Abstract: Disclosed is a surgical apparatus including a surgical instrument including a housing and a cannula, and a surgical tool including a shaft and a tip, and a drive interface and an electrical interface, and the drive interface producing a surgical motion of the tip, and the electrical interface producing a cauterizing action of the tip. Also disclosed is a cutting and cauterizing device for connection to a surgical instrument. Additionally, methods for using both the surgical apparatus and the cutting and cauterizing device are disclosed.

Abstract: Disclosed is a surgical apparatus including a surgical instrument including a housing and a cannula, and a surgical tool including a shaft and a tip, and a drive interface and an electrical interface, and the drive interface producing a surgical motion of the tip, and the electrical interface producing a cauterizing action of the tip. Also disclosed is a cutting and cauterizing device for connection to a surgical instrument. Additionally, methods for using both the surgical apparatus and the cutting and cauterizing device are disclosed.

Abstract: A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid.

Abstract: An electrosurgical electrode, comprising a metal conductor having a first external surface area and having a convex body, a flat face on the body, and a connector for attaching the body to an electrosurgical probe handle, and an insulating layer covering the first external surface of the metal conductor except at a selected second area of one of the convex body and the flat face, the second area being positioned on the metal conductor so that a line from a geometric center of the second area and substantially perpendicular to the second area intersects at an angle an axis formed by a probe handle and the metal conductor upon attachment of a probe handle to the connector, wherein the second area does not intersect the axis along the probe handle. Also disclosed are methods of manufacture and similar off-axis electrodes useful in endoscopic electrosurgery.

Abstract: Disclosed herein is a new arthroscopic probe with a concave distal tip which simultaneously constrains and cuts tissue. It is particularly adapted to cutting ligaments and tendons. Also disclosed is a thermal energy delivery apparatus which includes (a) a probe means with a distal end and a proximal end, wherein the distal end has a concave tip; (b) a first electrode means positioned at the distal end of the probe means, wherein the first electrode means is configured to deliver sufficient thermal energy to cut ligaments or tendons; and (c) a cabling means coupled to the proximal end of the probe means.In another embodiment of the invention a controller for controlling the delivery of energy and liquid to a surgical instrument with a temperature sensor is disclosed. The energy is supplied by an energy source and the liquid is supplied by a pump. The controller includes a temperature and a flow regulator. The temperature regulator is coupled to the energy source and coupled to the pump.

Abstract: A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue.

Abstract: An externally guidable intervertebral disc apparatus manipulates disc tissue present at a selected location of an intervertebral disc, comprising a catheter having a distal end, a proximal end, and a longitudinal axis, the catheter having an intradiscal section at the distal end of the catheter, the intradiscal section being extendible into the disc, having sufficient rigidity to be advanceable through the nucleus pulposus of the disc under a force applied longitudinally to the proximal end, having sufficient flexibility in a direction of the disc plane to be compliant with the inner wall, having insufficient penetration ability to be advanceable through the inner wall of the annulus fibrosus under the applied force; and a functional element located in the intradiscal section for adding or removing energy or a material at the selected location of the disc. Methods of using the apparatus are also disclosed.

Abstract: A percutaneous method treats degenerate disc disease characterized by a circumferential bulge. The method provides a catheter having a distal end, a proximal end, and a longitudinal axis, the distal end having an intradiscal section with at least one energy delivery device. The next step is applying a force longitudinally to the proximal end of the catheter which is sufficient to advance the intradiscal section through a nucleus pulposus and around an inner wall of an annulus, but which force is insufficient for the intradiscal section to puncture the annulus fibrosus. Next the energy delivery device is positioned at a selected location of the annulus by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. The thermal energy delivery device is positioned adjacent the annulus and used to heat and stiffen the disc. Optionally, there is an additional step of adding a substance to reinforce the area.

Abstract: A medical probe device comprising a catheter having a stylet guide housing with at least one stylet port in a side thereof and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. The stylet guide housing has an optical viewing means positioned for viewing the stylet and adjacent structure which includes a fiber optic channel means for receiving a fiber optic viewing device. The fiber optic channel means can include a guide port means for directing longitudinal movement of a fiber optic device with respect to the stylet guide means in a viewing zone and a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across the end of a fiber optic device when positioned in the viewing zone.

Abstract: A surgical apparatus includes: a surgical instrument including a housing and a cannula; and a surgical tool including a shaft, and a tip, and a longitudinal member. The longitudinal member is contained within the shaft and is extendable from an interior position to an exterior position in which it is energized in the exterior position to produce a cauterizing action at the tip.

