Disclosed are nozzles and nozzle assemblies of liquid jet-forming surgical instruments, surgical instruments employing such nozzles and/or nozzle assemblies, and methods of fabricating the nozzle assemblies in forming surgical instruments. Also, disclosed are liquid jet-forming surgical instruments including both liquid jet-forming nozzles and optional evacuation lumens, which when provided can be configured to receive the liquid jet and evacuate the liquid forming the liquid jet. Certain embodiments of such surgical instruments include inventive nozzle alignment component(s) to facilitate alignment of the nozzles and evacuation lumen upon assembly. In certain embodiments, surgical instruments are provided that include a nozzle that is shaped to form a liquid jet, which has surfaces that are optically smooth. In certain embodiments, the nozzle has a configuration enabling the nozzle to form a liquid jet that has the ability to remain collimated over longer distances than is typically achievable with conventional liquid jet surgical instrument nozzles having the same ratio of nozzle length to minimum inner diameter of the jet opening. In certain embodiments, nozzle assemblies comprising an operative assembly of at least two subcomponents, which together provide a nozzle are provided. In certain embodiments, the at least two sub-components may comprise a nozzle-providing component, such as a nozzle ring, and a holder that is configured to retain and position the nozzle-providing component in the nozzle assembly. In certain embodiments, the nozzle-providing component can comprise a liquid flow passage having a diameter that continuously decreases along at least a portion of its length.

A bipolar electrosurgical device including an outer shaft, an inner shaft, first and second electrode surfaces, and an irrigation channel. The outer shaft defines a lumen, a proximal end and a distal end forming a cutting window. The inner shaft is rotatably disposed within the outer shaft, and defines a distal portion forming a cutting tip. The cutting tip and the cutting window combine to define a cutting implement. The first and second electrode surfaces are electrically isolated, and are formed at the cutting implement. The irrigation channel extends parallel to the outer shaft, and terminates in at least one outlet port. The outlet port is proximally spaced from the cutting window and is located radially outside of the outer shaft. Fluid (e.g., saline) is emitted at the exterior surface of the device near the cutting window and is readily present for interacting with the electrode surfaces.

A vascular device is provided having a catheter body and a rotatable cutter assembly located at the distal end of the catheter body. The cutter assembly has at least one helical cutting surface within a housing that is coupled by a torque shaft to a drive mechanism. A conveyor mechanism helically wound about the torque shaft conveys occlusive material conveyed into the housing by the helical cutting blade further proximally along the catheter body for discharge without supplement of a vacuum pump. The catheter body is manipulated to insert the distal end of the catheter body within a body lumen and advance the distal end of the catheter body toward the occlusive material. The drive mechanism is operated to rotate the helical cutting surface to cut and convey the occlusive material from the body lumen proximally into the housing and to convey the occlusive material conveyed into the housing by the helical cutting surface further proximally along the catheter body by the conveyor mechanism for discharge without supplement of a vacuum pump. The distal end of the catheter body is deflected and rotated to sweep the cutter assembly in an arc about the center axis of the catheter body to cut occlusive material in a region larger than the outside diameter of the cutter assembly.

An arthroscopic system includes a re-useable, sterilizable handle integrated with a single umbilical cable or conduit. The single umbilical cable or conduit carries electrical power from a power and/or control console to the handle for operating both a motor drive unit within the handle and delivering the RF power to a disposable RF probe or cutter which may be detachably connected to the handle. The RF power delivered to the handle and on to the probe or cutter is typically bi-polar, where the handle includes first and second electrical bi-polar contacts that couple to corresponding bi-polar electrical contacts on a hub of the disposable RF probe or cutter is connected to the handle.

An apparatus for cutting a wall of a vessel, such as scoring or slicing a lesion associated therewith. A catheter (10) includes a shaft (12) having a distal portion supporting a housing (20) including a first lateral passage (20a). A cutter (22) is adapted for moving from a retracted position within the housing (20) to a deployed position for at least partially projecting from the passage (20a). A expandable actuator (24) within the housing (20), such as an inflatable balloon (26), actuates the cutter (22) to move from the retracted position fully within the housing (20) to the deployed position at least partially projecting from the housing (20). More than one cutter (22′) may be provided, which cutters (22′) may be simultaneously actuated by the same actuator (26′).

An endoluminal punch system including a sheath and dilator. The endoluminal punch may include energy delivery system capable of being transmitted from the proximal end to the distal end of the endoluminal punch to assist with tissue crossing and incisions. The dilator may include selectively deployable cutting mechanism to create incisions in tissue that are larger than their basic external diameter. The system may also be configured to reduce the risk of generating plastic emboli during insertion of the endoluminal punch.

A surgical atherectomy apparatus for removing particles such as plaque from an interior of a vessel having a motor housing slidable axially between a proximal position and a distal position. An axially fixed sheath extends from the outer housing and a catheter is connected to the motor housing and is positioned within the sheath. A rotatable shaft is positioned within the lumen of the catheter and is operatively connected to the motor for rotational movement, the rotatable shaft and catheter movable by movement of the motor housing between the proximal and distal positions. The rotatable shaft has an atherectomy bit extending therefrom for dislodgement of particles when rotated by the motor and dislodged particles are aspirated in the lumen of the catheter.

An apparatus for treating a lesion in a vasculature has a catheter shaft (12) with a plurality of openings (16), which may be axially spaced. One or more cutters (18, 18′) are adapted for moving from a retracted position to a deployed position projecting from one of the plurality of openings for cutting the lesion, such as by being biased toward the opening and retracting upon engaging a leading edge thereof when the support is advanced proximally. A shaft forming part of the catheter may include a plurality of lateral openings and a plurality of cutters. The cutter(s) may be attached to a support adapted for moving independently within the shaft from a first position in which the cutter(s) move to a deployed position to project from a corresponding one of the plurality of openings for cutting the lesion. Related methods are also disclosed.

Systems and methods for treating cellulite including an apparatus that applies or a method involving separating septa to eliminate or reduce the appearance of cellulite. In one approach, an interventional tool is placed between tissue layers to engage and treat septa connecting tissue layers between which fat deposits are contained.

Hysteroscopic system includes a hysteroscope having a main body coupled to an extension portion. The extension portion may be a shaft configured to extend transcervically to a patient's uterine cavity. First, second, and third channels extend from the main body to a distal end of the extension portion. A fluid source is coupleable to a proximal end of the first channel, and a pressure sensor is coupleable to a proximal end of the second channel. A tissue resecting probe is configured for introduction through the third channel. At least one resistance feature is included which is configured to provide a selected level of resistance to axial sliding of the probe through the third channel while permitting rotation of the probe within the third channel.