Patent Description:
The present invention relates generally to the field of surgical instruments, and more particularly relates to surgical instruments providing a passageway (lumen) through which fluids or other instrument components may be passed that is reinforced to prevent passageway collapse under bending forces. The instrument of some embodiments is a component of an electrosurgical wand in an electrosurgical system.

Surgical instruments with passageways, such as a shaft and internal lumen of an electrosurgical device, need to be bent during the performance of some surgical procedures, including but not limited to adenoidectomy. Such devices typically incorporate a suction or supply lumen for fluid and tissue passage through the shaft, which is being bent. Because the lumen may be made of a polymer and be operated under negative pressure and elevated temperature, the lumen may be prone to kinking when bent to a tight radius or bend angle. Similarly, the outer shaft around the lumen may be made from a metal that is a relatively soft annealed metal shaft. This metal shaft may be prone to kinking when bent to typical operating conditions. Such bending and kinking may restrict or even stop flow through the lumen.

Some manufacturers address flow restriction through lumen restriction by publishing bending guidelines in product Instructions For Use, recommending maximum bend angles to users. A reusable handheld bending guide to encourage a safe bend radius may also be provided. This solution may not allow a user to bend the device as much as desired for unique patient anatomies, and the bending guide is subject to being misplaced. Another prior art approach is to use more rigid, and expensive, Polyether ether ketone (PEEK) tubing and/or thicker tube walls to help increase the bending and collapse resistance of the lumen. These measures only address the problem in part. In addition to increased cost and geometric constraints within the device itself, where assembly and design clearances are often limited, these measures are unable to address the alternative failure mode in which the outer shaft kinks and crushes the lumen. It is also known in the prior art (especially with cardiovascular catheter instruments) to use flexible lumens that are reinforced by over-molding braided ribbons or very thin wires to provide structure within the tube walls. This is a relatively expensive solution that provides only limited support to the lumen in a configuration required for performing electrosurgical procedures. Such reinforced extrusions are effective at providing lumen support for torsion and axial resistance required for insertion of a catheter into tortuous cardiovascular anatomies, but ineffective at protecting a lumen from external crushing forces. Some manufacturers, such as is illustrated with Covidien's monopolar suction cautery device, have addressed the challenge by providing a polymer mandrel, such as a PTFE rod or filament, to be inserted through a shaft that serves as the suction passageway. Shaft integrity is enhanced by use of an aluminum shaft to prevent kinking. The polymer mandrel provides internal support for the lumen during bending and is removed to reveal the passageway that may be used while the device is bent. This approach incorporates an additional component and increases total cost. This approach also requires additional steps by an end user who, in addition to inserting and removing the mandrel each time a bend is desired, must also ensure that the mandrel remains readily accessible and sterile throughout the procedure.

It would be advantageous to provide surgical instruments that provide for adequate bending angles of the shaft and lumen to meet surgical needs while preventing restriction of passageways during bending. It may be further advantageous if instrument embodiments would provide enough bending resistance to prevent the instrument embodiments from being damaged when being subjected to typical use forces. It would be a cost advantage if components of the surgical instruments could be fabricated from off-the-shelf components more readily than prior art solutions that require over-molding and other relatively expensive manufacturing procedures.

<CIT> describes a catheter including a distal tip electrode and a flexible shaft that comprises a multi-layered coil member and a central lumen. It also includes irrigation tubing for delivering irrigation fluid to the distal tip electrode.

<CIT> describes surgical apparatus with an end region containing a mechanical cutting head and end region and means for articulating the end-region to access hard to-reach portions of the anatomy. The apparatus includes an elongated shaft that comprises an articulation region comprising helical wire.

<CIT> describes a device that includes a flexible sheath, an elongate shaft, and a distal portion that includes an energy transfer element such as an electrode. A coiled wire may be provided as a reinforcing element to prevent kinking or collapse of the shaft. Fluid may also be delivered through the shaft.

