Abstract:
One embodiment of the present invention relates to an electrosurgical device for conducting surgery. The device includes a tubular housing and a plurality of electrodes disposed within said tubular housing. The device further includes an actuator connected to the plurality of electrodes to extend and retract at least one of the plurality electrodes to and from the tubular housing.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application claims priority to provisional patent application 62/079,446, the entirety of which is hereby incorporated by reference. 
     
    
     BACKGROUND 
       [0002]    The present invention relates to surgery performed on a patient by a surgical physician, a surgeon, and, more specifically, relates to back surgery. Specialized back surgery on or in-between vertebrae of the spine and on spinal discs involves various meticulous surgical procedures which can be challenging, even for experienced surgeons who specialize in this particular surgery. Minimally invasive techniques are preferred over traditional open surgical procedures which require extensive operating time and post-operative recovery time. 
         [0003]    When employing minimally invasive surgical techniques on or between spinal vertebrae or on discs, one of the challenging requirements relates to providing electrodes of an electrosurgical device into the operative field. 
       SUMMARY OF THE INVENTION 
       [0004]    One embodiment of the present invention relates to an electrosurgical device for conducting spinal surgery. The device includes a tubular housing and a plurality of electrodes disposed within said tubular housing. The device further includes an actuator connected to the plurality of electrodes to extend and retract at least one of the plurality electrodes to and from the tubular housing. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0005]      FIG. 1  is a perspective view of an electrosurgical instrument according to one aspect of the invention; 
           [0006]      FIG. 2  is a plan view of an electrosurgical instrument according to one aspect of the invention; 
           [0007]      FIG. 3  is a cross-sectional view of an electrosurgical instrument according to an aspect of the invention; 
           [0008]      FIG. 4  is a perspective view of an electrosurgical instrument according to an aspect of the invention; 
           [0009]      FIG. 5  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0010]      FIG. 6  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0011]      FIG. 7  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0012]      FIG. 8  is a cross-sectional view of an electrosurgical electrode according to an aspect of the invention; 
           [0013]      FIG. 9  is a cross-sectional view of an electrosurgical electrode according to an aspect of the invention; 
           [0014]      FIG. 10  is a plan view of a distal end of an electrosurgical electrode according to an aspect of the invention; 
           [0015]      FIG. 11  is a plan view of a distal end of an electrosurgical electrode according to an aspect of the invention; 
           [0016]      FIG. 12  is a plan view of a distal end of an electrosurgical electrode according to an aspect of the invention; 
           [0017]      FIG. 13  is a plan view of a distal end of an electrosurgical electrode according to an aspect of the invention; 
           [0018]      FIG. 14  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0019]      FIG. 15  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0020]      FIG. 16  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0021]      FIG. 17  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0022]      FIG. 18  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0023]      FIG. 19  is a perspective view of an electrosurgical electrode according to an aspect of the invention; 
           [0024]      FIG. 20  is a schematic view of an electrosurgical electrode according to an aspect of the invention; 
           [0025]      FIG. 21  is a diagrammatic view of an electrosurgical instrument according to an aspect of the invention; and 
           [0026]      FIG. 22  is a schematic view of an electrosurgical electrode according to an aspect of the invention 
       
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
       [0027]      FIGS. 1 and 2  show one form of electrosurgical handpiece  10  according to one aspect of the invention,  FIG. 3  shows a cross-sectional view, and  FIG. 4  shows another form of electrosurgical handpiece  10 . The present application incorporates U.S. Pat. Nos. 7,101,370; 7,222,644; 6,352,533 and 7,905,882 in their entirety by reference. It will be observed that the cross-sectional view of the handpiece interior of  FIG. 3  is identical to that of  FIG. 2  of the referenced patent. It comprises a squeezable handle  12  assembly connected to and across two front  14  and rear  16  main slideable coaxially-aligned body parts enclosing an elongated outer tubular housing  18  from whose distal end  20  an inner electrode assembly  22  can be extended and retracted when the handle  12  is squeezed or released, respectively. The handpiece common axis is designated  8  in  FIG. 2 . At the right end an electrical cord  26  is terminated in a plug connector (not shown). Internally of the handpiece, wires of the electrical cord  26  are connected to the active electrode assembly  22 . The outer tubular housing  18  extends from the front at the left and through the center of the front body part  14 . Although the tubular housing  18  is shown as tubular or cylindrical, it will be appreciated that other shapes such as diamond, oval, square or any other shape may be employed. The front body part  14  contains a bore  32  which houses a compression spring  34  engaged by a reduced diameter projecting member of the rear body part  16 . The compression spring  34  biases apart the two body parts  14 ,  16 . In one aspect, the handle  12  keeps the body parts  14 ,  16  from relatively axially rotating. However, the body parts may be keyed or other means to keep the two body parts from rotating. Each of the front and rear handle parts, designated generally  64  and  66 , are rigid members from their lowest points, designated  88 ,  90 , to where they join at the fulcrum axis  70 . The electrode assembly, in one aspect, is affixed in rear body part  16  and slidable in tubular housing  18  such that squeezing of handle  12  causes electrode assembly  22  to extend from distal end  20 . 
