Methods, systems and devices for treating a patient include performing a first treatment to treat a first portion of tissue and performing a second treatment to treat a second portion of tissue. The second portion of tissue is treated at least twenty-four hours after the first portion of tissue is treated. In particular embodiments, the first portion of tissue includes duodenal tissue, and the second portion of tissue includes duodenal or other gastrointestinal tissue.

An electrosurgical device (10) operable to deliver microwave energy to cause targeted tissue ablation is provided. The electrosurgical device (10) comprises an antenna (26), a reflector (30), and a dielectric material (34) disposed therebetween. The selection of the dielectric material (30) and the relative positioning of the antenna (26) and the reflector (30) provide impedance matching between the antenna (26) and a transmission line (12) so as to minimize heating along the length of the device (10) during use.

Methods and devices for controlling motorized surgical devices are provided. In general, the methods and devices can allow a surgical device to grasp and cut tissue. In some embodiments, the device can include at least one sensor and a motor, and an output of the motor can be configured to be adjusted based at least in part on an output from the at least one sensor. The output of the motor can be configured to provide power for translation of a cutting element along an end effector of the device. Adjusting the motor's output can cause the cutting element to translate through the end effector at different speeds, thereby allowing the cutting element to cut through tissue being grasped by the end effector at different speeds.

An endoscope attachment of the present invention includes a light-shielding member disposed in a distal direction from a distal end of an endoscope insertion portion of an endoscope and shields a part of light emitted from a light source of the endoscope at a position separated from the light source; and a support portion connected to the endoscope insertion portion and being capable of holding the light-shielding member at a position distant from the distal end of the endoscope insertion portion.

Systems, devices 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 and/or submucosal tissue. Patients treated can safely eliminate or reduce their daily insulin intake.

Medical instruments, systems, and methods for applying energy to tissue, and more particularly ablating, sealing, coagulating, shrinking or creating lesions in tissue by means of contacting a targeted tissue in a patient with a vapor phase media wherein a subsequent vapor-to-liquid phase change of the media applies thermal energy to the tissue to cause an intended therapeutic effect. Variations include devices and methods for generating a flow of high-quality vapor and monitoring the vapor flow for various parameters with one or more sensors. In yet additional variations, the invention includes devices and methods for modulating parameters of the system in response to the observed parameters.

Embodiments of the present invention provide a device and a method for treating at least one of hypertension, pulmonary arteries, diabetes, obesity, heart failure, end-stage renal disease, digestive disease, urological disease, cancers, tumors, pain, asthma or chronic obstructive pulmonary disease by delivering an effective amount of a formulation to a tissue. In embodiments of the present invention, the formulation may include at least one of a gas, a vapor, a liquid, a solution, an emulsion, or a suspensions of one or more ingredients. In embodiments of the present invention, amounts of the formulation and/or energy are effective to injure or damage tissue, nerves, and nerve endings in order to relieve disease symptoms.

In one example, a medical device may include a handle including a proximal portion and a distal portion, and the proximal portion may pivot relative to the distal portion. The medical device may also include an insertion portion coupled to the distal portion of the handle and configured to be positioned within a body lumen; and an articulation wire extending from the handle through the insertion portion. Pivoting of the proximal portion of the handle relative to the distal portion of the handle may move the articulation wire relative to the insertion portion to bend a distal portion of the insertion portion.

A mass spectrometry imaging system includes an ionization source located at a first location configured to produce ions from a surface of a sample at the first location; a mass spectrometer located at a second location configured to perform mass spectrometry analysis by analyzing the produced ions based on mass to charge ratio of the ions; and an ion transfer device configured to transfer the ions from the first location to the second location such that the ion transfer device includes a plurality of electrodes, the plurality of electrodes configured to be flexible or flexibly connected to each other, and the ion transfer device is configured to be flexible or re-configurable while transferring the ions.

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.