Abstract: An apparatus for generating an alteration of biomechanical properties of ocular tissue, into which a photosensitizer (14) has been introduced, contains means (18, 20) for radiating into the tissue electromagnetic radiation (12?) which reacts with the photosensitizer for the purpose of generating a cross-linking. The setting means permit an inhomogeneous distribution of the irradiance in the tissue and a setting of the depth of action (16?).

Abstract: Embodiments of the invention are directed to a laser ablation system. In one embodiment, the laser ablation system comprises a shaft, a balloon, a laser fiber and a viewing fiber. The shaft has a proximal end and a distal end. The balloon is attached to the distal end of the shaft, a portion of which is within the balloon. The laser fiber has a distal end comprising a light dispenser that is configured to deliver laser light through the balloon. The viewing fiber is configured to image an interior balloon. In accordance with another embodiment, the laser ablation system comprises a shaft, a balloon and a laser fiber. The shaft has a proximal end and a distal end. The balloon is attached to the distal end of the shaft, which is within the balloon. The balloon includes an inflated state, in which the balloon is shaped to conform to a cavity of a patient. The laser fiber has a distal end comprising light dispenser that is configured to deliver laser light through the balloon.

Abstract: An improved procedure for performing liposuction is obtained by utilizing a needle that includes a laser source conductor with one end of the needle being configured for insertion into a target adipose skin volume and the other end being coupled to a laser source. The needle may include one or more channels for extracting the treated adipose area. A vacuum source can be used in the extraction of the treated adipose. Further, the first end of the needle may include a cap or end-piece that reduces the build up of carbon deposits. A temperature sensor may be used as input to adjust the laser power and prevent over exposure.

Abstract: Methods and devices for treating nasal airways are provided. Such devices and methods may improve airflow through an internal and/or external nasal valve, and comprise the use of mechanical re-shaping, energy application and other treatments to modify the shape, structure, and/or air flow characteristics of an internal nasal valve, an external nasal valve or other nasal airways.

Abstract: A surgical instrument, particularly an electrosurgical instrument, including an actuating element for actuating at least one first and one second functional unit, wherein the actuating element is movable in a translational and/or rotational motion within a movement range, wherein the first functional unit is actuatable by means of a movement within a first partial region of the movement range and the second functional unit is actuatable by means of a movement within a second partial region of the movement range, wherein a changeover device is provided such that, as a result of a movement of the actuating element through a changeover region between the first and second partial region, an operative connection between the first functional unit and the actuating element can be interrupted and an operative connection can be established between the second functional unit and the actuating element.

Abstract: A method for generating an improved tool path for cutting a bone so as to minimize soft tissue trauma, wherein the method comprises: accessing an image of the bone which is to be cut; accessing an image of a pre-determined cutting pattern; superimposing the image of the pre-determined cutting pattern against the image of the bone; calculating the intersection of the pre-determined cutting pattern and the bone using the superimposed images of the pre-determined cutting pattern and the bone; and generating a tool path based upon the intersection of the pre-determined cutting pattern and the bone so as to minimize soft tissue trauma by leaving a thin perimeter of bone at the boundary of the bone cut when the boundary of the bone cut is adjacent to a bone surface.

Abstract: A surgical cutting blade for cutting bone material when the blade is coupled to a hand-held surgical saw includes a distal portion comprising a plurality of cutting teeth, a shank portion adjacent the distal portion, and a proximal portion adjacent the shank portion. The proximal portion may include a longitudinally extending slot having a proximal opening. The slot may be shaped to receive a portion of the surgical saw through the proximal opening. The proximal portion may have a plurality of deflectable fingers respectively separated from a plurality of main body portions by respective gaps. The plurality of deflectable fingers may extend adjacent the longitudinally extending slot, and may deflect into the gaps to increase and decrease a width of a portion of the slot.