         [0028]    Referring now to  FIG. 5 , one embodiment of the distal end  20  of the electrosurgical handpiece  10  is shown and described. In  FIG. 5 , tubular housing  18  is shown encapsulating electrode assembly  22 . Electrode assembly  22  includes first electrode  36 A positioned adjacent and parallel to second electrode  36 B. The electrodes are affixed in rear body part  16  such that actuation of the handle  12  causes the electrodes  24  to extend from the tubular housing  18 . In one aspect, tubular housing  18  has a diameter of at least or approximately 6 mm. In the treatment of stenosis during spinal surgery, varying sizes of cannulas may be used and, in one aspect, a diameter of a cannula greater than 6 mm permits passage of tubular housing containing multiple electrode assemblies therethrough. However, one skilled in the art will recognize that the diameter of tubular housing  18  is not limited to that described herein and may be any diameter sufficient to support the electrodes. 
         [0029]    In the embodiment shown in  FIG. 5 , first electrode  36 A and second electrode  36 B are shown not being separated by any material between each respective element or tubular housing  18 . In such an arrangement, the space in-between the respective elements may be simply air and may assist in providing other features such as suction or the provision of fluids such as saline. Tubular housing  18  may be constructed of any number of material types including, but not limited to, metal, ceramics, plastics or other types of materials. In one aspect, tubular housing  18  is constructed of a dielectric or insulative material to prohibit electrical charge from being dissipated to tubular housing  18  or to a location outside tubular housing  18 . One skilled in the art will recognize other variants to the aforementioned description. Each of the electrodes  36 A or  36 B include tip portions  24 . Tip portions  24  will be described with respect to the following embodiments and descriptions. 
         [0030]    Referring now to  FIG. 6 , another embodiment of the present invention is shown and described. In  FIG. 6 , an insulating region  40  is provided and is positioned adjacent to and around each of the electrodes  36 . Apertures  41  are recessed into the face region of the insulating region  42  to permit ingress and egress of each of the electrodes  36  as will be described in greater detail. Insulating region  42 , in one aspect, insulates first electrode  36 A from second electrode  36 B. The apertures  41 , in one aspect, assist in guiding the electrodes  36  when being moved from retracted to extended positions. Additionally, apertures  41  may be spaced apart at a desired distance to facilitate locating the electrodes  36  in a patient during a surgical procedure. In one example, the apertures  41  may be spaced relatively far apart such that the electrodes  36 , when extended, are also positioned far part. Likewise, the electrodes  36  may be positioned relatively closer together such that, when extended, the electrodes are positioned relatively closer together. The insulating region  42  may be constructed of any dielectric or other insulating material and may extend from a planar surface of distal end of  22  to any desired depth. For example, insulating region  42  may extend the entire length of tubular housing  18  or it may extend only a certain predetermined distance from distal end  22  down tubular housing  18 . Conductive sheath  38  is positioned inside tubular housing  18  and located between tubular housing  18  and insulating region  42 . Conductive sheath  38  may be constructed of any conductive material including, but limited to, copper or silver. In one aspect, conductive sheath  38  is constructed of a non-oxidizing material such as gold to be used in connection with the surgical procedure. 
