Abstract: A device for clearing obstructions from a medical tube, such as a chest tube, is disclosed in various embodiments. The device features a clearance member in the form of a loop. The loop desirably has a diameter that substantially corresponds to the inner diameter of the medical tube. Also desirably, the loop presents a substantially unobstructed pathway therethrough for the flow of material from a location in the medical tube distal to the loop to a location in the medical tube proximal to the loop regardless whether the clearance member is being translated or is at rest in the medical tube. Methods of utilizing such a device are also disclosed.

Abstract: Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

Abstract: Described here are devices, systems, and methods for improving blood flow in a vessel. Generally, the method may comprise advancing a catheter into a first vessel proximal to an occlusion in the first vessel and forming a fistula between the first vessel and a second vessel. This may deliver blood flow around an occlusion to ischemic tissues located in the peripheral vasculature.

Abstract: Described here are devices, systems, and methods for cannulating a vessel. Generally, the method may comprise advancing a stent into a first vessel and deploying the stent in the first vessel to hold open one or more valves. This may permit retrograde blood flow through the blood vessel in peripheral vasculature and aid in cannulation of the blood vessel.

Abstract: An image-guided robotic system for advancing a penetrating member into a body lumen located beneath a skin surface of a patient, the image-guided robotic system comprising: a detector for obtaining data representative of a location of the body lumen beneath the skin surface of the patient; a robotic arm comprising: a penetrating member; a linear actuator for linearly advancing the penetrating member into the body lumen; a vibrational actuator for vibrating the penetrating member at a selected frequency; a processor in communication with the detector, the linear actuator and the vibrational actuator, the processor being configured to: (i) receive the data representative of the location of the body lumen from the detector; (ii) calculate the distance to a preselected target point within the body lumen; (iii) transmit linear advancement instructions to the linear actuator to linearly advance the penetrating member through the skin surface, through tissue between the skin surface and the body lumen and into the p

Abstract: Described here are methods of treating a patient having hypertension comprising advancing a catheter into a deep ulnar vein or an artery, wherein the catheter comprises an electrode. The methods further comprise forming a fistula between the deep ulnar vein and the artery with the electrode to reduce a blood pressure of the patient.

Abstract: Described here are devices, systems, and methods for adhering tubular structures, such as blood vessels. Generally, the methods may comprise advancing a first catheter comprising a first adhesion element into a first blood vessel and a second catheter comprising a second adhesion element into a second blood vessel. The vessels may be adhered together by heating tissue using the first and second adhesion elements.

Abstract: A surgical instrument assembly configured to display a representation of the surgical instrument relative to a trajectory (e.g., a desired trajectory for drilling into an implant) based image data from an image sensor (e.g., a camera). For example, the surgical instrument assembly may be configured to determine a desired trajectory (e.g., a central axis of a distal hole of an intramedullary nail) based on X-ray image data representing at least one fiducial marker (e.g., an array of ArUco markers) and representing an anatomical structure and/or an implant. The surgical instrument assembly may in real time display a representation of the orientation and/or position of the surgical instrument (e.g., the orientation and position of a drill bit of the surgical instrument) in relation to the desired trajectory based on image sensor data that is generated based on an orientation of the at least one fiducial marker detected by an image sensor.

Abstract: Systems, devices and methods described herein relate to fluid delivery devices and, in particular, fluid delivery devices that are designed to deliver small volumes of liquid.

Abstract: Embodiments described herein relate to systems, devices, and methods of cleaning endoscopes or other instruments during surgical procedures, which can be used with a robotic system.

Abstract: Embodiments described herein relate to systems, devices, and methods of cleaning endoscopes or other instruments during surgical procedures. In some embodiments, a system or device can include a trocar including a trocar shaft and a cap that collectively define fluid and/or electrical passages. In some embodiments, a system or device can include obturators with a wiping element and/or an absorbent element configured to remove debris and moisture from the interior walls of trocars. In some embodiments, a system or device can include a trocar with a liquid and gas interconnect device and venting systems for cleaning instruments disposed in the trocar channel.

Abstract: Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.

Abstract: An image-guided robotic system for advancing a penetrating member into a body lumen located beneath a skin surface of a patient, the image-guided robotic system comprising: a detector for obtaining data representative of a location of the body lumen beneath the skin surface of the patient; a robotic arm comprising: a penetrating member; a linear actuator for linearly advancing the penetrating member into the body lumen; a vibrational actuator for vibrating the penetrating member at a selected frequency; a processor in communication with the detector, the linear actuator and the vibrational actuator, the processor being configured to: (i) receive the data representative of the location of the body lumen from the detector; (ii) calculate the distance to a preselected target point within the body lumen; (iii) transmit linear advancement instructions to the linear actuator to linearly advance the penetrating member through the skin surface, through tissue between the skin surface and the body lumen and into the p

Abstract: An automatic insertion device and method of using the same is provided. A vibrator and an extender are connected to a penetrating member and are both in electrical communication with a controller. A detector identifies a subcutaneous target for insertion and the insertion angle, distance and trajectory for the penetrating member are calculated. The vibrator provides vibrations to the penetrating member and the extender advances the penetrating member for insertion. The vibrator and extender are in electrical communication with one another during the insertion process and adjustments to the insertion speed are made based on feedback of vibrational load encountered by the vibrator during insertion, and adjustments to the vibrations are made based on feedback of insertion load encountered by the extender during insertion. Iterative samples are taken to constantly adjust the operation of one motor based on the operations and feedback from the other motor.

Abstract: Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare loop and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare loop. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.

Abstract: Devices and methods for providing localized pressure to a region of a patient's heart to improve heart functioning. The devices include a cardiac jacket made of a flexible biocompatible material and at least one inflatable bladder disposed on an interior surface of the jacket. Inflation of the bladder causes the bladder to expand to exert localized pressure against a region of the heart. In some cases, a phase-change material is filled into the bladder as a liquid and the material solidifies at body temperature. In some cases, a positioning tool is used prior to the implantation of the jacket in order to determine effective positions for the inflatable bladder(s) to be located on the heart to improve heart functioning.

Abstract: Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.

Abstract: Described here are devices for closing one or more tissues, and handles for controlling these devices. Generally, the devices described here comprise a snare loop assembly, wherein the snare loop assembly comprises a snare and a suture loop, and a handle for controlling the snare loop assembly. In some variations the snare loop assembly may comprise a retention member that may releasably connect the suture loop to the snare. In other variations the devices comprise one or more force-reducing suture locks to help prevent the suture loop from inadvertently disengaging from the snare loop assembly. In still other variations, the excess-suture management features. The handles described here may be configured to remove excess suture from a suture loop, and may also be configured to release the suture loop from the snare loop assembly.

Abstract: Described here are devices, systems, and methods for forming a fistula between two blood vessels. The systems may comprise a first catheter including a housing and an electrode having a proximal end and a distal end. The proximal end is fixed relative to the housing and the distal end is longitudinally slidable within the housing.

Abstract: An automatic insertion device and method of using the same is provided. A vibrator and an extender are connected to a penetrating member and are both in electrical communication with a controller. A detector identifies a subcutaneous target for insertion and the insertion angle, distance and trajectory for the penetrating member are calculated. The vibrator provides vibrations to the penetrating member and the extender advances the penetrating member for insertion. The vibrator and extender are in electrical communication with one another during the insertion process and adjustments to the insertion speed are made based on feedback of vibrational load encountered by the vibrator during insertion, and adjustments to the vibrations are made based on feedback of insertion load encountered by the extender during insertion. Iterative samples are taken to constantly adjust the operation of one motor based on the operations and feedback from the other motor.