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.

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.

An electrosurgical instrument for applying to biological tissue RF electromagnetic energy and/or microwave frequency EM energy, wherein the instrument tip has a protective hull with a smoothly contoured convex undersurface facing away from a planar body, and wherein the planar body has a tapering distal edge, and wherein an underside of the planar body extends beyond the protective hull at the tapering distal edge. Also disclosed herein is an interface joint for integrating into a single cable assembly all of (i) a fluid feed, (ii) a needle movement mechanism, and (iii) an energy feed (e.g. a coaxial cable), and a torque transfer device for permitting controlled rotation of the cable assembly within the instrument channel of an endoscope. The interface joint and torque transfer device may be integrated as a single component.

An electrophysiologic catheter with a distal electrode assembly carrying very closely-spaced bipole microelectrodes on a plurality of divergent spines that can flexibly spread over tissue surface area minimized detection of undesirable noise, including far-field signals. Each spine has a flexible microelectrode panel having a substrate, at least one pair of microelectrodes, a trace for each microelectrode, and a soldering pad. Adjacent microelectrodes of a bipole pair are separated by a space gap distance ranging between about 50-300 microns. Each microelectrode may have a width of about 200 or 300 microns.

A device for vascular denervation comprising a catheter for insertion into a vessel, at least one elongated catheter arm having alternating regions of flexible joints and rigid blocks along the at least one catheter arm, wherein each of the at least one catheter arm comprises at least one tactile sensor and at least one temperature sensor; at least one electrode and electrical circuitry disposed on each of the at least one catheter arm and at least one linkage connected to all of the elongated catheter arms. A method for batch fabricating a plurality of catheter arms for the vascular denervation device is also provided and comprises the steps of depositing a first polymer coating on a semiconductor substrate, forming metal traces on the first polymer coating, patterning and etching the substrate to the first polymer coating to create flexible joint regions.

Forceps can include a drive pin, an outer tube, a first jaw, a second jaw, and an inner shaft. The outer tube can extend along a longitudinal axis. The first jaw can be pivotably connected to the outer tube. The first jaw can include a first flange that can be located at a proximal portion of the first jaw. The first flange can include a first chamfered edge configured to limit extension of the first flange laterally beyond an outer surface of the outer tube when the first jaw is in a closed position. The inner shaft can be located within the outer tube and can extend along the longitudinal axis.

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 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.

An electrosurgical dissection apparatus is disclosed, and includes a thermally insulating body, a thermally conductive insert, at least one active electrode, and at least one return electrode. The at least one active electrode is disposed on the thermally conductive insert, and the at least one return electrode is spaced from the at least one active electrode by a portion of the thermally insulating body. The thermally conductive insert is configured to cauterize tissue dissected by radiofrequency energy passing from the at least one active electrode to the at least one return electrode.

An ablation system for directing energy to a target volume of tissue is provided. The ablation system comprises an ablation antenna probe including at least one radiating portion configured to output electromagnetic radiation and at least one electromagnetic shielding reflector configured for removable positioning on the antenna probe. The at least one electromagnetic shielding reflector is configured to block electromagnetic radiation from the at least one radiating portion through the at least one electromagnetic shielding reflector such that a particular directionality of the electromagnetic radiation from the at least one radiation portion to a target volume of tissue is achieved.