The invention relates to a system (1) for stimulating renal nerves of a renal artery of a subject (3). The system comprises a stimulation device (12, 17, 28) for stimulating the renal nerves, a measuring unit (20) for measuring the blood pressure and/or the heart rate of the subject at at least two times, wherein at least one of these times is during or after the stimulation of the renal nerves, and a subject suitability determination unit (14) for determining whether the subject is suitable for a renal sympathetic denervation procedure based on the measured blood pressure and/or the measured heart rate. The invention allows therefore for a preselection of subjects which are suitable for a renal sympathetic denervation procedure.

A method for use with an intra-body probe, a distal end of which includes an ablation electrode and a temperature sensor, is described. While (i) the ablation electrode is driving an ablating current into tissue of a subject, and (ii) fluid is passed from the distal end of the intra-body probe at a fluid-flow rate, a processor receives a temperature sensed by the temperature sensor. The processor estimates a temperature of the tissue, based at least on the sensed temperature and at least one parameter selected from the group consisting of: the fluid-flow rate, and a parameter of the ablating current. The processor generates an output in response to the estimated temperature. Other embodiments are also described.

An electrosurgical apparatus for treating fluid-filled biological growths by replacing the fluid within the growth with a substance that assists in delivering treatment energy. The treatment energy may be microwave energy or may be thermal energy derived from microwave energy. The apparatus comprises an instrument having a radiating tip portion, and a fluid delivery mechanism for transporting fluid to and from a treatment zone located around the radiating tip portion. The fluid delivery mechanism comprises a rigid insertion element arranged to extend into the treatment zone, whereby fluid can be aspirated from the treatment zone, and a substance injected into the treatment zone to replace the aspirated fluid. The injected substance has dielectric properties selected to facilitate uniform delivery of treatment energy to biological tissue in the treatment zone.

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.

Systems and methods for controlling an irrigation flow rate during a lithotripsy procedure are provided. The system includes a laser configured for lithotripsy procedure, a lithotripsy irrigation system, and a temperature sensor configured to provide input to enable control of a flow of the lithotripsy irrigation system in response to a change in temperature from the operation of the laser.

A flow controllable type suction and irrigation device includes: a handle having an installation space therein; a cannula provided with a conductive tube and an insulating protective tube, the conductive tube extending in a forward direction of the handle to be inserted into the abdominal cavity of a patient and being coupled to an electrode for surgery, the insulating protective tube being disposed to surround the conductive tube; and a suction supply unit provided to the handle and supplying an irrigation fluid to the cannula or suctioning blood or contaminants from the abdominal cavity of the patient through the cannula.

An energy source is offset from an elongate probe axis with an extension. The amount of offset of the energy source can be controlled by varying an amount of offset of the extension. The energy source rotated and translated at the offset distance to resect tissue. In some embodiments, the probe is configured to receive a second treatment probe comprising a second energy source, in which the second energy source is rotated and translated relative to the first treatment probe, which can improve positional accuracy and stability. The energy source and the extension can be coupled to a linkage to offset the energy source, and to translate and rotate the energy source with varying amounts of offset. The linkage can be coupled to a processor and one or more of the energy source moved in accordance with a treatment profile.

An apparatus includes a tube, a tip electrode coupled to a distal end of the tube and shaped to define at least one cavity, a microelectrode disposed within the cavity and including an outer surface that is of lesser convexity than that of a portion of the tip electrode surrounding the cavity, and a conductive polymeric coating that coats the outer surface. Other examples are also described.

Various examples of an ablation end effector are shown and described with two balloons independently inflatable so that a distal balloon can be used to ensure stability of the second balloon for electrical ablation in a beating heart. Methods and techniques to operate the ablation end-effectors are also described.

An apparatus includes a flexible electrically-insulating substrate including an inner surface and an outer surface. The substrate is shaped to define multiple channels passing between the inner surface and the outer surface, at least some of the channels being concave channels. The apparatus further includes an outer layer of an electrically-conducting metal covering at least part of the outer surface, an inner layer of the electrically-conducting metal covering at least part of the inner surface, and respective columns of the electrically-conducting metal that fill the channels such as to connect the outer layer to the inner layer.