A device for treating tissue includes a catheter including an elongated body extending from a proximal end to a distal end and including a lumen extending therethrough, a distal tip connected to the distal end of the elongated body and including a first electrode and a second electrode extending thereabout, the first electrode extending to a distal opening of the lumen and a first needle extending longitudinally from a proximal end to a distal end, the first needle slidably received within the lumen of the catheter to be moved between a retracted bipolar configuration, in which the distal end of the needle is proximal the distal opening of the catheter, and an extended monopolar configuration, in which the distal end of the first needle extends distally past the distal opening of the catheter so that the first needle contacts the first electrode and is configured to cut tissue.

Presented herein are methods, systems, devices, and computer-readable media for image guided surgery. The systems herein allow a physician to use multiple instruments for a surgery and simultaneously provide image-guidance data for those instruments. Various embodiments disclosed herein provide information to physicians about procedures they are performing, the devices (such as ablation needles, ultrasound wands or probes, scalpels, cauterizers, etc.) they are using during the procedure, the relative emplacements or poses of these devices, prediction information for those devices, and other information. Some embodiments provide useful information about 3D data sets. Additionally, some embodiments provide for quickly calibratable surgical instruments or attachments for surgical instruments.

Devices and methods are described for a minimally invasive procedure offering immediate relief of brain compression and prevention of subdural hematoma re-accumulation. For example, this disclosure describes devices and methods for embolization of bleeding branch vessels of the middle meningeal artery and subdural hematoma drainage in a single endovascular intervention using multimodal catheter-based technology.

Presented herein are methods, systems, devices, and computer-readable media for image management in image-guided medical procedures. Some embodiments herein allow a physician to use multiple instruments for a surgery and simultaneously provide image-guidance data for those instruments. Various embodiments disclosed herein provide information to physicians about procedures they are performing, the devices (such as ablation needles, ultrasound transducers or probes, scalpels, cauterizers, etc.) they are using during the procedure, the relative emplacements or poses of these devices, prediction information for those devices, and other information. Some embodiments provide useful information about 3D data sets and allow the operator to control the presentation of regions of interest. Additionally, some embodiments provide for quick calibration of surgical instruments or attachments for surgical instruments.

A movement transfer mechanism for a surgical scoping device, wherein a rotational proximal input force is transformed into a longitudinal force that is conveyed down the length of an instrument channel of the scoping device, where it is transformed again into an operational movement of a distal instrument. The operational movement can be rotational movement, but may be any movement that changes the orientation or configuration of the distal instrument. By conveying a linear force along the instrument channel rather than a twisting force, the problems of slipping and discontinuous operation of the distal instrument due to friction between the instrument and the instrument channel can be reduced or eliminated.

A system and method are presented for treating targeted tissue using cryoablation. An introducer canula and a cryoprobe are inserted the targeted tissue. The cryoprobe is cooled and an ice ball is formed. The cryoprobe is removed while the ice ball is still frozen, and an ultrasound catheter is inserted. Ultrasound generated within the ice ball is used to determine the distance from the ultrasound catheter to a perimeter of the ice ball. This is repeated at different angles to model a slice of the ice ball. The ultrasound catheter is moved radially, and the process is repeated to create a model of at least a portion of the ice ball. The ice ball model can be displayed on a registered set of images representing the targeted tissue to ensure that the tissue lies within the treatment zone of the ice ball.

An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes at the distal ends of the guide tubes allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered to ablate nerves outside of the media.

A phacoemulsification device includes a needle, one or more piezoelectric crystals, and one or more thermocouples. The needle is configured for insertion into a lens capsule of an eye. The one or more piezoelectric crystals are configured to vibrate the needle. The one or more thermocouples are thermally coupled directly to the respective piezoelectric crystals and are configured to measure respective temperatures of the one or more piezoelectric crystals as the crystals vibrate, and to output indications of the respectively measured temperatures.

An instrument (14) is suitable for treatment of lung tumors and other tissues and a respective apparatus (15) detects the correct positioning of instrument (14) and its two electrodes (19, 20) in a suitable target tissue by observation of two parameters (G1, G2) and particularly their time-dependent change. If the change (V1, V2) of the two parameters (G1, G2) exceeds defined thresholds (S1, S2) respectively, a contact between the instrument and the tissue to be treated and thus also the positioning of the instrument in a desired position can be derived therefrom. This remarkably increases treatment safety.

A method and apparatus are disclosed for an optimized transseptal procedure for providing left heart access, that reduces the number of devices that are used in order to minimize procedural time, complexity and cost. The apparatus comprises a reshapeable hybrid dilator that comprises the combined functionality of a transseptal sheath and dilator assembly. The hybrid dilator comprises: a dilator shaft defining a lumen for receiving a crossing device therethrough, the dilator shaft comprising a stiffening member and a deflectable portion, being structured to provide support for the crossing device when the crossing device is used to create a puncture in a tissue; and a distal tip having an outer diameter which tapers down to an outer diameter of the crossing device for providing a smooth transition between the crossing device and the distal tip when the crossing device is inserted through the lumen and protrudes beyond the distal tip.