Abstract: A device (10) holds a hollow puncturing needle (11) which can be controllably moved in a first direction (16) within an aparture (21) in the device (10). The handle (14) can, when pushed, be moved in the direction of the arrow (15). If the handle (14) is moved in the direction of the arrow (15), the hollow puncturing needle (11) moves in the first direction (16). The device (10) is to be placed against a counter-surface via a support surface (20). The hollow puncturing needle (11) is held in the device (10) to be axially movable controllably in the first direction (16) via the movable handle (14).

Abstract: An intraocular surgical tool for removing material from an eye of a patient. The tool is provided with a cutting assembly and an aspiration apparatus to remove a portion of vitreous from the eye for inspection and testing. The tool is also fitted with a mechanism for replacing the removed vitreous with saline or similar fluid. The tool makes an incision small enough so that sutures are not required. The tool is portable having a housing and battery pack releasably coupled to one another. The cutting assembly is releasably secured to the housing. Accordingly, the housing may be removed and the cutting assembly discarded so that the housing may be sterilized before performing a vitrectomy.

Abstract: An ultrasonic surgical clamp coagulator apparatus is configured to effect cutting, coagulation, and clamping of tissue during surgical procedures. The apparatus includes an elongated portion having a pivotal clamp arm at a distal end thereof for clamping tissue against an associated ultrasonic end-effector. A clamp arm mount of the apparatus interferingly engages the pivotal clamp arm to thereby maintain the clamp arm in substantial alignment with the end-effector, while accommodating normal manufacturing tolerances of the components.

Abstract: A guillotine surgical cutter. The cutter includes an inner sleeve that moves within the inner channel of an outer sleeve. The distal end of the outer sleeve may have a plurality of outer ports. The inner sleeve may also have an inner channel and one or more openings that are in fluid communication with the outer ports of the outer sleeve. The inner sleeve can be connected to a diaphragm and a disk spring. The diaphragm may be adjacent to a drive chamber that is coupled to a source of pressurized air by a control valve. Actuation of the control valve pressurizes the drive chamber and moves the inner sleeve relative to the outer sleeve. The cutter may include a snap spring that is attached to the disk spring and which provides an additional acceleration of the inner sleeve. The springs return the inner sleeve back to the original position when the control valve is switched to reduce the pressure of the drive chamber.

Abstract: A coring device for coring body tissue to define reproducible patent channels in the body tissue is provided. The coring device utilizes a coring member that is rotatable and linearly advanceable at coordinated predetermined rates to core body tissue. The device can include a suction assembly suitable for use during biopsy procedures and a cautery assembly to cauterize the cored body tissue. The coring member can also be oscillated along its longitudinal axis to effect cauterization and/or coring. The coring device is particularly suited for Transmyocardial Revascularization (TMR).

Abstract: A bipolar push rod assembly is disclosed in conjunction with an endoscopic bipolar cautery scissors instrument. The push rod assembly has two conductive push rods which are substantially covered and insulated from each other by a double lumen flexible sheath. The proximal ends of the push rods are stabilized by an overmolded plastic collar and the distal ends of the push rods are stabilized by a ceramic insulator. The plastic collar is provided with a snap retainer for coupling it to a plastic plug retainer having a pair of spaced apart passages. A pair of female plug adapters are press fit onto the proximal ends of the push rods and are maintained in place by the plug retainer with each adaptor residing in a respective one of the passages. The distal ends of the push rods are swaged approximately 90.degree. in opposite directions. A ceramic insulator is disclosed as a one-piece unit into which the distal ends of the push rods are inserted.

Abstract: An amniotic membrane perforator comprising an elongated shaft portion having an arcuate bend at the proximal end of the shaft and a hook at the distal end of the shaft. A flag portion extends perpendicularly to the shaft substantially adjacent the distal end of the shaft, opposite the hook. The cross-section of an extended length of the shaft inward the distal end is substanially oval. During use, the physician's index finger is placed along the flat portion, and the thumb and second finger adjacent the oval cross-section portion.

Abstract: A surgical cutting instrument, disposed generally along a rotational axis, includes a member extending from a base. The member is rotatable to transmit torque from the base to a cutter carried at the distal end of the member. The cutter defines one cutting edge oriented in a right-handed direction, and another cutting edge oriented in a left-handed direction. The right-handed and left-handed cutting edges can be, e.g., defined by a symmetrical revolved surface, forward-swept, symmetrical, or separated by an uninterrupted circumferential band of material.

