every intermediate value between the upper and lower limits of the range, as well as any other specified or intermediate value within the range, is included within the scope of this invention. Furthermore, any optional features of the variants of the invention contemplated herein may be set forth and claimed independently or in combination with any one or more features described herein.

[0021] All existing subjects mentioned herein (e.g., publications, patents, patent applications, and hardware) are incorporated herein by reference in their entirety, unless to the extent that such subjects might conflict with the subject matter of this invention (in which case the content existing herein shall prevail). The referenced items are provided solely for their disclosure prior to the filing date of this application. Nothing herein should be construed as an admission that this invention is not entitled to rely on prior inventions preceding such material. Attached Figure Description

[0022] This disclosure will be more fully understood by referring to the following detailed description in conjunction with the accompanying drawings, wherein:

[0023] Figure 1 An electrosurgical system according to this disclosure is shown;

[0024] Figure 2A and 2B An electrosurgical device according to this disclosure is shown;

[0025] Figure 3A An end view of the electrosurgical device according to this disclosure is shown;

[0026] Figure 3B A side view of the electrosurgical device according to this disclosure is shown;

[0027] Figure 3C A bottom view of the electrosurgical device according to this disclosure is shown;

[0028] Figure 3D An alternative perspective view of the electrosurgical device according to this disclosure is shown;

[0029] Figure 4A A method for treating tissue using an electrosurgical device according to this disclosure is shown; and

[0030] Figure 4B A method for dissecting tissue using an electrosurgical device according to this disclosure is shown. Detailed Implementation

[0031] In the following description, similar parts have been given the same reference numerals, regardless of whether they are shown in different instances. To illustrate instances clearly and concisely, the figures may not necessarily be drawn to scale, and some features may be shown in a slightly schematic manner. Features described and / or shown with respect to one instance may be used in the same or similar manner in one or more other instances, and / or in combination with or in place of features of other instances.

[0032] As used in the specification and claims, for the purposes of describing and defining the invention, the terms “about” and “approximately” are used to indicate the inherent uncertainty attributable to any quantitative comparison, value, measurement, or other representation. The terms “about” and “approximately” are also used herein to indicate the extent to which a quantitative representation may differ from the stated reference without causing a change in the essential function of the subject matter under discussion. The forms “comprising,” “including,” and / or each” are open-ended and include the listed portions and may include additional portions not listed. “And / or” is open-ended and includes one or more listed portions and combinations of listed portions. The use of the terms “up,” “down,” “up,” etc., is intended only to help clearly describe this disclosure and is not intended to limit the structure, positioning, and / or operation of this disclosure in any way.

[0033] This disclosure relates to an electrosurgical device or rod that can be used to treat tissue during arthroscopic surgery. For example, the device can be used to treat tissue within the shoulder, knee, or hip joint. Access to the target tissue is preferably through a port into a fluid-filled cavity; therefore, the disclosed device includes a small-diameter shaft for insertion through this port or ports. Treatment can include finely dissecting or anatomy of a portion of the target tissue using high-frequency energy when the device is in a first orientation relative to the target tissue. Treatment of the tissue can also include subtracting or removing a larger volume of tissue when the device is in a second orientation relative to the target tissue. The device is electrically coupled to a high-frequency energy supply. The device can also be coupled to a fluid flow rate control device. Fluid and debris can be removed from the target area through at least one aspiration port of the device, and the fluid flow rate control device can influence or at least partially control the mode of tissue treatment. Different modes and their associated fluid aspiration rate control principles are disclosed in commonly owned patents 9,333,024 and 9,713,489, which are incorporated herein by reference in their entirety.

