Cooled Laser Fiber for Improved Thermal Therapy

In one embodiment, the disclosure is directed to an integrated apparatus for delivering energy to a tissue. The integrated apparatus included a housing having a distal end and a tubular structure located within the housing forming a first annulus between the tubular structure and the housing. The tubular structure is configured to accept an energy delivery component and is configured to form a second annulus between the tubular structure and the energy delivery component. The first annulus and the second annulus are configured to communicate with each other proximate to the distal end of the housing.

Renal nerve modulation devices

Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a renal nerve modulation device. The renal nerve modulation device may include an elongate shaft. A balloon may be coupled to the shaft. The balloon may have a hydrophilic electrode region. A flexible electrode may be coupled to the shaft and may be disposed within the balloon. The flexible electrode may have a plurality of openings formed therein.

Ultrasonic cutting blade with cooling liquid conduction

An ultrasonic surgical tool has probe body with an operative surface or edge contactable with organic tissues for performing a surgical operation on the tissues. A shank of the probe body is provided with a connector for operatively attaching the tool to a source of ultrasonic mechanical vibrational energy. The shank and a portion of the probe body are formed with a channel for fluid delivery to the probe body. At least a portion of the probe body located between the channel and the operative surface or edge has a microporous or sintered structure enabling fluid penetration to the operative surface or edge from the channel.

ENHANCED ABLATION AND MAPPING CATHETER AND METHOD FOR TREATING ATRIAL FIBRILLATION

A catheter for ablating tissue is provided. The catheter comprises an elongated generally-tubular catheter body having proximal and distal ends. An electrode assembly is provided at the distal end of the catheter body. The electrode assembly including a porous electrode arrangement that is generally transverse to the catheter body. The porous electrode arrangement comprises one or more electrodes electrically connected to a suitable energy source and a porous sleeve mounted in surrounding relation to the one or more electrodes and defining an open space between the porous sleeve and the one more electrodes. One or more irrigation openings fluidly connect the open space to a lumen extending through the catheter through which fluid can pass. In use, fluid passes through the lumen in the catheter, through the one or more irrigation openings, into the open space and through the porous sleeve. 1. A catheter for ablating tissue , the catheter comprising:an elongated generally-tubular catheter body having proximal and distal ends; and one or more electrodes electrically connected to a suitable energy source;', 'a porous sleeve mounted in surrounding relation to the one or more electrodes and defining an open space between the porous sleeve and the one or more electrodes; and', 'one or more irrigation openings fluidly connecting the open space to a lumen extending through the catheter through which fluid can pass;, 'an electrode assembly at the distal end of the catheter body, the electrode assembly including a porous electrode arrangement that is generally transverse to the catheter body, the porous electrode arrangement comprisingwherein, in use, fluid passes through the lumen in the catheter, through the one or more irrigation openings, into the open space and through the porous sleeve.2. The catheter according to claim 1 , wherein the electrode assembly further comprises a non-conductive tubing mounted on the distal end of the catheter over which the one or more ...

Electroporation for obesity or diabetes treatment

Endolumenal devices and methods can be used for the treatment of health conditions including obesity and diabetes. In some embodiments, the methods and systems provided herein can cause weight loss or control diabetes by reducing the caloric absorption of an individual. For example, this document provides several devices and methods for treating obesity and diabetes by using electroporation to modulate the duodenal mucosa. In addition, this document provides devices and methods for bypassing portions of the gastrointestinal tract to reduce nutritional uptake.

Continuous process for the preparation of thiocarboxylate silane

The invention is directed to a process for the preparation of thiocarboxylate silane comprising reacting an aqueous solution of a salt of a thiocarboxylic acid with a haloalkylalkoxysilane in the presence of a solid supported catalyst. The invention is also directed to a process for the preparation of an aqueous solution of a salt of a thiocarboxylic acid which comprises reacting an aqueous solution of a sulfide and/or hydrosulfide with a carboxylic acid halide and/or acid anhydride.

CATHETER SENSING AND IRRIGATING

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site. 123-. (canceled)24. A catheter , comprising:an elongated shaft having a proximal end region and a distal end region;an irrigation element at the distal end region of the elongated shaft and positioned to direct irrigation fluid away from the distal end region of the elongated shaft; andan electrical energy delivery electrode at the distal end region of the elongated shaft and enveloping the irrigation element, the electrical energy delivery electrode comprises multiple struts that define a plurality of bounded cells,', 'the struts are configured to conduct and deliver electrical energy along a majority of their length,', 'the struts are movable relative to one another, and', 'at least a portion of the struts are in electrical communication with one another to form a single electrical conductor., 'wherein—'}25. The catheter of wherein the electrical energy delivery electrode comprises a braid.26. The catheter of wherein the electrical energy delivery electrode comprises a mesh.27. The catheter of wherein the struts are coupled to one another at joints.28. The catheter of wherein the struts are moveable relative to one another such that a radial dimension of the electrical energy delivery electrode increases as the struts move ...

Osmotic Ablation Device

A tissue ablation device comprising a balloon catheter, or other expandable element, wherein said expandable element is comprised of a semipermeable membrane. The balloon membrane is expanded by an osmotically active solution to contact a vascular endothelium, or other desired tissue, whereupon the resultant osmotic gradient affects a water flux from the vascular endothelium, or other desired tissue, across the semipermeable membrane and towards the osmotically active solution.

System and methods of using a catheter with an anchoring mechanism

A catheter includes a catheter body and a distal tip section that includes an elongated member that extends along a longitudinal axis. An anchor mechanism can be disposed along an outer surface of the elongated member and/or within the elongated member in a first configuration. In a second configuration, the anchor mechanism can be configured to extend radially outward with respect to the longitudinal axis to surround at least a portion of the distal tip section.

ABLATION DEVICE USING BIPOLAR STEAM GENERATION

An ablation device includes first and second electrodes and an absorbent medium. The ablation device may include a permeable spacer or other mechanisms to position the ablation device in the uterus. The absorbent medium configured to absorb a conductive fluid and optionally to distend. A current can be applied to the first and second electrodes to convert the conductive fluid to a vapor or steam for ablation of the uterus. 1. An ablation device sized and arranged to be an intrauterine ablation device , comprising:a first permeable electrode having a first electrode connector;a second permeable electrode having a second electrode connector;an absorbent medium positioned between the first and second permeable electrodes, and configured to absorb a conductive fluid; anda permeable spacer adjacent to each of the first and second permeable electrodes.2. The ablation device of claim 1 , wherein the permeable spacer is configured to enclose the first and second permeable electrodes and the absorbent medium.3. The ablation device of claim 1 , further comprising a fluid conduit configured to provide the conductive fluid to the absorbent medium.4. The ablation device of claim 1 , further comprising at least one suction tube configured to channel any of fluid claim 1 , steam claim 1 , and vapor away from any of the absorbent medium and the first and second permeable electrodes.5. The ablation device of claim 4 , wherein the at least one suction tube is positioned and arranged to be near a fallopian tube opening when in use.6. The intrauterine ablation device of claim 4 , wherein the at least one suction tube comprises two suction tubes claim 4 , each positioned and arranged to be near a fallopian tube opening when in use.7. The ablation device of claim 1 , wherein the first and second permeable electrodes are planar electrodes disposed on opposite sides of the absorbent medium.8. The ablation device of claim 1 , wherein the permeable spacer includes the absorbent medium.9. The ...

Fluid-assisted medical devices, systems and methods

Surgical devices, systems and methods for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device comprises a handle ( 20 a ) having a proximal end and a distal end; a shaft extending distally beyond the distal end of the handle, the shaft having a proximal end and a distal end; an electrode tip ( 45 ), at least a portion of the electrode tip extending distally beyond the distal end of the shaft, the electrode tip extending distally beyond the distal end of the shaft comprising a spherical end surface portion ( 25 ) and a cylindrical side surface portion, the spherical end surface portion located distal to the cylindrical side surface portion and comprising at least a portion of the distal end surface of the surgical device; and a fluid passage directed to provide a fluid towards the cylindrical side portion of the electrode tip.

