Abstract: A device for performing transanal irrigation includes an elongated neck having a proximal end and a flushing liquid channel passing therethrough. In a system including the device, the flushing liquid channel communicates with a source of flushing liquid. An insert is positioned on the proximal end of the neck of the device and is inserted into a body cavity of a user. The insert has a flushing liquid opening that is in fluid communication with the flushing liquid channel of the neck. A control housing is connected to the neck of the device and contains a pump. Pressurized flushing liquid flows through the device channel and exits through the flushing liquid opening of the insert when the pump is activated. A pair of support arms are attached to the device neck and rest on a sitting user's legs with the insert positioned below a body cavity of the user.

Abstract: Systems for insufflation and recirculation of insufflation fluid in a surgical procedure include a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The pressure-controlled valve is in fluid communication with an insufflation gas supply, the supply conduit and the return conduit and is adapted and configured to respond to pressure control signals to adjust position and thereby system flow parameters, to reduce entrainment of air from the surrounding environment, and to increase the concentration of insufflation gas in an operative space, and/or to reduce an overpressure condition in the operative space.

Abstract: Systems for insufflation and recirculation of insufflation fluid in a surgical procedure include a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The pressure-controlled valve is in fluid communication with an insufflation gas supply, the supply conduit and the return conduit and is adapted and configured to respond to pressure control signals to adjust position and thereby system flow parameters, to reduce entrainment of air from the surrounding environment, and to increase the concentration of insufflation gas in an operative space, and/or to reduce an overpressure condition in the operative space.

Abstract: Systems for insufflation and recirculation of insufflation fluid in a surgical procedure include a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The pressure-controlled valve is in fluid communication with an insufflation gas supply, the supply conduit and the return conduit and is adapted and configured to respond to pressure control signals to adjust position and thereby system flow parameters, to reduce entrainment of air from the surrounding environment, and to increase the concentration of insufflation gas in an operative space, and/or to reduce an overpressure condition in the operative space.

Abstract: A catheter assembly allowing for non-contaminated insertion of the catheter into the urinary canal. The catheter assembly includes a urinary catheter, a catheter package and a sealing member. The urinary catheter defines a conduit and has a proximal end adapted for insertion into the urinary canal and an opposite distal end. The catheter package has a hose with a cavity for accommodation of the catheter, and a catheter outlet adapted to dismantle the proximal end of the catheter from the catheter package. The sealing member is adapted to provide a substantially liquid-tight seal between the catheter package and the urinary catheter while the catheter is being dismantled.

Abstract: An electrosurgical end effector for ablating tissue is provided that comprises at least one electrically-conductive ablation member adapted to be connected to a source of RF energy, with the ablation member having a tissue engaging surface and defining an internal fluid passageway. Preferably, the end effector includes two electrically conductive ablation members that are electrically isolated from one another and have their fluid passageways in fluid communication. Alternatively, the end effector may comprise four electrically conductive ablation members arranged as two pairs of ablation members, all of the ablation members having internal fluid passageways that are electrically isolated from each other, with the fluid passageways of each of the four ablation members being in fluid communication with each other.

Abstract: A system for monitoring and/or controlling tissue modification during an electrosurgical procedure is provided. The system includes an electrosurgical apparatus adapted to connect to an electrosurgical generator. The electrosurgical apparatus configured to transmit energy to tissue. The system also includes a control system having one or more electromagnetic wave sources configured to generate the interrogator wave of one or more frequencies adjacent tissue. One or more sensors are configured to transmit and sense a reflected portion of the interrogator wave of at least one frequency to determine dielectric boundary data. A processor operatively coupled to the control system and to the electrosurgical generator configured to control the delivery of electrosurgical energy from the electrosurgical generator to tissue based on dielectric boundary data provided by the one or more sensors.

