WO1998031290A9 - Appareil de vaporisation bipolaire et procede s'appliquant a l'arthroscopie - Google Patents
Appareil de vaporisation bipolaire et procede s'appliquant a l'arthroscopieInfo
- Publication number
- WO1998031290A9 WO1998031290A9 PCT/US1998/002499 US9802499W WO9831290A9 WO 1998031290 A9 WO1998031290 A9 WO 1998031290A9 US 9802499 W US9802499 W US 9802499W WO 9831290 A9 WO9831290 A9 WO 9831290A9
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- electrode
- distal end
- chondromalacia
- bipolar
- inner electrode
- Prior art date
Links
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Definitions
- This invention relates to electrosurgical devices and more specifically to a bipolar chondromalacia removal apparatus and method for arthroscopy.
- Arthroscopic surgery is used to treat: (i) torn menisci, anterior cruciate, posterior cruciate, patella malalignment, synovial diseases, loose bodies, osteal defects, osteophytes, and damaged articular cartilage (chondromalacia) of the knee; ( ⁇ ) synovial disorders, labial tears, loose bodies, rotator cuff tears, anterior impingement and degenerative joint disease of the acromioclavicular joint and diseased articular cartilage of the shoulder joint, (iii) synovial disorders, loose bodies, osteophytes, and diseased articular cartilage of the elbow joint; (iv) synovial disorder, loose bodies, ligament tears and diseased articular cartilage of the wrist; (v) synovial disorders, loose bodies, labrum tears and diseased articular cartilage in the hip; and (vi) synovial disorders, loose bodies, osteophytes, fractures, and diseased articular cartilage in the ankle.
- Articular cartilage is the
- Chondromalacia of healthy cartilage is usually a result of diseased or traumatic induced changes in hyaline cartilage and may cause pain, stiffness, effusion, and/or grinding in the joint
- a common arthroscopic treatment of such chondromalacia is to use a motorized rotary shaver to extricate and remove the damaged, worn or diseased articular cartilage tissue.
- the rotary shaver When performing such arthroscopy, it is not unusual for the rotary shaver to remove not only the damaged, worn, or diseased articular cartilage, but also to remove a significant amount of healthy cartilage, which is undesirable.
- the rotary shaver tends to grab and tear tissue that is not cut cleanly, the articular cartilage remaining after treatment with the rotary shaver is often left with a rough surface that can slow healing and accelerate the onset of new chondromalacia.
- the bipolar coagulator disclosed in U.S. Patent No. 5,089,002, issued in 1992 to Lawrence T. Kirwan, Jr., one of the co-inventors of this invention, and which is incorporated herein by reference, is a bipolar device that was designed for desiccating several microscopic layers of eye tissue, including tiny blood vessels, on the eye before eye surgery in order to reduce bleeding encounters during eye surgery. The result is that the tiny blood vessels near the eye surface, where the surgical incisions are to be made during eye surgery, are necrosed — virtually obliterated or erased — before any incisions are made.
- a more specific object of the present invention is to provide an improved method and apparatus for removing chondromalacia while minimizing damage to and removal of healthy tissue;
- the bipolar vaporization apparatus of this invention may comprise an elongated co-axial probe including an elongated inner electrode surrounded by an elongated outer electrode with a layer of electrical insulation positioned between the inner electrode and the outer electrode.
- a sleeve of electrical insulative material surrounds the outer electrode for approximately all of the length of the outer electrode. Distal ends of both the inner electrode and the outer electrode are not covered with electrical insulative material.
- the method of this invention may comprise positioning an end surface of a first electrode into a sterile fluid, preferably a normal saline fluid, and in contact with chondromalacia, positioning a second electrode in the sterile fluid in contact with the chondromalacia, and applying an RF electric current through the first electrode and the second electrode while applying a voltage across the first electrode and the second electrode.
