Abstract: A uterine manipulator includes a handle and a central shaft that extends distally from the handle. The central shaft includes a distal end portion supporting a balloon. The central shaft also supports a cervical cup. An occluder shaft is slidably supported on the central shaft. A non-inflatable plug is secured to the occluder shaft and configured to move with the occluder shaft as the occluder shaft slides along the central shaft.

Abstract: Devices for removing clot material from a blood vessel lumen and associated systems and methods are disclosed herein. A clot retrieving device may include, for example, an elongated shaft, a capture structure, a cover, and a connector coupled to the elongated shaft proximal of the capture structure. The connector may include an inner band and an outer band, wherein (a) the inner band at least partially surrounds a portion of the distal zone of the elongated shaft, (b) the outer band at least partially surrounds the inner band, and (c) the first portion of the cover is secured between the inner band and the outer band.

Abstract: An apparatus for applying clips to tissue, comprises a plurality of clips, each of the clips including a proximal end having a pair of opposed jaws and a distal end including a linking feature, where the clips are linked to one another to form a clip chain with a linking feature of a distal-most one of the clips being gripped between the jaws of an immediately proximal one of the clips and a control linkage coupled to a proximal-most one of the clips for applying tension and compression to the clip chain in combination with a magazine containing the clip chain, the magazine including an abutment surface sized to prevent passage distally therebeyond of a clip having received between its jaws a linking feature of an immediately distal clip and an opening location within which the jaws of a clip are permitted to open to release a linking feature therefrom.

Abstract: Suturing techniques and sutures capable of reducing the incidence of incisional herniae, including but not limited to subcutaneous surgical sutures performed after laparotomy. Such a suture includes a circular suture having at least first portions that are within a first region of tissue of a suture area that further contains rows of puncture sites aligned approximately parallel to an incision on opposite sides of the incision. The first region of tissue is located between the rows of puncture sites and surrounds the incision, and the first portions of the circular suture extend along the rows of puncture sites. The suture further includes a continuous suture in the suture area that penetrates the puncture sites and traverses the incision. The circular suture disperses stresses induced by tension in the continuous suture to inhibit tearing of tissue at the puncture sites.

Abstract: A medical overtube device has a main body formed by articulating a plurality of nested units into a first group of nested units and a second group of nested units and is bendable in a longitudinal direction thereof; a first shape-fixation mechanism configured to fix a shape of the first group which has a first wire, both end of the first wire coupled to the first group of nested units and a first pulley configured to be wound by the first wire; and a second shape-fixation mechanism configured to fix a shape of the second group which has a second wire, both end of the second wire coupled to the second group of nested units; and a second pulley configured to be wound by the second wire, wherein the first shape-fixation mechanism is configured to release the fixed shape of the first group independently from the second shape-fixation mechanism.

Abstract: Devices and methods for securing a tissue anchor in tissue of a patient, in particular to ensure proper deployment of a cardiac tissue anchor by regulating the force or pressure of a deployment tool against the tissue. One way to ensure proper deployment force is to visualize the distal end of the tissue anchoring catheter from outside the body using a display for an imaging sensor, where the distal end of the catheter changes configuration when it is pressed against the tissue. Another method involves automatically regulating the pressure applied to the tissue prior to deployment of the tissue anchor, which may also be used in conjunction with visualization. Several safety locks to prevent deployment of the tissue anchor prior to establishment of the proper pressure are disclosed, which again may be used with visualization and/or an automated pressure regulator.

Abstract: A heart valve annulus repair device having a tissue engaging member and a plurality of anchors. The tissue engaging member includes a loop of wire. Each of the anchors has a pointy front end and a back end and a slot that runs in a front-to-back direction. The anchors are distributed about the loop of wire with the front ends of the plurality of anchors facing the heart valve annulus and with the loop of wire passing through the slots. The device further includes means for implanting the anchors into the heart valve annulus tissue so that the tissue engaging member becomes affixed to the heart valve annulus.

Abstract: A surgical device comprising a housing, a shaft extending from the housing, an end effector extending from the shaft, a feeder drive, a rotatable clip magazine, and a rotary input is disclosed. The shaft defines a shaft axis and comprises a feeding chamber. The feeder drive is configured to move between a proximal position and a distal position relative the shaft. The rotatable clip magazine is configured to rotate about the shaft axis. The rotary input is selectively engageable with the feeder drive and the rotatable clip magazine. The rotary input is configured to be engaged with the feeder drive and the rotatable clip magazine to consecutively feed a clip from and deliver a clip to the feeding chamber.

Abstract: The invention relates to delivery system for deployment of a prosthetic valve, having a hypotube sheathed guidewire assembly having an outer sheath and an inner guidewire shaft that pushes against a guidewire collar on a tension arm of a compressed transcatheter valve to deliver the valve and position the valve to the RVOT or other location in the body.

Abstract: A suturing system including apparatus and methods for disposing stitches in a substrate comprising a thread carrier which inserts a thread in the substrate at a first location and withdraws the thread from the substrate at a second location.

Abstract: A stent graft delivery device includes a handle body, a distal handle, a proximal handle, a guidewire lumen, a nose cone, a rigid outer catheter, a graft push lumen, a sheath lumen, an inner sheath and a locking ring. The locking ring is switchable between an advancement position and a delivery position. The stent graft delivery device is employed in methods for endovascular delivery of stent grafts.