Abstract: Disclosed is an integrated surgical and cauterizing apparatus, comprising a surgical instrument including a drive member, a cannula, and a tool, and the cannula attached at a proximal end to the drive member and defining at a distal end thereof an opening, and the tool including a shaft and a tip, and the shaft contained within he cannula and connecting the tip in the opening of the cannula to the drive member to produce a surgical motion of the tip; and a cauterizing instrument comprising at least one electrode, and a conductor, and at least one electrode affixed to the cannula adjacent to the distal end of the cannula and the conductor providing an electrical path from the at least one electrode for the application of electrical power to the at least one electrode to produce a cauterizing effect.

Abstract: A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue.

Abstract: A method for modifying a ligament connection between two bones by applying radio frequency energy to a portion of a ligament in a patient that functions to maintain two or more bones in a standard configuration in a species to which the patient belongs, but which are in a relationship to each other that is not medically acceptable in the patient, for a time sufficient to induce thermal shrinkage of the portion of the ligament. The method is particularly useful for skeletal-shift disorders by applying radio frequency energy to one ligament of a set of ligaments of a patient that function to align two or more bones in a standard configuration in a species to which the patient belongs but which are causing a skeletal shift in the patient because of an imbalance of ligament-induced forces in the patient for a time sufficient to induce thermal shrinkage of the portion of the ligament, thereby alleviating the skeletal shift. Patellar shift and curvature of the spine are two examples of such disorders.

Abstract: A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid.

Abstract: A method and an apparatus is disclosed for delivering controlled heat to perform ablation to treat the benign prosthetic hypertrophy or hyperplasia (BPH). According to the method and the apparatus, the energy is transferred directly into the tissue mass which is to be treated in such a manner as to provide tissue ablation without damage to surrounding tissues. Automatic shut-off occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceed predetermined safe temperature limits. The constant application of the radio frequency energy over a maintained determined time provides a safe procedure which avoids electrosurgical and other invasive operations while providing fast relief to BPH with a short recovery time. The procedure may be accomplished in a doctor's office without the need for hospitalization or surgery.

Abstract: A radio frequency device for use on a human to resurface skin having collagen therein. The device includes a handle member having an end portion adapted for engaging the skin. At least one passageway extends through the handle member to an opening at the end portion. An electrically conductive liquid is supplied through the passageway to the opening. An electrode is carried by the end portion in communication with the passageway. Radio frequency energy supplied to the electrode causes the collagen in the skin to contract and thus tighten the skin.

Abstract: A method and an apparatus is disclosed for delivering controlled heat to perform ablation to treat the benign prosthetic hypertrophy or hyperplasia (BPH). According to the method and the apparatus, the energy is transferred directly into the tissue mass which is to be treated in such a manner as to provide tissue ablation without damage to surrounding tissues. Automatic shut-off occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceed predetermined safe temperature limits. The constant application of the radio frequency energy over a maintained determined time provides a safe procedure which avoids electrosurgical and other invasive operations while providing fast relief to BPH with a short recovery time. The procedure may be accomplished in a doctor's office without the need for hospitalization or surgery.

Abstract: A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue.

Abstract: An endocardial ablation apparatus, for introduction into a heart chamber formed by a wall, is provides. The ablation apparatus includes an inflatable, flexible porous membrane adapted to receive an electrolytic solution, and become inflated to substantially conform an exterior surface of the membrane to the wall of the heart chamber. An inner lumenal member is surrounded by and attached to the membrane. The inner lumenal member includes a lumen that permits blood flow through the inner lumenal member and heart chamber. An introducer catheter introduces the membrane and inner lumenal member into a selected heart chamber. A plurality of RF electrodes define a circuit positioned in the membrane or on an exterior surface of the inner lumenal member. The RF electrodes transfer thermal energy to the electrolytic solution. The electrolytic solution is the electrode that provides ablation of a selected site of the heart chamber. An RF power source is coupled to the RF electrodes.

Abstract: A transurethral needle ablation device for the treatment of the prostate of a human male using radio frequency energy wall comprising a sheath having a lumen extending therethrough. A guide tube assembly is slidably mounted in the lumen in the sheath and having a lumen extending therethrough. A needle electrode is slidably mounted in the lumen in the guide tube assembly. An insulating sheath is disposed about the needle electrode so that the distal extremity of the needle electrode is exposed. A handle adapted to be gripped by the human hand is mounted on the proximal extremity of the sheath. Levers are carried by the handle for causing bending of the distal extremity of the guide tube assembly at an angle with respect to its longitudinal axis whereby the lumen in the guide tube assembly can be directed so that it faces the urethral wall.