Abstract:
A pneumatic tissue dissector 10 useful for cutting or dissecting living tissue during endoscopic or laparoscopic procedures includes a dissector tip 16 for exuding a flow of pressurized gas, an inlet arrangement 24 for controlling the flow of gas from the tip 16, and an exhaust system 30 for exhausting the gas exuded from the tip 16. The exhaust system includes an inlet 32 adjacent to the tip 16 and an outlet spaced from the inlet 32. The outlet 34 is operable in coordination with the inlet arrangement 24 and is capable of exhausting a flow of gas about equal to that exuded by the tip 16, ensuring that the pressure in the cavity in which the procedure is performed does not increase or fluctuate. The flow of pressurized gas from the tip 16 is preferably compatible with an insufflation cavity pressure of no more than about 15 mm Hg, and the inlet arrangement 24 preferably supplies gas to the tip 16 at a pressure of no more than about 50 psi. The dissector 10 preferably further includes a laparoscopic introducer sheath 68 which is shorter in length than the distance between the inlet 32 and the outlet 34.
Abstract:
A surgical tissue bag for percutaneously debulking large volumes of tissue contained within the bag. The tissue bag comprises two layers of material, an inner layer of a puncture-resistant material and an outer layer of moisture-proof material for containing cells and fluid therein. The bag material is foldable and flexible for insertion through an access sheath into the surgical site and for forming a gas-tight seal when extended through the access sheath or puncture site. A drawstring is attached to the open end of the bag to close the bag when the tissue is contained therein and pulled through the puncture site in the outer surface of the skin. After the closed open end of the bag is pulled through the puncture site, the closed end is fanned out against the outer layer of the skin, and a morcellator is inserted into the bag for debulking the large volume of tissue. The open end of the bag is continually fanned out to maintain a compact and tight containment of the tissue and fluid remaining in the bag. The morcellation process is continued until the entire volume of tissue is removed at which time the remaining portion of the bag is completely removed from the surgical site area.
Abstract:
A urological guidewire includes a core formed of a first metallic material and extending toward an end of the guidewire. A coil having a plurality of convolutions is disposed around the core at the end of the guidewire, the coil being formed of a second metallic material different than the first metallic material. A mechanical interlock is formed to inhibit separation of the different materials forming the coil and the core. The mechanical interlock may include an enlargement at the end of the core and a bonding material fixing the enlargement to the coil. The convolutions may include a penultimate convolution with a first radius of curvature and an ultimate convolution having a second, shorter radius of curvature to form a bridge. In this case, portions of the core can be bent back on themselves and directed over or around the bridge to form the mechanical interlock.
Abstract:
A surgical obturator adapted to penetrate a body wall includes an elongate shaft having an axis which extends between a proximal end and a distal end. A bladeless tip, disposed at the distal end of the shaft has an outer surface which extends to a blunt point The outer surface has a pair of side sections separated by an intermediate section The side sections extend from the blunt point radially outwardly with progressive positions proximally along the axis. These side sections include a distal portion in proximity to the blunt point, and a proximal portion in proximity to the shaft. The distal portion of the side section is twisted radially with respect to the proximal portion of the side section. The outer surface in radial cross section has the general configuration of a geometric shape which rotates in a first direction about the axis with progressive proximal radial cross sections along the axis.
Abstract:
An electrosurgical tool can be used to fuse tissue. The electrosurgical tool can include a jaw assembly, an elongate shaft, and a handle assembly. Actuation of the handle assembly can actuate the jaw assembly. The elongate shaft can be rotatable without disrupting electrical connection to the jaw assembly. The electrosurgical tool can include a cutting blade to separate fused tissue. The electrosurgical tool can also include a jaw assembly configuration or an exterior cutting electrode to improve surgical access with the tool.
Abstract:
An electrosurgical tool can be used for tissue dissection. The tool can include several electrodes positioned on a jaw assembly. The electrodes can be selectively connected to a power source in a cutting arrangement or a coagulation arrangement. Switching from the cutting arrangement to the coagulation arrangement can be provided by opening and closing a handle to actuate the jaw assembly.
Abstract:
Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.
Abstract:
A surgical access device is adapted for performing laparoscopic surgical procedures with at least one instrument passing through the surgical access device and through an incision in the abdominal wall of a patient with the abdominal cavity pressurized with an insufflation gas. The surgical access device comprises an access seal. The material of the access seal is adapted to form a seal to generally maintain insufflation pressure within the abdominal cavity. At least one opening is formed through the material of the access seal between a proximal portion and a distal portion of the access seal. The at least one opening when operatively disposed is in communication with the incision and forms a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The material of the access seal conforms to a surface of an instrument inserted through the working channel.
Abstract:
A surgical obturator adapted to penetrate a body wall includes an elongate shaft having an axis which extends between a proximal end and a distal end. A bladeless tip, disposed at the distal end of the shaft has an outer surface which extends to a blunt point The outer surface has a pair of side sections separated by an intermediate section The side sections extend from the blunt point radially outwardly with progressive positions proximally along the axis. These side sections include a distal portion in proximity to the blunt point, and a proximal portion in proximity to the shaft. The distal portion of the side section is twisted radially with respect to the proximal portion of the side section. The outer surface in radial cross section has the general configuration of a geometric shape which rotates in a first direction about the axis with progressive proximal radial cross sections along the axis
Abstract:
A surgical access device includes a single valve forming a seal with the body wall and providing an access channel into a body cavity. The valve has properties for creating a zero-seal in the absence of an instrument and an instrument seal with instruments. The valve can include a gel comprised of an elastomer and oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon. A method for making the surgical access device includes combining a gelling agent with oil, preferably in a molding process. A method for using the device includes creating an opening with the instrument. An organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity.