Abstract: A tissue gripping device for use with a cannula. The device includes a housing member which has a generally cylindrical shape and is provided with a plurality of slots about its circumference. A cannula locking collet and collar are provided along with a tissue gripping member so that the entire device fits over a cannula and is secured thereto. Once the cannula is positioned in the body wall of a patient, the tissue gripping member is moved towards the housing member so that a plurality of finger-like expansion members protrude through the slots in the housing member to anchor the tissue gripping device and the cannula in place for a surgical procedure.

Abstract: Diseased portions of tissue lumens can be advantageously treated by the focal introduction of at least one therapeutic agent to the lumen at the diseased point. This can be accomplished by(a) introducing a catheter into the tissue lumen, said catheter comprising first and second expansile members and means for supplying therapeutic agent into a space between said first and second expansile members, and said catheter being positioned such that said first and second expansile members are disposed on opposite sides of the diseased region;(b) expanding the expansile members to occlude the diseased region of the tissue lumen;(c) introducing therapeutic agent to the occluded diseased region via said means for supplying therapeutic agent;(d) allowing the catheter to remain in place for a therapeutically effective period of time;(e) contracting the expansile members; and(f) removing the catheter.

Abstract: A surgical instrument that includes a rigid outer member within which is disposed a hollow inner member having rigid proximal and distal ends and a region disposed between the rigid proximal and distal ends that is relieved to render such region relatively flexible. The flexible region is integral with a portion of the proximal end disposed adjacent to the flexible region. The inner member transmits force (such as torsion) applied to its proximal end to move a cutting implement disposed at its distal end and cause it to cut tissue admitted through an opening in the distal region of the outer member. In another aspect, a region of the inner member is weakened (e.g., by relieving an integral region of the member) with respect to the remainder of the inner member to cause this region to break if the force (e.g., torque) applied to the inner member exceeds a predetermined threshold.

Abstract: A surgical instrument is provided that comprises two coaxial tubes mounted for relative telescoping motion, and a unitary jaw piece of springy material affixed to the remote end of one of said tubes and having two jaws normally biased apart to a selected open position. The other one of said tubes is movable longitudinally relative to said one tube so that the forward end of the said other tube forces the jaws to close. The jaw piece includes a body section joined to the two jaws by spring leaves having a selected configuration, with the result that when the jaws are moved to closed position, the forward ends of the jaws engage one another before there is any engagement between the rear ends of the jaws. The jaw piece also has an opening permitting introduction of an ancillary device to a position permitting communication with the space between the jaws.

Abstract: Surgical forceps, for example for endoscopic use, having distal mouth parts which are actuated by means of proximal grip sections via a rod and are mounted displaceably in the tubular forceps housing. An overload safety device, which prevents further actuation on exceeding a certain actuation force by radially deflecting the rod or a section of it against spring action and positively engaging it with a fixed part of the forceps housing, is provided to protect the sensitive mouth parts.

Abstract: An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

Abstract: An improved valve cutter for in-situ incision of valve leaflets which safely, efficiently, and consistently renders venous valves incompetent while minimizing frictional forces on the endothelium of the vessel and preventing inadvertent contact between cutting surfaces and the intima of the vein wall. The valve cutter includes a plurality of proximally directed prongs presenting sharp edges, where the prongs are separated by slots similarly presenting sharp edges to pierce the valve leaflets so that the cutting head is provided with a continuous cutting surface in multiple planes running along the entire forward edge of the cutting head.

Abstract: A surgical instrument includes a motor, a dissecting tool coupled to the motor for rotation about an axis of the motor, the motor further including a base at one end thereof. The motor is further provided with an elongate member extending from the base and parallel to the motor axis. A foot member extends laterally from a terminal end of the elongate member for protecting selected portions of tissue from exposure to the cutting action of the dissecting tool. The surgical instrument is further provided with indexing means to permit selective rotation of the elongate member relative to base from one of a plurality of angular positions to another of the plurality of angular positions, and to secure the elongate member in a selected angular position.

Abstract: A safety trocar is provided in which the cannula is reciprocally mounted to the cannula housing and reciprocates into the cannula housing when a proximally directed force is applied thereto. The piercing tip is maintained in the exposed position by a latching mechanism associated with the obturator shaft, and is automatically withdrawn into the cannula under the force of a spring when the proximal force is removed from the cannula, the cannula thus advancing distally and releasing the latching mechanism. Penetration force is maintained at a minimum, and safe and efficacious trocar entry is facilitated.

Abstract: A catheter system for mechanical dilatation of coronary arterial stenoses includes a balloon dilatation catheter, a guide wire and a guide catheter. The balloon dilatation catheter has, for the perfusion of vessel fluid during dilatation, side openings arranged both distal and proximal of the balloon and connected to one another via a lumen extending within the balloon. The internal lumen configuration of the balloon dilatation catheter permits the catheter system to be utilized as either a "monorail"-type or an "over-the-wire" system.

Abstract: A balloon dilatation catheter comprises a flexible, tubular catheter shaft which carries a dilatation balloon adjacent the distal end. The catheter shaft defines an inflation lumen communicating with the balloon and a guidewire lumen extending at least most of the length of the catheter and extending through the catheter distal end. A longitudinal slit is defined in the catheter shaft between the guidewire lumen and the catheter exterior. This slit longitudinally extends along the majority of the catheter length from a position proximal of the balloon to a position that is at least adjacent the catheter proximal end.

