Abstract: A steerable flexible microsurgical instrument is provided with a rotatable clevis. The instrument includes a flexible coil, a flexible pull wire extending through the coil, a clevis which is rotatably coupled to the distal end of the coil, a handle coupled to the proximal end of the coil, and end effectors coupled to the clevis and the pull wire. The clevis is coupled to the distal end of the flexible coil by a bushing which allows axial rotation of the clevis relative to the coil. The pull wire is formed from torsionally obdurate material and is coupled at its distal end to the end effector and at its proximal end to a movable part of the handle. The handle is provided with mechanism for rotating the pull wire relative to the coil and a mechanism for translating the pull wire relative to the coil. Translation of the pull wire relative to the coil moves the end effector relative to the clevis and rotation of the pull wire relative to the coil rotates the clevis and end effector relative to the coil.

Abstract: Remote control actuators for endoscopic tools are provided. Each remote control actuator includes a driver, a coupler which couple the endoscopic tool to the driver, a power source which power the driver, and a controller coupled to the power source and/or the driver for controlling the power applied to the driver. In conjunction with the controller, a user interface is preferably provided for user control of the remote control actuator which actuates the endoscopic tool. In addition, a sensing/feedback mechanism is preferably provided between the driver and the endoscopic tool and is coupled to the controller and/or the power source. The sensing/feedback mechanism senses the amount of tension or compression on the pull wire(s) of the endoscopic tool and provides a related signal to the controller so that the force applied to the endoscopic tool may be regulated. Various types of power sources are disclosed including electric, mechanical, hydraulic, and pneumatic.

Abstract: An endoscopic electrosurgical suction-irrigation instrument with insertable probes and attachments is disclosed. The instrument has a fluid chamber sealed at its proximal end with a slit valve for receiving the probes and connected at its distal end to a cannula through which the inserted probes extend. The fluid chamber is selectively provided with suction and/or irrigation and includes an electrical contact for supplying voltage to an inserted electrosurgical probe. Depending on the probe configuration suction and/or irrigation is provided in an annular space between the probe and the cannula or through the probe. Valves, connectors and switches for use with the instrument are also disclosed.

Abstract: A flexible microsurgical instrument having a distal portion which is ground to a reduced diameter and covered with a stiffening sleeve is disclosed. The instrument includes a proximal actuating handle coupled to a flexible coil containing at least one control wire and a distal end effector coupled to the distal end of the coil and the control wire. A distal portion of the coil is ground to a reduced outer diameter and thus a reduced thickness. The stiffness of the distal portion is enhanced by placing a stiffening sleeve over the ground distal portion. The stiffening sleeve has a thickness substantially equal to one half the difference between the reduced diameter of the ground distal portion and the diameter of the remainder of the coil so that the outer diameter of the coil is substantially constant along its length when the stiffening sleeve is in place.

Abstract: An endoscopic instrument with suction/irrigation end effectors includes a tube, a push rod which extends through the tube, an actuator engaging the tube and the push rod, and end effectors coupled to the tube and push rod, where the end effectors include or define a bore which acts as a lumen for suction/irrigation. A fluid conduit in the tube communicates with the bore in the end effectors and is coupled to a suction or irrigation source. In one embodiment, a pair of end effectors are each coupled to a separate irrigation/suction conduit which is fed through the tube. The proximal ends of the conduits are coupled to one or separate fluid couplings at the proximal end of the instrument for connection with suction/irrigation sources. In another embodiment, a stationary end effector is provided with a fluid bore which is coupled to a fluid conduit integral with the tube.

Abstract: A non-metallic end effector for use in an endoscopic surgical tool includes a metallic core for strength and for providing a selected electrode surface on the end effector. Selectively conductive end effectors are manufactured by insert molding a plastic or ceramic or other non-conductive body around a metallic or otherwise conductive core. The conductive core is exposed on a selected portion of the working surface of the end effector and extends through the non-conductive body of the end effector for coupling to an electrical source. Selectively conductive end effectors of this type can also be manufactured by coating a cast end effector member with a non-conductive polymer or by metallically plating a non-conductive ceramic end effector member. By extending the conductive core of a selectively conductive end effector member to the pivot hole of the member, electrical coupling can be made through the clevis and tube of an endoscopic instrument.

