Abstract: Systems and methods of placing one or more suture loops into tissue, such as the base of the tongue, are described. A system can include a variable-thickness suspension line for suspending tissue, including a suture having a first thickness dimension; an elastomer surrounding a portion of the suture and defining a central segment of the suspension line having a second thickness dimension greater than the first thickness dimension, and at least one transition zone extending from the central segment of the suspension line to a lateral end of the suspension line, the transition zones having a thickness dimension that tapers from the second thickness dimension to the first thickness dimension.

Abstract: A method of coupling a first portion of an anatomy to a second portion of the anatomy includes coupling first and second bones of the anatomy with a bone-tendon-bone implant. The bone-tendon-bone implant has a first bone end, a second bone end and a replacement tendon between the first and second bone ends. The first and second bone ends are positioned in corresponding first and second bores of the first and second bones. The first bone end is secured to the first bone with a first bone anchor. A second anchor coupled to the bone-tendon-bone implant is passed through and outside the second bore. The second anchor is coupled to an adjustable suture construct having two adjustable suture loops. Tensioning at least one of first and second ends of the adjustable suture construct tensions the replacement tendon and positions the first bone relative to the second bone.

Abstract: An assembly for securing a mesh patch to a surface of a peritoneum layer of an abdominal wall. The assembly includes first and second holding members coupled by a suture. After the two holding members are deployed from a shaft, tension on the coupler pulls the first holding member and the second holding member towards each other. Various locking arrangements are disclosed to cause the locking of the first and second holding members in position such that a mesh patch that is positioned against the peritoneum layer is secured thereagainst by one of the first and the second holding members while the other of the first and second holding members is retained against the fascia layer of the abdominal wall. Assemblies and methodologies for all of the foregoing are provided.

Abstract: A method for closing a tissue puncture, where the method includes tensioning a suture loop disposed within a vascular tissue of a patient, the suture loop having two free ends and a knot disposed on one of the free end. Those two free ends are disposed through a suture snare comprising a snare. Following detachment of the suture snare from the two free ends, the knot is advanced to close the suture loop and a cutting member is advance towards the knot and the two free ends are cut.

Abstract: An implant manipulator may have a distal end that retains an implant, a proximal end, and an intermediate portion between the ends. The implant manipulator may be a needle for a suture passer, with a suture capture feature at the distal end. The suture capture feature may have first and second members that flex apart to permit entry of the suture into a suture capture hole wherein the suture is retained until released. A suture passer may include one or more needles. The suture passer may also include a pusher; a distal end with a sharp, blade-like extension; or a side-loading distal end.

Abstract: A closure device for closing an opening in tissue is provided. The closure device includes an elongate member through which needles may be deployed. The closure device also includes a closure element having a foot portion and a needle guide portion. The foot portion and the needle guide portion are each movable between a delivery configuration and a deployed configuration. The foot portion includes cuffs removably mounted thereon and having sutures connected therebetween. The needle guide portion includes needle guide apertures that guide the needles to the cuffs. The needles securely engage the cuffs and draw the cuffs and suture through the lumen wall so that the opening in the lumen wall can be closed with the sutures.

Abstract: Suture passers and methods of use. Described herein are suture passers preloaded with suture, including cartridges that couple to a suture passer to form a loaded suture passer that are configured to prevent a length of suture (e.g., already-passed suture) from re-entering the channel of the suture passer jaw and getting recaptured and/or entangled by the tissue penetrator. In particular, described herein are preloaded and automatically re-loading suture passers that are adapted to include a gate, guide, or shield on one of the jaws of the suture passer, and methods of operating such suture passers for surgical use including repairing tissue.

Abstract: A surgical suturing device comprises a cartridge having a needle and suture. An elongate shaft has a proximal end and a distal end. An actuator is connected to the proximal end of the elongate shaft. A pair of jaws is connected to the distal end of the elongate shaft. The jaws have a closed position adapted to receive and retain the cartridge, and wherein the jaws are latched in the closed position. The jaws also have a partially opened position adapted to release the cartridge wherein the jaws are biased by a spring from the first opened position towards the closed position. The jaws also have and a fully opened position spaced apart further than the partially opened position, wherein spring does not bias the jaws towards the closed position.

Abstract: The present disclosure relates to a surgical device including a shaft having an outer member and an inner member slidably received within the outer member, a handle coupled to the shaft, and a means for providing movement to the inner member coupled to the inner member. A method of tissue repair is also disclosed.

Abstract: A device for accurately guiding and positioning a surgical instrument bearing suture material to a predetermined area within the body for closing an open wound includes an elongated conically shaped guide that is wider at the top and which has two openings in the side wall thereof. The top has two openings that communicate with the openings in the side wall through generally linear passageways that pass through the guide and which allow surgical instruments carrying suture material to pass therethrough. A thin elongated rod extends upwardly from the top wall approximately two inches and includes a handle at the top thereof. Raising the handle above the guide increases the field of view of the surgeon.

