Abstract: Embodiments of the invention provide swallowable devices, preparations and methods for delivering drugs and other therapeutic agents within the GI tract. Particular embodiments provide a swallowable device such as a capsule for delivering drugs into the intestinal wall or other GI lumen. Embodiments also provide various drug preparations that are configured to be contained within the capsule, advanced from the capsule into the intestinal wall and degrade within the wall to release the drug to produce a therapeutic effect. The preparation can be coupled to a delivery mechanism having one or more balloons or other expandable devices which are expandable responsive to a condition in the small intestine or other GI lumen to advance the preparation out of the capsule into the intestinal wall. Embodiments of the invention are particularly useful for the delivery of drugs which are poorly absorbed, tolerated and/or degraded within the GI tract.

Abstract: The invention relates to an intraruminal sustained release capsule which is capable of delivering a sustained release dose of a first medicament to an animal, as well as either or both of a dump dose of a second medicament or mineral, and an exit dose of a third medicament or mineral. The capsule can have a dissolvable overcap molded from plasticized starch enabling a dump dose of medicament to be held between the overcap and one end of the capsule. A piston within the body of the capsule can be modified to enable it to accommodate an exit dose of medicament within its hollow interior which is aligned with an aperture at the end of the capsule which enables release of the medicaments to the rumen. After insertion of the capsule in the animal the overcap (if present) dissolves and separates from the capsule to release the dump dose of medicament. The sustained release medicament is then dispensed via the apertured end, followed by the release of the exit dose of medicament (if present).

Abstract: A remote control system capable of precise operations or treatments in which the visual recognition and operation portions are as close to each other as possible, including: a) an imaging device for taking an image of the object; b) a manipulation tool having at its tip an illuminator for casting a spot light onto the object; c) a driver for changing the position of the manipulation tool; d) an external display unit for displaying an image; e) an input unit for allowing an operator to specify a position corresponding to the display of the external display unit; f) a distance calculator for calculating the distance between the position specified through the input unit and the position of the spot light cast from the illuminator onto the object; and g) a controller for controlling, based on the aforementioned distance, the driver so as to bring the tip of the manipulation tool closer to the specified position.

Abstract: The invention relates to a surgical instrument comprising a handle portion or mounting portion and a functional portion and/or tip, wherein a display device is provided on the instrument and includes or enables displays which serve to assist in image-guided and/or navigation-assisted surgery. It also relates to a method for navigating a surgical instrument, wherein its position is determined and tracked by means of a medical tracking system and the position data is processed within the framework of medical navigation by means of a medical navigation system, wherein displays for navigation assistance and/or for assisting in image-guided surgery are provided on the instrument or on an element which is positionally assigned to the instrument or fastened to the instrument.

Abstract: A system and method for treating ophthalmic target tissue, including a light source for generating a beam of light, a beam delivery system that includes a scanner for generating patterns, and a controller for controlling the light source and delivery system to create a dosimetry pattern of the light beam on the ophthalmic target tissue. One or more dosage parameters of the light beam vary within the dosimetry pattern, to create varying exposures on the target tissue. A visualization device observes lesions formed on the ophthalmic target tissue by the dosimetry pattern. The controller selects dosage parameters for the treatment beam based upon the lesions resulting from the dosimetry pattern, either automatically or in response to user input, so that a desired clinical effect is achieved by selecting the character of the lesions as determined by the dosimetry pattern lesions.

Abstract: A skin cooling method for a dermatologic treatment procedure, by which a skin target region is exposed for a specified duration to irradiation with electromagnetic energy emitted from an electromagnetic energy exit opening of a skin treatment applicator and the target region is cooled at least during part of the duration of the exposure to electromagnetic energy irradiation, wherein a cooling procedure is performed including an air cooling step comprising ejection of a directional flow of cooling air towards the skin treatment region, said directional cooling air flow having a temperature T in the interval 0° C.<T?15° C. In an apparatus according to the invention this method may be combined with one or more contact cooling steps.

