Abstract: The invention is directed to a novel method and apparatus for treatment of a diseased internal organ, specifically, the male prostrate gland. The method and apparatus are specific to a transperineal approach to the prostrate gland. The apparatus comprises a catheter containing a plurality of lumens therethrough, an inflatable transparent member in fluid communication with one of the lumens and placed on the distal end of the catheter, and visualizing means to allow for visualization of the area to be treated through said inflatable member. Upon inflation, the inflatable member aids in the separation of the prostrate gland from the rectal wall. Additionally, treating means can be inserted through another of the lumens in order to obtain the desired systemic effect on the prostate gland.

Abstract: An inflatable retractor including a main envelope enclosing a main chamber is provided. The main envelope is provided in a collapsed state. An elastomeric window is also provided. The main envelope of the inflatable retractor is placed adjacent the organ inside the body, and the main chamber is expanded to an expanded state to retract the organ. Following inflation of the main chamber to the expanded state, the elastomeric window is attached to the main envelope inside the main chamber to cover part of the main envelope. The surgical instrument is passed into the main chamber. An aperture is pierced in the pan of the main envelope covered by the elastomeric window to provide access for the surgical instrument to contact the tissue. The elastomeric window provides a gas-tight seal to maintain the main chamber in the expanded state.

Abstract: A first inflatable retraction device has a first inflatable chamber and a non-pressurized chamber inside the main chamber. The non-pressurized chamber is expanded by inflating a second inflatable chamber. The non-pressurized chamber enables the main chamber to remain inflated when an aperture is cut in the envelope of the main chamber, through which treatment is carried out. A second inflatable retraction device has an inflatable retractor and a maintainer. The inflatable retractor retracts the organ and the maintainer maintains the organ in its retracted condition after the inflatable retractor is deflated. The maintainer can be inflatable, and can be inside or outside the inflatable retractor. A self-retracting endoscope has an optical assembly with an expandable retractor fitted to its distal end. The distal end of the endoscope is inserted into the body with the retractor in a collapsed condition.

Abstract: An apparatus and method for cauterizing the endometrial tissue of the uterus includes an inflatable balloon mounted to the end of a cannula and spring members which shape the balloon to approximate the bicornual shape of the uterus. A heating coil heats a saline solution to approximately 190.degree.-210.degree. F. and a pump circulates the saline solution through the cannula and inflates the balloon. The inflated balloon contacts substantially all of the intrauterine surface and is held in contact with the surface for 5 to 7 minutes until the tissue has been necrosed. A fiberoptic scope is used to monitor balloon placement and cauterization effect.

Abstract: The invention provides a surgical clip applier particularly useful in laparoscopic and other least invasive surgical procedures. The clip applier includes a shaft having a distal end and a proximal end, the shaft defining an axial direction. Means are provided in the shaft for advancing a clip to the distal end. Hook means are fixed to the distal end of the shaft, the hook means having a distal portion disposed transverse to the shaft so as to define a surface facing in a proximal direction for engaging a tissue structure. A pair of movable jaws are mounted at the distal end of the shaft and are axially slidable relative to the hook means for closing a clip on a tissue structure engaged by the hook means. The movable jaws will define a U-shaped slot open in a generally distal direction. Means are further provided for advancing the jaws to a position adjacent the distal portion of the hook means, as well as means for closing the jaws.

Abstract: Hollow body structures may be manipulated and dissected from surrounding tissue using a manipulator device and a dissection device. The manipulator includes a rigid shaft having an inflatable balloon at its distal end. By inserting the balloon through a wall of the body structure and inflating the balloon, the body structure can be manipulated using the shaft to expose a dissection plane in an optimum manner. The dissection device is used to separate the body structure from its surrounding tissue. The separator device includes a separator head which is a cylindrical body having a plurality of axial channels therein. The dissector head is rotated or oscillated at a high frequency and acts to separate the body structure from the surrounding tissue with minimum damage.

Abstract: An gas-sealed instrument for use in laparoscopic procedures in a gas-insufflated body cavity. The instrument comprises a static portion, a moving portion, and a flexible seal for preventing gas from escaping from the body cavity through the static portion. The static portion includes a handle, and an elongate outer tube having a bore, a proximal portion attached to the handle, and a distal portion adapted for inserting into the body cavity. The moving portion includes an operating lever pivotally mounted in the handle, and an elongate operating rod mounted in the bore of the elongate outer tube, and sliding axially relative thereto in response to the operating lever. The flexible seal includes an outer portion attached to the static portion, an inner portion disposed about part of the moving portion, and a flexible mid portion between the outer portion and the inner portion. A rigid seal may be substituted for the flexible seal.

