Abstract: A surgical snare instrument according to several embodiments includes a first handle capable of controlling the rotational position of the snare, and a second handle adapted to control the opening and closing of the snare and cauterization. The first handle serves as a grippable element on the sheath and contains a system which rotates the shaft, and consequently the snare, so that when the physician grips the first handle, the physician is capable of steering the snare by operating the first handle. In addition, the physician is also capable of positioning the entire sheath relative to the endoscope by sliding the sheath into and out of the working channel of the endoscope. The proximal handle is operable by an assistant and permits longitudinal movement of the shaft and cautery application. According to other embodiments, the snare instrument is provided with a mount which enables the snare instrument to be adjustably fixed relative to an endoscope handle.

Abstract: A surgical instrument for excising includes an endoscopic portion with an ultrasonically vibratable loop. The loop is positioned around the tissue and closed, whereupon ultrasonic energy is transmitted to the loop to cut and cauterize the body tissue. The apparatus and method described herein are particularly suitable for colonoscopic polypectomy procedures.

Abstract: A laparoscopic bipolar electrosurgical instrument can apply a large closure force between its jaws without damaging the small yoke assembly.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: A micro-catheter system utilizing a microjoule pulsed electrical discharge between first and second electrodes in a recessed lumen at the catheter's working end for creating a cavitating volume of electrolytic fluid composition including a pharmacologic agent. The expansion and collapse of media at a high repetition rate creates acoustic waves that propagate distally from the working end of the micro-catheter to disrupt thrombus. The expansion and collapse of such cavitation bubbles “jet” the pharmacologic agent at a controlled velocity into the acoustically-disrupted thrombus to further depolymerize the thrombus. The catheter system includes a computer-controller for independent modulation of (i) all aspects of pharmacologic agent delivery, and (ii) all parameters of electrical discharge to “tailor” the combined acoustic wave effects and pharmacologic agent effects to dissolve thrombus rapidly and efficiently.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention includes a channeling technique in which small holes or channels are formed within tissue structures in the mouth, such as the tonsils, tongue, palate and uvula, and thermal energy is applied to the tissue surface immediately surrounding these holes or channels to cause thermal damage to the tissue surface, thereby stiffening the surrounding tissue structure. Applicant has discovered that such stiffening of certain tissue structures in the mouth and throat helps to prevent the tissue structure from obstructing the patient's upper airway during sleep.

Abstract: A puncture instrument capable of punctured high frequency treatments. The puncture instrument essentially includes: a guide tube to be inserted into an intracavitary portion of a patient; a puncture needle member having an elongated needle body slidably received in the guide tube, and a sharp-pointed needle head provided contiguously at the fore end of the elongated needle body and protrudable out of the guide tube to penetrate into a target intracorporeal portion to be treated when the needle body is manipulated in a forward direction; and a high frequency electrode provided on a fore end portion of the needle body to be penetrated into the target intracorporeal portion together with the sharp-pointed needle head.

Abstract: A grooved slider forming part of an electrode for use with a resectoscope is shown. The electrode includes an electrode lead member having an elongated conductor member. The elongated conductor member has a first end and a second end with an insulative cover extended therebetween. The first end has a protruding electrode adapted to be electrically connected to an electrosurgical generator and the second end terminates in an active member. An electrode support member is operatively connected to the active member. The electrode support member has an elongated semi-rigid bifurcated arm terminating in a conductive core spaced a predetermined distance from the active member. The bifurcated arm is covered with an insulative material except at the distal end where the grooved slider is located.

Abstract: A flexible sheath is removably inserted into an instrument-inserting channel of an endoscope. A treating member for applying a treatment to mucous membrane in a body cavity is projected from and withdrawn into the distal end of the sheath by an operation conducted at the proximal end of the sheath. An exposed electrode is provided at the distal end surface of the sheath. An electrically conductive member extending through the sheath is electrically connected at a distal end thereof to the electrode and at a proximal end thereof to a high-frequency power supply at the proximal end of the sheath.

