Abstract: A ureteral access sheath adapted for insertion into a urethra includes an elongate tube extending between a proximal end and a distal end. A handle assembly is disposed at the proximal end and includes enlarged portions which inhibit migration of the sheath into the urethra. The enlarged portions are shaped like the bell of a horn with a concave, distally-facing outer surface and a convex, proximally-facing inner surface. The inner surface functions as a funnel while the outer surface is sized and configured to receive adjacent fingers of a user's hand held in its natural position. In an associated method, this shape of the handle assembly facilitates maintaining the sheath in a stationary position during insertion and removal of instrumentation. The handle assembly can be movable on the tube to facilitate variation of the sheath link in situ.

Abstract: A trocar includes a valve housing and cannula which define a working channel. A valve disposed in the valve housing along the working channel includes a gel material which defines a slit that functions as a zero seal in the absence of an instrument, and an instrument seal in the presence of an instrument. The slit is formed by mating gel components which are preferably separated during storage of the device. This separation can be facilitated by a pull strip which can be pre-lubricated and inserted into the slit for ultimate removal prior to activation of the trocar.

Abstract: A surgical access device, such as a trocar, includes a pendent valve having an elongate structure extending from a proximal end to a septum valve disposed at a distal end. In operation, the elongate structure follows the angle of the instrument to pre-position the septum valve into the path of the instrument where it is not significantly challenged during instrument insertion or manipulation. The pendant valve can be made to float at both the proximal end and the distal end of the elongate structure, to further reduce the vulnerability of the septum valve. Since the valve is less vulnerable to instrument insertion, it can be formed to minimize friction and maximize the functional range of the access device.

Abstract: A trocar system for providing access across a body wall includes a trocar and an anchor provided in the form of a first helix. The anchor is adapted for placement in an operative position wherein the anchor extends at least partially through the body wall. A second helix formed on the trocar is size and configured to engage the first helix of the anchor so that rotation of the trocar relative to the anchor moves the second helix along the first helix. In this manner, the trocar is drawn into the anchor as it moves into the body wall. A proximal force applied to the anchor resists tenting of the abdominal wall. The anchor also holds the layers of the body wall together thereby resisting peritoneal separation.

Abstract: A surgical access device is adapted to facilitate access through an incision in a body wall having an inner surface and an outer surface, and into a body cavity of a patient. The device includes first and second retention members adapted to be disposed in proximity to the outer surface and the inner surface of the body wall, respectively. A membrane extending between the two retention members forms a throat which is adapted to extend through the incision and form a first funnel extending from the first retention member into the throat, and a second funnel extending from the second retention member into the throat. The throat of the membrane has characteristics for forming an instrument seal in the presence of an instrument and a zero seal in the absence of an instrument. The first retention member may include a ring with either a fixed or variable diameter. The ring can be formed in first and second sections, each having two ends.

Abstract: A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter, the retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound. A second ring has a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound. A plurality of retraction elements are disposed in a generally cylindrical relationship to each other, between the first ring and the second ring. These elements extend through the wound to exert a radial retraction force on the wound which is dependent on the distance separating the first ring and the second ring. Retraction elements, both distensible and non-distensible are contemplated with appropriate attachment elements at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force.

Abstract: An access device particularly adapted for use in laparoscopic surgery facilitates access with instruments, such as the hand of the surgeon, across a body wall and into a body cavity. The device can be formed of a gel material having properties for forming a zero seal, or an instrument seal with a wide range of instrument diameters. The gel material can be translucent facilitating illumination and visualization of the surgical site through the access device.

Abstract: A surgical clamp for occluding a body conduit includes first and second jaws moveable relative to each other in a generally parallel relationship. A handle assembly is operable to move the jaws relative to each other between a space position and proximate position. The first jaw has an elongate configuration characterized by a length and a width. First portions of the first jaw have in cross section a first shape which remains generally constant in area along the first jaw, while second portions have in cross section a second shape which varies in area along the length of the first jaw. The resulting clamp has a low profile jaw design which dimensional-shaped cross section which provide increased stiffness and reduced flexibility.

Abstract: An access port device is provided which enables hand access to a patient's body cavity while retaining pneumoperitoneum by minimizing gas leakage through the access port device. In one embodiment, the access port device includes first and second sleeves forming an inflatable chamber and a third sleeve mounted within the second sleeve including an elastic band for sealingly engaging a hand or wrist. The access port device may also include an exit opening seal for positioning within the patient's body cavity and a second sleeve retraction prevention device for preventing inadvertent movement of the second sleeve outwardly from the patient's body cavity through the incision. In another embodiment, an access port device provided which includes an inner annular sealing device and a non-adhesive outer annular sealing device for creating a non-adhesive seal against the outer surface of a patient. An access component forming an inflatable chamber and including an integral sleeved glove may also be provided.

Abstract: A modulator clip applier includes a cartridge containing multiple surgical clips, and a handle assembly for operating the cartridge to crimp one of the clips onto body tissue of a patient. The handle assembly has a scissors configuration with a bayonet coupling, and flange pairs widely separated to provide a high degree of stability. The bayonet coupling enables the handles of the assembly to be fully separated for cleaning. Snap fittings between the cartridge and handle assembly are provided at the fulcrum and also at a spaced location where an operating pin of the cartridge engages intersecting slots in the flanges. Overdrive protection of three different types is contemplated along with a structure facilitating operation of the handle assembly by palming a pair of handle bars.

