Abstract: Various aspects of a generator, ultrasonic device, and method for estimating a state of an end effector of an ultrasonic device are disclosed. The ultrasonic device includes an electromechanical ultrasonic system defined by a predetermined resonant frequency, including an ultrasonic transducer coupled to an ultrasonic blade. A control circuit measures a complex impedance of an ultrasonic transducer, wherein the complex impedance is defined as Z g ( t ) = V g ( t ) I g ( t ) . The control circuit receives a complex impedance measurement data point and compares the complex impedance measurement data point to a data point in a reference complex impedance characteristic pattern. The control circuit then classifies the complex impedance measurement data point based on a result of the comparison analysis and assigns a state or condition of the end effector based on the result of the comparison analysis.

Abstract: A surgical instrument includes a shaft, an end effector, and a wrist coupling the end effector to the shaft. The wrist has a central channel extending along a length of the wrist. An insert guide member is positioned in the central channel. The insert guide member has an exterior lateral wall extending between a first end and a second end of the insert guide member and an interior lateral wall extending between the first end and the second end. A passage extends from the first end of the insert guide member to the second end of the insert guide member. The passage can include a first portion extending through the insert guide member between an interior lateral wall of the insert guide member and the exterior lateral wall of the insert guide member, and a second portion intersecting the exterior lateral wall of the insert guide member.

Abstract: A system including a medical probe having a tube with a distal end for insertion into a cardiac chamber, an electrode at the distal end that conveys energy to myocardial tissue, a temperature sensor at the distal end that outputs a signal indicating a temperature of the tissue, a channel contained within the tube that delivers fluid to the distal end, and a fluid port at the distal end and coupled to the channel. The system also includes a generator that applies a specified level of the energy to the electrode, a pump that forces the fluid into the channel at a controllable rate, and a processor that controls the rate responsively to the signal so that a difference between a specified temperature, which is no greater than 55° C., and the indicated temperature is no greater than ±2.5° C. while the generator applies a constant level of the energy.

Abstract: The instant disclosure relates to electrophysiology catheters for tissue ablation within a cardiac muscle. In particular, the instant disclosure relates to an electrophysiology ablation balloon catheter with an electrode coil that is wrapped around at least a portion of the balloon and delivers ablation energy at a desired portion of tissue.

Abstract: A distal-end assembly of a medical device, the distal-end assembly includes a flexible substrate and electrical conductors. The flexible substrate is configured to be coupled to a distal end of an insertion tube. The electrical conductors are disposed on the flexible substrate and are shaped to form: (i) one or more electrodes, configured to exchange electrical signals with a proximal end of the medical device, and (ii) one or more printed filters, which are disposed adjacently to at least one of the electrodes and are configured to filter signals in a predefined frequency range from the electrical signals exchanged between the at least one of the electrodes and the proximal end.

Abstract: Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method comprises the steps of: (a) advancing a puncture device towards a heart, the puncture device including an energy delivery device at a distal end of the puncture device; (b) delivering a single pulse of a pulsed energy through the energy delivery device to a parietal pericardium of the heart to create a void relatively close to the energy delivery device while maintaining the distal end of the puncture device in a substantially stationary position relative to the parietal pericardium; (c) advancing the puncture device a short distance into the void; (d) checking if the puncture device has accessed the pericardial cavity by measuring pressure on the distal end of the puncture device; and (e) repeating steps (b), (c), and (d), if necessary, until the energy delivery device is located at least partially within the pericardial cavity.

Abstract: A method for the selective elevation and separation of tissues comprised of multiple layers and a surgical instrument for performing the method. The method may be performed without the requirement of a solid mechanical device insertion or transection through the mucosal layer. In particular, the method and surgical instrument may be used for the selected separation and/or resection of selected portions of benign or malignant tissues (e.g. defining tissue planes, polyp elevation and removal, submucosal tissue tunnelling, endoscopic mucosa resection, etc).

Abstract: According to some embodiments, a method of treating a subject having diabetes or symptoms associated with diabetes is provided. The method includes delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: An electrosurgical generator includes a first radio frequency source having a first power supply configured to output a first direct current waveform; a first radio frequency inverter coupled to the first power supply and configured to generate a first radio frequency waveform from the first direct current waveform; and a first controller configured to control the first radio frequency inverter. The electrosurgical generator also includes a second radio frequency source having: a second power supply configured to output a second direct current waveform; a second radio frequency inverter coupled to the second power supply and configured to generate a second radio frequency waveform simultaneously as the first radio frequency waveform; and a second controller configured to control the second radio frequency inverter.

Abstract: A method and system for creating permanent lesions in an area of target tissue, such as tissue at or proximate a junction between a pulmonary vein and the left atrium. The method may generally include positioning a medical device in contact with a pulmonary vein ostium, ablating the tissue, and recording a plurality of temperature measurements from one or more of three temperature sensors. The device may include an occlusion element in communication with a coolant source, a first sensor located distal of the occlusion element, a second sensor located proximal of the occlusion element, and a third sensor located in the occlusion element. One or more temperature measurements may be compared with each other to assess occlusion of the pulmonary vein, and/or may be compared with a set of reference temperatures to predict a real-time temperature within the target tissue.

Abstract: Disclosed herein is a system for treating skin and/or nails with cold plasma. The system includes a discharge device, which includes a handle and an applicator mounted thereon, and control infrastructure, which includes a waveform generator. The applicator includes an elongated tube housing therein a cathode. The handle includes a flyback amplifier. The waveform generator is configured to induce the flyback amplifier to establish a voltage at the cathode. The voltage produced by the flyback amplifier is configured to allow generating a self-sustaining Townsend avalanche when a distal end of the tube is positioned sufficiently near a target site on a skin surface or a nail of a subject, such as to produce a cold plasma discharge directed at the target site and having an average power between about 0.1 ?W and about 10 ?W, so that the target site is not heated.

