Abstract: A flat implant, particularly a hernia mesh, has the form of a textile net having an opening and made from non-resorbable monofilament yarns. The net includes yarns of different thicknesses which run parallel to each other.

Abstract: An improved method for marking a breast cyst or a breast biopsy site, using the steps of: inserting a first needle into the breast cyst or the breast biopsy site; removing fluid from the breast cyst or tissue from the breast biopsy site; inserting a second needle into the cyst or the breast biopsy site that includes a clip; pushing an actuator and a driver of the second needle along an inside portion of the second needle so that the clip travels down the inside portion of the second needle; and expelling the clip along a ramp that is in alignment with a hole in the first needle and the second needle resulting in the insertion of the clip into the breast cyst or the breast biopsy site to mark the same.

Abstract: The invention provides an applicator for forming a hole in a wall of a hollow organ and for connecting a hemostatic connection assembly to the hollow organ, wherein, when the hole is formed in the wall of the hollow organ, a first fluid seal exists between the hemostatic connection assembly and the wall of the hollow organ and a second fluid seal exists between the hemostatic connection assembly and the applicator, thereby minimizing fluid loss from the hollow organ.

Abstract: A catheter for performing a procedure at a treatment site in the lumen of a blood vessel. The catheter includes an elongate tubular shaft having a proximal bend, a distal bend and a hinge element. A distal portion of the shaft includes a window extending through the sidewall of the shaft between the hinge element and the distal end of the elongate tubular shaft. A working element is disposed within the lumen of the elongate tubular shaft and is configured for performing the procedure through the window at the treatment site. The bends and hinge element are configured to urge the window against a wall of the vessel at the treatment site.

Abstract: The present invention comprises a method of operating an ophthalmic surgical hand piece, providing a series of power pulses to the hand piece, each of the series of power pulses having a first portion that produces torsional movement of a cutting tip and a second portion that produces longitudinal movement of the cutting tip; measuring vacuum pressure; altering the duration of the first portion as vacuum pressure increases; and altering the duration of the second portion as vacuum pressure increases.

Abstract: Instrument and method for removing material from an intervertebral disc. The instrument includes outer and inner tubular members. The outer tubular member defines a passage and a cutting window. The inner tubular member is coaxially disposed within the passage, and defines a central lumen and a cutting tip. The cutting tip forms an open mouth having a plurality of teeth. Upon assembly, the cutting tip is exposed within the cutting window combining to define a shaving head. A manual decorticating implement is coupled to the outer tubular member and defining a scraping surface. A powered handpiece is coupled to the inner tubular member, and the shaving head is inserted into an intervertebral disc and positioned such that the cutting tip contacts targeted material (e.g., nucleus, annulus and/or end plate). The handpiece is activated to rotate the cutting tip relative to the cutting window. Contacted material is sheared between an edge of the cutting window and the teeth of the cutting tip.

Abstract: The present invention relates generally to the field of micro-scale or millimeter scale devices and to the use of multi-layer multi-material electrochemical fabrication methods for producing such devices with particular embodiments relate to shredding devices and more particularly to shredding devices for use in medical applications. In some embodiments, tissue removal devices include tissue anchoring projections, improved blade configurations, and/or shields or shrouds around the cutting blades to inhibit outflow of tissue that has been brought into the device.

Abstract: A lancet is pressed against a puncture needle cartridge while fitting a puncture needle loading inlet of the lancet to the axis of a puncture needle on the puncture needle cartridge. In order to facilitate the operation, one of plural puncture needles, arranged in parallel, is tilted up from its initial position at a predetermined angle, and the puncture needle is guided into a puncture needle holding rod of the lancet. Simultaneously, the puncture needle is pressed up to a position where the rear end part of the needle pushes the bottom surface of a puncture needle loading chamber of the puncture needle holding rod, whereby the puncture needle is loaded. When discarding a used puncture needle, the puncture needle is inserted into a lancet guide member of the puncture needle cartridge, whereby the puncture needle is reliably captured to be discarded.

Abstract: A lancet device for generating a puncture wound in a skin surface, comprising a housing, in which a lancet can be moved on a puncturing path, a lancet drive with a drive rotor that can be driven by a drive spring, a lancet coupling mechanism that transforms a rotational motion of the drive rotor into a puncturing and returning motion of the lancet during a working cycle of the lancet drive, a reference element that is mobile relative to the lancet and relative to the housing and is fixed in a defined position relative to the lancet drive during the puncturing and rests against the surface of the skin with a contact surface thereof such that a puncture wound with a reproducible puncturing depth is generated by the puncturing motion, and a reference element coupling mechanism that is coupled to the lancet drive in order to move the reference element. The invention further relates to a suitable lancet drive assembly for a lancet device of this type.

