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WO2003103521A1 - Techniques et dispositifs d'electrochirurgie - Google Patents

Techniques et dispositifs d'electrochirurgie Download PDF

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Publication number
WO2003103521A1
WO2003103521A1 PCT/US2003/018116 US0318116W WO03103521A1 WO 2003103521 A1 WO2003103521 A1 WO 2003103521A1 US 0318116 W US0318116 W US 0318116W WO 03103521 A1 WO03103521 A1 WO 03103521A1
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Prior art keywords
detector
active electrode
probe
detector detects
proximal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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PCT/US2003/018116
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English (en)
Inventor
Roy E. Morgan
Wayne K. Ii Auge
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Map Technologies LLC
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Map Technologies LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to AU2003243456A priority Critical patent/AU2003243456A1/en
Application filed by Map Technologies LLC filed Critical Map Technologies LLC
Publication of WO2003103521A1 publication Critical patent/WO2003103521A1/fr
Priority to US11/006,079 priority patent/US7771422B2/en
Anticipated expiration legal-status Critical
Priority to US11/010,174 priority patent/US7819861B2/en
Priority to US11/061,397 priority patent/US7445619B2/en
Priority to US12/239,320 priority patent/US7713269B2/en
Priority to US12/580,195 priority patent/US8591508B2/en
Priority to US12/757,021 priority patent/US8235979B2/en
Priority to US12/778,036 priority patent/US20110034914A1/en
Priority to US12/887,500 priority patent/US8734441B2/en
Priority to US12/887,475 priority patent/US8623012B2/en
Priority to US13/736,016 priority patent/US20130123779A1/en
Priority to US14/149,644 priority patent/US20140180283A1/en
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A61B2017/00035—Conductivity or impedance, e.g. of tissue pH
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A61B2018/1213—Generators therefor creating an arc

Definitions

  • the present invention relates to methods and devices for electrosurgery, including devices that operate in an electrolyzable media, including an aqueous electrolyzable media, by means of electrolysis and oxy-hydrogen combustion, and such devices with sensors and detectors for electrolysis and oxy-hydrogen combustion-specific parameters.
  • Electrosurgical devices have become widely popular for use in many medical treatment settings. However, limits in the ability to detect and measure the relevant parameters of the electrosurgical process have been known to impair the practitioner's ability to accurately and contemporaneously alter the electrosurgical application procedure to guard against treatment sequelae, induced iatrogenic damage, or to hinder the attainment of attaining treatment goals.
  • temperature sensing devices have been disclosed that allow feedback measurement of the treatment environment temperature, such as referenced in U.S. Patent Nos. 6,162,217, 5,122,137 and U.S. Published Patent Application 2001/0029369, and the like. These methods have been determined to be inaccurate due to the typically rapid changing milieu of the treatment locale. See, e.g., Radiofrequency energy-induced heating of bovine articular cartilage using a bipolar radiofrequency electrode. Am J Sports Med, 2000 Sep-Oct; 28(5):720-4. These devices do not accurately capture the multidimensional physiochemical occurrences of electrosurgery contemporaneously.
  • fluid field impedance and fluid field capacitance sensing devices have been disclosed in prior art that allow feedback control of generator power output that drives the electrosurgical process, such as referenced in U. S. Patent Nos. 6,306,134, 6,293,942, and the like.
  • Energy delivery control is limited to these bulk properties which have yet to be accurately or completely correlated to the physiochemical governing relations of electrosurgery, and has proved to be too inaccurate relative to tissue response to serve as therapeutic benchmarking or controlling parameters.
  • the electrosurgical process is governed not by plasma or related forms of ionization but by electrolysis and oxy-hydro combustion.
  • electrosurgical devices and methods that are tailored to detect and measure the relevant parameters of electrolysis and oxy-hydro combustion are more appropriate and needed to enable desired treatment outcome.
  • electrosurgical devices that are not only optimized to the true physical and chemical processes involved in the operation and use of such electrosurgical devices upon biologic tissue within safe energy spectra and power ranges, but also the need for the sensing and measurement of the true physiochemical occurrences of electrosurgery.
  • Such devices will allow the more accurate and safe application of electromagnetic energy for electrosurgery to achieve intended outcomes.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member and means for sensing and transducing pH concentrations in proximity to the active electrode and return electrode.
  • the means for sensing and transducing pH concentrations can include a miniature glass bulb and Ag-Cl sensing wire probe.
  • the electrosurgical probe of the invention can further include an electrosurgical controller that incorporates the pH signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an elongated member with an active electrode and a return electrode separated by an insulating member at the distal end of such elongated member, with a thermo-luminescent crystal generating a temperature signal positioned adjacent to the active electrode.
  • the thermo-luminescent crystal can include a beacon insert within a larger insulating member.
  • the thermo-luminescent crystal can be positioned so as to be immediately adjacent the active electrode.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the temperature signal generated by the thermo-luminescent crystal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a conductivity metering device that generates a conductivity signal.
  • the conductivity metering structure can be located adjacent to the active electrode.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the conductivity signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member and an acoustic detector device that generates an acoustic signal, thereby detecting the electrolysis phenomena and rate.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the acoustic signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and an ion sensor device generating an ion sensor signal.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the ion sensor signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a gas production sensor generating a gas production sensor signal.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the gas production sensor signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a thermo-electric semi-conductor generating a thermo-electric signal.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the thermo- electric signal in control algorithms to meter power output to the active electrode.
  • the invention provides an electrosurgical probe for performing electrosurgery, which probe includes an active electrode and a return electrode separated by an insulating member, and a piezo-electric thin-film pyrometer generating a piezo-electric signal.
  • the electrosurgical probe can further include an electrosurgical controller that incorporates the piezo- electric sensor signal in control algorithms to meter power output to the active electrode.
  • the invention further provides a method wherein sensing, measuring, and detecting one or more relevant parameters of electrosurgery is performed, thereby allowing increased treatment safety, efficacy, and allowing the ability to more effectively utilize either electrolysis and/or oxy hydro combustion reactions and phenomena that occur during electrosurgical application, wherein such use of electrolysis and/or oxy-hydro combustion that occurs during electrosurgical application is part of the treatment protocol.
  • a primary object of the present invention is to devices and methods relating to detection of one or more parameters relevant to electrolytic electrosurgery.
  • Another object is to provide detectors or sensors located proximal to the active electrode of an electrolytic electrosurgery probe.
  • Another object is to provide detectors or sensors disposed between an active electrode and a return electrode of an electrolytic electrosurgery probe.
  • Yet another object of the invention is to provide detectors or sensors for measuring one or more parameters including pH concentration, temperature, conductivity, impedance, ion concentrations, gas production or sound.
