Abstract: A rear-viewable port closure device is provided having a cannular housing, a suture placement assembly, a scope channel defined through the cannular housing for receiving a lens end of a surgical scope, a reflector at a tip region of the of a distal portion of the cannular housing, and an obscured light source, which, when an illumination portion of the light source is activated, provides a reflected rear view to the lens end that is viewable by the surgical scope. The device can be arranged for percutaneous insertion through a defect to an interior cavity of a body, and the reflector can be longitudinally translatable within the interior cavity for adjusting a span of the rear view and a breath of a scope view. A method for rear-viewable, in vivo, suture placement and port closure using the device can include evaluating suture placement via the surgical scope.

Abstract: A drive-enhanceable handheld advancer is provided for advancing an elongate device through a pathway defined in an advancer body that includes a rotatable manual thumbwheel partially embedded in the body for receiving a user-exerted manual control movement from a thumb, and a manual drive having a nip, a transmission, and a reverse clutch. The transmission operatively connects the thumbwheel to the nip for driving advancement, and the reverse clutch maintains a first interference grip connection between the nip and the elongate device. The manual control thumbwheel can move inward responsive to user-applied grip movements to increase grip with the elongate device. The reverse clutch applies augmented force from grip movements to the nip for increasing the grip drive connection, which can be applied at a different angle from the inward movements. The reverse clutch can include slotted pivot supports for the thumbwheel and drive rollers on the advancer body.

Abstract: A handheld advancer is provided for advancing an elongate device through a pathway defined in an advancer body and include a rotatable manual control partially embedded in the body to receive a user-exerted manual control movement from a thumb of a single hand that can hold and control the advancer and advancement. The advancer can include a manual drive arranged to convert torque applied by the thumb for a rotation arc distance into a translation drive force applied for translating the elongate device an advancement distance scaled at force factor and distance factor. The distance factor can be one or greater than one and translate the elongate device an amplified advancement distance compared with manual input. The advancer can include a nip having a pair of rollers extending into the pathway providing constant control and amplified translation via concave compressible surfaces forming continuous contact regions with the elongate device.

Abstract: A clip applier may be configured to apply a surgical clip. The clip applier may include a first jaw member and a second jaw member, where the first jaw member is configured to pivot between an open configuration and a closed configuration. The clip applier may also include a first leaf spring configured to bias the first jaw member into the open configuration, and a tubular member configured to advance over the first jaw member to cam the first jaw member into a closed configuration against the bias of the first leaf spring. The clip applier may further include a second leaf spring configured to bias the second jaw member into the open configuration, and a tubular member configured to advance over the second jaw member to cam the second jaw member into a closed configuration against the bias of the second leaf spring.

Abstract: A surgical clip may include a first leg member having a first inner surface with a concave curvature, a second leg member having second inner surface with a convex curvature, and a hinge member pivotally coupling the first leg member and the second leg member. The first leg member may have a first thickness in a compression direction, a first width in a lateral direction, and a first length in a longitudinal direction. The second leg member may have a second thickness in the compression direction, a second width in the lateral direction, and a first length in the longitudinal direction. The first width may be greater than the first thickness along at least half of the first length, and/or the second width may be greater than the second thickness along gat least half of the second length.

Abstract: A clip applier may be configured to apply a surgical clip. The clip applier may include first and second jaw members configured to engage the surgical clip, an actuating member configured to pivot at least one of the first and second jaw members between an open configuration and a closed configuration, and a stabilizing member configured to engage the surgical clip. The stabilizing member may be configured to move longitudinally with respect to the clip applier from a distal position at least partially between the first and second jaw members to a proximal position at least partially between the first and second jaw members. Movement of the stabilizing member between the distal position and the proximal position may be actuated by at least one of the first jaw member, the second jaw member, and the actuating member.

Abstract: A dilating cannula includes a radially expandable flange and an expandable shaft. The radially expandable flange is disposed at a proximal end portion of the dilating cannula and includes two or more sectors that are each independently movable. The expandable shaft extends from the proximal end portion to a distal end portion of the dilating cannula and defines an inner passageway of the dilating cannula and includes two or more arms. A first branch of the two or more arms extends from one end of the base section and a second branch of the two or more arms extends from another end of the base section. The first branch is connected to a first sector of the two or more sectors of the radially expandable flange and the second branch is connected to a second, different sector of the two or more sectors of the radially expandable flange.

Abstract: A system and method for extracting a pVAD device that is implanted with a distal portion in an aorta of the heart and a drive line extending across an inter-atrial septum and out of the body via a superior vessel of the venous vasculature, include a first device that is introduced into a femoral artery and through the descending aorta used to engage a distal part of the pVAD device in the aorta of a patient using an instrument. A second, cutter, device is introduced into the venous vasculature superior to heart, advanced to a position adjacent the inter-atrial septum, and used to cut the pVAD drive line adjacent to the inter-atrial septum. After cutting, a first portion of the pVAD is withdrawn from the body via the venous vasculature, and a second portion is withdrawn from the body via the femoral artery.

