Abstract:
A method of treating bowel diseases includes introducing a fluid into a portion of a patient&#39;s colon and applying energy thereto from an external energy source such that the fluid and the energy cooperate to treat tissue of the portion of the patient&#39;s colon in contact with the fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient&#39;s colon, introducing an electrically-conductive fluid thereto, and energizing an electrode disposed therein to treat tissue of the portion of the patient&#39;s colon in contact with the electrically-conductive fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient&#39;s colon and introducing a heated fluid at a temperature equal to or above 60° C. to treat tissue of the portion of the patient&#39;s colon in contact with the heated fluid.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
       [0001]    The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 62/258,053, filed on Nov. 20, 2015, the entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    Technical Field 
         [0003]    The present disclosure relates to treatment of Inflammatory Bowel Diseases (IBDs) and, more particularly, to surgical devices, systems, and methods for treating ulcerative colitis and other IBDs, e.g., Crohn&#39;s Disease. 
         [0004]    Background of Related Art 
         [0005]    Ulcerative colitis, an IBD, is a disease of the colon in which inflammation and ulcers, or sores, form on the interior wall of the colon. Ulcerative colitis manifests itself, usually intermittently and at varying degrees of severity, in symptoms such as stomach pain, diarrhea, and/or bloody stool. Typically, anti-inflammatory medication(s) are prescribed for patients suffering from ulcerative colitis. In extreme cases, chronic cases, or cases in which medication(s) fails to adequately treat the patient&#39;s symptoms, surgery to remove all or part of the diseased portions of the rectum and/or colon may be performed. 
         [0006]    Although medication(s) and surgical removal of diseased portions of the rectum and/or colon are effective in certain instances, there is a need for surgical devices, systems, and methods to more effectively and/or efficiently treat ulcerative colitis and other IBDs, e.g., Crohn&#39;s Disease, while minimizing side effects and damage to un-diseased tissue. 
       SUMMARY 
       [0007]    As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein. 
         [0008]    A method of treating bowel diseases provided in accordance with the present disclosure includes introducing a fluid into a portion of a patient&#39;s colon and applying energy towards the portion of the patient&#39;s colon from an energy source positioned externally of the patient such that the fluid and the energy cooperate to treat tissue of the portion of the patient&#39;s colon in contact with the fluid. 
         [0009]    In aspects of the present disclosure, introducing the fluid includes at least partially filling the portion of the patient&#39;s colon with the fluid. At least partially filling the portion of the patient&#39;s colon may include sealing off an area of the patient&#39;s colon to retain the fluid therein. Sealing off the area may include clamping the area on at least one end thereof or plugging the area on at least one end thereof. 
         [0010]    In aspects of the present disclosure, the energy source is a microwave energy source and wherein the fluid defines a dielectric constant greater than a dielectric constant of tissue such that, upon application of microwave energy from the microwave energy source, the fluid is heated, thereby treating tissue of the portion of the patient&#39;s colon in contact with the fluid. Alternatively, the energy source may be an ultrasound energy source and an acoustic impedance difference between the fluid and tissue may be utilized such that, upon application of ultrasonic energy from the ultrasound energy source, heating occurs at an interface between the fluid and tissue, thereby treating tissue of the portion of the patient&#39;s colon in contact with the fluid. 
         [0011]    Another method of treating bowel diseases provided in accordance with the present disclosure includes sealing off a portion of a patient&#39;s colon, introducing an electrically-conductive fluid into the sealed off portion of the patient&#39;s colon, and energizing an electrode disposed within the portion of the patient&#39;s colon such that energy is conducted through the electrically-conductive fluid and tissue of the portion of the patient&#39;s colon in contact with the electrically-conductive fluid to treat tissue of the portion of the patient&#39;s colon in contact with the electrically-conductive fluid. 
         [0012]    In an aspect of the present disclosure, the electrically-conductive fluid is an electrically-conductive gel, argon plasma, or isotonic saline. 
