Abstract: Disclosed is a method for digitally designing at least two attachment abutments, each attachment abutment comprising an implant connection section adapted for connection to a respective implant along an implant axis, a transition section separating the implant connection section and an attachment section, wherein the attachment section is adapted for receiving a mating part.

Abstract: Provided is a method for quickly producing a dental prosthesis with a good accuracy. The method for producing a dental prosthesis including: a melting step of melting a material including no less than 60.0 mass % and no more than 80.0 mass % of SiO2, no less than 10.0 mass % and no more than 20.0 mass % of Li2O, and no less than 5.1 mass % and no more than 10.0 mass % of Al2O3; a glass blank production step of cooling to solidify the molten material to obtain a glass blank; a lithium disilicate blank production step of heating the glass blank to obtain a lithium disilicate blank whose main crystalline phase is lithium disilicate; and a processing step of processing the lithium disilicate by machining.

Abstract: A dental cleaning system includes a cylindrical body with a first portion and a second portion. A cleaning portion is positioned within the second portion and includes a cavity to enable the cleaning portion to at least partially enclose a dental implant device. The cylindrical body rotates such that the cleaning portion therein rotates to clean at least a portion of the dental implant device. A projection extends outwardly from a surface of the cleaning portion such that the projection is positioned within the cavity. The projection removes debris from at least a portion of the dental implant device when the cylindrical body rotates. A plurality of cleaning protrusions extend outwardly from a sidewall of the cavity such that the cleaning protrusions at least partially circumscribe the projection. The cleaning protrusions remove the debris from at least a portion of the dental implant device when the cylindrical body rotates.

Abstract: An instructional, electronic toothbrush having an audio unit with a speaker for playing audio stored on a storage medium. The audio unit is operably coupled to a song playing system positioned in an interior compartment within the toothbrush. The system includes a computer processing unit (CPU) having a memory configured to store an instructional song that teaches the proper technique when brushing teeth. When a power switch is actuated on the toothbrush, the CPU relays the song stored on the memory to the speaker, which sounds the instructional song repetitively. A timer operably coupled to the audio unit stops the speaker from sounding the instructional song once two minutes have elapsed. In this way, children brushing their teeth to the instructional song using the present instructional toothbrush can be provided guidance on how to properly brush their teeth for the American Dental Association's recommended time period of two minutes.

Abstract: The invention relates to a light curing appliance, in particular a dental light curing appliance (10), with a light source and with a light emission element such as an optical waveguide (12), of which the light output end is intended in particular to be directed towards a material that is to be polymerized. It is provided with one or more control devices (16) for switching on the light source during a polymerization cycle, and with one or more sensors (20) or sensor combinations connected to the control devices (16). The sensor (20) is designed as a location sensor and/or as a motion sensor (20) which detects a movement of the light curing appliance (10), designed as a hand-held appliance, and sends signals reproducing the motion to the control devices (16).

Abstract: A teeth whitening appliance (10) such as a tray includes a seal member (18) which is attached to an interior surface (19) of the tray. The seal member comprises a fabric strip or a gecko adhesive strip which extends around the periphery of the interior surface of the tray adjacent the peripheral or boundary edge thereof. The seal member adheres to the teeth, so as to prevent gel from escaping from the tray when the tray is in place, as well as preventing water/saliva in the mouth from entering the tray, while also being convenient to remove.

Abstract: A system and related methods thereof involving self-administration of an agent to an animal. In certain embodiments, the system comprises an enclosure for the confinement of an animal; a sensor that produces a signal when purposefully activated by the animal in said enclosure, wherein the purposefully activation defines a first behavior of the animal that is located at a first behavior location; and an agent dispenser that is configured to provide the agent in the enclosure in response to the sensor being purposefully activated, wherein the agent is provided remotely from the first behavior location so as to require the animal to travel to the remotely provided agent at a remote provision location, wherein the traveling defines a second behavior of the animal. The system and related methods thereof can be used to provide a model system to evaluate the behavioral and/or physiological response(s) to a self-administered agent.

