Abstract: A surgical spreader assembly for use in implanting staples and other implants in a patient is disclosed. The spreader assembly may be included a kit with a number of other surgical instruments and the staples for implantation in the patient.

Abstract: A surgical instrument includes a drive shaft, a motor for rotating the drive shaft, and a motor speed control. The motor speed control includes a first switch and a second switch which are in communication with the motor. The first switch is disposed over and in registration with the second switch. The first switch has an activated state such that the first switch sends a first signal to the motor. The motor rotates the drive shaft in response to the first signal. The second switch sends a second signal to the motor that varies the speed that the motor rotates the drive shaft in response to a force applied to the second switch by the first switch.

Abstract: This document provides devices and methods for harvesting tissue. For example, this document provides devices and methods for harvesting abdominal wall fascial tissue in a minimally invasive manner.

Abstract: Surgical instruments are disclosed that are couplable to or have an end effector or a disposable loading unit with an end effector, and at least one micro-electromechanical system (MEMS) device operatively connected to the surgical instrument for at least one of sensing a condition, measuring a parameter and controlling the condition and/or parameter.

Abstract: An apparatus includes a body and a shaft assembly. The shaft assembly is in communication with the body and includes an end effector, first cam gear, second cam gear, and a lock bar. The end effector has an articulation joint. The first cam gear is rotatably positioned within the shaft assembly. The second cam gear is in communication with the end effector at the articulation joint. The lock bar is distally biased to lock against the second cam gear. The first cam gear is rotatable through a first range of motion to unlock the lock bar relative to the second cam gear. The first cam gear is rotatable through a second range of motion to rotate the end effector at the articulation joint.

Abstract: The present disclosure relates to an apparatus for endoscopic application of surgical clips to body tissue. The apparatus includes a handle portion, an elongated tubular member, one or more surgical clips, a jaw assembly and a locking cam driver. The elongated tubular member extends distally from the handle portion and defines a longitudinal axis. The surgical clips are disposed within the tubular member. The locking cam driver includes a bifurcated distal end portion that has a pair of angled camming surfaces to facilitate closure of the jaw assembly.

Abstract: A surgical clip applier is provided including a housing; at least one handle pivotably connected to the housing; a channel assembly extending distally from the housing; a plurality of clips loaded in the clip carrier; a drive channel translatably supported in the housing and the channel assembly, the drive channel being translated upon actuation of the at least one handle; and a counter mechanism supported in the housing, the counter mechanism including indicia visible through the housing, wherein the indicia corresponds to a quantity of clips loaded in the clip applier, wherein the indicia decrements upon each firing of the clip applier resulting in a reduction in the quantity of clips remaining of the plurality of clips.

Abstract: A circular anastomosis stapler is provided and includes a handle assembly having a firing trigger that is actuatable between a first firing stroke and a second firing stroke. A shell assembly includes a pusher assembly having a main pusher, a staple pusher and a knife pusher. A compressible member positioned between the main pusher and the knife pusher is movable between a first configuration for advancing the staple pusher through the first firing stroke to drive at least one staple from the shell assembly to staple tissue and a second configuration for advancing the knife pusher through the second firing stroke to drive a knife from the shell assembly to core the stapled tissue.

Abstract: A bristle device (8) for delivery into a body lumen comprises a longitudinally extending stem and a plurality of bristles extending generally outwardly from the stem for anchoring the device in a body lumen. There may beat least two bristle segments (96) and there are flexible sections (95) between the segments (96). The flexible sections (95) articulate to enable the device to pass through a catheter placed in a tortuous anatomy or to be deployed in a curved vessel, or across a bifurcation. In some cases at least some of the bristle segments (96) are spaced-apart to accommodate bending of the bristles.

Abstract: Systems and devices for minimally invasively treating an air leak in a lung comprise the steps of detecting an air leak in a lung; locating an airway in fluid communication with the air leak, introducing a bronchoscope into a patient's airway to a position adjacent the target section and occluding an airway upstream of the air leak for a period of time. The airway occlusion device is preferably removed after the air leak has substantially permanently healed. The occluding device may be a one-way valve. The occluding device may also comprise strut members and anchors that penetrate an airway wall.

