Abstract: A tool having a drilling portion and a tapping portion may be used to form female threaded holes in bone. The tool may include a shaft having a drill tap portion on one end. In the drill tap portion, a tap section may be located adjacent to a drill section. The drill section may be configured to form an opening in bone while the tap section may be configured to form female threads in the walls of a hole in bone. The drill tap portion may further include a spiral flute to aid in the removal of debris. The tool may further include a stop portion configured to limit the depth of the tapped hole to a predetermined maximum depth that may correspond to the length of a particular fastener such as a bone screw. A handle attachment portion may be provided to facilitate the use of a drill.

Abstract: A reduction sleeve for facilitating insertion of a spinal rod into a rod-receiving channel formed in a bone fixation element. The reduction sleeve may include a through-bore sized and configured to receive the bone fixation element and a substantially transverse channel sized and configured to receive the spinal rod. The channel being substantially aligned with the rod-receiving channel formed in the bone fixation element so that, once the bone fixation element has been inserted into the reduction sleeve, the spinal rod can pass through the aligned channels. The reduction sleeve may also include at least one break-off point or region for facilitating breaking and removal of the reduction sleeve once the spinal rod has been clamped into the rod-receiving channel of the bone fixation element.

Abstract: A tissue fixation device is provided that is preferably used to secure a ligament or graft within a prepared bone tunnel, for example in ACL replacement. The tissue fixation device generally includes an elongate member having a shaft portion that is adapted to be at least partially disposed within a bone tunnel, and a guide member that forms a portion of the proximal end of the elongate member. The guide member has a graft-seating surface that is effective to seat a graft and to position the graft toward one side of a bone tunnel when the device is disposed within the bone tunnel. The device also includes a graft-retaining member formed on at least a portion of the graft-seating surface.

Abstract: A graft retention tack is disclosed and can include a post configured to receive a bone growth factor and a head configured to receive a cartilage growth factor.

Abstract: A self-centering coupling device is provided for coupling a sensor array to a surgical instrument for use in computer guided surgery. The self-centering coupling device includes a sensor support having a stem and sensor support arms coupled to the stem to support the sensors of the sensor array. The self-centering coupling device is received within a recess formed in the surgical instrument.

Abstract: A method for locating the mechanical axis of a long bone involves generating an image of the long bone and determining the angle between the mechanical axis of the bone and a reference axis, which contains at least two reference points towards one end of the bone. A reference arm is positioned relative to the at least two predetermined reference points, and the mechanical axis is located relative to the reference arm with reference to the previously determined angle.

Abstract: The relationship between first and second portions of a bone in a patient's body is changed by moving a wedge member into a slot formed in the bone. Force is applied against hard cortical bone by the wedge member. This force pivots the first portion of the bone relative to the second portion of the bone about an axis extending through bone interconnecting the first and second portions of the bone. As the wedge member moves into the bone, a side surface of the wedge member is moved into alignment with an outer side surface of the bone. The wedge member is fixedly connected with the bone. The wedge member is rigid so that the bone can immediately be load bearing. One or more openings may be provided in the wedge member to enable bone to grow through the wedge member. The wedge member may contain a material which promotes growth of bone through the wedge member.

Abstract: The invention provides a method and a device for administering bone matrix with or without additional bone growth enhancing agents, or administering one or more bone growth enhancing agents to the interior surface of an unfractured vertebral body to enhance bone growth and strength, thus reducing susceptibility of the vertebral body to subsequent fracture.

Abstract: The present invention provides a holder for supporting a two optic accommodating intraocular lens device. The holder is capable of holding the device while taking measurements or performing manufacturing process steps on the device and/or packaging the device. In a preferred embodiment, the holder supports the device along the haptics thereof such that the optics remain untouched and unobstructed by the holder. As such, testing and/or processing of the optics during their accommodative and unaccomodative positions may be taken, and the device may be safely packaged and shipped with the holder.

Abstract: An insertion aid for medical instruments includes a shaft having a proximal end, a distal end, and a bending part, and a tension element for actuating the bending part. The bending part includes structures which allow a bending in at least one desired direction different from an extension direction of the shaft. The shaft further comprises an outer tube element and an inner tube element supported in the outer tube element so as to be axially movable. The tension element is hinged to one of the inner and outer tube elements and the bending part is provided at a distal end of the other of the inner and outer tube elements.

