Abstract: A medical system (10) and method detects amyloid brain plaque. A positron emission tomography (PET) image of a brain is received. The PET image is generated from a radiotracer binding to amyloid brain plaque. A cortical profile is generated from the PET image. The cortical profile describes cortical tracer uptake to varying projection depths inside the cortex of the brain. The PET image is quantitatively assessed using the cortical profile and/or at least a portion of the cortical profile is displayed.

Abstract: Embodiments include a system for determining cardiovascular information for a patient. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart, and create a three-dimensional model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create a physics-based model relating to a blood flow characteristic of the patient's heart and determine a fractional flow reserve within the patient's heart based on the three-dimensional model and the physics-based model.

Abstract: A SPECT diagnostic method of performing myocardial perfusion imaging on a patient, the method including (A) commencing a mycocardial perfusion diagnostic scan; (B) during the scan, determining the photon count rate; (C) using the photon count rate and a predetermined total photon count target, determining a scan duration time; (D) terminating the diagnostic scan when the scan duration time elapses.

Abstract: Systems and methods described herein determine an objective metric for analyzing health of a patient's liver. In some embodiments, the system may include a scanner that can detect radiation counts responsive to administration of radioactive compound to a patient. Further, the system may include an image detection module that can access image data responsive to the detected radiation counts by the scanner. The image detection module can programmatically identify a first region of interest corresponding to a liver of the patient from the image data. A parameter calculator module can programmatically determine a first attribute associated with the first region of interest and calculate a first parameter indicating health of the liver of the patient based at least in part on the first attribute associated with the first region of interest.

Abstract: A method includes receiving Emission Tomography (ET) data of a subject from an ET/Computed Tomography (CT) scanner. The method further includes generating a first motion signal corresponding to a first bed position of the ET/CT scanner from the received ET data and determining whether the first motion signal indicates a periodic motion. The method also includes calculating a first time period from the first motion signal in response to determining that the first motion signal indicates the periodic motion and sending a first acquire notification to the ET/CT scanner to acquire Cinematographic (CINE) Computed Tomography (CT) data from the first bed position based on the first time period.

Abstract: The present invention relates to calibration in X-ray phase contrast imaging. In order to remove the disturbance due to individual gain factors, a calibration filter grating (10) for a slit-scanning X-ray phase contrast imaging arrangement is provided that comprises a first plurality of filter segments (11) comprising a filter material (12) and a second plurality of opening segments (13). The filter segments and the opening segments are arranged alternating as a filter pattern (15). The filter material is made from a material with structural elements (14) comprising structural parameters in the micrometer region. The filter grating is movably arranged between an X-ray source grating (54) and an analyzer grating (60) of an interferometer unit in a slit-scanning system of a phase contrast imaging arrangement. The slit-scanning system is provided with a pre-collimator (55) comprising a plurality of bars (57) and slits (59). The filter pattern is aligned with the pre-collimator pattern (61).

Abstract: A tomographic device includes a recording unit with a central system axis, a patient couch movable along the system axis and also a radiation source and a radiation detector interacting with the radiation source. The inventors have recognized that a rapid, precise and reliable positioning of a first recording area can be achieved by the positioning being based on a trained model, wherein the model has been trained with training positions. The tomographic device therefore includes a computing unit, which is designed for calibration of a first position of the first recording area relative to the recording unit based on the trained model. Furthermore the tomographic device includes a control unit for positioning the first recording area in the first position by moving the patient couch relative to the recording unit. The tomographic device is designed for a first tomographic recording of the first recording area in the first position.

Abstract: Disclosed is an ultrasound apparatus. The ultrasound apparatus includes an ultrasound transceiver that transmits an ultrasound signal to an object and receives an ultrasound echo signal reflected from the object, a controller that detects a change amount of a diameter of a blood vessel of the object, based on the ultrasound echo signal, and a display unit that displays a blood pressure graph showing a blood pressure of the object and an image representing an inflection point in the blood pressure graph, based on the detected change amount of the diameter. The controller calculates a stiffness of the blood vessel, based on a blood pressure corresponding to the inflection point.

