Abstract: The devices and method described herein allow for therapeutic damage to increase volume in these hyperdynamic hearts to allow improved physiology and ventricular filling and to reduce diastolic filling pressure by making the ventricle less stiff.

Abstract: Structures for a bidirectional switch and methods of forming such structures. A substrate contact is formed in a trench defined in a substrate. A substrate includes a trench and a substrate contact in the trench. A bidirectional switch, which is on the substrate, includes a first source/drain electrode, a second source/drain electrode, an extension region between the first source/drain electrode and the second source/drain electrode, and a gate structure. A substrate-bias switch, which is on the substrate, includes a gate structure, a first source/drain electrode coupled to the substrate contact, a second source/drain electrode coupled to the first source/drain electrode of the bidirectional switch, and an extension region laterally between the gate structure and the first source/drain electrode.

Abstract: A device for treating tissue includes a catheter including an elongated body extending from a proximal end to a distal end and including a lumen extending therethrough, a distal tip connected to the distal end of the elongated body and including a first electrode and a second electrode extending thereabout, the first electrode extending to a distal opening of the lumen and a first needle extending longitudinally from a proximal end to a distal end, the first needle slidably received within the lumen of the catheter to be moved between a retracted bipolar configuration, in which the distal end of the needle is proximal the distal opening of the catheter, and an extended monopolar configuration, in which the distal end of the first needle extends distally past the distal opening of the catheter so that the first needle contacts the first electrode and is configured to cut tissue.

Abstract: A control device includes a processor configured to: execute a sealing control mode in which electrical power to seal a living tissue by heating the living tissue at a first temperature is supplied, and an incision control mode in which electrical power to incise the living tissue by heating the living tissue at a second temperature higher than the first temperature is supplied; calculate elapsed time, as an index value, since it has reached the second temperature by executing the incision control mode; compare the index value and a threshold; determine a residual heat level of an end effector based on a result of comparison between the index value and the threshold; and perform, based on a determination result of the residual heat level, at least one of: notification of information indicating a warning from a notifying unit; and adjustment of electrical power supplied to the end effector.

Abstract: An actuator for use in a surgical instrument, the actuator includes an upper portion configured to be actuated by one or more fingers, wherein the upper portion has an upper distal portion for operating the surgical instrument in a first mode of operation, and an upper proximal portion for operating the surgical instrument in a second mode of operation, and wherein the upper distal portion and the upper proximal portion have different respective tactile configurations for informing the user of the first and second modes of operation, respectively.

Abstract: An electrosurgical device having a pair of jaws, at least one electrode supported by one of the pair of jaws, and a polymer mat positioned in covering relation a portion of the at least one electrode. The polymer mat comprises a plurality of polymer fibers having an average width of between 1 and 100 micrometers. The polymer mat has a porosity of between 6E-10m2 and 2.5E-7m2. Between 10 and 90 percent of the electrode may be exposed.

Abstract: A catheter and catheter system may be used to treat disease tissue by gentle heating in combination with gentle or standard dilation. An elongate flexible catheter body with a radially expandable balloon having a plurality of electrodes engage tissue including diseased tissue when the structure expands.

Abstract: An electrosurgical forceps includes first and second shaft members pivotably coupled to one another via a pivot member such that pivoting of the first and second shaft members between spaced-apart and approximated positions pivots jaw members thereof between open and closed positions. A knife is translatable between retracted and extended positions. A knife deployment mechanism is operably coupled to the first shaft member and includes at least one trigger and at least one linkage coupling the at least one trigger with the knife such that pivoting of the at least one trigger relative to the first shaft member translates the knife between the retracted and extended positions. A knife lockout biased towards a locked position inhibits distal translation of the knife. The knife lockout is movable from the locked position to an unlocked position upon approximation of the jaw members to permit distal translation of the knife.

Abstract: Ablation systems, components thereof, and related methods are disclosed. An example ablation system may include a first ablation component including a first ablation component end effector configured to be positioned on a first side of a target tissue and a second ablation component including a second ablation component end effector configured to be positioned on a second side of the target tissue. The first ablation component may include a first ablation component permanent magnet that is translationally repositionable between an engaged configuration and a disengaged configuration. The second ablation component may include a second ablation component permanent magnet that is freely rotatable and is configured to rotatably self-orient into a magnetically attractive orientation with the first ablation component permanent magnet.