- a sterile fluid preferably a normal saline fluid
- Figure 1 is a preoperative view of the bipolar probe of the present invention as it may be used to ablate chondromalacia in a knee;
- Figure 2 is a simplified isometric view of the bipolar vaporization probe of the present invention positioned adjacent diseased cartilage or chondromalacia on a section of healthy cartilage and in immersing sterile fluid;
- Figure 3 is an isometric diagrammatic view of a prior art rotary shaver positioned adjacent healthy cartilage and chondromalacia and being used to remove chondromalacia to contrast results with the bipolar probe of the present invention
- Figure 4 is an elevation view of the bipolar probe of the present invention as it is being used to ablate chondromalacia to illustrate results contrasted to the prior art rotary shown in Figure 3;
- Figure 5 is an enlarged cross-sectional view of the bipolar probe of the present invention positioned to ablate strands of chondromalacia and illustrating the current path and ablation results;
- Figure 6 is a cross-sectional view similar to Figure 5, but after the strands of chondromalacia are ablated;
- Figure 7 illustrates an alternate embodiment of the bipolar probe of the present invention, with a tapered end
- Figure 8 shows another alternate embodiment with a square cross-section; and Figure 9 shows another alternate embodiment with the electrodes flat and sandwiched. Best Mode for Carrying out the Invention
- the bipolar vaporization probe 10 for removing chondromalacia is illustrated in Figure 1 in a typical application of arthroscopy in a knee joint, where chondromalacia can develop, for example, on the lateral femoral condyle 80, the medial femoral condyle 82, the lateral tibial plateau 84, the medial tibial plateau 86, the intracondylian notch 88, and the patella 89.
- the use of this invention is not limited to arthroscopy in the knee, but can also be used as well in removing chondromalacia in shoulders, elbows, wrists, hips, and ankles.
- the chondromalacia 12 comprises frayed strands 15 of diseased cartilage that extend outwardly from the surface 13 of remaining healthy cartilage 14, for example, on the inferior surface 13 of the lateral femoral condyle 80 as illustrated in the enlarged view of the lateral femoral condyle in Figure 2.
- the distal end 18 of the probe 10 is positioned near or on the surface 13 of healthy cartilage 14 and in contact with the diseased cartilage or chondromalacia 12.
- a sterile and transparent fluid 16, such as normal saline, ringer lactate, glycine, or other fluid suitable for use in arthroscopic surgery is injected into and circulated through the joint to expand the surrounding tissue and make it easier for the surgeon to see and work inside the joint as well as to flush away debris created during the surgical procedure, as is done in conventional arthroscopic procedures.
- the RF electric power represented schematically at 36, is turned on, causing RF current to flow through strands 15 of the diseased cartilage or chondromalacia 12 that comes near or into contact with the distal ends 21, 31 of outer electrode 20 and the inner electrode 30, respectively.
- the strands 15 of chondromalacia 12 that contact or are near the distal end 18 of the probe 10 conduct substantial amounts of electric current and can create virtual electric circuits between the outer electrode 20 and the inner electrode 30, thereby allowing the electric current to flow through the chondromalacia strands 15 between the outer electrode 20 and the inner electrode 30.
- the electric current flowing through the chondromalacia strands 15 heats the chondromalacia strands 15 to a sufficient extent to vaporize the chondromalacia strands 15, thus causing ablation (separation) of the chondromalacia strands 15 from the healthy cartilage 14, as illustrated in Figure 2 by the vaporized chondromalacia 17 and the path 19 cleared of chondromalacia 12.
- bipolar probe 10 An important feature of the bipolar probe 10 and its use in the method of ablating chondromalacia according to the present invention is the biophysics of the operation of the bipolar probe 10 and the vaporization of the chondromalacia 12 while having only minimal, if any, adverse effect on the healthy cartilage 14. Furthermore, the bipolar probe 10 sculpts the surface 13 of the healthy cartilage as the chondromalacia 12 is being removed and, as a result, the surface 13 of the healthy cartilage 14 will be generally smooth.
- the sterile fluid solution 16 is preferably a normal saline fluid, so it will conduct electric current, although the sterile fluid 16 can be any fluid suitable for use in arthroscopy.
- strands 15 of the chondromalacia 12 when positioned near or in contact with the outer electrode 20 and the inner electrode 30 of the probe, are usually, but not necessarily, more conductive than the sterile fluid 16.