[0034] Electrosurgical devices may include a rigid shaft, thereby having a fixed angular offset between the proximal end of the shaft and the distal end of the device. In other embodiments, the electrosurgical device may include an adjustable angular offset. For example, the shaft may be extendable, as a user can plastically deform a portion of the shaft to adjust the angular offset. Since this may impede access to the joint space through a small port, the device may be steerable. The device shaft may include, for example, an actuating rod or cable that elastically deforms the spine along the shaft, allowing the angular offset to be adjusted after insertion through the port. Exemplary devices with steerable shafts are disclosed in commonly owned Provisional Patent Application No. 62 / 962036, entitled “ARTICULATING SHAFT OF ASURGICAL DEVICE,” and International Patent Application No. PCT / US2021 / 013811, entitled “ARTICULATING SHAFT OF ASURGICAL DEVICE,” which are incorporated herein by reference in their entirety.

[0035] This device can be configured for arthroscopic surgery of the hip joint. The hip joint presents unique challenges for arthroscopic devices due to its access to areas that are both very tight and very deep. Accessing relevant anatomical structures for treatment can be difficult, which can affect treatment outcomes and the patient's total time during the procedure. For example, one of the target areas for hip arthroscopy is the hip joint capsule attached to the acetabulum, from which it may need to be separated. This allows the surgeon to access the acetabular rim for labral anchoring and treatment. Minimizing tissue loss is crucial for tissue preservation when separating the joint capsule from the acetabulum. Therefore, it is preferable to limit the separation to a specific and narrow local area that needs to be separated. Tissue loss may occur by applying electrosurgical energy to tissue outside this local area. In such tight and deep areas, the extent of tissue loss depends heavily on the skill of the surgeon.

[0036] The device includes surface and active electrode configurations that improve access to the target area and provide a means of guiding more targeted and localized separation of the hip joint capsule from the acetabulum, reducing reliance on surgeon skills.

[0037] Figure 1 An electrosurgical system 100 according to at least some embodiments is illustrated. Specifically, the electrosurgical system 100 includes an electrosurgical device 102 or a rod coupled to an electrosurgical controller 104 (hereinafter referred to as "controller 104"). The device 102 includes an elongated shaft 106 defining a distal end 108. The elongated shaft 106 also defines a handle 110 at a proximal end 111, which a surgeon holds the device 102 proximally during surgical procedures. The device 102 also includes housing one or more electrical leads (…). Figure 1 A flexible multi-conductor cable 112 (not specifically shown) terminates in a device connector 114. Figure 1 As shown, device 102 is, for example, through the outer surface of the casing 122 (on Figure 1 In an exemplary case, the controller connector 120 on the front surface is connected to the controller 104.

[0038] Despite Figure 1 Not visible in the view, in some embodiments, device 102 has one or more internal fluid conduits coupled to an externally accessible tubular member. As shown, device 102 has a flexible tubular member 116 for providing suction at a distal end 108 of the device. According to various embodiments, tubular member 116 is coupled to peristaltic pump 118, which is exemplarily shown as a component integrated with controller 104 (i.e., at least partially located within the housing 122 of controller 104). In other embodiments, the housing of peristaltic pump 118 may be separable from the housing 122 of controller 104 (e.g., ...). Figure 1(As shown by the dashed line in the diagram), but in any case, the peristaltic pump is operatively coupled to the controller 104. In other embodiments, the suction for aspiration can be provided from any suitable source, such as a suction outlet available in a hospital setting. An exemplary peristaltic pump 118 includes a rotor portion 124 (hereinafter referred to as "rotor 124") and a stator portion 126 (hereinafter referred to as "stator 126"). An exemplary flexible tubular member 116 is coupled within the peristaltic pump 118 between the rotor 124 and the stator 126, and movement of the rotor 124 against the flexible tubular member 116 causes fluid to move toward the discharge port 128.

[0039] Still referencing Figure 1 The display device or interface device 130 is visible through the housing 122 of the controller 104, and in some embodiments, a user can select the operating characteristics of the controller 104 via the interface device 130 and associated buttons 132. For example, using one or more of the buttons 132, a surgeon can select an energy range or mode during electrosurgical procedures for use with the device 102.

