Electrosurgical wand and related method and system

An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands including an elongate housing that defines a handle end and a distal end, a first discharge aperture on the distal end of the elongate housing, a first active electrode of conductive material disposed on the distal end of the elongate housing, a first return electrode of conductive material disposed within the first fluid conduit, and an aspiration aperture on the distal end of the elongate housing fluidly coupled to a second fluid conduit.

Systems and methods for turbinate reduction

The present disclosure includes an electrosurgical apparatus for treating tissue at a target site. The apparatus has a shaft with a proximal end and a distal portion, the distal portion comprising a return electrode and electrode support. There is also at least one active electrode on the shaft distal portion, which has a proximal portion and a distal portion and a plurality of aspiration apertures disposed therebetween. These apertures are fluidly connected to a fluid aspiration cavity that is located within the electrode support, and the cavity is connected with a fluid aspiration element that is located along the shaft. The plurality of apertures vary in size and are generally arranged so that the larger sized apertures are disposed towards the electrode proximal portion and the smaller sized apertures are generally located towards the electrode distal portion.

Slitter with mechanical holding finger

A slitter for slitting a guide catheter is assembled from a handle, a blade assembly coupled to the handle, and a holding mechanism coupled to the handle. The blade assembly includes a shroud for receiving an elongated body of a medical device and a slitting blade having an exposed cutting edge to slit the guide catheter.

METHODS AND SYSTEMS RELATED TO ELECTROSURGICAL WANDS

Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging. 1. A method comprising:creating a plasma proximate to an active electrode disposed at the distal end of an electrosurgical wand;drawing fluid through a primary aperture in the active electrode; and thendrawing the fluid through a primary lumen in a spacer, the spacer disposed at a distal end of the electrosurgical wand; anddrawing the fluid along a fluid flow path and then though the primary lumen, the fluid flow path defined by opposing mating surfaces of the active electrode and spacer distal surface.2. The method of further comprising:drawing fluid through a first slot defined through the active electrode, the first slot disposed closer to and outer perimeter of the of the active electrode than the primary aperture.3. The method of further comprising:drawing fluid through a second slot defined through the active electrode, the second slot disposed closer to the outer perimeter than the primary aperture, the first and second slot defined on an opposite side of the primary aperture from the first slot.4. The method of wherein drawing fluid through the first slot further comprises:drawing fluid through the first slot; and ...

ELECTROSURGICAL SYSTEMS AND METHODS

System and methods of an electrosurgical controller having multiple modes of operation that are configured for treatment of a specific targeted tissue type and the electrosurgical effect desired where the treatment and effect are provided by a single controller and an electrosurgical probe. The electrosurgical controller includes an integrated fluid control apparatus or pump where activation of the controller allows for selective energy delivery and corresponding fluid volume flow rates. The electrosurgical probe includes a fluid transport lumen and is in communication with the controller and the pump for operation of the probe in the various user selected modes with accompanying energy delivery and fluid control directed to the desired treatment and surgical effect. 1. A method comprising: controlling flow of fluid into an aperture on a distal end of the electrosurgical wand, the aperture proximate to the first electrode; and', 'controlling energy delivered to the first active electrode by an electrosurgical controller., 'implementing at least two modes of operation during an electrosurgical procedure, the implementing with a first active electrode of an electrosurgical wand coupled to an electrosurgical controller, the implementing by2. The method of wherein implementing further comprises implementing the at least two modes of operation with each mode of operation characterized in steady state by a distinct combination of volume flow rate into the aperture and energy delivered to the first active electrode.3. The method of wherein implementing at least two modes of ablation further comprises implementing modes of ablation selected from the group consisting of: a low mode for use ablating cartilage; a medium mode for use ablating fibro-cartilage; a high mode for ablating soft tissue; and a vacuum mode for removal of free floating tissue.4. The method of wherein implementing further comprises implementing at least three modes of ablation during the electrosurgical ...

Systems and methods systems related to electrosurgical wands with screen electrodes

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Fine dissection electrosurgical device

An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands including an elongate shaft that defines a handle end and a distal end, a first discharge aperture on the distal end of the elongate shaft, a first active electrode of conductive material disposed on the distal end of the elongate shaft, the first active electrode has an edge feature, a first return electrode of conductive material disposed a substantially constant distance from the first active electrode, and an aspiration aperture on the distal end of the elongate shaft fluidly coupled to a second fluid conduit.

Methods and systems related to electrosurgical wands

Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging.

SYSTEMS AND METHODS SYSTEMS RELATED TO ELECTROSURGICAL WANDS WITH SCREEN ELECTRODES

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity. 1. A method of treating a target tissue using an electrosurgical wand comprising:placing a distal end portion of the wand proximate a target tissue, the distal end portion comprising an active electrode and an insulative spacer, the active electrode supported by the spacer;applying a high frequency voltage between the active electrode and a return electrode spaced away from the active electrode, the high frequency voltage sufficient to generate a vapor layer proximate a tissue contacting surface of the active screen electrode;orienting the distal end portion so that a lateral edge surface of the active electrode is proximate the target tissue and treating the target tissue; andaspirating gas bubbles through at least one aspiration aperture disposed in a discrete location spaced away from the lateral edge surface, configured so as to minimally disrupt the vapor layer proximate the active electrode lateral edge surface, wherein the at least one aspiration aperture has a perimeter defined by a portion of the active electrode and a portion of a spacer aspiration cavity.2. The method of wherein the at least one aspiration aperture perimeter is defined by an outer peripheral edge of the active electrode and a portion of a perimeter of the spacer cavity.3. The method of wherein the at least one aspiration ...