Abstract: An improved method and equipment for tissue/vessel sealing is disclosed for the sealing, coagulation and transection of tissue during surgical procedures. The improvement is accomplished through better management of heat and moisture present during tissue treatment by having tissue grasping surfaces comprised of an outer non-conducting region and an inner conductive region, and including channels in the jaw assembly to direct steam and moisture away from surrounding tissue. The outer region follows the perimeter each jaw, isolating the treatment zone and preventing steam and excess heat from leaving the tissue treatment zone, reducing thermal margins and unintended patient burns. The outer region also prevents surrounding moisture from affecting the treatment zone and allowing more consistent results.

Abstract: Monopolar electrosurgery devices adapted for resecting tonsil and adenoid tissue. The devices minimize thermal injury by employing a plasma generated by pulsed electrical signals to precisely and effectively cut or coagulate the tissues. Suction may also be applied to the tissues to enhance the cutting, coagulation, and tissue manipulation functions. The devices include an interchangeable tip that may be switched for another tip, depending on which tip may be more suitable for tonsillectomy or adenoidectomy.

Abstract: The present invention is an electrophysiology, RF ablation, or similar catheter (i.e., catheter or sheath) that includes an actuator that significantly increases the length of travel (i.e., steering travel) of the actuation wires, as compared to the length of travel provided by prior art actuators. The catheter includes a hollow flexible tubular body, a pair of actuation wires disposed in a side-by-side relationship in the body, a handle attached to a proximal end of the body, an actuator pivotally mounted to the handle, an arcuate internal gear rack disposed on the actuator, one or more pulleys pivotally mounted on the handle and coaxially coupled to a pinion gear engaged with the gear rack, and a guide block mounted within the handle. The one or more pulleys include a first channel in which the first actuation wire resides and a second channel in which the second actuation wire resides. The actuation wires pass through holes in the guide block, which aligns the wires into their respective channels.

Abstract: An electrosurgical controller with output RF energy control. At least some of the illustrative embodiments are electrosurgical controllers configured to change a first output voltage on the first active terminal relative to the first return terminal by selective control of a number of turns of the primary winding of a transformer used to create the output voltage.

Abstract: A kit for the diagnosis or treatment of tissue in a body cavity includes an introducer and a catheter insertable through the lumen of the introducer having a proximal segment, a working segment and a flexible distal tip segment. The flexible distal tip segment is located adjacent the distal end of the working segment and includes a proximal end, a distal end and a pre-formed bend or curve that permits the catheter to exit the introducer in a lateral direction relative to the introducer body to prevent inadvertent damage to the tissue during a medical procedure. All or part of the working segment and the flexible distal tip segment may be adhesive-filled. The catheter may also include a plurality of sensing and/or energy delivery elements on the working segment and a shape-memory wire terminating at the distal end of the working segment. Methods of use and methods of manufacturing are also described.

Abstract: An arterial device, system and method are provided for use with a patient undergoing a cardiac procedure. The system is configured for enabling one or more arterial devices to be accommodated in the aorta of the patient in use of the system, and a perfusion lumen arrangement provides therethrough a target perfusion flow into the aorta having a target perfusion flow rate that is significantly greater than a nominal perfusion flow rate, by an excess perfusion flow rate. A suction lumen arrangement provides therethrough a suction flow out of the aorta at a suction flow rate. The target perfusion flow rate and the suction flow rate may be concurrently and selectively controlled to cause embolic debris that may be present in the aorta to be diverted to the suction inlet, while providing the nominal flow rate to the body circulation of the patient.

Abstract: A system and method of treating urinary incontinence including a catheter and injection guide operatively disposed together. At least one needle is operatively disposed within at least one lumen and at least one channel extending through the catheter and injection guide respectively. The injection guide is transformable from a pre-injection configuration for placement in the bladder to an injection configuration for injection of a pharmaceutical such as botulinum toxin into the bladder tissue. Upon introduction of the pharmaceutical to the bladder tissue, symptoms of incontinence are alleviated.

