Abstract: The present invention provides a forwardly directed fluid jet crossing catheter having a distally directed cylindrical flow fluid jet stream to cross a chronic total occlusion. The distal end of the device includes a formable catheter tip region having flexible internal components. Low and high pressure cavities are formed substantially by joined proximal and distal catheter tubes having an adhesive plug seal in common therebetween which partially defines one end of each of the low pressure and high pressure cavities. A guidewire tube and a high pressure tube are aligned along and within the low pressure and high pressure cavities and through the adhesive plug seal. The high pressure tube openly terminates in the high pressure cavity, whereby pressurized fluid transfers from the high pressure cavity in the guidewire tube entry hole to subsequently pass along the guidewire lumen and co-located guidewire to exit as a cylindrical fluid jet stream.

Abstract: The present disclosure is directed to a fluid cooled ultrasonic surgical instrument and related systems and methods of use therefor. In some embodiments, the disclosed ultrasonic surgical instrument is adapted for used within an insufflated cavity or pneumoperitoneum of a patient. The instrument includes a housing having an elongate shaft, a waveguide disposed at a distal end of the shaft, a coolant inlet port defined in an outer surface of the housing, and a coolant pump disposed within the housing and configured to move coolant from the coolant inlet port to the waveguide. During use, insufflation gas from within the pneumoperitoneum is drawn into the instrument shaft by the coolant pump, and blown over the waveguide to provide cooling. The delivery of ultrasonic energy and activation of the pump may be controlled by a processor in response to user input and waveguide temperature.

Abstract: A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.

Abstract: Apparatus for directed cranial access to a site includes a guidepiece and a receptacle. The receptacle includes a lower part having a rim and a base, and a hollow stem at the base adapted to be mounted in a hole in the skull; and an upper part having a rim and an opening at the top. Each part of the receptacle has an interior spherical surface, and they can be joined at the rims to form an inner surface enclosing a spherical interior. The guidepiece includes a body having a spherical outer surface and a cylindrical bore through the center, defining an alignment axis; and a guide tube in the bore. The guidepiece is dimensioned to fit rotatably within the receptacle interior, and the apparatus is assembled by joining the receptacle over the guidepiece body, with the guide tube projecting through the top opening.

Abstract: Devices and methods for performing a transseptal puncture procedure using a device which includes either an untapered or tapered blunt end cannula disposed in an introducer carrying a sharp guidewire disposed longitudinally through the lumen of the blunt cannula, and a blunt end dilator wherein the guidewire is flexible and has an atraumatic shape at its tip. The cannula gives the more flexible introducer a defined shape and steerabilty allowing an ordinarily skilled physician to easily access a selected location on the septal wall of the heart for transseptal puncture and introducer placement thereacross without employing an exposed sharp end needle during the procedure.

Abstract: Devices, systems, and methods for delivering a substance within a mammalian luminal organ or area adjacent thereto. In at least one exemplary embodiment of a system of the present disclosure, the system comprises an inner delivery device, comprising an inner portion configured to receive a substance therein, a pock tip at or near a distal end of the inner delivery device, the pock tip configured to deliver the substance from the inner portion, through a pock tip aperture defined within the pock tip, and into a mammalian tissue and/or luminal organ, and an embolus positioned within the inner portion, the embolus configured so that the substance remains distal to the embolus when the substance is positioned within the inner portion.

Abstract: In one embodiment the apparatus includes a first retractor, a second retractor, and a shaft. The shaft defines a central channel extending from a first end portion of the shaft to a second end portion of the shaft. The first retractor and the second retractor are configured to collectively form a lumen. The shaft is configured to be disposed within the lumen. In one embodiment method of disposing a graft within a body of a patient, includes making an incision in the body of the patient, inserting a medical device into the body of the patient through the incision, removing the shaft of the medical device from the body of the patient, and moving the first refractor within the body of the patient away from the second retractor.

Abstract: To provide a filling material for a bone defect part, which reduces pain and any sense of discomfort and also promotes short-term bone repair. Provided is a filling material for a bone defect part, wherein the filling material is filled in a bone defect part formed between fracture sites in living bone and applies to the fracture site a pressing force in the direction in which the living bone extends from the defect part. Also provided is a filling material for a bone defect part where the filling material is laid in a predetermined length across the bone defect part and continuously applies the pressing force to the fracture site.

