Abstract: An articulating suture hook for passing or retrieving suture. The suture hook having a handle with a proximal end and distal end. A stiffening tube is fixed to the distal end of the handle extending distally from the handle. A flexible outer tube is fixed to the stiffening tube and extends distally therefrom. A cut portion of the flexible outer tube has a plurality of cuts positioned therealong. In a first configuration, the flexible outer tube extends parallel to or in alignment with the stiffening tube, but in a second configuration, the flexible outer tube is curved at the cut portion. The plurality of cuts may be arranged into two patterns. Each cut arranged in a first pattern is offset at an angle from each cut arranged in a second pattern. The pattern, shape, and size of the cuts determines the movement of the flexible outer tube to the second configuration.

Abstract: Surgical repair systems and techniques for plantar plate repairs. The surgical repair systems and methods reconstruct the plantar plate through a dorsal incision. The surgical repair system embodies a variety of instruments that provide visualization and access to the plantar plate using suture to complete the repair. The repair system may include some or all of the following instruments: a metatarsal head pusher employed in open surgical space, to move the “capital fragment” in a controlled manner; a suture retriever instrument and a suture retriever funnel (sleeve); a suture passer such as a Mini Scorpion DX and accompanying needle, or a variety of shaped Micro Suture Lassos; a measuring guide; and a small joint distractor.

Abstract: A suture passer comprising: a hollow tube, the hollow tube comprising a distal end, a proximal end, and a lumen extending from the distal end to the proximal end; and a clamping rod slidably received in the lumen of the hollow tube, the clamping rod comprising a distal end and a proximal end, the distal end being bifurcated into a first arm and a second arm, one of the first and second arms extending distally of the other of the first and second arms and including a clamping surface; wherein at least one of the first arm and the second arm comprises a friction-enhancing surface for facilitating manipulation of a suture via engagement of the suture with the friction-enhancing surface.

Abstract: A control system having speed management control. The control system can be in signal communication with a battery, and the battery can be coupled to a motor. The speed management control can include a pulse width modulation circuit, which can control the duration of pulses supplied from the battery to the motor. The motor can include a primary set of coils and a secondary set of coils. The control system can direct surplus current to the secondary set of coils to maximize the torque generated by the motor.

Abstract: A surgical instrument includes a shaft, an end effector extending distally from the shaft, and a housing extending proximally from the shaft. The housing includes a motor configured to generate at least one motion to effectuate the end effector, and a power source configured to supply power to the surgical instrument, wherein the power source includes a casing, a data storage unit, and a deactivation mechanism configured to interrupt access to data stored in the data storage unit. In addition, the power source includes a battery pack and a deactivation mechanism configured to deactivate the battery pack if the casing is breached.

Abstract: A surgical instrument can comprise a handle, a motor, and a shaft extending from the handle. The handle and/or the shaft can define a longitudinal axis. The surgical instrument can further comprise a fastener cartridge comprising a plurality of fasteners removably stored therein, an anvil configured to deform the fasteners, a closure drive configured to move the anvil toward and away from the fastener cartridge which is rotatable about the longitudinal axis, and a firing drive configured to deploy the fasteners from the fastener cartridge which is rotatable about the longitudinal axis. The surgical instrument can further comprise a transmission comprising a first operating configuration which connects the motor to the closure drive and a second operating configuration which connects the motor to the firing drive.

Abstract: An arthroscopic surgical device for tunneling through hard tissue including an arcuate tunneling needle driver and a bone engagement element, the arcuate needle driver and the bone engagement element being joined together to provide a joined needle driver and bone engagement element having at least two different operative orientations including an arthroscopic operative orientation wherein the joined arcuate needle driver and bone engagement element has a trans-incision insertion cross-sectional footprint and a tunneling operative orientation suitable for tunneling, wherein the joined arcuate needle driver and bone engagement element has a tunneling cross-sectional footprint which is substantially greater than the insertion cross-sectional footprint.

Abstract: A catheter devices/systems and methods therefrom are described herein for treating acute kidney injury, especially the contrast-induced acute kidney injury wherein the devices may prevent the contrast dyes from entering into kidney and/or facilitate blood flow of kidney by said catheter system.

