Abstract: A surgical fastener applier is disclosed and includes a handle portion, a tubular member extending from the handle portion and defining a longitudinal axis, a drive member rotatably supported in the tubular member and in the handle portion, and a plurality of fasteners. The drive member is configured to rotate while in a deflected condition with respect to the longitudinal axis. The drive member includes a proximal portion, a central portion, and a distal portion, the central portion being relatively more flexible configuration as compared to at least one of the proximal portion and the distal portion. The plurality of fasteners is disposed within the tubular member and is configured to engage a portion of the drive member such that rotational motion of the drive member causes distal advancement of at least one fastener of the plurality of fasteners through the tubular member.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A surgical suture needle assembly includes an elongate tube defining a lumen through at least a portion of a length thereof; and a wound treatment material contained within the lumen of the suture structure. Methods of using the surgical suture needle assembly in anastomotic procedures and the like are disclosed.

Abstract: An intra-bronchial device placed and anchored in an air passageway of a patient to collapse a lung portion associated with the air passageway. The device includes a support structure, an obstructing member carried by the support structure that reduces ventilation to the lung portion by preventing air from being inhaled into the lung portion, and at least one anchor carried by the support structure that anchors the obstruction device within the air passageway. The anchor may engage the air passageway wall by piercing or friction, include a stop dimensioned for limiting the piercing of the air passageway wall, and may be releasable from the air passageway for removal of the intra-bronchial device. The anchors may be carried by a peripheral portion of the support structure, or by a central portion of the support structure. The obstructing member may be a one-way valve.

Abstract: A liquid embolic delivery system is provided for trapping an injected liquid embolic composition to prevent the liquid embolic from solidifying or otherwise passing outside of an embolization area. The delivery system includes a catheter for delivery of a liquid embolic composition and a containment member positioned at a distal end of the catheter which is shaped to trap the liquid embolic composition delivered through the lumen of the catheter. The containment member is formed as a brush, nest, sponge, swab, flexible sack, or other shape into and around which the liquid embolic composition is injected. The liquid embolic composition is trapped or meshes with the containment member during solidification containing the liquid embolic and preventing the embolic composition from passing into the blood stream.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A measurement system and method for determining a depth of penetration of a working portion of a surgical instrument (e.g., a rotating drill bit in a bore). A first sensor outputs a first signal representative of a displacement of the leading edge of the drill bit in the bore. A second sensor outputs a second signal representative of a force applied to the leading edge of the drill bit. A processor outputs a third signal representative of the depth of penetration of the leading edge of the drill bit when the leading edge of the drill bit passes from a first medium having a first density to a second medium having a second density. The third signal is based on the first and second signals.

Abstract: A sonotrode for an ultrasonic surgical instrument has a shaft and an instrument head at a distal end of the shaft. The instrument head is equipped with a cutting structure for the treatment of bones. The shaft has a helical cut-out. The helical cut-out is provided with a transversely running shoulder. A method produces a sonotrode and a surgical instrument having such a sonotrode. As a result of the shoulder in the helical cut-out, the torsional vibration of the instrument head is amplified such that bone material can be ablated in a particularly effective fashion.

Abstract: Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Abstract: Patient-matched surgical instruments, and methods for making patient-matched surgical instruments, may include patient-matched surgical instruments having an anatomy facing side with several discrete, physically separate anatomy contacting portions configured to match the anatomy of a particular patient. The anatomy contacting portions may be one or more of non-uniform in distribution, non-uniform in shape or non-uniform in surface area.

Abstract: The present disclosure relates to devices, systems, and methods associated with a catheter device for delivering energy to a vein. One or more catheter devices include a cooling device, an infusion device, and an energy delivery device for delivering energy to a vein to treat incompetent valves.

Abstract: A device for intravascular intervention can comprise an intervention element, an elongate manipulation member, and a joining element. The elongate member can comprise a hooked portion extending about a proximal portion of the intervention element. The joining element can substantially permanently attach the hooked portion to the intervention element.

Abstract: A minimally invasive endovascular device for treating a blocked or obstructed biological lumen, such as a blood vessel fully or partially obstructed by deposits of biological matters in or non-biological matters. Certain embodiments of the present invention comprise two capture members that are configured to be placed on either side of the obstruction and enclose around the obstruction for removal. Embodiments of the present invention also provide methods for implementing an endovascular device according to aspects of the present invention.

