Abstract: A ligation clip loading device includes a cannula including a cannula body and an instrument lumen extending through a longitudinal axis of the cannula body, and a stack of ligation clips axially arranged about the instrument lumen. The ligation clips are accessible through a series of slots allowing for loading of an endoscopic clip applier with the ligation clips within a body cavity, such as an intra-abdominal cavity.

Abstract: A medical instrument may include a tube, a sheath provided around and coaxial with the tube, and an inflatable balloon at a distal end of the sheath. The balloon may receive a fluid from a lumen of the sheath, and may have a central opening along a longitudinal axis thereof, and into which the tube extends, a proximal portion, a middle portion adjacent to and distal of the proximal portion, and a distal portion adjacent to and proximal of the middle portion. When the balloon is inflated with the fluid, a maximum diameter of the middle portion may be less than a maximum diameter of the proximal portion, and less than a maximum diameter of the distal portion. The medical instrument may also include an extraction member provided at a distal end of the tube, distal to the balloon, and movable axially relative to the balloon.

Abstract: Vascular expandable devices and associated methods are disclosed herein. An expandable vascular device can be implantable across an aneurysm in a blood vessel of a patient. The device can include a generally tubular structure formed of a plurality of braided metallic elements. The device can have a compressed state with a compressed state diameter of 0.027 inches or less and an expanded state with an expanded state diameter of 1.75 mm or more. Each of the plurality of metallic strands can have an oxide layer having a thickness of about 400 angstroms or less. The tubular structure can be configured to self-expand from the compressed state to the expanded state.

Abstract: An apparatus enables concurrent restoration of a gastroesophageal valve and tightening of the lower esophageal sphincter. The apparatus comprises a longitudinal member having a distal end arranged to be received within a stomach, a tissue shaper at the distal end of the longitudinal member that forms a gastroesophageal valve from stomach tissue, and a tissue gatherer that gathers fundus tissue at or aboral to the gastroesophageal junction to reduce an esophageal opening into the stomach and tighten the lower esophageal sphincter. A fastener deployer then deploys at least one fastener pair to maintain both the restored gastroesophageal valve and the tightened lower esophageal sphincter.

Abstract: A device for positioning suture through tissue, the device including a proximal elongate member having a longitudinal axis, the proximal elongate member being configured to receive a needle, and a tissue locator disposed distal the proximal elongate member, the tissue locator being coupled to an elongate member extending through the proximal elongate member and including a leg with a needle receiving opening configured to accommodate the needle. Proximal movement of the elongate member compresses the tissue locator and folds the leg of the tissue locator, the leg transitioning from extending longitudinally to extending outwardly in relation to a position of the leg in a pre-compressed state.

Abstract: An atherectomy system includes a drive mechanism that is adapted to rotatably actuate an atherectomy burr and a controller that is adapted to regulate operation of the drive mechanism. In some cases, the drive mechanism includes a drive cable that is coupled with the atherectomy burr and an electric drive motor that is adapted to rotate the drive cable. The controller is adapted to regulate operation of the electric drive motor such that the drive mechanism emulates one or more performance parameters of an air turbine.

Abstract: Systems and methods for removal of clot material from vessel lumens are disclosed. A medical device assembly can include a catheter having a lumen and a distal portion configured to be positioned at or adjacent a treatment site within a vessel. An expandable member has a first portion coupled to the distal portion of the catheter, and a second portion extending away from the catheter distal portion. An elongate shaft extends through the lumen of the catheter, and the second portion of the expandable member is releasably coupled to the shaft. When the shaft is slidably moved relative to the surrounding catheter, the second portion of the expandable member can be released from the shaft, and the shaft can be withdrawn or removed.

Abstract: The present disclosure describes devices, systems, and methods for loading, delivering, positioning, and deploying an artificial heart valve device at the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. The valve device is attached at the distal end of the delivery member, and is constrained within a valve cover of an outer sheath. A delivery catheter is configured to advance the valve relative to the outer sheath, and a suture catheter includes sutures/tethers which maintain proximal tension on the valve prior to deployment.

Abstract: A medical device is disclosed for cutting substances inside a body lumen. The medical device includes: a rotatable tubular drive shaft; a treatment member arranged on a distal side of the drive shaft; a device handle configured to locate the drive shaft; a guide cover located in the device handle and disposed to cover the drive shaft; an outer sheath disposed to cover the guide cover and located in a housing of the device handle; a first sealing member located proximal to a proximal end of the outer sheath and proximal to a fluid connection, the fluid connection configured to supply a saline solution into the outer sheath on the guide cover; and a drainage tube located proximal to the outer sheath and the first sealing member, the drainage tube being located in the housing of the device handle, and the drainage tube is fixed with respect to the housing.