SLITTER WITH MECHANICAL HOLDING FINGER

A slitter for slitting a guide catheter is assembled from a handle, a blade assembly coupled to the handle, and a holding mechanism coupled to the handle. The blade assembly includes a shroud for receiving an elongated body of a medical device and a slitting blade having an exposed cutting edge to slit the guide catheter. 155-. (canceled)56. A slitter for slitting a guide catheter , comprising:a handle; and a slitting blade having an exposed cutting edge, wherein the slitting blade comprises at least one or more mechanical engagement elements, wherein the one or more mechanical engagement elements comprise one or more cutouts and one or more flange elements extending in one or more directions from a blade portion of the slitting blade that includes the exposed cutting edge,', 'a shroud defining a groove for receiving an elongated body of a medical device, and', 'a nose piece extending forward of the cutting edge and configured to be inserted into the guide catheter between an outer surface of the elongated body of the medical device and an inner surface of the guide catheter, wherein at least a portion of the blade assembly comprises material overmolding at least a portion of the slitting blade such that the overmolding material of the blade assembly and the one or more mechanical engagement elements form a mechanical interlock between the slitting blade and the overmolding material of the blade assembly., 'a blade assembly coupled to the handle, wherein the blade assembly comprises57. The slitter of claim 56 , wherein the one or more mechanical engagement elements comprise the one or more cutouts defined in the blade portion.58. The slitter of claim 57 , wherein the one or more cutouts defined in the blade portion comprise a distal notch at a distal end of the blade portion proximate the cutting edge.59. The slitter of claim 56 , wherein at least the nose piece is formed of the overmolding material claim 56 , wherein at least a portion of a rear section of the ...

ELECTROSURGICAL WAND AND RELATED METHOD AND SYSTEM

Electrosurgical wand. At least some of the illustrative embodiment are electrosurgical wands including: an elongate housing that defines a handle end and a distal end; an aspiration aperture on the distal end of the elongate housing the aspiration aperture fluidly coupled to a first fluid conduit, the first fluid conduit within the elongate housing; a discharge aperture on the distal end of the elongate housing, the discharge aperture fluidly coupled to a second fluid conduit, and the second fluid conduit within the elongate housing; a first active electrode of conductive material on the distal end of the elongate housing, the first active electrode between the discharge aperture and the aspiration aperture; and a conductive plate that abuts the discharge aperture, at least a portion of the conductive plate disposed over the discharge aperture. 1. An electrosurgical wand comprising:an elongate housing that defines a handle end and a distal end;a connector comprising a first and second electrical pins;an aspiration aperture on the distal end of the elongate housing, the aspiration aperture fluidly coupled to a first fluid conduit, the first fluid conduit within the elongate housing;a discharge aperture on the distal end of the elongate housing, the discharge aperture fluidly coupled to a second fluid conduit, and the second fluid conduit within the elongate housing;a first active electrode of conductive material on the distal end of the elongate housing, the first active electrode between the discharge aperture and the aspiration aperture, and the first active electrode electrically coupled to the first electrical pin; anda conductive plate that abuts the discharge aperture, at least a portion of the conductive plate disposed over the discharge aperture, and the conductive plate electrically coupled to the second electrical pin.2. The electrosurgical wand of wherein the conductive plate defines a lip portion claim 1 , and wherein at least a portion of the lip portion ...

SLITTING TOOL

A tool for slitting an elongate sheath from about an elongate member that is disposed within a longitudinally extending lumen of the sheath includes a longitudinally extending tail portion projecting rearward of a slitting edge and a nose portion of the tool; a lower surface of the nose portion is disposed beneath the slitting edge for engaging a portion of the elongate member. The tail portion of the tool, approximately aligned with the sheath lumen when the lower surface, engages the elongate member and a leading edge of the nose portion is within the sheath lumen, is sized to fit within the sheath lumen after the sheath is slit by the slitting edge. A passageway between the nose portion and the tail portion allows a proximal segment of the elongate member to bend away from the tail portion when the elongate member is engaged by the nose portion. 1. A tool for slitting an elongate sheath from about an elongate member disposed within a longitudinally extending lumen of the sheath , the tool comprising:a slitting edge;a nose portion disposed beneath the slitting edge, the nose portion including a lower surface, for engaging a portion of the elongate member, and a leading edge;a longitudinally extending tail portion projecting rearward of the slitting edge and the nose portion, the tail portion approximately aligned with the sheath lumen when the lower surface of the nose portion engages the elongate member and the leading edge of the nose portion is within the sheath lumen, the tail portion including a profile closely conforming with the sheath lumen after the sheath is slit by the slitting edge; anda passageway disposed between the nose portion and the tail portion, the passageway allowing a segment of the elongate member to bend away from the tail portion when the lower surface of the nose portion engages the portion of the elongate member, the segment being proximal to the portion engaged by the lower surface.2. The tool of claim 1 , further comprising a handle ...

FINE DISSECTION ELECTROSURGICAL DEVICE

An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands including an elongate shaft that defines a handle end and a distal end, a first discharge aperture on the distal end of the elongate shaft, a first active electrode of conductive material disposed on the distal end of the elongate shaft, the first active electrode has an edge feature, a first return electrode of conductive material disposed a substantially constant distance from the first active electrode, and an aspiration aperture on the distal end of the elongate shaft fluidly coupled to a second fluid conduit. 1. An electrosurgical wand comprising:an elongate shaft that defines a handle end and a distal end;a connector comprising a first and second electrical pins;an insulative sheath characterized by a plurality of discharge apertures on the distal end of the elongate shaft, the plurality of discharge apertures fluidly coupled to a first fluid conduit, and the first fluid conduit within the elongate shaft;a first active electrode of conductive material disposed on the distal end of the elongate shaft, the first active electrode has an edge feature, and the first active electrode electrically coupled to the first electrical pin;a first return electrode of conductive material, the first return electrode comprising an extended feature disposed a substantially constant distance from a distal apex of the first active electrode, and the first return electrode electrically coupled to the second electrical pin; andan aspiration aperture on the distal end of the elongate shaft fluidly coupled to a second fluid conduit, the second fluid conduit within the elongate shaft.2. The electrosurgical wand of wherein the edge feature is at least one selected from the group consisting of: a scalloped portion claim 1 , a cut claim 1 , a divot claim 1 , and an asperity.3. The electrosurgical wand of wherein the edge feature comprises a cut claim 1 , the cut has a diameter and a depth on ...

