Other

Ethicon Endo-surgery, Inc.

Inbae Yoon

InBae Yoon

Samuel C Yoon

Suzanne J Yoon

Ronald J Brinkerhoff

Jai S Lee

David Stefanchik

William J Kraimer

Hal H Katz

Leo J Nolan

Jeffrey S Swayze

Bryan Dale Knodel

Rudolph Henry Nobis

Ronald John Kolata

John E Burbank, Iii

Delbert E Lucas

Ron J Brinkerhoff

Cynthia D Yoon

Donna R Motz

Kendall L Dobler

A multifunctional device for use in an endoscopically performed operative procedure of the type where a narrow portal is established through the skin to provide access to an operative site and the multifunctional device is introduced to the operative site through the narrow portal. The multifunctional device is formed of an absorbent material, preferably expandable, having a substantially rigid dry state prior to introduction to the operative site and a soft, flexible wet state after absorbing fluids. The absorbent material can be formed with a spine therein and the spine can be branched and tubular or solid. The multifunctional device can have a passage therethrough to accommodate laser, electrosurgical, biopsy or culturing instruments.

Apparatus for ablation of the endometrium of the uterus

An occlusion apparatus necrotizes an anatomical tissue structure which is disposed in a living body and has a plurality of vessels extending therefrom. The occlusion apparatus includes an elongated tubular member and an occluding mechanism. The tubular member extends along a central longitudinal axis to define a lumen and has a distal end positioned interiorly of the living body and a proximal end disposed opposite the distal end and positioned exteriorly of the living body. The occluding mechanism is operative at the distal end of the tubular member and includes a pair of occluding elements disposed opposite one another. The pair of occluding elements are moveable to and between an opened state and a closed state. In the opened state, the vessels to be occluded are received between the pair of occluding elements. In the closed state, the pair of occluding elements contact and occlude the vessels, thereby necrotizing the anatomical tissue structure. A method necrotizes the anatomical tissue structure and includes the steps of locating the anatomical tissue structure to be necrotized and the vessels extending therefrom, and occluding the vessels to prevent fluid flow into and out of the anatomical tissue structure, thereby causing ischemic necrosis of the anatomical tissue structure.

Occlusion apparatus and method for necrotizing anatomical tissue structures

A ring applicator for applying elastic rings to anatomical tissue during surgical procedures includes an inner member with a forceps movably disposed within a middle tubular member having a distal end configured to hold a plurality of elastic rings in an expanded state and a proximal end with a plurality of longitudinally spaced steps. The middle tubular member is movably disposed in an outer tubular member, and an adjustable stop mechanism is mounted on the proximal end of the outer tubular member to limit axial movement of the outer tubular member relative to the middle tubular member to select which rings are to be ejected. A distal handle is connected with the inner member via slots in the outer and middle tubular members, and a proximal handle is pivotally connected to the middle tubular member via a slot in the outer tubular member. A pusher has a distal end movable between a latched or locked position where the distal end of the pusher protrudes into apertures in the outer and middle tubular members to prevent pivotal movement of the proximal handle and an unlatched or unlocked position where the distal end of the pusher is disengaged from the aperture in the middle tubular member to permit pivotal movement of the proximal handle in order to move the outer tubular member axially relative to the middle tubular member to eject an elastic ring. Distal portions of the outer and middle tubular members are preferably transparent with scale markings formed thereon to allow the surgeon to accurately determine the length of the tissue disposed within the middle tubular member prior to ejecting a ring. A prerelease feature is also disclosed for unlocking the pusher to allow ejection of a ring when the forceps has not been completely withdrawn in to the middle tubular member.

Ring applicator and method for applying elastic rings to anatomical tissue structures

A surgical endoscopic instrument for visualizing anatomical tissue and including a tubular barrel carrying an endoscope with a CMOS image sensor and a physical parameter (e.g., temperature) sensor carried on the shaft. CMOS image sensors are fabricated on a single substrate or chip, with all of the required image signal processing circuitry, using the economical CMOS process. The CMOS image sensor is preferably mounted onto the distal end of the endoscope shaft and may include a light source for illuminating the field of visualization. In an alternative embodiment, the endoscope has a fixed objective lens carried on the distal end of a tubular body and a lens train or fiber optic bundle transmits the endoscopic image proximally to a CMOS sensor located in the hand piece. In the present invention, a single semiconductor substrate or chip has a CMOS imaging sensor with, preferably, a microprocessor and the associated signal processing circuitry for generating image signals for transmission to a display and to a data logging computer, outside the body. The surgical instrument carrying the CMOS image sensor preferably includes a distally mounted display, preferably a Liquid Crystal Display (LCD), mounted on a flexible stalk for convenient repositioning during a surgical procedure.

