Abstract: Devices, systems, and method for treating urinary incontinence generally rely on energy delivered to a patient's own pelvic support tissue to selectively contract or shrink at least a portion of that pelvic support tissue so as to reposition the bladder. The energy will preferably be applied to the endopelvic fascia and/or an arcus tendineus fascia pelvis. The invention provides a variety of devices and methods for applying gentle resistive heating of these and other tissues to cause them to contract without imposing significant injury on the surrounding tissue structures. Alternatively, heat-applying probes are configured to heat tissue structures which comprise or support a patient's urethra. By applying sufficient energy over a predetermined time, the tissue can be raised to a temperature which results in contraction without significant necrosis or other tissue damage.

Abstract: A medical system that allows a medical device to be controlled by one of two input devices. The input devices may be consoles that contain handles and a screen. The medical devices may include robotic arms and instruments used to perform a medical procedure. The system may include an arbitrator that determines which console has priority to control one or more of the robotic arms/instruments.

Abstract: Improved devices, systems, and methods for inhibiting hyperplasia in blood vessels provide controlled and safe cryotherapy treatment of a target portion within a body lumen of a patient. Efficacy of endoluminal cryogenic cooling can be enhanced by limiting cooling of target tissues using a thermal barrier disposed between a dual balloon cryotherapy catheter. Containment of both balloons can be monitored by applying a vacuum within a space between the first and second balloons, and by coupling the vacuum space to a fluid shutoff so as to inhibit flow of cryogenic fluid in response to a change in the vacuum space. Controlled cooling of the vessel can be improved by use of a nebulizer in fluid communication with a cryogenic liquid supply lumen and a gas supply lumen.

Abstract: A robotic system that moves a surgical instrument in response to the actuation of a control panel that can be operated by the surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the control panel. The robotic system is mounted to a cart which can be wheeled to and from an operating table. The cart has a clamping mechanism which attaches the cart to the table. The system also contains a spring loaded mount plate that allows the robotic arm to be rotated and adjusted relative to the cart and the patient. Both the robotic arm and the control panel are encapsulated by protective bags that prevent the system from being contaminated.

Abstract: Improved teleoperator techniques often make use of at least one input device which can be selectively operatively associated with, for example, either a surgical instrument to treat tissues, or with an image of a surgical worksite shown to a system operator. A novel image manipulation arrangement effects movement of the image corresponding to the movement of the input device so that the image appears substantially connected to the input device, optionally while the instrument (or instruments) remain at a fixed location at the worksite. This can give the operator the appearance of grasping and/or manipulating target tissue and worksite into a desired position for viewing, while movement of the image is actually effected by repositioning of the image capture device, electronic image manipulation, or the like.

Abstract: A medical system that allows a medical device to be controlled by one of two input devices. The input devices may be consoles that contain handles and a screen. The medical devices may include robotic arms and instruments used to perform a medical procedure. The system may include an arbitrator that determines which console has priority to control one or more of the robotic arms/instruments.

Abstract: A handle used to control movement of a medical instrument. The medical instrument may be coupled to a robotic arm that is connected to a controller. The medical instrument may have a plurality of functions such as wrist locking and motion scaling. One of the functions may be selected through a graphical user interface operated by the end user. The handle may have a plurality of buttons. One of the buttons may allow the end user to control the selected function. For example, when wrist locking/unlocking is selected, depressing the button can toggle the medical instrument wrist between a locked state and an unlocked state.

Abstract: The present invention provides cryotherapy treatment of dissections in a blood vessel of a patient. The present invention further provides cryotherapy treatment of side branch occlusion in a bifurcated blood vessel. One method for treating potential or existing dissections in a blood vessel comprises cooling the blood vessel to a temperature and for a time sufficient to remodel the blood vessel such that dissections of the blood vessel are reduced. Another method for treating side branch occlusion in a bifurcated blood vessel, the bifurcated blood vessel having a side branch and a main branch, the main branch having plaque disposed thereon, comprises cooling an inner surface of the main branch to a temperature and for a time sufficient to inhibit plaque shift from the main branch into the side branch.

Abstract: A teleoperator system with telepresence is shown which includes right and left hand controllers (72R and 72L) for control of right and left manipulators (24R and 24L) through use of a servomechanism that includes computer (42). Cameras (46R and 46L) view workspace (30) from different angles for production of stereoscopic signal outputs at lines (48R and 48L). In response to the camera outputs a 3-dimensional top-to-bottom inverted image (30I) is produced which, is reflected by mirror (66) toward the eyes of operator (18). A virtual image (30V) is produced adjacent control arms (76R and 76L) which is viewed by operator (18) looking in the direction of the control arms. By locating the workspace image (30V) adjacent the control arms (76R and 76L) the operator is provided with a sense that end effectors (40R and 40L) carried by manipulator arms (34R and 34L) and control arms (76R and 76L) are substantially integral.

Abstract: A medical system that allows a medical device to be controlled by one of two input devices. The input devices may be consoles that contain handles and a screen. The medical devices may include robotic arms and instruments used to perform a medical procedure. The system may include an arbitrator that determines which console has priority to control one or more of the robotic arms/instruments.

Abstract: A surgical method and a control system is provided. The surgical method and the control system can advantageously be used in a minimally invasive surgical apparatus. The method includes generating a desired surgical instrument movement command signal. It further includes comparing the desired surgical instrument movement command signal with at least one preset surgical instrument movement limitation. Should the desired surgical instrument command signal transgress the preset surgical instrument movement limitation, the desired surgical instrument movement command signal is restricted to yield a restricted surgical instrument movement command signal. A surgical instrument is then caused to move in response to the restricted surgical instrument movement command signal. The method further provides for haptic feedback on a master control in response to restriction of the desired surgical instrument movement command signal.

