Abstract: A prothesis is provided for repairing a defect in a muscle or tissue wall. The prothesis has a preformed shape that conforms to the wall to facilitate placement and minimize shifting of the prothesis when positioned on the wall. The prosthesis may include a body formed of a sheet of surgical mesh fabric having a flexible inner portion surrounded by a stiffer periphery that is capable of resuming the preformed shape after being temporarily deformed to allow for implantation. The body may include a tapered end to facilitate insertion of the prothesis between the parietal peritoneum and the abdominopelvic wall during hernia repairs. The body may also include a curved end to permit repositioning of the bladder after implantation. In one embodiment, the prothesis includes a conical portion at the tapered end and a spherical portion at the curved end.

Abstract: A steerable catheter control mechanism for manipulating a pair of catheter control wires comprises a slider mechanism coupled to the proximal ends of the control wires and displaceable along a linear path to place a selected one of said wires in tension without placing the other of said wires in compression.

Abstract: A suction and irrigation handpiece is disclosed having a trigger that cooperates with a locking mechanism to lock the trigger into one a plurality of preselected angular positions. The trigger has a plurality of grooves on an inner surface that removably couple with a tooth of the locking mechanism. The locking mechanism includes a shaft rotatably connected through the housing, a locking arm connected to the shaft, and the tooth at the far end of the shaft. The electrical connections between batteries and a motor in the handpiece also are arranged to facilitate manufacture and uniformly energize the pump at a preset position of the trigger. The handpiece thus has a first conductive lead connected between one pole of the battery and a contact port that is relatively far from the trigger pivot, and a second conductive lead is connected between one port of the motor and the contact port. These two leads form an open circuit at the contact port that may be closed by a conductor connected to the trigger.

Abstract: A steerable catheter is disclosed which includes a complexly curved proximal section shaped to seat the catheter relative to an anatomical feature within a patient. The catheter also includes a flexible intermediate section which has comparatively greater flexibility than other sections of the catheter. The flexible intermediate section bends in response to forces applied by an attached steering device and substantially all of the flex in the catheter may be contained within the flexible intermediate section. The catheter further has a pre-shaped distal section which is urged into contact with tissue within the patient when the flexible intermediate section flexes. In a preferred embodiment, the distal section supports a plurality of ring electrodes and is shaped to generally correspond to the physiology of a wall of the heart.

Abstract: A pulsatile pump the output of which is infinitely variable between a slow pulsatile flow and increased up to a sharply pulsed flow rate until the pulses run together and a smooth flow results, and which may be varied between wide output pressure and frequency limits. The pump is comprised of a pneumatic control circuit, at least two pneumatically isolated compression chambers, and a novel inlet/outlet pump cartridge and condition-responsive locking means. Operation of the pump is controlled by the use of novel tactile pneumatic response switches. Each compression chamber is communicated with a supply of working fluid through the cartridge. Means are provided for varying the operation of the pneumatic circuit and hence the pump. A flow of pressurized fluid, such as air or nitrogen, is used as the operating media of the pneumatic circuit, although other fluids may be used. Means for monitoring and adjusting pump system parameters are also provided.

Abstract: A surgical instrument assembly has an endoscope with an instrument channel and a sheathed elongate tubular member inserted into the instrument channel. The sheath is provided with a distal end portion having at least one resiliently biased, curved portion tending to direct the tip of the distal end portion in a direction angularly offset from the axis of the body insertion tube at its distal end. The elongate tubular member is itself longitudinally slidably positioned within the sheath. The instrument channel exerts forces sufficient to straighten the curved portions of the sheath when the curved portions are positioned within the body insertion tube, proximal of the tube's distal end. An elongate flexible endoscopic instrument is mounted into the tubular member so that an operative tip is located at a distal end of the tubular member.

Abstract: A handle is provided for attachment to a medical endoscope for advancing instrumentalities through the instrument channel of the endoscope. The handle is adapted for use with instrumentalities requiring multiple longitudinal strokes to be performed in a predetermined sequence. A detent mechanism is provided to assure that a first stroke is completed before the next succeeding stroke begins. The invention as disclosed is used to operate an endoscopic sewing machine.

Abstract: A steerable catheter control mechanism comprises a rotatable driver and a deflection device responsive to the driver to selectively secure a pair of control wires. The control wires are positioned such that rotation of the driver reduces the effective deflection device radius while loading a selected wire in tension, thereby maintaining a relatively constant torque acting on the driver and minimizing operator fatigue. The deflection device is also responsive to the driver to selectively place one of the control wires in tension while maintaining the other wire in a static state thereby minimizing control wire fatigue.

Abstract: An endoprosthesis assembly adapted to be positioned within a body lumen includes a resilient, self-expanding anchor attached to a tubular graft. The endoprosthesis can be recaptured in a delivery device to enable repositioning or removal of the endoprosthesis at any time prior to complete deployment of the endoprosthesis in the patient. The delivery device includes an outer tubular member that carries the endoprosthesis in a radially contracted configuration and an elongate inner tubular member that extends through the prosthesis and beyond the distal end of the outer tubular member. A retainer is carried by the inner member that engages and retains the proximal end of the endoprosthesis relative to the inner member until the endoprosthesis is released.

