Abstract: An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying a variable resistive body of a positive temperature coefficient material that has a selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The variable resistive body can be engineered to bracket a targeted thermal treatment range, for example about 60° C. to 80° C., at which tissue welding can be accomplished. In one mode of operation, the engagement plane will automatically modulate and spatially localize ohmic heating within the engaged tissue from Rf energy application across micron-scale portions of the engagement surface. In another mode of operation, a variable resistive body will focus conductive heating in a selected portion of the engagement surface.