Abstract: A robotic system that moves a surgical instrument in response to the actuation of a foot pedal that can be operated by the foot of a surgeon. The robotic system has an end effector that is adapted to hold a surgical instrument such as an endoscope. The end effector is coupled to a robotic arm assembly which can move the endoscope relative to the patient. The system includes a computer which controls the movement of the robotic arm in response to input signals received from the foot pedal.

Abstract: An endoscopic surgical instrument having a handle assembly, a body portion, and a tool mechanism in which a pivoting handle pivots about a stationary handle to open and close the tool mechanism. The instrument includes a rotatable body portion, in which a rotation knob is provided on the instrument at the stationary handle so that the user may rotate the body portion, and consequently the tool mechanism, using a single hand. Furthermore, an electrocautery connection is provided which is positioned out of the line of sight of the surgeon, so that the surgeon may have an unobstructed view to the surgical site. The pivoting handle is provided with a rotatable connection point for connecting the slidable rod member to essentially eliminate radial deflection of the rod within the outer tube during opening and closing of the handles. The tool mechanism may include grasping jaws having rounded, interdigitating teeth for grasping and securely holding tissue or organs for removal through a cannula.

Abstract: An apparatus for closing and sealing a vascular puncture is connected to an energy supply such that heat is generated in, or thermally conducted to, the tissue, thereby thermally fusing the vascular tissue together. The method for closing and sealing a vascular puncture comprises applying radio frequency or other energy to the tissue, the energy being sufficient to thermally fuse the tissue together, thus sealing the puncture. Embodiments of depth finding and guiding devices, as well as blood vessel occluders, are also disclosed.

Abstract: A laparoscopic surgical instrument which may be in the form of forceps or a cutter has, at the end of a hollow tube for introduction through the body cavity wall, a housing, a pair of pivotally mounted metallic jaws, a reciprocable control rod in the tube, and an actuator secured to the control rod. The actuator has a pair of guide grooves which are oppositely inclined with respect to a longitudinal axis of the instrument, and each jaw has a lug which fits in a respective groove, the lugs being spaced from the jaw pivots so that reciprocation of the control rod causes opening and closing of the jaws. The housing and the actuator are electrically insulating and the jaw pivots are spaced apart to achieve electrical isolation of one jaw from the other, for applying a radio frequency voltage across the jaws for bipolar electrosurgery.

Abstract: A device is provided for use with a medical instrument including a tip which is designed to penetrate the wall of an internal cavity (e.g., the abdomen) of a patient, for detecting when that tip penetrates through the wall. The device includes a source of a medium frequency detection signal and circuitry for coupling the signal to the tip of the medical instrument. The circuitry includes a transformer forming a high Q resonant circuit having an initial value of Q when the medical instrument is not in use. A return path for the signal provides that, in use of the instrument, a circuit is completed through the resonant circuit such that when the tip contacts patient tissue the initial Q of the resonant circuit changes and when the tip penetrates through the patient tissue of the Q of the circuit is restored to the initial value thereon.

Abstract: An irrigation arrangement is provided for electrically powered endoscopic probes that supplies the surgeon with suction or irrigation on demand. The irrigation arrangement is described for use with endoscopic probes employing thermal auto-regulating and bipolar electrosurgical probe tip configurations. An extendable shroud is also provided for selectively covering tip of the endoscopic probe while positioning or manipulating the endoscopic probe at the surgical site.

Abstract: A self-guiding electrode and cutting tip for use in electrical tissue resection. Self-guiding forces are those applied substantially perpendicular to the longitudinal axis of an electrode, or rotationally about the longitudinal axis. Forces sufficient to compensate in part for errors in cutting tip placement are produced by tissue pressure acting on tissue skids and keels. Tissue skids are intended to slide along tissue surfaces, maintaining structures to which they are coupled at a substantially fixed spacing from the surface. Tissue keels are intended to slide between tissue planes, whether they are naturally occurring or a result of a surgical incision. Lateral deviations from a straight incision made in a plane substantially perpendicular to a tissue surface tend to be resisted by forces on a tissue keel affixed in a leading or following relationship with respect to a cutting loop.

