Abstract: A replaceable handle for side loading the proximal end of a medical device therein, which is typically inserted with the operating lumen of an endoscope. The replaceable handle can side-load the proximal end of the device into the handle for added manipulation of the distal end such as in removing a stone from the kidney or ureter leading therefrom. An inner housing is rotatable within an outer housing of the handle to secure the medical device in the housing passageway, and is spring biased to then move proximally with respect to the outer housing, moving the inner control rod of the medical device proximally to withdraw the stone basket mostly into the outer cannula and capture the stone for removal from the patient. A push button in the proximal end portion of the inner housing is depressible to permit insertion or withdrawal of the proximal end of the inner control rod of the stone retriever within the inner housing, and is releasable to secure the inner control rod in the handle.

Abstract: A rigid extractor is revealed, a rigid device for use in percutaneous procedures to remove kidney stones directly from the kidneys. The rigid extractor uses an outer rigid cannula and an inner cannula to control a basket retriever for removing kidney stones and calculi from a kidney of a patient. The extractor is desirably used with a fluoroscope, in which the surgeon maneuvers the extractor with the aid of a view of the operating field provided by the fluoroscope. The surgeon then maneuvers the extractor to grasp the kidney stones and remove from the patient. The extractor may also be used with a nephroscope. The device may also be used with a retrieval assembly other than a basket, such as a pair of jaws, or a pair of scissors.

Abstract: A medical device comprises first and second members and first and second therapeutic agents. The agents have different diffusion rates through at least one of the members, and are positioned within the medical device based on the diffusion rates. The therapeutic agent having the greater diffusion rate is positioned in the device at a location that is a greater distance from a treatment site than that of the location of the therapeutic agent having the lesser diffusion rate. Methods of making medical devices include placing two or more therapeutic agents within a device based on the diffusion rates of the agents through at least one portion of the device.

Abstract: A sling for supporting a urethra in a patient has characteristics for resisting pull-out, roll-over and a combination of both pull-out and roll-over. To facilitate resistance to pull-out, sling material has protuberances or serrations to resist movement once placed in the patient by the surgeon. Improved resistance to roll-over or roll-up is achieved by providing relief on the sling in areas potentially subjected to roll-over forces by endopelvic fascia. The sling may be used on female or male patients, and may be used in conjunction with a wider support portion to support a bladder and a urethra, rather than a urethra alone. The sling may also be used to support other tissues within a patient.

Abstract: An implantable medical device 10 such as a catheter with a pharmacologically active ingredient layered between outer and inner elongated member tubes 11 and 13 for minimizing the risk of infection or other physiological afflictions associated with the implantation thereof. The outer and inner elongated member tubes include a base material mixed with a bioactive material including, for example, one and/or the other of rifampin and minocycline. An intermediate tube or layer 18 is positioned between and in communication with the outer and inner elongated member tubes 11 and 13. The intermediate tube or layer may also include a base material of, for example, silicone with a pharmacologically active ingredient mixed therein. The slower diffusion rate minocycline is included as or part of the bioactive material in the base material of the outer and inner elongated member tubes.

Abstract: A localization device (10) comprising an outer needle cannula (11), an optional inner sleeve cannula (13) and an anchor stylet comprising a plurality of preformed superelastic alloy wires (12). Once the distal portions (14) of the wires (12) are deployed from the ends of the sleeve and needle cannulae, they function as curved barbs (15) projecting outward to anchor the device into tissue, an organ, or a foreign body. A slidable locking member (18), such as a pin vise, can be included over the outer needle cannula for securing the localization device against a template.

Abstract: A replaceable handle for side loading the proximal end of a medical device therein, which is typically inserted with the operating lumen of an endoscope. The replaceable handle can side-load the proximal end of the device into the handle for added manipulation of the distal end such as in removing a stone from the kidney or ureter leading therefrom. An inner housing is rotatable within an outer housing of the handle to secure the medical device in the housing passageway, and is spring biased to then move proximally with respect to the outer housing, moving the inner control rod of the medical device proximally to withdraw the stone basket mostly into the outer cannula and capture the stone for removal from the patient. A push button in the proximal end portion of the inner housing is depressible to permit insertion or withdrawal of the proximal end of the inner control rod of the stone retriever within the inner housing, and is releasable to secure the inner control rod in the handle.

Abstract: A brachytherapy device 10 for exposing to radioactivity a patient includes an elongate member such as a needle or cannula 12 adapted for introduction into the patient and also includes a stylet 14 slideably receivable in a longitudinal throughbore 16 in the needle 12. The device 10 also includes a portion 64 near either the proximal end 18 of the needle 12 or the distal end 24 of the stylet 14 which provides a local, defined amount of friction between the needle 12 and the stylet 14. The device 10 further includes an anti-static handle 34 connected to the needle 12. The handle 34 has an interior ramp surface 40 in communication with the throughbore 16 of the needle 12, frustoconical in shape and possessing an included apical angle of at least about 16°. The localized friction portion 64 can be a crimp or flange 48 on the stylet 14, or a crimp 44 or deformation 46 in or of the needle 12.

