Abstract: A hemostatic clip assembly for mounting on a delivery device comprises a capsule and a clip slidably mounted within the capsule so that, when the clip is drawn proximally into the capsule, arms of the clip are drawn together to a closed position, an abutting surface of at least one of the arms contacting a corresponding surface of the capsule when the clip is drawn to a predetermined position within the capsule to provide a first user feedback indicating closure of the clip in combination with a tension member connected to the clip arms and biasing the clip arms toward an open, tissue receiving configuration and a yoke slidably received within the capsule and releasably coupled to the tension member, the yoke including a ball cavity for receiving a ball connector of a control element of the delivery device to maintain the clip assembly coupled to the delivery device, wherein the control element is frangible to detach the yoke from the delivery device and to provide a second user feedback and, wherein release

Abstract: An anchoring device having an elongate body at a proximal portion, a distal portion of the elongate body forming a loop at a distal portion of the anchoring device. The loop further includes a plurality of anchors disposed along a surface thereof and the loop also including an end effector. Methods for securing anchoring devices of the present disclosure are also disclosed.

Abstract: Methods and devices described herein facilitate improved treatment of body organs and relates to surgical instruments, useful in endoscopic, laparoscopic and/or open surgical procedures to effectively remove a suspect region of tissue such as a polyp, abnormal growth, cyst, tumor, lesion, or other abnormality from a base tissue structure.

Abstract: Surgical staplers include: (a) a stapler head having opposed first and second elongate jaws with opposing proximal and distal end portions; (b) a staple cartridge held in at least one of the first and second jaws, the stapler cartridge configured to concurrently deliver a plurality of parallel rows of staples; and (c) a tissue protection segment held in a proximal portion of at least one of the first and second jaws. The jaws are configured to close against target tissue and, at stapler firing, staples are delivered to a subset of tissue held inside the jaws so that tissue held by the tissue protection segment adjacent the proximal end portion of the stapler is not stapled.

Abstract: A surgical instrument including a handle assembly, an elongated portion, an end effector, and a stop member is disclosed. The end effector is disposed adjacent a distal portion of the elongated portion and includes a first jaw member and a second jaw member. At least one jaw member is movable with respect to the other jaw member between spaced and approximated positions. The first jaw member includes an upper tissue-contacting surface and a lower shelf portion. The shelf portion includes a groove disposed therein. The stop member is disposed adjacent a distal portion of the first jaw member and is pivotable with respect to the first jaw member between a first position, a significant portion of the stop member being positioned external to the first jaw member, and a second position where a lower portion of the stop member being positioned at least partially within the groove.

Abstract: A wound closure device for positioning within a wound gap defined between at least two tissue segments has an effect of drawing the at least two tissue segments to a state of proximity that closes the wound gap. The wound closure device includes a tubular collapsible member having an expanded configuration and a collapsed configuration. The wound closure device further includes tissue engaging structure for attaching the tissue segments to the tubular collapsible member.

Abstract: A flexible tack guide includes a tube with a wall thickness and having a distal end and a proximal end. A threaded insert is joined to an inner perimeter of the tack guide. The threaded insert includes an internally threaded section formed by helical members spaced axially from one another. The tack guide is more flexible towards the distal end and stiffer towards the proximal end. A portion of the guide between adjacent axially-separated cuts defines a link and each of the cuts serves as a joint between adjacent links.

Abstract: Apparatus is provided, the apparatus comprising (i) a housing (22, 222), shaped to define a channel (24, 224) having an anchor-storage zone (26, 226) and an opening (28, 228) configured to provide access for an anchor driver (60) to the anchor-storage zone; (ii) a tissue anchor (40), stored in the anchor-storage zone and slidable through the channel; and (iii) a retaining member (30, 230). The retaining member (a) has a retaining state in which the retaining member is configured to retain the tissue anchor in the anchor-storage zone, and (b) is configured, by moving in response to a proximally-directed force applied to the tissue anchor, to allow the tissue anchor to leave the anchor-storage zone in response to the proximally-directed force. The proximally-directed force is greater than a pre-determined threshold force. Other embodiments are described.

Abstract: A surgical fastener applying apparatus includes anvil (12?) and cartridge half-sections (14?)and a clamping lever. The cartridge half-section defines an elongated channel member having a distal portion for releasably receiving a single use loading unit (SULU) and a proximal portion for supporting a firing assembly. The firing assembly (20?) includes a stationary housing (26?) having a plurality of spaced-apart protrusions (27?) disposed along a length thereof, a firing lever (50), and a cam bar (46). The protrusions are releasably engagable within spaced-apart apertures (17?) defined within the channel member to releasably secure and align the firing assembly within the channel member. The clamping lever is operably associated with the half-sections and is movable from an undamped position to a clamped position to releasably secure an anvil portion of the anvil half-section in close approximation with the SULU.

