Abstract: A system for achieving patent hemostasis in arteries of a patient's wrist is disclosed. The system includes a flexible band for enclosure about the wrist at a puncture site. A first and second balloon are coupled to an inner surface of the flexible band. The second balloon is positioned relative to the first balloon such that a distance between the first balloon and the second balloon results in the first balloon being positioned proximal a first artery and the second balloon being positioned proximal a second artery when the flexible band is enclosed about the wrist. Upon inflation of the first balloon and the second balloon, patent hemostasis is achieved on the first artery and occlusive pressure is generated on the second artery.

Abstract: The disclosed technology provides a device for sealing an aperture in a tissue of a body lumen. The device comprises a flexible support member having a base having (i) a central portion and (ii) one or more lateral support portions, to engage and/or hold a sealable member of the device against an interior surface of the tissue when the device is in the sealing position. The lateral support portions provide additional support surfaces to engage peripheral portions of the sealable member against the interior surface of the tissue.

Abstract: A vessel closure device delivery system including a delivery device that couples to a vessel closure clip for delivering the clip onto a blood vessel and a retractable vessel locator is removeably attached to the delivery device, the distal end of the vessel locator being adapted to transition from a collapsed state suitable for insertion into a vessel and an expanded state that lodges against a wall of the vessel from inside the vessel.

Abstract: Surgical controlling systems and methods. A surgical controlling system includes: at least one surgical tool adapted to be inserted into a surgical environment of a human body for assisting a surgical procedure; at least one location estimating unit to real-time locate the 3D spatial position of at least one surgical tool at any given time t; and at least one movement detection unit in communication with a movement's database and with the location estimating means. The system also includes a controller having a processing unit in communication with a controller's database. The controller controls the spatial position of at least one surgical tool.

Abstract: An apparatus may include a handle having a first portion and a second portion. The second portion may extend at an angle from the first portion. The handle may also include a passage configured to receive a medical device therethrough and defined by the first portion. Further, the handle may include an actuator operably coupled to the first portion. The apparatus may also include an endoscopic insertion device coupled to and extending distally of the first portion of the handle. Further, manipulation of the actuator may be configured to deflect a distal portion of the insertion device.

Abstract: Devices for and methods that can be used in endoscopic surgery, and more particularly, devices and methods that can be used for endoscopically applying surgical sealants and other fluids to internal organs and tissues.

Abstract: A surgical access system including a tissue distraction assembly and a tissue retraction assembly, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A system for accessing a surgical target site and related methods, involving an initial distraction system for creating an initial distraction corridor, and an assembly capable of distracting from the initial distraction corridor to a secondary distraction corridor and thereafter sequentially receiving a plurality of retractor blades for retracting from the secondary distraction corridor to thereby create an operative corridor to the surgical target site, both of which may be equipped with one or more electrodes for use in detecting the existence of (and optionally the distance and/or direction to) neural structures before, during, and after the establishment of an operative corridor to a surgical target site.

Abstract: A retraction device that optionally includes a sheath that traverses from outside the body to a body cavity inside the body. The retraction device may include an outer retention ring and a plurality of shapeable extending elements coupled to the retention ring and extending distally therefrom, the extending elements being configured to transition from a first, low-profile, insertion condition to a second, expanded, high-profile retention condition in which distal ends of the extending elements extend radially outwardly. Alternatively, the retraction device may include an outer ring having a substantially annular shape with an adjustable circumference, the outer ring being divided into a plurality of curved ring segments, with a substantially tubular structure extending distally from the outer ring, wherein the diameter of the outer ring is increased by moving the curved ring segments further apart and the diameter is decreased by moving the curved ring segments closer together.

Abstract: A method of tissue fixation, which includes inserting a sleeve into a bone hole. The sleeve includes first and second openings and a length of filament slidably disposed therethrough. The length of filament includes a first free end extending from the first opening of the sleeve and a loop-end extending from the second opening of the sleeve. The method also includes tensioning the loop-end and first free end to secure the sleeve in the bore hole, passing the first free end through tissue at a first location and passing the loop-end through tissue at a second location, and advancing the first free end through a loop defined by the loop-end.

Abstract: Devices, systems, and methods are disclosed for relocating a meniscus horn in a knee. The invention may be deployed during an arthroscopic procedure to apply external forces to a meniscus horn to pull the meniscus into a load bearing area of the knee, which may reduce contact stresses on articular cartilage in the knee and thereby ameliorate pain associated with an osteoarthritic joint. In one embodiment, the system includes a guide needle, suture thread, plug, elongate member, and bone anchor.