Abstract: A tissue clip for adjoining tissues including a body portion, a biasing mechanism interconnecting the body portion to a tissue grasping mechanism, the grasping mechanism having a first condition wherein the grasping mechanism is extending against and away from the body portion and a second condition wherein the grasping mechanism is biased against the body portion. A tissue clip and deployer combination. A method of interconnecting tissue by deploying the tissue clip, puncturing tissue to be interconnected with the tissue clip, and interconnecting the tissue. A method of treating an aneurism by deploying the tissue clip at an aneurism site, closing off the aneurism site with the tissue clip, and treating the aneurism. A method of imaging a surgical procedure with ultrasound by modifying a surface of a metal surgical instrument, and imaging the metal surgical instrument with ultrasound during a surgical procedure.

Abstract: A surgical stapler including a hollow shaft and a tube slidable axially within the shaft between a forward position wherein one end of the tube projects beyond a free end of the shaft to enter a puncture site in a blood vessel and a rearward position wherein the end of the locator tube is retracted within the shaft. A surgical staple straddles the tube and is slidable thereon forwardly towards an anvil against which the staple may be deformed to staple together the opposite edges of the puncture site. A cam mechanism drives the staple forwardly along the tube into deforming engagement with the anvil and at the same time retracts the tube into the shaft in time to allow the legs of the staple to close onto the puncture site.

Abstract: A needle removal device is provided for removing needles from suturing systems. In an embodiment, the needle removal device may include a base member configured to be selectively positioned substantially adjacent a proximal portion of a suturing system. The proximal portion of the suturing system may include a plurality of needle lumens. The needle removal device may also include a plurality of needle receptacles at least partially defined by the base member. The needle receptacles may be positioned and configured to generally correspond to the needle lumens of the suturing system. The needle receptacles may be further configured to selectively receive and grasp onto one or more needles extending proximally from the needle lumens of the suturing system.

Abstract: A needle removal device is provided for removing needles from suturing devices and/or systems. In an embodiment, the needle removal device may be intended for use with a suturing device having one or more needle lumens. The needle removal device may include a first member having a first plurality of needle receptacles extending therethrough. The first needle receptacles may be configured and positioned to correspond to one or more of the one or more needle lumens of the suturing device. The needle removal device may also include a second member having a second plurality of needle receptacles extending therethrough. At least one of the first member or the second member may be moveable between a first position, wherein the first needle receptacles and the second needle receptacles are substantially aligned, and a second position, wherein the first needle receptacles and the second needle receptacles substantially unaligned.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: A tissue gripping device is formed from a shape-memory material, and has a base section, a first arm, and a second arm disposed opposite the first arm, each arm having a first end coupled to the base section and a free end extending from the base section. The arms of the tissue gripping device are configured to resiliently flex toward a relaxed configuration in a distal direction as the tissue gripping device is moved from a pre-deployed configuration toward a deployed configuration. The tissue gripping device is usable in a method for gripping tissue. The method includes positioning the tissue gripping device near target tissue and moving the tissue gripping device from a pre-deployed configuration toward a deployed configuration in order to grip the target tissue.

Abstract: A skin frame or other skin straining device strains skin on each side of a wound where a wound has been closed to off load stresses at the wound site. A dressing may be applied to the strained skin. The dressing may be integral with one or more elements of the skin straining device.

Abstract: Surgical instruments and their methods of use are disclosed. In some embodiments, the surgical instrument may include a handle and an elongated shaft assembly extending distally from the handle. The surgical instrument may also include a fastener deployment system for deploying fasteners from the elongated shaft assembly including a reciprocating driveshaft disposed within the elongated shaft assembly. The driveshaft may include an internal channel and at least one guide surface shaped and arranged to maintain an orientation of at least one fastener in the channel of the driveshaft. In other embodiments, the fastener deployment system may include a follower disposed within the elongated shaft assembly for displacing one or more fasteners within the elongated shaft assembly towards a distal fastener deployment position.

Abstract: A surgical stapler has a tool assembly including an anvil and a staple cartridge having a series of staples which are supported and configured to be rotatably ejected from the staple cartridge into the anvil to suture tissue. In embodiments, the surgical stapler includes a cartridge that supports a plurality of rotatable pushers. Each pusher supports a curved, substantially U-shaped staple having a single tissue penetrating distal leg portion and a proximal leg portion. The pusher is rotatable to drive the distal leg portion into an anvil to deform the staple into a substantially D-shaped configuration.