Abstract: Elastomeric fluid seals for endoscopic instruments include a single piece of molded elastomer surrounding a pushrod and placed with the outer tube or clevis of the instrument, thereby sealing the annular space between the pushrod and the outer tube. The dimensions of the seals are chosen such that they fit snugly inside the tube or clevis of the endoscopic instrument and the push rod of the endoscopic instrument fits snugly through the seal. When placed within the tube, the seal is preferably formed as a cylinder with a radially inward extending toroidal ring. As the push rod is moved through the fluid seal, the toroidal ring is pressed in an axial direction and thereby exerts a radially outward force on the seal which keeps the seal from moving inside the tube. When placed within the clevis, the seal is preferably formed as an adjacent cylinder and semi-cylinder which is inserted in a radial bore overlapping the proximal portion of the U-shaped cut-out of the clevis.

Abstract: A pericardial endoscopic scissors is provided and generally comprises a hollow tube with a clevis coupled thereto, first and second scissor blades laterally offset from each other and both having elongate straight blade edges angled at about 45 degrees relative to the hollow tube, with the first scissor blade pivotally engaging the clevis so that its blade can angle about 90 degrees relative to the hollow tube in an open position, a rod extending through the hollow tube and coupled to the pivoting first scissor blade, and an actuator engaging the rod and imparting reciprocal motion thereto, which reciprocal motion is translated to pivotal motion of the first scissor blade. The fixed second scissor blade is provided at its distal end with an integral probe element which is laterally offset relative to and indented from the straight blade edge.

Abstract: A disposable arthroscopic surgical instrument includes a hollow tube with a manual actuator coupled to its proximal end and an end effector coupled to its distal end. The actuator and the end effector are coupled by a push rod which passes through the hollow tube and the push rod includes a frangible link so that the push rod will break when a predetermined force is applied to the end effector by the actuator. The frangible link is a flattened portion of the cylindrical push rod having a strength reducing throughbore. An end effector having a stationary jaw and a movable jaw is also disclosed. The stationary jaw is coupled to the distal end of the tube and has a throughbore for receiving the push rod. The movable jaw is coupled to push rod and is pivotally coupled to the stationary jaw by arcuate engaging surfaces on both jaws. The movable jaw preferably includes a pair of arcuate grooves while the stationary jaw has a pair of arcuate flanges which engage the grooves on the movable jaw.

Abstract: A needleless IV quick-connect/disconnect assembly includes a first cylindrical member having a female luer, a resilient valve member having stem, a sealing surface, and a base, and a second cylindrical member having a fluid coupling extending from one end and an internal valve member support. The cylindrical members are sized so that the first cylindrical member fits snugly inside the second cylindrical member. A pair of radial ramped protrusions extend from the outer surface of the first cylindrical member and a pair of radial openings are provided in the second cylindrical member. In assembly, with the valve member stem in the female luer, the first cylindrical member is inserted into the second cylindrical member until the radial ramped protrusions engage the radial openings and the valve member base is engaged by the valve member support.

Abstract: Biopsy forceps jaws have a cup portion defined by a cup wall having an outer portion with a cup wall edge, and an inner portion having teeth. The teeth include peaks and valleys with the peaks rising above the outer portion cup wall edge, and the valleys remaining below the outer portion cup wall edge. The teeth are preferably arranged radially around at least a portion of the periphery of the cup and are offset by one half pitch so that two opposed identical jaws will mate. The radially outer surface of the peaks and the radially inner surface of the valleys are preferably radially chamfered. When two opposed jaws close, the peaks of the teeth on one jaw enter the valleys of the teeth on the other jaw and the edges of the cup walls of the two jaws touch such that the teeth of the two jaws are fully enclosed by the outer portions of the cup walls and the outer surface of the closed jaws is completely smooth.

Abstract: An endoscopic bipolar electrocautery instrument includes a proximal actuator coupled by a tube and push rod to a pair of distal graspers. The tube is covered with an insulating shrink wrap from its distal end up to an uncovered proximal portion. A stationary jaw with an integral clevis is mounted inside the distal end of the tube and electrically contacts the inner surface thereof. The clevis holds a pair of ceramic insulators between which a movable jaw is mounted on an insulated bushing with an axle pin. The movable jaw is electrically and mechanically coupled to the push rod which is covered with an insulating shrink wrap from a point just proximal of its connection with the movable jaw to a point near its proximal end. The uninsulated proximal end of the tube is mounted in a conductive bushing which rotates within a nonconductive handle. The proximal end of the push rod extends beyond the conductive bushing and a rubber insulator is fitted between the bushing and the push rod.