         [0013]    In another aspect of the present disclosure, the electrically-conductive fluid includes at least one medicament therein to facilitate healing of treated tissue. 
         [0014]    In yet another aspect of the present disclosure, sealing off the portion of the patient&#39;s colon includes clamping or plugging at least one end of the portion of the patient&#39;s colon. In such aspects, the method may further include inserting the electrode through a clamped or plugged end of the portion of the patient&#39;s colon and into the portion of the patient&#39;s colon prior to energizing the electrode. 
         [0015]    In still another aspect of the present disclosure, sealing off the portion of the patient&#39;s colon includes introducing an end effector into the patient&#39;s colon and engaging first and second sealing members of the end effector with respective ends of the portion of the patient&#39;s colon. In such aspects, introducing the electrically-conductive fluid may include pumping the electrically-conductive fluid through a port of the end effector disposed between the first and second sealing members, and/or energizing the electrode may include energizing an electrode of the end effector disposed between the first and second sealing members. 
         [0016]    In still yet another aspect of the present disclosure, energizing the electrode includes applying monopolar energy to the electrode. 
         [0017]    Another method of treating bowel diseases provided in accordance with the present disclosure includes sealing off a portion of a patient&#39;s colon and introducing a heated fluid at a temperature equal to or above 60° C. into the sealed off portion of the patient&#39;s colon to treat tissue of the portion of the patient&#39;s colon in contact with the heated fluid. 
         [0018]    In aspects of the present disclosure, sealing off the portion of the patient&#39;s colon includes clamping or plugging at least one end of the portion of the patient&#39;s colon. In such aspects, introducing the heated fluid may include inserting a probe through a clamped or plugged end of the portion of the patient&#39;s colon and pumping the heated fluid into the sealed off portion of the patient&#39;s colon through a port of the probe disposed within the sealed off portion of the patient&#39;s colon. 
         [0019]    In aspects of the present disclosure, sealing off the portion of the patient&#39;s colon includes introducing an end effector into the patient&#39;s colon and engaging first and second sealing members of the end effector with respective ends of the portion of the patient&#39;s colon. In such aspects, introducing the heated fluid may include pumping the heated fluid into the sealed off portion of the patient&#39;s colon through a port of the end effector disposed between the first and second sealing members. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0020]    Various aspects and features of the present disclosure described herein with reference to the drawings wherein: 
           [0021]      FIG. 1  is a schematic illustration of a method provided in accordance with the present disclosure for use in treating a diseased portion of the colon; 
           [0022]      FIG. 2  is a schematic illustration of another method provided in accordance with the present disclosure for use in treating a diseased portion of the colon; 
           [0023]      FIG. 3  is a schematic illustration of yet another method provided in accordance with the present disclosure for use in treating a diseased portion of the colon; 
           [0024]      FIGS. 4A-4B  are schematic illustrations of still another method provided in accordance with the present disclosure for use in treating a diseased portion of the colon; 
           [0025]      FIG. 5A  is a side view of a device provided in accordance with the present disclosure configured for use in treating a diseased portion of the colon; 
           [0026]      FIG. 5B  is a schematic illustration of the device of  FIG. 5A  shown in use treating a diseased portion of the colon; 
           [0027]      FIG. 6A  is a perspective view of another device provided in accordance with the present disclosure configured for use in treating a diseased portion of the colon; and 
           [0028]      FIG. 6B  is a schematic illustration of the device of  FIG. 6A  shown in use treating a diseased portion of the colon. 
       
    
    
     DETAILED DESCRIPTION 
       [0029]    As IBD&#39;s such as ulcerative colitis may only affect portions of the colon, it is desirable to focus treatment towards such diseased areas while limiting damage to surrounding tissue and critical structures. Accordingly, the present disclosure provides various devices, systems, and methods configured to facilitate the focused or controlled treatment of diseased portions of the colon while limiting damage to surrounding portions of the colon and other surrounding tissue and critical structures. 
