Abstract: An applier for ligation clip is provided. The applier includes: an outer tube having mounting bosses; a pair of jaws pivotally connected to the mounting bosses, the jaws having actuating projections; a feed tube located in the outer tube and configured to move axially within the outer tube, the feed tube having actuating slots in which the actuating projections are located; a clip lock arm located in the outer tube and configured to move axially within the outer tube; and a clip advance arm located in the outer tube and configured to move axially within the outer tube, the clip advance arm having flexible pinchers at one end of the clip advance arm. A method of applying a ligation clip is also disclosed.

Abstract: Bleeding from blood vessels located in difficult-to-compress regions of the body (especially the abdomen, pelvic or groin region) is controlled by the use of a portable, small-footprint belt-like device that contains multiple inflatable bladders. The inflatable bladders are selectively positioned and inflated over exsanguinating blood vessels, thereby exerting pressure to stop the bleeding. The device may also be used to provide perfusion support in low flow disease states such as hemorrhagic shock and cardiac arrest.

Abstract: A surgical instrument, for example a cutting block for use in knee surgery, comprises a mounting surface defining at least one opening for receiving a mounting projection. The mounting surface further defines a blind recess which extends linearly from the at least one opening. The blind recess may extend to an edge of the mounting surface. A system including a surgical instrument and one or more mounting projections is also disclosed. The blind recess can be used as a track to guide a projection to an opening, increasing the area of the instrument that can be used to locate the projection in the correct position. The recess acts as a guide for the projection to enter the opening by providing tactile feedback to guide the projection towards the opening. If the recess also extends to the edge of the instrument, the recess may be visible more easily when the surgeon is installing the instrument providing visual as well as tactile feedback.

Abstract: This document provides orthopedic and dental devices and methods for their use. For example, novel bone drills and dental drills are described. The bone and dental drills have at least some centers of mass that are offset from the drills' axis of rotation. Accordingly, the bone and dental drills may rotate and cut using a precessional pattern of motion. The design facilitates bone cutting, chip formation and hauling capacity, irrigation and bone harvesting. In some embodiments, the bone chips are collected in a removable apparatus fixed to the distal portion of the drill, and the collected bone chips can be used for bone grafting.

Abstract: The robotic mechanism may include a programmable computer which is connected with a drive member by a motor. In addition to the motor, a force measurement assembly may be connected with the drive member and computer. The force measurement assembly has an output to the computer indicating the magnitude of resistance encountered. The force measurement device may be a piezoelectric cell or a spring assembly which controls energization of the electric motor. A position sensor is connected with drive member and the computer. The position sensor has an output which is indicative of the position. The output from the position sensor may indicate the depth or distance. Ultrasonic vibratory energy may be transmitted to the force transmitting member from a source or generator of ultrasonic vibratory energy. The force transmitting member may function as a horn and apply the ultrasonic vibratory energy.

Abstract: Techniques associated with a system for joint fusion are described, including a drill guide assembly having a drill guide and a pin sleeve, the drill guide including a drill guide head having an opening, a shaft configured to receive the pin sleeve, a drill guide tip configured to engage a bone, and a cannula configured to receive an implant, a striker tube configured to fit over the pin sleeve, the striker tube having an edge configured to fit over the drill guide head, a cannulated drill bit configured to drill a pilot hole in a bone tissue configured to receive the implant, a stop collar configured to be placed over the cannulated drill bit, and a packing plunger assembly having a packing tube and a plunger partially inserted into the packing tube, the packing plunger assembly configured to pack the implant with a material.

Abstract: Techniques for joint fusion are described, including a drill guide assembly having a drill guide and a pin sleeve, the drill guide including a drill guide head having an opening, a shaft configured to receive the pin sleeve, a drill guide tip configured to engage a bone, and a cannula configured to receive an implant, a first guide pin configured to guide placement of the drill guide, a striker tube configured to fit over at least a portion of the pin sleeve, a cannulated drill bit configured to drill a pilot hole in a bone tissue, a stop collar configured to be placed over the cannulated drill bit and to be attached to the cannulated drill bit using a ridge, and a parallel spacer instrument configured to guide placement of a second guide pin at a distance from the implant after the implant is implanted into the bone tissue.

Abstract: A device for partial acetabular replacement includes a patient-specific acetabular guide. The acetabular guide has a first surface configured to nestingly mate in only one position to the patient's acetabulum. The acetabular guide includes a patient-specific guiding formation configured to guide a cutting tool to remove damaged tissue from a defect of the patient's acetabulum and prepare a patient-specific implantation slot corresponding to the defect after removal of the damaged tissue. A patient-specific partial acetabular implant can be configured to nestingly mate with the patient-specific implantation slot.

