Abstract: A transperineal biopsy guide including a guide member and a displacement member supported by the guide member. The guide member may be configured to operably couple with the transrectal probe and may include a distal end, a proximal end opposite the distal end, and a length extending along a longitudinal axis between the distal and proximal ends. The displacement member may be configured to support the access needle and displace the access needle along at least a portion of the length of the guide member between the distal and proximal ends. The access needle may extend into the subcutaneous tissue when the access needle is displaced to the distal end.

Abstract: Trocar for instrument access to body cavities in minimally invasive surgery, the trocar comprising:—a body having a first access opening and at least one second access opening, each for inserting an instrument;—a cannula arranged with a proximal end to the body and having a distal end suitable for insertion into body cavities in minimally invasive surgery, wherein the cannula has a substantially constant out of round cross-section along is length, wherein a channel in the cannula is connected to the first access opening to provide a first passageway for an instrument and to the second access opening to provide at least one second passageway separate from said first passageway; and—a gas inlet arranged at the body and in fluid connection with the at least one passageway for inflating the body cavity with a gas, such as carbon dioxide gas.

Abstract: The disclosure provides examples of a surgical needle for entering a joint space, such as the hip joint, through tissue.

Abstract: Disclosed are devices and methods for treating tension pneumothorax. A needle assembly may include an outer cannula defining a lumen and having a distal end portion with a sharp bevel, and an inner cannula slidably-disposed through the lumen of the outer cannula. The inner cannula moves between an extended and retracted position and includes a blunt distal end portion configured to extend beyond the sharp bevel of the outer cannula when the inner cannula is in the extended position. The blunt distal end portion can retract within the lumen of the outer cannula when the inner cannula is in the retracted position, thereby exposing the sharp bevel. The needle assembly further includes a bias disposed inside the housing and coupled to the inner cannula. A proximal end portion of the inner cannula is configured to extend through the housing when the inner cannula is in the retracted position.

Abstract: A puncture needle including: an elongated approximately-linear main body; a distal end portion that is located at a distal end of the main body and that has a blade surface formed of a distal end surface which is formed inclined with respect to a longitudinal direction; and a bending portion that is provided between the main body and the distal end portion to connect the main body to the distal end portion and that can be passively bent in response to an external force. The distal end portion functions as a bending-direction control portion for setting a bending direction of the bending portion to a direction in which the blade surface is made to face toward an inner side of a bent shape.

Abstract: The present application discloses embodiments related to an external bone fixation device configured to correct bone deformities or repair bone injuries. The device can include a plurality of bases configured to be attached to portions of a bone and a plurality of struts configured to be adjustable in length to change the position and orientation of the plurality of bases and the attached bone portions.

Abstract: An external fixing device for the treatment of bone fractures includes a first member, a second member, a central body arranged between the first member and the second member, a first ball joint for the articulated connection of the first member with the central body, a second ball joint for the articulated connection of the second member with the central body, locking means operatively associated to the first ball joint and with the second ball joint, respectively, the locking means being suitable for allowing/preventing the articulation of the first member and second member with respect to the central body, wherein the first member includes a first clamp, the second member includes a second clamp and the central body includes a third clamp for connection of the external fixing device to respective fractured bone portions to be treated.

Abstract: A growth rod distraction system a domino having first and second bores provided therein. First and second spinal rods are respectively disposed within the first and second bores for movement relative to the domino First and second spur gears are disposed within the domino and respectively cooperate with the first and second growth rods such that rotation of the spur gears causes axial movements of the growth rods relative to the domino The spinal rods may be formed either from a flexible polymer material (such as a PEEK, carbon fiber PEEK, PEAK, or similar medical grade polymer material) or a hybrid combination of such flexible polymer material and a metallic material (such as nitinol or similar medical grade metallic material). The spinal rods can also be used for fusion or non-fusion surgery of the spine to stabilize two or more vertebrae.

