Abstract: Disclosed is a torque wrench for an ultrasonic scalpel, the torque wrench comprising a torque wrench body (20) and a wrench rotor (10). The torque wrench body comprises a circular-hole-shaped torque hole (21), with a torque clamping catch being provided in the torque hole, and the wrench rotor being disposed in the torque hole. The wrench rotor comprises a scalpel head clamping hole (11), a rotor clamping catch (12) located outside the wrench rotor (10), and a scalpel head clamping slot (13) located inside the scalpel head clamping hole (11), wherein a wrench part (31), which is disposed on a scalpel head (30) of the ultrasonic scalpel that is fitted with the torque wrench of the ultrasonic scalpel, is clamped into the scalpel head clamping slot via the scalpel head clamping hole, the rotor clamping catch is fitted with the torque clamping.

Abstract: A fluid flow metal sleeve includes a sleeve main body and an elongation portion, which are of a hollow structure as a whole. The sleeve main body is connected to the elongation portion in a threaded manner, and a terminal end of the sleeve main body is connected to an ultrasound scalpel handle and enables an ultrasound scalpel to pass therethrough. The fluid flow metal sleeve can control the direction of fluid flow during incision with the ultrasound scalpel so as to achieve the lubricating and cooling effects on a scalpel head. In addition, due to the use of a metal structure, a user can extend an original holding part from an outer portion of the ultrasound scalpel handle to an outer wall of the metal sleeve as required. The fluid flow metal sleeve also has an adjustable telescopic function so as to be adapted to different application scenarios, and limits the length of extension of the scalpel head so as to limit the depth during incision to improve the safety of surgery.

Abstract: A thrombectomy device includes a handle at a proximal end portion of the device, a cage at a distal end portion of the device, the cage being moveable between an expanded orientation and a contracted orientation, and a first tube extending from the proximal end portion of the device to at least a proximal end portion of the cage. The device also includes a second tube extending from the proximal end portion of the device to at least a distal end portion of the cage, and a self-adjusting control assembly including a biasing element coupled to one of the first tube or the second tube. The biasing element exerts an axial force to urge the cage toward the expanded orientation.

Abstract: A trocar assembly for uterine and fetal surgeries includes a cannula defining a hollow tubular sleeve that extends from a first open end to a second open end, a hollow obturator defining a shaft that extends from a first open end that is tapered to a second open end, wherein the hollow obturator is located within the cannula, and wherein the trocar assembly is configured to be inserted into a patient's body to give access to a bodily cavity, such as the uterine cavity (amniotic cavity) or the fetus. The trocar assembly is configured for insertion into the uterine cavity using the Seldinger technique.

Abstract: A trocar assembly and method for uterine and fetal surgeries includes a cannula defining a hollow tubular sleeve that extends from a first open end to a second open end, a hollow obturator defining a shaft that extends from a first open end that is tapered to a second open end, wherein the hollow obturator is located within the cannula, and wherein the trocar assembly is configured to be inserted into a patient's body to give access to a bodily cavity, such as the amniotic cavity or the fetus. The trocar assembly is configured for insertion into the amniotic cavity using the Seldinger technique.

Abstract: Devices, methods, and systems are provided for placing an implant into a patient and removing it therefrom.

Abstract: An elongated medical assembly is configured to be maneuverable proximate to a first biological feature of a patient. The elongated medical assembly is also configured to facilitate movement along an elongated length of the elongated medical assembly of a first medical device and a second medical device.

Abstract: An apparatus may include a plunger and a substantially cylindrical body. The substantially cylindrical body may include an end portion having rounded edges and may define a cavity sized to receive the plunger. The substantially cylindrical body may include at least one opening extending from the cavity to an external surface. The at least one opening may a substantially irregular shape. In some embodiments, the at least one opening may extend from the cavity through a nub to the external surface. The nub may have a rounded shape. In some embodiments, the substantially irregular shape may include one of a slit, an oval shape, an elliptical shape, an hourglass shape, a rectangular shape, and a diamond shape. In some embodiments, the opening may be part of a non-cylindrical fluid passage.

