Abstract: Biomarkers are collected and used to determine biological propensities of a patient, to determine the efficacy of medical devices, to select and administer therapeutic agents, to select medical devices, to make adjustments to medical devices, and/or to adjust surgical techniques. An apparatus includes a port to draw a biological fluid (e.g., a mist) from a surgical site. The apparatus includes a sensor having a cantilevered beam. The beam includes substances selected to attract certain biomarkers as the fluid is communicated across the beam. The same apparatus or another apparatus is used to administer a therapeutic agent based at least in part on collected biomarker data. The therapeutic agent delivery apparatus may include a device that is also used to create a wound at a surgical site. For instance, a harmonic surgical instrument may be used to both collect biomarkers and administer a therapeutic agent (e.g., gene therapy using sonoporation).

Abstract: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath, a blade disposed at least partially within the hollow sheath and extending through an opening in the sheath, and at least one ultrasonic transducer operably coupled to the blade. The blade may include a polygonal cross-sectional shape and the tip may project away from the sheath's longitudinal axis. In another embodiment, the surgical instrument may include a blade with suction disposed therethrough and at least one ultrasonic transducer operably coupled to the blade. The blade may include a cutting edge that is positioned over a blade opening. Also, the cutting edge may project away from the blade's longitudinal axis.

Abstract: A cannula has a flange and a body with slots extending through the entire flange and into the body. The cannula may also have a longitudinal slot extending its entire length. An obturator used with the cannula may also have a longitudinal slot extending along its length. A surgical method using these instruments includes separating lengths of suture and managing the suture by placing lengths of suture in the slots in the cannula. The cannula and obturator may be used after suture is already in place by placing the suture in the longitudinal slots and then introducing the cannula and obturator to the tissue defect site. The cannula may also be used to deliver a therapeutic implant to the tissue defect site. The instruments and method may be used in mensical surgery.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that comprises a handpiece housing that rotatably supports an ultrasonic transducer assembly therein that may be selectively rotated by various motor configurations. Various slip ring arrangements are disclosed for supplying ultrasonic electrical signals and motor drive signals from a control system. Various forms of blade and cutting implements are disclosed for attachment to the ultrasonic transducer assembly such that such implements may be selectively rotatable within a hollow outer sheath. Vacuum may be applied to the cutting implement or through the outer sheath to draw tissue through an opening in the sheath and into contact with the cutting implement.

Abstract: Various embodiments are directed to a surgical instrument comprising, a shaft, and an end effector. The shaft may be coupled to the handle and may extend distally along an longitudinal axis. The end effector may be positioned at a distal end of the shaft and may comprise first and second jaw members, a reciprocating member, a shuttle and at least one cam pin. The first and second jaw members may define first and second longitudinal slots and first and second cam slots and may be pivotable towards one another about a pivot point. The reciprocating member may be translatable distally and proximally parallel to the longitudinal axis and through the first and second longitudinal slots. A distal portion of the reciprocating member may define a blade. The shuttle may be translatable distally and proximally parallel to the longitudinal axis. The cam pin may be coupled to the shuttle and positioned within the first cam slot and the second cam slots.

Abstract: A surgical device comprises a housing, a bioprocessing module, an end effector, and a pumping device. The bioprocessing module comprises media reservoirs, fluid conduits in communication with the reservoirs, and a port through which media is expelled. The end effector is configured for insertion into a lumen and delivering a tissue repair composition into that lumen. The end effector has at least one fluid conduit extending therethrough and at least one orifice in communication with the fluid conduit. The fluid conduit in the first end effector is in fluid communication with the port on the bioprocessing module. The pumping device is operable to urge a tissue repair composition comprising at least a portion of the contents of the media reservoirs through the fluid conduit of the first end effector such that the tissue repair composition is expelled from the at least one orifice.

Abstract: An end-effector assembly configured to be attached to a surgical instrument. The end-effector assembly comprises a first jaw and a second jaw comprising a staple cavity. At least one of the first jaw and the second jaw is movable relative to the other jaw. The end-effector assembly comprises a staple removably positioned within the staple cavity and an electrically-conductive driver configured to move the staple between a first stored position in which the staple is at least partially positioned within the staple cavity and a second position in which the staple is at least partially deployed from the staple cavity into tissue positioned intermediate the first jaw and the second jaw. The staple comprises an electrode.

Abstract: A nested trigger assembly for a surgical instrument may generally comprise a first trigger and a second trigger, wherein the first trigger and the second trigger are movable together on a first stroke of the nested trigger assembly, wherein the second trigger is configured to be biased away from the first trigger after the first stroke and before a second stroke, and wherein the second trigger is configured to be moved toward to the first trigger during the second stroke. A surgical instrument may generally comprise a shaft comprising a proximal end and a distal end, a handle extending from the proximal end, wherein the handle comprises a gripping portion, and a nested trigger assembly extending from the handle. The nested trigger assemble may comprise one of a separable trigger assembly and a divisible trigger assembly.

