A treatment system for debriding a treatment area of a tissue site and applying negative pressure is disclosed. In some embodiments, the treatment system may include an ultrasonic bubble generator fluidly coupled to a negative-pressure source, fluid source, and a dressing. Fluid may be drawn from the fluid source to the ultrasonic bubble generator, whereby micro-bubbles and ultrasonic waves may be generated in the fluid before the fluid is instilled to the dressing.

A microcavitation system, device, and ultrasonic probe assembly for generating directional microcavitation includes a cannula and an ultrasonic transmission member. The ultrasonic transmission member has a first end portion and a second end spaced apart from the first end portion. The cannula has a tubular side wall, a cannula lumen, a fluid input port, a proximal end, a distal end, and a distal end portion. The ultrasonic transmission member is located in the cannula lumen. The fluid input port of the cannula is connected in fluid communication with the cannula lumen. The distal end portion of the cannula is configured to define a cavitation generation chamber. The cavitation generation chamber has a distal end wall at the distal end of the cannula that is configured as a sieve to define a plurality of apertures.

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.

Transcatheter device for the treatment of calcified native heart valve leaflets comprising an outer hollow shaft (5), an inner hollow shaft (4) slidingly contained within said outer shaft (5) and an axle body (6) slidingly contained within said inner shaft (4); wherein the device comprises a commissure debridement system (7), located at the distal end of the axle body (6), that is made of at least two radially expandable arms (7) that are adapted to be inserted in and aligned with native commissures.

A surgical instrument includes a cutting assembly, an outer tubing, and a flexible torque component. The cutting assembly extends from a first proximal end to a first distal end. The cutting assembly includes an outer cannula defining a cutting window and an inner cannula disposed within the outer cannula. The outer tubing extends from a proximal tubing end to a distal tubing end. The distal tubing end is coupled to the outer cannula. The outer tubing is configured to receive a torque at the proximal tubing end and transmit the torque to the outer cannula to rotate the outer cannula. The outer tubing includes a plurality of first wires and a plurality of second wires each including more than eight wires and less than twenty four wires. The flexible torque component is coupled to a third proximal end of the inner cannula to rotate the inner cannula.

An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.

A catheter treatment apparatus comprises an elongate tubular member and an expandable support. The expandable support comprises a radioactive substance to treat cancerous tissue and is configured to expand from a narrow profile for insertion to a wide profile to engage and treat tissue remaining after resection. The expandable support can be sized to fit within a volume of removed tissue to place the radioactive substance in proximity to the capsule and remaining tissue, to spare the capsule and proximate nerves and vessels to treat tissue in proximity to the capsule. The elongate tubular member may comprise a channel such as a lumen to pass a bodily fluid such as urine when the expandable support engages the tissue to treat the patient for a plurality of days. The treatment apparatus can be used to resect and diagnose tissue concurrently. Based on the diagnosis, targeted segmental treatment may be given.

A fluid injection device includes a fluid supply unit that accommodates and supplies fluid, a fluid injection unit that injects fluid supplied from the fluid supply unit, and a driving waveform generating device which is equipped with at least one adjusting device, a one-input multiple-control parameter changing unit that simultaneously changes plural control parameters for determining a fluid injection condition of the fluid injection unit on the basis of a signal from the at least one adjusting device, and a driving waveform generator that generates and outputs a driving waveform of the fluid injection unit on the basis of the control parameters set by the one-input multiple-control parameter changing unit.

A surgical treatment apparatus comprises a waterjet configured to fragment tissue and provide intact cells such as stem cells with the fragmented tissue. The intact cells can be used in one or more of many ways such as for genetic or other testing, and the intact cells can be identified as stem cells. In many embodiments, the intact cells comprise stem cells. In many embodiments, a waterjet is configured to fragment tissue. The fragmented tissue can be collected with a filter having pores sized smaller than the tissue fragments. In many embodiments cavitation with a waterjet is used to fragment the tissue comprising the intact stem cells. The waterjet may comprise a waterjet immersed in a liquid comprising water so as to form a plurality of shedding pulses. The plurality of shedding pulses can be generated with a frequency sufficient to fragment the tissue. The shedding pulses can generate cavitations that fragment the tissue.

An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.