Surgical systems are provided. The surgical system includes an energy applying surgical instrument configured to apply energy to a natural body lumen or organ. A first scope device is configured to transmit image data of a first scene within a field of view. A second scope device is configured to transmit image data of a second scene within a field of view. A controller is configured to receive the transmitted image data of the first and second scenes and to provide a merged image of first and second scenes, where the merged image facilitates coordination of a location of energy to be applied to an inner surface of a tissue wall at a surgical site relative to an intended interaction location of a second instrument on an outer surface of the tissue wall in a subsequent procedure step at the surgical site.

An electrosurgical end effector for a surgical tool to perform teleoperated surgical operations. The electrosurgical end effector comprises a first end effector jaw; a second end effector jaw coupled to the first end effector jaw; and a coupling pin configured to rotatingly couple the first end effector jaw to the second end effector jaw so as to cooperatively rotate open and close about an axis of rotation. The electrosurgical end effector further comprises an actuation mechanism coupled to an end of the first end effector jaw to rotate the first end effector jaw about the coupling pin; an otomy feature coupled to the second end effector jaw; and a first electrical conductor to electrically couple the otomy feature to a generator. In one embodiment, the otomy feature is electrically activated by contact with a cam portion of the first end effector jaw, when opened beyond a predetermined jaw angle.

Systems and methods for treating cancerous tumors (including glioblastoma multiforme (GBM)) with electrotherapy, such as deep brain stimulation (DBS) technology, as disclosed herein. One or more configurations can be generated based on a patients tumor characteristics. The selected configurations can be electrode configurations or settings for an electrical source coupled to the electrodes. The one or more configurations can be targeted for inhibiting cell growth process, such as to inhibit mitosis, immune suppression, or to inhibit DNA replication. Inhibition of cell growth processes can initiate death of the cancerous cells.

Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

A smooth muscle stimulation device is intended for use with any one of a variety of electrosurgical units (ESU's) of the type used in tissue resection and other procedures that risk damage to non-target tissues. The smooth muscle stimulation devices typically include an enclosure with stimulation circuitry configured to generate a stimulatory electrical signal which when delivered to a target anatomy induces an observable response in the target anatomy during a medical procedure. An input connector on the enclosure detachably couples to a power output of the ESU, and an output connector on the enclosure detachably couples to an electrosurgical tool. Switching circuitry within the enclosure selectively connects either the power output of the ESU or the stimulatory electrical signal of the stimulation circuitry to the output connector in response to user input.

Flexible instruments and associated systems and methods are disclosed herein. In some embodiments, a flexible instrument comprises an elongate device having an inner conductor, an outer conductor surrounding the inner conductor, and a dielectric layer insulating the inner conductor from the outer conductor. The flexible instrument further includes a recess formed in the outer conductor. An insert is positioned within the recess and about the inner conductor.

Systems and methods for treating cancerous tumors (including glioblastoma multiforme (GBM)) with electrotherapy, such as deep brain stimulation (DBS) technology, as disclosed herein. One or more configurations can be generated based on a patients tumor characteristics. The selected configurations can be electrode configurations or settings for an electrical source coupled to the electrodes. The one or more configurations can be targeted for inhibiting cell growth process, such as to inhibit mitosis, immune suppression, or to inhibit DNA replication. Inhibition of cell growth processes can initiate death of the cancerous cells.

Embodiments of the present invention are directed to the treatment of hypertension, diabetes, obesity, heart failure, end-stage renal disease, digestive disease, urological disease, cancers, tumors, pains, asthma, pulmonary arterial hypertension, and chronic obstructive pulmonary disease by delivering of an effective amount of formulations at desired temperature to target tissue. The formulations include gases, vapors, liquids, solutions, emulsions and suspensions of one or more ingredients. The temperature may enhance safety and efficacy of the formulations for the treatments. The amounts of the formulation and/or energy are effective to injury or damage the tissues to have a benefit of symptom relive.

Systems, devices, and methods for delivering laser energy to a target in an endoscopic procedure are disclosed. An exemplary method comprises providing a first laser pulse train and a different second laser pulse train emitting from a distal end of an endoscope and incident on a target. The first laser pulse train has a first laser energy level, and the second laser pulse train has a second laser energy level higher than the first laser energy level. In an example, the first laser pulse train is used to form cracks on a surface of a calculi structure, and the second laser pulse train causes fragmentation of the calculi structure after the cracks are formed.

Methods and systems for surfactant enhanced laser-induced vapor bubbles for use in laser lithotripsy. Urinary tract stone disease is a common and costly disease that effects approximately 10% of the United States population. A preferred minimally invasive method for treatment of urinary tract stones is laser lithotripsy, which involves insertion of a flexible ureteroscope through the urinary tract to the stone's location, and then transmission of infrared (IR) laser energy through a flexible optical fiber, which is in turn placed through the single working channel of the ureteroscope. The IR laser energy is used for ablation of the urinary tract stone which is then removed. In order to have a more efficient ablation, the ureteroscope is fed with a surfactant composition which is flowed into the ureter and/or kidney of the subject. The laser causes larger bubbles to form in the surfactant composition, making a robust and longer lasting bubble.