Abstract:
A delivery apparatus for supporting an electrosurgical instrument and for connecting the electrosurgical instrument to an electrosurgical energy source is provided. The delivery apparatus includes a selectively positionable housing including a plurality of rigid segments and a joint member interposed between each adjacent rigid member; and a transmission medium extending through at least one of the segments of the housing. The transmission medium is configured to transmit electrosurgical energy between the electrosurgical energy source and the electrosurgical instrument. In use, the housing is movable between a first position wherein an electrosurgical instrument supported on an end of the housing is remote from an operative site and a second position wherein the electrosurgical instrument supported on the end of the housing is proximate to the operative site.

Description:
BACKGROUND 
       [0001]    1. Technical Field 
         [0002]    The present disclosure relates to medical/surgical therapeutic energy delivery procedures and apparatus and, more particularly, to an apparatus for efficient power delivery in electrosurgical energy delivery procedures and methods of efficiently delivering said electrosurgical energy to an electrosurgical treatment device. 
         [0003]    2. Background of Related Art 
         [0004]    In the treatment of diseases, such as cancer, certain types of cancer cells have been found to denature at elevated temperatures (which are slightly lower than temperatures normally injurious to healthy cells). These types of treatments, known generally as hyperthermia therapy, typically utilize electromagnetic radiation to heat diseased cells to temperatures above 41° C. while maintaining adjacent healthy cells at lower temperatures where irreversible cell destruction will not occur. Other procedures utilizing electromagnetic radiation to heat tissue also include ablation and coagulation of the tissue. 
         [0005]    Such electrosurgical procedures benefit from efficient transfer of electrosurgical energy from a point of power generation, e.g., a generator, to the point of application or to the treatment device. The overall efficiency of the electrosurgical energy transfer is dependent on the transmission path between the point of power generation and the point of application. The transmission path may include an elongated transmission medium or conductor, e.g., a rigid, semi-rigid or flexible coaxial cable, waveguide or other suitable conductor, one or more connectors, a transmission line of the electrosurgical energy delivery device and the electrosurgical energy delivery or treatment device itself, i.e., a microwave antenna, mono-polar or bi-polar RF energy delivery device or other type of applicator for power delivery. 
         [0006]    Flexible conductors inherently increase the power dissipated or lost along the transmission medium, due to the materials and dimensional configurations of their constructions. Non-flexible conductors (e.g., rigid, semi-rigid or waveguide transmission conductors), while potentially dissipating less energy along the transmission path as compared to flexible conductors, generally limit the ability to freely position and maintain the position of the electrosurgical energy delivery device as well as limit the movement and position of operators in the vicinity thereof. 
       SUMMARY 
       [0007]    The present disclosure relates an apparatus for efficient power delivery in electrosurgical energy delivery procedures and methods of efficiently delivering said electrosurgical energy to an electrosurgical treatment device. 
         [0008]    According to an aspect of the present disclosure, a delivery apparatus for supporting an electrosurgical instrument and for connecting the electrosurgical instrument to an electrosurgical energy source is provided. The delivery apparatus includes a selectively positionable housing including a plurality of rigid segments and a joint member interposed between each adjacent rigid member; and a transmission medium extending through at least one of the segments of the housing. The transmission medium is configured to transmit electrosurgical energy between the electrosurgical energy source and the electrosurgical instrument. In use, the housing is movable between a first position wherein an electrosurgical instrument supported on an end of the housing is remote from an operative site and a second position wherein the electrosurgical instrument supported on the end of the housing is proximate to the operative site. 
         [0009]    According to another aspect of the present disclosure, a system for maneuvering an electrosurgical instrument to/from an operative site and for connecting the electrosurgical instrument to an electrosurgical energy source is provided. The system includes an electrosurgical energy source; an electrosurgical instrument; and a delivery apparatus supported on and electrically coupled to the electrosurgical energy source. The delivery apparatus includes a selectively positionable housing including a plurality of rigid segments and a joint member interposed between each adjacent rigid member, the housing being configured to support the electrosurgical instrument at a free end thereof; and a transmission medium extending between the electrosurgical energy source and the electrosurgical instrument, through at least one of the segments of the housing, wherein the transmission medium is configured to transmit electrosurgical energy between the electrosurgical energy source and the electrosurgical instrument. In use, the housing is movable between a first position wherein the electrosurgical instrument supported on the free end of the housing is remote from the operative site and a second position wherein the surgical instrument supported on the free end of the housing is proximate to the operative site. 
