Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention includes a channeling technique in which small holes or channels are formed within tissue structures in the mouth, such as the tonsils, tongue, palate and uvula, and thermal energy is applied to the tissue surface immediately surrounding these holes or channels to cause thermal damage to the tissue surface, thereby stiffening the surrounding tissue structure. Applicant has discovered that such stiffening of certain tissue structures in the mouth and throat helps to prevent the tissue structure from obstructing the patient's upper airway during sleep.

Abstract: A left atrium ablation catheter (4), including a sheath (8) and a deflectable electrophysiology catheter (10) housed within the sheath, is used to ablate coronary tissue at a target site within the left atrium (LA) of a heart. The electrophysiology catheter has ablation electrodes (24) along the tip (10). The ablation catheter is introduced into the right atrium (RA) through either the superior vena cava (SVC) or the inferior vena cava (IVC). The distal open end of the sheath is guided through a punctured hole in the interatrial septum and into the left atrium. The distal end (20) of the sheath is either precurved or is steerable so the electrode tip can be directed to the coronary target site in the left atrium. The electrode tip is sized and configured to create the desired lesion at the target site without movement of the electrode tip.

Abstract: A device and method for treating collapsed bronchial tubes found in patients with chronic obstructive pulmonary disease and asthma are provided. The device includes an elongated member having a heating element that includes one or more energy delivery members. The method includes heating the bronchial tube to cause the wall of the tube to undergo a structural transformation similar to scarring whereby new connective tissue is formed. The procedure effectively reinforces the structural integrity of the wall and thereby prevents the lumen from collapsing.

Abstract: A method for inhibiting the restenosis of blood vessel walls after angioplasty, including the application of low grade heat to the vessel walls. A heat applying perfusion catheter is advanced to a recently dilated vessel region. Heat is applied to the region walls to inhibit restenosis. A preferred temperature range is from 42 to 45 degrees C. A preferred time period for treatment is from 3 to 6 minutes. A perfusion catheter allows longer heat treatment times. Electrical resistance heat, radio frequency current passage through inflation fluid, and microwave radiation are all heat sources within the scope of the invention.

Abstract: A catheter for use in an electrophysiological procedure to ablate a site includes a metallic tip having a first work function and energized by a source of RF energy. The RF energy return path is through a relatively large plate of a metallic material having a second work function and disposed at a location removed from the ablation site. The difference in work functions of the tip and the plate, operating in the presence of an electrolyte represented by the intermediate tissue, produces an exchange of electrical charges through chemical reaction to create a galvanic cell. By loading the galvanic cell with a shunt resistor, it becomes a current source providing a current linear with and highly dependent on the tissue temperature at the ablation site. This accurate representation of the tissue temperature at the ablation site is used to regulate the RF energy applied to maintain the tissue at the ablation site at a predetermined temperature during the ablation procedure.

Abstract: Electrode assemblies and associated systems employ a nonporous wall having an exterior for contacting tissue. The exterior peripherally surrounds an interior area. The wall is essentially free of electrically conductive material. The wall is adapted to assume an expanded geometry having a first maximum diameter and a collapsed geometry having a second maximum diameter less than the first maximum diameter. The assemblies and systems include a lumen that conveys a medium containing ions into the interior area. An element free of physical contact with the wall couples the medium within the interior area to a source of electrical energy to enable ionic transport of electrical energy from the source through the medium to the wall for capacitive coupling to tissue contacting the exterior of the wall.

Abstract: Methods and apparatus are provided for an achieving low-rate collagen shrinkage using an electrode array comprising an elongated insulator strip having at least one pair of spaced-apart bi-polar RF electrodes, and a “channeling” disposed on the strip between the bi-polar electrodes to direct the flow of RF current therebetween. The channeling electrode is not directly coupled to the RF power source, but only indirectly through the tissue in contact with the channeling electrode. The apparatus enables low RF power levels (e.g., 0.5 watts to 25 watts) to be applied over time intervals of 5 seconds to 180 seconds to attain low-rate collagen shrinkage by directing or focusing the path of the RF current.

