Abstract: The electrophysiological diagnostic catheter obtains an endomyocardial biopsy of heart tissues. The catheter includes a manipulation handgrip, main channel, distal ring and diagnostic rings connected with electrical connections. There is a centrally located, open internal channel, wherein inlet/outlet of internal channel is located in the distal ring, or is guided and monitored using a system for 3D electroanatomical mapping.

Abstract: Apparatus and methods for sealing a puncture through tissue includes an introducer sheath sized for introduction into a puncture, cartridge sized for insertion into the introducer carrying a sealant, and a locking element for coupling the introducer sheath to the cartridge. When the cartridge is advanced into the introducer sheath, the locking element couples the introducer sheath to the cartridge such that subsequent retraction of the cartridge causes the introducer sheath to retract, thereby deploying the sealant from the cartridge within the puncture beyond the introducer sheath.

Abstract: An array of a plurality of shape memory material microposts have a proximal end configured to be secured to a substrate with a tissue penetrating distal end.

Abstract: The present invention advantageously provides devices, systems, and methods for percutaneous access and closure of vascular puncture sites. In an embodiment, the device for enhancing the hemostasis of a puncture site in a body lumen or tract comprises a catheter having one tubular member having a proximal end and a distal end with one inner lumen extending between at least a longitudinal portion of the catheter tubular member. The one tubular member includes external and internal tubular bodies each having proximal and distal ends. At least one of the external and the internal tubular bodies is longitudinally movable with respect to the other. An expansible member with proximal and distal ends is disposed on the distal end of the one tubular member. The distal end of the expansible member is connected to the distal end of internal tubular body and with its proximal end connected to the distal end of external tubular body.

Abstract: A surgical instrument includes an elongate body, a toothed rack, and an end effector. The elongate body has a proximal end and a distal end and defines a first longitudinal axis. The toothed rack is disposed within the elongate body and is movable in a direction parallel to the first longitudinal axis. The end effector has a proximal end pivotally supported on the distal end of the elongate body. The end effector defines a second longitudinal axis and supports a gear operatively associated with the rack. Longitudinal movement of the rack effects pivotal movement of the end effector relative to the elongate body from a first position to a second position. In the first position, the second longitudinal axis is aligned with the first longitudinal axis. In the second position, the second longitudinal axis is misaligned with the first longitudinal axis.

Abstract: A specimen retrieval assembly including a housing containing a specimen retrieval bag and pliable spring, a distal end including a non-blunt tip, and a deployment mechanism. The specimen retrieval bag is moved from the stowed position within a hollow housing to a deployed position by sliding a rod from a retracted position partially within the hollow housing to an extended position that projects at least partially out of the hollow housing. Two portions of a flexible support ring unfold under spring bias from a folding position as the rod enters the extended position to open a mouth of the specimen retrieval bag. The distal end of the assembly has a non-blunt tip which is shaped to puncture human skin.

Abstract: Provided is a device of automatic mechanical wound opener for head and neck surgery. The device includes a wound opener including: a fixed unit and a plurality of drawing units, and at least one of the drawing units being movably connected on the fixed unit, wherein each of the drawing units includes a first arm, a second arm, and a blade connected to the second arm; wherein the first arm is connected to the fixed unit by one end thereof and to the second arm by the other end thereof; the second arm can be adjusted to an needed included angle relative to the first arm; and at least one of the blades includes an extension plate connected to an end of a plate part of the blade, and the extension plate is connected to the second arm for shortening the spacing between two blades.

Abstract: Stitching apparatus and methods are provided for placing a stitch through a layer of material such as tissue. Preferred methods include piercing a needle element through tissue, engaging a thread with the needle, and pulling the thread through the tissue. The needle suitably releasably engages the thread, e.g. magnetic engagement of the needle and thread.

Abstract: A surgical apparatus is provided. The surgical apparatus includes a proximal body portion, a distal body portion selectively articulable relative to the proximal body portion at an articulation joint, and a first drive gear disposed within the distal body portion. The distal body portion has a diameter and a length. The length of the distal body portion is substantially the same as the diameter of the distal body portion.

Abstract: A linear suturing and cutting device, comprising an upper jaw and a lower jaw capable of being closed or opened relative to each other; said upper jaw includes an anvil; said lower jaw includes a staple cartridge frame, said staple cartridge frame is detachably provided with a staple cartridge, said staple cartridge is arranged with cartridge holes inside which run throughout said staple cartridge to its working surface, and staple pushers correspondingly disposed inside said cartridge holes and being capable of sliding relative to said cartridge holes, said staple cartridge frame is slidably provided with a firing piece inside, said firing piece is configured with a wedge-shape staple pushing member capable of driving said staple pushers to slide in said cartridge holes, said cartridge holes are configured to be inclined towards the distal end of said staple cartridge.

