Abstract: An ultrasonic angioplasty device for use in removing unwanted material from the vascular system of a patient comprises a wire having a proximal end, a sheath or catheter surrounding the wire, and a wave generator operatively connected to the wire at the proximal end for generating an ultrasonic waveform and transmitting the waveform axially along the wire. The ultrasonic device further comprises one or more projections extending radially inwardly from the sheath or catheter towards the wire at a plurality of predetermined axial motion nodes along the wire for minimizing transverse motion of the wire while permitting axial motion of the wire during transmission of the waveform along the wire.

Abstract: The invention relates to a shock wave or ultrasound work process wherein shock wave or ultrasound generators are used to produce shock waves or ultrasound in a medium in which an effect is to be achieved, wherein to this medium is added a preparation which contains or produces microbubbles which cause an intensification of the shock wave or ultrasound effect, and to a preparation for carrying out the process wherein this preparation can also be used for the specific destruction of biological tissue with ultrasound and shock waves.

Abstract: A method of and apparatus for removing a thrombus deposit from the cardiovascular system of a patient without the need to surgically access the location of the thrombus deposit via a cut-down or other surgical procedure. A catheter is inserted percutaneously into the patient at a convenient location either directly or over a previously positioned guide wire. The distal end of the catheter is advanced under fluoroscopy to the site of the thrombus deposit. A balloon is inflated to stabilize the position of the distal end of the catheter within the center of the vessel lumen. A flexible metal tube conveys an extremely high pressure stream of sterile saline solution to at least one jet at the distal end of the catheter. At least one jet positions the thrombus deposit for emulsification by at least one other jet. By directing the jets toward the orifice of the large evacuation lumen of the catheter, a stagnation pressure is induced which propels the emulsion proximally for disposal.

Abstract: A drive for a phacoemulsification probe includes a drive circuit for supplying electrical power to the probe, circuitry for sensing the electrical power supplied by the drive circuit to the probe and for supplying electrical signals indicative of the magnitude of the electrical power supplied. A manually operable input device provides a signal indicative of the transducer power level desired by the user of the probe. A control circuit is responsive to the signal indicative of the desired transducer power level and to the signals indicative of the magnitude of the supplied electrical power for providing control signals to the drive circuit to control the power applied in an efficient manner. The drive circuit includes a voltage controlled oscillator, responsive to at least one of the control signals, connected to a class S amplifier. The output of the class S amplifier is filtered before application to the probe transducer. The drive circuit has high efficiency when compared to prior art probe drives.

Abstract: Containment sacs insertable into a body cavity through a minimal access incision for purposes of containing, manipulating, treating and/or extracting material from the body cavity. The sac may comprise a flexible sac body having at least one opening thereinto and a resilient or spring loaded rim member disposed about the opening to urge the opening to an open configuration when deployed in the body cavity. The containment sac may be further utilized in combination with a dedicated introducer sheath through which the containment sac may be inserted and extracted. A valving member may be positioned on the introducer sheath to prevent escape of gas from a pressurized body cavity such as a pneumoperitoneal. The containment sac may incorporate a grasping member whereby the containment sac may be grasped and inserted using a standard forecep/grasper instrument. Alternatively, the containment sac may be attached to an elongate rod member usable to insert and extract the containment sac.

Abstract: A multichannel probe comprising a hollow tube defining a distal end and a proximal end, the tube being made of a flexible self-supporting material enabling the tube to fold or to be curved, and said hollow tube being subdivided into at least three independent longitudinal channels by at least two internal partitions disposed longitudinally substantially parallel to the axis of symmetry of the tube.

Abstract: Thrombi are fragmented by a rotating action body secured on a torsion-resistant flexible shaft. The shaft is journalled in two parts of an internal catheter between which the action body is located. A grid surrounding the action body is formed by curved biassed resilient legs which connect the two parts of the internal catheter together.

