The present disclosure relates to electrosurgical systems and methods for controlling electrical treatment energy in connection with electrical arcs. A method in accordance with the present disclosure includes providing electrical treatment energy to an instrument based on an indicated electrical energy level, accessing voltage signal values over time relating to voltage of the electrical treatment energy and/or current signal values over time relating to current of the electrical treatment energy, determining whether an arc generated by the instrument is an arc to be maintained or an arc to be extinguished based on a threshold value and at least one of the voltage signal values or the current signal values, and controlling the electrical treatment energy based on determining that the arc is an arc to be extinguished.

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.

A catheter system (100) for placement within a blood vessel (108) having a vessel wall (108A) for treating a treatment site (106) within or adjacent to the vessel wall (108A) within a body (107) of a patient (109) includes a system console (123), one or more energy guides (122A), and an optical connector assembly (251). The system console (123) includes an energy source (124) and a console connection aperture (148). The one or more energy guides (122A) are configured to receive energy from the energy source (124). The optical connector assembly (251) includes a guide coupling housing (250) that retains at least a portion of each of the one or more energy guides (122A). The guide coupling housing (250) is configured to be mechanically connected to the system console (123) with at least a portion of the guide coupling housing (250) being configured to fit and be selectively retained within the console connection aperture (148) so that the one or more energy guides (122A) are adjustably and more precisely aligned within the guide coupling housing (250) and relative to the energy from the energy source (124) to receive the energy from the energy source (124).

An electrosurgical wand for reducing tissue is disclosed. The wand includes a handle and an elongate shaft, the shaft having a major longitudinal axis, a conduit extending therethrough and a non-insulated distal end portion defining a first electrode. The first electrode has a distal most edge configured to mechanically pierce tissue, and an arcuate surface extending proximally from the distal most edge along the major longitudinal axis, the arcuate surface having a convex surface that faces in a distal direction. First and second arcuate edges define lateral edges of the arcuate surface. A second electrode is disposed at an opening of the conduit and electrically isolated from the first electrode. The second electrode comprises an aperture, configured to aspirate fluid and tissue debris therethrough.

A theragnostic system includes a surgical station and a storage and processing device that contains data in a suitable storage in which patient data and treatment data, e.g. in form of electrical and optical features, are combined. The electrical features are derived from electrical parameters of the voltage and the current with which an instrument is supplied. The optical features are derived from light of the spark that is produced upon influencing the tissue. By combining electrical and optical features in a data collection, that even contains additional features, such as tissue features and patient characteristics, it can be determined whether the instrument influences benign or malign tissue. The prediction accuracy can be increased by machine learning by adding histological data to the data sets. These data can be collected in a cloud computing system that is connected with many surgical stations.

With the generator according to the invention the treatment of biological tissue by means of electrosurgical instruments, particularly by means of argon plasma probes, can be carried out reliably without depending on the personal skills of a treating person. With the aid of image-supported measurement value generation, for example using a camera or a medical imaging device, such as CT, a multiplicity of test treatments of tissue samples is carried out and on this basis a training data set is created. From the training data set based on machine learning a control data set is created that controls during subsequent use an apparatus located in an operation room without the aid of a camera observation of the field of operation. Only the typical pattern of sensor data are evaluated that have been assigned to specific tissue effects during the camera-monitored training sessions.

A catheter system (100) for placement within a blood vessel (108) having a vessel wall (108A) for treating a treatment site (106) within or adjacent to the vessel wall (108A) within a body (107) of a patient (109) includes a system console (123), one or more energy guides (122A), and an optical connector assembly (251). The system console (123) includes an energy source (124) and a console connection aperture (148). The one or more energy guides (122A) are configured to receive energy from the energy source (124). The optical connector assembly (251) includes a guide coupling housing (250) that retains at least a portion of each of the one or more energy guides (122A). The guide coupling housing (250) is configured to be mechanically connected to the system console (123) with at least a portion of the guide coupling housing (250) being configured to fit and be selectively retained within the console connection aperture (148) so that the one or more energy guides (122A) are adjustably and more precisely aligned within the guide coupling housing (250) and relative to the energy from the energy source (124) to receive the energy from the energy source (124).