Abstract: A medical instrument includes an endoscope shaft and an electrode cap with a pin axially movable in the endoscope shaft. A first electrode is held by a first electrode carrier at a distal end piece of the endoscope shaft, and a second electrode is held by a second electrode carrier at the electrode cap. A safety switch is arranged in proximity to one of the electrode carriers and interconnected with a feed line that feeds HF current to the second electrode. The safety switch can be brought into an OFF or disconnect position to disconnect HF current supply to the second electrode. The safety switch can include an outer contact ring fixed at a proximal end portion of the pin, and an actuating rod that protrudes from the pin at the distal end and transmits movement to the second electrode carrier.

Abstract: A device and system for thermally affecting tissue that includes a balloon catheter with a reduced distal length for ease of navigation and that also includes a balloon that is more resistant to bursting and delamination. The balloon may include a proximal neck generally attached to an elongate body and a distal neck generally attached to a shaft disposed within the elongate body. The distal neck is turned inward to extend within the balloon chamber and the proximal neck may either extend within the chamber or extend proximally away from the balloon chamber. Alternatively, the device may include an inner balloon and an outer balloon, the distal necks of both being turned inward and extending within the inner balloon chamber. The proximal necks may both also be turned inward to extend within the chamber or the proximal neck of the outer balloon may extend away from the balloon chamber.

Abstract: A surgical instrument includes an active electrode coupled to a source of electrosurgical energy. The active electrode includes a tissue-contacting surface on an exterior surface of the instrument such that the tissue-contacting surface of the active electrode may intimately engage tissue. A replacement electrode includes a tissue-contacting surface, and is located in an interior cavity of the instrument. A seal is formed between the active electrode and the interior cavity of the instrument such that the tissue-contacting-surface of the replacement electrode is isolated from contamination exposed to the exterior of the instrument. The active electrode is removable from the instrument to expose the tissue-contacting surface of the replacement electrode, and the replacement electrode is connectable to the source of electrosurgical energy when the active electrode is removed.

Abstract: A system and method for providing greater control over the temperature of a thermal treatment element of a medical device, enabling an operator to extend a thawing period of a cryoablation procedure. The system may include a fluid flow path that bypasses a subcooler, giving the operator selective control over the temperature of refrigerant delivered to the treatment element and, therefore, treatment element temperature. Additionally or alternatively, the system may include a fluid delivery conduit that is in communication with a liquid refrigerant and a gaseous refrigerant. Adjustment of the ratio of liquid to gaseous refrigerant also offers control over the treatment element temperature. Additionally or alternatively, the system may include one or more valves and/or heating elements in the fluid delivery and recovery conduits to control the treatment element temperature.

Abstract: Adapters for use with surgical systems including a surgical forceps, and a surgical clip; and methods for providing clip-applying functionality are disclosed. The adapter is releasably engagable with the end effector assembly of the surgical forceps. The surgical clip is releasably engagable with the adapter. With the surgical clip engaged with the adapter and the adapter engaged with the end effector assembly, the jaw members of the end effector assembly are configured to move from the spaced-apart position towards the approximated position to move the jaw bodies of the adapter towards one another to, in turn, urge the legs of the surgical clip towards one another to form the surgical clip.

Abstract: The invention is a system for monitoring and controlling tissue ablation. The system includes a controller configured to selectively control energy emission from an electrode array of an ablation device based on ablation feedback received during an ablation procedure with the ablation device. The controller is configured to receive feedback data from one or more sensors during the ablation procedure, the feedback data comprising one or more measurements associated with at least one of operation of the electrode array of the ablation device and tissue adjacent to the electrode array. The controller is further configured to generate an ablation pattern for controlling energy emission from the electrode array of the ablation device in response to the received feedback data.

