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 dissection apparatus is disclosed, and includes a thermally insulating body, a thermally conductive insert, at least one active electrode, and at least one return electrode. The at least one active electrode is disposed on the thermally conductive insert, and the at least one return electrode is spaced from the at least one active electrode by a portion of the thermally insulating body. The thermally conductive insert is configured to cauterize tissue dissected by radiofrequency energy passing from the at least one active electrode to the at least one return electrode.

The active electrode assembly for an electrosurgical device includes an electrically conductive shaft having opposed proximal and distal ends, the proximal end being adapted for connection to a conventional electrosurgical device. An electrically insulating sheath partially covers the distal end of the electrically conductive shaft. The electrically insulating sheath has a cut-out portion or recess formed therein, such that a portion of the distal end of the electrically conductive shaft is exposed therethrough. The exposed portion of the distal end defines an application surface for applying electrical current to the patient's tissue. The area surrounding the application surface remains covered by the electrically insulating sheath, thus providing electrically insulating protection for both the patient and the surgeon.

An electrosurgical probe includes an elongated shaft forming a lumen extending along a longitudinal axis from a proximal end portion to a distal end portion. An insulating layer is disposed on the distal end portion of the elongated shaft. A supply electrode is disposed on the insulating layer over a distal extent of the elongated shaft. A return electrode includes an exposed portion of the elongated shaft proximal of the insulating layer.

An electrosurgical probe includes an elongated tubular shaft including a lumen extending along a body from a proximal shaft portion to a distal shaft portion. The distal shaft portion forms an active electrode as a first exposed conductive portion at a distal extent of the elongated shaft. A first insulating layer extends over the body from the proximal end portion to the distal end portion. A conductive layer extends over the first insulating layer and terminates proximal of the first insulating layer. A second insulating layer extends over the first insulating layer and the conductive layer and terminates proximal of a distal conducting portion of the conducting layer forming a return electrode.

A method and apparatus are disclosed for providing forward fluid delivery through an electrosurgical device, while avoiding coring when energy is delivered to the electrosurgical device. The device has a distal face defining an opening, with the distal face including at least one cutting portion and at least one non-cutting portion. An embodiment of the electrosurgical device for puncturing tissue includes an elongate member defining a lumen for fluid; a distal portion including an electrode and the distal face which defines at least one aperture. The portion of the at least one cutting portion defines a leading portion partially surrounding a circumference of the at least one aperture wherein the outer diameter of the at least one of the distal portion of the electrosurgical device or the electrode decreases towards a distal tip of the electrosurgical device.

An apparatus for transseptal catheterization includes a dilator with an energy delivery element attached to its distal end. The energy delivery element is configured to deliver sufficient energy to a tissue, such as the fossa ovalis, adjacent the distal end to permit the dilator to penetrate the tissue and cross into the left atrium. The energy delivery element can be a radiofrequency electrode, a pulsed field ablation electrode, an ultrasound transducer, or the like. A guidewire and/or introducer may also be included to facilitate the transseptal catheterization.

Apparatus, having an insertion tube that is configured to be inserted into a body cavity. The apparatus also includes a distal tip connected to the insertion tube, the distal tip having an external surface and a cavity formed in the external surface, the cavity being surrounded by a region of the external surface having a curvature. The apparatus further includes a microelectrode configured to fit into the cavity so that a surface of the microelectrode is contoured, located and oriented to conform with the curvature of the region.

The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to devices, systems, and methods for controlled volume ablation of tissue. In one example, a catheter may include an elongated member having a distal end extending along a longitudinal axis. A first electrode may extend along the elongated member. The first electrode may have a distal portion arranged on a circumferential surface about the longitudinal axis at the distal end. A second electrode may extend along the elongated member. The second electrode may have a distal portion arranged on the circumferential surface about the longitudinal axis at the distal end of the elongated member. A sheath may be slidably disposed about the elongated member. The sheath may be configured to change position by sliding along the member to insulate a portion of one or both of the first and second electrode.

Tissue is treated using a radiofrequency power supply connected to an applicator having a chamber filled with an electrically non-conductive gas surrounded by a thin dielectric wall. A radiofrequency voltage is applied at a level sufficient to ionize the gas into a plasma and to capacitively couple the ionized plasma with the tissue to deliver radiofrequency current to ablate or otherwise treat the tissue.