- the electric current will find the path of least resistance to flow between the outer electrode 20 and the inner electrode 30, and since the path of least resistance is the best electrical conductor, i.e., usually the chondromalacia 12, and since the outer electrode 20 and inner electrode 30 are both positioned adjacent or in contact with strands 15 of the chondromalacia 12, a substantial proportion of the electric current will flow through those strands 15 of the chondromalacia 12. Therefore, the RF current flowing through the strands 15 of chondromalacia 12 is very concentrated, particularly in comparison with the amount of RF current flowing from the outer electrode 20 to the inner electrode 30 but not through the chondromalacia 12.
- the electric current flowing through the chondromalacia strands 15 and the voltage level across the chondromalacia strands 15 will cause electric power to be dissipated in the chondromalacia strands 15.
- Power is the product of the square of the current I times the resistance R, i.e., PR, so that substantial power is dissipated in the chondromalacia strands 15 where the current is concentrated. Power dissipates in the form of heat. Consequently, heat is created by the RF current flowing through the chondromalacia strands 15 sufficient to vaporize the chondromalacia strands 15, as indicated at 17, and thereby effectively remove the chondromalacia strands 15 from the healthy cartilage 14.
- the heat generated in the strands 15 of chondromalacia 12 will generally vaporize and remove all of such strands 15 from the remaining healthy tissue 14. However, if some portions of some of the strands 15 get ablated but do not get completely vaporized, the remaining unvaporized portions will never-the-less be flushed away by the sterile fluid 16 that is flowing through the joint, as indicated by the flow arrow 59.
- a rotary shaver 50 is shown in Figure 3 positioned adjacent a portion of chondromalacia 12, for example, on the inferior surface of a lateral condyle 80 of a knee joint similar to Figures 2 and 3.
- the conventional rotary shaver 50 typically has multiple, sharp-edged blades that are driven by a shaft 54 to rotate about an axis 57, usually in a clockwise angular direction as indicated by the arrows
- the rotary shaver 50 is usually used by sweeping the rotating blades 52 in a side-to-side pattern, as indicated by the arrow 58, such that the blades 52 cut or "scoop" out the strands 15 of chondromalacia 12, which are either sucked into the interior of the rotary shaver 50 by fluid 16 flowing into the shaver 50, as indicated by arrow 59, or washed or flushed away by a sterile solution, as indicated by flow arrow 59.
- Chondromalacia strands 15 that are not cut sharply by the rotating blades 52 are often pulled and torn from the surface 13 of healthy cartilage tissue 14, leaving the surface 13 abraded and rough.
- a rotary shaver 50 to remove chondromalacia 12 has two significant disadvantages.
- the rotary shaver 50 will ablate or remove portions of healthy cartilage 14 in addition to the chondromalacia 12, and, second, the rotary shaver 50 will leave the healthy cartilage 14 with a rough surface 68, which is a problem because such roughened cartilage, which is sometimes called "hayline,” does not heal due to its inherent histological properties and will often be the beginning of additional future chondromalacia development in the remaining healthy cartilage.
- a typical original, undiseased section of cartilage 14 can have a depth or thickness of, for example, approximately 3.0 millimeters (mm), as illustrated at 60 in Figure 3.
- the chondromalacia 12 can extend to a depth of, for example, 1.0 mm into the once healthy tissue 14, as indicated at 61 in Figure 3. Therefore, the remaining healthy cartilage
- the rotary shaver 50 will cut into and remove additional portions of the remaining healthy cartilage 14 along with the chondromalacia 12 as shown at 63.
- the rotary shaver 50 can easily remove up to 0.5 mm or more of the remaining healthy cartilage 14, as indicated at 64 in Figure 3, leaving less than 1.5 mm of healthy cartilage 14 remaining after the surgical procedure, as indicated at 66 in Figure 3.
- the rotary shaver 50 cannot select between the healthy cartilage 14 and the chondromalacia 12 when the rotary shaver 50 is being swept across the cartilage 14.
- the weight, size, and mechanical vibration of the rotary shaver 50 make it difficult for the operator to control, thereby limiting the operator's ability to control how much healthy cartilage 14 is removed by the rotary shaver 50 in addition to the chondromalacia 12.