Abstract: In at least one embodiment, a method of surgical navigation is provided. The method includes receiving an external three-dimensional model of a surgical site from the viewpoint of a headset, wherein the external three-dimensional model is derived from reflected light. The method further includes aligning the external three-dimensional model with an internal three-dimensional model of the surgical site from the viewpoint of the headset, wherein the internal three-dimensional model is derived from medical imaging, and generating an aligned view. The method further includes providing the aligned view to the headset, and updating the aligned view in real-time while the headset is moved or the surgical site is moved or modified during a surgical procedure.

Abstract: A deflection catheter is disclosed for aiding in bending of a catheter or other elongate medical device transseptally delivered within a left atrium of a heart. The deflection catheter includes a deflection aid assembly having an outer component, an inner component and a connecting band. The connecting band connects a first inner branch segment and a second inner branch segment of the inner component, and also extends between a first outer branch segment and a second outer branch segment of the outer component whereby a catheter receiving opening is defined between the connecting band and the first and second outer branch segments. Proximal/distal movement of the inner component relative to the outer component increases/decreases an area of the catheter receiving opening in order to secure the catheter or other elongate medical device to the deflection aid assembly for subsequent bending by proximally tugging or pulling on the deflection aid assembly.

Abstract: A surgical clip applier comprising an electric motor system is disclosed. The electric motor system is configured to drive a clip firing system of the surgical clip applier. The surgical clip applier further comprises a control system configured to control the electric motor system. The control system is configured to monitor a strain gauge circuit to assess the crimping force experienced by the clip firing system. In at least one instance, one or more strain gauges are mounted to a drive shaft and/or jaw of the clip firing system. The control system modifies the operation of the surgical clip applier when the voltage of the strain gauge circuit exceeds and/or falls below a threshold. In at least one instance, the control system modulates the width, or duration, of voltage pulses applied to the electric motor system to control the speed of the electric motor system.

Abstract: A stent delivery system includes a core member and a coupling assembly rotatably coupled to the core member distal segment. The coupling assembly includes first and second plates and first and second spacers. The first plate is rotatably coupled to the core member and includes an outer surface having three or more projections separated by recesses. The first spacer is coupled to the core member and disposed between the first plate and a proximal restraint. The second plate is rotatably coupled to the core member and includes an outer surface having three or more projections separated by recesses. The second spacer is coupled to the core member and disposed between the first plate and the second plate. A stent extends along the core member distal segment such that an inner surface of the stent is engaged by one or more projections of the first plate or the second plate.

Abstract: Apparatus and methods are described including a valve frame configured to support a prosthetic valve within a native atrio-ventricular valve. The valve frame includes a frame body that includes an atrial portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the atrial portion is disposed on an atrial side of the native atrio-ventricular valve, and a ventricular portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the ventricular portion is disposed within a ventricle of the subject. At least one arm is configured to extend from the ventricular portion of the frame body. Other applications are also described.

Abstract: A surgical system includes a bed extending along a main direction, a robotic arm disposed adjacent to the bed, and a surgical guide attached to the robotic arm. The bed has a table top to support a patient, the robotic arm is controllable to move in relation to the body of the patient; and the surgical guide is capable of holding a surgical instrument and measuring a translation of the surgical instrument as it moves through the surgical guide. The robotic arm is configured to position the surgical guide to a desired position in relation to a target area of the patient.

Abstract: A tissue guard for insertion within an access device disposed within an operating cavity includes a base section defining open proximal and distal ends and a lumen extending therethrough between the open proximal end and the open distal end. The base section includes one or more openings in a side thereof in fluid communication with the lumen. The proximal end of the base section includes an evacuation ring in fluid communication with the lumen. A tissue cuff is configured to encapsulate the base section and is selectively moveable between a distal position for facilitating insertion of the tissue guard within an access device disposed within a tissue opening in an operating cavity and a proximal position wherein the tissue cuff encloses the one or more openings to form an evacuation channel between the one or more openings and the evacuation ring to facilitate fluid evacuation from the operating cavity.

Abstract: Shortly after completing a thrombectomy procedure, a temporary carotid filter can be deployed downstream of an occlusion not treated by the thrombectomy (e.g. a carotid lesion having plaque buildup), and the temporary carotid filter can remain in place during the patient's recovery period following the ischemic stroke until a procedure to treat the remaining occlusion is completed and antiplatelet therapy is administered. The temporary carotid filter can anchor in place while deployed with or without being tethered to a wire extending through the patient's Femoral Artery.

Abstract: Apparatus and related methods for sequentially positioning and retaining opposing sides of a tissue wound. The apparatus includes a device body having a head portion for positioning between first and second sides of the wound, with the head portion defining first and second retention zones on opposed side of the head portion. The device body further includes first and second approximation arms. The device body further includes a trigger assembly defining three stages of operation. A first stage of operation positions the first approximation arm proximate the first retention zone. A second stage of operation positions the second approximation arm proximate the second retention zone with the first approximation arm remaining in approximation to the first retention zone. A third stage of operation advances a fastener into the first and second retention zones. In this manner, the apparatus sequentially positions the first and second sides with respect to the head portion.