Abstract: The present invention provides minimally invasive devices and methods for accessing the sinuses and their surrounding structures for surgery and other treatments. The anterior ethmoid and maxillary sinuses are accessed and treated under minimal anesthesia with little or no postoperative limitation of activity or adverse symptoms. Direct visual verification of the sinuses and their natural ostia is utilized. Other paranasal sinuses may be treated by this method as well. The sinuses, in particular the maxillary and anterior ethmoid, are accessed via a direct anterior to posterior axis and the natural ostia of those sinuses is directly visualized for placement of a guide-free dilator, in the desired location within the natural ostia. That access to the maxillary ostium is accomplished by the anterior transuncinate “keyhole” approach in which a hole is punched in the uncinate process with the described devices according to the described methods.

Abstract: A tool bit (100) of an ultrasonic osteotome includes: an arbor (2); and an end portion (1) of the tool bit connected to a front end of the arbor (2). The end portion (1) of the tool bit has a spoon-like shape and has a toothed front edge. An ultrasonic osteotome including the tool bit is also provided.

Abstract: Example ways of forming double-bladed scalpels and constituent parts are described. In one aspect a sleeve for coupling two-conventional scalpels together to form a double-bladed scalpel is described. Also described are male and female fastening mechanisms disposed along the sides of two independent scalpels. Each scalpel may be used independently of the other, or mated together via the fasteners to form a single double-bladed scalpel. In another aspect, a bracket is used to form a double-bladed scalpel from two-conventional scalpels. In another example, a double-bladed scalpel with a single handle is described.

Abstract: Disclosed herein is a surgical instrument having a cylindrical tube affixed thereto. A guidewire can be threaded through the cylindrical tube to allow for advancement of the surgical instrument to a surgical site.

Abstract: A system and method for nerve decompression comprise a knife unit having a parallel upper limb and lower limb terminating proximally at the cap of the tubular sheath and a triangular shaped surgical cutting blade disposed vertically in between the upper limb and the lower limb. Upper limb and lower limb extend distally beyond the cutting blade and have open slots to facilitate proper positioning and engaging of the tissue while allowing visualization of less routing structure. The knife receives the probe head of an endoscope just behind cutting blade for proper visualization and illumination. The guiding system comprises a handle unit and a pair of parallel guides with long open slots that act as a cannula of adjustable diameter. The open slots on parallel guides facilitate 360 degree visualization of the surroundings and also prevent derailing of endoscopic knife unit while passing through it.

Abstract: A thrombectomy catheter system is disclosed which includes a catheter having an exhaust lumen, an infusion lumen and a high pressure tube. The high pressure tube includes a nozzle orifice for forming a high pressure jet of fluid for cutting occlusive material from within a body lumen. The nozzle orifice is positioned to direct the high pressure jet of fluid into the distal end of the exhaust lumen which creates a suctioning effect. The infusion lumen replaces fluid that is removed from the body lumen through the exhaust lumen by a suctioning effect created by the fluid jet.

Abstract: Disclosed are a tool bit of an ultrasonic osteotome and an ultrasonic osteotome including the same, the tool bit comprising: an arbour (2); and an end portion (1) of the tool bit connected to a front end of arbour (2), wherein the end portion (1) of the tool bit has a hook-like shape and includes a hook tip (11), a hook handle (13), as well as a hook-shaped interconnecting piece (12) which is interconnected between the hook tip (11) and the hook handle (13). The hook handle (13) is connected with the arbour (2), and the inner side edge of the hook-shaped interconnecting piece (12) is tooth-like. With this ultrasonic osteotome, the cutting efficiency is high and surgery time is short, therefore the labour intensity of medical workers is decreased. Moreover, accurate positioning can be realized in cutting process with no skidding, so the chance of success of surgery can be improved.

Abstract: An ultrasound system has a catheter including an elongate flexible catheter body having at least one lumen extending longitudinally therethrough. The catheter further includes an ultrasound transmission member extending longitudinally through the lumen of the catheter body, the ultrasound transmission member having a proximal end connectable to a separate ultrasound generating device and a distal and coupled to the distal end of the catheter body. The distal end of the catheter body is deflectable. The ultrasound system also includes a sonic connector that connects the ultrasound transmission member to an ultrasound transducer. The ultrasound system also provides a method for reverse irrigation and removal of particles.

