Methods and apparatus for electrosurgical illumination and sensing

Abstract

An illuminated electrosurgical instrument includes a handle having a proximal end and a distal end; an optical element having a proximal end and a distal end, wherein the optical element is adjustably coupled to the handle such that a distance between the distal end of the optical element and the proximal end of the handle is adjustable; an illumination element configured to generate light and coupled to the proximal end of the optical element; and an electrosurgical tip extending distally from the distal end of the optical element, a smoke exhaust passage extending axially through the optical element from the distal end to the proximal end of the optical element.

Description

[0001] This application is a divisional application of the invention patent application with application date of December 8, 2015, application number 201580066743.1, and invention name “Method and device for electrosurgical illumination and sensing”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This application is a non-provisional application of and claims the benefit of the following U.S. Provisional Patent Applications: U.S. Provisional Patent Application No. 62 / 089,023, filed December 8, 2014; U.S. Provisional Patent Application No. 62 / 136,335, filed March 20, 2015; and U.S. Provisional Patent Application No. 62 / 212,516, filed August 31, 2015; the entire contents of which are incorporated herein by reference. Background Art

[0004] The present application relates generally to medical devices, systems and methods, and more particularly to illuminated electrosurgical instruments, such as illuminated energy tips, such as electrosurgical, plasma or laser tips. Conventional electrosurgical tools are typically used in most surgical procedures. Energy handpieces generally include a handpiece (also referred to herein as a handle) and an energy tip. The handpiece is ergonomically shaped to allow the surgeon to manipulate the handpiece during surgery and position the energy tip to the desired position, where energy, typically radiofrequency (RF) energy, is delivered to the target tissue to cut or coagulate the tissue. One of the challenges of these devices is that they are typically used in dark openings that are difficult to access without obstructing the surgical field and difficult to adequately illuminate. Commercially available energy handpieces do not always include lighting elements for illuminating the surgical field, and thus lighting must be provided by another device such as a headlamp worn by the surgeon or a manually adjusted overhead light. Handpieces that do provide illumination may have an illumination element, such as a light emitting diode (LED), releasably or fixedly mounted in the handle of the device, but this may not be the optimal position or distance from the work surface or target, and these devices may not have optimized lens action for collecting and shaping the light, and advanced light shaping may require larger profile lenses that are impractical for surgical applications with limited profiles. Light shaping is also critical because conventional LED dyes have a wide Lambertian output that requires collection and directionality. High-power LEDs also generate a lot of heat from the LED dye, and the heat can be conducted to the core of the LED board. Therefore, cooling is required to keep the entire device safe, especially when in contact with the patient. Moreover, it is desirable to have the light as close to the surgical target as possible to ensure sufficient brightness and intensity. Many commercially available devices have LEDs located at the very far tip of the device, but this can create challenges with respect to lighting quality, such as sufficient brightness, device profile, beam directionality, and light shaping and thermal management. Therefore, the light provided by the LEDs is preferably thermally safe, low-profile, and directed and shaped for optimal illumination of the surgical target. It would be desirable to provide improved energy handpieces that provide better illumination for illuminating a work surface or target area such as a surgical field. At least some of these objectives are met by the embodiments disclosed below. Summary of the Invention

[0005] The present invention relates generally to medical systems, devices and methods, and more particularly to lighting energy devices, systems and methods.

[0006] The illumination energy device may optionally include a waveguide to assist in delivering light to the target work area. Preferably, a waveguide is a light-guiding, non-fiber optic optical element in which light passing therethrough has at least one internal reflection.

[0007] In a first aspect of the present invention, an illumination energy device includes a handle, an optical waveguide coupled to the handle, and an energy tip coupled to the optical waveguide. The energy tip can be adjustably coupled to the waveguide or the handle, and adjustment of the optical waveguide can move a distal end closer to or further away from a target, such as a tissue target in a surgical field. The energy tip can be an electrode and can be removably coupled to the optical waveguide or the handle. The optical waveguide can be independently movable relative to the energy tip.

[0008] In another aspect of the present invention, a method for illuminating a surgical target includes providing an optical waveguide coupled to an energy tip (such as an electrode), illuminating a surgical field with light from the optical waveguide, and moving the optical waveguide and energy tip together or independently of each other toward or away from the surgical target. If the waveguide moves independently of the tip, this adjusts the length of the energy tip and the optical waveguide and can adjust the illumination of a target, such as target tissue in a surgical field. The method can also include replacing the energy tip with a different energy tip, such as an electrode of a different shape.

[0009] The energy tip can be integrated into the waveguide. The entire assembly can be moved closer to and further away from the target as desired by the user. The energy tip can travel through the entire length of the waveguide or alongside it. The energy tip can also travel only a portion of the length of the waveguide and can exit from the side of the waveguide.

[0010] The waveguide may be molded or pressed with various cavities or channels to collect smoke from the surgical field.

[0011] The device may include thermal management features, such as metal tubing or other heat conducting material coupled to the waveguide or lighting element to act as a heat sink.

[0012] Alternatively, the lighting element may be an LED and the lighting element may be coaxial with the energy tip, or the waveguide may be coaxial with the energy tip.

[0013] Optionally, the waveguide may have microstructures on its surface that shape the output light to have one or more desired optical properties. An optical coating or cladding may be disposed on the inner or outer surface of the waveguide to provide the desired optical properties. An air gap may be formed or otherwise maintained adjacent to the waveguide to minimize light loss.

[0014] In another aspect, a system for illuminating a surgical target includes an illumination element, an optical waveguide, an electrode tip, and a heat sink. The optical waveguide transmits light emitted from the illumination element, and the electrode tip is adjacent to the optical waveguide. The heat sink is thermally coupled to the illumination element and dissipates heat generated therefrom.

[0015] These and other embodiments are described in further detail in the following description with respect to the drawings.

[0016] Incorporation by reference

[0017] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the invention will be obtained by reference to the following detailed description and the accompanying drawings, which set forth illustrative embodiments in which the principles of the invention are utilized, wherein:

[0019] Figure 1A-1D A standard lighting energy handpiece is shown.

[0020] Figure 2A-2B An energy handpiece with an optical waveguide is illustrated.

[0021] Figure 3A-Figure 3B An optical waveguide is illustrated.

[0022] Figure 4A-4B A movable optical waveguide coupled to an energy handpiece is illustrated.

[0023] Figures 5A-5D An exemplary embodiment of a conductor element adjacent to an optical waveguide is illustrated.

[0024] Figures 6A-6D An exemplary embodiment of an optical waveguide for LED illumination is illustrated.