Abstract: A device comprising: a flexible tube comprising a first collapsible end portion; a first actuating element segment secured to the first collapsible end portion and extending along the first collapsible end portion, wherein, when the first collapsible end portion is threaded through a first aperture and the first actuating element segment is pulled proximally, the first collapsible end portion collapses proximally and forms a bulge larger than the first aperture, thereby anchoring the flexible tube against a rim of the first aperture.

Abstract: Apparatus is provided for use with a guidewire, the apparatus including a tissue anchor, and a tool for facilitating implanting of the tissue anchor. The tool includes a sheath, and an atraumatic tip, which is removably engaged to a distal end of the sheath, and which is shaped so as to define a body that defines a recess for housing the tissue anchor during guiding of the tool through vasculature of a patient.

Abstract: An anchor device and system for coupling soft tissue to osseous tissue includes a stopper member that supports a loop of suture material. A fixing member includes features that allow it to be rigidly coupled to surrounding bone and thus hold the stopper member in a cavity within the bone. The loop of suture material, in turn, supports a second suture device, which is coupled to, and thus retains, the soft tissue. In certain embodiments, the stopper member includes a mechanical linkage for coupling it to the fixing member, and surface features that resist withdrawal of the fixing member from the bone.

Abstract: A hand-held, surgical suturing device that can be operated and manipulated with one hand. The device has a suture spool that can be locked The device can rotate in either direction. It is configured to accept at least two different types of needles, a single hook needle and a corkscrew needle useful in different suturing applications. These needles can be supplied in different sizes and shapes. The needle, suture spool and needle carrier are typically supplied in sterile packages and are disposable. A first embodiment has a triangular-shaped squeeze handle that, when squeezed, causes the needle to rotate. A second embodiment has a cylindrical handle for manual stitching where the needle can be released to freely rotate by pressing a control button. In either embodiment, the suture spool can be locked or allowed to rotate freely by activating a releasing rod.

Abstract: A handle assembly for operating a surgical instrument is provided and includes a housing; a trigger operatively supported on the housing; and an articulation assembly supported on the housing for effectuating an articulation of an end effector operatively connected to the housing, the articulation assembly being operable to effect articulation of the end effector in a first pair of opposed directions and a second pair of opposed direction which is substantially transverse to the first pair of opposed directions.

Abstract: A device for suturing an anatomic valve can comprise an elongate body, a suture catch mechanism and a suture clasp arm. The suture catch mechanism can be operatively coupled to the elongate body for movement between a retracted position and an advanced position. The suture clasp arm can be attached to the elongate body for movement between a retracted position and an extended position. The suture clasp arm can comprise a suture clasp configured to releasably retain a suture portion. In some embodiments, the suture clasp is positioned on the suture clasp arm such that the suture catch mechanism retrieves the suture portion from the suture clasp arm while the arm is at least partially retracted. In some embodiments, the suture clasp arm can be closed about a tissue portion without damaging the tissue portion.

Abstract: A surgical stapling apparatus is disclosed which comprises a shaft, an end effector, and an articulation joint, wherein the end effector is rotatable relative to the shaft about the articulation joint. The stapling apparatus further comprises a firing drive responsive to an input, an articulation drive, and a switch assembly configured to selectively couple the articulation drive to the input. In various instances, the switch assembly is configured to lock the articulation drive in position when the articulation drive is not coupled to the input.

Abstract: A surgical instrument can include a shaft, an end effector, and an articulation joint configured to permit the end effector to rotate relative to the shaft about the articulation joint. The surgical instrument can further comprise a first articulation actuator for rotating the end effector in a first direction and a second articulation actuator for rotating the end effector in a second direction. The articulation actuators can be configured to push the end effector. The articulation actuators can assume different configurations depending on whether they are experiencing a compressive load or a tensile load. The articulation joint can comprise an articulation frame which forms a proximal joint with the shaft and a distal joint with the end effector. The joints can comprise fixed axis joints and/or ball-and-socket joints, for example. The articulation joint can comprise links having different sizes to facilitate the articulation of the articulation joint.

Abstract: A surgical stapling apparatus is disclosed which comprises a shaft, an end effector, and an articulation joint, wherein the end effector is rotatable relative to the shaft about the articulation joint. The stapling apparatus further comprises a firing drive responsive to an input, an articulation drive, and a switch assembly configured to selectively couple the articulation drive to the input. The switch assembly is configured to lock the articulation drive in position when the articulation drive is not coupled to the input.

