A method of producing an array of sharp tips including a biocompatible coating, wherein the biocompatible coating is thicker at a sharp end of the sharp tips than at a broader section of the sharp tips, the method including providing an array of sharp tips, and coating the sharp end of the sharp tips differentially from coating the broader section of the sharp tips. A method of treating skin including producing a hollow in the skin by heating and mechanically compressing epidermis while retaining a covering of stratum corneum. A method of treating tissue including heating a tip to a temperature suitable for producing a crater in the tissue, advancing the tip toward the tissue, detecting when the tip comes into contact with the tissue by detecting a change in mechanical resistance to the advancing, and measuring the mechanical resistance to the advancing. Related apparatus and methods are also described.

A device for thermal incision of tissue including a tissue heating element, an oscillatory mechanism that advances the tissue heating element toward tissue and retracts the tissue heating element from tissue, a detector that detects when the tissue heating element contacts the tissue, and a heat controller that controls heating of the tissue heating element, wherein the heat controller for the tissue heating element controls heating the tissue heating element based on detecting when the tissue heating element contacts tissue. Related apparatus and methods are also described.

An electrosurgical instrument includes an instrument shaft, and a suction tube extending along the shaft, the suction tube being formed of an electrically-conductive material and including a way or portion by which it can be connected to a source of electrosurgical energy. A blade-like tissue treatment electrode extends from the shaft, the blade-like tissue treatment electrode being integrally formed by the distal end of the suction tube. The distal end of the suction tube is flattened to form the blade-like tissue treatment electrode, and the distal end of the suction tube is disposed at an angle to the longitudinal axis of the shaft.

The present disclosure is directed to a medical device. Systems and methods are provided for utilizing a laser to break a kidney stones into smaller fragments and/or dust, and removing particles, stone fragments and/or stone dust from a patient. The medical device may include a tube having a distal end and a proximal end, a first lumen extending from the proximal end to the distal end of the tube and in fluid communication with the distal end and a plurality of side ports located at a distal portion of the tube, and a second lumen extending from the proximal end to the distal end of the tube.

There is a need for a minimally invasive surgical treatment method for periodontitis for the removal of deep pockets, elimination of disease, creation of reattachment of the gingiva to the tooth surface and true regeneration of the attachment apparatus (new cementum, new periodontal ligament, and new alveolar bone) on a previously diseased root surface. The PerioLase® MVP-7™ including eGUI or another device capable of laser dosimetry, such as an original MVP-7™ type laser without the eGUI, achieves this with the LANAP protocol (laser-assisted new attachment procedure) and the LENAP protocol (laser excisional new attachment procedure).

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.

An electrosurgical system includes a radiofrequency (RF) generator having a controller configured to detect an occurrence of a vaporization point of target tissue and a vaporization duration between commencement of delivery of the RF energy and the occurrence of the vaporization point. The controller can apply the vaporization duration to adjust a parameter during subsequent electrode activation, such as RF power level, an electrode activation sequence, a distance between activated electrodes, and a number of activated electrodes. The controller can apply the vaporization duration to determine if whether a predetermined depth of effect has been reached for use in subsequent parameter adjustments.

A method of producing an array of sharp tips including a biocompatible coating, wherein the biocompatible coating is thicker at a sharp end of the sharp tips than at a broader section of the sharp tips, the method including providing an array of sharp tips, and coating the sharp end of the sharp tips differentially from coating the broader section of the sharp tips. A method of treating skin including producing a hollow in the skin by heating and mechanically compressing epidermis while retaining a covering of stratum corneum. A method of treating tissue including heating a tip to a temperature suitable for producing a crater in the tissue, advancing the tip toward the tissue, detecting when the tip comes into contact with the tissue by detecting a change in mechanical resistance to the advancing, and measuring the mechanical resistance to the advancing. Related apparatus and methods are also described.

A lithotripsy apparatus includes: a treatment laser beam source that emits a treatment laser beam that crushes a stone; a guide light source that emits guide light; a photodetector that detects return light that returns as a result of the emitted guide light being reflected at the stone; and a processor including hardware, the processor being configured to: measure a distance from the treatment laser beam source to the stone on the basis of the return light; determine a condition of a bubble occurring between the treatment laser beam source and the stone on the basis of the measured distance; and adjust a light quantity of the treatment laser beam on the basis of the determined condition of the bubble.

Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.