Abstract: An apparatus for performing surgery using plasma is described. The apparatus includes a plasma generating unit, a plasma wand and a foot pedal. The plasma wand further includes a disposable tip which may be removed and replaced for each surgical procedure, so as to maintain operating sterility.

Abstract: An electrosurgical pencil is provided which includes an elongated housing, an electrocautery blade supported within the housing and extending distally from the housing. The electrocautery blade is connected to a source of electrosurgical energy. The pencil also includes at least one activation switch supported on the housing which is configured and adapted to complete a control loop extending from the source of electrosurgical energy. At least one voltage divider network is also supported on the housing and is electrically connected to the source of electrosurgical energy.

Abstract: The present invention provides instrumentation that facilitates access to both sides of the vertebral body from a single access point. More particularly, the present invention provides bendable access devices that can be steered so as to traverse the vertebral body from the point of entry into the vertebral body, through the cancellous bone within the vertebral body, and to the contralateral side of the vertebral body. This steerability is provided by forming the access device with a series of slots, grooves, or notches in the side of the access device near the distal end of the access device, which slots, grooves, or notches reduce the bending stiffness of the access device. As a result, the distal end of the access device bends as it is being advanced into the vertebral body.

Abstract: The present invention relates to limited incision total joint replacement methods for performing surgery on a joint in a patient's body, such as a knee. In one embodiment, an incision is made in a knee portion of one leg while a lower portion of the one leg is extending downward from an upper portion of the one leg and while a foot connected with the lower portion of the one leg is below a support surface on which the patient is disposed. The incision is relatively short, for example, between seven and thirteen centimeters. A patella may be offset from its normal position with an inner side of the patella facing inward during cutting of a bone with a cutting tool. During cutting of the bone, one or more guide members having opposite ends which are spaced apart by a distance less than the width of an implant may be utilized to guide movement of a cutting tool.

Abstract: A method and apparatus for repairing isolated chondral defects using synthetic implants. Lesions in articular tissue are corrected by forming a recipient socket in the tissue. A donor graft of a size corresponding to the recipient socket is harvested from a synthetic specimen made of a synthetic tissue material, such as poly (vinyl) alcohol hydrogel. The donor graft is implanted into the recipient socket.

Abstract: A system locates a femoral cutting guide on a distal end of a femur. The femoral cutting guide establishes at least a first reference plane to perform a distal femoral planar cut. The system generally includes a mounting rod operable to insert into the distal end of the femur. An index member is operable to abut the distal end of the femur. A bridge member extends from the index member. A cutting guide member extends from the bridge member. The cutting guide member includes a first channel that establishes the first reference plane. A mounting mechanism releasably couples the cutting guide member to the bridge member. The mounting mechanism is operable to generate a sliding resistance between the bridge member and the cutting guide member that is generally overcome to position the cutting guide member relative to the femur.

Abstract: An expandable body is inserted into an area of cancellous within a vertebral body through a percutaneous access path. A bone filler is conveyed into the expandable body to expand the expandable body and displace cancellous bone and create a cavity occupied at least in part by the expandable body and the bone filler. The expandable body and the bone filler are left within the cavity to strengthen the vertebral body.

Abstract: An improvement in a trialing system and method for use in connection with the implant of a prosthetic joint component having a first part for engaging bone at an implant site to secure the component at the implant site, and a second part for enabling articulation of the prosthetic joint. A trial first member corresponds to the first part of the component, a trial second member corresponds to the second part of the component, and an offset adapter facilitates selective coupling and uncoupling of the trial first member and the trial second member with the trial second member offset from the trial first member and placed at a selected angular orientation relative to the offset adapter.

Abstract: A translumenal approach through a natural body cavity to repair a ventral hernia is provided. In a transgastric approach, the abdominal cavity is accessed via an incision through a wall of the digestive tract. A system for the deployment of tissue anchors to anchor a tissue reinforcing mesh to repair the ventral hernia is provided. Particular tissue anchors are disclosed. In certain embodiments, the tissue anchors include a shaft and a head reconfigurably coupled to the shaft permitting the head and shaft to be in a substantially parallel loaded configuration and in a substantially transverse deployed configuration. In addition, tissue anchors may include biodegradable and non-biodegradable components, with the non-biodegradable component defining spaces for soft tissue ingrowth upon degradation of the biodegradable component.