Abstract: A bioresorbable implant and associated method for use in conjunction with septoplasty procedure comprises a thin, at least partially flexible mesh sheet constructed with struts of material intersecting at points defining openings entirely through the mesh sheet, and wherein the sheet defines a plane with opposing side surfaces. A plurality of projections extend away from the sheet on both side surfaces thereof. The openings through the mesh sheet have minimum dimensions in the range of 2 to 8 mm, and the projections have a length in the range of 1 to 5 mm. The openings in the mesh sheet may define regular polygons, whereby the struts may have minimum dimensions in the range of 2 to 8 mm. The projections may extend from the intersections of the struts, directly from the struts, or both from the intersections and the struts. A method of performing septoplasty in accordance with the invention is also disclosed.

Abstract: Described are implants, tools, and methods useful for treating pelvic conditions such as prolapse, by placing an implant to support pelvic tissue, the implants, tools, and methods involving one or more of an insertion tool that works in coordination with a sheath, adjusting engagements, specific implants and pieces of implants, placement of implants at locations within the pelvic region, and insertion, adjusting, and grommet management tools.

Abstract: Drug delivery devices include a flexible elongate body having a bladder end portion, a kidney end portion, and a drug lumen extending therebetween; and a drug reservoir which is located at the bladder end portion, contains a drug, and is defined at least in part by a semi-permeable wall. Methods include inserting the device into the ureter of a patient and permitting water in the bladder to diffuse through the semi-permeable wall to create an osmotic pressure to pump the drug through the drug lumen and out of the device at the kidney end portion and into the renal pelvis.

Abstract: A stent and associated method maintains a lacrimal duct in an open, unobstructed state following DCR. The self-expanding, bioresorbable tubular structure has a diameter in the range of 5-8 mm and a length in the range of 4-8 mm following self-expansion. A mesh structure includes struts interconnected through shape-memory hinge regions that open to facilitate expansion. The structure may assume an hour-glass form having a necked-down waist region and flared opposing end regions following expansion to assist in maintaining the stent in position. The stent is compressed to a diameter in the range of 1-3 mm, loaded into an inserter tool, and positioned into a lacrimal duct having an inner wall. The stent is inserted into the lacrimal duct, whereby the stent self-expands into a structure that conformally applies outward pressure to the inner wall of the lacrimal duct to hold open the duct, and the inserter tool is removed.

Abstract: Methods and devices for dilating a stricture of a body lumen are disclosed. In some embodiments, a device for dilating a lumen of a body comprises an elongate member having a proximal end and a distal end and an inflatable scaffold member disposed on the distal end of the elongate member, the inflatable scaffold member defining a lumen. In some additional embodiments, the device may further include an inflation member in fluid communication with the lumen of the inflatable scaffold member. Additionally, in some embodiments, the inflatable scaffold member is frangibly connected to the inflation member.

Abstract: A nephroureteral catheter is provided that comprises a detachable portion such that when the detachable portion is removed, the catheter converts into an internal stent. The catheter includes a tube with two retention features, a detachable portion, and an inner tube. The inner tube is removably insertable into both the tube and the detachable portion, and a wire extends through at least a portion of a lumen of the inner tube and through the tube, to keep the pieces attached. The wire may be removed to remove the inner tube and then the detachable portion from the tube. When the detachable portion is attached to the tube, the catheter is a nephroureteral catheter. When the detachable portion is removed from the tube, the catheter becomes a stent.

Abstract: An orthotopic artificial bladder endoprosthesis includes a base obtained with a multi-layered silicone membrane having an external surface and an internal surface both coated with pyrolytic turbostratic carbon; a resorbable cap obtained with a PGA fiber fabric, the base and the cap being connected with each other along respective edges to define a closed enclosure; the base is connectable to the urethra and to the ureters of a patient; the base also being of substantially triangular form.

Abstract: A graft device for a mammalian patient comprises a tubular conduit and a fiber matrix surrounding the tubular conduit. The fiber matrix can comprise one or more polymers delivered by an electrospinning device. Systems and methods of creating a graft device are also provided.

Abstract: A crimping tool is provided, where the tool comprises a mandrel (1) having a first portion (3) with a first outer diameter, and a second portion (5) with a second outer diameter which is greater than the first outer diameter. A chamfered abutment face (7) is provided between the first and second portions (3,5). At least one first collar (9) is mountable on the first portion (3) of the mandrel (5) and has a chamfered first end (11) which in use abuts the abutment face (7). At least one second collar (13) is mountable on the second portion (5) of the mandrel (1) and has a chamfered second end (15) which in use abuts the first end (11) of the first collar (9). A method of using the tool to form one or more crimps in a piece of fabric is also disclosed.