An embodiment of the disclosure is a lumen that includes at least an inner tubular member with an inside diameter and an outside diameter along its length and a support coil. Embodiments of the support coil have an inside diameter and an outside diameter along its length, the support coil comprising a helically formed wire with a wire diameter, the wire extending helically along the length of the support coil to produce walls of the support coil. The walls of the support coil may be defined by extents of the wire at the inside diameter of the support coil and the outside diameter of the support coil. Substantially all of each revolution of the wire about the length of the support coil of some embodiments occurs within a respective distance along the length of the support coil of three wire diameters.

Another embodiment of the disclosure is an electrosurgical wand with a wand body having a proximal end and a distal end, wherein the distal end includes at least a portion that is flexible, a fluid supply port coupled near the proximal end of the wand body and communicating through the wand body to facilitate the provision of fluid at or near the distal end of the wand body, a suction port coupled near the proximal end of the wand body and communicating through the wand body to facilitate the provision of negative pressure at or near the distal end of the wand body, a lumen, and an electrosurgical conductor passing through at least a portion of the wand body to supply tissue affecting energy at or near the distal end of the wand body. Embodiments of the lumen are located within at least a part of the portion of the distal end that is flexible and provide a passageway. Lumen embodiments may include an inner tubular member with an inside diameter and an outside diameter along its length and a support coil. Embodiments of the support coil have an inside diameter and an outside diameter along its length, the support coil comprising a helically formed wire with a wire diameter, the wire extending helically along the length of the support coil to produce walls of the support coil. The walls of the support coil may be defined by extents of the wire at the inside diameter of the support coil and the outside diameter of the support coil. Substantially all of each revolution of the wire about the length of the support coil of some embodiments occurs within a respective distance along the length of the support coil of three wire diameters.

Yet another embodiment of the disclosure is an electrosurgical system that includes at least a controller, a fluid control unit electrically coupled to the controller, the fluid control unit configured to provide fluids at a rate coordinated with operation of the controller, and an electrosurgical wand electrically coupled to the controller and fluidly coupled to the fluid control unit. The electrosurgical wand may include a wand body with a proximal end and a distal end, wherein the distal end includes at least a portion that is flexible, a fluid supply port coupled between the fluid control unit and near the proximal end of the wand body and communicating through the wand body to facilitate the provision of fluid at or near the distal end of the wand body, a suction port coupled near the proximal end of the wand body and communicating through the wand body to facilitate the provision of negative pressure at or near the distal end of the wand body, and a lumen.

The lumen may be located within at least a part of the portion of the distal end that is flexible, the lumen providing a passageway. The lumen may include at least an inner tubular member with an inside diameter and an outside diameter along its length, and a support coil with an inside diameter and an outside diameter along its length, the support coil comprising a helically formed wire with a wire diameter, the wire extending helically along the length of the support coil to produce walls of the support coil. The walls of the support coil may be defined by extents of the wire at the inside diameter of the support coil and the outside diameter of the support coil. Substantially all of each revolution of the wire about the length of the support coil may occur within a respective distance along the length of the support coil of three wire diameters. The electrosurgical wand may also include an electrosurgical conductor electrically coupled to the controller and passing through at least a portion of the wand body to supply tissue affecting energy at or near the distal end of the wand body.

Still another embodiment of the disclosure is a method of manufacturing a medical device that may include at least expanding a support coil with an inside diameter and an outside diameter along its length, the support coil comprising a helically formed wire with a wire diameter, the wire extending helically along the length of the support coil to produce walls of the support coil, inserting an inner tubular member with an inside diameter and an outside diameter along its length into the support coil inside diameter while the support coil is expanded, and causing the support coil to constrict around the inner tubular member such that the inside diameter of the support coil closely conforms to the outside diameter of the inner tubular member when the support coil is substantially straight along substantially all of its length.

Components of an embodiment of an electrosurgical system <NUM> are illustrated in <FIG>. The electrosurgical system <NUM> depicted includes a fluid control unit <NUM> electrically coupled to a controller <NUM> by a cable <NUM>. An electrosurgical wand <NUM> is shown electrically coupled to the controller <NUM> by a cable <NUM>. The controller <NUM> may optionally receive control signals from one or more external switching devices <NUM> electrically coupled through cable <NUM> to the controller <NUM>. In the illustrated embodiment, the one or more switching devices <NUM> are foot pedals, but in other embodiments may be or include one or more of knobs, buttons, other adjustment mechanisms, and level settings. The controller <NUM> may be, by way of non-limiting example, a COBLATOR II controller offered for sale by Smith and Nephew. The controller <NUM> shown includes a tissue removal intensity setting <NUM> and a vasculature coagulation intensity setting <NUM>. The controller <NUM> illustrated also includes electrical jacks for receiving cables <NUM>, <NUM>, and <NUM> as described above, and a power cord <NUM>.

