Abstract: A system and method for generating a gas-supersaturated fluid and delivering the fluid at high delivery pressures to thereby prevent bubble nucleation is disclosed. The system comprises a housing for containing a removable fluid assembly for housing a fluid to be gas-supersaturated and a drive assembly for delivering the fluid to a delivery site. The housing assembly comprises a cylinder and a piston which may be advanced along the inner surface of the cylinder to pressurize and to deliver the fluid. To generate a gas-supersaturated fluid, the housing assembly is removed from the system housing, filled with a fluid, and gas is introduced at or slightly above the desired gas partial pressure into the cylinder.

Abstract: An energy delivery probe is provided that may include any of a number of features. One feature of the energy delivery probe is that it can apply energy to tissue, such as a duct, to shrink, damage, or occlude the duct. In some embodiments, the energy can be applied with a vapor media. In some embodiments, the duct can be a ductus deferens or an ejaculatory duct of the male reproductive system. Another feature of the energy delivery probe is that it can utilize an inflatable member to form a seal to contain the vapor media. Methods associated with use of the energy delivery probe are also covered.

Abstract: A valve assembly for the sealed reception of an elongated object is provided. The assembly includes a valve body defining at least one opening configured and dimensioned to permit entry of an elongated object and defining a central longitudinal axis, and an elongated seal member having a resilient sealing structure and defining an aperture in general alignment with the opening of the valve body whereby the aperture is configured and dimensioned such that upon insertion of the object into the aperture, the resilient sealing structure resiliently engages the outer surface of the object in a tight manner. The sealing structure includes a plurality of elongated bristle members attached to the seal member. The bristle member are positioned to engage the elongated object upon at least partial insertion of the elongated object into the valve body.

Abstract: A method and apparatus to treat nosebleeds includes the steps of producing cold air using the input of air into a cooling apparatus and administering the cold air to the inside of the nose. The apparatus includes a cooling device with no moving parts. The cooling device can be a vortex tube or a Peltier-type thermoelectric cooler, or a pre-cooled tank of compressed air. The cold air can also be mixed with water to moisturize the cold air.

Abstract: An over tube comprises an over tube body that has an inner diameter fitting over the outer diameter of an insertion part, and is flexible and expandable in the direction of the outer diameter, a gas supply port provided on the base end side of the over tube body, an expansion/contraction part that is formed integrally with the gas supply port, provided to communicate from the base end side to a predetermined position on a distal end side, and can expand in the direction of the outer diameter by injecting a gas from the gas supply port, and at least one channel that is provided between the inner and the outer diameters of the over tube body, and penetrates from the distal end of the over tube through the base end side.

Abstract: An intravenous oxygenator for enriching blood with oxygen, said oxygenator having a bundle of fibers, said fibers being each connected to a gas supply means through a first connection and to a gas evacuation means through a second connection, with the fiber bundle being twisted during operation by relative rotation of the first connections of the fibers relative to the second connections of the fibers about a longitudinal axis of the oxygenator. Further, an intravenous oxygenator for insertion into a vein, the connections being respectively connected to a first and to a second fiber holder and being displaceable along a longitudinal axis of the oxygenator, with the fiber holders being mounted so as to be rotatable relative to one another about the longitudinal axis of the oxygenator. Such a constellation permits particularly efficient gas exchange.

Abstract: An operation system has a controller controlling a plurality of medical devices and a footswitch, the footswitch having a selection unit capable of selecting a medical device to be used and an output of the medical device; and a first and second pedals capable of instructing the selected medical device to perform the output, and the controller having a memory unit storing output pedal setting information comprising operator identification information, first pedal setting information and second pedal setting information; and a control unit controlling, when the selection unit selects given output pedal setting information and the respective pedals are held down, the respective medical devices on the basis of the first and second pedal setting information in the output pedal setting information.