Abstract: A medical balloon assembly includes a balloon fitted to a balloon catheter. The balloon includes a balloon wall (which is a co-extrusion) with ribs or strengthening elements including amorphous polymer material.

Abstract: A needle guide device for releasable mounting on an imaging transducer or on an adaptor bracket on an imaging transducer is disclosed. The needle guide device includes a universal lockable mounting member which is configured for slidable releasable engagement with a coupling member on a specially constructed imaging transducer or on a conventional imaging transducer onto which a specially constructed adaptor is mounted. The needle guide device makes use of a slidable mounting member to cooperate with the coupling member. The needle guide device is adjustable to establish various selectable angular trajectories for a needle and has a low profile form factor to result in the creation of a minimal blind zone when mounted on the transducer and even if establishing a large angle for shallow needle penetration.

Abstract: A holding arrangement for a surgical access assembly is disclosed. One holding arrangement includes a holder member and a support member configured to engage with the holder member. The support member supports an outer sheath of a surgical assembly. The support member is compatible with a magnetic resonance imaging device. Another holding arrangement includes a holder member configured to hold a medical or diagnostic device such as a catheter.

Abstract: A surgical instrument is disclosed having a proximal end and a distal end. The surgical instrument includes a hook portion arranged at said distal end for retracting tissue and/or organs during surgery. The surgical instrument further includes an elongate tube adapted for suction and/or irrigation, said tube extending essentially along a length of said surgical instrument.

Abstract: A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either device within the brain.

Abstract: One embodiment is directed to a system for deploying a device to a distal location across a vessel, comprising an elongate introducer sheath tubing member comprising open-cell fibrous wall material defining a lumen therethrough, wherein in a collapsed configuration the sheath has a first cross-sectional outer diameter and a first lumen inner diameter, and in an expanded configuration, the sheath has a second cross-sectional outer diameter and a second lumen inner diameter; and a substantially non-porous expandable layer coupled to a proximal portion of sheath and configured to prevent fluids present in the lumen from crossing the fibrous wall material. Also disclosed is a delivery assembly comprising an obturator which releasably captures the distal portion of an introducer sheath which obturator can be removed after the sheath is deployed to a desired location.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: A puncture treatment instrument for endoscope of the present invention includes: a concave portion with an opening on a distal end side and a bottom surface on a proximal end side; a holding portion adjacent to a proximal end of the concave portion, the holding portion allowing advancement and retraction of a needle; a puncture needle with a full length longer than a distance from a proximal end of the holding portion to a distal end of the concave portion; and a locking portion that generates resistance force in an advancing direction to stop retraction of the puncture needle when the puncture needle is retracted after the puncture needle is advanced to project into the concave portion from the holding portion.

Abstract: A surgical access attachment for use with a surgical access device is disclosed. The surgical access attachment includes a ring and an access portion assembly. The ring is configured to engage a proximal portion of a surgical access device. The access portion assembly includes at least one flexible tab having an engagement structure. The engagement structure is configured to selectively engage the ring. The access portion assembly is configured to retain a seal. The access portion assembly is configured to disengage from the ring in response to a predetermined amount of force exerted on one flexible tab of the at least one flexible tab.

Abstract: The present disclosure relates to an optical obturator that facilitates the visualization of tissue therethrough during use. The optical obturator disclosed herein includes a housing that is disposed at a proximal end thereof, an elongate member that extends distally from the housing, a distal end formed of a substantially opaque material with one or more openings formed therein, and a shield member.

Abstract: A gynocological cervical Os instrument. The gynecological cervical Os instrument includes a cervical Os finder having a passage for another medical instrument at least partially along the Os finder's length. In some aspects, the passage is only partially along the Os finder's length. The passage may be a groove, and the gynecological cervical Os instrument may include one or more retainers across the groove for the medical instrument. The gynecological cervical Os instrument may include a ramp out of the passage at the end of the passage and one or more bumps on the other end of the gynecological cervical Os instrument opposite the ramp indicative of a size of the gynecological cervical Os instrument. The gynecological cervical Os instrument may be made of a thermoplastic polymer such as polytetrafluoroethylene.

