Abstract: Systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ of a patient. An electrosurgical apparatus of the invention includes a shaft having an articulated electrode support at a distal end of the shaft, the electrode support bearing an active electrode on an inferior surface of the electrode support, a return electrode in the form of a tube, and an electrically insulating return tube tray affixed to the tube, the tube adapted for delivering an electrically conductive fluid between the active electrode and the return electrode. The probe can adopt a closed configuration or an open configuration. The closed configuration is adapted for clamping, coagulating, and ablating a target tissue while the apparatus is operating in a sub-ablation mode, while the open configuration is adapted for severing the target tissue via molecular dissociation of tissue components.

Abstract: The present invention provides systems, apparatus, and methods for dissecting, resecting, severing, cutting, contracting, coagulating, or otherwise modifying a tissue or organ of a patient. An apparatus of the invention includes an electrosurgical probe configurable between an open configuration and a closed configuration, the probe including an active electrode terminal, a fixed return electrode disposed proximal to the active electrode terminal, and a movable return electrode configured to move linearly with respect to the active electrode terminal between the open configuration and the closed configuration. A method of the present invention comprises clamping a blood vessel between the active electrode terminal and the movable return electrode, coagulating the clamped blood vessel by application of a first high frequency voltage, and severing the coagulated blood vessel by application of a second high frequency voltage.

Abstract: Described is a fingertip electrosurgical device useful for tissue grasping and tissue cutting, coagulating, welding and ablating in open and laparoscopic surgery applications. The electrosurgical medical device has a finger cuff assembly that attaches to the distal end of a surgeon's finger. An electrode is attached to, or is intrinsically part of, the finger cuff assembly. This electrode is connected to at least one electrically conductive wire that is adapted to transmit electric current to the electrode. The electrode may take any number of shapes depending upon the surgical procedure. Generally, two finger cuff assemblies are used in an opposable relationship to facilitate energy transfer or tissue grasping functions performed by the surgeon.

Abstract: An electrosurgical cutting blade (1) comprises a first electrode (2), a second electrode (3), and an electrical insulator (4) separating the first and second electrodes. The first and second electrodes (2 and 3) have dissimilar characteristics (cross-sectional area, thermal conductivity etc.) such that the first electrode (2) is encouraged to become an active electrode and the second electrode (3) is encouraged to become a return electrode. The spacing between the first and second electrodes (between 0.25 mm and 3.0 mm) and the peak voltage supplied to the electrodes are both selected such that arcing does not occur directly between the electrodes, but between the first electrode and the tissue at the target site. The arrangement is such that, in use, a thermal differential of at least 50° C. is established between the first and second electrodes, such that the second electrode is maintained below a temperature of 70° C.

Abstract: An apparatus for treating body tissue includes a treatment instrument 1 for treating the body tissue and a measuring unit 3 for measuring the actual value of a parameter of the body tissue at at least one measuring point. An identifier 4 is connected to the measuring unit 3 for identifying the body tissue to be treated on the basis of the actual value and for outputting a coordinate signal containing the coordinates of the body tissue to be treated. A positioning device 2 receives the coordinate signal and moves the treatment instrument 1 to the body tissue to be treated. An updating device 8 is connected to the measuring unit 3 and the identifier 4 and outputs an updating signal for triggering renewed measurement of the actual value and renewed identification of body tissue to be treated.

Abstract: A bipolar electrosurgical hook probe includes an end effector that includes first and second electrodes placed in parallel, closely-spaced relationship, each being of a relatively large surface area and a conductive reciprocally movable hook member that is movable into and out of a space between the first and second electrodes. A switch mechanism is provided by which an RF current can alternatively be made to flow between the first and second electrodes during electrocoagulation and from the hook electrode to each of the first and second electrodes when the instrument is operating in its cut mode.