Abstract: An electrophysiology energy treatment system for treating tissues within a patient's body with RF energy comprises an elongate catheter tube having a distal end, with a porous member thereon, insertable into the patient's body. An RF electrode is within the catheter tube adjacent the distal end and locatable within the patient's body, and an electrolyte fluid flows within the catheter tube for electrically connecting the electrode to the tissues to be treated within the patient's body.

Abstract: A biopsy sampling system and method for aspirating bone marrow and bone cores from a patient with minimal or no perceived pain to the patient. The system includes a bone aspiration needle assembly having a handle and an electrically conductive needle shaft and an electrical nerve stimulator (ENS) which supplies a current of adjustable intensity to the needle shaft. Thus, when the aspirating needle is inserted into the bone marrow cavity of the patient, the stimulator is activated to anesthetize the nerves in the vicinity of the aspiration permitting the extraction to commence with little or no increased pain to the patient. A nonconducting insulating shaft is also disclosed to be placed on the needle shaft in order direct the ENS current to the area of the shaft that can most efficiently anesthetize the pain conducting nerves, i.e. to the tip of the needle shaft.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention includes a channeling technique in which small holes or channels are formed within tissue structures in the mouth, such as the tonsils, tongue, palate and uvula, and thermal energy is applied to the tissue surface immediately surrounding these holes or channels to cause thermal damage to the tissue surface, thereby stiffening the surrounding tissue structure. Applicant has discovered that such stiffening of certain tissue structures in the mouth and throat helps to prevent the tissue structure from obstructing the patient's upper airway during sleep.

Abstract: A dual curve ablation catheter (2), especially suited for treating atrial flutter, includes a shaft (4) with a deflectable tip (20) at the distal end (6) and a handle (10) at the proximal end (8). The tip includes a highly flexible distal segment (30), a relatively stiff intermediate segment (28) and a flexible proximal segment (26) so that pulling on a manipulator wire (16) attached to the distal segment causes the distal segment to curve and engage, for example, an isthmus of tissue (106) adjacent the tricuspid valve (104) and the inferior vena cava (98) and causes the proximal segment to curve and press against the wall (110) of the inferior vena cava so to stabilize the catheter. Ablation energy can be supplied through the ablation electrodes (48, 68) simultaneously or one at a time to ablate tissue at the isthmus without the need for moving the catheter.

Abstract: The invention relates generally to methods and apparatus for inducing hypothermia in an animal. Known methods for inducing hypothermia all involve cooling the outside or inside of an animal, sometimes in conjuction with drugs that disable the animal's homeostatic responses. The present invention is directed to a method and apparatus for applying heat to the hypothalamus of a warm-blooded animal in order to utilize the physiological mechanisms that regulate body temperature to effect a compensatory cooling response, thereby lowering body temperature. It is new and unsuggested in the art to apply heat in an effort to reduce body temperature.

Abstract: This invention provides for an apparatus and method to cause a stricture in a body passageway. For example, urinary incontinence and vesicoureteral reflux can be treated by inserting an energy-delivering probe into the body passageway of the urinary tract and applying energy to an arcuate segment of the wall of the body passageway to cause injury to the wall, hyperplasia of the tissue surrounding the wall, and stricture of the body passageway. Other applications for the apparatus and method of the present invention includes treatment of gastro-esophageal reflux and fecal incontinence.

Abstract: The invention provides improved devices, methods, and systems for repeatably and reliably contracting fascia and other support tissues, particularly for the treatment of urinary incontinence. Rather than relying on a surgeon's ability to observe, direct, and control the selective shrinking of pelvic support tissues, a relatively large surface of a tissue contraction system is placed statically against the target tissue. Sufficient controlled energy is transmitted from the surface into the engaged tissue to contract the tissue and inhibit incontinence (or otherwise provide the desired therapeutic results).

Abstract: A surgical device including a relatively short shaft, a bendable spline assembly associated with the distal end of the shaft and having a predetermined configuration, the spline assembly being adapted to collapse in response to an application of an external force and to expand to the predetermined configuration in response to a withdrawal of the external force, and an operative element associated with the bendable spline assembly.