Abstract: An air passageway obstruction device includes a frame structure and a flexible membrane overlying the frame structure. The frame structure is collapsible upon advancement of the device into the air passageway, expandable into a rigid structure upon deploying in the air passageway and recollapsible upon removal from the air passageway. The flexible membrane obstructs inhaled air flow into a lung portion communicating with the air passageway. The device may be removed after deployment in an air passageway by recollapsing the device and pulling the device proximally through a catheter.

Abstract: Disclosed herein are medical devices comprising a single-lobed, thin-walled, expandable body and a flexible, elongated delivery device for treating saccular vascular aneurysms and occluding segments of blood vessels and other biological conduits. The expandable bodies may include gold and other metals that can be compressed, positioned in the lumen of an aneurysm, or other biological conduit and expanded. The external surface of the expandable bodies can be configured to promote local thrombosis and to promote the growth of tissue into and around the surface in order to reduce migration of the expandable body and to occlude and seal the aneurysm or biological conduit. For the treatment of saccular aneurysms, the expandable body may be deployed in combination with one or more coiled wires that contact both the wall of the aneurysm and the expandable body and exert force on the expandable body to aid in sealing the aneurysm neck.

Abstract: A method for forming a material in an in situ medical device by initiating polymerization of water soluble polymer precursors in an aqueous solution during or after transport of the polymerizable solution from its storage container to a space inside the in situ medical device is described. The stored aqueous solution with water soluble precursors lacks a free radical initiator which, in a powder form, is introduced into the aqueous solution during or after its transport into the space inside the in situ medical device. This storage and delivery system provides greater stability to the stored aqueous solution, allowing it to be stored at ambient temperature and providing extended shelf life over the solutions used in existing in situ polymerization systems. The flexibility to store and deliver/transport only one aqueous solution, instead of requiring the use of two different solutions, is also a benefit.

Abstract: A vascular occlusion device having an expandable frame that carries a membrane. The membrane can include a tubular portion configured to transition between an open configuration in which the tubular portion is configured to receive a guidewire and a closed configuration in which the tubular portion is configured to occlude blood flow.

Abstract: Methods and instruments for performing a kinematically-aligned total knee arthroplasty (TKA) are disclosed. Goals of the kinematically-aligned TKA can include restoration of (1) the femoral and tibial joint lines to the patient's natural joint line, (2) the patient's Hip-Knee-Ankle alignment to their constitutional alignment prior to developing osteoarthritis and (3) restoration of the patient's natural soft tissue laxity and envelope. A shim block assembly can be used in resecting the distal medial and lateral condyles to account for cartilage wear on the distal condyles from osteoarthritis. The shim block assembly can include a plurality of shims, and each shim can be attachable to or integral with a reference block. At least one of the plurality of shims can have a medial portion with a thickness different from a thickness of a lateral portion of the shim. The shims need not be joined together as a single medial/lateral component but may be independent of one another.

Abstract: A drill guide system is provided having a source for x-ray radiation along with a receiver to generate a visible image of the radiation. A bone with an intramedullary nail is located between the source and receiver. A drill with a passage transmits x-ray radiation from the source through a drill bit that then passes through the bone and nail. The user guides the drill bit using an image on the receiver. When the user lines up the drill with a hole in the nail, the alignment is visible on the receiver.

Abstract: A surgeon can place a bone perforator in contact with a bone, and can hammer on the bone perforator. The hammering can drive teeth on the bone perforator into the bone, thereby creating a perforation in the bone. The surgeon can pry or break the bone along the perforation, can access tissue beneath the bone as needed, and can replace the bone along the perforation. In some examples, the bone perforator is formed as a bendable sheet having teeth in a fixed, single-file pattern, with a hammerable surface opposite the teeth. In other examples, the bone perforator has repositionable teeth.

Abstract: This invention is directed to devices and methods for surgical access to the body, and particularly to surgical drills for accessing a body cavity and methods therefor. In general, a surgical drill is utilized to gain access to a body cavity or part, such as where bone and/or other hard tissues need to be pierced. For example, the skull and other bones with internal cavities may require surgical access to treat body portions contained within the bone. Further in general, it may be generally desirable to create access holes or openings which may be as small as possible and at a particular direction and/or trajectory. In this manner the access hole or opening may be utilized to guide another device, such as a treatment device, to a particular target along the established trajectory of the access hole or opening.

