Abstract: A system for maintaining a substantially fixed distance between a localized surface of the heart and the distal end of a surgical device for use in endoscopic surgical procedures. The system comprises a stabilizer for minimizing localized motion of the heart in attached communication with a sensor for sensing localized motion of the heart in a region proximal the stabilizer and a controller in electrical communication with the sensor for processing data indicative of the localized motion of the heart in a region proximal the stabilizer. The processor is in electrical communication with a controller for a robotic arm that holds an instrument for use in an endoscopic surgical procedure, said instrument having a proximal and distal end, and said robotic arm in electrical communication with the controller.

Abstract: In an apparatus for evaluating the performance characteristics of fiber optic endoscopes, a frame defines a carrier support, and an upstanding arm support mounted rearwardly of and adjacent to the carrier support. A plurality of targets are supported on a carrier movable along the carrier support, and an angularly adjustable mounting arm for supporting an endoscope is pivotally coupled to the arm support for movement relative to the plurality of targets supported on the carrier. A bracket is supported on the mounting arm and is adjustable in an axial direction of the mounting arm to accommodate endoscopes of different lengths. A plurality of endoscope holders are each receivable within the bracket on the mounting arm and each holder defines a different diameter corresponding to a respective endoscope for holding endoscopes of different configurations.

Abstract: Devices and methods for performing percutaneous spinal surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30). The fixture (30) includes a housing (31) attachable to the proximal end (22) of the cannula (20) that defines a working channel opening (35) which is in communication with the working channel (25). The housing (31) also defines an optics bore (60) adjacent the working channel opening (35).

Abstract: Devices and methods for performing percutaneous surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30, 170). The fixture (30, 170) includes a housing/body (31, 171) attachable to the proximal end (22) of the cannula (20).

Abstract: A method and a surgical guidance system (20) direct an instrument to a target (40) located inside a patient (22). The surgical guidance system (20) includes a fixation frame (28), a first arc member (36), a second arc member (38), and first (78) and second (84) electromagnetic (EM) radiative sources. The first arc member (36) and the second arc member (38) are adjustably coupled to rotate about a common axis (48) and are adjusted in response to a target address and at least three marker addresses so that the target (40) is located at the center point of a virtual sphere defined by the arc members. A first electromagnetic (EM) radiative beam (80) and a second electromagnetic (EM) radiative beam (86) are projected from the system (20) and intersect at a line. The line forms a trajectory (146) along which an instrument can be directed to the target (40).

Abstract: The invention relates to a holding arm system, particularly for holding surgical instruments in the region of an operation, with a holding arm incorporated into arm segments and into hinge joints connecting these. The holding arm at the proximal end is fastened to a rail which is guided in a horizontal position on the operating table. Each arm segment comprises straight-lined tube segments as outer sleeves and, in each arm tube, a shaft which is axially rotatable relative to the arm tube and which, with conical gearwheels on the end faces, engages into the shaft of the repective connecting arm segment. A fastening device is operable from a single arm segment and locks the whole holding arm by way of a braking device which engages at a defined location within the arm tube and by these means prevents the rotating of the shafts, connected with a positive fit, in the arm segments.

Abstract: An apparatus for mounting a surgical instrument to a stationary member comprising an arm adapted to support the surgical instrument, a mounting member fixedly attached to the stationary member, and a rotatable positioning segment for coupling the arm to the mounting member so that the arm is rotatable to a selected one of a plurality of desired radial positions relative to the mounting member and is detachably coupled to the mounting member in the desired radial position.

Abstract: A surgical manipulator system comprising at least one surgical manipulator, at least one guide, a detector, and a drive controller. The surgical manipulator has a surgical device for performing a desired operation. The guide guides the surgical device. The detector detects a position and/or orientation relationship between the surgical device and the guide, and/or a position and/or orientation relationship between the surgical device and another surgical device. The drive controller controls the surgical manipulator such that the surgical device is guided by the guide.

Abstract: A diagnostic instrument system includes a compact instrument housing having an interior for containing an illumination system and an optical viewing system for illuminating and viewing a target, both systems being arranged within the housing. The housing is separably and interchangeably mounted to a pair of supporting stand fixtures, each fixture having interfacing handle portions to which the instrument can be selectively attached without modification. The interfacing handle portions include electrical and video connections which interface with the optical and illumination systems of the instrument housing when attached to either fixture.

Abstract: An endoscope system having an endoscope, a scope holder holding the endoscope, a magnetic three-dimensional position sensor, and a TV monitor. The sensor detects the position of an object and generates data representing this position. According to the data, the view field of the endoscope is switched.

