Patent Publication Number: US-6702812-B2

Title: Multifunctional telescopic monopolar/bipolar surgical device and method therefor

Description:
This application is a Continuation of U.S. patent application Ser. No. 09/088,386, filed Jun. 1, 1998 now U.S. Pat. No. 6,355,034 and entitled “Multifunctional Telescopic Monopolar/Bipolar Surgical Device and Method Therefor”. This application is also related to, and herein incorporates by reference, U.S. patent application Ser. No. 08/500,045 entitled “Telescopic Surgical Device and Method Therefor,” now issued as U.S. Pat. No. 5,693,044. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates generally to an electrosurgical unit (ESU) pencil. More specifically, the present invention relates to an ESU pencil having a bipolar electrode wherein the active and return electrode are contained within the same tip of the ESU pencil and are separated by a high temperature resistant radio frequency (RF) dielectric. The ESU pencil having a bipolar electrode is designed for use with a monopolar ESU device in a bipolar function for cutting and coagulation in medical procedures. When used with a monopolar ESU device, the ESU pencil having a bipolar electrode can also be used for monopolar application wherein a separate electrode is applied to a part of the patient&#39;s body, usually on the patient&#39;s leg, to function as the return electrode. This monopolar function is prevalent in the prior art. 
     The present invention also relates to a telescopic laparoscopic monopolar/bipolar ESU pencil having an adjustable length electrode capable of accommodating different depths and/or different sizes of adult and children. The telescopic laparoscopic monopolar/bipolar ESU pencil can also be used with an integrated smoke evacuator system such as that previously described in U.S. Pat. No. 5/199,944. Also, the ESU pencil of the present invention having a bipolar electrode may be combined with the suction/irrigation system and apparatus previously described in my co-pending patent application entitled “Automatic Suction/Irrigation Apparatus for Use in Laparoscopic Surgery and Electrosurgery and Method Therefor” which is being simultaneously filed with the present application and is incorporated by reference thereto. Finally, the ESU pencil of the present invention having a bipolar electrode can be combined with attachments so that it can also be used for argon beam coagulation. 
     2. Description of the Prior Art 
     In the past, electrosurgical devices had an active electrode that was used for performing cutting and coagulation, and a return electrode which usually comprised an adhesive for attachment to a patient&#39;s skin. When the electrosurgery unit surgery pencil was activated, the RF energy circulated from the active electrode to the return electrode through the patient&#39;s body with the distances between the active and return electrodes being fairly significant. 
     This prior art system presents several deficiencies and creates, a number of problems that can be dangerous for the patient. First, because of the significant distance between the active and return electrodes, high voltages at high frequencies are transversed through the body in order to close the circuit between the active and return electrodes. These high voltages and frequencies can be very dangerous to the patient. Second, due to the fact that the body has an electrical resistance, the cutting and coagulation affects are significantly diminished as the distance between the active and return electrodes is increased. Accordingly, high power from the ESU is needed in order to obtain effective cutting and coagulation performance. Again, the high power required from the ESU can be dangerous to the patient. 
     Third, in many cases, patients have incurred significant burns because of poor contact between the return electrode and the patient&#39;s skin. Finally, dangerous capacitive coupling has occurred in laparoscopic surgery which has resulted in dangerous burns to the patient. These burns could not be detected because they are out of the field of view of the laparoscope thereby putting the patient&#39;s life in danger. 
     A bipolar function for open and laparoscopic procedures is presently being used with the bipolar suction of the ESU. However, this system and the related instruments are used only to stop bleeding within a patient and is not capable of performing a cutting operation. 
