Abstract: Devices and methods for therapeutic photodynamic modulation of neural function in a human. One embodiment of a method in accordance with the technology includes administering a photosensitizer to a human, wherein the photosensitizer preferentially accumulates at nerves proximate a blood vessel compared to non-neural tissue of the blood vessel. The method can further include irradiating the photosensitizer using a radiation emitter positioned within the human, wherein the radiation has a wavelength that causes the photosensitizer to react and alter at least a portion of the nerves thereby providing a therapeutic reduction in sympathetic neural activity. Several embodiments of the technology are useful for disrupting renal nerves, such as renal denervation, for treating hypertension, diabetes, congestive heart failure, and other indications.

Abstract: According to some embodiments, a method of treating conditions affecting a liver of a subject is provided. The method may include delivering a neuromodulation catheter within a vessel (e.g., hepatic artery) having surrounding nerves that innervate the liver (e.g., sympathetic nerves of the hepatic plexus). The method may also include modulating (e.g., disrupting, ablating, stimulating) the nerves by mechanical compression, energy delivery, or fluid delivery.

Abstract: Embodiments of the invention are directed to a laser ablation system. In one embodiment, the laser ablation system comprises a shaft, a balloon, a laser fiber and a viewing fiber. The shaft has a proximal end and a distal end. The balloon is attached to the distal end of the shaft, a portion of which is within the balloon. The laser fiber has a distal end comprising a light dispenser that is configured to deliver laser light through the balloon. The viewing fiber is configured to image an interior balloon. In accordance with another embodiment, the laser ablation system comprises a shaft, a balloon and a laser fiber. The shaft has a proximal end and a distal end. The balloon is attached to the distal end of the shaft, which is within the balloon. The balloon includes an inflated state, in which the balloon is shaped to conform to a cavity of a patient. The laser fiber has a distal end comprising light dispenser that is configured to deliver laser light through the balloon.

Abstract: Apparatus and method for ablating target tissue including a non-linear area of tissue in the left atrium of a patient. The method can include selecting an ablation apparatus having an ablator with a tissue engagement section, penetrating a chest cavity of the patient, and identifying the target tissue. The method can also include positioning the ablation apparatus adjacent to the target tissue so that the tissue engagement section can transfer ablation energy to the target tissue. The method can further include energizing the tissue engagement section with ablation energy in order to create a footprint on the non-linear area of tissue in the left atrium and to reduce an overall mass of excitable tissue in the left atrium.

Abstract: A method is provided for treating a neuromuscular defect in a subject. One step of the method includes locating a target nerve. After locating the target nerve, a treatment probe is provided. The treatment probe includes an elongated body member having a proximal end portion and a distal end portion. The distal end portion includes an energy delivery mechanism for stimulating or ablating the target nerve, a monitoring mechanism, and a fluid aspiration/delivery mechanism. Next, the target nerve is verified as an appropriate target for ablation by stimulating and then monitoring the target nerve via the energy delivery mechanism and the monitoring mechanism, respectively. After verifying the target nerve, a tumescent fluid is injected into the tissue surrounding the target nerve. An electric current is then delivered to the energy delivery mechanism to substantially ablate the target nerve.

Abstract: Unitary endoscopic vessel harvesting devices are disclosed. In some embodiments, such devices may comprise an elongated body having a proximal end and a distal end. A conical tip may be disposed at the distal end of the elongated body. In addition, the surgical instrument may include one or more surgical instruments moveable in a longitudinal direction along an axis substantially parallel to a central longitudinal axis of the cannula from a retracted position proximally of a distal end of the tip to an advanced position toward the distal end of the tip to seal and cut a blood vessel.

Abstract: Devices and methods for thermally-mediated treatment of blood vessels to elicit an immune response to cause rapid endothelial growth over at least portions of an implant or stent to prevent adverse events such as restenosis. Devices and methods for thermally-mediated treatment to inhibit contraction of vessels to elicit an immune response to cause rapid endothelial growth over at least portions of a stent to prevent adverse events such as restenosis.