Abstract: The invention relates to an instrument set for percutaneous stabilization of the spinal column using rods (8) and pedicle screws (1) that have a screw head (3) and a screw shank (4) and a distally open recess (13) for receiving a rod (8), with a screw manipulator (2) through which a central cavity (11) passes axially and which comprises a cylindrical sleeve (20) and a slide (24), wherein the wall of the cylindrical sleeve (20) is divided into two first wall segments (27) by two diametrically opposite and axially extending windows (26) which open out in the proximal end face of the sleeve (20), the proximal ends of the first wall segments (27) form grip elements (28) which, during a screw manipulation, receive between them at least a longitudinal portion of the screw head (3), and the slide (24) is displaceable in the axial direction on the sleeve (20) and is connected to the first wall segments (27) such that it secures these against moving radially apart at least in a proximal end position (E) of displace

Abstract: A system for flexibly stabilizing a vertebral motion segment of the facet joint by connecting a first vertebra and a second vertebra is disclosed. The system includes an elongate connection element with end portions interconnected by a flexible coupling member. The system includes first and second attachment portions for connecting the connection element to the vertebrae. A first resilient member is positioned between the first end portion and the first attachment portion, and a second resilient member is positioned between the first attachment portion and the second attachment portion.

Abstract: A surgical system and method for fusionless correction of a spine disorder are provided. The method comprising the steps of providing access to a spine; providing a longitudinal element extending between a first end including a first fixation element and a second end including a second fixation element; engaging the first fixation element with a first costovertebral surface and engaging the second fixation element with a second costovertebral surface such that the longitudinal element is disposed in a costotransverse orientation along a selected section of the spine; and preventing growth of the selected section of the spine with the longitudinal element.

Abstract: Open implant closure structures include a helically wound guide and advancement flange form having pivot-splay accommodating and splay control surfaces with opposing load flanks in initial non-parallel relation.

Abstract: A surgical screw assembly including: a fastener including an elongate shaft having a proximal end and a distal end and a head at the proximal end. A tulip having a an internal bearing surface is provided. A distal end of the tulip has a bore therethrough defining the internal bearing surface. Locking enhancement features are configured to cooperate with the head, such that, in an unlocked configuration, the head is movable relative to the tulip; in a provisionally locked configuration, the locking enhancement features engage the head with a first polyaxial grip strength; and in a finally locked configuration, the locking enhancement features engage the head with a second polyaxial grip strength greater than the first polyaxial grip strength.

Abstract: A bone anchoring device includes a shank to be anchored in a bone or vertebra, a head, and a receiving part receiving the head for connecting the shank to a rod. The shank and the head are separate parts. The head has a bore with a cylindrical inner surface, a ring-shaped groove provided on the inner surface, and at least one slit extending from the inner surface to the outer surface of the head. The shank has a first portion for anchoring in the bone or vertebra and a second portion with a cylindrical outer surface adjoining a free end. A projection is provided on the cylindrical outer surface which engages with the ring-shaped groove of the head, when the cylindrical second portion of the shank is inserted in the bore of the head.

Abstract: A spinal management system includes a stabilizing member adapted to extend substantially longitudinally along a target region of a spine tending to exhibit a defective curvature and a set of stabilizing anchors adapted for fixation to vertebrae and to receive the stabilizing member to secure the stabilizing member against substantial transverse translation relative to the vertebrae. The system also includes a first correction anchor adapted for fixation to a vertebra, a second correction anchor adapted for fixation to a vertebra, and a connection between the stabilizing member and the first correction anchor and between the first and second correction anchors adapted such that when the connection is tensioned a compressive force is selectively exerted between the first and second correction anchors.

Abstract: Provided is an interspinous fusion implant that is capable of fixing a vertebral body having a lesion by using hooking between spinous processes through a minimal incision without using a pedicle screw. The interspinous fusion implant includes an upper hooking member installed to be hooked with one spinous process and a lower hooking member installed to be engaged with another adjacent spinous process. The upper hooking member and the lower hooking member are coupled to each other and then fixed to each other through a fixing bolt after a distance between vertebral bodies having a lesion is reduced by using a separate mechanism.

