Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS1814791 A
Publication typeGrant
Publication dateJul 14, 1931
Filing dateMay 4, 1928
Priority dateMay 4, 1928
Publication numberUS 1814791 A, US 1814791A, US-A-1814791, US1814791 A, US1814791A
InventorsEnde Frank M
Original AssigneeEnde Frank M
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Diathermy
US 1814791 A
Abstract  available in
Images(1)
Previous page
Next page
Claims  available in
Description  (OCR text may contain errors)

F. M. ENDE July 14, 1931.

DIATHERMY Filed May 4, 1928 Patented July 14, 1931 UNITED STATES FRANK M. ENDE, F NEW YORK, N. Y.

DIATHERMY application med May 4, 1928. serial No. 275,154.

My invention relates to diathermy, and especially to an improved electrode and for producing localized coagulation of tissue.

In applying diathermy using the usual in- 'Y different and active electrodes, the-latter in Contact with the part to be treated, and the former applied to the patients buttocks or elsewhere, the degree of tissue destruction and the area actually destroyed is difficult to control with the certainty required to keep within the narrow limits permissible.

Causes for this are numerous. The electrical resistance between the inactive and active electrodes varies in different individuals and in different locations with a single individual. Changes and variations in the area of Contact between the active electrode and the tissue to which it is applied produce corresponding variations in current .density and cause the degree of tissue destruction to vary. Where the active work on tissue is out of sight, as, for example, in the cervical canal, the degree of destruction is beyond the control of the operator, because of his inability to see the area of coagulation as it forms, and

application of diathermy treatment may result in areas of excessive destruction and re'- sulting excessive scar tissue formation, and even in circular scar formation and resultant narrowing of the lumen of the canal (stric- ,ture

I )have discovered that very greatly improved and closely regulable results .in respect of depth, extent, and uniformityl of destruction of tissue can be obtained by making the application of the high frequency diathermy current to the tissue through a pair of active electrode elements of known size and known spacing. whereby the path of 0 current from one to the other is confined to the strip of tissue between these electrodes, and use of an indifferent electrode is elimi` nated. i lVhen the high frequency current is supplied by means of such electrodes connected to the poles of the diathermy machine, tissue destruction can be regulated over a definite arca and in such closely controlled fashion as to obtain the best results for localized tissue destruction and for subsequent healing.

In the accompanying drawings, I have shown apparatus by which my invention can be carried into effect, but it is to be understood that same is only for the purpose of affording an understanding of the invention and not for imposing limitations thereon.

In said drawings, Fig. v1 is a longitudinal cross-sectional view of a handle for receiving a removable electrode tip. Fig. 2 is a perspective showing the handle of Fig. 1 with a cervical electrode tip `in place therein. Figs. 3 and 4 are enlargedl views of the cervical tip of Fig. 2. Fig. 5 is a section on approximately the line 5-5, Fig. 4. Figs. 6 and 7 are views of some of the numerous modified forms of tips that can be used; and Fig: 8 is a side view of a dummy tip.

Reference character 10 designates a handle comprising a plug 12 having a pencil or rodr 14 `connected thereto as by means of p 'screws 16, and the spaced-apart insulated "wires 18, 18 extending therethrough, and

terminating at each end in jacks, the jacks 20, 2O at the plug end being adapted for connection of lead wires 22, 22 from the two poles of lthe standard diathermy machine, and the jacks 24, 24 atthe other end adapted to receive wires 26, 26 projecting from removable tips, as the cervical tip 28, preferably made of molded insulating material which will not deteriorate when washed or immersed in antiseptic solution. The projectin'g wires 26, 26 communicate with theelectrodesY 30, 30 which are preferably 4partially imbedded in the lateral surface of the tip 28 so as to be spaced a uniform distance apart, preferably about 1/8. l/Vhen tips containing these active electrodes are made of molded insulating material, the electrodes can be partially imbedded therein, except for the relatively small protruding portions, in

l the course of molding. The cervical tip 28 is preferably of tapered substantially pencillike formation and is graduated, preferably in units of l@ inch, as indicated at 32, enabling the depth of the cervical canal to be measured by the graduations on the tip. The rod 14 can be provided with a spline 34 to enter a splineway 36 on the several tips adapted to coagulation inasmuch as the reading of the milliammeter with which all diathermy machines are equipped is merely a rough indication of theA output and cannot be used as a basis of diathermy dosage.

