Abstract: A system and method for regional anesthesia using ultrasound to assist in locating the anesthetic needle are disclosed. One or more piezo-electric crystal transducers is placed either at the tip of the needle or near the tip of the needle on a stylet which is inserted into the lumen of the needle. The transducer(s) are pulsed with ultrasonic frequency, the reflected ultrasonic signals from structures are detected and converted into a digital signal and may be displayed in an oscilloscopic format to indicate anatomical structures forward to the needle and allow the medical professional to avoid errors and/or increase efficiency and accuracy. An array of transducers can be pulsed in a phased array fashion to generate a 2D image, or a single transducer can be pulsed to generate a 1D image.

Abstract: A coaxial cannula for extracting samples from tissue having a biopsy needle unit provided with a space for sample extraction and a sample separation unit that coaxially encompasses the biopsy needle on an external wall and that is longitudinally movable. The coaxial cannula includes a sealing element that is arranged on the proximal end thereof and closes the space between the internal wall of the coaxial cannula and the external wall of the sample separation unit. The sealing element opens an air outlet when the biopsy needle unit is inserted, and prevents air intake when the biopsy needle unit is positioned and vacuum is produced in the internal chamber of the biopsy needle.

Abstract: A biopsy device having a translating and rotating cutter is disclosed. The translational speed of the cutter is varied using a variable pitch member. The variable pitch member can include a shaft having a relatively coarse threaded portion for rapid cutter advance and a relatively finer threaded portion for cutter advance during tissue severing.

Abstract: A bodily fluid sampling device comprising a lancet which can be advanced against a skin-piercing site to produce a droplet of bodily fluid. A transport medium is positioned sufficiently close to the lancing medium to retain a droplet of bodily fluid therebetween by capillary action. One of the two mediums has hydrophobic material on its surface and the other hydrophilic. Various mechanisms are provided for relatively displacing the lancing and transport medium to move the droplet of bodily fluid away from the skin-piercing end. Furthermore, multiple lancet assemblies may be provided in a barrel or disk configuration and indexed to the displacing mechanisms for sampling a skin site.

Abstract: The present invention is directed to an intracorporeal device, preferably a guidewire, and method for making the device. The guidewire of the present invention is formed, at least in part, of a composite elongate core formed, at least in part, of precipitation hardened material. The elongate core members of the present invention will have an ultimate tensile strength and modulus of elasticity greater than the same for an identically dimensioned elongate member formed from superelastic NITINOL alone.

Abstract: A method and apparatus for measurement and distinguishing between brawny and pitting oedema comprises a measurement head including a tactile sensor to measure a first characteristic of the oedema and a force decay sensor mounted adjacent the tactile sensor, to measure a second characteristic of the oedema so as to distinguish brawny oedema from pitting oedema. The tactile sensor may be a resonance oscillating sensor which may determine frequency shift, and the forced decay sensor may provide information regarding the degree of displaced fluid as a measure of pitting oedema through measurement of decay of force.

Abstract: A method of treating tissue within a body includes aiming an ultrasound transducer towards target tissue, and delivering ultrasound energy towards the target tissue to thereby reduce pain at the target tissue. A method of treating tissue within a body includes aiming an ultrasound transducer towards target tissue, and delivering ultrasound energy towards the target tissue to increase nitric oxide at the target tissue. An ultrasound system includes a first ultrasound transducer for emitting ultrasound energy from outside a patient, and drive circuitry coupled to the first ultrasound transducer, wherein the drive circuitry is configured to generate a drive signal at a frequency that is between 20 kHz and 100 kHz for the first ultrasound transducer.

Abstract: An endoscopic lithotripsy probe apparatus includes a probe, ultrasonic-vibration source, mechanical shock generation source, and switch-mechanism. The ultrasonic-vibration source is detachably attached to the probe to transmit an ultrasonic-vibration to the probe in a state in which the proximal end of the probe is connected to the ultrasonic-vibration source. The mechanical shock generation source, which is disposed on the side of the proximal end of the probe, applies a force to the ultrasonic-vibration source in a state in which the ultrasonic-vibration source is detached from the proximal end of the probe, and allows the ultrasonic-vibration source to collide with the proximal end of the probe so that a mechanical shock is applied to the probe. The switch-mechanism switches a state in which the ultrasonic-vibration from the ultrasonic-vibration source is transmitted to the probe and a state in which the mechanical shock from the mechanical shock generation source is transmitted.