[0025] Figure 6E Another exemplary embodiment of an optical waveguide for LED illumination is illustrated.

[0026] Figure 7 An exemplary embodiment of an optical waveguide having electrodes is illustrated.

[0027] Figure 8 Highlighted Figure 7 The proximal portion of the waveguide.

[0028] Figure 9An exemplary embodiment of an illuminating electrode tip with smoke exhaust is illustrated.

[0029] Figure 10 An exemplary embodiment of an illumination handpiece with an energy tip is illustrated.

[0030] Figure 11-12 A cross-section of an exemplary embodiment of an illumination handpiece with an energy tip is illustrated.

[0031] Figures 13A-13B Illustrated are exemplary embodiments of an illumination element coupled to an energy tip or conductor element.

[0032] Figure 13C The coating on the electrode is shown.

[0033] Figures 14A-14C Alternative positions of the illumination elements relative to the waveguide are illustrated.

[0034] Figure 15 An exemplary embodiment of a locking mechanism is illustrated.

[0035] Figures 16A-16D Another exemplary embodiment of an illumination energy tip is illustrated.

[0036] Figures 17A-17B Optional battery features are shown.

[0037] Figures 18A-18F Another exemplary embodiment of an illumination energy tip is illustrated.

[0038] Figures 19A-19D Various electrode cross sections are shown. DETAILED DESCRIPTION

[0039] Detailed embodiments of the disclosed devices, delivery systems, and methods will now be described with reference to the accompanying drawings.Nothing in this detailed description is intended to suggest that any particular component, feature, or step is essential to the invention.

[0040] The present invention will be described with respect to an illuminating energy handpiece used during electrosurgery, for example, for cutting or coagulation of tissue. However, those skilled in the art will appreciate that this is not intended to be limiting and that the devices and methods disclosed herein may be used with other instruments and methods.

[0041] Figure 1AThe diagram shows a standard illumination energy handpiece 10 comprising a handle 12, an energy tip or electrode 20, an unmounted illumination element 16, a cable 14, and an external power source 40. The external power source 40 can be used to provide energy, such as RF energy, to the electrode 20. Typically, standard illumination energy devices have either a packaged power source (such as a battery in the handle) or an external power source with a separate plug or connection. Because the illumination element is attached to the distal portion of the handle 12, the light emitted from the illumination element 16 may not always have the desired intensity, directionality, uniformity, or other desired optical properties when directed onto the surgical field. This can also be seen when electrodes 20 of varying lengths are used with the handle 12, which will change the relative distance from the light source to the target (such as the surgical target). Since the intensity of light is inversely proportional to the square of the distance from the target, it is desirable to keep the source close to the target. Lenses can be used in conjunction with the illumination element 16, but these do not always provide the desired light quality, particularly because larger cross-section lenses are required, but these larger sizes are not always practical for surgical applications where space is very limited.

[0042] Figure 1B-1D An exemplary illuminated electrosurgical instrument is illustrated. Figure 1B An electrosurgical pencil with RF electrodes and LED lighting elements is illustrated. Figure 1C Highlighted Figure 1B Because the LED is attached to the pen, if a long electrosurgical tip is used, the LED may be too far away from the surgical field to adequately illuminate the tissue in the surgical field. Figure 1D Another electrosurgical pencil is illustrated having the illumination source housed in the pencil of the instrument, resulting in a large profile of the device that may obstruct access to the surgical field.

[0043] Some of the above-mentioned challenges may be overcome using the exemplary embodiments of the illuminated electrosurgical instrument described below.

[0044] Figure 2A An exemplary embodiment of an electrosurgical pencil is shown. The distal tip includes an electrode 214 for delivering energy (typically RF energy) to tissue for coagulation or cutting. A control button 206 on the pen 204 (also referred to as the handle) allows the surgeon or operator to control the mode of operation from cutting or coagulation. A plastic sheath 201 or sleeve with a textured surface (here, several eyelets) provides the operator with a finger grip to easily grasp the electrode and remove it from the pen 204.

[0045] Figure 2BAn exemplary embodiment of an illumination energy handpiece is illustrated, comprising a handle 204 having an optical waveguide 202 coupled to a distal portion of the handle 204, and an electrode (also referred to as an energy tip) 214 extending away from the waveguide 202. A cable 208 is coupled to the proximal portion of the handle and operatively couples the energy handpiece to an external power source 210. The power source 210 can provide RF energy to the electrode 214 and can also power an illumination element (not shown) that delivers light to the waveguide 202. Optionally, the power source 201 can also include an external light source (e.g., a xenon lamp) that can deliver light via a fiber optic cable included in the cable 208 to introduce light into the waveguide. The optional light source can be integral to the power source, or it can be a separate component. A control button 206 allows the user to turn power on and off for delivery to the electrode 214. Typically, two buttons 206 are used: one for supplying RF current to the electrode optimized for cutting tissue, and another for supplying RF current to the electrode optimized for coagulation. These controls can also automatically provide light to the waveguide, which then illuminates the surgical field as current is delivered from the electrode to the tissue. In some embodiments, a separate illumination control button can be placed on the handle to activate the light independently of the electrode power.

[0046] The electrode 214 may be fixedly attached to the waveguide 202 or handle 204, or it may be removably connected to the waveguide 202 or handle 204, allowing a user to replace the electrode tip depending on the procedure being performed.

[0047] The optical waveguide 202 can be fixedly attached to the handle 204, or it can be adjustably attached to the handle 204, such as with a removable connection to allow the length of the optical waveguide to be adjusted based on the length of the electrodes. Any mechanism known in the art can be used to allow adjustment of the removable optical waveguide, such as a collet, a threaded connection, a pin and detent mechanism, a spring-loaded mechanism, a ratchet and pawl mechanism, etc. An LED in the handle, coupled to the distal portion of the handle, or coupled to the proximal end of the waveguide can supply light to the optical waveguide. Thus, in this or any embodiment, the LED can move with the waveguide, and the waveguide can move independently of the electrodes. Any number of configurations of this device are possible, as described below. The energy tip can thus be fixedly attached to the waveguide, and the tip can move with it as the waveguide slides or otherwise moves inward or outward, or the tip can be detachably attached to the waveguide, and the tip can also move with the waveguide as it moves inward or outward. In other embodiments, the tip can be coupled to the handle, and the tip can remain stationary as the waveguide moves, or the tip can move independently of the waveguide.

[0048] In any embodiment, the optical waveguide can be a hollow tubular waveguide having a central channel extending through the tube and wherein the electrodes extend partially or completely through the central channel, or the optical waveguide can be a solid rod with no space between the electrodes and the conductor wires and the inner surface of the optical waveguide. In either embodiment, the optical waveguide can be fixed or adjustable. When the optical waveguide is fixed, it has a specific tube length attached to the handle.