From extended experimentation and observation, I have found that when the current of a machine is applied to the albuminous trial material .hereinafter referred to for a sufficient length of time to show a white strip of coagulated material against the black background of the dummy tip (the dummy tip is black for this purpose), the

application of the cervical tip to 'the cervical l tissue for a like length of time will produce tissue destruction tothe depth of about one millimeter, which is a desirable depth in practice.

In Fig. 8 of the drawings, I have shown what I' prefer to call a dummy tip 38, which is like'the tipalready described except that it is 'substantially cylindrical'throughout its length and is provided with an adjustable stop, which in the form shown consists of a perforated rubber stopper 40. The dummy tip 38 is preferably of dark colored or black molded insulating material and is graduated, preferably in quarter inches, like the tip 28, for convenient noting of the extent of protrusion beyond the stop 34.

With the depth of the cervical canal measured preliminarily by insertion therein of the cervical tip 28, same is removed from the handle 10 and replaced by the dummy tip and the stop 4() adjustedto a position on the dummy tip to expose a length of active electrodeequal to the length of the canal which has been measured. The measured protruding portion of such dummy tip is then referably immersed in egg albumen to Whic has been added suicient chloritone, or equivalent thereof, so that it will be preserved from decomposition and at the same time its electrical resistance is lowered to approximate the resistance of the cervical tissue.

The diathermy current is turned on and continued a suiiicientlength of time to coagulate a strip of albumin coming in contactwith the dummy tip and lying between the two active electrodes to an extent to show 'white and entirely opaque against the black background of the dumm tip material. The time period of current ow for the accomplishme'nt of this coagulation is auged,

T e output of t e machine is; then properly adjusted so that suiiicient power is, used to co agulate a one-inch strip in. fourfseconds, so that other cases may be treated on a basis .tion of the machine output by means of the vactive electrodes of my cervical tip having the same exposed electrode area and spacing as in the dummy tip.

` The cervical tip 28 with the electrodes parallel and spaced with relation to one another at a predetermined distance apart as described, which distance remains unchanged during use for tissuecoagulation, is adapted for producing the destruction of the tissue along a strip line, the strip being of the length of the exposed portion of the electrodes that are in contact with tissue and of a width correspnding to their distance apart. The complete uniform application to the cervical canal, for example, may be made by producing a series of strip destructions of tissue orrdiffusely by rotation of the tip over a. period of time which has been gauged in advance in the manner above described. It will of course be understood that when this gauging hasbeen donefor a given machine it is unnecessar to be repeated in its operation thereafter, .i the ammeter is read with the tip short-circuited,4 though check gauging may, of course, be resorted to from time to time if deemed necessary. By short-circuiting for readin the shorted output on the am n1eter, I am a le tosay that the machine in question will coagulate cervical canal one millimeter dee .when exposed one second per guarter-,inch o introduction if the machine is rst shorted and the output adjusted so that the meter reading is identical with that obtained by shortening the machine immediately after its successful operation on albu- `its end, and these ball-shaped electrodes, which are preferably about lg inch in diameter, can be a somewhat greater distance apart than in case of the elongated electrodes of the cervical tip 28. This arrangement of electrodes is adapted for destruction of tissue on an exposed surface, such as the surface around the mouth of the cervical canal, for example.

Numerous other forms of active spaced electrodes may be made use of in accordance With my invention. In Fig. 7 I have shown the tip 54 having electrodes 56, 56 of needle form.l These sharp-pointed needle electrodes are designed to perforate the tissue and may have a slidable collar back of their points,

as indicated at 58, so as to provide a stop to limit the extent of penetration. Elec- -.trodes of this type are of utility, for example, in connection with the step-by-step destruction of a ring of tissue surrounding a part or a neoplasm which is to be removed.`

I claim:

1. Therapeutical apparatus for destruction of tissue by high frequency current comprising bipolar electrodes, means for supporting same at a predetermined distance from each other, which is a small fractional part of an inch, so that such distance remains fixed during use, means for connecting up said electrodes to complete thepoutput circuit of a source of high frequency electrical current through tissue intervening between and in contact with the electrodes, and a non-con ducting handle. 2O 2. Apparatus as in the preceding claim, in

Which the electrode supporting means comprises a substantially pencil-like non-conductor, and the electrodes are arranged to ex` tend substantially parallel along substantially the surface of said non-conductor.

