Abstract: A rigid extractor is revealed, a rigid device for use in percutaneous procedures to remove kidney stones directly from the kidneys. The rigid extractor uses a handle fixed to an outer rigid cannula, and an inner cannula to control an extraction device that may be removable from the inner cannula. The extractor is desirably used with a fluoroscope, in which the surgeon maneuvers the extractor with the aid of a view of the operating field provided by the fluoroscope. The surgeon then maneuvers the extractor to grasp the kidney stones and remove from the patient. The extractor may also be used with a nephroscope. The device may be used with a removable extraction device such as a basket, a grasper a pair of jaws, or a pair of scissors.

Abstract: Double ended wire guides are manufactured so that either end, or both ends sequentially, may be inserted into a patient. The ends are different, so that the inventory requirements of wire guides are minimized. For example, a wire guide may have a straight end and an angled end, either end suitable for use on the patient. The wire guides may also differ in other characteristics, such as the stiffness or the diameters of the distal and proximal portions. The wire guide may also be stored in a package, the package including a fitting so that wetting solution may be injected into the package to wet the wire guide and prepare it for use.

Abstract: A rigid extractor is revealed, a rigid device for use in percutaneous procedures to remove kidney stones directly from the kidneys. The rigid extractor uses a handle fixed to an outer rigid cannula, and an inner cannula to control an extraction device that may be removable from the inner cannula. The extractor is desirably used with a fluoroscope, in which the surgeon maneuvers the extractor with the aid of a view of the operating field provided by the fluoroscope. The surgeon then maneuvers the extractor to grasp the kidney stones and remove from the patient. The extractor may also be used with a nephroscope. The device may be used with a removable extraction device such as a basket, a grasper a pair of jaws, or a pair of scissors.

Abstract: A medical retrieval device is provided which includes an elongated cylindrical member having a passage extending therein and having a metallic proximal and distal portions. The proximal and distal portions are formed as separate pieces and connected at a junction. The elongated cylindrical member has an area of substantially constant inner and outer diameters extending at least from a portion of the proximal portion closely adjacent to the junction through the junction and to a portion of the distal portion closely adjacent to the junction.

Abstract: A rigid extractor is revealed, a rigid device for use in percutaneous procedures to remove kidney stones directly from the kidneys. The rigid extractor uses an outer rigid cannula and an inner cannula to control a basket retriever for removing kidney stones and calculi from a kidney of a patient. The extractor is desirably used with a fluoroscope, in which the surgeon maneuvers the extractor with the aid of a view of the operating field provided by the fluoroscope. The surgeon then maneuvers the extractor to grasp the kidney stones and remove from the patient. The extractor may also be used with a nephroscope. The device may also be used with a retrieval assembly other than a basket, such as a pair of jaws, or a pair of scissors.

Abstract: A flexible cannula is revealed, the cannula useful in graspers for the removal of objects such as stones, calculi, concretions, foreign bodies and the like from the urinary, biliary, vascular or other systems. The flexible cannula is made by removing material in a portion of the cannula near the distal end. The material is preferably removed by laser-cutting the cannula in a spiral pattern, so that material continuity and integrity is maintained, while allowing much greater flexibility. The technique may be used on standard graspers and on laser graspers, and is useful as a part of medical devices, such as ureteroscopes, in which a physician enters a body to remove objects. The flexible cannula may also be used with other devices to cut or spear objects for removal, such as for a biopsy.

Abstract: A medical retrieval device 10 is disclosed comprising an elongated cylindrical member 11 that includes a continuum of a material 40, preferably a metal such as stainless steel or nitinol, that forms both the resilient grasping members 13 of retrieval basket 54, snare 26, or grasper forceps 23, and the proximal portion 21 or shaft of the device. The elongated cylindrical member can include a metal cannula 60 or solid rod 62 into which a series of laterally adjacent longitudinal slots 15 are cut or formed in the distal portion 37 of the elongated cylindrical member to form a plurality of resilient grasping members. These slots may be cut in a spiral configuration to produce a helical basket 69. The resilient grasping members in the original compact shape 17 are formed into an enlarged shape 18 to create a workspace volume 28 for the capture, manipulation and/or retrieval of an object within a patient.