Abstract: A spinal disc preparation tool is provided that includes an elongate shaft having an inner lumen extending therethrough along a longitudinal axis between proximal and distal ends thereof. A lower jaw is located on a distal end of the elongate shaft for receiving tissue and delivering tissue to the inner lumen, and an upper jaw is pivotally movable relative to the lower jaw. The tool can include various features to facilitate removal and/or collection of tissue.

Abstract: An instrument includes a distraction mechanism having a proximal end and an opposed distal end. The distal end includes opposed first and second end members. A first vertebral endplate spreader includes a proximal spreader section mounted to the first end member of the distraction mechanism. The first spreader also includes a distal spreader section operatively connected to the proximal spreader section for lateral movement relative to the proximal spreader section. A second vertebral endplate spreader is mounted to the second end member of the distraction mechanism. The distraction mechanism is configured and adapted to distract the spreaders apart and to retract the spreaders together along a distraction axis. The distal spreader section of the first spreader is configured to move relative to the second spreader in a lateral direction relative to the distraction axis for correction of vertebral alignment, as in treatment of spondylolisthesis, scoliosis, and the like.

Abstract: A method and instrument is used for inserting a bone screw through a hole in a bone plate into bone at a maximum angulation of a bone screw central longitudinal axis with respect to a central axis of the hole. The maximum angulation places the head of the bone screw at or below an outwardly facing surface of the bone plate. The instrument has a distal end including a gauge element spaced proximally from an end surface of the distal end when in contact with a counterbore surrounding the plate hole a distance less than a depth of the counterbore. The instrument is tilted with respect to a central axis of the bone plate hole to an angle wherein the gauge element remains at or below the outwardly facing surface of the bone plate adjacent the counterbore. A hole is drilled through a guide bore in the instrument.

Abstract: A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Abstract: A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Abstract: Various embodiments of components, devices, systems and methods are provided for a pneumatic surgical instrument having a distal end of a probe configured to penetrate bone, resect or microfracture bone. The injury caused to the bone by the penetration, resection or microfracturing of same causes blood to flow to the injury site and promote the growth of new bone at the site. Holes or recesses in the bone may also be employed to treat arthritis in patient, to form holes or recesses in which one or more orthopedic implants are attached or anchored to same, form microfractures in bone, resect bone, perform osteotomies, or to carry out yet other surgical procedures in bone.

Abstract: Various embodiments of components, devices, systems and methods are provided for a pneumatic surgical instrument having a probe or an impactor disposed at a distal end thereof and configured to make contact with a selected portion of an orthopedic implant or device. The instrument is configured to generate a shock wave, which is then transferred to the distal end of the probe or impactor, and then into the orthopedic implant or probe.

Abstract: A head holder for holding and tensioning the head of a bone screw, particularly a pedicle screw, is provided. Also provided is a ratcheting connector for connecting to the head holders while permitting rotational movement of the head holder when engaged with the ratcheting connector. Also provided is a flex arm connector for connecting multiple ratcheting connectors across multiple vertebral bodies. A tool set for managing and/or correcting spinal deformities, such as scoliosis, including at least one or more head holders and one or more ratcheting connectors is provided.

Abstract: The pedicle screw extension system may include a removable cannulated extension provided to a pedicle screw tulip head. The cannulated extension may permit percutaneous implantation of pedicle screws followed by rod placement that may be guided by slots running along the length of the extension. The cannulation may allow for passage and attachment of secondary instruments, such as for example: a screw driving device, a rod measuring device, and a set screw driving device. The screw extension may also include secondary device attachment features allowing the rod to be pushed down in a screw tulip head and for extension removal as needed.

Abstract: A hair removal system configured to destroy germinative cells at a base of at least one hair follicle is provided. The system comprises a casing and at least one pluck-head configured to trap at least one hair, and at least one oscillator mechanically coupled to the pluck-head and to the casing. The oscillator is configured to vibrate the pluck-head such that when the hair is trapped by the pluck-head, vibrations transmitted to the base are sufficient to destroy the germinative cells. A method of using the same is also disclosed.

