Abstract: The system comprises at least three anchors (2,2?,2?) intended to be attached to the patient and equipped with markers (5,5?,5?), an insertion guide device (6) with an insertion guide (7) intended to be attached to said anchors (2,2?,2?), an external calibration device (8) with at least three calibration markers (10,10?,10?) corresponding to said markers (5,5?,5?) and a planning and imaging software. The planning and imaging software is used to determine the position of a target point in the patient with respect to the markers (5,5?,5?), the calibration device is used to calibrate and orient the insertion guide (7) of the insertion guide device (6) mounted on said calibration markers (10,10?,10?) using the determination of the software before the insertion guide device is mounted on said markers (5,5?,5?) attached to the patient.

Abstract: The present invention generally relates to methods for preparing a skin graft. In certain embodiments, methods of the invention involve harvesting a plurality of skin grafts from a subject, applying the grafts to a first substrate, stretching the first substrate, and transferring the grafts from the first substrate to at least a second substrate for application to a patient recipient site.

Abstract: A surgical staple remover apparatus includes a handle located at a rear of the apparatus, an upward sloped jaw element comprising a pair of parallel jaws, an arm having a hook element on a first end, a pivot point located along the arm, such that the arm pivots about the pivot point, a lever coupled to the arm, wherein moving the lever closer to the handle results in the arm pivoting about the pivot point, the hook element moving downwards towards the jaw element and the arm retracting toward the rear, thereby resulting in the hook element pressing against a crown of a surgical staple and moving the surgical staple towards the rear, and a strip element located on top of the jaw element, such that the surgical staple is moved under the strip element and held in place by same.

Abstract: A digital suture fixation system includes an anchor, an introducer that is attachable to a finger of a person such that at least a distal tip of the finger is available to palpate tissue and identify a landmark within a patient, and a delivery device attached to the introducer. The anchor is removably attached to the delivery device. The anchor is exposed on an exterior of the delivery device and the delivery device is positioned to allow the finger to push the anchor into the landmark.

Abstract: A power driven vessel closure device is configured for closing a hole in a wall of a body lumen. The vessel closure device can include a power operated drive system and a closure element delivery system. The closure element delivery system can be removably, operably, couplable with the power operated drive system. That is, the closure element system can be directly or indirectly attached to and removed from the power operated drive system, or components thereof. The operation of the power operated drive system can operate the closure element delivery system so as to move the closure element within the vessel closure device and deploy the closure element to close the hole.

Abstract: A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. A medical device is used to secure the fastener to the elongate fastening member. The medical device includes a tensioning mechanism for tensioning the elongate fastening member. As crimping mechanism is used to secure the fastener to the elongated member, where a cutting mechanism cut the excess portion of the elongated member.

Abstract: In repairing soft tissue with a bone anchoring instrument (such as reattaching a tendon of a torn rotator cuff), the bone anchoring instrument may be used to anchor the soft tissue to a region of bone. The anchors inserted into the underlying bone may have one or more lengths of suture or wire attached thereto which may be tensioned independently of one another to affix the soft tissue to the bone by having a selector mechanism selectively engage and disengage ratcheted tensioning wheels from one another. Suture loading mechanisms may be employed for passing suture lengths into and/or through the anchors prior to deployment into the bone where such mechanisms may employ suture snares which are configured to reconfigure from an expanded shape through which suture lengths may be easily passed to a low-profile shape which secures the suture lengths within the snare.

Abstract: Medical suturing devices, systems, and methods will be useful for endoscopic or open surgeries, including ear, nose, and throat procedures. Articulation motions may be transferred from a handle to needle grasping jaws using an axial movement of a shaft. Portions of the devices may be disposable, replaceable, and/or reusable, with different needle-grasping jaws and/or different elongate extension bodies having different configurations optionally being selectably coupleably to an articulatable handle and housing so as to allow the user to configure the device for a particular procedure.

Abstract: A pre-rolled surgical mesh which allows its insertion to the abdominal cavity and having a comfortable lead and spread to a proper location. The pre-rolled mesh is double rolled from two opposite directions one toward the other. There is a device that holds, leads, releases and spreads the mesh in its proper location, related to the Hernia defect, and includes an element holds the double-rolled mesh, and allows its releasing; another element allows the spreading of the double-rolled mesh; additional element allows the leading and locating of the double-rolled mesh. A second shape assumed when spreading the mesh, as the center of the mesh matches the desired location, while the elements, which held and spread each side of the double rolled mesh had been released.

