Abstract: A device is described that may be positioned at a location in an intervertebral disc for diagnosis or treatment of the disc. Treatment may include, for example, applying energy or removing material, and may decrease intradiscal pressure. Radiofrequency energy may be applied. A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element.

Abstract: An electrosurgical instrument is provided which includes a holding formation, a probe shaft, an electric conductor, and a probe tip. The probe shaft is secured to the holding formation and has an elongated section extending therefrom. The electric conductor extends along the elongated section. The probe tip is located on a distal end of the probe shaft opposing the holding formation. The probe tip defines a volatization chamber with a mouth out of the probe tip. The probe tip includes an electrode, to which RF current is provided through the electric conductor. The electrode heats an area adjacent to the probe tip. The electrode also heats a liquid in the first volatization chamber to evaporate the liquid into a vapor pocket that ejects from the first volatization chamber through the mouth out of the probe tip. A pump effect is created so that the liquid maintains the probe tip at a more stable temperature.

Abstract: An apparatus for treating disrupted articular cartilage comprising an elongate probe member having proximal and distal extremities and a handle coupled to the proximal extremity of the elongate probe member. The distal extremity has a peripheral wall defining a cavity and a distal opening communicating with the cavity. A controllable environment is created within the cavity when the distal extremity is placed substantially flush against the disrupted articular cartilage. An electrode is positioned within the cavity at a distance spaced inwardly of the distal opening. The disrupted articular cartilage is sealed to form a substantially continuous surface when energy is supplied to the electrode. A method of using the apparatus is provided.

Abstract: A surgical instrument comprising a handle and an elongated probe connected to the handle. The elongated probe has a terminus distal to the handle. At least one electrode that includes an electrode surface is positioned on the terminus so that a line from a geometric center of the electrode surface and substantially perpendicular to the electrode surface intersects at an angle a longitudinal axis formed by the elongated probe. A conductor is provided for attaching the at least one electrode to the handle.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: A method and a device for improving cardiac function are provided. The device is packaged in a collapsed state in an end of a catheter. Portions of a frame construction of the device spring outwardly when the catheter is withdrawn from the device. Anchoring formations on the frame construction secure the frame construction to a myocardium of the heart. A membrane secured to the frame construction then forms a division between volumes of an endocardial cavity of the heart on opposing sides of the membrane.

Abstract: A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue.

Abstract: An electrosurgical instrument is provided, having a holding formation, an elongated probe, an electrode, and a conductor. The elongated probe is connected to and extends from the holding formation. The electrode is located on an end of the elongated probe opposing the holding formation, and has a leading edge and a face. The electrode is locatable so that the face is substantially in a horizontal plane and the leading edge is above the horizontal plane. The conductor extends along the elongated probe and has a portion connected to the electrode to provide RF power thereto. The electrode creates a temperature profile with a temperature adjacent to the leading edge being higher than a temperature adjacent to the face.

Abstract: A porous membrane is inserted into a ventricle of a heart. The porous membrane creates a relatively hemostatic volume in which a thrombus can grow. Blood can still pass through fenestrations of the membrane into and out of the hemostatic volume. The fenestrations reduce pressures that act on the membrane, and so reduce stresses within the membrane. The flow characteristics through the hemostatic volume promote growth of the thrombus from a base of the hemostatic volume. The thrombus grows to slightly larger than the original size of the hemostatic volume so as to provide support for the membrane. Any remaining stresses within the membrane are thereby substantially eliminated. The thrombus shrinks over an ensuing period of time, with the membrane merely acting as a barrier to which an outer wall of the myocardium retracts. The function of the membrane is then complete, and may be absorbed.