ELECTROSURGICAL WAND AND RELATED METHOD AND SYSTEM

Electrosurgical wand. At least some of the illustrative embodiment are electrosurgical wands including: an elongate housing that defines a handle end and a distal end; an aspiration aperture on the distal end of the elongate housing the aspiration aperture fluidly coupled to a first fluid conduit, the first fluid conduit within the elongate housing; a discharge aperture on the distal end of the elongate housing, the discharge aperture fluidly coupled to a second fluid conduit, and the second fluid conduit within the elongate housing; a first active electrode of conductive material on the distal end of the elongate housing, the first active electrode between the discharge aperture and the aspiration aperture; and a conductive plate that abuts the discharge aperture, at least a portion of the conductive plate disposed over the discharge aperture. 1. A method comprising:flowing a conductive fluid within a fluid conduit disposed within a electrosurgical wand, the conductive fluid is discharged through a discharge aperture in the direction of a return electrode, and the return electrode directs at least a portion of the conductive fluid toward an active electrode;applying electrical energy between the active and return electrodes;forming, responsive to the energy, a plasma proximate to the active electrode; andtreating a wound by placing the active electrode adjacent to the wound, and translating the active electrode along the wound.2. The method of wherein flowing further comprises flowing the conductive fluid past the return electrode in the form of a conductive plate with a distal bend.3. The method of wherein flowing further comprises flowing the conductive fluid past the return electrode in the form of a conductive plate with distal curvature.4. The method of wherein flowing further comprises flowing the conductive fluid such that the conductive fluid is directed toward the active electrode in the form of loop of wire.5. The method of further comprising aspirating ...

ELECTROSURGICAL WAND AND RELATED METHOD AND SYSTEM

An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands including an elongate housing that defines a handle end and a distal end, a first discharge aperture on the distal end of the elongate housing, a first active electrode of conductive material disposed on the distal end of the elongate housing, a first return electrode of conductive material disposed within the first fluid conduit, and an aspiration aperture on the distal end of the elongate housing fluidly coupled to a second fluid conduit. 1. A method comprising:flowing a conductive fluid within a fluid conduit disposed within a electrosurgical wand, the conductive fluid flows past a return electrode disposed within the fluid conduit, and is then discharged through a discharge aperture;applying electrical energy between an active electrode and the return electrode;forming, responsive to the energy, a plasma proximate to the active electrode; andtreating a wound by placing the active electrode adjacent to the wound, and translating the active electrode along the wound.2. The method of wherein flowing further comprises flowing the conductive fluid past the return electrode in the form of a coil of wire.3. The method of wherein flowing further comprises flowing the conductive fluid past the return electrode in the form of a coil of wire that defines a central axis claim 1 , and wherein the direction of flow of the conductive fluid prior to encountering the coil of wire is perpendicular to the central axis.4. The method of wherein flowing further comprises flowing the conductive fluid past the return electrode in the form of a wire mesh.5. The method of wherein flowing further comprises flowing the conductive fluid such that the conductive fluid is discharged at least partially toward the active electrode in the form of loop of wire.6. The method of further comprising aspirating through a fluid conduit in the electrosurgical wand claim 1 , the aspirating proximate to the ...

SYSTEMS AND METHODS FOR TURBINATE REDUCTION

The present disclosure includes an electrosurgical apparatus for treating tissue at a target site. The apparatus has a shaft with a proximal end and a distal portion, the distal portion comprising a return electrode and electrode support. There is also at least one active electrode on the shaft distal portion, which has a proximal portion and a distal portion and a plurality of aspiration apertures disposed therebetween. These apertures are fluidly connected to a fluid aspiration cavity that is located within the electrode support, and the cavity is connected with a fluid aspiration element that is located along the shaft. The plurality of apertures vary in size and are generally arranged so that the larger sized apertures are disposed towards the electrode proximal portion and the smaller sized apertures are generally located towards the electrode distal portion. 1. An electrosurgical apparatus for treating tissue at a target site comprising:an elongate housing that defines a handle end and a distal portion;an electrode support disposed on the distal portion, the electrode support fluidly coupled to a first fluid conduit, and the first fluid conduit disposed within the elongate housing;wherein the electrode support comprises an aspiration cavity, the aspiration cavity defines a cavity ramp;an active electrode disposed on an electrode support shelf, the shelf recessed within the electrode support, the active electrode characterized by a plurality of apertures;a return electrode disposed on the distal portion, the return electrode encircling at least a portion of the electrode support;wherein the plurality of apertures comprise at least a first plurality of apertures and a second plurality of apertures, the first plurality of apertures sized larger than the second plurality of apertures, the first and second plurality of apertures fluidly coupled with the aspiration cavity; andwherein the second plurality of apertures are positioned over the cavity ramp.2. The ...