Abstract: According to some embodiments, a method of accessing an intervertebral space of a patient's spine in a minimally invasive manner compromises creating a passage from a posterior end of a pedicle of a vertebral member using a probe, advancing the probe through the pedicle and to a main body portion of the vertebral member, advancing the probe through a superior endplate of the vertebral member and into the intervertebral space and enlarging the passage using at least one tap to create an enlarged passage from a posterior of the pedicle to the intervertebral space. In some embodiments, the enlarged passage traverses at least three cortical layers of the vertebral member.

Abstract: For a differentiated treatment of individual motion segments of the spine, a plastic rod (41, 42, 46) for the dynamic stabilization of the spine has different degrees of stiffness in its longitudinal direction. The different rod segments are interconnected along an oblique plane (13).

Abstract: In one embodiment, a medical device includes an elongate member, a first coupler, and a second coupler. The elongate member has a first end portion, a second end portion, and a side portion. The side portion of the elongate member has a first receiving portion and a second receiving portion. The first receiving portion is configured to receive a first support member. The second receiving portion is configured to receive a second support member. The first coupler is coupled to the elongate member and is configured to engage the first support member to help retain the first support member within the first receiving portion. The second coupler is coupled to the elongate member and is configured to engage the second support member to help retain the second support member within the second receiving portion.

Abstract: A posterior vertebral stabilizer has a resilient member such as a linear spring, which operates in tension and compression. The resilient member may be kept straight by a stabilization rod extending through the spring, or by a telescoping assembly that encases the resilient member. The ends of the stabilizer are attachable to pedicles of adjacent vertebrae so that the stabilizer adds stiffness to control flexion and extension of the vertebrae. Two such stabilizers may be used, and may be connected together by a crosslink designed to limit relative rotation of the stabilizers. Thus, the stabilizers may restrict axial rotation and lateral bending between the vertebrae, while permitting stiffened flexion and extension. Such stabilizers help provide the stiffness of a healthy intervertebral disc. In the event that fusion of the joint becomes necessary, a set screw or other component may be used to further restrict flexion and extension.

Abstract: A dynamic fixation medical implant having at least two bone anchors includes a longitudinal connecting member assembly having at least one transition portion and cooperating outer sleeve, both the transition portion and sleeve being disposed between the two bone anchors. The transition portion includes a rigid length or rod having apertures therein and a molded plastic length that extends through the apertures, thus attaching the plastic length to the rigid length. The sleeve surrounds the transition portion and extends between the pair of bone anchors, the sleeve being compressible in a longitudinal direction between the bone anchors.

Abstract: An instrument system for carrying out a surgical procedure on vertebrae by a posterior or posterolateral approach, made up of at least one tube and at least one spinal screw capable of engaging with the proximal end of said tube and having a head with multi-axial mobility, characterized by also comprising a wedge for temporarily blocking the position of the screw head.

Abstract: A spine system may include a rod, one or a plurality of screws and one or a plurality of screw connectors for connecting said one or a plurality of screws to the rod, all of which are solely or mostly made of a composite material.

Abstract: A sacroiliac joint fusion system including a joint implant, anchor element and delivery tool. The joint implant includes a bore extending non-parallel to the implant longitudinal axis. The anchor element is for receiving in the bore. The delivery tool includes an implant arm and anchor arm. The implant arm distal end is releasably coupled to the joint implant proximal end so the implant arm longitudinal axis is coaxial or parallel with the implant body longitudinal axis. An anchor arm distal end is engaged to the anchor element proximal end. The anchor arm is coupled to the implant arm such that the anchor element longitudinal axis is coaxially aligned with the bore longitudinal axis when the implant arm distal end is releasably coupled with the implant proximal end and the anchor arm distal end is engaged with the anchor element proximal end.

Abstract: A spinal fixation system includes a first plate, a post fixedly attached to the first plate and extending transverse therefrom. A second plate receives the distal end of the post. A locking mechanism is configured to restrict at least one of axial translation and/or orbital rotation of the second plate with respect to the post. The locking mechanism can include a locking nut having two non-concentric cylinders which enable an interference fit between the nut and the post, thus restricting axial translation of the second plate.