The fluid control unit <NUM> is configured to provide fluids at a rate coordinated with operation of the controller <NUM>. For example, when tissue removal is switched on at the controller <NUM>, or at external devices such as the external switching devices <NUM>, fluid may be released from the fluid control unit <NUM>. By way of non-limiting example, fluid may be a saline solution that works in conjunction with the electrosurgical wand <NUM> to accomplish cold ablation of tissue. The fluid control unit <NUM> may also include or be connected with a fluid reservoir such as an IV bag and may include a power switch <NUM> and a dial <NUM> or other control to designate a flow rate from the device.

In addition to electrical coupling to the controller <NUM> by the cable <NUM>, the electrosurgical wand <NUM> may be fluidly coupled to the fluid control unit <NUM> by an irrigant tube <NUM>. The electrosurgical wand <NUM> may also include a suction port <NUM> through which a negative pressure may be applied to the electrosurgical wand <NUM>. A suction tube <NUM> may couple to the suction port <NUM> and be connected to an operating room suction system having, by way of non-limiting example, a suction pressure in the range of <NUM>-<NUM> Hg. In alternative embodiments, suction portion may be connected to a fluid control unit configured to control a negative pressure or rate of fluid removal from the tissue treatment site.

An embodiment of the electrosurgical wand <NUM> and its components are illustrated in more detail in <FIG>. The electrosurgical wand <NUM> illustrated includes a wand body <NUM> with a proximal end <NUM> and a distal end <NUM>. The distal end <NUM> includes at least a portion that is flexible, as specifically illustrated in <FIG>. The flexible portion of the distal end <NUM> in some embodiments includes annealed stainless steel. More particularly, some embodiments include annealed SAE International <NUM> stainless steel, also known as A2 stainless steel. In some embodiments, the wand body <NUM> includes a <NUM> gauge hypodermic tube with a nominal outside diameter of about <NUM> and a wall thickness of about <NUM>. Other metallic or non-metallic materials such as polymers or other constructs with the ability to flex may be used in other embodiments. In some embodiments, the term "flexible" includes the ability to be deformed to a particular shape and hold that shape without continuing application of force until deformed to another shape or returned to an original shape. As used herein, a material that is more "flexible" than another material is a material that deforms more when subjected to the same load when it has the same shape as the other material.

A fluid supply port <NUM> coupled between the fluid control unit <NUM> and near the proximal end <NUM> of the wand body <NUM> and communicating through the wand body <NUM> to facilitate the provision of fluid at or near the distal end <NUM> of the wand body <NUM> is shown in <FIG> and <FIG>. A suction port <NUM> coupled near the proximal end <NUM> of the wand body <NUM> and communicating through the wand body <NUM> to facilitate the provision of negative pressure at or near the distal end <NUM> of the wand body <NUM> is also illustrated in <FIG> and <FIG>. In other embodiments, one or both of a fluid supply port and a suction port may be located at other locations on an electrosurgical wand. In other embodiments, only one of either a fluid supply port and or a suction port may be present.

The electrosurgical wand <NUM> embodiment illustrated includes a lumen <NUM> within at least a part of the portion of the distal end <NUM> of the wand body <NUM> that is flexible, as illustrated at least in <FIG>, and <FIG>. The term "lumen" is sometimes used to describe openings in tissue such as organ, but is used herein to refer to a tubular structure that is not necessarily an opening in tissue. The lumen <NUM> shown provides a passageway <NUM>. The lumen <NUM> includes an inner tubular member <NUM> with an inside diameter and an outside diameter along its length. Embodiments of the inner tubular member <NUM> have solid walls along substantially all of the length of the inner tubular member <NUM>. Other embodiments may have lateral openings into or out of an inner tubular member embodiment. In some embodiments, the wand body <NUM> is not only flexible, but also plastically deformable so that it will hold a particular shape when positioned to that shape. All or a portion of the distal end <NUM> is plastically deformable. The plastically deformable portion includes an annealed metal or other malleable material that retains a bent shape while still providing support to the lumen.