  • Yet another object of the invention is to provide control systems for controlling an electrolytic electrosurgery probe utilizing detectors or sensors determining one or more parameters relevant to electrolytic electrosurgery.
  • FIG. 1 A is the stoichiometric chemical equation for chemical reactions related to the invention which govern the electrosurgical process
  • FIG. 1B is the equation for and a view of the acid-base "throttle" effect
  • FIG. 1 C is the equation for and a view of the generalized form of the electrolysis and oxy-hydro combustion reaction process
  • FIG. 1 D is the equation for and a view of the generalized form of the electrolysis and oxy-hydro combustion reaction process showing the effect of varying molar coefficients;
  • FIG. 2A is a flowchart for a control logic of the invention provided by the sensing and control systems and the relevant decision/action points for a thermo-luminescent crystal monitoring system;
  • FIG. 2B is a flowchart for a control logic of the invention provided by the sensing and control systems and the relevant decision/action points for a generalized monitoring system;
  • FIG. 3 is a view of the cross section of a probe of the invention with a thermo-luminescent crystal sensing system resident on the distal tip;
  • FIG. 4 is a view of the cross section of a probe of the invention with a pH sensing system resident on the distal tip;
  • FIG. 5A is a view of an experimental apparatus set-up using an electrosurgical probe and an ionizing radiation detector
  • FIG. 5B is a view of a time integration experiment utilizing x-ray sensitive film for 30 minutes;
  • FIG. 6 is a view of a probe of the invention with a fiber-optic sensing array for utilizing FTIR, GFCR, and optical pyrometric algorithms and circuitry for governing electrosurgical processes;
  • FIG. 7A and 7B are views of a probe of the invention with a conductivity sensor at the distal tip for sensing acid-base shifts at the locality of the surgical site;
  • FIG. 8 is a view of a probe of the invention with a piezo-acoustic sensor for detecting oxy-hydro combustion zone sound shift and providing a feedback measurement for governing electrosurgical processes;
  • FIG. 9 is a view of a probe of the invention utilizing a single wire ion sensor
  • FIG. 10 is a view of a probe of the invention utilizing thermo-luminescent crystal material as an insert for a thermo-luminescent crystal beacon
  • FIG. 11 is a view of a probe of the invention utilizing a thermo-electric semi-conductor as a piezo-electric pyrometer;
  • FIG. 12 is an electrosurgical map which provides the arenas in which the methods and devices disclosed herein may be utilized;
  • FIG. 13 is generic characteristic curve for a hypothetical impedance profile of an established plasma
  • FIG. 14 is a generic characteristic curve for the impendance versus power of a typical immersed electrosurgical probe
  • FIG. 15 is a view of a probe of the invention with an adjustable insulating cylindrical sleeve and at least one detector.
  • Ionizing radiation is ubiquitous in the universe and is most commonly witnessed as the fusion process in stars.
  • the ubiquity of plasma becomes clear when the total abundance of all elements in the universe is considered as more than 99% of the universe's total mass exists within stars.
  • the state of matter found in stars is considered to be this fourth state of matter, or plasma.
  • a plasma differs from ordinary gases in that its particles are mostly deficient of an electron, making them positive ions. In natural stable plasmas like the sun, stability is maintained by the enormous gravitational forces which contain the particles.
  • Plasmas formed in laboratories and those used for industrial applications such as metal fabrication are considered metastable, as the equilibrium state of the plasma components at standard pressure and temperature is one of the more commonly known states of matter, i.e. solid, liquid, or gas.
  • plasmas Without sustained input energy, plasmas normally self-quench and revert to one of these more stable states of matter via several processes. The most common of these processes is the recombination of a free electron with an ion dropping the total internal energy of the plasma below its normal "activation" energy; in most cases this results in the formation of a gas.
  • a second common scenario is the attraction of the positive ions within the plasma to a negative ground. Positive ions will naturally flow toward the strong negative potential generated by the earth (lightning provides a commonly known example), similar to the conditions responsible for the movement of charge in electrical circuits.
  • Man-made plasmas must overcome these obstacles. This feat is typically accomplished by the steady input of energy into the plasma to constantly strip electrons from atoms and the confinement of both the electron and ion via a magnetic field (preventing the flow to ground).
  • Man-made plasma formation is the result of either of two well-known processes, radio frequency coupling or heating. These two processes are fundamentally different but create the same effect of ion formation and preventative recombination.
  • Plasmas generated by radio frequency sources use high frequency, high potential electromagnetic radiation to strip electrons from the outermost shells of the atoms in a gas. The energy coupled to plasma not only creates the ions and electrons, but also keeps them from recombining.
  • Yet another obstacle in the plasma paradigm of electrosurgery is the containment of the plasma as to prohibit the loss of charged particles to a ground plane so that they may be available for therapeutic effects.
  • This containment is ordinarily accomplished by confining the electrons and ions in a magnetic field, so that when plasma is condensed, the efficiency of free electron and gas interaction cascades, thereby converting yet more gas into plasma.
  • vacuum conditions a small partial pressure of gas can be excited to form a plasma with just one single electron.
  • a single electron yields a cascade effect inducing secondary electrons which in turn generate a third and multiple generation electrons to the point where a sustainable plasma is created. This is dependent upon the total pressure of the system and the necessary confinement of the plasma to prevent self- quenching. Without these conditions it is unlikely that a plasma could be sustained or even form at all.
  • man-made plasma begins within near ideal vacuum conditions and is constrained by high energy magnetic fields. In the industrial case, prolonged high energy input is required as in metal fabrication.
  • plasma states of matter as highly ionized gas conditions, are known to be excellent electrical and thermal conductors due to the rapid Brownian motion of the constituent atomic particles and freely available electrons for conduction of current. This suggests some specific behavioral characteristics which can be illustrated simply.
  • Plasmas do not exhibit high impedance characteristics that are common to simple gas volumes. Because they are highly ionized, there are sufficient free electrons to easily conduct current and as such do not provide significant impedance to current flow.
  • a generic characteristic curve for a plasma's impedance profile once established is set forth in FIG. 13. The response curve of a typical electrosurgical probe from a power versus impedance standpoint is significantly different from typical plasma behavior. In the fluid state prior to "vapor pocket" formation, electrical conduction dominates the mode of transmission and impedance slowly rises with the temperature of the fluid.
  • the impedance When vaporization results in nucleate boiling, the impedance begins a sharp rise and immediately “spikes” when full film boiling is initiated, i.e. the "vapor pocket.”
  • the characteristic curve for the impedance versus power of a typical immersed electrosurgical probe is as in FIG. 14.
  • thermo-chemical approximations of water rather than a 0.9% NaCI aqueous solution can be utilized, again underestimating energy requirements, on the assumption that the initial state of the water starts out at approximately 25° C and must result in full film boiling, approximately 100° C, to sustain the "vapor pocket" required for a "plasma.”