         [0030]    Turning now to  FIG. 1 , in embodiments provided in accordance with the present disclosure, in order to treat a diseased area “A” of the colon “C,” the diseased area “A” is initially filled with a fluid “F” and thereafter sealed off to retain the fluid “F” within the diseased area “A.” This may be accomplished by clamping off a first end of the diseased area “A” with a first clamping member  110 , filling the diseased areas “A” with the fluid “F” through the open second end thereof, and thereafter clamping off the second end with a second clamping member  120 . Clamping members  110 ,  120  may be occluding clips, constricting bands, forceps jaws, a combination thereof, or any other clamping members  110 ,  120  suitable for sealing off the first and second ends of the diseased area “A” of the colon “C” so as to retain the fluid “F” therein. As an alternative to clamping members  110 ,  120 , plugs, e.g., similar to plugs  310 ,  320  ( FIG. 3 ), or other suitable structures for sealing off diseased area “A” may also be utilized. 
         [0031]    With the diseased area “A” filled with the fluid “F” and sealed off so as to retain the fluid “F” therein, a microwave source  130 , disposed externally of the patient, may be energized to direct microwave energy towards the diseased area “A.” The fluid “F” may be water, or other suitable bio-compatible fluid having a dielectric constant greater than tissue and critical structures. Water is advantageous in that it is obviously bio-compatible and has a high dielectric constant. More specifically, the molecular makeup of water facilitates the absorption of microwave energy which ultimately leads to the rapid heating of water in the presence of microwave energy as compared to other matter such as tissue and critical structures, which necessarily have a lower water content than water itself. 
         [0032]    Upon application of the microwave energy from microwave source  130 , the fluid “F,” e.g., water, within the diseased area “A” is heated rapidly, faster than any surrounding tissue and critical structures, which have lower dielectric constants than water. The microwave energy is applied so as to heat the water sufficiently such that the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C” is thermally treated. Such thermal treatment may include burning, charring, ablating, coagulating, and/or desiccating the inflamed layer of tissue. By thermally treating the diseased area “A” in this manner and thereafter allowing the tissue to heal, the inflammation and ulceration can be reduced or eliminated entirely, thereby reducing the associated pain and discomfort. The particular fluid “F” provided and selective control of the frequency and power settings of the microwave source  130  may be utilized to ensure sufficient heating of the fluid “F” while inhibiting damage to surrounding tissue and critical structures. 
         [0033]    As an alternative to filling the diseased area “A” with fluid “F” and sealing off the diseased area “A,” the fluid “F” may be sprayed, coated, or otherwise applied to the diseased area “A.” Further still, rather than sealing off diseased area “A,” the entire colon “C” may be filled with the fluid “F” or sprayed, coated, etc. therewith. In either configuration, similarly as above, upon application of the microwave energy from the microwave source  130 , the fluid “F,” e.g., water, is heated so as to thermally treat the diseased area “A” of the colon “C” while inhibiting damage to surrounding tissue and critical structures. 
         [0034]    Turning now to  FIG. 2 , in some embodiments, rather than utilizing microwave energy, an ultrasound source  230 , positioned externally of the patient, may be utilized to direct focused ultrasonic energy to the diseased area “A” of the colon “C.” In such configurations, the fluid “F” may be air, or other suitable bio-compatible fluid that has a sufficiently different acoustic impedance as compared to tissue, e.g., the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C.” Such a fluid “F” establishes an impedance mismatch at the interface of the fluid “F” with the layer of inflamed, diseased tissue defining the diseased area “A.” 
         [0035]    In use, upon application of focused ultrasonic energy from the ultrasound source  230  to the diseased area “A,” localized heating of tissue occurs at the impedance mismatch interface, e.g., the interface between the fluid “F” and the layer of inflamed, diseased tissue defining the diseased area “A,” as the ultrasonic energy is transmitted from the tissue to the fluid “F” and vice versa. This localized heating is used to thermally treat the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C,” e.g., via burning, charring, ablating, coagulating, and/or desiccating the tissue. The particular fluid “F” provided and selective control of the frequency and power settings of the ultrasound source  130  may be utilized to ensure sufficient heating at the interface so as to effectively treat tissue while inhibiting damage to surrounding tissue and critical structures. 
