Abstract: An instrument and related method includes at least one substrate, and conductive layer, and a coating disposed on the conductive layer. The conductive layer is at partially disposed on the at least one substrate. The coating is disposed on the conductive layer and includes first and second materials. The first material and second materials are different from each other.

Abstract: Described herein are devices and methods for irrigating and suctioning fluids from the lumens or cavities of a mammalian body. The devices include a malleable irrigation tube and a suction tube that is slidably mounted upon the irrigation tube.

Abstract: A device for use in performing minimally invasive surgery. A system for performing minimally invasive surgery comprising the device according to the present invention. A method for performing minimally invasive surgery.

Abstract: The present invention provides methods, devices, and systems for in vivo treatment of cell proliferative disorders. Included is a method of treating tissue with electrical energy, the method comprising: delivering electrical energy to tissue using one or more electroporation devices comprising one or more electrodes; and cooling the tissue, surrounding tissue, one or more of the electrodes, or one or more of the electroporation devices to minimize heating. In embodiments, the invention can be used to treat solid tumors, such as brain tumors, and in some embodiments, exemplary methods rely on non-thermal irreversible electroporation (IRE) to cause cell death in treated tumors.

Abstract: A medical system includes a shaft, an inflatable balloon, a radial array of ultrasound transducers and a processor. The shaft is configured for insertion into a body of a patient. The inflatable balloon is coupled to a distal end of the shaft and configured to perform a treatment to surrounding anatomy. The ultrasound transducers are distributed circumferentially around the distal end of the shaft inside the balloon, and configured to transmit ultrasound waves at respective radial directions and receive respective ultrasound reflections. The processor is configured to estimate and output to a user, based on the ultrasound reflections received from the ultrasound transducers, an extent of mechanical contact between the balloon and the surrounding anatomy.

Abstract: Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

Abstract: Devices and systems for tissue engagement and methods of using the same. In at least one embodiment of a device of the present disclosure, the device comprises an elongated body having a proximal end, a distal end, and at least one lumen extending from the proximal end to the distal end; an engagement portion at the distal end of the elongated body, the engagement portion configured to engage a tissue adjacent thereto when the engagement portion contacts the tissue while suction is applied through the device; and at least one electrode present along the engagement portion and configured to contact the tissue when the engagement portion contacts the tissue and to obtain bioimpedance data from the tissue while suction is applied through the device.

Abstract: A system for augmenting spinal vertebrae utilizing a system that increases the bone density of adjacent vertebral bodies is disclosed. This system may be placed in the cranial and/or caudal end positions of the spinal construct to address potential adjacent level failure.

Abstract: An electrophysiology mapping system is provided with modules which can be attached thereto, each module including an item of subcutaneous interventional equipment and information about the item of subcutaneous interventional equipment, including shape information and size information. At least one sensor is placed upon the item of subcutaneous interventional equipment at a known location thereon. This sensor allows for position, and also preferably orientation, of the item within an image presented on a display of the electrophysiology mapping system. The at least one sensor can be at least one electrode or two or more electrodes, with different known positions for the electrode, or electrodes. The at least one sensor can be one or more magnetic field sensors interacting with a magnetic field associated with the electrophysiology mapping system. Transthoracic ultrasound fitted with sensors thereon can also be utilized as a further module attachable to the electrophysiology mapping system.

Abstract: Apparatuses, systems and methods are provided for treating pulmonary tissues via delivery of energy, generally characterized by high voltage pulses, to target tissue using a pulmonary tissue modification system (e.g., an energy delivery catheter system). Example pulmonary tissues include, without limitation, the epithelium (the goblet cells, ciliated pseudostratified columnar epithelial cells, and basal cells), lamina propria, submucosa, submucosal glands, basement membrane, smooth muscle, cartilage, nerves, pathogens resident near or within the tissue, or a combination of any of these. The system may be used to treat a variety of pulmonary diseases or disorders such as or associated with COPD (e.g., chronic bronchitis, emphysema), asthma, interstitial pulmonary fibrosis, cystic fibrosis, bronchiectasis, primary ciliary dyskinesia (PCD), acute bronchitis and/or other pulmonary diseases or disorders.

Abstract: Method and devices are provided for assessing tissue samples from a plurality of tissue sites in a subject using molecular analysis. In certain aspects, devices of the embodiments allow for the collection of liquid tissue samples and delivery of the samples for mass spectrometry analysis.

