Abstract: An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.

Abstract: A blood vessel in a patient is severed by inserting a shaft through an incision in the patient, the shaft carrying first and second clamps. The first and second clamps are closed against the vessel in closely adjacent relationship to one another. Thereafter, the clamps are moved in generally opposing directions to sever the vessel at a location between the clamps. Each clamp carries a cauterizing pad for cauterizing the severed ends of the vessel.

Abstract: A surgical instrument, such as an endoscopic or laparoscopic instrument, includes an ablation device. The ablation device includes an elongate flexible member having a proximal end and a distal end. A first working channel is formed within the flexible member. A first diagnostic probe having a proximal end and distal end is located within the first working channel and extends through the distal end of the flexible member. A first electrode is connected to the distal end of the first diagnostic probe electrode is adapted to be endoscopically located in a tissue treatment region. The first electrode is adapted to couple to an electrical waveform generator to receive an irreversible electroporation electrical waveform sufficient to ablate tissue located proximate to the first electrode. A system further includes an electrical waveform generator electrically coupled to the first electrode of the ablation device to generate an IRE waveform sufficient to ablate tissue located proximate to the first electrode.

Abstract: A method for resecting tissue from an organ of a patient, the organ being comprised of at least a first layer, a second layer and a third layer, the method including the steps of providing an EMR device with access to the organ, the EMR device including at least one deployable cutting element disposed on at least one moveable arm, identifying a target tissue area for resection, forming an incision through the first and second layers without penetrating the third layer, positioning the EMR device through the incision such that the device is positioned between the first third layers, advancing the moveable arm between the first and third layers, deploying the cutting element such that the cutting element is advanced in the direction of the first layer and away from the third layer and, while the EMR device is positioned between the first and third layers, cutting through the first layer.

Abstract: A system and method for controlling electrosurgical snares are disclosed. The system includes an electrosurgical instrument having an elongate tubular sheath having proximal and distal ends, the sheath having a longitudinal axis defined therethrough and a shaft having proximal and distal ends. The shaft extends through and is axially movable relative to the sheath. A snare loop is provided at the distal end of the shaft and is configured for encircling tissue. Movement of the shaft relative to the tubular sheath changes the diameter of the exposed snare loop. A feedback sensor operatively connected to the elongated tubular sheath which determines at least one condition of the snare loop, and an electrosurgical generator provides electrosurgical energy to the electrosurgical snare instrument. The generator is configured to receive feedback measurements from the electrosurgical snare instrument and to adjust electrosurgical energy as a function of the measurements.

Abstract: A system and method for performing electrosurgical procedures are disclosed. The system includes an electrosurgical generator adapted to supply electrosurgical energy to tissue in form of one or more electrosurgical waveforms having a crest factor and a duty cycle. The system also includes sensor circuitry adapted to measure impedance and to obtain one or more measured impedance signals. The sensor circuitry is further adapted to generate one or more arc detection signals upon detecting an arcing condition§. The system further includes a controller adapted to generate one or more target control signals as a function of the measured impedance signals and to adjust output of the electrosurgical generator based on the arc detection signal. An electrosurgical instrument is also included having one or more active electrodes adapted to apply electrosurgical energy to tissue.

Abstract: A gas-enhanced electrosurgical method and apparatus for coagulating tissue. The apparatus includes a first tube with a proximal end and a distal end. The proximal end of the first tube is configured to receive pressurized ionizable gas. The distal end of the first tube is configured to deliver ionized gas towards a treatment area. The apparatus also includes at least one electrode positioned to selectively ionize the pressurized ionizable gas before the pressurized ionizable gas exits the distal end of the first tube. The electrode is adapted to operatively couple to an electrical energy source. The apparatus also includes a second tube with proximal and distal ends. The second tube is configured to selectively evacuate the ionized gas and dislodged tissue material from the treatment area.

Abstract: An electrosurgical apparatus for coagulating tissue includes an elongated housing and an electrode located adjacent the distal end of the housing. The electrode can be connected to a source of electrosurgical energy. At least one actuator is included which electrosurgically energizes the electrode. The apparatus also includes a relatively small gas cylinder which contains a pressurized gas consisting of inert gas and which is selectively seated in the housing. Upon actuation of the actuator, gas is dispersed under pressure from the gas cylinder to the electrode and is ionized prior to the distribution of the gas into the operating field.