[0040] In some embodiments, the electrosurgical system 100 further includes a foot pedal assembly 134. The foot pedal assembly 134 may include one or more pedal devices 136 and 138, a flexible multiconductor cable 140, and a pedal connector 142. Although only two pedal devices 136 and 138 are shown, one or more pedal devices may be implemented. The housing 122 of the controller 104 may include a corresponding connector 144 coupled to the pedal connector 142. A physician can use the foot pedal assembly 134 to control various aspects of the controller 104, such as ablation modes. For example, pedal device 136 may be used for on / off control of applying radiofrequency (RF) energy to the device 102. Furthermore, pedal device 138 may be used to control and / or set the operating modes of the electrosurgical system. For example, actuation of pedal device 138 may switch between ablation and coagulation modes.

[0041] The electrosurgical system 100 in various embodiments performs ablation, employing Technology. In particular, the assignee of this disclosure is The owner of the technology. The technology involves applying a radio frequency (RF) signal between one or more active electrodes and one or more return electrodes of device 102 to generate a high electric field strength near target tissue. The electric field strength can be sufficient to vaporize a conductive fluid over at least a portion of one or more active electrodes in the region between the active electrodes and the target tissue. The conductive fluid may be inherently present in the body, such as blood, or in some cases, in extracellular or intracellular fluid. In other embodiments, the conductive fluid may be a liquid or a gas, such as isotonic saline. In some embodiments, such as arthroscopic surgery involving the knee, hip, or shoulder, the conductive fluid is delivered to the vicinity of the active electrodes and / or the target site via a delivery system separate and independent of system 100. The fluid may be present to dilate the joint to facilitate access to the target tissue.

[0042] Gases form when a conductive fluid is heated to a rate at which the vaporization of the fluid atoms exceeds the rate at which they recondense. When sufficient energy is applied to the gas, the atoms collide with each other, releasing electrons in the process, forming an ionized gas or plasma (the so-called "fourth state of matter"). In other words, plasmas can be formed by heating a gas and ionizing it by driving an electric current through it or by directing electromagnetic waves into it. Plasma formation methods directly provide energy to the free electrons in the plasma, electron-atom collisions release more electrons, and the process cascades until the desired level of ionization is achieved. A more complete description of plasmas can be found in Plasma Physics (1995) by R.J. Goldston and PH. Rutherford of the Plasma Physics Laboratory at Princeton University, the entire contents of which are incorporated herein by reference.

[0043] As the plasma density becomes sufficiently low (i.e., less than approximately 10²⁰ atoms / cm³ for aqueous solutions), the mean free path of electrons increases, causing subsequent injection of electrons to induce collisional ionization within the plasma. When the ion particles in the plasma layer possess sufficient energy (e.g., 3.5 electron volts (eV) to 5 eV), collisions between these ion particles and the molecules constituting the target tissue break the molecular bonds of the target tissue, dissociating the molecules into free radicals that then recombine into gaseous or liquid substances. Target tissue is removed volumetrically by molecular dissociation (as opposed to thermal evaporation or carbonization) by dissociating larger organic molecules into smaller molecules and / or atoms, such as oxides of hydrogen, oxygen, carbon, hydrocarbons, and nitrogen compounds. Molecular dissociation completely removes the tissue structure, as opposed to dehydrating tissue material by removing intracellular and extracellular fluids, as occurs in electrosurgical drying and vaporization in related technologies. A more detailed description of molecular dissociation can be found in commonly assigned U.S. Patent No. 5,697,882, the entire disclosure of which is incorporated herein by reference.