Abstract: A surgical instrument is provided with a gripping part arranged in a stationary manner on a tubular guide housing having a guide hole and with an actuating lever, which is pivotably mounted thereon and which is in functional connection via a lever arm with a plunger. The plunger is axially shiftable in a mounting housing, via which a tool can be actuated. The plunger has, in its end area located adjacent to the lever arm, a circumferential, radially expanded pushbutton, via which the plunger is guided axially adjustably against the spring force of an axial compression spring in the guide hole of the guide housing. The mounting housing is provided with a ring shoulder for axial fixation in the guide hole of the guide housing.

Abstract: A catheter having a multi-chamber balloon which includes a first chamber having a globular configuration and an adjacent second chamber having a generally cylindrical body portion are sequentially inflatable so when employed to enlarge an opening through a stent deployed at a bifurcation the stent is supported around the circumference of the side-branch opening while the stent wall opening is being enlarged.

Abstract: A surgical suture includes a plurality of intertwined unbarbed filaments defining a longitudinal axis and a barbed filament including an elongate body and a plurality of barbs disposed along a length thereof. The plurality of barbs extends radially outward from a surface of the elongate body, wherein the barbed filament at least partially intertwines with the plurality of unbarbed filaments.

Abstract: The invention pertains to medical devices for anchoring a suture engaged with soft tissue to a bone, the devices including tissue fastening medical devices, bone anchor medical devices, bone anchor driving tools and impactor tools, and procedures for using the same.

Abstract: An implant kit for supporting a spinal column comprises at least first and second support elements (8, 10, 12) for fixation to vertebrae of a spinal column, extending generally along the spinal column between spaced apart vertebrae. The kit includes a plurality of fixation devices for (i) fixing the support elements to one another in an end-to-end arrangement and (ii) fixing the support elements to the vertebrae. At least the first support element is formed from a material which exhibits shape memory properties.

Abstract: A spinal dynamic stabilization device is provided, including at least a main portion, at least a supporting structure, and a sliding bar. The main portion includes a guiding groove. The supporting structure includes two wing portions. The wing portions pivot on the main portion. The sliding bar connects to the supporting structure and moves in the guiding groove. When the sliding bar moves in the guiding groove, the wing portions expand rotatably toward the adjacent vertebrae of the spine of the patient by the sliding bar.

Abstract: A vertebral cleat and a vertebral support system employing the vertebral cleat is provided. Preferably, the vertebral cleat includes a base member having a superior and an inferior surface; an elongate keel portion having a cutting edge thereon depending from the inferior surface of the base member; and a spike portion depending from the inferior surface of the base member, the spike portion having a height that is greater than a height of the elongate keel portion. There is also provided a tool for grasping and implanting the vertebral cleat in a plurality of insertion configurations.

Abstract: This invention relates to interconnection assemblies for use with spinal fixation systems to treat spinal defects. The interconnection assemblies can include various spinal rod connecting members and interconnecting elements to secure the spinal rod connecting members to each other in variable orientations and lengths. The interconnection assemblies can be adjusted to minimize interference with the spinal column, bony processes, and associated neural, muscular, and ligament components of the spine all the while exhibiting a low profile. The interconnecting elements and related components can be provided as a completely assembled unit that does not inadvertently become disassembled prior to or during implantation.

Abstract: A vertebral column implant for the elastic stabilization of motion segments including an elastically bendable connecting element which can be passed through the seats of a number of pedicle screws having offset seat axes and be anchored. The connecting element is bendable elastically about every axis of its cross-section in such a way that the connecting element can be passed through, or inserted in, the seats of the screwheads, one behind the other, even when the seats are not situated on one and the same axis.

Abstract: The present application is directed to vertebral rods and methods of use. In one embodiment, the rod includes upper and lower sections that are separated by an intermediate section. The intermediate section may include one or more members, and may have a variety of configurations. An elastic member may be positioned within the intermediate section. The intermediate section and the elastic member may provide for variable resistance during movement of the upper and lower sections. In one embodiment, the resistance increases the further away the upper and lower sections move from a first orientation.

Abstract: Systems and methods are provided for spinal stabilization with flexible elements and other elements engaged to the vertebrae. Also provided are instruments and methods for insertion of the flexible stabilization elements and other elements and for reduction of displacement between adjacent vertebrae in a minimally invasive surgical approach.

