Abstract: A cryosurgical instrument includes a feed line for conveying fluid into an expansion chamber. The feed line has a capillary line section that terminates in the expansion chamber and forms an aperture for the fluid to undergo the Joule-Thomson effect. The flow cross-section of the feed line decreases in at least one transition section of the feed line in the form of a funnel. Following each transition section there preferably follows a step section, in which latter section the flow cross-section is preferably largely constant. The last step section is preferably formed by the capillary line section. Due to the acceleration of the fluid in the transition sections and the abating of pressure fluctuations in the capillary tube section and, optionally in the additional step sections, the expansion range in the expansion chamber is increased, without impeding the backflow of the expanded gas out of the expansion chamber.

Abstract: A vapor delivery device includes an induction coil system. The induction coil system can include a coiled fluid tube, a coiled wire, a capsule between the coiled fluid tube and the wire, and a cooling fluid supply configured to force a cooling fluid through the capsule across the coiled wire. The induction coil system can include a closed loop ferrite core, a wire coiled around a first portion of the ferrite core, and a fluid tube coiled around a second portion of the ferrite core. A wire coil can be contained in a cartridge system removably coupleable to a disposable vapor delivery device. The system can include a fluid flow controller and induction power regulation to maintain a specific operating pressure range for vapor within a uterus or other bodily cavity, tract, or duct.

Abstract: A generator, ultrasonic device, and method of determining a temperature of an ultrasonic blade are disclosed. A control circuit coupled to a memory determines an actual resonant frequency of an ultrasonic electromechanical system comprising an ultrasonic transducer coupled to an ultrasonic blade by an ultrasonic waveguide. The actual resonant frequency is correlated to an actual temperature of the ultrasonic blade. The control circuit retrieves from the memory a reference resonant frequency of the ultrasonic electromechanical system. The reference resonant frequency is correlated to a reference temperature of the ultrasonic blade. The control circuit then infers the temperature of the ultrasonic blade based on the difference between the actual resonant frequency and the reference resonant frequency.

Abstract: Methods for creating and maintaining an anastomosis between two adjacent blood vessels using percutaneous techniques, for use in hemodialysis procedures are disclosed and described.

Abstract: An electrosurgical apparatus and method for performing thermal treatment in the gastrointestinal tract, e.g. to ablate duodenal mucosal tissue. The apparatus comprises an instrument having a flexible cable and an applicator suitable for use with a gastroscope, which can be deployed within a patient to delivery energy in a targeted or otherwise controllable manner. The applicator can deliver microwave energy by radiation. The direct and depth-limited nature of microwave energy can be make it more effective than treatments that rely on thermal conduction. The applicator may include a radially extendable portion arranged to move an microwave energy delivery structure into contact with duodenal mucosal tissue at the treatment region. The applicator may comprise any of a balloon, bipolar radiator, movable paddle, and rotatable roller element.

Abstract: A medical device includes a body and at least one electrode disposed thereon. The electrode includes a metallic substrate, such as a platinum group metal, an alloy of platinum group metals, or gold. The surface of the substrate is modified in a manner that increases its effective surface area without inducing bulk heating. For example, the surface of the substrate can be laser textured and/or coated, such as with titanium nitride or iridium oxide.

Abstract: A medical device that has a first array of loop electrodes and a second array of loop electrodes. The first array of loop electrodes and the second array of loop electrodes are configured to expand within a uterus and deliver a therapy current to tissue defining the uterus.

Abstract: An endosurgical device is provided. The endosurgical device comprises a flexible tube having at least two lengthwise extending channels, an end effector comprising two opposite jaws having opposite cutting edges, an effector sleeve that surrounds the tube at least at the distal tube end, and means for reciprocating the end effector axially in relation to the effector sleeve to close the jaws when the effector sleeve is moved forward and backwards to close and open the jaws, respectively. The exterior face of the opposite jaws is electrically insulated, and an electrical cord for providing current to the end effector extends inside one of the lengthwise extending channels of the tube. The endosurgical device may allow the surgeon to take several tissue specimens from an organ and to perform several functionalities when the device is inside the organ.

Abstract: The invention relates to a system (1) for stimulating renal nerves of a renal artery of a subject (3). The system comprises a stimulation device (12, 17, 28) for stimulating the renal nerves, a measuring unit (20) for measuring the blood pressure and/or the heart rate of the subject at at least two times, wherein at least one of these times is during or after the stimulation of the renal nerves, and a subject suitability determination unit (14) for determining whether the subject is suitable for a renal sympathetic denervation procedure based on the measured blood pressure and/or the measured heart rate. The invention allows therefore for a preselection of subjects which are suitable for a renal sympathetic denervation procedure.

