Abstract: A portable reading light device utilizing an LEDs as the source of light mounted in a housing having a single lens through which light from the LEDs is projected, the power to the LEDs being controlled by Pulse Width Modulation.

Abstract: A method for joining tissue comprising aligning and abutting edges of the tissue to be joined applying a biodegradable, biological solder or an analogue thereof, across the edges and exposing the solder to an energy source under conditions which provide transfer of energy from the source to the solder to cause the solder to bond to the tissue surface adjacent the edges to provide a weld holding the edges together.

Abstract: Devices, systems and methods for transvascular interstitial interventions, including transvascular, catheter based vascular bypass, transmyocardial revascularization, bypass grafting of blood vessels, and interstitial surgical/interventional procedures wherein a catheter is advanced translumenally through the vasculature to a desired location and an operative instrument is passed through the wall of a blood vessel and to a target location (e.g. another blood vessel, an organ, a tumor, another anatomical structure) such that one or more operative devices may be advanced to the target location to perform the desired operative or interventional procedure.

Abstract: This invention is generally in the field of improved methods for the localized delivery of heat and the use thereof for the repair of tissue. The method involves localized induction of hyperthermia in tissue or materials by delivering nanoparticles to the tissue or materials and exposing the nanoparticles to an excitation source under conditions wherein they emit heat. The generation of heat effects the joining of the tissue or materials.

Abstract: The apparatus for uniting the lips of a wound comprises a laser having an emission wavelength chosen such that it can perform tissue bonding and unite the lips of a wound, and a holding piece suitable for being secured to the tissue around the wound so as to keep the lips of the wound approximated, at least while the wound is being exposed to said laser radiation, the holding piece including at least one region suitable for being positioned over the wound and sufficiently transparent at the wavelength of the laser radiation for the energy from said radiation to be sufficient, after it has passed through said region, to perform the desired tissue bonding.

Abstract: A method of fusing or welding bone in vivo and in a fluid medium, comprising: harvesting a piece of autologous implant bone; treating the implant bone and/or a receiving bone to expose organic component; treating the implant bone and/or the receiving bone by de-fatting; combining the implant bone with other compounds to create an interfacing agent; adding the interfacing agent between receiving bone segments to be fused or welded; and fusing or welding in vivo, in a fluid medium, utilizing electromagnetic energy.

Abstract: The invention encompasses methods and apparatus for pumping fluid from one location to another through the repetitive expansion and collapse of bubbles generated as a result of the absorption of repetitive pulses of radiation in a fluid. This pumping phenomenon can be used to aid removal of a total or partial occlusion in a body passage by emulsifying the occlusion with acoustic shock and pressure waves or by causing mechanically disrupting the occlusive material.

Abstract: Laser tissue welding can be achieved using tunable Cr4+ lasers, semiconductor lasers and fiber lasers, where the weld strength follows the absorption spectrum of water. The use of gelatin and esterified gelatin as solders in conjunction with laser inducted tissue welding impart much stronger tensile and torque strengths than albumin solders. Selected NIR wavelength from the above lasers can improve welding and avoid thermal injury to tissue when used alone or with gelatin and esterified gelatin solders. These discoveries can be used to enhance laser tissue welding of tissues such as skin, mucous, bone, blood vessel, nerve, brain, liver, pancreas, spleen, kidney, lung, bronchus, respiratory track, urinary tract, gastrointestinal tract, or gynecologic tract and as a sealant for pulmonary air leaks and fistulas such as intestinal, rectal and urinary fistulas.

Abstract: A urethral prosthesis provides relief of urinary retention and has first and second tubular elements with an interposed bridge segment. A valve can be disposed in the second tubular element to control the flow of urine therethrough.

Abstract: The apparatus for uniting the lips of a wound comprises a laser having an emission wavelength chosen such that it can perform tissue bonding and unite the lips of a wound, and a holding piece suitable for being secured to the tissue around the wound so as to keep the lips of the wound approximated, at least while the wound is being exposed to said laser radiation, the holding piece including at least one region suitable for being positioned over the wound and sufficiently transparent at the wavelength of the laser radiation for the energy from said radiation to be sufficient, after it has passed through said region, to perform the desired tissue bonding.