     As previously stated in the section referred to as “related application”, the present invention is related to the same inventor&#39;s pending patent application entitled “Telescopic Surgical Device and Method Therefor”. The similarities between the telescopic pencil described in the pending application and the present invention described in this application is that both inventions refer to a telescopic pencil which can have multifunctional applications. The main difference between the inventions is that the pending telescopic pencil patent application refers to a monopolar pencil only which has only one contact for the electrode while the ESU pencil of the present invention described in this application can be used as a monopolar instrument, a monopolar/bipolar instrument or a bipolar instrument. The ESU pencil of the present invention has an electrode which comprises two contacts, one which is used as an active electrode and another which is used as a return electrode when the instrument is used as a bipolar functioning instrument for a monopolar/bipolar functioning instrument. Alternatively, when the instrument is only used as a monopolar functioning instrument, a separate electrode is applied to a different part of the patient&#39;s body, usually on the patient&#39;s leg. This separate electrode functions as the return electrode. 
     SUMMARY OF THE INVENTION 
     A principal object of the present invention an electrosurgery electrode for performing cutting and coagulation for open and closed endoscopic and laparoscopic procedures wherein the electrosurgery electrode contains both the active electrode and the return electrode on the same tip. 
     It is a further objection of the present invention to provide a monopolar/bipolar electrode which can be used on the monopolar section of an electrosurgery unit to perform a bipolar function thereby eliminating the need for a separate return electrode. 
     It is still a further object of the present invention to provide a telescopic monopolar and monopolar/bipolar electrode and pencil with smoke evacuation means wherein the distance between the operating tip of the electrode and the hand piece is adjustable to accommodate desired lengths associated with different sized patients. 
     It is, yet a further object of the present invention to provide a telescopic monopolar and monopolar/bipolar endoscopic and laparoscopic electrode, with or without smoke evacuation means, wherein the length of the laparoscopic electrode is adjustable. 
     It is still a further objection of the present invention to provide a telescopic monopolar and monopolar/bipolar ESU pencil with suction/irrigation means wherein the bipolar electrode is automatically retracted upon activation of the suctioning means. 
     It is still a further object of the present invention to provide a telescopic monopolar and monopolaribipolar electrode and pencil for open and closed endoscopic and laparoscopic procedures with suction/irrigation means wherein the electrode can be automatically retracted upon the activation of the suctioning means. 
     It is yet a further object of the present invention to provide a multi-functional telescopic ESU pencil that can be used for open and laparoscopic electrosurgery that is also capable of performing suction and irrigation, and for argon beam coagulation when used with respective attachments as previously described in reference to my pending U.S. Patent Application entitled “TelescopicSurgical Device and Method Therefor”. 
     Accordingly, the multi-functional telescopic monopolar/bipolar surgical device of the present invention includes a bipolar electrode and a hand piece having electrical contacts wherein the bipolar electrode is connected to the electrical contacts of the hand piece and the electrical contacts of the hand piece are connected to an energy source for activating the device. An electrosurgery unit may be used as the energy source. The bipolar electrode includes an active electrode, a return electrode and an insulator which is sandwiched between the active and return electrodes. The multi-functional telescopic monopolar/bipolar surgical device may further include a telescopic member coupled to the bipolar electrode and the hand piece for adjusting the length of the bipolar electrode. Further, the multi-functional telescopic monopolar/bipolar surgical device may include a smoke evacuation means coupled to the bipolar electrode for removing smoke and other debris that is produced during electrosurgery. 
     The present invention is also directed to a telescopic suction/irrigation apparatus for open and endoscopic laparoscopic procedures which includes a hollow hand piece member having an open end and an open proximal end and connection means for connecting the hand piece to an energy source for activating suction and irrigation, an elongated hollow tubular member having distal and proximal open ends wherein the proximal open end is introduced into the open distal end of the hand piece so that the elongated hollow tubular members concentrically contained within the channel of the hand piece and locking means for locking the elongated hollow tubular member within the hand piece. Another embodiment of the telescopic suction/irrigation apparatus comprises a hand piece member having connection means to an energy source and means for effectuating suction and irrigation functions, a double channel telescopic suction/irrigation tube having an inner channel and outer channel wherein the double channel telescopic suction/irrigation tube is introduced into the hand piece member such that a portion of the double channel telescopic suction/irrigation tube is concentrically retained within the hand piece, connection means for connecting the inner channel of said double channel telescopic suction/irrigation tube with an irrigation port and the outer channel of the double channeled telescopic suction/irrigation tube with a suctioning port, and locking means for locking the double channel telescopic suction/irrigation tube within the hand piece member. 
