Abstract: An anchoring system is a combination of a nanofiber scaffold material and an arthroscopically deployable suture anchor. The anchor is deployed into a bone tunnel using common techniques. The nanofiber material extends out of the proximal end of the implant, once deployed. The implant also includes pre-loaded sutures or has the ability to accept and lock sutures to the implant. For an implant pre-loaded with suture, the implant is placed into the bone, the material is deployed above the anchor onto the surface of the bone, suture is passed through the soft tissue, and knots are tied to secure the tissue against the bone, sandwiching the material between the bone and tissue, to provide a pathway for cells from the bone marrow to the soft tissue-bone interface, promote the healing response, provide a biomimetic structure that cells readily adhere to, and create a larger healing footprint.

Abstract: A device for removing an obstruction from a lumen in a human or animal subject may include an inflatable balloon. The inflatable balloon may include a proximal tapered portion having a proximal taper angle, a central portion, and a distal tapered portion having a distal taper angle that is greater than the proximal taper angle. The balloon may also include at least one eversion feature on the proximal tapered portion and/or the distal tapered portion. The eversion feature may facilitate preferential eversion of the distal tapered portion into an inside of the balloon without the proximal tapered portion collapsing. Preferential eversion of the distal tapered portion may be provided by the differences in the distal and proximal taper angles and by one or more of a number of different types of eversion features.

Abstract: A tissue removal system is provided which enables optimally performing a full-thickness resection of a hollow organ while minimizing invasiveness. In this tissue removal system, a tissue pressing tool which has a tissue contacting part and which is guided into the abdominal cavity, and a resection and anastomosis device work together. The resection and anastomosis device resects and performs anastomosis of tissue positioned between a main body and an anvil part, and, when pressing the tissue to be cut to the cutting position of the resection and anastomosis device by means of the tissue contacting part, the tissue contacting part is pressed against two abutment parts of the resection and anastomosis device.

Abstract: In one embodiment, a suture attachment catheter configured to repair a heart valve by inserting a suture in a valve leaflet of a beating heart of a patient includes a handle control, a flexible catheter body, and a suture attachment assembly at a distal end of the catheter body. The suture attachment assembly can include a rail between a distal clamping jaw hingedly attached to the rail, and a proximal clamping jaw. One of the proximal clamping jaw or distal clamping jaw can be selectively slideable with respect to the other on the rail using a jaw actuator of the control handle to adjust a distance between the proximal clamping jaw and the distal clamping jaw. A needle can be selectively slideable within the catheter body by using a needle actuator of the proximal handle control to penetrate a valve leaflet and insert a suture through the valve leaflet when the valve leaflet is captured between the proximal clamping jaw and the distal clamping jaw.

Abstract: An improved holder and storage system for prosthetic heart valves that pre-shields or pre-constricts the commissure posts of the valve to prevent suture looping. Pre-shielding and pre-constriction mean at the time of manufacture, so that the valves are stored with the commissure posts shielded and/or constricted. The holders may have solid legs that directly contact and constrict and hold the commissure posts without the use of sutures in tension that might creep over the time in storage. The holder may have a base in contact with the inflow end and a shaft portion that projects through the valve leaflets and cooperates with movable legs on the outflow end of the valve in contact with the commissure posts. The holders may, alternatively, have flexible leg members that extend through the valve and have distal end portions configured to extend over and shield the tips of commissure posts.

Abstract: Aspects of the present invention provide apparatuses and methods for closing an apical hole in a heart of a subject, including a hole-closure device that includes a tissue-attachment portion configured to attach to cardiac tissue around the apical hole, and a collapsible portion coupled to the tissue-attachment portion and configured to close the hole by collapsing inwardly inside the apical hole.

Abstract: This disclosure relates to devices and methods for manipulating, such as with a suction based traction device, a target anatomic structure inside the body and delivering an ligation device around the anatomic structure. In particular examples, the target structure can be an atrial appendage, and the devices and methods are for atrial appendage ligation.

Abstract: A personalized prosthesis for implantation at a treatment site of a patient includes a self-expanding mesh and/or membrane having collapsed and expanded configurations. The collapsed configuration is adapted to be delivered to the treatment site, and the expanded configuration is oversized relative to the treatment site and configured to engage the personalized prosthesis with the treatment site. The self-expanding mesh is configured to reduce in one or more dimensions in response to being constrained in the one or more dimensions, such that the mesh in the expanded configuration self-adjusts to the treatment site without buckling of the mesh. The self-expanding mesh or membrane forms a central lumen configured to allow blood or other body fluids to flow therethrough. Methods of manufacturing and delivery of the personalized prosthesis are also disclosed.

Abstract: An implant structure includes a contracting mechanism, including a rotatable structure for contracting the implant structure, and a locking mechanism. A rotation tool is configured to engage and rotate the rotatable structure. A longitudinal guide member is removably coupled to the contracting mechanism, configured to guide the rotation tool to the rotatable structure, and includes a distal force applicator. The rotation tool is axially moveable with respect to the guide member. The contracting mechanism is arranged such that the locking mechanism is (a) unlocked when the guide member is coupled to the contracting mechanism in a first state, thereby allowing the rotatable structure to rotate, and (b) locked when (i) the guide member is coupled to the contracting mechanism in a second state, thereby restricting the rotation of the rotatable structure, and (ii) the guide member is not coupled to the contracting mechanism, thereby restricting the rotation of the rotatable structure.

