In some embodiments, disclosed herein are systems and methods of treating a patient that can include the steps of accessing the sphenopalatine fossa, and cannulating the inferior orbital fissure from the sphenopalatine fossa to access the retro-orbital space. The sphenopalatine fossa can be accessed via various routes, including percutaneously. Accessing the sphenopalatine fossa can include the step of inserting a needle-catheter system into the sphenopalatine fossa. Integrated needle-catheter systems as described herein can also be configured to access the trigeminal ganglion, epidural space, intrathecal space, and other desired anatomical locations.

Certain aspects of the present disclosure provide methods and apparatus for measuring an injection catheter needle insertion depth and/or injection solution efficacy. An example injection catheter may include a catheter tube and a retractable, electrically conductive needle disposed in the catheter tube and configured to extend from the catheter tube. The injection catheter may also include one or more electrodes disposed at a distal portion of the catheter tube, an electrical lead coupled to the needle, and electrical leads coupled to the electrode(s). An example method includes deploying such an injection catheter adjacent to the tissue, extending a needle into the tissue, receiving electrical signals from an electrical lead coupled to the needle and from other electrical leads coupled to the electrode(s), determining a bioelectrical parameter based on the received electrical signals, and determining a depth of the needle inserted into the tissue based on the bioelectrical parameter.

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.

An endosurgical device is provided. The endosurgical device comprises a flexible tube having at least two lengthwise extending channels, an end effector comprising two opposite jaws having opposite cutting edges, an effector sleeve that surrounds the tube at least at the distal tube end, and means for reciprocating the end effector axially in relation to the effector sleeve to close the jaws when the effector sleeve is moved forward and backwards to close and open the jaws, respectively. The exterior face of the opposite jaws is electrically insulated, and an electrical cord for providing current to the end effector extends inside one of the lengthwise extending channels of the tube. The endosurgical device may allow the surgeon to take several tissue specimens from an organ and to perform several functionalities when the device is inside the organ.

The present invention relates to a fully integrated sterilizable one time use disposable tissue visualization device and methods for using such devices. Preferred embodiments of the invention facilitate the visualization of an internal tissue site while causing a minimum of damage to the surrounding tissue. Further preferred embodiments may allow for the delivery of fluids and other treatment to an internal tissue site.

A tissue mapping system includes: an imaging stylet, a stylet-deploying mechanism, and a system console with data-processing capability. This tissue mapping system calculates, in-real time, a position of the stylet during tissue imaging and sensing. This position is then used to combine and re-map image and sensor data acquired by the stylet from different regions of the mapped tissue. The stylet is configured to acquire image data within its vicinity when inserted in a tissue, and also has a sensing region along a flexible distal portion of its length. The stylet-deploying mechanism inserts the stylet in different regions of the mapped tissue iteratively. The stylet-deploying mechanism also incorporates features for registering the position of the stylet by using strain sensing or image data. The system console communicates with the stylet to calculate the position of the stylet by using intra-operative tissue image data and distributed strain data within the sensing region of the stylet. The stylet incorporates optical guides that are advantageously used both for imaging and for distributed strain sensing. Another aspect of the invention is the use of the very same imaging and strain sensing optical guide to interrogate biochemical sensors disposed distally within the stylet in some embodiments.

Endoscopic light refraction imaging techniques are described for configuring a viewing trocar and/or angled endoscope with a light refracting element, such as glass and/or plastic prism for instance. The light refracting element can be utilized in and/or with the viewing trocar to refract (i.e., bend) light passing into the trocar through the trocar's window. As a result, the angled endoscope's field of view can be substantially aligned with the field of view of the trocar's window, thus allowing the angled endoscope and viewing trocar to be used together to create ports in a patient, including initial ports of endoscopic surgical procedures.

A method of inducing retrograde blood flow may include extending a sheath through opposite walls of one of an artery and a vein of a subject and through a wall of the other of the artery and the vein such that a distal end of the sheath may be positioned within one of the artery and the vein. The method may include inducing retrograde blood flow in the artery and delivering the induced retrograde blood flow into the vein of the subject via the sheath.

Devices, systems and methods for treating diseases and disorders effecting the cardiovascular system of the human body are disclosed. An exemplary device in accordance with this disclosure comprises a shaft, tip member fixed to the shaft, and a probe extending beyond a distal surface of the tip member. In some useful embodiments, the tip member is relatively atraumatic and the probe is shaped so as to be more likely to produce trauma than the tip member.

Apparatus for puncturing a fossa ovalis includes a catheter, which has a distal portion that is shaped so as to define a catheter distal end opening at a distal end of the catheter, and first and second lateral openings. The catheter is shaped so as to define a central catheter lumen open through the catheter distal end opening. A flexible longitudinal member passes from a proximal portion of the catheter to the distal portion of the catheter, out of the first lateral opening, and into the second lateral opening, so as to form a loop outside the catheter. A puncturing element is slidably disposed within the central catheter lumen, and is configured to puncture a hole through the fossa ovalis by being advanced out of the catheter distal end opening and through the fossa ovalis. Other embodiments are also described.