Abstract: A surgical rongeur device has an interchangeable, locking tip at a cutting end for engageable replacement with a variety of cutting tips for facilitating sterilization and blade changes. A detachable linkage between a handle portion and an interchangeable cutting tip (tip) provides a strong connection for actuation by the handle end but allowing for tip replacement via slidable, lateral displacement of the tip. The tip includes a blade and footplate formed from an amorphous metal for longevity and strength advantages. A handle provides a lever to actuate the tip from slidable communication via the detachable linkage. An interlocking member extends longitudinally from the handle into an internal slot on the tip for locking the tip by preventing lateral movement out of alignment with the handle. The aligned tip is responsive to actuation from the handle via a rail for disposing the blade longitudinally against the footplate.

Abstract: An implant resection system for preparing an implant site to replace a defect in an articular surface of a first bone includes a first guide configured to be coupled generally to the first bone. The first guide includes a body portion defining a channel configured to receive a pin, wherein the pin is configured to penetrate and form a longitudinally disposed bore within the first bone. The implant resection system further includes a second guide configured to be coupled generally perpendicular to the first bone proximate to the defect by way of the bore. The second guide includes a drill bit configured to form an excision site through a portion of the articular surface in preparation of receipt of an implant.

Abstract: An apparatus for slicing a cartilage sample includes a rear cartilage support cup, a cartilage clamp, a front cartilage support, a cartilage receiving region, and a cartilage cutting element. The cartilage clamp has first and second clamp members spaced apart from and aligned in a clamping direction transverse to a longitudinal axis. The cartilage receiving region is bounded by the first and second clamp members, the front cartilage support, and the rear cartilage support cup. The cartilage cutting element is spaced rearwardly from the front cartilage support by a cartilage slice thickness, the cartilage cutting element being movable across the cartilage receiving region in a cutting direction transverse to the longitudinal axis.

Abstract: A system for creating an arteriovenous (AV) fistula comprises a vessel access sheath having a hollow interior and an exit port, a side access needle catheter configured to fit within the hollow interior of the sheath, a needle configured to be inserted into a blood vessel through the side access needle catheter, a toggle delivery catheter configured to fit within the hollow interior of the sheath, and a toggle apparatus configured to be delivered into a vessel through the toggle delivery catheter. The toggle apparatus comprises a shaft and a toggle member pivotably attached to a distal end of the shaft. A source of RF energy or resistive heat energy may be provided for application to the toggle member and/or to a heater insert in the toggle delivery catheter, for the purpose of creating the fistula.

Abstract: A method of making a side-to-side anastomosis includes making first and second holes through a first vessel, and second vessel, respectively, by receiving a jaw of a punch tool into exposed ends of the respective vessels, and then moving a punch tool toward the jaw and through the wall of the vessel. The vessels are joined with an elongate eyelet with a passage that matches a shape of the oval first and second holes. The long axes of the oval holes are oriented parallel to a longitudinal axes of the respective vessels.

Abstract: A cutting edge of a punch includes side segments and a central segment disposed between the side segments. When the punch head slides into a hollow blade, the central segment of the cutting edge meets the punch head before the side segments meet the punch head. The central segment starts cutting first, which can help avoid a dog-bone shaped hole when the punch is used on a blood vessel, such as the aorta.

Abstract: Systems and methods for positioning a cut guide using navigation-based techniques are discussed. For example, a system for use in an orthopedic surgery on a target bone can comprise a cut guide adjustably positionable onto the target bone via two or more coupling receptacles created on the target bone. The coupling receptacles can include one or more guide members and a plurality of landing members. The system also includes an input interface that can receive a target bone representation, and a model receiver module that can receive a generic post-coupling bone model. The target bone representation can include a data set representing two or more landing sites of the target bone, and the generic post-coupling bone model can include a data set representing a bone having two or more coupling receptacles each sized, shaped or otherwise configured to receive and secure the respective coupling feature of the landing members.

Abstract: A tissue resection guide for use with a datum includes a base releasably engagable with the datum. The tissue resection guide has a first frame fixed relative to the base and the first frame has at least one integral first guide path that is sized and configured to at least partially capture and guide a first tissue resection tool relative to the first frame.

