Abstract: An endoscopic surgery pouch including a compartment attached to an elongate member, both made from woven plastics material. The pouch is deployed along a cannula using a flexible rod which also stiffens the deployed compartment. The pouch is particularly useful for gall bladder surgery.

Abstract: A surgical instrument assembly for use in snare cauterization operations includes a tubular sheath member, a cauterization loop, and a wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is connected to the wire for feeding an electrical current to the loop, while an actuatable shifter is connected to the wire for sliding the wire along the sheath. A flexible web member is removably attached to the loop to form a capture pocket. During use the loop is passed over a polyp to be removed so that the web member substantially surrounds the polyp. The loop is then closed to engage the polyp around a base region thereof and an electrical current is conducted through the loop to burn through the polyp at the base region. The severed polyp is automatically captured by the web member.

Abstract: The wire loop of a surgical snare is constructed so as to include a weakened or frangible region. When it is desired to open the loop so as to move it from its entrapped position on a polyp, an additional force is exerted on the loop to draw it further into the sheath. This causes the frangible region to break, thereby opening the loop and permitting the wire to slide free of the polyp. In accordance with an alternate embodiment, the wire loop is constructed so as to fold back on itself, with the folded back end being captured by a retaining element inside the sheath. When the loop becomes entrapped on a polyp, it is extended out of the sheath somewhat further than during normal use, at which point the captured end of the loop is released, opening the loop and permitting its removal from within the patient.

Abstract: A method for removing a polyp from inside a patient, comprises the steps of inserting an endoscopic insertion member into a patient, ejecting a cauterization loop from the insertion member, and maneuvering the insertion member and the cauterization loop from outside the patient to place the cauterization loop over a polyp inside the patient. A web member is ejected also from the endoscopic insertion member and is opened from a collapsed configuration to a substantially cup shaped opened configuration having a concave inner surface. The endoscope insertion member and the opened web member are maniipulated from outside the patient to juxtapose the concave inner surface of the web with the polyp, whereupon suction is applied to the web member to form a negative pressure zone between the web member and the polyp, thereby attaching the web member to the polyp in a vacuum seal. Then electrical current is conducted to the cauterization loop to sever the polyp from the patient.

Abstract: A laparoscopic surgical device comprises an elongate shaft having a plurality of electrically conductive flexible ribs connected to the distal end of the shaft and to one another to form a cage or basket. Upon placement of an organic body in the cage, the ribs are electrically energized. The organic body is pressed against the ribs to dissect the ribs in a single cauterization operation.

Abstract: A medical device has a body, an actuating member mounted to move relative to the body, a working element, and an elongated force-transmitting member capable of transmitting actuating force between the actuating member and the working element. The force-transmitting member includes a flexible cable portion, the force-transmitting member is attached, on one side of the cable portion, to the body and associated in a driving relationship on the opposite side of the cable portion with the working element. According to the invention the actuating member includes a pulley surface bodily movable therewith, the cable portion is trained about the pulley surface such that movement of the actuating member a given distance, relative to the body, causes the working element to move a substantially greater distance than the given distance. Another aspect of the invention is a medical snare with the above features.

Abstract: Various embodiments of a reclosable pouch device and methods for using the device in surgery are shown and described. The reclosable pouch has a wand and a rod attached to the wand near the front and extending back generally parallel to the wand. A part of the rod is flexible for bowing out from the wand when the rod handle is pushed forward and for straightening to come close to the wand when the rod handle is pulled backward. The handle is a part of the rod near the back, which may be rigid, rigid and slidably connected to the wand, or flexible and slidably connected to the wand. A bag may be attached to the rod and wand for receiving a mass during surgery. When the rod bows out, the bag is opened. When the rod straightens, the bag is closed to form a seal. A preferred embodiment includes a slot system having a channel with the rod received in the channel, held in the channel for part of its length, and capable of bowing out of the channel for part of its length.

Abstract: A surgical instrument assembly for use in snare cauterization operations includes a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over a polyp to be removed, so that the web member substantially surrounds the selected polyp.

Abstract: The present invention pertains to a device for deploying and retrieving a flexible tissue containment sac within a body cavity, through a minimal access incision. The device generally includes a tubular introducer having a flexible tissue containment sac disposable in a compressed configuration within the lumen of such tubular introducer. An elongate plunger shaft or pushing member is insertable or passable through at least a portion of the introducer lumen to push the containment sac out of the distal end of the lumen. Attached to the containment sac and extending through the lumen of the introducer is a tether. A portion of the tether may extend out of the proximal end of the introducer. The proximal end of the tether may be grasped and pulled in a proximal direction to pull the containment sac to a retrieved position on the end of an extractable shaft or, in embodiments absent such extractable shaft, to pull at least a portion of the containment sac into the introducer lumen.

