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公开(公告)号：US06632193B1
公开(公告)日：2003-10-14
申请号：US09477832
申请日：2000-01-05
IPC分类号： A61B1720
CPC分类号： A61B18/1402 , A61B18/042 , A61B18/1206 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2017/00101 , A61B2017/00247 , A61B2018/00029 , A61B2018/00083 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00327 , A61B2018/00392 , A61B2018/00505 , A61B2018/00577 , A61B2018/00583 , A61B2018/00678 , A61B2018/00702 , A61B2018/00726 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61M3/0283
摘要： Systems and methods are provided for removal (ablation) or modification of soft tissue with high frequency voltage through a capacitive charge process. Specifically, one of the conductors of a capacitor device maybe positioned adjacent to, or in the region of, a body structure. The other conductor is spaced, and electrically insulated from, the first conductor. A high frequency voltage is applied across the conductors to create a potential difference that results in a charge on the conductors and creates an electric field therebetween. High frequency alternating current flows between the conductors to a degree dependent on the capacitance and the current frequency. The charge on the first conductor is sufficient to modify the adjacent tissue. In some variations the charge is sufficient to heat the tissue for tissue coagulation or tissue shrinkage (i.e., collagen contraction). In other variations, the charge is sufficient to ablate or volumetrically remove the tissue.
摘要翻译： 提供了通过电容充电过程去除（消融）或修改具有高频电压的软组织的系统和方法。 具体来说，电容器装置的导体之一可以位于身体结构的邻近或者在身体结构的区域中。 另一导体与第一导体间隔开并与之电绝缘。 在导体之间施加高频电压以产生导致导体上的电荷并在它们之间产生电场的电位差。 导体之间的高频交流电流依赖于电容和电流频率。 第一导体上的电荷足以改变相邻的组织。 在一些变化中，电荷足以加热组织用于组织凝固或组织收缩（即胶原收缩）。 在其他变体中，电荷足以消融或体积去除组织
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公开(公告)号：US07572251B1
公开(公告)日：2009-08-11
申请号：US09457201
申请日：1999-12-06
CPC分类号： A61B18/12 , A61B18/1206 , A61B18/1402 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2017/00097 , A61B2017/00101 , A61B2017/00106 , A61B2017/00247 , A61B2017/00292 , A61B2017/003 , A61B2017/22001 , A61B2017/22038 , A61B2018/00029 , A61B2018/00083 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00196 , A61B2018/00327 , A61B2018/00392 , A61B2018/00505 , A61B2018/00565 , A61B2018/00577 , A61B2018/00583 , A61B2018/00601 , A61B2018/00642 , A61B2018/0066 , A61B2018/00678 , A61B2018/00702 , A61B2018/00726 , A61B2018/00738 , A61B2018/00755 , A61B2018/00761 , A61B2018/00791 , A61B2018/00797 , A61B2018/00821 , A61B2018/00827 , A61B2018/00875 , A61B2018/00886 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1246 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2090/378 , A61B2090/3782 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61F2/95 , A61M3/0283 , A61M25/0133
摘要： Systems and methods are provided for applying a high frequency voltage in the presence of an electrically conductive fluid to create a relatively low-temperature plasma for ablation of tissue adjacent to, or in contact with, the plasma. In one embodiment, an electrosurgical probe or catheter is positioned adjacent the target site so that one or more active electrode(s) are brought into contact with, or close proximity to, a target tissue in the presence of electrically conductive fluid. High frequency voltage is then applied between the active electrode(s) and one or more return electrode(s) to non-thermally generate a plasma adjacent to the active electrode(s), and to volumetrically remove or ablate at least a portion of the target tissue. The high frequency voltage generates electric fields around the active electrode(s) with sufficient energy to ionize the conductive fluid adjacent to the active electrode(s). Within the ionized gas or plasma, free electrons are accelerated, and electron-atoms collisions liberate more electrons, and the process cascades until the plasma contains sufficient energy to break apart the tissue molecules, causing molecular dissociation and ablation of the target tissue.
