Abstract: A surgical clip applier includes a housing, a pair of handles pivotably connected to opposite sides of the housing, a channel assembly which is anchored to the housing and a jaw assembly which is anchored to the channel assembly. The jaws are opened and closed by a cam plate which is slidably positioned in the channel assembly and is provided with cam slots at its distal end to engage drive rivets positioned on the jaw members. A pusher bar assembly is also provided to feed clips from a series of clips to the jaw mechanism, and the instrument operates such that all moving components move in the same direction during the closing stroke of the handle, and then move in the same direction opposite to the closing direction when the handles are in the opening stroke. A novel lockout mechanism is also provided to render the instrument inoperable after all the clips have been utilized from the instrument.

Abstract: An orthopaedic bone plate is coupled to a bone having an enlarged head at one end thereof which is attached to a shaft. The bone plate includes an elongate portion, a flared portion and an intermediate portion. The elongate portion is attachable to the bone shaft using a plurality of bone screws. The elongate portion generally defines a longitudinal axis. The flared portion is attachable to the bone head using at least one bone screw. The intermediate portion interconnects the elongate portion and the flared portion. The intermediate portion is structured and arranged to allow the elongate portion and the flared portion to move relative to each other in a direction transverse to the longitudinal axis when the elongate portion and the flared portion are attached to the bone.

Abstract: A method of suturing using a suture with an attached needle includes placing the suture at a desired site to be sutured by passing the needle from a first member of a suture passing forceps to a second member of the forceps. The suture is then secured at the site by passing the needle through a suture receiving passage in an outer member of a suture securing device to position a portion of the suture therein, and inserting an inner member of the suture securing device into the passage to secure the portion of the suture between the inner and outer members. The needle is passed through the passage by threading the needle through a suture threader disposed in the passage, and pulling the threader from the passage. The suture threader has one end terminating in the needled suture and an opposite end terminating in a suture receiving loop.

Abstract: A balloon delivery system for deploying stents including a balloon catheter, and a stent fixedly positioned on the balloon portion of the balloon catheter by at least one protrusion such as annular cuff formed around the balloon. The balloon can include two or more continuous or discontinuous cuffs formed along the balloon which maintain one or more stents in position on the balloon. The protrusion can be created from excess material of the balloon which is configured in a desired fashion around the balloon to form the protrusion. The protrusion improves the fixation of the stent on the balloon catheter until the balloon is inflated to deploy the stent within a body lumen. The protrusion restrains the movement of the stent without a significant change in the overall profile of the balloon delivery system.

Abstract: A device is provided for cutting dowels from a bone mass which is easily disassembled for cleaning and sterilization. The dowel cutter includes an axial mounting member having a proximal end portion configured for engagement with a drill chuck and a distal end portion configured to receive a cylindrical cutting blade, an elongated supporting shaft having a distal end portion configured to support a drill guide, and a securement mechanism formed integral with the mounting member for releasably maintaining the relative orientation of the supporting shaft and the axial mounting member during utilization.

Abstract: A plurality of embodiments of a distal perfusion device are disclosed, which device facilitates anastomosis constructions by maintaining a dry anastomosis site while simultaneously maintaining blood flow distally in the blood vessel to prevent ischemia and reduce overall patient trauma. The perfusion device is configured for installation into a blood vessel such as a left anterior descending coronary artery through an incision therein, to which is to be grafted a distal end of a blood vessel such as an internal mammary artery. The device includes a central member of selected configuration and material, terminating at either end thereof in respective selectively tapered end members. A lumen extending through the central member and end members, and selected perforations in the end members, maintain blood flow through the perfusion device.

Abstract: A rod, screw, and staple assembly for use in conjunction with anterior or lateral spinal rod implant apparatus includes a screw having a vertebral body screw which has a shaft which is insertable into a vertebral bone and a head portion which includes a rod receiving channel and a radially extending flange. The vertebral body staple includes a flat portion which has a hole through it. The hole has a rim which is upwardly extending and a concave recess formed in the underside of the flat portion around the hole. The staple also includes several barbs which independently hold the staple to the bone surface to which it is to be affixed. The screw is first inserted into the vertebral bone, and then the staple is mounted over the head portion of the screw, such that the head extends above the annular rim. The rod is then inserted into the rod receiving channel and seats against the uppermost surface of the annular rim.