Abstract: An elongate resilient tube of a mesh of shape memory alloy is used to therapeutically occlude an opening in body tissue. The tube is compressible so that it can be delivered to the opening in the body within a catheter. The tube self-expands as it is released from the catheter to contiguously form, sequentially, the following shapes: an outer bell-shaped structure; an inner bell-shaped structure disposed within the outer bell-shaped structure to conformingly engage an inner side of the outer bell-shaped structure; a tubular connector having a diameter substantially smaller than the inner bell-shaped structure, the tubular connector extending away from an apex of the inner bell-shaped structure; an inner plate-shaped structure; an outer plate-shaped structure; and a releasable connector. The bell shape is placed on one side of the opening, and the plate shape is placed on the other side of the opening, the connector passing through the opening.

Abstract: A device for use with a uterine tamponade apparatus, such as the Bakri® postpartum hemorrhage balloon, is disclosed. The device comprises an anchor for deployment within the vagina to securely retain the balloon in its proper position within the uterine cavity, allowing the balloon to function as intended for the control and management of postpartum hemorrhage and uterine bleeding. Methods of use of the vaginal anchor are also disclosed.

Abstract: A cutting block comprises a body having a top surface for guiding a saw blade, and a top plate connected to the body. The top plate can move between a first position in which the top plate is spaced apart from the body and a second position in which the top surface of the top plate is an extension of the top surface of the body. The top plate has first and second resiliently deformable arms extending from it, spaced apart along the top plate, and the body has first and second recesses formed in it extending substantially perpendicularly to the top surface of the body. The first and second arms on the top plate are inserted in the recesses so that the arms and the recesses define the path for movement of the top plate relative to the body between the first and second position.

Abstract: Disclosed is a tool bit for an ultrasonic osteotome comprising a grinding portion at a front end of the tool bit, and an arbor with one end connected to the grinding portion and the other end connected with a transducer for an ultrasonic osteotome. The grinding portion has a tapered shape dwindling from a rear end toward a front end thereof and is connected with the arbor at the rear end thereof. A plurality of grinding grooves are provided on a bottom surface and side surfaces of the grinding portion, and a front surface of the grinding portion is a smooth surface. The tool bit has a tapered shape, which is small in structure, simple and flexible for operation, and convenient in use. When the tool bit is used for a surgery, ultrasonic energy is concentrated at a tip end, and a surgical window has a large field of view.

Abstract: A device for use in orthopaedic surgery. The device includes a metallic central member. The device also includes an outer portion comprising a polymer. The outer portion surrounds the metallic central member. The outer portion has a profiled outer surface for removing bone. A surgical instrument kit including a plurality of differently sized devices of the kind described herein. The device can be a broach or rasp. A method of removing bone during orthopaedic surgery.

Abstract: The present invention relates to an implant system that comprises an implant, a handle configured to removably receive the implant, and, in some embodiments, a spacer tool configured to be mounted on the implant. In further embodiments, a k-wire is employed to guide the implant to a desired location. The handle has a hole for receiving a first portion of the implant. Using the handle to implant the implant, along with an associated spacer, provides a quick and convenient method for implanting the implant as described herein and in the associated drawings.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: Provided herein are methods and systems for anatomical occlusion removal, comprising a delivery wire having (i) a proximal end having an opening, (ii) a distal end, (iii) an outer surface, (iv) a lengthwise cavity, and (v) a first opening to the lengthwise cavity, the opening being in the outer surface of the delivery wire. A first tether having a proximal end and a distal end that may traverse the lengthwise cavity. A first body may be attached to the distal end of the first tether, the first body adapted to be slidably mounted to the delivery wire and releasably engaged to the delivery wire, wherein while engaged the first body remains fixed on the delivery wire and upon release moves axially along the delivery wire. In embodiments, a second tether may have a proximal end and a distal end traversing the lengthwise cavity and attached to the first body.