Abstract: A method of creating a native vessel bypass percutaneously includes steps of selecting a target procedural site adjacent to a paired artery and vein, usually near an occlusion or blockage disposed in the artery and advancing a catheter through the vein with its distal tip extending through the vessel walls into the adjacent artery. An anastomosis is formed by applying heat to tissue forming the vessel walls which is captured between surfaces on a proximal base and the distal tip of the catheter. The venous valves are disabled to permit retrograde venous flow of arterial blood, in order to bypass the arterial occlusion.

Abstract: System for increasing a target zone for electrical ablation includes a treatment control module executable by a processor. The control module directs a pulse generator to apply pre-conditioning pulses to subject tissue cells in a pre-conditioning zone to electroporation, the pre-conditioning zone being smaller than a target ablation zone. After the pre-conditioning pulses have been applied, the control module directs the pulse generator to apply treatment pulses to electrically ablate the tissue cells in the target ablation zone. The pre-conditioning pulses cause the pre-conditioning zone to have a much higher conductivity so that the zone acts as a larger electrode area when the treatment pulses are applied, which results in a much larger target ablation zone than otherwise possible.

Abstract: A medical device may include a handle having a handle lumen extending therethrough. The medical device further may include a first body shaft including a first body shaft lumen in direct communication with the handle lumen and an RF electrode tip may be positioned at a distal end of the first body shaft. The RF electrode tip may include a lumen extending therethrough and in direct communication with the lumen of the first body shaft. Additionally, an energy delivery wire may be electrically coupled with the RF electrode tip.

Abstract: An ultrapolar telescopic electrosurgery pencil that can be used in both monopolar and bipolar modes for cutting and coagulation. The ultrapolar telescopic electrosurgery pencil can operate at very low power levels (such as 15-20 Watts or less) to both cut and coagulate tissue thereby reducing patient risk and damage to tissue. An ultrapolar electrosurgery blade having a top, a bottom, opposing planar sides, a cutting edge, and a non-cutting end, an active electrode positioned on one of the opposing planar sides such that at least a portion of the opposing planar side is exposed near the cutting edge, and a return electrode positioned on the other opposing planar side such that at least a portion of the other opposing side is exposed near the cutting edge.

Abstract: A hemostatic sealer includes a handle having a switch to activate a source of thermal energy and a thermal assembly coupled to the handle. The thermal assembly includes an electrically resistive material disposed on an electrically insulative substrate. The resistive material is coupled to the switch to receive the source of thermal energy.

Abstract: A surgical instrument includes a shaft defining an axis, an end effector coupled to a distal portion thereof, a fixed handle coupled to a proximal portion thereof, a drive bar, a movable handle, and a linkage. The drive bar is disposed within the shaft and operably coupled to the end effector. The movable handle is movable relative to the fixed handle between open and closed positions and is coupled to the drive bar via a first pin on the axis. The linkage includes a first end portion coupled to the movable handle via a second pin and a second end portion coupled to the shaft via a third pin on the axis. In the closed position of the movable handle, the second pin is disposed in a near-over-center position relative to the axis to reduce a force necessary to maintain the movable handle in the closed position.

Abstract: A surgical assembly and system are disclosed. The system comprises a first generator for generating a first signal for use in generating an electrical field proximate a site of a surgical procedure for removing particles suspended proximate the surgical site. The assembly further comprises a surgical tool comprising a tool-piece communicatively couplable with the first generator and a second generator, the second generator being arranged to generate a second signal for use in cutting or cauterizing biological tissue of the patient during the surgical procedure, the assembly further comprising a switching assembly for switching the application of the first signal and second signal to the tool-piece and a controller for controlling the application of the first signal and second signal to the tool-piece.

Abstract: Ablation probes and methods of their use. Example probes include probe circuits configured to provide identifying information for the probe itself. The probe circuits may sense probe usage and/or age to determine probe end of life (EOL). In response to EOL, the probe circuit generates an output indicating EOL. The probe electronic circuit may also be configured to monitor probe usage via impedance or other features, independent of such operation by an ablation pulse generator.