Abstract: In an exemplary embodiment, the present invention provides an orthopedic plate blocking assembly that can be used for the fixation or fastening of an orthopedic plate to bone tissue. In particular, the present invention, in one embodiment, provides an orthopedic plate having a plurality of cavities where each cavity is configured and dimensioned to receive a bone anchoring member. The orthopedic plate further provides a blocking mechanism having a plurality of blocking members that block the bone anchoring members to prevent the bone anchoring members from “backing out” of cavities once the bone anchoring members are finally seated in the cavities.

Abstract: The present disclosure generally relates to a device for positioning and immobilizing at least two adjacent vertebrae. In particular, in one or more embodiments, the present disclosure relates to spinous process fusion devices that distract and immobilize the spinous processes of adjacent vertebrae.

Abstract: A spinal distractor for distracting opposed vertebrae in which a pair of elements are threadably connected by a screw having opposing threads, wherein actuating the screw spreads the elements apart and pushes the vertebrae apart.

Abstract: A spinal rod system includes a first instrument extending between a proximal portion and a distal portion along a longitudinal axis thereof. The proximal portion defines an inner cavity extending along the longitudinal axis. The first instrument includes a first arm extending along the longitudinal axis. The first arm defines a portion of a vertebral construct cavity disposed in communication with the inner cavity and includes a distal end being configured to engage a bone fastener. Methods of use are disclosed.

Abstract: Systems, assemblies, components and methods for correcting alignment of one or more vertebrae of a spine are provided. A first elongate derotator member includes a first elongate element having a first proximal end portion and a first distal end portion. The first distal end portion is releasably engageable with a first implant implanted in one of the vertebrae. A second elongate derotator member comprising a second elongate element is releasably engageable with a second implant implanted in the same vertebra. A transverse member is engageable with the first and second elongate elements.

Abstract: Systems, assemblies, components and methods for correcting alignment of one or more vertebrae of a spine are provided. A first elongate derotator member includes a first elongate element having a first proximal end portion and a first distal end portion. The first distal end portion is releasably engageable with a first implant implanted in one of the vertebrae. A second elongate derotator member comprising a second elongate element is releasably engageable with a second implant implanted in the same vertebra. A transverse member is engageable with the first and second elongate elements.

Abstract: Systems, assemblies, components and methods for correcting alignment of one or more vertebrae of a spine are provided. A first elongate derotator member includes a first elongate element having a first proximal end portion and a first distal end portion. The first distal end portion is releasably engageable with a first implant implanted in one of the vertebrae. A second elongate derotator member comprising a second elongate element is releasably engageable with a second implant implanted in the same vertebra. A transverse member is engageable with the first and second elongate elements.

Abstract: Medical implant which at least partially comprises a biocompatible, electrically conductive polymer with electrical resistivity p, having the property of being able to be heated and softened by a flow of current through the polymer.

Abstract: Systems and methods for treating conditions and diseases of the spine are disclosed herein. A device includes a balloon catheter comprising at least one inner lumen incorporated within an elongated shaft; a distal end having an inner balloon positioned inside and completely surrounded by an outer balloon; and a proximal end having an adapter for passage of at least one of an inflation fluid or a medical instrument; and an optical fiber comprising an outer diameter sized to pass through the inner lumen of the elongated shaft; a nonlinear light-emitting portion of a given length, wherein a portion of a cladding material from the nonlinear light-emitting portion has been removed so that light energy may be emitted along the length of the nonlinear light-emitting portion; and a linear elongated portion for guiding light towards the nonlinear light-emitting portion.

