Abstract: Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.

Abstract: Disclosed are devices for pericardial access to the heart, including direct access to the left atrium. In certain embodiments, the device may comprise a device and/or an atrial appendage (AA) portal having a configuration such that the distal end of the device and/or the portal can access an atrial appendage while the proximal end of the device and/or portal can extend to outside of the subject. The devices and methods may also include a pericardial portal for emplacement of the device and/or the AA portal. Also, methods for using such devices and/or AA portals and pericardial portals to perform surgery on the heart, and systems (e.g., kits) comprising these devices and/or portals in combination with other therapeutic devices are disclosed.

Abstract: An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: An apparatus for deployment of a hemostatic clip comprises a handle assembly, a shaft connected to a distal portion thereof and a clip assembly releasably coupled to a distal portion of the shaft. The clip assembly includes clip arms and a capsule cooperating with the clip arms to provide a first user feedback indicating a decision configuration of the clip assembly. In addition, the apparatus includes a control wire including a ball connector, the control wire extending from the handle assembly and coupled to the clip assembly by the ball connector to maintain the clip assembly coupled to the shaft, wherein the ball connector is detachable from the clip assembly to provide a second user feedback indicating separation of the clip assembly from the shaft.

Abstract: Endoscopes, medical devices for use with endoscopes, and methods for making and using endoscopes. An example medical device for use with an endoscope is a catheter having one or more ridges formed on an outer surface thereof. The ridges may interact, for example, with the elevator of an endoscope.

Abstract: When processing bone tissue, the work site is often out of alignment with the insertion path of a tool device. A tool device (1) is provided with an endoscope (2), through the working channel (2.1) of which a guiding part (3) and a tool part (5) guided in this can be moved with their distal ends to a distal working area. The tool part (5) has a tool shaft (5.1) with a rotating tool (5.3). In the tool device there is a secure connection between the endoscope and the guiding part, during the task, and, this connection can be established in a simple manner prior to the beginning of the task and it can also be released again in a simple manner after the task ends. The guiding part (3) is able to be connected rigidly with the endoscope (2) axially.

Abstract: A device for quickly advancing/retracting a biopsy tool (or other driven object) into position through a colonoscope or other such scope. The device includes a drive actuator, a transmission for coupling the actuator to a driven object (biopsy tool), an attachment assembly that couples the device to the endoscope, such as to a biopsy port on the endoscope, an electronic control unit, and a user interface. Preferably, the driver/biopsy tool coupling consists of a motor and a combination of gears and friction rollers.

Abstract: A sheath assembly for an endoscope includes an elongate tubular body and a plug. The endoscope has a handle portion and a scope portion extending therefrom to a tip. The body includes first and second wall sections and extends along a longitudinal axis between first and second distal openings. The first wall section extends radially about the longitudinal axis to define a scope lumen. The scope portion is receivable in the scope lumen. The second wall section extends radially about a portion of the first wall section and longitudinally between second distal and proximal end openings. The first and second wall sections define an integral suction lumen in fluid communication with a first source of negative pressure. The plug is mated with the distal end opening for closing the scope lumen and includes at least one suction opening disposed in co-registration with the first distal end opening.

Abstract: An endoscopic instrument system for performing endoscopic interventions via a natural access path, including a flexible endoscope with an endoscope handle and an elongate endoscope shaft introducible into a hollow space in a body, wherein the endoscope shaft includes a steerable end section and at least one instrument channel, and also includes an endoscopic instrument with a handle, an elongate instrument shaft and a tool which can be actuated by a pull and/or push element arranged within the instrument shaft and connected to the handle and to the tool, wherein the endoscopic instrument can be introduced into the instrument channel for conducting manipulations in the hollow space in the body, and wherein the instrument shaft includes a continuous flexible tube that is connected, such that it is rotationally fixed, to the handle and to the tool with respect to a longitudinal direction of the tube.

Abstract: An orthopedic infra-red laser medical device and methods of use for applying infra-red energy to an anatomic region of interest located within the body of a patient. The device includes a hollow needle and a housing on which the needle is releasably mounted. The housing includes an infra-red laser source for producing a laser beam and directing the beam through the needle to exit out of the open distal end of the needle. The distal end of the needle is sharp to pierce through the skin of the patient to a position closely adjacent the anatomic region of interest to deliver the infra-red laser beam thereto without any intervening skin and tissue attenuating the infra-red laser beam. The device can be used for various orthopedic purposes and can also be used on fat in a patient to release activated stem cells.

