Abstract: A tissue resecting or other medical device includes a handle coupled to an elongated shaft. A radiofrequency (RF) electrode is carried at a distal end of the elongated shaft, and the electrode is moveable across a window in a sleeve or other component of the shaft. The shaft has an interior channel connectable to a negative pressure source to remove debris from the channel. A motor is carried by the handle and operatively coupled to the electrode for moving the electrode relative to the window. An electronic image sensor and lens are disposed at a distal end of the shaft, and a plurality of conductors may extend through the shaft to the image sensor. The image sensor, lens and sensor conductors are disposed within a first tubular member, and an LED or other light source is also positioned at a distal end of the shaft with LED conductors or leads extending through a second tubular member of the shaft to the LED.

Abstract: The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

Abstract: A medical for removing tissue from a patient includes an elongated probe with a working end. A pair of jaws is provided at the working end. The jaws may be closed for cutting and treatment of the tissue. Cutting may be effective through a sharpened cutting blade, and RF cutting blade, and similar cutting edges. The tissue may be remodeled using heat generated from passive heating elements on the jaws, active heating elements on the jaws, a PTCR heating element carried by the jaws, or resistive heaters on the jaws.

Abstract: A tissue resecting device includes a handle coupled to an elongated sleeve assembly. The elongated sleeve assembly includes a windowed outer sleeve and an inner sleeve adapted to reciprocate and/or rotate relative to the window to resect tissue intruding into the window, where the resected tissue is captured in a channel in the sleeve assembly. One or more motors in the handle both move the inner sleeve relative to the window and operate a pump which causes a fluid to flow through the channel in the sleeve assembly to remove resected tissue therefrom.

Abstract: Systems and methods for treating vertebral compression fractures are discussed. In an embodiment, a method includes mixing bone cement precursors thereby causing a first chemical curing reaction characterized by a first time-viscosity profile, controllably applying energy to the bone cement from an external source to modify the first time-viscosity profile to a second time-viscosity profile, and injecting the cement into bone at a substantially constant viscosity greater than about 1000 Pa·s to greater than about 5000 Pa·s over an extended working time. In another embodiment, a bone cement injector system is provided that includes a first handle component that is detachably coupled to a second sleeve component having a distal end for positioning in bone and a flow channel extending through the first and second components. The system includes first and second thermal energy emitters for delivering energy to bone cement flows in a flow channel portion in the first and second components, respectively.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: A medical introducer includes an elongated tubular member having a proximal end, a distal portion, and a central lumen extending from the proximal end to a distal port in the distal portion. A frame structure is coupled to the distal portion of the elongated tubular member, where frame structure supports the distal portion of the elongated tubular member in a tapered shape and alternatively in a non-tapered shape. The elongated tubular member may include a rigid outer tube and a rigid inner tube carried in an interior lumen of the outer tube. The distal portion is typically a reinforced elastomeric tubular extension of the outer tube, and the reinforced elastomeric tubular extension may have a conical shape.

Abstract: Systems and methods for treating bone, such as vertebral compression fractures are disclosed. A method includes controllably applying energy to a bone cement volume outside of a patient's body to selectively accelerate the polymerization rate of the bone fill material volume prior to introduction into a bone. The method further includes sequentially introducing a plurality of cement carrying structures with the accelerated polymerization rate bone cement volume into the bone. A system for use in the method includes at least one elongated cement-carrying structure sized to carry a bone cement volume therein and an energy source operatively coupleable to the cement-carrying structure. The energy source applies energy to the bone cement volume to selectively accelerate a polymerization rate thereof. An elongated injector insertable into the bone has a passageway that removably receives the elongated cement-carrying structure to allow delivery of the accelerated polymerization rate bone cement into the bone.

Abstract: Disclosed herein are endoscope assemblies, and more particularly endoscopes with a working channel for use in hysteroscopy, and methods of use thereof. Devices and systems related to an integrated hysteroscopic treatment system including an endoscopic viewing system, a fluid management system, a resecting device and a controller for operating all the systems. Also disclosed are integrated hysteroscopic treatment systems that include an endoscopic viewing system, a fluid management system, a resecting device and a controller for operating all the systems.