Abstract: A method is provided for obtaining a quality discontinuous surgical suture of biological tissues. The method includes treating the biological tissues with a laser beam having a power flux density of 1-7 kW/cm2, preferably 3-5 kW/cm2, on the surface of the joined biological tissues. To form a discontinuous surgical suture, a laser is used which is powered by copper vapors for generating a laser beam at a wavelength of 0.5-0.6 microns in combination with short-focus optics. The source of laser radiation has a radiation power of 5-15 W, preferably 8-11 W, at a periodic pulse operating mode of laser beam generation and at a focal distance of the focusing objective of 3-7 cm and the exposure period of the biological tissues being treated by the laser radiation is 3-15 seconds.

Abstract: A composition for tissue welding is provided. The composition comprises an active compound, a solvent, and an energy converter and is insoluble in physiological fluids. A method for welding a tissue is also provided. The method comprises contacting a tissue with the above composition and exciting the composition such that the tissue becomes welded.

Abstract: The invention is directed to a device and method for delivering a therapeutic substance (64) to a bodily tissue in a minimally invasive manner. The device includes an elongate flexible tubular member (12) having a proximal end (14) and a distal end (16). A control lever (50) is provided for enabling the distal end (16) of the tubular member (12) to be controllably flexed in a transverse manner for positioning the distal end (16) of the tubular member (12) proximate to the bodily tissue to be treated. A hollow needle (62) is disposed at the distal end (16) of the tubular member (12) for delivering the therapeutic substance (64) into the bodily tissue. A marking device (78) is also included for indicating the location where an injection has been made in the tissue. This enables the surgeon to keep track of the areas in which injections are made so that the therapeutic substance (64) may be evenly distributed over a desired area of treatment.

Abstract: A device and method for treatment of a tissue specimen disposed in surrounding tissue has a tissue specimen isolating tool and a tissue specimen damager. The tissue specimen isolating tool isolates the tissue specimen from the surrounding tissue. The tissue specimen damager damages the tissue, with a possible end result being necrosis. The severing tool may have a cutting member that is extendable to an outwardly radially bowed position about device. The tissue specimen is isolated by rotating the cutting member about the tissue specimen. The cutting member may be functionally connected to a cutting member radio frequency generation source. The tissue specimen damager may damage the tissue specimen using ionizing radiation, cutting devices, thermal treatment devices, chemical treatment devices, or sealing an outer boundary of the tissue specimen.

Abstract: Radiation is delivered to a wound in a series of sufficiently short pulses, with adequate cooling between individual pulses, to produce cumulative thermal denaturation and welding of the skin edges at the immediate area of the wound site, while avoiding unnecessary thermal damage to surrounding healthy tissue.

Abstract: A method for joining tissue comprising aligning and abutting edges of the tissue to be joined applying biodegradable, biological solder or an analogue thereof, across the edges and exposing the solder to an energy source under conditions which provide transfer of energy from the source to the solder to cause the solder to bond to the tissue surface adjacent the edges to provide a weld holding the edges together.

Abstract: Apparatus for pumping fluid from one location to another via generation of bubbles in fluid, and expansion and callapse thereof, are described. These apparatus deliver repetitive pulses of radiation to a fluid to form bubbles therein. The expansion and collapse of the bubbles cause fluid motion or pumping. This pumping can be used to facilitate removal of a total or partial occlusion in a body passage by a variety of mechanisms. The apparatus are flexible to facilitate use within a body passage.

Abstract: The invention encompasses methods and apparatus for pumping fluid from one location to another through the repetitive expansion and collapse of bubbles generated as a result of the absorption of repetitive pulses of radiation in a fluid. This pumping phenomenon can be used to aid removal of a total or partial occlusion in a body passage by emulsifying the occlusion with acoustic shock and pressure waves or by mechanically disrupting the occlusive material.

Abstract: The present invention relates to an elastin-based biomaterial and to a method of using same to effect tissue repair or replacement. The invention further relates to a method of securing the biomaterial to existing tissue.

