An improved electrosurgical instrument and method is disclosed for simplifying making incisions and other treatments using
electrosurgery. The electrosurgical instrument comprises a body having more than two electrodes with at least two electrodes having
alternating current power supplied to them such that they comprise a bipolar
alternating current configuration and employ a means other than
electrode spacing, composition, or geometry for reducing or preventing accumulation of
eschar that would otherwise form a
short circuit current path and interfere with obtaining a predetermined surgical effect. In one aspect, such means for reducing or preventing
eschar accumulation consists of at least one other
electrode having a
direct current voltage between it and at least one of the two electrodes forming the
alternating current bipolar configuration. In another aspect of the invention two or more pairs of alternating current electrodes comprising bipolar electrodes are powered with alternating current having a nonzero RMS
voltage sufficient to at least reduce
eschar accumulations on one
electrode or induce
electrolysis of at least one component of a medium surrounding at least one pair of bipolar electrodes. The electrodes are separated from each other using electrically insulating materials such that
electric current does not flow between at least two of the bipolar alternating current electrodes unless they contact at least one other
electrically conductive medium, such as patient tissue or a medium comprising at least in part a
solid, liquid, gas, or ionized component that allows
electric current to flow between electrodes. In the aspect where at least one electrode is powered by
direct current the electrodes are configured such that
electrical current does not flow between at least one of the bipolar alternating current electrodes and at least one of the
direct current electrodes unless one or more media, such as patient tissue or a medium comprising at least in part a
solid, liquid, gas, or ionized component that allows
electric current to flow between electrodes, are contacting or adjacent to the electrodes having a direct
current voltage difference between them. The
assembly comprised of the electrodes and the separating insulating materials may also employ one or more means to reduce the current flowing between them that does not produce a desired predetermined surgical effect with one aspect of such means being using an outer insulating
coating configured such that one or more portions of at least one of the bipolar alternating current electrodes are insulated while leaving exposed other portions of such insulated electrodes so that they are capable of being in electrical communication with tissue or at least one material in electrical communication with tissue.