Abstract: A bipolar electrosurgical instrument for use in laparoscopic surgery or other minimally invasive internal surgical procedures is disclosed. In one embodiment, a bipolar electrosurgical apparatus (10) is provided which is suitable for laparoscopic applications. The apparatus (10) comprises an active electrode (18) and a current return electrode shoe (34). A spring (44) or other resilient member urges the shoe (34) into tissue contact when the active electrode (18) is positioned for surgery. In another embodiment, an axially retractable active electrode (90) is used to grip tissue and draw the tissue back to a passive electrode (92) The apparatus of the present invention is capable of functioning in cutting, coagulation and desiccation modes.

Abstract: An endoscopic bipolar cautery biopsy forceps device has a conduit, a pair of articulable opposed jaws, two conductive pull wires, and an actuator. The articulable opposed jaws are located at the distal end of the conduit. Each jaw is provided with a cutting surface at its distal end and a tang at its proximal end. At least a portion of the cutting surface is electrically conductive and a portion of the tang is electrically conductive and electrically coupled to the conductive cutting surface. The remainder of the jaw is preferably non-conductive or is coated with an insulator. The conductive pull wire is coupled to the conductive portion of the tang of each jaw and is insulated as it extends through the conduit to a handle portion which includes the actuator. The actuator is coupled to the proximal ends of the pull wires so that movement of the actuator pulls the pull wires and articulates the jaws.

Abstract: An instrument for use in surgery is provided. The instrument has a heating element with a working surface for providing hemostasis at an auto-regulated temperature. The working surface may include a tapered edge for providing thermally-enhanced cutting and a non-stick coating for operating the instrument at low auto-regulation temperatures. A process for making the instrument is also provided. Additionally, a method of performing surgery on a patient's tissue is also provided.

Abstract: An instrument for use in endoscopic surgery is provided. The instrument has a reusable shaft to which a disposable working tip can be removably attached. The disposable working tip has a working surface for providing hemostasis at an auto-regulated temperature. The working surface may include a tapered edge for providing thermally-enhanced cutting and a non-stick coating for operating the instrument at low auto-regulation temperatures. The instrument is capable of being used for a wide variety of endoscopic surgical procedures.

Abstract: An endoscopic surgical instrument having a handle assembly, a body portion, and a tool mechanism in which a pivoting handle pivots about a stationary handle to open and close the tool mechanism. The instrument includes a rotatable body portion, in which a rotation knob is provided on the instrument at the stationary handle so that the user may rotate the body portion, and consequently the tool mechanism, using a single hand. Furthermore, an electrocautery connection is provided which is positioned out of the line of sight of the surgeon, so that the surgeon may have an unobstructed view to the surgical site. The pivoting handle is provided with a rotatable connection point for connecting the slidable rod member to essentially eliminate radial deflection of the rod within the outer tube during opening and closing of the handles. The instrument also includes crescent-shaped blades which are curved in a plane defined by the pivot axis of the blades and the longitudinal axis of the instrument.

Abstract: The invention relates to an ablation catheter which controls the temperature and reduces the coagulation of biological fluids on a tip of a catheter, prevents the impedance rise of tissue in contact with the catheter tip, and maximizes the potential energy transfer to the tissue, thereby allowing an increase in the lesion size produced by the ablation. The ablation catheter includes a catheter body. The ablation catheter also includes a tip for monitoring electrical potentials, and applying electrical energy to a biological tissue. A fluid source is positioned at one end of the catheter for supplying a fluid flow through the catheter to the tip means. Passages are positioned within the tip in a variety of manners for directing the fluid flow through the tip means to the exterior surface of the tip to control the temperature and form a protective fluid layer around the tip. Monitoring structure is also positioned within the tip structure for measurement of the electrical potentials in a biological tissue.

