Abstract: Devices, systems, and method for treating urinary incontinence generally rely on energy delivered to a patient's own pelvic support tissue to selectively contract or shrink at least a portion of that pelvic support tissue so as to reposition the bladder. The energy will preferably be applied to the endopelvic fascia and/or an arcus tendineus fascia pelvis. The invention provides a variety of devices and methods for applying gentle resistive heating of these and other tissues to cause them to contract without imposing significant injury on the surrounding tissue structures. Alternatively, heat-applying probes are configured to heat tissue structures which comprise or support a patient's urethra. By applying sufficient energy over a predetermined time, the tissue can be raised to a temperature which results in contraction without significant necrosis or other tissue damage.

Abstract: A device and method for cryosurgical ablation. A tip has a thermally transmissive region along a length thereof in which the thermally transmissive region is operable at a temperature sufficient to cryosurgically ablate tissue in contact therewith. A plurality of cryosurgical fluid injection lumens each have a first end positioned within the tip at a different point along the length of the thermally transmissive region. Each of the first ends is arranged to cool overlapping respective portions along the length of the thermally transmissive region when cryogenic fluid is ejected from the plurality of cryogenic fluid injection lumens.

Abstract: An elongated catheter device with a distal balloon assembly is adapted for endovascular insertion. Coolant injected through the device may, in different embodiments, directly cool tissue contacting the balloon, or may cool a separate internal chamber. In the first case, the coolant also inflates the balloon, and spent coolant is returned to the handle via a return passage extending through the body of the catheter. Plural balloons may be provided, wherein a secondary outer balloon surrounds a primary inner balloon, the primary balloon being filled with coolant and acting as the cooling chamber, the secondary balloon being coupled to a vacuum return lumen to serve as a robust leak containment device and thermal insulator around the cooling chamber. Various configurations, such as surface modification of the balloon interface, or placement of particles, coatings, or expandable meshes or coils in the balloon interface, may be employed to achieve this function.

Abstract: A flexible cryosurgical catheter having a deflectable segment adjacent its distal end, a pull wire through said catheter connected to the deflectable segment, and a deflection mechanism in its handle for pulling on the pull wire to establish a desired curvature in the deflectable segment.

Abstract: A system for detecting electrode-tissue contact comprises a catheter having a location sensor and a distal tip electrode. The catheter preferably further comprises a reference electrode that is preferably protected from making contact with tissue. The system further comprises a signal generator to transmit test signals to the distal tip and reference electrodes. Tissue contact is detected by comparing the signals across the tip electrode to a return electrode versus the signal across the reference electrode to a return electrode. Ablation energy may be delivered to the distal tip electrode if contact of the electrode with tissue is detected.

Abstract: A system for recanalizing an occluded blood vessel including a centering catheter employed to center an ablative guide wire within the blood vessel as the guide wire traverses the occlusion. The centering catheter includes a catheter body with an operative lumen through which the ablative guide wire is slidingly disposed. The centering catheter further includes a distally disposed centering mechanism that, when activated, centers the ablative guide wire within the blood vessel as it traverses the occlusion. The centering mechanism can comprise various embodiments including a single inflatable balloon or segmented inflatable balloon, which is in fluid communication with an inflation lumen. An airless preparation lumen may be disposed within the inflation lumen for ease of centering catheter preparation. The ablative guide wire includes insulation that is preferably formed of heat shrink tubing, which is stretched prior or concurrently with the heating process.

Abstract: An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.

Abstract: A system for detecting and marking the positions of peripheral nerves is disclosed. A reusable electrode array comprising a plurality of electrodes is combined with a disposable skin attachment system comprising hydrogel islands. In use, the electrode array is connected to a peripheral nerve detection instrument. The disposable skin attachment system is then attached to an electrode sensor region. The skin attachment system is then adhered to an area of skin, detection is carried out, and then the electrode array is peeled back from the skin, leaving a skin marking guide in place. The skin marking guide is then used to mark areas of interest to a therapist.

Abstract: A suction assisted ablation device having a support surface, suction elements disposed adjacent the support surface, at least one electrode and at least one suction conduit is provided. The device may further include fluid openings, which allow fluid to irrigate target tissue and aid in ablation. A method for ablating tissue using suction is also provided.

Abstract: A plurality of electrodes are positioned at the distal end of a catheter such that the electrodes may be positioned proximal biological tissue. A select number of the electrodes have a temperature sensing device associated with them for providing a temperature signal indicative of the temperature at the interface between the electrode and the tissue. A generator operates under the control of a processor to apply power to each of the electrodes. The power has an associated phase angle and, within a time duration, a plurality of alternating on periods and off periods, one set of adjacent on and off periods defining a duty cycle. The processor is programmed to determine the temperature at the electrode/tissue interface based on the temperature signals, compare the temperature to a target temperature and to adjust the power to the electrode accordingly.

