Abstract: A tissue-removing catheter includes a cutter having an axial cavity and an opening extending from the axial cavity through the cutter to allow tissue removed from the body lumen by the annular cutting edge to pass proximally through the opening toward a tissue-transport passage of a catheter body. A screw blade extends longitudinally within the interior passage of the catheter body includes an external helical thread for transporting removed tissue proximally within the tissue-transport passage as the screw blade rotates about its axis. A cutter driveshaft extends longitudinally within a driveshaft passage of the screw blade and is rotatable about its axis relative to the screw blade. The cutter driveshaft having a distal end portion operatively coupled to the cutter for driving rotation of the cutter.

Abstract: Disclosed is an expandable percutaneous sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion to a second, enlarged cross-sectional configuration. The sheath is maintained in the first, low cross-sectional configuration by a tubular restraint. In one application, the sheath is utilized to provide access for a diagnostic or therapeutic procedure such as percutaneous nephrostomy or urinary bladder access.

Abstract: A spinal alignment correction system (1) has a posted lumbar pedicle screw called a MAC Pin (10) which has an elongated shaft (11) and a rod coupler assembly (20) and a cannulated tower (40). The elongated shaft (11) has an inner pedicle screw portion (12) with pedicle threads (12A), an outer second thread portion (14) with second threads (14A) and a transition or intermediate portion (16) disposed between the pedicle screw portion (12) and the second thread portion (14). The cannulated tower (40) when mounted over said elongated shaft (11) abuts said coupler (20) along an outer cam surface and further tightening rotation of the cannulated tower (40) causes outward movement of the elongated shaft (11). The system (1) allows for a controlled alignment correction of malaligned vertebral bodies using a number of methods used to correct a variety of indications.

Abstract: A polyaxial bone anchoring device includes a receiving part having a first end, an opposite second end, a channel at the first end, and an accommodation space at the second end for receiving a head of a bone anchoring element, and a pressure element configured to be positioned in the receiving part and to exert pressure on an inserted head, the pressure element including at least one flexible section. At least one of the receiving part or a free end of the flexible section of the pressure element has an inclined surface portion configured to engage the other one of the receiving part or the free end of the flexible section of the pressure element, such that a force directed towards the second end of the receiving part is exerted on the pressure element at the engagement to exert a pre-load on an inserted head of a bone anchoring element.

Abstract: The present invention is directed to a pedicle screw fixation system which can be made for either posterior cervical, thoracic, lumbar spine, or elsewhere. With this type of system a surgeon can implant a pedicle screw system utilizing the same instrument set for an open or closed procedure. The system is designed to avoid cross threading and splitting of tulip heard by use of an outer threaded tulip and reducing donut. The system also provides the ability for superior angulation for hard to reach areas that are common in spinal procedures. The system allows for a bio-absorbable part (the reduction donut) that enhances fusion in the coming months after the procedure. With the elongate tulip portion of the system the user is able to avoid the need for other cannula type instruments; the need of additional parts; the need of additional instruments which could introduce bacteria into the patient and the need for fluoroscopy. The system is completely cannulated so as to permit a HOLDING wire driven procedure.

Abstract: A system to stabilize and guide the growth of the spinal column includes an elongated support member having a width and a length and a guiding connector having a bone connecting portion and a guiding portion. The bone connecting portion secures the guiding connector to a vertebrae and the guiding portion has a bearing element with a passageway adapted to receive the elongated support member. The bearing element permits relative sliding movement of the elongated support element in the passageway of the bearing element. The system may further include a bone fixation element has an elongated support member receiving channel, a locking mechanism and a bone anchoring portion. The bone anchoring portion secures the bone fixation element to bone. The locking mechanism secures the elongated support member in the channel. The guiding connector is moveable along the elongated support member to permit and control the growth of the spinal column along a predetermined path.

Abstract: An anterior cervical includes a plate portion for stabilizing a human or animal spine by being placed ventrally of the spinal column and affixed to two or more different vertebral bodies, and a plurality of fastening portions adapted to be anchored in the different vertebral bodies. At least one of the fastening portions is rigidly connected to the plate portion and includes a sheath element with a longitudinal opening that is accessible from a proximal side and at least one hole that reaches from the longitudinal opening to an outside. The anterior cervical plate further includes a thermoplastic element that may be inserted in the sheath element and that is capable of being liquefied by, for example, mechanical energy acting on the thermoplastic element.