     The present invention is also directed to a method for performing electrosurgery on a patient which comprises the steps of connecting a bipolar electrode having an active electrode and a return electrode to a hand piece with means for alternately effectuating cutting and coagulation with the bipolar electrode, connecting both the active and return electrodes to an energy source, and activating either the cutting or coagulation function using the bipolar electrode. 
    
    
     The foregoing and other objections, features and advantages of the present invention, as well as details of the preferred embodiments thereof, will be more fully understood from the following descriptions made in conjunction with the accompanying drawings. 
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 a  is a diagrammatic view of electrosurgery being performed on a patient using a prior art ESU pencil having a monopolar electrode which requires a separate return electrode. 
     FIG. 1 b  is a diagrammatic view of electrosurgery being performed on a patient using the telescopic monopolar/bipolar surgical device of the present invention for electrosurgery. 
     FIG. 2 a  is a perspective view of a first embodiment of a bipolar electrode for use within the telescopic monopolar/bipolar surgical device of the present invention for electrosurgery which can also function as a monopolar electrode. 
     FIG. 2 b  is a perspective view of a second embodiment of a bipolar electrode for use within the telescopic monopolar/bipolar surgical device of the present invention for electrosurgery which can also function as a monopolar electrode. 
     FIG. 2 c  is a perspective view of a third embodiment of a bipolar electrode for use within the telescopic monopolar/bipolar surgical device of the present invention for electrosurgery which can also function as a monopolar electrode. 
     FIG. 2 d  is a perspective of a first embodiment of a bipolar electrode used in the multifunctional telescopic monopolar/bipolar surgical device of the present invention for endoscopic and/or laparoscopic procedures wherein the bipolar electrode is capable of a monopolar function. 
     FIG. 2 e  is a perspective view of a second embodiment of a bipolar electrode used in the multifunctional telescopic monopolar/bipolar surgical device of the present invention for endoscopic and/or laparoscopic procedures wherein the bipolar electrode is capable of a monopolar function. 
     FIG. 2 f  is a perspective view of a third embodiment of a bipolar electrode used in the multifunctional telescopic monopolar/bipolar surgical device of the present invention for endoscopic and/or laparoscopic procedures wherein the bipolar electrode is capable of a monopolar function. 
     FIG. 3 a  is a perspective view of the multi-functional monopolar/bipolar telescopic electrosurgical device of the present invention. 
     FIG. 3 b  is a perspective exploded view of the device in FIG. 1 shown without the electrical cord. 
     FIG. 3 c  is cross-sectional view of the device in FIG. 3A shown without the electrical cord. 
     FIG. 3 d  is perspective view of an endoscopic and/or laparoscopic telescope element which can replace the telescopic element of the multi-functional monopolar/bipolar telescopic electrosurgical device shown in FIG. 3C to create a multi-functional monopolar/bipolar telescopic electrosurgical device for endoscopic and/or laparoscopic procedures. 
     FIG. 4 a  is a perspective view of a suction/irrigation telescope which can replace the electrosurgery telescope in FIG. 3C or the laparoscopic telescope in FIG. 3D to provide a telescopic surgical device with suction/irrigation means capable of performing either suction or irrigation. 
     FIG. 4 b  is a perspective exploded view and partial cross-sectional view of a second embodiment of a suction/irrigation telescope which can replace the electrosurgery telescope in FIG. 3C or the laparoscopic telescope in FIG. 3D to provide a telescopic device with suction/irrigation means capable of performing suction and irrigation simultaneously. 
     FIG. 4 c  is a partial cross sectional view of a hydro dissection nozzle wherein the internal tube of the nozzle is shown retracted. 
