Electrosurgical devices and methods for selective cutting of tissue
Methods and devices for cutting or coagulating. A device comprises a) an elongate member having a distal end, b) at least one foot member extending from the distal end of the elongate member, said foot member having a upper surface and a lower surface, c) an electrically and thermally insulating covering formed on at least the lower surface of the foot member and d) at least one electrode on the upper surface of the foot member. In operation, the at least one electrode is energized so as to cause cutting or coagulation of tissue located above the upper surface(s) of the foot member(s) while not causing substantial damage to tissue located below the lower surface(s) of the foot member(s).
1. A device for cutting or coagulating tissue, said device comprising:
an elongate member having a distal end;
a bifurcated foot member extending angularly from and to one side of the distal end of the elongate member, said bifurcated foot member comprising a right foot member portion having an upper surface, an inner edge and a lower surface and a left foot member portion having an upper surface, an inner edge and a lower surface, the inner edges of the right and left foot member portions being juxtaposed to each other with an open area therebetween;
an electrically and thermally insulating covering formed on at least the lower surfaces of the right and left foot member portions; and
an electrode on the upper surface of the right foot member portion; and
an electrode on the upper surface of the left foot member portion;
wherein the electrodes are energizable to thermally cut or coagulate tissue at a location above the open space located between the inner edges of the right and left foot members, without causing substantial thermal cutting and/or coagulation of tissue located below the lower surfaces of the right and left foot members.
2. A device according to claim 1 in combination with an electrosurgical generator for energizing the electrodes.
3. A device according to claim 1 wherein the electrically and thermally insulating covering is formed on the upper and lower surfaces of the right and left foot members and wherein the electrodes are located on top of the electrically and thermally insulating covering.
4. A device according to claim 1 further comprising at least one lumen useable for infusion of fluid or matter and/or aspiration of fluid or matter.
5. A device according to claim 4 wherein the device comprises first and second lumens such that fluid or matter may be infused through one lumen while fluid or matter is aspirated through the other lumen.
6. A device according to claim 1 wherein the insulating covering comprises a coating.
7. A device according to claim 1 wherein the insulating covering comprises a polymer coating.
8. A device according to claim 7 wherein the polymer coating comprises a polyimide coating.
9. A device according to claim 1 wherein the covering comprises a coating that has been applied by a coating method selected from the group consisting of:
single layer dip coating
multi layer dip coating
painting
powder (electro statically)
vapor deposition.
10. A device according to claim 1 further comprising a handpiece from which the elongate member extends.
11. A device according to claim 10 wherein the elongate member is releasably attached to the handpiece.
12. A device according to claim 11 wherein the elongate member is disposable and the handpiece is reusable.
13. A device according to claim 10 wherein the elongate member is permanently attached to or integrally formed with the handpiece.
14. A device according to claim 13 wherein the handpiece and elongate member are autoclavable.
15. A system comprising a device according to claim 1 in combination with a cannula through which the device is insertable.
16. A system according to claim 15 wherein the cannula comprises a rigid cannula.
17. A system according to claim 15 wherein the cannula comprises a flexible catheter or percutaneously insertable catheter.
18. A system comprising a device according to claim 1 in combination with an endoscope that is useable to view the positioning of the device within the body of a human or animal subject.
19. A system according to claim 18 wherein the endoscopic device is selected from the group consisting of:
gastrointestinal endoscopes;
dental endoscopes;
sigmoidoscopes;
colonoscopes;
laparoscopes;
thoracoscopes;
cystoscopes; and
arthroscopes.
20. A method for selective electrosurgical cutting or coagulation of tissue, said method comprising the steps of:
A) inserting a device which comprises;
an elongate member having a distal end;
a bifurcated foot member that extends angularly from, and to one side of, the distal end of the elongate member, said bifurcated foot member comprising a right foot member portion having an upper surface, an inner edge and a lower surface and a left foot member portion having an upper surface, an inner edge and a lower surface, the inner edges of the right and left foot member portions being juxtaposed to each other and an open area existing therebetween;
an electrode on the upper surface of the right foot member portion;
an electrode on the upper surface of the left foot member portion; and
an electrically and thermally insulating covering formed on at least the lower surfaces of the right and left foot member portions;
B) positioning the device such that tissue that is to be cut or coagulated is located directly above the open area that exists between said inner edges; and
C) energizing the electrodes to thermally cut or coagulate tissue located above the open area that exists between said inner edges, without causing substantial thermal cutting and/or coagulation of tissue located below the lower surfaces of the right and left foot members.
21. A method according to claim 20 wherein the mass of tissue comprises a tumor.
22. A method according to claim 20 wherein the mass of tissue comprises a blood vessel.
23. A method according to claim 20 wherein the mass of tissue comprises an adhesion.
24. A method according to claim 20 wherein the mass of tissue comprises a gastrointestinal polyp, tumor or other growth that protrudes from a wall of the colon, small intestine, duodenum, stomach, esophagus, oropharynx or oral cavity.
25. A method according to claim 20 wherein the mass of tissue comprises a retinal blood vessel.
26. A method according to claim 20 wherein the mass of tissue comprises an epiretinal membrane.
27. A method according to claim 20 wherein the mass of tissue comprises gingival tissue.
28. A method according to claim 20 wherein the mass of tissue comprises a dermatological lesion.
29. A method according to claim 20 wherein the mass of tissue comprises neurological tissue or abnormal tissue that is attached to neurological tissue.
30. A method according to claim 20 wherein the mass of tissue comprises a nodule or other growth on a vocal chord.
31. A method according to claim 20 wherein the mass of tissue comprises pericardium, endocardium or cardiac tissue.
32. A method according to claim 20 wherein the mass of tissue comprises cartilage, tendon or ligament.
33. A method according to claim 20 wherein the device is inserted through a channel of an endoscopic device.