2531results about "Enemata/irrigators" patented technology

The present invention provides systems, apparatus, and methods for dissecting, resecting, severing, cutting, contracting, coagulating, or otherwise modifying a tissue or organ of a patient. An apparatus of the invention includes an electrosurgical probe configurable between an open configuration and a closed configuration, the probe including an active electrode terminal, a fixed return electrode disposed proximal to the active electrode terminal, and a movable return electrode configured to move linearly with respect to the active electrode terminal between the open configuration and the closed configuration. A method of the present invention comprises clamping a blood vessel between the active electrode terminal and the movable return electrode, coagulating the clamped blood vessel by application of a first high frequency voltage, and severing the coagulated blood vessel by application of a second high frequency voltage.

Apparatus and methods for treating an intervertebral disc by ablation of disc tissue. A method of the invention includes positioning at least one active electrode within the intervertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. In other embodiments, a curved or steerable probe is guided to a specific target site within a disc to be treated, and the disc tissue at the target site is ablated by application of at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s). A method of making an electrosurgical probe is also disclosed.

The present invention provides systems and methods for selectively applying electrical energy to a target location within the head and neck of a patient's body, particularly including tissue in the ear, nose and throat. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to remove and/or modify the structure of tissue structures. The present invention is particularly useful for treating sleep obstructive disorders, such as sleep apnea and snoring.

Systems and methods are provided for applying a high frequency voltage in the presence of an electrically conductive fluid to create a relatively low-temperature plasma for ablation of tissue adjacent to, or in contact with, the plasma. In one embodiment, an electrosurgical probe or catheter is positioned adjacent the target site so that one or more active electrode(s) are brought into contact with, or close proximity to, a target tissue in the presence of electrically conductive fluid. High frequency voltage is then applied between the electrode terminal(s) and one or more return electrode(s) to generate a plasma adjacent to the active electrode(s), and to volumetrically remove or ablate at least a portion of the target tissue. The high frequency voltage generates electric fields around the active electrode(s) with sufficient energy to ionize the conductive fluid adjacent to the active electrode(s). Within the ionized gas or plasma, free electrons are accelerated, and electron-atoms collisions liberate more electrons, and the process cascades until the plasma contains sufficient energy to break apart the tissue molecules, causing molecular dissociation and ablation of the target tissue.

The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to ablate, contract, coagulate, or otherwise modify a target tissue or organ of a patients. An electrosurgical apparatus of the invention includes a shaft having a shaft distal end bearing an active electrode and a return electrode. At least one of the active electrode and the return electrode is moveable such that the shaft distal end can adopt a closed configuration or an open configuration. The apparatus can operate in an ablation mode or a sub-ablation mode. The closed configuration is adapted for clamping and coagulating a target tissue while the apparatus is operating in the sub-ablation mode, while the open configuration is adapted for ablating the target tissue via molecular dissociation of tissue components. A method of the present invention comprises clamping a target tissue or organ with an electrosurgical probe. A first high frequency voltage is applied between the active electrode and the return electrode to effect coagulation of the clamped tissue. Thereafter, a second high frequency voltage is applied to effect localized molecular dissociation of the coagulated tissue. The present invention allows the ablation or modification of the target tissue with minimal or no damage to surrounding, non-target tissue.

The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to incise, dissect, harvest or transect tissues or an organ of a patient. The electrosurgical systems and methods are useful, inter alia, for accessing, dissecting, and transecting a graft blood vessel, such as the internal mammary arteries (IMA) or the saphenous vein, for use in a by-pass procedure. A method of the present invention comprises positioning an electrosurgical probe adjacent the target tissue so that one or more active electrode(s) are brought into at least partial contact or close proximity with a target site in the presence of an electrically conductive fluid. A high frequency voltage is then applied between the active electrode and one or more return electrode(s). During application of the high frequency voltage, the electrosurgical probe may be translated, reciprocated, or otherwise manipulated such that the active electrode is moved with respect to the tissue. The present invention volumetrically removes the tissue at the point of incision, dissection, or transection in a cool ablation process that minimizes thermal damage to surrounding, non-target tissue.

The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for removing a vertebral disc in preparation for implanting a prosthetic disc or removing a portion of the vertebral disc such as the nucleus pulposus in preparation for placing a prosthetic nucleus within the annulus of the disc. The present invention also teaches shrinking residual tissue in preparation for placing the implants.

