Abstract: Methods and apparatuses for treating a tissue with an electric treatment by rotating a pattern of electrodes partway through a treatment is disclosed. Also described herein are methods and apparatuses to treat tissue, including treating skin disorders, by selectively de-nucleating epidermal cells without provoking a significant inflammatory response, e.g., without increasing the density of leukocytes in the treated skin, and without affecting the non-cellular components of the dermis.

Abstract: Described herein are flexible catheters adapted to be inserted into a body to deliver high-voltage, fast (e.g., microsecond, sub-microsecond, nanosecond, picosecond, etc.) electrical energy to target tissue. Also disclosed herein systems including these catheters and method of using them to treat tissue.

Abstract: A surgical clamp comprises a pair of opposing jaws moveable relative to each other between a closed position and first and second open positions. The opposing jaws remain substantially parallel to one another when moving between the closed position and the first open position. The opposing jaws remain non-parallel to one another when moving between the first open position and the second open position.

Abstract: A surgical instrument comprises a spacer element comprising a proximal region and a distal region, an end effector coupled to a distal end of the spacer element, a user hand interface at a proximal end of the spacer element, and a securing element for securing the proximal end of the spacer element to a user wrist. The user hand interface comprises an elongate member including a lumen and extending from a distal end to a proximal end of the user hand interface. The user hand interface further comprises an actuation cable extending within the lumen from the distal end to the proximal end of the user hand interface. The proximal region of the spacer element comprises a curved portion extending from the user hand interface. The user hand interface is movable in a manipulation space proximal of the distal region and distal of the proximal end of the spacer element.

Abstract: A method comprises rotating a first rotating element to cause rotation of a second rotating element and restricting, by an elongate slot of a first body portion and a pin affixed to a second body portion, a range of rotational motion of first and second jaw portions of a medical instrument. The first jaw portion is coupled to the second jaw portion by the first body portion and the second body portion. The rotation of the second rotating element causes translation of a first actuation element along a rotational axis of the second rotating element. The translation of the first actuation element causes pivotal motion of the first jaw portion towards the second jaw portion about a single pivot pin. The elongate slot of the first body portion and the pin affixed to the second body portion are positioned between the second rotating element and the single pivot pin.

Abstract: A sub-microsecond pulsed electric field generator is disclosed. The field generator includes a controller, which generates a power supply control signal and generates a pulse generator control signal, and a power supply, which receives the power supply control signal and generates one or more power voltages based on the received power supply control signal. The field generator also includes a pulse generator which receives the power voltages and the pulse generator control signal, and generates one or more pulses based on the power voltages and based on the pulse generator control signal. In some embodiments, the controller receives feedback signals representing a value of a characteristic of or a result of the pulses and generates at least one of the power supply control signal and the pulse generator control signal based on the received feedback signals.

Abstract: A sub-microsecond pulsed electric field generator is disclosed. The field generator includes a controller, which generates a power supply control signal and generates a pulse generator control signal, and a power supply, which receives the power supply control signal and generates one or more power voltages based on the received power supply control signal. The field generator also includes a pulse generator which receives the power voltages and the pulse generator control signal, and generates one or more pulses based on the power voltages and based on the pulse generator control signal. The controller receives feedback signals representing a value of a characteristic of or a result of the pulses and generates at least one of the power supply control signal and the pulse generator control signal based on the received feedback signals.

Abstract: An electrode connectable to a pulse generator is disclosed. The electrode includes therapeutic terminals configured to deliver the pulse to a patient, first and second electrical pulse inlet holes, and a first pulse input terminal. The first pulse input terminal is in the first electrical pulse inlet hole and is spaced apart from an entrance to the first electrical pulse inlet hole by more than about 2.5 cm. Also, first pulse input terminal is connected with one or more of the therapeutic terminals. The electrode also includes a second pulse input terminal, where the second pulse input terminal is in the second electrical pulse inlet hole and is spaced apart from an entrance to the second electrical pulse inlet hole by a distance greater than about 2.5 cm. Also, the second pulse input terminal is electrically connected with one or more of the therapeutic terminals.

Abstract: A tool comprises a distal portion and a proximal portion spaced apart by a shaft along a longitudinal axis. The distal portion includes a distal link and the proximal portion including a proximal link. The distal link and proximal link form a pair of links. The tool also comprises a set of tension load bearing members connecting the proximal link and the distal link and terminating at the links of the pair to transfer movement therebetween. The tool also comprises an articulation lock positioned between the distal portion and the proximal portion and configured to allow through passage of the set of tension load bearing. The articulation lock is adjustable between an unlocked configuration in which the proximal and distal links are moveable and a locked configuration in which an effective length of the shaft is increased, creating a force to impede movement of the proximal and distal links.

Abstract: A handheld, therapeutic electrode and connector that are compatible with high voltages from a pulse generator are disclosed. The electrode includes therapeutic terminals on a tip configured to deliver high voltage pulses safely to a patient. The electrode includes sleeves, bosses, wiring channels, and other features that maximize a minimum clearance distance (across non-conductive surfaces) and air clearance between conductive connectors themselves or the connectors and a user, thus preventing dangerous arcing. Internal surfaces and seams are taken into account. The connector and its mating outlet can include similar features to maximize clearance distance. Skirts, skirt holes, and finger stops are also employed, and they can be on either the connector or outlet, or the tip or handle of the electrode.