Abstract: Apparatus used in insufflation comprises an insufflator 12 for generating an insufflation gas such as carbon dioxide and an aerosol generator 2 for aerosolising a fluid and entraining the aerosol with the insufflation gas which is delivered during surgery. The aerosol generator 2 comprises a vibratable member 40 having a plurality of apertures extending between a first surface and a second surface. The fluid may comprise a therapeutic or prophylactic agent. A controller 3 is used to control the operation of the aerosol generator 2. The controller 3 controls operation of the aerosol generator 2 responsive to the flow of insufflation gas such as detected by a flow sensor 11. The pulse rate at a set frequency of vibration of the vibratable member 40 is controlled.

Abstract: A tissue perforation device and method. The device preferably includes a housing having a housing pass-through, a penetrator securely and sealably positioned so that the penetrator device passes through the housing pass-through, and a vacuum system comprising a vacuum source securely and sealably attached through the housing for advancing a patient's tissue onto the penetrator device.

Abstract: The invention provides, in one embodiment, a multifunctional, multi-piece medical device and related method for providing access to an internal body cavity, such as for use with a vacuum lift shell. The device can include a cannula and a cannula extension. The device provides a conduit between the external environment and operative field inside the patient's body during medical procedures, including diagnostic, therapeutic and surgical procedures. The invention allows entry and exit of air or gas to help create and maintain the operative field. The invention can be used to provide an open and unobstructed working path, and allows the operative space to be maintained at ambient conditions of pressure and temperature.

Abstract: A method is provided, including physically contacting a gastric implantation site of a stomach via a transluminal approach, physically contacting the site via a transabdominal approach, stabilizing the site, and implanting an electrode at the site based on the physical contact provided by the transluminal and transabdominal approach. Other embodiments are also described.

Abstract: An instrument and a method are proposed for endoscopically controlled shortening and/or fragmentation of stents made from electrically conductive material situated in the gastrointestinal tract, in the tracheobronchial system or in other hollow organs. The instrument comprises an electrode device with an electrode for introducing a high-frequency current into at least one wire of the stent and/or to form electric arcs between the electrode and the at least one wire. Use of the instrument and the method results in little or reduced damage being caused by current and/or heat in tissues directly adjacent to the application site and in tissues remote therefrom.

Abstract: A surgical kit and method for transanal endoscopic surgical techniques. A medical instrument having an obturator tip with an insufflation channel and a tube for an optical device. A medical instrument having an insufflation channel and tube for an optical device, whereby a pressure system is used, such that auxiliary tools can be used to remove a tumor from a transanal cavity. A method for using the surgical kit and medical instruments individually and/or in sequence, whereby said surgical kit and medical instruments are used to access the transanal cavity by using a natural opening of the body.

Abstract: Systems, devices, and methods permit insufflation of a body cavity prior to the insertion of a cannula into the body cavity. Some embodiments of an access system comprise an obturator, a trocar, and a fluid flow channel. The access system has a closed configuration, in which a distal end of the access system is fluidly isolated from the fluid flow channel, and an open configuration, in which the distal end of the access system is fluidly connected to the fluid flow channel, thereby permitting fluid flow, for example, an insufflation gas into a body cavity.

Abstract: One aspect of the invention is an apparatus including an alarm for alerting an operator to recharge a humidifier, wherein such alarm is generated other than through the use of a humidity sensor. In one embodiment the total work performed during heating and hydrating an insufflation gas is measured and an alarm generated when the total work performed exceeds a particular threshold. In another embodiment, a flow meter is used to measure the total flow of insufflation gas so that when the total flow of insufflation gas reaches a predetermined level an alarm is activated.

Abstract: The invention includes a device, kit, and system capable of manually distending a subject's body cavity. In one embodiment, the invention includes a distention media reservoir (10), insertable member (20) for insertion into a body cavity, and a manually operated pumping member (12) capable of displacing distention media from the reservoir and into a body cavity. In some embodiments, the distention media reservoir may be air or CO2. In one embodiment, the invention is available in the form of a kit. In another embodiment, the devices include a reusable portion and a consumable portion. The reusable portion may include the media distention reservoir and pumping member, the consumable portion includes the insertable member, and may also include a barrier for preventing effluent from contaminating the reusable. In other embodiments, the device is adapted to function as a distention media booster pump that may be used in conjunction with an electro-pneumatic insufflation system.