  • the presence of ionizing radiation that might be produced in a saline solution (0.9% NaCI) with a standard electrosurgery tool was measured using radiation detector probe 270 and particle detector measuring and display unit 300 to monitor the treatment field for x-ray generation.
  • Industrially accepted electrosurgical generator 310 set at a power setting of 900 Volts peak to peak at 460 kHz + 1% and 245 Watts nominal maximum output power, was utilized, representing a relatively high energy configuration typically utilized in an ablation mode of electrosurgical operation. This high energy level was utilized to create the most advantageous situation for ionizing radiation to form if possible.
  • Bi-polar electrosurgical probe 260 was activated, using radiofrequency electrosurgical generator 310 in 0.9% by weight sodium chloride solution 290 in glass reservoir 280 until a yellow discharge optical emission was observed as described in Stalder et al.
  • This color is more correctly described (as opposed to the consideration of Stalder et al. discussed above) as the result of electron excitation, not to be confused with electron loss, and shows the standard color associated with the 590 nm wavelength light as depicted with optical emission instrumentation.
  • Radiation detector 270 connected to particle detector measuring and display unit 300, sensitive to 200 disintegrations per minute, was mounted on the beaker adjacent to the probe 260 in solution 290.
  • any plasma formation would result in free electron ion pairs and the release of low energy x-rays, due to liquid/electron interface interactions.
  • radiation detector 270 was placed approximately 1 mm away from the air-water interface when probe 260 was activated. At this distance, 0.5 keV x-rays would be transmitted. Should a plasma be formed by electrosurgical probe 260 in any appreciable quantity above normal background radiation, the resultant ion-electron/solid interaction would result in the generation of x-rays.
  • X-rays can be generated when an electron loses energy or when bound electrons in atomic shells are removed by ionizing radiation.
  • the removal of shell electrons emits a characteristic x-ray with energies from a few keV to over 100 keV.
  • Characteristic x-ray production for oxygen and sodium, for example, are below one keV.
  • the slowing or break-off of the electrons results in white radiation or bremsstrahlung photons. These photons would have a range of energies on the same magnitude of the characteristic elemental x-rays.
  • no detectable x-rays were sensed by radiation detector 270.
  • FIG. 5B illustrates an additional experiment that was performed using unexposed x-ray film
  • probe 330 in x-ray film case 320 to integrate a time exposure function that radiation detector 270 might have been unable to detect.
  • a power setting of 900 Volts peak to peak at 460 kHz + 1 % and 245 Watts nominal maximum output power was utilized from electrosurgical generator 310 to energize probe 260.
  • Fluid reservoir 280 was filled with 0.9% by weight NaCI solution 290 and probe 260 was fully immersed and placed within 1mm of the glass wall of the reservoir. Probe 260 was then activated, and the normal yellow discharge became visible. Probe 260 was fired for 30 continuous minutes allowing any high energy phenomenon, if present, to present itself by allowing any high energy particles, x-rays, or free electrons escaping from the active electrode area to integrate over time and thus expose the film.
  • Control source 265 of alpha ( ⁇ ) particles was adhesively affixed to x-ray film case 320 to demonstrate exposure to the film from high energy particles penetrating the film case for an extended period of time. After 30 minutes of exposure to both the firing probe and control ⁇ -particle source 265 only the area exposed to -particle source 265 was exposed. The film area immediately adjacent to the electrode remained unexposed and clear of any image.
  • Ionizing radiation when applied to cells or tissue leads to molecular changes and to the formation of chemical species that are damaging to cellular constituents, such as chromosomal material. Such damage leads to irreversible alterations in the function and construction of the cell itself, damage that is readily observed histologically.
  • the process that occurs when ionizing radiation is applied to the cell begins with conversion of water after ⁇ 10 "16 seconds. This is depicted as H 2 0 ⁇ H 2 0 + + e " with the application of ionizing radiation.
  • H and OH are considered free radicals and participate in further reactions.
  • the most prominent is the formation of hydrogen peroxide as follows: OH + OH ⁇ H 2 0 2 .
  • These products react with the organic constituents of the cell and tissue, such as nucleic acids and hydrogen extraction from pentose, to release organic free radicals induced by radiation damage. Histological evidence of the electrosurgical process as disclosed in U.S. Patent Application Serial No.
  • the equations of FIG. 1 A illustrate the chemical equations that describe the overall oxy- hydro reaction, with associated acid-base shifts, resulting from electrolysis of water and subsequent ignition of the resulting oxygen and hydrogen.
  • the physiochemistry of the electrosurgical process consists of an acid-base shift that governs the relative availability of the amount of water that can be consumed as part of an electrolysis chemical reaction.
  • the electrolysis reaction is driven by the high frequency current flowing between active and return electrodes in both the bi-polar and mono- polar modes of operation of electrosurgical probes.
  • This oxy-hydro combustion theory accounts for all necessary chemical and energy constituents that are present as well as the physical observations of light emission and heat generation during the use of such devices.
  • FIG. 1B illustrate the effect of the acid-base throttling reaction.
  • the oxy- hydro combustion process depicted is dynamic and occurs in a fixed fluid reservoir, which necessarily results in dynamically changing concentrations of salt ions as a function of electrolytic conversion of water to elemental gas.
  • This equation necessarily suggests that as the acid-base shift occurs in the reservoir, less and less water is available for electrolysis.
  • FIG. 1 B where acid-base pair 15 and 20 is shown in increased molar proportion to the normal stoichiometric quantity of base reactions 10.
  • the reduction of available water for electrolysis is evident in relationship 50 of oxygen and hydrogen gas to the acid-base pair.
  • This generalized reaction illustrates how hydronium and hydroxide ions can contribute to the same overall chemical reaction known as electrolysis and oxy-hydro combustion.
  • the equations of FIG. 1 D demonstrate the more general case of the electrolysis and oxy- hydro combustion reaction process in which the ionic salt is represented by variables 61, consisting of ⁇ , ⁇ , ⁇ , and ⁇ ; wherein, the molar quantities required for stoichiometric combustion are any value that appropriately satisfies the oxidation reduction valence requirements for the overall reaction.
  • This generalized reaction case shows how oxygen and hydrogen requirements can vary and still result in the same overall chemical reaction known as electrolysis and oxy-hydro combustion.
  • FIG. 1 A, FIG. 1B and FIG. 1 C depict theoretical stoichiometric reaction processes induced by application of high frequency electromagnetic energy to a salt ion solution, including salt ion solutions typically found within biologic tissues themselves.
  • the fundamental process is governed by the rate of electrolysis in the initial dissociation of water into oxygen and hydrogen gas, as shown in equations 10.
