Abstract: An instrument for obtaining tissue samples from a site deep within the body. The instrument has an elongated proximal portion that is constructed to follow a long, torturous path to the site and a distal end constructed to remove a tissue sample from the body, including tissue specimens, polyps or the like. The instrument is constructed to take multiple biopsy samples without being withdrawn from the body by including a storage space along the axis of the device suitable for storage of multiple, successively taken samples. The instrument includes a side-facing sampling element constructed such that it can be actuated in a first, rotational motion about the device axis to separate a tissue sample from the body and a second, axial motion for disposing the sample axially to facilitate positioning the sample in the storage space.

Abstract: There is presented a suture anchor comprising a head portion and a connector portion. The head portion includes a pointed free end, a cutting flute extending substantially throughout the length of the head portion, and screw threads extending substantially throughout the length of the head portion. The connector portion extends axially from the head portion for releasable connection to an anchor inserter. The connector portion is provided with structure for attachment of a suture thereto. There is further presented a suture anchor inserter for use in combination with the suture anchor in attachment of the anchor to a bone, and a suture anchor length of suture material. There is still further presented a method for anchoring a length of suture to a bone.

Abstract: The invention is directed to manipulator assembly (2) for holding and manipulating a surgical instrument (14) in a telerobotic system. The assembly comprises a base (6) fixable by passive or power driven positioning devices to a surface, such as an operating table, and an instrument holder (4) movably mounted on the base. The instrument holder comprises a chassis (6) and an instrument support (70) movably mounted on the body and having an interface engageable with the surgical instrument to releasably mount the instrument to the instrument holder. A drive assembly (7) is operatively coupled to the instrument holder for providing the instrument with at least two degrees of freedom. The instrument holder is separable from the base and the drive assembly so that the holder can be sterilized. The assembly further includes a force sensing element (52) mounted distal to the holder and the drive assembly for detecting forces exerted on the surgical instrument and providing feedback to the surgeon.

Abstract: A new cutting tip and a very simple method for making the tip are given. The tip has no flutes but has a built-in chip clearance. It is self-drilling, self-tapping, and self-locating and can be positioned on a threaded or unthreaded member. When it is the tip on a suture anchor, it maximizes holding strength of the anchor.

Abstract: An impact tool for use in surgical procedures is provided. The invented tool is useful for performing such surgical functions as freeing cement, implanting pins, setting guides, and inserting surgical staples. The tool comprises a body that has an impact force calibrating member coupled to a first end and a chuck in a second end. The chuck includes a rod that extends into a channel in the body. An impact inducing assembly is retained in the channel. The assembly causes a surgical implement retained in the chuck to deliver an impact with a calibrated force to a desired object. The impact inducing assembly comprises a piston, a spring interposed between the piston and calibrating member, and an actuation mechanism to engage the rod. An antirotation assembly may optionally be provided to prevent the implement from rotating relative to the body, as the rod is propelled along the channel. An object is impacted by applying pressure to the implement with the tool.

Abstract: An apparatus and method are provided for surgically securing bone parts, in particular for transsternal bilateral thoracotomy. The apparatus comprises a base piece from which are protruding two posts welded or attached thereto which are internally screwthreaded and adapted to receive screws, and a plate with holes is adapted to be positioned over the posts and secured relative to them by the screws. In the method of securing the bone parts using the apparatus, the posts are inserted into holes drilled in each respective bone part, so that the bone parts are held together with their sawn surfaces mutually opposing, and the plate is positioned above the bone parts and screwed into position into the posts by the screws through the holes and the plate.

Abstract: A medullary rotational reaming apparatus includes an elongated, flexible, hollow, tubular shaft formed of a nickel-titanium alloy and having coupling portions at the opposite ends thereof. Each of a cutter head and a rotational drive coupling element has a hollow tubular coupling shank, each shank having a coupling inner surface which is quadrilobular in transverse cross section and is dimensioned to prevent free reception of a coupling portion of the shaft therein. The coupling portions of the shaft are axially press-fitted in permanent engagement, respectively, within the shanks of the cutter head and the drive coupling element, with said coupling portions being permanently deformed to the transverse cross section of the coupling inner surface of the shanks, thereby to fix the cutter head and the coupling element to the shaft solely by the press-fitted engagement of the coupling portions in the shanks.

Abstract: A distal femoral sizing instrument includes an intramedullary rod for referencing the patient's intramedullary canal. A valgus module mounts to the intramedullary rod at a bore of the valgus. The bore of the module has a slant with respect to the flat reference surface of a valgus block. The module slidably connects to the block. The valgus block, referencing guide and a stylus (for connecting the valgus block and cutting together) are removed as a unit before shaping of the distal femur. An indexing system includes a gauge having a series of openings corresponding to "anterior" referencing and to "posterior" referencing. During anterior referencing, the gauge allows the surgeon to select the next smaller size prosthesis if the size falls in between available sizes. In posterior referencing, the gauge allows the surgeon to select the next larger size prosthesis if the gauge measures a size that falls in between available sizes.

