Abstract: A protective sleeve for use with an endoscopic surgical instrument is provided. The protective sleeve includes a flexible tube having an opening at each end of the tube and a length to cover a desired portion of the surgical instrument. At one end of the tube may be an elastic band that allows the sleeve to be positioned over the instrument or to be retracted to reveal the instrument for use. Additionally, the tube may also include a second band that may be fixed or movable. The tube also may have a perforation running along the length of the tube to allow for the sleeve to be easily removed from the instrument. A circumferential perforation may also be provided. A method for using the protective sleeve is also provided.

Abstract: Laparoscopic instruments and trocars are provided for performing laparoscopic procedures entirely through the umbilicus. A generally C-shaped trocar provides increased work space between the hands of the surgeon as well as S-shaped laparoscopic instruments placed through the trocar when laparoscopic instrument—trocar units are placed through the umbilicus. In order to facilitate retraction of intra-abdominal structures during a laparoscopic procedure, an angulated needle and thread with either one-or two sharp ends is provided. Alternatively, an inflatable unit having at least one generally C-shaped trocar incorporated within the unit's walls can be placed through the umbilicus following a single incision. Generally S-shaped laparoscopic instruments may be placed through the generally C-shaped trocars to facilitate access to intra-abdominal structures.

Abstract: An apparatus and method for treating female stress-induced incontinence and other similar diseases associated with weakening of the pelvic floor muscles. A guiding catheter with temperature sensor(s) is positioned in patient's urethra. An inflatable balloon carried by a forward end of the catheter is inflated to sit in a neck of a bladder. Measuring indicia on the exterior of the catheter is indicative of a distance between the bladder neck and external meatus. A vagina probe member provided with a laser output in a forward portion thereof is then positioned in place such that the laser output is at about a level of the bladder neck, as facilitated by the guiding catheter. The laser output is operationally connected to a medical laser generating and monitoring device that delivers a laser beam to selected areas in the pelvic floor to cause denaturing and recoiling of the tissue collagen in the area surrounding the urethra.

Abstract: A laser treatment apparatus for performing treatment by irradiating a part to be treated by a laser beam for treatment is disclosed. This apparatus includes a laser source which emits the treatment laser beam; a multi-articulated arm for delivering the treatment laser beam emitted from the laser source, the arm including a plurality of light delivery pipes at least one of which is axially extensible, a joint part for jointing the light delivery pipes, the joint part being rotatable with respect to at least one of the pipes jointed by the joint part, a reflection mirror disposed in the joint part; and a hand-piece connected to an end of the arm and used for irradiating the treatment laser beam delivered therein through the arm to the treatment part.

Abstract: A cryogenic catheter system includes a first handle portion having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path; a second handle portion having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path; and a catheter having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path. The first handle portion is matable with the second handle portion to place the respective first and second fluid flow paths of each handle portion in fluid communication. Additionally, the catheter system includes a multiple lumen co-axial connector for connecting the catheter flow pathways with a fluid source and control console.

Abstract: Methods, systems, and computer program products measure electrical activity of the cardiac tissue proximate the lesion site during an ablation treatment, and then compare the measurements to determine whether the lesion is clinically efficacious so as to be able to block myocardial propagation. The methods can include obtaining the measurements and performing the ablation therapy while the subject is experiencing atrial fibrillation and may measure the standard deviation of the electrogram signal.

Abstract: An implanted medical device (e.g. infusion pump) and an external device communicate with one another via telemetry messages that are receivable only during windows or listening periods. Each listening period is open for a prescribed period of time and is spaced from successive listening periods by an interval. The prescribed period of time is typically kept small to minimize power consumption. To increase likelihood of successful communication, the window may be forced to an open state, by use of an attention signal, in anticipation of an incoming message. To further minimize power consumption, it is desirable to minimize use of extended attention signals, which is accomplished by the transmitter maintaining an estimate of listening period start times and attempting to send messages only during listening periods. In the communication device, the estimate is updated as a result of information obtained with the reception of each message from the medical device.

