Abstract: An imaging apparatus is disclosed for diagnosis, which has multiple transceivers and can perform position correction of a generated tomographic image, based on a distance difference in an axial direction and/or an angular difference in a circumferential direction between the respective transceivers. The imaging apparatus generates an ultrasound tomographic image and an optical tomographic image by using a signal obtained in such a way that a transceiver in which an ultrasound transceiver and an optical transceiver are arranged moves in the axial direction while rotating inside a lumen of a measurement object body. The apparatus generates data for the ultrasound tomographic image and data for the optical tomographic image of a calibration tool having a reflection section. The apparatus calculates the angular difference in the circumferential direction around the axis between the ultrasound transceiver and the optical transceiver, based on positional information of the reflection section.

Abstract: A flexible tube assembly according to the present disclosure includes a multiple tube having at least a first tubular member that has an elongated shape and is hollow and a second tubular member that has an elongated shape and is disposed inside the first tubular member in such a manner as to be capable of advancing and retreating relative to the first tubular member; and a hand operation unit that is provided on a proximal side of the multiple tube and operates at least the first tubular member and the second tubular member.

Abstract: Disclosed herein is a biopsy device for efficiently sampling a specimen from a biological tissue, particularly if the biological tissue is a soft tissue. The biopsy device includes: an elongate shaft; a piercing spike for piercing a biological tissue, the piercing spike being disposed on a longitudinally distal end of the elongate shaft; a screw disposed on the elongate shaft, for guiding a specimen sampled from a living body from the longitudinally distal end of the elongate shaft toward a longitudinally proximal end thereof; and a screw cutter disposed on the screw, for peeling the specimen off the living body. The screw cutter peels the specimen off the biological tissue while the piercing spike is piercing the biological tissue.

Abstract: The invention relates to a sealing device for repair of cardiac and vascular defects or tissue opening such as a patent foramen ovale (PFO) or shunt in the heart, the vascular system, etc. and particularly provides an occluder device and trans-catheter occluder delivery system. The sealing device would have improved conformity to heart anatomy and be easily deployed, repositioned, and retrieved at the opening site.

Abstract: A retractor system, kit and method of use includes a plurality of retractors for use in retracting a wound during a minimally-invasive hip replacement surgery to define an access space to a surgical site is discussed. Each of the retractors comprises a handle portion configured to be held by a user, a curved bend portion distal of the handle portion, and a wound contact portion attached to the curved bend portion. The wound contact portion is configured to contact tissue of the wound when at least a portion of the retractor is inserted through a skin incision that defines the wound. Each retractor also has a distal portion disposed distally of the wound contact portion, wherein the wound contact portion has a generally curved cross-sectional profile perpendicular to its length that is configured to prevent necrosis of the tissue during retraction. In addition, the cross-sectional profile provides an improved line of sight during the surgical procedure.

Abstract: The device (10) has a handle assembly (40) and a bone anchor driver assembly (20). The handle assembly (40) has an upper handle portion (50) and a lower handle portion (60) as illustrated. The upper or lower handle portion is rotatable relative to the other handle portion. A bone anchor driver assembly (20) is for rotatably driving a bone anchor (12) into a hole in a bone is provided. The bone anchor driver assembly (20) is fixed to one of either the upper or lower handle portions (50 or 60).

Abstract: A fixation device comprises a biodegradable inner core extending along a longitudinal axis from a distal tip to a proximal end in combination with a sleeve surrounding the core along a portion of a length thereof and comprising a thermoplastic polymer formed of a material which softens and expands into surrounding bone tissue when activated by an energy source.

Abstract: The present disclosure relates to a suture anchor inserter. The suture anchor inserter includes a handle having a proximal component, a central component coupled to the proximal component, and a distal component coupled to the proximal component and the central component, the central component capable of rotating relative to the proximal component; and a shaft comprising a proximal end and a distal end, the proximal end coupled to the handle. A method of inserting a suture anchor into bone is also disclosed.

