KR19990076651A - Abloscope Electrode Assembly with Simultaneous Ablation and Solidification - Google Patents

Abstract

The electrode assembly of the ablation mirror 18 includes an ablation electrode 1 having a loop end tip and a first power density. The solidification electrode 2 has a loop end tip and a second power density less than the first power density. The support frame is connected to the ablation and coagulation electrodes 1, 2 and the energy source 24 to supply energy from the energy source 24 to the ablation and coagulation electrodes 1, 2. The coagulation electrode 2 coagulates the tissue while the ablation electrode 1 ablates the tissue. The ablation mirror 18 is disclosed with the electrode assembly included. The ablator includes a lid 14 having a lid aperture 14a, 14b, a work element 15, and a visualization device 16.

Description

Abloscope Electrode Assembly with Simultaneous Ablation and Solidification

BPH is the benign growth of the prostate gland located in the bladder outlet. BPH is one of the most common body abnormalities that adversely affects people over 50 years old. The incidence increases with age, reaching 80-90% at 80 years of age. In most patients, BPH does not cause any symptoms. However, in a few percent of patients, BPH will slowly and gradually block urinary excretion causing urinary symptoms of bladder obstruction and irritation. Also in very small percentages, the symptoms progress to cause complete pulmonary urination, urinary infections, bladder stones and similar damage. The decision to treat or not to treat patients is determined by the presence of symptoms and pain in the patient. Thus, for many BPH patients without symptoms, treatment is not needed. In patients with symptoms of BPH, various treatment methods may be utilized.

There are surgical treatments for BPH in two groups based on anesthetic needs. The first group requires general or spinal anesthesia, open prostatectomy, transurethral resection of the prostate (TURP), transurethral incision of the prostate gland ( TUIP), transurethral steam therapy (TVP) of the prostate gland, visual laser assisted prostatectomy (V-LAP), contact laser prostatectomy, prostate instrument dilation, and internal-prostatic stent It requires intra-prostatic stents. TURP is a "Gold Standard" treatment. It was the most efficacious and durable of all surgical treatments, with a success rate of 80-90%.

The prostate is a bloody organ that bleeds very much during resection (TURP). Bleeding results in a decrease in visual clarity which in turn leads to various surgical difficulties with undesirable outcomes. Bleeding is a major injury factor that leads to various problems: FIG. 1 is a flow chart listing complications of standard TURP.

The typical resection for transurethral resection consists of four main elements. The first element is a rigid telescope for observing the interior of the urinary tract in which surgical procedures are performed. The telescope includes an objective lens and a series of relay lenses housed in an endoscope barrel or bag, which is connected to an alternative lens housing containing suitable lenses suitable for proper magnification. The second element takes the form of a handle assembly generally referred to as the working element. The working element can serve as a means for connecting the electrosurgical current from the electrosurgical generator to the third element to the electrode assembly. The working element can also slide the electrode assembly along the longitudinal axis of the ablation mirror. The combination of the telescope, work element and electrode assembly is locked with a fourth element, an abloscope cover. The cover consists of a tube and a coupling body and a locking assembly. In operation, the entire excision is placed into the urethra.

A typical ablation electrode assembly is in the form of a U-shaped tungsten wire loop, the ends of which reach one or more wires that fit into the work element of the ablation mirror for current conduction. Wire arms are generally joined to an electrode lead which is joined at adjacent ends and extends behind the working element of the tool. In order to support the ablation loop so as to maintain a constant distance from the telescopic bag, a metal gap sleeve is generally placed between the electrode arms parallel to the telescopic bag or between the distal ends of the electrode leads immediately adjacent to the arms. Is provided. The metal spacing sleeve can slide along the telescope bag as the electrode assembly moves forward and back, and due to the direct contact between the spacing sleeve and the telescope bag, it is necessary to partially ensure proper insulation between the electrode and the sleeve.

To date, all new alternative surgical therapies generally fail to exhibit similar efficacy and durability, but such therapies have some advantages that minimize morbidity, the amount of blood loss suffered, and are easier to implement. A safer and less pathological approach is needed than TURP, which shows similar endurance efficacy.

The second group of surgical therapies requires local anesthesia without global or spinal anesthesia. These treatments use different energies to apply heat to the prostate. Such treatments include urethral microwave thermal therapy (TUMT), urethral heat-ablation therapy (T3), high intensity lesion ultrasound (HIFU), laser emission gap thermal therapy (LDIT), and prostate urethral needle ablation (TUNA). It is included. The treatments are more pathological than conventional TURP. The thermal therapies are currently under study and will require completion of phase 3 trials and FDA approval before such therapies are put to practical use.

