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.

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: Physicians performing invasive procedures require accuracy and precision when working with surgical tools. Surgical procedures are increasingly becoming minimally invasive, with physicians operating using cameras to view the surgery site and directing their tools through oculars or video displays. Ideally, the physician should be able to perform the invasive procedure while simultaneously observing both the real-time image of the patient and additional data critical for his medical decisions about the manipulation of the surgical tool and the next surgical step. The augmented reality navigation system of the present disclosure provides tool location visibility for invasive procedures through the use of location sensors included on a camera and/or on the tools used during a procedure. A location tracking system determines and monitors the locations of the tools and camera based on the characteristics of signals detected by the sensors and displays informational overlays on images obtained with a camera.

Abstract: This disclosure is directed to a method for providing electrical communication with a heart using a catheter having a lasso electrode assembly with a moveable spine. The lasso electrode assembly may have an array of sensing electrodes and may be configured to engage the ostium of the vessel of a patient. The moveable spine may have an ablation electrode and may travel along track around the circumference of the lasso electrode assembly. By adjusting the position of the moveable spine, tissue may be ablated to form lesions around a circumference of the vessel.

Abstract: A surgical instrument and method of tracking the surgical instrument includes a shaft, a cutting member, and navigation system. The shaft has a shaft lumen, a shaft window, and a shaft edge. The cutting member is disposed within the shaft lumen and is configured to cyclically move from a first position to a second position relative to the shaft. The cutting member includes a cutting window opening, a cutting edge, and a suction lumen to cut the tissue portion with the cutting member in the first position. The navigation system includes a navigation sensor positioned on at least one of the shaft or the cutting member that is configured to be tracked within a patient for identifying a positional movement of the shaft or the cutting member 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: A method of ablating tissue of a target anatomical structure in an ear, a nose, or a throat of a patient includes inserting a balloon catheter into the ear, the nose, or the throat. The distal end of the balloon catheter is advanced distally until the balloon is disposed in the target anatomical structure. The balloon is inflated to an expanded configuration in the target anatomical structure. The tissue is ablated using at least one of photodynamic therapy or heated inflation fluid within the balloon. For photodynamic therapy, a photosensitizer is exposed to a light to produce a form of oxygen to ablate the target anatomical structure when the balloon is in the expanded configuration. For heated inflation fluid, heat is applied by a heating element to heat the inflation fluid in the balloon and thereby ablate the target anatomical structure when the balloon is in the expanded configuration.

Abstract: A surgical instrument includes a handle assembly and a shaft assembly extending distally from the handle assembly and having a distal end sized to be inserted into the nasal cavity of a patient. The shaft assembly includes a cutting member configured to cut tissue within the nasal cavity, and a translating member slidably disposed over the cutting member. A navigation sensor is disposed within the distal end of the shaft assembly and is operable to generate a signal corresponding to a position of the distal end within the patient.

Abstract: A pump for use with a tube, having a rotor having an axis of rotation and a plurality of rollers configured to define an orbital path about the axis of rotation, the orbital path defined by a radius, and a roller bed having a surface adapted to support the tube for peristaltic compression by one or more rollers, wherein the surface has a predetermined profile comprising a circular arc segment and at least one side segment, the arc segment having a first curvature defined by the radius, and the at least one side segment having a second curvature lesser than the first curvature.

Abstract: A visualization system may be implemented with an image guided surgery navigation system for use during ENT procedures. Correlated datasets such as surgical paths and pre-operative image slices may be correlated with the coordinate system of the navigation system for reference during a procedure. A surgeon may wear a head mounted display (“HMD”) having a transparent screen through which the patient anatomy may be viewed. The orientation and distance of the head mounted display relative to the patient anatomy may be determined using magnetic position tracking, image analysis of images captured by a camera of the HMD, or both. Correlated datasets may then be transformed based on the relative distance and orientation and may be displayed via the transparent screen to overlay directly viewed patient anatomy. Some implementations may include optical fiducials integrated with a patient tracking assembly to aid in tracking the patient and determining perspective of the HMD.

Abstract: A console for performing a medical procedure has connection ports for electrically coupling equipment. Each connection port may have an associated indicator that signals whether a piece of equipment should be connected to the respective connection port. The indicators may be selectively activated depending on the procedure being performed with the console.