Abstract: A single surgical instrument to both pass a wire under a bone and twist the ends of the wire together is comprised of a hooked member mounted to a handle assembly. The hooked member has a notch to feed a wire as the hooked member is pulled about the bone. The handle assembly incorporates a crank comprised of two handles rotatably mounted to a grip to thereafter quickly and tightly twist the wires about the bone with the same instrument.

Abstract: An improved expandable removal element for an atherectomy device wherein the expandable removal element is movable between an expanded position and a contracted position. In one embodiment of the present invention, a drive shaft is operatively connected to the distal end of the expandable removal element for rotating the removal element. A catheter surrounds a portion of the drive shaft. The catheter is shiftable with respect to the drive shaft for moving the material removal element between the expanded position and the contracted position. In another embodiment of the present invention, dual coaxial drive shafts are employed. The inner drive shaft and the outer drive are shiftable with respect to one another for moving the removal element between the expanded position and the contracted position. The present invention also describes several embodiments of a removal element for increasing the durability and effectiveness of the removal element.

Abstract: An osteosynthetic fixation device consists of a fixation element 1 which has a conical head section 11 and an anchoring element 12 abutting it which is for attachment into the bone. The fixation device also consists of a spherically formed, layered, slotted clamping piece 2 which has a conical borehole 21 for installation of the conical head section 11, and which is meant for locking within a connecting piece 3 equipped with a spherically shaped layered borehole 31. Fixation piece 1 has an axially arrayed tension element 4, permitting axial displacement and wedging of conical head section 11 in the borehole 21 that corresponds with it. The fixation device is appropriate for use as a plate/screw system, an internal or external fixator, and in particular for spinal column fixation.

Abstract: The invention provides devices and method for performing extremely small-scale, minimally-invasive microsurgery such as thoracoscopic coronary artery bypass grafting. The instruments of the invention utilize a symmetrical, forcep-like actuator which provides extremely precise actuation and control of the instrument and which mimics the feel of instruments used in conventional open surgical procedures. The instruments generally include a pair of coaxially arranged shafts, an end-effector at the distal ends of the shafts, and an actuator at the proximal ends of the shafts. The actuator includes a pair of arms pivotally coupled to one of either the outer or inner shaft, and a pair of links pivotally coupled at one end to the arms, and at a second end to the other of the shafts. The links are coupled to a proximal portion of the arms to maximize mechanical advantage and reduce interference.

Abstract: An instrument for facilitating the use of sutures in laparoscopic surgical procedures includes a hollow housing defining an internal cavity. A plunger extends within the cavity of the housing and is supported therein for relative sliding movement between first and second axial positions. A spring disposed within the cavity urges the plunger to the first axial position relative to the housing. An introducer needle is secured to the housing and extends co-axially therefrom, terminating in an angled tip having a sharp point. An actuator tube is disposed within the introducer needle and is secured to the plunger for axial movement therewith relative to the housing. A flexible wire is disposed within portions of the actuator tube and is secured thereto for axial movement with the plunger. The wire is folded back over itself to form a looped end. When the plunger is in the first axial position, the looped end of the wire is withdrawn within the angled end of the introducer needle.

Abstract: A method of removing carious tooth material is effected by creating a laser light beam from a pulsed laser light source, and utilize a flexible light guide to direct the laser light beam as a light spot on carious tooth material of a tooth. The light source has a wavelength in the range from substantially 320 to 520 nm and the energy density per pulse in the light spot is substantially 0.14 to about 7.0 J/cm.sup.2.