         [0036]    Referring to  FIG. 3 , in some embodiments, the diseased area “A” of the colon “C” may be sealed off using first and second plugs  310 ,  320  disposed at either end of the diseased area “A.” Plugs  310 ,  320  may be resiliently flexible plugs  310 ,  320  configured to conform to the internal diameter of the colon “C” at each end of the diseased area “A” to sealingly enclose the diseased area “A,” or any other suitable plugs configured to seal off the diseased area “A.” Alternatively, clamping members, e.g., clamping members  110 ,  120  ( FIG. 1 ), may be utilized for similar purposes. 
         [0037]    One of the plugs, e.g., plug  320 , may include a zero-closure valve  325  defined therethrough. Zero-closure valve  325  may be a slit-valve, a duckbill valve, or any other suitable valve that is biased towards a closed position to inhibit the passage of fluid therethrough and is capable of sealingly receiving an instrument therethrough. 
         [0038]    With continued reference to  FIG. 3 , in use, initially, plugs  310 ,  320  are positioned within the colon “C” to sealingly enclose the diseased area “A” to be treated. Thereafter, a probe  330  is inserted through the zero-closure valve  325  and into the diseased area “A.” Probe  330  may include one or more ports  335  defined about the radial outer peripheral surface of probe  330  and/or at the distal end of probe  330 . Probe  330  is inserted through zero-closure valve  325  and into the diseased area “A” such that each of the ports  335  thereof is disposed within the diseased area “A.” Probe  330  may be inserted through the anus and navigated through the colon “C” to the diseased area “A,” as illustrated, although other approaches are also contemplated. Further, probe  330  is sufficiently insulated such that the exterior thereof remains at or near ambient temperature, thus inhibiting inadvertent damage to tissue and/or harm to the operator, the importance of which will be realized below. 
         [0039]    Once probe  330  is positioned as detailed above, a heated fluid “HF,” e.g., hot air, hot water, etc., from a heated fluid source  340  is pumped through probe  330 , out ports  335 , and into the diseased area “A.” The heated fluid “HF” is pumped into the diseased area “A” so as to at least partially fill the diseased area “A” and contact the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C.” The heated fluid “HF” may be heated to or above 43° C. or, in some embodiments, to or above about 60° C., such that the heated fluid “HF” is capable of thermally treating the layer of inflamed, diseased tissue, e.g., via burning, charring, ablating, coagulating, and/or desiccating the inflamed layer of tissue. 
         [0040]    Once sufficient thermal treatment of the inflamed, diseased layer of tissue with the heated fluid “HF” has been achieved, the heated fluid source  340  may be transitioned from a pumping or pressure mode to a suction mode to withdraw the heated fluid “HF” from the diseased area “A.” Thereafter or concurrently therewith, a cooling fluid source  350  may be activated to pump cooling fluid “CF,” e.g., ice water, cold air, etc. through probe  330 , out ports  335 , and into the diseased area “A” to cool the treated tissue. The temperature and duration of application of the heated fluid “HF” and/or cooling fluid “CF” can be controlled such that thermal treatment extends sufficiently deep into the layer of inflamed, diseased tissue so as to adequately treat the diseased tissue, while being sufficiently contained so as to inhibit damage to surrounding tissue and critical structures. 
         [0041]    Turning to  FIGS. 4A and 4B , in some embodiments, the diseased area “A” of the colon “C” may be sealed off using plugs  310 ,  320 , similarly as detailed above with respect to  FIG. 3 . Thereafter, a probe  430  is inserted through the zero-closure valve  325  of plug  320  and into the diseased area “A.” Probe  430  may include one or more ports  435 , similarly as detailed above with respect to probe  330  ( FIG. 3 ). Probe  430  is inserted into the diseased area “A” such that each of the ports  435  thereof is disposed within the diseased area “A.” 