Abstract: An inflated implant, such as an attenuation device, previously implanted in a urinary bladder can later be removed according to a number of different methods. Preferably, removal is accomplished transurethrally. Removal can be accomplished by reducing the inflated implant from an enlarged profile to a reduced profile so that it may be withdrawn transurethrally by a removal system. The removal system can be configured differently depending upon whether reduction from the enlarged profile to the reduced profile is accomplished by deflation, compression, and/or other ways.

Abstract: An instrument set for the microinvasive treatment of stenoses of the spinal canal and/or other constrictions of the spinal canal, comprising a microinvasive access tube (1) having a distal end insertable into the body; an ablation device (2) having an ablation head (21) which can be accommodated in the access tube (1) and which can be directed out of the access tube (1) at the distal end and brought into at least one working position; a screening element (31) for screening the ablation head (21) in relation to the dura which can be accommodated in the access tube (1) and which can be directed out of the access tube (1) at the distal end and brought into at least one working position in which the screening element (31) laterally protrudes above the access tube (1).

Abstract: A liquid sampling catheter contains a lumen filled by a sampling cannula with a hollow lumen and either a closed or open distal tip. Attached to the proximal end of the device is a modular blood storage component. The sampling stick slides through the patient's skin or through a seal and in-dwelling lumen on a corresponding sampling hub to sample blood from a patient. This embodiment establishes a simple, standardized, and quick procedure for sampling small amounts of bodily liquids such as blood for a variety of analyte tests.

Abstract: Medical devices are described and illustrated herein. In particular, steerable guide members and catheters useful in the identification and treatment of bodily passages are provided. Methods of identifying and treating bodily passages are also provided.

Abstract: An arthroscope having an elongated core with a square radial cross section.

Abstract: A hemostatic clip assembly for mounting on a delivery device comprises a capsule and a clip slidably mounted within the capsule so that, when the clip is drawn proximally into the capsule, arms of the clip are drawn together to a closed position, an abutting surface of at least one of the arms contacting a corresponding surface of the capsule when the clip is drawn to a predetermined position within the capsule to provide a first user feedback indicating closure of the clip in combination with a tension member connected to the clip arms and biasing the clip arms toward an open, tissue receiving configuration and a yoke slidably received within the capsule and releasably coupled to the tension member, the yoke including a ball cavity for receiving a ball connector of a control element of the delivery device to maintain the clip assembly coupled to the delivery device, wherein the control element is frangible to detach the yoke from the delivery device and to provide a second user feedback and, wherein release

Abstract: A method of performing arthroscopic surgery using an arthroscopic inflow and outflow sheath which provides an improved inflow and outflow system reducing the diameter of a continuous flow system while eliminating the need for a third portal during arthroscopy. The improved arthroscopic inflow and outflow sheath comprises an elongated atraumatic sheath having an inner surface, outer surface, proximal end, and distal end. The atraumatic sheath further comprises plurality of ribs extending from the inner surface of the sheath and designed to contact an outer surface of the arthroscope creating outer lumens facilitating the inflow and outflow of fluid to a surgical site. The atraumatic sheath further comprises a ridge to prevent the sheath from being easily removed from a surgical site.

Abstract: Positioning precision between an image-acquisition device and an objective lens is enhanced by suppressing manufacturing errors. Provided is an endoscope image-acquisition unit equipped with an objective-lens-unit frame that holds an objective lens and an image-acquisition-device holding frame that is fitted to the objective-lens-unit frame and that holds an image-acquisition device, wherein the objective-lens-unit frame and the image-acquisition-device holding frame are attached and secured to each other by means of thermosetting resin that is applied to fitting portions therebetween and in which polar-molecule materials are mixed, and one of the objective-lens-unit frame and the image-acquisition-device holding frame, whichever one is positioned outside at the fitting portions, is formed of a material that allows microwaves to pass therethrough.

Abstract: A method for confirming capture of a moving heart valve leaflet of a beating heart of a patient includes inserting an instrument through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the distal end of the instrument is operable to capture a moving valve leaflet. Proper capture of the valve leaflet is confirmed at a proximal end of the instrument with a fiber optic capture confirmation system.

Abstract: Various apparatuses and methods involve flexible components for insertion into tissue, such as for minimally-invasive surgical procedures. As consistent with one or more embodiments, an apparatus includes a plurality of elongated flexible segments and one or more rigid actuators coupled between the flexible segments. One or more tendons extend within and moves the flexible segments, which elastically flex upon insertion into tissue. Each rigid actuator also operates to move one or more of the flexible segments, providing further movement control. A manipulator circuit is coupled to each rigid actuator and operates to position one or more of the segments by actuating the rigid actuator (e.g., via electrical and/or mechanical input).

