Abstract: An internal bolster for use securing a medical device, such as a feeding tube, within a body of a patient is disclosed. In one embodiment, a feeding tube includes an internal bolster, comprising one or more bolster arms that each include a first end hingedly connected to a distal end of the medical device and a free second end. The bolster arms are selectively deployable between a first position wherein the bolster arms are substantially in-line with an axis of feeding tube, and a second position wherein the bolster arms are substantially deflected from the axis of the feeding tube to enable securement of the feeding tube within a stoma or other opening defined in the body. Various means for selectively moving the bolster arms between the first and second positions are disclosed. Related methods of use are also disclosed.

Abstract: A laryngoscope includes a blade that can be folded outwardly from a storage position to an operative position in which the blade extends from the handle at an angle of the order of 90°. Another laryngoscope includes two blade assemblies that are pivotally mounted together. Each assembly includes a blade and a removable outer sleeve or similar member that protects the blade. The assemblies can be folded outwardly from a storage position to an operative position in which the assemblies extend from each other an angle of the order of 90°. A doctor can remove the outer sleeve from a selected assembly and use the other assembly as a handle of the laryngoscope.

Abstract: Described herein are rotary transformers for coupling signals between components that rotate relative to one another. In an exemplary embodiment, a rotary transformer comprises a rotary shaft, a first magnetic core on the rotary shaft, and a first winding wound around the first magnetic core. The rotary transformer farther comprises a hollow second magnetic core, and a second winding wound along the inner wall of the second magnetic core. During operation, the first winding on the rotary shaft rotates within the second winding with the magnetic cores magnetically coupling signals between the two windings. Also, the first and second windings are closely spaced to provide capacitive coupling between the windings that extends the frequency response of the transformer. In one embodiment, the windings comprises substantially flat conductors wound in the shape of the windings. In another embodiment, each of the windings comprises circular loops connected by jogs.

Abstract: Systems and methods of removing bacterial biofilm from a target site using a biofilm removal endoscope. The endoscope has an insertion portion including an imaging channel terminating at a viewing window and an irrigation channel terminating at a nozzle. The imaging and irrigation channels are permanently affixed relative to one another. The insertion portion is inserted into the patient, with a working end thereof being disposed proximate the target site. The target site is imaged and a flow of fluid is dispensed via the nozzle to mechanically remove bacterial biofilm from the target site.

Abstract: A system of rotate-to-advance medical devices including catheters, dilators, occluders, stents, suprapubic catheters and camera introducers configured with external screw threads and depending substantially on rotation for means of advancement and emplacement in mammalian genitourinary and gastrointestinal passages and organs.

Abstract: Described herein are rotary transformers for coupling signals between components that rotate relative to one another. In an exemplary embodiment, a rotary transformer comprises a rotary shaft, a first magnetic core on the rotary shaft, and a first winding wound around the first magnetic core. The rotary transformer further comprises a hollow second magnetic core, and a second winding wound along the inner wall of the second magnetic core. During operation, the first winding on the rotary shaft rotates within the second winding with the magnetic cores magnetically coupling signals between the two windings. Also, the first and second windings are closely spaced to provide capacitive coupling between the windings that extends the frequency response of the transformer. In one embodiment, the windings comprises substantially flat conductors wound in the shape of the windings. In another embodiment, each of the windings comprises circular loops connected by jogs.

Abstract: The invention relates generally to medical devices and methods for the treatment of ocular disorders. One method provides an implant having an inlet portion with a first anchor and an outlet portion with a second anchor. The implant is implanted in tissue of an eye such the implant conducts fluid from an anterior chamber of the eye to a physiological outflow pathway of the eye. The implanting involves positioning the first anchor adjacent eye tissue, positioning the second anchor within the physiological outflow pathway, and deploying the second anchor such that the second anchor secures the implant within the physiological outflow pathway and a distal end of the second anchor is positioned further into the physiological outflow pathway than an outlet of the outlet portion.