Abstract: A method for generating power from an exerted energy associated with muscles acting across a joint is provided. The method including: absorbing energy during one or more periods of a periodic motion of the joint in which energy is absorbed by the muscles; and at least partially returning the absorbed energy to one of an energy storage device or power consuming device.

Abstract: In one embodiment, a method for improving the cardiac output of a patient who is suffering from pulseless electrical activity or shock and yet still displays some myocardial wall motion comprises sensing myocardial activity to determine the presence of residual left ventricular pump function having a contraction or ejection phase and a filling or relaxation phase. In such cases, a compressive force is repeatedly applied to the chest based on the sensed myocardial activity such that the compressive force is applied during at least some of the ejection phases and is ceased during at least some of the relaxation phases to permit residual cardiac filling, thereby enhancing cardiac output and organ perfusion. Also incorporated may be a logic circuit capable of utilizing multiple sensing modalities and optimizing the synchronization pattern between multiple phasic therapeutic modalities and myocardial residual mechanical function.

Abstract: A wall-mounted back massager adapted to allow a user to self-administer a massage is disclosed. The inventive wall-mounted back massager comprises: an elongated wall mount track vertically positioned on a wall; a vertically adjustable elongated base member slidably engaged to the wall mount track; a plurality of swivel head assemblies attached in series along the elongated base member; and at least first and second pairs of spaced apart and axially aligned wheels rotatably attached to each of the plurality of swivel head assemblies by respective first and second wheel axles. Each swivel head assembly is pivotably between first and second swivel head positions. In this configuration, vertical movement of a person's back due to bending and straightening of their knees effects movement of the swivel head assemblies and attached wheels relative to the person's back, thereby allowing the person to enjoy a self-administered massage.

Abstract: The present invention relates to a medical apparatus for spinal therapy, which is a bed-type apparatus equipped with a treatment head and performs message and acupressure while moving along the length of the spine, and more particularly to a fixing structure of a treatment head in the medical apparatus, which wears out slowly and allows the treatment head to move in a vertical direction. The medical apparatus for spinal therapy having the fixing structure of a treatment head is advantageous over known apparatuses in that it can give various types of stimulation to human body parts and incurs lower maintenance expenses.

Abstract: A reversible wrist and thumb support is formed of a sleeve of resiliently stretchable material and includes an optionally detachable thumb support coupled to the sleeve. The thumb support includes a plurality of removable battens formed of a semi-rigid material and disposed along the posterior of a wearer's thumb. A resiliently deformable support pad is disposed on an underside of the splint and a removable stiffening semi-rigid batten that optionally includes padded surfaces, is disposed in a pocket on the top side of the support. The reversible wrist and thumb support may be worn on either the wearer's left or right hand, and the battens need not be removed when the reversible wrist and thumb support is turned inside-out.

Abstract: A quick-release mechanism for disconnecting the footwear and footplate of an orthoses from a rotation bar, 90-degree bar, or other component of an orthosis is disclosed. The mechanism allows the footwear to be fitted to a patient with the bar or other component disengaged, while also allowing the angle between the bar or other component and the footplate to be locked when the orthosis is in place in order to treat conditions such as clubfoot.

Abstract: A dressing having a flexible sleeve shaped to accommodate a substantially cylindrical body or plant portion, the sleeve having a lining which is substantially non-adherent to the body or plant part being bandaged and having a peripheral securement means which attaches two peripheral portions to each other without those portions being circumferentially adhered to the sleeve portion.

Abstract: An ultrafiltration device adapted to be worn on a portion of the body of a patient includes a blood inlet tube leading from a first blood vessel, a blood pump, an anticoagulant reservoir for infusing anticoagulants into the blood, a blood filter including a substrate through which the blood is circulated and filtered, a fluid bag for storing the excess fluid and a blood outlet tube leading to a second blood vessel.