Abstract: A bending angle adjustment mechanism for an endoscope includes a rod member that is disposed along a traveling path of a long member that is connected to a bending portion that is bendable and is pulled, a support member made of metal that is integrally provided to support both ends of the rod member, an adjustment piece that is engaged with the rod member, is movable along the rod member, and restricts movement of the long member, a guide member made of resin having a guide surface for guiding movement of the adjustment piece, wherein the guide member is fixed in a state in which the guide member is sandwiched between the adjustment piece and the support member so that the guide surface is disposed in a position capable of guiding the adjustment piece.

Abstract: The invention relates to a multifunctional device for exploration and/or intervention, especially for medical use, comprising a hollow handle, which is continued by a main catheter, and a carriage which is mounted so as to slide along the handle and which is coupled to an instrument by a mechanical connection extending inside the main catheter. According to the invention, at least one intermediate carriage is mounted so as to slide along the handle, each of said intermediate carriages having an attachment housed in the handle via a longitudinal slot, in the continuation of which there is a secondary catheter extending inside the main catheter. Moreover, an auxiliary carriage is mounted so as to slide along each intermediate carriage, each of said auxiliary carriages being coupled to an instrument by a mechanical connection extending inside the secondary catheter.

Abstract: Kits, apparatus, devices and methods for treating varicose veins caused by an incompetent venous junction (e.g., the saphenofemoral and/or saphenopopliteal junctions) are disclosed. The kits may include a sheath, a vein closure device, and an injection device. Alternatively, a vein closure device may include an integral injection channel and injection device. Methods may include injecting a vein with a sclerosing agent through a needle that extends in a direction that is not aligned with a longitudinal axis of a sheath or shaft.

Abstract: Modules, systems, and methods are provided for cooling components of an inspection or testing apparatus, such as a borescope. In some exemplary embodiments, the modules include two heat sinks, with the top-most heat sink having a fan assembly approximately centrally disposed therein. The fan assembly can be operated to draw air into the top-most heat sink, and then exhaust airflow out of the top-most heat sink such that the exhaust air passes across at least a portion of the second heat sink to help cool both the first and second heat sinks, and components of the apparatus associated therewith, using the same fan assembly. As a result, the components of the apparatus can be cooled more easily, and the performance and efficiency of these components is improved, all while reducing the overall size and weight of the inspection apparatus.

Abstract: An endoscopic vessel harvester includes a vessel keeper for capturing a target vessel within a tunnel that has been dissected along the target vessel. A cutter member cuts and cauterizes side branches while the target vessel is slidably captured in the vessel keeper. A spray nozzle carried by the vessel keeper delivers a preservative fluid via a manual control valve and a conduit. The preservative fluid is sprayed on the target vessel proximate a respective side branch immediately after being cauterized. Thus, a harvested vessel is bathed in preservative fluid prior to being actually removed from the body, enhancing endothelial preservation from cascading events.

Abstract: Medical devices, systems and methods that are useable to facilitate transnasal insertion and positioning of guidewires and various other devices and instruments at desired locations within the ear, nose, throat, paranasal sinuses or cranium.

Abstract: A robotic surgical system is configured with rigid, curved cannulas that extend through the same opening into a patient's body. Surgical instruments with passively flexible shafts extend through the curved cannulas. The cannulas are oriented to direct the instruments towards a surgical site. Various port features that support the curved cannulas within the single opening are disclosed. Cannula support fixtures that support the cannulas during insertion into the single opening and mounting to robotic manipulators are disclosed. A teleoperation control system that moves the curved cannulas and their associated instruments in a manner that allows a surgeon to experience intuitive control is disclosed.

Abstract: A handpiece for removably attaching one of a plurality of probes including a housing, an actuation assembly arranged on the housing, a linkage assembly arranged on the housing and adapted to couple motion of the actuation assembly to actuation of the probe and an alignment feature arranged on the housing and adapted to control the orientation of a connected probe. Several probes are also disclosed in addition to method of performing a procedure.

Abstract: A track-forming device can form an insertion route (track) along which a treatment tool is easily inserted. The track-forming device includes: a plurality of track-forming segmented members that are arranged in the longitudinal direction with spaces therebetween; a soft wire that connects the plurality of track-forming segmented members; and a wire pulling section that brings the plurality of track-forming segmented members into contact with each other in the longitudinal direction. When the plurality of track-forming segmented members are brought into contact with each other by the wire pulling section, a predetermined track is formed.

