Abstract: A tissue sampling device includes a flexible sheath 34; a needle tube 35 which is inserted into the sheath 34 so as to advance and retreat and with which biological tissue is punctured; and an operating unit which is provided on a proximal side of the sheath 34 and is used for operating the advancing and retreating of the needle tube 35. This needle tube 35 has a distal portion provided with a slit 50 extending toward the proximal side from a distal opening 35c, and when the distal portion is in a state of protruding from a distal end of the sheath 34, at least a part of the distal portion is positioned further on the radially outside than the inner surface of the sheath when viewed from an axial direction of the needle tube 35.

Abstract: The invention provides a device, system and method for sample collection wherein a sample can be separated into multiple portions of sample at the site of collection. The separation of portions of sample occurs by separating parts of the specimen collection device. Each of the separable parts contacting a portion of sample can be deposited into separate vessels. The device reduces the risk of sample contamination, because the separable parts can be separated by the action of a release mechanism that allows a user to separate the parts without touching or otherwise contacting the sample collecting region. The release mechanism may be trigger-activated to expel a separable part of the device.

Abstract: There is provided a defect hole closing material which achieves minimally invasive medical treatment for Atrial Septal Defect, and poses little possibility of occurrence of a failure in the body in some distant future. The defect hole closing material (100) comprises two bioabsorbable material-made cylindrical bodies (the first cylindrical section (110) and the second cylindrical section (120)) having a mesh-like structure in the form of an hourglass shape, a numeral “8” shape, a double spindle shape, or a peanut shape. With the first end (112) kept held securely, the second end, or the other end (122) is pulled toward the first end (112) by operating the string (140), whereupon the cylinder diameter is increased, and also the first cylindrical section (110) and the second cylindrical section (120) move close to each other with respect to the substantially central section (130) serving as a center.

Abstract: The present invention relates to a vascular closure device for sealing a puncture site in a vascular wall comprising a sheath (10) having a distal end and at least one proximal end, wherein the sheath (10) comprises a tubular body (100). The vascular closure device (1) is characterized in that at least one distal balloon member (11) is firmly arranged at the distal end of the tubular body (100) of the sheath (10) and at least one expandable anchor member (12) is firmly arranged proximal to the distal balloon member (11) on the tubular body of the sheath (10), wherein at least the distal side of the distal balloon member (11) is a pressure area for applying pressure on the outside of the vascular wall. Furthermore a method of positioning of a vascular closure device (1) is described.

Abstract: An intraluminal occlusion device includes a frame and an attached covering. The frame includes longitudinal struts having concave and convex portions. The intraluminal occlusion devices can be implanted at an opening to a body vessel, such as a blind passage, to block the entry of fluid into the vessel. Methods of blocking the entry of fluid into bodily passages are also described.

Abstract: A method of providing a surgical device for closure of Atrial Septal Defect (ASD) with minimally invasive approach includes a head portion that includes a distal jaw being distal relative to a person holding the surgical device, a guide rod which drives the distal jaw, and a plurality of first suture-guide channels attached to the distal jaw, and a body portion which is stationary and includes a cylindrical base, a proximal jaw attached to the cylindrical base, and a plurality of second suture-guide channels attached to the proximal jaw. A lever drives the distal jaw away from the proximal jaw such that the distal jaw and the proximal jaw are spaced on different sides of an ASD hole. After a suture thread sutures a pericardium patch, the lever pulls the distal jaw backward toward the proximal jaw such that the first suture-guide channels couple with the second suture-guide channels.

Abstract: One embodiment is directed to a method for advancing a needle into a tissue structure, comprising: advancing a distal end of a needle insertion assembly, the assembly comprising an insertion member coupled to a tissue interface indentor member and movably coupled to an elongate needle member, against a targeted tissue structure such that a distally protruding shape feature of the tissue interface indentor member engages one or more portions of the targeted tissue structure adjacent a distal tip of the elongate needle member at a position at which the elongate needle member distal tip is configured to be advanced through the insertion member and into the tissue structure, and locally changes an available angle of penetration between such portions and the distal tip of the elongate needle member; and inserting the elongate needle member relative to the insertion member and tissue interface indentor member.