Abstract: A combination double-barreled and debranching stent graft and methods for its use, where the stent graft comprises, a main body stent graft defining a single lumen with distal and proximal ends, a first bifurcation in the main body defining first and second lumens, the main body stent graft defines a tubular wall that is contiguous with the first and second lumens such that any fluid entering the main body stent graft must exit by entering one of the first or second lumens, (c) a second bifurcation within the first lumen defining a first leg and a second leg, (d) a third bifurcation within the first leg defining a third leg and a fourth leg, and (e) a fourth bifurcation within the second leg between about 10 mm and about 20 mm distal from the second bifurcation defining a fifth leg and a sixth leg.

Abstract: The disclosure describes implantable medical products, that include dry or partially hydrated biocompatible constructs comprising collagen fibers configured to expand in situ after implantation to frictionally engage a bone tunnel wall to thereby affix the construct in the bone tunnel.

Abstract: A variety of configurations of implant management devices are provided. The configurations provide different combinations of features for maintaining a location of an implant with respect to the device and managing filaments of the implant. One exemplary embodiment of a device includes a generally rectangular-shaped body having an implantable body retainer, an opening disposed a distance apart from the retainer and configured to receive a ligament graft therein, and a fold extending across the body and intersecting the opening. Folding one end of the body towards a bottom surface of the body along the fold can form a filament loop engaging region to hold in tension a filament loop extending from the implant. Additional filament(s) associated with the implant can be managed by various filament retention features. Methods for preparing a ligament graft for implantation by relying upon indicia formed on a surface of the device body are also provided.

Abstract: An IOL includes an optic configured to be positioned along the optical axis of a patient's eye and a plurality of haptics extending from a periphery of the optic. Each of the plurality of haptics includes a proximal region extending from the periphery of the optic, an intermediate region extending from a distal end of the proximal region, and a distal region extending from a distal end of the intermediate region. The thickness of the distal region of each haptic is greater that the thickness of the intermediate region.

Abstract: Implantable reservoir structures include an interior and/or exterior modifying element joined to the interior and/or exterior surface of the membrane defining the reservoir in order to alter one or more physical properties thereof. The physical properties can be mechanical (e.g., material strength, flexibility, shear modulus, Young's modulus, hardness, and/or ductility); optical (e.g., refraction, transparency, transmission spectrum, absorption spectrum, fluorescence spectrum, and/or color); and/or permeability to liquids generally or to a particular type of liquid, solute, or suspended material.

Abstract: An apparatus for inserting a lens into an eye includes a handle portion having a proximal end and a distal end, an inserter head assembly slidably coupled to the distal end of the handle portion, a plunger sleeve securely coupled to the handle portion, an actuation sleeve securely coupled to the inserter head assembly, and a plunger coupled to the plunger sleeve and slidably received through the inserter head assembly, wherein the plunger includes a mounting post at a distal end for mounting the lens and a proximal or a distal movement of the actuation sleeve axially extends or retracts the inserter head assembly relative to the plunger. In accordance with other aspects of the present disclosure, an inserter head assembly for a lens insertion apparatus includes a mounting cap and a plunger having a mounting post configured for securing a lens thereon.

Abstract: A preloaded injector for storing and injecting hydrophobic intra ocular lenses (IOL) comprises a plunger (2), an injector body (12), an adapter (16), a rotatable member (18), a cartridge (20) with a nozzle tube (22) and a stopper (26). The rotatable member (18) is provided around the cartridge (20) for setting the cartridge (20) from an open position to a closed position. The rotatable member (18) is furnished with a portion interfering with a portion of the stopper (26) keeping the stopper (26) irremovable in its first position but releasing the stopper (26) in its second position.

Abstract: In one representative embodiment, a heart valve repair device comprises a plurality of prongs which are configured to torque a native heart valve leaflet to create a fold in the native heart valve leaflet.

Abstract: A valve prosthesis includes an expandable frame comprising an outflow portion and an inflow portion connected to the outflow portion. The frame defines a central lumen extending between the outflow portion and the inflow portion. The frame is generally cylindrical in a fully expanded configuration. When the frame is in the fully expanded configuration, an outer surface of the inflow portion is concave. The inflow portion has an upper inflow portion and a lower inflow portion. When the frame is in the fully expanded configuration, the upper inflow portion flares outwardly from the central lumen of the frame to greater extent than the lower inflow portion.