Abstract: Apparatus for reconfiguring tissue, the apparatus comprising a shaft having a distal end and a proximal end; at least one effector mechanism movably mounted to the distal end of the shaft, each effector mechanism comprising at least one gripping element for gripping tissue to that effector mechanism, the at least one effector mechanism being configured to capture the gripped tissue against said shaft, at least one actuating mechanism mounted to the proximal end of the shaft, and at least one connection mechanism connecting the at least one actuating mechanism to the at least one effector mechanism, whereby a user may utilize the at least one actuating mechanism to actuate the at least one effector mechanism so as to reconfigure tissue.

Abstract: A system for performing an end-to-side vascular anastomosis, including an anastomosis device, an application instrument and methods for performing a vascular anastomosis. The system is applicable for performing an anastomosis between a vascular graft and the ascending aorta in coronary artery bypass surgery, particularly in port-access CABG surgery. A first aspect of the invention includes a vascular anastomosis staple. A first configuration has two parts: an anchor member, forming the attachment with the target vessel wall and a coupling member, forming the attachment with the bypass graft vessel. The anastomosis is completed by inserting the coupling member, with the graft vessel attached, into the anchor member. A second configuration combines the functions of the anchor member and the coupling member into a one-piece anastomosis staple.

Abstract: An assembly for joining two vessel segments of a patient includes a coupler formed of adjoining coupler halves. Each coupler half includes an aperture for receiving an end of one of the vessel segments. One of the coupler halves includes a connector element configured for connection to the other coupler half. The vessel segments are alignable in the respective coupler halves such that a path for fluid flow is formed therebetween upon connection of the coupler halves. A probe is aligned in engagement with a coupler half for generating a signal corresponding to fluid flow through the path.

Abstract: Flexible sleeve having a leading (distal) edge that can be advanced over a conventional angioplasty guide-wire to facilitate balloon angioplasty catheter and stent catheter crossing complex coronary lesions such as chronic total occlusions or heavily calcified, non-compliant lesions.

Abstract: Rapid exchange angioplasty catheters and methods of constructing rapid exchange angioplasty catheters including features that provide good pushability and kink resistance. In an illustrative embodiment, a catheter is provided, the illustrative catheter including a proximal hypotube section, which connects to a more distal braided catheter section. The braided catheter section connects to a midshaft portion that includes a guidewire entry port. Distal of the midshaft portion is a distal section having a balloon disposed thereon. An inflation lumen extends the length of the catheter, while a guidewire lumen extends only from the guidewire entry port to the distal end of the catheter. Optionally, a core wire may extend across the joint from the hypotube, to the braided catheter section, and past the guidewire entry port.

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

Abstract: A lancing mechanism is adapted to move between a resting, cocking and a puncture position. The lancing mechanism comprises a lancet holder adapted to receive a lancet, a shaft attached to the lancet holder, at least one drive spring and at least one damping spring. The drive spring surrounds at least a portion of the shaft and drives the lancing mechanism from the cocking position to the puncture position. The damping spring moves the lancing mechanism from the puncture position to the resting position. The drive spring is located at least partially within the damping spring.

Abstract: An apparatus and method for performing needle guided interventions and especially needle guided dilations of tissue to create a therapeutic conduit between two luminal organs or structures. The device is particularly useful for creation of an artificial lumen between two hollow body organs using the working lumen of an endoscope.

Abstract: An introducer and method provides a surgical tool with a pathway through tissue to a surgical site, wherein the surgical tool includes at least one surgical instrument. The introducer comprises a flexible sheath having a distal portion including a distal end and is arranged for receiving the surgical tool. A tissue separation tip at the distal portion of the sheath advances the sheath into the tissue towards the surgical site. The tissue separation tip is arranged to form a tissue gap and provide the at least one surgical instrument access to the tissue gap for performing a medical procedure consonant with the formation of the tissue gap or the performance of work at the surgical site.

Abstract: Tissue expanders and their methods of use.

Abstract: The present invention discloses a nasal dilator comprising at least one breathable layer of adhesive-coated high MVTR layer, such as a polyurethane film, one or more adhesive-coated high modulus “spring” elements for dilating the nasal passages by applying a tension force to the skin, and a carrier delivery system. The carrier delivery system comprises a separation line or split through the carrier to allow for easy delivery of the nasal dilator. The carrier aids in the handling and delivery of the thin adhesive-coated high MVTR layer.

Abstract: A filter device assembly and a method of using such a device to capture and remove embolic material from a body lumen or blood vessel are provided. The filter device assembly generally includes a structure having a collapsed state and an expanded state with first, second, and optionally N additional filter members circumferentially attached thereto. Each filter member forms an annulus chamber with the first filter member having porosity P1; the second filter member circumferentially having porosity P2; and the N additional filter members each having porosity [P3 . . . P(2+N)]. The magnitude of the porosity for the first, second, and N additional filter members follows the relationship P1>[P3> . . . >P(2+N)]>P2. The first, second, and N additional filter portions are configured in the expanded state to allow blood to flow there through and to capture emboli in the annulus chambers.