Abstract: A surgical apparatus includes a proximal body portion configured for operable connection to an actuation assembly and a distal body portion selectively articulable relative to the proximal body portion at an articulation joint. The distal body portion includes a distal end configured for selective engagement with a loading unit and defines a longitudinal axis. A length of the proximal body portion is flexible. The proximal body portion may also define a working channel.

Abstract: There is described a platform device for use in forming an anastomosis and maintaining a desired curvature of a lumen in a desired shape during an anastomosis assistance period. The platform is formed from one or more bioabsorbable or biodegradable polymer filaments. There is also described a method for inserting a platform device for use in creation of an arteriovenous fistula by identifying a candidate artery and a candidate vein and dissecting the candidate vein. Next, inserting a platform device into the vein and creating a breach in the candidate artery at a desired angle and location. Next, introducing the platform device and vein into the candidate artery and forming the platform device into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery. The platform may also be used to maintain potency of supply blood vessels and/or organ blood vessels or the lumens during an organ transplant procedure.

Abstract: Implementations of the present disclosure relate to apparatuses, systems, and methods for anastomosing vascular systems in medical procedures. A pair of similar or identical coupling devices may be disposed at the ends of two vessels, either natural or synthetic. The coupling devices may be capable of hermaphroditically connecting to one another to provide a simple and secure connection which promotes growth of the vessels between the bio-absorbable coupling devices.

Abstract: The invention relates to deployable magnetic compression devices and systems and methods for the deployment of such magnetic compression devices. The magnetic compression devices are particularly useful for creating anastomoses, e.g., in the gastrointestinal tract. The devices are especially useful for minimally-invasive delivery, e.g., using endoscopic techniques. The systems, devices, and methods can be used to treat a variety of gastrointestinal and metabolic diseases, such as diabetes, obesity, and cancer.

Abstract: A surgical instrument that comprises a receiving portion for removably receiving therein an interchangeable part, wherein the receiving portion has a communication connection, a handle having a controller electrically connected to the communication connection, and an interchangeable part removably connected to the receiving portion and having an encryption device electrically removably connected to the communication connection when at the receiving portion, wherein the encryption device is programmed to authenticate the interchangeable part upon an exchange with the controller when the interchangeable part is at the receiving portion and, after at least a partial use of the interchangeable part, store a used status of the interchangeable part.

Abstract: An anvil introduction system is operable to provide smooth insertion of an anvil of a surgical stapling device through a bodily lumen such as the esophagus. The anvil introduction system is coupled to the anvil and includes a dilation feature. The dilation feature has a collapsed position and an expanded position. The dilation feature may cover staple pockets and an outer edge of the anvil with the dilation feature is in the expanded position. The anvil may be inserted through the bodily lumen with the dilation feature in the expanded position. The dilation feature may then be collapsed in order to complete an end-to-end anastomosis of the bodily lumen.

Abstract: A device for treating nosebleeds includes a mouth insert having a horizontally extending elongated portion, a center portion extending downward from a bottom surface of the elongated portion and a bite tab extending backward from the center portion. The elongated portion is shaped and dimensioned to be inserted into a buccal cavity of a user's mouth and to fit behind the user's upper lip and in front of the user's upper gums. The center portion is shaped and dimensioned to be positioned in front of the user's upper front teeth and the bite tab is shaped and dimensioned to provide a biting surface for the user's front teeth. Biting down onto the bite tab pushes the elongated portion upward and applies pressure upward to the user's buccal cavity and towards an anterior portion of the user's nose.

Abstract: The present invention relates to apparatuses and methods of using a resection line guide in various medical procedures. A resection line guide may include a first clamp member and a second clamp member configured to be positioned on a first side and a second side generally opposite that of the first side of an anatomical structure, such as, for example, a stomach. The clamp members may be configured to provide a clamping force on the stomach to secure the guide to the stomach. Further, at least one flexible member may be operatively coupled to the clamp members. The flexible member may be configured to be tensioned so as to provide at least a portion of the clamping force on the stomach.

Abstract: A device for occluding a vasculature of a patient including a micrograft having an absorbent polymeric structure with a lumen of transporting blood. The micrograft has a series of peaks and valleys formed by crimping. The occluding device is sufficiently small and flexible to be tracked on a guidewire and/or pushed through a microcatheter to a site within the vasculature of the patient. Delivery systems for delivering the micrografts are also disclosed.

