Abstract: This invention provides apparatus and means for protecting the axillary nerve during thermal capsullorhaphy. An electrosurgical probe is attached to a standard electrosurgical generator that is capable of producing coag waveforms. RF energy is generated by the generator in coag waveform and applied to discrete locations of the capsular ligaments through the electrosurgical probe. Noise produced by the coag waveform stimulates the axillary nerve, even in saline environments, thereby identifying the high-risk regions of the capsular ligaments that should be avoided during the procedure.

Abstract: A stainless steel electrosurgical blade has a single uniform layer of release material comprising substantially silicone (polysiloxane) applied directly onto the stainless steel blade portion without the necessity of one or more coatings of primer material(s), or multiple layering of the release material or mechanical roughening of the metallic blade body. Adherence of the release coating is achieved by thermally oxidizing the blade body, after cleaning it. The uniform layer is created by dipping the blade body. The release material is preferably thermally cured and non-blooming.

Abstract: This invention provides apparatus and means for protecting the axillary nerve during thermal capsullorhaphy. An electrosurgical probe is attached to a standard electrosurgical generator that is capable of producing coag waveforms. RF energy is generated by the generator in coag waveform and applied to discrete locations of the capsular ligaments through the electrosurgical probe. Noise produced by the coag waveform stimulates the axillary nerve, even in saline environments, thereby identifying the high-risk regions of the capsular ligaments that should be avoided during the procedure.

Abstract: A stainless steel electrosurgical blade has a single uniform layer of release material comprising substantially silicone (polysiloxane) applied directly onto the stainless steel blade portion without the necessity of one or more coatings of primer material(s), or multiple layering of the release material or mechanical roughening of the metallic blade body. Adherence of the release coating is achieved by thermally oxidizing the blade body, after cleaning it. The uniform layer is created by dipping the blade body. The release material is preferably thermally cured and non-blooming.

Abstract: A trocar device, comprising a trocar cutting element, a surrounding insulating sheath, and a cannula surrounding the sheath, also includes an arrangement providing a substantially smooth transition between the sheath and cannula at the distal end of the cannula during the insertion of the trocar device into a patient so as to reduce drag on the device at the transition. In one embodiment, the sheath includes a shaped portion of enlarged diameter, and the cannula includes, at the distal end thereof, inwardly directed slits forming corresponding resilient leaf members which engage the shaped portion to provide the smooth transition. The shaped portion includes oppositely tapered surfaces meeting at a common apex. In another embodiment, an expandable section, when expanded, provides the smooth transition.

Abstract: A surgical device includes a pair of end effector members. Rotation of one or both of the members about the longitudinal axis thereof enables a section of tissues to be inserted between the members and then grasped and compressed thereby. In use in laparoscopy, the members are rotated (or biassed) to the closed position to enable insertion of the members through a cannula, and, once inside the patient, the members are rotated from the closed position so that tissue can be inserted therebetween for gripping purposes. Electrosurgical current is applied to the members to provide coagulation of tissue held between the members. By simply rotating the rotating member between two opposed positions, coagulation can be carried out at two spaced zones. A third cutting member may then be used to cut the tissue along a midline between the coagulation zones.

Abstract: A controlled return path monitoring system is used in combination with an electrosurgical generator unit employing an active electrode for performing electrosurgery. The system includes internal electrode which is disposed, in use, within the body of a patient in proximity to the active electrode and is electrically connected to the electrosurgical generator unit so as to provide a preferred current return path back to the electrosurgical generator unit, and an external electrode which is disposed, in use, on the body of the patient and is electrically connected to the electrosurgical generator unit so as to provide a safety current return path back to the electrosurgical generator unit. A detector monitors the return current flow from the two electrodes back to the electrosurgical generator unit and controls the unit in accordance with the monitored return current flow, e.g., shuts off the unit when the flow exceeds a predetermined level.

Abstract: A trocar assembly includes an elongate trocar device and a surrounding cannula. The trocar device incorporates an electrosurgical cutting element which is used to make a guide hole for the cannula and thus enables the remainder of the trocar assembly to enlarge the puncture. An electronic control circuit senses the current flow to the cutting element and, when the trocar device breaks through the wall of the organ being cut, this circuit cuts off the connection to the associated electrosurgical generator. Further control circuitry prevents a surgeon from resuming electrosurgery until a predetermined time period has elapsed. Multiple trocars of different diameters are provided for the same assembly.

Abstract: The cutting surfaces of electrosurgical instruments are provided with an electroconductive coating of an inorganic silicon-containing non-stick material such as amorphous silica deposited thereon by plasma enhanced chemical vapor deposition.

Abstract: A device is provided for use with a medical instrument including a tip which is designed to penetrate the wall of an internal cavity (e.g., the abdomen) of a patient, for detecting when that tip penetrates through the wall. The device includes a source of a medium frequency detection signal and circuitry for coupling the signal to the tip of the medical instrument. The circuitry includes a transformer forming a high Q resonant circuit having an initial value of Q when the medical instrument is not in use. A return path for the signal provides that, in use of the instrument, a circuit is completed through the resonant circuit such that when the tip contacts patient tissue the initial Q of the resonant circuit changes and when the tip penetrates through the patient tissue of the Q of the circuit is restored to the initial value thereon.

Abstract: A manual control device for laparoscopic patient treatment by use of electrical curetage or coagulation, with means for clearing the surgical sight by irrigation or suction, finger operated buttons controlling the various functions, and an interlock mechanism disabling the electrical functions when a push button is depressed to enable irrigation or suction.

