Abstract: An esophageal ablation system including a positioner, an elongated, flexible shaft extending from the positioner, and a microwave emitter assembly disposed near the distal end of the shaft. The emitter assembly includes one or more microwave antennae and a balloon for spacing the antennae relative to target tissue. The device may have an inner balloon for deploying the antenna. The systems, devices and methods disclosed are useful for treating Barrett's Esophagus, Esophageal Adenocarcinoma, and Squamous Cell Carcinoma.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: A technique allows for an electrical connection between a thermal abrasion heating catheter and the energy delivery console that utilizes serial communication. Accordingly, the serial communication allows data such as measured temperature, start/stop status, intended treatment area, device identification, device calibration parameters and/or use history to be conveyed along the same wires that deliver power to a heating element. For example, data can be conveyed along a two wire connection and provided at a frequency that is filtered out so that it is not delivered to a heating feature. In this example, one wire provides power to the heating element, one wire provided communication from the energy delivery console, and a third wire provides a common ground which the heating catheter uses to communicate with the energy delivery console.

Abstract: Aspects of the disclosure relate to an instrument for pacing, mapping, sensing, and/or ablating cardiac tissue that includes an electrogram filtering circuit. To supply radio frequency energy, the disclosed instruments are only optionally connected to a radio frequency generator. When connected to a generator, the electrogram filtering circuit can be provided in a handle of the instrument, or in a connector, for example, to protect the instrument from potentially high-powered radio frequency energy. Alternatively, various disclosed embodiments are capable of pacing/sensing as a standalone device. The connector can be provided separately from both the instrument and the generator. In some embodiments, the electrogram filtering circuit is adaptive to suit a variety of generators.

Abstract: A method for performing cold atmospheric plasma therapy to treat breast cancer. The cancerous tumor is sampled and cold atmospheric plasma treatment is performed on sampled cancerous tumor cells ex vivo. The results of the testing are stored in an electronic storage media. A cell viability reduction rate of said tested samples is calculated with a processor and stored in memory. An average cell viability reduction rate is then calculated by the processor for the cancerous tumor. Cold atmospheric plasma dosages to be used in treatment of the cancerous tumor in vivo are then projected using the processor. The tumor is surgically removed from the patient. The surgical margins of the tumor are then treated with cold atmospheric plasma at the projected dosages.

Abstract: A surgical instrument includes an end effector, a handle assembly, a knife drive assembly, and a lockout assembly. The end effector includes a pair of jaws, a knife, and an RF electrode. The handle assembly includes a housing associated with the first jaw, and an arm associated with the second jaw. The arm is pivotably coupled with the housing and pivots the second jaw between the open position and the closed position. The knife drive assembly includes a trigger slidably coupled with the housing, an actuating assembly, and a return assembly. The actuation assembly converts proximal translation of the trigger into distal actuation of the knife. The return assembly automatically actuates the knife from the fired position to the pre-fired position in response to the trigger reaching a predetermined proximal position. The lockout assembly prevents activation of the electrode and distal actuation of the knife while in the locked configuration.

Abstract: Example apparatuses and systems are disclosed for providing controlled delivery of electrolysis treatment and cellular permeabilization treatment to a site in tissue. A system disclosed may include an electrode, a power supply, and a controller. The controller may control a charge applied to the electrode to induce a direct current through the aqueous matrix to produce electrolysis products and a voltage to produce electroporation. The duration and magnitude of the charge applied may determine the dose of the products and the degree of the permeabilization of cells in the treatment site. The composition of the electrodes may be chosen in accordance with the desired products produced and electroporation effects. An apparatus is disclosed that may be in the form of electrodes for electrolysis and electrodes for electroporation applied to the tissue. An apparatus is disclosed that may be used for treating internal tissue.

Abstract: Certain aspects relate to systems and techniques for a bipolar medical instrument. In one aspect, the medical instrument includes a first end effector, a first set of one or more distal pulleys coupled to the first end effector, and a wrist configured to house the first set of distal pulleys. The medical instrument also includes a plurality of cables extending through the wrist and a first insulating member formed between the first end effector and the first set of one or more distal pulleys.