Abstract: Methods and devices for cutting strips of tissue from masses of tissue inside or outside of the bodies of human or animal subjects. The device generally comprises a) an elongate cutting tube that has a distal end and a lumen that opens through an opening in the distal end and b) first and second cutting edges formed on generally opposite edges of the distal end of the cutting tube and separated by a distance D. The device is advanced through tissue to cut a strip of tissue of approximate width W. Width W is approximately equal to distance D.

Abstract: A medical instrument includes a flexible sheath, a pivot base, a medical needle knife base, a medical needle knife, and a handpiece. The flexible sheath has a distal sheath portion insertable within a patient and has a proximal sheath portion. The pivot base is attached to the distal sheath portion. The needle knife base is pivotally connected to the pivot base and has a passageway. The medical needle knife is extendable from the passageway and is retractable within the passageway. The handpiece is connected to the proximal sheath portion and includes a manually-operated articulation control operatively connected to the needle knife base for pivoting the needle knife base with respect to the pivot base.

Abstract: Devices, systems and methods for treating disorders characterized by low cardiac output. The devices, systems and methods use intra-aortic balloon counterpulsation in combination with hypothermia of all or a portion of a human or veterinary patient's body to improve coronary perfusion and cardiac output. To effect the hypothermia, a heat exchange catheter may be positioned in the a patient's vasculature separately from the intra-aortic balloon counterpulsation catheter. Alternatively, a combination Intra-aortic balloon counterpulsation/heat exchange catheter may be utilized. Such combination catheter comprises a) a catheter sized for insertion into the aorta, b) a counterpulsation balloon and c) a heat exchanger. A drive/control system receives temperature and electrocardiograph signals and drives the inflation/deflation of the counterpulsation balloon as well as the heating/cooling of the heat exchanger.

Abstract: A hemostatic guiding catheter is biased to curve toward the artery wall and the distal opening is shaped so its edge is congruent with the artery wall. One or more annular balloons are inflated to produce a barrier between the guiding/catheter and the artery wall stopping the flow of blood and thus hemostasis. The annular balloons may be biased to inflate more on the side away from the distal opening thus imparting a force vector toward the distal opening and/or biased to overhang their line of attachment like a foreskin over a penis to allow the hemostatic guiding catheter to move a short distance while the biased balloons maintain hemostasis.

Abstract: A filter device positionable within a blood vessel for trapping emboli in the vessel, the filter device having a head and a plurality of divergent legs each secured at a first end to the head; each leg having one or more hooks at a second end. The hooks can include an expandable and contractible sleeve or hook that provides securing means for the legs and which also allows for easy removal of the filter device.

Abstract: A system for enabling the insertion and removal of an embolic protection device, for capturing and retaining embolic debris which may be created during the performance of a therapeutic interventional procedure in a stenosed or occluded region of a blood vessel. The system, in an embodiment thereof, enables the device to be snap-fitted so as to engage the distal end of a guide wire, to provide a reference for positioning the device at a location distal to the interventional procedure site, and to enable an end of the device to be in tension, enabling a portion of the device to be in tension and another portion to be in compression, so as to assist in bending thereof in tortuous vasculature.

Abstract: A capture device for removal of clots and foreign bodies from vasculature or filtering of particulate from blood flow. The parachute-like capture device is connected to an elongate wire located within a longitudinally elongated tubular member. The invention provides a capture device that is radially expandable and a method for refolding the capture device into a reduced profile during contraction. Thereby, providing an atraumatic retraction of the capture device from within the vasculature.

Abstract: A device and method for closing a percutaneous vascular puncture with anchors at the distal ends of wires temporarily implanted in extravascular tissue adjacent the puncture. The wires are tensioned to draw the tissue together to approximate the edges of the puncture. The wires are retained in that position while the blood in the region of the arteriotomy clots. When hemostasis has been achieved, the anchoring wires then can be removed.

