Abstract: Disclosed is a wound closure device and method for using the same. The wound closure device includes a handle, a body portion extending distally from the handle, a stapling mechanism extending distally from the body portion and a mechanism for supplying electrical energy from an RF power supply to a fastener (e.g. staple) which is associated with the stapling mechanism. In a representative embodiment, the stapling mechanism includes an inner rod member disposed within an elongated outer sleeve and slidably movable therein. The rod member has an enlarged tip for deploying the fastener that is supported adjacent to the tip into body tissue. The wound closure device further includes an actuator mechanism associated with the handle and body portion and configured to facilitate relative movement of the inner rod and the outer sleeve so as to deploy the fastener into body tissue. In alternative embodiments, a second pole of the RF power supply is connected to a conductive ring associated with a vascular introducer.

Abstract: An electrosurgical tool comprises a retractable cutting element moveable along a linear cutting path and an electrical energy supply source which communicates electrical energy (e.g., radio frequency energy) through the cutting element and to tissue adjacent the cutting element. The cutting element may be formed of a sharp or non-sharpened material. During surgical procedures the electrosurgical cutting device is able to simultaneously cut tissue and cauterize, or fuse, the tissue in areas adjacent the incision through the application of electrical energy. The effect is a reduced amount of bleeding associated with surgical procedures and an enhanced ability to control and eliminate bleeding. Optionally, the electrosurgical cutting device may also include a supply of surgical staples which are deployed simultaneously with the cutting action and delivery of electrosurgical energy to adjacent tissue.

Abstract: An adapter unit for a mechanical tissue cutting implement such as a shaver, morcellator or the like includes a mounting block from which an electrically insulating sheath extends. The sheath fits over the cannula or shaft of the cutting implement, and is secured in alignment and attached so that the cutting tip, for example, the tool and its window in the cannula tip, are exposed through the sheath. A conductor, which may be a conductive layer, extends along the length of the sheath and is exposed to form a distal electrode at the tip in close proximity to the opening, constituting one electrode of a bipolar electrode arrangement at the exposed tool. The other electrode is provided by electrical connection to the implement itself, so that a high current density path is formed through tissue in the cutting region.

Abstract: An electrosurgical instrument has a handle and a body which position and close a jaw about a tissue site for simultaneously cutting and sealing relatively large tissue structures. The jaw includes an electrosurgical cutting member, which may be a blade or wire, against which tissue is biased along a cut line, and a clamping assembly that clamps a region adjacent to or surrounding the cut line. The clamping assembly includes sealing electrodes for heating the region and welding tissue along the side of the cut as the cutter parts the tissue. The clamping assembly preferably has first and second clamping jaws extending in parallel to grip the tissue as tension is released by the cut, allowing dependable and complete sealing of the cut ends over an extended time while the tissue is immobilized.

Abstract: An electrosurgical instrument includes an electrode assembly having an electrode mechanically interlocked with a non-conductive body to as to form a gap therebetween. In one embodiment, complimentary surface features of the respective electrode and the non-conductive body interlock the components of the electrode assembly. In another embodiment, the electrode assembly includes a generally spherical electrode that is rotatable with respect to a non-conductive hood. A gap is formed between an outer surface of the electrode and an inner surface of the hood.

Abstract: An electrosurgical instrument having an active electrode with a portion that is coated with an insulative material. An exposed portion of the electrode is effective to treat tissue while the insulative coating minimizes energy dissipation into surrounding isotonic solution.

Abstract: A system for detecting the position of a catheter in a patient includes three sets of excitation electrodes, with one set disposed in each of three intersecting axes. A signal processor measures a voltage indicative of impedance between a detection electrode disposed on the catheter and each of the three sets of excitation signals in order to determine the X coordinate, Y coordinate and Z coordinate of the catheter. The detected position of the catheter is recorded and the detection of subsequent catheter positions is performed relative to the recorded catheter position. The difference between subsequent catheter positions and the recorded position relative to the X, Y and Z axes is displayed in order to facilitate repositioning of the catheter at the recorded position. Excitation electrode embodiments utilizing as few as four excitation electrodes are disclosed. The excitation electrodes may be surface, subcutaneous or intracardiac electrodes.