Abstract: A self-cooling electrode for use with an ablation catheter has greater surface area that allows electrode to dissipate heat to the blood pool more effectively and increased thermal mass, and, therefor greater heating capacity/thermal conductivity for improved heat transfer between the electrode and tissue for more effective tissue heating. The electrode design allows increased power to be delivered with minimized risk of overheating or coagulation at the tissue-electrode interface. The increased thermal mass and thermal conductivity of the electrode design are achieved with a substantially solid electrode body with thick walls. Cooling and increased heat exchange are achieved with an alternating pattern of channels and projections that collectively define a plurality of edges either parallel or perpendicular to the electrode axis.

Abstract: A system and method for treating skin. The system comprises a source of radiation for irradiating the skin and a pair of electrodes for applying a voltage to the skin. An electrical meter measures an electrical response of the skin to the applied voltage. A processor adjusts a parameter of the radiation based upon the measured response. The invention may be used to control skin temperature during thermal treatment.

Abstract: The invention provides apparatus and methods for mapping conduction pathways and creating lesions in the heart wall for the treatment of atrial fibrillation. The apparatus may include at least one epicardial ablation probe having a plurality of electrodes for creating a lesion. The apparatus and method facilitate the formation of a lesion which electrically isolates the pulmonary veins from the surrounding myocardium.

Abstract: A deflectable interstitial ablation device includes an elongated housing, an electrode mounted within the elongated housing, a driver coupled to the electrode, an imaging device integrally mounted within the elongated housing and a deflection system disposed within the elongated housing. The elongated housing has a proximal end, a distal end, and a deflectable segment. The electrode is deployable from a first position within the elongated housing to a second position a predetermined distance beyond the distal end of the elongated housing. The electrode further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing, and can be deployed by the driver with a sufficient force such that penetration of the urethral wall occurs in a single motion. The imaging device further has a flexible portion capable of deflecting with the deflectable segment of the elongated housing.

Abstract: Systems and methods are provided for applying a high frequency voltage in the presence of an electrically conductive fluid to create a relatively low-temperature plasma for ablation of tissue adjacent to, or in contact with, the plasma. In one embodiment, an electrosurgical probe or catheter is positioned adjacent the target site so that one or more active electrode(s) are brought into contact with, or close proximity to, a target tissue in the presence of electrically conductive fluid. High frequency voltage is then applied between the active electrode(s) and one or more return electrode(s) to non-thermally generate a plasma adjacent to the active electrode(s), and to volumetrically remove or ablate at least a portion of the target tissue. The high frequency voltage generates electric fields around the active electrode(s) with sufficient energy to ionize the conductive fluid adjacent to the active electrode(s).

Abstract: A surgical bone preparation instrument that is effective to prepare the surface of adjacent bone structures, and more particularly to remove a predetermined portion of bone from the vertebral endplates of adjacent vertebral bodies, is provided. In general, the surgical bone preparation instrument includes a housing member having an inner lumen formed therein, and an elongate member rotatably disposable within the housing member. The housing member can include a distract member adapted to be disposed between adjacent bone structures, and optionally a rotation limiting element, and/or a stop member. In use, the elongate member is rotated with respect to the housing, thereby causing the cutting element to penetrate and remove bone from the adjacent bone structures.

Abstract: An apparatus (10) includes a member (12) and a fastener (16) that connects the member to a bone portion. The fastener (16) has a first end portion (22) engageable with the bone portion, a second end portion (26) extending through an opening (50) in the member (12), and an intermediate portion (32) engageable with the member between the first and second end portions. A connecting ring (42) connects the member (12) to the fastener (16). The connecting ring (42) extends into the opening (50) in the member (12). The connecting ring (42) has a passage (54) with a longitudinal axis (56) through which the second end portion (26) of the fastener (16) extends. A clamping member (28) engages the second end portion (26) of the fastener (16) and the connecting ring (42) to connect the connecting ring to the member (12) and connect the fastener to the connecting ring in any one of a plurality of angular positions relative to the connecting ring.

Abstract: A device for releasably clamping and connecting a longitudinal member within a surgical implant includes at least one yoke-like connecting body with a through-bore, coupling means arranged on the connecting body for fastening the connecting body to a further part of the implant, a yoke-like clamping body which can slide in the through-bore and has resilient side walls and a through-opening for receiving the longitudinal member, and fixation means. A wedging effect produced by elevations on side walls of the clamping body retains the longitudinal member in the through-opening.

