Abstract: A medical fluid suctioning device for selectively applying varied levels of suction pressure at a device-tissue interface includes a direct “trumpet”-type control mechanism in conjunction with a “venturi”-type control. A valve manifold is adapted to couple a vent pathway and a suction pathway simultaneously to the vacuum conduit adapted for connection to a vacuum source. The amount of resistance to flow due to vacuum pressure is adjusted simultaneously in both the vent pathway and the suction pathway in order to achieve controlled, selected levels of suction. Similarly shaped valve apertures are provided in inverse and reciprocal orientation along an axis of motion of a valve manifold. The apertures translate across ports to the suction and venting pathways simultaneously to vary applied suction to those pathways inversely.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within or on a patient's body. In particular, methods and apparatus are provided for resecting, cutting, partially ablating, aspirating or otherwise removing tissue from a target site, and ablating the tissue in situ. The systems and methods of the present invention are particularly useful for ablation and hemostasis of tissue in sinus surgery (e.g., chronic sinusitis and/or removal of polypectomies) and for resecting and ablating soft tissue structures, such as the meniscus and synovial tissue within a joint.

Abstract: An electrocautery instrument is provided with a hollow electrode having a source of conductive fluid coupled to a proximal end thereof. Conductive fluid is communicated through said electrode and expelled out of the distal end thereof during electrocautery, forming a “virtual electrode.” The infused conductive liquid conducts the RF electrocautery energy away from the conductive electrode, thereby displacing the region of thermal generation and reducing the extent of burns and perforations caused by conventional electrocautery electrodes. In one embodiment, the electrode is partially disposed within and extends distally out of a retractable suction tube, such that smoke and fluid are aspirated from the electrocautery site. When the suction tube is fully advanced, the electrode is concealed therein, enabling suction without electrocautery to be performed.

Abstract: A tip for a liquefraction surgical handpiece. The tip uses at least two channels or tubes. One tube is used for aspiration and at least one other tube is used to inject heated surgical fluid for liquefying a cataractous lens. The distal portion of the injection tube terminates just inside of the aspiration tube and can be steered or directed so that heated fluid escaping the injection tube can be injected directly into the eye or reflected off of the internal wall of the aspiration tube prior to entering the eye. Alternatively, the injection tube may be relatively rigid but be extendable or contain a rotatable deflector that alternatively allows the heated fluid to be injected directly into the eye or reflected off of the internal wall of the aspiration tube. The handpiece may also contain other tubes, for example, for injecting relatively cool surgical fluid.

Abstract: A medical fluid suctioning device for selectively applying varied levels of suction pressure at a device-tissue interface includes a direct “trumpet”-type control mechanism in conjunction with a “venturi”-type control. A valve manifold is adapted to couple a vent pathway and a suction pathway simultaneously to the vacuum conduit adapted for connection to a vacuum source. The amount of resistance to flow due to vacuum pressure is adjusted simultaneously in both the vent pathway and the suction pathway in order to achieve controlled, selected levels of suction. Similarly shaped valve apertures are provided in inverse and reciprocal orientation along an axis of motion of a valve manifold. The apertures translate across ports to the suction and venting pathways simultaneously to vary applied suction to those pathways inversely.

Abstract: An irrigator (20) useful for surgical and medical procedures. The irrigator includes a handpiece (22) to which a tip assembly (30) is attached. The tip assembly includes a discharge tube (32) through which irrigating fluid is discharged. A spray head (422) with spaced-apart shoulders (422) is moveably attached to the front of the discharge tube. When the spray head is in a first position, the shoulders do not interfere with the discharge of irrigation fluid. When the spray head is in a second position, the shoulders are in registration over the discharge openings; the discharged irrigation fluid is dispersed by the shoulders. A spray shield (181) is disposed over the discharge tube. The irrigation fluid defused by the spray head shoulders strikes the spray shield which further diffuses this discharge.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a fissure or tear location within an invertebral disc. The present invention applies high frequency (RF) electrical energy to one or more active electrodes in the presence of electrically conductive fluid to heat and seal a fissure on an annulus fibrosus. In one aspect of the invention, a method is provided for treating the fissure by applying sufficient electrical energy to the disc tissue to seal the fissure. In one embodiment, the RF energy is directed through the conductive fluid to heat the tissue immediately surrounding the fissure. The RF energy is sufficient to vaporize at least a portion of the fluid in contact with the active electrode. In another embodiment, the electrical current is directed through the tissue to directly heat the annulus tissue. This causes the annulus tissue to contract and seal the fissure. In a specific configuration, a sealant is added to the fissure to enhance the seal.