Abstract: Apparatus and methods are provided for use in filtering emboli from a vessel and/or performing thrombectomy and embolectomy, wherein a vascular device comprises one or more support hoops connected near a distal end of a guide wire, each support hoop having an articulation region, and a blood permeable sac affixed to the support hoop or hoops to form a mouth of the blood permeable sac. The mouth of the sac closes when the apparatus is collapsed for removal to prevent material from escaping from the sac.

Abstract: A medical tubular shaft instrument having a tube and a force transmission element extending lengthwise through the tube. The tube includes a jaw member arrangement on a distal end, which is coupled with the force transmission element and actuated by sliding the force transmission element along the tube. The tube includes a handpiece on a proximal end. The force transmission element, over part of its length, has a smaller outer diameter than the inner diameter of the tube to configure a ring-shaped flushing canal, and, one section along its length, it is centered in the tube in this section. The force transmission element includes precisely one section in which it is centered in the tube, and the section is in the vicinity of the distal end of the force transmission element and is perpendicular to its longitudinal axis by reshaping the force transmission element.

Abstract: Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.

Abstract: An apparatus for sealing a puncture through tissue to a vessel includes an elongate occlusion member including an expandable member, a cartridge carried on the occlusion member, and a sealant carried within the cartridge. The cartridge includes an outer member and a pusher member within the outer member. The sealant is disposed within the outer member adjacent the expandable member distal to the pusher member. During use, the occlusion member is introduced into a puncture until the expandable member and the sealant extend from the puncture into the vessel. The expandable member is expanded, and withdrawn until the expanded expandable member contacts the vessel wall, thereby withdrawing the sealant back into the puncture. The outer member is withdrawn to expose the sealant within the puncture, while the pusher member prevents removal of the sealant, and then the cartridge, occlusion member, and pusher member are successively removed.

Abstract: A closure device for closing a bodily passageway is provided. The device includes first and second frames and first and second crossbars. A sheet of biocompatible material is attached to one or more of the frames. The first crossbar extends across the first frame and has terminal crossbar ends connectively linked to separate sites on the first frame; the second crossbar is similarly linked to the second frame. The crossbars are attached to each other at a connection point, and they are each configured to bend away from the connection point when the closure device is deployed to close a bodily passageway. A method of making the closure device is provided, as well as a method for closing a bodily passageway using such a device. Further, a closure device assembly is provided, including a closure device, a delivery catheter housing, and a delivery release member.

Abstract: Biocompatible wound closure devices including an elongate body and a plug member are useful for wound repair. A wound closure device includes an elongate body defining a longitudinal axis and having a proximal end and a distal end, and a plug member having a tissue facing surface and including a first shaped section and a second shaped section, each of the first and second shaped sections having an abutment surface. The first and second shaped sections are movable about a hinge between a collapsed position in which the abutment surfaces extend away from the longitudinal axis of the elongate body and a deployed position in which the abutment surfaces abut and are substantially aligned with the longitudinal axis of the elongate body, the abutment surfaces controlling a deployed angle of the tissue facing surface of the plug member with respect to the elongate body.

Abstract: A surgical needle including a jam cleat for preventing slippage of suture. The jam cleat includes a suture engaging V-shaped tapered groove having opposing side walls that meet at a jam point.

Abstract: A suture and a suture retainer are positioned relative to body tissue. Ultrasonic vibratory energy is utilized to heat the suture retainer and effect a bonding of portions of the suture retainer to each other and/or to the suture. Portions of the body tissue may be pressed into linear apposition with each other and held in place by cooperation between the suture and the suture retainer. The suture retainer may include one or more portions between which the suture extends. The suture retainer may include sections which have surface areas which are bonded together. If desired, the suture may be wrapped around one of the sections of the suture retainer. The suture retainer may be formed with a recess in which the suture is received. If desired, the suture retainer may be omitted and the sections of the suture bonded to each other.

Abstract: A spinal fixation system includes a pedicle screw having a longitudinal axis. A fixation element is configured to connect the pedicle screw to at least one additional pedicle screw. A coupling mechanism includes a pedicle screw securing device adapted to secure the coupling mechanism to the pedicle screw and a fixation element securing device configured to secure the coupling mechanism to the fixation element. A fastening mechanism is configured to fasten both the pedicle screw securing device and the fixation element securing device. The fastening mechanism is located along the longitudinal axis of the pedicle screw.

