Electrosurgical device for fine dissection

Abstract

System, comprehensive: an electrosurgical controller (104) wherein the electrosurgical controller (104) is configured to generate radio frequency energy, RF energy, in an active terminal (724) with respect to a neutral terminal (726); an electrosurgical wand (902) connected to the electrosurgical controller (104), the electrosurgical wand (902) comprising: an elongated shaft (906) defining a handle end and a distal end (908); an insulating jacket (1006) characterized by a first (1008) and second (1009) plurality of outlet openings at the distal end (908) of the elongated shaft (906), wherein the first (1008) and the second (1009) plurality of outlet openings are in fluid communication with a first fluid conduit, and the first fluid conduit is located in the elongated shaft (906); a first active electrode (1002) made of conductive material, which is arranged at the distal end (908) of the elongated shaft (906), wherein the first active electrode (1002) has at least one roughened surface for improved tissue cutting capability and one smooth section for coagulation capability; a first neutral electrode (1004) made of a conductive material, wherein the first neutral electrode (1004) comprises an extension feature (1015, 1023a, 1023b) arranged at a substantially constant distance from the first active electrode (1002); and a suction opening (1022) at the distal end (908) of the elongated shaft (906), which is in fluid communication with a second fluid line, the second fluid line being located in the elongated shaft (906); wherein the first plurality of outlet openings (1008) is arranged proximal to the extension feature (1015, 1023a, 1023b) of the neutral electrode (1004) and partially encloses a proximal and lateral section of the neutral electrode (1004); and wherein the second plurality of outlet openings (1009) is located distal to the first plurality of outlet openings (1008) and is arranged on at least one lateral side of the rod (902) and adjacent to at least one roughened surface, such that fluid released from the second plurality of outlet openings (1009) flows directly to the at least one roughened surface.

