Frequency electrosugical tool with interchangeable electrode tips

Abstract

The present disclosure relates to electrosurgical tools / knives and, more particularly, to various electrodes / electrosurgical knife tip styles that are interchangeable with an endoscopic catheter and an exchange mechanism that provides a platform for exchanging the plurality of electrodes / electrode knife tip styles with the endoscopic catheter.

Description

FREQUENCY ELECTROSURGICAL TOOL WITH INTERCH NGEABLE ELECTRODE TIPSBACKGROUND1. Field of the Disclosure

[0001] The present disclosure relates to electrosurgical tools / knives and, more particularly, to various electrodes / electrosurgical knife tip styles that are interchangeable with an endoscopic catheter and an exchange mechanism that provides a platform for exchanging the plurality of electrodes / electrode knife tip styles with an endoscopic catheter.2. Description of Related Art

[0002] Luminal lesions within the gastrointestinal (GI) tract have the potential to transform into cancer, so early removal of these lesions is typically warranted. Surgical approaches such as removal of an entire section of the lumen are invasive and can be complex in hard-to-reach areas like the esophagus. Flexible endoscopy has become the standard of practice for removal of these lesions due to its natural orifice approach and ability to quickly access most of the GI tract. Lesions that have not invaded the muscularis can be dissected from the lumen using a “lift and cut” approach, in which the physician injects lifting agent into the submucosa via a catheter and dissects along the submucosal plane using electrosurgical energy coupled to another catheter. This procedure is known as Endoscopic Submucosal Dissection (ESD). Similar submucosal dissection procedures may be performed to resolve esophageal diverticula or resect hypertrophic muscle such as Per-Oral Endoscopic Myotomy (POEM). Clinical studies on these procedures have shown positive patient outcomes, comparable to surgery but with far shorter recovery times for the patient.

[0003] Description of the Related Art Section Disclaimer: To the extent that specific patents / publications / products are discussed above in this Description of the Related Art Section or elsewhere in this disclosure, these discussions should not be taken as an admission that the discussed patents / publications / products are prior art for patent law purposes. For example, some or all of the discussed patents / publications / products may not be sufficiently early in time, may not reflect subject matter developed early enough in time and / or may not be sufficiently enabling so as to amount to prior art for patent law purposes. To the extent that specific patents / publications / products are discussed above in this Description of the Related Art Section and / or throughout the application, the descriptions / disclosures of which are all hereby incorporated by reference into this document in their respective entirety(ies).BRIEF SUMMARY

[0004] The expansion of these conventional procedures / devices in GI (described above) has driven the inventor(s) to identify needs not solved by conventional devices, systems, and related methods / procedures (described herein) and find ways to improve efficiency and safety of the same. The tool used for dissection, and specifically the tip style, is often a topic of discussion. The inventor(s) recognize that in practice today, if the physician / surgeon needs a different style of electrode to address dissection challenges, the physician / surgeon is limited to using another catheter. The inventor(s) further recognize that there can be applications of different style tips for different ESD approaches, including there being a need for multiple tip styles in a procedure. For example, POEM typically requires injection with a needle catheter, incision, and dissection with a disc-style electrode on another catheter, and myotomy with an insulated triangle-style electrode on another catheter. The insulation is thought to reduce the risk of perforation from stray electrosurgical energy since the myotomy can come close to the serosa. Despite the need for different tips, there is no product on the market in GI that has an exchangeable tip feature (conventional products / systems have no central lumen for flushing capability and no option to change the tips attached). This is most likely due to technical challenges with making an exchangeable tip on a flexible catheter along with size constraints associated with endoscopic devices, which the novel interchange mechanism / system described and illustrated herein solves.

[0005] It is therefore a principal object and advantage of embodiments of the present disclosure to provide inventive devices, mechanisms, assemblies, and systems for meeting and exceeding the needs identified above. In particular, the present disclosure is directed to interchange system and exchanger device structured or configured to allow a user to remove and replace electrode tips on an endoscopic catheter and provides a platform for the design of new tips and attachments. A non-limiting goal associated with the inventive device embodiments is to allow for a wide variety of electrode tip styles and an exchanger that can include storage for additional replacement tips. A wide variety of device configurations with tools tailored to a specific procedure are made possible by embodiments of the exchanger disclosed herein.

[0006] As further described and illustrated with reference to the figures below, embodiments of the disclosure provide electrodes having a universal (or similar in design and construction) proximal portion configured and adapted to interface with an endoscopic catheter. Specifically, the proximal portion can include features to control one or more of an insertion force, a retention force, and a decoupling force. According to an embodiment, adesign is such that the decoupling force and the insertion or attachment force are discrete and distinct forces that can be individually controlled to achieve the desired exchange and removal experiences, as explained below. The interchange mechanism can be elastic enough so that electrode tip exchange can be repeatedly performed without compromising the integrity of the mechanism. The interchange mechanism can be conductive to facilitate the passage of electrosurgical energy from the proximal end of the catheter to the distal electrode tip, but can also contain insulating elements to prevent the energy from passing external to the catheter body along the catheter shaft (as should be understood by a person of ordinary skill in the art in accordance with a review of this disclosure). The electrodes can include a central lumen to facilitate passage of fluid from the proximal delivery catheter to the distal end of the electrode tip. The coupling can be designed to limit the amount of fluid flow external to the central lumen to preserve maximum flow rate through the electrode.

[0007] In accordance with a further embodiment, a system is provided that allows a user to remove and replace electrode tips on an endoscopic catheter and provides a platform for exchanging new tips and attachments. As described, the exchange mechanism can be elastic so that exchanges can be repeatedly performed (including removing and reloading the same attachment multiple times) without compromising the integrity of the device. The exchanger device can be comprised of a primary spring that can be engaged and disengaged via user interaction with a slide. The slide can be designed to move between a locked and unlocked position and to interface with a variety of geometries presented by the myriad of endoscopic tips. The exchanger device can also contain a secondary spring configured and adapted to support an endoscopic end effector when an endoscopic catheter is not within the exchanger cavity. This secondary spring can maintain an electrode’s position in the case where a user inappropriately operates the device. The exchanger device can contain detents that provide user feedback when the electrode cavity is locked or unlocked.

[0008] Advantages over conventional devices / systems provided by devices / systems of embodiments described and illustrated herein include providing an interchange system that allows a user to remove and replace the electrode tip with different style tips; a hollow central lumen of tips that allow flushing of fluid through entirety of the catheter; an exchanger device that allows storage of removed and replacement tips; a myriad of tip styles that can be utilized to suit a specific application or procedure; tips that are covered with eschar, for example, can now be replaced rather than replacing the whole catheter; and replaceable tips that can reduce medical waste by eliminating the need to use and dispose of multiple catheters.

[0009] These and other aspects of embodiments of inventive aspects of the disclosure will be apparent from and elucidated with reference to the embodiment(s) described hereinafter.BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS)

[0010] Embodiments of inventive aspects of the disclosure will be more fully understood and appreciated by reading the following Detailed Description in conjunction with the accompanying drawings. The accompanying drawings illustrate only typical embodiments of the disclosed subject matter and are therefore not to be considered limiting of its scope, for the disclosed subject matter may admit to other equally effective embodiments. Reference is now made briefly to the accompanying drawings, in which:

[0001] FIG. 1 A is a side view schematic representation of an electrode tip according to an embodiment.

[0002] FIG. IB is a side view schematic representation of an electrode tip according to an embodiment.

[0003] FIG. 1C is a side view schematic representation of an electrode tip according to an embodiment.

[0004] FIG. ID side view schematic representation of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly according to an embodiment.

[0005] FIG. IE is a side view schematic representation of an electrode tip according to an embodiment.

[0006] FIG. IF is a side view schematic representation of an electrode tip according to an embodiment.

[0007] FIG. 1G is a side view schematic representation of an electrode tip according to an embodiment.

[0008] FIG. 1H is a side view schematic representation of an electrode tip according to an embodiment.

[0009] FIG. II is a side view schematic representation of an electrode tip according to an embodiment.

[0010] FIG. 1 J is a side view schematic representation of an electrode tip according to an embodiment.

[0011] FIG. IK shows two side view schematic representations of an electrode tip according to an embodiment.

[0012] FIG. IL shows two side view schematic representations of an electrode tip according to an embodiment.

[0013] FIG. IM is a side view schematic representation of an electrode tip according to an embodiment.

[0014] FIG. IN is a side view schematic representation of an electrode tip according to an embodiment.

[0015] FIG. 10 shows two side view schematic representations of an electrode tip according to an embodiment.

[0016] FIG. IP shows two side view schematic representations of an electrode tip according to an embodiment.

[0017] FIG. IQ shows two side view schematic representations of an electrode tip according to an embodiment.

[0018] FIG. 1R shows a top view schematic representation of an electrode tip according to an embodiment.

[0019] FIG. 2 is a semi-transparent perspective side view schematic representation of an electrode tip device combined with an endoscopic catheter, according to an embodiment.

[0020] FIG. 3A is a close-up side view schematic of the electrode knife device / mechanism / assembly / system, according to an embodiment.

[0021] FIG. 3B is a close-up side view schematic of the electrode knife device / mechanism / assembly / system, according to an alternative embodiment.

[0022] FIG. 4A is a cross-sectioned view of the proximal handle portion of the electrode knife device / mechanism / assembly / system, according to an embodiment.

[0023] FIG. 4B is another cross-sectioned view of the proximal handle portion of the electrode knife device / mechanism / assembly / system, according to an embodiment.

[0024] FIG. 4C is a schematic representation of the proximal handle portion of the electrode knife device / mechanism / assembly / system, according to an embodiment.