As shown in FIG. 1, since a non-bleeding TURP device is needed, all problems of the standard TURP device can be substantially alleviated. This can be achieved with a TURP device which allows ablation and coagulation to occur simultaneously.

TECHNICAL FIELD The present invention relates to abloscope electrodes, and more particularly, to an ablation electrode assembly in which ablation and coagulation occur simultaneously and using only one power source.

1 is a flow chart depicting complications of the standard TURP procedure.

Figure 2 (a) is a perspective view showing an embodiment of an electrode assembly according to the present invention.

2 (b) is a cross-sectional view of the electrode assembly 2 (a) along the line 2 (b) -2 (b).

2 (c) is a cross-sectional view showing electrode assembly 2 (a) along line 2 (c) -2 (c).

2 (d) shows electrode assembly 2 (a) taken along line 2-2, with ablation and coagulation electrode end tips having different current densities by reducing the contact surface between electrode and tissue at a given power level. Cross-sectional view showing one embodiment of the.

FIG. 2 (e) shows electrode assembly 2 taken along line 2-2, with ablation and coagulation electrode end tips having different current densities by reducing the contact surface between electrode and tissue at a given power level. Cross-sectional view showing one embodiment of).

FIG. 2 (f) shows electrode assembly 2 (a) taken along line 2-2, with ablation and coagulation electrode end tips having different current densities by reducing the contact surface between electrode and tissue at a given power level. Cross-sectional view showing one embodiment of).

Figure 2 (g) shows electrode assembly 2 (a) taken along line 2-2, with ablation and coagulation electrode end tips having different current densities, by varying the electrode material limiting the current flowing through the electrode. Cross-sectional view showing one embodiment of).

Figure 2 (h) has different current densities for the ablation and solidification portions of only one end tip by having an ablation electrode composed of multiple layers of alternating metal and insulators, causing ablation and solidification to occur simultaneously. Cross-sectional view showing only one ablation and coagulation distal tip.

Figure 3 (a) is a perspective view showing a second embodiment of the electrode assembly of the present invention.

3 (b) is a cross-sectional view of the electrode assembly 3 (a) along the lines 3 (b) -3 (b).

3 (c) is a cross-sectional view of electrode assembly 3 (a) along line 3 (c) -3 (c).

3 (d) is a cross-sectional view showing electrode assembly 3 (a) along line 3 (d) -3 (d).

3 (e) is a cross-sectional view of electrode assembly 3 (a) along line 3 (e) -3 (e).

Figure 4 (a) is a perspective view of the ablation mirror.

4 (b) is a cross-sectional view showing the ablation mirror 4 (a) along lines 4 (b) -4 (b).

Figure 5 (a) is a diagram showing an ablation mirror, a power supply and a converter according to the present invention.

5 (b) is a diagram showing an abloscope, power supply and transformer conduit unit (without converter) according to the present invention.

6 is a diagram schematically showing an electronic circuit diagram suitable for the converter 23 of the present invention of FIG.

FIG. 7 is a schematic diagram of the electronic circuit of the first embodiment of the transformer 20 of FIG. 5 (a) with a unipolar device connected to the bipolar outlet of the RF power source.

8 is a schematic diagram of the electronic circuit of the second embodiment of the transformer 20 of FIG. 5 (a) with a unipolar device connected to the bipolar outlet of the RF power source.

9 (a), 9 (b), 9 (c) and 9 (d) show the third and fourth of the transformer 20 of FIG. 5 (a) with the bipolar device connected to the bipolar outlet of the RF power source. Diagrammatically showing the electronic circuit of the 5 and 6 embodiments.

It is therefore an object of the present invention to provide an ablation electrode assembly comprising a coagulation electrode loop that operates simultaneously (within about 1 second) with the ablation electrode loop.

It is still another object of the present invention to provide an ablation electrode assembly comprising a coagulation electrode, an ablation electrode and one power source for powering the two electrodes.

It is still another object of the present invention to provide an ablation electrode assembly comprising a solidification and ablation rod having a single loop having different current densities simultaneously carrying out ablation and solidification and having only one power source. To provide.

Another object of the present invention is to provide an ablation electrode assembly comprising a coagulation electrode and an ablation electrode, each having an end loop shape and having different current densities.

Another object of the present invention is to provide an ablation electrode assembly comprising an ablation and coagulation loop having first and second current densities, wherein the loop provides ablation and coagulation simultaneously.

It is still another object of the present invention to provide an ablation electrode assembly comprising a solidification loop and an ablation loop, wherein the solidification loop comprises an insulator on the contact surface to provide a solidification loop current density lower than the ablation loop current density. Equipped.