Abstract: A scalpel is provided with horizontally separated first and second scalpel blades and with manually operated devices to adjust the separation between the blades as desired.

Abstract: A minimally invasive medical device comprises a tubular member with a large-diameter distal end portion and a smaller-diameter proximal portion. A clot-intake port is disposed in the distal end portion of the tubular member, while a cutter element is movably disposed in the distal end portion for severing material sucked in through the intake port and for temporarily closing the intake port during an extraction of the severed material from the device. A hollow drive rod extends through the tubular member to the cutter element for shifting the cutter element, while an outlet port is disposed in the tubular member proximally of the intake port and distally of the proximal portion of the tubular member. The tubular member extends through a catheter so that the intake port is disposed outside the catheter and the outlet port is disposed inside the catheter.

Abstract: An ablation and cutting catheter (10), which may be used for angioplasty, includes a rotary shaft (20) adapted to be driven by a rotary motor (22). The shaft (20) is free for rotation and for some axial motion. The shaft (20) is coupled to a rotational-to-axial motion converter (FIGS. 2a, 2b, 2c; 3a, 3b, 3c) which is affixed to the shaft. The converter moves axially in response to rotation of the shaft, and also rotates. The axial motion is converted into acoustic energy for ablation, and the rotation can be used with a cutting tool for cutting. A guide-wire lumen exteds through the shaft and the cutter/acoustic applicator head, for accepting a guide-wire for guiding the catheter.

Abstract: A tool for cutting and/or grasping pieces of food particles or human tissue which includes a pair of jaw members having a first pivot connection and a second camming connection arranged to cause the jaw members to move laterally relative to one another during closing movement thereof, and to cause the closing force applied to the jaw members to increase as the jaw members move relative to one in a closing direction.

Abstract: An ultrasonic device and method for removing obstructive matter from an anatomical structure or passageway (e.g., blood vessel). The device comprises an elongate pliable catheter having a distal tip member attached to the distal end thereof, and an ultrasound transmission member which extends longitudinally therethrough to carry ultrasound from the proximal end of the catheter to the distal tip member. The distal tip member has a concave indentation formed in the distal surface thereof, and at least one inlet passageway extending therethrough in communication with a catheter lumen to facilitate suctioning of severed matter which becomes located within the concave indentation of the distal tip. The device may further incorporate means for infusing fluid (e.g., irrigation fluid, medicaments) separately or concurrently with the aspiration of the severed obstructive matter.

Abstract: A biopsy device and method are provided for removing samples of tissue from a patient's body. The device comprises a hollow outer needle with an opening, a rotatable inner needle with a cutting surface and a driving mechanism within a handle assembly. The needles are inserted into the patient's body and the inner needle is rotated so as to expose the cutting surface. The driving mechanism is activated and the inner needle is oscillated along its longitudinal axis at a desired frequency. The inner needle is then rotated and tissue is pinched between the cutting surface and the outer needle. The combination of the pinching force and the oscillating motion severs a uniform sample of tissue. The tissue is captured between the cutting surface of the inner needle and the inner surface of the outer needle. The driving mechanism is then deactivated and the device is removed from the patient's body. The needle portion of the device may be removed from the handle assembly and discarded.

Abstract: A method of and instrumentation for implanting a spherical prosthesis in a joint between a first bone and a second bone. The method includes the steps of exposing a joint between a first bone and a second bone; forming a semispherical cavity in the proximal surface of the first bone; forming a semispherical cavity in the distal surface of the second bone; and inserting a spherical prosthesis into the semispherical cavities in the proximal surface of the first bone and in the distal surface of the second bone.

Abstract: A powered handpiece for driving a surgical blade to cut anatomical tissue includes a reusable handpiece body having a distal end for being coupled with a surgical blade, a drive shaft in the handpiece body for rotatably driving the surgical blade, a motor assembly for being installed in the handpiece body to rotatably drive the drive shaft and a suction channel in the handpiece body including a portion extending through the drive shaft parallel to a longitudinal axis of the motor assembly for evacuating anatomical tissue cut by the blade from the handpiece body for external collection. The surgical blade is for use with the powered handpiece and carries a sealing arrangement facilitating irrigation and suction. The handpiece body is capable of being sterilized to medical standards prior to each use.

