Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

An electrosurgical smoke evacuation pencil includes a handle housing having a proximal end portion and a distal end portion, the handle housing defining a lumen therethrough, a nozzle in fluid communication with the lumen, a pressure sensor configured to sense a vacuum pressure at the nozzle, a connector coupled to the distal end portion of the handle housing, the connector configured to couple to a suction source, and an electrode configured to couple to a source of electrosurgical energy.

A hysteroscopic fluid management system includes a saline source with an electrolyte concentration, at least one pressure mechanism for circulating saline to and from a targeted site and through a filter having filter characteristics back to the source, and a controller. The controller provides a saline inflow in a first flow path to the site and a saline outflow in a second flow path from the site through the filter and back to the source at a controlled flow rate. A diagnostic or therapeutic procedure is performed at the site in the presence of the saline. The filter characteristics and the controlled flow rate are selected to (1) cause substantially no change in the electrolyte concentration in the saline, (2) to prevent hemolysis of greater than 5% of filtered red blood cells exposed to the saline, and/or (3) to minimize effect on prothrombin time of plasma exposed to the filter.

Systems and methods can be employed for trans-tympanic membrane access to the middle ear for delivery of a therapeutic agent, for example, to the round window niche adjacent to the cochlea under direct visualization. The systems and methods can also be used to improve accessibility and visualization for various otological surgical procedures, such as, but not limited to, cholesteatoma removal, tympanic membrane repair and ossicular chain repair.

An electrode apparatus for nerve denervation or modulation in body includes a main body including a shaft; an electrode unit formed to be drawn out from one end of the shaft and configured to denervate or modulate at least part of nerves on a tube in the body; and an electrode guide coupled to the electrode unit and deformed into a wound state to bring the electrode unit into contact with the tube in the body. The electrode guide includes a plurality of joint units disposed to enclose the circumference of the tube with the electrode unit interposed therebetween in the wound state.

Tissue is resected and extracted from an interior location in a patient's body using a probe or tool which both effects resection and causes vaporization of a liquid or other fluid to propel the resected tissue through an extraction lumen of the resecting device. Resection is achieved using an electrosurgical electrode assembly including a first electrode on a resecting member and a second electrode within a resection probe or tool. Over a first resecting portion, radio frequency current helps resect the tissue and over a second or over transition region, the RF current initiates vaporization of the fluid or other liquid to propel the tissue from the resection device. In one embodiment, an extending element extends from a housing and into a channel in a resecting member as the resecting member moves toward a distal position.

A medical device for performing a hysterectomy is provided. The medical device has a tissue incision assembly that includes a first cup nested within a second cup. The tissue incision assembly also includes a spacer assembly between the first cup and the second cup in order to maintain a spacing between the first and second cups. The tissue incision assembly also has a cutting implement that has a portion extending between, and movable with respect to, the first and second cups. The cutting implement can provide a circular cut guided via the spacing between the first and second cups.

A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.

In general, devices, systems, and methods for fiducial identification and tracking are provided.

A surgical instrument includes a shaft and a probe that extends distally from a distal end of the shaft. The probe includes a distal tip configured to puncture a tissue surface to enter a nerve canal of a patient, and an ablation element operable to ablate a nerve located within the nerve canal. The surgical instrument further includes a stop element arranged proximally of the distal tip. The stop element is configured to abut the tissue surface punctured by the distal tip. In some examples, the ablation element may be in the form of an RF electrode operable to ablate the nerve with RF energy. The surgical instrument may further include a navigation sensor operable to generate a signal corresponding to a location of the probe within the patient.