Abstract: An improved surgical instrument having an end effector mounted on the end of an elongate shaft extending from a handle. The end-effector has different operations, including grasping, cutting, and sealing and/or coagulating tissue, and one of the operations is controlled by a drive handle mechanism. The drive handle mechanism includes an actuator, a drive shaft and a spring assembly for transferring movement of the actuator to the drive shaft, which in turn controls the end effector. The drive handle mechanism limits the amount of force transferred from the drive handle mechanism to the end effector, preventing damage to the tissue. As the actuator is operated, the spring assembly transfers the movement of the actuator to the drive shaft and the end effector. At the same time, the spring assembly compresses to absorb some of the force applied. Such configuration prevents the tissue being unintentionally damaged by the end effector.

Abstract: A catheter is configured to access a renal artery. A lumen of the catheter's shaft is dimensioned to receive a flexible actuation member which extends between the shaft's proximal and distal ends. The actuation member is moveable within the lumen and subject to elastic deformation, friction, and/or whip along its length. A flexible support member is coupled to a distal end of the actuation member and extendible beyond a distal tip of the shaft. An RF ablation electrode at a distal end of the support member is configured to ablated perivascular renal nerve tissue. A position converter at the distal end of the shaft is configured to convert movement of the actuation member into one or both of controlled rotational and axial movement of the support member and electrode to one of a multiplicity of stable circumferential positions substantially free of elastic deformation, friction, and/or whip impacting actuation member movement.

Abstract: Methods for treating a human patient diagnosed with cancer with therapeutic neuromodulation and associated systems are disclosed herein. Sympathetic nerve activity can contribute to several cellular and physiological processes associated with the progression of cancer. One aspect of the present technology is directed to methods that attenuate neural traffic along target sympathetic nerves innervating tissue proximate a primary malignant tumor. Other aspects are directed to methods that at least partially inhibit sympathetic neural activity in a renal nerve of a patient diagnosed with cancer or who has a high risk of developing cancer. Targeted sympathetic nerve activity can be attenuated to improve a measurable physiological parameter corresponding to the progression of cancer in the patient. The attenuation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly, e.g.

Abstract: Adjacent tissue layers can be accessed using a catheter device with a distal tip having a conductive portion including a first cutting feature and one or more projections extending from the first cutting feature towards an outer diameter of the distal tip. Electrical energy can be supplied to the conductive portion of the device to cut tissue. A stent can be delivered to form a fluid communication between the adjacent tissue layers.

Abstract: A bipolar electrosurgical instrument includes first and second shafts each having a jaw member extending from its distal end. Each jaw member is adapted to connect to a source of electrosurgical energy such that the jaw members are capable of selectively conducting energy through tissue held therebetween. A knife channel is configured to reciprocate a cutting mechanism therealong. An actuator selectively advances the cutting mechanism. A switch is disposed on the first shaft and is configured to be depressed between a first position and at least one subsequent position upon biasing engagement with a mechanical interface disposed on the second shaft. The first position of the switch relays information to the user corresponding to a desired pressure on tissue and the at least one subsequent position is configured to activate the source of electrosurgical energy to supply electrosurgical energy to the jaw members.

Abstract: An actuation mechanism for actuating an electrosurgical end effector includes a housing and a shaft assembly extending distally from the housing. The shaft assembly includes an elongate collar, a shaft extending through the elongate collar, and a longitudinal bar axially movable relative to the shaft. The elongate collar has an internal threadform extending along a length thereof. The longitudinal bar includes a proximal end having an extension engaged to the internal threadform of the elongate collar and a distal end configured to be coupled to a knife blade of an electrosurgical end effector. Rotation of the elongate collar axially moves the longitudinal bar relative to the elongate collar to move the knife blade.

