Abstract: A qualifying connection for an instrument attaches to a source of electrosurgery energy to and the instrument and has first and second parts coupled to the instrument and the source, respectively. Optical couplings on the connection transmit invisible energy to identify the instrument and are proximate on the first and second parts. A light modifier on the first part is proximal to the second part for modification of radiation in the infrared wavelengths so infrared transmitters encode signals and non contact coded proximity detectors on the second part are the coupled detectors. Non contact coded proximity detectors respond to modified infrared light establishing an Nth bit identification code. An infrared light supply in the source pass from the transmitters across the communicating couplings for encoding signals by modification of the infrared light with a light modifier. Mechanical attachments include conjugating male and female portions physically extending between the parts for mating engagement.

Abstract: A clamping force mechanism and its method of use with electrosurgery allow a user to seal and/or join patient's particular vascular tissue; the mechanism is elongate with user and patient ends. An actuator is at the user end and the effectors are at the patient end. Each effector has a face of an area to contact the particular vascular tissue. A lost motion connection transfers user actuation to the effectors to hold a predetermined clamping force during electrosurgical tissue sealing. A yielding member in the loss motion connection clamps the particular tissue between the faces with a predetermined force. The yielding member is a spring, slip clutch or hydraulic coupling possibly near the actuator. An active electrode is carried on one end effector and a return electrode contacts the tissue so an electrosurgical energy supply connected thereacross delivers energy therebetween. A feedback circuit responds to parameters of energy delivered to tissue.

Abstract: An electrosurgical generator has an output power control system that causes the impedance of tissue to rise and fall in a cyclic pattern until the tissue is desiccated. The advantage of the power control system is that thermal spread and charring are reduced. In addition, the power control system offers improved performance for electrosurgical vessel sealing and tissue welding. The output power is applied cyclically by a control system with tissue impedance feedback. The impedance of the tissue follows the cyclic pattern of the output power several times, depending on the state of the tissue, until the tissue becomes filly desiccated. High power is applied to cause the tissue to reach a high impedance, and then the power is reduced to allow the impedance to fall. Thermal energy is allowed to dissipate during the low power cycle. The control system is adaptive to tissue in the sense that output power is modulated in response to the impedance of the tissue.

Abstract: A device for retrograde hole opening through tissue has a member elongate on an axis with a cross section shaped to insert axially through external tissue. A distal and a proximal end on the member respectively enter the tissue during placement and remain outside the tissue for control. A tip at the distal end has a deployable tissue divider with one or more tissue parting elements and each has a splitter. The tissue parting elements are located within the cross sectional dimensions of the member in a storage position and are movable relative to the tip for placement in an exposed position relative to the tip when shifted from storage so that the splitter thereof splits tissue during retrograde extraction along the axis and contact with tissue. Linkage between the proximal end and the deployable tissue divider retains each of the tissue parting elements with its splitter exposed.

Abstract: A clamping force mechanism for use with electrosurgery allow a user to seal and/or join patient's particular vascular tissue; the mechanism is elongate with user and patient ends. An actuator is at the user end and the effectors are at the patient end. Each effector has a face of an area to contact the particular vascular tissue. A lost motion connection transfers user actuation to the effectors to hold a predetermined clamping force during electrosurgical tissue sealing. A yielding member in the loss motion connection clamps the particular tissue between the faces with a predetermined force. The yielding member is a spring, slip clutch or hydraulic coupling possibly near the actuator. An active electrode is carried on one end effector and a return electrode contacts the tissue so an electrosurgical energy supply connected thereacross delivers energy therebetween. A feedback circuit responds to parameters of energy delivered to tissue.

Abstract: A constant power control circuit for an electrosurgical generator and a method for maintaining the electrical power output of an electrosurgical generator at a generally constant value throughout a given tissue impedance range are disclosed. The constant power control circuit and the method recognize and use the unique and simple linear characteristics associated with certain electrosurgical generator designs to monitor and control the electrical power output without having to calculate or monitor the actual output power. The constant power control circuit includes a current sampling circuit, a linear conversion circuit, and a feedback correction circuit.

