Abstract: A conscious sedation system and a cannula and response testing assemblage for a conscious sedation system. In one embodiment, a controller generates a request for a predetermined response from a patient and analyses at least a response made by the patient to the request to determine a level of sedation of the patient. A cannula is disposable on the face of the patient for monitoring the breathing of the patient. A request assembly communicates to the patient the request generated by the controller. A response assembly senses the response and communicates the response to the controller. At least a part of at least one of the request and response assemblies is supported by the cannula. In another embodiment, the cannula itself is used as the response assembly wherein the response is a breathing response of the patient to the request.

Abstract: A method for detecting transverse mode vibrations in an ultrasonic hand piece/blade is achieved by monitoring the power delivered to the hand piece/blade to determine whether it increases as expected when power levels applied to the hand piece/blade are changed. While the blade is being held in midair, the power delivered to the hand piece/blade and/or the impedance of the hand piece/blade is measured at a first power level. Using the value obtained at the first power level, the expected power at a second power level is calculated and used to set a pass/fail threshold level for an actual measured power. Alternatively, the threshold is set for the impedance is set. Next, the actual power delivered to the hand piece/blade and/or the impedance of the hand piece/blade is measured at a level 5 power setting. A determination is made whether the hand piece/blade exhibits transverse mode behavior based on whether the actual measured power exceeds the established pass/fail threshold level.

Abstract: An ultrasonic surgical instrument is described which incorporates an articulating shearing end-effector. The instrument comprises an ultrasonic transducer, an ultrasonically activated end-effector, and a substantially solid ultrasonic waveguide that connects the ultrasonic transducer to the end-effector. The waveguide comprises a transmission section extending from the transducer to a fixed node, and an articulation section extending from the fixed node to a pivoting node. The end-effector includes a bifurcated waveguide segment. A handle is adapted to hold the transducer. An outer sheath extends from the handle to the end-effector and surrounds the waveguide. An actuation trigger is rotatably positioned on the handle, and an actuation arm extends from a distal end of the actuation trigger to the pivoting node.

Abstract: A temperature monitoring device and/or method which control the tissue temperature at the end-effector of a therapeutic ultrasonic cutting and coagulating instrument as the tissue is being heated with ultrasonic vibrations from the end-effector. One or more temperature sensors are located at the end-effector, preferably on a clamping member. The temperature sensors measure the temperature of the tissue engaged by the end-effector either directly or indirectly. An alternate method and apparatus provides an electrical tissue impedance measure in combination with an ultrasonic cutting and coagulating instrument to provide active feedback control of an ultrasonic generator.

Abstract: A therapeutic ultrasound instrument is described for cutting, dissecting, or cauterizing tissue. Ultrasonic vibrations, when transmitted to organic tissue at suitable energy levels and using a suitable end-effector, may be used for the safe and effective treatment of many medical conditions. An ultrasonic surgical instrument is described which incorporates an articulating shearing end-effector. The instrument comprises an ultrasonic transducer, an ultrasonically activatable end-effector, and a substantially solid ultrasonic waveguide that connects the ultrasonic transducer to the end-effector. The waveguide comprises a transmission section extending from the transducer to a fixed node, and an articulation section extending from the fixed node to a pivoting node. The end-effector includes a bifurcated waveguide segment. A handle is adapted to hold the transducer. An outer sheath extends from the handle to the end-effector and surrounds the waveguide.

Abstract: An ultrasonic device with increased efficiency as a result of substantially increased pressure uniformity across individual PZTs and through the PZT stack. Specifically, the PZT stack is uniformly compressed by way of a bolt having a head that has a surface area roughly equal to the surface area of the individual piezoelectric elements. The bolt is further combined with an aft end bell that has a reduced surface contact with the bolt head and a larger surface contact with the adjacent piezoelectric stack.