Abstract: A surgical instrument includes a forceps unit for being positioned within an anatomical cavity and an inner member having a biopsy tool. The forceps unit includes a housing, an outer tubular member, an intermediate member, and a handle mechanism coupled with at least one of the intermediate and outer tubular members for creating relative movement between the intermediate and outer tubular members. The outer tubular member has a proximal end mounted on the housing and terminates distally at a distal end. The intermediate member has a tubular body disposed telescopically within the outer tubular member, a proximal end mounted in the housing and an integral one-piece distal end defining a pair of opposed jaws resiliently biased apart such that relative movement of the outer tubular member distal end over the jaws causes the jaws to close.

Abstract: An endoscopic instrument includes a forceps unit for being positioned within an anatomical cavity and inner member having a blade. The forceps unit includes a housing, an outer tubular member, an intermediate member, and a handle mechanism coupled with at least one of the intermediate and outer tubular members for creating relative movement between the intermediate and outer tubular members. The outer tubular member has a proximal end mounted on the housing and terminates distally at a distal end. The intermediate member has a tubular body disposed telescopically within the outer tubular member, a proximal end mounted in the housing and an integral one-piece distal end defining a pair of opposed jaws resiliently biased apart such that relative movement of the outer tubular member distal end over the jaws causes the jaws to close. The inner member includes a tubular member removably disposed at least partly within the intermediate member and a blade for performing surgical functions.

Abstract: A method to surgically promote the fusion of bone segments together in order to correct bone malformations of the finger or toe involves making an incision in the finger or toe to expose the malformed digit; removing a portion of the malformed digit; forming a bore through each digit from the malformed digit through a tip of the finger or toe; forming a hole, that is aligned with the bore, in a proximal digit; enlarging the diameter of the bore relative to the hole; and inserting a bone screw having a head portion into the bore through the tip of the finger or toe and threadably attaching the bone screw within the hole in the proximal digit until each distal digit is compressed between the head portion of the bone screw and the proximal digit. A tracker member, having a terminal sleeve portion adapted to receive a tip of the bone screw, is provided to guide the screw into the bore through the tip of the finger or toe.

Abstract: A hypodermic needle of the present invention includes an elongate hollow tube with a proximal end, a distal end and has a bore therethrough. The proximal end of the needle of the invention has a hub fixedly attached thereto to connect the needle releasably to a fluid handling device with the distal end having a point for facilitating penetration of the needle into a patient's tissue. The outside surface of the tube has a proximal portion with a lower coefficient of sliding friction with the patient's tissue than the coefficient of sliding friction with the patient's tissue than a distal portion of the outside surface of the tube. The higher coefficient of friction of the distal portion enables a practitioner to substantially discriminate the needle's penetration of structures in the patient's tissue while the lower coefficient of friction proximal portion substantially reduces drag force for passage of the proximal portion through the structures already penetrated by the distal portion.

Abstract: A method and apparatus for autogenous transplantation of articular cartilage with bone from one site, such as in the knee, to another to treat chondral defects. Graft harvesters and recipient site harvesters create identically-sized donor graft osteochondral cores and recipient sockets. Collared pins disposed within the harvesters facilitate removal of the harvested cores. Windows formed in the side of the harvester tubes allow visualization of the graft, such as when being inserted into the recipient socket. A removable three-piece driver/extractor is provided to allow for impact-driving and depth control of the harvesters into the selected sites.

Abstract: A surgical instrument includes a forceps unit for being positioned within an anatomical cavity and inner member having a needle on a distal end thereof. The forceps unit includes a housing, an outer tubular member, an intermediate member, and a handle mechanism coupled with at least one of the intermediate and outer tubular members for creating relative movement between the intermediate and outer tubular members. The intermediate member has a tubular body disposed telescopically within the outer tubular member, a proximal end mounted on the housing and an integral one-piece distal end defining a pair of opposed jaws resiliently biased apart such that relative movement of the outer tubular member distally over the jaws causes the jaws to close.

