An electrosurgical instrument with smoke evacuation, having an electrode, a suction lumen, and a plurality of slots connected to suction lumen, in which the slots may be longer than they are wide and wider than they are thick. The electrosurgical instrument may have the slots arranged longitudinally about its central axis, and the suction lumen may be wider than the slot widths.

An electrosurgical device (10) is provided that is operable to deliver microwave energy within a controlled angular expanse to cause targeted tissue ablation. The device (10) comprises a blocking or reflecting material such as cylindrical members (34) that are laterally spaced from the antenna (20) that is operable to emit the microwave energy. The reflecting material creates regions in and/or surrounding the device into which sensors (51), such as thermocouple wires, may be placed to monitor a condition associated with the device or the patient's body.

Various embodiments disclosed relate to a lubricant. The lubricant includes a first non-amphiphilic triglyceride. The lubricant further includes a second non-amphiphilic triglyceride. The second non-amphiphilic triglyceride is different from the first non-amphiphilic triglyceride. The lubricant further includes a non-amphiphilic glycol ester.

Retrieval of material from vessel lumens can be improved by use of a distal element comprising an expandable mesh. a treatment device includes an elongated member having a proximal portion and a distal portion configured to be positioned within a blood vessel at a treatment site at or near a thrombus. A distal element comprising an expandable mesh is coupled to the distal portion of the elongated member via a connection assembly. In an expanded state, at least a portion of the mesh is configured to be in apposition with the blood vessel wall at the treatment site to anchor or stabilize the elongated member with respect to the blood vessel. The distal element can be electrically coupled to an extracorporeal current generator.

An exemplary tissue detection and location identification apparatus can include, for example, a first electrically conductive layer at least partially (e.g., circumferentially) surrounding a lumen, an insulating layer at least partially (e.g., circumferentially) surrounding the first electrically conductive layer, and a second electrically conductive layer circumferentially surrounding the insulating layer, where the insulating layer can electrically isolate the first electrically conductive layer from the second electrically conductive layer. A further insulating layer can be included which can at least partially surrounding the second electrically conductive layer. The first electrically conductive layer, the insulating layer, and the second electrically conductive layer can form a structure which has a first side and a second side disposed opposite to the first side with respect to the lumen, where the first side can be longer than the second side thereby forming a sharp pointed end via the first side at a distal-most portion. The exemplary configuration can be used for (a) determination/detection of a tissue type using impendence of the electrically conductive layers, and/or (ii) determination of a location of at least one portion of the insertion device/apparatus. Based on such determination, it is possible to effectuate ablation or heating of tissue by applying RF energy across the electrically conductive layers.

Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.

In one embodiment, a medical system includes a medical instrument includes an elongated shaft having a distal end, at least one cutting element disposed at a distal end of the shaft, a position-tracking transducer disposed at the distal end of the shaft, and electrically insulated from the shaft and the at least one cutting element, and at least one metal coagulation electrode disposed at least partially over the position-tracking transducer, which electrically isolates the at least one metal coagulation electrode from the shaft, a signal generator coupled to apply an electrical current to the at least one metal coagulation electrode, and processing circuitry configured to receive signals generated by the position-tracking transducer, and track a location of the distal end responsively to the received signals.

An energy generator includes a connector port configured to couple to an electrosurgical instrument including an electrode having a polymeric dielectric coating; a power converter configured to generate energy; and a sensor coupled to the power converter and configured to sense a parameter of the energy. The energy generator also includes a controller coupled to the sensor and the power converter. The controller is configured to: control the power converter to output energy to modify an electrical property of the polymeric dielectric coating; and determine whether the electrical property of the polymeric dielectric coating has been sufficiently modified by the energy.

A tool has a handle and an elongate shaft that extends distally from the handle. A distal portion of the shaft is inserted into a subject during a surgical procedure. An optical fiber delivers laser energy to a tip at the distal portion of the shaft. The tip includes a mechanical cutting mechanism including a moving part that absorbs the laser energy, thermally conducts the absorbed energy to tissue that is disposed between the moving part and another part, and moves with respect to the other part in order to cut tissue that is disposed between the parts using a mechanical force that is lower than a mechanical force that would be required to cut the tissue in the absence of the laser energy. Other embodiments are also described.

A surgical apparatus for making an incision in a living tissue according to the present disclosure includes a hand piece including a loop-type electrode part and a generator configured to transmit electrical energy to the electrode part, wherein the generator applies electric-field pulse waveforms made of two consecutive pulse groups to the electrode part, the two consecutive pulse groups include a first pulse group and a second pulse group, each pulse group includes mini-pulses, a peak voltage of the first pulse group is less than a peak voltage of the second pulse group, and a duration of the first pulse group is longer than a duration of the second pulse group.