Abstract: A power control apparatus for an electrosurgical generator is used for controlling output power from the generator to the tissue or bodily fluids of a patient. The control apparatus rapidly determines the range of impedance of the load on the electrosurgical generator and adjusts the output power accordingly. Output current and output voltage from the electrosurgical generator are monitored and sent to a microprocessor. The microprocessor runs an algorithm that determines the impedance range of the load on the generator. The algorithm uses computational techniques, such as comparisons and bit shifting, that avoid long division and other time-consuming operations. The microprocessor can then adjust a high voltage power supply that effects the radio frequency amplifier stage. A method for controlling the power of the electrosurgical generator, including steps in the algorithm, is also disclosed.

Abstract: A surgical safety apparatus for use in connection with an energizable surgical device prevents inadvertent activation of a surgical tool. The energizable surgical device may include an electrosurgical system, a laser scalpel, an ultrasonic aspirator, and combinations thereof. An activation circuit is in connection with the source of energy and in connection with the handpiece. The activation circuit has two states: the first state disconnects the source of energy from the handpiece, the second state connects the source of energy to the handpiece. A sensing element is connected to the activation circuit. The sensing element signals the activation circuit to convert the activation circuit from the first state to the second state. The activation circuit may remain in the second state for a preestablished period of time followed by a reversion to the first state. The activation circuit may include a relay which may be connected to operate accessories including smoke evacuators, lights, videos or irrigators.

Abstract: The improved endoscopic instrument of the present invention includes handles, a shaft and an end effectors. The handle is capable of adjustment to accommodate variations in hand size, and grip style. The handle is also adjustable relative to the shaft for use in a variety of medical procedures. In addition, the control linkages for the end effector of the improved endoscopic instrument of the present invention do not directly contact the patient thereby enabling the instrument to be easily cleaned, sterilized and reused.

Abstract: An insulating switch base with a top, bottom and an edge has openings through the top and one edge for a conductor. A conductive switch lead frame has proximal ends with insulation displacement connectors bent in the openings. A resilient member on the frame has a moveable contact and is conductively associated with a connector. A contoured arm on the frame is distal of, but conductive with, another connector. The arm is spaced from the resilient member as an open contact capable of momentary engagement. A frangible area on each frame is between the resilient member and the arm. Recesses in the top support retain the frame. A slot and barbs on each connector receive one conductor securely in an opening after aligned installation in an opening, seating of the frame in its recess and severing the area over a passage in the base. A membrane attaches over the frame and a molding is applied about the membrane leaving the resilient member open.

Abstract: An automatic circuit measures electrosurgical generator output and controls in accord with impedance between activated movable bipolar electrodes able to contact tissue. Voltage monitor in parallel and current monitor in series with the electrodes measure instantaneous variations and generate proportional signals. First and second calculators receive the signals and find respectively, by dividing the voltage by current, short circuit impedances and impedances other than short circuit impedances between the electrodes. First and second comparators receive the respective outputs from the first and second calculators and assess them against respective first and second references providing signs of short conditions and assessments of changes in impedance between the electrodes. A logic analyzer receives the signs and assessments and evaluates them to permit the instantaneous starting, operating or stopping of the electrosurgical generator.

Abstract: A surgical device includes a frame member having a distal end and a proximal end and a pair of tissue holding mechanisms movably mounted to the frame member at the distal end thereof for securing holds on spaced organic tissues of a patient. Actuators mounted to the frame member at the proximal end thereof are operatively connected to the holding mechanisms for controlling the operation thereof. Another actuator, also mounted to the frame member, is operatively connected to the holding mechanisms for moving the holding mechanisms relative to one another, thereby stretching organic tissues between the held tissues and facilitating access to the stretched tissues. The instrument assembly is particularly useful during laparoscopic surgery.

