An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the bipolar electrosurgical instrument. The electrosurgical generator is arranged to supply RF energy through the bipolar electrosurgical instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.

Temperature sensing catheters and systems that can be used during cardiac ablation procedures to measure and monitor temperatures, and the rate and spread of temperature changes in the heart. The temperature data can be used to calculate temperature gradients, which may be used to estimate if and when certain regions of heart may undergo injury due to thermal exposure. The temperature data can be used to limit or cut-off power delivery to an ablation catheter, or otherwise modify the ablation procedure, to prevent injury to certain regions of heart. In some cases, the temperature data is used to control aspects of the ablation in a feedback loop control scheme.

A system for controlling a robotic end-effector is disclosed. The system includes a robotic arm, a surgical tool including an end-effector with articulatable arm and a clamp jaw. A tool driver is coupled to the surgical tool and a motor is coupled to the tool driver and is configured to drive the surgical tool. A sensor is configured to sense external forces applied to the end-effector. A central control circuit is configured to control the tool driver. The central control circuit is configured to receive a sensed parameter from the sensor, receive a sensed motor current (I) from the motor, and control the tool driver based on the sensed parameter and the motor current (I).

Embodiments described herein provide various techniques and systems for building machine-learning surgical tool presence/absence detection models for processing surgical videos and predicting whether a surgical tool is present or absent in each video frame of a surgical video. In one aspect, a process for ensuring patient safety during a laparoscopic or robotic surgery involving an energy tool is disclosed. The process can begin receiving a real-time control signal indicating an operating state of an energy tool during the surgery. Next, the process receives real-time endoscope video images of the surgery. The process simultaneously applies a machine-learning surgical tool presence/absence detection model to the real-time endoscope video images to generate real-time decisions on a location of the energy tool in the real-time endoscope video images. The process then checks the real-time control signal against the real-time decisions to identify an unsafe event and takes a proper action when an unsafe event is identified.

According to some embodiments, a method of confirming successful ablation of targeted cardiac tissue of a subject using a high-resolution mapping electrode comprises pacing said cardiac tissue at a predetermined pacing level to increase the heart rate of the subject from a baseline level to an elevated level, the predetermined pacing level being greater than a pre-ablation pacing threshold level but lower than a post-ablation pacing threshold level, delivering ablative energy to the ablation electrode, detecting the heart rate of the subject, wherein the heart rate detected by the high-resolution mapping electrode is at the elevated level before the post-ablation pacing threshold level is achieved, and wherein the heart rate detected by the high-resolution mapping electrode drops below the elevated level once ablation achieves its therapeutic goal or target, and terminating the delivery of ablative energy to the ablation electrode after the heart rate drops below the elevated level.

In an energy control device, a processor detects a gradual decrease start time at which the electric characteristic value in relation to electric energy output to an ultrasonic transducer starts a gradual decrease after a gradual increase. The processor calculates a difference value by subtracting the electric characteristic value from a peak value at gradual decrease start time and calculates an integrated value of the difference value from the gradual decrease start time. The processor executes, based on a fact that the integrated value become greater than a predetermined threshold, at least one of causing to stop or reduce the output of the electric energy to the ultrasonic transducer, and notifying that the integrated value become greater than the predetermined threshold.

An electrosurgical generator includes a processor and a memory storing instructions executable by the processor. The instructions when executed, cause the generator to provide an indicated treatment energy to the instrument, where the indicated treatment energy is set by a user and having a corresponding current limit, receive signals from the instrument over time relating to a load impedance between the active electrode and the return electrode of the instrument, determine based on the signals that the active electrode and the return electrode are currently shorted together, and prior to the short, the instrument was grasping tissue between the active electrode and the return electrode, and based on the determination, reduce a current limit of treatment energy being provided to the instrument to below the corresponding current limit.

An electrosurgical controller and related methods. At least some of the illustrative embodiments are methods including: placing a distal end of an electrosurgical wand in operational relationship with biological tissue; delivering energy to an active electrode of the electrosurgical wand. During delivering energy, the method may comprise: measuring a value indicative of flow of the energy to the active electrode; summing, over a first predetermined window of time, to create a first value indicative of energy provided to the active electrode; summing, over a second predetermined window of time, to create a second value indicative of energy provided to the active electrode. The method may further comprise: ceasing delivering energy responsive to the first value meeting or exceeding a predetermined value; and ceasing delivering energy responsive to the second value meeting or exceeding a threshold value.

An apparatus includes a current source, an electronic circuit and a circuit board. The current source is configured to flow an electrical current having a selected frequency between a pair of electrodes coupled to a medical probe. The electronic circuit is configured to measure a single-ended voltage relative to ground that is formed on at least one of the electrodes in the pair in response to the electrical current, and, based on the measured voltage, to assess physical contact between the at least one of the electrodes and tissue. The circuit board includes the current source and the electronic circuit, and includes a layout that produces, at the selected frequency, a predefined capacitance between the current source and ground, thus forming a reference for measurement of the single-ended voltage.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.