Abstract: Provided herein are methods and systems for anatomical occlusion removal, comprising inserting a guide catheter into a body lumen of a patient, and advancing an access catheter through the guide catheter, advancing a delivery catheter through the access catheter, the delivery catheter having a delivery wire therein, the delivery wire having a first body mounted thereto in a fixed position at a distal end of the delivery wire. The delivery catheter may be advanced through the occlusion, expanding the first body distal to the occlusion. A second body may be loaded onto the delivery wire. The second body may be advanced over the delivery wire to the occlusion, and the delivery wire, delivery catheter, access catheter, and guide catheter may be retracted from the patient.

Abstract: Catheter-delivered endovascular medical devices are described. The devices may include a pull wire connected to a proximal body and a distal body, which may be formed of a basket or other framework that has a plurality of cells. The distal body may move/articulate proximally relative to and toward the proximal body. Methods of using and making the devices are also described.

Abstract: The invention relates to a shaft for a medical instrument (12), in particular a homopolar or bipolar medical instrument, comprising a shaft member (16) that accommodates a tool (18) at the distal end, said tool (18) being provided with a first jaw part (19) and a second jaw part (21) which can be moved relative to each other from an open position (29) into a closed position (28) by a draw bar/push rod (26) that is guided inside the shaft member (16); at the proximal end, the shaft member (16) has a connecting piece (14) for attachment to a manipulating device (23) that allows the draw bar/push rod (26) to be moved back and forth; at the distal end, each jaw part (19, 21) is pivotally guided inside the shaft member (16) by means of a sliding block (49).

Abstract: Example embodiments include a drive unit and a hub and cutting implement that may be coupled to the hub by use of a latch between the hub and the drive unit. The latch may be configured to couple with the drive unit at locations on the perimeter of the drive unit. Some embodiments of the invention also include one or both of resection controls and fluid management systems.

Abstract: A cleaning device for cleaning a catheter lumen of a tissue removal catheter has a flushing chamber with distal and proximal seals and an inlet port. The proximal seal is a duckbill seal that includes a pair of opposing duckbill members that slidingly accept the distal end portion of a catheter body to form a seal about the catheter body proximal to a proximal opening in of the catheter lumen. Fluid is directed in the inlet port, into the flushing chamber, into proximal opening in the catheter body, and through the catheter lumen to discharge tissue contained in the catheter lumen. In some embodiments, the cleaning device is preloaded on the catheter body. The cleaning device can have an internal stop that engages with an external stop on the catheter body when the cleaning device is positioned in an operative position.

Abstract: Described herein are atherectomy catheters, systems and methods that include a distal tip region that may be moved laterally so that its long axis is parallel with the long axis of the main catheter body axis. Displacing the distal tip region laterally out of the main catheter body axis exposes an annular blade and opens a passageway for cut tissue to enter a storage region within the catheter. The annular blade may be internally coupled to a drive shaft that rotates the blade, and thus the exposed blade edge may have the same crossing profile (OD) as the rest of the distal end region of the catheter. Also described herein are gear-driven atherectomy devices that may use a cable drive shaft to actuate the annular blade. Both push-to-cut and pull-to-cut variations are described, as are methods for cutting tissue and systems including these atherectomy catheters.

Abstract: A medical device assembly may include a stylet having a distal stylet body and a proximal stylet hub, a cannula having a distal cannula body and a proximal cannula hub, and a lock for securing the stylet to the cannula, wherein the lock includes at least one abutment on at least one of the stylet hub and the cannula hub for restricting relative movement between the stylet hub and the cannula hub.

Abstract: Deployment devices include a locking mechanism configured to secure a medical device to the deployment device. Methods of operating a deployment device include securing a medical device positioned at least partially within at least one cannula of the deployment device with a locking mechanism and releasing the medical device and securing at least a portion of the at least one cannula of the deployment device with the locking mechanism.

Abstract: A catheter system for retrieving a leadless cardiac pacemaker from a patient is provided. The cardiac pacemaker can include a docking or retrieval feature configured to be grasped by the catheter system. In some embodiments, the retrieval catheter can include a snare configured to engage the retrieval feature of the pacemaker. The retrieval catheter can include a torque shaft selectively connectable to a docking cap and be configured to apply rotational torque to a pacemaker to be retrieved. Methods of delivering the leadless cardiac pacemaker with the delivery system are also provided.