Abstract: An embryo transfer tool has a flexible tube and a hub. The flexible tube has first and second microparticle-containing synthetic resin portions. The first and second microparticle-containing synthetic resin portions are not exposed in outer and inner surfaces of the flexible tube, and are formed by a synthetic resin and a large number of hollow glass beads having a diameter of 0.5 to 200 ?m. The hollow glass beads are dispersed in the synthetic resin. The first and second microparticle-containing synthetic resin portions include a large number of boundary surfaces that are formed between the synthetic resin and the hollow glass beads.

Abstract: A method for adjusting an adjustable implant includes broadcasting identification information from an adjustable implant implanted within a subject, receiving wirelessly with the adjustable implant, from a device external to the subject, an adjustment setting configured to be executed by the adjustable implant, receiving wirelessly with the adjustable implant, from a device external to the subject, an instruction to perform the adjustment setting, activating a motor on the adjustable implant to perform the adjustment setting, and sending, to a device external to the subject, a progress of the adjustment setting.

Abstract: A system includes a first pedicle screw, a second pedicle screw, and an adjustable rod having an outer housing coupled to one of the first pedicle screw and the second pedicle screw, the outer housing having a threaded shaft secured to one end thereof extending along an interior portion thereof. The system farther includes a hollow magnetic assembly disposed within the outer housing and having a magnetic element disposed therein, the hollow magnetic assembly having an internal threaded surface engaged with the threaded shaft, the magnetic assembly being coupled to the other of the first pedicle screw and the second pedicle screw, wherein the hollow magnetic assembly rotates in response to an externally applied magnetic field to thereby lengthen or shorten the distance between the first pedicle screw and the second pedicle screw.

Abstract: The present invention includes a pedicle screw made with a bone fastener and a rod coupling head, the rod coupling head comprising an upper rod coupling: the lower rod coupling having a lateral rod opening adapted to receive a permanent rod; an angled bore extends into the lateral rod opening; and a permanent rod fastener in the angled bore to engage a permanent rod in the lateral rod opening; and a upper rod coupling having an upper rod opening adapted to receive a temporary rod, wherein the upper rod opening is formed to receive a temporary rod fastener; wherein the upper rod coupling is detachable from the lower rod coupling at a transition and a temporary rod is temporarily affixed into the upper rod opening during a bone realignment and a permanent rod is positioned in the lateral rod opening and engaged by the permanent rod fastener upon final bone alignment.

Abstract: A spinal screw assembly providing an adjustable securement of a fixation rod across at least two vertebrae. The assembly includes a pedicle screw having a spherical head portion, a threaded shaft portion and a tool engagement surface in the head portion for use in driving the screw into a vertebrae. The head portion of the screw is positioned in a body member adjacent a curvilinear surface disposed about an aperture in the end of the body member such that the shaft portion of the screw extends therethrough and the curvilinear inner surface abuts and mates with the head portion of the screw so as to define a ball joint therewith. The body member additionally defines a pair of opposed parallel slots therein adapted to receive a portion of the fixation rod and a locking cap bears against the fixation rod to releasably secure the rod within the assembly.

Abstract: Implants, instruments, and methods for performing surgical procedures on the spine, including one or more of creating an operative corridor to the spine, delivering implants to the spine, fusing one or more segments of the spine, and fixing one or more segments of the spine.

Abstract: Provided is a novel rod reducing device including a screw jack mechanism that is moveably engaged with an elongated grasping fork assembly, the screw jack mechanism having an elongated threaded portion, the elongated threaded portion being connected at its most distal end to a rod contact member, which is positioned in sliding circumferential contact with each of the two opposing elongated grasping members and the most proximal end of the elongated threaded portion terminating in a controlling member, which can be activated in a measured and controlled manner. A method of using the device is also provided.

Abstract: A surgical system includes a sleeve defining a passageway. An adapter is removably coupled to the sleeve. The adapter defines a channel. A delivery device includes a distal end positioned in a channel of the adapter. A bone fastener includes a head and a shank defining a cannula. A distal portion of the adapter is positioned in the shank such that the channel is in communication with a cannula of the shank. A plunger is movably disposed in a lumen of the delivery device. The plunger is configured to move a material through the lumen and the channel and into the cannula. Methods and kits are disclosed.

