Abstract: Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.

Abstract: A variety of electrical ablation apparatuses and methods are disclosed. In one embodiment, an ablation apparatus includes an injector catheter electrode having a proximal end configured to couple to an energy source and a fluid source. A distal end of the injector catheter defines an injection needle and defines an electrically conductive hollow channel for communicating a fluid from the fluid source to a treatment site. A balloon electrode is in fluid communication with a balloon catheter. The balloon catheter has a proximal end configured to couple to the energy source and the fluid source and a distal end configured to inflate the balloon electrode.

Abstract: A device for guiding electrodes relative to a tissue treatment region. The device can comprise a body have a plurality of passages therethrough. Each passage can axially restrain an electrode positioned therein. When each electrode is axially restrained in a passage, the distal ends of the electrodes can be spaced a predetermined distance apart. Further, the electrodes can be held in a parallel or substantially parallel alignment when axially retained in the passages. The predetermined distance between the electrodes can correspond to a treatment distance in a tissue treatment region and the distal ends of the electrodes can be operably structured to conduct current therebetween when at least one of electrodes is energized by an energy source.

Abstract: Catheter systems, tools and methods are disclosed for the selective and rapid application of DC voltage to drive irreversible electroporation, with the system controller configurable to apply voltages to an independently selected subsets of electrodes, such that voltages of one polarity are applied to a multiplicity of electrodes on a first medical device and voltages of the opposite polarity to a multiplicity of electrodes on a second medical device. The first and second medical devices can be epicardial catheters positioned such that their opposing distal tips are approximately aligned and whose segments with electrodes collectively wrap around the pulmonary veins.

Abstract: An electrical ablation apparatus comprises first and second electrodes. Each electrode comprises a first end configured to couple an energy source and a second end configured to couple to a tissue treatment region. An energy source is coupled to the first and second electrodes. At least one electrode is movable between a first position and a second position. A first necrotic zone having a first shape is created when the electrodes are energized in the first position and a second necrotic zone having a second shape is created when the electrodes are energized in the second position. At least one electrode may be pre-formed with a radius.

Abstract: A surgical instrument, such as an electrical ablation device, including a first elongate body having an insert and a second elongate body having an electrically insulative sheath that defines a bore. A mating element mates the elongate bodies when at least a portion of the insert is received within the bore. The second elongate body is configured to receive electrical energy from the first elongate body and transmit the electrical energy to an electrode. In certain embodiments, the electrical ablation device may include first and second elongate bodies. The first includes an electrically conductive insert configured to electrically couple to an energy source and apply the electrical energy to tissue, and the second includes an electrically insulative sheath defining a bore configured to receive the insert therethrough and move proximally or distally relative to the insert.

Abstract: A device for guiding electrodes relative to a tissue treatment region. The device can comprise a body have a plurality of passages therethrough. Each passage can axially restrain an electrode positioned therein. When each electrode is axially restrained in a passage, the distal ends of the electrodes can be spaced a predetermined distance apart. Further, the electrodes can be held in a parallel or substantially parallel alignment when axially retained in the passages. The predetermined distance between the electrodes can correspond to a treatment distance in a tissue treatment region and the distal ends of the electrodes can be operably structured to conduct current therebetween when at least one of electrodes is energized by an energy source.

Abstract: An ablation system including a first probe extending through a first longitudinal lumen from a proximal end to beyond a distal end of a flexible shaft, a first electrode coupled to a distal end of the first probe, and a first conductor electrically coupled to the first electrode. The ablation system further includes a second probe extending through a second longitudinal lumen from the proximal end to beyond the distal end of the flexible shaft, a second electrode coupled to a distal end of the second probe, and a second conductor electrically coupled to the second electrode. The first and second probes are rotatable and translatable within the first and second longitudinal lumens respectively. Furthermore, the first electrode and the second electrode are rotatably and translatably positionable with respect to one another, via the first probe and the second probe respectively, to define a region therebetween.

Abstract: A surgical instrument, such as an endoscopic or laparoscopic instrument, includes an ablation device. The ablation device includes an elongate relatively flexible member having a proximal end and a distal end, the flexible member includes at least a first working channel. A first and second electrode extends from a working channel at the distal end of the flexible member. The first and second electrodes are adapted to be endoscopically located in a tissue treatment region. The first and second electrodes are adapted to couple to an electrical waveform generator to receive an irreversible electroporation electrical waveform sufficient to ablate tissue located between the first and second electrodes. The waveform parameters of the irreversible electroporation electrical waveform are determined based on image information received from the tissue treatment region.

Abstract: An energy source for use with an electrosurgical system is disclosed. In one embodiment, the energy source includes a power supply, one or more capacitors coupled to the power supply, and a switching component coupled to the one or more capacitors. The switching component is configured to output pulses of a biphasic waveform. The pulses are capable of treating undesired tissue by inducing a change in voltage potential across cell membranes of a plurality of cells in the undesired tissue to promote non-thermal cell death in the plurality of cells. The pulses are also capable of treating the undesired tissue with no or minimal muscle contractions in patient tissue within reach of the biphasic waveform during treatment of the undesired tissue.