Abstract: Devices and methods for forming and securing a tissue plication are disclosed herein. In one aspect, a tissue manipulation device is described that includes a first jaw member pivotally coupled to a distal end of an elongate shaft and having an articulating portion located distal to the proximal end of the first jaw member. The device also includes a second jaw member pivotally coupled to the first jaw member such that the jaws move in a first plane, and a fastener delivery member attached to the second jaw member. The articulating portion of the first jaw member is configured to move the first and second jaw members between a straight configuration in which a longitudinal axis of the elongate shaft is contained within the first plane and an articulated configuration in which the longitudinal axis of the elongate shaft is transverse to the first plane.

Abstract: Suture passers and methods of use. Described herein are suture passers preloaded with suture, including cartridges that couple to a suture passer to form a loaded suture passer; the suture passer may be operated to pass one or more lengths of suture without having to be manually reloaded. In particular, described herein are preloaded and automatically reloading apparatuses typically.

Abstract: A powered surgical cutting and fastening instrument includes a drive shaft; a motor; and a gear shifting assembly connected to the drive shaft and the motor. The gear shifting assembly may include at least a first stage gear assembly coupled to the motor and to the drive shaft for operating the gear shifting assembly in a first gear setting; and a gear coupling assembly for selectively coupling at least one additional gear to the drive shaft for operating the gear shifting assembly in a second gear setting.

Abstract: A piece of buttress material and an end-effector of a surgical instrument including features which can aid a surgeon in properly and quickly attaching the piece of buttress material to the end-effector. In various embodiments, a piece of buttress material can include retention features which can be engaged with portions of an end-effector to releasably retain the piece of buttress material to at least a portion of the end-effector. Similarly, an end-effector can include features configured to engage portions of a piece of buttress material to releasably retain the piece of buttress material to the end-effector. In at least one embodiment, more than one piece of buttress material can be releasably retained to an end-effector.

Abstract: A surgical stapler is provided having a pair of jaws including a staple containing cartridge and an anvil. Buttress material is releasable affixed to the staple containing cartridge and the anvil. One of the jaws includes a pair of longitudinal projections at a first end of the jaw and configured to frictionally engage corresponding slots in a first end the buttress material. One of the jaws includes a post at a second end of the jaw. The buttress material includes a hole in a second end of the buttress material for receipt of the post.

Abstract: An actuator is movable between a first position and a second position to move a drive mechanism between a first configuration and a second configuration relative to a housing. A cartridge assembly configured to be removably coupled to the housing to couple such that the cartridge assembly is coupled to the drive mechanism. A first member of the drive mechanism moves a first member of the cartridge assembly to advance a surgical clip of the cartridge assembly in a distal direction when the drive mechanism is placed in the first configuration. A second member of the drive mechanism moves a second member of the cartridge assembly relative to the clamp mechanism when the drive mechanism is placed in the second configuration to transition the clamp mechanism from a first configuration to a second configuration. The clamp mechanism is configured to clamp the surgical clip when in the second configuration.

Abstract: A piece of buttress material and an end-effector of a surgical instrument including features which can aid a surgeon in properly and quickly attaching the piece of buttress material to the end-effector. In various embodiments, a piece of buttress material can include retention features which can be engaged with portions of an end-effector to releasably retain the piece of buttress material to at least a portion of the end-effector. Similarly, an end-effector can include features configured to engage portions of a piece of buttress material to releasably retain the piece of buttress material to the end-effector. In at least one embodiment, more than one piece of buttress material can be releasably retained to an end-effector.

Abstract: An occlusive implant system may include a catheter having a lumen extending therethrough, a core wire slidably and rotatably disposed within the lumen, the core wire having a threaded member disposed at a distal end, and a medical implant having an expandable frame, an occlusive element disposed on the frame, and a threaded insert coupled to a proximal portion of the frame, wherein the threaded member is removably coupled to the threaded insert.