  • a preferred embodiment of the present invention disclosed herein is use of thermo- luminescent crystals 160 as depicted in FIG. 3.
  • An example of crystals that demonstrate linear temperature to luminescent profiles are described in Buenfil AE et al. Dosimetric Properties of europium-doped potassium bromide thermoluminescent crystals. Health Physics, Vol.
  • Crystal 160 is an encapsulated thermo-luminescent crystal in thin-walled zirconia shell 155, with a nominal thickness of 0.0001-0.002", providing shielding against thermo-chemical degradation of the potassium bromide crystal in harsh immersion environments, as shown in FIG. 3.
  • FIG. 3 thus depicts an electrosurgical probe immersed in electrolyzable aqueous media 166.
  • active electrode 150 is connected to active conductor wire 200, which in turn is connected to a power supply.
  • the power supply for this and all other embodiments presented herein, can provide radiofrequency energy at any frequency, and can alternatively supply direct current energy, pulsed direct current energy, or the like.
  • the probe is partially encased within insulating sheath 210, with exterior return electrode 170.
  • light 165 is emitted from thermo-luminescent crystal 160 in response to generated heat.
  • the detector system can further include fiber optic element ball ended lens 180 connected to light sensing optical fiber 190, located such that only light generated by crystal 160 is accumulated by lens 180.
  • the creation of such a device is possible through one of several means by which zirconia is deposited on the surface of the thermo-luminescent crystal and subsequently hardened, or alternatively by a simple double barrel pulse injection molding procedure familiar to those skilled in that art.
  • Console control algorithms 120 and 130, FIG. 2A and FIG. 2B, are fed an input signal from ball lens fiber optic element 180 in FIG. 3, which is used to transmit the luminescence from the temperature sensitive crystal to a photo- detector or colorimeter.
  • the photo-luminescence is transformed via analog to digital flip-flop circuitry into a digital signal of streaming data and recorded in time integration sampling circuitry, well known to those skilled in the art of real-time data sampling.
  • the data stream is modified by numerical software algorithms 70 to provide a stable control variable.
  • the stable control variable is used in traditional data comparison algorithms 80 to perform electrosurgical console radiofrequency power output "throttling" via inverse proportionality control circuitry 90, well known to those skilled in the art of power output control systems.
  • the circuitry performs real-time correlation of sensed color shifts by the thermo-luminescent crystal in response to temperature changes on the surface of the probe tip.
  • the optical fiber is placed immediately sub-surficial to the exterior of the electrode- insulating member such that a focusing "lens-effect" is utilized to transmit the thermo-luminescent crystal color to the control circuitry.
  • thermo-luminescent crystal material such as those described above, as depicted in FIG. 10 where the thermo-luminescent crystal material is used as an insert for thermo-luminescent crystal "beacon" 440 within the insulator in a bore at the extreme distal end of the insulator where the active site of the electrosurgical device exists.
  • thermo-luminescent crystal is formulated in a manner such that the chemical structure of the crystal is hydrophobic (by way of example an optically clear silica glass deposition coating may be applied to the crystal which does not dissolve in aqueous environments), the crystal can actually become external to the insulator and provide combined feedback of device and treatment site temperatures.
  • europium doping of zirconia-yttrium ceramic can be employed such that the thermo-luminescent function becomes that of ceramic insulator 450 itself.
  • FIG. 4 Yet another embodiment is shown in FIG. 4 wherein use of an instrument integrated pH monitoring system comprising a reference potential and use of glass bulb capacitive pH detector 240 is described.
  • the micro glass bulb detector 240 is connected to pH potential conductor wire 250.
  • the probe further comprises europium-doped thermoluminescent yttria-stabilized-zirconia insulating member 230 for temperature detection, and acid/base shift fluid outflow portal 220, it being understood that these elements represent alternative embodiments.
  • the pH monitoring system is coupled via electrical connection 250 to control circuitry for governing multiple parameters of the electrosurgical environment.
  • FIG. 2B depicts such circuitry providing both differential feedback for electrosurgical console output parameters 140 and integral feed-forward control 145 of adjunct devices that can provide additional inputs to the surgical field, such as surgical irrigation systems and pumps for irrigation systems, as disclosed in U.S. Patent Application Serial No. 10/157,651 , entitled Biologically Enhanced Irrigants, filed May 28, 2002.
  • measurement of pH has been determined to be an effective method to monitor the electrolysis that occurs in tissue.
  • FIG. 6 illustrates yet another embodiment of the configuration of an electrosurgical probe wherein the distal tip insulator includes a thermo-luminescent crystal 230 and contains an array of multiple independent optical fibers 190 and 195 configured to provide a distributed profile of surgical site field conditions.
  • Each independent optical fiber is a single or multi-mode fiber utilizing "ball-end" focusing lens 340 and 345 to provide means for viewing and determining "free-field" bulk property conditions at a predetermined focal length external to the probe, thermo-luminescence colorimetry/thermometry at the surface of the probe, and oxygen and hydrogen gas production using gas filter correlation radiometry or Fourier infra-red spectroscopy through optical switching performed within the control unit.
  • FIG. 7A and FIG. 7B depict yet another embodiment of an electrosurgical probe comprising a distal active electrode 150 and a proximal return electrode 170 separated by an insulator wherein is disposed conductivity meter pair electrodes 350 and 360 for sensing acid-base shifts due to the byproducts of electrolysis induced by electrosurgery.
  • Cylindrical conductivity electrode 350 is electrically connected to conductivity sensing voltage conductor wire 380, and electrode 360 is similarly connected to wire 370, it being understood that either electrode 350 or electrode 360 can serve as a reference electrode.
  • insulating member 230 is provided, which may optionally be an europium-doped thermoluminescent yttria-stabilized-zirconia insulating member.
  • the conductivity meter is electrically coupled to proportionality circuitry 140 for providing both differential feedback for electrosurgical console output parameters and integral feed-forward control 145 of adjunct devices that can provide additional inputs to the surgical field, such as surgical irrigation systems and pumps similar to those disclosed in U.S. Patent Application Serial No. 10/157,651.
  • FIG. 8 depicts yet another embodiment of an electrosurgical probe including a distal active electrode and a proximal return electrode separated by an insulator wherein is disposed piezo- acoustic sensor 390 positioned on the surface of the insulator and connected by means of conductor wire 400.
  • Piezo-acoustic sensor 390 may, in one embodiment, be a piezo-acoustic drum vibration transducer. Oxy-hydro combustion pressure waves created at the active electrode during electrosurgery are detected and transformed into electrical signal outputs. These electrical signals can be comparatively analyzed against numerically regressed curves of oxy-hydro combustion signature acoustic intensity in control algorithms 130, as depicted in FIG. 2B.