Abstract: An apparatus and method for cutting a material including conducting and non-conducting materials such as biological tissue, cellulose or plastic while the material is submerged in a conductive liquid medium. The apparatus has a cutting electrode with an elongate cutting portion having an aspect ratio (length to width) of 1 or more and a return electrode. The two electrodes are immersed in the conductive medium and a voltage is applied between them to heat the medium, thus producing a vapor cavity around the elongate cutting portion and ionizing a gas inside the vapor cavity to produce a plasma. The voltage applied between the electrodes is modulated in pulses having a modulation format selected to minimize the size of the vapor cavity, its rate of formation and heat diffusion into the material while the latter is cut with an edge of the elongate cutting portion. The modulation format includes pulses ranging in duration from 10 &mgr;s to 10 ms, as well as minipulses and micropulses, as necessary.

Abstract: An electrosurgical instrument that allows precise modulation of active Rf density in an engaged tissue volume. The working end of the instrument has a tissue-contacting surface of a conductive-resistive matrix that is variably resistive depending on its temperature. The matrix comprises a positive temperature coefficient (PTC) polymeric material hat exhibits very large increases in resistivity as any local portion increases beyond a selected temperature. In a method of use, the polymeric PTC material senses the temperature of engaged tissue in a manner akin to pixel-by-pixel sensing and thereby changes its resistance in a corresponding pixel-by-pixel manner. The instrument further carries cooling means to cause accelerated thermal relaxation of the PTC matrix during use to make the engagement surface highly responsive to temperature changes that in turn alter the matrix between being electrically conductive and electrically resistive.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an electrically conductive electrode, an electrically insulating material, and a metal shearing surface which is electrically insulated and physically spaced from the electrode by the insulating material which is disposed therebetween. In one embodiment, the electrode is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade, and the metal shearing surface which also provides the cutting edge is of a metal material which is fixed to the ceramic. In a second embodiment, the insulating material is a molded ceramic blade, with the electrode and the metal shearing surface layer metalized or otherwise fixed to the ceramic blade. In a third embodiment, the electrode is metalized on a thin layer insulating material which is fixed onto a metallic blade. In a fourth embodiment, metallic shearing and electrode layers are laminated to opposite sides of a fiberglass material.

Abstract: The present invention relates to devices and methods that enhance the accuracy of lesion excision, through severing, capturing and removal of a lesion within soft tissue. Furthermore, the present invention relates to devices and methods for the excision of breast tissue based on the internal anatomy of the breast gland. A tissue severing device generally comprises a guide having at least one lumen and a cutting tool contained within the lumen. The cutting tool is capable of extending from the lumen and forming an adjustable cutting loop. The cutting loop may be widened or narrowed and the angle between the loop extension axis and the guide axis may be varied. Optional tissue marker and tissue collector may additionally be provided. A method for excising a mass of tissue from a patient is also provided. The device and method are particularly useful for excising a lesion from a human breast, e.g.

Abstract: An electrosurgical instrument includes a pair of first and second elongated shafts each having an end effector attached to a distal end thereof and a handle. The handle is movable from a first position wherein the end effectors are disposed in spaced relation relative to one another to a second position wherein the end effectors are closer relative to one another. Each of the elongated shafts includes a hinge plate which mounts atop a pivot assembly for effecting movement of the end effectors relative to one another. The instrument also includes a hinge assembly made from an overmold composition which encapsulates and secures the hinge plates and the pivot assembly. The overmold composition is made from an electrically insulating material which insulates the end effectors from one another.

Abstract: This invention relates to an electrosurgical device having a hollow shaft, an electrically conductive distal tip that is also adapted for penetrating bone, and an intermediate electrically insulating spacer.

Abstract: Systems, apparatus, and methods for monitoring temperature at a region near a surgical site during a procedure. A temperature-indicating element of an electrosurgical device comprises an indicator composition adapted to undergo a change in appearance in response to a pre-defined temperature range. The change in appearance of the temperature-indicating element indicates to the operator of the device a temperature condition at the working end of the device.

