Abstract: A suturing device for grasping soft tissue and placing stitches in soft tissue during endoscopic procedures is described. An elongate housing with a stationary jaw and a movable jaw disposed at the distal end are configured for grasping and releasing soft tissue. A movable needle disposed within the housing is actuated to engage a length of suture and drive the suture into and through the grasped soft tissue. A suture capture member is disposed on the movable jaw and is configured to allow passage of the needle therethrough while securing a portion of the stitched length of suture.

Abstract: Stomach tissue is manipulated to form, for example, a restored flap of a gastroesophageal flap valve. The manipulation includes gripping stomach tissue from within the stomach while the stomach is inflated to promote visualization and stabilization of the gripped stomach tissue. Once the stomach tissue is gripped, the stomach is deflated and pulled into a mold. The molded tissue is then fastened with at least one fastener. The stomach is inflated to a first pressure during visualization and then to a second higher pressure during the stomach tissue gripping.

Abstract: A method for deforming a staple comprising a base, a first staple leg, and a second staple leg, wherein the base, the first staple leg, and the second staple leg are positioned within a common plane prior to being deformed, the method comprising positioning the first staple leg within a first cup of a staple pocket, the first cup comprising a first inner surface, applying a first compressive force to the first staple leg to bend the first staple leg toward the base and the second staple leg, contacting the first inner surface with the end of the first staple leg to bend the end of the first staple leg toward a first side of the base, and deforming the first staple leg such that the end of the first staple leg crosses a mid-line of the staple defined between the first staple leg and the second staple leg.

Abstract: An implant can include a bridge member having an upper surface, a lower surface and opposed sides extending between the upper and lower surfaces, where at least the sides can be formed of a porous metal construct having a porous metal outer surface. First and second fixation members can be integrally connected with the bridge member and can include a body having a width greater than a corresponding width of the bridge member and a length greater than a corresponding length of the bridge member, where at least the body can be formed of the porous metal construct with the porous metal outer surface. The implant can be positioned into the bone segments such that the bridge member can fix the bone segments in a first direction perpendicular to the bridge member and the fixation members can fix the bone segments in a second direction parallel to the bridge member.

Abstract: Provided herein are protective devices that can fully capture and enclose a needle for a medical procedure, e.g., a swedged suture needle, such that the needle may safely remain attached to a wound or surgical site via suture material but also prevent accidental needle-stick injuries to medical personnel and patients. Such devices may be employed for temporary or longer periods of time while other phases related to the medical procedure transpire.

Abstract: A puncture device is disclosed, which can include a puncture needle curved in an arc, turnably supported around an axis (J1) as a turning center, and having a needle tip which punctures a living body when the puncture needle is turned; a urethral insertion member having a urethral insertion portion of a linear shape which is inserted into the urethra; and a frame capable of connecting the puncture needle and the urethral insertion member to each other, the frame turnably supporting the puncture needle. When the puncture needle is turned, the needle tip of the puncture needle has a locus (plane f9), which is inclined by an inclination angle (?2) of 20 to 60 degrees with respect to a plane (f2) orthogonal to the urethral insertion portion.

Abstract: A fastener cartridge for creating a flexible fastener line is disclosed. The fastener cartridge includes a plurality of fasteners removably stored therein wherein at least some of the fasteners are oriented in directions which are transverse or oblique to an incision created by a cutting member passing through the fastener cartridge. Once these fasteners are deployed into tissue, the fasteners can translate and/or rotate within the tissue when the tissue is stretched.

Abstract: A method for creating a flexible fastener line is disclosed. The fastener line comprises fasteners oriented in directions which are transverse or oblique to a tissue incision created by a cutting member. The fasteners can translate and/or rotate within the tissue when the tissue is stretched thereby creating flexibility within the tissue.

Abstract: A buttress material for use with a surgical staple cartridge. In various forms, the buttress material comprises a buttress body that is sized to be operably received on a deck of the surgical staple cartridge. The buttress body includes at least four edges and a central portion. At least two of the edges have a plurality of edge notches formed therein. The central portion may include a plurality of cutout openings therein.