Abstract: The present invention provides a composition comprising a protein solder, a bioactive compound, and a vehicle for delivering the bioactive compound into a target cell having a genome. The present invention also provides a method for delivering a bioactive compound into a target cell having a genome comprising (a) contacting a tissue with a composition comprising the protein solder, a bioactive compound, and a vehicle for delivering the bioactive compound into the target cell, and (b) exciting the protein solder to effect delivery of the bioactive compound into the target cell.

Abstract: A method of permanently joining a first collagen-containing material to a second collagen-containing material, each material having free ends of collagen fibrils at a surface, by bringing the free ends of collagen fibrils at the surfaces of the first and second materials into contact, heating the first and second materials for a time and to a temperature sufficient to permanently join the first and second materials at an area of contact of the free ends, wherein the temperature is above a melting temperature of the collagen fibril free ends, and below a melting temperature of intact collagen fibrils, such that collagen fibrils in the first and second materials are not denatured except at their free ends, and optionally thereafter crosslinking the collagen along the area of contact.

Abstract: A method and device are provided for performing intraluminal tissue welding for anastomosis of a hollow organ. A retractable catheter assembly is delivered through the hollow organ and consists of a catheter connected to an optical fiber, an inflatable balloon, and a biocompatible patch mounted on the balloon. The disconnected ends of the hollow organ are brought together on the catheter assembly, and upon inflation of the balloon, the free ends are held together on the balloon to form a continuous channel while the patch is deployed against the inner wall of the hollow organ. The ends are joined or "welded" using laser radiation transmitted through the optical fiber to the patch. A thin layer of a light-absorbing dye on the patch can provide a target for welding. The patch may also contain a bonding agent to strengthen the bond. The laser radiation delivered has a pulse profile to minimize tissue damage.

Abstract: A method for joining or reconstructing biological tissue comprises providing a solid filler material in the form of a preformed sheet, where the sheet comprises collagen, gelatin or a mixture thereof. The filler material is placed over tissue. Radiofrequency energy or optical energy is thereafter applied to the filler material in an amount sufficient to melt or denature the filler material.

Abstract: Biological materials are joined, repaired or fused by heating the material in proximity to a mechanical support. Preferably, the mechanical support comprises a patch or bridge structure. In the most preferred embodiment, the patch is formed from collagen having a thickness from between 2 to 30 mils, and most preferably from 2 to 15 mils thick. Preferably, the patch or support structure contains holes or interlock vias which permit the coagulum to form a mechanical bond therewith, whether preformed or generated by an electrical energy source during welding. The preferred method comprises the steps of: first, placing the patch in contact with the materials to be joined, supplying energy to the tissue in an amount sufficient to form a coagulum at the surface of the patch, and finally, permitting the coagulum to form a mechanical bond with the support or patch.

Abstract: A method for closed-chest cardiac surgical intervention relies on viewing the cardiac region through a thoracoscope or other viewing scope and endovascularly partitioning the patient's arterial system at a location within the ascending aorta. The cardiopulmonary bypass and cardioplegia can be induced, and a variety of surgical procedures performed on the stopped heart using percutaneously introduced tools. The method of the present invention will be particularly suitable for forming coronary artery bypass grafts, where an arterial blood source is created using least invasive surgical techniques, and the arterial source is connected to a target location within a coronary artery while the patient is under cardiopulmonary bypass and cardioplegia.

Abstract: Methods and systems for endoscopic suturing of biological tissue are disclosed. Endoscopic instruments are described which serve to position a suture material at an anastomotic site and deliver laser radiation to the suture material to effect fusion. The suture material includes a structure adapted for positioning at an anastomotic site and has at least a portion of the structure formed by a photoreactive crosslinking agent, such that upon irradiation of the structure the crosslinking agent adheres to the biological material. In one embodiment, the suture material can also include a high tensile strength element which is coated with a laser activatable crosslinking agent or glue. Upon activation, the suture material creates a desired closure or joinder of the biological material and is left in place while the endoscope is advanced to another target site or removed.