Abstract: A modular system for stabilization the spinal column or other bones includes a first stabilization element, a second stabilization element to be connected to the first stabilization element, and an outer connection element to connect the first stabilization element to the second stabilization element. An end portion of the first stabilization element and an end portion of the second stabilization element each include a structure engaging with a corresponding structure provided in the outer connection element to establish a form-fit connection.

Abstract: A spinal fixation system includes a rod and anchor devices that include a bone engaging fastener having a head defining a spherical socket. A ball insert is placed within the socket and rotated so that the ball insert is juxtaposed with the socket. The anchor device further includes a yoke defining a yoke channel for receiving the rod and a stem engaged to the ball insert captured within the socket. A sleeve disposed between the yoke channel and the fastener head supports the rod. A set screw is operable to clamp the rod against the sleeve and draw the insert into engagement within the socket. A releasable detent defined between the yoke and the fastener head is configured to releasably retain the yoke in at least one discrete position relative to the fastener. Portions of the releasable detent may also exert a frictional retention force against the fastener head.

Abstract: A connector for connecting together elongated members in a side-by-side arrangement. The connector includes a first receptacle for connecting to the first elongated member, and a second receptacle for connecting to the second elongated member. The angular position of the second receptacle may be adjustable relative to the first receptacle to accommodate the elongated members. Further, the connector may be configured to extend between the elongated members and the patient when the connector is implanted in a patient.

Abstract: A method of providing spinal stabilization is provided herein. More specifically, the method includes positioning a plurality of fixation assemblies within a plurality of vertebrae in a trans-lamina orientation wherein each fixation assembly includes a proximal portion configured to securely receive a stabilization element (e.g., a stabilization rod). The proximal portions of the various fixation assemblies can be aligned so as to secure at least one stabilization element in a desired position (e.g., along and above a midline of the patient's spine, adjacent and parallel to the midline). A system for providing spinal stabilization is also provided which utilizes trans-lamina delivery and positioning of fixation assemblies within target vertebrae thereby providing stronger fixation and a significant reduction in associated tissue damage.

Abstract: A retraction device comprises at least one retracting blade and a pedicle screw. The retracting blade has a distal end having at least one projection with a passage for engaging a retention pin. The pedicle screw has a threaded body and a movable head. The movable head has at least one recess with a channel that can be aligned with the passage of the projection.

Abstract: A method and device are provided for reducing abnormal vertebral orientation using a fixation plate that is used in conjunction with a positioning tool to reduce spinal deviation and properly position and secure adjacent vertebrae for fusion of the spine. The disclosed embodiments are particularly useful in minimally invasive surgical techniques such as laterally performed anterolisthesis and retrolisthesis.

Abstract: A resorbable screw fastener and a method of firing with an applicator capable of applying a surgical fastener to tissue in order to form tissue connection to secure objects to tissue, the fastener including a body portion having a helical thread, a head portion disposed at the proximal end of the body portion. The resorbable screw fastener is 100% resorbed in vivo during a period of time ranging from about 14 days to about one year after implantation.

Abstract: A bone screw and method of inserting a bone screw into a bone is disclosed. In one example, the bone screw includes a tip segment for creating a starter hole in the bone. A pilot segment is located proximally of the tip segment for creating a pilot hole in the bone after creation of the starter hole. A threaded segment is located proximally of the pilot segment for fixedly securing the bone screw in the bone. A head is located proximally of the threaded segment for allowing a surgical rod to be fixedly secured to the bone screw.

Abstract: An orthopedic fastener rated to be received into a corresponding bone specimen. The corresponding bone specimen has (1) an overall outer thickness from near cortex to far cortex in a predetermined rated range of outer bone thicknesses, and (2) a predetermined bone hole preparation including an entry portion in the near cortex. The entry portion has a predetermined minimum entry diameter. The fastener provides a tapered portion. When the fastener is operably secured into the far cortex of a bone thickness for which it is rated to be received, the tapered portion of the fastener contacts the entry portion in the near cortex so as to impart no more than about 0.2 mm of radial preload into the bone surrounding the entry portion.

Abstract: A bone screw includes a head portion and shank portion. The shank portion includes a regularly outwardly expanding threaded portion.

Abstract: A system and method of providing a temperature controlled gaseous medium for dermatological applications is described. The gaseous medium may be cooled and applied to an area such as a skin area to provide an analgesic effect thereon. The system and method also include an automated defrost cycle for minimizing the effects of decreased hydraulic diameter due to freezing.