Abstract: A method and device for reducing the size of tissues and/or other materials contained within an intracorporeally positioned organ or artificial containment sac. In one embodiment, the device comprises an elongate cutting tool having a rotatable cutting head or impactor positioned on the distal end of the tool and, optionally, having one or more aspiration/infusion lumens extending longitudinally through the elongate shaft of the tool. In a second embodiment, the device may comprise (a) a separate guide/aspiration/infusion cannula initially insertable into the organ or sac and (b) a separate elongate cutting device which is insertable through and extractable from the prepositioned guide/aspiration/infusion cannula. An automatically deployable protective assembly may be positioned at the distal tip of either embodiment of the device so as to form a protective cage around the rotatable cutting head or impactor.

Abstract: An instrument for lithotripsy having a probe which can be vibrated longitnally by means of a drive and which extends through a guide channel in the shaft of an endoscope and is supported and guided externally of the shaft by a guide element aligned on the corresponding guide channel, is described. The guide element receives the housing of the probe drive also serving as a handle proximally, and its distal end can be releasably attached to a rinsing and probing attachment which can be connected to the proximal end of the endoscope and is provided with valves. The guide element is designed so that the valves can be actuated unimpeded.

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: Method and apparatus for fracturing hard deposits such as urinary and biliary stones and atherosclerotic plaque in the human body. A flexible guide having a hard mass capping an end is adapted for insertion through a fluid passage in a living body. An energy source creates a rapid vapor expansion adjacent to the cap causing it to undergo a pulse like movement, imparting a high-velocity impulse to an adjacent deposit, thereby fracturing it. The energy source may be a laser with a fiber optic delivery system in the guide terminating adjacent to the cap to cause vaporization of the mass cap to create the vapor expansion. The energy source may be a spark generator with a conductor associated with the guide to deliver a fluid vaporizing spark adjacent to the mass cap. Other forms of rapid energy delivery such as chemical detonations or ballistic impact may also be applicable.

Abstract: An extractor for gallbladders and appendices, comprising a protective guiding tube for insertion into the peritoneum of a patient, a gripping means provided at the front end of the protective guiding tube and comprising at least two bowls which are adapted to be opened and closed like tongs and which, in the closed state, form a rotational body extending longitudinally in the direction of the protective guiding tube, and an operating means for opening and closing the bowls and projecting from the rear end of the protective guiding tube, the transmission elements of the operating means lie within the protective guiding tube and extend therethrough.

Abstract: Apparatus for removing kidney stones or other calculi from the cavities of animal bodies by litholysis has an expandible and collapsible receptacle of acid-resistant material and a mechanism for introducing the receptacle into a cavity so that an inlet of the receptacle admits the calculus to be removed. A closure is thereupon actuated from the outside of the animal body to seal the inlet prior to circulation of an acid solvent through the thus sealed receptacle. The acid dissolves the calculus, and the dissolved calculus is evacuated from the receptacle with the solvent. The receptacle is thereupon flushed (if necessary) and collapsed to facilitate its extraction from the cavity. The circulating system can employ a solvent-admitting first conduit, a solvent evacuating second conduit, and discrete pumps one of which admits fresh solvent into the first conduit and the other of which draws solvent and dissolved calculus from the second conduit.

Abstract: A method and device is described for removing concretions such as calculus stones within human ducts such as the ureter or kidney. The device includes a flexible probe insertable through the human duct so that a tip thereof is juxtaposed against the concretion. The probe includes a positive electrode extending coaxially within the conduit and embedded in a solid electrically insulative material. A negative electrode is coextensive with and outwardly encircles the positive electrode. The solid electrically insulative material stops short by a distance R from the end of the probe, thereby leaving a recess without solid insulation between negative and positive electrodes at the tip end of the probe. The recess achieves a more efficient fragmentation of target calculi at lower energy, with less human tissue damage and increase in useful probe life.

Abstract: A process for degassing a coupling liquid is disclosed, comprising adding to said coupling liquid at least one chemical substance readily taking up gas in a sufficient quantity to absorb said gas substantially completely. This chemical substance is preferably a sulfite of alkaline- or alkaline-earth metal. The invention makes it possible to obtain pressure values of the pressure waves greater than those obtained by conventional physical degassing.

