Abstract: A treatment system comprises an outer sheath and an end effector. The end effector has a plurality of cutting features, at least a portion of which are configured to debride a tissue surface when the end effector is actuated. The cutting features may also be configured to harvest tissue. A medical fluid reservoir is in fluid communication with the end effector, such that the end effector may deliver a medical fluid to a target site such as a fistula. The medical fluid may include harvested tissue cells and a scaffold material. A vacuum cannula may be positioned coaxially within the interior cavity of the end effector, and an RF probe may be positioned co-axially within the interior cavity of the vacuum cannula. The vacuum cannula and RF probe may be used together to seal a fistula in which medical fluid has been dispensed.

Abstract: An electrosurgical device comprises an elongated shaft having an axis with an interior channel extending along the axis to an opening in a distal end of the shaft. The channel is configured to be coupled to a negative pressure source, and an electrode with a conductive, usually hook-shaped, distal portion is coupled to the shaft and moveable between a first position in which a distal tip of the electrode is disposed proximate to a periphery of the opening of and a second position in which the distal electrode tip is exposed and spaced apart from the opening.

Abstract: System, devices and methods are presented that integrate stretchable or flexible circuitry, including arrays of active devices for enhanced sensing, diagnostic, and therapeutic capabilities. The invention enables conformal sensing contact with tissues of interest, such as the inner wall of a lumen, a the brain, or the surface of the heart. Such direct, conformal contact increases accuracy of measurement and delivery of therapy. Further, the invention enables the incorporation of both sensing and therapeutic devices on the same substrate allowing for faster treatment of diseased tissue and fewer devices to perform the same procedure.

Abstract: A system and method for providing treatment feedback for a thermal treatment device (100) is provided. In certain embodiments, a thermal transmitter (120) is configured to apply an amount of thermal energy (104) to a target site (106), the thermal energy having a selected frequency and a selected power level for penetration to a depth beneath the surface of the skin. A thermal imager (140) is also provided, the thermal imager (140) being configured to capture thermal data and thermal images of the target site. The device may further provide a thermal display (160) configured to display the thermal images and thermal data, providing feedback to a user (201).

Abstract: An electrosurgical system includes at least a first unit and a second unit, the second unit being detachably connectible to the first unit and including an electrode assembly. The first unit includes a power supply, an RF oscillator circuit for generating a radio frequency output, and an output stage adapted to supply an RE output to the electrode assembly. The second unit includes an identification circuit presenting, in an alternating manner, a parameter with a first finite non-zero value for a first time period, and a parameter with a second finite value for a second time period. The first unit includes a sensing circuit and a controller adapted to detect a characteristic of the identification circuit and provide an output signal, the controller connected to the sensing circuit and receiving the output signal, adjusts the RF output so as to suit the particular electrode assembly.

Abstract: A system for monitoring ablation size is provided and includes a power source including a microprocessor for executing at least one control algorithm. A microwave antenna is configured to deliver microwave energy from the power source to tissue to form an ablation zone. A radiation detection device is operably disposed on the microwave antenna. The radiation detection device is configured to generate a voltage corresponding to a radius of the ablation zone, wherein the radiation detection device is in operative communication with at least one module associated with the power source. The at least one module triggers a signal when a predetermined threshold voltage is measured corresponding to the radius of the ablation zone.

Abstract: A removable guidewire funnel tool aids in backloading a catheter onto a guidewire. The guidewire funnel tool includes a pliable loading coupler having a lumen therethrough. The lumen has a tapered distal section that serves to receive a guidewire and a tapered proximal section that receives and couples with a correspondingly tapered distal tip of the catheter. The guidewire funnel tool has a longitudinal slot or area of weakness along the entire length of the loading coupler and a grip tab to enable easy removal of the guidewire funnel tool after the guidewire lumen of the catheter is loading with the guidewire.