Abstract: A vapor delivery needle and method is provided that is adapted for treating prostate cancer. The energy delivery probe can apply condensable vapor energy to tissue, such as a peripheral zone tissue in a human prostate. In one method, a needle is introduced into peripheral zone tissue of a human prostate, and vapor media is delivered through the needle to ablate peripheral zone tissue without ablating non-peripheral zone tissue. Systems for treating prostate cancer with vapor therapy are also provided.

Abstract: The present disclosure provides a system with an innovative electrode designed as an RF/microwave antenna as well as methods to monitor/assess biological tissue and perform surgical procedures.

Abstract: Embodiments include a system comprising a non-thermal plasma (NTP) device and at least one container including supersaturated gas emulsion (SSGE). A method is described involving configuring a supersaturated gas emulsion (SSGE) for application to a treatment site and configuring a device to generate a non-thermal plasma (NTP) at the treatment site.

Abstract: A surgical instrument includes an end effector, a handle assembly, and a knife drive assembly. The end effector includes a pair of jaws, a knife, and an RF electrode assembly. The knife actuates between a pre-fired position and a fired position. An arm of the handle assembly is configured to pivot the second jaw between the open position and the closed position. The knife drive assembly includes an input assembly, a rotary assembly, and an output assembly. The input assembly travels a first proximal distance to rotate the rotary assembly. The rotary assembly rotates in response to travel of the input assembly along the first proximal distance to drive the output assembly a first distal distance to thereby actuate the knife from the pre-fired position toward the fired position. The first distal distance is greater than the first proximal distance.

Abstract: A surgical end effector may comprise first and second jaw members. The second jaw member may comprise an offset proximal supply electrode that is positioned to contact an opposing member of the first jaw member when the first and second jaw members are in the closed position. The second jaw member may also comprise a distal supply electrode that is positioned distal of the offset proximal electrode and is aligned with a conductive surface of the first jaw member when the first and second jaw members are in the closed position. When the first and second jaw members are in the closed position, the proximal supply electrode may be in contact with the opposing member and the distal supply electrode is not in contact with the conductive surface of the first jaw member.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods include evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions.

Abstract: An ablation cannula comprising a tubular body, a tip at an end of the tubular body adapted to facilitate the insertion of the cannula into a vein or body cavity, the tip having a distal end, a transducer disposed within the tip, and at least one bore hole in the tip through which a medication or other fluid may be administered, wherein the borehole is separated from the distal end of the tip by a first distance, which may be approximately 2.5 millimeters. The tip may contain at least three boreholes substantially equally spaced around the circumference of the tip. The boreholes may have a diameter of approximately 0.21-0.51 millimeters. Additional configurations are described herein. The transducer is preferably a radio frequency transducer, and an insulative material may be disposed on a selected portion of the tip to attenuate energy emitted from the radio frequency transducer through the insulative material.

Abstract: Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

Abstract: An electrosurgical access catheter for assisting a physician perform an ancillary surgical procedure on a region of interest (ROI) in a patient has a tubular shaped elongate shaft and a ring-shaped active electrode located at the distal end. A passageway extends from the proximal section to the distal end of the shaft, and through the ring-shaped active electrode. The proximal section of the elongate shaft is detachably coupled to an electrosurgical controller such that the ring-shaped active electrode is operable with the electrosurgical controller and a dispersive electrode to electrosurgically make a circular-shaped incision through a tissue wall, carving a cylindrical-shaped tissue plug as the ring-shaped active electrode is advanced through the wall. The access sheath is advanced through the surgically created opening and without further dilation of the opening. The invention has particular applicability to the lung, and minimally invasive bronchoscopic procedures. Related methods are also described.

Abstract: An ablation device and method for pulsed field ablation, the device comprising a catheter including an expandable basket, a set of electrodes formed on the expandable basket, and a pulse generator suitable for generating electric pulses wherein the pulse generator being in electrical connection with the set of electrodes. The expandable basket is formed of a braided mesh of filaments, wherein the filaments are made of nonconductive material, wherein at least portion of the filaments comprises a lumen, wherein the filaments further include electrodes and conductive wires. The conductive wires at least partially lead inside of the lumen of the filaments and are electrically connected to the electrodes.