An endoscopic instrument containing a retractable tool at its end that is articulated by engaging an actuator that moves pull wires to angularly move the tip of the instrument along a plane for conducting a procedure at a target site. The tool of instrument is linearly move from an extension position to a retracted position by another actuator. The instrument provide rotational control of the tool and instrument tip portion with a rotational actuator for rotating housings that carry both pull wires and a conducting wire connected to the tool.

The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for delivering energy to difficult to access tissue regions (e.g. peripheral lung tissues), and/or reducing the amount of undesired heat given off during energy delivery.

A vapor ablation handpiece for assisting a physician perform vapor ablation with a vapor ablation catheter includes a vapor generating element arranged in a coil shape. A mandrel seated in the body of the handpiece affixes the vapor generating element in the coiled arrangement. A voltage difference is supplied across the length of the vapor generating element when activated, causing the vapor generating element to heat liquid therein converting the liquid to vapor. The heated condensable vapor is delivered to a target tissue through the catheter.

A vapor ablation handpiece for assisting a physician perform vapor ablation with a vapor ablation catheter includes a vapor generating element arranged in a coil shape. A mandrel seated in the body of the handpiece affixes the vapor generating element in the coiled arrangement. A voltage difference is supplied across the length of the vapor generating element when activated, causing the vapor generating element to heat liquid therein converting the liquid to vapor. The heated condensable vapor is delivered to a target tissue through the catheter.

A system and method of controlling the application of energy to tissue using measurements of impedance are described. The impedance, correlated to the temperature, may be set at a desired level, such as a percentage of initial impedance. The set impedance may be a function of the initial impedance, the size and spacing of the electrodes, the size of a targeted passageway, and so on. The set impedance may then be entered into a PID algorithm or other control loop algorithm in order to extract a power to be applied to a treatment device.

Method for ameliorating secondary pulmonary hypertension in a patient including determining a pulmonary vascular resistance (PVR) of the patient suffering from secondary pulmonary hypertension; assessing a change in the PVR in response to a selection treatment; and treating the patient with a pulmonary artery manipulation device to provide pulmonary artery denervation if the patient is determined to suffer from fixed PH, thereby ameliorating the secondary pulmonary hypertension of the patient.

A multicatheter subsystem is provided for a steerable catheter robotic system. The subsystem includes a flexible output sheath, a plurality of flexible multi-lumen assemblies and a plurality of robotic instruments for performing a surgical procedure. The plurality of flexible multi-lumen assemblies extends through the outer sheath. Each of the multi-lumen assemblies has a proximal end and a distal end. Each of the robotic instruments is operatively and removably attachable to the distal end of one of the multi-lumen assemblies such that each instrument is teleoperable independently of every other robotic instrument. At least a first of the robotic instruments includes a plurality of interconnected articulating segments. Each of the articulating segments is operatively and removably attachable to a different one of the multi-lumen assemblies.

A method of compressing tissue during a surgical procedure is disclosed. The method comprises obtaining a surgical instrument comprising an end effector, wherein the end effector comprises a first jaw and a second jaw, establishing a communication pathway between the surgical instrument and a surgical hub, and inserting the surgical instrument into a surgical site. The method further comprises compressing tissue between the first jaw and the second jaw, determining a location of the compressed tissue with respect to at least one of the first jaw and the second jaw, communicating the determined location of the compressed tissue to the surgical hub, and displaying the determined location of the compressed tissue on a visual feedback device.

In general, devices, systems, and methods for fiducial identification and tracking are provided.

An instrument and method for tissue thermotherapy including an inductive heating means to generate a vapor phase media that is used for interstitial, intraluminal, intracavity or topical tissue treatment. In one method, the vapor phase media is propagated from a probe outlet to provide a controlled vapor-to-liquid phase change in an interface with tissue to thereby apply ablative thermal energy delivery.