Abstract: In an electrosurgical system which is operable within the frequency range of from 100 kHz to 50 MHz and which has a handheld instrument with an elongate instrument shaft, the distal end of the shaft carries a bipolar electrode assembly for use in a conductive fluid field. The electrode assembly has an active electrode and, set back from the active electrode, a return electrode coated with an insulative dielectric layer. The insulative layer may be made of a plastics or a ceramic material and acts as the dielectric of a capacitor when the electrode assembly is immersed in the conductive fluid. One of the effects of the insulative layer is to provide a more uniformly distributed electric field over the return electrode than is obtained with an exposed return electrode, yielding improved tissue desiccation and vaporisation characteristics. The active electrode may have a similar dielectric covering.

Abstract: A system for facilitating the placement of a catheter within the human body, in a lumen or vessel such as the fallopian tubes, and controlling the catheter after placement. The system coordinates the operation of treatment electrodes on the catheter with informative displays and prompts to an operator, based on information derived from electrical parameters of position detection electrodes on the catheter.

Abstract: The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to, ablate, contract, coagulate, or otherwise modify a tissue or organ of a patients. An electrosurgical apparatus includes an electrode support bearing an active electrode in the form of a plasma blade or hook having an active edge and first and second blade sides. The active edge is adapted for severing a target tissue via localized molecular dissociation of tissue components. The first and second blade sides are adapted for engaging against, and coagulating, the severed tissue. s. A method of the present invention comprises positioning an electrosurgical probe adjacent to the target tissue so that a blade- or hook-like active electrode is brought into at least close proximity to the target tissue in the presence of an electrically conductive fluid.

Abstract: An implantable bipolar stimulating electrode (1) has a cathode (3) to be fixed in the heart (2) and an anode (4), which is set at a distance to the cathode and which is arranged near or on the connector (5) used to connect the stimulating electrode 1 to a cardiac pacemaker (7). In the working position the anode (4) is adapted to be located outside of the vein (8), through which the supply line to the cathode (3) is guided. The entire electrode and especially also the region near the cathode (3) can therefore be formed with corresponding flexibility.

Abstract: An electrosurgical generator for supplying RF power to an electrosurgical instrument for cutting or vaporising tissue has an RF output stage (42) with an RF power bridge (Q1, Q2, Q3, Q4), a pair of output lines (74) and a series-resonant output network (48). The output impedance of the output stage (42) at the output lines (74) is less than 200/{square root}P ohms, where P is the maximum continuous RF output power of the generator. The generator offers improved cutting and vaporising performance, especially in relation to the reliability with which an arc can be struck when presented with an initial low impedance load. Overloading of the output stage is prevented by rapidly operating protection circuitry responsive to a predetermined electrical condition such as a substantial short-circuit across the output lines. In the preferred embodiment, the output stage is capable of maintaining output pulses at least 1kW peak by supplying the power bridge from a large reservoir capacitor (60).

Abstract: The invention provides a system for treating tissue that includes a power measurement device, a flow rate controller coupled to the power measurement device, and an electrosurgical device configured and arranged to provide radio frequency power and conductive fluid to the tissue, wherein the flow rate controller is configured and arranged to modify a flow rate of the conductive fluid to the tissue, based on signals from the power measurement device. The invention also provides methods and devices for modifying flow rate of conductive fluid to tissue based on measurement of radio frequency power delivered to the tissue.

Abstract: In an electrosurgical system which is operable within the frequency range of from 100kHz to 50MHz and which has a handheld instrument with an elongate instrument shaft, the distal end of the shaft carries a bipolar electrode assembly for use in a conductive fluid field. The electrode assembly has an active electrode and, set back from the active electrode, a return electrode coated with an insulative dielectric layer. The insulative layer may be made of a plastics or a ceramic material and acts as the dielectric of a capacitor when the electrode assembly is immersed in the conductive fluid. One of the effects of the insulative layer is to provide a more uniformly distributed electric field over the return electrode than is obtained with an exposed return electrode, yielding improved tissue desiccation and vaporisation characteristics. The active electrode may have a similar dielectric covering.

