An electrosurgical instrument comprising an end effector including a first jaw, a second jaw, and an electrical circuit is disclosed. The first jaw comprises a first conductive skeleton, a first insulative coating selectively covering portions of the first conductive skeleton, and first-jaw electrodes comprising exposed portions of the first conductive skeleton. The second jaw comprises a second conductive skeleton, a second insulative coating selectively covering portions of the second conductive skeleton, and second-jaw electrodes comprising exposed portions of the second conductive skeleton. The circuit is configured to transmit a bipolar RF energy and a monopolar RF energy to the tissue through the first-jaw electrodes and the second-jaw electrodes. The monopolar RF energy shares a first electrical pathway and a second electrical pathway defined by the electrical circuit for transmission of the bipolar RF energy.

An electrosurgical instrument comprising a jaw configured to define an electrode is disclosed. The jaw comprises a first electrically conductive portion, a second electrically conductive portion, and an electrically insulative layer. The first electrically conductive portion is configured to resist heat transfer therethrough. The second electrically conductive portion is integral with and extending at least partially around the first electrically conductive portion. The second electrically conductive portion is configured to define a heat sink. The electrode is defined by selective application of the electrically insulative layer to an outer surface of the second electrically conductive portion.

An instrument (10) provided for simultaneous coagulation and dissection of tissue has tissue receptacles between the cutting electrode and the sealing electrode for the formation of tissue bulges to secure the tissue in the tool during the sealing process. In order to make it possible to form voluminous tissue bulges and to prevent their atrophy, the cutting electrode is supplied by a current limiting component, preferably in the form of a coupling capacitor. Thereby, in particular, in tissue that can be cut through easily, but which requires a long time for sealing, a high degree of process safety is achieved.

A device, system, and method for optically evaluating and treating or ablating tissue. Specifically, device, system, and method allow for the optical and/or electrical evaluation of tissue at the same location(s) at which ablation or treatment or ablation energy is delivered. This allows for a more accurate evaluation of lesion formation and tissue condition before, during, and/or after a treatment or ablation procedure. In one embodiment, a device for performing a medical procedure includes an elongate body including a proximal portion, a distal portion having a distal end, and a longitudinal axis, and a distal tip electrode at the elongate body distal end, the tip electrode being optically transparent and electrically conductive. The device may also include optical windows in the elongate body aligned with one or more transparent lateral electrodes for optically interrogating tissue and/or for delivering treatment or ablation energy to tissue.

A tissue resecting device includes an outer sleeve having an axial bore extending along a longitudinal axis from a proximal end to a distal end and opening to an outer window near the distal end. An inner sleeve is rotatably received in the axial bore of the outer sleeve and has an axial channel adapted for communication with a negative pressure source. A distal housing is attached to a distal end of the inner sleeve and has an annular dielectric portion and a circumferentially adjacent annular metal portion having an inner window with circumferentially spaced-apart sharp cutting edges that opens to the axial channel. An active electrode is carried by the annular dielectric portion, and the inner window is circumferentially spaced-part from the active electrode so that the inner window and the active electrode rotate alternately into alignment with the outer window as the inner sleeve is rotated within the outer sleeve.

A device for endometrial ablation having an elongated shaft with a working end comprising an expandable-contractable frame, a complaint energy-delivery surface carried by the frame, the surface and the frame being configured to engage against the interior of a patient's uterine cavity when the working end is inserted into the cavity and the frame is expanded.

A conductive coating may be adhered to a structure comprising a hydrophobic and/or adhesion-resistant surface. The conductive coating may have a polymer backbone with conductive particles suspended in the backbone. In some embodiments, the conductive coating may be applied directly to the surface. In other embodiments, the conductive coating may be indirectly applied by first applying a primer adhesive to the outer surface, and then applying the conductive coating over the primer adhesive. An example structure may be a catheter of an endoscopic medical device, such as a bipolar sphincterotome, where the conductive coating functions as a return electrode.

Systems and methods for estimating tissue parameters, including mass of tissue to be treated and a thermal resistance scale factor between the tissue and an electrode of an energy delivery device, are disclosed. The method includes sensing tissue temperatures, estimating a mass of the tissue and a thermal resistance scale factor between the tissue and an electrode, and controlling an electrosurgical generator based on the estimated mass and the estimated thermal resistance scale factor. The method may be performed iteratively and non-iteratively. The iterative method may employ a gradient descent algorithm that iteratively adds a derivative step to the estimates of the mass and thermal resistance scale factor until a condition is met. The non-iterative method includes selecting maximum and minimum temperature differences and estimating the mass and the thermal resistance scale factor based on a predetermined reduction point from the maximum temperature difference to the minimum temperature difference.

Dual-channel injection bipolar high frequency electrosurgical knife comprises an electrode part, a main part and an operation part. The electrode part comprises an active electrode, an insulating part and an inert electrode. The active electrode has a hollow tubular portion, which can cut the target lesion tissue when power on. The main part comprises a protective tube, an insulation sheath and an insulation coated screw, connector, seal. The insulation coated screw includes a conductive screw and an insulating coating on the surface. The operation part comprises a positioning structure, a slider, a core rod, a connection sheath, an infusion tube and a connection cable. 6% Luer tapers are attached to both the positioning structure and the infusion tube. Liquid can flow out from the dual-channel, a solution can be injected in submucosal layer to elevate the mucous membrane tissue or clean hemorrhage site.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.