Abstract: A system for monitoring and/or controlling tissue modification during an electrosurgical procedure is provided. The system includes an electrosurgical apparatus adapted to connect to an electrosurgical generator. The electrosurgical apparatus configured to transmit energy to tissue. The system also includes a control system having one or more electromagnetic wave sources configured to generate the interrogator wave of one or more frequencies adjacent tissue. One or more sensors are configured to transmit and sense a reflected portion of the interrogator wave of at least one frequency to determine dielectric boundary data. A processor operatively coupled to the control system and to the electrosurgical generator configured to control the delivery of electrosurgical energy from the electrosurgical generator to tissue based on dielectric boundary data provided by the one or more sensors.

Abstract: Microwave ablation applicators and methods for manufacturing the microwave ablation applicators are disclosed. A microwave ablation applicator includes a feed-line segment, a step-down segment, and a radiator base segment. The feed-line segment includes a first inner conductor, a first dielectric disposed on the first inner conductor, and a first outer conductor disposed on the first dielectric. The step-down segment includes a second inner conductor, a second dielectric disposed on the second inner conductor, and a second outer conductor disposed on the second dielectric. The radiator base segment includes a third inner conductor disposed on the third inner conductor, a third outer conductor disposed on the proximal end of the third dielectric so as to form a feed gap at a distal end of the radiator base segment, a balun dielectric disposed on the third outer conductor, and a balun outer conductor disposed on the balun dielectric.

Abstract: A system for monitoring ablation size includes a power source including a microprocessor for executing one or more control algorithms. A microwave antenna is configured to deliver microwave energy from the power source to tissue to form an ablation zone. A plurality of spaced-apart electrodes is operably disposed along a length of the microwave antenna. The plurality of spaced-apart electrodes is disposed in electrical communication with one another and each of the plurality of spaced-apart electrodes has a threshold impedance associated therewith corresponding to the radius of the ablation zone.

Abstract: A method and apparatus is disclosed for the ablation of biological tissue to produce a therapeutic effect. An adjustment is made to the output frequency of an electrosurgical generator during the ablation cycle to accommodate changes in the electrical properties of the apparatus and the biological tissues that occur as energy is transferred to the tissue. The adjustment is made to better align the source impedance with that of the load.

Abstract: A patient treatment unit for analyzing and treating abnormality of human or animal tissues, includes a display; a pulse generator circuit that outputs a sequence of electrical pulses at a pulse frequency, the electrical pulses having a pulse width, the pulse generator controlling the pulse frequency and the pulse width of the electrical pulses; a pair of probes for contacting a body of a patient and electrically coupled to the pulse generator; and a voltage and current sensing circuit that senses a voltage or a current via the probes when contacting the body of the patient.

Abstract: The present invention generally relates to methods for assessing the completeness of a varicose vein ablation. The method involves the use of imaging and/or functional measurement data to determine the extent to which a varicose vein has closed as a result of an ablation procedure.

Abstract: A device and method for retrieving an electrode array. The medical device includes a catheter defining a proximal end, a distal end, and a lumen therethrough. A control wire slidably receivable within the lumen is included, the control wire defining a proximal end and a distal end, the distal end of the control wire defining an enlarged portion. A treatment portion receivable within the lumen is included, the treatment portion including a proximal portion adapted to receive the enlarged portion at the distal end of the control wire.

Abstract: An ablation device is provided for forming one or more lesions on a wall of an artery, such as a renal artery. The device can include an elongate shaft having a proximal end and a distal end. The device may also include a handle disposed at the proximal end, a distal tip including an electrode disposed at the distal end, and one or a plurality of independently expandable splines proximate the distal end.

Abstract: Controlling conductive fluid flow during an electrosurgical procedure. At least some of the example embodiments are methods including: flowing conductive fluid from a source lumen to a suction lumen of an electrosurgical wand, the flowing with the electrosurgical wand in a first orientation; sensing a change in orientation of the electrosurgical wand to a second orientation different than the first orientation; and changing a control parameter associated with the conductive fluid flow, the changing responsive to the change in orientation of the electrosurgical wand.