Abstract: An implant capsule (10) and an implant delivery system are disclosed. The implant capsule (10) includes, sequentially from a proximal end to a distal end, a flexural section (102, 102a-102e), a reinforcement section (101, 101a-101e) and a radiopaque reinforcement ring (104a-104e). The reinforcement section (101, 101a-101e) has higher strength than the flexural section (102, 102a-102e). The implant delivery system includes the implant capsule (10). The implant capsule (10) can ensure the implant to be deployed in a coaxial condition and prevent over-expansion due to large expansion forces exerted by a stent of the implant.

Abstract: Embodiments of the present disclosure provide a prosthetic heart valve and a heart valve delivery apparatus for delivery of the prosthetic heart valve to a native valve site via the human vasculature. The delivery apparatus is particularly suited for advancing a prosthetic valve through the aorta (i.e., in a retrograde approach) for replacing a diseased native aortic valve. In one embodiment, a self-expanding valve comprises an expandable stent that is shaped to maintain the valve in the aortic annulus against axial without anchors or retaining devices that engage the surrounding tissue. A delivery apparatus for delivering s self-expanding prosthetic valve can be configured to allow controlled and precise deployment of the valve from a valve sheath so as to minimize or prevent jumping of the valve from the valve sheath.

Abstract: The present disclosure describes tissue gripping devices, systems, and methods for gripping mitral valve tissue during treatment of a mitral valve and while a tissue fixation device is implanted in the mitral valve. The tissue gripping device includes a flexible member and one or more tissue gripping members coupled to one or more arms of the flexible member. The flexible member is formed from a shape-memory material, such as nitinol, and the tissue gripping member(s) are formed from a material that is more rigid than the shape-memory material. The tissue gripping member(s) are attached to the flexible member by threading or looping suture lines around and/or through the tissue gripping member(s) and the flexible member and/or by applying a cover material to the tissue gripping device to hold the tissue gripping member(s) against the flexible member.

Abstract: Various embodiments of implant systems and related apparatus, and methods of operating the same are described herein. In various embodiments, an implant for interfacing with a bone structure includes a web structure, including a space truss, configured to interface with human bone tissue. The space truss includes two or more planar truss units having a plurality of struts joined at nodes. Implants are optimized for the expected stress applied at the bone structure site.

Abstract: Various embodiments of implant systems and related apparatus, and methods of operating the same are described herein. In various embodiments, an implant for interfacing with a bone structure includes a web structure, including a space truss, configured to interface with human bone tissue. The space truss includes two or more planar truss units having a plurality of struts joined at nodes. Implants are optimized for the expected stress applied at the bone structure site.

Abstract: A device for containing a graft material includes an outer member formed via an outer mesh sheet biased toward a coiled configuration in which the outer mesh sheet is coiled about a longitudinal axis thereof so that, when the outer member is positioned about separated portions of a target bone in an operative position, the outer member reverts to the coiled configuration and contracts about and engages the separated portions. The device also includes an inner member formed via an inner mesh sheet coiled about a longitudinal axis thereof. The inner member is movable between a first biased coiled configuration and a second coiled configuration. A diameter of the inner member in the first coiled configuration is larger than a diameter of the inner member in the second coiled configuration.

Abstract: A device for containing bone graft material includes a mesh outer sleeve extending longitudinally from a proximal end to a distal end and sized and shaped to correspond to a profile of an outer surface of a target bone. The outer sleeve includes a longitudinal slot extending along a length thereof. The device also includes a mesh inner sleeve connected to an interior surface of the outer sleeve via at least one strut so that a bone graft collecting space is defined therebetween. The inner sleeve is sized and shaped to correspond to a profile of a medullary canal of the target bone. In addition, the device includes an interstitial mesh extending radially away from an exterior surface of the inner sleeve toward an interior surface of the outer sleeve to hold graft material in the bone graft collecting space.

Abstract: An implant system includes a first portion, a second portion, and a third portion. The first portion includes a hydrogel. The second portion includes a porous material and the hydrogel in pores of the porous material. The third portion includes the porous material. The first portion is free of the porous material. The third portion is free of the hydrogel. Methods of making and using the implant system.