摘要翻译： 提供的系统和方法用于在存在导电流体的情况下施加高频电压以产生相对低温的等离子体，以消除与等离子体相邻或与其接触的组织。 在一个实施例中，电外科探针或导管邻近靶位置定位，使得在存在导电流体的情况下使一个或多个有效电极与目标组织接触或接近。 然后将高频电压施加在有源电极和一个或多个返回电极之间，以非热生成邻近有源电极的等离子体，并且对体积方法移除或消除至少一部分 目标组织。 高频电压以足够的能量产生有源电极周围的电场，以使邻近有源电极的导电流体离子化。 在电离气体或等离子体中，自由电子被加速，并且电子 - 原子碰撞释放出更多的电子，并且该过程直到等离子体含有足够的能量来分解组织分子，导致靶组织的分子解离和消融。
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公开(公告)号：US07094215B2
公开(公告)日：2006-08-22
申请号：US10402728
申请日：2003-03-28
CPC分类号： A61B18/148 , A61B2017/00761 , A61B2018/00011 , A61B2018/00821 , A61B2018/00827 , A61B2018/1253 , A61B2018/126 , A61B2018/1472 , A61B2018/162 , A61B2218/002
摘要： Systems and methods are provided for performing electrosurgical interventions, such as selectively contracting soft collagen tissue and other body structures, while limiting thermal damage or molecular dissociation of such tissue and limiting the thermal damage to tissue adjacent to and underlying the treatment site. The systems and methods of the present invention are particularly useful for surgical procedures in electrically conducting environments, such as arthroscopic procedures in the joints, e.g., shoulder, knee, hip, hand, foot, elbow or the like. The present invention is also useful in relatively dry environments, such as treating and shaping the cornea, and dermatological procedures involving surface tissue contraction of tissue underlying the surface of the skin for tissue rejuvenation, wrinkle removal and the like.
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4.发明授权Electrosurgical apparatus having digestion electrode and methods related thereto 失效具有消化电极的电外科设备及其相关方法公开(公告)号：US06896674B1
公开(公告)日：2005-05-24
申请号：US09709035
申请日：2000-11-08
CPC分类号： A61B18/1482 , A61B18/1206 , A61B18/14 , A61B18/1402 , A61B18/148 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2017/00101 , A61B2017/00247 , A61B2018/00029 , A61B2018/00083 , A61B2018/00095 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00267 , A61B2018/00327 , A61B2018/00392 , A61B2018/00434 , A61B2018/0044 , A61B2018/00577 , A61B2018/00583 , A61B2018/00589 , A61B2018/00601 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/0072 , A61B2018/00726 , A61B2018/00779 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/00988 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007 , A61F2/2493
摘要： Methods and apparatus for resecting and ablating tissue at a target site of a patient, the apparatus including a probe having an elongate shaft. The shaft includes a shaft distal end portion and a shaft proximal end portion, and a resection unit located at the shaft distal end portion. The resection unit includes a resection electrode support and at least one resection electrode arranged on the resection electrode support. The at least one resection electrode includes a resection electrode head. The probe and resection electrode head are adapted for concurrent electrical ablation and mechanical resection of target tissue. The shaft may include at least one digestion electrode capable of aggressively ablating resected tissue fragments. At least one fluid delivery port on the shaft distal end portion may provide an electrically conductive fluid to the resection unit or to the target site. The shaft may include at least one aspiration port, located proximal to the resection unit, for aspirating excess or unwanted fluids and resected tissue fragments from the target site. The at least one aspiration port is coupled to an aspiration lumen. The at least one digestion electrode may be arranged within the aspiration lumen for ablation of tissue fragments therein. In use, the digestion and resection electrodes of the probe are coupled to a high frequency power supply. A surgical kit comprising the probe is also disclosed, together with a method of making the probe.
摘要翻译： 用于在患者的目标部位切除和消融组织的方法和装置，该装置包括具有细长轴的探针。 所述轴包括轴远端部和轴近端部，以及位于所述轴远端部的切除单元。 切除单元包括切除电极支撑件和布置在切除电极支撑件上的至少一个切除电极。 所述至少一个切除电极包括切除电极头。 探针和切除电极头适用于靶组织的并行电消融和机械切除。 轴可以包括至少一个能够积极地消融切除的组织碎片的消化电极。 轴远端部分上的至少一个流体输送端口可以向切割单元或目标部位提供导电流体。 轴可以包括位于切除单元附近的至少一个抽吸端口，用于从目标部位吸出过量或不需要的流体和切除的组织碎片。 所述至少一个抽吸端口联接到抽吸腔。 所述至少一个消化电极可以布置在所述抽吸腔内用于在其中消除组织碎片。 在使用中，探头的消化和切除电极耦合到高频电源。 还公开了包含探针的外科手术套件以及制造探针的方法。
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公开(公告)号：US06805130B2
公开(公告)日：2004-10-19
申请号：US09845034
申请日：2001-04-27
IPC分类号： A61B1900
CPC分类号： A61B18/148 , A61B18/1482 , A61B18/1492 , A61B2017/00026 , A61B2017/00106 , A61B2017/00247 , A61B2018/0016 , A61B2018/00178 , A61B2018/00392 , A61B2018/00583 , A61B2018/00702 , A61B2018/00738 , A61B2018/00755 , A61B2018/00875 , A61B2018/00982 , A61B2018/1246 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2090/3782 , A61F2/2493 , A61F2/95
摘要： Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one aspect, the invention involves canalizing or boring channels, divots, trenches or holes through an avascular connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. In one method, an active electrode is positioned in close proximity to a target site on a tendon, and a high frequency voltage difference is applied between the active electrode and a return electrode to selectively ablate tendon tissue at the target site, thereby forming a channel or void in the tendon. The active electrode(s) may be moved relative to the tendon during, or after, the application of electrical energy to damage or sculpt a void within the tendon, such as a hole, channel, crater, or the like. In another aspect of the invention, an electrosurgical probe is used to elicit a wound healing response in a target tissue, such as an injured tendon, in order to stimulate vascularization of the target tissue. The present invention may also be used for vascularization of a torn or damaged tissue in conjunction with a surgical repair procedure.