Abstract: Therapeutic device intended for the selective cytoreductive treatment of an obstruction in a natural lumen or passage of the human or animal body, said lumen being obstructed by the effect of a local cell proliferation, said device comprising a tubular element, in particular of cylindrical shape, intended to be placed in said natural lumen and sufficiently flexible to conform to said natural lumen, but sufficiently rigid to maintain an artificial channel in said lumen. The tubular element supports lengthwise a medicinal sleeve which is intended to come into line with, and into contact with, the obstruction once the natural lumen has been intubated, and is designed to deliver locally, at least in its outer surface portion, at least one therapeutic agent which is cytoreductive, in particular cytotoxic, through contact with the cells under whose effect said lumen is obstructed.

Abstract: Systems and methods of removing bacterial biofilm from a target site using a biofilm removal endoscope. The endoscope has an insertion portion including an imaging channel terminating at a viewing window and an irrigation channel terminating at a nozzle. The imaging and irrigation channels are permanently affixed relative to one another. The insertion portion is inserted into the patient, with a working end thereof being disposed proximate the target site. The target site is imaged and a flow of fluid is dispensed via the nozzle to mechanically remove bacterial biofilm from the target site.

Abstract: An elongated cannula with an inner tube that is designed to cooperate with a corresponding outer tube. The cannula may include a cam mechanism, a plurality of flexible members designed to expand and deploy when the inner and outer tubes move relative to each other, and a pressure ring disposed on the outer tube. The inner and outer tubes are slidably moveable relative to each other in at least one direction.

Abstract: Methods are disclosed for the providing oxygenated blood to venous circulation. Embodiments include a femoral access approach to the creation of an Aorta-caval fistula at the bifurcation of the Aorta and the Inferior Vena Cava; an apparatus for the creation, modification and maintenance of a fistula; and a method of supplying oxygenated blood to the venous circulation of a patient. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

Abstract: A venous shunt system and method adapted to shunt cerebral spinal fluid in a patient. A fluid control device having a fluid passage is adapted to be placed allowing cerebral spinal fluid to flow through the fluid passage. A catheter having a lumen, the catheter being in fluid communication with the fluid control device. At least a portion of at least one of the catheter and the fluid control device being subjected to an anti-thrombogenic treatment.

Abstract: An apparatus for the injection of therapeutic and other agents at a target site within a patient's body. A catheter including a first elongated shaft having a distal end and a proximal end and a lumen extending therebetween. The catheter also including a second elongated shaft slidingly disposed in the first elongated shaft, the second elongated shaft having a distal end and a proximal and a lumen extending therebetween. The catheter further including a third elongated shaft disposed in and attached to the second elongate shaft, the third elongated shaft to move in a one-to-one relationship with the first elongated shaft and the second elongated shaft to maintain a predetermined needle deployment length as each are subjected to various bend configurations.

Abstract: An endoscope device obtains tissue information of a desired depth near the tissue surface. A xenon lamp (11) in a light source (4) emits illumination light. A diaphragm (13) controls a quantity of the light that reaches a rotating filter. The rotating filter has an outer sector with a first filter set, and an inner sector with a second filter set. The first filter set outputs frame sequence light having overlapping spectral properties suitable for color reproduction, while the second filter set outputs narrow-band frame sequence light having discrete spectral properties enabling extraction of desired deep tissue information. A condenser lens (16) collects the frame sequence light coming through the rotating filter onto the incident face of a light guide (15). The diaphragm controls the amount of the light reaching the filter depending on which filter set is selected.

Abstract: The present invention relates to a catheter that includes an elongate body having distal and proximal ends, the elongate body having at least one lumen therethrough, a distal portion of the elongate body having a perimeter. First and second retention members of the catheter are first and second retention members selectively disposed in either an insertion state or a retention state. In the insertion state, the first and second retention members form a distal body defining a central axis, the central axis being generally spaced apart from the perimeter of the distal portion of the elongate body, the distal body and elongate body insertable along a passageway of a mammal. In the retention state, the first and second retention members are selectively disposed in a spaced apart configuration to resist proximal movement of the catheter along the passage of the mammal.

