U.S. patent application number 09/728383 was filed with the patent office on 2002-06-06 for microlarynx electrosurgical probe for treating tissue.
Invention is credited to Ellman, Alan G., Garito, Jon C..
Application Number | 20020068933 09/728383 |
Document ID | / |
Family ID | 24926625 |
Filed Date | 2002-06-06 |
United States Patent
Application |
20020068933 |
Kind Code |
A1 |
Ellman, Alan G. ; et
al. |
June 6, 2002 |
Microlarynx electrosurgical probe for treating tissue
Abstract
A unipolar electrosurgical instrument that is configured for use
in MIS and other electrosurgical procedures, primarily for the
treatment of benign and malignant lesions of the upper
aerodigestive tract. The instrument is configured to cooperate with
the cannula of a laryngo-pharyngoscopes. The shape includes a short
proximal section at an angle to a long middle section which leads
to an offset working end containing a unipolar electrode. When
energized, a unipolar discharge is generated at the working end of
the electrode.
Inventors: |
Ellman, Alan G.; (Hewlett,
NY) ; Garito, Jon C.; (Hewlett, NY) |
Correspondence
Address: |
JACK OISHER, ESQ.
200 HIGH POINT ROAD-PH2
HARTSDALE
NY
10530
US
|
Family ID: |
24926625 |
Appl. No.: |
09/728383 |
Filed: |
December 4, 2000 |
Current U.S.
Class: |
606/41 ;
606/49 |
Current CPC
Class: |
A61B 2018/1253 20130101;
A61B 2018/00482 20130101; A61B 18/1402 20130101; A61B 2018/00327
20130101 |
Class at
Publication: |
606/41 ;
606/49 |
International
Class: |
A61B 018/14 |
Claims
What is claimed is:
1. A microlarynx electrosurgical probe for treating tissue,
comprising: (a) an elongated member having a major longitudinal
axis and having a proximal first end and a distal second end
comprising an active electrode, (b) said distal end comprising a
bare active electrosurgical electrode, (c) said elongated member
being constructed so as to allow the passage of electrosurgical
currents between its proximal and distal ends, (d) said distal end
including an offset section adjacent and leading to the active
electrode, (e) wherein electrosurgical currents applied to the
proximal end when an electrosurgical voltage is applied thereto
will reach and activate the active end.
2. The electrosurgical probe as claimed in claim 1, wherein the
section of the probe adjacent to the first end is angled in one
direction with respect to the longitudinal axis, and the offset
section is angled in a direction opposite to the one direction with
respect to the longitudinal axis.
3. The electrosurgical probe as claimed in claim 2, wherein the
probe comprises, starting from the proximal end, a bare shank, a
first electrically-insulating section, a second
electrically-insulating section, a third section, a fourth section,
and a fifth section leading to the active electrode.
4. The electrosurgical probe as claimed in claim 3, wherein the
angled probe section that is adjacent to the first end comprises
the bare shank and the first electrically-insulating section.
5. The electrosurgical probe as claimed in claim 4, wherein the
second, third, and fifth sections extend parallel to the axis.
6. The electrosurgical probe as claimed in claim 5, wherein the
fourth section is the offset section.
7. The electrosurgical probe as claimed in claim 4, wherein the
angled probe section is angled between about 40-50.degree. to the
axis.
8. The electrosurgical probe as claimed in claim 6, wherein the
fourth section is offset at an angle between about 145-165.degree.
to the axis.
9. The electrosurgical probe as claimed in claim 5, wherein the
overall axial length of the first and second sections is about 240
mm.
10. The electrosurgical probe as claimed in claim 9, wherein the
fifth section is about the same length as or shorter than the
fourth section, and the fourth section is shorter than the third
section.
11. The electrosurgical probe as claimed in claim 9, wherein the
fifth, fourth, and third sections are bare.
13. An electrosurgical system for treating ailments or diseases of
the larynx, comprising: (a) a laryngo-pharyngoscope, (b) an
electrosurgical probe for cooperating with the
laryngo-pharyngoscope, (c) said electrosurgical probe comprising:
(i) a handle, (ii) an elongated member connected to the handle and
having a major longitudinal axis and having a proximal first end
and a distal second end comprising an active electrode, (iii) said
distal end comprising a bare active electrosurgical electrode, (iv)
said elongated member being constructed so as to allow the passage
of electrosurgical currents between its proximal and distal ends,
(v) said distal end including an offset section adjacent and
leading to the active electrode, (vi) said elongated member being
sized to engage the laryngo-pharyngoscope such that the handle is
accessible at one end and the offset section and active electrode
project beyond the laryngo-pharyngoscope at the opposite end, (vii)
wherein when electrosurgical voltages are applied to the handle and
from the handle to the proximal end electrosurgical currents will
reach and activate the active end.
Description
[0001] This invention relates to a microlarynx electrosurgical
probe for treating ailments or diseases of the larynx.
BACKGROUND OF THE INVENTION
[0002] Our prior patent, U.S. Pat. No. 5,505,728, whose contents
are incorporated herein by reference, describes a novel
electrosurgical electrode for ablating or shrinking palatopharynx
throat tissue in a surgical procedure. This is accomplished by an
electrosurgical electrode activated by electrosurgical currents
that is applied by the surgeon to the patient.
