Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25° C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions.

Abstract: A probe contacts targeted tissue, sometimes while positioned adjacent to nontargeted live tissues. In preferred forms, the probe includes a support that only minimally conducts heat from nontargeted tissues. A very conductive targeted-tissue-contacting element, at an end of the support, is immersed in a liquid cryogen (preferably nitrogen) and then removed for contacting with (e. g., insertion into) the targeted tissue. An ultrathin highly thermoconductive polymeric tubing holds both a very conductive, cold material, forming the targeted-tissue-contacting element, and fine insulating material (e. g. highly insulating elastomer) forming part of the support. The targeted-tissue-contacting element is fashioned to fit the targeted tissue in at least one dimension, and the support to fit nontargeted live tissues (if any) adjacent to which the probe is positioned while contacting the targeted tissue.

Abstract: The cryoprobe assembly includes a cryoprobe and an outer sheath assembly detachably connected thereto. The cryoprobe includes: a Joule-Thomson nozzle; a high pressure gas supply line for supplying gas to the Joule-Thomson nozzle; a heat exchanger interposed between the high pressure gas supply line and the Joule-Thomson nozzle; a cryoprobe sheath containing the heat exchanger and Joule-Thomson nozzle, the cryoprobe sheath having an outer surface; and, a handle attached to the first sheath, the handle having a gripping portion directly graspable by an operator and a connecting portion. The outer sheath assembly includes an adapter covering substantially none of the gripping portion of the cryoprobe handle. The adapter is for attachment to the connecting portion. An outer sheath is connected to the adapter and surrounds the outer surface of the cryoprobe sheath wherein the outer sheath provides enhanced protection against any gas leaks.

Abstract: Surgical complications can be minimized by reducing, or eliminating, the release of substances such as TGF-&bgr; from a surgical site by immediately sealing the edges of a surgically-made puncture or incision site. In one system, a treatment device includes an electrically conductive surface that is connected to a source of electrical energy and which can be placed in contact with the edge of a surgical incision or perforation site such that, when the conductive surface is electrically activated, it operates to heat the cellular material at the edge of the surgical incision or perforation site to inhibit (i.e., reduce) the formation of complicating connective tissue bridges. The source of electrical energy is, preferably, a radio-frequency generator.

Abstract: The present invention features various methods and systems for performing radiation treatment of skin in connection with dynamic cooling of tissue, while minimizing or preventing occurrence of light flash during the treatment.

Abstract: A cooling head for attachment a skin treatment laser has a metal body with a mount at one end for attachment to a laser head to secure the metal body to the head. A cooling surface at the other end is for application to a patient's skin and has an aperture therethrough. A bore extends from the mount through the body to the aperture in the cooling surface to allow a laser beam to be passed therethrough to a treatment area of the patient's skin. An extraction port enables removal of debris from the treatment area and for connection to a vacuum source. An optically transparent window is disposed in the body to allow the treatment area at the aperture in the cooling surface to be viewed by a surgeon using the laser. A cooling means such a liquid flow heat exchanger or Peltier device enables heat removal from the body in use in order to cool the cooling surface.

Abstract: The invention provides a method for substantially reducing the size of a thrombus in a blood vessel in which blood is flowing. The method includes delivering a heat transfer element to a blood vessel in fluid communication with a thrombosed blood vessel. The temperature of the heat transfer element is adjusted such that the same is sufficient to remove heat from the flowing blood. Heat is transferred from a volume including the thrombus to the heat transfer element. In a separate embodiment, heat may be delivered to the volume including the thrombus from the heat transfer element. The resultant temperature of the volume may be sufficient to substantially reduce the size of a thrombus. For example, the resultant temperature of the volume may be sufficiently high to substantially enhance plasminogen activation near the thrombus.

Abstract: A cryoprobe system with a vented high pressure gas supply line. Venting of the gas supply line upon cut-off of high pressure gas quickens the warming process of the cryoprobe.

Abstract: A method of treating a brain disorder by heat transfer from brain tissue comprising the steps of surgically cutting a heat transfer aperture into a patient's skull, thereby exposing a predetermined portion of patient's brain; surgically implanting into said heat transfer aperture a heat pump having one or more electrical sensor elements and one or more temperature sensor elements; surgically implanting a heat transfer management unit in a body cavity of said patient such that a micro controller of the heat transfer management unit is connected to one or more activity sensor elements and one or more temperature sensor elements contacting brain tissue and connecting the heat transfer management unit to said heat pump via a lead bundle. Optionally, the heat transfer unit may be located external to the patient's body.