Abstract: Systems and methods for positioning a cut guide using navigation-based techniques are discussed. For example, a system for use in an orthopedic surgery on a target bone can comprise a cut guide adjustably positionable onto the target bone via two or more coupling receptacles created on the target bone. The coupling receptacles can include one or more guide members and a plurality of landing members. The system also includes an input interface that can receive a target bone representation, and a model receiver module that can receive a generic post-coupling bone model. The target bone representation can include a data set representing two or more landing sites of the target bone, and the generic post-coupling bone model can include a data set representing a bone having two or more coupling receptacles each sized, shaped or otherwise configured to receive and secure the respective coupling feature of the landing members.

Abstract: Systems and methods for positioning a cut guide using navigation-based techniques are discussed. For example, a system for use in an orthopedic surgery on a target bone can comprise a cut guide adjustably positionable onto the target bone via two or more coupling receptacles created on the target bone. The coupling receptacles can include one or more guide members and a plurality of landing members. The system also includes an input interface that can receive a target bone representation, and a model receiver module that can receive a generic post-coupling bone model. The target bone representation can include a data set representing two or more landing sites of the target bone, and the generic post-coupling bone model can include a data set representing a bone having two or more coupling receptacles each sized, shaped or otherwise configured to receive and secure the respective coupling feature of the landing members.

Abstract: Systems and methods for positioning a cut guide using navigation-based techniques are discussed. For example, a system for use in an orthopedic surgery on a target bone can comprise a cut guide adjustably positionable onto the target bone via two or more coupling receptacles created on the target bone. The coupling receptacles can include one or more guide members and a plurality of landing members. The system also includes an input interface that can receive a target bone representation, and a model receiver module that can receive a generic post-coupling bone model. The target bone representation can include a data set representing two or more landing sites of the target bone, and the generic post-coupling bone model can include a data set representing a bone having two or more coupling receptacles each sized, shaped or otherwise configured to receive and secure the respective coupling feature of the landing members.

Abstract: Systems and methods for positioning a cut guide using navigation-based techniques are discussed. For example, a system for use in an orthopedic surgery on a target bone can comprise a cut guide adjustably positionable onto the target bone via two or more coupling receptacles created on the target bone. The coupling receptacles can include one or more guide members and a plurality of landing members. The system also includes an input interface that can receive a target bone representation, and a model receiver module that can receive a generic post-coupling bone model. The target bone representation can include a data set representing two or more landing sites of the target bone, and the generic post-coupling bone model can include a data set representing a bone having two or more coupling receptacles each sized, shaped or otherwise configured to receive and secure the respective coupling feature of the landing members.

Abstract: A system for creating an arteriovenous (AV) fistula comprises a vessel access sheath having a hollow interior and an exit port, a side access needle catheter configured to fit within the hollow interior of the sheath, a needle configured to be inserted into a blood vessel through the side access needle catheter, a toggle delivery catheter configured to fit within the hollow interior of the sheath, and a toggle apparatus configured to be delivered into a vessel through the toggle delivery catheter. The toggle apparatus comprises a shaft and a toggle member pivotably attached to a distal end of the shaft. A source of RF energy or resistive heat energy may be provided for application to the toggle member and/or to a heater insert in the toggle delivery catheter, for the purpose of creating the fistula.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an energy delivery device that avoids coring when it delivers energy to a tissue. The device has a distal face defining an opening, with the distal face including at least one electrically exposed portion and at least one electrically insulated portion. An embodiment of the energy delivery device includes an elongate member defining a lumen structured to receive a fluid, and a distal face defining an aperture in communication with the lumen. The distal face includes an electrically exposed conductive portion and an electrically insulated portion. The electrically exposed conductive portion is configured such that the energy it delivers while the energy delivery device is advanced into a tissue punctures the tissue without the tissue substantially occluding the lumen and without creating embolic particles.

Abstract: A device for assisting in the removal of items endovascularly includes a catheter, an engagement head, and a pull rod. The pull rod has a proximal portion and a distal end connected to the engagement head. The pull rod is movable within the catheter to selectively extend and retract the engagement head from the distal end of the catheter. The engagement head is arranged to grab an item without regard to a particular orientation of the item. The engagement head has a generally cylindrical outer shape that corresponds to an internal surface of the catheter. The engagement head has a serrated proximal edge arranged to grab and hold an item against the distal end of the catheter, and an internal relief area located radially inwardly from said serrated proximal edge to aid in engaging an item.

Abstract: Devices and method for performing replacement prosthetic knee surgery are disclosed in which a spacing means is introduced between the femur (1) and tibia (2) while the patella (9) is in place. The spacing means separates the femur (1) from the tibia (2) by an amount essentially equal to or greater than the required flexion gap (4). An alignment device (26) is used for performing femoral bone cuts, which device attaches temporarily to a fitted tibial plate.