[0049] In an alternative embodiment, the sleeve can be integrated with a micro-LED dye, so that the electrosurgical electrode tip can provide power to the sleeve to generate light. Thus, when the tip is inserted into the pen and the current is activated, current also flows to the LED.

[0050] Figure 3A-Figure 3B Any embodiment of the optical waveguide 202 shown may include an optical structure such as a lenslet 302 on the distal end of the tube, or the lenslet may be disposed on the inner surface, outer surface, or any distal portion 304 of the tube. The lenslet helps extract and shape the light emitted from the waveguide. The proximal end of the waveguide may include an LED 306 that provides light to the waveguide 202. The LED can be coupled to the waveguide in any number of ways, including butt coupling to other coupling mechanisms, such as where the proximal end of the optical waveguide has a parabolic shape to capture a wide divergence of light emitted from the LED light source. In this embodiment, the ratio of the size of the waveguide diameter to the input size diameter of the parabola is preferably a minimum ratio of 2:1, as shown in Figure 3A, so that the LED light source 324 emits light 326 into the waveguide 320. The proximal portion of the waveguide has a parabolic shaped input 322 having an input diameter 330, as shown in Figure 3A. Figure 3B . The body of the waveguide is preferably cylindrical in shape and has multiple facets along the outer circumference to provide multiple surfaces that light can bounce off, allowing for better mixing of the light along the waveguide. The body of the waveguide has an output diameter 328 through which the light passes and is then extracted. In a preferred embodiment, the ratio of the output diameter 328 to the input diameter 330 is at least 2:1. An alternative embodiment has the LED positioned farther along an extended shaft, wherein the shaft can include the waveguide, the LED segment, and a metal tube that provides heat dissipation close to the LED source. The metal tube heat sink is described in more detail below. In addition, the tube used to dissipate heat can be made of any other material that dissipates heat.

[0051] In some embodiments, the optical waveguide can be slidably or otherwise extendable away from or toward the handle. Figure 4A-4B This feature is illustrated in the figure. Figure 4A In the case of the optical waveguide, it collapses into the handle and Figure 4BThe optical waveguide extends outwardly away from the handle. The optical waveguide can be a fixed length but can collapse into the handle, reducing the length of the exposed portion of the optical waveguide, or it can extend away from the handle, increasing the length of the exposed portion of the optical waveguide. Various mechanisms for allowing for retraction and expansion of the optical waveguide have been previously disclosed or are otherwise known in the art. Allowing the optical waveguide to be adjusted allows the user to bring the light closer to a working surface, such as a surgical target, or to move the light away from the working surface. This can be advantageous when the surgeon is using energy tips of various lengths with the handle. Thus, when using a long tip, a longer optical waveguide is desirable to ensure that the light is delivered close to the target tissue. Similarly, when using a short tip, a shorter optical waveguide is preferred so that the tip of the waveguide is not too close to the working surface. Thus, a variable-length optical waveguide allows the user to adjust the length and position the light output relative to the electrode tip as desired.

[0052] Figure 15 Illustrated is an exemplary embodiment of a locking mechanism that can be used with any embodiment of the movable waveguide or movable energy tip disclosed herein. The handle 1502 includes one or more control buttons, here three buttons 1504, 1506, 1508, which can be actuated by the user to turn the energy on or off in various modes. For example, one button can be used to turn the RF cutting energy to the energy tip on and off. A second button can be used to turn the coagulation RF energy to the energy tip on or off. A third button can be used to turn the illumination from the energy tip on and off without delivering energy to the energy tip. The third button can be a switch, such as a pressure sensor or other switch, such as a foot switch or a slider, instead of a button. Depending on how the lighting element is coupled to the handle, the lighting element (e.g., an LED) can be movable relative to the button, or it can be fixed. The waveguide 1510 is disposed in the handle 1502 and can extend outward or inward relative to the handle. The locking mechanism is preferably a "twist-lock" collet-style mechanism that clamps circumferentially around an extendable shaft, such as a waveguide or energy tip, to securely hold it in place at any extension length and rotation. The locking mechanism comprises two pieces, a nose piece 1514 and a collet base piece 1512. When in the unlocked position, the shaft or waveguide 1510 can freely rotate, extend, or retract through the inner diameter of the collet. When twisted a predetermined amount (preferably 90 degrees here), the shaft is securely held in place and resists axial movement and rotation in a clockwise motion.

[0053] The collet base member has a hollow inner diameter with a split tapered end and is designed for a round shaft to be inserted completely through the inner diameter. On the outer diameter of the base member are two small protrusions (at Figure 15 The nose member is provided with a protrusion (not shown) that mates with two internal helical grooves on the inner diameter of the nose member. These protrusions constrain the nose member from disengaging from the base member and allow the nose member to rotate a maximum of 90 degrees about the base. As the nose member rotates, the helical grooves track over the protrusions on the collet base and urge the nose member in a downward direction. The nose member and base member have interference cones so that the nose member tightens against the base member, creating an inward radial force, thereby producing a secure clamping action around the extendable shaft. This locking mechanism can be used in any of the embodiments described herein.

[0054] In any embodiment, the electrode tip can be positioned within the hollow tube, and as described above, the hollow tube can be moved independently of the electrode tip. Thus, the optical waveguide can slide relative to the length of the electrode tip, providing the surgeon with flexibility in positioning the light at a desired location relative to the electrode tip. This also allows the surgeon to adjust the spot size of the light emitted from the optical waveguide. Distally moving the optical waveguide moves the tip of the waveguide closer to the working surface, thereby reducing the spot size, while proximally retracting the optical waveguide moves the tip of the waveguide away from the working surface, thereby increasing the spot size.

[0055] Any embodiment of the optical waveguide can have a cylindrical optical waveguide, or other shapes such as square, rectangular, elliptical, oval, triangular, etc. can also be used. In one example, flat facets can be used to provide better mixing of light in the waveguide. An odd number of facets is preferred. The number of facets is determined by the size ratios mentioned earlier. More facets will push the outer waveguide shape closer to a circle, thereby increasing the overall cross-sectional size. Fewer facets will reduce the overall size of the waveguide. Some embodiments have a tapered optical waveguide, so that the proximal portion of the optical waveguide has a larger size than the distal portion. In other embodiments, the central channel of the hollow tube optical waveguide can be used to exhaust smoke from the surgical field. Therefore, a vacuum is applied to the proximal portion of the optical waveguide to draw smoke out of the surgical field and upward into the central channel.