SYSTEMS AND METHODS SYSTEMS RELATED TO ELECTROSURGICAL WANDS WITH SCREEN ELECTRODES

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity. 1. An electrosurgical wand for treating a target tissue within or on a patient's body comprising:an elongate shaft having a handle end and a distal end portion, the distal end portion comprising an active electrode, an insulative spacer body and a return electrode, wherein the active electrode is supported on the insulative spacer body and is spaced away from the return electrode;wherein the insulative spacer defines a side surface and wherein the active electrode defines a peripheral edge surface;wherein the insulative spacer side surface is configured to initially engage tissue and direct the peripheral edge surface towards the target tissue.2. The electrosurgical wand of wherein the insulative spacer body defines a planar end surface having a beveled edge and wherein the active electrode abuts the planar end surface claim 1 , and the active electrode edge surface is parallel to the beveled edge.3. The electrosurgical wand of wherein the active electrode edge surface is free of any asperities.4. The electrosurgical wand of wherein the active electrode further comprises an aspiration aperture spaced away from the active electrode peripheral edge surface.5. The electrosurgical wand of wherein the insulative spacer side surface is configured to initially engage tissue and also direct the electrode ...

METHODS AND SYSTEMS RELATED TO ELECTROSURGICAL WANDS

Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging.

METHODS AND SYSTEMS RELATED TO ELECTROSURGICAL WANDS

Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging.

ELECTROSURGICAL SYSTEMS AND METHODS

System and methods of an electrosurgical controller having multiple modes of operation that are configured for treatment of a specific targeted tissue type and the electrosurgical effect desired where the treatment and effect are provided by a single controller and an electrosurgical probe. The electrosurgical controller includes an integrated fluid control apparatus or pump where activation of the controller allows for selective energy delivery and corresponding fluid volume flow rates. The electrosurgical probe includes a fluid transport lumen and is in communication with the controller and the pump for operation of the probe in the various user selected modes with accompanying energy delivery and fluid control directed to the desired treatment and surgical effect. 1. An electrosurgical controller comprising:a processor;a memory coupled to the processor;a voltage generator operatively coupled to the processor, the voltage generator comprising an active terminal;an aspiration control mechanism, for controlling an aspiration flow rate of fluid through an aspiration conduit operatively coupled thereto, the aspiration control mechanism operatively coupled to the processor; implement a first mode of ablation by setting, via the aspiration control mechanism, the aspiration flow rate at a first rate and by setting a first predetermined energy provided by the voltage generator; and', 'implement a second mode of ablation by setting, via the aspiration control mechanism, the aspiration flow rate at a second flow rate and by setting a second predetermined energy provided by the voltage generator, the second flow rate different than the first flow rate, and the second predetermined energy different than the first predetermined energy., 'wherein the memory stores a program that, when executed by the processor, causes the processor to2. The electrosurgical controller of wherein the program claim 1 , during each mode of ablation claim 1 , further causes the processor to:adjust ...

SYSTEMS AND METHODS SYSTEMS RELATED TO ELECTROSURGICAL WANDS WITH SCREEN ELECTRODES

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity. 1. An electrosurgical wand for treating tissue at a target site within or on a patient's body comprising:an elongate shaft characterized by a handle and a distal end portion, the distal end portion comprising an active electrode, an insulative spacer body and a return electrode, wherein the active electrode is supported on the insulative spacer body and is spaced away from the return electrode;wherein the active electrode defines lateral and medial edge surfaces;wherein the insulative spacer body defines an aspiration cavity fluidly connected with an aspiration lumen, the insulative spacer body further defined by at least one tapered aperture extending beyond at least one of the medial edge surfaces and directed to the aspiration cavity.2. The electrosurgical wand of wherein at least one active electrode lateral edge surface is free of any asperities and spaced away from the at least one aperture.3. The electrosurgical wand of wherein the active electrode further comprises an electrode aperture in fluid communication with the aspiration cavity and spaced away from both the lateral edge surface and the at least one tapered aperture.4. The electrosurgical wand of further comprising at least two tapered apertures extending beyond the medial edge surfaces and directed to the aspiration cavity and wherein the ...

ELECTROSURGICAL SYSTEMS AND METHODS

System and methods of an electrosurgical controller having multiple modes of operation that are configured for treatment of a specific targeted tissue type and the electrosurgical effect desired where the treatment and effect are provided by a single controller and an electrosurgical probe. The electrosurgical controller includes an integrated fluid control apparatus or pump where activation of the controller allows for selective energy delivery and corresponding fluid volume flow rates. The electrosurgical probe includes a fluid transport lumen and is in communication with the controller and the pump for operation of the probe in the various user selected modes with accompanying energy delivery and fluid control directed to the desired treatment and surgical effect. 1. A method comprising: controlling flow of fluid into an aperture on a distal end of the electrosurgical wand, the aperture proximate to the first electrode; and', 'controlling energy delivered to the first active electrode by an electrosurgical controller., 'implementing at least two modes of operation during an electrosurgical procedure, the implementing with a first active electrode of an electrosurgical wand coupled to an electrosurgical controller, the implementing by2. The method of wherein implementing further comprises implementing the at least two modes of operation with each mode of operation characterized in steady state by a distinct combination of volume flow rate into the aperture and energy delivered to the first active electrode.3. The method of wherein implementing at least two modes of ablation further comprises implementing modes of ablation selected from the group consisting of: a low mode for use ablating cartilage; a medium mode for use ablating fibro-cartilage; a high mode for ablating soft tissue; and a vacuum mode for removal of free floating tissue.4. The method of wherein implementing further comprises implementing at least three modes of ablation during the electrosurgical ...