Abstract: An integrated catheter assembly for enabling diverse endoscopic in situ therapies. The assembly includes a catheter with an irrigation fluid lumen, a distal electrode tip portion that acts as a hemostat, and a cutting wire for making incisions in or ablating tissue. A cutting wire hub provides a sealing entrance for a cutting wire. An operator enables the physician to displace the cutting wire between extended and retracted positions. The cutting wire and electrode are electrically isolated. In addition, the catheter assembly may include a planar tip which, when extended outside the distal end of the assembly, assumes a substantially flat unbiased configuration for use. The apparatus of the present invention allows the physician to make incisions in or ablate tissue using electrosurgery, irrigate tissue, and cauterize or coagulate tissue without having to remove the apparatus from the working channel of the endoscope.

Abstract: A bi-polar electrocautery needle comprising an inner electrode on outer electrode and recoverable insulating-locking member for insulting the electrode from one another and locking them into relative position to one another. And the method of making the bi-polar electrocautery needle in accordance with this invention, the steps including: expanding recoverable dielectric material over an inner electrode; and recovering the material between the electrodes for insulating and locking the electrodes into relative position with one another.

Abstract: A power supply for a thermokeratoplasty system. The power supply can be connected to an electrode and a return element that are both coupled to a cornea. The power supply can perform a test routine to determine whether the cornea is too “wet” or too “dry”.

Abstract: An apparatus and method for minimally invasive surgery using a cutting tool with rotational cutting edges. The surgical instrument includes a tube having a distal end and a cutting edge at the distal end. A handle is attached to the proximal end of the tube. Within the tube is a shaft having a longitudinally extending blade at its distal end that is adjacent to the distal end of the tube. The blade is revolvable about the longitudinal axis of the instrument to provide rotational cutting action. One or both of the blade and the cutting edge on the tube can be electrically energized to provide for electrocauterization of the body tissue being cut.

Abstract: A surgical device for severing tissue, the surgical device comprising; a first shaft having a first internal lumen and a first slot disposed at a distal end; a clamp slidingly disposed in the first slot between open and closed positions to capture tissue in the first slot, the clamp having a clamping surface disposed at a distal end; at least one electrode for applying RF energy to the tissue captured in the first slot; a cutting blade slidingly disposed in the first slot between open and closed positions, the cutting blade having a cutting edge to sever the tissue; first actuation means for actuating the clamp between the open and closed positions; and second actuation means for actuating the cutting blade between the open and closed positions.

Abstract: The present invention provides a bipolar high-frequency treatment tool for coagulating and incising the vital tissue, comprising a pair of jaws provided at a distal end portion of an elongated member such that they can be closed and opened between a closed position and an open position, an operation unit having a handle provided at a proximal end portion of the elongated member, the operation unit closing and opening the jaws when the handle is operated, a first electrode portion provided at one of the jaws, and a second electrode portion provided at the other of the jaws. When vital tissue is gripped between the jaws, the effective electrode surface of the second electrode portion, which is to be brought into contact with the vital tissue, is smaller than that of the second electrode portion.

Abstract: An electrosurgical device has an electrode and a heat pipe to conduct heat from the electrodes where substantially all heat conducted from the electrode through the heat pipe is dissipated along the length of the heat pipe. The heat pipe can have a thermal time constant less than 60 seconds and preferably less than 30 seconds.

Abstract: An electrosurgical probe comprises a shaft having an electrode array (12) at its distal end and a connector at its proximal end. The array (12) includes a plurality of isolated electrode terminals, and an electrosurgical power supply (28) is provided with a multiplicity of independently limited or controlled current sources and a connector. The electrosurgical probe and the power supply may be connected through their respective connectors so that the independent current sources are connected to individual electric terminals. By applying very high frequency electrical energy to the electrode array, target tissue may be cut or ablated while heat dissipation through low impedance paths, such as blood and normal saline, will be minimized.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: A surgical instrument comprising an elongate hollow probe (1) having first and second apertures (4 and 5) at its distal end portion. An elongate drive shaft is disposed within the probe (1) and is mounted for rotation about its longitudinal axis within the probe. A cutting tool (2, 34) is located at the distal end of the drive shaft, and is positioned adjacent to the first aperture (4). A bipolar electrosurgical device (3) is located at the distal end of the probe (1) in the region of the second aperture (5). The electrosurgical device includes an active electrode (13) and a return electrode (11) separate and insulated therefrom. A motor (6) is provided for rotating the drive shaft; and suction means is provided for selectively providing a source of suction at either the first aperture (4) or the second aperture (5).

