An instrument for thermally-mediated therapies in targeted tissue volumes or for volumetric removal of tissue. In one embodiment, the instrument has an interior chamber that includes a diffuser structure for diffusing a biocompatible conductive fluid that is introduced under high pressure. The interior chamber further includes surfaces of opposing polarity electrodes for vaporizing the small cross-section diffused fluid flows created within a diffuser structure. In one embodiment, the diffuser structure includes a negative temperature coefficient of resistance material between the opposing polarity surfaces. The NTCR structure can self-adjust the lengths of current paths between the opposing polarities to insure complete vaporization of the volume of flow of conductive fluid. The non-ionized vapor phase media is ejected from a working surface of the instrument and a controlled vapor-to-liquid phase change in an interface with tissue applies thermal energy substantially equal to the heat of vaporization to ablate tissue. In another embodiment, the instrument provides voltage means for converting the non-ionized vapor phase media into an ionized media or plasma for applying energy to body structure.