Abstract: Method and apparatus for fracturing hard deposits such as urinary and biliary stones and atherosclerotic plaque in the human body. A flexible guide having a hard mass capping an end is adapted for insertion through a fluid passage in a living body. An energy source creates a rapid vapor expansion adjacent to the cap causing it to undergo a pulse like movement, imparting a high-velocity impulse to an adjacent deposit, thereby fracturing it. The energy source may be a laser with a fiber optic delivery system in the guide terminating adjacent to the cap to cause vaporization of the mass cap to create the vapor expansion. The energy source may be a spark generator with a conductor associated with the guide to deliver a fluid vaporizing spark adjacent to the mass cap. Other forms of rapid energy delivery such as chemical detonations or ballistic impact may also be applicable.

Abstract: A 1.4-1.6 mm diameter microendoscope is introduced into a duct leading to the submaxillary or parotid glands containing a concrement. The endoscope is adapted to contain a working channel, an image bundle, a light bundle and a wire, all structure fixedly spaced apart within the microendoscope. A laser fiber is inserted into the working channel to the concrement and the concrement is fragmented with a laser shock wave while flushing the fragments away through the working channel.

Abstract: A medical electrode arrangement for urological use, has a core with an aperture going therethrough. This aperture receives a first electrode. A cage is defined by at least a side wall having first and second ends. The first end has a receiving unit for receiving a second electrode. An inner space of said cage is situated between the first and second ends and is surrounded by the side wall. The inner space is adapted to receive the core with a first electrode and a second electrode. A plurality of openings penetrating through the side wall of the core and extend from the first end toward the second end.

Abstract: An improved surgical method and apparatus using laser energy for destroying body tissue which includes a surgical handpiece including a surgical tip assembly which is driven by means of laser to achieve optical breakdown, plasma formation and shockwave generation to emulsify or destroy body tissue. The surgical tip assembly includes a laser fiber, a focusing means to enhance optical breakdown of tissue or fluid caused by laser energy transmitted through the laser fiber and an emulsification tip that is resonate tuned to vibrate in response to shockwaves produced by the optical breakdown caused by the laser energy. The emulsification tip and focusing means are configured in a spaced relationship to form an acoustic resonating chamber which further emulsifies body tissue and facilitates mixing of tissue with irrigation fluid.

Abstract: Devices and a system for passing instruments into a body cavity and/or for containing, manipulating, treating and removing matter from the body cavity, through a minimal access incision typically no greater than 1 cm in length. In one embodiment, the device of the invention includes an upper valving member with a plurality of interchangeable lower trocar members such as a) a short trocar member of 0.5-0.3 inches in length, b) a long trocar member greater than 3.0 inches in length and/or c) a trocar member having a protective cage disposed about its distal end attachable thereto. The lower trocar members are insertable into the body cavity. Further, in accordance with the system of the present invention, various instruments are independently insertable through the upper valving member and lower trocar portions of the device to perform various functions.

Abstract: Laparoscopy organ retrieval apparatus and procedures are presented for minimum invasion surgery inclusive of laparoscopic nephrectomy, cholecystectomy and other organ dissection, morsellation removal from the abdomen through a keyhole incision. The apparatus and procedures permit the safe and total removal of an organ from a body cavity in a morsellated condition through the combination utilization of an entrapment envelope sheath. The entrapment envelope having an apparatus for opening and closing, the apparatus controlled from an exterior position of the body cavity wherein the entrapment envelope after entry of the sheath is extruded from the sheath which has been inserted through a laparoscopic port in place in a keyhole surgical opening. The entrapment envelope is constructed of flexible, relatively low bulk fluid impermeable materials having sufficient strength to contain morsellator entry, organ fragmentation and removal.

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 spark gap unit that is easy to manufacture and significantly lighter than previously used spark gap units for generating underwater shock waves, particularly for non-invasive lithotrispy, has an internal conductor with an inner electrode, an insulation which at least partially envelops the internal conductor, and an external conductor with a bow and an outer electrode. The internal conductor is significantly shorter than the external conductor, and the external conductor at the rearward end of the spark gap unit projects beyond the internal conductor. The internal conductor, the insulation, and the external conductor are coaxially arranged. An outside diameter of the internal conductor is relatively small in comparison to an inside diameter of the external conductor. The spark gap unit has a hollow space inside the insulation, this hollow space being open in the direction of a rearward end of the spark gap unit.

