System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

Disclosed herein are systems, devices, and methods for accessing a subdural space. In some embodiments, an apparatus may comprise a shaft configured to be slidably disposed within a lumen of a catheter. The shaft may be configured to be advanced distally from a distal end of the catheter and into a blood vessel of a subject. The shaft may include a perforating tip including an energy element configured to generate radiofrequency energy to form an opening through a wall of the blood vessel and dura of the subject and into an extravascular space of the subject. A curved section may be configured to be radially constrained within the lumen of the catheter and to curve toward the wall of the blood vessel and the dura upon exiting the lumen of the catheter such that the energy element is positioned to form the opening.

Example embodiments relate to surgical systems comprising an end-effector assembly and arm assembly. The end-effector assembly may include a first instrument assembly having a first instrument and first instrument driven portion configurable to be driven to move the first instrument relative to a first axis. The arm assembly may include first and second arm assembly bodies, first arm assembly joint portion for joining the first and second arm assembly bodies, first instrument drive assembly, and first arm assembly drive assembly. The first instrument drive assembly may include a first integrated motor and first instrument drive portion controllable by the first integrated motor to drive the first instrument driven portion. The first arm assembly drive assembly may include a second integrated motor and first arm assembly drive portion controllable by the second integrated motor to drive the first arm assembly body to move relative to the second arm assembly body.

Disclosed are methods of transseptal crossing to permit introduction of large bore catheters into to the left atrium, such as to deploy left atrial appendage closure devices or to repair or replace a mitral valve. The method may include the steps of providing a single pass, large bore transseptal crossing system, having a tubular access cannula and an energy delivery wire movably extending through the tubular access cannula. A first electrode tip on the energy delivery wire is brought into contact with a fossa ovalis and energized. The energy delivery wire and cannula are advanced into the left atrium. A large bore sheath is advanced directly over the access cannula and into the left atrium. The cannula and energy delivery wire are removed, and a large bore index procedure catheter may be advanced through the large bore sheath and into the left atrium.

An energy delivery probe and method of using the energy delivery probe to treat a patient is provided herein, The energy delivery probe has at least one probe body having a longitudinal axis and at least a first trocar and a second trocar. Each trocar comprises at least two electrodes that are electrically insulated from each other, and each electrode is independently selectively activatable. An insulative sleeve is positioned in a coaxially surrounding relationship to each of the first trocar and the second trocar. The probe also has a switching means for independently activating at least one electrode. The method involves independently and selectively activating the first and second electrodes to form an ablation zone, then repeating the ablation by delivering energy to a second set of electrodes, producing one or more overlapping ablation zone, and eliminating the need to reposition the ablation probes.

Example embodiments relate to surgical systems comprising an end-effector assembly and arm assembly. The end-effector assembly may include a first instrument assembly having a first instrument and first instrument driven portion configurable to be driven to move the first instrument relative to a first axis. The arm assembly may include first and second arm assembly bodies, first arm assembly joint portion for joining the first and second arm assembly bodies, first instrument drive assembly, and first arm assembly drive assembly. The first instrument drive assembly may include a first integrated motor and first instrument drive portion controllable by the first integrated motor to drive the first instrument driven portion. The first arm assembly drive assembly may include a second integrated motor and first arm assembly drive portion controllable by the second integrated motor to drive the first arm assembly body to move relative to the second arm assembly body.

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device (e.g., an energy delivery device).

Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Methods and surgical tools for treating back pain use a spinal facet debridement tool with cautery and denuding action and minimally invasive protocol that can denude and cauterize soft tissue associated with a synovial capsule of the spinal facet joint.