Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices are used in procedures to removal spinal tissue and in other embodiments, similar devices are used to remove thrombus from blood vessel.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: Described herein are tissue manipulation devices having a tight bipole network. In particular, described herein are smart tools such as rongeurs configured to sense the presence of a nerve or portion of nerve. Tissue may be cut (or otherwise manipulated) by using a tool having a tight bipolar network to sense when a nerve or portion of a nerve is in the tool prior to cutting. Also described are systems for determining if a nerve is nearby an insertable tool. These systems typically include a tool with a neurostimulation electrode, an accelerometer configured to detect muscle twitch, and a feedback controller to provide feedback indicating if the tool is near a nerve. Methods of controlling insertion of a tool using feedback from such a system are also described.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or a region of a device. In general, a device for determining if a nerve is nearby a device includes an elongate body having an outer surface with one or more bipole pairs arranged on the outer surface. Bipole pairs may also be referred to as tight bipoles. The bipole pairs may be arranged as a bipole network, and may include a cathode and an anode that are spaced relatively close together to form a limited broadcast field. In general, the broadcast filed is a controlled or “tight” broadcast field that extends from the bipole pair(s). Methods of using these devices and system are also described.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or a region of a device. In general, a device for determining if a nerve is nearby a device includes an elongate body having an outer surface with one or more bipole pairs arranged on the outer surface. Bipole pairs may also be referred to as tight bipoles. The bipole pairs may be arranged as a bipole network, and may include a cathode and an anode that are spaced relatively close together to form a limited broadcast field. In general, the broadcast filed is a controlled or “tight” broadcast field that extends from the bipole pair(s). Methods of using these devices and system are also described.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or a region of a device. In general, a device for determining if a nerve is nearby a device includes an elongate body having an outer surface with one or more bipole pairs arranged on the outer surface. Bipole pairs may also be referred to as tight bipoles. The bipole pairs may be arranged as a bipole network, and may include a cathode and an anode that are spaced relatively close together to form a limited broadcast field. In general, the broadcast filed is a controlled or “tight” broadcast field that extends from the bipole pair(s). Methods of using these devices and system are also described.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or a region of a device. In general, a device for determining if a nerve is nearby a device includes an elongate body having an outer surface with one or more bipole pairs arranged on the outer surface. Bipole pairs may also be referred to as tight bipoles. The bipole pairs may be arranged as a bipole network, and may include a cathode and an anode that are spaced relatively close together to form a limited broadcast field. In general, the broadcast filed is a controlled or “tight” broadcast field that extends from the bipole pair(s). Methods of using these devices and system are also described.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices are used in procedures to removal spinal tissue and in other embodiments, similar devices are used to remove thrombus from blood vessel.

Abstract: Described herein are tissue manipulation devices having a tight bipole network. In particular, described herein are smart tools such as rongeurs configured to sense the presence of a nerve or portion of nerve. Tissue may be cut (or otherwise manipulated) by using a tool having a tight bipolar network to sense when a nerve or portion of a nerve is in the tool prior to cutting. Also described are systems for determining if a nerve is nearby an insertable tool. These systems typically include a tool with a neurostimulation electrode, an accelerometer configured to detect muscle twitch, and a feedback controller to provide feedback indicating if the tool is near a nerve. Methods of controlling insertion of a tool using feedback from such a system are also described.

Abstract: A device for cleaning a lens of an endoscope inside a patient during a surgical procedure may include a cannula having a proximal end, a distal end and an opening, and an expandable member coupled with the cannula such that when fluid is introduced into the expandable member, it expands out of the opening in the cannula. A method for cleaning a lens of an endoscope inside a patient during a surgical procedure may involve: advancing a cannula into the patient; passing fluid into an expandable member coupled with the cannula to expand the expandable member, wherein some of the fluid passes through the expandable member to an outer surface of the expandable member; and contacting the endoscope lens with the outer surface of the expandable member, located inside the patient, to clean the lens.