[0025] FIG. 4D is another schematic representation of the proximal handle portion of the electrode knife device / mechanism / assembly / system, according to an embodiment.

[0026] FIG. 5 is a sectioned side view schematic representation of an electrode tip device combined with an endoscopic catheter, according to an embodiment.

[0027] FIG. 6 is a sectioned side view schematic representation of an electrode, according to an embodiment.

[0028] FIG. 7A is a schematic representation of a distal housing, according to an embodiment.

[0029] FIG. 7B is a close-up schematic representation of the distal housing shown in FIG. 5A, according to an embodiment.

[0030] FIG. 7C is another close-up schematic representation of the distal housing shown in FIG. 5 A, according to an embodiment.

[0031] FIG. 8 is a perspective view schematic representation of an insulative cap, according to an embodiment.

[0032] FIG. 9A is a schematic representation of a primary interchange mechanism, according to an embodiment.

[0033] FIG. 9B is another schematic representation of a primary interchange mechanism, according to an embodiment.

[0034] FIG. 9C is a close-up view of the schematic representation of the primary interchange mechanism shown in FIG. 7A, according to an embodiment.

[0035] FIG. 10 is a semi-transparent side view of a distal housing elastically deforming during a coupling action and a proximal housing, according to an embodiment.

[0036] FIG. 11A is a schematic representation of a portion of the catheter, according to an embodiment.

[0037] FIG. 1 IB is another schematic representation of a portion of the catheter, according to an embodiment.

[0038] FIG. 12 is a front perspective sectioned view of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly, according to an alternative embodiment.

[0039] FIG. 13 is a side sectioned view of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly, according to an alternative embodiment.

[0040] FIG. 14A is a schematic representation of a portion of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly, according to an alternative embodiment.

[0041] FIG. 14B is another schematic representation of a portion of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly, according to an alternative embodiment.

[0042] FIG. 14C is a close-up view of the schematic representation with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly shown in FIG. 13 A, according to an alternative embodiment.

[0043] FIG. 15A is a close-up side view schematic of the electrode knife device / mechanism / assembly / system according to an embodiment that utilizes an insulated catheter.

[0044] FIG. 15B is a close-up side view schematic of the electrode knife device / mechanism / assembly / system according to an alternative embodiment that utilizes an insulated catheter.

[0045] FIG. 16 is a side perspective view schematic representation of an exchange mechanism for endoscopic devices, according to an embodiment.

[0046] FIG. 17 is a top-down cross section view schematic representation of an exchange mechanism for endoscopic devices, according to an embodiment.

[0047] FIG. 18 is a perspective view schematic representation of a guide block, according to an embodiment.

[0048] FIG. 19 is a perspective view schematic representation of retention springs, according to an embodiment.

[0049] FIG. 20A is a schematic representation of a slider, according to an embodiment.

[0050] FIG. 20B is another schematic representation of a slider, according to an embodiment.

[0051] FIG. 20C is another schematic representation of a slider, according to an embodiment.

[0052] FIG. 21 is a perspective view schematic representation of a portion of an exchange mechanism for endoscopic devices, according to an alternative embodiment.

[0053] FIG. 22A is a perspective schematic representation of a portion of an exchange mechanism for endoscopic devices, according to an alternative embodiment.

[0054] FIG. 22B is a top view schematic representation of a portion of an exchange mechanism for endoscopic devices, according to an alternative embodiment.

[0055] FIG. 23A is a top view schematic representation of a portion of an exchange mechanism for endoscopic devices, according to an alternative embodiment.

[0056] FIG. 23B is a perspective view schematic representation of a portion of an exchange mechanism for endoscopic devices, according to an alternative embodiment.

[0057] FIG. 24A is a schematic representation of an exchange mechanism being loaded and unloaded with electrode (knife) tip device combined with an endoscopic catheter, according to an embodiment.

[0058] FIG. 24B is a schematic representation of an empty catheter being inserted into the channel of the exchange mechanism, according to an embodiment.

[0059] FIG. 24C is a schematic representation of a catheter being lined up with the exchange mechanism and the tip initiating engagement with the electrode distal housing, according to an embodiment.

[0060] FIG. 24D is a schematic representation of the exchange mechanism slider being moved to the unlocked position, according to an embodiment.

[0061] FIG. 24E is a schematic representation of a catheter pushed onto the tip, fully engaging the snap feature between the knife and the housing of the exchange mechanism, according to an embodiment.

[0062] FIG. 24F is a schematic representation of a loaded catheter being removed from the exchange mechanism with the knife connected, according to an embodiment.

[0063] FIG. 24G is a schematic representation of the catheter removed from the exchange mechanism leaving the knife secured in the locked exchanger, according to an embodiment.

[0064] FIG. 24H is a schematic representation of the exchange mechanism slider being moved into the locked position securing a knife, according to an embodiment.

[0065] FIG. 241 is a schematic representation of a loaded catheter being inserted into an unlocked exchanger, according to an embodiment.

[0066] FIG. 24J is a schematic representation of an exchange mechanism slider being moved into the locked position securing the knife, according to an embodiment.

[0067] FIG. 24K is a schematic representation of a catheter being removed from the exchange mechanism leaving the knife secured in the locked exchanger, according to an embodiment.

[0068] FIG. 25 is a side view of an electrode tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / system / assembly and spraying a jet of water through the central lumen of the electrode, according to an embodiment.

[0069] FIG. 26A is a sectioned side view schematic representation of an electrode tip device combined with an endoscopic catheter, according to an embodiment.

[0070] FIG. 26B is a sectioned side view schematic representation of an electrode tip device combined with an endoscopic catheter, according to an embodiment.

[0071] FIG. 27 is a flow path diagram of an electrode knife device / mechanism / system / assembly, according to an embodiment.

[0072] FIG. 28A is a perspective view schematic representation of an electrode knife / device / mechanism / system / assembly being inserted into an exchanger mechanism, according to an embodiment.

[0073] FIG. 28B is a top perspective view schematic representation of an electrode knife / device / mechanism / system / assembly being inserted into an exchanger mechanism, according to an embodiment.

[0074] FIG. 28C is a top perspective view schematic representation of an electrode knife / device / mechanism / system / assembly inserted into an exchanger mechanism, according to an embodiment.

[0075] FIG. 29 is a cross sectioned perspective view schematic representation of an electrode knife / device / mechanism / system / assembly, according to an embodiment.DETAILED DESCRIPTION

[0076] Inventive aspects of embodiments of the present disclosure and certain features, advantages, and details thereof, are explained more fully below with reference to the nonlimiting examples illustrated in the accompanying drawings. Descriptions of well-known structures are omitted so as not to unnecessarily obscure any inventive aspects in detail. It should be understood, however, that the detailed description and the specific non-limiting examples, while indicating inventive aspects of the disclosure, are given by way of illustration only, and are not by way of limitation. Various substitutions, modifications, additions, and / or arrangements, within the spirit and / or scope of the underlying inventive concepts will be apparent to those skilled in the art from this disclosure.

[0077] While embodiments of inventive aspects the present disclosure have been particularly shown and described with reference to certain exemplary embodiments, it will be understood by one skilled in the art that various changes in detail may be affected therein without departing from the spirit and scope of inventive aspects / features as defined by claims that can be supported by the written description and drawings. Further, where exemplary embodiments are described with reference to a certain number of elements or number / order of steps it will be understood that the exemplary embodiments can be practiced utilizing either less than or more than the certain number of elements or number / order of steps. If elements shown in a particular Figure discussed below are not specifically identified with respect to that Figure, the elements should be sufficiently identified with respect to at least one other Figure.

[0078] Embodiments of the disclosure illustrated by the appended Figures and described in detail below include a medical device / system which is used to perform electrosurgical assisted dissection of tissues during endoscopic procedures. In brief, according to an embodiment, a device / system can be catheter based to facilitate passage through a working channel of a flexible endoscope. The user can operate the device / system via thumb and / or finger actuators (e.g., slider, trigger, rings) built into a handle on the proximal end. The active cord of an electrosurgical generator can be connected to the device via an electrode attached to the handle. Fluid can be flushed through the device’s central lumen via a standard luer locksyringe connected to an injection port at the device’s handle, for example. The tip of the electrode can have a hollowed central lumen to allow fluid to exit through the distal end. Electrode tips can be interchanged by the user to suit the procedure using an exchanger device. Myriad tip styles can be used with the catheter and interchanged with other tip styles such as L-shaped, triangle, needle, ball, and ceramic insulated. Stated differently, electrode tips of any conceivable and useful geometry (in accordance with the discussion herein regarding use and functionality, and as should be understood by a person of ordinary skill in the art in conjunction with a review of this disclosure) can be exchanged with another tip in view of the universal proximal ends of each tip configured and adapted to interface with an endoscopic catheter. The tips can be partially, folly, or non-cannulated (the central lumen or channel extending from most proximal to most distal ends). There can be radial or face seals within the mechanism that limit fluid from flowing out of the device except through the tip lumen, and there can be compression features that pull the tip and catheter together. The interchange system is an improvement over conventional devices which only offer a single tip that is not removable by the user, and do not have hollowed central lumens to facilitate fluid passage.