Abstract: A calcaneal fracture fixation and reduction apparatus.

Abstract: An arthrodesis nail and nail adapter system having multiple coupling positions includes a bent arthrodesis nail and a nail adapter. The nail has multiple evenly spaced notches. The nail adapter has multiple evenly spaced protrusions corresponding to the notches. An arthrodesis nail adapter and target arm system having multiple coupling positions includes a nail adapter and a target arm. The nail adapter has a predetermined coupling orientation with a bent arthrodesis nail. The target arm has multiple coupling positions with the nail adapter. The arthrodesis nail and nail adapter system allows rotation of the bent nail for reduction of ankle deformity.

Abstract: The modified method of Biplane Double-supported Screw Fixation (Modified BDSF) (Calcar buttressed screw fixation) of femoral neck fractures is disclosed. BDSF is applied using three standard bone screws laid in two vertical oblique planes in the femoral neck: the inferior (distal) screw is placed at an obtuse angle in the posterior oblique plane, and touched on the inferior (distal) and on the posterior cortices of the femoral neck; the middle screw and the proximal screw are laid in the anterior oblique plane and in parallel to each-other, with the middle screw touched on the distal femoral neck cortex. With BDSF of the three screws, two are weight-bearing and act as console beams: the distal screw and the middle screw, each of them having two supporting points in the distal fragment: medial (on the distal femoral neck cortex), and lateral (in the place of screw entry into the lateral femoral cortex).

Abstract: Certain aspects relate to a two-part surgical guide system for use in surgical procedures such as osteotomies. Certain aspects provide a first part including a contact surface configured to conform to a portion of an anatomy of the patient to substantially restrict movement of the first part with respect to the anatomy of the patient. The first part further includes guiding elements configured to receive reference pins and guide placement of the reference pins in the anatomy of the patient. Certain aspects further provide a second part, separate from the first part. The second part includes apertures. Each aperture is configured to receive a reference pin and substantially restrict movement of the second part with respect to the anatomy of the patient. The second part further includes a functional element for guiding a procedure on the anatomy of the patient.

Abstract: A TPLO plate configured to accommodate flexible strands (flexible loops) attached to tissue to be attached to bone. The TPLO plate has one or more suture eyelets, to allow the user (surgeon) to pass a flexible strand through the eyelets and attach/reattach the tissue to the plate at the anatomical location, and to improve the rotational stability of the joint or bone. The eyelets may have various shapes, forms and configurations and may be provided on or within a surface of the TPLO bone plate in any number, depending on the characteristics of the fractured bone or bone segments, or of the plate design. The eyelets preferably receive one or more flexible strands.

Abstract: A TPLO plate configured to accommodate flexible strands (flexible loops) attached to tissue to be attached to bone. The TPLO plate has one or more suture eyelets, to allow the user (surgeon) to pass a flexible strand through the eyelets and attach/reattach the tissue to the plate at the anatomical location, and to improve the rotational stability of the joint or bone. The eyelets may have various shapes, forms and configurations and may be provided on or within a surface of the TPLO bone plate in any number, depending on the characteristics of the fractured bone or bone segments, or of the plate design. The eyelets preferably receive one or more flexible strands.

Abstract: A device for the cerclage of fractured bone as well as to a cerclage system using such device are provided. The cerclage device comprises a cerclage wire or thread and at least one spacer arranged on the cerclage wire or thread. The at least one spacer is made as a band having a substantially rectangular plan and a concave profile. Owing to the concave profile, the band can adapt to the surface of the fractured bone; in addition, the force exerted on the bone by the cerclage wire is advantageously distributed over the entire surface of the band. The cerclage device further comprises at least one safety thread which allows preventing the spacer from becoming lost in the patient's body in case the cerclage wire or thread tears off.

