Abstract: Methods and apparatus are disclosed for removal of biological tissue slices or layers, preferably in the form of lamellar sections of predetermined shape and thickness employing a reference member that engages a target tissue site and cooperates with a cutter in order to remove the tissue segment or lamella. The cutter preferably includes a flexible cutting element such as a wire or band element that is brought into physical contact with a guiding edge of the reference member and then draw along a path defined by the guide edge through the tissue to sever, at least partially, a tissue section. In one particularly useful aspect of the invention, methods and apparatus for keratectomy are disclosed employing an ocular reference member that engages the upper central region of the cornea and cooperates with a cutter to remove a lamellar segment from the cornea.

Abstract: An apparatus and method for treating stenosed blood vessels is provided, more particularly a percutaneous catheter, including a filter for capturing loose embolic material, used to deliver a stent, preferably within the ascending aorta, the aortic arch, or the carotid arteries. The catheter includes an expandable stent deployed on an inflatable balloon, or alternatively a self-expanding stent. A filter assembly is provided either directly on the catheter, or in a separate sheath or on a guidewire. The filter assembly comprises an expansion frame, having filter mesh attached to it, disposed on a guidewire inserted through the catheter or sheath, or alternatively attached directly on a distal region of the catheter. The expansion frame comprises a structure which is activated from a contracted condition into an enlarged condition in a blood vessel, thereby traversing the vessel with the filter mesh. The expansion frame includes biased struts, a mechanically operated frame, and/or a fluid-operated frame.

Abstract: Disclosed is a focal balloon having at least one reference zone and a focal zone. In one embodiment, the reference zone and focal zone are inflatable to a first generally cylindrical profile at a first pressure. At a second, greater pressure, the focal section expands to a second, greater diameter, while the reference zone remains substantially at the first diameter. In an alternate embodiment, the focal zone and the reference zone are inflatable to their respective predetermined diameters at the inflation pressure, in the absence of constricting lesions or anatomical structures. Both balloons may be utilized to conduct interactive angioplasty to provide real-time feedback about the morphology of the lesion, and both balloons may be utilized to implant or size intravascular stents.

Abstract: This invention relates generally to ultrasonic surgical apparatus. More particularly, this invention relates to an improved method and apparatus for generating profiled pulses of ultrasonic frequency vibratory energy at a distal surface of an ultrasonic applicator of an ultrasonic surgical instrument for application to tissues of a patient with specific relationships between a magnitude of the pulse of ultrasonic frequency vibratory energy and a duration of the pulse of ultrasonic frequency vibratory energy so that the ultrasonic applicator can be driven to vibratory amplitudes previously not achievable and a more expedient surgical effect obtained.

Abstract: A stent delivery system includes a catheter having a balloon mounted at its distal end for advancement into and withdrawal from a patient's vascular system by manipulation of the catheter from a point external to the patient's body, a lumen extending through the catheter into the balloon to allow the balloon to be selectively inflated and deflated from a pressurizing medium external to the patient's body, and spaced-apart radiopaque projections on the catheter adjacent the proximal and distal ends of the balloon to receive and retain a stent therebetween in overlying relation to the balloon and to provide x-ray markers thereof. The stent is deployed at a designated target site by selectively inflating the balloon to radially expand the diameter of the stent against the vascular wall.

Abstract: A device for staunching uterine bleeding comprising an expandable balloon and a tubular handle connected therewith for the insertion of the balloon into the uterine cavity, which can be connected to a fluid source for pressurizing the balloon to effecting and maintain the expansion thereof. The balloon is dimensioned to fill the uterine cavity at expansion and to exert pressure against the bounding wall thereof over substantially the total surface of the wall. The device further includes a pump and control unit and a hose connected to one end thereof with the handle at the other end thereof with a connection element for connecting to a fluid source. The hose can be detachable mounted to the pump and control unit in operative co-operation therewith and forms together with the balloon and the handle a separate unit for one-way use.