Abstract: A medical needle or cannula for stimulation or ablation includes a rigid bent tip for simplified placement at target sites within a patient's anatomy. The curved tip or shaft is used to steer the device within the patient's body and to avoid critical anatomical structures. The device is partially insulated and has a tip that is at least partially electrically exposed; a connection to an external signal generator provides electrical stimulation or high-frequency heating of the patient's tissue proximal to the exposed tip. The device includes a longitudinal passage to facilitate the injection of fluids or the insertion of instruments through the cannula or needle.

Abstract: A catheter capable of both sensing myocardial electrical activity and delivering ablating energy within myocardial tissue is disclosed. The catheter comprises electrodes on the outer sheath and contains a movable fiber optic cable that can be percutaneously advanced beyond the catheter body and into the myocardium for myocardial heating and coagulation, or modification of tissues responsible for cardiac arrhythmias. The fiber optic tip is designed to diffuse ablating energy radially to ablate a larger volume of tissue than is possible with a bare fiber optic tip. In addition, the tip is treated so that energy is not propagated in a forward direction, thus helping to prevent unwanted perforation of the heart tissue. Also disclosed is a method of cardioprotection from ischemia comprising inducing local hyperthermia in heart tissue.

Abstract: A collapsible electrode catheter assembly (10) having a delivery system (12) for controlling a catheter guide tube (16) having a catheter distal end assembly (22) thereon. The catheter distal end assembly (22) has an electrode structure (28) on an expanding assembly (34) for enlarging the electrode structure (28) in an expanded condition. A balloon structure (48) is used to expand and contract the expanding assembly (34) when an inflation medium (64) is alternately introduced into and withdrawn from the balloon structure (48).

Abstract: A surgical method and apparatus for positioning a diagnostic or therapeutic element within the body. The apparatus may be catheter-based or a probe including a relatively short shaft.

Abstract: The invention provides improved devices, methods, and systems for repeatably and reliably contracting fascia and other support tissues, particularly for the treatment of urinary incontinence. A probe surface includes at least one heating element with a heating area and at least one cooling element with a cooling area. The heating and cooling areas are interspersed along the probe surface so as to produce alternating heated and cooled regions across a tissue engaged by the probe. Sufficient controlled energy is transmitted from the surface into the engaged tissue to contract the tissue and inhibit incontinence (or otherwise provide the desired therapeutic results). The interspersed cooling element helps decrease trauma to the tissue for a given amount of shrinkage.

Abstract: A therapeutic device utilizes a flexible circuit board for generating heat in localized dermal areas. A source of power such as a battery is operably connected to the flexible circuit board. A pulse width modulator is interposed the source of energy and the circuit board to control the amount of heat generated thereby. The therapeutic device may be used conjointly with an adhesive bandage strip or gauze pad to absorb any body fluids secreted by the user in response to the heat generated by the device such as by a dermal eruption or the like.

Abstract: An electrode catheter for cardiac electrophysiology is provided. An elongated body suitable for intravascular insertion and forming an axial lumen is provided. A tip electrode defines an axial hole extending inward from a distal end of the tip electrode and is directly mounted to a distal end of the elongated body on a proximal end of the tip electrode. An eye electrode is located within the axial hole substantially concentric to and electrically insulated from the tip electrode. Electrode lead wires run through the axial lumen. One of the electrode lead wires is electrically connected to the eye electrode and another of the electrode lead wires is electrically connected to the tip electrode.

Abstract: An ablation apparatus for treating tissues, tubular organs, or atherosclerosis of a blood vessel of a patient having an implanted medical stent, the ablation apparatus comprising a catheter shaft having a retracable preshaped electrode means at the distal end of the catheter shaft, the electrode means having a plurality of expandable/collapsible wire members adapted for contacting the wire members to the stent and applying RF current to treat the tissues underlying the stent for therapeutic purposes.

Abstract: An ablation system for ablating cardiac tissue within a chamber of the human heart including a guiding introducer system, a rail, one end of which is contained within the guiding introducer system, and an ablation catheter system which is supported by the guiding introducer system. The guiding introducer system may be a single or multiple guiding introducers. The ablation system may include a slotted sheath which passes over the rail which supports the ablation catheter. A process is disclosed for ablation of cardiac tissue to form a linear lesion utilizing a rail catheter ablation and mapping system which includes a guiding introducer, a rail and an ablation catheter system advanced over the rail.