Abstract: A dual port ablation cannula kit includes a trocar and a hollow shaft defining a longitudinal lumen. The shaft has a proximal segment and a distal segment, such that the distal segment includes a distal tip substantially aligned with the shaft to permit passage of the trocar within the hollow shaft. The distal tip also is configured with a tissue-gripping surface in as much as a plane of the tissue-gripping surface is substantially perpendicular to a longitudinal axis of the shaft, dual ports extending from an exterior surface of the hollow shaft, each port defining a hollow passageway into the hollow shaft, and dual couplers, one coupling a suction line to one of the dual ports and another coupling an irrigation line to another of the dual ports. Finally, the kit can include a laser fiber.

Abstract: The invention is directed to a laser catheter (1) for bypass surgery, wherein the distal part (2) of the catheter (1) is provided with: a tubular arrangement (3) of optical fibers (4) having distal ends (5) defining a ring-shaped light emergence surface (6) for emitting a tubular bundle of light beams in the distal direction (D) of the catheter (1); and a stop surface (7) extending around the tubular arrangement (3) of optical fibers (4) and facing in the distal direction (D), the stop surface (7) being arranged at a distance (A) proximally from the light emergence surface (6). The light emergence surface (6) slants at a slanting angle (?) in the range of [20°, 60°] with respect to the longitudinal axis (8) of the catheter (1). The invention further relates to an assembly comprising such a catheter.

Abstract: Medical devices having electrically conductive pathways are disclosed. More particularly, the disclosure is directed to catheter shafts including an electrically conductive wire embedded in a polymeric tube. The disclosure is also directed to catheter shafts including an electrically conductive media coextruded in a polymeric tube. The disclosure is also directed to catheter shafts including electrically conductive pathways formed with electrically conductive ink, paste, adhesive and/or epoxy.

Abstract: A circuit for discharging stored energy in an electrosurgical generator. The circuit includes a pulse width modulator for controlling a high voltage power supply, an error signal generating circuit configured for delivering an error signal as a difference between an output signal voltage with a feedback voltage generated by the high voltage power supply. The error signal is transmitted to the pulse width modulator. The circuit further includes a switching circuit configured to switch in a load in parallel with an output of the high voltage power supply when the error signal is lesser than a first predetermined threshold to discharge the output.

Abstract: An ablation apparatus includes an ablation energy source producing an electromagnetic energy output. A multiple antenna device is included, and has a primary antenna with a longitudinal axis, a central lumen and a distal end, and a secondary antenna with a distal end. The secondary antenna is deployed from the primary antenna central lumen in a lateral direction relative to the longitudinal axis. The multiple antenna device is coupled to the ablation energy source.

Abstract: A catheter comprising a flexible tubing having a proximal end and a distal end. An electrode assembly is attached to the distal end of the flexible tubing. The electrode assembly includes an electrically conductive tip electrode and a coupler which is connected between the tip electrode and the distal end of the flexible tubing. The coupler and the tip electrode are coupled by an interlocking connection. A first magnet is at least partially housed in the coupler. A fluid lumen extends through the flexible tubing to the coupler. The fluid lumen extends completely through the first magnet and connects to at least one port formed in the electrode assembly. A second magnet is spaced from the electrode assembly along a longitudinal axis of the tubing. The first magnet and the second magnet are responsive to an external magnetic field to selectively position and guide the electrode assembly within a body of a patient.

Abstract: The effects produced by surgical devices that deploy an electrical circuit between electrodes are dependent on the nature of electrical work perform upon the conductive media in an around biologic tissues. Non-ablation radiofrequency surgical devices utilize a protective housing that provides, based upon procedure-specific needs, the ability to 1. move, manipulate, and segregate near-field effects both tangentially and perpendicularly to the tissue surface, 2. deliver far-field electromagnetic effects to tissue unencumbered by current deposition, and 3. serve as a 20 mechanical adjunct to and a selective throttling vent/plenum for energy delivery. Because the electrodes are non-tissue-contacting, this study characterizes the effects that non-ablation radiofrequency energy exerts upon interfacing media typically encountered during surgical applications.

