Abstract: Provided herein is a surgical instrument comprising a cap having a first and second aperture extending therethrough, a first extendable and retractable member having a distal end coupled to a first coupling, a first arm extending from the first coupling and pivotable with respect to the distal end of the first member, and a second arm connected to the first arm through a second coupling and pivotable, with respect to the first arm, a second extendable and retractable member having a distal end coupled to a third coupling, a third arm extending from the second coupling, the third arm pivotable, with respect to the distal end of the second member, and a fourth arm connected to the third arm through a fourth coupling and pivotable, with respect to the third arm, a first end effector connected to the second arm and a second end effector connected to the fourth arm.

Abstract: An ultrasonic surgical instrument that can be used in a robotic surgical system includes an end effector having an ultrasonic blade and a clamp arm pivotally secured relative to the ultrasonic blade. A shaft assembly extends proximally from the end effector and includes a tube, an acoustic waveguide received within the tube, and a sheath positioned between the acoustic waveguide and the tube to damp acoustic vibrations from the acoustic waveguide toward the tube. At least one sensor is positioned on at least one of the end effector or the sheath to measure a force applied at the end effector or the sheath as a measured force, respectively, and thereby provide real-time feedback of a non-clamping force applied against one of the ultrasonic blade or the clamp arm.

Abstract: An apparatus for guiding an elongated flexible instrument comprises a variable-length support assembly. The variable-length support assembly includes a first end, a second end, a plurality of support member pairs, and a plurality of eyelets configured to receive the elongated flexible instrument. Each support member pair comprises a first support member linked to a second support member, and each of the plurality of eyelets is movably coupled to at least one of the plurality of support member pairs along a longitudinal central axis between the first end and the second end. The variable-length support assembly is configured to selectively transition from a compressed configuration to an expanded configuration along the longitudinal central axis, and the plurality of eyelets are adapted to support the elongated flexible instrument as the elongated flexible instrument is advanced along the longitudinal central axis.

Abstract: An implantable embolic device having a stretch-resistant member passing therethrough that also serves as a tether for connecting the device to a delivery system. The stretch-resistant member is attached at a proximal and distal end of the device and extends proximally to the delivery device. The proximal attachment point serves to isolate a distal, stretch resisting segment of the member from axial tension placed on a proximal, connecting section of the member. Thus, the portion of the stretch-resistant member being used to connect the embolic device to a delivery device may be placed under tension without placing tension or distorting the implant.

Abstract: The steerable catheter invention facilitates the tracking and selection of branch vessels, as well as provide the means for stiffening the catheter body across the tortuosity to anchor the catheter and minimize the potential for the catheter backing out of position while delivering interventional devices to the distal anatomy.

Abstract: Flared stents are disclosed, and apparatus and methods for delivering such stents into a bifurcation between a main vessel and a branch vessel. The stent includes a first tubular portion a second flaring portion that may be flared radially outwardly to contact the ostium. The stent may include variable mechanical properties along its length. The stent may be delivered using a catheter including proximal and distal ends, the stent overlying first and second balloons on the distal end. During use, the catheter is advanced through an ostium into the branch to place the stent within the branch. The first balloon is expanded to flare the stent to contact a wall of the ostium, thereby causing the stent to migrate partially into the ostium. The second balloon is expanded to fully expand the stent within the ostium and branch.

Abstract: Surgical methods involving cutting and sealing tissue include affixing a first adjunct material to tissue at a treatment site, such as by stapling the adjunct to tissue. A second adjunct material is applied to at least a portion of the first adjunct material such that the second adjunct material interacts with the first adjunct material to form a seal in an area of the tissue covered by at least one of the first and the second adjunct material. The resulting tissue sealing structure, which includes a combination of the two adjuncts, is believed to be superior to the sealing properties of either adjunct alone.

Abstract: Systems and methods for creating autologous monocuspid and bicuspid valves can include a catheter having a single expandable element or a double expandable element. Once the leaflets of the valve are created, various techniques can be used to fix the leaflets to the vessel wall or to each other, including clips, tissue anchors, adhesives, and heat.

Abstract: The present disclosure describes implantable medical devices comprising covers, such as a balloon cover. Such devices can comprise a first layer of a porous polymeric material, such as ePTFE, surrounded by layers of a porous polymeric material having an imbibed elastomer, such as polyurethane. The cover can be used to assist in deployment of an expandable implant, such as a stent-graft, within the body of the patient.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes a tube extending axially along the catheter. A junction box housing is located at a distal end of the tube. An elongate body extends distally from the junction box housing. The elongate body is sized and shaped to be received in the body lumen. A gear assembly is disposed in the junction box housing. The gear assembly engages the elongate body for rotating the elongate body. A tissue-removing element is mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen.

