Abstract: The present invention relates to a connector for connection through a flexible barrier. The connector comprises at least a device pad and at least a landing pad. The device pad is arranged in close proximity to the landing pad for contactless connection through the flexible barrier to transmit and/or receive data and/or power between each other. The device pad and the landing pad are configured to attach and/or align to each other. Furthermore, a system for connection through a flexible barrier, an according method, computer program element and computer readable medium are provided.

Abstract: A device and method for directing a cannula toward a target location under a patient's skin. The device is handheld and the device operations may be automated. The device includes an imaging probe for imaging the target location, a positioning unit for manipulating a cannula towards the target location, and a processor. The processor receives imaging data from the imaging probe, cannula pose data from at least one cannula position sensor, and device pose data from at least one device position sensor. The target location is identified from the imaging data, and a trajectory for manipulating the cannula towards the target location is determined based on the imaging data, the cannula pose data, and the device pose data. The processor may determine that the trajectory becomes misaligned with the target position, and may update to a corrected trajectory based on the imaging data, cannula pose data, and the device pose data.

Abstract: Shape-sensing systems and methods for medical devices. The shape-sensing system can include a medical device, an optical interrogator, a console, and a display screen. The medical device can include an integrated optical-fiber stylet having fiber Bragg grating (“FBG”) sensors along at least a distal-end portion thereof. The optical interrogator can be configured to send input optical signals into the optical-fiber stylet and receive FBG sensor-reflected optical signals therefrom. The console can be configured to convert the reflected optical signals into plottable data for displaying plots thereof on the display screen. The plots can include a plot of curvature vs. time for each FBG sensor of a selection of the FBG sensors in the distal-end portion of the optical-fiber stylet for identifying a distinctive change in strain of the optical-fiber stylet as a tip of the medical device is advanced into a superior vena cava of a patient.

Abstract: A catheter comprises a flexible polymer catheter body including a proximal shaft section and a distal working section, a wire support structure embedded within the distal working section of the catheter body, a proximal adapter mounted to the proximal shaft section of the catheter body, and a wire disposed within the catheter body. The wire has a proximal end and a distal end. The proximal end of the wire being operably connected to the proximal adapter, and the distal end of the wire is anchored to the wire support structure.

Abstract: A computer-assisted surgical system simultaneously provides visible light and alternate modality images that identify tissue or increase the visual salience of features of clinical interest that a surgeon normally uses when performing a surgical intervention using the computer-assisted surgical system. Hyperspectral light from tissue of interest is used to safely and efficiently image that tissue even though the tissue may be obscured in the normal visible image of the surgical field. The combination of visible and hyperspectral images are analyzed to provide details and information concerning the tissue or other bodily function that were not previously available.

Abstract: Disclosed herein are systems, devices, and methods for treating heart failure. In some variations, a catheter for forming an anastomosis in a heart may comprise a first catheter comprising an electrode. A second catheter may be slidably disposed within the first catheter. The second catheter may comprise a barb and a dilator comprising a mating surface configured to engage the electrode.

Abstract: A device including a base sized to be hand-held, the base defining a longitudinal axis between first and second opposing longitudinal ends, a cover reversibly fastened to the base in a closed position; a sheath clamp coupled to the base, the sheath clamp capturing a sheath handle of a sheath to immobilize the sheath handle relative to the base, wherein the sheath clamp is an aperture formed in corresponding abutting edges of the cover and the base, the aperture being formed when the cover and the base are in the closed position; a catheter clamp capturing a catheter, a remote end of the catheter configured to deliver a catheterized medical procedure; the catheter clamp aligned to be substantially co-axial with the sheath clamp; and a linear actuator effecting back-and-forth linear motion of the catheter clamp relative to the sheath clamp.

Abstract: The invention describes a sinus balloon catheter and methods of use. Specifically a sinus balloon catheter for dilating a sinus cavity lumen is provided with a tip that can be extended. The catheter comprises a guide tube with a proximal and distal end, a sleeve member, a balloon disposed upon the sleeve member and a rounded tip arranged at the distal end and extendable along with the extension of the sleeve member.

Abstract: An optical shape sensing system includes an attachment mechanism (130) being configured to secure an optical shape sensing fiber to an instrument, the optical shape sensing fiber being connected to the instrument and configured to identify a position and orientation of the instrument. An optical shape sensing module (115) is configured to receive feedback from the optical shape sensing fiber and register the position of the instrument relative to an operating environment. A position response module (144) is configured to provide feedback to an operator based on position or orientation of the instrument to guide usage of the instrument.