Abstract: Methods and devices are provided for closing a puncture wound. In one exemplary embodiment, a puncture closure device is provided having an elongate tubular body that is disposable through a puncture in tissue and that includes proximal and distal portions. The proximal portion can be adapted to expand to form proximal wings upon rotation of the elongate tubular body, preferably in a first direction. The distal portion can be adapted to expand to form distal wings upon rotation of the elongate tubular body, preferably in a second, opposite direction. The proximal and distal portions can also be adapted to be moved toward one another as they expand upon rotation. As a result, the proximal and distal wings can engage tissue therebetween.

Abstract: Integrated systems and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device configured to deploy and implant anchoring devices for such purposes.

Abstract: Spring clips are arranged end to end in a cavity of an inner shaft. Such shaft slides within an outer shaft, and a pusher member slides in the cavity behind the clips. The clips have jaws biased together, but which are wedged apart by an opener as the pusher is moved distally. An opened clip is ejected by relative movement of the inner and outer shafts to clamp body tissue at a desired site.

Abstract: Apparatus and methods for Achilles tendon repair are described where an elongate tendon repair assembly may be introduced into a single incision to access the damaged tissue. The assembly may define a channel for receiving a portion of the tendon and which may provide support to the tissue during repair. One or more retractable needles each carrying a length of suture may be deployed within the channel for piercing through the tendon and a cinching member may secure each of the suture lengths for tensioning the suture against the damaged tendon. Once the suture lengths have been deployed, the needles may be retracted and the device removed from the incision.

Abstract: A medical treatment tool includes: an insert portion at least a part of which is provided by a flexing portion that is adapted to be flexed, the insert portion being adapted to be inserted into a human body of a patient; and an inflatable body provided on an outer circumference of the flexing portion, the inflatable body being inflated in a radial direction of the flexing portion. An axial distal end portion of the inflatable body is fixed to the insert portion while a proximal end portion of the inflatable body is axially movable relative to the insert portion.

Abstract: A medical device is configured to position a bag member filled with a therapeutic substance in a prescribed region of the brain. The use of this medical device involves, with a sheath inserted in the brain region, filling a therapeutic substance into a bag member through an infusion tube, followed by retracting the sheath relative to the infusion tube until the bag member protrudes forward beyond the distal end of the sheath. After this, the bag member is put indwelling in the brain region by moving an operating member relative to the infusion tube to detach the bag member from the distal end of the infusion tube.

Abstract: A surgical instrument includes a housing supporting first and second actuators thereon, and an elongated shaft extending distally from the housing. First and second drive members extend through the elongated shaft to operatively couple respective actuators to respective jaw members such that independent manipulation of one of the actuators may induce pivotal movement of an individual jaw member. A locking member is operatively associated with the first and second drive members, and is selectively movable between locked and unlocked positions. When the locking member is in the locked position, the first and second drive members are coupled to one another and move concurrently to drive the jaw members in a bilateral manner. When the locking member is in the unlocked position, the drive members are decoupled from one another and move independently to permit operation of the instrument in a unilateral manner.

Abstract: A bone fixation system includes a bone plate, bone anchors, temporary fixation members, and forceps. The temporary fixation members are configured to be inserted through apertures in the bone plate and into underlying bone segments that are separated by a bone gap. The forceps are configured to apply a force to the temporary fixation members that causes at least one of the underlying bone segments to translate with respect to the other bone segment, thereby reducing or distracting the bone segments without interfering with final fixation by screws of bone segments.

Abstract: The present invention provides, in certain aspects, devices and methods for plugging passageways and other open spaces in the body. In one embodiment, a plugging assembly comprises a first plug member and a second plug member, wherein the second plug member is configured to contact and move a portion of the first plug member in plugging a body passageway. These plug members may be formed with one or more of a variety of biocompatible materials including some that are naturally derived and some that are non-naturally derived. In another embodiment, such a plugging assembly is combined with a device that is suitable for delivering the assembly into a body passageway.