Abstract: A wound closure device for closing a surgical wound includes at least one compressive clip for applying pressure to a patient's tissue. The clip includes a first clamping arm, a second clamping arm, and a flexible pin maintained between the first and second clamping arms in a press-fit relationship. Each of the first and second clamping arms has a proximal first end, an opposing distal second end and a sidewall extending therebetween. The clip has a first position in which the proximal first ends of the first and second clamping arms partially engage or do not engage each other and a second position in which the proximal first ends of the first and second clamping arms pivotally engage each other. In the second position of the clip, a compressive force generated at the proximal first ends is transferred through the first and second clamping arms to the distal second ends.

Abstract: The invention is related to wound closure devices, systems and methods that comprise a wound closure strip comprising a three-part release liner assembly that permits accurate placement of the wound closure strip during the approximation of opposing wound surfaces while preserving the integrity of the device's adhesive. Preferably, after the wound closure strip has been applied to approximate a wound, a flowable, polymerizable adhesive is applied to the wound closure strip to form a flexible, wound closure composite device (i.e., wound closure strip/polymerized adhesive composite).

Abstract: A fastener cartridge assembly for use with a circular surgical fastening device. The fastener cartridge assembly includes a cartridge body that has a circular deck. A plurality of fastener cavities is provided in the circular deck. Each fastener cavity includes two cavity ends wherein one cavity end of each of the fastener cavities is positioned on a first circular axis having a first radius and wherein the other cavity end of each fastener cavity is positioned on a second circular axis that has a second radius that differs from the first radius.

Abstract: A staple cartridge that includes a multi-staple driver is disclosed. The multi-staple driver is configured to drive multiple staples from the staple cartridge. The staples are arranged in a staple array in which at least one staple is angularly-oriented relative to the longitudinal axis of the staple cartridge. The multi-staple driver can drive staples at various angular orientations and/or from multiple rows of staple cavities. A driverless staple cartridge is also disclosed. A sled in the driverless cartridge is configured to directly engage and drive staples. The staples are arranged in a staple array in which at least one staple is angularly-oriented relative to the longitudinal axis of the driverless staple cartridge.

Abstract: An end effector and a staple cartridge are disclosed. The staple cartridge includes an array of staples in which at least one staple is angularly-oriented relative to the longitudinal axis of the staple cartridge. The angled staple(s) provide longitudinal flexibility to the stapled tissue. Additionally, the staple cartridge and/or the end effector are configured to provide variable degrees of compression to tissue. For example, the compression of tissue before, during and/or after stapling can be optimized.

Abstract: A fastener cartridge assembly for use with a circular surgical fastening device. The fastener cartridge assembly includes a cartridge body that has a circular deck. A plurality of fastener cavities is provided in the circular deck. Each fastener cavity includes two cavity ends wherein one cavity end of each of the fastener cavities is positioned on a first circular axis having a first radius and wherein the other cavity end of each fastener cavity is positioned on a second circular axis that has a second radius that differs from the first radius.

Abstract: A suturing device is disclosed. The suturing device includes an end effector assembly disposed on a distal end of the suturing device. The end effector assembly includes at least one guide tube housing at least one elongated member, a guide rack, and an anchor configured for disposal in a tubular tissue circumferentially offset from the guide rack. The anchor includes at least one guide tube attached to a suture having a first end and a second end. The at least one elongated member is deployed to puncture tubular tissue and mate with the at least one aperture of the anchor such that extraction of the at least one elongated member simultaneously draws out the suture through the punctured tubular tissue.

Abstract: A catheter device is provided that includes an elongate body, an atraumatic member, an expandable member, and a locking device. The elongate body has a fluid flow lumen that is in fluid communication with an outlet port adjacent to a distal end of the elongate body. The atraumatic member can be at the tip of the elongate body. The expandable member is disposed proximal of the atraumatic tip and is configured to block an opening of the LAA. The locking device is disposed adjacent to the expandable member. The locking device has a first configuration in which the elongate body is coupled with the atraumatic member and second configuration in which the elongate body is uncoupled from the atraumatic member.