[0056] In other embodiments, the optical waveguide can be a solid rod so that there is no air space or gap between the electrode tip or conductor wire and the inner surface of the optical waveguide. As in the previous embodiments, the solid optical waveguide can be fixedly coupled to the handle, or it can be adjustably attached to the handle so that its length can be adjusted to the desired position. The optical waveguide can have a central cavity through which a conductive element (such as a conductor wire or conductor rod) is coupled to the electrode, or the proximal portion of the electrode tip can pass through the waveguide to occupy all the space in the central cavity, thereby creating a solid waveguide. In some embodiments, this can be accomplished by overmolding the waveguide onto the conductive element. The electrode tip can be coupled to the conductive element, or it can be integral with the conductive element. When the electrode tip is integral with the conductor element, the electrode tip is generally not interchangeable with other electrode tips. When the electrode tip is releasably coupled to the conductor element, it can be interchangeable with other electrode tips. Preferred embodiments include non-replaceable electrode tips that can be combined with adjustable optical waveguide (e.g., slidable or otherwise movable waveguide) features to allow the user to adjust the light closer to or further away from the work surface to obtain optimal lighting performance. Solid waveguides also provide additional benefits over hollow tube waveguides because they contain more material in the optical waveguide relative to hollow tube waveguides, which allows for the conduction of a greater amount of light. In addition, solid waveguides are structurally stronger than hollow waveguides. Therefore, stronger solid waveguides that can carry more light with a smaller cross-section are possible and preferred over hollow tubes, which carry less light and may be weaker and have a larger cross-section relative to solid waveguides. Conductor elements passing through the solid waveguides can also provide strength to the waveguide.

[0057] In some embodiments, a conductor element passing through a waveguide (solid waveguide or tubular waveguide) provides energy to the electrode from a power source (e.g., an RF power source). Figure 5A In FIG, the conductor element may be a wire 502 that is spirally or otherwise wound around the outer surface of the optical waveguide 202 and coupled to the electrode tip 214. Figure 5B In FIG, the conductor element may be a wire 502 running along the outer surface of the waveguide. Figure 5C Shown along Figure 5B An alternative embodiment of a cross section taken along line CC in which an optional concave cutout region 504 may be formed into the waveguide to accommodate the conductor element 502 to keep the overall cross section to a minimum. Figure 5CIn a variation of the embodiment in

[0015] , the conductor element can be shaped to complement the concave region of the waveguide so that when the conductor element and waveguide are mated together, they form a cylinder with a circular cross-section. In other embodiments, a conductive metal tube (not shown) can be positioned around the waveguide, similar to the electrical cladding positioned over the waveguide. Here, the energy tip is coupled to the outer conductive metal tube. Figure 5D Another embodiment of a conductor element 502 coupled to an optical waveguide 202 is shown. In this embodiment, the conductor element 502 is coupled to the outer surface of the waveguide and extends along its axial direction. The resulting cross section forms a figure-eight shape with a large-section waveguide and a smaller-section conductor element.

[0058] In any embodiment of the waveguide, a coating or cladding may be applied thereto to provide the waveguide with desired optical properties, thereby enhancing the efficiency of the waveguide. The coating or cladding may be applied to the outer surface of the waveguide, the central channel of the waveguide, or the outer surface of the conductive element to optically isolate the conductor element from the waveguide, as well as to provide electrical or other insulation as required. The cladding also provides a physical barrier to prevent the waveguide from being damaged by scratches, abrasion, or other damage caused by adjacent surgical instruments. Optionally, any embodiment described herein may use an air gap disposed adjacent to the waveguide to enhance optical transmission of light through the waveguide by minimizing light loss and by using standoffs to maintain an air gap between the waveguide and adjacent components.

[0059] Figures 6A-6D An exemplary embodiment of an optical waveguide illuminated by an LED is illustrated. Figure 6A In FIG. 6 , an LED board layout 606 includes an array of LEDs with dye elements 602 formed into a square pattern. Any number or combination of dye elements may be used to provide the desired light. A conductor element 604 passes through the center of the board layout 606. Figure 6B The diagram shows two LEDs with dye elements 602 instead of Figure 6A An alternative board layout 606 for an array of four LEDs is shown in FIG. Any pattern and number of LEDs may be used. Figure 6C A board layout 606 is illustrated in which conductor elements 604 pass through the board. Figure 6DThe diagram shows a board layout 606 coupled to the proximal portion of an optical waveguide 608, with a power cable 612 coupled to the board. A conductor element 604 extends axially through the waveguide, with a distal portion 610 exposed so that it can be formed into or coupled to the electrode tip. Preferably, the electrode tip is flat, and the conductor element can be round or flat to minimize the cross-section. The optical waveguide 608 can be any embodiment of an optical waveguide described herein. It can be cylindrical or have a hexagonal, octagonal, or other polygonal cross-section to promote mixing of light passing through the waveguide, as discussed previously. The polygonal cross-section preferably has flat, planar facets around the periphery of the waveguide. The flat surface enables better mixing of light from the LEDs, so that an image of the actual dye is not projected onto the target. The electrode tip is directly coupled to the LED board. The proximal end of the waveguide can be parabolic or have another custom shape to provide better capture and mixing of light from the LEDs or other light sources. Therefore, this embodiment preferably does not have a hole drilled through the waveguide to accommodate the conductive element. The conductive element fills the entire space in the waveguide, and the two are integral with each other, and the conductive element and the LED light source are integrated onto a single circuit board.

[0060] Figure 6E An optional variation of the previous embodiment is shown, in which the primary difference is that only a single LED is used. Plate 652 includes a recessed area 654 sized and shaped to receive a portion of a conductor 668 connected to an electrode tip 658. A single LED 656 is positioned on the plate and centered on the plate so as to be coaxial with the central axis of electrode 658 and optionally also coaxial with the waveguide. Electrode 658 may have any of the features of any electrode described herein, including a coating or other insulating layer, particularly with reference to Figure 16A - Figure 16C The electrode 658 comprises a generally flat and planar section having proximal and distal tapered ends 660. The distal portion of the electrode forms an electrode tip 662 for delivering energy to tissue. The proximal portion forms an elongated arm 664 having an angled section 666 that couples the electrode to a conductor 668, thereby positioning the conductor eccentrically from the central axis of the electrode.

