Systems and methods for electrosurgical treatment of fasciitis

Abstract

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.

1 . An electrosurgical method of treating fasciitis, comprising: 
 positioning an active electrode in close proximity to a target fascia, the active electrode disposed on a distal end of a shaft; and    applying a high frequency voltage across the active electrode and a return electrode, the high frequency voltage sufficient to facilitate healing of the fascia.    
     
     
         2 . The method of  claim 1 , wherein the fascia comprises plantar fascia.  
     
     
         3 . The method of  claim 1 , wherein an electrically conductive fluid is present between the active electrode and the fascia.  
     
     
         4 . The method of  claim 3 , wherein the electrically conductive fluid comprises an electrically conductive path between the active electrode and the return electrode.  
     
     
         5 . The method of  claim 3 , wherein the electrically conductive fluid comprises isotonic saline, and body fluid.  
     
     
         6 . The method of  claim 1 , wherein the high frequency voltage is sufficient to generate plasma at the active electrode.  
     
     
         7 . The method of  claim 1 , where the high frequency voltage is sufficient to increase fascia blood flow.  
     
     
         8 . The method of  claim 1 , wherein the high frequency voltage is sufficient to regenerate fascia tissue.  
     
     
         9 . The method of  claim 1 , wherein the high frequency voltage is sufficient to cause volumetric removal of fascia tissue.  
     
     
         10 . The method of  claim 9 , wherein the volumetric removal of tissue is by molecular dissociation of fascia tissue.  
     
     
         11 . The method of  claim 1 , wherein the return electrode is prevented from contacting the fascia.  
     
     
         12 . The method of  claim 1 , wherein the return electrode is located on the shaft proximally to the active electrode.  
     
     
         13 . The method of  claim 1 , including forming voids in the fascia with the active electrode.  
     
     
         14 . The method of  claim 13 , wherein the voids are up to about 0.5 mm deep.  
     
     
         15 . The method of  claim 13 , wherein the voids are up to about 5 mm deep.  
     
     
         16 . The method of  claim 13 , wherein the diameter of voids are from about 0.5 mm to 3 mm.  
     
     
         17 . The method of  claim 13 , wherein the diameter of the voids are from about 1 mm to 2 mm.  
     
     
         18 . The method of  claim 13 , wherein the voids are spaced apart at approximately 5 mm intervals.  
     
     
         19 . The method of  claim 1 , wherein the high frequency voltage is applied intermittingly to fascia tissue for about 0.5 second duration.  
     
     
         20 . The method of  claim 1 , wherein the active electrode comprised a pointed tip.  
     
     
         21 . The method of  claim 1 , wherein the active electrode is connected to a voltage regulator.  
     
     
         22 . The method of  claim 3 , wherein the conductive fluid is provided by a fluid delivery lumen on the shaft.  
     
     
         23 . An electrosurgical method of stimulating the wound healing response in fascia, comprising: 
 energizing an active electrode with a high frequency voltage, the active electrode disposed on the distal end of a shaft; and    transferring energy from the active electrode to the fascia sufficient to induce a healing response.    
     
     
         24 . The method of  claim 23 , wherein the soft tissue comprises plantar fascia.  
     
     
         25 . The method of  claim 23 , wherein the sufficient energy is transferred to stimulate collagen growth in the fascia.  
     
     
         26 . The method of  claim 23 , wherein the sufficient energy is transferred from the fascia to form voids in the fascia.  
     
     
         27 . The method of  claim 23 , wherein sufficient energy is transferred to heat the fascia.  
     
     
         28 . The method of  claim 23 , wherein sufficient energy is transferred to volumetrically remove a portion of the fascia tissue.  
     
     
         29 . The method of  claim 23 , wherein sufficient energy is transferred to damage the fascia and promote a neovascular response.  
     
     
         30 . The method of  claim 23 , wherein the high frequency voltage is applied across the active electrode and a return electrode disposed on the shaft.  
     
     
         31 . The method of  claim 23 , wherein an electrically conductive fluid is present between the active electrode and the fascia.  
     
     
         32 . The method of  claim 31 , wherein the electrically conductive fluid comprises an electrically conductive path between the active and return electrode.  
     
     
         33 . The method of  claim 28 , wherein volumetric removal of fascia tissue is plasma-induced.