Surgical instrument endoscope with CMOS image sensor and physical parameter sensor

An apparatus and method delivers an expandable body member into a uterine cavity of a uterus through a cervical opening and deploys the expandable body member in the uterine cavity. The expandable body member in a compressed state is inserted into the uterine cavity. A fluid is provided to the uterine cavity at a pressure sufficient to inflate the uterine cavity. The expandable body member expands from the compressed state to the expanded state. After expansion of the expandable body member and inflation of the uterine cavity, the fluid pressure is relieved thereby collapsing the uterine cavity about the expandable body member in the expanded state such that an endometrial layer of the uterus and a surface of the expandable body member substantially contact each other in a facially opposing relationship maximizing contact therebetween. The apparatus which performs the method includes an elongated tubular member having the expandable body member connected to a distal portion of the elongated tubular member and a fluid-providing device connected to a proximal portion of the elongated tubular member.

Apparatus and method for delivering and deploying an expandable body member in a uterine cavity

A penetrating endoscope provides visualization of organ or tissue structures or foreign objects in a body. The penetrating endoscope includes an elongate penetrating member, a complementary metal dioxide semiconductor (CMOS) image sensor and an objective lens. The CMOS image sensor is substantially planar and includes a plurality of pixels with a pixel signal processing circuit for generating a color image ready signal. The CMOS image sensor converts image light energy into electrical color image ready signal energy for transmission out of the body. The color image ready signal is viewed on a color image display. The CMOS image sensor is carried on the elongate penetrating member adjacent a distal end of the elongate penetrating member. The objective lens is also carried on the distal end of the elongate penetrating member on an optical axis and focuses an image corresponding to an endoscope field of view at an image plane intersecting the optical axis. The CMOS image sensor is mounted with the CMOS image sensor pixels disposed substantially in the image plane and on the optical axis. The penetrating endoscope may include end effectors such as cutters and forceps.

Penetrating endoscope and endoscopic surgical instrument with CMOS image sensor and display

An ovarian capsule includes a capsule body enclosing an interior for receiving an ovary and defining a selectively openable, selectively closeable access. The access, when open, forms a gap, space or opening in the ovarian capsule through which an ovary is introduced in the interior. When the access is closed, withdrawal of the ovary from the interior is prevented whereby the ovary is encapsulated by the ovarian capsule to prevent fertilization of ova released by the encapsulated ovary. A method of encapsulating an ovary in the body of a patient includes the steps of introducing an ovarian capsule in the abdominal cavity of the patient, opening the ovarian capsule to provide access to the interior thereof, positioning an ovary of the patient within the interior of the capsule and closing the ovarian capsule to encapsulate the ovary and prevent withdrawal of the ovary from the ovarian capsule.

Ovarian capsules and methods of surgical contraception by ovarian encapsulation

A multifunctional device for use in an endoscopically performed operative procedure of the type where a narrow portal is established through the skin to provide access to an operative site and the multifunctional device is introduced to the operative site through the narrow portal. The multifunctional device is formed of an absorbent material, preferably expandable, having a substantially rigid dry state prior to introduction to the operative site and a soft, flexible wet state after absorbing fluids. The absorbent material can be formed with a spine therein of either a continuous or a discontinuous, segmented construction, and the spine can be branched and tubular or solid. The absorbent material can have portions or segments thereof expandable to different sizes to produce rounded protuberances to facilitate manipulation at the operative site and can have predetermined, non-straight configurations in the wet state, the predetermined configurations being controlled by the spine in the absorbent material or the method of forming the absorbent material. The multifunctional device can have a passage therethrough to accommodate laser, electrosurgical, biopsy or culturing instruments.

Method for ablating portions of the uterus

A surgical endoscopic instrument for operating on anatomical tissue includes a rigid barrel, a shaft extending through the barrel and an offset endoscope mounted on the shaft. The endoscope is offset from the longitudinal axis of the shaft by a transverse connecting member, thereby permitting the endoscope viewing end to move through an arcuate path outside the diametrical dimension of the barrel. During insertion of the instrument through a portal or the like, the offset endoscope can be positioned within a diametrical dimension of the surgical instrument, either by rotating the shaft or by drawing the shaft and the endoscope viewing end into the barrel in an axial manner. The offset endoscope may be aimed to provide an oblique field of view of a surgical procedure and may include an articulable ball joint having a solid state imaging sensor and light source; the ball joint imaging sensor aim is preferably articulable or controllable from the instrument proximal end using control members (e.g., wires) connected to handle-mounted control wheels. In an alternative embodiment, the offset endoscope has a fixed objective lens carried on the distal end of a rigid tubular body carried on a transverse connecting member. The fixed objective lens is preferably angled to aim along the transverse offset axis and generally toward the endoscopic instrument axis, to provide an oblique field of view of other surgical instruments used in other channels.