Abstract: An apparatus comprises an end effector, a shaft assembly, and an interface assembly. The end effector is coupled with the shaft assembly. The shaft assembly comprises a translating member extending through the shaft assembly. The interface assembly is operable to engage the shaft assembly and comprises a plurality of drive shafts and a rack. One of the drive shafts is operable to drive the rack along a path that is parallel to the longitudinal axis of the shaft assembly. A plurality of racks may be used to rotate the shaft assembly, articulate the shaft assembly, and/or drive the translating member through the shaft assembly to thereby actuate the end effector.

Abstract: A renal denervation system includes a renal denervation catheter and a flow determining system. The renal denervation catheter includes a plurality of ablation members positioned at a distal end portion thereof. The renal denervation catheter is insertable into a renal artery. The flow determining system includes a processor and first and second flow determining members spaced apart on the renal denervation catheter. The processor is configured to determine a change in blood flow through the renal artery resulting from a renal denervation procedure using the renal denervation catheter in response to input from the first and second flow determining members.

Abstract: An apparatus comprises a body, a shaft assembly, and an end effector. The shaft assembly extends distally from the body. The end effector is in communication with the shaft assembly. The end effector comprises a first jaw and a second jaw. The second jaw comprises a proximal portion and a distal portion. The second jaw is moveable relative to the first jaw between a first position, a second position, and a third position. The second jaw in the first position is open relative to the first jaw. The second jaw in the second position is positioned such that the distal portion is closer to the first jaw than the proximal portion. The second jaw in the third position is parallel the first jaw.

Abstract: In some embodiments, the inventive subject matter is directed to a multimode electrosurgical system having an electrosurgical instrument with a first electrode configuration that operates in a bipolar mode and second electrode configuration that operates in a monopolar mode. In other embodiments, the inventive subject matter is directed to an instrument and system that provide multiple modes of surgical and/or therapeutic treatments, at least one being an electrosurgical mode of treatment, the instrument including at least one active electrode on a working portion, and the working portion including or supporting at least one non-electrosurgical functional element, the instrument including at least one operational return electrode configuration of selectively variable surface area.

Abstract: Medical devices and methods for using medical devices are disclosed. An example medical device may include an open-irrigated ablation catheter. The open-irrigated ablation catheter may include a catheter body, an electrode tip body with irrigation ports at a distal end, and a coolant conduit. The distal end of the coolant conduit may extend into a proximal portion of the electrode tip body. Fluid flow from the coolant conduit may be diverted proximally and/or towards the wall of the electrode tip body by one or more openings proximal of a closed distal end of the conduit or by a structure blocking and diverting flow from an open distal end of the conduit.

Abstract: A microwave ablation device including a cable assembly configured to connect a microwave ablation device to an energy source and a feedline in electrical communication with the cable assembly. The microwave ablation device further includes a balun on an outer conductor of the feedline, and a temperature sensor on the balun sensing the temperature of the balun.

Abstract: Devices and methods for fluid enhanced ablation therapy using microwave antennas are described herein that provide improved heat transfer into a target volume of tissue and improved antenna cooling compared to prior art designs. In one embodiment, fluid can be introduced into a target volume of tissue along with the delivery of therapeutic energy from a microwave antenna positioned within the target volume of tissue. The fluid can become heated by cooling the microwave antenna and, if additional heating of the fluid is desired, a heating element disposed within the microwave antenna can supplementally heat the fluid prior to introduction into the target volume of tissue.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm has an inner surface defining a cavity including a cutting portion configured to cut tissue.

Abstract: An apparatus comprises a shaft, and end effector, and an articulation section. The articulation section is disposed between the shaft and the end effector. The articulation section includes a proximal portion and a distal portion. The distal portion is pivotable relative to the proximal portion about a first pivot axis. A reinforcement member extends between the proximal and distal portions. The reinforcement member is configured to pivot relative to the proximal portion about a second pivot axis. The reinforcement member is configured to pivot relative to the distal portion about a third pivot axis. An articulation section may include a combination of a pivoting section and a flexing section. Reinforcement members may prevent a firing beam from buckling as the firing beam is driven through an articulated articulation section.