Abstract: A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Abstract: A staple drive assembly includes an actuation sled and at least one staple pusher. The staple drive assembly is adapted to fit within a staple cartridge having a plurality of staples and a corresponding number of retention slots. The at least one staple pusher includes at least one pusher plate for releasably engaging a backspan of a staple. The staple pusher may include a plurality of pusher plates that may be laterally and longitudinally spaced apart. An actuation member has at least one angled camming surface for engaging a complimentary angled surface of the at least one staple pusher. Camming engagement between the actuation member and the at least one staple pusher causes vertical movement of the at least one staple pusher. Lateral and longitudinal offset of the actuation member camming surfaces and the corresponding staple pusher following surfaces improves stability and control of the staple pusher during firing.

Abstract: A surgical fastener applying apparatus comprising a cartridge section having a cartridge containing a plurality of fasteners and an anvil section having an anvil for receiving the fasteners when advanced from the cartridge. The cartridge and anvil sections clamp tissue therebetween. A cam member is slidable within the cartridge section to fire the fasteners, and is movable from a first position defining a first distance from the anvil to a second position defining a second different distance from the anvil. A cam adjusting member is operably associated with the cam member and moves the cam member from the first position to the second position in response to a thickness of tissue clamped between the anvil and cartridge sections.

Abstract: The present invention includes a surgical stapler having a staple cartridge, an anvil, a cutting member having a cutting surface, and a driver operably engaged with the cutting member to move the cutting member relative to the anvil and the staple cartridge. In at least one embodiment, one of the anvil and the staple cartridge defines a slot which is configured to receive at least a portion of the cutting member and guide the cutting member as it is moved relative to the anvil and the staple cartridge. In these embodiments, the slot can also be configured to receive a portion of the driver operably engaged with cutting member and support the driver when it moves the cutting member. In at least one embodiment, the slot is defined by at least one radius of curvature.

Abstract: Magnetic anastomosis devices constructed from magnetic segments coupled together with members that help the devices spontaneously transform from a linear delivery configuration to a polygonal deployment configuration. When two devices are joined together over tissue(s), the compressive force causes the tissue(s) to necrose and form an anastomosis. By altering the arrangement of the magnetic poles of the magnetic segments in the devices, the magnetic interaction between paired devices can be altered. This property gives surgeons flexibility in choosing how much attractive force the devices will experience during a procedure.

Abstract: An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.

Abstract: A ligation and specimen retrieval device is described for endoscopic use that includes a pouch defining a receptacle and having an open end and a closed end, a first suture member defining a first loop, a second suture member defining a second loop and a closure member positioned about the open end of the pouch. The device is transitionable from a non-deployed state in which the pouch and the first and second loops are positioned within a distal end of an outer shaft of the device to a deployed state in which the pouch and the first and second loops are positioned externally of the outer shaft of the device.

Abstract: A surgical clip applier is provided and includes a handle assembly and an endoscopic assembly selectively connectable to a housing of the handle assembly. The handle assembly includes a housing, a trigger pivotally supported on and extending from the housing, and a drive assembly supported within the housing and operatively actuatable by the trigger. The endoscopic assembly includes a shaft assembly extending from the housing, the shaft assembly including an outer tube and a pair of jaws supported in and extending from a distal end of the outer tube.

Abstract: Implantable devices for placement at a cavity or opening such as an aneurysm are disclosed. The implantable devices, in a deployed condition, have a generally inverted U-shaped profile with a curved or angled framework support structure sized and configured for placement in proximity to tissue surrounding the opening and anchoring legs extending proximally from the framework structure sized and configured to contact the wall of a neighboring lumen at opposed locations. Occlusive and semi-occlusive membranes may be associated with the framework support structure and deployed over the opening to provide exclusion of the opening and flow diversion. Proximal anchoring segments providing additional lumen wall surface area contact for the implantable device following deployment may be incorporated.

Abstract: Devices and methods for treating vascular defects, such as, for example, balloon-type aneurysms, are described herein. In one embodiment, an apparatus includes an insertion portion and an expandable implant. The expandable implant is configured to be deployed in an aneurysm and is coupled to the insertion portion. The expandable implant has a first portion and a second portion coupled to the first portion. The expandable implant is movable between a first configuration in which the first portion and the second portion are substantially linearly aligned and a second configuration in which the second portion at least partially overlaps the first portion.