Abstract: The wire loop of a surgical snare is constructed so as to include a weakened or frangible region. When it is desired to open the loop so as to move it from its entrapped position on a polyp, an additional force is exerted on the loop to draw it further into the sheath. This causes the frangible region to break, thereby opening the loop and permitting the wire to slide free of the polyp. In accordance with an alternate embodiment, the wire loop is constructed so as to fold back on itself, with the folded back end being captured by a retaining element inside the sheath. When the loop becomes entrapped on a polyp, it is extended out of the sheath somewhat further than during normal use, at which point the captured end of the loop is released, opening the loop and permitting its removal from within the patient.

Abstract: An electrosurgical probe comprises an elongate probe body having a surgical hook at a distal end thereof. A paddle element is reciprocatably mounted within the distal tip of the elongate body so that it can be shifted between an extended position where it covers the hook tip and a retracted position where it leaves the hook tip exposed. The paddle thus can cooperate with the hook in tissue dissection, clean the hook, as well as provide an alternate electrosurgical probe tip for use in electrosurgical procedures.

Abstract: A dismantlable medical instrument has a central working rod (11) with worg tools (25), a guide tube (12) and an outer tube (13). The working rod (11), the guide tube (12) and the outer tube (13) are releasably attached to a handle (14).

Abstract: A multifunctional minimally invasive surgical instrument. The instrument includes a tool set on the opposite end of a support tube from a handle assembly. Grasping, manipulating, retracting, cutting, cauterizing, irrigation, suction, and electrosurgery functions can be performed by actuating the handle assembly. The tool set can also be rotated and articulated with respect to the handle assembly.

Abstract: The method comprises inserting an interuterine sheath through a guide tube into the uterus of a patient, and then inserting the shaft of the resectoscope to a predetermined depth within the uterus. A medical procedure is performed with the resectoscope, such as scraping the interuterine walls. An irrigation liquid is charged into the uterus and then collected from the uterus, while being monitored in order to provide an indication of perforation of the interuterine wall. The method is completed by removing the resectoscope, interuterine sheath and guide tube from the patent.

Abstract: Disclosed is an endoscope for use in the removal of tumours from hollow body organs such as the bladder. The endoscope consists of sheath (49) through which extends a telescope (46) and a suction diathermy tube (2, 31, 60) the non-operation end (3, 33) of which communicates with a suction device. Provision (51, 52) is made for an irrigation fluid to be passed through the endoscope. The diathermy tube (2, 31 60) may be a flexible plastics tube (2, 61) and the diathermy electrode tip (7, 8) may be formed from electrically conducting resistance wire connected (5, 39, 63) to a diathermy machine. The electrode tip is found adjacent an aperture (4, 9, 41) at the operative of the tube whereby tissue can be immediately removed by suction after severance by the electrode tip. The degree of suction applied to the tube (2, 31 61) being controlled by a finger hole (38a55, 66) located at or near the end (3, 33) of the tube (2, 31, 61).

Abstract: The invention relates to a bipolar radio-frequency surgical instrument with a rigid tube shaft (11) and a working tip (12) which preferably has substantially the same cross-section as the adjoining part of the tube shaft (11) and is preferably centrally provided with at least one working electrode, such as a cutting electrode (13, 13") or a coagulating electrode (13') which can be energized with a radio-frequency voltage, and a neutral electrode (14) which preferably has a significantly larger surface. The working tip (12) is connected with the rigid tube shaft (11) near the distal end of the instrument in a hinged or flexible manner in such a way that the working tip (12) can be pivoted from a position which is axially aligned with the tube shaft (11) to a position which forms an angle relative to the tube shaft (11), and such that means (17, 18, 19) are provided to pivot and return the working tip (12).

Abstract: Remote control actuators for endoscopic tools are provided. Each remote control actuator includes a driver, a coupler which couple the endoscopic tool to the driver, a power source which power the driver, and a controller coupled to the power source and/or the driver for controlling the power applied to the driver. In conjunction with the controller, a user interface is preferably provided for user control of the remote control actuator which actuates the endoscopic tool. In addition, a sensing/feedback mechanism is preferably provided between the driver and the endoscopic tool and is coupled to the controller and/or the power source. The sensing/feedback mechanism senses the amount of tension or compression on the pull wire(s) of the endoscopic tool and provides a related signal to the controller so that the force applied to the endoscopic tool may be regulated. Various types of power sources are disclosed including electric, mechanical, hydraulic, and pneumatic.