[0079] Referring now to the figures, wherein like reference numerals refer to like parts throughout, FIGS. 1A-C and E-Q are side view schematic representations of various electrode tips 1-2 - 1-17 and FIG. ID is a side view schematic representation of a tip device combined with an endoscopic catheter to form an electrode knife device / mechanism / assembly / system 100, according to an embodiment. Some of the possible electrode (knife) tips are shown (which can be used in different procedures or for different particular purposes, as should be appreciated by those of ordinary skill in the art in conjunction with a review of this disclosure), such as a triangle knife 1-2, a J styled knife 1-3, a knife with an insulated dielectric tip 1-4, an insulated hook knife 1-5, an injectable insulated hook knife 1-6, an injectable insulated knife 1-7, an arc, crescent, parabolic tip 1-8, an insulated arc, crescent, parabolic knife 1-9, square knife tip 1- 10, beveled / sharpened flat knife 1-11, a “seam ripper” style knife 1-12, a flat rounded- tip knife 1-13, an elongated arc, crescent, parabolic knife 1-14, a folly cored body knife 1-15, a partially cored body knife 1-16, and an injectable needle-like knife 1-17 (see FIGS. 1A-1C and 1E-1Q). The injectable needle-like knife 1-17 may or may not be used as an electrode to cut and could function entirely without cutting tissue or any intention of thermal therapy. These are only some of the potential electrode tips that can be used and some of the distal geometries are considered standard by many physicians in the industry. The electrode tip pictured on tip distal end 1-1 in FIG. ID is commonly known as a T type knife, and the distal geometry is substantially similar to T knives currently on the market. The insulated hook knife 1-5 can bewith or without fluid injection (with or without a cannulated tip, through which, e.g., electrically conducting fluid, saline and other, fluids can flow as should be understood by a person of skill in the art in conjunction with a review of this disclosure) with some percentage of the tip covered with an insulative material, such as ceramic. This can allow for use of all surfaces with different functions, but with the added safety of insulation. This can allow for added protection of surfaces surrounding intended treatment surfaces while still allowing for the utilization of the advantageous angled cutting surfaces on targeted tissue surfaces. The insulated hook knife 1-6 provides an additional exemplary embodiment of an insulated hook wherein a portion of the arm is insulated allowing for a more controlled reach of the uninsulated cutting surfaces. Additional surfaces of the hook can be insulated for similar reasons: protecting certain tissue surfaces while treating others in a safer and more controlled manner which allows for getting closer to the effected tissue without risk of unwanted treatment of the surrounding area. The injectable ceramic tip 1-7 can feature any known shaped electrode or any shape that is functionally practical underneath the ceramic (or without any ceramic), with the present example demonstrating a triangular shape. The arc, crescent, parabolic tip 1-8 can allow for more versatility than a triangle knife 1-2 and more control and surface contact compared to the hook knife 1-3, for example. This embodiment features edges with higher energy concentrations more adept at cutting and larger curved surfaces ideal for coagulating. This embodiment can be with or without fluid injection (with or without a canulated tip, through which, e.g., electrically conducting fluid, saline and other fluids can flow as should be understood by a person of skill in the art in conjunction with a review of this disclosure). The insulated arc, crescent, parabolic tip offers the versatility of the crescent knife 1-8 with the added safety of insulation. This insulation shown is just one example of form and may cover more or less of the electrode and the shape can vary in shape as is useful to the user. This embodiment can be with or without fluid injection (with or without a canulated tip, through which, e.g., electrically conducting fluid, saline and other fluids can flow as should be understood by a person of skill in the art in conjunction with a review of this disclosure). The square knife tip 1-10 allows for additional cutting surfaces and rounder points compared to the triangle allowing for more precision or less aggression depending on orientation which may be advantageous to the user depending on the situation. The flat style knife 1-11 has a non-circular cross-section stem which can provide for improved coagulation by increasing the surface area of the stem on the elongated sides while still providing a cutting edge on the narrower sides allowing for a more precise / controlled cut. This style allows for a more robust cutting edge that can treat larger areas more efficiently. The tip can be angled to provide aid when entering alifted site and additional precision by way of the thinner tip. This angle can vary and the angle shown herein is only one example. This embodiment can be with or without fluid injection (with or without a cannulated tip, through which, e.g., electrically conducting fluid, saline and other fluids can flow as should be understood by a person of skill in the art in conjunction with a review of this disclosure. This embodiment can be with or without insulation (with or without an added insulative material such as ceramic) covering any portion of the cutting surface to provide more control and safety. The “seam ripper” / flat knife 1-12 can provide the larger coagulation surface and increased robustness of 1 - 11 with the added double pointed edge which can have varying angles of the two points. This embodiment can aid in the efficiency of dissecting large areas, especially those containing fibrous tissue. The blunt flat knife 1-13 can provide a larger coagulation surface and increased robustness of 1-11 with a blunter end effector allowing for less aggression at the distal end for more control of the knife. This tip combines the universality of the T knife 1-1 with the increased surface area of 1-11. The elongated arc, crescent, parabolic knife 1-14 combines the versatility of 1-8 with the large cutting surface of 1-11 allowing for a larger cutting / coagulating electrode with the added versatility of the arc and points of the crescent. The fully cored 1-15 and the partially cored 1- 16 knives provide a method of reducing leakage around the knife when injecting through the center lumen. These embodiments can be combined with any of the above knives and any other potential embodiments not listed. Coring the proximal end of the electrode / knife, or increasing the inner diameter of the lumen allows for more liquid to enter the electrode / knife rather than finding a different path around the knife which would result in a leak external to the central lumen. The larger the lumen within the knife the lower the resistance to enter and the less liquid flowing around the tip, as equivalent frictional resistance due to viscous loss is decreased within the lumen. This creates less ‘fluid resistance’ through the lumen relative to any leak paths external to the lumen. The decrease in viscous loss is a nonlinear function based on the diameter and length of the core / lumen. This coring of the proximal lumen creates a taper / nozzle effect at the distal end of the knife to achieve the final desired cross section. The notched 1-18 shows an example embodiment of a flat knife example that has a notch (see FIG. 1R). Adding a notch allows for better grip in the exchanger 200 detailed further down. Electrode knives with no tip 18 would benefit from a notch-like feature or similar that allows for a grip point for the spring arms 109 detailed later. All above example embodiments 1-1 to 1-16 may have the addition of insulation if not already stated and may or may not have a cannulated tip (injection or no injection).

[0080] The rear / proximal portion of each of the electrode bodies described above is unique and novel to this disclosure and is discussed in detail below (see, e.g., 1-4-1 in FIG. 1A, which is similar to or the same size / geometry to the proximal tip portions discussed herein (as shown for example in FIGS. 1B-C and 1E-Q) so that each can fit the same distal end portion of a certain endoscopic catheter described and shown herein). Because the disclosed interchange mechanism is capable of transmitting fluid and electricity, ‘electrode tips’ can include the specific tips shown herein, and similar tips which are used for electrosurgery or injection as long as they each include the rear / proximal portion as described and illustrated herein (as should be understood by a person or ordinary skill in the art in conjunction with a review of this disclosure) (see, e.g., FIG. 4). Of note, a needle could be affixed to the proximal electrode geometry disclosed below and shown in the FIGS, and used for injection only. Similarly, a non-hollow electrode tip or a device fixedly attached to the disclosed electrode proximal body could be used with this device.

[0081] Referring to FIG. 2, a semi-transparent perspective side view schematic representation of electrode tip device combined with an endoscopic catheter 100 (as shown in FIG. ID), is shown according to an embodiment. The components can include but are not limited to, from the distal to the proximal end, electrode tip (hereafter “electrode”) 5, insulative cap 6, distal housing 7, proximal housing 8, drive wire 9, catheter shaft 10, and / or catheter coating 11, and outer housing / adaptor 12. Electrode 5 can be configured to translate axially within insulative cap 6 to extend and retract. Extending the electrode 5 distally with respect to the insulative cap 6 exposes a larger portion of the electrode to conduct electricity, deliver fluid, or interact mechanically with surrounding target tissue / fluids (as should be understood by a person of ordinary skill in the art in conjunction with a review of this disclosure), while retracting electrode 5 relative to insulative cap 6 reduces the exposed portion of the electrode.

[0082] Referring to FIGS. 3A-3B, in a typical configuration according to an embodiment, the electrode 5 can move between a fully extended state to a fully retracted state, wherein the extended state is limited by a mechanical stop preventing forward motion of electrode 5 and the retracted state typically will result in near flush, flush, or sub flush alignment of the distal most surfaces of electrode 5, as explained below. Near-flush defines a small protrusion of the electrode 5 distally from the distal most surface of insulative cap 6, while flush means the distal most surfaces of both 5 and 6 are aligned. Sub flush is defined when the distal most surface of electrode 5 is located proximal to the distal most surface of insulative ceramic cap 6. All three states can be considered as a “closed” state consistent with the expectation of clinicians based on conventional or comparative devices in use.

[0083] Electrode 5 is shown received within an inner aperture of electrode distal housing7 and may or may not be received within a circumferentially enclosed portion of electrode proximal housing 8. Electrode distal housing 7 can be coupled to electrode proximal housing8 to prevent axial translation between the two components. Electrode proximal housing 8 can be fixedly coupled to drive wire 9 to transmit axial movement from the proximal portion of the system, shown in an embodiment in FIG. 3 A to the system distal end 1. Referring to FIGS. 4A and 4B, axial movement of the drive wire 9 can be controlled using finger slide 141 to extend and retract the drive wire at the distal end. Energy can enter the system by way of the electrode interaction assembly 143 and connect to the drive wire 9 at the drive wire to electrical wire connection point 142. Fluid may enter the system through injection port 145 and flow distally down the insulated catheter 10-11 until exiting the system distal end 1. To prevent back flow of fluid from engaging with the electrode interaction assembly 143, a proximal sealing mechanism 144 can be used. To prevent leaking from the luer into the proximal handle, a distal sealing mechanism 146 can be used. Rotation can be achieved in different ways depending on the catheter embodiment. When using a catheter containing components 9, 10, and 11 , catheter- controlled torque transmission can be utilized. The dual seal allows for rotation of the outer catheter shaft without leakage. Referring to FIGS. 4A- 4C as reference, catheter-controlled rotation / torque transmission may be achieved by fixing the proximal end of the handle 148 and rotating the rotor 147. The injection port 145 component can remain stationary inside of the proximal handle and maintain the proximal seal 144 to protect the inner electrical components from back flow. The distal seal at 146 can ensure there is no leakage between the distal handle component(s) 147 and the proximal handle components enclosed and including the outer shell 148. When using a device containing components drive wire 9 and insulated catheter 10-11, drivetrain-controlled rotation / torque transmission can be utilized. Referring to FIGS. 4A-4B and 4D as reference, drivetrain-controlled rotation / torque transmission may be achieved by fixing the rotor 147 and rotating the proximal end of the handle. Again, the distal seal system 146 can ensure that no leaks occur between the twisting parts of the rotor 147 and the proximal handle 148, and the seals proximal to the injection port component 144 can ensure no backflow onto the electrical interaction assembly 143 occurs.

