Abstract: Methods and apparatus for magnetic resonance imaging (MRI) assisted cryosurgery. Optimal probe placements and cooling parameters are calculated prior to cryosurgery using MRI data. A MRI compatible cryoprobe and a stereotactic probe positioning device are provided. The resolution of MR images is enhanced by mounting a radio frequency MR coil on the intracorporeal end of a cryoprobe. During cryosurgery the temperature distribution in the frozen region is solved by determining the boundary of the frozen region and solving the heat equation for the known boundary conditions. During cryosurgery the temperature distribution in the unfrozen region is determined by T1 measurements. The process of freezing is controled using information from the solution of the energy equation in the frozen region and temperature measurements in the unfrozen region. After cryosurgery the extent of the tissue damage may be ascertained using phosphorus-31 and/or sodium-23 spectroscopy with a special coil set on the cryosurgical probe.

Abstract: The invention contemplates a fixation pin for retaining small bone fragments in an osteosynthesis procedure. The pin comprises a smooth-walled shank portion and an adjoining threaded portion, wherein a step-down conical shoulder is formed between the shank portion and the threaded portion.

Abstract: Instrumentation for positioning a cut guide to cut a posterior slope in the tibial plateau surface of a tibia. The instrumentation includes an intramedullary alignment guide for engaging the tibia, and a rotational alignment guide for providing a guide for the insertion of a rod portion of the intramedullary alignment guide into an intramedullary bore in the tibia with the intramedullary alignment guide rotationally aligned with the intramedullary bore so that the longitudinal axis of a handle portion of the intramedullary alignment guide is angled posteriorly with respect to the longitudinal axis of the rod portion and the longitudinal axis of the intramedullary bore as the rod portion of the intramedullary alignment guide is inserted into the intramedullary bore.

Abstract: The invention is in a cross pin and set screw femoral and tibial fixation apparatus and method for mounting a ligament graft that, in one embodiment is a bone tendon bone type ligament graft and in another embodiment is a soft tissue ligament graft, in femoral and tibial tunnel sections of a straight ligament tunnel formed in an arthroscopic cruciate ligament replacement procedure. The apparatus and the steps involved in its use include, a drill guide for drilling a transverse hole or holes, which drill guide is arranged to be releasable from a first twist drill so as to leave it in place, the first twist drill to be used for guiding further drilling and passage of a fastener device.

Abstract: The invention provides a surgical clip applier particularly useful in laparoscopic and other least invasive surgical procedures. The clip applier includes a shaft having a distal end and a proximal end, the shaft defining an axial direction. Means are provided in the shaft for advancing a clip to the distal end. Hook means are fixed to the distal end of the shaft, the hook means having a distal portion disposed transverse to the shaft so as to define a surface facing in a proximal direction for engaging a tissue structure. A pair of movable jaws are mounted at the distal end of the shaft and are axially slidable relative to the hook means for closing a clip on a tissue structure engaged by the hook means. The movable jaws will define a U-shaped slot open in a generally distal direction. Means are further provided for advancing the jaws to a position adjacent the distal portion of the hook means, as well as means for closing the jaws.

Abstract: An endotracheal intubating instrument has an elongate curvilinear blade member releasably attachable to a handle and a central channel sized to removably receive and slidably engage an endotracheal tube therein, an elongate tubular housing removably connected at its forward end to the rearward end of the endotracheal tube which removably receives a fiberoptic scope having an eyepiece at a rearward end and a fiberoptic bundle extending forwardly within the endotracheal tube, and an adjustable positioning element through which the forwardly extending fiberoptic bundle passes for adjustably positioning and maintaining the tip end of the fiberoptic bundle relative to the forward end of the endotracheal tube. The apparatus is placed in the mouth, the larynx is identified, and the endotracheal tube, housing, and fiberoptic scope are advanced as a unit into the trachea as the blade is removed. Then the fiberoptic scope and housing are withdrawn, leaving the endotracheal tube in the desired part of the trachea.