Abstract: A spinal fusion implant including a body and a jacket is disclosed. The jacket includes at least two radiopaque markers extending therefrom for use in determining the position of the implant after placement between intervertebral bodies. Methods of implanting and evaluating positioning of the implant are also disclosed.

Abstract: A tool for coring a hole in a portion of a patient's body. A cylindrical sheath includes a hollow bore open at both ends. A shaft is axially movable back and forth within the bore. A blade assembly is attached to one end of the shaft. The blade assembly comprises a hollow open cup portion having a closed end and a cutting edge formed around the margin of the open end. An interface is attached to the sheath which is shaped and dimensioned to communicate with a connector used to connect a medical device to a patient's body.

Abstract: In one embodiment, the present invention includes a method of alignment for resection of tissue including obtaining a surgical device comprising an alignment guide, a first guide structure and a second guide structure; securing the alignment guide to a bone, the alignment guide including a positioning block; placing the first guide structure onto the positioning block of the alignment guide; viewing a target location of a first resection plane on the bone using the first guide structure; adjusting the target location of the first resection plane by adjusting a position of the first guide structure; attaching the second guide structure to the first guide structure; viewing a target location of a second resection plane on the bone using the second guide structure; and adjusting the target location of the second resection plane by adjusting a position of the second guide structure.

Abstract: Disclosed is an aortic punch comprising a first body member having a proximal end and a distal end, a second body member disposed at least partially within said first body member, a manual actuator, a piston having an anvil disposed at a distal end thereof, and a shear, said shear being integral with said second body member. The first body member and second body member are axially movable relative to one another between a fully extended position and a fully retracted position and within a range of intermediate positions while maintaining the piston and shear in position relative to each other in the axial direction, and separately the shear is axially movable via manual actuation relative to said anvil between an insertion position and a shearing position and a range of intermediate positions.

Abstract: Methods and systems include an aspiration probe that includes a flutes section. The flutes section includes one or more longitudinal channels and another section that is coupled to the flutes section. The other section includes one or more openings corresponding to the one or more longitudinal channels. The flutes are configured to be placed within bone marrow through a hole in a bone. The openings are configured to be coupled to a suction device for generating suction. The flutes are configured to channel the bone marrow from within the bone into the openings based at least upon generating the suction.

Abstract: A coring knife can be used to make a circular incision. The coring knife can include an abutment that can be inserted into heart tissue. The circular incision is made by pressing the circular cutting edge of the coring knife against the abutment.

Abstract: Systems and methods for creating an arteriovenous (AV) fistula comprise an elongate member, a distal member connected to the elongate member and movable relative to the elongate member, and a heating member disposed on at least one of the movable distal member and the elongate member. The distal member comprises structure for capturing tissue to be cut to create the fistula, and the heating member is adapted to cut through the tissue to create the fistula. The elongate member comprises an elongate outer tube. A shaft connects the distal member to the elongate member, and is extendable and retractable to extend and retract the distal member relative to the elongate member.

Abstract: In the context of bone surgery and in particular arthroscopic surgery, there is frequently a need for the application of “percussive force” to the distal end component(s) of a surgical device, i.e., repetitive percutient or striking force analogous to that of a hammer driving a nail. Disclosed herein are mechanisms and methods for automating and/or controlling the application of such a percussive force so as to avoid the present need in the art for a “third hand”. The present invention addresses the significant and long felt need by providing a powered percussive driver device that may be controlled directly by the primary surgeon.

Abstract: Aspects of embodiments of the invention relate to a spring-return actuator comprising a first piston movable between a first and a second position by pressurized fluid to move a load; a safety system comprising a second piston movable by the pressurized fluid to arm the safety system and which returns the first piston from the second position to the first position when de-energizing the 3/2 pilot valve or when the pressure of the pressurized fluid drops below a safety pressure threshold; and a differential fluid channel for providing the pressurized fluid and configured so that the first piston while working to move the load remains substantially disengaged from the safety system being armed.

Abstract: A support apparatus for supporting a trocar while the trocar extends through a body wall of a patient includes an inflatable collar extending around the trocar which can be inflated to a predetermined size by a source of fluid where the source of fluid is located on the trocar support apparatus itself so as to be carried thereby and is defined by a pump mechanism to provide a fixed volume allowing inflation only to a fixed size. An abutment member is shaped to be received on an outer surface of the trocar sleeve and adjustable longitudinally of the trocar sleeve so as to be located at a selected position. A tube connecting the pump on the abutment to the inflatable collar is wrapped helically around the sleeve of the trocar. The collar includes a sleeve portion which can be unrolled on to the trocar sleeve.

