Abstract: A method, apparatus and system for template-controlled, precision laser interventions is described that greatly improves interventions such as laser microsurgery, particularly ophthalmic surgery, and industrial micromachining. The instrument and system are applicable to those specialties wherein the positioning accuracy of laser lesions is critical, such as whenever precise operations on a target or series of targets subject to movement during the procedure are to be effected. The system includes a user interface, wherein the user can either draw, adjust, or designate particular template patterns overlaid on a live video images of the target (such as the cornea) which are stabilized and produce an apparently stationary display of the target and provide the means for converting the template pattern into a sequence of automatic motion instructions to direct a laser beam to be sequentially applied replicating the designated template pattern into the corresponding surgical or industrial site.

Abstract: The invention provides an input device for robotic surgical techniques and other applications. The input device has a handle supported by a linkage having joints with a redundant degree of freedom, with the joints being movable with at least one more degree of freedom than the handle. At least one joint of the linkage is actively driven to prevent the linkage from approaching singularities of the joint system, motion limits of the joints, or the like, and also to drive the linkage toward a freely articulatable configuration. In one embodiment, a robotic master controller includes an arm assembly supporting a gimbal having such a redundant linkage, with the arm primarily positioning the gimbal in a three dimensional controller workspace and the gimbal coupling the arm to the handle with four rotational degrees of freedom. One or more additional degrees of freedom may also be provided for actuation of the handle.

Abstract: The invention provides intrafallopian devices and non-surgical methods for their placement to prevent conception. The efficacy of the device is enhanced by forming the structure at least in part from copper or a copper alloy. The device is anchored within the fallopian tube by a lumen-traversing region of the resilient structure which has a helical outer surface, together with a portion of the resilient structure which is biased to form a bent secondary shape, the secondary shape having a larger cross-section than the fallopian tube. The resilient structure is restrained in a straight configuration and transcervically inserted within the fallopian tube, where it is released. Optionally, permanent sterilization is effected by passing a current through the resilient structure to the tubal walls.

Abstract: Systems and methods verify and/or correct optical errors of an eye. A plan is generated for a corrective procedure of the eye from a measured optical error, and a verification lens is formed based on the measured optical error to verify the procedure plan. Alignment of an aperture (with a size selected to correspond to the size of the pupil) with the eye while measuring optical properties of the eye through the verification lens improves verification accuracy, as does mounting of the verification lens and aperture to the patient with a trial frame.

Abstract: The invention provides intrafallopian devices and non-surgical methods for their placement to prevent conception. The efficacy of the device is enhanced by forming the structure at least in part from copper or a copper alloy. The device is anchored within the fallopian tube by a lumen-traversing region of the resilient structure which has a helical outer surface, together with a portion of the resilient structure which is biased to form a bent secondary shape, the secondary shape having a larger cross-section than the fallopian tube. The resilient structure is restrained in a straight configuration and transcervically inserted within the fallopian tube, where it is released. Optionally, permanent sterilization is effected by passing a current through the resilient structure to the tubal walls.

Abstract: An input device for robotic surgical techniques and other applications has a handle supported by a linkage with a redundant degree of freedom, the joints being movable with at least one more degree of freedom than the handle. At least one joint of the linkage is actively driven to prevent the linkage from approaching singularities of the joint system, motion limits of the joints, and also to drive the linkage toward a freely articulatable configuration. A robotic master controller can include an arm assembly supporting a gimbal having a redundant linkage, with the arm primarily positioning the gimbal in a three dimensional controller workspace and the gimbal coupling the arm to the handle with four rotational degrees of freedom. One or more additional degrees of freedom may also be provided for actuation of the handle, to close the jaws of a surgical grasper.

Abstract: The invention provides intrafallopian devices and non-surgical methods for their placement to prevent conception. The efficacy of the device is enhanced by forming the structure at least in part from copper or a copper alloy. The device is anchored within the fallopian tube by imposing a secondary shape on a resilient structure, the secondary shape having a larger cross-section than the fallopian tube. The resilient structure is restrained in a straight configuration and transcervically inserted within the fallopian tube, where it is released. The resilient structure is then restrained by the walls of the fallopian tube, imposing anchoring forces as it tries to resume the secondary shape.

Abstract: Enhanced telepresence and telesurgery systems automatically update coordinate transformations so as to retain alignment between movement of an input device and movement of an end effector as displayed adjacent the input device. A processor maps a controller workspace with an end effector workspace, and effects movement of the end effector in response to the movement of the input device. This allows the use of kinematically dissimilar master and slave linkages. Gripping an input member near a gimbal point and appropriate input member to end effector mapping points enhance the operator's control. Dexterity is enhanced by accurately tracking orientational and/or angles of movement, even if linear movement distances of the end effector do not correspond to those of the input device.

Abstract: Systems, devices, and methods localize and/or treat arrhythmias of a heart of a patient using signals sensed at an accessible body surface. Based on a database of known heart signals and associated ectopic origin sites or exit sites for treatment guidance, continuous localization identifies candidate ectopic or exit sites throughout a continuous region of tissue. An integral from a selected time interval of a reference heart cycle can be compared statistically with known body surface maps. Statistical interpolation can identify a candidate ectopic or exit site which is different than the known ectopic or exit sites. Relative localization provides accurate site identification from one or more known pacing sites (and the associated heart signals) taken from the patient.

