Abstract: Embodiments disclose uterine manipulators, dye delivery systems and fornix delineators that address several issues, such as minimizing surgical error, minimizing loss of parts inside a patients, enabling easy manipulation of a patient's anatomy, securing and removing the device into and from the patient atraumatically, preventing loss of pnuemoperitoneum, and securing the device fastener and components efficiently and atraumatically. An embodiment includes a uterine manipulator having a fornix delineator, uterine shaft, outer tube, fastener, handle, inlet, tip, ring and connecting string, and/or occluder.

Abstract: A method of attaching an implant to a vessel can include clamping a portion of a wall of a vessel within a patient. The method can also include positioning an implant adjacent to an outer surface of the wall of the vessel, and the implant can include an access port. The method can also include cutting the wall of the vessel about the portion of the wall that has been clamped, passing the portion of the wall that has been clamped and that has been cut about through the implant to remove the portion of the wall from the patient and to provide an opening in the vessel, and securing the implant to the vessel such that the access port is in direct fluid communication with an interior of the vessel via the opening in the vessel.

Abstract: A surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one needle guide configured to guide at least one needle through the cuff receiving area and the tissue bite area. Another surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one pair of needle guides configured to guide both the needles of at least one pair of needles through the cuff receiving area and the tissue bite area. The guide tip also has at least one pair of ferrule receiving apertures. The cuff receiving area and the tissue bite area are oriented to avoid cross-over of a suture passed by the at least one pair of needles through tissue in the tissue bite area and a replacement anatomical device sewing cuff in the cuff receiving area.

Abstract: A medical instrument is disclosed having a structure capable of preventing liquid circulation between an inner layer side and an outer layer side of a peripheral wall portion. The medical instrument includes a main body portion in which a center hole and a radially outward space are partitioned by a tubular peripheral wall portion. The peripheral wall portion includes at least a first layer on which a hydrophilic member, in which a hydrophilic coating is formed on a first base portion, is disposed and a second layer on which a hydrophobic member, in which a hydrophobic coating is formed on a second base portion, is disposed. The peripheral wall portion is configured by the first layer and the second layer being stacked along a radial direction. As a result of swelling of the hydrophilic coating, the adjacent hydrophilic members come into contact with each other.

Abstract: Tissue fasteners carried on a tissue piercing deployment wire fasten tissue layers of a mammalian body together. The fasteners include a first member, a second member, and a connecting member extending between the first and second members. The first and second members are substantially parallel to each other. The fasteners may be deployed in limited spaces and in various applications including the restoration of a gastroesophageal flap valve.

Abstract: An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The tissue grasper is advanced through a working channel of an endoscope, engaged relative to tissue, and retracted to pull tissue into a path of a movable needle coupled at a distal end of the endoscope so that the needle can be passed through the tissue. The needle is preferably provided with a suture so that as the needle is passed through the tissue a stitch is formed.

Abstract: Described herein are low-profile electrodes for use with an angioplasty shockwave catheter. A low-profile electrode assembly may have an inner electrode, an insulating layer disposed over the inner electrode such that an opening in the insulating layer is aligned with the inner electrode, and an outer electrode sheath disposed over the insulating layer such that an opening in the outer electrode sheath is coaxially aligned with the opening in the insulating layer. This layered configuration allows for the generation of shockwaves that propagate outward from the side of the catheter. In some variations, the electrode assembly has a second inner electrode, and the insulating layer and outer electrode may each have a second opening that are coaxially aligned with the second inner electrode. An angioplasty shockwave catheter may have a plurality of such low-profile electrode assemblies along its length to break up calcified plaques along a length of a vessel.

Abstract: Medical devices for closing anatomical apertures, such as atrial or ventricular septal defects, are disclosed. The medical devices can include a plug body having a proximal end, a distal end, and a longitudinal axis. The plug body can include an exterior surface, an interior surface defining an interior lumen, and a seal which can be located within the interior lumen. The medical devices can also include at least one arm member extending through the plug body between the exterior surface and the interior surface of the plug body. In certain embodiments, the medical device can include a distal loop and a proximal loop extending through the plug body. In certain embodiments, the proximal loop can be smaller than the distal loop, such that a top end and a bottom end of the proximal loop can fit within a top end and a bottom end of the distal loop.

Abstract: An instrument port for introducing instruments into a surgical site, including a port body having a channel running therethrough from a proximal end to a distal end, an instrument sleeve in slidable contact with the channel, creating a gap therebetween, and fluid flow for removing emboli efficiently from the instrument port, wherein the fluid flow includes the gap is provided. A fluid flow system for use in an instrument port is provided. A method of removably securing an instrument sleeve to a port body by anchoring the instrument port to heart tissue, making at least one flood line in a channel, flushing out emboli, and performing surgery with the instrument port.

