Abstract: A surgical instrument for thermally-mediated therapies in targeted tissue volumes and for causing thermal effects in polymer tissue-contacting members. In one embodiment, the instrument has a working end with an interior chamber that is supplied with a biocompatible liquid. An energy source causes a liquid-to-vapor phase change within the interior of the instrument. The vapor phase media then is ejected from the working surface of the instrument, and a controlled vapor-to-liquid phase change in an interface with tissue applies thermal energy substantially equal to the heat of vaporization to ablate tissue. The vapor-to-liquid phase transitions, or internal energy releases, can be provided about thin-film flexible structures for engaging body lumens and cavities. An exemplary embodiment can be used for shrinking, sealing, welding or creating lesions in tissue—while causing limited collateral thermal damage and while totally eliminating electrical current flow in the engaged tissue.

Abstract: In order to improve a surgical appliance comprising a housing having at least one sealed cavity, and a drive unit arranged in the housing, such that the cavity can be sealed in a simple way, and the formation of germs can be reduced or these can be removed in a simple way from the cavity, it is proposed that a fluid connection be provided for forming a flow path into and out of the cavity, and that at least one sealing element be provided for closing the fluid connection to liquid fluids and opening the fluid connection to gaseous fluids.

Abstract: A system for ablating tissue comprises an ergonomically shaped handpiece having a proximal end and a distal end. An energy source is near the distal end of the handpiece and is adapted to deliver energy to the tissue and create a zone of ablation that blocks abnormal electrical activity in the tissue. The system also includes a barrier near a front face of the energy source. The barrier is adapted to prevent direct contact between blood and the energy source so that the blood does not coagulate on the front face.

Abstract: The invention relates to a gastric restraining device for treating excessive weight or obesity in mammals. The gastric restraining device includes an elastomeric sheet configured to be placed around a stomach of a mammal, an ablation device attached to the elastomeric sheet, the ablation device configured to emit energy toward an outer surface of the stomach when the elastomeric sheet is placed around the stomach, and an energy device coupled to the ablation device to generate the energy and to transfer the energy to the ablation device.

Abstract: Thermochemical ablation techniques may provide ablation of bodily tissue using chemical reaction energy.

Abstract: A prostate therapy system is provided that may include any of a number of features. One feature of the prostate therapy system is that it can access a prostate lobe from the urethra. Another feature of the prostate therapy system is that it can deliver condensable vapor into the prostate to ablate the prostate tissue. Another feature of the prostate therapy system is that it can aspirate tissue from the prostate. Yet another feature of the prostate therapy system is that it can rotate during delivery of vapor and aspiration of tissue. Methods associated with use of the prostate therapy system are also covered.

Abstract: A prostate therapy system is provided that may include any of a number of features. One feature of the prostate therapy system is that it can access a prostate lobe transurethrally. Another feature of the prostate therapy system is that it can deliver condensable vapor into the prostate to ablate the prostate tissue. Methods associated with use of the prostate therapy system are also covered.

Abstract: A method for contouring the body by destroying adipose tissue is disclosed. This method can reduce the circumference of the treated area, improve skin contour irregularities and smooth the appearance of the skin surface. The method is also used as a body treatment before and after a liposuction procedure.

Abstract: A system and method for controlling the inflation, ablation, and deflation of a balloon catheter is provided. The system includes a balloon catheter, a console having a pressurized gas or liquid inflation source, and an umbilical system to deliver pressurized coolant to the balloon catheter. The system comprises a PID (Proportional Integral Derivative) controller or other pressure-sensing device that monitors the amount of pressure and volume within the balloon catheter. During inflation, the pressure and/or volume of fluid within the balloon is maintained at a target amount in order to provide sufficient mechanized pressure against the desired target region. The system limits the inflation pressure such that a safe quantity of gas would be released should a leak occur. If the amount falls below a certain threshold level, gas or fluid egress is presumed and the inflation process is halted.