Abstract: A device for the implantation of electrolytically severable occluding spirals in body cavities or blood vessels comprising a source of electrical power, a cathode, a catheter and an occluding spiral adapted to serve as an anode and able to slide in the catheter in the longitudinal direction, wherein the occluding spiral (3) is designed to be electrolytically corrodible at several spaced apart points so that when in contact with a body fluid one or more variably dimensioned lengths of the occluding spiral (3) may be severed by electrolysis.

Abstract: A surgical device and method designed to make insertion of pressure equalization tubes for effusion of the inner ear faster, more reliable, and safer by combining the placement of the pressure equalization tube with suction of the inner ear, decreasing the number of instruments and instrument passes into and out of the ear canal. A surgical insertion tool permits the direct coaxial insertion of the stent through the surgically created ostium, and which may be under direct, clear endoscopic control.

Abstract: A tool for coring a portion of one or more hair follicles incorporates an elongate hollow tubular member with at least one cut-out disposed between its distal end and proximal end. The cut-out allows for removal of debris that moves it way up the hollow tubular member from the opened distal tip. The needle can also include a radially-extending projection that cooperates with zero or more ring-shaped members that are slipped concentrically over the distal end of the hollow tubular member to set the penetration depth of the coring needle. The tool can also include a stepped interface that is adapted to snag a root of a hair follicle unit cored by the hollow tubular member upon its withdrawal away from the patient's body.

Abstract: Provided herein is an instrument and method useful to incise in to the skin to a precise depth and at a specific angle with respect to the surface of the skin of a patient, for the extraction of individual follicular groups or individual follicular units. An instrument according to the invention precisely limits the depth of incision, and creates a circular incision around a hair, follicular unit, or follicular cluster in a manner such that no damage occurs to any of the hair shafts.

Abstract: The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

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: The present invention concerns a gauze implant for treating cuff injuries. The said implant is composed of several, preferably eight, overlapping layers of gauze. The use of an implant composed of several layers, allows better stress distribution and ingrowth of tissue between the different layers.

Abstract: Anchors, anchoring systems, anchor delivery devices, and method of using anchors are described. An anchor may be a flexible anchor having two curved legs that cross in a single turning direction to form a loop, wherein the legs are adapted to penetrate tissue. The ends of the curved legs may be blunt or sharp. The anchor can assume different configurations such as a deployed configuration and a delivery configuration, and the anchor may switch between these different configurations. In operation, the anchor may be inserted into tissue by releasing the anchor from a delivery configuration so that the anchor self-expands into the deployed configuration, so that the legs of the anchor may penetrate the tissue in a curved pathway.

Abstract: Compression plate apparatus enables vessels to be joined together in various anastomosis configurations. The compression plates are guided to each other in a parallel orientation by guides. The compression plate apparatus may be utilized with an intraluminally directed anvil apparatus or an externally positioned anvil apparatus. One of the compression plates assists in the eversion of the anastomosis fenestra contour. One of the compression plates enables a graft vessel to be pre-everted so that the anastomosis fenestra contours are everted. The apparatus provides a structure that enables the vessels to be joined without being penetrated.

Abstract: A device for cutting tissue in a human body may include an elongate, hollow shaft having a proximal portion and a distal portion, a bundle of flexible wires slidably disposed within at least a portion of the shaft and having a proximal end and a distal end, and an actuator coupled with the proximal portion of the shaft and the proximal end of the bundle of wires. The distal end of the bundle may be configured to facilitate cutting of tissue, and the wires of the bundle may be at least partially free to move, relative to one another, to allow a cross-sectional shape of the bundle to differ along a length from the proximal to the distal end. The actuator may be configured to move the wires back and forth through the hollow shaft to cause the distal ends of the wires to cut tissue.

Abstract: The present invention relates to an adapter sleeve that provides a contoured handle surface that is used to hold a scalpel blade during a surgical procedure. The adapter sleeve in a preferred embodiment can include a cavity in which the scalpel blade can be removably inserted for a single procedure. Alternatively, the adapter can be manufactured as a sterilizable unit with the scalpel blade capable of being rigidly mounted to a distal end of a handle.