Abstract: A catheter apparatus for treatment of a human patient is described, the catheter apparatus having a central axis and comprising a shaping structure moveable between a delivery state having a first helical shape, and a deployed state having a second helical shape. The shaping structure is configured to have a reverse taper with a structural diameter that varies over the length of the shaping structure such that the structural diameter of the shaping structure at the proximal end is smaller than the structural diameter of the shaping structure at the distal end.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm having an inner surface defines a cavity including a cutting portion configured to cut tissue.

Abstract: An energy delivery device cooling system includes a reservoir connector assembly and an elongate member. The elongate member has first and second lumens in fluid communication with the reservoir. The first lumen includes an outflow port and the second lumen includes a return port each in fluid communication with the reservoir. The device further includes a tubing system having a first end and a second end. The first end connected in fluid communication with the outflow port and the second end in fluid communication with the return port. The second end configured to return a fluid to the reservoir. The tubing system connects to an energy delivery device to cool the fluid.

Abstract: A cutting device includes an elongated shaft extending between a proximal end and a distal end. A lower portion extends from the distal end of the elongated shaft and includes an outer surface and an inner surface spaced apart from the outer surface which together form a blunt end configured as a stop so as to protect adjacent tissue. An upper portion extends from the distal end of the elongated shaft and including an inner surface. The upper portion is configured so as to be disposed opposite the lower portion. A cutting element is disposed between the lower portion and the upper portion and is configured for retractable extension beyond the distal end of the elongated shaft so as to contact tissue.

Abstract: A method of treating tissue including displaying a path to a point of interest within a luminal network, navigating a locatable guide to the point of interest following the displayed path, and deploying one or more fiducial markers proximate the point of interest. The method also including percutaneously inserting a microwave ablation device into the point of interest and ablating the tissue at the point of interest.

Abstract: Systems and methods for performing tissue modulation are disclosed. A nerve modulation assembly may include a guide sheath having a proximal end, a distal end, and a lumen extending therebetween. An actuation member, also having a proximal end and a distal end, extends along a central elongate axis disposed within the lumen. Further, the ablation member disposed at the distal end of the actuation member is configured to be actuated from the proximal end of the guide sheath. In particular, the ablation member includes a radiofrequency based electrode member, and an insulation member disposed circumferentially around the radiofrequency based electrode member.

Abstract: A steerable catheter system is provided including an elongated shaft having a proximal end, a distal end and an outer surface. The outer surface includes at least one cavity configured to facilitate movement of the distal end relative to the proximal end so as to steer the elongated shaft. A catheter tip is attached to the distal end of the shaft. The catheter tip comprises a curved body having at least one RF cutting edge and at least one non-cutting area recessed from the at least one cutting edge.

Abstract: An ablation system including an image database storing a plurality of computed tomography (CT) images of a luminal network and a navigation system enabling, in combination with an endoscope and the CT images, navigation of a locatable guide and an extended working channel to a point of interest. The system further includes one or more fiducial markers, placed in proximity to the point of interest and a percutaneous microwave ablation device for applying energy to the point of interest.

Abstract: Cutting device for resecting nerve or soft tissue while reducing or preventing arcing or heating of surrounding tissues are provided. The cutting devices include a probe having a lumen, a distal end and a proximal end, the distal end having a tip and a cutting surface positioned near its tip. The cutting surface has cutting edges configured to receive and conduct pulsed plasma mediated RF discharges. The cutting devices also include a sleeve covering the probe, the sleeve containing at least one aperture configured to expose the cutting surface. Intermediate the probe and the sleeve, some cutting devices include a metal insert that can cover the probe exposing only the cutting edges of the cutting surface. Methods for cutting nerve and/or soft tissue utilizing the cutting devices are also provided.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a medical device for modulating nerves. The medical device may include an elongate shaft having a distal region. Two or more electrodes may be positioned adjacent to the distal end region of the elongate shaft. A control unit may supply power and control algorithms to the electrodes. The control algorithm may allow the electrodes to be operated simultaneously and individually.