     FIG. 4 d  is a partial cross sectional view of the hydro dissection nozzle shown in FIG. 4 c  with the internal tube shown extended. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The present system for performing electrosurgery with an ESU pencil having a monopolar electrode is shown in FIG. 1 a . The electrosurgery pencil  10  comprises an active electrode  12  which performs cutting or coagulation on a patient  14 . The ESU pencil  10  comprising active electrode  12  is connected to the electrosurgery unit  16  which provides the energy source to activate the ESU pencil  10 . A return electrode  18  comprises an adhesive patch  20  which is positioned and applied to the patient  14  at a considerable distance  22  away from the active electrode  12 . The return electrode  18  is also connected to the electrosurgery unit  16  thereby creating a close circuit wherein the voltage and frequency emitted from the active electrode  12  is transmitted through the body of the patient  14  and received by return electrode  20 . FIG. 1 a illustrates how monopolar electrosurgery is presently performed. 
     Electrosurgery performed on a patient using the multifunctional telescopic monopolar/bipolar surgical device of the present invention is shown in FIG. 1 b . With the present invention, the electrosurgery pencil  10  comprises a bipolar electrode  11  which comprises an active electrode  12  and a return electrode  18  which are separated by a material dielectric  13  which functions as an insulator. Both the active electrode  12  and the return electrode  18  are connected to the electrosurgery unit  16  thereby performing a completed circuit. When the electrosurgery unit  16  is activated and the bipolar electrode  11  touches the tissue of the patient  14 , the circuit is closed through a very small portion of the patient&#39;s tissue between the active electrode  12  and the return electrode  18 . This shortened distance between the active electrode  12  and return electrode  18  results in decrease of the power requirement from that previously needed in association with the monopolar electrode of the prior art in order to effectuate cutting and coagulation. This decreased distance between the two electrodes  12 ,  18  also results in decreasing the dangers associated with passing high voltages at high frequencies throughout a substantial portion of the patient&#39;s body, one of those risks being an increased possibility of burns to the patient. 
     FIGS. 2 a-c  show perspective views of different embodiments of bipolar electrodes which comprise part of the multifunctional telescopic monopolar/bipolar surgical device of the present invention for open electrosurgery procedures. These electrodes are capable of exhibiting both bipolar and monopolar functioning in conjunction with an electrosurgery unit. 
     FIG. 2 a  represents a perspective view of a bipolar blade electrode. An insulator  26  is sandwiched between the active electrode  28  and the return electrode  30 . Active electrode  28  further comprises an active prong  32  which is designed to come in contact with an active conductor contained within the telescopic element of the device of the present invention which is shown and described later with reference to FIGS. 3 b  and  3   c . Further, the return electrode  30  comprises a return prong  34  which is designed to make contact with a return conductor contained within the telescopic element of the device of the present invention which is also shown and described later with reference to FIGS. 3 b - 3   c.    
     FIG. 2 b  represents a perspective view of a bipolar needle electrode. Again, an insulator  26  is sandwiched between the active electrode  28  and the return electrode  30  wherein the active electrode  28  and return electrode  30  further comprise an active prong  32  and return prong  34 , respectively, for connection to conductor elements contained within a telescopic element of a device of the present invention as shown in FIGS. 3 b - 3   c.    
     FIG. 2 c  represents a perspective view of a special angled bipolar electrode that can be used for cutting and/or coagulation, as well as for surface coagulation or ablation. An insulator  26  is sandwiched between active and return electrodes wherein one of each of an active electrode  28  and a return electrode  30  are positioned on opposite sides of the insulator  26 . More specifically, on a first side  36  (not shown) of insulator  26  there is a top active electrode  28 A and a bottom return electrode  30 B and on a second side  38  of insulator  26  there is a top return electrode  30 A and a bottom active electrode  28 B. Active prong  32  connects top active electrode  28 A to bottom active electrode  28 B while return prong  34  serves to connect top return electrode  30 A to bottom return electrode  30 B thereby forming connection means for the active electrode  28  and return electrode  30 , respectively, when connecting the active and return electrodes  28 ,  30  to conductors contained within the telescopic elements of the device of the present invention as further explained with reference. to FIGS. 3 b - 3   c . The previously described electrodes may further vary by comprising a variety of different shapes without detracting from the purpose of the invention. 
