Claims
- 1. A method of inducing a controlled inflammatory response in tissue, the method comprising:
selecting a target tissue from an area of soft tissue; applying energy to the target the target tissue; and forming at least one pattern of voids by repeating the applying act.
- 2. The method of claim 1 comprising:
selecting a target tissue from an area of soft tissue; positioning an active electrode in at least close proximity to the target tissue; removing a void in the tissue by applying a high frequency voltage to the active electrode, the high frequency voltage being sufficient volumetrically remove a portion of the target tissue; and forming at least one pattern of voids by repeating the positioning and applying acts.
- 3. The method of claim 2, wherein selecting the target tissue comprises selecting target tissue from a group consisting of a tendon, a ligament, and a meniscus.
- 4. The method of claim 2, wherein the pattern comprises a pattern selected from a group consisting of a grid, a circle, at least two circles, at least two concentric circles, a helical pattern, a linear pattern, a non-linear pattern, a random pattern, and a combination thereof.
- 5. The method of claim 4, wherein a spacing between voids ranges between 0.5 mm and 10 mm.
- 6. The method of claim 4, wherein a spacing between voids is constant.
- 7. The method of claim 4, wherein a spacing between voids varies.
- 8. The method of claim 4, further comprising placing a template adjacent to the target tissue prior to the positioning step, wherein the template comprises a plurality of holes arranged in a layout similar to the pattern.
- 9. The method of claim 8, wherein the forming step comprises using the template as a guide for positioning the active electrode.
- 10. The method of claim 8 wherein the template further serves to separate tissue adjacent to the target tissue.
- 11. The method of claim 2, wherein the void has a lateral dimension in the range of from about 0.5 mm to about 2.0 mm.
- 12. The method of claim 2, wherein the void has a depth in the range of from about 0.5 mm to about 4.0 cm.
- 13. The method of claim 2, wherein the void comprises an opening in tissue selected from the group consisting of a channel, a hole, a furrow, a crater, a divot, and a combination thereof.
- 14. The method of claim 13, wherein the act of removing the void comprises applying the high frequency voltage between the active electrode and a return electrode.
- 15. The method of claim 13, wherein the return electrode is located on an external surface of a patient's body.
- 16. The method of claim 13, wherein the return electrode and the active electrode are both located on an electrosurgical probe.
- 17. The method of claim 13, further comprising placing an electrically conductive fluid between the active electrode and the return electrode, the electrically conductive fluid providing a current flow path between the active electrode and the return electrode.
- 18. The method of claim 16, wherein the electrically conductive fluid comprises isotonic saline.
- 19. The method of claim 2, wherein the active electrode comprises a single electrode adjacent to a distal end of an electrosurgical probe.
- 20. The method of claim 19, wherein the active electrode comprises an electrode array comprising a plurality of electrically isolated active electrodes, and
- 21. The method of claim 2, further comprising providing an electrically conductive fluid between the active electrode and the target tissue.
- 22. The method of claim 2, further comprising introducing at least a distal end of an electrosurgical probe into a patient's knee, shoulder, or elbow; wherein said positioning step comprises positioning the distal end of the probe in at least close proximity to the tendon within the knee, the shoulder, or the elbow.
- 23. A template device for use in applying therapy to tissue, the template comprising:
a proximal surface and a distal surface, the distal surface being placed adjacent to tissue; a plurality of openings forming a pattern, the holes extending from the proximal surface to the distal surface; wherein at least the proximal surface and distal surface are bio-compatible and electrically non-conductive; and wherein the pattern comprises a pattern selected from a group consisting of a grid, a circle, at least two circles, at least two concentric circles, a helical pattern, a linear pattern, a non-linear pattern, a random pattern, and a combination thereof.
- 24. The template device of claim 23, wherein an entire surface of the template is coated with a bio-compatible and non-conductive coating.
- 25. The template device of claim 23, wherein a spacing between openings ranges between 0.5 mm and 10 mm.
- 26. The template device of claim 23, wherein a spacing between openings is constant.
- 27. The template device of claim 23, wherein a spacing between openings varies.
- 28. The template device of claim 23, wherein the openings comprise at least two channels.
