Treatment instrument with movable handle and fixed handle includes biasing member for biasing the movable handle in an opening direction and an assist system with attraction force, e.g., magnetic force, to attract the movable handle in a closing direction toward the fixed handle. Range of movement of movable handle includes first movable range and second movable range. The second movable range occurs when a second gripping piece, e.g. a jaw, is in contact with respect to a first gripping piece, e.g., a vibration transmission member, and the movable handle is then further moved in a direction toward the fixed handle to a fully closed position. In the second movable range, attraction forces associated with the assist system are smaller than biasing force from the biasing member so that, upon release of a gripping force by an operator, the movable handle moves away from the fixed handle.

Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods includes evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions.

An electrosurgical device including an elongated body extending from a proximal portion to a distal portion and defining an internal passageway configured to convey tissue from the distal portion to the proximal portion; a coring electrode at the distal portion of the elongated body, where the coring electrode is positioned at an opening to the internal passageway, and where the coring electrode is configured to deliver electromagnetic energy to adjacent tissue to cut a volume of the tissue as the tissue is conveyed into the internal passageway; and a powered conveyance mechanism positioned within the internal passageway configured to further cut the volume of the tissue and convey the volume of the tissue proximally within the internal passageway.

Various embodiments provide an electrosurgical instrument for delivering electromagnetic (EM) energy and ultrasonic vibrations for treating biological tissue. The electrosurgical instrument comprises: an instrument shaft arranged to convey EM energy and an electrical signal for driving a magnetostrictive ultrasound transducer; a distal end assembly arranged at a distal end of the instrument shaft to receive the EM energy from the instrument shaft and deliver the EM energy from the distal end assembly for tissue treatment; and a magnetostrictive ultrasound transducer arranged to receive the electrical signal from the instrument shaft and generate ultrasonic vibrations around the distal end assembly for tissue treatment. Other embodiments provide an electrosurgical generator, and an electrosurgical apparatus comprising the instrument and generator.

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.

A treatment instrument includes a rotating body and a housing. The rotating body includes a connecting portion including: a supported portion having a cylindrical outer peripheral surface, and an engaged portion that is adjacent to the supported surface. The housing includes a supporting portion that is configured to support the supported portion of the rotating body, the supporting portion being rotatable around a predetermined rotation axis; and an engaging portion that is configured to generate a frictional force larger than a frictional force between the supporting portion and the supported portion by coming into contact with the engaged portion.

A tissue cutting probe includes an outer sleeve assembly, an inner sleeve assembly, a burr and an electrode. Each of the inner and outer sleeves has a proximal end, a distal end, and central passage extending therebetween. The inner sleeve assembly is coaxially and rotatably received in the central passage of the outer sleeve assembly, and the burr has a plurality of metal cutting edges carried on a first side of the distal end of the inner sleeve assembly. The electrode is carried a second side of the distal end of the inner sleeve assembly.

A method for ablating a patient, consisting of ascertaining a CHA.sub.2DS.sub.2-VASc score for the patient and inserting a probe into the patient, so as to contact a pulmonary vein of the patient. The method further includes applying energy via the probe so as to ablate the pulmonary vein until pulmonary vein isolation (PVI) is achieved. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is less than a preset value, ablation of the pulmonary vein is ceased. When PVI is achieved and the CHA.sub.2DS.sub.2-VASc score is greater than or equal to the preset value, energy is applied to perform a further ablation.

A probe is configured with a flushing port and an evacuation port to establish a flow path to remove blood from a resected tissue. The probe comprises a balloon configured to expand and contact the resected tissue to compress filaments and improve access to the underlying blood vessels for coagulation with an energy source. An endoscope can be used to view the tissue, and the balloon may comprise a transparent material or a viewing port to allow imaging of the bleeding tissue through the balloon. The probe may have a light source to illuminate the tissue with a beam oriented at an oblique angle to the tissue surface, which can decrease interference from blood and may allow more localized coagulation of the blood vessel.

Described herein are elongate applicator tools adapted to be inserted into a body to deliver high voltage, sub-microsecond electrical energy to target tissue. These tools may be configured as laparoscopes, endoscopes, and/or catheters. Also disclosed herein systems including these tools and method of their operation.