Abstract: In one aspect, a fixed position RF electrode for conducting surgical procedures, includes a main device body detachably connectable to an RF generating system, a first polarized conductor and a second oppositely polarized conductor, a bipolar electrical conduit passing through the main device body that passes RF energy from the RF generating system to the first polarized conductor and the second oppositely polarized conductor, and a bipolar electrode for contacting a surgically operative material.

Abstract: A surgical device for operating on tissue comprises an end effector, a shaft, and an interface assembly. The shaft comprises an articulation section operable to provide deflection of the end effector relative to the longitudinal axis of the shaft. The interface assembly comprises a plurality of pulleys associated with drive shafts driven by an external system. The pulleys are operable to cause rotation of one or both of the shaft or end effector. The pulleys are further operable to cause articulation of the articulation section. The interface assembly further comprises drive components operable to cause movement of components of the end effector.

Abstract: A device for performing a surgical procedure includes an elongated shaft extending between a proximal end and a distal end. The shaft includes an outer surface and an inner surface. An expandable member is disposed at the distal end of the shaft. The expandable member is configured to receive inflation material. At least one electrode is disposed with the inflatable member. Methods of use are disclosed.

Abstract: A catheter including a proximal end and a distal end. An expandable element coupled to the distal end is included, the expandable element including a proximal portion and a distal portion, the expandable element defining an exterior surface. A first plurality of electrodes coupled to the exterior surface of the distal portion of the expandable element are included, each of the first plurality of electrodes being selectively operable to transmit unipolar radiofrequency energy. A second plurality of electrodes coupled to the exterior surface of the proximal portion of the expandable element are included, each of the second plurality of electrodes being selectively operable to transmit bipolar radiofrequency energy.

Abstract: An apparatus for operating on tissue includes an end effector, a first actuator, and a second actuator. The end effector includes a first jaw pivotable relative to a second jaw to a closed position. The first actuator is movable from a first position to a second position to pivot the first jaw to the closed position. The first actuator engages the second actuator in the second position to selectively provide RF energy to the end effector.

Abstract: The systems and methods of the present disclosure detect arcing patterns or impedance changes and adjust the level of electrosurgical energy provided to tissue based on the detected arcing patterns or impedance changes. In embodiments, the drag force imposed on the electrode or blade of an electrosurgical instrument may be controlled by adjusting the level of electrosurgical energy based on the detected arcing patterns or impedance changes. The arcing patterns or impedance changes may be detected by sensing voltage and/or current waveforms of the electrosurgical energy and analyzing the sensed voltage and/or current waveforms. The current and/or voltage waveform analysis may involve calculating impedance based on the sensed voltage and current waveforms and calculating changes in impedance over time. The waveform analysis may involve detecting harmonic distortion using FFTs, DFTs, Goertzel filters, polyphase demodulation techniques, and/or bandpass filters.

Abstract: Helical push wire electrodes are provided. The electrodes may create a continuous helical lesion. One or more electrodes may wind around a support section and create a set of helixes having fixed ends and hitches. Pushing or pulling an end of the electrode transforms the electrodes between a delivery configuration and a deployed configuration such that the set of helixes expand or contract axially. Different portions of the electrodes may be surrounded by sleeves. The sleeves may regulate how the wires transform and provide insulation. Various insulation configurations of the electrodes may provide creations of discrete lesions, efficient energy delivery and reduced power consumption.