Abstract: A device for treating a tissue includes a capsule extending longitudinally from a proximal end to a distal end and including a channel extending therethrough, the capsule releasably coupled to a proximal portion of the device and clip arms, proximal ends of which are slidably received within the channel of the capsule so that the clip arms are movable between an open configuration, and a closed configuration. A core member is coupled to the clip alms, the core member including a proximal portion and a distal portion releasably connected to one another so that, when the core member is subjected to a predetermined load, the proximal and distal portions are separated from one another. An electrically conductive control member is connected to the core member, a proximal end of the connected member connected to a power source for delivering an electrical current to the clip arms.

Abstract: An actuation mechanism, and a handle assembly and a surgical clip applier including the same are disclosed. The actuation mechanism includes a drive bar movable through a stroke having first and second stroke portions and an output gear rack. First and second intermediate gears include input portions operably coupled to a trigger and output portions defining different diameters. In the first stroke portion, the output portion of the first intermediate gear is engaged with the gear rack such that the first intermediate gear drives the drive bar. In the second stroke portion, the output portion of the second intermediate gear is disposed in engagement with the gear rack such that the second intermediate gear drives the drive bar. A different mechanical advantage is provided in the first portion of the stroke length as compared to the second portion of the stroke length.

Abstract: Surgical systems and methods are provided for controlling actuation and movement of various surgical devices.

Abstract: An irrigated ablation catheter includes a tip electrode with a thin shell and a plug, defining a plenum chamber. The tip electrode has an inlet of a predetermined size and noncircular shape, and a predetermined number of outlet fluid ports having a predetermined diameter in the shell wall. The tip electrode thus considers a diffusion ratio of total fluid output area to fluid input area, a fluid port ratio, and a fluid inlet aspect ratio where the fluid inlet has a noncircular radial cross-section. The plenum chamber has a narrow proximal portion opening to a wider distal portion so that fluid pressure decreases while fluid velocity increases thereby increasing turbulence which decreases momentum for a more uniform distribution of fluid in the tip electrode. Extending distally from the plug is a baffle member shaped to diffuse fluid entering the tip electrode and to house an electromagnetic position sensor.

Abstract: An LAA exclusion clip includes first and second clip struts and a bias device. The clip struts together define a heart-proximate side, a heart-distal side, bias and open clip ends, each strut having a tissue-contacting surface disposed opposite one another. The bias device includes a first biasing portion connecting the first and second clip struts, disposed on the heart-proximate side of the clip struts, and crossing over from the first clip strut to the second clip strut at the heart-proximate side of the first and second clip struts adjacent the bias clip end. The bias device includes a second biasing portion connecting the first and second clip struts, disposed on the heart-distal side of the first and second clip struts, and crossing over from the first clip strut to the second clip strut at the heart-distal side of the first and second clip struts adjacent the bias clip end.

Abstract: Systems, methods, and devices allow percutaneous mapping, orientation and/or ablation in bodily cavities or lumens. Such may include a structure that is percutaneously positionable in a cavity, such as an intra-cardiac cavity of a heart. Transducers carried by the structure are responsive to blood flow. For example, the transducers may sense temperature, temperature being related to convective cooling caused by blood flow. A controller discerns positional information or location, based on signals from the transducers. For example, blood flow may be greater and/or faster proximate a port in cardiac tissue than proximate tissue spaced from the port. Position information may allow precise ablation of selected tissue, for example tissue surround a port in the intra-cardiac cavity.

Abstract: Multi-electrode ablation systems, methods, and controllers are described. In one example, a multi-electrode ablation system includes a power supply configured to be coupled to a plurality of electrodes and a controller coupled to the power supply. The controller is configured to determine a thermal gain of each electrode of the plurality of electrodes. For each electrode of the plurality of electrodes, the controller sets a power limit based at least in part on said electrode's determined thermal gain. The power limit establishes a maximum power that may be dissipated through said electrode.

Abstract: The present invention provides improved methods and apparatus for skin treatment and tissue remodeling. The apparatus includes an array of needles that penetrate the skin and serve as electrodes to deliver radio frequency current or other electrical or optical energy into the tissue being treated, causing thermal damage in controlled patterns. The damaged regions promote beneficial results such as uniform skin tightening by stimulation of wound healing and collagen growth.

Abstract: The instant disclosure relates to electrophysiology catheters for tissue ablation within a cardiac muscle. In particular, the instant disclosure relates to an electrophysiology ablation balloon catheter with an electrode coil that is wrapped around at least a portion of the balloon and delivers ablation energy at a desired portion of tissue.

