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: A laparoscopic surgical ligation and electrosurgical coagulation device has an elongated handle sized to be received in a trochar and having a central passageway extending therethrough. A first channel is provided in the handle along one side of the passageway and is generally parallel thereto. A second channel is provided in the handle which is generally parallel to the passageway and spaced from the first channel. A suture extends through the central channel passageway and has a loop with a slip knot on the distal end thereof and a pull on the proximal end thereof, so that by pulling on the pull the loop can be drawn tightly about a tissue to be ligated. An electrosurgical wire is slidably received in the first channel and has an electrically insulated body extending through the first channel with an exposed wire hook formed at the distal end thereof for grasping the tissue to pull it through the suture loop.

Abstract: A thin layer of a material having a refractive index that varies non-abruptly between the refractive indexes of a first element and a second element in an optical device significantly reduces Fresnel losses in transmitting light from the first element into the second element. The layer is readily created by either an ion beam mixing process or by an ion beam enhanced deposition (IBED) process, forming a region of non-abruptly varying refractive index in one of the elements at an interface therebetween. A selected material is thus securely bonded into the laser light-receiving element which may conveniently be made of a material such as YAG, silica, sapphire, zirconia, quartz, silicon, germanium, zinc sulfide or zinc selenide, depending on the application at hand. In another aspect of this invention, the tip element is provided with an additional layer over the first layer to provide added protection thereto.

Abstract: An electrosurgical device for laparoscopic use in tissue dissection and coagulation. The device includes a barrel member having a dissection tip at the distal end thereof that is connected to a source of electrical energy. An insulating sheath member surrounds the barrel member. The sheath member is movable between a first position wherein the distal end thereof extends distally beyond the dissection tip and a second position wherein the dissection tip extends distally beyond the distal end portion of the sheath member. The device includes means to flush and vacuum the surgical site. The device also includes pressure relief means to limit the internal pressure within the device.

Abstract: Electrosurgical apparatus for performing at least cutting and coagulation of biological tissue, which comprises a hand operated electrosurgical pencil comprising an electrically insulated housing and an electrode with a distal end defining a tip, means for supplying high-frequency, alternating current, electrical energy from a generator through the electrode to the tissue and means for returning electrical energy from the tissue to the generator to complete an electrical circuit, switching means mounted on the housing for selecting the cut mode or the coagulating mode, which switching means is connected to an isolated low voltage, direct current circuit which provides an appropriate signal to control the generator in the cut mode or coagulating mode, respectively, whereby the generator supplies the desired high-frequency, alternating current, electrical energy to the electrode and current leakage is limited.

Abstract: A surgical instrument comprises a handle, an electrical cauterization electrode, a mounting for movably joining the electrode to the handle so that distance of the electrode from the handle may be adjusted prior to a surgical procedure, and an electrical supply mechanically connected to the handle and operatively connected to the electrode for supplying thereto an electrical voltage having a characteristic waveform.

Abstract: An electrosurgical unit for being capable of selection of desirable electrosurgical operation mode in cutting mode and coagulation mode. A handpiece for the operation is connected to a control means through an isolation means, and an operator performs the operations of cutting mode or coagulation mode by use of the handpiece. The handpiece is provided with a cutting mode switch and a coagulation mode switch. The operator can perform the mode change only in the sterile field by depression of these switches simultaneously.

Abstract: A device for enhancing the safety and efficiency of a hand-operated electrosurgical pencil having an exposed electrode with a distal end defining a tip for cutting biological tissue, which device comprises a nose piece adapted to be mounted about said electrode and defining at least one pathway for a stream of gas which shrouds the electrode at or near the tip thereof, and electrosurgical apparatus incorporating the device and a method for cutting biological tissue using the apparatus.

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: A surgical tissue coagulator includes an elongate, biocompatible, flexible tube having an open distal end and a proximal end. The tube has an external diameter of less than about 5 mm, and is insertable into and maneuverable within a surgical endoscope. The proximal end of the tube is connectable with a source of argon gas so that a stream of the gas can flow through the tube and exit the distal end of the tube. A flexible wire is provided within the tube for conducting radiofrequency (RF) current. The wire has a distal end for positioning adjacent the distal end of the tube, and a tungsten tip is provided at the distal end of the wire for discharging an arc of RF energy away from the distal end of the wire within the stream of argon gas exiting the distal end of the tube. The wire has a proximal end opposite the distal end thereof. The wire is connectable at the proximal end thereof with a source of RF energy.

