Abstract: The present invention provides methods, devices, and systems for supporting the urethra in a patient to treat urinary incontinence. Support of the urethra involves forming a loop under the urethra with a structure referred to as a urethral support and applying an upward force with the support to hold the urethra in a more desired position. The present invention utilizes the space of Retzius within which portions of the urethral support are positioned. Ingrowth by surrounding tissues to the urethral support material provide further stability and such ingrowth, combined with the position of the support, allow sufficient tension to be applied to support to hold the urethra in place. Placement of such a urethral support is achieved by minimally invasive techniques, such as with the use of laparoscopic instruments. Such techniques allows placement of the urethral support by accessing the space of Retzius through the vaginal wall without penetrating the abdominal wall.

Abstract: A heart stabilizer that may include a wrist which couples an end effector to a first linkage. The end effector and wrist may be inserted through an incision in the chest of a patient to assist in performing a minimally invasive coronary procedure. The wrist provides dexterity so that the end effector can be placed on the heart to stabilize the same. The end effector may include a pair of paddles that are moved between open and closed positions by a pair of manually actuated levers. The paddles may have cleats that allow sutures to be attached to the stabilizer during a minimally invasive procedure.

Abstract: The invention provides laser eye surgery devices, systems, and methods which measure the refractive error in the eye before, during, and/or after vision correction surgery. The invention allows adjustments during the vision correction operation, and allows qualitative and/or quantitative measurements of the progress of photorefractive treatments by projecting and imaging reference images though the cornea and other components of the ocular optical system. A slope of an image quality value such as an Optical Transfer Function may be monitored during the procedure to help determine when to terminate treatment.

Abstract: Improved systems, devices, and methods are provided for verifying the scanning motion or adjustment of a laser beam. The system can advantageously be used in laser eye surgery where accurate control of the laser beam is crucial for patient safety and successful vision correction. In one embodiment, a laser system is provided for sculpting a portion of the eye. The system includes a laser for generating a laser beam suitable for ablation of a portion of the eye. A laser beam adjustment mechanism is optically coupled to the laser beam from the laser. The adjustment mechanism scans or adjusts the laser beam in accordance with a predetermined ablation pattern of the laser beam on the eye. An energy motion sensor optically coupled to the laser beam downstream from the adjustment mechanism is provided to verify adjustment of the laser beam in accordance with the ablation pattern. Typically, the energy motion sensor has a mask arranged to block varying portions of the laser beam in response to laser beam adjustment.

Abstract: Devices, systems, and method for treating urinary incontinence generally relying on energy delivered to a patient's own pelvic support tissue to selectively contract or shrink at least a portion of that pelvic support tissue so as to reposition the bladder. The energy will preferably be applied to the endopelvic fascia and/or an arcus tendineus fascia pelvis. A variety of devices and methods are provided for applying gentle resistive heating of these and other tissues to cause them to contract without imposing significant injury on the surrounding tissue structures. By applying sufficient energy over a predetermined time, the tissue can be raised to a temperature which results in contraction without significant necrosis or other tissue damage. By selectively contracting the support tissues, the bladder neck, sphincter, and other components of the urinary tract responsible for the control of urinary flow can be reconfigured or supported in a manner which reduces urinary leakage.

Abstract: Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

Abstract: The present invention provides methods and devices for grasping, and optional repositioning and fixation of the valve leaflets to treat cardiac valve regurgitation, particularly mitral valve regurgitation. Such grasping will typically be atraumatic providing a number of benefits. For example, atraumatic grasping may allow repositioning of the devices relative to the leaflets and repositioning of the leaflets themselves without damage to the leaflets. However, in some cases it may be necessary or desired to include grasping which pierces or otherwise permanently affects the leaflets. In some of these cases, the grasping step includes fixation.

Abstract: A capillary array electrophoresis (CAE) micro-plate with an array of separation channels connected to an array of sample reservoirs on the plate. The sample reservoirs are organized into one or more sample injectors. One or more waste reservoirs are provided to collect wastes from reservoirs in each of the sample injectors. Additionally, a cathode reservoir is also multiplexed with one or more separation channels. To complete the electrical path, an anode reservoir which is common to some or all separation channels is also provided on the micro-plate. Moreover, the channel layout keeps the distance from the anode to each of the cathodes approximately constant.