Abstract: Disclosed is a method of controlling a modular battery powered handheld surgical instrument. The surgical instrument including a battery, a user input sensor, a controller, a radio frequency (RF) drive circuit, an ultrasonic transducer, ultrasonic transducer drive circuit, and an end effector. The end effector including an electrode electrically coupled to RF drive circuit, an ultrasonic blade acoustically coupled to the ultrasonic transducer, and a sensor to measure tissue parameters. The method includes applying an RF current drive signal to the electrode by the RF drive circuit; applying an ultrasonic drive signal to the ultrasonic transducer by the ultrasonic transducer drive circuit to acoustically excite the ultrasonic blade; controlling intensity, wave shape, and/or frequency of the RF current drive signal and the ultrasonic drive signal on a sensed measure of a tissue or user parameter.

Abstract: Provided is a system including a surgical instrument comprising a handle assembly comprising a handle; a shaft assembly coupled to the handle assembly; and a flexible circuit. The handle assembly comprises a proximal portion of the flexible circuit and the shaft assembly comprises a distal portion of the flexible circuit; the shaft assembly further comprising: an exterior shaft positioned around the distal portion of the flexible circuit and configured to change position while a sub-portion of the distal portion of the flexible circuit remains stationary; and shaft control electronics comprising a stationary portion and a non-stationary portion, the stationary portion coupled to the distal portion of the flexible circuit and the non-stationary portion coupled to the exterior shaft; wherein the stationary portion of the shaft control electronics is configured to measure a distance to the non-stationary portion of the shaft control electronics as the exterior shaft changes position.

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 driver configured to drive movement of at least one component of the surgical instrument; a motor powered by the battery assembly and configured to actuate the driver using an output of the motor; and a controller for the motor, configured to perform a limiting operation to the output of the motor when a limiting condition is met, wherein the limiting condition is determined based at least in part on a tissue characteristic.

Abstract: A microwave ablation system includes a first cannula, a trocar insertable through the first cannula and configured to facilitate insertion of the first cannula into a target tissue, and a microwave antenna assembly configured to interlock with the first cannula, the microwave antenna assembly including a coaxial feedline having a radiating section formed thereon, the microwave antenna configured to be inserted into the first cannula. The microwave ablation system further includes an actuator operatively connected to one of the first cannula or microwave antenna assembly. Operation of the actuator between a first position and a second position exposes the radiating section of the microwave antenna assembly from a distal portion of the first cannula.

Abstract: A method of identifying gaps between electrophysiology (EP) ablation points may comprise: obtaining a plurality of ablation points recorded from a completed electrophysiology ablation procedure; digitally mapping the plurality of ablation points to an anatomical model corresponding to the completed electrophysiology ablation procedure; calculating ablation gap probability distributions for each of the plurality of ablation points based on ablation tolerance variables associated with each of the plurality of ablation points; and overlaying the ablation gap probability distributions on to the digitally mapped plurality of ablation points on the anatomical model. In this way, ablation gaps may be non-invasively identified prior to patient discharge, thereby allowing for further EP treatment to remove the ablation gaps while reducing readmission rates.

Abstract: A surgical instrument includes an end effector assembly and a switch assembly. The end effector assembly includes a monopolar assembly and a bipolar assembly. The switch assembly includes first and second bipolar inputs, first and second bipolar outputs, a monopolar input, and a monopolar output. The switch assembly is transitionable between a first condition, wherein the first and second bipolar inputs are coupled to the first and second bipolar outputs, respectively, for supplying energy to the bipolar assembly, and a second condition, wherein the monopolar input and the monopolar output are coupled to one another for supplying energy to the monopolar assembly.

Abstract: Aspects of the present disclosure include methods of performing a cardiac surgical procedure on a subject. The methods include performing the cardiac surgical procedure in combination with pulmonary vein isolation and left atrial appendage modification. Kits for use in performing a cardiac surgical procedure are also provided, the kits including a device configured to perform a pulmonary vein isolation procedure, and a device configured to perform a left atrial appendage modification.

