Abstract: An endoscopic scissors includes a clevis having a relatively large diameter bore in its first arm and relatively smaller diameter bore in its second arm. A pair of scissor elements having mounting/pivot holes are mounted between the clevis arms. Either the small diameter bore in the second clevis arm or the mounting/pivot hole in the scissor element closest to the second clevis arm is threaded. A stepped diameter axle pin having a threaded portion is inserted with its smaller end entering the larger diameter bore of the first clevis arm. The threaded portion of the axle pin threadably engages either the threaded bore in the second clevis arm or the threaded mounting/pivot hole of the scissor element closest to the second clevis arm. In one embodiment, the bore in the second clevis arm is not threaded and the threaded portion of the axle pin engages only the threaded threaded mounting/pivot hole of the scissor element closest to the second clevis arm.

Abstract: An apparatus for counting the number of times a medical instrument has been sterilized includes an indicator having sequential indicia and a heat responsive member for indicating a next one of the indicia. Mechanical, fluid mechanical and electronic versions of the invention are disclosed. In the mechanical version, the indicator can be a ratchet member having teeth, a pawl and a display surface containing indicia. A heat responsive element such as a bimetallic member engages the teeth of the ratchet and advances the ratchet each time the apparatus is subjected to the heat of sterilization. A housing with a window masks the display to indicate one of the indicia as advanced by the heat responsive element. Preferred embodiments of the mechanical version include a ring-like ratchet member with interior teeth and an exterior display surface. The number of teeth is preferably one or more less than the number of indicia so that upon advancing the ratchet member to the last indicia, it can be advanced no further.

Abstract: A probe for use with an endoscopic suction-irrigation instrument is disclosed which permits a second probe to be inserted therethrough. The suction-irrigation instrument has a cannula, a fluid chamber having at least one port for irrigation and suction and a proximal opening, and a first seal in the proximal end of the fluid chamber. The fluid chamber has a distal end communicating with the cannula. The probe has a proximal handle portion, a middle portion, and a hollow distal portion. The handle portion has an axial passageway and a second seal therein. The middle portion extends from the handle portion through the first seal at the end of the fluid chamber and through the fluid chamber. The middle portion has an outer diameter shaped to contact the first seal such that the proximal end of the fluid chamber is sealed. The middle portion is also shaped to be smaller than the inner diameter of the fluid chamber, and the middle portion is provided with a second axial internal passageway extending therethrough.

Abstract: An endoscopic surgical instrument includes a proximal handle with a distally extending lever actuator. The handle and lever actuator are coupled by a tube and push rod to a pair of distal end effectors. The proximal end of the tube is mounted in a bushing having a flange which is freely rotatable within a flange receiving recess in the handle. The proximal end of the push rod extends proximally beyond the bushing and is coupled to the lever actuator by a ball and set screw coupling. The lever actuator preferably extends at least four inches distally from the proximal end of the handle and includes a finger ring near its distal end. The tube is preferably provided with a ferrule immediately distal of the handle for rotating the tube and push rod about the longitudinal axis of the instrument. The ferrule is preferably provided with a distal extension having an annular notch for locking engagement inside another endoscopic instrument.

Abstract: An endoscopic instrument is described having a fluid chamber, a cannula, a shell, a first locking mechanism, and a probe with a second locking mechanism. The fluid chamber has proximal and distal ends. The hollow cannula is coupled to the distal end of the fluid chamber. The port is located at the proximal end of the fluid chamber. The shell houses the fluid chamber, the port, and the first locking mechanism. The probe extends through the port, through the fluid chamber, and through the hollow cannula. In a first fully inserted position, the distal end of the probe extends past the distal end of the cannula. When the probe is partially withdrawn from the shell, the first locking means releasingly engages the second locking means on the probe. Different spring loaded mechanism are described, including one mechanism which is overcome by pulling on the handle of the probe, and another mechanism which requires an active release mechanism.

Abstract: An improved use counter for endoscopic instruments is mounted in the ferrule of the distal portion of an endoscopic instrument having separable proximal and distal portions. The counter includes a ratchet wheel having inner and outer teeth and a bimetallic coil having a fixed end and a free end. The fixed end of the bimetallic coil is attached to a hub portion of the ferrule and the free end of the bimetallic coil engages the inner teeth of the ratchet wheel. An inwardly extending tooth in the ferrule engages the outer teeth of the ratchet wheel to prevent backward movement of the ratchet wheel. The outer surface of the ratchet wheel is also provided with incremental indicia viewable through a window in the ferrule. As the bimetallic coil is heated and cooled when the instrument is sterilized, the free end of the coil engages and advances one tooth of the ratchet wheel. Movement of the free end is preferably limited by stops.

Abstract: An endoscopic electrosurgical suction-irrigation instrument with insertable probes and attachments is disclosed. The instrument has a fluid chamber sealed at its proximal end with a slit valve for receiving the probes and connected at its distal end to a cannula through which the inserted probes extend. The fluid chamber is selectively provided with suction and/or irrigation and includes an electrical contact for supplying voltage to an inserted electrosurgical probe. Depending on the probe configuration suction and/or irrigation is provided in an annular space between the probe and the cannula or through the probe. Valves, connectors and switches for use with the instrument are also disclosed.

Abstract: Disposable laparoscopic colo-rectal surgical bowel clamps for insertion through trocar tubes are disclosed. The instruments broadly include: a hollow aluminum tube; an aluminum clevis which is formed separately from the aluminum tube with the distal end of the hollow aluminum tube crimped around the proximal end of the clevis; axially off-set pivot pins coupled to the clevis; two bowel clamp blades each having a pivot hole through which the off-set pivot pin of the clevis is pivotally engaged, and each having another through-hole; an aluminum push rod extending at least partially through the hollow aluminum tube and apparatus for imparting reciprocal motion to the push rod relative to the aluminum tube, whereby the reciprocal motion is translated at an offset pivot of the clevis into high leverage pivotal motion of the blades. The blades are configured with bowed intermediate sections, and cutout proximal sections for the grasping and clamping of a bowel portion or other relatively large anatomical parts.

Abstract: Lung clamp end effectors for a thoracoscopic surgical instrument are disclosed. The lung clamp end effectors have a base portion, an intermediate portion, and a distal portion. Each base portion has a first through-hole for pivotally engaging a pin of the clevis of the thoracoscopic surgical instrument, and preferably, a second through-hole used in conjunction with connecting links which connect the lung clamp end effector to the push rod. The through-holes on a particular end effector are located on opposite sides of the longitudinal axis of the tool, thereby providing strong clamping action. The lung clamps are further arranged with their distal portions increasing in width to approximately 10 mm as they extend distally. The distal portion also have cut-outs which increase in width as they extend distally. The lung clamp end effectors are at least two inches long from their respective pivot through-holes to their respective distal ends.

Abstract: Disposable laparoscopic surgical instruments for insertion through trocar tubes are disclosed. The instruments broadly include: a hollow aluminum tube; an aluminum clevis which is formed separately from the aluminum tube with the distal end of the hollow aluminum tube crimped around the proximal end of the clevis, and with the clevis including an axially off-set pivot pin; at least one end effector element having a pivot hole through which the off-set pivot pin of the clevis is pivotally engaged, and another through-hole; an aluminum push rod extending at least partially through the hollow aluminum tube and mechanically coupled to the end effector element; and apparatus for imparting reciprocal motion to the push rod relative to the aluminum tube, whereby the reciprocal motion is translated at an offset pivot of the clevis into a high torque pivotal motion of the end effector element.