Abstract: A method is described to enhance the ability to evaluate the depth of a tissue component or a lesion having optical properties different from a surrounding tissue using time resolved optical methods. This invention may be particularly suitable for the evaluation of lesion depth during RF ablation (irreversible tissue modification/damage) using specially designed devises (catheters) that deliver heat in a localized region for therapeutic reasons. The technique allows for increased ability to evaluate the depth of the ablated lesion or detect the presence of other processes such as micro-bubble formation and coagulation with higher sensitivity compared to that offered by steady state spectroscopy. The method can be used for in-vivo, real-time monitoring during tissue ablation or other procedures where information on the depth of a lesion or tissue is needed. Exemplary uses are found in tissue ablation, tissue thermal damage, lesion and tissue depth assessment in medical applications.

Abstract: A power source delivers oscillating electrical energy to an electrical conductor, such as a wire or catheter, which is coated circumferentially with a ferromagnetic material in a selected region. With high frequency electrical energy, the ferromagnetic material has a quick response in heating and cooling adjustable by the controllable power delivery. The ferromagnetic material can be used for separating tissue, coagulation, tissue destruction or achieving other desired tissue effects in numerous surgical procedures.

Abstract: An energy delivery probe is provided that may include any of a number of features. One feature of the energy delivery probe is that it can apply energy to tissue, such as a prostrate, to shrink, damage, denaturate the prostate. In some embodiments, the energy can be applied with a vapor media. The energy delivery probe can include a vapor delivery member configured to extend into a transition zone prostate tissue. A condensable vapor media can be delivered from the vapor delivery member into the transition zone tissue, wherein the condensable vapor media can propagate interstitially in the transition zone tissue and be confined in the transition zone tissue by boundary tissue adjacent to the transition zone tissue. Methods associated with use of the energy delivery probe are also covered.

Abstract: A system and apparatus for automatic smoke evacuation using an RF sensor. The system and apparatus utilizes an RF sensor for automatic activation of an evacuator that evacuates smoke and/or debris during the use of any electrosurgical instrument or surgical instrument that is capable of generating smoke and/or debris and capable of producing a radiofrequency during its operation. Exemplary embodiments of the system and apparatus for automatic smoke evacuation include both wired and wireless embodiments.

Abstract: A cryoneedle comprises an outer tube having a distal section with a generally central gas supply line placed within the outer tube. The gas supply line supplies a cryogas for forming an iceball on an outer surface of the outer tube over the distal section. The gas supply line terminates in an expansion chamber placed within the distal section. The cryoneedle comprises a heat exchange helix contacting the inner surface of the outer tube. The heat exchange helix has an increasing surface area per unit distance of the distal section such that the iceball has a generally symmetric shape.

Abstract: A method is provided, comprising: (1) applying an excitatory current to renal nerve fibers of a subject; (2) determining a change in a parameter of the subject in response to the excitatory current, the parameter being a fastest rate of increase in arterial pressure during a systolic upstroke of an arterial pressure wave of the subject; (3) in response to the change, deciding whether to ablate the renal nerve fibers; and (4) in response to the deciding, applying ablation energy to the renal nerve fibers. Other embodiments are also described.

Abstract: A resectoscope includes a fixed electrode adapted to connect to a first electrical potential, a movable electrode adapted to connect to a second electrical potential and biased transversely towards the fixed electrode, and a spacer coupled to the movable electrode. The movable electrode and the spacer are longitudinally movable relative to the fixed electrode between a first position, wherein the spacer is disposed between the fixed electrode and the movable electrode so as to maintain a spacing between the movable electrode and the fixed electrode against the bias of the movable electrode, and a second position, wherein the spacer is disposed distally of the fixed electrode, allowing the movable electrode to move transversely towards the fixed electrode under the bias of the movable electrode.

Abstract: A method for treating a heart failure patient by ablating a nerve of the splanchnic sympathetic nervous system to increase venous capacitance and reduce pulmonary blood pressure. A method including: inserting a catheter into a vein adjacent the nerve, applying stimulation energy and observing hemodynamic effects, applying ablation energy and observing hemodynamic effects, applying simulation energy after the ablation and observing hemodynamic effects.

Abstract: An electrosurgical instrument is provided for the treatment of tissue, the instrument (3) comprising an instrument shaft (14) having a longitudinal axis, a suction lumen (16) extending at least partially along the instrument shaft, and a chisel electrode (21) at the distal end of the shaft. The chisel electrode (21) includes a body portion (22) at a first angle with respect to the longitudinal axis, and a hook portion (23) extending from the body portion at a second angle to the longitudinal axis. The chisel electrode (21) also includes a plurality of apertures (35, 36, 37, 38, 40) providing a suction lumen through the electrode, there being at least one aperture (35, 36, 37, 38, 42) in the body portion (22), and at least one aperture (40, 45) in the hook portion (23).

