Abstract: Surgical tissue fusion instrument and support structure having two gripping structures which are movable relative to each other and which are designed to bring together biological tissue sections that are to be connected to each other, with heat-generating means which are assigned to the gripping structures and, during tissue fusion, cause heat to be introduced in the area of a connection site of the biological tissue sections, and also with a support structure which is held between the gripping structures and, during tissue fusion, is operatively connected to the tissue sections. The support structure has at least one additional physical functional structure for aiding or promoting the tissue fusion.

Abstract: An electrode assembly comprises an electrode support, an electrode on the electrode support, the electrode having a working surface extending generally transverse to a thickness of the electrode, and a filament of electrically insulative material overlying a portion of the working surface of the electrode and at least partially extending through the thickness of the electrode. An electrosurgical may include an end effector having a jaw member comprising such an electrode assembly.

Abstract: An electrosurgical device is provided that includes a handset having a shaft extending therefrom, a pair of active electrodes at a distal end of the shaft, and a movable, electrically floating electrode selectively positionable between the active electrodes. The floating electrode, when positioned to contact tissue between the active electrodes, modifies the electrosurgical current flows through tissue. The resultant modified current flows enables a surgeon to more effectively to control tissue desiccation by focusing electrosurgical energy toward targeted tissue and by reducing peripheral current flows. Embodiments are provided wherein the active electrodes include cooling provisions. Related electrosurgical systems and method of use are also provided.

Abstract: A method and apparatus are disclosed for an RF guidewire for applying RF energy to create a channel through a region of tissue within a patient's body. The RF guidewire is configured to have a hydrophilic coating disposed thereon to reduce friction to facilitate traversal through vasculature while maintaining its mechanical, electrical and thermal properties.

Abstract: An electrosurgical device comprising: (a) forceps including: (i) a first working arm and (ii) a second working arm; (b) a blade electrode; wherein the electrosurgical device is capable of being switched between a first electrical configuration so that the electrosurgical device delivers a first therapy current through the first working arm, the second working arm, or both, and a second electrical configuration so that the electrosurgical device delivers a second therapy current through the blade electrode; and wherein the first working arm and the second working arm of the forceps are immobilized in the second electrical configuration so that both the forceps and the first therapy current are disabled.

Abstract: A sphincterotome device can be used to achieve appropriate positioning within the biliary duct during cannulation. The sphincterotome device enables performance of a “double-wire” or multiple wire procedure without the need for removal and reintroduction of the sphincterotome device, thereby allowing for a shorter procedure.

Abstract: A system and method for treating the skin by heating at least one discrete skin volume, comprising at least one treatment tip reversibly connectable to at least one applicator. The treatment tip comprises one or more electrodes, with the electrodes having one or more spaced apart protruding conducting elements. The protruding conducting elements are characterized by dimensions of height A and hypotenuse B, where the ratio A/B is in a predetermined range, and the protruding conducting elements penetrate the skin surface at discrete locations. The electrodes are configured to apply energy to skin volumes around the discrete locations so as to heat the skin volumes. The applicator comprises an energy generator configured to apply energy to the skin volumes by means of the electrodes and the spaced apart protruding conducting elements.

Abstract: Surgical instruments with position-dependent actuator cooperation and impedance are described herein. In general, movement of one actuator can cause proportional movement of another actuator depending upon the positions of each actuator. In one embodiment, a surgical instrument can include a distal end effector and a proximal actuator portion. First and second actuators coupled to the proximal actuator portion can each be configured to move between a first position and a second position. Further, the first actuator and the second actuator can be configured such that, when the first actuator and the second actuator are in the first position, moving the second actuator to the second position causes the first actuator to move to the second position, and when the first actuator is in the second position, the second actuator can be moved from the first position to the second position independent of the first actuator.

Abstract: A tissue fusion instrument having electrodes that are only connected in a punctiform manner to their electrode carrier such that they are electrically conducting and thus, heat-conducting. As a result, heat transfer from the electrode to the respective electrode carrier is restricted. This, on one hand, benefits the desired surgical outcome and, on the other hand, prevents parasitic heating of the surgical instrument and concomitant damage to surrounding tissue.

Abstract: A system and method for treating the skin by heating at least one discrete skin volume, comprising at least one treatment tip reversibly connectable to at least one applicator. The treatment tip comprises one or more electrodes, with the electrodes having one or more spaced apart protruding conducting elements. The protruding conducting elements are characterized by dimensions of height A and hypotenuse B, where the ratio A/B is in a predetermined range, and the protruding conducting elements penetrate the skin surface at discrete locations. The electrodes are configured to apply energy to skin volumes around the discrete locations so as to heat the skin volumes. The applicator comprises an energy generator configured to apply energy to the skin volumes by means of the electrodes and the spaced apart protruding conducting elements.

Abstract: Systems, devices and methods treat target tissue to provide a therapeutic benefit to the patient. A tissue treatment device comprises a tissue treatment element constructed and arranged to treat target tissue, such as duodenal mucosa and/or submucosal tissue. Patients treated can safely eliminate or reduce their daily insulin intake.

