A method of determining instability of an ultrasonic blade includes monitoring a phase angle φ between voltage Vg(t) and current Ig(t) signals applied to an ultrasonic transducer, coupled to an ultrasonic blade via an ultrasonic waveguide, inferring the blade temperature based on the phase angle φ, comparing the inferred temperature to an ultrasonic blade instability trigger point threshold, and adjusting a power level applied to the ultrasonic transducer to modulate the temperature of the blade. The method may also include determining a frequency/temperature relationship of an ultrasonic blade that exhibits a displacement or modal instability and compensating for a thermal induced instability of the ultrasonic blade. The method may be implemented in an ultrasonic surgical instrument or by a control circuit in a power generator for the ultrasonic surgical instrument.

An ultrasonic catheter has a flexible catheter body having a main lumen, a catheter body interior wall, and a catheter body open distal end. The ultrasonic catheter has an ultrasound transmission member disposed in the main lumen. The ultrasonic catheter has a distal tip that is disposed on the ultrasound transmission member distal end. The ultrasonic catheter includes an intermediate member having an intermediate member open proximal end, an intermediate member open distal end, and an intermediate member interior wall forming a hollow interior. The intermediate member is attached to the catheter body interior wall at the catheter body open distal end. The hollow interior has a smallest inner diameter adjacent the intermediate member open proximal end. The hollow interior configured to overlap the ultrasound transmission member distal end and at least a portion of the distal tip.

Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes using an apparatus to apply pressure to a parietal pericardium, retracting the apparatus, and puncturing the parietal pericardium by delivering electrical energy using a puncture device. Another method includes moving a portion of parietal pericardium away from a surface of myocardium of the heart and puncturing the parietal pericardium by delivering electrical energy using a puncture device. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device.

A system for delivering ultrasound energy to an internal anatomical target includes an ultrasound transducer having multiple transducer elements collectively operable as a phased array; multiple driver circuits, each being connected to at least one of the transducer elements; multiple phase circuits; a switch matrix selectably coupling the driver circuits to the phase circuits; and a controller configured for (i) receiving as input a target average intensity level and/or an energy level energy to be applied to the target and/or a temperature level in target, (ii) identifying multiple sets of the transducer elements, each of the sets corresponding to multiple transducer elements for shaping and/or focusing, as a phased array, ultrasound energy at the target across tissue intervening between the target and the ultrasound transducer, and (iii) sequentially operating the transducer-element sets to apply and maintain the target average energy level at the target. In various embodiments, the controller operates each of the transducer element sets in accordance with a pulse-width modulation pattern having a duty cycle selected to achieve the target average intensity level, energy level, and/or temperature level at the target in accordance with a time constant of the target tissue.

A radio frequency (RF) instrument may include a method of classifying a tissue in live time. The method may include activating the instrument for a first period of time T1 when the RF instrument contacts the tissue, plotting at least three electrical parameters associated with the tissue to classify the tissue into distinct groups, and applying a classification algorithm to classify the tissue into a distinct group in live time. The parameters may include an initial impedance of the tissue, a minimum impedance of the tissue, and an amount of time that the impedance slope is ˜0. The instrument may collect the parameters during a predetermined amount of time, such as within the first 0.75 seconds of the activation of the device. The classification algorithm may include a support vector machine algorithm that may use a linear, polynomial, or radial basis set.

A lithotripsy system can include a lithotripsy device and controller circuitry. The device for acoustic calculi fracture can include an acoustic treatment probe for providing acoustic energy along the probe to treat one or more calculi and an evacuation pathway extending at least partially via the prob, for removing at least a portion of the one or more calculi via the evacuation pathway. The controller circuitry, coupled to the lithotripsy device, can be configured to receive an indication of clogging of the evacuation pathway and at least one of initiate or adjust a anti-clogging mode for changing at least one characteristic of evacuation via the evacuation pathway in response to the received indication of clogging.

A surgical handpiece nosecone having an end overmold portion and/or an internal overmold portion. The end overmold portion is located at an end of the nosecone and compressed between the surgical handpiece housing and nosecone. The internal overmold portion is positioned radially about the nosecone on the inner surface to provide a fluid tight seal that prevents ingress of irrigation fluid into the housing.

An ultrasonic device having a tri-axial configuration including an ultrasound transmission member, a dilator, and a sheath is disclosed. The ultrasound device may be used in a procedure to treat an occluded blood vessel. The ultrasound transmission member can transmit ultrasonic energy from an ultrasonic transmission member into the subintimal space of a blood vessel. The sheath may articulate to aid in the process of re-entering the central lumen of the blood vessel.

A composition of a biological sample, such as tissue of a patient, can be estimated during an ablation procedure. A composition detector system can include a probe, an illumination source, and a spectrometer. A distal end of a probe can convey mechanical, acoustical, or ultrasonic energy to the tissue to ablate the tissue. The probe can extend through a working channel of a viewing scope. An illumination source can illuminate a portion of the tissue at the distal end of the probe or as the portion is being evacuated and collected for disposal. The illumination can generate response illumination from the portion of the tissue. The spectrometer can receive the response illumination, analyze the response illumination, and provide an estimate of the composition of the portion of tissue.

A device for introduction into a body vessel includes a shaft, a balloon positioned at the distal end of the shaft, a guidewire disposed longitudinally within the shaft to receive a guidewire during use, a balloon disposed at the distal end of the shaft, and longitudinal scoring wires to score a vascular lesion attached to the distal end of the shaft, disposed over the balloon and disposed within the shaft. The proximal ends are welded or otherwise affixed to a spring mounted in the handle. The balloon expands when fluid is delivered to the balloon through the inflation lumen. This expansion pushes the scoring wires against the vascular lesion.