Abstract: An ablation catheter is provided for ablating internal tissue of a patient. The catheter includes a distal end that is adapted to be inserted into a body cavity relative to a desired location therein (e.g., within the heart). An ablation electrode is connected relative to the distal end of the catheter for providing ablation energy to patient tissue. A heat sink is provided that is in thermal contact with the ablation electrode. The heat sink, in addition to being in thermal contact with the ablation electrode, is electrically isolated from the ablation electrode. This allows the heat sink to conduct heat away from the ablation electrode without dissipating electrical energy from the electrode. In this regard, the heat sink may prevent build-up of excess heat within the electrode that may result in blood coagulation and/or tissue charring.

Abstract: An endoscopic bipolar forceps includes a housing having a shaft affixed thereto, the shaft including jaw members at a distal end thereof. The shaft includes jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal. The forceps include a drive assembly that moves the jaw members relative to one another from a first position to a second position for manipulating tissue. A movable handle is included that is rotatable about a pivot. A knife assembly is also included having a movable knife rod to operatively engage a knife blade, the knife rod having a first longitudinal section having a first predetermined shape, and a second longitudinal section having a second predetermined shape. The first predetermined shape is different than the second predetermined shape.

Abstract: An electrosurgical system is disclosed. The system includes an electrosurgical generator adapted to supply electrosurgical power and an electrosurgical device coupled to the electrosurgical generator. The electrosurgical device includes a transformer and one or more active electrodes coupled thereto, wherein the transformer is adapted to step down the voltage of the power supplied by the electrosurgical generator.

Abstract: An end effector assembly is provided. The end effector assembly includes a pair of first and second jaw members including respective seal plates adapted to connect to a source of electrosurgical energy. The first and second jaw members operable in a first bipolar mode of operation for treating tissue and a second bipolar mode of operation for separating tissue. A dissector translatable through one of the first and second jaw members is in electrical communication with one of the seal plates of the first and second jaw members and activatable in the second bipolar mode of operation for separating tissue when the first and second jaw members are in one of the open and clamping position and tissue is adjacent thereto.

Abstract: A clamping device for an external fixation system includes a first clamp having an opening for receiving an external fixation element, the first clamp having an axle seat. A first base component includes a concave first surface and a second surface facing away from the first surface. The concave first surface is in selective engagement with the clamp. A swivel element comprises an axle component and a post component. The axle component is disposed on the axle seat of the first clamp. The post component extends from the axle component and has a length sized to extend from the axle component through a second external fixation clamp. The post component is arranged to swivel relative to the axle seat. Methods are also disclosed.

Abstract: Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve. Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted to restore the normal angular relationship of the vertebrae adjacent to that disc space. An extended outer sleeve having extended portions capable of maintaining the vertebrae distracted in their normal angular relationship is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

Abstract: An implant assembly for proximal femur fracture comprises of a targeting device and intramedullary nail having plurality of proximal holes directed towards head and neck of femur wherein the axis of the holes makes an ante version angle of about 5° to 20° with the horizontal plane and at the same time axis of plurality of distal holes making 90° angle to longitudinal axis of said nail that holds the femur wherein said nail has reducing cross section area from thigh end to knee end with grooved knee end with anterior curvature even in short length version, plurality of proximal sliding hip pins with smooth shaft for collapsibility, triflanged end with mores taper to hold proximal femur, large head and washer to get impaction and plurality of distal locking screw to hold distal fragment of femur, optional buttress plate and barrels supporting lateral cortex to get controlled limited guided collapse.

Abstract: A medical or surgical handpiece for driving a medical tool comprises a housing, a drive train accommodated therein and a motor. The motor includes a first drive shaft and a second shaft, the second shaft being at least partially arranged in the first drive shaft and mounted to rotate freely relative to the first drive shaft via at least one bearing, so that the second shaft is rotatable independently of the first shaft.

Abstract: There is provided a surgical saw blade for use in orthopaedic surgery. The saw blade comprising: a mounting cavity having a first substantially triangular-shaped opening and a second substantially triangular-shaped opening in communication with, and inverted relative to, the first opening, the first and second opening collectively define two mounting slots that form an angle relative to one another. In some embodiments, the planar portion further comprises an offset planar shelf. The offset shelf may be oriented along the length of the planar portion to allow for longitudinal reciprocation or may be oriented across the width of the planar portion to allow for lateral reciprocation.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Abstract: A system for attaching first and second spine fixation elements at a predetermined angle relative to each other to first and second locations of a vertebra, respectively includes first and second guide arms pivotally connected to each other at a first pivot point and configured to pivot around a pivot axis passing through the first pivot point, and first and second guide tubes passing through first and second elongated through-bore openings formed in the first and second guide arms, respectively, and forming an X-structure as they exit the first and second through-bore openings.