Abstract: A surgical apparatus providing access to an underlying body cavity through a tissue tract articulates a flexible surgical object inserted therein. The surgical apparatus includes a tube member defining a longitudinal axis and a lumen therethrough to receive the flexible surgical object. The tube member includes a proximal member, a middle member connected to the proximal member at a first joint, and a distal member connected to the middle member at a second joint. The surgical apparatus also includes articulation mechanisms to articulate the tube member.

Abstract: An endoscope sheath including an elongate flexible hose, which encloses a main lumen, for receiving at least one portion of a shank of a flexible endoscope, and at least one working channel, for receiving at least one portion of a flexible endoscopic working instrument, wherein the endoscope sheath has a transparent distal end portion. Further provided is an endoscope arrangement, and a method for providing an endoscope arrangement.

Abstract: A resection device for resecting tissue from a body. The device includes an elongate member having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end. The device further includes a cap assembly configured to be coupled to the distal end of the elongate member. The cap assembly may include a first cap defining a resection loop channel and a distal end having a first opening. The assembly may further include a second cap configured to receive a portion of the first cap. The second cap includes a distal end having a second opening. A distal portion of the first cap and a distal portion of the second cap may cooperate to define a resection loop track for receiving a resection loop.

Abstract: A surgical device is described. The surgical device may comprise a rotatable cutter configured to cut tissue for insertion of a cannula, and a first driver configured to be driven by a motor arrangement and to rotate the cutter. The surgical device may further include, for example, the cannula, at least one of the rotatable cutter and the first driver being disposed in a bore of the cannula. In one embodiment, the rotatable cutter may include an auger having a cutting thread. In another embodiment, the rotatable cutter may include a disk-shaped blade.

Abstract: A rotational atherectomy device that includes an expandable head that can clean a blockage from vessel larger than its rest diameter, in which the drive shaft may rotate in two opposite directions and may have different abrasive characteristics for each rotation direction. In one direction, the head may be configured for cutting and/or slicing, which may be well suited to removing particularly soft blockage material. In the other direction, the head may be configured for grinding, scraping and/or sanding, which may be well suited to removing particularly hard blockage material. The head includes one or more arms that are pivotally or hingedly attached to the drive shaft. One or more abrasive elements are disposed on or are attached to the one or more arms. The abrasive elements have a cutting feature, such as a sharpened edge that cuts like a razor blade when the drive shaft is rotated in the “cutting” direction.

Abstract: A device configured to facilitate resection of tissue. The device may include a proximal end configured to be secured to a distal portion of an introduction sheath and a distal end defining an opening that may communicate with a channel extending between the proximal and distal ends. The opening may be defined by at least one straight edge.

Abstract: A treatment tool for endoscope includes a pair of forceps members supported so as to be relatively movable by a rotation shaft, an operation section for performing opening/close operations of the forceps members, and an operation wire for connecting the forceps members to the operation section, wherein the operation section has an operation section main body, a first operation member to which the operation wire is connected and which is slideably attached to the operation section main body, a second operation member which is slideably attached to the first operation member, a force adjustment member which is attached to the second operation member and is compressed by the second operation member is slid to the first operation member.

Abstract: An endoscope-like implanting instrument includes an endoscope cap having a holding and withdrawing mechanism for a tissue clip adapted to be slipped onto an expanding sleeve of the endoscope cap. The endoscope cap has a front groove opening at the front edge of the sleeve. A withdrawing thread radially crosses the front groove at an axial front cap portion. The instrument further includes a tissue grasping mechanism being shiftably inserted into the working channel for manually grasping and drawing the tissue inside the endoscope cap. A clamping mechanism is integrally arranged inside the endoscope cap in axial extension to the working channel, holding a capsule-like device and connected with the tissue clip via a thread, band or string such that the capsule-like device will be automatically detached by the grasping mechanism when being manually actuated for tissue grasping.

Abstract: Pleural empyema removal devices are provided and enable the removal of empyema from the pleural cavity of a human or veterinary patient. The pleural empyema removal devices may be coupled with one or more additional devices, such as suction source, gas source, light source and/or camera source, and monitor. The devices and systems including the devices facilitate the removal of empyema from the pleural cavity of a patient while providing protections from damage to untargeted tissues. The devices, systems, and methods can be used in the treatment process to treat pleural empyema resulting from pleural effusions and infections stemming from various illnesses and disorders, such as pneumonia.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: An endoscope procedure instrument provided with: a tube part that is cylindrical in shape and attaches to the front end of the endoscope, the tube part having a slit provided to the side surface thereof extending along the direction of the central axis; and a grasping member that is disposed to the tube part extending along the slit, for holding a biologic tissue with respect to the endoscope.

