Abstract: A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Abstract: Vascular access devices, systems, and methods of their use are provided. In one embodiment, a vascular access device includes a catheter, a balloon, and an inflation lumen. The catheter includes an elongate flexible shaft having a proximal end and a distal end with a primary lumen therethrough. The balloon is disposed about the distal end of the catheter. The inflation lumen is in fluid communication with the balloon and extends toward the proximal end of the shaft of the catheter. The balloon is inflatable into a shape having a first open end, a second open end, a sidewall between the first and second open ends, and a passageway therethrough, which, when the balloon is deployed and inflated within a vessel, permits blood flowing in the vessel to flow through the passageway.

Abstract: A catheter device for heart repair comprises a leaflet anchor for placement in a leaflet of a heart valve, wherein the leaflet anchor is coupled to the artificial chord; a mechanical gripper device for grasping the leaflet of the heart valve, wherein the gripper device comprises a leaflet anchor channel for housing the leaflet anchor in a folded configuration; and a U-rod wire with a U-shaped rod at one end of the wire, with the free end of the U-shape abutting the end of the leaflet anchor; the gripper device and leaflet anchor being arranged such that when the gripper device grasps the leaflet, the U-rod wire can be used to push the leaflet anchor out of the leaflet anchor channel to pierce the leaflet and form the leaflet anchor into an unfolded configuration permitting hooked formations of the leaflet anchor to secure the leaflet anchor in the leaflet.

Abstract: A clot removal device for removing clot from a body vessel comprising an expandable structure and an elongate member. The elongate member can have a proximal end and a distal end, the elongate member being connected to the expandable structure at its distal end. The expandable structure can have a constrained delivery configuration, an expanded clot engaging deployed configuration, and an at least partially constrained clot pinching configuration. At least a portion of the expandable structure can be configured to engage clot in the expanded deployed configuration and to pinch clot on movement from the deployed configuration to the clot pinching configuration.

Abstract: In one embodiment, a medical device includes a delivery tool having a carrier member, and a cartridge. The cartridge is coupled to the delivery tool. The cartridge defines an opening. The cartridge is configured to retain an anchor defining a lumen. The carrier member has a retracted configuration and an extended configuration. The carrier member is configured to extend through the lumen defined by the anchor and through the opening defined by the cartridge when the cartridge is coupled to the delivery tool and the carrier member is in its extended configuration.

Abstract: This guide catheter includes a resin tube having an inner lumen through which a guide wire is insertable; a metal pipe attached to an inside of the tube to be coaxial with the tube; and a metal wire having a distal end portion welded to a region more distal than a proximal end of the pipe on an outer circumferential surface of the pipe. The pipe has a most proximal portion formed in a proximal end surface of the pipe, the most proximal portion is more proximal than other portions of the proximal end surface in a central axis direction of the pipe. A welding region of the wire welded to the pipe is formed on the outer circumferential surface of the pipe and a proximal end of the welding region is positioned apart from the most proximal portion of the pipe in the central axis direction of the pipe.

Abstract: A surgical device comprising an instrument shaft having a proximal end and a distal end, a control handle connected to the proximal end of the instrument shaft, a surgical end effector connected to the distal end of the instrument shaft at a joint, wherein the surgical end effector is configured to articulate, at the joint and with respect to the instrument shaft, about an articulation axis, and wherein the surgical end effector had a pull-to-release articulation lock configured to retain the joint in a fixed position and the control handle has an articulation lock actuator that is configured to, when actuated, release the articulation lock.

Abstract: A cord comprises a braided sheath of strands having an outer surface, an inner surface, and a central hollow portion defined by the inner surface and having a volume and a core within the central hollow portion of the tubular braided sheath, such that when the cord is in a relaxed state the tubular braided sheath has a cylindrical shape and a relaxed volume of the central hollow portion wherein the core does not fill the relaxed volume of the central hollow portion of the tubular braided sheath; when the cord is in a longitudinal tensioned state, the tubular braided sheath elongates under the longitudinal tension such that a tensioned volume of at least a part of the central hollow portion of the tubular braided sheath is less than the relaxed volume; and the inner surface of the tubular braided sheath of tensioned volume contacts and cinches a surface of the core.

Abstract: A robotic surgical system and accessory having a robotic base or hand piece having a plurality of motors and a mechanical actuator each for operating a mechanical positioning arm in a different degrees of freedom. The robotic base is reusable and provides the platform for the system. The drive system has a port that interfaces with the robotic base and allows for insertion of surgical instruments into the base.

Abstract: Tissue puncture devices, and systems and methods for accessing tissue (e.g., cardiovascular tissue) according to the present disclosure may include a tubular sheath extending along a longitudinal axis, the tubular sheath having a proximal end and a distal end, a needle disposed coaxially in the sheath, the needle having a proximal end and a distal end and being movable along the longitudinal axis of sheath, and a needle control mechanism disposed at the proximal end of the needle, the needle control mechanism being configured to lock the distal end of the needle in a first position retracted within the distal end of the sheath, and release the needle to an unlocked second position such that the distal end of the needle is extendable beyond the distal end of the sheath.