Abstract: This invention relates to a sound wave generator with a variable effective aperture angle according to the electromagnetic principle for therapeutic applications and particularly for the contactless smashing of a concrement situated in the body of a living being. The sound wave generator includes a flat coil and a metallic diaphragm which is insulated with respect to the flat coil. The flat coil includes three separately activatable and concentrically arranged coil sections. The sum of the areas of the inner coil section and the center coil section is equal to the sum of the areas of the central coil section and the outer coil section. By means of the varying activation of the coil sections, the aperture of the shock wave source can be changed so that the focus geometry and the peak pressures can be varied for different applications, particularly kidney and gallbladder lithotrity.

Abstract: An instrument for extracting stones from the urinary tract of a patient comprising a urological catheter (12) and a stone-extracting basket (26) formed from resilient wires and slidingly inserted into catheter (12). The instrument has a drive unit (18) which is connected to the basket via a rod (22). Drive unit (18) transmits to the rod rotation and axial vibrations, which in turn are transmitted to the basket. When rod (22) rotates, curved portion (21) generates radial vibrations which are transmitted to the basket. In order to prevent basket (26) from rotating, but to transmit to it only axial and radial vibrations, rod (24) is connected to basket (26) through a spherical joint (42). On its front end the basket has a filiform (38) which facilitates insertion of the instrument into the urinary tract. In use, after insertion of the catheter to a position in which the basket is aligned with the location of the stone, the basket is released from the catheter and expands.

Abstract: Instrument and method for removing stones (calculi) from the kidneys, the bladder and other parts of the body. A stone is captured in a basket at the distal end of an elongated tubular member and broken into pieces while it is held by the basket. The stone is broken up by a hammering action provided by a reciprocating shaft which extends through the tubular member into the basket and is driven toward the stone by a spring. The stone is removed from the body by withdrawing the tubular member from the body with the pieces of the stone in the basket. Since the tip of the shaft impacts upon the stone inside the basket, the instrument is safe in that the reciprocate tip cannot strike the tissue outside the basket.

Abstract: Calculi, stones, or calcified tissue are broken down for removal from within a body using laser pulses that are delivered via an optical fiber and have a wavelength and pulse duration selected to break down the object into smaller particles without delivering energy sufficient to cause damage to other tissue.

Abstract: A method of destroying tissue such as a gall bladder located within the body of a living. A sclerosing agent is introduced into the body in a volume contiguous with the surface of the tissue to be destroyed. The sclerosing agent comprises a flowable material made up of a liquid carrier and a large plurality of abrasive particles, e.g., acicular particles of carborundum, silicon carbide, etc., Optionally, a symphysis agent, such as an antibiotic, may be introduced into the volume. Once the agent is introduced, it is caused to circulate therein whereupon its scrapes across the surface of the tissue to effect the sclerosing thereof.

Abstract: An ultrasound type treatment apparatus includes an inner sheath covering an ultrasonic transmission member having a first suction passage and defining a space relative to the ultrasound transmission member and an outer sheath covering the inner sheath and defining a space relative to the inner sheath. In the treatment apparatus, a liquid medium supply passage is provided at one of the space between the ultrasound transmission member and the inner sheath and space between the inner sheet and the outer sheet to supply a liquid medium to the distal end of the ultrasound transmission member. A second suction passage is formed at the other of the space between the ultrasound transmission means and the inner sheath and space between the inner sheath and the outer sheath. The first suction passage is connected by a suction tube to the second suction passage.