CABLE FOR CONVEYING RADIOFREQUENCY AND/OR MICROWAVE FREQUENCY ENERGY TO AN ELECTROSURGICAL INSTRUMENT

Embodiments of the invention provide a hollow cable for conveying radiofrequency and/or microwave frequency energy to an electrosurgical instrument that can fit within, e.g. slide relative to, the hollow cable. The hollow cable provides a bipolar electrical connection to the electrosurgical instrument that is maintained when the electrosurgical instrument is rotated relative to the hollow cable. The cable may comprise a hollow coaxial transmission line having a rotatable component mounted at its distal end. The rotatable component comprises a longitudinal passageway continuous with the hollow coaxial transmission line. The rotatable component is rotatable relative to the transmission line and comprises a first and second conductive portions that are respectively electrically connected to first and second terminals on the coaxial transmission line and which are configured to maintain an electrical connection with their respective terminal when rotated relative to the coaxial transmission line. 1. A cable for conveying radiofrequency and/or microwave frequency energy to an electrosurgical instrument at a first end of the cable , the cable comprising:a hollow tube comprising inner and outer electrically conductive layers separated by dielectric material to form a transmission line;a first terminal at the first end of the cable for forming an electrical connection to the inner conductive layer;a second terminal at the first end of the cable for forming an electrical connection to the outer conductive layer; a first portion electrically connected to the first terminal, wherein the first portion and the first terminal are rotatable relative to each other and are configured to maintain an electrical connection when rotated relative to each other;', 'a second portion electrically connected to the second terminal, wherein the second portion and the second terminal are rotatable relative to each other and are configured to maintain an electrical connection when rotated ...

Pulsed radiofrequency ablation

Ablation systems and methods of the present disclosure are directed toward delivering pulsed radiofrequency (RF) energy to target tissue. The pulsations of the RF energy, combined with cooling at a surface of the target tissue, can advantageously promote local heat transfer in the target tissue to form lesions having dimensions larger than those that can be safely formed in tissue using non-pulsed RF energy under similar conditions.

CATHETER WITH COMPOSITE CONSTRUCTION

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter. 1. An ablation catheter , comprising:an elongated catheter body; at least one deflectable member and at least one support member arranged in an alternating sequence along the distal section, each support member carrying a ring electrode and a coil sensor on an outer surface of the support member, and', 'a tip electrode., 'a distal section distal the catheter body, the distal section comprising2. The catheter of claim 1 , the distal section being configured with a distal irrigation fluid path extending axially through the at least one deflectable member and the at least one support member to deliver irrigation fluid to the respective ring electrode and the tip electrode.3. The catheter of claim 1 , the coil sensor being wound around the outer surface of the support member.4. The catheter of claim 1 , the coil sensor being wound in a groove formed in the outer surface of the support member.5. The catheter of claim 1 , the coil sensor sitting in a groove formed on an outer surface of the support member.6. The catheter of claim 1 ...

CATHETER WITH COMPOSITE CONSTRUCTION

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter. 1. A method of constructing a catheter , comprising:providing a tubing;providing a plurality of support members, each support member having a plurality of lumens, each support member being constructed of a first material;providing a plurality of irrigated ring electrodes;mounting on the tubing at predetermined locations a plurality of support members by inserting the tubing through a first lumen of each support member, adjacent support members mounted on the tubing being separated by a predetermined spacing;mounting on each support member, a respective ring electrode;forming deflectable members by filling in the predetermined spacing between adjacent support members with a second material less rigid than the first material.2. The method of claim 1 , each deflectable member being formed with a plurality of lumens that are axially aligned with the plurality of lumens of the support member.3. The method of claim 1 , each support member having a groove on its outer surface.4. The method of claim 3 , further comprising winding a ...

Devices and methods for ablation of tissue

This document provides devices and methods for the treatment of heart conditions, hypertension, and other medical disorders. For example, this document provides devices and methods for treating atrial fibrillation by performing thoracic vein ablation procedures, including pulmonary vein myocardium ablation. In some embodiments, the ablation is performed in coordination with the delivery a pharmacological agent that can abate the formation of tissue stenosis or neointimal hyperplasia caused by the ablation.

CATHETER WITH IRRIGATED TIP ELECTRODE WITH POROUS SUBSTRATE AND HIGH DENSITY SURFACE MICRO-ELECTRODES

A catheter has a multifunctional “virtual” tip electrode with a porous substrate and a multitude of surface microelectrodes. The surface microelectrodes are in close proximity to each other and in a variety of configurations so as to sense tissue for highly localized intracardiac signal detection, and high density local electrograms and mapping. The porous substrate allows for flow of conductive fluid for ablating tissue. The surface microelectrodes can be formed via a metallization process that allows for any shape or size and close proximity, and the fluid “weeping” from the porous substrate provides more uniform irrigation in the form of a thin layer of saline. The delivery of RF power to the catheter tip is based on the principle of “virtual electrode,” where the conductive saline flowing through the porous tip acts as the electrical connection between the tip electrode and the heart surface. The substrate and the surface electrodes are constructed of MRI compatible materials so that the physician can conduct lesion assessment in real time during an ablation procedure. The surface electrodes include noble metals, including, for example, platinum, gold and combinations thereof. 1. A catheter comprising:an elongated catheter body;a distal electrode member having a porous substrate and a plurality of surface electrodes on portions of an outer surface of the porous substrate, the porous substrate having an interior chamber adapted to receive conductive fluid;a plurality of lead traces on an outer surface of the porous substrate, each of the plurality of lead traces connected to a respective one of the plurality of surface electrodes, at least one of the plurality of lead traces having a portion extending underneath at least one other of the plurality of surface electrodes, the portion of the at least one of the plurality of lead traces extending underneath the at least one other of the plurality of surface electrodes sitting in a groove on the outer surface of the ...

SALINE BETWEEN TIP AND TISSUE

An ablation catheter assembly including a source of ablation energy coupled to a lead wire disposed within an elongated catheter shaft having a proximal end and a distal end, the lead wire having an electrode disposed at the distal end. The ablation catheter assembly including a flexible tip connected to the distal end of the elongated catheter shaft, and a source of conductive fluid coupled to the flexible tip to direct flow of the conductive fluid into contact with the electrode, wherein the conductive fluid provides a conductive path from the electrode to tissue to be ablated. 1. An ablation catheter assembly comprising:an elongated catheter shaft having a proximal end and a distal end;a flexible tip connected to the distal end of the catheter shaft;a lead wire disposed within the catheter shaft;an electrode disposed at the distal end;a source of ablation energy coupled to the lead wire; anda source of conductive fluid coupled to the flexible tip to direct flow of the conductive fluid into contact with the electrode, wherein the conductive fluid provides a conductive path from the electrode to tissue to be ablated.2. The ablation catheter assembly of claim 1 , wherein the elongated catheter shaft and the flexible tip are separately steerable and comprising a catheter steering element to steer the elongated catheter shaft and a tip steering element to steer the flexible tip.3. The ablation catheter assembly of claim 1 , wherein the flexible tip is compliant to conform to the shape of the tissue to be ablated.4. The ablation catheter assembly of claim 1 , wherein the flexible tip extends distal of the electrode to engage tissue surrounding the tissue to be ablated and to maintain the electrode away from the tissue to be ablated.5. The ablation catheter assembly of claim 1 , wherein the electrode is disposed within the flexible tip such that at least a portion of the flexible tip is disposed between the electrode and the tissue to be ablated.6. The ablation catheter ...