Abstract: This invention relates to a multipoint stamping mould for forming a customised implant mould surface comprising a primary stamping unit (100) having a plurality of rods (101) positioned adjacent to and in contact with one another, each rod (101) having a rough surface along its longitudinal axis and a mould surface defining end (103), wherein the rods (101) are slidable about the longitudinal axis to thereby form a customised implant mould surface by the mould surface defining ends (103) of the rods, according to a predetermined implant surface of the customised implant; and a clamping means (105) for locking the plurality of rods (101) into a position that defines the mould surface. Preferably, the multipoint stamping mould further comprises a secondary stamping unit (200) positioned opposite and corresponding to the primary stamping unit (100).

Abstract: An orthopaedic hip implant includes an acetabular cup having a rounded outer surface configured to be implanted into a surgically-prepared surface of a patient's acetabulum. A porous metallic coating is disposed on the rounded outer surface of the acetabular cup, with a hydroxyapatite coating being disposed on the porous metallic coating in a pattern which defines a readable indicia.

Abstract: Implants, trial implants, and systems for treatment of a hip-joint of a patient are disclosed, as well as methods of making and using such implants, trial implants, and systems. Various embodiments include patient-adapted acetabular implants and/or trial implants.

Abstract: An orthopaedic hip prosthesis system is disclosed. The orthopaedic hip prosthesis system comprises a femoral head component configured to articulate with a natural or prosthetic acetabulum of a patient, the femoral head component having a tapered bore formed therein, a femoral stem component having a tapered trunnion configured to be received in the tapered bore of the femoral head component, and a shell positioned over the tapered trunnion of the femoral stem component. The shell includes a frame extending over the tapered trunnion, and a protective coating applied to the frame and the tapered trunnion. A method of performing an orthopaedic surgery is also disclosed.

Abstract: An orthopaedic tibial prosthesis includes a tibial baseplate with features designed for use with small-stature knee-replacement patients. The tibial prosthesis may include a shortened tibial keel, tibial keel fins which define a large angle with respect to a longitudinal axis of the keel, and/or tibial keel fins which extend along less than the entire longitudinal extent of the keel.

Abstract: Total joint replacements for implants include a first member configured to attach to a first bone, a second member configured to reside in an adjacent second hone and a locking mechanism. The locking mechanism is configured to (i) lock the first and second members in alignment for full extension or other defined stabilized configuration and (ii) unlock to allow the first and second members to pivot relative to each other for flexion or bending.

Abstract: Methods, systems, and devices for replacement of a joint with a prosthetic system that replicates the natural kinematics of the joint is disclosed. A prosthetic system according to one embodiment includes a tibial component having a tibial plateau and a tibial stem portion, the tibial plateau having a top side and a bottom side, a tibial insert, with a bearing surface, adapted to be positioned on the top side of the tibial plateau, a femoral component having a base portion and a central housing, the femoral component having an axis of extension-flexion rotation, the base portion having a pair of condyles, an a mechanical linkage component linking the tibial component with the femoral component and with the tibial insert in between the tibial component and the femoral component, so that there is a center of contact between the condyles and the bearing surface.

Abstract: A humeral trial and implant assembly for use in total shoulder arthroplasty is provided along with a method for using the same. The humeral trial and implant assembly includes a humeral fixation component, an adapter assembly, a humeral trial, a humeral implant, and a positioning guide. The humeral trial is coupled to the adapter assembly when the humeral trial and implant assembly is assembled in a trialing configuration. The humeral implant is coupled to the adapter assembly when the humeral trial and implant assembly is assembled in an installed configuration. A temporary connection releasably couples the humeral trial to the adapter assembly and provides separation of the humeral trial and the adapter assembly without requiring disassembly of the adapter assembly. A permanent connection fixedly couples the humeral implant to the adapter assembly. The temporary connection may be a magnetic connection.

Abstract: A glenoid trial and implant assembly for use in reverse total shoulder arthroplasty is provided along with a method for using the same. The glenoid trial and implant assembly includes a baseplate assembly, an adapter assembly, a glenoid trial, a glenoid implant, a humeral cup, and a positioning guide. The glenoid trial is coupled to the adapter assembly when the glenoid trial and implant assembly is assembled in a trialing configuration. The glenoid implant is coupled to the adapter assembly when the glenoid trial and implant assembly is assembled in an installed configuration. A temporary connection, which may be magnetic, releasably couples the glenoid trial to the adapter assembly and provides separation of the glenoid trial and the adapter assembly without requiring disassembly of the adapter assembly. A permanent connection fixes the glenoid implant to the adapter assembly.

