Abstract: A device (1) serves for creating perforations, borings or perfusion channels in the heart wall (2), especially in the myocardium, for generating channels running in the heart wall (2) for supplying it with blood. So that the chest cavity need not be opened in an operation for introducing such perforations, the device (1) has a catheter (4) introducible intracardially into the heart (3), which has at least one electrode or pole on its operating end and has a connection of this electrode or pole to a high frequency generator (5). Moreover, this distal operating end has at least one needle (6) insertible into the heart wall (2) from the inside, which needle functions as a coagulation tool, so that the lumen of the channel generated by it remains open and can be supplied with fresh blood from the interior of the heart (3).

Abstract: An improved electrosurgical instrument for use with a specially adapted electrosurgical trocar. The improved electrosurgical instrument including a handle, an end effector and an elongated closure tube connecting the handle to the end effector. The elongated closure tube including one or more electrical contacts adapted to provide electrical contact to the interior of a trocar cannula as the electrosurgical instrument is passed through the cannula. The contacts being electrically connected to the end effector of the electrosurgical instrument such that electrosurgical energy passes through the contacts to the end effector.

Abstract: A method for morselating and removing the morselated tissue through a small incision comprising in general inserting a tissue container into the body cavity of a patient through an incision, placing resected tissue in the vessel, inserting a morselator having a rotatable electrode thereon through the incision and into the vessel, morselating the tissue and removing the tissue from the containment vessel and the body. An apparatus for morselating and removing tissue through a small incision within the body cavity of a patient is also disclosed and may comprise a tissue container having an inner chamber for containing resected tissue, and a morselator having a proximal end and a distal end carrying an electrode wherein the distal end is insertable into the body cavity and containment vessel for morselating resected tissue.

Abstract: A novel, bipolar, electrosurgical instrument is provided with one metal and one ceramic end effector. Current is passed through the metal end effector and through an insulated conduit to the distal tip of the ceramic end effector. A connection at the distal tip of the ceramic end effector allows the current to return along exposed conductive strip which is spaced apart from the metal end effector in cutting action by a gap of approximately 0.020 inches when the ceramic and metal blade supports are brought into contact with tissue, a current flows from the exposed metal strip on the ceramic blade through to the metal blade thereby effecting cauterization, preferably slightly in advance or at the point of cutting between the ceramic and metal blades.

Abstract: In the present invention, a cordless capacitively coupled electrosurgical instrument is adapted to receive electrosurgical energy from a specially designed trocar or trocar adapter. In one embodiment of the present invention, a capacitively coupled electrosurgical instrument includes a handle, an elongated tube and an electrosurgical end effector. The handle may include an actuator such as a trigger which is operatively connected to the end effector through the elongated tube. The elongated tube may be a closure tube which is adapted to close the end effector when the handle actuator is moved. Alternatively, the closure tube may include a mechanism connecting the handle actuator to the end effector, which mechanism acts to close the end effector when the handle actuator is moved. The electrosurgical end effector is adapted to apply electrosurgical energy to biological tissue in order to effect treatment of the tissue.

Abstract: An electrosurgical instrument, such as a scissors, in which the handle and blade members are of a conventional construction. Each blade member supports a detachable cartridge member made of an insulating material and supporting at least one electrode. The cartridge members do not interfere with the cutting engagement of the blade members. Each cartridge member can also permit relative movement between its electrode and associated cutting edge from a first position in which the electrodes are between the cutting edges (when the blades are open) to a second position in which each electrode is behind its respective cutting edge (as the blades are closed).

Abstract: Methods and apparatus are provided for cauterizing predetermined volumes of abnormal biological tissue using a user selectable or adjustable energy applicator including two or more electrodes having electrode parameters configured to cause cauterization of predetermined volumes when operated in a bipolar mode. The energy applicators are employed with a control device that couples the energy applicators to a power source and includes circuitry for interrupting activation of the energy applicator when the current between the two or more electrodes decreases more than a predetermined amount from the current sensed upon initial activation of the energy applicator.

