Abstract: The invention provides a method and apparatus for producing reversible focal hypothermia of the nervous system to control chronic pain. Nerve conduction is blocked by mild cooling (0 to 25° C.), or hypothermia. At these temperatures, nerve tissue is not destroyed and recovers completely when cooling is terminated, such that the treatment is reversible. By blocking conduction in pain nerves, pain sensation is eliminated in a manner analogous to drugs such as lidocaine that also block nerve conduction to provide anesthesia. The invention can be applied to a variety of conditions such as urge incontinence, muscle spasticity, and epilepsy. Many of these disorders are mediated by nerve and nervous tissue that could be interrupted by cooling. In addition, neurologic dysfunction found in multiple sclerosis may improve by cooling of the nerves. The method and apparatus may be used to cool areas of the nervous system affected by multiple sclerosis to allow more normal functions.

Abstract: An electrosurgical pencil for delivering high frequency cutting and coagulation signals from an electrosurgical generator is disclosed. A flexible, elongated, substantially solid pencil housing is provided having a cable receiving end and a blade electrode receiving end opposed from the cable receiving end. A mechanism is provided within the pencil housing for bending of the pencil housing between the cable receiving end and the blade electrode receiving end. Additionally, a mechanism is provided within the electrosurgical pencil for retaining a bent position of the pencil housing. The electrosurgical pencil of the present design may be a foot controlled electrosurgical pencil or may include a manually actuated switch within the pencil housing to form a hand controlled electrosurgical pencil.

Abstract: A modular biopsy, ablation and track coagulation needle apparatus is disclosed that allows the biopsy needle to be inserted into the delivery needle and removed when not needed, and that allows an inner ablation needle to be introduced and coaxially engaged with the delivery needle to more effectively biopsy a tumor, ablate it and coagulate the track through ablation while reducing blood loss and track seeding. The ablation needle and biopsy needle are adapted to in situ assembly with the delivery needle. In a preferred embodiment, the ablation needle, when engaged with the delivery needle forms a coaxial connector adapted to electrically couple to an ablating source. Methods for biopsying and ablating tumors using the device and coagulating the track upon device removal are also provided.

Abstract: Post-angioplasty hyperplasia in blood vessels is treated using a cryosurgical balloon catheter. The balloon catheter is positioned at a target region within the blood vessel, and the balloon inflated by expanding a cryogenic fluid, such as liquid nitrogen, across an expansion orifice into a balloon. The balloon will be constructed so that cooling is achieved primarily in the central regions of the balloon, with the proximal and distal regions being less cold and acting to insulate adjacent regions of the blood vessel from excessive cooling.

Abstract: A bipolar electrosurgical handpiece, and electrode for use with the handpiece, that is configured for use in MIS and other electrosurgical procedures. The handpiece is constructed with a flexible end controllable by the surgeon so as to allow the surgeon to manipulate the end as desired during the surgical procedure. The electrode is housed in a tubular member. The electrode ends comprise bare loops projecting from the end of the housing in spaced parallel planes. When energized, a bipolar discharge is generated between the bare loops.

Abstract: A photosensitizer suitable for use in administering photodynamic therapy (PDT), conjugated with antibodies that are targeted to antigens on abnormal tissue and polyethylene glycol (PEG) or other polymer that extends the residence time of the conjugate within a patient's body. The resulting pegylated targeted conjugate is administered to a patient, and after the antibodies have had sufficient time to bind with the antigens, light from an external or internal source having a waveband corresponding to an absorption waveband of the photosensitizer is administered. Use of an external light source that emits relatively long wavelength light enables the light to pass through any intervening dermal layer and normal tissue between the external light source and the treatment site. Since the photosensitizer in the conjugate is bound to the abnormal tissue, the light therapy has minimal effect on the intervening normal tissue.

