Abstract: A surgical instrument assembly includes a surgical instrument having an instrument body, an elongate member with a distal end configured to be inserted into an anatomical passageway of a patient, a sensor operable to generate a signal corresponding to a location of the elongate member, and a first electrical connector electrically coupled with the sensor. The assembly further includes a cable assembly having a cable that communicates with a processor, and a coupling that releasably couples with the instrument body. The coupling includes a coupling body having first and second lateral sides that extend parallel to one another and are configured to extend parallel to a side of the instrument body when the coupling is coupled with the instrument body. The coupling includes a second electrical connector that electrically couples with the first electrical connector to transmit the signal from the sensor proximally through the cable and toward the processor.

Abstract: A surgical instrument includes an outer tube configured to be gripped by a user, and a needle slidably disposed within the outer tube. The needle includes a needle lumen, a distal needle tip configured to pierce tissue, and an electrode disposed at the distal needle tip. The needle lumen opens to the distal needle tip such that the distal needle tip is configured to deliver fluid from the needle lumen to tissue. The electrode is operable to deliver RF energy to tissue for ablating the tissue. The needle is translatable relative to the outer tube between a proximal retracted position in which the distal needle tip is housed coaxially within the outer tube, and a distal extended position in which the distal needle tip is exposed from the outer tube and configured to pierce tissue.

Abstract: A surgical instrument includes a sheath and an energy catheter. The sheath is configured to be inserted into a nasal cavity of a patient's head. The energy catheter includes a shaft and an end effector. The end effector is configured to selectively expand radially outwardly. The end effector includes an energy member that includes a flexible wire and electrodes disposed along the wire. The energy catheter is selectively translatable relative to the sheath. In a proximal position, the end effector is housed coaxially within the sheath to thereby prevent the end effector from radially expanding. In a distal position, the end effector is exposed from the sheath to thereby permit the end effector to expand for contacting tissue in the nasal cavity of the patient's head. When the end effector is in the expanded state, the end effector has a width and a length greater than the width.

Abstract: An array of sensors may be used to perform touchless registration of landmarks of a patient's face before an ENT procedure in order to associate those landmarks with pre-operative images in three-dimensional space, which is required for image guided surgery features such as navigation. Touchless or light-touch registration may improve accuracy by avoiding the need for substantial pressing against a patient's skin, which may deform and thereby introduce erroneous registration data. A sensor may also be implemented in forms other than an array such as handheld probe having a single sensor as opposed to an array.

Abstract: A method for treating a treatment site (106) within or adjacent to a vessel wall (108) or heart valve includes tapering an optical fiber (122) from a fiber proximal end (122P) to a fiber distal end (122D); positioning the optical fiber (122) such that the fiber distal end (122D) is positioned within an inflatable balloon (104); coupling an energy source (124) in optical communication with the fiber proximal end (122P); and receiving an energy pulse from the energy source (124) into the fiber proximal end (122P) so that the optical fiber (122) emits light energy in a direction away from the optical fiber (122) to generate a plasma pulse within the inflatable balloon (104). The method can further include coupling a first fiber member (250) to a second fiber member (258), which can include fusing the first fiber member (250) to the second fiber member (258) at a fused region (256); and encircling the fused region (256) with a ferrule (248).

Abstract: A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108) or a heart valve includes an inflatable balloon (104), an optical fiber (122), and an energy source (124). The optical fiber (122) has a fiber proximal end (122P), and a fiber distal end (122D) positioned within the inflatable balloon (104). The optical fiber (122) is configured to receive an energy pulse so that the optical fiber (122) emits light energy in a direction away from the optical fiber (122) to generate a plasma pulse within the inflatable balloon (104). The optical fiber (122) can be tapered from the fiber proximal end (122P) toward the fiber distal end (122D). The energy source (124) in optical communication with the fiber proximal end (122P) of the optical fiber (122), and can include a laser. The optical fiber (122) includes a first fiber member (250) and a second fiber member (258) that is coupled to the first fiber member (250).

Abstract: An apparatus includes a cannula assembly and a sensor assembly. The cannula assembly includes a proximal end, a distal end, and a first lumen extending from the proximal end to the distal end. The cannula is formed of a rigid material. The sensor assembly includes a sensor and a communication wire. The sensor is fixed to the cannula assembly. The communication wire is in electrical communication with the sensor. The communication wire extends along a length of the cannula assembly exterior to the first lumen.

Abstract: An apparatus includes a body, a first shaft, an actuation assembly, and a dilation catheter. The first shaft includes a malleable distal portion. The actuation assembly includes a second shaft and an actuator. The second shaft is coaxially positioned about the first shaft. The actuator is operable to selectively bend the malleable distal portion of the first shaft. The dilation catheter is coaxially interposed between the first shaft and the second shaft. The dilation catheter includes an expandable dilator. The dilation catheter is operable to translate along the malleable distal portion of the first shaft.

Abstract: A suction instrument includes a grip portion and a cannula. The grip portion includes a suction port and defines a first lumen. The cannula extends distally from the grip portion. The cannula defines a second lumen in fluid communication with the first lumen of the grip portion. The cannula includes a proximal portion and a distal portion. The proximal portion of the cannula defines a first portion of the second lumen. The first portion of the second lumen has a first cross-sectional area. The distal portion terminates into an open distal end. The distal portion of the cannula defines a second portion of the second lumen. The second portion of the second lumen has a second cross-sectional area. The second cross-sectional area is smaller than the first cross-sectional area.

