Nanosecond plasma-mediated electrosurgery with elongated electrodes

Progress in interventional medicine is associated with the development of more delicate and less invasive surgical procedures, which requires more precise and less traumatic, yet affordable, surgical instruments. Previously we reported on the development of the pulsed electron avalanche knife for dissection of soft tissue in liquid media using the 100 ns plasma-mediated electric discharges applied via a 25 μ m disk microelectrode. Cavitation bubbles accompanying explosive vaporization of the liquid medium in front of such a pointed electrode produced a series of craters that did not always merge into a continuous cut. In addition, this approach of surface ablation provided a limited depth of cutting. Application of an elongated electrode capable of cutting with its edge rather than just with its pointed apex faces a problem of nonuniformity of the electric field on a nonspherical electrode. In this article we explore dynamics of the plasma-mediated nanosecond discharges in liquid medium in positive and negative polarities and describe the geometry of an electrode that provides a sufficiently uniform electric field along an extended edge of a surgical probe. A highly enhanced and uniform electric field was obtained on very sharp ( 2.5 μ m ) exposed edges of a planar electrode insulated on its flat sides. Uniform ionization and simultaneous vaporization was obtained along the whole edge of such a blade with 100 ns pulses at 4-6 kV. A continuous cutting rate of 1 mm/s in the retina and in soft membranes was achieved at a pulse repetition rate of 100 Hz. The collateral damage zone at the edges of incision did not exceed 80 μ m . Negative polarity was found advantageous due to the lower rate of electrode erosion and due to better spatial confinement of the plasma-mediated discharge in liquid.