Abstract: Various embodiments of tool assemblies are provided having at least one rotary input coupling and at least one linear input coupling for allowing either a rotary output or a linear output (e.g., from a tool driver on a surgical robot) to activate at least one mechanism of the tool assembly. For example, mechanisms of the tool assembly can include a clamping assembly, a firing assembly, an articulation assembly, and a roll assembly. The clamping assembly can open and close jaws of an end effector, the firing assembly can translate a knife assembly through the end effector to fire staples and cut tissue, the articulation assembly can articulate the end effector, and the roll assembly can rotate the elongate shaft and/or the end effector.

Abstract: A system for removing a kidney stone from a ureter may include: an elongate, flexible, outer shaft having a distal end configured to be advanced into the ureter and a proximal end; an elongate, flexible, inner shaft extending through at least part of the outer shaft; an expandable stone retention member extending through at least part of the inner shaft and moveable along the longitudinal axis relative to the inner shaft; an elongate, flexible camera positioned coaxially within the retention member shaft, such that a distal end of the camera is located at or near a distal end of the inner shaft; and a handle coupled with the proximal end of the outer shaft, a proximal end of the inner shaft, and a proximal end of the retention member shaft.

Abstract: Apparatus and methods are provided for occluding blood vessels and other anatomical structures. Occlusion devices are delivered percutaneously and extraluminally through a small gauge needle and include expandable elements that are deployable on opposite sides of a target vessel to be occluded. When positioned about the vessel the elements are expanded and brought together to compress and occlude the vessel. Embodiments include those adapted for temporary as well as permanent use.

Abstract: Prostheses and methods of making the same are provided. The prosthesis has an internal branch configuration. A trough or branch opening is at least partially defined by a trough wall extending into a main lumen from a sidewall of the prosthesis. The internal branch extends from the trough within the main lumen towards one of the outflow end of the graft body in a helical, retrograde arrangement. Other arrangements are described. The prosthesis may include a scalloped fenestration having a width larger than the trough. The trough may be positioned along a tapered region of the prosthesis. The trough and internal branch may be made from the same graft material. The trough and internal branch, in addition to the main graft body, may be made from the same graft material.

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: Medical devices and methods for making and using medical devices are disclosed. An example system for delivering an implantable medical device includes an outer shaft and an inner catheter, each having a proximal end, a distal portion and a lumen extending therein, wherein the inner catheter extends within a portion of the outer shaft lumen. The system also includes an actuation shaft extending within a portion of the inner catheter lumen, wherein a distal end of the actuation shaft is coupled to the implantable medical device. The system also includes a guidewire shaft extending within a portion of the inner catheter lumen and a coupling component including a distal end region, a proximal end region and a length, wherein the actuation shaft and the guidewire shaft are coupled to the coupling component such that actuation of the coupling component translates the actuation shaft and the tubular guidewire shaft simultaneously.

Abstract: A medical device is disclosed for cutting substances inside a body lumen. The medical device includes: a drive shaft that is rotatable; at least one strut that is rotatably connected to a distal side of the drive shaft, the at least one strut extending along a rotation axis, and wherein a central portion of the at least one strut is bent so as to be expandable radially outwardly; and a support portion that is rotatably connected to the distal side of the drive shaft, and wherein the support portion is formed in a mesh shape and a tubular shape while including multiple gaps, at least a portion of which is positioned on a radially inside of the at least one strut, and which is expandable radially outwardly by a central portion in a direction extending along the rotation axis being bent.

Abstract: A stent delivery system includes a handle and an elongate catheter extending from the handle. The elongate catheter includes an inner member, an outer member mounted about the inner member and adapted for longitudinal movement relative to the inner member from an extended position to a retracted position and a stent mounted about the inner member. The stent delivery system also includes a thumbwheel mounted to the handle. The thumbwheel is adapted for rotational movement to cause corresponding movement of the outer member from the extended position to the retracted position. In some examples, the stent delivery system may include a lock member adapted to engage at least one of the outer member and the thumbwheel to prevent movement thereof when the lock member is secured relative to the handle.

Abstract: Surgical devices and methods of using the surgical devices are disclosed. The surgical devices generally include a trocar, a cannula releasably mounted on the trocar, and a propulsion system operatively connected to the trocar. The cannula includes a hub, and has a central opening through which the trocar extends. The propulsion system is operable to drive the trocar axially in a forward direction away from a proximal end of the surgical device.