Abstract: An electrosurgical device comprising: (a) a stylet including: (i) a first jaw; (ii) a second jaw that is movable relative to the first jaw from a first position where the first jaw and the second jaw are open to a second position where the first jaw and the second jaw move towards each other to grasp tissue therebetween; and (iii) one or more jaw support rods connected to the first jaw, the second jaw, or both; and (b) a housing connected to the stylet and the stylet extending from the housing, the housing including: (i) an operable mechanism including: (1) a fourth link; (2) a second link; (3) a first link being connected to the fourth link via a first pivot and being rotatable relative to the first pivot, and connected to the second link at a second pivot so that movement of the first link moves the second link relative to the fourth link; and (4) a third link being connected to the second link at a third pivot so that movement of the second link moves the third link, and the fourth link being connected to

Abstract: A surgical system includes an electrosurgical tool configured to be releasably coupled to a surgical robotic system having a control system. The tool has a shaft having an end effector with treatment electrodes configured to apply electrosurgical power to a tissue, and aspiration and irrigation tubes having ports in the vicinity of the electrodes. The control system can control a flow rate of an irrigation fluid based on deviation of power delivered by the electrodes to the tissue from a power set point, or based on an aspiration rate that is controlled based on tissue impedance. The tool can have first and second ports and a conduit configured to selectively provide or aspirate fluids through at least one of the ports. At least one of a flow rate and an aspiration rate are controlled by the control system based on a rotational angle of the shaft relative to a ground.

Abstract: A therapeutic treatment system includes a holding section configured to hold a biological tissue, electrodes provided in the holding section and capable of outputting first high-frequency energy for sealing the biological tissue at a first sealing temperature and second high-frequency energy for dissecting the biological tissue at a first dissection temperature higher than the first sealing temperature, electrodes provided in the holding section and capable of outputting first thermal energy for sealing the biological tissue at a second sealing temperature higher than the first sealing temperature and second thermal energy for dissecting the biological tissue at a second dissection temperature lower than the first dissection temperature and higher than the second sealing temperature, and a control section configured to control temperature of each of the electrodes to output the second thermal energy after the output of the first high-frequency energy.

Abstract: Systems, such as an electrosurgical unit, and method for use with an active electrode and a plurality of return electrodes are disclosure. An electrosurgical treatment is provided to tissue via the active electrode at a treatment site and a first return electrode of the plurality of return electrodes at the treatment site. An impedance measurement is received or determined of an impedance in the tissue between the active electrode at the treatment site and a second return electrode of the plurality of return electrodes at a site remote from the treatment site.

Abstract: An apparatus includes a body, a shaft assembly, an end effector, a first acoustic sensor, and a processor. The shaft assembly extends distally from the body. The end effector is located at the distal end of the shaft assembly. The end effector is operable to apply energy to tissue and thereby change a state of the tissue. The first acoustic sensor is configured to pick up sound emitted by tissue. The processor is in communication with the first acoustic sensor. The processor is configured to provide an automated response in response to a signal from the first acoustic sensor indicating a change in the state of the tissue.

Abstract: A probe having a temperature sensor on its distal portion is introduced into a fluid-filled body cavity of a subject, and an irrigating fluid passed through the probe. The temperature of the irrigating fluid exiting the probe differs from the temperature of the body cavity. Temperature readings of the irrigating fluid exiting the probe are recorded. A determination is made from the temperature readings that predetermined contact criteria between the probe and the interior wall of the body cavity are satisfied.

Abstract: An ablation applicator for an ablation device for ablating tissue of a blood vessel having a tubular body defining an inner lumen to which an ablation medium is conductable, a control mechanism for converting the tubular body between a passive operation mode for inserting the ablation applicator into the blood vessel and an active operation mode for ablating tissue of the blood vessel, and an ablation medium supply line for supplying the ablation medium to the inner lumen and positioned within the inner lumen and having a number of openings for passing the ablation medium from the ablation medium supply line to the inner lumen for thermally contacting the ablation medium with the tubular body wherein at least some of the openings are distributed along the ablation medium supply line with a predetermined spacing between neighboring openings.

Abstract: A catheter adapted for use in the pericardial sac to sense temperature of an ablation site and surrounding heart tissue within one of the heart's ventricles or atria via proximity with the epicardium in the pericardial sac, includes a catheter body and a temperature sensing array adapted for placement on and contact with the epicardium. The temperature sensing array may comprise a 2-D body, with a surface adapted to contact an area on the epicardial tissue or in pericardial space. The array may also comprise at least one finger member, each having at least one temperature sensing location. The array may further comprise an elongated body having a generally circular configuration, a distal portion of which is movable to a spirally inward position.

Abstract: An electrosurgical system includes an electrosurgical instrument, an electrosurgical power generating source, and a controller. The electrosurgical instrument includes a shaft extending from a housing. The shaft includes a distal end configured to support an end-effector assembly. The end-effector assembly includes opposing jaw members movably mounted with respect to one another and moveable from a first position in spaced relation relative to one another to at least one subsequent position wherein the jaw members cooperate to grasp tissue therebetween. At least one of the jaw members includes a temperature-sensing electrically-conductive tissue-contacting plate defining a bottom surface. One or more temperature sensors are coupled to the bottom surface.