Abstract: A suture loop is formed in a hollow braided suture by feeding one end of a length of suture through a part in the braid of the suture and into the inner lumen formed by the hollow braid. The braided configuration of the suture allows it to be expanded in diameter by pushing and reduced in diameter by pulling. Said end of suture is passed continuously through said inner lumen forming a loop of suture with a single tail. The loop may be tightened by pulling on said first end of the suture while pushing on said outer hollow braid. The loop may be locked by extending or pulling on said outer hollow braid to reduce its diameter and lock it down around said first end of the suture.

Abstract: An innovative bone anchor and methods for securing connective tissue, such as tendons, to bone are disclosed which permit a suture attachment which lies entirely beneath the cortical bone surface, and wherein the suturing material between the connective tissue and the bone anchor is oriented in a direction generally transverse to the longitudinal axis of the bone anchor, so that axial pull-out forces exerted on the bone anchor are minimized. The suture attachment to the bone anchor involves the looping of a substantial length of suturing material around a shaft of the anchor, thereby avoiding an eyelet connection which requires a knot and which concentrates stress on a very small portion of the suturing material. Thus, failure rates are greatly decreased over conventional techniques, and the inventive procedures are significantly easier to perform than conventional techniques.

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 an active screen electrode on the distal end portion; a return electrode arranged on the shaft spaced from the screen electrode; at least one electrical connector extending through the shaft that connects the active electrode with a high frequency power supply; at least one electrical coupling member (such as a ball wire) adapted to secure the active screen electrode to the shaft and to electrically couple the screen electrode to the at least one electrical connector; and an aspiration lumen within the shaft having a distal opening coupled to the single active electrode wherein the screen electrode inhibits clogging of the aspiration lumen.

Abstract: A system and method for surface tissue ablation on the patient's outer skin, such as the epidermis or the underlying dermis. An electrosurgical probe (130) comprises a shaft (132) having an array of active electrodes (136) on its distal tip and a connector (134) at its proximal end for coupling the electrode array to a high frequency power supply. An electrically conducting liquid is directed along a fluid flow path (142) past a return electrode surface (138) to the target site to provide a current flow path between the target site and the return electrode. High frequency voltage is then applied to the active and return electrodes so that an electric current flows from the active electrode, through a layer of vapor formed at the tip of the electrode, and to the return electrode through the current flow path provided by the electrically conducting liquid.

Abstract: An electrosurgical probe comprises a shaft having at least one electrode terminal at its distal end and a connector at its proximal end. The electrode terminal may be spaced from a return electrode such that when the electrode terminal is brought adjacent a tissue structure immersed in an electrically conductive fluid from outside the body, the electrically conductive fluid completes a conduction path between the electrode terminal and the return electrode. By applying high frequency electrical energy to the electrode terminal, target tissue may be cut or ablated while heat dissipation through low impedance paths, such as blood and normal saline, will be minimized. Related methods are disclosed.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove and/or modify the structure of tissue structures. The present invention is particularly useful for treating sleep obstructive disorders, such as sleep apnea and snoring.

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 to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for removing a vertebral disc in preparation for implanting a prosthetic disc or removing a portion of the vertebral disc such as the nucleus pulposus in preparation for placing a prosthetic nucleus within the annulus of the disc. The present invention also teaches shrinking residual tissue in preparation for placing the implants.

Abstract: Systems and methods are provided for performing electrosurgical interventions, such as selectively contracting soft collagen tissue and other body structures, while limiting thermal damage or molecular dissociation of such tissue and limiting the thermal damage to tissue adjacent to and underlying the treatment site. The systems and methods of the present invention are particularly useful for surgical procedures in electrically conducting environments, such as arthroscopic procedures in the joints, e.g., shoulder, knee, hip, hand, foot, elbow or the like. The present invention is also useful in relatively dry environments, such as treating and shaping the cornea, and dermatological procedures involving surface tissue contraction of tissue underlying the surface of the skin for tissue rejuvenation, wrinkle removal and the like.

Abstract: A method for treating obstructive sleep disorders includes accessing the interior of the tongue through an incision made in the skin in the vicinity of the jaw of a patient; advancing an instrument through the incision into the interior of the tongue; and removing an amount of tissue from the interior of the base of the tongue with the instrument. The present invention includes forming a cavity or plurality of channels in the tongue. The cavity may be collapsed using a suture, fastener or bioadhesive. An emplaced suture may be provided to hold the cavity in a collapsed position thereby reducing the degree of obstruction. Additionally, thermal energy may be applied to the tissue surface immediately surrounding the channels to cause thermal damage to the tissue surface, thereby creating hemostasis and stiffening the surrounding tissue structure.

Abstract: This relates to an improved delivery system for accurately loading and controlling the delivery of flowable material to a patient. Particularly, the system may be used in the injection of hard tissue implant materials such as PMMA under pressures up to about 4000 psi. The system includes an applicator with a first column having an implant material introduction section adapted to provide for effective loading of the implant material and a second column housing a piston. The introduction section has a larger size than that of a vessel section or bore in which the requisite pressure seal between the piston and bore wall is formed. The first column may include an introduction section flared open to an included larger funnel-like opening or a separate funnel may be used that interfaces with the introduction section to facilitate the introduction of implant material.

