УСТРОЙСТВО ДЛЯ АБЛЯЦИИ СЛИЗИСТОЙ ОБОЛОЧКИ БОЛЬШОЙ ПЛОЩАДИ

Группа изобретений относится к медицине, а именно к устройству и способу для абляции, в частности для абляции слизистой оболочки. Головка устройства содержит первый канал с первым электродом, расположенным по меньшей мере частично в нем, и второй канал со вторым электродом, расположенным по меньшей мере частично в нем. Первый и второй каналы вместе, а также первый и второй электроды вместе расходятся под острым углом. Ток протекает между биологической тканью и электродами устройства для абляции. При этом головку устройства перемещают вдоль пути поперек соединяющей электроды линии на расстоянии от подлежащей абляции ткани. Обеспечивается однородная абляция ткани большей площади с высоким качеством за счет более равномерного в терапевтическом смысле эффекта глубины по ширине полоски при коагуляции слизистой оболочки. 2 н. и 16 з.п. ф-лы, 7 ил.

Electrosurgical device

Electrosurgical apparatus and electrosurgical device

An electrical surgical instrument has RF electrodes and a gas conduit so that a plasma can be formed at a distal tip where a retractable surgical snare 338 is arranged such that the thermal plasma may be directed to biological tissue encircled by the snare. The RF is delivered to the tip electrodes via a coaxial cable 302 in the body of the instrument. The RF may include microwave frequencies and the probe may be fed from separate RF and microwave sources (204 206 figure 2). The snare may be cold snare (fig 3) and formed from an electrically insulating material. The snare alternatively may be electrically active (fig 4) and connected to receive RF energy to be radiated into the area encircled by the snare. The instrument can be used in different modes and configurations (see figures 3 and 4) : (i) a plasma to perform surface coagulation, (ii) a non-ionising microwave field (in the absence of plasma) to perform coagulation at a deeper level, and (iii) an RF field to assist with cutting.

Plasma coagulating electrosurgical instrument and electrosurgical apparatus incorporating the same

Articulated robotic probes

An articulated probe assembly comprises a base, an outer support rod extending through the base, an articulating control portion at a proximal end of the outer support rod, and a steerable portion comprising a plurality of outer links coupled to a distal end of the outer support rod. The steerable portion is manipulated in response to the articulating control portion ...

Electrosurgical ablation instrument

An electrosurgical instrument having a microwave ablation antenna dimensioned to be suitable for insertion into a pancreas via a surgical scoping device, to provide a rapid and accurate alternative to known RF ablation techniques. The instrument comprises a radiating tip portion connected at a distal end of a flexible coaxial cable that conveys microwave energy. The radiating tip portion comprises a proximal coaxial transmission line for conveying the microwave energy and a distal needle tip mounted at a distal end of the coaxial transmission line, wherein the distal needle tip operates as a half wavelength transformer. The length of the radiating tip portion may be in the range from 5 mm to 80 mm.

Electrosurgical rotating cutting device

An electrosurgical cutting device and method thereof for incising tissue are disclosed. The electrosurgical cutting device includes an asymmetrical cutting element that is affixed to a distal end of a torque cable. The cutting element is disposed within an end cap and is axially movable between a retracted position and an extended position. Rotation of the torque cable during a procedure allows the cutting element to rotationally align with and hook the target tissue onto the cutting element. An elongate member of the cutting element selectively lifts the target tissue away from surrounding tissue and structures. Having lifted the tissue away the surrounding tissue and structures, incision can occur.

Device for local heat treatment of tissue

Cyrogenic treatment systems

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

Cardiac tissue ablation device

Method to detect and electrosurgically treat aberrant myoelectric activity

Device for local heat treatment of tissue

SYSTEMS AND METHODS FOR MONITORING AND CONTROLLING USE OF MEDICAL DEVICES

A device (26) carries a use monitoring element (82,114) that possesses a state or condition that changes in response to use of the device and that is sensed when the device is presented for use. Reuse of the device is not permitted, if the use monitoring element (82, 114) indicates a prior use.

INTEGRATED TISSUE HEATING AND COOLING APPARATUS

Systems, and methods integrate the control of an energy generator (38), to supply energy to an electrode structure to heat a tissue region, and the control of a pumping mechanism (44), to supply cooling fluid to control tissue temperature in the region.

OPERATIVE DEVICES THAT CAN BE REMOVABLY FITTED ON CATHETER BODIES TO TREAT TISSUE REGIONS IN THE BODY

A targeted tissue region in a body is treated by a tissue heating element (44) attached to a carrier. The carrier is intended, in use, to be temporarily mounted to an exterior of a catheter body, such as an endoscope. The catheter body is deployed, with the carrier mounted on it, into the targeted tissue region. The tissue heating element (44) is operated, e.g., to form one or more tissue lesions, after which the catheter body is retrieved from the targeted tissue region. The carrier can then be removed from the catheter body, allowing the catheter body to the subsequently used for another purpose.

ENDOSCOPIC ABLATION SYSTEM WITH A PLURALITY OF ELECTRODES

A tissue ablation system is described. The tissue ablation system can include a plurality of electrode pairs and a viewing window between each pair of adjacent electrodes. The electrodes can be energized in a predetermined sequence to ablate tissue around the circumference of a body lumen.

ELECTROSURGICAL APPARATUS FOR DELIVERING RADIOFREQUENCY ENERGY AND MICROWAVE ENERGY AND A METHOD FOR ITS USE

An electrosurgical waveform (500) is to be provided having both radiofrequency (RF) energy and microwave energy components arranged to perform efficient haemostasis in biological tissue. The waveform comprises a first portion (506) primarily of RF electromagnetic energy and a second portion (508) primarily of microwave electromagnetic energy that follows the first portion. The second portion further comprises a plurality of RF pulses (510), wherein the first portion is to transition to the second portion when either a duration (512) of the first portion meets or exceeds a predetermined duration threshold or an impedance determined during the first portion meets or exceeds a predetermined threshold.

ELECTROSURGICAL RESECTION INSTRUMENT

An electrosurgical resection instrument (100) for applying to biological tissue radiofrequency electromagnetic energy has a protective hull (120) comprising a shaped piece of dielectric material mounted to cover an underside of an instrument tip (104) of the instrument (100). The protective hull (120) acts as a shield to protect tissue that may lie under the instrument tip (104) from damage during treatment. The instrument (100) may be particularly useful in procedures performed in a gastrointestinal tract, where bowel perforation is a concern, or in the pancreas, where damage to the portal vein or the pancreatic duct may occur when a tumour or other abnormality is being resected, dissected or removed.

ELECTROSURGICAL SYSTEM

Phase end point determination is provided to automatically halt the application of energy to tissue. Prior to the application of energy, the phase end point determination is identified by measuring the product of permittivity and conductivity of the tissue to be treated. An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

DEVICES AND METHODS FOR THE TREATMENT OF TISSUE

Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes.

Automatic Image guided tissue removal and processing

DEVICES AND METHODS FOR THE TREATMENT OF TISSUE

DEVICES AND METHODS FOR THE TREATMENT OF TISSUE

ABLATION IN THE GASTROINTESTINAL TRACT TO ACHIEVE HEMOSTASIS AND ERADICATE LESIONS WITH A PROPENSITY FOR BLEEDING

Devices and methods are provided for the ablation of regions of the digestive tract to achieve hemostasis and to eradicate chronically bleeding lesions as occur with gastric antral vascular ectasia (GAVE), portal hypertensive gastropathy (PHG), radiation proctopathy and colopathy, arteriovenous malformations, and angiodysplasia. Ablation is typically provided in a wide-field manner, and in conjunction with sufficient pressure to achieve coaptive coagulation. Ablation, as provided the invention, starts at the mucosa and penetrates deeper into the gastrointestinal wall in a controlled manner. Ablation control may be exerted by way of electrode design and size, energy density, power density, number of applications, pattern of applications, and pressure. Control may also be provided by a fractional ablation that ablates some tissue within a target region and leaves a portion substantially unaffected. Embodiments of the device include an ablational electrode array that spans 360 degrees and ...

TFT COAGULATION SAFEGUARD

The invention discloses a medical TFT instrument of bipolar design having at least two electrodes, held by electrode carriers which are movable relative to each other, which can each be charged with HF current via a supply line. According to the invention, the instrument is additionally provided with a safety switch mechanism arranged in the region of the electrode carriers and interconnected in at least one of the supply lines, said safety switch mechanism being moved to an off or disconnect position when at least one of the electrode carriers is transferred to a non-functional position/situation, thereby interrupting an HF current supply to the electrode associated with said supply line.

UTERINE TREATMENT APPARATUS

An apparatus to treat a uterus includes a deployable member (22) configured to be positioned in a uterine cavity in at least a partially deployed state to define a microwave chamber (20) in an interior of the deployable member (22), and removed from the uterine cavity in a non-deployed state. The deployable member (22) is at least partially microwave energy absorbable and formed of a fluid permeable material to house and controllably release a fluidic medium (34) from the microwave chamber (20) when the deployable member (22) is positioned in the uterine cavity in the at least partially deployed state. A microwave emitter (24) is positioned in the microwave chamber (20), the microwave emitter (24) is configured to be coupled to a microwave energy source and deliver microwave energy to the fluidic medium (34), wherein the fluidic medium (34) transfers thermal energy from the microwave emitter (24) to a uterine structure.

Method for treating a sphincter

A method for treating a sphincter provides a polymer material having a liquid state. The method also provides a catheter having a distal end, a tissue piercing device carried by the distal end, and an energy delivery device coupled to the tissue piercing device. The tissue piercing device has a lumen. The method introduces the catheter into an esophagus and pierces an exterior sphincter tissue surface within with the tissue piercing device. The method advances the tissue piercing device into an interior sphincter tissue site and conveys the polymer material while in a liquid state through the lumen into the interior sphincter tissue site. The method delivers energy to the tissue piercing device to transform the polymer material into a less liquid state within the interior sphincter tissue site, to thereby remodel the sphincter.

Medical device with improved wall construction

A medical device having a laminate elongate hollow member is disclosed. The laminate member provides torsional stiffness for controlling positioning of the distal end of the device, and provides bending flexibility for assisting in insertion of the device in the patient's esophagus or other body lumen.

Electrosurgical resection instrument

An electrosurgical resection instrument for applying to biological tissue radiofrequency electromagnetic energy has a protective hull comprising a shaped piece of dielectric material mounted to cover an underside of an instrument tip of the instrument. The protective hull acts as a shield to protect tissue that may lie under the instrument tip from damage during treatment. The instrument may be particularly useful in procedures performed in a gastrointestinal tract, where bowel perforation is a concern, or in the pancreas, where damage to the portal vein or the pancreatic duct may occur when a tumor or other abnormality is being resected, dissected or removed.

Apparatus for use in the prophylaxis or treatment of tissue

Apparatus ( 20 ) for carrying out a prophylactic or treatment procedure on tissue comprises a device ( 21 ) having a chamber ( 22 ) and at least one active element such as an electrode ( 23 ) within the chamber ( 22 ). The chamber ( 22 ) has an opening ( 26 ) through which tissue is drawn into the chamber ( 22 ). Means for drawing the tissue into the chamber may comprise a vacuum lumen with vacuum orifices ( 25 ) in the chamber ( 22 ). Treatment such as electroporation may be applied to tissue in the chamber ( 22 ).

CRYOGENIC ABLATION SYSTEM WITH ROTATABLE AND TRANSLATABLE CATHETER

An ablation assembly includes a handle, a catheter assembly and a connector locking assembly. The catheter assembly includes: a catheter shaft, a balloon and a connector at the distal and proximal ends of the catheter shaft, and a delivery tube extending between there between. The connector includes a connector body secured to the proximal end and a plug secured to the delivery tube, the plug and delivery tube movable axially and rotationally. The handle includes an open portion receiving the plug and the connector body. The connector locking assembly includes: means for simultaneously automatically connecting the plug and the connector body to the handle to place the connector in a load state prior to use, and means for automatically releasing the connector body and thereafter the plug from the handle to place the connector in an eject state to permit the connector to be removed from the handle.

Device, system and method for in-vivo cauterization

Devices, systems and methods for in-vivo cauterization. An autonomous in-vivo device may include a heating mechanism to cauterize in-vivo tissue. A system may include an autonomous in-vivo heating device having a heating mechanism to cauterize in-vivo tissue, and an in-vivo imaging device to acquire in-vivo images.

SEPTUM RESECTION METHOD AND ENDOSCOPIC TREATMENT DEVICE

An endoscopic treatment device has a sheath extending between a distal end portion and a proximal end portion; a first/second wire inserted through the sheath, wherein the first/second wire can protrude from the distal end portion of the sheath and cut tissue by being applied with current; an insulative member configured to connect distal ends of the first wire and the second wire; and a first/second insulative tube configured to cover the first/second wire protruding from the sheath, wherein the first/second insulative tube can move with respect to the first/second wire respectively, wherein the endoscopic treatment device switches between a first state where the second wire protruding from the sheath is covered by the second insulative tube and a second state where the first wire protruding from the sheath is covered by the first insulative tube.

Microwave energy-delivery device and system

A microwave ablation device including a cable assembly configured to connect a microwave ablation device to an energy source and a feedline in electrical communication with the cable assembly. The microwave ablation device further includes a balun on an outer conductor of the feedline, and a temperature sensor on the balun sensing the temperature of the balun.

SYSTEMS, DEVICES AND METHODS FOR PERFORMING MEDICAL PROCEDURES IN THE INTESTINE

A method for performing a medical procedure in an intestine of a patient is provided. The method comprises providing a system comprising: a catheter for insertion into the intestine, the catheter comprising: an elongate shaft comprising a distal portion; and a functional assembly positioned on the shaft distal portion and comprising at least one treatment element. The catheter is introduced into the patient, and target tissue is treated with the at least one treatment element. The target tissue comprises mucosal tissue of the small intestine, and the medical procedure can be configured to treat at least one of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH).

SYSTEMS AND METHODS FOR DIAGNOSING AND/OR TREATING GASTROINTESTINAL CONDITIONS

A medical tool for use with an endoscopic capsule includes: a jaw assembly configured to maintain the endoscopic capsule at a certain position or within a range of positions relative to the jaw assembly while the endoscopic capsule is inside a bodily lumen, the jaw assembly having a first jaw and a second jaw, the first jaw having a first portion and a second portion that is opposite from the first portion; and a control configured to move at least one of the first jaw and the second jaw from a first configuration in which the first and the second jaws are spaced at a first distance, to a second configuration in which the first and the second jaws are spaced at a second distance that is less than the first distance.

MEDICAL DEVICES UTILIZING SHAPE MEMORY ALLOYS AND ASSOCIATED SYSTEMS AND METHODS

Medical devices utilizing shape memory alloys and associated methods are disclosed herein. One aspect of the present technology, for example, is directed toward a treatment element configured to be positioned within a body lumen and coupled to an energy source. At least a portion of the treatment element may be made of a shape memory alloy, and wherein application of thermal energy to the treatment element from the energy source transforms the treatment element from the martensitic state to the austenitic state in which the treatment element is configured to cut, ablate, resect, and/or cauterize tissue.

CATHETERS THAT DELIVER PULSED ELECTRICAL FIELD FOR TARGETED CELLULAR ABLATION

Devices can be used to deliver pulsed electrical field for targeted cellular ablation. For example, this document describes catheter-based devices that deliver non-thermal irreversible electroporation to treat deep vein thrombosis by ablating cells of the venous thrombus to prevent cellular mechanisms that lead to clot organization, leaving the clot susceptible to physiological degradation.

APPARATUS TO ELECTROSURGICALLY TREAT ESOPHAGEAL SPHINCTERS

An apparatus to treat a sphincter includes a catheter means including a catheter means distal portion means. An energy delivery device means is coupled to the catheter means and includes a tissue piercing distal end. The energy delivery device means is configured to pierce a sphincter exterior surface, advance a sufficient distance in an interior of the sphincter to a tissue site, deliver energy to the tissue site and create controlled cell necrosis of the sphincter in order to reduce a frequency of sphincter relaxation. A cable means is coupled to the energy delivery device means.

DEVICES FOR THE TREATMENT OF THE SMALL INTESTINE

ENDOSCOPIC MUCOSAL RESECTION DEVICE WITH CONDUCTIVE TISSUE STOPPER AND USING METHOD THEREOF

PROBLEM TO BE SOLVED: To provide a medical apparatus with an opening on a side face, which utilizes suction to engage mucosal tissue for resection. SOLUTION: The medical apparatus includes a high frequency tissue cutting device disposed inward of a side opening and is useful for resecting tissue from the gastrointestinal tract. A tissue stopper can be used to control the depth of the tissue resected, and the tissue stopper can include openings for sucking the tissue into the side opening. The tissue stopper can be electrically grounded with respect to the high frequency tissue cutting device, and the tissue stopper can provide one pole of a high frequency electrical circuit. COPYRIGHT: (C)2005,JPO&NCIPI ...

