Abstract: An endoscopic snare net comprises a net engaging a loop, such as by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners or a collared, free-floating slip tether or both thereof, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube, even if the loop is over-extended beyond the end of the tube.

Abstract: A method of marking lesions is disclosed herein. The disclosed method may assist surgeons localize small nodules by marking the nodules with a fiducial coil soaked with a fluorescent dye. In some preferred embodiments, the fiducial coil is placed at the time of biopsy using a robotic surgery system. In alternate embodiments, non-robotic peripheral navigation platforms may also be used effectively as an adjunct to surgical resection. The dye marks the location of a nodule, making it visible and palpable at the time of surgery. A surgeon may then target cancerous tissue with greater precision. The disclosed method allows a fiducial coil to be placed several days prior to surgery.

Abstract: An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has an outer body and an inner body present within a lumen of the outer body. The outer body may be malleable and have a pre-set deflection or may be flexible and achieve deflection when being inserted into the epidural space. Once in the epidural space, the inner body is extended distally from the lumen of the outer body such that a distal tip on the inner body extends further into the epidural space to provide clearing to the target site without requiring further ingress of the outer body. The inner body is retracted and the clearing tool is removed. The medical lead is then inserted through the window and cleared epidural space until reaching the target site.

Abstract: A medical assembly and method of use includes a catheter, a medical instrument and a navigation system. A localization element is attached to a handle of the catheter. A localization element is attached to a handle of the medical instrument. The localization elements are detectable by the navigation system. The medical instrument includes a needle, when the needle is positioned entirely within a working channel of the catheter, a tip of the needle is in an unextended position and the location elements are in a zeroed out position. When the needle tip extends out of the working channel to an extended position, the location elements are in an extension position. In the extension position the distance between the location elements is less than in the zeroed out position. The difference between the zeroed out position and the extension position is displayed on a display as a needle stroke value.

Abstract: A looped wire is provided for placing an endograft into a blood vessel. The looped wire comprising a flexible guidewire with one or more loops distributed along its length. The one or more loops have an inner diameter that is larger than the thickness of a suture or wire for threading the suture or wire through. The one or more loops is adapted for sliding along the suture or wire. Endograft system comprising the looped wire, and methods of using the looped wire are also provided.

Abstract: An ergonomic medical device handle which allows for multiple type grip styles and reduces operator fatigue by balancing the weight of the device about a fulcrum point. More particularly a laparoscopic suction irrigation device having its tubing centrally located to allow the handle to rest comfortably and balanced on the hand in any of the commonly used grips. This dramatically reduces the fatigue associated with holding devices for long periods of time.

Abstract: An apparatus for retracting a sheath from over an expandable medical device includes a shell, configured to couple to a longitudinal element, a carriage disposed within the shell and configured to couple to the sheath, and a lever protruding from the shell. The lever is configured to retract the sheath while a distal end of the longitudinal element contacts the expandable medical device, by rotating proximally so as to move the carriage proximally by a first distance, and, subsequently to rotating proximally, sliding proximally so as to move the carriage proximally by a second distance. Other embodiments are also described.

Abstract: A tissue fixation system including a delivery tube and an elongated fastener with a loop at a proximal end and a distal end. A proximal end of an elongated curved needle is attached to the delivery tube. A distal end of the needle is configured to penetrate tissue. The needle includes an open channel sized to receive the elongated fastener with the loop located near the proximal end of the elongated curved needle and the distal end of the elongated fastener located near the distal end of the elongated curved needle. A capture needle is slidably positioned in the delivery tube to slide through the loop in the proximal end of the elongated fastener. The capture needle is configured to grasp the distal end of the elongated fastener and pull the distal end of the elongated fastener through the loop to cinch the elongated fastener.

Abstract: A method of using a suction device to remove an object from a subject's body includes extending a suction device into the body through a lumen of a medical device and expanding the suction head from a contracted configuration to an expanded configuration within the body. The suction head may be provided at a distal end of an elongate conduit. The method may also include applying suction to move the object into the expanded suction head, and removing the suction device with the object from the body.

Abstract: Polypectomy devices and methods for making and using polypectomy devices are disclosed. An example polypectomy device may include an elongate sheath having a proximal end region and a distal end region. A shaft may be slidably disposed within the sheath. A handle may be coupled to the proximal end region of the sheath. The handle may be designed to axially shift the shaft relative to the sheath. A snare may be coupled to the shaft. The snare may include a first region, a traction region, and a distal tip region. The first region may have a non-circular cross-sectional shape. The traction region may include a plurality of traction members. At a position between two adjacent traction members the snare may have a reduced cross-sectional area relative to the first region. The distal tip region may have a circular cross-sectional shape.

