Abstract: The disclosure concerns a minimally-invasive medical instrument with a rotatable inner shaft mounting a medical tool. The medical tool may be, for example, a forceps, a grasper, a cutter or other medical tool useful for therapeutic or diagnostic procedures. The medical tool is desirably used in endoscopic, laparoscopic or other minimally-invasive procedures. The jaws or other end-effectors of the tool are operated by a first control wire, which will act to open or close the jaws or other end-effectors of the tool. A second control wire is used with a camming mechanism to transform linear movement of the second control wire into rotary motion of the inner shaft, thus also rotating the medical tool. The medical tool may thus be oriented at the surgical sit as desired by the surgeon, by rotating the tool without having to remove and re-place the tool within the patient.

Abstract: A surgical instrument is adapted and configured for use in a minimally invasive surgical procedure. The surgical instrument includes at least one pair of segments including a plurality of articulating links having gaps therebetween. At least one gap stabilizer stabilizes the articulating links and facilitates maintaining equally sized gaps between the articulating links during bending of the surgical instrument.

Abstract: A method for insertion of an intraocular lens into the eye of a patient, the method including removably attaching loop extensions to loops of an intraocular lens prior to insertion of the intraocular lens into the eye of a patient, initially inserting into the eye of the patient the loop extensions, pulling on the loop extensions through sclerectomies formed in the sclera of the eye of the patient, inserting the intraocular lens into the eye of the patient, positioning the intraocular lens in a desired position in the eye of the patient by pulling on the loop extensions through the sclerectomies, and fixing the loops to the sclera of the eye of the patient at the sclerectomies and detaching the loop extensions from the loops.

Abstract: An abdominal aortic tourniquet having one-piece member for the bladder and cover portions and whose bladder has a triangular cross-sectional shape when inflated that significantly increases the amount of point pressure such that the intended artery is properly occluded. The one-piece bladder/cover design provides for a reduction in cost of materials and provides for a more compact piece as compared to prior designs. The abdominal aortic tourniquet uses a single piece of weldable and gas impermeable fabric that is configured in a novel manner to create a three-dimensional, pneumatic piston while also serving as storage/transport cover, attachment structure, and major component of the belt member.

Abstract: A treatment device includes a treatment portion, a transmission portion and a moment shift portion. The treatment portion transmits ultrasonic vibration. The length of the treatment portion is shorter than ¼ of a wavelength of the ultrasonic vibration. The transmission portion has one end at a node position where the first generated node from the distal end of the treatment portion appears, and is located closer to a proximal side than the node position. The length of the transmission portion is ¼ of the wavelength. The moment shift portion is located between the treatment portion and the transmission portion. An average of I1/A12 is greater than an average of I2/A22, where I1 is the second moment of area and A1 is a sectional area in the treatment portion, and I2 is the second moment of area and A2 is a sectional area in the transmission portion.

Abstract: An insertion device of a coil includes a delivery wire driving unit, a secondary catheter driving unit, and a control circuit. A platinum coil for coil embolization is attached to the tip of a delivery wire. The delivery wire driving unit is provided in the proximity of the entrance of a Y connector such that the delivery wire is advanced and moved back. The secondary catheter driving unit is provided in the proximity of the entrance of a Y connector such that the secondary catheter is advanced and moved back. The control circuit controls the delivery wire driving unit so as to insert the delivery wire by a predetermined insertion force. If the delivery wire cannot be inserted, the control circuit controls the secondary catheter driving unit such that the secondary catheter is advanced after being moved back, and then controls the delivery wire driving unit so as to insert the delivery wire.

Abstract: Self-locking knotless sutures and associated methods are disclosed. A system for securing tissue includes a monofilament and a braid having a fixed end and a capture end. A first end of the monofilament is connected to the fixed end of the braid. A second end of the monofilament opposite the first end is a free end. The capture end of the braid has a first opening and a second opening. The monofilament and braid are structured and arranged for the free end of the monofilament to be inserted into the first opening, passed through a tunnel formed by the braid, and passed out of the second opening, all while moving in a first direction. After insertion of the monofilament into the braid, the braid prevents movement of the monofilament in a second direction opposite the first direction to prevent the monofilament from being pulled out of the braid.

Abstract: A method of deploying an ocular implant into Schlemm's canal of a human eye including the following steps: inserting a distal tip of a delivery tool within an anterior chamber of the eye through trabecular meshwork of the eye into Schlemm's canal of the eye; and advancing an ocular implant through a curved portion and a distal opening of the delivery tool to place a body portion of the ocular implant in Schlemm's canal and an inlet portion of the ocular implant in the anterior chamber.

Abstract: Systems, devices, and methods are provided for securing soft tissue to bone. One exemplary embodiment of a surgical soft tissue repair device includes a snare assembly coupled to a soft anchor in which the soft anchor has a first, unstressed configuration that can be used to insert the anchor into bone and a second, anchoring configuration that can be used to fixate the anchor in the bone. The snare assembly can be configured to actuate the anchor from the first configuration to the second configuration, and it can also be used to engage and approximate tissue by drawing the tissue closer to the anchor fixated in the bone. The snare assembly can be used in conjunction with a number of different anchor configurations, and other exemplary systems, devices, and methods for use with soft tissue repair are also provided.