Abstract: Apparatus for accessing a bodily passageway, the apparatus comprising: a flexible tube having a distal end and a proximal end, a longitudinal axis extending between the distal end and the proximal end, and a lumen extending from the distal end to the proximal end, the lumen being sized to receive matter to be transported through the bodily passageway; and an external thread disposed over the distal end of the tube, the external thread having a sufficient structural integrity, and a sufficient surface profile, such that when the tube is disposed in a bodily passageway, rotation of the tube about the longitudinal axis will result in longitudinal motion of the tube along said bodily passageway.

Abstract: An ear cleaning device that creates a negative pressure within the patient's ear to draw fluid thereinto and provide cleansing thereof so as to substantially reduce the risk of damage to the tympanic membrane. The ear cleaning device includes a first container and a second container mechanically operably coupled together and in general axial alignment. Additionally, an ear chamber is included that is operably intermediate the first container and the second container. The ear chamber further includes a membrane to create a hermetic seal around a patient's ear. The first container is configured to receive a store a desired cleaning fluid. Operably coupled to the second container is a pressure reducing device. The ear cleaning device utilizes a hermetic seal between the second container, ear chamber and first container to transport the fluid from the first container into the ear chamber wherein the fluid is introduced in the ear canal of the patient and is subsequently collected within the second container.

Abstract: An irrigation ablation probe comprises a generally rigid probe body and a handle mounted to the proximal end of the probe body. The generally rigid probe body comprises an ablation electrode at its distal end having at least one irrigation opening through which fluid can pass. An infusion tube extends through the probe body for introducing fluid into the ablation electrode. The irrigation ablation probe is useful for treating atrial fibrillation during open heart surgery.

Abstract: Monopolar electrosurgery devices adapted for resecting tonsil and adenoid tissue. The devices minimize thermal injury by employing a plasma generated by pulsed electrical signals to precisely and effectively cut or coagulate the tissues. Suction may also be applied to the tissues to enhance the cutting, coagulation, and tissue manipulation functions. The devices include an interchangeable tip that may be switched for another tip, depending on which tip may be more suitable for tonsillectomy or adenoidectomy.

Abstract: A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures.

Abstract: A catheter particularly useful for ablation lesions within a tubular region of or near the heart is provided. The catheter comprises an elongated flexible tubular catheter body having an axis and proximal and distal ends. An ablation assembly is mounted at the distal end of the tubular body. The ablation assembly has a preformed generally circular curve having an outer surface and being generally transverse to the axis of the catheter body. The ablation assembly comprises a flexible tubing having proximal and distal ends that carries a tip electrode at its distal end. An electrode lead wire extends through the catheter body and into the ablation assembly and has a distal end connected to the tip electrode. In use, the distal end of the catheter is inserted into the heart of a patient.

Abstract: A flow element for use with flexible needles and flexible needle assemblies to minimize flow occlusion within a flexible needle is provided. The flow element is particularly suited for uses with a flexible needle for minimizing incidence of post-dural puncture headache. The flow element includes a body having an internal flow path for conducting a fluid through a flexible needle, and an anti-restriction member. The anti-restriction member includes an elongated body, a proximal end coupled to the body within the internal flow path, and a distal end for disposing at least a portion of the elongated body within a flexible needle. A flexible spinal needle assembly for minimizing flow occlusion through an internal flow path of a flexible needle by unintended kinking that is potentially caused by ligament or muscle layer movements is also provided.

Abstract: A shape memory shutter device for controlling the rectum of a disabled person, comprises a section of conduit to be connected to the rectum of the disabled person, and a shutter which controls the passage through the conduit section and actuated by a shape memory actuator. The shutter comprises a plurality of petals positioned circumferentially around the conduit section and able to move between a closed and an open position. The actuator comprises shape memory wires associated to the petals which are supplied with electrical current to cause opening of the petals.