Abstract: Surgical complications can be minimized by reducing, or eliminating, the release of substances such as TGF-&bgr; from a surgical site by immediately sealing the edges of a surgically-made puncture or incision site. In one system, a treatment device includes an electrically conductive surface that is connected to a source of electrical energy and which can be placed in contact with the edge of a surgical incision or perforation site such that, when the conductive surface is electrically activated, it operates to heat the cellular material at the edge of the surgical incision or perforation site to inhibit (i.e., reduce) the formation of complicating connective tissue bridges. The source of electrical energy is, preferably, a radio-frequency generator.

Abstract: A system for treating a target region in tissue beneath a tissue surface comprises a probe for deploying an electrode array within the tissue and a surface electrode for engaging the tissue surface above the treatment site. Preferably, surface electrode includes a plurality of tissue-penetrating elements which advance into the tissue, and the surface electrode is removably attachable to the probe. The tissue may be treated in a monopolar fashion where the electrode array and surface electrode are attached to a common pole on an electrode surgical power supply and powered simultaneously or successively, or in a bipolar fashion where the electrode array and surface electrode are attached to opposite poles of the power supply. The systems are particularly useful for treating tumors and other tissue treatment regions which lie near the surface.

Abstract: An integrated catheter assembly for enabling diverse endoscopic in situ therapies. The assembly includes a catheter with an irrigation fluid lumen, a distal electrode tip portion that acts as a hemostat, and a cutting wire for making incisions in or ablating tissue. A cutting wire hub provides a sealing entrance for a cutting wire. An operator enables the physician to displace the cutting wire between extended and retracted positions. The cutting wire and electrode are electrically isolated. The apparatus of the present invention allows the physician to make incisions in or ablate tissue using electrosurgery, irrigate tissue, and cauterize or coagulate tissue without having to remove the apparatus from the working channel of the endoscope.

Abstract: A bipolar electrosurgical instrument having an improved pivot screw design is disclosed. The bipolar electrosurgical instrument has a first half which has a first pivot surface and a first bore. The first bore has a first stepped portion and an elongated portion proximate to the first pivot surface. A second half has a second pivot surface and a second bore having a second stepped portion. An insulating material is disposed on the first pivot surface and the elongated portion of the first bore. A first insert having a third bore in which the third bore has first threads is disposed in the second bore and prevented from entering the first bore by the second stepped portion. A second insert having a fourth bore is disposed in the second bore between the second stepped portion and the first insert and prevented from entering the first bore by the second stepped portion.

Abstract: The invention provides improved devices, methods, and systems for repeatably and reliably contracting fascia and other support tissues, particularly for the treatment of urinary incontinence. Rather than relying on a surgeon's ability to observe, direct, and control the selective shrinking of pelvic support tissues, a relatively large surface of a tissue contraction system is placed statically against the target tissue. Sufficient controlled energy is transmitted from the surface into the engaged tissue to contract the tissue and inhibit incontinence (or otherwise provide the desired therapeutic results).

Abstract: A medical device for treating gingivae or reducing the mass of cellular tissue, wherein an elongated tubular element comprises at least one electrode disposed of at its distal section, the energy generating means, and means for generating vibration at the distal section of the tubular element to effect the heat treatment and the vibrational massage therapy for the targeted tissue.

Abstract: An apparatus and method for treating cancer and other illnesses in humans and animals are described. The treatment involves the low-power, pulsed application of radio frequency tuned with precision of at least one half part per million. Alternative embodiments are described for apparatus that generates the required RF signals and applies such signals therapeutically. Laboratory data is reported, showing the successful use of the disclosed apparatus and methods to suppress and eliminate cancerous tumors in mice.

