An improved method of treating an appendage of a patient using acoustic shock waves has the steps of: providing an appendage in need of an acoustic shock wave treatment; placing an acoustic shock wave applicator on a surface of the appendage; placing a gaseous filled membrane on an opposite surface of the appendage; activating an acoustic shock wave generator or source to emit acoustic shock waves from an acoustic shock wave applicator; and wherein the acoustic shock wave is transmitted from the acoustic shock wave applicator through the surface sending the emitted acoustic shock waves into the tissue of the appendage and exiting the opposite surface of the appendage to the gaseous filled membrane where a reflection of the acoustic shock wave occurs sending reflected acoustic shock waves back through the appendage.

A medical device comprises an ultrasound applicator comprising a shaft having proximal and distal ends; a plurality of channels defined in the shaft and extending from the proximal end of the shaft, including an ultrasound channel and a cooling channel; one or more ultrasound transducers disposed in the ultrasound channel; an ultrasound window defined in the shaft and aligned with the one or more ultrasound transducers; and a handle attached to the proximal end of the shaft. A fluid-collection ring is disposed on a distal side of the handle. The fluid-collection ring has an inner edge and an outer edge, the inner edge defining a hole through which the shaft extends. A distal side of the fluid-collection ring has a concave shape and is configured to direct fluid away from the handle.

A treatment system includes a generator and a fluid transfer cartridge. The fluid transfer cartridge includes a cartridge shell having a cartridge cavity. The cartridge cavity is between a front face and a rear face. A syringe barrel is disposed within the cartridge cavity, and has a syringe cavity. The fluid transfer cartridge includes a cartridge manifold in the cartridge cavity. The cartridge manifold includes a fluid transfer plate having a front fluid channel in a front plate surface, and a rear fluid channel in a rear plate surface. The cartridge manifold includes a fluid port extending through the fluid transfer plate from the front fluid channel to the rear fluid channel. The front fluid channel, the rear fluid channel, and the fluid port are in fluid communication with the syringe cavity. Other embodiments are also described and claimed.

A surgical instrument is disclosed that includes a tube, a waveguide extending through the tube, an end effector comprising an ultrasonic blade extending from the waveguide and a clamp arm pivotable relative to the ultrasonic blade between an open position and a closed position, and a pin configured to couple the clamp arm directly to the ultrasonic blade.