Abstract: A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion.

Abstract: This application describes a surgical retractor and related methods for providing access to a surgical target site for the purpose performing minimally invasive spinal fusion across one or more segments of the spinal column.

Abstract: A soft anchor assembly according to an exemplary aspect of the present disclosure includes, among other things, a sheath, a first flexible strand affixed as non-sliding relative to the sheath and a second flexible strand slidable relative to the sheath.

Abstract: One embodiment is directed to a system for advancing a needle into a tissue structure, comprising: an elongate needle member having a tapered distal tip; an insertion member having proximal and distal ends, the distal end being coupled to the elongate needle member, and the proximal end being configured to be manipulated by an operator; and a tissue interface indentor member coupled to the insertion member and operatively coupled to the elongate needle member, the tissue interface indentor member comprising a distally protruding shape feature configured to contact one or more portions of the tissue structure adjacent to the distal tip of the elongate needle member and change an available angle of penetration between such portions and the distal tip of the elongate needle member as the distal tip is inserted into tissue structure.

Abstract: A rotational action needle driver that comprises an cumbersome ergonomically designed handle, rotational mechanism and an integrated locking/unlocking system that permits surgeons to perform the surgical suturing procedure in a less complicated and more secure way by allowing more control over the suturing needle and the area to be stitched, even when the suturing area is small, deep, and/or restricted.

Abstract: An anvil assembly is described. The anvil assembly includes including an axis with a proximal and a distal portion, an anvil associated to the distal portion of the axis formed by a central portion and at least a remote rotating portion and a system for reducing the encumbrance of the assembly of the anvil and relative restoring of such encumbrance. This is possible thanks to a half-automatic system specifically activated by the user of the surgical instrument and/or by an automatic system integrated in the system for opening and closing the surgical instrument without the need of activating any specific mechanism. The reduction and the restoring of the anvil size is an advantage during the insertion and the removal of the anvil into and from the organ of the patient.

Abstract: A method of forming and deploying an improved absorbable fastener for hernia mesh fixation is disclosed. The absorbable fastener of the present invention functions to securely fasten tough, non macro-porous, and relative inelastic mesh to soft tissue. The fastener is formed from co-polymers of lactide and glycolide.

Abstract: A surgical device is provided that includes a jaw portion, having a first jaw in opposed correspondence with a second jaw, the second jaw including a surgical member. The surgical device may include a shaft portion coupled to a proximal end of the jaw portion and at least one motor configured to rotate the jaw portion relative to the shaft portion, to move the jaw portion relative to the shaft portion, move the first jaw relative to the second jaw and move the surgical member within the second jaw. The surgical member may be prevented from moving within the second jaw unless the first jaw is in a closed position relative to the second jaw. Advantageously, the surgical member may include one or both a cutting element or a stapling element, disposed within one of the jaws.

Abstract: Systems and methods are provided for detecting failure in clamping of a material and/or firing of a staple into a clamped material and indicating such failure to a user on a user interface. The system and methods are particularly suited for use with end effectors having closing and/or firing mechanisms coupled to an actuator. By monitoring a driving parameter of an actuator that effects the clamping and/or firing, the systems and methods provide an indication of failure in response to the monitored drive parameter. In some embodiments, an indication of failure is output when the monitored drive parameter is outside an acceptable range of desired driving parameters during clamping and/or firing. The disclosed systems and methods are particularly beneficial when used for minimally invasive surgery.

Abstract: An implant insertion device is adapted for use with a shape memory implant. The shape memory implant includes a bridge interconnecting first and second legs. The shape memory implant is movable between a first shape in which the first and second legs are substantially non-parallel and a second shape in which the first and second legs are substantially parallel. The implant insertion device engages the shape memory implant to maintain the shape memory implant in its second shape until the delivery of the shape memory implant into tissue or bone.