Abstract: An electrophysiology catheter having an electrode sleeve mounted on a distal section, the electrode sleeve comprising an electrically-nonconductive band and a plurality of discrete electrodes, the band extending circumferentially around the distal section, each discrete electrode occupying a different radial position around the band. The catheter includes a plurality of lead wires extending through the elongated body and the deflection section, and into the distal section, each lead wire passing through a respective aperture formed in the sidewall of the tubing of the distal section, each wire being connected at its distal end to a respective discrete electrode.

Abstract: An ablation device for creating linear lesions comprises a flexible support structure defining at least a partial curve; and an electrode disposed on the flexible support structure. The electrode comprises a pressure sensitive conductive composite that is configured for electrical communication with an electrical conductor and a flexible conductive outer covering that covers at least a portion of the pressure sensitive conductive composite. Electrical resistance of the pressure sensitive conductive composite varies inversely in proportion to pressure that is applied to the pressure sensitive conductive composite. Methods of creating linear lesions are also provided.

Abstract: An electrosurgical dissection apparatus is disclosed, and includes a thermally insulating body, a thermally conductive insert, at least one active electrode, and at least one return electrode. The at least one active electrode is disposed on the thermally conductive insert, and the at least one return electrode is spaced from the at least one active electrode by a portion of the thermally insulating body. The thermally conductive insert is configured to cauterize tissue dissected by radiofrequency energy passing from the at least one active electrode to the at least one return electrode.

Abstract: A system and method for providing greater control over the temperature of a thermal treatment element of a medical device, enabling an operator to extend a thawing period of a cryoablation procedure. The system may include a fluid flow path that bypasses a subcooler, giving the operator selective control over the temperature of refrigerant delivered to the treatment element and, therefore, treatment element temperature. Additionally or alternatively, the system may include a fluid delivery conduit that is in communication with a liquid refrigerant and a gaseous refrigerant. Adjustment of the ratio of liquid to gaseous refrigerant also offers control over the treatment element temperature. Additionally or alternatively, the system may include one or more valves and/or heating elements in the fluid delivery and recovery conduits to control the treatment element temperature.

Abstract: A surgical retractor includes a plurality of cameras integrated therein. One such retractor includes a tubular retractor and an insert supporting said plurality of cameras can be disposed within a tubular retractor.

Abstract: An irrigated ablation catheter includes a tip electrode with a thin shell and a plug to provide a plenum chamber. The tip electrode has an inlet of a predetermined size and noncircular shape, and outlets in the form of fluid ports formed in the thin shell wall. The plurality of the fluid ports is predetermined, as is their diameter. Each fluid port has a tapered configuration, for example, a frustoconical configuration, with a smaller inlet diameter and a larger outlet diameter.

Abstract: Devices and methods for shaping an ablation treatment volume formed in fluid enhanced ablation therapy are provided. The devices and methods disclosed herein utilize the interaction of fluids to create ablation treatment volumes having a variety of shapes. In one embodiment, a method for forming an ablation treatment volume having a desired shape includes delivering therapeutic energy to tissue to form an ablation treatment volume and simultaneously delivering a first fluid and a second fluid to the tissue. The first and second fluids can convect the therapeutic energy in a desired direction such that the ablation treatment volume has a desired shape.

Abstract: An image processing method includes the following operations: generate a display image by a display device; obtain an eye focus position by a photographic device; sense a head rotation angle to generate a head movement information by a sensing device; sense a body movement to generate a body movement information by a monitoring device; generate a focus target in the display image according to the eye focus position, generate a reference axis according to the focus target, and generate the display image according to the reference axis, the head movement information and the body movement information by a processing device.

Abstract: Described here are devices and methods for forming a fistula between two vessels. In some instances, the fistula may be formed between a proximal ulnar artery and a deep ulnar vein. The fistula may be formed using an electrode, and may be formed with a first catheter placed in a first blood vessel and a second catheter placed in a second blood vessel. In some instances, access to the proximal ulnar artery may be achieved through a brachial artery, and access to the deep ulnar vein may be achieved through a brachial vein.

Abstract: A multi-probe system and a method of lesioning for targeting a region of a vertebral body are disclosed. The method includes inserting a first introducer assembly into a first target location of the vertebral body to provide a first trajectory to access the vertebral body, the first introducer assembly including a first cannula. The method also includes inserting a second introducer assembly into a second target location of the vertebral body to provide a second trajectory to access the vertebral body, the second introducer assembly including a second cannula. The method further includes inserting a first bipolar probe through the first cannula of the first introducer assembly, the first bipolar probe including a first active tip at a distal end of the first bipolar probe, the first active tip including at least two electrodes.

Abstract: Surgical systems and methods are provided for controlling actuation and movement of various surgical devices.