Abstract: An apparatus for retracting an organ to gain access to treat a tissue. The apparatus has a main envelope, a second envelope, a first inflation device and a second inflation device. The main envelope encloses a main chamber, and includes a window and a removable window. The second envelope covers substantially all the main envelope, except the window and the removable window. The second envelope and the main envelope enclose a second chamber outside the main chamber. The first inflation device passes a fluid into the main chamber to expand the main chamber and the second chamber from a compacted state to retract the organ. The second inflation device passes a fluid into the second chamber to further expand the second chamber to maintain the organ in its retracted state after fluid has been released from the main chamber.

Abstract: A seal for use in a surgical instrument to provide a gas-tight seal with an instrument passed through the seal. The seal can form a gas-tight seal with an instrument having a diameter within a wide range of diameters. The seal comprises a seal body, an instrument seal, and a laterally-compliant seal mounting. The seal body includes a bore through which the instrument is passed. The instrument seal is made of an elastic material. The instrument seal extends radially outwards from an instrument port formed in the instrument seal through which the instrument is passed. The instrument port is substantially perpendicular to the axis. The instrument seal also extends axially from the instrument port in the direction opposite to that in which the instrument is passed through the instrument port.

Abstract: A seal for use in a surgical instrument to provide a gas-tight seal with an instrument passed through the seal. The seal can form a gas-tight seal with an instrument having a diameter within a wide range of diameters. The seal comprises a seal body, an instrument seal, and a laterally-compliant seal mounting device. The seal body includes a bore through which the instrument is passed. The instrument seal is made of an elastic material and is disposed substantially perpendicular to the axis defined by the bore in the seal body. The instrument seal includes an instrument port through which the instrument is passed. The laterally-compliant seal mounting device mounts the instrument seal to the seal body, forms a gas-tight seal between the instrument seal and the seal body, and allows the instrument seal to move freely laterally in response to lateral movement of the instrument.

Abstract: Apparatus for retracting an organ inside the body to gain access to an adjacent tissue. The apparatus comprises an expandable cage and an expansion element. The expandable cage is capable of being inserted into the body through a small incision or puncture in a collapsed state. The expansion element is for selectively expanding the expansible cage inside the body to an expanded state. The expansion element includes an envelope enclosing a fluid-inflatable chamber. The expansible cage includes an additional envelope mounted inside the inflatable chamber and enclosing an additional fluid-inflatable chamber. The expansible cage is additionally capable of maintaining the expanded state independently of the expansion element after the expansible cage has been expanded by the expansion element to the expanded state.

Abstract: A hand-held apparatus and method for insufflating an abdominal cavity includes a compact gas supply unit comprised of a gas cartridge which has a pair of tandem piercable seals positioned inside the cartridge neck and which contains a predetermined mass of compressed gas. A cap having a puncture stem is engaged with the gas supply unit, causing the puncture stem to penetrate the piercable seals and release gas through the puncture tube and into a hollow needle positioned inside the abdomen. The tandem piercable seals are arranged such that as the gas supply unit is engaged with the cap, the puncture stem punctures the first piercable seal and the first piercable seal seals around it before the puncture stem punctures the second piercable seal, thereby preventing accidental loss of gas and preserving the entire mass of gas for insufflation.

Abstract: The present invention is directed to a medical device for performing endoscopic procedures comprising a trocar and a cannula assembly having slidable adapter seals. The cannula assembly has a housing at the proximal extracorporeal end of a cannula. A generally semi-circular track follows the periphery of the cannula housing and at least one adapter seal slidably is engaged with the track. The adapter seal comprises a plate that accommodates a sealing element with an aperture for receiving surgical instruments. The adapter seal has engagement means for maintaining the adapter seal in the track. In addition, the adapter seal has releasing means that can be acted upon to apply a countering-force against a tensioning means in order to remove the adapter seal from the cannula assembly.