Abstract: The present disclosure provides a surgical instrument control circuit. The control circuit includes a primary processor, a safety processor, and a segmented circuit. The segmented circuit includes a plurality of circuit segments in signal communication with the primary processor. The plurality of circuit segments includes a power segment configured to provide a segment voltage to the primary processor, the safety processor, and each of the plurality of circuit segments. The power segment is configured to provide variable voltage protection of each segment.

Abstract: According to an aspect of the present disclosure, a surgical instrument for operating on tissue is provided. The surgical instrument includes an end effector including a first tissue engaging member and a second tissue engaging member in juxtaposed relation to the first tissue engaging member; a gap determination element operatively associated with each of the first tissue engaging member and the second tissue engaging member for measuring a gap distance between the first tissue engaging member and the second tissue engaging member; and a tissue contact determining element operatively associated with a respective tissue contacting surface of at least one of the first tissue engaging member and the second tissue engaging member. The present disclosure also relates to methods of using the surgical instrument.

Abstract: Tissue thickness compensators for use with surgical staplers that are configured to form staples having different formed heights. Various tissue thickness compensators are disclosed that have non-uniform cross-sectional thicknesses or profiles. The tissue thickness compensators may be formed with a surface that matches a non-planar surface of the anvil or the staple cartridge deck. Methods of forming tissue thickness compensators with non-uniform cross-sectional thicknesses or profiles are also disclosed.

Abstract: Provided herein is an anastomosis assembly for connecting a first tissue portion to a second tissue portion. The anastomosis assembly includes a first anastomosis portion having first tissue engaging structures for deployment, by actuation of a deployment mechanism of a deployment device, to attach to the first tissue portion, and a second anastomosis portion having second tissue engaging structures for deployment, by actuation of a deployment mechanism of a deployment device, to attach to the second tissue portion. During delivery of the anastomosis assembly, the first and second tissue engaging structures are contained within an inner diameter of the first and second anastomosis portions.

Abstract: A neural implant for bridging interruptions or defects within a nerve. The neural implant consists of thread-like spider silk formed from fibers of spider silk arranged around a carrier element. The carrier element consists of thread-like spider silk. The carrier element can carrier element be a plurality of pieces of spider silk arranged in parallel. The thread-like spider silk can be natural or modified spider silk, including chemically modified spider silk.

Abstract: Systems and methods capture and/or occlusion of selected body tissue using various tissue characteristics and/or techniques are described. In the context of left atrial appendage closure, the systems and methods can be used to capture the left atrial appendage while a closure instrument (suture, clip, ring, etc.) is placed over the appendage and tightened down or a closure method (ablation, cryogenic procedures, stapling, etc.) is performed to close the left atrial appendage.

Abstract: This invention presents a non-pneumatic tourniquet device designed for quick, easy application to an injured digit, such as a finger or a toe. One preferred embodiment comprises a frame, which is affixed to a flexible layer or membrane, and allows for an opening for the insertion of the injured digit through the device. This easy to use apparatus temporarily checks the bleeding or blood flow by applying an external pressure or a compression to the blood vessels in an appendage and also allows for exsanguination of the injured area.

Abstract: A femoral reamer (100) can include a base material (304) and a coating (302) disposed on the base material. The coating can be harder than the base material and, as a result, the femoral reamer can wear more slowly than if the coating was absent. The coating can be a different color than the base material. When the coating is worn off, such wear can be easily observed from a visual inspection of the femoral reamer. The coating can have an initial thickness (i.e., a thickness prior to use) that is related to a tolerance on a size and/or a shape of a hole drilled by the femoral reamer. When the coating is worn off, the size and/or the shape of the hole drilled by the femoral reamer may be at or near an edge of a specified tolerance range. The femoral reamer can be part of a kit and a method.