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

Abstract: An endoscopic high-frequency treatment tool includes a flexible sheath, a manipulating wire, a fixed electrode and a moving electrode. The manipulating wire is inserted within the flexible sheath and is movable back and forth along a longitudinal axis thereof. The fixed electrode is connected to a tip of the flexible sheath. The moving electrode is connected to a tip of the manipulating wire, and opposes the fixed electrode to form a predetermined gap therebetween in a direction of the longitudinal axis of the manipulating wire. At least one of the fixing and moving electrodes receives a high-frequency current, and the moving electrode is movable toward and away from the fixed electrode by moving the manipulating wire back and forth.

Abstract: An apparatus for thermal treatment of a tissue mass having an elongated housing having a proximal and a distal end and defining a longitudinal axis, and further including at least two electrodes supported at its distal end and mounted for rotation to facilitate entry and passage through a tissue mass. A drive shaft may be disposed within the elongated housing and operatively engageable with the electrodes for causing their rotational movement. The apparatus may include an electrode gear and a drive shaft gear in cooperative engagement whereby rotation of the drive shaft causes corresponding rotation of the electrodes. Preferably, a motor is operatively connected to the drive shaft causing its rotational movement. Desirably, the distal end of the electrodes are threaded. A method for thermally treating a tissue mass is disclosed.

Abstract: In the present invention, a surgical trocar is adapted to capacitively couple electrosurgical energy to specially adapted cordless electrosurgical instruments. In one embodiment of the present invention, an electrosurgical trocar includes a cannula, a capacitive electrosurgical adapter and a locking connector adapted to connect the cannula to the capacitive electrosurgical adapter. The cannula is an elongated tube which may be inserted into a body cavity, duct or vessel. The electrosurgical adapter includes a housing with an elongated central aperture, an adapter proximal capacitor plate and an adapter distal capacitor plate positioned in and extending axially along the elongated aperture, first and second electrical conductors, first and second external conductors, a compression mechanism, an outer housing and an electrical cord.

Abstract: An electrosurgical instrument, which is used to treat tissue in the presence of an electrically-conductive fluid, comprises an instrument shaft and an electrode assembly at one end of the shaft. The electrode assembly comprises a tissue treatment electrode (11) and a return electrode (12) which is electrically insulated from the tissue treatment electrode by means of an insulation member (15). The tissue treatment electrode (11) is exposed at the extreme distal end of the instrument, and the return electrode (12) has a fluid contact surface spaced from the exposed end of the tissue treatment electrode by the insulation member (15). The instrument further comprises feed means (17) for feeding electrically-conductive fluid to the region of the exposed end of the tissue treatment electrode (11) in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment and the return electrode (12).

Abstract: A drainage tube introducer for an endoscope includes an electrically conductive exposed portion provided on the outer surface of a part at the distal end of a drainage tube guide wire that is stabbed into the inner wall of a body cavity. An electric current conducting device is disposed in a sheath of the drainage tube guide wire to supply an electric current for cauterization to the electrically conductive exposed portion from the proximal end of the sheath.

Abstract: A device for coagulating, vaporizing, resecting, and removing prostate and bladder tissue. The resectoscope uses the standard diathermy electrical units available at hospitals. The resectoscope uses a rotating cutting/coagulation element to cut, coagulate and vaporize tissue at a much higher speed compared to the linear motion of currently available resectoscopes, allowing the operator to perform these procedures more efficiently, and also allowing the operator to retrieve most of the excised tissue for histological examinations.

Abstract: Disclosed is a high-frequency electrode havingan insulated lead extending in the direction of the longitudinal axis of a monopolar operating high-frequency instrument, andan electrode component, which is connected to the lead in an electrically conducting manner and with which the to be treated tissue is brought to engage, and which comprises two stirrups and a central section,characterized by the fact that said central section is designed like a plate having a longitudinal extension, i.e. an extension in the direction of the longitudinal axis of the instrument respectively the lead from 2 to 6 mm and that the stirrups are made of wire material having an essentially smaller longitudinal extension.