Abstract: A method and apparatus for creating a virtual electrode to ablate bodily tissue. The apparatus includes an outer tube, a first electrode, an inner tube and a second electrode. The outer tube is fluidly connected to a source of conductive fluid and defines a proximal end and a distal end. The distal end includes an opening for delivering conductive fluid from the outer tube. The first electrode is disposed at the distal end of the outer tube for applying a current to conductive fluid delivered from the outer tube. The inner tube is coaxially received within the outer tube and is connected to a source of conductive fluid. The inner tube defines a proximal end and a distal end, with the distal end forming an opening for delivering conductive fluid from the inner tube. Finally, the second electrode is disposed at the distal end of the inner tube for applying a current to conductive fluid delivered from the inner tube.

Abstract: Electrosurgical forceps are described that have jaws capable of being closed relative to one another, the jaws each supporting electrode structures especially shaped to enhance the ability of the instrument to desiccate/seal or cut tissue structures clamped between the opposed jaws. One of the opposed jaws has a generally arcuate cross-section with a raised central zone and the other electrode has a recess adapted to accommodate the raised central zone of the cooperating electrode. By appropriating the shaping the mating electrode surfaces, tissue structures placed between the jaws are stretched laterally as clamping occurs. The stretching action prevents bunching of the tissue and results in improved desiccation, sealing and cutting. A fine, uninsulated conductor disposed on the one jaw, but insulated from the electrode surface on that jaw, serves as a cutting electrode.

Abstract: An apparatus and method for minimally invasive surgery using a cutting tool with rotational cutting edges. The surgical instrument includes a tube having a distal end and a cutting edge at the distal end. A handle is attached to the proximal end of the tube. Within the tube is a shaft having a longitudinally extending blade at its distal end that is adjacent to the distal end of the tube. The blade is revolvable about the longitudinal axis of the instrument to provide rotational cutting action. One or both of the blade and the cutting edge on the tube can be electrically energized to provide for electrocauterization of the body tissue being cut.

Abstract: A multifunctional telescopic monopolar/bipolar electrosurgery pencil is disclosed for use with an electrosurgery unit (ESU). The monopolar/bipolar electrosurgery pencil includes a bipolar electrode having an insulator sandwiched between an active electrode and a return electrode wherein the bipolar electrode is connected to a handpiece capable of alternately effectuating cutting and coagulation with the bipolar electrode. The monopolar/bipolar electrosurgery pencil is capable of functioning as both a monopolar and bipolar device and can be used for open and closed laparoscopic and endoscopic procedures. Telescopic means for adjusting the length of the bipolar electrode is also provided as are means for smoke evacuation and suction/irrigation. The multifunctional telescopic monopolar/bipolar device can also be adapted for use with an ESU-argon beam coagulator.

Abstract: A polypectomy device and method which includes a snare cable, a fixed jaw and a moveable jaw. The snare cable is routed through both the fixed jaw and the moveable jaw. The snare cable forms a hoop for encircling the polyp. Shortening the snare cable positions the jaws about the base of the polyp and further shortening the cable closes the jaws. The fixed jaw includes a heating element which cauterizes the base of the polyp. The closing of the jaws and the heating of the heating element cuts and seals the polyp.

