Abstract: The disclosure describes devices, systems, and techniques for identifying and treating bladder dysfunction. In one example, a method includes identifying one or more focal points at respective locations of bladder tissue of a bladder of a patient, the one or more focal points initiating coordinated contractions of a detrusor muscle. The method may also, or alternatively, include ablating, for each of the one or more focal points, a respective portion of the bladder tissue at the respective location of the focal point. Ablation of these targeted portions of the bladder tissue may reduce the coordinated contractions of the detrusor muscle and alleviate overactive bladder symptoms.

Abstract: Apparatus and methods for creating tissue necrosis include an energy delivery apparatus that can be positioned adjacent a target treatment site such as a vessel without direct contact with the treatment site tissue. Collimated energy is then directed to the vessel to create necrotic regions in the tissue. Exemplary use in renal vessels creates necrotic regions in adjacent nerves which can alleviate hypertension in a patient.

Abstract: An electrosurgical instrument, in particular for argon plasma coagulation, includes a handpiece 10, an electrode (11) connected to the handpiece (10), a shaft (12) which surrounds the electrode (11) and is held in the handpiece (10), and an operating mechanism (13), which comprises at least one rotary knob (14) arranged on the handpiece (10). The shaft (12) is axially movable relative to the electrode (11) and a shear force can be applied to it by operating the rotary knob (14). The handpiece (10) has a brake device which exerts a braking force on the shaft (12), and the operating mechanism (13) forms a transmission gear (15) which is connected to the shaft (12) for transferring the shear force.

Abstract: A surgical instrument includes a shaft, an ultrasonic transducer, a waveguide acoustically coupled with the ultrasonic transducer and extending distally through the shaft, and an end effector arranged at a distal end of the shaft. The end effector includes an ultrasonic blade acoustically coupled with the waveguide, a clamp arm movable relative to the ultrasonic blade for clamping tissue, and an RF electrode operable to seal tissue with RF energy. The ultrasonic transducer is operable to drive the waveguide and the ultrasonic blade with ultrasonic energy. The surgical instrument further includes an ultrasonic electrical circuit operable to energize the ultrasonic transducer, and an RF electrical circuit operable to deliver RF energy to the RF electrode. A return path of the ultrasonic electrical circuit and a return path of the RF electrical circuit pass through a shared electrically conductive element.

Abstract: A system comprising a surgical instrument is disclosed. The surgical instrument includes a handle, a shaft, a plurality of magnets, a plurality of sensors configured to determine a distance away from one or more of the plurality of magnets, and a processor communicatively coupled to the plurality of sensors. The processor is configured to determine a three dimensional change in position of the shaft by computing a three dimensional change in position of the one or more magnets, using the change in the distances determined by the one or more plurality of sensors.

Abstract: A method of determining a pulsed field ablation waveform parameter for creating a desired lesion characteristic in cardiac tissue. The method of provides an electrosurgical generator configured to deliver electroporation pulses, the generator configured to: load predetermined waveform parameters (yi); load predetermined modeling data (xi); accept entry of a user inputted desired lesion characteristic (ui); and determine at least one corresponding pulsed field ablation waveform parameter based on (ui), (yi); and (xi).

Abstract: An ultrasonic surgical instrument and method for identifying tissue state and energizing the surgical instrument includes an end effector having an ultrasonic blade and an RF electrode, a shaft assembly, a body, and a power controller. A first ultrasonic energy input is configured to be actuated from a first unactuated energy input state to a first actuated energy input state. A trigger input is configured to be actuated from an unactuated trigger input state to an actuated trigger input state. The power controller is operatively connected to the ultrasonic blade, the RF electrode, the first ultrasonic energy input, and the trigger input and configured to direct at least one of the ultrasonic blade or the RF electrode to be selectively driven according to a predetermined drive function based on the tissue impedance, the state of the first energy input, and the state of the trigger input.

Abstract: An ultrasonic surgical instrument and method of sealing a tissue includes measuring a first measured termination parameter with a controller and terminating an ultrasonic energy and an RF energy when the first measured termination parameter reaches a set one of a first smaller tissue predetermined termination parameter or a first larger tissue predetermined termination parameter to thereby inhibit transecting the tissue. The ultrasonic surgical instrument further includes an end effector having an ultrasonic blade, an RF electrode, and a controller. The controller operatively connects to the ultrasonic blade and the RF electrode and is configured to terminate the ultrasonic energy and the RF energy when the first measured termination parameter reaches the set one of the first smaller tissue predetermined termination parameter or the first larger tissue predetermined termination parameter to thereby inhibit transecting the tissue.

Abstract: An ultrasonic horn, an ultrasonic transducer assembly including the same, and an ultrasonic surgical instrument including the same. The ultrasonic horn includes a body and a nose. The body defines a length and a maximum diameter of the ultrasonic horn. The body includes at least one depression arranged annularly thereabout that is configured to receive at least one protrusion for mounting the body within a support structure. The nose extends distally from the body. The body defines a proximal connector configured to enable the body to be secured to a piezoelectric stack and the nose defines a distal connector configured to enable the nose to be engaged with a waveguide for transmission of ultrasonic energy produced by the piezoelectric stack to the waveguide.