[0044] The energy density generated by the electrosurgical system 100 at the distal end 108 of the device 102 can be varied by adjusting a variety of factors, such as: the number of active electrodes; electrode size and spacing; electrode surface area; roughness and / or sharp edges on the electrode surface; electrode material; applied voltage; current limitation of one or more electrodes (e.g., by connecting an inductor in series with the electrodes); conductivity of the fluid in contact with the electrodes; density of the conductive fluid; and other factors. Therefore, these factors can be manipulated to control the energy level of the excited electrons. Since different tissue structures have different molecular bonds, the electrosurgical system 100 can be configured to generate energy sufficient to break the molecular bonds of some tissues but insufficient to break the molecular bonds of others. For example, adipose tissue (e.g., fat) has double bonds that require energy levels higher than 4 eV to 5 eV (i.e., approximately 8 eV) to break. Therefore, in some operating modes, The technology will not ablate such fatty tissue; however, lower energy levels The technology can be used to effectively ablate cells to release internal fat content in liquid form. Other modes of operation may involve increased energy, allowing double bonds to break in a manner similar to single bonds (e.g., increasing voltage or altering electrode configuration to increase current density at the electrodes). More complete descriptions of the various phenomena can be found in commonly assigned U.S. Patents 6,355,032, 6,149,120, and 6,296,136, the entire disclosure of which is incorporated herein by reference.

[0045] Figure 2 shows a perspective view of a device 102 according to an exemplary system. Device 102 includes an elongated shaft 106, which may be flexible or rigid, and a handle 110 coupled to a proximal end 111 of the elongated shaft 106. More clearly in the enlarged view portion, an active electrode 200, a return electrode 202, and an insulating spacer (electrode support member) 204 are present at the distal end 108. The relationships between the various components at the distal end 108 of device 102 will be discussed in more detail below. The active electrode 200 can be coupled to a controller 104 via one or more insulated electrical connectors (not shown) in a multi-conductor cable 112. Figure 1An active or passive control network is provided within the device 102. The active electrode 200 is electrically isolated from a common or return electrode 202 disposed on an elongated shaft 106. Proximal to the distal end, the return electrode 202 is concentric with the elongated shaft 106 of the device 102. A spacer 204 is located distal to the return electrode 202 and may be made of an electrically insulating material such as epoxy resin, plastic, ceramic, silicone resin, glass, etc. An insulating support 204 extends from the distal end 108 of the elongated shaft 106 (typically about 2 to 20 mm) and provides support for the active electrode 200. The insulating spacer 204 defines an electrically insulating material and is long enough (axially) to provide an electrically inert (non-conductive) portion of the distal end 108 of the device. The insulating spacer 204 is configured to define, guide, and stabilize the orientation of the active electrode 200 relative to the target tissue. The insulating spacer 204 is configured to space the return electrode 202 and the active electrode 200 apart from each other. Working in conjunction with the spacer surface, the active electrode 200 is designed so that each edge can be used for precise dissection and slicing of tissue, with the orientation toward each edge guided by an extended planar surface on the insulating spacer surface. The distal end 108 of the device is configured to precisely dissect tissue in a first orientation and to reduce tissue volume in a second orientation different from the first orientation.

[0046] The device is configured for use in a conductive fluid that can be present as part of arthroscopic surgery to expand the joint. Electrosurgical energy can thus be bridged between the active electrode 200 and the return electrode 202 using this conductive fluid. Tissue tends to have a slightly higher impedance than the conductive fluid, but lower than the spacer 202. Therefore, the spacer 202 in the device 102 is long enough to space the active electrode 200 from the return electrode 202, so that most of the electrical energy is preferentially directed through the conductive fluid even when the active and return electrodes (200, 204) are in contact with the tissue. This does not exclude any tissue effects or energy flowing through the tissue; the spacing is configured to preferentially minimize the energy flowing through the tissue, thereby avoiding electrically induced tissue alteration effects. The length of the spacer 202 is longer than that of many related technology devices and defines an inert or protective area of ​​the device, allowing the surgeon to engage and use the surface of the spacer 202 while minimizing alteration to the tissue it engages with.