     FIGS. 2 d - 2   f  depict perspective views of bipolar electrodes which comprise part of the multifunctional telescopic monopolar/bipolar surgical device of the present invention for. performing endoscopic and/or laparoscopic procedures wherein the electrode is also capable of monopolar functioning alone. FIGS. 2 d  and  2   e  represent hook-shaped bipolar electrodes for use in endoscopic and laparoscopic procedures wherein the bipolar electrodes are also capable of functioning as monopolar electrodes. FIG. 2 f  shows a paddle-shaped bipolar electrode for use in endoscopic and/or laparoscopic procedures which may also function as a monopolar electrode. All of the bipolar electrodes depicted in FIGS. 2 d - 2   f  comprise an insulator  26  which is sandwiched between an active electrode  28  and a return electrode  30 . Further, the active electrode  28  comprises an active prong  32  while the return electrode  30  comprises a return prong  34  wherein both the active prong  32  and return prong  34  serve as connection means for connecting the active electrode  28  and return electrode  30  to conductors contained within a laparoscopic/endoscopic telescope element of the device of the present invention as further detailed in reference to FIG. 3 d.    
     Other electrode shapes and forms may be used with respect to the bipolar electrodes for endoscopic and/or laparoscopic procedures without detracting from the purpose of the invention. Further, the active electrode  28  and return electrode  30  on all of the previously described bipolar electrodes in reference to FIGS. 2 a - 2   f  may be reversed such that the active electrode  28  and return electrode  30  are on opposite sides of the insulator  26  than those on which they are depicted in the Figures. 
     Active electrode  28  is preferably comprised of stainless steel or other suitable conductors and return electrode  30  is preferably comprised of a ceramic or other suitable material which can function as an insulator. The insulator  26  is preferably comprised of a dielectric material which is suitable for use as a dielectric in radio frequency applications and at very high temperatures such as certain types of ceramics. However, any dielectric materials that can meet the conditions for RF applications at very high temperatures may be used. 
     As previously explained with reference to FIG. 1B, the circuit created by the active electrode  28  and return electrode  30  is closed when the ESU is activated and the electrode touches the tissue of a patient. This very small portion of the patient&#39;s tissue closes the gap between the active electrode  28  and the return electrode  30 . As a result, much less power is needed to traverse the patient&#39;s tissue in order to close the circuit and effectuate the cutting and coagulation operations. A load resistor can be installed in series to avoid an accidental short circuit in between the two electrodes. 
     Turning now to FIG. 3 a , there is shown a perspective view of the multi-functional telescopic monopolar/bipolar electrosurgical device of the present invention. In brief, the multifunctional telescopic monopolar/bipolar electrosurgical device  40  of the present invention comprises a main body  42 , a telescopic body  44  circumferentially contained within the main body  42  such that it can be extended outward from, and retracted into, the main body  42 , a locking element  46  which locks the telescopic body  44  to the main body  42  at a predetermined extracted length, a bipolar electrode  48  contained within the telescopic body and main body such that it is capable of being in electrical contact with an electrosurgery unit, and a connector element  50  for connecting the main body  42  of the device  40  to a smoke evacuator tubing (not shown). The main body  42  of the device  40  further comprises a series of selection buttons, one selection button for cutting  52 , one selection button for coagulation  54 , and one selection button for argon beam coagulation  56 . The selection button for argon beam coagulation is optional. The main body may be provided with only cutting and coagulation selection buttons  52 ,  54 . 
     An exploded view of the multifunctional telescopic monopolar/bipolar electrosurgical device  40  of the present invention is illustrated in FIG. 3 b . The main body  42  of the device  40  comprises a distal thread  58  and a proximal thread  60  which are connected by a channel  62 . The main body  42  further comprises an active contact  64  and a return contact  66  which are located parallel to one another on an interior surface of the channel  62  having a gap located there between which resembles an elongated slot  68 . The telescopic body  44  comprises a distal end  70  and a proximal end  72  which are separated by a second channel  74  that is smaller in diameter than the channel  62  contained within the main body  42 . The telescopic body  44  further comprises a pair of elongated conductors  76 ,  78  located within the second channel  74  of the telescopic body  44 . Each of the elongated conductors  76 ,  78  terminate in contact prongs  80 ,  82 , respectively, such that the contact prongs  80 ,  82  are located on the external surface of the telescopic body  44  near its proximal end  72 . A hollow nozzle  84  may be connected to the distal end  70  of the telescopic body  44 . 