It is still another object of the present invention to provide an ablation electrode assembly comprising a solidification loop and an ablation loop, wherein the solidification loop has an increased surface area to provide a solidification loop current density less than the ablation loop current density. .

It is yet another object of the present invention to provide an ablation electrode assembly comprising a solidification loop and an ablation loop, wherein the solidification loop has a contact surface to provide a solidification loop current density lower than the coil, resistance element or ablation loop current density. It includes a printed circuit on the top.

It is yet another object of the present invention to provide an electrode system that enhances a substantially non-bleeding TURP procedure.

It is yet another object of the present invention to provide an electrode system for improving TURP procedures that provides increased visual clarity.

The above objects of the present invention are provided in an ablation electrode assembly. The ablation electrode assembly includes an ablation electrode and a solidification electrode, both electrodes having end tip loops. The ablation electrode loop has a higher density than the current density of the solidification loop. This allows the use of only one energy source and eliminates the need for a converter box. The support frame connects the ablation and coagulation rods to an energy source that supplies energy from the power source to the electrodes. Many kinds of energy sources may be used including, but not limited to, such as RF, microwave, inferior, and the like. The coagulation electrode coagulates the tissue while the ablation electrode ablates the tissue.

In another embodiment of the present invention, the electrode assembly has only one loop, which simultaneously excises and solidifies. The loop has a solidification portion with a lower power density than the ablation portion. This is accomplished by various methods including, but not limited to, different (i) material (ii) shape (iii) dimensions or (iii) insulators.

In another embodiment of the present invention, the ablation mirror is disclosed including an electrode assembly. The ablation mirror includes a lid having a lid aperture, a work element, and a visualization device.

The ablation mirror includes a lid including a lid aperture, a distal end, and an adjacent end. The electrode assembly includes an ablation electrode having an end portion having a loop shape and a coagulation electrode having an end portion, wherein the coagulation electrode end tip solidifies the tissue while the ablation electrode ablates the tissue. The work element is attached to the adjacent end of the cover. In addition, the visualization device is provided and received through the working element in the lid aperture extending from the lid end portion to the handle proximal end of the working element.

The present invention provides a surgical surgical electrode assembly for the resection, the resection is; Ablation and coagulation simultaneously under direct visualization; Easier work for urologists; Low risk of getting into the sinus; Low risk of excessive bleeding; Reduced translocation of blood transfusions; Low fluid irrigation and bladder distension; Low risk of TURP syndrome; Low risk of encapsulation and low risk of continuous fluid spillage into the abdomen; Low risk of urinary sphincter injury and subsequent urinary incontinence; Low risk of urinary duct injury and low risk of continuous urinary obstruction and bladder urinary regurgitation; Shorter surgery time; Less need for bladder catheterization and post-operative Foley contraction; Small risk of scar and bladder neck spasms after surgery; Less need for postoperative bladder irrigation; Shortened duration of Foley catheterization after surgery; Shorter hospitalizations; And less related costs than the standard TURP.

Only one energy source is needed. The electrode assembly may comprise one or more electrode loops. One loop may ablate at the same time as the second loop solidifies. Optionally, only one loop can provide two functions simultaneously. In any case, only one energy source is needed because of the different current densities for ablation and solidification. In addition to the above ablation glasses, the electrode system of the present invention can be used with substantially all RF commercial power sources.

It is a further object of the present invention to provide an electrical conduit unit in the form of a cable having a transformer unit coupled therein. The transformer separates the energy from the energy source into two given energy power levels, while the cable delivers the energy to the ablation electrode assembly. The transformer unit can be manufactured without coupling it inside the cable, such as a separate transformer (converter). The function of both the transformer unit and the converter is to split the energy into two given energy power levels that can be altered and adjusted to the dual simultaneous ablation and coagulation functions of the electrode assembly.

The present invention is an ablation electrode assembly, comprising an ablation electrode and a solidification electrode, two electrodes having end tip loops. The functional goal of the electrode assembly is to simultaneously resection and coagulate the tissue during the surgical procedure. The electrode assembly receives that energy from the power source energy. The general main energy from the power source is converted into two separation energies, each of which is used in each end loop of the electrode assembly. Partly designed energy converter or transformer conduit units result in the above. One permits only one energy source to supply two given energy powers to the two electrode assembly loops that simultaneously have different functional operating properties, which ablate tissue and one coagulate tissue. Moreover, the variety of electrode assembly end tips (loops) design is not limited to (i) materials, (ii) shapes, (iii) dimensions or (iii) insulators that allow for further functional adjustment and modification. It is provided as a basis. The variety of energy sources is not limited to such as RF (RF), microwave, heat and the like, but can be used including them.

