Abstract: A monopolar electrosurgical instrument for excising polyps from the gastrointestinal tract comprises an elongated flexible plastic tube having a first monopolar electrode mounted a small predetermined distance from the distal end of the tubular member and a conductive wire loop affixed to a pull-wire, the pull-wire extending through the lumen of the tubular member and being connected at its proximal end to a plunger-type handle whereby the loop can be opened and closed by extending and retracting the loop relative to the distal end of the tubulr member. By incorporating both the surface electrode and the loop on the same instrument, polyps may be severed electrosurgically using the snare and the wound then immediately cauterized using the surface electrode, thus obviating the need to do an instrument exchange in the endoscope to accomplish both functions.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter is characterized in having a tip member which during the initial placement of the catheter within the vascular system so that the distal tip member is disposed in a working relation with the lesion to be removed, means are provided for increasing the cross-sectional profile of the tip members to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: An intravascular catheter especially designed to surgically remove atheromas or other forms of stenotic or thrombotic lesions from the interior walls of a blood vessel using an RF discharge between two bipolar electrodes is described. Affixed to the distal end of an elongated, flexible, plastic, tubular member is a bipolar electrode structure comprising a cylindrical insulator having a first conductive metal ring electrode surrounding the periphery of that insulator. Projecting from the distal end of the cylindrical insulator is a second, frusto-conical shaped member whose major base is slightly less in diameter than the diameter of the cylindrical insulator. An insulative material covers all but the distal side edge of the first ring electrode and an annular zone of the second electrode located immediately adjacent to the exposed distal side edge of the first electrode.

Abstract: A biopsy instrument comprises an elongated flexible tube having a sharpened metal sleeve affixed to its distal end. An anvil member is affixed to the distal end of an elongated rod or wire which fits through the lumen of the tube and which is reciprocally moveable in the longitudinal direction by appropriately manipulating a handle device affixed to the proximal end of the tube. Affixed to the anvil member and electrically connected to the rod is an electrode. Means are provided for connecting an RF voltage between the electrode and metal sleeve for coagulating blood at the site where a tissue sample is excised from the internal wall of a body organ. The tissue sample is excised by positioning it against the sharpened edge of the metal sleeve and drawing back on the anvil to sever the sample and draw it into the interior of the sleeve where it remains until removed.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter has a distal tip member which is disposed in a working relation with the lesion to be removed during the initial placement of the catheter within the vascular system. Means are provided for increasing the cross-sectional profile of the tip member to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: An instrument for performing a percutaneous laparoscopic cholecystectomy includes a generally rigid, tubular body with a proximal end, a distal end and a lumen extending between these two ends and with a pair of bipolar electrodes projecting from the distal end of the tubular body and a handle member affixed to its proximal end. The outside diameter of the tubular body is sufficiently small that it can readily pass through a cannula inserted through a puncture made through the abdominal wall. A pair of conductors, connected at one end to the bipolar electrodes and at their other end to a source of radio frequency voltage, extend through the tube's lumen and a handle. Moreover, a fluid port may be formed through the handle so as to be in fluid communication with the lumen of the tube whereby fluids may be perfused through the instrument during its use or a suction may be applied to the proximal port for aspirating the surgical site.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter is characterized in having a tip member which during the initial placement of the catheter within the vascular system so that the distal tip member is disposed in a working relation with the lesion to be removed, means are provided for increasing the cross-sectional profile of the tip members to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: An electrosurgical implement for tunneling through tissue for effecting drainage of an organ or to restore patency to a blood vessel is described. The implement comprises a stainless steel, helically wound, wire body similar to a conventional guidewire of the type used in angiography, angioplasty or in implanting cardiac pacing leads. The exterior of the guidewire is coated with an insulating material, save for one or two convolutions at its distal end. A core wire having a Teflon.RTM. shrink tube surrounding it over substantially its entire length is disposed within the lumen of the helical guidewire and only a short segment of the distal end of the core wire is allowed to extend out from the distal end of the guidewire. This short segment is stripped free of insulation.