Abstract: A surgical irrigation apparatus includes a disposable assembly and a reusable assembly. The disposable assembly includes an irrigation fluid pump and a hand piece having a supply passage for delivery of irrigation fluid to the surgical site. The reusable assembly includes a motor, a power source, and a pressure detector. The pressure detector assists in changing the power being supplied to the motor. The power is transferred from the motor to the pump with a magnetic coupler or other suitable device. The reusable assembly may alternatively include a sound receiver for picking up voice commands or other sounds to change the power being supplied to the motor. The reusable assembly may also alternatively include a controller that is operatively connected to a switch on the hand piece to permit a user to manually change the power being supplied to the motor. Related methods for surgical irrigation are also described.

Abstract: An aspirating and irrigating apparatus and method provide rapid and effective aspirating and irrigating of body parts during medical procedures to such a degree that anesthetizing the patient is no longer necessary for that portion of the procedure. The apparatus is portable and includes a piston driven motor which drives a vacuum pump having an input port for providing a vacuum operating to vacuum levels exceeding approximately twenty-seven inches of mercury and an output port for providing air under pressure operating to pressure levels exceeding approximately one hundred and twenty pounds per square inch for permitting rapid fluid flows.

Abstract: Systems and methods are provided for removing adipose or fatty tissue underlying a patient's epidermis is disclosed (e.g., liposuction, abdominoplasty, and the like). The method includes positioning one or more active electrode(s) and one or more return electrode(s) in close proximity to a target region of fatty tissue. A high frequency voltage difference is applied between the active and return electrodes, and the fatty tissue or fragments of the fatty tissue are aspirated from the target region. The high frequency voltage either softens the fatty tissue or completely removes at least a portion of the tissue. In both embodiments, the remaining fatty tissue is more readily detached from the adjacent tissue in the absence of energy, and less mechanical force is required for removal. The bipolar configuration of the present invention controls the flow of current to the immediate region around the distal end of the probe, which minimizes tissue necrosis and the conduction of current through the patient.

Abstract: A disposable insertion tip for a body cavity cleaning or irrigation device includes at least one tear strip. Once attached to the cleaning device, the insertion tip is sealingly locked in a predetermined position permitting liquid to be dispensed into a body cavity and used liquid to be returned from the body cavity through respective interior chambers provided in the insertion tip. The tip cannot be removed without first tearing the tear strip, which once torn, disables the sealing capability of the tip relative to the cleaning device. The insertion tip is preferably made from a transparent material which permits a user to view the efficacy of a cleaning procedure and to note when removal of the tip is required.

Abstract: The present invention provides a series of devices for performing surgical procedures utilizing electrodes for performing electrocautery on a tissue of the body of a patient. The invention includes, in one aspect, a series of devices comprising surgical instruments providing at least one electrode for performing electrocautery, and, in another aspect, provides a method for cutting and cauterizing tissue with a surgical instrument. In yet another aspect, the invention involves a method for detecting the location of a bleeding vessel in a liquid-filled, visually monitored surgical field of a patient and for electrocauterizing the vessel to stop the bleeding before visualization of the surgical field is compromised. Preferred surgical instruments according to the invention also include operable components for forming a liquid cutting jet for cutting or ablating tissue of a patient and/or for providing a rotating, tissue contacting component for cutting, grinding, ablating, etc.