Abstract: Self-tapping screw for small-bone surgery, comprising a threaded proximal head (2), a threaded distal shank with greater pitch and an internal cannula (4), characterized in that the distal shank (3) is threaded over its entire length in that the end of the shank has, apart from milled portions forming self-tapping faces on the first distal threads, at least two milled faces and which with the cannula, determine at least two notches (11) and at least two self-boring edges at the distal end of the screw, and in that the thread of the head has, aside from milled portions forming self-tapping faces on the first threads of the proximal screw thread, chamfered faces (16-19), determining boring edges (12b-15b) preceded by a short groove.

Abstract: Endosteal fixation of a ligament graft with an interference fixation device installed in a retrograde manner in ACL reconstruction is disclosed. The interference fixation device may be a screw or a ribbed implant fitted with a length of reinforced suture or wire for pulling the interference fixation device through the tibial tunnel. The suture extends beyond the leading tip of the interference fixation device a sufficient length to allow the interference fixation device to be passed into the joint by pulling on the suture or wire exiting the tibial tunnel. A driver or an impaction device, such as a slap hammer, is employed to advance and insert the interference fixation device in a retrograde manner into the tibial tunnel. Accordingly, interference fixation of the graft near the tibial plateau is provided, thereby eliminating graft abrasion at the tibial plateau tunnel opening.

Abstract: This invention relates to an ancillary for a spinal osteosynthesis system comprising at least one implant that will be implanted in a spine. The implant comprises accommodation means located approximately along a centreline and that will accommodate at least one rod type connecting element. The ancillary comprises holding means that will cooperate with the said implant, and a manipulation means free to move with respect to the said holding means that will be used to manipulate the said connecting element. The said holding means will be arranged on one side of the accommodation means, and the said manipulation means comprises attachment means that will cooperate with the said implant on the side of the centreline of the accommodation means opposite the accommodation means.

Abstract: An improved method of performing surgery on a joint in a patient's body, such as a knee, includes making an incision in a knee portion of one leg while a lower portion of the one leg is extending downward from an upper portion of the one leg and while a foot connected with the lower portion of the one leg is below a support surface on which the patient is disposed. The incision is relatively short, for example, between seven and thirteen centimeters. A patella may be offset from its normal position with an inner side of the patella facing inward during cutting of a bone with a cutting tool. During cutting of the bone, one or more guide members having opposite ends which are spaced apart by a distance less than the width of an implant may be utilized to guide movement of a cutting tool.

Abstract: The disclosure provides implants, instruments and methods for bone fusion procedures. In some embodiments, the implants are particularly advantageous for use between opposing vertebral bodies to facilitate stabilization or arthrodesis of an intervertebral joint. The implants include, at least, a support component that provides structural support during fusion. In a typical embodiment, the implants also include a growth component. A growth component provides an environment conducive to new bone growth between the bones being fused. Several unique configurations to enhance fusion, instruments for insertion and methods for insertion are also disclosed.

Abstract: This invention relates to a malleolar implant for partial or total ankle prosthesis, comprising a head, intended to bear against the astragalus or astragalian prosthetic component and a shank provided to be introduced in a bore in the fibula, characterized in that said shank is provided with means for hooking a traction member adapted to be manoeuvred from the outer side of the fibula, in order to position said shank in said bore.

Abstract: A catheter guide for controlling an angle of entry of a catheter into a human cranium at an angle of 90 degrees to the surface and allowing for easy removable of the catheter guide from the catheter after use. A tubular member defines a catheter guide lumen to permit the passage therethrough of a catheter. A base supports the tubular member. In a two piece assembly, the tubular member may have a fracture line allowing the catheter guide to be separated from the catheter. In an integrated, break-away assembly, the catheter guide may be broken apart to allow for the removal of the catheter guide from the catheter. Alternatively, in an integrated assembly or in a two piece assembly, the catheter guide may be removed from a catheter through a slot in the catheter guide.