[0084] Referring to FIG. 5, a sectioned side view schematic representation of the electrode tip device combined with an endoscopic catheter 100 of FIG. 2 is shown according to an embodiment. FIG. 6is a side view schematic representation of the electrode 5 of FIG. 5 according to an embodiment. Electrode 5 is further defined by distal tip geometry 18, cutting portion 17, front flange 13, central lumen 14, rear retention groove 15, and insertion chamfer16. Distal tip geometry 18 can change depending on the instrument being used and the purpose of such use (as should be understood by a person of skill in the art in conjunction with a review of this disclosure), and can take the form of, for example, a disk, a hemisphere, a sphere, a square, a triangle, a polygon with N sides, a pyramid, a flat spade, an angled protrusion, or a compound structure (such as the insulated tip geometry or a similar multi-material composite). Different geometries are ideal in certain situations (as discussed above) and a physician may desire multiple geometries within a case, but be unwilling to use multiple disparate devices due to cost and waste considerations. Similarly, the cutting portion 17 can vary in geometry. The primary changes can be in length and diameter, although several alternate cross sections are contemplated. For example, a polygonal (elliptical, triangular, square, pentagonal, hexagonal, etc.) design can create current density concentrations along the sharper edges of the cross section, which could be used to drive direction of cut and heat affected zone. In adjusting the length of cutting portion 17, the user can set a desired depth of cut. Several knives have strived to do this previously by using a slider mechanism on the handle, but there are significant hysteresis challenges between the knife’s movement and the handle that can change depending on a catheter’s tortuosity. For this reason, physically swapping electrodes 5 with longer or shorter cutting portions 17 can have a major advantage, as the physician can know the device would never extend past “X” length (“X” being the length of the equipped cutting portion). In this instance, it can be advantageous for the electrode 5 to be retracted sub-flush to the distal most face of the insulative cap 6 when equipped with electrodes with shorter cutting portion17, so that electrodes with longer cutting portion 17 would thus be in a flush or near flush position relative insulative cap 6 when fully retracted.

[0085] Still referring to FIGS. 5-6, according to an embodiment, the electrode 5 can be further defined by a central lumen 14 which can run along the entire (or a partial (not entire) substantial portion) length of the component. The central lumen 14 can have a proximal entry and a distal exit, and neither the entry nor the exit needs to be aligned with the central axis of the device, but it can be. In most configurations, central lumen 14 can be coaxial to the electrode 5 along its length to limit frictional losses of fluids transported through said lumen. Central lumen 14 can have an internal chamfer on the proximal entry 30 to decrease minor losses from fluid entry to the electrode 5 (see FIG. 6). Central lumen 14 can have a non-circular profile at the distal exit 29 (tapered, widened, or oblong) to achieve certain flow cross sections (thus acting as a nozzle). FIGS. 1-15 and 1-16 show two example embodiments ofthis. Central lumen 14 may have substantially radial apertures to allow fluid to enter or exit the electrode on the proximal or distal ends, respectively.

[0086] Still referring to FIGS. 5-6, electrode 5 can contain a flange 13 that abuts the distal end of distal housing 7. This flange is configured to prevent over-insertion of electrode 5 into distal housing 7. Electrode 5 can also contain a rear retention groove 15 configured and adapted to engage internal retention feature 33 of electrode distal housing 7. The angle and form of the retaining surface 28 can be structured and or configured to assist in the retention and decoupling force (described herein; see also FIGS. 7 and 9). Increased angles of 28 relative to the axis of electrode 5 will increase the decoupling force. Decreased angles of 28 or continuous curvature forms (for example a fillet typically created from a grooving tool) will decrease decoupling force. The width of rear retention groove 15 relative to the internal retention feature 33 of electrode distal housing 7 will also impact retention force. Because there are different coefficients of static and dynamic friction, the retention force (defined as the force required to initiate axial movement of electrode 5 relative to electrode distal housing 7) may vary from the decoupling force (defined as the maximum axial force component required to completely disengage electrode 5 from distal housing 7). If the rear retention groove 15 is not as wide or radially deep as the mating feature in distal housing 7, a compression fit between the two components will occur, increasing the retention force (force before an initial slip occurs). In this specific case, if the corresponding retaining surface 36 of distal housing 7 is in contact with retaining surface 28, some amount of passive axial compression between the electrode 5 and electrode distal housing 7 can be seen. If retaining surface 28 and the corresponding retaining surface 36 of electrode distal housing 7 has an angle that creates an under-hang (similar to a dovetail groove), an electrode 5 could be locked into place with very little / no likelihood of removal. In the first case in which constant axial compression is generated, this compression can be used to increase contact pressure between front flange 13 electrode 5 and distal housing 7 when coupled, which in turn can limit fluid leakage between these two components. Changing the retention feature in a similar manner (angles, widths) can have similar outcomes as discussed above.

[0087] Referring to FIGS. 5, 7, and 8, according to an embodiment, insulative cap 6 can be cannulated and comprise a distal portion and a proximal portion. The distal portion can contain a radius between the distal diameter and distal most face which can facilitate smooth insertion into an endoscope or other accessory channel. Insulative cap 6 can have an aperture running axially through the entire length of the component. It is contemplated that the aperture could be non-circular in nature (oval, rectangular, or notched I non-uniform) in order to rotationally couple either electrode 5 or electrode distal housing 7. It can be advantageous to have some rotational coupling between the outer drivetrain (components 6, 12, 10, 11) and theinner drivetrain (components 5, 7, 8, 9), thus enabling rotation of the system distal end 100-1 according to input rotation to the catheter shaft (10+11). In this manner, the rotation can be controlled by contacting the external drivetrain at any point along its length, and therefore any end user able to contact the external drivetrain (technician, nurse, physician) has control over orientation at the distal end. It is conceivable that in an alternate embodiment such as that depicted FIG. 15, the function of catheter shaft 10 and catheter coating 11 can be accomplished through the single component insulative catheter 10-11 as described below.

[0088] A depiction of one such rotational coupling is found in FIG. 8, with a torque coupling feature “A” 39 on insulative cap 6 comprising a groove running along the length of the aperture to interlock with the torque coupling ridge 38 (see FIG. 7). Torque coupling feature “A” 39 could correspondingly extend into (or otherwise mate with) the aperture of insulative cap6 and engage with a flat or “negative” ridge (i.e. groove) 38. The proximal portion 19 of insulative cap 6 could comprise a second diameter that is smaller than the distal diameter that would fit inside the enlarged cavity 26 of plastic housing 12. The proximal portion of 6 does not necessarily need a different diameter than the distal portion to be received within 12 and could instead be a substantially cylindrical component. It is contemplated that, depending on the manufacturing joining method selected, certain ribs 40 on the proximal portion of the diameter of 6 could help in joining 6 and 12 by means of a mechanical press fit between 6 and 26, or to create additional surface area roughness for an adhesive. These ribs are not necessarily required depending on the overall force and pressure exerted on the external drivetrain. Rear mating flange 24 from plastic housing 12 can be housed between catheter shaft 10 and catheter coating 11.

[0089] Referring to FIGS. 7A-7C and 8, according to an embodiment, electrode distal housing 7 can comprise a body portion 31, a flange 34, at least two spring arms 32, an internal retaining feature 33, coupling cavities 35, an optional torque coupling feature “B” 38, corresponding insertion surface 37, and corresponding engaging surface 36. It is contemplated that although torque coupling feature “B” 38 is shown as a ridge on the distal body portion 31, it could also / instead be found on the outermost diameter of flange 34. In addition, the intent and function of torque coupling feature “B” can be identical if torque coupling features “A” 39 and “B” 38 were reversed, and 38 resembled a groove while 39 resembled a ridge. It is also contemplated that because a primary purpose of torque coupling features 38 “B” and 39 “B” is to transmit rotation between the internal and external drive trains, these features could conceivably be located on any of the internal components (5, 7, 8, 9) and external components (6, 12, 10, Ir respectively.