Abstract: A medical system that may include a filter/flow restrictor which limits the pressure drop within an aspiration system. The restrictor may include a flow restrictor that is coupled to a filter housing. The flow restrictor restricts the pressure drop within the aspiration system. The housing may contain a filter which prevents occlusion of the flow restrictor. When used in an opthtalmic procedure the flow restrictor may limit the minimum pressure within a cornea and prevent corneal collapse.

Abstract: A system and method for removing cataract cells inside of an eye having a heated inflatable brushing device adapted to pass through an incision in the lens capsule, the brush being inflated with a heated fluid after passing through the incision in the lens capsule. The brushing device has an abrasive surface and is coupled to a tube that is adapted to pass through the incision in the eye and kill and dislodge cells therefrom. The tube has a first passageway and a first orifice for infusing a fluid inside of the eye and dislodging cells therein and a second passageway and second orifice for aspirating the fluid and cells out of the eye. The brush device also can be coupled to a motor, which rotates or oscillates the brush device to further dislodge the cells from the incision of the eye, such as from the lens capsule. In another embodiment, the tube can be a closed system having an aperture in the periphery, the aperture extending from the surface of the tube to the first passageway.

Abstract: An ophthalmic cutter system that includes a cutter adapted to cut tissue such as a cataract lens and an irrigation handpiece adapted to hold the lens. The irrigation handpiece may be coupled to an irrigation system that introduces an irrigation fluid to the surgical site through the handpiece. The cutter may be coupled to an aspiration system that provides vacuum pulses to the surgical site. The vacuum pulses may pull tissue into a wire located at a distal end of a cutter cannula. The pulses may break and emulsify the tissue which is then aspirated through the cannula by the aspiration system. The wire may be connected to a controller that provides a current which is transformed into heat. The heat may assist in emulsifying the tissue.

Abstract: A method and apparatus is disclosed for mechanically-assisted liposuction treatment. The apparatus includes a hand-holdable housing, an electro-cauterizing cannula assembly, and a reciprocation mechanism. The hand-holdable housing has a cavity adaptable for receipt of a portion of the electro-cauterizing cannula assembly. The electro-cauterizing cannula assembly includes an inner cannula and an outer cannula, each having a distal end and a proximal end and at least one aspiration aperture about the distal end. The inner cannula is disposed within the outer cannula and the inner and outer aspiration apertures are in at least partial registration to form an effective aspiration aperture. The reciprocation mechanism is disposed within the housing and is operably associated with either the inner or outer cannula so that one of the cannulas can be selectively caused to reciprocate relative to the housing while the other is stationarily disposed relative to the housing.

Abstract: An aspiration system that may include a control valve to allow a flow of fluid into an aspiration line and vary a vacuum pressure within the line. The system may include a pressure transducer that is coupled to the aspiration line by a sensor line and a check valve. The check valve prevents a back flow of fluid from the aspiration line to the pressure line. The system may further have a control circuit that is coupled to the pressure transducer and the control valve. The control circuit may control the control valve and regulate the vacuum pressure within the aspiration line. The control circuit may receive an input signal that also controls a medical handpiece. The input signal can be generated by a foot pedal that also controls the handpiece. The system may thus have one foot pedal that can control the handpiece and the vacuum pressure of the aspiration line.

Abstract: The process consists in generating a firing pulse pattern characterized in that it implements a pressurized liquid channel and a pneumatic aspiration channel and in that the periodic firing of the pressurized jet is controlled during the periodic application of aspiration and in that the tension on the tissue is released during the cutoff of the aspiration by aeration. A variant of the process enables obtaining, even in the case of a high repetition rate, a steep trailing edge of the firing pulse, by means of establishment of communication with the exterior of the pressurized liquid feed line near the time of the cutoff of the feeding of the liquid. This invention is of interest to manufacturers of surgical and medical instruments and handpieces for interventions using a pressurized liquid jet.

Abstract: A nostril cleaning system for assisting individuals in the efficient cleaning of their nostrils. The nostril cleaning system includes a housing, a control pad having a plurality of control buttons, a plurality of section members pivotally attached within an upper portion of the housing forming a tapered shape, a covering removably positioned about the plurality of section members, and a cover member removably attachable about the upper portion of the housing for enclosing the covering. The covering is preferably comprised of foam material an outer layer and an inner layer wherein the inner layer is denser than the outer layer and capable of absorbing fluids. The control pad is mechanically connected to the section members for controlling their relative positions. When the section members are expanded outwardly, the covering is simultaneously expanded outwardly to engage the inner walls of the nasal passage.

