Abstract: Apparatus and methods for treating back pain of a patient by denervation of an intervertebral disc or a region of the posterior longitudinal ligament by the controlled application of heat to a target tissue. In one embodiment, the invention may include a procedure combining both decompression of a disc, and denervation of the annulus fibrosus. In one embodiment, a method of the invention includes positioning an active electrode of an electrosurgical instrument in at least close proximity to an intervertebral disc, and applying at least a first high frequency voltage between the active electrode and a return electrode, wherein nervous tissue within the annulus fibrosus is inactivated, and discogenic pain of the patient is alleviated.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for removing a vertebral disc in preparation for implanting a prosthetic disc or removing a portion of the vertebral disc such as the nucleus pulposus in preparation for placing a prosthetic nucleus within the annulus of the disc. The present invention also teaches shrinking residual tissue in preparation for placing the implants.

Abstract: Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one aspect, the invention involves canalizing or boring channels, divots, trenches or holes through an avascular connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. In one method, an active electrode is positioned in close proximity to a target site on a tendon, and a high frequency voltage difference is applied between the active electrode and a return electrode to selectively ablate tendon tissue at the target site, thereby forming a channel or void in the tendon. The active electrode(s) may be moved relative to the tendon during, or after, the application of electrical energy to damage or sculpt a void within the tendon, such as a hole, channel, crater, or the like.

Abstract: Systems and methods are provided for performing electrosurgical interventions, such as selectively contracting soft collagen tissue and other body structures, while limiting thermal damage or molecular dissociation of such tissue and limiting the thermal damage to tissue adjacent to and underlying the treatment site. The systems and methods of the present invention are particularly useful for surgical procedures in electrically conducting environments, such as arthroscopic procedures in the joints, e.g., shoulder, knee, hip, hand, foot, elbow or the like. The present invention is also useful in relatively dry environments, such as treating and shaping the cornea, and dermatological procedures involving surface tissue contraction of tissue underlying the surface of the skin for tissue rejuvenation, wrinkle removal and the like.

Abstract: Electrosurgical systems, apparatus, and methods for the controlled removal and treatment of a target tissue. An instrument of the invention includes a rotating member housed longitudinally within a shaft, a tissue removal port disposed at the shaft distal end portion, and an active electrode disposed at the instrument distal end. The active electrode is adapted to electrosurgically remove at least a portion of the target tissue as the rotating member rotates within the shaft. According to alternative embodiments, the active electrode may be disposed on the rotating member or on the shaft.

Abstract: Apparatus and methods for advancing and retracting a medical instrument within an introducer device, wherein the instrument includes a distal tip, a distal linear portion, a first distal curve, a substantially linear inter-curve portion, and a second proximal curve. The length of the distal linear portion and the angle of the first curve determine the position of the distal tip within a lumen of the introducer device, such that the distal tip occupies a substantially central transverse location within the lumen and the distal tip avoids contact with the introducer device. The length of the inter-curve portion and the angle of the second curve determine deflection of the distal tip from a longitudinal axis of the shaft when the second curve is extended distally beyond a distal end of the introducer device. Also, methods and apparatus for treating an intervertebral disc by ablation of disc tissue.

Abstract: The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ. The closed configuration is adapted for clamping and coagulating a target tissue while the apparatus is operating in the sub-ablation mode, while the open configuration is adapted for ablating the target tissue via molecular dissociation of tissue components. A method of the present invention comprises clamping a target tissue or organ with an electrosurgical probe. A first high frequency voltage is applied between the active electrode and the return electrode to effect coagulation of the clamped tissue. Thereafter, a second high frequency voltage is applied to effect localized molecular dissociation of the coagulated tissue.

Abstract: Systems, apparatus, and methods for treating spinal tissue and other body structures in open and endoscopic spine surgery to relieve symptoms, such as neck or back pain. In particular, the present invention provides methods for the controlled heating of various tissues in or around the vertebral column, including various interspinous tissues, such that spinal ligaments and cartilage surrounding the vertebrae and the facet joints are shrunk or tightened to stabilize the vertebral column of a patient. Thermal energy is applied to the target tissue in a subablation mode of an electrosurgical system to cause shrinkage of the tissue, thereby stiffening the interspinous tissue and stabilizing the vertebral column. In an exemplary embodiment, a high frequency RF voltage can be applied between one or more active electrode(s) and one or more return electrode(s) to heat a target interspinous tissue to within a temperature range at which irreversible shrinkage of the tissue occurs.

Abstract: Systems, apparatus, and methods for selectively applying electrical energy to a target location within the head or neck of a patient for treating obstructive sleep disorders. A method of the present invention involves positioning an electrosurgical probe with respect to a target tissue that affects the aperture of the upper airway of the patient. For example, the position of the tongue and the radix linguae affect the upper airway. The position of the tongue is controlled by the genioglossus muscle and tendon. The tendon of the genioglossus muscle may be irreversibly shrunk by positioning an electrosurgical probe in at least close proximity to the tendon, and applying a suitable high frequency voltage to the probe in a sub-ablation mode. Controlled heating of the tendon is effected by application of the high frequency voltage to the probe, wherein the voltage is insufficient to ablate the tissue of the tendon.

Abstract: Devices and methods for the selective orientation of electrodes for effecting the controlled ablation, coagulation, or other modification of a target tissue in vivo with no or minimal collateral tissue damage. The subject devices are electrosurgical wands configured to only bend in a single plane. The subject methods involve use of the subject devices to prepare for the treatment of a target tissue site.

