Abstract: A wound support (50) for use in the vacuum therapy of wounds, can be disposed in its intended use in a wound space underneath a vacuum dressing (6) sealing the wound space with respect to the atmosphere in an essentially vacuum-tight manner, wherein the wound space can communicate with a suction tube (10) to which a vacuum can be applied through an opening (20) in the vacuum dressing (6). The wound support (50) comprises a flexibly compliant foamed material and has a through-hole (54) that extends in the direction of the wound depth, which is used to insert or pass through a wound-side end section (44) of a fluid feed tube (40). A sleeve (56) is disposed in the through-hole (54) into which this end section (44) can be inserted.

Abstract: An apparatus includes a label configured to be coupled to a medicament delivery device. The label includes a first surface and a second surface. The first surface is configured to be coupled to an outer surface of the medicament delivery device. The second surface includes a textual indicia. The label further includes an electronic circuit system configured to output an electronic signal.

Abstract: The present invention relates to osmotic delivery devices, formulations, and methods for delivery of two or more beneficial agents. In one aspect, the present invention provides osmotic delivery devices useful for substantially concurrent administration of two or more beneficial agents. In another aspect, the present invention provides beneficial agent formulations for use in the osmotic delivery devices. The formulations include formulations wherein beneficial agents are soluble in the vehicle, suspension formulations comprising particle formulations of one or more beneficial agent, and combinations thereof. Further, methods for treatment of a variety of diseases or conditions using two or more beneficial agents are disclosed, wherein the methods are preferably practiced using the osmotic delivery devices and/or formulations of the invention.

Abstract: A compression tool is configured to compress one or more components of a delivery device, such as a closure element and one or more flanges of a pusher tube. The compression tool includes clamping means configured to close or release with rotation of actuating means (e.g., rotating means). In a closed position, the clamping means can sufficiently compress the one or more components of the delivery device so that a technician can easily position a garage tube about the compressed delivery device components. The assembled delivery device (or assembled garage tube) can then be removed from the compression tool upon reverse rotation of the actuating means, and subsequent opening of the clamping means.

Abstract: An instrument guide device comprises an elongated guide shaft having proximal and distal ends and including an instrument lumen for receiving therethrough a manually operated instrument having an instrument shaft. A distal bendable member is disposed at the distal end of the guide shaft and a proximal bendable member is disposed at the proximal end of the guide shaft. Actuation means extends between the distal and proximal bendable members and provides a bending of the distal bendable member controlled from the proximal bendable member. The proximal bendable member is controlled from the manually operated instrument to cause a corresponding bending of said distal bendable member.

Abstract: Hand-held surgical instruments that have and end effector attached to an elongate shaft are disclosed. The end effector is articulatable and rotatable relative to the shaft by a nozzle arrangement supported by a handle from which the elongate shaft extends. In various embodiments, the nozzle is operable by the same hand that is used to support the handle.

Abstract: A medical instrument in the form of an endoscopic shank instrument includes an actuation element which is axially displaceable in a shank. Two lever arms are pivotably articulated in a manner distanced to one another and are positioned at a proximal side of the shank. The lever arms form part of a grip part. The lever arms are coupled in movement to the actuation element and are coupled directly to one another.

Abstract: Systems and methods for removing an epithelial layer disposed over a stromal layer in a cornea irradiate a region of the epithelial layer with a pulsed beam of ablative radiation. The ablative radiation is scanned to vary the location of the beam within the region in accordance with a pulse sequence. The pulse sequence is arranged to enhance optical feedback based on a tissue fluorescence of the epithelial layer. The penetration of the epithelial layer is detected in response to the optical feedback. The use of scanning with the pulse sequence arranged to enhance optical feedback allows large areas of the epithelium to be ablated such penetration of the epithelial layer can be detected.