Abstract: In order to improve the cutting properties of surgical bipolar scissors with two scissor blades pivotable relative to each other, the first of which consists of an electrically conductive material and the second of an electrically insulating material on the side thereof facing the first scissor blade, but of an electrically conductive material on the side facing away from the first scissor blade, it is proposed that the second scissor blade comprise a ceramic shaped body in the form of a complete scissor blade which extends beyond a bearing point of the two scissor blades, that a metallic support blade which similarly extends beyond the bearing point rest against the outer side of the shaped body over the surface thereof, and that the shaped body and the support blade be permanently connected to each other at their contact surface.

Abstract: A method and a sensor holding and positioning device. In one embodiment, the device includes a sensor base having two feet, the base forming a raised bridge between the two feet. The bridge has one or more cross members spanning all or part of the space between the two feet. A sensor suspension including a sensor holder and sensor-height-adjustment mechanism is coupled by a pivot-arm axle to the sensor base, such that the sensor suspension is able to rotate in an arc about the long axis of the axle. In one such embodiment, the device further includes a pressure sensor attached to the sensor holder of the sensor suspension. In another such embodiment, the sensor suspension is able to slide back and forth along a line parallel to the long axis of the axle. Another aspect is a method for positioning a sensor over the radial artery, for example in a human's wrist. Yet another aspect is a pulse-waveform acquisition system.

Abstract: An ablation catheter including a probe, an electrode mounted on the probe so as to be movable relative thereto, a remote-operated actuator means for moving the electrode, an elongate conductor connected to the electrode and insulation provided around the conductor. The insulation can include a sleeve axially slidable on the probe, the elongate conductor extending longitudinally between the probe and the insulation sleeve and the insulation sleeve being retractable at least in part into a recess formed in a rearward portion of the probe.

Abstract: The invention provides a device and method for reducing or segmenting a large tissue mass in a body cavity during a minimally invasive surgery. This is accomplished with using a device that uses both mechanical and electro-surgical mechanisms by creating an electrical path between two electrodes through the tissue mass. The invention uses an isolation bag to insulate the electrical path created from the body cavity.

Abstract: A catheter system and method are provided which change the temperature of a fluid, such as blood, by heat transfer. Selective cooling or heating of an organ may be performed by changing the temperature of the blood feeding the organ. The catheter system includes an inlet lumen and an outlet lumen structured and arranged to carry a working fluid having a temperature different from the adjacent blood. The outlet lumen is configured to induce turbulence in the adjacent fluid passing adjacent the outlet lumen.

Abstract: The present invention relates to a tissue ablation device assembly which is adapted to form a conduction block along a length of tissue between two predetermined locations along the left atrial wall. The assembly comprises an ablation element on an elongated ablation member that is coupled to each of two delivery members, wherein the delivery members are adapted to controllably position and secure the ablation element along the length of tissue between the predetermined locations. A linear lesion in the tissue between the predetermined locations is then formed by actuation of the ablation element. The invention further provides that the ablation member may slideably engage one or two delivery members such that an adjustable length of the ablation element along the ablation member may be extended externally from the engaged delivery member and along a length of tissue.

Abstract: A surgical device including: a first shaft having a first projection radially offset from an axial direction of the first shaft, the first projection having a first clamping surface; a second shaft slidably disposed relative to the first shaft, the second shaft having a second projection radially offset from the axial direction, the second projection having a second clamping surface; a dissector for dissecting tissue from a blood vessel to be harvested; a first actuator for sliding the second projection relative to the first projection to capture a side branch of the vessel between the first and second clamping surfaces; at least one electrode for applying cauterizing energy to cauterize the captured side branch; a cutting blade movably disposed on one of the first or second projections; and a second actuator for moving the cutting blade to sever the side branch captured between the first and second projections.

Abstract: The invention relates to a medical instrument for removing tissue comprising a tool at its distal end which can be supplied with high frequency power. The instrument includes an HF power terminal and an HF power supply line extending frown a proximal end region of the instrument to its distal end. In the present instrument, the HF power supply is configured as a drive shaft for rotary drive of the tool. Furthermore, contact means are provided electrically connected to the HF power terminal, which electrically contact the drive shaft.

Abstract: A first electrode is positioned within an artery proximate an implanted intravascular stent. A second electrode is positioned at a separate location relative the position of the first electrode. Electrical energy is then delivered between the first and the second electrodes to produce an electrical field adjacent the implanted intravascular stent. When a intravascular stent is implanted in a coronary artery, the delivery of the electrical energy is coordinated to cardiac cycles detected in sensed cardiac signals, where the delivery of the electrical energy between the first electrode and the second electrode occurs during a predetermined portion of the cardiac cycle.

Abstract: A suction assisted ablation device having a support surface, suction elements disposed adjacent the support surface, at least one electrode and at least one suction conduit is provided. The device may further include fluid openings, which allow fluid to irrigate target tissue and aid in ablation. A method for ablating tissue using suction is also provided.