Flow blocking electrode

An electrosurgical wand is disclosed. The electrosurgical wand includes a handle that defines a proximal end of the electrosurgical wand. The electrosurgical wand includes an elongate shaft coupled to the handle; the elongate shaft defines a suction lumen therein. The electrosurgical wand also includes an electrically insulative spacer (404) coupled to the distal end of the elongate shaft, whereby the spacer defines a suction channel (412) fluidly coupled to the suction lumen. The electrosurgical wand includes a first means for blocking defined by the spacer, an active electrode (402) coupled on the distal end of the spacer and a second means for blocking associated with the active electrode and in operational relationship to the first means for blocking. In the electrosurgical wand, the first means for blocking includes an annular trough (416) that fully encircles the suction channel of the spacer and the second means for blocking includes an annular wall (414).

Electrosurgical systems and methods

System and methods of an electrosurgical controller having multiple modes of operation that are configured for treatment of a specific targeted tissue type and the electrosurgical effect desired where the treatment and effect are provided by a single controller and an electrosurgical probe. The electrosurgical controller includes an integrated fluid control apparatus or pump where activation of the controller allows for selective energy delivery and corresponding fluid volume flow rates. The electrosurgical probe includes a fluid transport lumen and is in communication with the controller and the pump for operation of the probe in the various user selected modes with accompanying energy delivery and fluid control directed to the desired treatment and surgical effect.

Method to use a deflectable medical therapy delivery device having comm on lumen profile

Published without an Abstract

Electrosurgical systems

Deflectable medical therapy delivery device having common lumen profile

A medical therapy delivery device that includes a shaft formed by an outer layer and a deflectable tip that includes a tapered portion. A manipulator wire extends through the shaft to adjust deflection of a second portion of the shaft relative to a first portion. The outer layer forms a single shaft lumen having a first lumen portion positioned about a thru lumen tubing and a second lumen portion, offset from and in fluid communication with the first lumen portion, the second lumen portion having a first side wall, a second side wall and a bottom wall extending between the first side wall and the second side wall. The thru lumen tubing, first side wall, the second side wall and the bottom wall position the manipulator wire within the second lumen portion.

Systems and methods systems related to electrosurgical wands with screen electrodes

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Systems and methods for turbinate reduction

An electrosurgical apparatus for treating tissue at a target site comprises a shaft (100, Fig 2A) with a proximal end and a distal portion 120, the distal portion having a return electrode 112 and an electrode support 122. At least one active electrode 104 is disposed on the shaft distal portion, itself having a proximal portion and a distal portion and at least one aspiration aperture 130, 131, 132 therein. The aperture/s is/are fluidly connected to a fluid aspiration cavity (135, Fig 2E) located within the shaft of the apparatus. In a first embodiment the electrode has a first and second plurality of apertures, the first plurality 130/131 being sized larger than the second plurality 132. In a second embodiment the plurality of apertures vary in size with the largest apertures disposed towards the electrode proximal portion and the smallest towards the distal portion, at least one aperture having an axis of symmetry which aligns with a long axis of the fluid aspiration cavity. In a third embodiment the shaft comprises a tubular insulating support member 150 and the return electrode gas at least one discharge aperture (115a, 115b, 115c, Fig 2D) disposed through the electrode and fluidly connected with a fluid supply.

Plasma surgery device

An electrosurgical wand is provided and includes a handle and an elongate shaft coupled to the handle and extending distally from the handle along an axis. An active electrode is disposed at a distal end of the electrosurgical wand. A return electrode abuts the elongate shaft and extends along and annularly about the axis. The return electrode has a top side adjacent the active electrode and an opposite bottom side and defines a notch. A support member is disposed in the notch between the electrodes and transitions curvilinearly from the notch to define a front surface extending laterally across and axially from the return electrode. The front surface tapers downwardly from the active electrode to define a first portion defining a first convex outer surface and also extends toward the bottom side of the return electrode to define a second portion defining a second convex outer surface.

Electrosurgical rod and associated method and system

Ein elektrochirurgischer Stab. Wenigstens einige der illustrativen Ausführungsformen sind elektrochirurgische Stäbe, die ein längliches Gehäuse beinhalten, das ein Griffende und ein distales Ende, eine erste Auslassöffnung am distalen Ende des länglichen Gehäuses, eine erste aktive Elektrode aus leitfähigem Material, die am distalen Ende des länglichen Gehäuses angeordnet ist, eine erste Neutralelektrode aus leitfähigem Material, die in der ersten Flüssigkeitsleitung angeordnet ist, und eine Absaugöffnung am distalen Ende des länglichen Gehäuses, die in Fluidverbindung mit einer zweiten Flüssigkeitsleitung verbunden ist, aufweist. An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical rods that include an elongated housing that includes a handle end and a distal end, a first outlet at the distal end of the elongated housing, a first active electrode made of conductive material disposed at the distal end of the elongated housing , a first neutral electrode made of conductive material, which is arranged in the first liquid line, and a suction opening at the distal end of the elongate housing, which is connected in fluid communication with a second liquid line.

Slitter with mechanical holding finger

Deflectable medical therapy delivery device having common lumen profile

A medical therapy delivery device that includes a shaft formed by an outer layer and a deflectable tip that includes a tapered portion. A manipulator wire extends through the shaft to adjust deflection of a second portion of the shaft relative to a first portion. The outer layer forms a single shaft lumen having a first lumen portion positioned about a thru lumen tubing and a second lumen portion, offset from and in fluid communication with the first lumen portion, the second lumen portion having a first side wall, a second side wall and a bottom wall extending between the first side wall and the second side wall, the thru lumen tubing. The first side wall, the second side wall and the bottom wall position the manipulator wire within the second lumen portion.

Electrosurgical Device

Disclosed herein is an electrosurgical device including a handle at a proximal end and an elongate shaft coupled to the handle and extending distally from the handle. The device also includes a distal working end, including a return electrode and an active electrode supported by an insulative spacer, the insulative spacer separating the return and active electrode. The active electrode has a planar surface that is distal facing and defines a maximum planar surface length. The insulative spacer is generally tapered between the return electrode and active electrode. The insulative spacer has a planar stabilizing surface on a device first side that has a length that extends along the longitudinal axis, extending from a distal-most end of the return electrode to a leading edge surface of the active electrode. This length is at least as long as the maximum planar surface length.

