Devices, systems, and methods of the present disclosure are directed to controlling distribution of electrical energy moving from an ablation electrode at a treatment site within a patient to a plurality of return electrodes on skin of the patient. Control over the distribution of electrical energy moving from the ablation electrode to the plurality of return electrodes can reduce or eliminate the need for manual intervention (e.g., repositioning the plurality of return electrodes on the skin of the patient, repositioning the patient, etc.) to achieve a suitable distribution of the electrical energy. Additionally, or alternatively, the devices, systems, and methods of the present disclosure can respond rapidly and automatically to changes in distribution of the electrical energy to reduce the likelihood and magnitude of inadvertent changes in the distribution of electrical energy over the course of a medical procedure.

An effector includes a tubular body having a proximal end and a distal end. The effector holds a plug or closure at the distal end of the tubular body; an active electrode at the distal end of the body; an insulator on the body; and one or more return electrodes on the insulator. The body dissipates heat generated by the one or more return electrodes from the distal end of the body to the proximal end of the body.

Cable connection systems allow for an electrosurgical return electrode to be simultaneously connected to multiple ESUs. The cable connection systems can include individual return cables for simultaneous connection to each of the ESUs. The cable connection system can also include a junction that joins, connects, or associates the return cables in a manner that allows for the multiple ESU cables to be electrically connected to the return electrode at a single connection point on the return electrode.

An electrosurgical return electrode configured for operable association with a transponder detection unit. The return electrode includes a conductive element having an aperture array configured to allow passage of a magnetic, electric, or electromagnetic interrogation signal from the transponder detection unit through the conductive element and through the return electrode. The return electrode is positionable over a transponder detection unit such that the return electrode may be placed upon the transponder detection unit and a patient may be positioned upon the return electrode. The return electrode enables the detection of a transponder located on, within, and/or near the patient without the need for repositioning the patient relative to the return electrode and without the need for positioning an ancillary transponder reader or transmitter above the patient.

A bipolar sphincterotome may include an elongate tubular member, a cutting wire, and a return path. The return path may include a conductive ink portion disposed on an outer surface at a distal portion of the tubular member. The return path may also include a return wire disposed within the tubular member that is electrically coupled to the conductive ink portion. In some example embodiments, the return wire may be disposed within a lumen configured to have two or more functions, one of which being to house the return wire. Additionally, in some example embodiments, the conductive ink portion may be circumferentially disposed on the outer surface to provide visual access to a wire guide lumen. Also, for some example embodiments, the bipolar sphincterotome may include two electrically isolated return paths.

A method of forming a spline for an electrode assembly includes providing a structural member including a first surface and a second surface. The method also includes providing a flexible circuit assembly including a plurality of electrodes and at least one flexible circuit substrate having a contact surface and an outer surface opposite the contact surface. The plurality of electrodes are disposed on the outer surface of the at least one flexible circuit substrate. The method includes positioning the flexible circuit assembly relative to the structural member such that a first set of electrodes is aligned with the first surface and a second set of electrodes is aligned with the second surface. The method also includes coupling the at least one flexible circuit substrate to at least one of the structural member and the at least one flexible circuit substrate.

Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

Aspects of the present disclosure are presented for managing simultaneous outputs of surgical instruments. In some aspects, methods are presented for synchronizing the current frequencies. In some aspects, methods are presented for conducting duty cycling of energy outputs of two or more instruments. In some aspects, systems are presented for managing simultaneous monopolar outputs of two or more instruments, including providing a return pad that properly handles both monopolar outputs in some cases.

The present disclosure provides electroporation systems and methods of preconditioning tissue for electroporation therapy. An electroporation generator includes an electroporation circuit, a preconditioning circuit, and a controller. The electroporation circuit is configured to be coupled to a catheter for delivering the electroporation therapy to target tissue of the patient. The electroporation circuit is further configured to transmit an electroporation signal through the catheter. The preconditioning circuit is configured to be coupled to a preconditioning electrode for stimulating skeletal muscle tissue of the patient. The preconditioning circuit is further configured to transmit a preconditioning signal to the preconditioning electrode. The controller is coupled to the electroporation circuit and the preconditioning circuit, and is configured to synchronize transmissions of the electroporation signal and the preconditioning signal such that the preconditioning signal is transmitted prior to transmission of the electroporation signal.

Medical devices and methods for making and using the same are disclosed. An example medical device may include a medical device for renal nerve ablation. The medical device may include an elongate shaft having a distal region. An expandable member may be coupled to the distal region. A plurality of electrodes may be coupled to the expandable member and a single conductive member may be coupled to each electrode. Where one of the plurality of electrodes is active, the remaining electrodes may be inactive and act as ground or return electrodes. The electrode of the plurality of electrodes that is active may change over time.