Abstract: Improved systems and methods are used for controlled infusion of fluid into a body cavity. In particular, the improved system allows a user to accurately control pressure created in a body cavity over a broad range of fluid flow rates required in various medical procedures. In one embodiment, the system comprises a pump having a conduit which defines a fluid flow path from the pump. Typically, a surgical instrument such as a resectoscope is coupled to the conduit to direct the fluid into the body cavity. The system controls pressure in the body cavity by using a first sensor to measure pump output and a second sensor to measure body cavity pressure. Preferably, the second sensor measures the actual pressure in the body cavity to correct for any pressure losses that may occur during fluid delivery from the pump.

Abstract: The present invention provides a tissue resection device comprising a handle housing having a fluid infusion lumen. A shaft is reciprocatably mounted to the housing, the shaft having an aperture adjacent to a distal end and a fluid and tissue aspiration lumen extending from the aperture to a proximal end of the shaft. A cutting member is disposed adjacent to the aperture to sever tissue as the shaft is reciprocated, and an imaging mechanism on the housing is oriented toward the cutting member, thereby allowing the attending surgeon to optically direct the removal of body cavity tissue. A chopping mechanism is disposed within the lumen of the shaft to reduce the size of tissues passing through the lumen.

Abstract: The invention provides systems and methods for interfering with the adhesion formation process. In some embodiments, the present invention makes use of intermittent blunt dissection of fibrin bridging adjacent tissues prior to the formation of adhesions. Dissection is generally provided by pulsing a balloon implanted between the tissues. Optionally, the balloon will comprise an elastic structure to disrupt the formation of fibrin between the balloon and the surrounding tissues. Alternatively, the balloon may be at least partially covered by a bio-active anti-adhesion material. In some embodiments, the anti-adhesion material forms an envelope which is left between the tissues when the balloon is removed.

Abstract: The present invention provides a tubular surgical cutter fabrication method comprising forming one or more tabs which extend beyond an end of a tube. Each of the tabs is then folded across at least a portion of the end of the tube, and affixed in the folded position to form an end structure extending across the end of the tube. A cutting edge is imposed on the tube adjacent to the end structure, thereby providing a tubular surgical cutter having the structural reinforcement of a closed end without resorting to welding or otherwise attaching a closed end structure about the perimeter of the tube.

Abstract: The invention provides tubular surgical cutters having conical or tapering cutting chambers along substantially the entire length of their cutting apertures. Tissues which are drawn into such a conical chamber and severed from the adjacent tissue are quite easily drawn proximally for aspiration, substantially reducing the likelihood that they will clog the cutter mechanism. In some embodiments, an inner cutting tube having an orifice which is smaller than that of the outer cutting tube limits the size of tissue fragments entrained within the cutting chamber, further reducing the possibility that those fragments will clog the aspiration lumen and interrupt the tissue removal process.

Abstract: The invention provides tubular surgical cutter devices which include aspiration flow control ports to enhance the ability of the cutter to remove severed tissues from an internal surgical site. The aspiration flow control ports will admit sufficient aspiration fluid to transport tissue fragments that are severed by the tubular surgical cutter through the lumen of the cutter, even when the severing aperture is entirely blocked by a target tissue. The aspiration flow control ports will typically be in one of two forms. In the first form, a vacuum relief port provides open fluid communication with the lumen of the tubular cutter when the cutting aperture is open to receive target tissues for severing. In the second form, a fenestration pattern through an outer tube of the cutter ensures that aspiration flow continues even when the cutting aperture of the outer tube is blocked.

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: 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 the distal end of the shaft, 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: This invention is directed to a member which is mounted on an elongated intraluminal device such as a catheter or a guidewire, preferably the proximal portion thereof, which releasably holds at least one turn of a coiled product. The coiled product may be the intraluminal device on which the fixture is mounted or it may be a separate product. In one embodiment of the invention, the turn holding member has a body and at least one flexible arm which holds a turn against the body of the fixture. In another embodiment of the invention, the holding member is a tubular element having a wall portion with a spirally shaped cutout through which a turn of coiled product can be advanced into the inner lumen or the tubular element.

Abstract: Providing fluid to an internal delivery site of a patient includes moving the fluid from a fluid reservoir through a conduit and through a delivery device at the delivery site while maintaining the fluid at a predetermined pressure. The delivery device may comprise an inflatable balloon with apertures formed in its periphery for directing the fluid into the vessel walls. Pressurized fluid is provided through the apertures of the balloon to the vessel wall. The pressure is automatically controlled to avoid both pressure spikes and unacceptable deflation of the balloon during administration of the fluid. A further feature includes comparing the pressure with the volume infused and in the event that pressure decreases while the volume infused increases beyond certain limits, the delivery of the fluid is stopped. Further features include a timer for limiting the inflation time of the delivery device and a volume detector for controlling the amount of fluid delivered.