[0090] As per the previously alternate embodiment describing the aperture in insulative cap 6, these torque coupling features can be construed as any substantially non-circular cross sections of body (internal drivetrain) or lumen / aperture (external drivetrain) which limit rotational motion between the two drive trains. Referring again to FIGS. 3A-3B, flange 34 can have a primary function of forming a hard stop during extension I retraction of the electrode (also called “actuation”). This hard stop is structured and / or configured to limit the maximum stroke of the inner drivetrain relative to the outer drivetrain within the context of system distal end 1. In addition, flange 34 can act as a seal in the open and closed positions. In the open position, flange 34 can contact the proximal face of insulative cap 6 to form a partial seal between the exterior of 7 and the interior of 6 (149 and indicated with the R-box on FIG. 3 A). This can limit the amount of liquid that can flow external to central lumen 14 of electrode 5 or between the proximal diameters of electrode 5 and the aperture of electrode distal housing 7. Furthermore, the distal surface of the end of body portion 31 of 7 forms a partial seal with the proximal face of front flange 13 of electrode 5 (Refer to B-box on FIG. 3A). In this way, a large proportion of fluid flow during injection can be directed through central lumen 14. This is also true when electrode distal housing 7 is fully retracted, as the proximal most face of 34 can form a partial seal with the distal face of rear cavity 27 of adaptor 12 (150 and indicated with the Y-box on FIG. 3B). The use of contact between these flanges and faces perpendicular to the axis of system distal end 1 is important for two reasons: A) - it limits the flow by having substantially constant to constant contact regardless of manufacturing tolerances on the diameters / exteriors of the internal drive train and the internal diameters / apertures of the external drivetrain and B) - it prevents jamming or friction on such small components as might be seen with the use of traditional radial seals (O-rings or wipers). This, in concert with axial compression or (at least) fixed axial position between electrode 5 and electrode distal housing 7, enables the interchange mechanism to transmit fluid, which is the only interchange mechanism for such a device in endoscopy capable of transmitting fluid (as should be understood by a person of ordinary skill in the art in conjunction with a review of this disclosure). Furthermore, relative differences in hardness between components 5, 6, 7, and 12 can result in a slightly better seal than if two components of different hardness were compressed. This is especially true for any seal created between components 7 and 12, as electrode distal housing 7 can be intentionally metallic (e.g., 300 series, 17-7ph, 17-4ph, 400 series or equivalent stainless steel) while the adaptor can be PEEK, Nylon, Ceramic, or a comparable polymer, according to an embodiment. For any seals between electrode 5, insulative cap 6, and electrode distal housing 7, one or more or all contact surfaces ofcomponents can be precision machined, ground, or molded such that surface finishes minimize gaps when in contact (32 Ra target or better).

[0091] Referring to FIGS. 9A-9C, the body portion 31 of electrode distal housing 7 can contain an aperture 41 which accepts the proximal portion of electrode 5 during electrode exchanges. Insertion chamfer 16 of electrode distal housing 7 helps guide the electrode into aperture 41 by decreasing required alignment precision. Spring arms 32 can be tapered in nature, providing additional elastic deflection prior to yield by distributing strain more equally along the length of the cantilevered arms. Spring arms 32 can also have a ring-shaped cross section that results in increased section modulus compared to a rectangular cross section of equal surface area, which in turn increases the retention and decoupling forces. According to an embodiment, other primary factors influencing decoupling force can be the length of the spring arm and the angle of retaining surface 28. The angle of corresponding retaining surface 36 can make a significant contribution if it is more acute with respect to the axis of electrode 5 extending in the proximal direction than the same angle formed by retaining surface 28. The geometry of the contact portion of corresponding retaining surface 36 (modeled as a perpendicular sharp) can influence the friction coefficient. The friction coefficient between the two components has a large impact on the decoupling forces as the angle of retaining surface 36 approaches 90° (square groove). The retention and decoupling forces can be fine-tuned by increasing these angles, decreasing the length of the spring arm 32 (within the elastic strain limit of the spring arm material) and / or increasing the nominal interference (the minimal diameter of the internal retention features 33 and the maximum diameter of the rear electrode body 44.

[0092] According to an embodiment, the inner diameter of rear retention groove 15 may not form a parallel cylinder with the axis of electrode 5 as depicted in FIG. 6, but can instead taper to form a conical groove as depicted in FIGS. 9A-9C. This can be used as another method to generate axial compression between front flange 13 of electrode 5 and the distal surface of body portion 31 of electrode distal housing 7. This can be a more gradual and tolerance forgiving method of generating compression as compared with under-sizing the groove width of rear retention groove 15 compared to the width of internal retention features 33. However, it can minimize the retention force as the friction induced by an interference fit can be decreased. The insertion force can be minimized while the decoupling and retention forces are maximized by controlling the contact angle of insertion chamfer 16 and corresponding insertion surface 37. The insertion force can be dictated by the component force vector of the contact force perpendicular to the central axis of the spring arm 32, and thus the closer toparallel that the insertion chamfer 16 and corresponding insertion surface 37 are with respect to a plane through the central axis of 5, the lower the required insertion force can be. This is a simple trigonometry relationship except that friction can play a nonlinearly increasing role in the force as the angle becomes less parallel. Thus, it can be advantageous to keep the insertion chamfer angle as gradual as possible, preferably below 30° with respect to the central axis of electrode 5. These contact force vectors and components are roughly denoted in 2D in FIGS. 9A-9C. It is important to note that while spring arms 32 are depicted as two opposing arms, any number of arms conceivably manufacturable could be used as long as the forces are balanced (in that the net radial force vectors of all arms add to substantially to or equal to zero). There can also be enough room between spring arms 32 for distal flanges 46 of component 8.

[0093] Still referring to FIGS. 9A-9C, according to an embodiment, electrode proximal housing 8 can be coupled to distal housing 7 by distal flanges 46. These flanges interlock concentrically and along the same circumference to form a curvature continuous surface. In the depicted configuration, distal flanges 46 are fixedly attached to the proximal base of flange 34. The attachment is contemplated to be made via welding, but a press fit between the distal-most portion of 46 and a cavity formed at the base of spring arms 32 is possible. In one instance (but not in all), there is no overlap in surfaces in the radial direction between electrode distal housing 7 and electrode proximal housing 8. If distal housing 7 were to be received inside of electrode proximal housing 8, electrode proximal housing 8 can limit the deflection of spring arms 32. If electrode proximal housing 8 were received into the inner diameter of 7, electrode proximal housing 8 can impede insertion of electrode 5. The rear electrode body 44 can extend past internal retention features 33 in order to engage rear retention groove 15 with 33. The rear electrode body 44 may or may not be received within aperture 47 of electrode proximal housing 8, depending on the length of distal flanges 46 relative to the length of spring arms 32. Proximal to aperture 47 are at least two proximally extending arms. These arms can couple to the drive wire 9 via a rigid or hinged connection. The connection between proximal arms 43 and drive wire 9 can limit axial translation between the two components. According to an alternative embodiment, electrode distal housing 7 and electrode proximal housing 8 can be combined as a single entity (“electrode housing”). The general form and function are unaffected if these two components are manufactured as the same entity, and that design is feasible to manufacture using metal injection molding or complex laser cutting. However, splitting the combined function of “electrode housing” into two components allows for simpler machining equipment and programming which can be advantageous from a cost and versatility perspective. The central continuous surface formed by spring arms 32 and distal flanges 46 is contemplated tobe co-radial or of slightly smaller diameter than body portion 31. This is intentional such that in the case of a press fit engagement between spring arms 32 of distal housing 7 and retention groove 15 of electrode 5, the slight radially outward deflection of 32 is still sub-flush or coradial to the surface of rear body 20 of proximal housing 8. This prevents retaining surface 36 from becoming a potential catching surface if the electrode 5 is fully and properly seated within distal housing 8. This is only true when internal retention features 33 are seated fully within rear retention groove 15, but not during coupling or uncoupling of the electrode 5.

[0094] Turning to FIG. 10, according to an embodiment, one consideration in the proximally extending spring arms 32 can be to limit proximal movement of the electrode housing assembly (electrode distal housing 7 and electrode proximal housing 8) during insertion of electrode 5. During an exchange, the interchange mechanism (electrode distal housing 7, electrode proximal housing 8, and electrode 5) exerts a net proximal force on the internal drivetrain, which is resisted by a distal force exerted by the drive wire 9 (see FIGS. 11A-11B). However, given that the drive wire 9 can be a thin wire (e.g., monofilament, multifilament, or a compounded assembly of the two), excessive proximal force can result in displacement of the interchange mechanism, potentially prematurely retracting the electrode assembly. This in turn could cause jamming between spring arms 32 of distal housing 7 that is configured to deflect radially to accommodate rear electrode body 44. For this reason, the low insertion force required to begin to axially deflect spring arms 32 is resisted by the distal force of the drive wire 9, but once the spring arms 32 reach a certain level of deflection, the circumscribed diameter of the deflected arms is greater than the inner diameter of rear cavity 27 of plastic housing 12. Because the ends of spring arms 32 (corresponding retaining surfaces 36) form a substantially perpendicular surface to the distalmost face of rear cavity 27, a hard stop is effectively formed which prevents further proximal travel of the interchange mechanism. This is highly advantageous to prevent jams as it decreases the amount of compressive counterforce required from drive wire 9. Given drastically varying ratios of force transmission from the proximal handle assembly to the device distal end 1 in tortuous configuration, this design supplies a more reliable interchange mechanism during exchanges.

[0095] Referring to FIGS. 5 and 11A-11B, according to an embodiment, adaptor 12 can extend over the outer diameter of catheter shaft 10 via rear mating flange 24. Catheter coating 11 can extend over the reduced diameter of rear mating flange 24 to form a semi-flush transition between 11 and 12. Catheter shaft can be comprised of a helical, braided, coiled, laser-cut, extruded, or composite catheter configured and adapted to transmit torque from the proximal portion of the system to system distal end 1. Catheter shaft 10 can be comprised of a non-uniform geometry so as to maximize torque while maintaining flexibility. Catheter coating 11 can be constructed of a material to A) minimize friction during rotation within an endoscope working channel and B) provide a dielectric barrier to high frequency, high voltage energy passing through the drive wire. Catheter coating 11 can be in the thickness range of 0.005” to 0.015” depending on the dielectric constant of the material used in the frequency range of 200- 400 kHz. PTFE, FEP, PEBAX, and PVC and their derivatives are all suitable materials. These are potential materials, but are not limited to those which may be used as should be understood by a person of skill in the art in conjunction with a review of this disclosure.