Abstract: A system for insufflation and recirculation of insufflation fluid in a surgical procedure. The system includes a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The fluid pump is adapted and configured to circulate insufflation fluid through the system. The supply conduit is in fluid communication with an output of the fluid pump and configured and adapted for delivering pressurized insufflation fluid to an output port of the control unit. The return conduit is in fluid communication with an input of the fluid pump for delivering insufflation fluid to the fluid pump and is configured and adapted for returning insufflation fluid from an input port of the control unit. The pressure-controlled is in fluid communication with the supply conduit and the return conduit, and is adapted and configured to receive a control signal and respond to the control signal by opening, thereby fluidly connecting the supply conduit and the return conduit with one another.

Abstract: In laparoscopic or thorascopic surgery, a trocar is used to provide an passage into the body cavity of a patient for injecting an inert gas to inflate it. A laparoscope or thorascope is passed through a sealing membrane of the trocar so the patient may be observed without releasing a large quantity of the inert gas. If the scope lens is clouded with body liquids or tissue, the scope is removed from the trocar and its lens cleaned. The trocar cannula is cleaned by running a swab through the sealing membrane into the cannula and removing body liquids, tissue and/or check valve lubricant from the inside of the cannula. The swab includes radiopaque markers on the sorbent end, measuring marks on the swab handle and an enlargement on the swab handle. The enlargement is positioned so it may be grasped and the swab pushed into the cannula a distance which is insufficient to push the sorbent end out of the end of the cannula.

Abstract: The present disclosure relates to surgical access assemblies and surgical valves or seals of the type adapted to allow the introduction of a surgical instrument or object therethrough. In particular, the surgical access assemblies and seals disclosed herein are adapted to facilitate the insertion, withdrawal, and manipulation of a surgical instrument through the incorporation of a lubricous substance or fluid.

Abstract: An apparatus and method for on-the-go humidifying an insufflation gas through water vapor transfer from a liquid to the insufflation gas through a barrier separating the gas from the liquid to enable the gas in a normally trauma inducing state to be brought to a conditioned state. If the gas is at an improper insufflation temperature the temperature of the gas can be brought to the proper insufflation temperature at the same time the gas is humidified through heat transfer through the barrier.

Abstract: An apparatus, such as a medical device, includes an elongate member having a proximal end portion and a distal end portion. The elongate member defines a lumen extending from the proximal end portion to the distal end portion. The distal end portion of the elongate member is configured to be inserted into a body of a patient. The apparatus includes a heating element configured to heat the lumen defined by the elongate member such that a material within the lumen is heated and can be delivered to bodily tissue.

Abstract: An insufflation system is provided that includes an insufflator having a delivery assembly for delivering insufflating gas from a pressurized source of insufflation gas to at least one gas delivery path. At least one output line is coupled to the at least one gas delivery path. At least one dual-capacity tube has a first tube with a first end coupled to the at least one output line and a second end. The dual-capacity tube has a pair of tubes that each has a first end attached with the second end of the first tube. The dual-capacity tube provides for fluid communication of the insufflating gas between the insufflator and laparoscopic equipment that is insertable into a peritoneal cavity.

Abstract: A tissue perforation device and method. The device preferably includes a housing having a housing pass-through, a penetrator device securely and sealably positioned so that the penetrator device passes through the housing pass-through, and a vacuum system comprising a vacuum source securely and sealably attached through the housing for advancing a patient's tissue onto the penetrator device.

Abstract: Apparatus and methods for internal surgical procedures are disclosed. The apparatus and methods may involve supporting internal body locations, creating submucosal separations (blebs), and/or for resecting mucosal tissue separated from underlying tissue by a bleb.

Abstract: An apparatus for equalizing pressure in a middle ear includes a hand-held air source for providing a continuous flow of air at a predetermined rate and a tapered sealing nostril plug adapted to be sealed against a nostril. The tapered nostril plug has a channel there through for delivering the continuous flow of air. The channel of the tapered plug is adapted to be placed in communication with the air source through an adjustable valve assembly for selecting a pressure limit for the air in the channel of the nostril plug.