Abstract: An interventional device includes an elongate member configured to be inserted into a body of a patient, the elongate member comprising a proximal portion and a distal portion, a sensing element disposed at the distal portion of the elongate member and configured to obtain measurement data associated with a body lumen; a stiffening mechanism coupled to the elongate member and configured to change the stiffness of the elongate member during a medical procedure. Associated devices, systems and methods are also provided.

Abstract: A method of controlling an industrial actuator, the method including receiving a manual input in the form of a displacement of an input element; in response to the manual input being a displacement of the input element from the neutral position in a first input direction, controlling the industrial actuator to move in a forward direction along a movement path and with a speed corresponding to a magnitude or a speed of the displacement from a neutral position; and in response to the manual input being a displacement of the input element from the neutral position in a second input direction, controlling the industrial actuator to move in a backward direction along the movement path and with a speed corresponding to a magnitude or a speed of the displacement from the neutral position.

Abstract: Provided are systems and methods for decalcifying aortic valves and/or other valves, blood vessels, and/or cardiac tissues in a mammalian (e.g., a human) patient (e.g., a patient having or suspected of having calcific aortic valve disease (CAVD)). A transcatheter (aortic) valve decalcification system/method can include applying one or more pulsed magnetic fields to the calcium deposit(s) within a valve or other vessel or tissue within the patient. The system can include a catheter having pulsed magnetic field ribbons disposed therein, and the catheter can be provided to the patient.

Abstract: A device for introduction into a body vessel includes a shaft, a balloon positioned at the distal end of the shaft, a guidewire disposed longitudinally within the shaft to receive a guidewire during use, a balloon disposed at the distal end of the shaft, and longitudinal scoring wires to score a vascular lesion attached to the distal end of the shaft, disposed over the balloon and disposed within the shaft. The proximal ends are welded or otherwise affixed to a spring mounted in the handle. The balloon expands when fluid is delivered to the balloon through the inflation lumen. This expansion pushes the scoring wires against the vascular lesion.

Abstract: An arthroscopy system includes both a motorized handpiece and a detachable probe. The motorized handpiece includes a rotating driver which is configured to engage a rotatable drive coupling within a hub of the probe. The probe has a shaft with an articulating distal region, and the rotatable drive coupling is configured to convert the rotary motion of the rotating driver to an articulating motion within the articulating region of the probe.

Abstract: A lead delivery catheter having a slittable pull ring is described. The lead delivery catheter includes a deflection wire attached to the slittable pull ring to deflect the catheter. The slittable pull ring has several ring holes arranged in a pattern. The pull ring is located distal to a tubular braid of the lead delivery catheter, and a size and pattern of the ring holes can be similar to a size and pattern of holes in the tubular braid. The structural similarity between the pull ring and the tubular braid facilitates use of a consistent cutting force to slit through the tubular braid and the pull ring of the lead delivery catheter. Other embodiments are also described and claimed.

Abstract: The following describes various applications and uses for a controllably rigidizable flexible device or sheath. Such rigidizing mechanisms can allow for a transition between a rigid state and a flexible state of a sheath. Rigidization can be applied along an entire length of a flexible sheath or along select portions of the sheath, and the rigidization can be of varying stiffness. Rigidization can be user controlled or automatically controlled using computer processes.

Abstract: A surgical instrument comprising an end effector, an articulation system, a firing system, a closure system, a lock system, and a control unit is disclosed. The end effector comprises a pair of movable jaws. The articulation system articulates the end effector when the articulation system is in an active state. The closure system is actuatable to move the pair of jaws. The lock system prevents the closure system from actuating when the lock system is in a locked state. The control unit controls the supply of power from a power source to the articulation system, the firing system, and the lock system. The control unit transitions the lock system to the locked state and prevents the supply of power from the power source to the firing system when the articulation system is in the active state.

Abstract: An introducer sheath assembly having a handle portion including a distal end and a proximal end, and an introducer sheath extending outwardly from the distal end of the handle portion, the introducer sheath including a device lumen configured to slidably receive a corresponding device, a guidewire lumen configured to slidably receive a corresponding guidewire, and at least one steering cable disposed within at least one steering cable lumens that are disposed radially outwardly from the device lumen, and the handle portion including at least one steering assembly for modifying the tension of at least one of the at least one steering cables.