         [0042]    Once probe  430  is positioned as detailed above, an electrically-conductive fluid “EF” from a fluid source  440  is pumped through probe  430 , out ports  435 , and into the diseased area “A.” The electrically-conductive fluid “EF” is pumped into the diseased area “A” so as to at least partially fill the diseased area “A” and contact the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C.” The electrically-conductive fluid “EF” may be any suitable bio-compatible fluid capable of conducting electrical energy therethrough such as, for example, a conductive gel, isotonic saline, argon plasma, etc. A conductive gel utilized as the electrically-conductive fluid “EF,” for example, may further be configured as a bio-absorbable gel configured for absorption into surrounding tissue and/or may include medicament, e.g., a debridement agent, an antimicrobial agent, an antibiotic, a growth factor, an analgesic, etc., to promote healing of tissue after treatment thereof. 
         [0043]    Probe  430  is further configured to receive one or more electrodes  450  therethrough, e.g., via the same or different lumen and/or port  435  than those that provide the electrically-conductive fluid “EF.” More specifically, once the electrically-conductive fluid “EF” has been pumped into the diseased area “A,” the fluid source  440  may be deactivated and one or more electrodes  450  inserted through or advanced from probe  430  such that each of the electrodes  450  protrudes distally from probe  430  into the electrically-conductive fluid “EF” disposed within the diseased area “A.” 
         [0044]    An electrosurgical generator  460  coupled to each of the electrodes  450  may then be activated to supply electrosurgical energy to the electrodes  450 . Generator  460  may be configured to supply monopolar energy to a single electrode  450  (wherein energy is returned via a remote return pad (not shown) placed on the patient), or may be configured to supply bipolar energy to multiple electrodes  450  (wherein at least one electrode  450  is charged to a positive potential and at least another electrode  450  is charged to a negative potential). Regardless of whether monopolar or bipolar energy is utilized, the electrically-conductive fluid “EF” facilitates the conduction of energy through the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C” for electrosurgically treating the layer of inflamed, diseased tissue, e.g., via burning, charring, ablating, coagulating, and/or desiccating the inflamed layer of tissue. 
         [0045]    Once tissue is sufficiently treated, the generator  460  may be deactivated, the electrode(s)  450  removed, and the electrically-conductive fluid “EF” withdrawn from the diseased area “A.” In order to withdraw the electrically-conductive fluid “EF,” the fluid source  440  is operated in a suction mode. Alternatively, in embodiments where an absorbable fluid and/or a fluid containing medicaments is provided, the electrically-conductive fluid “EF” may be left behind (permanently or for a period of time) to be absorbed into the body and/or facilitate healing of the treated tissue. 
         [0046]    Referring to  FIGS. 5A and 5B , an instrument  500  provided in accordance with the present disclosure and configured for use in treating IBD&#39;s is shown generally including a handle  510 , a shaft  520  extending distally from handle  510 , and an end effector  530  supported on shaft  520  towards the distal end thereof. Shaft  520  may define a flexible configuration to facilitate positioning within the colon “C” ( FIG. 5B ). End effector  530  includes a pair of longitudinally-spaced balloons  542 ,  544  defining a exposed portion  522  of shaft  520  therebetween. 
