Abstract: Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode.

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 treating herniated or swollen discs within a patient's spine by applying sufficient electrical energy to the disc tissue to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.

Abstract: System method and apparatus for accurately carrying out the in situ heating of a targeted tissue. Small implants are employed with the targeted tissue which exhibit an abrupt change of magnetic permeability at an elected Curie temperature. The permeability state of the implant is monitored utilizing a magnetometer. The implants may be formed as a setpoint temperature determining component combined with a non-magnetic heater component to enhance the tissue heating control of the system. With the system, a very accurate quantum of heat energy can be supplied to a neoplastic lesion or tissue carrying infectious disease so as to maximize the induction of heat shock proteins. The system also may be utilized in conjunction with non-magnetic arterially implanted stents for the hyperthermia therapy treatment of restenosis and in conjunction with the mending of boney tissue.

Abstract: An electrosurgical probe comprises a shaft having an electrode array (12) at its distal end and a connector at its proximal end. The array (12) includes a plurality of isolated electrode terminals, and an electrosurgical power supply (28) is provided with a multiplicity of independently limited or controlled current sources and a connector. The electrosurgical probe and the power supply may be connected through their respective connectors so that the independent current sources are connected to individual electrode terminals. By applying very high frequency electrical energy to the electrode array, target tissue may be cut or ablated while heat dissipation through low impedance paths, such as blood and normal saline, will be minimized.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. In one aspect, a method is provided for reducing the volume of enlarge swollen tissue in the patient's nose, such as swollen nasal tissue, mucus membranes, turbinates, polyps, neoplasms, cartilage (e.g., the nasal septum) or the like. In particular, the turbinates are treated by positioning one or more electrode terminal(s) adjacent to the turbinates, and delivering electrically conductive fluid, such as isotonic saline, to the nasal cavity to substantially surround the electrode terminal(s) with the fluid.

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: 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 treating herniated or swollen discs within a patient's spine by applying sufficient electrical energy to the disc tissue to contract or shrink the collagen fibers within the nucleus pulposis. This causes the pulposis to shrink and withdraw from its impingement on the spinal nerve.

Abstract: A method for transmyocardial revascularization of the heart of a patient includes positioning an active electrode surface in close proximity to a target site on the wall of a patient's heart, and applying high frequency voltage between the active voltage surface and a return electrode to ablate tissue at the heart wall. The high frequency voltage ablates, i.e. volumetrically removes the heart tissue, and the electrode surface is axially translated into the space vacated by the removed tissue to bore a channel through the heart tissue. The active electrode surface may be introduced into the thoracic cavity and placed adjacent the epicardium to form an inward channel toward the ventricular cavity, or it may be delivered into the ventricular cavity of the heart and positioned adjacent the endocardium to form a channel extending outward towards the epicardium.

Abstract: Implant apparatus and method for effecting a controlled heating of tissue within the region of dermis of skin. The heater implants are configured with a thermally insulative generally flat support functioning as a thermal barrier. One surface of this thermal barrier carries one or more electrodes within a radiofrequency excitable circuit as well as an associated temperature sensing circuit. The implants are located within heating channels at the interface between skin dermis and the next adjacent subcutaneous tissue layer such that the electrodes are contactable with the lower region of dermis. During therapy a conformal heat sink is positioned against the skin above the implants and a slight tamponade is applied through the heat sink to assure uniform dermis contact with electrode surfaces. An adjuvant may be employed to infiltrate dermis to significantly lower the thermal threshold transition temperature for dermis or dermis component shrinkage.

Abstract: Method, system and apparatus for carrying out a controlled heating of tissue in the region of skin dermis. A quasi-bipolar arrangement of wands or implants carrying multi-segmented active electrodes, temperature sensing and wand location LEDs as combined with a return electrode and heat sink function. Radiofrequency energization of the active electrodes is carried out in a ramping-up and pulsing fashion to provide relatively short therapy intervals. The combined return electrode and heat sink components may incorporate photo-detectors, which perform to insure proper alignment with the LED carrying active electrode sequences. An isotonic saline solution is located intermediate the contact surface of the combined return electrode and heat sink and the surface of skin over implanted active electrodes.

Abstract: Method for effecting a controlled heating of tissue within the region of dermis which employs heater implants which are configured with a thermally insulative generally flat support functioning as a thermal barrier. From the surface of this thermal barrier are supported one or more electrodes within a radiofrequency excitable circuit as well as an associated temperature sensing circuit. A model of R.F. current path flow is developed resulting in a current path index permitting a prediction of current path flow. Improved electrode excitation is developed with an intermittent R.F. excitation of electrodes shortening therapy time and improving skin protection against thermal trauma.

Abstract: Method, system and apparatus for carrying out accurate electrosurgical cutting. A thin resilient electrode is utilized at the forward end region of an instrument which is deployable from a longitudinally disposed slot positioned rearwardly of the tip of the instrument. Lateral sides of the slot extend between a forward location adjacent the tip and a rearward location. The electrode is deployed by urging it forwardly in compression to form an arch profile supported by the abutting slot sides adjacent the forward and rearward locations. Electrosurgically excitable with a cutting output, the electrode may carry out a cutting action both during its deployment and retraction into the noted slot. This permits a pivoting maneuver effective for circumscribing a volume of targeted tissue.

Abstract: Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

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: Methods and apparatus for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. In a method of the invention high frequency (RF) electrical energy is applied to one or more active electrodes on an electrosurgical probe in the presence of an electrically conductive fluid to remove, contract or otherwise modify the structure of tissue targeted for treatment. In one aspect, a dura mater and spinal cord are insulated from the electrical energy by an insulator positioned on a non-active side of the probe. In another aspect, a plasma is aggressively formed in the electrically conductive fluid by delivering a conductive fluid to a distal end portion of the probe and aspirating the fluid from a location proximal of the return electrode.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: A system and method for surface tissue ablation on the patient's outer skin, such as the epidermis or the underlying dermis. An electrosurgical probe (130) comprises a shaft (132) having an array of active electrodes (136) on its distal tip and a connector (134) at its proximal end for coupling the electrode array to a high frequency power supply. An electrically conducting liquid is directed along a fluid flow path (142) past a return electrode surface (138) to the target site to provide a current flow path between the target site and the return electrode. High frequency voltage is then applied to the active and return electrodes so that an electric current flows from the active electrode, through a layer of vapor formed at the tip of the electrode, and to the return electrode through the current flow path provided by the electrically conducting liquid.

Abstract: An electrosurgical probe comprises a shaft having at least one electrode terminal at its distal end and a connector at its proximal end. The electrode terminal may be spaced from a return electrode such that when the electrode terminal is brought adjacent a tissue structure immersed in an electrically conductive fluid from outside the body, the electrically conductive fluid completes a conduction path between the electrode terminal and the return electrode. By applying high frequency electrical energy to the electrode terminal, target tissue may be cut or ablated while heat dissipation through low impedance paths, such as blood and normal saline, will be minimized. Related methods are disclosed.

Abstract: Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.