Abstract: System and methods of an electrosurgical controller having multiple modes of operation that are configured for treatment of a specific targeted tissue type and the electrosurgical effect desired where the treatment and effect are provided by a single controller and an electrosurgical probe. The electrosurgical controller includes an integrated fluid control apparatus or pump where activation of the controller allows for selective energy delivery and corresponding fluid volume flow rates. The electrosurgical probe includes a fluid transport lumen and is in communication with the controller and the pump for operation of the probe in the various user selected modes with accompanying energy delivery and fluid control directed to the desired treatment and surgical effect.

Abstract: An electrosurgical wand for treating tissue at a target site within or on a patient's body is described, having an elongate shaft with a handle and a distal end portion. The distal end portion has an active electrode, an insulative spacer body and a return electrode; the active electrode supported by the insulative spacer body and spaced away from the return electrode. The active electrode has both lateral and medial edge surfaces. The insulative spacer body has an aspiration cavity fluidly connected with an aspiration lumen, and at least one tapered aperture extending beyond at least one of the electrode medial edge surfaces and directed to the aspiration cavity.

Abstract: Electrosurgical systems and methods include a generator which is operable to connect to an electrosurgical device and to identify the electrosurgical device. The generator automatically determines at least one device specific operational parameter for carrying out the electrosurgical procedure. In an exemplary embodiment, a generator includes a fluid pump and the generator automatically determines a candidate flowrate at which to operate the pump based on the type of device. The device specific operational parameter may be selected or modified by the operator prior to commencing the procedure.

Abstract: An electrosurgical controller and related methods. At least some of the illustrative embodiments are methods including: placing a distal end of an electrosurgical wand in operational relationship with biological tissue; delivering energy to an active electrode of the electrosurgical wand. During delivering energy, the method may comprise: measuring a value indicative of flow of the energy to the active electrode; summing, over a first predetermined window of time, to create a first value indicative of energy provided to the active electrode; summing, over a second predetermined window of time, to create a second value indicative of energy provided to the active electrode. The method may further comprise: ceasing delivering energy responsive to the first value meeting or exceeding a predetermined value; and ceasing delivering energy responsive to the second value meeting or exceeding a threshold value.

Abstract: Limiting joint temperature. At least some of the example embodiments are systems including an electrosurgical probe and a high frequency power supply. The electrosurgical probe may include: a shaft with a distal end, a proximal end, and lumen defined within the shaft; an active electrode disposed near the distal end; a return electrode disposed on the shaft; and a temperature sensor disposed on the shaft spaced away from the active electrode and the return electrode, the temperature sensor is electrically insulated from the electrically conductive fluid. The high frequency power supply may be coupled to the active electrode, and configured to provide an electrical energy output between the active electrode and the return electrode.

Abstract: A multi-suture knotless anchor and related method for securing soft tissue, such as tendons, to bone are described. The suture anchor includes a body, a sleeve, and an outer deformable bone locking structure. The bone locking structure has a first low profile configuration for insertion into the bone, and a second larger profile configuration for engaging the bone when actuated. The bone anchor and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Abstract: In repairing soft tissue with a bone anchoring instrument (such as reattaching a tendon of a torn rotator cuff), the bone anchoring instrument may be used to anchor the soft tissue to a region of bone. The anchors inserted into the underlying bone may have one or more lengths of suture or wire attached thereto which may be tensioned independently of one another to affix the soft tissue to the bone by having a selector mechanism selectively engage and disengage ratcheted tensioning wheels from one another. Suture loading mechanisms may be employed for passing suture lengths into and/or through the anchors prior to deployment into the bone where such mechanisms may employ suture snares which are configured to reconfigure from an expanded shape through which suture lengths may be easily passed to a low-profile shape which secures the suture lengths within the snare.

Abstract: Electrosurgical methods and systems. At least some of the illustrative embodiments are methods including maintaining plasma proximate to an active electrode in a first energy range, and a second energy range. During periods when plasma is proximate to the active electrode, the illustrative method may include controlling flow of fluid drawn into an aperture of an electrosurgical wand, and in some situations increasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue, and in other cases decreasing fluid flow drawing into the aperture responsive to the active electrode being in operational relationship with tissue. Further, during periods when plasma is proximate to the active electrode, the illustrative method may include providing output energy at a default energy setpoint, and then providing output energy at a second energy setpoint.

Abstract: Electrosurgical systems and methods include a generator which is operable to connect to an electrosurgical device and to identify the electrosurgical device. The generator automatically determines at least one device specific operational parameter for carrying out the electrosurgical procedure. In an exemplary embodiment, a generator includes a fluid pump and the generator automatically determines a candidate flowrate at which to operate the pump based on the type of device. The device specific operational parameter may be selected or modified by the operator prior to commencing the procedure.

Abstract: Limiting joint temperature. At least some of the example embodiments are systems including an electrosurgical probe and a high frequency power supply. The electrosurgical probe may include: a shaft with a distal end, a proximal end, and lumen defined within the shaft; an active electrode disposed near the distal end; a return electrode disposed on the shaft; and a temperature sensor disposed on the shaft spaced away from the active electrode and the return electrode, the temperature sensor is electrically insulated from the electrically conductive fluid. The high frequency power supply may be coupled to the active electrode, and configured to provide an electrical energy output between the active electrode and the return electrode.