Abstract: A surgical device including a relatively short shaft, a bendable spline assembly associated with the distal end of the shaft and having a predetermined configuration, the spline assembly being adapted to collapse in response to an application of an external force and to expand to the predetermined configuration in response to a withdrawal of the external force, and an operative element associated with the bendable spline assembly.

Abstract: A cutting loop (212) for an electrocautery probe (210). The cutting loop (212) includes a conductor member having a cutting portion (214) with a proximal edge (214a) and a distal edge (214b), the proximal edge (214a) being adapted for creating an incision, i.e., resecting human tissue as the cutting loop (212) is traversed in a cutting direction approximately perpendicular to the proximal edge (212a). During the resection procedure, the cutting portion defines a cutting plane that is generally parallel to the surface of the tissue being resected. The proximal edge (214a) of the cutting portion (214) is characterized as flat or blunt, and is oriented to be substantially perpendicular to both the cutting direction and the cutting plane. The flat or blunt shape of the proximal edge (214a) enhances the current distribution characteristics of the cutting loop (212).

Abstract: Apparatus and methods for stimulating revascularization and tissue growth are provided using an apparatus having a directable end region carrying a tissue piercing end effector. The apparatus optionally includes electrodes for depositing RF energy to form a controlled degree of scar tissue formation, means for delivering a controlled amount of a bioactive agent at the treatment site, or both.

Abstract: A multiple-lumen sheath which fits over a resectoscope and provides an electrosurgical resection energy (radio frequency) return path and at least one irrigant channel, comprising, a sheath body which fits over the resectoscope; a conductor disposed within the sheath body for carrying the electrosurgical resection energy; and an irrigant channel within the sheath body and outside of the conductor, for both carrying irrigant fluid and cooling the conductor.

Abstract: Systems and methods are provided for resecting and/or ablating tissue within the urethra, prostate and bladder, such as transurethral resection of the prostate (TURP). A resectoscope includes an active loop electrode and a return electrode oversheath for applying high frequency electrical energy therebetween. Electrically conductive fluid, e.g., isotonic saline, is delivered to the target site to generate a current flow path between the active and return electrodes, and it allows for a new mechanism for ablation or molecular dissociation of tissue. The isotonic saline also eliminates the complications associated with the use of hypotonic (low salt) irrigating solutions.

Abstract: Open surgery and endoscopic versions of an electrosurgical cutting instrument incorporating a unique cutting arrangement for opening and closing the cutting edge parallel to an anvil surface resulting in a simultaneous cutting of a linear section of tissue, large vessels, or a group of vessels. Simultaneous with the cutting, the instrument further being capable of either a monopolar or bipolar cauterization of tissue. Also disclosed herein, are methods for use of the various electrosurgical cutting instruments.

Abstract: A laparoscopic bipolar electrosurgical instrument can apply a large closure force between its jaws without damaging the small yoke assembly.

Abstract: An improved electrosurgical instrument is disclosed and claims which includes a reusable electrode shaft, a disposable tip and a novel, insulated coupling for removably connecting the disposable tip to the electrode shaft. The present invention provides several advantages and features. The coupling provides ease in connecting the disposable tip to the reusable electrode shaft in an operating room environment. Once the tip is connected to the shaft, the coupling ensures a rigid and secure connection between the tip and the shaft, such that the coupled tip/shaft assembly feels to the surgeon like a single, unitary instrument. In addition, the coupling ensures a good electrical connection between the tip and the shaft, prevents the tip from inadvertently or accidentally becoming separated from the reusable electrode shaft, and maintains the position of the tip relative to the shaft by preventing the tip from rotating relative to the holder.