Abstract: A medical implant delivery system is described. The system can be used to deliver a variety of implants including stents and/or stent grafts. The delivery system retains the implant during delivery and detaches the implant at a target location.

Abstract: Disclosed is a system for vascular access, where the system allows for transitions between retrograde and antegrade access without generation of multiple access sites and without inducing extensive vascular damage. In embodiments, the system can include a vascular access portion including a body with a first lumen for preferentially providing access in a retrograde direction into a vessel, and a second lumen for preferentially providing access in an antegrade direction into the vessel. The body can be transitioned (e.g., by way of expansion, contraction, or other deformation mode) between a retrograde delivery mode and an antegrade delivery mode.

Abstract: A tissue removal tool for use with an endoscope. The tool includes a loop formed by a piece of wire. The loop is movable between an open position and a closed position. The shape of the loop is defined in the open position by a proximal portion and a distal portion. The piece of wire may have a cross-sectional height in the proximal portion unequal to a cross-sectional height in the distal portion.

Abstract: An endoscopic forceps includes an elongate shaft defining an instrument axis. An end effector includes first and second jaw members each supporting an opposed sealing surface for clamping tissue. At least one of the jaw members is movable relative to the instrument axis such that the jaw members are movable between a first spaced-apart configuration and a second closed configuration for grasping tissue. A cutting instrument includes a reciprocating blade translatable relative to the sealing surfaces to sever tissue clamped between the jaw members. The reciprocating blade contacts an undersurface of at least one of the jaw members when the jaw members are in the second configuration to define a gap distance between the sealing surfaces. A handle adjacent the proximal end of the elongate shaft is operable to induce motion in the jaw members, and an actuator is operable to selectively translate the reciprocating blade.

Abstract: The present disclosure relates to an explantation assembly for retrieving an intracorporeal capsule implanted in a tissue of a patient comprising a first tube and a second tube. The first tube comprises a snare and a tissue. The second tube is configured to interact with the snare of the first tube and configured to be attached to the tissue of the patient.

Abstract: The endoscopic device includes a main member having a front slot and a shaft member having a spiral strip selectively running through the slot. The spiral strip is connected to a rotational element whose front end is provided with an optical element. A camera support element is extended from the main member and a camera element is supported by the camera support element. By running the spiral strip through the slot to turn the rotational element and the optical element, a viewing direction of the camera element is altered by the optical element.

Abstract: A containing element is used to capture material in a blood vessel for removal. The containing element is positioned within a constraining catheter while it is advanced through the blood vessel. A filament is coupled to the containing element which assists in opening and/or closing the containing element.

Abstract: A device and a method for increasing or restoring a flow in a body lumen are provided. The device and the method may treat conditions related to a stroke, such as an ischemic stroke, by removing an occlusion from a blood vessel and/or reopen a blood vessel. The device may comprise a tubing compartment, a central wire, and an engaging compartment. The engaging compartment may comprise a distal engaging element and a proximal engaging element. A clot or occlusion present in the body lumen such as an artery may be engaged in and/or between the distal and proximal engaging elements. Further, the positions of one or both of the engaging elements and the distance therebetween can be adjusted to ensure the engagement of the clot or occlusion.

Abstract: An apparatus including a basket device including a basket section; and a sheath on the basket device. The basket device and the sheath are configured to longitudinally slide relative to each other. The basket section includes at least two groups of loop petals including a first group having at least two first loop petals and a second group having at least two second loop petals, where the first loop petals have a different size than the second loop petals.

Abstract: An endoscopic snare net comprises a net engaging a loop, such as by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners or a collared, free-floating slip tether or both thereof, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube, even if the loop is over-extended beyond the end of the tube.

Abstract: Aspects of a device are described. One aspect is a device comprising: a housing having a first portion engageable with a scope, and a second portion engageable with a handle of a retrieval device; a platform that is movable relative to the housing, and engageable with a slider of the retrieval device; and a link assembly that is coupled the housing and the platform, and operable to move the platform and slider relative to the housing and handle. Aspects of related devices and systems also are described.

Abstract: Tissue ligation devices and methods are provides to mechanically strangulate abnormal or undesirable tissue. Tissue ligation devices include a catheter having an outer diameter smaller than the inner diameter of a standard endoscope channel such that the catheter can be inserted into the endoscope. Tissue ligation devices also include a ligation system with an expandable hood disposed located at the distal end of the catheter. A suture extends through a lumen of the catheter and has a distal loop portion exposed outside of the expandable hood.