Abstract: A method and apparatus for anchoring suture to bone includes an anchor formed by twisting a wire to provide a loop with two legs extending distally from the twist. Each leg bends outwardly through 180.degree. to define respective knee segments between inner and outer leg segments, the outer leg segments terminating in sharp points for penetrating a bone tunnel wall. The outer leg segments are initially parallel and define an anchor width smaller than the bone tunnel diameter, thereby permitting the anchor to be inserted into and removed from the tunnel. The anchor is deployed with an insertion tool arranged to deformably pivot the outer leg segments about the knee segments, thereby causing the pointed ends to penetrate the tunnel wall in response to applied withdrawal forces. The anchor wire may be assembled on an anchor sleeve through which the loop projects proximally while the outer leg segments reside in wire relief recesses defined in the sleeve periphery.

Abstract: A laser operation and control system preferably comprising a laser adapted to be grasped by a user and freely passed over a treatment area, control circuitry for activating and deactivating the laser, at least one boundary sensor operable to transmit a signal to the control circuitry to deactivate the laser upon passage thereof beyond a boundary of the treatment area and to transmit a signal to the control circuitry to activate the laser upon passage thereof within the boundary, and at least one proximity sensor for transmitting a signal to the control circuitry to deactivate the laser should the proximity sensor fail to sense a substantially solid surface within a predetermined distance therefrom and for transmitting a signal to the control circuitry to activate the laser should the proximity sensor sense such a surface.

Abstract: A method of putting a two-duct probe into place in the tear ducts using a hollow cylindrical cannula which is closed at its distal end, with an oblong opening being formed in the vicinity of the distal end. A slot extending proximally from the opening allows a narrowed portion of a guide filament attached to each end of a two-duct probe to pass in order to disengage the cannula from the filament. The cannula is removed from the tear duct and the ends of the guide filaments are each pulled into the nose to place the probe into the tear ducts.

Abstract: A removeably attachable wrist band device for use in helping an addicted cigarette smoker permanently quit smoking. The device comprises an elastic section, a hook fastener section, a loop fastener section, and an acupressure stimulator. The device is placed on a user's wrist such that the acupressure stimulator is positioned proximal to the L-7 acupuncture point and the elastic section of the wrist band is positioned on top of the user's wrist. The elastic section of the wrist band is designed to limit the maximal energy that the user can transfer to a unit area of skin when the band is snapped against the wrist. This is so that snapping the wrist band will not be perceived as aversive to the user. The disclosed wrist band has the dual functions of providing a non-aversive behavioral modification device together with providing continuous and differential stimulation of the L-7 acupuncture point, which has therapeutic value in treatment of smoking addiction.

Abstract: A dock leveler comprising a ramp hinged at its rear end to a supporting structure and movable between a generally horizontal position and an upwardly inclined position. A lip is hinged to the forward edge of the ramp and can be pivoted between a downwardly hanging pendant position and an extended position. Interposed between the ramp and the supporting structure is an inflatable bag, while a second inflatable bag interconnects the ramp and the lip. Blowers mounted beneath the ramp supplies low pressure air to both bags, and inflation of the first bag will move the ramp upwardly to the inclined position, while inflation of the second bag will move the lip from the pendant to the extended position.

Abstract: A Verres needle suturing device. The spring loaded probe of a Verres needle assembly is modified to include an angled guide for guiding the end of a piece of suture material from the channel of the probe out of the opening of the probe so that it can be snared by a snare introduced into the surgical site. The invention is particularly useful for relatively inaccessible surgical sites, such as result from endoscopic and laparoscopic surgery.

Abstract: A reusable endoscopic surgical instrument includes a tool assembly and a detachable handle. The tool assembly consists of an outer sleeve to which a surgical jaw assembly such as scissors or graspers is mounted. An inner extension is mounted inside the sleeve and is longitudinally translatable with respect to the sleeve. When the distal end of the extension is in engagement with the jaws of the jaw assembly, translation of the extension causes the jaws to open and close. The extension can be translated out of engagement with the jaws to permit disassembly of the instrument for cleaning and changing jaw assemblies. The tool assembly is retained within the handle assembly. The sleeve is retained within the handle in a longitudinally stationary position with respect to the handle, while the extension is permitted to move longitudinally within the sleeve.