Abstract: Methods for tissue welding using solders incorporating biologically active agents, such as growth factors or hemostatic agents, have been developed. Improved solder compositions have also been defined, yielding greater bursting strength as a function of protein concentration, and through the use of protein unfolding prior to laser-mediated denaturation and coupling. A method for repair of fistulas has been discovered, using water as a chromophore, in combination with solder concentration, to form columns to fill defects where tissue apposition is not possible. Methods have also been adapted for use with other forms of directed energy, including bipolar electrosurgery and light. Examples demonstrate increased strength of repairs by incorporation of growth factors into solders, alone and as a function of solder concentration. Increased adhesion is obtained through prevention of bleeding by incorporation of hemostatic agents such as thrombin or epinephrine, a vasoconstrictor.

Abstract: A method for joining or restructuring tissue consists essentially of providing a preformed film or sheet of a solid filler material which fuses to tissue upon the application of energy. The material comprises collagen, gelatin, mixtures thereof, optionally combined with a plasticizer, and the film may be cut prior to placing over the tissue. Radiofrequency energy is then applied at between about 20 and 120 Watts to the filler material and the tissue after the filler material has been placed over the tissue for about 1 to 60 seconds so that about 20 to 1800 joules are delivered to the filler material and tissue.

Abstract: A laser welding apparatus and system for surgically bonding tissue together provides a beam of coherent light at a wavelength corresponding to a specific tissue thickness at which full absorption of the laser energy occurs, and adjusts the energy of the laser beam in response to tissue temperature throughout the tissue thickness to prevent the tissue temperature from either exceeding a predetermined limit or varying outside a predetermined range. Preferably, the coherent light beam has a center wavelength of 1.9 .mu.m, and is variable between 1.85 and 1.91 .mu.m.

Abstract: A temporary stent and method for vascular anastomosis are disclosed. The method comprises placing, in a vessel to be anastomosed, a stent comprising a biocompatible material; applying staples to anastomose the vessel; and converting the stent material into a liquid that is miscible with blood by melting with warmed saline or pulsed radiation. Also disclosed is a method and composition for delivery of a drug that prevents thrombus formation and/or intimal hyperplasia at the anastomosis.

Abstract: A surgical apparatus for energy welding or otherwise joining two segments of living tissue, usually tubular in structure, comprising, means for clamping the first tissue section, means for clamping the second tissue section, means for moving one of said clamping means toward said other clamping means to bring the first and second sections into abutting relationship to form a seam. Means for transmitting energy to the seam may be provided to weld together the first and second sections. The means for clamping the first section comprises a first pair of opposed arms and the means for clamping the second section comprises a second pair of opposed arms, wherein at least one of said arms of each said pair of arms is pivotably connected to said opposing arm. The energy transmitting means comprises first and second housing sections adapted to be placed over opposing sides of the clamping means wherein each of the housing sections has a plurality of energy transmissive elements extending therethrough.

Abstract: A method of permanently joining a first collagen-containing material to a second collagen-containing material, each material having free ends of collagen fibrils at a surface, by bringing the free ends of collagen fibrils at the surfaces of the first and second materials into contact, heating the first and second materials for a time and to a temperature sufficient to permanently join the first and second materials at an area of contact of the free ends, wherein the temperature is above a melting temperature of the collagen fibril free ends, and below a melting temperature of intact collagen fibrils, such that collagen fibrils in the first and second materials are not denatured except at their free ends, and optionally thereafter crosslinking the collagen along the area of contact.

Abstract: Materials and methods for photoreactive suturing of biological tissue are disclosed. The suture material includes a structure adapted for positioning at an anastomotic site and has at least a portion of the structure formed by a photoreactive crosslinking agent, such that upon irradiation of the structure the crosslinking agent adheres to the biological material. In one embodiment, the suture material can also include a high tensile strength element which is coated with a laser activatable crosslinking agent or glue. The suture methods can be practiced manually, or with various apparatus, such as endoscopes, catheters or hand-held instruments.