         [0010]    The transmission medium may be continuous and flexible along at least a portion of its length. The transmission medium may include a plurality of segments electromechanically joined to one another. Each segment of the housing may support at least one segment of the transmission medium. 
         [0011]    The system may further include an electromechanical coupling inter-connecting adjacent segments of the transmission medium. Each electromechanical coupling may be configured to permit adjacent segments of the transmission medium to pivot off axis relative to one another and/or rotate axially relative to one another. 
         [0012]    The transmission medium may be a relatively flexible coaxial cable, a semi-rigid coaxial cable, a fully rigid coaxial cable, a fully rigid coaxial cable with an air dielectric, and/or a wave-guide. 
         [0013]    The housing may prevent bending of the segments of the transmission medium along their individual lengths. 
         [0014]    According to yet another aspect of the present disclosure, a method of maneuvering an electrosurgical instrument to/from a surgical site, wherein the electrosurgical instrument is electrically connected to an electrosurgical energy source is provided. The method includes the steps of providing a delivery apparatus supported on and electrically coupled to the electrosurgical energy source; supporting a transmission medium on a housing of the delivery apparatus; supporting the electrosurgical instrument on a free end of the housing and electrically connecting the electrosurgical instrument to the transmission medium; manipulating the housing to move the electrosurgical instrument to a first position to perform an electrosurgical procedure; and manipulating the housing to move the electrosurgical instrument to a second position upon completion of the electrosurgical procedure. 
         [0015]    The method may further include the step of minimizing a loss of energy transmitted from the electrosurgical energy source to the electrosurgical instrument. The method may further include the step of minimizing bending of the transmission medium between the electrosurgical energy source and the electrosurgical instrument. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]    Embodiments of the presently disclosed electrosurgical energy delivery apparatus are disclosed herein with reference to the drawings, wherein: 
           [0017]      FIG. 1  is a schematic illustration of a system for supplying electrosurgical energy for therapeutic energy therapy, including the electrosurgical energy delivery apparatus according to an embodiment of the present disclosure; 
           [0018]      FIG. 2A  is a schematic illustration of exemplary energy delivery devices configured for connection to the electrosurgical energy delivery apparatus of  FIG. 1 ; 
           [0019]      FIG. 2B  is a schematic illustration of an exemplary energy delivery device configured for connection to the electrosurgical energy delivery apparatus of  FIG. 1 ; 
           [0020]      FIG. 3  is a schematic, side elevational view of the electrosurgical energy delivery apparatus of  FIG. 1 ; and 
           [0021]      FIG. 4  is a top, plan view of the electrosurgical energy delivery apparatus of  FIGS. 1 and 2 . 
       
    
    
     DETAILED DESCRIPTION 
       [0022]    Embodiments of the presently disclosed electrosurgical energy delivery apparatus will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein and as is traditional, the term “distal” refers to the portion of the device or instrument that is furthest from the user and the term “proximal” refers to the portion of the device or instrument that is closest to the user. In addition, terms such as “above”, “below”, “forward”, “rearward”, etc. refer to the orientation of the figures or the direction of components and are simply used for convenience of description. 
         [0023]    One component that affects the efficiency of electrosurgical energy delivery between a point of power or energy generation (e.g., generator) and patient tissue and/or an energy delivery device is the loss of energy or energy dissipation along a transmission medium. The transmission medium may contain one or more components between the output connector on the electrosurgical generator and the input connector on the electrosurgical energy delivery device. 
         [0024]    Referring now to  FIG. 1 , a system for supplying electrosurgical energy (e.g., microwave energy) for therapeutic energy therapy (e.g., microwave energy treatment), according to an embodiment of the present disclosure, is shown as  10 . System  10  includes an electrosurgical generator  20  having a controller  22  for controlling the operation of electrosurgical generator  20 , at least one electrosurgical delivery instrument or device  30  (see  FIGS. 2A and 2B ), and an electrosurgical energy delivery apparatus  100 , according to an embodiment of the present disclosure, coupled between at least one power output  24  on the electrosurgical generator  20  and the at least one device  30 . 
