Abstract: An electrocautery probe with a variable morphology electrode includes a coil electrode extending through the distal end of a probe, an adjustment mechanism operable from a proximal end of the probe for changing the morphology of the coil electrode, and a connection for receiving a current for application through the electrode. The morphology of the electrode can be changed by adjusting the length of electrode which extends from the probe. In a preferred embodiment, the morphology of the electrode can also be changed through the use of slider having a shaped head which extends from the distal end of the probe and presses against the electrode. The shaped head of the slider can have a variety of shapes and when the shaped head of the slider urges against the electrode, the electrode is formed to the same shape as that of the distal end of the slider head. Also provided are mechanisms for adjusting and maintaining the position of the slider and shaped head with respect to the electrode.

Abstract: A bipolar push rod assembly is disclosed in conjunction with an endoscopic bipolar cautery scissors instrument. The push rod assembly has two conductive push rods which are substantially covered and insulated from each other by a double lumen flexible sheath. The proximal ends of the push rods are stabilized by an overmolded plastic collar and the distal ends of the push rods are stabilized by a ceramic insulator. The plastic collar is provided with a snap retainer for coupling it to a plastic plug retainer having a pair of spaced apart passages. A pair of female plug adapters are press fit onto the proximal ends of the push rods and are maintained in place by the plug retainer with each adaptor residing in a respective one of the passages. The distal ends of the push rods are swaged approximately 90.degree. in opposite directions. A ceramic insulator is disclosed as a one-piece unit into which the distal ends of the push rods are inserted.

Abstract: An endoscopic bioptome having a proximal end and a distal end includes a proximal handle assembly including first and second actuators, a distal end effector assembly having jaws for cutting tissue samples, and a hollow member extending between the handle and the end effector assembly. The hollow member includes a first axial portion extending from the proximal end to a second axial portion at the distal end of the hollow member. The second axial portion is more flexible than the first axial portion. The bioptome further includes a control member connected at the proximal end to the handle assembly and at the distal end to the end effector assembly. Actuation of the first actuator causes the control member to open and close the jaws. The bioptome further includes a deflecting device connected at the proximal end to the second actuator and extending through at least a portion of the hollow member.

Abstract: An endoscopic biopsy forceps instrument includes a distal jaws assembly detachable from a proximal handle assembly. The proximal handle assembly includes a centrally slotted shaft and a spool having a laterally seated cross block which passes through the central slot. The distal jaws assembly includes jaws mounted on a clevis at the distal end of a coil and coupled to a pull wire which extends through the coil to its proximal end. The proximal end of the coil is provided with a connecting sleeve provided with a frustoconical portion having double-helical threads for removably coupling the coil to a shaft having a distal frustoconical portion having double-helical threads. The proximal end of the pull wire is provided with a grooved mating member and the spool is provided with a locking assembly having a springbiased push button latch for releasably engaging the grooved mating member.

Abstract: An electrocautery probe includes a distal loop electrode mounted between a pair of arms which are joined at their proximal ends to an electrode lead, and a mounting sleeve for slideably coupling the probe to the guide tube of a resectoscope. The arms are skewed from a longitudinal axis defined by the electrode lead and are covered with an insulative material which extends to the distal end of the arms and terminates in a straight edge parallel to a plane substantially perpendicular to the arms. The loop electrode is angled approximately 25.degree.-35.degree. proximally relative to a plane substantially perpendicular to the electrode lead. The loop electrode further defines sharp upper distal and proximal edges. A cross-section of the electrode further defines an upper surface, a leading distal surface, a lower distal surface, a lower proximal surface.

Abstract: An endoscopic multiple sample bioptome includes a hollow outer member and an axially displaceable inner member extending therethrough. The proximal ends of the outer and inner members are coupled to an actuator for axially displacing one relative to the other. The distal end of the outer member is coupled to one of a cylinder having a sharp distal edge and a jaw assembly, while the distal end of the inner member is coupled to the other. The jaw assembly includes a pair of opposed, preferably toothed jaw cups each of which is coupled by a resilient arm to a base member. The arms are bent to urge the jaws away from each other. The base member is mounted inside the cylinder and axial movement of the jaw assembly and cylinder relative to each other draws the arms into the cylinder and brings the jaw cups together in a biting action.

Abstract: A tissue core biopsy cannula of the present invention includes a distal end which is ground in two planes which intersect each other at a first angle along a line which intersects the longitudinal axis of the cannula at a second angle. This produces a cardioid shaped opening in the distal end of the cannula. The entire edge of the sidewall is thereby inclined inward toward the distal opening and two distal cutting edges are provided. According to the presently preferred embodiment, the first angle at which the two planes intersect is approximately 60.degree. and the second angle at which the intersection of the two planes intersects the longitudinal axis of the cannula is approximately 20.degree.. In order to aid in removal of the biopsy sample from the target tissue site, the cannula according to the invention is provided with side fenestration holes and/or a split end which aids in grasping the tissue so that it can be pulled away from the target tissue site.