In another embodiment of the present invention, the electrode assembly has only one loop in which ablation and coagulation occur simultaneously. The loop has a solidification portion with a lower power density than the ablation portion. This is accomplished by a variety of methods, including but not limited to using different (i) materials, (ii) shapes, (iii) dimensions or (iii) insulators.

In another embodiment of the present invention, an ablation mirror is disclosed that includes an electrode assembly, an ablation rod cover, a work element, and a visualization device.

In addition, when compared to devices currently used as standard TURP devices, the present invention provides: enhanced visual clarity; Easier work for urologists; Low risk of getting into the sinus; Low risk of excessive bleeding; Reduced translocation of blood transfusions; Low fluid irrigation and bladder distension; Low risk of TURP syndrome; Low risk of penetrating the membrane and low risk of fluid overflow into the abdomen; Low risk of urinary sphincter injury and low risk of continuous urinary incontinence; Low risk of urinary duct injury and low risk of continuous urinary obstruction and low risk of urinary bladder regurgitation; Shorter surgery time; Less need for bladder catheterization and postoperative Foley contraction; Small risk of scar and bladder neck spasms after surgery; Less need for postoperative bladder irrigation; Shortened duration of polycatheterization after surgery; And shorter hospitalizations; And less related costs than the standard TURP.

For this purpose of presentation, the "simultaneous" is: (i) RF (energy)-energy is provided simultaneously to the ablation and coagulation electrode end tips. (Ii) RF (RF) -energy is provided to the two distal tips in less than one second. (Iii) During the same hand movement, for example, forward movement or retraction movement, energy is only supplied in ablation mode, and in other movements, energy is only supplied in coagulation mode. (Iii) When energy is delivered to the distal tips, the coagulation tip has an RF (RF) spread of heat or energy that, when ablation, reaches the ablation distal tip. (Iii) The two currents exit at the two end tips at the same time. (Iii) The transfer of thermal energy from the solidification electrode to the ablation electrode location occurs in less than a millisecond. It can be seen that heat spread from the solidification tip can be controlled. The higher the energy, the greater the spread. The lower the energy, the less spread. It is possible to have an RF (RF) energy spread over the physical location of the ablation electrode.

The electrode system and ablation mirror of the present invention can be operated in bipolar or unipolar mode. Bipolarity is particularly suitable when the two electrodes are very close together and when the spread of RF (RF) energy between the two electrodes needs to be limited or controlled. As the distance between the two electrodes becomes shorter, the RF energy spread does not extend significantly beyond the electrode. This is particularly useful where RF energy spreads to surrounding or adjacent tissues or structures that may cause undesirable results.

Moreover, the present invention can be used for such things as gastroscopy, general laparoscopic surgery, thoracoscopic diagnosis, heat and neck surgery, orthopedic surgery, gynecology and the like. Gastrostomy may be used to endoscopically cut intestinal tumors and other lesions. The electrode system and resection of the present invention more safely resecrate the tumors and lesions with improved visualization and reduced morbidity and mortality. Surgical planes that include internal organs such as laparoscopic biopsy, resection, lesion dissection, and liver can be made easier with less complications. Head and neck applications include, but are not limited to, oral cavity, throat, larynx, pharynx, fistula (blood pulsation), ear and lung system. Biopsy and resection of lesions that have bleeding potential, including but not limited to hemangiomas, nasal polyps, cancers, and the like, can be performed using the present invention. The field of endoscopic orthopedic surgery includes, but is not limited to, debridement and resection of hernia vertebral discs, cracked articular cartilage, scars, protrusions and the like. Gynecological surgery includes resection such as endometrial lesions, tumors, lymph nodes and the like.

Referring to Figures 2 (a), 2 (b) and 2 (c) showing the electrode assembly, the electrode assembly within its distal tip may have two electrode loops, a cut loop 1 and a solidification loop ) Is included. Suitable electrode loop shapes are limited to radial, circular, elliptical, curved, rounded, arched, arced, arcuate, crescent, semicircular, malleable rollers (spinning objects, revolvers, rotary) cylinders. Not only this, but also a roller ball. In an embodiment, a plurality of roller balls is included to form a loop having the shapes already mentioned. The loop size diameter can be 3 mm (9 small diameter measuring unit length) to 10 mm (30 small diameter measuring unit length) or can fit a commercially available ablation mirror (8 to 28 small diameter measuring unit length). It can be any size that is. Cross-sectional shapes of the wire include circular, semicircular, any portion of a circle, square, triangular, hexagonal, octagonal, etc., flat planes, and mixed forms above. The wire may comprise horizontal or longitudinal grooves. The cross-sectional diameter of the wire may be about 0.25-4 mm. The size of the roller may be 0.25 to 4 mm. The ablation loop 1 and the solidification loop 2 may be fixed at a fixed distance from each other. The distance between the two loops can range from 1 to 6 mm. This gives sufficient time for the ablation loop 1 to ablate tissue while the coagulation loop 2 solidifies the tissue at a distance slightly apart. Proper separation distance allows two loops to effectively ablate and solidify simultaneously without disturbing each other.