Abstract: A micromachined electrical cauterizer. Microstructures are combined with microelectrodes for highly localized electro cauterization. Using boron etch stops and surface micromachining, microneedles with very smooth surfaces are made. Micromachining also allows for precision placement of electrodes by photolithography with micron sized gaps to allow for concentrated electric fields. A microcauterizer is fabricated by bulk etching silicon to form knife edges, then parallelly placed microelectrodes with gaps as small as 5 .mu.m are patterned and aligned adjacent the knife edges to provide homeostasis while cutting tissue. While most of the microelectrode lines are electrically insulated from the atmosphere by depositing and patterning silicon dioxide on the electric feedthrough portions, a window is opened in the silicon dioxide to expose the parallel microelectrode portion. This helps reduce power loss and assist in focusing the power locally for more efficient and safer procedures.

Abstract: A bipolar electrosurgical instrument comprising a handle, an end effector and an elongated hollow tube. The handle includes first and second grip members. The end effector includes first, second and third electrodes. The first electrode is substantially triangular in shape. The first electrode is adapted to pivot between an open position and a closed position. The first electrode also pivots around its proximal to distal axis and includes a coagulating surface and a cutting edge. The second and third electrodes are arranged substantially parallel to the first electrode when the first electrode is in the closed position. The elongated hollow tube includes a mechanism connecting the handle to the end effector such that movement of the first and second grip members relative to one another causes the first electrode to move relative to the second and third electrodes.

Abstract: An electrosurgical instrument, 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 has an exposed end extending laterally through a cut-out provided in the insulation member at the distal end portion of the instrument. The return electrode has a fluid contact surface which overlies the insulation member in the region of the cut-out. The fluid contact surface is spaced from 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 electrode and the return electrode.

Abstract: An RF treatment apparatus includes a catheter with a catheter lumen. A removable needle electrode is positioned in the catheter lumen in a fixed relationship to the catheter. The needle electrode includes a needle lumen and a needle electrode distal end. A removable introducer is slidably positioned in the needle lumen. The introducer includes an introducer distal end. A first sensor is positioned on a surface of the needle electrode or the insulator. An RF power source is coupled to the needle electrode and a return electrode. An insulator sleeve is slidably positioned around the electrode and includes a second sensor. Resources are associated with the electrodes, sensors as well as the RF power source for maintaining a selected power at the electrode independent of changes in current or voltage.

Abstract: An ablation apparatus has a multiple antenna device with a primary antenna and a secondary antenna positionable in a lumen of the primary antenna. The secondary antenna is at least partially deployable from the primary antenna in a lateral direction relative to a longitudinal axis of the primary antenna with at least one radius of curvature. A distal end of the primary antenna is sufficiently sharp to pierce tissue. The primary and secondary antennas are configured to provide a selectable geometric ablation of a selected tissue mass. An insulation sleeve is positioned on an exterior of the primary antenna. One or more cables are coupled to the multiple antenna device.

Abstract: A device and method for treating infected or damaged heart valve tissue by selectively heating, applying pressure, or both to the heart valve tissue to sterilize any infected portion of the tissue, reshape any misshapen portion, effect selective thinning of any thickened portion, and reduce the floppiness of any selected portion. The heat can be applied to or induced in the heart valve tissue.

Abstract: An electrosurgical instrument having a first electrode that includes an elongated, electrically conductive member and a second electrode that includes a layer of electrically conductive material adhered over at least a portion of a distal region of the elongated member and separated therefrom by an insulator. The electrodes receive electrical power in a proximal region of the instrument and apply the power to an object in the body by inducing current flow between the electrodes at the distal region. In a related aspect, the second electrode is configured so that the outer diameter of the distal region is substantially the same as the outer diameter of the distal end of the first electrode. In another aspect, one of the electrodes has a reduced circumferential extent relative to the other electrode to limit an area of current flow between the electrodes and thus restrict the size of the region in which cauterization occurs.

