Abstract: An apparatus and method for facilitating the implantation of a medical device through an incision so as to promote soft tissue ingrowth into a biocompatible porous layer, e. g, titanium, carried on the periphery of the medical device. The method utilizes an incision (either percutaneous or subcutaneous) which is intentionally undersized by 10-20% relative to the width dimension of the porous layer. Accordingly, a physician must stretch the surrounding tissue to maximize the size of the opening to insert the device. Because the opening is undersized relative to the porous layer, the surrounding tissue remains physically stressed, i.e., radially and/or circumferentially, and acts to enhance cell proliferation and healing. A surgical cutting tool is preferably provided to assist the physician to form a properly dimensioned opening.

Abstract: Methods for facilitating access to the intervertebral disc to deliver materials for disc repair are disclosed. The methods may be used to replace or augment nucleus pulposus as well as to perform interbody fusion procedures. These methods include providing access to the intervertebral disc space by drilling a channel through a vertebral bone, optionally accessing the intervertebral disc space to at least partially remove the disc tissue through the channel in the vertebrae; delivering a disc repairing material to the intervertebral disc space and back-filling the channel in the vertebrae with a channel sealing material. The methods may further comprise distracting the intervertebral height and inserting a restrictor into the channel in the vertebrae. Kits for practicing these methods are also disclosed.

Abstract: A surgical portal assembly includes a portal adapted to provide access to underlying tissue and having a longitudinal opening extending along a longitudinal axis of the portal, and defining proximal and distal ends, and a seal. The seal comprises a gel material and a fabric material mounted relative to the gel material. The seal includes internal surfaces defining a passage for reception and passage of a surgical object in substantial sealed relation therewith. A fabric layer may be mounted adjacent each of proximal and distal surfaces of the seal. The internal surfaces defining the passage of the seal may include the gel material whereby the gel material establishes the sealed relation with the surgical object. The seal includes an inner seal segment which may generally taper in a distal direction to define a general funnel configuration.

Abstract: Apparatus for forming and enlarging a percutaneous penetration are disclosed. The apparatus includes an elongate dilation member including a radially expandable member having a first cross-sectional area; and an elongate expansion member including a tubular element having a second cross-sectional area which is larger than the first cross-sectional area. The apparatus further includes an advancing apparatus having a first arm with a first engaging feature for engaging the handle of the dilation member; a second arm with a second engaging feature for engaging the handle of the expansion member; and an operation member; the first arm and the second arm being connected so that operation of the operation member approximates the first engaging feature and the second engaging feature together.

Abstract: An improved surgical port device includes a port body with a tubular section having a distal end. A flexible flange is disposed at the distal end. A retention member is slidably mated along the tubular section such that a distance between the retention member and the flexible flange can be adjusted. In this manner, the position of the retention member with respect to the flexible flange is adjustably fixed to clamp portions of a body wall disposed therebetween, thus effectively clamping the port body in place. The flexible flange has an adaptable diameter that is reduced when the port body passes through a narrow opening in the body wall. Preferably, the flexible flange has a conically-shape that butts up against the inner surface of the body wall during use to thereby provide a seal between the body wall and the frusto-conical flange.

Abstract: An optical obturator apparatus includes an obturator sleeve defining a longitudinal axis and having a longitudinal bore for receiving surgical instrumentation and a transparent window mounted to the obturator sleeve and being dimensioned and configured to pass through tissue. The transparent window is mounted for movement between a first position in general alignment with the longitudinal axis of the obturator sleeve and a second position radially displaced from the longitudinal axis to thereby expose the longitudinal bore of the obturator sleeve to permit passage of the surgical instrumentation. The transparent window may include a cutting blade, or alternatively two cutting blades, adapted to penetrate tissue.

Abstract: A surgical penetrating system includes a cannula and an obturator. The cannula has an outer wall arranged about a longitudinal axis and a longitudinal opening. At least one substantially linear penetrating member is mounted with respect to the outer wall of the cannula and extends in a general longitudinal direction with respect to the longitudinal axis. The penetrating member is adapted to facilitate passage of the cannula through tissue. Another embodiment of the surgical penetrating system includes a cannula having a longitudinal bore and a penetrating member at least partially and slidably mounted within the longitudinal bore of the cannula. The penetrating member has at least one leg and is axially movable between non-deployed and deployed positions. Moreover, the penetrating member can be mounted for movement relative to the leading end of the cannula and within the longitudinal bore of the cannula between a non-deployed position and a deployed position.