Abstract: A lockable flexible element including an attachment and a substantially elongated and flexible body defining a body first end and a substantially opposed body second end, the body defining a body serrated surface substantially longitudinally spaced apart from the body second end. The attachment includes a collar provided substantially adjacent the body second end; a tongue provided at least partially inside the collar and extending substantially longitudinally thereinto, the tongue defining a tongue serrated surface, the tongue being deformable between a tongue extended configuration and a tongue retracted configuration; and a safety catch removably insertable between the tongue and the collar with the tongue between the body serrated surface and the safety catch.

Abstract: A reduced-pressure, deep-tissue closure device for applying a closing force on a deep tissue includes a contractible matrix that is formed with a first plurality of apertures and which has a first side and a second, inward-facing side. The contractible matrix is for disposing proximate to the deep tissue. A reduced-pressure source is fluidly coupled to the contractible matrix and operable to deliver reduced pressure to the contractible matrix. When under reduced pressure, the contractible matrix grips the deep tissue adjacent the contractible matrix and provides a closing force on the deep tissue. A system and method are also presented.

Abstract: A drawn surgical suture material includes an elongate main body and barbs for anchoring in biological tissues, wherein the barbs are formed by cuts made into the suture material in the undrawn state.

Abstract: Apparatus for securing an object to bone, the apparatus comprising: a suture anchor assembly comprising a suture anchor body and a suture; the suture anchor body being configured to be lockingly disposed within a hole formed in the bone, and having an opening formed therein for slidably receiving the suture therethrough; the suture having a first end, a second end and an intermediate portion extending therebetween; the suture extending through the opening in the suture anchor body so that the intermediate portion forms a loop on one side of the opening and the first and second ends are disposed on the other side of the opening, such that when the first end of the suture is passed through the loop and securingly engages the object, pulling on the second end of the suture draws the loop and a captured portion of the suture along a path toward the opening in the suture anchor body; the suture anchor body being configured so that when the suture anchor body is disposed in the hole in the bone, a tapered bindi

Abstract: An apparatus can include a first flexible member having first and second ends and a first body extending therebetween, where the first body defines a first passage portion. A second flexible member can have first and second ends and a second body extending therebetween, where the second body defines second and third passage portions. The first end of the first flexible member passes into and through the second passage portion such that the first end extends outside of the second passage portion, and the second end of the first flexible member passes into and through the third passage portion such that the second end extends outside of the third passage portion. The first and second ends of the second flexible member pass into and through the first passage portion to form a self-locking adjustable flexible member construct.

Abstract: A system and method for securing a medical implant within a patient. The method comprises disposing an anchor element around the implant, the anchor element including a pair of tabs each including an eyelet, and a flexible intermediate portion between the tabs, wherein disposing the anchor element around the implant includes positioning the implant within the intermediate portion and folding the anchor element such that the tabs contact one another and the eyelets aligned. The anchor element is positioned at a desired implantation position with the tabs positioned proximate soft tissue of the patient. The method further comprises inserting a distal tip of a fixation element delivery tool through the eyelets and into the soft tissue, the fixation element including at least one tissue anchor and an adjustable suture arrangement coupled to the tissue anchor. The at least one tissue anchor is deployed from the delivery tool and into the soft tissue of the patient.

Abstract: A polyaxial bone screw assembly includes a shank body having an upper head portion with a mating segment and a first partial spherical surface, a retainer structure being mateable with the mating segment of the upper head portion, the retainer structure having a second partial spherical surface such that when mated, the first and second partial spherical surfaces form a spherical ball member, a receiver defining an open channel and having a base with a seating surface partially defining a cavity, the open channel communicating with the cavity, the cavity communicating with an exterior of the base through an opening sized and shaped to receive the shank upper head portion therethrough, and a bushing sized and shaped to fit within open channel and cavity, the bushing having a lower rounded surface engageable with a top surface of the spherical ball member formed by the shank and retainer structure.