         [0047]    Instrument  500  further includes a first fluid tube  550  configured to connect to an inflation source  560 . First fluid tube  550  extends into handle  510  and through shaft  520 , ultimately coupling to balloons  542 ,  544  such that inflation fluid, e.g., air, may be delivered to and removed from balloons  542 ,  544  to inflate and deflate balloons  542 ,  544 . Further, a rocker switch  512 , or other suitable activation member(s), disposed on handle  510  and operably coupled to inflation source  560  and/or fluid tube  550  is provided to enable the selective inflation and deflation of balloons  542 ,  544 . More specifically, when a first portion  513   a  of rocker switch  512  is activated, pressure is supplied to pump fluid through first fluid tube  550  and into balloons  542 ,  544  to inflate balloons  542 ,  544 . On the other hand, when a second portion  513   b  of rocker switch  512  is activated, suction is applied to withdraw fluid from balloons  542 ,  544  through fluid tube  550  to deflate balloons  542 ,  544 . Alternatively, balloons  542 ,  544  may be independently inflatable and deflatable, e.g., via providing separate activation buttons. 
         [0048]    Exposed portion  522  of shaft  520  includes a plurality of ports  524  defined therethrough. Ports  524  are disposed at various radial and/or longitudinal positions along exposed portion  522  of shaft  520  and are each fluidly coupled with a second fluid tube  570  extending proximally through shaft  520 , handle  510 , and proximally therefrom. Second fluid tube  570  ultimate couples to an external treatment source  580 . Treatment source  580  is configured to pump heated fluid “HF,” e.g., steam, hot water, etc., through second fluid tube  570  and out ports  524 , into the area disposed between balloons  542 ,  544 . An activation button  514  disposed on handle  510  is operably coupled to second fluid tube  570  and/or treatment source  580  to enable the selective pumping of heated fluid “HF” through second fluid tube  570  and ports  524 . 
         [0049]    In use, shaft  520  of instrument  500 , led by end effector  530 , is inserted into the colon “C” such that end effector  530  is positioned adjacent the diseased area “A” of the colon “C” to be treated. Shaft  520  may be inserted through the anus and navigated through the colon “C” to the diseased area “A,” as illustrated, although other approaches are also contemplated. With end effector  530  positioned as desired, first portion  513   a  of rocker switch  512  may be activated to supply inflation fluid from the inflation source  560  through fluid tube  550  to balloons  542 ,  544  to inflate balloons  542 ,  544 . Balloons  542 ,  544  are sufficiently inflated so as to sealingly engage the inner wall of the colon “C” adjacent each balloon  542 ,  544 . This sealing engagement of balloons  542 ,  544  with the inner wall of the colon “C” seals off at least a portion of the diseased area “A” of the colon “C” with exposed portion  522  of shaft  520  extending through this sealed, diseased area “A.” 
         [0050]    Thereafter, activation button  514  may be actuated to initiate the supply of the heated fluid “HF” from the treatment source  580 , through second fluid tube  570 , out ports  524 , and into the sealed diseased area “A” disposed between balloons  542 ,  544 . The heated fluid “HF” is pumped into the diseased area “A” so as to at least partially fill the diseased area “A” and contact the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C.” Balloons  542 ,  544 , which sealingly enclose the diseased area “A” or portion thereof, retain the heated fluid “HF” within the diseased area “A” or portion thereof, thus inhibiting damage to surrounding tissue. The heated fluid “HF” may be heated to or above about 43° C. or, in some embodiments, to or above about 60° C. such that the heated fluid “HF” is capable of thermally treating the layer of inflamed, diseased tissue, e.g., via burning, charring, ablating, coagulating, and/or desiccating, the inflamed layer of tissue. 
         [0051]    Once sufficient thermal treatment of the inflamed, diseased layer of tissue has been achieved, treatment source  580  may be transitioned from a pressure mode to a suction mode to withdraw the heated fluid “HF” from the diseased area “A.” Further, similarly as detailed above, a cooling fluid source (not shown, similar to cooling fluid source  350  ( FIG. 3 )), may be activated to pump cooling fluid “CF” ( FIG. 3 ) into the diseased area “A” to cool the treated tissue. The temperature and duration of the application of the heated fluid “HF” and/or cooling fluid “CF” ( FIG. 3 ) can be controlled such that the thermal treatment extends sufficiently deep into the diseased tissue defining the diseased area “A” so as to adequately treat the tissue, while being sufficiently contained so as to inhibit damage to surrounding tissue and critical structures. 