Abstract: The device comprises a shock wave generator (1, 2, 3) of the ballistic type comprising a projectile (1) provided to execute a to and fro movement within a guide tube, under the control of pneumatic means (13, 14, 5) disposed at one end of this guide tube. A waveguide (4, 19) exhibits an entrance interface (9) situated at the other end of the guide tube (2) and provided to be struck periodically by the projectile and thus to generate, by ballistic effect, ultrasonic shock waves. This waveguide per se is formed by a metal rod, one end of which forms the abovementioned entrance interface and can oscillate longitudinally within a guide (12), while its other end is provided to act by impact on the object (21) to be destroyed or to be processed.

Abstract: An ultrasonic percussion device uses an ultrasonic generator attached to one end of a wire by a linking assembly which includes a radially elastically deformable sleeve (7) receiving the end of the wire and provided with a conical flared section (7B); a hole (8) provided in a member (9) integral with the generator and into which the sleeve is able to be introduced, the conical section (7B) of the sleeve (7) coming into contact with a complementary conical wall (8B) provided in the hole, and a clamping element (10) able to cooperate by screwing with the member (9) and to act against the sleeve (7); the device is particularly useful for destroying atheromata in clogged arteries.

Abstract: An electrohydraulic probe for impacting object is shown. The electrohydraulic probe comprises a first electrode, and a second electrode which positioned at a preselected space from the first electrode defining a uniformly spaced controlled discharge path therebetween. An insulating means is disposed between and encloses the space between the first electrode and second electrode. The insulating means comprises a relatively mechanically rigid dielectric material that structurally maintains the predetermined space between the first electrode and second electrode while preventing a controlled discharge through the insulating means to cause an electrical discharge shock to occur only across the uniformly spaced controlled discharge path which electrical discharge shock generates and applies a hydraulic shock wave through a fluid to the object to impact the same.

Abstract: Method and apparatus for fracturing hard deposits such as urinary and biliary calculi and arteriosclerotic plaque in the human body. An elongate guide member having an apertured hollow adjacent its distal end is inserted within the body with the distal end positioned adjacent the target. A working fluid is supplied to the hollow, and an electric spark is discharged within the hollow from an external energy source for generating pulse waves in the working fluid. The resulting pulse waves express working fluid from the hollow to impinge on the target. Makeup fluid is supplied and the spark repeated. The method and apparatus also may be advantageously employed for dilating narrowing in hollow internal structure in the body.

Abstract: An invasive lithotripter includes a pair of electrodes having rectangular cross sections, and having flat faces of rectangular configuration confronting one another. An insulating member is interposed between the electrodes and spaces them apart a predetermined distance. The insulating member at its forward edge is relieved to provide portions of the electrode flat faces exposed and confronting one another to permit an electrical spark to jump between the exposed portions of the electrode faces. The relieved portion comprises a reflector having a focus point. The portions of the electrodes facing one another across the relieved area are provided with protuberances aligned with the focus point. A spark across the exposed portions of the faces of the electrodes in an aqueous medium generates a shockwave that is focused by the reflector. A shield surrounds and extends beyond the electrode and the insulating member to inhibit radial propagation of shockwave energy while enhancing axial propagation thereof.

Abstract: A wedge-shaped probe for the removal of cataractous tissue from within the eye is provided. The wedge-shaped probe has polished distalmost edges so that there are no sharp edges and hence the risk of damage to the cornea, iris or posterior capsule when the probe is used is minimized. Furthermore, the sloped-shape of the probe tip permits effective scooping of cataract material within the eye. Likewise the wedge shape efficiently lifts cortical material off the posterior capsule and is useful for posterior capsule clean-up. The probe can also be used to remove soft cataract material without using ultrasound. Preferably, when the instrument is used for that purpose, a movable spatula element is mounted to the probe and its associated handpiece for crushing and removing material which becomes lodged in the aspiration opening. When operatively coupled to a source of ultrasonic energy, the probe can be used for phacoemulsification of cataract tissue whether or not a spatula is provided.

