An elongate electrode is configured to flex and generate plasma to incise tissue. An electrical energy source operatively coupled to the electrode is configured to provide electrical energy to the electrode to generate the plasma. A tensioning element is operatively coupled to the elongate electrode. The tensioning element can be configured to provide tension to the elongate electrode to allow the elongate electrode to flex in response to the elongate electrode engaging the tissue and generating the plasma. The tensioning element operatively coupled to the flexible elongate electrode may allow for the use of a small diameter electrode, such as a 5 μm to 20 μm diameter electrode, which can allow narrow incisions to be formed with decreased tissue damage. In some embodiments, the tensioning of the electrode allows the electrode to more accurately incise tissue by decreasing variations in the position of the electrode along the incision path.

The present disclosure provides an electrode assembly wherein an electrically conductive material is configured to extend into an insulating moulding via an opening in a wall of said moulding to electrically contact an active tip placed into the insulating moulding and thereby retain the active electrode therein, such that the height and space required to anchor the active electrode within the moulding is greatly reduced while still providing the necessary retention strength and electrical connection. As such, the electrode assembly retains and connects the active tip with a conductive element that is mounted within the insulating moulding.

An apparatus includes an elongated medical dilator including a cautery device configured to selectively form, by cauterization, a tissue passage through a tissue portion of a living body. The elongated medical dilator also includes a dilation device configured to dilate the tissue passage once the cautery device selectively formed the tissue passage.

A platform device for material excision or removal from vascular structures for either handheld or stereotactic table or robotics platform use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated as well as single or multiple arrays of image guidance elements, directional elements, ablation elements and other interventional assistance elements. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous or differential beak or scoopula closing under their differential rotation may be incorporated.

The disclosure relates to methods and systems incorporating physical modeling to identify the ultrafast laser/material interaction mechanisms and the impact of laser parameters, to optimize implementation of ultrafast laser-based processing for a given material. The process determines a laser fluence near the ablation threshold for a given material and given pulse duration. The repetition rate, scanning speed and scanning strategy are subsequently optimized to minimize heat accumulation, having an operable line scan overlap between 50% to 85% for achieving smooth ultrafast-laser polishing, while maintaining an optic-quality surface.

A device for enhancement of visual appearance including a first applicator to be coupled to a first area of a body region, with a first magnetic field generating device and a first radiofrequency electrode, a second applicator to be coupled to a second area of the body region, with a second magnetic field generating device. The device further includes a first energy storage device, a second energy storage device, and a first switching device to discharge energy from the first energy storage device to the first magnetic field generating to generate a first time-varying magnetic field to cause muscle contraction, and a second switching to discharge energy from the second energy storage device to the second magnetic field generating device to generate a second time-varying magnetic field. The first radiofrequency electrode may provide first radiofrequency waves causing heating of tissue within the first area of the body region.

In one aspect, recording instruments, probes, probe sheaths, and probe sleeves may include one or more recording elements, such as one or more ECG wires, EEG wires, and/or SEEG wires. A recording element may be used for lesion localization and assessment at the time of cryotherapy, thermal therapy, or temperature modulation therapy. A recording element may be used to provide positioning and monitoring during functional neurosurgery; to apply local tissue stimulation responsive to detection of an abnormal event to regulate cellular behaviors during treatment; to effect deep brain stimulation during a neurosurgical operation; to monitor internal electrical signals and identify abnormalities. Recording instruments may be deployed in vivo for hours or days while monitoring and analyzing signals. For signal analysis, leads disposed between recording element contact surfaces and along a shaft of the recording instrument may deliver recorded signals to a controller external to the patient for analysis.

An elongate electrode is configured to flex and generate plasma to incise tissue. An electrical energy source operatively coupled to the electrode is configured to provide electrical energy to the electrode to generate the plasma. A tensioning element is operatively coupled to the elongate electrode. The tensioning element can be configured to provide tension to the elongate electrode to allow the elongate electrode to flex in response to the elongate electrode engaging the tissue and generating the plasma. The tensioning element operatively coupled to the flexible elongate electrode may allow for the use of a small diameter electrode, such as a 5 μm to 20 μm diameter electrode, which can allow narrow incisions to be formed with decreased tissue damage. In some embodiments, the tensioning of the electrode allows the electrode to more accurately incise tissue by decreasing variations in the position of the electrode along the incision path.

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 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.