Abstract: The invention relates to a instrument for laparoscopic surgery which permits the operating surgeon to irrigate or suction the operative area while performing electrocautery or laser hemostasis and dissection of body tissue with the same instrument.The invention also relates to a laparoscopic tool for evacuating free stones or blood clots from the operating area which are to large to be suctioned from the body cavity or to remove gallstones from a gallbladder which has been distended by stones and cannot be retrieved through an umbillical sheath.

Abstract: In a method for removing a myoma, a distal end portion of a tubular member is inserted through laparoscopic trocar sleeve disposed in the patient's abdomen. The distal end portion of the tubular member is inserted into the myoma tissues to form a core thereof inside the tubular member. The myoma core is fragmented via an energizable laparoscopic instrument and the fragments are aspirated from the tubular coring member. The tubular member may be provided along a distal edge with a cauterizing element for facilitating the insertion of the distal end portion of the tubular member into the myoma.

Abstract: Apparatus and methods of effecting a medical procedure, e.g., laparoscopic, endoscopic, etc. procedures, through a small percutaneous incision or puncture in the body of a patient. One embodiment of the apparatus comprises an elongated outer tube, an elongated inner tube located within the outer tube and moveable relative thereto. An electrosurge electrode is mounted on the distal end of the inner tube so that it can be moved to a retracted position when it is not need or to an extended position when it is to be use. A vacuum system and an irrigation system are provided. The vacuum system is arranged to apply suction through an annular space between the tubes to effect the removal of tissue or other debris from the operative site within the patients body. The irrigation system is arranged to supply an irrigation liquid through the inner tube to the operative site. Each of the tubes is formed of an electrically insulating material so that the apparatus can be safely inserted within the patient's body.

Abstract: A coagulating cannula is described which effectively operates in a localized area quite rapidly, without the need for removal of motorized shaving instruments, by the incorporation of a selective manually operative electrocautery positioned at a distal end of the shaft of the cannula. The cannula incorporates a nonconductive cylindrical hollow shaft and a nonconductive hub portion through which the motorized shaving instruments are inserted and removed. The electrocautery component enters the cannula at an electrical contact which protrudes from an outer surface of the hub portion and continuously runs within the hub and into a wall of the shaft terminating at the distal end of the shaft in a prominance at the tip of the shaft. The prominance is of a small surface area such that the prominance provides a small electrical contact area with a surrounding saline environment, thereby providing a high resistance arcing to the surrounding tissue that needs to be coagulated.

Abstract: Smoke emitted during an electrocautery procedure may be removed from the environment of the procedure through the use of an electrocautery knife having an elongated handle provided with an inlet port at the end of the handle mounting the knife blade, an outlet port at the opposite end of the handle and adapted to be connected to available suction or vacuum, and an internal passage extending between the ports.

Abstract: Techniques for effectively sterilizing catheters, particularly long-dwelling intravenous catheters, are disclosed. The techniques include the transmission and dispersion of ultraviolet or infrared radiation, the heating or cooling of a catheter distal end portion, and the transmission of electrical current along the catheter and through the catheter lumen or organic tissues in which the catheter resides.

Abstract: A method and device is described for removing concretions such as calculus stones within human ducts such as the ureter or kidney. The device includes a flexible probe insertable through the human duct so that a tip thereof is juxtaposed against the concretion. The probe includes a positive electrode extending coaxially within the conduit and embedded in a solid electrically insulative material. A negative electrode is coextensive with and outwardly encircles the positive electrode. The solid electrically insulative material stops short by a distance R from the end of the probe, thereby leaving a recess without solid insulation between negative and positive electrodes at the tip end of the probe. The recess achieves a more efficient fragmentation of target calculi at lower energy, with less human tissue damage and increase in useful probe life.

Abstract: Forceps used in handling laboratory tissue samples being embedded in paraffin are prevented from accumulating congealed paraffin by maintaining the temperature of the grasping portions of the forceps above the point at which the paraffin remains liquid. Electrical resistance heaters are attached to the forceps, and these are energized by an appropriate electric circuit.

Abstract: In a method for use in cleaning a flexible endoscope, an elongate cleaning member having an embedded optical fiber, an electrical conductor, and/or a heat conductor is inserted into a biopsy channel of the endoscope. Sterilizing radiation of a predetermined wavelength is transmitted along the optical fiber from a proximal end of the elongate cleaning member towards a distal end thereof. The radiation is dispersed to at least partially sterilize the biopsy channel. Heat energy is conducted along the heat conductor to raise or lower the temperature of the biopsy channel for a predetermined period to effectuate a sterilizing action. Electrical current may also be transmitted along the biopsy channel wall by virtue of the electrical conductor. The method also comprises the step of ejecting a sterilizing fluid from the elongate cleaning member into the biopsy channel.