Abstract: A system including a battery assembly for use in a modular handheld surgical instrument, wherein the battery assembly includes a primary battery pack, a secondary battery pack, and a circuit configured to supply a first output voltage to a first load of the modular handheld surgical instrument via the primary battery pack, supply a second output voltage to a second load of the modular handheld surgical instrument via the secondary battery pack, and upon sensing a sagging voltage from the primary battery pack, supply a supplemental voltage to the first load, via the secondary battery pack, to prevent the battery assembly from supplying an output voltage below a predetermined threshold output voltage under the first load.

Abstract: A method is provided for ablating a portion of the myocardium. The method includes inserting an occlusion catheter into a vessel on a heart, occluding the vessel using the occlusion catheter, inserting an ablation catheter into a chamber of the heart, positioning the ablation catheter against the myocardium, and ablating a portion of the myocardium while the vessel is occluded. The system includes an occlusion catheter having a catheter body including a tubular member having a distal portion and a bend located in the distal portion, a balloon located proximal of the bend and configured to contact an inner surface of the CS when positioned therewithin, a plurality of marker bands positioned on the catheter body, and a plurality of electrodes positioned on the catheter body. One or more electrodes or coils can be used as a reference for an electroanatomical system and can be disposed on the occlusion catheter.

Abstract: An end effector for a surgical instrument is disclosed. The end effector includes an ultrasonic blade and a jaw member including an asymmetric electrode comprising a first electrode and a second electrode. The first electrode defines a first width and the second electrode defines a second width. The first width is not equal to the second width. A first gap is defined between the first electrode and the ultrasonic blade and a second gap is defined between the second electrode and the ultrasonic blade. The first gap is not equal to the second gap.

Abstract: A system includes a pulse waveform generator and an ablation device coupled to the pulse waveform generator. The ablation device includes at least one electrode configured for ablation pulse delivery to tissue during use. The pulse waveform generator is configured to deliver voltage pulses to the ablation device in the form of a pulsed waveform. A first level of a hierarchy of the pulsed waveform includes a first set of pulses, each pulse having a pulse time duration, with a first time interval separating successive pulses. A second level of the hierarchy of the pulsed waveform includes a plurality of first sets of pulses as a second set of pulses, a second time interval separating successive first sets of pulses, the second time interval being at least three times the duration of the first time interval.

Abstract: A system includes a pulse waveform generator and an ablation device coupled to the pulse waveform generator. The ablation device includes at least one electrode configured for ablation pulse delivery to tissue during use. The pulse waveform generator is configured to deliver voltage pulses to the ablation device in the form of a pulsed waveform. The pulsed waveform can include multiple levels of hierarchy, and multiple sets of electrodes can be activated such that their pulsed delivery is interleaved with one another.

Abstract: A multi-cannula surgical instrument (1), having an inner cannula (3) movably disposed within an outer cannula (2), the inner cannula (3) having a blunt distal tip (3b), one or more first inner ducts (31) and one or more first flow-through orifices (32) arranged to allow one or more fluid flows therethrough, where the inner and the outer cannula (2, 3) at the proximal ends (2a, 3a) thereof are mounted onto a hub (4) that includes a biasing mechanism (43) coupled to the inner cannula (3) and arranged to bias the inner cannula (3) automatically from a retracted towards an advanced position in case of absence of resistance against the inner cannula (3), where the outer cannula (2) has one or more second flow-through orifices (22) that are in fluid communication with one or more second ducts (21) arranged between the outer and the inner cannula (2, 3), where the second flow-through orifices (22), the hub (4) and the second duct(s) (21) are configured to allow at least one fluid flow therethrough.

Abstract: In one general aspect, various embodiments are directed to a surgical instrument that can supply mechanical energy and electrical energy to an end effector of the surgical instrument. The surgical instrument may be operated in a first operating mode in which a transducer of the surgical instrument produces mechanical energy, or vibrations, that are transmitted to the end effector and a second operating mode in which electrical energy, or current, can flow through the end effector to perform electrosurgery. In another general aspect, the surgical instrument may comprise a clamp, or jaw, which can be moved into a closed position to hold tissue against a waveguide, or blade, of the end effector. In the second operating mode of the surgical instrument, current can flow from a power source, through the waveguide, and return to the power source through a path comprising the jaw.