Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: A surgical instrument and related method includes an instrument body, a guide shaft distally projecting from the instrument body, and a first surgical tool. The guide shaft has a guide sidewall, a guide lumen, and a clearance opening radially extending through the guide sidewall in communication with the guide lumen. The first surgical tool has an elongate body and a distal head configured to deflect relative to the elongate body from a first position to a second position. The distal head in the first position is positioned within the guide lumen along the central axis. The distal head in the second position is deflected from the central axis and extends at least partially through the clearance opening thereby vacating at least a portion of the guide lumen for introducing a second surgical tool through the guide lumen.

Abstract: An apparatus includes a shaft assembly, an end effector, and a sensor. The shaft assembly defines a longitudinal axis. The end effector is positioned at a distal end of the shaft assembly. A portion of the end effector is offset from the longitudinal axis. The sensor is configured to generate a signal in response to a magnetic field. The signal is configured to indicate a position of the end effector within three-dimensional space. The sensor is coaxially positioned about the longitudinal axis.

Abstract: An apparatus includes a handle assembly, a guide tube, and a dilation catheter. The guide tube extends distally from the handle assembly. At least a distal portion of the guide tube is malleable. The dilation catheter is slidably positioned in the guide tube. The dilation catheter includes a distal end, a dilator, and a position sensor. The position sensor is configured to generate a signal indicating a position of the position sensor in three-dimensional space. The dilation catheter is configured to translate relative to the guide tube.

Abstract: A method of treating a patulous Eustachian tube includes forming a first pocket in a wall of a nasopharynx region proximate to a pharyngeal ostium, inserting a resiliently biased implant within the first pocket, and allowing the resiliently biased implant to expand within the first pocket to thereby urge the Eustachian tube towards a closed state. The wire implant may include a resilient stent or other resilient wire structure. In some versions, a deployment device having a balloon is used to deploy a malleable implant. This deployment device has a malleable implant disposed around the balloon, which is disposed around a guide catheter. The balloon is inflated and expands the malleable implant. The malleable implant retains the expanded shape and urges the Eustachian tube toward a closed state.

Abstract: Variations of integral navigation controls may be used in conjunction with a medical instrument to provide navigation functions for an image guided surgery (IGS) system that is in communication with the integral navigation controls. In some variations, a medical instrument with integrated navigation wheels allows movement of a cursor of the IGS system along the x and y axis by scrolling the wheel, or allows selection, zooming, or other controls by combined clicking and/or scrolling of wheels, and may be sterilized or discarded along with the device. In some other variations, a control overlay may be temporarily attached to the medical instrument to provide additional controls, such as buttons or a pointing stick, and then removed and sterilized or discarded after a procedure. In each variation, inputs may be communicated via wire or wirelessly to an IGS system to provide navigation of images during a surgical procedure.

Abstract: A surgical instrument for cutting a first tissue and detecting a second tissue includes a shaft, a cutting member, and a tissue monitor system. The shaft extends along a longitudinal axis and includes a shaft lumen and a shaft opening. The cutting member is disposed within the shaft lumen and configured to cyclically move from a first position to a second position relative to the shaft. The cutting member is further configured to cut a tissue portion of the first tissue for removal therefrom. The tissue monitor system is associated with at least one of the shaft or the cutting member configured to detect the second tissue distinct from the first tissue for selectively cutting and removing the first tissue relative to the second tissue.

Abstract: A method is used to manufacture a surgical instrument including a first tube, and a second tube. The first tube extends from a proximal first end portion to a distal first end portion. The second tube extends from a proximal second end portion to a distal second end portion. The second tube is positioned coaxially within the first tube with the distal second end portion positioned adjacent to the distal first end portion. The second tube defines a lumen. The sensor is secured proximal to the distal second end portion of the second tube. A die is engaged against a distal first end portion of the first tube while first tube rotates about its own longitudinal axis; and the die is simultaneously moved relative to the distal first end portion of the first tube along a predetermined path to form a predetermined shape.

Abstract: A surgical instrument and related method includes an instrument body, a guide shaft distally projecting from the instrument body, and a first surgical tool. The guide shaft has a guide sidewall, a guide lumen, and a clearance opening radially extending through the guide sidewall in communication with the guide lumen. The first surgical tool has an elongate body and a distal head configured to deflect relative to the elongate body from a first position to a second position. The distal head in the first position is positioned within the guide lumen along the central axis. The distal head in the second position is deflected from the central axis and extends at least partially through the clearance opening thereby vacating at least a portion of the guide lumen for introducing a second surgical tool through the guide lumen.

Abstract: A surgical instrument includes an elongate shaft having a proximal shaft portion and a malleable distal shaft portion. The elongate shaft is configured to be secured to a supporting surgical instrument. An ablation head is coupled to the malleable distal shaft portion and includes at least one electrode operable to deliver RF energy to tissue for ablating the tissue. The ablation head is sized to fit within the nasal cavity of a patient with a distal end of the supporting surgical instrument. The proximal shaft portion is configured to operatively couple with an RF energy source operable to energize the at least one electrode with RF energy. The malleable distal shaft portion is configured to bend relative to a longitudinal shaft axis defined by the proximal shaft portion for selectively orienting the ablation head relative to the longitudinal shaft axis.

Abstract: An apparatus includes a handle assembly, a guide tube, and a dilation catheter. The guide tube extends distally from the handle assembly. At least a distal portion of the guide tube is malleable. The dilation catheter is slidably positioned in the guide tube. The dilation catheter includes a distal end, a dilator, and a position sensor. The position sensor is configured to generate a signal indicating a position of the position sensor in three-dimensional space. The dilation catheter is configured to translate relative to the guide tube.

