Abstract: Devices and methods for treating rhinitis are described where the devices are configured to ablate a single nerve branch or multiple nerve branches of the posterior nasal nerves located within the nasal cavity. A surgical probe may be inserted into the sub-mucosal space of a lateral nasal wall and advanced towards a posterior nasal nerve associated with a middle nasal turbinate or an inferior nasal turbinate into a position proximate to the posterior nasal nerve where neuroablation of the posterior nasal nerve may be performed with the surgical probe. The probe device may utilize a visible light beacon that provides trans-illumination of the sub-mucosal tissue or an expandable structure disposed in the vicinity of the distal end of the probe shaft to enable the surgeon to visualize the sub-mucosal position of the distal end of the surgical probe from inside the nasal cavity using, e.g., an endoscope.

Abstract: Apparatus and methods for treating conditions such as rhinitis are disclosed herein where a distal end of a probe shaft is introduced through the nasal cavity where the distal end has an end effector with a first configuration having a low-profile which is shaped to manipulate tissue within the nasal cavity. The distal end may be positioned into proximity of a tissue region having a post nasal nerve associated with a middle or inferior nasal turbinate. Once suitably positioned, the distal end may be reconfigured from the first configuration to a second configuration which is shaped to contact and follow the tissue region and the post nasal nerve may then be ablated via the distal end. Ablation may be performed using various mechanisms, such as cryotherapy, and optionally under direct visualization.

Abstract: Surgical devices with integrated visualization and cauterization are described herein where such devices include an elongate structure having a central lumen and an expandable space-creating structure having at least one expandable leaflet mounted in the vicinity of the distal end and is configured for placement within a mammalian body proximate to a therapeutic target. Also included is a proximal terminal having an actuator mounted in the vicinity of the proximal end and is configured to remain outside of said body and provide an actuation mechanism for actuating the space-creating structure. Additionally, at least one fluid connector and said central lumen is in fluid communication between an interior of the expandable space-creating structure and the at least one fluid connector.

Abstract: A method to remove ascites from a mammalian body including: draining ascites from the peritoneal cavity to the bladder of the mammalian body, and evacuating the drained ascites out of the bladder. The method may be practiced with a valved fistula implanted into the bladder to form a passage between the peritoneal cavity and the bladder.

Abstract: An expandable member for characterizing a three-dimensional space within a mammalian body is described. The expandable member is delivered to a target region in a deflated state where it is expanded by inflation of the member. Sensory transducers that contact the member relay sensory information generated when the member is in an expanded state to a microprocessor located outside the body. Using the sensory information, a data-driven picture that characterizes the three-dimensional space within the body is created with a microprocessor. The apparatus is useful in preparation for minimally invasive surgical therapy.

Abstract: Epicardial access and treatment systems are described herein where such devices may utilize multiple expanding frame members coupled to a flexible or rigid deployment catheter shaft. The multiple frame members may extend distally to collapse into a low-profile configuration and may further expand or open radially to create a working or surgical field under direct visualization and defined by the frame members and surrounding membrane while retracting any surrounding tissue. Moreover, the distal ends of each frame member may be tapered such that the frame members may close tightly relative to one another forming an atraumatic end. Any number of therapeutic tools can be passed through the catheter for performing any number of procedures on the tissue.

Abstract: Methods and apparatus for cryo-therapy are disclosed herein. This includes a hollow guidewire disposed within a catheter having helical loops contacting tissue. A coolant delivery tube disposed within can have a coolant delivered from a proximal end into the guidewire lumen. The coolant flows back proximally through the guidewire while cooling the guidewire surface and cooling or cryogenically ablating the contacting tissue. To minimize guidewire exposure to surrounding fluids or tissue, insulative barriers can be attached to the guidewire. A coolant delivery tube and return lumen can be integrated from a single extrusion in various configurations. Expandable balloons can also be used to expand the loops of the guidewire to contact the tissue. Also, helical loops with a coolant delivery tube or stem disposed longitudinally within the loops can be used and the loops can also have a variable collapsible cooling region.