Abstract: A method, apparatus and system for a transverse tracker is described that can greatly improve the accuracy, speed, range, reliability, versatility, safety, and efficacy of interventions such as laser microsurgery, particularly ophthalmic surgery, and industrial micromachining. The instrument and system disclosed are applicable to those situations wherein the positioning accuracy of laser lesions is critical, and/or whenever precise operations on a target or series of targets subject to random movement during a procedure are to be effected. The present invention provides means for stabilizing the motion of targets in a plane perpendicular to the axial direction, thus allowing an imaging system, diagnostics illumination, and/or laser beam to maintain a lock on the target area, regardless of its movement.

Abstract: The present invention provides a robotic surgical tool for use in a robotic surgical system to perform a surgical operation. The robotic surgical tool includes a wrist mechanism disposed near the distal end of a shaft which connects with an end effector. The wrist mechanism includes a distal member configured to support the end effector, and a plurality of rods extending generally along an axial direction within the shaft and movable generally along this axial direction to adjust the orientation of the distal member with respect to the shaft. The distal member has a base to which the rods are rotatably connected by orthogonal linkage assemblies. Advancement or retraction of a first rod generally along the axial direction tips the base through a first angle so that the distal member faces a first articulated direction, such as to provide pitch.

Abstract: Improved systems, devices, and methods are provided for verifying the scanning motion or adjustment of a laser beam. The system can advantageously be used in laser eye surgery where accurate control of the laser beam is crucial for patient safety and successful vision correction. In one embodiment, a laser system is provided for sculpting a portion of the eye. The system includes a laser for generating a laser beam suitable for ablation of a portion of the eye. A laser beam adjustment mechanism is optically coupled to the laser beam from the laser. The adjustment mechanism scans or adjusts the laser beam in accordance with a predetermined ablation pattern of the laser beam on the eye. An energy motion sensor optically coupled to the laser beam downstream from the adjustment mechanism is provided to verify adjustment of the laser beam in accordance with the ablation pattern. Typically, the energy motion sensor has a mask arranged to block varying portions of the laser beam in response to laser beam adjustment.

Abstract: An ophthalmic surgery system and method for treating presbyopia by performing ablative photodecomposition of the corneal surface. A laser system ablates tissue to a predetermined ablation shape, and the cornea heals significantly to form a multifocal shape correcting presbyopia. The multifocal shape corrects for near-vision centrally and far-vision peripherally. The system and method enables wide area treatment with a laser having a narrower beam than the treatment area, and can be used in the treatment of many conditions in conjunction with presbyopia such as hyperopia, hyperopic astigmatism and irregular refractive aberrations.

Abstract: Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

Abstract: The invention improves the laser sculpting of a region of a material to a predetermined shape by improving the smoothness and accuracy of surfaces formed by the sculpting technique. The technique includes projecting plurality of partially overlapping beams toward the region. The invention includes blurring an edge of an ablation to smooth an internal portion of the ablation that is separate from the edge. The blurred edge may be formed by the partially overlapping beams. Using a computer controlled laser delivery system, the position and shape of the overlapping beams may be precisely controlled to sculpt the material to a desired shape according to a laser treatment table.

Abstract: Traditional orthodontic treatment often involves the use of basic repositioning devices, such as braces, and the use of supplementary devices, components or accessories to achieve desired end results. Such components may be mounted on fixed, non-removable devices or they may be part of a removable appliance typically worn prior to the application of the fixed devices. As with traditional treatment, it may be desired to utilize similar components when repositioning teeth with removable elastic repositioning appliances. Due to the nature of elastic appliances, such components may take a variety of forms ranging from readily available traditional accessories to specially created devices. Thus, traditional components may be mounted on or embedded in an elastic appliance, or the appliance may be formed to provide similar components. Likewise, the appliance may be modified to provide additional features for specific orthodontic treatments.

Abstract: Improved laser eye surgery and/or eye tracking systems, methods, and devices make use of two image capture devices, generally with both image capture devices disposed off the optical axis of the eye and/or any laser delivery system. This provides an enhanced imaging contrast for an imaging capture device such as a camera with a charge-couple device (CCD), particularly when using infrared imaging to track a pupil of the eye. The two off-axis cameras may be used independently to track movements of the pupil along two orthogonal lateral axes of the eye (often called X-Y tracking), and may also indicate a position of the eye along the optical or Z axis.