Abstract: A bipolar, plasma-generating electrosurgical apparatus and system wherein the return electrode is enclosed within an electrosurgical shaft, and the active electrode is located on the outside surface of the shaft such that in treating the tissue, the tissue is exposed to plasma generated on the active electrode, but is minimally exposed to electric fields generated between the active and return electrodes. Due to the configuration of the electrodes, electric fields generated between the electrodes are directed away from the target tissue and inwardly towards the return electrode within the shaft, thereby electrical stimulation of neuromuscular structures in the tissue by the electric fields is minimized.

Abstract: Electrosurgical methods and apparatus for the controlled ablation of tissue from a target site of a patient. The instrument includes a shaft having proximal and distal end portion and a planar active electrode on the distal end portion; a return electrode arranged on the shaft spaced from the active electrode; at least one electrical connector extending through the shaft that connects the active electrode with a high frequency power supply; and an aspiration lumen within the shaft having a distal opening. The active electrode is arranged vertically or perpendicular to the tissue treatment surface. The planar electrode may include one or more apertures.

Abstract: A bipolar, plasma-generating electrosurgical apparatus and system wherein the return electrode is enclosed within an electrosurgical shaft, and the active electrode is located on the outside surface of the shaft such that in treating the tissue, the tissue is exposed to plasma generated on the active electrode, but is minimally exposed to electric fields generated between the active and return electrodes. Due to the configuration of the electrodes, electric fields generated between the electrodes are directed away from the target tissue and inwardly towards the return electrode within the shaft, thereby electrical stimulation of neuromuscular structures in the tissue by the electric fields is minimized.

Abstract: A suturing instrument for placing mattress stitches in soft tissue, such as a rotator cuff, includes an elongate shaft with both a stationary jaw and a movable jaw disposed at the distal end thereof. The shaft is coupled to a handle grip at the proximal end, which is configured to manipulate the jaws into open and closed positions. The jaws are configured to allow for a traumatic grasping of soft tissues. The stationary jaw may include a molded tip that holds and positions opposite ends of a single strand of suture material. The serrated upper jaw is configured to grasp and immobilize the tissue to be sutured. Hooked needles are movably positioned to pierce the grasped and immobilized tissues, and to engage and retrieve the opposite ends of the single strand of suture material. The handle is released to open the moveable jaw, whereupon the instrument may be withdrawn, trailing the suture, and leaving a mattress stitch in the grasped tissue.

Abstract: Apparatus and methods for reducing nerve stimulation in electrosurgical instruments utilizing electrically isolated pairs of electrodes are disclosed. At least two pairs of electrodes may be configured to create at least two opposing currents which effectively cancel one another such that a net current flow is inhibited from developing within surrounding tissue structures to mitigate or eliminate undesired electrical stimulation of the tissue.

Abstract: A tunnel guide apparatus and method for forming two convergent tunnels in a bone. The apparatus includes a first bullet member for aiming a guide pin to form a first tunnel in the bone. A second bullet member adjustably connects to the first bullet member, for aiming a guide pin to form a second tunnel in the bone such that the first and second tunnels are convergent. The two bullet members are joined by a guide arm member disposed on a guide arc member such that the first and second bullet members and the guide arm member are adjustable on the guide arc member to form the two tunnels.

Abstract: Electrosurgical methods and apparatus for treating tissue at a target site of a patient. An electrosurgical instrument includes a shaft, having a shaft distal end and a shaft proximal end, and an electrode assembly disposed at the shaft distal end. The electrode assembly includes at least one active electrode disposed on an electrode support. The instrument is adapted for coupling to a high frequency power supply or electrosurgical generator. Each active electrode is adapted for removing tissue from a target site and/or for localized coagulation of the target tissue. In one embodiment, the instrument is adapted for laparoscopic procedures.

Abstract: The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to, ablate, contract, coagulate, or otherwise modify a tissue or organ of a patient. An electrosurgical apparatus includes an electrode support bearing an active electrode in the form of a plasma blade or hook having an active edge and first and second blade sides. The active edge is adapted for severing a target tissue via localized molecular dissociation of tissue components. The first and second blade sides are adapted for engaging against, and coagulating, the severed tissue. s. A method of the present invention comprises positioning an electrosurgical probe adjacent to the target tissue so that a blade- or hook-like active electrode is brought into at least close proximity to the target tissue in the presence of an electrically conductive fluid.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: A kit for packing and supporting the nasal cavities after surgical procedures performed on the nose comprising two inflatable non-elastomeric balloons (6?, 6?) and inflation means (27) arranged so that, in use, each balloon (6?, 6?) can be located in a nasal cavity and inflated.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid or saline-rich tissue to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for contracting a portion of the nucleus pulposus of a vertebral disc by applying a high frequency voltage between an active electrode and a return electrode within the portion of the nucleus pulposus, where contraction of the portion of nucleus pulposus inhibits migration of the portion nucleus pulposus through the fissure.

Abstract: A suturing instrument and method for placing mattress stitches in soft tissues is described. An elongate shaft with a stationary jaw and a moveable jaw disposed at the distal end is coupled to a handle grip at the proximal end configured to manipulate the jaws into open and closed positions. The jaws are configured to allow for atraumatic grasping of soft tissues. The stationary jaw is comprised of a serrated face incorporating apertures through which needles attached to opposite ends of a single strand of suture material may be driven out into and through grasped tissue. The serrated upper jaw is configured with needle catch adapted to accept and capture the needles and suture. The handle is released to open the moveable jaw, the instrument may be withdrawn, trailing the suture, and leaving a mattress stitch in the grasped tissue.