  • the acoustic sensor is electrically coupled to proportionality circuitry for providing both differential feedback 140 for electrosurgical console output parameters and integral feed-forward control 145 of adjunct devices that can provide additional inputs to the surgical field, such as irrigation systems and pumps similar to those disclosed in U.S. Patent Application Serial No. 10/157,651.
  • piezo-acoustic sensor 390 can be used to detect Doppler sound shifts using time integration circuitry 120, as depicted in FIG. 2B, with information about known irrigation fluid density correlated from impedance control circuitry to perform basic densitometry, thereby detecting acid-base shifts due to the byproducts of electrolysis induced by electrosurgical procedures.
  • the densitometry/acoustic sensor is electrically coupled to proportionality circuitry 140 for providing both differential feedback for electrosurgical console output parameters and integral feed-forward control 145 of adjunct devices that can provide additional inputs to the surgical field, such as irrigation systems and pumps similar to those disclosed in U.S. Patent Application Serial No. 10/157,651.
  • FIG. 9 depicts yet another embodiment of an electrosurgical probe including a distal active electrode 159 and a proximal return electrode 170 separated by an insulator 230 wherein is disposed a pH-meter comprising a single wire ion meter 420 comprised of Mg-Ni or similar material connected to pH potential conductor wire 250 to detect acid-base shifts due to the byproducts of electrolysis induced by electrosurgical procedures.
  • the pH sensor is optionally electrically coupled to proportionality circuitry 140 for providing both differential feedback for electrosurgical console output parameters and integral feed-forward 145 controls of adjunct devices that can provide additional inputs to the treatment field, such as irrigation systems and pumps similar to those disclosed in U.S. Patent Application Serial No. 10/157,651.
  • Fig. 10 depicts yet another embodiment of an electrosurgical probe including an active electrode 150 and return electrode 170 separated by an insulating member 450 wherein is disposed at the distal tip a thermoluminescent crystal member 440 embedded in primary insulating member 450.
  • the thermoluminescent crystal member acts as a "beacon" of localized temperature at the surgical site, providing means for visualization of real-time temperatures at the treatment site, additionally providing means to sense and display visual cues of temperature that are immune to interferences from propagating electromagnetic waves.
  • the crystal element includes Europium- doped magnesium bromide crystalline structures. The crystalline structure is stabilized for the electrosurgical environment by means of an optically clear coating, such as a quartz silica glass or polymethylmethacrylate polymer.
  • thermo-luminescent crystal is disposed on the distal portion of the insulating member in proximity to active electrode 150.
  • the energy flux between the active and return electrodes is the source of energy that drives electrolysis equations 10 and in so doing generates heat within the fluid surrounding the active electrode.
  • the heat generated is both convectively and conductively transferred through the irrigant media and or tissue, depending upon treatment methods, and convectively and conductively heats insulating member 450 with thermoluminescent element 440 disposed at the distal tip of the probe.
  • thermo-luminescent element 440 As thermo-luminescent element 440 is heated, molecular excitations cause electron orbital fluctuations and the release of photons of known wavelength.
  • thermoluminescent element 440 As the light and color shift of the crystal are correlated to its ambient temperature a direct visual aid is created that directly demonstrates the temperature of the energized probe. The clinician can then respond immediately to luminescence shifts in thermoluminescent element 440 to appropriately meter probe activation and tissue treatment as well as power set points on the electrosurgical controller.
  • Fig. 11 depicts yet another embodiment of an electrosurgical probe wherein the sensor is pyrometric sensor 460 constructed of a thin-film thermal-electric compound, such as bismuth- teliuride (available from the Hi-Z Corporation of San Diego, CA) connected to transducer conductor wire 400.
  • This thermo-electric sensor is optionally electrically coupled to proportionality circuitry 140 for providing both differential feedback for electrosurgical console output parameters and integral feed-forward 145 controls of adjunct devices that can provide additional inputs to the treatment field, such as irrigation systems and pumps similar to those disclosed in U.S. Patent Application Serial No. 10/157,651.
  • translatable sheath 181 can extend the insulating properties of insulator 151 beyond the end profile or position of active electrode 150, providing means to create a variable volume localized chamber when the translatable sheath 80 is extended.
  • translatable sheath 181 can be mechanically actuated, including by means of a thumb control, which may incorporate gears or other means of transferring energy, utilized by the operator.
  • translatable sheath 181 may, in one embodiment, simply be frictionally engage with a thumb control or other means of movement, may be mechanically actuated, or may be electro-mechanically actuated, as in FIG. 15.
  • sensor 391 provides primary control variable feedback to differential controller 501, optionally as an analog input. If the input is analog, it may be output via flip-flop A/D conversion to a digital control signal for use by application-specific integrated circuitry logic controller 511, such as an FPGA, MOSFET, or similar intermediate digital logic gate controlling array.
  • Flash RAM and additional high level input/output governance, is controlled by CPU 521, utilizing software governed database lookup techniques, such as those commonly known in C+ or C++ programming code, to provide dual proportional output via Primary RF Output Controller/Generator 522; and further and optionally also to Electronic Positioning Controller 523 for simultaneous balanced positioning of translatable sheath 80 coupled to matched power setting through controller 522, providing the primary controlling input to match user set-points according to primary control variable known characteristics correlation to a desired set point.
  • Electrical power may be provided by wires connected to a suitable source of power, which may be one or more sources of power, such as a high voltage source for operation of the active electrode and a lower voltage source for operation of the circuits provided.
  • the detector or sensor employed may be any detector or sensor described herein.
  • a fixed cavity probe may be employed, such that one or more active electrodes are disposed within a cavity, the distal end of the probe ending beyond the end of the one or more active electrodes.
  • Return electrodes may be provided, which return electrodes can be within the cavity or without the cavity, and in one embodiment are located on the exterior or interior surface of the probe on the portion of the probe forming a cavity.
  • one or more detectors or sensors may be provided, preferably located within the cavity. However, detectors or sensors may also be integrated into the probe body, such as by forming a part of the cavity wall, or may be located on the exterior of the probe.
  • the detector detects local pressure changes, and includes a pressure sensor.
  • a pressure sensor may be employed to determine the position of a probe with respect to tissues, such as whether the probe touches a tissue, or may alternatively be employed to detect local pressure changes relating to either electrolysis or oxy-hydro combustion.
  • the detector detects consumption of interfacing media, particularly oxygen or hydrogen, such consumption including consumption by oxy- hydro combustion.
  • the same sensor or detector may detect a parameter relating to electrolysis and also a parameter relating to oxy-hydro combustion, and may further detect parameters relating to the transition to oxy-hydro combustion.
