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1.发明授权Electrosurgical ablation and aspiration apparatus having flow directing feature and methods related thereto 有权电外科消融和抽吸装置具有流动特征和与之相关的方法公开(公告)号：US06949096B2
公开(公告)日：2005-09-27
申请号：US10264308
申请日：2003-01-21
IPC分类号： A61B18/14
CPC分类号： A61B18/14 , A61B18/148 , A61B2018/00583 , A61B2018/1407 , A61B2018/1467 , A61B2018/1472 , A61B2218/007
摘要： Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site of a patient. An electrosurgical apparatus of the invention includes an active electrode assembly having an active electrode screen surrounded by a plurality of flow protectors. Each flow protector defines a shielded region of the active electrode screen, each shielded region of the screen characterized by enhanced plasma formation. The active electrode assembly is adapted for removing tissue from a surgical site, and the active electrode screen is adapted for digesting fragments of resected tissue. In one embodiment, the apparatus is particularly suited to simultaneously removing both hard and soft tissue in, or around, a joint.
摘要翻译： 用于从患者的靶位点受控消融组织的电外科手术方法，系统和装置。 本发明的电外科设备包括一个有源电极组件，它具有由多个流动保护器包围的有源电极屏幕。 每个流动保护器限定有源电极屏幕的屏蔽区域，屏幕的每个屏蔽区域的特征在于增强的等离子体形成。 活性电极组件适于从手术部位去除组织，并且活性电极屏适于消化切除的组织的碎片。 在一个实施例中，该装置特别适用于同时去除关节内或周围的硬组织和软组织。
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公开(公告)号：US06589237B2
公开(公告)日：2003-07-08
申请号：US09766168
申请日：2001-01-19
申请人： Jean Woloszko , Theodore C. Ormsby , Christopher L. Willink , Terry S. Davison , Steve Masterson
发明人： Jean Woloszko , Theodore C. Ormsby , Christopher L. Willink , Terry S. Davison , Steve Masterson
IPC分类号： A61B1814
CPC分类号： A61B18/1206 , A61B18/1402 , 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 , A61B2018/00291 , A61B2018/00327 , A61B2018/00392 , A61B2018/00505 , A61B2018/00577 , A61B2018/00583 , A61B2018/00601 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/0072 , A61B2018/00726 , A61B2018/00779 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007
摘要： Electrosurgical methods and apparatus for removing tissue from a target site of a patient. An electrosurgical suction apparatus includes an aspiration channel in communication with a distal aspiration port, and an electrode support having a plurality of active electrodes disposed thereon, the plurality of active electrodes spanning the aspiration port. Each of the plurality of active electrodes is adapted for removing tissue from a target site to form low molecular weight ablation by-products. Each of the plurality of active electrodes is also adapted for digesting resected tissue fragments to yield low molecular weight ablation by-products. Ablation by-products and resected tissue fragments are readily removed from the target site via an aspiration stream flowing proximally through the aspiration channel. In one embodiment, each of a plurality of active electrodes protrude in different directions from a beveled treatment surface of the electrode support, and each of the plurality of active electrodes extend from the beveled treatment surface by substantially the same orthogonal distance.