Abstract: A method may include inflating a first balloon within an internal carotid artery so as to block antegrade flow of blood into an ophthalmic artery. Additionally, the method may include maintaining antegrade flow of blood in the internal carotid artery via a perfusion lumen in the first balloon. Further, the method may include inserting a device into the ophthalmic artery via a lumen extending through a portion of the first balloon to a side opening in the first balloon.

Abstract: A collapsible medical device is used for occluding an opening used for fetoscopic surgery. The device includes tubular woven metal fabric composed of braided metal strands, said woven metal fabric having an expanded preset configuration comprising an hourglass-shaped element and a waist element at a midpoint, wherein each end of the hourglass-shaped element has a diameter of about 5 mm, wherein the waist element has a diameter that is less than a diameter of each end of the hourglass-shaped element, said woven metal fabric further includes a bulbous element coupled to one end of the hourglass-shaped element via a shaft, wherein the woven metal fabric is deformable to a lesser cross-sectional dimension for delivery through a channel in a patient's body to said opening, and the woven metal fabric having a memory property whereby the medical device tends to return to said expanded preset configuration when unconstrained.

Abstract: A method and device for facilitating the anastomotic healing of a patient after a radical prostatectomy surgical procedure, without a urethral catheter, comprising the steps of performing a radical prostatectomy, fixedly positioning a splinting element between the urethra and the bladder, across the urethral opening, placing the splinting element during the performing of the radical prostatectomy and prior to surgical closure. The fixed positioning is effected from a position within the bladder with anchoring the splinting element in position relative to the interior of the bladder, setting a separate urine drainage tube, and removing the splinting element, after anastomotic healing, with a retrieval element on the splinting element or with dissolving of the splinting element.

Abstract: Implantable devices for placement at a cavity or opening such as an aneurysm are disclosed. The implantable devices, in a deployed condition, have a generally inverted U-shaped profile with a curved or angled framework support structure sized and configured for placement in proximity to tissue surrounding the opening and anchoring legs extending proximally from the framework structure sized and configured to contact the wall of a neighboring lumen at opposed locations. Occlusive and semi-occlusive membranes may be associated with the framework support structure and deployed over the opening to provide exclusion of the opening and flow diversion. Proximal anchoring segments providing additional lumen wall surface area contact for the implantable device following deployment may be incorporated.

Abstract: Described herein are systems, apparatus, and methods for precise placement and guidance of tools during a surgical procedure, particularly a spinal surgical procedure. The system features a portable robot arm with an end effector for precise positioning of a surgical tool. The system requires only minimal training by surgeons/operators, is intuitive to use, and has a small footprint with significantly reduced obstruction of the operating table. The system works with existing, standard surgical tools, does not require increased surgical time or preparatory time, and safely provides the enhanced precision achievable by robot-assisted systems.

Abstract: A tool for use by a surgeon for operating a basket device for capturing an object to be removed from a body of an animal. The tool includes a first controller and a second controller. The first controller is adapted to be coupled to the basket device for selectively controlling the basket device and moving the basket device between a first, closed position and a second, open position. The first controller includes a plunger and cylinder mechanism; and a handle coupled to the plunger for operating the relative position of the plunger with respect to the cylinder. The second controller is positioned adjacent to the first controller and adapted to be coupled to the basket device for selectively independently controlling the rotation of the relative to the first controller.

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: An assembly for the tricuspid orifice of a human heart, comprises an external frame connected to an internal stent carrying a tricuspid valve bioprosthesis and a sealing skirt. The external frame is configured to hold its position in the native tricuspid annulus. The internal stent is connected to the external frame by one or more fixing strands. The sealing skirt covers the interstitial space existing between the external frame and the internal stent. Developments are described which comprise in particular the use of a deformable region of the frame, various alternative embodiments of the sealing skirt, the use of a frame composed of multiple sub-sections, the use of fixing strands between the stent and the frame and of fixing elements for fixing the assembly to the native tissue, the use of sensors and/or actuators, and also the use of a stent in the inferior vena cava. Method aspects are described.

Abstract: The subject invention pertains to materials, including sets of nerve grafts, for performing breast neurotization with xenograft nerves in breast surgeries, such as reconstructive breast surgery. Certain embodiments of the set of nerve grafts comprise at least two nerve grafts prepared from one or more nerves, such as one or more intercostal nerves (ICNs), obtained from one or more animal sources. Such animal-sourced nerve grafts may be used as xenografts in the reconstruction of nerve defects in humans, and in particular, animal-sourced ICN grafts may be used as xenografts in the reconstruction of ICN nerve defects in humans, including through use of the breast neurotization technique described herein. These animal-sourced nerve grafts may also be used in the reconstruction of nerve defects in animal recipients, including as xenografts, allografts and autografts.

Abstract: A method of treating a defective heart valve includes inserting a delivery catheter through a small incision in a patient's groin, wherein the delivery catheter has a prosthetic device positioned along a distal end. The prosthetic device includes an insert member and an anchoring member. The insert member is positioned between the native heart valve and is allowed to self-expand. The anchoring member is preferably a stent connected to the insert member by at least one elongate member. The stent is deployed within an adjacent blood vessel for anchoring the insert member between the native leaflets. After deployment of the prosthetic device, the native leaflets of the heart valve form a tight seal against the insert member for preventing regurgitation through the native heart valve during ventricular systole.