     The bipolar electrode  48  is connected to the telescopic body  44  such that the active electrode  86  and return electrode  88  are in contact with the elongated conductors  76 ,  78 , respectively. Finally, the locking element  46  comprises a hollow interior having a distal end  90  and a proximal end  92 . The locking element  46  further comprises a ridge  94  contained within its hollow interior and an “O” ring  96  which is seated on the ridge  94 . As a result, the locking element  46  can be slid over the telescopic body  44  and connected to the distal thread  58  of the main body  42  to enable the telescopic body  44  to be locked in position within the main body  42 . 
     FIG. 3 c  shows a cross sectional view of the multifunctional telescopic monopolar/bipolar electrosurgery unit pencil shown in FIG. 3 a . As previously described, the main body  42  contains active contact  64  and patient return contact  66  which are parallel to one another so that they are separated by the same distance along their entire lengths. Contact prongs  80 ,  82  contained on the external surface of the telescopic body  44  are slightably engaged and maintained within the elongated slot  68  which separates the active contact  64  from the patient return contact  66 . The bipolar electrode  48  is connected to the contact prongs  80 ,  82  via the elongated conductors  76 ,  78 . The telescopic body  44  is extracted or retracted within the main body  42  to adjust for the desired length of the bipolar electrode  48 . 
     Argon beam coagulation attachments (not shown) replace the telescopic body  44  described above with a special telescope and end attachment similar to those described in my previous patent application entitled “A Telescopic Surgical Device and Method Therefor” may be attached to the proximal thread  60  of the main body  42  of the device  40 . A suction/irrigation attachment such as that later described and shown in FIGS. 4 a - 4   b , as well as a connector for smoke evacuation tubing (not shown) may also be connected to proximal thread  60  of the main body  42  of the device  40 . The locking element  46  is threaded onto the distal thread  58  of the main body  42  of the device  40  in order to lock the telescopic body  44  in place. The telescopic body  44  is locked in position by tightening the locking element  46  against the distal thread  58  of the main body  42 . As a result, the ridge  94  contained within the locking element  46  is pushed forward such that it presses over the “O” ring  96  which in turn presses over the telescopic body  44  thereby locking it in place. 
     During use, when either the cutting button  52  or the coagulation button  54  is depressed, the active contact  64  is energized and the return contact  66  acts to return current from the patient to the electrosurgery unit. Contact prongs  80 ,  82  function to pass the radio frequency energy through elongated conductor  76  to the bipolar electrode  48  and then return the RF energy through elongated conductor  78  back to contact prong  82 . If the multifunctional telescopic monopolar/bipolar surgical pencil device of the present invention is used for monopolar only, then the active contact  64  and return contact  66  will both conduct the active energy and a separate return electrode will be provided and utilized as represented in FIG.  1 A. Energy is brought to the multifunctional telescopic monopolar/bipolar surgical pencil device of the present invention by electrical cord  49  (See FIG. 3 a ) which is connected to an electrosurgery unit (not shown). 
     Turning now to FIG. 3 d , there is shown an endoscopic/laparoscopic telescopic body  98  which replaces the telescopic body  44  shown in FIGS. 3 b - 3   c  in order to perform endoscopic and/or laparoscopic procedures. The second locking element  100  works similar to the locking element  46  described with reference to FIGS. 3 b - 3   c . The cutting operation is activated when the cutting button  52  is depressed and coagulation is activated when the coagulation button  54  is depressed. Argon beam coagulation button number  56  is optional and, if used, the endoscopic/laparoscopic telescope body  98  is replaced with a different telescope such as that described in my pending patent application entitled “A Telescopic Surgical Device and Method Therefor” and an adaptor is attached to the end of the device  40  at the proximal thread  60  of the main body  42  of the device  40 . The adaptor is very similar to the adaptor for suction/irrigation that is later shown and described with reference to FIG.  4 . 