Abstract: An externally guidable intervertebral disc apparatus manipulates disc tissue at a selected location of an intervertebral disc. The apparatus comprises a catheter having a distal end, a proximal end and a longitudinal axis. The catheter has an intradiscal section at its distal end. The intradiscal section is extendible into the disc, has sufficient rigidity to be advanceable through the nucleus pulposus and around the annulus fibrosus of the disc under a force applied longitudinally to the proximal end, has sufficient flexibility in a direction of the disc plane to be compliant with the inner wall, and has insufficient penetration ability to be advanceable out through the annulus fibrosus under the applied force. A thermal energy delivery device is located in the intradiscal section for preferentially heating the selected location of the disc. The apparatus is used to locally and controllably heat but not char or burn tissue in a disc. Such heat shrinks the collagen component.

Abstract: A multi-electrode probe for use with a catheter in an electrophysiological procedure to map and to ablate any of several tissue sites without repositioning the probe includes at least a plurality of electrodes, such as a tip and metallic rings, less than all of the electrodes has a first work function and are selectively energized by a source of RF energy. The RF energy return path is through a further electrode(s) of a metallic material having a second work function and disposed at a tissue location removed from the ablation site. After the sites have been mapped and one or more sites are selected for ablation, the selected site(s) is ablated prior to any repositioning of the probe. Regulation of the temperature at the ablation site(s) is achieved by sensing the temperature dependent current of a galvanic cell created by the tissue between the energized tip/ring and the further electrode due to their different work functions.

Abstract: An apparatus for ablating body tissue, and particularly for creating linear lesions within a chamber of a patient's heart, includes an elongate member having an ablation section. The ablation section includes an infusion tube and a plurality of spaced electrodes. The infusion tube and electrodes are covered by a fluid permeable foam material, and the foam material is covered by a fluid impermeable covering having a plurality of holes formed in it. During use, the ablation section is positioned against tissue to be ablated. Radiofrequency energy is delivered to he electrodes while saline or other conductive fluid is delivered to the infusion tube. The fluid exits the infusion tube at the ablation section, contacts the electrodes, and carries RF energy from the electrodes through the foam, through the holes in the covering and into contact with the body tissue to form a burn in the body tissue.

Abstract: During an ablation procedure in a chamber of the heart RF energy is used to form a myocardial lesion for treatment of some arrhythmias such as sustained supraventricular tachycardia and accessory pathways. A galvanic cell, formed by a metallic electrode having a first work function at the ablation site, a second metallic electrode having a second work function located remote from the ablation site and the intervening tissue serving as an electrolyte, produces an output current signal reflective of the formation of a lesion at the ablation site and is used to control the RF energy applied. A curve depicting the output current signal has a maximum value at the point a burn or lesion begins and thereafter begins to decrease in value. A short duration inflection or bump of the curve occurs prior to charring and carbonization of the lesion and predicts lesion formation of a sufficient depth. Thereafter, RF energy should no longer be applied to prevent unnecessary damage to the myocardial tissue.

Abstract: An ablation apparatus system for treating tissues in a patient, the ablation apparatus comprising temperature sensing means for measuring a temperature, wherein said temperature sensing means comprises a temperature sensing probe and at least one temperature sensing wire secured to the temperature sensing probe; force measuring means for measuring force exerted onto the temperature sensing probe by a tissue; and RF current generating means for generating RF current, wherein the RF current generating means is connected to and controlled by the temperature sensing means and force measuring means, adapted for supplying RF current to the temperature sensing probe as an electrode for tissue treatment.