Abstract: An electrosurgical instrument comprising a first arm carrying at least a first and optionally a second and third electrode, and a second arm opposing the first arm, the second arm carrying one of a nonconductor element or one or more conductive elements.

Abstract: A tool assembly for use with an electrosurgical device for cutting tissue includes a base portion, an electrical insulator extending distally from the base portion, a return lead adapted to be electrically coupled to a return terminal, and an active lead adapted to be electrically coupled to an active terminal. The return lead is movably supported on the electrical insulator. The active lead is fixed to the electrical insulator. The return lead is rotatable about a pivot and translatable along a longitudinal axis relative to the electrical insulator and the active lead. Upon activation, electrosurgical energy is transmitted from the active lead through tissue to the return lead to cut tissue in contact with the active lead.

Abstract: An electrosurgical device comprises an electrically conductive elongate member for traversing body vasculature defining a hollow lumen with one or more apertures at or near its distal end, wherein electrical energy can flow through the wall of the elongate member; and an energy delivery device in electrical communication with the elongate member is located distal to the end of the elongate member. The energy delivery device includes an electrode for delivering energy. Methods of using the electrosurgical device include cutting through occlusions and creating transseptal punctures.

Abstract: Described embodiments include an apparatus that includes a flexible electrically-insulating substrate, including an inner surface and an outer surface, and shaped to define (i) multiple narrower channels passing between the inner surface and the outer surface, and (ii) one or more wider channels passing between the inner surface and the outer surface. The apparatus further includes an outer layer of an electrically-conducting metal covering at least part of the outer surface, an inner layer of the electrically-conducting metal covering at least part of the inner surface, a plating layer of the electrically-conducting metal that plates the wider channels such as to connect the outer layer to the inner layer, and respective columns of the electrically-conducting metal that fill the narrower channels such as to connect the outer layer to the inner layer. Other embodiments are also described.

Abstract: Electrosurgery blades including electrosurgery blade assemblies having argon beam capability. The electrosurgery blade includes a non-conductive planar member having opposite planar sides and a sharp cutting tip and a conductive layer located on one or both of the opposing planar sides of the non-conductive layer. In embodiments of the electrosurgery blade assemblies having argon beam capability, the electrosurgery blade assembly includes a non-conductive tube member having a hollow tubular shaped opening and a slot where at least a portion of the conductive layer of the electrosurgery blade is positioned within the slot of the non-conductive tube member.

Abstract: A surgical end effector includes an anvil assembly; a cartridge assembly including a plurality of fasteners; a drive assembly movable longitudinally to approximate the anvil assembly relative to the cartridge assembly; and a strain gauge circuit disposed within the cartridge assembly, the strain gauge circuit configured to measure a strain imparted on the cartridge assembly by the drive assembly.

Abstract: An arthroscopic cutting probe includes an outer sleeve having a longitudinal bore and an outer cutting window at its distal end. The outer sleeve has a metal body electrically insulated over its exterior except for a portion at least partially surrounding the outer cutting window which comprises an active electrode. An inner sleeve is rotationally disposed in a bore of the outer sleeve, and the inner sleeve has a distal end, a proximal end and a longitudinal passageway having an electrically conductive inner surface which comprises a return electrode. A dielectric cutting member is attached to the distal end of the inner sleeve and has a central passage extending from an inner cutting window at its distal end to an opening at its proximal end.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: An electrosurgical system having an electrosurgical device, an accessory charging circuit, and an electrosurgical unit is disclosed. The electrosurgical device is operable in at least one of a monopolar mode and a bipolar mode. The electrosurgical unit electrically is coupled to the electrosurgical device and the accessory charging circuit. The electrosurgical unit provides one of a monopolar RF energy signal and a bipolar RF energy signal to the electrosurgical device corresponds with an activated mode and a bipolar signal to the accessory charging circuit.

Abstract: A surgical end effector may comprise first and second jaw members. The second jaw member may comprise an offset proximal supply electrode that is positioned to contact an opposing member of the first jaw member when the first and second jaw members are in the closed position. The second jaw member may also comprise a distal supply electrode that is positioned distal of the offset proximal electrode and is aligned with a conductive surface of the first jaw member when the first and second jaw members are in the closed position. When the first and second jaw members are in the closed position, the proximal supply electrode may be in contact with the opposing member and the distal supply electrode is not in contact with the conductive surface of the first jaw member.