Abstract: An intervertebral implant component of an intervertebral implant includes an outer surface for engaging an adjacent vertebra and an inner surface. A keel extends from the outer surface and is designed to be disposed in a slot provided in the adjacent vertebra. This keel extends in a plane which is non-perpendicular to the outer surface; and preferably there are two of the keels extending from the outer surface which are preferably offset laterally from one another. In another embodiment, an anterior shelf is provided at an anterior end of the outer surface, and this anterior shelf extends vertically away from the inner surface in order to help prevent bone growth from the adjacent vertebra towards the inner surface. Further in accordance with disclosed embodiments, various materials, shapes and forms of construction of the component and/or keel provide various benefits.

Abstract: An adjustable spinal implant includes a lower body, an upper body, a locking pawl, and a locking key. The upper body and the lower body are pivotable relative to one another between a collapsed position and an expanded position. The upper body includes a locking flange that extends towards the lower body. The locking pawl is coupled to the lower body and is moveable between a locked position such that the upper and lower bodies are fixed relative to the one another and an unlocked position such that the upper and lower bodies are moveable relative to one another. The locking key is moveable between a locked state such that the locking pawl is fixed in the locked position and an unlocked state wherein the locking pawl is moveable between the locked position and the unlocked position.

Abstract: Various embodiments of implant systems and related apparatus, and methods of operating the same are described herein. In various embodiments, an implant for interfacing with a bone structure includes a web structure, including a space truss, configured to interface with human bone tissue. The space truss includes two or more planar truss units having a plurality of struts joined at nodes. Implants are optimized for the expected stress applied at the bone structure site.

Abstract: Various embodiments of implant systems and related apparatus, and methods of operating the same are described herein. In various embodiments, an implant for interfacing with a bone structure includes a web structure, including a space truss, configured to interface with human bone tissue. The space truss includes two or more planar truss units having a plurality of struts joined at nodes. Implants are optimized for the expected stress applied at the bone structure site.

Abstract: The present invention provides a device and methodology for use in spinal fusion surgeries. An implant is proved for forming a rigid structure between adjoining vertebrae in a patient. The implant is a cage defined by at least a first end, second end, first side, and second side surface, wherein first and second side surfaces extend substantially parallel to each other to span a space between adjoining vertebrae and first and second ends interconnect said first side surface and second side surface. The cage incorporates one or more flexible joints that allow the cage to be deformed for insertion into a patient. The ability to deform the cage allows a greater ease and flexibility in inserting and positioning the implant.

Abstract: Implants suitable for use in a carpometacarpal joint includes an upper surface, a lower surface, and sidewalls extending between the upper surface and the lower surface. The implant includes hydrogel material such as polyvinyl alcohol (PVA) hydrogel. Kits can include systems for preparing an implantation site, creating a cavity, and/or deploying the implant. Methods of treating a carpometacarpal joint include deploying an implant in a recess in a carpometacarpal bone.

Abstract: An acetabular guide system for placing a guide pin near an acetabulum, includes a patient specific acetabular guide including an interior surface and an exterior surface, the exterior surface being configured to have a geometry to register within the acetabulum of a specific patient, a first drill insert configured to be received by the guide at a first location, the first drill insert having a first longitudinal bore configured to be received concentrically in a guide bore of the guide, the guide bore extending exterior to the interior surface, a second drill insert configured to be fixed to a boney portion exterior to the acetabulum at a second location a predetermined distance from the first location, the second drill insert forming a second longitudinal bore, and a selectively removable alignment pin configured to be received by at least one of the first longitudinal bore and the second longitudinal bore.

Abstract: A surgical instrument suitable for preparing an intervertebral disc space includes an outer sleeve, an instrument head, an inner shaft, a handle, a universal joint, a coupling member, and a drive mechanism. The outer sleeve includes a proximal end, a distal end and a longitudinal axis. The instrument head defines a longitudinal axis and is disposed at the distal end of the outer shaft. The inner shaft is slidably disposed within the outer sleeve and includes a proximal end, a distal end and a longitudinal axis coaxially aligned with the longitudinal axis of the outer sleeve. The drive mechanism is coupled between the outer sleeve and the inner shaft and actuates the outer sleeve axially relative to the inner shaft, thereby setting an angle of the longitudinal axis of the instrument head in relation to the longitudinal axis of the inner shaft.