Abstract: A steerable system and methods for accessing bone. A control mechanism includes a handle configured to be detachably secured to a trocar. The handle includes a drive shaft coupled to a sliding shaft such that relative rotation is prevented and relative translation is permitted. A rod having a preformed bend is removably disposed within the cannula. The rod is prevented from rotating relative to the drive shaft such that a deflection plane of the preformed bend is predefined relative to each of the sliding shaft, the handle, and the trocar when the handle is coupled to the trocar. Rotating a sliding ring of the handle translates the drive shaft to advance the rod beyond the trocar such that the preformed bend extends laterally out of the trocar in the deflection plane. The rod may be removed from the cannula, and material may be injected through the cannula.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Abstract: System and method for selectively applying electrical energy to structures within or on the surface of a patient's body and controlling the flow of an electrically conductive fluid from the application site to provide or maintain a desired operating condition of the electrosurgical device. An electrosurgical probe is in communication with a fluid transport apparatus through a fluid transport lumen having an opening at an end proximate the application site and disposed proximate the electrosurgical probe. A controller in communication with the fluid transport apparatus provides control signals to the fluid transport apparatus in response to at least one operating parameter associated with the system. Based on the received control signals, the fluid transport apparatus adjusts a flow rate of the electrically conductive fluid at the application site through the fluid transport lumen in response to at least one operating parameter associated with the system.

Abstract: The disclosure relates to systems and methods for irrigated bipolar radiofrequency ablation. The system includes an ablation probe that includes an elongate inner electrode assembly and an elongate outer electrode assembly. An irrigation path for irrigation fluid flow is defined between the outer surface of the inner electrode assembly and the outer surface of the outer electrode assembly. The irrigation path enables cooling fluid to be circulated within the probe body, cooling the outer electrode during ablation.

Abstract: A catheter and catheter system for treatment of a blood vessel of a patient include an elongate flexible catheter body with a radially expandable structure. A plurality of electrodes or other electrosurgical energy delivery surfaces can radially engage material to be treated when the structure expands. A material detector near the distal end of the catheter body may measure circumferential material distribution, and a power source selectively energizes the electrodes to eccentrically treat of a body lumen.

Abstract: Flexible high-density mapping catheter tips and flexible ablation catheter tips with onboard high-density mapping electrodes are disclosed. These tips can be used for diagnosing and treating cardiac arrhythmias. The flexible, distal tips are adapted to conform to tissue and comprise a plurality of microelectrodes mounted to permit relative movement among at least some of the microelectrodes. The flexible tip portions may comprise a flexible framework forming a flexible array of microelectrodes (for example, a planar or cylindrical array) adapted to conform to tissue and constructed at least in part from nonconductive material in some embodiments. The flexible array of microelectrodes may be formed from a plurality of rows of longitudinally-aligned microelectrodes. The flexible array may further comprise, for example, a plurality of electrode-carrying arms or electrode-carrier bands. Multiple flexible frameworks may be present on a single device.

Abstract: An electrosurgical vessel sealing device that can seal biological vessels using a confined microwave field that yields a well-defined seal location with low thermal margin. The device comprises a pair of jaws that are movable relative to each other to grip biological tissue. A blade for cutting the gripped tissue is slidable between the jaws. A coplanar microstrip antenna is mounted on the inner surface of one or both of the pair of jaws to emit microwave energy into the gap therebetween. The device may comprise a separate dissector element to enable fine tissue cutting and dissection to be performed.

Abstract: In a flexible catheterization probe a resilient member couples the tip to the distal portion of the probe and is configured to deform in response to pressure exerted on the tip when engaging tissue. A position sensor in the distal portion of the probe senses the position of the tip relative to the distal portion of the probe. The relative position changes in response to deformation of the resilient member. The position sensor generates a signal indicative of the position of the tip responsively to a magnetic field produced by a magnetic field generator located in the position sensor. The position sensor has a first coil of conductive wire having first windings, and three second coils of conductive wire having respective second windings. The second coils are symmetrically distributed about the longitudinal axis of the first coil.