Abstract: Methods and devices are provided for implanting a cross-pin through a bone tunnel, such as in an arthroscopic surgical procedure. In general, the methods and devices allow a cross-pin hole to be formed in a medial side of a knee bone such that it intersects a bone tunnel formed in the knee bone. In one embodiment, a cross-pinning guide device is provided that can be configured to angularly position the cross-pin hole relative to the bone tunnel to allow the cross-pin hole to intersect the bone tunnel without passing through another side, e.g., a lateral side, of the knee bone. The knee bone can be a femur or a tibia such that the cross-pin hole and the bone tunnel can each be entirely formed in the femur or in the tibia.

Abstract: A retrieval snare for entrapping and retaining a foreign object located in a body and a method for manufacturing of the snare are provided. The snare comprises a structure having a proximal portion and a distal portion and includes a plurality of filaments. The filaments extend from an end of the proximal portion towards the distal portion and return to the end of the proximal portion to form a plurality of loops. The loops are not interconnected at the distal portion, but each side of each loop are connected to a side of an adjacent loop in the proximal portion at more than one point, thereby providing structural rigidity and dilatation ability to the snare.

Abstract: The devices and methods described herein relate to jointless construction of complex structures. Such devices have applicability in through-out the body, including clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: The devices and methods described herein relate to jointless construction of complex structures. Such devices have applicability in through-out the body, including clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: An endoscopic medical device system includes an elongated shaft assembly, a cam assembly and an articulating distal end assembly. The elongated shaft assembly extends along a main axis and includes first and second actuator rods arranged parallel to each other and the first actuator rod is longer than the second actuator rod. The cam assembly includes a cam, and the proximal ends of the first and second actuator rods are configured to be slidably attached to first and second locations of the cam, respectively, and the distal ends of the first and second actuator rods are positioned at the same distance from the cam center. The articulating distal end assembly extends along the main axis and is pivotally connected to the distal ends of the first and second actuator rods. Rotation of the cam around an axis perpendicular to the main axis provides angular displacement of the distal end assembly relative to the main axis.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm having an inner surface defines a cavity including a cutting portion configured to cut tissue.

Abstract: An ultrasonic surgical system includes an ultrasonic transmission member having a proximal end and a distal end. An ultrasonically actuated end-effector is attached at the distal end of the transmission member. A pressurized fluid delivery system includes a fluid nozzle in communication with at least one fluid source. The fluid nozzle is arranged and configured to deliver pressurized fluid to soft tissue at a rate to move the soft tissue away from the end-effector during use.

Abstract: A cannula is placed in an enlarged opening through a bladder wall and an abdominal wall by applying pulling tension to a placement guide extending through a small pathway to hold an inflated placement balloon in sealing contact with the bladder wall. The seal confines distension fluid in the bladder to establish sufficient reactive resistance to enlarge the opening through the bladder wall with blunt force dilation from an obturator.

Abstract: A seal comprises a first sealing member and a second sealing member. The sealing members each have an accessway to facilitate access from one side of the sealing member to the other side of the sealing member. The accessways are offset to facilitate sealed access of an object through the sealing members.

Abstract: In one general aspect, a medical device can include a base having a guide and a handle. The medical device can also include a needle member that has a curved portion and a handle portion. The curved portion of the needle member can be configured to slidably move within the guide of the base from a first position to a second position different than the first position when the handle portion of the needle member is moved towards the handle of the base.

Abstract: A minutely controlled dermabrasion hand piece includes a main hand piece body for holding the hand piece by a user, a treatment head to provide negative pressure to a treated tissue and a vacuum tube to provide negative pressure to the treatment head through the main hand piece body. The main hand piece body includes at least one opening to control the supply of negative pressure to the treatment head. The opening is blockable by the user holding the hand piece.

Abstract: Systems and methods for joint replacement are provided. The systems and methods include a surgical orientation device, a reference sensor device, and at least one orthopedic fixture. The surgical orientation device, reference sensor device, and orthopedic fixtures can be used to locate the orientation of an axis in the body, to adjust an orientation of a cutting plane or planes along a bony surface, or otherwise to assist in an orthopedic procedure(s).