Abstract: The present invention provides a cryogenic device and system for treating biological tissue, which includes at least two media-flow lumens and a media-expansion element for cooling media flowing within the device. A cooling portion of the device is located along a portion of one of the media-flow lumens. The cooling portion is of a construction suitable for good contact with tissue selected for treatment. Preferably, the device and system employ one or more closed media-flow pathways for efficient recycling of the media employed. Preferably, the device and system also employ efficacious heat-exchange relationships between media-flow conduits for optimal cooling. The device and system are particularly designed for the formation of lesions in biological tissue, most particularly, the formation of deep, elongated and continuous lesions in cardiopulmonary tissue. The present invention also provides a method of using the cryogenic device and system in the treatment of biological tissue.

Abstract: A method and system for monitoring the progress of an ice ball produced by a cryoprobe during a surgical procedure measures the complex impedance of the ice ball. An electrical model of the zones in the ice ball is employed to calculate the size of the zones using the complex impedance measurements. The ice ball zones are displayed to assist the surgeon in controlling the cryoprocedure.

Abstract: A cryogenic catheter having an elongate outer member and a plurality of inner members disposed within the elongate outer member is provided. The inner members define at least one cryogenic path through the outer member. At least one of the inner members has at least one controllable opening formed thereon to selectively release cryogenic fluid. The inner members also include an overtube and an injection tube slideably disposed to one another.

Abstract: The present invention involves a selective organ heat transfer device having a flexible coaxial catheter capable of insertion into a selected feeding artery in the vascular system of a patient. A heat transfer element is attached to a distal portion of the catheter as well as a turbulence-enhancing element which is adapted to enhance turbulent blood flow along the heat transfer element. The heat transfer element may include the turbulence-enhancing element and/or a turbulence-enhancing element may be located proximal of the heat transfer element.

Abstract: A system for surgically removing a cataract from an eye includes a cryomanipulator having a body and a manipulator head with a cryogenic tip for selectively freeze-gripping a region of contact of the catartact and for manipulating it within the eye. The cryomanipulator may include a heating device. The cryomanipulator may further include an irrigation/suction sleeve having an aperture for providing irrigation and/or suction. The system also includes a cataract removing device (CRD) for breaking up the cataract while it is at least partially frozen by the cryomanipulator. The CRD includes a drilling unit for breaking the cataract. The drilling unit includes a housing having a bore therein and a drill bit rotatably disposed within the bore. The drill bit includes a drill blade for breaking the cataract. The drill bit is rotatably couplable to a motor. The housing may also include conduits for providing irrigation fluid to the eye and for aspiring excess irrigation fluid and fragments of the broken cataract.

Abstract: A method for performing radiation treatment of skin in connection with dynamic cooling of tissue, while minimizing or preventing occurrence of light flash during the treatment.

Abstract: The present invention is a thermoelectric device and method designed to create a martensitic state in a shape memory alloy. The invention allows for prolonged use without overheating, and is more less expensive and easier to use than current art. The device is comprised of a cooling tip that is made of a thermally conductive material in contact with the thermoelectric module powered by an external DC converter. A heat sink is in thermal contact with the heating face of the module with cooling fins to draw heat away from the module. A continuous supply of cooling gas or liquid flows over the cooling fins or liquid channels to further cool the module. The DC power supply is controlled by a pneumatic device that will only operate under positive gas pressure, thus ensuring proper cooling of the heat sink of the invention. The cooling tip extends from the front end of an insulating body, the body having a threaded chucking hold for easy removal and changeout of the cooling tip.

Abstract: A cryosurgical instrument includes a cryoprobe operative to form an ice ball in tissue of a patient targeted for cryosurgery upon activation, a sheath disposed over the cryoprobe and at least one measuring device supported by the sheath for measuring a parameter of the tissue of the patient. The instrument includes a processor for predicting formation of the ice ball by the cryoprobe over time and a display for displaying the prediction of ice ball formation. The processor is responsive to an output signal provided by the measuring device and a model of the effective thermal conductivity of the tissue of the patient targeted for surgery. In one embodiment, the measuring device is embedded in the sheath and measures temperature, thermal conductivity, blood perfusion rate and/or thermal diffusivity. The processor may be further responsive to an impedance measurement circuit for verifying the prediction.