Abstract: An end effector for operating on tissue comprises an upper jaw, a lower jaw, a flexible member, and a pair of conductive members. The upper jaw and the lower jaw are configured to receive tissue when in an open position and the upper jaw is movable toward the lower jaw. The flexible member is coupled to either the upper jaw or the lower jaw, and is configured to deform in response to compression of tissue between the jaws. One of the conductive members is associated with the flexible member and is configured to move with the flexible member in response to compression of tissue between the jaws. The end effector may be configured to manipulate the position of muscle within tissue in response to compression of tissue between the jaws.

Abstract: A method for controlling an electrosurgical generator includes generating at least one electrosurgical waveform at a selected energy setting through an RF output stage comprising an RF inverter coupled to a power source. The at least one electrosurgical waveform has a duty cycle and a crest factor. The method also includes adjusting a repetition rate of the at least one electrosurgical waveform based on the selected energy setting to regulate the duty cycle of the at least one electrosurgical waveform. The method also includes applying the at least one electrosurgical waveform to tissue through at least one electrode and measuring an output voltage of the at least one electrosurgical waveform. The method also includes supplying a control signal to the RF inverter based on the repetition rate when the output voltage is increasing to regulate the crest factor of the at least one electrosurgical waveform.

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 catheter system with integral sensing and clearing of occlusions is described. The system can include a catheter in fluid communication with a shunt for transporting a bodily fluid within, or out of, a patient's body. The catheter and/or the shunt can include one or more detection wires and one or more transmission wires. The detection wires can be in electrical communication with the fluid and can enable the detection of changes in electrical properties of the fluid indicating an occlusion, or other anomaly, in the catheter. The transmission wires can be in electrical communication with the fluid and can enable the application of electromagnetic energy to the occlusion to facilitate its removal. The detection wires and the transmission wires can be the same or different wires. The system can include a probe that can be externally connected to the wires to provide detection and or transmission signals.

Abstract: An apparatus comprises an end effector, a shaft assembly, and an interface assembly. The end effector is operable to manipulate tissue, the shaft assembly is in communication with the end effector and a portion of the shaft assembly extends proximally from the end effector. The interface assembly is in communication with the shaft assembly. The interface assembly comprises a housing portion, a shaft cartridge, and a base portion. The housing portion can engage the shaft cartridge. The shaft cartridge is able to rotate and articulate the end effector, and the shaft assembly extends from the shaft cartridge. The base portion and the housing portion are able to enclose the shaft cartridge.

Abstract: Medical devices and methods for using medical devices are disclosed. An example medical device may include an open-irrigated ablation catheter. The open-irrigated ablation catheter may include a catheter body, an electrode tip body with one or more irrigation ports at a distal end, and a proximal insert for providing cooling fluid to a proximal end of the electrode tip body.

Abstract: A nested trigger assembly for a surgical instrument may generally comprise a first trigger and a second trigger, wherein the first trigger and the second trigger are movable together on a first stroke of the nested trigger assembly, wherein the second trigger is configured to be biased away from the first trigger after the first stroke and before a second stroke, and wherein the second trigger is configured to be moved toward to the first trigger during the second stroke. A surgical instrument may generally comprise a shaft comprising a proximal end and a distal end, a handle extending from the proximal end, wherein the handle comprises a gripping portion, and a nested trigger assembly extending from the handle. The nested trigger assemble may comprise one of a separable trigger assembly and a divisible trigger assembly.

Abstract: An intrauterine device includes an articulating array. The intrauterine device can be operated by articulating the articulating array into an installed position or geometry within the uterus of a patient. Further, the articulating array can be constructed to include an insertion geometry have a smaller cross section than an installation geometry. The articulating array can also be constructed to be housed within a sheath in the intrauterine device. Once the sheath has been inserted into a patient, for example through the patient's cervix, the articulating array can be deployed in its insertion geometry and then articulated into an installed position. The articulating array can include a plurality of expansion chambers. The expansion chambers can be constructed and arranged to take on the installed geometry when expanded. In one embodiment, the purpose of the articulating array is to position a conductive array within the patient's uterus enabling ablation of the uterine lining.