Abstract: A coupler or a coupling vessel for creating an anastomosis between a first vessel and a second vessel, the coupler comprising a proximal portion comprising a tubular portion having a proximal end, a distal end, an outer surface, an inner surface, and an axial lumen defined by the inner surface and extending between the proximal end and the distal end, and a distal portion comprising a flange surrounding the distal end of the tubular portion. A method for creating an anastomosis between a first vessel and a second vessel, the method comprising selecting the first vessel and the second vessel, providing a coupler or a coupling vessel according to the present invention, and joining the first vessel to the coupler through the proximal end of the tubular portion and joining the second vessel to the coupler through the distal portion, thereby creating an anastomosis with fluid continuity between the first vessel and the second vessel.

Abstract: An inflatable endoscopic retractor is disclosed for retracting organs and tissues in the body. The inflatable retractor comprises an inflatable balloon configured to retract specific organs and tissues at the site of the endoscopic procedure, with attached inflation and deflation means. In one embodiment, the inflatable balloon has an attached support rib to provide additional strength and rigidity during retraction. In another embodiment, the inflatable balloon has multiple projections, each with an attached support rib, to provide retraction in several directions. A retractor having an endoscopic housing with separate channels is also disclosed which provides retraction as well as the means for inserting a second endoscopic surgical tool.

Abstract: A trocar system for assisting in the generation of endosurgical ports is disclosed in which a trocar facilitator is used to place the peritoneum in counter-traction to facilitate the penetration of the trocar. Peritoneal counter-traction results in increased surface tension which reduces the force and downward momentum necessary to achieve trocar penetration, thereby eliminating the risk of excess penetration and injury to internal organs. The facilitator is of a corkscrew-like design, with an attached support ring and a removable guide piece having a hollow, cylindrical passageway which aids in the insertion and support of the trocar, cannula, and other endoscopic surgical instruments. In another embodiment, the facilitator is configured to aid in the introduction of carbon dioxide gas into the abdominal cavity of the patient. An improved curved tip of the blade of the trocar facilitator is also disclosed.

Abstract: A trocar system for assisting in the generation of ports for endoscopic surgery is disclosed in which a retractor is used to place the peritoneum in counter-traction to facilitate the penetration of the trocar. Peritoneal counter-traction results in increased surface tension which reduces the force and downward momentum necessary to achieve trocar penetration, thereby eliminating the risk of excess penetration and injury to internal organs. The retractor can taken on a variety of configurations, such as a half-cylinder design in which a distal blade is inserted beneath the deeper fascial tissues and rotated into position for releasable connection and articulation with a similar half-cylinder. The two retractor halves are then joined to form a combined guide and retractor to receive the trocar for countertraction and penetration. In another embodiment, the retractor is of an integral cylindrical design with lateral distal hooks for gripping the fascial tissues obliquely.

Abstract: A bipolar coagulation device suitable for use in endoscopic surgery is disclosed which reduces the adhesion of tissue to the electrodes and enables the user to clean the electrodes during the procedure without removal from the body. Bipolar electrocautery forceps are located at the distal end of a sheath suitable for use in endoscopic surgery. The tips of the forceps are manipulated using controls located at the control end of the sheath which remains outside the patient's body. The tips of the forceps are made of material having phosphorous in combination with metals of high thermal conductivity, which reduces the adhesion of tissue during cauterization. In addition, the device has a cleaner which acts to free the forceps of any adhering debris. This cleaning can be done inside the patient's body, without the need for any additional instrumentation. In a preferred embodiment, the tips of the bipolar coagulation device can also be pivoted to an angularly disposed position.

Abstract: A trocar system for assisting in the generation of endosurgical ports is disclosed in which a trocar facilitator is used to place the peritoneum in counter-traction to facilitate the penetration of the trocar. Peritoneal counter-traction results in increased surface tension which reduces the force and downward momentum necessary to achieve trocar penetration, thereby eliminating the risk of excess penetration and injury to internal organs. The facilitator is of a corkscrew-like design, with an attached support ring and a removable guide piece having a hollow, cylindrical passageway which aids in the insertion and support of the trocar, cannula, and other endoscopic surgical instruments. In another embodiment, the facilitator is configured to aid in the introduction of carbon dioxide gas into the abdominal cavity of the patient. An improved curved tip of the blade of the trocar facilitator is also disclosed.

Abstract: An inflatable endoscopic retractor is disclosed for retracting organs and tissues in the body. The inflatable retractor comprises an inflatable balloon configured to retract specific organs and tissues at the site of the endoscopic procedure, with attached inflation and deflation means. In one embodiment, the inflatable balloon has an attached support rib to provide additional strength and rigidity during retraction. In another embodiment, the inflatable balloon has multiple projections, each with an attached support rib, to provide retraction in several directions. A retractor having an endoscopic housing with separate channels is also disclosed which provides retraction as well as the means for inserting a second endoscopic surgical tool.

Abstract: A surgical shunt capable of revision and inspection on a minimal invasive basis is provided. The shunt comprises a ventricle tube and drain tube connected by an elbow. The elbow has branches and a bend therein so as to connect the tubes at nearly a right angle. A portal is mounted on the bend of said elbow. The portal comprises a concave slit valve and a portal cover thus forming a self-sealing access to the shunt. The portal is oriented on the elbow so as to allow passage therethrough into either of said tubes by an angioscope or other device. Thus, the angioscope or other device can be externally inserted into the interior regions of the shunt in order to remove blockages and improve cerebrospinal fluid flow without surgical procedures.

Abstract: A retractor is provided for use during endoscopic surgery. Bladed instruments located inside the patient's body at an insertion end of the retractor are manipulated by controls located outside the body at a control end. In three embodiments, the retractor comprises a tubular body having an insertion and control end. Two blades are movably connected in the insertion end of the body. The blades may be moved in various combinations, being extended away from the longitudinal axis of the retractor body and/or spread apart. The blades may be actuated with controls which extend from the control end of the body. In another embodiment, the retractor comprises a tubular body also having an insertion and control end. Three blades are movably attached to the insertion end of the body. The blades may be independently extended radially outward from the longitudinal axis of the retractor body. Each blade is actuable from a separate control located at the control end of the body.

Abstract: A surgical tool for cutting, shearing or clamping has a body formed of a single length of flexible steel and a collet mounted perpendicularly between the leaves of the body and affixed between the leaves near their rearward ends. The leaves are normally bowed outward, so that squeezing them together lengthens the body, thus producing relative displacement between the forward ends of the body and collet, respectively. The bifurcated forward end of the collet, which extends through an aperture in a bridge joining the leaves, terminates at a pair of jaws having inwardly working surfaces and outwardly facing cam surfaces. The cams are engaged by the sides of the aperture, which drive the jaws together when the leaves are squeezed toward one another.

Abstract: A plastic surgical clip comprises a pair of arms having inturned opposing tips, the arms being joined by a bridge having a lesser cross-section to provide a locus for bending by drawing the ears in parallel directions against an intermediate support.

Abstract: A forceps for holding and everting vessels in an anastomosis procedure includes three cooperating jaws mounted at the ends of respective relatively movable legs. The legs can be independently manipulated in order to secure and evert first one vessel, then another in apposition to the first, so that clips or sutures can be applied to complete the anastomosis.