Abstract: A surgical instrument that includes an elongate channel that is configured to operably support a surgical staple cartridge therein. In at least one form, an anvil is pivotally coupled to a proximal end of the elongate channel such that the anvil is pivotal about a discrete, non-movable anvil axis defined by the elongate channel. A firing member is configured for axial travel within the elongate channel in response to an application of firing motions thereto. The firing member is configured to movably engage the anvil and the elongate channel to space the anvil relative to the elongate channel at a desired spacing as the firing member is axially driven through the elongate channel. A closure member is configured to move the anvil from an open position to closed positions relative to the elongate channel upon application of closure motions to the closure member.

Abstract: A surgical instrument that includes a surgical end effector that is coupled to a shaft assembly by an articulation joint. A flexible firing beam extends through the articulation joint to interface with a firing member in the surgical end effector to apply a firing motion thereto. In at least one form, a pair of firing beam support members flank the flexible firing beam across the articulation joint. The firing beam support members are movably coupled together to prevent lateral movement away from each other in directions transverse to a shaft axis that is defined by the shaft assembly while permitting the firing beam support members to move axially relative to each other.

Abstract: A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

Abstract: A surgical instrument that includes a surgical end effector that is coupled to a shaft assembly by an articulation joint. A flexible firing beam extends through the articulation joint to interface with a firing member in the surgical end effector to apply a firing motion thereto. In at least one form, the surgical instrument further includes a movable firing beam support assembly that is configured to movably contact the firing beam on each lateral side thereof as the firing beam flexes about the articulation joint.

Abstract: A surgical instrument. In one form, the surgical instrument includes a housing that has an interchangeable shaft assembly removably attached thereto. The interchangeable shaft assembly includes an elongate shaft that has a surgical end effector operably coupled thereto for selective articulation relative to the elongate shaft. An articulation system is configured to selectively apply articulation motions to the surgical end effector when the articulation system is in an actuated orientation. A locking arrangement prevents detachment of the interchangeable shaft assembly from the housing when the articulation system is in the actuated orientation.

Abstract: A surgical instrument is disclosed. The surgical instrument can include an end effector, comprising an anvil and a staple cartridge. The surgical instrument can further include a shaft defining a longitudinal axis. The surgical instrument can also include an articulation joint, wherein the end effector is rotatably connected to the shaft about the articulation joint between an unarticulated position and at least one articulated position. The surgical instrument can include means for adjusting the length of a firing stroke as a function of the degree in which the end effector is articulated relative to the longitudinal axis. The surgical instrument can include a sensor configured to defect shifting of lateral portions of a flexible firing bar that extends through the articulation joint. Additionally or alternatively, the surgical instrument can include a relief feature configured to accommodate shifting of lateral portions of a flexible firing bar.

Abstract: A shaft assembly for a surgical instrument that includes a movable drive member. In at least one form, the surgical instrument includes a spine assembly that is couplable to the surgical instrument and has a surgical end effector coupled thereto by an articulation joint. The shaft assembly in one form includes a proximal firing member and an intermediate firing member that is coupled to a distal firing member. The distal firing member is configured for selective travel through the surgical end effector. At least one articulation driver is coupled to the surgical end effector to apply articulation motions thereto. A clutch assembly interfaces with the primary and intermediate firing members and the articulation driver such that when in an articulation orientation, movement of the drive member results in movement of the articulation driver and when in a firing orientation, movement of the drive member results in movement of the intermediate and distal firing members.

Abstract: The invention provides improved devices, systems, and methods for tissue approximation and repair at treatment sites. The invention provides devices, systems, and methods that may more successfully approximate and repair tissue by improving the capture of tissue into the devices. The invention may be a one-way mechanism that allows tissue to enter the mechanism but not easily exit, such as a leaf-spring, a protrusion, a pivoting arm and one or more frictional elements.

Abstract: The invention provides a surgical fastener. The fastener has a first element defining an axis of the fastener, and or more prongs attached to the first element at hinge regions. Deploying the fastener involves bending the prongs at the hinges so as to increase the distance of the prong tips from the axis and locking the fastener in this deployed configuration. The invention also provides a surgical fastening device and a method for attaching a surgical fastener to a site of a body tissue.

Abstract: An occlusion clip comprising: (a) a first elongated occlusion arm; (b) a second elongated occlusion arm; (c) a first elongated biasing arm coupled to a distal portion of the first elongated occlusion arm; (d) a second elongated biasing arm coupled to a distal portion of the second elongated occlusion arm, where a proximal portion of the first elongated biasing arm is coupled to a proximal portion of the second elongated biasing arm, where the first elongated occlusion arm extends parallel to the first elongated bias arm along a majority of its length, and where the second elongated occlusion arm extends parallel to the second elongated bias arm along a majority of its length.