CABLE FOR CONVEYING RADIOFREQUENCY AND/OR MICROWAVE FREQUENCY ENERGY TO AN ELECTROSURGICAL INSTRUMENT

Embodiments of the invention provide a hollow cable for transmitting radiofrequency and/or microwave frequency energy to an electrosurgical instrument, wherein the hollow cable is provided with electrical connectors for forming a bipolar electrical connection with an electrosurgical instrument that fits within, e.g. slides relative to, the hollow cable. The connectors can be conductive protrusions extending in an axial direction on opposite sides of the cable. The protrusions can be tabs, fins, rods, pins, or wires. The protrusions can be strips which engage corresponding terminals on the instrument. The transmission line structure of the invention can have a greater diameter than conventional coaxial cables, which can minimize loss whilst still providing access for control wires and/or fluid to reach a surgical instrument. The cable can be used with multiple instruments. 1. A cable for conveying radiofrequency and/or microwave frequency energy to an electrosurgical instrument at a first end of the cable , the cable comprising:a hollow tube comprising inner and outer electrically conductive layers separated by dielectric material to form a transmission line, the hollow tube having a central channel extending along its length;a first terminal at the first end of the cable, the first terminal being arranged to form an electrical connection between the inner conductive layer and a first cooperating terminal of the electrosurgical instrument; anda second terminal at the first end of the cable, the second terminal being arranged to form an electrical connection between the outer conductive layer and a second cooperating terminal of the electrosurgical instrument,wherein the first terminal comprises a first electrically conductive protrusion extending in an axial direction from the first end of the cable and electrically connected to the inner conductive layer; and/orwherein the second terminal comprises a second electrically conductive protrusion extending in an axial ...

Medical device and coating material

A coating material and a medical device. The medical device having an end effector and a coating to cover the end effector. The coating having one or more of: a plurality of hollow particles; and projections and depressions.

Devices and methods for ablation of tissue

This document provides devices and methods for the treatment of heart conditions, hypertension, and other medical disorders. For example, this document provides devices and methods for treating atrial fibrillation by performing thoracic vein ablation procedures, including pulmonary vein myocardium ablation. In some embodiments, the ablation is performed in coordination with the delivery a pharmacological agent that can abate the formation of tissue stenosis or neointimal hyperplasia caused by the ablation.

Medical device with sensor cooperating with expandable member

Disclosed is a method for attaching a sensor to an inflatable balloon. The method involves bonding the sensor to the balloon with an adhesive while the balloon is in an expanded state and then collapsing the balloon after the adhesive has at least partially cured. The method reduces the possibility of a failure of the bond between the sensor and the balloon. The method is particularly useful in the construction of a tissue ablation catheter for forming a lesion along a substantially circumferential region of tissue wherein a sensor is used for monitoring the temperature of the tissue being ablated.

Medical device with sensor cooperating with expandable member

Disclosed is a method for attaching a sensor to an inflatable balloon. The method involves bonding the sensor to the balloon with an adhesive while the balloon is in an expanded state and then collapsing the balloon after the adhesive has at least partially cured. The method reduces the possibility of a failure of the bond between the sensor and the balloon. The method is particularly useful in the construction of a tissue ablation catheter for forming a lesion along a substantially circumferential region of tissue wherein a sensor is used for monitoring the temperature of the tissue being ablated.

Multicurve deflectable catheter

An electrophysiology catheter (20) comprises a shaft (22) having a first bending stiffness and a deflectable tip (28) secured to the distal end (24) of the shaft with a second bending stiffness less than the first bending stiffness. At least one electrode (34, 36) is mounted to the tip for delivering current to or monitoring electrical activity of tissue. A manipulator wire (58) is coupled to the distal end of the deflectable tip, whereby the deflectable tip may be deflected by axial force applied to the manipulator wire. A stiffener member (66) is axially slidable relative to the tip so as to adjust the tip curvature without removing the catheter from the body. The catheter may further include a core wire (72) configured to rotate the deflectable tip about a longitudinal axis (2) without rotating the proximal end (26) of the catheter shaft, wherein the distal end of the deflectable tip remains in a substantially constant axial position, preferably in a plane perpendicular to the longitudinal axis.

Catheter system having a porous shaft and fluid irrigation capabilities

An improved ablation catheter having a distal tip section made of flexible porous plastic material for fluid infusion and irrigation at its electrode comprises a catheter shaft having a distal section and at least one lumen extending therebetween, wherein the catheter is inserted into the chambers of the heart to create deep and large lesions by applying radiofrequency energy along with irrigated fluid to the electrode.

流体配給システム及び電気外科用器具コントローラ

本発明は組織を処置するためのシステムを提供するものであって、それに含まれるのは、出力測定装置、その出力測定装置と組み合わせた流量コントローラ、及び、その組織にラジオ周波数出力及び導電性流体を供給するために構成された電気外科用器具であり、ここでこの流量コントローラは、出力測定装置からの信号に基づいて、導電性流体の組織への流量を変更できるよう、構成される。本発明はまた、組織に加えられるラジオ周波数出力の測定に基づいて、導電性流体の組織への流量を変更させるための方法と器具を提供する。

Vascular ablation

本公开包括一种静脉消融系统，所述静脉消融系统包括具有细长本体的导管。在一些实施例中，所述静脉消融系统包括在所述细长本体的远侧部分处的消融装置。根据一些实施例，所述静脉消融系统包括在所述细长本体的近侧部分处的控制装置。所述控制装置可以包括输入机构，所述输入机构被配置为同时地控制以下各项中的至少两者：所述消融装置通过目标血管的纵向平移、所述消融装置绕中心纵向轴线的旋转以及化学试剂到所述目标血管中的输注。

具有复合构造的导管

本发明提供了一种导管，所述导管在远侧节段具有复合和嵌段式构造，所述构造包括以交替顺序布置的可偏转构件和支撑构件，其中每个支撑构件承载环形电极并且所述可偏转构件为柔性的以允许所述远侧节段整体偏转。所述支撑构件的外表面上承载有线圈位置传感器。所述远侧节段被配置成具有远侧冲洗流体路径，所述远侧冲洗流体路径轴向延伸穿过所述可偏转构件和所述支撑构件，以将冲洗流体递送到所述环形电极和所述尖端电极。构造导管的方法包括通过以下步骤由内而外构建一段所述导管：将所述支撑构件安装在所述管上的预定位置并且用更柔性的材料填充其间的间隙，以通过挤出区段或注塑成型在所述导管内部的已组装部件上来形成所述可偏转构件。

Catheter with improved ablation electrode

System For Detecting Electrode-Tissue Contact

전극-조직 접촉을 검출하는 시스템은 위치 전극 및 말단 팁 전극을 구비한 카테터를 포함한다. 카테터는 조직과 접촉되는 것을 방지하는 기준 전극을 또한 포함한다. 시스템은 신호를 말단 팁과 기준 전극으로 전송하는 신호 발생기를 또한 포함한다. 조직 접촉은 팁 전극에서 복귀 전극으로의 신호와 기준 전극에서 복귀 전극으로의 신호를 비교함으로써 검출된다. 절제 에너지는 조직과의 전극의 접촉이 검출되면 말단 팁 전극으로 보내질 수 있다. 근접부, 말단부, 본체, 접촉 전극, 카테터, 기준 전극, 신호 발생기, 시스템 The system for detecting electrode-tissue contact includes a catheter having a position electrode and a distal tip electrode. The catheter also includes a reference electrode that prevents contact with tissue. The system also includes a signal generator for transmitting signals to the distal tip and the reference electrode. Tissue contact is detected by comparing the signal from the tip electrode to the return electrode and the signal from the reference electrode to the return electrode. Ablation energy can be directed to the distal tip electrode when contact of the electrode with tissue is detected. Proximity, distal end, body, contact electrode, catheter, reference electrode, signal generator, system

Fluid-assisted medical devices, systems and methods

Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

Cooled conductive balloon RF catheter for renal nerve ablation

A catheter includes a flexible shaft having a lumen arrangement and a length sufficient to access a target vessel of a patient. A balloon at the distal end of the shaft is fluidly coupled to the lumen arrangement. The balloon body comprises a first material and a second material different from the first material. The second material comprises a hydrophilic polymer that becomes electrically conductive in response to absorption of the conductive fluid. The fluid conductive regions facilitate perfusion of the conductive fluid through the balloon body to an inner wall of the target vessel during ablation of perivascular tissues. A cooling arrangement is configured for one of receiving a thermal transfer fluid from the lumen arrangement or facilitating perfusion of blood passing through the target vessel to cool the balloon body during ablation of the perivascular tissues.