Abstract: A suture anchor and kit for anchoring a suture member to human bone in an interference fit. A suture anchor includes a threaded portion and has a head at the proximal end thereof, the head being generally circular. A tip is located at a distal end of the shank. The shank is at least partially threaded and includes walls defining a reel portion. The shank also includes walls for engaging a suture, the walls for engaging the suture typically adjacent walls defining the reel portion. The head typically includes walls for engaging a drive tool. The kit includes a drive tool for rotating the suture anchor when a suture member is engaged with the walls for engaging the suture such that rotation of the anchor causes the suture material to wrap around the reel portion of the shank.

Abstract: Methods of attaching a soft tissue to an adjacent bone at a defect site are provided. At least one adjustable loop of a flexible construct is passed through the soft tissue. The at least one adjustable loop is passed through a passage construct. A locking member is passed through the at least one adjustable loop and the adjustable loop is reduced about or within the locking member such that the at least one loop is frictionally retained in the passage construct and locked in place by the locking member to thereby secure the soft tissue.

Abstract: Methods and devices for illuminating a surgical space in a patient are provided. A retractor provides a portal or working path for access to a working space location in the patient. The retractor transmits and emits light from a light delivery system to illuminate the working channel and surgical space.

Abstract: An embodiment of a system in accordance with the present invention can include an implant having a spacer with a thickness and a wing, wherein a first configuration of the wing has a first height substantially similar to the thickness and wherein the wing is adapted to be selectably arranged in a second configuration such that the wing has a second height greater than the first height. A periphery of the implant has a shape generally conformal with a shape of an inner surface of a cannula and a cross-sectional diameter smaller than an inner diameter of the cannula. The cannula is inserted such that a proximal end of the cannula is arranged between the adjacent spinous processes. The implant is then urged into position between the adjacent spinous processes by way of the cannula, and subsequently arranged in a second configuration to fix the implant in position.

Abstract: The cross connecting device includes a bar arm coupled to one of a pair of posterior rods or spinal fixation rods and a rod arm coupled to the other of the pair of the rods. The bar arm and rod arm are coupled together by a connector or coupling device. The coupling device has a shank extending through a bore in the bar arm and a connector bore through which a protrusion on the bar arm extends. The bar arm is rotationally movable in the connector bore. The shank is rotationally and translationally movable in the bar arm bore. The coupling device is vertically movable through the bore. The protrusion is rotationally and translationally movable in the connector bore. The cross connecting devices are coupled to the rods by a pair of opposing surface to surface contacts formed by a surface of a hook end and a surface of a pad.

Abstract: The present invention relates to a vertebral fixing system adapted to be mounted on a vertebra of the spine to connect it to a rod. Said fixing system comprises: a connecting part adapted to face the rib and/or said transverse process and to be connected to said rod; an elongate flexible ligature adapted to connect together said connecting part and at least one rib and/or one transverse process; and adjustable locking means fastened to said connecting part and adapted to fix simultaneously in position said connecting part relative to said rod and at least one portion of said ligature relative to said connecting part, so as to prevent relative displacement of said rod and said vertebra in opposite directions.

Abstract: The present application is directed to a device for connecting an elongated member within a patient. The device includes a body with a receiving section to receive the elongated member, and an engagement section to engage a support structure, such as a vertebral member. The receiving section is sized to receive the elongated member in a first orientation. The process of securing the elongated member within the receiving section causes the device to pivot about the elongated member to a second orientation. This pivoting motion causes the engagement section to more securely attach to the support structure.

Abstract: Provided is a lipolysis device using a low power laser, and more particularly, to a lipolysis device using a low power laser capable of non-invasively irradiating skin with a laser beam which may or may not be condensed through a lens or transparent window to obtain the same effect as lipolysis of adipose tissue exposed through incision using a conventional ultrasonic or low power laser. In addition, the lipolysis device includes a vacuum suction means to readily discharge liquefied fat discharged from an adipose cell and concentrated in a space between cell tissues through the groin area, where lymphatic vessels are abundant, and out of the body. Further the lipolysis device can stably contact human skin to break down fat and thus is convenient to use. Furthermore, the lipolysis device can break down subcutaneous fat by irradiating an abdominal region with a low power laser without skin damage or surgical operation, thereby effectively removing abdominal fat.