Abstract: A support stand for surgical implements is disclosed. The support stand provides an operating environment which is particularly useful for use in laparoscopic surgery. The support stand is compact and includes positionable wrists for providing spherical motion of surgical implements about fixed points which can be made to coincide with incisions in a patient being operated on. Each wrist includes a member pivotally mounted to a support arm. Rotating the member provides rotation about a first axis passing through a fixed point. A surgical instrument holder is connected to the member by a linkage which provides rotation about a second axis passing through the fixed point. The linkage has four pivotally connected links, two of which are bent through an angle to provide precise spherical rotation about the fixed point.

Abstract: For tracking a mono- or stereo-laparoscope in connection with minimally invasive surgery, where the laparoscope is moved by a robot in respect to surgical instruments located in the operation area, surgical instruments are color-coded and are identified in images provided by the camera of the laparoscope. Signals for controlling the robot are derived from the position of the color-coded surgical instruments in images generated by both cameras. The robot automatically brings the laparoscope into such a position that the color-coded surgical instruments are continuously shown in the center area of the monitor device and hold the laparoscope distance to the surgical instrument in the case of stereo. To prevent interfering movements of an image when working with the surgical instruments, the laparoscope continuously tracks the color-coded surgical instruments in such a way that the tracking of the image is controlled relatively lightly in the central area of the monitor, but strongly in its edge area.

Abstract: Apparatus and methods are disclosed for percutaneously providing a stabilized platform for performing endoscopic surgery. The disclosed instrumentation includes an endoscope, a fixation catheter, a loop suture, and a rigid mount. A loop end of the loop suture is inserted into the gastrointestinal lumen through the fixation catheter and encompasses the endoscope positioned within the gastrointestinal lumen. The thread end of the loop suture remains external of the patient and is tautly connected to the rigid mount to provide the desired stability to the endoscope for the performance of an endo-surgical operation. Distal to the stabilizing assembly, the endoscope has articulated joints for positioning the distal end of the endoscope in close proximity to the surgical site, and includes manipulator arms which extend beyond the distal face of the endoscope to facilitate access to the surgical site.

Abstract: A surgical hand support apparatus includes a support member having a supporting surface for supporting at least the hand of a patient, a finger restraining member moveable relative to the supporting surface to be positioned to engage the fingers of the patient and a thumb restraining member moveable relative to the supporting surface to be positioned to engage the thumb of the patient. A quick release mechanism is associated with the finger restraining member and the thumb restraining member to lock the respective members at predetermined positions relative to the supporting surface. The apparatus may also include a wrist restraining member to engage the patient's wrist. An instrument support member is associated with the wrist restraining member and is configured to support a surgical instrument.

Abstract: A tool holding and positioning device for remote operation through a narrow opening is described. The tool holding and positioning device has a proximal end, an elongated first tubular member extending from the proximal end, and a distal end. A second tubular member is attached to the first tubular member for rotation about a fixed point adjacent the distal end thereof to position the second tubular member in a particular angle with respect to the longitudinal axis of the first tubular member. A first rod or cable is connected between the proximal end and the second tubular member for controlling its angular position with respect to the longitudinal axis. A second rod or cable is extended from the proximal end through the first and second tubular members to support and position tool means at a variable distance from the fixed point. The tool means are operatively connected to the second rod or cable and are controlled by control means operated from the proximal end.

Abstract: Devices and methods for performing percutaneous spinal surgery under direct visualization and through a single cannula are shown. A device (10) is provided which includes an elongated cannula (20) having a first inner diameter (D.sub.I) and an outer diameter (D.sub.O) sized for percutaneous introduction into a patient. The cannula (20) defines a working channel (25) between its ends (21, 22) which has a second diameter (D.sub.2) equal to the diameter (D.sub.I) of the cannula sized for receiving a tool therethrough. An elongated viewing element (50) is engageable to the cannula (20) adjacent the working channel (25), preferably by a fixture (30). The fixture (30) includes a housing (31) attachable to the proximal end (22) of the cannula (20) that defines a working channel opening (35) which is in communication with the working channel (25). The housing (31) also defines an optics bore (60) adjacent the working channel opening (35).

Abstract: A remote-controlled device is capable of selectively positioning a medical instrument within a predetermined region of space. The device includes a clamp having two pivotally mounted sections enabling the clamp to be placed in either an opened position or a closed position. Each section has a drive wheel including an arc-shaped groove which accommodates the medical instrument when the clamp is placed in the closed position. Each of the wheels has a coupling gear positioned and configured to pivot apart when the clamp is placed in the open position with portions of teeth of the gears remaining engaged with each other. One of the drive wheels is directly driven by a motor housed in one of the sections of the clamp.

Abstract: In a robotic arrangement an elongate telescope(10) is provided adapted to be inserted into a patient(6). A drive arm(8) is connected to the telescope and means(7) are provided to rotate the drive arm about a substantially vertical axis. Drive means are provided associated with the drive arm(8) to adjust the angle of inclination of the cannula. This may comprise means to adjust the angle of inclination of the drive arm(8) itself.

Abstract: A surgical instrument positioning system includes a belt assembly positionable adjacent and across the body of the patient and a surgical instrument, such as a retractor, provided with an attachment portion for attachment to one or more of a plurality of adjustment positions provided on the belt assembly.

Abstract: There is disclosed an endoscope cover attaching apparatus including: a cover holding stage for holding an endoscope cover in the form of a straight line, the endoscope cover including an insertion part cover for covering the insertion part of an endoscope, and an insertion part inlet aperture located at an end of said insertion part cover near a hand operation position, wherein a tube is disposed in said endoscope cover; an operation part holding stage for holding the operation part of the endoscope, the endoscope including the insertion part in which an observation optical system is disposed, and the operation part which also serves as a grip of the endoscope; and rotation means for adjusting the rotational position of the operation part of the endoscope relative to the rotational position of the insertion part inlet aperture of the endoscope cover, wherein the rotation means is disposed at least either on the operation part holding stage or on the cover holding stage.

Abstract: The steps of selecting a hand held endoscope holder includes providing distally convergent tubular devices for receipt of the probes of respective endoscopes, securing such endoscopes in fixed relation within such holder converging distally toward one another at a predetermined angle, coupling such endoscopes through respective cameras and power sources to a multiplexer, coupling such multiplexer to a television monitor, fixing the cameras to a fixture to hold them relative to one another for viewing through three dimensional viewing glasses. The holder carrying such endoscopes is then inserted through an incision to transit the respective images of such endoscopes viewed from the respective relative angles of the endoscopes through such cameras, power source and multiplexer to the television monitor for viewing through such glasses.

Abstract: Each pivotal shaft normally urged in one direction by the urging means drives the movable barrel to push the pressure spring, so that the clutch disposed either to the inner ball or to the outer ball in each joint is brought into press contact with the other ball to lock the joint. Accordingly, once the holding arm holds a tool, the holding force of the arm does not decline with time. Since the pressure applied to the pressure spring by the movable barrel is released by turning the pivotal shaft in the opposite direction by the driving means, each joint assumes an unlocked state. Thus, the tool held at the free end portion of the holding arm can be moved to a desired position, and also the holding position can be changed very easily.

Abstract: A massager having a massage unit provided with elongate coaxial massage rollers rotational on a common axis in a common plane extending above the unit transversely of a travel path defined by a pair of laterally spaced parallel racks on which the unit reciprocably travels on two pairs of gears on opposite sides of the unit and engaged with the racks. A reversible electric motor provides all the necessary drive and associated coupling elements couple the electric motor for drive of the massage rollers and gears for reciprocable travel of the massage unit.

Abstract: The invention provides a percutaneous visualization system for direct, stereoscopic visualization of a body cavity during minimally-invasive surgical procedures. The visualization system includes a cannula having a distal end, a proximal end, and a passage extending therebetween. The passage is configured to allow stereoscopic vision therethrough, and is preferably tapered from the proximal end to the distal end. A sleeve is positionable in the passage of the cannula, the sleeve having an optical passage also configured to allow stereoscopic vision, preferably by tapering. A lens may be disposed in the optical passage of the sleeve tier wide-angle viewing. Magnification means may be positioned in optical alignment with the optical passage to provide a magnified image of a surgical site.

Abstract: A cannula and associated endoscope are secured to an operating table by a mechanical linkage assembly having linear and angular connections. These connections are adjustable for supporting an endoscope extending through an incision. Two angular connections are friction joints that allow manual repositioning of the scope by pivoting about respective orthogonal axes that intersect at a point along the scope that is coincident with the location of the incision.

Abstract: A surgical instrumentation kit for preliminary diagnostic endoscopic examination includes a trocar assembly, a self-contained insufflation unit having a supply of insufflation media and a self-contained illuminating unit for supplying illuminating light. The surgical kit is disposable and is intended for use with an endoscope of the type including an optical system and an illumination system. A method for utilizing the kit of the present disclosure is also disclosed.