Abstract: A bypass graft conduit is installed in the circulatory system of a patient using apparatus which facilitates performing most or all of the necessary work intraluminally (i.e., via lumens of the patient's circulatory system). A guide structure such as a wire is installed in the patient via circulatory system lumens so that a portion of the guide structure extends along the desired path of the bypass conduit, which bypass conduit path is outside the circulatory system as it exists prior to installation of the bypass graft. The bypass graft is then introduced into the patient along the guide structure and connected at each of its ends to the circulatory system using connectors that form fluid-tight annular openings from the bypass graft lumen into the adjacent circulatory system lumens. The guide structure is then pulled out of the patient.

Abstract: The present invention relates to an instrument for closing, by subcutaneous suturing, an orifice made in the abdominal wall of a patient.

Abstract: Apparatus for approximating and closing the walls of a hole or puncture in a physiological shell structure which, in one preferred form, comprises a pair of components that manipulate wire suture. The first component, sometimes referred to herein as a suture introducer, locates the edges of the hole and passes wire suture through them. The second component, sometimes referred to herein as a suture tensioner, gathers the free ends of the wire suture and twists them together, which in turn closes the hole. After the wire suture has been twisted sufficiently to effect closure, the excess wire is trimmed away. The apparatus can deploy more than one wire suture at a time if desired. Using self-locating features and tactile feedback, the apparatus is particularly well adapted to access remote surgical sites.

Abstract: This invention relates to novel methods, kits, and devices for stopping hemorrhaging of percutaneous wounds. The inventive subject matter involves insertion of a purse-string suture around the wound, insertion of the free two ends of the suture through a tension collar, manual tightening of the tension collar until hemostasis is achieved, and application of a suture lock to the free ends of the suture to secure the tension collar and maintain hemostasis. After a sufficient period of time to allow complete hemostasis, the suture lock and the tension collar are loosened; if hemostasis has been achieved, the suture lock, the tension collar, and the suture material are removed. If bleeding continues from the wound, the tension collar is tightened and the suture lock reapplied. This process may be repeated until complete hemostasis is achieved, without the need for additional suturing or manual compression.

Abstract: An implant device including a tubular matrix made of a biocompatible and bioresorbable biopolymeric material. The matrix has a first end and a second end, a wall of a homogeneous thickness; a plurality of ridges on the wall; and a channel which is defined by the wall and extends from the first end to the second end of the tubular matrix.

Abstract: An anastomosis system and method uses an anvil to control and support a tissue site during an anastomosis procedure. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel to the coronary artery because the wall of the coronary artery is very thin, difficult to grasp, and susceptible to tearing. In one method, the anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent and exterior of the target vessel. Staples are inserted through the tissue of the graft vessel and the target vessel by pivoting the arms of a staple holder towards the anvil. When the ends of the staples engage staple bending features on the anvil, the ends of the staples bend over securing the graft vessel and target vessel together.

Abstract: A rotary flexible agitator system for removing an obstruction from within a patient's vessel that a motor-driven rotary flexible agitator-shaft disposed in the tubular housing, the agitator-shaft having an offset distal-agitator attached to its distal end that extends out of the open distal end, the effective diameter of the offset distal-agitator being substantially larger than its cross-sectional diameter, wherein rotating the offset distal-agitator breaks the obstruction in the vessel to pieces and the relative motion between the rotary flexible agitator-shaft and the flexible tube reduces the longitudinal friction that may resist the movement of the pieces through the flexible tube; and a catheter in which the flexible tube is disposed and guided into the vessel having a barrier at its distal end section for temporarily blocking flow through the vessel and reducing the likelihood of distal embolization.

Abstract: A medical instrument for dissecting tissue in the human or animal body comprises a shaft. At least one movable tool is arranged at a distal end of the shaft. At least one movable grip element is arranged at a proximal end of the shaft. A force transmission element extends along the shaft, which force transmission element is movable relative to the latter and transmits thrust and/or tension forces and whose proximal end is non-positively joined to the at least one movable grip element and whose distal end is non-positively joined to the at least one movable tool. The shaft is further provided with a bend at at least one point between the distal end and the proximal end. The force transmission element is configured, at least in the region of the bend, as a flexible tubular element conforming to the bend, which is guided in contact with the shaft.