Abstract: An apparatus for assisting with wound closure includes oppositely disposed, and oppositely facing, proximal and distal surfaces separated by an apparatus body. The distal surface is configured for selective attachment to a patient tissue surface. At least one of the proximal surface, the distal surface, and the apparatus body is made substantially from an polymeric material. The polymeric material includes a structurally incorporated ability to self-repair damage caused by mechanical usage over time. A method of assisting with wound closure is also provided.

Abstract: A surgical instrument that includes jaw members, at least one of which may be moved to closed positions relative to the other jaw member upon actuation of a closure actuator. Actuation of the closure actuator causes an axially moveable closure member to apply closure motions to at least one of the jaw members. In at least one form, the closure actuator includes a first actuator portion that is configured to move through a first range of axial travel upon actuation of the closure actuator. A second actuator portion interfaces with the axially movable closure member such that upon actuation of said closure actuator, the second actuator portion moves the axially movable closure member through a second range of axial travel that is greater than the first range of axial travel.

Abstract: In one general aspect, various embodiments of the present invention can include a motorized surgical cutting and fastening instrument having a drive shaft, a motor selectively engageable with the drive shaft, and a manual return mechanism configured to operably disengage the motor from the drive shaft and retract the drive shaft. In at least one embodiment, a surgeon, or other operator of the surgical instrument, can utilize the manual return mechanism to retract the drive shaft after it has been advanced, especially when the motor, or a power source supplying the motor, has failed or is otherwise unable to provide a force sufficient to retract the drive shaft.

Abstract: A surgical stapling instrument including a staple sled which can be advanced and/or retracted relative to first and second jaw members, wherein the staple sled can be configured to deploy staples from a staple cartridge in one of the first and second jaw members. In at least one embodiment, the other of the first and second jaw members can include an anvil having at least one forming surface which can be configured to deform the staples as they are deployed from the staple cartridge. In at least one form of the invention, the anvil can be movably adjustable relative to the staple cartridge in order to adjust the distance in which the staples are deformed. In various embodiments, the anvil can be adjusted by a slidable adjusting plate and/or a rotatable cam.

Abstract: A device and method for supporting a joint formed by first and second patient tissue structures are provided. A device body includes a band having a first band end and a second band end laterally separated by a band length. The first and second band ends are configured for selective mutual interconnection. A top band portion and a bottom band portion are longitudinally separated by a band height. An inner surface of a device body is directly adjacent to the joint and is attached to at least one of the first and second patient tissue structures during use. An outer surface of the device body, oppositely facing from the inner surface, includes a semi-permeable membrane. The membrane permits liquid to penetrate therethrough in a first direction from the outer toward the inner surface. The membrane substantially prevents liquid from penetrating therethrough in a second direction opposite the first direction.

Abstract: The invention provides an anastomosis device for joining together hollow lumens or viscera, the device being suitable for being deployed at the surface of two superposed adjacent lumens, said device comprising a main tubular body of longitudinal axis (L), having first and second open ends and opposite outside and inside faces, said main tubular body comprising at least three columns of loops and at least three rows of loops.

Abstract: The present disclosure provides annular support structures for use in conjunction with stapling devices. These annular support structures may be suitable for reducing occurrences of leaking, bleeding and/or stricture, as well as anastomotic tension, when anastomosing various body structures.

Abstract: This application is directed to a surgical stapling device for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.

Abstract: An occluding device for occluding fluid flow through a lumen of a body vessel. The device comprises a coil and fibers attached to the coil. The coil has about 5 to 60 grams of initial tension to facilitate the coil to fold when deployed. The fibers extend from the coil at a length.

Abstract: A device for at least partially occluding an aneurysm is disclosed. The device includes a first elongate member having a distal end. A bridge is positioned proximate the distal end and transformable between a delivery configuration and a deployed configuration. A second elongate member is movable relative to the first elongate member, the first and second elongate members being configured such that one can be moved relative to the other in order to transform the bridge between the delivery and deployed configurations.

Abstract: Methods and systems for regulating aortic regurgitation during aortic valve replacement or repair procedures utilize a temporary aortic valve (TAV) catheter and a controller. The temporary aortic valve catheter has an expandable occlusion device which can partially occlude the aortic lumen during ventricular diastole with a lesser occlusion during ventricular systole. Exemplary balloon structures include multiple, independently inflatable balloons which are inflated in synchrony with the cardiac cycle by the controller. By controlling aortic regurgitation, the repair or replacement protocols can be conducted with less interference from blood flow.

