Abstract: An improved laser fiber assembly is provided which is capable of both effecting direct ablation of tissue or of effecting deep tissue coagulation. The fiber assembly is preferably provided with an orbicular tip for effecting direct ablation in a contact mode. Adjacent the orbicular tip is a cylindrical diffuser element which effects a cylindrical shaped emission pattern when the .orbicular tip is not in contact with tissue. The diffuser element is preferably protected with a covering, such as a teflon tubing element. Alternative embodiments use one or more cylindrical-segment diffuser elements in place of the cylindrical element. The fiber assembly is useful in a wide variety of surgical situations, and is particularly useful for treatment of benign prostatitis hyperplasia. The method of the invention includes the steps of bringing the tip of the dual action fiber assembly into contact with tissue to be ablated or adjacent tissue to be treated for deep tissue coagulation.

Abstract: For an interstitial thermotherapeutic treatment of biological tissue in which, for generating a coagulation necrosis, the radiation of the laser within a radiation period is guided into the tissue by way of a fiber optic waveguide, the laser power is reduced continuously or in steps during the radiation period.

Abstract: An adjustable locking handle securely grips an associated surgical tool for fixing the tool to the handle. The tool has first and second coupling portions, while the handle has an elongated body with fixed and movable jaws thereon respectively adapted for engagement with the first and second coupling portions on the tool. The movable jaw is pivotally movable about a fixed axis between locking and unlocking conditions relative to the fixed jaw by means of a linkage including a locking lever pivotally mounted on the body and a release lever pivotally interconnecting the locking lever and the jaw.

Abstract: An improved radial light emitting ureteral stent is disclosed having an elongated tubular member of substantially uniform outside diameter throughout its length and having a proximal and a distal end, the stent having a central lumen and at least one drainage opening extending through a wall connecting the lumen to the outside, the improvement being the inclusion of at least one fiber optic strand along a length of the tubular member, the strand capable of radially emitting light. The fiber optic strand is connected to a variable voltage source, the strand either being embedded within a wall of the stent or in associative contact with an exterior periphery of the tubular member.

Abstract: A method and apparatus are disclosed for automatically delivering a laser beam [30] to an intricate colored region [23] of a treatment area [32], e.g. for laser photocoagulation treatment of venular malformations and other dermatological conditions. Reflected light from the treatment area [32] travels into the delivery console [28] to a color-sensitive detector which signals a control system to permit the laser beam [30] to be delivered to the treatment area [32] only when the beam is focused on a spot having a predetermined color. By scanning over the treatment region, the laser automatically treats only the area having a specified color. Since reflective optics are employed, the reflected light precisely indicates the color of the region where the treatment beam is focused. Reflective optics also provide a smaller and more precise spot size for the treatment beam.

Abstract: A method is described to repair hallux valgus which involves a medial incision as the primary incision, mechanical stabilization of the first and second metatarsals during and after a proximal chevron osteotomy of the first metatarsal shaft, reorientation of the metatarsal segments to compensate for hallux valgus, and stabilization of the reoriented metatarsal during healing by insertion of a fixation device which may be removed later with little trauma to surrounding tissues. The fixation device comprises an elongated, relatively rigid stabilizing member of biocompatible material sized to pass from the medial side of the first metatarsal through the first and second metatarsals and out the lateral side of the second metatarsal, and two retainer members cooperating with the segments of the stabilizing member, medial to the first metatarsal and lateral to the second, adapted to prevent migration of the stabilizing member as the wound is healing.

Abstract: Disclosed is a device for delivering tissue adhesives to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or animal. Also disclosed is a method of delivering tissue adhesives to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity, within a human or animal. The method is particularly suited to sealing perforations in vascular walls, such as after arterial access for Percutaneous Transluminal Coronary Angioplasty (PTCA), Percutaneous Coronary Angiography and Percutaneous Coronary Atherectomy and similar diagnostic and therapeutic procedures.

Abstract: A tissue resection device for preferred use in an organ inflated with non-conductive optically transparent fluid under pressure is disclosed. The instrument includes a rigid shaft having a proximal end, a distal end, and defining a perfusion lumen extending therebetween. At its distal end, the shaft is provided with a rounded blunt end having an elongate aperture exposing the lumen near the distal end. A drive tube is rotatably disposed within the shaft lumen and has a proximal end, a distal end, and a drive tube aspiration lumen extending therebetween. A cutting head is mounted on the distal end of the drive tube and has a laterally disposed cutting edge which can resection either by conventional cutting or electrocautery. This laterally disposed cutting edge is communicated to an internal passage between the cutting edge and the aspiration lumen of the drive tube so that tissue severed as the cutting head is rotated may be drawn directly into the aspiration lumen.

Abstract: An apparatus and method are provided for reducing, stabilizing, and fixating a pelvic ring fracture. The apparatus is a modular device that includes a plurality of clamps mountable to an exposed fractured pelvis with bone screws, at least one clamp on either side of the fracture. The clamps and the fracture are spanned by an elongated rod that is sufficiently pliable to be shaped to conform to the contours of the pelvis and sufficiently strong to stabilize and fixate the fracture. The method of treating the pelvic fracture includes affixing at least one clamp on each side of the fracture, cutting and shaping the rod, and securing the rod within the clamps to fixate the fracture. The modularity of the apparatus provides that the rod can be easily removed for reshaping as needed, and that the clamps can be easily removed for repositioning as needed.