Abstract: A bioprosthetic device is provided for soft tissue attachment, reinforcement, and or reconstruction. The device comprises a naturally occurring extracellular matrix portion and a three-dimensional synthetic portion. In illustrated embodiments, the naturally occurring extracellular matrix portion comprises layers of small intestine submucosa, and the three-dimensional synthetic portion comprises a foam or a three-dimensional mesh, textile, or felt.

Abstract: A surgical instrument can comprise an end effector including a plurality of jaws which can be configured to compress tissue therebetween. The end effector can further comprise one or more electrodes which can be configured to direct a flow of electrical current through the tissue in order to heat the tissue and denature collagen and/or other proteins within the tissue. As the tissue cools, the collagen and/or other proteins can renature and thereby seal the tissue. In certain embodiments, the end effector of the surgical instrument can further comprise movable portions which can apply a tension force to the tissue surrounding the tissue being sealed. In various circumstances, the tension force can reduce the over-denaturation, shrinkage, and/or other damage to the surrounding tissue caused by heat flowing from the end effector during the sealing process.

Abstract: A tissue processing system includes a tray and a processing component. The processing component has teeth configured to dice, mince, and mix the tissue in the tray. In some versions, teeth of a rotary member mesh with teeth of a stationary member, such that the tissue is ground between the meshing teeth. The rotary member may be moved in an orbital path relative to the stationary member. In some versions, the teeth of two rotary members mesh together, and the rotary members are rotated in opposite directions to grind the tissue. The rotary members may also be alternatingly moved up and down to perform initial dicing on the tissue. Once the tissue has been processed, the tissue may then be used in a therapeutic manner, such as by being incorporated with a scaffold and then implanted in the same patient from whom the tissue was originally harvested.

Abstract: Orthopaedic devices are disclosed. The devices include a part that is made of extracellular matrix material that has been hardened. One method of hardening the extracellular matrix is to comminute naturally occurring extracellular matrix and dry the comminuted material. The hardened extracellular matrix material can be machined to form a variety of orthopaedic devices.

Abstract: One embodiment of the present invention is directed to compositions and methods for enhancing attachment of soft tissues to a metal prosthetic device. In one embodiment a construct is provided comprising a metal implant having a porous metal region, wherein said porous region exhibits a nano-textured surface, and a biocompatible polymer matrix coating the nano-textured surface. The polymer matrix coating comprises a naturally occurring extracellular matrix with biocompatible inorganic materials distributed within the matrix, or a biocompatible polymer and an osteo-inductive agent.

Abstract: In one general aspect, various embodiments are directed to methods for treating tissue within an aqueous environment. Various methods may include introducing a cutting implement of a surgical instrument into the aqueous environment. The cutting implement may have at least one cutting surface thereon and at least one ultrasonic portion thereon and be selectively rotatable within a hollow sheath. The methods may include rotating or rotatably oscillating the cutting implement within the hollow sheath for tissue cutting purposes. The cutting implement may also be retained in a position wherein the ultrasonic portion of the cutting implement may be applied to tissue and then have ultrasonic motion applied thereto.

Abstract: A tissue dicing and separation device comprises a housing having an interior that receives tissue for dicing and separation. The device includes a blade assembly connected to a motor and solenoid. The solenoid reciprocates the blade assembly while the motor clocks the blade assembly during each reciprocation cycle. This reciprocating and clocking action of the blade assembly dices and/or minces the tissue. The housing is filled with a fluid and then the blade assembly is continuously rotated to create a vortex within the housing. The vortex causes the diced tissue particles to separate by particle size. Outlets at different positions along the housing permit withdrawal of a slurry of fluid and tissue particles with the tissue particles having a desired size range. The obtained slurry may be used in conjunction with a fistula plug treatment device and method.

Abstract: A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can enable the sheath to act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.

Abstract: A connective tissue scaffold including opposed first and second anchoring segments formed from a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to a longitudinal axis of the scaffold and a plurality of bioresorbable polymeric fibers oriented in a direction substantially transverse to a longitudinal axis of the scaffold. A central segment joins the first and second anchoring segments and includes a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to the longitudinal axis of the scaffold. The scaffold can also a tissue particle and/or biological component.

Abstract: Surgical instruments for use in mapping tissue defects include telescoping rulers and tubes. One of the instruments has a pointed anchoring tip for piercing tissue near the site of the defect. Another instrument has a hook for catching an anatomical landmark. Measuring portions of the rulers of both instruments include distance indicia so that a coordinate system can be established for mapping the location of the defect or of an implant at the defect site. The coordinate system can be re-established at a later time using the same fixation point for the anchoring tip and the same landmark for the hook to evaluate the clinical effects of the treatment selected. The method of using the instrument set is also described.

Abstract: A connective tissue scaffold including opposed first and second anchoring segments formed from a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to a longitudinal axis of the scaffold and a plurality of bioresorbable polymeric fibers oriented in a direction substantially transverse to a longitudinal axis of the scaffold. A central segment joins the first and second anchoring segments and includes a plurality of bioresorbable polymeric fibers oriented in a direction substantially parallel to the longitudinal axis of the scaffold. The scaffold can also a tissue particle and/or biological component.

Abstract: A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can further include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can be set such that the sheath can act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath in order to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.