Abstract: A system for performing a diagnostic or therapeutic procedure within a subject includes a device having a distal portion configured for insertion within a lumen or duct of the subject, the device including an elongate body having a longitudinal axis, the elongate body comprising a polymeric material and having a proximal end and a distal end, one or more electrically-conductive tracings carried on a first surface of the elongate body and configured to carry a signal, and one or more conductors embedded within the polymeric material and configured to carry a signal.

Abstract: The invention comprises an apparatus for performing cardiac ablation by electroporation comprising: an applicator comprising a plurality of electrodes (16) each operable in use to supply an electrical potential across cells within an area of tissue (12); and a means to control the waveform of the electrical potential supplied by the plurality of electrodes, configured to provide a biphasic, truncated waveform with leading and trailing edges of differing magnitude.

Abstract: The present invention relates to a therapeutic device capable of alternatingly outputting a low-frequency wave or an ultrasonic wave and heat, and more particularly, the present invention includes: a heat output unit; and a low-frequency wave output unit which generates a low-frequency wave that is outputted alternatingly with heat outputted by the heat output unit, or includes: a heat output unit; and an ultrasonic wave output unit which generates an ultrasonic wave that is outputted alternatingly with heat outputted by the heat output unit.

Abstract: Apparatuses, systems and methods are provided for treating pulmonary tissues via delivery of energy, generally characterized by high voltage pulses, to target tissue using a pulmonary tissue modification system (e.g., an energy delivery catheter system). Example pulmonary tissues include, without cells), lamina propria, submucosa, submucosal glands, basement membrane, smooth muscle, cartilage, nerves, pathogens resident near or within the tissue, or a combination of any of these. The system may be used to treat a variety of pulmonary diseases or disorders such as or associated with COPD (e.g., chronic bronchitis, emphysema), asthma, interstitial pulmonary fibrosis, cystic fibrosis, bronchiectasis, primary ciliary dyskinesia (PCD), acute bronchitis and/or other pulmonary diseases or disorders.

Abstract: Novel and versatile apparatuses for delivering one or more of thermal ablation and irreversible electroporation therapies to target tissue. In some examples, a device includes at its distal end a plurality of electrodes that can be advanced or retracted to pierce patient tissue, with a variable position and size shaft electrode provided near the distal end of the device to allow manipulation of therapy fields to achieve various tissue destruction field shapes. A number of method of use examples are described as well.

Abstract: A target-treating system treats a target disposed within a bone of a patient. The system comprises a probe configured to be inserted into the bone and navigated therethrough toward the target. The probe comprises a shaft that includes a proximal end, a distal end, and a main body extending between and interconnecting the proximal end and the distal end. The distal end is configured to engage the target such that, upon activation of the probe, the target is treated.

Abstract: A sleeve insertion assembly includes a sleeve inserter defining an inner chamber and having a distal end and a proximal end opposite the distal end, a sleeve receivable within the inner chamber, and a blade guard receivable within the sleeve and having a cylindrical body that defines an interior and an open end. The open end is sized to receive jaw members of an end effector into the interior but prevent the end effector from entering the interior, and the blade guard is forced out of the sleeve when the sleeve is installed on the end effector.

Abstract: An ablation catheter for treating cardiac arrhythmias by ablating near pulmonary venous tissue is described. The ablation catheter includes a system of optical fibers containing respective fiber Bragg gratings (FBG) that are susceptible to changes in strain to thereby indicate to the physician the amount of force that the ablation head is exerting on the myocardial tissue during the ablation procedure. Optionally, the FBGs are used to indicate the exact orientation of the catheter and its ablation head inside the vasculature.

Abstract: In this patent disclosure, various embodiments of using near-field communication (NFC) to facilitate the transfer of data and power between a robotic surgical system and a surgical tool attached to the robotic surgical system are disclosed. In one aspect, a process for automatically managing surgical tool attachment in a robotic surgical system can begin by detecting an attachment of a surgical tool. The process next establishes a secure near-field communication (NFC) link between a first NFC module embedded in the robotic surgical system and a second NFC module embedded in the surgical tool. Next, the process requests tool calibration data from the surgical tool via the secure NFC link. The process subsequently uses the received tool calibration data to initialize the surgical tool so that the surgical tool is ready for use.