Abstract: This accessory comprises a remotely steerable catheter (40) extended by a tip (50) comprising a base (52) to which the catheter (40) connects to and a cylindrical portion (54) defining a volume (56) suitable for housing the capsule (10). A sub-catheter (30) and the capsule are telescopically extendable with respect to the catheter between i) a retracted position and a deployed position wherein the capsule is removed from the connector and is carried by the distal end of the sub-catheter, and the distal end of sub-catheter and the proximal region (18) of the capsule being provided with disconnectable means of attachment (20, 36). The tip presents, between its base (52) and its cylindrical portion (54), a flexible portion (58) providing, between the base and the cylindrical portion, an elastic deformability in bending and compression.

Abstract: The present invention provides a method of relieving or alleviating abdominal cancer pain or improving pain VAS score in a cancer patient Multiple electrodes are placed within a segment of the abdominal aorta of the patient and against blood vessel wall of the abdominal aorta. Radiofrequency energy is released through at least one of the multiple electrodes to nearby tissues, so as to increase the temperature of the nearby tissues and induce a thermal alteration of the nearby tissues.

Abstract: An instrument for large-area ablation of the mucosa including at least one first gas supply line and at least one second gas supply line whose distal ends are arranged to form an acute angle (?), so that the ends diverge distally. A free space between the distal ends of the gas supply lines allows the user to view the tissue region behind the distal end of the instrument. Due to the acute angle (?), electrodes arranged at least partially in the ends of the gas supply lines generate a wide plasma beam with which the mucosa ablation can be performed. The instrument can be guided precisely due to the view through the free space. A connecting element according to the invention is provided for attaching the ends of the gas supply lines.

Abstract: One embodiment of the present invention relates to an electrosurgical device for conducting surgery. The device includes a tubular housing and a plurality of electrodes disposed within said tubular housing. The device further includes an actuator connected to the plurality of electrodes to extend and retract at least one of the plurality electrodes to and from the tubular housing.

Abstract: Systems and methods for non-thermal ablation of tissue are provided. A non-implantable minimally invasive system for treatment of tissue in a body via direct current ablation is provided. A catheter for use in such system is further provided. The catheter includes a tubular body having a proximal end, a distal end, and a tip positioned at the distal end. The tubular body is semi-flexible, bi-directionally torqueable, and chemically resistant. The tubular body includes a plurality of routing holes provided between the proximal end and the distal end for facilitating deployment of electrodes from the tubular body. The tubular body further comprises an inner sheath generally at an interior portion and an outer sheath generally at an exterior portion and being chemically resistant.

Abstract: An electrode array and a delivery assembly are disclosed. The array is wrapped around a flexible core part of the delivery assembly. A sheath, also part of the delivery assembly, is disposed over the array and core. Steering cables extend through the core. Once the delivery assembly-encased array is inserted in the body, the combination is advanced to the tissue over which the array is to be deployed. By pulling on the steering cables the array and assembly are steered into position. Once the array is in position, the sheath is retracted, the array deploys over the target tissue.

Abstract: Devices, systems and/or methods for repairing soft tissue adjacent a repair site. In one embodiment, a repair device is delivered with a delivery device system configured to move a cartridge with the repair device disposed therein toward an anvil with soft tissue positioned thereon. The delivery device linearly moves the cartridge toward the anvil with a worm drive positioned within a housing by rotating a thumb wheel disposed around the worm drive. Such linear movement is provided with a finger element extending from the worm drive that is configured to cooperate with an internal surface of the thumb wheel. With this arrangement, upon rotating the thumb wheel, the worm drive rotates with the finger element engaged with the internal surface of the thumb wheel to linearly move the cartridge toward the anvil.

Abstract: Transducer-based systems and methods may be configured to display a graphical representation of a transducer-based device, the graphical representation including graphical elements corresponding to transducers of the transducer-based device, and also including between graphical elements respectively associated with a set of the transducers and respectively associated with a region of space between the transducers of the transducer-based device. Selection of graphical elements and/or between graphical elements can cause activation of the set of transducers associated with the selected elements. Transducer activation characteristics, such as initiation time, activation duration, activation sequence, and energy delivery characteristics, can vary based on numerous factors. Visual characteristics of graphical elements and between graphical elements can change based on an activation-status of the corresponding transducers.

Abstract: Certain aspects relate to systems and techniques for an articulating monopolar medical instrument. In one aspect, the medical instrument includes a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; a first cable configured to engage with the at least one proximal pulley and the at least one distal pulley; and a second cable configured to engage with the at least one proximal pulley without engaging the at least one distal pulley.

