Jaw members of end effector assemblies include sealing plates configured to direct the amount and flow of energy through the sealing plates. The sealing plates may have a height varying from a minimal height to a maximum height along a width or a length of the sealing plate and/or a sealing surface including at least two impedance zones having different impedance values.

An electrosurgical instrument with smoke evacuation, having an electrode, a suction lumen, and a plurality of slots connected to suction lumen, in which the slots may be longer than they are wide and wider than they are thick. The electrosurgical instrument may have the slots arranged longitudinally about its central axis, and the suction lumen may be wider than the slot widths.

A forceps having at least a first jaw with a longitudinal axis is disclosed. The first jaw can include a body portion, a first flange, a second flange and a cam pin. The first flange can define a first cam slot with a longitudinal extent along the longitudinal axis. The second flange can be spaced from the first flange a distance transverse to the longitudinal axis of the first jaw and can have a second cam slot. The cam pin, with a longitudinal axis, can be moveably secured within the first cam slot and the second cam slot. A diameter of the cam pin can be less than a width between a first longitudinal edge that defines a first side of each of the first cam slot and the second cam slot and a second longitudinal edge that defines a second opposing side of each of the first cam slot and the second cam slot so that the cam pin is moveably received by both the first cam slot and the second cam slot. With the first jaw pivoted to at least a first position, the cam pin and first flange can be configured such that the first longitudinal edge is contacted by the cam pin but the second longitudinal edge is spaced from the cam pin. The cam pin and second flange can be configured such that the first longitudinal edge is spaced from the cam pin but the second longitudinal edge is contacted by the cam pin.

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.

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.

A medical device and associated methods are disclosed. In one example, the medical device includes an electrosurgical forceps. In selected examples, one or more structural components of the electrosurgical forceps includes a sintered ceramic microstructure. In selected examples other medical devices, including a debrider and a lithotripter, include a sintered ceramic microstructure.

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 flexible tip electrode for an ablation catheter is disclosed. The catheter includes a catheter body and a hollow elongate tip electrode disposed at a distal end of the catheter body. The electrode includes a sidewall provided with one or more elongate gaps extending therethrough. The one or more elongate gaps providing flexibility in the sidewall for bending movement of the tip electrode relative to a longitudinal axis of the catheter body.

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.

Described embodiments include an apparatus that includes an intrabody probe and an electrode coupled to a distal end of the intrabody probe. The electrode includes a flexible electrically-insulating substrate, comprising a substrate surface. The electrode further includes a layer of an electrically-conducting metal covering at least part of the substrate surface. The electrode further includes a metallic sheet, comprising an inner sheet surface, and an outer sheet surface shaped to define multiple depressions. The electrode further includes an adhesive, which fills the depressions and bonds the outer sheet surface to the layer of the electrically-conducting metal. Other embodiments are also described.