3. Apparatus as claimed in claim 1 in which the bipolar electrodes are carried in a separable jack member whereby desired pre determined spacing and conformation of electrodes can be secured by jack replacement.

In testimony whereof, I have signed my name hereto.

FRANK M. ENDE.

Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US2611365 *Jan 3, 1949Sep 23, 1952Nat Electric Instr Company IncHigh-frequency therapeutic apparatus
US3460539 *Mar 10, 1967Aug 12, 1969Anhalt James E SrCautery tip
US3901242 *May 30, 1974Aug 26, 1975Storz Endoskop GmbhElectric surgical instrument
US3970088 *Apr 24, 1975Jul 20, 1976Valleylab, Inc.Electrosurgical devices having sesquipolar electrode structures incorporated therein
US3987795 *Aug 28, 1974Oct 26, 1976Valleylab, Inc.Electrosurgical devices having sesquipolar electrode structures incorporated therein
US4014343 *Apr 25, 1975Mar 29, 1977Neomed IncorporatedDetachable chuck for electro-surgical instrument
US4033351 *Sep 14, 1976Jul 5, 1977Siemens AktiengesellschaftBipolar cutting electrode for high-frequency surgery
US4074718 *Mar 17, 1976Feb 21, 1978Valleylab, Inc.Electrosurgical instrument
US4202337 *Jun 14, 1977May 13, 1980Concept, Inc.Bipolar electrosurgical knife
US4359052 *Apr 12, 1978Nov 16, 1982Concept Inc.Removable tip cautery
US4476862 *Sep 30, 1982Oct 16, 1984Pao David S CMethod of scleral marking
US4532924 *Apr 30, 1982Aug 6, 1985American Hospital Supply CorporationFor use in the treatment of tissue
US4674499 *Jan 10, 1985Jun 23, 1987Pao David S CCoaxial bipolar probe
US4765331 *Feb 10, 1987Aug 23, 1988Circon CorporationElectrosurgical device with treatment arc of less than 360 degrees
US4805616 *Nov 20, 1986Feb 21, 1989Pao David S CBipolar probes for ophthalmic surgery and methods of performing anterior capsulotomy
US4823791 *May 8, 1987Apr 25, 1989Circon Acmi Division Of Circon CorporationFor treatment of tissue
US4873969 *Aug 15, 1988Oct 17, 1989Huebsch Donald LMethod and apparatus for removal of bone cement
US4878493 *Dec 30, 1985Nov 7, 1989Ninetronix Venture IHand-held diathermy apparatus
US5009656 *Aug 17, 1989Apr 23, 1991Mentor O&O Inc.Bipolar electrosurgical instrument
US5071419 *Apr 30, 1990Dec 10, 1991Everest Medical CorporationPercutaneous laparoscopic cholecystectomy instrument
US5080660 *May 11, 1990Jan 14, 1992Applied Urology, Inc.Electrosurgical electrode
US5171311 *Sep 23, 1991Dec 15, 1992Everest Medical CorporationPercutaneous laparoscopic cholecystectomy instrument
US5250047 *Oct 21, 1991Oct 5, 1993Everest Medical CorporationBipolar laparoscopic instrument with replaceable electrode tip assembly
US5336222 *May 14, 1993Aug 9, 1994Boston Scientific CorporationIntegrated catheter for diverse in situ tissue therapy
US5342359 *Feb 5, 1993Aug 30, 1994Everest Medical CorporationBipolar coagulation device
US5403311 *Mar 29, 1993Apr 4, 1995Boston Scientific CorporationElectro-coagulation and ablation and other electrotherapeutic treatments of body tissue
US5709224 *Jun 7, 1995Jan 20, 1998Radiotherapeutics CorporationMethod and device for permanent vessel occlusion
US5827276 *Dec 12, 1996Oct 27, 1998Board Of Regents Of Univ Of NebraksaApparatus for volumetric tissue ablation
US5855576 *Dec 12, 1996Jan 5, 1999Board Of Regents Of University Of NebraskaMethod for volumetric tissue ablation
