Abstract: A cryosurgical system comprises a compressor unit and a probe assembly. A secondary refrigerant stream from the compressor unit pre-cools a heat exchanger within the probe assembly in a standby mode of operation. After the heat exchange is pre-cooled, a primary refrigerant stream can be passed through the cooled heat exchanger and thereafter expanded within a tissue-contacting portion of the probe assembly to achieve very low temperatures, typically minus 100° C. or lower. After cooling, the refrigerant stream may be passed through the probe assembly with no or partial expansion to warm the tissue-contacting surface of the probe. A probe sheath can be used to provide sterility.

Abstract: A morcellator for removing large masses of tissues during laparoscopic procedures includes a rotationally fixed, axially movable inner tube disposed within a rotating cutting member. The cutting member is often disposed in the annular space between the inner tube and an outer tube. A laparoscopic grasping instrument is inserted through the lumen and draws the tissue proximally through the morcellator. As the cutting member severs tissue, the tissue is drawn into the fixed lumen of the inner tube. This prevents the cutting member from twisting the severed tissue, thereby preventing any degradation of the surgeon's control. A novel valve is provided to prevent loss of insufflation gas when no instrument traverses the lumen. The inner tube can be translated distally to protect tissues and/or other surgical implements against inadvertent contact with the cutting edge of the cutting member.

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: The invention provides systems and methods for interfering with the adhesion formation process. In some embodiments, the present invention makes use of intermittent blunt dissection of fibrin bridging adjacent tissues prior to the formation of adhesions. Dissection is generally provided by pulsing a balloon implanted between the tissues. Optionally, the balloon will comprise an elastic structure to disrupt the formation of fibrin between the balloon and the surrounding tissues. Alternatively, the balloon may be at least partially covered by a bio-active anti-adhesion material. In some embodiments, the anti-adhesion material forms an envelope which is left between the tissues when the balloon is removed.

Abstract: The present invention provides electrosurgical needles, needle systems, and methods for their use which will allow the surgeon to target a tumor's blood supply. Generally, the invention facilities targeting the bloodflow of the tumor by incorporating a doppler ultrasound transducer into the needle or needle sheath. Preferably, the surgeon will also be able to control the temperature of the needle using an integral temperature sensor to effect maximum transfer of the RF energy into the tissue, thereby maximizing the volume of tissue destroyed. Furthermore, when used (for example) in the treatment of uterine fibroids, the present invention will reduce damage to the serosa by monitoring the uterine surface temperature during myolysis through a temperature sensor integrated into the sheath holding the myolysis needle.

Abstract: A surgical valve prevents loss of insufflation gas (or the like) when no instrument traverses the valve lumen. The valve is suitable for passing surgical implements distally, and for passing enlarged bodies (such as large morcels of severed tissue) proximally. A first set of valve segments angle together along a slit, similar to a duck-bill valve. A second set of valve segments angle outwardly distally, the second segments often having a passage so that distal pressure pushes the first segments together along the slit.

Abstract: The present invention provides devices, systems, and methods for using a single electrode structure for both resection and ablation. Generally, the electrode structures of the present invention comprise fixed wire shapes which avoid the complexity and binding that often result when known rolling ablation elements are powered to the high electrosurgical potentials required for removal of tissues. Electrosurgical energy requirements are minimized by concentrating potential at narrow cutting surfaces, and physician effort is avoided by minimizing the total profile of the device along a selected cutting axis. In the exemplary embodiment, a serpentine wire has multiple electrosurgical elements which are aligned with a low cutting profile, and which provide a large lateral surface area for simultaneous ablation of uterine and other tissues.

Abstract: The present invention provides a tubular surgical cutter fabrication method comprising forming one or more tabs which extend beyond an end of a tube. Each of the tabs is then folded across at least a portion of the end of the tube, and affixed in the folded position to form an end structure extending across the end of the tube. A cutting edge is imposed on the tube adjacent to the end structure, thereby providing a tubular surgical cutter having the structural reinforcement of a closed end without resorting to welding or otherwise attaching a closed end structure about the perimeter of the tube.

Abstract: The invention provides tubular surgical cutters having conical or tapering cutting chambers along substantially the entire length of their cutting apertures. Tissues which are drawn into such a conical chamber and severed from the adjacent tissue are quite easily drawn proximally for aspiration, substantially reducing the likelihood that they will clog the cutter mechanism. In some embodiments, an inner cutting tube having an orifice which is smaller than that of the outer cutting tube limits the size of tissue fragments entrained within the cutting chamber, further reducing the possibility that those fragments will clog the aspiration lumen and interrupt the tissue removal process.

Abstract: The invention provides tubular surgical cutter devices which include aspiration flow control ports to enhance the ability of the cutter to remove severed tissues from an internal surgical site. The aspiration flow control ports will admit sufficient aspiration fluid to transport tissue fragments that are severed by the tubular surgical cutter through the lumen of the cutter, even when the severing aperture is entirely blocked by a target tissue. The aspiration flow control ports will typically be in one of two forms. In the first form, a vacuum relief port provides open fluid communication with the lumen of the tubular cutter when the cutting aperture is open to receive target tissues for severing. In the second form, a fenestration pattern through an outer tube of the cutter ensures that aspiration flow continues even when the cutting aperture of the outer tube is blocked.