Abstract: The present invention provides an apparatus of novel design for use in the rapid, non-surgical removal of foreign bodies from the urethra and bladder. In accordance with one aspect of the present invention, there is provided a transurethral snaring tool for encircling and ensnaring a foreign body within the urethral lumen or bladder. The snaring tool is further provided in one embodiment with an introduction sheath, suitable for housing a cystoscope lens or other viewing means, and an obturator, for the atraumatic introduction of the sheath. In accordance with a further embodiment of the present invention, there is provided a foreign body removal apparatus having additional tools to insert through the transurethral sheath, including a rigid forward forceps and a lateral grasping forceps. There is additionally provided a non-surgical method for removal of a foreign body from a body cavity.

Abstract: A medical device is disclosed for enclosing an internal bodily organ or tissue during surgery. The device is a surgical pouch with two drawstrings. The first drawstring is made up of a resilient, wire-like thread for keeping the mouth of the pouch open during use, and is detachable from the pouch. The second drawstring is intended to cinch the mouth of the pouch closed after the organ or tissue is enclosed and the first drawstring is detached. It is composed of a compliant, bioabsorbable thread.A method of reducing or preventing post-operative ovarian adhesions is also disclosed. The method involves placing a bioabsorbable surgical pouch, especially the surgical pouch of this invention, over an ovary after a surgical procedure, and then cinching the mouth of the pouch closed to isolate the ovary from surrounding bodily tissue.

Abstract: A method for removing a gall bladder comprises the steps of (a) providing a surgical instrument including a flexible loop and a flexible web member connected to said loop to form a capture pocket, the loop defining a mouth opening of the pocket, (b) closing the cystic duct, (c) severing the cystic duct, and (d) passing the loop around a portion of the gall bladder including a closed and severed segment of the cystic duct, thereby enclosing the gall bladder portion in the capture pocket. The method further comprises the steps of (e) severing connective tissue between the gall bladder and the adjacent liver subsequently to the passing of the loop around the bladder, (f) maintaining the gall bladder portion surrounded by the capture pocket during the severing of the connective tissue, and (g) shifting the loop relative to the gall bladder to enclose a greater portion of the gall bladder in the capture pocket upon a severing of some of the connective tissue between the gall bladder and the adjacent liver.

Abstract: The wire loop of a surgical snare is constructed so as to include a weakened or frangible region. When it is desired to open the loop so as to move it from its entrapped position on a polyp, an additional force is exerted on the loop to draw it further into the sheath. This causes the frangible region to break, thereby opening the loop and permitting the wire to slide free of the polyp. In accordance with an alternate embodiment, the wire loop is constructed so as to fold back on itself, with the folded back end being captured by a retaining element inside the sheath. When the loop becomes entrapped on a polyp, it is extended out of the sheath somewhat further than during normal use, at which point the captured end of the loop is released, opening the loop and permitting its removal from within the patient.

Abstract: The present invention relates to a medical instrument. Since, in the case of instruments operated by gripping disks, a conventional spring preloading has not been adequate for an effective closing movement, an improvement is proposed here. This consists of so articulating a front gripping disk to an instrument member that, through a manually applied axially rearward movement of the gripping disk, the instrument members are closed.

Abstract: A surgical instrument assembly for use in snare cauterization operations comprises a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over the selected internal body tissues to be removed, so that the web member substantially surrounds the selected internal body tissues.

Abstract: A surgical snare having a wire which forms the snare loop made from a shape memory effect metallic alloy which exhibits superelasticity at room temperature. The wire is trained so that it assumes an intermediate snare loop size in an unrestrained free state. From this trained free state configuration, the loop can be expanded to a large loop and contracted to a very small loop without permanent deformation from the trained intermediate state. This range of movement enables an expanded range of applicability for snares in general, and also enables reducing the instrument tip size with improved loop configuration.