The inner tubular member <NUM> may in whole or in part be made from polyetheretherketone. In some embodiments, the inner tubular member <NUM> is substantially round and has an outside diameter of about <NUM> and a wall thickness of about <NUM>. This material and size selection enables some flexibility of the inner tubular member <NUM> while also providing some stiffness and some resistance to being crushed or collapsed under normal use. Additionally an inner tubular member that is electrically insulative may be preferable, to limit the current path between electrodes of the electrosurgical wand. An electrically conductive material may allow electrical currents to bridge to other unintended portions of the wand as the electrically conductive fluid travels there-along.

The electrosurgical wand <NUM> embodiment illustrated also includes a support coil <NUM> with an inside diameter and an outside diameter along its length. In some embodiments, the support coil <NUM> is substantially round and has an outside diameter of about <NUM> and a wall thickness of about <NUM>. The support coil <NUM> depicted has a helically formed metal wire with a wire diameter "D" (<FIG>). In the illustrated embodiment, wall thickness of the support coil <NUM> and D are the same. The wire extends helically along the length of the support coil <NUM> to produce walls of the support coil <NUM>. The walls of the support coil <NUM> shown are defined by extents of the wire at the inside diameter of the support coil <NUM> and the outside diameter of the support coil <NUM>. In other embodiments, the wire may be a non-metallic but resilient material, for example, a relatively rigid polymer. A support element of some embodiments may be a spiral cut metallic or non-metallic tube. In some embodiments, the support element of a lumen may be a series of stacked rings not coupled to one another, but rather constrained on their ends. Stacked ring embodiments may also be coupled to one another at limited locations or coupled to an inner tubular member.

As particularly illustrated in <FIG>, substantially all of each revolution of the wire about the length of the support coil <NUM> occurs within a respective distance along the length of the support coil <NUM> of two wire diameters "D". A distance of a revolution of the wire along the length of the support coil <NUM> is labelled with the designator "L", and cross-sections of a single revolution of the wire are "x" marked as elements 327a in <FIG>. In other embodiments, substantially all of each revolution of the wire about the length of a support coil may occur within a respective distance along the length of the support coil of three wire diameters. Relatively close spacing of wires of the support coil (tight winding) may be useful to provide hoop strength as a result of the configuration of the wire and thereby provide greater crushing resistance for the lumen. In the illustrated embodiment, the wire of the support coil <NUM> laterally touches adjacent revolutions of the wire of the support coil <NUM> along substantially the entire length of the support coil <NUM>. In some embodiments, the wire of the support coil <NUM> may have an axial pre-stress along the length of the wire that draws the support coil <NUM> into a compressed state. Such a pre-stress may be created by heat treatment, by mechanical force application, or by any other effective technique or process.

As shown in <FIG>, the inside diameter of the support coil <NUM> closely conforms to the outside diameter of the inner tubular member <NUM> when the support coil <NUM> is substantially straight along substantially all of its length. Substantially straight may be defined as a support coil <NUM> with a deviation of its longitudinal axis of less than about <NUM> degrees along the support coil longitudinal axis. Some embodiments include a distance between the inside diameter of the support coil <NUM> and the outside diameter of the inner tubular member <NUM> of about <NUM> on average. In some embodiments, the support coil <NUM> and the inner tubular member <NUM> are in contact along substantially the entire length of the support coil <NUM>. It may also be that the support coil <NUM> compresses against and indents into the inner tubular member <NUM>. In some embodiments, the support coil <NUM> must be radially expanded to fit around the inner tubular member <NUM> in the process of assembling the components. This may be accomplished by counter-rotating the support coil <NUM> about its longitudinal axis or by any other effective action. In still other embodiments, the outside diameter of the support coil may closely conform to the inside diameter of a wand body in which the support coil is positioned, and a space may be left between the support coil and an inner tubular member. In an alternative embodiment, an outside diameter of a support coil may closely conform to an inside diameter of a wand body in which the support coil is positioned. This configuration would limit potential crushing or collapse on an associated inner tubular member by also adding the strength of the wand body to the construct without necessarily having the support coil closely conform to the inner tubular member.