Abstract: Apparatus and associated methods relate to controlling electrical power of an electrotherapeutic signal that is provided to a biological tissue engaged by an electrosurgical instrument during a medical procedure. Electrical power—a product of a voltage difference across and an electrical current conducted by the engaged biological tissue—is controlled according to a therapeutic schedule. The electrotherapeutic schedule can be reduced or terminated in response to a termination criterion being met. In some examples, the termination criterion is a current characteristic, such as, for example, a decrease in current conducted by the engaged biological tissue. In some examples, the termination criterion is a biological tissue resistance characteristic, such as, for example, an increase in the biological tissue resistance that exceeds a predetermined delta resistance value.

Abstract: A bipolar surgical instrument having a front region (3) with at least four coagulation elements (6, 7, 8, 9) entered in the slots at the at least four corners of a rectangle or at least four quarters of a circle of the insulation body (22) for coagulating and one cutting element at the centre of insulating body for cutting the tissue and/or vessel in the body, thereby having an at least five electrode arrangement for handling and treating the tissue and/or vessel. The cutting element (10) can be at least one blade or at least one needle and it can be fixed or moved longitudinally in an advanced position or retracted position.

Abstract: A surgical instrument system is disclosed comprising a handle, an elongate shaft selectively attachable to the handle, a battery pack replaceably attachable to the handle, and an end effector extending distally from the elongate shaft. In various instances, the battery pack comprises a power source couplable to the motor and a display. The elongate shaft comprises a processor and a memory couplable to the processor. In various instances, the memory comprises a control program which, when executed, causes the processor to initiate a desired function. In various instances, the end effector comprises a sensing circuit configured to detect a condition of the end effector. The sensing circuit is in signal communication with the processor.

Abstract: A method and apparatus are disclosed for a needle for gaining access to the pericardial cavity of a heart. The needle includes an elongate member (e.g. a main shaft) defining a lumen and a side-port in fluid communication with the lumen; a blunt atraumatic tip for delivering energy for puncturing tissue; and a guiding surface (e.g. a ramp) for directing a device (e.g. a guidewire) through the side-port. The method includes using the needle for tenting a pericardium and delivering energy for puncturing the pericardium, and advancing a guidewire or other device through the needle and into the pericardial cavity.

Abstract: A self-contained, battery powered transseptal crossing system is disclosed. An elongate, flexible electrically conductive needle body has a proximal end and a distal end. An insulation layer surrounds the sidewall and leaves exposed a distal electrode tip. A generator is configured to deliver RF energy to the electrode tip, and includes a processor configured to take impedance measurements at the tip to confirm contact with the intra atrial septum and/or confirm entry into the left atrium.

Abstract: A surgical instrument that comprises an end effector comprising a first jaw, a second jaw, a staple cartridge, and at least one electrode. The surgical instrument further comprises a drive member, a motor assembly, and a control circuit. The control circuit is configured to cause the at least one electrode to deliver a therapeutic energy to the tissue in a first phase of a surgical treatment, cause the motor assembly to move the drive member to deploy staples into the tissue in a second phase of the surgical treatment, monitor a first tissue property in the first phase, and switch from the first phase to the second phase if at least one of two conditions is met, set a parameter of the second phase based on at least one measurement of the tissue property determined in the first phase, and monitor a second tissue property, in the second phase.

Abstract: A forceps includes an instrument housing, an elongated shaft assembly extending distally from the instrument housing, and a rotation knob assembly. The rotation knob assembly is supported in the instrument housing and includes a rotation knob and an inner housing. The rotation knob is coupled to the shaft assembly and positioned to rotate about the inner housing to rotate the elongated shaft assembly relative to the instrument housing. The inner housing is coupled to the instrument housing and supports electrical contacts configured to transmit electrical energy through the rotation knob assembly.

Abstract: A cutting element for an electrosurgical device. The cutting element includes an elongate non-conductive body having a first face opposite a second face, the first face and the second face defining an edge there between. A conductive element is disposed only along the edge, the conductive element being configured to cut tissue with monopolar radiofrequency energy.