Abstract: An improved system for safe and efficient generation of plasmas and vapors bubbles with continuous wave radiations and low levels of power densities, sufficient to treat medical pathologies and to avoid the creation damage to healthy tissue is provided. Transmission means in different configurations are used to achieve a high absorption in water, which is able to initiate plasma with low levels of power density. Once plasma and vapor bubbles are formed, they absorb other wavelengths in addition to the one that initiated it. Other wavelengths, more efficiently generated by diodes or diode pumped lasers, are added into the beam to improve treatment efficiency. This modulated plasma produces fast tissue ablation and good hemostasis effect with minimal overheating of remaining tissue. After plasma and high-energy vapors are generated, only laser radiation that passes through the plasma bubble directly interacts with soft tissues.

Abstract: The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body, a proximal end and a distal end; a first lumen; a second lumen; and an ablation element expandable from a first diameter to a second diameter, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more deformable balloon and/or flexible elements. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method, a tissue ablation device is provided and tissue in the left atrium is ablated with the device, whereby the ablation is created by freezing tissue.

Abstract: A method for modifying a geometry of a collagenous tissue mass includes heating the collagenous tissue mass to a temperature sufficient to cause denaturation, and introducing a biocompatible fixative, such as genepin, into the collagenous tissue mass.

Abstract: Tissue ablation systems and methods are provided, wherein a cardiac catheter incorporates a pressure detector for sensing a mechanical force against the distal tip when engaging an ablation site. Responsively to the pressure detector, a controller computes an ablation volume according to relationships between the contact pressure against the site, the power output of an ablator, and the energy application time. A monitor displays a map of the heart which includes a visual indication of the computed ablation volume. The monitor may dynamically display the progress of the ablation by varying the visual indication.

Abstract: The present invention provides systems and methods for radiometrically measuring temperature during ablation. An interface module includes a processor; a first input/output (I/O) port configured to receive digital radiometer and thermocouple signals from an integrated catheter tip (ICT) that includes a radiometer; a second I/O port configured to receive ablative energy from an electrosurgical generator; a temperature display; a patient relay in communication with the first and second I/O ports and the processor; and a computer-readable medium storing radiometer and thermocouple operation parameters and instructions for causing the processor to: calculate a temperature adjacent to the ICT based on the radiometer and thermocouple signals and the operation parameters, causing the temperature display to display the calculated temperature, and closing the patient relay so as to pass ablative energy received on the second I/O port to the first I/O port.

Abstract: The present invention provides methods, devices, and systems for in vivo treatment of cell proliferative disorders. The invention can be used to treat solid tumors, such as brain tumors. The methods rely on non-thermal irreversible electroporation (IRE) or supra-poration to cause cell death in treated tumors. In embodiments, the methods comprise the integration of ultra-short electric pulses, both temporally and spatially, to achieve the desired modality of cell death.

Abstract: An electrosurgical surgical instrument can comprise a handle and an end effector, wherein the end effector can comprise first and second jaws which can be opened and closed in order to capture tissue therebetween. In various embodiments, the first and second jaws can comprise one or more electrodes configured to apply a voltage across the tissue, wherein one or both of the first and second jaws can include a plurality of electrodes each comprised of a positive temperature coefficient material having a different switching temperature. The electrical resistances of the electrodes can increase significantly once the temperature of the electrodes exceed their switching temperatures and, owing to the increased electrical resistance, the flow of current through the electrodes can be reduced and/or prevented. In various circumstances, the different switching temperatures of the electrodes can allow some of the electrodes to switch off before the other electrodes.

Abstract: A bipolar medical instrument has a shaft and two jaw parts arranged at the distal end thereof. An axially movable force transmission element is disposed with the shaft and is surrounded by an isolating element. The isolating element is connected to at least one of the two jaw parts in an articulated manner. The two jaw parts are electrically isolated from one another and each provides an electrode to which high frequency current can be applied. A first electrical supply line is formed along the shaft via an electrically conductive first contact element to one of the two jaw parts. A second electrical supply line is formed along the axially movable force transmission element via an electrically conductive second contact element to the other of the two jaw parts. The first contact element is fixed at the isolating element surrounding the distal end area of the force transmission element.