The ablation loop 1 is continuous with the wire edges 1a and 1b. The solidification loop 2 is continuous with the wire edges 2a and 2b. Wires 1a and 2a terminate at their respective end caps 7 and 8 which serve to connect them to energy sources. The wires 1b and 2b terminate invisibly along the electrode assembly body where they are each insulated from the remaining portions of the electrode assembly components. Through the end cap 7, energy is transferred to the wire 1a to reach the ablation loop 1. Through the end cap 8, energy is transferred to the wire 2a to reach the solidification loop 2. The electrode wires 1b and 2a are respectively wrapped in the steel pipe 3 and outside the insulator sleeve 4, all of which are encased in the housing sleeve 5. The electrode wires 1a, 2b are similarly packaged inside the steel pipe 3 and outside the insulator 4 and put into the housing sleeve 5. The thickness of the insulator sleeve is in the range of 0.001 to 0.100 inches. The housing sleeves 5 extend along the electrode assembly at various distances to give sufficient support and strength to the inner contents thereof.

The light guide sleeve (s) 6 is not limited to such as a relay lens or the like, but is a light guide tube including the same, a support frame for the electrode loops 1 and 2, and electrode wires 1a, 2a, 1b and 2b. ), Part of the electrode assembly providing the steel pipe 3 and the housing sleeve 5. The light guide sleeve 6 may be cylindrical, tubular or cylindrical or part of a tube. Moreover, the light guide sleeve 6 may be one or multiple. It may extend in the range of 0.1 mm to 30 cm, ie from the proximal end to the distal end of the electrode assembly. The light guide sleeves 6 are mounted to the housing sleeve 5 anywhere along the length of the electrode assembly according to the shape of the ablator.

The ablation loop 1 and the solidification loop 2 can be made of various electrically conductive materials including, but not limited to, tungsten, alloys thereof, stainless steel, and the like. Their corresponding electrode wires 1a, 2b, 1b, 2b can similarly be made of electrically conductive materials. Insulation sleeves (4) are not limited to (i) fluoropolymers, (ii) polyimides, (iii) polyamides, (iii) polyaryl group sulfones, and (iii) silicone plastics, Can be. The steel pipe 3, the housing sleeve 5 and the light guide sleeve 6 may be made of a corrosion resistant material such as stainless or stainless steel.

2 (d) to 2 (g), cross sections of the ablation loop 1 and the solidification loop 2 are shown in various embodiments. 2 (d) to 2 (g), two loops having different power levels can be created by selectively using insulators (eg, teflon, oxide, paint). In each embodiment, the current density for the solidification loop 2 is lower than the current density of the ablation loop 1. In FIG. 2 (d), an insulator is used for the contact surface of the solidification loop 2. The electrodes have the same size as in FIG. 2 (d), while the electrodes in FIG. 2 (e) have different sizes. In FIG. 2E, the solidification loop 2 has an increased surface area. In Fig. 2 (f), the solidification loop 2 has an insulator substantially used around it. In Figure 2 (f) there is an increased size and increased passage. Referring to Figure 2 (g), the area is increased by providing coils.

Referring to Figure 2 (h), ablation and coagulation functions are combined into only one end loop with sharp edges that are hotter points and larger coagulation surfaces on the other side.

See Figures 3 (a), 3 (b), 3 (c), 3 (d) and 3 (e), which show other electrode assemblies. In this embodiment, only one arm conductor rod transmits two currents through the ablation electrode 1 and the solidification electrode 2 to the rods 1c and 2c to the body. In the crimp 9 in the housing 10, the rod 1c extends distal to form an ablation loop 1 and is connected to an electrode wire 2a that returns as an electrode wire 1b. In a similar manner within the crimp 9 inside the housing 10, the rod 2c is connected to an electrode wire 2a that extends distal to return as an electrode wire 2d to form an ablation loop 2. . The two electrode wires 1b, 2b return to the crimp 9 where they terminate invisibly inwardly and are insulated from the remainder of the electrode assembly components. In the path at the end to form the ablation loop 1 and the solidification loop 2, each electrode wire lies inside each steel pipe 3 and insulator 4.