Abstract: A cannula includes a tubular body and an endoscope for viewing through a transparent, blunt, tissue-separating tip substantially covering the distal end of the body. Endoscopic viewing through the tip is enhanced by inner walls that taper to a cusp adjacent the blunt tip in order to reduce visual distortion. Alternatively, a cannula includes a dissection probe and a removable or deflectable tip for exposing the probe and endoscope to facilitate viewing and the dissection of connective tissue and lateral vessels along the dissected cavity. Methods of using such cannulas produce an elongated cavity along the course of a vessel for subsequent harvesting or other treatment of the isolated vessel. Lateral branch vessels of a main vessel to be harvested are doubly clipped or otherwise doubly occluded, and then severed to isolate the main vessel for use, for example, in revascularizing the coronary artery.

Abstract: In a gas supply system, a selection unit is configured to send an instruction to select any one of first gas and second gas. In the gas supply system, a controller is operative to control at least one of a first gas supply unit for supplying the first gas and a second gas supply unit for supplying the second gas to selectively insufflate any one of the first gas and second gas into a body based on the instruction sent from the selection unit.

Abstract: The invention relates to a hose set for a device (1) for insufflation of gas into a human or animal body, comprising a first hose portion (2) including a first port (3) and a second port (4), said first port being connectable to the device (1) for insufflation, comprising a second hose portion (5) including a third port (6) and a fourth port (7), said fourth port (7) being connectable to an insufflation instrument (8), wherein said second port (4) comprises a first connecting element (9) and said third port (6) comprises a second connecting element (10), said first connecting element (9) and said second connecting element (10) being mechanically complementary with respect to each other, by means of said connecting elements (9, 10) said second port (4) and said third port (6) being connectable with each other in a gas-tight manner, and wherein said second or said third port (6) comprises a sterile filter element (11), which spans the inner cross section of said third port (6).

Abstract: An apparatus for conditioning gas for use in a medical procedure, such as endoscopy, the gas being received into the apparatus from a gas source. The apparatus comprises a housing defining a chamber having an entry port and an exit port. A humidification means comprising at least one water-retainer layer is disposed within the chamber in the path of travel of the gas for humidifying the gas as it passes through the chamber. A humidity sensor is disposed within the chamber that senses the humidity of the gas exiting the chamber. A monitoring circuit is connected to the humidity sensor that detects when the chamber requires a recharge of liquid based on the humidity of the gas in the chamber, and generates a recharge signal indicative thereof. A charging port on the housing provides access into the chamber to recharge the chamber with water. A heating element and temperature sensor are also disposed within the chamber. A control circuit further regulates the temperature of the gas exiting the chamber.

Abstract: An apparatus for conditioning gas for use in a medical procedure comprises a housing defining a chamber having an entry port and an exit port. The housing contains at least a humidification means comprising a container for liquid. A humidity sensor may be disposed within the chamber that senses the humidity of the gas exiting the chamber. A monitoring circuit is connected to the humidity sensor that detects when the chamber requires a recharge of liquid, and generates a recharge signal indicative thereof. A charging port on the housing provides access into the chamber to recharge the chamber with water. Alternatively, a backup container of liquid is provided to continuously supply liquid to the humidification means. A heating element and temperature sensor are also disposed within the chamber. A control circuit further regulates the temperature of the gas exiting the chamber.

Abstract: An apparatus (100) and a method for subcutaneous delivery of gas for therapeutic purposes, in particular carbon dioxide (CO2), are described. The apparatus (100) includes a tank (10) for gas delivery connected, by a delivery line (20), to a needle (4) designed to be inserted into the patient's subcutaneous tissue. The apparatus further includes a heating/sterilizing system (30) disposed in the delivery line (20), upstream of the injection needle (4), to sterilize the gas and heat it to an optimal temperature to enable it to be injected beneath the patient's skin.

Abstract: Apparatus used in insufflation comprises an insufflator 12 for generating an insufflation gas such as carbon dioxide and an aerosol generator 2 for aerosolising a fluid and entraining the aerosol with the insufflation gas. The aerosol generator 2 comprises a vibratable member 40 having a plurality of apertures extending between a first surface and a second surface. The fluid may comprise a therapeutic or prophylactic agent. A controller 3 is used to control the operation of the aerosol generator 2. The controller 3 controls operation of the aerosol generator 2 responsive to the flow of insufflation gas such as detected by a flow sensor 11.

