Abstract: A suction instrument includes a grip portion and a cannula. The grip portion includes a suction port and defines a first lumen. The cannula extends distally from the grip portion. The cannula defines a second lumen in fluid communication with the first lumen of the grip portion. The cannula includes a proximal portion and a distal portion. The proximal portion of the cannula defines a first portion of the second lumen. The first portion of the second lumen has a first cross-sectional area. The distal portion terminates into an open distal end. The distal portion of the cannula defines a second portion of the second lumen. The second portion of the second lumen has a second cross-sectional area. The second cross-sectional area is smaller than the first cross-sectional area.

Abstract: An apparatus includes a body, a shaft assembly, and a visualization assembly. The body includes first and second actuators. The shaft assembly extends distally from the body and includes a rigid proximal portion and a steerable distal portion. The steerable distal portion is positioned distally relative to the rigid proximal portion. The first actuator is operable to drive the steerable distal portion to deflect laterally relative to a longitudinal axis defined by the rigid proximal portion. The steerable distal portion is configured to fit within a nasal cavity of a patient. The visualization assembly is disposed within the shaft assembly. The visualization assembly includes a camera. The second actuator is operable to drive longitudinal translation of the visualization assembly relative to the shaft assembly.

Abstract: A surgical instrument includes a sheath and an ablation catheter disposed within the sheath. The sheath is configured to be inserted into a cavity of a patient's head. The ablation catheter extends along a longitudinal axis and includes at least one expandable ablation member configured to selectively radially expand outwardly from a non-expanded state to an expanded state for selectively ablating tissue within the patient's head. The ablation catheter is selectively translatable relative to the sheath between a proximal retracted position and a distal extended position. In the retracted position, the at least one expandable ablation member is housed within the sheath to thereby prevent the at least one expandable ablation member from radially expanding outwardly. In the extended position, the at least one expandable ablation member is exposed from the sheath to thereby permit the at least one expandable ablation member to radially expand outwardly for contacting tissue.

Abstract: An apparatus includes a guide member, a handle assembly, a gripping assembly, and a grip adjustment assembly. The handle assembly extends proximally from the guide member. The handle assembly includes a first engagement feature. The gripping assembly includes a second engagement feature. The gripping assembly is configured to selectively transition between a locked configuration and a movable configuration. In the locked configuration, the first and second engagement features are configured to engage one another to prevent relative movement of the gripping assembly relative to the handle assembly. The grip adjustment assembly includes a cam feature disposed on at least one of the handle assembly or the gripping assembly. In the movable configuration, the cam feature of the grip adjustment assembly is configured to flex the second engagement feature away from the first engagement feature allowing the gripping assembly to move relative to the handle assembly.

Abstract: An apparatus includes a body, a first shaft, an actuation assembly, and a dilation catheter. The first shaft includes a malleable distal portion. The actuation assembly includes a second shaft and an actuator. The second shaft is coaxially positioned about the first shaft. The actuator is operable to selectively bend the malleable distal portion of the first shaft. The dilation catheter is coaxially interposed between the first shaft and the second shaft. The dilation catheter includes an expandable dilator. The dilation catheter is operable to translate along the malleable distal portion of the first shaft.

Abstract: An ablation instrument includes a shaft that extends from a grip portion. A curved portion of the shaft is shaped to allow insertion into the head of a patient, and to position an ablation tip that extends from a distal tip of the shaft proximate to an ablation target, such as the posterior nasal nerve. When activated the ablation tip projects radiofrequency energy to ablate nearby tissue. An ablation assistance features of an image guided surgery navigation system is configured to segment and identify ablation targets within a set of pre-operative images. When a position tracked ablation instrument is configured for use, the system begins to monitor the proximity of the ablation tip to the ablation targets. When the tip is within an effective distance of the target for ablation, the system provides an alert and activates the instrument so that RF energy may be projected.

Abstract: An apparatus includes a shaft, an expandable dilation member, and a bulbous tip. The shaft has a first outer cross-sectional dimension. The dilation member is positioned proximal to the distal end of the shaft. The dilation member is operable to transition between a non-expanded configuration and an expanded configuration. The dilation member is sized to pass through a passageway associated with drainage of a paranasal sinus or a Eustachian tube when the dilation member is in the non-expanded configuration. The bulbous tip is positioned at the distal end of the shaft. The bulbous tip is distal to the dilation member. The bulbous tip has a second outer cross-sectional dimension. The second outer cross-sectional dimension is larger than the first outer cross-sectional dimension. The bulbous tip is removably secured to the distal end of the shaft.

Abstract: An apparatus includes a shaft assembly and an electrode assembly at a distal end of the shaft assembly. The electrode assembly includes a first conductive segment extending along a first angular range at the distal end of the shaft assembly. The first conductive segment is operable to apply RF energy to tissue at a first polarity. The electrode assembly further includes a second conductive segment angularly spaced apart from the first conductive segment. The second conductive segment extends along a second angular range at the distal end of the shaft assembly. The second conductive segment is operable to apply RF energy to tissue at a second polarity such that the first and second conductive segments are operable to apply bipolar RF energy to tissue.