US5868740 *Mar 24, 1995Feb 9, 1999Board Of Regents-Univ Of NebraskaMethod for volumetric tissue ablation
US5868744 *Apr 28, 1995Feb 9, 1999Willmen; Hans-RainerElectrosurgical instrument for therapeutic treatment of varices
US5925045 *Apr 2, 1997Jul 20, 1999Mentor CorporationBipolar electrosurgical instrument
US5944715 *Nov 25, 1996Aug 31, 1999Gyrus Medical LimitedElectrosurgical instrument
US5972416 *Jan 23, 1996Oct 26, 1999Mentor CorporationBipolar electrosurgical instrument and method for making the instrument
US6004319 *Jun 20, 1996Dec 21, 1999Gyrus Medical LimitedElectrosurgical instrument
US6013076 *Oct 25, 1996Jan 11, 2000Gyrus Medical LimitedElectrosurgical instrument
US6015406 *Aug 21, 1996Jan 18, 2000Gyrus Medical LimitedElectrosurgical instrument
US6027501 *Jun 20, 1998Feb 22, 2000Gyrus Medical LimitedElectrosurgical instrument
US6039734 *Oct 21, 1996Mar 21, 2000Gyrus Medical LimitedElectrosurgical hand-held battery-operated instrument
US6056746 *Mar 27, 1998May 2, 2000Gyrus Medical LimitedElectrosurgical instrument
US6077261 *Dec 31, 1997Jun 20, 2000Radiotherapeutics CorporationDevice for permanent vessel occlusion
US6090106 *Mar 26, 1998Jul 18, 2000Gyrus Medical LimitedElectrosurgical instrument
US6093186 *Dec 18, 1997Jul 25, 2000Gyrus Medical LimitedElectrosurgical generator and system
US6113594 *Jul 2, 1996Sep 5, 2000Ethicon, Inc.Systems, methods and apparatus for performing resection/ablation in a conductive medium
US6174308May 26, 1999Jan 16, 2001Gyrus Medical LimitedElectrosurgical instrument
US6210405Jun 17, 1997Apr 3, 2001Gyrus Medical LimitedUnder water treatment
US6212433Jul 28, 1998Apr 3, 2001Radiotherapeutics CorporationMethod for treating tumors near the surface of an organ
US6234178May 27, 1999May 22, 2001Gyrus Medical LimitedElectrosurgical instrument
US6241723Apr 21, 1999Jun 5, 2001Team Medical LlcElectrosurgical system
US6261286Oct 16, 1998Jul 17, 2001Gyrus Medical LimitedElectrosurgical generator and system
US6270495Feb 22, 1996Aug 7, 2001Radiotherapeutics CorporationMethod and device for enhancing vessel occlusion
US6277114Mar 18, 1999Aug 21, 2001Gyrus Medical LimitedElectrode assembly for an electrosurical instrument
US6287305Dec 23, 1997Sep 11, 2001Team Medical, L.L.C.Electrosurgical instrument
US6293942May 2, 1996Sep 25, 2001Gyrus Medical LimitedElectrosurgical generator method
US6306134Oct 16, 1998Oct 23, 2001Gyrus Medical LimitedElectrosurgical generator and system
US6337998Jul 14, 1999Jan 8, 2002Robert S. BehlApparatus and method for treating tumors near the surface of an organ
US6358273Apr 9, 1999Mar 19, 2002Oratec Inventions, Inc.Soft tissue heating apparatus with independent, cooperative heating sources
US6364877Oct 16, 1998Apr 2, 2002Gyrus Medical LimitedElectrosurgical generator and system
US6379350Oct 5, 1999Apr 30, 2002Oratec Interventions, Inc.Surgical instrument for ablation and aspiration
US6391028May 16, 2000May 21, 2002Oratec Interventions, Inc.Probe with distally orientated concave curve for arthroscopic surgery
US6416509Mar 26, 1998Jul 9, 2002Gyrus Medical LimitedElectrosurgical generator and system
US6454765Feb 9, 2000Sep 24, 2002The Board Of Regents Of The University Of NebraskaMethods for volumetric tissue ablation
US6461357Jun 25, 1999Oct 8, 2002Oratec Interventions, Inc.Electrode for electrosurgical ablation of tissue
