Abstract: A cosmetic method of regenerating the skin in the region of a stretch mark is disclosed. The method comprises operating a source of thermal energy with a low thermal time constant, and directing it at the surface of the skin adjacent to and within a stretch mark forming first and second adjacent regions of thermally-modified tissue. The first region is adjacent to, and overlies, the second region, and the first region is thermally modified to a greater extend than the second region such that, following treatment, the width of the stretch mark is reduced and the reticular architecture of the dermis in the stretch mark is at least partially restored.

Abstract: A tissue treatment system includes a radio frequency (r.f.) generator, a treatment instrument connectible to the generator and to a source of ionisable gas and operable to produce a plasma jet at a nozzle of the instrument when supplied with the ionisable gas and energised by the generator. The generator is adapted to supply treatment energy to the instrument in the form of at least one discrete burst of pulses of r.f. energy, the burst having a preset number n of pulses, where 2?n?5.

Abstract: A system and method are disclosed for removing a uterus using a fluid enclosure inserted in the peritoneal cavity of a patient so as to enclose the uterus. The fluid enclosure includes a distal open end surrounded by an adjustable loop, that can be tightened, a first proximal opening for inserting an electrosurgical instrument into the fluid enclosure, and a second proximal opening for inserting an endoscope. The loop is either a resilient band extending around the edge of the distal open end or a drawstring type of arrangement that can be tightened and released. The fluid enclosure is partially inserted into the peritoneal cavity of a patient in a deflated condition and then manipulated within the peritoneal cavity over the body and fundus of the uterus to the level of the uterocervical junction. The loop is tightened around the uterocervical junction, after which the enclosure is inflated using a conductive fluid.

Abstract: A method is disclosed for treating benign conditions, such as enlarged tonsils and/or adenoids located in a patient's throat or nasopharynx, or soft tissue lesions located in a patient's oropharynx or larynx. According to the method, a space containing the patient's nasopharynx, oropharynx or pharynx and larynx is isolated from the patient's trachea and lungs using an inflatable cuff tracheostomy tube or nasotracheal tube inserted in the patient's trachea. The cuff is inflated to occlude the trachea. The patient is placed in a supine position, whereupon at least a portion of the space containing the nasopharynx and/or oropharynx and larynx is filled with saline. An endoscope is then inserted into the space to view the operative site in which the tonsils or tissue lesion are to be treated.

Abstract: An electrosurgical system comprises a radio frequency generator (1), an electrosurgical instrument (E1), and a fluid enclosure (42). The generator (1) has a radio frequency output for delivery of power to the electrosurgical instrument (E1) when immersed in an electrically-conductive fluid. The electrosurgical instrument (E1) has an electrode assembly (32) at the distal end thereof, the electrode assembly comprising a tissue treatment electrode (34), and a return electrode (38) axially spaced therefrom in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment electrode and the return electrode. The fluid enclosure (42) is adapted to surround an operation site on the skin of a patient or an incision leading to a cavity surgically created within the patient's body.

Abstract: In an electrosurgical system which is operable within the frequency range of from 100 kHz to 50 MHz and which has a handheld instrument with an elongate instrument shaft, the distal end of the shaft carries a bipolar electrode assembly for use in a conductive fluid field. The electrode assembly has an active electrode and, set back from the active electrode, a return electrode coated with an insulative dielectric layer. The insulative layer may be made of a plastics or a ceramic material and acts as the dielectric of a capacitor when the electrode assembly is immersed in the conductive fluid. One of the effects of the insulative layer is to provide a more uniformly distributed electric field over the return electrode than is obtained with an exposed return electrode, yielding improved tissue desiccation and vaporisation characteristics. The active electrode may have a similar dielectric covering.

Abstract: An electrosurgical instrument, which is used for the treatment of tissue in the presence of an electrically-conductive fluid medium, comprises an instrument shaft (10), and an electrode assembly (12) at one end of the shaft. The electrode assembly (12) comprises a tissue treatment electrode (14) and a return electrode (18) which is electrically insulated from the tissue treatment electrode by means of an insulation member (16). The tissue treatment electrode (14) is exposed at the distal end portion of the instrument (10), and the return electrode (18) has a fluid contact surface spaced proximally from the exposed end of the tissue treatment electrode by the insulation member (16). The exposed end of the tissue treatment electrode (14) is constituted by a plurality of tissue treatment filamentary members made of an electrically-conductive material, the filamentary members being electrically connected to a common electrical supply conductor.