Abstract: A prosthesis for the replacement of at least a portion of the bone of a facet located on a mammalian vertebra, comprising: an articulating surface that articulates with another facet; a bone contacting surface that contacts a surface of the vertebra, the articulating surface being connected to the bone contacting surface; and a fixation element that attaches the bone contacting surface to the vertebra, the fixation element being adapted for implantation into an interior bone space of a pedicle of the vertebra; wherein the prosthesis is configured so that no portion of the prosthesis contacts the posterior arch of the vertebra.

Abstract: Devices and methods for aligning the components of polyaxial screws are described herein. In one embodiment, an alignment instrument includes an elongate frame having a longitudinal axis and a plurality of connection caps slidably disposed along the elongate frame. Each connection cap can removably couple to a polyaxial screw extension tube and selectively lock relative to the elongate frame such that a distance between the plurality of connection caps and an angular orientation of each connection cap relative to the elongate frame is maintained. The instrument can also include a transverse angle indicator to indicate an angular orientation of the elongate frame in a plane transverse to the longitudinal axis of the elongate frame. The device can, for example, capture the orientation of a plurality of polyaxial screws during spinal surgery such that the screws can be returned to the same orientation after manipulation to correct a spinal deformity, etc.

Abstract: A bone screw extender reattachment system including an elongated reattachment rod having a proximal and a distal end. The distal end of the elongated reattachment rod includes a tip configured to attach to a head of a bone screw. The elongated reattachment rod is configured so that a screw extender assembly having an inner sleeve, an outer housing and an extender head can slide over the reattachment rod. The bone screw extender reattachment system also includes a tension plunger having a plunger-type head and an elongated shaft configured to slide over the reattachment rod so as to communicate with the screw extender assembly.

Abstract: Targeting assemblies for implanting a compression nail are disclosed. An exemplary targeting assembly may include first and second arms coupled by a connecting shaft. The first and second arms may either or both be operable to rotate about a longitudinal axis defined by the connecting shaft. In some embodiments, the use of the disclosed targeting assembly allows for reduced misalignment of the alignment holes in the arms during the implant process.

Abstract: An orthopedic device includes a monolithic patient-specific guide. The patient-specific guide includes a three-dimensional contact surface preoperatively configured from medical scans of a specific patient as a negative surface of a medial portion of a proximal femoral bone of the patient according to a preoperative surgical plan for the patient. The guide also includes a proximal planar surface configured for guiding a resection of a femoral neck of the patient, and a scale formed on the planar surface. The scale is configured for indicating a preoperatively planned femoral version of a femoral stem implant and deviations therefrom.

Abstract: The invention relates to an anti-infective spacer for osteosynthesis plates comprising a plate having at least one opening for accommodating a screw, whereby the plate is made up of at least one biocompatible material, in which at least one antimicrobial substance is distributed, dispersed or dissolved. The invention also relates to a set comprising at least one osteosynthesis plate and at least one said spacer, preferably comprising at least one screw for each recess of each spacer.

Abstract: A bone plate structure adapted to fix a bone in an affected part is provided. The bone plate structure includes first and second bone plates. The first bone plate has a first stacking portion and a first extending portion and is adapted to be moved onto the bone through a wound of the affected part. The second bone plate has a second stacking portion and a second extending portion and is adapted to be moved onto the bone through the wound. When the first and second bone plates are located on the bone, the second bone plate is adapted to be moved relatively to the first bone plate, such that the first and second stacking portions are stacked with each other and the first and second extending portions are expanded relatively. A surgery device and a method for bone plate implant suitable for the bone plate structure is also provided.

Abstract: System, including methods, apparatus, and kits for binding bone. The system may include an encircling member and a fastening member that secures the encircling member in a loop around a portion of bone. In some embodiments, the fastening member may include any combination of the following: a cutting window, a guide aperture to guide a jaw of a crimping tool to a crimp region of the fastening member, multiple crimp regions, and/or apertures to receive adjustable prong members, among others.

