The present disclosure provides medical devices and techniques for enhancing formation of vapor bubbles by laser energy in a liquid medium. In particular, the present disclosure is directed at a liquid medium with a tendency to develop and/or sustain a gaseous state in the presence of laser energy and a system to both irrigate a treatment site with the liquid medium and irradiate a target in the liquid medium.

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.

Catheters, sheaths, or other tubular devices are provided that include a proximal end, a distal end sized for introduction into a patient's body, and a steerable distal portion carrying a plurality of electrodes. The tubular device includes a primary lumen extending between the proximal and distal ends; a steering element lumen adjacent the primary lumen; a plurality of wires extending proximally from the electrodes, and reinforcement members including windings extending helically along at least the distal portion, at least some of the windings passing between the primary and steering element lumens and wires, and at least some of the windings surrounding the primary lumen and one or both of the steering element lumen and the wires. In one embodiment, a steering element is slidably disposed within the auxiliary lumen. Apparatus and methods for making such tubular devices are also provided.

Apparatus, consisting of a probe with a temperature sensor and a transducer in contact with a living subject's tissue. A power supply delivers electrical power to the transducer for tissue ablation. A controller receives a signal from the temperature sensor and in response outputs a tissue temperature. During a first time period the power supply delivers no more than a first target power to the transducer, and reduces the power when a first maximum allowable temperature of the tissue is exceeded. During a transition time period the power supply delivers no more than a second target power, while reducing the delivered power when the first maximum allowable temperature of the tissue is exceeded. During a second time period the power supply delivers no more than the second target power, while reducing the delivered power when a second maximum allowable temperature, less than the first maximum allowable temperature, is exceeded.

Impedance devices and methods of using the same to obtain luminal organ measurements. In at least one embodiment of an impedance device of the present disclosure, the impedance device comprises an elongated body having a distal body end, and a first electrode located along the elongated body at or near the distal body end, the first electrode configured to obtain one or more conductance values within a mammalian luminal organ within an electric field, wherein a measured parameter of the mammalian luminal organ can be calculated based in part upon the one or more conductance values obtained by the first electrode.

A fluid handling system for a surgical procedure includes a console and a tubing set. The console exhibits a peristaltic pump, a pinch valve, one above the other. Two recessed seats are located to the left and right sides of the pump and valve. The tubing set includes an irrigation tube and an aspiration tube each coupled to a pair of magnetic disks disposable in respective ones of the recessed seats. Upon such disposition, the irrigation tube is disposable in operative engagement with the peristaltic pump and the aspiration tube is insertable into a slot of the pinch valve.

A surgical robotic system comprising: a robotic arm; a tool drive coupled to the robotic arm; a cannula interface configured to couple a cannula to the tool drive, the cannula interface having a fluid pathway in communication with an interior lumen of the cannula; and an insufflation pathway coupled to the robotic arm, the insufflation pathway having a distal end coupled to the fluid pathway and a proximal end coupled to a surgical insufflator.

Embodiments of the invention include an electrosurgical system with a controller, a fluid control unit electrically coupled to the controller, and an electrosurgical wand with a lumen having a coil-supported inner tubular member. Some embodiments include methods of manufacturing components of the electrosurgical system.

A surgical pump assembly includes a motor configured to provide a motor output, a transmission assembly configured to receive the motor output and provide a plurality of transmission outputs, and a plurality of pumps. Each pump of the plurality of pumps is configured to receive one of the transmission outputs of the plurality of transmission outputs. A surgical generator includes at least one energy module configured to generate an energy-delivery signal, at least one energy port configured to connect to a surgical instrument to deliver the energy-delivery signal thereto, and the surgical pump assembly.

A fluid handling system for a surgical procedure includes a console and a tubing set. The console exhibits a peristaltic pump, a pinch valve, one above the other. Two recessed seats are located to the left and right sides of the pump and valve. The tubing set includes an irrigation tube and an aspiration tube each coupled to a pair of magnetic disks disposable in respective ones of the recessed seats. Upon such disposition, the irrigation tube is disposable in operative engagement with the peristaltic pump and the aspiration tube is insertable into a slot of the pinch valve.