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is maintained in the exposed position by a latching mechanism associated with the obturator shaft, and is automatically withdrawn into the cannula under the force of a spring when the proximal force is removed from the cannula, the cannula thus advancing distally and releasing the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 fracture reduction clamp for the reduction of a fractured bone. The fracture reduction clamp is particularly suitable for surgical procedures wherein a bone having a fracture is to be fixated with a fixation apparatus after reduction of the bone with a strap. The fracture reduction clamp includes a bifurcated strap guiding head for contacting and firmly gripping the fractured bone, and a strap retainer disposed between the strap guiding head and a rotatable strap tensioner for retaining the ends of the strap being used to reduce the fractured bone. The strap guiding head can include a retractable spike for enhancing the grip of the fractured bone by the fracture reduction clamp. Rotation of the strap tensioner will tighten or loosen the strap about the fractured bone.

Abstract: Percutaneous tissue removal apparatus comprises a flexible drill shaft, a cutting tip mounted on the shaft for placement adjacent a tissue mass for cutting the tissue, means for transmitting motion to the shaft to move the cutting tip against the tissue to cut tissue fragments from the tissue, and means for removing the tissue fragments along the shaft by suction to a location outside the tissue mass while cutting. The apparatus may include means for collecting one or more selected components of the harvested tissue fragments for implantation of the fragments preferably into the body of the patient from whom they were removed. Where the tissue to be cut is bone, a cutting tip is preferably made of a polymeric material which is softer than the cortical portion of the bone, although the cutting tip may be made of a ceramic or a composite material. A second flexible shaft may be provided either within or about the flexible drill shaft.

Abstract: A balloon catheter is provided having an expandable distal portion and balloon protector means comprising a first removable sleeve having a variable inner diameter to ease sliding the first sleeve over the balloon, and an optional second removable (outer) sleeve positioned over the inner sleeve, the second (outer) sleeve having a constrictive relationship with the first (inner) sleeve, said first and second sleeves being removed prior to use of the catheter.

Abstract: An apparatus for reducing a medical device such as a stent in size is formed of cooperating crimping dies which are joined via a crimping die moving device. As the cooperating dies are moved together, an inward force is applied to the medical device to reduce the medical device in size.

Abstract: A surgical cutting tool which is provided with means enabling suction to be applied to the site of operation of the tool. The tool may for example be a pair of surgical scissors or a surgical scalpel. The tool may be provided with a mechanism for effecting cauterization, and/or clamping tissue on which the surgeon is operating.

Abstract: An apparatus and method for forming and enlarging percutaneous penetrations comprises an elongate dilation member which receives an elongate expansion member in an axial lumen thereof. The dilation tube includes a tubular braid which usually comprises a mesh of non-elastic filaments which are radially expandable from a small diameter configuration to a large diameter configuration and which is optionally covered by a removable sheath. The dilation tube is percutaneously introduced to a target site within a patient's body, usually within the abdomen in a laparoscopic procedure. The sheath (if present) is then removed, and the tubular braid thereafter radially expanded by axial insertion of the expansion member through its lumen. The tubular braid is anchored by axial shortening of the mesh and remains in place to permit subsequent exchange of dilation members to provide for different diameter access lumens.

Abstract: Microsurgical instruments for performing extremely small-scale, minimally-invasive microsurgery such as thoracoscopic coronary artery bypass grafting. The instruments 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 the outer and inner shafts, 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. The actuator may be easily adapted for either pull-type or push-type actuation, and for either outer shaft or inner shaft translation.

Abstract: A surgical sliding shaft instrument (10) comprising a guide element (12), which is provided with a carriage (14). It further includes a grip part element (16), which is comprised of a stationary grip part (18), one end of which is provided with a grip trunk (20) pivotably linked to the guide element (12) and also releasably inter-locked with the guide element (12). It further includes a movable grip part (22), which is pivotally connected to the grip trunk (20) and, via a push part (24) extending through a slit in the grip trunk (20), is in operable engagement with the carriage (14). A compression spring (28) tensions or biases the movable grip part (22) in a rest position. An inter-locking element (26) serves for releasable connecting of the grip trunk (20) and guide element (12). The compression spring (28) is integrated in the carriage (14) and pretensions both the carriage (14) as well as the movable grip part (22) in a rest position.

Abstract: A encapsulated stent device for implantation within the vascular system includes a balloon of a balloon catheter formed around and adhered to a wire-like stent so that the outer surface of the device is more regular for delivery through the vascular system without an exterior sheath. The encapsulation securely anchors the stent to the balloon and maintains a low profile for negotiation of tortuous and narrowed vessels. Encapsulation requires placement of the stent over the balloon, placement of a sheath over the stent on the balloon, heating and preferably pressurization of the balloon to cause it to expand around the stent within the sheath, and cooling while preferably maintaining pressure to cause the balloon to adhere to the stent and to set the shape of the expanded balloon. Retainers may be placed at the distal and/or proximal ends of the stent during the encapsulation process, or the balloon material may expand to form retainers.