ИНСТРУМЕНТ И СИСТЕМА ДЛЯ АБЛЯЦИИ

Endoskopische Schleimhautresektionsvorrichtung mit einem leitenden Gewebeanschlagelement

Ballonkatheter für die Vornahme von Schneidvorgängen in Gewebe von Individuen, insbesondere im Kardio- und/oder Gastrobereich

Kathetersystem für eine Kryoablation des Nervus vagus

Ein Kathetersystem für eine Kryoablation des Magens (1), aufweisend einen Katheter (5) und mindestens einen inflatierbaren Kryoballon (6), der an dem Katheter (5) befestigt ist und eine Kontaktkurve (7) aufweist, entlang derer der Kryoballon mit dem Fundus (3) in Kontakt bringbar ist, wobei die Kontaktkurve (7) eine geschlossene Kurve auf der Oberfläche des Kryoballons (6) ist und der Kryoballon (6) eine erste Kühleinrichtung (10) enthält, die entlang weniger als drei Vierteln der Länge der Kontaktkurve (7) verläuft.

Electrosurgical cutting tool

Electrosurgical snare

Electrosurgical apparatus for delivering RF and/or microwave energy into biological tissue

Dual-function plasma and non-ionising microwave coagulating electrosurgical instrument and electrosurgical apparatus incorporating the same

Electrosurgical apparatus and method

INTEGRATED EQUIPMENT FOR THE HEATING UP AND COOLING OF FABRIC

SYSTEM FOR THE TREATMENT OF OBESITY

INTEGRATED EQUIPMENT FOR THE HEATING UP AND COOLING OF FABRIC

Large area thermal ablation

Methods and systems for determining physiologic characteristics for treatment of the esophagus

A method and apparatus for treating abnormal mucosa in the esophagus is disclosed, such that the depth of the treated tissue is controlled. The depth of ablation is controlled by monitoring the tissue impedance and/or the tissue temperature. A desired ablation depth is also achieved by controlling the energy density or power density, and the amount of time required for energy delivery. A method and apparatus is disclosed for measuring an inner diameter of a body lumen, where a balloon is inflated inside the body lumen at a fixed pressure.

Cyrogenic treatment systems

Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment 5 area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. 10 Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session. 'a. \~ r) 74t ' ii I, 4/4' 44' '4. N "'N~ A 4$..

Surgical snare with ability to deliver electromagnetic energy and/or thermal plasma into biological tissue

A surgical snare comprising a means of delivering thermal plasma on to biological tissue encircled by the snare. The snare may be "cold" snare, i.e. formed from insulating material, or active, i.e. connected to receive RF and/or microwave energy to be radiated into the area encircled by the snare. The surgical snare may thus deliver into biological tissue encircled by a retractable loop any one of (i) a plasma to perform surface coagulation, (ii) a non-ionising microwave field (in the absence of plasma) to perform coagulation at a deeper level, and (iii) an RF field to assist with cutting.

Electrosurgical snare

An electrosurgical snare (500), e.g. suitably sized for insertion down the instrument channel of an endoscope, arranged to radiate microwave frequency energy (e.g. having a frequency greater than 1 GHz) from an elongate conductive element (122) within an area encircled by a retractable loop (118). The elongate conductive element (122) and retractable loop (118) may be independently slidable relative to a snare base (512) at a distal end of a sleeve (114) to provide an appropriate device configuration. By controlling the shape of the emitted microwave field, the risk of collateral thermal damage can be reduced.

Gastrointestinal neuromodulation and associated systems and methods

Methods for treating gastrointestinal conditions, conditions associated with sympathetic and/or parasympathetic activity in the gastrointestinal organs, and conditions associated with central sympathetic and/or parasympathetic activity in a patient with therapeutic gastrointestinal neuromodulation and associated systems and methods are disclosed herein. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a gastrointestinal artery of a gastrointestinal organ of a patient. Sympathetic drive in the patient can thereby be reduced in a manner that treats the patient for the gastrointestinal condition. Gastrointestinal sympathetic nerve activity can be modulated along afferent and/or efferent pathways. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly, e.g., a therapeutic assembly configured to use electrically-induced, thermally-induced ...

TRANSCUTANEOUS ELECTRICAL AND/OR MAGNETIC SPINAL STIMULATION FOR BLADDER OR BOWEL CONTROL IN SUBJECTS WITHOUT CNS INJURY

In various embodiments methods and devices are provided for facilitating locomotor function and/or voiding of bladder and/or bowel in a subject with a neuromotor disorder. In certain embodiments the methods involve providing magnetic stimulation of the spinal cord at a location, frequency and intensity sufficient to facilitate locomotor function and/or voiding of bladder and/or bowel.

CRYOSPRAY CATHETERS

A cryosurgery system for application of medical-grade liquid nitrogen to a treatment area via a small, low pressure, open tipped catheter. The system includes a console, including a touch panel computer, a cryogen module, a suction module and an electronics module, and a disposable spray kit. Features include optional low cryogen flow setting to reduce the cryogen flow rate by 50%, improved cryogen flow consistency reducing pressure pulses and peaks, an integrated suction pump for improved consistency and self-checks, specified vent tube areas and corresponding maximum expected pressures during cryospray procedure; optional pressure sensing capability to monitor pressure during a treatment, and novel catheter designs of multilayer and flexible construction providing a variety of spray patterns.

CYROGENIC TREATMENT SYSTEMS

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

ARTICULATED ROBOTIC PROBES

An articulated probe assembly comprises a base, an outer support rod extending through the base, an articulating control portion at a proximal end of the outer support rod, and a steerable portion comprising a plurality of outer links coupled to a distal end of the outer support rod. The steerable portion is manipulated in response to the articulating control portion.

ELECTROSURGICAL APPARATUS FOR TREATING GASTROESOPHAGEAL REFLUX DISEASE (GERD) 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.

고주파 절단 팁 및 가열식 풍선을 구비한 카테터

... 가성낭종을 배출하기 위한 방법 및 본원에서 사용하기 위한 스텐트 전달 시스템이 개시된다. 예시적인 시스템은 그의 원위 단부 영역에 부착된 팽창 가능한 풍선을 갖는 카테터 샤프트를 포함할 수 있다. 절단 전극이 시스템의 원위 단부에 배치될 수 있고, 적어도 하나의 가열 전극이 팽창 가능한 풍선 내에 배치될 수 있다. 자가 확장식 스텐트가 팽창 가능한 풍선 둘레에 배치될 수 있다. 스텐트는 형상 기억 중합체로 형성될 수 있다. 팽창 유체는 스텐트의 확장을 용이하게 하도록 풍선 내에서 가열될 수 있다.

CONTROL SYSTEMS FOR MULTIPLE ELECTRODE ARRAYS TO CREATE LESIONS IN TISSUE REGIONS AT OR NEAR A SPHINCTER

L'invention concerne plusieurs électrodes couplées les unes aux autres dans des réseaux unipolaires ou bipolaires afin de réaliser des formes de lésions dans des régions tissulaires au niveau ou à proximité d'un muscle sphincter. Une unité de commande (52) couple les électrodes à un générateur (38) de sorte qu'un canal de puissance unique desserve au moins une électrode unique.

INJECTATE DELIVERY DEVICES, SYSTEMS AND METHODS

An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided. 1. A catheter for ablating a luminal surface tissue in a body lumen , said catheter comprising:a shaft assembly having a distal portion and a proximal portion, said proximal portion configured to fluidly attach to a source of tissue expansion fluid;an expandable element positioned on the distal portion of the shaft assembly and configured to deliver ablation energy to the tissue surface when expanded within the body lumen;at least two tissue capture ports, each tissue capture port positioned on an outer surface of the expandable element and configured to capture tissue when a vacuum is applied to the tissue capture port;at least two fluid delivery elements, each fluid delivery element configured to penetrate and deliver the tissue expansion fluid to tissue captured by one of the tissue capture ports.2. The catheter of claim 1 , wherein the expandable element is configured to receive a heated fluid to deliver ablation energy to the luminal surface tissue.3. The catheter of claim 2 , wherein the proximal portion of the shaft is further configured to be connected to a source of heated ablation fluid and wherein the expandable element comprises a balloon configured to receive the heated ablation fluid from the ...

Method and Apparatus for Tissue Ablation

The present application discloses devices that ablate human tissue. The device comprises a catheter with a shaft through which an ablative agent can travel, a liquid reservoir and a heating component, which may comprise a length of coiled tubing contained within a heating element, wherein activation of said heating element causes said coiled tubing to increase from a first temperature to a second temperature and wherein the increase causes a conversion of liquid within the coiled tubing to vapor, a reusable cord connecting the outlet of the reservoir to the inlet of the heating component, and a single use cord connecting a pressure-resistant inlet port of a vapor based ablation device to the outlet of the heating component.

Graphical user interface for monitoring and controlling use of medical devices

A device for treating a tissue region is supplied with a separate usage key card. The usage key card comprises a storage medium, which is formatted to contain an identification code unique to the usage key card. The usage key card is adapted to be read by a remote reader, to download the identification code for processing by a controller for the device. Processing of the identification code by the controller either enables or disables operation of the device according to prescribed criteria. A viewable image is generated on a display screen that changes in response to processing of the identification code.

Ablation of stomach lining to treat obesity

The invention provides methods and devices for ablation of stomach tissue to treat obesity. For example, the invention may involve ablation of mucosal tissue to inhibit ghrelin production, recognized as a root cause of increased appetite. The invention alternatively may involve ablation of sub-mucosal tissue to alter myoelectric activity and thereby induce gastroparesis. As a further alternative, gastric muscle tissue, vagal nerves within the stomach or the pyloric region may be ablated to alter stomach function and thereby induce gastroparesis.

Devices and methods for transurethral bladder partitioning

Systems, devices, and methods to treat a urinary bladder are disclosed. An expandable member is introduced and expanded in the urinary bladder to appose one or more elongate conductors on the outer surface of the expandable member against the inner wall of the urinary bladder. The one or more elongate conductors are used to create a predetermined pattern of electrically isolated tissue regions having reduced electrical propagation such that electrical propagation through the urinary bladder as a whole is reduced. A mucus layer may be removed from the inner bladder wall prior to the ablation. Ablation may be regulated by impedance measurement with the one or more elongate conductors. The urinary bladder may be filled with a fluid to facilitate the impedance measurement.

Apparatus and methods for mapping out endoluminal gastrointestinal surgery

Apparatus and methods are provided for mapping out endoluminal gastrointestinal surgery, including endoluminal gastric reduction. Mapping is achieved by locally marking the interior of the gastrointestinal lumen at specified locations. In a first embodiment, the surgical map comprises localized RF scarring or mucosal ablation. In an alternative embodiment, the map comprises pegs. In another alternative embodiment, the map comprises dye and/or spheres injected into at least the submucosa. As a still further alternative, the map may comprise the shaft of an endoluminal surgical tool having specified dimensions and/or color-coding, etc. In another alternative embodiment, the map may be formed from surgical mesh. In one preferred embodiment, placement of the map is accurately achieved by approximating the interior of the stomach with an endoluminal support via suction ports and/or via an inflatable member disposed along the support. Methods of using apparatus of the present invention are provided ...

DEVICES AND METHODS FOR ENERGY TRANSFER MAPPING

The present disclosure relates generally to the field of energy transfer mapping, including fixtures with two-dimensional and three-dimensional sensor arrays. In particular, the present disclosure relates to devices and methods for mapping of energy transfer from and/or to an instrument inserted within and/or into body tissue, including the depths and patterns of penetration and/or amounts of energy transfer to and/or from an instrument delivered within biological tissue or materials that mimic biological tissue, including within fixtures with three-dimensional temperature sensor arrays configured to simulate anatomical geometries such as the gastrointestinal (GI) or respiratory tract.

Bipolar endoscopic device with parallel electrodes for endoluminal and transluminal haemostasis

A surgical device including a shaft defining an axis and having a distal end and a proximal end, a first elongated electrode pivotally connected to the distal end of the shaft and deployable from a first configuration, wherein the first electrode is generally coaxially aligned with the axis, to a second configuration, wherein the first electrode is generally perpendicular relative to the axis, and a second elongated electrode pivotally connected to the distal end of the shaft and deployable from a first configuration, wherein the second electrode is generally coaxially aligned with the axis, to a second configuration, wherein the second electrode is generally perpendicular relative to the axis, wherein the first elongated electrode is adapted to extend radially relative to the second elongated electrode.

Margin extension device and method

A margin extension device and method are disclosed herein. The margin extension device can be used for ablating one or several cancer cells and can include a contact member and a plurality of electrodes. The contact member can be electrically conductive, and can electrically connect the electrodes. The margin extension device can further include one or several leads that connect the electrodes of the margin extension device to a treatment controller. The treatment controller can include a pulse generator that can generate one or several electrical pulses that generate one or several electrical fields in tissue proximate to the margin extension device.

ELECTROSURGICAL ROTATING CUTTING DEVICE

Оценка качества контакта посредством анализа диэлектрических свойств

Einrichtung zur Koagulation biologischer Gewebe

INTEGRIERTES GERÄT ZUR ERWÄRMUNG UND KÜHLUNG VON GEWEBE

HF-chirurgisches Resektionsinstrument mit einer Einrichtung zur Kontrolle der Öffnungsweite einer Schlinge

Eine HF-chirurgische Resektionsschlinge umfasst wenigstens einen ersten elektrisch nicht isolierten Schlingenabschnitt und einen zweiten elektrisch isolierten Schlingenabschnitt. Der elektrisch nicht isolierte Schlingenabschnitt bringt Strom in das Gewebe, während der elektrisch isolierte Schlingenabschnitt nur zur mechanischen Halterung und Führung dient. Wenigstens einer der Schlingenabschnitte ist durch einen Manipulationsdraht, der in einem Katheter geführt wird, in seiner Länge einstellbar. An einem proximalen Ende des Katheters ist eine Skala und/oder Anzeigevorrichtung, welche die Öffnungsweite der Schlinge anzeigt und/oder signalisiert.

Electrosurgical snare

An electrosurgical snare 100 is arranged to radiate microwave frequency energy (e.g. >1 GHz) from an elongate conductive antenna 122 within an area encircled by a retractable loop 118. The antenna is coupled to the inner conductor 104 of a coaxial cable 106 which delivers microwave energy from a generator to the probe tip, where the cable is capped by an insulating snare base 112 having a feed channel to guide passage of the retractable loop. The antenna and retractable loop may be independently slidable relative to the snare base to aid deployment. The antenna may be a straight extension of the inner coax conductor (in which case the retractable loop is of electrically conductive material), or it may be a flexible C-shaped element (132, figure 2A) or it may be a conductive coating (142, figure 3A) on the retractable loop. The probe may be sized for insertion down the instrument channel of an endoscope.

Electrosurgical snare

A surgical snare 400 comprising: a coaxial cable 411 having inner and outer conductors 406,412; a head assembly 419 at a distal end of the coaxial-cable 411; and a snare wire 403. The head-assembly 419 comprises: an end cap 408 having an energy transfer structure connected to inner-conductor 406; and channels 413,414 in which the snare-wire 403 is disposed forming a retractable loop beyond the energy-transfer-structure. Coaxial-cable 411 may convey microwave energy where the energy-transfer-structure is configured as a microwave radiating antenna. Coaxial-cable 411 may convey radio frequency energy. The snare-wire 403 may be slidably mounted in the head-assembly 419, where the retractable loop is retractable toward the energy-transfer-structure and where the energy-transfer-structure may provide a reaction surface having a sharpened edge for contacting the fully retracted loop, so facilitating the cutting of biological tissue captured by snare-wire 403. The head-assembly 419 may include ...

Electrosurgical apparatus for delivering RF and/or microwave energy into biological tissue

An electrosurgical instrument for resecting biological tissue with RF electromagnetic energy and coagulating with microwave frequency EM energy. The instrument tip 224 has a protective hull 222 with a smoothly contoured convex undersurface facing away from an elongate planar body having conducting surfaces. The planar body has a tapering distal edge; its underside extends beyond the protective hull at the tapering distal edge; there may be a channel in the underside to receive a needle 234 for injecting liquid into the target tissue. Also disclosed is: an interface joint (figure 2) for integrating into a single cable assembly 216 all of (i) a fluid feed, (ii) a needle movement mechanism, and (iii) an energy feed (e.g. a coaxial cable 142); and a torque transfer device (figures 4A and 4B) for permitting controlled rotation of the cable assembly within the instrument channel of an endoscope. The interface joint and torque transfer device may be integrated as a single component (figure 6).

Electrosurgical apparatus for delivering RF and/or microwave energy into biological tissue

ELECTRICALSURGICAL DEVICE FOR THE TREATMENT OF CLOSING MUSCLES

Graphical user interface for monitoring and controlling use of medical devices

Electrosurgical system

Electrosurgical resection instrument

An electrosurgical resection instrument (100) for applying to biological tissue radiofrequency electromagnetic energy has a protective hull (120) comprising a shaped piece of dielectric material mounted to cover an underside of an instrument tip (104) of the instrument (100). The protective hull (120) acts as a shield to protect tissue that may lie under the instrument tip (104) from damage during treatment. The instrument (100) may be particularly useful in procedures performed in a gastrointestinal tract, where bowel perforation is a concern, or in the pancreas, where damage to the portal vein or the pancreatic duct may occur when a tumour or other abnormality is being resected, dissected or removed.

Method to electrosurgically treat esophageal sphincters

DEVICES AND METHODS FOR THE TREATMENT OF TISSUE

Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes. See Fig 4. WO 2012/099974 PCT/US2012/021739 Energy 330 Delivery Unit Controller Pa Tootioni35t Transfer 360 3/133 301 335 322b 370 maging 31b-- 311b Device -- 1 380 Protectivec Cap 332 311 b Ground Pad 311 a To PatAent 390 Tissue 316a Device 32 1 --371 500 Pharmaceutical Agents Body 510 Lumen mplantIG 4 ...