Abstract: A controller for displaying a puncture site of an intra-atrial septum for heart repairs includes a memory and a processor (710). The processor (710) executes instructions (784) to perform a process based on image data of a heart that includes a mitral valve and an intra-atrial septum. The process includes defining a mitral valve annulus plane along a mitral valve annulus of the mitral valve and a normal vector perpendicular to the mitral valve annulus plane. The process also includes defining an offset plane that intersects with the intra-atrial septum and that is parallel to the mitral valve annulus plane. A safe zone for the puncture site is identified and displayed on the intra-atrial septum. The safe zone is between a lower boundary plane (456) and an upper boundary plane (455) that are each parallel to the offset plane by specified distances.

Abstract: Medical tool positioning and control devices, systems, and methods. Handle assemblies that allow a steerable shaft to be steered, while allowing the separate movement of a medical tool. The handle assemblies can allow for rotation and axial movement of the medical tool, and optionally with an actuator disposed distal to a second actuator that controls steering of the steerable shaft.

Abstract: The device is a body with a truncated anterior portion and a cylindrical posterior portion, which are interconnected such that the cylindrical posterior portion of the body is rotatable about its own axis. The inside surface of the cylindrical posterior portion of the body is provided with a thread that is capable of engaging a lip of a slider disposed on guides inside the posterior portion of the body. The slider is connected to a barrel of a gripper having vanes with elastic elements at a delivery system gripping point such that the gripper is rotatable about its own axis, wherein the vanes of the gripper have protuberances disposed in a clamping cylinder which is arranged inside the body of the device and squeezes and releases the vanes of the gripper under the action of a release member.

Abstract: Systems and method for controlling the bending of a robotic catheter. A control backbone of the robotic catheter is coupled to a linear movement stage by a spring and linear movement of the control backbone causes a controllable bending of the robotic catheter. A sensor monitors a deflection of the spring and the bending of the catheter is controlled based on the spring deflection signal from the sensor. The spring allows passive bending of the robotic catheter without movement of the active linear movement stage and, conversely, allows external forces applied to the robotic catheter to limit a bending movement of the robotic catheter caused by—movement of the active linear movement stage. In some implementations, the robotic catheter includes a selectively deployable tip mechanism for deploying a steerable tip or for selectively exposing side windows on the catheter for increasing traction for clot removal.

Abstract: A method of scaling a desired velocity of a tool of a surgical robot with a processing unit includes receiving an input signal, determining a position of the tool relative to a boundary of a surgical site, and scaling a desired velocity of movement of the tool when the tool is within a predetermined distance of the boundary of the surgical site. The input signal includes the desired velocity of movement of the tool.

Abstract: A delivery apparatus includes a steerable shaft having a pull-wire conduit. A pull wire extends through the pull-wire conduit. The steerable shaft includes one or more layers. A compression-resistance portion is incorporated into at least one of the one or more layers. A cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft. The compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into.

Abstract: A medical device includes an elongate device and one or more processors coupled to the elongate device. The elongate device includes a steerable distal end and a shape sensor located along a length of the elongate device. While the elongate device is being traversed through one or more passageways of a patient, the one or more processors are configured to, based on information from a sensor, monitor an insertion motion of the elongate device, detect a data collection event, and capture, in response to detecting the data collection event, a plurality of points along the length of the elongate device using the shape sensor. The data collection event is at least partially based on a change in direction of the insertion motion of the elongate device.

Abstract: The present disclosure provides a medical device comprising an actuator restraining assembly configured to assist in restraining a catheter shaft in a deflected configuration. The actuator restraining assembly may include a brake element, a release element, a connecting sheath, and a connecting rod disposed in a catheter handle, wherein the connecting sheath and connecting rod are attached to an actuator mechanism, and wherein the at brake element is attached to the connecting sheath and the release element is attached to the connecting rod. The brake element is sized and configured to contact an inner wall of the handle to thereby provide resistance to movement of actuator mechanism in a proximal direction with respect to the handle. In one embodiment, the actuator restraining assembly is configured to allow for temporary, i.e., reversible, restraining of the catheter shaft in the deflected configuration.