Abstract: An electrosurgical blade is provided having a ceramic coating which is conductive, flexible and provides a surface which inhibits the build up of charred tissue. These properties enable the electrosurgical blade to deliver controlled amounts of radio-frequency energy to tissue. The manufacturing process produces a coating of titanium nitride on a stainless steel blade which is amorphous, enabling the electrosurgical blade to bend with the blade in order to perform a wide variety of surgical procedures without damaging the coating. The electrosurgical blade can therefore be used to efficiently cut, coagulate, fulgurate and desiccate tissue. While the blade is primarily used in the monopolar mode, the present invention also encompasses at least two electrosurgical electrodes having the same ceramic coating as the electrosurgical blade, and used in the bipolar mode for coagulation. The coating can be applied on a variety of shapes of electrocautery instruments.

Abstract: An electrosurgical instrument includes a roller electrode segmented into conductive and non-conductive portions. When the electrode is rolled over a treatment site, the region of the electrode that contacts the site receives current from an energy source and the non-contacting region of the electrode is isolated from the energy source. The electrode is well suited for use in an isotonic fluid environment, without resulting in significant current dissipation since the non-contacting portion is isolated from the energy source. The roller electrode has a substantially cylindrical shape and is rotatable about a longitudinal axis along which a bore extends. A conductor carrying current from the energy source is disposed through the bore such that, when the electrode is urged against a treatment site, the conductor delivers current to the contacting region of the roller electrode and is isolated from the non-contacting region.

Abstract: A bipolar electrosurgical instrument for cutting and coagulating tissue is disclosed. Also disclosed is a method for using the bipolar electrosurgical instrument. The instrument includes particular patterns of electrically conductive portions and electrically non-conductive portions on the interior surfaces of the shearing members such that the electrical current is localized in the tissue to be treated without causing a short circuit in the instrument. Other advantages of the device include an improved cutting ability aided by the localized electrical current and reduced manufacturing costs as compared to similar, prior art devices.

Abstract: An electrosurgical device for performing uvulopalatoplasty is provided. The device of the present invention comprises two configurations. The first configuration comprises a handle having an actuator which actuates a barrel fixedly mounted to a handle. This embodiment is contemplated to be disposable for single patient use. The second configuration comprises a handle having an actuator having a detachable barrel. Both devices of the present invention are designed to fit easily into a patient's mouth and maximize the surgeon's manual control.

Abstract: The invention features a bipolar electro-surgical apparatus having a first electrode that has a relatively large surface area for creating a diffuse current sufficient to heat a region of tissue to coagulation temperatures and a second electrode that has a relatively small surface area for creating a concentrated current region sufficient to heat tissue adjacent to the second electrode to resection temperatures. The first and second electrodes are relatively positioned along a treatment path, such that tissue is coagulated and resected as the electro-surgical apparatus is disposed along the path. The invention also features a method for bipolar electro-surgical tissue removal including positioning a pair of bipolar electrodes along a treatment path, flushing the treatment path with an ionic fluid, and imposing a voltage differential to cause current to flow through tissue between the electrodes, where the current flowing through the tissue is sufficient to heat and cause coagulation of the tissue.

Abstract: Surgical instruments which have multiple functions used in performing endoscopic surgeries, including arthroscopic surgery. The surgical instrument includes a mechanical cutting portion, such as a rotary blade or burr, and an electronic cutting and/or cauterizing portion comprising an electronic surgical device which operates in bipolar mode. This solves the problem of having to constantly remove and insert various surgical instruments into the surgery site in order to remove different kinds of tissues and at different rates and in different manners. A rotary burr works best to remove hard tissues, such as bone, while the bipolar device can be used to cut or ablate soft tissues and/or cauterize tissue, including blood vessels. Alternatively, the mechanical cutting portion may include a rotary blade, which works best for removing soft tissues.