Abstract: Devices, methods, kits, and methods remove clot material from the vasculature and other body lumens. Expansible baskets may be used as cooperating radially expansible shearing members. Helically oriented struts of each basket may wind in a uniform circumferential direction. The struts can be independently flexible, allowing the shearing members to flex axially together. The inner basket may be rotatably driven and may use an axial pump extending proximally from the shearing members and/or a distal penetrator for advancing into an occlusion which inhibits guidewire access. The struts may slide substantially continuously across each other, and may be sufficiently aggressive for highly effective thrombectomy.

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. One embodiment of the cryotherapy catheter comprises a catheter body having a proximal end and a distal end with a cooling fluid supply lumen and an exhaust lumen extending therebetween. A first balloon is disposed near the distal end of the catheter body in fluid communication with the supply and exhaust lumens. A second balloon is disposed over the first balloon with a barrier therebetween.

Abstract: The invention provides intrafallopian devices and non-surgical methods for their placement to prevent conception. The efficacy of the device is enhanced by forming the structure at least in part from copper or a copper alloy. The device is anchored within the fallopian tube by a lumen-traversing region of the resilient structure which has a helical outer surface, together with a portion of the resilient structure which is biased to form a bent secondary shape, the secondary shape having a larger cross-section than the fallopian tube. The resilient structure is restrained in a straight configuration and transcervically inserted within the fallopian tube, where it is released. Optionally, permanent sterilization is effected by passing a current through the resilient structure to the tubal walls.

Abstract: A high performance reconfigurable DWDM transmitter incorporates discrete optical components placed in v grooves etched in a substrate. Direct wavelength monitoring can be achieved with wavelength modulation locking applied independently to a gas absorption line and to etalon fringes. A set of equally-spaced wavelengths may be provided by a set of lasers, or a single laser can be used for a number of fixed frequencies.

Abstract: A tool guide for guiding an end effector of a robotically controlled surgical instrument from a position outside a patient body to a position in close proximity to an internal surgical site within the patient body is provided. The tool guide typically comprises a body, a seat formation on the body, the seat formation being arranged to seat in an aperture leading into the patient body so as to mount the tool guide on the patient body, and a sheath formation on the body. The sheath formation typically defines a longitudinally extending internal passage, an inlet leading into the passage and an outlet leading from the passage.

Abstract: The present invention provides methods, apparatus, and kits for detection and/or treatment of vulnerable plaque of a blood vessel having a lumen surface. Detection methods include sensing a temperature differential along a lumen surface with temperature sensors that thermally couple the lumen surface. Treatment methods include controlled and safe cryogenic cooling of vulnerable plaque to inhibit release of retained fluid within the vulnerable plaque so as to inhibit acute coronary syndrome and to help maintain patency of a body lumen. Treatment methods may include additional treatments, such as primary treatments or passivation.

Abstract: Improved systems, devices, and methods measure and/or change the shape of a tissue surface, particularly for use in laser eye surgery. Fluorescence of the tissue may occur at and immediately underlying the tissue surface. The excitation energy can be readily absorbed by the tissue within a small tissue depth, and may be provided from the same source used for photodecomposition of the tissue. Changes in the fluorescence spectrum of a tissue correlate with changes in the tissue's hydration.

Abstract: An input device for robotic surgery mechanically transmits a grip signal across a first joint coupling a handle to a linkage supporting the handle. The handle is removable and replaceable, allows unlimited rotation about the joint, and may optionally include a touch sensor to inhibit movement of a surgical end effector when the hand of the surgeon is not in contact with the handle.

Abstract: Improved systems, devices, and methods sense heart signals through a torso surface of a patient. These improved systems facilitate mounting of an array of sensors upon the patient's torso by supporting the sensor arrays on one or more panels. Four separate panels can be adapted for engaging the torso surface, with the four panels supporting most and/or all of the sensors necessary for localizing an arrhythmia within a chamber of a heart of a patient. The panels may have integrated components for use with other electrophysiology lab equipment such as cardiac imagers, defibrillation power sources, therapeutic probes, standard 12-lead electrocardiogram (ECG) systems, and the like. An exemplary arrhythmia sensing system is adapted for use in the high-noise environment of an electrophysiology lab includes a series of powered circuits distributed among the electrodes of the array.

Abstract: In a telemanipulation system for manipulating objects located in a workspace at a remote worksite by an operator from an operator's station, such as in a remote surgical system, the remote worksite having a manipulator with an end effector for manipulating an object at the workspace, such as a body cavity, a controller including a hand control at the control operator's station for remote control of the manipulator, an image capture device, such as a camera, and image output device for reproducing a viewable real-time image, the improvement wherein a position sensor associated with the image capture device senses position relative to the end effector and a processor transforms the viewable real-time image into a perspective image with correlated manipulation of the end effector by the hand controller such that the operator can manipulate the end effector and the manipulator as if viewing the workspace in true presence.

Abstract: The present invention provides improved devices, systems, and methods for compensating for friction within powered automatic systems, particularly for telesurgery and other telepresence applications. The invention allows uninhibited manipulation of complex linkages, enhancing the precision and dexterity with which jointed structures can be moved. This enhanced precision is particularly advantageous when applied to the robotic surgical systems now being developed. The friction compensation systems of the present invention address static friction (typically by applying a continuous load in the direction of movement of a joint) and the often more problematic static friction (generally by applying alternating loads in positive and negative joint actuation directions). The invention can accommodate imprecise velocity measurements by applying an oscillating load whenever the joint velocity reading falls within a low velocity range.