Abstract: A resectoscope has a shaft and a lock body which is slidable along the shaft and to which the proximal end portion of a resection electrode can be fixed. A handle is provided for displacing the lock body and thus the electrode along the shaft. The handle consists of a first portion connected to the lock body and projecting radially outwardly of the lock body and a second portion connected to the shaft, for engagement by a thumb of the user of the resectoscope. The first portion of the handle is formed as a disc provided with gripping aids for the user's fingers.

Abstract: The present invention relates to an improved resectoscope which enhances versatile and ergonomic operating and handling performance thereof. The resectoscope includes a plurality of thumb engageable portion's a central block assembly used to displace an electrode from a sheath of the resectoscope. Also disclosed is a drip guard assembly which coacts with the outer sheath and is releasably retained in any one of a plurality of positions on the outer sheath so as to accommodate different operations and patients. Additionally, provision is made for improved electrode guiding and stabilizing structures which enhance stability of the electrode assembly by facilitating easy and correct insertion of the electrode without requiring disassembly of resectoscope components.

Abstract: A bipolar coagulation device suitable for use in endoscopic surgery is disclosed which reduces the adhesion of tissue to the electrodes and enables the user to clean the electrodes during the procedure without removal from the body. Bipolar electrocautery forceps are located at the distal end of a sheath suitable for use in endoscopic surgery. The tips of the forceps are manipulated using controls located at the control end of the sheath which remains outside the patient's body. The tips of the forceps are made of material having phosphorous in combination with metals of high thermal conductivity, which reduces the adhesion of tissue during cauterization. In addition, the device has a cleaner which acts to free the forceps of any adhering debris. This cleaning can be done inside the patient's body, without the need for any additional instrumentation. In a preferred embodiment, the tips of the bipolar coagulation device can also be pivoted to an angularly disposed position.

Abstract: A procedure for endoscopically removing a polyp utilizes an elongate tubular member having a cup-shaped web member at a distal end portion and an electrically conductive cauterization loop inserted through the tubular member. Upon insertion of an endoscope assembly into a patient, the distal end portion of the tubular member and the cauterization loop are ejected from the distal end of the biopsy channel of the endoscope assembly. Upon a subsequent opening of the cauterization loop, the cauterization loop is placed over a polyp to be removed, the web member is then opened and suction is applied through the tubular member to entrain the polyp to the web member. Electrical current is conducted to the cauterization loop to sever the polyp from the patient, and the loop is closed. The severed polyp is held in the web member by suction and is subsequently removed from the patient.

Abstract: An apparatus for electrosurgical incision of a stricture within or adjacent to a body lumen, which comprises an electrically conducting, deflectable wire associated with an introducer for introducing the apparatus into the body lumen, wherein a proximal portion of the wire is deflectable outwardly relative to the introducer, and a source of RF electric current connected to the wire whereby RF electric current may be transmitted through the wire when it is in the deflected position.

Abstract: An electrosurgical instrument is provided for cauterization and/or welding of tissue of varying impedances, thicknesses 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. 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.

Abstract: A high-frequency treating instrument comprises an insertion tube having electric conductivity, an electrically insulating, tubular member fitted over an outer periphery of the insertion tube with a distal open end of the tubular member projected ahead of a distal end of the insertion tube, a current supply section for supplying a high-frequency current which is fed from a power source to the insertion tube, an electrode section fixedly provided on the distal end of the insertion tube to carry the high-frequency current there, the electrode section being projected out of the distal open end of the tubular member to allow the high-frequency current which is fed from the power source to be received through the insertion tube, and a treating section provided on the distal end of the electrode section projected out of the distal open end of the tubular member and allowing the high-frequency current to be carried therethrough so that an affected living tissue of a human subject can be treated through heat resulting