Abstract: An infusion system with a needleless or needle-requiring injection site placed downstream of a fluid selection stopcock valve and upstream of the infusion cannula. In an alternate embodiment the fluid selection stopcock valve and injection site may be formed as a single consumable unit.

Abstract: A trocar assembly for use in surgery in a patient, comprising an elongated outer tubular member having a first or proximal end and a second or distal end. The proximal end has a housing enclosing a fluid pressure chamber therein. The distal end of the outer tubular member has a gaseous fluid discharge arrangement therethrough, through which a medical instrument is disposed for surgical manipulation of the patient.

Abstract: An ear cleaning apparatus for removing ear wax from an ear canal has a housing having an ear insertion tip shaped to fit into a person's ear. The housing has first and second passageways with each passageway having an opening in the insertion tip adjacent to each other. The first passageway has an air bleed thereinto. A heater is mounted in the housing first passageway for generating heat, such as with a butane burner. A fan is mounted in the second passageway for drawing air thereinto through the second passageway opening from the first passageway opening when the ear insertion tip is inserted into an ear thereby drawing heated air from the first passageway into the ear and into the second passageway.

Abstract: A respiratory assist device and method for the prevention of ventilator acquired pneumonia in a patient is described. The respiratory assist device administers nitric oxide to the oropharyngeal area in order to decontaminate or prevent the contamination of secretions that collect in the oropharyngeal area during intubation of the patient. The respiratory assist device and method may be adapted for use, for example, as an endotracheal tube or as a tracheotomy tube.

Abstract: An insufflation apparatus includes an elongated sleeve defining a longitudinal axis and having a proximal end and a distal end with a sharpened tip, an insufflation housing connected to the proximal end of the elongated sleeve and defining a port for receipt of insufflation gases, and a stylet disposed within the elongated sleeve and defining a passageway to direct the insufflation gases from the port into a body cavity. The stylet is movable between an extended position wherein the distal end of the stylet extends beyond the sharpened tip of the elongated sleeve and a retracted position wherein the distal end of the stylet is proximal of the sharpened tip of the elongated sleeve. A biasing member may be engagable with the stylet so as to bias the stylet toward the extended position. Preferably, the housing has a translucent wall and the stylet is dimensioned so that the proximal end of the stylet is visible through the translucent wall when the stylet is in the retracted position.

Abstract: An improved consumable for use in a fluid/gas exchange in vitreoretinal surgery. The consumable includes a syringe having a barrel with a first opening for receiving a retinal tamponading gas, a stopper slidably disposed within and fluidly sealed to the barrel, a plug assembly, and a plunger. The plug assembly facilitates both the filling of the syringe with retinal tamponading gas as well as the injection of the tamponading gas into the eye.

Abstract: A laser energy delivery device is provided that is suitable for irradiating a body tissue with relatively long wavelength laser energy in the presence of an aqueous liquid without significant absorption of the laser energy by the liquid. The device includes an elongate hollow sheath that has an open aperture at its distal end portion and closed at its proximal end, a laser energy conduit such as an optical fiber or hollow wave guide, within the sheath, the distal end of the conduit being disposed near the open aperture at the distal end portion of the sheath, and the proximal end of the conduit being adapted for connection to a source of long wavelength laser energy. The sheath also includes an inlet port, spaced from the proximal end of the sheath, and adapted to receive and deliver a biologically compatible gas through the sheath to a body tissue site in contact with the open distal end of the sheath.

Abstract: A cannula assembly for the maintenance of an operative pneumoperitoneum in a patient comprising an elongated cannula having a proximal end and a distal end. A removable valve is securely arranged in the proximal end of the cannula to provide a seal and minimize the escape of gas introduced into the patient's pneumoperitoneum when an operative instrument is passed therethrough.

Abstract: A method of topically treating the respiratory tract of a mammal with nitric oxide exposure includes the steps of providing a source of nitric oxide containing gas and delivering the nitric oxide containing gas nasally to the upper respiratory tract of the mammal. Also provided are several designs for a nasal delivery device for the controlled nasal deliver the nitric oxide containing gas.