Abstract: An ultrasonic surgical instrument and method of limiting an ultrasonic blade temperature includes adjusting at least one power parameter of the ultrasonic energy in response to reaching a predetermined frequency parameter change threshold in the ultrasonic blade limiting the temperature of the ultrasonic blade to an upper temperature limit. The ultrasonic surgical instrument further includes an end effector having an ultrasonic blade, a jaw, and a controller. The jaw is movably positioned relative to the ultrasonic blade and configured to move between an open position and a closed position. The controller operatively connects to the ultrasonic blade and is configured to measure an ultrasonic frequency of the ultrasonic blade. The controller has a memory including a plurality of predetermined data correlations that correlate changes in measured ultrasonic frequency of the ultrasonic blade to a blade temperature of the ultrasonic blade.

Abstract: A surgical instrument comprises a shaft assembly comprising a shaft and an end effector coupled to a distal end of the shaft; a handle assembly coupled to a proximal end of the shaft; a battery assembly coupled to the handle assembly; a radio frequency (RF) energy output powered by the battery assembly and configured to apply RF energy to a tissue; an ultrasonic energy output powered by the battery assembly and configured to apply ultrasonic energy to the tissue; and a controller configured to, based at least in part on a measured tissue characteristic, start application of RF energy by the RF energy output or application of ultrasonic energy by the ultrasonic energy output at a first time.

Abstract: A surgical instrument includes a handle assembly; a shaft assembly and an end effector. The shaft assembly includes an exterior shaft, a first clutch positioned within the exterior shaft to drive a first function of the surgical instrument when engaged. A second clutch within the exterior shaft to drive a second function when engaged. A rotary driver is positioned within the exterior shaft and configured to rotate within the exterior shaft. The rotary driver includes a first clutch engagement mechanism to engage the first clutch and a second clutch engagement mechanism configured to engage the second clutch independent of the first clutch engagement mechanism engaging the first clutch, such that, at different times both the first clutch and the second clutch are engaged simultaneously only the first clutch is engaged only the second clutch is engaged and neither the first clutch nor the second clutch is engaged simultaneously.

Abstract: Bipolar belt ablation systems and methods for treating patient tissue involve the use of an ablation an ablation apparatus with a plurality of ablation elements carried by a flexible tube structure, a radiofrequency generator capable of delivering a plurality of differing radio frequency power signals to the ablation elements of the ablation device, wires transmitting the radiofrequency power signals from the radiofrequency generator to the ablation elements, and a control mechanism to enable temperature-based power control to each of the powered ablation elements.

Abstract: A device (10) for tissue coagulation, in particular for fusion, encompasses an electric source (18), which is connected or which can be connected to electrodes (12, 13) for influencing biological tissue (11) with current. A control unit (22) controls the source (18) during phases I and II of the tissue fusion. These phases I and II correspond to operating phases I, II and III of the device (10). During operating phase I, a monitoring unit (23) determines the energy E1, which is applied into the tissue (11). In the subsequent operating phases II and III, the control unit (22) controls the source (18) by means of the determined energy E1. Such a device turns out to be particularly reliable and to be robust in use.

Abstract: Ablation apparatus is provided. The apparatus includes an ablation electrode shaped to define a cavity thereof, and comprising a metallic distal face that is shaped to define a plurality of apertures. A fluid-delivery channel is configured to deliver fluid to the apertures. At least one ultrasound transducer is disposed within the cavity of the ablation electrode, the transducer being configured to transmit an ultrasound wave through the apertures. Other embodiments are also described.

Abstract: Provided is a system and medical device that includes self diagnosing control switches. The control switch may be slidable within a slot in order to control activation of some function of the medical device. Due to natural wear and tear of movement of a control switch, the distances along the sliding slot that correspond to how much energy is used for the function may need to be adjusted over time in order to reflect the changing physical attributes of the actuator mechanism. The self diagnosing control switches of the present disclosures may be configured to automatically adjust for these thresholds using, for example, Hall effect sensors and magnets. In addition, in some cases, the self diagnosing control switches may be capable of indicating external influences on the controls, as well as predict a time until replacement is needed.

Abstract: A surgical system includes a surgical instrument having a body, an ultrasonic transducer, a shaft extending distally from the body, and an end effector at a distal end of the shaft and being operable to treat tissue with ultrasonic energy. An accessory device is configured to operatively couple the surgical instrument with a generator operable to power the surgical instrument to provide ultrasonic energy. A primary EEPROM is provided within the instrument body and is operable to track usage of the surgical instrument. The system further includes at least one of: an accessory EEPROM integrated into the accessory device and being operable to track usage of the accessory device; a transducer EEPROM integrated into the ultrasonic transducer and being operable to track usage of the ultrasonic transducer; or an ASIC integrated into the accessory device and being operable to communicate with the generator regarding a state of the surgical instrument.

Abstract: A surgical instrument comprises a controller configured to control application of RF or ultrasonic energy at a low level when displacement or intensity of a button is above a first threshold but below a second threshold higher than the first threshold, and control application of RF or ultrasonic energy at a high level when the displacement or intensity exceeds the second threshold. In another aspect, a surgical instrument comprises a first sensor configured to measure a tissue characteristic at a first location, a second sensor configured to measure the tissue characteristic at a second location, and a controller configured to, based at least in part on the measured tissue characteristic at the first location and the second location, control application of RF or ultrasonic energy.

Abstract: A method of altering skin tissue includes creating an electrochemical reaction in the tissue, wherein the electrochemical reaction occurs while avoiding electro-thermal damage to the tissue.

Abstract: Cardiac ablation is carried out by placing two ablation electrodes on opposite sides of a wall of the heart to generally oppose one another. The effective current transmission area of one of the electrodes is then varied according to the distance between the two electrodes or the thickness of the wall. Sufficient electrical current is transmitted between the two electrodes to achieve transmural ablation.