Abstract: Embodiments of the disclosure relate to tourniquet devices that have a strap which store an extension in a pocket. The extension can be deployed and wrapped around a ring of the strap to cinch the strap against an appendage to reduce blood flow below the tourniquet device. Some embodiments include a ratchet device that further constricts the appendage to reduce blood flow. These tourniquet devices can be worn in water and out of water and can be associated with various water sport accessories.

Abstract: A method of creating a patient specific instrument (PSI) for use in knee replacement surgery is described which includes performing at least two X-ray scans of a bone, each of the X-ray scans being taken from different angular positions, generating a digital bone model of the bone based solely on the X-ray scans, planning the PSI based on the digital bone model, including determining locations for one or more anchor points on the PSI which are adapted to abut a surface of the bone, the determined locations of the anchor points being disposed on the PSI at locations corresponding to areas of expected high accuracy on the digital bone model generated by the X-ray scans. The areas of expected high accuracy include at least a peripheral bone contour in at least one of the angular position of the X-ray scans. A suite of such PSI instruments is also described.

Abstract: Surgical feedback systems and methods include a surgical tool having a functional tool and a handle for manipulation by a surgeon in a surgical environment. At least one sensor connected to the surgical tool generates a signal indicative of an acoustic signal and/or a vibration signal generated by the functional tool. The signal may be modified and supplied to an output device.

Abstract: An ultrasonic surgical device capable of cutting biological tissues such as bone and cartilage. The ultrasonic surgical device includes a static casing, which sheaths an ultrasonic horn, and a lubrication film, which separates the ultrasonic horn and the static casing. The static casing, which also incorporates a plurality of fluid channels to allow passage of fluids along its length and eventual distribution of such fluids at the cutting end and biological tissue interface, inhibits the transfer of heat generated along the ultrasonic horn. The cutting end and the static casing are separated by a flexible joint, which serves to inhibit the transfer of vibrational energy, and consequently heat, from the cutting end to the static casing. As such, the static casing remains stable and can be used both to manipulate the surgical device with greater haptic control and facilitate effective penetration of larger cross-sections of biological tissue.

Abstract: An instrument for preparing an acetabulum. The instrument includes a handle having a reamer coupling feature and a trial coupling feature. The instrument further includes an acetabular reamer having an outer cutting surface and an inner concave surface having an apex. The acetabular reamer has a first handle coupling feature located at the apex adapted to couple to the reamer coupling feature of the handle. A trial having an outer convex surface having an apex is also included. The outer convex surface adapted to fit inside the inner concave surface of the acetabular reamer. The trial has a second handle coupling feature located at the apex of the outer convex surface adapted to couple to the trial coupling feature of the handle.

Abstract: An orthopaedic surgical instrument assembly includes a hemispherical component having a convex outer surface extending from a circular rim to an apex point, and a plurality of cutting teeth extending outwardly from the outer surface between the circular rim and the apex point. Each cutting tooth of the plurality of cutting teeth includes an elongated cutting edge that is positioned on an arced imaginary line of a plurality of arced imaginary lines extending outwardly from the apex point of the hemispherical component. A method of manufacturing an orthopaedic surgical instrument assembly is also disclosed.

