A new method for the ablation of undesirable tissue such as cells of a cancerous or non-cancerous tumor is disclosed. It involves the placement of electrodes into or near the vicinity of the undesirable tissue through the application of electrical pulses causing irreversible electroporation of the cells throughout the entire area of the undesirable tissue. The electric pulses irreversibly permeate the cell membranes, thereby invoking cell death. The irreversibly permeabilized cells are left in situ and are removed by the body immune system. The amount of tissue ablation achievable through the use of irreversible electroporation without inducing thermal damage is considerable.

Tissue ablation with irreversible electroporation

A closed-loop control system is disclosed for use with an electrosurgical generator that generates electrosurgical energy. The closed loop control system includes a user interface for allowing a user to select at least one pre-surgical parameter, such as the type of surgical instrument operatively connected to the generator, the type of tissue and the desired surgical effect. A sensor module is also included for continually sensing at least one of electrical and physical properties proximate a surgical site and generating at least one signal relating thereto. The system also includes a control module for continually receiving the at least one selected pre-surgical parameter from the user interface and each of the signals from the sensor module, and processing each of the signals in accordance with the at least one pre-surgical parameter using at least one of a microprocessor, computer algorithm and a mapping. The control module generates at least one corresponding control signal relating to each signal from the sensor module, and relays the control signal to the electrosurgical generator for controlling the same. A method is also disclosed for performing an electrosurgical procedure at a surgical site on a patient. The method includes the steps of: applying at least one electrical pulse to the surgical site; continually sensing electrical and physical properties proximate the surgical site; and varying pulse parameters of individual pulses of the at least one pulse in accordance with the continually-sensed properties.

Method and system for controlling output of RF medical generator

A control circuit of a surgical device is disclosed. The control circuit includes a first circuit portion coupled to at least one switch operable between an open state and a closed state. The first circuit portion communicates with a surgical generator over a conductor pair to receive a control signal to determine a state of the at least one switch.

Surgical generator for ultrasonic and electrosurgical devices

A surgical instrument. The surgical instrument may comprise a transducer and an end effector. The transducer may be configured to provide vibrations along a longitudinal axis at a predetermined frequency and may comprise a piezoelectric stack positioned along the longitudinal axis. The transducer also may comprise a first metallic end mass positioned along the longitudinal axis adjacent a first end of the piezoelectric stack and a second metallic end mass positioned along the longitudinal axis adjacent a second end of the piezoelectric stack. The length of the transducer may be greater than or equal to of one wavelength and less than ½ of one wavelength. The end effector may be coupled to the transducer and may extend along the longitudinal axis. The length of the transducer and the end effector may be a multiple of ½ of one wavelength.

Ultrasonic surgical instruments

Various embodiments described herein are directed to ultrasonic blades. For example, an ultrasonic blade may comprise a proximally positioned straight section extending along a longitudinal axis and a distally positioned curved section coupled to the straight section and curved away from the longitudinal axis. The curved section may define a radius of curvature and subtend a first angle. A point of tangency between the curved section and the straight section may be positioned at either a node of the ultrasonic blade or an anti-node of the ultrasonic blade.

Surgical instruments with articulating shafts

Methods and system are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

Methods and systems for thermally-induced renal neuromodulation

Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

Methods and apparatus for thermally-induced renal neuromodulation

Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.

Methods and apparatus for performing a non-continuous circumferential treatment to a body lumen

Methods and apparatus are provided for pulsed electric field neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly. The methods and apparatus of the present invention may, for example, be used to modulate one or more target neural fibers that contribute to renal function.

Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach

Methods and apparatus are provided for intravascularly-induced neuromodulation or denervation. Neuromodulation may be achieved via direct and/or via indirect application of energy or neuromodulatory agents to target neural matter, or to vascular structures that support the target neural matter. In some embodiments, parameters of the target neural matter, of non-target tissue, or of the apparatus may be monitored via one or more sensors for controlling the neuromodulation or denervation. Such monitoring data optionally may be utilized for feedback control of the neuromodulation or denervation.

Denise Demarais

Papers

Methods and systems for thermally-induced renal neuromodulation

Methods and apparatus for thermally-induced renal neuromodulation

Methods and apparatus for performing a non-continuous circumferential treatment to a body lumen

Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach

Methods and apparatus for intravascularly-induced neuromodulation or denervation