Abstract: Systems and methods for opening a tissue to a target value using microbubbles are disclosed herein. In an embodiment of a method for opening a tissue to a target value using microbubbles, a region of the tissue is targeted for opening, an acoustic parameter corresponding to the target value is determined, and an ultrasound beam is applied to the target region at the acoustic parameter such that the tissue at the target region is opened to the target value with the microbubbles. The acoustic parameter can be selected to control an acoustic cavitation event and, in some embodiments, controlling an acoustic cavitation event can include controlling a location, number and/or magnitude of acoustic cavitation events.

Abstract: This relates to treating an asthmatic lung and more particularly, relates to advancing a treatment device into the lung and treating the lung with the device. This also includes additional steps of treating the airway wall, applying energy or heat to the airway wall in an asthmatic lung.

Abstract: A medical device is configured to prevent a member attached to the distal end of an operation wire passing through a catheter from dropping out from an operation wire. The medical device includes an operation wire which passes through a catheter and which is advanceable and retractable toward the axial direction with respect to the catheter, a distal member interlocked on the distal side of the operation wire, and a grasping unit which is interlocked on the proximal side of the operation wire. The medical device also includes a safety mechanism for releasing the interlock between the operation wire and the grasping unit by a load lower than the breaking strength between the operation wire and the distal member.

Abstract: A gripping instrument with two jaw parts, which are connected to each other by a pivot joint and are movable toward each other, by pushing together of two grip arms connected to the jaw parts, and are movable away from each other, by pushing apart of the grip arms, wherein the grip arm has a bending joint, by means of which, when the grip arms are pushed together, a force limited by a resiliency of the bending joint is transmitted, via the grip arm with the bending joint, to the corresponding jaw part, and which bending joint includes a directional abutment, wherein an applied manual force acts directly through the directional abutment during the pushing apart.

Abstract: Various embodiments relate to a surgical instrument. The surgical instrument includes a first handle member having a first handle portion and a first shaft portion; a first end member connected to the first handle member having a first instrument portion and a tab; a second end member connected to the tab of the first end member having a second instrument portion and a shaft portion; a second handle member connected to the shaft portion of the second end member; and a lock that releasably connects the second handle member to the shaft portion of the first handle member.

Abstract: A forceps includes an end effector assembly including first and second jaw members. One or both of the jaw members is movable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. One or both of the jaw members is configured to conduct energy between the jaw members and through tissue grasped therebetween to treat tissue. An insulative tubular member is movable relative to the end effector assembly between a retracted position, wherein the insulative tubular member is positioned proximally of the end effector assembly, and an extended position, wherein the insulative tubular member is disposed about the end effector assembly. A monopolar member is configured to apply energy to tissue to treat tissue when the insulative tubular member is disposed in the extended position.

Abstract: A retrograde resection apparatus may include a cutting blade including a slot defined in the cutting blade, a recess defined in at least a portion of the slot, a screw, including a proximal end and a distal end defining a bore therethrough, a shaft having a distal end and a proximal end, wherein the shaft passes through the bore and the distal end is configured to be received in the recess, and a biasing device configured to bias the shaft against the cutting blade. In addition, the apparatus may include a tether, a first portion of which is affixed to the cutting blade and a second portion of which passes through the bore.

Abstract: The shaped output is for use with an ultrasonic surgical tool vibratable in torsional mode. The output has a generally cylindrical first waveguide (1) with, at a distal end a second waveguide extension member (3) of reduced diameter. The second waveguide (3) is curved in one plane from the axis of the first waveguide. It has at least two blade faces (4) extending radially outwardly from its distal end.

Abstract: In one embodiment of the invention, a replaceable electrosurgical end effector cartridge is provided to couple to a mechanical wrist of a surgical instrument for a robotic surgical system. The replaceable electrosurgical end effector cartridge includes two end effectors, a fastener to rotatably couple the two end effectors together, and a cam mechanism. At least one of the two end effectors is a moveable end effector having a jaw portion, an off-center portion, and a base portion. The cam mechanism is coupled to the base portion of the at least one moveable end effector to pivot it about the fastener to open and close the jaw portion of the at least one moveable end effector with respect to the other.

Abstract: A water jet surgical device comprises a fluid feed device, which is controllable by control signals from a control device, for delivering a fluid into a connecting line of a surgical instrument with an outlet nozzle. The fluid feed device includes at least one measuring device, which is configured such that following the connection of the surgical instrument to the fluid feed device, the measuring device generates measuring signals to represent a quantity of fluid delivered. The quantity of fluid delivered may be displayed on a display or recorded in a recording unit. This enables improved monitoring of surgical operations.