Abstract: The invention describes a disposable device for operations on the arteria haemorroidalis, which comprises a retractor tube (1), closed and rounded on the end (101) which is inserted in the anal cavity, and open and diverging on the external end (201) to which is connected a griping handle (M) which removable houses a luminous source (F). In the connection zone of the handle to the external mouth of the retractor there is provided a channel (C) which contains a parabola (5) which reflects the light supplied from said luminous source (F) and which sends the reflected light inside of the same retractor, to illuminate a lateral window (8) through which appears the rectal mucosa upon which the operation must be made for the ligature of the arteria haemorroidalis.

Abstract: A composite anoscope for ano-rectal diagnostic and surgery, wherein the anoscope (2) also comprises an internal component (1), to be inserted therein, and a suitably shorter external component (3), ending with a conic frustum mantle (18), wherein the anoscope (2) is to be inserted. The three components (1, 2, 3) are all conic frustum shaped hollow bodies having circular cross-section. The internal component (1), when inserted in the anoscope (2), forms therewith a single body having a compact and smooth external surface and an ogival tip. The external component (3) is provided close to its mouth with slotted wings (19, 20), to be fixed to the perianal skin for securing the whole composite anoscope during the diagnostic and surgical operations.

Abstract: An anoscope for inspection and/or surgery is provided. The anoscope includes a tubular body having a distal end, a proximal end, and a longitudinal axis defined therebetween, where the tubular body includes at least one elongated slot. The anoscope also includes an insert removably attached to the at least one elongated slot in the tubular body. The insert including an elongated slot having a smaller width than the at least one elongated slot in the tubular body.

Abstract: A portal device maintains an opening in the skin of a patient to allow for the passage of surgical device therethrough. Tabs disposed at one end of the portal device may be used to resist removal of the device, retract soft tissue from the operative site, and seal the opening to prevent the escape of gases or liquids.

Abstract: A disposable cover for the opposed blades of a vaginal speculum comprises a tube of sheet plastic or elastomeric material having an opening at one end of the tube to receive the opposed blades of a speculum and pouches adjacent to the open opposite end of the tube for receiving the tips of the speculum blades to prevent rolling back of the sheet tube during vaginal inspection. The ends of the tube adjacent to the pouches terminate in resilient pointed tips to ease insertion of the covered blades in the vaginal area. The sheet cover is preferably prelubricated for ease of use and to eliminate excess lubricant interfering with cervical cytology results or microbiology studies.

Abstract: A pair of lateral structures is removably attached to a vaginal speculum after the speculum is inserted and opened to retract anterior and posterior vaginal tissue. Each of the lateral structures includes a blade extending along a side of a space provided between the opposed blades of the vaginal speculum to retract lateral vaginal tissue.

Abstract: An anoscope for use with a medical instrument insertable within the interior of the anoscope. The anoscope comprises a tubular member having a longitudinal axis with a proximal end and a distal end. The distal end is insertable into the rectum of a patient while the proximal end remains outside the body. A first longitudinal slot extends from the distal end toward the proximal end, and a second longitudinal slot extends from the proximal end toward the distal end. The first and second longitudinal slots are separated by about 180° on the surface of the tubular member. The first longitudinal slot is adapted to permit access to a site to be treated within the rectum and the second longitudinal slot is adapted to accommodate pivoting of the medical instrument at an angle to the longitudinal axis of the tubular member to improve access to the site to be treated.

Abstract: To assess the sensitivity of a subject's pharynx, an open mouthpiece (1) fitted with a thin guide tube (2), having an articulated end (4), is inserted into the subject's mouth. A pipe (9) is inserted into the guide tube, under visual observation through the mouthpiece, until it touches the subject's palate. The position on a measurement scale (11) provided on the pipe facing a second end of the guide tube is noted, and the pipe is withdrawn over a preset distance, for example 1 cm, and fixed in this position onto the guide tube. A variable gas flow is injected into the pipe and reaches the pharyngeal mucous situated facing the pipe. The sensitivity of the subject's pharynx, measured by the threshold of sense perception, is determined by the lowest flow value perceived by the subject.

