Abstract: Various exemplary methods and devices are provided for manipulating and/or anchoring devices and body parts during surgical procedures. In one embodiment, an anchor member is provided for anchoring a device or body part to tissue, such as an internal wall of a body cavity. The device can be, for example, an endoscopic device, an accessory channel coupled to an endoscopic device, or a support member adapted to support or manipulate an organ. The anchor member can include or form an opening through which the device can be inserted. The anchor member or device can thus be manipulated relative to the tissue to control movement of and/or provide support to the device, tools inserted through the device, and/or organs grasped by the device or tools.

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.

Abstract: A surgical instrument can comprise two positive electrodes positioned along a first line, and two negative electrodes positioned along a second line, wherein the first line can be perpendicular to the second line. The positive electrodes can be positioned further away from a central axis than the negative electrodes in order to expand the voltage field created by the electrodes. In various embodiments, a surgical instrument can comprise a first array of electrodes positioned along a first line and a second array of electrodes positioned along a second line. In at least one embodiment, the first array of electrodes can comprise both positive and negative electrodes, and, in addition, the second array of electrodes can comprise both positive and negative electrodes.

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: Ablation probes for ablating cardiac tissue through a patient's natural orifice and methods for ablating cardiac tissue through a patient's natural orifice. In some embodiments, an ablation probe, which may include electrodes, a radio frequency probe or a cryoprobe, is inserted through an incision made through the patient's esophagus. A balloon catheter may be inserted through the incision after it has been made to expand the area between the heart and the esophagus. The ablation probe is then brought into contact with the cardiac tissue and activated to irreversibly damage the tissue. The ablation probes may employ vacuum to retain the tissue in contact with the probe during ablation.

Abstract: A medical instrument includes a flexible catheter, a medical guidewire, and a mechanized guidewire drive assembly. The catheter has a distal end insertable into a body lumen of a patient. The mechanized guidewire drive assembly is adapted for operable engagement with the medical guidewire. The mechanized guidewire drive assembly includes a motor and includes a controller which drives the motor with a driving force. The driving force has a predetermined upper limit.

Abstract: A medical instrument including a medical catheter having a distal end insertable within a body lumen of a patient, having a first flexible catheter segment, and having a second flexible catheter segment located distal the first flexible catheter segment. The first flexible catheter segment includes a first loop sensor and includes an active first catheter stiffener adapted to stiffen and un-stiffen substantially only the first flexible catheter segment. The second flexible catheter segment includes a second loop sensor and includes an active second catheter stiffener adapted to stiffen and un-stiffen substantially only the second flexible catheter segment. A method for using the medical instrument is also presented.

Abstract: The present invention relates to a fusible suture for joining portions of tissue. The suture includes an elongate electrical conductor. The conductor extends between opposite ends of the suture and has sufficient flexibility to permit segments of the conductor to overlap, thereby forming a loop sized for joining portions of tissue. The overlapped segments of the conductor are heated upon application of an electrical current to the conductor. The suture further includes a coating that at least partially covers the conductor and extends over at least one of the segments of the conductor. The coating softens when its temperature is at and above a softening temperature so that the overlapping segments of the coating coalesce. The softening temperature is lower than a melting temperature of the conductor. The coating returns to a non-softened state when its temperature falls below a hardening temperature, thereby forming a bond between the overlapped segments of the conductor.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. The catheter has an articulated section. The medical guidewire has first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second medical instrument includes a flexible catheter, a mechanized guidewire assembly, and a medical guidewire extendable beyond a distal end of the catheter. The catheter has an articulated section. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second medical instrument includes a flexible catheter, a mechanized guidewire assembly, and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: A first medical instrument includes a flexible catheter having a distal end which has a substantially bullet-nose shape, which is insertable into a body lumen of a patient, and which has at least one guidewire passageway opening. The first medical instrument also includes a medical guidewire having a working portion extendable beyond the at-least-one guidewire passageway opening. A second medical instrument includes a flexible catheter, a medical guidewire having a working portion extendable beyond the distal end of the catheter, and at least one wire length counter which is operably connectable to the medical guidewire to measure a length of the working portion being extended beyond the distal end of the catheter. A third medical instrument includes a flexible catheter, a medical guidewire, and a force/torque-limiting clutch operatively connectable to the medical guidewire.

Abstract: A surgical system including a bipolar generator having a first electrical connection and a second electrical connection, a needle, the needle being formed from a first electrically conductive material and electrically connected to the first electrical connection, and a conductor coaxially disposed over the needle, the conductor being formed from a second electrically conductive material and electrically connected to the second electrical connection, wherein the needle is electrically isolated from the conductor.

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 surgical system including a source of electrical energy, the source including a first electrical connection and a second electrical connection, a first jaw member including a first electrode connected thereto and electrically isolated therefrom, the first electrode being electrically connected to the first electrical connection, a second jaw member pivotally connected to the first jaw member and including a second electrode connected thereto and electrically isolated therefrom, the second electrode being electrically connected to the second electrical connection and electrically isolated from the first electrode, and an elongated shaft having a distal end and a proximal end, wherein the first jaw member and the second jaw member are connected to the distal end of the shaft.

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 illuminating system scatters light into the mucosal lining of the stomach adjacent to an ulcerated area, an area containing a lesion, or ather area of interest. A light detector positioned on the opposite side of the area of interest uses detected light patterns to identify the location of circulatory structures beneath the mucosal lining adjacent to the area of interest.

Abstract: A surgical instrument, such as an endoscopic or laparoscopic instrument, includes an ablation device. The ablation device includes an elongate member comprising first and second channels. First and second probes are disposed within the respective first and second channels, where the first and second probes each define a central axis. First and second electrodes are coupled to distal ends of the respective first and second probes. A distance between the first and second electrodes is adjustable by rotating at least one of the first and second probes about the central axis of the at least one of the first and second probes.

Abstract: A connector configured to receive electrical energy from an energy source. A fastener is coupled to the connector. The fastener is configured for attachment through a tissue wall. A first electrode includes at least one electrically conductive portion and is coupled to the connector by a first electrically conductive wire.

Abstract: A surgical instrument, such as an endoscopic or laparoscopic instrument, includes an ablation device. The ablation device includes an elongate flexible member having a proximal end and a distal end. A first working channel is formed within the flexible member. A first diagnostic probe having a proximal end and distal end is located within the first working channel and extends through the distal end of the flexible member. A first electrode is connected to the distal end of the first diagnostic probe electrode is adapted to be endoscopically located in a tissue treatment region. The first electrode is adapted to couple to an electrical waveform generator to receive an irreversible electroporation electrical waveform sufficient to ablate tissue located proximate to the first electrode. A system further includes an electrical waveform generator electrically coupled to the first electrode of the ablation device to generate an IRE waveform sufficient to ablate tissue located proximate to the first electrode.

Abstract: An electrical ablation apparatus includes a housing extending along a longitudinal axis. A first electrode and a second electrode are disposed within the housing. The electrodes are configured to connect to electrically conductive wires. The first and second electrodes are separated by a gap. The second electrode includes first and second prongs defining an opening suitable to receive tissue to be ablated therebetween. When the first and second electrodes are energized at a predetermined energy level, an electric current suitable to ablate the tissue flows across the gap and forms an electric arc between the distal end of the first electrode and the tissue. A system includes an energy source to drive the electrical ablation apparatus. A method includes introducing the electrical ablation apparatus into a patient and ablating tissue with the electric arc.