Abstract: Devices and methods for tissue lesion assessment and/or creation based on dielectric properties are disclosed. In some embodiments, one or more probing frequencies are delivered via electrodes including an electrode in proximity to a tissue (for example, myocardial tissue). Measured dielectric properties (such as impedance properties), optionally together with other known and/or estimated tissue characteristics, are used to determine the lesion state of the tissue. In some embodiments, a developing lesion state is monitored during treatment formation of a lesion (for example, ablation of heart tissue to alter electrical transmission characteristics).

Abstract: An electrosurgical system includes an RF current generator, a handle body, and an end effector in mechanical communication with the handle body. The end effector has a first jaw including a first electrode having a first electrode surface in electrical communication with a first terminal of the generator. The end effector also includes a second jaw including a second electrode having an essentially planar second electrode surface in electrical communication with a second terminal of the generator The first jaw includes at least one feature configured to apply an amount of a compressive force to a tissue compressed between the at least one feature and the second electrode surface that differs from an amount of a compressive force applied to the tissue compressed between the first electrode surface and the second electrode surface when the first jaw is placed in a proximate position to the second jaw.

Abstract: Volumetrically oscillating plasma flows, the volume of which controllably expands and contracts with time, are disclosed. Volumetrically oscillating plasma flows are generated by providing an energy with a power density that changes with time to the plasma-generating gas to form a plasma flow. The changes in the energy power density result in plasma flow volumetric oscillations. Volumetric oscillations with a frequency of above 20,000 Hz results in ultrasonic acoustic waves, which are known to be beneficial for various medical applications. System for providing volumetrically oscillating plasma flows and a variety of surgical non-surgical applications of such flows are also disclosed.

Abstract: An embodiment of the present invention provides a medical cooling device including a cooling medium configured to cool a target region through thermal contact with the target region, a cooling generator configured to supply cooling energy to the cooling medium, and a cooling medium accommodating unit that has one surface to which the cooling generator is attached and that is configured to thermally connect the cooling medium to the cooling generator, wherein a center-of-cooling-power region is disposed in a region where the cooling medium and the cooling medium accommodating unit overlap and has a center of cooling power which is a center with respect to thermal conductivity of the center-of-cooling-power region, and a distance from a front end of the cooling medium to the center of cooling power is less than or equal to 30 mm.

Abstract: An electrosurgical instrument having a microwave ablation antenna dimensioned to be suitable for insertion into a pancreas via a surgical scoping device, to provide a rapid and accurate alternative to known RF ablation techniques. The electrosurgical instrument comprises: a proximal coaxial transmission line for conveying microwave electromagnetic (EM) energy; a distal radiating portion; and an intermediate impedance transformer arranged to match an impedance of the coaxial transmission line to an impedance of the distal radiating portion, wherein the distal radiating portion comprises a microwave antenna for emitting the microwave EM energy conveyed by the coaxial transmission line, wherein the distal radiating portion has a maximum outer diameter less than an outer diameter of the coaxial transmission line. With these features, the instrument is able to deliver microwave energy via a small diameter structure.

Abstract: A thermal accelerant is delivered to a tissue site and localized to modulate the shape, extent or other characteristic of RF or microwave-induced hyperthermic tissue ablation. The accelerant may be provided via an image-guided hand piece or via a lumen added to a microwave antenna, and promotes faster heating, more complete ablation and/or a more extensive treatment region to reduce recurrence of treated cancers, overcoming natural limitations, variations in tissue response and drop-off or thermal loss away from the antenna. The accelerant is delivered as a viscous but heat sensitive fluid, and is fixed in place to provide regions of preferential absorption or heating. Shorter exposure times to heat the far field may allow survival of vulnerable tissue such as vessels, and multiple antennae may be used for effective treatment of irregular or large tumors.

Abstract: An instrument that includes forceps. The forceps include a jaw assembly. The jaw assembly includes a first jaw and a second jaw. The first jaw includes a gripping section, and the second jaw includes a gripping section. The jaw assembly is moveable between an open position and a closed position. The first jaw is electrically conductive, the second jaw is electrically conductive, or both the first jaw and the second jaw are electrically conductive. The first jaw includes a first tissue stop that is centered on a medial plane of the first jaw. The tissue stop extends from the first jaw towards the second jaw. The first tissue stop is adapted to block an anatomical feature from extending beyond a proximal end of the gripping section of the first jaw, a proximal end of the gripping section of the second jaw, or both.

Abstract: A surgical instrument includes an end effector, a handle assembly, and a knife drive assembly. The end effector includes a first jaw, a second jaw, a knife, and an electrode assembly. The handle assembly includes a housing, and an arm. The arm may pivot the second jaw between the open position and the closed position. The knife drive assembly includes an input assembly, and output assembly coupled with the knife, and a compound pulley assembly. The compound pulley assembly includes a pair of pulley wheels each having an input track, an output track, an input cable, and an output cable. The input assembly can drive the input cable a first proximal distance in order to rotate the pair of pulley wheels in a first angular direction, thereby driving the output cable a first distal direction to actuate the knife from the pre-fired position toward the fired position.

Abstract: An apparatus includes a shaft assembly and an electrode assembly at a distal end of the shaft assembly. The electrode assembly includes a first conductive segment extending along a first angular range at the distal end of the shaft assembly. The first conductive segment is operable to apply RF energy to tissue at a first polarity. The electrode assembly further includes a second conductive segment angularly spaced apart from the first conductive segment. The second conductive segment extends along a second angular range at the distal end of the shaft assembly. The second conductive segment is operable to apply RF energy to tissue at a second polarity such that the first and second conductive segments are operable to apply bipolar RF energy to tissue.