A61B2018/00083

Enhanced control systems including flexible shielding and support systems for electrosurgical applications

An active electrode probe for an enhanced control surgery system is disclosed. The probe has a flexible conductor for delivering electrosurgical energy during an electrosurgical procedure, and is adapted for connection to an electrosurgical generator. The probe also has a flexible electrical insulation substantially surrounding the conductor. The probe also has a flexible conductive shield substantially enclosing the electrical insulation, the flexible conductive shield electrically connected to a reference potential, whereby any current which flows in the flexible conductive shield from the conductor is conducted to the reference potential. The flexible conductive shield is formed from a conductive wire.

ELECTROSURGICAL INSTRUMENT
20230181234 · 2023-06-15 · ·

An electrosurgical instrument end effector comprises a rotary shaver arrangement, and an active electrode for supplying radio-frequency (RF) power to a surgical site. The rotary shaver arrangement comprises a rotatable shaver blade, and a stator that partially surrounds the rotatable shaver blade. At least part of the stator is electrically non-conductive.

Illuminated and isolated electrosurgical apparatus
11672591 · 2023-06-13 · ·

Unintended current flow or plasma discharge has been observed in known illuminated electrosurgical devices having a metallic tubular heat sink surrounding a conductive electrode and an illumination element, and having a distal outer edge that abuts against the light emitting element. An insulating, shielding or other isolating element that prevents or discourages unintended plasma formation between the distal outer edge and nearby patient tissue can reduce the potential for tissue damage to a patient or injury to a surgeon.

Slip-ring contact assembly for electrosurgical instruments
11672590 · 2023-06-13 · ·

A surgical instrument includes a slip-ring contact assembly. The slip-ring contact assembly includes an insulative housing defining a plurality of slots. A plurality of slip-ring contacts is operably supported in the insulative housing. Each slip-ring contact is configured to engage one or more electrical contacts formed circumferentially around a rotatable shaft of the surgical instrument. Each slip-ring contact includes a tang extending through a corresponding slot defined in the insulative housing and configured to be operably connected to an external wire connection. The plurality of slip-ring contacts is configured to allow unlimited rotation of the rotatable shaft while maintaining continuous electrical contact between each slip-ring contact and the corresponding electrical contact of the rotatable shaft.

Methods and apparatus for intravascularly-induced neuromodulation

Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient's vessel, e.g., with the impedance-altering element deployed into contact with the vessel wall at a treatment site within the patient's vasculature, a magnitude of applied voltage delivered across the bipolar electrodes necessary to achieve desired neuromodulation is reduced relative to an intravascular PEF system having similarly spaced electrodes but no (or an undeployed) impedance-altering element. In a preferred embodiment, the impedance-altering element comprises an inflatable balloon configured to locally increase impedance within a patient's vasculature. The methods and apparatus of the present invention may be used to modulate a neural fiber that contributes to renal function.

Instruments and methods for thermal tissue treatment

Disclosed herein are high efficiency surgical devices and methods of using same using radio frequency (RF) electrical power and/or electrically heated filaments to destroy tumors, form lesions, denaturize, desiccate, coagulate and ablate soft tissues, as well as to drill, cut, resect and vaporize soft tissues. According to the principles of this invention, the electrosurgical instruments can be used with externally supplied conductive or non-conductive liquids, as well as without externally supplied liquids, a mode of operation often referred to as “dry field” environment.

Tissue extraction devices and methods

A tissue cutting device has an outer sleeve with a distal window and an inner cutting sleeve which moves past the window to cut tissue. The inner cutting sleeve has a lumen which may have a larger proximal diameter than distal diameter. A perimeter of the window may comprise a dielectric material. A distal edge of the inner sleeve may be displaced inwardly.

Systems and methods for interrupting nerve activity to treat a medical condition
11672595 · 2023-06-13 · ·

Provided are devices, systems, and methods for treating or preventing heart failure or a symptom of heart failure through coordinated nerve activity interruption for one or more target nerves. Devices disclosed herein may comprise a vascular catheter comprising a telescopic needle assembly configured to puncture vascular tissue in contact with the catheter, wherein the needle assembly comprises one or more electrodes configured to deliver electrical energy to a tissue in contact with the one or more electrodes. Methods may include treating or preventing heart failure or a symptom of heart failure by inserting a catheter into a vascular tissue of the subject; guiding the catheter towards the greater splanchnic nerve; piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve; and ablating the target nerve by delivering a stimulation energy to the target nerve with one or more electrodes.

CATHETER WITH MAPPING AND ABLATING TIP ASSEMBLY

Ablation systems of the present disclosure facilitate the safe formation of wide and deep lesions. For example, ablation systems of the present disclosure can allow for the flow of irrigation fluid and blood through an expandable ablation electrode, resulting in efficient and effective cooling of the ablation electrode as the ablation electrode delivers energy at a treatment site of the patient. Additionally, or alternatively, ablation systems of the present disclosure can include a deformable ablation electrode and a plurality of sensors that, in cooperation, sense the deformation of the ablation electrode, to provide a robust indication of the extent and direction of contact between the ablation electrode and tissue at a treatment site.

ACCESS AND ABLATION SYSTEM AND METHOD FOR USE THEREOF
20230172656 · 2023-06-08 ·

An access and radio-frequency (RF) ablation system and method for use thereof is provided. The access and RF ablation system can include an RF ablation probe, a stylet, a cannula, a needle, and a drill. The method of using the access and radio-frequency ablation system can include inserting portions of a combined stylet into a patient's body to create a pathway therethrough and position a distal end of the stylet and a distal end of the cannula adjacent hard and/or soft tissues requiring ablation or tissues adjacent thereto; pushing portions of the needle into, through, and out of an interior cavity of the cannula to position a curved distal end of the needle adjacent the distal end of the cannula in the pathway; lengthening the pathway in an angled and curved direction relative to a mid-longitudinal axis of the cannula by pushing the curved distal end portion of the needle further into the hard and/or soft tissues requiring ablation or the tissues adjacent thereto; guiding a drill using the needle to enlarge and/or further lengthen the pathway in the hard and/or soft tissues requiring ablation or the tissues adjacent thereto in an angled and curved direction relative to the mid-longitudinal axis of the cannula; pushing portions of the RF ablation probe into, through, and out of the cannula and into and through the pathway to position a distal end portion of the RF ablation probe adjacent the hard and/or soft tissues requiring ablation; and activating the RF ablation probe to ablate all or portions of the hard and/or soft tissues requiring ablation.