Electrocautery hemostasis clip

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

Electrosurgical apparatus for delivering radiofrequency energy and microwave energy and a method for its use

An electrosurgical waveform (500) is to be provided having both radiofrequency (RF) energy and microwave energy components arranged to perform efficient haemostasis in biological tissue. The waveform comprises a first portion (506) primarily of RF electromagnetic energy and a second portion (508) primarily of microwave electromagnetic energy that follows the first portion. The second portion further comprises a plurality of RF pulses (510), wherein the first portion is to transition to the second portion when either a duration (512) of the first portion meets or exceeds a predetermined duration threshold or an impedance determined during the first portion meets or exceeds a predetermined threshold.

AN ELECTROSURGICAL SYSTEM AND GENERATOR

H:\dxl\Introven\NRPortbl\DCC\DXL4368 II.doc-14/08/2014 An electrosurgical generator arranged to output electrosurgical energy through a removably coupled bipolar electrosurgical tool, the electrosurgical generator comprising a radiofrequency amplifier supplying a measurement signal through at least one electrode disposed on a bipolar electrosurgical tool and supplying electrosurgical energy after the supply of the measurement signal through the at least one electrode disposed on the bipolar electrosurgical tool; and a controller determining a phase angle and a phase rate of the supplied electrosurgical energy and ceasing the supply of electrosurgical energy when the determined phase angle reaches a predetermined phase angle and the determined phase rate reaches a predetermined phase rate. GENERATOR FEEDBACK 20 F~f~7CIRCUIT 14 PHASE 22 L -J DISCRIM FL - 2 ACTUATOR --- 16 1 1TISSUE16 ID. 24 MODULE 1 \-426 80 ONTROLLER 30 42 INDICATOR 82 42FA1 84-4 TISSUE SEL. 50 70 ----- 72 72 ' NRPT ...

ELECTROSURGICAL APPARATUS FOR TISSUE ABLATION

An electrosurgical apparatus for treating fluid-filled biological growths by replacing the fluid within the growth with a substance that assists in delivering treatment energy. The treatment energy may be microwave energy or may be thermal energy derived from microwave energy. The apparatus comprises an instrument having a radiating tip portion, and a fluid delivery mechanism for transporting fluid to and from a treatment zone located around the radiating tip portion. The fluid delivery mechanism comprises a rigid insertion element arranged to extend into the treatment zone, whereby fluid can be aspirated from the treatment zone, and a substance injected into the treatment zone to replace the aspirated fluid. The injected substance has dielectric properties selected to facilitate uniform delivery of treatment energy to biological tissue in the treatment zone.

MICROWAVE ENERGY-DELIVERY DEVICE AND SYSTEM

A microwave ablation device including a handle assembly fluidly enclosing a portion of a microwave feedline and a cooling assembly and a tubular member extending from the handle assembly and enclosing a distal portion of the feedline and the cooling assembly. The distal portion of the feed line terminates in a radiating section and the distal portion of the cooling assembly is configured to cool the radiating section. The microwave ablation device also includes a flexible cable assembly connected to the handle assembly and enclosing a proximal portion of the feedline, the flexible cable assembly configured to connect the feedline to an energy source, and a temperature sensing system associated with the cable assembly and configured to sense a temperature profile of tissue surrounding the distal radiating end of the tubular member.

ELECTROSURGICAL SYSTEM

Phase end point determination is provided to automatically halt the application of energy to tissue. Prior to the application of energy, the phase end point determination is identified by measuring the product of permittivity and conductivity of the tissue to be treated. An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

BALLOON TISSUE DAMAGE DEVICE

An inflatable medical instrument (18) for tissue damage in gastric reduction surgery includes a main chamber (20) composed of a biocompatible material capable of being selectively inflated. The medical instrument also includes a longitudinally extending tab member (26) secured to an outer surface of the main chamber, a series of suction holes (30) are formed along the tab member and an electrode (38) is mounted on the tab member. The present invention also provides a method for forming a tissue junction used in defining a gastric pouch including damaging opposed tissue layers, apposing the tissue layers and fastening the tissue layers to allow the tissue layers to heal together.

STEERABLE MEDICAL INSTRUMENT

A steerable medical instrument (136) includes a control handle (144), a s haft (140), steering control wires, and an end effector (100) at the distal end of the shaft. The end effector is a separate component engineered to dis tribute the stress and strain of bending moments along the length of the end effector to achieve predicable, repeatable, fine motion control over the di stal end of the instrument. The end effector may be customized for any medic al application. For example, the end effector may comprise a grasping device , a cutting devise, a snare, a specimen retrieval device, or a wound closure device (such as a stapler).

Endoluminal fold creation

Devices and methods are provided for forming one or more plications in the walls of a body cavity. In particular, endoscopic devices and methods are provided for forming and/or securing endoluminal tissue folds to reduce the volume of the gastric cavity. An end effector that includes a tissue receiving cavity can be delivered to a desired surgical site to allow a tissue fold to be formed within the tissue receiving cavity. A fastener can be used to secure the adjacent layers of tissue that form the tissue fold. The tissue folds can be effective to limit the stomach's capacity and create a feeling of satiety.

Endoluminal fold creation

Devices and methods are provided for forming one or more plications in the walls of a body cavity. In particular, endoscopic devices and methods are provided for forming and/or securing endoluminal tissue folds to reduce the volume of the gastric cavity. An end effector that includes a tissue receiving cavity can be delivered to a desired surgical site to allow a tissue fold to be formed within the tissue receiving cavity. A fastener can be used to secure the adjacent layers of tissue that form the tissue fold. The tissue folds can be effective to limit the stomach's capacity and create a feeling of satiety.

Devices and methods for treatment of luminal tissue

Devices and methods are provided for treatment of tissue in a body lumen with an electrode deployment device. Embodiments typically include a device with a plurality of electrodes having a pre-selected electrode density arranged on the surface of a support. The support may comprise a non-distensible electrode backing that is spirally furled about an axis and coupled to an expansion member such as an inflatable elastic balloon. In some embodiments, the balloon is inflated to selectively expose a portion of the electrode surface while maintaining the electrode density.

Electrical ablation devices and methods

An ablation apparatus may generally comprise an elongated body having a proximal end and a distal end and a non-conductive tip at the distal end, a conductive sheath at least partially surrounding a portion of the elongated body intermediate the proximal end and the tip, and an electrical conductor electrically connected to the conductive sheath. The ablation apparatus may comprise a first electrode having a first diameter and a plurality of second electrodes each having a second diameter, wherein the first diameter is greater than the second diameter. Methods of using the ablation apparatus are also described.

Surgical Snare with Electrosurgical Tip and Method of Use

A medical device includes a tissue dissector and a snare loop on a common shaft. At least the distal tip of the snare loop is energizable to function as an electrosurgical element for tissue dissection. In use the snare loop is partially extended from the shaft to expose the electrosurgical element for electrosurgical dissection, and the snare loop is fully extended from the shaft to deploy the snare loop for retrieval and positioning of an implant such as a gastric banding device. The snare loop may be deployed through a pair of jaws also mounted on the shaft for use in tissue dissection.

Method for Reducing the Absorption of Nutrients Through the Gastrointestinal Tract

The present invention features methods for applying a force, such as laser or radiofrequency (RF) energy to the wall of the small intestine, which targets and eliminates a portion of the capillary and vascular network responsible for the transportation of nutrients to the patient. This causes the patient to absorb a reduced percentage of nutrients, which results in a reduced caloric intake. Various types and shapes of applicators are used to deliver the treatment energy, and these applicator devices are within the scope of the present invention. The applicator can be deployed through either a body cavity (e.g., the oral cavity), an open surgical procedure, or a minimally invasive incision or incisions.

Catheter system for cryoablation of the vagus nerve

A catheter system for cryoablation of the stomach, comprising: a catheter and at least one inflatable cryoballoon which is fastened to the catheter and exhibits a contact curve along which the cryoballoon can be brought into contact with the fundus, wherein the contact curve is a closed curve on the surface of the cryoballoon, and the cryoballoon contains a first cooling arrangement which extends along less than three quarters of the length of the contact curve.

DEVICES, SYSTEMS, AND METHODS FOR CRYOGENIC BIOPSY SAMPLING

In some embodiments, devices, systems, and methods for cryogenic biopsy sampling are provided. In some embodiments, a device for cryogenic biopsy sampling is provided, the device including: a dual lumen tube; an elongated probe tip coupled to the distal end of the dual lumen tube, with a first lumen extending into a hollow portion in the tip and a second lumen in fluid communication with the hollow portion; a first port in fluid communication with the first lumen; a second port in fluid communication with the second lumen, wherein the first lumen, the elongated probe element, and the second lumen provide a closed pathway through which a substance introduced through the first port can flow through the first lumen into the elongated probe element, and out of the elongated probe element through the second lumen to the second port. 1. A device for cryogenic biopsy sampling , comprising:a dual lumen tube having a proximal end and a distal end; a first lumen of the dual lumen tube extending into a hollow portion of the elongated probe element, and', 'a second lumen of the dual lumen tube being in fluid communication with the hollow portion;, 'an elongated probe element coupled to the distal end of the dual lumen tube,'}a housing coupled to the proximal end of the dual lumen tube;a first port coupled to the housing and in fluid communication with the first lumen; and 'the first lumen, the elongated probe element, and the second lumen providing a closed pathway through which a substance introduced through the first port flows through the first lumen into the elongated probe element and out of the elongated probe element through the second lumen to the second port.', 'a second port coupled to the housing and in fluid communication with the second lumen,'}2. The device for cryogenic biopsy sampling of claim 1 , wherein the elongated probe element comprises aluminum.3. The device for cryogenic biopsy sampling of claim 1 , wherein at least a portion of the inner surface of the ...

Methods, systems and devices for performing multiple treatments on a patient

Methods, systems and devices for treating a patient include performing a first treatment to treat a first portion of tissue and performing a second treatment to treat a second portion of tissue. The second portion of tissue is treated at least twenty-four hours after the first portion of tissue is treated. In particular embodiments, the first portion of tissue includes duodenal tissue, and the second portion of tissue includes duodenal or other gastrointestinal tissue.

Treatment Method and Medical Device

A treatment method and medical device for enhancing peristalsis are provided. The treatment method comprises enhancing the peristaltic movement of the gastrointestinal tract by performing a treatment to reduce the activity of the autonomic nerve in a blood vessel V having a surrounding nerve Sa innervating the gastrointestinal tract of the patient. 1. A treatment method comprising a treatment to increase peristaltic movement of a gastrointestinal tract of a patient by performing a procedure to decrease activity of autonomic nerves in a blood vessel having surrounding nerves that innervate the gastrointestinal tract , thereby increasing the peristaltic movement of the gastrointestinal tract.2. The treatment method according to claim 1 , wherein the treatment promotes relief of one or more of constipation abdominal bloating claim 1 , abdominal pain claim 1 , perineal discomfort claim 1 , and frequent stools caused by abnormal peristalsis of the gastrointestinal tract in the patient.3. The treatment method according to claim 1 , wherein performing the treatment promotes relief of symptoms of slow transit time constipation.4. The treatment method according to claim 1 , wherein the blood vessel is at least one of a superior mesenteric artery claim 1 , a celiac artery claim 1 , and an inferior mesenteric artery claim 1 ,wherein the treatment impairs the surrounding nerves by imparting energy to one or a plurality of the surrounding nerves and increases the peristaltic movement of the gastrointestinal tract by completely or partially blocking autonomic nerve transmission to the gastrointestinal tract by the surrounding nerves.5. The treatment method according to claim 4 , wherein the treatment is performed by activating a medical device disposed in the blood vessel claim 4 , the medical device comprising a long catheter body and an energy transmitting member disposed at a tip of the long catheter body and capable of imparting energy.6. The treatment method according to ...

SYSTEMS AND METHODS FOR TREATING TISSUE WITH RADIOFREQUENCY ENERGY

A device for applying radiofrequency energy for sphincter treatment comprising a flexible outer tube, an expandable basket having a plurality of arms movable from a collapsed position to an expanded position, and a plurality of electrodes movable with respect to the arms from a retracted position to an extended position. An advancer is slidably disposed within the outer tube to move the plurality of electrodes to the extended position. An actuator moves the advancer from a first position to a second position to advance the plurality of electrodes. An aspiration tube extends within the outer tube. An assembly includes an aspiration disabler having a first position to enable aspiration from a distal portion of the aspiration tube to a proximal portion and a second position to disable aspiration. 116-. (canceled)17. A method of treating gastrointestinal reflux disease comprising:providing a treatment device having a plurality of electrodes and an assembly having a disabler for disabling aspiration through an aspiration tube extending within the device, the disabler having a first position to enable aspiration from a distal portion of the aspiration tube to a proximal portion of the aspiration tube, the disabler movable to a second position to disable aspiration to facilitate axial and rotational movement of the treatment device within tissue and to limit undesired movement of tissue which can cause overtreatment of tissue and tissue ablation;applying radiofrequency energy to the plurality of electrodes to thermally treat tissue below a tissue ablation threshold and create a plurality of tissue lesions along axially spaced tissue levels within the upper gastrointestinal tract;monitoring tissue temperature throughout the applying of radiofrequency energy; andregulating power ensuring in response to the monitoring of tissue temperature that the tissue temperature does not exceed a predetermined value which would cause tissue ablation and/or tissue necrosis.18. The method ...

RADIAL ILLUMINATION SYSTEM

A radial illumination system is for projecting a light pattern radially. A light source generates a light output to an optical fiber. A ferrule is provided around the end of the optical fiber, and a reflector is mounted over or in the ferrule or integral with the ferrule, for redirecting the light to form generally radial light. In this way, a simple design with low component count is able to perform the optical alignment and optical reflecting functions. 1. A radial illumination system for projecting a light pattern radially comprising:a light source for generating a light output;an optical fiber which is adapted to transmit the light output and to emit the light in a direction centered along an axis, from an end of the optical fiber;a ferrule around the end of the optical fiber; anda reflector coupled to or integral with the ferrule, for redirecting the emitted light to form a ring of generally radial light around the axis,wherein the ferrule comprises a reflecting face which faces away from the end of the optical fiber, and the reflector comprises a cap which is mounted over end of the ferrule and which has a reflecting surface which faces the end of the optical fiber, such that an optical path is defined from the end of the optical fiber, to the reflecting surface and then to the reflecting face.2. A radial illumination system as claimed in claim 1 , wherein the light source comprises a laser.3. A radial illumination system as claimed in claim 1 , wherein the reflector is axisymmetric.4. A radial illumination system as claimed in claim 1 , wherein the cap has a radial light output window arrangement.5. A radial illumination system as claimed in claim 1 , wherein the reflecting surface of the cap is curved claim 1 , such that the reflected light is collimated.6. A radial illumination system as claimed in claim 1 , wherein the reflecting face of the ferrule is conical.7. A radial illumination system as claimed in claim 1 , wherein the cap and the ferrule comprise ...

PAPILLOTOME FOR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

A papillotome for percutaneous endoscopic gastrostomy including a front opening located in a free end region of a catheter and at the outlet of a first lumen, a rear opening further from a free end than the front opening and connects the first lumen to the outside, and a cutting wire located in the first lumen in an axially displaceable manner and extends through the front opening and the rear opening and is located on the outside between the front opening and the rear opening. When the cutting wire is tensioned, the free end region is deformed in an arc shape and the cutting wire forms a transversely extending cutting edge between the front opening and the rear opening. The front opening is arranged at a distance of at least 3 mm from the free end. A projection is formed between the free end and the front opening. A cutting tip is formed at the free end of the catheter. The cutting tip is connected to the cutting wire and forms the foremost end of the papillotome. 1. A papillotome for percutaneous endoscopic gastrostomy , comprising:a handle;an elongate flexible catheter attached to the handle which has a free end region with a free end and has at least one first lumen;a front opening which is located in the free end region and connects the first lumen to an outside of the catheter;a rear opening, which is located in the free end region of the catheter, and lo is further from the free end than the front opening and which connects the first lumen to the outside, wherein the front opening and the rear opening are arranged with the same orientation to the catheter;a cutting wire, which is located in an axially displaceable manner in the first lumen, extends through the front opening and the rear opening, and is located between the front opening and the rear opening on the outside, and which is fixed in the free end region and in the handle,wherein, when the handle is actuated, the cutting wire is tensioned, the free end region is deformed in an arc shape and the ...

METHODS AND SYSTEMS FOR REDUCING NEURAL ACTIVITY IN AN ORGAN OF A SUBJECT

The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves. According to some embodiments, the sensory nerves include neurons configured to transmit signals triggered by food passing through the duodenum, such as, but not limited to, neurohormonal signals. 1. A method for reducing neural activity in a submucosal layer of a duodenum wall of a subject , the method comprising:introducing at least one device configured to transmit acoustic energy into the duodenum of the subject; anddirecting an acoustic beam at the duodenal wall, such that an area of the submucosal layer including sensory neurons is selectively modified, while functional activity of the mucosal layer and muscle tissue around the area is maintained.2. The method of claim 1 , wherein the sensory neurons comprise at least part of a Meissner's plexus and ganglia nerves within the submucosal layer.3. The method of claim 1 , wherein the sensory neurons comprise at least one neuron that is activated by food passing through the duodenum.4. The method of claim 1 , wherein said subject is afflicted with a metabolic disorder.5. The method of claim 1 , wherein said subject is afflicted with a medical condition selected from the group consisting of obesity claim 1 , type 2 diabetes claim 1 , insulin resistance and combinations thereof.6. The method of claim 1 , further comprising stretching the duodenum thereby ...