Abstract: An endoscopic suturing system includes an endoscope, a suturing device, a needle assembly movable through tissue by the suturing device, and first and second devices used in association with the suturing device. The cap assembly includes a rotatable needle arm supporting the needle assembly and actuatable by a proximal handle via a transmission assembly. First and second separate lumen extends outside the endoscope from the cap assembly to a proximal handle to advance instruments therethrough to engage the needle assembly and target the tissue. The cap assembly is retained at an end of the endoscope by a securing arm. The securing arm may be resilient or rotatable. Ancillary clips are also provided about the first and second lumen and transmission assembly to couple them to the endoscope.

Abstract: A system for treating tissue includes a clip assembly including a pair of clip arms, proximal ends of which are slidably received within a channel of a capsule to be moved between a tissue receiving configuration, in which distal ends of the clip arms are separated from one another, and a tissue clipping configuration, in which the distal ends are moved toward one another. The system also includes an applicator including a catheter and a control member extending therethrough. The control member configured to be connected to the clip arms to move the clip assembly between the tissue receiving and tissue clipping configurations. The system also includes a coupler attached to one of a proximal end of the capsule of the clip assembly and a distal end of the catheter, and configured to releasably couple the capsule and the catheter to one another.

Abstract: A stent delivery device has a handle and a sliding body, the sliding body is slidable with respect to the handle. The handle has a grip and a guide. The sliding body has at least two flange portions extending from the sliding body. The flange portions are offset from one another along the length of the sliding body. The operator can thereby deploy a relatively long stent by first gripping the nearest flange portion and pulling the sliding body toward the handle; subsequently, the operator can reposition his/or finger on the next-nearest flange portion and continue deployment of the stent by pulling the sliding body further toward the handle.

Abstract: Embolic protection devices and systems capture and/or deflect emboli from entering one or more arterial branches of the aorta. An embolic protection device may include an anchor section that is positionable within an arterial branch of the aorta and a shield section that is operatively coupled to the anchor section. The shield section is positionable relative to one or more ostia of the aortic branches and is held in that position by the anchor section.

Abstract: Distal tips for use with delivery catheters are disclosed that are configured to maintain complete engagement between the distal tip and a distal opening of a sheath component of the delivery catheter so as to prevent separation therebetween and/or to prevent fish-mouthing of a distal leading edge of the sheath component during in vivo use. Distal tips so configured realize one or more of the objectives of safer tracking of the delivery catheter through the vasculature, safe crossing of the delivery catheter through structural components of the vasculature and heart, such as through native valves, and safe removal of the delivery catheter post deployment.

Abstract: A rotation adapter for a minimally invasive surgical apparatus is disclosed. The rotation adapter has a proximal journal and a distal journal. The rotation adapter also has a rotation index coupled between the proximal and distal journals. The rotation adapter further has an actuator input and an effector output. A rotation adapter receiver for a minimally invasive surgical apparatus is also disclosed. The rotation adapter receiver has opposing beams and a proximal bushing coupled between the opposing beams. The rotation adapter receiver also has a distal bushing coupled between the opposing beams. The rotation adapter receiver further has a rotation constraint coupled between the opposing beams and positioned between the proximal and distal bushings.

Abstract: An actuation mechanism for actuating an electromechanical end effector includes a housing, and a shaft assembly extending distally from the housing. The shaft assembly includes a shaft, a longitudinal knife bar, a first hub, and a second hub. The shaft is axially movable relative to the housing and configured to be coupled to the electromechanical end effector. Rotation of a first screw of the housing moves the first hub to effect longitudinal movement of the shaft. The longitudinal knife bar is axially movable relative to the shaft and configured to be coupled to a knife blade of the electromechanical end effector. Rotation of a second screw of the housing moves the second hub to effect axial movement of the longitudinal knife bar.

Abstract: Devices and methods for creating a breathing passage and/or for maintaining a position of a septum. An exemplary device includes a base member, a first side member extending upward away from a first edge of the base member and being configured to contact a septum of a nasal cavity, and a second side member extending upward away from a second edge of the base member and being configured to contact a turbinate. The first and/or second side members are made of a flexible material. An exemplary method includes inserting a septum support into one side of a nasal cavity for creating a breathing passage, placing a first side member and a second side member of the septum support into contact with a septum and a turbinate, respectively. The first and second side members are biased away from one another such that pressure is applied to the septum.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting apparatus is configured to engage formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting apparatus is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting apparatus causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The slitting apparatus is supported by a distal end support device configured to lock onto the lead. While supported, a slitting element of the apparatus places fibers of the formed tissue under tension and performs a lifting cut operation. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: Medical devices and delivery systems for delivering medical devices to a target location within a subject. In some embodiments the medical devices can be locked in a fully deployed and locked configuration. In some embodiments the delivery systems are configured with a single actuator to control the movement of multiple components of the delivery system. In some embodiments the actuator controls the independent and dependent movement of multiple components of the delivery system.