Surgical instrument for ablation and aspiration

Abstract

An electrosurgical aspiration instrument that permits aspiration of an area being treated by the instrument. The instrument is coupled at a proximal end to a power source and includes an energy application surface area at a distal end. The power source supplied energy to the energy application surface area such that the distal end of the instrument may apply energy to the treatment area to modify the characteristics of biological material, such as biological tissue in the area. An aspiration lumen is formed through the instrument with an opening through the energy application surface area. The energy application surface area is configured to reduce blockage of the opening. Accordingly, aspiration may be performed simultaneously with electrosurgical treatment whereby unwanted matter such as by-products, biological debris and excess fluid is removed from the treatment area. The electrosurgical aspiration instrument also permits both functions to be performed at different times, with the advantage of not requiring instruments to be switched on during the treatment procedure or removed from the treatment site.

1 - 40 . (Cancelled)  
     
     
         41 . A surgical instrument comprising: 
 a shaft having distal and proximal ends, the shaft defining a lumen;    a conductive member disposed at the distal end of the shaft across the lumen and forming an electrode, the conductive member having an opening therethrough communicating with the lumen for aspirating material through the conductive member, the opening being smaller than a diameter of the lumen to avoid clogging of aspirated material downstream of the opening, the conductive member having an ashtray shape; and    a conductor connected to the conductive member.    
     
     
         42 . The surgical instrument of  claim 41  further comprising: 
 a second electrode disposed on the shaft proximally from the electrode; and  
 a second conductor connected to the second electrode.  
 
     
     
         43 . The surgical instrument of  claim 42  wherein the second electrode is disposed around the shaft proximally from the electrode.  
     
     
         44 . The surgical instrument of  claim 41  wherein the electrode further comprises a sharp edge forming a mechanical treatment surface.  
     
     
         45 . The surgical instrument of  claim 41  wherein the electrode includes a mechanical treatment surface having an edge configured to form a high current density at the edge for an ablative effect along the edge.  
     
     
         46 . The surgical instrument of  claim 41  wherein the lumen has multiple diameters.  
     
     
         47 . A surgical instrument for use with a power source, the surgical instrument comprising: 
 a shaft having distal and proximal ends, the shaft defining a lumen;    a conductive member disposed at the distal end of the shaft across the lumen to define an energy application plane across the lumen and forming an electrode, the conductive member having an opening therethrough communicating with the lumen for aspirating material through the conductive member across the energy application plane, the opening being smaller than a diameter of the lumen to avoid clogging of aspirated material downstream of the opening, the electrode having an ashtray shape and having a mechanical treatment surface for the mechanical removal of tissue at a surgical site; and    a conductor connected to the conductive member and adapted for coupling to the power source.    
     
     
         48 . The surgical instrument of  claim 47  further comprising: 
 a second electrode disposed on the shaft proximally from the electrode; and  
 a second conductor connected to the second electrode.  
 
     
     
         49 . The surgical instrument of  claim 48  wherein the second electrode is disposed around the shaft proximally from the electrode.  
     
     
         50 . The surgical instrument of  claim 48  wherein one of the conductor and the second conductor is formed by the shaft.  
     
     
         51 . The surgical instrument of  claim 47  wherein the lumen has an insulative coating.  
     
     
         52 . The surgical instrument of  claim 47  further comprising a suction source coupled to the proximal end of the shaft for providing negative pressure to the lumen so as to cause matter to be aspirated through the opening of the conductive member.  
     
     
         53 . The surgical instrument of  claim 47  wherein the mechanical treatment surface is an edge, provided on the electrode, configured to form a high current density to provide an electrical and mechanical effect.  
     
     
         54 . The surgical instrument of  claim 47  wherein the mechanical treatment surface includes a sharp edge.  
     
     
         55 . The surgical instrument of  claim 47  wherein the electrode is concentrically disposed at the distal end of the shaft.  
     
     
         56 . The surgical instrument of  claim 47  wherein the proximal end of the shaft is mounted to a handle, the handle providing a connection for the conductor to a power supply and a connection for the lumen to a vacuum source.  
     
     
         57 . The surgical instrument of  claim 47  wherein the lumen has multiple diameters.  
     
     
         58 . A surgical device comprising: 
 an elongated shaft defining a lumen;    a first electrode coupled to the elongated shaft and forming a tissue treatment surface configured to treat tissue, the tissue treatment surface defining at least part of a lumen opening in communication with the lumen; and    a second electrode coupled to the elongated shaft and electrically isolated from the first electrode.    
     
     
         59 . The surgical device of  claim 58  wherein the second electrode comprises an exposed portion not disposed around an entirety of a circumference of the elongated shaft, the exposed portion being disposed entirely proximal of the first electrode, and the surgical device further comprises an insulator extending longitudinally along an entire side of the elongated shaft such that non-target tissue adjacent the insulator is insulated during electrosurgery.  
     
     
         60 . The surgical device of  claim 58  wherein the second electrode includes an exposed portion not disposed around an entirety of a circumference of the elongated shaft.  
     
     
         61 . The surgical device of  claim 58  further comprising an insulator extending longitudinally along an entire side of the elongated shaft such that non-target tissue adjacent the insulator is insulated during electrosurgery.  
     
