Abstract: A method for modifying a geometry of a collagenous tissue mass includes heating the collagenous tissue mass to a temperature sufficient to cause denaturation, and introducing a biocompatible fixative, such as genepin, into the collagenous tissue mass.

Abstract: A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Abstract: A system and method for recording and depicting ultrasound images of a moving object are disclosed. In a preferred embodiment, ultrasound images are acquired as the field of view of an ultrasound probe is advanced across the tissues of interest during a resting period between periods of relatively large-scale heart cycle motion. A series of images acquired during a particular resting period may be represented as a three-dimensional volume image, and the comparison of volume images from adjacent cardiac resting periods enables three-dimensional volume image modulation analysis which may be presented for a user as a moving volume image of the objects of interest within the field of view.

Abstract: A robotic surgical tool includes an elongate shaft having a working end and a shaft axis, and a pair of linking arms each having a proximal end and a distal end. The proximal end is pivotally mounted on the working end of the shaft to rotate around a first pitch axis to produce rotation in first pitch. A wrist member has a proximal portion pivotally connected to the distal end of the linking arm to rotate around a second pitch axis to produce rotation in second pitch. An end effector is pivotally mounted on a distal portion of the wrist member to rotate around a wrist axis of the wrist member to produce rotation in distal roll. The wrist axis extends between the proximal portion and the distal portion of the wrist member. The elongate shaft is rotatable around the shaft axis to produce rotation in proximal roll. At about 90° pitch, the wrist axis is generally perpendicular to the shaft axis. The proximal roll around the shaft axis and the distal roll around the wrist axis do not overlap.

Abstract: A methods using a robotic catheter system to perform a procedure on a patient includes generating a control signal corresponding to movement of a master input device, and moving a plurality of drive elements of an instrument driver in response to the control signal, the drive elements operatively coupled to a corresponding plurality of control elements of an elongate guide instrument, the control elements secured to a distal end of the guide instrument and moveable axially relative to the guide instrument such that movement of the drive elements causes a corresponding movement of the guide instrument distal end.

Abstract: An apparatus for sealing a passage through tissue includes a bioabsorbable, threaded plug carried by a delivery device. A guide wire is receivable through lumens in the plug and delivery device that includes wings on a bioabsorbable distal portion. With the wings collapsed, the guide wire is advanced through the passage into a blood vessel, the wings expanding once located within the vessel, and the guide wire is withdrawn until the wings contact the vessel wall. The plug is threaded into the passage over the guide wire until the plug is disposed adjacent the wings. The distal portion of the guide wire is secured to the plug, e.g., by compressing a collet within the plug lumen that seals the lumen, and is severed from a proximal portion thereof. Thus, the plug and distal portion are deployed with the plug sealing the passage.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. A positively positionable multi-disk wrist mechanism includes a plurality of disks or vertebrae stacked in series. Each vertebra is configured to rotate in pitch or in yaw with respect to each neighboring vertebra. Actuation cables are used to manipulate and control movement of the vertebrae. In specific embodiments, some of the cables are distal cables that extend from a proximal vertebra through one or more intermediate vertebrae to a distal vertebra, while the remaining cables are medial cables that extend from the proximal vertebra to one or more of the intermediate vertebrae. The cables are actuated by a pivoted plate cable actuator mechanism.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: An apparatus for sealing a passage through tissue includes a bioabsorbable, threaded plug carried by a delivery device. A guide wire is receivable through lumens in the plug and delivery device that includes wings on a bioabsorbable distal portion. With the wings collapsed, the guide wire is advanced through the passage into a blood vessel, the wings expanding once located within the vessel, and the guide wire is withdrawn until the wings contact the vessel wall. The plug is threaded into the passage over the guide wire until the plug is disposed adjacent the wings. The distal portion of the guide wire is secured to the plug, e.g., by compressing a collet within the plug lumen that seals the lumen, and is severed from a proximal portion thereof. Thus, the plug and distal portion are deployed with the plug sealing the passage.

Abstract: An apparatus for tissue dissection and instrument anchoring and methods for using such apparatus are disclosed. The apparatus includes a cannula, a dissection balloon releasably attached to the cannula at the distal end, an anchoring balloon disposed on the cannula, and a means for inflating both balloons.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. A positively positionable multi-disk wrist mechanism includes a plurality of disks or vertebrae stacked in series. Each vertebra is configured to rotate in pitch or in yaw with respect to each neighboring vertebra. Actuation cables are used to manipulate and control movement of the vertebrae. In specific embodiments, some of the cables are distal cables that extend from a proximal vertebra through one or more intermediate vertebrae to a distal vertebra, while the remaining cables are medial cables that extend from the proximal vertebra to one or more of the intermediate vertebrae. The cables are actuated by a pivoted plate cable actuator mechanism.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: A system and method for recording and depicting ultrasound images of a moving object are disclosed. In a preferred embodiment, ultrasound images are acquired as the field of view of an ultrasound probe is advanced across the tissues of interest during a resting period between periods of relatively large-scale heart cycle motion. A series of images acquired during a particular resting period may be represented as a three-dimensional volume image, and the comparison of volume images from adjacent cardiac resting periods enables three-dimensional volume image modulation analysis which may be presented for a user as a moving volume image of the objects of interest within the field of view.

Abstract: The present invention provides a robotic surgical tool for use in a robotic surgical system to perform a surgical operation. The robotic surgical tool includes a wrist mechanism disposed near the distal end of a shaft which connects with an end effector. The wrist mechanism includes a distal member configured to support the end effector, and a plurality of rods extending generally along an axial direction within the shaft and movable generally along this axial direction to adjust the orientation of the distal member with respect to the shaft. Advancement or retraction of a first rod generally along the axial direction tips the base through a first angle. The addition of a second angle allows the distal member to direct the end effector in essentially a compound angle. The robotic surgical tool may also include provisions for roll movement.

Abstract: A system and method for recording and depicting ultrasound images of a moving object are disclosed. In a preferred embodiment, ultrasound images are acquired as the field of view of an ultrasound probe is advanced across the tissues of interest during a resting period between periods of relatively large-scale heart cycle motion. A series of images acquired during a particular resting period may be represented as a three-dimensional volume image, and the comparison of volume images from adjacent cardiac resting periods enables three-dimensional volume image modulation analysis which may be presented for a user as a moving volume image of the objects of interest within the field of view.

Abstract: Assemblies, systems, and methods related to remotely-steerable ablation procedures are described. A necked-down ablation catheter may be coupled within a working lumen of a robotically-steerable sheath configured to be driveably coupled to an electromechanical instrument driver. The ablation catheter may be an irrigated ablation catheter having an irrigation fluid reservoir at its distal tip. The outer diameter of the distal portion of the ablation catheter is generally larger than that of the more proximal aspects due, in part, to the fact that the proximal aspects are designed to fit through a relatively low-profile steerable sheath.

Abstract: Assemblies, systems, and methods related to in-situ graft fenestration are described. Subsequent to placement of a graft or stent graft into a lumen, such as a blood vessel, a steerable catheter platform is utilized to create fenestrations, or holes, into the material comprising the graft to facilitate flow of fluids, such as blood, out of the holes and into other structures, such as side branch vessels. The catheter platform preferably comprises one or more fenestration elements located distally and configured to controllably create the fenestrations through common graft materials, such as Dacron®. The catheter also may be utilized to size and/or locate side branching structures, confirm fenestration sizes and/or locations, and deploy additional grafts through the fenestrations into other branching structures.

Abstract: An apparatus for tissue dissection and instrument anchoring and methods for using such apparatus are disclosed. The apparatus includes a cannula, a dissection balloon releasably attached to the cannula at the distal end, an anchoring balloon disposed on the cannula, and a means for inflating both balloons.

Abstract: A flexible spine for use in one or more surgical instruments including a catheter and/or sheath of a robotic instrument system. The spine includes an elongate body that defines a central lumen and that is a unitary structure having a plurality of discrete sections, each of which has a distinguishing structural attribute that differentiates it from the other sections. Such distinguishing structural attributes may include, without limitation, materials, material attributes, shapes, sizes and/or attributes related to apertures in a wall of the elongate body, such as a number, shape, size, spacing and degree of overlap of such apertures. The arrangement of discrete, structurally different sections results in varying flexibility of the elongate spine and of corresponding sections of a surgical instrument incorporating the spine.

Abstract: An instrument driver operable to control catheter instruments. First and second carriages are movably coupled to a frame of an instrument driver. Each carriage is configured to support a catheter instrument. The first and second carriages are independently rotatable about a longitudinal axis of the respective first and second catheter instruments and rotatable independently of an instrument driver frame. Independent carriage control provides for the carriages being independently movable in at least three different directions with at least two different types of motion.