Abstract: A lancet assembly comprising an elongated lancet and a plurality of cooperative members at least some of which are movable relative thereto so as to selectively orient the lancet in a covered position, operative position or protected position. The plurality of members each comprise at least one coded structure visually indicative of the lancet being in one of the aforementioned positions dependent at least in part on which one or more of the coded structures are predominantly observable. The coded structures may comprise color codings which may be visually distinguishable or visually indistinguishable from one another. Coded structures other than color codings may be utilized.

Abstract: The present invention is an aneurysm treatment device for treating aneurysms of various shapes and sizes.

Abstract: A metal balloon catheter having a main tubular body, a metal balloon proximate a distal end of the main tubular body, a central annulus extending along an entire longitudinal aspect of the catheter for accommodating a guidewire therethrough and an inflation annulus adjacent the central annulus which extends along the longitudinal axis of the main tubular body and terminates in fluid flow communication with an inflation chamber of the metal balloon. The metal balloon catheter may be either unitary integral metal catheter in which the main tubular body and the balloon are fabricated of metal, or it may consist of a polymeric main tubular body and a metal balloon.

Abstract: Disclosed is a focal balloon having at least one reference zone and a focal zone. In one embodiment, the reference zone and focal zone are inflatable to a first generally cylindrical profile at a first pressure. At a second, greater pressure, the focal section expands to a second, greater diameter, while the reference zone remains substantially at the first diameter. In an alternate embodiment, the focal zone and the reference zone are inflatable to their respective predetermined diameters at the inflation pressure, in the absence of constricting lesions or anatomical structures. Multiple lobed and drug delivery embodiments are also disclosed.

Abstract: Multi-lumen balloons for use as or in conjunction with balloon dilation catheters, and methods for making such balloons, are disclosed.

Abstract: A tissue opening occluder comprising first and second occluder portions, each occluder portion including a frame structure and an attachment structure to attach one portion to the other portion. The frames may be utilized to constrain the tissue between the two portions enough to restrict the significant passage of blood therethrough. The frame portions may be covered by a fabric suspended from a perimeter thereof. The occluder portions are conjoined at least one point on each portion.

Abstract: A vascular compression apparatus and method for applying pressure onto an area of a patient generally including a blood vessel and a wound site, such as a blood vessel puncture, after a cannulated procedure for the purpose of controlling bleeding and achieving hemostasis. The vascular compression apparatus includes a handle, an elongate shaft and a pad. The shaft extends generally downward from the cente of the bottom side of the handle, The pad is connected generally at the center of its top side to the bottom end of the shaft. In use, the pad is generally placed proximal to the catheter insertion site and over the blood vessel containing the catheter. The catheter is then removed from the blood vessel and pressure applied to the gandle by the user in a downward direction to force the pad to compress the blood vessel for the purpode of controlling bleeding and, further, to achieve hemostasis. The entire vascular compression apparatus may then be discarded after use.

Abstract: A tourniquet system having a strap, a clamp for selectively engaging the strap in which once the clamp engages the strap, the clamp permits the strap to pass substantially freely in a direction away from the clamp and substantially prevents the strap from passing in a direction towards the clamp and securing structure attached to the strap for securing the strap.

Abstract: A surgical instrument suitable for use in an implant procedure is disclosed. A surgical instrument of the invention can be particularly advantageous for use in grasping, holding and placement of implants in an intervertebral disc space. In a typical embodiment, the surgical instrument has a grasping region to hold the implant, and an impact head for receiving a force in order to insert the implant.

Abstract: Endoscopic surgical operation such as evisceration has been so far hardly achieved by a medical robot, since it requires high power. The present invention provides a downsized high-flexibility active forceps to enable such an operation, without needing a large space for manipulation to target a limited operative area.

Abstract: A mechanical stapling device for fastening deep tissue during the closing of peritoneal side of a stab wound, which is associated with a laparoscopic surgical procedure, is provided. Also provided is a unique staple for use with the stapling device of the present invention. A method of using the device and staple of the present invention is also provided.