Abstract: A method of in vitro fertilization wherein the embryo is implanted into the uterus of a female patient at least two, and preferably three to twelve months after the eggs are retrieved from the patient in order to reduce the effect of autoimmune rejection of the embryo by the patient's autoimmune system and increase the probability and success of pregnancy and wherein prior to embryo implantation, the endometrium in the uterus is prepared for embryo implantation by introducing peripheral blood mononuclear cells (PBMCs) into the uterus. The procedure is combined with cryopreservation techniques to preserve the oocytes or the IVF-produced embryos of the patient.

Abstract: An orthopedic clamp for affixing at least two fixation members relative to each other is disclosed. The clamp includes a first clamp comprising first outer and inner jaws that define first clamping surfaces that form a first recess, and a second clamp comprising second outer and inner jaws that define second clamping surfaces that form a second recess. The clamps also include a post extending from the second outer jaw and through the second inner jaw, the first inner jaw and the first outer jaw. The post defines a clamping axis, and the second recess defines an axis that intersects the clamping axis. The clamp further includes a clamping nut threadably coupled to the post configured to exert a clamping force to the first and second clamps to fix at least one of a first fixation member within the first recess and a second fixation member within the second recess.

Abstract: An orthopaedic attachment device (1) which can adopt at least two positions, an inoperative position and a locked position. The orthopaedic attachment device comprises two clamps (2a, 2b) mounted opposite each other through a resilient member, and held by a clamping rod along a median axis by through-holes. Each of the clamps (2a, 2b) comprises a body part that comprises a outer jaw (4b) and an inner jaw (4a), connected by a joining wall (5), and which defines an opening that is designed to accommodate a stiffening bar or a pin via an insert. The opening extends inwards from the clamp (2a, 2b) as far as the joining wall (5) towards a passage and a hinge region. In the inoperative position, the outer jaw (4b) is fixed, whereas the inner jaw (4a) is moveable inwards towards the resilient member.

Abstract: Dynamization devices and methods of use are provided. A dynamization device may comprise first and second modules that are mated together in a substantially cylindrical shape. The outer surface of the first and second modules are connected to deformable rings that may be deformed when a longitudinal force is applied to the first and second modules. The deformation of the rings creates a longitudinal mechanical bias in the device to return it to its original shape. The strength, spring coefficient, and size of the dynamization device can be adjusted depending upon the particular needs of the application.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: A bone securement apparatus includes a bone plate configured and dimensioned to be applied across a joint of at least two bones or a space between at least two bone fragments. The bone plate includes first and second openings. A beaming member is configured to pass through the first opening, and the beaming member includes a third opening. A support member is configured to pass through the second opening and the third opening.

Abstract: A pedicle screw assembly including a bone fastener having a lower end for engaging bone and an upper end remote from the lower end; a head having a rod-receiving channel attached to the upper end of said bone fastener; a spinal rod insertable into the rod-receiving channel of said head, said spinal rod having an outer surface extending between first and second ends thereof, wherein at least one of the first and second ends has a reduced diameter section. A spinal rod having an outer surface extending between a first end and a second end thereof; wherein the outer surface of said spinal rod has a reduced diameter section at at least one of the first and second ends.

Abstract: A vertebral fixing system having a flexible elongated member, a connecting part, and an anchor, where the anchor may engage a bone structure (e.g., a vertebra) through an opening of the connecting part and the flexible elongated member may connect to the connecting part. In some cases, the vertebral fixing system may include a tightening part configured to apply a tension to the elongated member and/or secure the elongated member with respect to the connecting part. The vertebral fixing system may be configured to receive a rod and may be capable of connecting thereto. The connecting part may have a plurality of connecting members, where at least one of the connecting members includes an opening for receiving the anchor and at least one of the connecting members connects to the elongated member.

Abstract: In one aspect, a bone anchor assembly is provided having a bone anchor with a head, a resilient locking cap extending about a portion of the bone anchor head, and a cap drive member having a depending annular wall. In another form, a bone plate system is provided including a bone plate having an elongated throughbore and a resilient support member received therein. In another aspect, an insertion device is provided for manipulating and inserting a spinal device at or within a spinal joint. The insertion device is configured to actively pivot the implant about the implant gripping end of the device and to allow manipulation and release of the implant in any pivoted orientation from approximately 0 to 90 degrees.