Abstract: A surgical device which is configured to apply energy to living tissue and to be used to perform a surgical procedure includes a grasping portion, an incising portion, an introduction portion and a treatment portion. The grasping portion grasps the living tissue having a first surface and a second surface. The incising portion is movable forward and backward with respect to the living tissue and incises the living tissue. The introduction portion is movable forward and backward with respect to the living tissue and introduces a biocompatible material, which is chemically bound with the living tissue, to a space between the first surface and the second surface. The treatment portion is configured to apply high-frequency energy and thermal energy to the living tissue.

Abstract: An electrosurgical instrument for coagulating and/or cutting biological tissue which can be manufactured easily and economically and which allows a surgical intervention to be carried out easily and reliably The instrument includes two linked branches which can be moved toward one another, gripping devices at a proximal region of the branches or of the instrument for bringing the branches together, electrode parts at a distal region of the branches or of the instrument for grasping tissue and for conducting a high-frequency current through the tissue, current feed devices for feeding the high-frequency current to the electrode parts from a high-frequency generator, a switching device for activating the high-frequency current with the branches brought together, at least one spacing element to form a defined minimum spacing between the electrode parts, and at least one elastically deformable element, which is arranged at one of the branches or the gripping devices such that, on closing the branches and reaching

Abstract: An orthopedic assembly for stabilizing a fractured bone. The orthopedic assembly includes a support structure and an anchor. The anchor includes a first portion and a second portion moveably coupled to the first portion to adjust an angular orientation of the anchor relative to the femur.

Abstract: An apparatus to promote bone fusion between portions of bone tissue comprises a bone engagement member and a flexible retention member. The bone engagement member comprises (a) an extramedullary bone contacting main body with a first surface defining a hole in the main body and (b) an intramedullary bone engaging projection extending from the main body. The projection engages the intramedullary portions of at least one the portions of bone tissue. The projection includes a second surface that defines a retention passage in the projection. The retention passage is spaced away from the hole and oriented transversely relative to the hole. The flexible retention member is configured and dimensioned to extend through the retention passage and into the hole to help retain the projection in intramedullary engagement with the at least one of the portions of bone tissue.

Abstract: A method and tool for creating a location for a fixation device to be secured to a bone. The method includes bringing a bone cutting tool extending along a longitudinal axis into engagement with an outer surface of the bone. The bone cutting tool is rotated about the longitudinal axis while driving it from the outer surface of the bone to a predetermined depth in the bone to form a bore. The bone cutting tool is then continuously rotated at the predetermined depth to establish an enlarged bone pocket at a distal end of the bore. The bone pocket defines a shoulder extending around a circumference between the bone pocket and bore. The bone cutting tool is removed from the bone pocket and bore. The fixation device is then inserted into the bone pocket through the bore, where it is seated against the bone pocket shoulder.

Abstract: A medical electric drill includes a drilling head, a microprocessor, a pressure sensor unit, a torque sensor unit and a gravity sensor unit. The drilling head is for drilling a bone. The microprocessor is signally connected to the drilling head for calculating a displacement of the drill. The pressure sensor unit is for detecting a pressure change and provides a pressure change signal to the microprocessor. The torque sensor unit is for detecting a torque change and provides a torque change signal to the microprocessor. The gravity sensor unit is for detecting an acceleration variation of the drilling head and provides an acceleration voltage signal to the microprocessor. The microprocessor determines a work period of drilling the bone according to the pressure change signal and the torque change signal, and then the microprocessor calculates the displacement of the drilling head by using the acceleration voltage signal during the work period.

Abstract: A system and method may be used for accessing an articular surface and for preparing an implant site on the articular surface. The method may include locating a portion of the articular. An access passage may be drilled towards the articular surface though bone behind the articular surface. An implant site may be excised in the articular surface relative to an axis defined by the access passage.