Abstract: One embodiment of the present invention is directed to a bone plate assembly that includes a bone plate, bone screw(s) received in aperture(s) in the bone plate, and screw fixation member(s). The screw fixation member(s) may, alone or in conjunction with the bone plate, fix the bone screw(s) in place when such bone screw(s) are inserted in the aperture(s) in the bone plate. In one example (which example is intended to be illustrative and not restrictive) when the bone screw(s) have been received by the bone plate and inserted into bone and/or tissue, the bone plate assembly can-be used to fuse anatomical structures together (such as adjoining bones) and/or to heal a fracture in bone.

Abstract: A dynamic subsidence plate is described having a first plate member and a second plate member in sliding engagement that may infinitely subside between a first and second assembled position. The plate includes a lock assembly associated with the first and second plate members. The lock assembly includes a ramp portion, an interference portion, and a bearing member situated between the ramp portion and the interference portion. The lock assembly of the plate is configured to allow movement of the first member with respect to the second member in a first direction in an infinite number of positions between a first assembled position and a second assembled position. Further, the lock assembly alternatively prevents movement of the first member with respect to the second member in an opposite second direction between the first and second assembled positions.

Abstract: A cannulated torque-limiting device with one or more lumen therein which may mate with an additional operational tool. An A-O tip engagement for receiving and securing tips and tools for varying applications and needs is also disclosed.

Abstract: Cryotherapeutic systems with features that can facilitate pressure relief in the event of exhaust-passage blockage and associated devices, systems, and methods are disclosed herein. A cryotherapeutic system configured in accordance with a particular embodiment can include an elongated shaft having a distal portion and a pressure-relief portion proximal to the distal portion. The cryotherapeutic system can further include a supply lumen, an exhaust passage, and a balloon configured to receive refrigerant from the supply lumen and to exhaust refrigerant to the exhaust passage. The pressure-relief portion can be configured to release refrigerant from the exhaust passage when a pressure of refrigerant in the exhaust passage exceeds a threshold pressure less than a pressure rating of the balloon. The pressure-relief portion, for example, can include a rupture element configured to rupture at about the threshold pressure.

Abstract: A cryogenic needle probe having a proximal and distal region. A cooling supply tube provides pressurized cooling fluid within the needle. The proximal region is more conductive that the distal region. The proximal region is conductively coupled to a heat source.

Abstract: Ablation devices comprising a probe or needle useful for destroying nerve and soft tissue via a minimally invasive procedure to alleviate pain are provided. The probe comprises at least two prongs spaced apart and parallel to each other. The at least two prongs each having an interior surface and an exterior surface and an internal passage disposed in the interior surface of the at least two prongs. A filament is disposed in the internal passage of the at least two prongs that has an opening configured to release a pressurized material into the interior surface of the at least two prongs so as to cool the exterior surface of the at least two prongs to a temperature configured for ablating nerve and/or soft tissue. Methods for ablating nerve and/or soft tissue utilizing the ablation devices are also provided.

Abstract: Various embodiments of a capsule polishing device include a resistive-heating element including an electrically resistive, superelastic wire forming a loop between first and second ends of the superelastic wire. The first and second ends of the loop may at least partially extend from a planar face defined by the loop, to an insulating portion. In some embodiments, the capsule polishing device may be configured to perform active capsule polishing through a combination of hyperthermia of LECs and mechanical abrasion of the capsule surface. In some embodiments, at least a side and end portion of the loop of the capsule polishing device may be shaped to follow a contour of the capsule bag. The loop may be heated to approximately 40 to 47 degrees Celsius to destroy LECs (other temperatures are also possible). In some embodiments, the loop may include a roughened surface to increase mechanical abrasion.

Abstract: A method for performing a medical procedure, includes, coupling a probe to tissue in an organ of a patient. Ablation energy is applied to the tissue using the probe. A model of an evolution of steam pressure in the tissue, caused by the ablation energy, as a function of time is estimated. Based on the model, an occurrence time of a steam pop event caused by the steam pressure is predicted, and the predicted occurrence time of the steam pop event is indicated to an operator.