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公开(公告)号：US06602248B1
公开(公告)日：2003-08-05
申请号：US09676194
申请日：2000-09-28
IPC分类号： A61B1814
CPC分类号： A01N43/52 , A01N43/80 , A01N43/90 , A61B18/1206 , A61B18/1402 , A61B18/1477 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B90/11 , A61B2017/00026 , A61B2017/00084 , A61B2017/00101 , A61B2017/00247 , A61B2017/00261 , A61B2018/00029 , A61B2018/00083 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00327 , A61B2018/00392 , A61B2018/0044 , A61B2018/00505 , A61B2018/00577 , A61B2018/00583 , A61B2018/00589 , A61B2018/00601 , A61B2018/00678 , A61B2018/00702 , A61B2018/00726 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1425 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61M3/0283 , C07D403/12 , C07D409/12 , C07D413/12 , C07D491/04
摘要： Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.
摘要翻译： 用于通过椎间盘组织消融治疗椎间盘的装置和方法。 本发明的方法包括将至少一个有效电极定位在椎间盘内，以及在活性电极和一个或多个返回电极之间施加至少第一高频电压，其中髓核的体积 减轻了髓核对纤维环的压力，缓解了患者的椎间盘疼痛。 在其他实施例中，弯曲或可操纵的探针被引导到待治疗的椎间盘内的特定靶部位，并且通过在有源电极之间施加至少第一高频电压来消除目标部位的椎间盘组织， 和一个或多个返回电极。 还公开了一种制造电外科探针的方法。
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7.发明授权System and methods for electrosurgical treatment of obstructive sleep disorders 有权用于电外科治疗阻塞性睡眠障碍的系统和方法
公开(公告)号：US6159208A
公开(公告)日：2000-12-12
申请号：US268616
申请日：1999-03-15
CPC分类号： A61B18/1485 , A61B18/149 , A61B18/1206 , A61B2017/00026 , A61B2018/00119 , A61B2018/00327 , A61B2018/00583 , A61B2018/00702 , A61B2018/00827 , A61B2018/00875 , A61B2018/124 , A61B2018/1273 , A61B2018/1467 , A61B2018/162 , A61B2018/165
摘要： The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention includes a channeling technique in which small holes or channels are formed within tissue structures in the mouth, such as the tonsils, tongue, palate and uvula, and thermal energy is applied to the tissue surface immediately surrounding these holes or channels to cause thermal damage to the tissue surface, thereby stiffening the surrounding tissue structure. Applicant has discovered that such stiffening of certain tissue structures in the mouth and throat helps to prevent the tissue structure from obstructing the patient's upper airway during sleep.
摘要翻译： 本发明提供了用于选择性地将电能施加到患者身体的头部和颈部内的目标位置，特别是包括耳朵，鼻子和喉部中的组织的系统和方法。 本发明包括一种通道技术，其中在孔中的组织结构内形成小孔或通道，例如扁桃体，舌头，上颚和尿道，并且热能被施加到紧邻这些孔或通道的组织表面，以引起 对组织表面的热损伤，从而使周围的组织结构变硬。 申请人已经发现，口腔和喉部中某些组织结构的这种硬化有助于防止组织结构在睡眠期间阻塞患者的上呼吸道。
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公开(公告)号：USRE40156E1
公开(公告)日：2008-03-18
申请号：US10682600
申请日：2003-10-09
IPC分类号： A61B18/14
CPC分类号： A01N43/52 , A01N43/80 , A01N43/90 , A61B18/1206 , A61B18/1402 , A61B18/1477 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B90/11 , A61B2017/00026 , A61B2017/00084 , A61B2017/00101 , A61B2017/00247 , A61B2017/00261 , A61B2018/00029 , A61B2018/00083 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00327 , A61B2018/00392 , A61B2018/0044 , A61B2018/00505 , A61B2018/00577 , A61B2018/00583 , A61B2018/00589 , A61B2018/00601 , A61B2018/00678 , A61B2018/00702 , A61B2018/00726 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1425 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61M3/0283 , C07D403/12 , C07D409/12 , C07D413/12 , C07D491/04
摘要： Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.