Abstract: The various embodiments of the present inventions provide stabilization devices and methods for use of the stabilization devices with minimally invasive gynecological procedures such as methods of preventing pregnancy by inserting intrafallopian contraceptive devices into the fallopian tubes.

Abstract: Methods and devices described herein facilitate improved treatment of body organs.

Abstract: Methods and devices are disclosed that, in various embodiments and permutations and combinations of inventions, diagnose and treat Pulmonary Embolism or associated symptoms. In one series of embodiments, the invention consists of methods and devices for identifying patients whose Pulmonary Embolism or associated symptoms are caused or exacerbated, at least in part, by blockages of one or more of the patient's internal pulmonary veins. In some instances, stenoses or other flow limiting structures or lesions in the patient's affected veins are identified. Further, in some instances the nature of such lesions and whether there is a significant disruption of blood pressure, or both, is ascertained. In some embodiments, methods and devices for applying one or more therapies to the blockages in the patient's pulmonary veins are provided.

Abstract: Apparatus and methods are provided to concentrate energy delivery in non-superficial target tissue within a trigone region of a human bladder wall to modulate bladder function.

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.

Abstract: A surgical instrument is provided including a handle portion and a body portion extending distally from the handle portion and defining a longitudinal axis. The surgical instrument also includes an end effector assembly disposed at a distal end of the body portion, the end effector assembly including an electromagnetic manipulator in cooperation with an ultraviolet (UV) light source for performing tacking of an implant. In an alternative embodiment, the end effector assembly includes an electromagnetic manipulator in cooperation with at least one tack for performing tacking of an implant. The implant may be a mesh having a ferromagnetic coating activated by the electromagnetic manipulator. The tissue may have a UV coating activated by UV light applied by the UV light source.

Abstract: In one embodiment, the disclosure is directed to an integrated apparatus for delivering energy to a tissue. The integrated apparatus included a housing having a distal end and a tubular structure located within the housing forming a first annulus between the tubular structure and the housing. The tubular structure is configured to accept an energy delivery component and is configured to form a second annulus between the tubular structure and the energy delivery component. The first annulus and the second annulus are configured to communicate with each other proximate to the distal end of the housing.

Abstract: The present disclosure relates generally to systems and methods for aligning directionally operable medical devices with and upon target tissue. In particular, the instant disclosure relates to systems and methods for aligning medical devices such as directional ablation catheters to and upon target tissue by monitoring irrigant backpressure.

Abstract: A method and apparatus are provided for treating targeted tissue as a function of the force sensed to move through the tissue. The method and apparatus can be used for treating and/or reducing the appearance of undesirable conditions such as cellulite.

Abstract: Methods and systems for treatment of hypoxic tumors are provided, including the steps of positioning a delivery device in a bodily cavity adjacent to tumor tissue, delivering an oxygenating agent to the tumor tissue via the delivery device and radiating the tumor tissue with radiation. Methods and systems of treatment of tumors are also provided, including the steps of positioning a delivery device in a bodily cavity adjacent to tumor tissue, delivering a photosensitizing agent to the tumor tissue via the delivery device, and radiating the tumor tissue with light.

Abstract: The tissue augment sheet delivery system includes a tube funnel adapter and a tissue augment sheet delivery instrument. The tube funnel adapter includes a oval/conical shaped funnel. The tissue augment sheet delivery instrument includes a handle. A cylindrical tube is connected to the handle. A wire is inserted in the tube. The wire is formed in a large loop with small loops formed in the large loop. A tissue augment sheet is attached to one side of the large loop using a monofilament. In use, the tube funnel adapter is inserted in body. The tissue augment sheet is placed in mouth of the oval/conical shaped funnel and gently moved down. While moving down, the tissue augment sheet conforms to the internal diameter of the tube funnel adapter. The handle is withdrawn to remove the large loop from the body leaving the tissue augment sheet in body.