Abstract: An ablation electrode is mounted on the distal end of a catheter with a first portion inside and a second portion outside the catheter. The second portion is adapted to have a surface that makes maximum contact with a tissue to be ablated, leaving a minimum area not covered by the tissue and potentially exposed to blood. The first portion is adapted to provide an extended surface area for efficient exchange of heat with a coolant flowing inside the catheter. Outlets provided near the area not covered by the tissue in the second portion prevents blood from getting close to or come directly in contact with the area, thereby greatly reducing formation of dangerous blood clots. The minimizing of an electrical circuit through blood greatly reduces wasted power into the electrode so that the efficiently cooled electrode is not burdened. The catheter preferably has multiple electrodes with similar features.

Abstract: A robotic surgical system including a control system that controls the movement of a robotic arm is described. The robotic arm can be coupled to a tool assembly that includes an end effector positioned at a distal end of a shaft. The tool assembly can include one or more sensors that measure a variety of forces or velocities associated with either the robotic arm or end effector. The control system can collect and monitor such sensed forces and velocities to determine and control one or more appropriate movement parameters associated with the robotic arm thereby controlling the cutting of tissue and preventing unwanted cutting of tissue. Furthermore, movement parameters associated with more than one robotic arm can be controlled by the control system.

Abstract: An ablation electrode is mounted on the distal end of a catheter with a first portion inside and a second portion outside the catheter. The second portion is adapted to have a surface that makes maximum contact with a tissue to be ablated, leaving a minimum area not covered by the tissue and potentially exposed to blood. The first portion is adapted to provide an extended surface area for efficient exchange of heat with a coolant flowing inside the catheter. Outlets provided near the area not covered by the tissue in the second portion prevents blood from getting close to or come directly in contact with the area, thereby greatly reducing formation of dangerous blood clots. The minimizing of an electrical circuit through blood greatly reduces wasted power into the electrode so that the efficiently cooled electrode is not burdened. The catheter preferably has multiple electrodes with similar features.

Abstract: This disclosure is directed to a catheter having a lasso electrode assembly with a movable spine. The lasso electrode assembly may have an array of sensing electrodes and may be configured to engage the ostium of the vessel of a patient. The movable spine may have an ablation electrode and may travel along track around the circumference of the lasso electrode assembly. By adjusting the position of the movable spine, tissue may be ablated to form lesions around a circumference of the vessel.

Abstract: An irrigated needle electrode ablation catheter has a distal tip section with a tip electrode, a needle electrode assembly longitudinal movable relative to the catheter, and a needle centering insert in a channel in the tip electrode. The assembly has a proximal tubing and a distal needle electrode, and the insert supports the needle electrode in the channel at a predetermined separation distance from the tip electrode while enabling irrigation to flow circumferentially around the needle electrode through the channel and exit at the distal end of the tip electrode. The catheter also provides a first dedicated fluid pathway through the assembly and exits at the distal end of the needle electrode, and a second dedicated fluid pathway to supply fluid to the channel in the tip electrode, wherein the second pathway is defined by a guide tube and directed by a plunger member.

Abstract: A microwave ablation system includes a generator including a first energy source, a second energy source and a diplexer, the diplexer multiplexes a first energy from the first energy source and a second energy from the second energy source. The system also includes a cable including a center conductor and an outer sheath where the multiplexed energy is transmitted through the center conductor. In addition an antenna is provided that is operable to receive the multiplexed energy from the center conductor and to deliver the multiplexed energy to a region of tissue. The outer sheath acts as a return path of the second energy to the second energy source. A sensor is also provided that measures at least one parameter of the second energy generated by the second energy source and the second energy returned from the region of tissue.

Abstract: An electrosurgery handpiece/pencil with smoke evacuation having features that support use at high frequencies without insulation breakdown and that provides increased efficiency of smoke evacuation during cutting and/or coagulation. The electrosurgery handpiece/pencil includes a handpiece, an electrode positioned within an end of the handpiece, and a nozzle member for retaining the electrode which fits within an interior of the end of the handpiece that contains the electrode.