Abstract: An apparatus (10) includes a fastener (16) engageable with a bone portion to connect a longitudinal member (12) to the bone portion. A housing (40) has a first passage (42) configured to receive the longitudinal member (12) and a second passage (44) extending transverse to the first passage. The fastener (16) extends through an opening (50) in the housing (40) into the second passage (44). A longitudinal axis (18) of the fastener (16) is positionable in any one of a plurality of angular positions relative to a longitudinal axis (46) of the second passage (44). A spacer (60) received in the second passage (44) of the housing (40) is engageable with the fastener (16) and the longitudinal member (12). A member (70) applies a force to prevent relative movement between the fastener (16) and the housing (40) and permit manual movement of the fastener (16) relative to the housing (40) against the force when the longitudinal member (12) is disengaged from the spacer (60).

Abstract: A device for fixing a bony structure to a support member. The device includes a main body with first and second members, the second member being movable in rotation with respect to the first member, around a first axis. A flexible member passes between the members and forms a loop around a bony structure. A clamping mechanism moves the first and second members into a clamping position. A support member and the flexible member are secured between the members in the clamping position. The first axis is movable in translation along a first direction and the second member is movable in translation along the first direction. The clamping mechanism cooperates with the first and second members to move the second member in translation in the first direction.

Abstract: Surgical systems and methods are disclosed for safe bi-cortical bone screw placement within a bone segment. Included is a method of measurement to control advancement of instruments and implants to repeatedly obtain bi-cortical screw fixation while minimizing protrusion of the lead end of the screw beyond the distal cortical wall therein reducing incidence of injury to adjacent soft tissues.

Abstract: Expandable support devices for tissue repair are disclosed. The devices can be used to repair hard or soft tissue, such as bone or vertebral discs. A method of repairing tissue is also disclosed. Surgical devices and methods for adjusting (e.g., removing, repositioning, resizing) deployed orthopedic expandable support devices are also disclosed. The expandable support devices can be engaged and surgically implanted by an engagement device and affixed to bone to provide stability and support for the devices. The expandable support devices are attachable to spinal fixation devices such as screws or plates, and may be used to support such devices when placed in weakened or damaged areas of bone.

Abstract: A sternal clamp having a first sliding body member and a second sliding body member telescopically mated, and a suture-receiving channel disposed on the exterior of the first sliding body member and the second sliding body member, wherein the first sliding body member and the second sliding body member are securable about a severed sternum by encircling and securing a suture about the first sliding body member and the second sliding body member, the suture being received and retained within the suture-receiving channel.

Abstract: Apparatus, devices, methods, systems, computer programs and computing devices related to autofluorescent imaging and ablation are disclosed.

Abstract: Methods of delivering optical stimulation to a target tissue from an optical stimulation device are provided. One method comprises sensing a temperature at the optical stimulation device or proximate to the optical stimulation device, and adjusting the delivery of light to the target tissue based on the sensed temperature. Another method comprises delivering the light to the target tissue with an optical light guide and sensing bioelectric signals with a sense electrode, wherein the optical light guide and the sense electrode each comprise a material that produces substantially no induced current in an electromagnetic field. Another method comprises delivering light from a light source of an optical stimulation device to a window of the optical stimulation device, delivering the light from the window to an optical light guide optically connected to the window, and delivering the light to a target tissue via the optical light guide.

Abstract: A method of performing therapy on tissue using a medical apparatus. The apparatus includes a shaft configured for insertion into a hollow anatomical structure (HAS) and has a tissue sensor and a therapeutic energy application device both located on the shaft. The method comprises: receiving electrical power at a first power level and directing the first-level power to the tissue sensor and not to the therapeutic energy application device, thereby enabling tissue sensing with the tissue sensor; receiving electrical power at a second power level higher than the first-level power; and, in response to receipt of the second-level power, directing the second-level power to the therapeutic energy application device, thereby enabling performance of therapy on the tissue with the therapeutic energy application device. Additional methods and apparatus are disclosed as well.