The methods and devices disclosed provides for the delivery of agents to an orifice cavity and subsequent aspiration of the agent and orifice contents from the orifice cavity and related areas. In one form, the delivery and aspiration system comprises an agent delivery sub-assembly, an aspiration sub-assembly and a device tip sub-assembly. The subassemblies operate to first deliver an agent contained within the device to an orifice cavity and after an optional time delay, subsequently aspirate the delivered agent and orifice contents from the orifice cavity and related areas. In another form, a removable reservoir is provided whereby the aspirated agent and orifice contents from the orifice are assayed either independent of or within the device itself.

Apparatus and methods for treating an inter-vertebral disc by ablation, coagulation, shrinking, stiffening, or other treatment of disc tissue. A method of the invention includes positioning at least one active electrode within the inter-vertebral disc, and applying at least a first high frequency voltage between the active electrode(s) and one or more return electrode(s), wherein the volume of the nucleus pulposus is decreased, pressure exerted by the nucleus pulposus on the annulus fibrosus is reduced, and discogenic pain of a patient is alleviated. An apparatus of the invention includes an electrosurgical probe, an introducer needle adapted for passing the distal end of the probe therethrough, and a positioning unit for monitoring a position of the probe in relation to the introducer needle.

Apparatus and method for treating a body joint wound subsequent to surgical intervention. An infusion tube is insertable into the wound for transporting a prepared solution to the joint. A second tube is insertable into the wound for transport of fluid removed from the joint. A vacuum device is coupled to the second tube. Suction is automatically turned on to evacuate the wound for a prescribed period of time and then stopped for another prescribed period of time. The on and off cycle may be repetitive. During the entire period, the prepared solution is constantly infused. The infusion tube and evacuation tube are isolated from each other so that no contaminants can be infused. A plurality of preadjusted suction duty cycles are available, from which one may be selected as appropriate for the type of wound to be treated.

Systems and methods for treating a patient having a head with a first ear and a second ear, function by mounting a support structure to the head of the patient; aligning the support structure with a target tissue in an ear canal of the first ear; stabilizing the support structure relative to the target tissue by injecting a material into the canal and hardening the material; and actuating a device while the device is supported by the support system so that the device therapeutically remodels the target tissue of the first ear.

The present invention provides systems and methods for selectively applying electrical energy to a target location within a patient's body, particularly including tissue in the spine. The present invention applies high frequency (RF) electrical energy to one or more electrode terminals in the presence of electrically conductive fluid or saline-rich tissue to contract collagen fibers within the tissue structures. In one aspect of the invention, a system and method is provided for contracting a portion of the nucleus pulposus of a vertebral disc by applying a high frequency voltage between an active electrode and a return electrode within the portion of the nucleus pulposus, where contraction of the portion of nucleus pulposus inhibits migration of the portion nucleus pulposus through the fissure.

The present invention provides a system and a method for distending a body tissue cavity of a subject by continuous flow irrigation such that minimal or negligible fluid turbulence is present inside the cavity, such that any desired cavity pressure can be created and maintained for any desired outflow rate. The present invention also provides a method for accurately determining the rate of fluid loss, into the subject's body system, during any endoscopic procedure without utilizing any deficit weight or fluid volume calculation or flow rate sensor. The system and the methods of the present invention described above can be used in any endoscopic procedure requiring continuous flow irrigation few examples of such endoscopic procedures being hysteroscopic surgery, arthroscopic surgery, trans uretheral surgery, endoscopic surgery of the brain and endoscopic surgery of the spine.

Aspects of the present disclosure are presented for a single surgical instrument configured for performing sealing procedures on tissues using electrosurgical or ultrasonic energy, irrigating tissue at the sealing site, and evacuating material from the sealing site. An end effector of the surgical instrument may include multiple members arranged in various configurations to collectively perform the aforementioned functions. The evacuation and irrigation elements may comprise one or more fluid paths configured to remove material from or deliver fluid to a surgical field. The instrument may include electrical and mechanical aspects that may be used to control the evacuation and irrigation functions. In this way, a user may use a single surgical instrument to perform these tasks during a tissue sealing procedure.

The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to, ablate, contract, coagulate, or otherwise modify a tissue or organ of a patient. An electrosurgical apparatus includes an electrode support bearing an active electrode in the form of a plasma blade or hook having an active edge and first and second blade sides. The active edge is adapted for severing a target tissue via localized molecular dissociation of tissue components. The first and second blade sides are adapted for engaging against, and coagulating, the severed tissue. s. A method of the present invention comprises positioning an electrosurgical probe adjacent to the target tissue so that a blade- or hook-like active electrode is brought into at least close proximity to the target tissue in the presence of an electrically conductive fluid. A high frequency voltage is applied between the active electrode and a return electrode to effect cool ablation or other modification of the target tissue. During application of the high frequency voltage, the electrosurgical apparatus may be translated, reciprocated, or otherwise manipulated such that the active edge is moved with respect to the tissue. The present invention volumetrically ablates or otherwise modifies the target tissue with minimal or no damage to surrounding, non-target tissue.