Abstract: Described herein are devices, systems and methods for determining if a nerve is nearby a device or a region of a device. In general, a device for determining if a nerve is nearby a device includes an elongate body having an outer surface with one or more bipole pairs arranged on the outer surface. Bipole pairs may also be referred to as tight bipoles. The bipole pairs may be arranged as a bipole network, and may include a cathode and an anode that are spaced relatively close together to form a limited broadcast field. In general, the broadcast filed is a controlled or “tight” broadcast field that extends from the bipole pair(s). Methods of using these devices and system are also described.

Abstract: Described herein are devices and systems for accessing a spine and particularly the epidural region of the spine and methods of using these systems and devices to access the spine or regions of the spine. In particular, cannulas that may be anchored to the ligamentum flavum or the periosteum are described. Ligamentum flavum access tools are also described. These tools may be used with (or without) an anchoring cannula to penetrate the ligamentum flavum and provide access to the epidural space without risk of injury to other structures within the epidural space. The devices, methods and systems described herein are particularly useful in minimally invasive surgical (MIS) uses. The devices, methods and systems described herein may be used for performing spinal decompressions and other spinal procedures.

Abstract: Described herein are method, systems and devices for measuring the region adjacent to or around a nerve root, such as the space within an intervertebral foramen before, during and/or after a spinal decompression procedure. Measurement devices may be advanced by pulling on them using a guidewire passing through the intervertebral foramen and out of the subject. The measurement device may include sounds for determining one or more dimensions of the space around a nerve root within an intervertebral space, lateral recess or central canal. Various embodiments of sounds, including calibrated, inflatable, expandable, moldable, and tapered sounds (or combinations of these) are described.

Abstract: A device for cutting ligament and/or bone tissue in a lateral recess and/or an intervertebral foramen of a spine of a patient to treat spinal stenosis may include: an elongate shaft having a rigid proximal portion and a distal portion articulatable relative to the proximal portion; a handle coupled with the proximal portion of the shaft; a tissue cutter disposed on one side of the distal portion of the shaft; a first actuator coupling the handle with the tissue cutter for activating the tissue cutter to cut tissue; and a second actuator coupling the handle with the distal portion for articulating the distal portion relative to the proximal portion. In some embodiments, the distal portion of the shaft may be configured to pass at least partway into an intervertebral foramen of the patient's spine.

Abstract: A method of delivering nutrition and one or more pharmaceutical agents to a patient after obesity surgery to enhance the patient's nutritional intake and/or compliance with oral medication(s) may include: providing a food product in an amount suitable for fitting within a stomach of the patient after the obesity surgery, wherein the food product is formulated to include amounts of carbohydrate, fat, protein, vitamins, minerals and electrolytes to satisfy specific nutritional needs of the post-obesity-surgery patient; incorporating into the food product an effective amount of at least one pharmaceutical agent that modulates at least one of appetite, hyperlipidemia, hypertension, diabetes, sleep apnea, degenerative joint disease, or depression to produce a supplemented food product; and administering the supplemented food product to the patient after obesity surgery so as to enhance at least one of the patient's nutritional intake or compliance with oral medication.

Abstract: Eyewear comprises a microphone and a speaker. An eyewear neck strap couples the microphone and speaker to a wearer unit carried by the eyewear wearer. The wearer unit exchanges wireless signals with a base station. The base station is coupled to various devices such as surgical theater equipment, and/or to a telecommunication system, such as a telephone system. The eyewear enables the wearer to conduct hands-free communication such as telephone conversations and command and control operations, as well as to perform other hands-free tasks such as dictation. The wearer also receives data in audio form or as an image using a video display coupled with the eyewear.

Abstract: A surgical training apparatus and method are provided simulating a patient having background radiation emissions level and at least one concentrated source of radiation emissions. The apparatus includes a plurality of notches in a lower base portion for receiving test sources, and a cover for overlaying the lower base during the training procedures. Identification indicia is provided within each of the notches and on the cover to correlate the notch position with the closed cover surface. A radiation detection device is used to scan the surfaces in training surgeons for radiation identification and localization techniques.