Abstract: A laser and electrosurgical system has a handpiece with a proximal and distal end from which laser radiation and/or electrosurgical energy is selectively or concurrently directed. The ends are along an axis; an electrode extends distally along the axis. Sources of laser and electrosurgical energy are available and controlled. An initiation circuit for the laser selectively delivers it before electrosurgery. Prior delivery targets tissue. The laser creates an ionized conductive pathway for electrosurgery. The combined concurrent application of laser and electrosurgery has a mechanism to selectively distribute energy about the axis. A laser deflecting surface or a beam deflector vibrate relative to the axis. A power switch has levels for laser cut and ionization and/or a delay therebetween for electrosurgical coagulation. A wave guide or an array thereof deliver radiation along the axis.

Abstract: A control responds to impedance and temperature between active and return electrodes of the electrosurgical generator during tissue desiccation. Tissue contacts separately and independently provide high frequency power to effect tissue electrosurgically. An instantaneous impedance monitor between each contact and the return electrode signals. A regulator receives the signals and separately and independently controls tissue impedance at each contact in accord with signals to change independently the power to the return electrode. A temperature sensor for each contact transmits its temperature to the generator to regulate power to each contact. A first multiplexer provides high frequency electrosurgical power separately and independently to each contact from the generator. A second multiplexer relays temperature amounts of each contact to the generator.

Abstract: An ultrasonic surgical handpiece for surgery on a patient has a handpiece with distal and proximal ends on a housing thereof for manipulation by a surgeon. A vibrator is carried within a hollow inside of the housing. A tool extends from the vibrator at the distal end to a distal tip and is tubular with a bore along its axis so axial vibrations at high frequency are transmitted to the distal tip. Fluid flows from the distal tip to the vibrator, cools the vibrator and connects to a source of suction at the proximal end. A flue carried cantilever on the distal end extends about the tool so a space is between the tool and the flue for guiding fluid from the distal end to the distal tip. A port located through the tool connects between the space and the bore and is axially positioned near the distal end to collect fluid. An inlet on the flue is near the distal end for fluid provided by a supply. The inlet is axial distal of the port and/or may meter fluid to a preset range.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patient'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 access 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 tabular 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 swinging 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 active electrode switches from a monopolar mode extending from a handpiece and a patient return to a bipolar mode with the active and return electrodes extending. An active lead selectively connects the active output and the active electrode. A return lead selectively connects the return electrode and the return output in the monopolar mode or the return terminal when in the bipolar mode. Terminals connect with wiring to the electrodes to complete the circuit for the bipolar mode. One terminal is on the generator and one is in the handpiece to connect to the electrodes and complete the circuit for bipolar. The electrode has a control on the handpiece for the surgeon to change circuitry and to position the electrode for each mode. The return electrode in the monopolar mode is in the handpiece disconnected from its terminal. The return electrode connects to its terminal when extended from the handpiece but for monopolar a pair of patient pads connected to a monitoring circuit test continuity.

Abstract: A connection of first and second members wherein each has a body and a connecting end with an inner surface so the second connecting end has an outer surface shaped for telescoping into the inner surface of the first connecting end. A shoulder is located on the second member and a groove is in the outer surface of the second connecting end. A raised nub on the inner surface of the first connecting end is radially inward to engage the groove. An elastomeric gasket is positioned to bear against the shoulder and be compressed between the first and second bodies. An engaging trough in the groove holds the first connecting end against the shoulder with the nub against the groove by the compression force of the gasket. An indexing trough in the groove positioned along the groove beyond the engaging trough allows the nub to follow therethrough and slightly compress the gasket thus giving the user a tactile indication that it has been rotated beyond the engaging trough.

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: An actuator for a self-adjusting pump head assembly has a variable position pump shoe slidably attached to a base. The assembly pumps liquids through a tube in a peristaltic pump, including a translator of rotational motion into linear motion and a crank for automatically compensating for the manufacturing tolerances of the tube in the pump pivotally attached to the translator and the shoe. The crank for automatically compensating has a linkage or pair of links, carrying a helical compression spring, pivotally anchored to the translator and the shoe. The peristaltic pump includes a self-adjusting pump head, including a variable position pump shoe slidably attached to a base and a control for positioning, locking and applying a continuous reaction force on the shoe to compress the tube between the shoe and at least one roller located on the periphery of a mandrel.