Abstract: An inner assembly for a modular surgical drive hub includes a drive adapter, an inner blade adapter, and a compression member, the inner blade adapter mounted within the drive adapter and biased in a distal direction by the compression member, the drive adapter and the inner blade adapter including a key-way and a key for transmitting rotational force from the drive adapter to the inner blade adapter; wherein the inner assembly is configured to be inserted into and retained within the modular surgical drive hub. A modular surgical drive hub and a surgical instrument are described.

Abstract: A surgical device of a drill/driver with bit recognition to set a desired application mode and a method of utilization thereof is provided. Various operating modes of the drill/driver are automatically set by a sensor which recognizes the bit applied to the drill/driver. A method of utilizing the drill/ driver allows the drill driver to apply surgical screws at very high speeds while automatically preventing excessive torque levels that would strip out the surgical screw from the patient's bone.

Abstract: A discectomy instrument capable of removing portions of the spinal disc between adjacent vertebrae in a controlled manner that is efficient and easy to use. The discectomy instrument may include a handle, a rotary scraper, a barrel, a drive shaft, an outer sleeve and a retaining clip.

Abstract: A detachable vertical cutter for insertion into a cylinder or tube is formed as a single unitary structure. The single blade has a pair of tool attachment end portions and a cutting blade extending in a loop between the attachment ends. The cutting blade is inclined vertically relative to a longitudinal axis of a cylinder or tube into which the attachment ends can slide into. The cutting blade has a cutting edge, a portion of which when extended free of the cylinder or tube will extend a distance greater than the tube outside diameter. The cutting edge when pushed inwardly and pulled outwardly between adjacent vertebrae scrapes and cuts disc material. When retracted the cutting blade deflects into the cylinder or tube for insertion or extraction into or from the disc space.

Abstract: A flexible auger design for low-torque transmitting drive shafts, which allows effective tissue material transport through curved, flexible tubes and channels. A hollow auger has a hollow center, so that the helical member hugs the inner wall of the tube and material is transported along the center axis and the inner wall of the tube. The hollow flexible auger allows for transportation of material from an operative location in the patient (material removal) as well as to operative location in the patient (material delivery).

Abstract: A drill guide system is provided having a source for x-ray radiation along with a receiver to generate a visible image of the radiation. A bone with medical device or implant is located between the source and receiver. A drill with a passage transmits x-ray radiation from the source through a drill bit that then passes through the bone and implant. The source of the x-ray radiation is offset from the drilling axis and a system is used to combine multiple or varying images to reduce an occluded area generated by the drill bit. The user guides the drill bit using an image on the receiver. When the user lines up the drill with a hole in the nail, the alignment is visible on the receiver.

Abstract: Methods and systems to optimize ligament reconstruction surgical outcomes by enabling bone tunnel(s) to be precisely and optimally placed through the use of pre-operative planning systems coupled with precision control bone evacuation machines, such as robotic drills are provided. The methods generally include receiving and processing scan data of a patient's bone(s); pre-determining the optimal tunnel placement parameter(s) with the scan data; placing registration marker(s) on the patient's bone(s) percutaneously; and creating a tunnel in the patient's bone(s) with a system coupled to receive and execute according to the pre-determined optimal tunnel placement parameter(s).

Abstract: Fixation guide devices and methods for positioning and inserting an intramedullary nail are disclosed. The fixation guide devices include a frame with a first end and a second end, a compression device removably coupled to the first end of the frame, and the intramedullary nail secured to a nail attachment apparatus of the frame. An intramedullary nail including a body with a fastening end, a closed end, and at least two openings is also disclosed. A compression device includes a compression member, a knob, and a bolt secured in the knob and rotatably engaging the compression member is also disclosed. An alignment guide is disclosed and includes a base member, an alignment member, and a fixation guide. A method of inserting an intramedullary nail into two bones for fixation of the two bones is also disclosed.