Abstract: A bipolar endoscopic scissors is provided with scissor blades where at least one scissor blade is coated with an electrically non-conductive ceramic from its cutting edge along at least a contiguous portion of its shearing surface. The coated blade is provided with a cutting edge having an obtuse included angle which is preferably between approximately 95.degree.-140.degree., and more preferably between 110.degree. and 120.degree.. The blades according to the invention may be configured in several different ways with regard to the number of layers and types of material used, the extent of the ceramic coating, and whether one or both blades are configured in an identical manner. The blades according to the invention having cutting edges defined by obtuse angles cut well and provide a good cutting feel to the practitioner while preventing the ceramic coating from chipping at the cutting edge.

Abstract: Devices, systems, and method for treating urinary incontinence generally rely on energy delivered to a patient's own pelvic support tissue to selectively contract or shrink at least a portion of that pelvic support tissue so as to reposition the bladder. The energy will preferably be applied to the endopelvic fascia and/or an arcus tendineus fascia pelvis. The invention provides a variety of devices and methods for applying gentle resistive heating of these and other tissues to cause them to contract without imposing significant injury on the surrounding tissue structures. Alternatively, heat-applying probes are configured to heat tissue structures which comprise or support a patient's urethra. By applying sufficient energy over a predetermined time, the tissue can be raised to a temperature which results in contraction without significant necrosis or other tissue damage.

Abstract: The invention provides exemplary electrosurgical probes and methods for their use. In one exemplary embodiment, an electrosurgical probe comprises a probe body having a proximal end, a distal end and at least one lumen. An electrode assembly is operably coupled to the distal end. The electrode assembly includes an electrode and a jacket disposed to cover at least a portion of the electrode. The jacket and the electrode have a combined mass sufficient to dissipate heat during operation of the electrode so that the electrode does not experience material degradation. Further, the jacket provides insulation between the electrode and a conductive medium such that the electrode is operable in the conductive medium.

Abstract: An electric cautery used with an endoscope includes a hood mounted to a distal end of an insertion part of the endoscope. An electrode is provided to an inner surface and/or an end surface of the hood. A cable is provided to supply electricity to the electrode. The cable extends in the channel of the insertion part of the endoscope.

Abstract: An electrosurgical instrument includes an electrode assembly having an electrode mechanically interlocked with a non-conductive body to as to form a gap therebetween. In one embodiment, complimentary surface features of the respective electrode and the non-conductive body interlock the components of the electrode assembly. In another embodiment, the electrode assembly includes a generally spherical electrode that is rotatable with respect to a non-conductive hood. A gap is formed between an outer surface of the electrode and an inner surface of the hood.

Abstract: An electrosurgical instrument having an active electrode with a portion that is coated with an insulative material. An exposed portion of the electrode is effective to treat tissue while the insulative coating minimizes energy dissipation into surrounding isotonic solution.

Abstract: A flat section is provided at a distal end of a snare pipe located in a sheath. When a snare is pushed, the snare is moved in the snare pipe with a looped expansible section of the snare kept in contact with both opposite sides of the flat section. As a result, the expansion direction of the looped section is regulated.

Abstract: An electrosurgical probe (10) comprises a shaft (13) having an electrode array (58) at its distal end and a connector (19) at its proximal end for coupling the electrode array to a high frequency power supply (28). The shaft includes a return electrode (56) recessed from its distal end and enclosed within an insulating jacket (18). The return electrode defines an inner passage (83) electrically connected to both the return electrode and the electrode array for passage of an electrically conducting liquid (50). By applying high frequency voltage to the electrode array and the return electrode, the electrically conducting liquid generates a current flow path between the return electrode and the electrode array so that target tissue may be cut or ablated. The probe is particularly useful in dry environments, such as the mouth or abdominal cavity, because the electrically conducting liquid provides the necessary return current path between the active and return electrodes.