Abstract: A flexible three-paths catheter provided with a balloon carries a sealingly sheathed radiofrequency radiating antenna, together with the shielded power supply cable and with some thermocouples, within a plastic lining surrounded by a flow of liquid; a second path carries the power supply cables of some outer thermocouples, flooded by the reverse liquid flow, while the third path allows a fluid to flow through for inflating the balloon.Introduction of the catheter into a hollow organ makes it possible to perform hyperthermal therapy of tumors by means of radiation.

Abstract: A spring loaded screw and an associated driver for use in orthopedic applications, particularly for temporarily securing cutting guides and the like to the tibia and femur for preparation of the bone surfaces in a total knee replacement. A slidable sleeve on said screw is spring biased away from the driver. As the screw sleeve seats, the sleeve slides upwardly against the compression spring to disengage the driver from the proximal end of the screw. The driver contains a slidably disposed central cylinder which can be axially moved by sliding an externally mounted sleeve. To retract the screw, the driver sleeve is advanced toward the screw to urge the cylinder toward the proximal end of the screw sufficiently far to enable grasping of the proximal end of the screw for retraction thereof.

Abstract: The suturing instrument of the present invention uses an electromagnet to position, orient and hold a needle at the end of an elongated barrel, thereby eliminating the mechanical jaws which are otherwise required. The electromagnet is contained in a barrel and extends along the length of the barrel. One end of the electromagnet emerges at the distal end of the barrel and extends to an end cap, which includes a groove for orienting the needle. Wires extending from the electromagnet and through the barrel connect to a power source which supplies current to the wires. The power source preferably has multiple power settings for supplying different levels of current. When sufficient current is applied to the electromagnet, the electromagnet attracts the needle to it, causing the needle to move to a predetermined position within the groove.

Abstract: A femoral intramedullary rod has a thin or reduced proximal segment so as to provide room for the use of femoral hip screws. Use of the rod for femoral shaft fixation permits subsequent independent treatment of an ipsilateral femoral hip fracture as an isolated injury, regardless of whether initially detected. Different rod embodiments are formed by the omission of different proximal portions of the rod. It is in such portions that the femoral screws may be placed to set hip fractures. The rod is cannulated for installation over a guide wire. Internal rod threads, below the thin proximal segment in some embodiments, are used for initial installation of the rod with a driving member screwed into such threads. Without driving forces on the thin proximal segment, such segment can be made even thinner. Once the rod is seated, hip screws may be installed if there is a detected hip fracture. Subsequent to healing, the femoral screws and interlocking screws (if any) may be removed.

Abstract: The present invention relates to an apparatus and method for penetrating body tissue. The apparatus comprises a handle member having an electrical connection port, a shaft member fabricated from an electrically conductive material and having a proximal end portion secured to the handle member so as to extend outwardly from the handle member. A housing fabricated from an electrically insulating material is concentrically positioned about the outwardly extending portion of the shaft member. The distal end portion of the shaft member is configured to extend outwardly from the housing sufficiently to facilitate penetration of the body tissue.

Abstract: An instrument for cutting, ablating and coagulating tissue has a rod of ferromagnetic material fusion welded to the base of a conical tip of copper with the rod adjacent the base of the conic being of lesser diameter than the base to provide a region to accept a potted coil of wire about the rod whereby when the coil is connected to a constant current high frequency source the rod and tip are heated to a temperature approaching the Curie temperature of the ferromagnetic rod. As Curie temperature is approached the rod becomes essentially non-magnetic heating decreases to produce a temperature below Curie temperature and the cycle repeats. As a result of the excellent heat exchange interfaces produced by fusion welding the energy delivered to the tissue or other load which may be non-biological is closely controlled by temperature which is self regulated. A ferromagnetic sleeve is placed about the coil to concentrate magnetic flux in the rod.