Abstract: An effector includes a tubular body having a proximal end and a distal end. The effector holds a plug or closure at the distal end of the tubular body; an active electrode at the distal end of the body; an insulator on the body; and one or more return electrodes on the insulator. The body dissipates heat generated by the one or more return electrodes from the distal end of the body to the proximal end of the body.

Abstract: An electrosurgical device having a pair of jaws, at least one electrode supported by one of the pair of jaws, and a sheet of expanded polytetrafluoroethylene positioned in covering relation to at least a portion of the at least one electrode. The sheet may have a porosity of between thirty and ninety percent. The sheet may have a plurality of pores with an average diameter of between 0.2 and 1.0 micrometers.

Abstract: An electrode assembly for use with an electrosurgical instrument includes a base portion, a return lead adapted to be electrically coupled to a return terminal of an electrosurgical generator, an electrical insulator supported on a distal portion of the return lead, a tensioning mechanism, and an active lead adapted to be electrically coupled to an active terminal of the electrosurgical generator. The tensioning mechanism includes a slider slidably disposed in the base portion, a rotation rod threadably coupled to the slider, and a spring proximally biasing the slider. The active lead having a first end portion securely fixed to the base portion and a second end portion slidably coupled to the rotation rod of the tensioning mechanism. A portion of the active lead extends around the electrical insulator. Rotation of the rotation rod causes axial displacement of the second end portion of the active lead to tension the active lead about the electrical insulator.

Abstract: A modular surgical instrument system that comprises modular components and a control circuit electrically couplable to the modular components. The modular components comprise a shaft and a handle assembly. The handle assembly comprises a disposable outer housing. The disposable outer housing is movable between an open configuration and a closed configuration. The handle assembly further comprises a control inner core receivable inside the disposable outer housing in the open configuration. The disposable outer housing is configured to isolate the control inner core in the closed configuration. The modular components further comprise a loading unit releasably couplable to the shaft and a staple cartridge releasably couplable to an end effector. The loading unit comprises the end effector.

Abstract: A cautery pen tip accessory cover comprises a cylindrical member that can receive a cautery pen in a first end and the tip of the cautery pen can extend from a second opposite end when the cover is in a retracted configuration. The cylindrical member has an opened lateral exposure that allows the feel of the cautery pen therethrough. A cover exposure opening in the cylindrical member to provide access to a trigger of the cautery pen when the cautery pen tip cover is in the retracted configuration. A resilient member urges the cautery pen tip cover to the non-retracted configuration where access to the cautery pen trigger is prevented. The cylindrical member is easily retracted by a finger ring configured permanently into the cylindrical member, allowing easy retraction of the cover by the operator squeezing the cover to a resistance bar stabilization system accessory configured over the cautery pen.

Abstract: A catheter ablation system includes: a catheter probe having distal end including: a temperature sensor; a plurality of irrigation holes; and an ablating electrode; a radiofrequency (RF) heating controller coupled to the catheter probe and configured to supply RF energy to the ablating electrode to control the ablating electrode to emit heat at a target power; an irrigation controller coupled to the catheter probe and configured to supply an irrigation fluid at a continuously adjustable irrigation flow rate through the catheter probe to exit through the irrigation holes; and an operating console having a processor and memory, the memory storing instructions that, when executed by the processor, cause the processor to control the irrigation controller to set the irrigation flow rate based on the target power and a target average temperature.

Abstract: A catheter device for renal denervation ablation includes a flexible catheter shaft having an electrically insulating expandable member in its distal portion with at least one electrode located proximal to the member, at least one electrode located distal to the member, and with openings in the distal shaft with at least one opening proximal to the proximal electrode and one opening distal to the distal electrode of said electrode pair, said openings connected through an inner lumen in the catheter that provides a path for blood to flow through the expandable member. In one embodiment, the device comprises a flexible catheter shaft with a multiplicity of recessed paired electrodes disposed in recessed spaces in its distal portion, such that an electrically conducting portion of each electrode is exposed to the exterior of the catheter within a recessed space, and with an electrical insulator separating the electrodes of each pair.

