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.

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.

A control circuit for use with an electrosurgical system is disclosed. The control circuit is programmed to provide an electrosurgical signal comprising a plurality of pulses to first and second electrodes and receive a first reading of an impedance between the first and second electrodes. The control circuit is programmed to receive a second reading of the impedance between the first and second electrodes. The control circuit is programmed to determine a difference between the first and second readings and determine that a short circuit is present between the first and second electrodes based on a magnitude of the difference between the first reading and the second reading. The control circuit is programmed to generate a signal indicating the short circuit between the first and second electrodes.

A bipolar electrosurgical instrument includes a handle portion, a shaft extending from the handle portion, a pad electrode coupled to the distal end of the shaft, and a loop electrode configured to be selectively transitioned from a deployed configuration, wherein the loop electrode extends outwardly from a distal end of the shaft in a manner capable of receiving tissue, to a non-deployed configuration, wherein the loop electrode is disposed proximate to the distal end of the shaft, to treat tissue.

The invention relates to a device (100) for RF skin treatment, comprising an active electrode (1) arranged on an operational side (15) of the device and having a first skin contact surface for contact with a skin of a user, which first skin contact surface has a largest cross-sectional dimension smaller than or equal to 2 mm. The device comprises a return electrode (2) arranged on the operational side (15) of the device and having a second skin contact surface for contact with the skin of the user, wherein an area of the second skin contact surface is at least five times larger than an area of the first skin contact surface. An RF generator (21) is arranged to supply an RF treatment voltage between the active electrode (1) and the return electrode (2) so as to heat a skin region below the active electrode, wherein the RF treatment voltage has a frequency in a range of 100 MHz-3 GHz. By using a frequency of the RF treatment voltage in said range, a depth of thermal lesions voltage is considerably increased as compared to RF skin treatment devices using a comparable RF treatment voltage, but at a much lower frequency.

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 bipolar electrode instrument for use in a resectoscope and having an elongated shaft section, through which a first conductor extends, which forms a working electrode to which high-frequency current can be applied at the distal end of the electrode instrument, and a second conductor further extending through the shaft section, which forms a counter electrode in the distal end region of the electrode instrument. The working electrode and the counter electrode are spatially separated from one another in such a way that the distance between them cannot be bridged by a straight conductor which has a length of 6 mm or less. When used in a resectoscope for endoscopic surgery with a cladding tube, the electrode instrument is mounted so as to be longitudinally displaceable inside the cladding tube.

An energy-based surgical device includes an elongated outer tube having a distal overhang, a proximal hub, a distal cutting member, and a flat spring. The distal cutting member has a U-shaped cutting edge and defines a mouth with the distal overhang extending therethrough. The flat spring includes a first portion extending distally along an exterior surface of the elongated outer tube and the distal overhang, a second portion extending from the first portion and bent over a free distal end of the distal overhang, and a third portion extending from the second portion proximally through the mouth of the distal cutting member and into the lumen of the elongated outer tube and traverses a majority of a diameter thereof. The distal cutting member and flat spring are adapted to connect to a source for electrosurgical energy for conducting bipolar energy through tissue disposed therebetween to cut tissue.

An electrode assembly for an electrosurgical instrument includes a housing configured to operably receive a distal end of an instrument shaft, the housing including a pair of opposing spring clips. An active electrode is included having a proximal end configured to engage the distal end of the shaft and includes a cutting edge defined about a periphery thereof. An insulator is included that encapsulates the active electrode while leaving the cutting edge exposed. A pair of return electrodes is included that is each configured to operably engage an exposed side of the insulator, each return electrode including a recess defined therein configured to removably receive a distal end of each respective spring clip such that, upon selective engagement of the active electrode with the distal end of the shaft, each spring clip removably snaps into each respective recess to removably lock the active and return electrodes to the housing.

Devices and methods for monitoring the temperature of tissue at various locations in a treatment volume during fluid enhanced ablation therapy are provided. In one embodiment, an ablation device is provided having an elongate body, at least one ablation element, and at least one temperature sensor. The elongate body includes a proximal and distal end, an inner lumen, and at least one outlet port to allow fluid to be delivered to tissue surrounding the elongate body. The at least one ablation element is configured to heat tissue surrounding the at least one ablation element. The at least one temperature sensor can be positioned a distance away from the at least one ablation element and can be effective to output a measured temperature of tissue spaced a distance apart from the at least one ablation element such that the measured temperature indicates whether tissue is being heating to a therapeutic level.