Abstract: An endoscopic scissors includes a clevis having a relatively large diameter bore in its first arm and relatively smaller diameter bore in its second arm. A pair of scissor elements having mounting/pivot holes are mounted between the clevis arms. Either the small diameter bore in the second clevis arm or the mounting/pivot hole in the scissor element closest to the second clevis arm is threaded. A stepped diameter axle pin having a threaded portion is inserted with its smaller end entering the larger diameter bore of the first clevis arm. The threaded portion of the axle pin threadably engages either the threaded bore in the second clevis arm or the threaded mounting/pivot hole of the scissor element closest to the second clevis arm. In one embodiment, the bore in the second clevis arm is not threaded and the threaded portion of the axle pin engages only the threaded threaded mounting/pivot hole of the scissor element closest to the second clevis arm.

Abstract: An arthroscopic surgical instrument includes a hollow tube with an actuator coupled to its proximal end and an end effector coupled to its distal end. The actuator and the end effector are coupled by a cylindrical push rod which passes through the hollow tube. The push rod includes a frangible link in the form of a flattened portion with strength reducing semicircular side cuts which breaks when a predetermined force is applied to the end effector by the actuator. The end effector includes a stationary jaw and a movable jaw. The stationary jaw is coupled to the distal end of the tube and receives the push rod. The movable jaw is coupled to push rod and is pivotally coupled to the stationary jaw by arcuate engaging surfaces on both jaws. The movable jaw is also provided with a pair of serrated knife-like edges with an inner concave surface between them and the stationary jaw is provided with a receiving opening into which the movable jaw fits when the jaws are in a closed position.

Abstract: A coaxial bone marrow biopsy needle assembly is disclosed. The assembly includes a hollow cannula with a handle having an interlocking device and a trocar insertable in the cannula and having a second handle with another interlocking device which mates with the interlocking device in the cannula handle. The interlocking devices are a spring biased pin radially entering a receiving socket, and a notched projection which extends into the receiving socket. The pin has a ramped portion, and the notched projection has a rounded or conical tip which rides down the ramped portion of the pin and thereby pushes the biased pin radially out of the socket during assembly of the hollow cannula with the trocar. The assembled handles provides a smooth upper surface which fits comfortably in a palm and a lower gripping surface around which fingers easily wrap. The interlocking devices hold the handles securely together keeping the trocar within the cannula during puncture, but are easily separated thereafter.

Abstract: A bone marrow needle assembly includes a cannula housing supporting a cannula having a sharp distal end. The cannula housing is provided with a central throughbore in fluid communication with the cannula and with an ergonomic handle having a curved distal surface. A female luer lock fluid coupling is provided in the housing at the proximal end of the throughbore and within the periphery of the curved handle. A trocar is located within the cannula and extends through the luer lock and the throughbore. The trocar has a cap which extends over the luer lock and is rounded so that a substantially continuous rounded surface is presented by the semi-circular handle and the trocar cap. The distal end of the housing is provided with a threaded portion which receives a locking nut and a depth stop. The depth stop has a mating interior threaded bore which couples with the threaded distal portion of the housing so that the depth stop may be rotated to adjust the effective piercing length of the cannula.

Abstract: An apparatus for counting the number of times a medical instrument has been sterilized includes an indicator having sequential indicia and a heat responsive member for indicating a next one of the indicia. Mechanical, fluid mechanical and electronic versions of the invention are disclosed. In the mechanical version, the indicator can be a ratchet member having teeth, a pawl and a display surface containing indicia. A heat responsive element such as a bimetallic member engages the teeth of the ratchet and advances the ratchet each time the apparatus is subjected to the heat of sterilization. A housing with a window masks the display to indicate one of the indicia as advanced by the heat responsive element. Preferred embodiments of the mechanical version include a ring-like ratchet member with interior teeth and an exterior display surface. The number of teeth is preferably one or more less than the number of indicia so that upon advancing the ratchet member to the last indicia, it can be advanced no further.

Abstract: Several embodiments of an electrocautery probe with a variable morphology electrode are disclosed. In one embodiment, the probe has two arms and the electrode is attached to distal ends of the arms. Movement of the distal ends of the arms relative to each other changes the morphology of the electrode. Several electrode embodiments and several ways of moving the distal ends are also disclosed. In another embodiment the electrocautery probe with a variable morphology electrode includes a hollow probe arm within which the electrode is mounted for movement relative to the hollow probe arm. Movement of the electrode relative to the hollow probe arm changes the morphology of the electrode. Several electrode embodiments for use with the hollow probe arm are disclosed.