Abstract: An apparatus includes a shaft assembly, an end effector, and a sensor. The shaft assembly defines a longitudinal axis. The end effector is positioned at a distal end of the shaft assembly. A portion of the end effector is offset from the longitudinal axis. The sensor is configured to generate a signal in response to a magnetic field. The signal is configured to indicate a position of the end effector within three-dimensional space. The sensor is coaxially positioned about the longitudinal axis.

Abstract: A method of treating a patulous Eustachian tube includes forming a first pocket in a wall of a nasopharynx region proximate to a pharyngeal ostium, inserting a resiliently biased implant within the first pocket, and allowing the resiliently biased implant to expand within the first pocket to thereby urge the Eustachian tube towards a closed state. The wire implant may include a resilient stent or other resilient wire structure. In some versions, a deployment device having a balloon is used to deploy a malleable implant. This deployment device has a malleable implant disposed around the balloon, which is disposed around a guide catheter. The balloon is inflated and expands the malleable implant. The malleable implant retains the expanded shape and urges the Eustachian tube toward a closed state.

Abstract: An endoscope assembly includes a shaft assembly, an endoscopic camera assembly, and an anatomy elevation assembly. The shaft assembly includes a flexible outer shaft defining a lumen, a first electrical communication line, and a first fluid communication line. The endoscopic camera assembly is in communication with the first electrical communication line. The anatomy elevation assembly includes an inflatable member coupled to the flexible outer shaft. The inflatable member includes an interior surface. The first fluid communication line is in fluid communication with the inflatable member. The inflatable member is configured to transition between a deflated configuration and an inflated configuration. The interior surface is configured to define a viewing path distal to the endoscopic camera assembly while the inflatable member is in the inflated configuration.

Abstract: A method is used to manufacture a surgical instrument including a first tube, and a second tube. The first tube extends from a proximal first end portion to a distal first end portion. The second tube extends from a proximal second end portion to a distal second end portion. The second tube is positioned coaxially within the first tube with the distal second end portion positioned adjacent to the distal first end portion. The second tube defines a lumen. The sensor is secured proximal to the distal second end portion of the second tube. A die is engaged against a distal first end portion of the first tube while first tube rotates about its own longitudinal axis; and the die is simultaneously moved relative to the distal first end portion of the first tube along a predetermined path to form a predetermined shape.

Abstract: A surgical instrument for cutting a first tissue and detecting a second tissue includes a shaft, a cutting member, and a tissue monitor system. The shaft extends along a longitudinal axis and includes a shaft lumen and a shaft opening. The cutting member is disposed within the shaft lumen and configured to cyclically move from a first position to a second position relative to the shaft. The cutting member is further configured to cut a tissue portion of the first tissue for removal therefrom. The tissue monitor system is associated with at least one of the shaft or the cutting member configured to detect the second tissue distinct from the first tissue for selectively cutting and removing the first tissue relative to the second tissue.

Abstract: A system (11) includes a medical probe (36) for insertion into a cavity of an organ, which includes a position and direction sensor (60) and a camera (45), both operating in a sensor coordinate system (62). The system further includes a processor (44) configured to: receive, from an imaging system (21) operating in an image coordinate system (28), a three-dimensional image of the cavity including open space and tissue; receive, from the medical probe, signals indicating positions and respective directions of the medical probe inside the cavity; receive, from the camera, respective visualized locations inside the cavity; register the image coordinate system with the sensor coordinate system so as to identify one or more voxels in the image at the visualized locations, and when the identified voxels have density values in the received image that do not correspond to the open space, to update the density values of the identified voxels to correspond to the open space.

Abstract: A surgical instrument includes an elongate shaft having a proximal shaft portion and a malleable distal shaft portion. The elongate shaft is configured to be secured to a supporting surgical instrument. An ablation head is coupled to the malleable distal shaft portion and includes at least one electrode operable to deliver RF energy to tissue for ablating the tissue. The ablation head is sized to fit within the nasal cavity of a patient with a distal end of the supporting surgical instrument. The proximal shaft portion is configured to operatively couple with an RF energy source operable to energize the at least one electrode with RF energy. The malleable distal shaft portion is configured to bend relative to a longitudinal shaft axis defined by the proximal shaft portion for selectively orienting the ablation head relative to the longitudinal shaft axis.

Abstract: A system to dilate a stenotic region of an airway of a patient includes a stylet and a dilation catheter. The dilation catheter includes a catheter shaft and an inflatable balloon. The catheter shaft defines a shaft lumen and is configured to receive at least a portion of the stylet. The shaft lumen is axially aligned with a first longitudinal axis. The inflatable balloon is in fluid communication with an inflation lumen. The inflatable balloon is configured to transition between non-expanded and expanded configurations using the inflation lumen. The inflatable balloon has an outer perimeter configured to contact the stenotic region of the airway when in the expanded configuration. The inflatable balloon includes a pass-through lumen that is axially aligned with a second longitudinal axis that is laterally offset a distance from the first longitudinal axis. The pass-through lumen is disposed completely within the outer perimeter of the inflatable balloon.

Abstract: An apparatus includes a cylindraceous sleeve body, a navigation sensor, and an interface feature. The cylindraceous sleeve body includes an open proximal end, an open distal end, and a lumen extending from the open proximal end to the open distal end. The lumen is sized and configured to receive a shaft of a medical instrument. The navigation sensor is positioned at the open distal end of the cylindraceous sleeve body. The interface feature is configured to couple the navigation sensor with an image guidance system. The navigation sensor is configured to cooperate with an image guidance system to provide feedback indicating a position of the navigation sensor in three-dimensional space.