Abstract: A system for highlighting an instrument in an image includes a probe (122) for transmitting and receiving ultrasonic energy to and from a volume and a marker device (120) configured to respond to a received ultrasonic signal and emit an ultrasonic signal after a delay. The ultrasonic signal includes one or more pulses configured to generate a marker, when rendered, of a given size at a position within an image. A medical instrument (102) is disposed in the volume and includes the marker device. A control module (124) is stored in memory and is configured to interpret the ultrasonic energy received from the probe and from the marker device to determine a three dimensional location of the medical instrument and to highlight the three dimensional location of the marker device with the marker in the image.

Abstract: A system includes a treatment probe, a first tracking sensor configured to track a location of the treatment probe, an ultrasound imager, a second tracking sensor configured to track a location of the ultrasound imager, and a tracking system. The ultrasound imager generates real-time ultrasound images. The tracking system receives location information from the first and second tracking sensors, tracks the location of the treatment probe and the location of the ultrasound imager, and displays the real-time ultrasound images and a representation of the treatment probe in one or more pre-stored images.

Abstract: Embodiments associated with a gel locking mechanism for ultrasound devices are described. The locking mechanism is formed as an attached adaptor or as part of an ultrasound device. In one embodiment, an adaptor device includes a housing formed with a mounting end and a gel receiving end; wherein the gel receiving end includes a side wall formed from the housing that defines a gel cavity for receiving a solidified gel. The adaptor device includes a cap formed with a frame and having a central opening defined therethrough, wherein the frame is configured to lock to and unlock from the gel receiving end of the housing.

Abstract: An imaging system includes a display device and a transducer to transmit acoustic pulses modulated with a carrier frequency and to collect at least a portion of a high-frequency backscatter signal comprising radio frequency (RF) data. A processing device is operatively coupled to the transducer probe and to the display device, and to: calculate a summation of a square of a real part and a square of an imaginary part of the backscatter signal, to generate an envelope signal including a mode-specific image suitable for display on the display device; calculate a difference of the square of the real part and the square of the imaginary part of the backscatter signal, to generate a complement signal; demodulate the complement signal to generate a low-frequency complement image suitable for display; and display the complement image on the display device to improve diagnostic imaging.

Abstract: Provided is an ultrasound diagnosis apparatus including: a controller configured to recognize an object included in an ultrasound image and search at least one piece of texture information corresponding to the recognized object; a display configured to display the ultrasound image and the searched at least one piece of texture information; a user interface configured to receive an input for selecting one piece of texture information from among the searched at least one piece of texture information; and an image processor configured to perform texture mapping of the selected piece of texture information onto at least one region in the ultrasound image of the object.

Abstract: Provided are an ultrasound diagnosis apparatus and an ultrasound diagnosis method that provide to a user an ultrasound image which is easy to recognize. The ultrasound diagnosis apparatus includes a probe, an ultrasound transmitter configured to transmit ultrasound waves to an object by using the probe, an ultrasound receiver configured to generate ultrasound data based on reflection waves corresponding to the transmitted ultrasound waves, a bio-signal obtaining unit configured to obtain bio-signals that are periodically generated, a data processor configured to obtain first loop image data and second loop image data based on the ultrasound data, and an image generator configured to generate combined data by combining the first loop image data and the second loop image based on the bio-signals.

Abstract: Disclosed herein is an ultrasound imaging apparatus including: an image creator configured to create an ultrasound elastic image that represents a degree of elasticity for a region of interest including a predetermined point of interest of an object; and a display configured to display the ultrasound elastic image together with an ultrasound image for the object and a high-resolution medical image matching with the ultrasound image.

Abstract: An image processing apparatus includes a speckle energy analyzer configured to analyze speckle energy of an ultrasound image signal, the ultrasound image signal being received from an ultrasound probe, and an image decomposer configured to decompose the ultrasound image signal into one or more ultrasound image signals of different frequency bands, based on the analyzed speckle energy of the ultrasound image signal.

Abstract: An ultrasound observation apparatus includes: a main power-supply button that operates an internal power-supply unit to be turned on/off as a result of depression of the main power-supply button; a moving member capable of moving substantially in parallel to a direction of the depression of the main power-supply button in conjunction with the depression of the main power-supply button; an internal power-supply switch provided at the power-supply unit so as to be in contact with the moving member, the internal power-supply switch switching the power-supply unit on/off by being depressed along with movement of the moving member; and a movement amount adjusting mechanism that upon the depression of the main power-supply button, if an amount of movement of the main power-supply button exceeds a predetermined movement amount, adjusts an amount of movement of a contact portion of the moving member.

