A percutaneous vascular access assembly for use with a radiofrequency (RF) energy source is disclosed. The percutaneous vascular access assembly includes an RF perforation instrument to be coupled to the RF energy source. The RF perforation instrument has an elongate shaft defining a longitudinally extending lumen and an instrument distal tip having an instrument electrode to deliver the RF energy. A puncture member is to be disposed within the lumen and extendable from the instrument distal tip. The puncture member is to be coupled to the RF energy source. The puncture member includes a puncture member distal tip having a puncture member electrode to deliver the RF energy.

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.

An electrosurgical device including an elongated body extending from a proximal portion to a distal portion and defining an internal passageway configured to convey tissue from the distal portion to the proximal portion, and a coring electrode positioned at the distal portion of the elongated body, where the coring electrode is at an opening to the internal passageway, and where the coring electrode is configured to deliver electromagnetic energy to adjacent tissue to cut a volume of the tissue as the tissue is conveyed into the internal passageway.

Methods of ablating a basivertebral nerve (BVN) in a lumbar or sacral vertebral body of a patient. An introducer and one or more instruments are selected after a pre-surgical evaluation. The introducer has a handle coupled to a shaft defining a central channel and an opening at a distal tip thereof. The introducer is inserted through a pedicle of the vertebral body such that its opening reaches a cancellous portion of the vertebral body. The one or more instruments are delivered through the central channel. A distal deflectable section of the one or more instruments is advanced past the introducer's opening to position it proximate to the BVN in a posterior midline section of the vertebral body. An active element is extended relative to at least a portion of the one or more instruments. Energy is delivered to the active element to ablate at least a portion of the BVN.

System and methods are shown having a tube-within-tube assembly with a deployable curved deflectable tube or cannula that deploys from a straight cannula or trocar. The curved cannula has pre-curved distal end to create an angular range of 0 to 180 when fully deployed from the straight trocar. The curve is configured such that the flexible element carrying a treatment device can navigate through the angular range of deployment of the curved cannula. The curved cannula allows the flexible element to navigate through a curve within bone without veering off towards an unintended direction.

The present invention relates to comprehensive systems, devices and methods for delivering energy to tissue for a wide variety of applications, including medical procedures (e.g., tissue ablation, resection, cautery, vascular thrombosis, treatment of cardiac arrhythmias and dysrhythmias, electrosurgery, tissue harvest, etc.). In certain embodiments, systems, devices, and methods are provided for delivering energy to difficult to access tissue regions (e.g. peripheral lung tissues), and/or reducing the amount of undesired heat given off during energy delivery.

An electrosurgical device including an elongated body extending from a proximal portion to a distal portion and defining an internal passageway configured to convey tissue from the distal portion to the proximal portion, and a coring electrode positioned at the distal portion of the elongated body, where the coring electrode is at an opening to the internal passageway, and where the coring electrode is configured to deliver electromagnetic energy to adjacent tissue to cut a volume of the tissue as the tissue is conveyed into the internal passageway.

Methods of ablating a basivertebral nerve (BVN) in a lumbar or sacral vertebral body of a patient. An introducer and one or more instruments are selected after a pre-surgical evaluation. The introducer has a handle coupled to a shaft defining a central channel and an opening at a distal tip thereof. The introducer is inserted through a pedicle of the vertebral body such that its opening reaches a cancellous portion of the vertebral body. The one or more instruments are delivered through the central channel. A distal deflectable section of the one or more instruments is advanced past the introducer's opening to position it proximate to the BVN in a posterior midline section of the vertebral body. An active element is extended relative to at least a portion of the one or more instruments. Energy is delivered to the active element to ablate at least a portion of the BVN.

A system for pericardial puncture includes a medical device having an elongate shaft extending between a proximal end and a distal end, and having a distally facing electrode at the distal end of the shaft. An impedance meter is electrically connectable with the electrode for measuring an impedance associated with the electrode. A display is provided for displaying an indication of a position of the electrode. The indication of the position is based on of the impedance.

A method for delivering cancer therapy may comprise introducing a tissue resection device to the tissue site, using the tissue resection device to create a core of tissue, removing at least a portion of the core of tissue from the body to create a tissue cavity, and performing therapeutic management of malignant tissue via the tissue cavity.