Abstract: A stent delivery and deployment system for placement of vascular stents having apertures therein for deployment at intersecting blood vessels. The device employs a guide wire having an angled distal end which is threaded into position at the intersection of a first blood vessel and second blood vessel. With the angled portion of the guide wire threaded into the intersecting blood vessel, the stent may be translated along the guide wire to easily position the aperture in line with the intersecting blood vessel.

Abstract: The present invention relates to devices and methods for the treatment of diseases in the vasculature, and more specifically, devices and methods for treatment of aneurysms found in blood vessels. In a first embodiment of the present invention, a two part prostheses, where one part is an expandable sponge structure and the other part is an expandable tubular mesh structure, is provided. In the first embodiment, the expandable sponge structure is intended to fill the aneurysm cavity to prevent further dilatation of the vessel wall by creating a buffer or barrier between the pressurized pulsating blood flow and the thinning vessel wall. In the first embodiment, the expandable tubular mesh structure is placed across the aneurysm, contacting the inner wall of healthy vessel proximal and distal to the aneurysm.

Abstract: The current invention discloses tubes that can be constrained and expanded by either axial or torsional strain. By torsionally displacing the tube in a direction counter to the biased helices and angularly displacing the lower angle helix to an angle equal to, but opposite, the starting angle, the tube is expanded diametrically with no significant change in length after expansion of the tube. These tubes find utility in medical and non medical applications.

Abstract: The present invention relates to a bioresorbable scaffold for a vascular stent comprising a nitric oxide agonist and a polymer comprising a lactide, a glycolide and a lactone. The nitric oxide agonist is a statin or a HMG CoA reductase inhibitor. The nitric oxide agonist may be coated on the polymer, incorporated within the polymer or chemically bonded to the polymer. The invention also relates to a method for treating atherothrombosclerotic occlusive disease of an artery comprising implanting into the artery a stent with a bioresorbable scaffold comprising a nitric oxide agonist and a polymer comprising a lactide, a glycolide and a lactone, wherein the nitric oxide agonist is exuded from or released from the bioresorbable scaffold.

Abstract: Implantable medical prosthesis, in particular a breast implant, comprising gel-type filling materials having different rigidities in a specific geometrical arrangement. For example, a breast implant comprises an outer shell and at least one first gel-type filling and at least one second gel-type filling, wherein at least one first gel-type filling has a softer consistency than at least one second gel-type filling, wherein said at least one first gel-type filling extends predominantly along the posterior part of the prosthesis, and wherein said at least one second gel-type filling extends predominantly along the superior portion of the anterior surface of the prosthesis without extending along the entirety of such anterior surface of the prosthesis.

Abstract: A passive ossicular prosthesis includes a first and second fastening element for connection to the tympanic membrane. A connecting element connects the fastening elements in a sound-conducting manner. The connecting element includes a receiving part and an insertion part. The insertion part is inserted into a receiving opening of the receiving part. The receiving part encloses an end section of the insertion part in the manner of a clamp by way of two opposing, parallel legs disposed parallel to a shank axis of the connecting element. The legs have catch devices that fix the enclosed end section discrete spatial positions relative to the shank axis.

Abstract: This invention provides a method for producing bioactive coral bone graft substitutes and to products obtained thereby.

Abstract: Modular spinal prosthesis having one of both of adaptable and configurable components are provided. The modular spinal prosthesis described herein provide an artificial articular configuration to replace damaged, worn or otherwise removed spinal facet elements.

Abstract: A method for replacing at least a portion of an intervertebral disc in a spinal column includes: removing the portion of the intervertebral disc from the spinal column; and inserting an apparatus for replacing the portion of the intervertebral disc into an intervertebral disc space defined substantially between adjacent vertebral bones of the spinal column, and positioning the apparatus between the vertebral bones, wherein the apparatus is operable to permit the adjacent vertebral bones to articulate relative to one another about at least one of: (i) a first center of rotation for at least one of flexion and extension that is located outside the intervertebral disc space, and (ii) a second center of rotation for lateral bending that is located outside the intervertebral disc space.