Abstract: An electrocautery probe includes a pair of arms between which a roller electrode is rotatably mounted. The arms are joined at their proximal ends to an electrode lead and a mounting sleeve is provided intermediate of the arms and the lead for slideably coupling the probe to a resectoscope. According to one aspect of the invention, the roller electrode includes a cylindrical member having a central bore and an outer surface, and an insert extending longitudinally through the central bore. Preferably the cylindrical member is made of a first conductive material and the insert is made of a second conductive material. The insert has a plurality of corners and an axial bore. The roller electrode is preferably made of stainless steel, while the insert is preferably made of copper or tungsten. The outer diameter of the roller electrode is preferably approximately 0.

Abstract: An endoscopic infusion needle device includes a catheter within which an injection tube having a distal injection needle is slideably disposed. A proximal actuating handle is coupled to the proximal ends of the catheter and the injection tube, and a distal stopping structure is provided on distal portions of the catheter and the injection tube. In one embodiment, the stopping structures include a rigid elongate skeletal structure occupying a portion of the annular space between the tube and the catheter, and an annular band on the tube which resides within the skeletal structure. The skeletal structure fits tightly within the cannula, allows irrigation fluid to pass through the annular space between the tube and the catheter to exit the distal end of the catheter, prevents the annular band from escaping through the proximal end or the distal end of the skeletal structure, and maintains the tube in substantial axial alignment with the catheter.

Abstract: Electrodes for electrocautery probes for use with a resectoscope include full loop electrodes wherein the full loop has a working surface which extends below the axis of the cautery probe and a working surface which extends above the axis of the cautery probe, composite full loop electrodes wherein the upper working surface and the lower working surface have different morphology, combined full loop and roller electrodes wherein one of the upper or lower portions of the loop serves as the axle for a roller electrode, and bifurcated full loop electrodes wherein the upper working surface and the lower working surface can be independently energized. The electrodes according to the invention permit resection of upper and lower prostate lobes without requiring inversion of the resectoscope, thereby shortening the time for the procedure. In addition, the full loop electrodes with different upper and lower morphology provide additional treatment options while also reducing the time for the procedure.

Abstract: A biopsy forceps instrument is provided having a proximal actuation handle, a flexible multi-lumen tubular member, at least one control member extending through a lumen, an irrigation means, an aspiration means, and a distal assembly. The proximal actuation handle includes a shaft and a spool slidably mounted on the shaft. The actuation handle is coupled to the proximal ends of both the flexible tubular member and the control member. Lumens of the tubular member form irrigation and aspiration conduits. The distal assembly includes a hollow jaw cup coupled to the aspiration conduit and a hollow movable jaw coupled adjacent the irrigation conduit. The movable jaw is coupled to the control member, such that actuation of the actuation handle moves the movable jaw relative to the jaw cup. Moving the hollow jaws into a closed position provides a substantially fluidtight coupling between the irrigation and aspiration conduits.

Abstract: An endoscopic bioptome includes a jaw assembly, a tubular member, and a control wire extending through the tubular member, where the distal end of the control wire and tubular member are both coupled to the jaw assembly, and the jaw assembly includes a pair of opposed end effectors having resilient arms and a pair of opposed resilient anchors oriented orthogonal of the end effectors. Preferably the end effectors and the anchors are formed from a super-elastic metal. The anchors are blunt-tipped and also include angled portions which urge the anchors away from each other. The end effectors include resilient arms having proximal angled portions and distal portions which terminate with end effector jaw cups. The proximal angled portions urge the jaw cups away from each other. The jaw cups each have a sharp cutting rim. Another embodiment of the jaw assembly include jaw cups having radially arranged teeth.

Abstract: A colposcopic surgical punch instrument includes a hollow tube and a push rod extending through the hollow tube. A handle is coupled to the proximal end of the tube and an actuation lever is pivotally coupled to the handle and the proximal end of the push rod for effecting axial movement of the push rod relative to the tube. A stationary jaw in the form of a die having an open top and bottom is coupled to the distal end of the tube and a movable jaw in the form of a punch is pivotally coupled to the stationary jaw by a tongue and groove arrangement. In one embodiment, the stationary jaw is provided with a pair of ramped projections on its sides and a tab projection on its distal end. A removable plastic sleeve fits over the stationary jaw. The plastic sleeve has an open proximal end and an open top. A pair of holes in the sides of the sleeve engage the ramped projections on the sides of the stationary jaw and a hole in the distal end of the sleeve engages the distal tab on the stationary jaw.

Abstract: A surgical trocar assembly includes a disposable valve assembly, a cannula assembly, and a trocar with a handle. The cannula assembly includes a cannula base having a valve assembly coupling device at its proximal end, and a cannula extending from its distal end. The disposable valve assembly has a coupling device for removably coupling it with the cannula base. The valve assembly also includes a valve body with a fluid passage communicating with the hollow cannula when it is coupled to the cannula base. A slit or flapper valve and a universal washer are mounted within the valve body and allow the insertion of the trocar or other endoscopic instruments therethrough while providing a fluid sealing of the fluid passage. The valve assembly may be provided with a side port which optionally contains an automatic valve actuated by a luer coupling. Several different valve assembly-cannula base couplings are disclosed as well as several different types of trocars.

