A surgical instrument comprising a firing system configured to perform one or more staple firing strokes, a power system, and a control system is disclosed. The firing system comprises a cutting member and an electric motor configured to drive the cutting member through each staple firing stroke and retract the cutting member after each staple firing stroke. The control system comprises a powered operating state in which the power system has enough power to drive the cutting member through a staple firing stroke, a limited-power operating state for placing the surgical instrument in a default condition that has sufficient functionality to retract the cutting member, a firing system lockout configured to prevent the firing system from performing a staple firing stroke when the control system is in the limited-power operating state, and a display configured to indicate that the surgical instrument is in the limited-power operating state.

Methods and apparatus for dermatological laser treatment, e.g. for the removal of unwanted tattoos or other skin pigmentation. Removal of multiple colors with a single pulsed laser beam may be achieved using intensities in excess of about 50 GB/cm.sup.2. Methods for reducing the pain and tissue damage associated with laser tattoo removal include using a spot size of less than 2 mm with a fluence in the range of 0.5-10 J/cm.sup.2. Scanning the laser beam over an area of skin to be treated allows such areas to be treated accurately with scanning patterns calculated to promote rapid dissipation of heat away from treated portions of the skin. Multiple treatment rooms may be served by a single pulsed treatment laser by beam toggling, splitting or pulse-picking to minimise downtime of the laser.

A system includes a focus optic configured to converge an electromagnetic radiation (EMR) beam to a focal region located along an optical axis. The system also includes a detector configured to detect a signal radiation emanating from a predetermined location along the optical axis. The system additionally includes a controller configured to adjust a parameter of the EMR beam based in part on the signal radiation detected by the detector. The system also includes a window located a predetermined depth away from the focal region, between the focal region and the focus optic along the optical axis, wherein the window is configured to make contact with a surface of a tissue.

Described here are devices and methods for forming shock waves. The devices may comprise an axially extending elongate member. A first electrode pair may comprise a first electrode and a second electrode. The first electrode pair may be provided on the elongate member and positioned within a conductive fluid. A controller may be coupled to the first electrode pair. The controller may be configured to deliver a series of individual pulses to the first electrode pair, where each pulse creates a shock wave. The controller may cause current to flow through the electrode pair in a first direction for some of the pulses in the series and in a second direction opposite the first direction for the remaining pulses in the series.

In one embodiment, an electroporation method includes inserting a catheter having multiple electrodes into a chamber of a heart, applying an electrical field using at least two of the electrodes to tissue of the chamber of the heart at a given location within the chamber with an amplitude sufficient to cause reversible electroporation, but below a threshold for irreversible electroporation, and measuring an effect of the reversible electroporation on electrical activation signals in the tissue of the chamber of the heart in a vicinity of the location.

An atherectomy system includes a handle and a drive motor that is adapted to rotate a drive cable extending through the handle and operably coupled to an atherectomy burr. A control system is adapted to regulate operation of the drive motor, including providing the drive motor with a high frequency pulse width modulation (PWM) drive signal in order to operate the drive motor. The control system monitors a motor performance parameter such as motor speed or motor torque, and when the motor performance parameter approaches a limit of a performance range, the control system adds a low frequency PWM signal to the high frequency PWM drive signal, thereby causing the drive motor to produce a tactile signal that signals to the user that the motor performance parameter is approaching the limit of the performance range.

A method of body tissue ablation includes defining an ultrahigh-power ultrashort-duration (UPUD) ablation protocol that specifies an ablation signal having (i) a target ablation power of at least 400 Watts and (ii) a pulse duration that does not exceed three seconds, for creating a specified lesion in tissue in a body of a patient. Contact is made between an ablation probe and the tissue. Using the ablation probe, the ablation signal is applied to the tissue according to the UPUD protocol, which delivers the ablation signal having the specified target ablation power and duration.

According to some embodiments, a system for fractionally treating tissue includes: an electromagnetic radiation (EMR) source configured to generate an EMR beam having a transverse ring energy profile; an optic configured to converge the EMR beam to a focal region located within a tissue; and, a window assembly located down-beam from the optic configured to cool the tissue when placed in contact with an outer surface of the tissue.

A powered surgical stapler comprising a handle including an electric motor configured to output rotary motions, a shaft extending from the handle, an end effector extending from the shaft, a staple cartridge including a plurality of staples, and a firing member operably responsive to the rotary motions is disclosed. The end effector comprises a first jaw and a second jaw movable relative to the first jaw between an open position and a closed position. The firing member is configured to move the second jaw into the closed position. The firing member is further configured to move distally within the end effector at a first rate to eject the plurality of staples from the staple cartridge. The firing member is further configured to move proximally within the end effector at a second rate that is different from the first rate.

A device (10) to occlude the left atrial appendage (1) of a heart of a subject comprises an implantable occlusion apparatus (30) configured for radial expansion upon deployment to fluidically occlude the left atrial appendage, an elongated catheter member (80) having a distal end attachable to the implantable occlusion apparatus for transluminal delivery of the implantable occlusion apparatus to the left atrial appendage, a tissue energising module (20) having a plurality of electrodes (26) disposed around a circumference of the implantable occlusion apparatus in which each electrode is configured to contact a wall of the left atrial appendage at a tissue focal point upon deployment of the implantable occlusion apparatus, and an electrical controller (40) including a pulsed field energy delivery generator operably attachable to an electrical power source (50) and the plurality of electrodes and configured to energise the electrodes in a pulsed field ablation modality. The electrical controller is configured to independently energise each of the plurality of electrodes to apply a non-uniform pulsed field ablation treatment circumferentially around the wall of the left atrial appendage.