Abstract: A porous membrane is inserted into a ventricle of a heart. The porous membrane creates a relatively hemostatic volume in which a thrombus can grow. Blood can still pass through fenestrations of the membrane into and out of the hemostatic volume. The fenestrations reduce pressures that act on the membrane, and so reduce stresses within the membrane. The flow characteristics through the hemostatic volume promote growth of the thrombus from a base of the hemostatic volume. The thrombus grows to slightly larger than the original size of the hemostatic volume so as to provide support for the membrane. Any remaining stresses within the membrane are thereby substantially eliminated. The thrombus shrinks over an ensuing period of time, with the membrane merely acting as a barrier to which an outer wall of the myocardium retracts. The function of the membrane is then complete, and may be absorbed.

Abstract: A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus.

Abstract: A thermal energy delivery apparatus has a probe including a distal end and a proximal end. A first electrode is positioned at the distal end of the probe. The first electrode is configured to deliver sufficient thermal energy to a fibrillated cartilage surface to reduce a level of fibrillation of the fibrillated cartilage surface. A cabling is coupled to the proximal end of the probe. A method for thermal protection of non-targeted tissues that may be exposed to thermal probes used during arthroscopic procedures includes a pre-procedural cooling Lavage. The pre-cooled tissues provide a convective buffer for tissues not intended for thermal intervention, thereby reducing collateral damage.

Abstract: A radially expandable intravascular medical device is disclosed. The device typically includes two members. The first member is an outer tube-shaped sheath which is radially expandable by being formed from elastic material or other means and having relatively low column strength. The second member is an inner portion extending throughout the outer tube. This inner portion includes a slit to allow it to expand radially as well. Using the structure diagnostic, therapeutic, or other desired objects may be conveyed through the device yet still enable the device to have a smaller cross-sectional area throughout most of its length than the object conveyed therethrough.

Abstract: A method and a device for improving cardiac function are provided. The device is packaged in a collapsed state in an end of a catheter. Portions of a frame construction of the device spring outwardly when the catheter is withdrawn from the device. Anchoring formations on the frame construction secure the frame construction to a myocardium of the heart. A membrane secured to the frame construction then forms a division between volumes of an endocardial cavity of the heart on opposing sides of the membrane.

Abstract: A method and a device for improving cardiac function are provided. The device is packaged in a collapsed state in an end of a catheter. Portions of a frame construction of the device spring outwardly when the catheter is withdrawn from the device. Anchoring formations on the frame construction secure the frame construction to a myocardium of the heart. A membrane secured to the frame construction then forms a division between volumes of an endocardial cavity of the heart on opposing sides of the membrane.

Abstract: An electrosurgical instrument is provided which includes a holding formation, a probe shaft, an electric conductor, and a probe tip. The probe shaft is secured to the holding formation and has an elongated section extending therefrom. The electric conductor extends along the elongated section. The probe tip is located on a distal end of the probe shaft opposing the holding formation. The probe tip defines a volatization chamber with a mouth out of the probe tip. The probe tip includes an electrode, to which RF current is provided through the electric conductor. The electrode heats an area adjacent to the probe tip. The electrode also heats a liquid in the first volatization chamber to evaporate the liquid into a vapor pocket that ejects from the first volatization chamber through the mouth out of the probe tip. A pump effect is created so that the liquid maintains the probe tip at a more stable temperature.

Abstract: An electrosurgical probe is provided to vaporize, cut, coagulate or remove tissue from a body structure. A method of surgically treating a mammal includes providing a surgical instrument including a length of shaft and an active electrode having a curved current density edge with at least one convex surface; and ablating a tissue surface with said surgical instrument.

Abstract: A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue.

Abstract: A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid.

Abstract: A spinal fusion implant device is provided for insertion into a generally cylindrical bore formed between adjacent vertebrae. The device includes: a shaft having a longitudinal central axis; and a plurality of projections extending radially from the shaft and terminating in a surface, each of the projections being oriented to form a thread like segment for engaging the internal surface of the cylindrical bore to advance the device axially into the bore upon rotation of the device about the longitudinal axis. In an embodiment, each of the projections includes an elongated member terminating in a surface including at least one rib adapted to form a thread like segment for engaging the internal surface of the bore. The elongated member further includes a bulbous head forming the surface at a distal end of the elongated member.