Abstract: A surgical device for osteotomy allows for accurate determination of the angle at which a bone in the human or animal body should be corrected, and for precisely maintaining the angle constant during the entire surgical procedure. The surgical device having on its distal end a circular segment fixed to a distal end of a first blade and further moveably connected to a distal end of a second blade. The distal end of the second blade is allowed to move along the circular segment, wherein the proximal ends of the first and second blade converge at an angle. At least a pair of pin guide openings are provided in parallel for inserting and positioning at least two parallel pins or drill bits. The surgical device provides unique fixed reference means allowing to perform a precise surgery according to predetermined parameters and angles even at the final stages of the operation.

Abstract: A surgical apparatus includes a combination of a drill guide and a bone fixation device. The bone fixation device includes a plurality of screw receiving apertures extending therethrough. The drill guide includes a top face and a plurality of drill apertures extending from the top face through the drill guide. The drill apertures of the drill guide are arranged such that the drill apertures can be separated into two groups by an imaginary dividing line, and, if a separation between the two groups in the plane of the top face and normal to the dividing line were increased by a distance d, then the arrangement of the drill apertures would match, or otherwise be aligned with, that of the screw receiving apertures.

Abstract: A system and method for developing customized apparatus for use in one or more surgical procedures is disclosed. The system and method incorporates a patient's unique anatomical features or morphology, which may be derived from capturing MRI data or CT data, to fabricate at least one custom apparatus. According to a preferred embodiment, the customized apparatus comprises a plurality of complementary surfaces based on a plurality of data points from the MRI or CT data. Thus, each apparatus may be matched in duplicate and oriented around the patient's own anatomy, and may further provide any desired axial alignments or insertional trajectories. In an alternate embodiment, the apparatus may further be aligned and/or matched with at least one other apparatus used during the surgical procedure.

Abstract: A method of treating a varicose vein involves inserting the distal portion of an intraluminal device into a varicose vein, wherein the device includes an elongated outer sheath and an expandable expansion member at the distal end of the outer sheath. The method also involves relatively moving the distal and proximal ends of the expandable spiral expansion member to reduce the distance between the distal and proximal ends of the expansion member and cause the expansion member positioned inside the varicose vein to outwardly expand to an expanded expansion member comprising a plurality of contact members in contact with the inner wall of the varicose vein. The method further includes axially moving the expanded expansion member while the contact members are in contact with the inner wall of the varicose vein and rotating the expanded expansion member during the axial movement.

Abstract: An apparatus and method are presented for a lithotripter comprising a handle, a driver resource contained within the handle, a probe housed within the handle, an extension which may be the probe, a shielding insert, or a removable passageway which extends through a central lumen of the driver resource and protects the central lumen from surgical debris when in use and as a result reduces time required to perform sterilization. Sealing means may be provided to connect the probe into the handle, including a ferrule, collet, split collet, screw connection, O-rings, or a combination thereof to further limit debris entering the central lumen of the handle. It is contemplated that the device of the present invention is capable of achieving a four minute flash cycle validation.

Abstract: A device for removing objects from an in vivo subject includes vacuum tube adapted to be associated with a sheath sized to be inserted into a passageway of the subject. The vacuum tube provides a suction channel extending therethrough. A navigation mechanism is designed to guide the vacuum tube through the passageway. The removal device is designed to remove debris having an approximate diameter of between about 0.0001 mm to about 8 mm.

Abstract: A treatment device which applies energy to a biological tissue to treat the biological tissue, includes: an interlocking mechanism that regulates at least one of a closing time until first and second jaws reach a closed state from an opened state when one operation is input into an operating body for a handle, and a unit closing amount from the opened state toward the closed state, interlocks at least one of the first and second jaws with the operating body, and is interposed between the operating body and the handle; and an elastic member that is disposed in the interlocking mechanism, couples the operating body with the handle, pulls the operating body toward the handle at a constant load or a constant pressure, and regulates the closing time until the closed state is reached from the opened state.