Abstract: A percutaneous access device includes an inner tube and an outer tube disposed about at least a portion of the inner tube. The outer tube may be sized to span from a skin incision in a patient to a site proximate the spine of the patient. The distal end of the outer tube may be adapted to releasably engage a bone anchor. The inner tube may be adjustable relative to the outer tube between a first position and a second position in which the distal end of the inner tube contacts the bone anchor. A bone anchor assembly includes a bone anchor having a distal bone engaging portion and a receiving member having a recess for receiving a spinal fixation element. The proximal end of the receiving member may have an arcuate groove formed on an exterior surface thereof to facilitate connection of an instrument to the receiving member.

Abstract: A spine distraction implant alleviates pain associated with spinal stenosis and facet arthropathy by expanding the volume in the spine canal and/or neural foramen. The implant provides a spinal extension stop while allowing freedom of spinal flexion.

Abstract: An insert for establishing a desired spacing between a pair of succeeding vertebrae and having a body including an extending end for supporting a location associated with a first selected lumbar vertebrae. An opposite extending end supports a spaced apart and opposing location associated with a second successively positioned lumbar vertebrae. Upon pre-positioning the body in an open space established between the vertebrae, an actuating input causes the first extending end to displace outwardly relative to the second end and into contacting support with the vertebrae.

Abstract: Provided is a novel low profile transverse connector system having a first and second spinal rod connection member disposed at opposing ends of an elongated cross connection device, each connection member having a distal end configured to be capable of connecting to a spinal rod and a proximal end having a multidirectional articulation joint at which a centrally disposed cross connecting assembly is provided to attach the first and second connection members to each other, the first and second spinal rod connection members each defining two opposing compression slots that serve to facilitate a secure connection to spinal rods and to the cross connecting assembly by the tightening of only one locking screw. Also provided is a method of stabilizing vertebrae using the disclosed system.

Abstract: Medical apparatuses for restricting the motion of a vertebra relative to another vertebra and methods for using the apparatuses are provided herein. The medical apparatuses comprise a flexible element having two ends and a connector capable of securing the ends of the flexible element to a first vertebra disposed above or below a second vertebra or to a spinal device. The flexible element is disposed across at least a portion of one or more vertebral elements of the second vertebra and is tensioned to restrict the motion of the second vertebra relative to the first vertebra.

Abstract: An elongated connecting element and system for dynamic spinal stabilization is disclosed. The connecting element and system provides for resistance to shear forces applied to the connecting element as well as provides for rotational stability of a resilient intermediate element disposed between two end members.

Abstract: An orthopedic stabilization system of implants that includes a bone attachment means that provides poly-axial fixation of the system to the vertebrae, and a connector means that connects the bone attachment means to the spinal rod in a fashion that allows variable height adjustment of the spinal rod (dorsal in the case of posterior spinal pedicle fixation). The orthopedic stabilization system includes a locking means with a tightenable ball-joint arrangement that locks a post means to the bone attachment means in a desired relative spatial orientation. Several embodiments are disclosed, some using traditional mechanical locking means such as screw fasteners, taper-locking interfaces and collets. Embodiments are described that use the austenitic transformation of shape memory alloy (SMA) material to effect a locking of both the ball-joint arrangement and the connector means.

Abstract: The present invention generally is directed toward a spinal fixation system whereby a coupling element allows the physician to selectively lock or unlock either the connection between the coupling element and a fastener, such as to allow for repositioning of the coupling element, or the connection between the coupling element and an elongate rod. The locking or unlocking of these connections may be made independently and as desired by the physician.

Abstract: In one form, systems and methods for positioning a connecting member adjacent the spinal column include at least one anchor that is engageable to bony structure and has a receiver for receiving the connecting member. A pair of elongated members is engaged to the receiver and defines a pathway that extends proximally from the receiver. The connecting member is movable along the elongated members to the receiver of the bone anchor. The elongated members are removable from the receiver of the bone anchor after the connecting member is positioned in the receiver to provide a low profile anchor and connecting member assembly when finally implanted in the patient. However, other embodiments, forms and applications are also envisioned.

Abstract: Described is an arthroscopic bone transplanting procedure for transplanting a section of a first bone to a second bone. The described procedure is particularly useful for the treatment an anterior shoulder instability, where the first bone is the coracoid and the second bone is the glenoid. Also described is a kit of medical instruments particularly useful in such a procedure.