  • electrolysis and oxy-hydro combustion may occur successively or simultaneously, and the relationship thereof can be monitored and determined by means of data collected by the sensor or detector.
  • any of the probes or devices disclosed herein may have two or more active electrodes, and may also have two or more return electrodes.
  • the return electrode may form a part of the body of the probe.
  • two or more different detectors or sensors may be provided, determining two or more different parameters.
  • two or more detectors or sensors may be provided, but at different locations on the probe, providing relevant information about either electrolysis or oxy-hydro combustion.
  • one temperature probe may be located at the distal end of the probe, to measure temperature at the site closest to tissue being treated, while a second temperature probe may be removed some distance, such as by locating on an insulated exterior surface of the probe, to determine the area of temperature change.
  • Other such combinations and permutations are both possible and contemplated.
  • FIG. 1 A illustrates a preferred embodiment of the physiochemistry of the electrolysis and oxy-hydro combustion reaction.
  • the physiochemistry of the electrosurgical process consists of an acid-base shift that governs the relative availability amount of water that can be consumed as part of an electrolysis chemical reaction.
  • the electrolysis reaction is driven by the high energy density / flux modes of operation of electrosurgical probes.
  • FIG.1 A illustrates the chemical equation that describes the overall electrolysis and oxy-hydro reaction as it pertains to electrosurgery in the underwater, cellular, and biologic environment. From this reaction it is noted that all the necessary chemical participants are accounted for and that the physical observations of light emission and heat generation are also accounted for.
  • the series of chemical equations 10 that govern the process first provide an electrolysis function thereby liberating elemental oxygen and hydrogen gas 30. Given that the entire electrosurgical process is typically observed to occur fully immersed in a saline solution (0.9% by weight) the presence of sodium chloride (NaCl) must also be accounted for. The normal stoichiometry of the electrolysis reaction dictates that when elemental gas separation is occurring, then the solute participants must join with the remaining solution components of water to form a complementary acid-base pair. This pair is clearly shown on the right-hand side of the upper half of equations 10 as a hydrochloric acid 15 and sodium hydroxide 20 base pair. The hydrogen and oxygen gases 30 can be co-mingled without immediate spontaneous exothermic reaction.
  • a small amount of energy such as the radio frequency energy 40 indicated in the lower of equations 10, needs to be added to overcome the nominally endothermic reaction and ignite the oxy-hydro combustion. Once ignited, the reaction will cascade, or self-perpetuate, until all the reactants are consumed and reduced to the products shown on the right-hand side of the lower equations 10.
  • FIG 1B illustrates a variation of the acid-base throttling reaction of the preferred embodiment.
  • the entire electrolysis and oxy-hydro combustion process is a dynamic process, occurring in a fixed reservoir of fluid, which necessarily implies dynamically changing concentrations of salt ions, based on water volume converted to elemental gas. This suggests that as the acid-base shift occurs in the reservoir less and less water is available for electrolysis.
  • This reaction is clearly seen in FIG. 1 B where the acid-base pair 15 and 20 is shown in increased molar proportion to the normal stoichiometric quantity of the base reactions 10. The reduction of available water for electrolysis is evident in relationship 50 of oxygen and hydrogen gas to acid-base pair.
  • FIG. 1C illustrates the more general case of the electrolysis and oxy-hydro combustion reaction process wherein the ionic salt is represented by variable 60, X which could be any of the appropriate group I, period 1-7 elements of the periodic table.
  • This generalized reaction case shows how the hydronium and hydroxide ions can contribute to the same overall chemical reaction known as electrolysis and oxy-hydro combustion.
  • FIG. 1 D illustrates the more general case of the electrolysis and oxy-hydro combustion reaction process wherein the ionic salt is represented by variables 61, ⁇ , ⁇ , ⁇ , ⁇ , the molar quantities required for stoichiometric combustion could be any value that appropriately satisfies the oxidation reduction valence requirements for the overall reaction.
  • This generalized reaction case shows how the oxygen and hydrogen requirements can vary and still result in the same overall chemical reaction known as electrolysis and oxy-hydro combustion.
  • FIG. 2A and FIG. 2B illustrate both general and specific cases of control mechanisms by which relevant parameters of electrosurgical process can be accurately governed.
  • Ordinary signal transduction from the instrumentation corporeal contact part to the electrosurgical controller is required to provide means for input signal recording using time integration circuitry 110 and performing subsequent mathematical operations 120 to condition the input signal so as to use it effectively as a stable control variable.
  • analog detector signals acquired from any of the probes of FIGS. 3, 4, 6, 7A, 7B, 8, 9, 10 or 11 can be converted by analog-to-digital converter 100.
  • mathematical operations 120 such as microprocessor driven software algorithms, may be employed, optimally using software algorithms 130 for comparison of time-averaged data points against a determined data standard.
  • Such mathematical algorithms can include averaging, integration, differential rate of change calculations, and the like.
  • a simple time averaging algorithm 70 of specified periodicity can be applied to the data stream to "smooth" the feedback signal and provide general control based on real-time trend information of selected parameters.
  • Such control output can be performed in the manner of ratio controlling 90 and 140 to "throttle" equipment output functions based on sensed/detected parameters at the surgical site.
  • Standard communications links 145 can be used to interconnect adjunct equipment to the electrosurgical controller or other ratio-controller that works in tandem with the electrosurgical controller.
  • FIG. 3 illustrates use of encapsulated thermo-luminescent crystal 160 to perform real-time visual feedback to the practitioner of temperature shifts at the treatment site.
  • active electrode 150 When active electrode 150 is energized and conducts high frequency electrical current to return electrode 170 the normal process of electrolysis of aqueous media 166 immediately begins. The endothermic reaction requires the input of energy that subsequently heats the aqueous media, convectively and conductively heating thermo-luminescent crystal 160.
  • the thermo-luminescent crystal emissions rise proportionally with temperature rise the luminance is captured by optical fiber ball end lens 180 and transmitted down optical fiber 190 to an opto-electrical coupling within an electrosurgical controller unit.
  • the opto-electrically transformed signal thus provides means for input signal recording using time integration circuitry 110 and performing subsequent mathematical operations 120 to condition the input signal so as to use it effectively as a stable control variable.
  • the mathematical algorithms can include averaging, integration, differential rate of change calculations, and the like.
  • a colorimetric averaging algorithm 120 can be employed from known color correlating data to crystal dynamics to "quantize” the feedback signal and provide general control based on real-time trend information of selected parameters.
  • control output can be performed in the manner of ratio controlling 140 to "throttle" equipment output functions based on sensed/detected parameters at the treatment site.
  • Standard communications links 145 can be used to interconnect adjunct equipment to the electrosurgical controller or other ratio- controller that works in tandem with the electrosurgical controller.