Abstract: The invention relates to a kit of parts comprising a collecting device for collecting a tissue sample and a storage tube for storing the tissue sample therein. The collecting device comprises a punch and a plunger located within a bore of the punch and being adapted to slide within the bore. The storage tube comprises a tube body having an open first end, a closed second end, and a cap located at the first end of the tube body, the cap having a breakable seal that extends across the body of the tube to seal the first end of the tube body. The collecting device is adapted to break the seal of the cap and to fill the resulting opening to close off the storage tube.

Abstract: The invention includes systems and methods for controlling devices including surgical instruments using a wireless footswitch. The systems of the invention include a wireless footswitch, a footswitch adapter, and an electric console for powering and controlling surgical instruments. The systems of the invention further include a wireless footswitch for controlling battery powered surgical instruments. The methods of the invention include syncing a wireless footswitch with a controlled device or a wireless footswitch adapter using a lower power wireless mode, then signaling the controlled device or wireless footswitch adapter using a higher power wireless mode. The systems and methods of the invention include using a wireless device or wireless footswitch adapter to monitor transmissions from other wireless devices to prevent syncing with the wireless footswitch adapter using the same channel or network identification as other wireless devices or wireless footswitch adapters.

Abstract: A tool for application of a haemostat to a site of bleeding comprises a cylindrical barrel, a plunger slidable in the barrel, the barrel having an outlet end. The outlet end may be configured as a cone or rounded end with a central aperture and longitudinal slots in a cruciform arrangement, or may be left open. The barrel may have a slot alignable with a slot in an inner member for insertion of a haemostat body in the barrel. The barrel and plunger may be separable for insertion of the body into an open end of the barrel.

Abstract: A tissue engaging device and a corresponding deployment apparatus. The tissue engaging device has a generally annular-shaped body disposed about a central axis. The body has a plurality of inwardly protruding members separated by corresponding intermember spaces. The body is movable between a first position where the body is substantially convex before engagement with the tissue and a second position where the body is substantially concave when the body is engaged with the tissue. The tissue engaging device may be bioabsorbable. The deployment apparatus has a sheath and a tissue eversion apparatus for everting the tissue and positioning the everted tissue within the tissue engaging device.

Abstract: The invention encompasses devices and methods used to provide wound closure based on rings positioned within the tissue layers of the wound opening (with the rings regionally separate the wound depth tissue layers into 2 compartments), followed by suture transport through the rings and full-thickness tissue layers of both compartments. Upon suture transport via synchronous or asynchronous manner and device removal, wound closure is achieved by tying the 2 ends of the suture without incorporating tissue above the level of the rings such as skin. When the device is applied to abdominal or chest wall wound opening, all tissue layers except the skin are incorporated in the suture closure of the wound. The closure process can be performed in a simple, reliable, and expeditious manner.

Abstract: Apparatus for securing a first object to a second object, the apparatus comprising: an elongated body having a distal end, a proximal end, and a lumen extending between the distal end and the proximal end, the lumen comprising a distal section and a proximal section, the distal section of the lumen having a wider diameter than the proximal section of the lumen; a window extending through the side wall of the elongated body and communicating with the lumen, the window being disposed in the vicinity of the intersection between the distal section of the lumen and the proximal section of the lumen and being sized to receive a first object therein; an elongated element extending through the lumen of the elongated body, the elongated element comprising a proximal end and a distal end; and a locking element mounted to the distal end of the elongated element and disposed in the distal section of the lumen; whereby, when the elongated body is disposed in a second object, and the first object extends through the window

Abstract: A flexible fixation assembly including a flexible main body and a suture engagement portion of the flexible main body. The suture engagement portion is configured to cooperate with a suture to mate the suture with the flexible main body.