Abstract: A cutting coagulating bipolar electrosurgical forceps having a pair of jaws that can be moved from an opened to a closed disposition on tissue when grasping and coagulating. The jaws include a plurality of notched or opposed side edges thereof which define a plurality of tabs. The tabs on the first jaw member are offset relative to those of the second jaw member so that when the jaws are made to close, the tabs on the first jaw fall into the notches on the second jaw with the free ends of the tabs on corresponding side edges of each jaw member disposed collinearly relative to one another, but without making electrical contact between the pair of jaws.

Abstract: Apparatus and method for endoscopically harvesting an elongate structure such as a blood vessel or nerve from a patient's body. A harvesting head defines a channel for receiving a blood vessel or the like and an outer surface for dissecting and retracting connective tissue surrounding a vessel received in the channel. The head may have a substantially ovate shape and may depend from an extended handle. The head has at least one slot that extends between the outer surface and channel for receiving side branches of the vessel. The slot contains a blade for cutting the side branches and electrocauterizing plates for sealing the cut ends of the side branches. An opening may be provided for application of a ligation device to the side branch. The apparatus may be inserted into an incision in a patient's body and advanced along the length of a vessel to endoscopically dissect, ligate and transect the side branches to harvest the main trunk of the vessel to support subsequent surgical procedures.

Abstract: A process for providing an endoscopic scissors blade with the necessary roughness to receive a ceramic coating, without first requiring that the blade surfaces be roughened by gritblasting, includes obtaining an investment mold with an interior textured surface. The investment mold is textured by first texturing an injection mold cavity by etching, gritblasting, or electric-discharge machining the inside surface of the injection mold cavity to produce a desired roughness. A blade pattern (wax) is then formed in the injection mold with a resulting textured surface, and using the textured blade pattern, the investment mold with the textured interior cavity is generated. When metal is injected into the investment mold using a lost wax process, the resulting cast blades will have the necessary roughness for permitting a ceramic to be bonded thereto without the need for any additional roughening. Thus, the so-formed blades are coated with a ceramic material.

Abstract: Devices and methods for minimally invasive harvesting of a vessel, especially the internal mammary artery for coronary artery bypass grafting, are disclosed. Generally, an electrosurgical instrument is provided which has a scissors mechanism or other end effector for dissecting tissue. The instrument also has monopolar or bipolar capabilities. Bipolar blade configurations provide current flow between blades or within each blade of the scissors mechanism or both. The instrument includes at least one ergonomically positioned actuator for actuating movement of the blades or end effectors for cutting tissue, for actuating current flow for cauterizing tissue, or for simultaneously or sequentially actuating movement and current flow. In one embodiment, the actuator is operable by a fingertip. The instrument also has a shaft which extends between the scissor mechanism and a handle portion which may be selectively rotatable or malleable to optimize orientation of the scissor mechanism.

Abstract: An apparatus for treating body tissue using controlled application of heat includes an catheter having an expandable device defining a fluid reservoir about the distal end of the catheter. Fluid is provided to the fluid reservoir through a fluid supply conduit, and fluid drains from the fluid reservoir via a fluid drainage conduit. The apparatus includes a first pressure control valve that controls the outflow of fluid through the fluid drainage conduit, so that fluid pressure within the fluid reservoir is maintained within a desired range. The apparatus may also include a second pressure control valve that drains the fluid reservoir in case of an overpressure, such as may occur upon failure of the first pressure control valve.

Abstract: An electrosurgical cutting device comprises an instrument body, and first and second cutting blades, at least one of which is pivotally mounted on the body to execute a scissor action with respect to the other blade. Electrical supply conductors associated with the body supply an electrosurgical voltage to the first and second blades. The first blade is a composite blade comprising a conductive outer electrode, an inner conductive layer, sandwiched between the outer electrode and the inner layer, an insulating layer. The supply conductors are connected respectively to the outer electrode and to the inner layer.