  • FIG. 4 illustrates use of pH sensing within the electrode-insulator combination to provide a stable control variable for governing electrosurgical process.
  • miniature glass bulb pH sensor 240 is disposed within a semi-enclosed cavity of the electrode insulator combination 230 and 150.
  • Acid-base shifted water can accumulate within the cavity and flow out of acid-water outflow portal 220.
  • the pH signal is transduced along conductor wire 250, optionally to an analog to digital flip-flop circuit where the signal is transformed for use in software algorithms as a stable control variable.
  • Such mathematical algorithms can include averaging, integration, differential rate of change calculations, and the like.
  • a logarithmic averaging algorithm 120 from acid-base shift rates of change data correlated to electrolysis and oxy-hydro combustion rates is employed to "quantize” the feedback signal and provide general control based on real-time trend information of selected parameters.
  • control output can be performed in the manner of ratio controlling 140 to "throttle" equipment output functions based on sensed/detected parameters at the treatment site.
  • Standard communications links 145 can be used to interconnect adjunct equipment to the electrosurgical controller or other ratio-controller that works in tandem with the electrosurgical controller.
  • FIG. 6 depicts use of optical fiber sensing at and within the distal tip of a probe as part of an array of independently connected optical fibers providing means to sense both internal and external to the distal tip of the electrosurgical probe.
  • Internal optical fiber 195 uses ball ended lens 340 to collect light emitted from within the insulating member, such as a thermo-luminescent crystal or europium doped yttria-stabilized-zirconia crystal 230.
  • External optical fiber 190 uses a ball ended lens 345 to collect infrared light emitted from the surgical site, with ball ended lens 345 being comprised of a spherical lens with a ground-in focal point of approximately 3-5 mm.
  • the optical fiber is optionally made of a single-mode silica glass optimized for the transmission of infrared light, well known to those skilled in the art of optical fiber production.
  • alternative ball end lens 345 can be optically switched at the controller unit to an alternative detector designed to measure gas production using gas filter correlation radiometry or Fourier infra-red spectroscopy.
  • spectral averaging algorithm 120 from electrolysis and oxy- hydrogen gas production rate data is correlated to thermal rise created by nominal electrolysis and oxy-hydro combustion heat of reaction to "quantize" the feedback signal and provide general control based on real-time trend information of selected parameters.
  • Such control output can be performed in the manner of ratio controlling 140 to "throttle" equipment output functions based on sensed/detected parameters at the treatment site.
  • Standard communications links 145 can be used to interconnect adjunct equipment to the electrosurgical controller or other ratio-controller that works in tandem with the electrosurgical controller.
  • FIG. 7A and FIG. 7B depict use of conductivity electrode pair 350 and 360 separated by insulating member 230 to sense the changes in conductivity that electrolysis induces through the creation of acid-base pairs. Electrolysis occurs when active electrode 150 is electrically energized and conducts current to return electrode 170, forming acid-base pairs which alter the natural conductivity of traditionally utilized electrosurgical irrigants. As the resulting hydronium ion concentrations are raised and lowered the conductivity of the surrounding fluid is also raised and lowered.
  • the generally accepted methodology for detecting conductivity is the application of a known DC voltage across electrode pairs 350 and 360 while measuring the current flow through the conductive media. Electrical conductors 370 and 380 carry the current through a detection loop circuit within the electrosurgical controller.
  • time averaging algorithm 70 from acid- base pair conductivity shift data is correlated to pH change which in turn can be correlated to treatment response catalog data to "quantize” the feedback signal and provide general control based on real-time trend information of selected parameters. Controlling acid-base pair production along treatment response constraints allows for improved overall treatment response and reduced collateral damage.
  • Such control output can be performed in the manner of ratio controlling 140 to "throttle" equipment output functions based on sensed/detected parameters at the treatment site.
  • Standard communications links 145 can be used to interconnect adjunct equipment to the electrosurgical controller or other ratio-controller that works in tandem with the electrosurgical controller.
  • FIG. 8 depicts use of a piezo-electric acoustic sensor to transmit sound waves generated by oxy-hydro combustion from the electrode-insulator interface to the electrosurgical controller.
  • Piezo- acoustic sensor 390 is tuned to operate in the 10 kHz to 600 kHz range of sound output. From the probe specific response data, characteristic sound thresholds are established that allow the conducted analog acoustic signal carried in transducer conductor wire 400 to be converted via A/D flip-flop for use in software comparative algorithms 140. Each quantized acoustic increment can be accurately correlated to oxy-hydro combustion rates.
  • active electrode 150 is energized and completes the circuit with return electrode 170 the normal electrolysis phenomenon occurs.
  • FIG. 9 depicts use of the alternative pH-sensing embodiment utilizing single wire ion-specific detector 420, which is accurately correlated to probe power output and acid-base shift at the treatment site and circuitry for governing electrosurgical processes.
  • the ion specific pH wire sensor is, in one embodiment, made of an Mg-Ni metal alloy for sensing capacitive shift in the presence of Cl ' ions or similar metal alloy for sensing Na + ions.
  • Irrigation fluid electrolyte 410 is drawn toward the active electrode as part of the c ⁇ nvective forces induced by normal heating of the active electrode 150.
  • the conductor wire for the pH ion detector wire 250 delivers the capacitive shift data driven by the presence of acid-base pairs at the sensor 420. This capacitive shift can be converted at the electrosurgical controller to a digital signal via A/D flip-flop for use in software driven algorithms.
  • FIG. 10 depicts use of thermo-luminescent crystal beacon element 440 to provide visual feedback system to the practitioner for understanding treatment site temperature.
  • the crystal element includes europium doped magnesium bromide crystalline structures.
  • the crystalline structure is optionally stabilized for the electrosurgical environment, such as by means of an optically clear coating, for example a quartz silica glass or polymethylmethacrylate polymer.
  • the thermo-luminescent crystal is disposed on the distal portion of the insulating member in proximity of the active electrode 150. Proximity to active electrode 150 provides means to sense both contact conducted temperature of the actual treatment site being affected by the energy flux completing the circuit between active electrode 150 and return electrode 170.
  • thermo-luminescent element 440 disposed at the distal tip of the probe.
  • thermoluminescent element 440 is heated, molecular excitations cause electron orbital fluctuations and the release of photons of known wavelength.
  • the light and color shift of the crystal are correlated to its ambient temperature a direct visual aid is created that directly illustrates the temperature of the energized probe.
  • thermo-electric semi-conductor 460 constructed of bismuth-telluride.
  • electrolysis is initiated and dependent on total power input rates increase to the ignition point of sustained oxy-hydro combustion.
  • total power input is increased, localized heating of the conductive intermediary agent, irrigant, or media is raised.