Electrosurgical wand with a spacer and with an active electrode, an associated system and an ablation method including generating a plasma

An electrosurgical wand is disclosed. The electrosurgical wand includes a handle that defines a proximal end of the electrosurgical wand. The electrosurgical wand includes an elongate shaft coupled to the handle; the elongate shaft defines a suction lumen therein. The electrosurgical wand also includes an electrically insulative spacer (404) coupled to the distal end of the elongate shaft, whereby the spacer defines a suction channel (412) fluidly coupled to the suction lumen. The electrosurgical wand includes a first means for blocking defined by the spacer, an active electrode (402) coupled on the distal end of the spacer and a second means for blocking associated with the active electrode and in operational relationship to the first means for blocking. In the electrosurgical wand, the first means for blocking includes an annular trough (416) that fully encircles the suction channel of the spacer and the second means for blocking includes an annular wall (414).

Articulating shaft of a surgical device

Disclosed is a surgical instrument with a handle and elongate shaft assembly extending distally from the handle. The elongate shaft assembly has a longitudinal axis and is able to articulate between a fully flexed configuration and a lesser flexed configuration. The elongated shaft assembly includes a first tubular member having a first flexible portion with a first preferential bending direction. The elongated shaft assembly also includes a second member including a second flexible portion axially fixed to the first tubular member at a position distal from the first flexible portion. The first flexible portion is defined by a plurality of cutouts, each cutout defining a cutout longitudinal axis transverse the shaft longitudinal axis and wherein the plurality of radial cutouts have an asymmetrical shape about the cutout longitudinal axis.

Systems and methods for the reduction of the turbinate

Die vorliegende Offenbarung beinhaltet eine elektrochirurgische Vorrichtung zur Behandlung von Gewebe an einer Zielstelle. Die Vorrichtung weist einen Schaft mit einem proximalen Ende und einem distalen Teil auf, wobei der distale Teil eine Neutralelektrode und einen Elektrodenträger umfasst. Es befindet sich außerdem mindestens eine Aktivelektrode an dem distalen Teil des Schafts, der einen proximalen Teil und einen distalen Teil und eine Vielzahl von dazwischen angeordneten Absaugöffnungen aufweist. Diese Öffnungen sind fluidisch mit einem Absaughohlraum verbunden, der sich innerhalb des Elektrodenträgers befindet, und der Hohlraum ist mit einem Fluidabsaugelement verbunden, das entlang des Schafts positioniert ist. Die Vielzahl von Öffnungen variiert in Größe und ist im Allgemeinen derart angeordnet, dass die größeren Öffnungen in Richtung auf den proximalen Teil der Elektrode angeordnet sind und die kleineren Öffnungen im Allgemeinen in Richtung auf den distalen Teil der Elektrode angeordnet sind. The present disclosure includes an electrosurgical device for treating tissue at a target site. The device has a shaft with a proximal end and a distal part, the distal part comprising a neutral electrode and an electrode carrier. There is also at least one active electrode on the distal part of the shaft, which has a proximal part and a distal part and a plurality of suction openings arranged therebetween. These openings are fluidly connected to a suction cavity located within the electrode carrier and the cavity is connected to a fluid suction element positioned along the shaft. The plurality of openings vary in size and are generally arranged such that the larger openings are arranged towards the proximal part of the electrode and the smaller openings are generally arranged towards the distal part of the electrode.

Methods and systems of variable aspiration control in surgical procedures

Variable aspiration control in surgical procedures. At least one example is a method of performing a surgical procedure, the method comprising: driving, by a surgical controller, a motor within a handpiece coupled to a resection instrument, the driving causes mechanical resection of tissue by the resection instrument; aspirating, by a peristaltic pump associated with the surgical controller, fluid and tissue fragments through a suction lumen of the resection instrument during the resection of tissue; and modulating, by the surgical controller, speed of the peristaltic pump during the driving and aspirating, the modulating responsive to an interface device defined on an exterior surface of the handpiece.

Methods and systems of electrosurgical coagulation devices

Electrosurgical coagulation devices. At least some of the example embodiment are methods including: applying RF energy between a first electrode and a second electrode, the first and second electrodes define an interstice; flowing an electrically conductive fluid through a first nozzle and a second nozzle of the first electrode, the first nozzle defines a first spray direction, the second nozzle defines a second spray direction, and a first angle between the first spray direction and the second spray direction is 180 angular degrees or less measured through the interstice; flowing an electrically conductive fluid through a third nozzle and a fourth nozzle of the second electrode, the third nozzle defines a third spray direction, the fourth nozzle defines a fourth spray direction, and a second angle between the third spray direction and the fourth spray direction is 180 angular degrees or less measured through the interstice.

Methods and systems of electrosurgical coagulation devices

Electrosurgical coagulation devices. At least some of the example embodiment are methods including: applying RF energy between a first electrode and a second electrode, the first and second electrodes define an interstice; flowing an electrically conductive fluid through a first nozzle and a second nozzle of the first electrode, the first nozzle defines a first spray direction, the second nozzle defines a second spray direction, and a first angle between the first spray direction and the second spray direction is 180 angular degrees or less measured through the interstice; flowing an electrically conductive fluid through a third nozzle and a fourth nozzle of the second electrode, the third nozzle defines a third spray direction, the fourth nozzle defines a fourth spray direction, and a second angle between the third spray direction and the fourth spray direction is 180 angular degrees or less measured through the interstice.

