A surgical device for stapling and fastening body tissues, comprises an insertion section extending from an operation section for insertion into a body cavity, stapling member connected to a distal end of the insertion section, for treating body tissues with a high-frequency current within a body cavity. The stapling member includes an anvil and a cartridge between which the tissues are sandwiched, and a cutter. Staples are applied to the anvil from the cartridge for stapling the tissues and the cutter cuts the tissue while it applies a high-frequency current thereto.

Surgical device for stapling and fastening body tissues

A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.

Medical probe device and method

An acoustic imaging system for use within a heart has a catheter, an ultrasound device incorporated into the catheter, and an electrode mounted on the catheter. The ultrasound device directs ultrasonic signals toward an internal structure in the heart to create an ultrasonic image, and the electrode is arranged for electrical contact with the internal structure. A chemical ablation device mounted on the catheter ablates at least a portion of the internal structure by delivery of fluid to the internal structure. The ablation device includes a material that vibrates in response to electrical excitation, the ablation being at least assisted by vibration of the material. The ablation device may alternatively be a transducer incorporated into the catheter, arranged to convert electrical signals into radiation and to direct the radiation toward the internal structure. The electrode may be a sonolucent structure incorporated into the catheter, through which the ultrasound device is arranged to direct signals. An acoustic marker mounted on the catheter emits a sonic wave when electrically excited. A central processing unit creates a graphical representation of the internal structure, and super-imposes items of data onto the graphical representation at locations that represent the respective plurality of locations within the internal structure corresponding to the plurality of items of data. A display system displays the graphical representation onto which the plurality of items of data are super-imposed.

Catheters for imaging, sensing electrical potentials and ablating tissue

In an electrosurgical generator for generating radio frequency power, the generator includes a radio frequency output stage having two or more output connections, and a power supply coupled to the output stage for supplying power to the output stage. A controller is operable to cause the generator to supply a blended output signal alternating constantly between a first output signal across the output connections in which the radio frequency output voltage developed across the output connections is limited to at least a first predetermined threshold value for cutting or vaporisation of tissue, and a second output signal across the output connections in which the radio frequency output voltage developed across the output connections is limited to a second threshold value for coagulation. There is also provided adjustment means, operable by a user of the electrosurgical generator, for changing between various preset settings for the blended signal, the preset settings each having a predetermined duty cycle of the blended signal that is limited to the first threshold value for cutting or vaporisation, and a predetermined duty cycle of the blended signal that is limited to the second threshold value for coagulation.

Electrosurgical generator and system

Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart. Elongated instruments may be introduced through the tubular access device into an interior chamber of the heart to perform procedures such as septal defect repair and electrophysiological mapping and ablation. A method of septal defect repair includes positioning a tubular access device percutaneously through an intercostal space and through a penetration in a muscular wall of the heart, passing one or more instruments through an inner lumen of the tubular access device into an interior chamber of the heart, and using the instruments to close the septal defect. Devices and methods for closing the septal defect with either sutures or with patch-type devices are disclosed.

Method and apparatus for thoracoscopic intracardiac procedures

A catheter includes a flexible elongated catheter body that defines a needle-receiving, or probe-receiving, lumen, a retractable tissue-penetrable needle, or probe, and an electrode mounted on the distal portion of the catheter body. The needle provides a fluid passage for introducing fluid into tissue to permit the introduction of sclerotic agents for enhancing electrocoagulation of the tissue, heat-responsive drugs for improving the bonding to tissue surfaces, or vaso-constrictor drugs. The probe can also have a passage for fluid. The electrode can provide bipolar electro-coagulation of tissue in combination with an additional electrode mounted on the catheter body, or alternatively, the electrode can be employed in combination with either the needle or probe to establish a bipolar electro-coagulation path through tissue. The needle, or probe, in combination with an external electrode can be used to provide unipolar electro-coagulation, or ablation. In certain instances, the electrode can be used to provide a mapping function inside cardiac chambers.

John E. Abele

Papers

Electro-coagulation and ablation and other electrotherapeutic treatments of body tissue