Abstract: The present invention is directed to a speculum assembly for single-use in colon lavage therapy. The speculum assembly comprises a tubular body to which a tubing-set is attached. The tubular body has a leading end, a middle portion, and a trailing end. The leading end has a tapering body transitioning into a tip, a scallop opening adjacent to the tip, and at least one annular rib about the tubular body, positioned between the scallop opening and the middle portion. The middle portion has a flange. The flange is in communication with a portion of an irrigation tube. The trailing end of the tubular body comprises a handle that selectively retains a portion of the irrigation tube and attaches to a portion of a waste hose, elements of the tubing set.

Abstract: A hand access device (1, 50, 55, 60, 65) for use as a seal for sealing a surgeon's forearm (2) on entry through a wound opening (3), for example in an abdominal wall (4) comprises a substantially tubular sleeve (5) of pliable gas tight material. The tube is turned axially back on itself to define an outer sleeve section (11) and an inner sleeve section (12) which define therebetween a scaled inflatable chamber. The inner sleeve section (12) is engaged by the forearm (2) which, on insertion, causes the sleeve to ever The device has version limiting means in the form of inner and outer rings (30, 31) which are of elastomeric material.

Abstract: A speculum according to the invention comprises two parts, an outer member (1) and an inner member (2). The outer member (1) comprises a tubular body (3) having an anterior end (4) with an opening (6) and a posterior end (5) with an opening (7). An elongate slot (11) is formed in the side wall (12) of the tubular body (3), extending from the opening (7) at the posterior end (5) towards the anterior end (4). The inner member (2) of the speculum comprises a cup-shaped body (13) having an anterior end (14) formed as a plug (16) and a posterior end (15) with an opening (17). An elongate key member (18) is formed in the side wall (19) of the cup-shaped body (13), extending from the opening (17) at the posterior end (15) towards the anterior end (14). The speculum is assembled by inserting the inner member (2) within the outer member (3) and aligning the key member (18) with the elongate slot (11).

Abstract: A vaginal speculum of the kind including a tubular probe (6) for penetrating the vagina wherein the probe is encircled by an annular sealing element (13), in the form of a thick walled, domed shell of polyethylene foam, spaced from the leading end of the probe and which seals only against a circumferential zone of the internal tissue defining the vaginal orifice. The external surface of the sealing element is shaped as a surface of revolution wherein the diameter of the sealing surface increases progressively with axial distance from the leading end of the sealing element and wherein the rate of increase diminishes progressively with said axial distance. The seal therefore provides a low-pressure seal over a limited range of depths of penetration of the probe into the vagina and over a range of angular alignments of the probe.

Abstract: The invention relates to a combination of a vaginal speculum with a single-lens colposcope for use in a screening process for detecting mucosal abnormalities of cervical intraepithelial neoplasia or invasive cancer, e.g., in the vaginal cavity or on the external parts of the genitalia, as an addition to a Pap Smear screening process. The vaginal speculum is identical to a conventional speculum in its shape, dimensions, and function and differs from a conventional instrument only by having on the inner surface of the lower blade a small projection with a slot for guiding a single-loop colposcope. The latter consists of a tubular rod that can be slidingly inserted into the aforementioned slot and support on its distal end an optical lens. The lens may have a central opening for insertion of surgical instruments, e.g., a biopsy sampler. The proximal end of the tubular rod may support a rubber bulb for suction fluids from the distal end of the lower blade via the tubular rod.

Abstract: An anoscope for surgery and/or inspection comprising: a tubular body (2) having a distal blind end and a proximal open end; an inner light reflecting surface (7) located at said distal blind end; at least one slot (3) formed in said tubular body; a light source (6) placed in light reflection relationship with said inner reflecting surface (7), and a maneuvering handle (5) arranged to act on said proximal end of said tubular body (2).

Abstract: An infrared ray clinical thermometer enhanced in fitted probe cover stability is provided with a simple structure. A mechanism for detecting the presence or absence of a fitted probe cover is provided near the root of a probe, and is mainly composed of a slide member as a movable part, a spring as thrusting means for thrusting the slide member, and a switch for making contact with and departing from the slide member. The slide member is movable disposed in a direction nearly perpendicular to the detaching direction of the probe cover, that is, from the inner side to the outer side, and from the outer side to the inner side of the probe.