Abstract: A blunt dissection cannula and method selectively isolate a vessel of interest within the body of a patient by dissecting connective tissue in and about the adventitial tissue plane. The procedure includes selectively advancing the cannula and transparent tapered tip along the vessel of interior to form an insufflated cavity along the course of the vessel while visualizing the vessel and side branches within the field of view of an endoscope through the transparent tip. An electrocautery electrode selectively extends through an access port at the distal end of the cannula, eccentrically relative to the transparent tip, to facilitate visualizing rotational and translational positioning of the electrode to contact and electrocauterize side branches within the field of view through the transparent tip.

Abstract: A device and method for the insertion and removal of an internal fracture fixation implant are disclosed. The device includes a slide rod having a tubular body with first and second ends and a bore for receiving the implant, a securing element located on the first end of the slide rod for maintaining the implant in the bore, a handle on the second end of the slide rod for manipulation of the device, and a slap hammer having a body member configured and dimensioned to be releasably and slideably connected to the slide rod so that displacement against the securing element results in impaction while displacement against the handle results in extraction of the implant. Removing the slap hammer from the slide rod when it is not needed facilitates use of the device. In a preferred embodiment, the slap hammer has a grip and the slap hammer body member has a channel for receiving the slide rod and at least one retaining element for maintaining the slide rod in the channel.

Abstract: A bone fastener including an expandable member having an axial channel and an elongated element insertable into the axial channel is described. The expandable member is configured to be insertible into a bore drilled in bone. The distal end of the expandable member also may include a structure for axially releasing the expandable member from an emplacement device that places the expandable member into a bone opening. In one embodiment, the structure for axially releasing includes a frangible membrane capable of being severed from the expandable member during emplacement of the expandable member in a bone opening.A rivet for coupling an object to bone for use with an expandable member is also described. The distal end of the elongated element is shaped into a radially projecting portion adapted for engagement with a washer that contacts the object to be coupled. The washer, having upper and lower surfaces and a bore defined between the surfaces, is disposed around a portion of the shaft.

Abstract: A polyaxial pedicle screw device for use with rod implant apparatus, which utilizes a rod mounted ferrule, includes a screw having a curvate head and a rod receiving body. The body has a rod receiving channel and an axial bore into which the head of the screw is inserted. The interior surface of the bore is inwardly curvate at the lower end thereof to form a socket for polyaxially retaining the curvate head of the screw. In an initial position the screw head remains polyaxially free with respect to the body. The rod mounted ferrule seats into a small curvate recess in the upper portion of the screw head such that the rod may enter the body at a variety of angles while maintaining a secure seating against the head of the screw. The insertion of a top set screw compresses down on the ferrule, locking the rod in position, and onto the screw head, locking it and the body in position, thus completely securing the assembly.

Abstract: Disclosed herein is a catheter device which is operably positionable for use in a biological conduit. The catheter device includes a catheter body having a proximal end and a distal end; a flexible housing; a work element and a sleeve. The housing connects to the distal end of the catheter body and holds the work element. The sleeve slidably mounts with housing for selectively reinforcing the housing to inhibit bending. Accordingly, the housing is normally flexible to facilitate insertion of the catheter device into a biological conduit. When the sleeve moves with respect to the housing, the sleeve reinforces the housing to facilitate operation of the work element.

Abstract: An improved valve utilizes a ball or sphere positioned within a housing which is movable by source of magnetic force external to the housing, the housing having a fluid inlet and a fluid outlet, and a sealing member positioned within the housing adjacent the fluid inlet or the fluid outlet. A modular control valve apparatus is provided having at least one or a plurality of valves in the housing, each having a fluid inlet and a fluid outlet, and a passage from a source of fluid or aspiration to an instrument or other device to direct and/or utilize the fluid or aspiration. Control is provided by including one or more pressure monitors, such as diaphragms positioned in recesses in a surface of the housing, coupled to passageways connected to passageways leading to fluid flow conduits. Variations in pressure in the conduits are transmitted from the diaphragm to a sensor such as a transducer to generate a signal, which activates a correcting electronic circuit which in turn controls a pump for a vacuum system.

Abstract: A surgical tack for use in surgical procedures. The surgical tack has a base member and a distally extending spiral member having a distal piercing point. The spiral member forms a spiral. The tack may be used to fasten tissue, sutures, or medical devices to tissue.