[0003] There is a need in the art for devices to simplify the
treatment of benign and malignant lesions of the upper
aerodigestive tract. These include, among others, lesions,
laryngomalacia,--cysts, laryngocele, hemangioma, stenosis, nodules,
polyps, tumors, etc.
[0004] Laser have been used for such purposes in a minimally
invasive surgery (MIS) procedure but has disadvantages, which
include, but are not limited to: the radiation can be dangerously
reflected by shiny metallic surfaces, requiring the use of
non-reflective laryngo-pharyngoscopes made of special plastic which
are expensive instead of the standard stainless steel
laryngo-pharyngoscopes, and limiting the use of reflecting
instruments; laser beam scatter may cause skin burns, fire or the
generation of toxic products; problems may arise if the laser beam
impinges on the endotracheal tube; safety measures are necessary
such as warning lights, safety glasses, and laser safety courses
are required.
SUMMARY OF THE INVENTION
[0005] An object of the invention is an improved microlarynx
electrosurgical probe for treating tissue.
[0006] Another object of the invention is an improved microlarynx
electrosurgical probe for treating tissue that can use a standard
operating room laryngo-pharyngoscope.
[0007] Still another object of the invention is an improved
microlarynx electrosurgical probe for treating tissue that avoids
the use of laser radiation.
[0008] In accordance with a feature of the invention, a microlarynx
electrosurgical probe comprises an elongated shaft configured such
that it can be fitted down a standard operating room
laryngo-pharyngoscope and allows the surgeon to conduct the
procedure with improved visualization of the surgical site.
[0009] In a preferred embodiment, the elongated probe comprises at
its proximal end a bare shank for fitting into a standard
electrosurgical handpiece or its equivalent, and at its distal end
an offset section leading to the active electrode, which may be,
for example, a conventional ball, wire, needle, or loop. By
"proximal" is meant the end closest to the handpiece, and by
"distal" is meant the end furthest from the handpiece.
[0010] The construction of the invention will provide the same
important benefits not only for MIS of lesions of the upper
aerodigestive tract but also for other MIS arthroscopic procedures
where the novel electrode configuration may be of importance, as
well as for general electrosurgical procedures where the volumetric
reduction of tissue or ablation of tissue is desirable.
[0011] The various features of novelty which characterize the
invention are pointed out with particularity in the claims annexed
to and forming a part of this disclosure. For a better
understanding of the invention, its operating advantages and
specific objects attained by its use, reference should be had to
the accompanying drawings and descriptive matter in which there are
illustrated and described the preferred embodiments of the
invention, like reference numerals designating the same or similar
elements.
BRIEF DESCRIPTION OF THE DRAWINGS
[0012] In the drawings:
[0013] FIG. 1 is a schematic view of a microlarynx electrosurgical
probe according to the invention mounted in a handle or handpiece
connected to electrosurgical apparatus;
[0014] FIGS. 2, 3, and 4 are, respectively, side and perspective
views of one form of microlarynx electrosurgical probe according to
the invention but with different active electrodes;
[0015] FIG. 5 is a schematic view of the probe of FIG. 2 shown in
use with a patient.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0016] The reader is directed to the referenced prior patent for a
more detailed description of electrosurgical procedures and
principles of operation which will assist in understanding the
invention described in the present application.
[0017] In the present application, FIG. 1 is a generally schematic
side view of one form of electrosurgical instrument 10 in
accordance with the invention. It comprises a handle 12 with a
conventional front end 14 adapted to receive and hold rigidly the
shank end (not shown in FIG. 1) of an elongated electrode or probe
16 whose working end 18 is shown at the distal end. The handle 12
is typically electrically-insulating or if conductive covered with
an electrically-insulating coating. Similarly, the entire electrode
elongated shaft 20 except for the bare shank end, is also coated
with an electrically-insulating coating, leaving bare the active
electrode 24 at the working end 18. The shaft 20 is long enough to
extend through the trocar or channel of a standard stainless steel
laryngo-pharyngoscope so that its working end 18 is exposed inside
the patient's throat. At the left end of the handle 12 is shown a
cable 26 which contains wires for receiving unipolar
electrosurgical currents from a conventional electrosurgical
apparatus 28. The electrosurgical apparatus preferably is an ultra
high frequency (RF) radiosurgical energy source, which operates in
the range of about 3.8-4.0 MHz. Studies have shown that the 3.8-4.0
MHz frequency range is the preferred RF energy to incise and
coagulate tissue because tissue thermal necrosis is minimal and,
when interfaced with the electrosurgical electrode of the
invention, provides excellent cutting and hemostasis especially for
throat procedures. An example of suitable electrosurgical apparatus
is the Model SURGITRON Dual-Frequency electrosurgical unit
manufactured by and available from Ellman International, Inc. of
Hewlett, N.Y.
[0018] FIGS. 2-4 illustrate three embodiments of the invention
which differ only in the shape of the active electrode end. In FIG.
