Abstract: Apparatus monitors RF return current to maximize the AC signal of impedance at two return electrodes. A transformer with driving and driven windings isolates ESU and patient. At ends of the driving winding are signal and ground terminals joined to the return electrodes with capacitors returning current. An AC coupling capacitor at the signal terminal has a timing circuit in sync to the voltage wave and relative to impedance of the return electrodes. Microprocessing the voltage at the signal terminal of the driving winding watches impedance and determines if the RF return current path is adequate. Voltage detection within the timing circuit has a voltage shaping circuit. A voltage comparator after the voltage detection forms a square wave. A current detection circuit and a coupling capacitor allow AC flow to the driving winding. Current shaping circuit in the current detection circuit has a voltage comparator at the output to form a square wave.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patent's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide assess for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tubular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows movement relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.

Abstract: A surgical system has a multiple electrode electrosurgical capability in combination with a gas plasma capability for delivery of electrosurgical energy to the tissue or bodily fluids of a patient. The system includes a holder, a source of electrical energy, electrodes connected to the source of electrical energy, one or more passages carried on the holder for transporting ionizable gas, and a source of ionizable gas of a selectable flow rate. The gas passages may include at least one electrode extending toward the operative site. The gas passages may include a part that creates a vortex in the gas flow. The electrodes may be coaxially placed in the gas passages. The system may also be configured such that two electrodes are each shrouded by the ionized gas so that the electrosurgical energy is conducted to the tissue or bodily fluids of the operative site by passing along conductive pathways in the ionized gas from each electrode. There may also be a dielectric barrier between the conductive pathways.

Abstract: An apparatus and method for igniting plasma in a surgical system is disclosed. A corona discharge is generated on a surgical handpiece which is used to ignite a plasma arc for surgical operations. The advantages include greater reliability and repeatability of plasma arc ignition. The apparatus comprises a handpiece incorporating an active electrode, a passage for ionizable gas, and a corona return electrode. The corona return electrode has a terminus on the holder and near the distal end of the holder. The corona return electrode is electrically connected to the return path of the electrosurgical generator. A non-uniform electric field is generated between the active electrode and the corona return electrode of sufficient strength so that a corona is formed near the active electrode. A separate return electrode may be on the patient, or the apparatus may be configured for bipolar electrosurgical operation by carrying the return electrode on the handpiece.

Abstract: A bipolar electrosurgical scissors has an improved coagulation capability. Both poles of electrosurgical energy are exposed on the exterior surfaces of each shearing member so that the scissors can be used to coagulate tissue using only one shearing member. There may be two or more electrically conductive regions on the exterior surface of each shearing member. The conductive regions may be formed by laminating, depositing, or inlaying electrically conductive material on the exterior surfaces. The conductive regions are electrically insulated from each other. In one embodiment, the shearing surfaces are also electrically conductive and are each connected to the same electrical pole. In another embodiment, the conductive material that forms one of the conductive regions on each exterior surface also extends through the shearing member to also form a conductive shearing surface.

Abstract: In electrosurgical apparatus for tissue desiccation and cutting, an electrosurgical generator has a series-connected output inductor which forms a series resonant circuit with the capacitance of the generator load, the load including an electrode unit and a cable coupled to the generator output. The series resonant frequency is typically 1.5 f where f is the operating frequency of the generator. A capacitor may be included, coupled between the conductors which connect bipolar electrodes to the generator, to increase the load capacitance. The effect of these measures is to boost the output voltage available for electrosurgical treatment, especially for tissue cutting.

Abstract: An electrosurgical generator is disclosed that includes an exit spark control system. Exit sparking occurs when energy arcs to the patient as the active electrode is withdrawn from the patient. A basis for controlling the exit spark is to automatically change the frequency at which the final amplifier is driven whenever the conditions for an exit spark are detected. The change in frequency acts to lower the gain and efficiency in the final amplifier and dissipate energy as heat. The exit spark control system includes a frequency adjustable waveform generator and a logic capability for determining the conditions when exit sparking is likely to occur. Sensors and an algorithm in a microcontroller are preferably required to detect the conditions preceding exit sparking occurrence.