Adjacently, the rod 1c is present in the hollow rod 2c with the inner insulating sleeve 11 therebetween. The outer insulating sleeve 12 covers the outer portion of the rod 2c. The housing sleeve 3 surrounds portions of the outer insulator 12 that support and add body strength to the electrode assembly. At the distal end of the electrode assembly, the rods 1c and 2c are exposed except for the insulating sleeves 11 and 12 to be connected to an energy source. The purpose of the single arm electrode assembly at the end is to use it in a variety of commercially available ablation rods. Insulating materials can be any of plastic or other non-conductive materials that can be used in medical devices.

See Figures 4 (a) and 4 (b), which illustrate the ablation mirror. The abloscope includes the following parts: cover 14, work element 15 and visualization device 16. The parts that engage the electrode assembly are placed together to form a functional ablation mirror. When assembly is complete, the ablation and coagulation loops 1, 2 of the electrode assembly are located in a lid aperture 14a at the distal end of the ablator lid 14.

The ablator lid 14 has a lid aperture 14b extending substantially along the entire length of the lid from its distal end 14a to its adjacent end 14e. Near its distal end 14e lies an inlet socket 14c and an outlet socket 14d used to circulate the fluid irrigation during surgery. The ablation glasses work element 15 includes the following elements. (Iii) thumb 쥠 handle 15a, (ii) finger 쥠 handle 15b, (iii) spring mechanism 15c lying between the two handles, i.e. electrode assembly tips in the lid, which is the handle To keep them individually. (Iii) an internal socket 15d into which the distal end of the electrode assembly is plugged and fixed for current connection and transmission, and (iii) an external socket 15e for plugging into an external cable for carrying current from a converter and an energy source. All connections are insulated to prevent current dissipation. The electrode assembly passes through and fits inside the work element 15.

The ablation mirror visualization device 16 includes a distal end having an eyepiece, a socket 16b for attaching a light source cable, a rod lens 16c, and a distal end 16d. The rod lens 16c is the actual body of the visualization device 16 and extends from the proximal end 16a to the distal end 16d.

The light guide sleeve 6 of the electrode assembly (i) arranges and attaches a rod lens to the electrode assembly and fixes the two together, and (ii) maintains the correct and proper position of the electrode assembly through the lid aperture 14b. And (iii) the electrode assembly slides longitudinally inward and outward parallel to the lens rod 16c during use to maintain the positional relationship throughout the surgical procedure.

Referring to FIG. 5 (a), the abloscope 18 receives power from an energy source 24. The energy source is operated by the foot control 26. The energy generated from the energy source 24 is transferred through the current cable 17 to the converter 23 where energy is separated into two given energy power levels. The energy separation rate and the levels of energy power exiting the converter 23 can be manually adjusted on the front panel 23 (a) which causes ablation and solidification at the same time. The main modes of current transfer are ablation and coagulation but may include other modes, such as (i) continuous ablation, (ii) continuous coagulation and other combinations determined by control on the front panel 23 (a). have. The current cable 19 delivers the separated energy to the ablation mirror 18 to provide two loops 1, 2 of its electrode assembly for ablation and solidification at the same time. By using two different current densities in only one loop, such as loop 1, 2 or embodiment 2h, only one energy source 24 is needed. Converter 23 allows commercially available energy sources to be used substantially in the present invention. Suitable RF power sources are commercially available from Valley Labs, Erbe as well as from other commercial merchants. Other energy sources may be used including, but not limited to, microwaves, ultrasounds, heat and other electromagnetic sources.

Referring to FIG. 5B, the ablation mirror 18 receives power from the energy source 24 through the transformer / pathway unit 20. The energy source is operated from the foot control 26. The transformer / path unit 20 includes an electrical passage (cable) that plugs into the power supply 24 through its adjacent adapter 20 (b). The distal end of the electrical passage is plugged into the abloscope 18. Along the electrical passage lies a transformer unit 20 (a), which is coupled to it. In FIG. 5 (b), the transformer unit 20 (a) lies toward the distal end of the transformer / path unit 20, but is not limited to this position. The transformer unit 20 (a) may be placed anywhere along the length of the transformer / passage unit 20. The ground pad 22 (a) is placed on the patient's skin and attached to the ground cable 22 (b). The ground cable 22 (b) has an adapter 22 (c) at its adjacent end which is connected to the energy source 24. Adapter 22 (c) is also connected to adapter 20 (c) of transformer / passage unit 20 via connecting cable 21.