Abstract: Systems and methods are described and illustrated for percutaneously implanting a stimulation lead for treating sleep-related disordered breathing.

Abstract: A method is provided, comprising: (1) making a transapical puncture into a left ventricle of the heart; (2) making a transseptal fenestration in the heart; (3) delivering a prosthetic valve via the transapical puncture and implanting the prosthetic valve at a mitral valve of the heart; and (4) subsequently to delivering the prosthetic valve and making the transseptal fenestration, closing the transapical puncture. Other embodiments are also described.

Abstract: A vein harvesting assembly for harvesting a vein in a body comprises: a dissecting member, with the dissecting member being insertable into the body and moved along a vein to dissect tissue surrounding the vein. A covering member possesses a proximal end portion and a distal end portion, with the covering member possessing a covered space extending from the proximal end portion to the distal end portion, and the covering member being mountable on and movable along the dissecting member when the dissecting member is positioned in a living body. A cutting member is comprised of an elongated member and a blade member so that rotation of the elongated member results in turning of the cutting member to cut tissue surrounding the vein. The cutting member is insertable into the space in the covering member and is movable in a distal direction along the space.

Abstract: A surgical device and methods of using the surgical device are disclosed. The surgical device includes a trocar, a cannula releasably mounted on the trocar, and a propulsion system operatively connected to the trocar. The cannula includes a hub, and has a central opening through which the trocar extends. The propulsion system is operable to drive the trocar axially in a forward direction away from a proximal end of the surgical device.

Abstract: An angioplasty catheter comprises a catheter body having a balloon or other radially expandable shell at its distal end. An external structure is carried over the shell and scores a stenosed region in a blood vessel when the balloon is inflated therein. The catheter has an attachment structure disposed between the catheter body and the balloon to accommodate foreshortening and rotation of the external structure as the balloon is expanded. The external structure may be part of a helical cage structure which floats over the balloon. Stabilizing struts are provided between at least some of the helical struts.

Abstract: Described herein include various embodiments of a tool assembly for performing endoscopic surgery that can be used manually and/or with a robotic surgical system. The tool assembly can include a shaft assembly that extends from a housing of the tool assembly. A distal end of the shaft can include an end effector that includes a clamp arm pivotally coupled to a blade for cutting and/or sealing tissue. Pivoting of the clamp arm between the open and closed configurations can be caused by movement of a yoke that is slidably disposed within the housing of the tool assembly. For example, the yoke can be caused to move by one or more outputs (e.g., a manual output, a rotary output, and/or a linear mechanical output). Furthermore, some tool assembly embodiments can include a biasing system that biases the yoke such that the clamp arm is in the open configuration. In some embodiments, the tool assembly can be configured for tissue spread dissection using the clamp arm and blade.

Abstract: Systems and methods for tissue containment and retrieval are disclosed. The containment system includes a primary chamber interconnected with a secondary channel extending from the primary chamber. A tissue specimen is mobilized inside a body cavity and placed into the primary chamber through a first opening. The first opening is pulled through a first incision or orifice and the narrower secondary channel is placed at a second incision or orifice. A second opening at the end of the secondary channel permits observation via a scope inserted through the second opening of the tissue specimen in the primary chamber undergoing morcellation via the first opening. Other systems and methods for deployment, containment, debulking and sealing of the second opening to create a closed system for the safe retrieval of the tissue specimen are provided.

Abstract: A catheter for delivery of intraluminal and expandable devices. The catheter is provided with a flexible curved tip distal to the device loaded onto the catheter for delivery to a desired site within a body conduit. The curved distal tip causes the catheter to rotate to a preferred rotational orientation, which may be desirable for any device having asymmetric features, particularly when used in tortuous body conduits.

Abstract: A medical clamping instrument includes first and second tubular members pivotally connected together, a first rod member pivotally connected to the second tubular member, a second rod member pivotally connected to the first rod member, first and second claw arms respectively providing first and second clamping portions and first and second connecting portions and respectively pivotally connected to the second tubular member, third and fourth rod members respectively pivotally connected to the first and second connecting portions, a screw nut pivotally connected to the third and fourth rod members, a screw rod threaded into the screw nut and driven by a driving rod via the first universal joint, the fifth rod member and the second universal joint. Thus, operating the driving rod can move the first and second clamping portions, maintaining the clamping force stably.

Abstract: An apparatus for forming a passageway through tissue includes a dilator mounted to a shaft, wherein the dilator includes a first portion, which has an increasing taper from a first outer diameter to a larger second outer diameter, and a second portion, which has a decreasing taper from the first portion to a distal end of the dilator, and which includes an external non-cutting thread formed along the decreasing taper. Lumens of the dilator and shaft provide a conduit for means to pierce through the tissue, for example, an elongate wire that includes a piercing tip. In some cases, the dilator first portion is expandable to, and contractible from, the larger second outer diameter, wherein the apparatus may include a spreading member configured to slide between the shaft and the first portion. The apparatus may be included in a system with an introducer sheath.

Abstract: An instrument for removing debris from an eye during the treatment of an ocular disorder has a swab and a rigid member. The swab includes a tip portion sized to provide access to the debris on an eyelid of the eye. The rigid member has a distal end portion affixed to the swab and a proximal end portion with a cross-sectional member profile. The cross-sectional member profile is non-circular and has a first groove. The first groove extends longitudinally along the proximal end portion for cooperating with a chuck such that rotation of the proximal end portion within the chuck is inhibited.