Abstract: A surgical tissue morcellator (10) for percutaneously morcellating and debulking tissue during a minimally invasive, endoscopic surgical procedure. In an insertion configuration, the morcellator includes an outer cutting sheath (11) and an insertion member (15) inserted therethrough and positioned relative thereto via a connector (20). The connector includes an adaptor (18) positioned at the proximal portion (13) of the outer cutting sheath. The adaptor includes a lock member (22) such as a pin extending radially into the bore (19) of the adaptor. A second lock member (23) in the form of a T-shaped slot is formed in the surface of the insertion member to receive and position the pin therein. In a morcellation configuration, the morcellator includes a handle (24) that is positioned in the bore of the adaptor.

Abstract: A releasable, surgical clamp (10) for insertion through a surgical introducer sheath (11) and into a cavity (12) of a patient (13) during a minimally invasive surgical procedure. The releasable clamp comprises a continuous wire (39) that is shaped for insertion through the surgical sheath and into opposing jaws (14, 15). The jaws have a plurality of open and closed positions. One of the jaws has a retainer (16) that maintains the lateral displacement (17) between the opposing jaws and prevents the clamp from twisting off a vessel. A resilient assembly (18) including a torsion spring (19) and first and second resilient arms (20, 21) extending to the opposing jaws urges the jaws to a closed position. Each of the resilient arms includes a distal portion which cross each other urging the opposing jaws to a closed position.

Abstract: A medical retrieval device is provided which includes an elongated cylindrical member having a passage extending therein and having a metallic proximal and distal portions. The proximal and distal portions are formed as separate pieces and connected at a junction. The elongated cylindrical member has an area of substantially constant inner and outer diameters extending at least from a portion of the proximal portion closely adjacent to the junction through the junction and to a portion of the distal portion closely adjacent to the junction.

Abstract: A medical retrieval device 10 is disclosed comprising an elongated cylindrical member 11 that includes a continuum of a material 40, preferably a metal such as stainless steel or nitinol, that forms both the resilient grasping members 13 of retrieval basket 54, snare 26, or grasper forceps 23, and the proximal portion 21 or shaft of the device. The elongated cylindrical member can include a metal cannula 60 or solid rod 62 into which a series of laterally adjacent longitudinal slots 15 are cut or formed in the distal portion 37 of the elongated cylindrical member to form a plurality of resilient grasping members. These slots may be cut in a spiral configuration to produce a helical basket 69. The resilient grasping members in the original compact shape 17 are formed into an enlarged shape 18 to create a workspace volume 28 for the capture, manipulation and/or retrieval of an object within a patient.

Abstract: A replaceable handle (10) for side loading the proximal end of a medical device (41) therein, which is typically inserted with the operating lumen of an endoscope. The replaceable handle is easily removed from the proximal end of the medical device for removing an endoscope over the medical device. with the endoscope removed, the replaceable handle can side-load the proximal end of the device for added manipulation of the distal end such as in removing a stone from the kidney or ureter leading therefrom. the replaceable handle includes an outer elongated housing (11) with passage (13) extending longitudinally therein with external communication (14) therealong. The outer housing also includes a first attachment mechanism (15) disposed about the distal end for receipt of a first medical device member therein. The handle also includes an inner elongated member (17) positioned in the housing passage and extending proximally therefrom.

Abstract: A minimally invasive, medical device 10 for removing stones, calculus or the like from the renal or biliary systems includes a reversibly collapsible basket 12 and an elongated member 14 for delivering the basket 12 to the location of the stones, calculus or the like. The basket 12 is tipless and atraumatic in use, and includes at least one superelastic wire loop 20 and at least one superelastic wire leg 26, the wire leg 26 preferably being incorporated into a second superelastic wire loop 24. The basket 12 is preferably formed from a shape memory material such as a suitably annealed nitinol alloy. The basket 12 includes means 28 for restricting relative movement of the first wire loop 20 and the wire leg 26 or the second wire loop 24, continuously formed with the first loop 20 and the leg 26 or the second loop 24. The movement restricting means 28 is preferably formed as a first smaller loop 30 in the first loop 20 interlocked with a second smaller loop 32 in the leg 26 or in the second loop 24.

Abstract: A releasable, surgical clamp (10) for insertion through a surgical introducer sheath (11) and into a cavity (12) of a patient (13) during a minimally invasive surgical procedure. The releasable clamp comprises a continuous wire (39) that is shaped for insertion through the surgical sheath and into opposing jaws (14, 15). The jaws have a plurality of open and closed positions. One of the jaws has a retainer (16) that maintains the lateral displacement (17) between the opposing jaws and prevents the clamp from twisting off a vessel. A resilient assembly (18) including a torsion spring (19) and first and second resilient arms (20, 21) extending to the opposing jaws urges the jaws to a closed position. Each of the resilient arms includes a distal portion which cross each other urging the opposing jaws to a closed position.

