# US 2019/0167335 A1 · Instrument and System for Ablation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167335 A1 - Document ID: US20190167335A1 - Status: Published application - Kind: A1 - Application number: 15/917,295 - Filed: 2018-03-09 - Published: 2019-06-06 - Earliest claimed: 2017-03-10 - Assignees: Erbe Elektromedizin GmbH - Applicants: Erbe Elektromedizin GmbH - Inventors: Thomas Staebler; Charlotte Herrberg; Achim Brodbeck - Web page: https://patentgrep.com/patent/US20190167335A1 ## CPC - A61B 18/042: {using additional gas becoming plasma} - A61B 1/00087: {Tools (A61B17/00234 takes precedence)} - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 1/2736: {Gastroscopes} - A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)} - A61B 2018/00166: {Multiple lumina} - A61B 2018/00494: {Stomach, intestines or bowel} - A61B 2018/00577: {Ablation} - A61B 2018/00982: {combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes} - A61B 2218/005: using gas or vapor, e.g. for protection or purging - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract An instrument for large-area ablation of the mucosa including at least one first gas supply line and at least one second gas supply line whose distal ends are arranged to form an acute angle (α), so that the ends diverge distally. A free space between the distal ends of the gas supply lines allows the user to view the tissue region behind the distal end of the instrument. Due to the acute angle (α), electrodes arranged at least partially in the ends of the gas supply lines generate a wide plasma beam with which the mucosa ablation can be performed. The instrument can be guided precisely due to the view through the free space. A connecting element according to the invention is provided for attaching the ends of the gas supply lines. ## Claims ### Claim 1 An instrument (11) for the treatment of tissue, in particular for mucosa ablation, comprising: a first gas supply line (35a) with a first electrode (41a) that is arranged at least partially in said line, and a second gas supply line (35b) with a second electrode (41b) that is arranged at least partially in said line, wherein the first gas supply line (35a) and the second gas supply line (35b) are arranged relative to each other in such a manner that a distal end (36a) of the first gas supply line (35a) forms an acute angle (α) with a distal end (36b) of the second gas supply line (35b), so that the first gas supply (35a) and the second gas supply line (35b) diverge in distal direction at their distal ends (36a,b), wherein, between the distal end (36a) of the first gas supply line (35a) and the distal end (36b) of the second gas supply line (35b), there is provided a free space (45) that allows a user to view between the distal ends (36a,b) of the gas supply lines (35a,b) through to a region of effect of the instrument (11) in front of the distal ends (36a,b) of the gas supply lines (35a,b). ### Claim 2 (depends on 1) The instrument (11) according to claim 1, wherein the first gas supply line (35a) and the first electrode (41a) are associated with a first probe (44a) and the second gas supply line (35b) and the second electrode (41b) are associated with a second probe (44b), wherein the first probe (44a) and the second probe (44b) are held by a connecting element (29) in such a manner that the distal end (36a) of the first gas supply line (35a) forms the acute angle (α) with the distal end (36b) of the second gas supply line (35b). ### Claim 3 (depends on 2) The instrument (11) according to claim 2, wherein at least one of the first and second probes (44a,b) is interchangeably attached with the connecting element (29). ### Claim 4 (depends on 2) The instrument (11) according to claim 2, wherein the distal ends (36a,b) of the gas supply lines (35a,b) project distally beyond the connecting element (29). ### Claim 5 (depends on 2) The instrument (11) according to claim 2, wherein at least one section of the first gas supply line (35a) is configured as a plastic line (38a) that extends, without interruption, through the connecting element (29), and wherein at least one section of the second gas supply line (35b) is configured as a plastic line (38b) that extends, without interruption, through the connecting element (29). ### Claim 6 (depends on 1) The instrument (11) according to claim 1, wherein the first gas supply line (35a) comprises a ceramic tube (39a) that is inserted in a distal end (40a) of a plastic line (38a) of the first gas supply line (35a), and wherein the second gas supply line (35b) comprises a ceramic tube (39b) that is