Abstract: A device is described for washing the external audtitory meatus comprising at least ne inlet channel (6) for the washing liquid and one discharge channel (8) which connects the end portion of the inlet channel with the outside environment, the discharge channel being designed to discharge the washing liquid outside if a further channel(9), designed to discharged the liquid and the products of washing (wax, epithelial scales, etc.) outside, is at least partially obstructed by the products of washing. The further channel may consist of the external auditory meatus, of an aural speculum in which the washing device (10) is inserted, or f an outlet channel made in the body of the washing device(10).

Abstract: A gas filler device for use in medical procedures such as laparoscopy is disclosed. Preferably, the gas filter device includes a housing having a first side wall and a second side wall, and a gas filter including a porous element including a hydrophobic membrane, the gas filter device allowing gas to pass through the porous filter element and the first side wall.

Abstract: A smoke filter device for use in medical procedures such as laparoscopy is disclosed, the device comprising a filter housing having an inlet port and first and second side walls, the side walls comprising non-woven media, and a smoke filter capable of filtering smoke from gas, wherein the filter is disposed in the housing.

Abstract: Infusion liquid is expelled distally of an ablation burr for washing a blood vessel lesion being treated by the burr. The infusion liquid can be aspirated in a proximate direction to carry the infusion liquid and loose ablated particles of the lesion away from the treatment area. The infusion liquid can be supplied through one or more passages in the burr, In addition to distally extending passages, the burr can include transverse passages extending at least partly in a proximate direction, with the distally extending and proximately extending passages sized so that only a minor portion of the infusion liquid is expelled distally.

Abstract: A device for tissue ablation and a method of using the device.

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: Essentially inelastic backing material for medical purposes, characterized in that the backing material has an addition of high-strength fibers, multi-strand yarns, mixed multistrands or filaments having an ultimate tensile stress strength of at least 60 cN/tex, preferably from 80 to 500 cN/tex, the high-strength fibers, multi-strand yarns, mixed multistrands or filaments having a water absorption of less than 10%, preferably less than 5% and, with particular preference, less than 3% and the high-strength fibers, multi-strand yarns, mixed multistrands or threads giving the backing material an ultimate stress strength of at least 50 N/cm, preferably from 60 to 450 N/cm and, with particular preference, from 65 to 250 N/cm, and in that the backing material is coated at least partially on at least one side with a hotmelt adhesive composition.

Abstract: A smoke extraction device for use with an electrosurgical instrument is provided. The smoke extraction device includes an elongated body portion defining a first lumen having first and second ends. The first end of the first lumen is adapted to be connected to a source of vacuum. A channel portion defining a second lumen is connected to the body portion. The channel portion defines a second lumen and includes an inlet opening which communicates with the first and second lumens. An attachment member is operatively secured to the elongated body portion. The attachment member is configured and dimensioned to releasably secure the smoke extraction device to a surgical instrument having a distally extending tool member. The attachment member is positioned on the elongated body such that when the smoke extractor device is releasably secured to a surgical instrument, the inlet opening of the channel portion is positioned below the tool member.

Abstract: Dialysis apparatus including:structure (14) for preparing a dialysis liquid containing sodium, comprising structure (18) for regulating the sodium concentration;a dialysis liquid circuit comprising a feed line (12) and a discharge line (13), the feed line (12) having one end connected to the structure (14) for preparing dialysis liquid, and another end which can be connected to a dialyser (1), the discharge line (13) having an end which can be connected to the dialyser (1);structure (9, 10, 12) for infusing a patient with an infusion solution containing sodium and a substance A at determined concentrations [Na.sup.+ ]sol and [A]sol;structure (32) for determining the sodium concentration [Na.sup.+ ]dial of the dialysis liquid so that the patient's body tends towards a desired sodium concentration [Na.sup.+ ]des, as a function of the dialysance D of the dialyser (1) for sodium, of the desired sodium concentration [Na.sup.