Abstract: Devices, methods and systems are provided for occluding an opening within the tissue of a body, such as a left atrial appendage. In one embodiment, a delivery system for use in occluding an opening in the tissue of a body includes an actuation assembly operatively coupled to a medical device including an anchor portion and an occluder portion. The actuation assembly is configured to move the anchor portion between a deployed state and retracted state while the occluder portion maintains a deployed state. With this arrangement, the deployed occluder portion can be visualized via imaging at a preferred position prior to deploying the anchor portion of the medical device.

Abstract: Expandable occlusive plugs and methods of using them are disclosed. The devices generally include a tubular body bearing multiple slits defining leaves, which expand radially outward when the ends of the device are brought toward one another.

Abstract: The present disclosure describes an occlusion device and methods of delivering the occlusion device. The occlusion device can include an expandable structure configured to move between an unexpanded configuration and an expanded configuration. The expandable structure can be configured to have an expansion ratio of at least about 5:1. Further, the occlusion device can be configured to prevent substantially all fluid from flowing past the occlusion device when the occlusion device is in the expanded configuration in the vessel.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction., and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Abstract: An orthopaedic surgical instrument comprising an orthopaedic cutting tool includes a metallic cutting insert configured to remove portions of a patient's bone and a body molded to the cutting insert. The cutting insert includes a plurality of chemically etched holes, and the body is molded to the cutting insert such that each of the plurality of chemically etched holes is at least partially filled by a portion of the body. The cutting insert may include a plurality of cutting teeth configured to remove portions of the patient's bone. A method of manufacturing an orthopaedic surgical instrument is also disclosed.

Abstract: Systems and methods to provide patient-specific cutting blocks that allow for bone resurfacing procedures, such as milling or burring, with simplified devices. A computer assisted surgical cutting block is produced having a surface region that matches with the surface region of a patient's bone to be altered. A cutting tool may be provided having a contoured bone mating surface and a contoured and patient-specific shaped cutting guide surface located in a plane above the bone mating surface. One or more channels are provided in the cutting block, and as the surgeon moves the cutting tool (a milling or burring, for example) in the channels, the tool cuts the bone both laterally along the surface of the bone and vertically into the bone according to the cutting guide surface and other preselected surface features of the cutting block.

Abstract: An orthopaedic surgical instrument comprising an orthopaedic cutting block includes a metallic bearing insert configured to support a bone cutting tool and a body molded to the bearing insert. The bearing insert includes a plurality of chemically etched holes, and the body is molded to the bearing insert such that each of the plurality of chemically etched holes is at least partially filled by a portion of the body. The body of the orthopaedic cutting block may include a bone-facing surface adapted to contact a portion of a patient's bone, and the bearing insert may be positioned to allow a surgeon to perform a cut on the patient's bone using the bearing insert for support. A method of manufacturing an orthopaedic surgical instrument is also disclosed.

Abstract: A medical device and method are disclosed which can facilitate maintenance work of a filter for capturing a capturing target, and which can improve operability or convenience in the maintenance work. The medical device has an accommodation unit, an impeller holding unit, and a filter. The accommodation unit accommodates a capturing target which is present inside a living body. The impeller holding unit includes an impeller which causes a fluid to flow from a distal side toward a proximal side inside the living body so as to cause the accommodation unit to aspirate the capturing target together with the fluid. Here, the impeller holding unit is configured to be attachable to and detachable from the accommodation unit on a proximal side of the accommodation unit. The filter is arranged in the accommodation unit and/or the impeller holding unit, and captures at last one or more of the capturing target.

Abstract: A medical device and method are disclosed, which can sufficiently capture a capturing target even if a lumen is deformed. A medical device has an accommodation unit and an impeller holding unit. The accommodation unit includes a lumen which accommodates a capturing target present inside a living body, in which a shape of at least a portion on a distal side is deformable, and whose inner surface before and after deformation is configured to be flat as a whole, a distal opening portion and a proximal opening portion which respectively communicate with the lumen, and a filter for capturing at least one or more of the capturing targets. The impeller holding unit includes an impeller which causes a fluid to flow from the distal opening portion toward the proximal opening portion inside the living body so as to allow the lumen to aspirate the capturing target together with the fluid.

