Abstract: An apparatus is disclosed for guiding a medical instrument to a predetermined target location within the periurethral tissues of a patient. The apparatus directs the instrument along a predetermined path with respect to the patient's urethra and limits penetration of the instrument to a predetermined depth. The disclosed embodiment comprises an apparatus for implanting inflatable prostheses within the periurethral tissues to coapt the urethra and thereby manage incontinence. A method for effecting coaptation of a urethra of a patient is also disclosed. According to this method, a pair of working channels are formed within the periurethral tissues, and an inflatable prosthesis is introduced into each working channel. The prostheses are inflated only after both working channels have been formed, and preferably after both prostheses have been positioned within their respective working channels. The inflated prostheses confront the urethra and effect coaptation of the urethra.

Abstract: A device and method of use for facilitating the axial connection of small diameter wires, and in particular for connecting a guidewire to an extension guidewire. Using a male/female interconnecting arrangement, the end of a guidewire is connected axially to the end of an extension guidewire using a device having a first body member including a channel or groove located on the upper surface of the first body member, the channel having a cross-section corresponding to that of the larger guidewire and dimensioned slightly wider so that the guidewires are in a sliding fit in the channel; and a second body member dimensioned to fit over the first body member as a cover, the second body member having a transparent portion located over the channel, the transparent portion being curved throughout its length to effect magnification and provide visual assistance thereof.

Abstract: An exchange length guidewire for use in percutaneous transluminal coronary angioplasty is formed in two sections including a proximal section and a distal section. The proximal end of the distal section is rotatably attached to the distal end of the proximal section so that it may be rotated freely with respect to the proximal section. The proximal section may be maintained in a coiled configuration in a storage hoop while the distal portion may be used as a steerable guidewire to assist in navigating a catheter to the intended vascular treatment site. When it is desired to perform a catheter exchange, the proximal section is removed from the storage hoop to permit the wire to extend to its full exchange length, typically slightly more than twice the length of the catheter. The catheter exchange then may be performed. Thereafter, the proximal section of the exchange wire may be reinserted into the storage hoop and while the distal portion may continue to serve as a steerable guidewire.

Abstract: A precalibrated sensing system for determining a blood parameter such as the partial pressures of oxygen (pO.sub.2) and carbon dioxide (pCO.sub.2), and the negative logarithm of hydrogen ion activity (pH). A dry sensor is provided which may be calibrated in the factory, packaged, sterilized and stored, without requiring recalibration prior to use.

Abstract: A novel apparatus for a catheter for use in aspirating and/or infusing fluids into a patient. The catheter, having a proximal end and a distal end, comprises a plurality of valves in the walls of the catheter comprised of relatively soft material while maintaining a predetermined degree of structural integrity at the catheter tip. The plurality of valves are radially distributed in offset relation around the distal end of the catheter such that no two valves lie in any one radial plane. Similarly, the plurality of valves are longitudinally separated or offset in their placement at relatively short, but differentiated, distances from the distal end of the catheter such that no two valves lie in any one axial plane. The radial and longitudinal separation of the valves helps avoid structrual weakness in the catheter, particularly at the distal end of the catheter. The catheter may be a single-lumen catheter, or a multi-lumen catheter.

Abstract: A guidewire for use in the placement of a catheter includes an elongate flexible core wire and a helical coil wrapped about the core wire. The pitch of the turns of the coil is relatively wide over most of the length of the guidewire with a distal segment having coil turns that are closely adjacent each other. The coil is formed from a radiopaque material. The wide pitch of the coil presented reduced contact area between the guidewire and the catheter, thereby reducing frictional drag between the two. The distal dip defines a relatively dark radiopaque image while the more proximal portions of the guidewire present a less radiopaque relatively gray image. The black/gray fluoroscopic images enable clear determination of the precise position and contour of the guidewire but without obstructing fluoroscopic visualization of radiopaque contrast liquid injected into the body lumen containing the guidewire and catheter.

Abstract: A micro-injection port having a low profile is provided. The micro-injection port has a septum and an injection chamber located side-by-side. When implanted, the puncture surface of the septum lines substantially perpendicular to the surface of the the micro-injection port also has a filter systems skin. The filter is formed from an opening in the side wall of the injection port and a shaft secured within the opening.

Abstract: A surgical gripping instrument comprises a support assembly, a slide mounted on the support assembly for relative movement with respect thereto, a wire movable with the slide relative to the support assembly, gripping means at the distal end of the wire, and a sheath enveloping the wire. Movement of the wire a predetermined distance relative to the sheath causes the gripping means to be actuated. A belt or gear arrangement is provided to enable the slide to be moved a distance relative to the support assembly less than the predetermined distance causing sufficient displacement of said sheath relative to the gripping means to actuate the latter.

Abstract: A disposable biopsy forceps includes an elongate tubular member having proximal and distal ends. Manually operated actuating means is mounted to the proximal end of the flexible tubular member. A biopsy jaw assembly is mounted to the distal end of the tubular member and is operatively connected to the actuating means by a control wire extending through the tubular member. Several embodiments of jaw arrangements are disclosed. At least the cups and cutting rim portion of the cutting jaws is formed from an injection molded plastic capable of holding and retaining an edge sufficiently sharp to cut tissue.