Abstract: A removable tip attachable to an instrument handpiece, including a back hub at a proximal end of a tip body and having back hub screw threads configured to threadedly engage outer tube threads of an outer tube of the handpiece, an end effector at a distal end of the tip body, and a yoke at the proximal end of the tip body and having yoke screw threads configured to engage shaft screw threads of an inner shaft of the handpiece, the yoke configured to move within the backhub to actuate the end effector, wherein the yoke screw threads engage with the inner shaft screw threads before the back hub screw threads engage the outer tube threads upon attachment of the tip to the handpiece, and the distance between a proximalmost point of the yoke and a beginning of the back hub screw threads is between 0.533? and 0.608?.

Abstract: Embodiments of the invention provide a laparoscopic morcellating device and method for removing tissue from a body cavity. The morcellating device includes a containment mechanism having an aperture, a cutting mechanism designed to fit into an interior space of the containment mechanism and a retractor mechanism that is coupled to the cutting mechanism. The containment mechanism and cutting mechanism combination surrounds the tissue and the aperture of the containment mechanism is closed around the tissue. The morcellating device further includes a motor for actuating the retractor such that the cutting mechanism constricts and morcellates the tissue. The laparoscopic morcellating device further allows for torque balancing of the retractor mechanism, gas flow regulation of the body cavity, and safety feedback mechanisms that can alert the surgeon.

Abstract: A laparoscopic scissor instrument can include a scissor assembly pivotally coupled to an elongate shaft. The scissor assembly can be formed of scissor blades having pivot posts thereon. The pivot posts can engage apertures on the elongate shaft, thus eliminating the need for a through-pinned pivot connection of the scissor blades. The scissor blades can also include actuation posts thereon. An actuation mechanism can include a slot to engage the actuation posts and open or close the blades of the scissor assembly. The scissor assemblies described herein can have a relatively low operational height such that they do not extend beyond a diameter of the elongate shaft during opening and closing of the scissor assembly.

Abstract: Methods and systems are provided for determining the location of procedure sites, for example hair implantation sites, the method and systems enabling a natural looking randomness to be maintained to achieve a desired density while avoiding previously created procedure sites and existing features.

Abstract: An ultrasonic surgical instrument includes an inner tube, an outer tube, an ultrasonic blade, and a clamp member pivotably moveable relative to the ultrasonic blade. The ultrasonic blade is acoustically coupled to an ultrasonic transducer. The clamp member pivotably movable relative to the ultrasonic blade between an open configuration and an approximated configuration with respect to the ultrasonic blade, wherein the clamp member is pivotably coupled to the inner tube, wherein the clamp member is pivotably coupled to the outer tube, and wherein movement of the outer tube relative to the inner tube between the first position and the second position transitions the clamp member between the open configuration and the approximate configuration.

Abstract: An ultrasonic surgical instrument is disclosed, and includes a handle assembly, an elongate tubular member, and an end effector. The elongate tubular member extends from the handle assembly and defines a channel therethrough. The end effector is coupled with a distal end of the elongate tubular member and includes a first jaw member pivotably attached to the tubular member, and a second jaw member longitudinally movable within the channel of the elongate tubular member. One of the first jaw member and the second jaw member includes at least one ultrasonic transducer.

Abstract: An apparatus for insertion of a medical device in the skin of a subject is provided, as well as methods of inserting medical devices.

Abstract: The invention provides an improved cannula assembly comprising a first cannula having a first length and first inner diameter, the first cannula having at least a flexible distal portion; a trochar having a second length and second diameter, the trochar having a sharp distal position capable of puncturing through skin and one or more blood vessels of a patient and sized such that the trochar may be inserted within the first cannula and extend beyond the flexible distal portion thereof; and at least one flexible second cannula for insertion in the first cannula, each second flexible cannula sized to extend beyond the distal portion of the first cannula for a predetermined length.

Abstract: Medical devices that have a releasable intermediate member and tubular member are described. Methods of using medical devices that have a releasable intermediate member and tubular member are also described. An example medical device comprises an elongate member, an intermediate member, and a tubular member. Each of the intermediate member and tubular member is releasably disposed on the elongate member.