Abstract: Embodiments herein are generally directed to rod reduction clips that can efficiently attach to orthopedic fixation devices and reduce rods therein. Other embodiments herein are generally directed to coupling elements having removable extended tabs for use in orthopedic fixation devices.

Abstract: Devices and methods for preparing a surgical site, and in particular vertebral members, which may include a retractable tool and an actuator. The tool may include distal and proximal members. A distal side of the distal member may be fixed in a longitudinal direction and pivotable at a point of rotation. A proximal side of the proximal member may be pivotably connected to the actuator. In a retracted position, the distal member may be pivotably connected to the proximal member longitudinally in between the point of rotation and the proximal side of the proximal member. Moving the actuator in a distal direction may push the proximal member and the distal member such that the proximal member pivots with respect to the actuator and distal member, the distal member pivots with respect to the proximal member and point of rotation, and the proximal member and distal member move laterally outward.

Abstract: Minimally invasive vertebral stabilization systems may include at least one fastener, at least one coupling element connected to the fastener, and an elongate rod member. The fastener is deliverable to a vertebral body of a patient through an opening. The coupling element has at least one extended tab which defines an open central portion and a central longitudinal axis. The elongate rod member is configured to extend through the open central portion and be secured to the coupling element. The extended tab is configured to be removed from the coupling element once the elongate rod is secured to the coupling element.

Abstract: A rod insertion system and at least two bone anchors including: a rod guide configured to accommodate a spinal stabilization rod therein; a holding device including a clamping portion configured to hold a portion of the rod guide; and an adapter configured to moveably support the holding device. The holding device is configured to move and pivot along an adapter such that the rod guide is positioned proximal to a rod channel of one of the at least two bone anchors. In a first state, the rod guide is fixed to the holding device by the clamping portion, and, in a second state in which the holding device supports the portion of the rod guide, the clamping portion is released from the portion of the rod guide to permit the orientation of the rod guide relative to the holding device to be polyaxially adjusted.

Abstract: An intramedullary fixation assembly for bone fusion includes a first member positioned at a proximal end of the intramedullary fixation assembly, where the first member includes a plurality of first and second retaining screws, and a second member positioned at a distal end of the intramedullary fixation assembly, where the second member includes a plurality of third and fourth retaining screws. The first member is slideably coupled to the second member and provides for an interference fit with the second member.

Abstract: A bone plate apparatus for securing a bone or a bone fragment in a proper position with respect to another bone or a bone fragment has a plate with a first portion and a second portion in which the first portion is hingedly connected to the second portion, and a fixing element cooperative with the first and second portions so as to fix an angular orientation of the first portion with respect to the second portion. The fixing element is a screw that is rotatable in the hinge in one direction such that the first portion is freely pivotable with respect to the second portion and rotatable in an opposite direction so as to fix an angular orientation with the first portion with respect to the second portion. Each of the first portion and the second portion has holes formed therein suitable for the receipt of bone screws such that the portions can be affixed against a surface of the bone or the bone fragment.

Abstract: The present disclosure includes a method for reducing a bone fracture and an apparatus such as a cable button for use with a bone plate, the cable button including cable button threads, a plurality of cable button apertures, a hex socket, and a hex opening. The present disclosure also includes a method for reducing a bone fracture and an apparatus such as a cable button for use with a bone plate, the cable button including a plurality of legs, where a leg includes a protrusion, where the protrusion engages the bone plate, and the cable button defines at least one cable button aperture.

Abstract: One aspect of the invention relates to a flexible drive assembly (12) which includes drive elements (14) connected to one another in series. Each drive element has a body (16) with a central axis (18) and male and female ends (20, 22). The male end includes a projecting rib (26) of non-circular cross-section and the female end defines a socket (36) with a groove (44) therein which is of non-circular cross-section. The drive elements are connected to one another in series by location of the male end of one element in the series in the socket at the female end of a neighbouring element in the series with the rib of the male end received as a snap fit in the groove of the socket. The male ends and sockets are configured to allow limited pivotal movement to take place between adjacent elements, in each case about an axis transverse to the central axes of the elements, while also allowing the connected elements to transmit rotational torque in either direction from one to the other.

