Abstract: Devices and methods for delivering a fluid to a patient are disclosed herein. In one embodiment, a method includes providing a wearable delivery device that includes an electrochemical actuator and a reservoir containing a fluid with viscosity greater than 15 cP. The electrochemical actuator can be actuated such that the actuator exerts sufficient force on the reservoir to cause the fluid within the reservoir to be communicated to the patient's body over a time period. In some embodiments, the time period is two hours. In one embodiment, a delivery system includes a reservoir containing a fluid having a viscosity greater than 15 cP and a fluid communicator in fluid communication with the reservoir. An electrochemical actuator is coupled to the reservoir and configured to exert a sufficient force on the reservoir for a time period upon actuation such that the fluid within the reservoir is communicated through the fluid communicator.

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 moulded from plasticised 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 surgical instrument is disclosed. The instrument includes a handle portion, a body portion extending distally from the handle portion and defining a first longitudinal axis and an articulating tool assembly defining a second longitudinal axis and having a proximal end. The articulating tool assembly is disposed at a distal end of the body portion and is movable from a first position in which the second longitudinal axis is substantially aligned with the first longitudinal axis to at least a second position in which the second longitudinal axis is disposed at an angle with respect to the first longitudinal axis. The instrument also includes an articulation mechanism configured to articulate the articulating tool assembly, the articulation mechanism including an articulation sensor assembly configured to transmit a sensor signal to a microcontroller which is configured to determine an articulation angle of the articulation assembly.

Abstract: A method of photodisruptive laser surgery includes selecting a target region of a tissue for fragmentation, directing a beam of laser pulses to the selected target region of the tissue, and forming cells in the target region of the tissue by directing the laser beam to generate cell boundaries. The cells can be arranged in regular or irregular arrays. The cells can be generated in parallel or successively, with cell sizes and laser parameters which reduce the time of ophthalmic surgery considerably.

Abstract: A steerable laser probe may include a handle, an actuation structure of the handle, a housing tube, a flexible tube, an optic fiber, and a wire having a pre-formed curve. The flexible tube may be disposed within the housing tube wherein a distal end of the flexible tube projects out from a distal end of the housing tube. The optic fiber may be disposed within an inner bore of the handle, the housing tube, and the flexible tube. The wire may be disposed within the housing tube.

Abstract: Method, apparatus and systems for laser surgery as part of cataract surgery. The implementation thereof includes: A means to perform incisions in the cornea and inside the eye. In particular Limbal Relaxating Incisions and an anterior or posterior capsulotomy/capsulorhexis using a rapid fire sequence of photodisruptive laser pulses, placed to open the capsule for cataract surgery. The system and methods provides the means to target and direct the laser pulse sequence into the desired region of the eye without the need of a patient interface that is locked to the laser delivery system and holds the eye in a fixed position relative to the delivery system.

Abstract: Described herein are methods, systems, and devices for automated laser ablation and/or tissue resection triggered by Raman spectroscopic information. These systems and methods provide for precise removal of cancerous or other diseased tissue with minimal damage to adjacent healthy tissue.

Abstract: A device for providing a cryotherapy ablation treatment includes a piping assembly and a snow horn adapted to create a spray of snow from a pressurized source of a low-temperature liquid, a tubular applicator for collecting a mass of snow at a prescribed density that is sufficient to allow the mass to serve as the needed, low temperature, thermal reservoir for the device after the applicator's distal end has been disconnected from the snow horn end so that it can to be used during the treatment process, and an applicator tip adapted to allow it to connect to the applicator's distal end and be used to treat those specific locations which are to receive this treatment.

Abstract: A point of incision is created within tissue, the tissue having a temporoparietal fascia-deep temporoparietal fascia layer (TPF-sDTF) beneath skin and a temporal branch of a target nerve extending along a portion of the TPF-sDTF, the point of incision being laterally displaced from the target nerve. A cryogenic probe having a distal tip extending from an elongated body is inserted into the point of incision. The TPF-sDTF is bluntly dissected using the cryogenic probe such that a treating portion of the cryogenic probe is directly adjacent to a first treatment portion of the target nerve. The cryogenic probe is activated to create a first treatment zone at the first treatment portion of the target nerve to cause a therapeutic effect.