Abstract: The present invention provides a method for stabilizing a fractured bone. The method includes positioning an elongate rod in the medullary canal of the fractured bone and forming a passageway through the cortex of the bone. The passageway extends from the exterior surface of the bone to the medullary canal of the bone. The method also includes creating a bonding region on the elongate rod. The bonding region is generally aligned with the passageway of the cortex. Furthermore, the method includes positioning a fastener in the passageway of the cortex and on the bonding region of the elongate rod and thermally bonding the fastener to the bonding region of the elongate rod while the fastener is positioned in the passageway of the cortex.

Abstract: A retaining mechanism for use in affixing a stratum to bone is disclosed. The retaining mechanism comprises a stratum, a retaining element and a spring element. The stratum comprising a first surface, a second surface, and a hole extending between the first surface and the second surface, wherein the second surface is configured to engage at least a portion of the bone. The retaining element comprises a first position that permits a fastener to be passed through the hole, and a second position that at least partially overlaps the hole. The spring element is configured to engage the stratum and configured to engage the retaining element such that the spring element helps maintain the retaining element in its second position so as to help prevent inadvertent backing out of the fastener after the fastener has been fully inserted into the hole.

Abstract: Apparatus for repair of a proximal humeral fracture is disclosed including a fixation plate adapted to be located at an external surface of the proximal humerus, a support element adapted to be implanted in the proximal humerus; and one or more connection elements adapted to connect the fixation plate to the support element.

Abstract: Methods and devices for fixation of a lateral compression fracture are disclosed. At least one compression device may be provided in a deployer. The deployer may be positioned adjacent to a facture line of a fractured bone. The at least one compression device may be laparoscopically delivered from the deployer to the fractured bone and secured the fractured bone. A compression device may include a central portion and a plurality of arms. The central portion may have a first side surface configured to contact a bone fracture and a second side surface. Each arm may extend from a proximal end attached to the central portion and have a distal end that includes a locking mechanism. Each locking mechanism may include at least one of a conical projection, a barb hook, a claw hook, and a serrated hook.

Abstract: A fastener assembly that can be used for the fixation or anchoring of orthopedic devices or instruments to bone tissue. In particular, a low profile variable angle or fixed angle fastener assembly is able to securely connect the orthopedic device to bone tissue. The fastener assembly may have a locking mechanism that will quickly and easily lock the fastener assembly with respect to the orthopedic device.

Abstract: Provided is a medical screw which can be readily extracted from bones after fusion of bone fractures or at replacement of the screw. The medical screw 11 has a screw thread 11b extending on the outer surface of a distal end portion of the screw 11 and an inner reverse thread extending on the inner surface of a proximal end portion 11d of the screw 11 and made in the opposite direction to the thread direction of the screw thread 11b. An outer reverse thread at a distal end portion of the removal jig 17 is engaged with the inner reverse thread of the screw 11, while being rotated in the opposite direction to the thread direction of the screw thread 11b. This engagement integrates the screw 11 with the removal jig 17. The removal jig 17 is then rotated in the opposite direction to the drilled direction of the screw 11 to detach the screw thread 11b of the screw 11 from the bone fractured region D.

Abstract: An orthopedic implant device and system support the fusion of bones in the medial column of the human foot. An exemplary implant uses an improved lag screw and supplemental components, including a washer plate and transverse screws which penetrate transverse through holes in the shaft of the lag screw. Additionally, a surgical procedure is described which may employ such an implant. The improved lag screw may be inserted at the plantar surface of the first metatarsal and support the fusion of, for example, the transverse tarsal joint, the cuneonavicular joint, and the tarsometatarsal joint.

Abstract: A pedicle screw assembly includes a threaded shank portion formed from a polymer material and a head assembly. The head assembly includes a tulip having extending arms, the tulip engaging a reaction bar such that loads applied to the pedicle screw assembly can be transferred to another pedicle screw assembly in order to immobilize a section of a spinal column.

