2278results about "Surgical instruments for cooling" patented technology

Devices, systems and methods are disclosed for the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be constrained within the lumen of a catheter, and deployed to take on an expanded condition. The carrier assembly includes multiple electrodes that are configured to ablate tissue at low power. Systems include an interface unit with a visual display that provides a visual representation of the geometry of the ablation elements and / or provides selection means for selecting an icon provided on the display.

A surgical tool system includes an electrosurgical tool for sealing and transecting tissue and a tactile feedback system integrated onto a handle of the tool that generates relevant feedback in at least the form of haptic effects to the user. The tactile feedback alerts the user of tissue properties, i.e., when tissue located within jaws of the tool is completely sealed, when the tissue is ready to be cut, the cutting rate or speed, the quantity of tissue located within jaws of the tool, and whether a blood vessel is fully located within jaws of tool. In addition, the tactile feedback alerts the user to the operating status of energy application during the procedure.

The invention relates to a device and related method for sealing and / or dissecting body tissue using a reverse action instrument. The devices and methods described permit laparoscopic or natural body orifice access to an anatomical space and facilitate sealing portions of tissue together, dissecting tissue or combinations thereof. A surgical instrument for sealing and dissecting body tissue is described having distal and proximal ends with an elongated body. The body includes a jaw member positioned at the distal end that is defined by a stationary arm and a pivotable arm. A moveable closure sleeve is disposed at least partially about the body and the closure sleeve is configured such that coaxial movement of the sleeve along the longitudinal axis of the body causes the jaw member to open or close.

Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and / or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air / gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities / nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

Devices, systems and methods for performing image guided interventional and surgical procedures, including various procedures to treat sinusitis and other disorders of the paranasal sinuses, ears, nose or throat.

An electrophysiology catheter and method of use for mapping and ablation procedures. The catheter includes a braided conductive member at its distal end that can be radially expanded. The catheter can be used in endocardial and epicardial mapping and ablation procedures.

Post-angioplasty hyperplasia in blood vessels is treated using a cryosurgical balloon catheter. The balloon catheter is positioned at a target region within the blood vessel, and the balloon inflated by expanding a cryogenic fluid, such as liquid nitrogen, across an expansion orifice into a balloon. The balloon will be constructed so that cooling is achieved primarily in the central regions of the balloon, with the proximal and distal regions being less cold and acting to insulate adjacent regions of the blood vessel from excessive cooling.

A thermal energy controller system useful in medical procedures includes a controller coupled to a probe, and a thermal element to vary probe temperature. The controller includes memory storing a non-continuous algorithm that permits user-selectable settings for various probe types such that controller operation is self-modifying in response to the selected probe setting. Probe output power Pout is constant in one mode to rapidly enable probe temperature to come within a threshold of a target temperature. The controller can then vary Pout dynamically using a proportional-integral-derivative (PID) algorithm Pout=Kp·P+Ki·I+Kd·D, where feedback loop coefficients Kp, Ki, Kd can vary dynamically depending upon magnitude of an error function e(t) representing the difference between a user-set desired target temperature and sensed probe temperature. Advantageously, target temperature can be rapidly attained without overshoot, allowing the probe system to be especially effective in arthroscopic tissue treatment.

A system and method for discriminating tissue types, controlling the level of therapy to tissue, and determining the health or a known tissue by measuring the characteristics an electrical signal applied to conductive element located within or by the tissue. Additionally, the system and method may be used for determining whether the conductive tip of a pedicle probe or pedicle screw is located in one of cortical bone, cancellous bone, and cortical bone near a boundary with soft tissue, whether the conductive tip of a cannula is located adjacent to one of nerve tissue and annulus tissue, and whether the conductive tip of a cathode is located adjacent to one of nerve tissue and prostate gland tissue.

An apparatus for cooling a skin surface includes an RF device that has an RF electrode with dielectric and conductive portions. The RF device is configured to be coupled to an RF energy source. A cooling member is coupled to the RF device. A memory is coupled to the RF device. The memory is configured to store information to facilitate operation of at least one of the RF electrode, the cooling member, and the RF energy source.

Devices, systems and methods are disclosed for the mapping of electrical signals and the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be transformed from a compact, linear configuration to a helical configuration, such as to map and ablate pulmonary vein ostia.

Described herein are methods and systems for precisely placing and / or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and / or manipulated within the body. Devices to modify tissue may also be positioned or manipulated so that a target tissue within the body is modified.