Abstract: A medical device may include a handle, a sheath fixed relative to the handle, a longitudinal actuator movable relative to the handle, an end effector, a member extending proximally from the end effector through the sheath, with a portion of the member being fixed relative to the longitudinal actuator, and a rotation actuator. Movement of the rotation actuator may cause rotation of the member relative to the sheath, and movement of the longitudinal actuator may cause longitudinal movement of the member relative to the rotation actuator.

Abstract: An endoscope device is provided, which includes: an insertion part inserted into an examination subject; an outer coat tube disposed at an outer circumferential portion of the insertion part; a fixing member at least a part of which is inserted into the outer coat tube, and the fixing member being in contact with an inner circumferential surface of the outer coat tube; a tight binding thread wound around the outer coat tube, the tight binding thread being made flat in a state in which at least a void is pressed to be flattened, and the tight binding thread being wound such that a longitudinal surface in a flat cross section of the tight binding thread is in contact with an outer circumferential surface of the outer coat tube; and a resin layer formed on the outer coat tube to cover the tight binding thread.

Abstract: The endoscopy tool and methods of use disclosed herein are used to move gastrointestinal tissue. The endoscopy tool includes an auxiliary gastrointestinal device, or a catheter, having a proximal region and a distal region. The endoscopy tool includes a non-conductive, polymeric loop coupled to and extending distally from the distal end of the gastrointestinal device. The surfaces of the loop are smooth such that the loop can move intestinal tissue without causing lacerations.

Abstract: There is provided an endoscopic snare including: a flexible sheath 1; a cable 2 configured to slide in the sheath; a snare loop 3 connected to the cable 2, and projecting from or retracting into the sheath 1; a distal end tip 4 disposed in a distal end part of the sheath and retaining the snare loop 3; and a hand operating part for operating the snare loop 3 via the cable 2. One end of the snare loop 3 is attached to the distal end tip and the other end of the snare loop 3 is attached to a distal end of the cable. The snare loop 3 is expanded into a ring shape without a protruding portion when it is projected from the sheath 1, and is formed into an asymmetric shape where expansion is deviated to either side about an axis of the sheath.

Abstract: An apparatus, device and method are provided for executing a clot or plaque removal procedure. In one embodiment, a clot removal device may include a clot holding element for penetrating a target clot and stabilizing the clot in its position; a controllable distal filter that can be extended to cover the target clot; a distal filter, openable downstream from the clot, designed to substantially prevent flow through of clot elements, and further designed to drag the clot out of a vessel, for retrieving by the clot removal device.

Abstract: The devices and methods described herein relate to improved structures for removing obstructions from body lumens. Such devices have applicability in through-out the body, including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: An apparatus (100) includes: a expandable structure (140) formable into three dimensional shapes including a range of diameters (D) and corresponding lengths (L); a movable component (106) moveable between a range of positions (124, 126) effecting the range of diameters; and a mechanical linkage (110) disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel (204) of an endoscope (202) when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location (400) past a distal end (404) of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

Abstract: A system for removing a thrombus. The system includes an expandable device that maintains axially fixed engagement with the thrombus. The expandable device applies a first force to the thrombus according to surrounding vessel size. The expandable device applies a second force to the thrombus according to an increased vessel size to maintain axially fixed engagement.

Abstract: A removable dual endovascular filter that may be introduced into arteries of the heart during surgery to allow sufficient blood flow to a cerebral vascular system while minimizing or preventing embolic material from traveling throughout a body circulatory system. The removable dual endovascular filter reduces the risk of stroke while minimizing obstruction of the patient's aorta.

Abstract: A catheter according to an embodiment of the present disclosure includes a mesh member, a first hollow shaft, a front end tip, a guiding film, and a core wire. The mesh member has a tubular shape and is radially expandable and contractable. The guiding film is formed with a stretchable material and is disposed on the mesh member, the guiding film having a front end located between a base end of the front end tip and a front end of the first hollow shaft. A thickness of a base end of the guiding film is larger than a thickness of the front end of the guiding film.

Abstract: An endoscopic cutting device for cutting free a probe, provided with a retaining plate, which, within the scope of a percutaneous endoscopic gastrostomy, is arranged in a stomach wall and is overgrown by the gastric mucosa, wherein, for the adjustment of the cutting element provided at a distal end of a tube via a pulling cord, an actuation force of an actuation element can be transmitted to same. In addition, the cutting device includes a cutting wire which is electrically heatable and connected to the pulling cord, and which runs outside the tube via a distal section to form a first diathermy blade. In addition, the distal end of the tube is slanted at an angle to the transverse plane thereof to form a tip, wherein the tip is facing the first diathermy blade. Furthermore, the cutting wire is directed externally around the tip to form a second diathermy blade.