Abstract: An ultrasonic treatment instrument includes an ultrasonic transducer for generating ultrasonic oscillation, a hand piece containing the ultrasonic transducer, and a probe having a proximal end portion connected to the ultrasonic transducer and a distal end portion to which the ultrasonic oscillation of the ultrasonic transducer is transmitted. A sheath covers the probe and has a front end portion extending toward the distal end portion of the probe and a rear end portion connected to the hand piece. A hook-shaped treatment section is provided at the distal end portion of the probe and has a hook portion bent which is substantially perpendicular to an axis of the sheath and an axial body extending from a proximal end of the bent hook portion.

Abstract: A ring blade and drive system, and method of using same, for harvesting bone-tendon-bone ligament grafts having substantially cylindrical bone plugs. The ring blade disclosed is a circular ring having a predetermined arcuate gap formed in its periphery. The drive system includes a blade holder to peripherally hold the ring blade and a fixed-center oscillating mechanism to oscillate the ring blade about its axis within a predetermined arcuate range of motion. The ring blade structure enables the production of a substantially cylindrical bone plug of unlimited length. Harvesting of a bone-tendon-bone ligament graft is facilitated with the ring blade and method disclosed which enables the ring blade to be placed partially around a tendon segment to create bone plugs aligned with the tendon fibers included in the defined tendon segment. The cuts into the bone may be initiated into the bone at either end of the tendon segment from the tendon side through to the exterior of the bone to which the tendon is attached.

Abstract: Intravascular catheters that include a flexible catheter body, a distal housing secured to the catheter body, a work element disposed within the housing and exposed to the external environment through a side window, and a guiding structure for the work element, are disclosed. An axial path through the housing is defined by the guiding structure. Embodiments of the guiding structure include a slot or channel formed in the housing, a coaxial tube attached to the housing, a radially offset ribbon attached to the housing, or the external surface of the housing itself. The work element, such as a rotatable cutting blade in an atherectomy catheter, is coupled to the guiding structure such that the work element is retained within the housing during insertion and operation of the catheter and even when the housing is bent or distorted as a result of bends in the blood vessel.

Abstract: A system for controlling a plurality of ophthalmic microsurgical instruments is disclosed. Particularly, the present invention includes an ophthalmic surgical handpiece, such as an intraocular surgical scissors or forceps which is powered by an electric stepper motor. The handpiece converts the rotational motion of the stepper motor into a linear motion to operate the surgical scissors- or forceps-type instruments.

Abstract: An ultrasonic surgical clamp coagulator apparatus is configured to effect cutting, coagulation, and clamping of tissue by cooperation of a clamping mechanism of the apparatus with an associated ultrasonic end-effector. Selective, indexed rotational positioning of the clamping mechanism and end-effector is achieved by the provision of a detent mechanism incorporated into the clamp drive mechanism of the apparatus. An improved clamping mechanism permits the desired clamping force to be applied to tissue positioned against the end-effector in an instrument having a desirably small cross-section.

Abstract: Disclosed herein is an intravascular universal catheter having interchangeable work elements and methods of use thereof. The catheter comprises a flexible catheter body having a distal end, a proximal end and a lumen extending between the ends. A housing having an open interior and an aperture on a lateral side is attached to the distal end of the catheter body by a coupling element. A work element is movably disposed within the housing and operative through the aperture. A work element connector is disposed in a lumen of the catheter body and has a distal end connected to the work element. At least the distal portion of the lumen defines a receiving space within the catheter body, and the coupling element is configured to allow retraction of the work element from the housing through the open proximal end into the receiving space. In a preferred embodiment, perfusion ports are disposed in the catheter body and the housing proximate to the junctional region of the catheter body with the housing.

Abstract: A counter-balanced oscillating surgical saw for use in surgical procedures is described which greatly reduces the vibrations caused when the saw blades contact the patient's anatomy. The reduction of vibration is achieved by the present saw which uses two oscillating blades to counter the kinetic energy typically lost when only one blade is used. The preferred embodiment of the present invention includes at least two cutting blades mounted on at least two actuator blocks. The actuator blocks are preferably mounted on at least two shafts which extend from the top of the saw handle: a pivot shaft and a rotatable shaft which is rotated by an electric motor. At least two eccentric bearings are mounted to the rotatable shaft (one bearing for each actuator block) such that the bearings orbit about the rotatable shaft 180.degree. out-of-phase with respect to one another.