Abstract: A surgical scalpel has a retractable sleeve. An elongated handle with a contoured grip portion is releasably attached to a blade holder securing a surgical blade. The blade holder is secured to the handle by a hook and groove assembly and a male to female connection. The sleeve slides between an extended position and a retracted position on the handle and blade holder. The extended position of the sleeve covers the blade thereby protecting operating room personnel. An arch on the sleeve contacts the hook and disengages the hook out of the groove to facilitate removal of the blade holder.

Abstract: The invention provides a fixator device for controlling the position of the femur relative to the pelvis during surgery, comprising a first curved rigid bar member having a pelvis anchor member disposed along its length for anchoring the bar member to the innominate bone of the pelvis, said bar member having a first end for anchoring to the upper pelvis and a second end for anchoring to the lower pelvis, and a second bar member attached at one end to the first bar member, and having a femur anchor member at its second end for anchoring to the base of the femur, to thereby control and fix the position of the femur relative to the pelvis during surgical operations.

Abstract: A surgical instrument facilitates tying of a knot in a length of suture material at a remote surgical location. The instrument is comprised of an inner rod having a length of suture wrapped over the rod in a particular pattern. A needle may be secured to a free end of the suture and the pattern of wrapping the suture on the rod enables loops of suture to move off the rod end and over the needle to form a knot in the suture. The inner rod is received in an interior bore of an outer rod for manually controlled reciprocating movement therein. The inner rod is manually retracted into the interior bore of the outer rod to cause the outer rod to move the loops of suture off the inner rod end and over the needle in forming a knot in the suture.

Abstract: An illuminator including a differential optical radiator and a laser fiber disposed within the differential optical radiator. The differential optical radiator includes a first region that has a first level of reflectivity and a first level of transmissivity and a second region that has a second, higher level of reflectivity and a second, lower level of transmissivity. The first and second regions are positioned such and their reflectivities and transmissivities are chosen such that the radiator produces a substantially uniform pattern of illumination from the first and second regions.In another embodiment, the illuminator includes an expandable radiator and a laser fiber disposed within the expandable radiator. The reflectivity of the expandable radiator is such that the illumination at the outer surface of the expandable radiator is substantially uniform.

Abstract: An actuator mechanism and assembly for sequentially advancing and retracting a lancet needle includes a housing having an opening for operating projection of the needle. Two guide tracks are provided within the housing for guiding separate motions of a two-part needle holder structure propelled by a drive spring, and the needle itself is smoothly guided along one of the tracks to advance and thrust the needle into a tissue penetration position immediately followed by automatic retraction along the same highly accurate linear path.

Abstract: A surgical reamer is used in conjunction with a femoral neck cutting guide to enlarge the intramedullary canal of a resected host femur to expose hard cortical bone. The reamer has a longitudinally fluted cutting head that is flexible and able to bend relative to its longitudinal axis whereby to conform to axial or curved cortical bone surfaces to be engaged by like mating surfaces of a hip prosthesis to be implanted therein. In this regard, the cutting head includes a helical band spiralling between the ends of the cutting head.

Abstract: A surgical cutter is provided for removing body tissue during surgery. The surgical cutter includes a cannula having a proximal end and a distal end and a side wall defining an interior region. The distal end of the cannula is positioned inside a patient's body during surgery with the proximal end situated outside of the patient's body. The side wall of the cannula is formed to include an orifice for receiving body tissue. The surgical cutter further includes a first annular wall fixed to the distal end of the cannula and an annular intermediate wall. The first annular wall is arranged to define an annular gap disposed between the first annular wall and the cannula side wall. The annular intermediate wall includes an annular distal edge sized to be received by the gap.

Abstract: The surgical instrument system disclosed is particularly useful for endoscopic procedures. In the preferred embodiment, a hemostatic clip applicator can be directly connected to a trigger assembly or indirectly connected to the trigger assembly through the use of an extension. The connection between the extension and the clip applicator is secured to prevent accidental release during the procedure. The applicator receives a longitudinal input and translates the input into relative component motion through the use of gearing to apply the clips. The handle stem assembly in an alternative embodiment has a drive rod configuration that connects to a closure member so as not only to provide the distal biasing force, but also to provide, if needed, a proximal pulling force to assist in release of the jaw if it becomes necessary.

Abstract: A surgical instrument, in particular microsurgical scissors or cutters or tweezers or forceps, with a gripping portion and at least one gripping surface which extends over at least a section of the gripping portion and which affords enhanced friction in comparison with the adjacent sections of the instrument, is improved in that the gripping surface is in the form of a roughening with small, juxtaposed raised portions and depressed portions of different dimensioning and with an arrangement which is irregular in respect of dimensioning.

Abstract: A surgical instrument with two elements sliding into one another has at least one jaw part connected with a sliding element. Both elements are connected with one another detachably by means of a catch device. A distance between the end of a sliding element and the jaw part is variable, but is invariable when at least one jaw part is fixed.

Abstract: An apparatus to automatically position and operate surgical instruments, particularly for refractive keratic surgery, particularly lamellar refractive surgery, which includes a device for correctly positioning the apparatus in correspondence with an operating cot; a device for vertically raising all the apparatus; a horizontal guide, a first support member slideably arranged on the horizontal guide, a horizontal linear actuator, which determines the slide in both directions of the support member on the horizontal guide; a vertical guide, integral with the first support member, and at right angles to the horizontal guide; a second support member slideable in both directions on the vertical guide by way of a first vertical linear actuator; a member for operating and supporting the surgical instrument, borne by the second support member; a horizontal plate integral with the support member and endowed with a second vertical linear actuator which allows its raising and lowering in an autonomous manner, and an arm