Abstract: An ablation device may generally comprise a first electrode, a plurality of second electrodes, and a grounding pad. Each of the plurality of second electrodes may comprise a first conductive section, a second conductive section, and a non-conductive section between the first conductive section and the second conductive section. The first electrode and each of the plurality of second electrodes may be coupled to an energy source delivering a series of electrical pulses to tissue to induce cell necrosis by irreversible electroporation.

Abstract: An electrical ablation device may generally comprise first and second electrodes coupled to an energy source operative to generate and deliver a first sequence of electrical pulses and a second sequence of electrical pulses to tissue having a necrotic threshold, wherein the first sequence of electrical pulses delivers a first energy dose that is less than the necrotic threshold to induce thermal heating in the tissue and the second sequence of electrical pulses delivers a second energy dose equal to or greater than the necrotic threshold to induce cell necrosis in the tissue by irreversible electroporation. The first sequence of electrical pulses may each be independently characterized by a first amplitude, a first pulse width, and a first frequency. The second sequence of electrical pulses may be characterized by a second amplitude, a second pulse width, and a second frequency.

Abstract: A computer-implemented system for delivering energy to tissue having a necrotic threshold may generally comprise an electrode array comprising a plurality of electrodes, a central electrode positioned intermediate the plurality of electrodes, and a controller configured to not only apply a first sequence of electrical pulses to the electrode array to induce thermal heating in the tissue and reduce the necrotic threshold of the tissue but also apply a second sequence of electrical pulses to the central electrode to induce cell necrosis in the tissue by irreversible electroporation. Electrical ablation devices and methods of using the same are also described herein.

Abstract: An electrosurgical system may generally first and second electrodes coupled to an energy source operative to generate and deliver pulses of a biphasic radio frequency (RF) waveform to treat undesirable tissue in a patient. The pulses may induce non-thermal cell death in the patient's tissue while causing no or minimal muscle contractions in the treated patient. The pulses may be grouped in bursts wherein the pulses within a burst repeat at a particular pulse frequency.

Abstract: An ablation apparatus may generally comprise an elongated body having a proximal end and a distal end and a non-conductive tip at the distal end, a conductive sheath at least partially surrounding a portion of the elongated body intermediate the proximal end and the tip, and an electrical conductor electrically connected to the conductive sheath. The ablation apparatus may comprise a first electrode having a first diameter and a plurality of second electrodes each having a second diameter, wherein the first diameter is greater than the second diameter. Methods of using the ablation apparatus are also described.

Abstract: A method for delivering energy to tissue having a necrotic threshold may generally comprise inserting an electrode array comprising a plurality of electrodes into the tissue, inserting a central electrode into the tissue, positioning a ground pad proximal to the tissue, applying a first sequence of electrical pulses to the electrode array less than the necrotic threshold to induce thermal heating in the tissue, applying a second sequence of electrical pulses to the central electrode equal to or greater than the necrotic threshold to induce cell necrosis in the tissue by irreversible electroporation, and applying a ground potential to the ground pad. Electrical ablation devices and systems and methods of using the same are also described herein.

Abstract: An apparatus for treating tissue in a tissue treatment region. The apparatus can comprise an electrode ring having an interior perimeter and an electrode probe having a proximal end and a distal end. The distal end of the electrode probe can be structured to axially translate relative to the interior perimeter of the electrode ring. The electrode ring and the electrode probe can be operably structured to conduct current therebetween when at least one of the electrode ring and the electrode probe is energized by an energy source. Further, the energy source can be a Radio Frequency (RF) energy source, a pulsed energy source, an irreversible electroporation energy source, or a pulsed irreversible electroporation energy source. A current from the energy source can be selected to non-thermally ablate tissue in the tissue treatment region.

Abstract: An electrical ablation apparatus comprises first and second electrodes. Each electrode comprises a first end configured to couple an energy source and a second end configured to couple to a tissue treatment region. An energy source is coupled to the first and second electrodes. The energy source is configured to deliver a first series of electrical pulses sufficient to induce cell necrosis by irreversible electroporation and a second series of electrical pulses sufficient to induce cell necrosis by thermal heating, through at least one of the first and second electrodes. The first series of electrical pulses is characterized by a first amplitude, a first pulse length, and a first frequency. The second series of electrical pulses is characterized by a second amplitude, a second pulse length, and a second frequency.

Abstract: A module for attachment to a medical instrument to scan the anatomy with a beam of radiation. The module comprising a housing suitable for insertion in the anatomy that includes a window and a fastener to attach the housing to a medical instrument, an oscillating reflector within the housing that directs a beam of radiation onto the anatomy, and a collector to receive radiation returned from the anatomy.

Abstract: A surgical instrument can comprise a first electrode, a second electrode, and a retractable sheath. At least one of the electrodes can comprise an insulative jacket extending along the length thereof which can comprise a tissue stop for limiting the progression of the electrode into tissue. In various embodiments, a surgical instrument can comprise a first electrode, a second electrode, and a displaceable arc guard positioned between the electrodes. In certain embodiments, a surgical instrument can comprise an electrode including a flexible mesh configured to conform to the tissue against which it is positioned.