Abstract: A stent delivery device having a delivery configuration for delivering a stent to a treatment location and a deployment configuration for deploying the stent at the treatment location may include an outer sheath, an inner shaft slidably disposed within a lumen of the outer sheath, and a distal tip member fixedly attached to a distal end of the inner shaft. A distal portion of the outer sheath may include a plurality of longitudinal strips circumferentially disposed about the lumen of the outer sheath. At least a portion of the distal tip member may be configured to slide over a distal end of the outer sheath in the delivery configuration.

Abstract: The present invention is a system for three-dimensionally mapping a heart, comprising: a mapping catheter including three or more optical cores each of which has a plurality of FBGs disposed in the lengthwise direction of a catheter body, and a plurality of electrodes disposed in the lengthwise direction of the catheter body and exposed on the outer circumferential surface of the catheter body, wherein the electrodes make contact with the inner wall of the heart; and a mapping processor for calculating coordinates of the FBGs by wavelength information of reflected light received from the three or more optical cores, and calculating coordinates of the electrodes from the coordinates of the FBGs so as to build a three-dimensional shape of the heart by using a sample point at which the plurality of electrodes make contact.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A handle is mounted to the proximal end portion of the elongate body and operable to cause rotation of the elongate body. A tissue-removing element is mounted on the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body and is coupled to the handle at a proximal end portion of the inner liner. The inner liner defines a guidewire lumen. A sensor is arranged with respect to the inner liner and is configured to produce a signal for indicating the presence of a guidewire within the inner liner.

Abstract: The present disclosure relates to an augmented reality (AR) enabled electronic device and method. The electronic device includes a camera, a display, touch input circuitry, a motion sensor, and a processor. The processor implements the method, including acquiring a preview image captured by the at least one camera, setting an object area and/or a space area in the preview image, displaying the acquired preview image on the display, detecting an input to the display using the touch input circuitry, determining whether the detected input requests application of an object-based drawing or a space-based drawing, and applying the object-based drawing or the space-based drawing to the to the acquired preview image according to the detected input.

Abstract: Methods and apparatuses provide improved navigation through tubular networks such as lung airways by providing improved estimation of location and orientation information of a medical instrument (e.g., an endoscope) within the tubular network. Various input data such as image data, EM data, and robot data are used by different algorithms to estimate the state of the medical instrument, and the state information is used to locate a specific site within a tubular network and/or to determine navigation information for what positions/orientations the medical instrument should travel through to arrive at the specific site. Probability distributions together with confidence values are generated corresponding to different algorithms are used to determine the medical instrument's estimated state.

Abstract: A handheld endoscope has a disposable, single-use portion that includes a fluid hub, cannula, distal tip and is steerable by the operator though actuation of one or two levers. The endoscope also includes re-usable portion that has a handle and display module. The distal tip includes LED illumination and an imaging module that feeds live video to the display module that is rotatable to allow viewing by the operator and others. The single-use and re-usable portions mate and un-mate with each other via physically separated mechanical and electrical connectors. The single use portion can include grasper device that can be actuated by an operator using an actuation tab.

Abstract: A robotic surgical instrument comprising: a shaft; an articulation at a distal end of the shaft configured to articulate an end effector, the articulation driveable by a pair of driving elements; and an instrument interface at a proximal end of the shaft, the instrument interface comprising: an instrument interface element configured to drive the pair of driving elements, the instrument interface element displaceable over a displacement range, the pair of driving elements fast with the instrument interface element such that a displacement of the instrument interface element is transferred to the pair of driving elements; a tensioning mechanism configured to tension the pair of driving elements; and an alignment mechanism configured to set the displacement position of the instrument interface element to a predetermined alignment position when the end effector has a predetermined configuration, the alignment mechanism being independent of the tensioning mechanism.

Abstract: A surgical system according to one or more embodiments may include: a plurality of surgical instruments each including a flexible shaft and an end effector; an insertion tube to hold the plurality of flexible shafts and to be inserted into a body of a patient from one end of the insertion tube; and a support device for supporting the plurality of surgical instruments and the insertion tube. The support device includes a plurality of supports respectively supporting the plurality of surgical instruments, a support mechanism supporting the plurality of supports together, and an insertion tube holder holding the insertion tube. The plurality of supports independently and movably support the plurality of surgical instruments, respectively.