Abstract: The present invention comprises a vulnerable plaque treatment catheter arrangement for the treatment of a lipid pool at a site of vulnerable plaque within an artery. The catheter arrangement includes an elongated, hollow, flexible shaft having a proximal end and a distal end and an elongated, flexible, steerable, lipid-enterable needle arranged within the shaft. The needle has at least one lumen therethrough in communication with a treatment source, to permit the rendering of the lipid pool into an innocuous entity.

Abstract: An endovascular system for arresting a patient's heart and maintaining the patient on cardiopulmonary bypass. A venous cannula, venting catheter and an aortic occlusion device are all coupled together so that the blood drawn into each of these catheters may be fed to a pump. A manifold has valves which control flows through the venous cannula, venting catheter and aortic occlusion device. A blood storage element is also provided so that the amount of blood in the perfusion circuit may be varied if necessary. The blood storage element is preferably positioned in parallel with the pump so that the pump may be used to add and remove blood to and from the blood storage element.

Abstract: A method and apparatus are provided for cleaning a medical device tube, for example a catheter tube. The distal end portion of the tube has a distal opening and at least one side opening adjacent to the distal opening. The distal end of the tube is disposed in a closed chamber with the distal opening generally opposite from a first orifice defined in the chamber. A liquid is introduced into the chamber and is drawn into the distal opening in the tube, for example by a suction force. A different fluid medium, such as air, is drawn through the first orifice and into the distal opening in the tube. A turbulent flow path is established with the fluid medium wherein the medium is drawn through the first orifice, into the distal opening in the tube, out the side opening in the tube, and back into the distal opening in the tube. This turbulent flow path enhances the cleaning action of the liquid introduced into the chamber for cleaning the distal end portion of the tube within the chamber.

Abstract: A system and method for removing impacted cerumen from within a person's auditory canal. The system includes a hand held instrument that is held against the ear, and a base that creates a negative pressure in the hand held instrument when it is not in use. The hand held instrument contains an auditory canal plug that seals over the auditory canal when manually biased against the auditory canal. The plug contains an aperture that leads to a vacuum chamber within the hand held instrument. The flow of air through the auditory canal plug and into the vacuum chamber is controlled by a manually operated flow control valve. The hand held instrument merely carries the vacuum chamber. To create a negative pressure in the vacuum chamber, the hand held instrument must be placed on a base. The base contains a vacuum pump that pneumatically interconnects with the vacuum chamber when the hand held instrument is placed on the base.

Abstract: A surgical instrument system, in particular, for use in non-endoscopic surgery having a surgical instrument provided with a shaft in which a supply channel having a distally disposed liquid emergence opening and an evacuation channel having a distally disposed liquid draw-off opening, and a pump device which pumps a liquid into the supply channel with such a pressure that the tissue in front of the distal end of the surgical instrument is separated along natural separation planes by the liquid emerging from the emergence opening, and the liquid out of the liquid bubble surrounding the distal end of the surgical instrument is pumped through the evacuation channel to the proximal end of the surgical instrument.

Abstract: Apparatus, systems, methods, and kits are provided for isolating a target lung segment and treating that segment, usually by drug delivery or lavage. The systems include at least a lobar or sub-lobar isolation catheter which is introduced beyond a second lung bifurcation (i.e., beyond the first bifurcation in a lobe of the lung) and which can occlude a bronchial passage at that point. An inner catheter is usually introduced through the isolation catheter and used in cooperation with the isolation catheter for delivering and/or removing drugs or washing liquids from the isolated lung region. Optionally, the inner catheter will also have an occluding member near its distal end for further isolation of a target region within the lung.