- the second significant disadvantage of the rotary shaver 50 is that the surface 68 on the healthy cartilage remaining 14 is roughened, torn, and not smooth. Therefore, it remains irregular and may have a propensity to deteriorate again due to the roughness.
- the surface of the healthy cartilage 14 left remaining after the procedure would not contain the rough, irregular surface 68 that is common with removal of chondromalacia 12 with a mechanized rotary shaver 50.
- a bipolar probe 10 is positioned adjacent a portion of chondromalacia 12 in a joint, such as in a shoulder, knee, or other joint.
- the bipolar probe 10 is moved preferably, but not necessarily, primarily in the direction indicated by the arrow 70 to vaporize the chondromalacia 12.
- the bipolar probe 10 does not cut or scoop out any of the healthy cartilage 14 under the chondromalacia 12, since no blades or edges are used with the bipolar probe 10.
- the amount of healthy cartilage 14 remaining after removal of the chondromalacia 12 with the bipolar probe 10 can easily be as much as 1.7 mm, as indicated by the arrow 72. Since vaporizing the chondromalacia 12 with the bipolar probe 10 produces heat, however, some thermal activity does take place on the surface 13 of the healthy cartilage 14 at the distal end 18 of the probe 10, as indicated at 71, and a very thin layer 73 of cartilage 14 (best seen in Figure 5) will usually be necrosed by the heat generated from the bipolar probe 10. The thickness of the layer of necrosed cartilage 73 on the surface 13 will usually be less than 0.3 mm, as indicated at 74 in Figure 5.
- the thickness 74 of the layer of necrosed cartilage 73 can be reduced by reducing the amount of time the bipolar probe 10 is kept in one place and increasing the speed with which the bipolar probe 10 is moved through the chondromalacia 12. While the layer of necrosed cartilage 73 reduces slightly the amount of healthy cartilage 71 remaining after the chondromalacia 12 is removed with the bipolar probe 10, the thickness 74 of the layer of necrosed cartilage 73 is much smaller than the depth 63 of healthy tissue removed by the rotary shaver 50 that was illustrated in Figure 3 and described above, and it also actually provides a significant benefit. Specifically, the layer of necrosed cartilage 73 forms a smoother surface 13 on the remaining healthy cartilage 14 than is possible with the rotary shaver 50 discussed previously above. A smooth surface 13 on the healthy cartilage
- the overall structure of the probe 10 is similar to the structure described in U.S. Patent 5,089,002, which is incorporated herein by reference, but with several significant differences. Similar to that structure, the probe 10 of this invention has a coaxial bipolar arrangement with the elongated outer electrode 20 positioned concentrically around the elongated inner electrode 30 and with an elongated concentric electrical inner insulation layer 40 positioned between the outer electrode 20 and the inner electrode 30. A portion of the distal ends of the outer electrode 20 and the inner insulation layer 40 are shown cut away in Figure 2 and 4 and in cross section in Figure 5 to reveal this structure more clearly.
- the probe 10 of this invention also has an elongated outer electrical insulation sleeve 42 concentrically around the outer electrode 20, and, as shown in Figure 1, a proximal end outer housing 44 terminating in a plug 46 with two prongs 48, 49 that are electrically connected (not shown) in the housing 44 to outer electrode 20 and inner electrode 30, respectively.
- the prongs 48, 49 of the plug 46 are adapted to plug into a suitable receptacle indicated only by phantom lines 47 in Figure 1 , which will be understood by persons skilled in the art and can be a conventional connection to an RF generator 36, which is denoted only schematically.
- the distal ends 21, 41, 31, and 43 of the outer electrode 20, inner insulation layer 40, inner electrode 30, and outer insulation sleeve 42, respectively, can be, but are not required to be, circular. With such a circular configuration, there is no rotationally preferred orientation of the probe 10 with respect to the chondromalacia 12 or the healthy cartilage 14.
- the distal end 18 of the bipolar probe 10 can be in a plane that is perpendicular to the longitudinal axis 45, as shown in Figure 5, or it can be angled, as best seen in Figure 7, which will increase the exposed surface area of the outer electrode 20 and the inner electrode 30, thereby increasing the amount of chondromalacia 12 that will be adjacent the outer electrode 20 and the inner electrode 30 simultaneously.