Abstract: Catheter apparatus for performing diagnostic and therapeutic modalities in the biliary tree includes a catheter with multiple lumens. A first lumen is adapted to receive a guidewire and can serve as a transport lumen for contrast agent. A second lumen carries a cutting wire for performing a sphincterotomy. A third lumen can be used as an inflation lumen for a distally located balloon. Expansion of the balloon occludes a portion of the biliary tree and allows the catheter to sweep any gallstones through the sphincter of Oddi into the duodenum.

Abstract: A surgical system that is able to sense the onset of an occlusion or other surgical event as well as the instant an occlusion breaks. To help avoid overheating of the tip, the system determines a temperature of an eye using irrigation flow rate and reduces the power to the handpiece automatically if an overheating situation is predicted. Alternatively or in addition, the system monitors the power drawn by the handpiece, which is indicative of the cutting load on the tip, and automatically adjusts the power or stroke of the tip to compensate for increased loads on the tip.

Abstract: A handpiece having at least one set of piezoelectric elements polarized to produce longitudinal motion when excited at the relevant resonant frequency. The piezoelectric crystals are connected to an ultrasonic horn to which a cutting tip is attached. The horn and/or the cutting tip contains a plurality of diagonal slits or grooves. The slits or grooves produce optimized torsional movement in the cutting tip when the piezoelectric crystals are excited at a second resonant frequency.

Abstract: Prevention of Acute Renal Failure following myoglobinemia in cases of rhabdomyolysis by means of trapping myoglobin released to circulation following striated muscles injury using a temporary intravenous filter, hence prophylaxis of Acute Renal Failure, which commonly follows this situation. It is directed to all cases of rhabdomyolysis especially for “In situ prevention” in cases of disasters, crush injuries, and reperfusion injury in a limb.

Abstract: A wireless communication system from an IV medication infusion pump to a hospital information management system (HIMS) is disclosed. The system includes an IV pump having pump operation circuitry for monitoring pre-selected characteristics of pump operation indicative of IV administration of medication to a patient. A transmitter or transceiver is connected to the pump operation circuitry for receiving a wireless pump signal representing instructional data to the IV pump and for transmitting a wireless pump signal representing the pre-selected pump operation characteristics. The wireless pump transmitter or transceiver communicates with a hospital information management system (HIMS). The HIMS includes a receiver or transceiver capable of transmitting and receiving the pump signal representing the pump operation characteristics and also includes a computer processor capable of storing and displaying the pump operation characteristics that are represented by the received wireless pump signal.

Abstract: The present invention relates to a multi-function catheter assembly for treating arterial plaques. The multifunction catheter comprises a flexible tubular catheter body, an inflatable balloon assembly capable of multi-stage inflation at a distal end of the catheter body, at least one fluid delivery conduit formed on the catheter body, and at least one balloon control conduit formed within the catheter body. The balloon, when inflated to a first stage inside a vessel at the treatment site, defines a chamber between the balloon and the vessel wall. The at least one fluid delivery conduit is adapted to permit the delivery of an agent into the chamber to dissolve a plaque. After the removal of the plaque, the balloon is further inflated to a second stage to install a stent in the space that is vacated by the plaque. The stent can be a pre-manufactured stent or a customized stent formed by filing the space between the balloon and the treated vessel wall with a fluent composition that is solidified in situ.

Abstract: The present invention relates to a surgical catheter, and more particularly, a balloon catheter having an auxiliary lumen configured to permit the advancement of a functional measurement wire to a treatment site. The auxiliary lumen communicates with a working lumen that is configured to permit the advancement of a guidewire and the functional measurement wire, so that the guidewire and functional measurement wire may selectively be advanced to the treatment site during a surgical procedure.

Abstract: A catheter has a lumen for a thrombectomy device and at least two balloons of different compliancies. In one embodiment, the catheter is adapted to clear dialysis grafts. One balloon is adapted to expand a stenosis at a venous junction of a dialysis graft and another balloon is adapted to pull a stenosis at an arterial junction of a dialysis graft. A single catheter may be used to perform a dialysis thrombectomy procedure.

Abstract: The invention is directed to a method of bonding a hermetically sealed electronics package to an electrode or a flexible circuit and the resulting electronics package that is suitable for implantation in living tissue, such as for a retinal or cortical electrode array to enable restoration of sight to certain non-sighted individuals. The hermetically sealed electronics package is directly bonded to the flex circuit or electrode by electroplating a biocompatible material, such as platinum or gold, effectively forming a plated rivet-shaped connection, which bonds the flex circuit to the electronics package. The resulting electronic device is biocompatible and is suitable for long-term implantation in living tissue.

