US-12622740-B2 - Electrosurgical device with knife edge

Abstract

An electrosurgical device for treating tissue have a sharp forming a distal end thereof. The electrosurgical device can include two or more electrodes spaced from the sharp that can each reciprocate. Other arrangements for the two or more electrodes such as those that do not reciprocate but are held stator relative to the sharp are contemplated.

Inventors

• Aaron GERMAIN

Assignees

• RELIGN Corporation

Dates

Publication Date

20260512

Application Date

20230524

Claims (19)

1. 1 . A probe for an electrosurgical device for treating tissue, the probe comprising: a tip having a sharp at a distal most end thereof, a first electrode adjacent the sharp on a first side thereof, and a second electrode adjacent the sharp on a second side thereof, wherein the first electrode is spaced from the second electrode; wherein the sharp comprises an edge and the tip includes a first distal face extending laterally and longitudinally from the edge and a second distal face extending laterally and longitudinally from the edge, wherein the first distal face includes a first aperture receiving the first electrode and the second distal face includes a second aperture receiving the second electrode; wherein the first electrode and the second electrode are configured to reciprocate relative to the tip to selectively move between a first configuration where a distal end of first electrode is distal of the sharp and a distal end of the second electrode is proximal of the sharp and a second configuration where the distal end of the first electrode is proximal of the sharp and the distal end of the second electrode is distal of the sharp.
2. 2 . The probe of claim 1 , wherein at least one of the first distal face or the second distal face includes at least a port configured for vacuum aspiration of fluid including tissue debris from adjacent the tip.
3. 3 . The probe of claim 2 , further comprising an elongate outer shaft having a proximal end, a distal end and defining one or more passages extending therein from the proximal end to the distal end, wherein the tip is coupled to or forms the distal end of the outer shaft.
4. 4 . The probe of claim 3 , wherein at least one of the one or more passages is in fluid communication with the port.
5. 5 . The probe of claim 1 , wherein the first electrode is spaced from the second electrode by between 0.02 inches and 0.08 inches, inclusive.
6. 6 . The probe of claim 1 , wherein the tip is an electrically non-conductive material.
7. 7 . The probe of claim 6 , wherein the tip is a ceramic or ceramic composite and wherein the sharp is one of an edge or point.
8. 8 . The probe of claim 1 , wherein the first electrode and the second electrode are tungsten or an alloy containing tungsten.
9. 9 . The probe of claim 1 , wherein the first electrode and the second electrode have a diameter of between 0.01 inches and 0.02 inches, inclusive.
10. 10 . The probe of claim 1 , wherein the distal end of the first electrode and the second electrode is moved distal of the sharp by between 0.001 inches and 0.25 inches, inclusive.
11. 11 . The probe of claim 1 , further comprising an illumination device adjacent the tip.
12. 12 . The probe of claim 1 , further comprising a cam mechanism and a linkage arm, wherein the cam mechanism is coupled to one of the first electrode and the second electrode and the linkage arm is coupled to both the first electrode and the second electrode.
13. 13 . The probe of claim 1 , further comprising a handle, wherein the probe is configured to couple with the handle.
14. 14 . The probe of claim 1 , wherein the probe is configured with an electrosurgical coagulation mode that halts reciprocation of the first electrode and the second electrode and positions the first electrode and the second electrode in a substantially stationary arrangement adjacent the sharp.
15. 15 . The probe of claim 14 , wherein in the electrosurgical coagulation mode a distal end of the first electrode and a distal end of the second electrode are substantially flush with a tip of the sharp.
16. 16 . The probe of claim 1 , the first electrode serves as a first polarity electrode and the second electrode serves as a second polarity electrode of a bipolar electrode pair, wherein the probe is configured for electrosurgical resection and electrosurgical coagulation of the tissue.
17. 17 . The probe of claim 16 , wherein at least one of the first electrode and the second electrode is in selective contact with the tissue at any point during the treating of the tissue.
18. 18 . A probe for an electrosurgical device for treating tissue, the probe comprising: a tip having a sharp at a distal most end thereof; a first electrode adjacent the sharp on a first side thereof; a second electrode adjacent the sharp on a second side thereof, wherein the first electrode is spaced from the second electrode; and a cam mechanism and a linkage arm, wherein the cam mechanism is coupled to one of the first electrode and the second electrode and the linkage arm is coupled to both the first electrode and the second electrode; wherein the first electrode and the second electrode are configured to reciprocate relative to the tip to selectively move between a first configuration where a distal end of first electrode is distal of the sharp and a distal end of the second electrode is proximal of the sharp and a second configuration where the distal end of the first electrode is proximal of the sharp and the distal end of the second electrode is distal of the sharp; and wherein the cam mechanism includes a surface with undulations.
19. 19 . A probe for an electrosurgical device for treating tissue, the probe comprising: a tip having a sharp at a distal most end thereof; a first electrode adjacent the sharp on a first side thereof; and a second electrode adjacent the sharp on a second side thereof, wherein the first electrode is spaced from the second electrode; wherein the first electrode and the second electrode are configured to reciprocate relative to the tip to selectively move between a first configuration where a distal end of first electrode is distal of the sharp and a distal end of the second electrode is proximal of the sharp and a second configuration where the distal end of the first electrode is proximal of the sharp and the distal end of the second electrode is distal of the sharp; and wherein the reciprocation of the first electrode and the second electrode is between 1,000 RPM to 30,000 RPM, inclusive.