Abstract: Embodiments of the present invention relate to cryogenic systems and methods useful to cool objects, including living tissue, to freezing or cryogenic temperatures by placing the object in thermal communication with sub-cooled supercritical nitrogen.

Abstract: A coil-integrated pad assembly for inductively heating a hyperthermia needle device includes a barrier pad and an electromagnetic unit. The barrier pad is adapted to be inserted into a patient's body and to be placed between the hyperthermia needle device and a non-target tissue of the patient's body when the hyperthermia needle device penetrates a target tissue. The electromagnetic unit has a coil that is at least partially disposed in the barrier pad and that is electrifiable to generate a magnetic field sufficient to inductively heat the hyperthermia needle device.

Abstract: A therapeutic apparatus (300, 400, 500) comprising a high intensity focused ultrasound system (302) comprising an ultrasound transducer (306). The ultrasound transducer has an electronically adjustable focus (318). The high intensity focused ultrasound system has a beam deflection zone (322, 608, 704, 1010). The intensity of ultrasound at the electronically adjustable focus divided by the acoustic power emitted is above a predetermined threshold (606, 1008) within the beam deflection zone. The therapeutic apparatus further comprises a processor (328) for controlling the therapeutic apparatus. Execution of machine executable instructions (350, 352, 354) causes the processor to: receive (102, 202) real time medical data (342, 424, 506) descriptive of the location of a moving target (320, 802); adjust (104, 204) the electronically adjustable focus to target the moving target using the real time medical data; and sonicate (106, 206) the moving target when the moving target is within the beam deflection zone.

Abstract: A high-frequency electrosurgical treatment instrument for operations, includes a pair of forceps pieces, an insulating member, a transmission member, a manipulation rod member, a distal end cover member, a shaft member and a manipulation portion. The instrument, includes a flow channel portion formed between the manipulation rod member and the shaft member, the flow channel portion being disposed along a longitudinal direction of the manipulation rod member to allow liquid to flow; a groove portion that communicates with the flow channel portion to allow the liquid to flow from the flow channel portion; and an opening portion that communicates with the groove portion to supply the liquid near the proximal end portions of the pair of forceps pieces.

Abstract: A method of controlling electric fields created by a plurality of electrodes. The method includes repetitively applying multiple sets of voltages to at least some of a plurality of electrodes over a treatment period to achieve and maintain a target temperature, the at least some of the electrodes being treatment electrodes. The sets of voltages may be in patterns such that a unique current pattern between electrodes is created for each set of voltages, resulting in temperature averaging. The voltage at each electrode may be determined based on a temperature of an adjacent electrode. The voltage at each electrode may also or alternatively be determined based on an estimated voltage at the electrode.

Abstract: This invention relates to medical methods, instruments and systems for creating a controlled lesion using temperature to control the growth of the lesion. The treatment can be used in any tissue area and is particularly useful in or around a vertebral body. The features relating to the methods and devices described herein can be applied in any region of soft or hard tissue including bone or hard tissue.

Abstract: This disclosure describes impedance computation techniques that may reduce the effect of crosstalk, thus generating more accurate impedance measurements. In particular, an ablation system models the electrical interaction among the active electrodes and a common return electrode using a star-configuration resistor model. The ablation system computes one or more parameters of the star-configuration resistor model and adjusts the therapy based on at least the computed parameters of the star-configuration resistor model.

Abstract: The present disclosure relates to an apparatus and method for preventing reuse of a surgical instrument. The single-use surgical instrument includes a housing, an electrical connector and a treatment component. Indicia may be printed on the housing, the electrical connector and/or the treatment component. A removable ink is applied to any portion of the surgical instrument in the form of indicia that is readable by a scanning device. The removable ink includes a protein-based composition that is reactivateable with a sterilization solution having an enzyme-based composition such that upon sterilization, the removable ink reacts with the sterilizing solution and becomes unreadable by the scanning device.

Abstract: A system and method for wirelessly powering an electrosurgical device using a generator to generate a radio frequency (RF) energy field. A switch on the electrosurgical device sends a wireless signal to the generator, where the generator allows a current to pass through an inductive coil to generate the RF energy field. The RF energy field induces a current to flow across an inductive coil within the electrosurgical device. The current flow is then processed through a RF conditioning circuit and outputted to the end effector assembly of the device.