Abstract: Devices used to repair ruptured tendons are described, particularly a tendon grasping device and devices for the application thereof and to the uses if these devices; the tendon grasping device is made of a suitable for surgery bio-compatible material, a series of curved elements connected sequentially to form a hollow deformable structure; in use each curved element surrounds the tendon and the structure deforms between a radially extended condition and a radially retracted condition, in which each curved element firmly surrounds the tendon by applying pressure around the tendon without penetrating it.

Abstract: A medical device includes a handle with a proximal arm and a distal arm. The proximal arm and the distal arm are pivotable via a joint. The medical device also includes a tube coupled to the distal arm and a drive wire. A distal portion of the drive wire includes an expandable end effector. A portion of the drive wire is positioned within the tube, and a different portion of the drive wire extends proximally of the distal arm and is coupled to the proximal arm.

Abstract: A tissue specimen retrieval device includes a first shaft and a second shaft telescopically movable relative to the first shaft. The second shaft supports an end effector assembly at a distal end thereof and is movable relative to the first shaft between a retracted position, wherein the end effector assembly is disposed within the first shaft, and a deployed position, wherein the end effector assembly extends from the first shaft in an expanded configuration. The end effector assembly includes a bag brim having a wire support with first and second ends that operably engage the distal end of the second shaft. The bag brim is transitionable from a first collapsed configuration within the first shaft to an expanded configuration upon deployment therefrom. The wire support includes torsion springs disposed between the first and second ends that cooperate to facilitate expansion of the bag brim upon deployment from the first shaft.

Abstract: Systems and methods for delivering and retrieving a leadless pacemaker are described. A leadless pacemaker retrieval system includes a catheter system having a snare assembly to capture the leadless pacemaker. The catheter system includes sheaths extending distally from a shaft, and the snare assembly includes several snare legs, such as segments of snare loops, that extend from one sheath to connect to another sheath. The snare loops can have bights that connect to opposing sheaths to form a docking space between the legs of the snare loops and radially between the sheaths. The snare assembly is movable between an engaged position and a disengaged position by translating the snare legs within lumens of the corresponding sheaths. In the engaged position, the snare assembly tightens around the leadless pacemaker to allow the leadless pacemaker to be retrieved. Other embodiments are also described and claimed.

Abstract: In a tissue binding method, a ring-shaped part (15) of a snare wire (10b) is disposed at a position surrounding a binding target site, the tissue at the binding target site is pulled while the ring-shaped part (15) is pressed against the tissue around the binding target site at a plurality of pressing points that are located away from each other in the circumferential direction of the ring-shaped part (15), and, in a state in which the tissue at the binding target site is pulled, the diameter of the ring-shaped part (15) is reduced to bind the tissue, while adjusting the position in the pressing direction at one or more of the pressing points.

Abstract: A treatment device includes a flexible sheath; a control wire that can move axially within the flexible sheath; a first treatment member connected to a distal end of the control wire; a second treatment member connected to a distal end of the first treatment member; and a protection member that covers the second treatment member depending on the mode of operation. When the treatment device is in a first treatment mode, the second treatment member projects from a distal end of the protection member. When the treatment device is in a second treatment mode, the first treatment member projects from the distal end of the flexible sheath, and the protection member covers the second treatment member.

Abstract: A medical device may include a handle having a first portion and a second portion angled with respect to the first portion. The handle may further include a rail extending along the first portion of the handle. The rail may include a groove. The handle may also include a first actuator longitudinally moveable with respect to the handle along the rail and a second actuator rotatable about an axis collinear to a longitudinal axis of the first portion. Further, the handle may include a shaft longitudinally fixed relative to the first actuator.

Abstract: A method for increasing or restoring a flow in a body lumen can treat conditions related to a stroke, such as an ischemic stroke, by removing an occlusion from a blood vessel and/or reopen a blood vessel. The method makes use of a device that includes a central wire, a pusher tube, a distal structure, and a proximal structure into the blood vessel, in which the distal structure is closed at its proximal end. A clot or occlusion present in the body lumen such as an artery may be engaged in and/or between the distal and proximal engaging elements. Further, the positions of one or both of the engaging elements and the distance between them can be adjusted to ensure the engagement of the clot or occlusion.