Abstract: The invention concerns an inner plate fixator device (1) for the correction of severe bone malformations, of the type comprising an elongated plate (2, 2?) in which through holes (3, 4) for receiving bone screws are provided. The use of this fixator device allows the pediatric correction of severe bone malformations, in particular malformations of the proximal portion of the femur.

Abstract: A bone stabilizing plate includes two plate portions, each affixable to bones of a patient, the plate portions telescoping together with mating rails and grooves. A limiter associated with one of the plate portions sliding engages one a catch associated with the other of the plate portions, when the plate portions are telescoped together, and resists stops telescoping when the plate portions are telescoped a predetermined distance apart. Once the limiter and catch are engaged, the plate portions enable imposition of a minimum compressive force between bones connected to the plates. The limiter is resiliently positioned to deflect into a relief formed in its respective plate portion. A groove positioned proximate the catch enables free telescoping motion limited by the engagement of the catch and limiter, whereby the minimum compressive force between bones is maintained, and Wolfe's Law may apply.

Abstract: A bone plate is provided that is configured to provide compression to comminuted bone fragments, so as to reduce the respective bone gaps and promote healing. The bone plate can be moved from a first position to a loaded position, and placed against bone in the loaded position. The bone plate can then be secured to underlying bone. The bone plate then moves to an intermediate compression position that compresses bone fragments of a comminuted bone fracture together. An insertion instrument is also described that can be used to place the bone plate against the underlying bone, and guide insertion of a bone anchor to secure the bone plate to the underlying bone.

Abstract: Devices and methods for locking one or more bone screws to a fixation plate. A cam-style locking feature may be disposed in the fixation plate such that, when the locking feature is in a first position, the bone screw is able to traverse an opening in the fixation plate and engage adjacent bone; and when the locking feature is rotated into a second position, an interference between the locking feature and bone screw causes the bone screw to be firmly secured to the fixation plate.

Abstract: A curved inflatable bone tamp includes an outer shaft defining a passageway. An inner shaft is positioned within the passageway. The inner shaft extends between opposite first and second end. The inner shaft defines a lumen. The inner shaft is curved between the first end and the second end. A first leg of a balloon is coupled to the outer shaft and a second leg of the balloon is coupled to the inner shaft such that a material can flow through the lumen and into the balloon to inflate the balloon. The balloon includes a wall having a variable thickness between the legs when the balloon is uninflated and a uniform thickness between the legs when the balloon is inflated. Kits, systems and methods are disclosed.

Abstract: A sliding cross-fluoroscopy auxiliary apparatus includes: a holder (1) and a lifting pillar (2) on the holder (1), wherein a supporting arm (3) is provided on a top end of the lifting pillar (2), and a telescopic shaft (4) is arranged inside the supporting arm (3); a first end of the telescopic shaft (4) is connected to a first driver (5), and a second end of the telescopic shaft (4) is connected to an A arc (6); the first driver (5) drives the telescopic shaft (4) to extend out, draw back or rotate; a second driver (7) is arranged at a joint between the A arc (6) and the telescopic shaft (4), and a B arc (8) is placed between the second device (7) and the A arc (6); the second driver (7) drives the B arc (8) to rotate along the A arc (6).

Abstract: A fluid detection assembly for detecting fluid contamination within a medical device includes a first pair of detection wires and a controller. The first pair of detection wires includes an input first detection wire and a spaced apart output first detection wire that are in fluid communication with one another. The input first detection wire conducts a first electrical signal and the output first detection wire receives the first electrical signal. The controller receives the first electrical signal from the output first detection wire and determines a first propagation delay. The controller can determine a type of fluid contamination, such as blood or saline, based on the first propagation delay. The fluid detection assembly can include a second pair of detection wires that is spaced apart from the first pair of detection wires.

Abstract: A non-invasive thermal ablation method is provided for heating a lesion area using a non-invasive thermal ablation device. The non-invasive thermal ablation method includes: generating a time-varying magnetic field in a lesion area including a liquid metal using a magnetic field-generating element of the non-invasive thermal ablation device to heat the lesion area. In addition, a non-invasive thermal ablation device for the method is also provided.