SYSTEM AND METHOD FOR COMBINATION OF COLD ATMOSPHERIC PLASMA TREATMENT WITH RADIATION AND CHEMOTHERAPY

A method for applying cold atmospheric plasma treatment to target tissue comprising the steps of selecting through a graphical user interface a particular soft tissue sarcoma cell line associated with target tissue, retrieving, with said computing device, settings data associated with said selected soft tissue sarcoma cell line from a database of cell line data and associated settings data in a storage, and applying, with said computing device, said retrieved settings data to a cold atmospheric plasma system. 1. A method for applying cold atmospheric plasma treatment to target tissue comprising:selecting through a graphical user interface a particular soft tissue sarcoma cell line associated with target tissue;retrieving, with said computing device, settings data associated with said selected soft tissue sarcoma cell line from a database of cell line data and associated settings data in a storage; andapplying, with said computing device, said retrieved settings data to a cold atmospheric plasma system.2. A method for applying cold atmospheric plasma treatment to target tissue comprising:generating a database of a plurality of soft tissue sarcoma cell lines and optimum cold atmospheric plasma settings associated with each of said plurality of soft tissue sarcoma cell lines;storing said database in a storage medium;selecting through a graphical user interface on a computing device a particular soft tissue sarcoma cell line associated with said target tissue;retrieving, with said computing device, settings data from a database of cell line data and associated settings data in a storage; andapplying, with said computing device, said retrieved settings data to a cold atmospheric plasma system.3. A method for applying cold atmospheric plasma treatment to target tissue according to claim 2 , wherein said cold atmospheric plasma settings in said generated database are based upon a predicted cold atmospheric plasma effectiveness derived from testing said plurality of soft ...

APPARATUS AND METHODS OF INDUCING WEIGHT LOSS USING BLOOD FLOW CONTROL

Methods and apparatus for inducing weight loss using blood flow control are described herein. The apparatus and methods operate by controlling blood flow to the stomach and/or small bowel. 112-. (canceled)13. A method of inducing weight loss , the method comprising reducing blood flow to the gastrointestinal tract by ablating one or more blood vessels that supply the stomach and/or small bowel to limit dilation of the blood vessels to increase flow after the ablating.14. A method according to claim 13 , wherein the ablating is configured to cause fibrosis of the one or more blood vessels that supply the stomach and/or small bowel claim 13 , wherein the fibrosis limits dilation of the blood vessels to increase flow.1518-. (canceled)19. A system for inducing weight loss claim 13 , the system comprising:a controller operably connected to one or more input devices, wherein the controller is configured to determine that a patient is ingesting food; andone or more blood flow constriction devices operably connected to the controller, the one or more blood flow constriction devices configured to reduce blood flow to the gastrointestinal tract.20. A system according to claim 19 , wherein the one or more input devices comprise one or more of: a sensor configured to detect distention and/or increased pressure in a stomach claim 19 , a sensor configured to detect swallowing claim 19 , and a sensor configured to detect flow into a stomach.21. A system according to claim 19 , wherein the one or more input devices comprise a direct input device actuated by a patient to provide a signal to the controller that food is being ingested.22. A system according to claim 19 , wherein the one or more blood flow constriction devices comprises a device configured to mechanically constrict one or more blood vessels that supply the stomach and/or small bowel.23. A system according to claim 19 , wherein the one or more blood flow constriction devices comprises a device configured to cool an ...

GASTRO-INTESTINAL-TRACT ABLATION SYSTEM

An ablation system includes: an endoscope; an ablation treatment tool; an overtube; a first operation member that is provided at a base end portion of the overtube; and a second operation member that is attachable to and detachable from an intermediate position in a longitudinal direction of an insertion portion of the endoscope. The overtube has a balloon that is configured to fix the overtube to the gastro-intestinal tract; the insertion portion and the ablation treatment tool can be integrally moved in the overtube in the longitudinal direction; and the first and second operation members each have a finger holder that holds at least one finger of one hand. The first operation member is distinct from the overtube, and is attachable to and detachable from an outer circumferential surface of the overtube, at an arbitrary position in the longitudinal direction of the overtube. 1. A gastro-intestinal-tract ablation system comprising:an endoscope having an elongated insertion portion;an elongated ablation treatment tool that applies ablation treatment to mucosal tissue;a tubular overtube that is inserted into the gastro-intestinal tract, and that allows the insertion portion and the ablation treatment tool to pass therethrough;a first operation member that is provided at a base end portion of the overtube; anda second operation member that is attachable to and detachable from an intermediate position in a longitudinal direction of the insertion portion of the endoscope,wherein the overtube has a balloon that is configured to fix the overtube to the gastro-intestinal tract,wherein the insertion portion and the ablation treatment tool can be integrally moved in the overtube in the longitudinal direction with the endoscope,wherein the first operation member has a first finger holder that holds at least one finger of one hand of an operator,wherein the second operation member has a second finger holder that holds, among fingers of the one hand, at least one finger other ...

ABLATION-TREATMENT-TOOL CONTROL DEVICE, ABLATION SYSTEM, AND ILEAL-MUCOSA ABLATION TREATMENT METHOD

A control device for an ablation treatment tool includes: a target-value storage unit that stores a target value for the total treatment area; an energy-source output unit that outputs, to the ablation treatment tool, an energy source for performing ablation treatment; an area calculation unit that calculates the total treatment area of the ileal mucosa on which the ablation treatment has been performed; and a control unit that controls termination of the ablation treatment performed by the ablation treatment tool. The control unit notifies an operator of the termination of the ablation treatment or stops the output of the energy source from the energy-source output unit when the calculated total treatment area of the ileal mucosa becomes equal to or greater than the target value. 1. An ablation-treatment-tool control device that is configured to control an ablation treatment tool that performs ablation treatment on ileal mucosa , which covers an inner surface of the ileum , the control device comprising:a target-value storage unit that is configured to store a target value for the total treatment area of the ileal mucosa, the target value being set on the basis of at least one of the characteristics and the conditions of a patient;an energy-source output unit that is configured to output, to the ablation treatment tool, an energy source for performing the ablation treatment;an area calculation unit that is configured to calculate the total treatment area, which is the total of the areas of treatment regions of the ileal mucosa on which the ablation treatment has been performed by the ablation treatment tool; anda control unit that is configured to control termination of the ablation treatment of the ileal mucosa performed by the ablation treatment tool,wherein the control unit comprised one or more processors,the one or more processors performsnotifying an operator of the termination of the ablation treatment or stopping the output of the energy source from the ...

Methods of neural inhibition for treating bowel diseases and disorders

The present invention is directed to a method for treating a bowel disease in a subject in need thereof, the method comprising inhibiting the activity of neurons of the insular cortex of the subject. Further provided is a system comprising a transcranial stimulation transducing coil for transcranial stimulation configured to provide a series of pulses to neurons of the insular cortex.

Treatment tool for endoscope, and method for manufacturing treatment tool for endoscope

A treatment tool includes a second sheath ( 12 ) having a slit ( 12 e ) through which a guide wire is configured to be taken in and out of a first lumen, and a sheath-retaining part having a guide wire insertion opening ( 20 b ) having a slit ( 20 c ) and a main opening ( 20 d ), wherein a first end portion of the second sheath ( 12 ) has a first side cut surface ( 12 g ) and a second side cut surface ( 12 h ) intersecting in an X-shape, an axially cut surface formed by cutting in parallel to a central axis (O 12 ) from an end surface ( 12 k ), an opening surrounded by the first side cut surface ( 12 g ), the second side cut surface ( 12 h ), and the axially cut surface and communicating with the first lumen at a position overlapping the main opening ( 20 d ), and a piece-like part.

Endoscopic cutting device having a cutting wire directed through openings in a tube to form two diathermy blades, and a probe for a percutaneous endoscopic gastrostomy

An endoscopic cutting device for cutting free a probe, provided with a retaining plate, which, within the scope of a percutaneous endoscopic gastrostomy, is arranged in a stomach wall and is overgrown by the gastric mucosa, wherein, for the adjustment of the cutting element provided at a distal end of a tube via a pulling cord, an actuation force of an actuation element can be transmitted to same. In addition, the cutting device includes a cutting wire which is electrically heatable and connected to the pulling cord, and which runs outside the tube via a distal section to form a first diathermy blade. In addition, the distal end of the tube is slanted at an angle to the transverse plane thereof to form a tip, wherein the tip is facing the first diathermy blade. Furthermore, the cutting wire is directed externally around the tip to form a second diathermy blade.

Automated image-guided tissue resection and treatment

A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.

SYSTEMS AND METHODS FOR DEPOSITING MATERIAL IN A PATIENT

A system for treating a medical condition comprises a harvesting device, a processing device, and a depositing device. The harvesting device harvests tissue from a mammalian subject at a harvest site. The processing device processes the harvest tissue. The depositing device deposits material in a patient at a deposit site, the material based on the harvested and processed tissue. The deposited material is configured to generate resultant tissue configured to treat the medical condition of the patient. Methods are also provided, the methods including harvesting and processing tissue, and treating a patient by depositing material in the patient, the material being based on the harvested and processed tissue. 1. (canceled)2. A method of treating a medical condition , the method comprising:harvesting tissue with a harvesting device from a mammalian subject at multiple harvest sites within the ileum and/or the colon;processing the harvested tissue with a processing device, the processing device comprising a cell sorting kit configured to perform a cell sorting process based on the presence of cell surface antigens; anddepositing material with a depositing device in a patient at a deposit site, the material based on the harvested and processed tissue;wherein the deposited material is configured to generate resultant tissue configured to treat the medical condition of the patient; andwherein the medical condition comprises insulin resistance.3. The method according to claim 2 , wherein the method is further configured to treat a medical condition selected from the group consisting of: Type 2 diabetes; non-alcoholic fatty liver disease; obesity; an obesity-related disorder; non-alcoholic steatohepatitis; pre-diabetes; liver insulin resistance; and combinations thereof.4. The method according to claim 2 , wherein the harvesting device is configured to perform a biopsy.5. The method according to claim 2 , wherein the harvesting device is configured to perform an endoscopic ...

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.

Systems, devices, and methods for performing medical procedures in the intestine

A method for performing a medical procedure in an intestine of a patient is provided. The method comprises providing a system comprising: a catheter for insertion into the intestine, the catheter comprising: an elongate shaft comprising a distal portion; and a functional assembly positioned on the shaft distal portion and comprising at least one treatment element. The catheter is introduced into the patient, and target tissue is treated with the at least one treatment element. The target tissue comprises mucosal tissue of the small intestine, and the medical procedure can be configured to treat one or more diseases or disorders based on a measured physiologic parameter of the patient.

Ablation System for Large-area Surface Coagulation of Biological Tissue

The ablation system ( 10 ) according to the invention works with an ablation probe ( 12, 12 a ) that comprises two alternatingly working spark plasma electrodes ( 31, 32 ). They generate a plasma beam ( 47, 48 ) having a non-circular cross-section, which beam is to be guided—transversely with respect to the large longitudinal axis of its preferably oval cross-section—over the tissue to be ablated, in particular the mucosa ( 14 ). In doing so, it is possible to treat large-area tissue regions by means of a reliable and easily controllable procedure.

Surgical system for connecting body tissue

A surgical system for connecting body tissue is provided. The surgical system includes a surgical instrument having two tool elements movable relative to each other, each of which comprises a high-frequency electrode. The high-frequency electrodes, in an approach position of the tool elements, define a minimum distance from each other, lying opposite each other and facing each other. The instrument has a shaft at the distal end of which at least a first one of the tool elements is arranged or formed. A second tool element is movable from an operating position, in which it is adapted for movement into the approach position, into a removal position and/or vice versa. A surface area of a perpendicular projection of the second tool element onto a projection plane extending perpendicularly to a shaft direction in a region of the second tool element is smaller in the removal position than in the operating position.

Gastric Reflux Treatment with Lasers

Method/devices for endoscopic laser treatment of gastrointestinal disorders such as, gastro-esophageal reflux disorder (GERD) are disclosed. Treatment involves irradiating tissue of the digestive tract to strengthen muscle tone and shrink anatomical areas reducing occurrence of reflux of food/liquids from the stomach to the esophagus. In a preferred embodiment, equipment comprises a gastro-endoscope with a working channel for inserting an optical fiber. Laser device comprises a diode laser source emitting a suitable wavelength and wave pattern through optical fiber. Laser radiation is applied near the Z line at the esophago-gastric junction. Measures are taken to assure irradiation is very accurate. Injury to the mucosa and adjacent structures, e.g. nerves, are avoided by focusing at the muscularis layer while preventing thermal effects on mucosa. This is achieved using wavelengths of ca. 1470 nm or ca. 980 mm. Energy is emitted perpendicular to fiber axis using optical fibers with side fiber distal tips, radial fiber distal tips or twister fiber distal tips.

Vapor-Based Ablation Treatment Methods with Improved Treatment Volume Vapor Management

Ablation catheters and systems include flexible catheter tips with a distal needle or ports for delivery of an ablative agent to a target tissue. Pressure monitoring during ablation ensure operation is performed within safe limits and with desired efficacy. Positioning elements help maintain the devices in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues.

Catheter Apparatuses, Systems, and Methods for Renal Neuromodulation

Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a catheter treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver an energy delivery element to a renal artery via an intravascular path. Thermal or electrical renal neuromodulation may be achieved via direct and/or via indirect application of thermal and/or electrical energy to heat or cool, or otherwise electrically modulate, neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. 144-. (canceled)45. A method , comprising:percutaneously introducing a neuromodulation assembly at a distal portion of a treatment device proximate to neural fibers innervating a gastrointestinal organ of a human subject diagnosed with a gastrointestinal condition;at least partially disrupting function of the neural fibers via the neuromodulation assembly; andremoving the neuromodulation assembly from the subject after treatment,wherein at least partial disruption of the function of the neural fibers therapeutically treats the diagnosed gastrointestinal condition.46. The method of wherein the gastrointestinal condition is an autoimmune disorder or a gastric motility disorder.47. The method of wherein the gastrointestinal condition is an autoimmune disorder claim 46 , and wherein at least partial disruption of the function of the neural fibers therapeutically reduces inflammation in the gastrointestinal organ of the subject.48. The method of wherein the gastrointestinal condition is a gastric motility disorder claim 46 , and wherein at least partial disruption of the function of the neural fibers therapeutically increases gastric motility.49. The method of wherein the gastrointestinal condition is a gastric motility disorder claim 46 , and ...

ELECTROSURGICAL SNARE

An electrosurgical snare, e.g. suitably sized for insertion down the instrument channel of an endoscope, arranged to radiate microwave frequency energy (e.g. having a frequency greater than 1 GHz) from an elongate conductive element within an area encircled by a retractable loop. The elongate conductive element and retractable loop may be independently slidable relative to a snare base at a distal end of a sleeve to provide an appropriate device configuration. By controlling the shape of the emitted microwave field, the risk of collateral thermal damage can be reduced. 113.-. (canceled)14. A surgical snare comprising:a retractable loop for encircling an area containing biological tissue;a radiating structure arranged to radiate microwave frequency energy into the area encircled by the retractable loop;a coaxial cable for conveying the microwave frequency energy to the radiating structure, the coaxial cable comprising an inner conductor, an outer conductor surrounding and coaxial with the inner conductor, and a dielectric material separating the inner conductor and the outer conductor; anda snare base at a distal end of the coaxial cable, wherein the retractable loop is retractable relative to the coaxial cable towards the snare base, andwherein the radiating structure comprises a curved conductive portion partially bounding the area encircled by the retractable loop, the curved conductive portion being connected to the inner conductor of the coaxial cable and electrically insulated from the outer conductor of the coaxial cable to act as a radiating microwave monopole antenna.15. A surgical snare according to claim 14 , wherein the curved conductive portion extends between two ends claim 14 , which are spaced at equal distances from a connection point at which the inner conductor of the coaxial cable is connected to the curved conductive portion.17. A surgical snare according to claim 15 , wherein the electrical length of the curved conductive portion is 10 mm or ...

Method for endoscopic treatment

A method for endoscopic treatment that performs treatment under an endoscope includes irradiating a subject with first narrow band light having a predetermined peak wavelength, performing mucosal incision on a living tissue after irradiation with the first narrow band light, radiating second narrow band light having a peak wavelength in spectral characteristics in a wavelength band closer to a long wavelength side than the first narrow band light after the mucosal incision, and performing treatment other than the mucosal incision on the living tissue after radiation of the second narrow band light.

Method and Apparatus for Tissue Ablation

The present application discloses devices that ablate human tissue. The device comprises a catheter with a shaft through which an ablative agent can travel, a liquid reservoir and a heating component, which may comprise a length of coiled tubing contained within a heating element, wherein activation of said heating element causes said coiled tubing to increase from a first temperature to a second temperature and wherein the increase causes a conversion of liquid within the coiled tubing to vapor, a reusable cord connecting the outlet of the reservoir to the inlet of the heating component, and a single use cord connecting a pressure-resistant inlet port of a vapor based ablation device to the outlet of the heating component.

