Abstract: A surgical instrument for facilitating the injection of a contrast fluid into the cystic duct during the course of a laparoscopic cholecystectomy procedure comprises an elongated, rigid outer tubular member whose outer diameter permits it to pass through the lumen of a trocar penetrating the patient's abdominal wall and of a length allowing the distal end of the instrument to abut the patient's cystic duct. Affixed to the proximal end of the outer tubular shaft is a grip that includes a plunger which can be reciprocally moved in the longitudinal direction and joined to the plunger is an inner tube which can be joined at its proximal end to a source of contrast fluid and which extends through the lumen of the outer tubular shaft.

Abstract: An instrument for cauterizing blood vessels while performing an endoscopic procedure includes a rigid outer tube with a proximal end, a distal end and an inner, semi-rigid, tube passing through the outer tube from its proximal end to its distal end. The inner tube has at least one lumen allowing passage of a pair of conductive leads therethrough. The leads terminate at the distal end of the tube in a pair of forceps jaws. The leads are mechanically connected to a scissors-style handle and are electrically connected to an RF generator. The outside diameter of the outer tubular body is sufficiently small that it can readily pass through the working lumen of an endoscope. Associated with the handle is a knob for rotating the inner tube and the conductive leads. The handle also contains a means for effecting translational motion of the inner tube within the outer tube and over the forceps and a means for introducing a preset gap to prevent complete closure of the forceps' jaws.

Abstract: An electrosurgical instrument for use in endoscopic procedures features an electrode assembly which can be readily connected and disconnected from the remaining body of the instrument to allow a replacement electrode assembly to be substituted. The instrument comprises an elongated rigid tube having a handle on the proximal end, the handle including a spring-loaded plunger which is connected by a push rod to a stem member disposed in the lumen of the tube near its distal end. The electrode assembly is designed to mate with the stem and when the plunger is actuated to extend the stem beyond the distal end of the tube, the electrode assembly may be installed. Retraction of the stem within the lumen of the tube serves to hold the electrode assembly in place.

Abstract: A bipolar biopsy device for removing tissue samples for biopsy purposes or other purposes. The bipolar biopsy device has an elongated flexible end and a lumen extending therebetween. A cutting head is mounted on the distal end and has a hollow fixed member containing an electrode having an electrical surface thereon and a hollow cup-shaped moveable relative to the fixed member. The electrode surfaces are electrically connected to an outside voltage source. A handle is affixed to the proximal end and a core wire is affixed to the handle which extends through the lumen and is affixed to the movable hollow cup-shaped member. The core wire manipulated by way of the handle facilitates the movement of the movable cup-shaped member. Tissue samples are obtained by positioning the electrode surfaces close to each other about the tissue sample. An arc is created to break tissue down by applying a voltage to the 2 electrode surfaces.

Abstract: A bipolar sphincterotomy for use in endoscopic retrograde sphincterotomy procedures includes an elongated, flexible, plastic tube having either a single or a double lumen extending between its distal and proximal ends. At least one, but preferably two, aperture(s) is formed through the wall of the plastic tubular member a predetermined distance proximal of the distal end of the plastic tubular member. A pair of conductive wires extend through the lumen from the proximal end and exit the lumen through the aperture(s). The distal ends of pair of wires are mechanically joined to the tube so that the portions of the wires extending exteriorly of the lumen are in parallel, spaced relation with a predetermined gap therebetween. The exposed portions of the wires comprise a bipolar pair of electrodes.

Abstract: An electrosurgical instrument having a protective, extendable and retractable sheath or sleeve is disclosed. The sheath is disposed around and coaligned with an elongated cylindrical rod, from which extends at least one electrode. A conductor extending from the electrode is joined to a conventional power supply cord for connection to a source of RF voltage. Power supply is regulated using either a convention hand or foot switch. The sheath protects the distal electrode(s) as the instrument is inserted through a laparoscopic trocar or endoscope. It also provides an effective extension of an irrigation/aspiration lumen which extends along the length of the cylindrical rod. The proximal end of the irrigation/aspiration lumen is joined to a supply tube which either may be connected to a fluid reservoir for irrigation or to a collection reservoir for aspiration of fluids. Alternative embodiments feature alternative mechanisms for extending the sheath.