Fluid cooled and perfused tip for a catheter

The invention relates to an ablation catheter which controls the temperature and reduces the coagulation of biological fluids on a tip of a catheter, prevents the impedance rise of tissue in contact with the catheter tip, and maximizes the potential energy transfer to the tissue, thereby allowing an increase in the lesion size produced by the ablation. The ablation catheter includes a catheter body. The ablation catheter also includes a tip for monitoring electrical potentials, and applying electrical energy to a biological tissue. A fluid source is positioned at one end of the catheter for supplying a fluid flow through the catheter to the tip means. Passages are positioned within the tip in a variety of manners for directing the fluid flow through the tip means to the exterior surface of the tip to control the temperature and form a protective fluid layer around the tip. Monitoring structure is also positioned within the tip structure for measurement of the electrical potentials in a biological tissue. Ablation structure is also positioned within the tip for application of ablative energy to the biological tissue.

Bipolar/monopolar endometrial ablation device and method

An endometrial ablation device and a method of manufacturing and using the device. An RF current is passed through an endometrium to heat it. 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 power delivered from a power source to the balloon is selectively provided to a plurality of electrode area segments on the balloon with each of the segments have a thermistor associated with it whereby temperature is monitored and controlled by a feedback arrangement from the thermistors. The selective application of power is provided on the basis of a switching arrangement which provides either monopolar or bipolar energy to the electrodes. The method of manufacturing the ablation device includes using commercially available stretchable sheet material or providing a mandrel or support base and coating the mandrel or base with an uncured emulsion. The emulsion is then cured to form a bladder-like coating. The coating is thereafter removed from the mandrel or base to form a bladder. Electrons and temperature sensors are formed on or secured to the bladder during or after the curing process and a fluid delivery tube is secured to the bladder for inflating the bladder.

Coagulating forceps

A method and an apparatus for selectively coagulating blood vessels or tissue containing blood vessels involves the placement of the blood vessels or tissue containing blood vessels between the prongs of a forceps with the jaws of the forceps containing a plurality of electrodes which are energized by radio-frequency power. A plurality of sensors are associated with the electrodes and in contact with the vessels or tissue in order to measure the temperature rise of the tissue or blood vessels and to provide a feedback to the radio-frequency power in order to control the heating to perform coagulation of the vessels or tissue. In a further development, the upper prong of the device is split into two parts with a cutting blade between the two upper parts in order to provide for cutting of the coagulated vessels subsequent to the coagulation. The cutting may be accomplished either mechanically or with an electrosurgical cutting device.

Method and apparatus for endometrial ablation

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° C. and 90° 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° 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. The balloon can be constructed with an electroconductive elastomer such as a mixture of polymeric elastomer and electroconductive particles or can be a non-extensible bladder having a shape and a size, in its fully expanded form, which will extend the organ and effect contact with the endometrial lining to be destroyed. The electroconductive member may consist of a plurality of electrode area segments having a thermistor associated with each electrode segment whereby the temperature from each of said plurality of segments is monitored and controlled by a feedback arrangement from the thermistors.

Fluid cooled apparatus for supporting diagnostic and therapeutic elements in contact with tissue

Surgical methods and apparatus for positioning diagnostic an therapeutic elements on the epicardium or other organ surface. The apparatus include a relatively short shaft and a tissue cooling apparatus.

Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and forming an incision in tissue with minimal blood loss

A surgical method, including the steps of coagulating soft tissue to a predetermined depth by transmitting energy through the soft tissue and forming an incision in the coagulated soft tissue, and a surgical tool set, including a first device adapted to coagulate soft tissue and a second device adapted to form an incision in the coagulated soft tissue.

Fluid-assisted medical devices, systems and methods

Surgical devices, systems and methods for treating tissue are provided. An exemplary surgical device comprises a tip portion including first and second jaws each having a tissue grasping surface, at least one of the jaws being movable toward the other jaw. The tissue grasping surface of each jaw has includes an electrically insulative surface. The device also includes first and second electrodes connectable to different terminals of an RF generator to generate electrical current flow therebetween, with each of the electrodes having an electrode surface. One of the electrode surfaces is located on one of the jaws separated from one edge of the tissue grasping surface, and the other of the electrode surfaces is located on one or the other of the jaws separated from the other edge of the tissue grasping surface. The device also includes at least one fluid passage being connectable to a fluid source.

Multi-electrode catheter, system and method

A system for detecting electrode-tissue contact comprises a multi-electrode catheter having a location sensor and a plurality of contact electrodes. The catheter preferably further comprises a reference electrode that is preferably protected from making contact with tissue. The system further comprises a signal generator to transmit test signals to each of the contact electrodes and to the reference electrode. Tissue contact is detected by comparing the signals across the tip electrode to a return electrode versus the signal across the reference electrode to a return electrode. Ablation energy may be delivered to the contact electrodes if contact of the electrode with tissue is detected.

Ablation system and method of use

A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal amplitude in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the amplitude of a local electrogram measured with electrodes located adjacent tissue to be ablated first gradually drops and then stabilizes, indicating that the tissue being monitored has ceased making any contribution to the sensed electrogram. The amplitude drop and/or the following amplitude plateau may be used alone or together as indicators of transmurality. Detection of a rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too quickly and may be employed to trigger a reduction in the power of applied ablation energy. Detection of an insufficiently rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too slowly and may be employed to trigger an increase in the power of applied ablation energy.

Apparatus system and method for coagulating and cutting tissue

A combination tissue coagulation and cutting apparatus, system and method for coagulating and cutting tissue. A clamp element includes first and second clamp members having respective first and second porous electrodes, such as sintered metal electrodes. A portion of tissue, such as a blood vessel, is held between the porous electrodes, and fluid from a fluid source can pass through the porous electrodes. The tissue portion can be coagulated when electrical current is applied to the first and second porous electrodes, and an adjustable cutting element that is associated with the clamp members is positioned to cut a segment or all of the coagulated tissue portion. In this manner, the same surgical instrument is used to coagulate and cut tissue.

Electrosurgical instrument employing an electrode

An electrosurgical surgical instrument can comprise a handle and an end effector, wherein the end effector can comprise first and second jaws which can be opened and closed in order to capture tissue therebetween. In various embodiments, the first and second jaws can comprise one or more electrodes configured to apply a voltage across the tissue, wherein at least one of the electrodes can comprise a conductive material positioned within a non-conductive, or high-resistance, material. In use, current flowing through the conductive material can heat the conductive material and cause it to evaporate and leave behind the non-conductive material. In such circumstances, the current flowing through the electrode may cease or may be substantially reduced.

Electrosurgical instrument

An electrosurgical instrument comprising a support member; at least one electrode mounted on the support, the electrode consisting essentially of a material having a figure of merit of at least 0.15 at room temperature where the figure of merit is the product of the thermal conductivity, the heat capacity and the density of the material in the metric system; and a heat sink in thermal contact with the electrode for removal of heat therefrom. A carbon coating for the electrode is also disclosed where the coating may be formed by different techniques including thermal decomposition of certain carbohydrate containing materials, the latter method providing a porous carbon coating particularly suited for expediting the starting of the instrument. Also disclosed are a number of heat sinks for effecting removal of heat from the electrode. Further disclosed is a monolithic blade made from carbon.