In addition to the passageway <NUM>, a transfer space <NUM> may exist between the wand body <NUM> the lumen <NUM>, as illustrated in <FIG>, and <FIG>. Either of the passageway <NUM> or the transfer space <NUM> may be used to pass fluid between more proximal and distal portions of the wand body <NUM>. In some embodiments, the passageway <NUM> of the inner tubular member <NUM> is a suction tube that is coupled to a negative pressure source through, for example, the suction port <NUM>. Likewise, the transfer space <NUM> may be open to a negative pressure source through, for example, the suction port <NUM> in other embodiments. The reciprocal may be true of other embodiments where the fluid supply port <NUM> may be in fluid communication with either of the passageway <NUM> of the inner tubular member <NUM> or the transfer space in respective embodiments.

Electrosurgical system embodiments may also include an electrosurgical conductor electrically coupled to the controller <NUM> and passing through at least a portion of the wand body <NUM> to supply tissue affecting energy at or near the distal end of the wand body. The electrosurgical conductor may pass through, between, or among any combination or singular component of the electrosurgical wand <NUM> including but not limited to the wand body <NUM>, the lumen <NUM>, the inner tubular member <NUM>, the support coil <NUM>, the passageway <NUM>, and the transfer space <NUM>. One or more electrosurgical conductors may implement monopolar or bipolar tissue ablation, tissue cauterizing, or any other effective electrosurgical procedure or technique. In embodiments where the support coil <NUM>, or a similar support component, is a conductor between the controller <NUM> and a distal electrode or other electrically operable component of the electrosurgical wand <NUM>, a wire of such a support coil may be insulated.

A side elevation view of an embodiment of the electrosurgical wand <NUM> of the electrosurgical system <NUM> with a distal portion of the electrosurgical wand <NUM> in a bent state is illustrated in <FIG> particularly illustrates a cross-sectional view of the bent distal portion of the electrosurgical wand <NUM>. As evident in <FIG>, a space <NUM> may develop between the outside diameter of the inner tubular member <NUM> and the inside diameter of the support coil <NUM> when the electrosurgical wand <NUM> is in a bent state. However, it is nonetheless valuable that embodiments of the present invention maintain a passageway <NUM> through the inner tubular member <NUM> when the electrosurgical wand <NUM> is in a bent state. In addition, while in a bent configuration, some portion of each revolution of the wire about the length of a support coil may no longer occur within a respective distance along the length of the support coil of three wire diameters. This may depend on how small or sharp the radius of curvature is formed. This is best seen in <FIG>, showing support coil <NUM> extending along a bend, the bend defining an outer curve where the space <NUM> has opening up and inner curve. Not only may a space <NUM> open up, but also portions of the coil along this outer curve may spread to be further spaced from each other, while portions along the inner curve may be more tightly packed or relatively close along the inner radius. Therefore in the bent configuration, a portion of each revolution of the wire may occur within a respective distance along the length of the support coil of more than two wire diameters along the outer curve, and each revolution may spread to be up to four diameters, however still sufficient to shield the softer inner tubular member <NUM>. Preferably, the support coil <NUM> may still have revolutions sufficiently close to prevent the inner tubular member from distending laterally outwards at the location of the bend. Additionally, in the bent configuration a portion of each revolution of the wire may occur within a respective distance along the length of the support coil of less than three wire diameters (inner curve).