         [0031]    Referring now to  FIG. 7 , another embodiment of the present invention is shown and described. In  FIG. 7 , electrode assembly  22  is constructed similar to that of  FIG. 6 . However, in  FIG. 7 , insulating region  40  is removed leaving space between first electrode  36 A, second electrode  36 B, and conductive sheath  38 . In this arrangement, suction may be provided through the spacing between the electrodes and the conductive sheath  38 . Such suction may be provided by an external source, thereby drawing fluids and liquid from the operative field. In another aspect, various liquids or gases may be provided through the space such as plasma, saline, or argon into the operative field. In one aspect, the pressure of suction may be anywhere between 90-120 mm Hg. It will be understood that such section provision of liquids or gases in the present embodiment may be similarly applied to the embodiment shown in  FIG. 5 . 
         [0032]    With reference to  FIG. 8 , an embodiment of electrodes  36  is shown and described. Electrode  36  shown in  FIG. 8  is a bipolar electrode. Wires  74  extend along the inside of sheath  92  in a parallel fashion separated by insulator  94 . Sheath  92 , in one aspect, insulates wires  74  from any external shorting or grounding to elements outside sheath  92 . Wires  74  terminate at tip  24 A and tip  24 B through connection regions  96 . Connection regions  96  may be soldered or welded connections or other suitable connections. Accordingly, electrical communication may be exhibited along each of the wires  74 , through connection regions  96  and terminating at respective tip portion  24 A or tip portion  24 B. Tip portions  24 A and  24 B are conductive such that electrical signals provided by wires  74  are transmitted to the tip portions and respectively to the operative field or the patient. 
         [0033]    Referring now to  FIG. 9 , another embodiment of the present invention is shown and described. In  FIG. 9 , electrode  36  includes a single wire  74  passing inside of sheath  92 . As noted in the figure, electrode  36  does not include insulator  94  separating tip  24  into two separate sections. As such, electrical signals may be provided by wire  74  to tip  24 . As will be understood, the present embodiment provides a monopolar electrode. 
         [0034]    One skilled in the art will readily recognize that additional tip portions may be provided through adding additional wires  74 , connection regions  96  and insulators  94 . Accordingly, one skilled in the art will recognize that numerous additional portions may be provided including four, six, eight or any other number that may be supported by the sheath  92 . 
         [0035]    Referring now to  FIGS. 10-13 , various configurations of electrode assembly  22  are shown and described. The illustrations shown in  FIGS. 10-13  are plan view schematics that correspond with  FIGS. 5-7 . In  FIG. 10 , conductive sheath  38  is shown encapsulating bipolar electrodes  24 A and  24 B. In the presently described embodiment, tip portions  24 A and  24 B of each of the electrodes  36 A and  36 B may have different polarities or neutral polarities. For example, for first electrode  36 A, tip portion  24 A may be positive while tip portion  24 B is negative. Likewise, for electrode  36 B, tip portion  24 A may also be positive while tip portion  24 B is negative. In such a configuration, the current direction for each positive tip portion will flow generally to the negatively charged tip portions or in accordance with convention. Conductive sheath  38  may also be negatively or positively charged, thereby influencing the current flow associated with the positively or negatively charged tip portions. 
         [0036]    In another embodiment associated with  FIG. 10 , electrodes  36 A and  36 B may be monopolar electrodes that are positively charged while conductive sheath  38  is negatively charged. In such a situation, current flow would flow from each of the positively charged electrodes  36 A and  36 B to the negatively charged conductive sheath  38 . Similarly, sheath  38  could be positively charged while each of the electrodes  36 A and  36 B are negatively charged. One skilled in the art will recognize various configurations through adjustment of the charges associated with each of the Lip portions  24  and the conductive sheath  38 . 
         [0037]    Referring now to  FIG. 11 , another embodiment of the present invention is shown and described. In  FIG. 11 , four separate bipolar electrodes are shown encapsulated by conductive sheath  38 . Each of the tip portions  24 A or  24 B may be positively or negatively charged depending on the desired current flow characteristics desired. Likewise, conductive sheath  38  may also be positively or negatively charged. As such, current flow from any of the positively charged tip portions  24  to the respective opposite charged portion or conductive sheath  38  as the case may be. 