US6468273Feb 9, 2000Oct 22, 2002The Board Of Regents Of The University Of NebraskaMethods for volumetric tissue ablation
US6470218Sep 5, 2000Oct 22, 2002Radiotherapeutics, Inc.Apparatus and method for treating tumors near the surface of an organ
US6482202Jan 10, 2001Nov 19, 2002Gyrus Medical LimitedUnder water treatment
US6494881Sep 30, 1997Dec 17, 2002Scimed Life Systems, Inc.Apparatus and method for electrode-surgical tissue removal having a selectively insulated electrode
US6533781Dec 29, 2000Mar 18, 2003Team Medical LlcElectrosurgical instrument
US6544260Dec 31, 1999Apr 8, 2003Oratec Interventions, Inc.Method for treating tissue in arthroscopic environment using precooling and apparatus for same
US6565561Apr 3, 2000May 20, 2003Cyrus Medical LimitedElectrosurgical instrument
US6575967Feb 9, 2000Jun 10, 2003The Board Of Regents Of The University Of NebraskaMethod and systems for volumetric tissue ablation
US6620156 *Sep 20, 2002Sep 16, 2003Jon C. GaritoBipolar tonsillar probe
US6645203Jan 2, 2001Nov 11, 2003Oratec Interventions, Inc.Surgical instrument with off-axis electrode
US6656173Apr 30, 2001Dec 2, 2003Radio Therapeutics CorporationMethod and device for enhancing vessel occlusion
US6695839Feb 8, 2001Feb 24, 2004Oratec Interventions, Inc.Method and apparatus for treatment of disrupted articular cartilage
US6780180Mar 8, 2000Aug 24, 2004Gyrus Medical LimitedElectrosurgical instrument
US6889089Apr 11, 2001May 3, 2005Scimed Life Systems, Inc.Apparatus and method for treating tumors near the surface of an organ
US6939346Jun 28, 2002Sep 6, 2005Oratec Interventions, Inc.Method and apparatus for controlling a temperature-controlled probe
US6997926Feb 4, 2002Feb 14, 2006Boston Scientific Scimed, Inc.Resistance heated tissue morcellation
US6997941Mar 17, 2003Feb 14, 2006Oratec Interventions, Inc.Method and apparatus for treating annular fissures in intervertebral discs
US7226447Jun 23, 2004Jun 5, 2007Smith & Nephew, Inc.Electrosurgical generator
US7267683Nov 14, 2003Sep 11, 2007Oratec Interventions, Inc.Method for treating intervertebral discs
US7282061Nov 14, 2003Oct 16, 2007Oratec Interventions, Inc.Method of treating intervertebral disc
US7377919Nov 10, 2004May 27, 2008Surginetics, Inc.Electrosurgical instrument
US7400930Nov 14, 2003Jul 15, 2008Oratec Interventions, Inc.Method for treating intervertebral discs
US7537595Dec 21, 2007May 26, 2009Tissuelink Medical, Inc.Fluid-assisted medical devices, systems and methods
US7571729Feb 28, 2005Aug 11, 2009Usgi Medical, Inc.Apparatus and methods for performing mucosectomy
US7604635Aug 9, 2004Oct 20, 2009Salient Surgical Technologies, Inc.Fluid-assisted medical devices, systems and methods
US7645277Dec 22, 2005Jan 12, 2010Salient Surgical Technologies, Inc.Fluid-assisted medical device
US7647123Oct 31, 2007Jan 12, 2010Oratec Interventions, Inc.Method for treating intervertebral discs
US7651494Jan 29, 2003Jan 26, 2010Salient Surgical Technologies, Inc.Fluid-assisted medical device
US7655003Jun 22, 2005Feb 2, 2010Smith & Nephew, Inc.Electrosurgical power control
US7703459Sep 29, 2004Apr 27, 2010Usgi Medical, Inc.Apparatus and methods for mapping out endoluminal gastrointestinal surgery
US7727232Feb 4, 2005Jun 1, 2010Salient Surgical Technologies, Inc.Fluid-assisted medical devices and methods