Abstract: An implantable medical device includes first and second material capture elements which are disposed in opposing orientations and have their narrow ends facing one another. The first and second material capture elements are connected by a flexible connector, which enables the implantable medical device to curve within a curved vessel of a patient. The flexible connector is either closed or has a lumen passing therethrough and includes a closure element for closing the lumen after deployment of the device within a patient. The structure enables the device to be positioned reliably within a curved vessel and benefits from the advantage of a double-ended device.

Abstract: A surgical clip applicator includes a base housing having a body portion, a movable trigger, a cannula, and a clip application mechanism extending within and through at least a portion of a length of the cannula. The clip application mechanism includes a movable first linkage and a jaw rotatable about a pivot mount. A first actuation of the trigger causes the first linkage to be moved in a linear direction with respect to the body portion and the cannula and the jaw to be rotated in a first direction about the pivot mount, for placing the clip in an open position on the patient's tissue. A second actuation of the trigger causes the jaw to be rotated in second direction about the pivot mount, the second direction being opposite to the first direction, placing the clip in a closed position on the patient's tissue.

Abstract: A device for treating pulmonary hypertension includes an inflatable balloon structure (1), an implantable port (9), and a conduit (2) connecting the balloon (1) and the implantable port in a sealed manner. The balloon, the port and the conduit are filled with a gas, and the pressure is such that the balloon (1) is normally inflated but is capable of being compressed during systole. The inflatable balloon (1) has first and second segments sized to extend into the left branch and the right branch of the pulmonary artery bifurcation respectively. The conduit (2) may connected in a T-junction to a middle portion of the balloon (1) or may be bifurcated into first and second branches (12a,12b) which are connected to the first and second balloon segments (13a,13b), respectively. The device may also have guide tubes opening at the longitudinal ends of the balloon (1) and guide wires (4, 6) engaged and capable of sliding in said guide tubes.

Abstract: Soft embolic implants exhibiting secondary shapes are disclosed. Some of the embolic implants exhibit progressively increasing softness from the distal end to the proximal end of the coil. The embolic implants have a primary coil, an optional second coil, a shape wire, and a stretch resistant fiber disposed in the lumen of the primary coil. An optional distal support wire is also disclosed. The embolic implants include a proximal constraint assembly configured to be releaseably retained by a delivery device. Disposed near each end of some of the implants are elliptical hole washers through which the shape wire and the stretch resistant fiber are threaded. The embolic implants have a primary, linear configuration for delivery through an implant tool, and a secondary configuration after deployment from the implant tool. The secondary shape can be J-shaped, helical, spherical, complex, or a combination of shapes.

Abstract: The present disclosure provides improved medical devices for occluding a left atrial appendage. In one embodiment, the medical device includes a temperature activated memory shape foam that is constructed to transition from a first collapsed conformation to a second expanded conformation upon an increase in temperature such that it can expand to provide an occlusive benefit inside a left atrial appendage. In another embodiment the medical device includes a flowable thermoset that is injected into the left atrial appendage where is it cured so that it may assume the conformation of the left atrial appendage and provide an occlusive benefit.

Abstract: A surgical drilling instrument with a Curved Burr Attachment having an adapter removably coupled to a drill motor and a burr attachment coupled to said adapter. The burr attachment includes a tube with a wire shaft supported therein and a coil wire surrounding said wire shaft and having each of the coils touch the outer periphery surface of the wire shaft and the inner peripheral surface of said tube to enhance cooling of said outer periphery of said tube from the heat generated by said wire shaft and attenuate vibrations while allowing said burr attachment to be bent without kinking.

Abstract: A customized patient-specific orthopaedic instrument for facilitating implantation of an acetabular cup prosthesis in a coxal bone of a patient and method of use is disclosed. The customized patient-specific orthopaedic instrument includes a customized patient-specific acetabular reaming guide. The customized patient-specific acetabular reaming guide includes a longitudinal passageway for an acetabular reamer and a plurality of arms with attached feet. Each foot of the reaming guide is positioned relative to the body based on the contours of the coxal bone of the patient and a predetermined degree of version and inclination angles of the acetabular cup prosthesis when implanted in the patient's coxal bone.