[0096] Pertaining to the disclosed embodiments, several alternate embodiments I modifications to the primary embodiment are contemplated, including but not limited to, the following: a plurality of spring arms 32; additional geometries of electrode 5 distal to distal flange 13 which can be used for a specific clinical benefit; and a shortened adaptor 12 in which cavity 27 and rear mating flange 24 are no longer present. In this configuration, insulative cap 6 may or may not be combined with adaptor 12 and catheter shaft 10 can be accepted directly into enlarged cavity 26. The smaller inner diameter of catheter shaft 10 can now receive the proximal portion of proximal housing 8 including proximal arms 43. Proximal arms 43 may or may not have a reduced diameter relative to portions of electrode proximal housing 8 such that 43 is allowed to translate proximally to the distal end of insulative catheter 10-11. The distal most face of catheter shaft 10 can now contact flange 34 to act as a rear hard stop and a fluid seal. Other derived additional embodiments of features and components are described in this detailed description. Many configurations can be extrapolated by combining the various contemplated embodiments of the features.

[0097] In addition to the embodiments listed above, several pre-cursors to the disclosed design embodiments are alternate devices, assemblies and / or systems to solve the problem of providing an interchangeable electrosurgical cutting accessory with fluid injection. Of note, many of the components have the same name as the previous embodiment but are given a new number to avoid confusion between these alternative embodiments and the above discussed embodiments.

[0098] Referring to FIG. 12, one such alternate embodiment can comprise an electrode tip 48, an insulative cap 49, an electrode housing 50, a flow adapter 51, and an adaptor 52. Each of the components on the internal drivetrain (48, 50, 51) can be electrically conductive, while components 49 and 52 can be insulative.

[0099] Referring to FIG. 13, according to an embodiment, electrode 48 can be coupled to electrode housing 50 via a snap fit connection with at least two radially deflectable arms springarms 55. In the given embodiment, the electrode housing 50 comprises three spring arms 55. The electrode can be moved to a retracted state by moving the electrode housing 50 backwards via the flow adapter 51 coupled to a proximal drive wire (not shown) until its proximal end contacts the proximal internal ring of adaptor 52. The electrode 48 can be moved to an extended position (open) when 50 is moved distally and spring arm ends 56 contact ceramic tip rear face54. In this embodiment, the rear chamfer on the body of electrode 5 deflects spring arms 55 radially outwards until spring arms ends 56 engage a groove in the proximal diameter of electrode 48. Spring arm ends 56 are shown with annular ledges that extend radially inward and radially outward, the inward ledges making contact with the groove on the electrode 48.

[0100] The proximal body of electrode 48 can extend past the base of spring arms 55 to create a narrow slip fit with the rear aperture of electrode housing 50. This narrow annular clearance can create a small hydraulic diameter for fluid to leak around the electrode, encouraging primary flow through the central lumen of 48. Similarly, a small hydraulic diameter in the annulus formed between electrode 48 and the aperture through ceramic tip 49 can restrict any flow external to the central lumen of the knife significantly. Spring arm ends 56 of electrode housing 50 can extend radially outward from the outer surface of spring arms55. This creates a stepped diameter which prevents electrode housing 50 from moving within the second narrowing (from the distal end) of the plastic housing when spring arms 55 are deflected outward. Once spring arm ends 55 have engaged the groove on the proximal end of electrode 48, the circumscribed outer diameter can be once again small enough to retract within the second narrowing of 52. Spring arms 55 can have a slight conical taper to distribute strain more evenly along the cantilevered length. Additionally, once electrode 48 is coupled to electrode housing 50, it can be difficult to dislodge the electrode by pulling it with a distal force relative to the catheter shaft (and / or insulative cap). This greatly lowers the risk of accentual removal of the electrode. Because rear ceramic face 54 is tapered slightly, forward movement of 48 and 50 puts axial compression on spring arm ends 56. The reaction force vectors from 54 result in a downward force component which resists outward deflection of 55.

[0101] In accordance with an embodiment, the coupling and decoupling of the spring arms 32 / 55 of the housing to the proximal end of the electrode tip (as discussed herein) occurs via an axial force. Stated differently, the axial force required to couple is a force on the electrode in the proximal direction (in the direction of the proximal end of the electrode toward the yet to be connected free ends of the spring arms 32 / 55 within the slot / gap 15 -until so connected). The axial force required to decouple is a force on the electrode in the distal direction (the tensile force in the axial direction on the distal tip of the electrode that pulls the electrode out of thehousing, ultimately pushing the spring arms radially outward from the slot - moving / deflecting the spring arms from the relaxed state in the gap of the electrode radially outwards so that the electrode tip may be removed). The axial translation of the electrode distally and the angle of the surface contact with the spring arms within the gap (as described herin and shown in the FIGS) creates a radially outward force component to deflect the arms.

[0102] Additionally, the axial force component results in high friction between 56 and 54. These factors combine to drastically increase the removal force as compared to the force typically required to decouple the snap fit joint. Instead, an exchange mechanism 200 cavity is designed such that the electrode is allowed to retract roughly, for example, 0.005-0.010” if proximal force is applied to the internal drivetrain. Then, by continuing to actuate the internal drive train in the proximal direction, axial tension from the drive wire deflects spring arms 55 outward, and the roughly, for example, 0.005-0.010” gap between the distal most surface of spring arm ends 56 and rear ceramic face 54 ensures that there is little to no frictional or reaction force between the two components. Thus, the device can be exchanged in a specialized mechanism such as that disclosed in the primary embodiment yet remain resistant to accidental dislodgement from tensile force exerted on the electrode tip during a procedure.

[0103] Referring to FIGS. 14A-14C, another possible embodiment contains electrode 57 coupled to electrode housing 58 via an annular snap fit, wherein undercut 61 of 58 fits on the flats 62 on the proximal barrel of the electrode. Here, electrode housing 58 is shown to have three arms, although any number above two can be sufficient and is contemplated. The corresponding flats cut into the proximal barrel of electrode 58 create A) a notch for undercut 61 to prevent axial translation and B) “sharp” ridges between the three flats (edges) that protrude into the spaces between the snap fit arms of electrode 58. In this way, axial and rotary coupling is achieved. In this embodiment (but not in all), the snap fit assembly process can only occur when spring arms 63 are extended distally from the aperture through insulative cap 59. The exchange of electrodes is completed using the same external mechanism and principle as the primary embodiment above. The difference in this design is that the electrode assembly and inner drivetrain move from a ‘retracted’ state to and ‘extended state’ and then finally an ‘exchange’ state. In a fully retracted state, spring arms 63 are prevented from outward deflection by ceramic cap 59, effectively locking the electrode 57 in place. When the electrode assembly is in the ‘extended’ state, electrode cutting shaft base 64 is flush with the distalmost face of insulative cap 59. When the electrode assembly is moved to the exchange state, spring arms 63 are free to deflect. The user can have control of these three states at the handle by use of a slider and detents (as should be understood by a person of ordinary skill in the art inconjunction with a review of this disclosure). Tight clearances between electrode 57, electrode housing 58 and ceramic tip 59 limit fluid flow outside of that which could flow through the central lumen of electrode 57 (not pictured).

[0104] Referring to FIGS. 15A and 15B, two possible embodiments are shown. In FIG. 15A, the catheter make-up was changed from a subassembly consisting of a drive wire 9, catheter shaft 10, and catheter coating 11, to have drive wire 9 and insulated catheter 10-11. Insulated catheter 10-11 can be composed of materials similar to those exampled for the catheter coating 11. The difference is insulated catheter 10-11 combines the column strength of the catheter shaft 10 detailed in FIG. 5 embodiment with the friction and dielectric strength requirements of the coating 11 detailed in FIG. 5. The wall thickness for this embodiment can range from 0.010-0.030” with an ID ranging from 0.035-0.075”. The proximal housing 8 was altered on the proximal end by decreasing the ID near the fluid entry windows 23 to be line to line with the OD of the drive wire 9. This change allows for a more concentric attachment to the drive wire 9 which in turn reduces opportunities for catching. In a preferred embodiment, these thin walls are at least 0.002” in wall thickness and this wall thickness requirement increases as the OD of the drive wire 9 deceases within reason. The OD rear body 20 of proximal housing 8 surrounding the fluid entry was also decreased to create a more consistent wall thickness and improve attachment conditions between 8 and 9. The proximal channel 27 of the adaptor 12 was also changed by decreasing the inner diameter such that there is a near line-to-line fit between the electrode housing (7 & 8) and the adaptor 12. This creates a bushinglike mechanism that supports a straight extension and retraction of the housing with electrode (5, 7, & 8) to limit opportunities for catching, especially in tortuous conditions. The back of channel 27 was also rounded to create the atrium of the adaptor ##-l that assists in removing opportunities for the housing to get caught during actuation. The proximal-most end of the adaptor 12, or ##-2, the connection point to the catheter has been altered to create a stronger interference with the catheter shaft 10. This embodiment features a barbed fitting similar to those seen in tubing connections. Another embodiment of feature ##-2 include a plug-like connection featured a drafted surface greater than 1 -degree but not more than 25 -degrees that increases the interference between the distal end and the endoscopic catheter. Other example embodiments of ##-2 can include a combination of the two above examples as when as other connection features such as but not limited to ridges, spirals, and hooks. These connections features can be used in combination with various assembly methods such as, but not limited to, heat to expand the catheter shaft over the proximal end of the adaptor and having it cool and shrink down into a tight interference fit, or high temperature biocompatible adhesive.