As shown in FIG. 6, the bridge 30 rectifies the RF (RF) signal, is filtered by the filter 31, and then the regulator 32 provides a supply voltage to a control electronic circuit suitable for two frequency bands. Controlled by The two control frequency bands are identical. RF (RF) from an external generator is delivered in a balanced manner to the first and second FET device pairs 40 and 40 'which act as voltage controlled power resistors. The gate voltage is generated by sampling the outputs from the current sensors 41 and 41 'and the bridge rectifiers 42 and 42' and compare it with a preset level. The preset level is obtained through six position switches 43, 43 'and a resistor network 44, 44' connected to a Vcc power source such as a divider. Amplifiers 45 and 45 'compare the two levels, and the difference drives the FET pair gates 40 and 40'. The output RF to the ablation loop tip 1 and the solidification tip 2 may provide isolation transformers 46 and 46 'that deflect the first and second pairs of FETs 40 and 40'. It is provided through. Capacitors on the output provide direct current (DC) blocking to further protect the patient.

Referring to the cable schematic of FIG. 7, only one power source 24 was used without electronic control to maintain power levels. The ablation and coagulation electrodes have a variable center tab 52 which allows for selective separation with a given amount of power from the power source 24. In Figure 8, the cable allows for unipolar remote control. Remote control switch 50 is included. The position of the switch 50 is communicated through the conductors inside the cable to the relay driver 51 which opens and closes the center tab 52 to obtain the desired combination.

9 (a), 9 (b), 9 (c) and 9 (d) illustrate bipolar embodiments. Although the embodiment shown in Figs. 9A and 9B is not wired in advance, Figs. 9B and 9C are wired in advance. 9 (a), 9 (b), 9 (c) and 9 (d) show that power is received by the bipolar outlet, although it operates in unipolar mode with a ground pad.

The basic principle upon which the embodiments in FIGS. 7, 8, 9 (a), 9 (b), 9 (c) and 9 (d) are based is based on a given RF (RF) power level in the transformer primary coil. The ability to separate into two or more outputs, depending on the respective secondary turns ratio for the winding of the secondary coil. Since the second winding transfers RF (RF) power to the unipolar electrode in the ablation mirror of the present disclosure, ground return indicates that the bipolar output of the ESG is grounded to the reference tab 21 in FIG. 5 (b). When used as such, it must be provided.

In operation, power supply 24 is set to a power level greater than the maximum required level of at least 5 Watts, in order to power the electronic circuit. The power level for each frequency band is preset by the control switches. When the power source 24 supplies power, each frequency band delivers a reduced level of power, depending on the setting of the switch.

The foregoing description of the preferred embodiment of the present invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed. Clearly, many modifications and variations will be apparent to those skilled in the art. The scope of the invention is not limited by the following claims and their equivalents.

Claims (39)