Abstract: The present invention provides an apparatus for retrieval, dissection and removal of small organs and tissue from a patient's body. The instrument includes a collapsible basket defining a basket cavity. An anvil is attached to the distal end of the basket to form an impacting surface. A cutting cannula defining a cutting cavity is positioned to be reciprocatingly movable to pass through the basket cavity and impact the anvil. The cutting cannula is manually and reciprocatingly driven to pass into and through the basket cavity, cutting any tissue contained in the basket cavity. The cut tissue is then suctioned from the body for analysis.

Abstract: A retrieval catheter (10) for removing deleterious materials (S) from body lumens has an elongate catheter body (12) having a slack net (26) at its distal end (16). The slack net may be collapsed to facilitate introduction into the body lumen and opened in situ to permit capture and retrieval of the deleterious materials. A method for removing ureteral stones from the ureter is described.

Abstract: A surgical collector and extractor for specimem removal through a cannula in a laparoscopic procedure. A flexible sac has an opening adapted for specimem collection. The sac is constructed to expand, when not confined, to form a receptacle having a size larger than the inside of the cannula and being rigid enough to hold its expanded shape. The sac is composed of a collapsible material permitting it to be reduced in size to be accommodated within the cannula.

Abstract: A surgical instrument assembly for use in snare cauterization operations comprises a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over a polyp to be removed, so that the web member substantially surrounds the selected polyp.

Abstract: An appendix extractor includes a cannula (10) with two spaced apart guide members (12 and 14) and an appendix grasping line (16) threaded through each of the guide members (12 and 14). Finger loops (20, 28, and 30) allow for easy insertion into a hole in the patient's abdomen, movement of the appendix grasping assembly forward from the cannula (10), and enlargement and contraction of the appendix grasping region (26) of the appendix grasping line (16).

Abstract: An improved surgical snare apparatus includes an elongated tubular tip extending from a control handle. The ends of a single U-formed snare wire extend through the tip and out of its proximal end where they are secured to a control element in the handle that enables moving of the wire. The distal end is modified from conventional snares to allow the contracted snare loop to be substantially nested within the tip. In the fully contracted nested position, the wire substantially closes the modified distal end so that the sharp cutting edges of the distal end are not exposed to contact with body tissue during insertion into an incision or opening. Thus, the combination of the modified distal end and the single wire nested within presented a tip the minimizes trauma during insertion.The configuration of the expanded single wire loop is modified from conventional dual wire snare loops into a more rounded form which is easier to manipulate around tissue to be severed, a polyp for example.

Abstract: A surgical instrument for laparoscopic and endoscopic treatment of tissue and organs is disclosed. It includes a handle with a tubular member extending therefrom. Disposed within the tubular member and extending from the distal end thereof is an extendable and retractable grasping loop or belt, joined at its proximal ends to a slide assembly contained within the handle.The slide member assembly includes a thumb loop, and finger grips mounted on the handle receive additional fingers of the surgeon. Proximal movement of the thumb loop withdraws the belt further into the tubular member to close the grasping loop, while distal movement extends the belt outward to form a flexible grasping loop at the distal end of the instrument to open it to encompass the organ or tissue.The flexible grasping loop may be placed around an internal organ or tissue, then its grasp tightened by proximal movement of the thumb loop.

Abstract: A monopolar electrosurgical instrument for excising polyps from the gastrointestinal tract comprises an elongated flexible plastic tube having a first monopolar electrode mounted a small predetermined distance from the distal end of the tubular member and a conductive wire loop affixed to a pull-wire, the pull-wire extending through the lumen of the tubular member and being connected at its proximal end to a plunger-type handle whereby the loop can be opened and closed by extending and retracting the loop relative to the distal end of the tubulr member. By incorporating both the surface electrode and the loop on the same instrument, polyps may be severed electrosurgically using the snare and the wound then immediately cauterized using the surface electrode, thus obviating the need to do an instrument exchange in the endoscope to accomplish both functions.

Abstract: A device for the in situ collection of surgically excised material, including whole gall bladder, gallstones, dissected gall bladder and other tissues, for removal from the body, particularly in laproscopic surgical procedures.

Abstract: Surgical method and instrument such as a snare or forceps clamps, which can be moved to a position to firmly grasp a polyp. A tissue marking agent is disposed on the surface of the instrument that contacts a polyp, and the marking agent is crushed against the polyp. The marking agent is absorbed by the polyp and stains the tissue from which the polyp projects, the assist in visualizing the polyp site if conventional surgery is later required. The method and device may optionally provide for cutting and removing of the polyp and for application of a hemostatic agent to the polyp base to minimize bleeding.