Abstract: A gauge assembly includes a distal femur gauge including medial and lateral condyle paddles each having a shape and size corresponding to a pre-operative planned distal resection of a patient's femur, and a tibial cutting block connected to the distal femur gauge. The condyle paddles include features, for example, pin-receiving holes, that permit intra-operative anterior-posterior and/or internal-external adjustment of the position of the distal femur gauge. The tibial cutting block includes features, for example, pin-receiving slot and holes, that permit fixing of the varus-valgus and flexion-extension degrees of freedom prior to fixing the internal-external and medial-lateral degrees of freedom.

Abstract: The invention provides methods and systems for increasing the open cross-section of a vascular fistula that is obstructed by thrombus. Using a catheter having an imaging element and a thrombus disrupting element, the thrombus can be disrupted and removed, and the fistula evaluated with the imaging element. The imaging element is preferably an ultrasound imaging element.

Abstract: An arterial device, system and method are provided for use with a patient undergoing a cardiac procedure. The system is configured for enabling one or more arterial devices to be accommodated in the aorta of the patient in use of the system, and a perfusion lumen arrangement provides therethrough a target perfusion flow into the aorta having a target perfusion flow rate that is significantly greater than a nominal perfusion flow rate, by an excess perfusion flow rate. A suction lumen arrangement provides therethrough a suction flow out of the aorta at a suction flow rate. The target perfusion flow rate and the suction flow rate may be concurrently and selectively controlled to cause embolic debris that may be present in the aorta to be diverted to the suction inlet, while providing the nominal flow rate to the body circulation of the patient.

Abstract: According to an example of the present disclosure, a retrieval device having a contracted state and an expanded state may include at least three support members each having a lumen, a fixed proximal end, and a movable distal end, and at least two members movable relative to the support members. Each movable member may include a first end and a second end and extending distally through a lumen of a support member and proximally through a lumen of a different support member. The device may include a stop located at the second end of at least one movable member to restrict movement of the second end after moving a distance distally during movement of the retrieval device toward the expanded state.

Abstract: A medical manipulator is provided with a brake release mechanism. The brake release mechanism is provided with a release button which is provided on a tilt wheel, and a lever mechanism which has at least one portion arranged on the inside of the tilt wheel and which is pressed when the release button moves inwards. By the action of the lever mechanism when the release button is operated, braking by a brake mechanism is released.

Abstract: A medical manipulator is provided with a brake mechanism. The brake mechanism is provided with a brake rotor and a brake shoe which can contact the outer periphery of the brake rotor. On the outer periphery of the brake rotor, a first gear is provided along the circumference. On the portion of the brake shoe which is opposite of the outer periphery of the brake rotor, a second gear is provided which can mesh with the first gear.

Abstract: The present invention provides an improved curved blade shaver for abriding tissue associated with a surgical site, the curved blade assembly including a curved outer shaft in receipt of an substantially linear inner instrument having a flexible region adapted for rotation and reciprocal receipt within the curved outer shaft and presenting a shaving means for debriding the tissue. The curved outer shaft also includes a portal for reciprocal receipt of a substantially rigid instrument when desired.

Abstract: An aspiration control device may include a conduit having a distal end and a proximal end. The conduit may define a conduit lumen and an aperture vent open to the conduit lumen. A coupling may be configured to couple the proximal end of the conduit with a vacuum source and an inner cannula of a tissue cutting device. The inner cannula may define an inner cannula lumen wherein the vacuum source is configured to supply a vacuum to each of the coupling lumen and the inner cannula lumen. A sleeve may be movably disposed about the conduit, and a device motor may be in communication with the sleeve and be configured to move the sleeve to a predefined position relative to the vent in response to an input single from a user interface. The predefined position of the sleeve may correspond to a predefined level of vacuum to be supplied to the inner cannula lumen.