Abstract: Methods of creating a curvilinear cavity within a vertebral body or other bony structure and devices that may be used to perform the steps to create the curvilinear cavity. In one embodiment, a method of forming a curvilinear void in bony structure may include the steps of accessing a bony structure with a cannula, inserting a distal end of a drill device through the cannula and into the bony structure, manipulating the distal end of the drill device to create a curvilinear void in the bony structure, enlarging the void by expansion of a balloon element mounted to the drill device, and deflating the balloon element and removing the drill device from the cannula.

Abstract: A drill bit comprising a cutting portion having an edge for penetrating bone and a resilient tine configured to be inserted into a drill housing, the resilient tine including a tab having an abutment surface configured to establish a snap-fit connection with a drill gear within the drill housing, and wherein the drill bit is capable of being removed from the drill housing by disengaging the abutment surface from the drill gear.

Abstract: A custom arthroplasty guide and a method of manufacturing such a guide are disclosed herein. The method of manufacturing the custom arthroplasty guide includes: a) generating medical imaging slices of the portion of the patient bone; b) identifying landmarks on bone boundaries in the medical imaging slices; c) providing model data including image data associated with a bone other than the patient bone; d) adjusting the model data to match the landmarks; e) using the adjusted model data to generate a three dimensional computer model of the portion of the patient bone; f) using the three dimensional computer model to generate design data associated with the custom arthroplasty guide; and g) using the design data in manufacturing the custom arthroplasty guide.

Abstract: The invention features bone drill guides, sleeves, and methods of use thereof in inserting hardware into bones, in particular to repair bone defects. The bone drill guides are designed to seat firmly against bone while allowing translational, rotational, and angular movement during an operation. The bone drill guides also allow for insertion of multiple devices, such as guide wires, into bone at defined and constrained relative position.

Abstract: A dual reconstructive wire system for use with an anatomy can include a first guide wire, a second guide wire, a first guide instrument, a first cannulated insertion instrument, and a second cannulated insertion instrument. The first guide wire can pass through the first cannulated insertion instrument such that a first end and a second end of the first guide wire extends beyond the first end and the second end, respectively of the first cannulated insertion instrument. The second guide wire can pass through the second cannulation insertion instrument such that a first end and a second end of the second guide wire extends beyond the first end and the second end, respectively of the second cannulated insertion instrument.

Abstract: A drill guide for use with a bone plate is provided in accordance with various aspects of the present teachings. The drill guide can include a body and a quick-connect coupling arrangement. The body can have a proximal end, a distal end and can define a guide passage therebetween. The distal end can have a bone plate engaging portion. The quick-connect coupling arrangement can be associated with the bone plate engaging portion, and can include first and second lobes projecting radially outward from an outer surface of the bone plate engaging portion. The bone plate engaging portion and the first and second lobes can be operable to be slidably received in a bone screw hole in the bone plate so as to removably couple the drill guide to the bone plate in a predetermined orientation relative to the bone screw hole.

Abstract: Provided herein are patient-specific surgical device that allow for a stable fitted position for use in shoulder surgery. The patient-specific surgical devices may have different functions such as a function as a guide.

Abstract: A ligament balancer for a knee is disclosed that includes a first guide portion having a first guide hole extending there through, and a second guide portion having a second guide hole extending there through, the first and second guide portions being moveable with respect to each other along a movement axis, the balancer being adapted such that, in use, the movement axis is substantially parallel to the anterior/posterior axis of a distal femoral surface. Also disclosed is a kit of parts that includes the ligament balancer and a drill guide for a knee, the drill guide includes first and second connected arms, each arm comprising at least two guide openings extending there through, the guide openings being spaced longitudinally along each arm, longitudinal axes of the first and second arms intersecting at a predetermined angle. Also disclosed is a method of attaching a cutting block to a distal femoral surface as part of a knee replacement procedure.