Abstract: A method is provided for making an electrode tip for use in a bipolar electrosurgical instrument from a single flat blank of metal. The method uses a photo chemical machining process. The resultant electrode tip has a generally loop shaped working portion. Use of the flat blank of metal results in electrodes having working portions with sharp edges in cross-section. The working portions emit concentrated energy in the radial direction.

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

Abstract: A bipolar electrocautery valvulotome in the form of an elongated catheter having a longitudinal axis, a proximal end for being held and manipulated by a user, and a distal end. A first electrode is provided adjacent the distal end of a main body of the catheter and has an exposed surface facing distally of the catheter. The first electrode is electrically coupled to device for generating a current. A second electrode is disposed distally of the first electrode and is also electrically coupled to the current generating device. The second electrode has an exposed surface in a plane substantially perpendicular to the longitudinal axis of the catheter. At least one of the first and second electrodes is movable relative to the other so as to selectively capture a venous valve structure to be cauterized therebetween.

Abstract: A catheter for delivering electrical energy to a selectable region of a patient's body has at least one layer of fibers with at least one electrically conductive fiber stranded over a flexible core. Each layer of fibers is stranded over the flexible core and underlying layers opposite in direction from that of the immediately preceding layer so as to provide a catheter with good torque transfer properties in addition to its electrical energy transfer properties. The outermost layer of stranded fibers is electrically conductive and is covered by an electrically insulative outer layer which is mechanically strippable to expose selectable regions of the underlying layer of stranded fibers. Electrical energy is transmitted along the outermost layer of stranded fibers to tissue which is in contact with the exposed contact region of the outermost layer of stranded fibers. The catheter can also deliver electrical energy through a cutting tip for multipolar electro-cautery.

Abstract: A coaxial electrosurgical instrument has an elongate inner electrode insulated from and contained coaxially within a hollow tubular elongate outer electrode, each electrode having a distal uninsulated end portion contactable simultaneously to tissue. A controlled, high-frequency, potential difference is provided between the electrodes so that an electrical current flows substantially only through contacted tissue which lies between the contacting portions of the inner and outer electrodes. An undamped voltage enables incision of the tissue. Cauterization and coagulation are performed by applying a periodically damped voltage. The outer electrode has an end surface of an uninsulated distal end portion to form a leading edge. An axially oriented cutout extends inwardly from the leading edge and accommodates a distal end portion of the insulating sleeve, permitting selective location of the inner and outer electrode surfaces contacting tissue during use.

Abstract: A method and apparatus for ablating at least a portion of a nasal concha. The apparatus includes a catheter having a distal portion with a dimension configured for positioning through a nostril of a patient into a nasal meatus adjacent a nasal concha, and an energy delivery device coupled to the catheter distal portion including one or more energy delivering probes extendable from the catheter distal portion a sufficient distance to be inserted into an interior of the nasal concha to deliver ablative energy therein. The distal portion of the apparatus may also include an expandable member, expansion of the expandable member within the nasal meatus immobilizing the distal portion within the nasal meatus.

Abstract: An electrode for vaporizing tissue is disclosed which has a head provided with projections and recesses and which is supported by at least one externally insulated electrically conducting branch. In order to provide a better and more effective electrode with regard to vaporization power and which can be easily cleaned and cheaply manufactured, the head which is rigidly fixed to the branch comprises essentially of part of a rotationally symmetrical body.

Abstract: A method for morselating and removing the morselated tissue through a small incision comprising in general inserting a tissue container into the body cavity of a patient through an incision, placing resected tissue in the vessel, inserting a morselator having a rotatable electrode thereon through the incision and into the vessel, morselating the tissue and removing the tissue from the containment vessel and the body. An apparatus for morselating and removing tissue through a small incision within the body cavity of a patient is also disclosed and may comprise a tissue container having an inner chamber for containing resected tissue, and a morselator having a proximal end and a distal end carrying an electrode wherein the distal end is insertable into the body cavity and containment vessel for morselating resected tissue.