Abstract: A method of mapping includes receiving inputs measured by a probe at respective locations inside a body cavity of a subject. At each of the respective locations, a respective contact quality between the probe and a tissue in the body cavity is measured. The inputs for which the respective contact quality is outside a defined range are rejected, and a map of the body cavity is created using the inputs that are not rejected.

Abstract: A system, apparatus, and method of using the same are disclosed for carrying out a transvascular procedure such as a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure using energy to create a tract between the hepatic vein and the portal vein. The present invention provides a flexible puncturing solution to effectively perform a transvascular procedure such as a TIPS procedure while minimizing damage to the liver and surrounding soft tissues or organs.

Abstract: An articulable wrist for an end effector includes a first linkage rotatably coupled to a second linkage at a first articulation joint, a flexible member extending at least partially through a central channel cooperatively defined by the first and second linkages, and a first pair of roller supports arranged at the first articulation joint and laterally offset from each other, each roller support extending parallel to a first pivot axis extending through the first articulation joint. A drive cable extends through a first axially-extending conduit defined in the flexible member and through a gap defined between the first pair of roller supports. The drive cable is supported at the first articulation joint by the first pair of roller supports during articulation and the first pair of roller supports prevents a centerline of the drive cable from moving past the first pivot axis during actuation of the end effector.

Abstract: An apparatus for fragmenting a stone includes an endoscope, a laser fiber, a sheath and a detection feedback system. The endoscope includes a working channel. The working channel is configured to have a retrieval basket inserted therethrough. The sheath may include a first lumen and a second lumen. A first one of the lumen is connected to the endoscope with a shaft of the endoscope extending through the first lumen. A second one of the lumen is spaced from the shaft of the endoscope providing a channel proximate an exterior side of the shaft. The second lumen has the laser fiber inserted therethrough. The detection feedback system is configured to deliver a low energy check pulse from the laser fiber and detect a response, and configured to at least partially control delivery of a high energy laser pulse from the laser fiber to cause the stone to fragment.

Abstract: Described herein are systems, devices, and methods for closing a perforation in any hollow vessel associated with a mammalian surgical procedure, for example a device for sealing an aperture in a tissue, the device comprising an implant and a delivery shaft configured to engage the implant, the delivery shaft comprising (i) a retaining sleeve, (ii) a release sleeve, and (iii) a handle coupled to the delivery shaft.

Abstract: The disclosure relates to a medical instrument for minimally invasive tissue ablation by means of an HF electrode, with a hollow shaft, wherein the HF electrode is electrically insulated from the hollow shaft, is arranged at a distal end of the latter and, in order to ablate tissue, protrudes axially beyond the hollow shaft at least in part. The angle orientation of the HF electrode relative to the hollow shaft is adjustable in a controlled manner to a working position in which the HF electrode, protrudes radially beyond an outer circumference of the hollow shaft in order to ablate tissue. In the working position, by means of suitable adjustment of the shaft and of the HF electrode, a position can always be found in which the distal end of the HF electrode sufficiently reaches or touches tissue portions that are to be ablated in the region of the bladder neck.

Abstract: For position sensors, e.g., a fiber-based system, that build a shape of an elongated member, such as a catheter, using a sequence of small orientation measurements, a small error in orientation at the proximal end of the sensor will cause large error in position at distal points on the fiber. Exemplary methods and systems are disclosed, which may provide full or partial registration along the length of the sensor to reduce the influence of the measurement error. Additional examples are directed to applying selective filtering at a proximal end of the elongated member to provide a more stable base for distal measurements and thereby reducing the influence of measurement errors.

Abstract: A triggering device includes an optical fiber (126) configured for optical shape sensing. A supporting element (104) is configured to support a portion of the optical fiber. An interface element (106) is configured to interact with the optical fiber associated with the supporting element to cause a change in a property of the fiber. A sensing module (115) is configured to interpret an optical signal to determine changes in the property of the fiber and accordingly generate a corresponding trigger signal.

Abstract: Delivery systems, methods and associated devices to facilitate delivery and deployment of a heart implant. Such delivery systems and methods of delivery include use of a pair of magnetic catheters, including an anchor delivery catheter carrying an anchor, which can be stacked with or can be axially offset from the magnetic head. Such systems further include use of a puncturing guidewire advanceable through the magnetic head of the anchor delivery catheter to establish access to a chamber of a heart and which is attached to a bridging element such that continued advancement of the guidewire draws a bridging element attached to the first anchor across the chamber of the heart while the bridging element remains covered by the magnetically coupled catheters. Methods and devices herein also allow for cutting and removal of a bridge element of a deployed heart implant.