Abstract: A bone screw, comprising a proximal end and a distal end spaced from the proximal end in a distal direction along a longitudinal axis of the bone screw and a cannulation extending from the proximal end to the distal end. The bone screw further including a threaded region extending along at least a portion of a length of the screw, the length extending from the proximal end to the distal end. The threaded region defining at least one external thread that extends about the longitudinal axis along a helical path. The threaded region includes at least one flute that extends to the distal end of the bone screw. The at least one flute defines an associated at least one cutting tooth that, in turn, defines a cutting face oriented so as to define an angle with respect to the longitudinal axis. The angle is in the range of about 5 degrees and about 25 degrees, and the flute circumferentially interrupts at least a portion of the external thread.

Abstract: Methods for temporarily fixing an orientation of a bone or bones. Methods of correcting a bunion deformity. Bone positioning devices. Methods of using a bone positioning device. Bone preparation guides. Methods of using a bone preparation guide.

Abstract: The cable-locking plate with screw allows for compression of bone fractures using a tensioned cable. The cable-locking plate with screw allows the use of a cable as a flexible bridging member, such as a cable, helps create compression while accommodating the unusual shape. The cable-locking plate with screw allows a surgeon to tension a cable through the plate, then grip the cable by tightening a screw associated with the plate. The compression is created is across the fracture, not around the bone, thus avoiding compression of nerve and blood vessels along the bone's surface. The cable is guided into an ideal position using cable channels, allowing the surgeon to concentrate on tension and screw compression. The plate and cable system are then left in the patient while the bone mends. The cable-locking plate with screw is either left permanently or removed during a later surgery.

Abstract: A surgical impact tool comprises an electromagnetic impactor hermetically sealed within a sterilizable housing having one or more external mechanical coupling for transmitting an impact to an object external to the tool. The housing also contains an energy storage medium rechargeable through the hermetic seal, and electronic controls operable through the hermetic seal.

Abstract: Devices, systems, and methods for maintaining cryoballoon size, cryoballoon pressure, and/or coolant flow rate based on physical characteristics of the tissue to be ablated. In one embodiment, a cryoablation system comprises: a cryoablation device, the cryoablation device including: an expandable treatment element defining an interior chamber; and a pressure sensing system at least partially within the interior chamber; a fluid flow path including at least one valve that is in communication with at least one PID device; and a control unit including processing circuitry in communication with the pressure sensing system and the at least one PID device, the processing circuitry being configured to: determine a target pressure of the expandable treatment element based on a target size of the expandable treatment element; and determine a target flow rate of coolant through the fluid flow path based on the target pressure of the expandable treatment element.

Abstract: Disclosed is a cryotherapy device comprising at least one inflow channel, at least one outflow channel, control means for controlling the evacuation of expanded cryo-fluid from a body lumen, wherein the control means receive data from at least one sensor that gathers data regarding at least one parameter of the body lumen and wherein the cryotherapy device is introduced into the body lumen via an endoscope.

Abstract: An elongate electrode is configured to flex and generate plasma to incise tissue. An electrical energy source operatively coupled to the electrode is configured to provide electrical energy to the electrode to generate the plasma. A tensioning element is operatively coupled to the elongate electrode. The tensioning element can be configured to provide tension to the elongate electrode to allow the elongate electrode to flex in response to the elongate electrode engaging the tissue and generating the plasma. The tensioning element operatively coupled to the flexible elongate electrode may allow for the use of a small diameter electrode, such as a 5 ?m to 20 ?m diameter electrode, which can allow narrow incisions to be formed with decreased tissue damage. In some embodiments, the tensioning of the electrode allows the electrode to more accurately incise tissue by decreasing variations in the position of the electrode along the incision path.

Abstract: A surgical system includes a forceps having an end effector at a distal end thereof that includes first and second opposing jaw members electrically conductive plates the jaw members pivotable relative to one another between an open position and a closed position. A generator is included that is configured to produce multiple modalities of electrical energy upon activation thereof. A first cable connects to the generator, the first cable including leads disposed therein configured to carry energy to the plates. A first switch is disposed on the forceps. A second cable connects to the electrical generator and to a second switch. Activation of the first switch activates the generator to transmit energy having a first modality through the first cable and to the plates and activation of the second switch activates the generator to transmit electrical energy having a second modality through the first cable to the opposing electrical plates.