Abstract: A system for determining probability of tissue damage includes a plurality of return electrodes adhered to a patient and adapted to couple to an electrosurgical generator configured to generate an electrosurgical current. The system also includes a current monitor and a switching component connected in series with each of the plurality of the return electrodes. The current monitor is configured to measure the electrosurgical current passing therethrough. The system further includes a processor coupled to each of the current monitors and the switching components. The processor is configured to determine the balance of a current load among the plurality of the return electrodes and configured to control each of the switching components to adjust the current passing through each of the return electrodes to balance the current load.

Abstract: A catheter is adapted to ablate tissue and provide lesion qualitative information on a real time basis, having an ablation tip section with a generally omni-directional light diffusion chamber with one openings to allow light energy in the chamber to radiate the tissue and return to the chamber. The chamber is irrigated at a positive pressure differential to continuously flush the opening with fluid. The light energy returning to the chamber from the tissue conveys a tissue parameter, including without limitation, lesion formation, depth of penetration of lesion, cross-sectional area of lesion, formation of char during ablation, recognition of char during ablation, recognition of char from non-charred tissue, formation of coagulum around the ablation site, differentiation of coagulated from non-coagulated blood, differentiation of ablated from healthy tissue, tissue proximity, and recognition of steam formation in the tissue for prevention of steam pop.

Abstract: A device (10) for tissue coagulation, in particular for fusion, encompasses an electric source (18), which is connected or which can be connected to electrodes (12, 13) for influencing biological tissue (11) with current. A control unit (22) controls the source (18) during phases I and II of the tissue fusion. These phases I and II correspond to operating phases I, II and III of the device (10). During operating phase I, a monitoring unit (23) determines the energy E1, which is applied into the tissue (11). In the subsequent operating phases II and III, the control unit (22) controls the source (18) by means of the determined energy E1. Such a device turns out to be particularly reliable and to be robust in use.

Abstract: A medical TFT instrument of the bipolar design includes at least two electrodes held by electrode carriers movable relative to each other which can be charged with HF current via a respective feed line. A safety switch mechanism arranged in the area of the electrode carriers and interconnected in at least one of the feed lines is additionally provided which, upon transfer of at least one of the electrode carriers into the out-of-function/situation, is brought into an OFF or disconnect position, whereby a HF current supply to the electrode associated with this feed line is disconnected.

Abstract: A control handle for a surgical tool, e.g., an irrigated ablation catheter for use with a fluid side arm, has a housing defining an interior cavity and having a port through which the component can extend into the interior cavity. The housing has a detachable plug covering at least a portion of the port and being at least partially surrounded by a recessed groove to facilitate detachment of the plug from the housing. The recessed groove may be formed on an outer surface of the housing and there may be a second recessed groove on an inner surface of the housing generally tracing the first groove. The plug may also include a hinge to allow the plug to be arranged at an angled position relative to the housing without being fully detached from the housing.

Abstract: In an electrode assembly for a catheter system, a plurality of struts each extend from a proximal end to a distal end of the electrode assembly. Each strut spirals about the longitudinal axis of the electrode assembly and has a corresponding electrode disposed thereon. The electrode assembly is configurable between a collapsed configuration and an expanded configuration, with the electrodes being transversely spaced from the longitudinal axis of the electrode assembly a greater distance in the expanded configuration than in the collapsed configuration. In the expanded configuration the electrodes are transversely equally spaced from the longitudinal axis of the electrode assembly. In other aspects, at least one asymmetric element is provided on the electrode assembly to facilitate symmetric expansion about the longitudinal axis of the assembly. In another aspect, the electrode assembly is a single coil that winds about the longitudinal axis of the assembly.

Abstract: A catheter with ablation and potential sensing capabilities is adapted for outer circumferential contact with an opening of a tubular region and inner circumferential contact within the tubular region. The catheter has a proximal electrode assembly and a distal electrode assembly for ablation of an ostium and potential sensing inside the pulmonary vein so that it is possible to obtain ECG signals inside a pulmonary vein when ablating around the ostium. The distal electrode assembly has an elongated member defining a longitudinal axis and a plurality of spines surrounding the member and converging at their proximal and distal ends, where each spine has at least one electrode and a curvature so that the spine bows radially outwardly from the member.