Surgical wand

Methods and systems of electrosurgical coagulation devices

Electrosurgical coagulation devices. At least some of the example embodiment are methods including: applying RF energy between a first electrode and a second electrode, the first and second electrodes define an interstice; flowing an electrically conductive fluid through a first nozzle and a second nozzle of the first electrode, the first nozzle defines a first spray direction, the second nozzle defines a second spray direction, and a first angle between the first spray direction and the second spray direction is 180 angular degrees or less measured through the interstice; flowing an electrically conductive fluid through a third nozzle and a fourth nozzle of the second electrode, the third nozzle defines a third spray direction, the fourth nozzle defines a fourth spray direction, and a second angle between the third spray direction and the fourth spray direction is 180 angular degrees or less measured through the interstice.

Articulating shaft of a surgical device

Disclosed is a surgical instrument with a handle and elongate shaft assembly extending distally from the handle. The elongate shaft assembly has a longitudinal axis and is able to articulate between a fully flexed configuration and a lesser flexed configuration. The elongated shaft assembly includes a first tubular member having a first flexible portion with a first preferential bending direction. The elongated shaft assembly also includes a second member including a second flexible portion axially fixed to the first tubular member at a position distal from the first flexible portion. The first flexible portion is defined by a plurality of cutouts, each cutout defining a cutout longitudinal axis transverse the shaft longitudinal axis and wherein the plurality of radial cutouts have an asymmetrical shape about the cutout longitudinal axis.

Arthroscopic resection probe

A combination arthroscopic tissue resecting probe is disclosed, including an elongated shaft with an outer, electrically conductive sleeve and an inner sleeve. Each sleeve has a distal region with a cutting window, the inner sleeve being rotatable to cut tissue. An outer surface of the outer sleeve distal region carries a ceramic body (580) and an electrode (570). The active electrode (570) defining two portions, angularly offset from each other, the two portions including a first portion (571) that extends circumferentially and axially along the tubular distal end and a second portion (578) that extends from a distal end of the first portion and across the tubular distal end, the second portion having at least one flange (595) configured to engage a notch (581) in the electrically insulative spacer (580) to resist separation of the active electrode from the electrically insulative spacer (580). The electrode, the ceramic body and the outer sleeve each define a first aspiration (572, 586, 512) opening for aspirating fluid ablation byproducts therethrough into an interior of the shaft. Various methods of improved electrode attachment are disclosed, that provides a low profile probe distal end, while maintaining electrosurgical functionality.

Arthroscopic resection probe

A combination arthroscopic tissue resecting probe is disclosed, including an elongated shaft with an outer, electrically conductive sleeve and an inner sleeve. Each sleeve has a distal region with a cutting window, the inner sleeve being rotatable to cut tissue. An outer surface of the outer sleeve distal region carries a ceramic body and an electrode. The electrode, the ceramic body and the outer sleeve each define a first aspiration opening for aspirating fluid ablation byproducts therethrough into an interior of the shaft. Various methods of improved electrode attachment are disclosed, that provides a low profile probe distal end, while maintaining electrosurgical functionality.

Katheter zur erfassung und zur ablation der herzwand

Methods and systems of variable aspiration control in surgical procedures

Variable aspiration control in surgical procedures. At least one example is a method of performing a surgical procedure, the method comprising: driving, by a surgical controller, a motor within a handpiece coupled to a resection instrument, the driving causes mechanical resection of tissue by the resection instrument; aspirating, by a peristaltic pump associated with the surgical controller, fluid and tissue fragments through a suction lumen of the resection instrument during the resection of tissue; and modulating, by the surgical controller, speed of the peristaltic pump during the driving and aspirating, the modulating responsive to an interface device defined on an exterior surface of the handpiece.

Systems and methods systems related to electrosurgical wands with screen electrodes

An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Methods and systems of electrosurgical coagulation devices

Electrosurgical coagulation devices. At least some of the example embodiment are methods including: applying RF energy between a first electrode and a second electrode, the first and second electrodes define an interstice; flowing an electrically conductive fluid through a first nozzle and a second nozzle of the first electrode, the first nozzle defines a first spray direction, the second nozzle defines a second spray direction, and a first angle between the first spray direction and the second spray direction is 180 angular degrees or less measured through the interstice; flowing an electrically conductive fluid through a third nozzle and a fourth nozzle of the second electrode, the third nozzle defines a third spray direction, the fourth nozzle defines a fourth spray direction, and a second angle between the third spray direction and the fourth spray direction is 180 angular degrees or less measured through the interstice.

Methods and systems of variable aspiration control in surgical procedures

Variable aspiration control in surgical procedures. At least one example is a method of performing a surgical procedure, the method comprising: driving, by a surgical controller, a motor within a handpiece coupled to a resection instrument, the driving causes mechanical resection of tissue by the resection instrument; aspirating, by a peristaltic pump associated with the surgical controller, fluid and tissue fragments through a suction lumen of the resection instrument during the resection of tissue; and modulating, by the surgical controller, speed of the peristaltic pump during the driving and aspirating, the modulating responsive to an interface device defined on an exterior surface of the handpiece.

Guide catheter

An elongated sheath of a guide catheter includes a fully radiopaque and echogenic distal tip having a length greater than approximately 0.08 inch.

Fine dissection electrosurgical device

Guide catheter

An elongated sheath of a guide catheter includes a fully radiopaque and echogenic distal tip having a length greater than approximately 0.08 inch.