[0061] Figure 7An exemplary embodiment of an optical waveguide 702 having an electrode tip 714 is illustrated. The electrode tip 714 is a flat, planar shape and is coupled to a conductor element 712 that extends through the waveguide 702. A cladding layer 710 is disposed over the conductor element to isolate it from the waveguide 702. Additionally, a cladding layer 704 is disposed over the outer surface of the waveguide 702 to isolate it from blood or contaminants. In this embodiment, the waveguide is a polygonal shape (e.g., hexagonal, octagonal, etc.) with flat, planar facets on the outer surface. An LED 706 is coupled to the distal end of the waveguide, and the distal end of the waveguide is a parabolic shape 708 to maximize light reception from the LED. Other coupling means may be used to optically couple the LED to the waveguide, such as through the use of a lens, a hollow reflector, a gradient lens, etc. Furthermore, a coating may be applied to the waveguide to enhance coupling efficiency. The illumination element 706 may be an LED or an array of LEDs, including any of the LED embodiments disclosed herein.

[0062] Figure 8 Pictured Figure 7 The conductor element 712 extends completely through the waveguide and exits from the proximal end of the waveguide and is coupled to the lighting element 706. The conductor element can be electrically bonded to the lighting element 706, or it can be placed in a hole extending through the lighting element 706. The lighting element in this embodiment is an array of LED elements 714, which generally takes the form of Figures 6A-6D . Furthermore, the proximal portion of the waveguide is parabolic in shape to capture the maximum amount of light from the LED. It is seen that the cladding 710 is positioned over the conductor element 712 to isolate the conductor element from the waveguide and help prevent light loss from contact between the two components. Furthermore, as previously disclosed, an air gap can be used to help minimize light loss.

[0063] Any embodiment of the illuminating electrode tip may also include a smoke emission feature. Figure 9An exemplary embodiment of an illuminating electrode tip having a smoke exhaust cavity (also referred to as a channel) is illustrated. An optical waveguide 702 includes a cladding 704 disposed over the outer surface of the waveguide. A conductor element 712 extends through the waveguide, and a cladding 710 is disposed over the conductor element. An electrode tip 714 is coupled to the conductor element 712. The electrode can be bent relative to the conductor element or the optical waveguide. An optional small lens 902 is disposed on the distal face of the optical waveguide to shape the light exiting the waveguide to provide a desired illumination pattern on a target (here, a surgical target). A smoke exhaust channel 904 can extend entirely axially through the waveguide to its proximal end, wherein the exhaust channel is coupled to a vacuum so that suction can be applied to the channel to extract smoke generated during electrosurgery. In other embodiments in which the optical waveguide is a hollow tube, the central channel of the hollow tube can be used for smoke exhaust.

[0064] Figure 10 Another exemplary embodiment of an illumination energy tip and handpiece 1002 is illustrated, demonstrating many of the various features previously described above combined into one embodiment. The illumination energy tip and handpiece 1002 includes a handle 1004, an optical waveguide 1006, a conductor element 1012, and an energy tip 1010. The optical waveguide 1006 is preferably coaxially disposed within the handle 1004 and coaxial with the tip 1010 and can be fixed to the handle or slidably adjustable, as described above, so that the exposed length of the waveguide 1006 can be increased or decreased as desired. The waveguide 1006 preferably has multiple flat, planar facets forming a polygonal outer surface of the waveguide. As previously discussed, this shape facilitates light mixing within the waveguide. An optional tube 1015 is disposed above the waveguide and made of a thermally conductive material, acting as a heat sink to conduct heat away from the device. Additionally, an optional lenslet 1008 is disposed at the distal end of the optical waveguide to shape and direct the light so that the beam properly illuminates the surgical target. An optical cladding (such as a polymeric fluorinated ethylene propylene (FEP)) or heat shrink can be placed over the waveguide to isolate it from direct contact with the handle, thereby minimizing light leakage and protecting it from damage caused by contact with adjacent surgical instruments. A conductor element 1012 preferably extends coaxially through the optical waveguide and into the handle 1004 and provides energy to the tip 1010. The energy tip 1010, here a flat planar blade, is coupled to the conductor element. A thin neck region can be used to couple the energy tip to the conductor element so that the energy tip can be bent into a desired shape during use. An optical cladding and / or insulating layer 1014 can be placed over the conductor element to isolate it from the optical waveguide. The cladding or insulating layer 1014 helps prevent light leakage from the optical waveguide and can also help prevent energy leakage from the conductor element.

[0065] Figure 11 Pictured Figure 10 1002, and highlighting the relationship of some of the components of the device. For example, the energy tip 1010 is coupled to a conductor element 1012, which extends through the waveguide 1006. An outer FEP (fluorinated ethylene propylene) sheath 1112 is disposed over the waveguide 1006, and an inner layer of FEP sheath 1114 is disposed over the conductor element 1012. The waveguide and conductor element preferably extend coaxially through the handle 1004. An external heat sink 1106 can be coupled to the inside surface of the handle to help dissipate heat from the waveguide. The heat sink can be a metal cylinder extending axially along the longitudinal axis of the handle, or it can be made of other thermally conductive materials other than those that can act as a heat sink. A small wire channel 1104 can extend through the proximal end of the waveguide to allow the conductor element or wires coupled to the conductor element to pass through the proximal end of the waveguide, which in this embodiment is preferably a parabolic proximal end similar to those previously described. A metal core LED printed circuit board (PCB) 1110 and this can have LEDs as described elsewhere in this specification. An internal heat sink such as a metal tube 1108 can be butt-coupled to or otherwise coupled to the proximal end of the waveguide to further help dissipate heat from the waveguide, and an elongated portion 1102 of the PCB can extend axially away from the LED PCB to the proximal end of the handle, where it can be coupled with an accessory or connector to allow it to be operably coupled to an external power source or other service. In this embodiment, the waveguide has a length that is longer than the length of the internal heat sink. In an alternative embodiment, instead of or in addition to an internal heat sink that is butt-coupled to the proximal end of the waveguide, a heat sink can be placed over the waveguide to partially or completely surround the waveguide and dissipate heat. The assembly can thus have a metal tube heat sink, a waveguide, and any LED embodiments, along with any energy tip and handle embodiments.

[0066] Figure 12 The diagram shows Figure 11 , with the primary difference being that the waveguide 1202 is substantially shorter than the internal heat sink 1204. The internal heat sink 1204 is coupled to the proximal end of the waveguide 1202. In any embodiment, the internal heat sink 1204, 1108 may also be conductive to provide energy to the LED PCB or the energy tip.