Abstract: Devices and methods are provided for temporarily inducing cardioplegic arrest in the heart of a patient and for establishing cardiopulmonary bypass in order to facilitate surgical procedures on the heart and its related blood vessels. Specifically, a catheter based system is provided for isolating the heart and coronary blood vessels of a patient from the remainder of the arterial system and for infusing a cardioplegic agent into the patient's coronary arteries to induce cardioplegic arrest in the heart. The system includes an endoaortic partitioning catheter having an expandable balloon at its distal end which is expanded within the ascending aorta to occlude the aortic lumen between the coronary ostia and the brachiocephalic artery. Means for centering the catheter tip within the ascending aorta include specially curved shaft configurations, eccentric or shaped occlusion balloons and a steerable catheter tip, which may be used separately or in combination.

Abstract: A selectively coupleable and remotely actuateable surgical attachment for use with an electromechanical driver device for use in expanding occluded vessels and lumens. The attachment includes an axial rod which is coupleable to the electromechanical driver device, and which is selectively rotateable in accordance with the action of the electromechanical driver device. The rod is also threaded in opposing orientations at either end thereof. A pair of nuts are mounted to the rod, and specifically on the opposing threads. The rod and nuts are disposed within an axial track which permits the rod to turn, but constrains the rotational motion of the nuts, thereby permitting the nuts to move axially along the threadings of the rod when the rod turns. Attached to the nuts are a series of jointed spokes which are coupled to a flexible tubular shroud which surrounds the entire assembly.

Abstract: An expandable cage is expanded within a narrowed region of a blood vessel. The expandable cage has openings therein so that plaque protrudes through the openings when the cage is expanded. A material removing element passes within the cage to remove the plaque extending into the openings. The openings are preferably formed by integrally formed elements which provide a smooth internal surface. The material removing element passes along the smooth internal surface when removing the plaque. A collection bag is coupled to the material removing element to capture the material which has been removed.

Abstract: The present invention provides a catheter positioning system which serves to control and stabilize a distal end of a catheter at a treatment site within a patient so that a medical procedure can be performed with accuracy. Generally, the positioning system operates by providing a deformable mechanical members at the distal end of the catheter which can be operated from the proximal end of the catheter to extend radially outward to engage surrounding tissue adjacent to treatment site. In one embodiment of the invention a flexible superstructure comprising the plurality of flexible veins extending longitudinally along the distal end of the catheter can be deformed to bow radially outward to engage surrounding tissue. The distal tip of the catheter joined to one of the veins was correspondingly displaced or rotated angularly as the veins bow outward.

Abstract: An embolic protection device for use in medical, veterinary, non-medical or industrial applications where removal of an obstruction from a small diameter vessel or vessel-like structure could produce particles, which, if allowed to remain in the vessel, could cause undesirable complications and results. One embodiment comprises a catheter for insertion into a vessel and a trap operably connected to the catheter and to a rotatable member. Rotating the rotatable member relative to the catheter actuates the trap. One embodiment comprises a rotatable member that actuates a flexible strut between an arcuately expanded position and a helically twisted position, and a membrane operably connected to the flexible strut.

Abstract: A catheter including an injection port at or near the distal end thereof and a mechanism for causing the injection port to move between a first position and a second position. In the first position the injection port is substantially aligned with a central axis of the catheter. Upon activation of the mechanism, the injection port moves between the first position and the second position perpendicular to the central axis of the catheter. The mechanism also causes the injection port to move away from the central axis of the catheter and into a wall of the vasculature.

Abstract: By interposing an adapter between the endotracheal or tracheal tube inserted to a patient and the ventilation and suction systems that are connected to the endotracheal tube, a medication catheter could be inserted via an input port built into the adapter so as to enable a medical personnel to provide medicaments to a patient without having to disconnect either one of the systems connected to the endotracheal tube. The adapter is configured to have a securing mechanism that allows the medical personnel to secure the medication catheter in place. A one way valve fitted to the apertured arm that forms the input port of the adapter prevents any back flow of fluid from the input port.