Abstract: A minimally invasive skin treatment system includes a platform having a recessed area on its bottom and one or more injection ports orthogonal to its top, each injection port including a through-hole to the recessed area. The system includes an injection device including a needle slidably disposed in a selective port such that the needle passes into the recessed area and percutaneously through a dermis disposed within the recessed area. A nozzle is configured to discharge a fluid at a high pressure in a direction orthogonal to an axis of the needle and parallel to the top of the platform to cut create a plane of dissection within the subcutaneous tissue.

Abstract: A fluid injection device includes a pulse generator which converts fluid into pulse flow, a suction pipe projecting from the pulse generator, an injection pipe which is eccentrically inserted into the suction pipe such that the outer circumferential surface of the injection pipe contacts the inner circumferential surface of the suction pipe, and has an injection opening communicating with the pulse generator, and a suction channel and a suction opening formed between the inner circumferential surface of the suction pipe and the outer circumferential surface of the injection pipe. The injection pipe is fixed to the inner circumferential surface of the suction pipe in the vicinity of the injection opening.

Abstract: A microdebrider comprising: (a) a handpiece; (b) an interchangeable tip connected to the handpiece; (c) an outer tube rotatably connected to the interchangeable tip, the outer tube including an outer tube window; (d) an inner tube extending at least partially through the outer tube, the inner tube including an inner tube window; (e) a lock selector connected to the inner tube; and (f) a bias device; wherein the bias device is movable, and upon movement of the bias device into contact with the lock selector the inner tube is immobilized so that the inner tube window is aligned with the outer tube window, aligned with a wall of the outer tube, or in a condition therebetween.

Abstract: The invention is directed to methods and apparatus for centering a microcatheter within a vasculature. In one aspect, the methods and apparatus can be used to support centering and to facilitate a guidewire to cross through a chronic total occlusion. In one embodiment, the catheter apparatus includes: a microcatheter having a lumen, a distal opening and a distal end; one or more guidewires for passing through the lumen of the microcatheter; an inner shaft having a lumen, a distal opening and a distal end for passing the inner shaft over the microcatheter; an outer shaft having a lumen, a distal opening and a distal end for passing the outer shaft over the inner shaft; and a self-expandable scaffold structure disposed towards the distal end of the inner shaft. The self-expandable scaffold structure is preferably non-occluding thereby allowing blood to flow through the scaffold. Preferably, the inner shaft and microcatheter are capable of being independently operable.

Abstract: Methods and devices for detecting positioning of a probe in a tissue of a patient. A method can include providing a detection device; advancing a device coupled probe through the tissue of the patient and toward the patient's spinal canal; detecting a change in pressure about the distal portion of the coupled probe during advancing, where the detected pressure change indicates probe positioning in the patient's spinal canal; outputting the detected pressure change or indication of probe positioning to a visual display.

Abstract: In various examples, an apparatus includes a needle assembly including an outer cannula including a tubular sidewall disposed around a lumen. At least a portion of the sidewall includes an exterior including a polymeric material configured to inhibit skiving of an interior of a dilator with movement of the outer cannula within the dilator. An inner cannula is disposed within the lumen and is selectively slidable with respect to the outer cannula. A handle is disposed at a proximal portion of the needle assembly. The handle includes a first handle portion coupled to and movable with the outer cannula. A second handle portion is coupled to and movable with the inner cannula, wherein the first handle portion is selectively movable with respect to the second handle portion to extend a distal end of the inner cannula from within the lumen of the outer cannula.

Abstract: A surgical access system comprises a trocar, an insufflating optical obturator slidably insertable into the trocar, and a laparoscope slidably insertable into the obturator. A distal end of the obturator comprises a tip, at least a portion of which comprises a wall with a generally uniform thickness comprising a transparent material. At least one vent hole disposed at the obturator tip is fluidly connected to a gas flow channel defined by an interior surface of the obturator and the laparoscope, which is fluidly connected to an insufflation gas inlet disposed at a proximal end of the trocar. Improved optical characteristics of the trocar system permit precise and accurate visual placement thereof into a body cavity. Accordingly the access system is suitable as a first entry surgical access system. Embodiments of the trocar access are also useful for drug delivery, and/or for fluid and/or tissue aspiration.

Abstract: The present invention generally provides methods and devices for removing fluid from a surgical instrument. Surgical access devices and seal systems are generally provided having one or more valves or seal assemblies to create a closed system between the outside environment and the environment in which the surgical access device is being inserted. In one embodiment, a seal assembly is provided and can include a seal having an opening configured to receive a surgical instrument therethrough and a fluid remover in the form of an absorbent element, a scraper element, a wicking element, or any combination thereof can be associated with the seal and configured to remove fluid from the opening and/or a surgical instrument.

