Abstract: A sound attenuating system is provided for pneumatically powered surgical instruments. In one aspect, the exhaust hose is formed of at least two dissimilar materials to impede the transmission of vibrations or audible noise. In an alternative form, the exhaust hose has proximal and distal portions of dissimilar internal diameters.

Abstract: An assembly for treating tissue in the anal canal uses a barrel structure having a dimension that can be selectively altered to be conducive for insertion into an anal canal according to an anatomic condition assessed within the anal canal. An electrode is carried by the barrel structure that can be coupled to a source of tissue ablation energy, which, when applied through the electrode, forms a lesion.

Abstract: A suction sleeve is configured to couple to the shaft of an RF device to evacuate hot gasses, fluids and/or other aspirates. The suction sleeve may be configured to be disposed coaxially around the shaft between the first end of the shaft and the work element (e.g., an RF cutting element) thereof. The suction sleeve defines a suction port and a plurality of openings near the work element, and is configured to enable suction in through the plurality of openings and out through the suction port.

Abstract: A collapsible ultrasonic reflector incorporates a gas-filled reflector balloon, a liquid-filled structural balloon an ultrasonic transducer disposed within the structural balloon. Acoustic energy emitted by the transducer is reflected by a highly reflective interface between the balloons. In a cardiac ablation procedure, the ultrasonic energy is focused into an annular focal region to ablate cardiac tissue extending in an annular path along the wall. Devices for stabilizing the balloon structure and for facilitating collapse and withdrawal of the balloon structure are also disclosed.

Abstract: The invention provides a method and system for treating disorders in parts of the body. A particular treatment can include on or more of, or some combination of: ablation, nerve modulation, three-dimensional tissue shaping, drug delivery, mapping stimulating, shrinking and reducing strain on structures by altering the geometry thereof and providing bulk to particularly defined regions. The particular body structures or tissues can include one or more of or some combination of region, including: the bladder, esophagus, vagina, penis, larynx, pharynx, aortic arch, abdominal aorta, thoracic, aorta, large intestine, sinus, auditory canal, uterus, vas deferens, trachea, and all associated sphincters. Types of energy that can be applied include radiofrequency, laser, microwave, infrared waves, ultrasound, or some combination thereof.

Abstract: An instrument holder (10) for surgical use has a remote locking mechanism (12) and is elongated having a proximal end (14) and a distal end (16). The holder (10) has an elongated shank (20), a ring (22), a locking component (28) and a spring (32). The elongated shank (20) is equipped, at the distal end (16), with a head (26) adapted to receive an instrument (24). The locking component (28) is substantially cylindrical, elongated and is biased in a first direction (30) toward the head (26) by a spring (32). The locking component (28) includes structures (34) capable of locking the instrument (24) onto the distal end (16). The ring (22) is biased by the spring (32) in a second direction (36) against the locking component (28) towards the proximal end (14) constrained to slide longitudinally on the shank (20), at the proximal end.

Abstract: Methods and apparatus for ablating a target tissue are discussed. Such methods and apparatus include those that simplify tissue ablation. For example, a tissue ablation device having an actuator, such as a trigger mechanism, coupled to a power source and an electrode is discussed. A single step of engaging the actuator causes the electrode to be introduced into the target tissue and causes energy to be delivered from the power supply to the tissue via the electrode. By way of additional example, a tissue ablation device having an actuator coupled to a fluid source and an electrode is discussed. A single step of engaging the actuator causes conductive fluid to flow from the fluid source to the target tissue location and causes the electrode to be introduced to the target tissue location. The fluid source may be a conductive fluid, such as saline, which may increase the efficiency of ablation. Various other configurations and methods that simplify tissue ablation are also discussed.

Abstract: A method and apparatus for reducing the likelihood of post operative atrial fibrillation by cooling specific nerves in the heart. In an exemplary method, a semi-rigid probe having a distal portion capable of cooling tissue to temperatures below freezing, is placed on tissue proximate cardiac nerves to temporarily or permanently inhibit signal conduction in the nerves.

Abstract: Various high-strength microwave antenna assemblies are described herein. The microwave antenna has a radiating portion connected by a feedline to a power generating source, e.g., a generator. The antenna is a dipole antenna with the distal end of the radiating portion being tapered and terminating at a tip to allow for direct insertion into tissue. Antenna rigidity comes from placing distal and proximal radiating portions in a pre-stressed state, assembling them via threaded or overlapping joints, or fixedly attaching an inner conductor to the distal portion. The inner conductor is affixed to the distal portion by, e.g., welding, brazing, soldering, or by adhesives. A junction member made from a hard dielectric material, e.g., ceramic, can be placed between the two portions and can have uniform or non-uniform shapes to accommodate varying antenna designs. Electrical chokes may also be used to contain returning currents to the distal end of the antenna.

Abstract: The invention relates to a method for hypothermia and rewarming of the cerebrospinal fluid in the brain. In one embodiment, cooling and rewarming of the cerebrospinal fluid is accomplished by applying cooling and rewarming elements externally placed in contact with the skin overlying the cerebrospinal fluid cisterns at the back of the head and spine regions of a patient. In another embodiment, hypothermia and rewarming is accomplished using a double barrel ventricular catheter placed within the lateral ventricles with one catheter used for heat exchange and the other for drainage of excess cerebrospinal fluid. In yet another embodiment of the invention, hypothermia and rewarming is accomplished using a loop catheter with fluid running through the loop placed in the lateral ventricles.

