Abstract: The invention contemplates a method for making a disposable element adapted for selective placement in the path of laser beam delivery to the cornea. The element carries a membrane of uniform thickness which is opaque to the laser-beam and which is subject to ablation when exposed to the laser beam. The central area of the uniform thickness membrane is then selectively exposed to the laser-beam so as to cause full depth removal at one locality in the central area and essentially zero depth removal at another area, so as to provide an article which, when interposed the cornea and an ablative laser beam, will, during a given laser-beam course of exposure will require greater or lesser time to locally ablate the membrane and thus permit laser-beam exposure past the membrane and into correspondingly localized ablating impingement with the cornea. Stated in other words, the article so manufactured will provide a varying spot size at the cornea on illumination with a laser-beam of uniform intensity profile.

Abstract: Systems and methods for ablating body tissue using actively cooled electrodes deploy the electrode for contacting tissue to form a tissue-electrode interface. The systems and methods conduct ablation energy to the electrode for transmission by the electrode into tissue at the tissue-electrode interface. The systems and methods simultaneously cool the electrode while the electrode transmits ablation energy using a diode coupled to the electrode for conducting heat energy from the electrode in response to current flow from a current source.

Abstract: A coagulating microknife includes at least one knife blade that is comprised of a doped semiconductor body that exhibits a resistive current-carrying characteristic and a sharp cutting edge. A power supply is connected to the knife blade and applies a metered current which heats the knife blade to a controlled temperature for cauterizing tissue during a cutting action. The semiconductor body includes a pair of contact areas which extend into the body and enable localized heating at the tip of the knife blade.

Abstract: A handheld confocal imaging system for in vivo observation of dermal and subdermal tissue allows diagnosis of conditions substantially beneath the surface of the skin. A confocal head has optics which scan the tissue so as to provide images of vertical sections of the tissue. Both two and three dimensional imaging may be provided for diagnosis and location of basal cell carcinomas and melanomas, and so as to enable visualization of tumor borders prior to excision.

Abstract: Optical localization fiber embodiments (200, 260, 270, 290, 310, 330, and 350) suitable for preoperative localization of soft tissue lesions by X-ray mammography, CT MRI, ultrasonography or nuclear medicine are provided. In these embodiments at least one hook is carried by an optical fiber for retention in soft tissue. The tip of the optical fiber is visible through the soft tissue when the origin of the optical fiber is attached to a light source. Embodiments include dual hooks (224, 226) attached through a hole (214) in the tip portion (206), a hook (262) fused to the tip (264), a hook (272) glued to the tip (274), a hook (292) held on by a cap (294), a hook (312) screwed into the tip (320), a hook (340) held in a bore in the tip portion (336) by cement, and a hook (358) in a groove (352). A supplemental optical fiber probe (250) provides a method for locating the fibers inside soft tissue.

Abstract: A surgical technique for removing corneal tissue with scanned infrared radiation is disclosed which utilizes short mid-infrared laser pulses to provide a tissue removal mechanism based on photospallation. Photospallation is a photomechanical ablation mechanism which results from the absorption of incident radiation by the corneal tissue. Since photospallation is a mechanical ablation process, very little heat is generated in the unablated adjacent tissue. The disclosed surgical system includes a scanning beam delivery system which allows uniform irradiation of the treatment region and utilizes low energy outputs to achieve controlled tissue removal. A real-time servo-controlled dynamic eye tracker, based on a multiple-detector arrangement, is also disclosed which senses the motion of the eye and provides signals that are proportional to the errors in the lateral alignment of the eye relative to the axis of the laser beam.

Abstract: Microwave heating apparatus for fixating tissue comprises an electrically conductive waveguide structure having opposite first and second walls each of which has opposite first and second ends and a longitudinal centerline. A body of non-magnetic dielectric material inside the waveguide structure bridges the first and second walls preferably at their centerlines. A pocket extends through a wall of the waveguide structure into the body and a tissue holder containing contents, namely a tissue sample and a fixation solution, is arranged to be received in the pocket. The dielectric constant of the body is selected to closely match the composite dielectric constant of the tissue holder and its contents so that when microwave power is delivered into the waveguide structure for heating a succession of samples, variations in the dielectric properties of the different samples will not significantly affect the tuning of the waveguide structure.

Abstract: An input command controller (A) provides logic function selection signals and proportional signals. The signals are generated by movement of a ball member (12) and socket member (14) relative to two orthogonal axes. When the joystick is implanted, a transmitter (50) transmits the signals to a patient carried unit (B). The patient carried unit includes an amplitude modulation algorithm such as a look-up table (124), a pulse width modulation algorithm (132), and an interpulse interval modulation algorithm (128). The algorithms derive corresponding stimulus pulse train parameters from the proportional signal which parameters are transmitted to an implanted unit (D). The implanted unit has a power supply (302) that is powered by the carrier frequency of the transmitted signal and stimulation pulse train parameter decoders (314, 316, 318). An output unit (320) assembles pulse trains with the decoded parameters for application to implanted electrodes (E).

Abstract: A surgical instrument is described that incorporates bipolar electrodes on opposing shearing members for passing a high frequency current through the tissue for causing hemostasis of the tissue and for cutting the tissue. An electrically insulating material is interposed between the shearing members so that the electrodes are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes through the tissue and not between the opposing shearing surfaces. The insulating material has a higher hardness than the opposing members to reduce wear of the insulation and provide a self-sharpening feature. Methods of simultaneously causing tissue and severing tissue are also provided. The use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.

