Abstract: A system for performing multi-tool minimally invasive medical procedures through a single instrument port into a body cavity includes a rigid tube carried by a mount. Cannulas having instrument channels and steerable distal ends extend distally from the rigid tube. During a procedure using the system, the mount is supported by an operating room fixture, and instruments are advanced through the steerable instrument channels. Manipulation of the instrument handles engages actuators positioned on the mount, which steer the distal ends of the cannulas through the action of pull cables. The distal ends of the instruments may thus be steered within the body by the distal ends of the steerable cannulas.

Abstract: A multi-instrument access device includes a base positionable within a percutaneous opening formed in a body. Ports are positioned on the base for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having steerable distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: Methods and systems are disclosed for stimulating contents of the carotid sheath using an intravascular pulse generator and lead. The lead carries an energy delivery device such as an electrode, which is anchor within the portion of the internal jugular vein that is disposed within the carotid sheath. The energy delivery device is energized to transvenously direct energy to target contents of the carotid sheath external to the internal jugular vein. Such target contents may include nervous system elements associated with the carotid sinus baroreceptors, the carotid sinus nerve and associated nerve branches, and or the vagus nerve and associated nerve branches. The system may be used to control blood pressure and/or to lower heart rate and may be suitable for treatment of hypertension, heart failure, or other conditions.

Abstract: A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: The present application describes an intravascular implantable pacing and/or defibrillation system. The described system includes a pulse generator that is implantable within a blood vessel and proportioned to blood flow through the blood vessel, and at least one electrode attachable to the pulse generator. During implantation, the pulse generator is introduced into a patient's vasculature, advanced to a desired vessel and anchored in place within the vessel. The electrode or electrodes are placed within the heart or surrounding vessels as needed to deliver electrical pulses to the appropriate location.

Abstract: A system for performing minimally invasive medical procedures includes an elongate support advanceable into a body cavity. The elongate support supports a frame that carries a pair of tool cannulas, each of which has a lumen for receiving a tool useable to perform a procedure in the body cavity. The frame is expandable using pivotable frame members to orient the tool cannulas such that they allow the tools to be used in concert to carry out a procedure at a common location in the body cavity.

Abstract: A medical implant system comprises an implant proportioned for implantation within a blood vessel, a lead coupled to the implant, and an anchor coupled to the lead, the anchor configurable in a radially compressed position so as to be positioned in the blood vessel, and a radially expanded position for engagement with the wall of blood vessel. The anchor functions as an antenna for telemetric communication with an extracorporeal device and/or as a receiver for inductive recharging of secondary cells in the implant using an extracorporeal charging device.

Abstract: An intravascular lead is used to deliver energy for stimulating nervous system targets using energy delivery elements (e.g. electrodes) that are in direct contact with the nervous system targets. The lead may be positioned within the internal jugular vein and the nervous system targets may include the carotid artery/carotid sinus bulb and/or associated baroreceptor afferents, and/or surrounding nervous system targets in the region of the internal jugular vein, such as the carotid sinus nerve and/or associated nerve branches and/or the vagus nerve and/or associated nerve branches. Stimulation energy travels along a conductive bridge that extends from the intravascular lead to the nervous system target, or is relayed from the intravascular lead to another device disposed within or surrounding the target structure.

Abstract: An energy harvesting device positionable within a blood vessel for use in generating energy for powering all or a portion of the functions of a diagnostic or therapeutic medical implant. The energy harvesting device includes piezoelectric elements arranged to generate a voltage in response to mechanical blood vessel activity such as bending, expansion or contraction of the blood vessel, or flow of blood through the blood vessel. The electrical energy generated by the piezoelectric elements may be used to recharge a battery, stored in a capacitor, and/or used in real time to generate the energy used for operation of the implant.

Abstract: Methods and systems are disclosed for stimulating contents of the carotid sheath using an intravascular pulse generator and lead. The lead carries an energy delivery device such as an electrode, which is anchor within the portion of the internal jugular vein that is disposed within the carotid sheath. The energy delivery device is energized to transvenously direct energy to target contents of the carotid sheath external to the internal jugular vein. Such target contents may include nervous system elements associated with the carotid sinus baroreceptors, the carotid sinus nerve and associated nerve branches, and or the vagus nerve and associated nerve branches. The system may be used to control blood pressure and/or to lower heart rate and may be suitable for treatment of hypertension, heart failure, or other conditions.

Abstract: A multi-instrument access device includes a base positionable within an opening (e.g. an incision or puncture) formed in a body wall and a dome-shaped seal on the base and positioned such that it is disposed outside the body wall during use. A plurality of instrument ports extend proximally from the seal for receiving instruments to be inserted into the body for use in a procedure. Tubular instrument tubes having pre-curved distal ends may be insertable through the ports for receiving the instruments and for orienting the operative ends of the instruments toward a target site.

Abstract: A system for minimally invasive medical procedures includes an elongate tubular access cannula comprising an elongate tubular member having a rigid proximal portion and an articulating portion. The tubular member has a first branch and a tubular bifurcation extending from the first branch, allowing simultaneous use of multiple instruments. A dissector suitable for use with the access cannula, or other access devices, for implantation of gastric bands or for other procedures includes a pre-curved distal portion having a dissection element such as a monopolar RF conductor and/or a dissection balloon, as well as a snare. In one method, the dissector is advanced around the posterior side of the stomach to form a tunnel in the connective tissue, and the snare is then extended from the dissector to engage a portion of the band and withdraw it through the tunnel.

Abstract: The present application describes an intravascular implantable pacing and/or defibrillation system. The described system includes a pulse generator that is implantable within a blood vessel and proportioned to blood flow through the blood vessel, and at least one electrode attachable to the pulse generator. During implantation, the pulse generator is introduced into a patient's vasculature, advanced to a desired vessel and anchored in place within the vessel. The electrode or electrodes are placed within the heart or surrounding vessels as needed to deliver electrical pulses to the appropriate location.

Abstract: An intestinal implant includes a proximal anchor self-expandable from a radially compressed position to a radially expandable position for engagement with a wall of the intestinal lumen and a flexible sleeve coupled to the anchor. The sleeve is implanted with the anchor downstream from the pylorus and the sleeve extending further downstream through the intestinal lumen.

Abstract: An artificial intervertebral disc and disc nucleus are described herein having chambers and dampening members. The dampening members may be within or outside of the main body of the device. The chambers may be filled with a suitable liquid, gas, or both, and separated by valves to regulate flow of fluid between chambers, within a dampening member, between the main body and dampening member, or all of the above. Chambers may be filled with responsive hydrogels, EPAM, or other suitable materials, and the device may have activation plates or members, a strain gauge, a pressure sensor, or other means for detecting changes in the materials and/or triggering desired changes in the materials in order to mimic the behavior of a healthy native disc or disc nucleus. A control system may be in communication with the device for receiving feedback and delivering stimuli to initiate desired changes in the fluids or other materials.