Abstract: A device includes an insertion member having a distal end portion configured to be removably engaged with an implant, and a sheath having an exit portion and defining a lumen. The exit portion of the sheath includes a set of dilation members configured to be moved from a first configuration to a second configuration. The set of dilation members forms a dilation surface when the set of dilation members is in the first configuration and defines an opening when the set of dilation members is in the second configuration. The sheath includes a hinge configured to facilitate movement of the set of dilation members between the first configuration and the second configuration. The distal end portion of the insertion member configured to move within the lumen to convey the implant from within the lumen via the opening when the set of dilation members is in the second configuration.

Abstract: Disclosed is a fixing and connecting apparatus with stress-dispersing capability for anterior superior spine and iliac crest, comprising: two side splints disposed opposite, which connects with each other at upper ends, with the shape of upper end at the inner wall of the two side splints coinciding with the shape of the upper surface of the anterior superior spine and iliac crest, and a cavity defined by the inner walls of the two side splints matching with the profile of the anterior superior spine and iliac crest; a fixing hole which is provided inclined downwards at upper part of at least one of the side splints with a diameter matching with the diameter of a kirschner pin; and a connecting structure which is provided at the upper part of any one of the side splints for connecting to a traction apparatus.

Abstract: The invention relates to an osteosynthesis device. The osteosynthesis device comprises a cervico-cephalic screw (1) provided with a distal thread able to be screwed into the bone, a support (3) formed by a plate with a shape suitable for fixing same to the bone or by an intramedullay nail able to be inserted into the medullary cavity, and a blocking means (6) blocking the screw in the support and movable in the support along the axis of the screw, and the final positioning of the screw is variable. The device is intended for holding in place and compressing fragments of a fractured bone.

Abstract: Devices, systems and methods for surgical fixation, including multi-screw anchoring devices for anchoring to various anatomical locations such as a sacral level or other anatomy of the spine. Anchoring devices include screw assemblies that are adjustable in a variety of different ways to grant a surgeon various options for placement and/or orientation of the primary and supplemental fixation screws.

Abstract: Various exemplary methods and devices are provided for fixing bone anchors to bone. In general, the methods and devices can allow for a bone anchor to be fixed to a bone at a desired angle to a receiver member. In an exemplary embodiment, a bone anchor assembly is provided that includes a bone anchor configured to engage bone, a receiver member that polyaxially seats a spherical head of the bone anchor, and a compression member seated within the receiver member, proximally of the head of the bone anchor. The compression member can have a distal end with gripping features thereon configured to create at least one line contact and/or one band contact with the head of the bone anchor, thus providing a firm grip on the head of the bone anchor and reducing a risk of slippage of the bone anchor with respect to the receiver member.

Abstract: Devices, systems and methods for connecting surgical screws together, which can be utilized to attach surgical screws in a variety of configurations, such as where the screws and/or attached tulip head components are not parallel or where a significant amount of anatomical variation creates widely divergent screw placement. Also disclosed are low profile crosslink arrangements having a high degree of strength and capable of providing an extremely strong connection to various components of a surgical screw.

Abstract: A subcutaneous implantable device for aligning a spine having a plurality of vertebrae including a first brace assembly secured to a first vertebra of the spine, a second brace assembly secured to a second vertebra of the spine, a rod secured by the at least two brace assemblies, the rod arranged for limited sliding movement within the at least two brace assemblies, a gear mechanism attached to the rod, a control means attached to the gear mechanism, and a cable fixedly secured to a third vertebra of the spine by an anchor. The third vertebra is located between the first and second vertebrae, and the cable is arranged for pulling the third vertebra towards the rod. A subcutaneous implantable device for gradually lengthening a bone.