[0105] Referring to another alternative embodiment shown in FIG. 15B, the insulative cap 6 shown in FIG. 15A has been removed, the flange 34 on the distal housing 7 has been moved to proximal housing 8 and a plug ##-3 has been added to connect adaptor 12 and the catheter shaft 10. This embodiment allows for a reduced risk of catching in tortuous configurations. Moving the flange to the proximal housing 8 decouples the two functions of the electrode housing (7 and 8) as the distal housing 7 would be responsible for attaching onto the electrode 5 and proximal housing 8 would be responsible for controlling the extension and retraction of the electrode 5 within the distal end. The embodiment shown in FIG. 15B can utilize the same endoscopic catheter assembly as FIG. 15A. The plug component ##-3 is composed of an insulative material such as PEEK or ceramic. The purpose of the component is to provide a connection between the distal end and the electrode catheter. Attachment features such as those discussed for ##-2 may be utilized. The advantage of this component embodiment is that it allows for the entire actuation motion of the flange 34 from hard stop to hard stop to be contained within one chamber further reducing the opportunity for catching of the inner housing on the outer adaptor. The plug ##-3 and the adaptor 12 would connect by way of a press fit between their two thin-wall chambers. This will strengthen both thin walls compared to if they were to stand alone. Tight fit tolerances from the altered adaptor channel 27 will be translated to the inner channel of the plug ##-3. Another advantage of this embodiment is decreased complexity of the adaptor 12 and similar complexity of the plug ##-3 compared to the insulative cap 6 that is replaced. In addition, the assembly operations to assemble the distal components and attach to the electrode catheter have been simplified allowing for improved design for assembly. Components of either of the above alternate embodiments can be combined with each other or any other embodiment (as should be understood by a person or ordinary skill in the art in conjunction with a review of this disclosure).

[0106] The following are embodiment descriptions of a related exchange mechanism for endoscopic devices. These descriptions are associated with FIGS. 16-22. Embodiments of the exchange mechanism 200 can be used to facilitate rapid removal and application of new electrode tips to an endoscopic catheter, which makes the system work most effectively and efficiently.

[0107] Referring to FIG. 16, an exchange / exchanger system 200 view is given which depicts guide block 101, retention springs 102, slider 103, and user grip 104. Guide block 101 can have a primary purpose of aligning an interchange catheter with the exchange mechanism 200 (e.g., as disclosed herein) and providing a hard stop for an electrode / end effector. Retention springs 102 interact with the electrodes / end effectors to lock and unlock the electrodes / endeffectors in place and maintain electrode position once stored. Slider 103 provides a means for the user to interact with the exchange mechanism 200 to lock and unlock electrodes / end effectors. User grip 104 houses at least one (or more) exchange mechanisms 200 in a manner which is easy for the user to interact with. User grip 104 and / or guide block 101 can contain graphics to show which direction is locked vs unlocked on the slider. They can also contain graphics of the various knife types to allow techs to quickly identify which electrode style is contained within each exchanger 200.

[0108] Referring to FIG. 17 (cross section system view), guide block 101 houses retention springs 102 and is slidably coupled to slider 103. Guide block 101 contains front taper 129 and guide lumen 105 to align an interchange catheter in the proper axis to the retention springs 102. Additionally, hard stop 121 is fixedly attached to guide block 101 (either rigidly connected or as a feature within the component) and sets the depth of an electrode I end effector during exchange. Alignment boss 117 couples retention spring 102 to guide block 101. It is contemplated that depending on the interaction between components 117 and 102 (press fit, slip fit, detent) varying degrees of rigidity can be achieved between the two components. With some modification for moldability, components 101 and 102 can be combined as a single component. It can be desirable to leave components 101 and 102 as two separate components to change out springs more easily in the manufacturing process, or to combine them for possible cost-savings.

[0109] Slider 103 has snap-fit arms 114 that slidably couple to guide block 101 via support wall 113. This constrains slider 103 to move parallel to the axis of guide lumen 105. Lock spring arms 115 contact primary spring arm 108 to exert an inward force on primary spring arm 108 when the slider is moved “forward” into the locked configuration. Detents 127 shown in FIG. 20B can interact with detent cavity 111 to lock the slider and primary spring into place in the configuration. Conversely, wedge 116 on slider contacts internal face 123 (see FIG. 19) of primary spring arm 108 when slider 103 moves to the unlocked configuration. In the locked configuration, opposing compression features 109 are brought into contact with the electrode / end effector (if present) or each other resulting in compression between the two surfaces. In the unlocked position, opposing compression features 109 are separated from each-other to a sufficient distance to allow the electrode I end effector to be inserted to hard stop 121. Safety spring 106 supports the electrode / end effector when the interchange catheter is not inserted through and past guide lumen 105. This prevents the electrode / end effector from displacing if the exchanger device 200 is opened prematurely without the interchange catheter in place.

[0110] Referring to FIG. 18, according to an embodiment, guide block 101 contains a tapered cavity 129 that is coaxial with guide lumen 105. Guide lumen 105 is sized such that the maximum radial misalignment between the interchange catheter axis and the axis of 105 can be approximately 0.005” in this example (but is not limited to this size). Hard stop 121 is of a height equal to at least the centerline of 105, and preferably extending to the height of the top of guide lumen 105. Hard stop 121 can include an end effector cavity 130 that constrains motion of end effector tip in the horizontal direction relative to guide bock base 120. Hard stop 121 can contain a rear gusset or radius to increase stiffhess / strength. If guide block 101 and retention spring 102 are constructed as separate entities, guide block base 120 is appropriately shaped to allow horizontal deflection of primary spring arms 108 and lock spring arms 115 while accepting retention spring base 119. Support wall 113 contains guide groove 122 which is configured and adapted to accept retention notches 124 (see also FIGS. 20A and 20B). Guide block 101 can be a single component / single mold with user grip 104. The shape of user grip 104 can be a ‘flashlight style” handle as shown, a gun-type handle, affixed to an existing endoscopic handle, a rectangular or circular cartridge, or a series of interconnectable blocks (like Legos®) that can be snap fit together depending on how many electrodes are needed.

[0111] Referring to FIG. 19, according to an embodiment, retention springs 102 comprise spring base 119, guide block mating feature 118, lock detent 111, opposing compression features 109, safety spring 106 and electrode cradle 107, primary spring arm 108, internal face 123, and primary spring base 112. The primary spring can be elastic in its anticipated deformation zone. ABS, Nylon, certain PC, and other resins can be a good fit for the spring material, as an example. If local deformation is seen due to the minute nature of electrodes being exchanged, glass or carbon fiber additives can increase material stiffness and yield (as should be understood by a person of ordinary skill in the art in conjunction with a review of this disclosure). Front safety spring 106 can play a critical role in preventing lost or misaligned electrode tips if the slider is opened prematurely. Electrode cavity 107 can firmly compress the electrode, and contain at least one groove so as to keep a stored electrode from moving in when the catheter is not in place. As the catheter is inserted into guide lumen 105, it contacts the base of 106 and deflects the arms out of the way when a catheter is being inserted for changes.

[0112] Referring to FIGS. 20A-20C, slider 103 can have a top grip 128 with fenestrations and a curved surface to make the slider 103 easier to actuate. Guide arms 114 can contain retention notches 124. As the slider 103 is assembled, guide arms 114 deflect inward slightly until retention notches 124 snap into place in guide groove 111. Lock detents 127 sit at the end of spring arms 125. These deflect outwards and exert compression on primary spring arm 108when the device is moving into a locked position. Each spring arm 125 on the slider device is designed to be flexible using a cantilever arm (body of spring arm 125) and a torsional ring 112 which connects it to the bottom surface of slider 103. This allows for a greater degree of flexibility in the relatively short spring arms 125. Wedge 116 spreads primary spring 108 outward in order to accept an electrode ready to be exchanged.

[0113] Referring to FIG. 21, an alternate embodiment of the slider is shown. Here, this embodiment comprises a slider 131, a user grip 132, a primary spring 134 and a return spring 133 is provided. In this embodiment, return spring 133 biases the mechanism towards closed, so the slider must be actuated to open and held in place while an electrode is inserted for exchange (removal). Once the electrode is seated, the slider may be let go and return spring 133 will actuate the slider forward to put compression on primary spring 134.

[0114] Referring to FIGS. 22A-22B, another alternate embodiment for an exchanger device 200 is disclosed in which a user grip 135 contains at least one button 137. Each button 137 is seated on a cantilever and includes a wedge 139. When the button is depressed, the wedge opens primary spring 140 in order to separate two opposing surfaces 136. The electrode can then be inserted into a hard stop molded within the spring cavity as part of the user grip. Upon releasing the button, both a U-shaped feature and two “wing” features compress opposing surfaces 136 onto an electrode, at which time an exchange can be made.

[0115] Referring to FIG. 23, another embodiment for an exchanger device is disclosed in which the embodiment from FIG. 16, for example, has an interlocking feature which allows multiple exchanger devices to be connected in a customizable manner. The male dovetail feature 153 is connected to the female dovetail feature 154 by sliding one exchanger system onto another. Other differences from this embodiment and the one detailed in FIG. 16 include the lock and unlock feedback features 151 and 152 detailed below when describing the exchange process. This embodiment allows for the user to connect their desired electrode tip device contained within the exchanger systems such that multiple exchangers will not be loose allowing for more opportunity to lose devices. This embodiment also reduced the amount of material used as grip 104 is not needed. Graphics may be included on the surface of 101 to indicate lock / unlock positions and identify which electrode tip (knife) type is being secured within the exchanger.