Electrosurgical apparatus for generating radiofrequency energy and microwave energy for delivery into biological tissue

An isolating circuit for electrosurgical generator arranged to produce radiofrequency (RF) energy and microwave energy for treating biological tissue. The generator has an RF channel and a microwave channel which are combined at signal combiner to enable the RF energy and microwave energy to be delivered into tissue along a common feed path. The isolating circuit comprises a tunable waveguide isolator at a junction between the microwave channel and signal combiner, and can include a capacitive structure between a ground conductor of the signal combiner and a conductive input section of the waveguide isolator to inhibit coupling of the RF energy and leakage of the microwave energy. The isolating circuit can combine into a single tunable unit all the necessary components to isolate the microwave and RF channels from one another whilst providing a high withstanding voltage.

Apparatus and methods of inducing weight loss using blood flow control

Methods and apparatus for inducing weight loss using blood flow control are described herein. The apparatus and methods operate by controlling blood flow to the stomach and/or small bowel.

High-frequency treatment tool and high-frequency treatment system

Provided is a high-frequency treatment tool. A positioning member that regulates movement of a second wire part within a sheath relative to a first wire part in a direction of a longitudinal axis of the second wire part is present in the sheath. In a state in which a folded part is located close to a distal end of the sheath, a loop formation part is fed from the distal end of the sheath with the second wire part fixed.

BLADDER TISSUE MODIFICATION FOR OVERACTIVE BLADDER DISORDERS

Regions of tissue having reduced electrical propagation are created in a bladder to affect its electrical or mechanical properties. To create these tissue regions, a tubular device is advanced through the urethra leading to the interior of the bladder, a distal expandable structure of the device is expanded to contact the inner wall of the bladder, and electrodes or other active energy delivery elements of the device are activated to deliver ablation energy. The electrodes or other active energy delivery elements are disposed over the expandable structure which is shaped to conform to the interior of the bladder. The inner wall of the organ is ablated in a predetermined pattern. The same or other electrodes disposed over the expandable structure can used to electrically map the bladder. This map of electrical activity can be used to create the predetermined pattern. 1. A device for treating a disorder in a hollow bodily organ , the device comprising:a shaft advanceable through a bodily channel of a subject to reach a cavity of the organ;an ablation member having a collapsed configuration for advancement through the bodily channel and an expanded configuration adapted to create a predetermined pattern of electrically isolated tissue regions in an inner wall of the hollow bodily organ, with each electrically isolated tissue region being defined by at least one continuous ablation line and being no larger than half of a total inner surface area of the bodily organ.2. The device of claim 1 , further comprising an expandable member coupled to a distal end of the shaft claim 1 , the expandable member having a collapsed configuration advanceable through the bodily passage to reach the cavity of the organ and an expanded configuration configured to contact an inner wall of the organ when the expandable member is advanced therein.3. The device of claim 2 , wherein the ablation member is disposed over the expandable member.4. The device of claim 2 , wherein the expandable ...

Systems, devices, and methods for treating metabolic medical conditions

Provided herein are systems for treating a patient, the systems comprising: a treatment device for treating a minimum amount of mucosal tissue of the patient's small intestine. The system is configured to treat a medical condition of the patient. Methods of treating a patient are also provided.

Ingestible capsule for the phototherapeutic treatment of infections

An ingestible capsule arranged, in use, to cross a human stomach for carrying out a phototherapic treatment arranged to combat an infection due to the presence of the bacterium Helicobacter pylori, said ingestible capsule comprising at least one primary light source arranged to emit an electromagnetic phototherapic wave having a wavelength λ1, at least one auxiliary light source arranged to emit an electromagnetic phototherapic wave having a wavelength λ2, a wrapper arranged to contain said or each primary light source and said or each auxiliary light source, said wrapper being at least partially transparent to said wavelengths λ1 and λ2, a control unit arranged to selectively activate said or each primary light source and/or said or each auxiliary light source, and at least one energy source arranged to provide energy for feeding said control unit and/or said light sources. In particular, 400 nm<λ1<525 nm and 525 nm<λ2<650 nm. Furthermore, said control unit is configured to receive an information of position reporting in real time an area of said stomach crossed by said ingestible capsule; to determine, known said information of position, a wavelength, a dosage and a duration of administration of said electromagnetic phototherapic waves for an optimal phototherapic treatment of said area of said stomach; to selectively activate said or each primary light source and/or said or each auxiliary light source to provide said optimal phototherapic treatment of said area of said stomach.

METHOD FOR CUTTING AND HEMOSTASIS OF BIOLOGICAL TISSUE USING HIGH-PRESSURE STEAM-BASED SURGICAL TOOL

The present disclosure relates to a surgical tool for cutting and hemostasis of biological tissues. The surgical tool includes a hollow blade comprising a cutting implement residing within a hollow cavity configured to provide high-pressure steam through an apical surface. The cutting implement can operate independently or in cooperation with the provided high-pressure steam. The surgical tool of the present disclosure applies a directionally-controlled, high-pressure steam flow to a tissue region of interest. A control unit provides temperature-controlled steam at a flow-rate determined in accordance with tissue type and intended procedure. 120-. (canceled)21. A method for incision and hemostasis of a biological tissue comprising:incising a target tissue with a surgical tool comprising a cutting implement residing within a hollow cavity configured to provide an ablative agent through one or more ports at an apical surface of the surgical tool, andablating the incised target tissue by delivering the ablative agent to the biological tissue via one or more ports on the apical surface of the surgical tool thereby coagulating the incised tissue.22. The method of claim 21 , wherein the biological tissue is an internal tissue.23. The method of claim 21 , wherein said cutting implement comprises a hollow blade.24. The method of claim 21 , wherein the ablative agent is steam.25. The method of claim 21 , further comprising grasping or holding the target tissue with an assisting element.26. The method of claim 21 , further comprising grasping or holding the target tissue with an assisting element that comprises a movable jaw.27. The method of claim 21 , wherein the surgical tool further comprises an imaging tool for guided surgery.28. The method of claim 21 , wherein the surgical tool comprises an apparatus comprising:a handle, disposed at a proximal end of the apparatus, including a reservoir for storage of the ablative agent;a hollow tube, adjacent to the handle and ...

CONTACT QUALITY ASSESSMENT BY DIELECTRIC PROPERTY ANALYSIS

Devices and methods for assessing tissue contact based on dielectric properties and/or impedance sensing are disclosed. In some embodiments, one or more probing frequencies are delivered via electrodes including an electrode in proximity to a tissue (for example, myocardial tissue). In some embodiments, dielectric parameter values, optionally together with other known and/or estimated tissue characteristics, are measured to determine a contact quality with the tissue. In some embodiments, dielectric contact quality is used, for example, in guiding the formation of a lesion (for example, RF ablation of heart tissue to alter electrical transmission characteristics). 1. A system for evaluation of dielectric contact quality of an intra-body ablation probe with target tissue , the intra-body ablation probe including at least one electrode , and the system comprising:an electrical field measurement device, configured to measure dielectric properties in the environment of the at least one electrode using signals sensed by the at least one electrode at a plurality of electrical field frequencies; anda contact characterization module, comprising a data structure mapping the dielectric properties to characterization of contact, and configured to characterize contact between the intra-body ablation probe and the target tissue, based on the data structure and on the dielectric properties measured by the electrical field measurement device.2. The system of claim 1 , including the intra-body ablation probe.3. The system of claim 2 , wherein the intra-body probe comprises an ablation electrode configured for ablation of the target tissue.4. The system of claim 3 , wherein the at least one electrode comprises the ablation electrode.5. The system of claim 1 , comprising a display configured to display the characterized contact as an estimate of contact force.6. The system of claim 1 , wherein the electrical field measurement device comprises the at least one electrode.7. The system ...

PAPILLOTOME FOR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

The invention relates to a papillotome for percutaneous endoscopic gastrostomy comprising a front opening (), which is located in a free end region of a catheter () and at the outlet of a first lumen (), a rear opening (), which is further from a free end () than the front opening () is and which connects the first lumen () to the outside, and a cutting wire (), which is located in the first lumen () in an axially displaceable manner and extends through the front opening () and the rear opening () and is located on the outside between the front opening () and the rear opening (). When the cutting wire () is tensioned, the free end region is deformed in a arc shape and the cutting wire () forms a transversely extending cutting edge () between the front opening () and the rear opening (). The front opening () is arranged at a distance of at least 3 mm from the free end (). A projection () is formed between the free end () and the front opening (). A cutting tip () is formed at the free end () of the catheter (). The cutting tip is connected to the cutting wire () and forms the foremost end of the papillotome. 2. The papillotome according to claim 1 , wherein the cutting tip is connected to a metal piece which is located claim 1 , at least over a part of the region between the free end and the front opening on the outside claim 1 , which is connected to the cutting wire and which forms a longitudinally extending cutting edge that is disposed with the same orientation to the catheter as the front opening and the rear opening.316. The papillotome according to claim 1 , wherein the cutting wire () forms at least one of the cutting tip or the metal piece.4. (canceled)5. The papillotome according to claim 1 , wherein the free end is beveled claim 1 , and wherein a tip of the bevel is disposed with the same orientation to the catheter as the front opening and the rear opening.6. The papillotome according to claim 1 , wherein the front opening is disposed at a distance of ...

DEVICES, SYSTEMS, AND METHODS FOR TREATING ULCERATIVE COLITIS AND OTHER INFLAMMATORY BOWEL DISEASES

A method of treating bowel diseases includes introducing a fluid into a portion of a patient's colon and applying energy thereto from an external energy source such that the fluid and the energy cooperate to treat tissue of the portion of the patient's colon in contact with the fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient's colon, introducing an electrically-conductive fluid thereto, and energizing an electrode disposed therein to treat tissue of the portion of the patient's colon in contact with the electrically-conductive fluid. Another method of treating inflammatory bowel diseases includes sealing a portion of a patient's colon and introducing a heated fluid at a temperature equal to or above 60° C. to treat tissue of the portion of the patient's colon in contact with the heated fluid. 1. A method of treating bowel diseases , comprising:introducing a fluid into a portion of a patient's colon; andapplying energy towards the portion of the patient's colon from an energy source positioned externally of the patient such that the fluid and the energy cooperate to treat tissue of the portion of the patient's colon in contact with the fluid.2. The method according to claim 1 , wherein introducing the fluid includes at least partially filling the portion of the patient's colon with the fluid.3. The method according to claim 2 , wherein at least partially filling the portion of the patient's colon includes sealing off an area of the patient's colon to retain the fluid therein.4. The method according to claim 3 , wherein sealing off the area includes clamping the area on at least one end thereof or plugging the area on at least one end thereof.5. The method according to claim 1 , wherein the energy source is a microwave energy source and wherein the fluid defines a dielectric constant greater than a dielectric constant of tissue such that claim 1 , upon application of microwave energy from the microwave energy ...

APPARATUSES, SYSTEMS AND METHODS FOR TREATING ULCERATIVE COLITIS AND OTHER INFLAMMATORY BOWEL DISEASES

An apparatus for treating inflammatory bowel diseases is provided. The apparatus includes a body and an elongate spring coil extending distally from the body and configured to be positioned within a patient's colon. The elongate spring coil defines a spiral configuration and is configured to be selectively moved relative to the body. The apparatus also includes at least one electrode disposed on the elongate spring coil and configured to emit energy. The at least one electrode is moved along a spiral path in response to movement of the elongate spring coil relative to the body. A method of use for treating inflammatory bowel diseases is also provided. 1. An apparatus for treating inflammatory bowel diseases , comprising:a body;an elongate spring coil extending distally from the body and configured to be positioned within a patient's colon, the elongate spring coil defining a spiral configuration and configured to be selectively moved relative to the body; andat least one electrode disposed on the elongate spring coil and configured to emit energy, wherein the at least one electrode is moved along a spiral path in response to movement of the elongate spring coil relative to the body.2. The apparatus according to claim 1 , wherein the body includes a crank operatively coupled to the elongate spring coil and configured to move the elongate spring coil relative to the body upon manual turning of the crank relative to the body.3. The apparatus according to claim 1 , wherein the body includes a switch disposed thereon and operably coupled to the at least one electrode claim 1 , wherein activating the switch energizes the at least one electrode.4. The apparatus according to claim 1 , wherein the at least one electrode is a monopolar electrode.5. An apparatus for treating inflammatory bowel diseases claim 1 , comprising:a body;a flexible elongate member extending distally from the body, the flexible elongate member configured to be positioned within a patient's colon; anda ...

DEVICES, SYSTEMS AND METHODS FOR TREATING ULCERATIVE COLITIS AND OTHER INFLAMMATORY BOWEL DISEASES

An apparatus for treating inflammatory bowel diseases is provided. The apparatus includes a handle, a shaft extending distally from the handle, and an end effector disposed on a distal end of the shaft. The shaft is configured to be advanced within the colon of a patient. The end effector includes a radiating portion and a nozzle disposed thereon. The radiating portion is configured to emit energy therefrom and the nozzle is configured to emit a fluid therefrom. A method of treating inflammatory bowel diseases is also provided. 1. An apparatus for treating inflammatory bowel diseases , comprising:a handle;a shaft extending distally from the handle, the shaft configured to be advanced within a patient's colon; andan end effector disposed at a distal end of the shaft, the end effector including a radiating portion configured to emit energy and a nozzle configured to emit a fluid.2. The apparatus according to claim 1 , wherein the radiating portion and the nozzle are disposed in a concentric orientation with the nozzle disposed within the radiating portion.3. The apparatus according to claim 1 , wherein the nozzle is disposed distal of the radiating portion.4. The apparatus according to claim 1 , wherein the end effector includes an expanding portion claim 1 , the expanding portion configured to expand to engage an inner wall of a patient's colon.5. The apparatus according to claim 4 , wherein the radiating portion is disposed within the expanding portion.6. The apparatus according to claim 5 , wherein the expanding portion is configured to diffuse light.7. The apparatus according to claim 1 , wherein the handle includes a first switch disposed thereon operably coupled to the radiating portion claim 1 , wherein activating the first switch causes the radiating portion to emit energy therefrom.8. The apparatus according to claim 7 , wherein the handle includes a second switch disposed thereon operably coupled to the nozzle claim 7 , wherein activating the second switch ...

Assembly for Positioning Electrodes for Radiofrequency Tissue Ablation

Assembly ( 10 ) for positioning an electrode assembly ( 16 ) for radiofrequency ablation, comprising a first linear motion guide ( 11 ) defining a first axis of motion ( 103 ) and comprising a first carriage ( 111 ) operable to move along the first axis of motion ( 103 ), an XY positioner ( 12 ) operable to move a second carriage ( 123 ) in a two-dimensional space defined by a second axis of motion ( 104 ) and a third axis ( 105 ) orthogonal to the second axis of motion. The XY positioner is positioned relative to the first linear motion guide ( 11 ) such that the second axis of motion and the third axis are orthogonal to the first axis of motion ( 103 ). A first coupling means ( 125, 14 ) couples the electrode assembly ( 16 ) to the second carriage ( 123 ). A second linear motion guide ( 13 ) defining a fourth axis of motion ( 106 ) is disposed such that the fourth axis of motion is parallel to the second axis of motion ( 104 ). The second linear motion guide ( 13 ) comprises a third carriage ( 131 ) operable to move independently of the second carriage ( 123 ). A second coupling means ( 133, 15 ) for coupling a tissue stabilising instrument is mounted to the third carriage ( 131 ).

Guide Wire Joint

Disclosed is a guide wire joint, comprising: a first cover board ( 1 ), a second cover board ( 2 ), a connecting part ( 3 ) connecting the first cover board and the second cover board, and a connecting piece ( 4 ); the connecting piece ( 4 ) can connect the guide wire joint to a medical device; a side of the first cover board ( 1 ) and a side of the second cover board ( 2 ), both are away from the connecting part ( 3 ), are contacted with or separated from each other to adjust closing and opening of the guide wire joint. When the guide wire joint is closed, a guide wire passage ( 10 ) is formed between the first cover board ( 1 ) and the second cover board ( 2 ) allowing the guide wire to pass through and penetrate into a guide wire cavity of a medical device having a C-shaped groove; and when the guide wire joint is opened, the guide wire can be rapidly detached from the guide wire joint, and can be rapidly separated from the medical device.