Abstract: A system for detecting the position of a catheter in a patient includes three sets of reference electrodes, with one set disposed on each of the mutually orthogonal X, Y and Z axes. A signal processor measures the differential voltage indicative of impedance between a detection electrode disposed on the catheter and each electrode of each of the three sets of reference electrodes in order to determine the X coordinate, Y coordinate and Z coordinate of the catheter. The detected position of the catheter is recorded and the detection of subsequent catheter positions is performed relative to the recorded catheter position. The difference between subsequent catheter positions and the recorded position relative to the X, Y and Z axes is displayed in order to facilitate re-positioning of the catheter at the recorded position. Optional EKG and/or respiratory sensors may be used to synchronize the catheter position detection in order to reduce detection inaccuracies due to EKG and/or respiratory artifacts.

Abstract: An electrosurgical apparatus includes a rotary, tissue affecting device in the form of one or more rotating blades, a rotating drill, or a rotating shaving/abrading device that serves as an active, energy delivering electrode. The active electrode effectively cuts tissue at the surgical site without relying solely upon the mechanical cutting action of the tissue affecting device. The rotary surgical device can be in a form such that it is suitable for use in open or closed surgery.

Abstract: An electrosurgical instrument includes a roller electrode segmented into conductive and non-conductive portions. When the electrode is rolled over a treatment site, the region of the electrode that contacts the site receives current from an energy source and the non-contacting region of the electrode is isolated from the energy source. The electrode is well suited for use in an isotonic fluid environment, without resulting in significant current dissipation since the non-contacting portion is isolated from the energy source. The roller electrode has a substantially cylindrical shape and is rotatable about a longitudinal axis along which a bore extends. A conductor carrying current from the energy source is disposed through the bore such that, when the electrode is urged against a treatment site, the conductor delivers current to the contacting region of the roller electrode and is isolated from the non-contacting region.

Abstract: An electrosurgical system having a visual indicator is provided. In a first embodiment, the electrosurgical system includes an active electrode coupled to a power supply for providing electrosurgical energy from the power supply to a tissue area and a return electrode separated from the active electrode, the return electrode being adapted to receive a current flowing through the tissue. The electrosurgical system further includes a lamp in electrical communication with the active and return electrodes, wherein the neon bulb is illuminated when the current flowing through the tissue exceeds a predetermined threshold. In a further embodiment, the electrosurgical system includes a second lamp illuminated when a voltage through the tissue is greater than a predetermined threshold. In another embodiment, a monopolar electrosurgical device includes a visual indicator for indicating conditions at an area of affected tissue.

Abstract: An electrosurgical feedback system for detecting the effects of electrosurgical energy on tissue. The feedback system can include an acoustical detection element that acoustically detects the effects of energy on tissue and then generates an acoustic output signal indicative of these energy effects. A power regulation element, in response to the acoustic output signal, regulates the electrosurgical energy supplied to the tissue. Alternatively, the feedback system can include an impedance determination circuit that determines the impedance of the tissue. The tissue determination stage can include a first and second differentiator circuit to determine the time-based derivative of the measured tissue impedance. The tissue determination stage generates an impedance output signal of either the first or second derivative of the tissue impedance, which is conveyed to the power regulation element. The regulation element regulates the amount of energy supplied to the tissue in response to the impedance output signal.

Abstract: An impedance feedback electrosurgical system is useful with electrosurgical tools to maintain a substantially constant level of current within the tissue in contact with the tool. The system comprises active and return electrodes associated with an electrosurgical tool, an impedance monitoring device and a power control unit. Energy sufficient to affect tissue is delivered through the active electrode to tissue and to the return electrode. The impedance measuring device is in circuit with the return electrodes and measures the impedance of tissue. A signal representative of tissue impedance is communicated from the impedance measuring device to the power control unit. The power control unit adjusts the energy applied to tissue to maintain tissue impedance within a preselected and desired range.

Abstract: An electrosurgical tool comprises a retractable cutting element moveable along a linear cutting path and an electrical energy supply source which communicates electrical energy (e.g., radio frequency energy) through the cutting element and to tissue adjacent the cutting element. The cutting element may be formed of a sharp or non-sharpened material. During surgical procedures the electrosurgical cutting device is able to simultaneously cut tissue and cauterize, or fuse, the tissue in areas adjacent the incision through the application of electrical energy. The effect is a reduced amount of bleeding associated with surgical procedures and an enhanced ability to control and eliminate bleeding. Optionally, the electrosurgical cutting device may also include a supply of surgical staples which are deployed simultaneously with the cutting action and delivery of electrosurgical energy to adjacent tissue.