Endometrial ablation apparatus and method

An endometrial ablation method comprising passing sufficient RF current having a frequency of from 250 kHz to about 100 MHz through substantially the entire surface of the endometrium to heat the endometrium, in a single operation, to a temperature within the range of from 45° C. to 90° C. and preferably not above 70° C. for a time sufficient to destroy the cells of the lining while maintaining the average temperature of the myometrium at a temperature below about 42° C. The apparatus comprises a electroconductive expandable member such as a balloon for extending the organ and effecting electrical contact with the endometrial lining to be destroyed. The balloon is connected to a power source adapted to provide radiofrequency electric power having the desired characteristics to selectively heat the endometrial lining to the desired temperature. The balloon can be an electroconductive elastomer such as a mixture of a polymeric elastomer and electroconductive particles. Alternatively, it can be a non-extensible bladder having a shape and size, in its fully expanded form, which will extend the organ and effecting contact with the endometrial lining to be destroyed. One surface of the non-extensible bladder can be coated with electroconductive material. The coating can be applied to the inner surface of the non-extensible bladder if the bladder wall thickness is less than about 25 mm.

Fluid assisted medical devices, fluid delivery systems and controllers for such devices, and methods

Medical devices, methods and systems for treating tissue are provided. An exemplary system comprises a fluid from a fluid from a fluid source at a fluid flow rate, a surgical device which provides power and the fluid to the tissue and a control mechanism which changes a fluid flow rate provided from the surgical device and changes a power level provided from the surgical device. The fluid flow rate changes between at least two-zero flow rates and the power level changes between at least two non-zero levels. An exemplary method comprises providing a fluid from a fluid source at a fluid flow rate, providing a surgical device which provides power and the fluid to the tissue, and changing the fluid flow rate of fluid provided from the surgical device with a change in power level provided from the surgical device.

Apparatus system and method for coagulating and cutting tissue

A combination tissue coagulation and cutting apparatus, system and method for coagulating and cutting tissue. A clamp element includes first and second clamp members having respective first and second porous electrodes, such as sintered metal electrodes. A portion of tissue, such as a blood vessel, is held between the porous electrodes, and fluid from a fluid source can pass through the porous electrodes. The tissue portion can be coagulated when electrical current is applied to the first and second porous electrodes, and an adjustable cutting element that is associated with the clamp members is positioned to cut a segment or all of the coagulated tissue portion. In this manner, the same surgical instrument is used to coagulate and cut tissue.

Fluid-assisted medical device, system and method

Catheter with composite construction

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter.

An ablation catheter

一种消融导管，包括一个手柄和一个管状冲洗构件，该管状冲洗构件限定了一个流体管腔并且具有在该管状冲洗构件的远端附近的多个穿孔。至少一个消融电极被安排在插入在该管状冲洗构件的管腔之中的一个长形管状鞘的远端处，该长形管状鞘是在该管状冲洗构件的管腔内轴向地可移位的。该消融导管还可以包括伸缩式地安排在该管状冲洗构件内的两个消融电极，这些电极各自附接到一个长形管状鞘上。这些消融电极可以是一起或单独地同时可移位的。

Catheter with composite construction

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter.

Catheter with composite construction

A catheter has a composite and segmented construction in a distal section that includes deflectable members and support member arranged in alternating sequence, with each support member carrying a ring electrode and the deflectable members being flexible to allow deflection of the distal section as a whole. Carried on an outer surface of the support member is a coil location sensor. The distal section is configured with a distal irrigation fluid path extending axially through the deflectable members and the support members to deliver irrigation fluid to the ring electrode and the tip electrode. A method of constructing a catheter includes building a section of the catheter from the inside out by mounting the support members on a tubing at predetermined locations and filling gaps in between with a more flexible material to form the deflectable members by extrusion segments or injection molding over assembled components internal to the catheter.

An ablation catheter

An ablation catheter including a handle, a tubular irrigation member defining a fluid lumen and having a plurality of perforations proximal the distal end of the tubular irrigation member. At least one ablation electrode is arranged at the distal end of an elongate tubular sheath inserted into the lumen of the tubular irrigation member, the elongate tubular sheath being axially displaceable within the lumen of the tubular irrigation member. The ablation catheter may also include two ablation electrodes each attached to an elongate tubuar sheath which are telescopically arranged within the tubular irrigation member. The ablation electrodes may be displaceable simultaneously together or individually.

An ablation catheter

An ablation catheter including a handle, a tubular irrigation member defining a fluid lumen and having a plurality of perforations proximal the distal end of the tubular irrigation member. At least one ablation electrode is arranged at the distal end of an elongate tubular sheath inserted into the lumen of the tubular irrigation member, the elongate tubular sheath being axially displaceable within the lumen of the tubular irrigation member. The ablation catheter may also include two ablation electrodes each attached to an elongate tubuar sheath which are telescopically arranged within the tubular irrigation member. The ablation electrodes may be displaceable simultaneously together or individually.

An ablation catheter

Electrosurgical sphincter treatment instrument

An apparatus treats tissue at or near a sphincter. The apparatus has an elongated member having at least one lumen including an inflation lumen, and a basket assembly including a first and a second arm. An inflatable member is coupled to the inflation lumen and has a deployed and a non-deployed state. In the deployed state, the inflatable member expands the basket assembly into contact with tissue. At least one of the first and second arms of the basket assembly has a fluid lumen having an aperture for conveying a fluid from the basket assembly. A source of fluid is coupled to the fluid lumen for conveyance of fluid through the aperture. The fluid can be, e.g., an electrolytic solution, and/or an anti-infection agent, and/or an echogenic media, and/or a steroid, and/or an anesthetic, and/or a medicament, and/or a tissue cooling agent. The source can be a drug delivery device.

Electrosurgical device

Elektrochirurgische Vorrichtung zur Behandlung eines Patienten, umfassend:eine Nadel (30) mit einer Innenfläche, die ein Lumen (36) aufweist; undeine erste Elektrode (31, 131, 231), die in einer ersten Stellung im Inneren des Lumens der Nadel (30) positioniert ist, wobei die erste Elektrode (31, 131, 231) innerhalb der Nadel (30) zwischen der ersten Stellung und einer Mehrzahl von anderen Stellungen beweglich ist, wobei sich die erste Elektrode (31, 131, 231) in der Mehrzahl von anderen Stellungen über ein distales Ende der Nadel (30) hinaus erstreckt,wobei die Nadel (30) als eine zweite Elektrode dient, wobei die erste Elektrode (31, 131, 231) und die Nadel (30) derart angeordnet sind, dass sie ein gewünschtes Energieniveau zu einem vorbestimmten Gewebeabschnitt liefern, wenn sich die erste Elektrode (31, 131, 231) in der Mehrzahl von anderen Stellungen befindet, um den vorbestimmten Gewebeabschnitt abzutragen, dadurch gekennzeichnet, dass die erste Elektrode (31, 131, 231) mindestens einen Anker (46A, 46B; 146A, 146B, 146C; 246A, 246B, 246C, 246D) aufweist, der ein Eindringelement (50A, 50B; 150A, 150B, 150C; 250A, 250B, 250C, 250D) mit einer Spitze (52A, 52B; 152A, 152B, 152C; 252A, 252B, 252C, 252D) besitzt, die in den vorbestimmten Gewebeabschnitt eindringt, sowie ein abgewinkeltes Element (48A, 48B; 148A, 148B, 148C; 248A, 248B, 248C, 248D), welches sich in den vorbestimmten Gewebeabschnitt einhakt, um die erste Elektrode (31, 131, 231) an dem vorbestimmten Gewebeabschnitt zu fixieren. Electrosurgical apparatus for treating a patient, comprising: a needle (30) having an inner surface containing a lumen (36); anda first electrode (31, 131, 231) positioned in a first position within the lumen of the needle (30), the first electrode (31, 131, 231) being positioned within the needle (30) between the first position and movable to a plurality of other positions, the first electrode (31, 131, 231) extending beyond a distal end of the needle (30) in the plurality of ...

