An electrosurgical wand for reducing tissue is disclosed. The wand includes a handle and an elongate shaft, the shaft having a major longitudinal axis, a conduit extending therethrough and a non-insulated distal end portion defining a first electrode. The first electrode has a distal most edge configured to mechanically pierce tissue, and an arcuate surface extending proximally from the distal most edge along the major longitudinal axis, the arcuate surface having a convex surface that faces in a distal direction. First and second arcuate edges define lateral edges of the arcuate surface. A second electrode is disposed at an opening of the conduit and electrically isolated from the first electrode. The second electrode comprises an aperture, configured to aspirate fluid and tissue debris therethrough.

The present invention is directed to an endoscopic implant cutting and/or fragmenting apparatus of the bipolar type, operating on direct current, comprising an endoscope instrument having at least two opposing electrodes at its distal instrument head forming a cutting gap inbetween for receiving an electrically conductive implant or implant section to generate punctiform physical contact with the implant, and a DC-impulse generator having or connected to a control device adapted to generate a direct current in a pulsed way being controlled by the control device such that in a first phase of physical contact, the current pulse is adjusted preferably by controlling the current value at the electrodes to induce electric energy into the implant material being sufficient to melt the implant material exclusively in the area of the contact portion and in a second phase of physical noncontact, the current pulse is adjusted preferably by controlling the voltage value at the electrodes to generate an electric arc between at least one electrode and the melted implant material being sufficient to cut the melted implant material.

A catheter system for treating a treatment site within or adjacent to a vessel wall or a heart valve includes an energy source, a balloon, an energy guide, and an electrical analyzer assembly. The energy source generates energy. The balloon is positionable substantially adjacent to the treatment site. The balloon has a balloon wall that defines a balloon interior that receives a balloon fluid. The energy guide is configured to receive energy from the energy source and guide the energy into the balloon interior. The electrical analyzer assembly is configured to monitor a balloon condition during use of the catheter system. The electrical analyzer assembly can include a first electrode, a second electrode, and an impedance detector that is electrically coupled to the first electrode and the second electrode. The impedance detector is configured to detect impedance between the first electrode and the second electrode.

An electrosurgical device including the disclosure describes an electrosurgical device including an elongated body having a tubular section extending from a proximal end to a distal end and defining an evacuation channel configured to evacuate tissue from the distal end to the proximal end, a curette at the distal end of the tubular section, wherein the curette defines a perimeter cutting edge that forms a distal opening to the evacuation channel, a plasma cutting electrode defined by the perimeter cutting edge of the curette, where the plasma cutting 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 portion of the curette, the dielectric coating electrically insulating the curette from target tissue and the volume of cut target tissue, wherein the dielectric coating comprises a ceramic material.

An electrosurgical generator includes a processor and a memory storing instructions executable by the processor. The instructions when executed, cause the generator to provide an indicated treatment energy to the instrument, where the indicated treatment energy is set by a user and having a corresponding current limit, receive signals from the instrument over time relating to a load impedance between the active electrode and the return electrode of the instrument, determine based on the signals that the active electrode and the return electrode are currently shorted together, and prior to the short, the instrument was grasping tissue between the active electrode and the return electrode, and based on the determination, reduce a current limit of treatment energy being provided to the instrument to below the corresponding current limit.

A catheter system for treating a treatment site within or adjacent to a vessel wall within a body of a patient includes an energy source, a balloon, and an energy guide. The energy source generates energy. The balloon includes a balloon wall that defines a balloon interior. The balloon is configured to retain a balloon fluid within the balloon interior. The balloon is selectively inflatable with the balloon fluid to expand to an inflated state, wherein when the balloon is in the inflated state the balloon wall is configured to be positioned substantially adjacent to the treatment site. The balloon further includes a balloon central axis that extends through a geometric center of the balloon when the balloon is in the inflated state. The energy guide selectively receives energy from the energy source and guides the energy from the energy source into the balloon interior. The energy guide including a guide distal end that is positioned on the balloon central axis when the balloon is in the inflated state.

An apparatus (14) for supplying a medical instrument (15) for the treatment of biological tissue (11) due to the action of a plasma (28) is disposed, in accordance with the invention, in a special manner for the ignition and the stable development of a plasma (28) on the electrode (27) of the instrument (15). To accomplish this, the apparatus (14) comprises a control device (23) that, during an ignition test, limits—preferably in an instrument-specific manner—the current deliverable to the instrument (15) and/or limits the electrical power to be output to the instrument (15), and/or, in doing so, works with a reduced operating voltage. With this measure, a rapid, stable plasma development with minimal spark play is achieved with a large variety of connectable instruments (15a-15e).

The plasma sensor monitors parameters characterizing the condition of the plasma during the treatment phase and/or the change thereof in order to recognize a prefiguring or already occurred interruption of the plasma in this manner and to avoid this interruption and, in the ideal case, avoid this by already changing the voltage form previously. The mentioned mechanisms can be used by the control device (22) also during a pulse packet. The length of each pulse packet is adapted at each change of the voltage form according to their characteristics in order to guarantee a constant average power.

A catheter system (100) used for treating a treatment site (106) within or adjacent to the heart valve (108) includes an energy source (124), an energy guide (122A), and a balloon assembly (104). The energy source (124) generates energy. The energy guide (122A) is configured to receive energy from the energy source (124). The balloon assembly (104) is positionable substantially adjacent to the treatment site (106). The balloon assembly (104) includes an outer balloon (104B) and an inner balloon (104A) that is positioned substantially within the outer balloon (104B). Each of the balloons (104A, 104B) has a balloon wall (130) that defines a balloon interior (146). Each of the balloons (104A, 104B) is configured to retain a balloon fluid (132) within the balloon interior (146). The balloon wall (130) of the inner balloon (104A) is positioned spaced apart from the balloon wall (130) of the outer balloon (104B) to define an interstitial space (146A) therebetween. A portion of the energy guide (122A) that receives the energy from the energy source (124) is positioned within the interstitial space (146A) between the balloons (104A, 104B) so that a plasma-induced bubble (134) is formed in the balloon fluid (132) within the interstitial space (146A).

A tissue cutting device has an outer sleeve with a distal window and an inner cutting sleeve which moves past the window to cut tissue. The inner cutting sleeve has a lumen which may have a larger proximal diameter than distal diameter. A perimeter of the window may comprise a dielectric material. A distal edge of the inner sleeve may be displaced inwardly.