Abstract: An embolic protection device for use in medical, veterinary, non-medical or industrial applications where removal of an obstruction from a small diameter vessel or vessel-like structure could produce particles, which, if allowed to remain in the vessel, could cause undesirable complications and results. One embodiment comprises a catheter for insertion into a vessel and a trap operably connected to the catheter and to a rotatable member. Rotating the rotatable member relative to the catheter actuates the trap. One embodiment comprises a rotatable member that actuates a flexible strut between an arcuately expanded position and a helically twisted position, and a membrane operably connected to the flexible strut.

Abstract: A surgical introducer sheath comprising a first member having a first longitudinally extending lumen dimensioned to receive a surgical instrument therethrough, a second member having a second longitudinally extending lumen dimensioned to receive the first member, and a retainer adjacent a distal portion of the second member movable from a first retracted position to a second extended position to limit proximal movement of the introducer sheath. Rotational movement of the second member in a first direction moves the retainer to the extended position and rotational movement of the second member in a second direction moves the retainer to a retracted position.

Abstract: An angioplasty device and particle trap for use in medical, veterinary, non-medical or industrial applications where removal of an obstruction from a small diameter vessel or vessel-like structure could produce particles, which, if allowed to remain in the vessel, could cause undesirable complications and results. One angioplasty device embodiment comprises a catheter for insertion into a vessel-like structure and a trap operably connected to the catheter and to a rotatable member. Rotating the rotatable member relative to the catheter actuates the trap. One particle trap embodiment comprises a rotatable member that actuates a flexible strut between an arcuately expanded position and a helically twisted position, and a membrane operably connected to the flexible strut.

Abstract: A system of rotate-to-advance medical devices including catheters, dilators, occluders, stents, suprapubic catheters and camera introducers configured with external screw threads and depending substantially on rotation for means of advancement and emplacement in mammalian genitourinary and gastrointestinal passages and organs.

Abstract: A selectively coupleable and remotely actuateable surgical attachment for use with an electromechanical driver device for use in expanding occluded vessels and lumens. The attachment includes an axial rod which is coupleable to the electromechanical driver device, and which is selectively rotateable in accordance with the action of the electromechanical driver device. The rod is also threaded in opposing orientations at either end thereof. A pair of nuts are mounted to the rod, and specifically on the opposing threads. The rod and nuts are disposed within an axial track which permits the rod to turn, but constrains the rotational motion of the nuts, thereby permitting the nuts to move axially along the threadings of the rod when the rod turns. Attached to the nuts are a series of jointed spokes which are coupled to a flexible tubular shroud which surrounds the entire assembly.

Abstract: A device for occluding a vessel employs one of a number of different expansion members joined to one or more elongate members. The expansion member may include a braid, one or more coils, ribs, a ribbon-like structure, a slotted tube, or a filter-like mesh. If the expansion member is enclosed by a suitable membrane, the device seals with the vessel wall to partially or completely occlude the vessel. A perforated membrane may be used to permit the perfusion of blood. The expansion member may be self-expanding, or it may be expanded by engaging it with one of the elongate members. Alternatively, the expansion member may be expanded by heating it.

Abstract: A method for treatment of multiple sclerosis and related disease states. A histamine H2 mimicking agent is administered in an amount which is effective to stimulate production of a cyclic AMP in the body. A phosphodiesterase inhibitor is administered in conjunction with the histamine H2 mimicking agent to conserve the cyclic AMP which is thus produced. It is believed that the increased cyclic AMP levels serve to maintain the patient's myelin against self degeneration. The histamine H2 mimicking agent may be histamine phosphate and the phosphodiesterase inhibitor may be caffeine. The histamine H2 mimicking agent and the phosphodiesterase inhibitor may be mixed in a gel and administered using a transdermal patch.