Abstract: An anti-backout stylus comprising a stylus and a locking stylus holder. The locking stylus holder engages the stylus at a series of discrete positions during insertion of the stylus into the holder. The locking stylus holder prevents inadvertent backing out of the stylus by preventing the stylus from being withdrawn to a previous one of the discrete positions. The locking stylus holder can preferably be selectively disengaged from the stylus to allow for selective withdrawal of the stylus. Each engagement of one of the discrete positions by the locking stylus holder preferably indicates a femoral size. The discrete positions are preferably defined by detents formed on the stylus and a stop member on the locking stylus holder. The locking stylus holder can be provided on an anterior rough cut guide, with the anterior rough cut guide preferably mountable on an intramedullary rod.

Abstract: An orthopaedic surgical instrument includes an orthopaedic distraction device sized to be positioned between a distal end of a patient's femur and a proximal end of the patient's tibia and configured to apply force between the patient's femur and the patient's tibia. The orthopaedic surgical instrument also includes a user-operated control device operable to actuate the orthopaedic distraction device to apply force between the patient's femur and the patient's tibia. In actuating the orthopaedic distraction device, a rotary input of the user-operated control device that is coupled to the orthopaedic distraction device may be used. The orthopaedic surgical instrument also includes a display positioned on an outer surface of the orthopaedic distraction device and a circuit configured to control the display. The display is configured to provide visual feedback indicative of force applied by the distraction device.

Abstract: Disclosed herein is a tool for guiding a drill hole along a central axis of a femur head and neck for preparation of a femur head that is the subject of a hip resurfacing surgery. In one embodiment, the tool includes a mating region and a guide hole. The mating region is configured to matingly receive a predetermined surface of the femur. The mating region and guide hole are positionally correlated or referenced with each other such that when the mating region matingly receives the predetermined surface of the femur, the guide hole will be generally coaxial with a central axis extending through the femur head and the femur neck.

Abstract: Improved tools and procedures relate to the immobilization of the sacroiliac joint for the treatment of pain associated with the joint. Kits comprise, for example, a guide element and an immobilization element of a biocompatible material with a size and shape suitable for placement within the sacroiliac joint. Suitable immobilization elements include, for example, pins, nails, screws, darts, wedges, shims and hardening material. A bioactive agent can be delivered into the joint to compliment the immobilization and promote healing. Suitable procedures can be done in a less invasive procedure through a cannula or the like.

Abstract: An instrument for use in a joint replacement procedure includes a trial head that corresponds to the head of an orthopaedic joint component having an upper surface defined by a curved surface and a bore formed in a lower surface and a trial connector for connecting the trial head to a stem part of the orthopaedic joint component which is intended for location in the intramedullary cavity of a bone. The trial connector can be fitted into the bore in the trial head at a variable angular orientation.

Abstract: Methods and apparatus for treating bones, including, in one or more embodiments, methods and apparatus for treatment of vertebral fractures that include an inflation device for cavity creation and an inflation and containment device for maintaining vertebral height and cement containment. Methods for treating a bone comprising: creating a cavity in the bone; inflating a containment jacket in the cavity; inflating a balloon within the containment jacket so that the balloon occupies a first portion of the containment jacket; introducing a first filler material into a second portion of the containment jacket, wherein the second portion of the containment jacket is not occupied by the balloon; removing the balloon from the containment jacket; and introducing a second filler material into the first portion of the containment jacket.