Abstract: A tissue closure device including a tissue eversion apparatus, and a first and a second, redundant closure element that are placed on the external surface of a tissue puncture wound to enhance the efficacy of closure. The first closure element and the second closure element closure are left resident on the external surface of or in proximity to the tissue puncture wound in order to provide redundancy of closure.

Abstract: Ablation device including a probe structure 10 having a proximal end 12 and a distal end 14. Probe structure 10 includes a tubular first catheter 16, a tubular second catheter 18 surrounding the first catheter and a tubular guide catheter extending within the first catheter 16. The first catheter 16 carries a cylindrical ultrasonic transducer 20 adjacent its distal end. The transducer 20 is connected to a source of electrical excitation. The ultrasonic waves emitted by the transducer are directed at the heart wall tissue. Once the tissue reaches the target temperature, the electrical excitation is turned on and off to maintain the tissue at the target temperature. Alternatively, the transducer 20 is subjected to continuous excitation at one power level and upon the tissue reaching the target temperature, the power level of the continuous excitation is switched to a second lower power level.

Abstract: There is disclosed a plasma gun for bio/medical treatment using atmospheric plasma. The disclosed plasma gun comprises a housing having an elongate chamber provided therein, the chamber having an end at which a nozzle for spraying plasma is positioned; a gas supply unit for supplying a reaction gas to the chamber; and a plasma discharge unit formed with an elongate cavity communicating with the nozzle, the plasma discharge unit including first and second electrodes and a dielectric or insulating barrier material for plasma ignition in the elongate cavity.

Abstract: Methods and devices for occluding a vessel during a percutaneous ablation procedure. An elongated access device having a lumen and a tissue piercing, open distal end in communication with the lumen is used to percutaneously access a vessel that supplied blood to the tissue to be treated. An elongated balloon deployment device is used to deliver a balloon into the interior of the vessel. The balloon is inflated, resulting in the occlusion of the vessel. The tissue to be treated is ablated. Because there is little or no blood to transfer the thermal energy away from the heated tissue, the ablation procedure is performed more efficiently. The balloon may be subsequently deflated allowing normal flow through the vessel to return.

Abstract: The present invention is directed toward a device that performs ablation of tissue. The device has a catheter with a shaft through which an ablative agent can travel, a first positioning element attached to the catheter shaft at a first position and a second positioning element attached to the catheter shaft at a second position. The shaft also has ports through which the ablative agent can be released.

Abstract: The present invention is directed toward a device that performs ablation of tissue. The device has a catheter with a shaft through which an ablative agent can travel, a first positioning element attached to the catheter shaft at a first position and a second positioning element attached to the catheter shaft at a second position. The shaft also has ports through which the ablative agent can be released.

Abstract: An apparatus adapted to position a functional device tip, such as a sensor, in a body site having both fluid and non-fluid tissue components, in a manner that substantially mitigates the impingement of non-fluid tissue impingement on the device tip. One such apparatus can be used to both remove fluid from a tissue site, such as a site exhibiting tissue swelling, and to determine tissue pressure, using a single catheter. An apparatus can provide a pressure sensor that is adapted to be positioned and used within the tissue site itself, without substantial impingement by non-fluid tissue, and optionally also provides the ability to concurrently remove and/or deliver fluids or components thereof to or from the tissue site.

Abstract: A system and method for approaching the intervertebral disc through a percutaneous insertion from the back of a patient for thermal or electromagnetic treatment of an intervertebral disc, includes an elongated probe member having a guidable region adjacent its distal end with an undulating groove defined in its outer surface. The undulating groove is dimensioned to facilitate bending of the guidable region in at least one radial direction of movement relative to a longitudinal axis of the thermal probe. Preferably, the guidable region includes a plurality of undulating grooves, whereby adjacent undulating grooves are longitudinally spaced with respect to each other. The undulating grooves each define a sinusoidal configuration which may be arranged about an undulating axis extending in oblique relation to the longitudinal axis. The guidable region also includes a longitudinally extending backbone which resists bending of the guidable region in a radial direction of movement.

