A surgical instrument includes an outer tube configured to be gripped by a user, and a needle slidably disposed within the outer tube. The needle includes a needle lumen, a distal needle tip configured to pierce tissue, and an electrode disposed at the distal needle tip. The needle lumen opens to the distal needle tip such that the distal needle tip is configured to deliver fluid from the needle lumen to tissue. The electrode is operable to deliver RF energy to tissue for ablating the tissue. The needle is translatable relative to the outer tube between a proximal retracted position in which the distal needle tip is housed coaxially within the outer tube, and a distal extended position in which the distal needle tip is exposed from the outer tube and configured to pierce tissue.

Provided herein are systems for treating tissue of a patient. The system comprises an energy delivery console and at least one energy delivery device. The energy delivery console can provide a first dose of energy and a second dose of energy. An energy delivery device comprises a first delivery element configured to deliver the first dose of energy to target tissue, and a second delivery element configured to deliver the second dose of energy to the target tissue. The first dose of energy can comprise a delivery of energy that reversibly alters the target tissue, and the second dose of energy can comprise a delivery of energy that irreversibly alters the target tissue. The first dose of energy can be delivered to enhance a therapy provided by the second dose of energy.

An ablation instrument comprises an elongate shaft having a cannula channel and a scope channel, and an electrode disposed in the cannula channel. The electrode is slidable between a first position in which a distal end of the electrode is contained within the cannula channel, and a second position in which the distal end of the electrode extends out of a distal opening of the cannula channel. The ablation instrument further comprises a distal head coupled to the elongate shaft and configured for engaging tissue.

The invention includes a system for generating virtual images of proposed and designated areas on a patient's anatomy that are to be treated in a RFA procedure. The images include a size, shape, and location of lesion/ablation patterns. The virtual images include dynamic (developing) or static (developed) lesions selected for the RFA procedure. The images are provided on at least one user interface that superimposes or overlays the lesion pattern(s) on an image of a patient's anatomy that undergoes the procedure. The images can be used to accurately and efficiently conduct RFA procedures and to record the procedures with enhanced visual data to confirm treated tissue areas. The invention further includes a diagnostic method of generating images in preparation for a RFA procedure, and a method of conducting the RFA procedure in which measured parameters determine the size and shape of the ablated areas achieved in the procedure.

Methods for treating and managing pain in a patient with therapeutic neuromodulation and associated systems and methods are disclosed herein. Chronic or debilitating pain can be associated, for example, with a disease or condition of the abdominal or reproductive viscera. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a target blood vessel of a diseased or damaged organ of a patient experiencing pain. Targeted sympathetic nerve activity can be modulated at least along afferent pathways which can improve a measurable parameter associated with the pain of the patient 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, and/or chemically-induced approaches to modulate the target sympathetic nerve.

Systems and methods provide interface to a patient's autonomic nerves via an interior lumen wall of a blood vessel. Systems can include a probe having at least one electrode for receiving electrical signals from the interior of the lumen wall. The system can include processing components for extracting the signals from noise within the patient's body. Systems can include stimulation electrodes for providing stimulation and eliciting action potentials within the patient and destructive processes for destroying nervous function. The effect of nerve destruction on the propagation of action potentials can be effectively used as a feedback mechanism for determining the amount of nervous function destruction in the patient.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

A catheter device for renal denervation ablation includes a flexible catheter shaft having an electrically insulating expandable member in its distal portion with at least one electrode located proximal to the member, at least one electrode located distal to the member, and with openings in the distal shaft with at least one opening proximal to the proximal electrode and one opening distal to the distal electrode of said electrode pair, said openings connected through an inner lumen in the catheter that provides a path for blood to flow through the expandable member. In one embodiment, the device comprises a flexible catheter shaft with a multiplicity of recessed paired electrodes disposed in recessed spaces in its distal portion, such that an electrically conducting portion of each electrode is exposed to the exterior of the catheter within a recessed space, and with an electrical insulator separating the electrodes of each pair.

Apparatus, systems, and methods of controlling energy delivered to electrodes used in electrically and/or thermally induced neuromodulation are provided to improve neuromodulation. In particular, a catheter treatment device having a control algorithm that regulates current or current density delivered to an electrode is provided. The electrode may maintain a known and consistent electrode contact surface area with the vessel. The control algorithm controls energy delivery to provide consistent current or current density to the treatment site, even though the tissue impedance Z may vary from patient to patient and vessel to vessel, and despite changes in impedance of the treatment, site during the course of the treatment. The controlled delivery of energy can be used to control and maintain placement of the zone of thermal treatment and reduce undesirable energy delivery to unwanted locations near the treatment site.

Methods for treating and managing pain in a patient with therapeutic neuromodulation and associated systems and methods are disclosed herein. Chronic or debilitating pain can be associated, for example, with a disease or condition of the abdominal or reproductive viscera. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate a target blood vessel of a diseased or damaged organ of a patient experiencing pain. Targeted sympathetic nerve activity can be modulated at least along afferent pathways which can improve a measurable parameter associated with the pain of the patient 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, and/or chemically-induced approaches to modulate the target sympathetic nerve.