Certain aspects relate to systems, devices and techniques for vessel sealing and cutting. In particular, an instrument is provided that is capable of performing multiple functions, including sealing and cutting. The instrument can be robotically controlled, and can include a shaft, a multi-DOF wrist, and an end effector. The end effector is capable of generating and delivering heat via different energy modalities to perform the various functions at different temperatures.

An electrosurgical instrument comprising an end effector is disclosed. The end effector comprises a first jaw and a second jaw. At least one of the first jaw and the second jaw is movable to transition the end effector from an open configuration to a closed configuration to grasp tissue therebetween. The second jaw comprises linear portions cooperating to form an angular profile and a treatment surface comprising segments extending along the angular profile. The segments comprise different geometries and different conductivities. The segments are configured to produce variable energy densities along the treatment surface.

Provided is a flex-PCB catheter device that is configured to be inserted into a body lumen. The flex-PCB catheter comprises an elongate shaft, an expandable assembly, a flexible printed circuit board (flex-PCB) substrate, a plurality of electronic components and a plurality of communication paths. The elongate shaft comprises a proximal end and a distal end. The expandable assembly is configured to transition from a radially compact state to a radially expanded state. The plurality of electronic elements are coupled to the flex-PCB substrate and are configured to receive and/or transmit an electric signal. The plurality of communication paths are positioned on and/or within the flex-PCB substrate. The communication paths selectively couple the plurality of electronic elements to a plurality of electrical contacts configured to electrically connect to an electronic module configured to process the electrical signal. The flex-PCB substrate can have multiple layers, including one or more metallic layers. Acoustic matching elements and conductive traces can be includes in the flex-PCB substrate.

A treatment instrument includes: a sheath; and an end effector that is provided at a distal end of the sheath. The end effector is capable of gripping a living tissue and applying high frequency energy to the living tissue. The end effector includes a treatment surface, and a pair of electrodes that can grip the living tissue and apply the high frequency energy to the living tissue. The treatment surface includes a distal end area that is provided on a distal end side of the treatment surface, and another area that is provided on a proximal end side of the treatment surface. The distal end area applies, to the living tissue, high frequency energy that is higher than high frequency energy applied by the other area. One of the pair of electrodes includes a distal end portion and a proximal end portion.

A plasma probe comprises a hose with a conductor arranged therein that supports an electrode at least at its distal end. The electrode is either directly secured on the conductor or the conductor is provided with a plastic sheathing at least at its distal end by means of which the electrode is held. The electrode can be inserted between the conductor and the plastic sheathing and can be clamped in this manner. After first use the plastic sheathing can be fused to the electrode. The conductor is placed with clearance inside a channel or hollow space of electrode, however, whereby also in case of spot-like contact between the conductor and the electrode due to the gap provided between them apart therefrom the heat transmission from the electrode on the conductor is impeded and thereby the heat introduction in the plasma probe is limited.

A surgical instrument that includes a surgical end effector that is articulatable relative to a proximal shaft segment of the surgical instrument. The surgical end effector is attached to the proximal shaft segment by an articulation joint that comprises a plurality of movably interconnected links that interface with a centrally disposed drive member to apply articulation motions thereto and which serve to provide improved lateral stability to the articulation joint.

A partially-masked electrode includes a conductive material and an insulated coating having an outer surface. The insulated coating defines a contoured opening that exposes or reveals an area of the conductive material, wherein the contoured opening has an upper perimeter at the outer surface of the insulated coating. When the upper perimeter of the insulated surface coating is placed in contact with a tissue of interest, wherein the tissue of interest is proximate a blood pool, the insulated coating creates a seal between the blood pool and the contoured opening so that no blood in the blood pool can contact the conductive material. This seal reduces or eliminates the reception of far field effects in the blood pool by the electrode, making it easier to locate and diagnose unhealthy tissue.

An apparatus includes a tube, a tip electrode coupled to a distal end of the tube and shaped to define at least one cavity, a microelectrode disposed within the cavity and including an outer surface that is of lesser convexity than that of a portion of the tip electrode surrounding the cavity, and a conductive polymeric coating that coats the outer surface. Other examples are also described.

An electrosurgical device including an elongated body extending from a proximal end to a distal end and defining an evacuation lumen. The elongated body including an irrigation channel carried by the elongate body, the irrigation channel configured to deliver a fluid to a target tissue adjacent to the distal end, a coring electrode at the distal end of the elongated body, where the coring electrode defines an opening to the evacuation lumen, and where the coring electrode is configured to operate in a monopolar configuration to deliver radio frequency (RF) plasma energy to adjacent tissue to cut a volume of the target tissue, and a dielectric coating on at least a distal portion of the elongated body, the dielectric coating electrically insulating the elongated body from target tissue and the volume of cut target tissue, where the dielectric coating comprises a ceramic material.

An apparatus includes a shaft assembly, first and second electrode assemblies, and a controller. The shaft assembly is configured to fit in a nasal cavity of a patient. The first and second electrode assemblies are at the distal end of the shaft assembly. The second electrode assembly includes a stimulus electrode and a sensing electrode. The stimulus and sensing electrodes are positioned on opposing lateral sides in relation to the longitudinal axis of the shaft assembly. The controller is operable to generate an electrical signal to perform one or both of tissue ablation or denervation of a targeted nerve via the first electrode assembly, generate an electrical stimulus signal to stimulate the targeted nerve via the stimulus electrode of the second electrode assembly, and process a response signal received from the targeted nerve via the sensing electrode of the second electrode assembly.