Abstract: A surgical tool includes a drive housing, a closure tube that extends from the drive housing, an end effector arranged at an end of the closure tube and having opposing jaws, and a closure yoke mounted to the closure tube and having a projection extending therefrom. A gearing assembly includes one or more spur gears attached to a corresponding one or more drive shafts such that rotation of the one or more drive shafts correspondingly rotates the one or more spur gears, and a closure cam gear positioned to intermesh with the one or more spur gears and defining a profile that receives the projection. Rotating the one or more spur gears causes the closure cam gear to rotate, which causes the projection to traverse the profile, and the projection traversing the profile urges the closure yoke and the closure tube to linearly displace and thereby actuate the jaws.

Abstract: A trajectory guiding apparatus and one or more methods associated therewith for facilitating precision-guided alignment and implantation of a DBS therapy device in a patient. Orthogonally disposed first and second arcuate racks are independently actuatable by respective pinion drives, wherein the first arcuate rack is coupled to a base support and the second arcuate rack is operative to support a slider assembly arranged to accommodate an instrumentation column (IC) containing the therapy device. The first pinion drive is actuatable to cause a first curvilinear motion of the second arcuate rack including the slider assembly, the first curvilinear motion defined along a first arcuate path on a first perpendicular plane.

Abstract: Snare device with anti-skewing. In one embodiment, the snare device includes a core-wire. The core-wire is made of a superelastic material and includes a proximal portion of greater cross-sectional area and a distal portion of lesser cross-sectional area. The distal portion includes a looped shape in a relaxed state. A flexible coil is mounted around the core-wire and is straight in a compressed state. The distal ends of the core-wire and the coil are coupled together. The proximal end of the core-wire is coupled to a handle of an actuator, and the proximal end of the coil is coupled to a slide of an actuator, the slide being slidably mounted on the handle. The tensile strength of the coil multiplied by the cross-sectional area of the coil is greater than the upper plateau stress of the core-wire distal portion multiplied by the cross-sectional area of the core-wire distal portion.

Abstract: This invention is related to the device used in the valve sparing aortic root replacement which is a special operation aimed at the root of the main vessel—aorta originating from the heart or known as ‘David Procedure’ (Re-implantation technique) in the literature.

Abstract: A tool for use by a surgeon for coupling to a working channel port and for operating a sheath and wire including a basket device for capturing an object to be removed from a body. The tool includes a controller adapted to be coupled to the sheath and the wire for selectively controlling the position of the wire with respect to the sheath and for operating the basket device between a first, closed position and a second, open position, the controller including a base portion having a wire actuation unit including a movable plunger for coupling with the wire and for moving the wire with respect to the sheath; and a sheath control unit removably coupled to the wire actuation unit for independently controlling the position of the sheath. The controller is configured to longitudinally move the wire and operate the basket device to selectively open and close the basket.

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: A method is provided, including (1) identifying the subject as having mitral valve regurgitation; (2) during a medical procedure, in response to identifying the subject as having mitral valve regurgitation, implanting a prosthetic valve at a mitral valve site of the heart; and (3) during the same medical procedure, implanting a therapeutic septal device at a septum of the heart. Other embodiments are also described.

Abstract: Particular embodiments disclosed herein provide a surgical instrument comprising a device having a functional end configured to be inserted into a body part, a shaft coupled to a proximal end of the device, and a shaft housing configured to receive a distal end of the shaft and operable to move along a central axis of the shaft. The surgical instrument further comprises a tube coupled to the distal end of the shaft housing and configured to partially house the device such that the functional end of the device at least partially extends beyond the distal end of the tube. The surgical instrument further comprises a plurality of arcuate levers such that pressing one or more of the plurality of arcuate levers moves the shaft housing and the tube toward the functional end of the device, causing the tube to transition the device from a deactivated state to an activated state.

Abstract: A trajectory guiding apparatus and one or more methods associated therewith for facilitating precision-guided alignment and implantation of a DBS therapy device in a patient. A pivotally rotatable stage is pivotally coupled to a base support and a vertical support operative to support a slider assembly arranged to accommodate an instrumentation column (IC) containing the therapy device. A first gimbal drive is disposed between the pivotally rotatable stage and the base support, wherein the first gimbal drive is actuatable to cause a first pivotal motion of the slider assembly including the IC, the first pivotal motion defined along a first arcuate path pivoted around a first pivotal axis.

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: A system and method are provided for a guide system for guiding an interventional medical instrument toward a region of interest (ROI) along a predetermined trajectory path. The guide system comprises a base, an adjustment ring, and a plurality of guide blocks. The adjustment ring is configured to be selectively fixed in one of a plurality of rotational orientations with respect to the base. The plurality of guide blocks are each configured to be selectively fixed in one of a plurality of rotational orientations with respect to the adjustment ring and each include a guide hole. Each of the plurality of guide blocks include at least one of differing angles of trajectory or differing locations of the guide hole from others of the plurality of guide blocks to provide a selectable, predetermined location of the guide hole and angle of trajectory.