Abstract: The present invention is directed to a bipolar electrosurgical end effector for use in medical instruments. A bipolar end effector according to the present invention includes a tissue slot and electrodes arranged on either side of the tissue slot. The opposing electrodes are electrically connected such that tissue passing through the slot is electrically treated with electrosurgical current passing laterally through the tissue. An end effector according to the present invention further includes a tissue separator arranged at the end of the slot to divide tissue as it is passed through the slot and after it is treated.

Abstract: The present invention is directed to an ultrasonic surgical blade including a top surface, a bottom surface and a cutting-edge. The cutting-edge is defined by a cutting-surface intermediate the top surface and the bottom surface, and the top surface has a width greater than the width of the bottom surface. The blade may be straight or curved. In one embodiment of the invention, at least a portion of the cutting-surface is substantially parallel to at least a portion of the top surface. In still another embodiment of the invention first and second side-walls intersect the top surface to form first and second cutting-edges that may be sharp or blunt. Alternately, a second cutting-edge may be defined by a second cutting surface intermediate the top and bottom surfaces. Depending on the angle between the intermediate cutting-surface and the top surface, the cutting-edge may be sharp or blunt.

Abstract: An ultrasonic surgical clamp coagulator apparatus is configured to effect cutting, coagulation, and clamping of tissue by cooperation of a clamping mechanism of the apparatus with an associated ultrasonic end-effector. The clamping mechanism includes a pivotal clamp arm which cooperates with the end-effector for gripping tissue therebetween. The clamp arm is preferably provided with a clamp tissue pad having a plurality of axially spaced gripping teeth which cooperate with the end-effector to achieve the desired ultrasonic effect on tissue, while facilitating grasping and gripping of tissue during surgical procedures.

Abstract: An intrauterine ablation device having a catheter, a handle, and a distensible bladder. The catheter contains a joint such that the catheter may be articulated to facilitate access into the uterus.

Abstract: An ultrasonic surgical clamp coagulator apparatus is configured to effect cutting, coagulation, and clamping of tissue by cooperation of a clamping mechanism of the apparatus with an associated ultrasonic end-effector. Selective articulational positioning of the end-effector is achieved by the provision of an articulating mechanism incorporated into the clamp coagulator apparatus. The arrangement permits an elongated portion of the apparatus to be selectively articulatably positioned with respect to an apparatus housing.

Abstract: An apparatus, system, and method for treating body tissue includes an electrode assembly having a first electrode and a second electrode, with at least the first electrode formed of a foam-like material. Conductive fluid is delivered to the operating site, which may involve injecting the conductive fluid through the porous foam-like material of the first electrode via a fluid supply conduit. The apparatus may also include a fluid withdrawal conduit. The second electrode may also be formed of a foam-like material. The electrode assembly may be positioned on a catheter shaft having a distal end, with the first electrode positioned on the catheter shaft distal end. In treating desired tissue at a selected operational site, the electrode assembly is introduced to the site with one or more of the first electrodes positioned adjacent to the desired tissue. Conductive fluid, such as a saline solution, is delivered to the operational site via the supply conduit.

Abstract: The present invention provides a tissue resection device comprising a handle housing having a fluid infusion lumen. A shaft is reciprocatably mounted to the housing, the shaft having an aperture adjacent to a distal end and a fluid and tissue aspiration lumen extending from the aperture to a proximal end of the shaft. A cutting member is disposed adjacent to the aperture to sever tissue as the shaft is reciprocated, and an imaging mechanism on the housing is oriented toward the cutting member, thereby allowing the attending surgeon to optically direct the removal of body cavity tissue. A chopping mechanism is disposed within the lumen of the shaft to reduce the size of tissues passing through the lumen.

Abstract: An ultrasonic surgical device includes a transducer assembly adapted to vibrate at an ultrasonic frequency in response to electrical energy. A transmission component having a transmission component adapted to receive ultrasonic vibration from the transducer assembly and to transmit the ultrasonic vibration from a first end to a second end. A braking device is configured to apply a force to the outer surface of the transmission component to dampen the ultrasonic vibration being transmitted from the first end of the transmission rod to the second end of the transmission rod. A method of inserting a trocar cannula into tissue of a patient is also provided.