Abstract: The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

Abstract: Systems and methods for evaluating neuromodulation via hemodynamic responses are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a neuromodulation catheter comprising an elongated shaft having a distal portion, and a plurality of electrodes spaced along a distal portion. The system can further include a controller communicatively coupled to the electrodes. The controller can be configured to apply first and second stimuli at and/or proximate to a target site within a blood vessel before and after delivering neuromodulation energy to the target site, and detect, via at least one of the electrodes, vessel impedance resulting from the first and second stimuli to determine a baseline impedance and a post-neuromodulation impedance. The controller can further be configured to assess the efficacy of the neuromodulation based, at least in part, on a comparison of the baseline impedance and the post-neuromodulation impedance.

Abstract: A surgical device is disclosed for cutting tissue, including for performing a capsulotomy of a lens capsule of an eye. This device includes a reversibly collapsible cutting element for cutting a portion of a capsule membrane of the eye. The cutting element includes an outer layer, an inner layer, and a bottom layer that has a higher electrical resistance than the electrical resistance of the outer layer and the inner layer. The bottom layer is configured to conduct an electrical current between the outer layer and the inner layer, which causes a temperature increase in the bottom layer for cutting tissue.

Abstract: Devices, systems, and methods treat cosmetic defects, and often apply cooling with at least one tissue-penetrating probe inserted through of the skin of a patient. The cooling may remodel one or more target tissue so as to effect a desired change in a composition of the target tissue and/or a change in its behavior. Exemplary embodiments of the cooling treatments will interfere with the nerve/muscle contractile function chain so as to mitigate wrinkles of the skin. Related treatments may be used therapeutically for treatment of back and other muscle spasms, chronic pain, and the like. Some embodiments may remodel subcutaneous adipose tissue so as to alter a shape or appearance of the skin surface.

Abstract: The present invention relates to systems and devices for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In particular, the present invention relates to systems and devices for the delivery of energy with heat transfer ability. In some embodiments, the systems and devices also have variable characteristic impedance as a result of the use of heat transfer materials. In certain embodiments, methods are provided for treating a tissue region (e.g., a tumor) through application of energy with the systems and devices of the present invention.

Abstract: Aspects of the present disclosure are presented for a surgical instrument for cutting and sealing tissue. In some embodiments, the surgical instrument includes a handle assembly, a shaft, and an end effector. The end effector may include: a blade that vibrates at an ultrasonic frequency, a shielded portion enclosing a back edge of the blade, a high-friction surface coupled to the shielded portion and positioned between the shielded portion and the back edge of the blade. A space is defined between the high-friction surface and the back edge of the blade when the end effector is in a cutting configuration. In a sealing configuration, the high-friction surface contacts the back edge of the blade, which generates heat based on ultrasonic vibrations of the blade rubbing against the high-friction surface. The shielded portion can coagulate bleeding tissue based on heat transfer from the high-friction surface to the shielded portion.

Abstract: An electrode arrangement for forming a dielectric barrier plasma discharge between a flat surface (4) of the electrode arrangement and a surface to be treated which functions as a counter surface and on which a fluid can collect, comprising a flat electrode (14) which can be connected to a high-voltage source by means of a connector and which is completely embedded in a flat dielectric (2), except for the connector for the high-voltage source, wherein the dielectric (2) forms an upper surface (1) and a lower surface (4) which appears as a flat surface to the surface to be treated, enables the drainage or supply of a fluid by means of a simple design.

Abstract: There is provided in accordance with an exemplary embodiment of the invention a method and/or a device of treating tissue near a first lumen comprising inserting an energy emission element into a second lumen and delivering energy in an amount sufficient to cause one or more spaced apart areas of tissue damage at preselected locations in tissue near the first lumen. There is also provided a method and/or a device for treating a carotid artery wall, for example, to reduce signal conduction. There is also provided a method and/or a device for treating a wall of a lumen in a limb, for example, to increase blood flow. There is also provided a method and/or a device for treating a wall of a heart, for example, to stop abnormal signal propagation.

Abstract: A neuromodulation system including a catheter having a balloon along its distal end is disclosed in several embodiments. An ultrasound transducer positioned within an interior of the balloon can be selectively activated to emit acoustic energy radially outwardly in order to target nerve tissue and other portions of the subject anatomy. In some embodiments, the system is configured to be delivered over a guidewire.

Abstract: The invention relates to a tissue ablation system including an ablation device having a deployable applicator head configured to be delivered to a tissue cavity and ablate marginal tissue surrounding the tissue cavity. The deployable applicator head is configured to be delivered to a tissue cavity while in a collapsed configuration and ablate marginal tissue surrounding the tissue cavity while in an expanded configuration.

Abstract: A surgical device integrating a suction mechanism with a coagulation mechanism is provided for improving lesion creation capabilities. The device comprises an elongate member having an insulative covering attached about means for coagulating soft tissue. Openings through the covering expose regions of the coagulation-causing elements and are coupled to lumens in the elongate member which are routed to a vacuum source. A fluid source to passively transport fluid along the contacted soft tissue surface may be provided in order to push the maximum temperature deeper into tissue.