Abstract: A cannula assembly for use in laproscopic surgery includes a cannula having a proximal end for use in orientating the assembly into an abdominal cavity, a distal end for insertion into a patient, and a passage through which surgical instruments can be inserted. An expandable feature in the form of an anchor is located toward the distal end of the cannula and is selectively expandable and collapsible. The feature in its expanded state prevents withdrawal of the cannula. A collar is pushed distally until it releasably cinches to the outside of the abdominal cavity thereby creating an airtight seal and stabilizing the assembly. The collar has a friction fit with the cannula designed to prevent excessive force against the cavity walls.

Abstract: Embodiments are described for creating and closing tissue access ports, such as transapical access ports, which involve placement of an introducer across the subject tissue structure, and deployment of a controllable port closure device assembly configured to remain in place with a ratcheting mechanism, and to hold the tissue surrounding the previous access port location closed against a sealing disc with proximal and distal strut assemblies, after the introducer has been removed.

Abstract: The present disclosure describes a labor assistance system comprising a perianal support member and grip. The perianal support member includes a contact surface, an inner surface opposing the contact surface, and a rigid compression element. The contact surface has a generally continuous compression surface apex extending from the contact surface in a first direction, oriented to extend from an anterior edge to a posterior edge along a midline axis in a sagittal plane of the patient without substantially interfering with the birthing canal of the patient. The grip is coupled to the inner surface between the anterior edge and the posterior edge of the support member. The present disclosure also describes an intrapartum pelvic floor support device that is applied to tissue in the perianal and/or anococcygeal regions of the patient during an intrapartum period to support the anococcygeal region tissues and at least a portion of the pelvic floor.

Abstract: Devices, systems, and methods for delivering fluid are provided. Devices include a housing configured for intravaginal deployment and retention, at least one reservoir configured to contain a fluid, and a fluid dispensing mechanism configured to dispense the fluid past the cervix and to the uterus of the subject. Methods include intravaginally deploying and retaining a device in the subject, and dispensing the fluid from the device such that the fluid is driven past the cervix to the uterus of the subject.

Abstract: The present disclosure provides an external fixation strut for an external fixation device having a ball joints that can be attached to the outer or inner surface of the ring and locked to increase overall stability of the external fixation device. Some embodiments of the fixation strut include a first ball joint coupled to a first end portion of a strut housing, the strut housing having an axial bore defined therethrough. A second ball joint is coupled to a second end portion of an elongated member. The elongated member is coupled to an adjustment mechanism, which is coupled to an upper end portion of an adjustment sleeve. The adjustment sleeve is slidably disposed in the axial bore of the strut housing, and is used to effect coarse strut length adjustments. Gradual strut adjustments are effected by translating the elongated member.

Abstract: Orthopedic fixation devices, assemblies, and methods. The orthopedic fixation devices may comprise coupling elements, hook components, and/or bone fasteners. The bone fastener may be loaded into the coupling element through the bottom of a bore in the coupling element. The orthopedic fixation devices may include modular locking clamp assemblies that can be fixed onto fasteners that are already implanted in bone. The modular locking clamp assemblies can include polyaxial locking clamp assemblies, as well as monoaxial locking clamp assemblies. The hook components may include a female hook component slidably coupled to a male hook component.

Abstract: Apparatus and devices for percutaneously extending an existing spinal construct ipsilaterally with an additional spinal construct in a patient are disclosed. The additional spinal construct comprises a rod connector that includes an elongate additional rod integrally attached thereto. The additional rod is placed through an access port in a first orientation generally parallel to the longitudinal axis of the access port and rotated to a different second orientation generally transverse to the longitudinal axis of the access port. During such rotation the additional rod is moved subcutaneously beneath the skin of the patient from the existing spinal rod to an additional bone engaging implant. In another arrangement, the extension of an existing spinal construct in a minimally invasive procedure comprises a rod connector having an offset support for receiving an additional spinal rod that may be placed laterally interiorly or exteriorly of the existing spinal construct.

Abstract: A spinal correction implant comprises a body extending between a first end and a second end. The body has a curvature. A first longitudinal element is connected with the first end. A ratchet is disposed with the body. A second longitudinal element is connected to the ratchet and is incrementally movable relative to the body. Systems and methods are disclosed.