Abstract: Disclosed herein are patient-specific cutting guides for guiding a surgical instrument for resecting a portion of a glenoid of a patient. The cutting guides include a base portion having a contact surface shaped to substantially match at least a portion of a cavity of the glenoid. The base portion has a guide hole extending therethrough in which the guide hole has an axis coaxial with an axis of rotation. The cutting guides include one or more stabilization members extending outwardly from the base portion and having a contact surface shaped to substantially match an outer surface of a portion of a scapula of the patient. The stabilization members are oriented to take into account the patient's anatomy in orienting and stabilizing the guide with respect to the glenoid. The guide hole of the base portion is for guiding the surgical instrument to create a guide hole in the glenoid.

Abstract: This invention is a device and a method for preparing a knee joint for a prosthesis in a patient undergoing TKA surgery for any knee implant (prosthesis). The device and the method are used in a universal and an open platform fashion for any currently available knee implant, all patient specific implants and any knee implants that could be produced in future. The device is a patient specific instrument, which is based on a method comprising of image based (CT, MRI or computed X-ray) 3-D preoperative planning to design the templates (PSI) that are used to perform the knee surgery for any knee implant in a universal and open platform fashion.

Abstract: A balloon suction catheter may be used to remove clots and increase blood flow to obstructed vessels such as a cerebral artery in a stroke patient. The catheter may be used to apply suction on the clot while providing flow arrest, embolic protection, and optionally flow reversal. The same catheter may also be used to provide for a flow modulation procedure known as post-conditioning to potentially reduce any damage from the sudden reintroduction of blood flow reperfusion injury.

Abstract: The devices and methods described herein relate to jointless construction of complex structures.

Abstract: A surgical instrument comprising a shaft (1) on which a first handle (3) is formed, a pushing part (2) which is actuated by a second handle (4), and a force accumulator for returning the pushing part (2), wherein the force accumulator and the pushing part (2) are integrally formed.

Abstract: Devices, systems, and techniques are disclosed for intelligent semiconductor based medical tweezers and instrumentation including microscale sensors, actuators and circuitry for tissue detection and characterization. In one aspect, a tweezer device includes a hinge structure to enable tweezing motion of the device for clamping a sample, two leg components coupled to the hinge structure, a plurality of microprobes configured on both of the two leg components, and an electronic circuit electrically coupled to the microprobes to process and/or transmit the electronic signals. The microprobes include sensors in a sensing tip structured to penetrate into the sample when the device clamps the sample and produce electronic signals from the sensors of a property of the sample, the sensors of the sensing tip including at least one of an electrode to measure an electrical potential, an electrical permittivity sensor to measure electrical permittivity, or a strain gauge to measure mechanical compliance.

Abstract: A surgical tool can include a main unit and a first rigid sheath. The main unit includes an inner tube that is received within an outer tube. The first rigid sheath removably receives the main unit and connects to the main unit via a coupling between a first connector portion of the main unit and a second connector portion of the rigid sheath. The first rigid sheath can be completely removed from the main unit when the first connector portion is decoupled from the second connector portion. A different rigid sheath having a different shape from the shape of the first rigid sheath can then be removably attached to the main unit instead of the first rigid sheath. A surgical tool kit includes a plurality of rigid sheaths having different shapes and having the ability to be removably attached to the main unit.

Abstract: In an ultrasonic probe, an insulation layer portion is formed on an outer surface of a probe main body portion. A first electrode portion provided on an outer surface of the insulation layer portion so that at least part of the first electrode portion is exposed to an outside in a treatment section, and at least part of a second electrode portion is exposed to the outside in the treatment section. The second electrode portion is electrically insulated from the first electrode portion by the insulation layer portion. The probe main body portion vibrates integrally with the insulation layer portion, the first electrode portion and the second electrode portion.

Abstract: A surgical apparatus comprises a body, a shaft assembly, and an end effector. The end effector comprises a clamp arm and an ultrasonic blade in acoustic communication with an ultrasonic transducer via an acoustic waveguide that extends through the shaft assembly. The clamp arm is configured to pivot about a first pivot point toward and away from the ultrasonic blade along a first angular path from a first position to a second position to thereby provide a tissue sealing mode of operation. The clamp arm is further configured to pivot about a second pivot point toward and away from the ultrasonic blade along second angular path from the second position to a third position to thereby provide a tissue cutting and sealing mode of operation. The second pivot point is proximal to the first pivot point.