Abstract: A telescoping catheter is provided such as for distal neurovascular aspiration or access. The catheter includes an elongate, flexible tubular body, having a proximal section with at least one lumen and a distal section which is axially movably positioned within the lumen. A control is provided for advancing the distal section from a first, proximally retracted position within the proximal section to a second extended position, extending distally beyond the proximal section. The distal end of at least one of the proximal and distal sections may be provided with at least one active feature, such as at least one movable jaw or rotatable agitator, to assist in the capture of vascular obstruction. The jaw may be operable in response to application of pulsatile negative pressure through the catheter.

Abstract: According to an embodiment of the present invention, there is provided a ligation device that includes an insertion portion that has a lumen through which are passed a ligature having a first end having a contractible loop formed by a knot, and a pull thread having a folded-back portion fed through the loop; an operation portion provided at a proximal end portion of the insertion portion, the operation portion including a anchoring portion to which a first end of the pull thread is anchored; and a movable member movable relative to the operation portion while switching between a first state in which a second end of the pull thread is anchored to the movable member and pulled and a second state in which the ligature is pulled and the pull thread is let out simultaneously.

Abstract: A medical device may include a snare loop and an elastic member that connects at least two sides of the snare loop. The elastic member is configured to transition from an unexpanded state where the elastic member is in a plane of the snare loop to an expanded state where the elastic member is outside the plane of the snare loop. The snare loop has a same shape when the elastic member is in the unexpanded shape and the expanded shape.

Abstract: Implementations described and claimed herein provide systems and methods for delivering and retrieving a leadless pacemaker. In one implementation, a leadless pacemaker has a docking end, and the docking end has a docking projection extending from a surface. A docking cap has a body defining a chamber. A retriever has sheaths extending with lumens distally from the chamber. A snare extends between the lumens forming a first snare loop pointing in a first direction and a second snare loop pointing in a second direction with a docking space formed therebetween. The snare is movable between an engaged position and a disengaged position by translating the first snare wire and the second snare wire within the first snare lumen and the second snare lumen. The engaged position includes the first snare wire and the second snare wire tightened around the docking projection within the docking space.

Abstract: In a system for retrieving an implanted device, a flared inner surface of a catheter tubular sidewall may define a distal-most opening of a device receptacle; the opening has a first diameter equal to that of the receptacle, and a second diameter, coincident with a distal-most edge of the tubular sidewall, and at least 5% greater than the receptacle diameter. Alternately, a retrieval tool in sliding engagement within a lumen of a catheter includes a shaft assembly, through which a snare member passes, and which includes a collapsible spring-biased perimeter sidewall; the sidewall defines a capture member passageway approximately coaxial, and in fluid communication with a lumen of the shaft assembly. A distal-most opening of the passageway has a spring-biased diameter that is greater than that of a distal-most opening of a device receptacle of the catheter, and a collapsed diameter that is less than the receptacle distal-most opening diameter.

Abstract: Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

Abstract: A method for removing material within a body lumen of a patient is disclosed. The method include introducing a distal end of a tubular member into a body lumen. The tubular member has a guide member extending distally from the distal end. Next, the tubular member is positioned such that the distal end is disposed adjacent material to be removed and a distal tip of the guide member is disposed beyond the material. One or more lumen clearing elements are then deployed from the distal tip of the guide member. Each lumen clearing element includes an expandable structure that expands from a contracted condition within the guide member to an expanded condition when deployed from the distal tip. Then, the deployed one or more lumen clearing elements are retracted along a track of the guide member to engage the material disposed adjacent the distal end of the tubular member and draw the material into a lumen of the tubular member.

Abstract: A calculus removing device includes a retaining portion (e.g., a wire or gel), a cylinder, an introduction tube, and a hand-operated unit. The retaining portion is configured to retain calculi and broken calculus pieces. The cylinder includes a storage portion configured to store the calculi, an opening communicating with the storage portion, and an introducing portion configured to permit the retaining portion to be introduced into the storage portion. The introduction tube is provided with a lumen which allows introduction of the retaining portion into the storage portion via the introducing portion. The hand operating unit is provided with an operating member configured to operate the introduction of the retaining portion into the storage portion.

Abstract: The present invention provides a method for manufacturing a medical basket treatment tool. The method for manufacturing a medical basket treatment tool having one or more wire formed using an alloy containing two or more metals includes a heating process of performing heat treatment on a target portion of at least one wire among the wires one or more times, the heat treatment irradiating the target portion with a laser with an irradiation fluence of 103 J/cm2 or more and heating the target portion to become a predetermined temperature lower than the solid solubility limit of the alloy.