[0047] Figure 3A An end view of the distal end 108 is shown. For simplicity, the handle 110 has been removed from... Figure 3ARemoval. The active electrode 200 generally defines a planar electrode positioned along a single plane oriented at an angle between 30 and 60 degrees relative to the longitudinal axis LL of the distal end 108. The active electrode 200 defines a distal planar surface 302 having a polygonal shape. The planar surface 302 faces distally. As shown, the active electrode 200 defines a quadrilateral having four linear edges 303, 304, 305a, 305b connected by circular vertices. In use, the active electrode 200 can be oriented to place one of these four linear edges 303, 304, 305a, 305b directly adjacent to tissue for precise tissue dissection. Alternatively, the active electrode 200 can be oriented to engage a large portion of the planar surface 302 with the target tissue for tissue volume reduction. The planar surface 302 is oriented at an angle to the longitudinal axis of the distal end 108, defining the distal edge (leading edge) 303 of the surface 302. The leading edge 303 may be linear within its range and may be parallel to the nearest side edge 304 of the active electrode 202, defining a trapezoidal surface 303. Lateral side edges 305a and 305b extend between the leading edge 303 and the nearest side edge 304, extending at equal and opposite angles θ to the central vertical axis along the planar surface 203; θ is between 10 and 30 degrees (°).

[0048] Also Figure 3A As shown, spacer 202 may define the outermost proximal boundary 320 of insulating spacer 204, which may define a circular boundary. Spacer 204 is axially tapered, defining a distal surface 322, which defines a planar surface facing distally and parallel to the active electrode surface 302. The tapering of spacer 204 is such that the outermost proximal boundary 320 of support member 204 is larger than the outermost distal boundary of distal surface 322 of support member 204. The outer surface of support member 204 defines a generally conical shape, symmetrical about a vertical plane passing through the center of support member 204 and parallel to the distal longitudinal axis. The outer surface of support member 204 is asymmetrical with respect to a horizontal plane passing through the center of support member and parallel to the distal longitudinal axis. The cone angle on the top side of the device is larger than the cone angle on the bottom side. The nearest end of support member 204 may define a circular cross-section or outer perimeter. The distal surface 322 preferably defines a shape that matches or is similar to the active electrode 202. For example, if the active electrode 202 defines a trapezoid, then the farthest edge surface 322 can also define a trapezoidal surface. The active electrode 202 and the farthest surface 322 can be identical or nearly identical.

[0049] Mirroring the shape of the active electrode 202, the outer surface 325 of the spacer defines a plurality of planar segments extending from the corresponding linear edges 303, 304, 305a, 305b of the active electrode 200. The spacer 204 defines a conical outer surface 325 formed by a plurality of planar surfaces or faces having curved apex portions therebetween. For example, planar surface 333 extends proximally from the edge of surface 322 corresponding to or directly adjacent to the linear leading edge 303. Planar surface 333 is planar in its lateral extent, which generally corresponds to the linear lateral extent of edge 303. Similarly, planar surface 334 extends proximally from edge surface 322 corresponding to or directly adjacent to the linear edge surface 304 of the active electrode 202, and planar surface 334 also gradually transitions to a larger outer peripheral boundary 320. Surface 334 may have a wider lateral extent than surface 333 and is also mirroring the edge length of the active electrode. The transverse surfaces 335a and 335b also define planar surfaces in a similar manner. The multifaceted surfaces of the support 204 are configured to define the orientation of the active electrode 200 during tissue dissection, which will be discussed in more detail below.

[0050] The orifice 310 extends through the active electrode 108 and is in fluid communication with a fluid delivery conduit configuration. As disclosed herein, the fluid delivery conduit configuration includes a conduit defined by a support member 204 and a conduit or lumen extending along a device axis 106, wherein it is in fluid connection with a conduit 116. The orifice 310 is sized to draw tissue debris, plasma byproducts, and fluid from it into the fluid delivery conduit. As previously disclosed, the aspiration rate through the orifice 310 can be controlled to at least partially influence or control the tissue effect mode at the active electrode 202.