Plasma surgery device

An electrosurgical wand is provided and includes a handle and an elongate shaft coupled to the handle and extending distally from the handle along an axis. An active electrode is disposed at a distal end of the electrosurgical wand. A return electrode abuts the elongate shaft and extends along and annularly about the axis. The return electrode has a top side adjacent the active electrode and an opposite bottom side and defines a notch. A support member is disposed in the notch between the electrodes and transitions curvilinearly from the notch to define a front surface extending laterally across and axially from the return electrode. The front surface tapers downwardly from the active electrode to define a first portion defining a first convex outer surface and also extends toward the bottom side of the return electrode to define a second portion defining a second convex outer surface.

Electrosurgical wand with a spacer and with an active electrode, an associated system and an ablation method including generating a plasma

An electrosurgical wand is disclosed. The electrosurgical wand includes a handle that defines a proximal end of the electrosurgical wand. The electrosurgical wand includes an elongate shaft coupled to the handle; the elongate shaft defines a suction lumen therein. The electrosurgical wand also includes an electrically insulative spacer (404) coupled to the distal end of the elongate shaft, whereby the spacer defines a suction channel (412) fluidly coupled to the suction lumen. The electrosurgical wand includes a first means for blocking defined by the spacer, an active electrode (402) coupled on the distal end of the spacer and a second means for blocking associated with the active electrode and in operational relationship to the first means for blocking. In the electrosurgical wand, the first means for blocking includes an annular trough (416) that fully encircles the suction channel of the spacer and the second means for blocking includes an annular wall (414).

Methods and systems related to electrosurgical wands

Slitter with mechanical holding finger

A slitter (10) for slitting a guide catheter (70) is assembled from a handle (12), a blade assembly (20) coupled to the handle, and a holding mechanism (30) coupled to the handle. The blade assembly includes a shroud (28) for receiving an elongated body of a medical device and a slitting blade (22) having an exposed cutting edge (26) to slit the guide catheter.

Slitter with mechanical holding finger

A slitter (10) for slitting a guide catheter (70) is assembled from a handle (12), a blade assembly (20) coupled to the handle, and a holding mechanism (30) coupled to the handle. The blade assembly includes a shroud (28) for receiving an elongated body of a medical device and a slitting blade (22) having an exposed cutting edge (26) to slit the guide catheter.

Method and system of control of conductive fluid during coagulation

Method and system of control of conductive fluid during coagulation using radio frequency energy. At least one example is of sealing blood vessels, the method comprising: applying, by an electrosurgical controller, radio frequency (RF) energy between two electrodes of a coagulation wand, the two electrodes abutting tissue at a surgical site, and the RF energy at a coagulation energy; supplying, by the electrosurgical controller, a flow of conductive fluid to the surgical site; measuring, by the electrosurgical controller, a value indicative of impedance of tissue and conductive fluid between the two electrodes; and decreasing, by the electrosurgical controller, the flow of conductive fluid as the value indicative of impedance decreases.

System of control of conductive fluid during coagulation

Method and system of control of conductive fluid during coagulation using radio frequency energy. At least one example is of sealing blood vessels, the method comprising: applying, by an electrosurgical controller, radio frequency (RF) energy between two electrodes of a coagulation wand, the two electrodes abutting tissue at a surgical site, and the RF energy at a coagulation energy; supplying, by the electrosurgical controller, a flow of conductive fluid to the surgical site; measuring, by the electrosurgical controller, a value indicative of impedance of tissue and conductive fluid between the two electrodes; and decreasing, by the electrosurgical controller, the flow of conductive fluid as the value indicative of impedance decreases.

Systeme und Verfahren zur Reduktion der Nasenmuschel

Elektrochirurgische Vorrichtung zur Behandlung von Gewebe an einer Zielstelle, umfassend:ein längliches Gehäuse, das ein Griffende und einen distalen Teil definiert;einen Elektrodenträger (150), der auf dem distalen Teil angeordnet ist, wobei der Elektrodenträger (150) fluidisch an eine erste Fluidleitung gekoppelt ist und die erste Fluidleitung innerhalb des länglichen Gehäuses angeordnet ist;wobei der Elektrodenträger (150) einen Absaughohlraum (135) umfasst und der Absaughohlraum (135) eine Hohlraumrampe (136) definiert;eine Aktivelektrode (104) angeordnet auf einer Elektrodenträgerablage (122), wobei die Ablage (122) innerhalb des Elektrodenträgers (150) versenkt ist und die Aktivelektrode (104) durch eine Vielzahl von Öffnungen charakterisiert ist;eine Neutralelektrode (112), die auf dem distalen Teil angeordnet ist, wobei die Neutralelektrode (112) mindestens einen Teil des Elektrodenträgers (150) umschließt;wobei die Vielzahl von Öffnungen mindestens eine erste Vielzahl von Öffnungen (130, 131) und eine zweite Vielzahl von Öffnungen (132) umfasst, wobei die erste Vielzahl von Öffnungen (130, 131) größer als die zweite Vielzahl von Öffnungen (132) ist und die erste und zweite Vielzahl von Öffnungen fluidisch mit dem Absaughohlraum (135) gekoppelt ist; undwobei die zweite Vielzahl von Öffnungen (132) über der Hohlraumrampe (136) positioniert ist.

Symmetric switching electrode method and related system

Electrosurgical system and related methods that include: producing energy by a generator of an electrosurgical controller, the generator comprises a first terminal coupled to a first electrode of an electrosurgical wand, and the generator comprises a second terminal coupled to a second electrode of the electrosurgical wand; forming, responsive to the energy, a plasma proximate to the first electrode, and acting as a current return by the second electrode; reducing energy output of the generator such that the plasma proximate the first electrode is extinguished, the reducing energy output during periods of time when the electrosurgical controller is commanded to produce energy; producing energy from the generator with the first terminal coupled to the first electrode and the second terminal coupled to the second electrode; and forming, responsive to the energy, a plasma proximate to the second electrode, and acting as a current return by the first electrode.