Abstract: Tissue is treated using a radiofrequency power supply connected to an applicator having a chamber filled with an electrically non-conductive gas surrounded by a thin dielectric wall. A radiofrequency voltage is applied at a level sufficient to ionize the gas into a plasma and to capacitively couple the ionized plasma with the tissue to deliver radiofrequency current to ablate or otherwise treat the tissue.

Abstract: A fluid management system includes a disposable cassette carrying inflow and outflow tubing sections that are configured for releasably mating with a console including a control unit and a pair of roller pump heads. The console may automatically identify the disposable cassette and weigh the fluid in an inflow source. During operation, the system can monitor pressure in the working space, and provide for inflow and outflow control to maintain any desired operating parameters.

Abstract: The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

Abstract: Systems and methods for treating vertebral compression fractures are discussed. In an embodiment, a method includes mixing bone cement precursors thereby causing a first chemical curing reaction characterized by a first time-viscosity profile, controllably applying energy to the bone cement from an external source to modify the first time-viscosity profile to a second time-viscosity profile, and injecting the cement into bone at a substantially constant viscosity greater than about 1000 Pa·s to greater than about 5000 Pa·s over an extended working time. In another embodiment, a bone cement injector system is provided that includes a first handle component that is detachably coupled to a second sleeve component having a distal end for positioning in bone and a flow channel extending through the first and second components. The system includes first and second thermal energy emitters for delivering energy to bone cement flows in a flow channel portion in the first and second components, respectively.

Abstract: A fluid management system is with a fluid source, a fluid receptacle, and a surgical tool having an inlet port for receiving fluid from the fluid source and an outlet port for discharging fluid to the fluid receptacle. The fluid management system includes a pump head assembly and a tubing cassette removably insertable over the pump head assembly. The pump head assembly includes an inlet pump and an outlet pump, where each pump has a rotor, a plurality of rollers, an arcuate roller backing adjacent the rotor to define a tube receiving channel therebetween, and a rotor position sensor. An inlet motor configured to rotate the inlet pump rotor, and an outlet motor configured to rotate the outlet pump rotor. The tubing cassette includes an inlet tubing loop and an outlet tubing loop, where each tubing loop is received about the rollers in the tube receiving channel of the inlet pump when the cassette is placed over the pump head assembly.

Abstract: A tissue-resecting probe includes an elongated outer sleeve extending about an axis to a distal housing having a first window for receiving tissue. An edge of the first window has a dielectric surface. A rotatable inner sleeve has a second window, and at least a portion of an edge of the second window provides a first polarity electrode. Rotation of the inner sleeve within the outer sleeve moves the probe between window-open and window-closed configurations to resect tissue.

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.

Abstract: The present disclosure relates to bone cement formulations that have an extended working time for use in vertebroplasty procedures and other osteoplasty procedures together with cement injectors that include energy delivery systems for on-demand control of cement viscosity and flow parameters. The bone cement formulations may include a liquid component having at least one monomer and a non-liquid component including polymer particles and benzoyl peroxide (BPO). The non-liquid component may be further configured to allow controlled exposure of the BPO to the liquid monomer so as to enable control of the viscosity of the bone cement composition.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: Methods, systems and devices for endometrial ablation. In accordance with a method, a working end of an RF ablation device is positioned in a patient uterus to contact endometrial tissue, the working end comprising a dielectric wall capable of non-expanded and expanded shapes and for conforming to an asymmetric or symmetric shape of the patient's cervix. An expandable seal is provided for sealing the cervical canal.

Abstract: A tissue resection system includes a introducer sleeve with a hub. An obturator having a shaft with a blunt tip is adapted for insertion through the introducer sleeve, and an electrosurgical resecting device with an elongated extension member is adapted for insertion through the introducer sleeve.