Abstract: A non-metallic end effector for use in an endoscopic surgical tool includes a metallic core for strength and for providing a selected electrode surface on the end effector. Selectively conductive end effectors are manufactured by insert molding a plastic or ceramic or other non-conductive body around a metallic or otherwise conductive core. The conductive core is exposed on a selected portion of the working surface of the end effector and extends through the non-conductive body of the end effector for coupling to an electrical source. Selectively conductive end effectors of this type can also be manufactured by coating a cast end effector member with a non-conductive polymer or by metallically plating a non-conductive ceramic end effector member. By extending the conductive core of a selectively conductive end effector member to the pivot hole of the member, electrical coupling can be made through the clevis and tube of an endoscopic instrument.

Abstract: A shielded energy transmitting surgical instrument for treating anatomical tissue with energy includes an energy transmitting member having a distal end for contacting tissue to be treated, a shield for shielding the distal end of the energy transmitting member and a hub mounting the energy transmitting member and the shield. The shield is movable, automatically in response to a force from tissue contact or manually, between an extended position protecting the distal end of the energy transmitting member and a retracted position wherein the distal end of the energy transmitting member is exposed for contact with the tissue. A source of energy supplies energy to the distal end of the energy transmitting member to treat the tissue, and the shield is movable thereafter toward the extended position to remove tissue from and protect the distal end of the energy transmitting member.

Abstract: The invention provides an actuator handle useful in connection with a variety of surgical instruments, in particular, least invasive surgical instruments having an elongate shaft and an axial passage in the shaft in which a linkage is slidably disposed. In a preferred embodiment, the actuator handle comprises a tubular housing axially aligned with the shaft having an axially-aligned elongate opening on a lateral side thereof. A lever is disposed in the elongate opening and is pivotally coupled to the housing at a first end and coupled to the linkage of the surgical instrument at a second end. The second end of the lever is coupled to the linkage wherein the linkage is translated axially by pivoting the lever relative to the housing. The actuator handle further includes a locking lever to lock the lever in an inward position, as well as a pigtail connector for connecting the linkage to an electrosurgical generator.

Abstract: An instrument capable of selectively cutting or cauterizing tissue includes a handle and an elongated electrically conductive probe with a longitudinally extending lumen communicating with the handle. The distal end of the probe has an aperture formed therethrough between the lumen and the exterior of the probe. An elongated drive shaft is disposed within the lumen for rotation about the longitudinal axis of the drive shaft. A cutting tool is positioned on the shaft opposite the aperture. An electrically insulative layer is disposed on the exterior of the probe extending from the proximal end of the probe to the periphery of a preselected region on the distal end of the probe. The preselected region is selectively couplable to a power source to permit cauterization. An alternate embodiment employs an electrically insulative probe and an embedded electrically conductive pathway coupled to the preselected region.

Abstract: A laparoscopic surgical cutting tool has a handle attached to a hollow tube. A tube end segment is pivotally attached to the tube. A linkage connects the handle to the end segment to allow the surgeon to adjust the angle between the end segment and tube, using the handle. A step projects upwardly at an angle at the distal end of the end segment. A lip attached to the end segment extends in a plane generally parallel to the axis of the end segment. Electrifiable cutting wires extend from an upper inside surface of the end segment to the lip.

Abstract: A probe for use with an endoscopic suction-irrigation instrument is disclosed which permits a second probe to be inserted therethrough. The suction-irrigation instrument has a cannula, a fluid chamber having at least one port for irrigation and suction and a proximal opening, and a first seal in the proximal end of the fluid chamber. The fluid chamber has a distal end communicating with the cannula. The probe has a proximal handle portion, a middle portion, and a hollow distal portion. The handle portion has an axial passageway and a second seal therein. The middle portion extends from the handle portion through the first seal at the end of the fluid chamber and through the fluid chamber. The middle portion has an outer diameter shaped to contact the first seal such that the proximal end of the fluid chamber is sealed. The middle portion is also shaped to be smaller than the inner diameter of the fluid chamber, and the middle portion is provided with a second axial internal passageway extending therethrough.