Abstract: A balanced ultrasonic surgical instrument according to the present invention includes an ultrasonic transmission rod which is connected to a blade or end effector by a balance portion, which includes first and second balance asymmetries designed to compensate for the imbalances induced by the blade.

Abstract: A power transmission mechanism comprising: a flexible power transmission element; a pair of a drive pulley and a driven pulley on which the flexible power transmission element is wound, each the pulley having a pin-embedding hole formed to extend from the outer circumferential thereof toward the center thereof, and a slit elongated in the circumferential direction of the pulley to extend to opposite sides of the embedding hole and communicating with the embedding hole; and a pair of columnar or tapered anchor pins each having a path hole penetrating the anchor pin across the lengthwise direction thereof to receive the flexible power transmission element inserted therein, wherein each the anchor pin receiving the flexible power transmission element in the path hole thereof is embedded in the embedding hole of the associated pulley under pressure, and the flexible power transmission element is thereby held on the pulley.

Abstract: Apparatus for implanting single hair grafts in implant sites in a skin is adapted to apply a tiny adhesive dot in a manner to secure the implanted graft to the skin surface. The quick hardening of the adhesive allows the placement of implants in closely spaced, neighboring sites without causing dislodgment of previously implanted grafts. Illustrative apparatus for providing such implants comprises a hollow needle with a coaxial solid rod in a fixed position. The needle is moved along its axis for implanting a graft and a channel in the rod is positioned to deliver the adhesive dot.

Abstract: The present invention provides a device and method for use in laparoscopic surgery, in particular hand assisted laparoscopic surgery, the device comprising a flexible body having a sidewall of double wall construction which defines an inflatable cavity enabling the body to be inflated from a collapsed state into an expanded state, in order to distend a surgical cavity to provide an enclosure within which a surgical procedure may be performed, the body having an opened to allow communication between the enclosure defined by the body when in the expanded state and tissue/organs surrounding the body, in particular directly adjacent, in use, the open end of body.

Abstract: A method includes moving an actuator from a first position to a second position such that a first shaft is rotatable relative to a second shaft. The second shaft is disposed within the first shaft and coupled to an expandable member. The actuator is moved from the second position to the first position such that the second shaft is rotatable relative to the first shaft through a plurality of discrete increments.

Abstract: In some embodiments, an apparatus includes an elongated member, an expandable member coupled to the elongated member, and an outer sheath. The outer sheath, which can be constructed from a different material than the expandable member, is disposed about the expandable member such that an outer surface of the expandable member is in discontinuous contact with an inner surface of the outer sheath. The expandable member and the outer sheath are configured to cooperatively displace a bone structure when moving between a collapsed configuration and an expanded configuration.

Abstract: An apparatus includes an expandable member and an elongate assembly. The expandable member is configured to displace a first portion of a bone structure relative to a second portion of the bone structure when moved from a collapsed configuration to an expanded configuration. The elongate assembly includes a shaft and an elongated member disposed with a lumen defined by the shaft. A proximal end portion of the expandable member is coupled to a distal end portion of the shaft such that the proximal end portion of the expandable member does not rotate relative to the distal end portion of the shaft when at least a portion of the expandable member is twisted about the elongated member through at least four revolutions.

Abstract: Tissue dilation tools and methods of use are disclosed that provide gradual and controlled stretching of the tissue surrounding a surgical incision. The tools utilize a plurality of operably connected, coaxial sleeves or members of different sizes to gradually enlarge the incision.

Abstract: A method of stretching the skin of a patient such as a patient who has undergone a mastectomy is described. A surgeon implants an expander under the skin of the patient and inserts a small amount of liquid to enlarge the expander. Thereafter the patient herself operates a patient controlled liquid delivery machine (“PCD”) to deliver amounts of the liquid to the expander. The PCD is arranged so that only small amounts of liquid can be introduced at each actuation thereof and that there is a delay between the times that the PCD can be actuated. Thus the expander can be increased in size in small increments which will not cause the patient pain until the expander has reached the desired size.

Abstract: Devices, methods for treatment of obesity, as well as instruments and tools used in placing, adjusting and maintaining devices for treatment of obesity. Various embodiments of devices that are implanted extra-gastrically are provided. Various embodiments of devices that are implanted intra-gastrically are provided. Methods include laparoscopic, percutaneous and/or trans-oral methods. Alternatively, devices describe can generally also be implanted by open surgical procedures.