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公开(公告)号：US06772012B2
公开(公告)日：2004-08-03
申请号：US09848843
申请日：2001-05-03
IPC分类号： A61F700
CPC分类号： A61B18/1402 , A61B18/1206 , A61B18/14 , A61B18/1477 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B90/11 , A61B2017/00026 , A61B2017/00084 , A61B2017/00101 , A61B2017/00247 , A61B2017/00261 , A61B2017/00274 , A61B2018/00029 , A61B2018/00083 , A61B2018/00119 , A61B2018/0016 , A61B2018/00178 , A61B2018/00291 , A61B2018/00327 , A61B2018/00392 , A61B2018/00434 , A61B2018/0044 , A61B2018/00505 , A61B2018/00547 , A61B2018/00577 , A61B2018/00583 , A61B2018/00589 , A61B2018/00601 , A61B2018/00607 , A61B2018/00678 , A61B2018/00702 , A61B2018/00726 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1425 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61M3/0283
摘要： Systems, apparatus, and methods for treating spinal tissue and other body structures in open and endoscopic spine surgery to relieve symptoms, such as neck or back pain. In particular, the present invention provides methods for the controlled heating of various tissues in or around the vertebral column, including various interspinous tissues, such that spinal ligaments and cartilage surrounding the vertebrae and the facet joints are shrunk or tightened to stabilize the vertebral column of a patient. Thermal energy is applied to the target tissue in a subablation mode of an electrosurgical system to cause shrinkage of the tissue, thereby stiffening the interspinous tissue and stabilizing the vertebral column. In an exemplary embodiment, a high frequency RF voltage can be applied between one or more active electrode(s) and one or more return electrode(s) to heat a target interspinous tissue to within a temperature range at which irreversible shrinkage of the tissue occurs.
摘要翻译： 用于在开放和内窥镜脊柱手术中治疗脊髓组织和其他身体结构的系统，装置和方法，以缓解症状，例如颈部或背部疼痛。 特别地，本发明提供了用于受控加热椎骨柱内或周围的各种组织的方法，包括各种棘突间组织，使得脊椎韧带和围绕椎骨和小关节的软骨收缩或收缩以稳定椎骨柱的 病人。 以电外科系统的消融模式将热能施加到靶组织，引起组织收缩，从而加强棘突间组织并稳定脊柱。 在示例性实施例中，可以在一个或多个有效电极和一个或多个返回电极之间施加高频RF电压，以将目标棘突间组织加热到组织发生不可逆收缩的温度范围内 。
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公开(公告)号：US06726684B1
公开(公告)日：2004-04-27
申请号：US09708962
申请日：2000-11-08
IPC分类号： A61B1814
CPC分类号： A61B18/1482 , A61B18/1206 , A61B18/14 , A61B18/1477 , A61B18/148 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B90/11 , A61B2017/00261 , A61B2018/00119 , A61B2018/0016 , A61B2018/00291 , A61B2018/00327 , A61B2018/00392 , A61B2018/00434 , A61B2018/0044 , A61B2018/00577 , A61B2018/00583 , A61B2018/00589 , A61B2018/00702 , A61B2018/00791 , A61B2018/00827 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/1273 , A61B2018/1425 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002
摘要： Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode. In another aspect, a distal end of an electrosurgical probe having at least one electrode on a biased, curved, bent, or steerable shaft is guided or steered to a target site within an intervertebral disc having a disc defect for treatment of tissue to be treated at the target site by the selective application of electrical energy thereto.
摘要翻译： 用于选择性地将电能施加到患者体内的目标位置，特别是包括脊柱中的组织的方法和装置。 在本发明的方法中，在存在导电流体的情况下，将高频（RF）电能施加到电外科探针上的一个或多个有效电极，以移除，收缩或以其它方式改变用于治疗的组织的结构。 在一个方面，硬脑膜和脊髓通过位于探针非活动侧的绝缘体与电能绝缘。 在另一方面，通过将导电流体输送到探针的远端部分并从返回电极附近的位置抽吸流体，在导电流体中积极地形成等离子体。 在另一方面，电外科探头的远端在偏置的弯曲的，弯曲的或可操纵的轴上具有至少一个电极，被引导或转向具有盘缺损的椎间盘内的靶部位，用于治疗待治疗的组织 在目标地点通过选择性地施加电能。
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