Description

CLAIM OF PRIORITY This application claims the benefit of U.S. Provisional Patent Application Ser. No. 63/346,417, filed on May 27, 2022, the benefit of priority of which is claimed hereby, and which is incorporated by reference herein in its entirety. FIELD OF THE INVENTION The present invention relates generally to apparatuses for surgical procedures and, more particularly, to apparatuses to surgically cut tissue such as bone and soft tissue. BACKGROUND A variety of surgical apparatuses exist for endoscopic cutting and removal of bone including for subacromial decompression, anterior cruciate ligament reconstruction involving notchplasty, and arthroscopic resection of the acromioclavicular joint. Currently, surgeons use arthroscopic shavers and burrs having rotational cutting surfaces to remove hard tissue in such procedures. A need exists for endoscopic cutting instruments that remove tissue rapidly. Overview The present invention provides improved tissue cutting devices, systems and methods for their use, where the likelihood of electrical arching during resection of tissue is greatly reduced. The devices, systems and methods may utilize one or more of a number of separate features, described in details below. Many endoscope probes in use include lumens within rotatable shafts for the vacuum aspiration of fluid including tissue debris from the working site. Many of these tools also rely on the delivery of monopolar radiofrequency (RF) current from the handpiece to the working end of the probe for coagulation or ablation. With such monopolar arrangement, current must be passed from the working end of the probe through tissue to an electrical grounding pad worn by the patient. The present inventor has developed improved surgical apparatuses and systems, with a thin distal edge cutting profile (such as that of a scalpel, forceps, trocar, etc.). This configuration provides that the apparatuses and systems are tissue sparing and that they have better manipulation capability for controlled cutting of tissue. Typically, a thin distal edge cutting profile with an electrosurgical device would result in an incomplete circuit with electrical arcing, as at least one of a pair of electrodes would not be in contact with tissue. However, the present inventor has recognized that the pair of electrodes operate as a bipolar electrode pair if closely arranged together and if the pair of electrodes are reciprocated in a rapid manner (e.g., between 2,500 to 30,000 RPM, inclusive). More particularly, the present inventor has invented an arrangement where a first of the pair of electrodes can be positioned on a first side of a distal edge or distal point (also referred to as a distal tip or sharp herein) and a second of the pair of electrodes can be positioned on a second side of the distal edge or distal point. The pair of electrodes can reciprocate such that the first of the pair of electrodes can be extended distally beyond the distal edge or distal point while the second of the pair of electrodes can be retracted proximally of the distal edge or distal point, and vice versa. Thus, one of the first or second of the pair of electrodes can extend distally of the distal edge or distal point while the other of the first of the pair of first or second of the pair electrodes can be proximal of the distal edge or distal point. Reciprocal movement of the pair of electrodes can be extremely rapid such that surgical apparatus shifts from passing current to the tissue to electrically isolated and back to passing current such that arcing between the pair of electrodes is impossible. The present inventor has developed improved surgical apparatuses and systems, such as with the combined capability to perform coagulation, endoscopic tissue cutting using RF and fluid removal. The present inventor further has developed a system wherein a reusable handpiece may be removably connected to the replaceable, usually disposable, probe while permitting the various functions discussed above while allowing for vacuum aspiration of fluids including tissue debris and smoke through a probe shaft and outwardly through the handpiece without interfering with the electrical and/or mechanical operation of the surgical system to deliver radiofrequency (RF) current to the probe. The present inventor contemplates the surgical apparatuses and systems can have the pair of electrodes be bipolar to allow for the use of RF in sensitive environments such as in neurological, spinal and cardiac applications where the use of RF was not thought possible among other benefits. Relevant commonly owned patent publications include: US 2018-0303509; US 2019-0008541; US 2019-0059983; US 2019-0134279; US 2019-0021788; US 2018-0317957; US 2019-0008538; US 2019-0083121; US 2018-0263649; and US 2019-0015151, the full disclosures of which are incorporated herein by reference. The following, non-limiting examples (referred to as aspects/techniques), detail certain aspects of the pres