Developed is a tissue joining device for endoscopic surgery, which can be used in NOTES, or the like. As a result of intensive studies carried out to solve the problem described above, the inventors of the present invention have conceived of two tissue joining device having quite novel structures and completed the present invention.

An esophageal ablation system including a positioner, an elongated, flexible shaft extending from the positioner, and a microwave emitter, assembly disposed near the distal end of the shaft. The emitter assembly includes one or more microwave antennas and a balloon for spacing the antennas relative to target tissue. The device may have an inner balloon for deploying the antenna. The systems, devices and methods disclosed are useful for treating Barrett's Esophagus, Esophageal Adenocarcinoma, and Squamous Cell Carcinoma.

A cautery pen tip accessory cover comprises a cylindrical member that can receive a cautery pen in a first end and the tip of the cautery pen can extend from a second opposite end when the cover is in a retracted configuration. The cylindrical member has an opened lateral exposure that allows the feel of the cautery pen therethrough. A cover exposure opening in the cylindrical member to provide access to a trigger of the cautery pen when the cautery pen tip cover is in the retracted configuration. A resilient member urges the cautery pen tip cover to the non-retracted configuration where access to the cautery pen trigger is prevented. The cylindrical member is easily retracted by a finger ring configured permanently into the cylindrical member, allowing easy retraction of the cover by the operator squeezing the cover to a resistance bar stabilization system accessory configured over the cautery pen.

An articulating, steerable surgical probe includes an elongated, flexible transfer tube adapted for insertion into a surgical region for endoscopic laryngeal laser surgery. A lumen is defined by an interior of the transfer tube, and a laser fiber extends through the lumen for delivering a therapeutic laser signal to a distal end of the laser fiber. An articulating tip at the distal end of the transfer tube is responsive to articulating forces from a retractable tether for directing the treatment probe in a direction of the articulation, and a linkage to the tether from a control module effects controlled retraction of the tether for articulating the tip towards a surgical target, such that the articulating tip imposing a bend radius based on a signal loss through the laser fiber.

A method of and apparatus for treating tissue wherein a handpiece with a cartridge of motor driven needles is placed in contact with tissue. The motor is energized to drive the needles. Energy is applied energy to the needles. Tissue impedance at the start of treatment is measured. Tissue impedance at the end of treatment is measured. The operator is then notified that corrective action is needed if the measured ending impedance is higher than the measured starting impedance indicating the needles are not inserted into the tissue.

A medical endodevice for an intervention inside a human or animal body includes an elongated liaising structure having a distal end arrangeable inside a body of the human or animal being and a proximal end arrangeable outside the body while the distal end is inside the body. The endodevice has an intervention tool arranged to manipulate a target tissue inside the human or animal body. The intervention tool is arranged at the distal end of the liaising structure. The endodevice further includes a positioning unit having a moving formation arranged to dislocate the intervention tool relative to the target tissue, and an anchoring formation arranged to fix the moving formation to a fixing tissue inside the human or animal body such that the target tissue is positioned in a workspace of the intervention tool.

A micro-sized cold atmospheric plasma accessory. The micro-sized cold atmospheric plasma accessory comprises a tube, an active electrode within said tube, and a nozzle at a distal end of said tube, said nozzle having an inner diameter less than 1 mm and a length less than 30 mm. A distal end inner diameter of said tube is greater than said inner diameter of said nozzle. The nozzle preferable is 15-25 mm in length. The nozzle may comprise stainless steel. The tube may have an inner diameter greater than 1 mm. The nozzle preferably has a distal end inner diameter less than 280 μm. The micro-sized cold atmospheric plasma accessory may further comprise a return electrode on an outside of said tube. The tube may comprise a quartz tube

Flexible instruments and associated systems and methods are disclosed herein. In some embodiments, a flexible instrument comprises an elongate device having an inner conductor, an outer conductor surrounding the inner conductor, and a dielectric layer insulating the inner conductor from the outer conductor. The flexible instrument further includes a recess formed in the outer conductor. An insert is positioned within the recess and about the inner conductor.

A method and apparatus are disclosed for an optimized transseptal procedure for providing left heart access, that reduces the number of devices that are used in order to minimize procedural time, complexity and cost. The apparatus comprises a reshapeable hybrid dilator that comprises the combined functionality of a transseptal sheath and dilator assembly. The hybrid dilator comprises: a dilator shaft defining a lumen for receiving a crossing device therethrough, the dilator shaft comprising a stiffening member and a deflectable portion, being structured to provide support for the crossing device when the crossing device is used to create a puncture in a tissue; and a distal tip having an outer diameter which tapers down to an outer diameter of the crossing device for providing a smooth transition between the crossing device and the distal tip when the crossing device is inserted through the lumen and protrudes beyond the distal tip.

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.