Abstract: A surgical instrument assembly for use in snare cauterization operations comprises a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over the selected internal body tissues to be removed, so that the web member substantially surrounds the selected internal body tissues.

Abstract: An electrosurgical tool comprises a retractable cutting blade movable along a linear cutting path and an electrical energy supply source which communicates electrical energy (e.g., radio frequency energy) through the cutting blade and to tissue adjacent the cutting blade. During surgical procedures the electrosurgical cutting device is able to simultaneously cut tissue and cauterize, or fuse, the tissue in areas adjacent the incision through the application of electrical energy. The effect is a reduced amount of bleeding associated with surgical procedures and an enhanced ability to control and eliminate bleeding. Optionally, the electrosurgical cutting device may also include a supply of surgical staples which are deployed simulaneously with the cutting action and delivery of electrosurgical energy to adjacent tissue.

Abstract: A surgical instrument assembly for use in snare cauterization operations comprises a tubular sheath member, a metallic cauterization loop, and a metal wire operatively connected to the loop, the wire passing longitudinally through the sheath. An electrical supply is operatively connectable to the wire for feeding an electrical current to the loop via the wire, while a manually actuatable shifter is operatively connected to the wire for longitudinally sliding the wire along the sheath in alternately opposite directions. A flexible web member is connected to the loop to form a capture pocket, the loop defining a mouth opening of the pocket. During use of the snare cauterization instrument, the loop is at least partially expanded from a collapsed configuration and passed over a polyp to be removed, so that the web member substantially surrounds the selected polyp.

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: The invention provides a surgical instrument having a pair of opposed jaw members, at least one of which jaw members is moveable with respect to the other jaw member. A cutting and/or cauterizing heat source such as a hot wire element and/or laser transmission fiber is carried on at least one of the jaw members.

Abstract: A device for enhancing the safety and efficiency of a hand-operated electrosurgical pencil having an electrode with a distal end defining a tip for cutting or coagulating biological tissue, which device comprises a nose piece adapted to be mounted about said electrode and containing conduit means defining converging pathways for streams of gas which impinge obliquely on said electrode at or near the tip thereof, and electrosurgical apparatus incorporating said device and a method for coagulating or cutting biological tissue using said apparatus.

Abstract: A clip-on attachment for a surgical instrument of the type having a handle which supports an electrode and switches for selectively applying high frequency electrical energy to the electrode acts to withdraw smoke, fumes or other fluids that may be produced in the region of of the electrode by contact with living tissue. The attachment includes an elongate tube which extends along the instrument handle and which preferably has a helically curved forward end that makes a partial turn around the forward end of the handle. A length of flexible tubing connecting with a source of low pressure is threaded through the tube to extend from the front end of the tube towards the electrode. Resilient clamps on the tube clasp the instrument handle while enabling axial sliding movement and partial rotation of the attachment around the instrument handle to enable repositioning of the flow intake under different operating conditions.

Abstract: A cart (10) is provided for conveniently carrying an electrosurgical generator (14) and for providing electricity from the generator (14) and inert gas from gas tanks (66-68) to an electrosurgical pencil (40). The cart (10) comprises a platform (12) constructed and arranged to receive any electrosurgical generator (14). A wheeled support structure (16) allows storage and transport of the necessary components for operating the generator (14) and the pencil (40). The cart (10) contains space for receiving gas tanks (66-68) and the connections for transferring the gas from the tanks (66-68) to the pencil (40) at a desired flow rate. The cart (10) also provides the electrical connections to provide electricity to the generator (14) and to the pencil (40) simultaneously with the inert gas.