Abstract: In an electrosurgical system which is operable within the frequency range of from 100kHz to 50MHz and which has a handheld instrument with an elongate instrument shaft, the distal end of the shaft carries a bipolar electrode assembly for use in a conductive fluid field. The electrode assembly has an active electrode and, set back from the active electrode, a return electrode coated with an insulative dielectric layer. The insulative layer may be made of a plastics or a ceramic material and acts as the dielectric of a capacitor when the electrode assembly is immersed in the conductive fluid. One of the effects of the insulative layer is to provide a more uniformly distributed electric field over the return electrode than is obtained with an exposed return electrode, yielding improved tissue desiccation and vaporisation characteristics. The active electrode may have a similar dielectric covering.

Abstract: A system and method are disclosed for removing a uterus using a fluid enclosure inserted in the peritoneal cavity of a patient so as to enclose the uterus. The fluid enclosure includes a distal open end surrounded by an adjustable loop, that can be tightened, a first proximal opening for inserting an electrosurgical instrument into the fluid enclosure, and a second proximal opening for inserting an endoscope. The loop is either a resilient band extending around the edge of the distal open end or a drawstring type of arrangement that can be tightened and released. The fluid enclosure is partially inserted into the peritoneal cavity of a patient in a deflated condition and then manipulated within the peritoneal cavity over the body and fundus of the uterus to the level of the uterocervical junction. The loop is tightened around the uterocervical junction, after which the enclosure is inflated using a conductive fluid.

Abstract: A method is disclosed for treating soft tissue lesions located in a patient's oropharynx or larynx. According to the method, a space within the patient's oropharynx and larynx is isolated from the patient's trachea and lungs using an inflatable cuff tracheostomy tube inserted in the patient's trachea. The cuff is inflated to occlude the trachea. The patient is placed in a supine position, whereupon at least a portion of the space within the oropharynx and larynx is filled with saline. An endoscope is then inserted into the space to view the operative site in which the soft tissue lesion is to be treated. An electrosurgical instrument having an active tissue treatment electrode and a return electrode connected to an electrosurgical generator is then inserted into the space, either along side the endoscope or through the endoscope's working channel.

Abstract: A method for skin treatment comprises the steps of delivering at least one pulse of radio frequency power to at least one electrode in order to create an electric field; passing gas through the electric field in order to form plasma from the gas; and applying the plasma to the surface of skin. The amount of radio frequency power may be relatively low such that the application of plasma causes denaturation of collagen within the collagen-containing tissue beneath the skin surface, which may promote the generation of new collagen within the collagen-containing tissue.

Abstract: An electrosurgery system includes an electrosurgical generator (10) coupled to or part of an electrosurgical instrument, the generator being operable to generate electrosurgical power in low frequency (typically at 1 MHz) and high frequency bands (typically at 2.45 GHz) either simultaneously or individually. The generator includes a load-responsive control circuit which, in one mode, causes power to be generated predominantly at 1 MHz when the load impedance is high and predominantly at 2.45 MHz when it is low. This allows automatic switching between cutting and coagulation operation. In one embodiment, the instrument includes a gas plasma generator operating such that an ionisable gas is energised in a gas supply passage by the 2.45 GHz component to form a plasma stream which acts as a conductor for delivering the 1 MHz component to a tissue treatment outlet of the passage.

Abstract: An electrosurgery system includes an electrosurgical generator (10) coupled to or part of an electrosurgical instrument, the generator being operable to generate electrosurgical power in low frequency (typically at 1 MHz) and high frequency bands (typically at 2.45 GHz) either simultaneously or individually the generator includes a load-responsive control circuit which, in one mode, causes power to be generated predominantly at 1 MHz when the load impedance is high and predominantly at 2.45 MHz when it is low. This allows automatic switching between cutting and coagulation operation. In one embodiment, the instrument includes a gas plasma generator operating such that an ionizable gas is energized in a gas supply passage by the 2.45 GHz component to form a plasma stream which acts as a conductor for delivering the 1 MHz component to a tissue treatment outlet of the passage. (FIG. 4).

