Abstract: A cardiac ablation device, including a steerable catheter (10) and an expandable ablation element (18) incorporating one or more balloons (20,22) at the distal end of the catheter, has a continuous passageway (28, 30) extending through it from the proximal end of the catheter to the distal side of the expandable ablation element. A probe (72) carrying electrodes is introduced through this passageway and deploys, under the influence of its own resilience, to a structure incorporating a loop (82) which is automatically aligned with the axis of the expandable ablation device, so that minimal manipulation is required to place the sensor probe.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that comprises a transducer configured to produce vibrations along a longitudinal axis at a predetermined frequency. In various embodiments, an ultrasonic blade extends along the longitudinal axis and is coupled to the transducer. In various embodiments, the ultrasonic blade includes a body having a proximal end and a distal end, wherein the distal end is movable relative to the longitudinal axis by the vibrations produced by the transducer.

Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation and clamping of tissue during surgical procedures. An elongated portion of the instrument can be configured for endoscopic applications and has an outside diameter of less than 6 mm. The construction includes a clamping mechanism, including a clamp arm pivotally mounted at the distal portion of the instrument, which is specifically configured to create a desired level of tissue clamping forces, exceeding 4 pounds when the trigger is fully closed. The clamping mechanism includes a force-limiting mechanism that effectively smooths out abusive tissue forces.

Abstract: Disclosed is an ultrasonic surgical instrument that includes a blade end-effector having a curved geometry. The curved geometry creates a curved surface with multiple asymmetries causing multiple imbalances within the blade. Imbalance due to the asymmetries of the blade is corrected by the appropriate selection of the volume and location of material removed from a functional asymmetry.

Abstract: A handpiece having at least one set of piezoelectric elements polarized to produce longitudinal motion when excited at the relevant resonant frequency. The piezoelectric crystals are connected to an ultrasonic horn to which a cutting tip is attached. The horn and/or the cutting tip contains a plurality of diagonal slits or grooves. The slits or grooves produce optimized torsional movement in the cutting tip when the piezoelectric crystals are excited at a second resonant frequency.

Abstract: Disclosed herein, among other things, are methods and apparatus related to ablation catheter systems with wireless temperature sensing. The present subject matter provides an ablation catheter system including an ablation catheter configured to ablate a target zone of tissue and at least one temperature sensitive resonator coupled to the ablation catheter. The resonator is configured to wirelessly emit a signal indicative of a sensed temperature in response to an interrogation signal. The ablation catheter system also includes an external device configured to provide the interrogation signal and to receive and decode the emitted signal from the resonator. The temperature sensitive resonator is configured to be placed proximate to and in thermal conduction with the target zone of tissue and to resonate at a frequency dependent upon a temperature of the resonator when excited by the interrogation signal, in various embodiments.

Abstract: In a surgical device having a control device and a button operatively connected to the control device, the control device operative to carry out at least two operational conditions of the surgical device, a method for operating the surgical device comprising pressing a single actuation member of the button to a first depressed position to thereby effect a first of the at least two operational conditions and pressing the actuation member in substantially the same direction to a second depressed position to thereby effect a second of the at least two operational conditions different from the first operational condition.

Abstract: Disclosed herein, among other things, are methods and apparatus related to ablation catheters with wireless temperature sensing. The present subject matter provides an ablation catheter system including an ablation transducer and a wireless temperature sensor. The wireless temperature sensor includes at least one temperature sensing element configured to sense a temperature-dependent parameter, circuitry configured to measure the sensed parameter and compute a temperature, a transmitter configured to wirelessly transmit a signal including at least one of the sensed parameter and the computed temperature, and a power supply. A controller is provided to coordinate timing of ablation therapy and sensing of the wireless temperature sensor, in various embodiments.

Abstract: An insert for a handheld ultrasound surgical device is disclosed. The insert comprises an interface to receive ultrasound vibrations and provide fluid to a channel within the insert. The insert also comprises a tip having a plurality of cutting elements disposed in a substantially circular configuration. Each of the cutting elements is disposed radially from the opening to provide a plurality of corridors that allows that fluid to pass from the opening to an edge of the tip.