Abstract: Methods and devices to externally create a restriction on the stomach are described. In some embodiments, the devices are contoured to fit the stomach and can be further anchored to the stomach. In further embodiments, the degree of deployment of the extragastric restriction device is controllable after implantation. In other embodiments, specialized wires, catheters, ports, and trocars specific for placement of extragastric restriction devices are presented. In still further embodiments, systems are described in which adjustability of the devices is provided along with sensing and actuating ability.

Abstract: A vertebral body is selected for treatment. The vertebral body has a cortical wall enclosing a cancellous bone volume. At least one maximum dimension for the cancellous bone volume is ascertained, and an expandable device is provided that has a predefined dimension when substantially expanded that is less than the maximum dimension. The expandable device is introduced into the vertebral body through a percutaneous access path while in an unexpanded condition. The expandable device is expanded while disposed within the cancellous bone volume from the unexpanded configuration toward the expanded configuration. An expansion barrier is provided in association with the expandable device that directs expansion of the expandable device in a desired direction to create a cavity in the cancellous bone volume.

Abstract: A fire cupping jar includes a cup portion and a lamp that is provided in the cupping jar. The cupping jar can be repeatedly used without needing to be replenished with alcohol and can use fire capable of providing uniform flame.

Abstract: Apparatus is provided for protecting a patient's limb from tourniquet-related injury, comprising: a tourniquet cuff having a length sufficient for encircling a limb protection sleeve applied to a limb at a location having a limb circumference of not less than a predetermined minimum limb circumference and not more than a predetermined maximum limb circumference; limb protection sleeve adapted for applying to the limb at the location, wherein the sleeve has a tubular shape and a tubular circumference predetermined to be less than the predetermined minimum and wherein the sleeve is formed to allow elastic stretching of the tubular shape sufficient to increase the tubular circumference to be substantially equivalent to the limb circumference at the location when the sleeve is applied to the limb, thereby applying a pressure to the limb that is greater than a predetermined minimum pressure and less than a predetermined maximum pressure; and identification means perceptible to a user for providing an indication to

Abstract: A vacuum-assisted wound healing device is provided comprising an airtight hollow conical member surrounding a skin-breaching bone stabilization device, and a port for attaching a suction tube. The conical member has an opening at one end conforming to the circumference of the shaft of a bone stabilization device, and a opening at the other end to enclose a wound in a patient's skin surrounding the bone stabilization device. The device may be used to provide controlled reduced pressure to the wound site, reducing healing time and risk of infection.

Abstract: The present disclosure relates generally to devices, systems and methods for use with cardiac defects. A closure device includes an elongate body with a first actuator segment and a second actuator segment associated with the elongate body that can be bent into a first predetermined position and then to a second predetermined position where the distal end and the proximal end are more closely positioned than when in the first predetermined position.

Abstract: The present disclosure relates generally to devices and methods for use with cardiac defects, more particularly, the present disclosure relates to a device including a frame defining a lumen, where the frame expands from a first configuration to a second configuration larger than the first configuration. The device also includes an anchoring member extending from the frame to secure the frame while in the second configuration and a plug portion of the frame to occlude at least a portion of the lumen.

Abstract: A method of occluding a fistula in a patient is provided. The method includes inserting a placement member having a coupling structure, such as a wire guide having a loop at one end, through the primary opening of a fistula and at least partially into the fistula tract; connecting the coupling structure to a medical device, such as a plug, graft, or other occluding member; and inserting the medical device into the fistula by pulling the placement member through the fistula until the medical device contacts the interior wall of the fistula. Medical devices and systems for occluding fistulas are also provided.

Abstract: Anchors, anchoring systems, anchor delivery devices, and method of using anchors are described. An anchor may be a flexible anchor having two curved legs that cross in a single turning direction to form a loop, wherein the legs are adapted to penetrate tissue. The ends of the curved legs may be blunt or sharp. The anchor can assume different configurations such as a deployed configuration and a delivery configuration, and the anchor may switch between these different configurations. In operation, the anchor may be inserted into tissue by releasing the anchor from a delivery configuration so that the anchor self-expands into the deployed configuration, so that the legs of the anchor may penetrate the tissue in a curved pathway.