Abstract: An endoscopic instrument is described having a fluid chamber, a cannula, a shell, a first locking mechanism, and a probe with a second locking mechanism. The fluid chamber has proximal and distal ends. The hollow cannula is coupled to the distal end of the fluid chamber. The port is located at the proximal end of the fluid chamber. The shell houses the fluid chamber, the port, and the first locking mechanism. The probe extends through the port, through the fluid chamber, and through the hollow cannula. In a first fully inserted position, the distal end of the probe extends past the distal end of the cannula. When the probe is partially withdrawn from the shell, the first locking means releasingly engages the second locking means on the probe. Different spring loaded mechanism are described, including one mechanism which is overcome by pulling on the handle of the probe, and another mechanism which requires an active release mechanism.

Abstract: This invention relates to a surgical apparatus having four general embodiments: (1) the use of an ultrasonic vibrator and a radio frequency generator to simultaneously cut and cauterize tissue, (2) the use of an ultrasonic vibrator to cut tissue coupled with the independent use of a radio frequency generator to cut tissue, (3) the exclusive use of a radio frequency generator to cut and cauterize tissue, and (4) the use of a laser to fulgerate tissue. An aspiration system is preferably combined with these embodiments to facilitate surgery and biopsy.

Abstract: Endoscopic surgical instruments are provided that have bipolar electrodes on opposing movable members for passing a high frequency current through tissue for simulataneously severing or manipulating the tissue and causing hemostasis of the tissue. An electrically insulating material is interposed between the movable members so that the electrodes are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes through the tissue. Methods of endoscopically achieving hemostasis while simultaneously, manipulating and cutting tissue are also provided. Use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.

Abstract: A cautery probe is described for use with an endoscopic instrument where the endoscopic instrument has an electrical contact located therein. The probe includes an insulated handle which extends out of the instrument, a conductive probe element which is mounted in the insulated handle and extends through the distal end of the endoscopic instrument, and an insulating cover. The conductive probe element has a distal cautery surface, and an electrical contact surface at a location between the proximal end of the conductive probe and the distal cautery surface, with the electrical contact surface contacting the electrical contact in the endoscopic instrument when said cautery probe is inserted in the endoscopic instrument. The insulating cover substantially covers the conductive probe element from the insulated handle up to but not at the electrical contact surface, and substantially covers the probe element from a point beyond the electrical contact surface, up to but not at the distal cautery surface.

Abstract: An electrocautery suction/irrigation endoscopic instrument having an electrocautery safety override is provided. The instrument preferably includes a cannula, an irrigation conduit in fluid communication with the cannula, an irrigation valve for regulating fluid flow in the irrigation conduit, an actuator coupled to the valve, an electrocautery probe coupled to a source of current, and an electrical switch coupled to the source of current and to either the irrigation valve or to the actuator. When the actuator is activated to permit fluid flow through the irrigation conduit, the switch is switched and prevents the flow of cautery current from the current source to the electrocautery probe. Preferably, the switch opens a DC circuit which is used to signal the current source to provide an high voltage AC electrocautery current. Alternatively, the switch may be located in the high voltage AC circuit. Both foot and thumb activated cut/coag switches are disclosed for use with the instrument.

Abstract: A safety shield for use in laparoscopic or like electrosurgical procedures where the shield surrounds the active electrode and extends from a trocar or the like to the field of view of the surgical procedure. The shield is connected to the return lead via a low impedance path which includes monitor circuitry for determining whether the shield current is associated with an abnormal condition.

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 cardiac ablation catheter includes a distal, energy delivering electrode and at least one sensing electrode proximal to the energy delivering electrode. The catheter communicates with an electrosurgical generator which provides electrical energy, such as a radio frequency energy, to the distal electrode. The sensing electrodes communicate with a monitor for recording electrical signals within the heart. One or more resistors is positioned adjacent each sensing electrode, and in series with a conductor associated with the sensing electrode, to reduce or eliminate any current tending to be emitted through the sensing electrodes as a result of delivery of electrical current through the distal electrode.

