Various exemplary methods and devices (10, 110, 210) for delivering liquid therapeutic agents in solid tumors are provided. In general, a delivery device configured to deliver a liquid therapeutic agent into a solid tumor or other soft tissue can be configured to compress tissue and seal any fluid gaps around the delivery device during the delivery of the liquid therapeutic agent. In an exemplary embodiment the delivery device includes three elongate tubular shafts (12, 14, 16, 112, 114, 116, 212, 214, 216) configured to move longitudinally relative to one another. The elongate tubular shafts are configured to cooperate with one another to deliver the liquid therapeutic agent through a passageway of the delivery device to the solid tumor or other soft tissue and seal any fluid gaps around the delivery device while the liquid therapeutic agent is delivered into the solid tumor or other soft tissue.

An image processing apparatus includes a processor including hardware, the processor being configured to: estimate, based on image information from a medical device that includes at least an endoscope, a plurality of procedure actions of an operator of the endoscope; perform different supports respectively for procedures by the operator, according to an estimation result of the procedure actions; and output a display for the supports to a display.

A surgical instrument includes a housing (20), a syringe carriage (40), a movable handle (25), a shaft (30), a needle sheath (50), and a needle (60). The syringe carriage is operably coupled to the housing and configured to couple to a syringe. The movable handle is movable relative to the housing and operably coupled to the syringe carriage to distally advance the syringe carriage. The shaft extends distally from the housing and defines a lumen. The needle sheath extends through the lumen of the shaft, defines a lumen, and is movable relative to the shaft between an extended condition and a retracted condition. The needle extends through the lumen of the needle sheath and is configured to operably couple to a syringe coupled to the syringe carriage.

In some embodiments, disclosed herein are systems and methods of treating a patient that can include the steps of accessing the sphenopalatine fossa, and cannulating the inferior orbital fissure from the sphenopalatine fossa to access the retro-orbital space. The sphenopalatine fossa can be accessed via various routes, including percutaneously. Accessing the sphenopalatine fossa can include the step of inserting a needle-catheter system into the sphenopalatine fossa. Integrated needle-catheter systems as described herein can also be configured to access the trigeminal ganglion, epidural space, intrathecal space, and other desired anatomical locations.

Certain aspects of the present disclosure provide methods and apparatus for measuring an injection catheter needle insertion depth and/or injection solution efficacy. An example injection catheter may include a catheter tube and a retractable, electrically conductive needle disposed in the catheter tube and configured to extend from the catheter tube. The injection catheter may also include one or more electrodes disposed at a distal portion of the catheter tube, an electrical lead coupled to the needle, and electrical leads coupled to the electrode(s). An example method includes deploying such an injection catheter adjacent to the tissue, extending a needle into the tissue, receiving electrical signals from an electrical lead coupled to the needle and from other electrical leads coupled to the electrode(s), determining a bioelectrical parameter based on the received electrical signals, and determining a depth of the needle inserted into the tissue based on the bioelectrical parameter.

An electrosurgical apparatus for treating fluid-filled biological growths by replacing the fluid within the growth with a substance that assists in delivering treatment energy. The treatment energy may be microwave energy or may be thermal energy derived from microwave energy. The apparatus comprises an instrument having a radiating tip portion, and a fluid delivery mechanism for transporting fluid to and from a treatment zone located around the radiating tip portion. The fluid delivery mechanism comprises a rigid insertion element arranged to extend into the treatment zone, whereby fluid can be aspirated from the treatment zone, and a substance injected into the treatment zone to replace the aspirated fluid. The injected substance has dielectric properties selected to facilitate uniform delivery of treatment energy to biological tissue in the treatment zone.

Medical devices and methods for delivering fluid. The medical devices include one or more needles for delivering fluid. The methods may optionally include expanding an expandable member such as an inflatable member to expand an expandable scaffold outward toward a lumen wall. The devices may include one or both of one or more spine securing members or one or more needle alignment members.

A method of delivering a therapeutic agent to a nucleus pulposus of an intervertebral disc is provided. The method comprises inserting a delivery tool containing the therapeutic agent through an anterior portion, a lateral portion, or an anterolateral portion of an annulus fibrosus and into the nucleus pulposus of the intervertebral disc; and delivering the therapeutic agent to the nucleus pulposus of the intervertebral disc. Devices and kits are also provided.

Medical devices and methods for delivering fluid. The medical devices include one or more needles for delivering fluid. The methods may optionally include expanding an expandable member such as an inflatable member to expand an expandable scaffold outward toward a lumen wall. The methods may include delivering a first fluid out of one or more needles, and delivering a secondary fluid (which may be the same type of fluid as the first fluid, or a different type of fluid) from the device without delivering the secondary fluid through a needle.

Devices for transferring fluid to or from a subject include an elongate tubular cannula having opposing proximal and distal ends with an axially extending lumen. The devices also include an elongate needle having opposing proximal and distal ends. The elongate needle is configured so that the distal end of the needle extends out of the distal end of the cannula a suitable adjustable distance. The devices also include a housing with a length adjustment mechanism that adjusts a length between the tip of the needle and the distal end of the tubular cannula.