Abstract: An excisional biopsy device includes a tubular member having a window near a distal tip thereof; a cutting tool, a distal end of the cutting tool being attached near the distal tip of the tubular member, at least a distal portion of the cutting tool being configured to selectively bow out of the window and to retract within the window; and a tissue collection device externally attached at least to the tubular member, the tissue collection device collecting tissue excised by the cutting tool as the biopsy device is rotated and the cutting tool is bowed.

Abstract: An atherectomy device is provided wherein a catheter has a cutting region including plurality of slotted tubular members interconnected by flexible segments. Each slotted tubular member includes cutting edges that sever occlusive material from the interior of a vessel when the cutting region is rotated. The flexible segments may be formed by cutting windows in a tapered hollow tubular member, or may comprise bellows-shaped tubes or helical coils, and may be coated with a flexible material allowing suction to be drawn through the device, or to permit the delivery of contrast agents, dyes, fluids or drugs to the operative site. A guide catheter also may be provided for positioning the cutting region of the atherectomy device at the operative site.

Abstract: Improved stent configurations exhibiting limited recoil, resistance to compression and improved longitudinal flexibility.

Abstract: This is an implantable vaso-occlusive device. It is typically a vaso-occlusive coil comprising a primary helically wound coil which may then be wound into a secondary shape. Central to the invention is the use of a stretch-resisting member extending through the lumen formed, which stretch-resisting member is fixedly attached, directly or indirectly, to the coil in at least two locations. The stretch-resisting member is preferably somewhat loose within the interior of the lumen so to prevent the coil from collapsing, binding, and therefore stiffening during passage of turns through the human body. The coil should bend easily. In some variations of the invention, the stretch-resisting member may be formed into coil tips at the ends of the coil using simple equipment such as soldering irons or the like. The tips are typically of the same diameter as is the coil body itself. This stretch-resisting member is for the primary purpose of preventing stretching of the coil during movement of that coil, e.g.

Abstract: An apparatus for implementing a skin incision has a torsion spring and a method of assembling the apparatus. The apparatus has a housing having a pair of housing sections, each of the housing section having a base and a plurality of walls. The housing defines an inner space and an exterior. A pivot arm is pivotally mounted to a base of a housing section. The pivot arm is guided between a first position and a second position by a follower in a cam carried by the housing. A torsion spring carried by a spring post is coupled to the arm to exert a spring force on the arm in the first position. The housing has an indentation with a raised level and a lower groove on the base for receiving a portion of the spring post. The opening through the base extends from the lower groove. The spring post has a cylindrical base portion adapted to be received by the indentation in the base and a detent portion.

Abstract: A medical instrument includes an elongated shaft, a plurality of implements mounted to the shaft, and an actuator coupled to produce relative movement between the implements. At least one of the implements is detachable from the shaft and the actuator and from another one of the implements. The actuator includes a distal portion with an inclined slot. One of the implements is detachably coupled to the slot such that movement of the actuator causes the relative movement between the implements. A coupler including an opening for receiving the actuator is mounted to a handle for rotation relative to the handle.

Abstract: An irrigation surgical tool system comprises a motorized handpiece, a tool for insertion in the handpiece, a console including a mounting plate and peristaltic pump rotor and a tube set including a cassette installable on the console for peristaltic pumping of irrigation liquid to the tool. Passages in the tool allow irrigation liquid flow, between a fixed outer tube and rotating inner tube of the tool, to a surgical site, through windows in the tool inner and outer tubes. Application of suction to the tool enables withdrawal through the inner tube of irrigation and surgical debris from the surgical site.

Abstract: Balloon loaded dissection devices with elongate balloons and a pushing member are disclosed for creating a tunnel alongside an elongate vessel in the body. The devices may utilize an elongate balloon of any suitable length which may be formed of an elastic or non-elastic material. The balloon may be of double walled construction and may be provided with a central lumen which may receive a guide rod, scope or other surgical instrument. The device may have a support tube secured to the inner wall of the balloon to provide columnar support for the apparatus. The support tube may have a transparent shroud attached to a distal end of the support tube. There is an open space between the distal end of the support tube and the end of the shroud allowing access to adjacent tissue. The shroud may perform blunt dissection and/or retraction to clear an open space for viewing or for performing surgical procedures.