In addition, a method of use may begin with placing a distal end of the wand near a target tissue, the wand distal end being oriented at a first angular orientation relative to a proximal end of the wand. This first orientation may be substantially straight or coaxial with the wand proximal end. Fluid may then be transferred along an inner tubular member of the wand, the inner tubular member having a support coil wrapped round the inner tubular member, as disclosed herein. The method may also include treating a target tissue electrosurgically and transferring treated tissue along the inner tubular member. The method further comprises plastically deforming a portion of the wand, such that the wand distal end is disposed at a second angular orientation relative to a proximal end of the wand, the wand configured to hold this second angular orientation. This second orientation is different from the first orientation. Fluid may then be transferred along the inner tubular member of the wand, the support coil wrapped round the inner tubular member as disclosed herein to support the inner tubular member and inhibit the inner tubular member from kinking. The method may further comprise plastically deforming a portion of the wand, such that the wand distal end is now oriented at a third angular orientation relative to a proximal end of the wand. This third orientation is different from at least one of the first or second orientation. Fluid may then be transferred along the inner tubular member of the wand, the support coil configured to inhibit the inner tubular member from kinking or deforming and thereby inhibit fluid flow. For example, the support coils assists in maintaining an opening along the inner tubular member to allow sufficient fluid to flow therethrough. In some embodiments, the steps of transferring fluid further comprises flowing treated tissue fragments therethough, and the support coil is configured to limit deformation of the inner tubular member to maintain a sufficient inner tubular member opening to allow passage of the tissue fragments therethrough.

Another embodiment of the disclosure is a method of manufacturing a medical device. The medical device may be, by way of non-limiting example, a lumen or an electrosurgical device that includes a lumen. Such method embodiments may include expanding a support coil, such as the support coil <NUM>, with an inside diameter and an outside diameter along its length. The support coil <NUM> illustrated includes a helically formed wire with a wire diameter. The example wire illustrated extends helically along the length of the support coil <NUM> to produce walls of the support coil <NUM>. The particular support coil <NUM> disclosed may be a standard medical grade spring such as an off-the-shelf extension spring. This type of spring is potentially much less expensive than a specially manufactured support coil, and even a greater savings compared to a support coil or other strand that has to be over-molded by another material to form the manufactured medical device.

The act of expanding the support coil <NUM> in some embodiments includes holding the support coil <NUM> at proximal and distal locations and applying a rotational force to the support coil <NUM> about an axis along the length of the support coil <NUM> in a direction opposite to the direction of winding of the helically formed wire that makes up the support coil <NUM>. In other embodiments, expanding the support coil <NUM> may include applying a wedging force inside the support coil <NUM>. For example, a wedged shaped mechanism such as a tapered mandrel may be forced inside the support coil <NUM> from one or both ends. In still other embodiments, expanding the support coil <NUM> may include placing an expandable mechanism in the support coil <NUM> and applying a force to increase the size of the expandable mechanism to a size that is large enough to expand the support coil <NUM>.

The manufacturing method may also include inserting an inner tubular member, such as the inner tubular member <NUM> with an inside diameter and an outside diameter along its length into the support coil <NUM> inside diameter while the support coil <NUM> is expanded. Insertion of the inner tubular member <NUM> may occur while the support coil <NUM> is expanded to a size significantly larger than the outside diameter of the inner tubular member <NUM>, or the fit may be tighter such that a lengthwise force is required to force the inner tubular member <NUM> into the support coil <NUM>.

The manufacturing method may additionally include causing the support coil, such as the support coil <NUM>, to constrict around the inner tubular member <NUM> such that the inside diameter of the support coil <NUM> closely conforms to the outside diameter of the inner tubular member <NUM> when the support coil <NUM> is substantially straight along substantially all of its length. An example straight support coil <NUM> conforming closely to the outside diameter of the inner tubular member <NUM> is shown in <FIG>. The act of causing the support coil <NUM>, or other support coil embodiments, to constrict may include reducing a force used to expand the support coil <NUM>. Such reductions of force may include one or more of reducing the counter-rotating force on the support coil <NUM>, applying a twisting force to remove a wedge from one or more ends of the support coil <NUM>, applying a tensile force to remove a wedge from one or more ends of the support coil <NUM>, and any other effective force application or reduction.