Vascular sealing device with microwave antenna

A device and method are provided for sealing a puncture in a body vessel. The device has an elongated body having a proximal end and a distal end sized to be positioned within a lumen of the body vessel; at least one closure composition precursor lumen within the elongated body having a entrance port adjacent the proximal end of the elongated body through which one or more fluent closure composition precursors can be delivered into the closure composition precursor lumen and an exit port adjacent the distal end of the elongated body through which the one or more fluent closure composition precursors can be delivered outside the vessel adjacent the vessel puncture; and a microwave antenna for delivering microwave energy adjacent the distal end of the elongated body to the fluent closure compound precursor. The microwave antenna according to this embodiment is preferably incorporated onto the elongated body adjacent the body distal end. Alternatively, the device can include a guidewire lumen and a guidewire which includes a microwave antenna.

Method for internal ablation of turbinates

A method and apparatus for ablating at least a portion of a nasal concha. The apparatus includes a catheter having a distal portion with a dimension configured for positioning through a nostril of a patient into a nasal meatus adjacent a nasal concha, and an energy delivery device coupled to the catheter distal portion including one or more energy delivering probes extendable from the catheter distal portion a sufficient distance to be inserted into an interior of the nasal concha to deliver ablative energy therein. The distal portion of the apparatus may also include an expandable member, expansion of the expandable member within the nasal meatus immobilizing the distal portion within the nasal meatus.

Catheter distal assembly with pull wires

A catheter assembly having a sheath, which includes a side wall enclosing an interior bore, and a distal region. The assembly also has a bendable catheter tube, which is carried for sliding movement in the interior bore. A pull wire also runs through the interior bore of the sheath, preferably within a lumen. The catheter tube has a distal portion with a coupling which joins the distal portion of the catheter tube and the distal portion of the pull wire. Relative movement of the pull wire and the sheath causes bending of the catheter tube outwardly through the opening, in response to sliding movement of the catheter tube within the interior bore toward the distal region of the sheath.

Device for the treatment of body tissue

Fluid assisted medical devices, fluid delivery systems and controllers for such devices, and methods

Medical devices, methods and systems for treating tissue are provided. An exemplary system comprises a fluid from a fluid source (24a) at a fluid flow rate, a surgical device (5a) which provides power and the fluid to the tissue and a control mechanism which changes a fluid flow rate provided from the surgical device and changes a power level provided from the surgical device. The fluid flow rate changes between at least two non-zero levels. An exemplary method comprises providing a fluid from a fluid source at a fluid flow rate, providing a surgical device which provides power and the fluid to the tissue, and changing the fluid flow rate of fluid provided from the surgical device with a change in power level provided from the surgical device.

Surgical system including clamp and apparatus for securing an energy transmission device to the clamp and method of converting a clamp into an electrophysiology device

An apparatus for use with a clamp including a base member configured to be secured to the clamp and at least one energy transmission device carried by the base member. An apparatus for use with a clamp and a probe that carries at least one energy transmission device including a base member configured to be secured to the clamp and an engagement device associated with the base member and configured to engage the probe. A clamp including first and second clamp members, at least one of which is malleable, and a movement apparatus that moves at least one of the first and second clamp members relative to the other. A surgical system including a clamp with first and second clamp members and a device that removably mounts at least one electrode on at least one of the first and second clamp members.

Ultrasonic cutting blade with cooling liquid conduction

An ultrasonic surgical tool has probe body with an operative surface or edge contactable with organic tissues for performing a surgical operation on the tissues. A shank of the probe body is provided with a connector for operatively attaching the tool to a source of ultrasonic mechanical vibrational energy. The shank and a portion of the probe body are formed with a channel for fluid delivery to the probe body. At least a portion of the probe body located between the channel and the operative surface or edge has a microporous or sintered structure enabling fluid penetration to the operative surface or edge from the channel.

Ultrasonic cutting blade with cooling liquid conduction

An ultrasonic surgical tool has probe body with an operative surface or edge contactable with organic tissues for performing a surgical operation on the tissues. A shank of the probe body is provided with a connector for operatively attaching the tool to a source of ultrasonic mechanical vibrational energy. The shank and a portion of the probe body are formed with a channel for fluid delivery to the probe body. At least a portion of the probe body located between the channel and the operative surface or edge has a microporous or sintered structure enabling fluid penetration to the operative surface or edge from the channel.

Electrosurgical vascular sealer having opposing sealing surfaces with varying gap heights

本发明公开了一种电外科器械，所述电外科器械包括：近侧手柄部分；细长管状主体部分，所述细长管状主体部分从所述近侧手柄部分向远侧延伸；以及钳口组件，所述钳口组件与所述主体部分的远侧端部可操作地相关联并且包括一对协作的钳口构件，所述一对协作的钳口构件被安装成用于在打开位置与闭合位置之间移动，每个钳口构件具有密封表面，其中当所述钳口构件处于所述闭合位置时，所述钳口构件的所述密封表面在其间限定血管密封间隙，并且其中所述血管密封间隙具有沿所述钳口组件的轴向范围在所述钳口组件的近侧端部部分与所述钳口组件的远侧端部部分之间变化的高度。

Patent DE3915636C1

Thin layer ablation apparatus

An ablation apparatus has an expandable member that is inserted into an organ of a body and ablates all or a selected portion of the inner layer of the organ. Electrolytic solution fills the expandable member, and the expandable member includes a plurality of apertures from which electrolytic solution flows from the expandable member. First and second fluid conduits, which can be first and second conforming members, are in a surrounding relationship to the expandable member. The second conforming member, including a conductive surface, is made of a material that provides substantial conformity between the conductive surface and a shape of the inner layer of the organ. A plurality of electrodes is positioned between the two conforming members. The expandable member serves as an insulator to RF energy. Each electrode includes an insulator formed on a surface of the electrode positioned adjacent to the second conforming member. The combination of sandwiching the electrodes between the two conforming members, and the use of two insulators, one on the electrode and the other on the expandable member, provides selectable ablation of the inner layer of the organ. A feedback device is included and is responsive to a detected characteristic of the inner layer. The feedback device provides a controlled delivery of RF energy to the electrodes.

Thin layer ablation apparatus

An ablation apparatus for ablating an inner layer in an organ or lumen of a body, or any desired thin layer, includes an expandable member made of a material with a porous exterior surface. An electrolytic solution, housed in an interior of the expandable member, releases electrolytic solution through the porous exterior surface. A conforming member, which can be an open cell foam material, has an RF conductive surface, and a back side in a surrounding relationship to an exterior surface of the expandable member. Further, the conforming member includes non-zone areas that have a first porosity rate for delivering electrolytic solution to the inner layer. The conforming member also includes a zone for housing each RF electrode and electrolytic solution. Zones have a second porosity rate that is less than the first porosity rate, thus permitting electrolytic solution to pass through the non-zone areas at a faster rate than in the zones. The zones provide an area where electrolytic solution is heated to a higher temperature, due to the differences in porosity with the non-zones. With the combination of the electrode and the heated electrolytic solution in each zone, a larger electrode is created, and there is a more effective, and even application of both RF and thermal energy to the tissue site, such as the endometrium.

Expandable-collapsible electrode structures for capacitive coupling to tissue

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.

