An irrigated ablation catheter includes a shaft and an electrode assembly affixed to a distal end of the shaft. The distal electrode assembly includes a manifold and an ablation electrode affixed together and extending along a center axis. The electrode has a distal irrigation passageway extending therethrough to an opening at a distal tip of the electrode. The opening of the irrigation passageway is offset in distance from the center axis, and allows a thermal sensor such as a thermocouple to be located in a sensor cavity in the electrode on or near the center axis. One variation involves providing a pair of distal irrigation passageways through the electrode where both of the openings of the passageways are offset from the center axis. The thermal sensor in this variation is located in the sensor cavity substantially on the center axis.

Body tissue ablation is carried out by inserting a probe into a body of a living subject, urging the probe into contact with a tissue in the body, generating energy at a power output level, and transmitting the generated energy into the tissue via the probe. While transmitting the generated energy the ablation is further carried out by determining a measured temperature of the tissue and a measured power level of the transmitted energy, and controlling the power output level responsively to a function of the measured temperature and the measured power level. Related apparatus for carrying out the ablation is also described.

Surgical instruments having articulating portions or joints are described herein. In one embodiment, a surgical instrument can include a distal end effector, a proximal actuating portion, and an articulating portion disposed between the end effector and the actuating portion. The articulating portion can include an inner component formed of a first material and an outer component formed of a second material, wherein a modulus of elasticity of the first material is higher than a modulus of elasticity of the second material. Such an instrument can be less complex and less expensive than known articulation mechanisms while providing similar capabilities.

A method for introducing a shaped portion of an elongate medical instrument into a body of a subject includes at least partially straightening the shaped portion of the elongate medical instrument. A retention element may be introduced into an interior of the shaped portion of the elongate medical instrument to place and/or maintain the shaped portion in an at least partially straightened configuration. Such straightening may be accomplished without application of external force to an exterior of the shaped portion. With the retention element in place, the shaped portion may be introduced to a desired location within a hollow interior of an internal organ. The retention element may then be removed to enable the shaped portion to return to its desired shape. A straightening apparatus includes a retention element that can place and/or maintain a shaped portion of an elongate medical instrument in an at least partially straightened configuration without assistance of external force.

Systems and methods for controlling an irrigation flow rate during a lithotripsy procedure are provided. The system includes a laser configured for lithotripsy procedure, a lithotripsy irrigation system, and a temperature sensor configured to provide input to enable control of a flow of the lithotripsy irrigation system in response to a change in temperature from the operation of the laser.

An esophageal monitoring device includes a camera and, optionally, one or more lights to enable visualization of an interior of a subject's esophagus. Visualization of the interior of the subject's esophagus before and after a left atrial ablation procedure may enable a healthcare provider to determine whether or not the left atrial ablation procedure has damaged the subject's esophagus before the subject experiences any symptoms of such damage. An esophageal monitoring device may also include sensors and/or markers that enable a determination of its location within a subject's esophagus. Such an esophageal monitoring device may be configured for three-dimensional mapping, and enable the generation of an accurate three-dimensional map of the physical relationship between a subject's esophagus and the left atrium of his or her heart. Methods of monitoring a subject's esophagus while a left atrial ablation procedure is being conducted on the subject's hear are also disclosed.

The invention refers to a syringe for the application of a surgical material to a human or animal tissue, in particular of bone wax to a human or animal bone tissue. The syringe includes a hollow main body with a material receiving space for receiving a surgical material and an outlet, a pushing element, which is movably arranged in the hollow main body for pushing the surgical material through the outlet, and a heat-generating device for heating the surgical material. The heat-generating device includes at least one heat-generating element that is arranged on an outer surface of the hollow main body.

Systems and methods for controlling an energy output setting of a lithotripsy device during a lithotripsy procedure are provided. The system includes a laser or other lithotripsy device configured for facilitating the lithotripsy procedure, an irrigation system configured for supplying an irrigant such as saline to a surgical site, and a temperature sensor configured to provide temperature data associated with the irrigant. The system can modulate the energy output setting of the lithotripsy device based on an estimated temperature that is determined based at least in part on the temperature data and one or more other factors such as a current energy output setting or a flow rate of the irrigant.

A device for exchanging heat with a subject having skin is provided. The device includes a heat exchanging member having a heat transfer surface configured to form a heat conducting interface with the subject's skin. The device further includes a substantially flexible sensing device disposed in the interface between the heat exchanging member and the subject's skin. The sensing device is configured to measure a parameter of the interface without substantially impeding heat transfer between the heat exchanging member and the subject's skin.

Systems and methods for controlling an energy output setting of a lithotripsy device during a lithotripsy procedure are provided. The system includes a laser or other lithotripsy device configured for facilitating the lithotripsy procedure, an irrigation system configured for supplying an irrigant such as saline to a surgical site, and a temperature sensor configured to provide temperature data associated with the irrigant. The system can modulate the energy output setting of the lithotripsy device based on an estimated temperature that is determined based at least in part on the temperature data and one or more other factors such as a current energy output setting or a flow rate of the irrigant.