A method and apparatus are disclosed for providing forward fluid delivery through an energy delivery device that avoids coring when it delivers energy to a tissue. The device has a distal face defining an opening, with the distal face including at least one electrically exposed portion and at least one electrically insulated portion. An embodiment of the energy delivery device includes an elongate member defining a lumen structured to receive a fluid, and a distal face defining an aperture in communication with the lumen. The distal face includes an electrically exposed conductive portion and an electrically insulated portion. The electrically exposed conductive portion is configured such that the energy it delivers while the energy delivery device is advanced into a tissue punctures the tissue without the tissue substantially occluding the lumen and without creating embolic particles.

A surgical instrument for bonding body tissue includes an instrument shank or shaft, a first tool element, a second tool element axially movable relative to the first tool element, and an annular sleeve-like cutting element. The second tool element includes a plurality of tool element members that are radially deflectable. The first and second tool elements are each equipped with at least one electrode. The second tool element includes a biasing member that biases the tool element members in a radially inward direction. A stop member is operable in a first position to hold the tool element members against the biasing force of the biasing member in which the tool element members assume a maximum outer diameter. The stop member is further operable in a second position to release the tool element members such that the tool element members can deflect radially inwardly and cut body tissue.

A polypectomy snare comprising two snare parts has a snare part that is completely electrically insulated and another snare part that is not electrically insulated in at least one distal portion thereof. The snare furthermore has at least one electrically insulated, HF surgically inactive skid at its distal end.

Electrode assemblies include segmented electrodes disposed on a catheter. The segmented electrodes can be constructed at the tip of the catheter. Tip electrodes can be constructed from an electrically insulative substrate comprising an inner lumen, an external tip surface, and a plurality of channels extending from the inner lumen to the external tip surface, a plurality of segmented electrodes, and a plurality of spot electrodes. Each of the plurality of segmented electrodes and each of the plurality of spot electrodes can be laterally separated from each other by an electrically non-conductive substrate portion and each of the spot electrodes and each of the segmented electrodes can be electrically coupled to at least one wire or conductor trace.

Cardiac ablation is carried out by placing two ablation electrodes on opposite sides of a wall of the heart to generally oppose one another. The effective current transmission area of one of the electrodes is then varied according to the distance between the two electrodes or the thickness of the wall. Sufficient electrical current is transmitted between the two electrodes to achieve transmural ablation.

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.

Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

A circular microwave ablation antenna is provided with a chamber for accommodating the coaxial cable and the conduit, the chamber and the conduit extend forward to the front end of the antenna. An emission window of the antenna is at least partially located in the conduit to enable the cooling medium to cool the emission window area of the antenna. The conduit of the microwave emission area is made of an insulation material, so that the microwave can radiate outward, and the rest of the conduit is made of a microwave shielding material. The choke ring located at the rear side of emission area is hermetically fixed to the conduit, so that the choke ring acts to block the microwave. A gap exists between the choke ring and the needle bar, and the gap is used for the backflow of the cooling medium.

A catheter has a multifunctional “virtual” tip electrode with a porous substrate and a multitude of surface microelectrodes. The surface microelectrodes are in close proximity to each other and in a variety of configurations so as to sense tissue for highly localized intracardiac signal detection, and high density local electrograms and mapping. The porous substrate allows for flow of conductive fluid for ablating tissue. The surface microelectrodes can be formed via a metallization process that allows for any shape or size and close proximity, and the fluid “weeping” from the porous substrate provides more uniform irrigation in the form of a thin layer of saline. The delivery of RF power to the catheter tip is based on the principle of “virtual electrode,” where the conductive saline flowing through the porous tip acts as the electrical connection between the tip electrode and the heart surface. The substrate and the surface electrodes are constructed of MRI compatible materials so that the physician can conduct lesion assessment in real time during an ablation procedure. The surface electrodes include noble metals, including, for example, platinum, gold and combinations thereof.

A monopolar suction coagulator device is provided for use with a vacuum source and an electrosurgical generator to perform a coagulation procedure and an evacuation procedure at a surgical site. The device includes an active electrode portion at the distal end of a probe, and the probe is formed of a thermally conductive and electrically conductive, non-stick metal material along all or substantially all of its length, to aid in heat dissipation during a coagulation procedure.