Abstract: A removable filter has a hub defining a waist and a longitudinal filter axis; a plurality of primary struts extending from a first axial side of the hub, and a plurality of secondary struts extending from a second axial side of the hub opposite the first axial side. The secondary struts form a radially outward arc extending from the hub over an angle of at least about 180° in the expanded state, preferably between about 190° and about 270°. A retrieval coil with a proximal end fastened to an elongated wire has several longitudinally offset windings. The retrieval coil is preferably more rigid than the primary struts. The coil may preferably have a distal winding with an inner diameter that is greater than the diameter of the hub and smaller than the diameter of the filter in the expanded state.

Abstract: A delivery device can include a number of different features including, one or more of, but not limited to, the following. Shuttle and trigger retraction of an outer sheath. Arcuate movement of a trigger. An interlock device to prevent actuation of the trigger. An interlock device that can adjust the position of the outer sheath and the inner shaft. A retraction override switch and lock.

Abstract: A system for repairing separated body tissues includes a tensioning device having a movable housing, a pair of stationary tensioning tips distal to and attached to the movable housing, and suture tensioning jaws on a proximal end of the movable housing. The tensioning jaws are pivotable between open and closed orientations. A buckle is provided for securing and tensioning suture and the like, having a first plate, a second plate spaced from the first plate so that there is a gap between the first and second plates, and a lock bar within the gap and movable between a first position wherein suture may be freely passed through the gap as tensioning of the suture proceeds, and a second locking position wherein the suture is clamped in place within the gap. A tension tab is provided for securing the lock bar in its first position until tension on the suture exceeds a predetermined level.

Abstract: Sutures can be placed in difficult to access areas of the human body with devices, and related methods, utilizing a suture carrier with a sharpened tip and a notch for holding a formed suture tip.

Abstract: An ultrasonic surgical instrument including an ultrasonically actuated blade or end effector having a treatment portion. The blade can define a central axis and at least one axis which is transverse to the central axis, wherein the transverse axis can lie within a plane which is perpendicular, or normal, to the longitudinal axis and can define a cross-section of the treatment portion. Such a cross-section can include a central portion and a step extending from the central portion, wherein the central portion can comprise a width, and wherein the step can comprise a cutting edge. In at least one embodiment, the cutting edge can be defined by first and second surfaces which define an angle therebetween. In various embodiments, the position of the cutting edge and/or the angle between the cutting edge surfaces can be selected in order to balance the blade with respect to the transverse axis.

Abstract: An occluder for sealing gaps between a medical device and adjacent body tissue includes an expandable body configured to fill the gaps between the medical device and the body tissue. The occluder includes a fastener at one end of the body and adapted to couple to a first end of the medical device, and an expandable disk at the other end of the body and adapted to couple to the medical device at a position spaced from the first end.

Abstract: Described herein are systems and methods from delivering prosthetic devices, such as prosthetic heart valves, through the body and into the heart for implantation therein. The prosthetic devices delivered with the delivery systems disclosed herein are, for example, radially expandable from a radially compressed state mounted on the delivery system to a radially expanded state for implantation using an inflatable balloon of the delivery system. Exemplary delivery routes through the body and into the heart include transfemoral routes, transapical routes, and transaortic routes, among others.

Abstract: Described here are devices and methods for accessing the pericardial space. The access devices may include a piercing member such as a needle and a proximal shoulder having a contact surface for contacting the pericardium as the piercing member pierces the pericardium. In some instances, the distance between the piercing member and the proximal shoulder may be adjustable.

Abstract: Methods and systems for fetal intervention to address malformations or other conditions are presented. In one instance, a method is provided that includes introducing a guide catheter into the fetus' venous system and using controlled magnets to position the guide catheter at a desired location. The method also involves positioning the treatment catheter at a treatment location using the guide catheter and delivering a treatment using the treatment catheter at the treatment location. In one particular application, a hypoplastic left heart is treated by using a balloon catheter as the treatment catheter and inflating a balloon on the balloon catheter at the aortic valve. Other methods and systems are disclosed.

Abstract: An apparatus provides mechanical energy to vibrate a needle. An irrigating sleeve is disposed around the needle and includes one or more irrigation ports through which irrigation liquid is ejected during emulsification. To prevent the needle from occluding the irrigation ports with its deflections, one or more bumpers are provided between the sleeve and the needle.

Abstract: A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a closure element having a foot portion and a needle guide portion. The foot portion and the needle guide portion are each movable between a delivery configuration and a deployed configuration. The foot portion includes cuffs removably mounted thereon and having sutures connected therebetween. The needle guide portion includes needle guide apertures that guide the needles to the cuffs. The needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.