Abstract: A vapor delivery system and method is provided that includes a number of features. In one embodiment, a method comprises inserting a vapor delivery needle into tissue of a patient, activating a flow of vapor from a vapor generator through vapor delivery ports of the vapor delivery needle to cause condensed liquid to exit vapor delivery ports of the vapor delivery needle, generating vapor in the vapor generator, delivering a dose of vapor through the vapor delivery ports of the vapor delivery needle into the tissue, and after the dose of vapor is delivered, re-activating the flow of vapor from the vapor generator through the vapor delivery ports of the vapor delivery needle to prevent a vacuum from forming in the vapor delivery needle. Vapor therapy systems are also provided.

Abstract: A treatment tool includes: a pair of openable/closable jaws; a substrate provided on at least one of the jaws; a wiring pattern provided on one surface of the substrate in a state of being electrically insulated from the substrate, the wiring pattern including an electric resistance pattern configured to generate heat when a current is carried to the electric resistance pattern, and a connecting section configured to be electrically continuous to the electric resistance pattern; and a heat transfer plate disposed facing the one surface and configured to transfer, to a living tissue, the heat in contact with the living tissue; and a lead wire configured to be a current-carrying path to the wiring pattern, the lead wire being positioned on a side separated from the heat transfer plate with respect to the wiring pattern and being electrically connected to the connecting section from the separated side.

Abstract: An electro-surgical pencil comprising: a housing forming an axially extending main suction passage from a proximal opening to a distal opening; a tube forming an extension of the main suction passage from the proximal opening to a proximal extension opening, the tube being configured for telescoping movement through the proximal opening; an electrode for cutting and/or coagulating tissue, the electrode being attached to the tube and extending axially from the proximal extension opening; and a suction tip attached to the tube and forming a further extension of the suction passage. Since both the tube and the suction tip are movable relative to the housing, a short and a long configuration can be obtained while good smoke removal capabilities are maintained.

Abstract: Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device an energy delivery device).

Abstract: The devices and method described herein allow for therapeutic damage to increase volume in these hyperdynamic hearts to allow improved physiology and ventricular filling and to reduce diastolic filling pressure by making the ventricle less stiff. For example, improving a diastolic heart function in a heart by creating at least one incision in cardiac muscle forming an interior heart wall of the interior chamber where the at least one incision extends into one or more layers of the interior heart wall without puncturing through the interior heart wall and the incision is sufficient to reduce a stiffness of the interior chamber to increase volume of the chamber and reduce diastolic filing pressure.

Abstract: A method and apparatus that utilizes a force-time integral for real time estimation of steam pop in catheter-based ablation systems. The apparatus measures the force exerted by a contact ablation probe on a target tissue and an energization parameter delivered to the ablation probe. The exerted force and energization parameter can be utilized to provide an estimation of the probability of steam pop. In one embodiment, the force and energization metrics can be used as feedback to establish a desired contact force and energization level combination to prevent steam popping.

Abstract: The present invention provides a catheter apparatus with a carrier comprising right-handed wire helixes and left-handed wire helixes that are plainly or bi-axially woven into a tubular structure. A therapeutic assembly wraps around one of the wire helixes to stabilize an associated interstice of the tubular structure. The regular shape of the carrier may be quickly recovered after the carrier is seriously bent or distorted in an intravascular treatment.

Abstract: An electrosurgical apparatus and method for performing thermal treatment in the gastrointestinal tract, e.g. to ablate duodenal mucosal tissue. The apparatus comprises an instrument having a flexible cable and an applicator suitable for use with a gastroscope, which can be deployed within a patient to delivery energy in a targeted or otherwise controllable manner. The applicator can deliver microwave energy by radiation. The direct and depth-limited nature of microwave energy can be make it more effective than treatments that rely on thermal conduction. The applicator may include a radially extendable portion arranged to move an microwave energy delivery structure into contact with duodenal mucosal tissue at the treatment region. The applicator may comprise any of a balloon, bipolar radiator, movable paddle, and rotatable roller element.