Abstract: A thoracentesis device for removing fluid from a cavity includes a hypersensitive dual spring indication mechanism for alerting the user of any contact to internal body organs. The thoracentesis device includes a handle and an outer needle fixedly attached to the handle. The outer needle forms a sharp distal end and a spring-loaded inner needle, including a blunt tip distal end, is slidably disposed inside the conduit of the outer needle. A first spring has a first spring force that urges the inner needle into a fully extended position and a second spring has a second spring force that acts on the inner needle in opposition of the first spring force. A first and second opposite colored indicators are arranged in contact with the springs so as to alert the user to any initial contact made by the thoracentesis device.

Abstract: This invention relates to skin-based localizer markers that can be placed on the external anatomy of a patient during CT, MRI, or other scanning methods for producing identifiable index marks in stereotactic localization. In a preferred embodiment, the markers are of an annular or axially symmetric geometry, with provision for radiopaque and therefore CT-visible elements and also MRI-visible medium within the marker. The annular shape enables accurate identification of the centroid of the marker in the CT, MRI, or other tomographic image. Because the markers are visible in multi-modal imaging, such as CT and MR, registration of these images or stereotactic indexing can be done from one or both imaging types. In another embodiment, the marker has an index or concave central portion which enables a stereotactic digitized pointer to be placed stably within the indentation during calibration or marker identification in a surgical context.

Abstract: A probe is connected to a probe carrier that is positioned with respect to the body of a patient. The probe is moved into or out of the body incrementally by means of a driver mechanism and flexible coupler. The flexible coupler in one embodiment comprises a flexible sheath with a flexible driver shaft that can be passed within the flexible sheath and can be rotated or pushed forward and backward with respect to the sheath by a driver element thereby causing translational movement of probe. Several forms of probes, flexible coupling elements, and driver apparatus as well as methods of applications accommodate specific objectives.

Abstract: A rotatable bipolar forceps for clamping and coagulating tissue includes a body portion and an electrode which is selectively removable from the body portion. The forceps further includes at least one handle attached to the body portion for imparting movement to a shaft which causes the jaws to move from a first open position wherein the jaws are disposed in spaced relation relative to one another to a second clamping position wherein the jaws cooperate to grasp tissue therebetween. A rotating member rotates the electrode and the jaws relative to a longitudinal axis disposed through the body portion and releasably couples the electrode to the housing.

Abstract: This invention relates to a three-dimensional digitizer and a probe means associated with said digitizer that enables a virtual target point to be visualized and depth and range measurements to that target to be determined. In one embodiment, a mechanical articulated arm or other type of 3-D digitizer is used in conjunction with a graphics workstation which displays images from CT, MR, or other scanning means of the anatomy. By registration of the digitizer to the patient's physical anatomy, a representation of the digitizer on the display means of the graphics workstation is possible. The position of the digitizer will be displayed in its quantitative relationship to the patient's anatomy, including internal pathologies such as tumors. The end means of the 3-D digitizer could be a holder or fixation device which can accept a sliding probe. The probe, for example, could be a shaft which slides in a spring-loaded or non-spring-loaded fashion within the fixation means of the digitizer.

Abstract: An apparatus and method are disclosed for providing visual and audible indications corresponding to the operational status of an electrosurgical generator so that the visual and audible indications can be readily observed and heard within an area normally associated with a working area of a typical operating room. Facilities are provided to mute the audible indication and to indicate that said audible indication has been muted. The indicators preferably include a visual and audible indication corresponding to the RF current delivered by the electrosurgical generator.

Abstract: A system for positioning and repositioning of a portion of a patient's body with respect to a treatment or imaging machine includes multiple cameras to view the body and the machine. Index markers, either light-emitting, passive, geometric shapes, or natural landmarks, are identified and located by the cameras in 3D space. In one embodiment, such reference or index markers are in a determinable relationship to analogous markers used during previous image scanning of the patient. Anatomical targets determined from image scanning can be located relative to reference positions associated with the treatment or diagnostic machine. Several forms of camera, index markers, methods and systems accommodate different clinical uses. X-ray imaging of the patient further refines anatomical target positioning relative to the treatment or diagnostic imaging reference point.

Abstract: An electrosurgical device is provided having at least one elastomeric seal capable of providing bio-contamination and dielectric protection by inhibiting the ingress of fluids and contaminants through the nose and actuator areas. The elastomeric seal is manufactured from a thermoplastic elastomer or resin which while in liquid form is placed within a mold. A housing section having the main circuit components and mechanisms of the electrosurgical device is then placed within the mold. Once the elastomer cures, the elastomeric seal seals the components and mechanisms within the housing partial-section. The elastomeric seal defines a flexible first opening at a distal end of the electrosurgical device to accommodate varying diameters of electrodes or blades connected to the nose area of the electrosurgical device. An actuator seal is also provided on the actuator area of the electrosurgical device to prevent fluids and contaminants from entering the electrosurgical device through the actuator area.

Abstract: A qualifying connection for an instrument attaches to a source of electrosurgery energy and to the instrument and has first and second parts coupled to the instrument and the source, respectively. Optical couplings on the connection transmit invisible energy to identify the instrument and are proximate on the first and second parts. A light modifier on the first part is proximal to the second part for modification of radiation in the infrared wavelengths so infrared transmitters encode signals and non-contact coded proximity detectors on the second part are the coupled detectors. Mechanical attachments include conjugating male and female portions physically extending between the parts for mating engagement. An identifying circuit couples to the second part and responds to invisible light optically communicated across the couplings for verifying the type of instrument connected by the cable to the source.