- the distal end 18 of the bipolar probe 10 and, therefore, the distal ends 21, 41, 31, and 43 of the outer electrode 20, inner insulation layer 40, inner electrode 30, and outer insulation sleeve 42, respectively, can have other shapes depending on the preference of the surgeon, the ease of manufacture, or area in which chondromalacia 12 is to be removed.
- the distal ends 21, 41, 31, 43 of the outer electrode 20, inner insulation layer 40, inner electrode 30, and outer insulation sleeve 42, respectively can be oval, square, rectangular, or other shapes.
- the inner insulation layer 40 and outer insulation sleeve 42 can be any of a variety of high temperature, flexible plastics, such as, for example, polyvinylidene flouride (PVDF), silicone, rubber, tetrafluorethylene (Teflon TM *, (PEEK), or perfluoralkoxy (PFA), as is understood by persons skilled in the art.
- PVDF polyvinylidene flouride
- silicone silicone
- rubber tetrafluorethylene
- Teflon TM * Teflon TM *, (PEEK)
- PFA perfluoralkoxy
- the probe 10 of this invention is particularly suited for use in removing chondromalacia 12 encountered during arthroscopy in the knee, and can also be used to remove chondromalacia in shoulders, elbows, wrists, hips, knees, and ankles.
- the outer electrode 20 and inner electrode 30 be made of a malleable metal or alloy, for example aluminum, which can be easily formed or bent into any desired shape or configuration by the surgeon to enable ready access and optimum positioning of the distal end 18 of the probe 10 in places that are tight or difficult to reach.
- the probe 10 is shown in Figure 1 bent at 81 and 83 to enhance access and optimal positioning on the three-dimensional surfaces in the knee.
- the distal end 18 of the probe 10 is shown in position with its longitudinal axis 38 generally parallel to the surface 13 of the cartilage 14, so that the respective distal ends 21, 31 o the outer electrode 20 inner electrode 30.
- the electric current is an RF (radio frequency) alternating current, so it flows in both directions, but the arrow 24, while not strictly technically accurate, does depict in a simplified diagrammatic manner the current path through the chondromalacia strands 15 and sterile fluid 16 between the outer electrode 20 and the inner electrode 30 in a sufficient manner to describe the invention, as will be understood by persons skilled in the art.
- the electric current flowing through the strands 15, as indicated by arrow 24, heats the strands 15 to a sufficient extent to cause almost instantaneous vaporization of the strands 15, especially where the strands 15 are in contact with, or closest to, one or both of the outer electrode 20 and inner electrode 40.
- outer insulation 42 cover the entire length of the probe 10 so that the distal end 43 of die outer insulation 42 is about flush with the distal end 21 of outer electrode
- the current flow distribution can be modeled as two parallel circuits 90, 92.
- Circuit 90 has a resistance 94 representing current flow through strands 15, and circuit 92 has a resistance 96 representing current flow through the sterile fluid 16. It is beheved, based on observation of the bipolar probe 10 in operation according to this invention, that the tissue is less resistive to flow of electric current than the sterile fluid 16, or at least not substantially greater.
- the result of partial or complete vaporization of the strands 15 that are very close to, or in contact with, the probe 10 is that the current path 24 flows only through the sterile fluid 16 between the outer electrode 20 and the inner electrode 30, as shown in Figure 6, at least until the probe 10 is moved closer to more of the unvaporized chondromalacia.
- This self-limiting feature in which the current flow does not vaporize healthy cartilage 14 or even desiccate and necrose more than only a minimal thickness 74 into the healthy tissue 14 and with no carbonation of tissue, but instead reverts to flowing through primarily only the sterile fluid 16, as illustrated by both resistances 94' and 96 in Figure 6, is a significant feature of this invention.
- bipolar means that it is possible for both the outer electrode 20 and die inner electrode 30 to be surgically active, even though they might not both always be actually surgically active.