Abstract: The method for preventing extravasation of bone cement used in balloon kyphoplasty involves first forming a void in a vertebral body. A pair of unfilled balloons are then inserted into the void in the vertebral body. An injection tube or catheter is inserted through an inlet port of each of the balloons, and the balloons are filled with bone cement. The injection tubes are then removed from the inlet ports. The bone cement is preferably provided in the form of pellets or granules. The inlet ports are each provided with a seal, such as an elastic band mounted thereabout, or the like, allowing the inlet port to be automatically sealed as soon as the corresponding injection tube is withdrawn. The device includes at least the balloon and the seal, but may be furnished as a kit that also includes the bone cement and injection tube.

Abstract: Internal bone fixation devices and methods for using the devices for repairing a weakened or fractured bone are disclosed herein. According to aspects illustrated herein, there is provided a device for repairing a fractured bone that includes a delivery catheter having an elongated shaft with a proximal end, a distal end, and a longitudinal axis therebetween, the delivery catheter having an inner void for passing at least one reinforcing material, and an inner lumen for accepting a light pipe, wherein a distal end of the inner lumen terminates in an optical lens; a conformable member releasably engaging the distal end of the delivery catheter, the conformable member moving from a deflated state to an inflated state when the at least one reinforcing material is delivered to the conformable member; and an adapter releasably engaging the proximal end of the delivery catheter for receiving the light pipe and the at least one reinforcing material.

Abstract: The present disclosure relates to a device for use in ligament reconstruction surgery. The device includes a handle, a tube coupled to the handle, and a locking mechanism coupled to the handle. A method for use during ligament reconstruction surgery is also disclosed.

Abstract: First and second bone segments separated by a fracture line or joint can be fixated or fused by creating an insertion path through the first bone segment, through the fracture line or joint, and into the second bone segment. An anchor body is introduced through the insertion path. The distal end of the anchor body is anchored in the interior region of the second bone segment. An elongated implant structure is passed over the anchor body to span the fracture line or joint between the bone segments. The proximal end of the anchor body is anchored to an exterior region of the first bone segment to place, in concert with the anchored distal end, the anchor body in compression, to thereby compress and fixate the bone segments relative to the fracture line or joint.

Abstract: A method for implanting an intraocular lens into the eye of a subject includes placing the intraocular lens into the eye of a subject and administering a drug in an amount sufficient to maintain an accommodative state of the eye. The method further includes permitting at least a portion of the intraocular lens to become coupled to at least a portion of the eye while maintaining the eye in the accommodative state. In certain embodiments, the method may include forming an intraocular lens while maintaining an accommodative state of the eye. In such embodiments, the method may exclude permitting at least a portion of the intraocular lens to become coupled to at least a portion of the capsular bag.

Abstract: A surgical retrieval apparatus includes a housing defining a longitudinal axis and including an elongated sleeve extending distally therefrom. The housing and the elongated sleeve cooperate to define a lumen extending longitudinally therethrough. A shaft having an end effector disposed at a distal end thereof is selectively translatable between a first position, wherein the end effector is disposed within the elongated sleeve, and a second position, wherein the shaft is translated through the lumen such that the end effector extends distally from the elongated sleeve. An articulation mechanism operably coupled to the end effector is configured for articulating the end effector relative to the longitudinal axis. A specimen retrieval bag is coupled to the end effector and is deployed therefrom upon movement of the end effector from the first position to the second position.

Abstract: A medical device includes an elongate member having a plurality of flexibility features and a basket having a plurality of legs. The elongate member and the basket are formed from a single piece of a material. The flexibility features are formed by removing first portions of the material to increase flexibility of the elongate member. The legs are formed by removing longitudinal portions of the material.

Abstract: A system for a controlled insertion and withdrawal of at least one electrode in the anatomy. The system can include a guide device and at least one electrode located within the guide device to at least one of record or stimulate an anatomy. The system can also include an indicator coupled to the electrode to indicate a position of a distal end of an electrode relative to the guide device.

Abstract: Apparatus is provided, including a tissue-adjusting member configured to be coupled to tissue of a patient, a rotatable structure that is configured to adjust a tension of the tissue-adjusting member, a tissue anchor coupled to the tissue-adjusting member and configured to screw into the tissue of the patient, and a delivery tool reversibly coupleable to the rotatable structure. The delivery tool comprises a first actuating element configured to rotate the tissue anchor so as to facilitate screwing of the tissue anchor into the tissue of the patient while not facilitating rotation of the rotatable structure, and a second actuating element configured to rotate the rotatable structure while not facilitating rotation of the tissue anchor. Other applications are also described.

