Abstract: Systems and methods for soft tissue to bone repairs, without knot tying. The soft tissue repair systems include self-cinching constructs with splices, loops and inserts that are pre-loaded onto knotless anchors to position the self-locking, adjustable construct at the repair site. The splice incorporates an insert in the form of a flexible strand with at least one barb, or simply in the form of a cut length of suture or braid that is inserted into the center of the cinching loop to create a thicker portion. When the cinching loop is tightened, the insert prevents loosening of the loop, locking in the cinching loop and preventing movement of the loop.

Abstract: A stent delivery system, and associated manufacturing method, are such that the outer diameter of the distal portion of the stent delivery system is relatively small. The stent delivery system includes a hollow shaft portion, an inflatable balloon disposed on the outer periphery of a distal portion of the shaft portion, and a stent disposed on the outer periphery of the balloon and having struts expanded by inflation of the balloon. The balloon has a ridge portion with which the stent is engaged. The ridge portion is sandwiched in a space between the struts, and a top portion of the ridge portion has a concave portion recessed toward the axis of the shaft portion.

Abstract: A device and method for removing atheroma. An expandable atherectomy device comprises a rotatably motor-driven flexible hollow shaft that is slidable over a guidewire introducible through a flexible catheter tube and is coaxial with the longitudinal axis of the guidewire, an expandable cutting unit connected to a distal end of the hollow shaft, and an actuator which is operable to induce selective expansion of the cutting unit. The cutting unit, when expanded, is eccentrically rotatable about the longitudinal axis to cut and remove atheromous material from a blood vessel. In one embodiment, the method also includes the step of drilling an occlusion present in the lumen of a blood vessel by a drill unit connected to the cutting unit.

Abstract: A connection mechanism and manufacturing method for a surgical instrument includes an inner shaft member that extends at least partially through an elongated shaft member of the instrument and defines proximal and distal ends and is selectively movable in a longitudinal direction with respect to the elongated shaft member and includes at least one aperture that extends partially along the longitudinal direction and disposed distally from the proximal end. The inner shaft member enables a drive collar member to slide on the inner shaft member and reciprocate along the longitudinal direction. A drive collar stop member slides on the inner shaft member and moves along the longitudinal direction. The drive collar stop member then moves in a direction relative to the longitudinal axis to engage the aperture and limit further longitudinal motion of the drive collar member. An inner shaft stop member limits movement of the inner shaft.

Abstract: A device to extract elements contained in cavities that uses a bag for their extraction that folds onto itself and an applier provided with an air chamber, which bag has pockets into which tentacles of the applier are introduced; and that is provided with means to pull from same; an applier that is comprised by a first piece called outer tube, that is hollow and of rigid material which, at its distal end, turns into at least two tentacles that allow its radial flexibility, and in its proximal end, means are provided to fix the second piece, called inner tube, which is a hollow tube, open at its ends, that slides into the body of the outer tube and that provides a funnel at its distal end. The device may have grade scale either on the tentacles, the inner tube as well as on the bag. Additionally, this provides two rings used as reference, on each of the folds of the bag.

Abstract: An apparatus for operating on tissue includes a body, a shaft, an ultrasonic blade, and an acoustic assembly. The shaft extends distally from the body. The blade is disposed at the distal end of the shaft. The acoustic assembly comprises an acoustic waveguide coupled with the blade, a piezoelectric transducer element, a fastener, and a coupling member. The transducer element defines an inner diameter surface and an outer diameter surface. The fastener is configured to secure the transducer element relative to the waveguide. The coupling member is configured to provide electrical continuity between the fastener and the inner diameter surface of the transducer element. The outer diameter surface of the transducer element includes an annular recess. Another coupling member is configured to provide electrical continuity between the annular recess of the piezoelectric transducer element and a power source while permitting the piezoelectric transducer element to rotate relative to the body.

Abstract: A treatment instrument is that a maximum dimension of the loop portion in a direction orthogonal to the longitudinal axis in a state where half of a total length of the loop portion in a direction of the longitudinal axis of the loop portion is pulled into the sheath is 40% to 60% of a maximum dimension of the loop portion in the orthogonal direction in a state where the whole loop portion protrudes from a distal end of the sheath.

Abstract: An ear cleaning device is provided for removing debris from an ear. In one form, the ear cleaning device includes a shaft, a head connected to the shaft, and a contiguous pocket structure of the head. The contiguous pocket structure includes a plurality of pockets that may be configured to receive debris. In another form, the ear cleaning device has a handle, a bulbous cleaner connected to the handle, and a solid inner core of the bulbous cleaner. The bulbous cleaner has two or more spaced, longitudinal walls disposed outward of the inner core that are configured to remove debris with turning of the ear cleaning device about a longitudinal axis of the device.