Abstract: Dynamically cooling the epidermis of a port wine stain patient undergoing laser therapy permits maximization of the thermal damage to the port wine stain while at the same time minimizing nonspecific injury to the normal overlying epidermis. A cryogenic spurt is applied to the skin surface for a predetermined short period of time in the order of tens of milliseconds so that the cooling remains localized in epidermis while leaving the temperature of deeper port wine stain vessels substantially unchanged. The result is that epidermal denaturation and necrosis which normally occurs in uncooled laser irradiated skin sites does not occur and that clinically significant blanching of the port wine stains at the dynamically cooled sites establishes that selective laser photothermolysis of the port wine stain blood vessels is achieved. In addition, dynamic epidermal cooling reduces patient discomfort normally associated with flashlamp-pumped pulsed dye laser therapy.

Abstract: A technique relating to orthokeratology for correcting presbyopic and hyperopic errors by means of a shallow-plane photo-microwelded intralamellar band. The technique is non-contact and is intended to be micro-invasive to allow its frequent repetition as a maintenance therapy. Non-contact photonic energy and a cyro-energy systems are provided in combination for creating an "inverse" thermal gradient in the anterior cornea. A computer-controlled spatial application system is provided for very high speed scanning of a photonic beam over the cornea. A "prosthetic" lens maintains the corneal surface in an optimal condition and prolate curvature. The lens-prosthesis further is adapted to mediate cryo- and photonic energies that propagate through the cornea to create the desired shallow-plane microweld effects.

Abstract: A method for performing hypothermia of a selected organ without significant effect on surrounding organs or other tissues. A flexible coaxial catheter is inserted through the vascular system of a patient to place the distal tip of the catheter in an artery feeding the selected organ. A chilled perfluorocarbon fluid is pumped through an insulated inner supply conduit of the catheter to cool a flexible bellows shaped heat transfer element in the distal tip of the catheter. The heat transfer bellows cools the blood flowing through the artery, to cool the selected organ, distal to the tip of the catheter.

Abstract: A high resolution cryosurgical method and device for treating a patient's prostate are provided. The method includes the steps of (a) introducing a plurality of cryosurgical probes to the prostate, the probes having a substantially small diameter, the probes being distributed across the prostate, so as to form an outer arrangement of probes adjacent the periphery of the prostate and an inner arrangement of probes adjacent the prostatic urethra; (b) producing an ice-ball at the end of each of said cryosurgical probes, so as to locally freeze a tissue segment of the prostate.

Abstract: A surgical instrument comprising a probe for insertion into the body of a host and for manipulating the tissues of the host, the probe including an ultrasound transducer element for locating and positioning the probe within the body of the host; and a method for manipulating the tissues of a host using the surgical instrument.

Abstract: The invention relates to a medical cryo-surgical device. Hitherto, such devices have employed the Joule-Thompson cooling effect, liquid nitrogen, or a sprayed volatile liquid. All such devices will serve the required purpose of cooling tissue to the level that will cause ice crystal formation, but all are relatively inefficient. The invention seeks to provide an improved device, an objective met by a construction comprising a primary heat extraction means (1), a secondary heat extraction means (12) associated with a part to be applied to a patient, and a coolant circuit (14) connecting the primary and secondary heat extraction means. The heat extraction means may be thermo-electric devices that can be sequentially or concurrently activated.

Abstract: In methods and apparatus for cooling surfaces, a pressurized liquid refrigerant is dispensed through a shaped member composed of an open celled foam. The method is particularly useful for localized freezing of a wart or other growth prior to its removal from skin of a human being or another animal.

Abstract: Cryocoolers for use in cryosurgery and other applications comprising dual finned tube helical coil heat exchangers. The size and shape of iceballs created by the probes is controlled by the location of the gas outlets within the cryocooler outer sheath.