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.

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 for photoselective vaporization of prostate tissue includes delivering laser radiation to the treatment area on the tissue, via an optical fiber for example, wherein the laser radiation has a wavelength and irradiance in the treatment area on the surface of the tissue sufficient because vaporization of a substantially greater volume of tissue than a volume of residual coagulated tissue caused by the laser radiation. The laser radiation is generated using a neodymium doped solid-state laser, including optics producing a second or higher harmonic output with greater than 60 watts average output power. The delivered laser radiation has a wavelength for example in a range of about 200 nm to about 650 nm, and has an average irradiance in the treatment area greater than about 10 kilowatts/cm2, in a spot size of at least 0.05 mm2.

Abstract: Methods for decreasing the size and/or changing the shape of pelvic tissues. Energy, preferably radio frequency or laser energy, may be applied to endopelvic fascia or other subcutaneous tissue transcutaneously, through one or more incisions in skin, or directly to the desired subcutaneous tissue after a strip of mucosa or skin has been removed. Such an application of energy may cause the subcutaneous tissue to shrink, thereby bringing the mucosa or skin edges closer together while minimizing damage to deep nerves and other surrounding tissues. Such manipulation of the layers of the skin may be utilized to decrease the size or change the shape of numerous anatomical structures and may also serve to alleviate the symptoms of urinary incontinence, dyspareunia, or chronic pelvic pain. The method steps of the present invention may further provide for the beneficial pretreatment of a tissue site prior to stem cell implantation.

Abstract: The invention relates to a sterile barrier (S) for a surgical robot (1) comprising at least one joint (12 . . . 15) with two opposing joint members (40, 42) that rotate relative to one another about a common joint axis (16 . . . 19) and a torque sensor (29) comprising: at least two sterile barrier sections (24 . . . 28) each with an end section (38, 39) for sealed attachment to a respective joint end section (41, 43) of the joint member (40, 42); and a sealing arrangement (30) for producing a sterile and sealed rotating connection of the end sections (38, 39) of the at least two sterile barrier sections (24 . . . 28); and a surgical robot (1).

Abstract: The invention is directed to a laser catheter (1) for bypass surgery, wherein the distal part (2) of the catheter (1) is provided with: a tubular arrangement (3) of optical fibers (4) having distal ends (5) defining a ring-shaped light emergence surface (6) for emitting a tubular bundle of light beams in the distal direction (D) of the catheter (1); and a stop surface (7) extending around the tubular arrangement (3) of optical fibers (4) and facing in the distal direction (D), the stop surface (7) being arranged at a distance (A) proximally from the light emergence surface (6). The light emergence surface (6) slants at a slanting angle (?) in the range of [20°, 60°] with respect to the longitudinal axis (8) of the catheter (1). The invention further relates to an assembly comprising such a catheter.

Abstract: A device for the treatment of rhinitis by biostimulative illumination. The device comprises a pair of LEDs (504a; 505b) containing probes (202a; 202b) adapted to be inserted into the nostrils of a patient. A probes support casing (204), the probes being normally flexibly attracted one against the other. The casing accommodates an electric power source (502), an ON/OFF normally open micro-switch (504a) and circuit means for activating/deactivating the LEDs (504a; 504b). The casing (204) is made of at least partly elastomeric material whereby the micro-switch (504a) becomes activated by pressing against a side-wing (206a) of the casing also causing the probes to spread apart from each other and the micro-switch remains closed for as long as the probes are kept apart from each other.

Abstract: An improved device and method for safe, accurate and efficient surgical procedures are disclosed. The disclosed device is an optical fiber set with an asymmetric distal end configuration, comprising a bent tip fiber with a fused sleeve as an integral part of it, placed at the fiber's distal (output) end and with a rotatable connector at the proximal (input) side. Fiber tip and tissue-contacting surface located at the distal end of the tip may be constructed with different shape configurations, such as convex tip to improve focusing characteristics, concave tip to achieve diverging irradiation or an expanded beam tip to achieve an effect similar to that obtained by electrosurgical tools. A grip guarantees and enhances the ability to twist and rotate it easily. In another preferred embodiment, twisting maneuvers are enhanced through a special configuration.