Abstract: According to the present invention there is provided a strain sensor apparatus comprising, two or more strain sensors each of which is capable of measuring strain and each of which is configured such that it can be arranged to cooperate with a structure to be monitored so that strain in the structure can be detected by a strain sensor, and one or more position references which is/are arranged in a predetermined position relative to the two or more strain sensors and wherein the one or more position references are each configured such that they are suitable for cooperating with a measuring means; one or more measuring means which is configured to cooperate with the one or more position references so that the angular orientation of the one or more position references can be determined. There is further provided a corresponding method for sensing strain in a structure.

Abstract: A flexible endoscope includes a handle, a flexible shaft having a distal end and a proximal end, a coupling mechanism releasably attaching the handle to the distal end of the flexible shaft, an illumination unit disposed in the flexible shaft, the illumination unit providing light to an area in front of the distal end of the flexible shaft, and an imaging unit disposed in the flexible shaft, the imaging unit generating image data of the area in front of the distal end of the flexible shaft, wherein the coupling mechanism includes an electrical channel for transmitting electrical power to the illumination unit and the imaging unit, and a data channel for transmitting the image data from the imaging unit.

Abstract: A method of supporting a tool (106) in an assembled apparatus (10) comprises the steps of (a) inserting a support structure (60) through a first aperture (52,56) in a casing (50,54) of the apparatus (10), a first end (62) of the support structure (60) being outside the casing (50,54) and a second end (64) of the support structure (60) being inside the casing (50,54), (b) securing the first end (60) of the support structure (60) to the casing (50,54), (c) arranging a first portion (78) of the support structure (60) to abut at least one surface within the casing (50,54), (d) inserting a tool (106) through the first aperture (52,54) or a second aperture in the casing (50,54), and (e) securing the tool (106) to a second portion (102) of the support structure (60) within the casing (50,54).

Abstract: Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.

Abstract: Systems and methods for treating spinal stenosis include endoscopic access devices and bone removal devices used to perform a foraminotomy or other bone removal procedures. A bone removal device includes a cannulotome with an endoscopic imaging lumen. Optionally, an endoscope retaining device can be used to facilitate advancement of the endoscope through the cannulotome.

Abstract: Medical devices, systems, and related methods of use are disclosed. The systems may comprise a sheath for insertion into a body lumen and an extraction tool for passage through the sheath, wherein the extraction tool may include a handle, an end effector, and an optical device. Methods disclosed herein include introducing an extraction tool into a urethra for retrieving and removing tissue from the body, e.g., with an end effector, without morcellating the excised tissue.

Abstract: A surgical instrument (10, 100) configured to facilitate gripping and manual adjustment by a left-handed or righted-handed user. The surgical instrument includes a rod (11) having a first end (12a) attachable to a working end (13, 113) of the instrument via a mount (16). The rod has a second end (12b) coupled to a handle (14) having rotational directionality for gripping by a first hand of the user. The handle is rotatable about the rod so as to allow the user to adjust an angular displacement of the user's finger relative to the working end, and a locking member (20, 146) prevents rotation of the handle relative to the rod when the beveled indent is optimally located relative to the working end.

Abstract: The present disclosure describes a single incision method of placing a drainage catheter in the peritoneal cavity.

Abstract: A propulsion apparatus for an endoscope includes a propulsion assembly for mounting on a tip device of the endoscope, for propulsion in a body cavity. First and second wire devices are disposed to extend from the tip device in a proximal direction, having a coil winding, for rotating to drive the propulsion assembly. First and second motors are connected with proximal ends of respectively the first and second wire devices, for rotating the first and second wire devices. A timer is actuated if a speed difference between rotational speeds of the first and second motors becomes equal to or more than a reference speed value, for measuring an elapsed time. A break detector detects breakage of the first wire device if the elapsed time becomes equal to or longer than a predetermined time. A controller controls the first and second motors in response to an output of the break detector.

Abstract: A surgical instrument includes a hollow member having a sidewall provided with a window and a closure member movably connected to the hollow member for alternately covering and uncovering the window. The hollow member has a first clamping surface along an edge of the window, while the closure member has a second clamping surface opposing the first clamping surface and disposable substantially adjacent thereto in a clamping or closure configuration of the instrument. The instrument additionally comprises a tissue occlusion component mounted to at least one of the hollow member and the closure member for acting on tissues gripped between the first clamping surface and the second clamping surface, to couple the tissues to each other.