Abstract: An expandable and collapsible isolation bag having at least two layers which are bonded together at a plurality of connection sites distributed over a surface of the bag and a system for supplying a fluid between the two layers and opening the isolation bag. The two layers preferably include polyurethane film and the bag may further include a lubricous outer surface, such as a nylon mesh layer, bonded to the polyurethane film. A neck channel may be formed around the openable end of the isolation bag for supporting a drawstring which is movable through the neck channel to close the open end of the bag. The bag can be made by bonding the nylon mesh layer to two layers of polyurethane film using a radio frequency welder to form a plurality of weld sites distributed across the surface of the laminate. The drawstring is then introduced into the neck channel. The finished laminate with the drawstring is welded to form a bag assembly having an opening at one end.

Abstract: A suture applying device comprises an elongate shaft having a length of suture therein. A pre-tied loop suture is held at the distal end of the shaft with a free end of the suture being attached within a handle secured to the proximal end of the shaft. In a first embodiment, a pulley and puller assembly is provided for closing the pre-tied suture loop, where the pulley permits a greater length of suture to be taken in than is traveled by the puller. In a second embodiment, a pair of opposed jaws are slidably mounted within the handle for selectively engaging and gripping the free end of the suture. In this way, an arbitrarily large length of suture may be taken in by pulling on the free end of the suture in successive strokes. The device further includes a sheath slidably disposed on the shaft for protecting the suture during introduction. The sheath automatically retracts when the device is introduced through a trocar sleeve or cannula, thereby exposing the suture loop.

Abstract: A medical device for forming an external extension of the pneumoperitoneum, thus allowing the surgeon more flexibility in a surgical procedure. The device includes an enclosure and an elastically deformable flange or ring at an open end of the enclosure. The flange/ring is deformed and inserted into a trocar puncture site, upon which it deploys against the inner surface of the abdominal wall. By maintaining a gentle lifting force on the external portion of the device (this being essentially a balloon shape) the neck of the device forms a seal between the opening in the abdominal wall and the `balloon`, allowing the insufflation gas to inflate the external `balloon` or `bubble` portion of the device. Once inflated, the internal pressure maintains the device in a stable shape. The device includes one or more valved openings which allow access to the interior of the balloon, and hence the abdominal cavity.

Abstract: An improved device and method for suturing penetrations and incisions through tissue into a body cavity. The device should find particular use in laparoscopic and other types of minimally invasive surgical procedures. A device according to the invention includes a shaft and an inverted needle joined to the shaft. Two ends of a length of suture material are attached at or near a sharpened proximal tip on the needle. The device may include a movable shield that is slidable to alternately cover and expose the sharpened tip of the needle. This shield may include a blunt distal end and an inclined proximal surface to assist the surgeon in guiding the hook into and out of the body cavity. The device may be provided with a visual and tactile indicator on one side of the device to assist the user in threading and removing the suture material into and out of a selected side of the hook.

Abstract: An electrosurgical probe comprises an elongate probe body having a surgical hook at a distal end thereof. A paddle element is reciprocatably mounted within the distal tip of the elongate body so that it can be shifted between an extended position where it covers the hook tip and a retracted position where it leaves the hook tip exposed. The paddle thus can cooperate with the hook in tissue dissection, clean the hook, as well as provide an alternate electrosurgical probe tip for use in electrosurgical procedures.

Abstract: A suture device including a hook needle, a body portion which fits within a wound site and a handle portion pivotally attached to the body portion. The needle is J-shaped with a long straight part and short curved part terminating in a pointed end. The long part of the needle slides in a channel in the handle portion and the pointed end moves axially toward and away from the handle with the curved part of the needle facing internal organs during closure of a wound site in an abdominal cavity.