Abstract: A system and methods for modeling the death of tissue cells that are thermally treated using thermal treatment devices is disclosed. A cell-death model accurately predicts, in real-time, which voxels of cells are dead or are about to die as the thermal treatment is applied to these cells. The effects of thermal treatment are monitored by a thermal measurement device which feeds thermal information to the cell-death model. The cell-death model accounts for the temperature of each voxel of tissue cells with respect to a temperature threshold value and the duration over which the thermal treatment is applied. When the thermal measurement device is an imaging device, the results of the thermal treatment may be displayed to the user in real-time. As a result, a user of the thermal treatment device can determine, in real-time, which target voxels of cells he has killed and which still need to be killed. The user can also more easily avoid inadvertently killing healthy tissue that he does not intend to kill.

Abstract: A surgical process for freezing or cauterizing infected tissue, by inserting a transparent sleeve through a small slit in the flesh of a patient and wherein the inserted end of the sleeve is provided with a cone-shaped tip. Monitoring of the sleeve and probe insertion and location of the infected area is achieved by video camera. After removing the solid and rigid probe, a fiber optic tube is inserted into the sleeve whereby ambient light is conducted through the tube. A carbon rod is inserted through the fiber optic tube having its pointed end in contact with the infected area. The carbon rod is connected to a source of cold or heat. In a cold application, the infected area is frozen so when the carbon rod is removed and replaced by a suction device, the frozen area can be fragmented and the particles removed.

Abstract: A method for ablating tissue comprising controlling a heating element using a variable phase angle control to heat an ablation fluid to a desired temperature and determining a heating percentage corresponding to a percentage of a maximum available heating power represented by a current level of power supplied to the heating element and, when the heating percentage remains below a threshold level for a predetermined period of time, indicating a flow obstruction condition of the fluid.

Abstract: The present invention is directed toward a device that performs ablation of tissue. The device has a catheter with a shaft through which an ablative agent can travel, a first positioning element attached to the catheter shaft at a first position and a second positioning element attached to the catheter shaft at a second position. The shaft also has ports through which the ablative agent can be released.

Abstract: System and methods are shown having a tube-within-tube assembly with a deployable curved deflectable tube or cannula that deploys from a straight cannula or trocar. The curved cannula has pre-curved distal end to create an angular range of 0° to 180° when fully deployed from the straight trocar. The curve is configured such that the flexible element carrying a treatment device can navigate through the angular range of deployment of the curved cannula. The curved cannula allows the flexible element to navigate through a curve within bone without veering off towards an unintended direction.

Abstract: An embodiment of the invention includes inserting into a gastrointestinal lumen, a catheter having a first balloon and a second balloon spaced from the first balloon. The first balloon and the second balloon are inflated to sealingly engage the lumen. A liquid is introduced into a volume bounded by the first balloon, the second balloon and the lumen so that the liquid contacts at least a portion of the lumen.

Abstract: An MRI guided surgical apparatus includes a heat source formed by a laser and an optical fiber carrying the heat energy into a part to be coagulated by hyperthermia with an end reflector to direct the energy in a beam to one side of the fiber end. A reinforcing sleeve for the fiber is mounted in a shielded, Piezo-electric motor which causes movement of the fiber longitudinally and angularly within a rigid elongate cannula. A magnetic resonance imaging system is arranged to generate a series of output signals over a period of time representative of temperature in the part as the temperature of the part changes during that time. The heat source is controlled in heat energy applied and location and orientation of the beam to stop heating when the temperature at the boundary of a tumor reaches the required hyperthermic temperature. Cooling of the tip portion of the probe is effected by expansion of a supplied cooling fluid in gaseous form through a restrictive orifice into an expansion zone at the probe end.

Abstract: A device for circulating fluid to a target site within a living body, comprises a longitudinal member including an inlet lumen supplying fluid to the target site and a return lumen withdrawing fluid from the target site, the return lumen surrounding the inlet lumen and a screen coupled to a distal end of the longitudinal member, the screen including a plurality of openings extending therethrough from a radially inner surface forming a radially outer wall of a distal portion of the return lumen to an outer surface thereof.