Abstract: A surgical device. The surgical device may comprise a transducer configured to provide vibrations along a longitudinal axis and an end effector coupled to the transducer and extending from the transducer along the longitudinal axis. The surgical device also may comprise a lower jaw extending parallel to the end effector. The lower jaw may comprise a clamp face extending toward the longitudinal axis. Also, the lower jaw may be slidable relative to the end effector to bring the clamp face toward a distal end of the end effector.

Abstract: A surgical system includes a surgical instrument including a conducting section transmitting ultrasound vibration generated by an ultrasound transducer to a distal end portion and transmitting a high-frequency output signal to the distal end portion, an ultrasound drive section outputting an ultrasound drive signal to the ultrasound transducer, a high-frequency output section outputting a high-frequency output signal to the conducting section, a detection section detecting an ultrasound impedance of a surgical site to which ultrasound energy and high-frequency energy are provided from the distal end portion by outputting both signals simultaneously to the surgical instrument, a determination section determining whether the detected ultrasound impedance is in a predetermined range, and a control section performing control to increase a high-frequency output value by a first predetermined amount or decrease the high-frequency output value by a second predetermined amount when the detected ultrasound impedance i

Abstract: Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes advancing a puncture device towards a heart, the puncture device including an energy delivery device; measuring an electrical impedance at the energy delivery device; delivering energy from the energy delivery device to at least partially puncture a pericardium; and repeating one or more of the above steps, if necessary, until the energy delivery device is located at least partially within the pericardial cavity. Some embodiments of the method include using supplemental means of monitoring, including measuring voltage to plot an ECG, medical imaging and using contrast fluid, using tactile feedback, and aspirating fluid.

Abstract: A phacoemulsification needle having a hollow passageway terminates in a straight needle tip having a rectangular cross-sectional shape larger than the cross-sectional shape of the needle passageway. The tip is formed off-axis from the passageway, allowing the needle tip to move eccentrically when the needle is subjected to torsional or longitudinal vibratory motion. The inner and outer surfaces of the needle tip are roughened, as by sandblasting, to enhance the cutting effect of the tip when used with a non-longitudinal handpiece. The lip of each needle tip is polished to a high degree of smoothness and the edges of the tip are rounded to lessen the incidence of snags or cuts.

Abstract: An ultrasonic surgical instrument includes a transducer assembly having a distal engagement member and configured to supply ultrasonic energy. A waveguide defines a longitudinal axis and has a proximal engagement member configured to threadingly engage the distal engagement member. The waveguide is configured to transmit the ultrasonic energy therealong to a distal end thereof for treating tissue. A torque member is coupled to the transducer assembly and is disposed about the longitudinal axis. The torque member is selectively rotatable about the longitudinal axis and relative to the waveguide to threadingly engage the transducer assembly and the waveguide to one another. The torque member includes a plurality of fingers pivotably coupled thereto and movable between a closed position and an open position. In the open position, each finger extends substantially perpendicularly from the longitudinal axis to define a moment arm that facilitates the engagement of the transducer assembly and the waveguide.

Abstract: An ultrasonic treatment device includes a probe in which a hole-shaped portion, being opened at a first opening position placed at a distal end portion of the probe and a second opening position placed at an outer peripheral portion of the probe and allowing the first opening position and the second opening position to communicate with each other, is formed. The ultrasonic treatment device includes a path which is extended in the hole-like portion from the first opening position to the second opening position along the longitudinal axis, and which is extended to an outside of the probe from the second opening position, and the path being extended to the extending position of the fixed handle toward the handle extending direction in the fixed handle.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Generally, an ultrasound catheter includes an elongate flexible catheter body with one or more lumens. An ultrasound transmission member or wire extends longitudinally through the catheter body lumen and, in many embodiments, a guide wire tube also extends through the same lumen. A distal head is fixed to or otherwise mechanically coupled with the distal end of the ultrasound transmission member or wire and is positioned adjacent the distal end of the catheter body. Although the distal end of the catheter body overlaps the distal head, the distal head is not directly affixed to the distal end of the catheter body. Thus, the distal tip may move freely, relative to the distal end of the catheter body when ultrasonic energy is applied through the ultrasound transmission member.