Abstract: An assembly comprising: an iris retractor forceps comprising two forceps legs which join together at a proximal junction, the forceps legs comprising distal graspers for grasping an iris retractor or a holder for such an iris retractor; and a locking element slidingly received in a groove in the forceps legs, the locking element sliding between at least two positions, the at least two positions comprising: a first position in which the forceps legs are spread apart, and a second position in which the forceps legs are squeezed together, wherein in the second position the locking element is held in a locked position.

Abstract: A surgical device including a disposable needle assembly, a reusable handle assembly and a retractable slide. A method for inserting and releasing a disposable needle assembly from a reusable handle assembly is included. The handle assembly includes a ratchet mechanism, locking mechanism, arming mechanism and a cage.

Abstract: Rotational couplers for use with surgical devices that are actuated by semi-flexible actuators such as wires and the like. The couplers enable the actuators to apply various actuation motions to actuation features on the surgical device as well as other actuators to apply axial and rotational motions to the surgical device to manipulate the device into various orientations relative to an elongate shaft to which the device is movably attached.

Abstract: Apparatus and methods for a magnetic coupling motor drive for a surgical cutting instrument. A magnetic coupling motor drive unit includes a motor housing containing a motor and a magnetic drive hub assembly, the magnetic drive hub assembly having a drive hub and a driven hub, the driven hub rotating about a driven hub spindle, the driven hub spindle attached to a seal cap, the seal cap sealing the drive hub and the motor to the motor housing, wherein the drive hub includes an array of magnets aligned to a respective array of magnets in the driven hub.

Abstract: A surgical endoscopic cutting device includes cutting elements fitted in a protective tube. The device has an inlet for fluid, a discharge outlet for tissue and fluid, and a further outlet that discharges most of the fluid.

Abstract: Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

Abstract: An ultrasonic instrument comprises a handle assembly or other kind of body configured to receive an ultrasonic transducer, a shaft assembly having an acoustic waveguide and an ultrasonic blade, and a removable clamp arm. The ultrasonic blade is in acoustic communication with the acoustic waveguide such that the ultrasonic transducer is operable to drive the ultrasonic blade to vibrate ultrasonically via the acoustic waveguide. The clamp arm is configured to selectively couple with and decouple from the shaft assembly and/or handle assembly of the ultrasonic instrument. The clamp arm may include a coupler or other coupling feature configured to selectively couple the clamp arm with the shaft assembly and/or the handle assembly. The ultrasonic instrument may further comprise a guidance system configured to position and/or orient the clamp arm relative to the ultrasonic instrument.

Abstract: An ultrasonic instrument comprises a handle assembly configured to receive an ultrasonic transducer, a shaft assembly having an acoustic waveguide and an ultrasonic blade, and a retractable clamp arm. The ultrasonic blade is in acoustic communication with the acoustic waveguide such that the ultrasonic transducer is operable to drive the ultrasonic blade to vibrate ultrasonically via the acoustic waveguide. The clamp arm is configured to selectively translate between an inoperative position and an operative position. The clamp arm is positioned generally proximal to the ultrasonic blade when the clamp arm is in the inoperative position. The clamp arm is positioned lateral to the ultrasonic blade when the clamp arm is in the operative position. When in the operative position, the clamp arm is operable to move toward and away from the ultrasonic blade so as to capture and compress tissue between the clamp arm and the ultrasonic blade.

Abstract: A device and method for holding at needle along a desired percutaneous path into the body of a patient is disclosed. The device includes a base, a needle guide, a hinge, and a shapeable mass. The base has a top surface and a bottom surface. The needle guide has an inner surface and an outer surface, with the inner surface defining an elongate linear channel. The needle guide is pivotably connected to the base by the hinge, so that it can be oriented and the device positioned on the skin of the patient, whereupon a portion of the needle is disposed within the needle guide at its desired orientation. The shapeable mass is arranged to be secured between the outer surface of the needle guide and the top surface of the base to hold the needle guide in that desired orientation.