Abstract: A cranial implant and a method for generating and implementing the cranial implant is provided, wherein the cranial implant includes at least one fixation tab. The method includes determining the characteristics of a skull of a patient and an opening in the skull, identifying the desired location of the at least one fixation tab, fabricating the cranial implant based on at least one of a predetermined algorithm and experience of a fabricator in response to at least one of the characteristic of the skull/opening in the skull and the location of the fixation tabs, adjusting the cranial implant to fit within the opening of the skull such the cranial implant is substantially flush with a surface of the skull and securing the cranial implant to the skull using one or more fixation screws.

Abstract: A polyaxial bone anchoring device includes a receiving part configured to be pivotably connected to a head of an anchoring element, the receiving part having a channel for receiving a rod and an accommodation space having an opening for accommodating the head, and a sleeve-like insert piece having a sleeve axis and a spherical segment-shaped outer surface portion. The insert piece is configured to be positioned around a portion of the head in the receiving part and to pivot in the receiving part, and includes a first part and a separable second part configured to be connected with the first part by a connection structure configured to permit translational movement between the first part and the second part in a direction transverse to the sleeve axis, while preventing movement between the first part and the second part in a direction parallel to the sleeve axis.

Abstract: A method of treating a fracture includes creating an access path to a fracture site in a bone and inserting a guidewire through the access path into the fracture site is provided. The method includes the steps of positioning a cannulated drill bit having a distal end including helical flutes configured for drilling through bone over the guidewire into the fracture site, and advancing the drill bit to create a passageway in the bone configured to receive a screw. Positioning a cannulated inflatable bone tamp over the guidewire and inflating the inflatable bone tamp to compress at least a portion of the bone in or near the fracture site so as to create a void. Delivering a bone void filler into the void through the access path to fill the void. Systems and kits are disclosed.

Abstract: an orthopedic tube for delivering medical fluids, having a viscosity of at least 1 Pa.S and not to exceed 10000 Pa.S, into a bone cavity comprising an elongated hollow stem having a smooth stem outer wall. The elongated hollow stem has an external diameter sufficient to be inserted into a bone cavity formed in a bone. The elongated hollow stem has a proximal end and a distal end with the proximal end adapted to be in communication with a pressurized medical fluid injector; and the elongated hollow stem has an internal diameter sufficiently large to permit a path of least resistance to a flow of the cement from the injector. The distal end of the elongated stem is closed. There is at least a fenestration zone defined on the stem wall spaced from the distal end, and a plurality of distinct ports distributed in a pattern in the fenestration zone.

Abstract: A long-bone fracture-reduction robot is provided, and includes a machine base; a support slidably connected onto the machine base and able to move up and down; a plurality of electro-hydraulic drivers; and a six-degrees-of-freedom parallel robot arranged on the support, with the motion of the robot in six degrees of freedom hydraulically controllable using the plurality of electro-hydraulic drivers. The long-bone fracture-reduction robot includes two long-bone-fixing frames, one frame being coupled to the support and other being coupled to the six-degree-of-freedom parallel robot. The two long-bone-fixing frames are arranged to be side by side. Each of the two long-bone-fixing frames is fixedly connected to a corresponding mounting-and fixing plate.

Abstract: A method of treating scoliosis in a subject includes securing a scoliosis treatment device to first and second locations on the subject's skeletal system, the scoliosis treatment device including a first portion, a second portion moveably mounted relative to the first portion, and an adjustment device disposed on the device and configured to change a distraction force between the first location and the second location, the adjustment device including a rotationally mounted magnetic element configured to move the second portion relative to the first portion in response to rotation of the magnetic element. An external adjustment device is provided external to the subject and is able to adjust the distraction force between the first location and second location.

Abstract: Thermochemical ablation techniques may provide ablation of bodily tissue using chemical reaction energy.

Abstract: An impedance matching circuit may be used to adjust for manufacturing and design tolerances in a surgical instrument. The matching circuit may match the load of a thermal element with the impedance of a power source used to deliver electrical energy to the surgical instrument. The matching circuit may include capacitors, inductors, coaxial cables, varactors, transformers, resistors, and/or combinations thereof. The matching circuit may also comprise a circuit board or flex board layers which may be modified to adjust the impedance of the load.