         [0038]    Referring now to  FIG. 12 , another embodiment of the present invention is shown and described.  FIG. 12 , a single monopolar electrode  36  is shown having a tip  24 . Conductive sheath  38  encapsulates the monopolar electrode  36 . In the present embodiment, monopolar electrode  36  is positively charged while conductive sheath  38  is negatively charged. Accordingly, current flows from electrodes  38 , through the patient and to conductive sheath  38 . 
         [0039]    Referring now to  FIG. 13 , another embodiment of the present invention is shown and described. In  FIG. 13 , a monopolar electrode  36 A is shown positioned adjacent to a bipolar electrode  36 B. The monopolar electrode  36 A and bipolar electrode  36 B are encapsulated by conductive sheath  38 . In the presently described configuration, the monopolar electrode may be positively charged while the bipolar electrode  36 B has positively and negatively charged tip portions  24 A and  24 B respectively. In the present configuration, the surgeon may desire to utilize a monopolar electrode. In this instance, electrodes  30 A is activated and extended with the positive charge while conductive sheath  38  provides a negative or ground charge. As such, current flows from electrodes  36 A to conductive sheath  38 . However, if the surgeon desires to utilize the bipolar electrode such as  36 B, then the surgeon activates and extends electrode  36 B by supplying positive charge to tip portion  24 A and negative or ground to tip portion  24 B to create a bipolar electrode. In this configuration, conductive sheath  38  is insulated such that it provides neither a ground or a positive charge. 
         [0040]    Referring now to  FIG. 14 , another aspect of the invention is shown and described. In  FIG. 14 , tubular housing  18  is shown having a curved portion. The curved portion curves each of the electrodes  36  such that the electrodes  36  exit the distal end  20  in a direction different from the axis of the remainder of the electrosurgical handpiece  10 . In  FIG. 14 , electrodes are shown as electrode  36 A and  36 B. In one aspect, the embodiment shown in  FIG. 14  corresponds with that shown in  FIG. 10 . 
         [0041]    With reference to  FIG. 15 , another aspect of the invention is shown and described.  FIG. 15  is similar as that described in  FIG. 14 . Electrode  36  in this embodiment is a single electrode that may be either a monopolar or bipolar electrode similar to that in  FIG. 12 . With reference to  FIG. 16 , another embodiment of the invention is shown and described.  FIG. 16 , a single electrode  36  which may be monopolar or bipolar shown curving in a direction toward parallel with the electrosurgical handpiece  10 . Such curvature may be obtained through any number of methods including that depicted in any of the aforementioned patents incorporated by reference. With reference to  FIG. 17 , a perspective view is shown according to an aspect of the invention. The depiction in  FIG. 17  corresponds to that of  FIG. 11 . With reference to  FIG. 18 , an embodiment of the invention is shown and described. In  FIG. 18 , electrode  36  is shown curved towards the electrosurgical handpiece  10 . The curvature may be obtained through any means including that depicted in the aforementioned patents Incorporated by reference. 
         [0042]    Referring now to  FIG. 19 , another aspect of the invention is shown and described. In  FIG. 19 , tubular housing  18  is shown having a curved configuration. Electrode  36 , similar to some of the aforementioned embodiments, also has a curved configuration. Curvature of tubular housing  18  curving electrode  36  as the electrodes  36  exits distal end  20  of tubular housing  18 . 
         [0043]    Referring now to  FIG. 20 , an embodiment of the actuation of electrodes  36  is shown and described. In  FIG. 20 , a plurality of electrodes  36 A through  36 D are shown positioned adjacent to one another. Each of the electrodes  36 A through  36 D are mounted in  FIGS. 1 through 4  respectively. It will be understood that triggers  36 A and  36 D may be any triggering device that permits a user of the electrosurgical device  10  to cause any of the electrodes to exit tubular housing  18 . For example, triggers  36 A through  36 D may be independent triggering devices and mounted similar to that shown for front body part  14  and rear body part  16 . Accordingly, in the present embodiment, when a user or surgeon desires to initiate movement of only one electrode, for example only electrode  36 A in  FIG. 6 , then only one of the triggers  114  would be triggered. Thus in the present example, trigger  114 D could be initiated to move electrode  36 D out of distal end  20  while the remainder of electrodes  36 A through  36 C remain retracted. 