Abstract: A bipolar electrosurgical device includes electrodes that are part of a tip which removable from a handle. The electrodes are configured for connection to electrical contacts when the tip is attached to the handle, and disconnected from the contacts which the tip is detached. The electrodes are mounted on a housing of the tip so that the proximal ends of the electrodes are spaced from each other. The handle has an opening which receives the housing, and a plurality of contacts disposed for connection to the proximal ends of the electrodes when the housing is inserted into the opening. Because the electrodes themselves provide the connection with the electrical components of the handle, there is no need for a separate electrical connector. The tip and the electrodes are economically disposable after, e.g., a single use, while the handle can be reused in multiple surgical procedures with other tips. An inventory of differently-constructed tips (e.g.

Abstract: A surgical instrument is described that incorporates bipolar electrodes on opposing shearing members for passing a high frequency current through the tissue for causing hemostasis of the tissue and for cutting the tissue. An electrically insulating material is interposed between the shearing 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 and not between the opposing shearing surfaces. The insulating material has a higher hardness than the opposing members to reduce wear of the insulation and provide a self-sharpening feature. Methods of simultaneously causing tissue and severing tissue are also provided. The 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 surgical instrument according to the present invention includes a handle, an elongated closure tube, an end effector, a pair of wireform elements which may be, for example, wireform conductors, extending through the elongated tube from the handle to the end effector and a knife blade at the end effector and a tissue stop adapted to shield the knife blade when the knife blade is in its proximal most position. In a surgical instrument according to the present invention, the wireform elements are positioned within wireform guide channels formed in the tissue stop. In a surgical instrument according to the present invention, the closure tube includes a tissue stop including a distal end and a proximal end. The tissue stop further includes a body, a neck a knife housing and knife channel, the knife channel being adapted to support the shank of the knife as it moves within the knife channel.

Abstract: A device for retrograde hole opening through tissue has a member elongate on an axis with a cross section shaped to insert axially through external tissue. A distal and a proximal end on the member respectively enter the tissue during placement and remain outside the tissue for control. A tip at the distal end has a deployable tissue divider with one or more tissue parting elements and each has a splitter. The tissue parting elements are located within the cross sectional dimensions of the member in a storage position and are movable relative to the tip for placement in an exposed position relative to the tip when shifted from storage so that the splitter thereof splits tissue during retrograde extraction along the axis and contact with tissue. Linkage between the proximal end and the deployable tissue divider retains each of the tissue parting elements with its splitter exposed.

Abstract: A cordless electrocautery unit for use in surgical procedures is described in which the unit is battery operated and therefore cordless. The unit is microprocessor controlled and provides for automatic feedback and control of the output power, in accordance with one of multiple power levels selected by the user.

Abstract: An RF ablation apparatus has a delivery catheter with a delivery catheter lumen and a delivery catheter distal end. A first RF electrode is positioned in the delivery catheter lumen. The first RF electrode has a distal end, RF conductive surface, and a lumen. A second RF electrode has a distal end. The second RF electrode is at least partially positioned in the lumen of the first catheter, with its distal end positioned at the exterior of the first RF electrode distal end. Additionally, the second RF electrode distal end has a geometry that permits it to be substantially a groundpad. The distal end of the first RF electrode is moved in a direction away from the second RF electrode distal end to create a painting effect of an ablation band or line between the two distal ends. Alternatively, the distal end of the second RF electrode can be moved in a direction away from the distal end of the first RF electrode.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an outer electrically conductive layer, an intermediate electrically insulating layer, and an inner face layer which is a coating of titanium dioxide, chromium dioxide, or zirconium dioxide. In one embodiment, the conductive layer is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade. In a second preferred embodiment, the insulating layer and the inner face layer are applied simultaneously by coating the metal blade with a mixture of ceramic and titanium dioxide, chromium dioxide, or zirconium dioxide. In a third embodiment, the insulating layer is a molded ceramic blade, and the electrically conductive layer is metalized or otherwise fixed to the ceramic blade. In all embodiments, the cutting edges and shearing surfaces are insulated from the electrodes, and no short circuit can form between the electrodes even though the cutting edges and shearing surfaces are metal.

