Abstract: A wound closure device which maintains pneumoperitoneum while allowing a surgeon to capture an mount of tissue which is substantially wider than the diameter of a trocar cannula through which the device is inserted. The wound closure device includes, an elongated guide member, a hook shaped needle and a retracting mechanism for moving the needle from an open position to a closed position. In the closed position, the tip of the needle is positioned within the guide member so that the needle can be easily inserted into a body. In the open position, the needle tip is positioned outside of the guide member at a distance from the guide member which is greater than the diameter of the guide member.

Abstract: An aspiration/irrigation tip adapted for use with a handpiece for the removal of a cataractous lens from the eye is described. The tip, which may be used with an ultrasonic handpiece, is a bent, hollow-bore needle. The shaft of the needle is bent to form a distal invasive portion and a proximal non-invasive portion which attaches to the handpiece. The angle in the shaft enables the surgeon to hold the handpiece at an ergonomically preferred angle with respect to the eye while performing phacoemulsification. Heating of non-target tissues such as the cornea due to friction between the non-target tissue and the vibrating needle is reduced.

Abstract: An articulated dissecting surgical tool includes an elongate member having a longitudinal axis and a dissecting tip located at a distal end of the elongate member. The tip includes a pair of opposed jaws and a coupling mechanism pivotally coupling the pair of opposed jaws together at a proximal end of the tip to permit pivotal movement of the opposed jaws relative to each other in a first plane between opened and closed positions. Each of the jaws includes a distal section having a forward and rear end, a proximal section having a forward and rear end, and an articulating pivot connection between the proximal and rear sections. The pivot connection is adjacent the rear end of the distal section and the forward end of the proximal section to permit angular movement of the distal section relative to the proximal section in a second plane different from the first plane to establish a desired angular relationship between the distal and proximal sections of each of the jaws.

Abstract: The invention is directed to a system and method for releasably holding a surgical instrument (14), such as an endoscopic instrument configured for delivery through a small percutaneous penetration in a patient. The instrument comprises an elongate shaft (100) with a pair of mounting pins (116) laterally extending from the shaft between its proximal and distal ends. An instrument holder comprises a support having a central bore (202) and an axially extending slot (204) for receiving the instrument shaft and the mounting pins. A pair of locking slots (206) are cut into the support transversely to and in communication with the axial slot so that the mounting pins can be rotated within the locking slots. The instrument support further includes a latch assembly for automatically locking the mounting pins within the locking slots to releasably couple the instrument to the instrument holder.

Abstract: A cable winding for retention of bone in surgery having a crimp for retaining the cables together. The crimp has a bore of oval cross section, with its exterior being preferably oval in cross section as well. The cable sections extend through the single bore in side-by-side relation. Outwardly projecting flanges extend from the crimp ends for at least about 120.degree. about the periphery to create a space between the flanges when the flanges rest on bone. This space may be used to receive the crimping jaws during the crimping process so that the crimp does not have to be forced outwardly from the bone during the crimping process. Thus, a more consistent, predetermined tension can be provided to the cable on crimping.

Abstract: This invention is an occlusive device for inserting into body cavities or vesicles. More particularly, it is a vasoocclusive device which, as used, is in the approximate shape of an anatomical cavity. It may be ultimately deployed as a substantially spherical shape in the operable configuration. The device is a self-forming shape made from a pre-formed occlusive strand of flexible material. The occlusive strand may be helically coiled or braided and may be adapted with various polymeric fibers. The device is typically introduced through a catheter in the substantially linear inoperable configuration. The invention provides a plurality of such substantially spherical strand portions which nest concentrically with each other in the operable configuration. The invention also includes methods of producing and using the substantially spherical vasoocclusive devices.

Abstract: A surgical apparatus for suturing body tissue comprising first and second jaws relatively movable between an open and closed position, a first needle retaining section having a first securing mechanism mounted therein removably mounted to the first jaw, and a second needle retaining section having a second securing mechanism mounted therein removably mounted to the second jaw. The surgical needle is transferable between the first and second sections upon closing of the jaws such that the surgical needle can be retained in either of the first and second sections by the respective securing mechanism.

Abstract: Apparatus and methods for suturing and ligating anatomical tissue utilizes one or more knotting elements connected between two or more length portions of filamentous suture material to form one or more contractible loops for confining segments of the length portions therein. The knotting elements receive the suture material to effect a knot for one or more adjustably tensioned stitches created when the segments are passed through the loop and the suture material is received by the knotting elements.

Abstract: This invention introduces a system which allows a low level of pressure to be applied to the wound site in order to prevent bleeding during a stable period. Some models of this unit also give the option of allowing the unit to be inflated in order to increase the pressure in the area and stop bleeding if it occurs later. Automatic ways of recognizing bleeding are also introduced that utilize a computerized means of recognition and/or application of a set of proper reactions after bleeding, and an automated pressure application as well. It is believed that this unit will help human beings significantly.

Abstract: The device includes a bar having a longitudinal axis and adapted to be inserted into a fistulous tract. A cutting tool cooperates with the bar such that the cutting tool separates the fistulous tract from the surrounding tissue by coring the fistula.

Abstract: A preassembled disposable driver and suture anchor are provided for threaded engagement into a bone to provide an attachment point for soft tissue. The anchor is formed to have an externally threaded body portion for engaging the bone, a distal end portion, and a proximal end portion. When the anchor is threaded into an opening in a bone, the distal end portion is adjacent a bottom of the opening and the proximal end portion is adjacent a mouth of the opening. A suture is attached to said anchor having free ends extending outwardly from the bone opening. The driver is elongated and has a distal end which engages the proximal end of the anchor and a proximal end for gripping by the surgeon. The driver also has a slot for receiving the suture which extends away from the anchor.

