Abstract: A light delivery system for use in irradiating vascular tissue includes a balloon catheter with a working lumen for receiving an optical fiber therein and an inflation/flushing lumen adapted to receive a liquid at a proximal end and leading to a space defined within the balloon member attached to a distal end of the catheter. The balloon member has a pattern of holes or pores in the wall thereof through which the saline may flow when the balloon is inflated, causing any blood or other absorbing substances that may interfere with good radiant energy transmission to be flushed away from the treatment site.

Abstract: Implantable devices for treatment of proliferative disorders are described. In one aspect, the invention provides an implantable apparatus for treating a proliferative disorder in a patient. The device comprises a treatment fluid receptacle for receiving a treatment fluid, an inflatable balloon having a balloon body, a catheter connected between the treatment fluid receptacle and the balloon and defining a fluid flow path therebetween, and a diffusion barrier disposed in the fluid flow path between the treatment fluid receptacle and the balloon. Methods for treating proliferative disorders with the devices are also disclosed.

Abstract: An electrosurgical instrument for cutting and coagulating tubular tissue structures, especially tubular ones, includes a pair of spaced-apart electrodes that are stationarily mounted at the distal end of an elongated tubular barrel. A hook-shaped cutting member has an incline segment thereon for cooperating with a ramp formed at the distal end of the instrument. A tubular body structure to be severed is first brought into contact with electrodes and subjected to a RF current sufficient to coagulate and seal the same. Actuation of a lever on the instrument's handle causes the hook-shaped cutting member to deflect into a space containing the tissue structure and with continued actuation in a proximal direction causing a cutting edge on the hook of the cutting member to pass through and sever the tissue structure.

Abstract: An instrument for achieving rapid hemostasis at the conclusion of a catheterization procedure comprising a hemostatic agent injection device for use with a conventional introducer sheath used to gain access to the blood vessel. The injection device includes an elongated tubular member having ejection ports proximate its distal end. A hub member is located on the proximal end of the tubular member and includes an elongated groove or track located in its surface with a transparent cover. The enclosed track is in fluid communication with the lumen extending through the tubular member. After the catheterization procedure, the instrument is inserted into the introducer sheath. Blood flows into the lumen of the device and into the enclosed track. The leading edge of the blood pulsates within the enclosed track, clearly indicating that the ports are located in the blood vessel and subjected to variations in blood pressure.

Abstract: A light delivery system for use in irradiating vascular tissue includes a balloon catheter with a working lumen for receiving an optical fiber therein and an inflation/flushing lumen adapted to receive a liquid at a proximal end and leading to a space defined within the balloon member attached to a distal end of the catheter. The balloon member has a pattern of holes or pores in the wall thereof through which the saline may flow when the balloon is inflated, causing any blood or other absorbing substances that may interfere with good radiant energy transmission to be flushed away from the treatment site.

Abstract: An arthroscopy instrument for debriding tissue also includes an electrocautery electrode for effecting hemostasis in the surgical site. The drive motor for the debriding instrument is placed remotely from the instrument's handle and provision is made for electrically insulating the handle from the drive motor and associated power supply even though the arthroscopic surgery is taking place under saline.

Abstract: A surgical instrument for treating a blood vessel wall following percutaneous transluminal coronary angioplasty (PTCA) includes an optical system for transmitting radiant energy, preferably UV light energy, from a laser source to the distal end portion a PTCA catheter and causing the radiant energy to exit the catheter in a relatively narrow radial band. A microprocessor-controlled stepping motor is used to longitudinally reposition the band along the length of the balloon of the PTCA catheter to thereby expose endothelial tissue spanned by the balloon to radiation for the purpose of inhibiting smooth muscle proliferation reducing incidences of restenosis.

Abstract: A hand operable bipolar scissors instrument comprising two interfacing pivotal blade members which are each an electrode electrically insulated from the other and individually pivotable in relation to each other. Each blade member comprises a substrate base upon which a layer of non-conductive material is secured on the interior surface thereof so that the non-conductive material of each blade member interfaces with that of the other at the meeting surfaces.

Abstract: A hand operable bipolar forceps instrument comprising two interfacing pivotal blade member's which are each an electrode individually pivotable in relation to each other. Pivotal movement of the blades is effectuated by two respective electrically-conductive rigid rods, each coupled to a respective blade member, extending through an elongated tubular member having disposed at its proximal end a scissors type handle whose hand operation causes the blade members to pivot in relation to each other. The rods are connectable proximally to an energy source to thereby electrically activate the blade members.

Abstract: A bipolar electrosurgical device for coagulating and cutting tissue has an elongated tubular member from which a bipolar tissue cutting forceps and cutting instrument extends at the distal end. The cutting instrument is connected to a moveable rod extending through the lumen of the tubular member. A first and second conductor pair extend in spaced apart parallel arrangement to allow the cutting instrument and its moveable rod to extend therebetween. The first and second conductor pairs are operatively connected to the forceps jaws. A moveable guide member is disposed within the lumen of the elongated tubular member and has means for selectively engaging the first and second conductor pairs for closing and opening jaws of the forceps. The forceps jaws have a slot for receiving the cutting instrument therebetween. A handle member is fixed to the proximal end of the first tubular member.