Abstract: An electrosurgical instrument is provided for the treatment of tissue in the presence of an electrically-conductive fluid medium. The instrument comprises an instrument shaft (10), a tissue treatment electrode (12) at one end of the shaft, and removal means, the instrument having an apertured portion (20a) through which matter can be aspirated by the removal means from the region surrounding the tissue treatment electrode. The removal means comprises a channel formed within the instrument shaft (10) and leading from the apertured portion (20a). The channel is provided with agitation means (14) for preventing the build-up of sublimation products within the channel.

Abstract: An electrosurgical instrument is provided for the treatment of tissue in the presence of an electrically-conductive fluid medium. The instrument comprises an instrument shaft (10), and a tissue treatment electrode (12) at the distal end of the shaft for electrosurgically excising tissue pieces at an operation site. The tissue treatment electrode (12) is cyclically movable relative to the distal end of the shaft (10). Threshold control means are provided for controlling the power threshold for vaporisation of the electrically-conductive fluid medium at the tissue treatment electrode (12).

Abstract: A surgical technique for treating bladder outflow obstruction is disclosed in which access is gained to the treatment site via the bladder itself through one or more suprapubic conduits. The disclosed technique includes inserting at least a first conduit suprapubically into the bladder, inserting at least a surgical instrument along the first conduit, distending the bladder with an isotonic fluid, viewing the position of the instrument using remote visualisation means, direct visualisation means, or a combination of the two, and using the surgical instrument to create at least one hole in the prostate gland, thereby to debulk the adenoma. Preferably the procedure is performed using electrosurgery, which offers significant advantages in terms of minimally invasive surgery and patient recovery times in comparison to more conventional forms of surgery.

Abstract: An electrosurgical instrument is provided for the treatment of tissue in the presence of an electrically-conductive fluid medium. The instrument comprises an instrument shaft (10), and a tissue treatment electrode (12) at the distal end of the shaft for electrosurgically excising tissue pieces at an operation site. The tissue treatment electrode (12) is cyclically movable relative to the distal end of the shaft (10). Threshold control means are provided for controlling the power threshold for vaporization of the electrically-conductive fluid medium at the tissue treatment electrode (12).

Abstract: An electrosurgical instrument, which is used for the treatment of tissue in the presence of an electrically-conductive fluid medium, comprises an instrument shaft, and an electrode assembly at one end of the shaft. The electrode assembly comprises a tissue treatment electrode and a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member. The tissue treatment electrode has an exposed end for treating tissue, and the return electrode has a fluid contact surface which is spaced from the tissue treatment electrode in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment electrode and the return electrode. The electrode assembly is provided with a plurality of apertures in the region of the tissue treatment electrode, through which apertures vapour bubbles and/or particulate material can be aspirated from the region surrounding the tissue treatment electrode.

Abstract: A method for skin treatment comprises the steps of delivering at least one pulse of radio frequency power to at least one electrode in order to create an electric field; passing gas through the electric field in order to form plasma from the gas; and applying the plasma to the surface of skin. The amount of radio frequency power may be relatively low such that the application of plasma causes denaturation of collagen within the collagen-containing tissue beneath the skin surface, which may promote the generation of new collagen within the collagen-containing tissue.

Abstract: An electrosurgical system comprises a radio frequency generator (1), an electrosurgical instrument (E1), and a fluid enclosure (42). The generator (1) has a radio frequency output for delivery of power to the electrosurgical instrument (E1) when immersed in an electrically-conductive fluid. The electrosurgical instrument (E1) has an electrode assembly (32) at the distal end thereof, the electrode assembly comprising a tissue treatment electrode (34), and a return electrode (38) axially spaced therefrom in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment electrode and the return electrode. The fluid enclosure (42) is adapted to surround an operation site on the skin of a patient or an incision leading to a cavity surgically created within the patient's body.