Abstract: A surgical fastener for fixation of graft tendon (26) in a bone hole comprising a screw (10) having a head (11), neck (12), and shank (13), and a washer (17) disposed about the neck. The tendon (26) is attached to the washer (17) so as to ensure that the tendon (26) is immobilised between the head (11) of the screw (10) and the wall of the bone hole thereby reducing pistoning under load and reducing graft failure. In one embodiment, the fastener includes a bone plug (38) disposed about the neck (12) of the screw (10) between the head (11) and the washer (17), the neck (12) being adapted to laterally press the bone plug (38) and thereby immobilise a tendon (26) attached to the washer between the bone plug (38) and the wall of the bone hole. In another embodiment, the invention consists in a surgical staple (60) having two substantially parallel legs (61), a transverse head member (62) and a washer (66) which holds a loop of tendon (26) under the staple (60) when it is into a bone.

Abstract: A device and method of closing an incision or puncture in a patient by inserting a vessel plug into the incision or puncture until the distal end of the vessel plug is adjacent to the outer lumen of the blood vessel or target organ so that the vessel plug does not obstruct the flow of fluid through the blood vessel or target organ. The precise positioning of the vessel plug in the incision or puncture is accomplished through the use of a balloon catheter or a cylindrical insertion assembly having a proximal plunger member associated therewith.

Abstract: A compression locking variable length cross-link device having modular components, including rod and/or pedicle screw coupling elements each having a hole which may be disposed co-linearly with respect to other such holes in opposing elements such that a threaded hinge-post may be inserted therein. A nut is utilized to compress the elements together to rigidly secure the elements once they have been properly positioned relative to one another. In an additional set of embodiments, a linkage member having an elongate hole therein may be used to couple similar elements thereto in a similar flexible hinge-post manner such that the elements may be coupled to the linkage member instead of to the opposing elements directly.

Abstract: An assembly piece for assembling together two rods (T.sub.1, T.sub.2) of an osteosynthesis device, in particular for osteosynthesis of the spine. According to the invention, the assembly piece comprises: a body (1) of generally rounded shape having a slot (2) separating the body into two portions (1a, 1b), and two bores (5, 6) on transverse axes (A, B) passing obliquely through the slot, each adapted to receive a respective rod to be assembled; and a clamping screw (3) interconnecting said portions so that tightening the screw locks the two rods in place by clamping them between said portions (1a, 1b).

Abstract: A surgical clip applier includes a housing, a pair of handles pivotably connected to opposite sides of the housing, a channel assembly which is anchored to the housing and a jaw assembly which is anchored to the channel assembly. The jaws are opened and closed by a cam plate which is slidably positioned in the channel assembly and is provided with cam slots at its distal end to engage drive rivets positioned on the jaw members. A pusher bar assembly is also provided to feed clips from a series of clips to the jaw mechanism, and the instrument operates such that all moving components move in the same direction during the closing stroke of the handle, and then move in the same direction opposite to the closing direction when the handles are in the opening stroke. A novel lockout mechanism is also provided to render the instrument inoperable after all the clips have been utilized from the instrument.

Abstract: Transverse connector (10) bridges rod connector assemblies (40 and 70), and includes an elongate body (12) along longitudinal axis (L). A first portion (20) is formed at a first end (22) of elongate body (12), and has an interlocking surface (26) configured to engage rod connector assembly 40 in variable rotational positions which need not be perpendicular to rod (R1). A second portion (30) is formed at an opposite second end (32) of elongate body (12) and has interlocking surface (36) configured to engage rod connector assembly (70) in variable linear positions. As a result, transverse connector (10) accommodates variable spacing of rods (R1 and R2), and variable positioning of rod connector assemblies (40 and 70) thereon. Rod connector assemblies (40 and 70) include bone screw plates (50 and 80), respectively, connected thereto. A spinal fixation system results which permits connection of a transverse connector (10) at the same site along a rod as a vertebral fixation element.

Abstract: Method and apparatus for determining the direction of the mechanical axis of the femur of a patient in relation to the corresponding knee of the patient in connection with resecting the distal femur for the reception of a femoral knee prothesis include at least partially suspending the patient's leg to locate the knee at a suspended position wherein external forces on the knee, such as the weight of the leg, are balanced and the knee remains essentially stationary at the suspended position, applying a force to the femur at a predetermined location relative to the mechanical axis of the femur, directing the applied force in a direction such that the knee remains undeflected from the suspended position while the force is applied to the femur in that direction, and employing that direction of the applied force to indicate the direction of the mechanical axis of the femur.

Abstract: A device for the gradual correction of a bone fracture which has already been set in the operating theatre comprises an elongated structure (1) which defines a longitudinal axis (L) which can be positioned parallel to the bone and comprises a pair of end supports (10, 11) releasably anchored to corresponding bolt-bearing end clamps (6, 7) of an external fixation unit (2) which has already been fitted to the fractured pieces (F1, F2), a central body (24) connected to supports (10, 11) by connection means formed by longitudinal (32) and transverse (25) adjustment means to correct the longitudinal distance and transverse offset between the supports respectively, angular adjustment means (39) to correct the relative inclination of one of the supports with respect to the longitudinal axis (L) rotating it about a transverse axis (T), and centering means (40, 49, 50, 51) to align the transverse axis (T) with the centre of the fracture.