Abstract: The present invention pertains to the field of neurosurgery and describes new methods to reduce basilar invagination (BI) and atlanto-axial dislocation (AAD). The invention further discloses novel surgical instruments useful in reducing basilar invagination (BI) and atlanto-axial dislocation (AAD). The novel techniques disclosed include distraction, compression and extension reduction and dynamic distraction coupled with cable compression.

Abstract: A method for treating vertebrae includes the steps of: providing a first penetrating element and a second penetrating element; disposing a first penetrating element with a first vertebral body; disposing a second penetrating element with a second vertebral body; removing the first penetrating element from the first vertebral body; providing a spinal implant including at least a first opening and a second opening; disposing the spinal implant adjacent the vertebral bodies such that second opening is aligned with the second penetrating element; providing a fastener; aligning the fastener with the first opening; and attaching the fastener with the first vertebral body. Systems and devices are disclosed.

Abstract: A fixing system for cervical vertebrae includes a fixing apparatus for cervical vertebrae in which a cervical vertebrae-fixing plate is made close contact with cervical vertebrae and a screw is inserted into the cervical vertebrae through a screw hole formed in the cervical vertebrae-fixing plate, and a driver that rotates the screw. Here, clips for holding the inserted screw are provided in the screw hole, a convex portion is positioned at the rear of a front end portion of the driver which is fitted in a groove on the screw, and the driver loosens the inserted screw while spreading the clips using the convex portion, when the inserted screw is loosened.

Abstract: In some embodiments a method comprises disposing an implant into contact with a first bone portion and into contact with a second bone portion, the implant having (1) a first interface configured to receive a restraining member, and (2) a second interface. The method further comprises inserting a portion of the fastener member into the first interface. The method further comprises securing the fastener member such that the first bone portion and the second bone portion are fixed to each other, at least in part by a substance after the securing, at least a portion of the substance disposed through the second interface.

Abstract: Orthopedic implant and methods of implantation for fixing adjacent bones. In one embodiment, the implant includes a locking mechanism that is adapted to be advanced by a locking instrument, wherein advancement of the locking mechanism in a first direction produces rotation of a first rigid abutment surface of the implant from a first orientation to a second orientation, and continued advancement of the locking mechanism produces advancement of the first rigid abutment surface towards a second rigid abutment surface of the implant. The continued advancement may also place a compressive load onto the implant sufficient to immobilize the implant relative to a first bony surface and a second bony surface.

Abstract: Instruments are provided for shifting elongate members, such as spinal rods, with respect to coupling members of spinal fixation systems. The instruments include a low friction drive mechanism having one or more rolling elements that ride along a helical groove or track in order to transform rotational movement of a drive member into linear shifting of a reducer member that shifts the elongate member. A one-way locking mechanism may be provided to selectively prevent unwanted counter-rotation of the low friction drive mechanism. The one-way locking mechanism may include annular ratchet teeth arranged on the exterior of the drive member and a ratchet pawl located adjacent to the teeth and selectively engageable therewith.

Abstract: There is disclosed a device and method for stabilizing a bone. The device includes a polymer with a glass transition temperature. The polymer is relatively deformable at a temperature above the glass transition temperature and relatively rigid at a temperature below the glass transition temperature. The device, while the polymer is above the glass transition temperature, is responsive to a bending force to bend during insertion into the intramedullary canal of the bone. The device, while the polymer is below the glass transition temperature, is relatively rigid and able to provide reinforcement to the bone.

Abstract: Embodiments of the present invention provide an osteosynthesis apparatus for proximal femur fractures. The osteosynthesis apparatus for proximal femur fractures has a structure in which a lag screw set and a nail are assembled via screwing process. The lag screw is assembled with a key ring and a fastening nut in advance. When inserting this lag screw set into a bone, grip bars are inserted radially at a predetermined angle and direction, resulting in a strong bone holding power. Further, in a final step, a strong fixed coupling is achieved by forcibly screwing and engaging the lag screw and the fastening nut by an interference of the threads of the lag screw and the fastening nut. Thus, the osteosynthesis apparatus for proximal femur fractures has a strong bone holding power and is stable without loosening.