Abstract: A bipolar electrosurgical scissors instrument comprising a proximal portion having a proximal linear axis and a distal blade portion having blade members with a nonlinear axis in relation to the proximal linear axis. The blade members each comprise an electrically conductive outer surface and an electrically nonconductive inner surface, with the inner surface comprising a ceramic layer having a honed cutting edge. At least one, and preferably both, of the blade members can pivot in relation to each other. Pivoting of the blade members causes the honed cutting edge of the first blade member to wipe the honed cutting edge of the second blade member to thereby cause separation of tissue therebetween. The blade members in one preferred embodiment are curved in relation to the proximal linear axis, while the blade members in a second preferred embodiment are angled in relation to the proximal linear axis.

Abstract: A bipolar electrosurgical scissors for use in open or endoscopic surgery has a pair of opposed blade members pivotally joined to one another and to the distal end of the scissors itself by a rivet which extends through a insulated bushing member. Each of the blade members comprises a blade support and a blade itself, each fabricated from metal, such as stainless steel. The blades are affixed to their associated supports by means of a suitable adhesive or adhesive composite material such as a fiberglass reinforced epoxy exhibiting dielectric properties. Cutting is performed, steel-on-steel, without causing a short circuit between the two blade supports which themselves function as the bipolar electrodes.

Abstract: A bipolar coagulation instrument comprising three concentric tubes, wherein the outer tube is generally rigid, the central tube is an electrically conductive metal in communication with an energy source, and the inner tube is electrically non-conductive. The distal end of the central tube extends beyond the distal end of the outer tube and functions as an electrode and first jaw of the coagulation instrument. The inner tube, which is translationally movable by an operator, has extending therethrough within its lumen a conductive lead whose distal end protrudes distally therefrom beyond the distal end of the outer tube and is configured at its distal end to function as an opposing second jaw to the first jaw. Translational movement of the inner tube distally forces the second electrode jaw toward the first electrode jaw to thereby bring the first and second jaws into contact with each other.

Abstract: A bipolar electrosurgical scalpel comprising a handle having a pair of loop electrodes extending outwardly from the distal end thereof in parallel, spaced relation, such that the spacing defines a dielectric such as an air gap therebetween. When a RF voltage of a predetermined amplitude is applied across the two electrodes and they are drawn across tissue, cutting occurs by virtue of the arc established between the two electrodes. The electrodes may be formed from tungsten wire to withstand high operating temperatures and are sufficiently rigid to withstand the pressure forces encountered during electrosurgery without shorting together across the gap. The electrodes may be formed in various shapes, depending upon the nature of the cutting desired. Possible configurations include open rounded loops, open elongated loops, open triangular-shaped loops, L- or J-shaped hooks.

Abstract: A surgical instrument for facilitating the injection of a contrast fluid into the cystic duct during the course of a laparoscopic cholecystectomy procedure comprises an elongated, rigid outer tubular member whose outer diameter permits it to pass through the lumen of a trocar penetrating the patient's abdominal wall and of a length allowing the distal end of the instrument to abut the patient's cystic duct. Affixed to the proximal end of the outer tubular shaft is a grip that includes a plunger which can be reciprocally moved in the longitudinal direction and joined to the plunger is an inner tube which can be joined at its proximal end to a source of contrast fluid and which extends through the lumen of the outer tubular shaft.

Abstract: An instrument for cauterizing blood vessels while performing an endoscopic procedure includes a rigid outer tube with a proximal end, a distal end and an inner, semi-rigid, tube passing through the outer tube from its proximal end to its distal end. The inner tube has at least one lumen allowing passage of a pair of conductive leads therethrough. The leads terminate at the distal end of the tube in a pair of forceps jaws. The leads are mechanically connected to a scissors-style handle and are electrically connected to an RF generator. The outside diameter of the outer tubular body is sufficiently small that it can readily pass through the working lumen of an endoscope. Associated with the handle is a knob for rotating the inner tube and the conductive leads. The handle also contains a means for effecting translational motion of the inner tube within the outer tube and over the forceps and a means for introducing a preset gap to prevent complete closure of the forceps' jaws.

Abstract: An electrosurgical instrument for use in endoscopic procedures features an electrode assembly which can be readily connected and disconnected from the remaining body of the instrument to allow a replacement electrode assembly to be substituted. The instrument comprises an elongated rigid tube having a handle on the proximal end, the handle including a spring-loaded plunger which is connected by a push rod to a stem member disposed in the lumen of the tube near its distal end. The electrode assembly is designed to mate with the stem and when the plunger is actuated to extend the stem beyond the distal end of the tube, the electrode assembly may be installed. Retraction of the stem within the lumen of the tube serves to hold the electrode assembly in place.

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 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 surgical instrument for laparoscopic and endoscopic treatment of tissue and organs is disclosed. It includes a handle with a tubular member extending therefrom. Disposed within the tubular member and extending from the distal end thereof is an extendable and retractable grasping loop or belt, joined at its proximal ends to a slide assembly contained within the handle.The slide member assembly includes a thumb loop, and finger grips mounted on the handle receive additional fingers of the surgeon. Proximal movement of the thumb loop withdraws the belt further into the tubular member to close the grasping loop, while distal movement extends the belt outward to form a flexible grasping loop at the distal end of the instrument to open it to encompass the organ or tissue.The flexible grasping loop may be placed around an internal organ or tissue, then its grasp tightened by proximal movement of the thumb loop.