An electrosurgical device is disclosed. The electrosurgical device includes a handle, a shaft extending distally from the handle, and an end effector coupled to a distal end of the shaft. The end effector comprises a first electrode and a second electrode. The second electrode includes a first position and a second position. The second electrode is configured to move from the first position to the second position when a force is applied to the end effector by a tissue section. The first electrode and the second electrode define a treatment area when the second electrode is in the second position.

The disclosure pertains to an intravascular catheter for nerve modulation, comprising an elongate member having a proximal end and a distal end, a balloon having a lumen and a balloon wall, the balloon wall comprising RF permeable sections and non-electrically conductive sections, an electrode disposed within the balloon and extending distally to the furthest distal RF permeable section. The RF permeable sections may comprise a plurality of RF permeable windows, each window having a greater circumferential dimension than an axial dimension. The intravascular system is suited for modulation of renal nerves.

An electrosurgical tool for conveying electrical energy comprising an elongated electrode extending in an axial direction from a proximal electrode end to a distal electrode end. The distal electrode end defining a working end configured for cutting or coagulation of tissue by way of electrical energy received by the electrosurgical tool. At least one layer of an insulation material covering an outer surface of the working end so that a portion of the outer surface of the working end is not covered by the insulation material. When electrical energy is provided to the elongated electrode, current is only conducted through an exposed portion of the outer surface of the working end. At least one layer of the insulation material prevents current from straying from the outer surface of the working end covered with the insulation material.

A surgical instrument comprising a shiftable transmission is disclosed. The transmission comprises a mechanism for assuring that the transmission is in one of a plurality of predefined configurations.

An electrosurgical system includes an electrosurgical instrument having an electrode with a polymeric dielectric coating; and an electrosurgical generator, which includes a power converter configured to generate RF energy; a sensor coupled to the power converter and configured to sense a parameter of the RF energy; and a controller coupled to the sensor and the power converter. The controller is configured to control the power converter to output an RF waveform to achieve conductor breakthrough through the polymeric dielectric coating. The controller is further configured to determine whether the conductor breakthrough occurred based on the parameter; and execute a treatment algorithm based on a determination of the conductor breakthrough.

The disclosure provides a method of manufacturing a flexible circuit electrode assembly and an apparatus manufactured by said method. According to the method, an electrically conductive sheet is laminated to an electrically insulative sheet. An electrode is formed on the electrically conductive sheet. An electrically insulative layer is formed on a tissue contacting surface of the electrode. The individual electrodes are separated from the laminated electrically insulative sheet and the electrically conductive sheet. In another method, a flexible circuit is vacuum formed to create a desired profile. The vacuum formed flexible circuit is trimmed. The trimmed vacuum formed flexible circuit is attached to a jaw member of a clamp jaw assembly.

A portable cryogenic applicator includes a vessel for liquid nitrogen to deliver liquid nitrogen for treatment of skin surfaces using the rotating roller from porous biocompatible material. The cryogenic applicator includes a capillary U-bend to prevent spontaneous discharge of liquid nitrogen through the capillary system to the roller during filling or refilling the cryogenic applicator with liquid nitrogen. The cryogenic applicator also includes a vacuum valve that produce an insulating vacuum environment in a vacuum cavity to prevent heat transfer between the vessel for liquid nitrogen and a vacuum casing, which allows the external surface of the cryogenic applicator to be maintained at ambient temperature. The cryogenic applicator may include a control valve for regulating and maintaining the working pressure in the vessel for liquid nitrogen sufficient to deliver liquid nitrogen through the capillary system and the porous roller body to the surface skin of a patient.

An energy generator includes a connector port configured to couple to an electrosurgical instrument including an electrode having a polymeric dielectric coating; a power converter configured to generate energy; and a sensor coupled to the power converter and configured to sense a parameter of the energy. The energy generator also includes a controller coupled to the sensor and the power converter. The controller is configured to: control the power converter to output energy to modify an electrical property of the polymeric dielectric coating; and determine whether the electrical property of the polymeric dielectric coating has been sufficiently modified by the energy.

The disclosure provides a method of manufacturing a flexible circuit electrode assembly and an apparatus manufactured by said method. According to the method, an electrically conductive sheet is laminated to an electrically insulative sheet. An electrode is formed on the electrically conductive sheet. An electrically insulative layer is formed on a tissue contacting surface of the electrode. The individual electrodes are separated from the laminated electrically insulative sheet and the electrically conductive sheet. In another method, a flexible circuit is vacuum formed to create a desired profile. The vacuum formed flexible circuit is trimmed. The trimmed vacuum formed flexible circuit is attached to a jaw member of a clamp jaw assembly.

One described aspect is an optical fiber comprising: a fiber core that extends along a fiber axis, is configured to transmit a laser energy along the fiber axis, and terminates at a distal end; a first cladding that extends along the fiber axis, is adjacent to the fiber core, and terminates at a distal end; a coating that extends along the fiber axis and terminates at a distal end, wherein the coating is a gold coating; a second cladding that surrounds a portion of the gold coating along the fiber axis, and terminates at a distal end; an outer jacket that extends along the fiber axis and terminates at a distal end; and a fiber tip. Associated laser systems are also disclosed.