Abstract: A device for implanting a bone fixation system comprises an insertion instrument extending from a proximal end to a distal end, the distal end having an engagement portion for removably engaging a proximal end of a bone plate, the insertion instrument having an elongated channel extending therethrough to permit insertion of a first protection sleeve therethrough, wherein a longitudinal axis of the elongated channel is coaxial with a longitudinal axis of a first opening extending through the bone plate and a first protection sleeve insertable into the elongated channel and guiding insertion of an anti-rotation screw therethrough and through the bone plate, a longitudinal axis of the first protection sleeve being angled with respect to the longitudinal axis of the elongated channel.

Abstract: A bone plate has a curved elongated body including a first end portion and a second end portion. The first end portion is laterally offset relative to the second end portion, and includes a plurality of screw holes. A first screw hole is defined by the second end portion. Each of the screw holes of the first end portion are laterally offset from a straight line extending in a direction along a length dimension of the bone plate and bisecting the first screw hole of the second end portion, and each of the screw holes of the first end portion are on the same side of the straight line as one another.

Abstract: A cervical plate and one or more locking assemblies that help prevent screw backout without impinging on therapeutically valuable settling of the screws. In some cases, the locking assembly is configured to be permanently attached to the plate, to be securely but efficiently locked, to be readily unlocked for revision surgery, and/or to reduce the possibility of operator error in installation by providing simplified visible and tactile indicia of the locked and unlocked positions.

Abstract: A locking mechanism assembly to allow locking of a fastener in an orthopedic implant having its axis at a variable angle relative to the axis of threaded through opening in the implant. The assembly includes a locking insert, having threads which mates with the threads of the through opening and which includes a smooth opening that forms a torque driving recess and an annular flange. A fixator has a head portion with external threads of a harder material than that which forms the through opening so that the threads of the fixator will deform the insert to lock the fixator in a desired position relative to the plate.

Abstract: Methods and implants to treat anterior cruciate ligament (ACL) injuries are disclosed. The methods involve advancing the insertion of the patellar tendon to the proximal tibia by means of a partial osteotomy and a wedge-shaped cage (30). The wedge-shaped cage is specifically designed to facilitate transfer of not only compressive loads, but also of shear loads due to pull by the patellar tendon at its insertion to the tibial tuberosity. The cage decreases the angle between the patellar tendon and the common tangent plane formed by the condyles of the femur and the condyles of the tibia (sometimes called tibial plateau) and consequently modifies the internal joint force, restoring stability to the joint even if the ACL is ruptured. The methods and implants are applicable to both human and canine patients.

Abstract: System, including methods, apparatus, and kits for binding bone. The system may include an encircling member and a fastening member that secures the encircling member in a loop around a portion of bone. In some embodiments, the fastening member may include any combination of the following: a cutting window, a guide aperture to guide a jaw of a crimping tool to a crimp region of the fastening member, multiple crimp regions, and/or apertures to receive adjustable prong members, among others.

Abstract: An apparatus and methods for delivery of reinforcing materials to a weakened or fractured bone is disclosed. An apparatus for delivering a reinforcing mixture to a bone including a tube having a proximal end, a distal end, and a longitudinal axis therebetween, wherein the tube has at least one inner lumen capable of allowing a bone reinforcing mixture to pass therethrough; a balloon engaging the tube wherein the balloon expands from a substantially deflated state to a substantially inflated state upon the bone reinforcing mixture entering the balloon; and at least one light guide extending through the tube into the balloon to guide a light into the balloon.

Abstract: A method of applying bone cement for an orthopedic procedure of a patient includes coupling a proximal end of a nozzle component to a bone cement applicator and applying bone cement on a surface of an implant or on a bone surface through an elongated distal opening of a distal portion of the nozzle component. The method includes separating the distal portion from an intermediate portion of the nozzle component at a frangible connecting portion and exposing a circular distal end of the intermediate portion.

