Abstract: Methods of endoscopic surgery are disclosed. The methods utilize a suction/irrigation endoscopic instrument and a second endoscopic instrument. The suction/irrigation endoscopic instrument has a cannula, a fluid chamber in communication with the cannula, and an automatic valve at the proximal end of the fluid chamber. The second endoscopic instrument has end effectors and actuating means, and the end effectors of the second endoscopic instrument is inserted through the automatic valve, through the fluid chamber, and through the cannula. The methods involve inserting the suction/irrigation instrument through a trocar tube, and then inserting the second endoscopic instrument therethrough. The automatic valve insures that there is no leakage when the second instrument is inserted. The second endoscopic instrument may rotated inside, or may be partially withdrawn into the suction/irrigation instrument.

Abstract: A thoracentesis sheath catheter assembly includes a catheter connected to a valve body. The valve body is provided with a throughbore coaxial to the catheter for receiving a thoracentesis needle therethrough and a drainage bore in fluid communication with the first throughbore. The valve body is constructed as a first cylindrical portion which is connected to the catheter and a second cylindrical portion of larger inner diameter which is joined to the first cylindrical portion by a tapered inner wall. The second cylindrical portion contains a valve comprising a blocking ball and a spring biased plunger having a throughbore coaxial to the catheter, and is closed with a cap having a central hole and/or a gasket for sealingly receiving the thoracentesis needle. A thoracentesis needle extends through the hole of the cap, the gasket, the plunger, the first cylindrical portion and into and through the catheter.

Abstract: A trocar catheter includes a trocar rod having a stepped diameter distal end for use with a catheter having a stepped diameter lumen wherein the trocar is inserted into the lumen of the catheter and the trocar is used to incise a patient and install the catheter after which the trocar is removed from the lumen of the catheter. The distal end of the trocar rod is provided with a stepped coaxial bore into which a piercing point rod, a spring and a safety sleeve are assembled. The piercing point rod has a proximal small diameter portion which is press fit into a correspondingly small diameter portion of the coaxial bore in the distal end of the trocar rod. The spring is carried on the small diameter portion of the piercing point rod and biases the safety sleeve in a distal direction.

Abstract: An endoscopic suctioning instrument with variable suction is disclosed. The instrument has a hollow cannula having a proximal end and a distal end, and sliding sleeve having a proximal end and a distal end and a longitudinal axis, with the sliding sleeve being coaxial to and closely surrounding and slidingly engaging the hollow cannula. The sliding sleeve has a plurality of lateral holes at its distal end with the lateral holes being spaced along the longitudinal axis.

Abstract: Medical instruments are provided having end effectors and end effector actuator apparatus which are rotatable relative to the end effectors. The instruments generally include a tube which is typically coupled to the end effectors via a clevis around which the end effectors pivot, a push rod extending through the tube and coupled to the end effectors, and an actuator apparatus engaging the tube and the push rod with the actuator apparatus including a handle which surrounds and rotatably engages the proximal end of the tube, and a lever arm which pivotally engages the handle and is coupled to the push rod such that pivotal movement of the lever arm relative to the handle effects axial movement of the push rod relative to the tube and pivotal movement of the end effectors.

Abstract: An endoscopic tool for dispensing units of hemostatic agent broadly comprises a hollow tube which holds a plurality of individual units of the hemostatic agent, a valve at the distal end of the hollow tube which permits the hemostatic agent to pass therethrough but prevents foreign matter from contacting the hemostatic agent while in the tube, a plunger which extends into the hollow tube and contacts a proximal unit of the hemostatic agent, and a mechanism for moving the plunger distally in incremental movements to cause, upon each incremental movement, an individual unit of the hemostatic agent to be pushed through the valve. Typically, the mechanism for moving the plunger and the proximal end of the hollow tube are held in a handle. One mechanism for moving the plunger utilizes a portion of the plunger as a ratchet by forming a plurality of conical elements thereon, and utilizes a switch in the handle which has a V-spring coupled thereto as a pawl for advancing the conical elements.

Abstract: A ferrule for a laparoscopic surgical instrument is enclosed. The ferrule is an integral plastic piece which shields a peripheral uncovered portion of a metal tube of the surgical instrument which is intermediate a shrink wrap covered portion of the metal tube and an actuator housing which closely surrounds an extended portion of the metal tube. The ferrule has first and second end portions and a middle portion, with a cylindrical bore in the first end which closely contacts the shrink wrap covered portion of the metal tube, a first outwardly flaring frusto-conical bore in the middle portion and adjacent the cylindrical bore which surroundingly covers the uncovered portion of the metal tube, and a second outwardly flaring frusto-conical bore in the second end adjacent the first outwardly flaring bore.