- 29. The template device of claim 23, further comprising a plurality of incremental markings on at least the proximal surface, the markings denoting the spacing of openings.
- 30. The template device of claim 23, further comprising a tissue retractor portion adapted to separate tissue.
- 31. An electrosurgical device for applying energy to tissue, the device comprising:
an instrument shaft having proximal and distal end portions and an active electrode disposed on the distal end portion; and a connector disposed on or within the shaft, the connector adapted for coupling the active electrode to a high frequency power supply, the high frequency power supply adapted for applying a high frequency voltage to the active electrode, the high frequency voltage being sufficient to effect the volumetric removal of tissue adjacent to the active electrode; a fluid delivery lumen extending at least through a portion of said instrument shaft and having an opening adjacent to the active electrode; and a self-contained fluid supply unit coupled to the fluid delivery element, the selfcontained fluid supply comprising a reservoir, a fluid driving member, and a connector lumen, wherein the fluid driving member is moveably located in the fluid reservoir and the connector lumen fluidly couples the reservoir to the fluid delivery lumen.
- 32. The electrosurgical device of claim 31, further comprising an electrically conductive fluid located in the reservoir, the fluid supply unit being configured such that it cannot be re-filled.
- 33. The electrosurgical device of claim 31, wherein at least a portion of the fluid supply unit is located externally to the instrument shaft.
- 34. The electrosurgical device of claim 31, wherein at least a portion of the fluid supply unit is located in the instrument shaft.
- 35. The electrosurgical device of claim 34, wherein the entire fluid supply unit is located in the instrument shaft, and wherein a portion of the fluid driving member extends out of the instrument shaft.
- 36. The electrosurgical device of claim 31, further comprising a gate in fluid communication with said fluid delivery lumen, the gate adapted to prevent leaking or discharge of fluid from the device.
- 37. The device of claim 31, further comprising a return electrode adapted for coupling to the high frequency power supply, the high frequency power supply adapted for applying a high frequency voltage difference between the return electrode and the active electrode.
- 38. The device of claim 37, wherein the return electrode is disposed on the instrument shaft at a location proximal to the active electrode.
- 39. The device of claim 37, wherein the return electrode is a dispersive pad in contact with an external body surface of a patient.
- 40. The device of claim 37, further comprising an electrically conductive fluid in the reservoir of the fluid supply unit, wherein fluid delivery element is adapted to provide fluid the active electrode and the return electrode to provide a current flow path therebetween.
- 41. The device of claim 31, wherein the maximum lateral dimension of the distal end portion of the instrument shaft is less than about 1.0 mm.
- 42. The device of claim 31, wherein the active electrode is substantially surrounded by an electrically insulating support.
- 43. The device of claim 31, wherein the instrument shaft is configured for arthroscopic delivery into ajoint cavity, the joint selected from the group consisting of a knee, a shoulder, and an elbow.
- 44. The device of claim 31, wherein the distal end portion of the instrument shaft is sized for advancing into a space vacated by the volumetrically removed tissue.
- 45. The device of claim 44, wherein the distal end portion of the instrument shaft space has a maximum lateral dimension of about 2.0 mm.
- 46. The device of claim 31, further comprising an electrode array disposed at or near the distal end of the instrument shaft, the electrode array including a plurality of electrically isolated active electrodes, wherein current flow from at least two of the plurality of electrically isolated active electrodes is independently controlled based on impedance between each of the at least two active electrodes and a return electrode.
- 47. The device of claim 31, further comprising a return electrode coupled to the high frequency power supply, the high frequency power supply adapted for applying a voltage difference between the return electrode and the active electrode, the voltage difference being sufficient to promote vascularization of the tendon tissue.
- 48. A kit for applying energy to tissue comprising:
a template device for use in treating tissue, the template comprising a proximal surface and a distal surface, the distal surface being placed adjacent to tissue, a plurality of openings forming a pattern, the holes extending from the proximal surface to the distal surface, wherein the proximal surface and distal surface are bio-compatible and nonconductive, and an electrosurgical device for applying energy to tissue, the device comprising an instrument shaft having proximal and distal end portions and an active electrode disposed on the distal end portion, and a connector disposed on or within the shaft, the connector adapted for coupling the active electrode to a high frequency power supply, the high frequency power supply adapted for applying a high frequency voltage to the active electrode, the high frequency voltage being sufficient to effect the volumetric removal of tissue adjacent to the active electrode.