  • the thermoelectric sensor develops intermolecular excitations from the increase in temperature and subsequently conducts current at the electrons in the semi-conductor translate, a technique familiar to those skilled in the art of Pelltier type thermoelectric generators.
  • thermoelectrically generated current is conducted along conductor 400 and is coupled to the electrosurgical controller and can be used as disclosed above to perform both basic and advanced control functions based on localized treatment site temperature.
  • thermoelectric sensor can easily be substituted with a piezo-electric thin-film pyrometer that functions in a similar manner to the bismuth-telluride semiconducting thermoelectric materials.
  • the use of methods and devices that allow sensing, detecting, measuring, and controlling relevant parameters of electrosurgery as described in this invention provide for new and unexpected advantages to the medical practitioner and patient in improving electrosurgical treatments, providing better control of electrosurgical treatments, and improving overall efficaciousness of electrosurgical treatments, as depicted in FIG. 12. This occurs due to improved understanding of physiochemical interactions which are accurately controlled for such outcomes.
  • these sensing, measuring, and detecting methods and devices for electrosurgery allow for the accurate therapeutic use of the electrolysis and oxy-hydro combustion reactions during electrosurgery. This allows the practitioner to harness the electrolysis and/or the oxy-hydro combustion portions of the electrosurgical phenomenon designed for specific therapeutic interventions by sensing, measuring, and detecting relevant parameters of electrosurgery.
  • the determination of when oxy-hydro combustion is occurring is important so that oxy-hydro combustion can be avoided in those settings.
  • the determination of when electrolysis is occurring is important so that electrolysis can be avoided in those settings.
  • the determination of when each reaction is occurring is important so they can be regulated in those settings.
  • These determinations can be via sensing, measuring, or detecting temperature, pH, gas production, conductivity, ions, acoustic parameters, and the like at the electrosurgical treatment site, which optionally are translated to visible or controller indication/feedback of the actual probe system and treatment site occurrences.
  • This enables the devices and instrumentation to self-regulate as to when it is appropriate to decrease or increase energy input or other local parameters, such as irrigants, temperature, acid-base flush, salt concentration, and the like, so that the reactions can be more accurately controlled.
  • the practitioner will have additional information regarding the specific treatment locale so that yet another level of control can be imposed upon the treatment venue.

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Abstract

L'invention concerne des dispositifs et des techniques d'électrochirurgie. Un détecteur (270), qui est situé à proximité d'une électrode active sur une sonde électrochirugicale (260), éventuellement entre ladite électrode active et une électrode de retour, détecte au moins un paramètre en rapport avec l'électrolyse. Le paramètre détecté peut concerner la température, la conductivité, la concentration de pH, l'impédance, les concentrations ioniques, la consommation de gaz électrolytique, la production de gaz électrolytique, la pression ou le son. Le paramètre détecté peut être utilisé dans des systèmes de commande pour enclencher ou faire fonctionner une sonde électrochirurgicale.
PCT/US2003/018116 2000-08-18 2003-06-06 Techniques et dispositifs d'electrochirurgie Ceased WO2003103521A1 (fr)

Priority Applications (12)

Application Number Priority Date Filing Date Title
AU2003243456A AU2003243456A1 (en) 2002-06-06 2003-06-06 Methods and devices for electrosurgery
US11/006,079 US7771422B2 (en) 2002-06-06 2004-12-06 Methods and devices for electrosurgery
US11/010,174 US7819861B2 (en) 2001-05-26 2004-12-10 Methods for electrosurgical electrolysis
US11/061,397 US7445619B2 (en) 2000-08-18 2005-02-17 Devices for electrosurgery
US12/239,320 US7713269B2 (en) 2000-08-18 2008-09-26 Devices for electrosurgery
US12/580,195 US8591508B2 (en) 2001-08-15 2009-10-15 Electrosurgical plenum
US12/757,021 US8235979B2 (en) 2001-08-15 2010-04-08 Interfacing media manipulation with non-ablation radiofrequency energy system and method
US12/778,036 US20110034914A1 (en) 2000-08-18 2010-05-11 Devices for Electrosurgery
US12/887,475 US8623012B2 (en) 2001-08-15 2010-09-21 Electrosurgical plenum
US12/887,500 US8734441B2 (en) 2001-08-15 2010-09-21 Interfacing media manipulation with non-ablation radiofrequency energy system and method
US13/736,016 US20130123779A1 (en) 2000-08-18 2013-01-07 Methods and Devices for Electrosurgery
US14/149,644 US20140180283A1 (en) 2001-08-15 2014-01-07 Electrosurgical Plenum

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US38711402P 2002-06-06 2002-06-06
US60/387,114 2002-06-06

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US7713269B2 (en) 2000-08-18 2010-05-11 Nuortho Surgical, Inc. Devices for electrosurgery
US7819861B2 (en) 2001-05-26 2010-10-26 Nuortho Surgical, Inc. Methods for electrosurgical electrolysis
US7955296B1 (en) 2001-05-26 2011-06-07 Nuortho Surgical, Inc. Biologically enhanced irrigants
US7819864B2 (en) 2001-08-15 2010-10-26 Nuortho Surgical, Inc. Electrosurgery devices
US8734441B2 (en) 2001-08-15 2014-05-27 Nuortho Surgical, Inc. Interfacing media manipulation with non-ablation radiofrequency energy system and method
US9532827B2 (en) 2009-06-17 2017-01-03 Nuortho Surgical Inc. Connection of a bipolar electrosurgical hand piece to a monopolar output of an electrosurgical generator
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US9408658B2 (en) 2011-02-24 2016-08-09 Nuortho Surgical, Inc. System and method for a physiochemical scalpel to eliminate biologic tissue over-resection and induce tissue healing
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US10154873B2 (en) 2013-11-14 2018-12-18 Rm2 Technology Llc Methods, systems, and apparatuses for delivery of electrolysis products
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US10939949B2 (en) 2015-05-01 2021-03-09 Inter Science Gmbh Methods, systems, and apparatuses for tissue ablation using pulse shape designs
CN112998846A (zh) * 2015-05-01 2021-06-22 因特科学股份有限公司 用于使用脉冲形状设计的组织消融的方法、系统及设备
WO2016178697A1 (fr) * 2015-05-01 2016-11-10 Inter Science Gmbh Procédés, systèmes et appareils pour ablation de tissu à l'aide de conceptions de forme d'impulsion
US11857244B2 (en) 2015-05-01 2024-01-02 Inter Science Gmbh Methods, systems, and apparatuses for tissue ablation using pulse shape designs
US12127779B2 (en) 2018-09-04 2024-10-29 Inter Science Gmbh Methods, systems, and apparatuses for tissue ablation using a modulated exponential decay pulse

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