Abstract: Provided is a catheter (100) including: a flexible sheath (1); a flexible shaft (2) which is provided by being inserted inside the sheath (1) and which is capable of sliding in a longitudinal direction of the sheath (1); an electrode section (10) which is capable of being in contact with a renal artery wall. The catheter (100) is configured such that a plurality of electrodes (12) provided to the electrode section (10) do not exist on a single plane perpendicular to a moving axis of the shaft (2). According to the present invention, it is possible to easily and quickly perform renal artery ablation while avoiding post-ablation renal artery stenosis.

Abstract: A surgical device and procedure for accessing tissue to perform microsurgery, including a capsulotomy of a lens capsule of an eye. The device includes a handpiece with a tip for insertion into an incision. A sliding element is disposed within the handpiece and a suction cup is mounted to the sliding element. The sliding element can be translated to move the suction cup into and out of the handpiece. A compression mechanism associated with the suction cup and the handpiece compresses the suction cup for deployment through the tip of the handpiece. The suction cup can expand inside the anterior chamber into a cutting position. A cutting element mounted to the suction cup is used to cut a portion and to remove the portion. The cutting element may be mounted to a cutting element support structure in a way that prevents heating of the device.

Abstract: An electrosurgical suction coagulator includes a housing having proximal and distal ends and an elongated tube-like shaft extending longitudinally from the distal end of the housing. The elongated tube-like shaft includes a tube-like dielectric sheath, a tube-like conductor, and an external insulator. The tube-like conductor is disposed coaxially through the tube-like dielectric sheath. The distal end of the tube-like conductor protrudes at least partially from the distal end of the tube-like dielectric sheath. The external insulator is disposed coaxially around the tube-like dielectric sheath. The external insulator extends from about the proximal end of the dielectric sheath to about the distal end of the dielectric sheath.

Abstract: A surgical instrument includes a shaft having a proximal end and a bifurcated distal end defining a first shaft portion and a second shaft portion. An end effector assembly is disposed at the distal end of the shaft and includes first and second jaw members. One (or both) of the jaw members is moveable relative to the other between an open position and a closed position for grasping tissue therebetween. Each of the jaw members defines an opposed jaw surface and is independently coupled to one of the first and second shaft portions. The first and second shaft portions are configured to flex relative to one another during movement of the jaw members to the closed position to grasp tissue therebetween such that the opposed jaw surfaces of the jaw members are disposed in substantially parallel orientation relative to one another when grasping tissue therebetween.

Abstract: An external fixator system comprising at least two fixation plates which are arranged at a distance to each another, at least one adjustable length strut having a first end region and a second end region which are in connection with the fixation plates and at least one actuation unit to adjust the length of the strut in order to adjust the distance and/or orientation between the fixation plates. The actuation unit is in a fixed connection with at least one of the fixation plates as well as with at least one of the end regions of the respective strut in order to connect the strut with the fixation plate. The actuation unit comprises a feedback unit which provides the user with a feedback concerning the degree of the actuation.

Abstract: External fixation systems, and methods for immobilizing joints or fractured bones. An external fixation system may include one or more clamp assemblies connected to one or more rod assemblies at polyaxial joints. Each rod assembly may be length adjustable, and may include a one-way locking mechanism to provisionally lock the length of the rod assembly, and additional locking mechanisms to permanently lock the length of the rod assembly. The system may be deployed pre-assembled as a unit to immobilize a joint or fracture. Another external fixation system further includes a spanning member extending transverse to the rod assemblies. Two or more external fixation systems may be deployed in a stacked configuration on one set of bone pins to immobilize two joints and/or fractures. The systems may be provided in kits including guiding instrumentation, bone pins and pin clamping assemblies for connecting the bone pins to the external fixation systems.

Abstract: Systems, methods, and devices are described for providing orthopedic implant augments having fastener locking mechanisms. The augments include a surface for mating with an implant component and a surface for interfacing with a patient's bone. The fastener locking mechanisms are aligned such that the augment may be locked in a variety of orientations while maintaining close contact with both an implant and a patient's bone. The alignment of the locking mechanisms provides variability and adjustability to the augment to address a variety of bone anatomies and requirements.