Abstract: A trocar system comprises a trocar housing, a pointed stylet arranged so that the pointed tip can be selectively extended outwardly (distally) from the trocar housing, a return spring in the trocar housing for retracting the stylet into the housing and a piston and piston latch system disposed within the trocar housing for restraining the stylet from retracting. The piston includes a cam element for de-latching the piston from its latched position to allow the return spring to retract the piston into the housing. The stylet engages the piston in a slot to permit limited longitudinal movement of the stylet into the housing. A distally-biased element which carries an engaging pin and is forced to move proximally by the tissue resistance experienced as the trocar is forced to puncture a body cavity wall, automatically moves to its original distal location after the tip of the trocar has completely passed through the wall.

Abstract: A balloon dilatation catheter adapted for use in percutaneous transluminal coronary angioplasty has an integral guidewire. The balloon and its supporting members are not attached to the guidewire at their distal ends. The supporting members are attached at their proximal ends to the guidewire. The guidewire has an increased freedom of rotational movement and the balloon and its supporting members do not adversely twist about the guidewire.

Abstract: An improved laparoscopic medical retractor for separating body parts during a surgical procedure to thereby create or maintain a surgical cavity. The retractor comprises an interior rod having a distal end and a proximal end and an exterior tube positioned to receive the central rod, the exterior tube having a distal end and a proximal end. A plurality of straps having their distal ends are coupled to the distal end of the interior rod and have their proximal ends coupled to the distal end of the exterior tube. The straps are flexible whereby movement of the distal end of the exterior tube distally toward the distal end of the interior rod will cause the straps to assume a generally spherical configuration, the total diameter of the retracted device being less than 1.5 centimeters. Coupling means secure the interior rod and exterior tube against relative axial movement with respect to each other so that a surgeon may move the expanded retractor to enlarge a surgical cavity in which it is located.

Abstract: A surgical scalpel (10) is provided with a retractable guard (11) for its cutting blade (12). The guard (11) is mounted on the handle (24) of the scalpel (10) for sliding movement between an advanced position in which the blade (12) is covered and a retracted position in which the blade (12) is exposed. The guard (11) may be moved with one hand, and the surgeon, nurse and/or assistant does not have to take his or her eyes away from the patient or the instrumentation during a surgical procedure. A two-position resiliently-biased manually-releasable detent member (29), is disposed within the longitudinal center plane (30) of the handle (24) and extends above the handle (24). A cut-out (49) on the bottom wall (15) of the guard (11), together with the detent member (29), facilitates the one-hand actuation of the guard (11). A slot (25) on the guard (11) and a pin (26) or the handle (24), limits the sliding movement of the guard (11) independently of the detent action. Two embodiments are disclosed.

Abstract: The present coaxial traction detachment system improves intravascular occlusion by providing a means for greater control in the placement of endovascular devices. The detachment apparatus (10) includes a guide wire (16) slidably disposed within a sheath (14). An endovascular device (18) is attached to the distal end of the guide wire (16). The sheath (14) is guided through a catheter (12) to a device detachment location. The device (18) is attached to the wire (16) either by a glue or solder or by mechanical means such as the intertwining of the device (18) to the guide wire (16). Following device placement and prior to detachment, the operator is able to observe the position and configuration of the device. If the position is unsatisfactory, he need only withdraw the sheath to remove the device. If placement is satisfactory, the system utilizes a coaxial detachment method such that the operator places traction on the guide wire and the device is pulled against the outer sheath, causing it to detach.

Abstract: A surgical knife having a body with a blade at one end is provided that has an attached, movable shield that can be moved between either one of two locked positions. The shield can be placed in one position in which it covers and protects the blade and in a second position where it forms a portion of the body for use of the knife.

Abstract: A surgical scalpel is provided with a retractable guard for its cutting blade. The scalpel includes a resiliently-biased locking means and a releasing mechanism for, alternatively, selectively locking the guard in an extended position for covering the blade and in a retracted position for exposing the blade. The guard is disposed on the body of the scalpel for sliding movement between its extended and retracted positions--with the use of only one hand--and without requiring the surgeon, nurse and/or assistant to take his or her eyes away from the patient. The locking mechanism produces a auditory sensory warning to signal to the user thereof that the guard is locked into either its extended or retracted position, without the necessity of visually observing the scalpel, and the locking and releasing mechanisms may be tactually located by the user and activated without visually observing the scalpel.

Abstract: An access device is adapted to facilitate introduction into a body cavity, such as the abdominal cavity, of an instrument having an elongate shaft and a bend in the shaft. The device includes a hub having a wall disposed at the proximal end of a cannula which is configured to extend into the cavity. The hub has a normal configuration with a length and diameter which inhibits passage of the bend of the shaft through the hub, but the wall of the hub is progressively bendable from the normal configuration to facilitate passage of the bend through the hub.

Abstract: According to the invention there is provided an intravascular catheter comprising an elongated flexible jacket having opposed proximal and distal ends and a central passageway extending between and interconnecting the ends. A rotating working head is located at the distal end of the jacket. A flexible drive cable extends through the passageway of the jacket, having a driving end operatively connected to the working head for rotating it, and a driven end operatively connected to a high-speed motor. The working head is rotatably mounted in a bearing sleeve which is further attached to the catheter jacket. The working head is actuated, by a actuator which adjust the a pair of tip portions from an at least initial retracted position with a first effective working diameter to an extended position with a second effective working diameter greater than the first effective diameter. Centrifugal forces generated by rotation of the cable cause the tip portions to assume the greater effective working diameter.