Abstract: A surgical instrument is provided including an outer housing shell defining a cavity, the outer housing shell defining an upper outer housing half and a lower outer housing half, wherein the upper outer housing half defines a longitudinal axis and an instrument module selectively insertable into the cavity of the outer housing shell. The instrument module includes an inner housing shell, at least one motor disposed within the inner housing shell, a control board being in electrical communication with the at least one motor and an energy source being in electrical communication with the at least one motor and the control board. The instrument module is inserted into the cavity of the outer housing shell in such a manner that the operative axis of the at least one motor is substantially parallel to the longitudinal axis of the upper outer housing half.

Abstract: An apparatus comprises a body, a shaft, an end effector, and a firing beam. The shaft extends distally from the body. The end effector is positioned at the distal end of the shaft. The end effector comprises a first jaw and a second jaw, with the first jaw being pivotable toward the second jaw. The firing beam is operable to translate relative to the end effector to thereby drive the first jaw toward the second jaw. The firing beam includes a deformable portion operable to deform in response to a stress imposed by the end effector on the firing beam as the jaws clamp on dense or thick tissue. The deformable portion is defined in part by a cutout. A compliance restriction feature restricts deformation in the firing beam. A resilient member biases the firing beam to a non-deformed configuration.

Abstract: An endoscopic bipolar forceps includes a housing, a shaft affixed to the housing, and a pair of jaw members attached to a distal end of the shaft. The forceps also includes a drive assembly for moving one of the jaw members relative to the other jaw member from a first position to a second position for manipulating tissue. A movable handle is included which is rotatable about a pivot to force a drive flange of the movable handle into mechanical cooperation with the drive assembly to move the jaw members from the first position to the second position. The forceps is connected to a source of electrosurgical energy connected to each jaw member such that the jaw members are capable of conducting bipolar energy through tissue held therebetween.

Abstract: An electrosurgical bipolar probe with internal cooling for use in systems and methods for lesioning in bone and other tissue is disclosed. The bipolar probe includes tubular electrodes configured such that the inner surface of the electrodes are cooled, directly or indirectly, while keeping the electrodes electrically isolated. An exemplary disclosed method of using a bipolar probe having an active tip having at least two electrodes for delivering energy includes the steps of: advancing the active tip into a bone tissue; delivering energy substantially between the electrodes in a bipolar manner; and supplying cooling fluid to the active tip for internal cooling of the electrodes. Some versions of the method further include the steps of monitoring the temperature of tissue to which the energy is being delivered; and controlling the delivery of energy in response to the temperature of the tissue.

Abstract: Devices and systems for ultrasonically imaging anatomical structures and performing ablation therapy within the body are disclosed. A combined ablation and ultrasound imaging probe includes an ablation electrode tip including an ablation electrode configured for delivering ablation energy, and a number of ultrasonic imaging sensors configured for imaging the tissue surrounding the probe. The ultrasonic imaging sensors are supported within the interior of the tip via a tip insert, and deliver ultrasonic waves through acoustic openings formed through the tip. The tip insert separates an interior lumen within the tip into a proximal fluid chamber and a distal fluid chamber. During an ablation procedure, the ultrasonic imaging sensors can be tasked to generate a number of ultrasonic images that can be displayed on a user interface.

Abstract: A method of controlling output of an electrosurgical power generating source includes the steps of receiving image data including tissue temperature information of a target tissue volume, calculating a specific absorption rate as a function of the tissue temperature information from the image data, and determining one or more operating parameters associated with the electrosurgical power generating source based on the calculated specific absorption rate.

Abstract: The present invention is directed to systems, apparatus, methods and procedures for the noninvasive treatment of tissue, including treatment using microwave energy. In one embodiment of the invention a medical device and associated apparatus and procedures are used to treat dermatological conditions using, for example, microwave energy.

Abstract: A method of manufacturing a glove that includes discrete elements and component systems, such as, but not limited to, lights, electrical cautery, suction, and irrigation, attached to the surgical glove. The gloves produced by this method can be used as surgical gloves or for other industrial applications. In a particular application, the method includes providing a former comprising a hand-shaped portion and a first surgical system comprising a first surgical instrument, and a first switch for controlling the first surgical system. The former includes a first depression for receiving the first surgical system. The first depression is adapted to produce an interference fit with at least a portion of the first surgical system. The first surgical system can be loaded into the first depression and a polymer coating can be applied over the loaded former to form a surgical glove.

