Abstract: A flexible endoscopic device including an elongate flexible member having opposite ends, an effector assembly mounted on one of the opposite ends of the flexible member, and a handle mounted on the end of the flexible member opposite the effector assembly. The handle includes a fastener for receiving a portion of the flexible member spaced from the end of the member opposite the effector assembly. The device also includes an actuator assembly extending through the flexible member and operatively connected to the effector assembly for actuating the effector.

Abstract: An ablation catheter is provided for ablating internal tissue of a patient. The catheter includes a distal end that is adapted to be inserted into a body cavity relative to a desired location therein (e.g., within the heart). An ablation electrode is connected relative to the distal end of the catheter for providing ablation energy to patient tissue. A heat sink is provided that is in thermal contact with the ablation electrode. The heat sink, in addition to being in thermal contact with the ablation electrode, is electrically isolated from the ablation electrode. This allows the heat sink to conduct heat away from the ablation electrode without dissipating electrical energy from the electrode. In this regard, the heat sink may prevent build-up of excess heat within the electrode that may result in blood coagulation and/or tissue charring.

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: A surgical ablation system employing an ablation probe having a deployable ground plane is disclosed. The disclosed system includes a source of ablation energy and a source of electrosurgical energy, and a switching assembly configured to select between ablation and electrosurgical modes. The probe includes a cannula having a shaft slidably disposed therein. The shaft includes a deployable ground plane electrode assembly and a needle electrode disposed at distal end of the shaft. As the shaft is extended distally from the cannula, the ground plane electrode unfolds, and the needle electrode is exposed. Electrosurgical energy is applied to tissue via the needle electrode to facilitate the insertion thereof into tissue. Ablation energy is applied to tissue via the needle electrode to achieve the desired surgical outcome. The shaft, ground plane electrode and needle electrode are retracted into the cannula, and withdrawn from the surgical site.

Abstract: The present invention involves a surgical device and method of use, particularly an assembly and method incorporating a shaped expandable member along the distal region of an ablation device to facilitate ablation of a circumferential region of tissue engaged by the expandable member. The ablation device assembly includes an elongate body with a proximal end portion, a distal end portion, and a longitudinal axis. A contact member is located along the distal end portion of the elongate body. The contact member has a circumferential wall and is expandable from a radially collapsed condition to a radially expanded condition. The contact member also includes a single chamber having a single bulbous section. The single bulbous section has a plurality of longitudinally adjacent circumferential regions wherein adjacent regions have dissimilar wall thicknesses.

Abstract: An electrode structure and a mechanism for automated or user-selected operation or compensation of the electrodes, for example to determine tissue coverage and/or prevent arcing between bottom electrodes during electrocautery is disclosed.

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: A mechanical cutting device that makes use of mechanical (rotary) motion and suction to engage tissue also applies a cutting energy sufficient to vaporize the tissue. The rotation and suction are used to engage the tissue (sucking tissue into cutting windows when the cutting windows of inner and outer blades are aligned), and then the cutting member(s) function as an electrode(s) by having an electrical cutting signal applied thereto so that the cutting member(s) electrically cut the tissue as the cutting members relatively rotate. The electrical cutting signal is only applied as the windows become aligned up until the cutting of the tissue is completed. The cutting signal preferably is stopped after the cutting windows become misaligned. While the cutting windows are misaligned, a coagulation signal can be supplied to the cutting member so that the device functions as an electrocautery device.

Abstract: Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. The methods include maintaining the positions of a puncture device and of a portion of a parietal pericardium relative to one other while delivering energy from the puncture device to create a channel through the pericardium. Additional embodiments disclosed include delivering a pulse or pulses of energy to the parietal pericardium and attempting to advance the puncture device through the parietal pericardium between deliveries of energy pulses.

Abstract: A family of barrel structures is provided in a kit. Each barrel structure is differently sized and configured for advancement into anal canals of different anatomic morphologies. Instructions are provided for using the barrel structures to treat an individual. The instructions instruct assessing an anatomic morphology of an anal canal of an individual to be treated and selecting one of the barrel structures based upon the assessed anatomic morphology. Each barrel structure carries an electrode sized and configured to be coupled to a source of tissue ablation energy to be applied through the electrode to form a lesion. Each barrel structure includes a transparent side wall visualized by a direct line of sight from an end portion of the first barrel structure. The instructions instruct inserting the selected barrel structure into the anal canal and visualizing by the direct line of sight through the transparent side wall of the selected barrel structure the dentate line and the targeted tissue region.