Abstract: A suture and needle combination is disclosed for use during surgical and non-surgical procedures comprising a suture needle 16 with a breakaway tip 20, insertable tip 24 or reusable tip 32. Suture 10 passes freely through hollow needle 16 after a user removes needle tip (20,24, or 32) during use. This suture needle combination reduces the amount of room needed within a surgical site, reduces the length of needle 16 needed to exit tissue (for example) while suturing, and decreased trauma to at risk anatomical structures during a surgical procedure or other use.

Abstract: A high strength surgical suture formed of ultrahigh molecular weight polyethylene (UHMWPE) yarns, the suture being coated with native or denatured collagen. The braided jacket surrounds a core formed of twisted yarns of ultrahigh molecular weight polyethylene. The suture has exceptional strength, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: A high strength surgical material with improved tie down characteristics and tissue compliance formed of ultrahigh molecular weight polyethylene (UHMWPE) yarns, the suture being coated with arginine-glycine-aspartate (RGD) peptide. The suture has exceptional strength, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone are described herein Such devices and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Abstract: Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue.

Abstract: Systems and methods using a heart valve and an implantable medical device, such as for event detection and optimization of cardiac output. The cardiac management system includes a heart valve, having a physiological sensor. The physiological sensor is adapted to measure at least one of an intrinsic electrical cardiac parameter, a hemodynamic parameter or the like. The system further includes an implantable electronics unit, such as a cardiac rhythm management unit, coupled to the physiological sensor of the heart valve to receive physiological information. The electronics unit is adapted to use the received physiological information to control delivery of an electrical output to the subject.

Abstract: Various system embodiments comprise a neural stimulation delivery system adapted to deliver a neural stimulation signal for use in delivering a neural stimulation therapy, a side effect detector, and a controller. The controller is adapted to control the neural stimulation delivery system, receive a signal indicative of detected side effect, determine whether the detected side effect is attributable to delivered neural stimulation therapy, and automatically titrate the neural stimulation therapy to abate the side effect. In various embodiments, the side effect detector includes a cough detector. In various embodiments, the controller is adapted to independently adjusting at least one stimulation parameter for at least one phase in the biphasic waveform as part of a process to titrate the neural stimulation therapy. Other aspects and embodiments are provided herein.

Abstract: Systems, methods and devices are provided for improving the hemodynamic efficiency of a patient's heart by implanting one or more reinforcement elements on or with the heart and providing electrical stimulation to the heart. The reinforcement elements may include magnetic and/or shape memory material and are configured to reshape the heart so as to boost the heart's mechanical energy during a response to the electrical stimulation. In some embodiments, at least one reinforcement element includes an electrode configured to sense electrocardiogram signals within the heart. An electrical stimulation device such as an implantable or external pacemaker/defibrillator may be configured to control delivery of electrical pulses to the heart based on the sensed electrocardiogram signals. In addition, or in other embodiments, at least one reinforcement element includes an electrode configured to deliver the electrical pulses to the heart.

Abstract: A method for determining a cardiac shock strength, for example the programmed first-therapeutic shock strength of an implantable cardioverter defibrillator (ICD), including the steps of sensing a change in a T-wave of an electrogram with respect to time such as the maximum of the first derivative of a T-wave of an electrogram; delivering a test shock by (i) delivering a test shock at a test-shock strength and at a test-shock time relating to the maximum of the first derivative of the T-wave with respect to time; and (ii) sensing for cardiac fibrillation. If fibrillation is not sensed, test-shock delivery is repeated at the same test-shock strength and at specific, different test-shock times relating to the maximum of the first derivative of the T-wave. If fibrillation is still not sensed, the shock strength is decreased and test shocks are repeated at the same specific test shock times relative to the maximum of the first derivative of the T-wave.

Abstract: A device and method for delivering high-energy electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The high-energy stimulation mimics the effects of exercise and improves symptoms even in patients who are exercise intolerant. The high-energy stimulation may be delivered on an intermittent basis either as pacing pulses in accordance with a programmed pacing mode and with a higher pacing pulse energy than used for conventional pacing or as low energy shock pulses.