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.

Abstract: An improved trocar is provided which includes converters for adapting to different size surgical instruments while maintaining sealing. The invention also includes an improved trocar tube body seal design which accepts and accommodates surgical tool angulation while still maintaining sealing. Still further, the invention provides a trocar obturator with a snap-fit joint which permits the forward portion of the obturator to be detached from the trocar body and separately used with the trocar tube subassembly. With this option, a latch mechanism is configured opposite to a converter to retain the obturator fixed with the trocar tube subassembly.

Abstract: According to the present invention, a surgical clip applier includes means for preventing closure of the clip closing mechanism when no clips are left in the applier. The clip applier includes a shaft having distal and proximal ends, means in the shaft for advancing clips to the distal end, means at the distal end for closing clips and a jam clip carried by the advancing means proximally of the surgical clips, wherein the jam clip is positioned in the clip closing means and prevents closure thereof after all surgical clips have been applied.

Abstract: The invention provides a surgical clip for use in conjunction with a clip applier. The clip may be closed in a curved shape, has improved gripping capabilities, and maximizes the gripping surface relative to clip size. The clip preferably includes a longitudinal channel through the gripping surfaces of the clip legs, the channel having at least one sidewall inclined to form an undercut, such that the channel is wider at its floor than at its opening in the gripping surface. The clip further may have one leg longer than the other such that the clip may be closed in a curved shape with the legs parallel and the tips of the legs substantially even. The clip may also have one or more inverse arcuate portions on at least one of its legs to improve the tightness of clip closure.

Abstract: A device for mounting a tubular sleeve for an obturator of a trocar to a patient's body includes a sleeve-holding part for attaching to the sleeve and a skin-fixation part for attaching to the patient's skin surface. The sleeve-holding part may be formed by an annular washer made of an elastic material which permits a user to move it longitudinally with respect to the sleeve so as to adjust their relative positions. The skin-fixation part may be a crossbar and a cord attached to the washer at one end and to the crossbar at the other. The cord is stapled to the patient's body for fixation.

Abstract: According to the present invention, improved apparatus and methods are provided for applying surgical clips to body tissue in inaccessible places and at various angles with particular usefulness in laparoscopic surgery. In one embodiment, the apparatus comprises a shaft having a distal end and a proximal end; means for advancing clips along the shaft toward the distal end with the legs of the clip oriented in a distal direction; means at the distal end of the shaft for rotating the clips relative to the shaft to orient the legs in a lateral direction and means for closing the legs of the clips after the rotation. The means for advancing usually comprises a movable belt disposed in the shaft having a plurality of retainers for holding clips; means for closing typically includes an anvil mounted at the distal end of the shaft and a hammer movable against the anvil.

Abstract: A method and apparatus for removing a pre-placed prosthetic appliance anchored in place in a bone recess by a cement mantle and conditioning the recess for receipt of a replacement appliance. The preplaced appliance is first pulled from the mantle of hardened cement holding it within the recess, thus leaving a cavity within the mantle. A screw threaded post having nuts threadably engaged therewith at longitudinally spaced locations is then anchored within the cavity with a new mass of cement. Thereafter, the post is threadably disengaged from the nuts, leaving the nuts in place within the new mass of cement. A pulling tool is then successively engaged with the nuts and tensioned to incrementally remove the mantle from the recess.

Abstract: A method and apparatus for removing a pre-placed prosthetic joint from a bone cavity and conditioning the cavity for receipt of a replacement joint. The pre-placed joint is first pulled from the mantle of hardened cement holding it within the cavity, thus leaving a cavity within the mantle. A mass of fluid cement is then placed within the cement cavity, after which a pulling tool is inserted into the fluid cement and the fluid cement is permitted to cure to bond with the hardened cement and form an integral mass. The pulling tool has helical screw thread on it, with means to connect a slap-hammer to its proximal end, so that its insertion into the fluid cement defines a threaded passageway. The pulling tool is then partly removed from the passageway by unscrewing it. Tension is then applied to the pulling tool to remove the tool and the cement mantle surrounding it from the bone cavity. The tool is then reinserted and the process is repeated as many times as desired until all of the cement mantle is removed.

Abstract: An improved pneumoneedle wherein the stylet forms part of an assembly removably received within the needle housing. The assembly carries a valve to selectively open or close the needle to fluid flow. The stylet is slidably carried by the assembly and resiliently biased to extend through the needle. Removal of the assembly opens the needle. A septum is engagable with the housing to seal the needle when the assembly is removed. A viewable indicator carried by the stylet signals when the needle has completed penetration.

Abstract: A method and apparatus for removing a pre-placed prosthetic joint from a bone cavity and conditioning the cavity for receipt of a replacement joint. The pre-placed joint is first pulled from the mantle of hardened cement holding it within the cavity, thus leaving a cavity within the mantle. A mass of fluid cement is then placed within the cement cavity, after which a pulling tool is inserted into the fluid cement and the fluid cement is permitted to cure to bond with the hardened cement and form an integral mass. The pulling tool has detachable sections or sleeves, each with grip forming elements on its exterior and structure to connect a slap-hammer to its proximal end. Tension is then applied to the each section to remove the section and the cement mantle surrounding it from the bone cavity. The process is repeated for each section until all of the cement mantle is removed.

Abstract: A mantle of cement having an elongate cavity formed therein is removed from adhered condition within a bone recess by successively breaking away sections of the mantle with a plurality of elongate screw threaded pulling elements proportioned to engage a limited length of a screw threaded mass of cement received in the cavity. The apparatus of the invention is provided in kit form with sufficient elements to enable the full length of the mantle to be removed in successive steps. The kit may also include a cement injection syringe and vent tube to fill the cavity of the mantle with a mass of cement, a die to form a screw threaded passage in the mass of cement, and a slap hammer connectable to the pulling elements.

Abstract: A bone-cutting surgical implement, commonly called a rongeur, has a pistol-like grip with a finger controlled lever in pivotal engagement with the handle. Extending from the handle is a rod defining an upward facing, longitudinal keyway. The rod also has an upwardly angularly protruding jaw facing backward along the rod. A second rod is in slidable engagement with the first rod by a key disposed in the keyway. The arrangement constrains the slidable rod to rectilinear motion along the first rod. At an extremity of the slidable rod proximal to the handle, the slidable rod is pivotally connected to the lever. By moving the lever an operator is able to move the slidable rod along the fixed rod. A replaceable, disposable jaw is releasably coupled to a distal extremity of the slidable rod and faces the end jaw of the first rod. The replaceable jaw is also guided by the keyway defined by the first rod.

Abstract: A method and apparatus for removing a pre-placed prosthetic joint from a bone cavity and conditioning the cavity for receipt of a replacement joint. The pre-placed joint is first pulled from the mantle of hardened cement holding it within the cavity, thus leaving a cavity within the mantle. A mass of fluid cement is then placed within the cement cavity, after which a pulling appliance is inserted into the fluid cement and the fluid cement is permitted to cure to bond the appliance to the mantle. Tension is then applied to the pulling appliance to remove the appliance and the cement mantle from the bone cavity as a unit. The fluid cement partially dissolves and softens the hardened cement mantle so that an integral cement mass is formed upon curing of the fluid cement. The pulling appliance is of a screw-like configuration, with means to connect a slap-hammer to its proximal end.