Abstract: Tissue may be cut and extracted from an interior location in a patient's body using a probe or tool which both effects cutting and causes vaporization of a liquid or other fluid to propel the cut tissue through an extraction lumen of the cutting device. The cutting may be achieved using an electrosurgical electrode assembly, including a first electrode on a cutting member and a second electrode within a cutting probe or tool. Thus, over a first cutting portion, radio frequency current may help cut the tissue and over a second or over transition region, the RF current may initiate vaporization of the fluid or other liquid to propel the tissue from the cutting device.

Abstract: A cryoprotective device includes a hollow cryoprotective probe having a distal tip, a removable obturator, and at least one integral temperature sensor monitoring temperature at least adjacent the distal tip. An injector is able to inject a cryoprotective substance (CPS) through the cryoprotective probe and out the distal tip when the obturator is removed. The CPS is of a material that prevents freezing of a substance at which it is injected when adjacent cryotherapy occurs. A processor monitors temperature of the at least one the temperature sensor and can indicate if a preset limit is exceeded.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed, with the device including a set of splines coupled to a catheter for medical ablation therapy. Each spline of the set of splines may include a set of electrodes formed on that spline. The set of splines may be configured for translation to transition between a first configuration and a second configuration. The devices described herein may be used to form a lesion via focal ablation.

Abstract: An apparatus for mechanically manipulating hollow organs within the body of a subject, or an organ manipulation apparatus, includes a manipulation section. The manipulation section may include a substantially two-dimensional element, which may have a width that exceeds a distance across a portion of the interior of a hollow organ within which the manipulation section is to be positioned. The manipulation section is configured to manipulate at least a portion of a hollow organ from within, which may modify at least one of a shape, orientation, or location of at least part of the hollow organ. Methods for manipulating hollow organs are also disclosed, as are operating techniques, such as left atrial ablation, in which the shapes, orientations, and/or locations of hollow organs are manipulated to move the hollow organs away from the site of the medical procedure, reducing the potential for damage to the hollow organs.

Abstract: An improved surgical instrument having an end effector mounted on the end of an elongate shaft extending from a handle. The end-effector is capable of several different operations, including grasping, cutting, and sealing and/or coagulating tissue, and one of the operations is controlled by a trigger mechanism contained within the handle. In some embodiments, the end effector includes a blade assembly, the trigger mechanism being formed of a three pivot slider-crank mechanism arranged to drive the blade assembly longitudinally along a rotatable drive shaft contained within the elongate shaft. As such, the mechanism is configured so as to drive the blade assembly with enough force that the cutting blade is able to cut through tissue without the user needing to apply any additional force to the trigger, the me. Such an arrangement is particularly advantageous when the blade is being used to cut thick tissue.

Abstract: Disclosed herein is an apparatus for cooling a sterile liquid for use in cryotherapy, the apparatus comprising: a first chamber (202) adapted to receive a removable container (201) of sterile liquid and a fluid port for receiving a fluid for applying, in use, pressure to a received removable container (201); and a second chamber (203) comprising a cooler; wherein the first chamber (202) is arranged to be in thermal conductivity with the second chamber (203) such that, in use, the contents of the first chamber (202) are cooled by the cooler of the second chamber (203). Advantageously, embodiments provide a system, heat exchanger unit within the system and method for supplying a sterilised working fluid to a catheter system for cryotherapy, the working fluid being supplied at a desired and easily controllable temperature and flow rate.

Abstract: An RF electrode can have a straight shaft to generate an RF heat lesion that is asymmetric about the central axis of the cannula through which the RF electrode is introduced into bodily tissue. For example, system for tissue ablation including a cannula and an electrode, the cannula including an elongated shaft having a proximal end and a distal end, the cannula shaft including an electrically conductive active tip distal to an electrically insulated cannula shaft portion, the cannula shaft including a lumen extending from a proximal opening at the proximal end of the shaft to a distal portion of the shaft.