- Surgically active means that sufficient heat is produced in cells at or immediately adjacent to the electrode to alter cells physically, such as desiccation, coagulation, necrosis, ablation, vaporization, carbonization and the like. Therefore, to be truly bipolar for purposes of this invention, the probe 10 must be capable of causing such surgical activity in tissue or immediately adjacent both the outer electrode 20 and the inner electrode 30.
- the surface area of either electrode must be less than about ten times as large as the surface area of the other electrode to keep the ratio of the respective surface areas less than about 10: 1.
- the surface area of the outer electrode 20 is effectively the uninsulated surface area of the distal end 21 of die outer electrode 20.
- the surface area of the inner electrode 30 is essentially the uninsulated surface area of the distal end 31 of inner electrode 30. If the distal end 31 of the inner electrode 30 should also extend slightly beyond the inner insulation, which, while not preferred, will work according to this inventory, then the surface area of the inner electrode 30 would also include any additional uninsulated surface area of the periphery of the inner electrode 30 for purposes of the 10:1 ration of respective surface areas of electrodes described above. Also, if the distal end 21 of the outer electrode 20 is made to extend beyond the distal end 43 of outer insulation 42, the uninsulated portion of the peripheral surface of the outer electrode would be included in the uninsulated surface area of the outer electrode 20.
- outer electrode 20 and inner electrode 30 within the 10:0 ratio described above does no mean that surgical activity occurs at or immediately adjacent both the outer electrode 20 and the inner electrode 30 at all times.
- the distal end 31 of die inner electrode 30 is spatially removed from strand 15, so there may not be actual surgical activity strictly at the inner electrode 30, while vaporization of the strand 15 and the slight desiccation and necrosis in the area 71 occurs, as described above.
- such surgical activity stops also at and near outer electrode 20.
- the probe 10 is oriented in such a way as to contact more of the outer electrode 20 surface area to healthy cartilage 14 or even to contact both the outer electrode 20 and the inner electrode 30 with healthy cartilage 14, desiccation and necrosis of the healthy cartilage would only occur to a shallow depth. Then, since desiccated tissue is highly resistive to electric current flow, the current flow would self- limit and either stop or shift back to the fluid 16, thus preventing any deep necrosis or vaporization of healthy cartilage 14.
- the diameter of the probe 10 is preferred in the range of 3.0 - 10.0 mm with the inner electrode 30 being about 1 - 2 mm diameter and die outer electrode 20 being about 2.5 - 5.0 mm diameter.
- the inner insulation 40 is preferably in the range of about 0.2 to 3 mm thick and the outer insulation is preferably in the range of about 0.2-3 mm thick.
- the length of the probe 10 should be long enough to extend through an incision or cannula to reach any desired location in the shoulder or knee joint, it is also preferred, but not necessary, that the RF current supply is approximately three-hundred (300 KHz) to three megahertz (3 MHz) and, optimally, the RF current supply is approximately five-hundred kilohertz (500 KHz).
- the power should be in the range of about twenty to one-hundred watts and is preferably in the range between forty and seventy watts into a load impedance in the range of about 25-1000 ohms preferably about 50-250 ohms, for example, 100 ohms to achieve the desired desiccation and shrinking of blood vessels, coagulation of blood, and necrosis of tissue as described above along with the self-selective current paths and self-limiting of surgical activity according to this invention.
- the distal end 18 of the probe 10 can be tapered at an angle ⁇ from a plane 39 that is perpendicular to the longitudinal axis 38 of the probe 10.
- This angle ⁇ can be any desired angle, but it has been found that an angle in the range of 10 °-30 degrees works well, and about 20° is preferred, because it provides the most convenient orientation for rotating the probe 10 to reach different cartilage surfaces in the tight spaces where arthroscopic procedures are usually performed.
- the cross-section of the probe does not have to be circular, as mentioned above.
- an alternate probe 300 with a square cross-section fee concentric inner electrode 330, inner insulation 340, outer electrode 320, and outer insulation 342, as shown in Figure 8 can be used according to this invention.
- Other cross-sectional configurations, such as oval polygonal, or other shapes can also be used.
- the electrodes It is also not necessary for the electrodes to be concentric.
