Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: An apparatus includes a shaft assembly, an end effector, and a sensor. The shaft assembly defines a longitudinal axis. The end effector is positioned at a distal end of the shaft assembly. A portion of the end effector is offset from the longitudinal axis. The sensor is configured to generate a signal in response to a magnetic field. The signal is configured to indicate a position of the end effector within three-dimensional space. The sensor is coaxially positioned about the longitudinal axis.

Abstract: Catheters are presented herein having planar end effectors of various configurations, generally providing a two-sided and multi-layered platform for electrodes and sensors. In some examples, the end effector has a support frame (e.g. nitinol) between a pair of flexible circuits. The end effector can also include a polymer (e.g. silicone, LCP, etc.) between the flexible circuits and encapsulating the support frame. This platform facilitates positioning of electrodes on either side (including both sides) of the end effector in a variety of spacings and facilitates ultra-tight electrode spacing and/or a large area electrode. Sensors (ultrasound transducers, navigation coils, etc.) can be layered within the end effector between outer surfaces of the flexible circuits in a variety of configurations.

Abstract: An apparatus includes a handle assembly, a guide tube, and a dilation catheter. The guide tube extends distally from the handle assembly. At least a distal portion of the guide tube is malleable. The dilation catheter is slidably positioned in the guide tube. The dilation catheter includes a distal end, a dilator, and a position sensor. The position sensor is configured to generate a signal indicating a position of the position sensor in three-dimensional space. The dilation catheter is configured to translate relative to the guide tube.

Abstract: A method of treating a patulous Eustachian tube includes forming a first pocket in a wall of a nasopharynx region proximate to a pharyngeal ostium, inserting a resiliently biased implant within the first pocket, and allowing the resiliently biased implant to expand within the first pocket to thereby urge the Eustachian tube towards a closed state. The wire implant may include a resilient stent or other resilient wire structure. In some versions, a deployment device having a balloon is used to deploy a malleable implant. This deployment device has a malleable implant disposed around the balloon, which is disposed around a guide catheter. The balloon is inflated and expands the malleable implant. The malleable implant retains the expanded shape and urges the Eustachian tube toward a closed state.

Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: A method is used to manufacture a surgical instrument including a first tube, and a second tube. The first tube extends from a proximal first end portion to a distal first end portion. The second tube extends from a proximal second end portion to a distal second end portion. The second tube is positioned coaxially within the first tube with the distal second end portion positioned adjacent to the distal first end portion. The second tube defines a lumen. The sensor is secured proximal to the distal second end portion of the second tube. A die is engaged against a distal first end portion of the first tube while first tube rotates about its own longitudinal axis; and the die is simultaneously moved relative to the distal first end portion of the first tube along a predetermined path to form a predetermined shape.

Abstract: A surgical instrument includes an elongate shaft having a proximal shaft portion and a malleable distal shaft portion. The elongate shaft is configured to be secured to a supporting surgical instrument. An ablation head is coupled to the malleable distal shaft portion and includes at least one electrode operable to deliver RF energy to tissue for ablating the tissue. The ablation head is sized to fit within the nasal cavity of a patient with a distal end of the supporting surgical instrument. The proximal shaft portion is configured to operatively couple with an RF energy source operable to energize the at least one electrode with RF energy. The malleable distal shaft portion is configured to bend relative to a longitudinal shaft axis defined by the proximal shaft portion for selectively orienting the ablation head relative to the longitudinal shaft axis.

Abstract: An apparatus includes a handle assembly, a guide tube, and a dilation catheter. The guide tube extends distally from the handle assembly. At least a distal portion of the guide tube is malleable. The dilation catheter is slidably positioned in the guide tube. The dilation catheter includes a distal end, a dilator, and a position sensor. The position sensor is configured to generate a signal indicating a position of the position sensor in three-dimensional space. The dilation catheter is configured to translate relative to the guide tube.

Abstract: An apparatus includes a shaft assembly, an end effector, and a sensor. The shaft assembly defines a longitudinal axis. The end effector is positioned at a distal end of the shaft assembly. A portion of the end effector is offset from the longitudinal axis. The sensor is configured to generate a signal in response to a magnetic field. The signal is configured to indicate a position of the end effector within three-dimensional space. The sensor is coaxially positioned about the longitudinal axis.

Abstract: A method of treating a patulous Eustachian tube includes forming a first pocket in a wall of a nasopharynx region proximate to a pharyngeal ostium, inserting a resiliently biased implant within the first pocket, and allowing the resiliently biased implant to expand within the first pocket to thereby urge the Eustachian tube towards a closed state. The wire implant may include a resilient stent or other resilient wire structure. In some versions, a deployment device having a balloon is used to deploy a malleable implant. This deployment device has a malleable implant disposed around the balloon, which is disposed around a guide catheter. The balloon is inflated and expands the malleable implant. The malleable implant retains the expanded shape and urges the Eustachian tube toward a closed state.