Abstract: A surgical knot pusher, including a body shaft, a tip arranged on one end of the body shaft, and a slot in a sidewall of the tip for manipulating suture material extending through an opening in an endwall of the tip. A notched slit is connected to the opening and the opening has a diameter which is larger than the width of the slit. The slot may include two channels which intersect each other with a first channel of the slot parallel to a long axis of the body shaft. The surgical knot pusher may also include a blade slidable in the slot for shearing the suture material after the knot pusher is used to advance and tighten a slip knot in the suture material. The blade may be attached to an end of a spring-biased cutter shaft slidable inside the body shaft.

Abstract: The invention provides a tissue manipulation system including a tethered clamp, a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity, and a rigid positioning shaft for engaging the clamp and/or tether to manipulate the clamp. In a further embodiment, the tissue manipulation system includes an introducer through which the tether can be withdrawn from the abdominal cavity and a retainer attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

Abstract: A balloon catheter including a pumping mechanism for inflating the balloon, an actuator and control wire for deflecting a distal tip of the catheter and a luer connection for passing a guidewire through the catheter. The balloon can be inflated with a push button which can be locked when depressed so as to inflate the balloon. The balloon is deflated by rotating the push button so that a return spring expands an air bladder and returns the push button to a non-inflating position. The control wire is manipulated by a pivotal lever or a slidable ring. The ring can include a projection which extends through a slot in the housing or the ring can include a circumferentially extending surface which can be finger actuated at any position around the catheter tube.

Abstract: A medical device such as a retractor or isolation bag including an inflatable member which expands from a collapsed configuration to an expanded configuration when pressurized gas or liquid is supplied thereto. The member can include a plurality of fluid channels, ribs and pre-shaped wire members. The device is inserted into a body cavity through a tube. The device can also be actuated by a honeycomb reinforcing structure with or without the use of pressurized fluid. The device can be manufactured by forming one or more air conduits in a member of expandable material or by enclosing a honeycomb reinforcing structure in a polymer material.

Abstract: A medical device and method of using the device such as during laparascopic procedures for reducing the size of specimens so that they can be removed from the body by a minimally invasive surgical technique. The device is thermally activated and is useable in conjunction with or as part of a tissue isolation bag. The device includes an inner wall defining an empty space for receiving surgically removed tissue. The member is in an expanded condition at body temperature but shrinks to a smaller specimen reducing configuration wherein the empty space becomes smaller when the member is heated to a temperature above body temperature. By careful selection of the material for the specimen reduction device, a range of specific shrink temperatures may be obtained which are suitable for use within the body. For example, the member can be of a shape memory metal or a shape memory polymer.

Abstract: A steerable surgical device including an inner tubular member and an outer tubular member surrounding the inner tubular member. A distal end of the inner tubular member and/or the outer tubular member is prebent in a curved configuration. A distal end of the device can be oriented in a desired direction by rotating the inner and outer tubular members with respect to each other. A tool such as an arthroscopic grasper can be mounted on a distal end of the inner and/or outer tubular members and the tool can be oriented in any desired direction simply by rotating one of the tubular members with respect to the other tubular member.

Abstract: A medical device such as a retractor or isolation bag including an inflatable member which expands from a collapsed configuration to an expanded configuration when pressurized gas or liquid is supplied thereto. The member can include a plurality of fluid channels, ribs and pre-shaped wire members. The device is inserted into a body cavity through a tube. The device can also be actuated by a honeycomb reinforcing structure with or without the use of pressurized fluid. The device can be manufactured by forming one or more air conduits in a member of expandable material or by enclosing a honeycomb reinforcing structure in a polymer material.

Abstract: A uniplanar medical steering device which includes a tubular member of a material such as stainless steel, a hinge formed by a cut-out in a wall of the tubular member and a control wire for bending a first end of the tubular member back and forth in a plane towards and away from a second end of the tubular member. A medical device such as a catheter can be provided within the tubular member and an outer member surrounding the tubular member can be used to cover the cut-out. The steering device allows accurate positioning of a medical device and prevents twisting of the medical device when bent by the control wire.