- the probe 400 shown in Figure 9 has an inner electrode 430 sandwiched between two outer electrodes 420, 420' with respective inner insulation layers 440, 440' intervening.
- the two outer electrodes 420, 420' can be, but are not necessarily at the same electrical potential as each other.
- the outer insulation 442 surrounds all of the electrodes.
- Many other variations of the invention are also possible to provide d e bipolar surgical activity within the surface area ratios and exposed outer electrode parameters described above.
Abstract
L'invention porte sur une sonde de vaporisation bipolaire (10) possédant un dispositif bipolaire coaxial pourvu d'une électrode externe allongée (20) positionnée de manière concentrique sur l'électrode interne allongée (30), et d'une couche isolante interne (40) électrique, concentrique, allongée, positionnée entre l'électrode externe (20) et l'électrode interne (30). Cette sonde bipolaire (10) comporte également un manchon isolant (44) électrique, externe, allongé, positionné de manière concentrique sur l'électrode externe (20), et un corps externe au niveau de son extrémité proximale se terminant par une prise dotée de deux fourches qui sont raccordées électriquement dans le corps à l'électrode externe (20) et l'électrode interne (30). Les fiches de la fiche mâle sont conçues de façon à s'emboîter dans un bloc femelle approprié de façon à effectuer une connexion avec un générateur HF (36).
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU62748/98A AU6274898A (en) | 1997-01-15 | 1998-01-15 | Bipolar vaporization apparatus and method for arthroscopy |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US78485897A | 1997-01-15 | 1997-01-15 | |
US08/784,858 | 1997-01-15 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO1998031290A1 WO1998031290A1 (fr) | 1998-07-23 |
WO1998031290A9 true WO1998031290A9 (fr) | 1998-12-23 |
Family
ID=25133743
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1998/002499 WO1998031290A1 (fr) | 1997-01-15 | 1998-01-15 | Appareil de vaporisation bipolaire et procede s'appliquant a l'arthroscopie |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU6274898A (fr) |
WO (1) | WO1998031290A1 (fr) |
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US9364281B2 (en) | 2002-03-05 | 2016-06-14 | Avent, Inc. | Methods for treating the thoracic region of a patient's body |
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US7819869B2 (en) | 2004-11-15 | 2010-10-26 | Kimberly-Clark Inc. | Methods of treating the sacroilac region of a patient's body |
US11291496B2 (en) | 2002-03-05 | 2022-04-05 | Avent, Inc. | Methods of treating the sacroiliac region of a patient's body |
US9949789B2 (en) | 2002-03-05 | 2018-04-24 | Avent, Inc. | Methods of treating the sacroiliac region of a patient's body |
US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7776036B2 (en) * | 2003-03-13 | 2010-08-17 | Covidien Ag | Bipolar concentric electrode assembly for soft tissue fusion |
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US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
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US8016827B2 (en) | 2008-10-09 | 2011-09-13 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
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JP2016146767A (ja) * | 2015-02-10 | 2016-08-18 | 株式会社 ジャパン・ティッシュ・エンジニアリング | 培養軟骨及びその製法 |
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Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4674499A (en) * | 1980-12-08 | 1987-06-23 | Pao David S C | Coaxial bipolar probe |
US4805616A (en) * | 1980-12-08 | 1989-02-21 | Pao David S C | Bipolar probes for ophthalmic surgery and methods of performing anterior capsulotomy |
US4943290A (en) * | 1987-06-23 | 1990-07-24 | Concept Inc. | Electrolyte purging electrode tip |
US5089002A (en) * | 1989-04-06 | 1992-02-18 | Kirwan Surgical Products, Inc. | Disposable bipolar coagulator |
-
1998
- 1998-01-15 AU AU62748/98A patent/AU6274898A/en not_active Abandoned
- 1998-01-15 WO PCT/US1998/002499 patent/WO1998031290A1/fr active Application Filing
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9216053B2 (en) | 2002-03-05 | 2015-12-22 | Avent, Inc. | Elongate member providing a variation in radiopacity |
US9364281B2 (en) | 2002-03-05 | 2016-06-14 | Avent, Inc. | Methods for treating the thoracic region of a patient's body |
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