Abstract: A discharge device and method are disclosed that can discharge a discharge substance with a desired discharge amount at a desired flow rate. A storage unit provided in a discharge device includes a storage space which can store a discharge substance, and a discharge section which can discharge the discharge substance stored in the storage space toward the proximal side of a main body in an axial direction, and is configured to be capable of expanding deformation and contracting deformation in response to introduction and discharge of the discharge substance.

Abstract: Catheter systems of the invention are directed to the removal of occlusions, such as thrombi and plaque, within blood vessels. In certain aspects, catheter systems of the invention include an elongate body defining a first lumen and comprising a distal portion, an inner member configured for insertion into the first lumen, the inner member comprising an energy source configured to deliver therapeutic energy to a treatment site; and a dissolution element coupled to the distal portion of the elongate body. The dissolution element may include a heating element, steam, and a balloon.

Abstract: An extracorporeal shock wave lithotripter and a charging and discharging circuit for an extracorporeal shock wave lithotripter are disclosed. The charging circuit is formed by a resistor and a capacitor, and the discharging circuit is formed by the capacitor, a high-voltage switch and a shock wave source apparatus. The capacitance of the capacitor is 1.5 ?F˜2.5 ?F, the pressure peak value of the focus of shock waves generated by discharging to the shock wave source apparatus by the capacitor is 6 Mpa˜30 MPa, a positive pressure period of the bottom pulse width is 3 ?s and a negative pressure period is 5 ?s.

Abstract: Electrosurgical forceps having a clad metal structure and a method of manufacturing electrosurgical forceps using a cladding process are provided. The clad metal structure of the forceps includes a first layer of non-stick material, which may be copper, a copper alloy, silver, or a silver alloy, and a second layer of a material providing good mechanical properties and light weight, which may be aluminum, an aluminum alloy, titanium, a titanium alloy, or stainless steel.

Abstract: Methods for delivering a sheet-like implant to a target site including a means of deploying and orienting the sheet-like implant within the body.

Abstract: A forceps includes an end effector assembly having first and second jaw members movable relative to one another between a spaced-apart position, a first approximated position, and a second approximated position. One or both of the jaw members including a first stop member coupled thereto and disposed between the jaw members. The first stop member is longitudinally translatable along a surface of the at least one jaw member from a first position, wherein the first stop member inhibits approximation of the jaw members beyond the first approximated position, and a second position, wherein the first stop member inhibits approximation of the jaw members beyond the second approximated position.

Abstract: A surgical instrument including a handle assembly, an elongated member, and first and second jaws positioned adjacent a distal portion of the elongated member. At least one of the first or second jaws is movable with respect to the other jaw. A first movable member is movable between first and second positions to effect jaw movement in a grasping action and a second movable member is movable between first and second positions to effect jaw movement in a cutting action. A selector is engageable with the handle assembly and movable from a first position to a second position, wherein in the first position the selector is in blocking engagement with the handle assembly to prevent jaw movement in the cutting action and in the second position the selector is in blocking engagement with the handle assembly to prevent jaw movement in the grasping action.

Abstract: A method, device and system for modifying the gingival margin of a patient is disclosed. A method includes obtaining an electronic model of the dentition of a patient, determining an incision path along the gingival surface based on the electronic model, generating and fabricating a guide arrangement to assist in cutting the gingival surface of the patient, mounting the guide arrangement to the dentition of the patient, and cutting the gingival surface of the patient with the assistance of the guide arrangement. A guide arrangement includes a mounting portion and a template portion coupled to the mounting portion along the gingival surface of the guide arrangement and positioned to provide a desired incision path. A system includes a three dimensional scanner, a computer system and a fabricating device.

Abstract: The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using electrically-induced pressure waves created within a sheath to disrupt vascular blockages via the sheath and/or a tip at the end of the sheath.

Abstract: The present devices and methods relate generally to medical devices and methods for cutting, resecting, excising and/or evacuating tissue from various regions of a patient's body. In particular, devices and methods for cutting and/or removing various tissues, e.g., polyps or endometrium, from a uterus or uterine space are provided. Devices and methods for cutting and/or removing various tissues from the human body, such as during laparoscopic or thoracoscopic surgery, are also provided.

Abstract: A method is disclosed for treating an ultrasonic end effector or surgical blade. The method includes providing an ultrasonic end effector or surgical blade and inducing a residual compressive stress along at least one surface of the ultrasonic end effector or surgical blade. The residual compressive stress may be induced by peening the at least one surface. Such treatment improves the resistance of the ultrasonic end effector or surgical blade to fracture propagation and improves the fatigue life of the ultrasonic end effector or surgical blade. Ultrasonic surgical instruments comprising an ultrasonic end effector or surgical blade treated according to the method are also disclosed.