An aspiration catheter includes an aspiration shaft and a telescoping outer sheath which can be passed over a guidewire. The sheath includes “nesting” proximal and distal tubes. The distal tube slides within a proximal tube lumen, and the aspiration shaft slides within a distal tube lumen. The catheter can be placed in an expanded position by pushing the aspiration shaft, thereby causing the distal tube to be moved distally. The catheter can be retracted by pulling the aspiration shaft proximally so that a distal segment of the aspiration shaft is drawn into the distal tube lumen and the distal tube is drawn into the proximal tube lumen. Alternatively, a middle tube is slidingly disposed over the aspiration shaft between the proximal and distal tubes. In this embodiment, the middle tube nests within the proximal tube lumen and the distal tube nests within a middle tube lumen.

A flexible plastic cannula for use during arthroscopic surgery. The cannula is a flexible elongated tube having longitudinally staggered slots disposed on the distal end of the tube. The tube is tapered along its length so that the proximal portion of the tube is relatively rigid, while the distal end is narrower and more flexible. The tube is sufficiently flexible to allow the tube to bend with a joint during arthroscopic surgery.

A device for making an incision in the tympanic membrane, withdrawing fluid from the tympanic cavity and administering a medicament to the space behind the tympanic membrane is provided. The device has a barrel-shaped casing (1) having a rotatable end turret (38). A first trigger (2) allows a shaft (18) to pierce the tympanic membrane and a tubular vacuum cartridge (32). The cartridge allows aspiration of fluid. A second trigger (4) causes medicament (34) to be released into the space behind the tympanic membrane.

An apparatus for cleansing wounds in which irrigant fluid from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are recirculated by a device for moving fluid through a flow path which passes through the dressing and a means for fluid cleansing and back to the dressing. The cleansing means (which may be a single-phase, e.g. microfiltration, system or a two-phase, e.g. dialytic system) removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The dressing and a method of treatment using the apparatus.

A device for evacuating waste product through an orifice in a mammalian body, the device including a chamber having an irrigating means for introducing an irrigating fluid into the orifice and a suction means for removing the irrigating fluid waste products from the orifice.

A tissue penetrating catheter that is usable to advance a tissue penetrator from within a blood vessel, through the wall of the blood vessel to a target location. The catheter includes at least one stabilizing device thereon for stabilizing catheter prior to advancing the tissue penetrator. The tissue penetrator may extend through a lumen in the body of the catheter and project transversely through an exit port. The stabilizing device may be located closely adjacent to the exit port, or may surround the exit port. The stabilizing device may be one or more balloons, or other mechanical structure that is expandable into contact with the inner luminal wall of the blood vessel. Desirably, the exit port is forced into contact with the blood vessel wall to shorten the distance that the tissue penetrator projects from the catheter body to the target location. The catheter is particular useful for forming blood flow tracts between blood vessels, in particular in coronary revascularization procedures. Methods of utilizing such a catheter to bypass an arterial obstruction is also disclosed.

An apparatus (1) for cleansing wounds (5) in which irrigant fluid from a reservoir connected to a conformable wound dressing (2) and wound exudate from the dressing are moved by a device (18) (which may be a single pump or two pumps) for moving fluid through a flow path (6, 7, 9, 10) which passes through the dressing with a means for providing simultaneous aspiration and irrigation of the wound, and means for supplying thermal energy to the fluid in the wound. The former provides a desired balance of fluid at a controlled nominal flow rate that removes materials deleterious to wound healing, while distributing materials that are beneficial in promoting wound healing over the wound bed. The latter maintains a temperature at the wound bed under the wound dressing at a level that promotes wound healing.

The end of the elongated tubular element of the appliance that is designed to be inserted into a body cavity or vessel is formed entirely of soft, compliant material. That end carries an inflatable balloon formed in its fully inflated shape. The balloon is inflated to a predetermined low pressure level to prevent pressure necrosis in the adjacent tissue. A method and apparatus for introducing the soft end of the appliance into the body cavity are also provided. The introducer apparatus includes rigid core surrounded by a soft, compliant sleeve. The sleeve extends beyond the rigid core to form an invertable section. The soft end of the appliance is situated adjacent the apparatus, the balloon is wrapped around the apparatus, and the sleeve section is inverted over the appliance, compressing the balloon and forming a soft, rounded insertion tip. The unit is then introduced into the body cavity. After the appliance is separated from the apparatus, the apparatus is withdrawn.