Abstract: A surgical instrument assembly includes a metallic hemispherical component and a driver component removably coupled to the hemispherical component. The metallic hemispherical component has a convex outer surface configured to engage a patient's natural acetabulum, a concave inner surface positioned opposite the outer surface and defining a cavity in the hemispherical component, a plurality of cutting teeth extending outwardly from the outer surface, and a plurality of apertures defined in the inner surface. The driver component has a shank and a plurality of ribs secured to, and extending outwardly from, the shank. Each rib has a tab that is received in a corresponding aperture of the hemispherical component to secure the driver component to the hemispherical component.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: Devices, systems, and methods are provided for ligament repair procedures, and can be used to establish a location and trajectory for forming a bone tunnel in bone. One exemplary embodiment of a surgical guide for using in a ligament repair procedure includes a guide arm and a carriage that can be selectively locked along the guide arm to define an angle of the bone tunnel. The guide arm also defines a location of a distal end of the bone tunnel. In some embodiments the carriage is configured to have a bullet side-loaded into it, and the bullet can be used to define a location of a proximal end of the bone tunnel. The present disclosure also provides for a gage that limits the distance a drill pin that drills the bone tunnel can travel. A variety of other, devices, systems, and methods are also provided.

Abstract: A system and method for aligning a guiding pin relative to a glenoid including a guiding pin insertion guide for orienting the guiding pin relative to the anatomic structure and an axis alignment device. The guiding pin insertion guide includes a base plate and a movable pin orientation device coupled to and extending from the base plate. The axis alignment device has a plurality of through holes that each define a different alignment axis. The guiding pin mates with one of the through holes to align the guiding pin at a patient-specific alignment axis, the guiding pin is then received within the guiding pin insertion guide when mated with the one of the through holes to align the guiding pin insertion guide along the patient-specific alignment axis relative to the base plate, and the guiding pin insertion guide is fixed to the base plate along the patient-specific alignment axis.

Abstract: A method and apparatus of performing a procedure relative to the glenohumeral joint. Resection of the glenoid and/or the humerus can proceed through an incision formed near the glenohumeral joint. The incision can be formed generally near a superior-lateral portion near the glenohumeral joint and allow less invasive access to the glenohumeral joint and the portions that form the glenohumeral joint. The procedure can be performed with no or little detaching of the subscapularis, and with no or little dislocating of the glenohumeral joint.

Abstract: The present disclosure relates to a guide. The guide includes a handle and a shaft coupled to the handle, the shaft including a lip located at a distance from the longitudinal axis of the shaft and extending a distance from an end of the shaft. A method of tissue repair is also disclosed.

Abstract: Patient-specific guides for a tibial tubercle osteotomy are provided. The guides include a guide body defining a portion with a bone-engaging surface that conforms as a negative surface to a corresponding surface of a specific patient's tibia, and a guide portion that guides a surgical instrument to a specific location on the specific patient's tibia, wherein the bone-engaging surface and guide portion are configured during a pre-operative planning stage. Methods for performing a tibial tubercle osteotomy with the patient-specific guides are also provided.

Abstract: Disclosed is a femoral resection guide for measuring and guiding resection of anterior portion and posterior portion of a femur and method thereof. The femoral resection guide comprises a front block, a rear block, a reference gauge means and a locking means. A main scale marked portion is provided corresponding to the front scale member and the rear scale member in order to obtain a size of a patient's femur. The front block and the rear block are respectively provided with a resection guide surface for guiding a cutting tool to cut the femur. Moreover, the positions of the front resection guide surface and the rear resection guide surface in relation to the distal section of the femur can be adjusted, so that the problem of over or insufficient resection can be avoided, and the purchase cost and the storage space of the femoral resection instruments can be significantly reduced.

Abstract: The apparatus of the present invention includes a number of components including tibial and femoral alignment guides, tibial and femoral cutting guides and tibial and femoral implants for total knee arthroplasty procedures

Abstract: A balloon including an outer circumferential portion which dilates to form a hollow circular cross-section and deflates when the internal pressure is reduced, an inner circumferential portion positioned inside the outer circumferential portion, and support portions positioned between the outer circumferential portion and the inner circumferential portion to support deflating the outer circumferential portion while compressing the outer circumferential portion. The support portions form first compression portions, which have a high compressive strain, and second compression portions, which have a compressive strain lower than the first compression portions.