Abstract: Methods for treating tissue with irreversible electroporation and immunotherapy are described. The methods include placing a probe in tissue within a human body, wherein the probe has at least a first electrode, applying a plurality of electrical pulses through the first electrode and a second electrode, causing irreversible electroporation (IRE) of the tissue within a target ablation zone, and administering one or more exogenous agents into the tissue within the target ablation zone or to the human, thereby stimulating or otherwise modulating an immune system response within the body.

Abstract: Electrosurgical wands. At least some of the illustrative embodiments are electrosurgical wands having features that reduce contact of tissue with an active electrode of a wand, decrease the likelihood of clogging, and/or increase the visibility within surgical field. For example, wands in accordance with at least some embodiments may comprise standoffs, either along the outer perimeter of the active electrode, or through the main aperture in the active electrode, to reduce tissue contact. Wands in accordance with at least some embodiments may implement slots on the active electrodes to increase bubble aspiration to help keep the visual field at the surgical site clear. Wands in accordance with at least some embodiments may implement aspiration flow pathways within the wand that increase in cross-sectional area to reduce the likelihood of clogging.

Abstract: A catheter with a variable circular loop responsive to a contraction wire for coiling is supported by a member having a tapered distal section that transitions from a circular cross-section to a generally rectangular cross-section while maintaining a uniform cross-sectional area along the entire tapered length for improved coiling characteristics. A radially constrictive sleeve prevents separation of the contraction wire from the support member to minimize misshaping of the loop during contraction.

Abstract: An ablation probe is provided. The ablation probe includes a housing that is configured to couple to a microwave energy source. A shaft extends distally from the housing and includes a radiating section at a distal end thereof. A sensor assembly is operably disposed on the housing and includes a pair of sensor contacts. One or more sensors are positioned adjacent the radiating section and extend along the shaft. The sensor(s) have a pair of sensor contact pads that are positioned on the shaft for contact with the pair of sensors such that during transmission of microwave from the radiating section into target tissue at least one electrical parameter is induced into the at least one sensor and detected by the pair of sensor contacts.

Abstract: Methods for treating tissue with irreversible electroporation and immunotherapy are described. The methods include placing a probe in tissue within a human body, wherein the probe has at least a first electrode, applying a plurality of electrical pulses through the first electrode and a second electrode, causing irreversible electroporation (IRE) of the tissue within a target ablation zone, and administering one or more exogenous agents into the tissue within the target ablation zone or to the human, thereby stimulating or otherwise modulating an immune system response within the body.

Abstract: A catheter has a two-piece tip electrode with a shell and a support structure that are secured to each other by multiple redundant mechanisms in order to reduce the risk of tip detachment during a procedure. The tip electrode includes at least two different welds attaching the shell to the support structure to provide a dual failure mode. One weld includes a seam weld and another weld includes a penetration weld.

Abstract: A variety of methods for managing a re-usable ultrasonic medical device may include a medical device control module capable of receiving functional data from a user assembled or reassembled ultrasonic medical device, and notifying the user if a value of the functional data lies within an acceptance range. If the value of the functional data does not lie within the acceptance range, the control module may prompt a user to reassemble the device or to clean or replace one or more components thereof. The functional data may relate to a clamp force of a jaw assembly, an impedance or resonant frequency value of an ultrasonic blade, or a mechanical displacement value of one or more moving components of the device.

Abstract: A deflectable device, such as a catheter, is provided that includes a hinge that enhances the ability of the device to deflect or bend within a predetermined plane. The catheter comprises an elongated tubular catheter body having proximal and distal ends and at least one lumen extending therethrough. A distal segment is provided distal to the distal end of the catheter body. A tubular hinge is provided between the distal end of the catheter body and the proximal end of the distal segment. The hinge has an axis and at least one lumen extending therethrough. The tube includes at least one slot, and preferably a plurality of slots, extending part of the way through the hinge generally transverse to the axis of the hinge.

Abstract: A method of identifying gaps between electrophysiology (EP) ablation points may comprise: obtaining a plurality of ablation points recorded from a completed electrophysiology ablation procedure; digitally mapping the plurality of ablation points to an anatomical model corresponding to the completed electrophysiology ablation procedure; calculating ablation gap probability distributions for each of the plurality of ablation points based on ablation tolerance variables associated with each of the plurality of ablation points; and overlaying the ablation gap probability distributions on to the digitally mapped plurality of ablation points on the anatomical model. In this way, ablation gaps may be non-invasively identified prior to patient discharge, thereby allowing for further EP treatment to remove the ablation gaps while reducing readmission rates.

Abstract: This invention relates to a method of straddling an intraosseous nerve with an energy transmitting device to improve the therapeutic treatment of the nerve.