Abstract: Devices and method for performing replacement prosthetic knee surgery are disclosed in which a spacing means is introduced between the femur (1) and tibia (2) while the patella (9) is in place. The spacing means separates the femur (1) from the tibia (2) by an amount essentially equal to or greater than the required flexion gap (4). An alignment device (26) is used for performing femoral bone cuts, which device attaches temporarily to a fitted tibial plate.

Abstract: A system for creating an arteriovenous (AV) fistula comprises a vessel access sheath having a hollow interior and an exit port, a side access needle catheter configured to fit within the hollow interior of the sheath, a needle configured to be inserted into a blood vessel through the side access needle catheter, a toggle delivery catheter configured to fit within the hollow interior of the sheath, and a toggle apparatus configured to be delivered into a vessel through the toggle delivery catheter. The toggle apparatus comprises a shaft and a toggle member pivotably attached to a distal end of the shaft. A source of RF energy or resistive heat energy may be provided for application to the toggle member and/or to a heater insert in the toggle delivery catheter, for the purpose of creating the fistula.

Abstract: An ophthalmic endoprobe including a hand-piece and a cannula assembly having a longitudinal axis is provided. The cannula assembly including an inner tube concentric with an outer tube; wherein the hand-piece may further include a motor powered by a pneumatic energy source, the motor providing motion to a transmission shaft; and a transmission system to couple the shaft motion to the cannula assembly; wherein the transmission system provides a counter-rotating motion to the inner tube and the outer tube about the longitudinal axis of the cannula. A fluid console for use in endoscopic ophthalmic microsurgery including a pneumatics module to obtain a pneumatic force from an external source and provide an adjustable pneumatic force; a scanning module coupled to the pneumatics module; and an endoprobe coupled to the scanning module is also provided.

Abstract: The invention relates to a surgical instrument comprising a handling part and a tool part that encompasses at least one movably mounted tool which is actuated via a force-transmitting and/or actuating mechanism. The force-transmitting and/or actuating mechanism is operated from the handling part and is provided with a fluid-operated drive unit. With the drive unit in a first driving position the movably mounted tool is subjected to a first actuating force in an actuating direction and in at least a second driving position is subjected to at least a second actuating force in the actuating direction.

Abstract: A rongeur comprising a bottom shaft comprising a proximal end, a distal end terminating in a footplate, a substantially flat upper surface extending along the bottom shaft, and a groove characterized by a wider proximal recess and a narrower distal recess comprising an undercut; a top shaft comprising a proximal end, a distal end, a substantially flat bottom surface extending along the top shaft, and a tongue characterized by a crossbar connected to the flat bottom surface by a vertical riser; wherein the flat bottom surface rests on the flat upper surface and the tongue is slidably disposed in the groove so that when the top shaft is moved distally relative to the bottom shaft, the tongue slides from the proximal recess into the distal recess; and further wherein the top shaft comprises a passageway for admitting air into the portion of the proximal recess vacated by the tongue.

Abstract: Implantable devices and methods for delivering drugs and other substances to locations within the body of a human or animal subject to treat or diagnose sinusitis and a variety of other disorders. The invention includes implantable substance delivery devices that comprise reservoirs and barriers that control the rate at which substances pass out of the reservoirs. The delivery devices may be advanced into the body using guidewires, catheters, ports, introducers and other access apparatus. In some embodiments the delivery devices may be loaded with one or more desired substance before their introduction into the body. In other embodiments the delivery devices are loaded and/or reloaded with a desired substance after the delivery device has been introduced into the body.

Abstract: Provided herein is an instrument and method useful to incise in to the skin to a precise depth and at a specific angle with respect to the surface of the skin of a patient, for the extraction of individual follicular groups or individual follicular units. An instrument according to the invention precisely limits the depth of incision, and creates a circular incision around a hair, follicular unit, or follicular cluster in a manner such that no damage occurs to any of the hair shafts.

Abstract: Disclosed herein is a device for sampling blood by capillarity for separating a plasma phase of the blood from the cell phase. The device is a strip and includes a filter having a membrane with no clumping agents, a prefilter for spreading blood over the surface of the membrane; and an absorbent paper downstream from the filter. The membrane is dimensioned to cover only a part of the surface of the prefilter and the migration of blood by capillarity within the prefilter takes place essentially lengthwise relative to the strip before blood comes into contact with the membrane.