The present invention provides devices and methods for decalcifying an aortic valve. The methods and devices of the present invention break up or obliterate calcific deposits in and around the aortic valve through application or removal of heat energy from the calcific deposits.

Methods, systems, and kits for treating breast tissue rely on transferring energy to or from cells lining an individual breast duct. Energy can be introduced into the breast duct, e.g., by filling the duct with an electrically conductive medium and applying radiofrequency energy to the medium. Other energy forms could also be used, such as light, ultrasound, radiation, microwave energy, heat, cold, direct current, and the like. By treating individual breast ducts, cancerous and pre-cancerous conditions originating in the duct can be effectively treated.

System, devices and methods are presented that integrate stretchable or flexible circuitry, including arrays of active devices for enhanced sensing, diagnostic, and therapeutic capabilities. The invention enables conformal sensing contact with tissues of interest, such as the inner wall of a lumen, a the brain, or the surface of the heart. Such direct, conformal contact increases accuracy of measurement and delivery of therapy. Further, the invention enables the incorporation of both sensing and therapeutic devices on the same substrate allowing for faster treatment of diseased tissue and fewer devices to perform the same procedure.

Techniques and devices for treating atherosclerotic disease use controlled cryogenic cooling, often in combination with angioplasty and / or stenting. A combination cryogenic / angioplasty catheter may cool the diseased blood vessel before, during, and / or after dilation. Controlled cooling of the vessel wall reduces actual / observed hyperplasia as compared to conventional uncooled angioplasty. Similar reductions in restenosis may be provided for other primary treatments of the blood vessel, including directional arthrectomy, rotational arthrectomy, laser angioplasty, stenting, and the like. Cooling of vessel wall tissues will often be performed through plaque, and the cooling process will preferably take the thermodynamic effects of the plaque into account.

Apparatus and method for ablating target tissue including a non-linear area of tissue in the left atrium of a patient. The method can include selecting an ablation apparatus having an ablator with a tissue engagement section, penetrating a chest cavity of the patient, and identifying the target tissue. The method can also include positioning the ablation apparatus adjacent to the target tissue so that the tissue engagement section can transfer ablation energy to the target tissue. The method can further include energizing the tissue engagement section with ablation energy in order to create a footprint on the non-linear area of tissue in the left atrium and to reduce an overall mass of excitable tissue in the left atrium.

The invention provides a method and system for treating disorders in parts of the body. A particular treatment can include on or more of, or some combination of: ablation, nerve modulation, three-dimensional tissue shaping, drug delivery, mapping stimulating, shrinking and reducing strain on structures by altering the geometry thereof and providing bulk to particularly defined regions. The particular body structures or tissues can include one or more of or some combination of region, including: the bladder, esophagus, vagina, penis, larynx, pharynx, aortic arch, abdominal aorta, thoracic, aorta, large intestine, sinus, auditory canal, uterus, vas deferens, trachea, and all associated sphincters. Types of energy that can be applied include radiofrequency, laser, microwave, infrared waves, ultrasound, or some combination thereof. Types of substances that can be applied include pharmaceutical agents such as analgesics, antibiotics, and anti-inflammatory drugs, bulking agents such as biologically non-reactive particles, cooling fluids, or dessicants such as liquid nitrogen for use in cryo-based treatments.

An apparatus for cooling a skin surface includes a support structure coupled to an electromagnetic energy delivery device. The electromagnetic energy delivery device is configured to be coupled to an electromagnetic energy source. A cooling member is coupled to the electromagnetic energy delivery device and is configured to create a reverse thermal gradient through a skin surface. A memory is coupled to the electromagnetic energy delivery device and is positioned at the support structure or the electromagnetic energy delivery device. The memory is configured to store information to facilitate operation of at least one of the cooling member, and the electromagnetic energy source. Resources are coupled to the cooling member to permit different levels of cooling at different times of treatment.

Methods of ablating tissue in an alimentary tract are provided. The methods include advancing an ablation structure into an alimentary tract while supporting the ablation structure with an endoscope. The methods further include a step of moving at least part of the ablation structure with respect to the endoscope and toward a tissue surface, before activating the ablation structure to ablate a tissue surface.

Devices, systems and methods are disclosed for the mapping of electrical signals and the ablation of tissue. Embodiments include an ablation catheter that has an array of ablation elements attached to a deployable carrier assembly. The carrier assembly can be transformed from a compact, linear configuration to a helical configuration, such as to map and ablate pulmonary vein ostia.