Abstract: Differing shaped fittings to retrofit an otoscope to use to inspect and remove foreign material from a nose or an ear depending upon need and fittings to allow use of foot pressure or finger pressure to vary internal pressure in the otoscope are provided within kits of differing makeups.

Abstract: An otoscope kit includes a light source, an otoscope head for mounting on the light source; an adapter for removably mounting to the otoscope head, the adapter having a helical slit about its periphery; and at least one speculum for mounting on the adapter, the speculum having a projection wherein for engaging the slit for drawing the speculum into close contact with the adapter to removably secure the speculum to the adapter during use.

Abstract: A portable data collection device is provided for diagnostic image and data collection at a remote location. The device is implemented as an otoscope including a speculum and light source for illumination of the ear canal. A digital camera element collects the reflected images and provides the images to a processor. The processor processes the images using pattern matching techniques and displays and/or stores suitable images. The images are transferred to a base station for subsequent transmission to a remote server or computer, where an authorized party may access and examine the images. An authorization or prescription from the remote server or computer may be required to enable data collection and transmission by the otoscope.

Abstract: An apparatus and method permit a general practitioner to obtain specimens from a bodily orifice of an animal, such as, for example, a sinus specimen from a nasal area of a human. The apparatus includes a specimen access tube fixedly or removably connected to a speculum, which may be a standard nasal speculum attachment. Anti-contamination structures, either inside or outside the specimen access tube protect against contamination of the specimen due to contact with other matter in the bodily orifice. In accordance with the method, a practitioner advances the specimen access tube into the bodily orifice, and advances the speculum toward the orifice to visualize the advancement of the specimen access tube. When the tip of the specimen access tube is proximate the specimen to be collected, the practitioner advances an applicator into the end of the specimen access tube such that a head of the applicator contacts and holds the specimen.

Abstract: A probe cover of a tympanic thermometer having a probe comprises a base in the form of a ring-type plastic sheet formed with a central opening; and a film sheath that is infrared transparent and has an open end and a closed end, wherein the open end is attached to the base, the sheath portion extended from the central opening can be fitted on the probe of tympanic thermometer, the film sheath comprises a first wall section, a second wall section, and a window between the open end and the closed end, wherein the entire first wall section is formed of a plurality of pleat surfaces and the width of each pleat surface is gradually reduced in the direction from the open end to the closed end, the second wall section is formed by plastic deformation and thus has a smooth wall surface, and the window is in the form of a flat closed surface for fitting on the front end of the probe.

Abstract: A manipulating part of an endoscopic treatment tool, in which, to a cylindrical member having a first finger retaining member, there is slidably mounted a second finger retaining member slidably for remotely driving a distal end operating part using a sliding movement of the second finger retaining member along the cylindrical member. For the manipulating part, a stopper is added, which is movably provided on the cylindrical member, and which is fixed at an arbitrary position on the cylindrical member. The stopper is designed to restrict a length of the sliding movement of the second finger retaining member.

Abstract: A retractor system of the present invention includes an adjustable arm, a carriage, and an activating device disposed in the carriage. The activating device causes movement of at least the adjustable arm to selectively stiffen or release the adjustable arm. The activating device further includes an engagement mechanism that causes movement of at least the carriage to selectively move the carriage. The present invention further includes a tubular retractor distally attached to the adjustable arm having a fiber optic cable embedded in the case of the tubular retractor that is capable of lighting the distal end of the tubular retractor when connected to a light source.

Abstract: Mechanically operable extensions for an otoscope speculum holder to allow line of sight through the otoscope to manually position finger like projections around or over an object such as a bug or peanut and with finger pressure on a lever hold such object for manual removal by removing the otoscope.

Abstract: A method for percutaneous surgery on the spine of a patient under direct visualization is performed through a single cannula having a predetermined length. The length is determined by measuring a distance from the lamina of a spinal vertebra to the skin of the patient, determining a first portion of the length to be less than the measured distance, and determining a second portion of the length to be about one fourth (1/4) the length of the first portion. The first portion is the length of the cannula to be introduced into the patient and the second portion extends external to the patient. This length is preferably 5.5 to 7.0 times greater than the transverse dimension of the cannula. Such dimensions for the cannula permits the longitudinal axis of a tool to be angled between 5 degrees and 8 degrees with respect to the longitudinal axis of the cannula.

