Abstract: A guide wire for a catheter has a tubular portion with a flexible body fixed to its distal end. The distal end of the body may be composed of a radiopaque material. Optical fibers are disposed within the assembly and terminate in a radiopaque tip at the distal end of the body. The guide wire may have a longitudinal marker wire or mandrel for providing stiffness and radioscopic tracking characteristics, as well as providing torsional control and tip shaping capabilities. The guide wire has a proximal end attached to the tube and a distal end that also terminates in the tip. The wire may be maneuvered in a vascular area like a conventional guide wire and may be used in conjunction with a support catheter to increase its maneuverability. Then, laser energy is conveyed to the vascular area by the optical fibers to ablate an obstruction. The proximal end of the guide wire is then removed and a larger catheter may then be slid over the guide wire to continue the ablation operation.

Abstract: The present invention is a catheter with a twistable tip. The catheter having a flexible wall for use in complex twisting anatomy contains a torque wire or a torquable guide wire lumen. The torque wire or torquable guide wire lumen extends through the length of the catheter and is attached to the catheter at or near the distal end thereof. The distal face of the catheter is angled to self align the catheter with an obstruction upon insertion. The proximal end of the torque wire protrudes from the proximal end of the catheter and is attached to a turn limiter. Rotation of the turn limiter imparts a torque to the torque wire or torquable guide wire lumen which is transmitted through the catheter to the distal end of the catheter where the applied torque twists the distal tip to manually align the tip with an obstruction.

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: 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: The present invention is a turn limiter for a catheter with a twistable tip. The catheter having a flexible wall for use in complex twisting anatomy contains a torque wire or a torquable guide wire lumen. The torque wire or torquable guide wire lumen extends through the length of the catheter and is attached to the catheter at or near the distal end thereof. The proximal end of the torque wire protrudes from the proximal end of the catheter and is attached to a turn limiter. Rotation of the turn limiter imparts a torque to the torque wire or torquable guide wire lumen. The turn limiter allows limited rotation of the proximal end of the torque wire or torquable guide wire lumen without axial dislocation. The turn limiter may have a feature for indicating the amount of torque applied to the torque element.

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: Various embodiments of flexible plastic tubing are disclosed for connection to an endoscopic instrument having suction, irrigation and electrocautery capabilities, with the electrocautery capability requiring connection to an electrical wire. Generally, the tubing is an integral, extruded flexible plastic tube having a first suction portion with a first interior cylindrical passageway, a second irrigation portion with a second interior cylindrical passageway, and a third portion with a third passageway for the electrical wire. The third portion joins the other portions. The third portion has a substantially cylindrical interior passageway with first and second flexible lips defining a peripheral opening which is narrower than the electrical wire such that the electrical wire is inserted past the lips and held in the passageway and is removable from the passageway.

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: A cautery probe is described for use with an endoscopic instrument where the endoscopic instrument has an electrical contact located therein. The probe includes an insulated handle which extends out of the instrument, a conductive probe element which is mounted in the insulated handle and extends through the distal end of the endoscopic instrument, and an insulating cover. The conductive probe element has a distal cautery surface, and an electrical contact surface at a location between the proximal end of the conductive probe and the distal cautery surface, with the electrical contact surface contacting the electrical contact in the endoscopic instrument when said cautery probe is inserted in the endoscopic instrument. The insulating cover substantially covers the conductive probe element from the insulated handle up to but not at the electrical contact surface, and substantially covers the probe element from a point beyond the electrical contact surface, up to but not at the distal cautery surface.

Abstract: An electrocautery suction/irrigation endoscopic instrument having an electrocautery safety override is provided. The instrument preferably includes a cannula, an irrigation conduit in fluid communication with the cannula, an irrigation valve for regulating fluid flow in the irrigation conduit, an actuator coupled to the valve, an electrocautery probe coupled to a source of current, and an electrical switch coupled to the source of current and to either the irrigation valve or to the actuator. When the actuator is activated to permit fluid flow through the irrigation conduit, the switch is switched and prevents the flow of cautery current from the current source to the electrocautery probe. Preferably, the switch opens a DC circuit which is used to signal the current source to provide an high voltage AC electrocautery current. Alternatively, the switch may be located in the high voltage AC circuit. Both foot and thumb activated cut/coag switches are disclosed for use with the instrument.

Abstract: A pinch valve for a flexible conduit is provided. The pinch valve has an arcuate rigid hook, an arcuate rigid pincher, and an actuator. The arcuate rigid hook has an inner surface of a diameter substantially equal to outer diameter of the flexible conduit, wherein the inner surface receives the conduit. The arcuate rigid pincher has an outer arcuate surface with a diameter at least as small as the inner diameter of the flexible conduit, and the flexible conduit is located between the arcuate hook and the arcuate rigid pincher. The actuator is coupled to either the hook or the pincher, and moves the hook relative to the pincher relative from a first position to collapse and pinch the flexible conduit therebetween to a second position where said flexible conduit is not collapsed and pinched. Preferably, the actuator is spring loaded so that the conduit is pinched.

Abstract: A torque control mechanism for a medical catheter, comprising a torque wire affixed to a tip of the catheter, and attached to a rotation control mechanism carried by a proximal end of the catheter. The torque wire has high torsional stiffness but longitudinal flexibility, so that rotation of the torque wire is efficiently transmitted to the catheter tip, but so that the torque wire may flex easily as the catheter is put into place adjacent a treatment site within a patient. The catheter tip includes a guide wire lumen for sliding over a conventional guide wire in emplacing the catheter, and rotation of the torque wire causes the catheter tip to rotate about an axis of the guide wire. However, when high friction is encountered by the catheter, rotation of the torque wire causes rotation of the catheter tip about a central axis of the catheter. This is assisted by the configuration of a preferred embodiment, wherein the catheter tip is rotatable separately from the catheter body.

Abstract: Methods and apparatus by which a transducer is employed to create a digital signal representing numerically the value of a changeable physical parameter. The signal from the transducer is subject to large and unpredictable amounts of offset due to either or both (i) manufacturing tolerance departures from the desired target of creating a zero output signal value when the sensed parameter is zero and (ii) changes in offset due to changes in one or more physical conditions (other than the sensed parameter) to which the transducer and its associated electrical components are subjected. A bistate device is associated with the transducer and controlled so as (a) to first apply substitutionally to the transducer a known, and preferably zero, value of the parameter--with the output signal value being stored so as to represent the then-existing offset, and then (b) to apply the changeable physical parameter to the transducer.