摘要翻译： 用于从患者的目标部位去除组织的电外科手术方法和装置。 电外科抽吸装置包括与远端抽吸端口连通的抽吸通道，以及电极支撑件，其具有设置在其上的多个有效电极，所述多个活性电极跨越抽吸端口。 多个有效电极中的每一个适于从目标部位去除组织以形成低分子量消融副产物。 多个活性电极中的每一个也适于消化切除的组织片段以产生低分子量消融副产物。 消融副产物和切除的组织碎片容易地通过向近侧流过抽吸通道的抽吸流从目标部位去除。 在一个实施例中，多个有源电极中的每一个从电极支撑件的斜面处理表面沿不同方向突出，并且多个有效电极中的每一个从斜面处理表面延伸大致相同的正交距离。
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公开(公告)号：US06746447B2
公开(公告)日：2004-06-08
申请号：US09836940
申请日：2001-04-17
IPC分类号： A61B1814
CPC分类号： A61B18/1206 , A61B18/1402 , 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 , A61B2018/00291 , A61B2018/00327 , A61B2018/00392 , A61B2018/00505 , A61B2018/00577 , A61B2018/00583 , A61B2018/00601 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/0072 , A61B2018/00726 , A61B2018/00779 , A61B2018/00791 , A61B2018/00827 , A61B2018/00875 , A61B2018/00982 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1407 , A61B2018/1467 , A61B2018/1472 , A61B2018/162 , A61B2018/165 , A61B2218/002 , A61B2218/007
摘要： Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site of a patient. An electrosurgical instrument includes a working portion having a plurality of working zones differentiated according to their relative rates of aspiration and ablation. The instrument further includes an aspiration channel in communication with a plurality of aspiration ports, and a plurality of active electrodes disposed on the working portion. Each of the plurality of working zones may have at least one of the plurality of active electrodes and at least one of the plurality of aspiration ports. The aspiration rate of each working zone is dependent, inter alia, on the number, size, and distribution of the aspiration ports on that zone. In one embodiment, the ablation rate of a working zone is inversely related to the aspiration rate of that zone. Each of the plurality of active electrodes is adapted for ablating tissue to form low molecular weight ablation by-products. The ablation by-products may be aspirated from the target site via aspiration port(s) on one or more of the plurality of working zones.
摘要翻译： 用于从患者的目标部位受控消融组织的电外科手术方法，系统和装置。 电外科器械包括具有根据其相对吸气和消融速率而区分的多个工作区的工作部分。 仪器还包括与多个抽吸端口连通的抽吸通道和设置在工作部分上的多个有效电极。 多个工作区域中的每一个可以具有多个有效电极中的至少一个和多个抽吸端口中的至少一个。 每个工作区域的抽吸率尤其取决于该区域的抽吸口的数量，大小和分布。 在一个实施例中，工作区域的消融速率与该区域的吸气速率成反比。 多个有效电极中的每一个适于消融组织以形成低分子量消融副产物。 消融副产物可以通过多个工作区中的一个或多个上的抽吸端口从目标部位吸出。
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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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6.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：US20100318083A1
公开(公告)日：2010-12-16
申请号：US12845283
申请日：2010-07-28
申请人： Terry S. Davison , Brian Warne , Martin Kwende
发明人： Terry S. Davison , Brian Warne , Martin Kwende
IPC分类号： A61B18/12
CPC分类号： A61B18/1402 , A61B2018/00452 , A61B2018/1213 , A61B2018/1472 , A61B2218/007
摘要： An electrosurgical method for sterilizing chronic wound tissue, comprising: positioning an active electrode in proximity to the chronic wound tissue; delivering an electrically conductive fluid proximate the active electrode; and applying a high frequency voltage between the active electrode and a return electrode in the presence of the electrically conductive liquid sufficient to generate an ionized vapor layer at the active electrode, wherein the ionized vapor layer sterilizes at least a portion of the chronic wound tissue.
摘要翻译： 一种用于消毒慢性伤口组织的电外科手术方法，包括：将活性电极定位在所述慢性伤口组织附近; 在所述有源电极附近传送导电流体; 以及在所述导电液体存在下，在所述有源电极和返回电极之间施加高频电压，所述导电液体足以在所述有源电极处产生电离蒸气层，其中所述电离蒸汽层对所述慢性伤口组织的至少一部分进行灭菌。
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公开(公告)号：US07691101B2
公开(公告)日：2010-04-06
申请号：US11327089
申请日：2006-01-06
申请人： Terry S. Davison , Brian Warne
发明人： Terry S. Davison , Brian Warne
IPC分类号： A61B18/18
CPC分类号： A61B18/1402 , A61B2018/00452 , A61B2018/1213 , A61B2018/1472 , A61B2218/007
摘要： An electrosurgical method for treating foot ulcer, including diabetic foot ulcer, comprising: positioning an active electrode in close proximity to the ulcer, the active electrode being disposed on a distal end of an electrosurgical shaft; applying a high-frequency voltage potential difference across the active electrode and a return electrode in the presence of an electrically conductive fluid, the voltage potential being sufficient to generate plasma at the active electrode; and stimulating the ulcer with the active electrode to increase blood flow, remove unhealthy tissue and induce the body's natural healing response.