Abstract: A graft assembly for securely positioning a graft at a predetermined location across an abdominal aortic aneurysm. The assembly includes a resilient self-expanding anchor that is secured to the graft. The anchor is characterized as being at least as long as the graft, and further as being adapted to be removed or repositioned at any time prior to complete deployment in the patient.

Abstract: A monitor is disclosed for measuring a liquid discharged from a patient's body. A housing defines a cavity having a floor. A substantially rigid wall container is removably positioned within the cavity, the container having a bottom wall portion supported on the floor of the cavity. A transducer is mounted in the floor of the cavity and engages the bottom wall portion of the container. The transducer is periodically engaged to transmit energy through the bottom wall portion and into a pool. The time duration required for the transmitted energy to travel from the transducer means to the upper surface of the pool and back again is determined, and this time duration is converted into a volume of fluid by reference to a look-up table, a mathematical algorithm, or both. The monitor includes an optical sensor to detect the presence of a container in the housing and provides an indication if no container is detected.

Abstract: An automated tissue sampling device is disclosed which permits its needles to be cocked either simultaneously or sequentially and can be cocked with only one hand. The cocking mechanism is arranged so as to virtually eliminate the possibility that the needles will be cocked in the wrong sequence. The physician can readily confirm, either visually or tactilely, whether the device is uncocked, half cocked, or fully cocked. The disclosed tissue sampling device also comprises two different trigger buttons, one adjacent the front end of the device and the other at the rear, and manipulating either of the two trigger buttons will actuate the device.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. A finger tab is movable on the handle in a single distal direction through multiple stage. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In an associated method the needles are threaded on the far side of the body wall and withdrawn from the wound providing access to the suture ends on the near side of the body wall. Tying the suture ends closes the wound.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. In one embodiment of the invention, a finger ring is movable on the handle in a single distal direction through multiple stages. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In another embodiment, the finger ring is movable in a distal direction to deploy and thread the needles, and movable in a proximal direction to tension the suture and withdraw the needles.

Abstract: An improved stone basket is disclosed which comprises a handle having a slide and a piston movably mounted to it. In a first embodiment the distal end of a sheath is attached to the slide, and the distal end of a control wire is attached to the piston. A basket shaft is fixedly mounted to the handle. Initial rearward movement of the slide causes the sheath to retract over the fixed basket shaft, exposing a basket member at the forward end of the basket shaft and permitting it to open. Further rearward movement of the slide by the physician brings the slide into driving engagment with the piston. Thereafter, subsequent movement of the slide displaces the piston to exert a tension on the control wire to expand the basket member. In a second embodiment the sheath is fixedly mounted to the forward end of the handle. The rearward end of the basket shaft is mounted to the thumb slide, and the rearward end of the control wire is attached to the piston.

Abstract: A ligating band dispenser has a plurality of elastic ligating bands at least one of which is supported on each of a series of partially nested cylinders. Inner and intermediate cylinders comprise axially sliding cylinders for dispensing the ligating bands. An outer cylinder,which may be attached to the distal end of an elongated introducer, surrounds at least the proximal portion of the intermediate cylinder and is adapted to receive the sliding cylinders slide into its distal end. A trip wire is connected to the inner cylinder and extends proximally therefrom through the elongated introducer. The trip wire is adapted to cause an axially sliding motion of the sliding cylinders during an application of force to the trip wire. A restraining means is associated with each sliding cylinder to restrain sliding motion thereof during the application of force to the trip wire.

Abstract: A hydrophilic, lubricious, durable, flexible, coating comprising a crosslinked polyurea matrix complexed with a hydrophilic polymer selected from the group consisting of poly (ethylene oxide) and polyvinylpyrrolidone, said crosslinked polymer formed from the reaction of an isocyanate and a compound having at least two active hydrogens per molecule selected from the group consisting of polyamines, polymercaptans, and polycarboxylates or compounds with NH, NH.sub.2, SH or COOH groups on same molecule in the presence of said hydrophilic polymer, with the total sum of the average isocyanate functionality plus the average active hydrogen functionality exceeding 4 and the molar ratio of total NCO groups to total active hydrogens being at least 0.8.

Abstract: A composition and method are provided that are effective in revitalizing scar tissue by introducing a bioactive substance having angiogenic activity into the scar tissue. The bioactive substance can be introduced by itself, or it can be introduced into the scar tissue in a timed release form. The present invention is effective in treating stress urinary incontinence or localized muscular dysfunction.

Abstract: A self contained pulsatile surgical irrigation device that includes a housing, a trigger moveably connected to the housing, a motor within the housing, a pump within the housing, and a mechanical drive train for coupling the motor to the pump. The trigger is mechanically connected to the drive train to enable the stroke of the pump to be varied, thereby varying the output flow from the device.

Abstract: The present invention is an injectable medical device useful for replacing natural lubricating fluids in the body of humans or animals. The method and composition can be used for the treatment of joints and other parts of the body wherein natural lubrication between surfaces is deficient or where additional lubrication is required. The composition comprises a hydrophilic polymer suspended in a hydrophobic carrier so that the suspension is easily injectable into the desired body part. After injection, the carrier diffuses away from the polymer and is replaced by aqueous body fluids thereby causing the polymer to absorb or adsorb water forming a viscous, lubricating fluid.