Abstract: Methods and systems for endoscopic suturing of biological tissue are disclosed. Endoscopic instruments are described which serve to position a suture material at an anastomotic site and deliver laser radiation to the suture material to effect fusion. The suture material includes a structure adapted for positioning at an anastomotic site and has at least a portion of the structure formed by a photoreactive crosslinking agent, such that upon irradiation of the structure the crosslinking agent adheres to the biological material. In one embodiment, the suture material can also include a high tensile strength element which is coated with a laser activatable crosslinking agent or glue. Upon activation, the suture material creates a desired closure or joinder of the biological material and is left in place while the endoscope is advanced to another target site or removed.

Abstract: Method for fusing bone. The present invention is a method for joining hard tissue which includes chemically removing the mineral matrix from a thin layer of the surfaces to be joined, placing the two bones together, and heating the joint using electromagnetic radiation. The goal of the method is not to produce a full-strength weld of, for example, a cortical bone of the tibia, but rather to produce a weld of sufficient strength to hold the bone halves in registration while either external fixative devices are applied to stabilize the bone segments, or normal healing processes restore full strength to the tibia.

Abstract: The method and apparatus of the invention use a beam of laser emitted optical energy to effect wound closure and reconstruction of biological tissue. In response to input as to tissue type and thickness, a computer determines the output power, exposure time and spot diameter of the emitted beam to control the application of optical energy to produce thermal heating of biological tissue. The tissue is heated to a degree suitable for denaturing the tissue proteins such that the collagenous elements of the tissue form a "biological glue" to seal immediately and/or to reconstruct the tissue being heated without any injurious tissue shrinkage. In a given embodiment, the computer directly controls output power of the laser by regulating the laser's input current, and limits exposure time by deactivating a shutter mechanism when the predetermined time is reached.

Abstract: A system for welding tissue by irradiation with laser energy, includes a laser for generating a beam of laser energy and directing the beam toward the tissue so as to irradiate the region to be welded. The laser has a control input and is responsive to a control signal supplied to said control input to adjust the power of the beam of laser energy. An infrared sensor senses the temperature of the tissue in the region to be welded by sensing infrared radiation coming from this region. The sensor provides a sensor output indicative of the temperature. A computer control arrangement is responsive to the sensor output. The computer control arrangement supplies a control signal to said laser such that the region to be welded is heated to a predetermined temperature.

Abstract: A warp knitted fabric is described in which each individual wale contains stitches formed from both elastic and inelastic yarn. The fabric is extensible in the direction of the wales and may be used as a substrate in an orthopaedic splinting bandage. Orthopaedic splinting bandages are also described which comprise the warp knitted fabric coated with a hardenable resin such as an isocyanate terminated propolymer. The lengthwise extensibility of the substrate makes the uncured bandage conformable during application to the body.

Abstract: A method and apparatus for sealing and/or grasping lesions or incisions of luminal tissue is provided. The apparatus has a generally tubular assembly with portions which expand away from each other. The apparatus is inserted into the lumen of a tissue and placed adjacent the area to be sealed. The portions expand to contact the inner wall of the luminal tissue. Energy is delivered with a media through the expanded tubular assembly to heat the tissue to a nondestructive range where the tissue forms a denatured proteinaceous substance. The media delivering the energy is rotated in the expanded tubular assembly to heat different areas of the tissue without moving the tubular assembly itself. In an alternate embodiment of the invention, tubular portions of the assembly are provided which have side edges that slide toward and away from each other. The assembly is placed in the lumen and the tissue edges are inserted into the assembly between the side edge.

Abstract: A method and apparatus for applying optical or other thermal energy to tissue using a clamp. The energy is supplied at a frequency which biologically welds or fuses tissue. A material that is transmissive to the energy treatment frequency is embedded in one or more jaws of the clamp and engage the tissue during the tissue fusion process. The transmissive material has a thickness selected to insure that the energy source is spaced at the proper distance from the tissue so that the tissue receives the proper amount of energy for sealing. The transmissive material holds the tissue in the jaw to maintain the edges of the tissue in tight approximation. The energy may be coupled to the clamp by one or more optical fibers. These fibers are recessed in or placed adjacent to the jaw at a specified distance from the surface of the transmissive material and directs treatment energy through the transmissive material to weld the edges of the tissue together.