Abstract: An illumination cannula system for vitreous surgery. The cannula system has a plurality of illuminated cannula ports, each including a multiplicity of optical fibers annularly arranged about a central conduit channel provided with a double seal onto which a sleeve connector or boot of an infusion line adapter or sealing plug can be attached. The adapter includes an extended tube for discharging fluid beyond the terminations of the fibers. The double seal provides a convenient, positive snap-action sealing connection. Identical configurations of the cannula ports enable post-placement selection and interchange of infusion and instrumentation ports.

Abstract: An endoscopic or laparoscopic surgical instrument having an internally disposed locking mechanism located within a barrel portion of a handle assembly. The instrument includes a handle assembly having a pivoting handle and a stationary handle, a barrel portion to which an elongated body assembly is secured, and a locking mechanism for releasably positioning a tool mechanism located at the distal end of the body assembly. In one embodiment the locking mechanism comprises a trigger, a brake and a latch spring. In another embodiment the locking mechanism comprises a latch spring and a locking block. A rotational knob and locking member may also be provided to position the body assembly at various orientations to the longitudinal axis.

Abstract: This invention is an apparatus for endovascular occlusion through the formation of thrombi in arteries, veins, aneurysms, vascular malformations, and arteriovenous fistulas. In particular, it deals with a sacrificial link between an endovascular device which is introduced to and is intended to remain at the desired thrombus formation site and the device used to introduce the device. The invention further includes a method for introduction of the device and its electrolytic separation.

Abstract: A lead extraction device which utilizes laser light to separate an implanted object, such as a pacemaker lead, from fibrous scar tissue and thereby permit the implanted object to be extracted from a body. The extraction device features a catheter having a central lumen. The lumen is preferably dimensioned so a pacemaker lead will fit within. The catheter is thereby guided by the lead. The catheter has at least one optical fiber to emit laser light from the distal end and thereby separate the lead from fibrous scar tissue. Disclosed embodiments include catheters which emit light parallel as well as inwardly perpendicular to the catheter and the lead. Through such catheters the lead may be separated along its length, as well as separated at its distal end from fibrous scar tissue, thereby permitting the lead to be readily extracted from the body.

Abstract: The present invention relates to a trocar adapted to provide a surgeon with an indication when the trocar has penetrated body tissue. The trocar includes an obturator assembly and a cannula assembly. The obturator assembly has an obturator housing and an obturator shaft. The shaft has a proximal end portion connected to the housing and a distal end portion adapted to conduct electricity and penetrate body tissue. An electric connection assembly is associated within the obturator housing and provides a conductive path between the conductive portion of the obturator shaft and an outer surface portion of the obturator housing. The connection assembly is also adapted to receive an external electrical connector.

Abstract: A laser catheter for irradiation of human myocardial tissue containing a movable feedback mechanism for monitoring the damage created by laser irradiation, and which is usable with standard catheters designed for angiography and angioplasty. Means for sensing distal temperature are provided in the form of a plurality of movable thermocouples, along with the ability to cool the fiber optic and distal tip with a flushing solution. Flushing of the area adjacent to the tip is provided for by a fluid which travels the length of the laser catheter.

Abstract: A keratorefractive surgical blade has opposing sides and first and second edges which intersect each other to form a point. The first edge is shaped to form a sharp cutting edge extending from the point a predetermined distance shorter than the distance from the base of a surgical incision to Bowman's membrane, a portion of the first edge adjacent to the sharp cutting edge being dull relative to the cutting edge.

Abstract: A chiropractic table for the treatment of the muscular and skeletal cervical, thoracic, and lumbar areas of the patient's spine. The chiropractic table includes a base frame having an upright support with a table top disposed above the base frame and coupled to the upright support such that different segments of the table top may be articulated to assist in the treatment of the patient. A drive assembly is provided for reciprocating at least a portion of the chiropractic table. The drive assembly is isolated from the base frame and table top by a plurality of isolators, which attenuate the noise and vibration produced by the drive assembly while reciprocating the table top.