Abstract: An electrode structure and a mechanism for automated or user-selected operation or compensation of the electrodes, for example to determine tissue coverage and/or prevent arcing between bottom electrodes during electrocautery is disclosed.

Abstract: Systems and methods for endometrial ablation. The systems include a handle and elongated introducer sleeve extending to an expandable working end having a fluid-tight interior chamber. A thin dielectric wall surrounds at least a portion of the interior chamber and has an external surface for contacting endometrial tissue. The thin dielectric wall surrounds a collapsible-expandable frame and receives an electrically non-conductive gas. First and second polarity electrodes are exposed to the interior and exterior of the chamber, respectively. A radiofrequency power source operatively connects to the electrode arrangement to apply a radiofrequency voltage across the first and second electrodes, wherein the voltage is sufficient to initiate ionization of the neutral gas into a conductive plasma within the interior chamber, and to capacitively couple the current in the plasma across the thin dielectric wall to ablate endometrial tissue engaged by the external surface of the dielectric structure.

Abstract: An electrode catheter and a method for assessing catheter-tissue contact for tissue ablation are disclosed. An exemplary electrode catheter comprises a flexible catheter shaft. At least one piezoelectric sensor is oriented coaxial to the flexible catheter shaft. The at least one piezoelectric sensor is responsive to movement of the flexible catheter shaft by generating electrical signals corresponding to the amount of movement. The system may also include an output device electrically connected to the at least one piezoelectric sensor. The output device receives the electrical signals for dynamically assessing a level of contact between the flexible catheter shaft and a moving tissue. In another exemplary embodiment, the system may be implemented in a hydrodynamic environment.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus comprising: a substantially tubular member defining a tubular member lumen; an end member partially positioned within the tubular member lumen at a distal end of the tubular member, the end member including an electrode; and an electrical insulator extending along the substantially tubular member.

Abstract: Systems and methods are disclosed for assessing tissue contact, e.g., for mapping tissue ablation or other procedures. An exemplary tissue contact sensing system comprises a flexible tip device. At least one piezoelectric sensor is housed within the flexible tip device. The at least one piezoelectric sensor is responsive to contact stress of the flexible tip device by generating electrical signals corresponding to the amount of contact stress. An output device is electrically connected to the at least one piezoelectric sensor. The output device receives the electrical signals for assessing tissue contact by the flexible tip device. Methods for assembling and using the flexible tip device are also disclosed.

Abstract: High-strength microwave antenna assemblies and methods of use are described herein. The microwave antenna has a radiating portion connected by a feedline to a power generating source, e.g., a generator. Proximal and distal radiating portions of the antenna assembly are separated by a junction member. A reinforcing member is disposed within the junction member to increase structural rigidity.

Abstract: A surgical instrument includes an elongated tube having a proximal end and a distal end, a handle coupled to the proximal end of the tube, and a tool that is rotatable and translatable relative to the tube, wherein the handle includes a control for rotating the tool relative to the tube, and wherein the control is coupled to the tool such that a movement of the control through an angle ?c rotates the tool relative to the tube by an angle ?t that is greater or less than ?c, and wherein the angle ?c is variable as determined by a user.

Abstract: Devices, systems and methods are provided for deployment of one or more functional devices, such as therapeutic or diagnostic medical devices, or positioning devices, at various locations relative to a defined operative path. The devices, systems, and methods can include a guide system and a positioning element. The guide system defines the operative path when deployed within a patient's body. The positioning element cooperates with the guide system to define one or more positions relative the defined operative path from which the one or more functional devices are deployed. The present inventions allow for the accurate and reliable placement of the one or more functional devices at the one or more positions relative the operative path. In one embodiment, the functional device is an ablation device adapted to ablate cardiac tissue for the treatment of cardiac arrhythmias, such as atrial fibrillation.

Abstract: Devices, systems and methods are disclosed for the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be constrained within the lumen of a catheter, and deployed to take on an expanded condition. The carrier assembly includes multiple electrodes that are configured to ablate tissue at low power. Systems include an interface unit with a visual display that provides a visual representation of the geometry of the ablation elements and/or provides selection means for selecting an icon provided on the display.

Abstract: Either an endoscopic or open bipolar forceps includes a flexible, generally tubular insulating boot for insulating patient tissue, while not impeding motion of the jaw members. The jaw members are movable from an open to a closed position and the jaw members are connected to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal. A knife assembly may be included that allows a user to selectively divide tissue upon actuation thereof. The insulating boot may be made from a viscoelastic, elastomeric or flexible material suitable for use with a sterilization process including ethylene oxide.