Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include at least one balloon which is adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. Embodiments including multiple balloons enhance the surface area of contact, and the mixing of both the heat exchange and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body without cooling the entire body system. It is of particular advantage in brain surgeries where stroke, trauma or cryogenic tumors can best be addressed under hypothermic conditions.

Abstract: The present invention includes an adapter for advancing a temperature sensor through the drainage lumen of an operational Foley catheter. The Foley catheter includes a catheter body having proximal end, a distal end and a drainage lumen extending between the ends. A balloon mounts on the distal end for holding the catheter in the bladder of a patient. The adapter attaches to the proximal end for inserting a temperature sensor via the catheter drainage lumen to the distal end of the catheter. This adapter enables a typical Foley catheter to achieve a temperature sensing capability and provides collocated sensor elements in Foley catheters having a single temperature sensor element. Such temperature sensor measurements are useful, for example, in conjunction with various heat exchange catheter systems.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A system for exchanging heat with the body of a patient for cooling or warming the patient provides for automatic temperature control in accordance with the monitored temperature of the patient. The system comprises at least one fluid circuit in communication with an indwelling catheter, and a temperature control module, wherein body temperature measurements are used to control the temperature of fluid circulating within the fluid circuit.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include at least one balloon which is adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. Embodiments including multiple balloons enhance the surface area of contact, and the mixing of both the heat exchange and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body without cooling the entire body system. It is of particular advantage in brain surgeries where stroke, trauma or cryogenic tumors can best be addressed under hypothermic conditions.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. In one embodiment of the invention, a finger ring is movable on the handle in a single distal direction through multiple stages. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In another embodiment, the finger ring is movable in a distal direction to deploy and thread the needles, and movable in a proximal direction to tension the suture and withdraw the needles.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. In one embodiment of the invention, a finger ring is movable on the handle in a single distal direction through multiple stages. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In another embodiment, the finger ring is movable in a distal direction to deploy and thread the needles, and movable in a proximal direction to tension the suture and withdraw the needles.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. A finger tab is movable on the handle in a single distal direction through multiple stage. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In an associated method the needles are threaded on the far side of the body wall and withdrawn from the wound providing access to the suture ends on the near side of the body wall. Tying the suture ends closes the wound.

Abstract: Apparatus for suturing a wound in a body cannula having an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end and a pair of needles disposed at the distal end, the needles being movable between a proximal position and a distal position. A suture manipulator carried by the cannula is insertable through the wound and operable to manipulate the suture into an engaging relationship with the needles on the far side of the body wall. A finger tab is movable on the handle in a single distal direction through multiple stage. In a first stage the needles are deployed; in a second stage, the suture manipulator is activated to thread the needles; and in a third stage the suture is released from a tensioning mechanism. In an associated method the needles are threaded on the far side of the body wall and withdrawn from the wound providing access to the suture ends on the near side of the body wall. Tying the suture ends closes the wound.

Abstract: An infusion catheter, for use in conjunction with a balloon dilatation catheter, comprises an elongate, flexible tube defining an infusion lumen, and an expansible infusion sleeve located near its distal end, the sleeve comprising an expansible network of spacer elements disposed between proximal and distal elastomeric sealing bands. When deployed at a treatment site in a blood vessel or other bodily passage, the elongate tube of the present invention concentrically surrounds the dilatation catheter, the infusion lumen being defined therebetween, with the infusion sleeve concentrically surrounding the balloon. The spacer elements of the expansible network create an axially-elongated, circumferential flow path or interstice between the balloon and the vessel wall when the balloon is inflated, the interstice being in fluid communication with the infusion lumen, through which a therapeutic fluid is delivered to the treatment site.

Abstract: A self-introducing infusion catheter comprises a substantially rigid, elongate shaft having a longitudinal passage therethrough and an infusion port at its distal end. An electrode is further mounted at the distal end. The electrode is electrically coupled to a connector at the proximal end of the shaft which may be connected to an electrosurgical power supply. The connector is further in communication with the passage in the shaft and provides fluid connection with an infusion fluid delivery device. In the method of the invention, the catheter is connected to an electrosurgical power supply and ablative energy is applied to abdominal tissue through the electrode. This facilitates penetration of the tissue to position the device in the abdominal cavity through the abdominal wall. The distal end of the catheter is positioned through an incision in a body structure, such as the cystic duct, and the proximal end is connected to an infusion fluid delivery device.

Abstract: An electrosurgical probe comprises an elongate probe body having a surgical hook at a distal end thereof. A paddle element is reciprocatably mounted within the distal tip of the elongate body so that it can be shifted between an extended position where it covers the hook tip and a retracted position where it leaves the hook tip exposed. The paddle thus can cooperate with the hook in tissue dissection, clean the hook, as well as provide an alternate electrosurgical probe tip for use in electrosurgical procedures.

Abstract: The invention provides a tissue manipulation system including a tethered clamp, a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity, and a rigid positioning shaft for engaging the clamp and/or tether to manipulate the clamp. In a further embodiment, the tissue manipulation system includes an introducer through which the tether can be withdrawn from the abdominal cavity and a retainer attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

Abstract: The invention provides an actuator handle useful in connection with a variety of surgical instruments, in particular, least invasive surgical instruments having an elongate shaft and an axial passage in the shaft in which a linkage is slidably disposed. In a preferred embodiment, the actuator handle comprises a tubular housing axially aligned with the shaft having an axially-aligned elongate opening on a lateral side thereof. A lever is disposed in the elongate opening and is pivotally coupled to the housing at a first end and coupled to the linkage of the surgical instrument at a second end. The second end of the lever is coupled to the linkage wherein the linkage is translated axially by pivoting the lever relative to the housing. The actuator handle further includes a locking lever to lock the lever in an inward position, as well as a pigtail connector for connecting the linkage to an electrosurgical generator.

Abstract: The invention provides an apparatus and method for tissue ligation and transection. In a preferred embodiment, the apparatus comprises a shaft with a slot at the distal end in which a tissue structure may be positioned. A suture is mounted about the periphery of the slot with a free end of the suture on a first side of the slot and a knotted loop on a second side of the slot. The free end of the suture is retrieved and threaded through knotted loop so as to form a ligature surrounding the tissue structure. The free end is drawn proximally to tighten the ligature, and the knotted loops are cinched tight to lock the ligature in position. A blade slidably mounted in the shaft may be advanced to transect the tissue structure adjacent or between ligatures. A sleeve for compressing tissue within the slot during ligation, as well as electrodes for cauterizing the tissue, are also disclosed.

Abstract: A suture applier comprises a shaft having proximal and distal ends and carrying a length of suture along its axis. The suture has a surgical needle at its distal end and a knotted loop formed proximally of the needle. The knotted loop is carried at the distal end of the shaft, and a slidable handle is provided at the proximal end for applying axial tension on the suture. In this way, the needle may be used to suture a wound in tissue and may be tied by passing the needle through the knotted loop and closing the loop by pulling on the slidable handle.

Abstract: The invention provides a tissue manipulation system including a tethered clamp and a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity. In a further embodiment, the tissue manipulation system includes a introducer through which the tether can be withdrawn from the abdominal cavity and a clamp attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.