Abstract: An electrosurgical control for a trocar has a trocar with a cannula with a stylet coaxially fit therein. The stylet is movable relative to the cannula along a common axis. The trocar is shaped for insertion in a direction generally along the axis through tissue in a puncture procedure with its stylet. A distal end and a proximal end on the elongate cannula so the distal end enters the tissue while the proximal end remains outside. A tip on the stylet end, near the distal end of the cannula, normally extends therebeyond in position to puncture the tissue. The stylet has an energy supply passing from the tip to its opposite end and moves reciprocally relative to the cannula so the tip extends or is fully within the cannula. An electrosurgical generator provides energy to the opposite end of the stylet and an electrosurgically active device is a part of the tip and connects to the energy supply.

Abstract: An ultrasonic oscillator drives a tool at a set frequency. An amplitude control runs the oscillator to set the vibration level. A frequency regulator joins the amplitude and the oscillator. A control feedback loop, in the frequency regulator, keeps handpiece linear dynamics. An operational transconductance amplifier, in the oscillator, governs gain of the loop. A circuit connects to the control to retard the rate of current application over time to the amplifier. The circuit has switching to either retard the rate or reset for start up. The amplifier is a current output device with current directly proportional to the bias current and input voltage with bias as gain change for the loop. The circuit limits the bias to the amplifier to modify frequency response and output current. A capacitor delays application of the bias to the amplifier. Replaceable tools of various lengths or shapes positioned along an axis vibrate for surgery at the frequency and a wave length.

Abstract: A monitoring circuit for an electrosurgical generator has active and return output conductors. Voltage, current and the inverse of current picked up inductively are provided to a adder circuits for summing the picked up voltage and current and computing the difference of the picked up voltage and the current. Root mean square to direct current converters signal RMS average values of the sum and difference. A microprocessor squares the values and applies them to a formula wherein the sum signals have subtracted therefrom the difference signals; the results are divided by four to provide the root mean square of the power applied to the load. During desiccation the output is regulated in response to impedance to shut off output. A diagnostic circuit relates impedance load and output response during operation to a look up table or a microprocessor algorithm to calibrate. Feedback modifies the output when the adders determine the power applied to the load in real time.

Abstract: An electrosurgical tip for the application of electromagnetic energy in either a monopolar or a bipolar circuit through the tissue and the bodily fluids of an animal or human has a metallic electrically and thermally conductive electrode for connection to an electrosurgical generator proximally and for transmission of the electromagnetic electrosurgical energy to the tissue and the bodily fluids of the animal or human distally. A sheath of heat shrinkable fluorinated polymeric substance is an electrical and thermal insulator held about the electrode for preventing the flow of electromagnetic and thermal energy from the metallic electrically and thermally conductive electrode to the tissue and the bodily fluids. A smooth surface of the sheath contacts the tissue and the bodily fluids and has a low surface free energy. Openings through the sheath extend from the electrode to the surface for permitting the passage of energy.

Abstract: Apparatus and method find leakage due to tissue load or transients and has active and return electrodes for RF energy sensed by transformers for a circuit that finds leakage at more than two thousand times per second or a frequency dependent on the phase shift between voltage and current. Software and feedback manage V.sub.rms to reduce the voltage or increase the crest factor, which is V.sub.rms divided by peak voltage, by pulse width modulation of the RF drive. Voltage and current phase shift changes, angle .theta., are compared to a threshold, and when greater, the frequency at which the differences between the active and return current signals are examined is increased. The differences between the active and return currents are examined and when greater than maximum leakage while in coagulation mode, the RF drive pulse width is reduced to maintain voltage wave peaks at a preset value and reduce V.sub.rms thereby reducing leakage to the allowable maximum.