Claims

[1] System comprising: an electrosurgical controller (104), the electrosurgical controller (104) configured to generate radio frequency energy, RF energy, in an active terminal (724) with respect to a neutral terminal (726); an electrosurgical rod (902) connected to the electrosurgical controller (104), the electrosurgical rod (902) comprising: an elongated shaft (906) defining a handle end and a distal end (908); an insulating jacket (1006), characterized by a first (1008) and second (1009) plurality of outlet openings at the distal end (908) of the elongated shaft (906), the first (1008) and second (1009) plurality of outlet openings being in fluid communication with a first fluid conduit, the first fluid conduit being located in the elongated shaft (906); a first active electrode (1002) made of conductive material disposed at the distal end (908) of the elongated shaft (906), the first active electrode (1002) having at least one roughened surface for improved tissue cutting capability and a smooth portion for coagulation capabilities; a first neutral electrode (1004) made of a conductive material, the first neutral electrode (1004) comprising an extension feature (1015, 1023a, 1023b) arranged at a substantially constant distance from the first active electrode (1002); and a suction port (1022) at the distal end (908) of the elongated shaft (906) in fluid communication with a second fluid conduit, the second fluid conduit being located in the elongated shaft (906); wherein the first plurality of outlet openings (1008) are disposed proximal of the extension feature (1015, 1023a, 1023b) of the return electrode (1004) and partially enclose a proximal and lateral portion of the return electrode (1004); and wherein the second plurality of outlet openings (1009) are located distal of the first plurality of outlet openings (1008) and are disposed on at least one lateral side of the rod (902) and adjacent to at least one roughened surface such that fluid discharged from the second plurality of outlet openings (1009) flows directly to the at least one roughened surface. [2] The system of claim 1, wherein the at least one roughened surface comprises an inverted bump (1003). [3] The system of claim 1 or 2, wherein the inverted bump (1003) is defined by two smooth curved sections such that the active electrode (1002) moves smoothly over target tissue (1030), and wherein an intersection line of the two smooth curved sections is located proximal to a tissue contact surface of the active electrode (1002). [4] The system of claim 3, wherein the cut line has a uniform depth from the distal surface (1020) of the first active electrode (1002). [5] A system according to any one of the preceding claims, wherein the first (1008) and second (1009) plurality of outlet openings are in fluid communication with a plurality of fluid flow channels disposed in an annular space between the insulating jacket (1006) and the elongated shaft (906). [6] A system according to any one of the preceding claims, wherein the first (1008) and second (1009) plurality of outlet openings enclose the elongated shaft (906). [7] The system of any preceding claim, further comprising a non-conductive spacer (1000) disposed between the first active electrode (1002) and the return electrode (1004), and wherein the spacer (1000) is tapered to enhance fluid flow from the return electrode (1004) to the active electrode (1002). [8] A system according to any preceding claim, wherein the plurality of outlet openings are arranged in fluid communication with a plurality of fluid flow channels in an annular space between the insulating jacket (1006) and the elongated shaft (906). [9] A system according to any one of the preceding claims, wherein the first (1008) and second (1009) plurality of outlet openings enclose the elongated shaft (906). [10] The system of any preceding claim, wherein the first active electrode (1002) further comprises a substantially smooth portion, free of any roughened surface, operable to provide a hemostatic tissue effect to a target tissue (1030). [11] A method comprising: Flowing a conductive fluid in a fluid conduit disposed in an electrosurgical wand (902), wherein the conductive fluid flows out through both a first plurality of outlet openings (1008) and a second plurality of outlet openings (1009), wherein the second plurality of outlet openings (1009) are located distal from the first plurality of outlet openings (1008) and are disposed on at least one lateral side of the wand (902); Discharging the liquid from the first plurality of outlet openings (1008) via a neutral electrode (1004) located distal to the liquid conduit and then via an active electrode (1002), while discharging the liquid from the second plurality of outlet openings (1009) directly via the active electrode (1002); Aligning the rod (902) such that a roughened surface on the active electrode (1002) is in contact with a target tissue (1030); Applying electrical energy between the active electrode (1002) and the neutral electrode (1004); Forming, in response to the energy, localized plasma near the roughened surface; Ablating, by the localized plasma, a portion of the target tissue (1030) near the roughened surface; and Heating, in response to the energy, the target tissue (1030) proximate a smooth portion disposed on the active electrode (1002) at a distance from the roughened surface to provide simultaneous hemostasis; wherein the method does not comprise a method for surgical or therapeutic treatment of the human or animal body. [12] The method of claim 11, further comprising aspiration through a fluid conduit located in the electrosurgical wand (902), wherein the aspiration is arranged in discrete regions of a substantial portion of the outlet openings such that discharged fluid flows over a substantial portion of the return electrode (1004) and the active electrode (1002) to provide broader wetting of the exposed surface of the return electrode (1004) to enable more uniform plasma formation. [13] The method of claim 11 or 12, wherein the neutral electrode (1004) comprises an extension feature (1015, 1023a, 1023b) disposed at a substantially constant distance from the active electrode (1002). [14] The method of any one of claims 11 to 13, further comprising the steps of: reorienting the rod (902) such that a smooth portion of the active electrode (1002) is substantially in contact with a target tissue (1030); Applying electrical energy between the active electrode (1002) and the neutral electrode (1004); forming, in response to the energy, localized plasma near the smooth portion of the active electrode (1002); Heating, in response to the energy, the target tissue (1030) near the smooth portion to provide hemostasis. [15] The method of any one of claims 11 to 14, further comprising the step of forcing the target tissue (1030) into a space disposed between the active electrode (1002) and a non-conductive spacer (1000) while applying energy to produce a focused point of heating in response to the energy and a deeper localized heating effect in the target tissue (1030). [16] The method of claim 15, wherein realigning the rod (902) causes a substantial portion of the return electrode (1004) to be inverted, and wherein the first plurality of outlet openings (1008) partially enclose both proximal and lateral sides of the return electrode (1004) such that the liquid flows to wet the return electrode (1004) and form a meniscus on the return electrode (1004) even when inverted. [17] A method according to any one of claims 11 to 16, wherein liquid from the second plurality of outlet openings (1009) flows past the neutral electrode (1004), directly over a non-conductive spacer (1000) and into the vicinity of the roughened surface of the active electrode. [18] System according to one of claims 1 to 10, wherein at least one of the neutral electrode (1004) and the active electrode (1002) has a shape selected such that the distance between an edge of a part of the neutral electrode (1004) and the edge of the active electrode (1002) is constant along the edge; wherein the edge of the active electrode (1002) has two curved surfaces that meet at an intersection line between the two curved surfaces to form a bump-shaped notch in the edge of the active electrode (1002). [19] The system of claim 18, wherein the bump-shaped notch forms an inverted bump (1003). [20] The system of claim 18 or 19, wherein the distance between the hump-shaped notch and the neutral electrode (1004) is different from the constant distance along the edge. [21] A non-surgical, non-therapeutic method comprising the method according to any one of claims 11 to 17. [22] Controller (104) configured to carry out the method according to one of claims 11 to 17.

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