6356results about "Trocar" patented technology

The invention is directed to an apparatus for use in a transluminal procedure. The apparatus, comprising, for example, a housing having a guide lumen and a seal proximal to a distal end of the housing that extends across and completely seals the guide lumen; a fixation element in the housing and adapted to secure the distal end of the housing to tissue; and a channel extending through the side wall of the housing having an outlet in communication with the lumen distal of the seal. Methods are also provided. For example, a method includes, performing a transluminal procedure by: securing a datum and position indicator to a wall of a target lumen; forming an opening in the wall; advancing an instrument through the opening; and tracking the advancement of the instrument using the datum and position indicator.

A surgical instrument including a housing, an endoscopic portion, a shaft portion and an end effector is disclosed. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The shaft portion is selectively connectable to a distal end of the endoscopic portion. The end effector is selectively connectable to a distal end of the shaft portion.

A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient's tissue while delivering fasteners, two at a time to attach the cuff to the tissue from the inside out. The tool stores a plurality of fasteners. Drawstrings are operated from outside the patient's body and cinch the sewing cuff to the valve body. The cuff is releasably mounted on the tool and the tool holds the cuff against tissue and drives the fastener through the cuff and the tissue before folding over the legs of the fastener whereby secure securement between the cuff and the tissue is assured. At least two rows of staggered fasteners are formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner.

An electrosurgical system comprises a radio frequency generator (1), an electrosurgical instrument (E1), and a fluid enclosure (42). The generator (1) has a radio frequency output for delivery of power to the electrosurgical instrument (E1) when immersed in an electrically-conductive fluid. The electrosurgical instrument (E1) has an electrode assembly (32) at the distal end thereof, the electrode assembly comprising a tissue treatment electrode (34), and a return electrode (38) axially spaced therefrom 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. The fluid enclosure (42) is adapted to surround an operation site on the skin of a patient or an incision leading to a cavity surgically created within the patient's body. The fluid enclosure (42) includes sealing means (44) for sealing against the patient's tissue, and the fluid enclosure includes at least one port (50a, 52a) through which the electrosurgical (E1) is insertable, and through which the electrically-conductive fluid can enter and/or leave the enclosure.

A system and method are disclosed for removing a uterus using a fluid enclosure inserted in the peritoneal cavity of a patient so as to enclose the uterus. The fluid enclosure includes a distal open end surrounded by an adjustable loop, that can be tightened, a first proximal opening for inserting an electrosurgical instrument into the fluid enclosure, and a second proximal opening for inserting an endoscope. The loop is either a resilient band extending around the edge of the distal open end or a drawstring type of arrangement that can be tightened and released. The fluid enclosure is partially inserted into the peritoneal cavity of a patient in a deflated condition and then manipulated within the peritoneal cavity over the body and fundus of the uterus to the level of the uterocervical junction. The loop is tightened around the uterocervical junction, after which the enclosure is inflated using a conductive fluid. The loop forms a pressure seal against the uterocervical junction to contain the conductive fluid used to fill the fluid enclosure. Endoscopically inserted into the fluid enclosure is an electrosurgical instrument that is manipulated to vaporize and morcellate the fundus and body of the uterus. The fundus and body tissue that is vaporized and morcellated is then removed from the fluid enclosure through the shaft of the instrument, which includes a hollow interior that is connected to a suction pump The fundus and body are removed after the uterus has been disconnected from the tissue surrounding uterus.

A cutting instrument including a metal blade has a recess formed therein and a semiconductor substrate affixed to the blade in the recess. The semiconductor substrate includes at least one sensor formed thereon. The sensor formed on the semiconductor substrate may comprise at least one or an array of a strain sensors, pressure sensors, nerve sensors, temperature sensors, density sensors, accelerometers, and gyroscopes. The cutting instrument may also further include a handle wherein the blade is affixed to the handle and the semiconductor substrate is electrically coupled to the handle. The handle may then be coupled, either physically or by wireless transmission, to a computer that is adapted to display information to a person using the cutting instrument based on signals generated by one or more of the sensors formed on the semiconductor substrate. The computer or handle may also be adapted to store data based on the signals generated by one or more of the sensors. A method of making said cutting instrument includes the steps of at least one sensor being formed on a semiconductor wafer and a layer of photoresist being applied on a top side of the semiconductor wafer according to a pattern that matches the defined shape of the semiconductor substrate. The portion of the semiconductor wafer not covered by the photoresist is removed and thereafter the photoresist is removed from the semiconductor wafer, thereby leaving the semiconductor substrate having a defined shape and at least one sensor formed thereon. The semiconductor substrate having a defined shape and at least one sensor formed thereon is then affixed to a metal blade in a recess formed in said blade.