摘要翻译： 一种用于治疗足部溃疡（包括糖尿病足溃疡）的电外科手术方法，包括：将活性电极定位在所述溃疡附近，所述活性电极设置在电外科轴的远端; 在存在导电流体的情况下在有源电极和返回电极两端施加高频电压电位差，该电压电位足以在有源电极处产生等离子体; 并用活性电极刺激溃疡，增加血流量，去除不健康的组织，诱导人体的自然愈合反应。
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公开(公告)号：US20090216227A1
公开(公告)日：2009-08-27
申请号：US12435581
申请日：2009-05-05
申请人： Terry S. Davison , Brian Warne
发明人： Terry S. Davison , Brian Warne
IPC分类号： A61B18/14
CPC分类号： A61B18/1402 , A61B2018/00452 , A61B2018/1213 , A61B2018/1472 , A61B2218/007
摘要： An electrosurgical method for treating foot ulcer, including diabetic foot ulcer, comprising: positioning an active electrode in close proximity to the ulcer, the active electrode being disposed on a distal end of an electrosurgical shaft; applying a high-frequency voltage potential difference across the active electrode and a return electrode in the presence of an electrically conductive fluid, the voltage potential being sufficient to generate plasma at the active electrode; and stimulating the ulcer with the active electrode to increase blood flow, remove unhealthy tissue and induce the body's natural healing response.
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公开(公告)号：US06500173B2
公开(公告)日：2002-12-31
申请号：US09860662
申请日：2001-05-18
IPC分类号： A61B1814
CPC分类号： A61B18/12 , A61B18/1206 , A61B18/14 , A61B18/1402 , A61B18/148 , A61B18/1482 , A61B18/1485 , A61B18/149 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2017/00097 , A61B2017/00101 , A61B2017/00247 , A61B2017/00292 , A61B2017/003 , A61B2017/22001 , A61B2017/22038 , A61B2018/00029 , A61B2018/0016 , A61B2018/00196 , A61B2018/00392 , A61B2018/00434 , A61B2018/00577 , A61B2018/00583 , A61B2018/00642 , A61B2018/0066 , A61B2018/00678 , A61B2018/00726 , A61B2018/00761 , A61B2018/00791 , A61B2018/00797 , A61B2018/00821 , A61B2018/00827 , A61B2018/00875 , A61B2018/00886 , A61B2018/1213 , A61B2018/124 , A61B2018/1253 , A61B2018/126 , A61B2018/1273 , A61B2018/1467 , A61B2018/1472 , A61B2018/1497 , A61B2018/162 , A61B2090/378 , A61B2218/002 , A61B2218/007 , A61F2/2493 , A61M25/0133 , A61M25/0147 , A61M25/0158
摘要： The present invention provides systems and methods for selectively applying electrical energy to a target location within of a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove, contract or otherwise modify the structure of tissue structures. In one aspect of the invention, a method is provided for treating herniated discs within a patient's spine by applying sufficient electrical energy to the disc tissue to reduce a volume of the disc, thereby relieving pressure on a spinal nerve. In one embodiment, the high frequency voltage is sufficient to ablate a portion of the nucleus pulposis, either the extruded portion outside of the annulus or a portion or all of the pulposis within the annulus. In another embodiment, the electrode terminal is advanced into the annulus and sufficient high frequency voltage is applied to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.
摘要翻译： 本发明提供了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系统和方法。 本发明在存在导电流体的情况下将高频（RF）电能应用于一个或多个电极端子，以去除，收缩或以其它方式改变组织结构的结构。 在本发明的一个方面，提供了一种通过向椎间盘组织施加足够的电能来减轻椎间盘的体积来治疗脊柱神经的压力来治疗患者脊柱内的椎间盘突出的方法。 在一个实施例中，高频电压足以消融髓核的一部分，环形空间之外的挤出部分或瓣环内部的一部分或全部髓介素。 在另一个实施例中，电极端子进入环形空间，施加足够的高频电压以收缩或收缩髓核内的胶原纤维。 这导致骨髓收缩并退出脊髓神经上的冲击。
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