Abstract: A method of forming an elongate, flexible drive shaft which has utility as a rotational atherectomy device. In accordance with this method, an inner helical coil having a lumen and a proximal end is formed by winding a plurality of wires about a forming mandrel. An outer helical coil having a lumen and a proximal end is formed by winding a single wire with a mandrel-less coil forming machine. The inner helical coil is positioned within the outer helical coil to define a drive shaft. The inner and outer helical coils are oriented such that the inner helical coil is wound in a direction opposite that in which the outer helical coil is wound.

Abstract: Mechanical retractors for bluntly dissecting tissue at a remote surgical site include extendable elements disposed near the distal end of an elongated cannula body with direct mechanical linkage to manual actuators disposed near the proximal end of the cannula body. Individual extendable elements may be arranged in symmetrical or asymmetrical configurations about the central axis of the body for selectively bluntly dissecting bodily tissue in patterns of greater diversity than merely omni-radially as provided by conventional pressurizable balloon tip cannulas.

Abstract: A device useful in minimally-invasive procedures involving the visualization, dissection and/or harvesting of vessels in the body includes a shaft having a handle mounted on one end and a dissecting tip on the other end. The dissecting tip optionally includes a light source for directing light transverse of the tip and structures to retain the tip in position adjacent the vessel as the tip is advanced along the vessel. Also disclosed are associated methods for transilluminating a vessel, dissecting the vessel from surrounding tissue, and transecting the vessel and side branches and removing the vessel from the body.

Abstract: A system and method for performing a reshaping of a cornea of an eye for improved vision is presented. The system comprises a first appartus for determining dark adapted pupil size of an eye and a second apparatus for reshaping a cornea of the eye in an area approximately equal to the dark adapted pupil size as determined by the first apparatus. The method of the present invention involves dilating the pupil of an eye to its dark adapted size, determining the diameter of the dilated pupil, and ablating the cornea of the eye to match the dilated pupil size. The advantage to using such a system and method when reshaping a cornea of an eye is reduced halo effect or improved night vision.

Abstract: A cannula (10) receives surgical instruments (120) for performing a surgical procedure on a body (130). The cannula (10) comprises a tube structure (12) defining a passage (16) through which the surgical instruments (120) are inserted into the body (130). The tube structure (12) has a proximal end (20) and a distal end (62). The tube structure (12) includes an expandable portion (40) for enabling an increase in the cross-sectional area of the passage (16) at the distal end (62). The expandable portion (40) of the tube structure (12), when expanded, has a conical configuration.

Abstract: A surgical knife which provides improved multi-sided incisions and is preferably allows for a substantially cruciate, or cross-shaped incision. The surgical knife includes a handle and a multi-bladed portion located at one end of the handle. The handle is sized and configured to maximize grip and surgical manipulation thereof. The multi-bladed portion is formed from a primary blade and a secondary blade. The primary blade is configured with two exemplary primary blade members. The primary blade members are formed with sharpened edges which combined to form a sharpened distal point of the primary blade. The secondary blade is formed with sharpened edges and cooperates with the primary blade. The coupling of the primary blade and the secondary blade is such that the distal end of the secondary blade is located at a distance from the sharpened distal point of the primary blade.

Abstract: A catheter includes an introducer and a flow isolator adapted for disposition in a primary conduit to facilitate flow in the primary conduit while inhibiting flow and intersecting secondary conduits. The flow isolator may include a tubular mesh and surrounding balloon structure. Alternatively, a sleeve can be provided with a primary opening and a secondary opening which are sized to inflate the sleeve with the body fluid. Structures for deploying the sleeve between a low-profile state and high-profile state may include expandable fingers, or pneumatic chambers inflatable from an external source. In operation the sleeve can be forced by the body fluid against the intersection with the secondary conduits to achieve isolation. Alternatively, the pneumatic chambers can be inflated to form seals with the primary conduit. A blood filter or snare is contemplated to filter any blood clots which may develop around the flow isolator.

Abstract: A disposable lancing element is adapted for use in a lancing device for making an incision through a user's skin. The lancing element includes a body which defines a longitudinal axis, and has a skin-lancing member projecting from a front end thereof. A capillary tube is mounted in the body in laterally spaced relationship to the skin-lancing member and is slidable longitudinally relative to the body so as to be extended forwardly past the skin-lancing member. The body includes a plurality of circumferentially spaced, radially outwardly projecting bosses formed thereon for guiding the disposable element installation in a carrier element. The skin-lancing member may comprise a plurality of needles or barbs arranged in parallel side-by-side relationship. In lieu of a skin-lancing member, the disposable element may possess a longitudinal through-hole for conducting a skin-piercing laser light beam or pressurized fluid. A capillary tube may have an outwardly flared lower (inlet) end.

Abstract: A guide wire is disclosed which has a radiopaque distal lip and three or nor discrete highly radiopaque sections separated by relatively non-radiopaque sections. The highly radiopaque sections may be formed of coils and may have a width greater than their diameter. A method of marking the position of an intravascular anatomical feature (e.g., a stenosis) using the guide wire is also disclosed.

Abstract: An apposition sensing system including a stent; a catheter assembly to which the stent is coupled for deployment into a lumen; and a sensor positioned on the catheter assembly adjacent to an end of the stent. The sensor is adapted to provide an electrical parameter which is indicative of apposition of the end of the stent to the inner wall of the lumen. In one aspect of the invention, the sensor includes first and second pressure sensors positioned at proximal and distal portions of the catheter assembly adjacent to proximal and distal ends of the stent. A monitoring unit monitors pressure changes sensed by the sensors. In accordance with an alternative embodiment of the invention, there is provided an expansion sensing system including a stent having an electrically conductive region; an expandable insulating sleeve; a catheter assembly to which the stent is coupled for deployment into a lumen; and at least one electrode associated with the catheter assembly.