Abstract: A sheath through which a shunt for relieving hydrocephalus can be withdrawn from or advanced into the brain of a patient includes a tubular member which is slidably engageable with the shunt in a surrounding relationship with the shunt. The tubular member has a distal end segment, and an electrically resistive cutting element is positioned on the distal end segment for selectively cutting tissue adjacent the cutting element as the tubular member is advanced over the shunt. Preferably, the cutting element is connected to a source of electrical pulses for selectively heating the cutting element and thus for selectively thermally cutting tissue that has grown into the shunt away from the shunt. The sheath also includes a small fiber tube through which an optical fiber can be positioned to provide a means for presenting a video display of the brain during shunt retrieval and replacement through the sheath.

Abstract: An electrosurgical instrument for causing hemostasis having a first predetermined region for contact with flesh or tissue, said instrument being coated over at least a portion of said predetermined region by a composite coating consisting essentially of a nickel-phosphorous matrix having particles of polytetrafluoroethylene distributed substantially uniformly therein.

Abstract: A waterproof body for an electric cautery containing cautery parts, comprising a cautery tip assembly, a first hollow half body with a button hole in its side and a receptacle in one end so as to receive the cautery tip assembly, a second hollow half body with a receptacle in on end to receive the cautery tip assembly, a waterproof flexible membrane fastened to the inside of the first half body so as to seal the button hole in a waterproof manner, and an electrical switch button fastened in the button hole of the first half body. The first and second half bodies are joined together in a waterproof manner by ultrasonic welding. The electrical switch button slides in an axial manner relative to the body.

Abstract: A monopolar electrosurgical instrument for excising polyps from the gastrointestinal tract comprises an elongated flexible plastic tube having a first monopolar electrode mounted a small predetermined distance from the distal end of the tubular member and a conductive wire loop affixed to a pull-wire, the pull-wire extending through the lumen of the tubular member and being connected at its proximal end to a plunger-type handle whereby the loop can be opened and closed by extending and retracting the loop relative to the distal end of the tubulr member. By incorporating both the surface electrode and the loop on the same instrument, polyps may be severed electrosurgically using the snare and the wound then immediately cauterized using the surface electrode, thus obviating the need to do an instrument exchange in the endoscope to accomplish both functions.

Abstract: A thermal atherectomy catheter has a tip of high magnetic permeability cylindrical stem with an enlarged head at one end and an enlarged collar at the other end, a coil of wire wrapped about the stem adjacent the head and removed from said collar, a sleeve of ferromagnetic material disposed about the coil and a second sleeve of non-magnetic outer sleeve extending between and of the diameter of the head and collar to define a space between the sleeves whereby the outer sleeve to collar are maintained at a lower temperature than the head.

Abstract: Bone cement is removed from a bone cavity, such as the intramedullary canal, during a prosthetic revision. The bond cement is pre-molded by a thermal chisel which includes a shaft for extending into the bone cavity, a plasticizer chisel on a working end of the shaft, and a heat element carried by the shaft for heating the chisel to a temperature within a range of temperatures sufficient to plasticize the bone cement. This deforms and weakens the bone cement upon direct non-impact type contact between the heated tip of the chisel and the cement. The cement is removed by pre-molding it with the heated working end of the thermal chisel, preferably by molding a distally located circumferential furrow in the bone cement and then molding circumferentially spaced apart longitudinal furrows from the circumferential groove to the proximal end of the bone cement.

Abstract: A stimulation device for the determination of the temperature perception of the skin of a patient by means of a stimulator, which is arranged in a casing and which can be heated up or cooled down by a Peltier element. The stimulator (1) is arranged moveably along an axis (5) in the casing (4) and shows a projection (14) in relation to the casing (4) in the starting position. A first pressure device (6) cooperates with said stimulator (1) in such a way that said stimulator (1) can be shifted along said axis (5) by expenditure of force until said projection (14) is at zero. The force is predefined or adjustable by said first pressure device (6).

Abstract: A catheter includes at least two electrical conductors extending from the proximal to the distal ends. A semiconductor chip generator of electromagnetic radiation is located at the distal end and is energized by electrical power supplied by the electrical conductors. The chip may be a laser or include an oscillator for generating electromagnetic radiation at a selected frequency or frequencies. In one embodiment, two chip radiation generators are located distally, each connected to one of the conductors. A third conductor is connected in common to both chips, whereby they may be energized independently. An axial aperture may be provided for a guide wire. A balloon may surround the distal end of the catheter, and may be inflated by way of another axial aperture.