Abstract: A surgical instrument is described that incorporates bipolar electrodes on opposing shearing members for passing a high frequency current through the tissue for causing hemostasis of the tissue and for cutting the tissue. An electrically insulating material is interposed between the shearing 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 and not between the opposing shearing surfaces. The insulating material has a higher hardness than the opposing members to reduce wear of the insulation and provide a self-sharpening feature. Methods of simultaneously causing tissue and severing tissue are also provided. The 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 clamping force mechanism for use with electrosurgery allow a user to seal and/or join patient's particular vascular tissue; the mechanism is elongate with user and patient ends. An actuator is at the user end and the effectors are at the patient end. Each effector has a face of an area to contact the particular vascular tissue. A lost motion connection transfers user actuation to the effectors to hold a predetermined clamping force during electrosurgical tissue sealing. A yielding member in the loss motion connection clamps the particular tissue between the faces with a predetermined force. The yielding member is a spring, slip clutch or hydraulic coupling possibly near the actuator. An active electrode is carried on one end effector and a return electrode contacts the tissue so an electrosurgical energy supply connected thereacross delivers energy therebetween. A feedback circuit responds to parameters of energy delivered to tissue.

Abstract: A system and associated method ablate body tissue using multiple emitters of ablating energy. The system and method convey ablating energy individually to each emitter in a sequence of power pulses. The system and method periodically sense temperature at each emitter and compare the sensed temperatures to a desired temperature established for all emitters to generate a signal individually for each emitter based upon the comparison. The system and method individually vary the power pulse to each emitter based upon the signal for that emitter to maintain the temperatures at all emitters essentially at the desired temperature during tissue ablation.

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: 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 multifunctional instrument for performing endoscopic operations has an rator hand grip (11) and an instrument socket (12) on which an instrument body (13) with a multilumen tube (14) which can be guided through a trocar is mounted. The operator hand grip (11) extends transverse to the central axis (15) of the instrument body (13). The instrument body (13) is rotatable about the central longitudinal axis (15) relative to the instrument socket (12), which is fixedly connected to the operator hand grip (11), and securely holdable in the selected rotational position.

Abstract: Bipolar electrosurgical scissors are disclosed having a pair of blades joined for relative movement in a scissor-like action between open and closed positions. At least one of the blades comprises a tissue contacting surface and first and second spaced apart electrodes extending along the surface. Current flow between the first and second electrodes promotes hemostasis in tissue contacting the surface. Preferably, each blade of the scissors includes first and second spaced-apart electrodes.

Abstract: An ablation apparatus includes a multiple antenna device coupled to an electromagnetic energy source that produces an electromagnetic energy ablation output. The multiple antenna device includes a primary antenna with a lumen and a longitudinal axis, and a secondary antenna deployable from the lumen in a lateral direction relative to the longitudinal axis. At least a distal end of each secondary antenna is structurally less rigid than the primary antenna, and the primary antenna is sufficiently rigid to be introduced through tissue. At least one cable coupling the multiple antenna device to the energy source. A cooling element is coupled to the primary antenna. A variety of energy sources can be used including RF, microwave and laser.

Abstract: An surgical stapling instrument is provided which uses a thermogenic energy preferably bipolar radiofrequency energy for cauterization and/or welding tissue. The instrument compresses tissue between one pole of a bipolar energy sources contained on a first interfacing surface and a second pole of a bipolar energy source contained on a second interfacing surface. Staples and thermogenic energy are applied to the compressed tissue. In a preferred embodiment a cutting element for cutting tissue is incorporated into the instrument.