An embodiment of the invention provides a tissue biopsy and treatment apparatus that comprises an elongated delivery device that is positionable in tissue and includes a lumen. A sensor array having a plurality of resilient members is deployable from the elongated delivery device. At least one of the plurality of resilient members is positionable in the elongated delivery device in a compacted state and deployable with curvature into tissue from the elongated delivery device in a deployed state. At least one of the plurality of resilient members includes at least one of a sensor, a tissue piercing distal end or a lumen. The sensor array has a geometric configuration adapted to volumetrically sample tissue at a tissue site to differentiate or identify tissue at the target tissue site. At least one energy delivery device is coupled to one of the sensor array, at least one of the plurality of resilient members or the elongated delivery device.

A medical instrument that includes an instrument shaft having proximal and distal ends; a tool for performing a medical procedure; a control handle; a distal motion member for coupling the distal end of the instrument shaft to the tool; a proximal motion member for coupling the proximal end of the instrument shaft to the control handle; actuation means extending between the distal and proximal motion members for coupling motion of the proximal motion member to the distal motion member for controlling the positioning of the tool; a control tube through which the instrument shaft and tool extend; the control tube including, along the length thereof, a curved section; the curved section of the control tube, upon rotation thereof, providing an additional degree of freedom by displacing the tool out of a plane defined by the curved section of the control tube.

A surgical sealing device (405), suitable for use during a surgical procedure such as a laparoscopic procedure or a hand-assisted laparoscopic procedure, comprises a first sealing member (5) and a second sealing member (6). A thin slit is defined between the sealing members (5, 6). In a closed configuration, the first sealing member (5) overlaps the distal end opening of a passageway (2) through the second sealing member (6) to prevent leakage of insufflation gases out of an abdomen (4). In an open configuration, the first sealing member (5) is retracted to reveal the distal end opening of the passageway (2) and thus facilitate passage of an object, such as a surgeon's hand or forearm (3), into the abdomen (4). The device (405) comprises a planar support element (406) fixedly attached to the proximal exterior surface (408) of the first sealing member (5). The first sealing member (5) is fixedly attached to the second sealing member (6) at an attached region (409), with a detached region (407) remaining detached from the second sealing member (6). The support element (406) acts as a stiffening element to increase the stiffness of the detached region (407) of the first sealing member (5) to minimise the deformation of the detached region (407) of the first sealing member (5) when the surgeon's hand/forearm (3) is pushed through the passageway (2). It is thus easier for the surgeon to retract the first sealing member (5) laterally to reveal the distal end opening of the passageway (2) by pushing the hand/forearm (3) through the passageway (2) and easier for the surgeon to pass the hand/forearm (3) through the device (405) and gain access to the abdomen (4).

A medical device for removing or manipulating tissue of a subject is provided with a distal housing having an end effector, and an elongate member configured to introduce the distal housing to a target tissue site of the subject. The elongate member may have proximal and distal portions interconnected by a joint mechanism that is configured to allow the two portions to articulate relative to one another. In some embodiments, the joint mechanism includes one or more nested crown gear(s) configured to drive associated spur gear(s) to accomplish the articulation. In some embodiments, the end effector is a powered scissors device.

A medical device is disclosed. The medical device includes a handle configured to be grasped by a human hand, and an elongate obturator coupled to the handle. The obturator includes a proximal end proximate the handle and a distal end extending away from the handle. The distal end of the obturator includes a tip configured to pierce a body. The medical device also includes a vibration generating device coupled to the obturator. The vibration generating device is configured to induce a vibration having a frequency and an amplitude on the obturator.

Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve. Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted to restore the normal angular relationship of the vertebrae adjacent to that disc space. An extended outer sleeve having extended portions capable of maintaining the vertebrae distracted in their normal angular relationship is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

A surgical cutting and fastening instrument that includes an elongate channel that is attached to a handle assembly by an elongate shaft assembly. The elongate channel is configured to receive a cartridge and has a pivotally translatable anvil attached thereto and a knife bar supported therein. The anvil may be selectively opened and closed by manipulating a closure trigger supported by the handle assembly. The knife bar may be distally advanced through the elongate channel by actuating a firing trigger that cooperates with a reversible rotary drive supported by the handle assembly. The knife bar may also be retracted to its starting position by actuating the firing trigger after the reversible rotary drive has been shifted to a retraction orientation.

Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

A surgical system includes an instrument driver having a distal end positionable in a body cavity and a user input device. The instrument driver and user input device are positioned to removably receive distal and proximal portions, respectively, of a surgical instrument. The user input device is configured to generate movement signals in response to manual manipulation of the proximal portion of the surgical instrument. At least one motor operable to actuate the instrument driver in response to the movement signals and to thereby change position of the distal portion of the surgical instrument within the body cavity.

An image guided navigation system for navigating a region of a patient includes an imaging device, a tracking device, a controller, and a display. The imaging device generates images of the region of a patient. The tracking device tracks the location of the instrument in a region of the patient. The controller superimposes an icon representative of the instrument onto the images generated from the imaging device based upon the location of the instrument. The display displays the image with the superimposed instrument. The images and a registration process may be synchronized to a physiological event. The controller may also provide and automatically identify an optimized site to navigate the instrument to.

An apparatus for detection and quantitation of an electrochemically-detect- able analyte, such as glucose, in blood or interstitial fluid includes a meter unit, a lancet and an electrochemical sensor. Of these components, the meter is preferably reusable, while the lancet and the electrochemical sensor are preferably incorporated in assemblies intended for single-use. The meter unit has a housing, within which a lancet is engaged with a mechanism for moving then lancet; a connector disposed within the housing for engaging an electrochemical sensor specific for the analyte and transmitting a signal indicative of the amount of analyte, and a display operatively-associated with a connector for displaying the amount of the analyte to user. The electrochemical sensor is adapted for detection of a particular analyte. In addition, the electrochemical sensor has an absorptive member for uptake of a sample of blood or interstitial fluid. In one version, the lancet moves from a initial position to a piercing position in which skin of the user is pierced and optionally back to a retracted position. The electrochemical sensor is disposed such that the absorptive member takes up a sample from the pierced skin of the user when it is pierced by the lancet without movement of the apparatus. In an alternative version, the lancet is a hollow cannula through which blood or interstitial fluid is transported from the puncture site to an absorbent portion of the electrochemical sensor. In either version, the apparatus provides single-step operation in which sample acquisition and analysis occur as a result of the single action of pressing the apparatus against the users skin.

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

Disclosed is an ultrasonic surgical instrument that combines end-effector geometry to best affect the multiple functions of a shears-type configuration. The shape of the blade is characterized by a radiused cut offset by some distance to form a curved geometry. The cut creates a curved surface with multiple asymmetries causing multiple imbalances within the blade. Imbalance due to the curve of the instrument is corrected by a non-functional asymmetry proximal to the functional asymmetry. Imbalance due to the asymmetric cross-section of the blade is corrected by the appropriate selection of the volume and location of material removed from a functional asymmetry. The shape of the blade in one embodiment of the present invention is characterized by two radiused cuts offset by some distance to form a curved and potentially tapered geometry. These two cuts create curved surfaces including a concave surface and a convex surface. The length of the radiused cuts affects, in part, the acoustic balancing of the transverse motion induced by the curved shape.

A method of securing tissue is provided. The method includes obtaining a section of tubing, sizing the section of tubing to a desired length, securing the section of tubing to a connector member, securing the connector member to an end effector of a surgical instrument, guiding the end effector to a target location using the section of tubing, and performing a surgical procedure with the end effector.

Systems and methods for delivering material into bone deploy a cannula through soft tissue to establish a subcutaneous path into bone. A material is introduced into bone through the cannula. The systems and methods advance a tamping instrument through the cannula to urge material residing in the cannula into bone. The introducing step delivers material at a pressure no greater than about 360 psi.

Apparatus and methods are provided for delivering a guidewire, agents, and the like through an occlusion in a body vessel or other body lumen. The apparatus includes a flexible catheter or other elongate member including a proximal end, a distal end sized for insertion into a body lumen, and a first lumen extending from the proximal end to a distal region of the tubular member. An expandable sheath is provided on the distal region of the catheter that is expandable from a contracted condition to minimize a profile of the sheath to allow insertion along with the tubular member into a body lumen, to an enlarged condition wherein the sheath at least partially defines a lumen communicating with and extending distally from the first lumen of the tubular member.

A flexible spinal fixation device having a flexible metallic connection unit for non-rigid stabilization of the spinal column. In one embodiment, the fixation device includes at least two securing members configured to be inserted into respective adjacent spinal pedicles, each securing member each including a coupling assembly. The fixation device further includes a flexible metal connection unit configured to be received and secured within the coupling assemblies of each securing member so as to flexibly stabilize the affected area of the spine.