Abstract: Electrode structures are formed from flexible, porous, or woven materials. One such structure is made by forming first and second body sections, each including a peripheral edge. The first and second body sections are joined together about their peripheral edges with a seam, thereby forming a composite structure. Another one of such structures is made by forming a body having a three dimensional shape and opposite open ends, and at least partially closing at least one of the opposite ends by forming a seam. Another one of such structures is formed from a sheet of material having peripheral edges. The sheet is placed on the distal end of a fixture, while the peripheral edges of the sheet are gathered about the proximal end of a fixture, thereby imparting to the sheet a desired shape. At least one pleat is formed to secure the gathered peripheral edges together. The seams or pleats are formed by thermal bonding, or ultrasonic welding, or laser welding, or adhesive bonding, or sewing.

Abstract: A cardiac ablation catheter has an energy emitting surface for thermally destroying tissue. The surface normally presents a compact, low profile for introduction into the heart. Once introduced, the energy emitting surface can be significantly enlarged. The enlarged surface emits ablation energy sufficient to create a lesion that is significantly larger in terms of volume and geometry than the surface's initial low profile would provide.

Abstract: The invention provides exemplary electrosurgical probes and methods for their use. In one exemplary embodiment, an electrosurgical probe comprises a probe body having a proximal end, a distal end and at least one lumen. An electrode assembly is operably coupled to the distal end. The electrode assembly includes an electrode and a jacket disposed to cover at least a portion of the electrode. The jacket and the electrode have a combined mass sufficient to dissipate heat during operation of the electrode so that the electrode does not experience material degradation. Further, the jacket provides insulation between the electrode and a conductive medium such that the electrode is operable in the conductive medium.

Abstract: A device and method for treating collapsed bronchial tubes found in patients with chronic obstructive pulmonary disease and asthma are provided. The device which has a balloon at a distal end delivers energy so that the tissue is indirectly, i.e., conductively, heated by contact with a heated surface of the balloon which has been in turn heated by a heated fluid. The method includes heating the bronchial tube to cause at least a portion of the cross links of the collagen in the wall to unlink/open and subsequently form new cross links after the collagen fibers have realigned. The procedure effectively reinforces the structural integrity of the wall and thereby prevents the lumen from collapsing.

Abstract: A catheter assembly comprising a elongated, flexible support structure having an axis. The assembly also includes an elongated porous electrode assembly carried by the support structure along the axis for contact with tissue. The elongated porous electrode assembly comprises a wall having an exterior peripherally surrounding an interior area, a lumen to convey a medium containing ions into the interior area, and an element coupling the medium within the interior area to a source of electrical energy. At least a portion of the wall comprising a porous material is sized to allow passage of ions contained in the medium to thereby enable ionic transport of electrical energy through the porous material to the exterior of the wall to form a continuous elongated lesion pattern in tissue contacted by the wall. The support structure can have a curvilinear geometry, e.g., a loop shape, and the elongated porous electrode assembly conforms to the curvilinear geometry.

Abstract: An externally guidable intervertebral disc apparatus manipulates tissue at a selected location of an intervertebral disc. The apparatus comprises a catheter having a distal end, a proximal end and a longitudinal axis, the catheter having an intradiscal section at the distal end of the catheter, the intradiscal section being extendible into the disc. The intradiscal section has sufficient rigidity to be advanceable through a nucleus pulposus and around an inner wall of an annulus fibrosus under a force applied longitudinally to the proximal end, sufficient flexibility in a direction of a disc plane to be compliant with the inner wall, but insufficient penetration ability to be advanceable out through the annulus fibrosus under the force. The apparatus also has an electromagnetic energy device located at the intradiscal section. Methods of using the apparatus are also provided.

Abstract: Systems and methods for heating or ablating tissue use a porous electrode. The porous electrode comprises a wall having an interior area that contains an electrically conductive element. At least a portion of the wall comprises a porous material sized to block passage of blood cells while passing ions. The systems and methods position the porous electrode in contact with tissue. The systems and methods couple the electrically conductive element to a source of electrical energy. The systems and methods convey a fluid medium containing ions into the interior area to enable ionic transfer of electrical energy from the electrical conducting element through the fluid medium and porous material to ablate tissue. The systems and methods also specify differing electrical resistivities for the porous material based, at least in part, upon achieving differing desired tissue heating or ablation effects.