Abstract: A method for relieving pain associated with an intervertebral disc having a disc nucleus pulposus is provided. The method includes the initial step of: providing an elongated probe member having proximal and distal ends and defining a longitudinal axis, and having a flexible guidable region adjacent the distal end. The method also includes the steps of: introducing the flexible guidable region of the probe into the nucleus pulposus of the intervertebral disc and supplying energy to the guidable region from an energy source, to heat or induce an electromagnetic field within the nucleus pulposus sufficient to denature proteins expressing at least one inflammatory cytokine.

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.

Abstract: Catheters and methods for epicardial ablation are provided. A suitable catheter comprises an elongated catheter body and an ultrasound transducer mounted at or near the distal end of the catheter body. The transducer has a front surface and an opposing back surface, wherein the transducer is positioned to transmit ultrasound energy toward tissue facing the front surface but not toward tissue facing the back surface. A sensor is mounted within the catheter near the ultrasound transducer for sensing a location and an orientation of the ultrasound transducer within a patient. A suitable method involves introducing the distal end of the catheter introducing into the pericardium of a patient. The transducer's front surface is positioned so that it generally faces tissue to be ablated, and the tissue is ablated with ultrasound energy generated by the transducer.

Abstract: Devices and methods for biological tissue closure are disclosed. Arteriotomy closure and hemostasis devices and methods are disclosed. A device that can provide a lateral tension across an opening in the tissue and apply energy to seal the tissue is disclosed. Methods for using the device are also disclosed.

Abstract: A surgical instrument for thermally-mediated therapies in targeted tissue volumes and for causing thermal effects in polymer tissue-contacting members. In one embodiment, the instrument has a working end with an interior chamber that is supplied with a biocompatible liquid. An energy source causes a liquid-to-vapor phase change within the interior of the instrument. The vapor phase media then is ejected from the working surface of the instrument, and a controlled vapor-to-liquid phase change in an interface with tissue applies thermal energy substantially equal to the heat of vaporization to ablate tissue. The vapor-to-liquid phase transitions, or internal energy releases, can be provided about thin-film flexible structures for engaging body lumens and cavities. An exemplary embodiment can be used for shrinking, sealing, welding or creating lesions in tissue—while causing limited collateral thermal damage and while totally eliminating electrical current flow in the engaged tissue.

Abstract: A control system alters one or more characteristics of an ablating element to ablate tissue. In one aspect, the control system delivers energy nearer to the surface of the tissue by changing the frequency or power. In another aspect, the ablating element delivers focused ultrasound which is focused in at least one dimension. The ablating device may also have a number of ablating elements with different characteristics such as focal length.

Abstract: A focused ultrasound system includes a transducer array, a controller for providing drive signals to the transducer array, and a switch. The transducer array includes a plurality of “n” transducer elements, and the controller includes a plurality of “m” output channels providing sets of drive signals having respective phase shift values, “m” being less than “n.” The switch is coupled to the output channels of the controller and to the transducer elements, and is configured for connecting the output channels to respective transducer elements. The controller may assign the transducer elements to respective output channels based upon a size and/or shape of a desired focal zone within the target region, to steer or otherwise move a location of the focal zone, and/or to compensate for tissue aberrations caused by tissue between the transducer array and the focal zone, geometric tolerances and/or impedance variations of the transducer elements.

Abstract: A gold nanostructure, comprising a substrate, a dielectric material, one or more of gold nanoparticles is provided together with related devices and methods.

Abstract: The present invention relates to a device assembly and tissue ablation transducer having a plurality of helical elements that can be operated out of phase to orient the acoustical energy beam forward or backward in the longitudinal direction. The transducers includes a cylindrical inner electrode, a cylindrical piezoelectric material disposed over the inner electrode, and a cylindrical outer electrode disposed over the cylindrical piezoelectric material. Spiral grooves are cut through at least the outer electrode separating the transducer into a plurality of functionally discrete helical transducer segments. The helical transducer segments can be operated independent from one another. An array of intertwined helical transducers arranged linearly along a helical axis are also contemplated.