Abstract: A laser treatment device and process with controlled cooling. The device contains a rod with high heat conduction properties, which is transparent to the laser beam. A surface of the rod is held in contact with the tissue being treated and other surfaces of the rod are cooled by the evaporation of a cryogenic fluid. The cooling is coordinated with the application of the laser beam so as to control the temperatures of all affected layers of tissues. In a preferred embodiment useful for removal of wrinkles and spider veins, the rod is a sapphire rod. A cryogenic spray cools the walls. A first surface is in contact with the skin surface being treated and an opposite surface is contained in an anticondensation oil chamber that is optically connected to a laser beam delivering fiber optic cable.

Abstract: A method and apparatus for performing hypothermia of a selected organ without significant effect on surrounding organs or other tissues. A flexible catheter is inserted through the vascular system of a patient to place the distal tip of the catheter in an artery feeding the selected organ. A compressed refrigerant is pumped through the catheter to an expansion element near the distal tip of the catheter, where the refrigerant vaporizes and expands to cool a flexible heat transfer element in the distal tip of the catheter. The heat transfer element cools the blood flowing through the artery, to cool the selected organ, distal to the tip of the catheter.

Abstract: The invention features an apparatus and method for protecting tissue from freeze damage during cryosurgery. According to the method, a cryoprotective agent is introduced to a tissue to be protected in an amount sufficient to protect the tissue from damage during cryosurgery, and cryosurgery is performed on tissue to be destroyed.

Abstract: A hand-held cryosurgical instrument is provided with an insulating, cold-resistive, non-slip grip, which fits onto the neck of a cryosurgical instrument by means of machined threads. The grip has a lip for the users hand to rest against to protect it from the cold metal of the instrument.

Abstract: A method for removing fatty tissue in a body combines cryosurgery and liposuction. Cryosurgery first destroys fatty tissue to be removed by controllably freezing the tissue, and facilitates removal of the fatty tissue. Liposuction subsequently removes the destroyed fatty tissue by aspiration.

Abstract: An apparatus is described which is suitable for thermal treatment of the human or animal skin and underlying tissue, substituting ice frictions, and cold sprays. This cryoprobe is characterised by a Peltier module with a cold and a hot side. An electrical power supply drives the Peltier module. The cold side is mounted at a cooling head, by which the skin is treated, whereas the hot side is cooled by a heat dissipation element which is itself cooled by a cooling fluid. A temperature sensor in the cooling head allows to control the temperature of treatment. The cryoprobe may be controlled by a micro-controller or by a personal computer.

Abstract: Cryogen spray cooling of skin surface with millisecond cryogen spurts is an effective method for establishing a controlled temperature distribution in tissue and protecting the epidermis from nonspecific thermal injury during laser mediated dermatological procedures. Control of humidity level, spraying distance and cryogen boiling point is material to the resulting surface temperature. Decreasing the ambient humidity level results in less ice formation on the skin surface without altering the surface temperature during the cryogen spurt. For a particular delivery nozzle, increasing the spraying distance to 85 millimeters lowers the surface temperature. The methodology comprises establishing a controlled humidity level in the theater of operation of the irradiation site of the biological tissues before and/or during the cryogenic spray cooling of the biological tissue. At cold temperatures calibration was achieved by mounting a thermistor on a thermoelectric cooler.

Abstract: A method and apparatus for performing hypothermia of a selected organ without significant effect on surrounding organs or other tissues. A flexible catheter is inserted through the vascular system of a patient to place the distal tip of the catheter in an artery feeding the selected organ. A compressed refrigerant is pumped through the catheter to an expansion element near the distal tip of the catheter, where the refrigerant vaporizes and expands to cool a flexible bellows shaped heat transfer element in the distal tip of the catheter. The heat transfer bellows cools the blood flowing through the artery, to cool the selected organ, distal to the tip of the catheter.

Abstract: In a cryosurgical instrument having a dewar and a cap which is threaded onto the dewar when in use, with a main valve portion secured to the cap by threads, the handedness of the threads on the main valve portion are opposite to the handedness of the cap threads, whereby applying thrust through the main valve portion to remove the cap from the dewar will tend to tighten, rather than loosen the main valve portion in the cap.

Abstract: A method for increasing the damage to targeted cells to the point of rupture during freezing while minimizing the freezing of nearby non-targeted tissues comprising: inducing a hyperosmotic condition in the targeted tissue; bloating the targeted tissue; freezing the targeted tissue to cause increase of damage to the targeted tissue to the point of rupture while minimizing freezing of nearby non-targeted tissues.