Abstract: A mixing and discharging device (1) has a syringe-like container (10), in which a plunger can be moved. A press-out spindle (30) having an external thread (31) interacts with a counterpart (40) by means of a thread engagement. The counterpart comprises one or more thread segments, which can be deflected outward in order to release the thread engagement. A securing element (5) can be slid onto the counterpart (40) in a distal direction in order to prevent a release of the thread engagement. A mixing rod (61) extends through the plunger (20). An operating element (70) is connected to the proximal end of the mixing rod by means of a releasable form closure or force closure. A locking element (80) can be moved between a locking position and a release position. In the locking position, the locking clement prevents a release of the form closure or force closure. Insulating ribs (13) minimise the input of heat into the interior of the container due to touching.

Abstract: The present disclosure relates to a tool for injecting a bonding agent into the prepared end of a bone for bonding a joint replacement device to the bone. The tool incorporates vented cells for containing the bonding agent. Force is applied to the back of the tool, while placing the front of the tool filled with bonding agent against the prepared bone area. The force causes the cells to cut into the end of the prepared bone. The force also causes the bonding agent to be forced deep into the cuts and pores of the bone.

Abstract: An apparatus for treating uterine disorders by effecting necrosis of the uterine endometrium. The apparatus comprises a catheter with a bladder which can be inflated with a hot medium. To prevent inflation of the bladder during heating of the medium, and therefore to prevent too early inflation, the apparatus operates the inflation means in the negative direction during heating of the inflation medium.

Abstract: The disclosure relates to a spacer in the form of an attachment (15) to be mounted to an endoscope (1), said attachment being formed like a cap, enclosing a spatial volume (16) and being made of an insulating material. The attachment (15) is further equipped with a mounting device/adapter (6) designed to be coupled to a distal end of the endoscope (1). The attachment (15) comprises an area (11) designed to be in contact with a target tissue and further forms an aperture (12) enclosing a surface area (12a). Within the spatial volume, there is arranged an electrode (9) comprising a distal (9b) and a proximal (9a) end, the distal (9b) end of the electrode (9) having a predetermined minimum distance to the closest point of the surface area (12a).

Abstract: A cautery device includes an elongated handpiece extending axially from a proximal end to a distal end and a cautery tip extending coaxially with the handpiece from the distal end of the handpiece. The tip defines a channel extending coaxially with the handpiece along an entire length of the cautery tip from a proximal open end to a distal open end. The device includes a gas supply connection extending from the proximal end of the handpiece for supplying gas to the cautery tip. The gas supply connection is fluidly coupled to the cautery tip. The device includes an electric supply connection extending from the proximal end of the handpiece for supplying electricity to the cautery tip. The electric supply connection is electrically coupled to the cautery tip. The gas supplied to the cautery tip is introduced to the channel at the proximal open end and exits the tip at the distal open end.

Abstract: A cautery device includes an elongated handpiece extending axially from a proximal end to a distal end and a cautery tip extending coaxially with the handpiece from the distal end of the handpiece. The tip defines a channel extending coaxially with the handpiece along at least a portion of the length of the cautery tip from a proximal open end to a distal end. The device includes a gas supply connection extending from the proximal end of the handpiece for supplying gas to the cautery tip. The gas supply connection is fluidly coupled to the cautery tip. The device includes an electric supply connection extending from the proximal end of the handpiece for supplying electricity to the cautery tip. The electric supply connection is electrically coupled to the cautery tip. The gas supplied to the cautery tip is introduced to the channel at the proximal open end and exits to envelop the distal tip.

Abstract: A surgical device and procedure are provided for performing microsurgery, including a capsulotomy of a lens capsule of an eye. The device has an elastically deformable cutting element mounted within an elastomeric suction cup. The suction cup is attached to an arm for manipulating the device. The device can be inserted into the anterior chamber of the eye, through a corneal incision, to cut a piece from the anterior portion of the lens capsule of the eye. The device is secured against the lens capsule using suction applied by one or more suction elements. The device is then removed from the eye, with the cut piece of membrane retained within the device by suction.

Abstract: An ablation device may generally comprise a first electrode, a plurality of second electrodes, and a grounding pad. Each of the plurality of second electrodes may comprise a first conductive section, a second conductive section, and a non-conductive section between the first conductive section and the second conductive section. The first electrode and each of the plurality of second electrodes may be coupled to an energy source delivering a series of electrical pulses to tissue to induce cell necrosis by irreversible electroporation.