Abstract: A method for securing a strand to a fixation member for arthroscopic fixation, wherein the fixation member includes a channel on an exterior surface and an aperture therethrough. The method includes passing a strand having first and second ends through a flexible sleeve, passing the sleeve through the aperture of the fixation member in a first direction, tensioning the strand, and pulling the sleeve in a second direction different than the first direction to secure the sleeve to the fixation member without tying the strand on the fixation member.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a suture anchor is provided that includes one or more bone-engaging surfaces features and an external sidewall. The external sidewall can allow a suture coupled to the suture anchor and located between the anchor and bone to be movable relative to the suture anchor, even when the suture anchor is partially or fully disposed within a bone hole. Suture threaders and suture anchor drivers are also provided that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: A blunted safety needle is provided, which includes a hollow needle having a sharp distal tip and a stylus having a blunted end. The stylus is positioned within at least a portion of the needle. After the needle is used to deliver or deploy a substance and/or a device, the blunted end of the stylus is positioned to extend through the sharp distal tip of the needle and un-releaseably lock into position, thereby providing a blunted safety needle assembly.

Abstract: Suture constructs and methods are provided for securing soft tissue to bone. One exemplary embodiment of a construct includes a first limb, a second limb, a coaxial region, and a collapsible snare defined by the first and second limbs. The coaxial region can be formed by a portion of the second limb being disposed in a volume of the first limb, which allows for a low profile construct that is useful in various soft tissue repair procedures. The construct can be configured to be disposed in tissue to draw the tissue toward bone, and the coaxial region can be deconstructed so that the first and second limbs can be used to help secure the desired location of the tissue with respect to the bone. Various features of the construct and methods for using the same in a surgical procedure are also provided.

Abstract: A suture-based vessel closure device can perform the dilation of an arteriotomy puncture and does not require previous dilation of the arteriotomy puncture by a separate device or by a procedural sheath dilator. The suture-based vessel closure device can place one or more sutures across the vessel access site such that, when the suture ends are tied off after sheath removal, the stitch or stitches provide hemostasis to the access site.

Abstract: A plication lock delivery system that enables a suture lock assembly to be delivered percutaneouly. The plication lock delivery system comprises a lock assembly that secures sutures in place, a control assembly that allows a clinician to engage a suture to a suture lock assembly, apply tension to the sutures to cause tissue plication, and deploy the lock assembly, and a catheter assembly. This plication lock delivery system can be used to repair mitral regurgitation percutaneouly or in an open-heart surgery.

Abstract: A surgical clamp or gastric traction device and method for grasping and manipulating the stomach and providing continuous and uniform tension along a predetermined staple line during the serial stapling and stomach transection portions of a laparoscopic gastric sleeve procedure. The clamp typically includes a handle for gripping and manipulating the clamp and the engaged stomach, and a pair of elongated jaws coupled to the handle via a central portion. The pair of elongated jaws include a first jaw member and a second jaw member, and the length of the jaws are substantially equal to the length of a predetermined staple line which spans the stomach from the pyloric area to the area of the Angle of His. In one embodiment, the handle assembly can impart articulating and pivoting motion to the clamp assembly.

Abstract: A surgical stapling instrument includes a handle assembly, an elongate shaft extending distally from the handle assembly, and a tool assembly coupled to a distal end of the elongate shaft. The tool assembly includes a cartridge assembly including a plurality of surgical staples each including a code embedded portion and a first sensor for detecting the position of the surgical staples prior to and during a formation of the staples. The tool assembly further includes an anvil assembly including a second sensor that detects the position of the surgical staples after the formation of the surgical staples.

Abstract: A jaw restraint is provided to temporarily secure an anvil assembly relative to a cartridge assembly during shipping. The jaw restraint generally includes a body portion having an upper arm for releasably securing the anvil assembly and a lower arm for releasably securing the cartridge assembly. An inwardly projection is provided between the upper and lower arms. The anvil assembly is secured between the upper arm and the inwardly directed projection and the cartridge assembly is secured between the lower arm of the inwardly directed projection. One or more finger members extending proximally from the body portion may be provided to facilitate biasing the upper arm away from the lower arm to release the anvil and cartridge assemblies from the jaw restraint. The jaw restraint may be provided with structure for engagement with shipping packaging.