[0067] Figures 13A-13BAn exemplary embodiment of an illumination element coupled to an energy tip or conductor element is illustrated. The illumination element is preferably a waveguide such as those described herein, but can be any illumination element including those disclosed herein. The energy tip can similarly be any energy tip disclosed herein. The energy tip 1308 is coupled to the conductor element 1306, which is coupled to the handle 1302. Figure 13A In the embodiment, the waveguide can be a rigid or stretchable waveguide 1304, which is coupled to a conductor 1306, and Figure 13B , waveguide 1304 can be rigid or malleable and is coupled to energy tip 1308. This provides illumination close to the energy tip. In any embodiment, the energy tip can be fixedly coupled to the conductor element or handle, or the energy tip can be releasably coupled to the conductor element or handle. The energy tip, conductor element, waveguide, or handle can be any embodiment disclosed herein. The waveguide can be formed from any waveguide material disclosed herein.

[0068] Figure 13C Shown Figures 13A-13B The invention also provides an embodiment of the present invention and the use of an optional coating on an electrode or any electrode described herein. Electrode 1904 is at least partially disposed in a waveguide 1902, which in turn is movably coupled to an electrosurgical pencil or other handle. Portions of electrode 1906 can be coated with glass and / or polished to help reflect light emitted from waveguide 1902. The light is preferably reflected toward the tip and toward the target working area, and this can help minimize glare emitted toward the surgeon or other operator. The coated portion 1906 can be selectively disposed on only a portion of the electrode, or it can be disposed on the entire portion of the electrode. The coating can also be on a distal portion 1908 adjacent to the portion of the electrode where energy is delivered to the target tissue.

[0069] In any embodiment, the LED can be positioned in several locations other than just at the proximal end of the waveguide. For example, the LED can be located between the proximal and distal ends of the waveguide, or the LED can be located at the distal end. Furthermore, the LED can be located in any number of orientations relative to the waveguide.

[0070] Figures 14A-14C Alternative embodiments with varying LED positions are illustrated. Figure 14AAn energy tip 1406 is shown coupled to a conductor element 1404, which extends through the waveguide 1402. The conductor element, such as a wire 1408, is coupled to an electrical connection 1412 on an LED board 1410 and supplies energy, such as RF energy, to the energy tip 1406. A single LED 1414 or an array of LEDs can be positioned on the LED board 1410. In this embodiment, the LED board is positioned against the handle and the proximal portion of the waveguide 1402. The parabolic proximal portion 1416 of the waveguide receives light from the LED. Figure 14B An end view of an LED board is shown. The LED board is preferably transverse to the longitudinal axis of the waveguide. A single LED can be coaxial with the electrode tip, and the board can be in a plane that is generally orthogonal or otherwise transverse to the axis of the waveguide. The board can help dissipate heat to a heat sink, which can surround the waveguide or be butt-coupled to the board. Optionally, in any embodiment, the waveguide can be coaxial with the electrode.

[0071] Figure 14C An alternative embodiment is illustrated in which an LED board 1410 is oriented approximately parallel to the longitudinal axis of waveguide 1402 and positioned adjacent to the proximal end of the waveguide. An angled parabolic section 1420 of the waveguide receives light from the LED and transmits it distally toward energy tip 1406. In this embodiment, a conductor element, such as a wire 1422, is coupled to conductor element 1404 for providing energy to energy tip 1406. Furthermore, conductor element 1424 provides power to the LED board. Other locations for the LEDs along the waveguide are contemplated, and these embodiments are not intended to be limiting.

[0072] Figure 16A An exploded view of another exemplary embodiment of an illumination energy tip 1602 is shown that can be coupled to a handpiece such as an electrosurgical pencil (not shown). One advantage of this embodiment is that the lamp and electrode can rotate together, thereby ensuring uniform illumination of the target tissue. The illumination energy tip 1602 includes an anodized aluminum shaft 1602, an FEP coating 1604, an LED board 1606, a waveguide half 1608, and an electrode blade 1612. The waveguide can be molded as a single unit, as described elsewhere in this specification, and thus does not need to have two halves coupled together.

[0073] The electrode blade 1612 preferably includes a distal portion for delivering energy (preferably RF energy) to the tissue in order to cut or coagulate the tissue. The distal section 1616 is preferably insulated with a layer of material (preferably a glass coating here). The glass coating is advantageous because it has desirable optical properties and is located away from the waveguide 1608 and thus helps ensure that light emitted therefrom is properly reflected from the waveguide toward the surgical target area and minimizes glare back toward the surgeon or other operator. The tip is preferably insulated by a Teflon (polytetrafluoroethylene, PTFE) coating. This coating will scatter and absorb light. Having a reflective surface on the tip will contribute to the efficiency of the device by reflecting light from the surface of the waveguide that leaves the tip toward the target and thus reduce unnecessary scattering. The tip can also have various shapes to help with the divergence of light. The tip can have a curvature or a taper. For example, Figure 19A A top view of electrode 1902 is shown. Figure 19B A cross section of electrode 1902 taken along line BB is shown, and shows upper and lower flat planar surfaces, while Figure 19C and Figure 19D Optional convex upper and lower surfaces are shown. The distal portion can be thin enough to allow the operator to bend the tip to conform to the anatomical structure being treated. The middle section 1614 of the electrode blade 1612 is also preferably insulated, preferably with FEP (fluorinated ethylene propylene) to prevent energy from leaking out of the electrode along the middle section. FEP also provides a refractive index lower than that of the waveguide 1608, thereby helping to prevent or minimize light leakage from the waveguide due to contact between the waveguide and the electrode blade. A low refractive index refractive coating or air gap can also be used in conjunction with or in place of FEP to provide similar results. The proximal portion of the electrode includes a thin, elongated section that acts as a conductor element and allows the electrode to be coupled to a wire in a handle (not shown), which is operably connected to a power source, preferably an RF generator. The proximal portion of the electrode can be straight and linear, or it can have an angled section so that the proximal portion of the thin, elongated section is off-center, allowing it to pass off-center through the LED board 1606. Alternatively, the proximal portion of the electrode may also be straight and pass through the center of the LED board.

[0074] The waveguide halves 1608 can be snap-fit, adhesively bonded, ultrasonically welded, or otherwise joined together, thereby sandwiching the electrode between the two waveguide halves. The waveguide halves form a cylindrical shape around the electrode, thereby providing illumination around the electrode. The distal portion of the waveguide can include a lens, multiple lenslets, or other optical features that help shape the light emitted therefrom. In this embodiment, the optical waveguide has an outer surface that is faceted, thereby forming a polygon that approximates a cylinder. This extraction surface of the waveguide can be flat or curved or even angled or tapered to provide better light directionality, such as with respect to divergence of light. Having multiple facets allows for better mixing of light as it passes through the waveguide. Standoffs 1610 in the channel in each half of the waveguide prevent direct contact between the waveguide and the electrode, thereby minimizing contact and subsequent light loss. The channel in each half of the waveguide preferably matches the shape of the electrode located therein.