Abstract: Catheter exchange systems and methods may use a cutting tool to sever an encrusted catheter. The cutting tool may include a flexible cannula to encompass and move along the encrusted catheter. A sheath may selectively cover the cutting tool. The cutting tool may selectively transition between a first position in which the cutter is within the sheath and a second position in which the cutting tool is extended beyond the sheath to sever a suture of the catheter. A locking stylet may be used to secure the position of the encrusted catheter and remove the encrusted catheter.

Abstract: Provided herein is a catheter assembly including, in some embodiments, a core wire configured for linear actuation and a damping mechanism around the core wire. The core wire includes a proximal end with a sonic connector configured to couple to an ultrasound-producing mechanism. The core wire includes a distal end configured to modify intravascular lesions with vibrational energy from the ultrasound-producing mechanism. The damping mechanism includes a gasket system and a retainer to retain the gasket system in a damping-mechanism bore of the catheter assembly. The damping mechanism is around a proximal-end portion of the core wire, where the damping system can provide a compressive force sufficient to dampen transverse wave-producing vibrational energy in the proximal-end portion of the core wire without restricting the linear actuation of the core wire through the damping mechanism including extension and retraction of the core wire through the damping mechanism.

Abstract: Devices and methods for deploying self-cinching surgical clips. A device can access at least two layers of tissue or material from only one side of the tissue or material and puncture through the two layers of tissue or material. The various configurations of clips disclosed herein can be made of a superelastic material such as Nitinol, and have a constrained and a relaxed state, and no sharp edges or tips so as to reduce tissue irritation following deployment. The clip can be disposed within the housing of the delivery device and held in a constrained state until deployment wherein the clip assumes its relaxed state, where the ends of the clip can be brought into close approximation, thereby securing the layers of tissue or material together.

Abstract: A method of performing bariatric surgery using a robotic surgical system includes positioning a gastrectomy device in a selected location in a stomach; applying an adherent material to the stomach along a desired transection line; and cutting the stomach along the desired transection line delineated by the adherent material.

Abstract: There is provided an apparatus for extraction of at least one object from a cavity. The apparatus includes a sleeve including an inflatable section configured to surround the at least one object during inflation; a handle configured to enable a user to hold the sleeve, the handle defining a holding edge of an opening at a first portion of the sleeve; and a handle-mount mounted to a peripheral area around the opening, the handle-mount being for attachment of a pump used for inflating the inflatable section. There is also provided a pressure limitation apparatus configured to operate with a birth assistance device when attached via a conduit.

Abstract: Disclosed are systems, methods, and devices for percutaneous retrieval of objects, such as endovascular devices, from an internal body space. The present inventions have vascular, non-vascular (gastrointestinal), and surgical (laproscopic) applications. The inventions include a retrieval end having one or more compressed states and an expanded state, the retrieval end adopting the expanded state when the retrieval end is deployed into a subject's internal body space, the retrieval end having a mouth through which an object can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state; wherein when at least a portion of the retrieval end of the inner sheath is transitioned to a compressed state following capture of the object, the retrieval end exerts an inward force that at least partially collapses or compresses the object.

Abstract: A method for removing a tissue specimen from a patient includes introducing a bag at least partially into a cavity in the body of the patient, the bag comprising an open end and a port, positioning a tissue specimen to be removed from the patient into an interior of the bag by passing the tissue specimen through the open end of the bag, sealing the open end of the bag, removing gas from the interior of the bag through the port while the tissue specimen is contained in the interior of the bag, and entirely withdrawing the bag containing the tissue specimen from the cavity. The bag may include a closure device configured to hermetically seal the open end of the bag, and the port may include a one-way gas valve configured to prevent or retard gas from entering the interior of the bag through the port.

Abstract: Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

Abstract: A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Abstract: This document provides methods and materials for improving the training on the use of tourniquets. For example, methods and devices for confirming the proper pressure of a tourniquet using a tourniquet training device are provided.

Abstract: An expandable introducer sheath with an interlock dilator. The present technology provides an expandable sheath with a step feature inside its distal opening, and a dilator with an interlock that includes a catch surface configured to engage with the step feature and resist further relative movement so that the body of the dilator is prevented from exiting the distal end of the expandable sheath. This interlocking engagement may allow the dilator to be used to extend and maintain tension on the expandable sheath during insertion into a patient, and then to be retracted from the expandable sheath by pulling the dilator in the opposite direction. The present technology also provides a dilator hub with a spring mechanism configured to achieve and maintain a desired tension on the expandable sheath and to prevent overextension of the expandable sheath when the dilator is being inserted into the expandable sheath.