Abstract: A cryosurgical probe and method for treating cancer by cryosurgically destroying cancer cells by way of an ice ball formed at the distal end of the cryosurgical probe being located in proximity to the cancerous tissue to be treated. The probe is surrounded by a thermally insulating sheath. By varying the length and thickness of the thermally insulating sheath as well as the length of the unsheathed distal tip of the probe, the size and shape of the ice ball produced by the cryosurgical probe can be controllably tailored to correspond to the size, shape and location of the cancerous tissue so as to localize the cryogenic effect. Alternatively, the size and shape of the ice ball can be controlled by surrounding the cryosurgical probe with a heated sheath having a heating element and a temperature sensor to detect the temperature to which the sheath is heated.

Abstract: A cryotherapy method for reducing tissue injury after balloon angioplasty or stent implantation contemplates use of a well insulated, low profile catheter designed to transport a low temperature medium such as gas, fluid or a mixture thereof at a particular temperature over a guide wire to the site of a lesion. The lesion may or may not have undergone previous procedure for balloon angioplasty or stent implantation. The cryo-medium is introduced from a well insulated storage chamber having a small nozzle to which a conduit may be attached to allow conveyance of the fluid to a point of use. A handheld valve is incorporated into the conduit to allow the surgeon to closely control the flow of the cryo-medium to the point of use. The conduit extends downstream of the valve and is fluidly connected to the catheter that is positioned at the point of the lesion in the body. If desired, antibiotics, anticoagulants, antiproliferative agents, gene materials, etc.

Abstract: A cryogenic catheter includes a flexible member having an elongate, thermally-transmissive region and a cryogenic fluid path through the flexible member to the thermally-transmissive region. The thermally-transmissive region can be deformable from a linear configuration to an arcuate configuration and can include multiple thermally-transmissive elements having a first side exposed to the cryogenic fluid path and a second side exposed to points exterior to the flexible member. The thermally-transmissive elements can be rigid or flexible longitudinal strips. Alternatively, annular, cylidrical, or wedge-shaped metallic structures disposed in a spaced-apart relationship can define the thermally-transmissive region. In other embodiments the thermally-transmissive region is defined by a helical coil that is at least partially embedded in the flexible member. The helical coil can also define at least a portion of the cryogenic fluid path through the flexible member and include a gas expansion or boiling chamber.

Abstract: A cryogenic catheter includes a flexible member having an elongate, thermally-transmissive region and a cryogenic fluid path through the flexible member to the thermally-transmissive region. The thermally-transmissive region can be deformable from a linear configuration to an arcuate configuration and can include multiple thermally-transmissive elements having a first side exposed to the cryogenic fluid path and a second side exposed to points exterior to the flexible member. The thermally-transmissive elements can be rigid or flexible longitudinal strips. Alternatively, annular, cylindrical, or wedge-shaped metallic structures disposed in a spaced-apart relationship can define the thermally-transmissive region. In other embodiments the thermally-transmissive region is defined by a helical coil that is at least partially embedded in the flexible member. The helical coil can also define at least a portion of the cryogenic fluid path through the flexible member and include a gas expansion or boiling chamber.

Abstract: Apparatus is described for feeding a cryosurgical device by passing a liquid cryogen (e.g. liquid nitrogen) through the device to produce cooling by vaporization, and to enable thawing of the device by passing a heated inert thaw gas (e.g. nitrogen gas) through the device when the liquid cryogen is turned off. The thaw gas is passed through the device in the same direction of flow as the liquid cryogen. The apparatus can supply a plurality of cryosurgical devices, and provide independent control of cryogen and thaw for each probe. Novel valve arrangements are also disclosed for controlling the supply of liquid cryogen and the supply of the thaw gas.

Abstract: A cryoprobe instrument for endoscopic use has been provided that permits the delivery of liquid or gaseous cryogens in the form of a spray. In an embodiment, the cryoprobe instrument includes an elongated, flexible tube having a fluid passage defined therethrough; a proximal connector portion provided at the proximal end of the tube for coupling the tube to a pressurized source of cryogenic refrigerant; and a nozzle tip mounted to the distal end of the tube. The nozzle tip has an outlet orifice constructed and arranged such that through the Joule-Thompson effect, cryogenic refrigerant exiting through the outlet orifice rapidly and substantially expands and cools.