Abstract: A surgical handpiece having two coaxially mounted tubes or channels mounted to a body. The first tube is used for aspiration and is smaller in diameter than the second tube so as to create an annular passage between the first and second tube. The annular gap communicates with a pumping chamber formed between two electrodes. The pumping chamber works by boiling a small volume of the surgical fluid. As the fluid boils, it expands rapidly, thereby propelling the liquid downstream of the pumping chamber out of the annular gap. The distal end of the annular gap is sealed by frictionally fitting together the distal ends of the first and second tube. One or more grooves formed in either the first or second tubes allow fluid being propelled down the annular gap to escape. A stop may be provided against which the escaping fluid impinges such as by crimping the second tube near the distal end of the second tube.

Abstract: Phaco tip apparatus for a phacoemulsification/irrigation and aspiration handpiece having an ultrasonic drive assembly includes a needle having a tip for emulsifying a cataractic lens and a lumen for aspirating emulsified lens. A compressible sleeve establishes an annular passage around the needle and enables irrigation fluid to pass into an eye through a cornea/sclera wound while cooling the needle. The compressible sleeve includes a wall configuration for controlling compression of the sleeve in order to cause the compressible sleeve to shape and conform to the cornea/sclera wound and limit fluid egress from the wound. A bypass port, disposed in said needle and under said compressible sleeve, establishes fluid communication between the lumen and the annular passage in order to enable irrigation fluid to pass into said lumen upon clogging of the tip, thus providing fluid surge protection.

Abstract: A method and apparatus is disclosed for mechanically-assisted liposuction treatment. The apparatus includes a hand-holdable housing, an electro-cauterizing cannula assembly, and a reciprocation mechanism. The hand-holdable housing has a cavity adaptable for receipt of a portion of the electro-cauterizing cannula assembly. The electro-cauterizing cannula assembly has a distal end and a proximal end and at least one aspiration aperture about the distal end. The reciprocation mechanism is disposed within the housing and is operably associated with either the cannula so that the cannulas can be selectively caused to reciprocate relative to the housing. As the cannula is caused to reciprocate relative to the housing, the aspiration aperture formed through the distal end of the cannula assembly is caused to undergo periodic displacement.

Abstract: A method and device for clot maceration and removal, including inserting a shaft having two lumens into an occluded blood vessel, the shaft having: a guidewire/drug delivery lumen defined partially by a first wall and a thrombus removal lumen defined partially by a second wall. The thrombus removal lumen further defines a skived section where a thrombus may be trapped for removal. A portion of the first wall is coextensive with a portion of the second wall, and the coextensive portion defines at least one hole whereby a drug delivered through the guidewire/drug delivery lumen may pass to the thrombus removal lumen. A maceration device is also disclosed which may be used independently or may be inserted within the guidewire/drug delivery lumen. The maceration device includes: a base wire; a capping plug attached to a distal end of the base wire; a pressure translator slidably attached to the base wire; and a means for maceration coupled between the pressure translator and the capping plug.

Abstract: A system for recovering bone particles removed from a patient, comprising a sub-system for removing particles of bone; a sub-system for irrigating the operative site to yield a slurry comprising the bone particles; a sub-system for removing the slurry from the operative site; and a sub-system for recovering the bone particles from the slurry.

Abstract: Electrosurgical methods, systems, and apparatus for the controlled ablation of tissue from a target site of a patient. An electrosurgical instrument includes a working portion having a plurality of working zones differentiated according to their relative rates of aspiration and ablation. The instrument further includes an aspiration channel in communication with a plurality of aspiration ports, and a plurality of active electrodes disposed on the working portion. Each of the plurality of working zones may have at least one of the plurality of active electrodes and at least one of the plurality of aspiration ports. The aspiration rate of each working zone is dependent, inter alia, on the number, size, and distribution of the aspiration ports on that zone. In one embodiment, the ablation rate of a working zone is inversely related to the aspiration rate of that zone. Each of the plurality of active electrodes is adapted for ablating tissue to form low molecular weight ablation by-products.