Abstract: A vibratory device (20) for treating female voiding dysfunctions, such as urinary stress incontinence, by inserting it into a patient's urinary tract and imparting vibrations to the urethral walls and the bladder neck. The device is made in the form of a urological bougie (23) which has a distal end and a proximal end and consists of two resilient rods (26 and 28). The rods are removably interconnected at their distal ends by means of two short extensions (52a and 52b) which are inserted into a cup-shaped cavity (68). This cavity is formed at the end of a cam (66). The cam has an elliptical or oval shape and is driven into rotation from a rotary drive unit (24) through a cam shaft (64) which passes through the hole formed by grooves (54) on the mating surface of the rods. Due to the elliptical configuration of the cam, its rotation causes expansion of the rods (26 and 28).

Abstract: A mechanical prosthesis deployment device for enlarging a flow passage of a vessel by delivering and deploying an expandable stent or prosthesis within an obstruction in the vessel. The prosthesis deployment device comprises a cylindrically shaped expansion member adapted to be disposed within the expandable prosthesis and includes a means engaged to the expansion member for altering the distance between the proximal end and the distal end of the expansion member thereby transforming the expansion member between a diametrically contracted configuration and a diametrically expanded configuration.The present method comprises the steps of advancing the expansion member to the obstruction in a vessel and applying opposed forces on said expansion member in an axial direction to move the expansion member to an expanded configuration wherein the expansion member exerts radial force on said prosthesis and said prosthesis is expanded and implanted into the vessel.

Abstract: A multi-lumen enteral feeding and medicating device having a gastric tube adapted to be introduced into the interior of a patient's stomach through a stoma. The gastric tube has a balloon to engage and seal against the interior wall of the stomach around the stoma and a locking ring to engage the skin of the patient surrounding the exterior opening of the stoma. A jejunal tube is slidably engaged in the gastric tube for relative longitudinal sliding displacement so that the distal end of the jejunal tube may be threaded through the stomach into the jejunum for introduction of a fluent material through ports adjacent the distal end of the jejunal lumen. A fluid lumen is provided in the gastric tube for applying positive and negative pressure to the interior of the balloon to extend and retract the same and an inlet attachment is provided for accessing the gastric lumen for introducing fluent material into the stomach through the gastric lumen.

Abstract: An intravascular stent and delivery system comprising a helically-shaped spring and means for expanding the stent from a first diameter to a second larger diameter, and releasing the stent for implantation within a vessel lumen; a method for intraluminal implantation of an intravascular stent using the said device. The stent and delivery device are particularly adapted to hold open a blood vessel after a vascular procedure therein such as an angioplasty.

Abstract: An apparatus is provided for supporting a Verres needle which includes a mechanism for grasping a portion of the abdomen such that the needle may be moved to penetrate the abdomen to create a space between the abdominal wall and the abdominal organs and includes a mechanism for advancing the Verres needle toward the abdominal cavity by relative movement to the needle with respect to the portion of the apparatus which holds the needle. The apparatus further includes a mechanism for controlling the movement of the needle relative to the grasping portion of the apparatus.

Abstract: An in vivo extrapulmonary blood gas exchange device is disclosed having a hollow fiber bundle in gaseous communication with a coaxial dual lumen tube and having a furling apparatus for twisting one coaxial lumen relative to the other. The furling apparatus enables the outside diameter of the bundle of gas permeable tubes to be selectively adjusted to provide either a furled, small insertion diameter when inserting the apparatus into the venae cavae of a patient or an unfurled, expanded oxygenation diameter after the apparatus is in place within the venae cavae and the bundle of gas permeable tubes is deployed therein. The oxygenator is inserted into the patient through a single incision at one of the right external iliac, common femoral, or internal jugular veins. A novel distal tip configuration permits the oxygenator to be inserted into the patient utilizing an over-the-guidewire intravascular insertion technique.