[0051] Now go to Figure 3B The diagram shows a side elevation view of the distal end 108, which includes an active electrode 200, an insulating support member 204, and a return electrode 202. The longitudinal axis LL of the distal end 108 is shown. The distal longitudinal axis may be offset angularly from the proximal end of the longitudinal axis along the device axis 106, close to the proximal end 111. The active electrode 200 intersects the longitudinal axis but is offset towards the lower or bottom side of the device via its central axis. Further active electrodes 200 are disposed below the longitudinal axis LL. The planar surface 302 of the active electrode 200 is oriented at an angle α relative to a horizontal plane parallel to the longitudinal axis LL. The angle α may be between 30 and 60 degrees (°), and is preferably about 45 degrees (°). The angle α, combined with the faceted surface of the support member 204, is configured to orient the leading edge surface 303 of the active electrode in a targeted orientation.

[0052] Figure 3BA tapered support 204 is also shown, comprising a planar lower surface 333 and a planar lower surface 334. Each of surfaces 333 and 334, 325a, 325b, blends into the more cylindrical proximal end of the support 204 towards the proximal end. The planar lower surface 333 tapers radially away from the longitudinal axis as it extends proximally from surface 322. The planar lower surface extends at an angle A, which can be between 10 and 25 degrees (°) and more preferably about 15 to 20 degrees (°). The planar upper surface 334 tapers radially away from the longitudinal axis as it extends proximally from surface 322, at an angle B that can be greater than angle A. Angle B can be between 20 and 40 degrees (°) and more preferably about 25 to 35 degrees (°). The return electrode 202 defines a distal edge surface 342, which defines a radius R that can be between 3 and 4 mm. Angle A and angle α together define angle C, which extends between the two outer surfaces of the spacer 204 adjacent to the leading edge 303 of the active electrode and through the support 204. Angle C is between 55 and 70 degrees, and preferably between 60 and 65 degrees, and is configured to orient the leading edge 303 of the active electrode and the planar surface 302 in a targeted orientation during acetabular anatomy, as will be explained in more detail later.

[0053] Spacer 204 provides a non-conductive region between active electrode 200 and return electrode 202. Spacer 204 includes a contoured and faceted surface that blends the edge of active electrode 200 and the cylindrical shape of return electrode 202. Planar surfaces such as surfaces 333, 334 or 335a, 335b provide inert planar surfaces that can rest against underlying adjacent tissue to aid in the orientation of active electrode 200 for tissue dissection. Surfaces that provide stability for the orientation of distal end 108 of the device are provided over their extent. Consider, for example, related technical devices that define a curved outer surface, such as tubular electrode supports. In these related technical devices, resting a curved surface on underlying tissue does not provide lateral stability, and the related technical device can rotate freely about its axis when the surgeon moves the device. Therefore, maintaining target orientation relies more on the surgeon's skill. In contrast, by resting the planar surface of the support of device 102 on underlying tissue, the surgeon can reliably place the leading edge 303 of the electrode on the target tissue and dissect that tissue. The planar surface provides a reference surface for the surgeon.

[0054] Furthermore, the planar surface of the support 204 provides an inert or non-conductive region for the device. This is at least in part due to the spacer length, or the distance between the active electrode 200 and the return electrode 202, such as L. sThis length is significantly longer than that of related technology devices, and is sufficiently long that the electrosurgical energy delivered to the tissue upon which the spacer 204 rests is minimally altered. Therefore, the surgeon can place the planar surface of the support 204, corresponding to the selected electrode edges (303, 304, 305a, 305b), onto the tissue, using it as a guiding and stabilizing surface, without concern for unintentional tissue effects on the underlying tissue. For example, a device with a maximum shaft diameter or width of approximately 5 mm, and a main length L between 2 and 3 mm. A Active electrode, linear length L s The length can be at least 2 mm, preferably at least 3 mm, and up to 5 mm. The linear length L of the spacer 204... s It can be at least the same as the main length L of the active electrode A They are the same length. The linear length L of support member 204 is... s It can be more than half of the shaft's maximum diameter or width. Linear length L s Long enough to preferably protect along a linear length L s The tissue in contact is protected from unintentional tissue treatment.

