Abstract: A surgical end effector may comprise first and second jaw members. The second jaw member may comprise an offset proximal supply electrode that is positioned to contact an opposing member of the first jaw member when the first and second jaw members are in the closed position. The second jaw member may also comprise a distal supply electrode that is positioned distal of the offset proximal electrode and is aligned with a conductive surface of the first jaw member when the first and second jaw members are in the closed position. When the first and second jaw members are in the closed position, the proximal supply electrode may be in contact with the opposing member and the distal supply electrode is not in contact with the conductive surface of the first jaw member.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods include evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions.

Abstract: An ablation cannula comprising a tubular body, a tip at an end of the tubular body adapted to facilitate the insertion of the cannula into a vein or body cavity, the tip having a distal end, a transducer disposed within the tip, and at least one bore hole in the tip through which a medication or other fluid may be administered, wherein the borehole is separated from the distal end of the tip by a first distance, which may be approximately 2.5 millimeters. The tip may contain at least three boreholes substantially equally spaced around the circumference of the tip. The boreholes may have a diameter of approximately 0.21-0.51 millimeters. Additional configurations are described herein. The transducer is preferably a radio frequency transducer, and an insulative material may be disposed on a selected portion of the tip to attenuate energy emitted from the radio frequency transducer through the insulative material.

Abstract: Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

Abstract: An electrosurgical access catheter for assisting a physician perform an ancillary surgical procedure on a region of interest (ROI) in a patient has a tubular shaped elongate shaft and a ring-shaped active electrode located at the distal end. A passageway extends from the proximal section to the distal end of the shaft, and through the ring-shaped active electrode. The proximal section of the elongate shaft is detachably coupled to an electrosurgical controller such that the ring-shaped active electrode is operable with the electrosurgical controller and a dispersive electrode to electrosurgically make a circular-shaped incision through a tissue wall, carving a cylindrical-shaped tissue plug as the ring-shaped active electrode is advanced through the wall. The access sheath is advanced through the surgically created opening and without further dilation of the opening. The invention has particular applicability to the lung, and minimally invasive bronchoscopic procedures. Related methods are also described.

Abstract: An ablation device and method for pulsed field ablation, the device comprising a catheter including an expandable basket, a set of electrodes formed on the expandable basket, and a pulse generator suitable for generating electric pulses wherein the pulse generator being in electrical connection with the set of electrodes. The expandable basket is formed of a braided mesh of filaments, wherein the filaments are made of nonconductive material, wherein at least portion of the filaments comprises a lumen, wherein the filaments further include electrodes and conductive wires. The conductive wires at least partially lead inside of the lumen of the filaments and are electrically connected to the electrodes.

Abstract: Methods, systems and devices for evaluating the integrity of a uterine cavity. A method comprises introducing transcervically a probe into a patient's uterine cavity, providing a flow of a fluid (e.g., CO2) through the probe into the uterine cavity and monitoring the rate of the flow to characterize the uterine cavity as perforated or non-perforated based on a change in the flow rate.

Abstract: A catheter is provided comprising a flexible heat transfer element provided on an outer surface of the catheter, a conduit arranged to supply an inflation fluid for inflating the flexible heat transfer element so as to form an inflated balloon, a guide wire lumen for receiving a guide wire, and an elongate cooling element arranged to cool said inflation fluid for inflating the balloon. Said cooling element and said guide wire lumen are arranged inside the flexible heat transfer element such that, when inflated the cooling element is substantially central within the balloon and said guide wire lumen is parallel to and radially offset from the cooling element.

Abstract: Electrosurgical systems and components thereof configured to deliver RF energy to a target site of a human or other animal patient with selectable RF energy delivery profiles, temperature sensors and controls, and/or electrodes configured to more uniformly or effectively delivery energy to target tissue.