Abstract: The invention provides an electrosurgical tissue penetrating probe (e.g., a trocar) for use with surgical procedures such as a laproscopy. The trocar has a stylet disposed within the housing member, having an active electrode disposed on a distal end thereof to deliver electrosurgical energy to the target tissue in contact with the stylet. A return electrode is disposed on the housing member to form part of a return electrical path to the delivery electrosurgical energy. The invention also provides an electrosurgical trocar system having an impedance monitor and associated power regulating circuitry to control the amount of electrosurgical energy delivered to tissue so that the measured tissue impedance is maintained within a preselected range.

Abstract: A bipolar electrosurgical tool comprises a retractable cutting element movable along a cutting path and an electrical energy supply source which communicates electrical energy (e.g., radio frequency energy) through one or more energy delivering electrodes associated with a tissue affecting portion of the tool to tissue adjacent the electrodes. One or more additional electrodes, such as return electrodes, form a second pole of the bipolar electrical connection are also associated with the tissue affecting portion and are electrically isolated from the energy delivering electrode. Various combinations of electrically conductive and electrically isolated elements associated with the tissue affecting portion of the device can be used as the two poles of the bipolar system.

Abstract: An electrosurgical probe is disclosed which provides the ability to both cut and cauterize tissue. The probe includes at least one cauterization electrode mounted upon a distal portion of the electrode and adapted to deliver electrosurgical energy to tissue. Further, a central lumen is disposed within the probe. The lumen is adapted to accommodate the flow of fluid from a remote source to tissue through an outlet port in the distal end of the probe. Also, the lumen houses a cutting electrode which is selectively deployable. Both cauterization and coagulation can be conducted in a bipolar mode. The flow of fluid through the lumen serves to limit the heat transfer from the cauterization electrode to adjacent tissue to an extent sufficient to prevent the sticking of tissue to the probe. A feedback system is also provided to optimize the electrode temperature.

Abstract: The invention provides an electrosurgical tissue penetrating probe (e.g., a trocar) for use with surgical procedures such as a laproscopy. The trocar has a stylet disposed within the housing member, having an active electrode disposed on a distal end thereof to deliver electrosurgical energy to the target tissue in contact with the stylet. A return electrode is disposed on the housing member to form part of a return electrical path to the delivery electrosurgical energy. The invention also provides an electrosurgical trocar system having an impedance monitor and associated power regulating circuitry to control the amount of electrosurgical energy delivered to tissue so that the measured tissue impedance is maintained within a preselected range.

Abstract: An electrosurgical probe is disclosed which provides the ability to both cut and cauterize tissue. The probe includes at least one cauterization electrode mounted upon a distal portion of the electrode and adapted to deliver electrosurgical energy to tissue. Further, a central lumen is disposed within the probe. The lumen is adapted to accommodate the flow of fluid from a remote source to tissue through an outlet port in the distal end of the probe. Also, the lumen houses a cutting electrode which is selectively deployable. Both cauterization and coagulation can be conducted in a bipolar mode. The flow of fluid through the lumen serves to limit the heat transfer from the cauterization electrode to adjacent tissue to an extent sufficient to prevent the sticking of tissue to the probe. In another embodiment the probe is adapted only for cauterization and does not include a cutting electrode.

Abstract: An ablation catheter has an ablation electrode at a distal end coupled to an ablation power source through a low impedance coupling. The ablation electrode also functions as a sensing electrode, for monitoring the endocardial signal and preferably also tissue impedance during the ablation procedure, and is coupled to an electrode monitor through a high impedance coupling. A timing element operates a plurality of switches to selectively isolate, dampen, or interconnect various signal paths during plural repetitive non-overlapping ablation and quiescent intervals which alternate at a rate substantially above a Nyquist sampling rate. RF energy is delivered to the ablation site during the ablation intervals. The local endocardial signal is measured during the quiescent intervals.