Abstract: Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

Abstract: Suture clip appliers, suture clips and methods of their use for securing sutures during an endoscopic or laparoscopic procedure are provided, wherein the method includes the steps of providing a suture clip applier having a working tip configured to retain and fire a suture clip; providing a suture clip having a biased closed configuration; loading the suture clip into the working tip of the clip applier; translating the suture clip distally relative to the working tip to a first position wherein the suture clip is splayed open; inserting a suture into the opened suture clip; and translating the suture clip distally relative to the working tip such that the suture clip is ejected from the working tip and biased to the closed configuration to close on and to retain the suture.

Abstract: A surgical apparatus, including an instrument, a shaft part with a jaw opening at its distal end and a thread carrier guided by the shaft part displaceable from a retracted position, in which it exposes the jaw opening, and an advanced position, in which it crosses the jaw opening. A thread supported by the thread carrier can be guided through or around human or animal tissue to form a suture or ligature. The thread has a bulge at its end made of the material of the thread so that when the bulge is pushed through a passage opening of the jaw part it elastically deforms and is retained when the thread carrier is retracted.

Abstract: A method of implanting a fabric into a body to repair a pelvic floor includes preventing wrinkle formation in the fabric with a bio-absorbable support, and implanting the bio-absorbable support and the fabric into the body.

Abstract: A shunt rivet for implantation in the aorta and inferior vena cava to treat chronic obstructive pulmonary disease, and a method of treating chronic obstructive pulmonary disease.

Abstract: This invention generally relates to minimal invasive surgery. More specifically the current invention relates to an apparatus especially adapted to fold prosthetic patches and to insert said patches into a body cavity through a cannula or an incision.

Abstract: Provided is an apparatus that includes a nerve conduit and a nested manifold for providing a reduced pressure. Also provided is a system that includes a source of reduced pressure, a nerve conduit and nested manifold, and a conduit for providing fluid communication between the manifold and the source of reduced pressure. Additionally provided is a method that includes implanting the above nerve conduit and manifold at a site of damaged nerve tissue and applying a reduced pressure to the manifold thereby stimulating repair or regrowth of nerve tissue.

Abstract: Systems and methods are described for the use of floating magnetic elements in medical implants. The magnetic elements within the medical implant are allowed to rotate freely to align with a strong external magnetic field, such as that of an MRI scanner, and align to attract each other during the normal functioning of the medical implant in the absence of a strong external magnetic field.

Abstract: An ultrasonic surgical instrument includes a body such as a handle assembly and an acoustic transmission assembly. The acoustic transmission assembly includes an ultrasonic transducer and an end effector. A mounting ring is positioned on a horn of the transducer. A rotatable drum is positioned distal to the mounting ring. Piezoelectric components of the transducer are positioned proximal to the mounting ring. Electrical conduits extend from the drum to the piezoelectric components and are routed over or through the mounting ring. The drum is coupled with a power source through a slip ring assembly to selectively activate the transducer.

Abstract: Provided herein is a method for treating spinal stenosis comprising percutaneously accessing the epidural space from a first side of the spine. The first side of the spine is located on one side of the medial plane with respect to the spinal cord. A tissue removal tool is then advanced through the first side of the epidural space into the other side of the epidural space, where the other side of the epidural space is located on the other side of the medial plane of the spinal cord. Once the tissue removal tool is located on the second side of the medial plane, stenosis can be reduced using the tissue removal tool.

Abstract: Tissue manipulation devices are disclosed. In various forms, the devices include tissue manipulation arms that are arranged in a position suitable to enable the device to be inserted into the colon then, upon application of at least one actuation motion thereto, at least some of the tissue manipulation arms are moved to deployed positions wherein they contact corresponding portions of the colon to thereby expand the colon. Various devices are actuatable by various forms of actuation forces. In various embodiments, the tissue manipulation arms may be movable along corresponding axes that are transverse to an insertion axis and may also be rotated about the insertion axis as well as be moved in directions that are substantially parallel to the insertion axis.