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 device for ablating target tissue of a patient with electrical energy is provided. An elongate shaft includes a proximal portion and a distal portion, and a radially expandable element is attached to the distal portion. An ablation element for delivering electrical energy to target tissue is mounted to the radially expandable element. The device can be constructed and arranged to ablate the duodenal mucosa of a patient while avoiding damage to the duodenal adventitial tissue. Systems and methods of treating target tissue are also provided.

Systems and methods deploy a therapeutic or diagnostic element into contact with a body tissue region. The systems and methods can sense position of the therapeutic or diagnostic element relative to a targeted tissue region without direct or indirect visualization, by sensing fluid pressure in a fluid path having an outlet located at or near the therapeutic or diagnostic element. The systems and methods can also inflate the therapeutic or diagnostic element during use, while taking steps to avoid over-inflation and/or while dynamically monitoring the pressure conditions within the expanded element.

The present invention is directed to a method of endoscopically ablating/resecting/excluding (A/R/E) the mucosa of the gastric fundus and body. The method of the present invention is intended to cause cellular death to the X/A-like, ghrelin producing and other hormone cells. This is in contrast to present methods to provide only transient ischemia. The use of the method of the present invention results in a more permanent and robust method of reducing ghrelin and other hormone levels. In addition, a method according to the present invention can be used to induce scarring of the gastric fundus which will reduce gastric accommodation of excess food and result in early satiety.

Ablation catheters and systems include coaxial catheter shafts with an inner lumen for delivering an ablative agent and an outer lumen for circulation of a cooling element about the catheter. Induction heating is used to heat a chamber and vaporize a fluid within by wrapping a coil about a ferromagnetic chamber and providing an alternating current to the coil. A magnetic field is created in the area surrounding the chamber which induces electric current flow in the chamber, heating the chamber and vaporizing the fluid inside. Positioning elements help maintain the device in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues.

An improved gastric tube for displacing a section of an esophagus during cardiac ablation procedures is disclosed. The improved gastric tube is an elongated flexible tube designed to be inserted in the esophagus of a patient and extended past the portion of the esophagus which overlies the heart. The improved gastric tube includes a first lumen extending the length of the tube which receives a control wire, plastic stylet, or other apparatus which would function for displacement of the portion of the esophagus overlying the heart. A second lumen is included which extends to the operative section of the gastric tube, where the esophagus overlies the heart, so that contrast liquid or cooling liquid can be injected into the esophagus at that location. A temperature sensor can also be included to measure the temperature of the esophageal wall, as well as electrodes to connect to a three-dimensional mapping system.

The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for treating a tissue region (e.g., a tumor) through application of energy.

According to one aspect, an apparatus for treating tissue may include an elongate tube. The elongate tube may include a slot extending longitudinally along a first side of the elongate tube, a first elongate jaw member on a first side of the slot, and a second elongate jaw member on a second side of the slot. The apparatus may also include a shaft coupled to the elongate tube along a second side of the elongate tube. The first elongate jaw member may be movably coupled to the shaft, such that the first elongate jaw member may be movable toward the second elongate jaw member to converge tissue walls within the slot and cut the tissue walls within the slot.

A system for treatment target tissue comprises an ablation device and an energy delivery unit. The ablation device comprises an elongate tube with an expandable treatment element. The system delivers a thermal dose of energy to treat the target tissue. Methods of treating target tissue are also provided.

Systems, device and methods treat target tissue to provide a therapeutic benefit to the patient. A tissue treatment device comprises a tissue treatment element constructed and arranged to treat target tissue, such as duodenal mucosa tissue.