Abstract: Various systems and methods for selectively controlling the activation of an ultrasonic surgical instrument according to the presence of tissue within an end effector are disclosed. A control circuit can be configured to determine whether tissue is present within the end effector and permit activation of the ultrasonic transducer at a power level according to whether tissue is present within the end effector. In some aspects, the control circuit can be configured to automatically activate the ultrasonic transducer in response to tissue being detected within the end effector.

Abstract: A method for determining a change of temperature of an object. The method may include heating an object and measuring scattering parameters (S-parameters) of scattered microwave electric fields from the object. A distorted Born iterative method may be used to determine a change of a dielectric property of the object based on the measured S-parameters. A change of temperature of the object may be determined based on the change of the dielectric property of the object.

Abstract: A method includes providing electrical energy to a transducer for sealing a vessel, where a frequency of the electrical energy is in an ultrasound range, controlling the electrical energy to achieve a predetermined velocity of an end effector coupled to the transducer, when the end effector is grasping the vessel, sensing parameters of the electrical energy when the end effector achieves the predetermined velocity, calculating power of the electrical energy based on the sensed parameters and estimating a size range of the vessel based on the power, and controlling the electrical energy to achieve a target velocity, which is determined based on the estimated size range of the vessel, to seal the vessel.

Abstract: An electrosurgical instrument (1) includes a first shaft member (110) pivotably coupled to a second shaft member (120), and a trigger (184) disposed on the second shaft member (120). The first and second shaft members (110,120) respectively include first and second handle members (130,140), and first and second jaw members (150,160). The first and second shaft members (110,120) define a longitudinal axis extending through a pivot, and first and second pivot axes that are substantially orthogonal to each other and the longitudinal axis. At least one of the first or second handle members (130,140) is pivotable about the first pivot axis to move the first and second jaw members (150,160) to an open position, a grasping position, or a sealing position. The trigger (184) is movable to pivot at least one of the first or second shaft members (110,120) about the second pivot axis to laterally displace the first and second jaw members (150,160) relative to each other to a cutting position.

Abstract: A medical device includes a shaft including a central lumen configured to direct a flow of fluid through the shaft, and an electrode positioned at a distal portion of the shaft. The electrode includes an electrode lumen in fluid communication with the central lumen, and the electrode lumen is configured to receive the flow of fluid from the central lumen. The electrode also includes one or more channels angled relative to the electrode lumen, and the one or more channels are in fluid communication with the electrode lumen to receive the flow of fluid from the electrode lumen. The one or more channels are configured to divert the flow of fluid from the electrode lumen toward one or more outlets laterally offset from the electrode lumen.

Abstract: A structure of a surgical instrument configured for thermally cutting tissue. The structure includes a frame and a thermal cutting element. The frame includes a proximal flange portion and a distal body portion. The distal body portion includes a proximal section extending from the proximal flange portion, a distal section, and a center section extending between the proximal and distal sections. The distal body portion includes first and second distal body portion segments. The distal body portion segments are disposed a first distance apart from one another at the proximal section, a second distance apart from one another at the distal section, and a third distance apart from one another at the center section. The third distance is greater than the first and second distances. The thermal cutting element is disposed within the distal body portion of the frame and extends from the proximal section, through the center section, to the distal section.

Abstract: A medical cooling device for reducing the body core temperature of a patient and a method for operating the same are provided. The cooling process provided by the medical cooling device is based on the state or degree of shivering of the patient.

Abstract: The device includes an outer conductor and an inner conductor arranged approximately coaxial with each other. The outer conductor surrounds the inner conductor. The outer conductor and the inner conductor are arranged and configured to generate an electromagnetic field with lines of force extending from a front surface of the inner conductor to a front surface of the outer conductor. The device further includes an energy delivery window arranged in front of the outer conductor and the inner conductor.

Abstract: Aspects of the present disclosure are presented for managing simultaneous outputs of surgical instruments. In some aspects, methods are presented for synchronizing the current frequencies. In some aspects, methods are presented for conducting duty cycling of energy outputs of two or more instruments. In some aspects, systems are presented for managing simultaneous monopolar outputs of two or more instruments, including providing a return pad that properly handles both monopolar outputs in some cases.

Abstract: A device, system, and method for treating an area of tissue and evaluating lesion formation and quality. The system may include a medical device having a plurality of mapping electrodes on a treatment element, the plurality of mapping electrodes being configured to record from the area of tissue at least one of unipolar impedance measurements, bipolar impedance measurements, local electrical activity, and pace threshold measurements before, during, and after circulation of the cryogenic fluid within the treatment element. These measurements may be transmitted to a control unit having processing circuitry configured to compare pre-treatment measurements, in-treatment measurements, and/or post-treatment measurements to each other and/or to threshold values to determine occlusion and/or lesion quality, such as lesion transmurality.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.