Abstract: A thermal energy delivery apparatus has a probe including a distal end and a proximal end. A first electrode is positioned at the distal end of the probe such that the electrode is positioned on a recessed longitudinal portion of the probe. The first electrode is configured to deliver sufficient thermal energy to a fibrillated cartilage surface to reduce a level of fibrillation of the fibrillated cartilage surface. A cabling is coupled to the proximal end of the probe.

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 catheter for ablating and/or mapping tissue on the inner wall of a blood vessel, including a body portion and a tip portion having a proximal section and a distal section, the proximal section including a proximal ablation electrode and a proximal mapping electrode and the distal section including a distal ablation electrode and a distal mapping electrode, wherein the tip portion is deflectable from a first, generally straight, configuration in which the proximal and distal sections are substantially co-linear to a second, J-shaped, configuration in which the proximal and distal sections are generally parallel with a separation therebetween substantially corresponding to the inside diameter of the blood vessel.

Abstract: An intravascular device for the formation of linear lesions which has particular utility in the treatment of atrial fibrillation and flutter. The intravascular device has an outer delivery sheath with a distal section which has an elongated opening and a support member coextending with the opening. An EP device having a plurality of electrodes on its distal portion is slidably disposed within the inner lumen of the delivery sheath but it is secured by its distal end within the distal extremity of the delivery sheath at least while in operation. In this manner an axial force in the distal direction on the proximal extremity of the EP device, which extends out of the patient during the procedure, will cause the distal portion of the EP device to arch outwardly out of and away from the distal section of the delivery shaft and engage the surface of the patient's heart chamber. High frequency, e.g.

Abstract: An Rf energy applicator with a working end that carries a bi-polar Rf electrode system for creating a Rf-tissue interaction or ionothermal effect in subsurface tissue (a first ionothermal system) which effect is focused by concurrent actuation of a photonic tissue-sensitizing system or photoconductance system (a second ionothermal system). The photonic energy system is adapted to create a "lens electrode" in subsurface tissue that enhances the targeted tissue's conductance of Rf current which serves as a means of focusing Rf ionothermal effects at a subsurface level. A dosimetry control system is provided that controls the dose and timing of Rf energy delivery as well as the dosimetry of photonic energy delivery. The ionothermal applicator has a handle portion coupled a tubular extending member. The distal termination of the probe has at least one pair of opposing conductive electrodes in a spaced relationship around a perimeter of the distal termination of the extending member.

Abstract: Systems and associated methods for ablating body tissue employ an electrode for contacting tissue to form a tissue-electrode interface. The electrode is adapted to be connected to a source of ablation energy to conduct ablation energy for transmission by the electrode into tissue at the tissue-electrode interface. The systems and methods also include an element to cool the electrode. The systems and methods hold a tissue temperature sensing element in a carrier in thermal conductive contact with tissue beneath the tissue-electrode interface. The systems and methods include a controller that is coupled to the tissue temperature sensing element to control either the supply of ablation energy, or the rate at which the electrode is cooled, or both based, at least in part, upon temperature sensed by the temperature sensing element.

Abstract: A probe system for volumetric tissue heating and ablation comprises a cannula having a multiple electrode component reciprocatably mounted therein. Individual electrodes within the array have spring memory so that they assume a radially outward, arcuate configuration as they are advanced distally from the cannula. Preferably, the electrodes fully evert as they are advanced from the cannula. Prior to deployment, the electrodes are constrained within a lumen of the cannula. The electrodes are maintained with a uniform circumferential spacing by confining them within an annular envelope defined by a core member within the cannula lumen, by providing electrodes having asymmetric cross-sectional geometries, and/or by nesting the electrodes closely together. Optionally, a cutting current may be applied to the electrodes as they are advanced.

Abstract: An improved method and apparatus for facilitating removal of fat from obese, or lipodystrophic patients, by external application of electromagnetic energy. After infiltrating the proposed zone with intumescing solution, radio frequency or microwave electromagnetic energy is applied via externally placed applicators to the body site of unwanted fatty tissue. The electromagnetic energy supplies heat to the fatty tissue and to the intumescing solution, aiding in subsequent fat removal by conventional, or preferably, ultrasound-assisted, or microwave-assisted, internal liposuction. Depth of tissue penetration is controllable by selection of the appropriate electromagnetic frequency and by varying the configuration of the applicators. Restricting the intumescing procedure to only the desired body sites subject to subsequent internal surgical intervention reduces unwanted heating of the underlying muscle or other organs. Multiple-frequency capability is incorporated in the power supply.