Abstract: A ring blade and drive system, and method of using same, for harvesting bone-tendon-bone ligament grafts having substantially cylindrical bone plugs. The ring blade disclosed is a circular ring having a predetermined arcuate gap formed in its periphery. The drive system includes a blade holder to peripherally hold the ring blade and a fixed-center oscillating mechanism to oscillate the ring blade about its axis within a predetermined arcuate range of motion. The ring blade structure enables the production of a substantially cylindrical bone plug of unlimited length. Harvesting of a bone-tendon-bone ligament graft is facilitated with the ring blade and method disclosed which enables the ring blade to be placed partially around a tendon segment to create bone plugs aligned with the tendon fibers included in the defined tendon segment. The cuts into the bone may be initiated into the bone at either end of the tendon segment from the tendon side through to the exterior of the bone to which the tendon is attached.

Abstract: A surgical instrument provides improved precision and performance for use in highly intricate surgeries such as vitrectomy which frequently involves removing dense vitreous base firmly adherent to the retinal surface. The instrument includes two concentric tubes, an outer tube having ports near the closed end, and a slidable inner tube which fits snugly inside the outer tube. The inner tube includes a sharp cutting edge formed on one end that slides back and forth across the ports to cut vitreous, and an axial passage to pass the cut portions of vitreous. Such a surgical instrument maintains highly effective and accurate cutting member for removing vitreous without cutting into the retina.

Abstract: A surgical tissue cutter. The cutter includes an inner sleeve that moves adjacent to an outer port of an outer sleeve. The outer port is coupled to a source of vacuum that pulls tissue into the outer port when the inner sleeve is moved away from the port. The inner sleeve then moves across the outer port and severs the tissue in a guillotine fashion. The inner sleeve is coupled to a rotating output shaft of a motor by a wobble plate which induces an oscillating translational movement of the sleeve in response to a rotation of the output shaft. The motor speed is controlled by a foot pedal which allows the surgeon to directly control the cutting speed of the device. The wobble plate can be replaced to vary the stroke and duty cycle of the inner sleeve. The inner sleeve is coupled to an aspiration line that pulls the severed tissue out of the cutter. The level of the aspiration vacuum pressure can be controlled by varying the speed of the motor and the movement of the inner sleeve.

Abstract: An operative element mover (22) is used as a part of an ultrasound imaging or other catheter system (2) including a hollow sheath (6) and a case (16) housing a rotary driver (10). A drive cable or other connecting member (8) is disposed within the sheath with a transducer (24) at its distal end (26) and its proximal end (12) coupled to the rotary driver. The rotary driver rotates the transducer about the longitudinal axis (14) of the sheath. A hemostasis valve (50) anchors the sheath to the patient where the sheath enters the patient. The transducer mover (22) is used to move the drive cable along the longitudinal axis and includes a body (38) fixedly mountable to and dismountable from the case and a movable anchor post (40). The anchor post is clipped to the sheath and is moved by a sheath anchor drive (46) to translate the sheath from or toward the case. This causes the transducer to move within the sheath in a proximal or distal longitudinal direction (52).

Abstract: A surgical apparatus for making perfectly circular incisions comprises a cylindrical post; a ring supported at the bottom of the post for engaging a surgical site to be incised; a guide mounted for rotation on the post, the guide adapted to be translated upwardly and downwardly along the post; and a scalpel mounted on the guide, whereby the scalpel is adapted to incise a perfect circle on the surgical site.

Abstract: A surgical apparatus for removing tissue, which includes (i) an elongated body defining an opening at a distal end and forming a tissue receiving cavity in communication with the opening (ii) a blunt dilator at least partially disposed in the tissue receiving cavity and (iii) a cutting member operatively movable transverse to the elongated body in proximity to the opening.

Abstract: An acoustic ablation catheter driven by a rotating shaft (18) includes a rotary-to-axial-motion converter (210), which includes a rotary driver (220, 420) in the form of a shell (222, 422) defining an inner surface (228, 428) which features a depressed groove (230, 330, 430). A follower (250, 490, 724) includes protuberance(s) (254, 494) which extend radially outward to engage the groove. This arrangement provides higher frequency response than some prior-art arrangements, and has the advantage of lesser diameter. In a particular embodiment, the shell (422) is made up of a cylinder (422) with a smooth interior, together with two end pieces (470, 480) which have axially-directed bumps or teeth (472, 482) which together define the guide path (330, 430). In a particular embodiment of the invention, the body (12) of the catheter (10) is made from a braided tube impregnated with a cured liquid, such as polymer.