Abstract: The present invention is directed to systems, methods and apparatus for removing implanted objects from a patient's body, particularly implanted endocardial or epicardial pacemaker leads and transvenous defibrillation leads from a patient's heart. In one aspect of the invention, an electrosurgical catheter is advanced to a position within the thoracic cavity adjacent a portion of a pacemaker lead that is affixed to heart tissue. Preferably, the catheter is advanced over the pacemaker lead, i.e., using the pacemaker lead as a guidewire, to facilitate this positioning step. Once the distal end of the catheter reaches a blockage, or a portion of the lead that is attached to fibrous scar tissue, a high frequency voltage difference is applied between one or more electrode terminal(s) at the distal end of the catheter and one or more return electrode(s) to remove the scar tissue around the lead.

Abstract: An improved method of fragmenting and removing soft tissues of a patient is disclosed. More particularly, the method includes steps for the surgical removal of unwanted fatty tissues using an ultrasonic frequency vibratory probe and a separate multi-lumen suction and irrigation cannula. The ultrasonic frequency vibratory probe and the multi-lumen suction and irrigation cannula are separate instruments that are used to separate the tissue fragmentation and removal processes, thereby decreasing procedure time and reducing trauma to tissues.

Abstract: An electrosurgical aspiration instrument that permits aspiration of an area being treated by the instrument. The instrument is coupled at a proximal end to a power source and includes an energy application surface area at a distal end. The power source supplied energy to the energy application surface area such that the distal end of the instrument may apply energy to the treatment area to modify the characteristics of biological material, such as biological tissue in the area. An aspiration lumen is formed through the instrument with an opening through the energy application surface area. The energy application surface area is configured to reduce blockage of the opening. Accordingly, aspiration may be performed simultaneously with electrosurgical treatment whereby unwanted matter such as by-products, biological debris and excess fluid is removed from the treatment area.

Abstract: The invention provides a variety of surgical instruments for forming a liquid jet, which are useful for performing a wide variety of surgical procedures. In some embodiments, the invention provides surgical liquid jet instruments having a pressure lumen and an evacuation lumen, where the pressure lumen includes at least one nozzle for forming a liquid jet and where the evacuation lumen includes a jet-receiving opening for receiving the liquid jet when the instrument is in operation. In some embodiments, the pressure lumen and the evacuation lumen of the surgical liquid jet instruments are constructed and positionable relative to each other so that the liquid comprising the liquid jet, and any tissue or material entrained by the liquid jet can be evacuated through the evacuation lumen without the need for an external source of suction.

Abstract: An apparatus designed to clean surfaces and to recycle a cleaning fluid. The apparatus has a hand-holdable housing that includes a head with a distal end through which cleaning solution may be impelled. The apparatus further has a pump for both impelling and urging cleaning fluid back through a return path. The pump has a flexible membrane and a pump drive mechanism in which two pistons drive the flexible membrane. The cleaning fluid includes a foaming-resistant composition that has an abrasive agent; a shear thinning fluid matrix, and a non-foaming means.

Abstract: An improved irrigation system for removing arthritis causing fragments from a joint in the body includes a handpiece and a tip that is connectible to the handpiece. The tip includes a shaft that forms an irrigation lumen, and a debrider disposed along at least a part of the shaft. The debrider defines a substantially planar debriding surface for debriding the interior surfaces of the joint. The debrider may include a plurality of bristles extending from the shaft to the debriding surface.

Abstract: In general the ultrasonic probe for improved fragmentation is comprised of a longitudinal shank having a proximal end, a distal end, and a shaft. The shaft joins the proximal end and the distal end. The proximal end of the longitudinal shank has a connector for connecting the longitudinal shank to a source of ultrasonic vibrational energy. The distal end of the longitudinal shank may have a blunt or bullet-nosed tip. The shaft has one or more grooves near the tip which circumscribe the shaft of the longitudinal shank. The walls of the one or more grooves in the shaft of the longitudinal shank provide surface area on the distal end of the ultrasonic probe in planes generally perpendicular to the axis of the ultrasonic probe. The additional surface area increases the tissue fragmenting surface area of the distal end of the ultrasonic probe without increasing the diameter of the distal end of the ultrasonic probe.