Electrosurgical instrument and method of operation

Die Erfindung betrifft ein elektrochirurgisches Instrument zum Einführen in ein Körperlumen oder interstitiell in Körpergewebe in einer Einführrichtung zur Behandlung von menschlichem oder tierischem Gewebe sowie ein Verfahren zum Betreiben eines solchen elektrochirurgischen Instrumentes. Das elektrochirurgische Instrument (1, 100) umfasst einen Instrumentenschaft (50, 150), mindestens ein Energieabgabeelement (10, 100), und mindestens ein Reservoir (20) mit mindestens einer Austrittsöffnung (21, 121), wobei in dem Reservoir ein leitfähiges Medium (30) und ein expansionsfähiges Medium (40) derart angeordnet und ausgebildet sind, dass bei einer Expansion des expansionsfähigen Mediums das leitfähige Medium durch die mindestens eine Austrittsöffnung aus dem Reservoir austritt. The invention relates to an electrosurgical instrument for insertion into a body lumen or interstitially into body tissue in an insertion direction for the treatment of human or animal tissue and a method for operating such an electrosurgical instrument. The electrosurgical instrument (1, 100) comprises an instrument shaft (50, 150), at least one energy delivery element (10, 100), and at least one reservoir (20) with at least one outlet opening (21, 121), wherein in the reservoir a conductive medium (30) and an expansible medium (40) are arranged and designed such that upon expansion of the expansible medium, the conductive medium exits through the at least one outlet opening from the reservoir.

Thin layer ablation apparatus

An ablation apparatus has a balloon that is inserted into an organ of a body and ablates all or a selected portion of the inner layer of the organ. Electrolytic solution fills the balloon, and the balloon includes a plurality of apertures from which electrolytic solution flows from the balloon. The flow rate of electrolytic solution is dependent on the pressure applied to the balloon by the electrolytic solution. A conforming member, with a conductive surface and a back side, is made of a material that substantially conforms to a shape of the inner layer of the organ and delivers the electrolytic solution and RF energy through the conductive surface to the inner layer. Advantageously, difficult to access areas are reached with the inclusion of the conforming member. Optionally positioned between the conforming member and the balloon is a porous membrane. A printed circuit is printed in or on the conforming member and delivers RF energy to selected sections of the inner layer. The printed circuit provides for the monitoring of impedance, temperature and circuit continuity. Additionally, the printed circuit can be multiplexed.

Method for R-F ablation

A method and apparatus for ablation of body tissue. A catheter provided with a hollow needle is employed both for mapping the location to be ablated by injection of an excitability reducing agent and for ablating tissue, employing RF energy in conjunction with an injected, conductive fluid.

Method for treating a sphincter

A method of treating a sphincter that provides an expandable basket structure with a first energy delivery device. The basket structure is introduced in a sphincter. The first energy delivery device is advanced from the basket structure into an interior of the sphincter. Sufficient energy is delivered from the first energy delivery device to create a desired tissue effect in the sphincter. Thereafter, the basket structure is removed from the sphincter.

Method to treat esophageal sphincters

A method of treating a sphincter provides a catheter means and an energy delivery device means coupled to the catheter means. The energy delivery device means has a tissue piercing distal end. The catheter means is introduced into an esophagus. A sphincter exterior surface is pierced with the energy delivery device means tissue piercing distal. The energy delivery device means tissue piercing distal end is advanced a sufficient distance in an interior of the sphincter to a tissue site. Energy is controllably delivered to the tissue site. Controlled cell necrosis is created in the sphincter to reduce a frequency of sphincter relaxation.

Method to treat esophageal sphincters

A method of treating a sphincter provides a treatment apparatus that includes an expandable device coupled to an introducer distal portion and an energy delivery device. The expandable device includes a first arm and a second arm each with proximal and distal section. The expandable member has a non-deployed configuration and a deployed configuration when the first and second arm distend away from each other. The expandable device is at least partially introduced in the sphincter. At least a portion of the energy delivery device is advanced from the expandable device into an interior of the sphincter. Sufficient energy is delivered from the energy delivery device to create a desired tissue effect in the sphincter. The expandable device is then removed from the sphincter.

Gerd treatment apparatus and method

An apparatus includes an expandable member. The expandable member is sized to be positionable in a sphincter. An energy delivery device is positioned on a surface of the expandable member. The energy delivery device has a configuration that provides sufficient energy delivery to create lesions in the interior of the sphincter. When the expandable member is removed from the sphincter, the sphincter returns to its closed or contracted configuration.

Method to detect and treat aberrant myoelectric activity

A method of treating a sphincter provides a sphincter electropotential mapping device with a mapping electrode. The sphincter electropotential mapping device is introduced into at least a portion of the sphincter. Aberrant myoelectric activity of the sphincter is detected. Energy is delivered from the sphincter electropotential mapping device to treat the aberrant myoelectric activity of the sphincter.

GERD treatment apparatus and method

An apparatus includes an expandable member. The expandable member is sized to be positionable in a sphincter. An energy delivery device is positioned on a surface of the expandable member. The energy delivery device has a configuration that provides sufficient energy delivery to create lesions in the interior of the sphincter. When the expandable member is removed from the sphincter, the sphincter returns to its closed or contracted configuration.

Electrosurgical sphincter treatment apparatus

Method for treating a sphincter

A method of treating a sphincter that provides an expandable basket structure with a first energy delivery device. The basket structure is introduced in a sphincter. The first energy delivery device is advanced from the basket structure into an interior of the sphincter. Sufficient energy is delivered from the first energy delivery device to create a desired tissue effect in the sphincter. Thereafter, the basket structure is removed from the sphincter.

Method to treat esophageal sphincters by electrosurgery

A method of treating a sphincter provides a treatment apparatus that includes an expandable device coupled to an introducer distal portion and an energy delivery device. The expandable device includes a first arm and a second arm each with proximal and distal section. The expandable member has a non-deployed configuration and a deployed configuration when the first and second arm distend away from each other. The expandable device is at least partially introduced in the sphincter. At least a portion of the energy delivery device is advanced from the expandable device into an interior of the sphincter. Sufficient energy is delivered from the energy delivery device to create a desired tissue effect in the sphincter. The expandable device is then removed from the sphincter.

Conformable electrode catheter and method of use

An apparatus and method for closing the tunnel of a patent foramen ovale (PFO) including the steps of advancing a device, including an energy delivery element, in the lumen of the tunnel of the PFO, energizing the energy delivery element, and withdrawing the energized energy delivery element from the second end of the lumen of the tunnel toward the first end of the lumen of the PFO tunnel, thereby substantially sealing the tissues in the tunnel of the PFO.

Ablation catheter assembly with radially decreasing helix and method of use

A catheter assembly for treatment of cardiac arrhythmia. The catheter assembly includes a catheter body and an ablative energy source. The catheter body includes a proximal portion, an intermediate portion, and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and includes an ablation section and a tip. The ablation section forms a loop defining a diameter greater than an outer dimension of a pulmonary vein ostium. The tip extends distally from the ablation section and is configured to locate a pulmonary vein. Finally, the ablative energy source is associated with the ablation section. With this configuration, upon activation of the energy source, the ablation section ablates a desired lesion pattern. In one preferred embodiment, the ablation section forms a distally decreasing radius helix, whereas the tip includes a relatively linear leader section. With this one preferred configuration, the tip readily locates a pulmonary vein and guides the ablation section to a seated relationship about a pulmonary vein ostium (or extra-ostial).

Monopolar energy delivery devices and methods for controlling current density in tissue

Devices, systems and methods for providing energy to treat large areas of tissue. Several embodiments of the devices control resistance or other parameters to provide substantially uniform current density along a length of tissue with reduced edge effects.

Catheter assembly

Devices for sealing punctures in body vessels

A closure device is provided for sealing a puncture in a body vessel. The closure device includes an energy delivery device for delivering energy to tissue adjacent the vessel puncture which enhances an adhesiveness of the tissue to a closure composition precursor. The closure device includes a sealer/dilator for dilating tissue adjacent a vessel puncture, at least one closure composition precursor lumen within the sealer/dilator having an entrance port adjacent the proximal end of the sealer/dilator through which one or more fluent closure composition precursors can be delivered into the closure composition precursor lumen and an exit port adjacent the distal end of the sealer/dilator through which the one or more fluent closure composition precursors can be delivered outside the vessel adjacent the vessel puncture, and a plugging catheter for positioning within the vessel puncture, the plugging catheter extending distally from the sealer/dilator and including at least one position sensing mechanism such that the exit port of the closure composition precursor lumen is outside the vessel when the at least one position sensing mechanism is detected to be outside the vessel.