Abstract: An ablation system for treating atrial fibrillation in a patient comprises an inner shaft having proximal and distal ends as well as a lumen therebetween. A distal tip assembly is adjacent the inner shaft distal end, and the distal tip assembly comprises an energy source and a sensor. The energy source is adapted to deliver energy to a target tissue so as to create a zone of ablation in the target tissue. This blocks abnormal electrical activity and thus reduces or eliminates atrial fibrillation in the patient. The system also has an outer shaft with proximal and distal ends, and a lumen therebetween. The inner shaft is slidably disposed in the outer shaft lumen, and the inner shaft is rotatable, bendable and linearly slidable relative to the outer shaft. The outer shaft is rotatable, bendable and linearly slidable relative to the target tissue.

Abstract: Disclosed is an ignition system for initiating a plasma arc in an electrosurgical system. The system includes a source of high frequency electrical energy having a terminal of active potential and a terminal of return potential a base having a distal end from which a plasma arc emanates, an active electrode operatively coupled with the base and electrically in circuit with the terminal of active potential. The ignition system may have a piezoelectric device electrically coupled to the active electrode to create at least one high voltage spark when the system is initially activated. Alternately, the ignition system may include a heater or heating device of heating the active electrode and producing free electrons to assist in the initiation of the plasma arc.

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

Abstract: An intra-atrial ablation therapy apparatus is disclosed. The apparatus comprises a balloon adapted for intra-atrial inflation to fill at least part of the atrium, the balloon being adapted to permit a flow of blood from a pulmonary vein to a mitral valve when inflated in the atrium. The apparatus further comprises an inflation lumen being in fluid communication with the balloon and adapted for conducting an inflation fluid to the balloon. The apparatus also comprises an ablation tool connected to the catheter.

Abstract: A method of fusing biomaterial and tissue using radiofrequency energy includes the steps of: providing a vessel sealing instrument having opposing jaw members which are movable relative to one another to compress tissue therebetween. The vessel sealing instrument includes at least one stop member affixed thereto for regulating the distance between the opposing jaw members. The method also includes the steps of: providing a biomaterial; positioning the biomaterial in abutting relation to tissue; approximating the biomaterial and tissue between the jaw members; compressing the biomaterial and tissue between the jaw members under a working pressure within the range of about 3 kg/cm2 to about 16 kg/cm2; and energizing the jaw members with radiofrequency energy to effectively fuse the biomaterial and the tissue such that the biomaterial and the tissue reform into a single, fused mass.

Abstract: The present invention involves a surgical device and method of use, particularly an assembly and method incorporating dual expandable members along the distal region of an ablation device to facilitate ablation of a circumferential region of tissue engaged by the expandable member. The ablation device assembly includes an elongate body with a proximal end portion, a distal end portion, and a longitudinal axis. A first expansion element is located along the distal end portion of the elongate body, and is fluidly coupled to a first source of inflation fluid. A second expansion element having a circumferential wall is located along the distal end portion proximal the first expansion element, and is fluidly coupled to a second source of inflation fluid.

Abstract: Products, compositions, systems, and methods for modifying a target structure which mediates or is associated with a biological activity, including treatment of conditions, disorders, or diseases mediated by or associated with a target structure, such as a virus, cell, subcellular structure or extracellular structure. The methods may be performed in situ in a non-invasive manner by application of an initiation energy to a subject thus producing an effect on or change to the target structure directly or via a modulation agent. The methods may further be performed by application of an initiation energy to a subject in situ to activate a pharmaceutical agent directly or via an energy modulation agent, optionally in the presence of one or more plasmonics active agents, thus producing an effect on or change to the target structure. Kits containing products or compositions formulated or configured and systems for use in practicing these methods.

Abstract: The variable stiffness heating catheter includes a heating catheter shaft including at least one electrically conductive member, a reinforcing tube with apertures formed around the surface of the reinforcing tube, and at least one coaxial outer layer of a polymer, metal, or both for providing desired variations in stiffness along at least a portion of the length of the shaft. The apertures can be formed as axial or helical slits in the surface of the reinforcing tube, and the reinforcing tube can also be formed to be tapered at the point where the apertures are formed in the reinforcing tube to provide a heating catheter that is torqueable and pushable at the proximal end, yet soft and flexible at the distal end.