Abstract: A method and device for improved minimally invasive vascular treatments. The method comprises introducing a catheter into a vein to be treated. The catheter is adapted to introduce an energy transmitting member and a fluid into the vein to be treated. The fluid introduced via the catheter can include, but is not limited to: saline solutions, cooled saline solutions, liquids for vapor generation, vasoconstricting agents, anesthetic agents and/or a formulation containing an ingredient which can be activated by the applied energy.

Abstract: A technique for detecting and providing alerts or indications that can be used for controlling or altering the displacement speed of an applicator coupling skin heating energy across a treated skin. A temperature sensor monitors the rate of skin temperature change and provides feedback related to altering the applicator displacement speed according to the rate of skin temperature change. Disclosed is also an applicator for implementing this method.

Abstract: A system is provided for identifying the sufficiency of lesions formed during a tissue ablation procedure. The system captures live and still images from the surgical site and provides composite imaging to the operator. Through the use of the system, the aiming light used to direct ablative energy is captured on the still images and used to indicate locations in a surgical site where energy has been directed. Through the use of processing modules, the system can analyze the lesions and determine the sufficiency thereof.

Abstract: An apparatus and method for treating a cardiac condition with visual inspection of a tissue treatment site includes the step of delivering an expanding member formed on a distal end of a catheter to a position adjacent a tissue treatment area within a patient's heart. The expandable member has an elastic portion configured to conform to the tissue treatment area. The method further includes the steps of expanding the expandable member thereby allowing the elastic portion of the expandable member to conform to the tissue treatment area and positioning an energy emitter at a first location within an inner lumen of the catheter. A visible aiming beam is projected during positioning of the energy emitter and ablative energy is delivered from the energy emitter to the tissue treatment area thereby resulting in a first spot lesion.

Abstract: An apparatus and a method are provided for the treatment of soft tissue. The apparatus includes a light source and at least two optical assemblies. Each of the optical assemblies includes at least one optical element and a light-transmitting contact surface configured to transmit a substantially uniform distribution of light therethrough. The apparatus further includes at least two optical transmission devices each disposed between the light source and a corresponding one of the at least two optical assemblies. The apparatus also includes a handpiece to which the at least two optical assemblies are attached, and which is adapted to bring the light-transmitting contact surfaces of the at least two optical assemblies in contact with soft tissue disposed therebetween.

Abstract: Lysing of fat cells in adipose tissue beneath the skin and liquefying the released fat is achieved by introducing a side-firing thermal energy device into the tissue to be irradiated, while thermal energy, such as laser energy, is emitted at a selected level for a selected period of time, depending on the volume to tissue to be irradiated. The side firing device is advanced into tissue and withdrawn and, while energy is emitted, is aimed separately at 3 o'clock and 9 o'clock and, is repetitively rotated through an arc of about 120°, producing a bowtie-shaped irradiation pattern. The side firing device may be centered and sealingly held in position in a liposuction cannula by ribs extending inwardly from the interior of the liposuction cannula. At least one of the ribs has a channel for infusion of an irrigating liquid.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: A method and apparatus for performing minimally-invasive image-guided laser ablation of targeted region within a tissue or organ comprising the following: A guidance tool that can guide laser source to a predefined target region from a planning image; A controller that can control energy from laser source, duration of its application and dosage of energy from laser source; and a computer with software that can compute thermometry based on precise location and duration of application or dosage of the laser source. The computer receives signal from controller and can control or shut-off laser energy.