Abstract: A device and method for removal of organic deposit obstructions in blood vessels by use of a supersonic microjet liquid flow for canalizing the organic deposit obstruction to be removed. The device has a bendable tube insertable into a blood vessel in which an obstruction is to be removed. Within the tube extends a pressure-resistant duct having an outlet or nozzle orifice developed therein by a liquid under pressure provided from a pump. A small collapsable balloon, when inflated, centers the outlet and isolates a volume within the blood vessel upstream of the outlet for containing the microjet fluid and matter from the obstruction eroded and abraded from the deposit during canalizing. The volume is evacuated by a suction on the tube taken by a pump and the small balloon is inflated through the bendable tube with which it communicates.

Abstract: A magnetic resonance imaging device is used to provide the static magnetic field for transducers. The static magnetic field in combination with electric current pulses energize phased arrayed transducers to generate acoustic waves or motion. The transducers can be arranged in the magnetic resonance imaging device static magnetic field to focus acoustic shock waves for the disintegration of target calculi in extracorporeal shock wave lithotripsy. The magnetic resonance imaging device is also used for target localization and monitoring of the mechanical energy effects of the transducers. In further embodiments, the transducers include coils that are implantable within a subject body and can be moved in the magnetic resonance imaging device's static magnetic field.

Abstract: A device is disclosed for the disintegration of concretions in body cavities. The device comprises at least one piezoelectric transducer element, for connection to a generator. The transducer element is connected between a reflector and a horn. Ultrasonic waves generated by the transducer element are directed by means of a sonotrode, to a concretion to be destroyed. At least the horn is provided with surface depressions which do not run parallel to its axis of symemtry, for the generation of transverse and rotational oscillations.

Abstract: A method and apparatus are disclosed for generating a high current, high-voltage pulse suitable for driving a shock wave source of the type which generates a shock wave in an acoustic transmission medium. In the apparatus, a signal generator generates a low-voltage signal having an energy content sufficient for generating the shock wave, and a pulse-shaping network, connected between the signal generator and the shock wave source, as a transfer function which shortens the signal duration of the low voltage signal from the signal generator so that the low-voltage signal is converted into a high voltage pulse suitable for driving the shock wave source. The high-voltage pulse has an energy content substantially the same as that of the low-voltage signal.

Abstract: A method of manufacturing an electrohydraulic probe for use with a lithotriptic instrument is shown. The probe comprises a first electrode, a second electrode and a relatively rigid spacer means therebetween to maintain a relatively constant equidistant space between the first and second electrodes during the entire work life of the probe. The method comprises the steps of connecting a distal end spacer member with a first electrode wherein the spacer member has a central aperture therein with a relatively constant thickness between its central aperture and an outer perimeter of the space member at the distal tip of the probe and wherein the spacer member comprises a relatively mechanically rigid dielectric material; and connecting a second electrode with the spacer member wherein the central aperture such that said second electrode is spaced equidistantly from the first electrode at the distal tip of the probe.

Abstract: An apparatus for disintegrating calculi situated in the body of a life form having a cable with a shielded middle conductor connecting a pulse generator and a shock wave generator. The connecting cable is a triaxial cable that has a middle conductor having two concentric shieldings. The middle conductor and the first shielding form forward and return conductors and the second shielding is connected to ground at both ends.

Abstract: An ultrasound type treatment apparatus includes an ultrasonic oscillation device for outputting an ultrasonic oscillation wave, a drive circuit for driving the ultrasonic oscillation device, a probe connected to the ultrasonic oscillation device to transmit that ultrasonic oscillation wave to an affected region of interest of a human being, a sheath formed around the probe, through which cooling medium is passed and a supply tank for supplying cooling medium to the sheath. In this treatment apparatus, an arithmetic operation circuit monitors a drive state of the ultrasonic oscillation device, a comparator is provided for receiving monitor information from the arithmetic operation circuit and for determining whether or not the supply of cooling medium to the sheath is normal and a controller is provided for stopping a drive of the ultrasonic oscillation device when the supply of the cooling medium is determined by the comparator as being not normal.

