Abstract: A method and system for treating tissue with a surgical device includes the steps of displaying an image created by collecting imaging data from an imaging device, selecting at least one tissue target from the image, collecting image data and tracking the tissue target during at least one respiration cycle, determining the dwell position of the tissue target, and displaying an image created from image data collected with the tissue target at the dwell position. The method may further include determining the position and orientation of the surgical device with respect to the dwell position and indicating the trajectory of the surgical device on the display screen. The method may further include the steps of monitoring the respiration cycle, indicating when the tissue target is approaching the dwell position, positioning the surgical device in the patient based upon the dwell position and trajectory and treating the tissue target.

Abstract: The disclosed device can hold, or effect relative longitudinal movement between, two members of a medical instrument, such as an instrument used for fastening two hollow organs together. The device may comprise a handle member having a longitudinal guide defining a line of travel and a longitudinal groove having a detent catch therein; a longitudinally spring-biased moving member slidable within the longitudinal guide and having pawl receiving slots along a line parallel with the line of travel; and a transversely and rotationally spring-biased driving trigger member comprising a pawl proximate to the moving member and adapted to engage the pawl receiving slots when aligned therewith, and a fulcrum member movable within the groove and adapted to be releasably captured by the detent, the driving trigger member being rotatable about the fulcrum member to cause the pawl to engage or disengage the pawl receiving slots.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having a deformable wall and actuated by movement of a rod, and a lodging member. In another embodiment the end effector may comprise a positioner and a lodging member, which further comprises a hollow, substantially cylindrical body that is compressed or elongated, and thereby actuated, by relative movement of two substantially coaxial tubes within the tube assembly.

Abstract: Embodiments for an anchor for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy are disclosed. The anchor may comprise a shaft with a lodging structure. Alternative embodiments may include a penetration limiting structure, a driver interface proximate to a rearward end, a forward end with a penetration facilitating shape that may comprise a point defined by three flat intersecting faces, a bioabsorbable portion of one or more bioabsorbable materials, and a metal portion of one alloy, or a plurality of alloys which may have differing expansion properties.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having an extendable and retractable petal operably connected to a tube, and an anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver pin operably connected to a tube.

Abstract: The instrument disclosed may comprise a tube assembly further comprising substantially coaxially situated and relatively longitudinally movable tubes, supporting and operating an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In alternative embodiments the tube assembly may comprise a rod and two tubes, three tubes, a rod and three tubes, or four tubes. The method disclosed may comprise inserting an instrument having an end effector into the bladder lumen, and using the end effector to urge the bladder wall to the pelvic floor and drive an anchor through the bladder wall and into the pelvic floor.

Abstract: The method disclosed may be used following a prostatectomy, and may comprise inserting an instrument into the bladder lumen through incisions in the abdomen and bladder wall; using an end effector thereon to urge the bladder wall to the pelvic floor and align the openings of the bladder and urethra, and drive an anchor through the bladder wall into the pelvic floor, thereby connecting a balloon harness to the pelvic floor; inflating a balloon within the harness, which holds the bladder wall surrounding the bladder opening against the pelvic floor; maintaining the balloon in place and draining the bladder via a catheter during the time required for the tissues to effectively knit; and then deflating the balloon, disconnecting the harness, and withdrawing the instrument. The instrument may comprise one or more tubes that support an end effector comprising a positioner, an anchor driver, a harness, a balloon and a catheter.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having a positioner arm that is extendable and retractable by rotation of a tube, and an anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver arm that is extendable and retractable by rotation of a tube.

Abstract: The method disclosed may be used following a prostatectomy may comprise inserting an instrument having an end effector into the bladder lumen via the urethra; using the end effector to urge the bladder wall to the pelvic floor and drive an anchor through the bladder wall into the pelvic floor, thereby connecting a balloon harness within the bladder to the pelvic floor; withdrawing the end effector; inserting and inflating a balloon catheter within the balloon harness, thereby pressing the bladder wall surrounding the bladder opening against the pelvic floor; maintaining the balloon catheter in place and draining the bladder during the time required for the tissues to effectively knit; and then deflating and withdrawing the balloon catheter and disconnecting and withdrawing the balloon harness. The instrument may comprise one or more tubes that support an end effector comprising a positioner and an anchor driver.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having an extendable and retractable petal operably connected to a tube, an anchor driver, and an anchor releasably held by the anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver pin operably connected to a tube.

Abstract: A handheld biopsy device is provided for the collection of soft tissue samples from a surgical patient. At least one electrode is provided, such as between a handle and the knife tip of the biopsy device. The electrodes can be provided on a sleeve. The sleeve with electrodes can be releasably supported on the biopsy device.

Abstract: An electrosurgical instrument is provided for cauterization and/or welding of tissue of varying impedances, thicknesses and vascularity especially in the performance of endoscopic procedures. The instrument compresses the tissue between an electrode associated with a first pole of a bipolar energy source located on one interfacing surface off a first element, and a second interfacing surface of a second element. The first and second elements are used to engage and compress tissue between the first and second interfacing surfaces. A second electrode associated with a second pole is located one of the two interfacing surfaces. The first electrode is either recessed into the first tissue contacting surface and/or offset from the second electrode on the same or opposing surfaces. A preferred application of the invention is in a cutting instrument wherein a hemostatic line is formed along a cut line using RF energy.

Abstract: A retractable obturator trocar with a puncturing tip is provided. Preferably the obturator includes a safety shield covering the puncturing tip in an unarmed position and permitting the tip to extend distally from the safety shield in an armed position. The obturator preferably includes a spool retracting mechanism which causes the distally extended obturator to retract into the safety shield when a force is applied to the puncturing tip. The obturator may also be manually disengaged. The safety shield and obturator preferably extend out of the distal end of the cannula whether the trocar is armed or unarmed.

Abstract: A safety trocar is provided which includes a spring-loaded shield that shields the cutting tip of the obturator after the obturator penetrates tissue. The distal end of the shield is conical in profile and contains a slot which conforms to the geometry of the cutting tip. The obturator tip contains a knife edge blade which extends the length of the cannula inner diameter. Ideally, the knife is made of an amorphous metal, and may be serrated at its edge.