Abstract: A cutting block comprises a body having a top surface for guiding a saw blade, and a top plate connected to the body. The top plate can move between a first position in which the top plate is spaced apart from the body and a second position in which the top surface of the top plate is an extension of the top surface of the body. The top plate has first and second resiliently deformable arms extending from it, spaced apart along the top plate, and the body has first and second recesses formed in it extending substantially perpendicularly to the top surface of the body. The first and second arms on the top plate are inserted in the recesses so that the arms and the recesses define the path for movement of the top plate relative to the body between the first and second position.

Abstract: A bone fragment and osteomedullary tissue harvesting system that includes a harvesting device, a collection vessel and tubing. The harvesting device includes a needle portion and a handle portion. The needle portion that has a needle bore that extends through at least part of the needle portion. The handle portion is operably attached to the needle portion. The handle portion includes a connection port and a vacuum control mechanism that are in communication with a handle bore that extends through the handle portion. The needle bore is in communication with the handle bore. The vacuum control mechanism includes a vacuum aperture that extends through a surface of the handle portion and is in communication with the handle bore. The collection vessel is capable of receiving aspirated bone fragments and tissue. The tubing operably connects the connection port and the collection vessel.

Abstract: Apparatus and methods are described, including a method for opening a natural ostium of a sinus of a subject. An artificial hole is formed in a bone wall of the sinus, and a stent is implanted in the hole. The ostium is then opened by pumping a fluid through the stent such that the fluid is in direct contact with the sinus. Other applications are also described.

Abstract: Resection guides, implants and methods are disclosed. A guide may include a plate with a first end opposite a second end and a medial portion extending therebetween. The guide may also include at least one opening in the first end of the plate. The guide may further include at least one hole positioned along a longitudinal axis of the plate near the at least one opening. Surgical methods for using the guide for bone and joint fusions is also disclosed.

Abstract: A surgical instrument includes a hollow member having a sidewall provided with a window and a closure member movably connected to the hollow member for alternately covering and uncovering the window. The hollow member has a first clamping surface along an edge of the window, while the closure member has a second clamping surface opposing the first clamping surface and disposable substantially adjacent thereto in a clamping or closure configuration of the instrument. The instrument additionally comprises a tissue occlusion component mounted to at least one of the hollow member and the closure member for acting on tissues gripped between the first clamping surface and the second clamping surface, to couple the tissues to each other.

Abstract: A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves. The shock waves propagate through the liquid and impinge upon the valve to decalcify and open the valve.

Abstract: A guide catheter for use in treating sinuses, the catheter including a catheter shaft configured to provide suction about a balloon catheter and a distal portion shaped for navigating body anatomy. In one embodiment, the guide catheter includes a valve for sealing the balloon catheter and a vent for controlling suction.

Abstract: A medical treatment instrument includes a sheath, a needle advanceably and retractably inserted into the sheath, and a stylet having a first outer diameter and advanceably and retractably inserted into the needle. A distal end portion of the needle includes a housing portion, a small-diameter portion provided at a proximal end of the housing portion and having an inner diameter smaller than that of the housing portion, and a slit extending at least from a distal end of the housing portion to a proximal end of the small-diameter portion. A distal end portion of the stylet includes a large-diameter portion having a second outer diameter larger than the first outer diameter. The small-diameter portion and the housing portion are elastically deformed to expand in a radial direction of the needle while a width of the slit expands by the large-diameter portion being engaged with the small-diameter portion.

Abstract: A medical device is described having a handle, a shaft coupled to the handle and an end effector coupled to the shaft. In one embodiment, the device includes an ultrasonic transducer and is arranged so that ultrasonic or electrical energy can be delivered to a vessel or tissue to be treated. Various novel sensing circuits are described to allow a measure of the drive signal to be measured and fed back to a controller. An active fuse circuit is also described for protecting one or more batteries of the device from an over-current situation.

Abstract: An intravascular device can comprise a carrier and an expansion apparatus. The device can be used for intravascular treatment of atherosclerotic plaque. The carrier can be reversibly expandable and collapsible within a vessel and can have ribbon strips extending between opposite ends in a longitudinal direction of the carrier. The ribbon strips can each be formed with a plurality of elongated protrusions thereon. The expansion apparatus can be used to actuate the ribbon strips each with the plurality elongated protrusions to pierce a luminal surface of the plaque with lines or patterns of microperforations which act as serrations for forming cleavage lines or planes in the plaque.

Abstract: The present invention provides a tool and method for performing a lumbar puncture. The tool may include a first arm and a second arm and may form a T-shape. The first arm may be longer than the second arm. Also included is a projection extending from one of the arms. The projection has a downward angle and a passageway that is sized to accommodate a needle. The tool is configured to maintain the perpendicular placement of a needle between vertebrae and a preferred angle of insertion of about 15° during a procedure.

