Abstract: A device suitable for guiding a trajectory of a surgical shunt or needle comprising two protractors on a curved frame configured to fit over, or attach to, the skull of a patient, wherein the two protractors are respectively oriented in a circular dimension and anterior-posterior/medio-lateral directions. A method for using the device to guide a surgical needle, probe, shunt or other instrument during surgery.

Abstract: Devices described herein include an actuated clot retrieval catheter system. The system includes a catheter having a frame disposed proximate the distal end of the catheter. The frame expands to form a seal with the inner wall of a vessel. In some examples, the frame also captures a clot for removal from the vessel. The frame is manufactured from a shape memory material that can be heat set into a predetermined shape. An electrical connection to an electronic circuit causes a current to run through the frame. The electrical resistance of the shape memory material causes the frame to heat and transition from a martensite to an austenite phase. When the frame is heat set into an expanded configuration, the current causes the frame heat and expand. When the frame is heat set into a closed configuration, the current causes the frame heat and collapse upon a clot.

Abstract: An endoscopic snare net comprises a net engaging a loop, such as by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners or a collared, free-floating slip tether or both thereof, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube, even if the loop is over-extended beyond the end of the tube.

Abstract: A surgical robotic instrument comprising: a shaft; an end effector element; an articulation connecting the end effector element to the shaft, the articulation comprising: a first joint driveable by a first pair of driving elements, the first joint permitting the end effector element to rotate about a first axis transverse to a longitudinal axis of the shaft; a second joint driveable by a second pair of driving elements; a pulley arrangement around which the second pair of driving elements is constrained to move, the pulley arrangement comprising: a first set of pulleys rotatable about the first axis; and a second set of pulleys proximal to the first set of pulleys and comprising a first pulley rotatable about a second axis, and a second pulley rotatable about a third axis parallel to and offset from the second axis; and a clevis unit comprising two arms supporting the pulleys of the pulley arrangement, and a pulley guard extending from one of the arms for guarding one of the first and second pulleys.

Abstract: The present invention relates to a tissue protection device for mitral valve cerclage annuloplasty and, more particularly to a tissue protection device for protecting tissues of the body (heart) during mitral valve cerclage annuloplasty that is performed on a mitral valve cerclage patient with mitral regurgitation. The tissue protection device for mitral valve cerclage annuloplasty of the present invention is a hollow cylindrical tube where cerclage sutures (10a, 10b) are inserted, in which a hole (22) is formed at a predetermined portion of the cylindrical tube so that a coronary sinus cerclage suture (10a) inserted in a coronary sinus comes out of the cylindrical tube, and a lower section from the hole is inserted into the tricuspid valve to protect tissues of the tricuspid valve and the ventricular septum.

Abstract: Surgical tools for use during scarless or near scarless surgical procedures. At least some of the surgical tools can include a handle portion and a working end removably connected to the handle portion.

Abstract: During a medical procedure, a transseptal fenestration is made at a septum of the heart and a shunt is implanted into the transseptal fenestration. During the same medical procedure, a transapical puncture is made into a left ventricle of the heart. A prosthetic valve is delivered via the transapical puncture and implanted at a mitral valve of the heart. Subsequently to delivering the prosthetic valve and making the transseptal fenestration, the transapical puncture is closed. Other embodiments are also described.

Abstract: A surgical instrument comprising an end effector configured to perform a plurality of end effector functions is disclosed. The surgical instrument further comprises a drive shaft which is both rotatable and translatable to drive the end effector functions.

Abstract: A surgical suturing system is disclosed. The surgical suturing system comprises a shaft comprising a shaft diameter, a firing drive, and an end effector extending distally from the shaft. The end effector comprises a needle track and a needle comprising suturing material attached thereto, wherein the needle is configured to be guided by the needle track and actuated by the firing drive through a firing stroke, and wherein the needle is movable along a needle path comprising a maximum capture width which is greater than the shaft diameter.

Abstract: A medical device is disclosed for collecting substances inside a body lumen. The medical device includes an elongated shaft portion; a filter portion that has multiple gaps, that is formed in a net shape, that is deformable to be in an expanded state where the filter portion has a basket shape so as to form a concave portion, and that is deformable from the expanded state to be in a contracted state where an opening end portion of the concave portion is contracted; and a support portion that is formed to include a gap larger than gaps of the filter portion and that includes an interlock portion interlocked with the opening end portion of the filter portion and a support side connection portion connected to the shaft portion.

Abstract: Systems and methods for tissue containment and retrieval are disclosed. The containment system includes a primary chamber interconnected with a secondary channel extending from the primary chamber. A tissue specimen is mobilized inside a body cavity and placed into the primary chamber through a first opening. The first opening is pulled through a first incision or orifice and the narrower secondary channel is placed at a second incision or orifice. A second opening at the end of the secondary channel permits observation via a scope inserted through the second opening of the tissue specimen in the primary chamber undergoing morcellation via the first opening. Other systems and methods for deployment, containment, debulking and sealing of the second opening to create a closed system for the safe retrieval of the tissue specimen are provided.