Abstract: A guidable catheter for heating or cooling a surrounding fluid in a feeding vessel in a vasculature of a patient. The catheter includes a heat transfer element, the heat transfer element having a plurality of exterior surface irregularities shaped and arranged to create turbulence in a surrounding fluid. The surface irregularities have a depth at least equal to the boundary layer thickness of flow of the surrounding fluid in the feeding vessel. The catheter assembly also includes a supply catheter having a portion disposed within the heat transfer element to deliver a working fluid to an interior of the heat transfer element. The catheter assembly further includes a return catheter to return a working fluid from the interior of the heat transfer element. A guidewire tube is provided adjacent one of the supply catheter or the return catheter and runs substantially parallel to the axis of the guidable catheter to receive a guidewire disposed within the guidewire tube.

Abstract: A device for cooling an infant's brain includes a cooling liner that may be sandwiched between an outer padded cap and an inner elastic liner. The device fits closely over the infant's skull and is cooled by a recirculating cooling fluid passing through a serpentine conduit. One application for the device is to cool a newborn infant's brain that has suffered a hypoxic shock.

Abstract: A device for localizing a target tissue mass in a body includes a tubular trocar portion having a distal end and a proximal end portion that is removably attachable to a handle portion. The trocar portion contains at least a first plurality of locator wires that are movable between a retracted position within the trocar and a deployed position extending radially from the trocar. In a preferred embodiment, the trocar portion has an electrosurgical cutting element at its distal end, and first and second pluralities of locator wires that, when deployed, respectively define first and second locating perimeters. The first plurality of locator wires is connected to a first wire carrying member longitudinally mounted for axial movement within the trocar portion between a proximal position corresponding to the retracted position of the first plurality of locator wires, and a distal position corresponding to the deployed position of the first plurality of locator wires.

Abstract: Systems and methods are provided for selectively applying electrical energy to a target location on an external body surface, such as skin tissue removal and/or collagen shrinkage in the epidermis or dermis, e.g., the removal of pigmentations, vascular lesions (e.g., leg veins), scars, tattoos, etc., and for other surgical procedures on the skin, such as tissue rejuvenation, cosmetic surgery, wrinkle removal, hair removal and/or transplant procedures. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals adjacent an external body surface, such as the outer surface of the skin, to remove and/or modify the structure of tissue structures within the skin. Depending on the specific cosmetic procedure, the present invention may be used to: (1) volumetrically remove tissue or hair (i.e.

Abstract: The present invention is an apparatus, or plug, for closing an inlet port. The inlet port is formed in a sheet of a typically flexible material. The inlet port is designed to mate with an air hose nozzle. The plug blocks the inlet port when no air hose nozzle is engaged. The plug has a generally planar shape with coplanar extensions extending radially from the plug body. The plug is engaged by causing at least two of the extensions to be received in the inlet port. When the extensions are received, the plug is retained gains the inlet port.

Abstract: A method of determining the physiological reactivity of an individual with respect to images, comprising: measuring at least one physiological parameter of an individual during a baseline calm period of time; measuring the said at least one physiological parameter of said individual during a stress period of time and a succeeding rest period of time; dividing said measured data for each of said periods of time into a plurality of predetermined time segments; computing a histogram or Fourier analysis as appropriate on said predetermined time segments for each said period of time; standardizing said computed data; conducting a principal component analysis, a canonical discriminant analysis, or a neural network, on said data to establish a baseline calm or rest period set of scores and a stress period set of scores; measuring the said at least one physiological parameter of said individual during an image presentation period of time; repeating said time segmenting, said histogram or Fourier analysis, and said st

Abstract: Methods and apparatus for inducing necrosis and degradation of blood vessels are described. The invention is suitable to treat various conditions such as varicose veins and telangiectasia. The apparatus for inducing degradation of a blood vessel in a tissue, e.g., skin, includes an external energy source that non-invasively delivers to the blood vessel energy that is preferentially absorbed by the blood vessel to heat the blood vessel walls to a temperature of at least about 60 degrees centigrade, and a pressure source connected to the energy source to collapse the blood vessel once the blood vessel walls have been heated to at least about 60 degrees centigrade for a period of time and with a force sufficient to permanently weld the apposed walls of the blood vessel together, whereby the blood vessel undergoes necrosis and degradation.