         [0025]    In the illustrated embodiment, delivery apparatus  100  includes a jointed, articulating arm, in the form of a rig, boom, armature or housing  110  coupled to electrosurgical generator  20 . Housing  110  is configured to house at least a portion of a transmission medium  120  therein. Delivery apparatus  100  includes a first connector  112  electrically connected to a first end of transmission medium  120 , proximate a proximal end of housing  110 , and configured for connection to a complementary connector  24  provided on or in electrosurgical generator  20 . Delivery apparatus  100  further includes at least a second connector  114  electrically connected to a second end of transmission medium  120 , proximate a distal end of housing  110 , and configured for connection to a complementary connector provided on or in the electrosurgical energy delivery device  30 . 
         [0026]    Housing  110  may be formed from any suitable material capable of housing transmission medium  120  and capable of providing sufficient strength for supporting the various components contained therewithin (e.g., connectors  112 ,  114 ). Housing  110  may include any number of sections or segments  110   a  joined to one another via interconnecting, articulatable joints  110   b . Joints  110   b  may be any suitable hinge-like member capable of enabling deflection of one segment  110   a  of housing  110  relative to an adjacent segment  110   a  of housing  110 . Joints  110   b  may be configured to enable adjacent sections  110   a  of housing  110  to deflect uni-directionally or omni-directionally. 
         [0027]    Housing  110  of delivery apparatus  100  may be configured to retain any number of transmission mediums or segments, such as, for example, two transmission mediums  120   a ,  120   b , as shown in  FIGS. 3 and 4 . 
         [0028]    Transmission medium  120  is formed from one or more sections of a relatively low loss cable (rigid, semi-rigid or flexible coaxial cable), a waveguide, a bus-bar or any other suitable means for transmitting electrosurgical energy or any desirable combination thereof. The various sections of transmission medium  120  may be coupled to one another using suitable low loss couplings or connectors (not shown). Suitable low loss couplings or connectors may include rotating couplings or connectors that insure that the physical limitations, e.g., minimum bend radiuses, operating tensions and temperatures, of the transmission medium are not violated. Exemplary transmission mediums  120  are shown and described in commonly owned U.S. application Ser. No. 11/85,052, filed on May 22, 2007, entitled “Energy Delivery Conduits for Use With Electrosurgical Devices”. 
         [0029]    Suitable transmission media for use or inclusion in housing  110  of delivery apparatus  100  include, and are not limited to, a non-rigid/flexible coaxial cable (having a relatively high degree of transmission loss), a semi-rigid coaxial cable (having a relatively moderate-to-high degree of transmission loss), a fully rigid coaxial cable (having a relatively moderate degree of transmission loss), a fully rigid coaxial cable with an air dielectric (having a relatively moderate-to-low degree of transmission loss), and a wave-guide transmission medium (having a relatively low degree of transmission loss). 
         [0030]    The particular type of transmission medium included in housing  110  will determine the type of joint or couplings interconnecting various sections of the transmission medium. For example, if a flexible coaxial cable is the selected transmission medium, no couplings may be required as a single length of said transmission medium is sufficiently flexible to pass through housing  110  and be relatively unaffected by joints  110   b  of housing  110 . 
         [0031]    If a transmission medium having a relatively higher degree of rigidity is selected, the transmission medium may be separated into individual segments corresponding to the various segments  110   a  of housing  110 . In this embodiment, a suitable electromechanical coupling or fitting is employed to interconnect adjacent segments of the transmission medium. Electromechanical couplings are configured to permit adjacent segments of the transmission medium to pivot off axis relative to one another, to rotate axially relative to one another and to minimize energy loss from one segment of the transmission medium to the next. 
         [0032]    As seen in  FIG. 2A , delivery apparatus  100  is configured to selectively couple with various electrosurgical energy delivery devices  30 , such as, for example, an electrosurgical pencil, probe, needle antenna or the like. Delivery device  30  may be directly coupled to second connector  114  of delivery apparatus  100 , or delivery device  30  may be coupled to second connector  114  of delivery apparatus  100  via a further electrical conduit  32  or the like and a corresponding plug  34 . 