Abstract: An insufflation apparatus includes an elongated sleeve defining a longitudinal axis and having a proximal end and a distal end with a sharpened tip, an insufflation housing connected to the proximal end of the elongated sleeve and defining a port for receipt of insufflation gases, and a stylet disposed within the elongated sleeve and defining a passageway to direct the insufflation gases from the port into a body cavity. The stylet is movable between an extended position wherein the distal end of the stylet extends beyond the sharpened tip of the elongated sleeve and a retracted position wherein the distal end of the stylet is proximal of the sharpened tip of the elongated sleeve. A biasing member may be engagable with the stylet so as to bias the stylet toward the extended position. Preferably, the housing has a translucent wall and the stylet is dimensioned so that the proximal end of the stylet is visible through the translucent wall when the stylet is in the retracted position.

Abstract: Smoke evacuation apparatus designed to provide safe and efficient filtration and evacuation of smoke plume generated by laser-surgical, electrosurgical, radiosurgical, and electrocautery devices. A filter assembly is removably mounted on a front panel of the apparatus housing and is thus easily accessible from the front side which typically faces the user. The filter assembly at its front is provided with a hose connector to which the suction hose of the system is conveniently attached, and the front of the filter assembly is configured with a symbol, such as a letter or number, that represents an identification of the system supplier or manufacturer, and the hose connector is mounted on that symbol identifier.

Abstract: A trocar assembly for use in surgery in a patient, comprising an elongated outer tubular member having a first or proximal end and a second or distal end. The proximal end has a housing enclosing a fluid pressure chamber therein. The distal end of the outer tubular member has a gaseous fluid discharge arrangement therethrough, through which a medical instrument is disposed for surgical manipulation of the patient.

Abstract: A hollow plastic cannula with plunger having a funnel shape entrance at one side and a sharp slant cut on the other. A hollow polyethylene catheter is shaped to fit within the cannula once inserted in the abdomen. The present invention is a means of performing an error-free abdominal insufflation for Laparoscopic procedures.

Abstract: A method and apparatus for treating gas for delivery into a body cavity, body space or body surface of an animal. The apparatus comprises a housing defining a chamber having an entry port and an exit port. One or more agents are released into the gas stream that flows through the chamber so that the gas stream carries the agent to the animal.

Abstract: A method of addressing a condition of a living body comprising the steps of using an energy beam to form a set of pores in a work piece biocompatible membrane. The pores should have a mean area of less than 500 ?m through the biocompatible membrane, thereby producing a microporous membrane adapted to facilitate tissue in growth. This membrane is placed at least partially about an article that is adapted to be implanted in a living body, which is implanted into the living body, thereby addressing the condition.

Abstract: The present invention generally relates to medical devices. Specifically, the invention pertains to implantable medical devices that produces gaseous agents from precursors and releases them into the body. More specifically, the invention provides for the controlled release of the gaseous agent to the body to produce a local or systemic therapeutic effect.

Abstract: A trocar system for providing access across a body wall includes a trocar and an anchor provided in the form of a first helix. The anchor is adapted for placement in an operative position wherein the anchor extends at least partially through the body wall. A second helix formed on the trocar is size and configured to engage the first helix of the anchor so that rotation of the trocar relative to the anchor moves the second helix along the first helix. In this manner, the trocar is drawn into the anchor as it moves into the body wall. A proximal force applied to the anchor resists tenting of the abdominal wall. The anchor also holds the layers of the body wall together thereby resisting peritoneal separation.

Abstract: The invention refers to a method for creating a protecting atmosphere in a volume, including the steps of: providing a device, which is arranged to permit the supply of a gas and which includes at least a supply conduit including a discharge end and a porous body provided at said discharge end, supplying said gas by means of said device through the porous body in such a way that a controlled flow of said gas is formed and providing said porous body in relation to said volume in such a way that the controlled gas flow forms a gas cushion, which substantially fills said volume, and that said gas cushion is arranged to prevent air from the environment from reaching said volume. The invention also refers to a device for creating a protecting atmosphere in a volume.