Abstract: A curved ultrasonic blade including a concave top surface, a convex bottom surface and a central ridge running along the concave top surface is described. In a curved blade according to the present invention the blade has a cross section which is substantially trapezoidal. The blade edges may be sharp or blunt and the convex bottom surface has a width of at least two times the width of the central ridge and, preferably, three times the width of the central ridge. A balanced ultrasonic instrument including a curved blade having a trapezoidal cross section is also described. A balanced ultrasonic surgical instrument according to the present invention includes an ultrasonic transmission rod which is connected to the curved blade by a balance portion which includes first and second balance asymmetries designed to compensate for the imbalances induced by asymmetry of the curved blade.

Abstract: An apparatus and method for treating cerebral blood vessels such as carotid arteries. The system generally includes an apparatus and method for safely and easily deploying a self-expanding stent in a vessel while preventing embolic migration using a filter.

Abstract: The present invention provides a technique for treating diseased portions of tissue lumens by the focal introduction of at least one therapeutic agent at the diseased region. A catheter is positioned in a lumen such that first and second expansile members surround the diseased portion of tissue. The expansile members are expanded to occlude the diseased region and a therapeutic agent is introduced to the occluded diseased region via the catheter. The catheter is allowed to remain in place for a therapeutically effective period of time to allow the therapeutic agent to contact the diseased portion for such a period of time. The catheter arrangement also can be used to occlude a diseased region, remove physiological fluid from the occluded region and subsequently to disrupt the diseased region and/or apply the therapeutic agent. The therapeutic agent can be selected to suppress cell proliferation in the diseased region, and the occluded region can be treated with a medicament to promote vessel healing.

Abstract: A driven rotary incision scalpel having a pistol handle-shaped housing halves providing for mounting of a small form factor motor having a drive shaft. A gear on the front end of the drive shaft is enmeshed with the inner teeth of a ring gear of a two-stage reduction mount, which in turn drives a bevel gear that is enmeshed with a second driven bevel gear on a hollow rotary scalpel. When a trigger assembly is pulled backward and locked in, the outer barrel simultaneously moves to the rear, causing the front end of the hollow rotary scalpel to extend and switching on the motor that drives the blade at the front end into synchronous rotation.

Abstract: An orthopedic implant assembly comprising a stabilizing element, a securing element which attaches the stabilizing element to the bone, and a stopping member in the stabilizing element which inhibits the securing element from loosening or backing out of the bone. The stabilizing element has at least one bore with the stopping member therein. In one embodiment, the stopping member has a reversibly expandable inner and outer diameter to allow the securing element to pass posteriorly through the stopping member, but thereafter prevent or inhibit the securing element from anteriorly backing out of the posterior section of the transverse passageway.

Abstract: An acupressure device for use on a selected skin surface portion of a human body. The device comprises a thin flexible base sheet having a first side, a second side and a margin. The margin has at least a portion of its length shaped as an orienting margin, wherein the orienting margin is shaped to correspond to a shape on, or adjacent to, the selected skin surface portion when the base sheet is placed on the selected body surface. An adhesive layer is on the first side of the base sheet that is suitable for attaching the base sheet to the selected skin surface portion. There is at least one bead on the adhesive layer suitable for positioning against the selected body surface that will provide acupressure to at least a portion of the selected body surface when the acupressure patch is placed against the selected body surface.

Abstract: In accordance with the present invention, there is provided a method of making a stent-graft for insertion into target site within a vessel of a patient. The graft has a crimped state for delivery to the target site, and an expanded state for implantation therein. The method uses a self-expanding tubular elastic outer stent having a crimped and expanded state, and includes the step of expanding the outer stent to its expanded state. The method also uses a tubular flexible porous graft member and includes the step of inserting the graft member along an interior of the outer stent. The method also uses a self-expanding tubular elastic inner stent, and includes the step of crimping the outer stent to a diameter smaller than a diameter of the expanded outer stent. The method then continues by inserting the inner stent within an interior of the graft member, and expanding the inner stent such that the inner stent, the graft member and the outer stent are all abutting.

Abstract: An emboli capturing system captures emboli in a body lumen. A first elongate member has a proximal end and a distal end. An expandable emboli capturing device is mounted proximate the distal end of the first elongate member, and is movable between a radially expanded position and a radially contracted position. When in the expanded position, the emboli capturing device forms a basket with a proximally opening mouth. A second elongate member has a proximal and a distal end with a lumen extending therebetween. The lumen is sized to slidably receive a portion of the first elongate member. An expandable delivery device is mounted to the distal end of the second elongate member and is movable from a radially retracted position to a radially expanded position. The delivery device has a receiving end configured to receive the emboli capturing device, and retains at least the mouth of the emboli capturing device in a radially retracted position.

Abstract: Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.

Abstract: An expandable orthopedic drill includes a shaft provided with a handle at is proximal end. Several cutters are supported around the hub by a linkage which maintains the edges of the cutters at a predetermined angle to the axis of the tool. The cutters are driven outward from the shaft, expanding the effective size of the drill, by means of a sleeve. The sleeve is driven along the shaft by turning a nut engaged with threads on the shaft. Tapered holes may be produced by changing the lengths of the links.