Abstract: A system and method for extracting a pVAD device that is implanted with a distal portion in an aorta of the heart and a drive line extending across an inter-atrial septum and out of the body via a superior vessel of the venous vasculature, include a first device that is introduced into a femoral artery and through the descending aorta used to engage a distal part of the pVAD device in the aorta of a patient using an instrument. A second, cutter, device is introduced into the venous vasculature superior to heart, advanced to a position adjacent the inter-atrial septum, and used to cut the pVAD drive line adjacent to the inter-atrial septum. After cutting, a first portion of the pVAD is withdrawn from the body via the venous vasculature, and a second portion is withdrawn from the body via the femoral artery.

Abstract: A clip applier may be configured to apply a surgical clip and have a pair of jaw members. Each of the jaw members may have an inner surface and a stabilizing member extending from the inner surface. Each of the jaw members may be configured to engage a distal portion of a leg member of the surgical clip. The stabilizing members may be configured to be positioned on opposite lateral sides of a proximal portion of the surgical clip to reduce lateral movement of the surgical clip. An inner portion of each of the stabilizing members may be spaced apart from the opposing jaw member in an open configuration, and each of the jaw members may have a channel on the inner surface to receive the opposing stabilizing member in a closed configuration.

Abstract: A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Abstract: Described is a tool positioning system comprising an introduction device, a first tool support and a second tool support. The introduction device is constructed and arranged to slidingly receive an articulating probe. The first tool support comprises at least one guide element constructed and arranged to slidingly receive a first tool. The first tool support is oriented toward a first operator location. The second tool support comprises at least one guide element constructed and arranged to slidingly receive a second tool. The second tool support is oriented toward a second operator location.

Abstract: A suction-irrigiation aspiration device may be provided with a tip capable of mechanical action to break up or emulsify material into smaller particles during a suction or irrigation procedure. The mechanical action in the tip may the in the form of a rotational or linear reciprocating motion to cut or emulsify the blood or tissue and thereby prevent or reduce clogging of the suction-irrigiation aspiration device.

Abstract: A surgical clip cartridge, assembly, and method are provided for the storage, delivery, and loading of clips, such as those used in a surgical ligating process. The surgical clip cartridge includes a base portion extending in a longitudinal direction, the base portion having a bottom surface and defining a mounting groove for attaching the base portion onto a surgical instrument shaft. The base portion further includes a plurality of dividers extending from the base portion in a direction opposite of the bottom surface, and the plurality of dividers may be used to retain individual surgical clips therebetween for subsequent retrieval and loading onto a clip applier. The attachment of the surgical clip cartridge to the surgical instrument shaft enables the surgical clip cartridge to be deployed intracorporeally for use in surgical operations requiring applications of multiple surgical clips.

Abstract: A surgical clip cartridge, assembly, and method are provided for the storage, delivery, and loading of clips, such as those used in a surgical ligating process. The surgical clip cartridge includes a base portion extending in a longitudinal direction, the base portion having a bottom surface and defining a mounting groove for attaching the base portion onto a surgical instrument shaft. The base portion further includes a plurality of dividers extending from the base portion in a direction opposite of the bottom surface, and the plurality of dividers may be used to retain individual surgical clips therebetween for subsequent retrieval and loading onto a clip applier. The attachment of the surgical clip cartridge to the surgical instrument shaft enables the surgical clip cartridge to be deployed intracorporeally for use in surgical operations requiring applications of multiple surgical clips.

Abstract: A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Abstract: A ligation clip applier is provided. The clip applier includes: a pair of jaws; a distal clevis tube to which the jaws are pivotally mounted; a proximal clevis tube located behind the distal clevis tube, wherein the distal clevis tube and the proximal clevis tubes move axially with respect to each other; a clip lock actuator fixed to one of the proximal and distal clevis tubes; and a distal pushrod extending through the distal and proximal clevis tubes and forming a camming connection with the jaws configured to close and move the jaws toward a proximal direction toward the clip lock actuator when the distal pushrod is moved in the proximal direction. A method for applying a clip on a vessel is disclosed.

Abstract: A dilating cannula includes a radially expandable flange and an expandable shaft. The radially expandable flange is disposed at a proximal end portion of the dilating cannula and includes two or more sectors that are each independently movable. The expandable shaft extends from the proximal end portion to a distal end portion of the dilating cannula and defines an inner passageway of the dilating cannula and includes two or more arms. A first branch of the two or more arms extends from one end of the base section and a second branch of the two or more arms extends from another end of the base section. The first branch is connected to a first sector of the two or more sectors of the radially expandable flange and the second branch is connected to a second, different sector of the two or more sectors of the radially expandable flange.

Abstract: A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion.

Abstract: A narrow profile surgical ligation clip has two legs with clamping surfaces joined by a hinge near the proximal ends, allowing the clip to reversibly open and close. A locking mechanism is proximal to the hinge to bias or lock the clip closed, including first and second jaw structures spaced on opposite sides of a longitudinal axis of the clip thereby defining a locking space therebetween. In one embodiment, a wedge or buttress body moves by application of an external force applied to a proximal end of the clip towards the hinge to move into the locking space such that one or more outer surfaces or projections of portions of the body fit into or abut against complementary surfaces or other parts of the locking mechanism or clip assembly to bias or lock the clip in a closed position and provide additional closing force to the inner clamping surfaces.