Abstract: A trocar assembly includes an elongate trocar device and a surrounding cannula. The trocar device incorporates an electrosurgical cutting element which is used to make a guide hole for the cannula and thus enables the remainder of the trocar assembly to enlarge the puncture. The cutting element comprises a bi-polar electrode assembly. An electronic control circuit senses the current flow to the cutting element and, when the trocar device breaks through the wall of the body cavity being cut into, this circuit cuts off the connection to the associated electrosurgical generator. Further control circuitry prevents a surgeon from resuming electrosurgery until a predetermined time period has elapsed. Multiple trocars of different diameters are provided for the same assembly.

Abstract: An apparatus for inserting a thoracotomy tube in a patient without damaging adjacent lung tissues is provided. The thoracotomy tube is adapted to receive a trocar having screw threads on the distal end thereof. The proximal end of the trocar has a handle thereon to rotate the trocar so that the screw threaded distal end forms an incision within the skin of the patient and the tip end of the screw thread passes into the pleural cavity. The distal end of the thoracotomy tube is provided with screw threads on the outer surface thereof to form a continuation of the screw threads of the trocar. The distal tip or end of the trocar terminates in a short flexible tube. A hollow needle extends through a central passageway in the trocar and through the flexible tip on the trocar. The opposite end of the hollow needle is provided with a pressure chamber which is in fluid communication with the passageway in the needle.

Abstract: An electrosurgical probe is provided which reduces the likelihood of arcing from the probe. In addition, the probe provides the ability to place a fiber-optic cable through the probe for providing for laser surgery or for laproscopic examination of the patient. The electrosurgical probe comprises an electrosurgical tip, a cylindrical body attached to the tip, and a base attached to the cylindrical body. The tip may have many different shapes but a spatula shape is generally preferred. The tip has at least one notch in the periphery of the spatula shape for retaining a fiber-optic cable. The cylindrical body is substantially hollow so that suction, irrigation, and laparoscopy may be carried out through the probe. To aid the surgeon in determining dimensions of organs within a patient, the cylindrical body has a plurality of striped regions having a predetermined thickness spaced apart at predetermined intervals on an outer surface of the cylindrical body.

Abstract: A method and apparatus for induction of pneumoperitoneum and insertion of a laparoscopic sheath is provided in which a trocar carrying a sheath or cannula has a tapered distal end with screw threads formed on the outer surface of the distal end. The distal tip or end terminates in a short flexible tube. A hollow needle extends through a central passageway in the trocar and through the flexible tip on the trocar. The opposite end of the hollow needle is provided with a pressure chamber which is in fluid communication with the passageway in the needle. In use, the trocar and cannula are screwed into the body tissues of the patient and when the distal end of the needle enters the peritoneal space within the body, liquid within the pressure chamber passes through the hollow needle and into the peritoneal space. The release of the fluid from the pressure chamber is an indicator to the surgeon that the end portion of the needle has entered the peritoneal space.

Abstract: A suction and irrigation apparatus is provided for selectively delivering suction or irrigation fluid to a patient during surgery or the like. A pair of resilient tubes are provided which is connected with a suction source and irrigation source at one end and is connected through a Y-shaped connector at the other end with a handpiece having clamping valves thereon disposed between the ends of the resilient tubes. The handpiece has a housing with openings in the ends thereof to provide passageways for the resilient tubes. Clamping valves are mounted in the housing which are spring urged to close the resilient tubes. A bracket is slidably mounted on the sides of the handpiece housing and the bracket is slidable to a position overlying the clamping valves so as to maintain the clamping valves in an open position. When the clamping valves are held in an opened position by the bracket, the handpiece can be moved along the length of the resilient tubes to position the handpiece at any desired location.

Abstract: A cannula is provided for laparoscopic surgery wherein the cannula comprises a housing and elongated tube with a passageway formed within the housing so that laparoscopic instruments may be passed through the housing and the elongated hollow tube into the abdominal cavity of a patient. A pair of rollers are mounted within the housing, the rollers being spring-urged together to close the passageway through the housing when an instrument is withdrawn. A slidable plate having apertures of different sizes are mounted in the housing with the apertures provided with slitted seals therein to close the passageway through the housing. The varying sized apertures in the slidable plate permit laparoscopic instruments of varying diameters to be used and to maintain an effective seal around the instrument. In another embodiment of the cannula a valve is provided which is closed when the rollers within the housing are in engagement with each other.

Abstract: The present invention is directed to a self-contained, totally disposable apparatus for the collection and reinfusion of blood which is suitable for use with a chest drainage unit to provide for the autotranfusion of autologous blood and the method of using the apparatus. The blood collection and reinfusion apparatus is separate in structure from the chest drainage unit and comprises a rigid outer container and an inner flexible container in conjunction with portals for blood collection, reinfusion, and attachment to a vacuum source. The apparatus and method of the invention provides a closed system, requires minimal handling of the blood, and provides for greater patient safety in that no interruption of the operation of the chest drainage unit is required.

Abstract: The present invention is directed to a self-contained, totally disposable apparatus for the collection and reinfusion of blood which is suitable for use with a chest drainage unit to provide for the autotransfusion of autologous blood and the method of suing the apparatus. The blood collection and reinfusion apparatus is separate in structure from the chest drainage unit and comprises a rigid outer container and an inner flexible container in conjunction with portals for blood collection, reinfusion, and attachment to a vacuum source. The apparatus and method of the invention provides a closed system, requires minimal handling of the blood, and provides for greater patient safety in that no interruption of the operation of the chest drainage unit is required.

Abstract: A reinforcement for thin film materials is provided by coating the films with an ink-type material. Ink coating of moisture vapor-permeable films such as polyurethane allows for a film suitable for use on skin which has an optimal rate of moisture vapor transmission. If desired, an adhesive can be provided on the ink-coated polyurethane membrane, and such materials are suitable for retaining I.V. needles and the like in place on a patient.