Abstract: The in-line hand operated valve controls the flow of at least one, and preferably both, irrigation fluid and suction respectively to and from a surgical site via a delivery line. In one working embodiment, suction fluid is supplied to the valve via a first source line and suction is supplied to the valve via a second source line. The valve body defines, source ports in fluid communication with the source lines and a delivery port in fluid communication with the delivery line. The valve body includes at least one, and preferably two, collapsible internal fluid carrying channels in fluid communication with the respective source port and the delivery port. Each valve mechanism includes an operator control surface, a stem, and a compressor member acting on and closing and opening the collapsible segment of the fluid carrying channel or body. A biasing element (such as a spring or other resilient body) keeps the valve stem and the compressor element in either an open or a closed state.

Abstract: A sleeve apparatus for a phacoemulsification/irrigation and aspiration handpiece having an ultrasonic drive assembly attached to a hollow needle includes a compressible sleeve for establishing an annual passage around the needle and enabling the irrigation fluid to pass into an eye through a cornea/sclera wound while cooling the needle. The compressible sleeve includes a wall configuration for controlling compression of the sleeve in order to cause the compressible sleeve to shape and conform to the corneal/sclera wound and limit fluid egress from the wound. A hub is provided for attaching the compressible sleeve to the handpiece and enabling the needle to be angularly displaced within the compressible sleeve means during phacoemulsification.

Abstract: Aspiration catheters suitable for use in the treatment of an occlusion in a blood vessel are disclosed. These catheters are especially useful in the removal of occlusions from saphenous vein grafts, the coronary and carotid arteries, arteries above the aortic arch and even smaller vessels. The catheters of the present invention are provided in either over-the-wire or in single operator form. Radiopaque markers are preferably incorporated into distal ends of the catheters to facilitate their positioning within the body. The catheters are provided with varying flexibility along the length of the shaft, such that they are soft and flexible enough to be navigated through the vasculature of a patient without causing damage, but are stiff enough to sustain the axial push required to position the catheter properly and to sustain the aspiration pressures.

Abstract: Electrosurgical methods and apparatus for removing tissue from a target site of a patient, the apparatus including a probe adapted for coupling to a power supply. The electrosurgical probe includes a shaft having a first electrode type and a second electrode type. The electrosurgical apparatus/probe lacks a dedicated return electrode. Instead, the first electrode type and the second electrode type alternate between serving as active electrode and serving as return electrode. The first electrode type comprises at least one ablation electrode adapted for aggressively removing tissue from a target site. The second electrode type comprises at least one digestion electrode adapted for aggressively digesting resected tissue fragments present in an aspiration stream.

Abstract: A device for dosing vaccum, mainly for medical applications, such as tracheal suction, consists of: (a) a tube with a cylindrical section with two troncoconical ends; said tube has small outlet holes and a middle partition wall; (b) a cylindrical rubber tube; (c) a cylindrical body or container which forms a clearance with the wall of said rubber tube; (d) a valve device with a lever which allows to open the vaccum circuit; (e) a stem projecting slightly over the surface of the lid of said valve. In stand-by state the rubber tube closes the outlet holes and vaccum is excluded. Moving forward the stem communicates the inside of the body, expanding the rubber tube and allowing suction of air or intaken material. It permits a close control of the vaccum, with a complete closure in stand-by and immediate start of suction on demand. Possible contamination of operator, as well as the intake of strange materials is prevented.

Abstract: Apparatus and methods are disclosed for accessing the interior of an intervertebral disc to perform a function within the disc. The apparatus comprises a catheter having a lumen; and a guide wire having a distal portion and a proximal portion, and configured to be positioned within and moved relative to the lumen of the catheter; wherein the guide wire is capable of navigating itself within an intradiscal section of the intervertebral to a selected section of the disc and the catheter is capable of being advanced relative to the guide wire such that the catheter follows a path of the guide wire within the intradiscal section of the disc to the selected section. These apparatus and methods may be used for the treatment of intervertebral disc disorders such as sealing fissures of the annulus fibrosus, which may or may not be accompanied with contained or escaped extrusions. These apparatus and methods may also be used for the removal or addition of material to the intervertebral disc.