Abstract: A balloon-tipped, wire-guided double lumen, endobronchial blocker catheter (6) is provided for insertion into the tracheal bronchial tree using a fiberoptic bronchoscope (2). The catheter incorporates a removable wire guide (14), which runs the entire length of the catheter exiting the tip as a small unencased wire loop (12). The small unencased wire loop is positioned around the circumference of a fiberoptic bronchoscope and when advanced along the fiberoptic bronchoscope thereby allows the catheter to navigate the airway using the fiberoptic bronchoscope as a guide or stint allowing the catheter to reach portions of the lung where access is difficult due to sharp bends in the tracheal bronchial tree. A balloon (8) thereof is inflated to provide obstruction of a portion of the lung from ventilation. The long wire guide loop is removable allowing communication of the blocked segment with the proximal end of the catheter.

Abstract: A method and device 10 for providing an ostomy 102 through the wall 100 of the trachea are particularly advantageous in allowing the ostomy 102 to be formed atraumatically and to be enlarged without risk of perforating the rear of the trachea. The method employs a balloon catheter 16 including an inflatable balloon 18 and entails: positioning the catheter 16 over a percutaneously inserted wire guide 54; advancing the catheter 16 along the wire guide 54 until the balloon 18 lies across the tracheal wall 100; and inflating the balloon 18 to dilate a portion of the tracheal wall 100 and form an ostomy 102. The method desirably includes the further steps of deflating the balloon 18 and inserting a tracheal tube 20 into the ostomy 102. The method is preferably carried out with a device 10 which includes a dilator tube 12 carrying the catheter 16 and tracheal tube 20 on it. Such a construction allows the dilator tube 12, the balloon catheter 16 and the tracheal tube 20 to be advanced on the wire guide 54 together.

Abstract: A device (10, 80 or 120) for creating a sub-atmospheric pressure near the carina (12) of a human or veterinary patient (48) includes a channel (28) or perforation (92 or 132) for the passage of an oxygen-containing gas therethrough, the channel (28) or perforation (92 or 132) being open in a direction distal of the patient, so as to establish a zone (30, 94 or 142) of sub-atmospheric pressure by reverse venturi effect during patient exhalation. The sub-atmospheric pressure in the zone (30, 94 or 142) facilitates removal of carbon dioxide from the lungs (54) of the patient and permits intratracheal and/or intratracheal pulmonary ventilation to be performed at pressures less than those conventionally required for such ventilation.

Abstract: Multi-lumen wire guide introducer and method of inserting a wire guide or the like into the introducer prior to positioning the introducer in a vessel of the vascular system of a patient. The multi-lumen wire guide introducer comprises a tubular member formed of a semi-rigid plastic material such as a radiopaque polytetrafluoroethylene with first and second adjacent lumens extending longitudinally therein. In one aspect, the tubular member includes a tapered outer surface extending proximally from the distal end of the member and centered about the first lumen. The second lumen includes an opening in the tapered outer surface of the tubular member for extending a wire guide therefrom and into the blood vessel. In another aspect, the tubular member has proximal and distal portions with a first lumen extending longitudinally therethrough. The proximal portion includes a second lumen extending longitudinally therein and communicating with the first lumen prior to the distal portion.

Abstract: A multiple lumen vascular access introducer sheath having a main lumen for introduction of another device such as a catheter therethrough and into the vascular system and a secondary lumen having a cross-sectional area significantly less than that of the main lumen for infusion of small doses of medication therethrough at a controlled rate and directly into the vascular system. The introducer sheath comprises a tubular member of an inelastic, semi-rigid plastic material such as fluorinated ethylene propylene or nylon. The main lumen extends longitudinally through the tubular member and opens at the distal and proximal ends thereof. The secondary lumen is positioned adjacent to and separated from the main lumen with a cross-sectional area approximately fifteen percent of that of the main lumen. The distal end of the tubular member is tapered with the distal end of the secondary lumen closed. The secondary lumen has a side port near the tapered distal end.

Abstract: Method and apparatus are disclosed for replacing an endotracheal tube. The apparatus comprises an endotracheal tube obturator having an air passageway therein and a removable connector positioned at the proximal end of the obturator tube for ventilating the patient during replacement of the endotracheal tube. The obturator tube also includes a plurality of side ports for further ventilating the patient should mucous block the distal end of the obturator tube passageway. The removable connector includes a ventilator fitting and a removable and lockable obturator tube fitting joined thereto. The obturator tube fitting includes a sleeve having a plurality of flexible members for grasping the proximal end of the obturator tube. Extending into the passageway of the sleeve is a projection from the members for engaging the outside surface of the obturator tube when inserted in the passageway.