Abstract: A surgical instrument is provided for clamping and cutting during surgical procedures, particularly for use with tissues of varying thicknesses. The instrument in a preferred embodiment compresses tissue between electrodes associated with jaws of the clamping device and applies electrosurgical energy to the tissue. The invention provides an expandable cutting element which is adapted to compensate for various thicknesses in tissue and contractible by providing a knife which can be contained within the jaws and expand as needed for thicker tissues. The cutting element is preferably actuated as or after the electrosurgical energy has been applied, to cut tissue engaged and treated by the jaw members.

Abstract: A surgical instrument in which a surgical tool is carried distally of a bend region in a stationary support member by an assembly that transmits proximally applied forces through the bend region to both operate the surgical tool and selectively change the rotational orientation of the surgical tool with respect to the stationary member. In another aspect, in which the stationary member does not include a bend region, a rotatable member supported by the stationary member transmits rotational force to the surgical tool to selectively change the rotational orientation of the tool, and a driver member supported by the stationary member transmits axial force to the surgical tool to operate it.

Abstract: An endoscopic treatment tool according to the present invention is led into the body through the endoscope channel. A treatment section (2) is operated by transmitting the operating power of an operating section (4) on the operator's side to the treatment section (2) at the forward end thereof. The endoscopic treatment tool is characterized in that a tubular sheath (28) is adapted to be inserted into the endoscope channel, rotative operation means (55) is arranged in the operating section (4) for rotatively operating the treatment section (2), and an operating wire (33) is rotatably inserted into the sheath (28) and has a torque transmissivity for coupling the treatment section (2) and the rotative operation means (55) and capable of transmitting the rotation torque from the rotative operation means (55) to the treatment section (2).

Abstract: A longitudinal position translator includes a probe drive module and a linear translation module. The probe drive module is coupled operatively to an ultrasonic imaging probe assembly having a distally located ultrasound transducer subassembly in such a manner that longitudinal shifting of the transducer subassembly may be effected. The probe drive module is preferably mounted to the linear translation unit so as to be moveable between a condition whereby longitudinal shifting of the transducer subassembly can be conducted either manually or automatically. When in the automatically-operable condition, the probe drive module will be engaged with a motor-driven screw associated with the linear translation module so as to cause the probe drive module to be longitudinally displaced at a constant motor-driven rate. In this manner, the distally located ultrasound transducer is longitudinally shifted during an ultrasound scan of surrounding intravascular (or other) tissue to thereby allow axially-spaced 360.degree.

Abstract: The BTR device of the present invention preferably comprises a housing chamber with an attached hand grip and actuating ringlet positioned to be grasped and pulled toward the hand grip. Inside the housing chamber is a hollow, open-ended, helically-slotted cylindrical element having a diagonal groove formed within the outer surface. A travelling pin, attached to the actuating ringlet, is fitted within the diagonal groove such that movement of the actuating ringlet simultaneously moves the travelling pin and rotates the helically-slotted cylindrical element. Gear teeth on the helically-slotted cylindrical element engage gear teeth on an inner shaft element rotatably positioned within the helically-slotted cylindrical element such that rotation of the helically-slotted cylindrical element is transferred to the inner shaft element.

Abstract: A pull push device for removing a clot. The device includes an elongate tubular member having a suction port and an irrigation or fluid pressurization port respectively connectable to a vacuum source and a pressurizable fluid reservoir. The tubular member also has a clot intake port positionable through a patient's skin inside a clogged vascular vessel. The vacuum source enables clot suction into the clot intake port for severing while liquid pressure supplies fluid for clot ejection and device clearance. A single piece rotating or reciprocating cutter and intake closure component is mounted inside the tubular member for closing the clot intake port upon each small vacuum assisted severing of clot mass by the cutting element. By simultaneously severing the clot and closing the intake port by the closure component, the device automatically converts from a suction to a pressure mode, thus ejecting any clot through the suction port.