     FIGS. 4 a - 4   c  show another embodiment of the electrosurgery pencil of the present invention which is directed toward a telescopic suction/irrigation pencil for electrosurgery. The telescopic monopolar/bipolar surgical pencil depicted and described in FIGS. 3 a - 3   d  will become a telescopic suction/irrigation pencil by replacing the telescopic body  14  in FIGS. 3 b - 3   c  and the endoscopic/laparoscopic telescopic body  98  in FIG. 3 d  with the attachments presented in. FIGS. 4 a - 4   b . The resulting telescopic suction/irrigation pencil is advantageous in that it permits the surgeon to adjust the lengths of the suction/irrigation tip without the need for removing and reattaching tips of different lengths. 
     FIG. 4 a  shows a perspective view of a first embodiment of a suction/irrigation attachment  102  comprising a singular hollow tube  104  having a distal end  106  and a proximal end  108 . The suction/irrigation attachment  102  further comprises a sliding guide  110  which is circumferentially fit about the proximal end  108  of the singular hollow tube  104  thereby allowing the suction/irrigation attachment  102  to be slidably engaged within the main body  42  of the telescopic monopolar/bipolar electrosurgery device  40  shown in FIG. 3 b . The locking element  46  shown in FIG. 3 b  is also used in conjunction with the suction/irrigation attachment  102  shown in FIG. 4 a  in order to lock the suction/irrigation attachment  102  in place at a predetermined extracted length from the main body  42  shown in FIG. 3 b . The resulting device is a telescopic suction/irrigation pencil for use with electrosurgery as well as laparoscopic and endoscopic procedures. 
     Suction and irrigation are activated by using the cutting button  52  shown in FIG. 3 a  for irrigation and the coagulation button  54  shown in FIG. 3 a  for suction. During irrigation, the irrigation fluid enters the telescopic suction/irrigation pencil through connector element  50 , then passes through the proximal end  108  of the singular hollow tube  104  shown in FIG. 4 a  and then exits the telescopic suction/irrigation pencil through the distal end  106  of the singular hollow tube  104  shown in FIG. 4 a . In contrast, when suction is activated, fluid is drawn from the patient and enters the telescopic suction/irrigation pencil at the distal end  106  of the singular hollow tube  104 , is further drawn past the proximal end  108  of the singular hollow tube  104 , and finally exits the telescopic suction/irrigation pencil through the connector element  50  shown in FIG. 3 b.    
     The distal end  106  of the suction/irrigation attachment  102  may be narrowed to form a nozzle  112  such as that shown in FIG. 4 a . The nozzle  112  configuration of the distal end  106  facilitates the use of the telescopic suction/irrigation pencil for hydro-dissection by enabling the irrigation fluid to exit the distal end  106  of the suction/irrigation attachment  102  with high pressure and velocity. 
     FIG. 4 b  illustrates an exploded perspective view of a second embodiment of a suction/irrigation attachment  114  which is capable of performing suction and irrigation simultaneously. The lengths of the telescopic suction and irrigation tubes may also be adjusted. The second embodiment of the suction/irrigation attachment  114  comprises a double channeled tube  116  and a singular connection tube  118 . The double channeled tube  116  comprises a first hollow tube  120  circumferentially contained within a second hollow tube  122  wherein the first and second hollow tubes  120 ,  122  are of substantially the same length. The double channeled tube  116  further includes a distal end  124 , a proximal end  126 , a spacer element located at the proximal end  126  of the double channeled tube  116 , and a locking element  46  which functions like the locking element  46  shown and described with reference to FIG. 3 b.    