Abstract: An electrosurgical controller and related methods. At least some of the illustrative embodiments are methods including: placing a distal end of an electrosurgical wand in operational relationship with biological tissue; delivering energy to an active electrode of the electrosurgical wand. During delivering energy, the method may comprise: measuring a value indicative of flow of the energy to the active electrode; summing, over a first predetermined window of time, to create a first value indicative of energy provided to the active electrode; summing, over a second predetermined window of time, to create a second value indicative of energy provided to the active electrode. The method may further comprise: ceasing delivering energy responsive to the first value meeting or exceeding a predetermined value; and ceasing delivering energy responsive to the second value meeting or exceeding a threshold value.

Abstract: A suturing device for grasping soft tissue and placing stitches in soft tissue during endoscopic procedures is described. An elongate housing with a stationary jaw and a movable jaw disposed at the distal end are configured for grasping and releasing soft tissue. A movable needle disposed within the housing is actuated to engage a length of suture and drive the suture into and through the grasped soft tissue. A suture capture member is disposed on the movable jaw and is configured to allow passage of the needle therethrough while securing a portion of the stitched length of suture.

Abstract: Electrosurgical system with selective control of active and return electrodes. At least some of the illustrative embodiments are systems comprising an electrosurgical wand and an electrosurgical controller. The wand comprises a non-conductive outer surface, at least three electrodes disposed on a distal end of the wand, and at least three electrical leads extending from a proximal end of the wand (one electrical lead electrically coupled to each electrode). The controller comprises a voltage generator and a control circuit coupled between the voltage generator and the electrodes of the wand. The control circuit is configured to: selectively electrically couple the active terminal singly and in combination to the electrodes of the wand; and selectively electrically couple the return terminal singly and in combination to electrodes of the wand.

Abstract: A suture manipulating instrument for passing and retrieving suture through a tissue includes a handle mechanism, an elongate shaft extending from the handle, and a working distal end. The working distal end includes a needle body, a lumen defined by the needle body, a tissue penetrating distal tip, and a lateral slot. A preformed inner member is movably disposed within the lumen of the needle. The handle mechanism is used to extend the wire from the lateral slot of the needle, and to retract the wire into the lateral slot, allowing the working end of the instrument to grasp and manipulate suture by pinning and/or trapping the suture against the needle. In embodiments the inner member is further retracted within the needle lumen, drawing a length of suture into the needle lumen. The suture is subsequently ejected from the needle lumen to form a suture loop.

Abstract: An electrosurgical controller with output RF energy control. At least some of the illustrative embodiments are electrosurgical controllers configured to change a first output voltage on the first active terminal relative to the first return terminal by selective control of a number of turns of the primary winding of a transformer used to create the output voltage.

Abstract: A knotless tissue repair assembly for attachment of tissue to bone includes an anchoring implant with a length of suture threaded therethrough. The implant is preferably a soft flexible three-dimensional structure. The implant may be actuated from a first elongate low profile shape into a second short radially expanded shape having a larger diameter than the hole through which it was placed. The suture extends through the anchor, through a tissue to be secured, and back through a designated suture-binding region or passageway within the anchor enabling the suture to be secured therein and without the need for a physician to tie a knot. Further tension applied to a suture leg approximates the tissue to the anchor until a desired tension or distance between the tissue and anchor is achieved.

Abstract: A tissue repair assembly for attachment of tissue to bone or tissue to tissue having a soft anchoring implant 100 with a length of suture 120 there through for tensioning the implant and facilitating attachment of other tissue. The implant 100 is a soft, flexible, three-dimensional structure that has a resident volume 200. An inserter tube 310 facilitates the placement of the implant 100 into bone or adjacent soft tissue where it may be deployed. Upon deployment, the soft anchoring implant 100 shortens axially and expands radially, achieving a larger diameter than the hole through which it was placed, thus resisting pull out.

Abstract: A knotless tissue repair assembly for attachment of tissue to bone includes an anchoring implant with a length of suture threaded therethrough. The implant is preferably a soft flexible three-dimensional structure. The implant may be actuated from a first elongate low profile shape into a second short radially expanded shape having a larger diameter than the hole through which it was placed. The suture extends through the anchor, through a tissue to be secured, and back through a designated suture-binding region or passageway within the anchor enabling the suture to be secured therein and without the need for a physician to tie a knot. Further tension applied to a suture leg approximates the tissue to the anchor until a desired tension or distance between the tissue and anchor is achieved.

Abstract: A suture manipulating instrument for passing and retrieving suture through a tissue includes a handle mechanism, an elongate shaft extending from the handle, and a working distal end. The working distal end includes a needle body, a lumen defined by the needle body, a tissue penetrating distal tip, and a lateral slot. A preformed inner member is movably disposed within the lumen of the needle. The handle mechanism is used to extend the wire from the lateral slot of the needle, and to retract the wire into the lateral slot, allowing the working end of the instrument to grasp and manipulate suture by pinning and/or trapping the suture against the needle.

Abstract: Electrosurgical system with selective control of active and return electrodes. At least some of the illustrative embodiments are systems comprising an electrosurgical wand and an electrosurgical controller. The wand comprises a non-conductive outer surface, at least three electrodes disposed on a distal end of the wand, and at least three electrical leads extending from a proximal end of the wand (one electrical lead electrically coupled to each electrode). The controller comprises a voltage generator and a control circuit coupled between the voltage generator and the electrodes of the wand. The control circuit is configured to: selectively electrically couple the active terminal singly and in combination to the electrodes of the wand; and selectively electrically couple the return terminal singly and in combination to electrodes of the wand.