In some embodiments, causing the support coil <NUM> to constrict includes waiting a period of time. For example, if the support coil <NUM> is made from a shape memory material, some period of time may need to be waited before an expanded support coil <NUM> will constrict around the inner tubular member <NUM>. The period of time waited may also be merely the period of time after an inner tubular member <NUM> is moved into a support coil until the force used to move the components together is ended. Some acts causing the support coil <NUM> to constrict may also include changing the temperature of the support coil <NUM>. In some embodiments, causing the support coil, such as support coil <NUM>, to constrict includes applying a constricting force around the support coil <NUM>. Causing the support coil <NUM> to constrict around the inner tubular member <NUM> may cause the distance between the inside diameter of the support coil <NUM> and the outside diameter of the inner tubular member <NUM> to be about <NUM> on average. In other embodiments, causing the support coil <NUM> to constrict around the inner tubular member causes the support coil <NUM> and the inner tubular member <NUM> to be in contact along substantially the entire length of the support coil <NUM>.

Other embodiments of the method may include coupling a lumen, such as the lumen <NUM>, inside an electrosurgical wand, such as the electrosurgical wand <NUM>, to provide a flexible and collapse-resistant passageway through the electrosurgical wand <NUM>. The lumen <NUM> may be offered as a separate medical device or device component, or may be incorporated into the electrosurgical wand <NUM> and sold as part of the electrosurgical wand <NUM>. One or both of the lumen <NUM> and the electrosurgical wand <NUM> may also be offered as part of the electrosurgical system <NUM>.

Various embodiments of a system wholly or its components individually may be made from any biocompatible material. For example and without limitation, biocompatible materials may include in whole or in part: non-reinforced polymers, reinforced polymers, metals, ceramics, adhesives, reinforced adhesives, and combinations of these materials. Reinforcing of polymers may be accomplished with carbon, metal, or glass or any other effective material. Examples of biocompatible polymer materials include polyamide base resins, polyethylene, Ultra High Molecular Weight (UHMW) polyethylene, low density polyethylene, polymethylmethacrylate (PMMA), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), a polymeric hydroxyethylmethacrylate (PHEMA), and polyurethane, any of which may be reinforced. Polymers used as bearing surfaces in particular may in whole or in part include one or more of cross-linked and highly cross-linked polyethylene. Example biocompatible metals include stainless steel and other steel alloys, cobalt chrome alloys, zirconium, oxidized zirconium, tantalum, titanium, titanium alloys, titanium-nickel alloys such as Nitinol and other superelastic or shape-memory metal alloys.

Terms such as proximal, distal, near, and the like have been used relatively herein. However, such terms are not limited to specific coordinate orientations, distances, or sizes, but are used to describe relative positions referencing particular embodiments. Such terms are not generally limiting to the scope of the claims made herein. Any embodiment or feature of any section, portion, or any other component shown or particularly described in relation to various embodiments of similar sections, portions, or components herein may be interchangeably applied to any other similar embodiment or feature shown or described herein.

Claim 1:
A surgical wand (<NUM>) comprising:
a wand body (<NUM>) with a proximal end (<NUM>) and a distal end (<NUM>), wherein the distal end (<NUM>) includes at least a portion that is flexible;
a fluid flow port (<NUM>) coupled near the proximal end (<NUM>) of the wand body (<NUM>) and communicating through the wand body (<NUM>) to facilitate the flow of fluid to or from the distal end (<NUM>) of the wand body (<NUM>);
a lumen (<NUM>) within at least a part of the portion of the distal end (<NUM>) that is flexible, the lumen (<NUM>) providing a passageway, the lumen (<NUM>) comprising:
an inner tubular member (<NUM>) in fluid communication with the fluid flow port (<NUM>) and with an inside diameter and an outside diameter along its length, and
a support coil (<NUM>) with an inside diameter and an outside diameter along its length, the support coil (<NUM>) comprising a helically formed wire with a wire diameter, the wire extending helically along the length of the support coil to produce walls of the support coil (<NUM>),
wherein the walls of the support coil (<NUM>) are defined by extents of the wire at the inside diameter of the support coil (<NUM>) and the outside diameter of the support coil (<NUM>), and
wherein substantially each revolution of the wire occurs within a respective distance along the length of the support coil (<NUM>) of three wire diameters;
wherein the flexible portion of the distal end (<NUM>) is plastically deformable and includes a malleable material that can retain a bent shape when positioned to that shape without continuing application of force while still providing support to the lumen (<NUM>).