Abstract: A portable thermal therapeutic apparatus, adapted to transfer heat between a creature and the atmosphere by circulating heat transfer fluid within a conduit held in contact with the creature. The apparatus includes a housing with a support structure that is particularly adapted for portable use. A heat pump is disposed within the housing, and operates to transfer heat between a first portion and a manifold. A heat sink is thermally coupled to the first portion, and transfers heat between the first portion and the atmosphere. A pump is disposed within the housing and circulates the fluid through the manifold and the conduit. A power supply is disposed within the housing and drives the pump, thereby causing the fluid to circulate within the manifold and the conduit. The power supply is also provides direct current to the heat pump, thereby causing heat to flow from the manifold to the first portion.

Abstract: A medical, electrically powered thermal cover for fitting predominantly the trunk and head of a person experiencing or potentially experiencing traumatic or cold-exposure hypothermia. The thermal cover encases all of the torso and neck, and portions of other body areas. Heating may be distinctly non-uniform, being applied to the body surface only in special regions where the body's capacity for heat uptake may be relatively high. In sum, the system may monitor deep body core temperature, direct heat to the body core where it may be most needed, and controls therapy over time to restore normothermia.

Abstract: An implantable medical device is disclosed comprising a high-density lipoprotein (HDL), recombinant HDL, high-density lipoprotein mimics (HDLm), or a combination thereof. Method are also disclosed for local and systemic administration HDL, recombinant HDL or HDLm for the prevention, treatment, or amelioration of a vascular disorder, disease or occlusion such as restenosis or vulnerable plaque.

Abstract: A catheter device including an elongate catheter shaft comprising a multifilar cable tubing having a proximal portion and a distal portion. At least a part of the distal portion is more flexible than the proximal portion.

Abstract: A delivery system for delivering an endoluminal implant to a distal deployment location inside a body lumen from a proximal access location outside the lumen. The system includes the implant, a catheter, and a slidable sheath having an advanced position in which the sheath covers the implant and a retracted position in which the implant is exposed. The catheter includes a stabilizer having a distal end adjacent the implant proximal end and/or a catheter tip attached to a central core slideably disposed relative to the implant and having a proximal end adjacent the implant distal end. The catheter tip proximal end and/or the stabilizer distal end includes a docking section adapted to releasably engage a portion of the implant. Each docking section has an engagement geometry including a flared engagement surface that extends inside a short axial length of the implant or a pocket having a bottleneck geometry.

Abstract: A endovascular prosthesis for implantation in a body passageway. The prosthesis comprises a tubular wall which is: (i) movable between a first longitudinal length and a second longitudinally length, and (ii) radially expandable for implantation of the prosthesis in the body passageway. In one embodiment, the tubular wall has a longitudinally length which is variable by an “accordion”-like action. In another embodiment, the tubular wall has a longitudinally length which is variable by an “telescoping”-like action. The longitudinal length of the tubular wall may be varied in vivo to optimize deployment of the endovascular prosthesis.

Abstract: A method for repairing a diseased or damaged section of an aorta (i) introduces an intraluminal directing device from a remote access site to a location within a prosthesis at a target site in an aorta where the diseased or damaged section exists, the intraluminal directing device including a deflectable distal region; (ii) establishes a path to a desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the desired fastening site; (iii) introduces from an intraluminal fastener applier, that is introduced along the path established in (ii), at least one tissue-piercing fastener into tissue at the desired fastening site to anchor the prosthesis; (iv) establishes a path to a different desired fastening site on the prosthesis by manipulating the intraluminal directing device within the prosthesis to orient the distal region with respect to the different desired fastening site; (v) introduces from an intraluminal fa

Abstract: A drug-coated stent and a method for fabricating the stent are disclosed. The stent has an originally flat pattern and connection points where the sides of the flat pattern are joined. The method includes the steps of a) cutting a stent pattern into a flat piece of metal thereby to produce a metal pattern, b) spraying the flat metal stent pattern with a polymer and a drug, c) deforming the metal pattern so as to cause two opposing sides to meet, and d) joining the two opposing sides at least at one point. Substantially no portion of the stent projects into the lumen of the stent when the stent is expanded against the internal wall of a blood vessel.