US7811282Nov 14, 2005Oct 12, 2010Salient Surgical Technologies, Inc.Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
US7815634Dec 22, 2003Oct 19, 2010Salient Surgical Technologies, Inc.Fluid delivery system and controller for electrosurgical devices
US7896875Jun 29, 2006Mar 1, 2011Microline Surgical, Inc.Battery powered electrosurgical system
US7918869May 7, 2004Apr 5, 2011Usgi Medical, Inc.Methods and apparatus for performing endoluminal gastroplasty
US7935112Jun 29, 2006May 3, 2011Microline Surgical, Inc.Electrosurgical instrument
US7951148Feb 6, 2004May 31, 2011Salient Surgical Technologies, Inc.Electrosurgical device having a tissue reduction sensor
US7998140Mar 30, 2004Aug 16, 2011Salient Surgical Technologies, Inc.Fluid-assisted medical devices, systems and methods
US8038670Dec 22, 2005Oct 18, 2011Salient Surgical Technologies, Inc.Fluid-assisted medical devices, systems and methods
US8048070Feb 11, 2003Nov 1, 2011Salient Surgical Technologies, Inc.Fluid-assisted medical devices, systems and methods
US8052675Jan 21, 2010Nov 8, 2011Smith & Nephew, Inc.Electrosurgical power control
US8075557Oct 30, 2007Dec 13, 2011Salient Surgical Technologies, Inc.Fluid-assisted medical devices and methods
US8187312Oct 15, 2007May 29, 2012Neurotherm, Inc.Method for treating intervertebral disc
US8226646 *Aug 9, 2006Jul 24, 2012Olympus Medical Systems Corp.High frequency treatment instrument
US8226697Oct 15, 2007Jul 24, 2012Neurotherm, Inc.Method for treating intervertebral disc
US8348934Sep 23, 2011Jan 8, 2013Smith & Nephew, Inc.Electrosurgical power control
US8348938May 6, 2009Jan 8, 2013Old Dominian University Research FoundationApparatus, systems and methods for treating a human tissue condition
US8357154Jun 29, 2006Jan 22, 2013Microline Surgical, Inc.Multielectrode electrosurgical instrument
US8357155Jun 29, 2006Jan 22, 2013Microline Surgical, Inc.Multielectrode electrosurgical blade
US8361068Oct 12, 2010Jan 29, 2013Medtronic Advanced Energy LlcFluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof
US8475455Oct 28, 2003Jul 2, 2013Medtronic Advanced Energy LlcFluid-assisted electrosurgical scissors and methods
US8603082Dec 5, 2012Dec 10, 2013Smith & Nephew, Inc.Electrosurgical power control
US8726909Jan 27, 2006May 20, 2014Usgi Medical, Inc.Methods and apparatus for revision of obesity procedures
DE3612646A1 *Apr 15, 1986Apr 30, 1987Ellman InternationalElectrosurgical handle piece for blades, needles and forceps
EP0455321A1 *Feb 5, 1991Nov 6, 1991Everest Medical CorporationPercutaneous laparoscopic cholecystectomy instrument
EP0777445A1 Aug 11, 1995Jun 11, 1997Rita Medical Systems, Inc.Multiple electrode ablation apparatus
WO1981003271A1 *Oct 28, 1980Nov 26, 1981American Hospital Supply CorpA multipolar electrosurgical device
WO1981003272A1 *May 4, 1981Nov 26, 1981American Hospital Supply CorpA multipolar electrosurgical device
WO1991017717A1 *Apr 25, 1991Nov 28, 1991Applied Urology IncElectrosurgical electrode
WO1995029644A1 *Apr 28, 1995Nov 9, 1995Willmen Hans RainerElectrosurgical instrument for therapeutic treatment of varices
Classifications
U.S. Classification606/50
International ClassificationA61B18/14
Cooperative ClassificationA61B18/1485
European ClassificationA61B18/14S