Abstract: Embodiments of the present disclosure provide a delivery apparatus for a prosthetic heart valve. Disclosed delivery apparatuses can include a housing, a steerable shaft, a slide nut, and a threaded shaft disposed over the slide nut. The slide nut can have an external threaded surface and an internal surface comprising a slot. The threaded shaft can have an internal threaded surface engaging the external threaded surface of the slide nut. The delivery apparatus can further include an elongated nut guide extending into the slot of the nut to restrain the slide nut against rotation relative to the housing, and a pull wire having a proximal end portion extending into the housing and coupled to the slide nut, and a distal end portion coupled to a distal end portion of the steerable shaft. The threaded shaft can be rotatable relative to the housing to produce axial movement of the slide nut within the threaded shaft.

Abstract: An insertion device includes an insertion portion in which a movable member is held in contact with an outer circumferential surface of a hollow cylindrical member. When drive power is transmitted from the hollow cylindrical member to the movable member as the hollow cylindrical member is rotated about a longitudinal axis of the insertion portion, the movable member is rotated around its own axis parallel to the longitudinal axis and moved around the longitudinal axis. The insertion portion includes a membrane covering the movable member from an outer circumferential side thereof. The membrane urges the movable member toward the longitudinal axis, thereby pressing the movable member against the outer circumferential surface of the hollow cylindrical member.

Abstract: Embodiments of clinical support systems and methods are disclosed. In one embodiment, methods for clinical performance measurement are disclosed comprising defining a range of acceptable treatment variable values for a treatment variable of a subject, performing a selected intervention, determining an affected treatment variable value and determining a selection performance measure by comparing the affected treatment variable value to the acceptable treatment variable values. In one embodiment, methods for clinical decision training are disclosed comprising defining a treatment variable of a simulated subject, selecting an intervention on the treatment variable, modeling the selected intervention and presenting a visual representation of the selected intervention.

Abstract: A body cavity drainage device includes a drainage tube with a distal end configured for insertion into the body cavity of a patient, a fluid outlet at a proximal end of the drainage tube; and an activation apparatus coupled to the drainage tube between the proximal end of the drainage tube and the distal end of the drainage tube. The activation apparatus may be configured to alter a position of the distal end of the drainage tube in response to an input at a control device of the activation apparatus, and a first portion of the drainage tube extending from the activation apparatus toward the distal end may be at least substantially coaxial with a second portion of the drainage tube extending from the activation apparatus toward the proximal end. Methods relate to forming a body cavity drainage devices.

Abstract: Steerable medical devices and methods of use. In some embodiments, the steerable medical devices can be steered bi-directionally. In some embodiments the steerable medical devices include a first flexible tubular member and a second flexible tubular member secured together at a location distal to a steerable portion of the steerable medical device.

Abstract: A device for introducing material into a body cavity is shown. The device includes a catheter with a distal tip. A first lumen extends through the catheter. The catheter is configured to faun a mist from liquid passed through the first lumen, for example including a misting nozzle in fluid communication with the first lumen and configured to provide a mist from a flow of liquid through the first lumen. An inflatable balloon may be included on the catheter to allow the user to isolate the portion of the body in which the material is introduced. Additional described features can provide for controlled deflection of a distal region of the catheter, guidewire or guide loop tool lumens, misting nozzles on the catheter, and delivery apparatuses including the catheter devices coupled to endoscopes such as bronchoscopes. Methods of use of the catheter devices and delivery apparatuses are also described.

Abstract: A hand held, hand operated apparatus for rotating, or spinning, rotatably oscillating and/or inducing back and forth longitudinal movement in a device, such as an elongated medical device. A drive shaft of the hand held, hand operated rotational drive apparatus includes a ratcheting mechanism capable of enabling oscillating (repeated forward and reverse) rotation of a device that has been coupled thereto when there is little or no resistance on the rotated device, and of enabling an actuator to return to a position that will enable further forward, or driving, rotation of the drive shaft and the rotated device when resistance on the rotated device prevents the rotated device and the drive shaft from rotating in a reverse direction.