Abstract: A surgical cutting instrument for coring, debulking, and removing a large, tough tissue mass such as a fibroid tumor through a trocar access sheath during a minimally invasive surgical procedure. The instrument includes an outer sheath having a distal cutting end for coring the tissue mass and an inner elongated member having a distal, tissue affixation end such as a helical coil for inserting into and stabilizing the tissue mass during the surgical coring procedure. The cutting instrument further includes an instrument engagement assembly when in an engaged position for urging the outer sheath toward the distal end of the inner elongated member. As a result, tissue affixed to the distal end of the inner elongated member is cored as the outer sheath is urged toward the distal end of the inner member and engages the affixed tissue. The instrument engagement assembly includes sheath and member engagement subassemblies.

Abstract: A needle driver (100) for fixedly positioning a curved suture needle (101) in a channel (114) of an inner rod (109) thereof and in a preferred 90 degree orientation with respect to the longitudinal axis of the inner rod. The needle driver includes an outer tube (102) with a beveled edge (110) positioned transversely at the distal end thereof. The beveled edge includes a substantially straight segment (119) inclined at a preferred angle with respect to the longitudinal axis of the outer tube. The channel of the inner rod includes an undercut surface (116) and an intermediate surface (117) extending longitudinally therefrom. The undercut surface is formed at a preferred angle with respect the longitudinal axis of the inner rod, whereas the intermediate surface is substantially parallel to the axis.

Abstract: A surgical trocar access sheath having a laterally expandable retention mechanism for percutaneous insertion through a body cavity wall. The expandable retention mechanism is positioned about the distal end of the sheath for retaining the access sheath within the body cavity. The access sheath has an inner elongated member cannula and an outer elongated member tube having a slick surface for ready insertion through a puncture site. The laterally expandable retention mechanism includes a plurality of strips extending and formed longitudinally in the outer tube. The retention mechanism has an expanded state and a retracted state. In the expanded state, the longitudinal strips extend radially from the outer elongated member tube to engage the interior surface of the body cavity wall. The expandable retention mechanism is actuated by sliding an actuating mechanism hub attached to the distal end of the outer elongated member tube against another hub fixedly attached to the inner elongated member cannula.

Abstract: Echogenic medical devices and methods of fabrication and of use are disclosed. The devices are adapted to be inserted into a patient. The device includes an elongated member including a material having an acoustic impedance different from that of the surrounding medium. The medium includes surrounding biological tissue or fluids surrounding the member when inserted into a passageway of the patient. The acoustic impedance of the elongated member is sufficiently different from the surrounding medium for enhancing an image produced in response to a sonic beam produced from imaging equipment. The elongated member also includes an interface layer of a high density metal of which the deposition on the base material of the member is ion beam assisted. The interface layer includes an outside surface having a plurality of particulate-type, discontinuous curved surfaces of partially spherical indentations formed therein or spheres extending therefrom.

Abstract: Echogenic medical devices and methods of fabrication and of use are disclosed. The devices are adapted to be inserted into a patient. The device includes an elongated member including a material having an acoustic impedance different from that of the surrounding medium. The medium includes surrounding biological tissue or fluids surrounding the member when inserted into a passageway of the patient. The acoustic impedance of the elongated member is sufficiently different from the surrounding medium for enhancing an image produced in response to a sonic beam produced from imaging equipment. The elongated member also includes an interface including the outside surface of the member and a plurality of partially spherical indentations therein. Alternatively, generally spherical particles are attached to the surface of the member for producing the image in response to the sonic beam. Materials such as stainless steel, plastic, and glass are utilized in the manufacture of the medical device.

Abstract: A suture guide and, in particular, a urethral sound having interchangeable tips for placing sutures in the severed end of a body duct. The urethral sound includes an attachment mechanism having interconnection parts longitudinally rotatable when interconnected. The sound further includes an elongated member having a distal end portion including one of the interconnection parts. A plurality of interchangeable tips are provided each having a rounded distal end and a proximal end including the second interconnection part. Interchangeable tips are positioned at the distal portion of the elongated member and are longitudinally rotated thereat. Various tips include one or more apertures for placing sutures through, for example, a severed urethral stump created during a radical prostatectomy. Channels are also placed in a number of the tips to provide placement of individual sutures about the distal end of the severed stump as desired by the physician.