Abstract: Disposable laparoscopic colo-rectal surgical bowel clamps for insertion through trocar tubes are disclosed. The instruments broadly include: a hollow aluminum tube; an aluminum clevis which is formed separately from the aluminum tube with the distal end of the hollow aluminum tube crimped around the proximal end of the clevis; axially off-set pivot pins coupled to the clevis; two bowel clamp blades each having a pivot hole through which the off-set pivot pin of the clevis is pivotally engaged, and each having another through-hole; an aluminum push rod extending at least partially through the hollow aluminum tube and apparatus for imparting reciprocal motion to the push rod relative to the aluminum tube, whereby the reciprocal motion is translated at an offset pivot of the clevis into high leverage pivotal motion of the blades. The blades are configured with bowed intermediate sections, and cutout proximal sections for the grasping and clamping of a bowel portion or other relatively large anatomical parts.

Abstract: A pinch valve for a flexible conduit is provided. The pinch valve has an arcuate rigid hook, an arcuate rigid pincher, and an actuator. The arcuate rigid hook has an inner surface of a diameter substantially equal to outer diameter of the flexible conduit, wherein the inner surface receives the conduit. The arcuate rigid pincher has an outer arcuate surface with a diameter at least as small as the inner diameter of the flexible conduit, and the flexible conduit is located between the arcuate hook and the arcuate rigid pincher. The actuator is coupled to either the hook or the pincher, and moves the hook relative to the pincher relative from a first position to collapse and pinch the flexible conduit therebetween to a second position where said flexible conduit is not collapsed and pinched. Preferably, the actuator is spring loaded so that the conduit is pinched.

Abstract: Lung clamp end effectors for a thoracoscopic surgical instrument are disclosed. The lung clamp end effectors have a base portion, an intermediate portion, and a distal portion. Each base portion has a first through-hole for pivotally engaging a pin of the clevis of the thoracoscopic surgical instrument, and preferably, a second through-hole used in conjunction with connecting links which connect the lung clamp end effector to the push rod. The through-holes on a particular end effector are located on opposite sides of the longitudinal axis of the tool, thereby providing strong clamping action. The lung clamps are further arranged with their distal portions increasing in width to approximately 10 mm as they extend distally. The distal portion also have cut-outs which increase in width as they extend distally. The lung clamp end effectors are at least two inches long from their respective pivot through-holes to their respective distal ends.

Abstract: A bone marrow biopsy needle assembly for obtaining a bone marrow core biopsy and a bone marrow aspirate biopsy in a single procedure includes an outer aspiration sheath which closely surrounds a coaxial inner hollow coring needle, and a trocar which extends through the coring needle. A handle arrangement is provided to allow insertion into the bone of the central trocar, the core biopsy needle and the outer aspiration sheath as an assembly, and to further allow stable manipulation of each component of the system without displacing the outer aspiration sheath. After insertion of the combined system through the cortical bone layer, the trocar is withdrawn. Further pushing and, if desired, twisting of the remaining assembly forces a bone marrow core biopsy into the inner, coring needle. The coring needle is then withdrawn and the bone marrow core biopsy is pushed out in a retrograde manner.

Abstract: Surgical instruments of the invention are provided with distal ends having a clevis and two discrete investment cast end effectors. One end effector is stationary relative to the clevis, and the other moves or rotates about a transverse pin of the clevis. The rotating end effector includes a first hole through which the transverse pin extends, and the surgical instrument includes an actuation mechanism for causing the rotating end effector to rotate about the transverse pin. The actuation mechanism preferably includes a push rod which is either directly coupled to the proximal end of the rotating end effector or coupled by a staple element. On the other hand, the stationary second end effector, while including a first hole through which the transverse pin extends, has a boss which preferably engages a hole in the clevis and is not coupled to the actuation mechanism.

Abstract: A biological forceps device is disclosed for the taking of tissue samples from a body. The biopsy forceps device comprises a flexible main coil having a distal end which is stiffer than the majority of the coil, a pair of opposed jaws hingedly disposed on the distal end of the coil, and an actuator having a distal end coupled to the hingedly disposed jaws for effecting articulation of the jaws. Preferably, shrink wrap tubing is placed on the distal end of the coil and acts as the stiffening agent thereof. A stiffer distal end permits the practitioner to press the jaws deeper into the tissue and reduces the jump experienced at the distal end when the coils go from a state of tension (jaws open) to a state of compression (jaws closed), so that a better sample can be obtained.