Abstract: A laser applicator includes an optical fiber with a core surrounded by a cladding. The cladding contains openings (40) for coupling radiative energy outward. To accomplish an even distribution of energy, the size of the opening increases from the proximal end to the distal end. The openings (40) are combined into groups (45), with the number of openings within a group varying. The openings (40) are of a uniform size so that the area of decoupling (13) can be produced in a simple manner.

Abstract: An intravascular diagnostic or therapeutic apparatus capable of removing blood in an intravascular lumen to be observed using a minimally invasive method is provided. The apparatus includes high-intensity pulsed light generating means and high-intensity pulsed light transmitting means for transmitting high-intensity pulsed light, capable of irradiating the interior of a blood vessel with high-intensity pulsed light, producing water-vapor bubbles and temporarily removing the blood in the blood vessel.

Abstract: Device for electrically isolating the pulmonary veins in atrial fibrillation for treatment thereof by means of ablation of a circumferential zone of tissue in a position where a pulmonary vein extends from an atrium, comprising: a catheter (1) having a terminal part and a distal part and comprising a first tubular element (2); a second tubular element (4) concentric with said first tubular element (2) and an axial rod-like element (6) which extends beyond the distal end of said first and second tubular elements (2; 4); a first tubular toroidal element (13) supported by a plurality of tubular arms (11) which extend from said distal end towards said toroidal element (13) forming a kind of cage which can be opened in umbrella fashion around the distal end of said catheter (1), said tubular arms (11) and said toroidal element (13) being in fluid communication with each other and with said second tubular element (4) of said catheter (1); and a second toroidal tubular element (9) in fluid communication by means of

Abstract: A method of transluminal surgery is provided, which utilizes an endoscopic surgery apparatus having pivotable arms attached by hinges on its distal end. The arms are interchangeable with arms of various configurations. The method includes the steps of inserting an endoscopic surgery apparatus into a body cavity of a patient, making an incision in the body cavity wall to allow access to the patient's abdominal cavity, and further inserting the apparatus through the incision. Surgery is performed at the desired surgical site and the apparatus is withdrawn into the body cavity where the incision is closed. Finally, the apparatus is withdrawn from the patient's body.

Abstract: A light diffuser, which is particularly suitable for introducing diffuse light into a tissue, is produced by interpenetration of a diffuser material in a liquid state into a boundary layer of a porous shaping material, by which process a diffuser surface is formed having a surface structure which represents essentially a negative of the pore structure of the shaping material and includes undercut structures induced by a surface tension. The light diffuser is e.g. produced by introducing a diffuser blank including material that is liquefiable through mechanical vibration into the shaping material and simultaneously stimulating it with mechanical vibrations, such that the liquefiable material liquefies at least there where it is in contact with the shaping material and is pressed into the shaping material. An in situ production of the diffuser is particularly advantageous for photodynamic therapy in bone tissue.

Abstract: Guided ablation instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias, including atrial fibrillation. In one aspect of the invention, a percutaneous catheter is disclosed with an endoscope positionable in the instrument's distal end region to obtain an image. The image allows the clinician to determine whether contact has been achieved (or blood has been cleared from an ablative energy transmission path) before ablation begins or while ablation is occurring. In one embodiment, percutaneous ablation catheters are disclosed having at least one central lumen and one or more balloon structures at the distal end region of the instrument. Also disposed in the distal end region are an illuminating light source and an endoscope capable of collecting sufficient light to relay an image to the user. The instruments can further include an ablation element.

Abstract: An improved procedure for performing liposuction is obtained by utilizing a needle that includes a laser source conductor with one end of the needle being configured for insertion into a target adipose skin volume and the other end being coupled to a laser source. The needle may include one or more channels for extracting the treated adipose area. A vacuum source can be used in the extraction of the treated adipose. Further, the first end of the needle may include a cap or end-piece that reduces the build up of carbon deposits. A temperature sensor may be used as input to adjust the laser power and prevent over exposure.