Abstract: Disclosed is an apparatus for occluding resilient tubing which effectively and conveniently occludes tubing without damage to the tubing, even after repeated clamping. Included in embodiments of the invention are a clamping structure and a protective sleeve formed from a resilient material which is interposed between the tubing to be occluded and the clamp. Also included are structures to prevent the application of the clamp immediately adjacent to the ends of the tubing. Moreover, the clamp can be applied at any one of a plurality of positions along the tube so that no one location along the length of the tube is subject to excessive fatigue. The protective sleeve and the clamp are joined together such that the clamp cannot be applied to the tube without the protective sleeve interposed therebetween. The embodiments of the present invention prevent damage to tubing, such as fragile silicone rubber tubing used in medical applications, even when subjected to repeated clampings.

Abstract: Apparatus and a non-surgical method for hypodermically implanting a genitourinary prosthesis comprising an extensible, inflatable containment membrane to be located between the urethra and the subcutaneous corpus spongiousum of a patient to overcome urinary incontinence by means of localized, controlled tissue volume increase. Hypodermic positioning, injecting and inflating instruments are also disclosed for implant of the containment membrane and for percutaneously infusing the membrane with bicompatible fluid or particulate matter. The containment membrane functions as an envelope for retaining the fluid or particulate matter therewithin while controllably and advantageously increasing localized tissue volume and simultaneously preventing the migration of such fluid or particles. Accordingly, an increased passive occlusive pressure may be applied to the patient's urethra to achieve continence.

Abstract: A control module for regulating the flow of gases in a suction drainage apparatus. The drainage apparatus includes a collection container in communication with a body cavity to receive body fluids (including liquids and gases) therefrom and a suction source for creating a negative pressure within the collection container and removing the gases of the body fluids. The control module includes a serial arrangement of chambers and a plurality of flow control means in a unitary compact structure which fits within a recess provided in the collection container. The control module is adapatable to different sizes and types of collection means and does not add appreciably to the overall size of the device. Baffle means are provided to prevent the loss of the indicator liquid from the air leak indicator means if the device is tipped in any direction.

Abstract: A medical apparatus for automatically measuring and displaying the quantity of a liquid discharged by a patient during a defined real time interval. The apparatus is comprised of a reusable housing and a disposable plastic container adapted to be removably received in a cavity in the housing. A transducer is mounted in the floor of the cavity to engage the container and transmit sonic pulses through the container wall into a liquid pool in the container. A molded silicon rubber cap is fitted over the transducer to assure good acoustic coupling between the transducer and the container without requiring the use of an intermediate gel substance. The container is configured such that when it is received in the housing cavity, it is oriented to cause liquid entering an inlet port in the top portion to pool over the flat section of the container bottom wall.

Abstract: A catheter with a heater mounted on its distal end is used to melt atherosclerotic plaque to clear an obstruction within an artery. The catheter heater is a tapered cone that emits heat from its outer, leading edges. Several embodiments are disclosed in which the power for the heater is generated by electrical resistance heating or by laser energy absorption. In the disclosed method of use, the guidewire is inserted into the lumen of the catheter so that the distal tip of the guidewire extends a few centimeters beyond the heater tip. The catheter is directed into the proper coronary branch by means of the guidewire and the wire is advanced until it meets the obstruction. If the wire can be advanced through the obstruction, the catheter is advanced over the wire until the heater contacts the plaque. The heater is then operated and the catheter is advanced as the plaque melts.

Abstract: Leakage cancelling apparatus suitable for use in electrosurgery apparatus to prevent electrical burns is disclosed. The apparatus comprises a transformer which is connected in the electrical circuit between the electrosurgical source and the patient. The transformer has a primary winding connected in series with the active surgical electrode and a secondary winding connected in series with the return path to the electrosurgical generator. The connections to the windings are polarized so that during normal operation the magnetic fields in the transformer core generated by current flow are almost completely cancelled. Consequently, the transformer windings present very small impedances in series with the electrosurgical circuit.

Abstract: A blood pressure measuring device is disclosed which uses an inflatable cuff to apply external pressure to a patient's body member. The device detects and measures amplitude of pressure oscillations induced in the cuff by blood flow in the body member as the cuff pressure is decreased in steps from a magnitude above the expected systolic pressure to a magnitude below the expected diastolic blood pressure. The means arterial blood pressure is measured at the step at which the pressure oscillations reach a maximum. Systolic blood pressure is determined by making a first linear approximation to a plurality of amplitude measurements occurring below the expected systolic pressure and making a second linear approximation to a plurality of points occurring above the expected systolic pressure. The systolic pressure is calculated by setting the two approximations equal.

Abstract: A device for tissue sampling by thick needle punctuation including a needle assembly including a hollow first needle and second needle extending through the hollow first needle. The needle assembly is contained in a housing having an opening through which the needles extend. Compressed springs in the housing are caused to expand to urge the needles away from the housing during the sampling of tissue. A rod is provided extending from the housing to simultaneously place the springs in a compressed condition.

Abstract: A device for tissue sampling by thick needle punctuation including a needle assembly including a hollow first needle and second needle extending through the hollow first needle. The needle assembly is contained in a housing having an opening through which the needles extend. Compressed springs in the housing are caused to expand to urge the needles away from the housing during the sampling of tissue. A rod is provided extending from the housing to simultaneously place the springs in a compressed condition.