Abstract: Bleeding is controlled on an inner surface of a body cavity by inserting into the cavity an expandable balloon which is covered by a hemostatic shroud, expanding the balloon, and compressing the shroud against the site of bleeding. The balloon may be disposed around a central tube to supply inflation medium. The tip of the device is soft to aid with insertion. The invention includes the corresponding devices and systems for such control of bleeding within a body cavity or passageway, as well as a method of making the devices.

Abstract: Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site, such as a synovial joint, of a patient. An electrosurgical probe of the invention includes a shaft, and a working end having an electrode array comprising an outer circular arrangement of active electrode terminals and an inner circular arrangement of active electrode terminals. The electrode array is adapted for the controlled ablation of hard tissue, such as meniscus tissue. The working end of the probe is curved to facilitate access to both medial meniscus and lateral meniscus from a portal of 1 cm. or less.

Abstract: Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one aspect, the invention involves canalizing or boring channels, divots, trenches or holes through an avascular connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. In one method, an active electrode is positioned in close proximity to a target site on a tendon, and a high frequency voltage difference is applied between the active electrode and a return electrode to selectively ablate tendon tissue at the target site, thereby forming a channel or void in the tendon. The active electrode(s) may be moved relative to the tendon during, or after, the application of electrical energy to damage or sculpt a void within the tendon, such as a hole, channel, crater, or the like.

Abstract: This relates to an improved delivery system for accurately loading and controlling the delivery of flowable material to a patient. Particularly, the system may be used in the injection of hard tissue implant materials such as PMMA under pressures up to about 4000 psi. The system includes an applicator with a first column having an implant material introduction section adapted to provide for effective loading of the implant material and a second column housing a piston. The introduction section has a larger size than that of a vessel section or bore in which the requisite pressure seal between the piston and bore wall is formed. The first column may include an introduction section flared open to an included larger funnel-like opening or a separate funnel may be used that interfaces with the introduction section to facilitate the introduction of implant material.

Abstract: A system and method for surface tissue ablation on the patient's outer skin, such as the epidermis or the underlying dermis. An electrosurgical probe 130) comprises a shaft 132) having an array of active electrodes 136) on its distal tip and a connector 134) at its proximal end for coupling the electrode array to a high frequency power supply. An electrically conducting liquid is directed along a fluid flow path 142) past a return electrode surface 138) to the target site to provide a current flow path between the target site and the return electrode. High frequency voltage is then applied to the active and return electrodes so that an electric current flows from the active electrode, through a layer of vapor formed at the tip of the electrode, and to the return electrode through the current flow path provided by the electrically conducting liquid.

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 patients. 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: Systems, apparatus, and methods for treating spinal tissue and other body structures in open and endoscopic spine surgery to relieve symptoms, such as neck or back pain. In particular, the present invention provides methods for the controlled heating of various tissues in or around the vertebral column, including various interspinous tissues, such that spinal ligaments and cartilage surrounding the vertebrae and the facet joints are shrunk or tightened to stabilize the vertebral column of a patient. Thermal energy is applied to the target tissue in a subablation mode of an electrosurgical system to cause shrinkage of the tissue, thereby stiffening the interspinous tissue and stabilizing the vertebral column. In an exemplary embodiment, a high frequency RF voltage can be applied between one or more active electrode(s) and one or more return electrode(s) to heat a target interspinous tissue to within a temperature range at which irreversible shrinkage of the tissue occurs.

Abstract: Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one variation, the invention involves creating a pattern of voids in connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. This also includes using a template device to assist in the creation of the pattern of voids. Also included is an electrosurgical device with a self-contained fluid supply for providing conductive fluid to the target tissue or to active electrodes of the device.

Abstract: The present invention provides systems, apparatus and methods for selective applying energy to a patient's dermis tissue to generate the growth of new collagen in this tissue, while minimizing the effect on the outer epidermis layer, thereby minimizing or suppressing the wound healing phase of the procedure. In one aspect of the invention, a method includes positioning a first electrode adjacent to, or in contact with, a region on or within a patient's skin, and applying a sufficient high frequency voltage between the first electrode and a second electrode to create a heat injury to a target tissue within the patient's dermis layer without ablating the epidermis layer overlying the target tissue. Typically, the voltage applied to the first and second electrodes is sufficient to induce heating of the dermis layer to about 60°-80° C., preferably about 65°-75° C.

Abstract: A bi-polar electrocautery needle comprising an inner electrode on outer electrode and recoverable insulating-locking member for insulting the electrode from one another and locking them into relative position to one another. And the method of making the bi-polar electrocautery needle in accordance with this invention, the steps including: expanding recoverable dielectric material over an inner electrode; and recovering the material between the electrodes for insulating and locking the electrodes into relative position with one another.