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: An apparatus includes a shaft, a balloon, a tip member, and a heating feature. The tip member is distal to the balloon and has a larger outer diameter than the shaft. The heating feature is operable to ablate tissue of the Eustachian tube contacting the balloon in the expanded state. The heating feature may include an illuminating element and a photosensitive coating on the balloon. Alternatively, the heating feature may include a thermal heating element that heats the balloon inflation fluid and thereby heats the wall of the balloon. Another apparatus includes a shaft, a tip member, and an electrode assembly. The electrode assembly includes a plurality of electrodes positioned along the shaft near the distal end, proximal to the tip member. The electrodes are spaced apart from each other along a longitudinal axis and are operable to apply RF energy to tissue to thereby ablate the tissue.

Abstract: A virtual endoscopic view shows a surgical area and surrounding anatomy and may also show a position of a surgical instrument in use during a surgical procedure, allowing a surgeon to virtually view the surgical area when direct viewing or actual endoscopic views are incomplete, obstructed, or otherwise unavailable or undesirable. In order to render the endoscopic view, an IGS navigation system may be configured with an observer point and an observer orientation within 3-D space based upon user inputs. A user interface for defining these points allows a user to view a virtual endoscopic preview in real-time while providing inputs, thus improving the likelihood that the resulting virtual endoscopic view is as desired by the user; and reducing time spent redefining and reconfiguring the virtual endoscopic view. The virtual endoscopic preview may provide combinations of static and dynamic images to illustrate the spatial relationship of the provided inputs.

Abstract: An apparatus includes a body, a shaft assembly, and a shaft actuation assembly. The shaft assembly extends distally from the body and defines a longitudinal axis. A portion of the shaft assembly is configured to be inserted into an anatomical passageway associated with an ear, nose, or throat of a patient. The shaft assembly further defines a working passageway that is dimensioned to receive an instrument. An actuator of the body is operable to drive the instrument longitudinally relative to the shaft assembly. The shaft actuation assembly is operatively coupled with a proximal portion of the shaft assembly. Further, the shaft actuation assembly is translatable in a distal direction to extend the shaft assembly distally along the longitudinal axis and is translatable in a proximal direction to retract the shaft assembly proximally along the longitudinal axis.

Abstract: An apparatus includes a body, a shaft assembly, and a deflection actuation assembly. The shaft defines a longitudinal axis and includes a flexible distal portion. The deflection actuation assembly includes a first rotary actuator, a translatable actuation member, and a resilient member. The translatable actuation member extends through the shaft assembly and is operatively coupled with the first rotary actuator and the flexible distal portion of the shaft assembly. The first rotary actuator is rotatable by a rotational force to thereby drive the translatable actuation member longitudinally. The resilient member is positioned between the first rotary actuator and the body and is configured to apply a friction force between the first rotary actuator and the body. The friction force is operable to increase the rotational force required to rotate the first rotary actuator.

Abstract: A surgical navigation system includes an endoscope having a body, a shaft having a distal shaft end, an optical conduit, and a moveable optical element. The moveable optical element is configured to provide a field of view defining a line of sight, and is operable to capture an image within the field of view. The system further includes a drive mechanism operable to move the movable optical element to adjust a direction of the line of sight, a navigation sensor operable to generate a signal corresponding to a location of the distal shaft end within a patient, and a processor. The processor is operable to determine a location of the distal shaft end within the patient based on the signal, and command the drive mechanism to position the movable optical element so the line of sight is directed toward a selected point of interest within the patient.

Abstract: A virtual camera may be positioned relative to a 3-D model of a patient anatomy in order to provide a virtual camera view of the surrounding anatomy and tracked surgical instruments being deployed to the anatomy. Visual context provided by the virtual camera may be limited in some cases, such as where a surgical instrument is being used within a very narrow anatomical passageway or cavity. To provide more placement flexibility, an IGS system providing a virtual camera receives inputs defining variable visual characteristics for different segments or regions of the 3-D model, which may include hiding certain segments or making certain segments semi-transparent. With such a system, the view of the 3-D model provided by the virtual camera view may be modified to remove or deemphasize less relevant segments, to display or emphasize more relevant segments (e.g., critical patient anatomy), or both.

Abstract: A guidewire includes a guidewire shaft and an inflatable element arranged at a distal end of the guidewire shaft. At least a portion of the guidewire shaft is formed of metal, and the guidewire shaft includes a lumen that fluidly communicates with an interior of the inflatable element. The inflatable element is operable to transition between a deflated state in which the inflatable element is configured to pass through an isthmus of a Eustachian tube (ET), and an inflated state in which the inflatable element is configured to dilate the ET.

Abstract: Physicians performing invasive procedures utilize instruments inserted into a human body to perform the procedures. Such procedures typically involve actions to be performed on specific targeted anatomical structures. During the procedure, nearby anatomical structures unrelated to the procedure should generally be avoided. A system and techniques are provided herein for monitoring the position of such unrelated nearby anatomical structures relative to one or more surgical instruments. The system emits a warning to a human operator such as a surgeon if one of the instruments is too close to a monitored anatomical structure.

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: 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.