Abstract: A biopsy system with a grid plate used as either a lateral or medial compression plate of a localization fixture used with a breast coil includes a rotatable guide cube that may be inserted into a desired rectangular recess in the grid plate after rotating to position a selected guide hole in the desired spatial orientation. Versions of a guide cube include those rotatable in two axes to provide additional hole positions, angled holes, enlarged circular holes that function with a rotating guide to support a noncircular biopsy instrument cannula (e.g., trocar/sleeve combination, core biopsy probe of a biopsy device) for rotation. A rotating guide may have an unlocked state for easily sliding to a selected longitudinal position thereon. Thereafter, the rotating guide is locked to serve as a positive depth stop (e.g., quarter turn locking elastomeric rings, triangular and scissor clips, and shutter depth stops).

Abstract: System and methods are shown having a tube-within-tube assembly with a deployable curved deflectable tube or cannula that deploys from a straight cannula or trocar. The curved cannula has pre-curved distal end to create an angular range of 0° to 180° when fully deployed from the straight trocar. The curve is configured such that the flexible element carrying a treatment device can navigate through the angular range of deployment of the curved cannula. The curved cannula allows the flexible element to navigate through a curve within bone without veering off towards an unintended direction.

Abstract: A method of percutaneous implantation of a pedicle screw system comprising the steps of implanting a first pedicle screw assembly in a first vertebra, the first pedicle screw assembly including a first coupling element connected with a first extension defining a first space and implanting a second pedicle screw assembly in a second vertebra, the second pedicle screw assembly including a second coupling element connected with a second extension and intersecting at least one a portion of the second extension with the first space.

Abstract: A polyaxial bone screw assembly includes a receiver, a shank, an articulation structure for retaining the shank in the receiver and a compression insert for engagement with a longitudinal connecting member such as a rod. The articulation structure includes substantially spherical convex and concave surfaces that slidably engage both shank and receiver surfaces to provide compound articulation between the receiver and the shank. The receiver includes inwardly directed spring tabs engaging the insert and prohibiting rotation of the insert within the receiver.

Abstract: A surgical instrument enables dispensing of a series of fasteners within a patient's body. The device includes a magazine sized and dimensioned to hold a series of fasteners, the series of fasteners insertable through an opening at the end of the magazine. A splined guide bore is rotatably supported within the magazine, and slidingly supports a shaft having an external surface mateable with the splined guide bore to restrict radial rotation of the shaft with respect to the support about said longitudinal axis. A biasing element is connected between the support and the shaft, to urge the shaft along a longitudinal axis towards a distal end of the instrument. A ratchet is connected to the shaft and engages the magazine to permit sliding of the shaft in a direction for dispensing fasteners only, unless disengaged with the magazine.

Abstract: Cross connectors, kits, and methods useful in the treatment of bones, such as vertebrae, are described herein. An example cross connector is comprised of a first member, a second member, a saddle, a locking member, and a stop member. The first member is pivotally, rotatably, and slidably moveable within a passageway defined by the second member.

Abstract: A spinal construct comprising a first portion. A second portion defines a longitudinal axis and is configured to penetrate tissue. A tether is fastened with the first portion such that a spinal implant connected with the tether is movable to a plurality of orientations relative to the longitudinal axis. Systems and methods are disclosed.

Abstract: A spinal construct comprises at least one tether including a first end connectable with a first fastener connected with spinal tissue and a second end connectable with a second fastener connected with spinal tissue. The at least one tether has a tension between the fasteners. A member defines an axis and includes an element disposed transverse relative to the axis. The element is engageable with the at least one tether. The member further includes a drive engageable with the dement to adjust the tension. Systems, implants and methods are disclosed.

Abstract: A bone holding device comprising: at least one conformable elongated member having a first portion, a second portion and an intermediate portion therebetween; a rod with at least one transverse passage which opens into at least one of two opposite side faces of the rod, said passage being delimited by inner surfaces of the rod, and at least one compression member, the compression member and said inner surfaces both defining clamping surfaces and cooperating so that the first and second portions of the elongated member can be inserted and clamped between said clamping surfaces. A method using such a device.

Abstract: In some embodiments, a method includes disposing a flexible band through an aperture of a support member, the support member having a fixation portion configured to secure the support member to a first bone portion. The method includes advancing a portion of the flexible band through an attachment portion of the flexible band until the flexible band is secured to a second bone portion. The method includes advancing a portion of the fixation portion of the support member into the first bone portion until the support member is secured to the first bone portion.