a) an ablation electrode having a loop end tip to provide a first power density; b) a solidification electrode having a loop end tip to provide a second power density less than the first power density; And c) conductor means connected to the ablation and coagulation electrodes and the energy source to supply energy to the ablation and coagulation electrode from the energy source, wherein the coagulation electrode is a conductor means that coagulates the tissue while the ablation electrode ablates the tissue. Electrode assembly of the ablation mirror comprising a. The method of claim 1, The ablation electrode loop end tip is An ablative electrode assembly having an ablation contact surface area less than the solidification contact surface area of the solidification loop end tip. The method of claim 1, The solidified loop end tip is An electrode assembly according to claim 1, further comprising an insulator on the solidifying contact surface area. The method of claim 1, The solidified loop end tip is An electrode assembly with an ablator, characterized in that a resistive material is provided on the surface of the solidified loop end tip. The method of claim 1, The solidified loop end tip is And a shape that provides a second power density less than the first power density of the ablation loop distal tip. The method of claim 1, The energy source is connected to the coagulation and ablation loop end tips, wherein the energy source supplies equal energy to respective coagulation and ablation loop end tips. The method of claim 6, The conductor means An ablation electrode assembly comprising two electrical conductors. The method of claim 7, wherein The conductor means An atypical electrode assembly comprising at least two materials providing different current densities at each solidified electrode loop end tip and ablation electrode loop end tip. The method of claim 1, The coagulation electrode An electrode assembly according to claim 1, wherein the ablation electrode coagulates the tissue within 1 second after the tissue is excised. a) a lid comprising a lid aperture, a distal end and an adjacent end; b) an ablation electrode having a loop end tip shape to provide a first power density; A coagulation electrode having a loop end tip for providing a second power density less than the first power density, the coagulation electrode end tip loop being able to coagulate the tissue while the ablation electrode end tip loop ablates the tissue An electrode assembly comprising a solidified electrode; c) working elements attached to adjacent ends of the cover; And and d) a visualization device housed within the aperture extending from the lid end to the proximal end of the work element. The method of claim 10, The ablation electrode loop end tip is An ablation mirror having an ablation contact surface area less than the coagulation control surface area of the coagulation loop end tip. The method of claim 11, The solidified loop end tip is An ablation mirror comprising an insulating substance on a solidified contact surface area. The method of claim 10, The solidified loop end tip is And a resistive material on the surface of the solidified loop end tip. The method of claim 10, The solidified loop end tip is And have a shape that provides a second power density less than the first power density of the ablation loop end tip. The method of claim 13, A power source coupled to solidification and ablation loop end tips, wherein the power source further comprises a power source connected to respective solidification and ablation loop end tips. The method of claim 15, And an energy transfer device coupled to the power source and the solidification and ablation loop distal tips. The method of claim 16, The energy delivery device An ablative mirror comprising at least one electrical conductor. The method of claim 17, The energy delivery device An ablator characterized in that it is made of at least two or more materials that provide different current densities to respective solidification and ablation loop end tips. The method of claim 16, The energy delivery device An ablation mirror comprising two electrical conductors. The method of claim 19, The two electrical conductors Resection glasses, characterized in that made of different materials. The method of claim 19, The energy delivery device And means for transferring power from said external power source to said ablation loop and said solidification loop. The method of claim 21, The delivery means And a monopolar adjustable transformer for varying the rate of power delivered to said ablation loop and said solidification loop. The method of claim 21, The delivery means An ablative mirror comprising a bipolar primary coil winding. The method of claim 10, And the ablation electrode distal end and the coagulation electrode distal end are in a fixed relationship with each other. The method of claim 10, The visualization device An ablator, characterized in that it is a telescope assembly having light. The method of claim 25, The telescope assembly An ablation mirror comprising an optical fiber. The method of claim 10, Adjacent ends of the visualization device An ablation mirror comprising an enlarged objective lens. a) a single ablation and coagulation electrode having a loop end tip, an ablation portion and a solidification portion, wherein the ablation portion provides a first current density, the solidification portion having a second current density less than the first current density Providing a single ablation and coagulation electrode; And b) conductor means connected to the ablation and coagulation electrode and the energy source for supplying energy from the energy source to the ablation and coagulation electrode, wherein the ablation and coagulation electrode comprises conductor means for simultaneously providing ablation and coagulation. An electrode assembly for an ablation mirror, characterized in that. The method of claim 28, The ablation portion And an ablation surface area less than the solidification surface area of the solidification portion. The method of claim 29, The solidification part An electrode assembly for an ablation mirror, characterized in that it has a shape that provides a power density less than that of the ablation portion. cover, A telescope in the lid having an objective lens at an adjacent end of the ablation mirror, An electrode assembly in the sheath comprising an ablation loop and a coagulation loop at the distal end of the ablation mirror for simultaneously ablation and coagulation of tissue, the ablation loop providing a power density greater than the power density of the coagulation loop Electrode assembly, Conductor means extending through the lid to interconnect the electrode assembly to an external power source; And a handle assembly at the adjacent end of the ablation mirror that is connected to the electrode assembly to move the electrode assembly in the cover. The method of claim 31, wherein The conductor means And means for supplying power from an external current supply to the ablation loop and the solidification loop. The method of claim 32, The delivery means And an unipolar adjustable transformer for varying the ratio of power delivered to said ablation loop and said solidification loop. The method of claim 32, The transformer means An ablation mirror comprising a bipolar primary winding. a) providing an electrode assembly comprising an ablation loop and a solidification loop, b) through the current through the electrode assembly, the ablation loop has a first power density and the coagulation loop has a second power density less than the first current density, and c) moving the ablation loop and the coagulation loop through the tissue so that the tissue is resected by the ablation loop and coagulated by the coagulation loop at the same time. . 36. The method of claim 35 wherein And fluidly irrigating the tissue during step c). 36. The method of claim 35 wherein A power source is applied directly to the ablation electrode and the coagulation electrode, wherein the first power density and the second power density are determined by the shape of the electrode. 36. The method of claim 35 wherein And a power source is coupled to the ablation electrode and the coagulation electrode through a transformer. 36. The method of claim 35 wherein Wherein the tissue is excised by the ablation loop within about 1 second of tissue coagulation by the coagulation loop.