Abstract: The invention is directed to an expandable stent for implanting in a body lumen, such as a coronary artery, peripheral artery, or other body lumen. The invention provides for an intravascular stent having a plurality of cylindrical rings connected by undulating links. A plurality of inverted cylindrical end rings can be coupled at least in part to a plurality of adjacent cylindrical rings in the form of mirror images such that a symmetrical configuration is present on at least one of a proximal end and a distal end of the stent. The stent has a high degree of flexibility in the longitudinal direction, yet has adequate vessel wall coverage and radial strength sufficient to hold open an artery or other body lumen. The inverted end ring configuration of the stent aims at reducing the stent-to-shoulder distance as well as delivering therapeutic drug to the peri-stent area while maintaining a pristine stent deployment.

Abstract: The invention includes methods of and apparatus for endovascularly replacing a heart valve of a patient. One aspect of the invention provides a method including the steps of endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve in an unexpanded configuration; and applying an external non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to change the shape of the anchor, such as by applying proximally and/or distally directed force on the anchor using a releasable deployment tool to expand and contract the anchor or parts of the anchor. Another aspect of the invention provides an apparatus including a replacement valve; an anchor; and a deployment tool comprising a plurality of anchor actuation elements adapted to apply a non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to reshape the anchor.

Abstract: An improved stent design and stent delivery catheter assembly for repairing a main vessel and a side branch vessel forming a bifurcation. The stent includes rings aligned along a common longitudinal axis and connected by links, where the stent has one or more portals for aligning with and partially expanding into the opening to the side branch vessel. The stent is implanted at a bifurcation so that the main stent section is in the main vessel, and the portal section covers at least a portion of the opening to the side branch vessel. A second stent can be implanted in the side branch vessel and abut the expanded central section to provide full coverage of the bifurcated area in the main vessel and the side branch vessel. Radiopaque markers on the stent and on the tip of the delivery catheter assist in aligning the portal section with the opening to the side branch vessel.

Abstract: In at least one embodiment, a stent comprises a plurality of interconnected framework members defining a plurality of cells. A portion of the interconnected framework members comprise a side branch structure defining an inner side branch cell that is shaped differently than other cells of the stent. The side branch structure comprises a first serpentine ring extending around the inner side branch cell. The first serpentine ring comprises alternating inner turns and outer turns connected by straight struts. The inner turns are distributed around a reference circle centered upon a side branch center point. The side branch structure further comprises a second serpentine ring extending around the first serpentine ring. The second serpentine ring comprises alternating inner turns and outer turns connected by straight struts. The second serpentine ring has the same number of inner turns and outer turns as the first serpentine ring.

Abstract: In some embodiments, a stent comprises a side branch structure defining an inner side branch cell. The inner side branch cell has a shape that is different from any other cell of the stent. The stent further comprises first and second support members, which are positioned on opposite sides of the side branch structure. The first and second support members each have a strut width that is greater than the width of a strut included in the side branch structure. The stent further comprises first and second connecting members, which are positioned on opposite ends of the side branch structure. Each connecting member is connected at one end to the first support member and is connected at the other end to the second support member. Each connecting member comprises a serpentine structure having a plurality of straight struts and turns. One or both of the connecting members includes at least one straight strut that has a length that is at least ten times its width.

Abstract: Methods implant one or more fastening structure(s) in a targeted body region, e.g., within a hollow body organ or an intraluminal space. The fastening structure(s) are implanted to a vessel wall, and serve to secure a prosthesis within the hollow body organ or intraluminal space.

Abstract: The present invention, in an exemplary embodiment, provides a stent, which combines many of the excellent characteristics of both silicone and metal stents while eliminating the undesirable ones. In particular, a principal objective in accordance with the present invention is to provide a family of stents where the relative hardness/softness of regions of the stent can differ from other regions of the stent to provide additional patient comfort and resistance to compression forces. Exemplary embodiments provide a stent that is covered so as to provide certain predefined characteristics. In particular, a covered stent is provided that is coated internally such that the outer scaffolding surface of the stent has enhanced friction points while the internal surface exemplifies certain characteristics.

Abstract: Apparatus for endovascularly replacing a patient's heart valve, including: a replacement valve adapted to be delivered endovascularly to a vicinity of the heart valve; an expandable anchor adapted to be delivered endovascularly to the vicinity of the heart valve; and a lock mechanism configured to maintain a minimum amount of anchor expansion. The invention also includes a method for endovascularly replacing a patient's heart valve. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve; expanding the anchor to a deployed configuration; and locking the anchor in the deployed configuration.