Abstract: An instrument for holding a bone plate may include a first arm, a second arm connected to and adjustable relative to the first arm, a first connection tip at the distal end of the first arm configured to connect to the first side wall of the bone plate, and a second connection tip at the distal end of the second arm configured to connect to the second side wall of the bone plate. A stabilizing member is connected to the first connection tip. The stabilizing member is distally spaced apart from the first connection tip to form an opening for receiving a portion of bone between the first connection tip and the stabilizing member.

Abstract: A tamping apparatus is described that includes a cannula that has a tubular wall that includes a distal end portion that defines a tamping face. The cannula defines a longitudinally aligned aperture or lumen that provides access for an insert and the injection of treatment materials such as a bone graft. The distal end portion of the cannula can also include a plurality of movable elements that can be a part of or connected to the tubular wall. The tamp apparatus can also include a cannula or stylet that can be moved within aperture of cannula and is employed to move elements between the first position and second position of tamp apparatus.

Abstract: A cutting guide for performing a bone osteotomy procedure is disclosed. The cutting guide includes a first arm having a first cutting guide surface formed therein, a second arm having a second cutting guide surface formed therein pivotably connected to the first arm and a distractor operatively connected to the first arm. The cutting guide is adapted to be affixed to the bone such that the first cutting guide surface is open to the second cutting guide surface. The first arm and second arm are rotatable with respect to each other such that manipulation of the distractor creates a force between the first arm and the second arm causing rotation of the first arm and second arm relative to each other. A method for using the cutting guide in a bone osteotomy procedure is also disclosed.

Abstract: A method of surgically preparing a tibia for implantation of a tibial prosthetic component is disclosed.

Abstract: In some embodiments, an apparatus includes an elongated member, an expandable member coupled to the elongated member, and an outer sheath. The outer sheath, which can be constructed from a different material than the expandable member, is disposed about the expandable member such that an outer surface of the expandable member is in discontinuous contact with an inner surface of the outer sheath. The expandable member and the outer sheath are configured to cooperatively displace a bone structure when moving between a collapsed configuration and an expanded configuration.

Abstract: A surgical instrument for acetabular cup implantation includes an acetabular cup, a shell body and a drive shaft. The drive shaft includes a drive rod and a handle bar. The handle bar engages the pivot for angular displacement having forward position and backward position. In the forward position the drive rod rotates the acetabular cup forward, and in the backward position the drive rod shifts backward resulting in the acetabular cup engaged the extension portion. Accordingly, the operator rotates the handle bar to control the acetabular cup inserting into the position of acetabulum. The rotation of the handle bar results in the gripping or releasing of the acetabular cup or insert from the invention. Thus the invention provides a clear and ergonomic instrument for medical personnel concerning the operation of acetabular cup implantation.

Abstract: A delivery system comprising a biodegradable single or multi compartment covering is provided. The covering can be a mesh bag including a pre-attached detachable holding member surrounding the opening of at least one compartment and a pre-attached removable filling member configured to fit within the opening of the at least one compartment. The opening of the bag can include a closing member. The pre-attached detachable holding member can be a collar including finger grips and is used to hold the bag in one position while filling it. In some embodiments, the pre-attached detachable filling member can be a funnel for loading the mesh bag with bone graft material. Once the covering is filled, the holding member and filling member can be removed and the covering is closed with a closing member such as a drawstring. A method of treatment utilizing the delivery system is also provided.

Abstract: A method for treating a vertebral bone comprises providing a gaseous substance and providing a flowable and settable bone filling material. The method further comprises introducing the gaseous substance into the bone filling material to form a porous bone augmentation material and inserting a material delivery device into the vertebral bone. The method further comprises injecting the porous bone augmentation material from the material delivery device and into the vertebral bone.