Abstract: A ring blade and drive system, and method of using same, for harvesting bone-tendon-bone ligament grafts having substantially cylindrical bone plugs. The ring blade disclosed is a circular ring having a predetermined arcuate gap formed in its periphery. The drive system includes a blade holder to peripherally hold the ring blade and a fixed-center oscillating mechanism to oscillate the ring blade about its axis within a predetermined arcuate range of motion. The ring blade structure enables the production of a substantially cylindrical bone plug of unlimited length. Harvesting of a bone-tendon-bone ligament graft is facilitated with the ring blade and method disclosed which enables the ring blade to be placed partially around a tendon segment to create bone plugs aligned with the tendon fibers included in the defined tendon segment. The cuts into the bone may be initiated into the bone at either end of the tendon segment from the tendon side through to the exterior of the bone to which the tendon is attached.

Abstract: A distal atherectomy catheter is disclosed for removing obstructions, plaque, stenosis, occlusions, or the like from an artery or coronary vessel. The catheter comprises a flexible, hollow catheter tube. A cutting element is located within a cylindrical housing mounted at the distal end of the catheter tube. The cutting element is connected to a hollow, flexible drive shaft concentrically located within the catheter tube. The cutting element housing includes a side opening window or port providing access to the interior of the housing. An idler shaft journaled about the drive shaft provides a non-rotating surface adjacent the cutting element. An annular return passage is defined between the catheter tube and the flexible drive shaft providing a discharge passage communicating with external aspirating means for collection of cuttings removed by the cutting element from the artery or coronary vessel.

Abstract: An intracellular surgical tool for removing material from an eye of a patient. The tool is provided with a blade to allow the tool to make its own incision in the eye. The tool is provided with a cutting assembly and an aspiration apparatus to remove a portion of vitreous from the eye for inspection and testing. The tool is also fitted with a mechanism for replacing the removed vitreous with saline or similar fluid. The tool is portable having a housing and battery pack releasably coupled to one another. The cutting assembly is releasably secured to the housing. Accordingly, the housing may be removed and the cutting assembly discarded so that the housing may be sterilized before performing a vitrectomy.

Abstract: A method and apparatus for minimally invasive tissue removal contemplates a system including a tissue cutting tool having a motor driven cutting blade reciprocating within a percutaneously introducable cannula. In accordance with one method of the invention, the frequency of reciprocation of the cutting blade is tuned to a characteristic frequency of the target tissue to be excised, which frequency is a function of certain properties of the target tissue and the surrounding tissue. Cutting at the characteristic frequency of the target tissue not only enhances the speed and efficiency of the tissue excision, but also minimizes the risk of cutting surrounding tissue. Another aspect of the system includes feedback control of both aspiration and irrigation circuits of the system. With the feedback control, coupled with user settable inputs, the surgeon can control the system to "tease" tissue into the cutting opening to provide more manageable bite sizes of the excised tissue.

Abstract: A sinus debrider apparatus comprising a housing, a motor mounted in the housing and a cutter head mounted to the housing. The cutter head frustum conical shaped and defines an interior chamber, a suction passageway and a fluid passageway. A blade holder is mounted to the head and axially aligned with the interior chamber with a blade member being rotatably mounted in the blade holder. A coupling member is mounted in the interior chamber and connects the motor and the blade member to transmit motion from the motor shaft to the blade member. A manifold member defining separate passageways communicates with the suction passageway and the fluid passageway of the head and forms a connection section to hold a flexible tube providing suction and fluid to the cutter head.

Abstract: A method and apparatus minimally invasive tissue removal contemplates a system including a tissue cutting tool having a motor driven cutting blade reciprocating within a percutaneously introducable cannula. In accordance with one method of the invention, the frequency of reciprocation of the cutting blade is tuned to a characteristic frequency of the target tissue to be excised, which frequency is a function of certain properties of the target tissue and the surrounding tissue. Cutting at the characteristic frequency of the target tissue not only enhances the speed and efficiency of the tissue excision, but also minimizes the risk of cutting surrounding tissue. Another aspect of the system includes feedback control of both aspiration and irrigation circuits of the system. With the feedback control, coupled with user settable inputs, the surgeon can control the system to "tease" tissue into the cutting opening to provide more manageable bite sizes of the excised tissue.

Abstract: A device for performing an anterior capsulotomy procedure has an elongate tubular member with an opening formed near the distal end thereof. A cutter is movably disposed within the tubular member and has a blade formed thereon. A vacuum port is in fluid communication with the lumen of the tubular member. An actuator effects movement of the cutter so as to move the blade across the opening. The opening is configured to draw in a portion of a capsule when a vacuum is applied to the vacuum port such that the cutter forms a generally circular cut of a predetermined size in the capsule when the actuator is actuated.