Abstract: The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. In one aspect, a method is provided for reducing the volume of enlarge swollen tissue in the patient's nose, such as swollen nasal tissue, mucus membranes, turbinates, polyps, neoplasms, cartilage (e.g., the nasal septum) or the like. In particular, the turbinates are treated by positioning one or more electrode terminal(s) adjacent to the turbinates, and delivering electrically conductive fluid, such as isotonic saline, to the nasal cavity to substantially surround the electrode terminal(s) with the fluid.

Abstract: A high-frequency treatment device for an endoscope has an elongated piercing portion. A sleeve-like first electrode is disposed at a distal end portion of this piercing portion. A bar-like second electrode is coaxially disposed within the first electrode. A sleeve-like insulative layer is interposed between the first electrode and the second electrode.

Abstract: An endoscopic surgical device has a tubular shaft and an instrument carrier inside and moveable relative to the tubular shaft. A switch mechanism with which the device may be selectively switched into different operational states is coupled to movement of the instrument carrier.

Abstract: The present invention provides a tissue resection device comprising a handle housing having a fluid infusion lumen. A shaft is reciprocatably mounted to the housing, the shaft having an aperture adjacent to a distal end and a fluid and tissue aspiration lumen extending from the aperture to a proximal end of the shaft. A cutting member is disposed adjacent to the aperture to sever tissue as the shaft is reciprocated, and an imaging mechanism on the housing is oriented toward the cutting member, thereby allowing the attending surgeon to optically direct the removal of body cavity tissue. A chopping mechanism is disposed within the lumen of the shaft to reduce the size of tissues passing through the lumen.

Abstract: A shaped conductive core electrode member having an elongated curved sharp leading cutting edge forming part thereof for use with a resectoscope is shown. The electrode includes an electrode lead member having an elongated conductor member having a first end and a second end with an insulative cover extended therebetween. The first end has a protruding electrode adapted to be electrically connected to an electrosurgical generator. The second end terminates in an electrode support member which is operatively connected to or forms an integral part of the shaped electrode as an active member. The electrode support member has an elongated semi-rigid bifurcated arm terminating in a conductive core. The bifurcated arm is covered with an insulative material except at the distal end where the shaped electrode is located.

Abstract: An electrosurgical instrument for sequentially cutting and coagulating tissue, including methodology for electrosurgical procedures incorporating principles of the inventive instrument. The instrument comprises a cutting electrode connectable to a first power source having a first power signal sufficient to cut tissue, and a coagulating electrode connectable to a second power source having a second power signal sufficient to coagulate tissue. The electrodes may be separated by an electrical insulator to maintain the electrodes in a spaced relationship such that the coagulating electrode can immediately follow the cutting electrode during movement of the instrument, thereby providing sequential yet substantially simultaneous cutting and coagulating of tissue. Methodology for performing an electrosurgical procedure in tissue includes providing the above described instrument with power delivery to the electrodes.

Abstract: An RF activated catheter apparatus for performing transmyocardial revascularization. The catheter apparatus including an elongate catheter shaft having proximal and distal ends, the distal end including an RF emitter which is coupled to an RF generator for cutting channels into the myocardium of a patient's heart.

Abstract: An electrosurgical instrument, which is used to treat tissue in the presence of an electrically-conductive fluid, comprises an instrument shaft and an electrode assembly at one end of the shaft. The electrode assembly comprises a tissue treatment electrode and a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member. The tissue treatment electrode is exposed at the extreme distal end of the instrument, and the return electrode has a fluid contact surface spaced from the exposed end of the tissue treatment electrode by the insulation member. The instrument further comprises feed means for feeding electrically-conductive fluid to the region of the exposed end of the tissue treatment electrode in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment and the return electrode.

Abstract: The knife has the flexible, electrically insulating casing (24) inserted into a body cavity via an endoscope. A wire within this casing receives the HF current from a HF source and can be displaced to project relative to a suction opening (38) at the distal end of the casing to define the cutting zone (42).The operating device at the proximal end of the casing has a suction mouthpiece coupling to the suction opening (38). The casing is strengthened via an inserted support ring (56) between the suction opening (38) and the cutting zone (42) and/or via an internal strengthening wire (50).ADVANTAGE--Prevents blockage of suction path during bending. (20 pp Dwg.No.