Abstract: A remotely controllable growing rod device comprises a housing containing on-board electronics and at least one drive assembly operable to move associated extension elements relative to each other. Each extension element terminates in an anchor element configured to be anchored to a part of the spine, such as the pedicle of a vertebral body. The on-board electronics includes a microprocessor, a power supply, such as an inductive power supply, and a receiver/transmitter. The microprocessor is configured to receive remotely transmitted movement data through the receiver and is further configured for feedback controlled actuation of the drive assembly for relative movement the associated extension elements to achieve a desired physiological condition of the patient's spine.

Abstract: A bone fastener includes a proximal member having an inner surface that defines an implant cavity and an outer surface including a first threaded portion configured for penetrating fixation with tissue and a second portion. The proximal member defines a longitudinal axis. An intermediate member includes an inner surface extending between a proximal portion connected with the second portion and a distal portion. A distal member includes an outer surface extending between a proximal portion disposed with the distal portion of the intermediate member and a distal portion configured for penetrating fixation with tissue. The distal member is configured for axial translation relative to the intermediate member. Methods of use are disclosed.

Abstract: A locking pedicle screw assembly has been designed which avoids misalignment and locks into place once the cap is fully threaded into the tulip, avoiding over tightening or stripping of the threads. The locking cap includes a retaining or locking ring, positioned either at the bottom of the cap so that it locks into a groove at the bottom of the threads in the tulip or at the top of the threads in the cap, locking into a groove at the top of the tulip when the cap is fully seated. In one embodiment, an audible signal is generated when the cap locks. In another embodiment, the cap is secured to a swiveling saddle that locks the rod into place as the screw cap is tightening, but does not interfere with the locking mechanism.

Abstract: A locking device includes a first locking member including a first end, a second end, a central axis, an outer surface with an external thread, a coaxial bore, and an internal thread provided along at least a portion of the bore, and a second locking member including a first end, a second end, and an outer surface with an external thread. When the second locking member is positioned in the first locking member, the second locking member is movable along the central axis by rotating the second locking member. Movement of the second locking member is limited towards the first end of the first locking member by a first stop and towards the second end of the first locking member by a second stop, where at least one of the first stop or second stop is arranged in the bore of the first locking member.

Abstract: A bone anchoring device for securement to a bone. The device includes an anchor, a receiver, a retainer and an insert. The receiver includes a seating surface defining a cavity communicating with the exterior of the receiver through a first opening configured to receive the connection head of the anchor therethrough. The retainer includes at least two discrete retaining members configured to engage with the receiver seating surface when they are captured between the connection head and the seating surface. The insert is disposed within the receiver and configured to frictionally engage the connection head. The insert includes a main body and at least one pin protruding from the main body, for circumferential insertion between two adjacent retaining members of the retainer.

Abstract: Systems for securely connecting a spinal implant to a bone anchor by using an offset connection assembly. The variable angle connection assembly is able to securely connect the spinal implant to the anchors even when there is a variance in the angle and position of the anchors with respect to the spinal implant. The connection assembly will not inadvertently lock the components of the connection assembly preventing the relative movement of the components.

Abstract: A transverse rod connector includes an elongate member having first and second ends and first and second connection members. The first and second connection members are connected with first and second ends, respectively. The first and second connection members are configured for multidirectional positioning with respect to the elongate member. The first and second connection members are each dimensioned to be selectively and releasably secured to a bone anchor.

Abstract: The present teachings provide one or more surgical implements for repairing damaged tissue, such as in the case of spinal stenosis. An implant for insertion between adjacent spinous processes is provided. The implant can include a body having a first end, a second end and defining a bore. The implant can include a first cap coupled to the first end of the body, a second cap coupled to the second end of the body, with each of the caps defining a space. The implant can include a connector coupled to the first cap and the second cap through the bore. The implant can include at least one deployable member coupled to the first end of the body and the first cap. The at least one deployable member can be retained within the first space in a first position, and can extend from the first space in a second position.

Abstract: In some embodiments a method comprises disposing an implant into contact with a first bone portion and into contact with a second bone portion, the implant having (1) a first interface configured to receive a restraining member, and (2) a second interface. The method further comprises inserting a portion of the fastener member into the first interface. The method further comprises securing the fastener member such that the first bone portion and the second bone portion are fixed to each other, at least in part by a substance after the securing, at least a portion of the substance disposed through the second interface.