Abstract: An ultrapolar telescopic electrosurgery pencil that can be used in both monopolar and bipolar modes for cutting and coagulation. The ultrapolar telescopic electrosurgery pencil can operate at very low power levels (such as 15-20 Watts or less) to both cut and coagulate tissue thereby reducing patient risk and damage to tissue.

Abstract: A surgical end effector may comprise first and second jaw members. The second jaw member may comprise an offset proximal supply electrode that is positioned to contact an opposing member of the first jaw member when the first and second jaw members are in the closed position. The second jaw member may also comprise a distal supply electrode that is positioned distal of the offset proximal electrode and is aligned with a conductive surface of the first jaw member when the first and second jaw members are in the closed position. When the first and second jaw members are in the closed position, the proximal supply electrode may be in contact with the opposing member and the distal supply electrode is not in contact with the conductive surface of the first jaw member.

Abstract: An electrosurgical instrument (1) includes a first shaft member (110) pivotably coupled to a second shaft member (120), and a trigger (184) disposed on the second shaft member (120). The first and second shaft members (110,120) respectively include first and second handle members (130,140), and first and second jaw members (150,160). The first and second shaft members (110,120) define a longitudinal axis extending through a pivot, and first and second pivot axes that are substantially orthogonal to each other and the longitudinal axis. At least one of the first or second handle members (130,140) is pivotable about the first pivot axis to move the first and second jaw members (150,160) to an open position, a grasping position, or a sealing position. The trigger (184) is movable to pivot at least one of the first or second shaft members (110,120) about the second pivot axis to laterally displace the first and second jaw members (150,160) relative to each other to a cutting position.

Abstract: A device for treating tissue includes a catheter including an elongated body extending from a proximal end to a distal end and including a lumen extending therethrough, a distal tip connected to the distal end of the elongated body and including a first electrode and a second electrode extending thereabout, the first electrode extending to a distal opening of the lumen and a first needle extending longitudinally from a proximal end to a distal end, the first needle slidably received within the lumen of the catheter to be moved between a retracted bipolar configuration, in which the distal end of the needle is proximal the distal opening of the catheter, and an extended monopolar configuration, in which the distal end of the first needle extends distally past the distal opening of the catheter so that the first needle contacts the first electrode and is configured to cut tissue.

Abstract: An arthroscopic system includes a hand piece with a motor drive. an elongate shaft assembly is detachably secured to a distal end of the hand piece, and the elongate shaft assembly includes an outer sleeve and an inner sleeve rotatably mounted in the outer sleeve. The inner sleeve couples to the motor drive when the elongate shaft assembly is attached to the hand piece, and an inner distal cutting window on the inner sleeve moves in and out of alignment with an outer distal cutting window on the outer sleeve as the motor drive rotates the inner sleeve.

Abstract: In general, systems, methods, and devices for electrosurgical devices with monopolar and bipolar functionality are provided. In an exemplary embodiment, a surgical device can have bipolar functionality, in which tissue engaged by the device is treated in a bipolar energy delivery mode, and can have monopolar functionality in which tissue engaged by the device is treated in a monopolar energy delivery mode.

Abstract: A surgical instrument end effector assembly includes a first jaw member and a second jaw member. The second jaw member includes an ultrasonic blade body and first and second electrodes disposed on either side of the ultrasonic blade body and extending longitudinally along a majority of a length of the ultrasonic blade body. The ultrasonic blade body is adapted to receive ultrasonic energy from an ultrasonic waveguide. The first and second electrodes taper in width proximally to distally and are adapted to connect to a source of electrosurgical energy. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween.

Abstract: A treatment system comprises a treatment tool and an energy source apparatus is used to electrically communicate with the treatment tool. The energy output source is configured to output high-frequency electric power to the bipolar electrodes so as to cause a high-frequency current to flow through a treatment target between the bipolar electrodes. A processor is used to control the energy output source. The processor performs an output control process on the heater electric power so that the heater reaches a target temperature and maintains at the target temperature. The processor detects a parameter related to the heater from the heater in the output control process based on the target temperature. The processor sets a threshold value used to determine to stop or to lower the output to the bipolar electrodes while the treatment target is being modified by the high-frequency current applied thereto based on the detected parameter.