Abstract: According to the invention there is provided an electro-surgical pencil of a type having an electrode projecting out one end of said pencil, an electrical coupling operative to couple the electrode to an external electrical source. The pencil has an elongated housing having a hollow interior passageway, an open electrode end through which the electrode projects and an open end opposite to the electrode end couplable to a vacuum source. The hollow interior passageway is of a diameter sufficiently large to permit a flow and velocity of air sufficient to aspirate and evacuate smoke produced by the pencil. An electrode support in the hollow interior passageway holds the electrode. The electrode support and the electrode present a cross-sectional area which is substantially less than that of the hollow interior passageway. An optical switch is coupled to the elongated housing.

Abstract: A method and apparatus is disclosed for mechanically-assisted liposuction treatment. The apparatus includes a hand-holdable housing, an electro-cauterizing cannula assembly, and a reciprocation mechanism. The hand-holdable housing has a cavity adaptable for receipt of a portion of the electro-cauterizing cannula assembly. The electro-cauterizing cannula assembly includes an inner cannula and an outer cannula, each having a distal end and a proximal end and at least one aspiration aperture about the distal end. The inner cannula is disposed within the outer cannula and the inner and outer aspiration apertures are in at least partial registration to form an effective aspiration aperture. The reciprocation mechanism is disposed within the housing and is operably associated with either the inner or outer cannula so that one of the cannulas can be selectively caused to reciprocate relative to the housing while the other is stationarily disposed relative to the housing.

Abstract: An electrocautery instrument is provided with a hollow electrode having a source of conductive fluid coupled to a proximal end thereof. Conductive fluid is communicated through said electrode and expelled out of the distal end thereof during electrocautery, forming a “virtual electrode.” The infused conductive liquid conducts the RF electrocautery energy away from the conductive electrode, thereby displacing the region of thermal generation and reducing the extent of burns and perforations caused by conventional electrocautery electrodes. In one embodiment, the electrode is partially disposed within and extends distally out of a retractable suction tube, such that smoke and fluid are aspirated from the electrocautery site. When the suction tube is fully advanced, the electrode is concealed therein, enabling suction without electrocautery to be performed.

Abstract: A medical device 10 particularly adapted for debriding an abscess, phlegmon, or hematoma in a human or veterinary patient, for removing debrided and other materials from the abscess and for draining the abscess first includes a flexible catheter 12 having a longitudinally extending flow lumen 14, a rounded distal tip 16, a side portion 18 extending proximally from the distal tip 16 and an oval or other lateral opening 20, 44 or 46 extending through the side portion 18. The device also includes a cutting cannula 22 positionable in and longitudinally slidable in the flow lumen 14 in the catheter 12. The cannula 22 has an open distal end 24 and a sharp, beveled circumferential cutting edge 26 formed on the open distal end 24, the circumferential cutting edge 26 being disposed perpendicularly to the flow lumen 14 of the catheter 12.

Abstract: An intraocular irrigation/aspiration device (10) including a hollow shaft (12) with a distal tip portion (20) and a proximal portion (24). The shaft (12) includes a lumen (18) extending through the shaft (12) wherein the lumen (18) is of reduced cross-sectional area in the proximal portion (24) so as to regulate aspiration of fluid and reduce post occlusion surge phenomena. Preferably, the device (10) includes an outer sleeve (26) which is flexible so as to enable a small incision in the eye to engage closely with the shaft (12).

Abstract: A surgical system having a cassette with an aspirant collection chamber and an aspiration vent line that draws fluid from the aspirant collection chamber. The pressure within the collection chamber is maintained near ambient so that when the aspiration vent line is open, fluid flows from the collection chamber and into the aspiration line. Such a system does not require a second source of irrigation fluid, minimizes pressure surges into the irrigation fluid line and does not affect the fluidic performance of the aspiration system. In addition, various vent pressures can be achieved by varying the vertical position of the reservoir relative to the aspiration line.