Abstract: A vibratory method for treating female voiding dysfunctions by applying to the inner walls of the urethra radial expansion forces combined with axial friction forces. This improves blood circulation, trains the urethral sphincters, and produces massaging action on the urethral walls. A device for realization of the method comprises a probe (12) formed of two rods (16) and (18) and a drive unit (14). Drive unit (14) have two output elements, which reciprocate simultaneously in mutually opposite directions. Each rod (16, 18) is connected to a respective drive unit. On their inner or mating surfaces the rods have respective cams (32, 34) and curved grooves (36, 38). During reciprocation of the rods, the cams and grooves interact and thus provide radial expansions of probe (12). Massaging action is provided by serrations (40) which are formed on the outer surface of the rods and massage the inner walls of the urethra through application of friction forces.

Abstract: The luxation-proof drainage and instrument duct for the arthroscopy comprises a hollow cylinder (20) and a sleeve (30) longitudinally displaceable thereupon which are interconnected at the one end, while the sleeve (30), within the area of its connecting end, is constructed in such a way that, when the sleeve (30) is displaced towards the connection plane, a terminal area of the sleeve is outwardly expanded in a basket-like manner over the circumference of the sleeve, the basket-like expanded sleeve end being provided with a plurality of perforations (135') disposed so as to be distributed over the circumference and in side-by-side arrangement. The sleeve (30) is arrested on the hollow cylinder (20) in the expanded state of the terminal section of the sleeve (FIG. 1).

Abstract: A mechanically-expandable instrument for treating diseases in the urethra and the neck of the urinary bladder, comprising a driver having two elements which, upon selective activation thereof, will reciprocate in two mutually opposite directions; a probe comprising two rods, each having a semicircular cross-section such that when one of the rods is placed adjacent the other, they will form a substantially complete circle in cross section. The rods are attached to each other at one end thereof to form a tip, their other ends being attached to the respective reciprocating elements, the mating surfaces of the rods having at least one pair of engaging cams, for causing the rods to expand and contract in diameter due to engagement of the cams in response to reciprocations of the rods.

Abstract: This invention provides an improvement in a method of surgically treating an esophageal varix utilizing an endoscope wherein air under pressure is directed to expand a patient's esophagus and wherein the varix is located, punctured and injected with a sclerosing material. The subject improvement involves directing a dual-lumen balloon tube through the patient's esophagus, the dual-lumen balloon tube including a primary suction lumen and a secondary inflation lumen. After the vatix is located, punctured and injected with sclerosing material, the balloon tube is partially withdrawn to position the balloon adjacent the varix and fluid under pressure is directed through the secondary lumen to inflate the balloon to thereby compress the varix to assist in stemming the flow of blood therefrom. Suction is then applied to the primary lumen to relieve pressure in the patient's stomach.

Abstract: A catheter for insertion into a biological duct such as an artery, comprised of a flexible aspiration tube disposed within a delivery sleeve and connected at one end to a source of vacuum for providing suction within the duct in the vicinity of a biological obstruction, such as a blood clot. An injection tube extends through the aspiration tube for injecting medication into the duct, and an ultrasonic energy source also extends through the aspiration tube for transmitting ultrasound in the vicinity of the obstruction. The transmitted ultrasound and injected medication cooperate to emulsify and fragment the obstruction, and the fragmented obstruction is removed through the aspiration tube in response to suction being applied thereto. The catheter is compact and easily manipulable, providing substantial surgical accuracy.

Abstract: The intravascular expandable device is adapted to be inserted within and through the lumen of a blood vessel and to be manipulated therethrough to a stenotic area where it can be operated for re-establishing desired blood flow through the blood vessel. The device comprises an elongate tubular body having a distal end and a proximal end, an expandable pressure applying assembly including a flexible tubular member mounted to the distal end of the tubular body and a mechanism operable to expand the tubular member outwardly. A tip member is connected to the distal end of the flexible tubular member and an expansion and retraction control mechanism is coupled to the pressure applying assembly for expanding, maintaining expanded or retracting the flexible tubular member relative to a stenotic area within the blood vessel. Preferably, passage means are provided around or through the pressure applying assembly in the device so that the flow of blood through the vessel is not interrupted.