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: An endoscope for transurethral surgery and has a main body irrotationally supporting an optics and a surgical instrument, further an outer tube affixed to the main body and tubularly enclosing the optics and the surgical instrument, which is characterized in that the outer tube is rotational relative to the remaining endoscope parts.

Abstract: An improved endoscopic instrument suitable for performing internal procedures through a trocar in which the instrument handle is provided with a control mechanism for rotating the instrument thereby enabling a surgeon to manipulate and utilize the instrument with one hand.

Abstract: A handle device for an endoscope incorporates controls for adjusting the degree of curvature of the distal tip portion of the endoscope as well as the degree of extension of the surgical instrument beyond the distal end of the endoscope's working lumen. The handle member comprises a generally hollow body which is dimensioned to be readily grasped by the surgeon and it incorporates a thumb-slide having a ratchet surface thereon, the thumb-slide being joined to a pull-wire extending the length of the endoscope and fastened at its distal end to the body of the endoscope. By depressing and longitudinally sliding the thumb-slide, the curvature of the distal end of the steerable endoscope is controlled. The degree of extension of the working instrument beyond the distal end of the working lumen is controlled by a rotatable threaded rod which is designed to produce only translational motion to the instrument without any twisting thereof.

Abstract: A medical coagulation-cutting instrument has an instrument shaft (11) with wo stationary coagulation electrodes (12, 13) and a movable cutting electrode (14). An actuating head (19) is arranged at the distal end of the instrument shaft (11). The radio frequency feedlines for the two coagulation electrodes (12, 13) are conductive tubes (15, 16) arranged concentric to one another and to the instrument shaft within which the high frequency feedline for the cutting electrode (14) is arranged in an insulated manner as an axially directed conductive bar (17) which is axially movable by the actuating head (19).

Abstract: An electrosurgical probe is provided which reduces the likelihood of arcing from the probe. In addition, the probe provides the ability to place a fiber-optic cable through the probe for providing for laser surgery or for laproscopic examination of the patient. The electrosurgical probe comprises an electrosurgical tip, a cylindrical body attached to the tip, and a base attached to the cylindrical body. The tip may have many different shapes but a spatula shape is generally preferred. The tip has at least one notch in the periphery of the spatula shape for retaining a fiber-optic cable. The cylindrical body is substantially hollow so that suction, irrigation, and laparoscopy may be carried out through the probe. To aid the surgeon in determining dimensions of organs within a patient, the cylindrical body has a plurality of striped regions having a predetermined thickness spaced apart at predetermined intervals on an outer surface of the cylindrical body.

Abstract: An electro-surgical dissecting and cauterization tool comprises a linear, rigid insulating sleeve surrounding means providing an electric conducting path between a proximal, electric plug end and working tip electrode distal end. The plug attaches the tool to a conventional electro-surgical unit which supplies electrical energy to the working tip electrode end of the tool. A rigid arm extends between the sleeve and the working tip electrode and includes portions laterally offset from the main axis of the sleeve to increase visualization of the working tip electrode during surgery.

Abstract: A multi-functional endoscopic probe apparatus to selectively apply either a low or high frequency voltage to cut and cauterize. The apparatus has an elongated multi-lumen tube that is attached to a pistol grip having a multiplicity of functions contained thereon. The multi-lumen tube has a first lumen for the passage of either a high or a low pressure irrigation stream therethrough, a second lumen for suction to remove excess fluid and debris, and a third lumen for the passage of a slidably extendable and retractable electro-surgical cutting tip. The pistol grip handle has a wheel which enables the surgeon to rotate the multi-lumen tube containing the surgical cutting tip relative to the pistol grip. A plurality of push-button valves enable the selective application a negative pressure for withdrawing excess fluids and removing incident tissue debris from the surgical site and to operatively apply a flood irrigation stream or a precise irrigation stream to the surgical site to wash and cleanse the tissue.