Abstract: A surgical cutting instrument for removing objects, such as a pacemaker lead or catheter, embedded in biological tissue. The cutting instrument includes a rigid proximal end and a flexible distal end, the flexible distal end having circular opening and a cutting blade disposed longitudinally therein. A control handle connected to the rigid proximal end and extending radially therefrom provides a force applied to an inner member which extends the cutting blade beyond the circular opening and simultaneously rotates the cutting blade to cut tissue exposed to the blade.

Abstract: A device and method for clearing a stenosis in a vessel of a patient requires a catheter having a rigid, cone-shaped probe at its distal end. The probe has a distally diminishing taper and also has a plurality of blades which are mounted on the probe and longitudinally aligned with the catheter. The probe is formed to include a series of grooves which span the length of the probe. Advancement of the probe through the vessel to the stenosis can be accomplished either over a prepositioned guidewire or through a prepositioned guide catheter. At the stenosis, the probe with mounted blades are reciprocally moved back and forth across the stenosis to incise and dilate the stenosis and, thus, clear the stenosis. Blood flow is maintained within the vessel by the grooves formed in the surface of the probe. Movement of the probe across the stenosis can be facilitated by selectively activating a rigidizer which is located on the catheter immediately proximal to the probe.

Abstract: A method and apparatus for minimally invasive tissue removal contemplates a system including a tissue cutting tool having a motor driven cutting blade reciprocating within a percutaneously introducable cannula. In accordance with one method of the invention, the frequency of reciprocation of the cutting blade is tuned to a characteristic frequency of the target tissue to be excised, which frequency is a function of certain properties of the target tissue and the surrounding tissue. Cutting at the characteristic frequency of the target tissue not only enhances the speed and efficiency of the tissue excision, but also minimizes the risk of cutting surrounding tissue. Another aspect of the system includes feedback control of both aspiration and irrigation circuits of the system. With the feedback control, coupled with user settable inputs, the surgeon can control the system to "tease" tissue into the cutting opening to provide more manageable bite sizes of the excised tissue.

Abstract: A trephine device for at least partially removing a section of the anterior epithelial cells from a corneal surface, typically prior to laser excimer reshaping of a portion of the corneal surface, comprises a housing having upper and lower end portions, removal apparatus integral to the housing, and apparatus for activating and deactivating the removal apparatus. The removal apparatus may have at least one cutting surface adapted to conform substantially to the shape of the cornea, with the cutting surface contacted with the cornea at a pressure sufficient to remove the anterior epithelial cells without affecting underlying corneal tissue.

Abstract: A surgical instrument provides improved precision and performance for use in highly intricate surgeries such as vitrectomy which frequently involves removing dense vitreous base firmly adherent to the retinal surface. The instrument includes two concentric tubes, an outer tube having ports near the closed end, and a slidable inner tube which fits snugly inside the outer tube. The inner tube includes a sharp cutting edge formed on one end that slides back and forth across the ports to cut vitreous, and an axial passage to pass the cut portions of vitreous. Such a surgical instrument maintains highly effective and accurate cutting device for removing vitreous without cutting into the retina.

Abstract: A flexible elongate device including a flexible elongate tubular member having proximal and distal extremities. A flexible coil spring is provided having proximal and distal extremities. The proximal extremity of the coil spring is secured to the distal extremity of the flexible elongate tubular member. A rounded tip is secured to the distal extremity of the coil spring. A flexible elongate element having proximal and distal extremities is disposed within said coil spring and extends longitudinally of the coil spring. The distal extremity of the flexible elongate element is secured to the rounded tip. A vibrator is secured to the proximal extremity of the flexible elongate element for imparting vibratory motion to the flexible elongate element to cause vibratory impact motion of the rounded tip in a direction longitudinal of the axis of the flexible elongate element.

Abstract: In a valvulotome, when an operating wire is advanced or withdrawn, a pair of arms project from or sink into a sheath, and cutters at the tips or the arms open or close. When the arms are stowed in the sheath, forces causing the two cutters to join change directions sequentially with three pairs of bents of the arms as boundaries. Thus, the blades of the two cutters are stowed in the sheath reliably.