         [0044]    Referring now to  FIG. 21 , the circuit diagram depicting a circuit according to an embodiment of the present invention is shown and described. In  FIG. 21 , IC circuit  118  is shown electrically connected to input  116 , conductive sheath  38 , electrode  36 A and corresponding tip portions  24 A and  24 B, and electrode  36 B and corresponding tip portions  24 A and  24 B. IC circuit  118  provides a number of outputs to each of the respective components depending on desired characteristics requested by a surgeon. It will also be understood that additional electrodes as described in any of the aforementioned embodiments may also be connected to IC circuit  118 . To provide desired outputs. In one aspect, IC circuit  118  activates electrode  36 A such that tip portion  24 A is positive and tip portion  24 B is negative. In another aspect, IC circuit  118  grounds conductive sheath  38  such that conductive sheath  38  is negative. In another aspect, IC circuit  118  activates electrode  36 B such that tip portion  24 A and tip portion  24 B are positive and negative respectively. In another aspect, IC circuit  118  activates only tip portion  24 A of the electrodes  36 A to be positive while grounding conductive sheath  38  to create a monopolar relationship. In a further aspect, IC circuit  118  distributes charge to each of the respective electrodes  36 A and  36 B in accordance with the previously discussed charging characteristics at a particular frequency. For example, IC circuit  118  may activate electrode  36 A while keeping electrode  36 B deactivated and then, subsequently, activating electrode  36 B and deactivate electrode  36 A. This cycle may be repeated any particular frequency set by the surgeon through IC circuit  118 . This frequency approach may also be employed with respect to any of the electrodes and the conductive sheath  38 . 
         [0045]    Referring now to  FIG. 22 , another embodiment is shown and described. In  FIG. 22 , an electrode is shown that could be used instead of any of the previously described electrodes. Here, the electrode is shown having a body  103  having a first half  105  and a second half  107 . The first half and second half may be monopolar such that they have the same polarity (positive for example) and ground or conduct through a patient body or through a grounding sheath. Alternatively, a bipolar arrangement may be used where first half is positive while second half is negative with a dielectric region located in body  103  that insulates first half  105  from second half  107 . 
         [0046]    In this specification, various preferred embodiments may have been described with reference to the accompanying drawings. It will, however, be evident that various modifications and changes may be made thereto, and additional embodiments may be implemented, without departing from the broader scope of the invention as set forth in the claims that follow. The present invention is thus not to be interpreted as being limited to particular embodiments and the specification and drawings are to be regarded in an illustrative rather than restrictive sense. 
         [0047]    It will be appreciated that the system and methods described herein have broad applications. The foregoing embodiments were chosen and described in order to illustrate principles of the methods and apparatuses as well as some practical applications. The preceding description enables others skilled in the art to utilize methods and apparatuses in various embodiments and with various modifications as are suited to the particular use contemplated. In accordance with the provisions of the patent statutes, the principles and modes of operation of this invention have been explained and illustrated in exemplary embodiments. 
         [0048]    It is intended that the scope of the present methods and apparatuses be defined by the following claims. However, it must be understood that this invention may be practiced otherwise than is specifically explained and illustrated without departing from its spirit or scope. It should be understood by those skilled in the art that various alternatives to the embodiments described herein may be employed in practicing the claims without departing from the spirit and scope as defined in the following claims. The scope of the invention should be determined, not with reference to the above description, but should instead be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. It is anticipated and intended that future developments will occur in the arts discussed herein, and that the disclosed systems and methods will be incorporated into such future examples. Furthermore, all terms used in the claims are intended to be given their broadest reasonable constructions and their ordinary meanings as understood by those skilled in the art unless an explicit indication to the contrary is made herein. In particular, use of the singular articles such as “a,” “the,” “said,” etc. should be read to recite one or more of the indicated elements unless a claim recites an explicit limitation to the contrary. It is intended that the following claims define the scope of the invention and that the method and apparatus within the scope of these claims and their equivalents be covered thereby. In sum, it should be understood that the invention is capable of modification and variation and is limited only by the following claims.