Abstract: A method of forming an access opening through a psoas muscle to a patient's spine includes laterally inserting a stimulating dilator into the psoas muscle. The stimulating dilator has a stimulation channel formed in an outer surface thereof. An electrical pulse is transmitted into the stimulating dilator to locate a position of a nerve in the patient's psoas muscle. The stimulating dilator is laterally inserted through the psoas muscle and toward the patient's spine in a way that avoids the nerve. A stimulating probe is inserted into the stimulation channel along the outer surface of the stimulating dilator while transmitting an electrical pulse into the stimulating probe to verify the position of the nerve.

Abstract: Disclosed herein are representative embodiments of methods, apparatus, and systems used to deliver a prosthetic heart valve to a deficient valve. In one embodiment, for instance, a support member is positioned to at least partially surround the native chordae tendineae and/or leaflets of a valve. The support member can comprise a flexible, distensible material to reduce abrasion and other mechanical damage to surrounding structures. A locking member may be used to couple both ends of the support member, forming a support ring. The support member may have two magnetic end portions which can be magnetically coupled to form a support ring. An expandable prosthetic heart valve can be delivered into the native heart valve and expanded within the support band, thereby causing one or more of the native chordae tendineae and/or leaflets of the native heart valve to be frictionally secured between the support ring and the expanded prosthetic heart valve.

Abstract: Forceps include a tubular shaft, an inserted member, a gripping portion, a handle, and a fixing portion. The inserted member is a rod-like member that is inserted inside the tubular shaft and is movable in an axial direction inside the tubular shaft. The gripping portion is provided at a distal end of the inserted member and is coupled to a distal end of the tubular shaft. The handle is coupled to a terminal end of the inserted member. The fixing portion detachably fixes the handle to the tubular shaft in a state where the handle is coupled to the inserted member. The distal end of the tubular shaft has a larger diameter than the diameter of a main body of the tubular shaft. A joint portion, having a smaller diameter than the diameter of the main body of the tubular shaft, is formed at the terminal end of the inserted member. The handle is provided with a joint receptacle that houses the joint portion and is advanced and retracted by manipulation of the handle.

Abstract: A prosthesis implanting system includes a delivery sheath for receiving the prosthesis and delivering it to the treatment site and an alignment device on the sheath visible to a user for indicating a rotational and an axial position of the sheath with respect to the treatment site. The alignment device is part of a delivery assembly slidably disposed in a handle.

Abstract: An object of the present invention is to provide a medical tubular body that is excellent in visibility under X-ray fluoroscopic control, insertion property into a catheter and sliding property in a catheter, that suppresses contact of a marker with a tubular body or an adjacent marker in a diameter reduction state, and that is able to further reduce its diameter. The present invention provides a medical tubular body 100 comprising a tubular body whose diameter is expandable and a marker 121 provided inside the tubular body.

Abstract: Devices and methods are provided for forming a hole in bone and implanting a suture anchor in the bone hole. The devices and methods disclosed herein allow a suture coupled to tissue to be passed through a shaft that is also configured to receive a drill bit. Exemplary guide devices are provided having a shaft with a cross-sectional shape that allows the suture to be seated in a secondary region that is offset from a primary region that receives the drill bit therethrough. A drill bit can be passed through the shaft without causing any damage to the suture extending through the shaft, and subsequently an anchor can be advanced along the suture through the shaft and guided into the bone hole.

Abstract: One example of a surgical apparatus may include a feeder belt, a plurality of staples frangibly connected to the feeder belt, and at least one pull tab extending laterally from the feeder belt. An example of a surgical method of treating tissue within the body of a patient may include providing at least one feeder belt and staples frangibly connected thereto, and at least one wedge movable relative to the feeder belt; moving at least one wedge in a first direction to contact and thereby form and shear at least one staple from at least one feeder belt; and moving at least one wedge in a second direction to engage and advance the feeder belt.

Abstract: The present invention relates to a minimally invasive surgical instrument implementing a motor. According to one embodiment of the present invention, a minimally invasive surgical instrument comprises a shaft, an end effector connected to one end of the shaft, and a handle unit connected to the other end of the shaft. The handle unit includes a pair of linearly moving members, at least one rotating member for moving the pair of linear moving members away from each other in opposite directions, and a driving element for driving said at least one rotating member. The pair of linearly moving members operates the end effector in the pitch direction or in the yaw direction.

Abstract: A method and apparatus for inserting inserts helically into soft tissue is provided. The inserter is made up of a housing assembly, a hollow helical needle; and a matched first and second hypoid gear. In its basic form, the apparatus includes a housing assembly, a hollow helical insert guide, a helical insert drive and a guide removal device. The hollow helical insert guide is held in functional relationship by the housing assembly and is adapted to be loaded with the insert for helical transport therewith into the soft tissue. The helical insert drive drives the helical insert guide in rotation and translation into the soft tissue. When an insert is present within the insert guide, the guide removal device removes the insert guide while leaving the insert in its intended implant location in the soft tissue. The method and apparatus insert an implantable member helically into soft tissue, thereby better fixing the implantable member in the soft tissue when such tissue is deformed.