Abstract: Lead extraction is the removal of one or more leads from inside the heart utilizing a lead removal catheter having a tubular sheath that is placed in the blood vessel, either subclavian or femoral. The sheath of the lead removal catheter may accidentally tear or perforate the blood vessel as it is advanced over the lead toward the heart. Such an occurrence must be dealt with quickly to prevent harm to the patient or subject. An expandable member, such as a balloon, attached to the exterior of the sheath of a lead removal catheter can be deployed temporarily adjacent the perforation in the vessel wall. Inflation of the balloon not only stops (or substantially stops) the bleeding, but, upon inflation, the balloon may include one or more channels that allow blood to continue to flow through the channel(s) until the blood vessel perforation can be repaired.

Abstract: The present invention relates to an arched membrane and/or a membrane having rounded edges for regenerating a bone, in particular a distraction membrane, suitable for callus distraction, notably in the jaw region, to the use of the membrane for callus distraction, and to methods for callus distraction.

Abstract: Systems, devices, and associated methods for correcting spinal column deformities that help minimize a number of attachment anchors utilized for correction, facilitate use of straight or contoured rods, and/or help promote a more natural, physiologic motion of the spinal column.

Abstract: Devices, methods and systems for stabilizing at least a portion of the spinal column are provided. Devices include anchors and coupling members for engaging an elongate member. Systems include an elongate member sized to span a distance between at least two vertebral bodies and being at least partially formed of a flexible material. A number of anchors and coupling members are used to secure the elongate member to each of the vertebral bodies. The anchors can be compressed towards one another and the elongate member secured thereto and/or the elongate member can be tensioned to provide corrective forces to the spine.

Abstract: Provided are rod coupler devices, systems, kits and methods, which include at least one saddle having a concave configuration that either abuts a bone fastener and/or a locking cap and is shaped so as to contact the rod in two or more lines of contact, which reduces pressure on the rod, and therefore permits use of a rod having various materials, such as PEEK, without significant deformation of the rod. Also provided is the saddle itself and integrated locking caps that include a saddle, the locking cap and a set screw. Also provided are elongate rods having advantageous shapes, configurations, and/or compositions for rod coupler devices, systems and methods. Further provided are screw and cap devices and systems that themselves include a concave configuration so as to contact a rod in two or more lines of contact, which reduces pressure on the rod.

Abstract: The present invention is generally directed to orthopedic fixation devices that comprise a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element. The orthopedic fixation devices described herein can include modular locking clamp assemblies that can be fixed onto fasteners that are already implanted in bone. The modular locking clamp assemblies can include polyaxial locking clamp assemblies, as well as monoaxial locking clamp assemblies.

Abstract: A fusion implant for a facet joint comprises a bearing module and a fusion module, in which the fusion model is arranged on the bearing module and has a holder for a transfacetal fastener, whereby the bearing module includes an expansion element and jaw elements, which have contact surfaces for the lamina on their outer sides moving away from each other and which are arranged to move longitudinally on a guide, so that the distance of the fusion module is changeable using the expansion element. The bearing module forms a secure and safe anchoring for the fusion module, which can be repositioned. In addition, the bearing module has the effect of an augmentation, and as a result treatment is possible even on vertabrae that are weakened by defects.

Abstract: An intramedullary nail has a posterior side, an anterior side, a proximal portion and a distal portion is described. A transverse bore is arranged in the proximal portion and is configured to receive a bone engagement member. The transverse bore includes at least two recesses formed at an inner wall of the transverse bore, wherein one recess is arranged on the posterior side and the other recess is arranged on the anterior side of the transverse bore of the intramedullary nail.

Abstract: An orthopedic assembly is described that comprises an orthopedic device, an anchor, and a locking mechanism. The orthopedic device can be a plate member having an aperture that is configured to receive the anchor. The anchor can include a head, neck and shank portion. The head portion can include a plurality of arms separated by grooves that are capable of splaying. The assembly is configured such that when the locking mechanism is inserted into the head portion, this causes expansion of the arms of the head. This expansion locks and secures the anchor to the orthopedic device. Various instruments are provided that can deliver the locking mechanism to the anchor, and can provide impact to lock functionality.

Abstract: This system includes a retaining housing formed by a hole intended to receive the anchoring member and a retaining portion arranged on the anchoring member; said retaining housing is arranged in a part having a degree of elastic flexibility and is delimited by a continuous wall of this part; the retaining housing, on the side of a first axial end, forms a first collar forming a continuous circular projection capable of being elastically deformed by the retaining portion arranged on the anchoring member; the wall of said part delimiting the retaining housing also forms, on a second axial end, a second collar not able to be elastically deformed by said retaining portion.