Abstract: A valve and irrigator used with a suction tube has an elongate funnel with an axis through an enlarged entrance and an opposed extended exit duct of a flexible elastomer. A flow passage through the elongate funnel connects the entrance to the exit permitting fluid communication. A web across and near the enlarged entrance sealingly separates that from the exit. The web and the elongate funnel are made of silicone elastomer and are adhesively adhered to together. A portal in the web passes therethrough along the axis and is circular in shape to surround in fluid tight engagement the suction tube. A lid, proximally of the web on the enlarged entrance, has an inlet for irrigation and a pass through for the tube; the lid closes the enlarged entrance forming a chamber between the web and the lid. A slit within the web, near the portal and spaced from the axis is in the form of a closed mouth composed of a pair of sealing lips.

Abstract: A control system and method for the operation of neurosurgical bipolar electrodes for application to the tissue and bodily fluids of a patient provides a source of high frequency energy connected to bipolar electrodes. Contacting surfaces are on the bipolar electrodes of highly electrically conductive material with resistance per unit area substantially less than the impedance of the tissue and bodily fluids. A current transducer attached to the source of high frequency energy responds to the RMS current applied through the tissue and bodily fluids between the contact surfaces as a measure relative to the instantaneous values of the RMS current. A current transducer attached to the source of high frequency energy responds to the RMS current through a capacitor applied across the contact surfaces to provide a signal correlated to the instantaneous values of the RMS voltage between the contacts and across the tissue and bodily fluids.

Abstract: A partially coated electrosurgical electrode has a portion of a medical grade metallic material as a substrate for energy application. Conductive of sites of metallic material or alloys thereof pass energy through peaks that define valleys nearby. A partial coating in the valleys has a low surface free energy. A treated surface across the peaks and generally over the filled valleys is relatively smooth for non stick characteristics during application of electrosurgery to tissue and bodily fluids. Openings in the treated surface through the partial coating are at the peaks of conductive sites to expose the metallic material or alloys thereof. The partial coating is a fluorinated polymer. The treated surface is a relatively even level that is not flat. The metallic material substrate is an alloy of stainless steel or nickel chrome. A mechanically deformed surface finish, plasma or vapor deposition on the substrate forms the conductive sites.

Abstract: A method of making a return pad for an electrosurgical system comprises the following steps. A first step includes die cutting an electrically conductive foil on a backing using a rotary press to create a foil blank. A second step includes peeling the conductive foil from around the blank, and leaving the blank on its backing. A third step includes layering electrically conductive gel together with the die cut foil to form a layered sheet. A fourth step includes blanking the return pad from the layered sheet using a rotary die. The rotary die has cutting edges and a die packing material adjacent to at least a portion of the edges. The die packing material compresses the gel prior to cutting. The compression is preferably sufficient to cause elastic deformation in the gel so that the gel retracts after being cut. The retraction of the gel leaves a border around the edge of the pad. The border region helps prevent the possibility of the gel coming into electrical contact with an unintended object.

Abstract: A design and method of manufacture is disclosed for an electrosurgical electrode with a silicone coating. The coating resists the buildup of eschar. The silicone material is thick enough in the flat area of the blade to withstand the electrosurgical voltage without breakdown. The electrosurgical current path is primarily through the blade edges and tip. The flat of the blade remains insulated under most conditions. The relatively thick coating also provides high tear strength and added durability. The composition of the electrode coatings may include silicone elastomers in the form of adhesives, dispersions, or liquid rubbers. The coating composition may also contain adhesion promoters, heat stabilizers, plasticizers, release enhancers, crosslinking agents, and colorants. Several methods of manufacture are illustrated by way of examples.

Abstract: Apparatus monitors RF return current to maximize the AC signal of impedance at two return electrodes. A transformer with driving and driven windings isolates ESU and patient. At ends of the driving winding are signal and ground terminals joined to the return electrodes with capacitors returning current. An AC coupling capacitor at the signal terminal has a timing circuit in sync to the voltage wave and relative to impedance of the return electrodes. Microprocessing the voltage at the signal terminal of the driving winding watches impedance and determines if the RF return current path is adequate. Voltage detection within the timing circuit has a voltage shaping circuit. A voltage comparator after the voltage detection forms a square wave. A current detection circuit and a coupling capacitor allow AC flow to the driving winding. Current shaping circuit in the current detection circuit has a voltage comparator at the output to form a square wave.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patent's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide assess for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tubular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows movement relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.