Abstract: An apparatus for compressing and extracting internal body tissues wherein the apparatus is insertable through a trocar device and encompasses the tissue to be removed while compressing the tissue in situ outside of the trocar or of any incision access device, and then being removable from the trocar/incision device.

Abstract: A catheter assembly for the delivery of a vascular stent into human arteries and veins is disclosed. The system disclosed in the present invention is an apparatus capable of deploying a vascular stent mounted on a catheter, either on a balloon catheter or on the distal portion of a catheter tube. In the case of a stent mounted on the balloon of a balloon catheter, the spring sheath is withdrawn and the balloon is inflated to deploy the stent to the inner wall of the vasculature. In the case of a self-expanding stent, the spring sheath is withdrawn, causing the stent to expand to the vessel wall. The apparatus is withdrawn after the stent has been deployed.

Abstract: A device for monitoring the flexion, extension, and rotation of a user's torso. An upper and a lower sensing arm extend vertically in opposite directions from a measuring and control box that is held about the midsection by a belt, and both arms are spring biased to hold them against the user's back. The torso engaging portions of each of the sensing arms are curved to cup the engaged portion of the anatomy and thus allows for the sensing of torso rotation due to a pair of protrusions integral to the sensing arms and ensconced within the control box. Both arms are telescopically adjustable to allow the device to be fit to differently sized people and the amount of flexion, extension, and rotation that is allowed by the device before a warning tone is sounded is adjustable.

Abstract: An anchoring system includes a simply structured suture-like device which permits a fluid tube or similar article to be easily attached to the patient without the use of needles and without actually suturing anything to the patient. The anchoring device desirably includes two threads or filaments and two corresponding receptacles. The filaments include protuberances which cooperate with apertures of the receptacles to permit easy insertion of the distal end of the filaments into the receptacles, but inhibit retraction of the filament distal ends from the receptacles. A healthcare provider simply wraps the filament around the fluid tube and then threads the distal end of the filament through the receptacle aperture until the filament holds the tube tightly against a base of the anchoring system. The base in turn includes an adhesive bottom surface which can be attached to the patient's skin.

Abstract: This invention relates to a method for the dissection of blood vessels, lymph nodes and other body organs from the surrounding tissue and to a novel balloon dissection instrument for use in the method. The dissection instrument comprises an elongated tube having at least one inflatable balloon attached around the outer wall of a distal portion of the tube. The method of dissecting a vein, such as the saphenous vein, involves severing of the vein at two sites, defining the length of vein to be dissected. The vein is then accessed by securing the severed end, for example by a thread attached thereto and passed through the lumen of the dissection instrument to serve as a controllable anchor. The distal end of the dissection instrument, with the balloon deflated, is placed over the free end of the vein so that the vein enters the lumen of the instrument and the distal end of the instrument is pressed between the outer layer of the vein, i.e., the adventitia, and the connected fascia.

Abstract: A chiropractic mallet instrument for delivering a selected impact to the spinal vertebrae and or other bones of a patient in order to remove a vertebral subluxation and or other subluxations includes a tubular housing with a central handle movably supported thereon, a compression spring engaging a latch assembly and an elongate anvil member coaxially and movably fitted within an interior of the housing and extending from one end thereof, the anvil member including a distal end zone with a distal tip structured for removable attachment of various impact heads of different sizes, shapes and densities, the anvil member being axially movable relative to a longitudinal axis of the housing between a retracted, cocked position and an extended, released position. The latch assembly is operably interconnected to the central handle and carries and holds the anvil member in the retracted, cocked position upon movement of the central handle towards a palm handle on an opposite end of the housing.

Abstract: Disclosed is a specially tapered balloon such as for sizing an implantable tubular stent that has been positioned within an ostium. In one application of the present invention, a stent is positioned within the right coronary ostium, and the tapered balloon of the present invention is positioned within the stent to provide a radial outward flare on the proximal end of the stent. In this manner, the proximal end of the stent is pressed back against the aortic wall surrounding the right coronary ostium, thereby minimizing any obstruction to blood flow in the aorta, and possibly reducing the risk of restenosis at the right coronary ostium.

Abstract: A surgical instrument provides improved precision and performance for use in highly intricate surgeries such as vitrectomy which frequently involves removing dense vitreous base firmly adherent to the retinal surface. The instrument includes two concentric tubes, an outer tube having ports near the closed end, and a slidable inner tube which fits snugly inside the outer tube. The inner tube includes a sharp cutting edge formed on one end that slides back and forth across the ports to cut vitreous, and an axial passage to pass the cut portions of vitreous. Such a surgical instrument maintains highly effective and accurate cutting device for removing vitreous without cutting into the retina.

Abstract: The invention provides an improved external fixation device which is designed for use in the treatment of bone fractures in a military setting, and comprises a main hollow housing (11) having opposite open ends, first and second end closure members (12, 13) removably attached to the opposite ends of the housing, the member (12) comprising a drill handle forming element (26) while the member (13) comprises a chuck-forming element (31), the end members (12, 13) when detached from the housing (11) being adapted for gripping engagement within respective clamp holders (14, 15) so as to form a hand tool assembly which can operate as a brace-and-bit. A bit element (40) is releasably locked in the socket (38) of the chuck element (31). A holder unit (33) is housed within the interior of the housing (11) and serves to store the ancillary equipment (40, 41, 42) within the housing during transport of the device.