2 the active end is a needle or pointed wire 30. In FIG. 3 the
active end is a ball 32. In FIG. 3 the active end is a loop 24,
also as shown in FIG. 1.
[0019] The shape or configuration of the electrode 16 is
significant. As will be observed, the shank 36 at the left or
proximal end is bare and extends into a first
electrically-insulated section 38--which is about 1 inch long,
referenced 72, preferably about 0.75-1.25 inches long--that extends
at an angle 40 of about 45.degree., preferably about 40-50.degree.,
with respect to the longitudinal or long axis 42 of the adjacent
second electrically-insulated section 44,--which is about 8.75
inches long, referenced 74 preferably about 8-9.25 inches long--.
The second section 44 terminates in a thinner third section
46--which is about 0.25 inches long, referenced 80, preferably
about 0.1.-0.33 inches long--, axially aligned with the axis 42,
which leads into a fourth section 48--which is about 0.125 inches
long, referenced 82, preferably about 0.1-0.3 inches long--that is
offset at an angle 50 of about 155.degree., referenced 50,
preferably about 145-165.degree. but angles in the opposite
direction from that of the first section 38. The whole electrode is
in the same plane, that of the drawing. So, where the first section
38 extends downward from the axis 42, then the fourth section 48
extends upward away from the axis 42. After a short distance, the
fourth section 48 leads into a fifth section 52--which is about
0.125 inches long, referenced 84, preferably about 0.1-0.3 inches
long--which extends approximately parallel to the axis 42 and
finally leads into the active electrode end 24, 30, 32. The third
46, fourth 48, and fifth 52 sections may all remain bare or may be
covered if desired, since the ablation action occurs at the active
electrode. The overall length, measured parallel to the axis 42
from the beginning or proximal end of the first section 38 to the
distal end of the second section 44 is about 9.5 inches or 240 mm,
which can vary about 10% in length. The significance of this
configuration will be easier to understand from FIG. 5 which
illustrates a typical use.
[0020] A patient 60, with his mouth 62 open, lies on a table or
sits in a chair. The superstructure 63 is used to support a
standard laryngo-pharyngoscope 64 which includes a scope and light
whose electrical cord 66 is shown. The surgeon 68 is peering
through a microscope 70 through which he or she can view the
surgical site at the larynx of the patient. His left hand holds the
instrument of FIG. 1 by the handle 12. The cable 26 and
electrosurgical apparatus 28 are not shown in this view. The fourth
electrode section 44 extends down through a channel (not shown) in
the laryngo-pharyngoscope 64 with the active end exposed inside the
throat of the patient and available for ablation or coagulation.
The surgeon can thus manipulate the handle 12 and thus the active
electrode end 24 as desired. The offset fourth section 48 increases
the visibility of the active end to the surgeon who is using the
scope to view the surgical site and the active electrode while
conducting the procedure. The bent first section 38 allows the
surgeon to hold the instrument 10 in an approximately horizontal
position that he or she is accustomed to with other MIS instruments
yet be capable of manipulating the active working end as needed.
The overall length allows sufficient tolerance for moving the probe
electrode longitudinally as needed for the procedure.
[0021] In this description, by "axial" is meant parallel to the
long axis 42 of the electrode (horizontal in FIGS. 2-4). By
"lateral" is meant transverse to the long axis 42. "Offset" is
intended to include lateral directions as well as acute angles with
respect to the long axis 42.
[0022] Once the surgeon has positioned the working end 18 of the
instrument with respect to the tissue to be operated on, he or she
then activates the electrosurgical apparatus 28 causing a discharge
of unipolar currents between a ground plate (not shown) and the
bare electrode 24, 30, 32 capable of causing excision or ablation
or shrinkage of tissue or cauterization of a blood vessel in the
usual way. As with the embodiments of the prior patent, the
insulating coatings on the electrode 16 will prevent accidental
touching of patient tissue by the electrode sides, so that the
unipolar discharge is localized to the region surrounding the
working end 24, 30, 32. The operation can take place in a dry or
wet field. The surgeon positions the electrodes 24, 30, 32 so as to
touch or pass lightly over the tissue to be modulated as needed for
the procedure being followed.
[0023] For example, a suitable metal for the electrodes is brass or
stainless steel. A suitable thickness of the electrode 16 is about
0.125 inches.
[0024] The benefits of the invention include: the use of a standard
operating room (OR) laryngo-pharyngoscopes; no laser beam scatter
can cause skin burns, fire or the generation of toxic products; the
surgeon need not be concerned about a laser beam hitting an
endotracheal tube which may ignite and possibly threaten a
patient's life; special laser safety measures are unnecessary such
as warning lights, safety glasses, and safety courses; clinically,
the thermal alteration from radio frequency energy is less than
that of laser energy; radiosurgery with the RF microlaryngeal probe
of the invention minimizes thermal damage and penetration is
negligible with radio frequency energy.
[0025] While the invention has been described in connection with
preferred embodiments, it will be understood that modifications
thereof within the principles outlined above will be evident to
those skilled in the art and thus the invention is not limited to
the preferred embodiments but is intended to encompass such
modifications.
* * * * *