Abstract: An bipolar electrosurgical instrument especially designed especially for use in freeing and rerouting of the internal mammary artery during coronary bypass surgery. It comprises a rigid pen-like handle having appropriate cut and coag control switches mounted thereon and a bendable tubular extension projecting from the distal end of the handle member. Mounted on the distal end of the extension is a blade holder designed to contain an ultrasonic transducer as well as the proximal end of the blade itself. The blade comprises a ceramic substrate having a pattern of metallization thereon defining a bipolar cutting gap along the side and end edges of the blade and a bipolar coagulating gap located inwardly from the side and end edges. A cable is used to join the implement to an electrosurgical generator and the individual wires in the cable extend through the pen-like body, the tubular extension and into the blade holder where electrical connections are made to the electrodes on the blade itself.

Abstract: An apparatus coupled to a laser delivery device comprising a housing having a laser waveguide for receiving a laser beam from the delivery device and for transmitting the laser beam to an area of medical treatment and a connection for receiving radio frequency electrical current and transmitting the current to an electrode for providing the current to the area of medical treatment. The apparatus combines the advantages of radio frequency electrosurgery techniques and laser surgery techniques in one device, offering the surgeon instant access to both techniques during surgery, as needed.

Abstract: A waveform generator for electrosurgical apparatus disclosed includes a MxNxP storage device and a parallel to series conversion device. For the storage device, M is the maximum number of different waveforms being stored, N equals the number of bits being output from the storage device at a time and P is the maximum number of N bits that can be stored for each waveform. An address counter selects the next N bits of the waveform and these N bits loaded from the storage device into the conversion device and output in a sequential or series output signal to drive the RF power amplifier of electrosurgical apparatus. The output signal has a bit rate N times faster than the storage device is accessed.

Abstract: A surgical tissue separation system comprises a handle formed with a bore, a metal blade mounted to one end of the handle and supplied with electricity, and a suction tube connected to the opposite end of the handle by a connector which includes a first section for connection to the suction tube, a second section for connection to a vacuum source for removing smoke and fumes produced by burnt tissue, and a third section for connection to an auxiliary vacuum tip for removing fluids.

Abstract: An electro-surgical implement with an improved handle having a cutting mode of operation and a coagulating mode of operation. The implement includes a blade member having an electrically conductive pad area, and a predetermined pattern of electrical conductors. Electrical switch apparatus is contained in the handle member for altering the mode of operation between the cutting mode and coagulating mode when the handle member is in a locked disposition. Apparatus is also contained within the handle member for vibrating the blade member at a predetermined frequency and amplitude sufficient to create cavitation to prevent buildup of tissue and debris, and apparatus for energizing the blade for cutting and coagulating including apparatus for forcing the electrically conductive pad area against the vibration apparatus when the handle member is in a locked disposition. Mechanical switch apparatus is included to allow safe removal of the blade.

Abstract: An electrosurgical apparatus comprises an electrosurgical generator for producing cutting and coagulation signals and has either pedal operated or hand operated switches for switching on and off and between cutting and coagulation signals. A cutting and coagulation probe is energized by the generator and has a handle portion and a probe element. An on/off switch controls energization of the probe element. A switch is operated to switch the probe element between the cutting current and coagulation current. A holder member removably supports the probe element and has an electric socket therein. The probe element is removably supported in the holder member and has an electric connector cooperable with the holder member socket to complete an electric connection to the probe element. An electric connector connects the probe element to the electrosurgical generator circuit. The on/off switch may be in the holder element or in a pedal operated switch.

Abstract: An electrosurgical generator for driving one or more separate electrosurgical implements, e.g., an electrosurgical scalpel and an electrosurgical forceps, over separate output channels. Bipolar electrodes on the scalpel blade are energized by a radio frequency (rf) power source which, by proper manipulation of push-button switches on the scalpel handle, can be made to operate selectively in a CUT and in a COAG (coagulate) mode. In the CUT mode, the rf energy is applied to the tissue, via electrodes which are closely spaced, yielding a high current density. In the COAG mode, the energy is applied to electrodes which are spaced relatively far apart so as to produce heating sufficient to cauterize, but not to the point where the tissue is rent. The generator also provides circuitry for energizing an ultrasonic transducer mechanically coupled to one of the surgical implements whereby vibratory energy is simultaneously applied to the implement along with the rf CUT/COAG energy.