         [0052]    Instrument  500  may subsequently be used to treat other diseased area(s) of the colon “C” in either an incremental fashion or a continuous fashion. More specifically, with respect to use in an incremental fashion, after treatment as detailed above, balloons  542 ,  544  may be deflated, e.g., via activating second portion  513   b  of rocker switch  512 , allowing end effector  530  to be repositioned adjacent another diseased area to be treated. Thereafter, balloons  542 ,  544  may be re-inflated and subsequent treatment of the other diseased area(s) may be accomplished in a similar fashion as detailed above, e.g., using heated fluid “HF.” With respect to use in the continuous fashion, instrument  500 , with balloons  542 ,  544  maintained in the inflated state, may be pulled through the colon “C” such that the sealed area between balloons  542 ,  544 , is moved along the colon “C.” As the sealed area is moved along the colon “C,” the heated fluid “HF” may be supplied through ports  524  to the sealed area, as detailed above, to continuously thermally treat tissue as the instrument  500  is moved through the colon “C.” 
         [0053]    Turning to  FIGS. 6A and 6B , another instrument  600  provided in accordance with the present disclosure and configured for use in treating IBD&#39;s is shown generally including a handle  610 , a shaft  620  extending distally from handle  610 , and an end effector  630  supported on shaft  620  towards the distal end thereof. Handle  610  includes a rocker switch  612  and activation button  614  disposed thereon, an electrical cable  616  coupled thereto and extending therefrom, and a fluid tube  618  coupled thereto and extending therefrom. Shaft  620  may define a flexible configuration to facilitate positioning within the colon “C” ( FIG. 6B ). 
         [0054]    End effector  630 , as mentioned above, is disposed about shaft  620  towards the distal end thereof. End effector  630  includes a pair of longitudinally-spaced disc members  642 ,  644  disposed about shaft  620  so as to define an exposed portion  622  of shaft  620  therebetween. A ring electrode  650  of end effector  630  is disposed about exposed portion  622  of shaft  620  between disc members  642 ,  644 . Exposed portion  622  of shaft  620  defines a plurality of ports  624  disposed at various radial and/or longitudinal positions along exposed portion  622  of shaft  620 . 
         [0055]    Disc members  642 ,  644  are configured to enable positioning within the colon “C” in sealing engagement therewith. More specifically, disc members  642 ,  644  may be configured to enable such sealing engagement based upon the dimensions thereof and/or may include resiliently flexible portions, inflatable portions, etc. to facilitate formation of a seal within the colon “C” to seal off a diseased area “A” to be treated between disc members  642 ,  644 . Disc members  642 ,  644  further include a plurality of ports  643 ,  645  disposed on longitudinally-opposed faces thereof and arranged radially about shaft  620 . 
         [0056]    Ports  643 ,  645  of disc members  642 ,  644 , respectively, and ports  624  of exposed portion  622  of shaft  620  are fluidly coupled with fluid tube  618 , which extends distally through handle  610  and shaft  620 . Fluid tube  618  is ultimately configured to couple to a fluid source  670  for pumping an electrically-conductive fluid through fluid tube  618  and some or all of ports  624 ,  643 ,  645 . Fluid source  670  may further be configured for suctioning the electrically-conductive fluid through some or all of ports  624 ,  643 ,  645  and fluid tube  618 . Fluid tube  618  may include separate inlet and outlet lumens (not shown) for the inflow and outflow of the electrically-conductive fluid or may be configured to permit both the inflow and outflow of the electrically-conductive fluid through a common lumen. Further, some of the ports, e.g., ports  624 , may be configured for inflow to deliver the electrically-conductive fluid to the diseased area “A,” while other ports, e.g., ports  643 ,  645 , may be configured for outflow to withdraw the electrically-conductive fluid from the diseased area “A.” However, the reverse configuration or other suitable configurations are also contemplated. 