Method of ablating body tissue

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.

Vacuum-based catheter stabilizer

A medical probe for use with tissue includes an elongate member having a proximal end and a distal end, an operative element carried at the distal end of the elongate member, and a stabilizer configured for applying a vacuum force to secure the operative element relative to the tissue. A method of performing a medical procedure on a patient includes introducing a medical probe having an operative element within the patient, the operative element being adjacent a target tissue, applying a vacuum force between the medical probe and the target tissue to secure the operative element relative to the target tissue, and operating the operative element to perform the medical procedure on the target tissue while the operative element is secured relative to the target tissue.

Ablation probe for delivering fluid through porous structure

Ablation probes are provided for perfusing the tissue, while the tissue is ablated. The ablation probe comprises an elongated shaft and an ablative element, such as a needle electrode. The ablation probe further comprises a lumen that extends through the probe shaft, which will be used to deliver a fluid to the distal end of the probe shaft for perfusion into the surrounding tissue. The ablation probe further comprises a porous structure that is associated with the distal end of the shaft in fluid communication with the lumen. For example, the distal end of the shaft, or the entirety of the shaft, can be composed of the porous structure. Or, if the ablative element is an electrode, the electrode can be composed of the porous structure. Because the pores within the porous structure are pervasive, the fluid will freely flow out into the tissue notwithstanding that some of the pores may become clogged.

Electrosurgical devices and systems having one or more porous electrodes

提供了具有一个或多个多孔电极的电外科装置和系统。提供了一种具有轴、手柄、和至少一个多孔电极的电外科装置。轴耦合到手柄，并且至少一个多孔电极布置在轴的远侧末端上。至少一个多孔电极传导提供给远侧末端的能量并使提供给远侧末端的流体能够通过至少一个电极的多孔结构，使得电外科能量和流体同时地施加到与至少一个多孔电极邻近的患者组织。在一个方面，电外科装置包括切换装置，该切换装置配置为使使用者能够选择向远侧末端提供至少第一流体(例如，生理盐水)或第二流体中(例如，氦气)中的哪种。

Steerable electrophysiology catheter

An electrophysiology catheter (20) comprises a shaft (22) having a first bending stiffness and a deflectable tip (28) secured to the distal end (24) of the shaft with a second bending stiffness less than the first bending stiffness. At least one electrode (34, 36) is mounted to the tip for delivering current to or monitoring electrical activity of tissue. A manipulator wire (58) is coupled to the distal end of the deflectable tip, whereby the deflectable tip may be deflected by axial force applied to the manipulator wire. A stiffener member (66) is axially slidable relative to the tip so as to adjust the tip curvature without removing the catheter from the body. The catheter may further include a core wire (72) configured to rotate the deflectable tip about a longitudinal axis (2) without rotating the proximal end (26) of the catheter shaft, wherein the distal end of the deflectable tip remains in a substantially constant axial position, preferably in a plane perpendicular to the longitudinal axis.

Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall

This invention is related to a tissue ablation system and method that treats atrial arrhythmia by ablating a circumferential region of tissue at a location where a pulmonary vein extends from an atrium. The system includes a circumferential ablation member with an ablation element and also includes a delivery assembly for delivering the ablation member to the location. The circumferential ablation member is generally adjustable between different configurations to allow both the delivery through a delivery sheath into the atrium and the ablative coupling between the ablation element and the circumferential region of tissue.

Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall

This invention is related to a tissue ablation system and method that treats atrial arrhythmia by ablating a circumferential region of tissue at a location where a pulmonary vein extends from an atrium. The system includes a circumferential ablation member with an ablation element and also includes a delivery assembly for delivering the ablation member to the location. The circumferential ablation member is generally adjustable between different configurations to allow both the delivery through a delivery sheath into the atrium and the ablative coupling between the ablation element and the circumferential region of tissue.

Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall

This invention is related to a tissue ablation system and method that treats atrial arrhythmia by ablating a circumferential region of tissue at a location where a pulmonary vein extends from an atrium. The system includes a circumferential ablation member with an ablation element and also includes a delivery assembly for delivering the ablation member to the location. The circumferential ablation member is generally adjustable between different configurations to allow both the delivery through a delivery sheath into the atrium and the ablative coupling between the ablation element and the circumferential region of tissue.

Circumferential ablation device assembly

Circumferential ablation device assembly and methods of use and manufacture providing an ablative circumferential band along an expandable member

A medical balloon catheter assembly includes a balloon having a permeable region and a non-permeable region. The balloon is constructed at least in part from a fluid permeable tube such that the permeable region is formed from a porous material which allows a volume of pressurized fluid to pass from within a chamber formed by the balloon and into the permeable region sufficiently such that the fluid may be ablatively coupled to tissue engaged by the permeable region. The non-permeable region is adapted to substantially block the pressurized fluid from passing from within the chamber and outwardly from the balloon. The porous material may be a porous fluoropolymer, such as porous polytetrafluoroethylene, and the pores may be created by voids which are inherently formed between an interlocking node-fibril network which makes up the fluoropolymer. Such voids may be created according to one mode by expanding the fluoropolymer. The balloon may be formed such that the porous material extends along both the permeable and non-permeable regions. In one mode of this construction, the porous material is porous along the permeable region but is non-porous along the non-permeable region, such as for example by expanding only the permeable region in order to render sufficient voids in the node-fibril network to provide permeable pores in that section. The voids or pores in the porous material may also be provided along both permeable and non-permeable sections but are substantially blocked with an insulator material along the non-permeable section in order to prevent fluid from passing therethrough. The insulator material may be dip coated, deposited, or extruded with the porous material in order to fill the voids. The insulator material may in one mode be provided along the entire working length of the balloon and then selectively removed along the permeable section, or may be selectively exposed to only the non-permeable sections in order to fill the voids or pores there.

Surgical ablation probe for forming a circumferential lesion

Circumferential ablation device assembly with dual expandable members

Abstract of the Disclosure The present invention involves a surgical device and method of use, particularly an assembly and method incorporating dual expandable members along the distal region of an ablation device to facilitate ablation of a circumferential region of tissue engaged by the expandable member. The ablation device assembly includes an elongate body with a proximal end portion, a distal end portion, and a longitudinal axis. A first expansion element is located along the distal end portion of the elongate body, and is fluidly coupled to a first source of inflation fluid. A second expansion element having a circumferential wall is located along the distal end portion proximal the first expansion element, and is fluidly coupled to a second source of inflation fluid. An ablation element having an ablative energy source is located along the distal end portion within the second expansion element, wherein the ablation element cooperates with the second expansion element such that the ablative energy source emits a substantially circumferential pattern of energy through the circumferential wall.

Multi-region staged inflation balloon

The present invention involves a surgical device and method of use, particularly an assembly and method incorporating a shaped expandable member along the distal region of an ablation device to facilitate ablation of a circumferential region of tissue engaged by the expandable member. The ablation device assembly includes an elongate body with a proximal end portion, a distal end portion, and a longitudinal axis. A contact member is located along the distal end portion of the elongate body. The contact member has a circumferential wall and is expandable from a radially collapsed condition to a radially expanded condition. The contact member also includes a single chamber having a single bulbous section. The single bulbous section has a plurality of longitudinally adjacent circumferential regions wherein adjacent regions have dissimilar wall thicknesses. The ablation device also has an ablation element having an ablative energy source that is located along the distal end portion, wherein the ablation element cooperates with the contact member such that the ablative energy source emits a substantially circumferential pattern of energy through the circumferential wall.