Abstract: Methods and devices are provided for forming holes in bone to stimulate bone growth. In one exemplary embodiment, a surgical instrument set can include a driver having a first mating element, and a bone pick have a second mating element configured to releasably mate with the first mating element at any of a plurality of angular orientations. When releasably mated together, the driver and the bone pick can be configured to be adjustably positioned relative to one another with three degrees of freedom, e.g., pitch, yaw, and roll. The bone pick can include a piercing tip configured to form a hole in a bone, such as in microfracture. When the driver and the bone pick are releasably mated together, the driver can be configured to be struck, impacted, or otherwise manipulated to drive the piercing tip into the bone.

Abstract: Systems and methods for preparing a ligament graft for a ligament reconstruction procedure are provided. In general, the described techniques utilize a graft preparation system having a holder and a delivery suture assembly removably coupled thereto. The delivery suture assembly can include a spine coupled with an anchor suture configured to form a self-tightening knot used to position the assembly around a graft and a plurality of suture windings configured to be affixed to the graft when the assembly is deployed. The assembly is delivered to the graft using the holder and the sutures can be affixed to the graft without penetrating therethrough. The spine helps to evenly distribute the load among the windings compressing the graft which are thus are capable of withstanding increased loads. Thus, an improved, simplified, and time- and labor-saving approach to preparing ligament grafts is provided.

Abstract: A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to supply energy from a power source to captured tissue. The surgical instrument comprises a tissue-cutting element to transect the captured tissue. The rate of distal translation of the tissue-cutting element during the operational stroke may be regulated by a damper. The damper may have barrel and a plunger.

Abstract: A surgical instrument includes a body assembly, a waveguide, a transducer, and a coupling assembly. In some versions the coupling assembly translates the transducer to couple the transducer to the waveguide. For instance, a gear having arcuate troughs may engage pins on the transducer and/or waveguide to mate the transducer to waveguide. A pawl may selectively engage and prevent rotation of the gear. Alternatively, lever arms may cam the transducer into the waveguide. The lever arms may selectively couple to a casing to prevent decoupling of the transducer and waveguide. In another configuration, a locking tab can be slid and locked into a slot to couple the transducer and waveguide. Further still, levers with self-locking pins may engage and couple the transducer to the waveguide. In another version, a rotatable body portion may engage a tab on the transducer to rotate and couple the transducer to the waveguide.

Abstract: A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue.

Abstract: An ultrasonic surgical instrument comprises a handpiece and an ultrasonically actuated blade distal to the handpiece. The instrument includes an activation member that is operable to selectively activate the blade and a controller that is operable to select the energy level at which the blade will be activated. The activation member may comprise capacitive switches; resistive sensors; resonant cavity switching technology; infrared sensing technology; technology that uses a resonant, standing wave on a surface that is perturbed by the presence of a finger; and/or any other suitable type of technology. The controller may comprise the same. The controller may permit selection from three or more available ultrasonic energy levels. The activation member and/or controller may be manipulated from various longitudinal positions on the handpiece and/or various rotational positions about the handpiece, such that the handpiece may be gripped in a variety of ways.

Abstract: A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue.

Abstract: A needle targeting apparatus comprises a sense head configured to locate an implanted device and a guide. The guide is associated with the sense head and comprises an upper surface, a lower surface, and a support member. The support member comprises a channel extending through the support member that provides access to an injection site. In some versions, a needle targeting apparatus comprises a locating feature, an alignment feature, and a support feature. The locating feature is configured to locate an implanted device. The alignment feature is configured to align a syringe needle with the implanted device. The support feature is configured to support a syringe upon insertion of the syringe needle into the implanted device. In some versions, a needle targeting apparatus comprises a sense head configured to locate an implanted device and a guide. The guide is configured to identify the center of the sense head.

Abstract: An injection port includes a port body having a fluid reservoir and a connector in fluid communication with the reservoir. The injection port further includes a conduit protection feature that is configured to protect against kinking of the conduit, decoupling of the conduit from the connector, or penetration of the conduit by a needle. The protection feature may include an anchor for anchoring the conduit to tissue to reduce conduit movement. The protection feature may include a recess that is configured to receive part of the conduit. The protection feature may include a bend formed in the connector to reduce transverse stresses in the conduit. The protection feature may include a bell-shaped shroud encompassing the connector. A sleeve may further protect the conduit and/or the coupling between the connector and the conduit.

Abstract: A surgically implantable injection port has one or more tissue in-growth promoting surfaces. The injection port includes a housing, a fluid reservoir defined in part by the housing, a needle penetrable septum, and a tissue in-growth promoting surface integrally provided on an exterior surface of the port. The tissue in-growth promoting surface may be provided by surgical mesh or a textured surface on the injection port. The injection port may be used as part of a gastric band system or some other type of system.