Abstract: A modular surgical tool that is used to insert instruments into the intervertebral disc space of a patient to measure the height of the intervertebral disc space, to prepare the intervertebral disc space for an implant, and to insert the implant into the intervertebral disc space using a plurality of interchangeable tool ends. Advantageously, this modular surgical tool permits multiple insertion angles.

Abstract: A stylet-guided balloon vertebroplasty system, as well as methods for bone augmentation using same are provided. In certain embodiments, a pre-curved stylet with an overlying delivery tube may be used to target an approximately centered target site within a bone structure, facilitating direction thereto of an expandable member useful for creating a cavity that may receive curable material to restore bone height and/or to reinforce the bone structure.

Abstract: A spacer and implant assembly are disclosed, the spacer including an outer balloon that is folded so as to be dilatable, and an inner balloon that is folded so as to be dilatable, and that is removably inserted into the outer balloon. The inner balloon dilates in response to introduction of a dilating fluid having a lower viscosity than a viscosity of a filling material inserted into the outer balloon, and the outer balloon dilates in response to the dilation of the inner balloon.

Abstract: Cryogenic medical devices and apparatus are disclosed which are capable of generating cryogen to a supercritical state, specifically supercritical nitrogen. The cryogenic medical devices and apparatus disclosed are useful in methods of treating damaged, diseased, cancerous or other unwanted tissues.

Abstract: Systems and methods for treating tissue with cryogenic media and/or high pressure jet media for cutting either sequentially or contemporaneously and removing tissue from a site in a patient body.

Abstract: A multi-mode electrosurgical apparatus for use in cold plasma applications, electrosurgical cutting, electrosurgical coagulation and mechanical cutting is provided. The electrosurgical apparatus includes a housing having a passage extending therethrough, an electrically conducting tube being disposed in the passage of the housing; an insulating outer tube disposed around the electrically conducting tube coupled to the housing, the electrically conducting tube being movable along a longitudinal axis of the housing and outer tube; an electrically conducting blade coupled to the distal end of the electrically conducting tube, and a transformer assembly disposed on a proximal end of the housing, the transformer assembly including a first transformer and a first switch for selectively coupling the first transformer and an external second transformer to the electrically conducting tube for providing electrosurgical energy thereto.

Abstract: An electrocautery surgical device comprising a battery source and radio-frequency signal generating circuitry electrically coupled to the battery source and operable to deliver power.

Abstract: Electrosurgical systems and methods are described herein, the system including an electrosurgical probe with an active electrode disposed near the probe distal end, a system with a power supply for delivery of voltage to the active electrode and a controller that receives and processes a signal from a current sensor and a temperature sensor. The current sensor measures the current output of the power supply and the temperature sensor is adjacent an electrically conductive fluid located at a target site. The controller may be programmed to operate in a low voltage mode that limits the power supply to a low voltage output so as to determine whether the current output from the current sensor is within a current output range. This range is defined by predetermined upper and lower limits that are modified by at least one measured value.

Abstract: Electrosurgical procedures. At least some of the example methods that include: supplying energy to an active electrode of an electrosurgical wand, the supplying energy to the active electrode by an electrosurgical controller; monitoring an electrical parameter associated with the energy; and determining, based on the electrical parameter, the presence of a wand condition of the electrosurgical wand, the wand condition being at least one selected from the group consisting of: a surface area of the active electrode is less than a predetermined threshold surface area; the surface area of the active electrode is approaching the predetermined threshold surface area; and that the electrosurgical wand is affected by a blockage.

Abstract: A treatment system includes a fluid cooling supply system for chilling and delivering liquid coolant to a patient. The fluid cooling supply system includes a cooling device and a heat exchanger device. The heat exchanger device is biased to the cooling device and is in fluid communication with a treatment device in a patient. The fluid cooling supply system includes at least one biasing mechanism to provide a given biasing force between the heat exchanger device and the cooling device to effectuate and improve heat transfer. The liquid coolant may be circulated through an energy delivery device positioned in an airway of a patient to preserve tissue. The system is controlled to circulate liquid coolant at a given temperature and pressure for a selected amount of time during pulmonary treatment of a patient.