Surgical instrument with rotatably mounted offset endoscope

A safety penetrating instrument for penetrating an anatomical wall or a body lumen comprises an elongated penetrating member having proximal and distal ends. The distal end of the elongated penetrating member has a sharp or blunt tip for piercing the anatomical wall or penetrating the body lumen. A covering for the tip comprises an expandible sponge material having a first state with a first hardness and a second state with a second hardness less than the first hardness. Hydrating the covering material causes it to transition from the first hardness state to the second hardness state so that when the distal end of the elongated penetrating member passes from a position outside the anatomical wall or body lumen to a position inside the anatomical wall or lumen, the covering transitions from the first state to the second state to form a relatively soft protective member for the sharp or blunt tip. A method of safety penetration comprises the steps of covering the tip with an expandible sponge material and hydrating the covering during penetration of the anatomical wall or body lumen. The safety penetrating instrument may comprise a trocar with a portal sleeve, a cannula, needle, catheter or the like and may be provided with devices for optical viewing, imaging and/or sensing parameters, such as pressure, temperature, pH and other chemistry.

Safety penetrating instrument with expandible portion and method of penetrating anatomical cavity

An instrument for operating on anatomical tissue includes a barrel having at least one shaft. An end is offset from the shaft. In an insertion position, the end effector is confined within the diametrical dimension of the barrel at a distal end thereof. After insertion, the end effector can be manipulated to extend beyond the diametrical dimension of the barrel to provide a large working span in which tissue can be manipulated.

Method of using surgical instrument with rotatably mounted offset end effector

A packing device for use in endoscopic operative procedures is formed of an elongate strip of absorbent, preferably expandable material having a rigid, dry state of a size to permit passage through a narrow endoscopic portal to an internal operative site and having a soft wet state when body fluids are absorbed thereby such that the packing device exposes and isolates tissue to be treated and protects adjacent tissue at the operative site while, in the dry state, is sufficiently rigid to manipulate tissue. A method of packing an internal operative site during an endoscopically performed procedures includes inserting a rigid strip of absorbent, preferably expandable, material through a narrow endoscopic portal and positioning the strip of material at the operative site such that at least a portion of the strip of material absorbs body fluids to become soft and pliable.

Methods for performing endoscopic procedures

An expandable endoscopic portal for providing a passage through a body cavity wall includes a cannula comprising an absorbent member having a distal end for positioning in the body cavity, a proximal end for positioning external of the body cavity and a passage between the distal and proximal ends for receiving instruments. The absorbent member has a compressed dry state prior to introduction through the cavity wall and an expanded wet state when supplied with fluid upon introduction of the distal end in the body cavity. The absorbent member is rigid in the dry state to facilitate passage through the cavity wall and is soft in the wet state. The absorbent member has an initial cross sectional size in the dry state for introduction through an opening in the cavity wall corresponding in size to the initial cross sectional size. The absorbent member in the wet state has a cross sectional size greater than the initial cross sectional size to dilate the opening and/or form a seal along the thickness of the cavity wall. Instruments of various cross sectional sizes can be introduced in the body cavity through the passage in sealing relation. A method of establishing a passage through a cavity wall includes introducing an elongate absorbent member in an opening in the cavity wall with the absorbent member in a dry state such that the absorbent member extends longitudinally through the cavity wall and hydrating the absorbent member to place the absorbent member in a wet state to cause the absorbent member to expand radially within the opening.

Expandable endoscopic portal and methods therefor

An instrument and method for suturing anatomical tissue with a suture needle includes a barrel having two needle holders therein which can be manipulated from a proximal end of the barrel to cause the needle to pass through tissue and to pass the needle from one needle holder to the other. The needle holders are operative to move the needle through a path in a plane not perpendicular to a longitudinal axis of the barrel. The angle of the plane with respect to the longitudinal axis can be adjusted.

Suturing instrument with angled needle holder and method for use thereof

An instrument for operating on anatomical tissue includes a barrel having two or more driver therein which can be manipulated from a proximal end of the barrel. End effectors of each driver are offset from a rotatable shaft by a transverse arm. In an insertion position, the end effectors are confined within the diametrical dimension of the barrel at a distal end thereof. After insertion, the end effectors can be manipulated to extend beyond the diametrical dimension of the barrel to provide a large working span for manipulating tissue or performing other procedures on tissue.

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Phoenix, MD, United States of America

InBae Yoon