Abstract: A laparoscopic defogging apparatus for regulating and maintaining the temperature of a lens and end portion of the laparoscope is disclosed. A receptacle is provided which contains a first sterile fluid at a sufficient depth to allow the lens and end portion of the laparoscope to be placed in thermal contact with the first sterile fluid. A container is provided into which the receptacle is placed, which container is adapted to receive and contain a second sterile fluid at a sufficient depth to provide thermal contact with at least a part of the receptacle side wall portion. A heating device is provided to heat the sterile fluids whereby the laparoscope is maintained at a constant desired temperature, thereby preventing lens fogging.

Abstract: A surgical hand support apparatus includes a support member having a supporting surface for supporting at least the hand of a patient, a finger restraining member moveable relative to the supporting surface to be positioned to engage the fingers of the patient and a thumb restraining member moveable relative to the supporting surface to be positioned to engage the thumb of the patient. A quick release mechanism is associated with the finger restraining member and the thumb restraining member to lock the respective members at predetermined positions relative to the supporting surface. The apparatus may also include a wrist restraining member to engage the patient's wrist. An instrument support member is associated with the wrist restraining member and is configured to support a surgical instrument.

Abstract: The invention features a remote-controlled device for selectively positioning a medical instrument within a predetermined region of space. The remote-controlled device has a motor which provides mechanical energy to the remote-controlled device, a driver that is coupled to the motor and that has a predetermined relationship with the motor. The driver physically engages the medical instrument and converts the mechanical energy into controlled motion of the medical instrument. The remote-controlled device receives control signals from a remote location that direct the motor to supply a predetermined amount of mechanical energy, whereby the driver, with the predetermined relationship with the motor, selectively positions the medical instrument within the region of space.

Abstract: A medical instrument stabilizer for use in endoscopic procedures includes a stabilizer body for being placed against an external surface of an anatomical cavity wall and having a port for receiving medical instruments to be introduced into the anatomical cavity through the stabilizer body and the anatomical cavity wall. An anchoring system carried by the stabilizer body includes a tissue penetrating member movable between a retracted position wherein a tissue penetrating tip of the tissue penetrating member is disposed in a safe, non-exposed position and an extended position wherein the tissue penetrating tip extends from the stabilizer body to penetrate the anatomical wall and anchor the stabilizer thereon. Medical instruments inserted into the anatomical cavity through the port of the stabilizer are secured relative to the stabilizer and, therefore, the anatomical wall.

Abstract: A holding tray assembly for holding an endoscopic sheath during installation of the sheath onto an insertion tube of an endoscope and removal of the sheath from the insertion tube, wherein the sheath has a distal end and an open proximal end shaped to receive the insertion tube. The holding tray assembly has a tray with a slot formed therein extending inward from the peripheral edge of the tray. The slot is adapted to receive at least a portion of the endoscopic sheath so the proximal end of the sheath is positioned above the tray and the distal end of the sheath is below the tray. A sheath holding clamp is connected to the tray adjacent to a closed end of the slot, wherein the sheath holding clamp is adapted to releasably hold at least a portion of the endoscopic sheath within the slot. A tray securing apparatus is connected to the tray and is adapted to secure the tray onto a floor stand or other tray support structure.

Abstract: The invention is directed to a combination of a viewing and/or documenting apparatus and an endoscope connected forward thereof. The endoscope can be pulled out relative to the apparatus and can be deflected at an angle if desired. A coupling is provided between the focusing position of the main objective of the apparatus and the pull-out length of the endoscope in such a manner that the intermediate image supplied by the endoscope is always focused independently of the particular pull-out length.

Abstract: A method is presented for stereoscopically observing a tissue in a patient's body cavity which includes the selection of a hand held holder formed with a pair of elongated open ended tubular housings for receipt of conventional elongated monoscopic endoscopes. The housings are rigidly connected together and converge distally inwardly toward one another at a predetermined angle for receipt of the respective endoscopes so they can project from the distal end thereof for observation of the patient's tissue. The surgeon may position the endoscopes in the respective housings and affix them in position to be held angled toward one another. An incision may be made for access to the patient's chest or abdomen and the tissue to be examined manipulated away from the opening. A multiplexer device is selected and coupled with the endoscopes and a monitor selected for use with a muliplexing device to display images thereon. Three dimensional viewing glasses may be selected for use with the monitor to view the tissue site.