Abstract: An electrosurgical instrument for the removal of tissue polyps and the like is disclosed. It features a bipolar pair of conductive electrodes for the cutting of tissue in which at least one electrode is moveable in relation to the other. These electrodes are mounted relative to an insulating plug, which is secured at the distal end of a tubular member. Pressure exerted on a thumb loop shifts the position of one electrode relative to the other. Upon application of RF voltage, the distance at which the electrodes are placed controls the amount of arcing which will occur between electrodes, when placed within a proper range. The electrodes are supplied with power from a standard RF energy source, controlled from a foot or hand switch. The insulating plug may further include metal traces disposed on the peripheral surface. When energized, these traces function as a bipolar pair of electrodes for effecting electrocoagulation of tissue and blood.

Abstract: An electrosurgical cutting instrument with bipolar electrodes integrally formed into a pivoting ceramic working head. The ceramic head is pivotable about a pivot point by selectively retracting a substantially rigid wire internal to a working element which is slidably and rotatably received within an introducer and connected to a point on the ceramic head offset from a longitudinal axis. Radial incisions are induced into a prostate gland during a transurethral resectioning of the prostate gland (TURP) by applying an RF energy across the bipolar electrodes from an external power source and drawing the electrodes across prostate gland tissue. The pivotal head can be selectively reciprocated to approximately a 90.degree. angle relative to a longitudinal axis of the introducer to effectively cauterize tissue during surgery to perform resectioning of the prostate. Increased maneuverability of the instrument allows a surgeon to more quickly and effectively complete a TURP.

Abstract: A biopsy instrument comprises an elongated flexible tube having a sharpened metal sleeve affixed to its distal end. An anvil member is affixed to the distal end of an elongated rod or wire which fits through the lumen of the tube and which is reciprocally moveable in the longitudinal direction by appropriately manipulating a handle device affixed to the proximal end of the tube. Affixed to the anvil member and electrically connected to the rod is an electrode. Means are provided for connecting an RF voltage between the electrode and metal sleeve for coagulating blood at the site where a tissue sample is excised from the internal wall of a body organ. The tissue sample is excised by positioning it against the sharpened edge of the metal sleeve and drawing back on the anvil to sever the sample and draw it into the interior of the sleeve where it remains until removed.

Abstract: An instrument for performing a percutaneous laparoscopic cholecystectomy includes a generally rigid, tubular body with a proximal end, a distal end and a lumen extending between these two ends and with a pair of bipolar electrodes projecting from the distal end of the tubular body and a handle member affixed to its proximal end. The outside diameter of the tubular body is sufficiently small that it can readily pass through a cannula inserted through a puncture made through the abdominal wall. A pair of conductors, connected at one end to the bipolar electrodes and at their other end to a source of radio frequency voltage, extend through the tube's lumen and a handle. Moreover, a fluid port may be formed through the handle so as to be in fluid communication with the lumen of the tube whereby fluids may be perfused through the instrument during its use or a suction may be applied to the proximal port for aspirating the surgical site.

Abstract: A surgical instrument for laparoscopic and endoscopic treatment of tissue and organs is disclosed. It includes a handle with a tubular member extending therefrom. Disposed within the tubular member and extending from the distal end thereof is an extendable and retractable grasping loop or belt, joined at its proximal ends to a slide assembly contained within the handle.The slide member assembly includes a thumb loop, and finger grips mounted on the handle receive additional fingers of the surgeon. Proximal movement of the thumb loop withdraws the belt further into the tubular member to close the grasping loop, while distal movement extends the belt outward to form a flexible grasping loop at the distal end of the instrument to open it to encompass the organ or tissue.The flexible grasping loop may be placed around an internal organ or tissue, then its grasp tightened by proximal movement of the thumb loop.