Abstract: A catheter tip has an outer surface section, an inner surface section, a spatial configuration and at least one segment of electroactive polymer. The inner surface section defines a guide wire lumen. The electroactive polymer has an actuated state and a non-actuated state. In an actuated state, the electroactive polymer alters the spatial configuration of the catheter tip.

Abstract: A delivery system is provided with a balloon catheter having a stent mounted thereon. A retention wire is provided to restrain the stent on the balloon of the balloon catheter. The retention wire is coupled to the catheter adjacent the distal end of the stent and adjacent the proximal end of the stent. The retention wire extends along the length of the stent adjacent the outer surface thereof. Thus, the retention wire may restrain the stent from moving longitudinally during inflation of the balloon.

Abstract: An elongate medical body for implanting an embolic coil at a desired position, or retrieving an embolic coil from an aneurysm, includes a flexible wire main body, and an electromagnet provided at a distal end portion of the wire main body. The electromagnet can generate a magnetic field at the distal end portion. An energization state of the electromagnet is switched to attach and detach a spiral embolic coil having a magnetically attractable proximal end portion to and from the distal end portion.

Abstract: Self-expandable, woven intravascular devices for use as stents (both straight and tapered), filters (both temporary and permanent) and occluders for insertion and implantation into a variety of anatomical structures. The devices may be formed from shape memory metals such as nitinol. The devices may also be formed from biodegradable materials. Delivery systems for the devices include two hollow tubes that operate coaxially. A device is secured to the tubes prior to the implantation and delivery of the device by securing one end of the device to the outside of the inner tube and by securing the other end of the device to the outside of the outer tube. The stents may be partially or completely covered by graft materials, but may also be bare. The devices may be formed from a single wire. The devices may be formed by either hand or machine weaving.

Abstract: A stent graft introducer has stent graft releasably retained onto a deployment catheter and a sheath encloses the stent graft. A handle assembly has a handle, a first slide and a second slide. The first slide retracts within the second slide and the second slide retracts within the handle. An actuation arrangement comprises a first longitudinal gear rack on the first slide, a second longitudinal gear rack on the second slide and a ratchet lever assembly on the handle. Actuation of the ratchet lever assembly causes the second slide to fully retract into the handle at which time the ratchet lever assembly engages the first gear rack through an aperture in the second rack and continued actuation causes retraction of the first slide thereby retracting the sheath from the pusher to expose the stent graft.

Abstract: A stent having a transitional section positioned between a middle section with different struts lengths and circumferentially non-aligned peaks, and a symmetrical section that has equal strut lengths and circumferentially aligned peaks.

Abstract: Polymer stents with break-away links and methods of forming the links for improved stent retention on an expandable member during delivery are disclosed.

Abstract: A stent has a first stent body and a second stent body. The first stent body is a rolled stent having a first end and a second end and the second stent body is a tubular stent. The stent has a deployed state, the stent being within a body lumen in the deployed state. The second stent body at least partially disposed within the first stent body when the stent is in the deployed state so that the first end of the first stent body overlaps the second end of the first stent body for a first overlap length.

Abstract: A stent or stent-graft delivery system includes a stent ejection component. The stent ejection component includes a body and an ejection collar. The ejection collar extends from the body in the proximal direction. The ejection collar assists in automatically ejecting a proximal end of a stent when the tapered tip is moved in the distal direction to deploy the stent. A stent or stent-graft delivery system may also include a retain-sleeve landing component. The retaining-sleeve landing component includes a body and a landing collar. The landing collar extends from the body in a distal direction. The landing collar automatically captures a tapered tip of the delivery system when the tapered tip is moved in a distal direction to deploy a stent contained in the delivery system. Upon capture of the tapered tip, the stent ejection component with the tapered tip attached has an atraumatic profile.

Abstract: A valve for use in a body lumen, where the valve includes a valve leaflet with delayed leaflet deployment relative an in vivo implant time. The valve includes a valve frame, a valve leaflet coupled to the valve frame. The valve leaflet includes a commissure that can reversibly seal for unidirectional flow of a liquid through the valve, and a biodegradable adhesive between the valve leaflet and the valve frame to hold at least the commissure of the valve leaflet in a static relationship relative the valve frame for a predetermined time once implanted in vivo.

Abstract: A stent is fabricated utilizing a polymer that is selected for its tendency to degrade from the surface inwardly rather than undergo bulk erosion so as to substantially reduce the risk of large particles becoming detached and being swept downstream. Such polymer is hydrophobic yet has water-labile linkages interconnecting the monomers. Ester or imide bonds are incorporated in the polymer to render the surface degrading materials suitable for use in stent applications. The stent may be coated with such polymer or may be wholly formed therefrom.