Abstract: A medical system includes a sheath and an acoustic reflective element that is capable of amplifying acoustic energy. Methods of using a medical system are also provided herein.

Abstract: Methods and devices are provided for dissecting tissue. In one embodiment, a surgical device can include an elongate shaft configured to be introduced into a body of a patient. A transducer coupled to the elongate shaft can be configured to deliver mechanical energy to the elongate shaft, e.g., axially along the elongate shaft, to rotate, vibrate, and/or flex the elongate shaft to facilitate dissection of tissue adjacent at least a leading end or a distal end of the elongate shaft. In some embodiments the elongate shaft can include at least two coaxial coils, and the transducer can be configured to move at least one of the coaxial coils to facilitate tissue dissection using the elongate shaft.

Abstract: In a method for re-entry from extraluminal space into the central lumen of a vessel, a guidewire is advanced into the extraluminal space of the vessel, and then a directional catheter is advanced over the guidewire through the extraluminal space. Thereafter, the guidewire is removed from the directional catheter, an ultrasound device is placed through the directional catheter, and the ultrasound device is advanced through the extraluminal space into the central lumen and then activated.

Abstract: An ophthalmic surgical hand piece has a horn and two transducers. The horn has a central axis. A flange having a generally flat surface is coupled to the horn. The flange extends radially from the horn and generally perpendicular to the central axis. A first ear having a generally flat surface is coupled to the horn. The first ear extends from the horn such that the generally flat surface of the first ear is generally perpendicular to the generally flat surface of the flange. A first transducer is held against the flange, and a second transducer held against the ear.

Abstract: A method of at least partially removing the nucleus pulposus of an intervertebral disc comprising the nucleus and an annulus surrounding the nucleus is described. The method comprises the steps of : insonating the nucleus with ultrasound thereby to cause at least partial fragmentation of the nucleus; and extracting at least part of the fragmented nucleus. A system for performing the method is also described.

Abstract: The present invention relates to ultrasonic surgical clamping instruments and, more particularly, to a curved clamp arm for use with ultrasonic surgical instruments that have an ultrasonically actuated blade that, in one case, is ultrasonically actuated to have motion in substantially a single plane. The curved clamp arm opens and closes with respect to the blade and also has a plane of curvature that is parallel to the plane of motion of the blade when the clamp arm is in the closed position, and not parallel to the plane of motion of the blade when the clamp arm is in the open position.

Abstract: A surgical apparatus includes: a treatment section treating a living tissue; an energy generation section generating energy for providing ultrasound vibration or high-frequency current to the treatment section; a probe provided in the treatment section, for performing the ultrasound vibration; a liquid feeding unit supplying a liquid; a liquid feeding conduit feeding the liquid; a liquid feeding port, provided in the treatment section, for feeding the liquid toward the probe to feed the liquid to between the living tissue and the treatment section; a liquid feeding unit supplying the liquid to the liquid feeding conduit; an impedance detection section detecting an impedance of the living tissue is in contact with the treatment section; and a control section that controls the liquid feeding unit, after the stoppage of the output of the energy, so that as the impedance is larger, a predetermined period of time or a predetermined amount increases.

Abstract: A handpiece having a single set of piezoelectric elements polarized to produce longitudinal motion when excited at the relevant resonant frequency. The piezoelectric crystals are connected to an ultrasonic horn to which a cutting tip is attached. The horn and/or the cutting tip contains a plurality of diagonal slits or grooves. The slits or grooves produce optimized torsional movement in the cutting tip when the piezoelectric crystals are excited at a second resonant frequency. Preferably, the two drive frequencies are not coincident, but provided in non-overlapping pulses.