Abstract: A spinal fastening apparatus for use in spinal fixation systems, comprising a bone screw, a collar and a locking pin. The bone screw has a threaded shaft portion with a generally longitudinal axis and a head portion having an eyelet with a central bore. The collar is generally U-shaped with a transverse axis and a slot adapted for placement over the eyelet portion of the screw. The elongated locking pin has an outer surface with gripping means on at least a portion of the outer surface and is sized and shaped to be slidably inserted through the eyelet. Surface portions of the collar and eyelet each include means for engaging the gripping means of the pin when the pin is inserted through the eyelet bore and the eyelet occupies the slot of the collar. The collar is capable of pivoting in relation to the eyelet to adjust for angulation between the longitudinal axis of the threaded shaft and the transverse axis of the collar and being locked into a selected angled position.

Abstract: A flexible electrode circuit laces through a slit sleeve to expose electrodes outside the sleeve while enclosing the rest of the circuit within the sleeve. A stiffener member extends through the sleeve to support the sleeve and the flexible electrode circuit. The stiffener member is preferably connected to and constrained at opposite ends by a hub and a base to urge the stiffener member, the sleeve, and the electrode circuit into a predetermined curvilinear contour.

Abstract: A coupling system for detachably connecting a surgical tool to a driver to form a surgical instrument. The coupling system includes two members. The first member has a cylindrical body with at least one, preferably two, projection(s) or lobe(s) protruding from the body. The second member has a cylindrical recess, at least one (two if two projections are present on the opposite member) longitudinal passageway(s) adjoining the cylindrical recess, and at least one undercut recess adjoining both the cylindrical recess and the passageway. A reversible rotation blocking mechanism is also present. Preferably, an axial cannula is present in the coupling. A kit and a method of surgery are also disclosed.

Abstract: An ear piercing apparatus is disclosed which comprises a pistol (1) and a disposable cassette (20) mounted on said pistol, the pistol (1) having a body portion (10), a handgrip (11), a spring biased plunger (12) and means for releasing said plunger from a cocked state, with said disposable cassette (20) comprising a stud housing (22) positioned adjacent said body portion (10) for cooperation with said plunger (12) and a back clasp housing (23) cooperating with the stud housing (22) via a guide member (33) extending from the back clasp housing (23) and passing into the stud housing (22) for cooperation with positioning means controlled by a positioning lever (38) on said pistol (1) for relative axial displacement of the stud housing (22) and the back clasp housing (23).

Abstract: Apparatus in the form of a trocar adapted for penetration of the wall of a blood vessel, such as the ascending aorta, contains an inflatable diaphragm carried in a collapsed condition within the interior of the trocar and an appropriate fluid connection of the diaphragm to a source of inflating fluid effects the expansion of the diaphragm and release from the trocar into occluding relation with the blood vessel wall to obstruct the flow of blood through the occluded passage.

Abstract: In a suturing instrument for remote suturing of the edges of tissue wherein a stationary and a pivotal jaw are arranged at the distal end of an instrument shaft and a suturing wire guide channel extends through the instrument shaft for supplying a suturing wire from the instrument's proximal end to the stationary jaw and wherein an outer tube is movably disposed on the instrument shaft for engaging the pivotal jaw to move it toward and from the stationary jaw and hold the jaws in an operating position in which they are arranged parallel to one another, the jaws have spaced wire guide grooves with groove bases defining, in the operating position of the jaws, a screw line which is followed by the suturing wire when it is advanced by advancing means operated by a handle disposed at the proximal end of the suturing instrument.

Abstract: An ablation catheter system, including a guiding/mapping catheter assembly and a laser catheter. The guiding/mapping catheter includes ring electrodes, tip electrodes, a moveable fixation wire, and a central catheter lumen for an ablation catheter. A laser catheter includes an optical fiber for passing laser energy, tip electrodes, an optical fiber port, and thermocouples on the end of hypodermic tubing.