         [0057]    Rocker switch  612  is disposed on handle  610 , operably coupled to the fluid source  670  and/or fluid tube  618 , and configured to enable the selective pumping and suctioning of the electrically-conductive fluid through fluid tube  618  and ports  624 ,  643 ,  645 . More specifically, when a first portion  613   a  of rocker switch  612  is activated, the electrically-conductive fluid is pumped through fluid tube  618  and out some or all of ports  624 ,  643 ,  645 . On the other hand, when a second portion  613   b  of rocker switch  612  is activated, suction is applied through fluid tube  618  to suction the electrically-conductive fluid through some or all of ports  624 ,  643 ,  645  and fluid tube  618 . The electrically-conductive fluid may be any suitable biocompatible fluid capable of conducting electrical energy therethrough such as, for example, a conductive gel, isotonic saline, argon plasma, etc. 
         [0058]    Ring electrode  650 , as mentioned above, is disposed about exposed portion  622  of shaft  620  between disc members  642 ,  644 . Ring electrode  650  is electrically coupled with electrical cable  616 , e.g., via one or more electrical leads (not shown) extending through shaft  620  and handle  610 . Electrical cable  616 , in turn, is configured to couple to an electrosurgical generator  680  configured to supply electrosurgical energy to the ring electrodes  650 . Generator  680  may be configured to supply monopolar energy to ring electrode  650 , with the energy being returned to generator  680  via a remote return pad (not shown) placed on the patient. However, bipolar energy configurations are also contemplated. Activation button  614  is disposed on handle  610  and operably coupled between generator  680  and ring electrode  650  to enable the selective supply of energy to ring electrode  650 . 
         [0059]    In use, shaft  620  of instrument  600 , led by end effector  630 , is inserted into the colon “C” such that end effector  630  is positioned adjacent the diseased area “A” of the colon “C” to be treated. Shaft  620  may be inserted through the anus and navigated through the colon “C” to the diseased area “A,” as illustrated, although other approaches are also contemplated. With end effector  630  positioned in this manner, disc members  642 ,  644  are disposed on either side of the diseased area “A” (or a portion thereof) sealingly enclosing the diseased area “A.” 
         [0060]    Once this position has been achieved, first portion  613   a  of rocker switch  612  may be activated to pump the electrically-conductive fluid through fluid tube  618  and out some or all of ports  624 ,  643 ,  645  into the diseased area “A” to at least partially fill the diseased area “A.” 
         [0061]    After the electrically-conductive fluid has been introduced, or concurrently therewith, activation button  614  may be actuated to initiate the supply of energy to ring electrode  650 . Upon energization of the ring electrode  650 , the electrically-conductive fluid facilitates the conduction of energy therethrough and to the layer of inflamed, diseased tissue defining the diseased area “A” of the colon “C” for electrosurgically treating the layer of inflamed, diseased tissue, e.g., via burning, charring, ablating, coagulating, and/or desiccating the inflamed layer of tissue. 
         [0062]    Once tissue has been treated, or intermittently during tissue treatment, second portion  613   b  of rocker switch  612  may be activated to withdraw the electrically-conductive fluid through fluid tube  618 , allowing for subsequent introduction of additional electrically-conductive fluid. Alternatively, instead of a rocker switch  612 , instrument  600  may be provided with an activation switch (not shown) that concurrently provides both pumping and suctioning of the electrically-conductive fluid. Such a configuration may be particular advantageous with respect to the use of argon plasma as the electrically-conductive fluid, wherein the suctioning defines an exhaust path, while the pumping concurrently provides additional electrically-conductive fluid to replace the exhausted fluid. 
         [0063]    Instrument  600  may subsequently be used to treat other diseased area(s) of the colon “C” in either an incremental fashion or a continuous fashion, similarly as detailed above with respect to instrument  500  ( FIGS. 5A and 5B ). 
         [0064]    From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, 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. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.