Abstract: This ultrasonic oscillation probe is an ultrasonic oscillation probe for transmitting ultrasonic vibration. A first region where the crystal grain size is relatively small and a second region where the crystal grain size is relatively large are respectively formed in at least one place. A method for manufacturing an ultrasonic oscillation probe respectively forms a first region where the crystal grain size is relatively small and a second region where the crystal grain size is relatively large in at least one place and heats a portion of the ultrasonic oscillation probe to a grain coarsening temperature or higher of a material that forms the ultrasonic oscillation probe, to form the second region.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Ultrasound catheter devices generally include an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. Improved features of ultrasound catheters include catheter bodies and ultrasound transmission members with increasing distal flexibility, guidewire tubes allowing contact between a guidewire and an ultrasound transmission member, distal heads with improved guidewire lumens, and torquable proximal housings for enhancing disruption of blood vessel occlusions.

Abstract: A method and system for noninvasive face lifts and deep tissue tightening are disclosed. An exemplary method and treatment system are configured for the imaging, monitoring, and thermal injury to treat the SMAS region. In accordance with an exemplary embodiment, the exemplary method and system are configured for treating the SMAS region by first, imaging of the region of interest for localization of the treatment area and surrounding structures, second, delivery of ultrasound energy at a depth, distribution, timing, and energy level to achieve the desired therapeutic effect, and third to monitor the treatment area before, during, and after therapy to plan and assess the results and/or provide feedback.

Abstract: A phacoemulsification needle having a hollow passageway terminates in a straight needle tip formed off-axis from the passageway, allowing the needle tip to move eccentrically when the needle is subjected to torsional or longitudinal vibratory motion. The tip may be flared or may be coextensive with the needle body. The aspiration passageway formed through the needle body may be formed off-axis from the needle body axis. The tip may also be angled with respect to the needle body. The inner and outer surfaces of the needle tip are roughened, as by sandblasting, to enhance the cutting effect of the tip when used with a non-longitudinal handpiece. The lip of each needle tip is polished to a high degree of smoothness and the edges of the tip are rounded to lessen the incidence of snags or cuts.

Abstract: According to some embodiments there is provided a method for controlling a treatment effect on blood vessel tissue during an ultrasonic treatment, the method comprising positioning an ultrasonic transducer device in the blood vessel lumen; controlling a treatment effect by controlling fluid flow, wherein controlling comprises deploying a fluid restrictor at a location relative to the transducer effective to block at least a portion of fluid flowing upstream, downstream or adjacent the transducer. According to some embodiments there is provided an ultrasonic transducer device sized for placement in a body lumen, and comprising a fluid restrictor effective to block at least a portion of fluid flowing upstream, downstream or adjacent the transducer. In some embodiments, the fluid is blood.

Abstract: The invention relates to a method for generating ultrasonic waves focused on a focal zone (5) in order to carry out biological lesions, comprising the activation of a plurality of ultrasonic transducer elements (3). According to the invention: a target zone, in which homogenization of the supply of energy of the ultrasonic waves emitted by the ultrasonic transducer elements is desired, is chosen, the focusing effect and the acoustic attenuations of the ultrasonic waves on their path between the target zone and the ultrasonic transducer elements (3) are determined, the focusing effect and the acoustic attenuations of the ultrasonic waves are compensated, with ultrasonic transducer elements (3) at least some of which have non-identical emission surfaces such that in the target zone, the supply of energy of the ultrasonic waves emitted by the different ultrasonic transducer elements (3) is more or less identical.

Abstract: Apparatus and methods are described that include ultrasound imaging devices, which may operate in a transmissive ultrasound imaging modality, and which may be used to detect properties of interest of a subject such as index of refraction, density and/or speed of sound. Devices suitable for performing high intensity focused ultrasound (HIFU), as well as HIFU and ultrasound imaging, are also described.

Abstract: Apparatus and methods are described that include ultrasound imaging devices, which may operate in a transmissive ultrasound imaging modality, and which may be used to detect properties of interest of a subject such as index of refraction, density and/or speed of sound. Devices suitable for performing high intensity focused ultrasound (HIFU), as well as HIFU and ultrasound imaging, are also described.

Abstract: An ultrasound transducer assembly includes an acoustic focusing lens and a therapy transducer mounted to a holder member so that the lens is movable relative to the transducer. The lens and the transducer are mounted to the holder member so that the lens is spaced a predetermined distance from the transducer element. A liquid layer having a thickness of the predetermined distance is provided between the lens and the transducer element. A solid backing member is disposed on a side of the transducer element opposite the lens. The backing member is spaced by an additional liquid layer of a predetermined thickness from the transducer element. The focusing depth of the lens—transducer assembly is controllable by transducer operating frequency.