Abstract: A medical retrieval device may include an elongate sheath, a first and a second control wire extending through the sheath, and a basket coupled to a distal end of the first control wire. The retrieval device may additionally include an engaging member coupled to a distal end of the second control wire and the basket. The engaging member may be configured to transform from a constrained configuration within the sheath to an unconstrained configuration outside to the sheath, wherein transforming the engaging member from the unconstrained configuration to the constrained configuration may rotate the basket about an axis perpendicular to a longitudinal axis of the sheath.

Abstract: A medical device for collecting a solid object together with a fluid in a living body, including: a cylindrical member having an inner cavity, a suction port provided on the distal end of the inner cavity, and a discharge port on a side wall and communicating with the inner cavity; an impeller in the inner cavity configured to carry the fluid from the suction port to the discharge port; and a filter in the inner cavity configured to collect the solid object. At least part of the wall surface of the cylindrical member, which defines a flow channel allowing movement of the fluid from the impeller to the discharge port, is inclined from a center axis of the cylindrical member toward a distal end with respect to a transverse direction of the cylindrical member.

Abstract: A medical retrieval device may include a member extending longitudinally between a proximal end and a distal end. The member may include at least one lumen configured to be fluidly coupled to a vacuum source and to receive a medical tool therethrough. The member may be configured to transition between a compressed configuration and an expanded configuration, wherein in the expanded configuration, the distal end may have a larger cross-sectional area than the proximal end.

Abstract: A method of retrieving calculus includes positioning an elongated member in the lumen of the living body, wherein the elongated member includes a sealing member positioned in the lumen of the elongated member and possessing an outer surface in sealing contact with the inner surface of the lumen of the elongated member. The method also involves proximally moving the sealing member while the outer surface of the sealing member is in contact with the inner surface of the lumen in the elongated member to cause fluid and calculus in the living body to pass through the inlet of the elongated member and be introduced into a retrieval space, discharging at least some of the fluid in the retrieval space out of the retrieval space by way of an outlet, and withdrawing the elongated member from the living body while the calculus in the retrieval space remains in the retrieval space.

Abstract: A device for retrieving calculus in a lumen of a living body includes an elongated member positionable in the living body lumen and including an inlet, an outlet and a retrieval space between the inlet and the outlet, and a sealing member movably positioned in the lumen of the elongated member to axially move in distal and proximal directions, wherein the sealing member is in sealing contact with the inner surface of the lumen in the elongated member. A plunger is connected to the sealing member and includes two parts separated from one another to form a divided sealing member when the plunger is moved in the distal direction and that directly contact one another to form an integrated sealing member when the plunger is moved in the proximal direction to draw fluid and the calculus into the retrieval space.

Abstract: Surgical devices are provided having power-assisted or fully powered jaw closure. The devices herein generally include a handle portion, an elongate shaft, and an effector having first and second jaws configured to engage tissue. A motor and one or more compression springs can be operatively coupled, and activation of the motor can compress the spring(s) to reduce the amount of user supplied force to compress tissue between the jaws. In some embodiments, the devices can be configured to regulate an amount of compression applied by the jaws prior to, during, and/or after cutting of the tissue to promote hemostasis. For example, the devices can include sensors, processors, and/or other components that analyze data indicative of tissue type and tissue load. Based on this feedback, the device can automatically adjust the amount of compression or energy applied to the tissue to seal the tissue.

Abstract: Disclosed is a four-jawed combinational scissor-grasper surgical tool for use in laparoscopy, Cutting and grasping functionalities are respectively enabled via movement of a pair of such specially contoured jaw members sliding against or splaying apart from the other pair. Also disclosed are means for achieving selectable interlocking of jaw members and mechanical linkage for their actuation by human user.