CATHETER STRUCTURE AND METHOD FOR LOCATING TISSUE IN A BODY ORGAN AND SIMULTANEOUSLY DELIVERING THERAPY AND EVALUATING THE THERAPY DELIVERED

A catheter structure is provided for use with an electroviscerogram (EVG) system. The catheter structure includes an elongated tube structure having distal and proximal ends. Three electrodes are associated with distal end of the tube structure and are constructed and arranged obtain signals relating to myoelectrical activity internally of an intra-abdominal organ to thereby locate targeted tissue that includes main pathways of electrical generation in the organ. Therapy delivery structure, associated with the distal end of the tube structure and separate from the electrodes, is constructed and arranged to provide therapy at the targeted tissue simultaneously as the electrodes obtain the signals at the targeted tissue so that effectiveness of the therapy can be monitored. 114-. (canceled)15. A method of providing therapy to an intra-abdominal body organ of a patient , the method comprising the steps of:a) providing catheter structure including electrodes and therapy delivery structure, separate from the electrodes,b) inserting the catheter structure into an internal cavity of the organ endoscopically,c) determining a baseline electroviscerogram (EVG) rhythm of the organ using the electrodes,d) obtaining signals with the electrodes that relate to myoelectrical activity of the organ to thereby locate targeted tissue that includes main pathways of electrical generation in the organ,e) providing therapy, with the therapy delivery structure, at the targeted tissue simultaneously as the electrodes obtain the signals at the targeted tissue,f) evaluating the signals to determine the effectiveness of the therapy provided, andg) comparing results of the therapy provided to the baseline EVG rhythm.16. The method of claim 15 , wherein after the comparing step claim 15 , if the resulting therapy provided is not adequate claim 15 , the method includes repeating steps d) through g).17. The method of claim 15 , wherein the step of providing therapy includes ablating at least ...

Electrosurgical snare

An electrosurgical snare, e.g. suitably sized for insertion down the instrument channel of an endoscope, arranged to radiate microwave frequency energy (e.g. having a frequency greater than 1 GHz) from an elongate conductive element within an area encircled by a retractable loop. The elongate conductive element and retractable loop may be independently slidable relative to a snare base at a distal end of a sleeve to provide an appropriate device configuration. By controlling the shape of the emitted microwave field, the risk of collateral thermal damage can be reduced.

Endoscopic tissue manipulation tool

A medical device configured to manipulate tissue within a body of a subject may include an elongate shaft having a proximal end and a distal end. The distal end of the shaft may be configured to be inserted into the body. The device may include end effectors coupled to the distal end of the elongate shaft. The end effectors may include a needle pivotably coupled to the shaft and configured to inject a fluid into the tissue. The end effectors may also include an articulating arm pivotably coupled to the shaft, and a cutting wire extending between the needle and the arm.

Method and Apparatus for Tissue Ablation

Ablation catheters and systems include multiple inline chambers for containing and heating an ablative agent. The heating chamber includes one or more channels to increase the contact surface area of the ablative agent with the walls of the heating chamber to provide more efficient heating. Induction heating is used to heat a chamber and vaporize a fluid within by wrapping a coil about a ferromagnetic chamber and providing an alternating current to the coil. A magnetic field is created in the area surrounding the chamber which induces electric current flow in the chamber, heating the chamber and vaporizing the fluid inside. Positioning elements help maintain the device in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues.

INJECTATE DELIVERY DEVICES, SYSTEMS AND METHODS

An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided. 1. (canceled)2. An injectate delivery device for expanding tissue comprising:at first tissue capture port comprising an opening;a first fluid delivery tube comprising a proximal end, a distal end, and a lumen therebetween;a first fluid delivery element in fluid communication with the first fluid delivery tube lumen, the first fluid delivery element constructed and arranged to be advanced into the first tissue capture port;a radially expandable element comprising the first fluid delivery element and the first tissue capture port;a supply of vacuum fluidly attached to the first tissue capture port, the supply of vacuum constructed and arranged to cause tissue to be captured by the first tissue capture port; andat least one control constructed and arranged to:expand the radially expandable element;activate the supply of vacuum;a vacuum lumen; anda sensor constructed and arranged to detect an occlusion within the vacuum lumen;wherein the injectate delivery device is constructed and arranged to deliver an injectate to target tissue through the first fluid delivery element.3. The injectate delivery device according to claim 2 , wherein the first tissue capture port opening comprises a length of at least 0.1″ and ...

Treatments for Diabetes Mellitus and Obesity

Methods of treatment in subjects suffering from diabetes mellitus or obesity are provided. The methods comprise ablation of a region of the small intestine in the subject, in particular ablation of a region of the duodenum. The ablation may be a mechanical, electrical, thermal, radiative, or chemical ablation and may in some cases target a sensory nerve. The methods may, in some cases, comprise the step of administering an active agent directly to the small intestine in the subject, in particular administering the active agent directly to the duodenum. The active agents useful in the treatments described herein include analgesic agents and, in particular, antinociceptive agents such as capsaicin, resiniferatoxin, and their analogues. 1. (canceled)2. A method of treatment comprising:administering an analgesic agent in a targeted fashion to the duodenum in a subject, wherein the subject suffers from diabetes mellitus or obesity.3. The method of claim 2 , wherein the analgesic agent comprises a topical analgesic agent.4. The method of claim 2 , wherein the analgesic agent comprises an antinociceptive agent.5. The method of claim 2 , wherein the analgesic agent comprises a local anesthetic from the amide group.6. The method of claim 2 , wherein the analgesic agent is administered by infusion through a syringe.7. The method of claim 2 , wherein the analgesic agent is administered following surgical exposure of the small intestine of the subject.8. The method of claim 2 , wherein the analgesic agent is administered by a laparoscope or an endoscope.9. The method of claim 2 , wherein the analgesic agent is administered by topical application directly to the duodenum.10. The method of claim 2 , wherein the analgesic agent is administered to the sensory nerve on a serosal surface of the duodenum.11. The method of claim 2 , wherein the subject suffers from diabetes mellitus.12. The method of claim 2 , wherein the subject suffers from type 2 diabetes mellitus.13. The method of ...

CATHETER WITH RADIOFREQUENCY CUTTING TIP AND HEATED BALLOON

Methods for draining pseudocysts and stent delivery systems for use therein are disclosed. An illustrative system may include a catheter shaft having an inflatable balloon affixed to a distal end region thereof. A cutting electrode may be disposed at the distal end of the system and at least one heating electrode may be disposed within the inflatable balloon. A self expandable stent may be disposed about the inflatable balloon. The stent may be formed of a shape memory polymer. The inflation fluid may be heated within the balloon to facilitate expansion of the stent. 1. A stent delivery system , comprising:a catheter shaft having a proximal end and a distal end;an inflatable balloon having an inner region and an outer surface, the inflatable balloon disposed adjacent to the distal end of the catheter shaft;a cutting electrode positioned at the distal end of the catheter shaft;a heating electrode disposed about the inner region of the inflatable balloon; anda stent disposed about the outer surface of the inflatable balloon, the stent having a non-expanded state and an expanded state.2. The stent delivery system of claim 1 , wherein the cutting electrode and the heating electrode are each in electrical communication with a control console through separate electrical circuits.3. The stent delivery system of claim 1 , wherein the cutting electrode is configured to be operated in a first cutting mode and the heating electrode is configured to be operated in a second heating mode.4. The stent delivery system of claim 1 , wherein the expanded state of the stent includes a flared proximal end region and a flared distal end region.5. The stent delivery system of claim 1 , wherein the inflatable balloon comprises a dumbbell shape in the expanded state.6. A stent delivery system claim 1 , comprising:a catheter shaft extending from a proximal end to a distal end;an inflatable balloon having a proximal end and a distal end affixed to the catheter shaft proximal to the distal end ...

Microwave energy-delivery device and system

A method of manufacturing a microwave ablation device, the method including applying a balun short circumferentially about an outer conductor of a coaxial feedline and applying a dielectric material circumferentially about the outer conductor of the coaxial feedline and in contact with the balun short to form a balun. The method further including extending a temperature sensor along the coaxial feedline such that the sensor contacts the balun short, securing the temperature sensor to the coaxial feedline with a first heat shrink material, and securing the dielectric material, balun short, and temperature sensor in contact with each other and to the coaxial feedline using a second heat shrink material.

Tissue dissection device and related methods of use

Embodiments of the present disclosure include a method for treating tissue. The method may include delivering a medical device through a channel of an endoscopic device, wherein the medical device may include an elongate member, a cap coupled to a distal end of the elongate member and having a cavity, and an electrically-conductive tool extending into the cavity of the cap. The method may also include extending a portion of the medical device out of the channel of the endoscopic device and to the tissue, drawing a portion of the tissue into the cavity of the cap, electrically activating the tool to pierce the portion of the tissue, and cutting the tissue by moving the medical device along a plane of the tissue.

TFT COAGULATION SAFEGUARD

A medical instrument includes an endoscope shaft and an electrode cap with a pin axially movable in the endoscope shaft. A first electrode is held by a first electrode carrier at a distal end piece of the endoscope shaft, and a second electrode is held by a second electrode carrier at the electrode cap. A safety switch is arranged in proximity to one of the electrode carriers and interconnected with a feed line that feeds HF current to the second electrode. The safety switch can be brought into an OFF or disconnect position to disconnect HF current supply to the second electrode. The safety switch can include an outer contact ring fixed at a proximal end portion of the pin, and an actuating rod that protrudes from the pin at the distal end and transmits movement to the second electrode carrier. 1. A medical instrument of bipolar design comprising:an endoscope shaft comprising a distal end piece having an end face;an electrode cap including a pin supported to be axially moveable in the distal end piece of the endoscope shaft;at least two electrodes comprising a first electrode and a second electrode, the first electrode held by a first electrode carrier, and the second electrode held by a second electrode carrier, the second electrode located at the electrode cap, and the first electrode located at the distal end piece;a first feed line for feeding current to the first electrode;a second feed line for feeding current to the second electrode;the first electrode carrier and the second electrode carrier being moveable relative to each other to enter into an operating position in which the first electrode can be charged with HF current via the first feed line, and the second electrode can be charged with HF current via the second feed line, so as to interact with each other; anda safety switch mechanism arranged in proximity to at least one of the first and second electrode carriers and interconnected with at least one of the first feed line and the second feed line, ...

INSTRUMENTS, SYSTEMS, AND METHODS FOR SEALING TISSUE STRUCTURES

A method of sealing bowel tissue includes grasping bowel tissue between first and second electrically-conductive surfaces, applying a clamping pressure to the grasped bowel tissue in a range of about 1 kg/cmto about 2.5 kg/cm, supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue to seal the grasped bowel tissue, and monitoring one or more parameters during the supplying of energy to the electrically-conductive surface(s). Instruments, end effector assemblies, generators, and systems suitable for this purpose are also provided. 118-. (canceled)19. A surgical system for sealing tissue , the system comprising:an energy-based surgical instrument including an end effector assembly having first and second jaw members, at least one of the first or second jaw members movable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween, each of the first and second jaw members including an electrically-conductive surface, the end effector assembly further including at least one sensor operably associated therewith and configured to sense an impedance of the grasped tissue; monitor the impedance of the grasped tissue as a function of time during the supply of energy to the at least one electrically-conductive surface;', 'determine an actual impedance ramp, wherein the actual impedance ramp represents the monitored impedance of the grasped tissue as a function of time;', 'compare the actual impedance ramp with a target impedance ramp, wherein the target impedance ramp represents a change in impedance as a function of time that results in sealing of tissue while minimizing tissue denaturation, tissue damage, and breakdown of tissue layer architecture; and', 'control the supply of energy from the energy output to the at least one of electrically-conductive ...

TREATMENT INSTRUMENT AND ENDOSCOPIC SYSTEM

The disclosed technology is directed to a treatment instrument that comprises a sheath main body having opposed respective distal and proximal end regions. The sheath main body includes an outer diameter such that the sheath main body capable of being fit into the channel for insertion of the treatment instrument of the endoscope. The sheath main body includes a lumen extending along a longitudinal axis in the distal end region. A wire-shaped incising portion is configured to engage with the sheath main body so as to protrude from an outer circumferential surface of the sheath main body in the distal end region and extending along the longitudinal axis of the sheath main body. The wire-shaped incising portion is used to incise a tissue. A wire is attached to at least a portion of the sheath main body and having a region in which the wire has different bending resistances. 1. A treatment instrument for use with an endoscope having a bendable portion with a channel for receiving the treatment instrument , and an elevator configured to raise the treatment instrument while being inserted in the channel for insertion of the treatment instrument , the treatment instrument comprising:a sheath main body having opposed respective distal and proximal end regions along a longitudinal axis, the sheath main body includes an outer diameter such that the sheath main body capable of being fit into the channel for insertion of the treatment instrument of the endoscope, the sheath main body includes a lumen extending along the longitudinal axis in the distal end region,a wire-shaped incising portion configured to engage with the sheath main body so as to protrude from an outer circumferential surface of the sheath main body in the distal end region and extending along the longitudinal axis of the sheath main body, the wire-shaped incising portion being used to incise a tissue, anda wire being attached to at least a portion of the sheath main body, inserted in the lumen, and having a ...

DEVICES AND METHODS FOR THE TREATMENT OF TISSUE

Systems, methods and devices for the treatment of tissue are disclosed. A system includes an elongate tube with a distal portion. A treatment element is positioned on the elongate tube distal portion, the treatment element constructed and arranged to treat target tissue. In one embodiment, gastrointestinal tissue is modified for the treatment of diabetes. 1. A system for treating diabetes in a patient , the system comprising a body access device and a treatment device including:an elongate tube having a distal portion;a viewing component constructed and arranged to allow the duodenal mucosa to be evaluated, the viewing component comprising an imaging device mounted on the body access device, the imaging device configured to provide direct visualization of internal body spaces and tissue;a controller constructed and arranged to select a target area of the patient's duodenal mucosa to treat;a treating component constructed and arranged to treat a treatment area of the patient's duodenal mucosa, such that the treatment leaves the patient's duodenum anatomically intact with respect to the patient's stomach and jejunum, the treating component comprising a treatment element positioned on the elongate tube distal portion, said treatment element configured to treat mucosal tissue, wherein the treatment element comprises a balloon constructed and arranged to receive a hot fluid to circumferentially deliver energy to a wall of the small intestine for controlled depth ablation of the mucosal tissue, the controller constructed and arranged to provide the hot fluid to the balloon and to adjust the pressure within the balloon; anda plurality of needles configured to expand a full circumferential portion of said submucosal tissue to increase a target treatment volume;wherein the body access device is configured to be advanced with the elongate tube.2. The system of wherein the treating component is adapted to remove the patient's duodenal mucosa and the treatment comprises ...

SYSTEMS, DEVICES AND METHODS FOR PERFORMING MEDICAL PROCEDURES IN THE INTESTINE

A method for performing a medical procedure in an intestine of a patient is provided. The method comprises providing a system comprising: a catheter for insertion into the intestine, the catheter comprising: an elongate shaft comprising a distal portion; and a functional assembly positioned on the shaft distal portion and comprising at least one treatment element. The catheter is introduced into the patient, and target tissue is treated with the at least one treatment element. The target tissue comprises mucosal tissue of the small intestine, and the medical procedure can be configured to treat at least one of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). 1. A method for performing a medical procedure in an intestine of a patient , comprising:selecting a patient diagnosed with at least one of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH);providing a system comprising:a catheter for insertion into the intestine, the catheter comprising:an elongate shaft comprising a distal portion; anda functional assembly positioned on the shaft distal portion and comprising at least one treatment element;introducing the catheter into the patient diagnosed with at least one of NAFLD or NASH; andtreating target tissue with the at least one treatment element, wherein the target tissue comprises mucosal tissue of the patient's small intestine;wherein the medical procedure is configured to treat the at least one of NAFLD or NASH.2. The method according to claim 1 , wherein the medical procedure is further configured to treat insulin resistance.3. The method according to claim 1 , wherein the medical procedure is further configured to treat a disease or disorder selected from the group consisting. of: Type 2 diabetes; Type 1 diabetes; “Double diabetes”; gestational diabetes; hyperglycemia; pre-diabetes; impaired glucose tolerance; insulin resistance; and combinations thereof.4. The method according to claim 1 , ...

PROCESS UTILIZING PULSED ENERGY TO HEAT TREAT BIOLOGICAL TISSUE

A process for heat treating biological tissue includes repeatedly applying a pulsed energy to a target tissue over a period of time so as to controllably raise a temperature of the target tissue to create a therapeutic effect to the target tissue without destroying or permanently damaging the target tissue. After the first treatment is concluded the application of the pulsed energy to the target tissue is halted for an interval of time. Within a single treatment session a second treatment is performed on the target tissue after the interval of time by repeatedly reapplying the pulsed energy to the target tissue so as to controllably raise the temperature of the target tissue to therapeutically treat the target tissue without destroying or permanently damaging the target tissue. 1. A process for heat treating biological tissue , comprising the steps of:treating a target tissue by repeatedly applying a pulsed energy to the target tissue over a first period of time so as to controllably raise a temperature of the target tissue to therapeutically treat the target tissue without destroying or permanently damaging the target tissue and to create a level of heat shock protein activation in the target tissue;halting the application of the pulsed energy to the target tissue for an interval of time that exceeds the first period of time; andre-treating the target tissue after the interval of time within a single treatment session by repeatedly reapplying the pulsed energy to the target tissue so as to controllably raise the temperature of the target tissue to therapeutically treat the target tissue without destroying or permanently damaging the target tissue and to increase the level of heat shock protein activation in the target tissue.2. The process of claim 1 , wherein the first period of time is less than ten seconds.3. The process of claim 1 , wherein the first period of time is less than one second.4. The process of claim 1 , wherein the interval of time comprises ...

Catheter or guidewire device including flow sensing and use thereof

Devices and methods are provided for performing procedure on tissue with flow monitoring using flow sensors. The devices include an elongated member, and at least one flow sensor disposed on the elongated member. The flow sensor includes at least one temperature sensor and at least one heating element having a cavity. At least a portion of the at least one temperature sensor is housed in the cavity. A temperature measurement of the temperature sensor provides an indication of the flow rate of a fluid proximate to the flow sensor.