Abstract: A staple for attaching a sheet-like implant to tissue or bone may include first and second arms, and first and second flukes. In some embodiments, the first arm has a proximal end and a distal end, and the second arm has a proximal end and a distal end. A bridge extends from the proximal end of the first arm to the proximal end of the second arm. The first fluke has a proximal end abutting the distal end of the first arm, and the first fluke extends distally from the first arm. The first fluke has a lateral extent larger than a lateral extent of the first arm and is mounted eccentrically thereto. The first fluke includes a proximal surface projecting at an outward angle in a proximal direction away from the distal end of the first arm to engage the tissue or bone when inserted therein. The second fluke has similar features. This arrangement causes the first and second flukes to rotate in response to a pullout force on the bridge.

Abstract: A surgical stapling apparatus is disclosed which comprises cartridge body and a layer. The layer is implantable against tissue by staples deployed from the cartridge body and deformed by an anvil. The cartridge and the layer comprise co-operating features which reduce relative movement between the cartridge and the layer. Such co-operating features can also releasably retain the layer to the cartridge body. In addition to or in lieu of the above, the anvil and the layer comprise co-operating features which reduce relative movement between the anvil and the layer. Such co-operating features can also releasably retain the layer to the anvil. In certain instances, the layer can be positioned against the anvil, but releasably attached to the cartridge. The layer can comprise buttress material and/or a tissue thickness compensator, for example.

Abstract: A method of performing a surgical anastomosis is disclosed. The method includes providing an anastomotic device including a fluid supply channel extending between a handle assembly and a head assembly. The method also includes positioning the head assembly of the anastomotic device adjacent a hollow tissue organ, inserting the head assembly of the anastomotic device into the hollow tissue organ, and discharging an inflation fluid through at least one fluid outlet and into the hollow tissue organ to insufflate at least a portion of the hollow tissue organ.

Abstract: An embodiment of the invention relates to an apparatus comprising: a flexible sleeve configured to envelop at least a portion of a uterus; and an adjustable pressure applicator configured to provide pressure on a uterus of a patient. According to an embodiment of the invention, the pressure applicator is a bladder adapted to receive and dispel a fluid. Embodiments of the invention relate to use of the apparatus to control post partum hemorrhage, in particular, after caesarean section delivery.

Abstract: A retaining device includes a first member, a second member, a third member, a support section supporting the first member and supporting the second member and the third member movably relative to the first member, and a manipulation part moving the first member, the second member, and the third member relative to each other. The first member and the third member can grasp a first tissue with the first tissue disposed between the first member and the second member and between the first member and the third member, and the first member and the second member can grasp the first tissue and a second tissue such that the second tissue is disposed between the first member and the second member and between the second member and the third member to contact with the first tissue with the first member and the third member grasping the first tissue.

Abstract: Medical device used to cause hemostasis of blood vessels using a clip arrangement delivered to a target region through an endoscope. Method for using the device to cause hemostasis of a blood vessel through an endoscope. Medical device including a reversibly closeable clip, a locking arrangement, a control wire, a sheath, and a handle with an actuating trigger. Through the endoscope, hemostatic clipping device that is fully reversible and lockable. Hemostatic clip that reversibly targets and clips bleeding ulcers.

Abstract: A device for deploying, adjusting, and retrieving a medical implant is described. The device has at least one wing with a receiving element formed thereon for engaging the medical implant. An outer sheath may be used to move the device from the open configuration to the closed configuration. A method for using such a device is also provided.

Abstract: The present invention relates generally to an emergency tourniquet for rapidly and easily reducing or stopping blood flow to an injured limb. The tourniquet utilizes a closed loop system that is formed by passing a portion of a twistable strap, which comprises the loop, through a side opening in a buckle and cinching the strap tightly above an injury and thereafter twisting the strap. Otherwise, a loop may be formed and the injured limb passed through the loop prior to tightening it about the injured limb. The buckle includes an elongated opening that accepts an end or edge of the twistable strap. A free end of the twistable strap passes into a J-hook opening and is secured therein. The strap is then twisted and a notch in the buckle is hooked on an edge of the twistable strap. Bulbous regions are provided on either end of the buckle. A base plate may also be included for further securing the buckle in place to maintain the tourniquet in place until it can be removed by a competent medical professional.