Abstract: A bipolar push rod assembly is disclosed in conjunction with an endoscopic bipolar cautery scissors instrument. The push rod assembly has two conductive push rods which are substantially covered and insulated from each other by a double lumen flexible sheath. The proximal ends of the push rods are stabilized by an overmolded plastic collar and the distal ends of the push rods are stabilized by a ceramic insulator. The plastic collar is provided with a snap retainer for coupling it to a plastic plug retainer having a pair of spaced apart passages. A pair of female plug adapters are press fit onto the proximal ends of the push rods and are maintained in place by the plug retainer with each adaptor residing in a respective one of the passages. The distal ends of the push rods are swaged approximately 90.degree. in opposite directions. A ceramic insulator is disclosed as a one-piece unit into which the distal ends of the push rods are inserted.

Abstract: An endoscopic instrument is provided with a hollow tube, first and second end effectors coupled to the hollow tube and having arms biased away from each other, a cylindrical member slidably disposed over the hollow tube, a push/pull wire extending through the tube, a handle assembly coupled to the push/pull wire and the hollow tube, and a disk segment connected to the push/pull wire and connected to the cylindrical member by a crimp in the cylindrical member. When the handle assembly is actuated, the push/pull wire moves the disk segment and hence the cylindrical member relative to the end effectors and causes the cylindrical member to ride over the arms of the end effectors, thereby forcing the end effectors closed or permitting them to open. Preferably, the disk segment has two curved sides which are coupled to the cylindrical member by crimping, and two substantially parallel sides which provide room for the arms of the end effectors so that the disk segment can move relative to the end effectors.

Abstract: The methods and devices of the invention include an encoder, an endoscopic robotic instrument, and an encoder/robotic instrument interface. A preferred embodiment of the encoder has a chest/shoulder plate provided with telescoping tubes and joints. Each joint is provided with a direct drive potentiometer to monitor movement and provide a corresponding signal. The chest plate is preferably adaptable to a large range of human chest sizes and the telescopic segments are strapped to the arms of the practitioner at the elbows. A pistol grip is provided at the wrist end of the telescopic segments. According to the presently preferred embodiment, the encoder encodes flexion and rotation at the shoulder, elbow and wrist of each arm in addition to gripping at each hand. The encoding device is coupled to a circuit which operates a servo system. The servo system includes a series of servo motors. A series of pulleys corresponding to the number of servo motors are arranged in a housing.

Abstract: An endoscopic forceps jaw assembly for an endoscopic instrument includes a pair of articulating opposed jaws each having a jaw cup. The jaw cups are provided with teeth which increase in height from the proximal end of the jaw cup to the distal end. The jaws are rotatable relative to each other about a common axis and define an open position and a closed position. When the jaws are rotated toward the closed position, the teeth interleave substantially simultaneously. An endoscopic instrument utilizing the jaws of the invention is also provided and further includes an actuation handle, a tubular member, and a control member. The jaw assembly is coupled to the distal end of the control member and rotatably coupled to the distal end of the tubular member, such that the pair of articulable opposed jaws open and close by rotating in response to movement of the control member relative to the tubular member. The jaws may also be electrically conductive and coupled to an electrocautery voltage supply.

Abstract: An automatic suturing instrument generally includes a proximal actuation handle assembly, a flexible tubular member, a control wire, and an end effector assembly. The control wire extends through the tubular member and the end effector-assembly is coupled to the distal end of each of the tubular member and the control wire, while the handle is coupled to the proximal end of each of the tubular member and the control wire. Actuation of the handle moves the control wire relative to the tubular member and thereby moves the end effector assembly from an open to a closed position. The end effector assembly generally includes two end effectors, a needle engaged by one of the end effectors (but which can be engaged by either end effector alternately), and a suture material. The end effector assembly further includes a needle passing mechanism that automatically alternates which end effector engages the needle each time the end effectors are moved into a closed position.

Abstract: An endoscopic bioptome includes a flexible coil having a lumen with an axially displaceable wire extending therethrough. The proximal ends of the coil and wire are coupled to a manual actuator for axially displacing one of the coil and wire relative to the other. The distal end of the coil is coupled to either a jaw assembly or a cylinder. The jaw assembly includes a pair of jaws each having a distal jaw cup having a proximal neck and a relatively narrow bent resilient arm. The distal end of the wire is coupled to the other of the cylinder or the jaw assembly. The cylinder is slidable over the jaw assembly. Axial movement of either the wire relative to the coil or vice versa moves the cylinder over the arms of the jaws and over the necks of the jaw cups, thereby forcing the jaw cups together in a biting action. In one embodiment, the axially displaceable wire is provided with a coaxial stopping band or sleeve which stops its movement as soon as the jaws close.