Abstract: A transdermal transport device includes a reservoir for holding a formulation of an active principle, a needle with a bore through which the formulation is transported between the reservoir and a target area of a biological body, and an impedance sensor. The impedance sensor has an electrode positioned to measure the impedance of a portion of the target area between the needle and the electrode to indicate the depth of penetration of the needle into the target area.

Abstract: A method and apparatus for injecting fluid into areas having high density tissue that creates a high backpressure resistance on the injection device is disclosed. The high backpressure resistance is overcome through a mechanical advantage achieved by using a secondary reservoir having a cross-sectional area smaller than the cross-sectional area of a primary reservoir. Exemplary injection device reservoir housings may comprise a primary reservoir, a secondary reservoir, a check valve, a septum penetrating cannula, travel limits, a pen needle connecting portion, sliding seal guide ribs, a sliding seal, a pen needle assembly, a needle stop, and a patient needle.

Abstract: An injection device comprising an outer housing inside which is located a medicament-holding barrel (9) with a needle (10) at one end thereof, at least part of the needle being moveable in and out of the outer housing, a plunger (8) moveable within the barrel, an inner housing (7) intermediate the outer housing (6) and the barrel and plunger and an energy source (1) in communication with said inner housing. The inner housing is moveable by the energy source between a first position in which the plunger and barrel are movable axially so as to move at least part of said needle out of the outer housing; a second position in which the plunger is movable axially into said barrel so as to expel medicament through the needle; and a third position in which the plunger and barrel are able to retract in order to retract the needle into the outer housing.

Abstract: A seal is provided for effectively inhibiting the egress of fluids from the working channel of an endoscope when an elongate device having a region with a non-circular cross-sectional shape is disposed therein. The seal has a body portion with a proximal end adapted for insertion of the elongate device, a distal end adapted for connection to the proximal end of the endoscope, and a wall defining a lumen adapted to receive the elongate device and to provide access to the working channel of the endoscope. The seal includes a sealing element for sealing the region of the elongate device with a non-circular cross-sectional shape. The sealing element conforms to the profile of the non-circular region.

Abstract: A prefilled medical syringe includes a syringe barrel. A syringe plunger is disposed in the barrel and displaceable by means of a plunger rod. An end plug closes off a cannula side of the syringe barrel. The plug is provided with a through-channel closed off by a membrane. A finger support is disposed at the end of the syringe barrel opposite the end plug and provided with a through-opening for the plunger rod. A thread system cooperates with the plunger rod and the finger support. The thread system includes a thread sleeve detachably connected with the finger support. The thread sleeve is provided with an inner thread that cooperates with an outer thread on the plunger rod.

Abstract: A needle having a shaft with a distal end defining a distal opening. The shaft has a longitudinal axis that extends through the distal opening and the distal opening has a projected area that is smaller than a cross-sectional area of a section of the shaft proximal to the distal end of the shaft. Also provided are methods of directly delivering a therapeutic agent to a target site using a Huber needle or pencil-point needle.

Abstract: A wound therapy and tissue management system utilizes fluid differentiation. Fluid is differentiated by establishing a gradient within the system. A gradient can be established with matter or energy. Patient interfaces for establishing, maintaining and varying one or more gradients include transfer elements with first and second zones having different flow coefficients. The transfer elements exchange fluid with a patient, generally through a wound site, and with external components of the system. Osmotic solution gradients are controlled by a methodology involving the present invention for extracting solutions, which can include toxins, from patients and for introducing fluids and sumping air to wound sites.

Abstract: The take-off needle comprises a main hollow lance having a distal end adapted to perform a pricking operation, said hollow lance being connected to two pipes each provided with a spigot for it to be connected to a tube, said needle further comprising a body for holding the main hollow lance, said holding body defining two internal cylindrical surfaces forming said pipes, the main hollow lance comprising, at its proximal end, a sleeve having an internal channel of which the distal end is connected to the proximal end of the main hollow lance, and of which the proximal end opens into the holding body, said sleeve comprising at its proximal end two crescent-shaped surfaces inclined towards the interior of the internal channel and towards the distal end of the sleeve, each of said crescent-shaped surfaces being disposed so as to extend in line with one of the internal cylindrical surfaces of the holding body.

