Tissue surface treatment apparatus and method

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface, wherein the at least one electrode has a longitudinal axis in substantial alignment with one of a longitudinal axis of the aperture, a locus of the aperture, or a line perpendicular to a plane of the aperture;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed into a target tissue site with curvature to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed into a target tissue at an angle with respect to a plane of the tissue contact surface to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and deployed to a selectable depth into a target tissue to define an ablation volume at least partly bounded by a tissue surface wherein the at least one electrode is deployable with curvature from the housing;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing, the handpiece including at least one of a bendable portion or a curved portion;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface having at least one of curved contour, a concave contour a convex contour or a sloping contour;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface being substantially conformable, controllably conformable or bendable;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior, at least a portion of the tissue contact surface including a movable or detachable insulative layer;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• a switching device coupled to at least one of the at least one electrode, a power supply coupled to the at least one electrode or a ground pad electrode coupled to the power supply;
• impedance measurement circuitry coupled to the at least one of at least one electrode or the ground pad electrode;
• logic resources coupled to at least one of the impedance measurement circuitry or the switching device, the logic resources configured to redirect at least a portion of a current flow going to the ground pad electrode responsive to an impedance change measured by the impedance measurement circuitry;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to the power supply.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• a multiplexing device coupled to the at least one electrode, a power supply coupled to the at least one electrode or a ground pad electrode coupled to the power supply;
• and
• a cable coupled to at least one of the housing, the multiplexing device or the energy delivery device, the cable being configured to be coupled to a power supply.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, at least a portion of the tissue contact surface being a conductive contact surface, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to at least one of the housing ,the energy delivery device, or the conductive surface, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, at least a portion of the tissue contact surface being a porous portion comprising a porous material, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus , comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• at least a portion of the tissue contacting surface having a lubricous coating;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• at least a portion of the tissue contacting surface having a textured surface;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, tissue contacting surface having a substantially radiused edge or a substantially tapered edge, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• at least one stop coupled to one of the housing or the advancement member the stop configured to limit a movement of at least one of the advancement member or the at least one electrode;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface, the at least one electrode including an insulator positioned in a surrounding relationship to the electrode;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a sensor coupled to at least one of the housing, the tissue contact surface, the energy delivery device, the at least one electrode or the advancement member;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• at least one infusion port coupled to at least one of the tissue contact surface, the energy delivery device, or the at least one electrode;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface, the housing defining an interior;
• an fluid delivery device positionable in the housing interior, the fluid delivery device including at least one hollow non conducting infusion member with at least one infusion aperture and a tissue penetrating distal end, the at least one infusion member configured to be advanced from the housing interior and into a target tissue site to infuse a fluid into tissue and define a tissue infusion volume, the fluid delivery device configured to be coupled to a fluid source;
• a handpiece coupled to the housing;
• an advancement device coupled to the fluid delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one infusion member from the housing interior into the target tissue site and completely withdrawal the at least one infusion member into the housing interior;
• and
• a conductor coupled to at least one of the fluid delivery device or the infusion member, the conductor being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing having a proximal end, a distal end including a tissue contacting surface having a plurality of apertures and a tissue access port, the housing defining an interior;
• an energy delivery device positionable in the housing interior, the energy delivery device including at least one electrode with a tissue penetrating distal end in substantial alignment with an aperture of the plurality of apertures, the at least one electrode configured to be advanced from the housing interior through the aperture and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece coupled to the housing;
• an advancement device coupled to the energy delivery device, the advancement device being at least partly positionable within at least one of the housing or the handpiece, the advancement device configured to advance at least a portion of the at least one electrode from the housing interior into the target tissue site and completely withdrawal the at least one electrode into the housing interior;
• and
• a cable coupled to one of the housing or the energy delivery device, the cable being configured to be coupled to an energy source.

A tissue surface treatment apparatus, comprising:

• a housing means having a proximal end, a distal end including a tissue contacting surface means having a plurality of apertures means, the housing means defining an interior;
• an energy delivery device means positionable in the housing means interior, the energy delivery device means including at least one electrode means with a tissue penetrating distal end in substantial alignment with an aperture means of the plurality of apertures means, the at least one electrode means configured to be advanced from the housing means interior through the aperture means and into a target tissue site to define an ablation volume at least partly bounded by a tissue surface;
• a handpiece means coupled to the housing means;
• an advancement device means coupled to the energy delivery device means, the advancement device means being at least partly positionable within at least one of the housing means or the handpiece means, the advancement device means configured to advance at least a portion of the at least one electrode means from the housing means interior into the target tissue site and completely withdrawal the at least one electrode means into the housing means interior;
• and
• a cable means coupled to one of the housing means or the energy delivery device means, the cable means being configured to be coupled to an energy source means.