Electrosurgical snare

The disclosure relates to three enhancements for a surgical snare: an electrosurgical snare in which the loop of snare wire extends from an energy transfer surface which can act both as a physical reaction surface for mechanical cutting using the snare and as a region for emitting electromagnetic energy; a surgical snare having a snare wire having a first end connected to a movable boss that is slidably mounted on a coaxial cable; and a surgical snare having an end cap with a distally facing reaction surface and a pair of channels for guiding a snare wire, where the distally facing reaction surface is arranged to contact the retractable loop when fully retracted.

SYSTEMS, DEVICES AND METHODS FOR PERFORMING MEDICAL PROCEDURES IN THE INTESTINE

A method for performing a medical procedure in an intestine of a patient is provided. The method comprises providing a system comprising: a catheter for insertion into the intestine, the catheter comprising: an elongate shaft comprising a distal portion; and a functional assembly positioned on the shaft distal portion and comprising at least one treatment element. The catheter is introduced into the patient, and target tissue is treated with the at least one treatment element. The target tissue comprises mucosal tissue of the small intestine, and the medical procedure can be configured to treat polycystic ovarian syndrome (PCOS). 1. A method for treating a patient diagnosed as having polycystic ovarian syndrome , said method comprising:treating a target mucosal tissue of the patient's small intestine to modify at least one of nutrient absorption by the target mucosal tissue, hormonal signaling from the target mucosal tissue, or secretions of the target tissue, wherein the treatment is configured to treat polycystic ovarian syndrome.2. The method according to claim 1 , wherein the medical procedure is further configured to treat insulin resistance.3. The method according to claim 1 , wherein the medical procedure is further configured to treat a disease or disorder selected from the group consisting of: Type 2 diabetes;Type 1 diabetes; “Double diabetes”; gestational diabetes; hyperglycemia; pre-diabetes; impaired glucose tolerance; insulin resistance; and combinations thereof.4. The method according to claim 1 , wherein treatment is performed with a system comprising:a catheter for insertion into the intestine, the catheter comprising:an elongate shaft comprising a distal portion;a functional assembly positioned on the shaft distal portion and comprising at least one treatment element; anda console operably attached to the functional assembly, and wherein the console comprises one or more variable console parameters used to control the functional assembly;and wherein ...

Method and Apparatus for Tissue Ablation

Methods of ablating endometrial tissue are disclosed. The methods include providing an ablation device that has a catheter with a hollow shaft through which an ablative agent can travel, a first positioning element, and a second positioning element positioned on the catheter distal to the first positioning element. The second positioning element is a disc shaped wire mesh and has a diameter in a range of 0.1 mm to 10 cm.

Devices and methods to treat and prevent diverticulitis

A method of treating diverticulitis and the diverticulum by reducing the bioactivity of the diverticulum such that the diverticulum necroses. The devices and methods include placing an endoscopic device within a colonic lumen relative to at least one diverticulum and inverting the diverticulum. Once inverted, the diverticulum is collapsed and sealed. Overtime, the inverted diverticulum will necrose and be absorbed by the body or slough off and be expelled.

Methods and devices for access across adjacent tissue layers

Adjacent tissue layers can be accessed using a catheter device with a distal tip having a conductive portion including a first cutting feature and one or more projections extending from the first cutting feature towards an outer diameter of the distal tip. Electrical energy can be supplied to the conductive portion of the device to cut tissue. A stent can be delivered to form a fluid communication between the adjacent tissue layers.

Devices and methods for treatment of luminal tissue

Devices and methods are provided for treatment of tissue in a body lumen with an electrode deployment device. Embodiments typically include a device with a plurality of electrodes having a pre-selected electrode density arranged on the surface of a support. The support may comprise a non-distensible electrode backing that is spirally furled about an axis and coupled to an expansion member such as an inflatable elastic balloon. In some embodiments, the balloon is inflated to selectively expose a portion of the electrode surface while maintaining the electrode density.

Combination tumor treatment

In some aspects, the present disclosure pertains to methods of treating a tissue volume comprising (a) administering an implantable composition comprising a releasable membrane-active agent to a target site such that the membrane-active agent is locally released to the tissue volume and (b) performing irreversible, reversible and/or thermal treatment by application of a pulsed electric field to the tissue volume. In other aspects, the present disclosure pertains to embolic compositions that comprise releasable membrane-active agents.

METHODS AND SYSTEMS FOR REDUCING NEURAL ACTIVITY IN AN ORGAN OF A SUBJECT

The present disclosure provides, according to some embodiments, methods and systems for selectively reducing, blocking or inhibiting at least part of the neural activity in an organ of a subject. In preferred embodiments, the method and system are used for selectively blocking at least part of the neural activity in a duodenum of a subject in need thereof. According to some embodiments, the selective blocking occurs through use of laser radiation. According to some embodiments, the selective blocking comprises causing damage to at least part of sensory nerves located within a target area while maintaining functional activity of tissue surrounding the sensory nerves. According to some embodiments, the sensory nerves include neurons configured to transmit signals triggered by food passing through the duodenum, such as, but not limited to, neurohormonal signals. 1. A catheter for reducing neural activity in a submucosal layer of a duodenum of a subject , the catheter comprising:an elongate catheter body having a proximal end and a distal end;a laser emitting element coupled with the catheter body at or near the distal end and configured to emit a laser beam in a first direction parallel to a longitudinal axis of said catheter body; anda rotatable optical element and focusing lens coupled with the laser emitting element configured to direct and focus the beam essentially perpendicular to the longitudinal axis of the laser emitting device focused below mucosal layer of the duodenum; andat least one pressure-inducing element coupled with the catheter body and configured to exert pressure on at least part of the duodenum to obtain a fixed diameter thereof;wherein the catheter is configured to ablate an area of the submucosal layer including sensory neurons, while maintaining functional activity of the mucosal layer and muscle tissue around the area.2. The catheter of claim 1 , wherein the laser emitting element comprises at least one optical fiber.3. The catheter of claim ...

Electrocautery Hemostasis Clip

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

Tft coagulation safeguard

A medical TFT instrument of the bipolar design includes at least two electrodes held by electrode carriers movable relative to each other which can be charged with HF current via a respective feed line. A safety switch mechanism arranged in the area of the electrode carriers and interconnected in at least one of the feed lines is additionally provided which, upon transfer of at least one of the electrode carriers into the out-of-function/situation, is brought into an OFF or disconnect position, whereby a HF current supply to the electrode associated with this feed line is disconnected.

Tissue spreader for accessing papilla, and related methods of use

The medical device may include an elongate member having a proximal end and a distal end, and a plurality of legs coupled to the distal end of the elongate member. The medical device may also include a moveable element distal to the distal end of the elongate member, disposed around the plurality of legs. The moveable element may be reciprocally moveable relative to the elongate member and plurality of legs between a first and second position. The plurality of legs may be in a collapsed configuration when the moveable element is in the first position, and may be in an expanded configuration when the moveable element is in the second position.

RF Surgical Resection Snare for Flexible Endoscopy

A polypectomy snare comprising two snare parts has a snare part that is completely electrically insulated and another snare part that is not electrically insulated in at least one distal portion thereof. The snare furthermore has at least one electrically insulated, HF surgically inactive skid at its distal end. 117.-. (canceled)18. A resection snare comprising:a first snare portion having a first electrical conductor, a first length, a first proximal end, and a first distal end, the first electrical conductor having a first insulation element electrically insulating said first electrical conductor at the first proximal end;a second snare portion having a first electrical conductor, a second length, a second proximal end, and a second distal end, the second electrical conductor having a second insulation element electrically insulating said second electrical conductor at the second proximal end;a catheter containing and configured to guide a manipulation wire therein,wherein the first and second proximal ends are connected with or merging in said manipulation wire;wherein the first and second snare portions form a snare tip at the first and second distal endswherein at least one of the first and second electrical conductors includes a not electrically-insulated region at a corresponding distal end from the first and second distal ends; andwherein the resection snare includes at least one electrically-insulated HF-surgically inactive skid at a distal end of the snare.191. A resection snare according to claim , wherein said not electrically-insulated region of the at least one of the first and second electrical conductors has a length in a range from 10 mm to 30 mm.202. A resection snare according to claim , wherein said at least one electrically-insulated HF surgically inactive skid is present on an opposite side of said non electrically-insulated region as seen from a snare center.21. A resection snare according to claim 19 , wherein at least one of the first and ...

Diabetes Treatment Methods and Devices

Endoluminal devices and methods that facilitate treatment of a desired treatment region of the gastrointestinal tract, in particular the duodenum, are provided herein. Such devices include a catheter having a treatment delivery portion disposed between proximal and distal balloons. The treatment can include thermal ablation of the treatment region by delivering a treatment fluid to the treatment region between the inflated balloons. In one aspect, the treatment fluid is delivered so as to fill the entire treatment region between the balloons without regard to the inflated balloon pressure. To ensure filling, the treatment fluid can be delivered into the treatment region until a pressure increase is observed or until a pre-determined volume is delivered. Other treatment devices and methods include means of uniformly distributing a treatment gas for plasma ablation, electrical ablation energy or a chemical or drug eluting stent. 1. A method of treating a gastrointestinal disorder of a patient , the method comprising:advancing a first catheter through a gastrointestinal tract of the patient into a duodenum of the gastrointestinal tract, the first catheter having a distal treatment region with a treatment delivery portion disposed between a proximal balloon and a distal balloon, wherein the treatment delivery portion comprises one or more delivery openings fluidly coupled with a delivery lumen extending to a proximal region of the first catheter;positioning the distal treatment region within a desired treatment region of the duodenum;inflating each of the proximal and distal balloons, sealingly engage an inside surface of the duodenum at opposite ends of the treatment region of the duodenum;delivering a treatment fluid through the one or more openings while the proximal and distal balloons are sealingly engaged with the inside surface of the duodenum;substantially filling the treatment region of the duodenum between the proximal and distal balloons with the treatment ...

Unfurling electrode devices

Methods, systems, and devices for providing treatment to a tissue in body lumens are described. The system may include a catheter, an expansion member coupled with a distal portion of the catheter, an ablation structure including one or more longitudinal electrode segments, and an ablation structure support coupled to the ablation structure configured to at least partially unfurl as the expansion member expands and furl as the expansion member contracts. The ablation structure may include multiple separately wired and/or separately controlled longitudinal electrodes, longitudinal electrode zones, or both, such that each longitudinal electrode or longitudinal electrode zone may be selectively enabled or selectively disabled. In some instances, one or more springs are coupled to the ablation structure configured to promote unfurl or furl around the expansion member. In some instances, one or more protection elements are be positioned along the catheter.

Heat ablation systems, devices and methods for the treatment of tissue

A system for treatment target tissue comprises an ablation device and an energy delivery unit. The ablation device comprises an elongate tube with an expandable treatment element. The system delivers a thermal dose of energy to treat the target tissue. Methods of treating target tissue are also provided.

METHODS AND DEVICES FOR CONTROLLING MOTORIZED SURGICAL DEVICES

Methods and devices for controlling motorized surgical devices are provided. In general, the methods and devices can allow a surgical device to grasp and cut tissue. In some embodiments, the device can include at least one sensor and a motor, and an output of the motor can be configured to be adjusted based at least in part on an output from the at least one sensor. The output of the motor can be configured to provide power for translation of a cutting element along an end effector of the device. Adjusting the motor's output can cause the cutting element to translate through the end effector at different speeds, thereby allowing the cutting element to cut through tissue being grasped by the end effector at different speeds. 120-. (canceled)21. A surgical method , comprising:clamping tissue between opposed jaws of an end effector of a surgical device such that at least one electrode on at least one of the jaws is in contact with the tissue;actuating a first actuator of the surgical device with a force to simultaneously cause (1) energy to be applied to the clamped tissue via the at least one electrode, and (2) a cutting element of the surgical device to cut the clamped tissue, 'wherein, in response to the force being less than the predetermined force, non-electrically driving the cutting element to cut the clamped tissue; and', 'wherein, in response to the force being equal to or greater than a predetermined force, electrically driving the cutting element to cut the clamped tissue, and'}actuating a second actuator of the surgical device to cause energy to be applied to the clamped tissue without the cutting element cutting the clamped tissue.22. The method of claim 21 , wherein electrically driving the cutting element includes a motor providing an output that causes the driving of the cutting element; andnon-electrically driving the cutting element includes mechanically driving the cutting element.23. The method of claim 22 , wherein the motor is on board the ...

Methods and systems for treatment of tissue in a body lumen

A system for measuring physiologic characteristics or treating tissue in a body lumen. The system may be used for treating abnormal mucosa in the esophagus. The system comprises an energy delivery device, such as an ablation device including an electrode support and an electrode pattern on the support. The ablation device may expand in size from a pre-deployed state to a deployed state. The system may include a sizing device having an inflatable balloon on a distal end of a catheter that is inflated with an expansion medium to expand the balloon to engage the wall of the esophagus so that the internal cross-section can be calculated or measured. The sizing device may also a controller for delivering an expansion medium and measuring the amount and pressure of the expansion medium inside the catheter. Methods of treating or diagnosing tissue are also disclosed.

Surgical Micro-Shears and Methods of Fabrication and Use

Methods and devices are provided for use in medical applications involving tissue removal. One exemplary powered scissors device includes a distal housing having a fixed cutting arm located thereon, an elongate member coupled to the distal housing and configured to introduce the distal housing to a target tissue site of the subject, a rotatable blade rotatably mounted to the distal housing, the rotatable blade having at least one cutting element configured to cooperate with the fixed arm to shear tissue therebetween, a crown gear located at a distal end of an inner drive tube, and a first spur gear configured to inter-engage with the crown gear and coupled with the rotatable blade to allow the crown gear to drive the rotatable blade. 1: A powered scissors device comprising:a distal housing having a fixed cutting arm located at a distal end thereof and extending beyond an interior portion of the distal housing;an elongate member coupled to a proximal end of the distal housing and configured to introduce the distal housing to a target tissue site of the subject, the elongate member comprising an outer tube and an inner drive tube rotatably mounted within the outer tube;a rotatable blade, rotatably mounted to the distal housing, having one or more cutting elements configured to cooperate with the fixed arm to shear tissue therebetween wherein the tissue that is being sheared is not located in an interior of the distal housing at the time of shearing;a crown gear located at a distal end of the inner drive tube; anda first spur gear configured to inter-engage with the crown gear and coupled with the rotatable blade to allow the crown gear to drive the rotatable blade through a rotation of at least one full revolution,wherein every cutting edge of the one or more cutting elements remains in a single, common cutting plane as the one or more cutting elements rotate about an axis of rotation, thereby allowing the rotatable blade to make a single cutting line through the ...

Chemical ablation and method of treatment for various diseases

Embodiments of the present invention provide a device and a method for treating at least one of hypertension, pulmonary arteries, diabetes, obesity, heart failure, end-stage renal disease, digestive disease, nonalcoholic fatty liver disease, urological disease, cancers, tumors, pain, asthma or chronic obstructive pulmonary disease by delivering an effective amount of a formulation to a tissue. In embodiments of the present invention, the formulation may include at least one of a gas, a vapor, a liquid, a solution, an emulsion, or a suspensions of one or more ingredients. In embodiments of the present invention, amounts of the formulation and or energy are effective to injure or damage tissue, nerves, and nerve endings in order to relieve disease symptoms.

INSTRUMENTS, SYSTEMS AND METHODS FOR SEALING TISSUE STRUCTURES

A method of sealing bowel tissue includes grasping bowel tissue between first and second electrically-conductive surfaces, applying a clamping pressure to the grasped bowel tissue in a range of about 1 kg/cmto about 2.5 kg/cm, supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped bowel tissue to seal the grasped bowel tissue, and monitoring one or more parameters during the supplying of energy to the electrically-conductive surface(s). Instruments, end effector assemblies, generators, and systems suitable for this purpose are also provided. 118-. (canceled)19. A method of sealing tissue , comprising:grasping tissue between first and second electrically-conductive surfaces;supplying energy to at least one of the first and second electrically-conductive surfaces such that the energy is conducted between the first and second electrically-conductive surfaces and through the grasped tissue;monitoring an impedance of the grasped tissue as a function of time during the supplying of energy to the at least one of the first and second electrically-conductive surfaces; andcontrolling the supply of energy to the at least one of the first and second electrically-conductive surfaces to maintain a target impedance ramp of the grasped tissue such that the grasped tissue is sealed with minimal tissue denaturation, tissue damage, and breakdown of tissue layer architecture.20. The method according to claim 19 , wherein the target impedance ramp is about 0.010 Ω/ms.21. The method according to claim 19 , wherein supplying energy to the at least one of the first and second electrically-conductive surfaces includes supplying energy until tissue impedance reaches a target end impedance.22. The method according to claim 21 , wherein the target end impedance is about 200Ω.23. The method according to claim 19 , wherein the tissue is bowel ...

Methods and devices for applying energy to bodily tissues

Devices and methods for treating tissue with microwave energy used in applications such as destroying a soft tissue by microwave ablation and/or creating point, line, area or volumetric lesions. Various embodiments of flexible, low-profile devices are also disclosed where such device can be inserted non-invasively or minimally invasively near or into the target tissue such as cardiac tissue. The devices disclosed herein comprise antennas wherein the field profile generated by an antenna is tailored and optimized for a particular clinical application. The antennas use unique properties of microwaves such as interaction of a microwave field with one or more conductive or non-conductive shaping elements to shape or redistribute the microwave field.