     
         62 . The surgical device of  claim 58  wherein the first electrode defines the entire lumen opening.  
     
     
         63 . The surgical device of  claim 58  wherein the surgical device comprises a distal end, and the lumen opening is at the distal end.  
     
     
         64 . The surgical device of  claim 58  wherein: 
 the lumen has at least one diameter including a minimum lumen diameter, and  
 the lumen opening is smaller than the minimum lumen diameter to avoid clogging of aspirated material downstream of the lumen opening.  
 
     
     
         65 . The surgical device of  claim 60  wherein the second electrode is not disposed at all around the circumference of the elongated shaft.  
     
     
         66 . The surgical device of  claim 60  wherein the second electrode is disposed within the lumen.  
     
     
         67 . The surgical device of  claim 60  wherein the surgical device includes a front face and the second electrode is disposed on the front face.  
     
     
         68 . The surgical device of  claim 58  wherein the first and second electrodes each face toward a common direction.  
     
     
         69 . The surgical device of  claim 68  wherein the common direction is forward.  
     
     
         70 . The surgical device of  claim 58  wherein the first electrode is forward-facing.  
     
     
         71 . The surgical device of  claim 58  wherein the first and second electrodes are not disposed on opposite sides of the elongated shaft.  
     
     
         72 . The surgical device of  claim 58  wherein the device has only two electrodes.  
     
     
         73 . The surgical device of  claim 61  wherein the insulator comprises a thermal and electrical insulator.  
     
     
         74 . The surgical device of  claim 61  wherein the insulator is disposed over at least 45 degrees of a circumference of the elongated shaft.  
     
     
         75 . The surgical device of  claim 61  wherein the surgical device defines a return path for current that does not go under the insulator.  
     
     
         76 . The surgical device of  claim 58  wherein the first electrode comprises a scraping surface configured to scrape tissue.  
     
     
         77 . The surgical device of  claim 76  wherein the first electrode is configured in an ashtray configuration and the scraping surface comprises an edge in the ashtray configuration.  
     
     
         78 . The surgical device of  claim 58  wherein: 
 the elongated shaft defines a longitudinal axis and comprises a distal portion, and  
 the first electrode is coupled to the distal portion of the shaft and is configured to contact tissue straight-on along the longitudinal axis.  
 
     
     
         79 . The surgical device of  claim 58  wherein: 
 the first electrode is configured to provide radio frequency energy to ablate tissue, and  
 the second electrode is configured to operate in a bipolar mode with the first electrode.  
 
     
     
         80 . The surgical device of  claim 58  wherein the second electrode comprises an exposed portion that is disposed entirely proximal of the first electrode.  
     
     
         81 . The surgical device of  claim 58  wherein the entire second electrode is disposed proximal of the first electrode.  
     
     
         82 . A method of performing surgery, the method comprising: 
 applying electrical energy to a first electrode of a bipolar surgical device to perform electrosurgery on a target tissue, the first electrode being disposed on an elongated shaft of the bipolar device, the bipolar device further including a second electrode; and    transferring fluid through a lumen and a lumen opening of the surgical device, the lumen opening being in communication with the lumen and being defined at least in part by a tissue treatment surface formed by the first electrode.    
     
     
         83 . The method of  claim 82  wherein applying electrical energy comprises applying electrical energy to a first electrode of a bipolar surgical device in which the second electrode is not disposed around an entirety of a circumference of the elongated shaft.  
     
     
         84 . The method of  claim 83  further comprising providing an insulating surface extending longitudinally along an entire side of the elongated shaft, such that non-target tissue adjacent the insulating surface is shielded during the application of electrical energy to target tissue.  
     
     
         85 . The method of  claim 82  further comprising providing an insulating surface extending longitudinally along an entire side of the elongated shaft, such that non-target tissue adjacent the insulating surface is shielded during the application of electrical energy to target tissue.  
     
     
         86 . The method of  claim 85  wherein providing the insulating surface comprises providing a thermally and electrically insulating surface.  
     
     
         87 . The method of  claim 82  wherein applying electrical energy to perform electrosurgery comprises ablating the target tissue.  
     
     
         88 . The method of  claim 82  wherein transferring fluid through the lumen comprises aspirating fluid through the lumen.  
     
     
         89 . The method of  claim 82  further comprising scraping the target tissue using a scraping surface on the first electrode.  
     
     
         90 . The method of  claim 82  further comprising inserting the bipolar surgical device into a body such that the first electrode is adjacent the target tissue.  
     
     
         91 . A surgical device comprising: 
 an elongated shaft defining a lumen, and the surgical device defining a lumen opening in communication with the lumen, the lumen opening being smaller than a diameter of the lumen to avoid clogging of aspirated material downstream of the lumen opening;    a first electrode coupled to the elongated shaft; and    a second electrode coupled to the elongated shaft and electrically isolated from the first electrode.    
     
     
         92 . The surgical device of  claim 91  wherein the second electrode is not disposed around an entirety of a circumference of the elongated shaft.  
     
     
         93 . The surgical device of  claim 91  further comprising an insulator extending longitudinally along an entire side of the elongated shaft such that non-target tissue adjacent the insulator is insulated during electrosurgery.  
     
     
         94 . The surgical device of  claim 58  wherein the lumen has multiple diameters.