Devices and methods for performing cryo therapy, cryo ablation or cryoplasty. A cryo therapy apparatus may comprise an elongate shaft, a cooling member disposed at the distal end of the shaft, and a pressure gauge coupled to the cooling member.

A device for diagnosis and treatment of tumors and lesions within the body. A cannula adapted to apply suction through the lumen of the catheter to the tumor or lesion is described. The lumen has a self sealing valve through which a cryoprobe is inserted while the suction is being applied. The cryoprobe is then inserted into the lesion, and operated to ablate the lesion.

A method for treating the lung during an acute episode of reversible chronic obstructive pulmonary disease such as an asthma attack. The method comprises transferring energy to an airway wall of an airway such that a diameter of the airway is increased. The energy may be transferred to the airway wall prior to, during or after an asthma attack. The energy may be transferred in an amount sufficient to temporarily or permanently increase the diameter of the airway. The method may be performed while the airway is open, closed or partially closed.

Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

A medical balloon catheter assembly includes a balloon having a permeable region and a non-permeable region. The balloon is constructed at least in part from a fluid permeable tube such that the permeable region is formed from a porous material which allows a volume of pressurized fluid to pass from within a chamber formed by the balloon and into the permeable region sufficiently such that the fluid may be ablatively coupled to tissue engaged by the permeable region. The non-permeable region is adapted to substantially block the pressurized fluid from passing from within the chamber and outwardly from the balloon. The porous material may be a porous fluoropolymer, such as porous polytetrafluoroethylene, and the pores may be created by voids that are inherently formed between an interlocking node-fibril network that makes up the fluoropolymer. Such voids may be created according to one mode by expanding the fluoropolymer. The balloon may be formed such that the porous material extends along both the permeable and non-permeable regions. In one mode of this construction, the porous material is porous along the permeable region but is non-porous along the non-permeable region, such as for example by expanding only the permeable region in order to render sufficient voids in the node-fibril network to provide permeable pores in that section. The voids or pores in the porous material may also be provided along both permeable and non-permeable sections but are substantially blocked with an insulator material along the non-permeable section in order to prevent fluid from passing therethrough. The insulator material may be dip coated, deposited, or extruded with the porous material in order to fill the voids. The insulator material may in one mode be provided along the entire working length of the balloon and then selectively removed along the permeable section, or may be selectively exposed to only the non-permeable sections in order to fill the voids or pores there.

A tissue ablation probe, system, and method are provided. The ablation probe comprises an elongated member, an ablative element mounted on the distal end of the elongated member, and at least one thermoelectric device mounted to the member in thermal communication with the ablative element. The system may include the ablation probe, thermal control circuitry for controlling the thermal effect of the thermoelectric device, and an ablation source for suppying ablation energy to the ablative element. A plurality of circumferentially distributed thermoelectric devices can be provided, so that radial tissue sectors can be selectively affected by independently controlling the thermal effect of the thermoelectric devices. In one embodiment, the thermoelectric device(s) can be used to cool a heat ablative element. In another embodiment, the thermoelectric device(s) can be used to heat an ablative element, thereby forming a heat ablative element. In still another embodiment, the thermoelectric device(s) can be used to cryogenically cool an ablative element, thereby forming a cryogenic ablative element.

A cryocatheter for introduction into a body vessel or into an organ, with a catheter inner surrounded by a catheter sheath, and with a catheter tip arranged at its distal end, with a feed line for an expansion or cooling agent arranged in the catheter sheath or the catheter inner, and with a balloon, arranged close to the catheter tip, which can be expanded and contracted again by means of the expansion and cooling agent, is to be constructed in such a way that by simple manipulation it can be positioned at a precise target position in the body vessel and, in addition, it minimizes the burden on the patient from invasive interventions. For this purpose, in accordance with the invention an image capture device, with at least one imaging sensor for mapping the region of the vessel around the balloon, is positioned in the region of the catheter tip.

Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

Apparatus for drug administration is provided, including an ingestible capsule, which includes a drug, stored by the capsule, and an environmentally-sensitive mechanism, adapted to change a state thereof responsively to a disposition of the capsule within a gastrointestinal (GI) tract of a subject. The capsule further includes first and second electrodes, and a control component, adapted to facilitate passage of the drug, in response to a change of state of the environmentally-sensitive mechanism, through an epithelial layer of the GI tract by driving the first and second electrodes to apply a series of pulses at a current of less than about 5 mA, at a frequency of between about 12 Hz and about 24 Hz, and with a pulse duration of between about 0.5 milliseconds and about 3 milliseconds.