Abstract: A tissue removal device is disclosed. In one arrangement, the tissue removal device includes a cutting member operatively connected to an actuator assembly and a fixed member. The cutting member is configured to slide with respect to the fixed member in a reciprocating manner. The fixed member includes an upwardly extending foot plate that defines a contact surface that is configured with an uneven texture that serves as a grip to operatively retain material to be cut when the cutting member is moved toward the foot plate.

Abstract: Systems and methods are provided for harvesting hair grafts from a body surface utilizing a removal tool comprising first and second elongated bodies. The described systems and methods serve to eliminate and/or at least minimize unnecessary compression of adjacent tissue during the removal process, thereby minimizing damage to the follicular unit being removed, reducing the opportunities for the follicular unit to intersect the path of the harvesting tool, and/or improving the quality of the removed specimen, preferably preserving its integrity.

Abstract: A surgical instrument for use with a surgical portal apparatus includes an elongate shaft defining a longitudinal axis. A dilating member disposed at a distal end of the elongate shaft and has a first longitudinal arc segment and a second longitudinal arc segment being in diametrical opposed relation. The first and second longitudinal arc segments define respective first and second radii of curvature transverse to the longitudinal axis, and decrease from proximal to distal to define a generally tapered configuration of the dilating member. The first radius of curvature is greater than the second radius of curvature at predefined longitudinal positions of the dilating member such that the first longitudinal arc segment extends distally beyond the second longitudinal segment to define a penetrating tip. The penetrating tip has a reduced profile and is dimensioned to facilitate initial insertion of the dilating member into tissue.

Abstract: A tissue harvesting and processing apparatus comprises a body and a distally extending needle. The needle includes an aperture configured to receive tissue. A tissue cutting member is movable relative to the needle to sever a specimen from tissue protruding through the aperture. The tissue cutting member is further operable to mince the severed tissue specimen. The minced tissue may be mixed with a medical fluid component contained in a reservoir. A plunger may expel the medical fluid mixture from the needle. An applier tip may be coupled with the needle to facilitate administration of the medical fluid mixture at a target site in a patient. The needle may comprise a cannula with a needle adapter, which be removed from the cannula to allow the applier tip to be coupled with the cannula. The tissue cutting member may comprise a perforated disc or tube with inwardly projecting blades.

Abstract: A surgical introducer including a body portion, a shaft and a sensor is disclosed. The body portion includes a reference indicator. The shaft defines a longitudinal axis and is positionable adjacent the body portion. The shaft is rotatable with respect to the body portion and includes a longitudinal indicator and a circumferential indicator. The sensor is disposed in mechanical cooperation with a distal portion of the shaft and is adapted to provide physiological data pertaining to a surgical worksite. At least a portion of the sensor is substantially aligned with the circumferential indicator. Rotation of the shaft with respect to the body portion causes displacement between the circumferential indicator and the reference indicator. Longitudinal movement of the shaft with respect to the body portion causes displacement between the longitudinal indicator and the reference indicator.

Abstract: A surgical obturator that includes an elongated shaft defining a longitudinal axis and an obturator member disposed adjacent a distal end of the elongated shaft. The obturator member may include a proximal section being convex along a majority of its length. It may also include a central section disposed adjacent the proximal section, the central section including a first pair of surfaces disposed relative to each other on radially opposite sides of the central section, and a second set of surfaces disposed between the first pair of surfaces and further being disposed relative to each other on radially opposite sides of the central section, at least a portion of a length of each one of the first pair of surfaces being concave, and at least a portion of a length of each one of the second pair of surfaces being convex. The obturator member may also include a guiding nub disposed distally of the central section and including a rounded distal-most portion.

Abstract: Technologies are generally described for a punch tool and method of use. In an example, the punch tool may include a malleable shaft and a finger grip body configured to encompass at least part of a shaft of a finger button. The finger grip body may be connected to a first end of the malleable shaft. The malleable shaft may be adjustable to a particular conformation and to maintain the particular conformation during use of the punch tool. A second end of the malleable shaft may be connected to an anvil. The shaft of the finger button may be connected to a first end of a flexible body member. The flexible body member may be adapted to move over the malleable shaft, the movement conforming to the particular conformation of the malleable shaft. A cutter may be operatively connected to a second end of the flexible body member.