Abstract: An ultrasound probe of the type having, successively from its head to tail end, an ultrasound scanner head assembly accommodating an ultrasound transducer element rotatably within an end cap, an elongated flexible cord having a flexible transmission shaft of tightly wound metal wire coils within an outer sheathing tube, and a tail end connector.

Abstract: An electrosurgical instrument, which is used for the treatment of tissue in the presence of an electrically-conductive fluid medium, comprises an instrument shaft, and an electrode assembly at one end of the shaft. The electrode assembly comprises a tissue treatment electrode and a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member. The tissue treatment electrode is exposed at the distal end portion of the instrument, and the return electrode has a fluid contact surface spaced proximally from the exposed end of the tissue treatment electrode by the insulation member. The exposed end of the tissue treatment electrode is constituted by a plurality of tissue treatment filamentary members made of an electrically-conductive material, the filamentary members being electrically connected to a common electrical supply conductor.

Abstract: A visually-positioned electrical monitoring apparatus includes an electrical assembly comprising an elongate, flaccid dielectric body having at least one electrical contact, a passage and an open distal end. An endoscope extends through the passage and has its distal end substantially in registry with the distal end of the body. A method for placing an electrical monitoring assembly to coact with human tissue at a target site includes providing the aforedescribed monitoring assembly, extending an endoscope into the passage, aligning the distal end of the endoscope with the distal end of the body and visually guiding the assembly to the site.

Abstract: An ultrasound transmission medium feed device particularly for an endoscopically inserting ultrasound probe adapted to be introduced into a body cavity through and under the guidance of one of biopsy channels provided on an endoscope.

Abstract: A device and method for treating patent ductus arteriosus in a human. A catheter having a collapsible/expandable heating element at a distal end for entering an infant transcutaneously and being advanced to the ductus arteriosus. A method of heating the inner surface of the ductus arteriosus with the heating element to a temperature sufficient to produce a material change in the collagen of the ductus arteriosus such that the ductus arteriosus passage shrinks to closure.

Abstract: The invention is related to an instrument for endoscopic surgery. The instrument comprises a casing 10, further comprises a sliding tube 16 which extends into the casing with its proximal end 20 and which is disposed longitudinally slidable with respect to the casing by means of an actuating mechanism 38, further comprises an electrode tube 18 which extends through the sliding tube 16, which extends into the casing with its proximal end and is axially lockable therein, and further comprises two isolated wire pieces 32 which extend through the inside of the electrode tube 18.

Abstract: An ablative catheter assembly whose electrode is completely covered by a buffer layer. The buffer layer prevents areas of high current density at the surface of the catheter tip, which helps to reduce popping and clotting. The buffer layer may be in the form of a conductive fluid (such as saline solution) pumped into a cavity surrounding the electrode. In this case, the conductive fluid couples the electrode to the surrounding tissue so that RF energy will pass from the electrode to the tissue, thereby effecting ablation. Also, the buffer layer may be in the form of a porous coating which covers an electrode tip. In this case, blood or fluid which infuses the porous coating couples the electrode tip to the surrounding tissues to be ablated.

Abstract: An electrosurgical instrument is provided for cauterization and/or welding of tissue of varying impedance, thickness and vascularity especially in the performance of endoscopic procedures. The instrument compresses the tissue between one pole of a bipolar energy source located on one interfacing surface, and a second interfacing surface applying pressure in a predetermined range. A second pole is located one of the two interfacing surfaces. In a preferred embodiment, the second pole is located on the same interfacing surface as the first pole and an insulator electrically isolates the two poles. A preferred application of the invention is in a cutting instrument wherein a hemostatic line is formed along a cut line using RF energy.