Abstract: Devices, systems, methods, and kits for treating the tissue structures of the ear make use of a guide structure that can mechanically register a treatment probe with a target region of a target tissue, the guide structure being fittingly received in an auditory canal and often comprising a conformable body such as a compressible foam, or the like. The guide structure may include an articulating mechanism for selectively orienting the treatment probe toward the target region of, for example, a tympanic membrane. The guide structure may also support a videoscopic image capture device, illumination transmitting optical fibers, an aiming beam transmitter, and the like. Such structures facilitate myringotomy, tympanostomy tube placement, and the like, under local anesthesia in a doctor's office.

Abstract: Improved devices, systems, and methods use a Non-Liner Optic (NLO) to effect a conversion of an input laser energy to an output energy. The output energy will have a wavelength which is different than the input energy, and the conversion will vary in response to both an angle of the energy relative to the NLO and a temperature of the NLO. Passive control over the angle of the NLO based on thermal expansion of a member thermally coupled to the NLO can compensate for the temperature-induced change in the conversion so as to maintain a desired output frequency, conversion efficiency, phase matching, and/or the like.

Abstract: Contraceptive methods, systems, and devices generally improve the ease, speed, and reliability with which a contraceptive device can be deployed transcervically into an ostium of a fallopian tube. A distal portion of the contraceptive device can function as a guidewire. The proximal portion may remain in a small profile configuration while a sheath is withdrawn proximally, and is thereafter expanded to a large profile configuration engaging the surrounding tissues.

Abstract: This invention relates to establishing alignment or a desired orientational relationship between a master and a slave of a telerobotic system. The invention can advantageously be used in a surgical apparatus. A method of establishing a desired orientational relationship between a hand-held part of a master control and an end effector of an associated slave as viewed in an image displayed on a viewer is provided. The method includes causing the end effector to remain stationary, determining a current orientation of the end effector relative to a viewing end of an image capturing device operatively associated with the viewer and determining a desired corresponding orientation of the hand-held part of the master control relative to the viewer, at which orientation the desired orientational relationship between the hand-held part of the master control and the end effector would be established.

Abstract: Improved devices, systems, and methods for sensing and/or identifying signals from within a signal detection region are well-suited for identification of spectral codes. Large numbers of independently identifiable spectral codes can be generated by quite small bodies, and a plurality of such bodies or probes may be present within a detection region. Simultaneously imaging of identifiable spectra from throughout the detection region allows the probes to be identified. As the identifiable spectra can be treated as being generated from a point source within a much larger detection field, a prism, diffractive grading, holographic transmissive grading, or the like can spectrally disperse the images of the labels across a sensor surface. A CCD can identify the relative wavelengths of signals making up the spectra. Absolute signal wavelengths may be identified by determining positions of the labels, by an internal wavelength reference within the spectra, or the like.

Abstract: Devices, systems, and methods for localizing and/or treating arrhythmias of a patient's heart, which are particularly useful for localizing focal atrial fibrillation, allow locating arrhythmogenic regions of a chamber of the heart using heart cycle signals measured from a body surface of the patient. Non-invasive localization of the ectopic origin or exit site allows focal, circular, and/or perimeter treatment to be directed so as to inhibit complex arrhythmias without having to rely on wide-spread and time consuming sequential searches and/or on massively invasive simultaneous electrocardial sensors. The invention recognizes that effective localization of these complex arrhythmias can be significantly enhanced by techniques and structures which separate heart cycle signals originating from differing chambers and/or regions of the heart tissue.

Abstract: Devices, systems, and methods for diagnosing and/or treating urinary incontinence can accurately and reliably monitor both a vesicle pressure and a maximum urethral pressure of a patient during an abdominal pressure pulse so as to determine relationships between these pressures. Alignment between the location of maximum urethral pressure and a pressure sensor of a catheter can be maintained using an anchoring structure having a surface which engages a tissue surface along the bladder neck, urethra, or external meatus, which move with the urethra during abdominal pressure pulses. A pressuregram is generated graphically showing an increase in urethral pressure relative to an increase in vesicle pressure, and is often displayed in real time to a system operator adjacent the patient. Quantitative and/or qualitative diagnostic output allow selective remodeling of the patient's support structure so that the incontinence is inhibited.

Abstract: Devices, systems, methods, and compositions of matter can track and/or identify a library of elements, particularly for use with fluids, particulates, cells, and the like. Signals from one or more semiconductor nanocrystals may be combined to define spectral codes. Separation of signal wavelengths within dedicated wavelength ranges or windows facilitates differentiation of spectral codes, while calibration signals within the spectral codes can avoid ambiguity. Modeling based on prior testing can help derive libraries of acceptable codes.

Abstract: A retractor with devices that allow a surgeon to control the amount of retractor force. The retractor may include a first blade and a second blade. The second blade can be moved by a gear mechanism. A torque measuring device, force measuring device and/or slip clutch may be coupled to the gear mechanism. The torque measuring device may have a readout that displays the amount of torque being applied by the surgeon to the retractor. The readout provides accurate feedback that allows the surgeon to gauge the amount of force being applied to the patient. Likewise the force measuring device may provide a visual indication of the actual force being applied by the retractor onto the patient. The slip clutch may actuate at a threshold torque to prevent an excessive exertion of force on a patient.