Abstract: An apparatus for treating dermatological conditions with radiation includes a Peltier device for cooling the treatment area of the patient's skin. The Peltier cooling device has a cold surface in thermal communication with the treatment area and a hot surface, with an aperture extending between the cold and hot surfaces through which radiation is directed to the treatment area. In one embodiment, a lens disposed within the aperture of the cooling device distributes the cooling effect to provide substantially uniform cooling across the treatment area. A temperature sensor senses the temperature of the treatment area and is used to control the Peltier cooling device and/or the radiation source to ensure that the treatment area does not exceed a predetermined temperature. Various radiation sources are suitable for use with the Peltier cooled apparatus, including lasers and gas-discharge lamps, such as arc lamps and flash lamps.

Abstract: A laser handpiece apparatus for use in therapeutic procedures employing selective cooling, the apparatus for use in conjunction with a controllable laser source, the apparatus including laser delivery device for controllably delivering a predetermined amount of laser energy to a preselected surface area, a reservoir having a predetermined volume, cryogen liquid contained in the reservoir, and a valve for controllably delivering a portion of the cryogen liquid to the preselected surface area.

Abstract: Dynamically cooling the epidermis of a port wine stain patient undergoing laser therapy permits maximization of the thermal damage to the port wine stain while at the same time minimizing nonspecific injury to the normal overlying epidermis. A cryogenic spurt is applied to the skin surface for a predetermined short period of time in the order of tens of milliseconds so that the cooling remains localized in epidermis while leaving the temperature of deeper port wine stain vessels substantially unchanged. The result is that epidermal denaturation and necrosis which normally occurs in uncooled laser irradiated skin sites does not occur and that clinically significant blanching of the port wine stains at the dynamically cooled sites establishes that selective laser photothermolysis of the port wine stain blood vessels is achieved. In addition, dynamic epidermal cooling reduces patient discomfort normally associated with flashlamp-pumped pulsed dye laser therapy.

Abstract: Cryocoolers for use in cryosurgery and other applications comprising finned tube helical coil heat exchangers and warming gas flow through a warming gas supply line fitted Joule-Thomson nozzle. The cryocoolers use helium, hydrogen or neon as a warming gas which is expanded from the Joule-Thomson nozzle to heat the probes.

Abstract: Cryocoolers for use in cryosurgery and other applications comprising finned tube helical coil heat exchangers and a flow directing sheath covering portions of the heat exchanger coil and isolating portions of the heat exchanger coil from the outer sheath of the cryocooler. The size and shape of iceballs created by the probes is controlled by the extent and location of the flow directing sheath.

Abstract: In methods and apparatus for cooling surfaces, a pressurized liquid refrigerant is dispensed through a shaped member composed of an open celled foam. The method is particularly useful for localized freezing of a wart or other growth prior to its removal from skin of a human being or another animal.

Abstract: A surgical instrument comprising a supporting structure and a thermal barrier coupled to the supporting structure. The barrier is sized and adapted for placement between the prostate and rectum during cryosurgical treatment of the prostate. The supporting structure includes a frame movable between an extended position and a retracted position and a handle coupled to the frame. The barrier includes flexible sheet material mounted on the frame and movable with the frame between the extended and retracted positions. The barrier is substantially sonolucent allowing ultrasound visualization of areas beyond the barrier.

Abstract: The disclosure relates generally to cryogenic techniques the mapping and ablation of arrhythmias or tachycardia in atrial or ventricle heart muscles and, more particularly, to an epicardial approach which either addresses the heart directly through an open chest or employs transcutaneous subxiphoid pericardial approach for the mapping and ablation of tachycardia using laparoscopy/thoracoscopy techniques via an intrapericardial/epicardial approach. The technique involves electrograms recording and cryogenic verification and ablation, although RF ablation can also be used.

Abstract: A surgical probe having the ability to thermally insulate adjacent healthy tissue from cooling or heating effects at adjacent tissue being subjected to thermal destruction by cryosurgery, electrosurgery and hyperthermia. The probe includes a spatula shaped thermally insulating member that is mounted at the distal end of an elongated rigid member of a width sized for insertion through a small cutaneous incision. The insulating spatula is of a material transparent to ultrasound thus allowing ultrasonic imaging of tissue through the thermal insulator without substantial image deterioration.