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: 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: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: Devices and methods for treating or repairing a heart are disclosed. The device includes at least one radially expandable tissue-engaging element, an elongate member (e.g., suture) coupled to the expandable element, and a locking mechanism (e.g., locking clip, suture knot). The expandable element may be anchored to heart tissue within the heart, such as in the left ventricle, with the elongate member extending from the expandable element and across a heart chamber to a second location such as the heart apex where the elongate member is held by the locking mechanism.

Abstract: The present invention relates in general to anchoring systems for occluder devices, and more specifically, to an anchoring system and method for implanting an occluder device within a left atrial appendage (“LAA”) of the heart. The anchoring system is configured so that an anchor penetrates the inner endocardium layer, middle myocardium layer, and outer epicardium layer of an LAA wall. The purpose of the present invention is to provide an occluder device anchor that has a low risk of embolization and/or causing injury to neighboring valve structures. An additional purpose of the present invention is to provide an anchoring system and method for implanting an occluder device within the LAA that allows for the occluder device to be retrievable after initial placement, reusable, and repositionable for an optimal final placement within the LAA.

Abstract: A system for stapling tissue comprises a flexible endoscope and an operative head including a pair of opposed, curved tissue clamping jaws sized to pass through an esophagus, the jaws being moveable with respect to one another between an open tissue receiving configuration and a closed tissue clamping configuration, a first one of the curved jaws including a stapling mechanism and a second one of the jaws including a staple forming anvil surface, the stapling mechanism including staple slots through which staples are fired arranged in a row extending from a proximal end of the first jaw to a distal end thereof in combination with a control handle which, when the operative head is in an operative position within one of a patient's stomach and esophagus, remains outside the patient, the control handle including a first actuator for moving the jaws relative to one another and a second actuator for operating the stapling mechanism.

Abstract: Apparatus for closing a surgical incision comprise a base having left and right panels, a force distribution structure coupled to each panel, and a closure component which releasably attaches to the force distribution structure to draw the inner edges of the panels together in order to close adhered tissue edges. The force distribution structures allow the inner edges of the panels to expand while restraining expansion of the outer edges of the panels and limiting elongation of the lateral dimension of the panels. The incision closure appliance may be placed on skin or other tissue prior to forming the incision to be available to close said incision at the end of the surgical procedure.

Abstract: A lancing device includes a housing, a lancet carrier translational within the housing, a drive spring for propelling the lancet carrier through a translational lancing stroke, and a charging mechanism. The charging mechanism includes a first cam member that is rotatable relative to the housing, a second cam member that abuts the first cam member, is coupled to the lancet carrier, and is restricted from rotation relative to the housing, and a rotatable handle co-rotationally attached to the first cam member. Rotation of the handle rotates the first cam member with it, causing the first cam member to rotate against the second cam member, which in response traverses axially because it is restricted from rotation, thereby retracting the lancet carrier to a retracted or charged state.

Abstract: A system for implanting a heart valve includes a radially self-expandable tubular body having an inflow end and an outflow end and a preformed groove disposed at an outer surface of the tubular body between the inflow end and the outflow end. The preformed groove extends at least partially around the tubular body and has a circumferential opening facing radially outward of the tubular body. A valve is disposed within and is attached to the tubular body, and an elongate outer member is configured to form a loop encircling the preformed groove so as to guide portions of native valve leaflets and/or chords into the preformed groove. The outflow end of the tubular body includes a frustoconical shape that slopes radially outward from the preformed groove toward the outflow end when the outflow end but not the inflow end has been released from a delivery catheter.

Abstract: Various exemplary methods, systems, and devices for surgical suturing are provided. In general, a loading element can be configured to facilitate loading of a plate into a surgical instrument configured to facilitate passage of a suture through tissue. The surgical instrument can be configured to advance the suture through a tissue of a patient, to capture a free end or looped end of the suture after the suture's advancement through the tissue, and to pull the captured suture out of the patient's body with a portion of the suture remaining passed through the tissue within the patient's body.

Abstract: A cutting instrument comprising: an outer tube comprising a distal end and a proximal end; an inner tube rotatably disposed within said outer tube, said inner tube comprising a distal end, a proximal end and a region intermediate said distal end and said proximal end, said region comprising a plurality of slits formed in said inner tube so as to render said region of said inner tube flexible; and a bellows disposed adjacent to said plurality of slits so as to render said region of said inner tube fluid-tight.

Abstract: A catheter extraction tool has a head that can be placed in position to significantly surround a diameter of a catheter. The head is shaped to have a low enough profile above the catheter to allow the head to be slid down the catheter and into a subdermal region in which the catheter is subdermal with respect to a patient. The head of the catheter extraction tool is expanded sufficiently to slide the head over a catheter cuff located in the subdermal region. After the head of the catheter extraction tool slides over the catheter cuff, the head is contracted to engage the catheter so that a user can pull the catheter out of the patient using the catheter extraction tool.