Thermal, electrosurgical and mechanical modalities may be combined in a surgical tool. Potentially damaging effects in a first modality may be minimized by using a secondary modality. In one example, thermal hemostasis may thus help electrosurgical applications avoid the adverse tissue effects assoc
Thermal, electrosurgical and mechanical modalities may be combined in a surgical tool. Potentially damaging effects in a first modality may be minimized by using a secondary modality. In one example, thermal hemostasis may thus help electrosurgical applications avoid the adverse tissue effects associated with hemostatic monopolar electrosurgical waveforms while retaining the benefits of using monopolar incising waveforms.
대표청구항▼
1. A multi-mode surgical tool comprising: an electrosurgical electrode for treating tissue by passing electrical energy through the tissue; anda thermal surgical element for generating heat and conducting said heat from the thermal element to tissue to thereby treat the tissue, the thermal surgical
1. A multi-mode surgical tool comprising: an electrosurgical electrode for treating tissue by passing electrical energy through the tissue; anda thermal surgical element for generating heat and conducting said heat from the thermal element to tissue to thereby treat the tissue, the thermal surgical element comprising: an elongate conductor for receiving electrical energy; anda ferromagnetic coating disposed circumferentially about the elongate conductor;wherein delivering electrical energy to the elongate conductor causes the ferromagnetic coating to heat to a temperature of between about 40 degrees Centigrade and below a Curie temperature of the thermal surgical element;wherein the elongate conductor of the thermal surgical element is also the electrosurgical electrode; andwherein the ferromagnetic coating, when heated, is movable between air and liquid without causing fracturing of the ferromagnetic coating. 2. The multi-mode surgical tool of claim 1, wherein the electrosurgical electrode is a monopolar electrode. 3. The multi-mode surgical tool of claim 1, further comprising a handle, wherein a section of the elongate conductor extends to and from the handle, and wherein the ferromagnetic coating covers less than all of the section of the elongate conductor extending from the handle. 4. The multi-mode surgical tool of claim 1, wherein the electrosurgical electrode is configured to operate as a monopolar electrode and wherein the elongate conductor is a wire. 5. The multi-mode surgical tool of claim 1, further comprising a single conductive pathway for delivering a multiplexed signal to both the electrosurgical electrode and the thermal surgical element. 6. The multi-mode surgical tool of claim 5, wherein the tool further comprises a signal generator for generating a multiplexed signal. 7. The multi-mode surgical tool of claim 5, wherein the multiplexed signal further comprises a monopolar signal. 8. The multi-mode surgical tool of claim 7, wherein the monopolar signal is between 200 kHz and 2 MHz. 9. The multi-mode surgical tool of claim 8, wherein the monopolar signal is between 350 kHz and 800 kHz. 10. The multi-mode surgical tool of claim 7, wherein the multiplexed signal further comprises an inductive heating signal. 11. The multi-mode surgical tool of claim 10, wherein the inductive heating signal is between 5 MHz and 24 GHz. 12. The multi-mode surgical tool of claim 11, wherein the inductive heating signal is between 40 MHz and 928 MHz. 13. The multi-mode surgical tool of claim 3, further comprising a catheter, wherein the electrosurgical electrode and the thermal surgical element are disposed upon the catheter. 14. The multi-mode surgical tool of claim 13, wherein the catheter is rigid. 15. The multi-mode surgical tool of claim 13, wherein the catheter is flexible. 16. The multi-mode surgical tool of claim 13, wherein the catheter is configured for aspiration. 17. The multi-mode surgical tool of claim 13, wherein the catheter is configured for substance delivery. 18. The multi-mode surgical tool of claim 13, wherein the catheter further comprises at least one sensor. 19. The multi-mode surgical tool of claim 13, wherein the catheter further comprises means for generating visual feedback. 20. A multi-mode surgical tool comprising: a tip comprising an electrical conductor forming a physically continuous conductive pathway having an exposed portion that extends to and from the tip;a ferromagnetic coating covering a first part of the exposed portion of the electrical conductor, the ferromagnetic coating being selected from ferromagnetic coatings which will convert some frequencies of oscillating electrical energy into thermal energy thereby causing the ferromagnetic coating to heat and will pass other frequencies of oscillating electrical energy into tissue;wherein the heated ferromagnetic coating is moveable between a first environment and a second environment without causing the ferromagnetic coating to fracture even when the first environment and the second environment have a large temperature differential. 21. The multi-mode surgical tool of claim 20, further comprising a signal generator for sending a multiplexed signal into the electrical conductor. 22. The multi-mode surgical tool of claim 20, wherein the electrical conductor further comprises an electrosurgical electrode. 23. The multi-mode surgical tool of claim 22, wherein the electrosurgical electrode is a monopolar electrode. 24. The multi-mode surgical tool of claim 20, wherein the ferromagnetic coating is configured to simultaneously disperse thermal energy and oscillating electrical energy into tissue. 25. A thermally adjustable multi-mode surgical tip comprising: a cable;a small diameter electrical conductor having a proximal and distal end, wherein the proximal end is configured to receive radiofrequency energy from the cable;a thin plating of ferromagnetic material disposed circumferentially about the small diameter electrical conductor, wherein the thin plating of ferromagnetic material is configured with a Curie point sufficiently high to encompass a desired set of therapeutic temperature ranges;wherein the small diameter electrical conductor further comprises an electrosurgical element configured to receive power from the cable and configured to release radiofrequency energy into nearby tissue; andwherein the thin plating of ferromagnetic material, when heated, is movable between air and liquid without causing the thin plating of ferromagnetic material to crack. 26. The multi-mode surgical tool of claim 25, wherein the electrosurgical element is a monopolar element. 27. The multimode surgical instrument of claim 1, wherein the thermal surgical element is configured to reach a sufficient temperature for self-cleaning when a power source is applied thereto. 28. The multi-mode surgical tool of claim 1, further comprising a power source configured to deliver an oscillating current to the thermal surgical element. 29. The multi-mode surgical tool of claim 28, further comprising a sensor disposed adjacent the thermal surgical element. 30. The multi-mode surgical tool of claim 29, wherein the power source is configured to react to the sensor. 31. The multi-mode surgical tool of claim 29, wherein the sensor is configured to measure tissue properties. 32. The multi-mode surgical tool of claim 29, wherein the sensor is configured to allow visual observation of tissue. 33. The multi-mode surgical tool of claim 28, wherein the power source is configured to measure a temperature indicator of the ferromagnetic coating and adjust an output to maintain a predetermined therapeutic temperature range in tissue. 34. The multi-mode surgical tool of claim 20, further comprising a temperature sensor disposed adjacent the electrical conductor for measuring temperature. 35. The multi-mode surgical tool of claim 31, wherein the sensor is configured to measure transferred heat.
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