Abstract: An endplate for an intervertebral prosthesis includes an inner domed region and a peripheral rim wherein the inner domed region has a non-circular plan and has an area that is at least 50% of the area of the endplate. A surgical instrument for milling a recess in a vertebral endplate includes a cutting tool having a drive shaft with a positioning collar, a guard frame, and a pair of guide plates attached to the guard frame and spaced to confine the positioning collar and having guide slots for the drive shaft.

Abstract: Reamer sleeves, reamer assemblies, and methods of assembling the reamer assemblies are disclosed. The reamer sleeves include a base portion with a top surface and a bottom surface and a securement mechanism extending away from the top surface of the base portion. The securement mechanism includes an opening, at least one engagement member adjacent the opening, and at least one engagement protrusion extending away from the engagement member into the opening. The opening extends through the securement mechanism to the bottom surface of the base portion. The bone reamer assembly including a reamer and a reamer sleeve removably coupled to the reamer. The reamer including a shaft with a first and second end, a cutting member coupled to the second end of the shaft, and a groove near the second end of the shaft. A method of assembling a hard tissue reamer assembly is also disclosed.

Abstract: The present disclosure relates to a surgical aimer including a shaft having a proximal portion and a distal portion and a handle coupled to the proximal portion of the shaft. The handle includes a mechanism for coupling the shaft to the handle and releasing the shaft from the handle.

Abstract: A mechanism for removing a fluid-filled object from a patient. The apparatus includes a deflation tube with a puncture member at one end of the tube for piercing a hole in the object wall. The apparatus includes a retrieval mechanism slidable within the deflation tube lumen. The retrieval mechanism includes an expansion element that is expandable when positioned within the object from a first configuration with a dimension less than that of the deflation tube lumen to a second or deployed configuration with a dimension that is greater than an outer dimension of the puncture member. The expansion element contacts an inner surface of the inflatable object as the deflation tube and retrieval mechanism are withdrawn from the body cavity. The expansion element may be a T-bar, a foldable anchor, an inflatable member, or another expandable form.

Abstract: Methods, systems, and devices for providing treatment to a target site are described. The system may include a guide assembly, an expandable support device coupled with the distal end of the guide assembly, and an operative member disposed on the expandable support device. The expandable support device may be configured to transition between a collapsed and expanded configuration. The expandable support device may be supported by one or more flexible supports aligned in parallel with an axis about which the expandable support device collapses and/or multiple splines arranged in a pattern configured to promote transitioning of the expandable support device between an expanded and collapsed configuration. The guide assembly may be configured to provide torque to the expandable support device. The operative member can include multiple electrodes arranged in parallel to the axis about which the expandable support device collapses.

Abstract: A device for regulating blood pressure between a patient's left atrium and right atrium, and apparatus for delivery the device, are provided. The delivery apparatus may include one or more latching legs, a release ring, a pull chord, and a catheter wherein the latching legs are configured to engage the device for delivery. The inventive devices may reduce left atrial pressure and left ventricular end diastolic pressure, and may increase cardiac output, increase ejection fraction, relieve pulmonary congestion, and lower pulmonary artery pressure, among other benefits. The inventive devices may be used, for example, to treat subjects having heart failure, pulmonary congestion, or myocardial infarction, among other pathologies.

Abstract: The invention relates to a surgical device (100) designed to be inserted into a stump or a hollow organ (40) of a person or animal in order to prepare a circular anastomosis, wherein the device (100) is designed without a stapling unit for producing a surgical stapled scam, wherein the device (100) has an instrument shaft (120) having a handle section (121, 300) and, at the end of time instrument shaft (120) away from the handle section (121, 300), a head section (130) that is or can be coupled to the instrument shaft (120) by means of a detachable coupling (113), wherein the handle section (121, 300) is designed for a user to hold the device (100), wherein the head section (130) has at least one first molded body (109) and a counter-pressure plate (111) of a surgical circular stapling device (160) connected to the first molded body (109), wherein the surgical device has fu least one first molded body (109) and one second molded body (108) between the handle section and the counter-pressure plate, the second

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: A guide wire includes elements in a telescoping arrangement which impart stiffness to the guide wire for maneuverability in the tortious cardiac vessels. This arrangement also creates engagements between an inner shaft and the tip, that when released, result in a tip which can move outward with forces sufficient to penetrate a lesion in the coronary vessels.