Abstract: Methods for manipulating and/or reinforcing tissues are provided. The method includes applying a tissue reinforcement material to at least a portion of tissue to be manipulated and applying energy to one or both of the tissue reinforcement material and the tissue.

Abstract: The present invention relates to an apparatus, device and a method for harvesting blood vessels, and in particular, to such an apparatus, device and method in which the internal mammary artery (IMA) is harvested for coronary artery bypass graft (CABG) surgery using a minimally invasive approach or a conventional procedure.

Abstract: An ultrasonic instrument comprises an ultrasonic transducer, an acoustic waveguide, and an ultrasonic blade. The blade includes a pair of obliquely extending edges. The obliquely extending edges diverge away from the longitudinal axis of the waveguide and away from each other along respective paths extending distally in relation to the waveguide. A distal portion of the blade is wider than a proximal portion of the blade along a plane. The blade further includes a curved distal edge and several laterally presented surfaces. The laterally presented surfaces may provide combinations of concave and convex curvatures. The laterally presented surfaces may be angled and/or curved along one or more orthogonal planes associated with the longitudinal axis of the waveguide.

Abstract: Devices, systems and methods useable for dilating the ostia of paranasal sinuses and/or other passageways within the ear, nose or throat. A dilation catheter device and system is constructed in a manner that facilitates ease of use by the operator and, in at least some cases, allows the dilation procedure to be performed by a single operator. Additionally, the dilation catheter device and system may be useable in conjunction with an endoscope and/or a fluoroscope to provide for easy manipulation and positioning of the devices and real time visualization of the entire procedure or selected portions thereof. In some embodiments, an optional handle may be used to facilitate grasping or supporting a device of the present invention as well as another device (e.g., an endoscope) with a single hand.

Abstract: Various embodiments are directed to an apparatus and method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument. The method comprises generating at least one electrical signal. The at least one electrical signal is monitored against a first set of logic conditions.

Abstract: A surgical instrument comprising a trigger configured to be actuated by a proximally directed force and by a distally directed force. The trigger may comprise a proximal trigger portion having a first length and a distal trigger hook comprising a distal portion having a second length. The second length may be less than the first length. The distal trigger hook may be coupled to the proximal trigger portion.

Abstract: An ultrasound system has a catheter including an elongate flexible catheter body having at least one lumen extending longitudinally therethrough. The catheter further includes an ultrasound transmission member extending longitudinally through the lumen of the catheter body, the ultrasound transmission member having a proximal end connectable to a separate ultrasound generating device and a distal end coupled to the distal end of the catheter body. The distal end of the catheter body is deflectable. The ultrasound system also includes a sonic connector that connects the ultrasound transmission member to an ultrasound transducer. The ultrasound system also provides a method for reverse irrigation and removal of particles.

Abstract: Method and medical devices for generating and stabilizing micro or nano bubbles, and systems and methods for therapeutic applications using the bubbles, is provided. Two novel bubble generating means are provided: in-line capillary tubes and mix chambers flow focusing, and cross flow bubble generation with optimized bubble detachment means. A method and medical device to stabilize bubble sizes and improve bubble size homogeneity through rectified diffusion is disclosed. A method and system to facilitate acoustic activation of therapeutic agents using ultrasound energy is provided.

Abstract: This relates to treating airways in a lung to decrease asthmatic symptoms. The also includes steps of measuring a parameter of an airway at a plurality of locations in a lung, identifying at least one treatment site from at least one of the plurality of locations based on the parameter, and applying energy to the treatment site to reduce the ability of the site to narrow.