Abstract: Apparatus and method for using radio frequency coil systems for magnetic resonance imaging within an open architecture apparatus is provided. The MRI coil system includes a support structure with an open architecture in which secondary support structures, compression systems and plates containing RF coil systems may be introduced. These structures and RF coils can be moved relative to the patient, or removed entirely from the system. In one embodiment the system consists of a tabletop coil system, while another embodiment consists of a dedicated stretcher design.

Abstract: Minimally invasive robotic surgical instruments and related methods are disclosed. A surgical instrument includes an interface fitting that couples a proximal chassis of the instrument with a holding fixture of a robotic manipulator. A securing feature releasably prevents relative axial sliding between the interface fitting and the chassis. In response to binding of the surgical instrument within a minimally invasive surgical site so as to inhibit removal of the surgical instrument from the surgical site and inhibit disengagement of the interface fitting from the holding fixture, the securing feature can be released to allow relative axial sliding between the interface fitting and the chassis, thereby allowing the holding fixture and the interface fitting to be separated from the rest of the surgical instrument and repositioning of the robotic manipulator out of the way.

Abstract: A medical robotic system has a robotic arm holding a medical device, and a control system for controlling movement of the arm according to operator manipulation of an input device. If the medical device is being commanded to a state exceeding a limitation by a threshold amount, then the control system disengages control of the medical device by the input device, servos the arm so that it remains in its current state, servos the input device so that it is set at a position such that a force being applied on the input device remains at its current level, requests the operator to lighten hold of the input device, sets a parameter associated with the input device upon detecting such lightened hold so that the medical device is commanded to a different state that does not exceed the limitation, and reengages control of the medical device by the input device.

Abstract: A robotic catheter system includes a robotic controller; a robotic manipulator; and in input controller. The input controller includes communication circuitry configured to receive a signal from a user input device; memory having stored therein a plurality of device drivers associated with a different type of input device or a differently configured input device; and a processor configured to recognize an input device connected with the communications circuitry, load a device driver according to the recognized input device, initialize the input device, and/or one of reject and notify an end user, and deliver an image to a display or graphical user interface.

Abstract: A surgical instrument is provided, including: at least one articulatable arm having a distal end, a proximal end, and at least one joint region disposed between the distal and proximal ends; an optical fiber bend sensor provided in the at least one joint region of the at least one articulatable arm; a detection system coupled to the optical fiber bend sensor, said detection system comprising a light source and a light detector for detecting light reflected by or transmitted through the optical fiber bend sensor to determine a position of at least one joint region of the at least one articulatable arm based on the detected light reflected by or transmitted through the optical fiber bend sensor; and a control system comprising a servo controller for effectuating movement of the arm.

Abstract: Methods and devices are provided for controlling movement of a distal end of a surgical instrument. In general, the methods and devices can allow for controlling movement of surgical tools, and in particular for causing mimicked motion between an external control unit and a surgical tool positioned within a patient's body. In one embodiment, a surgical system is provided having a master assembly including an input tool and a slave assembly including a surgical instrument. The master assembly and the slave assembly can be configured to be electronically coupled together such that movement of the master assembly can be electronically communicated to the slave assembly to cause mimicked movement of the slave assembly.

Abstract: Described herein is a surgical instrument guide for use with a robotic surgical system, for example, during spinal surgery. In certain embodiments, the guide is attached to or is part of an end effector of a robotic arm, and provides a rigid structure that allows for precise preparation of patient tissue (e.g., preparation of a pedicle) by drilling, tapping, or other manipulation, as well as precise placement of a screw in a drilled hole or affixation of a prosthetic or implant in a prepared patient situation.

Abstract: A method for preparing the reconstruction of a damaged bone structure using an implant, comprising the following steps which are carried out by a computer (2): a) performing atlas segmentation on a structure dataset which represent the structure to be reconstructed, and determining healthy objects and defective objects within the damaged structure; b) determining a target structure by modelling replacements for the defective objects within the damaged structure; c) selecting an implant on the basis of the target structure, and providing a shape dataset which represents the shape of the implant; d) positioning the selected implant in order to find the optimum implant position; e) determining whether or not the selected implant is suitable, and returning to step c) if the implant is determined to not be suitable; and f) exporting the suitable implant to a medical navigation process.