Abstract: The female vaginal douche with cervical shield is a unique device with a wide range of health implications. The device is unique because there is no existing device available that offers the ability to cleanse the vaginal mucosa without allowing a forceful flow of fluid, debris, and bacteria (both commensal and pathogenic), into the uterine cervix. At present, when vaginal douching takes place, there is no barrier in place to protect or shield the cervix from this potentially harmful practice. By combining the vaginal douche applicator with an attached cervical shield, access to the uterine cervix will be limited. The limitation theoretically prevents microorganisms from entering the upper female genital tract. Shielding the cervix during vaginal douching has the potential to prevent serious pelvic infections including pelvic inflammatory disease, tuboovarian abscess, endometritis, as well as female factor infertility and potentially life threatening ectopic pregnancy.

Abstract: The cuff on the patient end of a tracheal tube is attached at one end to the inside of the tube and at the opposite end to the outside of the tube. The cuff encloses an axial sleeve that is slidably mounted within the patient end of the tube and is urged forwardly by a resilient collar. The sleeve can be retracted by applying vacuum to the cuff and, when released, extends forwards to prevent the cuff occluding the patient end of the tube.

Abstract: A fillable dermal or transdermal delivery device that utilizes injection ports for post assembly introduction of medicinally active or inactive agents. The device is comprised of a pressure sensitive skin contact adhesive layer which is affixed to a diffusion membrane comprised of a porous film. A backing layer is provided and is sealed along its perimeter to the perimeter of the porous film, thereby creating a fillable reservoir. The reservoir is filled by means of a loading port that is comprised of a septum. The fillable reservoir is filled by means of a loading needle such as a hypodermic needle that is inserted through the septum of the loading port. A shield is provided in the interior of the fillable reservoir to protect the diffusion membrane from damage in the event that the hypodermic needle is inserted far enough through the loading port to make contact with the porous film.

Abstract: A medicament delivery device has a reservoir within a housing and means for driving medicament from the reservoir. The device is provided with a filling mechanism upon which a medicament container sealed by a penetrable stopper is mounted. The mechanism comprises an internal bore which accommodates an internal rod from which a needle projects. Needle is hollow and is in communication with the reservoir. In order to fill the reservoir, the container is pressed into the bore, causing the needle to pierce the stopper, the stopper abutting against the rod and acting as a piston to drive medicament from the container as the container is pushed into the bore and moves relative to the stopper. Thus, the reservoir can be filled with the sterile medicament which is stable when stored in the container, and the filling is easily accomplished without the use of a syringe. A further advantageous feature is provided by a delivery needle which is mounted on the periphery of the lower surface of the housing.

Abstract: A method and apparatus are provided for introducing molecules such as genes and pharmacological compounds into living blood cells of a patient for therapeutic purposes. A device is implanted into the body of the patient for generating an electric field at a preselected location within a selected blood vessel. Preselected molecules are infused into the selected blood vessel. Simultaneously an electric signal is applied to the implanted device to repeatedly subject a quantity of blood flowing within the selected blood vessel past the preselected location to electric fields of a predetermined amplitude and duration. The parameters of the electric fields are precisely controlled in order to make the walls of preselected cells in the blood transiently permeable to permit the molecules to enter said preselected cells without killing said cells. The device can include either a pair of electrodes implanted in the blood vessel, or alternatively, an induction coil that surrounds the blood vessel.

Abstract: In a transdermal drug delivery system, encapsulation material used to coat drug granules controls the release of an active ingredient. The active ingredient is released into a water retaining matrix, which acts as a reservoir, and transdermal drug penetration is driven by the resulting concentration gradient. The delivery system is enclosed in a patch comprising a composite shell, which acts as an occlusive covering when attached to skin, thus enhancing the hydration of the skin area and fostering absorption of the drug. Visible change indicators incorporated into the system provide indicators at significant "landmarks" in the lifetime of the patch. Microcapsules used for the indicator may be formulated so that the penetration of moisture effects a color change at a time when the active ingredient is almost exhausted. This feature alerts to the user to the need for application of a replacement patch.

Abstract: A rectal speculum for use in conjunction with a colon lavage apparatus has a pair of opposed lateral inlets disposed at the distal end for receiving fecal matter. An inlet tube includes a first annular barb at the terminal end for engagement by the end of a first length of tubing and a second annular barb for engagement by the end of a second length of tubing after severance of the first annular barb.

