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

Devices and methods provide for ablation of cardiac tissue for treating cardiac arrhythmias such as atrial fibrillation. Although the devices and methods are often be used to ablate epicardial tissue in the vicinity of at least one pulmonary vein, various embodiments may be used to ablate other cardiac tissues in other locations on a heart. Devices generally include at least one tissue contacting member for contacting epicardial tissue and securing the ablation device to the epicardial tissue, and at least one ablation member for ablating the tissue. Various embodiments include features, such as suction apertures, which enable the device to attach to the epicardial surface with sufficient strength to allow the tissue to be stabilized via the device. For example, some embodiments may be used to stabilize a beating heart to enable a beating heart ablation procedure. Many of the devices may be introduced into a patient via minimally invasive introducer devices and the like. Although devices and methods of the invention may be used to ablate epicardial tissue to treat atrial fibrillation, they may also be used in veterinary or research contexts, to treat various heart conditions other than atrial fibrillation and/or to ablate cardiac tissue other than the epicardium.

Cardiac ablation devices and methods

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

Various embodiments are direct to a surgical instrument comprising and end effector, an articulating shaft and an ultrasonic transducer assembly. The end effector may comprise an ultrasonic blade. The articulating shaft may extend proximally from the end effector along a longitudinal axis and may comprise a proximal shaft member and a distal shaft member pivotably coupled at an articulation joint. The ultrasonic transducer assembly may comprise an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer assembly may be positioned distally from the articulation joint.

Ultrasonic surgical instruments with distally positioned transducers

Surgical systems, devices and methods including one or more tissue stimulation elements that, in some instances, may also be used for sensing purposes. Some of the surgical devices also include a tissue coagulation element.

Clamp based methods and apparatus for forming lesions in tissue and confirming whether a therapeutic lesion has been formed

Low temperature lesion formation apparatus, systems and methods. The apparatus includes a base member and an inflatable element carried by the base member.

Low temperature lesion formation apparatus, systems and methods

A dual mode lesion formation apparatus and associated methods. A dual mode lesion formation apparatus may include a probe component having an energy transmission element carried on a shaft, a clamp component mountable on the clamp member and including a temperature sensor, a first electrical connector and a second electrical connector. The first electrical connector is operably connected to a probe component energy transmission element. The second electrical connector is operably connected to a probe component energy transmission element and to a clamp component temperature sensor.

Dual mode lesion formation apparatus, systems and methods

Saline Enhanced Radiofrequency Ablation
Background

Radiofrequency (RF) ablation of scar-mediated ventricular tachycardia is limited by the size of lesions achieved with conventional catheters. We examined the gross and histopathology characteristics of warm saline-enhanced radiofrequency (SERF) ablation delivered to left ventricular (LV) infarction scars via a novel catheter employing an extendable infusion needle electrode.



Methods and Results

Yorkshire pigs (n = 14) underwent LV infarction by left anterior descending artery balloon occlusion. After 4–6 weeks, baseline hemodynamic data were obtained and endocardial electroanatomic mapping was performed in 13 surviving animals. Following single, 40 Watt SERF ablations delivered endocardially to the center of infarctions, 4 were examined the same day (day 0). The rest underwent repeat measurements and were sacrificed at 1 week (n = 6), and at 4 weeks (n = 3). Average lesion depth and diameter were: 1.85 ± 0.7 cm and 2.33 ± 0.7 cm at day 0, 0.91 ± 0.1 cm and 1.9 ± 0.4 cm after 1 week, and 1.0 ± 0.2 cm and 1.89 ± 0.76 cm after 4 weeks, respectively. Histopathology at 1 week showed that ablation lesions covered 41 ± 10.6% of the infarct area. SERF ablation lesions extended 100%, 90%, and 68% of the total wall thickness at day 0, 1 week, and 4 weeks, respectively. Hemodynamic parameters were unchanged. There were no myocardial wall perforations or aneurysms.



Conclusion

SERF ablation within myocardial infarct tissue produced large, near-transmural lesions, without evidence of myocardial perforation, wall thinning, or aneurysm formation. Ablations did not produce any negative hemodynamic effects in this small group of experiments.

Characterization of Warm Saline‐Enhanced Radiofrequency Ablation Lesions in the Infarcted Porcine Ventricular Myocardium

Apparatus, systems and methods for forming lesions in target tissue and positioning an insulation element adjacent to non-target tissue.

Wrap based lesion formation apparatus and methods configured to protect non-target tissue

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