Abstract: A single ultrasonic surgical apparatus can provide a substantial cutting effect on tissue, a substantial coagulation effect on tissue, and an appropriate blend of simultaneous cutting and coagulation effects on tissue. The ultrasonic surgical apparatus is comprised of a handpiece which incorporates a transducer and a surgical tool, a source of electrical energy, a controller, and a switch. The apparatus may be operated at two frequencies within the ultrasonic spectrum, where the first frequency is selected at the low end of the spectrum for enhanced tissue cutting performance, and the second frequency is approximately three times higher for enhanced tissue coagulation performance. The two frequencies may be operated selectively or concurrently, and may be independently adjustable as to amplitude. The transducer may be composed of magnetostrictive or piezoelectric elements. The surgeon to set the desired amplitude of the mechanical vibrations.

Abstract: A system changes the rate of operation of a smoke evacuator used with an electrosurgical generator during treatment of a patient electrosurgically at an operative site. A mono or bipolar circuit for electrosurgery has an electrosurgical generator, ESU. A switch in the circuit activates the ESU when keyed. An active output connects the ESU to supply radio frequency energy and a return input to the ESU receives energy. A handpiece has an active electrode and an active lead connects between the output and the electrode. A return lead connects the return input and has a terminus to the patient. A controller in the ESU controls the various output signals of the ESU in response to hand or foot switching inputs or sensed current in the patient circuit. A trigger is connected to the controller in the ESU. The smoke evacuator operates at a different rate when the trigger in the ESU is keyed. A rate controller adjusts the condition of its function per unit time in accord with the trigger on the ESU.

Abstract: A method and assembly for electrically and mechanically connecting one or more flexible conductive members, with one or more insulated wires using one or more insulation piercing terminals. The flexible conductive member may have one or more electrically conductive layers attached to a pliable backing. The insulated wire may have one or more conductors. The insulation piercing terminal provides a low impedance electrical connection between the flexible conductive member and the insulated wire, while also providing a mechanical connection between the flexible conductive member and the insulated wire which minimizes movement of the insulated wire due to any axial and/or longitudinal forces that may be applied to the insulated wire or the flexible member during manufacturing and use. The insulation piercing terminal combines one or more piercing members with an integral mechanical securing means and an electrical contact for engaging the flexible conductive member.

Abstract: A power control apparatus for an electrosurgical generator is used for controlling output power from the generator to the tissue or bodily fluids of a patient. The control apparatus rapidly determines the range of impedance of the load on the electrosurgical generator and adjusts the output power accordingly. Output current and output voltage from the electrosurgical generator are monitored and sent to a microprocessor. The microprocessor runs an algorithm that determines the impedance range of the load on the generator. The algorithm uses computational techniques, such as comparisons and bit shifting, that avoid long division and other time-consuming operations. The microprocessor can then adjust a high voltage power supply that effects the radio frequency amplifier stage. A method for controlling the power of the electrosurgical generator, including steps in the algorithm, is also disclosed.

Abstract: A surgical safety apparatus for use in connection with an energizable surgical device prevents inadvertent activation of a surgical tool. The energizable surgical device may include an electrosurgical system, a laser scalpel, an ultrasonic aspirator, and combinations thereof. An activation circuit is in connection with the source of energy and in connection with the handpiece. The activation circuit has two states: the first state disconnects the source of energy from the handpiece, the second state connects the source of energy to the handpiece. A sensing element is connected to the activation circuit. The sensing element signals the activation circuit to convert the activation circuit from the first state to the second state. The activation circuit may remain in the second state for a preestablished period of time followed by a reversion to the first state. The activation circuit may include a relay which may be connected to operate accessories including smoke evacuators, lights, videos or irrigators.