[0075] The LED board 1606 includes one or more LEDs for providing light through the waveguide. The LED board can be any LED or other light source described in this specification. The LED can also be parabolically shaped to help focus the light and deliver it to the waveguide. In some embodiments, the conductor portion of the electrode can pass through the center of the LED board, or the conductor can pass through the LED board eccentrically.

[0076] The FEP coating is placed over the waveguide and can be thermally shrunk downward onto the two halves, thereby securing them together. Optionally, other optical coatings may be used in conjunction with or as an alternative to the FEP coating in this or any of the embodiments disclosed herein to provide a low refractive index material adjacent to the waveguide to prevent or minimize light loss. Furthermore, an air gap may be placed against the waveguide to help minimize or prevent light loss, as the air gap will provide a lower refractive index adjacent to the waveguide. An outermost aluminum tube 1602 or other thermally conductive material is then placed over the FEP coating and helps hold the assembly together and also acts as a heat sink to remove heat buildup. This tube is coupled to the LED core to dissipate the heat. The entire assembly can then be coupled to a handpiece, and it can be telescoped within or outside the handpiece. A locking mechanism (not shown), such as a collet or quarter-turn lock, can be used to lock the electrode in place once it has been telescoped into the desired position.

[0077] Figure 16B is an end view of the illumination energy tip 1602, and Figure 16C It is along Figure 16B The cross section is taken along line BB. Figure 16CThe FEP coated section 1620 is highlighted, as is the section of the electrode 1622 that couples with the standoff 1610 to minimize direct contact between the electrode and the waveguide.

[0078] In any of the embodiments described herein, the waveguide may also be a lens or have a lens portion for controlling the light delivered from the waveguide. Thus, a waveguide with or without a lens or a separate lens may be mounted on or otherwise coupled to an LED light source or lighting element used. Optionally, embodiments may thus include an optical element (such as a lens) mounted in front of a lighting element (such as an LED) to direct and shape the light onto the surgical field.

[0079] In any embodiment described herein, light can be provided to the waveguide by any number of technologies. The lighting element can be placed in the handle or adjacent to a portion of the waveguide. The lighting element can be a single LED or multiple LEDs. The LED or multiple LEDs can provide white light or any desired color. For example, when multiple LEDs are used, the LEDs can provide different colors, such as red, green, or blue (RGB), and thus multiple LEDs can be adjusted to provide light of the desired color input into the waveguide. Therefore, the waveguide becomes more important because it mixes light of different colors as the light is transmitted along the length of the waveguide, mixing light of different colors so that uniform color light is delivered to the target. Multiple colors can be used to provide varying shades of white light, or any desired color to help the surgeon or operator visualize and distinguish various objects (such as tissues) in the surgical field. Filters or coatings can be applied to any waveguide to filter out energy of a specific frequency.

[0080] Alternatively or in combination, in any embodiment described herein, the lighting element can be an optical fiber or fiber bundle. For example, the optical fiber can input light to the waveguide from an external source such as a xenon lamp. The light from the external source can be transmitted through the cable, through the handle and to the proximal end of the waveguide by the optical fiber or fiber bundle. The optical fiber or fiber bundle can be docked against the waveguide to provide light to the waveguide and then through the waveguide to the surgical field. A lens or other optical element can be used at the distal end of the optical fiber or fiber bundle to input light with desired optical properties to the waveguide. A light source, such as an external light box, can be provided outside the surgical field. Alternatively or in combination, the light source can be a light source in a cable connection. Alternatively or in combination, the light source can be provided in a housing coupled to the cable or any part of the device.

[0081] In any embodiment, the waveguide can be made of a material with desired optical and mechanical properties. Exemplary materials include acrylic acid, polycarbonate, cycloolefin polymer or cycloolefin copolymer. In addition, ductile silicone can be used to form the waveguide so that they can be shaped (plastically deformed) to the desired configuration. Moldable silicone can also be directly coupled to the energy tip to provide a waveguide that is coupled to the tip and flexes with the tip when the tip is bent or otherwise flexed. Manufacturers such as Dow Corning and Nusil produce moldable silicones that can be used to form waveguides.

[0082] Furthermore, in any of the embodiments described herein, sensors can be integrated into the waveguide or energy tip. These sensors include, but are not limited to, image sensors such as CMOS or CCD sensors. Sensors can also be thermal or fiber optic to collect spectroscopic information. Sensors can be mounted or otherwise integrated into the handle.

[0083] The tip may also include a means for sensing to actively measure the inductance of tissue in the surgical field. Knowing the inductance of the tissue allows the user to be warned if the tip is about to cut through or otherwise damage critical structures. It is also envisioned that fiber sensing will be integrated into the tip to measure the temperature distribution of the tissue and perform spectroscopy analysis of the tissue. Other embodiments may include an imaging element, such as a camera, which may be mounted on the pen handle or integrated into the sleeve or other parts of the electrosurgical tip. Any of these features may be used or combined with an illuminating tip. Figure 16D An exemplary embodiment of an energy tip 1602 is shown having a sensor 1624 integrated therein. The sensor 1624 can be, for example, an optical sensor, a thermal sensor, an inductive sensor, or a spectroscopic sensor. While only one sensor is shown herein, it is understood that any number or combination of sensors can be integrated into one or more of the energy tip, the waveguide, the handle, or a combination thereof.

[0084] Other embodiments may include a handle with ventilation features that allow air to circulate through the handle, thereby promoting cooling of the handle and waveguide.

[0085] Figures 17A-17B The use of an optional battery or other power source to provide energy to the lighting elements is illustrated.This optional feature may be used in any of the embodiments described herein.

[0086] Figure 17AAn electrosurgical instrument is illustrated having a pen or handle 1702 having an electrode 1704 with or without an illumination element coupled to a distal portion of the handle. An instrument cable 1706 is fixedly or releasably coupled to the proximal portion of the handle, and the opposite end of the cable 1706 includes a plug or adapter or connector 1708 having electrical connector pins 1701 for coupling to an electrosurgical generator or any other external box (e.g., a controller, light source, power source, etc.).