Abstract: An ultrasonic surgical instrument includes a transducer assembly having a distal engagement member and configured to supply ultrasonic energy. A waveguide defines a longitudinal axis and has a proximal engagement member configured to threadingly engage the distal engagement member. The waveguide is configured to transmit the ultrasonic energy therealong to a distal end thereof for treating tissue. A torque member is coupled to the transducer assembly and is disposed about the longitudinal axis. The torque member is selectively rotatable about the longitudinal axis and relative to the waveguide to threadingly engage the transducer assembly and the waveguide to one another. The torque member includes a plurality of fingers pivotably coupled thereto and movable between a closed position and an open position. In the open position, each finger extends substantially perpendicularly from the longitudinal axis to define a moment arm that facilitates the engagement of the transducer assembly and the waveguide.

Abstract: A dermatological skin treatment device is provided. The device comprises a handpiece and a cutting tool, wherein the tool is inserted through the conduit and percutaneously inserted into a tissue disposed within a recessed area of the handpiece. The device and method cut the fibrous structures under the skin that cause cellulite at an angle substantially parallel to the surface of the skin and replace these structures with a non-cellulite forming structure by deploying a highly fibrous mesh through a single needle hole to create a highly fibrous layer directly or through wound healing processes.

Abstract: Assemblies and methods for scoring a stenotic region within a vessel of a patient are disclosed. An assembly can comprise a scoring member and a deployment member. The scoring member can include an elongate push structure and a tubular, self-expanding scaffold. The elongate push structure can be positioned proximal of the self-expanding scaffold and, at its distal end portion, eccentrically coupled with a proximal end portion of the self-expanding scaffold. The deployment member can be removably positioned within a central lumen of the self-expanding scaffold and detachably engageable with a portion of the self-expanding scaffold. The self-expanding scaffold can be movable between a downsized configuration, when receiving axial tension from the deployment member, and an expanded configuration, in the absence of axial tension.

Abstract: A method and apparatus for treating a clot in the blood vessel of a patient, and particularly the treatment of a pulmonary embolism is disclosed. The treatment includes restoring flow through the clot followed by clot removal, either partially or substantially completely. The clot treatment device is expandable into the blood vessel and may contain radial extensions that assist in restoring flow as well as in removing clot material.

Abstract: Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.

Abstract: An epidural space identification device to identify when a tip of a needle used for epidural anesthesia enters an epidural space that includes a barrel formed in a cylindrical shape and communicatively connected to a needle section, a plunger formed in a cylindrical shape, retractably inserted into the barrel, and having an air hole communicating with an inside of the plunger, and an expansible member having an expansible part provided at a front end part of the plunger and bulging inside of the plunger with a positive pressure generated by pushing the plunger while air discharge from a needle side is regulated.

Abstract: For producing a skin opening for minimally invasive surgery an instrument is employed, comprising a grip (10) and a puncture awl (16). The puncture awl (16) is provided on the distal end of a grip (10), which distal end forms a stop surface (12), which limits the penetration depth of the puncture awl (16).

Abstract: Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.

Abstract: Methods and apparatus are disclosed for a needle comprising a distal shaft and a proximal shaft joined at a junction, the needle having a distal tip which includes an electrode for delivering energy to puncture a tissue, wherein the distal shaft is comprised of a superelastic material. In typical embodiments, the needle includes a lumen for delivering and withdrawing fluids from a treatment site. In some embodiments the junction is comprised of a superelastic material.

Abstract: An extended sole and heel care device with strengthened extended handles to be held in each hand and pulled back and forth in a see-saw motion across the sole or heel of the foot to be used for cleaning, removing dry or calloused skin, or to apply lotions and oils. Centered between the structured ends is a flexible tool holding area where different skin care tools can be placed. The strengthened extended handles allow the tool holding area to drape behind the rear heel at an angle that allows for ease in abrading or cleaning the heel. An abrasive strip can be placed in tool area for rougher skin treatments like callus removal on the sole of the foot, or a soft absorbent pad can be attached for easy lotion application at the rear of the heel.

Abstract: A pedicure assembly includes a housing that has a handle portion and a motor portion. A buffing unit is attached to the housing and the buffing unit abrasively removes calluses. The buffing unit comprises a drive and a head. An abrasive pad is attached to the head and the abrasive pad may be positioned to abut the callus thereby facilitating the abrasive pad to abrade and eliminate the callus.