Abstract: A monopolar electrosurgical instrument for excising polyps from the gastrointestinal tract comprises an elongated flexible plastic tube having a first monopolar electrode mounted a small predetermined distance from the distal end of the tubular member and a conductive wire loop affixed to a pull-wire, the pull-wire extending through the lumen of the tubular member and being connected at its proximal end to a plunger-type handle whereby the loop can be opened and closed by extending and retracting the loop relative to the distal end of the tubulr member. By incorporating both the surface electrode and the loop on the same instrument, polyps may be severed electrosurgically using the snare and the wound then immediately cauterized using the surface electrode, thus obviating the need to do an instrument exchange in the endoscope to accomplish both functions.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter is characterized in having a tip member which during the initial placement of the catheter within the vascular system so that the distal tip member is disposed in a working relation with the lesion to be removed, means are provided for increasing the cross-sectional profile of the tip members to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: An intravascular catheter especially designed to surgically remove atheromas or other forms of stenotic or thrombotic lesions from the interior walls of a blood vessel using an RF discharge between two bipolar electrodes is described. Affixed to the distal end of an elongated, flexible, plastic, tubular member is a bipolar electrode structure comprising a cylindrical insulator having a first conductive metal ring electrode surrounding the periphery of that insulator. Projecting from the distal end of the cylindrical insulator is a second, frusto-conical shaped member whose major base is slightly less in diameter than the diameter of the cylindrical insulator. An insulative material covers all but the distal side edge of the first ring electrode and an annular zone of the second electrode located immediately adjacent to the exposed distal side edge of the first electrode.

Abstract: A biopsy instrument comprises an elongated flexible tube having a sharpened metal sleeve affixed to its distal end. An anvil member is affixed to the distal end of an elongated rod or wire which fits through the lumen of the tube and which is reciprocally moveable in the longitudinal direction by appropriately manipulating a handle device affixed to the proximal end of the tube. Affixed to the anvil member and electrically connected to the rod is an electrode. Means are provided for connecting an RF voltage between the electrode and metal sleeve for coagulating blood at the site where a tissue sample is excised from the internal wall of a body organ. The tissue sample is excised by positioning it against the sharpened edge of the metal sleeve and drawing back on the anvil to sever the sample and draw it into the interior of the sleeve where it remains until removed.

Abstract: An endocardial electrosurgical catheter for locating and subsequently ablating ectopic foci in cardiac tissue comprises an elongated flexible tubular catheter sized to permit its being routed through the vascular system and into a cardiac chamber of the heart. The elongated catheter includes at least one pair of spaced bipolar sensing electrodes near its distal end whereby depolarization signals develop within the heart can be picked up and transmitted over electrical conductors passing through the lumen of the tubular catheter body to be applied to a EKG monitor. Also extending through the lumen of the tubular catheter body are a pair of conductors whose distal ends may selectively be made to project from or be retracted into the body of the catheter.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter has a distal tip member which is disposed in a working relation with the lesion to be removed during the initial placement of the catheter within the vascular system. Means are provided for increasing the cross-sectional profile of the tip member to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: An instrument for performing a percutaneous laparoscopic cholecystectomy includes a generally rigid, tubular body with a proximal end, a distal end and a lumen extending between these two ends and with a pair of bipolar electrodes projecting from the distal end of the tubular body and a handle member affixed to its proximal end. The outside diameter of the tubular body is sufficiently small that it can readily pass through a cannula inserted through a puncture made through the abdominal wall. A pair of conductors, connected at one end to the bipolar electrodes and at their other end to a source of radio frequency voltage, extend through the tube's lumen and a handle. Moreover, a fluid port may be formed through the handle so as to be in fluid communication with the lumen of the tube whereby fluids may be perfused through the instrument during its use or a suction may be applied to the proximal port for aspirating the surgical site.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter is characterized in having a tip member which during the initial placement of the catheter within the vascular system so that the distal tip member is disposed in a working relation with the lesion to be removed, means are provided for increasing the cross-sectional profile of the tip members to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: A bipolar electrosurgical instrument designed for resecting tumorous growths from the esophagus, bladder or other internal organ where the site of the tumor is reached by way of an endoscope, the instrument being dimensioned to fit down the central lumen of the endoscope, comprises an elongated, flexible tube having a conductive helical spring cantilevered from the distal end of the tube and forming a return electrode and a conductive wire hoop spaced a predetermined gap distance from the distalmost convolution of the helical spring and whose plane is perpendicular to the longitudinal axis of the flexible tube forms the active electrode. Wires for applying a high frequency RF voltage across the electrodes extend through the lumen of the flexible tube. As the distal end portion of the instrument is dragged over the tumor to be resected, the cantilevered helical spring is laterally displaced, allowing the RF current leaving the active hoop electrode to cut through the tumorous tissue.