Abstract: An energy delivering probe is used for thermally coagulating and/or constricting hollow anatomical structures (HAS) including, but not limited to, blood vessels such as perforator veins. The probe includes a shaft and at least two electrodes where at least one of the electrodes has a perimeter that increases as it extends proximally.

Abstract: An engine comprises a liquid piston disposed within a chamber of an engine body. The chamber is defined by at least one wall. The liquid piston has one or more free surfaces that are not in contact with the chamber wall. A laser directly heats the free surface of the liquid piston. A gas spring is disposed within the chamber adjacent the free surface of the liquid piston and within the propagation path of the laser energy. The engine also includes a spring mechanism. The spring mechanism is positioned within the housing to exert pressure on another surface of the liquid piston.

Abstract: A cryosurgery device includes an aerosol container holding a liquid refrigerant and having a valve and a stem extending out therefrom; an actuator seated on the stem and including an outlet tube for receiving released refrigerant from the container; a hub mounted on the container and including slots therein; and a base having a central opening for receiving the hub, the base including aligning projections that enter the slots in the hub to engage and apply pressure to the actuator to cause the actuator to depress the stem and release refrigerant into the base. The container may further contain an applicator tube mounted to the hub in fluid communication with the outlet tube with a porous tip mounted to a distal end of the applicator tube for receiving the refrigerant and, being chilled thereby, applied to a skin lesion to be treated.

Abstract: The invention relates to an irrigated ablation catheter that has a pressure sensor to determine tissue contact as well as methods of using the same. The irrigated ablation catheter contains fluid tubing, an electrode with passages and a lumen and a pressure sensor located inside the lumen of the electrode. In some embodiments, a cooling fluid, such as saline, is passed through the catheter.

Abstract: A gas-enhanced electrosurgical instrument includes a hand-held applicator and a portable actuator assembly. The hand-held applicator has a gas delivery member adapted to deliver pressurized ionizable gas to the proximity of an electrode located adjacent a distal end of the applicator. The portable actuator assembly is capable of holding a source of pressurized ionizable gas, such as a cylinder or cartridge, and includes at least one controller to control the delivery of the gas from the source to the hand-held applicator and to control the delivery of electrosurgical energy to the hand-held applicator.

Abstract: Apparatus for retrieving a tissue volume of a variety utilizing an electrosurgically excited cable implemented capture component which performs in combination with an improved precursor assembly. Where that assembly is electrosurgically excited, then it is located and dimensioned to avoid arc-over with the capture component cables. A precursor assembly also is implemented with electrically insulative ceramic blade and trocar configurations.

Abstract: A system and method for heat ablation of tissue in which energy is sequentially applied to at least two electrodes inserted into tissue. The system is comprised of a radiofrequency (RF) source for supplying RF energy, at least two electrodes configured to apply RF energy to tissue, at least one return electrode for returning the RF energy to the RF source, and a controller configured to sequentially apply the RF energy to each of the at least two electrodes. The sequential delivery of energy is determined by the measured current and voltage, the calculated impedance at each of the electrodes and the timing for each electrode. An internal load may be activated with the previously activated channel and remain on until the next channel is activated to avoid the generator from having an open circuit.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: A bipolar electrosurgical instrument has a pair of pivotable juxtaposed jaw members and a locking mechanism operatively associated with a second of the jaw members. The locking mechanism has a first position engaged with the second jaw member for preventing movement of the second jaw member between an axially aligned orientation and at least one angled orientation, and a second position. The second position is disengaged from the second jaw member allowing for movement of the second jaw member between the axially aligned orientation and the at least one angled orientation. The instrument has an actuation mechanism operatively connected to a first of the jaw members with the actuation mechanism operable to move the first jaw member between an axially aligned first orientation and at least one angled orientation. An articulation knob is operatively associated with the locking mechanism and effectuates independent operation of the locking and actuation mechanisms.