Abstract: A trocar assembly for use in minimally invasive surgical procedures includes a cannula subassembly and an obturator subassembly. The obturator assembly includes an obturator shaft member defining a longitudinal axis and an obturator tip configured to be removable from the obturator shaft member or, alternatively, constructed with the obturator member as a single unit. Various designs of the obturator tip are contemplated.

Abstract: A punch biopsy device is disclosed with an integrated tissue base cutting component. In an embodiment, the punch biopsy device includes a cutting blade with first and second arms operatively coupled to a handle. The punch biopsy device includes a prong flexible and integral to the cutting blade, the prong comprising top and lateral sharp edges configured to pierce and cut tissue, respectively. The prong is configured to be inserted into a body in a neutral position with the prong parallel with the first and second arms. The prong is configured to move to a position perpendicular to the first and second arms when the cutting blade is withdrawn to allow for the prong to catch and pierce the tissue. The prong is configured to cut the tissue while in the position perpendicular to the first and second arms when the cutting blade is rotated manually via the handle.

Abstract: A tissue sampling device includes a cannula having an elongate tubular body with a sharpened coring tip. A shaft extends within the cannula and is coupled with a cutter having an axially advancing wire extending between a distal end of the shaft and the sharpened coring tip. The axially advancing wire is movable in a cutting path defining an arc about the longitudinal axis, by way of rotating the shaft relative to the cannula.

Abstract: The combination of a) a dilator having: a tubular body with a length, an internal passage, and proximal and distal ends spaced in a lengthwise direction; and b) an elongate guide wire having a length and capable of being received in, and movable in a lengthwise direction within, the internal passage with the dilator and guide wire in operative relationship. The tubular body has a locally flexible length that allows a limited predetermined degree of bending of the tubular body at, or adjacent, the distal end of the tubular body to allow the dilator to conform to a curved guide wire shape.

Abstract: A punch for removing hair follicles from a donor site comprises a generally tubular body having a proximal end region terminating in a tissue-cutting edge, a distally-extending segment of reduced outer diameter—preferably a generally concave segment—terminating at its proximal end at or near the cutting edge and terminating at its distal end with a diameter substantially the same or greater than the diameter of the cutting edge. The punch further includes a follicle-receiving chamber defined by an inner wall extending distally from the proximal end of the punch. Preferably, at least a portion of the chamber lying within the external region of reduced diameter is generally converging in the distal direction.

Abstract: Various embodiments of the present invention provide a conduit device including an attaching device configured for defining a helical pathway through a tissue wall and complementary ring in cooperation for securing the device within an aperture defined in the tissue wall. Some embodiments of the present invention further provide a system for implanting a conduit device in a tissue wall. More specifically, some embodiments provide a system including a coring device for defining an aperture in a tissue by removing and retaining a tissue core and securely implanting a conduit device therein so as to provide fluid communication between a first and second surface of the tissue wall via the conduit device.

Abstract: In a surgical instrument with a shaft part (1), to which a slide (3) is assigned, wherein shaft part (1) and slide (3) are releasably connected to each other, a detent element (14) is intended to protrude from the shaft part (1) and/or from the slide and, as the slide (3) slides along the shaft part (1), the detent element (14) enters a recess (13) of the slide (3) and/or of the shaft part.

Abstract: A medical punch with a hollow shaft, a tool point that is positioned on the distal end of the shaft and includes a rigid cutting part and a cutting part that can slide with respect to the rigid cutting part, and with a handle positioned on the proximal end of the shaft, such that the displaceable cutting part and the handle are operatively connected with one another by a push/pull device that is displaceably mounted in the hollow shaft and an anti-tilt mechanism is positioned on the tool point to stabilize the cutting parts in their axially parallel alignment to one another. The rigid cutting part includes a sleeve-shaped proximal portion that encloses the displaceable cutting part and a distal punch portion configured as a single unit with the sleeve-shaped portion and that the rigid cutting part should be detachably connected with the hollow shaft by a coupling mechanism formed on the sleeve-shaped portion.

Abstract: The invention relates to an apparatus and method for forming a hole in a wall of a hollow organ. The applicator includes a hole forming element for forming a hole in the wall of the organ, a positioning means for positioning the hole forming element, and a retractor element. In addition, the applicator includes a sequencing means for coordinating the relative movement of the retractor element and the hole forming element in a sequential manner to thereby carry out a procedure for forming a hole in the wall of the hollow organ. The sequencing means may further include a safety latch element operatively coupled to the retracting means and the hole forming element. The safety latch of the invention keeps prevents damage to the internal surface of the organ during the formation of the hole.