An electrosurgical generator with a high-voltage power supply that supplies a DC output voltage receives the DC output voltage of the high-voltage power supply and generates a high-frequency AC output voltage. When generator is operating, a control unit receives signals from an AC output voltage measuring unit and current measuring unit. The control unit limits an increase of DC output voltage of the high-voltage power supply as soon one predefined maximum value is reached or exceeded. When the generator is operating, the control unit configured to receive signals from a DC output voltage measuring unit that represent a respective current value of the DC output voltage, and to compare a respective current value of DC output voltage with a predefined minimum value for DC output voltage, and to cause the DC output voltage of the high-voltage power supply to increase as soon as it falls below the predefined minimum value.

A multifunctional surgical instrument (1) is provided. The multifunctional surgical instrument (1) comprises a proximal portion (13) and two legs (14), each leg comprising a distal end (11, 12), wherein a default position of the multifunctional surgical instrument is an open position, wherein the distal ends (11, 12) of the legs (14) do not meet in the open position, characterized in that each leg (14) comprises an aspiration half-channel (26, 27), the proximal portion (13) comprises an aspiration connection (29) and at least one of the distal ends (11, 12) comprises at least one aspiration orifice (28), wherein the two half-channels (26, 27) are configured to form an air-tight and water-tight continuous channel (25) connecting the at least one aspiration orifice (28) to the aspiration connection (29) when the multifunctional surgical instrument is in a fully closed position and are configured to open the aspiration channel (25) when the multifunctional surgical instrument is not in the fully closed position.

Systems and methods are provided for locating anatomical features in the skin based on analysis of reflected light, and treating the located anatomical features using high-energy light. A labeling agent can be administered to optically differentiate the anatomical feature.

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 method of optimizing the irradiation of a target with laser radiation includes selecting and mounting on a laser radiation delivery device either a waveguide or optical fiber type to be used; also, selecting at least the following parameters: selecting the total energy of the at least one train of pulses to be delivered to the target, and selecting the distance from the distal delivery end to the target; then, initiating irradiation of the target for the at least one train of pulses by generating a first laser pulse with sufficient energy (E.sup.i) to form a vapor bubble in a liquid medium; allowing the vapor bubble formed to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the distal delivery end and the target; and, thereafter, after the selected time delay (T.sup.d) sufficient for the formed vapor bubble to reach its optimum extent, generating a second laser pulse (E.sup.p), the second laser pulse being delivered to the target through the formed vapor bubble.

An electrode assembly for an electrosurgical instrument includes an active electrode and retainer arrangement that are inserted to a cavity of an insulator and then welded together to secure the active electrode in the insulator for use in tissue treatment. The active electrode and retainer are configured to interlock with at least one internal retention surface of the cavity. Once assembled in the cavity, both the active electrode and the retainer may have a portion that extends out of the cavity to protrude from the insulator. This allows opposing biasing forces to be exerted on the active electrode and the retainer respectively so as to push the two components against a retention surface within the cavity. When the active electrode and the retainer are welded together, any clearance with the retention surfaces inside the cavity, caused by variations between parts during the manufacturing process, is removed or at least minimized.

A medical system includes an insertion device including a handle and a delivery portion, a laser fiber, a conductive wire, and a lock. The laser fiber extends through the insertion device and is coupled to a laser slider to control a position of the laser fiber relative to a distal end of the delivery portion. The conductive wire extends through the insertion device and is coupled to a wire slider to control a position of the laser fiber relative to a distal end of the delivery portion. The lock is positioned within the handle and is movable in order to selectively lock either the movement of the laser slider or lock the movement of the wire slider.

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.

A laser can produce pulses of light energy for tissue-type selective ejection of a volume of the target tissue, and the energy can be delivered to a treatment site through a waveguide, such as a fiber optic waveguide. The incident laser energy can be absorbed within a volume of the target tissue with a tissue penetration depth and pulse direction such that the propagation of the energy from the tissue volume is inhibited and such that the target tissue within the volume reaches the spinodal threshold of decomposition and ejects the volume, for example without substantial damage to tissue adjacent the ejected volume. The pulses are set to be tissue selective.

Systems, devices, and methods for identifying a target in a body using a spectroscopic feedback from the target are disclosed. An exemplary surgical feedback control system comprises a feedback analyzer configured to receive a reflected signal from a target in response to electromagnetic radiation directed at a target, and a controller in operative communication with the feedback analyzer. The controller can generate a control signal to a surgical system to perform a predetermined operation based upon the received reflected signal, including determining a composition of the target, or programming a laser setting to direct laser energy to the target.