Abstract: A catheter is disclosed comprising a catheter shaft including a proximal end and a distal end. A flexible framework can be connected to the distal end of the catheter shaft, wherein the flexible framework includes a plurality of heating electrodes and a temperature sensor. The plurality of heating electrodes can be configured to be heated to a first temperature, the first temperature being lower than which radio frequency ablation is performed. The plurality of heating electrodes can be configured to be heated to a second temperature, the second temperature being a temperature at which radio frequency ablation is performed.

Abstract: Ablation systems and methods detect and address distortion caused by a variety of factors. A method includes measuring a temperature curve at target tissue; applying ablation energy to the target tissue; determining a peak temperature on the temperature curve; if the peak temperature is greater than the predetermined peak temperature, determining a time at which the temperature curve crosses to a lower temperature; and if the determined time is greater than a predetermined time, generating a message indicating that the target tissue was successfully ablated. Another method includes determining a distance between a remote temperature probe and an ablation probe, applying ablation energy to target tissue, measuring temperature at the remote temperature probe, estimating ablation size based on the determined distance and the temperature measured by the remote temperature probe, and determining whether the target tissue is successfully ablated based on the estimated ablation size.

Abstract: An aspiration thrombectomy system, comprising an aspiration catheter having a proximal end and a distal end, wherein the proximal end of the aspiration catheter comprises a lumen configured to accommodate fluid, a vacuum source comprising a controllable vacuum valve, and a controller configured to detect a change in a connection between the aspiration catheter and the aspiration thrombectomy system, wherein the controller is further configured to change a pulsation protocol associated with the aspiration catheter responsive to the change in the connection between the aspiration catheter and the aspiration thrombectomy system, wherein the pulsation protocol specifies pressure variations and pressure patterns to modulate the vacuum valve to change a level of vacuum at the distal end of the aspiration catheter.

Abstract: A system and method for assessing effective delivery of ablation therapy to a tissue in a body is provided. A three-dimensional anatomical map of the tissue is generated and displayed with the map defining a corresponding volume. An index is generated corresponding to a location within the volume with the index indicative of a state of ablation therapy at the location. The index may be derived from one or more factors such as the duration an ablation electrode is present at the location, the amount of energy provided, the degree of electrical coupling between an ablation electrode and the tissue at the location and temperature. A visual characteristic (e.g., color intensity) of a portion of the anatomical map corresponding to the location is then altered responsive to the index.

Abstract: A biological tissue monitoring system has control circuitry programmed or configured to monitor an impedance of biological tissue. The control circuitry is programmed or configured to receive or determine an impedance measurement of the biological tissue in response to power delivered to the biological tissue at a plurality of frequencies and a plurality of time points, and adjust or cause to be adjusted the power delivered to the biological tissue at a subsequent time point based on the impedance measurement at the plurality of frequencies and the plurality of time points.

Abstract: A handle for longitudinal movement of a first tubular member over a second tubular member includes a handle body, a nose cone, a locking mechanism, and a retraction control. The nose cone has a sleeve and an outer wall that define a control channel therebetween. The nose cone is moveable over the handle body between extended and retracted positions. The locking mechanism has locked and unlocked positions for selectively fixing the nose cone in the extended and retracted positions. A finger of the retraction control is positioned within the control channel of the nose cone. The retraction control has first and second positions relative to the nose cone for transitioning the locking mechanism between the locked and unlocked position and for moving the nose cone between the extended and retracted positions.

Abstract: A method, system, and device for electroporation. A system may include a medical device with a plurality of electrodes borne on an expandable element and an energy generator in communication with the electrodes. The energy generator may have processing circuitry configured to selectively deliver electroporation energy to at least one of the electrodes. The processing circuitry may determine whether an alert condition is present and, if so, cease the delivery of electroporation energy to one or more electrodes identified as the cause of the alert condition and/or prevent the delivery of electroporation energy to the one or more electrodes identified as the cause of the alert condition. The energy generator may also be configured to deliver electroporation energy in a sequence of a plurality of energy delivery patterns to enhance lesion formation.

Abstract: Described herein are methods of performing immunotherapy on a subject and/or determining if a subject will be responsive to ablation immunotherapy.