Abstract: An ultrasound system has an ultrasound transducer having a transducer housing and a horn provided at the distal end of the transducer housing, an ultrasound transmission member, a sonic connector that is connected to the horn and the proximal end of the ultrasound transmission member, and a catheter knob having a proximal end that is coupled to the distal end of the transducer housing. The catheter knob has a proximal bore that houses the sonic connector. The system also includes a nesting piece that is retained inside the proximal bore of the catheter knob. The nesting piece can be moved from a first position where the sonic connector is received inside the nesting piece to a second position where the sonic connector is separated from the nesting piece when ultrasound energy is being propagated through the ultrasound transmission member.

Abstract: One aspect of the present disclosure relates to a device for aspirating a biological tissue from a subject. The device can comprise a flexible, hollow shaft and an ultrasound assembly. The shaft can have a central portion that extends between a proximal end and a distal end thereof. The shaft can include a first lumen that extends between the proximal and distal ends. The ultrasound assembly can be connected to the distal end of the shaft. The ultrasound assembly can include a casing, at least one ultrasound transducer disposed within the casing, and a second lumen that extends through the ultrasound assembly and is in fluid communication with the first lumen. The at least one ultrasound transducer can be configured to generate acoustical waves having an intensity and frequency sufficient to disrupt, but not substantially damage, the biological tissue so that the biological tissue can be aspirated through the device.

Abstract: A method and system for ultrasound treatment of skin laxity are provided. Methods and systems can include ultrasound imaging of the region of interest for localization of the treatment area, delivering ultrasound energy at a depth and pattern to achieve the desired therapeutic effects, and/or monitoring the treatment area to assess the results and/or provide feedback. The exemplary treatment method and system can be configured for producing arrays of sub-millimeter and larger zones of thermal ablation to treat the epidermal, superficial dermal, mid-dermal and deep dermal components of tissue.

Abstract: An ultrasonic surgical instrument includes a body such as a handle assembly and an acoustic transmission assembly. The acoustic transmission assembly includes an ultrasonic transducer and an end effector. A mounting ring is positioned on a horn of the transducer. A rotatable drum is positioned distal to the mounting ring. Piezoelectric components of the transducer are positioned proximal to the mounting ring. Electrical conduits extend from the drum to the piezoelectric components and are routed over or through the mounting ring. The drum is coupled with a power source through a slip ring assembly to selectively activate the transducer.

Abstract: Described herein are methods and devices for selectively applying either fluids (e.g., anesthetics, nerve-blockers, etc.) or energy, such as radiofrequency or ultrasound energy, to a target tissue from within a blood vessel while minimizing the amount of fluid or energy applied to non-target tissue. The catheters described herein may include an elongate body, a directional injector, and one or more holdfasts for securing the catheter. In addition, catheters can include energy applying features for delivering energy to the target tissue.

Abstract: Disclosed are ultrasonic and electrosurgical devices. The disclosed embodiments include ultrasonic blades comprising various grasping features, devices configured to prevent ingress of surgical matter, e.g., fluid and tissue, in the space between an ultrasonic blade and an inner or outer tube distal of the distal seal, alternate closure mechanisms for ultrasonic devices, ultrasonic transducer rotation limiters to limit the rotation of an ultrasonic transducer, ultrasonic transducer rotation systems to provide unlimited continuous rotation of an ultrasonic device, integrated ultrasonic instrument electrically connected to provide RF spot coagulation with an ultrasonic (RF) generator, and coated ultrasonic/RF blades.

Abstract: Embodiments of dermalogical cell treatment are described generally herein. Other embodiments may be described and claimed.

Abstract: An ultrasonic clamp coagulator assembly that is configured to permit selective cutting, coagulation and clamping of tissue during surgical procedures. An elongated portion of the instrument can be configured for endoscopic applications and has an outside diameter of less than 6 mm. The construction includes a clamping mechanism, including a clamp arm pivotally mounted at the distal portion of the instrument, which is specifically configured to create a desired level of tissue clamping forces, exceeding 4 pounds when the trigger is fully closed. The clamping mechanism includes a two-piece pad design and pad material that enables the higher tissue clamping forces and a force-limiting mechanism that effectively smooths out abusive tissue forces. The assembly also features hand activation configured to provide an ergonomical grip and operation for the surgeon. Hand switches are placed in the range of the natural swing of the surgeon's thumb, whether gripping the surgical instrument right-handed or left handed.