Abstract: A probe cover for an infrared (IR) thermometer having two distinct portions, one which is substantially rigid, and the other which is stretchable by at least two times to envelop the probe of the IR thermometer. The stretchable portion allows IR radiation to pass toward the optical window of the IR thermometer probe. The rigid portion of the probe cover is engaged with the probe during the installation process.

Abstract: An anoscope adapted for the suturing of hemorrhoids during a hemorrhoid removal procedure is disclosed. The anoscope has a distal conical tip, a channel body extending proximally from the distal conical tip and a flange radiused outwardly from the channel. A slot is formed in the channel body and runs longitudinally from the distal conical tip through the flange and is flanked by a pair of mutually opposed finger wings that extend out from the flange. The finger wings each have a distal finger wing tip and a concave surface embedded within the finger wing tips. The concave surfaces are sized for the placement of a finger of a user therein.

Abstract: Hemorrhoidectomy apparatus comprising an anoscope comprising a generally cylindrical body having a longitudinal axis, said body comprising an open proximal portion and an open distal portion, said proximal portion comprising a generally cylindrical ring from which distally extend a plurality of strips annularly spaced from each other about the longitudinal axis of said body.

Abstract: A disposable probe cover for an electronic tympanic ("ear") thermometer is made of closed-cell foam that is laminated with a sheet of high density polyethylene plastic film substantially transparent to infrared radiant energy. The probe cover is hollow, defining a central passageway that accepts an oversized probe and can potentially accommodate a variety of different probe configurations. The foam construction allows the probe cover to stretch over the oversized probe--retaining the probe cover on the probe during use. The foam construction also allows the probe cover to deform when inserted into a patient's ear--sealing the patient's ear canal to prevent external heat and light from affecting the measurement, and providing a high degree of cushioning and comfort not available in any prior disposable probe cover design. The film laminate and foam provide a barrier that is impervious to germs, fluids and other secretions--further reducing the already low risk of cross-contamination.

Abstract: A disposable probe cover for an electronic tympanic ("ear") thermometer is made of closed-cell foam that is laminated with a sheet of high density polyethylene plastic film substantially transparent to infrared radiant energy. The probe cover is hollow, defining a central passageway that accepts an oversized probe and can potentially accommodate a variety of different probe configurations. The foam construction allows the probe cover to stretch over the oversized probe--retaining the probe cover on the probe during use. The foam construction also allows the probe cover to deform when inserted into a patient's ear--sealing the patient's ear canal to prevent external heat and light from affecting the measurement, and providing a high degree of cushioning and comfort not available in any prior disposable probe cover design. The film laminate and foam provide a barrier that is impervious to germs, fluids and other secretions--further reducing the already low risk of cross-contamination.

Abstract: An otoscope retrofit speculum extension with a sidearm thereon connectable to a vacuum source to pull a vacuum in the interior of said retrofit extension to pull and to hold a foreign body against an end of said extension to allow removal of foreign bodies from an ear or a nose by removal of the otoscope.

Abstract: An endoscope, in particular a mediastinoscope, in which the handle and the optics guided therein form an inseparable unit and which includes a first and second spatula-like part which can be separated from one another in the longitudinal direction. An adjusting mechanism is provided which permits a separation, a fastenable displacement parallel to the axis and a fastenable pivoting of the two parts relative to one another. In particular by way of the pivotability an expansion of a body cavity to be visually examined or which is to undergo therapy by way of introduced auxiliary instruments is made possible according to requirements.

Abstract: A removable Tee piece to allow connecting to a vacuum source to pull a vacuum in the interior of an otoscope and to allow finger pressure control of the interior vacuum and a plastic foreign body remover extension of the speculum holder of the otoscope allows insertion of the otoscope for removal of foreign bodies from an ear or a nose by using the vacuum to pull and hold a foreign body against the extension as the otoscope is withdrawn. A speculum holder modified to prevent the speculum from making a seal with the outer ear and differing embodiments of the foreign body remover extension are shown. In all instances the retrofitted unit is prevented from making an outer ear seal. Removal of the Tee piece and extension of the speculum holder retrofit units allows the normal use of the otoscope for an ear inspection.