Abstract: A sterilization device (10) is provided having a flexible housing element (12) that is smaller in diameter than the diameter of the lumen of the isthmic portion of the fallopian tube, a heating element (14) carried by the housing element adjacent to its distal end, and an energy source (18) coupled to the heating element such that when the energy source is energized the temperature of the heating element will be increased. A procedure is described for inserting the sterilization device (10) through the uterus and into the isthmic portion of the fallopian tube where the heating element (14) is energized and the heat generated destroys the mucosal layer and damages the muscular layer of the fallopian tube wall inducing sufficient scarification to occlude the fallopian tube.

Abstract: An endometrial ablation apparatus and method wherein an RF current having a frequency of between 250 kHz and 100 MHz is passed through the entire surface of an endometrium in order to provide heating of the endometrium. An electroconductive expandable member such as a balloon is used as the medium for passing the current and causing the heating of the endometrium. The temperature of the endometrium is raised to a temperature between 45.degree. C. and 90.degree. C. and preferably not above 70 for a time sufficient to destroy the cells of the lining while maintaining the average temperature of the myometrium at a temperature below approximately 42.degree. C. The expandable balloon is connected to a power source which provides the radio frequency power having the desired characteristics to selectively heat the endometrial lining to the desired temperature.

Abstract: A catheter for use in an electrophysiological procedure to ablate a site includes a first electrode having a first work function and energized by a source of RF energy. A second electrode having a second work function is disposed adjacent tissue. The difference in work functions of the first and second electrodes, operating in the presence of an electrolyte represented by intermediate tissue, produces an exchange of electrical charges through chemical reaction to create a galvanic cell. The galvanic cell serves as a current source to provide a unique electrode signal used to regulate the RF energy applied to the first electrode.

Abstract: Apparatus for being held by the human hand for performing refractive keratectomy on the eye of a patient by the use of radio frequency energy from a radio frequency generator. An elongate probe has proximal and distal extremities. The proximal extremity is sized to be grasped by a human hand. The elongate probe has a length so that the distal extremity can be held in close proximity to the cornea while the proximal extremity is held by the human hand. An energy delivery member is carried by the distal extremity. Conductors are carried by the elongate probe for conducting radio frequency from the generator to the energy delivery member. A dispersive member is carried by the energy delivery member for dispersing the radio frequency energy from the energy delivery member and applies the energy to the cornea to remove a portion of said cornea in order to reshape the cornea and improve vision.

Abstract: The invention provides improved devices, methods, and systems for shrinking of collagenated tissues, particularly for treating urinary incontinence in a noninvasive manner by directing energy to a patient's own support tissues. This energy gently heats fascia and other collagenated support tissues, causing them to contract. The energy will preferably be applied between a pair of large plate electrodes having cooled flat electrode surfaces. Such cooled plate electrodes are capable of directing electrical energy through an intermediate tissue and into fascia while the cooled electrode surface prevents injury to the intermediate tissue. Ideally, the plate electrode comprises an electrode array including discrete electrode surface segments so that the current flux can be varied to selectively target the fascia.

Abstract: Systems and methods for ablating body tissue use an ablation element for contacting tissue to form a tissue interface. The ablation element is adapted to be connected to a source of ablation energy to conduct ablation energy for transmission by the ablation element into tissue at the tissue interface. The systems and methods include a tissue temperature sensing element held in a carrier in thermal conductive contact with tissue beneath the tissue interface. A mechanism attached to the carrier selectively advances the carrier relative to the ablation element to different depths beneath the tissue interface. A controller is coupled to the mechanism and to the tissue temperature sensing element to control advancement of the carrier beneath the tissue interface based, at least in part, upon tissue temperatures sensed by the sensing element beneath the tissue interface. Preferably, the controller controls the mechanism to locate the sensing element at the depth where the hottest sensed tissue temperature exists.