Abstract: An apparatus and method for igniting plasma in a surgical system is disclosed. A corona discharge is generated on a surgical handpiece which is used to ignite a plasma arc for surgical operations. The advantages include greater reliability and repeatability of plasma arc ignition. The apparatus comprises a handpiece incorporating an active electrode, a passage for ionizable gas, and a corona return electrode. The corona return electrode has a terminus on the holder and near the distal end of the holder. The corona return electrode is electrically connected to the return path of the electrosurgical generator. A non-uniform electric field is generated between the active electrode and the corona return electrode of sufficient strength so that a corona is formed near the active electrode. A separate return electrode may be on the patient, or the apparatus may be configured for bipolar electrosurgical operation by carrying the return electrode on the handpiece.

Abstract: A surgical system has a multiple electrode electrosurgical capability in combination with a gas plasma capability for delivery of electrosurgical energy to the tissue or bodily fluids of a patient. The system includes a holder, a source of electrical energy, electrodes connected to the source of electrical energy, one or more passages carried on the holder for transporting ionizable gas, and a source of ionizable gas of a selectable flow rate. The gas passages may include at least one electrode extending toward the operative site. The gas passages may include a part that creates a vortex in the gas flow. The electrodes may be coaxially placed in the gas passages. The system may also be configured such that two electrodes are each shrouded by the ionized gas so that the electrosurgical energy is conducted to the tissue or bodily fluids of the operative site by passing along conductive pathways in the ionized gas from each electrode. There may also be a dielectric barrier between the conductive pathways.

Abstract: A bipolar electrosurgical scissors has an improved coagulation capability. Both poles of electrosurgical energy are exposed on the exterior surfaces of each shearing member so that the scissors can be used to coagulate tissue using only one shearing member. There may be two or more electrically conductive regions on the exterior surface of each shearing member. The conductive regions may be formed by laminating, depositing, or inlaying electrically conductive material on the exterior surfaces. The conductive regions are electrically insulated from each other. In one embodiment, the shearing surfaces are also electrically conductive and are each connected to the same electrical pole. In another embodiment, the conductive material that forms one of the conductive regions on each exterior surface also extends through the shearing member to also form a conductive shearing surface.

Abstract: A single ultrasonic surgical apparatus can provide a substantial cutting effect on tissue, a substantial coagulation effect on tissue, and an appropriate blend of simultaneous cutting and coagulation effects on tissue. The ultrasonic surgical apparatus is comprised of a handpiece which incorporates a transducer and a surgical tool, a source of electrical energy, a controller, and a switch. The apparatus may be operated at two frequencies within the ultrasonic spectrum, where the first frequency is selected at the low end of the spectrum for enhanced tissue cutting performance, and the second frequency is approximately three times higher for enhanced tissue coagulation performance. The two frequencies may be operated selectively or concurrently, and may be independently adjustable as to amplitude. The transducer may be composed of magnetostrictive or piezoelectric elements. The surgeon to set the desired amplitude of the mechanical vibrations.

Abstract: A system changes the rate of operation of a smoke evacuator used with an electrosurgical generator during treatment of a patient electrosurgically at an operative site. A mono or bipolar circuit for electrosurgery has an electrosurgical generator, ESU. A switch in the circuit activates the ESU when keyed. An active output connects the ESU to supply radio frequency energy and a return input to the ESU receives energy. A handpiece has an active electrode and an active lead connects between the output and the electrode. A return lead connects the return input and has a terminus to the patient. A controller in the ESU controls the various output signals of the ESU in response to hand or foot switching inputs or sensed current in the patient circuit. A trigger is connected to the controller in the ESU. The smoke evacuator operates at a different rate when the trigger in the ESU is keyed. A rate controller adjusts the condition of its function per unit time in accord with the trigger on the ESU.

Abstract: A method and assembly for electrically and mechanically connecting one or more flexible conductive members, with one or more insulated wires using one or more insulation piercing terminals. The flexible conductive member may have one or more electrically conductive layers attached to a pliable backing. The insulated wire may have one or more conductors. The insulation piercing terminal provides a low impedance electrical connection between the flexible conductive member and the insulated wire, while also providing a mechanical connection between the flexible conductive member and the insulated wire which minimizes movement of the insulated wire due to any axial and/or longitudinal forces that may be applied to the insulated wire or the flexible member during manufacturing and use. The insulation piercing terminal combines one or more piercing members with an integral mechanical securing means and an electrical contact for engaging the flexible conductive member.