An ultrasonic surgical instrument and method for identifying tissue state and energizing the surgical instrument includes an end effector having an ultrasonic blade and an RF electrode, a shaft assembly, a body, and a power controller. A first ultrasonic energy input is configured to be actuated from a first unactuated energy input state to a first actuated energy input state. A trigger input is configured to be actuated from an unactuated trigger input state to an actuated trigger input state. The power controller is operatively connected to the ultrasonic blade, the RF electrode, the first ultrasonic energy input, and the trigger input and configured to direct at least one of the ultrasonic blade or the RF electrode to be selectively driven according to a predetermined drive function based on the tissue impedance, the state of the first energy input, and the state of the trigger input.

An electrosurgical system for treating biological tissue that comprises: an electrosurgical generator to supply microwave energy; a surgical scoping device having a steerable insertion cord for insertion to a treatment site; and an electrosurgical instrument dimensioned to fit within an instrument channel that is located within the insertion cord. The electrosurgical instrument comprises: a flexible coaxial cable arranged to convey the microwave energy; and a radiating tip portion connected at an end of the coaxial cable and configured to receive microwave energy. The radiating tip portion comprises: a coaxial transmission line for conveying the microwave energy; and a needle tip mounted at an end of the proximal coaxial transmission line, wherein the electrosurgical instrument is slidable within the instrument channel to extend the needle tip beyond an end of the instrument channel to puncture biological tissue; the needle tip is arranged to deliver the microwave energy into biological tissue.

The present invention is directed to a system and method for adaptive multivariate control for performing a radiofrequency (RF) ablation procedure with an energy delivery device. The system includes an energy source for delivering energy to a patient's body; one or more energy delivery devices; two or more sensors for measuring at least two factors related to an ablation procedure, respectively; and at least one processor. The method includes steps of: measuring at least two factors related to an ablation procedure; determining a first operating threshold based, at least in part, on a first factor; controlling an energy delivery device based on the first operating threshold to create a lesion at the target site within the patient; determining a second operating threshold based, at least in part, on a second factor; switching control of the energy delivery device from the first factor to the second factor; and controlling the energy delivery device based on the second operating threshold to create a lesion at the target site within the patient. The present invention is also directed to a RF probe configured to be used with the adaptive multivariate control system and method to perform RF ablation procedures.

Systems, devices, and methods for temperature and pressure management of an anatomic site are provided. A system can include a scope configured to provide a view of an anatomic site, an energy delivery device configured to deliver therapy energy to the anatomic site, a first irrigation conduit configured to transfer fluid to the anatomic site, a first temperature sensor situated to provide first temperature data associated with the anatomic site, and control circuitry electrically coupled to receive the first temperature data, the control circuitry being configured to adjust, based at least in part on the first temperature data, at least one of (i) a first temperature of the fluid, (ii) a flow parameter of the fluid, or (iii) a setting of the energy delivery device to manage a second temperature of the anatomic site.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically-controlled access, navigation, imaging, and/or treatment.

The illustrated embodiments include an apparatus to reduce or eliminate full thickness injury in tissue and to deform tissue which includes a probe or mechanism for deforming tissue, and a subsystem for selectively cooling and/or heating tissue while deformation is of the tissue is being performed. The illustrated embodiments of the invention also extend to a method to reduce or eliminate full thickness injury in tissue and to deform tissue including the steps of deforming tissue, and selectively cooling and/or heating tissue while deformation of the tissue is being performed.

A balloon for renal nerve modulation is disclosed. The balloon may include a polymer material forming a balloon wall having an outer surface and flexible circuits comprising a base selectively adhered to the exterior surface of the balloon wall. Adhesive is selectively applied to the outer surface of the balloon, to the flexible circuit or to both such that the adhesive is selectively deposited on the at least a portion of the at least two pads or on the at least a portion of the at least two pads and to a portion of the distal spline. The portion of the at least two pads or the portion of the at least two pads and a portion of the distal spline are adhered to the outer surface of the balloon and a remainder of the flexible circuit moves freely with respect to the outer surface of the balloon.

Method and devices for delivering pulsed RF ablation energy to enable the creation of lesions in tissue are disclosed. The delivery of RF energy is controlled such that the generator power setting remains sufficiently high to form adequate lesions while mitigating against overheating of tissue. An ablation catheter tip having high-thermal-sensitivity comprises a thermally-insulative ablation tip insert supporting at least one temperature sensor and encapsulated, or essentially encapsulated, by a conductive shell. A system for delivering pulsed RF energy to a catheter during catheter ablation comprises an RF generator and a pulse control box operatively connected to the generator and configured to control delivery of pulsatile RF energy to an ablation catheter comprising at least one temperature sensor mounted in its tip. Also disclose is a method of controlling the temperature of an ablation catheter tip while creating a desired lesion using pulsatile delivery of RF energy.

An energy delivery system comprises a transmission member and an antenna at a distal end of the transmission member. The antenna includes a first conductive arm, an insulator extending around the first conductive arm, and a second conductive arm. The second conductive arm includes a coil. The system also comprises a barrier layer surrounding the transmission member and antenna. The barrier layer extends from a proximal portion of the transmission member to a distal portion of the antenna. The system also comprises a jacket surrounding the barrier layer and forming a fluid channel for receipt of a cooling fluid.

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 optical path, 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.