An end-firing surgical laser fiber suitable for Thulium Laser Fiber lithotripsy applications includes an internally reflective tube that extends beyond the distal end surface of the fiber to provide a standoff sleeve, and that is welded or otherwise fixed to an end section of the fiber. The standoff sleeve may be made of silica glass or sapphire, a reflective metal, and/or may include a reflectivity-enhancing coating or structure on an inner surface of the tube. In addition, the reflective standoff sleeve may be tapered to increase or decrease a diameter of a distal end of the sleeve to control output power density, and may include index matched fillers or structures that absorb, transmit, or scatter energy away from the fiber cladding, and/or an energy blocking or absorbing structure positioned at an upstream end of the sleeve. Still further, the laser output may be modified by adding relatively low power, extended duration pulses to a high frequency pulse train in order to clear suspended dust particles from an interior of the sleeve during a lithotripsy procedure, and prevent buildup of the particles on the inside diameter of the sleeve.

A treatment device equipped with high frequency capability includes a pair of clasping jaws that serves as bipolar electrodes. Another treatment device equipped with high frequency capability includes a high-frequency knife that serves as monopolar electrode. An anti-fouling coating that minimizes or prevents adhesion of cauterized tissues is incorporated on the electrode surfaces. Durability and functioning of the anti-fouling coating is improved by one or a combination of increased coating thickness, increased density of the coating, and incorporation of glass and/or high molecular weight PFPE into the coating. The anti-fouling coating can be applied to different locations of the treatment portion, e.g., an insulated portion and a recess of an electrode, an insulated portion and a boundary portion with an electrode.

An end effector of an electrosurgical device may include a first body, a first electrode on the left side of the first body, and a second electrode on the right side of the first body. The first and second electrodes may be configured to receive electrosurgical energy to treat tissue in a target treatment zone. The end effector may also include a fluid aspiration port in fluid communication with a fluid path. The fluid aspiration port may be configured to remove a material from the target treatment zone.

In one embodiment, the present disclosure relates to an electrosurgical device that includes an outer body, an inner body disposed partially within the outer body, three plates and an insulator. A first plate of the three plates includes a plurality of apertures and is positioned so that each of two projections extending from the inner body extend through a respective aperture of the plurality of apertures of the first plate. A second plate and a third plate of the three plates are both disposed on the first plate such that each of the two projections extends through an aperture of the second plate or the third plate, the second and third plates being fixed to a respective projection. The insulator is disposed around the inner body and is attached to the outer body at a first end and abuts the first plate at a second end opposite the first end.

An apparatus and methods for tissue restoration are provided. The apparatus may include a catheter shaft extending from a proximal end to a distal tip, the catheter shaft defining lumens including an inflation lumen and a light fiber lumen, a coated balloon positioned on a translucent distal segment of the catheter shaft proximal to the distal tip in fluid communication with the inflation lumen, the coated distal balloon comprising a translucent material and a coated material on an outer surface of the coated balloon, and a light fiber positioned in the catheter shaft in the light fiber lumen and extending through the translucent distal segment.

Disclosed a device for body contouring treatment. The device includes a layer of electrically conductive material, bound by a frame with cooling fluid conducting channels; a ceramic material layer with first side configured to contact conductive material layer and a second side configured to contact a treated skin surface; and wherein the dimensions of the ceramic material layer exceed the dimensions of the layer of electrically conductive material by at least 5 mm in each direction.

A surgical instrument includes an ultrasonic transducer supported by a housing and an elongated assembly extending distally therefrom. The elongated assembly includes a jaw and a waveguide coupled to the transducer and defining a blade having upper and lower tissue-contacting surface and first and second lateral surfaces disposed therebetween that are coated with a material. The jaw is pivotable relative to the blade and includes a structural base having a backspan and first and second uprights extending from the backspan. The jaw further includes a jaw liner supported within the structural base and positioned to oppose the upper tissue-contacting surface with the first and second uprights disposed on either side of the blade. In an ultrasonic mode, ultrasonic energy produced by the transducer is transmitted along the waveguide to the blade. In an electrosurgical mode, electrosurgical energy is conducted between the blade and the first and second uprights.

A surgical device is disclosed for cutting tissue, including for performing a capsulotomy of a lens capsule of an eye. This device includes a reversibly collapsible cutting element for cutting a portion of a capsule membrane of the eye. The cutting element includes an outer layer, an inner layer, and a bottom layer that has a higher electrical resistance than the electrical resistance of the outer layer and the inner layer. The bottom layer is configured to conduct an electrical current between the outer layer and the inner layer, which causes a temperature increase in the bottom layer for cutting tissue.

Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Disclosed embodiments include apparatuses, systems, and methods for positioning electrodes within a body. In an illustrative embodiment, a control handle is selectively engageable with primary and secondary actuators respectively coupled with primary and secondary electrodes. At a first position, the primary and secondary actuators are movably engaged to move in concert to a second position where distal ends of the electrodes extend into a target region. At the second position, the control handle is engaged with the secondary actuator and movable independently of the primary actuator in a first direction to a third position where the distal end of the secondary electrode extends beyond the distal end of the primary electrode. At the third position, the control handle is movably engaged with the primary actuator and movable independently of the secondary actuator in a second direction to a fourth position to partially retract the distal end of the primary electrode.