A fluid stream is directed toward tissue to generate a plurality of shedding clouds. The fluid stream can be scanned such that the plurality of shedding clouds arrive a different overlapping locations. Each of the plurality of shedding clouds can remove a portion of the tissue. In many embodiments, an apparatus to ablate tissue comprises a source of pressurized fluid, and a nozzle coupled to the source of pressurized fluid to release a fluid stream, in which the fluid stream generates a plurality of shedding clouds.

A polypectomy snare comprising two snare parts has a snare part that is completely electrically insulated and another snare part that is not electrically insulated in at least one distal portion thereof. The snare furthermore has at least one electrically insulated, HF surgically inactive skid at its distal end.

Improved systems for diagnosing and/or treating arrhythmia of a heart makes use of an array of articulation balloons to control movement of a distal portion of a catheter inside the heart, and may be used to align a diagnostic or treatment tool with a target tissue surface region along or adjacent an inner surface of one of the chambers of the heart. The articulation balloons can generate articulation forces at the site of articulation, and the movement may provide greater dexterity than movements induced by transmitting articulation forces proximally along a catheter body that winds through a tortuous vascular pathway. One or more fluid channels may transmit pressure signals that can be used to determine engagement forces between an electrode or other surface near the distal and of an elongate flexible structure and a tissue or other surface, and those same channels may also be used to control inflation of a balloon articulation array, with the pressure signals optionally providing both force and engagement orientation information.

A probe device (50), for a resectoscope (10) or another microinvasive instrument for working or manipulating tissue, includes a probe shaft (60) with a cylindrical portion (66) for arrangement in an instrument shaft (20) and with a distal end for arrangement near a distal end of the instrument shaft (20), an effecting device at the distal end of the probe shaft (60), and a sealing device (70) with a probe shaft channel (76) in which the cylindrical portion (66) of the probe shaft (60) is arranged. The probe shaft (60) is movable relative to the sealing device (70) parallel to the longitudinal axis of the probe shaft (60) and parallel to the longitudinal axis of the probe shaft channel (76). The sealing device (70) is formed from metal or ceramic or from another non-elastic material and is connected permanently to the probe shaft (60).

High-frequency tools are used in medicine for manipulating body tissue, using an HF resectoscope. For electrical insulation of an electrode from an electrode support, the ends of the electrode are initially guided through ceramic tubes. These ceramic tubes are sensitive in particular to forces transverse to the longitudinal axis of the resectoscope. A high-frequency tool that has increased stability with respect to transverse forces. An electrode has two ends, which for establishing a connection to an electrode support are each insertable into a receiving opening of the ends of the electrode support, or positionable in front of the ends, and wherein the electrode is contacted in an electrically conductive manner, at least in the area of a receiving opening, with a conductor wire that is guided in the electrode support.

A medical device for performing an endoscopic procedure through an endoscope is provided. The device includes an elongated catheter having a first lumen and a second lumen; a needle system for injecting a target tissue within a body; and a base disposed at a proximal end of the catheter. The actuator tube is inserted through the base and the first lumen. A needle housing member is positioned between the needle and the first lumen when the needle is in a stored position. The needle housing member has a predetermined length so that the needle is disposed within the needle housing member when the needle is at the stored position. The needle housing member has a continuous inner surface and prevents the needle from penetrating the first lumen. The needle includes a tip, deflected towards a center axis of the needle. The first and second lumens have different deflected forces.

The disclosure relates to three enhancements for a surgical snare: an electrosurgical snare in which the loop of snare wire extends from an energy transfer surface which can act both as a physical reaction surface for mechanical cutting using the snare and as a region for emitting electromagnetic energy; a surgical snare having a snare wire having a first end connected to a movable boss that is slidably mounted on a coaxial cable; and a surgical snare having an end cap with a distally facing reaction surface and a pair of channels for guiding a snare wire, where the distally facing reaction surface is arranged to contact the retractable loop when fully retracted.

A device and system for removing polyps is provided and includes a tubular member having proximal and distal ends, a snare portion operably extending from within the distal end of the tubular member, the snare portion including a cutting member for severing the sealed tissue. The polyp removal device may further include a handle portion operatively extending from within the proximal end of the tubular member. The handle portion may be configured for operable engagement by a user and the cutting member may extend between distal ends of the first and second electrodes.

The present disclosure relates to a surgical snare instrument that includes a tube having a hollow, an excising unit having a wire installed to be slidable along the hollow of the tube and a loop part installed at an end of the wire and inserted into one end of the tube to be tightened to excise a polyp, an advancing-and-retracting unit installed at the other end of the tube to make the wire advance or retract along the hollow of the tube, and a rotating unit installed adjacent to the one end of the tube and configured to rotate the loop part when the wire moves with respect to the tube.

A device including a tissue manipulator, a conductive coating and at least one connector area. For example, the tissue manipulator may be scissors, clip appliers or clips, staplers and staple or a vessel sealing device. The conductive coating may be applied to the clip, staple or jaws of the scissors or sealing device. Electrical energy can be supplied through areas of contact (connector areas)such as between an anvil and a pusher of the stapler and the conductive coating on the staple. The conductive coating can be energized along with mechanical application of the manipulator to transform and facilitate attachment of tissue layers.