Abstract: Systems and methods for neuromodulation therapy are disclosed herein. A method in accordance with embodiments of the present technology can include, for example, positioning a plurality of reference electrodes at the skin of a human patient and intravascularly positioning a plurality of ablation electrodes within a blood vessel lumen at a treatment site. The method can include obtaining impedance measurements between different combinations of the reference electrodes and the ablation electrodes and, based on the impedance measurements, identifying two or more electrode groups for treatment, where at least two of the electrode groups include a different one of the reference electrodes and a different one of the ablation electrodes.

Abstract: Medical methods and systems are provided for effecting lung volume reduction by selectively ablating segments of lung tissue.

Abstract: A medical device system may include a structure including a first elongate member, a line including a plurality of flexible members, and an actuator coupled to the line to selectively transmit force to at least the first elongate member. The structure may include a delivery configuration in which at least a portion of the structure is arranged to be percutaneously delivered to a bodily cavity. Respective portions of the flexible members may be intertwined together to form a braided portion of the line, and the line may include an unbraided portion secured at least to the first elongate member. The braided portion of the line may be located between the actuator and the first elongate member.

Abstract: A method, consisting of ablating tissue for a time period, measuring a contact force applied during the time period, and measuring a power used during the time period. The method further includes ceasing ablating the tissue when a desired size of a lesion produced in the tissue, as estimated using an integral over the time period of a product of the contact force raised to a first non-unity exponent and the power raised to a second non-unity exponent, is reached.

Abstract: Intrauterine devices and methods for facilitating deployment thereof using a bumper are disclosed. In one embodiment, an intrauterine device comprises a structure including a first central support member and a deployment mechanism coupled to the first central support member. The intrauterine device further comprises a bumper positioned at a distal end of a second central support member and at a more distal position relative to a distal end of the structure so as to prevent the distal end of the structure from contacting the fundus of the uterus of a patient during deployment of the deployment mechanism. In another embodiment, the intrauterine device comprises a bumper coupled to the deployment mechanism and configured to move from a more distal to a more proximal position relative to a distal end of the structure.

Abstract: A cutting guard for use with a wound retractor includes a body having a lumen including a flexible inner surface with a ground contact extending therethrough. A ground guard is included having proximal and distal openings that define a guard lumen therethrough, the ground guard encapsulating the flexible inner surface of the body lumen. A biasing element is disposed within the guard lumen and encircles the flexible inner surface and biases the flexible inner surface inwardly. A cutting electrode is disposed proximate the distal opening of the ground guard and connects to a first electrical potential and the ground guard connects to a second electrical potential. Upon externalizing of tissue through the distal opening, oversized tissue forces the flexible inner surface of the body lumen and the ground contact outwardly to engage the ground guard to complete an electrical circuit and energize the cutting electrode to excise oversized tissue.

Abstract: An electrophysiology catheter has a micro capacitive tactile sensor provided in the distal section. The distal section may include a tip electrode, a ring electrode and/or a balloon catheter adapted for tissue contact. The capacitive force sensor is configured to exhibit a change in capacitance with tissue contact wherein the force applied with tissue contact is measured and reliably calibrated in assessing and determining the applied force. The capacitive force sensor has a first plate affixed to a tissue contact portion of the catheter, a second plate configured for contact with the tissue, and an elastically compressible dielectric between the first and second plates, wherein the force sensor has a first capacitance when the first and second plates are separated by a first distance, and the force sensor has a second capacitance when the first and second plates are separated by a second different from the first distance.

Abstract: An electroporation therapy apparatus method, and system is provided. The apparatus, system, and method comprise an electroporation generator (26). The electroporation generator (26) is configured to output an asymmetric balanced waveform to a medical device, and the asymmetric balanced waveform comprises a first positive phase and a first negative phase. The first positive phase comprises a first current and a first time and the first negative phase comprises a second current and a second time. The first current is greater than the second current and the second time is greater than the first time. The asymmetric balanced waveform is configured to irreversibly electroporate a target tissue.

Abstract: A method of treating an anatomical cavity of a patient comprises introducing an infusion/aspiration catheter into the patient, such that a plurality of arms of the catheter reside within the anatomical cavity, delivering a fluid into the at least one of a connector, such that fluid exits the at least one fluid port of at least one of the arms, thereby infusing the anatomical cavity with the fluid, and aspirating the fluid into the at least one fluid port of at least one of the arms, such that the fluid exits the connector(s).