Abstract: A Jacobs type curved clamping or dissector element for a disposable laparoscopic instrument is provided. The Jacobs' type end effectors generally comprises first and second pivotally mounted elongate, opposed clamp members each of which has a straight base portion, an intermediate portion extending away from the axis of the base portion and a curved distal portion which angles 70 to 90 degrees relative to the intermediate portion and which extends back toward and slightly beyond the longitudinal projection of the base portion. The clamp members mate when pivotally rotated to a closed-clamp position.

Abstract: Disposable laparoscopic surgical instruments for insertion through trocar tubes are disclosed. The instruments broadly include: a hollow aluminum tube; an aluminum clevis which is formed separately from the aluminum tube with the distal end of the hollow aluminum tube crimped around the proximal end of the clevis, and with the clevis including a pivot pin; at least one end effector element having a pivot hole through which the pivot pin of the clevis is pivotally engaged, and another through-hole; an aluminum push rod extending at least partially through the hollow aluminum tube and mechanically coupled to the end effector element; and a plastic actuator engaging the proximal end of the push rod and for imparting reciprocal motion to the push rod relative to the aluminum tube, where the reciprocal motion is translated at the clevis into pivotal motion of the end effector element.

Abstract: Releasable ratchet mechanism for medical instruments such as endoscopic instruments are disclosed. The ratchet mechanism includes: a leaf spring with a locking barb which is located on a handle of the medical instrument; a ratchet on a lever arm of the medical instrument which lever arm is pivotally engaged to the handle; and a latch on the handle of the medical instrument. The latch on the handle engages and resiliently deforms the leaf spring to cause engagement of the locking barb in a groove of the ratchet when the latch is in a first position. When in a second position, the latch releases the locking barb from the ratchet groove. Preferably, the locking barb has an extending edge surface on an axis which is substantially parallel to the pivoting axis of the handle and lever arm, and the teeth of the ratchet have extending edge surfaces on axes substantially parallel to the extending edge surface of the locking barb.

Abstract: Medical instruments are provided having end effectors and end effector actuator apparatus which are rotatable relative to the end effectors. The instruments generally include a tube which is typically coupled to the end effectors via a clevis around which the end effectors pivot, a push rod extending through the tube and coupled to the end effectors, an actuator apparatus engaging the tube and the push rod and imparting reciprocal axial motion to the push rod relative to the tube, and end effectors. The actuator apparatus includes a sleeve, spring, handle, and lever arm. The sleeve is movable along the longitudinal axis of the tube against a biasing force of the spring, but is restrained from rotating about the tube. The sleeve has a locking element on its proximal end. The handle surrounds and rotatably engages the proximal end of the tube and has a locking element on its distal end which mates with the locking element of the sleeve and disengages therewith when the sleeve is advanced along the tube.

Abstract: End effectors for an endoscopic surgical instrument are provided and comprise a pair of identical elongate longitudinally extending arms having tooth-like terminal projections which closely mesh in a closed position. A preferred embodiment of the end effectors are hermaphroditic claw extractors which grasp and pierce tissue without endangering nearby tissue.

Abstract: A disposable laparoscopic single acting scissors is provided, and generally includes a hollow aluminum tube, a clevis coupled to a first end of the aluminum tube and including a pivot rod, a first scissors blade element having a pivot hole for pivotally engaging the pivot rod of the clevis, and having a through-hole in a base section of said first scissors blade element, a second scissors blade element fixedly engaging the clevis, a thin wire rod extending at least partially through the aluminum tube with a first end of the rod having a longitudinally offset terminal portion for engaging the through-hole of the base section of the first scissors blade element, and a plastic actuator engaged to the other end of the rod for imparting reciprocal motion to the rod relative to the aluminum tube which is translated at the clevis into pivotal motion of the first scissors blade element. The first scissors blade element is preferably formed from investment cast bronze.

Abstract: Disposable laparoscopic surgical instruments for insertion through trocar tubes are disclosed. The instruments broadly include: a hollow aluminum tube; an aluminum clevis which is formed separately from the aluminum tube with the distal end of the hollow aluminum tube crimped around the proximal end of the clevis, and with the clevis including an axially off-set pivot pin; at least one end effector element having a pivot hole through which the off-set pivot pin of the clevis is pivotally engaged, and another through-hole; an aluminum push rod extending at least partially through the hollow aluminum tube and mechanically coupled to the end effector element; and apparatus for imparting reciprocal motion to the push rod relative to the aluminum tube, whereby the reciprocal motion is translated at an offset pivot of the clevis into a high torque pivotal motion of the end effector element.