Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A bone plate system for the internal fixation of a fractured bone of a patient has a bone plate with one or more threaded bone fastener apertures and one or more non-threaded bone fastener apertures. The system also has a plurality of bone fasteners, each with a shaft and a head. The heads are dimensioned and configured to threadedly engage the threaded bone fastener apertures to provide a fixed angle locking construct. The heads also are dimensioned and configured to directly engage the non-threaded bone fastener apertures to provide a polyaxial non-locking compressive construct.

Abstract: An orthopedic screw system includes a screw with a locking head that can both lockingly engage in a fixed angle threaded screw hole to secure a plate to a bone without compression, and non-lockingly engage at a compression screw hole to provide compression between the plate and the bone. The structure of the system is particularly well adapted to plates and screw of small dimensions, such as screws smaller than 3.5 mm and is capable of providing high compressive force, on the order of 120 lbs of axial load, without significant plastic deformation between the screw and plate.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to an axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having tissue-piercing posts, and the second part includes a second base defining apertures receiving the posts and a portion movable relative thereto between first and second orientations. When the posts are inserted into the apertures, the movable portion can be moved from the first unlocked orientation into the second configuration to lock the fastener parts together in an implanting position determined by various alignment measures, including markings or flags on the jaws or at the housing. The instrument is adapted to move the second part into the second configuration.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A pair of plate benders are provided for bending a bone plate. Each bender includes a lever arm having a first end and a second end. The first end includes a fulcrum for placement on the upper surface of the plate, and a foot insertable through the oblong screw hole to contact the lower surface of the plate. The second end includes a cut-out with a central divider. The cut-out has a length dimensioned to extend widthwise about the plate at the location of the oblong screw hole with the divider extending into the oblong screw hole for stability. The second end may also be provided with a deep slot that accommodates the thickness of the plate. In use, plate benders with such structure can be used in pairs to longitudinal bend the plate; bend the plate in plane; or twist the plate along its axis.

Abstract: A retractor for manipulating an object includes a body having proximal and distal ends and a retraction device with a head connected to the distal end of the body, a connector movably disposed in the body, and flexible needles of a shape memory material having a memory shape. The needles are connected to the connector and each have a distal tip. The memory shape of the needles include a portion with an arcuate shape biasing the needles in a memory direction out and away from the head and toward the body to position the distal tip of each of the needles closer to the body when the needles are fully extended out of the head than when the needles are only partially extended out of the head. An actuation device is connected to the proximal end of the body and operatively connected to the connector through the body, the actuation device, upon actuation thereof, moves the connector to selectively extend the needles out of the head in different directions and withdraw the needles into the head.

Abstract: A drill guide system is provided for forming a hole along a desired trajectory in the bone of a surgical patient. The drill guide system comprises a drill bit defining a drill bit axis and a drill guide comprising a frame having a proximal arm and a distal arm fixedly spaced apart. The drill guide further comprises a first guide portion extending from the proximal arm and including a first channel defining a first guide axis, and a pointer projecting proximally from the distal arm and aligned with the first guide axis. The drill bit is transversely insertable into the first channel into an operational position in which the drill bit is constrained to translate only along the first guide axis.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: A multifilar flexible rotary shaft includes a plurality of individual filaments which are not wound around each other or around a central core, a loose ensemble of filaments. The input ends of each filament are coupled to each other and the output ends of each filament are coupled to each other. A loose ensemble of N filaments can transmit N times the torque of a single filament, and will have N times the torsional stiffness of a single filament, while retaining the minimum radius of operation of a single filament. Since a loose ensemble of filaments does not have any appreciable contact forces among the filaments (because they are not forcibly twisted together), there is no appreciable internal friction or hysteresis. The filaments should be no more than loosely twisted together, if at all. Several practical applications of the invention are also disclosed.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.

Abstract: A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A method for fastening a two-piece surgical fastener to bodily tissue whereby the surgical fastener has a safety position. The method comprises inserting first and second piercing posts through at least two layers of tissue and attaching a receiving portion to the coupling ends of the first and second piercing posts. Each of the first and second piercing posts have a fixed end and a coupling end, the first piercing post being fixedly-attached at its fixed end to a first base portion, the second piercing post being fixedly-attached at its fixed end to a second base portion, the first and second base portions being foldably coupled to one another by a hinge, where a bias device imparts a bias force on at least one of the first base portion and the second base portion in a direction toward the other and substantially perpendicular to a longitudinal axis of the hinge.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A drill guide system is provided for forming a hole along a desired trajectory in the bone of a surgical patient. The drill guide system comprises a drill bit defining a drill bit axis and a drill guide comprising a frame having a proximal arm and a distal arm fixedly spaced apart. The drill guide further comprises a first guide portion extending from the proximal arm and including a first channel defining a first guide axis, and a pointer projecting proximally from the distal arm and aligned with the first guide axis. The drill bit is transversely insertable into the first channel into an operational position in which the drill bit is constrained to translate only along the first guide axis.