Abstract: A bipolar electrosurgical instrument designed for resecting tumorous growths from the esophagus, bladder or other internal organ where the site of the tumor is reached by way of an endoscope, the instrument being dimensioned to fit down the central lumen of the endoscope, comprises an elongated, flexible tube having a conductive helical spring cantilevered from the distal end of the tube and forming a return electrode and a conductive wire hoop spaced a predetermined gap distance from the distalmost convolution of the helical spring and whose plane is perpendicular to the longitudinal axis of the flexible tube forms the active electrode. Wires for applying a high frequency RF voltage across the electrodes extend through the lumen of the flexible tube. As the distal end portion of the instrument is dragged over the tumor to be resected, the cantilevered helical spring is laterally displaced, allowing the RF current leaving the active hoop electrode to cut through the tumorous tissue.

Abstract: A bioplar sphinctertome for use in endoscopic retrograde sphincterotomy procedures includes an elongated, flexible, plastic tube having either a single or a double lumen and includes a segment near its distal end which is both flexible and conductive. This segment is connected by a wire extending through the lumen to a terminal at the proximal end of the device adapted to be coupled to an electrosurgical generator. A second, longitudinally movable wire passes through the lumen and is connected at the proximal end to a finger-operated slide mechanism while its distal end passes through a small aperture formed in the tube just proximal of the flexible conductive segment. That wire is then anchored distally of the flexible conductive segment so that when a tensioning force is applied to the wire, the distal end portion of the instrument will bow, with the exposed wire comprising the active electrode and the flexible conductive segment functioning as the return electrode.

Abstract: An improved handle for a polypectome snare for use in excising polyps from an internal body cavity. The apparatus generally comprises a radio frequency polypectome snare which includes a hand grip assembly, a flexible tubing assembly capable of fitting within an endoscope, an electrode loop portion and a power supply means. The hand grip assembly is made of molded pieces of inflexible plastic comprising a longitudinal housing portion and a slide member having opposing finger grip members. When the slide member is in its most proximal position, the electrode loop portion is withdrawn into the flexible tubing. As the slide member is advanced toward the distal end of the longitudinal housing, the electrode wires are advanced out of the flexible tubing, forming a loop that can be placed around the stem of a polyp. Once again withdrawing the loop into the end of the flexible tubing while simultaneously applying RF voltage shears the polyp at its base.

Abstract: An electrosurgical instrument for use in combination with an endoscope for cutting tissue and cauterizing/coagulating the resulting wound area is described. The instrument comprises an elongated flexible tubular member having a proximal end, a distal end, and plural lumens extending therebetween. Affixed to the distal end of the tube is a bullet-shaped ceramic tip member having a centrally-disposed longitudinal bore passing through the side wall of the tip member. The ceramic exterior surface of the tip member is covered with a conductive layer forming a first inactive electrode. An electrical conductor joined to that electrode surface feeds back through a lumen of the tube to its proximal end where it may be coupled to an electrosurgical generator. Also running through a lumen in the tube is another conductor which can be made to project outwardly through the opening in the tip member.

Abstract: A valvuloplasty catheter is described which includes an elongated flexible plastic tube dimensioned so as to allow it to be passed through the vascular system. Affixed to the distal end portion of the tube is an inflatable expander member which is intended to be positioned in the annulus of the valve to be treated. Inflation ports expose the interior of the expander member to the lumen of the tube so that when an inflation fluid is injected, under pressure, at the distal end of the tube, the expander member expands radially outward to spread the valve and free-up its leaflets. The novelty resides in providing first and second inflation ports of differing size so that the expander member inflates so as to create a dog-bone effect, tending to stabilize the expander member relative to the valve being treated.

Abstract: A RF ablation catheter for removing athero-stenotic lesions or modifying the tissue characteristics of the interior walls of selected blood vessels is described. The catheter is characterized in having a tip member which during the initial placement of the catheter within the vascular system so that the distal tip member is disposed in a working relation with the lesion to be removed, means are provided for increasing the cross-sectional profile of the tip members to thereby cause it to move into engagement with the lesion to be excised. The application of an RF voltage across a pair of bipolar electrodes is used to create an electric arc for effecting the cutting action, or alternatively, just sufficient RF energy to sear or otherwise alter the tissue surfaces engaged by the distal tip member.