Abstract: An ultrasonic surgical instrument comprises a handpiece and an ultrasonically actuated blade distal to the handpiece. The instrument includes an activation member that is operable to selectively activate the blade and a controller that is operable to select the energy level at which the blade will be activated. The activation member may comprise capacitive switches; resistive sensors; resonant cavity switching technology; infrared sensing technology; technology that uses a resonant, standing wave on a surface that is perturbed by the presence of a finger; and/or any other suitable type of technology. The controller may comprise the same. The controller may permit selection from three or more available ultrasonic energy levels. The activation member and/or controller may be manipulated from various longitudinal positions on the handpiece and/or various rotational positions about the handpiece, such that the handpiece may be gripped in a variety of ways.

Abstract: A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to supply energy from a power source to captured tissue. The surgical instrument comprises a tissue-cutting element to transect the captured tissue. The surgical instrument may have a indicator to provide feedback signals during the operational stroke. The feedback signals assist in regulating the rate of distal translation of the tissue-cutting element.

Abstract: An instrument comprises a handle, an articulating shaft, an end effector, and a translatable hook member. The shaft defines a side aperture, proximal to an articulating section of the shaft, through which the hook member protrudes when the hook member is translated distally. The end effector is used to form a retrogastric tunnel through blunt dissection in tissue near a patient's gastro-esophageal junction; and then to pull a gastric band through the tunnel to position the gastric band about the gastro-esophageal junction. The end effector is then used to hold a first portion of the gastric band in place while the hook member is extended distally to engage a second portion of the gastric band. The hook member may then be retracted proximally to couple the second portion of the gastric band with the first portion of the gastric band, thereby latching the gastric band in place.

Abstract: An apparatus comprises a port, a catheter, a sleeve in communication with the catheter, and an alignment feature. The port is configured to be in fluid communication with an implantable band. The port comprises a septum operable to be pierced by a needle. The catheter is configured to establish fluid communication between the port and the implantable band. The catheter is further configured to deliver fluid to the implantable band. The sleeve is configured to interface with the port. The alignment feature is responsive to the catheter being fully secured to the port. The alignment feature prevents the port from being fully sutured to tissue unless the catheter is fully secured to the port.

Abstract: An apparatus for forming a gastric restriction includes an implantable band and at least one tab. In some versions, the at least one tab may serve to stabilize the apparatus as it forms a gastric restriction. In some versions, an opening may be formed in the tabs such that sutures may be used. In some versions, a tissue scaffold and/or matrix may be used on the implantable band and/or the tabs to facilitate long term support for the implantable band, such as by substantially preventing the implantable band from sliding along an axis defined by an anatomical structure about which the implantable band is wrapped.

Abstract: A pressure sensing or monitoring device may be used with an implantable band system. In some versions, the device may be used with a syringe. The device may comprise a visual indicator for monitoring pressure. The device may govern operation of the syringe by setting a threshold pressure to limit the amount of pressure applied to an implantable band system by the syringe.

Abstract: A surgically implantable injection port has a tissue in-growth promoting surface associated with a fluid conduit that is coupled to the injection port. The injection port includes a housing, a fluid reservoir defined in part by the housing, a needle penetrable septum, a fluid conduit in communication with the reservoir, and a tissue in-growth promoting surface coupled to the fluid conduit. The tissue in-growth promoting surface may be provided by surgical mesh wrapped around the conduit or through which the conduit is threaded. The injection port and the fluid conduit may be used as part of a gastric band system or some other type of system.

Abstract: An implantable restriction device is configured to provide a restriction in a patient. A pressure sensor implanted in the patient is configured to sense pressure associated with the restriction device. A remote input device is configured to wirelessly receive pressure measurements from the pressure sensor and transmit the pressure measurements to a display device. The display device is configured to plot the pressure measurements as a function of time. The remote input device also includes buttons that may be used to annotate the pressure measurements, such as to indicate physical events associated with the patient (e.g., coughing, sneezing, etc.). The display device is also configured to display the annotations on or near the plot of pressure measurements. A viewer may thus take the annotations into account when evaluating the pressure measurements, such as by ignoring pressure measurements associated with certain types of annotations.

Abstract: An ultrasonic surgical instrument that is configured to permit selective positioning of the relative distance between an end effector for cutting and coagulating tissue and a power actuation switch that is carried by the instrument for selectively energizing the end effector. In one instance, the end effector is able to change position relative to the actuation switch, alternatively, the actuation switch moves relative to the end effector, and still further, both the end effector and the actuation switch are capable of moving relative to each other.