Abstract: A prosthesis is provided for implantation at a native semilunar valve of a native valve complex, the native valve complex having three semilunar sinuses and three native commissures. The prosthesis includes a valve prosthesis support, which comprises a support structure comprising exactly three engagement arms that meet one another at three respective junctures. The engagement arms are shaped so as define three peak complexes at the three respective junctures, and three trough complexes, each of which is between two of the peak complexes. Upon implantation of the prosthesis, each of the engagement arms is at least partially disposed within a respective one of the semilunar sinuses, such that each of the peak complexes is disposed distal to and in rotational alignment with a respective one of the native commissures, and each of the trough complexes is disposed at least partially within the respective one of the semilunar sinuses.

Abstract: A compacted vascular implant can be delivered to a target location within a delivery device. During delivery, the implant can be partially released from the delivery device before full deployment. The delivery device can include an elongated support tube, a locking mechanism, and a sheath. The locking mechanism can be provided on the support tube. The sheath can be configured to slide over the elongated support tube and can be configured to cover the locking mechanism and to restrain at least a portion of the implant.

Abstract: Delivery devices and methods for percutaneously delivering a prosthetic valve to the heart of a patient. These prosthetic valves may be configured to provide complimentary features that promote optimal placement of the prosthetic valve in a native heart valve, such as the aortic valve, mitral valve, pulmonic valve, and/or tricuspid valve. The delivery device includes a release sheath assembly housed within an outer delivery sheath. A release sheath component of the assembly captures a portion of the prosthetic valve to the delivery device, and effectuates complete release of the prosthetic valve with retraction of the outer sheath.

Abstract: An intraocular lens is adapted for insertion into a capsular bag having a zonular contact region. The intraocular lens comprises a shape changing optical element and an accommodating element comprising at least one force transmitting element and a plurality of spaced apart contacting elements each adapted to contact a portion of the zonular contact region and transmit compressive displacement radially inward at an oblique angle to the optical element and configured to cooperate with at least one of the ciliary muscle of the mammalian eye, the zonules of the mammalian eye and the vitreous pressure in the eye to effect an accommodating shape and a disaccommodating shape change to the optical element.

Abstract: A soft tissue fixation system, most typically applicable to orthopedic joint repairs, such as anterior cruciate ligament (ACL) knee repair procedures, comprises an implant which is placeable in a tunnel disposed in a portion of bone, wherein the tunnel is defined by walls comprised of bone. A first member is deployable outwardly to engage the tunnel walls for anchoring the implant in place in the tunnel, and a second member is deployable outwardly to engage tissue material to be fixed within the tunnel. The second member also functions to move the tissue material outwardly into contact with the tunnel walls to promote tendon-bone fixation. Extra graft length is eliminated by compression of the tendon against the bone at the aperture of the femoral tunnel, which more closely replicates the native ACL and increases graft stiffness. The inventive device provides high fixation of tendon to bone and active tendon-bone compression.

Abstract: Assemblies of one or more implant structures make possible the achievement of diverse interventions involving the fusion and/or stabilization of lumbar and sacral vertebra in a non-invasive manner, with minimal incision, and without the necessitating the removing the intervertebral disc. The representative lumbar spine interventions, which can be performed on adults or children, include, but are not limited to, lumbar interbody fusion; translaminar lumbar fusion; lumbar facet fusion; trans-iliac lumbar fusion; and the stabilization of a spondylolisthesis.

Abstract: An artificial spinal implant for placement between adjacent vertebrae to replace disk material and to stabilize the involved vertebrae is described. The artificial disk may be disassembled for installation and/or removal for repair, replacement or adjustment, and may be assembled from the front of the spine as individual component parts, thereby permitting alignment of the spine during the assembly process, and the stabilization of the involved vertebrae once assembly has been completed. Further, the components may be chosen from a set of similar components having different sizes, thereby enabling the implant to be tailor fit to the requirements of the patient.

Abstract: A composite interbody device includes superior and inferior endplates with a plastic core molded therebetween. The core includes one or more features for permitting bone growth through the core. Each endplate includes a bone interface side coated with hydroxyapatite, for promoting bone on-growth. Pores in the bone interface sides permit bone in-growth. Core interface sides of the endplates include relatively larger pores for accepting molten material from the core, for example during injection molding, to enhance bonding of the endplates with the core. Each endplate has a central barrier layer for preventing the molten core material from extruding through the core interface pores into the bone interface pores, reserving the bone interface pores for bone in-growth. A method of manufacturing the composite interbody device is also disclosed.