A catheter system includes an inflatable balloon, an optical fiber and a laser. The optical fiber has a distal end positioned within the inflatable balloon. The optical fiber receives an energy pulse to emit light energy in a direction away from the optical fiber to generate a plasma pulse within the inflatable balloon. The laser includes a seed source that emits a seed pulse, and an amplifier that increases energy of the seed pulse. The energy pulse can have a somewhat square or triangular waveform with a duration T, a minimum power P.sub.0, a peak power P.sub.P, and a time from P.sub.0 to P.sub.P equal to T.sub.P, wherein T.sub.P is not greater than 40% of T. T can be within the range of greater than 50 ns and less than 3 μs. T.sub.P can be within the range of greater than 2.5 ns and less than 1 μs. P.sub.P can be within the range of greater than 50 kW and less than 1000 kW. A ratio in kW to ns of P.sub.P to T.sub.P can be greater than 1:5. The seed pulse can at least partially increase in amplitude over time.

An endoscope includes a handle including a handle housing, an irrigation inlet port adapted to receive irrigation fluid, and an irrigation channel; and an insertion cord extending distally from the handle. The insertion cord includes an insertion tube; a bending section extending from the insertion tube; a distal tip extending from the bending section and including a tip housing; a camera at least partially enclosed in the tip housing; interstitial space within the insertion tube in fluid communication with the irrigation channel; and at least one interstitial flow opening in fluid communication with the interstitial space and adapted to discharge the irrigation fluid.

A laser can produce pulses of light energy for tissue-type selective ejection of a volume of the target tissue, and the energy can be delivered to a treatment site through a waveguide, such as a fiber optic waveguide. The incident laser energy can be absorbed within a volume of the target tissue with a tissue penetration depth and pulse direction such that the propagation of the energy from the tissue volume is inhibited and such that the target tissue within the volume reaches the spinodal threshold of decomposition and ejects the volume, for example without substantial damage to tissue adjacent the ejected volume. The pulses are set to be tissue selective.

In some aspects, a surgical system for taking advantage of capacitive coupling is presented. The surgical system may include: a monopolar energy generator; a surgical instrument configured to transmit electrosurgical energy through the electrode to tissue of a patient at a surgical site; and at least one detection circuit configured to: measure an amount of conductivity in a return path of the electrosurgical energy; determine that the amount conductivity in the return path falls below a predetermined threshold; and transmit a signal to cause the monopolar generator to increase current leakage in the surgical system by increasing alternating current frequency in the electrosurgical energy generation. The monopolar energy generator may further include a sensor configured to determine that a monopolar energy circuit is completed by detecting that the current leakage has reached a ground terminal in the monopolar energy generator.

A surgical instrument has an ultrasonic blade that connects to a distal end of an ultrasonic waveguide. A clamp arm assembly is moveable from an opened position for receiving a tissue, toward a closed position for clamping the tissue. A clamp arm actuator connected to the clamp arm assembly directs the clamp arm assembly from the opened position toward the closed position. An outer sheath surrounds at least a portion of the ultrasonic waveguide. The outer sheath includes a cover removably received against a sheath body, and a sheath securement feature able to detachably couple the cover to the sheath body such that the cover can be detached from the sheath body for accessing the ultrasonic waveguide within the outer sheath.

Systems, devices, and methods for identifying a target in a body using a spectroscopic feedback from the target are disclosed. An exemplary surgical feedback control system comprises a feedback analyzer configured to receive a reflected signal from a target in response to electromagnetic radiation directed at a target, and a controller in operative communication with the feedback analyzer. The controller can generate a control signal to a surgical system to perform a predetermined operation based upon the received reflected signal, including determining a composition of the target, or programming a laser setting to direct laser energy to the target.

A system and method for determining the optimum dose of cryotreatment to an area of target tissue to achieve isolation based on the time to effect (TTE). The system may generally include a treatment device, a sensing device, and a processor programmed to calculate the optimum dose of cryotreatment, in seconds, based on TTE. The TTE may be based on electrical signals received by the processor from the sensing device. The processor may be further programmed to automatically terminate a cryoablation procedure when the optimum dose of cryotreatment has elapsed. The optimum dose of cryotreatment may be the time, in seconds, it takes to achieve isolation, which may be the time it takes for an area of tissue to reach approximately −20° C.

Dermatological systems and methods for providing a therapeutic laser treatment using a handpiece delivering one or more therapeutic laser pulses to a target skin area along a first optical path, and sensing the temperature of the target skin area based on infrared energy radiating from the target skin area along a second optical path generally counterdirectional to the first office action, and sharing a common optical axis with the first optical path for at least a portion of the first and second optical paths. The handpiece may also provide contact cooling for a first skin area comprising the target skin area.

In combined methods for treating a patient using time-varying magnetic field, treatment methods combine various approaches for aesthetic treatment. A magnetic field generating device is placed proximate to a body region of the patient. The magnetic field generating device generates a time-varying magnetic field with a magnetic flux density in a range of 0.5 to 7 Tesla. The time-varying magnetic field is applied to the body region of the patient in order to cause a contraction of a muscle within the body region. A second therapy may be used by applying one or more of optical waves, radio frequency waves, mechanical waves, negative or positive pressure or heat to the body region of the patient.

A catheter apparatus for assessing denervation comprises: an elongated catheter body; a deployable structure coupled to the catheter body, the deployable structure being deployable outwardly from and contractible inwardly toward the longitudinal axis of the catheter body; one or more ablation elements disposed on the deployable structure to move outwardly and inwardly with the deployable structure; one or more stimulation elements spaced from each other and disposed on the deployable structure to move with the deployable structure, the stimulation elements being powered to supply nerve stimulating signals to the vessel; and one or more recording elements spaced from each other and from the stimulation elements, the recording elements being disposed on the deployable structure to move with the deployable structure, the recording elements configured to record response of the vessel to the nerve stimulating signals.