Abstract: An implant for repairing a joint between a first bone and a second bone includes a first section constructed of a substantially rigid material and a graft constructed of soft tissue having a first end and a second end. The first section has a first end surface configured for positioning against the first bone. The graft is configured for stabilizing the first section relative to the first bone. A first fastener is configured for mounting to the graft and the first section to anchor the graft to the first section. A second fastener is configured for mounting to the graft and the first bone to anchor the graft to the first bone.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws. The tool set includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Intermediate guide tools having guiding pass through slots are utilized to guide intermediate locations along the rod toward associated bone screws. An attachment structure operably connects the guide tools to the bone screws. The guide tools each include a lower guide and advancement structure to allow a closure top with mating structure to be rotated and driven downward against the rod and to cooperate with similar structure in the bone screw to seat and lock the rod therein. A method utilizing the tool set allows a surgeon to percutaneously implant the rod in the patient.

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

Abstract: A bone plate and to a fixation system comprising two types of bone screws. The bone plate has two intersecting stepped round holes which are different in size and in the upper regions of which a circumferential rib extends. The upper region of the smaller round hole is designed to slidably guide a bone screw having a partially spherical heads and a screw having a thread or conical head. The lower region of the larger round hole is used to support a conical head.

Abstract: A bone fixation plate includes a first opening formed in a plate that is configured to receive a first fastener; a second opening formed in the plate that is configured to receives a second fastener, and a retention member that extends into a third opening formed in the plate between the first opening and the second opening, wherein the retention member is elastically deformable between at least three positions.

Abstract: A device of performing osteosynthesis includes an osteosynthesis element, e.g., a bone plate, having an upper face, a lower face and an opening with a central axis linking the upper and lower faces. The opening receives a multi-axial pivotable insert for a longitudinal bone fixing element, such as a bone screw. The insert has a central passage with a longitudinal axis for housing the bone fixing element. The insert may be configured as a helical spring with an external sheath surface and an internal sheath surface that defines the central passage. When placed in the through hole, the insert is rotationally fixed relative to its longitudinal axis, but remains pivotally adjustable within the through hole relative to the osteosynthesis element.

Abstract: A system and method facilitating replacement of comminuted bone fractures or portions thereof adjacent bone joints. The system and method employs a prosthesis to replace at least a portion of the comminuted bone fractures. The prosthesis serves in reproducing the articular surface of the portion or portions of the comminuted bone fractures that are replaced. In doing so, the prosthesis serves in restoring joint viability and corresponding articulation thereof.

Abstract: The present invention discloses an approximately ?-shaped improved bone plate structure, fixed on a bone of an animal for maintaining the relative positions of different portions of the bone. One of the other features of the present invention is that bone plate structure comprises at least one contouring portion for allowing the surgeons to intra-operatively adjusting the shape in accordance with the shape of the bone. Furthermore, the present invention may fit the bone with multi-axis, decreasing stress concentration, preventing the opening portion from being unsuitably covered and preventing the wound deformation from being pressed.

Abstract: A fastener, for example a bone screw, is sized to pass into an aperture of an implant, for example a bone plate, the fastener having an anchor portion engageable with body tissue, and a head portion formed by an assembly of an insert and an anchor extension. The implant has an aperture with a reduced entry dimension. The insert and anchor extension cooperate to form a reduced dimension passable into the aperture, and an expanded dimension not passable out of the aperture. The size of the assembly is configurable by bending resilient tabs of the anchor extension or the implant, using ramped surfaces, or an expanding diameter of a threadable insert.

Abstract: A two-component system for joining two bones or bone fragments, in which a first component is threaded, self-tapping and bears an annular mating end to engage two mating pins on the end of a second component which is also threaded and self-tapping. The two components have opposite handed threads thereon, so that upon final installation into adjacent bone the final rotation brings the abutted bone surfaces into a compressive engagement as each components burrows deeper into its respective bone surface.

Abstract: A fracture fixation system serves in repairing comminuted bone portions of a bone. The fracture fixation system includes a plate having an upper surface, a lower surface opposite the upper surface, one of a screw and a post, and at least one aperture for receiving the one of the screw and the post therethrough. The plate is secured to a main portion of the bone, and the one of the screw and the post is inserted through the at least one aperture through the plate. The portion of the comminuted bone portions is attached to the one of the screw and the post using at least one suture. The one of the screw and the post is rotated to wind the at least one suture therearound to reposition the portion of the comminuted bone portions relative to the main portion of the bone.

Abstract: An interbody fusion device including a body member, at least one side member engaging the body member, and at least one movement mechanism that engages at least one side member and the body member. A surgical method for maintaining a space between two vertebral bodies in a spine, including the steps of obtaining a medical device, such as an interbody fusion device, and inserting and coupling an expansion tool into an opening within the medical device. The surgical method also including slidingly inserting the medical device into a space between two vertebral bodies and rotating the expansion tool to move the at least one side member in a direction relative to the body member. The method may further include detaching the expansion tool from the medical device and removing the tool from the space between the two vertebral bodies in the spine.