Abstract: In certain embodiments, a vial adaptor for removing liquid contents from a vial comprises a piercing member and a bag. The bag can be contained within the piercing member such that the bag is introduced to the vial when the vial adaptor is coupled with the vial. In some embodiments, the bag expands within the vial as liquid is removed from the vial via the adaptor, thereby regulating pressure within the vial. In other embodiments, a vial comprises a bag for regulating pressure within the vial as liquid is removed therefrom. In some embodiments, a vial adaptor is coupled with the vial in order to remove the liquid. In some embodiments, as the liquid is removed from the vial via the adaptor, the bag expands within the vial, and in other embodiments, the bag contracts within the vial.

Abstract: Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies.

Abstract: A carrier catheter (20) for the introduction and positioning or changing of one or more guidewires (GW1, GW2, GW3) or interventional devices in a vessel V in the body of a subject. The catheter (20) includes an elongated, thin flexible body (22) having a primary lumen (24) and ancillary lumens (26, 28). Each lumen has an opening at the proximal end and an opening (30, 32, 34) at the distal end to permit a guidewire or device to extend through and exit the lumen. The openings at the distal ends of the lumens are positioned so that the respective guidewires or interventional devices can exit the lumens at different locations along the distal end of the catheter. One introduction of the device allows the deployment of any combination of multiple guidewires and interventional devices. The catheter can be used for a rapid replacement of an indwelling catheter or rapid replacement of a dedicated guidewire.

Abstract: A self-sealing male Luer connector attaches to any standard female Luer valve to open a flow channel between the two. The self-sealing male Luer connector includes a rigid housing having a distal end with a rigid male Luer connector and a proximal end at which a proximal seal is formed. The distal end of the housing includes a valve seat. Located within the housing is a resilient biasing member that biases an actuator into contact with the valve seat to prevent fluid flow through the male connector. Upon engagement with a female connector, the actuator is moved in the proximal direction to open the distal valve and then the proximal seal. A partial vacuum is formed within the male connector upon disengagement with the female connector that draws any fluids on the external surface of the distal end of the male Luer connector into the male tip.

Abstract: The variable stiffness heating catheter includes a heating catheter shaft including at least one electrically conductive member, a reinforcing tube with apertures formed around the surface of the reinforcing tube, and at least one coaxial outer layer of a polymer, metal, or both for providing desired variations in stiffness along at least a portion of the length of the shaft. The apertures can be formed as axial or helical slits in the surface of the reinforcing tube, and the reinforcing tube can also be formed to be tapered at the point where the apertures are formed in the reinforcing tube to provide a heating catheter that is torqueable and pushable at the proximal end, yet soft and flexible at the distal end.

Abstract: The invention provides a non-invasive method for treatment of arrhythmia. In a first aspect, a method for treatment of atrial fibrillation in a heart of a patient comprises directing radiation from outside the patient toward one or more target treatment regions of the heart so as to inhibit the atrial fibrillation. The radiation may induce isolation of a pulmonary vein.

Abstract: The invention provides a medical device that includes a housing, a tubular member extending from the distal end of the housing, a first arm extending from the distal end of the tubular member, the first arm including a first electrode, a second arm extending from the distal end of the tubular member, the second arm including a second electrode and being disposed coaxially with the first arm, at least one solution infusion opening on each electrode, and a solution delivery channel for delivery of a conductive solution to the solution infusion openings. According to the invention, at least one of the first arm or the second arm is translationally moveable, and at least one of the first arm or the second arm is adapted to be coupled to a source of radiofrequency energy. The invention also provides a corresponding method for treating blood vessels or other tissues of the body.

Abstract: A coagulating cutter according to the present invention comprises: a transmitting member for transmitting energy, for treating living body tissue, to the living body tissue; an outer sheath through which the transmitting member is passed; and a grasping section supported at the tip end portion of the outer sheath so as to be capable of turning with respect to the transmitting member, which allows the living body tissue to be grasped against the transmitting member.