Abstract: A system for welding tissue by irradiation with laser energy, includes a laser for generating a beam of laser energy and directing the beam toward the tissue so as to irradiate the region to be welded. The laser has a control input and is responsive to a control signal supplied to said control input to adjust the power of the beam of laser energy. An infrared sensor senses the temperature of the tissue in the region to be welded by sensing infrared radiation coming from this region. The sensor provides a sensor output indicative of the temperature. A computer control arrangement is responsive to the sensor output. The computer control arrangement supplies a control signal to said laser such that the region to be welded is heated to a predetermined temperature.

Abstract: An apparatus for sealing approximated edges of tissue with thermal energy includes a clamp having members which grasp and hold tissue. A transmissive material is supported by at least one of the members. The members pivot to pull the tissue edges in tight approximation against the transmissive material to form a seam. Thermal energy is then directed at the tissue through the transmissive material and at the seam with sufficient intensity and duration to heat the tissue to an adhesive proteinaceous substance to seal the seam. The approximated seam is held against the transmissive material with an appropriate pressure to avoid over inverted or over everted tissue approximation.

Abstract: A method and apparatus for sealing luminal tissue is disclosed. The apparatus is inserted into the lumen of the organ and positioned adjacent an area on the organ to be sealed. Energy sufficient to heat tissue to form a denatured proteinaceous substance is delivered through the lumen to the apparatus. The apparatus then directs the energy at the area to be sealed.

Abstract: A method for use in performing an anastomosis includes the steps of juxtaposing free ends of two sections of a ressected tubular organ of a patient so as to form a continuous lumen through the sections, placing a strip of a biocompatible material over the sections along a seam therebetween, and bonding the strip to outer surfaces of the sections so as to form a seal about the sections at the seam. The juxtaposition of the organ sections is facilitated by inserting an inflatable balloon made of bioabsorbable material into the sections at their free ends, inflating the ballon and pulling the sections over the inflated balloon.

Abstract: Materials and methods for photoreactive suturing of biological tissue are disclosed. The suture material includes a structure adapted for positioning at an anastomotic site and has at least a portion of the structure formed by a photoreactive crosslinking agent, such that upon irradiation of the structure the crosslinking agent adheres to the biological material. In one embodiment, the suture material can also include a high tensile strength element which is coated with a laser activatable crosslinking agent or glue. The suture methods can be practiced manually, or with various apparatus, such as endoscopes, catheters or hand-held instruments.

Abstract: A method of joining or reconstructing biological tissue which comprises applying optical energy to the biological tissue while providing a collagen filler material thereto; denaturing the collagen filler material and biological tissue with the optical energy to cause joining of the collagen filler material and biological tissue, thus joining or reconstructing such tissue.

Abstract: Apparatus and methods for laser fusion of biological structures are disclosed employing a laser for delivery of a beam of laser radiation to an anastomotic site, together with a reflectance sensor for measuring light reflected from the site and a controller for monitoring changes in the reflectance of the light of the site and controlling the laser in response to the reflectance changes. In one embodiment, the laser radiation is delivered through a hand-held instrument via an optical fiber. The instrument can also include one or more additional fibers for the delivery of illumination light (which can be broadband or white light or radiation from a laser diode) which is reflected and monitored by the reflectance sensor. Reflectance changes during the course of the fusion operation at one or more wavelengths can be monitored (or compared) to provide an indication of the degree of tissue crosslinking and determine when an optimal state of fusion has occurred.

Abstract: A method for closing and sealing a puncture at a puncture site in an artery located beneath the skin after a catheter is removed from the puncture. The method includes the steps of applying pressure directly to the artery at the puncture site, and applying laser energy directly to the artery at the puncture site while pressure is applied. The laser energy is sufficient to thermally weld the artery at the puncture site. Preferably, the step of applying pressure directly to the artery includes the steps of advancing a tube having an inflatable balloon at its distal end through the overlying tissue to the punction site, and inflating the balloon. Laser energy is carried thorugh an optical fiber to the balloon and is directed through the wall of the balloon to the puncture site.