Abstract: Porous spacers (100) are provided for foot and ankle fusion. The porous spacers disclosed herein may be implanted between separate bones of a joint or between two segments of a single bone following an osteotomy procedure. Such spacers may be used in conjunction with an ankle resection system which includes a resection frame (150) and a resection guide (170). The resection frame can be anchored to the distal tibia and/or the talus and provides an opening (155) through which a bone cutting element can pass for cutting underlying bone. The resection guide can include one or more cutting slots (169, 171, 172) and the resection guide can be coupled to the resection frame with the one or more cutting slots positioned over the opening in the resection frame so that the bone cutting element can pass through the one or more cutting slots and through the opening in the resection frame for cutting the distal tibia and/or the talus.

Abstract: A cutting apparatus for resecting a distal face of a femur prior to implanting a femoral component of a total knee prosthesis, comprises an elongate rod adapted for inserting into an intramedullary canal of the femur, a distal femoral cutting block, and a distal femoral jig assembly. The jig assembly can position the distal femoral cutting block on either left leg or right leg. It includes a distal femoral jig having at least one passage for slidingly receiving the rod with a preset valgus angle and a distal end face being adapted for abutting against on the distal face of the femur of either left leg or right leg dependent on its two flip orientations.

Abstract: Apparatus and methods for bone cavity preparation. Formed broaching members may be supported inside a bone by a rotator. The broaching members may be bowed out inside the bone to create a cavity having a shape determined by the broaching members and bone anatomy.

Abstract: Measurement of a leading edge of an instrument passing from a first medium having a first density to a second medium having a second density using a displacement sensor alone. In particular, a displacement signal, a velocity signal, and an acceleration signal measured from or derived from a displacement sensor are analyzed to determine when the leading edge of the instrument passes from the first material to the second material as the leading edge of the instrument is advanced relative to the material. For instance, the measurement may be used to output an occurrence signal that indicates to a user that the instrument has passed from the first medium to the second medium. Additionally, a length measurement of the path of the instrument when passing from the first medium to the second medium may be recorded, and/or the instrument may be controlled (e.g., the instrument may be stopped).

Abstract: There are provided a surgical jig (24) which is directly used during surgery to make it possible to accurately recognize a position where a recess (44, 46) is to be formed in the surface of a surgical target bone (14) of a patient; and a verification jig (34) which is directly used during surgery to make it possible to precisely verify whether or not the recess (44, 46) formed in the surface of the surgical targeted bone (14) of the patient is of a required shape. The surgical jig (24) has an inner surface (26) matching the surface shape of the surgical target bone (14) of the patient, and a penetrating opening (30, 32) formed in correspondence with a site where the recess (44, 46) is to be formed. The verification jig (34) has a protrusion (40, 42) protruding from an inner surface (36) thereof in correspondence with the recess (44, 46) to be formed.

Abstract: A device for partial acetabular replacement includes a patient-specific acetabular guide. The acetabular guide has a first surface configured to nestingly mate in only one position to the patient's acetabulum. The acetabular guide includes a patient-specific guiding formation configured to guide a cutting tool to remove damaged tissue from a defect of the patient's acetabulum and prepare a patient-specific implantation slot corresponding to the defect after removal of the damaged tissue. A patient-specific partial acetabular implant can be configured to nestingly mate with the patient-specific implantation slot.

Abstract: A two phase method for reducing the formation of biofilm includes an evacuation of ambient air from a region about the surgical or treatment site, to extract airborne or aerosolized bacteria ejected from the site by the treatment. The extracted bacteria are prevented from settling back onto the cleansed tissue surface, thus at least reducing colonial bacteriological growth and concomitantly exuded biofilm material. A second phase involves the attachment of one or more ultrasonic transducers to the patient over or near a surgical treatment site after the surgery is terminated. Each applied ultrasonic transducer is used to vibrate the patient's tissues at the treatment site to disrupt biofilm formation.

Abstract: A two phase method for reducing the formation of biofilm includes an evacuation of ambient air from a region about the surgical or treatment site, to extract airborne or aerosolized bacteria ejected from the site by the treatment. The extracted bacteria are prevented from settling back onto the cleansed tissue surface, thus at least reducing colonial bacteriological growth and concomitantly exuded biofilm material. A second phase involves the attachment of one or more ultrasonic transducers to the patient over or near a surgical treatment site after the surgery is terminated. Each applied ultrasonic transducer is used to vibrate the patient's tissues at the treatment site to disrupt biofilm formation.

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.