Abstract: A pin allows for convenient and noninvasive adjustment and tightening relative to the bone to correct and/or avoid loosening of the pin and attached external fixator. In one embodiment, the pin includes a shank extending from a head toward a distal tip end of the pin. Adjacent to the distal tip of the pin is a threaded region with a varying pitch and the shank of the pin is tapered or conical having an increasing minor and/or major diameter along the pin from the tip end. In an alternative embodiment, an anchor is provided on the distal tip for engagement with the far cortex of the bone. The anchor includes a tapered region proximate the tip that decreases in diameter. A split ferrule, expansion bushing or collar is seated on the tapered region. The shank of the pin also includes a threaded region on which a washer and nut are engaged for rotational movement longitudinally on the shank.

Abstract: A vertebral stabilization assembly for stabilizing vertebrae is provided. The vertebral stabilization assembly includes a first and a second pedicle screw, a first and second connecting screw, and a connecting member. The first and second pedicle screws each have a shaft provided with a threaded portion operable for threading engagement of the first and second pedicle screws with a first and second vertebra, respectively, each shaft also has an engaging portion. The first and second connecting screws each have a first end adapted to be received by the engaging portions of the first and second pedicle screws, respectively. The connecting member has a first end connected to the first connecting screw and a second end connected to the second connecting screw for stabilization of the first and second vertebra. A guide member for placement of the connecting screw and method for anteriorly stabilizing vertebrae is also provided.

Abstract: A method of implanting a vertebral implant in a void between a pair of vertebral endplates comprises positioning the vertebral implant between the vertebral endplates and coupling an implantation tool to the vertebral implant. The method further comprises actuating the implantation tool to generate alternating motion relative to the vertebral endplates. The alternating motion has a speed and creates a displacement of the vertebral implant. The method further comprises seating the vertebral implant into a profile formed in at least one of the vertebral endplates and decoupling the implantation tool from the vertebral implant. The vertebral implant remains implanted in the at least one vertebral endplate.

Abstract: A method and device for cutting orthopedic cable including tensioning and crimping the cable in a desired position within a surgical cavity. A free end of the cable is inserted a device with two coaxial members having coordinating shearing faces. The shearing faces are moved along the cable to a position proximate a portion of the cable to be cut. Cutting is achieved is by rotating the coaxial members with respect to one another.

Abstract: A medical retrieval device is used to retrieve and/or fragment stones (and/or other objects) from the body of a patient. The device has a retrieval basket with a releasable tip. The tip release is designed to release in a controlled pre-determined manner and under a pre-determined force before any other component of the device fails due to a force exerted on the basket.

Abstract: A compression and ligation device includes a pair of jaws including one or more Doppler chips oriented to send and receive Doppler signals across the jaws, to assist a practitioner in determining whether or not a uterine artery is between the jaws. A suture leader with an attached suture can be pushed through a channel on one of the jaws, through tissue behind the uterine artery, into another channel on the other jaw, and proximally out the device so that the practitioner can ligate the artery and effect hemostasis.

Abstract: A device for occluding a hollow anatomical structure includes a clamp having at least first and second clamping portions adapted to be placed on opposite sides of the anatomical structure. At least one of the first and second clamping portions is movable toward the other from an open position to a clamping or closed position to occlude the anatomical structure. The clamp has an annular shape configured to surround the hollow anatomical structure in the open position and a flattened shape in the clamping position configured to occlude the hollow interior of the anatomical structure. The clamp is preferably covered with fabric to promote tissue ingrowth. A clamp delivery and actuation device is provided for allowing the clamp to be applied in either an open surgical procedure or a minimally invasive procedure.

Abstract: Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues, organs, anatomical structures, grafts or other structures within the body of human or animal subjects for the purpose of treating a diseases or disorders and/or for cosmetic or reconstructive purposes and/or for research and development purposes or other purposes.

Abstract: A surgical instrument for applying an anastomotic ring device comprises a handle connected to an anastomotic ring deployment mechanism by a shaft. The shaft has at least one articulation joint that is capable of articulating in at least one direction to allow the surgeon to alter the angle of approach in order to compensate for disadvantageous placement of a trocar port through which the instrument is inserted. An articulation joint may comprise a ribbed member. One or more cables may be used to effect articulation of the articulation joint.