Abstract: Epicardial access and treatment systems are described herein where such devices may utilize multiple expanding frame members coupled to a flexible or rigid deployment catheter shaft. The multiple frame members may extend distally to collapse into a low-profile configuration and may further expand or open radially to create a working or surgical field under direct visualization and defined by the frame members and surrounding membrane while retracting any surrounding tissue. Moreover, the distal ends of each frame member may be tapered such that the frame members may close tightly relative to one another forming an atraumatic end. Any number of therapeutic tools can be passed through the catheter for performing any number of procedures on the tissue.

Abstract: Apparatus and methods for cooling selected regions within a body are described herein. An implantable cooling system is used to cool regions of the brain, spinal cord, fibrous nerve bodies, e.g., vagus nerve, etc. down to about 30° C. to diminish nerve impulses which control seizures or chronic pain. The system includes an implantable unit containing a pumping mechanism and/or various control electronics. It also has a heat exchanger attachable to a tubular body organ, such as the superior vena cava or the inferior vena cava, through which the heat is effectively dissipated. Also included is a heat pump such as a Peltier junction configured to be placed into contact with the region of tissue to be cooled. The heated portion of the Peltier junction is cooled by a liquid heat transfer medium which absorbs the heat from the junction and dissipates it into the tubular body organ.

Abstract: Apparatus and methods for cooling selected regions within a body are described herein. An implantable cooling system is used to cool regions of the brain, spinal cord, fibrous nerve bodies, e.g., vagus nerve, etc. down to about 30° C. to diminish nerve impulses which control seizures or chronic pain. The system includes an implantable unit containing a pumping mechanism and/or various control electronics. It also has a heat exchanger attachable to a tubular body organ, such as the superior vena cava or the inferior vena cava, through which the heat is effectively dissipated. Also included is a heat pump such as a Peltier junction configured to be placed into contact with the region of tissue to be cooled. The heated portion of the Peltier junction is cooled by a liquid heat transfer medium which absorbs the heat from the junction and dissipates it into the tubular body organ.

Abstract: An expandable member for characterizing a three-dimensional space within a mammalian body is described. The expandable member is delivered to a target region in a deflated state where it is expanded by inflation of the member. Sensory transducers that contact the member relay sensory information generated when the member is in an expanded state to a microprocessor located outside the body. Using the sensory information, a data-driven picture that characterizes the three-dimensional space within the body is created with a microprocessor. The apparatus is useful in preparation for minimally invasive surgical therapy.

Abstract: Tissue visualization devices having multi-segmented frame are described herein where such devices may utilize multiple expanding frame members coupled to a flexible deployment catheter shaft or rigid shaft. The multiple frame members may extend distally to collapse into a low-profile configuration and may further expand or open radially to create a working field between the frame members. Moreover, the distal ends of each frame member may be tapered such that the frame members may close tightly relative to one another forming an atraumatic end. Additionally, any number of therapeutic tools can also be passed through the catheter or shaft for performing any number of procedures on the tissue for identifying, locating, and/or treating tissue.

Abstract: Apparatus and methods for cooling and/or heating selected regions within a body are described herein. An implantable system is used to cool or heat nerve bodies down to about 15° C. to diminish nerve impulses. In one embodiment, the system can include an implantable unit containing a pumping mechanism and/or various control electronics. The system has a cooling element. The cooling element can be a Peltier junction or a catheter through which hot or cold fluid flows. The heated portion of the Peltier junction can be cooled by a liquid heat transfer medium which absorbs the heat from the junction and dissipates the heat elsewhere.

Abstract: Apparatus and methods for cooling selected regions within a body are described herein. An implantable cooling system is used to cool regions of the brain, spinal cord, fibrous nerve bodies, e.g., vagus nerve, etc. down to about 30° C. to diminish nerve impulses which control seizures or chronic pain. The system includes an implantable unit containing a pumping mechanism and/or various control electronics. It also has a heat exchanger attachable to a tubular body organ, such as the superior vena cava or the inferior vena cava, through which the heat is effectively dissipated. Also included is a heat pump such as a Peltier junction configured to be placed into contact with the region of tissue to be cooled. The heated portion of the Peltier junction is cooled by a liquid heat transfer medium which absorbs the heat from the junction and dissipates it into the tubular body organ.

Abstract: Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.