Abstract: A calibration apparatus is disclosed for measuring the properties of a laser beam. The apparatus includes a photoreactive element having a composition which reacts with laser radiation in a manner proportional to the intensity or intensity profile of the laser beam and an alignment means for disposing the photoreactive element in the path of a laser beam, such that the beam can be activate to impinge upon the photoreactive element and the properties of the beam are recorded by changes in the state of the calibration element. The calibration element may also be used to provide corrective feedback for modifying or controlling the properties of the laser beam.

Abstract: A trocar which automatically deactivates upon penetration through a body wall includes a housing portion, an obturator shaft mounted with respect to the housing portion and having proximal and distal ends, a conductor element extending at least partially along the obturator shaft for conducting energy from an energy source and a conductive tip member associated with the distal end of the obturator shaft for penetrating tissue. The conductive tip member is mounted for movement relative to the obturator shaft between a first position in communication with the conductor element and a second position disassociated from the conductor element.

Abstract: There is provided a side-emitting optical fiber having a proximal end for receiving radiation and a distal end for emitting the radiation in a direction laterally of the longitudinal axis of the fiber via a radiation exit region at the distal end; characterized in that the outer surface of the distal end of the a glass cap is formed with a visually discernible surface formation which is narrow at one end thereof and which increases in width towards the opposite end thereof, to thereby enable visually discerning the orientation of the optical fiber with respect to the radiation exit region thereof.

Abstract: An endoscopic instrument comprising an elongate body having a proximal end and a distal end. Actuating mechanism is located at the proximal end and operating mechanism at the distal end. The operating mechanism comprises a pair of V-shaped jaw members, a cautery wire associated with jaw members to incise tissue gripped by the jaws and a mucosa-protecting balloon attached to and movable with one of the jaw members.

Abstract: An input command controller (A) provides logic function selection signals and proportional signals. The signals are generated by movement of a ball member (12) and socket member (14) relative to two orthogonal axes. When the joystick is implanted, a transmitter (50) transmits the signals to a patient carried unit (B). The patient carried unit includes an amplitude modulation algorithm such as a look-up table (124), a pulse width modulation algorithm (132), and an interpulse interval modulation algorithm (128). The algorithms derive corresponding stimulus pulse train parameters from the proportional signal which parameters are transmitted to an implanted unit (D). The implanted unit has a power supply (302) that is powered by the carrier frequency of the transmitted signal and stimulation pulse train parameter decoders (314, 316, 318). An output unit (320) assembles pulse trains with the decoded parameters for application to implanted electrodes (E).

Abstract: A method and an apparatus for conducting microsurgery on human or animal tissue which includes alternately providing an Argon laser beam pulse and a YAG laser beam pulse in a cycle which is equal to or less than one second. A robotic device including piston and cylinder arrangements is provided for activating the control keys on a control panel associated with the Argon and YAG lasers.

Abstract: Endoscopic surgical instruments are provided that have bipolar electrodes on opposing movable members for passing a high frequency current through tissue for simulataneously severing or manipulating the tissue and causing hemostasis of the tissue. An electrically insulating material is interposed between the movable members so that the electrodes are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes through the tissue. Methods of endoscopically achieving hemostasis while simultaneously, manipulating and cutting tissue are also provided. Use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.

Abstract: This invention is a device and procedure for the correction of optical abnormalities in a human eye. It involves use of an inventive electrosurgical energy probe with specific physical configurations. The process preferably utilizes a high frequency RF electro-desiccation or ablation device. The procedure involves the initial step of forming at least one access site allowing access to the corneal volume behind the Bowman's Layer. It preferably is placed in the anterior surface of the cornea through and ending posterior to the Bowman's layer of the eye. The electrosurgical probe is then introduced into the access site and, depending upon the visual abnormality to be corrected, the probe is activated to adjust the volume of the corneal stromal layers through ablation or desiccation. The shape of the volume desiccated or ablated is dependent upon the aberration to be corrected.

Abstract: Endoscopic surgical instruments are provided that have bipolar electrodes on opposing movable members for passing a high frequency current through tissue for simulataneously severing or manipulating the tissue and causing hemostasis of the tissue. An electrically insulating material is interposed between the movable members so that the electrodes are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes through the tissue. Methods of endoscopically achieving hemostasis while simultaneously, manipulating and cutting tissue are also provided. Use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.

Abstract: An improved electrode assembly for a resectoscope includes at least one electrical lead that connects at a proximal end via a handle of the resectoscope to an electrosurgical generator to receive electrical power. The electrode assembly further includes an electrode tip at a distal end. The electrode tip has a surface that includes at least one aperture and preferably multiple apertures that extend through the tip. The aperture serves to increase the area of the electrode tip relative to its mass thereby increasing the performance of the electrode for cutting, ablating, vaporizing, or coagulating tissue. The electrode tip performs these functions with relatively lower power requirements compared to conventional resectoscope electrodes.

Abstract: A system is provided for use with an ophthalmic treatment laser that produces a treatment laser beam. The system automatically inhibits transmission of the treatment laser beam when a threshold amount of eye movement is detected. An eye movement sensor determines measurable amounts of eye movement such as saccadic eye movement. The eye movement sensor generates light energy that is eye safe, focuses the light energy on the eye, and detects energy reflected from the eye due to the incident light energy. The eye movement sensor determines the measurable amount of eye movement based on changes in the reflected energy. A dichroic beamsplitter is optically disposed between the ophthalmic treatment laser and the eye to direct the treatment laser beam to the eye. The beamsplitter is also optically disposed between the eye movement sensor and the eye to direct the sensor's light energy to the eye and the resulting reflected energy back to the sensor.