- 49. The kit of claim 48 further comprising a self-contained fluid supply unit, the self-contained fluid supply comprising a reservoir containing an electrically conductive fluid, a fluid driving member moveably located in the fluid reservoir and a connector lumen for fluidly coupling to the electrosurgical device.
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present invention is a non-provisional of U.S. Provisional Application No. 60/375,735. This application is also a continuation-in-part of U.S. patent application Ser. No. 09/845,034, filed Apr. 27, 2001, which is a non-provisional of U.S. Provisional Application No. 60/200,712, filed Apr. 27, 2000, and which is a continuation-in-part of U.S. patent application Ser. No. 09/570,394, filed May 12, 2000, which is a divisional of U.S. patent application Ser. No. 09/089,012, filed Jun. 2, 1998 now U.S. Pat. No. 6,102,046, the complete disclosures of all of which are incorporated herein by reference for all purposes.
[0002] The present invention is related to commonly assigned co-pending U.S. patent application Ser. No. 08/990,374, filed Dec. 15, 1997 (Attorney Docket No. E-3), which is a continuation-in-part of U.S. patent application Ser. No. 08/485,219, filed on Jun. 7, 1995, now U.S. Pat. No. 5,697,281 (Attorney Docket 16238-000600), U.S. patent application Ser. Nos. 09/058,571, 08/874,173 and 09/002,315, filed on Apr. 10, 1998, Jun. 13, 1997, and Jan. 2, 1998, respectively (Attorney Docket Nos. CB-2, 16238-005600 and C-9, respectively) and U.S. patent application Ser. No. 09/054,323, filed on Apr. 2, 1998 (Attorney Docket No. E-5), U.S. patent application Ser. No. 09/010,382, filed Jan. 21, 1998 (Attorney Docket A-6), and U.S. patent application Ser. No. 09/032,375, filed Feb. 27, 1998 (Attorney Docket No. CB-3), U.S. patent application Ser. Nos. 08/977,845, filed on Nov. 25, 1997 (Attorney Docket No. D-2), 08/942,580, filed on Oct. 2, 1997 (Attorney Docket No. 16238-001300), 09/026,851, filed Feb. 20, 1998 (Attorney Docket No. S-2), U.S. patent application Ser. No. 08/753,227, filed on Nov. 22, 1996 (Docket 16238-002200), U.S. patent application Ser. No. 08/687792, filed on Jul. 18, 1996 (Docket No. 16238-001600), and PCT International Application, U.S. National Phase Serial No. PCT/US94/05168, filed on May 10, 1994, now U.S. Pat. No. 5,697,909 (Attorney Docket 16238-000440), which was a continuation-in-part of U.S. patent application Ser. No. 08/059,681, filed on May 10, 1993 (Attorney Docket 16238-000420), which was a continuation-in-part of U.S. patent application Ser. No. 07/958,977, filed on Oct. 9, 1992 (Attorney Docket 16238-000410), now U.S. Pat. No. 5,366,443, which was a continuation-in-part of U.S. patent application Ser. No. 07/817,575, filed on Jan. 7, 1992 (Attorney Docket 16238-00040), now abandoned, the complete disclosures of which are incorporated herein by reference for all purposes.
Provisional Applications (2)
|
Number |
Date |
Country |
|
60375735 |
Apr 2002 |
US |
|
60200712 |
Apr 2000 |
US |
Divisions (1)
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Number |
Date |
Country |
Parent |
09089012 |
Jun 1998 |
US |
Child |
10174266 |
Jun 2002 |
US |
Continuation in Parts (2)
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Number |
Date |
Country |
Parent |
09845034 |
Apr 2001 |
US |
Child |
10174266 |
Jun 2002 |
US |
Parent |
09570394 |
May 2000 |
US |
Child |
10174266 |
Jun 2002 |
US |