Abstract: The present invention relates to a device for fixation of bone fragments at bone fractures. The device comprises at least two fixation means (5, 6) and a securing plate (4). With the object of preventing or counteracting re-dislocation, the respective fixation means (5, 6) each have a first fixing portion (19) for fixing the fixation gleans in an inner bone fragment (3), a second fixing portion (21) for locking the fixation means to the securing plate (4) which is disposed on the outside of an outer bone fragment (2) and allows movement of the outer bone fragment relative to it, so that the fixation means are prevented from changing their angular position relative to the securing plate and relative to one another, and a middle portion (22) which is situated between the fixing portions and runs through the outer bone fragment, along which middle portion the outer bone fragment can slide inwards towards the inner bone fragment in which the fixation means is fixed.

Abstract: A bone plate has a first frame portion with a plurality of apertures. The apertures may have central axes angled with respect to a bone contacting surfaces adjacent thereto at an angle of other than 90°. The plate has a second plate portion comprising a plurality of apertures therethrough and has a first end connected to the first portion. The plate has a third plate portion having first and second ends respectively connected to a second end of the second plate portion and to the first plate portion at a point thereon closer to a center of the first plate portion than the first end of the second plate portion to the first plate portion. The first, second and third plate portions having an arcuate shape capable of conforming to an arcuate bone surface, the bone contacting surface forming a concave portion of the arcuate shape.

Abstract: A closure system may secure a first bone portion to a second bone portion. The closure system may include a bracket, a band and a tensioning device. The bracket may include a first portion adapted to engage the first bone portion and a second portion adapted to engage the second bone portion. The band may engage the bracket and may be adapted to be looped around the first and second bone portions. The tensioning device may include a body and a threaded member. The threaded member may be received in the body and may engage the band such that rotation of the threaded member relative to the body moves a first end of the band relative to a second end of the band.

Abstract: Techniques are generally described related to a method and system for treating an injury with a bone screw. One example bone screw may be configured to fracture at a pre-selected frangible location so that the point of failure is not in an inaccessible location, e.g., deeply embedded below the surface of a treated bone. The bone screw may further include a material disposed over the frangible location that is designed to temporarily strengthen the screw and selected to be absorbed by the body over a period of time after installation of the screw in the bone. One example bone screw may include an unthreaded portion that is configured to facilitate removal of an embedded screw fragment from a bone in the event that the screw fails in vivo.

Abstract: An orthopaedic implant system includes an orthopaedic implant implantable at a selected location within a corporeal body. The implant includes a first structural material and a second structural material. The first structural material is non-resorbable relative to the corporeal body and is different relative to the second structural material. The implant is an internal fixation device.

Abstract: An improved joint fusion screw for transiliac fixation has an elongate hollow shaft. The hollow shaft has an externally threaded end portion extending to a tip end and a non-externally threaded shank portion having openings. The tip end has at least two bone cutting flutes at the bottom of the shaft. Each bone cutting flute has a cutting edge on a circumferential exterior of the threaded tip to cut bone and direct the cut bone internally into the hollow shaft toward the shank.

Abstract: Methods and apparatus for treating bones, including, in one or more embodiments, methods and apparatus for treatment of vertebral fractures that include a containment assembly for cement containment and/or a balloon assembly for maintaining vertebral height. A containment assembly comprising a containment jacket adapted to be deployed inside bone; and a dividing wall that separates the interior of the containment jacket into a proximal region and a distal region, the dividing wall having an opening for providing access to the distal region from the proximal region.

Abstract: A curable material delivery cannula device and method are disclosed. The device includes a cannula and a hub. The cannula includes an open proximal end and a deflectable distal segment, and a distal orifice(s) fluidly connected to the lumen. When distally extended from the guide cannula, the deflectable segment assumes a curved shape, which may be used to create a void in the bone for receiving curable material. During use, curable material, such as bone cement, is delivered from the distal orifice(s).

Abstract: A driver instrument for engaging and transferring rotational torque to a bone anchor already screwed into a bony structure. The driver instrument may be advanced through an incision while disengaged from the bone anchor and thereafter engaged in a driver socket of the bone anchor. The driver instrument includes an elongate shaft extending distally from a handle, a tapered distal tip, and a driver engagement feature located proximally of the tapered distal tip. The tapered distal tip and the driver engagement feature are configured such that the longitudinal rotational axis of the driver instrument automatically moves into parallel alignment with the longitudinal rotational axis of the bone anchor as the driver engagement feature of the driver instrument is advanced into the driver socket of the bone anchor.