Abstract: A laparoscopic insufflation device is provided in the configuration of a coil with a blunt tip. The device is capable of passing through the abdominal wall without cutting tissue, and exiting the abdominal wall substantially parallel to the inner surface. While rotation of the coiled device results in forward movement through the abdominal wall, a counter force can be applied to the device to create a safety space between the wall and the interior organs. With the blunt distal tip, parallel exit angle, and safety space, there is substantially no threat to the interior organs during placement of the device. Further space can be generated with the use of pressured gas to produce an abdominal cavity for the subsequent placement of trocars. By rotatably attaching the coiled insufflation device to a trocar, the advantage of a counter force can be used not only to establish the safety space but also to pull the trocar into the abdominal wall with a counterforce which resists tenting.

Abstract: A catheter having an elongate drainage tube with a proximal end and a distal end, is adapted to extend through a body conduit and into a body cavity. An anchor disposed the distal end of the tube is disposed in the body cavity and is adapted to be moved from an insertion position to a withdrawal position. The anchor in the insertion position has a low profile when the tube is moved distally and in the withdrawal position has a low profile when the tube is moved proximally. The first end of the anchor is attached to the tube, and a tension member is provided to extend distally of the tube to releasably hold the second end of the anchor in a fixed relationship with the tube. In an associated method, this tension member is severed to release the second end of the anchor from the tube and permit withdrawal of the tube and the anchor in a low-profile state.

Abstract: A surgical clip having a sliding state and a crimped state is adapted for use in a surgical procedure initially to slide along suture ends to an operative position and ultimately to crimp the suture ends at the operative position. A substrate, bendable between the sliding state and the crimped state carries at least one coating having either lubricious or traction enhancing properties. A second coating can be added to form a coating laminate with the outer coating having lubricious properties facilitating the sliding state and the inner coating having traction enhancing properties facilitating thee crimped state.

Abstract: An electrosurgical instrument includes a handle with a hollow elongate configuration and an electrosurgical assembly having ends disposed within the hollow handle and forming a continuous loop moveable by operation of the handle between an enlarged state and a contracted state. An electrosurgical element included in the assembly has an outer surface and axis and a lumen extending along the axis. Transverse portions of the element define a plurality of slots extending transverse to the axis and providing fluid communication between the lumen and the outer surface of the element. The element includes an insulated backbone and a plurality of ribs disposed to extend in space relationship to each other transverse to the backbone. A method of manufacture includes the step of creating slots in the element to define the ribs in the backbone.

Abstract: An instrument for cutting hair comprises first and second members extending longitudinally in a direction generally parallel to a hinge axis 19 of a hinge that connects the two members. Each member has an arm and a leg. The legs have sockets in which tools are received. The arms comprise grip portions for grasping and actuating by a user's hand. During use, the actuation of the arms moves the legs in an arcuate path of a common circle about the hinge axis 19. The legs and the tools disposed in the sockets of the legs have straight features that remain parallel to each other and to the axis 19 of the hinge during movement along the arcuate path. The instrument has a closed pinching or clamping position in which the tools meet each other in abutting relation.

Abstract: In electrosurgical system includes an electrosurgical generator providing power through an electrode, and a laser providing laser energy through an optical fiber. The electrode optical fiber and a source of environmental gas can all be included in a handpiece, catheter or other delivery device. In operation, the environmental gas can be released into the vicinity of an operative site and the laser activated to energize atoms along a pathway. Electrosurgical power can then be applied to ionize the items of the atoms of the pathway and create a path of least resistance for an electrosurgical arc. A reduction in the laser power required can be achieved by matching the photon frequency of the laser with the excitation frequency of the environmental gas. In a laparoscopic procedure, the insufflation gas may be used as the environmental gas.

Abstract: A method for removing a first sorbate having a first desorption activation energy and a second sorbate having a second desorption activation energy from a sorbent, involves a two-stage desorber. In a first stage, the first sorbate, second sorbate and the sorbent are contacted with a stripping fluid having a first temperature sufficient to separate the first sorbate in a vapor phase from the sorbent. In a second stage, the second sorbate and the sorbent is heated to a second temperature higher than the first temperature to separate the second sorbate in a vapor phase from the sorbent. The second sorbate can then be condensed to a liquid phase and sold to offset the costs of the process. Heating in the second phase can be facilitated by the introduction of microwave or infrared energy for stripping the second sorbate from the sorbent. Use of the microwave or infrared energy can be facilitated with a purging gas which can also be heated to function as a stripping gas.

Abstract: A gasket assembly includes an upper housing forming a seal with the outlet of a bathroom fixture, and a lower housing forming a seal with a sewer pipe. The lower housing has an outer surface extending along an axis and a toroidal gasket disposed in sealing relationship with the outer surface and the sewer pipe. To accommodate larger sewer pipes, the outer surface can be formed on an adapter and a second gasket provided to form a seal with the adapter. In an associated method for mounting the gasket assembly, the gasket is rolled axially in a continuous sealing relationship with the lower housing.

Abstract: A urological guidewire includes a core formed of a first metallic material and extending toward an end of the guidewire. A coil having a plurality of convolutions is disposed around the core at the end of the guidewire, the coil being formed of a second metallic material different than the first metallic material. A mechanical interlock is formed to inhibit separation of the different materials forming the coil and the core. The mechanical interlock may include an enlargement at the end of the core and a bonding material fixing the enlargement to the coil. The convolutions may include a penultimate convolution with a first radius of curvature and an ultimate convolution having a second, shorter radius of curvature to form a bridge. In this case, portions of the core can be bent back on themselves and directed over or around the bridge to form the mechanical interlock.

Abstract: A microdermabrasion handpiece includes a supply lumen and a return lumen in fluid communication with an abrasion chamber. A window formed at a distal end of the handpiece is off-centered from the supply lumen. The supply lumen directs a flow of abrasive particulate in a first direction. A supply nozzle adjacent to the distal end of the handpiece directs the flow of abrasive particulate at the window in a second direction different from the first direction. Methods for performing microdermabrasion are also provided.