Abstract: Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.

Abstract: A thrombectomy catheter includes a catheter body having a catheter lumen. An outflow orifice is positioned along a catheter perimeter. A fluid jet emanator communicates with a high pressure tube. The fluid jet emanator includes at least one jet orifice for directing a fluid jet from the fluid jet emanator through the catheter lumen toward the outflow orifice. The fluid jet emanator provides a jet stream from the catheter body through the outflow orifice. The jet stream includes first and second stream portions. An entrainment fluid flow circuit includes at least the first stream portion, and the entrainment fluid flow circuit entrains particulate and macerates the particulate therein. An exhaust fluid flow path includes the second stream portion, and the exhaust fluid flow path draws entrained particulate from the entrainment fluid flow circuit at a location exterior to the catheter body and directs it toward the catheter proximal portion.

Abstract: Various embodiments are directed to a method of driving an end effector coupled to an ultrasonic drive system of a surgical instrument. The method comprises generating at least one electrical signal. The at least one electrical signal is monitored against a first set of logic conditions. A first response is triggered when the first set of logic conditions is met. A parameter is determined from the at least one electrical signal.

Abstract: A cutting balloon catheter and method of making and using the same. The cutting balloon catheter may include a catheter shaft having a balloon coupled thereto. One or more cutting members or blades may be coupled to the balloon. The cutting members may configured to be more flexible.

Abstract: This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.

Abstract: A cannula including a hollow cannula body having first and second tubular end portions, a collapsible section interconnecting the end portions, the collapsible section including a plurality of circumferentially spaced arms extending between the end portions, wherein in an extended configuration the arms are substantially aligned with the first and second end portions and in a collapsed configuration the arms deform to extend radially outwardly and a flange extending radially outwardly from the first end portion, so that the arms and flange are spaced apart when the cannula body is in the collapsed configuration, thereby allowing tissue to be sandwiched therebetween to thereby effect a seal between the cannula and the tissue so that the cannula provides an opening through the tissue.

Abstract: The invention relates to a surgical protective device for a surgical sealing element of a surgical sealing system comprising a trocar sleeve, the surgical sealing element having an expandable insertion opening. Said protective device comprises a ring-shaped or substantially ring-shaped main body adapted to be arranged on the trocar sleeve, on a part thereof or on the sealing element and defines a through-opening with a plurality of protective elements arranged in the circumferential direction and extending parallel to or pointing towards a longitudinal axis of the protective device. Each of the protective elements is configured asymmetrically in relation to a plane containing a longitudinal axis defined by the main body.

Abstract: The present invention relates to a tube with an integrated heating element for laparoscopy. By means of a humidifying material in the interior of the tube, the gas introduced during laparoscopy is heated and humidified.

Abstract: Devices and methods for vaginal insertion are disclosed.

Abstract: Prostheses, methods and related instrumentation for treating disorders of the knee by displacing a connective tissue acting on the patella to alter the location, angle or magnitude of forces exerted by the tissue on the patella so as to achieve a therapeutic effect in patellofemoral compartment of the knee.

Abstract: A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.

Abstract: The present application discloses methods for treating a spinal deformity. In one embodiment, an elongated member is attached to vertebral members with fasteners. A separate fastener may attach the elongated member to each of the vertebral members. The elongated member may apply a force to limit growth on one side of the vertebral members, such as a convex side of a scoliotic spine. Each fastener may be constructed to limit a direction of growth of the vertebral member thereby applying a specific, corrective force to the vertebral member. The fasteners may allow relative motion between adjacent vertebral members without losing the attachment between the vertebral members and the fasteners. The net result may be controlled modulation of growth to reduce and/or eliminate the spinal deformity through redirection of growth potential.