     The double channeled tube  116  contains a central inner channel  130  which is defined by the hollow inner area of the first hollow tube  120  and an outer ring-shaped channel  132  which is defined by the opening generated by the difference between the inner diameter of the second hollow tube  122  and the outer diameter of the inner hollow tube  120 . Irrigation is conducted through the central inner channel  130  while suction is conducted through the outer ring-shaped channel  132 . 
     The second hollow tube  122  is closed about the first hollow tube  120  at the proximal end  126  of the double channeled tube  116  but a plurality of apertures  134  are contained about the circumference of the second hollow tube  122  near proximal end  126  thereby creating an opening through which fluid can pass from the outer ring-shaped channel  132 . The spacer element  128  comprises a shortened hollow cylinder having a proximal open end and a plurality of wings  136  located within its opposite open end. The plurality of wings  136  are positioned within the outer ring-shaped channel  132  located between the first hollow tube  120  and the second hollow tube  122  to maintain the distance between the tubes  120 ,  122  and support the outer ring-shaped channel  132  while still allowing irrigation fluid to pass through the outer ring-shaped channel  132  with minimal resistance. 
     The singular connection tube  118  comprises a tube  138  having an open distal end  140  and an open proximal end  142  wherein the open proximal end  142  is seated within a multi-connector piece  144 . Multi-connector piece  144  comprises a hollow piece having a large open distal end  146  with grooves  148  for receiving threads and two smaller channels  150 ,  152  each having threads  154  located at its proximal end  156 . Threaded channel  150 , is designed to be attached to an irrigation means while threaded channel  152  is designed for attachment to a suctioning means. 
     During use, the grooves  148  at the large open distal end  146  of the multi-connector piece  144  are connected to the proximal thread  60  of the main body  42  of the device  40  shown in FIG. 3 b  while the tube  138  is inserted through the channel  62  of the main body  42  such that tube  139  will exit the channel  62  and enter the central inner channel  130  of the first hollow tube  120  of the double channeled tube  116  when the spacer element  128  is slid within the main body  42  of the device  40  shown in FIG. 3 b . Tube  138  has an outer diameter that is slightly smaller than the inner diameter of the first hollow tube  120  so that hollow tube  120  and tube  138  form a telescope when concentrically enjoined. 
     When irrigation is activated, irrigation fluid will be introduced under pressure through the open proximal end  142  of tube  138  and willtraverse the telescopic configuration resulting from joining tube  138  inside of first hollow tube  120 , and will then exit at the distal end  124  of the double channeled tube  116  through the first hollow tube  120 . When suction is activated, suctioning means is applied at suctioning channel  152  and fluid is drawn from the patient through the plurality of apertures  134  contained within the second hollow tube  122 . The fluid is drawn through the ring-shaped outer channel  132  and then exits at the suctioning channel  152 . Spacer element  128  slides within the main body  42  of the device  40  shown in FIG. 3 b  and the second hollow tube  122  is locked into place by connecting locking element  46  to distal thread  58  of the main body  42  of the device  40 . 
     The distal end  124  of the double channeled tube  116  of the suction/irrigation attachment shown in FIG. 4 b  may comprise an alternative configuration such as that shown in FIGS. 4 c - 4   d . FIGS. 4 c - 4   d  depict a nozzle configuration in which the distal open end  158  of first hollow tube  120  forms a needle nose  160  which is capable of being extracted and retracted from within the second hollow tube  122  thereby allowing the operator or surgeon to adjust the length of the irrigation means such that it extends ‘beyond the length of the suctioning means at the cite of application. 
     While the invention has been particularly shown and described with reference to the preferred embodiments thereof, it will be understood by those skilled in the art that changes in form and detail of the foregoing may be made without departing from the spirit and scope of the present invention. For example, if a different shape or form is given to the monopolar/bipolar electrodes but they are still capable of functioning with a monopolar ESU suction to provide a bipolar function, this new configuration is believed to be included within the scope of the present invention. Further, different locking means for locking the telescopic functioning elements in place as well as different configurations for providing electrical contact means within the telescopic body and main body of the device are believed to be included within the spirit and scope of the present invention.