Abstract: An insulating switch base with a top, bottom and an edge has openings through the top and one edge for a conductor. A conductive switch lead frame has proximal ends with insulation displacement connectors bent in the openings. A resilient member on the frame has a moveable contact and is conductively associated with a connector. A contoured arm on the frame is distal of, but conductive with, another connector. The arm is spaced from the resilient member as an open contact capable of momentary engagement. A frangible area on each frame is between the resilient member and the arm. Recesses in the top support retain the frame. A slot and barbs on each connector receive one conductor securely in an opening after aligned installation in an opening, seating of the frame in its recess and severing the area over a passage in the base. A membrane attaches over the frame and a molding is applied about the membrane leaving the resilient member open.

Abstract: An automatic circuit measures electrosurgical generator output and controls in accord with impedance between activated movable bipolar electrodes able to contact tissue. Voltage monitor in parallel and current monitor in series with the electrodes measure instantaneous variations and generate proportional signals. First and second calculators receive the signals and find respectively, by dividing the voltage by current, short circuit impedances and impedances other than short circuit impedances between the electrodes. First and second comparators receive the respective outputs from the first and second calculators and assess them against respective first and second references providing signs of short conditions and assessments of changes in impedance between the electrodes. A logic analyzer receives the signs and assessments and evaluates them to permit the instantaneous starting, operating or stopping of the electrosurgical generator.

Abstract: A laser and electrosurgical system has a handpiece with a proximal and distal end from which laser radiation and/or electrosurgical energy is selectively or concurrently directed. The ends are along an axis; an electrode extends distally along the axis. Sources of laser and electrosurgical energy are available and controlled. An initiation circuit for the laser selectively delivers it before electrosurgery. Prior delivery targets tissue. The laser creates an ionized conductive pathway for electrosurgery. The combined concurrent application of laser and electrosurgery has a mechanism to selectively distribute energy about the axis. A laser deflecting surface or a beam deflector vibrate relative to the axis. A power switch has levels for laser cut and ionization and/or a delay therebetween for electrosurgical coagulation. A wave guide or an array thereof deliver radiation along the axis.

Abstract: A control responds to impedance and temperature between active and return electrodes of the electrosurgical generator during tissue desiccation. Tissue contacts separately and independently provide high frequency power to effect tissue electrosurgically. An instantaneous impedance monitor between each contact and the return electrode signals. A regulator receives the signals and separately and independently controls tissue impedance at each contact in accord with signals to change independently the power to the return electrode. A temperature sensor for each contact transmits its temperature to the generator to regulate power to each contact. A first multiplexer provides high frequency electrosurgical power separately and independently to each contact from the generator. A second multiplexer relays temperature amounts of each contact to the generator.

Abstract: An ultrasonic surgical handpiece for surgery on a patient has a handpiece with distal and proximal ends on a housing thereof for manipulation by a surgeon. A vibrator is carried within a hollow inside of the housing. A tool extends from the vibrator at the distal end to a distal tip and is tubular with a bore along its axis so axial vibrations at high frequency are transmitted to the distal tip. Fluid flows from the distal tip to the vibrator, cools the vibrator and connects to a source of suction at the proximal end. A flue carried cantilever on the distal end extends about the tool so a space is between the tool and the flue for guiding fluid from the distal end to the distal tip. A port located through the tool connects between the space and the bore and is axially positioned near the distal end to collect fluid. An inlet on the flue is near the distal end for fluid provided by a supply. The inlet is axial distal of the port and/or may meter fluid to a preset range.

Abstract: A minimally invasive retractor and dissector for internal surgical use on a patient's body has a tubular support for passing into the patient's body. A proximal end on the tubular support located outside the patient's body is in position to provide access for the surgeon. A distal end on the tubular support located inside the patient's body to provide access within the patient for surgery. A control is located at the proximal end of the tabular support. One or more articulated members are movably positioned relative to the distal end of the tubular support so each of the articulated members allows swinging relative to the distal end. A rotator connects to the proximal end of the tubular support for movement relative to the control. An instrument moves independently of the tubular support when the articulated members and the distal tips cooperatively function on the tissue.