Abstract: An endoscope assembly includes a shaft assembly, an endoscopic camera assembly, and an anatomy elevation assembly. The shaft assembly includes a flexible outer shaft defining a lumen, a first electrical communication line, and a first fluid communication line. The endoscopic camera assembly is in communication with the first electrical communication line. The anatomy elevation assembly includes an inflatable member coupled to the flexible outer shaft. The inflatable member includes an interior surface. The first fluid communication line is in fluid communication with the inflatable member. The inflatable member is configured to transition between a deflated configuration and an inflated configuration. The interior surface is configured to define a viewing path distal to the endoscopic camera assembly while the inflatable member is in the inflated configuration.

Abstract: The disclosed technology includes a catheter for electrophysiology applications. The catheter can comprise a shaft extending along a longitudinal axis to a distal end and an end effector coupled to the distal end of the shaft. The end effector can include a plurality of loop members. Each loop member of the plurality of loop members can include a corresponding stress distribution node positioned at a distal portion of the respective loop member and a plurality of electrodes affixed to the plurality of loop members.

Abstract: A method is used to manufacture a surgical instrument including a first tube, and a second tube. The first tube extends from a proximal first end portion to a distal first end portion. The second tube extends from a proximal second end portion to a distal second end portion. The second tube is positioned coaxially within the first tube with the distal second end portion positioned adjacent to the distal first end portion. The second tube defines a lumen. The sensor is secured proximal to the distal second end portion of the second tube. A die is engaged against a distal first end portion of the first tube while first tube rotates about its own longitudinal axis; and the die is simultaneously moved relative to the distal first end portion of the first tube along a predetermined path to form a predetermined shape.

Abstract: A system (11) includes a medical probe (36) for insertion into a cavity of an organ, which includes a position and direction sensor (60) and a camera (45), both operating in a sensor coordinate system (62). The system further includes a processor (44) configured to: receive, from an imaging system (21) operating in an image coordinate system (28), a three-dimensional image of the cavity including open space and tissue; receive, from the medical probe, signals indicating positions and respective directions of the medical probe inside the cavity; receive, from the camera, respective visualized locations inside the cavity; register the image coordinate system with the sensor coordinate system so as to identify one or more voxels in the image at the visualized locations, and when the identified voxels have density values in the received image that do not correspond to the open space, to update the density values of the identified voxels to correspond to the open space.

Abstract: A surgical instrument includes an elongate shaft having a proximal shaft portion and a malleable distal shaft portion. The elongate shaft is configured to be secured to a supporting surgical instrument. An ablation head is coupled to the malleable distal shaft portion and includes at least one electrode operable to deliver RF energy to tissue for ablating the tissue. The ablation head is sized to fit within the nasal cavity of a patient with a distal end of the supporting surgical instrument. The proximal shaft portion is configured to operatively couple with an RF energy source operable to energize the at least one electrode with RF energy. The malleable distal shaft portion is configured to bend relative to a longitudinal shaft axis defined by the proximal shaft portion for selectively orienting the ablation head relative to the longitudinal shaft axis.

Abstract: An apparatus includes a catheter shaft assembly, an end effector, a coupling member, and a position sensor assembly. The end effector includes at least one electrode. The coupling member is positioned at the distal end of the catheter shaft assembly and at the proximal end of the end effector. The coupling member includes a body having an exterior. The position sensor assembly includes at least one coil. The at least one coil is configured to generate a signal indicative of a position of the at least one coil in response to an alternating magnetic field. At least a portion of the position sensor assembly is positioned about the exterior of the coupling member such that the portion of the position sensor assembly positioned about the exterior of the coupling member is external to the coupling member.

Abstract: An apparatus includes a cylindraceous sleeve body, a navigation sensor, and an interface feature. The cylindraceous sleeve body includes an open proximal end, an open distal end, and a lumen extending from the open proximal end to the open distal end. The lumen is sized and configured to receive a shaft of a medical instrument. The navigation sensor is positioned at the open distal end of the cylindraceous sleeve body. The interface feature is configured to couple the navigation sensor with an image guidance system. The navigation sensor is configured to cooperate with an image guidance system to provide feedback indicating a position of the navigation sensor in three-dimensional space.

Abstract: An apparatus includes a mounting portion and a sensor portion. The mounting portion is configured to fit over a nose of a preselected patient. The mounting portion includes a base and a pair of rigid nose pads fixedly coupled to the base. Each nose pad of the pair of nose pads includes a respective nose-gripping surface. The nose-gripping surfaces of the nose pads are configured to engage the nose of the preselected patient at respective predetermined locations along the nose. Each nose-gripping surface is sized and shaped to complement a corresponding unique structural feature of the nose of the preselected patient at the predetermined location. A sensor portion is fixedly attached to the mounting portion. The sensor portion includes a first sensor configured to generate a first signal corresponding to a position of the first sensor in three-dimensional space.

Abstract: An apparatus includes a catheter shaft assembly and an end effector. The end effector is configured to transition between a first configuration and a second configuration. The end effector is configured to fit within an outer sheath in the first configuration. The end effector is configured to expand outwardly away from the longitudinal axis in the second configuration when exposed distally relative to the distal end of the outer sheath. The end effector includes a resilient frame assembly that is configured to resiliently bias the end effector toward the second configuration. The end effector further includes a first flex circuit assembly secured to the resilient frame assembly. The first flex circuit assembly includes a first flexible substrate and a first plurality of electrodes positioned on the first flexible substrate. The electrodes are configured to pick up electrical potentials from tissue or blood or ablate tissue.