Electrosurgical generator

This invention relates to high-frequency ablation of tissue in the body using a cooled high-frequency electrode connected to a high frequency generator including a computer graphic control system and an automatic controller for control the signal output from the generator, and adapted to display on a real time graphic display a measured parameter related to the ablation process and visually monitor the variation of the parameter of the signal output that is controlled by the controller during the ablation process. In one example, one or more measured parameters are displayed simultaneously to visually interpret the relation of their variation and values. In one example, the displayed one or more parameters can be taken from the list of measured voltage, current, power, impedance, electrode temperature, and tissue temperature related to the ablation process. The graphic display gives the clinician an instantaneous and intuitive feeling for the dynamics and stability of the ablation process for safety and control. This invention relates to monitoring and controlling multiple ground pads to optimally carry return currents during high-frequency tissue ablation, and to prevent of ground-pad skin burns. This invention relates to the use of ultrasound imaging intraoperatively during a tissue ablation procedure. This invention relates to the use of nerve stimulation and blocking during a tissue ablation procedure.

INJECTATE DELIVERY DEVICES, SYSTEMS AND METHODS

An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided. 1. A catheter for ablating a luminal surface tissue in a body lumen , said catheter comprising:a shaft assembly having a distal portion and a proximal portion, said proximal portion configured to fluidly attach to a source of tissue expansion fluid;an expandable element positioned on the distal portion of the shaft assembly and configured to deliver ablation energy to the tissue surface when expanded within the body lumen;at least two tissue capture ports, each tissue capture port positioned on an outer surface of the expandable element and configured to capture tissue when a vacuum is applied to the tissue capture port;at least two fluid delivery elements, each fluid delivery element configured to deliver the tissue expansion fluid to tissue captured by one of the tissue capture ports.2. The catheter of claim 1 , wherein the expandable element is configured to receive a heated fluid to deliver ablation energy to the luminal surface tissue.3. The catheter of claim 2 , wherein the proximal portion of the shaft is further configured to be connected to a source of heated ablation fluid and wherein the expandable element comprises a balloon configured to receive the heated ablation fluid from the source of ...

Devices and methods for transurethral bladder partitioning

Systems, devices, and methods to treat a urinary bladder are disclosed. An expandable member is introduced and expanded in the urinary bladder to appose one or more elongate conductors on the outer surface of the expandable member against the inner wall of the urinary bladder. The one or more elongate conductors are used to create a predetermined pattern of electrically isolated tissue regions having reduced electrical propagation such that electrical propagation through the urinary bladder as a whole is reduced. A mucus layer may be removed from the inner bladder wall prior to the ablation. Ablation may be regulated by impedance measurement with the one or more elongate conductors. The urinary bladder may be filled with a fluid to facilitate the impedance measurement.

Treatment tool for endoscope and incision system

A treatment tool for an endoscope includes a sheath which is extended along a longitudinal axis; a pre-curved portion which is disposed at a distal portion of the sheath; a knife wire lumen which is formed along the longitudinal axis of the sheath; a first communication hole and a second communication hole which are open on an outer circumferential surface to communicate the outer circumferential surface positioned with the knife wire lumen; a wire-shaped cutting portion which is protruded from the first communication hole and the second communication hole, and is extended in a position spaced from the outer circumferential surface and the virtual plane; a fixing portion which is provided to fix an end portion of a wire connected to the cutting portion inside the knife wire lumen, and a bending portion which is provided to bend the wire.

MICROWAVE TREATMENT DEVICES AND METHODS

The present invention discloses medical systems and methods adapted for the delivery of various medical components such as microwave antennas within or on a body for performing one or more medical procedures. Several embodiments herein disclose medical systems comprising a combination of one or more medical components and one or more elongate steerable or non-steerable arms that are adapted to mechanically manipulate the one or more medical components. Several embodiments of microwave antennas are disclosed that comprise an additional diagnostic or therapeutic modality located on or in the vicinity of the microwave antennas. 1. A microwave emitting device for delivering energy from an energy source and for use with a second power supply , the microwave emitting device comprising:a microwave antenna configured to be coupled to the energy source, the antenna having a proximal end, a distal end and an antenna axis, where the microwave antenna generates a microwave field upon application of energy from the energy source;an electrode positioned along the microwave antenna and between the proximal end and the distal end of the antenna, wherein the electrode is exposed to the microwave field and is electrically isolated from the antenna, where the electrode is coupleable to the second power supply; anda wire electrically coupled to the electrode wherein the wire is electrically isolated from the antenna and wherein a first portion of the wire exposed to the microwave field emitted by the antenna is helically disposed about the axis of the antenna such that arrangement of the conductive wire relative to the antenna reduces distortion of the microwave field due to the electrode.2. The system of claim 1 , where the electrode is located externally over the microwave antenna.3. The system of claim 1 , wherein the first portion of the wire is shaped in a helix having an axis and is disposed such that the helix axis is parallel to the antenna axis.4. The system of claim 1 , ...

CRYOGENIC ABLATION SYSTEM WITH ROTATABLE AND TRANSLATABLE CATHETER

An ablation assembly includes a handle, a catheter assembly and a connector locking assembly. The catheter assembly includes: a catheter shaft, a balloon and a connector at the distal and proximal ends of the catheter shaft, and a delivery tube extending between there between. The connector includes a connector body secured to the proximal end and a plug secured to the delivery tube, the plug and delivery tube movable axially and rotationally. The handle includes an open portion receiving the plug and the connector body. The connector locking assembly includes: means for simultaneously automatically connecting the plug and the connector body to the handle to place the connector in a load state prior to use, and means for automatically releasing the connector body and thereafter the plug from the handle to place the connector in an eject state to permit the connector to be removed from the handle. 1. An ablation assembly comprising:a control assembly comprising a handle assembly , a controller, and a user control assembly coupled to the controller, the handle assembly comprising a first connector element; a catheter shaft having proximal and distal ends and a catheter shaft lumen extending between the proximal and distal ends;', 'a connector at the proximal end of the catheter shaft selectively connected to the first connector element of the handle assembly, the connector comprising a connector body and a second connector element, the first and second connector elements being mating connector elements;', 'an expandable and collapsible balloon mounted to the distal end of the catheter shaft, the balloon having an inner surface defining a balloon interior;', a delivery tube housed within the catheter shaft for axial and rotational movement relative to the catheter shaft, the delivery tube having a proximal end connected to the second connector element; and', 'a diffuser, within the balloon, fluidly coupled to the delivery tube; and, 'a delivery tube assembly comprising ...

ENERGY TREATMENT INSTRUMENT

An energy treatment instrument includes: an insertion section, a base, a needle section, an output section, and a cover portion. The needle section includes a tip end projecting in a first direction relative to the base. The output section is configured to output energy to an outside of the needle section when supplied with energy. The cover portion includes an end portion which is movable relative to the base. The cover portion is configured to move between a first position and a second position. In the first position, the cover portion is configured to protect the tip end of the needle section and the output section. In the second position, the end portion of the cover portion is evacuated from the tip end of the needle section and the output section. 1. An energy treatment instrument comprising:an insertion section in which a longitudinal axis is defined;a base provided on a distal side along the longitudinal axis of the insertion section;a needle section including a tip end projecting in a first direction relative to the base;an output section provided toward a side of the base with respect to the tip end of the needle section, and configured to output energy to an outside of the needle section when supplied with energy; and a first position where the end portion of the cover portion is disposed in a position which is equal to the tip end of the needle section or in a position which projects from the tip end in the first direction, and the cover portion is configured to protect the tip end of the needle section and the output section, and', 'a second position where the end portion of the cover portion is evacuated from the tip end of the needle section and the output section., 'a cover portion including an end portion which is movable relative to the base, the cover portion being configured to move between2. The energy treatment instrument of claim 1 , wherein when the cover portion is in the second position claim 1 , a projection length of the output section ...

SYSTEMS AND METHODS FOR TREATING TISSUE WITH RADIOFREQUENCY ENERGY

A system for controlling operation of a radiofrequency treatment device to apply radiofrequency energy to tissue to treat tissue to create lesions without ablating the tissue. The system includes a first treatment device having a plurality of electrodes. The electrodes are maintained in axial alignment and fixed radial spacing in retracted and extended positions. The device includes a basket having a plurality of arms. The arms are maintained in a fixed radial spacing in the collapsed position of the basket. 116-. (canceled)17. A method of treating tissue by applying non-ablative radiofrequency energy comprising the steps of:a. providing a device having a plurality of electrodes movable between a retracted position and an advanced position, the plurality of electrodes having structure to maintain an equidistant radial spacing and to maintain longitudinal alignment of penetrating tips of the electrodes in the retracted position;b. inserting the device into a sphincter of a patient;c. advancing the electrodes to penetrate sphincter tissue at a first location, the electrodes having penetrating tips longitudinally aligned in the advanced position and further being equidistantly radially spaced in the advanced position;d. applying radio frequency energy to the electrodes to apply radiofrequency energy to tissue in a first area of the penetrating tips of the electrodes, the radiofrequency energy applied so a minimum distance is maintained between regions of sphincter tissue treated by the electrodes;e. retracting the electrodes within the device;f. rotating the device to a second position;g. advancing the electrodes from the device so that the penetrating tips penetrate sphincter tissue at a second location, the penetrating tips of the electrodes being longitudinally aligned and maintained in an equidistant radial spacing; andh. applying radiofrequency energy to the electrodes to apply radiofrequency energy to sphincter tissue in a second area of the penetrating tips of ...

SYSTEM AND PROCESS OF UTILIZING ENERGY FOR TREATING BIOLOGICAL TISSUE

A process for heat treating biological tissue includes providing a plurality of energy emitters formed into an array. Treatment energy is generated from the plurality of emitters and applied to target tissue. The treatment energy has energy and application parameters selected so as to raise the target tissue temperature sufficiently to create a therapeutic effect while maintaining an average temperature of the target tissue over several minutes at or below a predetermined temperature so as not to destroy or permanently damage the target tissue. 1. A process for heat treating biological tissue , comprising the steps of:providing a plurality of energy emitters formed into an array;generating treatment energy from the plurality of emitters; andapplying the treatment energy to target tissue;wherein the treatment energy has energy and application parameters selected so as to raise the target tissue temperature sufficiently to create a therapeutic effect while maintaining an average temperature of the target tissue over several minutes at or below a predetermined temperature so as to not destroy or permanently damage the target tissue.2. The process of claim 1 , wherein the selected energy and application parameters comprise tissue application spot size or area claim 1 , average power or average power density claim 1 , and exposure duration.3. The process of claim 1 , including the steps of:providing an initial treatment to the target tissue by repeatedly applying the energy to the target tissue in a pulsed manner for the exposure duration comprising less than one second;halting application of the pulsed energy to the target tissue for an interval of time comprising between three seconds and three minutes; andproviding a secondary treatment to the target tissue after the interval of time, within a single treatment session, by repeatedly reapplying the pulsed energy for the exposure duration comprising less than one second.4. The process of claim 1 , wherein during an ...

Systems and methods for treating tissue with radiofrequency energy

A device for applying radiofrequency energy for sphincter treatment comprising a flexible outer tube, an expandable basket having a plurality of arms movable from a collapsed position to an expanded position, and a plurality of electrodes movable with respect to the arms from a retracted position to an extended position. An advancer is slidably disposed within the outer tube to move the plurality of electrodes to the extended position. An actuator moves the advancer from a first position to a second position to advance the plurality of electrodes. An aspiration tube extends within the outer tube. An assembly includes an aspiration disabler having a first position to enable aspiration from a distal portion of the aspiration tube to a proximal portion and a second position to disable aspiration.

Electrosurgical apparatus for generating radiofrequency energy and microwave energy for delivery into biological tissue

An isolating circuit for electrosurgical generator arranged to produce radiofrequency (RF) energy and microwave energy for treating biological tissue. The generator has an RF channel and a microwave channel which are combined at signal combiner to enable the RF energy and microwave energy to be delivered into tissue along a common feed path. The isolating circuit comprises a tunable waveguide isolator at a junction between the microwave channel and signal combiner, and can include a capacitive structure between a ground conductor of the signal combiner and a conductive input section of the waveguide isolator to inhibit coupling of the RF energy and leakage of the microwave energy. The isolating circuit can combine into a single tunable unit all the necessary components to isolate the microwave and RF channels from one another whilst providing a high withstanding voltage.

ENDOSCOPIC GASTRIC MUCOSAL ABLATION/RESECTION/EXCLUSION (A/R/E) AS A MINIMALLY INVASIVE WEIGHT LOSS APPROACH

The present invention is directed to a method of endoscopically ablating/resecting/excluding (A/R/E) the mucosa of the gastric fundus and body. The method of the present invention is intended to cause cellular death to the X/A-like, ghrelin producing and other hormone cells. This is in contrast to present methods to provide only transient ischemia. The use of the method of the present invention results in a more permanent and robust method of reducing ghrelin and other hormone levels. In addition, a method according to the present invention can be used to induce scarring of the gastric fundus which will reduce gastric accommodation of excess food and result in early satiety. 1. A method for treating obesity in a subject comprising:inserting an endoscope through a mouth of the subject and into an esophagus of the subject;advancing the endoscope to a region of treatment;treating ghrelin and other hormone producing cells disposed in the region of treatment;reducing food intake for the subject; andinducing weight loss and alterations in a metabolic profile in the subject.2. The method of wherein treating ghrelin and other hormone producing cells disposed in the region of treatment comprises ablating a gastric mucosa of the subject.3. The method of wherein treating ghrelin and other hormone producing cells disposed in the region of treatment comprises treating the area with a topical gel or solution to induce cell death.4. The method of wherein treating ghrelin and other hormone producing cells disposed in the region of treatment comprises resecting a mucosa of a gastric fundus and body of the subject.5. The method of wherein treating ghrelin and other hormone producing cells disposed in the region of treatment comprises creating a submucosal tunnel to separate gastric mucosa from submucosa to allow a resulting space to be filled with a solution or a gel to act as a barrier or result in cell death.6. The method of wherein inducing weight loss and improvement in metabolic ...

SYSTEMS AND METHODS FOR TREATING TISSUE REGIONS OF THE BODY

Systems and methods deploy a therapeutic or diagnostic element into contact with a body tissue region. The systems and methods can sense position of the therapeutic or diagnostic element relative to a targeted tissue region without direct or indirect visualization, by sensing fluid pressure in a fluid path having an outlet located at or near the therapeutic or diagnostic element. The systems and methods can also inflate the therapeutic or diagnostic element during use, while taking steps to avoid over-inflation and/or while dynamically monitoring the pressure conditions within the expanded element. 111-. (canceled)12. A method for sensing position of a device relative to a high pressure zone within a body lumen of a patient based on fluid pressure detection for treating GERD , the method comprising the steps of:a) providing a device having an operative or diagnostic element for treating the lower esophageal sphincter for treating GERD, an inflatable balloon, a an irrigation lumen forming a fluid path positioned external of the balloon to convey fluid to an internal circumferential region of a sphincter at a plurality of radially spaced regions, and a fluid outlet to body tissue located at or near the operative or diagnostic element, the operative or diagnostic element includes a basket structure having a plurality of arms and an electrode element movable within the plurality of arms, the fluid outlet communicating with the fluid path to output fluid to a body region where tissue contact by the basket structure is intended, the irrigation lumen forming the fluid path extending through the arms of the basket structure;b) inserting the device into the body region of the patient;c) while the balloon is in a collapsed condition, providing pressurized fluid through the fluid path of the device to exit the fluid outlet at or near the operative or diagnostic element so the fluid comes into contact with body tissue as the device is moved, the fluid outlet including a ...

Multi-Stage Vapor-Based Ablation Treatment Methods and Vapor Generation and Delivery Systems

Ablation catheters and systems include flexible catheter tips with a distal needle or ports for delivery of an ablative agent to a target tissue. Pressure monitoring during ablation ensure operation is performed within safe limits and with desired efficacy. Positioning elements help maintain the devices in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues. 1. A multi-stage method for treating at least one of excess weight , obesity , eating disorders , metabolic syndrome , dyslipidemia , diabetes , polycystic ovarian disease , fatty liver disease , non-alcoholic fatty liver disease , or non-alcoholic steatohepatitis disease by ablating duodenal tissue using a vapor ablation system , wherein the vapor ablation system comprises a controller having at least one processor in data communication with at least one pump and a catheter connection port in fluid communication with the at least pump , the multi-stage method comprising:connecting a proximal end of a first catheter to the catheter connection port to place the first catheter in fluid communication with the at least one pump, wherein the first catheter comprises at least two positioning elements separated along a length of the catheter and at least two ports positioned between the at least two positioning elements, wherein each of the at least two positioning elements has a first configuration and a second configuration, and wherein, in the first configuration, each of the at least two positioning elements is compressed within the catheter and in the second configuration, each of the at least two positioning elements is expanded to be at least partially outside the catheter;positioning the first catheter inside a patient such that, upon being expanded into the second configuration, a distal one of the at least two positioning elements is positioned within in the patient's small intestine and a proximal one of the at least two positioning elements ...