Instrument for endoscopic posterior nasal nerve ablation

Abstract

A surgical instrument includes an elongate shaft having a proximal shaft portion and a malleable distal shaft portion. The elongate shaft is configured to be secured to a supporting surgical instrument. An ablation head is coupled to the malleable distal shaft portion and includes at least one electrode operable to deliver RF energy to tissue for ablating the tissue. The ablation head is sized to fit within the nasal cavity of a patient with a distal end of the supporting surgical instrument. The proximal shaft portion is configured to operatively couple with an RF energy source operable to energize the at least one electrode with RF energy. The malleable distal shaft portion is configured to bend relative to a longitudinal shaft axis defined by the proximal shaft portion for selectively orienting the ablation head relative to the longitudinal shaft axis.

1 - 20 . (canceled) 
     
     
         21 . A surgical instrument assembly comprising:
 (a) an endoscope, the endoscope including an elongate shaft defining a longitudinal axis and having a distal end, the endoscope having a window with a field of view, the field of view including a region proximal to the distal end; and   (b) a surgical instrument comprising:
 (i) an elongate shaft having a malleable distal portion, a proximal region of the malleable distal portion being fixed against longitudinal movement relative to the endoscope; and 
 (ii) an ablation head coupled to the malleable distal portion, the ablation head including at least one electrode operable to deliver energy to tissue for ablating the tissue. 
   
     
     
         22 . The surgical instrument of  claim 21 , the at least one electrode comprising first and second electrodes operable to deliver bipolar RF energy to tissue. 
     
     
         23 . The surgical instrument of  claim 21 , the ablation head defining a distal end of an ablation instrument. 
     
     
         24 . The surgical instrument of  claim 21 , the ablation head extending distally from the malleable distal portion along a head axis, the malleable distal portion being configured to bend relative to the longitudinal shaft axis to orient the ablation head in a position in which the head axis is offset from and parallel to the longitudinal shaft axis. 
     
     
         25 . The surgical instrument of  claim 21 , the ablation head comprising a planar surface, the at least one electrode being disposed on the planar surface. 
     
     
         26 . The surgical instrument of  claim 21 , the ablation head being rectangular. 
     
     
         27 . The surgical instrument of  claim 21 , further comprising an electrical conductor housed within the elongate shaft, the electrical conductor being configured to electrically couple the at least one electrode of the ablation head with an energy source. 
     
     
         28 . The surgical instrument of  claim 21 , the elongate shaft comprising an electrically conductive material configured to electrically couple the at least one electrode of the ablation head with an energy source. 
     
     
         29 . The surgical instrument of  claim 21 , further comprising an electrical connector coupled with a proximal portion of the elongate shaft of the surgical instrument, the electrical connector being configured to releasably couple with an energy source to place the at least one electrode in electric communication with the energy source. 
     
     
         30 . The surgical instrument assembly of  claim 21 , the ablation head being configured to be positioned within the field of view. 
     
     
         31 . The surgical instrument assembly of  claim 21 , a proximal portion of the elongate shaft of the surgical instrument extending parallel to the elongate shaft of the endoscope. 
     
     
         32 . The surgical instrument assembly of  claim 21 , a proximal portion of the elongate shaft of the surgical instrument being in contact with the elongate shaft of the endoscope, the ablation head being configured to assume a position in which the ablation head is spaced apart from the elongate shaft of the endoscope. 
     
     
         33 . The surgical instrument assembly of  claim 21 , the ablation head including a first surface that faces toward the elongate shaft of the endoscope and an opposed second surface that faces away from the elongate shaft of the endoscope, the at least one electrode being disposed on the second surface. 
     
     
         34 . The surgical instrument assembly of  claim 21 , the endoscope further comprising a handle from which the elongate shaft of the endoscope extends distally, the elongate shaft of the endoscope and the surgical instrument being rotatable together relative to the handle about a longitudinal axis defined by the elongate shaft of the endoscope. 
     
     
         35 . A surgical instrument assembly comprising:
 (a) an endoscope, the endoscope including an elongate shaft having a longitudinal axis and a distal shaft end through which the endoscope is configured with a field of view, the field of view encompassing a region proximal to the distal shaft end; and   (b) an ablation instrument fixedly secured relative to the elongate shaft of the endoscope, the ablation instrument comprising:
 (i) a malleable shaft portion, and 
 (ii) an ablation head secured to the malleable shaft portion, the ablation head including at least one electrode operable to ablate patient tissue. 
   
     
     
         36 . The surgical instrument assembly of  claim 35 , the at least one electrode comprising first and second electrodes operable to deliver bipolar RF energy to tissue. 
     
     
         37 . The surgical instrument assembly of  claim 35 , a proximal end of the ablation instrument including an electrical connector configured to releasably couple with an energy source operable to deliver energy to the at least one electrode. 
     
     
         38 . A method of ablating tissue of a patient with a surgical instrument assembly comprising an endoscope and an ablation instrument, the endoscope defining a longitudinal axis and including a distal end configured to capture an image of patient anatomy within a field of view that includes a region that is proximal to the distal end, the ablation instrument being fixedly secured to the endoscope and including a malleable shaft portion and an ablation head having an electrode, the method comprising:
 (a) inserting the distal end of the endoscope and the ablation head into a cavity of a patient;   (b) under visualization provided by the endoscope via the field of view, positioning the electrode of the ablation head in electrical contact with the tissue; and   (c) energizing the electrode to thereby ablate the tissue.   
     
     
         39 . The method of  claim 38 , the ablation head including first and second electrodes, ablating the tissue comprising delivering bipolar RF energy to the tissue. 
     
     
         40 . The method of  claim 38 , further comprising bending the malleable shaft portion to position the ablation head at a first location relative to the distal end of the endoscope, inserting the distal end of the endoscope and positioning the electrode of the ablation head each being performed while maintaining the ablation head at the first location relative to the distal end of the endoscope.