inserted in a distal end (40b) of a plastic line (38b) of the second gas supply line (35b). ### Claim 7 (depends on 6) The instrument (11) according to claim 6, wherein the first gas supply line (35a) and the first electrode (41a) are associated with a first probe (44a) and the second gas supply line (35b) and the second electrode (41b) are associated with a second probe (44b), wherein the first probe (44a) and the second probe (44b) are held by means of a connecting element (29), and wherein proximal ends (46a,b) of the ceramic tubes (39a,b) are arranged in the connecting element (29). ### Claim 8 (depends on 6) The instrument according to claim 6, wherein the ceramic tubes (39a,b) project, at the distal ends (36a,b) of the gas supply lines (35a,b), distally beyond the plastic lines (38a,b). ### Claim 9 (depends on 1) The instrument (11) according to claim 1, wherein the instrument (11) comprises an additional probe (61) having a distal end (60) arranged on a distal end of the instrument (21). ### Claim 10 (depends on 9) The instrument (11) according to claim 9, wherein the first gas supply line (35a) and the first electrode (41a) are associated with a first probe (44a) and the second gas supply line (35b) and the second electrode (41b) are associated with a second probe (44b), wherein the first probe (44a) and the second probe (44b) are held by means of a connecting element (29), and wherein the additional probe (61) is arranged in a seat (65) of the connecting element (29) for the additional probe (61). ### Claim 11 (depends on 9) The instrument (11) according to claim 9, wherein the additional probe can be moved, relative to the arrangement of the distal end (36a) of the first gas supply line (35a) and the distal end (36b) of the second gas supply line (35b), in a proximal direction out of the free space (45). ### Claim 12 (depends on 1) The instrument (11) according to claim 1, (11) further comprising a sliding element (90) for guiding the instrument (11) over the tissue. ### Claim 13 (canceled) ### Claim 14 (depends on 2) The instrument (11) according to claim 2, wherein the connecting element (29) has distal extensions (53a,b), wherein the first gas supply line (35a) extends through the first extension (53a) and the second gas supply line (35b) extends through the second extension (53b), and wherein the free space (45) extends between the distal extensions (53a,b). ### Claim 15 (depends on 1) A system (91) comprising an endoscope (10) and the instrument (11) according to claim 1, wherein the instrument (11) is fastened to an outside of the endoscope (10). ### Claim 16 A method for tissue ablation with an instrument (11) comprising: a first gas supply line (35a) with a first electrode (41a) that is arranged at least partially in said line, and a second gas supply line (35b) with a second electrode (41b) that is arranged at least partially in said line, wherein the first gas supply line (35a) and the second gas supply line (35b) are arranged relative to each other in such a manner that a distal end (36a) of the first gas supply line (35a) forms an acute angle (α) with a distal end (36b) of the second gas supply line (35b), so that the first gas supply (35a) and the second gas supply line (35b) diverge in distal direction at their distal ends (36a,b), wherein, between the distal end (36a) of the first gas supply line (35a) and the distal end (36b) of the second gas supply line (35b), there is provided a free space (45) that allows a user to view between the distal ends (36a,b) of the gas supply lines (35a,b) through to a region of effect of the instrument (11) in front of the distal ends (36a,b) of the gas supply lines (35a,b), the method comprising: moving the instrument (10) along a path, transversely with respect to a line connecting the first and second electrodes (41a,b), at a distance from tissue to be ablated. ### Claim 17 (depends on 16) The method according to claim 16, further comprising applying an RF voltage to the first and second electrodes (41a,b) and alternatingly pulsing the RF voltage between the first and second electrodes (41a,b). ### Claim 18 (depends on 16) The method according to claim 16, further comprising, before thermal ablation of mucosa (84) by the instrument (11), introducing fluid into a stomach wall (82) in such a manner that a fluid cushion will form under desired ablation site (81). ### Claim 19 (depends on 9) The instrument (11) according to claim 9, wherein the additional probe (61) is configured to be slid in a distal direction beyond the distal ends (36a,b) of the first and second gas supply lines (35a,b).