Abstract: A temporary diameter reduction constraint arrangement for a stent graft in combination with a stent graft is disclosed. The stent graft has a proximal end and a distal end and comprises a biocompatible graft material tube and a plurality of longitudinally spaced apart self-expanding stents fastened thereto, including at least an end stent and a plurality of intermediate stents. The constraint arrangement comprises: an elongate receiver extending longitudinally within the graft material tube; a first wire extending longitudinally along the graft material tube in a first serpentine pattern; and a second wire extending longitudinally along the graft material tube in a second serpentine pattern, wherein at least one of the first and second wires repeatedly loops over the receiver along a longitudinal length of the stent graft thereby securing the stent graft to the receiver. In one embodiment there is also a plurality of loops of thread to reduce the stent graft.

Abstract: Funnel-trap type delivery and/or retrieval devices for Inferior Vena Cava (IVC) filters or other medical implants are described in which the devices comprise two layers of braid with an axially support member. The support member may be interposed between braid layers or set inside the braid layers but interposed between heatset features. Delivery and/or retrieval devices, kits in which they are included, methods of use and methods of manufacture are all contemplated herein.

Abstract: A method of treating a vessel in a subject comprises the steps of advancing a device distally across a treatment zone in a vessel, wherein the device comprises an elongated catheter having a lumen and a distal end, and a radially expansive treatment element disposed in the lumen and configured for axial movement relative to the catheter; deploying the radially expansive treatment element proud of the distal end of the catheter to radially expand and circumferentially impress against the vessel lumen at a distal end of the treatment zone; and withdrawing the deployed radially expansive treatment element proximally along the treatment zone with the treatment element circumferentially impressed against the vessel lumen to mechanically and circumferentially denude the treatment zone of the vessel. The radially expansive treatment element is then recaptured into the lumen of the catheter, before the device is withdrawn from the treated vessel.

Abstract: A surgical instrument holder includes a carriage and a drive coupler. The carriage is configured for movable engagement to a surgical robotic arm. The drive coupler includes an outer member and a first gear rotatably disposed therein. The outer member extends from the carriage and defines a lateral slot configured for lateral receipt of a surgical instrument. The first gear defines a lateral slot and is rotatable within the outer member to a first position, in which the lateral slot of the first gear is in alignment with the lateral slot of the outer member such that a surgical instrument is receivable within the drive coupler through the lateral slots of the outer member and the first gear.

Abstract: In one embodiment, a delivery apparatus handle, such as for a mechanical heart valve frame can comprise an actuation knob with a toggle mechanism that can toggle the actuation knob from a first state in which the actuation knob is operable to cause the linear or rotational movement of multiple elements or sets of elements, such as tubes that are attached to, e.g., a mechanical heart valve frame to cause expansion or collapsing of the frame, to a second state in which only a single element or set of elements is moved, allowing for additional operations, such as, e.g., locking the frame and/or releasing it from the delivery apparatus.

Abstract: Provided is a robotic system that includes a surgical instrument with a wrist including an elongate shaft extending between a proximal end and a distal end, a wrist extending from the distal end of the elongate shaft, and an end effector extending from the wrist. The end effector may include a first jaw and a second jaw, the first and second jaw being moveable between an open position in which ends of the jaws are separated from each other, and a closed position in which the ends of the jaws are closer to each other as compared to the open position. The surgical instrument may also include a tube extending through the elongate shaft and the wrist, the tube having an outlet in fluid communication with a passage formed by an interior of the first and second jaws when the jaws are in the closed position.

Abstract: Certain aspects relate to systems, devices, and techniques for clot manipulation and removal. At least some of the devices for clot manipulation and removal can be robotically controlled. These devices can include one or more elongate members that can be robotically driven through a patient's vasculature. One such device can include a first elongate member that can serve as an access sheath, a second elongate member that can serve as a clot removal catheter, a third elongate member that can serve as a clot disruptor, and a fourth elongate member that can serve as a guidewire.

Abstract: A first part of an annuloplasty structure is anchored to an annulus of a valve of a heart by using a driver to screw a tissue-coupling element of a first anchor into a first site of the annulus, such that the tissue-coupling element enters cardiac tissue in a direction parallel to a central longitudinal axis of the driver through the distal end of the anchor driver. The same is subsequently done for second and third parts of the annuloplasty structure using second and third anchors at second and third sites of the annulus, mutatis mutandis. Between anchors, the driver is retracted out of the heart. Subsequently, the valve is treated by reducing a distance between the first site and the second site, and a distance between the second site and the third site, by tightening a flexible and elongate contracting member of the annuloplasty structure.

Abstract: Braid-balls suitable for aneurysm occlusion and/or parent vessel occlusion/sacrifice (e.g., in treating neurovascular defects) are disclosed. Especially for aneurysm treatment, but also for either one of the aforementioned treatments, the form of the ball is very important. In particular, the density of the device is paramount in applications where braid itself is intended to moderate or stop blood flow—allowing thrombosis within a volume formed by the ball.