Dual-mode electrosurgical devices and electrosurgical methods using same
Herein disclosed are dual-mode electrosurgical devices designed to function in a first mode in which high-density RF energy is used to cut or vaporize tissue, and then a second mode in which lower-density RF energy desiccates tissue to produce hemostasis, as well as methods of performing electrosurgery using same. Devices formed in accordance with the principles of this invention may be used for any surgical procedure in which highly vascular tissue is cut electrosurgically in a dry or semi-dry field, examples of which include tonsillectomy, liver resection, and cosmetic procedures such as breast augmentation, breast reduction, breast mastopexy, and abdominoplasty.
1. A method of performing an electrosurgical procedure on a living subject in which target tissue of interest within a surgical site is first cut or vaporized then desiccated so as to produce hemostasis at said site, said method comprising the steps of: a. introducing a dual-mode electrosurgical device into the subject, wherein said dual-mode electrosurgical device comprises a distal end active electrode characterized by (i) a tubular proximal portion that includes at least one irrigation port configured to introduce a conductive irrigant to the surgical site and (ii) a flattened distal portion comprising a blade element having a top side and a bottom side that terminates in a distal-most cutting edge, b. manipulating said device to the surgical site; c. using said dual-mode electrosurgical device to apply high-density RF energy to tissue at said surgical site so as to cut or vaporize said tissue; and d. using said dual-mode electrosurgical device to apply a lower-density RF energy to said surgical site so as to desiccate remaining tissue and produce hemostasis at said site, wherein said conductive irrigant is supplied on command to the surgical site via said at least one irrigation port between steps (c) and (d) so as to reduce the current density and thus produce desiccation of tissue in contact with said conductive irrigant.
2. The method of claim 1 , wherein the blade element comprises a movable element and the tubular proximal portion of the active electrode comprises a fixed element, wherein in a first extended position, the blade element contacts the tissue and acts as a cutting element, and in second retracted position, the blade element is proximally retracted into said tubular proximal portion to thereby allow the conductive irrigant to flow to said surgical site via said at least one irrigation port and produce desiccation of tissue in contact with said conductive irrigant.
3. The method of claim 1 , wherein the electrosurgical device comprises a brush of non-conductive fibers that spread the conductive irrigant over the surgical site so as to further reduce the current density and enhance desiccation.
4. The method of claim 3 , wherein the nonconductive fibers are randomly oriented so as to form a wool or mat saturated with conductive irrigant that forms a conductive path for RF energy to tissue that contacts the nonconductive wool.
5. The method of claim 1 , wherein irrigant is supplied to the device by one of: gravity from a hung bag, a manual pump activated by the surgeon, and a mechanical pump.
6. The method of claim 1 , wherein irrigant is supplied to the surgical site upon manual action, or electrical activation by the surgeon.
7. The method of claim 1 , wherein the electrosurgical procedure comprises a tonsillectomy.
8. The method of claim 1 , wherein the electrosurgical procedure comprises a liver resection.
9. The method of claim 1 , wherein the electrosurgical procedure comprises a cosmetic procedure selected from among breast augmentation, breast reduction, breast mastopexy, and abdominoplasty.
10. The method of claim 1 , wherein said blade element retracts into said tubular proximal portion.
11. The method of claim 1 , wherein distal-most cutting edge includes serrations that enhance cutting performance.
12. The method of claim 1 , wherein said blade element has a closed distal end.
13. The method of claim 1 , wherein said tubular proximal portion comprises a first irrigation port proximate to said blade element top side and an opposed second irrigation port proximate to said blade element bottom side.
14. The method of claim 1 , wherein said active electrode is fabricated from a piece of metal tubing having proximal and distal portions, wherein the proximal portion of said metal tubing has a diameter equivalent to that of the tubular proximal portion of said active electrode and the distal portion of said metal tubing is flattened to form the blade element of said active electrode.
15. The method of claim 1 , wherein step (c) is performed in the absence of conductive irrigant whereas step (d) is performed in the presence of conductive irrigant.