Abstract: An apparatus includes a body, a first shaft, an actuation assembly, and a dilation catheter. The first shaft includes a malleable distal portion. The actuation assembly includes a second shaft and an actuator. The second shaft is coaxially positioned about the first shaft. The actuator is operable to selectively bend the malleable distal portion of the first shaft. The dilation catheter is coaxially interposed between the first shaft and the second shaft. The dilation catheter includes an expandable dilator. The dilation catheter is operable to translate along the malleable distal portion of the first shaft.

Abstract: An ablation instrument includes a shaft that extends from a grip portion. A curved portion of the shaft is shaped to allow insertion into the head of a patient, and to position an ablation tip that extends from a distal tip of the shaft proximate to an ablation target, such as the posterior nasal nerve. When activated the ablation tip projects radiofrequency energy to ablate nearby tissue. An ablation assistance features of an image guided surgery navigation system is configured to segment and identify ablation targets within a set of pre-operative images. When a position tracked ablation instrument is configured for use, the system begins to monitor the proximity of the ablation tip to the ablation targets. When the tip is within an effective distance of the target for ablation, the system provides an alert and activates the instrument so that RF energy may be projected.

Abstract: An apparatus includes a cannula assembly and a sensor assembly. The cannula assembly includes a proximal end, a distal end, and a first lumen extending from the proximal end to the distal end. The cannula is formed of a rigid material. The sensor assembly includes a sensor and a communication wire. The sensor is fixed to the cannula assembly. The communication wire is in electrical communication with the sensor. The communication wire extends along a length of the cannula assembly exterior to the first lumen.

Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: An apparatus includes a shaft, a balloon, a tip member, and a heating feature. The tip member is distal to the balloon and has a larger outer diameter than the shaft. The heating feature is operable to ablate tissue of the Eustachian tube contacting the balloon in the expanded state. The heating feature may include an illuminating element and a photosensitive coating on the balloon. Alternatively, the heating feature may include a thermal heating element that heats the balloon inflation fluid and thereby heats the wall of the balloon. Another apparatus includes a shaft, a tip member, and an electrode assembly. The electrode assembly includes a plurality of electrodes positioned along the shaft near the distal end, proximal to the tip member. The electrodes are spaced apart from each other along a longitudinal axis and are operable to apply RF energy to tissue to thereby ablate the tissue.

Abstract: An apparatus includes a body, a shaft assembly, and a shaft actuation assembly. The shaft assembly extends distally from the body and defines a longitudinal axis. A portion of the shaft assembly is configured to be inserted into an anatomical passageway associated with an ear, nose, or throat of a patient. The shaft assembly further defines a working passageway that is dimensioned to receive an instrument. An actuator of the body is operable to drive the instrument longitudinally relative to the shaft assembly. The shaft actuation assembly is operatively coupled with a proximal portion of the shaft assembly. Further, the shaft actuation assembly is translatable in a distal direction to extend the shaft assembly distally along the longitudinal axis and is translatable in a proximal direction to retract the shaft assembly proximally along the longitudinal axis.

Abstract: An apparatus such as a suction instrument includes a position sensor proximate to a distal tip of a malleable shaft. A sensor wire couples the position sensor to a processor of an image guided surgery system such that signals generated by the position sensor can be interpreted to determine the position of the surgical instrument. The malleable shaft includes a malleable outer shaft and a flexible inner tube. The flexible inner tube includes a primary lumen that can provide suction, fluid, or various deployable surgical tools, and an inner lumen that holds the sensor wire. Protected within the inner lumen, the sensor wire runs the length of the shaft and exits the inner lumen and passes through a slot in the outer shaft to reach the position sensor. A heat shrink cover wraps the distal tip, sealing the components together and providing an opening suitable for suction.

Abstract: A surgical navigation system includes an endoscope having a body, a shaft having a distal shaft end, an optical conduit, and a moveable optical element. The moveable optical element is configured to provide a field of view defining a line of sight, and is operable to capture an image within the field of view. The system further includes a drive mechanism operable to move the movable optical element to adjust a direction of the line of sight, a navigation sensor operable to generate a signal corresponding to a location of the distal shaft end within a patient, and a processor. The processor is operable to determine a location of the distal shaft end within the patient based on the signal, and command the drive mechanism to position the movable optical element so the line of sight is directed toward a selected point of interest within the patient.

Abstract: A guidewire includes a guidewire shaft and an inflatable element arranged at a distal end of the guidewire shaft. At least a portion of the guidewire shaft is formed of metal, and the guidewire shaft includes a lumen that fluidly communicates with an interior of the inflatable element. The inflatable element is operable to transition between a deflated state in which the inflatable element is configured to pass through an isthmus of a Eustachian tube (ET), and an inflated state in which the inflatable element is configured to dilate the ET.

Abstract: Apparatus, including a patient tracker, attached to a subject, having magnetic field sensors and optical landmarks with known spatial relationships to each other. A camera acquires a 3D optical image, in a first frame of reference (FOR), of the subject's face. A magnetic radiator assembly generates magnetic fields at the subject's head, thereby defining a second FOR. A processor: processes field sensor signals to acquire location coordinates of the sensors in the second FOR; segments a tomographic image of the subject, having a third FOR, to identify the subject's face in the third FOR; computes a first transformation between the third and first FORs to map the tomographic face image to the 3D optical image; maps the optical landmarks to the third FOR; maps the respective location coordinates of the sensors to the first FOR; and computes a second transformation between the second FOR and the third FOR.

Abstract: Physicians performing invasive procedures utilize instruments inserted into a human body to perform the procedures. Such procedures typically involve actions to be performed on specific targeted anatomical structures. During the procedure, nearby anatomical structures unrelated to the procedure should generally be avoided. A system and techniques are provided herein for monitoring the position of such unrelated nearby anatomical structures relative to one or more surgical instruments. The system emits a warning to a human operator such as a surgeon if one of the instruments is too close to a monitored anatomical structure.