Abstract: An irreversible electroporation (IRE) includes setting an initial IRE protocol for applying IRE pulses by electrodes of a catheter placed in contact with tissue in an organ. A notification is issued to a user upon determining that the initial IRE protocol is expected to cause bubbles in blood. In response to the notification, user input is received from the user, that selects between the initial IRE protocol and an alternative protocol that is not expected to cause the bubbles. The IRE pulses are applied according to the initial IRE protocol or the alternative IRE protocol, depending on the user input.

Abstract: An electrically insulating insert for detachable connection to the distal end region of a resectoscope shaft, characterized in that the insulating insert has a hollow portion with an elongate cavity for the passage of pass-through instruments, and that the insulating insert has fastening means for detachable connection to the resectoscope shaft. An electrode instrument is connected to this insulating insert and to a resectoscope including the same.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: A transseptal crossing needle has an elongate, flexible tubular body, having a proximal end, a distal end and an electrically conductive sidewall defining a central lumen. The distal end has a radially inwardly extending annular recess. The tubular body has a first outside diameter proximally of the annular recess and a second, smaller outside diameter in the recess. An electrode tip has a proximally extending connector residing within the annular recess, and the electrode tip has a third outside diameter distally of the connector, which is greater than the first diameter. An insulation layer encloses the sidewall and the connector, and has an outside diameter approximately the same as the third diameter to provide a uniform outside diameter throughout a distal zone of the needle.

Abstract: A catheter has a two-piece tip electrode with a shell and a support structure that are secured to each other by multiple redundant mechanisms in order to reduce the risk of tip detachment during a procedure. The tip electrode includes at least two different welds attaching the shell to the support structure to provide a dual failure mode. One weld includes a seam weld and another weld includes a penetration weld.

Abstract: A reusable tip for minimally invasive surgical instruments can include an end effector, a two-part hub, and a yoke. The end effector can include one or more movable portions enabling the end effector to move between first (e.g., open) and second (e.g., closed) positions via manipulation of the yoke within the hub. The hub can include a proximal hub and a distal hub coupled together. The end effector can be coupled to the distal hub, which can be made of a metal to provide high strength and secure shape to the distal hub. The proximal hub can be made of an autoclavable insulation material capable of maintaining a removable coupling with a control shaft. The proximal hub can be made of polyetheretherketone (PEEK).

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.

Abstract: Example embodiments relate to surgical systems having an end-effector assembly, first arm assembly, elbow joint section, and second arm assembly. First arm assembly forms a first arm assembly axis. First end of elbow joint section is pivotable relative to its second end. Second arm assembly includes second arm assembly body and first elbow drive assembly. Second arm assembly body forms a second arm assembly axis. First elbow drive assembly includes a first integrated motor and first elbow drive portion. First elbow drive portion is controllable by the first integrated motor to pivotally move the first arm assembly relative to an elbow axis. First arm assembly includes a second elbow drive assembly having a second integrated motor and a second elbow drive portion. Second elbow drive portion is controllable by the second integrated motor to rotate first arm assembly relative to first arm assembly axis.

Abstract: Methods and apparatus are disclosed for puncturing tissue, including a surgical introducer with a stiff main body and a flexible tip which can be used with a puncture device to gain epicardial access. The surgical introducer comprises an introducer shaft having a rigid portion and a flexible tip portion. The rigid portion has a metal tube extending to the rigid portion distal end. The flexible tip portion is distal of the metal tube distal end. The flexible tip portion includes a first polymer and a second polymer, wherein the second polymer is more flexible than the first polymer. The second polymer extends distally from the metal tube distal end to define a second polymer flexible tip segment. The first polymer extends distally from the second polymer flexible tip segment end to define a flexible tip portion cap.

Abstract: A surgical cutting and fastening instrument. The instrument comprises a handle and an end effector connected to the handle. The end effector comprises upper and lower opposing jaw members, wherein the upper jaw member comprises a plurality of co-linear, separately actuatable, RF electrodes.