Abstract: A replaceable accessory cord and handswitch set adapted for use with an electrosurgical instrument that has a proximal end handle for holding by the surgeon and distal end effectors for delivery of electrosurgery to a patient. A replaceable accessory cord is adapted to electrically couple an electrosurgical generator to the instrument with two or more conductors. A handswitch with normally open contacts is near the proximal end. One of the contacts attaches to an active conductor and another of the conductors connected to the other contact. A receptacle on the handswitch connects electrically to the contact. An insulated support on the handswitch engages the instrument preventing relative movement. A button on the support is accessible to the surgeon, but remote from the receptacle land the terminal. The button is electrically isolated from the contacts, the receptacle, the terminal and the conductors.

Abstract: A method for electrosurgically sealing a tissue includes steps of: (A) applying an initial pulse of RF energy to the tissue, the pulse having characteristics selected so as not to appreciably heat the tissue; (B) measuring a value of an impedance of the tissue in response to the applied pulse; (C) in accordance with the measured impedance value, determining an initial set of pulse parameters for use during a first RF energy pulse that is applied to the tissue; and (D) varying the pulse parameters of individual ones of subsequent RF energy pulses in accordance with at least one characteristic of an electrical transient that occurs during subsequent RF energy pulses. The method terminates the generation of subsequent RF energy pulses upon a determination that the electrical transient is absent or that a minimum output voltage has been reached.

Abstract: An apparatus and method for separating a first layer of tissue from a second layer of tissue. An inflatable balloon is mounted to a delivery device. The inflatable balloon has a first, inwardly-displaced portion which everts when the balloon is inflated. The balloon is inserted into a patient between the first and second tissue layers when the balloon is in the deflated state. The balloon is then inflated so that the first portion is everted thereby minimizing trauma to the tissue layers.

Abstract: This invention relates to the quantitative determination of a target or volume in the living body relative to external apparatus based on CT (computer tomography) or other image data. The invention describes a means of taking CT image data of the anatomy and of natural or implanted index positions on the patient's body, and relating the CT data to a coordinate system related to external apparatus which may be in fixed position relative to the patient. One implementation uses a transformation between the CT image data coordinate system and the second coordinate system. This makes it possible to do frame-based or frameless stereotactic target identification and approaches without the need for attaching a frame to the patient at the time of CT scanning.

Abstract: A Head fixation apparatus includes a frame and a fixation structure for repeatably and reproducibily fixing the frame to a patient's head such that locations within the head are spatially definable with reference to frame. The fixation structure includes a cast of the patient's upper teeth and/or palate. The fixation structure further includes a support for rigidly connecting the cast to the frame and biasing structure operable between the head and the frame and/or the fixation structure to bias the cast into positive contact with the upper teeth and/or palate. The apparatus is used in stereotatic diagnosis and treatment.

Abstract: A bipolar electrosurgical instrument has opposable seal surfaces on its jaws for grasping and sealing vessels and vascular tissue. Inner and outer instrument members allow arcuate motion of the seal surfaces. An open lockbox provides a pivot with lateral support to maintain alignment of the lateral surfaces. Ratchets on the instrument members hold a constant closure force on the tissue during the seal process. A shank portion on each member is tuned to provide an appropriate spring force to hold the seal surfaces together. During surgery, the instrument can be used to grasp and clamp vascular tissue and apply bipolar electrosurgical current through the clamped tissue. In one embodiment, the seal surfaces are partially insulated to prevent a short circuit when the instrument jaws are closed together. In another embodiment, the seal surfaces are removably mounted on the jaws.

Abstract: A system for quantitative computer graphic determination of positions on a patient's anatomy and positions on associated equipment located near the patient's anatomy in relation to anatomical data, as from CT or MR scanning. A first camera produces a quantitative electronic readout of its field-of-view which provides a determination of relative spacial coordinates of uniquely identifiable points in its field-of-view. A second camera produces a quantitative electronic readout of its field-of-view which provides a determination of relative spacial coordinates of uniquely identifiable points in its field-of-view. The two cameras are located with respect to the patient's anatomy and the associated equipment so that the fields-of-view of the cameras include both the patient's anatomy and the equipment, but are taken from different directions. A body marker is positioned with respect to the patient's anatomy at a known position relative to said patient anatomy.

Abstract: An inert gas enhanced electrosurgical apparatus is disclosed including a housing having at least one ridge formed therein. An electrode assembly has at least a portion thereof disposed within the housing. A support member has at least a portion thereof disposed within the housing and about at least a portion of the electrode assembly. The ridges of the housing are engageable with the support member such that a seal is formed therebetween. The housing can include a first opening adjacent a distal portion of the housing and a second opening adjacent a proximal portion of the housing. Ribs may be formed on an inner surface of the housing. An electrical spring contact may be disposed within the housing and configured to cooperate with the ribs to facilitate electrical communication with the electrode assembly. Wedge projections may be disposed on an outer surface of the housing.

Abstract: The present invention provides for a dual port arrangement for a water seal chamber of a drainage device for channeling and restricting fluid flow through the water seal during normal operation of the device when the patient is breathing normally, while preventing the breach of the water seal during reverse flow conditions when the patient takes a sudden and deep inhalation. The dual port arrangement comprises a narrow side port and a low profile tunnel port defining an elongated conduit interposed between and in communication with both arms of the water seal chamber. The side port has a thin slot configuration that restricts fluid flow communication through the side port, and the back tunnel port defines a low profile, elongated conduit with openings that channel fluid flow between both arms of the water seal chamber. The elongated configuration of the conduit prevents a steep water gradient from falling below the upper portion of the conduit opening during reverse flow conditions.