[0055] Still referencing Figure 3B In the exemplary device 102 shown, the return electrode 202 has a top side 368 and a bottom side 370 adjacent to and opposite the leading edge 333 of the active electrode. The top side 368 of the return electrode 202 has a first length measured axially from the handle, and the bottom side 370 has a second length measured axially from the handle 110, the second length being greater than the first length to define a recessed bottom portion of the return electrode 202. A spacer 204 extends and retracts within the return electrode 202 and is located within the recess 372. As shown, when measured or considered along the longitudinal axis LL, no portion of the return electrode 200 axially overlaps with the active electrode 200. Although the combination of length and angle spacers the return electrode and the active electrode apart to eliminate overlap, the increased length of the support 204 is configured to sufficiently space the active electrode and the return electrode to eliminate this overlap.

[0056] Figure 3CA bottom view of the distal end 108 of the device is shown. This view can be one that a surgeon might have when the device is positioned for volume reduction of a larger surface area of ​​tissue. In this orientation, a large portion of the planar surface 302 can be positioned to contact the tissue. The planar surface 333 of the spacer is shown, and the leading edge 303 is advantageously visible. Visibility of the active electrode 200 is preferred throughout treatment to ensure that treatment is performed on the target portion of the tissue. The tapered support 204 is tapered such that the active electrode 200 is visible from all sides of the electrode 200. The device can also be used for volume reduction or coagulation of tissue in this orientation relative to the tissue. For example, this can be used to remove a portion of the top surface of the acetabulum before placing hardware therein.

[0057] Figure 3D An alternative view of the distal end 108 is shown, illustrating the tapered and multifaceted spacer 204. A planar surface 333 is also shown relative to the leading edge 303.

[0058] Figure 4A A front view of the distal end 108 of the device is shown, with the device in a first orientation relative to the tissue; a lower planar surface 333 rests on the underlying tissue 400. This orientation allows for tissue dissection at the leading edge 303. The lower planar surface 333 defines a broad, flat surface for stable contact with the tissue. Resting the lower planar surface 333 on the tissue 400 orients the leading edge 303 onto or directly adjacent to the tissue 400 for precise tissue dissection. In this example, surface 302 is preferably spaced apart from or angled to any adjacent tissue.

[0059] This is particularly applicable to dissecting the first tissue 400 from the second tissue 405, such as Figure 4B As shown in the diagram. This is a side view. By placing surface 333 on the surface of tissue 400, the device is stably oriented to position the leading edge 303 at the intersection "I" between tissues 400 and 405. This can also preferably orient the active electrode surface 302 away from tissue 405. Furthermore, the inert surface 333 preferably protects the tissue in region 402 from electrosurgical treatment.

[0060] Tissue 405 can be the joint capsule tissue within the hip joint, and tissue 400 can be the acetabulum. The distal end of the device is configured to dissect the joint capsule from the acetabulum, preserving adjacent tissues. By limiting the tissue effect to the cross region "I", loss of joint capsule tissue can be minimized. In other examples, the tissues can be the labrum and acetabulum of the hip.

[0061] Those skilled in the art will recognize that this disclosure may be practiced in other specific forms without departing from its spirit or essential characteristics. Therefore, the foregoing examples are to be considered illustrative in all respects and not to limit the disclosure described herein. The scope of this disclosure is therefore indicated by the appended claims rather than by the foregoing description, and thus all variations in the meaning and scope of the equivalents of the claims are intended to be included therein.

Claims

1. An electrosurgical device, comprising: The device includes a handle at a proximal end, an elongated shaft extending distally from the handle to define a longitudinal axis, and a distal end having a return electrode, an active electrode, and an electrically insulating spacer axially separating the return electrode and the active electrode. The active electrode is positioned along a single plane and defines a distally facing planar surface, the planar surface being angled relative to the longitudinal axis to define a linear leading edge of the active electrode, the linear leading edge having a lateral extent and defining the distal edge of the electrosurgical device; The electrically insulating spacer is tapered between the return electrode and the active electrode and defines a first planar surface that extends along the longitudinal axis and spans the extent of the electrically insulating spacer on a first side of the distal end of the electrosurgical device, which also includes the linear leading edge of the active electrode.