Abstract: The present invention relates to a minimally invasive surgical instrument implementing a motor. According to one embodiment of the present invention, a minimally invasive surgical instrument comprises a shaft, an end effector connected to one end of the shaft, and a handle unit connected to the other end of the shaft. The handle unit includes a pair of linearly moving members, at least one rotating member for moving the pair of linear moving members away from each other in opposite directions, and a driving element for driving said at least one rotating member. The pair of linearly moving members operates the end effector in the pitch direction or in the yaw direction.

Abstract: Provided are surgical instruments, and more particularly, surgical instruments that may be manually operated to perform laparoscopic operations or various surgical operations.

Abstract: The robotic device for positioning a surgical instrument relative to the body of a patient includes a first robotic arm with a device for rigidly connecting to at least one surgical instrument, a device for anatomical realignment of the first arm by realigning an image that is of an area of the anatomy of the patient, and a device for compensating the movements of the first arm on the basis of detected movements. One version of the device includes at least one second robotic arm having sensors for detecting inner movements of the anatomical area, and a device for controlling the positioning of the first arm relative to sensed inner movements and to the outer movements induced in the second arm.

Abstract: A positioning apparatus includes a first portion (123) having a first opening (125) for alignment with a port entry point. A second portion (127) is positionable for alignment with the first opening from a plurality of different positions. An actuation mechanism (142) is coupled to at least one of the first portion and the second portion to set relative positions of the first and second portions to permit a tool axis formed between the first and second portions to be aligned through the first opening such that a tool (104) provided on the tool axis would include a known position and orientation.

Abstract: Devices, systems, and methods for compensate for friction within powered automatic systems, particularly for telesurgery and other telepresence applications. Dynamic friction compensation may comprise applying a continuous load in the direction of movement of a joint, and static friction compensation may comprise applying alternating loads in positive and negative joint actuation directions whenever the joint velocity reading falls within a low velocity range.

Abstract: The embodiments disclosed herein relate to various medical device components, including components that can be incorporated into robotic and/or in vivo medical devices. Certain embodiments include various actuation system embodiments, including fluid actuation systems, drive train actuation systems, and motorless actuation systems. Additional embodiments include a reversibly lockable tube that can provide access for a medical device to a patient's cavity and further provides a reversible rigidity or stability during operation of the device. Further embodiments include various operational components for medical devices, including medical device arm mechanisms that have both axial and rotational movement while maintaining a relatively compact structure. medical device winch components, medical device biopsy/stapler/clamp mechanisms, and medical device adjustable focus mechanisms.

Abstract: An apparatus for facilitating removal of wax from a subject in conjunction with a waxing process includes a contact member for positioning against soft wax applied to the skin of a subject. The contact member includes a main body segment defining a general longitudinal axis, and a tab segment coterminous with the main body segment. The main body segment has an outer periphery. At least the main body segment may comprise an absorbable material, e.g., a non-woven fabric or woven fabric such as muslin cloth, which is dimensioned and adapted to at least partially absorb the soft wax during hardening of the wax. The tab segment may define an outer periphery having a path deviating from a path defined by the outer periphery of the main body segment to present the tab segment for engagement by the user, to thereby facilitate removal of the contact member subsequent to hardening of the wax.

Abstract: A suture placement device is inserted into an endoscopic trocar port site. A pivot bar with a pair of receptor ports is moved from a folded to an extended position below the fascia. The trocar port is removed over the device as the pivot bar is pulled upward against the fascia. A pair of stylet guides are deployed from two sides of the device housing, and intercept the receptor ports, thereby creating a suture path through the first guide, through a channel in the pivot bar between the receptor ports, and through the second guide. A stylet is directed through the suture path to pull a suture through the path. The guides are refracted, the pivot bar is folded, the device is removed, and the suture is tied. A stylet guide may have a partially deployed position to accurately inject an anesthetic at a desired intra-muscular layer.

Abstract: The present invention relates to an openwork prosthetic knit (1) made from a single piece based on first yarns of biocompatible polymer materials that define a first face (2) and a second face that are opposite one another and on a second biocompatible yarn that generates barbs (3) that protrude outwards from at least said first face, characterized in that said first face comprises at least one zone in which it is provided with said barbs and at least one zone (5) in which it is free of such barbs. It also relates to a process for manufacturing such a knit (1) and to a prosthesis comprising such a knit (1).