Abstract: Disclosed is a method for excluding a pathological defect such as an aortic aneurysm. By the disclosed method, a grafstent complex is advanced through each branch of the patient's femoral and iliac system. The graftstent complex includes a segment of graft material attached at each end to a respective stent. The cephalic stents of each graftstent complex are positioned relative to one other in a common region of normal aortic tissue on one side of the aneurysm and then deployed. The caudal stents are deployed in the iliac arteries. Additional steps can be taken to ensure that the internal iliac artery is not blocked when the caudal stents are deployed.

Abstract: A laparoscopic surgical scissors for cutting tissue is disclosed. The laparoscopic surgical scissors has a handle body assembly having an actuation member moveable toward and away from the handle body assembly. An elongated shaft having a proximal and a distal end that define a longitudinal axis is connected to the handle body assembly at the proximal end of said shaft. A pair of cutting blades have a first blade member and a second blade member that are co-operably connected about a common pivot member adjacent to the distal end of the elongated shaft. The common pivot member defines a common pivot axis perpendicular to the elongated shaft. The first blade member has a first cutting edge and the second blade member has a second cutting edge facing the first cutting edge. The blade members have a single point of blade contact translating proximally and distally as the blade members open and close in response to movement of the actuation member away from and toward the handle body assembly.

Abstract: An ultrasonic treating tool comprises a gripping section incorporating an ultrasonic vibration element for generating an ultrasonic vibration, a vibration transmitting section for transmitting a vibration from the ultrasonic vibration element to a distal end, a clamping member opened and closed relative to the probe, and a handle provided at the gripping section to open and close the clamping member, in which a force applying point of the handle is displaced more on a proximal end side than at a swing center of the handle and the acting direction of a force application point is toward and away from the gripping section.

Abstract: An instrument for application in endoscopic surgery has a shaft provided with a plurality of ducts, two of which receive forceps elements and at least one of which receives a surgical instrument for cooperation with the forceps elements. Each of the forceps elements has a distal end pivotal about a pivot axis which extends orthogonally to a longitudinal axis of the shaft, so that the distal ends of the forceps elements can be displaceable at a distance greater than on outer dimension of the shaft upon its insertion into a corporeal cavity.

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: The present invention is directed to a device and methods for immobilizing a localized region of a compliant body. A device of the invention includes at least two arms, an elbow region between the arms, and a suction arrangement. During use the region of the compliant material to be immobilized is flanked by the arms and a negative pressure is applied through the suction arrangement to immobilize the flanked region. The device of the invention is suited for use in medical applications, for example, coronary bypass graft surgery.

Abstract: A method and apparatus for transurethral resection of the prostate, which includes inserting a transurethral incisional device through the patient's urethra, incising off at least one piece of targeted prostatic tissue using the incisional device, inserting a morcellation probe through the patient's urethra, morcellating the excised piece of targeted prostatic tissue with the morcellation probe, and aspirating the morcellated prostatic tissue through the morcellation probe and out of the patient. The morcellation probe of the present invention includes an elongated inner probe tube that defines an aspiration channel therein and an aperture with opposing cutting edges formed adjacent to its distal end. The inner probe tube is slidably disposed inside an outer probe tube, and moves relative thereto in a longitudinal reciprocating manner. The outer probe tube has an open distal end and another aperture with opposing cutting edges.

Abstract: An endoscopic bipolar forceps comprises an elongated tubular member dimensioned to fit through the working lumen of an endoscope where the tubular member includes a handle at its proximal end and a pair of end effectors at its distal end and with a lumen extending between them. The end effectors each have a metal tissue cutting and tissue sample capturing and retaining element facing one another and capable of being open and closed by manipulating the handle. Each of the end effectors includes an electrode supported by and insulated from it. A push rod coupling the handle to the end effectors for inducing the pivotal movement thereof also serves as an electrical conductor for applying a first potential to the metal tissue cutting and tissue sample capturing and retaining element. A second conductor extends through the lumen of the tubular member and is electrically connected to the electrodes on each of the end effectors.

Abstract: An intracranial bolt, for installation in an opening in the skull to provide access to the brain for a medical device, has a bore therethrough for the passage of the medical device, and an inflatable member in the bore which when inflated engages a medical device in the bore, releasably anchoring the device. The inflatable member comprises a cylinder of flexible sheet material inside the bore and secured to the wall of the bore defining an annular pocket therebetween. A passage extends through the bolt to the pocket for the introduction of fluid into the pocket to expanding radially inwardly. The bolt in a medical procedure on the brain by forming an opening in the skull; installing the intracranial bolt in the opening in the skull; and securing the cap on the bolt. When it is time to conduct the procedure, the cap is removed and a medical device can be inserted into the brain through the bolt. The inflatable member can be inflated to temporarily hold the medical device in place.

Abstract: A guide wire brake for use in an ablation assembly includes a clamp positioned in and between recesses provided in an air-actuated piston and a retainer. The clamp is provided with a first member and a second member coupled together on opposite sides of a spring member. An outer surface of the clamp is tapered to matingly engage the tapered inner surface of the first and second recesses. In operation, the piston is in fluid communication with a source of air. As air contacts an inner surface of the piston, the piston moves toward the retainer, thereby pushing the first and second recesses together along the tapered outer surface of the clamp. This action causes the first and second members to overcome the spring force of the spring member, and clamp together against a guide wire extending therethrough, thereby preventing longitudinal and rotational motion of the guide wire.