2. The electrosurgical device of claim 1, wherein the planar surface of the active electrode defines a planar surface length extending from the leading edge to the opposing trailing edge, and the first planar surface of the electrically insulating spacer has a first length extending from the return electrode to the leading edge of the electrically insulating spacer, the first length being at least as long as the planar surface length of the active electrode.

3. The electrosurgical device of claim 1, wherein the planar surface of the active electrode is oriented at an acute angle relative to the first planar surface of the electrically insulating spacer, the acute angle extending through the electrically insulating spacer.

4. The electrosurgical device of claim 1, wherein the first planar surface is configured to guide the leading edge of the active electrode onto the first tissue while angularly distancing the remaining portion of the planar surface of the active electrode away from the first tissue.

5. The electrosurgical device of claim 1, wherein the electrically insulating spacer defines a second planar surface on the side of the device opposite to the first planar surface, the second planar surface being longer in the axial direction than the first planar surface.

6. The electrosurgical device of claim 1, wherein the electrically insulating spacer defines a multifaceted outer surface, the multifaceted outer surface comprising at least a first planar surface, a second planar surface, and a plurality of curved surfaces separating the first planar surface and the second planar surface.

7. The electrosurgical device of claim 1, wherein the electrical insulating spacer is asymmetrically tapered between a first side and an opposite second side of the electrical insulating spacer, the opposite second side having a larger cone angle than the first side.

8. The electrosurgical device of claim 1, wherein the planar surface of the active electrode defines a trapezoidal boundary.

9. The electrosurgical device of claim 8, wherein the electrically insulating spacer defines a farthest surface that coincides with the planar surface of the active electrode.

10. An electrosurgical device, comprising: A handle at the proximal end, an elongated shaft extending distally from the handle along a longitudinal axis, and a distal end having a return electrode, an active electrode, and an electrically insulating spacer axially separating the return electrode and the active electrode; The active electrode defines a planar surface facing the distal side, the planar surface being angled relative to the longitudinal axis to define a leading edge of the active electrode, the leading edge defining the farthest edge of the distal end; The electrically insulating spacer is tapered between the return electrode and the active electrode and defines a first planar surface that extends proximally along the longitudinal axis from the leading edge of the electrically insulating spacer directly adjacent to the leading edge of the active electrode and also extends laterally across the electrically insulating spacer. The first planar surface is configured to engage a first tissue and stabilize the orientation of the leading edge of the active electrode relative to the target tissue.

11. The electrosurgical device of claim 10, wherein the active electrode defines a principal planar surface length and the first planar surface of the electrically insulating spacer has a linear length extending along the longitudinal axis, the linear length being at least as long as the principal planar surface length of the active electrode.

12. The electrosurgical device of claim 10, wherein the planar surface of the active electrode is oriented at an acute angle relative to the first planar surface of the electrically insulating spacer, the acute angle extending through the electrically insulating spacer.

13. The electrosurgical device of claim 10, wherein the electrically insulating spacer defines a second planar surface on the side of the electrosurgical device opposite to the first planar surface, the second planar surface being longer in the axial direction than the first planar surface.

14. The electrosurgical device of claim 10, wherein the electrically insulating spacer defines a multifaceted outer surface, the multifaceted outer surface comprising at least a first planar surface and a second planar surface.

15. The electrosurgical device of claim 10, wherein the electrical insulating spacer is asymmetrically tapered between a first side and an opposing second side of the electrical insulating spacer, the opposing second side having a larger cone angle than the first side.

16. The electrosurgical device of claim 10, wherein the planar surface of the active electrode defines a trapezoidal boundary.

17. The electrosurgical device of claim 16, wherein the electrically insulating spacer defines a distal surface that faces distally and coincides with the planar surface of the active electrode.

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