Abstract: A positioning apparatus including a needle holder having a through hole for regulating needle placement and movement, a needle positioning unit, and an engagement member that fixes a position of the needle holder with respect to the needle positioning unit. The needle holder is either least partially detachably attached to the needle positioning unit or deformable. The positioning apparatus may be designed to accommodate the placement of multiple needles.

Abstract: An expandable adapter collar assembly is provided for use with a surgical access port having an outer diameter in order to increase the apparent outer diameter of the combination of the surgical access port and expandable collar in order to conform to the size of a surgical incision. The expandable adapter collar is an inflatable collar which is selectively detachably positionable so as to surround the surgical access port and expandable from a deflated or contracted smaller diameter to an inflated or expanded larger diameter to fill the surgical incision. The expandable adapter collar may be provided as part of an expandable collar assembly including a source of inflation fluids. There is also provided a method of adapting a surgical access port for use in a surgical incision having a size larger than the original design parameters for the surgical access port.

Abstract: A system for accessing underlying tissue includes an elongated access sheath defining a longitudinal axis and a penetrating tip releasably mounted to the access sheath and dimensioned for facilitating passage through tissue. The penetrating tip is removable through the access sheath. The penetrating tip may include a transparent region adapted to permit passage of light.

Abstract: A trocar for thoracoscopic surgery includes a cylindrical portion with an elliptical cross section, and an outer flange and an inner flange provided on respective ones of both ends of the cylindrical portion. The cylindrical portion has two planar side wall portions, two arcuate portions connecting the side wall portions at both ends thereof, and a partitioning wall portion partitioning the interior of the cylindrical portion between both side wall portions. Both side wall portions per se and both arcuate portions per se are formed in curved fashion in such a manner that outer surfaces thereof take on a concave shape.

Abstract: An expandable introducer sheath for use in inserting a medical device into a body vessel of a patient includes a body which extends from a proximal end to a distal end along an axis. The body includes an inner layer, an outer layer, and an expandable reinforcement member which is disposed between said inner and outer layers. The expandable reinforcement member is configured to radially expand as the medical device is axially advanced or retracted through said introducer sheath. Once the medical device has exited the introducer sheath, the expandable reinforcement member facilitates a return of the introducer sheath to its original or unexpanded condition.

Abstract: A method of surgical navigation into the brain includes establishing a trajectory through the skull into the brain to a target, drilling a hole in the skull using a drill, and verifying the trajectory of the drilled hole during drilling using image guidance. A surgical navigation system includes a cannulated drill, a cannulated access member, and a coupling member for coupling the access member to the drill and for maintaining alignment of the cannulations in the drill and the access member. The access member is movable relative to the coupling member such that the access member can be secured to tissue while the coupling member maintains the alignment of the cannulations. A surgical kit includes a cannulated drill, a cannulated access member, a coupling member for coupling the access member to the drill, and a probe for receipt within the cannulated drill.

Abstract: The invention provides methods of selection of mammalian oocytes. In particular, the invention provides in-vitro methods of selection of viable oocytes from a population of mammalian oocytes by ranking and selecting viable oocytes.

Abstract: Technologies are generally provided for a meniscal repositioning device to achieve at least a partial unloading of an ipsilateral tibiofemoral articulation. The device may include at least a shortening component and a fixation component. The shortening component may be configured to reduce a functional length of a meniscal root of a meniscus through an introduction of a targeted and strategic deviation in the device associated with an accommodation of the meniscal root. The deviation may cause a path of at least one portion of the meniscus to be altered, further causing the meniscus to be drawn inward towards a midline of a knee to induce a distraction force in a medial or lateral compartment of the knee between menisci. The fixation component may affix the shortening component to a portion of a tibia adjacent to the meniscal root or an anterior and/or posterior portion of the meniscal root.