Systems and methods are provided for applying a high frequency voltage in the presence of an electrically conductive fluid to create a relatively low-temperature plasma for ablation of tissue adjacent to, or in contact with, the plasma. In one embodiment, an electrosurgical probe or catheter is positioned adjacent the target site so that one or more active electrode(s) are brought into contact with, or close proximity to, a target tissue in the presence of electrically conductive fluid. High frequency voltage is then applied between the active electrode(s) and one or more return electrode(s) to non-thermally generate a plasma adjacent to the active electrode(s), and to volumetrically remove or ablate at least a portion of the target tissue. The high frequency voltage generates electric fields around the active electrode(s) with sufficient energy to ionize the conductive fluid adjacent to the active electrode(s). Within the ionized gas or plasma, free electrons are accelerated, and electron-atoms collisions liberate more electrons, and the process cascades until the plasma contains sufficient energy to break apart the tissue molecules, causing molecular dissociation and ablation of the target tissue.

A medical treatment device comprising an elongate probe member having proximal and distal extremities. The elongate probe member has a longitudinal axis and at least one passageway extending from the proximal extremity to the distal extremity. A guide is mounted in the at least one passage of the elongate probe member and has proximal and distal extremities with the distal extremity of the guide being in the vicinity of the distal extremity of the elongate probe member. The guide has an opening in the distal extremity and a lumen extending from the proximal extremity to the opening in the distal extremity. A needle is slidably disposed in the lumen of the guide. The needle is in the form of a tube having an axial lumen extending therethrough. A control mechanism is coupled to the proximal extremity of the elongate probe member and is secured to the needle for advancing and retracting the needle relative to the guide.

A medical system comprising apparatus and methods for improved irrigation and lavage in wound management. The device attaches to at least one irrigation fluid source and is configured to administer the fluid indirectly to a wound or tissue.

Apparatus for controlling the volume of surgical fluid present in a cavity in the body of a patient during surgery includes a conduit to the cavity for conducting the surgical fluid therefrom to at least one receptacle for receiving the fluid from said cavity. A source of vacuum assists in withdrawing fluid from the cavity and a vacuum controller interposed between the vacuum source and the receptacle controls the duration of time the receptacle is exposed to vacuum from the vacuum source. The apparatus preferably has a vacuum sensor for sensing vacuum levels in the receptacle when disconnected from the source of vacuum and shares the source of vacuum with another application, giving priority to maintaining a proper vacuum level in the receptacle.

An apparatus and method of determining when a container holding surgical fluid to be provided to a surgical handpiece, such as a liquefracture handpiece, is nearly exhausted is disclosed.

A mechanical wound therapy (MWT) system includes a connection for a vacuum source, which is routed through an airtight covering to a porous material positioned over the wound. The porous material may be a tubing network interspaced by a netting material constructed of biologically inert or bioabsorbable material. Alternatively, the porous material may be a layered unified dressing in which layers of mesh, netting or thin perforated film are separated and fixedly attached to functional elements of the dressing (e.g., irrigation tubing) or spacers. The vacuum and irrigation systems may be completely separated. An airtight sealing layer or foldable adhesive sealing layer may seal the dressing and facilitate sealing the dressing to the wound margins. Additional modular devices such as a wound approximating system, positive pressure bladders and adjuvant therapy modules as well as enhanced monitoring technology can be added to synergistically increase the capabilities of each dressing.

The invention provides a therapeutic system comprising:

• • a console, wherein the console comprises a controller and an energy generator;
  • a therapeutic device comprising: an operational head configured for transmitting the energy output from to a biological tissue; and a memory device comprising control instructions, wherein said control instructions comprise instructions for controlling the console;
  • a reversible memory operable linkage linking the memory device to the controller; and
  • a reversible connector configured for operably linking the energy generator to the operational head.

Optionally, the energy generator is a generator of ablation energy or heat energy (e.g. RF generator) and the control instructions comprise instructions for controlling the output of the energy generator. Optionally, the control instructions comprise one or more parameters of energy output or an algorithm configured for controlling the energy output. Optionally, the system further comprises one or more secondary therapeutic devices and the control instructions comprise instructions for controlling the one or more secondary therapeutic devices. Optionally, the system further comprises one or more sensors configured for sensing parameters of energy output or biological or environmental effects of the energy output and the control instructions comprise instructions for controlling the energy output and/or secondary therapeutic devices based on the parameters of energy output or biological or environmental effects. In some embodiments, one advantage provided by the present invention is the use of a single console with a plurality of interchangeable reversibly connected therapeutic devices.