Abstract: A system for treating uterine tissue having a seal assembly configured for positioning in a patient's cervical canal and uterine cavity; an expandable distal balloon portion; an expandable elongate medial balloon portion configured for movement between a first transversely expanded shape for engaging a cervical canal and a second transversely non-expanded shape for trans-cervical insertion; and a fluid source in communication with distal balloon portion and medial balloon portion for expansion of said balloon portions.

Abstract: A transcatheter heart valve includes a paravalvular seal that is configured for transfemoral delivery. The valve includes a frame and the seal is formed from a plurality of outwardly extending fibers.

Abstract: A lancing device including a latch that pivots between a non-blocking position allowing a lancet carrier and a lancet to advance and retract through a first forward and reverse lancing stroke and a blocking position preventing further/excess/secondary oscillation of the lancet carrier and lancet. The pivotal latch can pivot about an axis perpendicular (e.g., for an L-shaped latch) or parallel/coaxial (e.g., for a sleeve latch) to the advancement and retraction motion of the lancet carrier and lancet.

Abstract: A transcatheter heart valve includes a paravalvular seal that is configured for transfemoral delivery. The valve includes a frame and the seal is formed from a plurality of outwardly extending fibers.

Abstract: Some implementations provide a high-powered compact ultrasonic transducer having an integral piezoelectric ceramic force sensing element utilized to enable enhanced tissue selectivity with a piezoelectric based transducer. Some implementations additionally or alternatively relate to methods and apparatus for driving ultrasonic surgical devices, such as methods and apparatus that modulate an amplitude of a drive signal, provided to an ultrasonic surgical device, in accordance with a selected tissue selectivity level. For example, the amplitude of the drive signal for a given tissue selectivity level can be varied with time in accordance with amplitude modification parameters that are particularized to the given tissue selectivity level. Some of those implementations additionally implement a corresponding duty cycle, for the drive signal, that corresponds to the selected tissue selectivity level.

Abstract: Systems and methods for treating an afflicted vessel and/or vessel associated with an afflicted tissue of a mammalian patient are presented herein. In particular, devices for the control of flow rate and/or pressure within a vessel of a mammalian patient, and methods of treating an afflicted vessel and/or a vessel associated with an afflicted tissue using the devices are presented herein.

Abstract: A system for delivering an implant device to a vascular site in a patient a delivery pusher apparatus, an implant device detachably connected to the delivery pusher apparatus by a tether having a distal end connected to a proximal end of the implant device, wherein the tether is substantially non-tensioned when connecting the implant device to the delivery pusher, and an electrical heating element configured coaxially around at least a portion of the tether, wherein heat generated by the heating element severs the tether at a point near the proximal end of the implant device.

Abstract: The present disclosure relates to devices, systems and methods for endoscopic suturing or stitching through an access tube or the like. An endoscopic stitching device is provided and includes a handle assembly; an elongate shaft supported by and extending from the handle assembly; and an end effector supported on a distal end of the elongate shaft. The end effector includes a neck assembly configured and adapted for articulation in one direction between a substantially linear configuration and an off-axis configuration, and a pair of juxtaposed jaws pivotally associated with one another. Each jaw defines a suture needle receiving recess formed in a tissue contacting surface thereof.

Abstract: This disclosure details a surgical system and method, which is permits percutaneous insertion of anchors, and is useful in orthopedic surgical procedures involving fixation of soft tissue to bone. Because the anchors may be inserted percutaneously, the anchors can be inserted into bone without requiring a skin incision and without requiring a pre-drilled bone hole. As such, use of the disclosed system and method leads to a reduction in the number of steps in a surgical procedure, which reduces surgery time, while also reducing the size of openings formed in the skin relative to other known techniques, which reduces recovery times and results in smaller and less noticeable scarring.

Abstract: A device for closing an opening in a body lumen, the device having a first elongate member with a first lumen, a second elongate member distal the first elongate member, and a needle assembly slidably cooperating with the first elongate member to position a plurality of sutures within the lumen of the first elongate member. The needle assembly includes a needle base and a plurality of needle portions extending from the needle base. Slidable movement of the needle assembly in relation to the first elongate member locates the plurality of sutures selectively mounted to the needle assembly within the first lumen.