Abstract: A tissue removal system for extracting a tissue specimen from a patient is disclosed. The system has a retrieval bag, a first electrode, and a return electrode. The retrieval bag has a flexible container with an opening. The first electrode is coupled to an interior of the flexible container, and has a conductive wire with an exposure area, a first load-bearing area, a coating having a first active electrode surface area, and an impedance that is greater than an impedance of the conductive wire. The first active electrode surface area is less than the exposure area. The coating is configured to degrade during application of electrosurgical power and wherein the degradation expands the first active electrode surface area during the application of the electrosurgical power.

Abstract: Tissue regions are treated using a multiple lead electrode probe. A plurality of electrodes may be disposed about an elongate shaft. The elongate shaft may be slidably disposed within a lumen of a delivery sheath. One or more probes including one or more electrically active regions may also be slidably disposed within the delivery sheath. The one or more probes may be configured to extend radially about the elongate shaft. The plurality of electrodes and the electrically active regions may be individually connected to a control and power unit through individual channels.

Abstract: A device for performing a surgical procedure includes an elongated shaft extending between a proximal end and a distal end. The shaft includes an outer surface and an inner surface. An expandable member is disposed at the distal end of the shaft. The expandable member is configured to receive inflation material. At least one electrode is disposed with the inflatable member. Methods of use are disclosed.

Abstract: A slip ring mechanism for a medical manipulator, the slip ring mechanism including: a rotating rod that rotates together with a drive shaft; rotating terminals that are positioned so as to be coaxial to the rotating rod; conductive members that contact the rotating terminals and are electrically connected to an end effector; holding members that hold the conductive members such that the conductive members are sandwiched between the holding members and the rotating terminals; and contact terminals that contact the rotating terminals so as to be capable of rotating and sliding relative thereto.

Abstract: A surgical implant-cutting instrument of the bipolar type, operated with direct current, is disclosed, with an instrument head which is located at the distal end of an instrument shank and which is provided for minimally invasive insertion of the instrument into a patient's body, wherein at least two mutually opposing instrument branches, preferably of the linear type, are arranged on the instrument head and between them define a cutting gap for receiving an electrically conductive implant or implant section between them. According to the invention electrodes are formed on the mutually facing longitudinal sides of the branches or these are each equipped with at least one electrode, which electrodes are in turn shaped at their mutually facing longitudinal sides to form a cutting edge in order to effect a quasi linear or punctiform physical contact engagement with the electrically conductive implant or implant section for an electrical short circuit of the mutually opposing electrodes.

Abstract: A sphincter tissue region is treated using a support structure sized for advancement into the anal canal. At least one electrode is carried by the structure. A mechanism is coupled to the electrode to move the electrode between a first position retracted in the support structure and a second position extended from the support structure through surface tissue to penetrate a subsurface tissue region at or near a sphincter in the anal canal. A cable is coupled to the electrode to conduct energy for application by the electrode to form a lesion in the subsurface tissue region.

Abstract: A catheter is adapted to ablate tissue and provide lesion qualitative information on a real time basis, having an ablation tip section with a generally omni-directional light diffusion chamber with one openings to allow light energy in the chamber to radiate the tissue and return to the chamber. The chamber is irrigated at a positive pressure differential to continuously flush the opening with fluid. The light energy returning to the chamber from the tissue conveys a tissue parameter, including without limitation, lesion formation, depth of penetration of lesion, cross-sectional area of lesion, formation of char during ablation, recognition of char during ablation, recognition of char from non-charred tissue, formation of coagulum around the ablation site, differentiation of coagulated from non-coagulated blood, differentiation of ablated from healthy tissue, tissue proximity, and recognition of steam formation in the tissue for prevention of steam pop.