Abstract: A method and system for supporting an HF surgical procedure in which tissue is treated. The method includes supplying an HF instrument including an HF electrode and an HF generator with HF current, providing a plurality of HF modes adapted to respective ones of a plurality of tissue types, and orienting an optical capturing device toward the HF electrode such that a field of view of the optical capturing device is configured to encompass a region of the tissue to be treated around the HF electrode during an intended treatment of the tissue. The method further includes performing an optical classification of a tissue type of the tissue in the region of the HF electrode based on optical measurement signals captured by the optical capturing device, and setting a specific HF mode for the tissue type based on the result of the optical classification.

Abstract: Provided is a surgical electrode in which an end portion capable of emitting a high frequency has a surface treatment film that includes a first coating and a second film in the order mentioned. The first coating is formed by contacting a surface treatment agent (X) with or over the entirety or a part of the surface of the end portion at least, which surface treatment agent (X) contains at least an amino group-containing compound, and the second film is formed by contacting a surface treatment agent (Y) with a part or the entirety of the surface of the first coating, which surface treatment agent (Y) contains: a silicone resin (A); a compound (B) containing a metal element selected from titanium, platinum, rhodium and palladium; and an aromatic hydrocarbon-based solvent (C), and satisfies: (I) the content of the silicone resin is in a range of 90% by mass to 99.

Abstract: An electrosurgical system includes an electrosurgical generator and an electrosurgical instrument coupleable to the electrosurgical generator. The electrosurgical generator includes a controller, a power supply coupled to the controller, and a power converter coupled to the power supply. The controller is configured to cause the power converter to generate a pulsed electric field configured to electroporate tissue and RF current configured to seal tissue. The electrosurgical instrument includes a pair of opposing jaw members configured to grasp tissue. Each of the pair of opposing jaw members includes an electrically conductive tissue-contacting surface configured to electroporate tissue disposed in proximity to the electrically conductive tissue-contacting surfaces via the pulsed electric field and deliver the RF current to the electroporated tissue to seal the electroporated tissue.

Abstract: A surgical instrument includes an end effector, a handle assembly, and a knife drive assembly. The end effector includes a pair of jaws, a knife, and an RF electrode assembly. The knife actuates between a pre-fired position and a fired position. An arm of the handle assembly is configured to pivot the second jaw between the open position and the closed position. The knife drive assembly includes an input assembly, a rotary assembly, and an output assembly. The input assembly travels a first proximal distance to rotate the rotary assembly. The rotary assembly rotates in response to travel of the input assembly along the first proximal distance to drive the output assembly a first distal distance to thereby actuate the knife from the pre-fired position toward the fired position. The first distal distance is greater than the first proximal distance.

Abstract: A method for treating tissue includes determining whether tissue is present between first and second jaw members. In a case where it is determined that tissue is present between the first and second jaw members, the method further includes determining whether activation has been initiated. In a case where it is determined that activation has been initiated, the method further includes supplying electrosurgical energy to the first and second jaw members to seal the tissue and, if it is determined that sealing is complete: stopping the supply of electrosurgical energy; activating a thermal cutting element to supply thermal energy to cut the sealed present tissue; determining if thermal cutting is complete; and, in a case where it is determined that the thermal cutting is complete, stopping and the supply of thermal energy.

Abstract: The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices, and more specifically including end effectors that can be incorporated into such devices. Certain end effector embodiments include various vessel cautery devices that have rotational movement as well as cautery and cutting functions while maintaining a relatively compact structure. Other end effector embodiments include various end effector devices that have more than one end effector.

Abstract: A method and tool are described for relieving lower back pain via destruction and removal of suprapedicular tissues, particularly via the destruction and removal of the peridural membrane. The tool comprises a narrow tubular body having one of a plurality of tip designs at one end and a handle at the other end. The tool is inserted through the suprapedicular canal, and mechanical manipulation of the tool effects the destruction of the target tissues responsible for chronic lower back pain.

Abstract: A medical apparatus includes a probe, which includes an insertion tube configured for insertion into a body cavity of a patient and a basket assembly connected distally to the insertion tube and including a plurality of resilient, conductive spines, which are configured to contact tissue within the body. The apparatus further includes an electrical signal generator configured to apply between one or more pairs of the spines bipolar pulses having an amplitude sufficient to cause irreversible electroporation (IRE) in the tissue contacted by the spines.