Abstract: An ablation needle apparatus (10) for delivering ablation energy (20) to a subject (40) comprising a hypotube with a proximal and distal end and having a hollow lumen, including a puncture member and a first electrode disposed at the distal end of the hypotube; a second electrode disposed within the hollow lumen; and a first ring member disposed about the second electrode and slidably holding the second electrode apart from the first electrode; wherein the first ring member comprises a semipermeable structure that allows for the passage of a gas and resists the passage of a liquid from the distal end to the proximal end of the hypotube.

Abstract: Embodiments disclosed herein are directed to devices, methods, and systems for the treatment of tissue using energy delivery. Specifically, certain embodiments may be used for the treatment of lung tissue, such as lung nodules, using RF ablation, via a catheter provided with a first electrode attached to a distal end of the catheter, wherein the first electrode is hollow, wherein the first electrode comprises a piercing tip configured to pierce through an airway wall and a second electrode received in a movable manner within the first electrode, wherein the second electrode is extendable from the first electrode to form a first extended configuration.

Abstract: In some embodiments, data sensed and/or operational parameters used during a catheterization procedure are used in the motion frame-rate updating and visual rendering of a simulated organ geometry. In some embodiments, measurements of and/or effects on tissue by sensed and/or commanded probe-tissue interactions are converted into adjustments to the simulated organ geometry, allowing dynamic visual simulation of intra-body states and/or events based on optionally partial and/or non-visual input data. Adjustments to geometry are optionally to 3-D positions of simulated data and/or to simulated surface properties affecting geometrical appearances (e.g., normal mapping). Optionally, the organ geometry is rendered as a virtual material using a software environment (preferably a graphical game engine) which applies simulated optical laws to material appearance parameters affecting the virtual material's visual appearance.

Abstract: Methods, devices, and systems are described herein for applying energy to tissue for ablation of tissue while allowing the tissue to be resorbed within the body. Such methods, devices, and systems control application of energy to maintain a temperature of target tissue above an ablation temperature, being dependent upon the activation time, and below a transformation temperature, also being dependent upon the activation time, where the transformation prevents or hinders resorption of the treated tissue by the body.

Abstract: A surgical instrument includes a housing, energizable member, first activation switch, cable assembly, and second activation switch. The housing is operatively associated with the energizable member. The first activation switch is coupled to the energizable member and is selectively transitionable from an open condition to a closed condition. The cable assembly is coupled to the housing at a first end and includes a plug at a second, opposite end, the plug housing a second activation switch selectively transitionable from an open condition to a closed condition. The plug is adapted to connect to the source of electrosurgical energy, wherein transitioning of the first activation switch from the open condition to the closed condition transitions the second activation switch from the open condition to the closed condition such that the second activation switch communicates with the source of electrosurgical energy to initiate the supply of energy to the energizable member.

Abstract: A method includes operating an optical tracking sensor to track configurations of first and second sets of optical fiducials, the first set on a patient and the second set on a reference portion of a medical instrument including an elongated flexible body and a rigid proximal body comprising a reference portion. A teleoperational manipulator is configured to move the rigid proximal body and second set along a fixed linear path. The method includes receiving shape information from a shape sensor and determining, using the second set, a position of a reference point of the shape sensor for a plurality of insertion measurements of a position measuring device. The method also includes determining a pose of a portion of the elongated flexible body with respect to a patient anatomy using the configuration of the first set of optical fiducials, the position of the reference point, and the shape information.

Abstract: A medical system, including a medical device having a plurality of deployable arms, and at least one electrode on at least one of the plurality of arms; and an electric signal generator in communication with the medical device, the electric signal generator programmed to deliver pulsed energy to the medical device sufficient to induce irreversible electroporation ablation.

Abstract: The present invention relates to a high-frequency treatment device for spinal endoscopic surgery, the device including: a casing; an insert rod extending in a longitudinal direction of the casing; and an electrode tip formed at a front end of the insert rod to apply heat to a treatment part. Accordingly, it is possible to not only immediately remove in-body soft tissues or ligaments that interfere with the visual field of an endoscope in an operation, but quickly stop bleeding, and it is also possible to discharge contaminated substances with a saline solution from a treatment part, thereby allowing an accurate and effective operation.