Abstract: A catheter for facilitating the exchange of guidewires during the course of a transluminal angioplasty or related procedure which comprises an elongated, flexible, tubular member having at least one lumen running the full length thereof from its proximal end to its distal end and which at least three apertures or ports extending through the wall thereof at longitudinally spaced locations near the distal end of the tubular member. These ports communicate with the lumen of the tubular member and a longitudinal slit is also provided through the wall of the tubular member connecting the most proximal port to the next proximal port. The exchange catheter may also include a proximal hub connected to the proximal end of the elongated plastic tube.

Abstract: A catheter for facilitating the exchange of guidewires during the course of a transluminal angioplasty or related procedure which comprises an elongated, flexible, tubular member having at least one lumen running the full length thereof from its proximal end to its distal end and with at least three apertures or ports extending through the wall thereof at longitudinally spaced locations near the distal end of the tubular member. These ports communicate with the lumen of the tubular member and a longitudinal slit is also provided through the wall of the tubular member connecting the most proximal port to the next proximal port. The exchanger catheter may also include a proximal hub connected to the proximal end of the elongated plastic tube.

Abstract: A blood pressure monitoring catheter for use in a Monorail.TM. intravascular system for measuring the pressure gradient across a stenotic lesion. It comprises an elongated, flexible, plastic, extruded, tubular member having a guidewire port extending through the wall thereof a short distance proximal to the distal end of the tubular member to intersect with a lumen which extends to the distal end. The second lumen runs the entire length of the tubular member from its distal end to its proximal end. The proximal end of the blood pressure monitor catheter is fitted to a molded plastic hub to facilitate the attachment of the catheter to the blood pressure measuring apparatus with which the catheter is to be used.

Abstract: A hand-operated inflator device for inflating the expander on a balloon-type catheter. It comprises a molded plastic housing for retaining a syringe tube therein for containing an inflation fluid. The housing also includes an internally threaded surface. A syringe plunger having an internal longitudinal bore and a longitudinal slot formed through the wall thereof has a piston mounted on the distal end for insertion into the syringe body. Fitted into the longitudinal slot is an externally threaded member which can be raised and lowered in a radial direction by manipulation of a manuable actuable means positioned in the longitudinal bore of the plunger. When the externally threaded member is raised, its teeth mesh with the teeth on the internally threaded annular surface of the housing, but when lowered, the threaded surfaces are disengaged. When the two are engaged, the piston is advanced in the syringe tube by rotating the plunger.

Abstract: A polypectome snare whose loop comprises a pair of electrodes mechanically joined but electrically insulated from one another at their distal ends and adapted to be energized by a source of RF voltage for excising polyps on the inside of a body cavity is described. The polypectome snare is designed to be used with an endoscope and includes two concentric flexible plastic tubes each having proximal and distal ends and a lumen running the length thereof. At the proximal end is a hand grip which is secured to the wires leading to the bipolar electrodes with one of the wires passing through the lumen of the outermost tube and the other wire extending through the lumen of the inner tube. In this fashion, the wires remain insulated from one another over the length of the instrument and due to this same arrangement, the conductors comprising the bipolar electrodes cannot become twisted at the distal end of the implement to thereby create a short which would render the snare inoperative.

Abstract: A catheter for facilitating the restoration of patency to a blood vessel occluded with an atheroma or other similar lesion or thrombus comprising an outer flexible plastic tubular member having a plurality of ports proximate its distal end and concentrically surrounding an inner flexible plastic tubular member having a cutting loop at its distal end. The distal end portion of the inner tubular member is journaled for rotation in the distal end portion of the outer tubular member. A motor is provided at the proximal end of the catheter assembly for rotatably driving the inner tubular member and the cutting loop thereof while flushing the treatment site and aspirating the flushing liquid, blood and any debris loosened during the procedure.