         [0033]    As seen in  FIG. 2B , a connector expansion plug  125  may be provided for selective inter-connection with second connector  114 . Expansion plug  125  is configured to expand the number of electrosurgical energy delivery devices  30  that may be coupled to delivery apparatus  110  via second connector  114 . For example, as seen in  FIG. 2B , expansion plug  125  may be configured to accommodate any suitable number of electrosurgical energy delivery devices  30  (three shown). Electrosurgical energy delivery devices  30  may be coupled to plug  125  via corresponding electrical conduits  32  and plugs  34 . Alternatively, electrosurgical energy delivery devices  30  may be coupled to plug  125  via an articulating armature  32   a  and a corresponding plug  34 . 
         [0034]    With reference to  FIGS. 3 and 4 , the path of transmission medium  120  of delivery apparatus  100  may be defined by at least one guide or positioning member  130  that functions to guide and/or constrain transmission medium  120  along a path through sections  110   a  of housing  110 . Guide members  130  aid in ensuring that the physical properties of transmission medium  120  are not violated as housing  110  is manipulated, for example, minimum bend radiuses and tensions. As shown in  FIGS. 3 and 4 , guide members  130  are configured to constrain transmission medium  120  and limit the movement and/or degree of deflection of transmission medium  120  to ensure that, as sections  110   a  of housing  110  are manipulated, any physical limitations of transmission medium  120  are not violated (e.g., minimum bend radius of transmission medium  120  that is a rigid or semi-rigid coaxial cable). 
         [0035]    As seen in  FIGS. 3 and 4 , guide members  130  include pins, dowels or the like disposed on opposed sides of transmission medium  120 . In this manner, as sections  110   a  of housing  110  are articulated with respect to one another about joints  110   b , guide members  130  function to enlarge a radius of curvature of transmission medium  120  as transmission medium  120  is being bent. In so doing, the efficiency of the transmission of energy through a bent transmission medium  120  is maintained relatively high and/or the dissipation of energy through transmission medium  120  is minimized. 
         [0036]    A position, orientation and/or location of delivery apparatus  100  may be achieved relative to, and independently of, the position of generator  20 . For example, a distal-most end of housing  110  of delivery apparatus  100  may be moved in horizontal (X and Y axes) and vertical (Z axis) directions to optimize or maximize a distance between generator  20  and the distal-most end of housing  110 . In particular, joints  110   b  of housing  110  are configured to enable movement of sections  110   a  of housing  110  is any direction and for maintaining the position of sections  110   a  of housing  110  after housing  110  is released by the user. 
         [0037]    By way of example only, sections  110   a  of housing  110  may be interconnected by articulating and/or pivoting joints  110   b  which may have an adjustable tension or tightening feature enabling the joints to retain the relative positioning of sections  110   a , to allow relatively free movement of any of sections  110   a  relative to one another, or allow relatively controlled movement of any of sections  110   a  relative to one another. It is contemplated that joints  110   b  may be selected such that when a distal end of housing  110  is unsupported or not held by the user, that housing  110  will remain in the last position moved to by the user. 
         [0038]    Movement of segments  110   a  of housing  110  may be facilitated through one or more mechanical joints  110   b , as mentioned above. Joints  110   b  may include hinge joints, ball joints or other suitable means to provide movement between two adjacent sections  110   a . Joints  110   b  may be integrally formed with segments  110   a  of housing  110  or may be fixed to segments  110   a  of housing  110 . In an alternate embodiment, at least one segment  110   a  of housing  110  may be formed of a semi-rigid, yet flexible, tube-like material that can be manipulated, flexed and/or bent in a plurality of positions and/or directions. 
         [0039]    Since the distance between generator  20  and second connector  114  of electrosurgical energy delivery apparatus  100  is traversed by the low loss transmission medium  120 , the dissipation and losses of energy therebetween are minimized. As such, a relatively more flexible medium, albeit higher energy dissipating, may be used to transfer power from second connector  114  of electrosurgical energy delivery apparatus  100  to a point of application or to an electrosurgical energy delivery device  30 , without unduly increasing the dissipation and/or losses of energy of the entire system. 
         [0040]    The electrosurgical energy delivery apparatus and the methods of use discussed above are not limited to microwave antennas used for hyperthermic, ablation, and coagulation treatments but may include any number of further microwave antenna applications. While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Modification of the above-described system and methods for using the same, and variations of aspects of the disclosure that are obvious to those of skill in the art are intended to be within the scope of the claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments.