Abstract: A robotic catheter system includes a controller including a master input device and instrument driver in communication with the controller. An elongate flexible guide instrument is operatively coupled to the instrument driver. A fluid injection needle may be advanced from, or retracted into, a distal portion of the guide instrument.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: Described herein are methods for achieving access to a compressed space in spinal anatomy. In some embodiments, a method for achieving access may include the steps of advancing a distal portion of a cannulated probe toward a neural foramen from a lateral side of the foramen, extending a first end of a elongate member from a distal end of the cannulated probe and through the neural foramen from the lateral side to a medial side of the foramen and at least partially around an anterior portion of a facet joint and posterior to a spinal disc, and extending the first end of the elongate member out of the patient, wherein a portion of the elongate member remains curved around the facet joint. In some embodiments, the method may further include the step of extending a first end of an inner cannula from a distal end of the cannulated probe.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures. The current invention includes specific tools that enable safe tissue modification in epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired.

Abstract: Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.

Abstract: A robotic catheter system includes a controller including a master input device and instrument driver in communication with the controller. An elongate flexible guide instrument is operatively coupled to the instrument driver. A fluid injection needle may be advanced from, or retracted into, a distal portion of the guide instrument.

Abstract: Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.

Abstract: A robotic catheter system includes a controller including a master input device and instrument driver in communication with the controller. An elongate flexible guide instrument is operatively coupled to the instrument driver. A fluid injection needle may be advanced from, or retracted into, a distal portion of the guide instrument.

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 retractor and a surgical tool are positioned at the distal end of the cannula. A dissection cradle is located at the distal end of a distal portion of the retractor that is resiliently skewed relative to the cannula axis, and includes two substantially parallel, spaced legs with the retractor shaped in a loop therebetween. The procedure includes locating a vessel and side branch of interest and extending the retractor to retain the vessel in the dissection cradle to urge the vessel away from the axis of the cannula in order to isolate a side branch for exposure to the surgical tool.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that comprises a profile having a width that is substantially greater than a height.

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: The present invention relates to a minimally invasive method of performing annuloplasty. According to one aspect of the present invention, a method for performing annuloplasty includes accessing a left ventricle of a heart to provide a discrete plication element to the left ventricle, and engaging the plication element to tissue near a mitral valve of the heart. Engaging the plication element includes causing the plication element to gather a portion of the tissue to create a plication. In one embodiment, accessing the left ventricle of the heart to provide the plication element includes accessing the left ventricle of the heart using a catheter arrangement.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Abstract: The present disclosure is directed generally to systems and methods for relieving dyspnea. A method in accordance with a particular embodiment includes receiving an input signal from a patient sensor, the input signal corresponding to an indication of the patient's breathing. The method can further include, based at least in part on the input signal, at least reducing the patient's sensation of dyspnea by delivering electrical stimulation to at least one electrode, the at least one electrode being positioned in signal communication with at least one of the patient's inspiratory muscles, expiratory muscles, afferent neural pathways of the inspiratory muscles, and afferent neural pathways of the expiratory muscles.

Abstract: Systems and methods for treating a patient with dyspnea are disclosed. A method in accordance with a particular embodiment includes identifying the patient as suffering from dyspnea, and, based at least in part on identifying the patient as suffering from dyspnea, implanting an electrical signal delivery element within the patient in signal communication with an afferent neural pathway of a carotid body chemoreceptor. The method can further include at least reducing dyspneic sensations in the patient by directing an electrical signal from the electrical signal delivery element to the neural pathway to at least partially block afferent signals from the chemoreceptor.

Abstract: A first tissue region can be ablated after pre-cooling a nearby second tissue region to inhibit damage to the second tissue associated with the ablation of the first tissue.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.