Abstract: Annuloplasty rings optimally sized to take into account more of the common degenerative valve pathologies. Each ring has a structural ring body with a shape that complies with predicted shapes of degenerative valvular diseases, such as fibroelastic deficiency (FED), Marfan's or Barlow's. The predicted shapes are obtained through careful echocardiographic and intraoperative measurements, and often differ for different annulus orifice sizes. For instance, in mitral rings the larger rings have larger minor axis and oblique axis dimensions relative to their major axis dimensions, and are more circular as opposed to D-shaped. The rings may also be three-dimensional and the relative heights around the rings may change for different sized rings. A mitral ring may have a higher anterior saddle relative to a posterior saddle, with the relative heights varying across the ring sizes. The ring may have varying flexibility around the ring periphery which also changes for different ring sizes.

Abstract: A suture locking assembly for use with a heart valve repair device. The suture locking assembly including a rim and a suture band. The rim defines a first flange and a second flange spaced from the first flange. The rim is configured to extend at least partially around a periphery of the heart valve repair device. The suture band is maintained between the first flange and the second flange. The suture locking assembly is configured to securely maintain a suture segment that is pulled from a first position to a second position relative the suture locking assembly, the second position being at least partially defined near an outer periphery of the rim.

Abstract: A spinal implant include a top, wherein at least a portion of the top is configured to contact a first vertebra, a bottom, wherein at least a portion of the bottom is configured to contact a second vertebra, a side having a releasable attachment to receive an insertion device and a cam surface to engage a cam on the insertion device.

Abstract: An intervertebral disc device is provided to support or repair one or both of the disc annulus and the disc nucleus. The intervertebral disc device includes an annulus support and an elongated member to support the disc nucleus. The disc annulus support has an elongated wire and an annulus closure. The disc nucleus has an elongated member that is expandable. Any of the devices can be loaded with biologics. Moreover, any of the devices may include a scarring factor to promote fibrous growth.

Abstract: Insertion methods for placing dynamic interbody devices between a first vertebra and a second vertebra using a posterior approach are provided. In an embodiment, the insertion method may be based on the first vertebra. A bridge assembly may be attached to tap shafts positioned in the first vertebra. The bridge assembly may establish an insertion angle of implants into a disc space between the vertebrae. In an embodiment, the insertion method may be based on the position of expandable trials positioned between the vertebrae. The trials may be positioned and a bridge assembly may be coupled to the expandable trials and taps positioned in the first vertebra. One or more posterior stabilization systems may be coupled to the vertebrae after insertion of the dynamic interbody devices between the vertebrae.

Abstract: The invention relates to an intervertebral disk implant having two implant plates contacting prepared vertebral body surfaces in the implanted state and an implant core which can be introduced between the implant plates. The invention further relates to a method for the manufacture of an intervertebral disk implant.

Abstract: Systems for minimally invasive disc augmentation include an anulus augmentation component and a nucleus augmentation component. Both are suited for minimally invasive deployment. The nucleus augmentation component restores disc height and/or replaces missing nucleus pulposus. The anulus augmentation component shields weakened regions of the anulus fibrosis and/or resists escape of natural nucleus pulposus and/or the nucleus augmentation component. Methods and deployment devices are also disclosed.

Abstract: Disclosed is a set of prosthetic components for use in shoulder replacements. A glenoid component having a base and a plurality of coupling members are disclosed. The coupling members are used to couple the base to at least one of the acromion or coracoid process. A polymer insert which is configured to couple to the base member and articulate with a humeral component is provided.

Abstract: The present invention provides a cannulated hemi-implant with a base and a threaded stem for fixing the stem of the implant within a medullary canal of a phalanx or other bone in the foot. The implant includes a tri-part head capable of both cutting bone and self-threading, with bone forming the medullary canal of a phalanx of a human foot. The present invention also provides a hand tool which engages and rotates the implant within the medullary canal of the phalanx. The present invention further provides a method of surgically implanting the implant in the medullary canal of the phalanx or other bone.