Abstract: An electrosurgical instrument is provided which includes a holding formation, a probe shaft, an electric conductor, and a probe tip. The probe shaft is secured to the holding formation and has an elongated section extending therefrom. The electric conductor extends along the elongated section. The probe tip is located on a distal end of the probe shaft opposing the holding formation. The probe tip defines a volatization chamber with a mouth out of the probe tip. The probe tip includes an electrode, to which RF current is provided through the electric conductor. The electrode heats an area adjacent to the probe tip. The electrode also heats a liquid in the first volatization chamber to evaporate the liquid into a vapor pocket that ejects from the first volatization chamber through the mouth out of the probe tip. A pump effect is created so that the liquid maintains the probe tip at a more stable temperature.

Abstract: An apparatus for treating disrupted articular cartilage comprising an elongate probe member having proximal and distal extremities and a handle coupled to the proximal extremity of the elongate probe member. The distal extremity has a peripheral wall defining a cavity and a distal opening communicating with the cavity. A controllable environment is created within the cavity when the distal extremity is placed substantially flush against the disrupted articular cartilage. An electrode is positioned within the cavity at a distance spaced inwardly of the distal opening. The disrupted articular cartilage is sealed to form a substantially continuous surface when energy is supplied to the electrode. A method of using the apparatus is provided.

Abstract: A bipolar electrosurgical instrument useful in harvesting blood vessels such as veins and arteries. The instrument has a pair of jaws and a central cutting element displaceable distally and proximally to dissect tissue contained between the jaws. The central cutting element has an electrode surface.

Abstract: A method is disclosed for treating soft tissue lesions located in a patient's oropharynx or larynx. According to the method, a space within the patient's oropharynx and larynx is isolated from the patient's trachea and lungs using an inflatable cuff tracheostomy tube inserted in the patient's trachea. The cuff is inflated to occlude the trachea. The patient is placed in a supine position, whereupon at least a portion of the space within the oropharynx and larynx is filled with saline. An endoscope is then inserted into the space to view the operative site in which the soft tissue lesion is to be treated. An electrosurgical instrument having an active tissue treatment electrode and a return electrode connected to an electrosurgical generator is then inserted into the space, either along side the endoscope or through the endoscope's working channel.

Abstract: A surgical device includes a return electrode, an active electrode, and an insulating region adjacent to the active electrode. A rasping surface is provided by either the active electrode or the insulating region. Another surgical device includes an adapter configured to couple to a generator and to convert monopolar output from the generator into bipolar output. A method of applying electricity to tissue includes bringing a surgical device into close proximity with tissue and applying electricity to the tissue using the surgical device.

Abstract: An electrosurgical device for use in surgical procedures is disclosed. The electrosurgical device comprises a main body having a proximal end and a distal end. A heat delivery modality is situated and arranged at the distal end of the main body. A sensor arrangement is also situated and arranged at the distal end of the main body. The heat delivery modality provides thermal energy to a tissue being treated while the sensor arrangement is configured to engage and detect a change in dimension of the tissue being treated. Accordingly, the electrosurgical device of the present disclosure allows a surgeon to precisely achieve the desired amount of dimensional change of the tissue being treated.

Abstract: A bipolar high frequency treatment tool includes a flexible insulating tube to be inserted through an accessory channel of the endoscope. The insulating tube has a pair of guide channels extending over the length thereof through which a pair of conductive wires is passed. An end effector is attached to a distal end of the insulating tube. The end effector includes a pair of electrodes that opens and closes like a pair of pincers. The pair of electrodes is connected with the pair of wires so that a high frequency power can be supplied to the pair of electrodes.

Abstract: A endoscopic bipolar forceps for clamping and sealing tissue includes first and second jaw members pivotally attached in opposing relation relative to one another which are movable from a first open position wherein the jaw members are disposed in spaced relation relative to one another to a second clamping position wherein the jaw members cooperate to grasp tissue therebetween. A drive rod assembly connects each of the jaw members to a source of electrical energy such that the jaw members are capable of conducting bipolar energy through the tissue held therebetween. A handle attached to the drive rod assembly imparts movement of the first and second jaw members from the first and second positions. At least one stop member is attached to the jaw members for controlling the distance between the jaw members. The forceps may also include a yoke member for insulating the jaw members from one another to prevent short circuiting of the forceps.