Abstract: A method and an apparatus for screw removal from bone plates used in osteosynthesis. The method includes the steps of: performing an incision in the soft tissue surrounding an implanted bone screw having a screw head inserted in an elongated plate hole of a bone plate; positioning an expandable tip of the apparatus in a portion of the plate hole which is not occupied by the bone screw and in the proximity of the screw head of the bone screw, wherein the expandable tip is in an unexpanded position; and widening the plate hole in a lateral direction essentially perpendicular to a major axis of the elongated plate hole by expanding the expandable tip of the apparatus from the unexpanded position to an expanded position.

Abstract: A tissue retractor assembly may be moved through an opening formed in vertebrae in a patient's spinal column. The robotic mechanism may be utilized to form the opening in the vertebrae and to move the contracted tissue retractor assembly into the vertebra. The tissue retractor assembly may include a cannula or scope which is utilized to position the balloon or bladder relative to the vertebra and to conduct the fluid (gas or liquid) into the balloon or bladder to effect expansion of the balloon or bladder. The balloon or bladder may be formed of a biodegradable material. The robotic mechanism may be utilized to position the cannula through which the flow of synthetic bone material or cement is conducted into the space created in the vertebra by expansion of the balloon or bladder.

Abstract: A bone distractor assembly configured to distract first and second bone segments on opposite sides of a bone gap is provided. In one embodiment the distractor assembly includes a distractor having a first coupler and a second coupler, a first footplate releasably coupled to the first coupler, a second footplate releasably coupled to the second coupler, and a locking mechanism releasably coupling the first and second footplates to the first and second couplers. The first and second footplates releasably are each configured to attach to bone. The locking mechanism includes a tube, wherein removal of the tube releases the first and second footplates from the first and second couplers.

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

Abstract: An electrode catheter and a method for assessing electrode-tissue contact and coupling are disclosed. An exemplary electrode catheter comprises an electrode adapted to apply electrical energy. A measurement circuit is adapted to measure impedance between the electrode and ground as the electrode approaches a target tissue. A processor determines a contact and coupling condition for the target tissue based at least in part on reactance of the impedance measured by the measurement circuit. In another exemplary embodiment, the electrode catheter determines the contact and coupling condition based at least in part on a phase angle of the impedance.

Abstract: An end-effector assembly includes first and second jaw members disposed in opposing relation relative to one another, at least one of the jaw members moveable from an open position to a closed position for grasping tissue therebetween. First and second conductive plates are disposed on opposing surfaces of corresponding first and second jaw members. First and second compressible membranes are configured to electrically connect corresponding first and second conductive plates to a surgical field when subjected to a compression bias.

Abstract: An electrosurgical wand. At least some of the illustrative embodiments are electrosurgical wands including an elongate shaft that defines a handle end and a distal end, a first discharge aperture on the distal end of the elongate shaft, a first active electrode of conductive material disposed on the distal end of the elongate shaft, the first active electrode has an edge feature, a first return electrode of conductive material disposed a substantially constant distance from the first active electrode, and an aspiration aperture on the distal end of the elongate shaft fluidly coupled to a second fluid conduit.

Abstract: This invention relates generally to apparatus and methods for tightening tissue of the female genitalia by heating targeted connective tissue with radiant energy, while cooling the mucosal epithelial surface over the target tissue to protect it from the heat. Embodiments include a handle and treatment tip that has both an energy delivery element and a cooling mechanism. The handle may be a two-handed handle allowing control even while rotating and maneuvering the treatment around the genital opening. The apparatus or system may also include an integrated controller, which may confirm tissue contact without applying RF energy, based only on the temperature of the applicator and the time since the last application of energy from the applicator.

Abstract: Some embodiments of a medical instrument can be configured to reduce the formation of coagulum by delivering a negative charge bias to conductive surfaces that interface with blood or bodily tissue during a medical procedure. The application of the negative charge at the instrument-blood interface can reduce the fibrinogen deposition and the formation of coagulum because fibrinogen molecules in general are negatively charged at neutral pH levels. In addition, some embodiments of the instrument may be configured to irrigate the instrument-blood interface with RGD/ClfA peptides, a bicarbonate solution (or other high pH solution), or both to further repel the fibrinogen and thereby inhibit the formation of coagulum. Accordingly, some embodiments of the medical instrument can substantially reduce the risks of thromboembolism during particular medical procedures.