Abstract: This invention relates to the working end of a medical instrument that applies energy to tissue. In one embodiment, the instrument has a microfluidic tissue-engaging surface fabricated by soft lithography means together with optional superlattice cooling means that allows for very precise control of energy application, for example in neurosurgery applications. The tissue-engaging surface can eject a high-heat content vapor into the engaged tissue for treating tissue, while the superlattice cooling structure can prevent collateral thermal damage. Also, the superlattice cooling structure can be used to localize heat at a selected depth in tissue and prevent surface ablation. Also, the superlattice cooling structure can be used to prevent tissue sticking to a thermal energy delivery surface. In another embodiment, the tissue-engaging surface can be used in a jaw structure for sealing tissue together with hydrojet means for transecting the tissue.

Abstract: A method of localized cell heating introduces a plurality of ferroelectric comprising particles into a target region of a patient, and applies a time varying electrical field to the target region. The ferroelectric particles absorb energy from the electrical field and heat the target region in response, such as to a temperature sufficient to induce apoptosis of cancer cells in the target region. A ferroelectric hyperthermia-based cancer treatment system includes a time varying electrical field source for applying a time varying electrical field to a plurality of ferroelectric particles disposed in a target cancer containing region of a patient. A composition of matter includes a particle having a ferroelectric portion, the particle being non-toxic, slowly biodegradable in body fluids, and less than 15 ?m in its maximum dimension.

Abstract: A vapor delivery and insulation device is provided that may include any of a number of features. One feature of the device is that it can deliver vapor to the veins of a patient. The vapor can be generated within the device, in a handle of the device, or external to the device. Another feature of the device is that it can actively insulate the vapor to minimize heat transfer from a vapor delivery lumen of the device to an exterior surface of the device. The active insulation can be a vacuum or a flowing gas. Methods associated with use of the device are also covered.

Abstract: In one embodiment, an endoscope has a proximal end portion opposite a distal end portion. A view port is included at the distal end portion to view an internal body region through a passageway of a patient's body. Also located at the distal end portion are one or more piezoelectric elements operable in one mode to determine position of the distal end portion relative to internal body region and operable in a second mode to ablate tissue of the internal body region. The endoscope carries a balloon positioned about the one or more piezoelectric elements to selectively hold the distal end portion in a desired position in the passageway.

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

Abstract: Devices, systems and methods for in-vivo cauterization. An autonomous in-vivo device may include a heating mechanism to cauterize in-vivo tissue. A system may include an autonomous in-vivo heating device having a heating mechanism to cauterize in-vivo tissue, and an in-vivo imaging device to acquire in-vivo images.

Abstract: A tissue welding apparatus is adapted to fuse a first piece of tissue to a second piece of tissue which are disposed in a surface proximate relationship. An elongate shaft carries a first jaw, and a second opposing jaw moveable relative to the first jaw. At least one penetrating member is carried by the first jaw and moveable relative to the second jaw to create a channel through the first piece of material and the second piece of material. A source of heat is coupled to the penetrating member for denaturing the tissue defining the channel. This denatured tissue forms a column binding the first piece of tissue to the second piece of tissue. A chemical agent can be carried to the tissue with the penetrating member.

Abstract: A focused ultrasound ablation device and method includes an ultrasound emitting member having a plurality of individual ultrasound emitting elements arranged in an array. The ultrasound emitting elements are actuatable to emit ultrasound energy and focus the emitted ultrasound energy a predetermined distance from the ultrasound emitting member such that the ultrasound energy is focused within anatomical tissue adjacent which the ultrasound emitting member is positioned. The anatomical tissue is heated by the ultrasound energy focused therein to form an internal lesion within the tissue. The ultrasound emitting elements are selectively, independently actuatable, allowing selected ones of the ultrasound emitting elements to be actuated to emit ultrasound energy to obtain a lesion of desired or selected size and/or surface configuration in the tissue of a particular patient.