Abstract: An adjustable spine distraction implant alleviates pain associated with spinal stenosis and facet arthropathy by expanding the volume and/or cross sectional area in the spinal canal and/or neural foramen. The adjustable implant provides a spinal extension inhibitor. The implant includes elliptical or oval shaped adjustable member or spacer for positioning between and adjustably spacing apart the spinous processes.

Abstract: A method for providing stabilization and compression of a bone fracture, the method comprising: providing an intramedullary prosthesis sized for insertion into the intramedullary canal of a bone and having a distal end, a proximal end and a porous structure therebetween, wherein (i) in a first state, the prosthesis is longitudinally expanded and radially contracted, and (ii) in a second state, the prosthesis is longitudinally contracted and radially expanded, conforms to the shape of the adjacent bone and exerts forces on the adjacent bone; and positioning the intramedullary prosthesis within the intramedullary canal of a bone so that the intramedullary prosthesis spans the bone fracture, whereby to provide stabilization and compression of the bone fracture.

Abstract: A drill guide system and method including a bone plate and a guide block removably engaged with the bone plate, and with drill guide passages in the guide block substantially aligned with bone screw openings in the bone plate and each having a conically-shaped inner guide surface. A fixed angle drill guide includes a distal portion selectively positioned within a selected one of the drill guide passages and has a conically-shaped outer guide surface matingly engaged with the conically-shaped inner guide surface of a selected drill guide passage to maintain orientation of the fixed angle drill guide at a predetermined fixed angular orientation. A variable angle drill guide includes a distal portion selectively positioned within a selected one of the drill guide passages and has an outer guide surface sized smaller than the conically-shaped inner guide surface of a selected drill guide passage to permit orientation of the variable angle drill guide at a variable angular orientation.

Abstract: An encasement for coating a bone plate with a substrate includes a sidewall structure having an upper edge and a cover disposed on the upper edge of the sidewall structure. The encasement includes a base from which the sidewall structure rises such that the sidewall structure, the cover and the base combine to create an open interior space of the encasement. An aperture in the sidewall structure provides access to the open interior space of the encasement and a plurality of cover protrusions extend from the cover into the open interior space. The encasement blather includes a plurality of base protrusions extending from the base directly opposing the plurality of cover protrusions. A combined height of an individual cover protrusion and all opposing base protrusion is less than or equal to a height of the sidewall structure.

Abstract: In an exemplary embodiment, the present invention provides an orthopedic plate blocking assembly that can be used for the fixation or fastening of an orthopedic plate to bone tissue. In particular, the present invention, in one embodiment, provides an orthopedic plate having a plurality of cavities where each cavity is configured and dimensioned to receive a bone anchoring member. The orthopedic plate further provides a blocking mechanism having a plurality of blocking members that block the bone anchoring members to prevent the bone anchoring members from “backing out” of cavities once the bone anchoring members are finally seated in the cavities.

Abstract: An intra-osseous support structure can be used to fixate opposed portions of bone. In some examples, the intra-osseous support structure is positioned in openings formed in adjacent portions of bones. Fasteners are inserted through the bone portions to secure the intra-osseous support structure in the bones. Depending on the application, one or more external bone plates may also be applied to the bone portions. The external bone plate may be in compression while the intra-osseous support structure is in tension under load in situ.

Abstract: A bone fragment-fixing device of the present invention including: a supporting portion for supporting, on an inner side of a mandible, a bone fragment generated by cutting the mandible; a connecting portion which is connected to one side of the supporting portion and protrudes to a height corresponding to the outer side of the mandible along the cut surface of the bone fragment; and a fixing portion connected to the connecting portion and formed in a shape corresponding to the mandible around the bone fragment.

Abstract: A spinal implant includes a proximal end including a thread and at least one resistance element. A distal end includes the thread and is configured to penetrate tissue. The at least one resistance element is engageable to increase a resistance during penetration of the tissue. Systems and methods of use are disclosed.

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: Device for the mixing of polymethylmethacrylate bone cement and for storing a monomer liquid and a cement powder as starting components of the bone cement, comprising a cartridge having an internal space closed on one side by a mobile dispensing plunger; a monomer container for a monomer liquid and/or a connector for attachment of a monomer container which can be opened in the device so that the monomer liquid flows from the monomer container into the device; and a connecting conduit through which the monomer liquid can be guided into the internal space of the cartridge; having a pumping plunger that can be shifted axially in the hollow cylinder arranged in the hollow cylinder, which can be used to push monomer liquid from the hollow cylinder through the connecting conduit into the internal space of the cartridge by actuating the pumping plunger.