The cooling system cools a patient's tissue while applying suction to the skin and applying ultrasound waves to the tissue to reduce fat cells. The cooling applicator simultaneously provides suction, cooling, and ultrasound to the treatment area of the patient. The applicator connects to a suction to draw the tissue longitudinally into a cavity of the applicator. Cooling plates located laterally outward from the cavity cool the tissue during the treatment. A transducer located longitudinally above the cavity transmits ultrasound waves longitudinally downward into the cavity and the tissue. The ultrasound provides non-focused treatment such that the transducer transmits the ultrasound waves oriented horizontally and vertically longitudinally downward at the tissue. A treatment pad placed on the patient's skin directly contacts the patient such that the applicator does not directly contact the patient. The treatment pad is constructed from a fabric storing a glycerin gel, deionized water, and fructose.

A thermal control unit for controlling a patient's temperature includes a fluid outlet for delivering temperature-controlled fluid to a patient, a pump, a heat exchanger, and a controller that automatically pauses thermal treatment of the patient prior the patient reaching a target temperature. During the pause, the controller assesses a reaction of the patient and changes a temperature of the fluid only inside the thermal control unit if the patient is likely to reach the target temperature without further thermal treatment. However, if the patient is unlikely to reach the target temperature without further thermal treatment, the controller restarts the thermal treatment. The controller may pause thermal treatment again prior to reaching the target temperature and assess the patient's reaction. In some embodiments, the controller may selectively include and exclude a fluid reservoir in a circulation channel within the thermal control unit.

An intra-cardiac mapping system is based on locating the ports through which blood flows in or out the heart chambers. For many procedures, such as ablation to cure atrial fibrillation, locating the pulmonary veins and the mitral valve accurately allows to perform a Maze procedure. The location of the ports and valves is based on using the convective cooling effect of the blood flow. The mapping can be performed by a catheter-deployed expandable net or a scanning catheter. The same net or catheter can also perform the ablation procedure.

A system for laparoscopic thermal treatment of visceral fat includes an elongate cooling probe configured for placement through a trocar, the probe including an elongate shaft having a proximal end and a distal end and having a maximum transverse dimension, and an expandable endpiece having a proximal end and a distal end, and including a collapsed state configured for placement through a channel of the trocar and an expanded state, the expanded state having a maximum outer diameter, the maximum outer diameter at least about twice the maximum transverse dimension of the shaft, wherein the proximal end of the endpiece is sealingly coupled to the distal end of the shaft, and a heat exchanger coupled to the cooling probe and configured to remove heat from the endpiece such that adipose tissue placed in contact with the endpiece can be cooled to a temperature of between about 2° C. and about .sup.+1° C.

An electrosurgical apparatus and method for performing thermal treatment in the gastrointestinal tract, e.g. to ablate duodenal mucosal tissue. The apparatus comprises an instrument having a flexible cable and an applicator suitable for use with a gastroscope, which can be deployed within a patient to delivery energy in a targeted or otherwise controllable manner. The applicator can deliver microwave energy by radiation. The direct and depth-limited nature of microwave energy can be make it more effective than treatments that rely on thermal conduction. The applicator may include a radially extendable portion arranged to move an microwave energy delivery structure into contact with duodenal mucosal tissue at the treatment region. The applicator may comprise any of a balloon, bipolar radiator, movable paddle, and rotatable roller element.

A device for therapeutic neuromodulation in a nasal region can include, for example, a shaft and a therapeutic element at a distal portion of the shaft. The shaft can locate the distal portion intraluminally at a target site inferior to a patient's sphenopalatine foramen. The therapeutic element can include an energy delivery element configured to therapeutically modulate postganglionic parasympathetic nerves at microforamina of a palatine bone of the human patient for the treatment of rhinitis or other indications. In other embodiments, the therapeutic element can be configured to therapeutically modulate nerves that innervate the frontal, ethmoidal, sphenoidal, and maxillary sinuses for the treatment of chronic sinusitis.

Treatment systems, methods, and apparatuses for improving the appearance of skin or other target regions are described. Aspects of the technology are directed to improving the appearance of skin by tightening the skin, improving skin tone or texture, eliminating or reducing wrinkles, increasing skin smoothness, or improving the appearance sites with cellulite. Treatments can include cooling a surface of a patient's skin and detecting freezing in the cooled skin. The tissue can be cooled after the freeze event is detected so to maintain the frozen state of the tissue to improve the appearance of the treatment site.

Cosmetic method and apparatus are provided that can provide cooling and/or freezing of skin tissue proximal to the skin surface to generate an appearance of lightening or reduced pigmentation in the skin. The skin can be cooled to a temperature of less than about −5 degrees Celsius for a duration of about one minute or less, using a cooled surface that is at least 3 cm in width. A cooling arrangement can be provided to provide controlled heat removal from the skin tissue being treated. A sensor can optionally be provided to detect freezing of tissue proximal to the cooled surface.

A medical device, including: a cooling system; a heating system; and an applicator including a cold base operationally coupled to the cooling system and a heating element operationally coupled to the heating system, and an applicator head collocated with the cold base and the heating element and adapted for applying a combination of heat and cold to a target area such as target tissue.

An electrosurgical apparatus and method for performing thermal treatment in the gastrointestinal tract, e.g. to ablate duodenal mucosal tissue. The apparatus comprises an instrument having a flexible cable and an applicator suitable for use with a gastroscope, which can be deployed within a patient to delivery energy in a targeted or otherwise controllable manner. The applicator can deliver microwave energy by radiation. The direct and depth-limited nature of microwave energy can be make it more effective than treatments that rely on thermal conduction. The applicator may include a radially extendable portion arranged to move an microwave energy delivery structure into contact with duodenal mucosal tissue at the treatment region. The applicator may comprise any of a balloon, bipolar radiator, movable paddle, and rotatable roller element.