Abstract: An implantable tissue marker incorporates a contrast agent sealed within a chamber in a container formed from a solid material. The contrast agent is selected to produce a change, such as an increase, in signal intensity under magnetic resonance imaging (MRI). An additional contrast agent may also be sealed within the chamber to provide visibility under another imaging modality, such as computed tomographic (CT) imaging or ultrasound imaging.

Abstract: Embodiments are provided for a patterned dental positioning appliance. One method embodiment includes receiving a dental mold of a patient's dentition, applying a pattern to a portion of the dental mold, and applying a material to the dental mold to form the removable dental positioning appliance that includes either the pattern on the portion of the dental mold or an inverse thereof.

Abstract: Various designs of dental orthodontic brackets are described. Some brackets are self-ligating with no moving parts. Some brackets include multiple pathways for wires so an amount and type of force applied by the bracket can be varied without moving the bracket. Optionally, a same bracket is used for an entire orthodontic process.

Abstract: Implant removal tool (1) which allows removing an implant (5) from a patient's bone (6). The implant removal tool (1) comprises a head (2), to which a torque-providing system is attached, and a threaded body (4) preferably with a decreasing diameter. The threaded body (4) preferably has a thread to the left and is intended to be threaded into the hole (7) of the implant (5). The extraction of the implant (5) is relatively simple to carry out, removing the implant (5) in an almost clean manner and leaving a very small cavity (13) in the patient's bone (6). Therefore, the implant removal tool (1) according to the invention makes the removal of an implant (5) a far less traumatic procedure for the patient.

Abstract: Animal feeding apparatuses that include a plurality of protrusions extending into a feeding well. The protrusions clean the teeth or gums of an animal as it feeds from the feeding well. Also described herein are methods of cleaning an animal's teeth with such a bowl and animals that feed from such a bowl.

Abstract: This invention is directed to a device and a method for controlling fecal incontinence. The device of this invention is easily inserted into the anal canal, and is designed for remaining where required in the anal canal or rectum, above the dentate line and hemorrhoidal vein area, despite the peristaltic movements of the intestine.

Abstract: An incontinence treatment system for a male patient includes a support, a brace attachable to the support, and an introducer provided to deliver an anchor through the support and into periosteum tissue over a pubic bone of the pelvis of the male patient. The brace includes a base portion, a first post extending from the base portion and a second post extending from the base portion. A first hanger is attached to an end portion of the first post and a second hanger attached to an end portion of the second post. A first slot is formed between the end portion of the first post and the first hanger and a second slot formed between the end portion of the second post and the second hanger. The hangers are insertable into pockets formed in a pair of longitudinal arms of the support.

Abstract: Technologies are generally provided for a trans-vaginal sling delivery device for deploying a sub-urethral sling to treat urinary incontinence. A delivery tool coupled with an interior of a delivery tube may be advanced through the vagina, and a pointed end of the delivery tube may puncture the vaginal wall. A sub-urethral sling may be attached to the delivery tube, and the sling may be longitudinally wrapped into a reduced delivery profile around the delivery tool within the delivery tube. The delivery tube may include a longitudinal slit opening, and the sling may be deployed from the delivery tool by rotating the delivery tool. Two delivery tubes and delivery tools may be employed to deploy each end of the sling, such that each end of the sling may be anchored on a right and left side of the urethra with a portion of the sling supporting the urethra from beneath.

Abstract: Implants are described herein which contain an activated adhesive on at least a portion of the surface of the implant. A release sheet may be positioned over at least a portion of the adhesive. Packages which contain the implants and methods of preparing the implants are also described.

Abstract: The present invention is directed to bistable cells and their use in devices, particularly medical devices such as stents, clamps and valves. An expandable stent formed of a plurality of bistable cells is described. The stent has two or more stable configurations, including a first stable configuration with a first diameter and a second stable configuration with a second, larger diameter. A valve comprising a bistable cell for use in eliminating incontinence is also disclosed.

Abstract: The present disclosure relates to a fixation device. The fixation device includes a base portion having a first leg, a second leg, and a groove located between the first and second legs, and a top portion extending from the base portion. A method of tissue repair and a kit are also disclosed.