Abstract: Described herein are treatment tip apparatuses (e.g., devices, systems, etc.) including one, or more preferably a plurality, of electrodes that are protected by an electrode partition, such as an electrode housing (which may be retractable) until pressed against the tissue for deployment of the electrodes and delivery of a therapeutic treatment. In particular, these apparatuses may include a plurality of treatment electrodes (e.g., needle electrodes) and be configured for the delivery of nanosecond pulsed electric fields.

Abstract: A surgical instrument includes a proximal end and a distal end, a first linking member coupled to a user interface positioned near the proximal end, a second linking member coupled to a clamp tool positioned near the distal end, an elongate shaft extending between the first and second linking members, and at least one cable set extending through the elongate shaft and coupling the first and second linking members such that movement of the first linking member causes corresponding movement in the second linking member. The user interface includes a handle having a first part connected to the first linking member, a second part pivotably connected to the first part, and a rotational element connected to the handle. The first linking member includes a first articulating portion and the second linking member includes a second articulating portion including a plurality of discrete links defining a plurality of lumens.

Abstract: The pulse applicator includes a first arm, including a first electrode, a second arm, including a second electrode, and a spacer. The first arm, the spacer, and the second arm are movably connected, and define a gap between the first arm and the second arm. The first electrode, the gap, and the second electrode are selectively alignable, and the first electrode and the second electrode are configured to deliver an electrical field across the gap in response to an electrical pulse received across the first and second electrodes.

Abstract: Described herein are methods and systems for using the treatment tip apparatuses and high-voltage connectors with robotic surgical systems. For example, retractable treatment tip apparatuses (e.g., devices, systems, etc.) including one, or more preferably a plurality, of electrodes that are protected by a housing (which may be retractable) until pressed against the tissue for deployment of the electrodes and delivery of a therapeutic treatment, are disclosed. In particular, these apparatuses may include a plurality of treatment needle electrodes and may be configured for the delivery of nanosecond pulsed electric fields. Also described herein are high-voltage connectors configured to provide high-voltage energy, such as nsPEF pulses, from a generator to the retractable treatment tip apparatuses.

Abstract: Methods and apparatuses for treating a tissue with an electric treatment by rotating a pattern of electrodes partway through a treatment is disclosed. Also described herein are methods and apparatuses to treat tissue, including treating skin disorders, by selectively de-nucleating epidermal cells without provoking a significant inflammatory response, e.g., without increasing the density of leukocytes in the treated skin, and without affecting the non-cellular components of the dermis.

Abstract: A pulse generation system is disclosed. The pulse generation system includes a controller, an output terminal, and a plurality of pulse generator circuits. The controller is configured to cause a driving signal pulse to be transmitted to any selected one or more of the pulse generator circuits, and to cause the driving signal pulse to not be transmitted to any selected one or more other pulse generator circuits. Each of the pulse generator circuits is configured to generate an output voltage pulse at the output terminal in response to the driving signal pulse being transmitted thereto.

Abstract: The invention provides articulating mechanisms, and flexible members and flexible segments that can form such articulating mechanisms. The mechanisms are useful, for example, for remote steering, guidance and/or manipulation of various instruments and tools at a targeted location. The mechanisms, members or segments include links connected by flexible hinges. The proximal and distal ends of the mechanisms are connected by at least one set of cables in such a fashion that a proximal active flexible segment forms a discrete pair with a distal active flexible segment. Movement of active flexible segments at the proximal end of the mechanism results in a corresponding, relative movement of segments at the distal end of the mechanism. This configuration allows each flexible segment pair to move independently of one another and also permits the articulating mechanism to undergo complex movements and adopt complex configurations.

Abstract: An electrode connectable to a pulse generator is disclosed. The electrode includes therapeutic terminals configured to deliver the pulse to a patient, first and second electrical pulse inlet holes, and a first pulse input terminal. The first pulse input terminal is in the first electrical pulse inlet hole and is spaced apart from an entrance to the first electrical pulse inlet hole by more than about 2.5 cm. Also, first pulse input terminal is connected with one or more of the therapeutic terminals. The electrode also includes a second pulse input terminal, where the second pulse input terminal is in the second electrical pulse inlet hole and is spaced apart from an entrance to the second electrical pulse inlet hole by a distance greater than about 2.5 cm. Also, the second pulse input terminal is electrically connected with one or more of the therapeutic terminals.

Abstract: A system for deploying needles in tissue includes a controller and a visual display. A treatment probe has both a needle and tines deployable from the needle which may be advanced into the tissue. The treatment probe also has adjustable stops which control the deployed positions of both the needle and the tines. The adjustable stops are coupled to the controller so that the virtual treatment and safety boundaries resulting from the treatment can be presented on the visual display prior to actual deployment of the system.

Abstract: An articulating mechanism comprises a first link, a second link, an intermediate portion, a first hinge between the first link and the intermediate portion, and a second hinge between the second link and the intermediate portion. The first link, the second link, the intermediate portion, the first hinge, and the second hinge are integrally formed. The articulating mechanism also comprises a plurality of cables for rotating the first and second links about the first and second hinges. The cables extend through channels in the first link and the second link without extending through the intermediate portion. The first and second hinges are oriented parallel to each other to permit the first and second links to rotate in the same plane about the first and second hinges, respectively. The first and second links are rotatable about the first and second hinges in two directions under control of the cables.