Abstract: Systems, instruments, and methods for minimally invasive procedures including one or more of fractional resection, fractional lipectomy, fractional skin grafting, and/or fractional scar revision are described. Embodiments include instrumentation comprising a scalpet assembly coupled to a carrier, and the scalpet assembly includes a scalpet array. The scalpet array includes one or more scalpets configured for fractional resection, fractional lipectomy, fractional skin grafting, and/or fractional scar revision. The system includes a vacuum component coupled to the scalpet assembly and configured to evacuate tissue from the a site. The carrier is configured to control application of a rotational force and/or a vacuum force to the scalpet assembly.

Abstract: A kit of parts for use in treatment of tissue by a contained plasma and/or plasma products is disclosed. The kit of parts includes a plasma generating device for use with a membrane dressing attached to tissue requiring treatment. The plasma generating device comprises a first cavity with an opening at one end formed between a grounded electrode and a cathode such that, in use, an arc discharge between the cathode and the grounded electrode ionizes a feed gas to produce at the open end a thermal plasma. Furthermore, the plasma generating device also comprises a second cavity with an opening at one end formed between a high voltage electrode and a grounded electrode such that, in use, a dielectric barrier discharge between the high voltage electrode and grounded electrode ionizes a feed gas to produce at the open end a non-thermal plasma.

Abstract: The disclosure relates to a medical imaging device, a method for supporting medical personnel, a corresponding computer program product, and a corresponding computer-readable storage medium. In the method, a 3D data record is received from a first imaging modality and image data of an examination object is received from a second imaging modality. Different tissue regions of the same organ are imaged with different imaging properties at least under the second imaging modality. A tissue boundary is detected between the tissue regions in the image data. For registration of the image data with the 3D data record, the tissue boundary is aligned at a corresponding tissue boundary in the 3D data record. In addition, or alternatively, based on the tissue boundary, an automatic movement compensation takes place of a movement of the examination object which has occurred during the generation of the image data.

Abstract: Energy delivery devices with a flexible circuit. The energy delivery devices may be used in the treatment of human tissue, and the flexible circuit move or flex during use. The flexible circuit may include an electronic component and a trace connected with the electronic component. The trace may have a plurality of sections that provide parallel current paths over a portion of the trace. Alternatively, the flexible circuit may include a plurality of traces that are connected with the terminal of the electronic component to provide parallel current paths over their entire length to the terminal of the electronic component. These redundant parallel current paths improve device reliability.

Abstract: The present invention provides devices and methods for decalcifying an aortic valve. The methods and devices of the present invention break up or obliterate calcific deposits in and around the aortic valve through application or removal of heat energy from the calcific deposits.

Abstract: Methods and apparatus for end effector control and calibration are described. The method may include detecting a signal in response to movement of a first tube relative to a second tube, the first tube driving movement of a clamp arm of the end effector. The method may further include determining a clamp arm position of the end effector relative to a ultrasonic blade of the end effector based on the signal. The method may also include adjusting a power output to the ultrasonic blade of the end effector based on the clamp arm position.

Abstract: The present invention generally relates to improved medical devices, systems, and methods, with exemplary embodiments providing improved cooling treatment probes and cooling treatment methods and systems. In some embodiments, freezing of the skin may be desirable to effect the hypopigmentation of the skin of the patient. Generally, embodiments may limit supercooling of the skin of the patient during a cooling treatment. Additionally, embodiments may limit adverse side effects such as hyperpigmentation. It has been found that the freezing behavior (frequency and time to freeze) can be modified by adjusting the thermal parameters of the cooling applicator. Accordingly, in some aspects of the invention, a method of treating the skin may be provided where the thermal parameters of the cooling applicator are adjusted during treatment.

Abstract: A robotic surgical system employing a treatment catheter (30) (e.g., a thermoablation catheter or a cyroablation catheter), and an articulated robot (40) including a the linkages for navigating the treatment catheter (30) within an anatomical region. The robotic surgical system further employs a robot controller (41) for controlling a navigation by the articulated robot (40) of the treatment catheter (30) along a intraoperative treatment path within the anatomical region relative to the anatomical structure derived from a planned treatment path within the anatomical region relative to the anatomical structure based on a registration between the articulated robot (40) and a preoperative image (21a) illustrative of the planned treatment path within the anatomical region relative to the anatomical structure.