Abstract: The present invention provides systems, apparatus and methods for removing the outer layer, or stratum corneum, of a patient's skin. In one aspect of the invention, a method includes positioning an active electrode adjacent to or near a target site on a patient's outer skin, and applying a sufficient high frequency voltage to the active electrode to remove the stratum corneum without removing the entire epidermis layer. In this manner, the present invention removes dead and/or damaged skin cells on the surface of the skin which improves the overall appearance of the skin. In addition, this process helps to stimulate the bodies own rejuvenation process. In some embodiments, this rejuvenation process occurs by the actual removal of the stratum corneum, which accelerates the regrowth of new cell layers in the skin. In other embodiments, thermal energy is applied to the underlying epidermis and/or dermis to stimulate the growth of new collagen.

Abstract: The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ. The closed configuration is adapted for clamping and coagulating a target tissue while the apparatus is operating in the sub-ablation mode, while the open configuration is adapted for ablating the target tissue via molecular dissociation of tissue components. A method of the present invention comprises clamping a target tissue or organ with an electrosurgical probe. A first high frequency voltage is applied between the active electrode and the return electrode to effect coagulation of the clamped tissue. Thereafter, a second high frequency voltage is applied to effect localized molecular dissociation of the coagulated tissue.

Abstract: A transverse suspension device for ACL graft fixation in a femoral tunnel includes a body section and a smooth head section forming the leading end of the device. The body and smooth head sections each may be cannulated along their entire lengths. The head section may further include a recess-engaging section extending proximally from the distal end and is operable to engage with a recess formed in the bone tunnel. The device may further include a graft loop support section between the recess-engaging section and the body section adapted to stably support the graft loop.

Abstract: A method for treating a bone body comprises inserting a probe having at least one active electrode into the target tissue and applying a voltage difference between an active electrode and return electrode to ablate the tissue. The method is particularly directed to removing tumors in a bone body and or removing cancellous bone in a bone body. The bone body may be a vertebral body. An apparatus includes a plurality of active electrodes and a distal section including two bends. The bends serve to prevent the active electrodes from impinging upon the shaft of an introducer needle. Also, a kit includes an electrosurgical probe, an electrosurgical generator, an introducer needle, and a fluid connector to connect the introducer needle to a fluid source such that liquid may be supplied to the target site during an application.

Abstract: A device for attaching connective tissue to bone has a longitudinal axis and comprises an annular toggle member and a body member disposed distally of the toggle member, such that there is an axial space between the toggle member and the body member. The toggle member is movable between an undeployed position wherein the toggle member has a smaller profile in a direction transverse to the axis and a deployed position wherein the toggle member has a larger profile in the direction transverse to the axis. When installed in a desired procedural site, in suitable bone, suturing material extends axially through a center aperture in the annular toggle member, without being secured to or contacting the toggle member. This approach permits a suture attachment which lies entirely beneath the cortical bone surface, and which further permit the attachment of suture to the bone anchor without the necessity for tying knots, which is particularly arduous and technically demanding in the case of arthroscopic procedures.

Abstract: An electrosurgical method for treating foot ulcer, including diabetic foot ulcer, comprising: positioning an active electrode in close proximity to the ulcer, the active electrode being disposed on a distal end of an electrosurgical shaft; applying a high-frequency voltage potential difference across the active electrode and a return electrode in the presence of an electrically conductive fluid, the voltage potential being sufficient to generate plasma at the active electrode; and stimulating the ulcer with the active electrode to increase blood flow, remove unhealthy tissue and induce the body's natural healing response.

Abstract: A surgical anchor device for the repair of a torn ligament or tendon, primarily the anterior cruciate ligament in the knee, is used to affix the ligament within a femoral bone tunnel in the distal portion of the femur from the intra-articular surface, the device providing a pulley for a suture, wherein a free end of the suture may be pulled away from the device to draw the suture attached to the ligament graft within the femoral bone tunnel securing the ligament graft within the bone tunnel. Installation of the device is provided by insertion of the device through a tibial hole, through the femoral tunnel out of the lateral femoral cortex, pulling the attached sutures simultaneously to flatten the device against the lateral femoral cortex, attaching one end of the suture to the ligament graft and pulling the other end of the suture until the graft is situated properly within the femoral bone tunnel and tying the free end of the suture to retain the graft within the femoral bone tunnel.

Abstract: A knotless suture lock and bone anchor wherein a suture, looped through a tissue, is threaded through a plurality of body holes in the anchor to cinch the suture and tissue to the anchor without tying a suture knot on the tissue, and wherein the anchor is adapted for embedding in a bone. The tissue is secured to the anchor by suturing the tissue without a suture knot, fastening the standing leg portion of the suture on a suture leg-anchoring structure, and threading the working leg portion of the suture through the body holes. Pulling on the working leg portion of the suture tightens the suture on the body structure and cinches the loop without a suture knot on the tissue. The bone-embedding structure comprises a plurality of barbs adapted to resist pullout of the anchor from the bone.