Abstract: A cryogenic medical system includes a medical device and a console connectable to the medical device at a connection point. The console controls the temperature of the medical device. The console includes a first cooling system directing coolant to the medical device at a first temperature along a coolant supply line and a second cooling system chilling the coolant within the coolant supply line to a temperature below the first temperature before the coolant reaches the connection point.

Abstract: Methods, devices, and systems for treating the support structures of the body, particularly for incontinence, take advantage of two mechanisms to enhance the support provided by the fascia, ligaments and tendons: first, the invention increases a modulus of elasticity of these tissues, and particularly of the fascial tissues. The increase in modulus can be effected by directing sufficient energy to the fascial tissue so as to promote the formation of scar tissue. The second mechanism attaches tissue planes together, often by directing energy to an interface between adjacent fascial tissues.

Abstract: According to one aspect of the present invention, there is provided a treatment device for cutting a living tissue, comprising a main unit which is to be inserted into a body, a tip-end treatment portion which is disposed at a tip end of the main unit to cut the living tissue, a notch groove which is disposed at the tip-end treatment portion and which compresses the living tissue guided into the notch groove, and an electrode which is positioned in a part of the notch groove and which electrically cuts the living tissue compressed by the notch groove.

Abstract: Devices, systems, and methods can treat incontinence by heating between about 100 and about 800 cubic millimeters of endopelvic fascia for sufficient time to effect substantial collagenous tissue shrinkage. A probe body may directly engage the endopelvic fascia, or may be separated from the endopelvic fascia, heating through (for example) the vaginal wall. In either case, tissue-penetrating electrodes may be inserted from the probe body so as to heat the endopelvic fascia.

Abstract: The present invention provides a method and apparatus for controlling the internal body temperature of a patient. According to the present invention, a catheter is inserted through an incision into a large blood vessel of a patient. By selectively heating or cooling a portion of the catheter lying within the blood vessel, heat may be transferred to or from blood flowing within the vessel and the patient's body temperature may thereby be increased or decreased as desired. The invention will find use in treating undesirable conditions of hypothermia and hyperthermia, or for inducing a condition of artificial hypothermia when desired.

Abstract: A device and method for providing body cooling. The cooling device applies cooling to blood flowing in a vena cavae that is then distributed throughout the body. The cooling can be assisted by use of thermoregulatory drugs or warming devices to prevent shivering and vasoconstriction.

Abstract: A method of manufacturing a seal in an electrosurgical device includes placing components of the electrosurgical device within an elongated housing section, the housing section including an actuator opening, introducing the housing section within a mold filled with a liquid thermoplastic elastomer and allowing the elastomer to flow within the housing, forming an elastomeric inwardly-extending lip portion circumferentially surrounding an opening at a distal end of the electrosurgical device for introducing an electrode therein, and allowing the molded elastomer to cure and become integral with the housing to seal the components within the molded elastomer contained within the housing section. The method may also include the step of forming an elastomeric actuator seal around the actuator opening.

Abstract: An electrosurgical medical device and method for creating thermal welds in engaged tissue. In one embodiment, at least one jaw of the instrument defines a tissue engagement plane carrying a variable resistive body of a positive temperature coefficient material that has a selected decreased electrical conductance at each selected increased temperature thereof over a targeted treatment range. The variable resistive body can be engineered to bracket a targeted thermal treatment range, for example about 60° C. to 80° C., at which tissue welding can be accomplished. In one mode of operation, the engagement plane will automatically modulate and spatially localize ohmic heating within the engaged tissue from Rf energy application across micron-scale portions of the engagement surface. In another mode of operation, a variable resistive body will focus conductive heating in a selected portion of the engagement surface.

Abstract: The present invention provides robotic surgical instruments and systems that include electrosurgical cutting/shearing tools and methods of performing a robotic surgical procedure. The surgical instruments can advantageously be used in robotically controlled minimally invasive surgical operations. A surgical instrument generally comprises an elongate shaft having a proximal end and a distal end. An end effector, for performing a surgical operation such as cutting, shearing, grasping, engaging, or contacting tissue adjacent a surgical site, is coupleable to a distal end of the shaft. Preferably, the end effector comprises a pair of scissor-like blades for cooperatively shearing the tissue. A conductor electrically communicating with at least one blade delivers electrical energy to tissue engaged by the blades. An interface coupled to the proximal end of the shaft and removably connectable to the robotic surgical system is also included.

Abstract: A method for controlling heat dissipated from a prosthetic retinal device is described. A heat transfer device employs the Peltier heat transfer effect to cool the surface of the retinal device that faces the retina by dissipating/transferring collected heat away from the retina and towards the iris or front of the eye. According to one embodiment, a heat pump is formed in a second substrate on the retinal device. The heat pump is controlled by a temperature sense device that activates the heat pump, when a first predetermined temperature limit is exceeded. The temperature sense device deactivates the heat pump, when a temperature of the retinal device drops below a second predetermined temperature. According to another embodiment, a supply current of the retinal device may pass through the heat pump and a direction of heat transfer by the heat pump can be reversed, when the first predetermined temperature is exceeded.