Abstract: This is an implantable vaso-occlusive device. It is typically a vaso-occlusive coil comprised of a primary helically wound coil which may then be wound into a secondary shape. Central to the invention is the use of a stretch-resisting member fixedly attached within at least a portion of the primary coil. The stretch-resisting member may be formed into coil tips at the ends of the coil by melting the polymeric fibers or alloys or by attaching the fibers with a glue. This stretch-resisting member is for the primary purpose of preventing stretching of the coil during movement of that coil, e.g., by retrieval or repositioning after deployment. The device typically has a self-forming secondary shape made from a pre-formed primary linear helically wound coil, although it need not have the secondary form. External fibers may be attached to the device and affixed to the pre-formed linear member to increase . The vaso-occlusive member may be also be covered with a fibrous braid.

Abstract: An angiostomy apparatus has an ultrasonic oscillator for generating predetermined ultrasonic energy. A holding member has at least a substantially annular end face or an annular portion, and holds a blood vessel at its inner peripheral side. A probe is used to hold a portion of the blood vessel between itself and an outer peripheral side portion of the substantially annular end face or the annular portion of the holding member. An oscillation transmitting section transmits ultrasonic oscillation from the ultrasonic oscillator to that portion of the blood vessel which is in contact with the holding member or the probe. The holding member is a cylindrical member having a slit formed therein.

Abstract: A surgical dissector has two sets of dissecting jaws with serrated inner surfaces to firmly grasp and dissect tissue. The second set of jaws projects transversely from the first set of jaws. Both sets of jaws are curved, and in one alternative, curvature of the second set of jaws is in a direction opposite to the curvature of the first set of jaws, while in the second alternative, the curvature of the second set of jaws is in the same direction as the curvature of the first set of jaws. In a first embodiment, for use during laparoscopic surgery, the dissector is positioned within a trocar for insertion into the body. In a second embodiment, for use during open surgery, a forceps type of dissector is disclosed.

Abstract: A rotating endoscopic shaver blade assembly adapted for side-cutting and end-cutting. A pair of longitudinally extending, symmetrical fingers extends from the distal end of an elongated tubular inner member and are juxtaposed adjacent a window at the distal end of an elongated tubular outer member. Each of the fingers is provided with laterally facing and transversely facing cutting edges and has a curvilinear profile terminating at a distal tip. The distal tips of the fingers are separated by an axially aligned gap which enables limited stress-relieving radial movement of the fingers.

Abstract: An operative instrument for endoscopic surgery which can be used in combination with a normal, straight trocar. The operative instrument for endoscopic surgery includes a jacket tube (11), which is formed from an elastic tubular member to normally maintains a curved shape and can be elastically deformed to be insertable into a straight, cylindrical trocar (1), a manipulating shaft (27), which is elastic, has a distal end operative member (24) connected to the distal end thereof for performing a treatment within the body, and is passed through the jacket tube (11), and a manipulating part (30), which is connected to the proximal side of the jacket tube (11) for manipulating the distal end operative member (24) via manipulating shaft (27).

Abstract: A blade guard (12) for preventing a saw blade (16) or other cutting member from cutting into tissue the cutting member is not intended to cut. The blade guard includes a body (20) that is attached to the surgical tool (10) from which the cutting member extends. A leg (24) extends from the body. A foot (34) is attached to the end of the leg. The foot encapsulates the end of the cutting member to prevent it from penetrating into tissue the cutting member is not intended to cut. The leg is formed with a tapered profile such that it has a leading edge (29) adjacent the cutting member that is narrow in width than the trailing edge (30) spaced from the cutting member. The tapered profile of the leg provides the leg with structural strength. The tapered profile also facilitates the separation of the sections of the bone that define the kerf as the cutting member and blade guard pass through the bone.