Abstract: A surgical method comprises the steps of (a) piercing an abdominal wall of a patient to form an opening in the wall, (b) inserting a tubular member through the opening, (c) pushing a inert flexible membrane through the tubular member and into a body cavity of the patient, (d) opening the injected membrane from a collapsed configuration into an at least partially opened configuration, (e) juxtaposing the membrane and an internal organ part of the patient, (f) closing the membrane about the body organ part upon juxtaposition of the membrane and the organ part, and (g) drawing the membrane, together with the enclosed organ part, from the patient's body cavity through the tubular member. An associated surgical kit comprises a tubular member insertable through an opening in an abdominal wall of a patient and a flexible membrane disposed in a collapsed configuration at least partially inside the tubular member.

Abstract: Calculi, stones, calcified tissue and other material are broken down for removal from within a body using laser pulses that are delivered via an optical fiber and have a wavelength, intensity, energy per pulse and pulse duration selected to break down the object into smaller particles without delivering energy sufficient to cause damage to other tissue.

Abstract: An ultrasonic surgical apparatus for crushing, sucking and removing undesirable substances inside the body such as an ulcerous tissue, thrombus and calcium clod by means of mechanical vibrations of a flexible ultrasonic probe (17). The surgical apparatus comprises a horn (5) connected to an ultrasonic vibration source (4) and adapted to transmit and amplify mechanical vibrations of an ultrasonic frequency, an ultrasonic probe (17) including a flexible linear transmitting member (44) having a working portion (21) adapted to effect mechanical vibration of an ultrasonic frequency, a horn cover (6) at least a portion of which is made of a flexible material, and a flexible tube (8) having three inner holes and three branch tubes communicating with the inner holes and connected to the horn cover (6) through the one branch tube (7).

Abstract: A laser lithotriptor includes a laser adapted to emit pulsed light which is absorbed by water in the vicinity of a human stone or concrement to cause rapid erosion of the stone. A light transmitting device such as a fibreoptic cable is employed inside of an endoscope to direct the laser pulses to the vicinity of the stones. An irrigation apparatus also ensures that the tip of the light transmitting device and the stone are continuously immersed in water and also serves to remove the powder-like debris of the disintegrated stone from the body. Preferably, a NdYAG laser operating at 1.44 .mu.m which emits 27 pulses per second is coupled to the body stone through an anhydrous quartz fibreoptic cable passing through the interior of an endoscope.

Abstract: A catheter and method of use for engaging material within the body of a living being to accomplish a medical and/or surgical procedure, e.g., from and enlarging an opening in a restriction in a vessel, duct, or lumen formed by the material, or to destroy a stone or other hard body formed of the material. The catheter comprises an elongated body portion and a rotatable working head located at the distal end of the catheter. The catheter is positioned with the working head adjacent the material to be enlarged. The working head comprises at least two, non-sharp, impacting surfaces, each of differing aggressiveness of restriction opening action. The less aggressive of the impacting surfaces is brought into engagement with the material when the working head is rotated in one rotational direction. The more aggressive of the impacting surfaces is then rotated in the opposite rotational direction and brought into engagement with the material to complete the procedure.

Abstract: An ultrasonic treating apparatus includes an inpedance detection unit for detecting the impedance of an ultrasonic vibration element for transmitting ultrasonic vibrations and a determining unit for determining whether the ultrasonic vibration element is good or not. If the ultrasonic vibration element is found not to be good, then a control unit inhibits ultrasonic vibrations from being generated from the ultrasonic vibration element. It is thus possible to prevent any breakage of the apparatus.

Abstract: A shock wave generator for the fragmentation of concrements, having a light-pulse-transmiting light guide and a converter arranged at the distal light guide end and having an ionization surface which, when a light pulse impinges, initiates a shock wave in the surrounding fluid, as well as having a shock wave outlet zone. In order to increase its efficiency and durability, the generator is constructed such that the ionization surface extends obliquely sloped with respect to the beaming axis of the impinging light pulse and the shock wave outlet zone is arranged in the direct shock wave beaming area of the ionization surface, thereby permitting a largely unhindered, low-loss propagation for the shock wave to the application point.

Abstract: Method and apparatus are provided for laser lithotripsy by subjecting calcified matter in the mammalian body, especially the human body, to two spatially and temporally overlapping pulsed laser light beams in the 300-450 and 600-900 nanometer wavelength range.