Abstract: The present invention relates to compositions for killing undifferentiated epithelial cells during cataract surgery on an eye to prevent posterior capsule clouding after the surgery and to a method for performing cataract surgery on an eye including injecting a cell-killing substance between the anterior capsule and the natural lens prior to removing the natural lens from the eye. The cell-killing substance is preferably an acid or base adjusted aqueous solution having a pH in the range between about 1.0 to below 6.5 or about above 7.5 to 14.0; or a hypotonic solution having a salinity less than 0.9% or a pH adjusted hypotonic solution having a salinity less than 0.9% and a pH either below 6.5 or above 7.5. The compositions of the present invention also incorporates a viscoelastic material, a dye or a mixture thereof, in combination with the cell-killing substance.

Abstract: A single use intrauterine injector for use in hysterosalpingography and other procedures requiring injection of a fluid into a uterus. The injector has an inflatable balloonlike member adjacent its tip for insertion into a cervical canal and by which the injector is held by fluid pressure against the walls of the cervical canal. A stop is provided on the injector for preventing insertion of the balloonlike member into the uterus.

Abstract: A colonic lavage apparatus including a speculum (12) in which the speculum (12) takes the form of an elongated tubular body (29) having a tapered leading end (30) provided with a pair of diametrically opposed apertures (36). The major length of the body (29) tapers rearwardly from the leading end (30) into a trailing end (45) which is coupled to a liquid delivery line (L) from a source of liquid under pressure. A control line (L') is coupled to a valve assembly (16) at an opposite end of the speculum (12) to that of the delivery line (L), the valve assembly (16) including an elastic tubular liner (28) and a pressure port (24) positioned on an external surface of the valve (16) which is in communication with the source of liquid under pressure, the valve (16) being opened and closed in response to the differential pressure between the liquid in the pressure port (24) and the speculum (12).

Abstract: Lavage apparatus comprises lavage fluid supply apparatus, a first catheter having a distal end for positioning in the uterus of an animal and a proximal end for communication with the lavage fluid supply, a pair of bilateral catheters connected to the proximal end of the first catheter for extending into respective horns of the uterus, and catheter locating means for locating the catheters in the uterus. The first catheter defines respective supply and drain lumens. The bilateral catheters each define respective lumens for fluid communication between the supply lumen and the interior of the respective uterine horn. The lavage fluid supply apparatus may include a pump for supplying lavage fluid under pressure. The supply may also include a lavage fluid storage tank for containing a volume of fluid, and a heater to maintain the temperature of the stored fluid within a predetermined range.

Abstract: A method of treating a solid tumor, including the steps of localizing the tumor and the arterial vessel that supplies it, and injecting into the vessel, a vaso-occlusive collagen material adapted to produce occlusion of vessels having lumen diameters between about 10 and 150 microns. The injected material is effective to produce occlusion of the secondary and tertiary vessels supplying the tumor, distal to the collateral blood vessels which may also supply the tumor. The region of the occluded tumor is heated under conditions that produce tissue necrosis selectively in the occluded tumor tissue.

Abstract: Method and apparatus for unidirectional irrigation of at least a portion of the gastrointestinal tract between a point of access thereto and a distant or remote point of the tract. The distal end of an irrigating tube is passed through a point of access to the gastrointestinal tract to a distant point in the tract beyond which irrigation is not desired. The irrigating tube has one or more apertures formed therein only in the region substantially proximate to the distal end thereof. In the case where the portion of the tract being irrigated is not already occluded at the distant point, the tract is then occluded at that point whereupon irrigant is introduced into the irrigating tube through a proximal end thereof whereby the irrigant passes through the irrigating tube and is discharged therefrom through the aperture into the gastrointestinal tract at the region of the occluded distant point thereof and flows unidirectionally through the tract towards and out from the point of access.