Abstract: A forceps includes an end effector assembly, a handle assembly, a first switch assembly, and a second switch assembly. The end effector includes first and second jaw members, at least one of the jaw members movable relative to the other between a spaced-apart position, a first approximated position and a second approximated position, at least one of the jaw members adapted to connect to a source of energy. The handle assembly includes a movable handle operably coupled to the end effector, and is movable between an initial stage, a first actuated stage, and a second actuated stage. The first switch assembly is activatable to supply a first energy to the end effector to seal tissue grasped, and the second switch assembly is activatable to supply a second energy to the end effector to cut tissue grasped.

Abstract: Medical methods and systems are provided for effecting lung volume reduction by selectively ablating segments of lung tissue.

Abstract: In general, in one aspect, the disclosure features a system that includes a flexible waveguide having a hollow core extending along a waveguide axis and a region surrounding the core, the region being configured to guide radiation from the CO2 laser along the waveguide axis from an input end to an output end of the waveguide. The system also includes a handpiece attached to the waveguide, wherein the handpiece allows an operator to control the orientation of the output end to direct the radiation to a target location of a patient and the handpiece includes a tip extending past the output end that provides a minimum standoff distance between the output end and the target location.

Abstract: Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes.

Abstract: An intracerebral probe (11) comprising a first part (20) with laser or cryogenic treatment means and further comprising a hollow second part (22) surrounding the first, the first part sliding inside the second part along its longitudinal axis (A); and a plurality of detectors (16) distributed along a portion of the second part (22) in such a manner as to be capable of identifying a brain dysfunction zone along the longitudinal axis (A) of the second part. Advantageously, the probe presents a lateral treatment window enabling the action of the treatment means to be directed. The invention also provides a kit and a treatment system including such a probe, and the use thereof of treating cell dysfunctions that give rise to neurological or psychiatric symptoms.

Abstract: A lower esophageal sphincter tightening device for treating gastro esophageal reflux disease which includes an insertion device, an energy source, and an energy transmitting device. The insertion device, by insertion through a body opening, positions the energy transmitting device in the proximity of the lower esophageal sphincter. The energy generates and transmits energy via the insertion device to the energy transmitting device which directs the transmitted energy onto the lower esophageal sphincter which is comprised largely of collagen. The energy source transmits energy at a level sufficient to cause heating of the sphincter's collagen resulting in a shrinkage of the collagen and a tightening of the sphincter.

Abstract: A method is provided for treating a neuromuscular defect in a subject. One step of the method includes locating a target nerve. After locating the target nerve, a treatment probe is provided. The treatment probe includes an elongated body member having a proximal end portion and a distal end portion. The distal end portion includes an energy delivery mechanism for stimulating or ablating the target nerve, a monitoring mechanism, and a fluid aspiration/delivery mechanism. Next, the target nerve is verified as an appropriate target for ablation by stimulating and then monitoring the target nerve via the energy delivery mechanism and the monitoring mechanism, respectively. After verifying the target nerve, a tumescent fluid is injected into the tissue surrounding the target nerve. An electric current is then delivered to the energy delivery mechanism to substantially ablate the target nerve.

Abstract: A method for the treatment of a patient for the purpose of lowering blood pressure and/or treating other medical conditions such as cardiac arrhythmias. A catheter having an ablation element is placed inside the body of a patient and is directed to a targeted location either on in the abdominal aorta where the right or left renal arteries branch from the aorta at or near the superior junction or ostia or on the inside of the inferior vena cava near the junction with the right renal vein or in the left renal vein at a position spatially near where the left renal artery branches from the abdominal aorta. Catheters designed for use in the method where these targeted locations are also disclosed and claimed.

Abstract: Devices and methods for thermally-mediated treatment of blood vessels to elicit an immune response to cause rapid endothelial growth over at least portions of an implant or stent to prevent adverse events such as restenosis. Devices and methods for thermally-mediated treatment to inhibit contraction of vessels to elicit an immune response to cause rapid endothelial growth over at least portions of a stent to prevent adverse events such as restenosis.