Abstract: A modular automated external defibrillator (AED) system includes a base unit and at least one interconnected module. The base unit typically includes a functional circuit and includes an interface that couples the functional circuit to the module. Likewise, the module includes an interface that couples the module to the base unit. By manufacturing such modular AED models instead of one-piece, i.e., integrated, AED models, a manufacturer can reduce the cost and complexity of its manufacturing process. Furthermore, the manufacturer may be able to bring such a modular AED to market more quickly than it could bring an integrated model of the AED to market. Moreover, a modular AED allows the manufacturer and customer flexibility in respectively providing and selecting feature sets. In addition, a customer can obtain replacements for broken modules, and the manufacturer can provide cheaper upgrades by upgrading a module or base unit instead of upgrading the entire AED.

Abstract: In one embodiment, a method is characterized by measuring a patient parameter associated with a human body; in response to the patient parameter, retrieving a maximum expected device parameter; and setting a limit on an energy source such that during defibrillation of the patient a defibrillation parameter associated with the maximum expected device parameter is within a defined tolerance. In another embodiment, a method is characterized by specifying at least one device parameter limit of a defibrillation unit; and in response to the at least one specified device parameter, determining a prediction confidence level at which the device parameter limit is exceeded for one or more values of a patient parameter.

Abstract: A cardiac rhythm management system detects edema. In response to an episode of detected edema, it initiates or adjusts a cardiac resynchronization therapy and/or a cardiac contractility modulation (CCM) therapy.

Abstract: A device and method for cardiac rhythm management in which one heart chamber, designated as the synchronized chamber, is paced in accordance with a pacing mode that employs sense signals from the opposite chamber, designated as the rate chamber. A synchronized chamber protection period triggered by an intrinsic or paced beat in the synchronized chamber is used to inhibit pacing without otherwise disturbing the pacing algorithm.

Abstract: An implantable medical device, such as an implantable cardioverter/defibrillator (ICD) issues a notification when it has been left in a programmed state for some time, possibly inadvertently. The patient or another person may then initiate a course of corrective action, such as programming the device to an appropriate state.

Abstract: An implantable medical device, perhaps a pacemaker lead, has a medical unit and a casing at least partially enclosing the medical unit. The casing is formed of a base polymer having surface modifying pendant groups formed of an acrylamide polymer or an acrylamide copolymer, perhaps polyisopropyl acrylamide. The base polymer may be a polyurethane, polyimide, fluoropolymer or polyolefin, for example.

Abstract: Methods of using physical stimulation by itself or in conjunction with growth factors to treat and prevent visual loss due to choroidal, retinal pigment epithelial and/or neuroretinal cell degeneration and dysfunction are presented.

Abstract: An implantable medical device communication system includes an implantable medical device, a medical information management system, and a module interface apparatus for facilitating communication therebetween. The implantable medical device includes transmitter/receiver circuitry coupled to a device antenna. The medical information management system includes at least a computer processing unit and a display unit. The module interface apparatus includes interface receiver/transmitter circuitry coupled to an interface antenna to communicate with the device transmitter/receiver circuitry via the device antenna. Further, the module interface apparatus includes interface circuitry operable to adapt data (e.g., programming commands) received from the medical information management system for transmittal to the implantable medical device and adapt data received from the implantable medical device (e.g., device data including operational data, physiological parameter data, analyzed data, diagnostic data, etc.

Abstract: A pharmaceutical composition, method and apparatus for treatment, diagnosis or both treatment and treatment of hyperproliferative malignant and non-malignant diseases of epithelial tissues is disclosed. The invention comprises local application of the pharmaceutical composition to a predetermined area of the tissue characterized by complete and consistent coverage of the tissue, including irregularly shaped tissue. The pharmaceutical composition consists of an active component, such as a photosensitizer or a precursor thereof, and at least one carrier substance including a viscous fluid, a gel, or a fluid that becomes viscous upon contact with the tissue. The gel's viscosity allows it to adhere to the tissue for a sufficient amount of time to transfer the photosensitizer or precursor. In a preferred embodiment the pharmaceutical composition is sprayed onto the surface of the diseased tissue.