Abstract: A bipolar high frequency treatment tool includes an inserting portion to be inserted into a human body through an instrument channel of the endoscope. An electrode assembly is attached to the distal end of the inserting portion. The electrode assembly includes a supporting member having a slit, a pair of shafts held by the supporting member so as to cross the slit, and a pair of electrodes. The pair of electrodes is pivotably supported by the pair of shafts so as to open and close like a pair of pincers. An insulator block is located in the slit between the pair of electrodes to prevent the pair of electrodes from making a short circuit within the slit. The pair of shafts is pressed into the insulating block so that the shafts do not come of from the insulating block and hence from the supporting member.

Abstract: Electrosurgical forceps are described that have jaws capable of being closed relative to one another, the jaws each supporting electrode structures especially shaped to enhance the ability of the instrument to desiccate/seal or cut tissue structures clamped between the opposed jaws. One of the opposed jaws has a generally arcuate cross-section with a raised central zone and the other electrode has a recess adapted to accommodate the raised central zone of the cooperating electrode. By appropriating the shaping the mating electrode surfaces, tissue structures placed between the jaws are stretched laterally as clamping occurs. The stretching action prevents bunching of the tissue and results in improved desiccation, sealing and cutting. A fine, uninsulated conductor disposed on the one jaw, but insulated from the electrode surface on that jaw, serves as a cutting electrode.

Abstract: A bipolar medical instrument comprises a tubular shaft and two jaw parts. The jaw parts are arranged movably, one relative to the other, at the distal end of the tubular shaft and coupled one with the other via a joint. Each of the jaw parts forms a work electrode of different polarity. Each jaw part has associated to it a separate current line, one of such current lines being constituted by an axially movable force transmission element that is arranged in the tubular shaft and that is frictionally coupled to at least one of the jaw parts. At least one of the jaw parts comprises, at least in the region of the joint, a single-piece main body made from an electrically insulating material on which an electrically conductive jaw part insert is fastened, which forms a respective work electrode and which is connected, in an electrically conductive fashion, to the respective associated current line.

Abstract: The invention describes a method of treating a patient's left atrial appendage through the pericardial space. The process takes place through the pericardial space from an access point outside the pericardium or pericardial space.

Abstract: An RF treatment apparatus includes a catheter with a catheter lumen. A removable needle electrode is positioned in the catheter lumen in a fixed relationship to the catheter. The needle electrode includes a needle lumen and a needle electrode distal end. A removable introducer is slidably positioned in the needle lumen. The introducer includes an introducer distal end. A first sensor is positioned on a surface of the needle electrode or the insulator. An RF power source is coupled to the needle electrode and a return electrode. An insulator sleeve is slidably positioned around the electrode and includes a second sensor. Resources are associated with the electrodes, sensors as well as the RF power source for maintaining a selected power at the electrode independent of changes in current or voltage.

Abstract: An intravascular device and methods for forming multiple percutaneous myocardial revascularization (PMR) holes in a heart chamber wall simultaneously. One device includes a basket formed of flexible arms carrying cutting probes over their length. The basket arms are outwardly arcuately biased so as to assume an outwardly bowed, arcuate shape when unconstrained. The device includes an inner shaft distally secured to a proximal portion of the basket and slidably disposed within an outer shaft. The inner shaft and collapsed basket can be retracted within the outer shaft, delivered intravascularly to the left ventricle, and distally advanced, forcing the basket to assume the bowed shape. Radio frequency current supplied to the electrical cutting probes burn holes into the ventricle wall and myocardium. One embodiment has high pressure fluid jet cutting means. Another embodiment uses a basket as an anchor to position a steerable cutting probe.

Abstract: A surgical instrument useful in harvesting blood vessels such as veins and arteries. The instrument has a pair of jaws and a central cutting element displaceable distally and proximally to dissect tissue contained between the jaws.