Abstract: A speculum for use in a colonic lavage which includes a hollow cylindrical body for introducing cleansing fluids into the colon wherein the outermost end of the speculum receives a dissolvable insertable tip to facilitate the initial insertion of the speculum into the anal canal of a patient.

Abstract: An ear speculum is provided for use with a standard otoscope for simultaneously viewing and removing an obstruction from a patient's ear canal. Alternative embodiments can perform like functions in other body canals. Affixed to the speculum is a guide tube through which an elongated, flexible probe may be passed into the ear canal without hindering visibility through the speculum. Various embodiments of the flexible probe function to grasp, suction, or cut obstructions within the ear canal. Additionally, the speculum may be used in conjunction with an embodiment of the probe designed to puncture a patient's eardrum and collect a sample of middle ear fluid which is subsequently released into the ear canal.

Abstract: A disposable probe cover for an electronic tympanic ("ear") thermometer is made of closed-cell foam that is laminated with a sheet of high density polyethylene plastic film substantially transparent to infrared radiant energy. The probe cover is hollow, defining a central passageway that accepts an oversized probe and can potentially accommodate a variety of different probe configurations. The foam construction allows the probe cover to stretch over the oversized probe--retaining the probe cover on the probe during use. The foam construction also allows the probe cover to deform when inserted into a patient's ear--sealing the patient's ear canal to prevent external heat and light from affecting the measurement, and providing a high degree of cushioning and comfort not available in any prior disposable probe cover design. The film laminate and foam provide a barrier that is impervious to germs, fluids and other secretions--further reducing the already low risk of cross-contamination.

Abstract: The invention is of an intubation system which is based on a specially designed fiberscopic instrument of a new design to address the unique requirements for intubation. The fiberscope (referred to as an "endoscopic stylet" by the inventor) has a largely semi-rigid insertion cord which permits a user to pre-form the endoscopic stylet to follow the anticipated contours of the airway leading to the trachea and to insure that it reliably shepherds the associated endotracheal tube to the intended tracheal position. By visually tracking the progress of the endoscopic stylet through the airway, specifically through the vocal cords and into the trachea, placed at the proper distance above the carina, as permitted by the fiberoptic portions of the endoscopic stylet, proper positioning of the endotracheal tube is virtually assured, and post-intubation verification would be unnecessary in most instances since intubation is itself verification of proper endotracheal tube placement.

Abstract: Inflatable dual-walled speculums, used for gynecological examinations, that are controllably inflated by the patient with a warmed fluid are provided. A retaining device inserted after inflation of the speculum provides a base and safety for the use of other instruments during the examination. Control of the device by the patient results in a more comfortable examination environment for the patient.

Abstract: An expandable speculum is described which may be provided in kit form. The speculum includes a handle with an integral eyepiece. A set of first elongated tubular members, each releasably connectable to the handle adjacent the eyepiece are formed of a substantially rigid material. Each includes an external surface and an internal bore formed along a longitudinal axis. A selected one of the tubular members may be selected and attached to the handle. The elongated tubular members in the set include various lengths and cross-sectional dimension at the external surfaces thereof to permit selection according to use and patient physiology. Elastic tubular sheaths are disposed axially over the external surfaces of the first elongated tubular members and are radially inflatable with respect to the first tubular members and said longitudinal axis in response to application of fluid pressure.

Abstract: The present invention relates to a surgical manipulator for remotely grasping and manipulating things in response to movements of a human hand controlling the device. Movements of human fingers can be transmitted to mechanical finger-like devices through mechanical cables and linkages. In one embodiment the linkages include a mechanical movement reduction device to translate large hand movements to smaller distal movements. Various structures are provided at the proximal and distal ends for sensing and replicating the movements of a human hand.

Abstract: A speculum having a dilator for insertion into a body cavity of a patient and an opening mechanism for opening the dilator to dilate the body cavity. The dilator has at least two dilator blade members which are pivotal. The opening mechanism consists of a collar which is rotatable to contact and bear against the blade members. This causes the blade members to pivot and move apart, thereby opening the dilator. This results in the body cavity of the patient being dilated which allows for easy examination thereof.

Abstract: A speculum for dilating a body cavity includes a base and a number of arms pivotably attached to the base. There is an actuator movably attached to the base for causing each of the arms to move relative to each other from a closed position to an opened position so that a body cavity can be smoothly opened after the arms have been inserted into the body cavity.