Abstract: A forceps is provided and includes a housing having a shaft. An end effector assembly operatively connects to a distal end of the shaft and includes a pair of first and second jaw members. One or both of the first and second jaw members is movable relative to the other jaw member from a clamping position to an open position. A resilient member operably couples to at least one of the first and second jaw members. The resilient member is configured to bias the first and second jaw members in the clamping position and provide a closure force on tissue disposed therebetween.

Abstract: A new method for the ablation of undesirable tissue such as cells of a cancerous or non-cancerous tumor is disclosed. It involves the placement of electrodes into or near the vicinity of the undesirable tissue through the application of electrical pulses causing irreversible electroporation of the cells throughout the entire area of the undesirable tissue. The electric pulses irreversibly permeate the cell membranes, thereby invoking cell death. The irreversibly permeabilized cells are left in situ and are removed by the body immune system. The amount of tissue ablation achievable through the use of irreversible electroporation without inducing thermal damage is considerable.

Abstract: A device includes an inner shaft rotatable within an outer shaft for cutting tissue. Additionally, the device can deliver energy including bipolar radiofrequency energy for sealing tissue which may be concurrent with delivery of fluid to a targeted tissue site. An inner shaft can be formed of two portions separated by an insulating layer. The portions define electrodes for delivery of energy.

Abstract: A method of ablating endometrial lining tissue, includes delivering radiofrequency power to the endometrial lining tissue of a uterine cavity, and modulating the delivered power so that a measured impedance of the endometrial lining tissue tracks a target impedance as a function of time.

Abstract: An electrosurgical device having a tubular outer shaft and an inner shaft is disclosed. The tubular outer shaft includes an axis and a distal end region. The distal end region includes a distal-most tip and a cutting edge defining a window in the outer shaft proximal along the axis to the distal-most tip. The inner shaft inner shaft coaxially maintained within the outer shaft such that the inner shaft is movable about the axis with respect to the outer shaft and wherein a portion of the inner shaft is exposed in the window of the outer shaft. A first electrode is disposed on the outer shaft in a region proximal along the axis to the window, and a second electrode is electrically isolated from the first electrode and disposed on the inner shaft. The second electrode is exposed in the window of the outer shaft.

Abstract: A catheter system for creating lesions for the treatment of cardiac arrhythmias is disclosed that includes a catheter having a distal ablation segment that has an electrode array comprising a plurality of spaced ablation and recording electrode devices arranged in a tight loop configuration that is used to create a series of overlapping loop-shaped ablation footprints to produce a continuous lesion resembling a chain-link configuration.

Abstract: An apparatus, including an insertion tube having a proximal tube end and a distal tube end that includes an electrode, a first irrigation line including proximal and distal irrigation line ends and configured to supply fluid from the distal irrigation line end through apertures in the tube, and an electrical line including a proximal electrical line end and a distal electric line end coupled to the electrode. The apparatus includes a slip ring unit having a stator, a rotor connected to the proximal electrical line end, and a hollow channel extending through respective centers of the stator and the rotor along a longitudinal axis of the slip ring unit. The apparatus includes a rotary joint in fluid communication with the proximal irrigation line end, an angle sensor configured to detect torsion of the proximal irrigation line end, and a drive mechanism coupled to rotate the rotor responsively to the torsion.

Abstract: Catheter based ablation devices, systems, and methods for achieving intraluminal and/or transluminal neuromodulation, stimulation or ablation by intraluminal access are disclosed herein. One aspect of the present application, for example, is directed to devices, systems, and methods that incorporate a spiral support frame treatment device on an elongate shaft or as a temporary or permanently implanted therapy device. The elongated shaft is sized and configured to deliver a spiral treatment device to a treatment position via an intravascular path. Intraluminal and transluminal neuromodulation, stimulation or ablation or other therapeutic outcomes may be achieved via energy delivered via the spiral element. One therapy includes modulation of neural fibers that contribute to or alter vascular structures that feed or perfuse the neural fibers.