[0116] Turning to FIG. 24A-24K, an example of the electrode (knife) tip device combined with an endoscopic catheter system 1 and separated from an endoscopic catheter system 1 is shown. FIGS. 24A-F show how to attach the electrode (knife) tip to the endoscopic catheter and FIGS. 24G-K show how to remove catheter system from the exchanger system with theelectrode tip device remaining in place. FIG. 24A shows an example of the electrode (knife) tip in the exchanger in the locked position as it would be secured and stored until it is to be loaded into an endoscopic catheter system 1. FIG. 24B shows an example of the endoscopic catheter system 1 being inserted into an exchanger system and in a locked position / configuration according to an embodiment. FIG. 24C shows the endoscopic catheter beginning to surround the electrode (knife) tip. The proximal end of the electrode 44 begins interacting with the distal housing 7 at the distal end of the catheter. FIG. 24D shows the slider being actuated to unlock the electrode tip device. Note: the exchanger embodiment can advantageously have feedback features that will produce tactile and audible feedback to indicate that the slider has been moved to the unlocked and locked positions. The fully opened / unlocked configuration feature (the position of the slider indicating that the electrode (knife) can be moved) is referred to as the unlocked feedback features 151. FIG. 24E shows the endoscopic catheter system 1 being pushed further into the exchanger to fully engage the snap feature between distal housing 7 and electrode 5 and secure the electrode (knife) tip device into the endoscopic catheter device. The two systems have now been combined. FIG. 24F shows the endoscopic catheter being removed from the exchanger system with the electrode tip device remaining in place. The electrode tip device can be removed from the endoscopic catheter if and when desired by completing the steps detailed in FIGS. 24G-K to transfer the electrode tip device to the exchanger system by using the exchanger system. FIG. 24G shows the exchanger system with no electrode tip device contained and in the locked configuration. FIG. 24H shows the slider being moved to the unlocked or open configuration. A user will know that the exchanger system has been fully opened in the shown exchanger system embodiment in part by the tactile / audible feedback received from the unlocked feedback features 151. FIG. 241 shows the combined endoscopic catheter and electrode tip device system inserted into the channel of the exchanger system 129. The system is inserted into the exchanger system until the electrode tip hits hard stop 121. FIG. 24J shows the slider being moved into the locked / closed configuration. A user with know the exchanger system has been moved to the locked position successfully by receiving the tactile and audile feedback of the locked feedback features 152. At this point, the electrode tip device has been secured into the exchanger system. FIG. 24K shows the endoscopic catheter system being removed from the exchanger system. The electrode tip device remains secured in the exchanger system and is ready to be combined with the endoscopic catheter system again by following FIG. 24A-F. The steps depicted in FIG. 24A-K are only one embodiment of the exchange system. The process can be simplified, combined, or adjusted. One example of a change could be to allow theelectrode tip device to be able to be fully secured into the endoscopic catheter system while the exchanger is in the closed / locked position and then opening the slider to the unlocked position to remove the combined endoscopic catheter electrode tip device from the exchanger system.

[0117] Referring to FIG. 25, a knife spraying a jet of water through a central lumen is shown.

[0118] Referring to FIG. 26A, an alternative configuration is disclosed in which ceramic cap 6 and plastic housing 12 are combined and connected directly to catheter 10-11, decreasing overall part count and shortening the rigid length of the device. In this configuration, insulated catheter 10-11 could be accepted directly into cavity 26 to a specified depth. The former proximal portion 19 of insulative cap 6 would now take the form of an internal step 25 that could maintain the function as a distal stop and seal with flange 34 of distal housing 7. The smaller inner diameter of catheter shaft 10 would now receive the rear body 20 of proximal housing 8 including proximal arms 43. The distal most face of insulated catheter 10-11 would now contact flange 34 to act as a rear hard stop and a fluid seal when the electrode is in a retracted state.

[0119] Referring to FIG. 26B, a related configuration to FIG. 26A is disclosed in which distal housing 7 no longer possess a distal body portion 31. This shortens the overall rigid length of the device even further, yet increases the leak around the distal housing 7 when the electrode is not in a fully extended or fully retracted state (when flange 34 therefore is not making a face seal with another corresponding stop / surface). This configuration would be advantageous in tortuous anatomies when a minimized rigid length of the device enables insertion around a smaller radius formed by the path of an endoscopes working channel, such as when an endoscope is in a retroflexed configuration.

[0120] Referring to FIG. 27, a flow path diagram is shown. The input flow 155 is introduced to the distal end from the injection port on the handle and the fluid travels down the catheter to the distal end. The main flow path 156 allows the injected fluid from the injection port at the proximal end of the device (i.e., handle) to enter the electrode (i.e., knife tip) 5 through the proximal housing windows 23 and into the lumen 14 of the electrode 5. The fluid then exits out the distal most end of the tip 18. Successful injection / lifting and separating tissue is achieved by the fluid exiting this main flow path. Leakage path 1 157 shows the fluid that never entered the proximal housing window 23 and went between the housing subassembly and the adaptor. This fluid can leak out around knife tip 18, especially in the partially closed or closed / retracted position. Y-box shown in FIG. 3B can help with this leak. When in the fully extended position, R-box on FIG. 3A helps with this leak. Leakage path 2 158 shows the fluidthat enters into window 23 but does not enter electrode lumen 14 and flows from inside the proximal housing 8 to around the housing by exiting at the space between housing arms 32 and 46. The fluid may also continue to flow around the electrode but inside of the combined housing subassembly of components 7 and 8. B-box on FIG. 3 A helps with this leak.

[0121] FIGS. 28A-28C show various views of the electrode knife device / mechanism / assembly / system 100 being inserted into the exchange system 200, as described above and according to an embodiment.

[0122] FIG. 29 shows a zoomed-out perspective view of the electrode knife device / mechanism / assembly / system 100 according to an embodiment.

[0123] While embodiments of inventive aspects the present disclosure have been particularly shown and described with reference to certain exemplary embodiments, it will be understood by one skilled in the art that various changes in detail may be affected therein without departing from the spirit and scope of inventive aspects of the disclosure as defined by claims that can be supported by the written description and drawings. Further, where exemplary embodiments are described with reference to a certain number of elements it will be understood that the exemplary embodiments can be practiced utilizing either less than or more than the certain number of elements. In addition, any of the alternative embodiments, and parts thereof, can be combined in any way mechanically possible.

[0124] While various embodiments have been described and illustrated herein, those of ordinary skill in the art will readily envision a variety of other means and / or structures for performing the function and / or obtaining the results and / or one or more of the advantages described herein, and each of such variations and / or modifications is deemed to be within the scope of the embodiments described herein. More generally, those skilled in the art will readily appreciate that all parameters, dimensions, materials, and configurations described herein are meant to be exemplary and that the actual parameters, dimensions, materials, and / or configurations will depend upon the specific application or applications for which the teachings is / are used. Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments described herein. It is, therefore, to be understood that the foregoing embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto, embodiments may be practiced otherwise than as specifically described and claimed. Embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and / or method described herein. In addition, any combination of two or more such features, systems, articles, materials, kits, and / or methods, if such features, systems, articles, materials, kits,and / or methods are not mutually inconsistent, is included within the scope of the present disclosure.

[0125] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of any inventive aspect of the disclosure. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as, “has” and “having”), “include” (and any form of include, such as “includes” and “including”), and “contain” (any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a method or device that “comprises”, “has”, “includes” or “contains” one or more steps or elements. Likewise, a step of method or an element of a device that “comprises”, “has”, “includes” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.

[0126] The corresponding structures, materials, acts and equivalents of all means or step plus function elements in the claims below, if any, are intended to include any structure, material, or act for performing the function in combination with other claimed elements as specifically claimed. The description of the embodiments has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to any inventive aspects in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of any inventive aspects of the disclosure. The embodiment was chosen and described in order to best explain the principles of one or more any inventive aspects of the disclosure and the practical application, and to enable others of ordinary skill in the art to understand one or more inventive aspects of the disclosure for various embodiments with various modifications as are suited to the particular use contemplated.

Claims

What is claimed is:

1. An electrode and an endoscopic mechanism comprising: a first electrode comprising a first distal tip and a first universal proximal portion configured and adapted to interface and couple via a coupling with an endoscopic catheter; wherein: the first universal proximal portion is structured or configured to facilitate a decoupling force of the electrode from the endoscopic catheter to decouple the electrode from the endoscopic catheter.

2. The mechanism of claim 1, further comprising a second electrode comprising a a second distal tip and a second universal proximal portion configured and adapted to interface and couple via a coupling with an endoscopic catheter.

3. The mechanism of claim 1, wherein the electrode may have a non-axisymmetric tip which features surfaces more adept at cutting while simultaneously having surfaces more adept at coagulating.

4. The mechanism of claim 2, wherein the second distal tip is different in shape as compared to the first distal tip.

5. The mechanism of claim 2, wherein the second universal proximal portion is the same size and shape as compared to the first universal proximal portion.

6. An exchange mechanism that provides a platform for exchanging a plurality of electrodes with an endoscopic catheter, the exchange mechanism comprising: an actuator configured or structured to interface with one or more electrode tips, wherein each of the one or more electrode tips comprises a universal proximal portion configured and adapted to interface and couple via a coupling with the endoscopic catheter; and a primary spring configured or structured to engage and disengage with the actuator, and to couple or decouple the one or more electrode tips with the endoscopic catheter.

7. An electrode and an endoscopic mechanism comprising:a first electrode comprising a first distal tip and a first universal proximal portion configured and adapted to interface and couple via a coupling with an endoscopic catheter; wherein: the coupling mechanism is configured to constrain the first electrode when the first universal proximal portion is adjacent to the coupling mechanism; and the coupling mechanism does not deform with axial translation unless it interfaces with an electrode.

8. The mechanism of claim 7, wherein the coupling mechanism transiently deforms during a coupling action.

9. The mechanism of claim 7, wherein transient deformation during the coupling action prevents proximal translation of the coupling mechanism.

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