Abstract: A surgical system and method for fusionless correction of a spine disorder are provided. The method comprising the steps of: providing access to a spine; providing a longitudinal element extending between a first end including a first fixation element and a second end including a second fixation element; engaging the first fixation element with a first costovertebral surface and engaging the second fixation element with a second costovertebral surface such that the longitudinal element is disposed in a costotransverse orientation along a selected section of the spine; and preventing growth of the selected section of the spine with the longitudinal element.

Abstract: Apparatus and methods to facilitate fixation of a fracture are disclosed. These apparatus include a bone plate for the fixation of a fractured bone having a plurality of fastener openings so that the bone plate may be secured by a plurality of fasteners across a reduced fracture to fixate a reduced fracture. The bone plate is configured to flex in situ to conform to the surface of the bone while providing sufficient stiffness in the plane of the device to resist forces and moments in the plane. Methods of use of the present invention include fastening the bone plate to a first side of the fracture, flexing portions of the bone plate to bias against the bone surface on the second side of the fracture, fastening the portions of the bone plate so biased to the second side of the fracture, thereby fixating the fracture by fastening the bone plate to the second side of the fracture.

Abstract: A spinal plate comprises a body portion and at least one locking mechanism for engaging the body portion. The body portion is made of a radiolucent material, such as a polymer or polyether ether ketone (PEEK), and includes a plurality of bone screw openings for receiving a plurality of bone screws, such as bone screws. The at least one locking mechanism is for securing at least one of the plurality of bone screws when received into the body portion.

Abstract: A bone fastening assembly for use with a screw and including a bone plate and a bushing having a bore adapted for receiving the screw. The bone plate has a substantially planar portion and is provided with a hole in the portion for receiving the bushing. The portion of the bone plate and the bushing are cooperatively configured for providing pivotal movement of the bushing within the hole about a pivot axis and restricting the pivot axis to a plane extending in the portion of the bone plate. A new bone attachment screw for use with the bone fastening assembly is provided.

Abstract: A plate of biocompatible material is provided having curvature in two planes such that it conforms to the curvature of the L5 vertebral body and to the patient's lordotic curve. Holes are provided receiving screws for anchorage in the vertebral body and sacrum. A flange or foot portion on the plate provides a wider base end area for support in the L5-S1 interspace. The foot portion is also arranged for appropriate entry angle of screws into the sacrum such as to improve anchorage in the sacrum. Anti-backout and low profile features are incorporated. The anterior lumbar plate is situated to maintain the anterior interbody bone graft in compression by resisting tensile forces during extension.

Abstract: A threaded bone anchor includes a plurality of recesses formed lengthwise along an exterior cylindrical surface for engagement with a driver instrument through which a user applies clockwise or counterclockwise torque for the insertion or removal of the bone anchor into and from bone. The bone anchor includes a cross-sectional geometry that minimizes the anchor's outer diameter, survives high insertion/removal torque without compromising the anchor's bending/shear strength, and allows a mating clamp to be attached to the entire non-threaded surface, including the recessed portion.

Abstract: The present invention relates to a screw for fixing vertebra comprising a cage as a prosthesis which can be extended to be protruded beyond an external diameter of a screw, and improving the drawback from detaching from the spine following surgical procedures.

Abstract: System, including methods, apparatus, and kits, for connecting bones and/or bone portions using a bone connector with a pivotable joint.

Abstract: A method of treating tissue is provided, including positioning a stimulation device proximate a phrenic nerve; stimulating the phrenic nerve with the stimulation device; measuring a physiological response to the stimulation; defining a threshold physiological response value based at least in part on the measured physiological response; positioning a thermal treatment element proximate to an arrhythmogenic cardiac tissue region; applying a thermal treatment regimen to the cardiac tissue region with the medical device; measuring a physiological parameter during the thermal treatment regimen application; and conveying the measured physiological parameter to a controller, the controller comparing the measured physiological parameter to the defined physiological response value threshold, the controller adjusting the thermal treatment regimen in response to the comparison of the measured physiological parameter to the defined physiological response value threshold.

Abstract: A system for treating meibomian gland dysfunction comprising a heating element that applies heat to the outside of the eyelid to provide conductive heat transfer to the meibomian glands, which assists in the expression of obstructions or occlusions in the meibomian glands to restore sufficient sebum flow to the lipid layer to treat dry eye. A force application device may also apply force to the patient's eyelid during the application of heat to improve conductive heat transfer and reduce blood flow in the eyelid that causes convective heat loss, and to help express obstructions from the meibomian gland, including from a channel of the meibomian gland. Reaching increased temperature levels may improve the melting, loosening, or softening of obstructions or occlusions in the meibomian glands while reducing the amount of time to reach desired temperature levels and/or aid in reducing discomfort to the patient during treatment.