[0087] Figure 17B The features of plug 1708 are highlighted. Plug 1708 includes a recessed area 1714 whose size and shape are designed to receive batteries 1712 or other power sources (e.g., capacitors) that can be used to provide power to lighting elements (e.g., LEDs). Contacts on battery 1716 engage corresponding contacts 1718 in recessed area 1714 to complete the electrical circuit. The battery can be a disposable battery or a rechargeable battery. This feature allows for easy replacement of batteries during surgical procedures without disturbing the surgeon who may be using an electrosurgical instrument. Moreover, this portion of the plug is typically outside the sterile area, thereby further facilitating its replacement. The end of the cable 1706 coupled to plug 1708 can be fixedly or releasably attached to the plug. Therefore, if necessary, the plug can easily be interchanged with a new plug with new batteries, thereby further facilitating the process.

[0088] Figures 18A-18E Another exemplary embodiment of an illuminated electrosurgical tip 1802 is illustrated. Those skilled in the art will appreciate that any features described in this embodiment may be used in conjunction with, or in place of, features in any of the other embodiments described herein.

[0089] Figure 18A An illuminated electrosurgical tip 1802 is illustrated having an electrode tip 1804 coupled to a waveguide 1808 and having an illumination element 1828 on a circuit board 1826 adjacent the proximal end of the waveguide. The electrode tip 1804 has a distal rounded tip 1805 and may have insulating and non-insulating regions similar to those previously described in other embodiments to control the delivery of energy to the target tissue. The electrode tip 1804 flares outward 1816 (or tapers distally) into a flat planar section which in turn terminates with only an elongated arm 1822 extending proximally. The elongated arm 1822 serves as a conductor to deliver energy from an energy source to the electrode tip. The waveguide has a narrow, vertically oriented slit 1818 which in turn transitions into an elongated channel 1820 for receiving the flat planar section and the elongated arm. A circular protrusion 1832 (at Figure 18B) extends from the elongated arm portion and is received in a correspondingly shaped recess in the waveguide and prevents axial movement of the electrode relative to the waveguide.

[0090] The waveguide is preferably a non-fiber optical waveguide formed as a single, integral piece, such as by injection molding. The distal portion of the waveguide includes a plurality of microstructures 1812 for controlling the light extracted therefrom and ensuring that the extracted light has the desired optical properties (e.g., divergence, intensity, etc.). A rim 1814 is formed around the microstructures and serves as a surface against which the inner surface of the metal tube can rest. The metal tube has been previously described above and acts as a heat sink. The body of the waveguide is preferably faceted, with a series of exterior planar surfaces forming a polygonal outer surface. This aids light transmission through the waveguide because the multiple surfaces allow light to bounce off multiple surfaces, thereby providing more mixing of the light.

[0091] The proximal end of the waveguide is preferably parabolic in shape to help guide light from the lighting element 1828, preferably an LED, into the waveguide. The parabola is centered over the LED. The arm 1820 is offset from the central axis of the waveguide and is received in a slot 1830 in the circuit board 1826.

[0092] Figure 18B An exploded view of the lighting electrode tip 1802 is shown, and Figure 18D An exploded side view of the lighting electrode tip 1802 is shown.

[0093] Figure 18E A perspective view of electrode 1804 is shown, and Figure 18F Shown Figure 18F perspective drawing.

[0094] Although preferred embodiments of the present invention have been shown and described herein, it will be apparent to those skilled in the art that such embodiments are provided by way of example only. A variety of modifications, variations, and permutations will now occur to those skilled in the art without departing from the present invention. It should be understood that various alternatives to the embodiments of the present invention described herein may be employed in practicing the present invention. The appended claims are intended to define the scope of the present invention and are intended to cover methods and structures within the scope of these claims and their equivalents.

Claims

1. An illuminated electrosurgical instrument, comprising: a handle having a proximal end and a distal end; an optical element having a proximal end and a distal end, wherein the optical element is adjustably coupled to the handle such that a distance between the distal end of the optical element and the proximal end of the handle is adjustable; an illumination element configured to generate light and coupled to the proximal end of the optical element; an electrosurgical tip extending distally from a distal end of the optical element, a smoke evacuation passage extending axially through the optical element from the distal end of the optical element to a proximal end of the optical element; and a conductive element disposed around the optical element; wherein the conductive element is coupled to the electrosurgical tip to provide radiofrequency energy to the electrosurgical tip; wherein the conductive element comprises a metal tube.

2. The illuminated electrosurgical instrument according to claim 1, wherein: The optical element is coaxial with the electrosurgical tip.

3. The illuminated electrosurgical instrument according to claim 1, wherein: The optical element is elliptical.

4. The illuminated electrosurgical instrument according to claim 1, wherein: The optical element includes an optical waveguide.

5. The illuminated electrosurgical instrument according to claim 1, wherein: The optical element includes one or more lenses.

6. The illuminated electrosurgical instrument according to claim 1, wherein: The optical element includes one or more hollow reflectors.

7. The illuminated electrosurgical instrument of claim 1 , further comprising one or more sensors, wherein: The one or more sensors include an image sensor, a thermal sensor, an inductive sensor, or a spectroscopic sensor.

8. The illuminated electrosurgical instrument of claim 1, further comprising a covering disposed on the conductive element.

9. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The electrosurgical tip is bent relative to the conductive element.

10. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The electrosurgical tip is curved relative to the optical element.

11. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The optical element includes a plurality of lenslets located on a distal face of the optical element.

12. The illuminated electrosurgical instrument of claim 4, further comprising an optical cladding disposed on an outer surface of the optical waveguide.

13. The illuminated electrosurgical instrument of claim 4, wherein: The electrosurgical tip is removably coupled to the optical waveguide.

14. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The electrosurgical tip is a flat planar blade.

15. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The lighting element includes one or more LEDs, xenon lamps, or any combination thereof.

16. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The lighting element includes a parabolic LED.

17. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The lighting element is positioned in the handle.

18. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The lighting element is external to the handle.

19. The illuminated electrosurgical instrument of claim 4, wherein: The illumination element and the electrosurgical tip are configured to move with the optical waveguide as the optical waveguide is adjusted relative to the handle.

20. The illuminated electrosurgical instrument of claim 1, wherein: A proximal portion of the electrosurgical tip is angled relative to a central axis of the electrosurgical tip.

21. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The optical element and the electrosurgical tip are configured to rotate together relative to the handle.

22. The illuminated electrosurgical instrument of claim 4, further comprising a locking mechanism, the locking mechanism being a twist-lock collet style mechanism that clamps circumferentially around the optical waveguide or electrosurgical tip to securely hold the optical waveguide or electrosurgical tip in place at any extended length and rotation.

23. The illuminated electrosurgical instrument according to any one of claims 1 to 8, wherein: The optical element and the electrosurgical tip are configured to move along a longitudinal axis to telescope relative to the handle.

Images