Abstract: A bone cement injection device whereby bone cement is inserted through the skin and into bone, and can easily be separated during outflow of the bone cement into the blood vessels and spinal canal and curing. An outer insertion member has an outer needle tube having one end that is sharpened to be inserted through the skin and into bone and a partially closed part where the cross-sectional area of the internal space is reduced. A main hand grip is integrally formed on the other end of the outer needle tube and has a fastening part able to be fastened to a bone cement supply. An inner insertion member includes an inner needle rod for insertion into the other end part of the outer needle tube which opens through the main hand grip, and an auxiliary hand grip which is integrally formed on the inner needle rod.

Abstract: The invention relates to a surgical device, the device comprising a probe part and means to generate a Shockwave in the probes sufficient to separate, adjust of attach two or more, parts when the probe is applied to one of the part in vivo, the arrangement being such as to allow the application of a Shockwave that is regulated in amplitude and repeatable.

Abstract: Surgical devices configured to apply and hold a defined pre-set or pre-load tension to target tissue, such as, for example, a blood vessel, tendon or ligament during a surgical procedure.

Abstract: An apparatus transfers predetermined spatial positioning information to an adjustable tool. Means are provided for temporarily holding at least a carrier portion of the adjustable tool stationary relative to a manipulable reference surface. Means are provided for imparting predetermined spatial positioning information to the reference surface in a first degree of freedom. Means are provided for imparting predetermined spatial positioning information to the reference surface in a second degree of freedom. The predetermined spatial positioning information is imparted to the reference surface in the first and second degrees of freedom to generate a pre-set reference surface. At least a portion of the adjustable tool is held stationary relative to the pre-set reference surface. At least a functional portion of the adjustable tool is manipulated into a predetermined setting position relative to the reference surface. The predetermined setting position reflects a position of the pre-set reference surface.

Abstract: A device for inserting an intraocular lens (IOL) into an eye includes a tubular body member with an inner surface and a plunger with an gripping device that is receivable within the body member. The gripping device includes a locking member and is configured such that when urged longitudinally in a distal direction, the gripping device is movable in the distal direction within the body member. However, when urged longitudinally in a proximal direction, the gripping device is prevented from moving in the proximal direction by the locking member engaging with the inner surface of the body member. As such, inadvertent movement of the plunger in the proximal direction caused by pulling back on the plunger is substantially prevented. If proximal movement of the plunger is desired, then the plunger may include handle that is operatively coupled to the gripping device such rotation of the handle causes the handle to move longitudinally in the body member.

Abstract: A system for treating uterine tissue having a seal assembly configured for positioning in a patient's cervical canal and uterine cavity; an expandable distal balloon portion; an expandable elongate medial balloon portion configured for movement between a first transversely expanded shape for engaging a cervical canal and a second transversely non-expanded shape for trans-cervical insertion; and a fluid source in communication with distal balloon portion and medial balloon portion for expansion of said balloon portions.

Abstract: A medical device and method for breaking a concretion in a body into smaller pieces and removing the pieces from the body are described. The device comprises a dilator sheath, a lithotripsy probe, a tubular member, and a retrieval basket. The dilator sheath adapted to penetrate into a passage of the body to reach the location where the concretion is located. The lithotripsy probe is configured for shattering the concretion into smaller pieces. The tubular member is mounted within the dilator sheath adapted to permit the lithotripsy probe to be inserted into the tubular member. The retrieval basket is coupled to the tubular member, and configured for entrapping the concretion and the smaller pieces for their extraction from the body.

Abstract: The present invention generally relates to methods for preparing a skin graft without culturing or use of biologics.

Abstract: A dermatome having a handle and an attachment including a valve, where the valve may include a first bobbin at least partially defining a first flow path and a second flow path, a second bobbin at least partially defining a first flow path, an inlet port at least partially defined by the second bobbin and an outlet port at least partially defined by the first bobbin. The ports of the valve may open in response to an application of a mechanical act to the attachment and the ports may close in response to the absence or removal of the mechanical act.