Abstract: Systems, device and methods treat target tissue to provide a therapeutic benefit to the patient. A tissue treatment device comprises a tissue treatment element constructed and arranged to treat target tissue, such as duodenal mucosa tissue.

Abstract: An exemplary system, method and computer-accessible medium for determining particular for a portion(s) of an organ of a patient(s) can be provided, which can include, for example, receiving an in vivo optical coherence tomography (OCT) imaging information for the portion(s), and determining (i) a lesion formation on or in the portion(s), (ii) a contact of a catheter on or with the portion(s), or (iii) an angle of the catheter with respect to the portion(s), by applying a convolutional neural network(s) to the in vivo OCT imaging information.

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: Electrical instrument for applying radiofrequency and/or microwave frequency energy to tissue, comprising: a distal part comprising an instrument tip for applying radiofrequency and/or microwave frequency energy to tissue, the instrument tip comprising first and second conductive elements; a coaxial feed cable comprising an inner conductor, a tubular outer conductor coaxial with the inner conductor, and dielectric material separating the inner and outer conductors, the coaxial feed cable being for conveying radiofrequency and/or microwave frequency energy to the distal part; wherein: the inner conductor is electrically connected to the first conductive element and the outer conductor is electrically connected to the second conductive element through a rotatable connection between the distal part and the coaxial feed cable that allows rotation of the distal part relative to the coaxial feed cable; and the instrument comprises an actuator for rotating the distal part in a first rotational direction relative to

Abstract: A method of perforating a tissue of a heart of a patient when an inferior approach to the heart is contraindicated. The method utilizes an electrosurgical apparatus having an energy delivery device which can function as an ECG measuring device at a distal end thereof and a delivery system comprising a dilator. Said method comprises the steps of (a) advancing the dilator through a superior vena cava into the heart of the patient, from a superior approach, until a distal end of the dilator is adjacent the tissue; (b) checking an ECG signal to confirm a position of the energy delivery device; (c) using the electrosurgical apparatus, which is positioned through the dilator, to create a perforation in the tissue by delivering electrical energy to the tissue; (d) advancing the distal end of the electrosurgical apparatus through the perforation; and (e) advancing the dilator over the electrosurgical apparatus.

Abstract: A method and device for modulating the autonomic nervous system adjacent a pericardial space to treat cardiac arrhythmia includes a treatment source arranged to supply a treatment medium, a catheter having an end sized for insertion into the pericardial space, a medium delivery assembly having a distal end arranged to be positioned by the catheter into the pericardium, with the distal end of the delivery assembly comprising a delivery tip arranged to extend away from the distal end of the catheter into the pericardial space. A connector operatively couples the delivery tip of the medium delivery assembly to the treatment source, and the delivery tip of the medium delivery assembly including a plurality of delivery points for delivering the treatment medium at a plurality of treatment areas within the pericardial space. The device performs modulation or ablation of the autonomic nervous system at selected treatment areas within the pericardium.

Abstract: A controllable stiffness catheter includes a shaft comprising inner and outer sheaths, the sheaths each having proximal and distal ends. The outer surrounds the inner from the proximal to the distal end of the inner sheath, defining an annulus therebetween including a proximal portion having a vacuum connection to which vacuum is applied. The distal ends of the sheaths are longitudinally fixed to one another and sized for neurological vascular procedures. The outer has a substantially constant outer diameter over a distal portion of the annulus proximate to the distal ends. A vacuum device fluidically connects to the vacuum connection and is configured to apply vacuum thereto. Responsive to vacuum, annulus pressure lowers to draw the sheaths toward one another and stiffen the shaft over at least the distal portion to substantially and passively stiffen and maintain a current shape of the shaft over at least the distal portion.

Abstract: Methods and systems for modifying tissue use a pressurized fluid stream carrying coherent light energy. The methods and systems may be used for resecting and debulking soft and hard biological tissues. The coherent light is focused within a stream of fluid to deliver energy to the tissue to be treated.