Abstract: An apparatus for suturing fascial tissue for deep puncture wounds utilizes a flexible membrane inserted into a body cavity through a trocar sheath positioned in a wound. A suture to be applied to the wound has anchors attached to each of its ends. A pair of suture-carrying needles each carry an end of the suture and its corresponding anchor. The suture-carrying needles are passed through the fascial layer surrounding the wound and are subsequently passed through the flexible membrane. The suture ends and corresponding anchor means are released from the needles. A lifting force is applied to the flexible member via a cord or shaft which extends out of the wound. The anchors are engaged by the flexible membrane as it is withdrawn out of the wound, pulling the ends of the suture out of the wound to close the opening in the fascial tissue.

Abstract: An apparatus for applying a manipulating force to manipulate a hollow body. The apparatus comprises a hollow shaft at the distal end of which is attached an elastomeric balloon that is inflatable from a collapsed state to an expanded state to engage the hollow body. A tether, attached to the distal tip of the elastomeric balloon, limits distal excursion, and freely allows proximal excursion, of the distal tip of the elastomeric balloon in response to the manipulating force. The tether may be flexible, with its distal end attached to the distal tip of the elastomeric balloon, and its proximal end attached within the hollow shaft. Alternatively, the tether may include an elongate member slidably mounted within the hollow shaft, and a stop that limits distal sliding of the elongate member. The distal tip of the balloon is attached to the distal end of the elongate member. In a method according to the invention for manipulating a hollow body, the apparatus just described is provided.

Abstract: The invention provides an apparatus and method for manipulating parts of the body in surgical procedures, particularly useful for peritoneal distension in laparoscopic surgery. The apparatus comprises a positionable support structure having an extendible horizontal arm rotatably mounted to an extendible vertical post, the post having a clamp at its lower end for mounting to a surgical table. An end segment at the distal end of the horizontal arm has a mount for mounting end-of-arm tooling, for example, peritoneal distension instruments. Locking mechanisms are disposed in the horizontal arm, vertical post and end segment to lock the support structure in a desired position. A motor is disposed within the vertical post for power-assisted extension and retraction of the vertical post. Preferably, the locking mechanisms and motor are controllable using switches mounted on the end segment.

Abstract: A first inflatable retraction device has a first inflatable chamber and a non-pressurized chamber inside the main chamber. The non-pressurized chamber is expanded by inflating a second inflatable chamber. The non-pressurized chamber enables the main chamber to remain inflated when an aperture is cut in the envelope of the main chamber, through which treatment is carried out. A second inflatable retraction device has an inflatable retractor and a maintainer. The inflatable retractor retracts the organ and the maintainer maintains the organ in its retracted condition after the inflatable retractor is deflated. The maintainer can be inflatable, and can be inside or outside the inflatable retractor. A self-retracting endoscope has an optical assembly with an expandable retractor fitted to its distal end. The distal end of the endoscope is inserted into the body with the retractor in a collapsed condition.

Abstract: A trocar is received in a trocar tube for movement relative to the tube between a position extended from the tube for piercing and a retracted position shielded by the tube. The trocar is mounted within a housing which carries a spring normally biasing the trocar to the retracted position. A latch mechanism within the housing is engageable with the trocar to maintain the trocar in the extended position. The latch mechanism senses the application of piercing force to the trocar and, upon the interruption of such force in response to the completion of a piercing operation, functions to release the trocar for retraction by the spring.

Abstract: A method for retracting an organ inside the body in the course of treating adjacent tissue. An inflatable retractor is provided. The inflatable retractor includes a flexible wall which may be expanded into place within the body, and which enclosed a main chamber. The inflatable retractor also includes an envelope attached to the flexible wall. The envelope and part of the flexible wall enclose an additional chamber. The inflatable retractor is placed in a collapsed state adjacent to the organ, and is inflated to expand the flexible wall and to retract the organ. Finally, an aperture is pierced in a part of the flexible wall of the retractor remote from the additional chamber to provide access to the tissue.

Abstract: An endoscope for stereoscopic viewing of surgical procedures, consisting of two solid-state cameras and a bundle of illuminating optic fibers. The width of the optic fiber bundle is approximately equal to that of the endoscope thereby maximizing the amount of light which the bundle can provide. The viewing cameras can be separated to a distance greater than the width of the sheath for enhanced depth perception and greater light delivery, and withdrawn into the sheath for insertion and withdrawal of the endoscope from the surgical cavity. The orientation of the cameras can be controlled to provide off-axis viewing.