Abstract: Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site, such as a synovial joint, of a patient. An electrosurgical probe of the invention includes a shaft, and a working end having an electrode array comprising an outer circular arrangement of active electrode terminals and an inner circular arrangement of active electrode terminals. The electrode array is adapted for the controlled ablation of hard tissue, such as meniscus tissue. The working end of the probe is curved to facilitate access to both medial meniscus and lateral meniscus from a portal of 1 cm. or less.

Abstract: Electrosurgical methods and apparatus for the controlled ablation of tissue from a target site of a patient. The instrument includes a shaft having proximal and distal end portion and a planar active electrode on the distal end portion; a return electrode arranged on the shaft spaced from the active electrode; at least one electrical connector extending through the shaft that connects the active electrode with a high frequency power supply; and an aspiration lumen within the shaft having a distal opening. The active electrode is arranged vertically or perpendicular to the tissue treatment surface. The planar electrode may include one or more apertures.

Abstract: The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ of a patients. An electrosurgical apparatus of the invention includes a shaft having a shaft distal end bearing an active electrode and a return electrode. At least one of the active electrode and the return electrode is moveable such that the shaft distal end can adopt a closed configuration or an open configuration. The apparatus can operate in an ablation mode or a sub-ablation mode. The closed configuration is adapted for clamping and coagulating a target tissue while the apparatus is operating in the sub-ablation mode, while the open configuration is adapted for ablating the target tissue via molecular dissociation of tissue components. A method of the present invention comprises clamping a target tissue or organ with an electrosurgical probe.

Abstract: Apparatus and methods for treating back pain of a patient by denervation of an intervertebral disc or a region of the posterior longitudinal ligament by the controlled application of heat to a target tissue. In one embodiment, the invention may include a procedure combining both decompression of a disc, and denervation of the annulus fibrosus. In one embodiment, a method of the invention includes positioning an active electrode of an electrosurgical instrument in at least close proximity to an intervertebral disc, and applying at least a first high frequency voltage between the active electrode and a return electrode, wherein nervous tissue within the annulus fibrosus is inactivated, and discogenic pain of the patient is alleviated.

Abstract: An electrosurgical system and method for ablating, resecting, or cutting body structures, with minimal or no damage to tissue adjacent to the treatment site. The system includes an electrosurgical probe having a shaft with a shaft distal end bifurcated to provide first and second arms. First and second electrode supports are disposed on the first and second arms, respectively. At least one active electrode, in the form of a loop or partial loop, is arranged between the first and second electrode supports. A return electrode, also in the form of a loop or partial loop, is arranged between the first and second electrode supports distal to the active electrode. The active and return electrodes are configured to promote substantially high electric field intensities and associated high current densities between the active portion and the target site when a high frequency voltage is applied to the electrodes.

Abstract: Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site of a patient. An electrosurgical apparatus of the invention includes an active electrode assembly having an active electrode screen surrounded by a plurality of flow protectors. Each flow protector defines a shielded region of the active electrode screen, each shielded region of the screen characterized by enhanced plasma formation. The active electrode assembly is adapted for removing tissue from a surgical site, and the active electrode screen is adapted for digesting fragments of resected tissue. In one embodiment, the apparatus is particularly suited to simultaneously removing both hard and soft tissue in, or around, a joint.

Abstract: The present invention provides systems, apparatus, and methods for dissecting, resecting, severing, cutting, contracting, coagulating, or otherwise modifying a tissue or organ of a patient. An apparatus of the invention includes an electrosurgical probe configurable between an open configuration and a closed configuration, the probe including an active electrode terminal, a fixed return electrode disposed proximal to the active electrode terminal, and a movable return electrode configured to move linearly with respect to the active electrode terminal between the open configuration and the closed configuration. A method of the present invention comprises clamping a blood vessel between the active electrode terminal and the movable return electrode, coagulating the clamped blood vessel by application of a first high frequency voltage, and severing the coagulated blood vessel by application of a second high frequency voltage.

Abstract: A method for treating a bone body comprises inserting a probe having at least one active electrode into the target tissue and applying a voltage difference between an active electrode and return electrode to ablate the tissue. The method is particularly directed to removing tumors in a bone body and or removing cancellous bone in a bone body. The bone body may be a vertebral body. An apparatus includes a plurality of active electrodes and a distal section including two bends. The bends serve to prevent the active electrodes from impinging upon the shaft of an introducer needle. Also, a kit includes an electrosurgical probe, an electrosurgical generator, an introducer needle, and a fluid connector to connect the introducer needle to a fluid source such that liquid may be supplied to the target site during an application.

Abstract: Methods and apparatus for resecting and ablating tissue at a target site of a patient, the apparatus including a probe having an elongate shaft. The shaft includes a shaft distal end portion and a shaft proximal end portion, and a resection unit located at the shaft distal end portion. The resection unit includes a resection electrode support and at least one resection electrode arranged on the resection electrode support. The at least one resection electrode includes a resection electrode head. The probe and resection electrode head are adapted for concurrent electrical ablation and mechanical resection of target tissue. The shaft may include at least one digestion electrode capable of aggressively ablating resected tissue fragments. At least one fluid delivery port on the shaft distal end portion may provide an electrically conductive fluid to the resection unit or to the target site.

Abstract: The present invention comprises electrosurgical apparatus and methods for maintaining patency in body passages subject to occlusion by invasive tissue growth. The apparatus includes an electrode support disposed at a shaft distal end having at least one active electrode arranged thereon, and at least one return electrode proximal to the at least one active electrode. In one embodiment, a plurality of active electrodes each comprising a curved wire loop portion are sealed within a distal portion of the electrode support. The apparatus and methods of the present invention may be used to open and maintain patency in virtually any hollow body passage which may be subject to occlusion by invasive cellular growth or invasive solid tumor growth. Suitable hollow body passages include ducts, orifices, lumens, and the like, with exemplary body passages including the coronary arteries.