Abstract: A microwave ablation probe for providing microwave energy to tissue is disclosed. The probe includes a feedline having an inner conductor, a secondary inner conductor, and insulating spacer, and an outer conductor. The inner conductor is slidably disposed within the secondary inner conductor. The feedline also includes a radiating portion having an extruded portion of the inner conductor centrally disposed therein, wherein longitudinal movement of the inner conductor relative to the feedline tunes the radiating portion.

Abstract: A microwave energy delivery and measurement system, including a microwave generator and a microwave energy delivery device, for performing medical procedures, and a remote power coupler system for measuring one or more parameters of the microwave energy signal including a remote RF sensor housed in the microwave energy delivery device and a power coupler processer coupled with the processing unit of the microwave energy delivery device.

Abstract: A microwave antenna has a radiating portion connected by a feedline to a power generating source, e.g., a generator. Proximal and distal radiating portions of the antenna assembly are separated by a junction member. A reinforcing member is disposed within the junction member to increase structural rigidity.

Abstract: An electrosurgical ablation system includes an energy source adapted to supply energy to an energy delivery device. The energy delivery device includes a handle assembly configured to couple a pair of antennas extending from a distal end thereof to the energy source for application of energy to tissue. A power splitting device is operatively associated with the handle assembly and has an input adapted to connect to the energy source and a pair of output channels operably coupled to the respective pair of antennas. A phase shifter is operatively associated with the handle assembly and is operably coupled to the pair of output channels. The phase shifter is configured to selectively shift a phase relationship between the pair of output channels.

Abstract: A skin treatment system comprising a light based skin treatment device (10, 20, 30) is provided. The device (10, 20, 30) comprises a treatment light source (18) for providing a treatment light beam (21) for treating hair or skin tissue, a transparent exit window (14) for allowing the treatment light beam (21) to leave the device (10, 20, 30), and an exit location control unit (17) for controlling a position for the treatment light beam (21) to pass through the exit window (14). The system further comprises a detection light source for providing a detection light beam.

Abstract: Sterile drapes for C-arm X-ray devices that allow users to easily maintain sterility in a surgical field as the C-arm is rotated or moved around a patient are described. The sterile drape contains a slide rail assembly configured to be connected to a C-arm of an X-ray device that extends from a lower portion of the C-arm to an upper portion of the C-arm, a sterile drape assembly comprising a length of compliant material, the sterile drape assembly configured to be detachably coupled to the upper portion of the C-arm and to the slide rail assembly, and an anchor assembly configured to be connected to the X-ray device at one end and configured to be connected to the sterile drape assembly at the other end so that the anchor assembly draws the sterile drape assembly along the slide rail assembly as the C-arm is rotated. The sterile drape is connected to the X-ray device so that one end of the sterile drape assembly remains in substantially the same position regardless of the movement of the C-arm.

Abstract: A surgical system can include a surgical probe having a deflectable tip, and a plurality of guide arms that are movable so as to cause the tip to deflect. Thus, the surgical probe can be steered toward a target anatomical location. The surgical system can further include a control system that includes a free floating user interface, and a motion sensor that detects motion of the user interface. The control system is configured to cause the probe tip to deflect in response to the detected motion of the user interface.

Abstract: A robotic system includes a bedside system comprising an axial drive mechanism and a rotational drive mechanism. An engagement mechanism engages and disengages a percutaneous device from at least one of the axial drive mechanism and rotational drive mechanism. A remote work station includes a user interface and a control system operatively coupled to the user interface. The control system is configured to communicate a control signal to the engagement mechanism to engage and disengage the percutaneous device from one of the axial drive mechanism and rotational drive mechanism.

Abstract: A surgical instrument arrangement has a modular motor drive unit which has a drive arrangement having at least one output element, an instrument shaft that can be detachably connected to the drive unit, and a drive arrangement having at least one input drive element. The output drive arrangement and the input drive arrangement can be coupled to each other by a mechanical interface that has at least one single-sided linkage, a pin, and a cut-out, wherein the pin can be radially expanded in the cut-out. Alternatively, a gap may be formed between the pin and the cut-out, which gap is wavy in the radial direction, and in which a radially displaceable, axially fixed intermediate element arrangement is arranged. The surgical instrument arrangement may also include a sterile barrier, which is provided to envelop the drive unit and to be arranged between the drive unit and the instrument shaft.