Abstract: A spinal implant for immobilizing the C1 vertebra with respect to the C2 vertebra of the spine provides controlled coupling between the C1 and C2 vertebrae, and includes a C1 component attachable to the C1 vertebra, two C2 components attachable to the C2 vertebra, and a transverse element. The C1 component has two wings each of which retains a rod holder that rotates and translate for capturing a C2 component rod. Each C2 component has a hook for connection with a side of the C2 vertebra lamina and a rod for attachment to one of the rod holders of the C1 component. Each C2 component receives and secures the transverse connector which holds position of the C2 components relative to one another. Each C2 component may include a plate configured for compression against the C2 vertebra spinous process, with each plate including spikes to aid in preventing construct migration.

Abstract: A bone screw having a screw member possessing a threaded section and a head and a receiving part at the head end for receiving a rod to be connected to the bone screw is provided. The receiving part has on open first bore and a substantially U-shaped cross-section having two free legs provided with a thread. Furthermore, the receiving part has a second bore on the end opposite to the first bore whose diameter is greater than that of the threaded section and smaller than that of the head. On the bottom of the first bore a seat for the head is provided. In order that the screw member can be pivoted to at least one side by an enlarged angle, the edge bounding the free end of the second bore viewed relative to the axis of the first bore is of asymmetric construction.

Abstract: Devices and methods for altering the spacing and motion at the facet joints of the vertebral column are provided. One embodiment of the invention comprises a prosthesis with surfaces configured to articulate with the facets of the facet joint. A retaining member for anchoring the prosthesis within the facet joint is optionally included. Methods for surgically and less invasively implanting the prosthesis and securing the prosthesis to the articular processes or surrounding soft tissue are also provided.

Abstract: Systems, methods, and kits incorporating a clamp for securing to bone tissue. The clamp includes gripping members to secure the clamp to the bone tissue without the use of screws. The clamp may be used to treat spinal conditions, and may be secured to the spinous process of vertebrae. Systems, methods and kits can incorporate a fusion member configured to fuse between adjacent spinous processes.

Abstract: A method for treating a complex fracture with a variable length nail is provided. The nail is configured for at least 5 mm of axial length change in each direction. The method involves making a first hole or incision in the skin of the patient in proximity to a fractured long bone and at least partially clearing a canal through the center of the long bone. The variable length nail is inserted into the canal and securing a distraction shaft and a housing of the nail to separate portions of the fractured long bone. The hole or incision is allowed or caused to close. An external adjustment device comprising at least one rotatable magnet is placed in proximity to the patient's skin. The external adjustment device is operated so that a magnetic field of the at least one rotatable magnet of the external adjustment device causes the rotatable permanent magnet of the variable length nail to rotate, causing either extension or retraction of the distraction shaft relative to the housing.

Abstract: A bone plate system for fixation of bone includes a bone plate and a first fastener. The bone plate includes a bone contacting surface, an upper surface, and a first opening extending between the bone contacting surface and the upper surface. The first opening includes a lower portion, a non-threaded upper portion, and a threaded portion. The threaded portion includes threads and converges towards the lower portion. The lower portion includes a smallest diameter of the first opening. The first fastener includes a head at least partially comprising a spherical portion and a first material. When the first fastener is inserted into the first opening, the threads of the first opening form threads in the first material on the head of the first fastener to secure the first fastener in place at one of a plurality of possible angles within the first opening.

Abstract: A method of implanting a supplemental fixation system in, a cancellous portion of a bone to supplement fixation of an orthopedic device located in the bone. At least one fixation structure is delivered through a lumen in the orthopedic device into the cancellous portion of the bone near a distal portion of the orthopedic device. A curable, flowable biomaterial is delivered to the cancellous portion of the bone into engagement with a portion of the fixation structure near the distal portion of the orthopedic device. The fixation system is releasably secured to, the orthopedic device to supplement fixation of the orthopedic device to the cancellous portion of the bone. The orthopedic device is detachable from the fixation system to facilitate subsequent removal of the orthopedic device from the cancellous portion of the bone without removing the fixation structure or the cured biomaterial from the bone.