Abstract: Embolic protection elements are integrated with a catheter or access sheath for any catheter. A catheter with an integrated embolic protection element comprises a catheter shaft, an embolic filter slidably mounted on a distal portion of the shaft, a proximal stop for limiting the proximal movement of the embolic filter, and a distal stop for limiting the distal movement of the embolic filter. The filter comprises a porous mesh material defining a collection chamber for captured emboli and has a collapsed and a deployed configuration. The filter may be collapsed by an access sheath used with the catheter. An access sheath may comprise a tubular main body and an embolic filter mounted on the distal portion of the tubular main body. The embolic filter may evert into the central lumen of the sheath or may be constrained on the exterior of the sheath with a larger diameter outer tube.

Abstract: A surgical assembly, the assembly including a first guidewire, a second guidewire, in which each of the first guidewire and the second guidewire are configured to be received by a bone block, a first suture loop, a second suture loop, a first locking component, and a second locking component, in which the first locking component is coupled to the first suture loop and the second locking component is coupled to the second suture loop.

Abstract: A teether includes a body, and a teething member. When the teether is frozen, the teething member is positioned within the teether providing rigidity to the teether. The teething member is moveable within the body as the frozen material within the body melts. The teether may include a cylindrical body, a nipple, and a cap with the teething member providing rigidity to the nipple. The teether may also be formed from a flexible membrane with at least one acute edge. An insulative storage container for the teether has an internal structure sized to hold multiple teethers.

Abstract: A system for delivering an implant including a handle, a trigger, and an actuation assembly. The actuation assembly can include a planet carrier, at least one planet gear operatively coupled to the planet carrier, a sun gear shaft operatively engaged with the planet gear, a ring gear operatively engaged with the planet gear, a first clutch driver, and a second clutch driver. The actuation assembly can be configured to displace the outer tubular member in the proximal direction a distance (d) relative to the handle and to separately move the inner shaft member distally a distance (x) relative to the handle upon deployment of the trigger from a first position to a second position, and move the inner shaft member proximally a distance (y) relative to the handle with no displacement of the outer tubular member upon return of the trigger from the second position to the first position.

Abstract: An aortic occlusion device includes a catheter and a balloon mounted along the catheter, wherein the balloon is a narrow profile balloon. The narrow profile balloon comprises an anchored end fixed to the catheter, a movable end distal to the fixed end, a wall extending between the anchored end and the movable end, an inflatable tube located proximate along the wall and circumscribing the wall, and at least one tension wire attached to the movable end and extending through the catheter such that the at least one tension wire is accessible to move the movable end of the balloon towards the anchored end when the catheter is positioned in the aorta.

Abstract: A system for delivering an implant including a handle, a trigger, and an actuation assembly. The actuation assembly can include a planet carrier, at least one planet gear operatively coupled to the planet carrier, a sun gear shaft operatively engaged with the planet gear, a ring gear operatively engaged with the planet gear, a first clutch driver, and a second clutch driver. The actuation assembly can be configured to displace the outer tubular member in the proximal direction a distance (d) relative to the handle and to separately move the inner shaft member distally a distance (x) relative to the handle upon deployment of the trigger from a first position to a second position, and move the inner shaft member proximally a distance (y) relative to the handle with no displacement of the outer tubular member upon return of the trigger from the second position to the first position.

Abstract: There is provided herein, a method of attaching a mesh to a loop member, which includes covering a wire with a layer, manipulating the wire along with the layer to form the loop member, wherein the loop member has a shape, placing the mesh over the loop member, wherein portions of the mesh extend beyond a circumference of the loop member, transferring heat to the layer to cause it to partially melt and become tacky, allowing the mesh to fuse with the tacky layer and form a secure bond on cooling, and trimming portions of the mesh extending beyond the circumference of the loop member. A retrieval device formed by the method includes the loop member and attached mesh positioned and longitudinally movable within a tubular sheath. The loop member and mesh are deployed to capture a target object and partially retracted for removal of the object.

Abstract: In a surgical tool, the treatment tool piece operating joint includes a first operating rotation member which is coupled to the moving member and is rotated around a predetermined rotation center; a second operating rotation member which is coupled to the first operating rotation member so as to relatively rotate around a rotation center coaxial with the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member or around a rotation center that is a position closer to the first bending rotary shaft than the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member; and a link which converts a rotational force of the second operating rotation member into the operation of the treatment tool piece.

Abstract: A balloon for medical treatments such as percutaneous transluminal coronary angioplasty (PTCA), delivery of a vascular stents or stent grafts, employs reinforcement materials that are patterned so as to promote consistent folding of the balloon. Methods and apparatus for biocidal treatment using such a balloon, including balloons with fiber fabric reinforcements.

Abstract: This document provides vascular filtering devices and methods for their use. In some embodiments, the vascular filtering devices include an elongate member having a wall with one or more apertures and a lumen. The vascular filtering devices can also include a porous membrane bag portion with multiple elongate extensions that extend through the apertures of the elongate member and through the lumen of the elongate member, exiting the lumen at the proximal region of the elongate member.

Abstract: Techniques for mesh augmentation and prevention of incisional hernia, including systems and methods for affixing mesh to a fascial incision. A mesh strip can be integrated with one or more uni-directional fasteners. Each fastener can include an anchoring mechanism adapted for affixation to anterior abdominal wall fascia and a mating interface. An applicator can include tension arms adapted to interface with the mating interfaces of the fasteners to maintain a vertical tension of the mesh strip and a handle coupled with the tension arms adapted to spread the tension arms and thereby control a horizontal tension of the mesh strip. The mesh strip can be configured to be aligned over a fascial incision using the applicator and affixed under tension to anterior abdominal wall fascia by tissue penetration of the anchoring mechanisms of the one or more fasteners.