A surgical instrument for being endoscopically or laparoscopically inserted into a surgical site for simultaneous stapling and severing of tissue includes an elongate channel that is configured to operably support a staple cartridge therein. An anvil is coupled to the elongate channel and is configured to interact therewith such that at least a mounting portion of the anvil can seatingly engage corresponding portions of the elongate channel at any one of a discrete number of predetermined locations to adjust a tissue clamping space between the anvil and the elongate channel in response to a thickness of tissue received between the elongate channel and the anvil and application of a closing motion to the anvil.

Implantable devices and methods for delivering drugs and other substances to locations within the body of a human or animal subject to treat or diagnose sinusitis and a variety of other disorders. The invention includes implantable substance delivery devices that comprise reservoirs and barriers that control the rate at which substances pass out of the reservoirs. The delivery devices may be advanced into the body using guidewires, catheters, ports, introducers and other access apparatus. In some embodiments the delivery devices may be loaded with one or more desired substance before their introduction into the body. In other embodiments the delivery devices are loaded and/or reloaded with a desired substance after the delivery device has been introduced into the body.

Apparatuses and methods for debulking a tissue in a patient's body are disclosed herein. In one variation, an apparatus includes a cannula configured to provide percutaneous access to an interior portion of a tissue. The cannula has a distal portion, a proximal portion, and a lumen defined between the distal portion and the proximal portion. A flexible member is coupled to the cannula and configured to steer the distal portion of the cannula within the tissue. An elongate body has a distal portion and is configured to be movably disposed within the lumen of the cannula. The distal portion of the elongate body defines a cutting portion configured to disrupt at least a portion of the tissue when the cutting portion is moved, for example, rotated and/or shuttled. In one variation, the disrupted portion of tissue includes a portion of a tumor.

Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point. Adjustable anchor assemblies, as well as anchor delivery systems, are also provided.

Various embodiments of a laparoscopic trocar assembly are disclosed. The port assemblies include inserted parts that protect the patient's tissues at the point of deployment. The port assemblies include seals for maintaining pneumoperitoneum both when instrument are being used and when instruments are not inserted.

An excisional biopsy system includes a tubular member that has a proximal end and a distal end in which one or more windows are defined. A first removable probe has a proximal portion that includes a cutting tool extender and a distal portion that includes a cutting tool. The first removable probe may be configured to fit at least partially within the tubular member to enable the cutting tool to selectively bow out of and to retract within one of the windows when the cutting tool extender is activated. A second removable probe has a proximal section that includes a tissue collection device extender and a distal section that includes a tissue collection device. The second removable probe may also be configured to fit at least partially within the tubular member to enable the tissue collection device to extend out of and to retract within one of the windows when the tissue collection device extender is activated. A third removable probe may also be provided. The third removable probe may also be configured to fit at least partially within the tubular member and may include an imaging device, such as an ultrasound transducer, mounted therein. By selectively activating the cutting tool and the tissue collection device while rotating the excisional device, a tissue specimen may be cut from the surrounding tissue and collected for later analysis.

The invention is directed to a hand access system that provides hand access to a surgical area while maintaining pneumoperitoneum during laparoscopic surgery. The hand access system comprises a sheath retractor adapted to dilate a wound stretchable to a desired diameter, the sheath retractor includes a first ring being adapted for disposition interiorly of the wound, a second ring being adapted for disposition exteriorly of the wound, and a sheath being disposed in a generally cylindrical form between the first ring and the second ring and operable to exert a radial retraction force on the wound. The hand access system further comprises a detachable hand seal adapted to be removable from the second ring of the sheath retractor. The sheath retractor may be formed of an elastomeric material, and the hand seal may be formed of a gel material and includes a slit providing an instrument seal in the presence of an instrument or hand and a zero seal in the absence of the instrument or hand. In another aspect, there is disclosed a surgical access device adapted for disposition relative to an incision in a patient comprising a valve including a plurality of overlapping sheets defining an access channel, and a ring having an inner diameter for holding the valve by fixing each of the overlapping sheets along a portion of the perimeter, the access channel extends into communication with the incision in the patient. Each of the overlapping sheets includes a portion of the perimeter that is not fixed to the inner diameter of the ring, which provide open edges defining the access channel. The open edges slightly overlap at the center of the ring. The open edges may have different shapes including at least one of a straight edge, concave, convex and a cross-configuration. The hand access device may further comprise a septum seal formed at the proximal and distal ends of the ring.