A treatment instrument includes a rotating body and a housing. The rotating body includes a connecting portion including: a supported portion having a cylindrical outer peripheral surface, and an engaged portion that is adjacent to the supported surface. The housing includes a supporting portion that is configured to support the supported portion of the rotating body, the supporting portion being rotatable around a predetermined rotation axis; and an engaging portion that is configured to generate a frictional force larger than a frictional force between the supporting portion and the supported portion by coming into contact with the engaged portion.

Described here are devices, systems, and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter and a second catheter, which may comprise one or more fistula-forming elements. The first and second catheters may comprise one or more magnetic elements, which may be used to assist in bringing the first and catheters in closer proximity to facilitate fistula formation. In some variations, the magnetic elements may have magnetization patterns such that the flux generated by the magnetic elements is locally concentrated. In some instances, the system may comprise a magnetic control device, which may comprise a magnet, and may be used to increase or create an attractive force between the first and second catheters.

A catheter-mounted balloon includes an inflatable chamber defining a volume expandable from a deflated state to an inflated state, the inflatable chamber having a distal transition portion, a proximal transition portion, and a cylindrical body portion disposed between the distal transition portion and the proximal transition portion. The cylindrical body portion of the inflatable chamber includes a pleat zone having a pleat when the inflatable chamber is in the deflated state. The catheter-mounted balloon further includes an electrode disposed along a wall of the inflatable chamber. The pleat traverses the electrode such that is electrode is pleated as well.

A method of ultrasonic sealing includes activating an ultrasonic blade temperature sensing, measuring a first resonant frequency of an ultrasonic electromechanical system that includes a transducer coupled to the blade via a waveguide, making a first comparison between the measured first resonant frequency and a first predetermined resonant frequency, and adjusting a power level applied to the transducer based on the first comparison. The first predetermined frequency may correspond to an optimal tissue coagulation temperature. The method may further include measuring a second resonant frequency of the system, making a second comparison between the measured second frequency and a second predetermined frequency, and adjusting the power level based on the second comparison. The second predetermined frequency may correspond a melting point temperature of a clamp arm pad. An ultrasonic instrument and a generator may implement the method.

A method of ultrasonic sealing includes activating an ultrasonic blade temperature sensing, measuring a first resonant frequency of an ultrasonic electromechanical system that includes a transducer coupled to the blade via a waveguide, making a first comparison between the measured first resonant frequency and a first predetermined resonant frequency, and adjusting a power level applied to the transducer based on the first comparison. The first predetermined frequency may correspond to an optimal tissue coagulation temperature. The method may further include measuring a second resonant frequency of the system, making a second comparison between the measured second frequency and a second predetermined frequency, and adjusting the power level based on the second comparison. The second predetermined frequency may correspond a melting point temperature of a clamp arm pad. An ultrasonic instrument and a generator may implement the method.

An electrosurgical device having first and second poles; blade electrode with a metal shim having two opposing faces and one or more facets, a nonconductive coating which covers at least the faces and a portion of the facets of the metal shim, while a distal portion of the one or more facets remains uncovered by the nonconductive coating; a lateral electrode comprised of a broad shim having one or more conductive faces and is placed parallel to the blade electrode so that at least one of the one or more conductive faces is exposed and a distal end of the blade electrode protrudes from the lateral electrode; the lateral electrode is fixed stationary relative to the blade electrode; the nonconductive coating insulates the blade electrode from the lateral electrode; and the first pole is connected to the blade electrode and the second pole is connected to the lateral electrode.

A surgical port includes a first end, a second end opposite the first end, and a longitudinal axis extending through the first end and the second end. An outer sidewall extends between the first end and the second end. First and second channels extend through the port from the first end to the second end. A first electrically conductive portion extends from the first channel to the outer sidewall, and a second electrically conductive portion extends from the second channel to the outer sidewall. The first electrically conductive portion provides a first electrically conductive path between the first channel and the outer sidewall and the second electrically conductive portion provides a second electrically conductive path the second channel and the outer sidewall. The second electrically conductive path is separate from the first electrically conductive path. Devices and methods relate to surgical ports.

Embodiments described herein include apparatus that includes an electrical interface and a processor. The processor is configured to receive, via the electrical interface, a first signal that indicates a time-varying force that was applied to a portion of tissue, and one or more second signals that are derived from ultrasound reflections received from the portion of tissue. The processor is further configured to learn, from the first signal and the second signals, a dependency of a thickness of the portion of tissue on the force applied to the portion of tissue. Other embodiments are also described.

A method includes, using a probe, applying irreversible electroporation (IRE) pulses to tissue over a time period to form a lesion in the tissue. A contact force applied to the tissue by the probe is measured over the time period. An IRE index is calculated based on the measured contact force and on a power level of the IRE pulses. Application of the IRE pulses to the tissue is ceased in response to the calculated IRE index reaching a prespecified target IRE index value.

A method of generating a representation of an active heating zone on a display in real time during an ablation procedure includes processing imaging data of a surgical site generated by an imaging device, navigating an ablation device in proximity to target tissue, delivering electrosurgical energy to the target tissue via the ablation device to generate an active heating zone, detecting a Doppler shift in the imaging data based on the delivery of electrosurgical energy to the target tissue, and generating a representation of the active heating zone relative to the surgical site based on the detected Doppler shift.