Devices, systems and methods are disclosed for the ablation of tissue. A steerable ablation catheter can include one or more ablation elements at its distal end and one or more ablation elements fixedly attached to its shaft. The distal end of the ablation catheter can be deflected to assume a number of different deflection geometries in at least one direction along the shaft. One feature of the ablation catheter is that its shaft can comprise materials of differing durometers or stiffnesses attached together at a joint. Methods associated with use of the ablation catheter are also covered.

A device for sealing tissue within an anatomical structure includes a handle having an elongated shaft extending therefrom. A reciprocating element is disposed within the elongated shaft and is configured for reciprocation therein. The reciprocating element includes a distal end extending from a distal end of the elongated shaft. A rope-like filament is secured to the distal end of the reciprocating element and remains exposed relative to the distal end of the elongated shaft during reciprocation thereof. A motor is disposed within the handle and is configured to induce reciprocation of the reciprocating element upon activation thereof, the motor is adapted to connect to a generator configured to selectively supply power to the motor upon activation thereof.

A surgical end effector assembly includes a pair of jaw members, a knife defining a longitudinal slot, a pivot pin coupling the jaw members to one another, and a drive member including a drive pin that is engaged to the jaw members. The pivot pin and/or the drive pin extends through the longitudinal slot of the knife to couple the knife to the jaw members and/or the drive member. The end effector assembly is transitionable between a use position, wherein the knife and drive member are generally aligned with one another to facilitate releasable engagement of the end effector assembly with a surgical instrument, and a cleaning position, wherein the jaw members, knife, and drive member are fanned apart from one another to facilitate cleaning of the end effector assembly. Methods of disengaging and sterilizing end effector assemblies for reuse are also provided.

A surgical instrument with insulating grips is described. The grips can include internal metal frames that are arranged to limit electrical conductivity within the grips and to other components that attach to a grip, such as a ratchet. The internal metal frames can be constructed of multiple internal portions, spatially separated from one another to interrupt electrical conductivity between the internal portions, but coated with an insulating overmold to provide mechanical coupling between the portions. An internal metal frame can also include a notch, cut-out, or other region partially surrounded by the structure of the internal metal frame, which can be coated with an insulating overmold to define a region of the grip that does not have an internal metal frame therein but which can include an attachment point for mechanically coupling other components while limiting electrical coupling between the metal frame and the other components.

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.

Disclosed embodiments include apparatuses, systems, and methods for positioning electrodes using a single control surface. In an illustrative embodiment, an apparatus includes an actuator shaft defining a lumen through which a primary electrode and a secondary electrode are linearly movable. A primary actuator is movably couplable with the actuator shaft and a primary electrode with the primary actuator being configured to extend and retract the primary electrode. A secondary actuator is movably couplable with the primary actuator and a secondary electrode with the secondary actuator being configured to extend and retract the secondary electrode. An actuator controller is configured to move along the shaft in a first direction to engage and motivate the primary actuator and is further configured to move along the shaft in a second direction to engage and motivate the secondary actuator. The primary actuator and the secondary actuator are sequentially manipulatable using only the actuator controller.

A manipulable portion of a catheter system advances out of a lumen of a catheter sheath at a distal end of a shaft, which is also within the lumen of the catheter sheath. The catheter system causes different advancement and retraction trajectories of a manipulable portion out of and into the lumen based at least upon different relative movements between the catheter sheath and the shaft. A projection and a corresponding receiver may be used to control relative positioning of the catheter sheath and the shaft, as well as to control positioning of the manipulable portion. The catheter system may control metering rates of a control element coupled to the manipulable portion during advancement and retraction of the manipulable portion. A control element of the catheter system has varying amounts of length outside a distal end of the catheter sheath during advancement and retraction of the manipulable portion.

Disclosed is an adjustable cryoablation needle, comprising a needle rod (3), a front-segment heat-insulated tube (1), a rear-segment heat-insulated tube (2), and an gas inlet structure (7) penetrating the needle rod (3) and the front-segment heat-insulated tube (1), wherein the needle rod (3) can move relative to the rear-segment heat-insulated tube (2) in the axial direction of the rear-segment heat-insulated tube (2) so as to adjust a first axial distance between the front end of the rear-segment heat-insulated tube (2) and the front end of the needle rod (3); and the front-segment heat-insulated tube (1) can move relative to the rear-segment heat-insulated tube (2) in the axial direction of the rear-segment heat-insulated tube (2) The adjustable cryoablation needle can prevent the inconvenience caused by a doctor selecting the model of the cryoablation needle.

An articulating electrosurgical instrument includes a housing having an elongated shaft extending therefrom and a wrist assembly operably supported to a distal end of the elongated shaft and configured to support an end effector assembly at distal end thereof. The wrist assembly includes a proximal link operably coupled to the distal end of the elongated shaft, a distal link operably coupled to the end effector assembly, and a central link operably coupled between the proximal link and the distal link. A transition lumen is configured to be received within the distal link, central link and proximal link. The transition lumen includes a helical passageway defined therein configured to guide a blade rod therethrough for operable engagement with a blade disposed within the end effector assembly.

The recovery of an intact volume of tissue proceeds with a delivery cannula distal end positioned in confronting adjacency with the volume of tissue to be recovered. A tissue cutting and capture assembly formed of a plurality of metal leafs is deployed from the distal end of the delivery cannula. The tips of these leafs carry a pursing cable assembly, which is resistively heated by the passage of electrical current through the cable, attaining temperature level sufficient to thermally cut around and circumscribe the tissue volume. These pursing cables are tensioned to complete the envelopment of the tissue volumes by drawing the leaf tips together. An essential attribute of the disclosed apparatus is the confinement of the path of electrical conduction of constant current required to achieve tissue cutting to only those portions of the deploying and retracting resistively heated portion of the electrically conductive cutting and pursing cable that are in direct contact with tissue.