Abstract: An apparatus for delivering and deploying a closure element to an opening formed in a body lumen, including a delivery assembly positionable through the tissue and into the opening. The delivery assembly includes a distal locator portion and a carrier portion oriented proximal to the distal locator portion. The distal locator portion is configured to selectably engage the body lumen adjacent to the opening, and the carrier portion is configured to carry and support the closure element in a substantially tubular configuration. The carrier portion is further configured to urge the closure element toward an expanded cross-sectional dimension for deployment thereof, such that the closure element is oriented to engage the tissue when deployed and, when released, to return to the natural, substantially planar configuration and the natural cross-section dimension wherein the engaged tissue is drawn substantially closed.

Abstract: Apparatus and methods for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract: A novel occluder application and clip device for treatment of embolic stroke caused by atrial fibrillation uses multiple sutures in a non directional handle to affix the occlusion device to the applicator and manipulate the occluder from an open and receiving position to a closed and occluding position. The occluder is retained in place by a clamping means related to locks retainers, resilient material or otherwise. An actuator mechanism is used to manipulate the occluder to a locked or occluding position. The applicator with the occluder attached has a low profile and remote manipulations to allow the occluder to be delivered to the clamping location within a patient through a small incision or delivery port such as a trocar cannula or the like.

Abstract: In some embodiments, an apparatus includes a handle and an elongate member coupled to the handle. The elongate member has a first portion, a second portion and a third portion. The first portion of the elongate member extends from the handle and defines a first longitudinal axis. The second portion of the elongate member extends from the first portion and defines a second longitudinal axis. The first longitudinal axis and the second longitudinal axis define a first angle and a first plane. The third portion of the elongate member extends from the second portion of the elongate member and defines a third longitudinal axis. The third longitudinal axis and the second longitudinal axis define a second angle and a second plane. The second plane is non-parallel with the first plane.

Abstract: An absorbable surgical screw fastener is provided which includes a head and a tapered shaft extending distally of the head. Buttress threads are provided about the tapered shaft to secure the fastener in tissue. The fastener includes slots formed in the head and buttress threads. A gap is provided between the buttress threads in the head to secure a prosthetic. There is also provided a surgical instrument having novel lockout structure to prevent inadvertent actuation.

Abstract: An apparatus for suturing tissue includes first and second needles. A first structure associated with the first needle is adapted and configured to pass a leading portion of the suture from a near side of a tissue to a far side of the tissue. A second structure cooperates with the second needle to capture and secure the suture. Proximal movement of the apparatus after the suture is captured moves the suture from the far side of the tissue to the near side of the tissue.

Abstract: Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Abstract: A device for placing sutures through thick and/or moving tissue such as the wall of a beating heart. The device includes a tissue welting tip having a trough for forming a welt in a tissue section, an alignment guide having an opening receiving a guide wire and pivotally mounted in the distal end adjacent to the trough, and an elongated sleeve slidably engagable with the guide wire. The device also includes one or more expandable tissue engaging member(s) on the sleeve expandable from a collapsed configuration having a diameter small enough to pass through the opening in the tip to an expanded configuration having a diameter large enough to engage a tissue section and urge it into the trough to form a welt in the tissue section and a retractable needle extendable through at least two portions of a tissue section while the tissue section is engaged with the trough.

Abstract: Endoluminal treatment devices and methods are provided. Generally, the device and methods can allow an endoluminal device to be introduced into a lumen of a patient and engage a wall of the lumen with an implant device, which can be a drug delivery device or medical device. In one embodiment, a medical implant apparatus is provided that includes an anchor object configured to couple with tissue, and an adjustable mechanism configured to interact with the anchor object such as to apply alternative forces upon the anchor object in response to a stimulus.

Abstract: A method for extracting a tubular structure from tissue using a device including a handle having an actuator, an elongate body with a first end coupled to and extending from the handle, and an operational head disposed at a second end of the elongate body. The operational head is longitudinally movable between a neutral position and an actuated position. The method includes inserting the elongate body into the tubular structure; placing the operational head into the actuated position; engaging the tubular structure with the operational head when in the actuated position; and pulling the tubular structure from the tissue by moving the operational head.