Abstract: An electrosurgical instrument includes a housing having an elongated shaft extending therefrom and an end effector assembly coupled thereto. The housing includes a knife drive shaft and a jaw drive shaft disposed therein and movable within the elongated shaft. The end effector assembly includes a pair of opposing jaw members, a knife member, and a driven member. A proximal end of the knife member is selectively engageable to a distal end of the knife drive shaft such that movement of the knife drive shaft moves the knife member. A proximal end of the driven member is configured to operably couple to the jaw drive shaft and a distal end of the driven member is operably coupled to the jaw members to move the jaw members. A coupling member is configured to releasably secure the end effector assembly and the elongated shaft.

Abstract: Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall to at least partially surround the occlusion, and removing at least a portion of the surrounded occlusion from the lumen.

Abstract: Disclosed in a needle handling device engageable to an introducer tool used for implantation of a penile prosthetic insert in a corpora cavernosum of a penis. The needle handling device includes an attachment section, a needle capturing section and an intermediate section. The attachment section is provided at a first end of the needle handling device and is releasably attached to the introducer tool. The needle capturing section is provided at a second end of the needle handling device and is configured to capture and extract a needle out of the introducer tool. The intermediate section connects the first and the second end of the needle handling device. A method of implanting a penile prosthetic insert in a corpora cavernosum of a penis using a needle handling device is also disclosed.

Abstract: The application discloses a set of surgical instruments that may be used to access a human or animal body cavity for medical purposes without causing damage to internal tissues or organs therein, and methods of using the same. The instruments include a safety needle and flexible sheath that may be coupled together and used to establish a minimally invasive method to access a targeted body cavity while preventing or reducing damage to organs or tissues within the targeted cavity. Additional instruments are included within the invention that may be used to establish an access port in the wall of the targeted cavity. That port may be used to introduce catheters or other instruments into the body cavity. It may also be used as a drainage tube for draining or injecting gases and/or fluids from or into the targeted cavity.

Abstract: A surgical port assembly for use with surgical instruments includes a body including an exterior surface and an interior space defined by an interior surface of the body. The surgical port assembly includes a control interface including a plurality of drive members coupled to the body and controllable to apply a force to a different portion of a shaft of an surgical instrument, when the shaft is disposed within the interior space, to move a distal portion of the surgical instrument to a desired position within a body cavity.

Abstract: A system for stabilizing the heart via a helical needle, providing access to the interior of the heart via an introducer sheath, and forming a purse string suture using suture delivered by the helical needle. A helical needle projects distally from the device in a helical shape and terminates in a sharp distal tip. The helical needle is advanced into the heart wall, and is used to stabilize the heart and to pass a purse string suture through the heart tissue. An access port provides access to the interior of the heart via an opening passing through the heart wall in an area circumscribed by the helical needle. A length of suture may pass through the helical needle and exit at an opening at or near the needle distal tip. A free end of the length of suture may extend out of the distal tip and back into the hollow suture needle through the opening. The helical needle may have a deflection segment adjacent the distal tip that is more flexible than the rest of the helical distal portion of the helical needle.

Abstract: The disclosure relates to a needle assembly for delivering a lead and methods of use. The needle assembly is configured to cut tissue and reduce the potential for cutting vulnerable bodily structures. The needle assembly includes an outer needle with a blunt tip and an inner needle with a sharp tip. The outer needle may be curved, and the inner needle may be curved. When the inner needle is rotated with respect to the outer needle, the inner needle protracts or retracts with respect to the outer needle. A stopping feature on the needle assembly may be included to resist over-rotation or over-extension. The needle assembly provides an initial path that may be further dilated for delivering a lead, such as a vagus nerve stimulation lead to a target site. The target site may be electrically tested with some embodiments.

Abstract: A fluid management system for use with a fluid reservoir includes an inflow pump and an outflow pump. The inflow pump is connectable to a probe for delivering a distention fluid to a body cavity. The outflow pump removes the distention fluid through the same probe, thus establishing a re-circulating volume of distention fluid within the body cavity. The removed fluid is filtered and returned to a fluid reservoir for eventual recycling to the body cavity. A controller adjusts the flow rates of the inflow pump and the outflow pump to maintain a pre-selected fluid pressure or volume within the body cavity.