Abstract: An end effector includes a first jaw, a second jaw, and a cartridge. The first cartridge includes a sled and the second jaw includes an anvil. The first and second jaws are moveable relative to one another. The cartridge is disposed on the first jaw and has a plurality of staples. The sled is configured to engage each staple to the plurality of staples to eject the plurality of staples from the cartridge as the sled is longitudinally translated through the cartridge. A loading unit is also disclosed including an elongated body and an end effector that is articulable relative to the end effector. The end effector and the elongated body of the loading unit are configured to pass or fit through a 5 mm opening.

Abstract: A loading unit includes a shell assembly and a locking band. The shell assembly has a proximally extending annular body. The annular body defines two hook openings that oppose one another, a lug opening positioned between the hook openings, and a central passage for receiving a portion of a surgical instrument. The locking band has an arced body with two ends, a retention hook positioned adjacent each end of the body and extending from the inner surface of the body. Each of the retention hooks is disposed within a respective one of the hook opening to retain a respective one of the ends of the locking band to the annular body. The lug is disposable through the lug opening into the central passage to secure the loading unit to a surgical instrument.

Abstract: An anvil assembly suitable for trans-oral delivery includes an anvil head configured to receive a guide suture that is separable from the anvil assembly during a stapling procedure. An anvil delivery assembly includes the anvil assembly and a suture guide assembly secured to the anvil assembly.

Abstract: A surgical instrument including a handle assembly, an elongated body portion, a head portion and an elongated channel. The elongated body portion extends distally from the handle assembly. The head portion is disposed adjacent a distal end of the elongated body portion and includes an anvil assembly and a shell assembly. The elongated channel includes a proximal opening and a distal opening. The proximal opening is disposed distally of a proximalmost end of the handle assembly and proximally of the shell assembly. The distal opening is disposed on the shell assembly.

Abstract: A device for retarding birth including an upper ring for surrounding a cervix, an anchoring component for anchoring the device, and an elastic component for attaching the upper ring to the anchoring component, wherein the elastic component pushes the upper ring and the anchoring component apart. A device for retarding birth including a sleeve for surrounding a cervix along a greater portion of a length of the cervix, a support strip on the sleeve directed along an axis of the sleeve, and a ring at least partially around the sleeve, in which when a top of the sleeve is pushed to expand radially, the support strip pivots on the ring, such that an end of the support strip near the top of the sleeve moves radially outward, and an end of the support strip near the bottom of the sleeve moves radially inward. Related apparatus and methods are also described.

Abstract: A ligation clip applier is provided. The clip applier includes: a pair of jaws; a distal clevis tube to which the jaws are pivotally mounted; a proximal clevis tube located behind the distal clevis tube, wherein the distal clevis tube and the proximal clevis tubes move axially with respect to each other; a clip lock actuator fixed to one of the proximal and distal clevis tubes; and a distal pushrod extending through the distal and proximal clevis tubes and forming a camming connection with the jaws configured to close and move the jaws toward a proximal direction toward the clip lock actuator when the distal pushrod is moved in the proximal direction. A method for applying a clip on a vessel is disclosed.

Abstract: A system for treating tissue includes a clip assembly including a pair of clip arms, each of the clip arms extending from a proximal end to a distal end, the proximal end of the clip arms connected to one another via a central member slidably received within a channel of a capsule to be moved between a tissue receiving configuration and a closed configuration, a cartridge for encasing the clip assembly including a groove formed therein to accommodate the clip assembly and an opening extending thereinto in communication with a portion of the groove such that the groove is open to an exterior of the cartridge via the opening, and an applicator releasably connectable to the clip assembly to move the clip assembly between the open and closed configurations, a distal portion of the applicator insertable through the opening of the cartridge to be connected to the clip assembly.

Abstract: A vaso-occlusive device, delivery system and method of delivery to a selected site of the vessel in a manner allowing the vaso-occlusive device configured with a self-adaptive floating diameter in a relaxed condition to substantially assume a diameter of an inner surface of the vessel or aneurism sac at the site of the embolization procedure. The vaso-occlusive device or embolic coil comprises a distal end having a loop for anchoring at the site, a proximal end with a loop for detaching from a gripper assembly adapted to deliver to the site, a primary coil formed of a plurality of primary omega curves extending between the proximate and distal ends, and a secondary coil arrangement formed from a plurality of secondary omega curves that follow the trajectory of the plurality of primary omega curves along the longitudinal length of the embolic coil between the proximate and distal ends.

Abstract: An apparatus and method for introducing portals into bone is described herein. An example apparatus for introducing portals into bone includes a handle, a base, and a driving member. The driving member can be made to project past the base by operating the handle. The base is detachable from the handle. The apparatus also includes a guide coupled at a first end to the handle and at a second end to the base. The base is detachably coupled to the guide. A base coupling detachably coupling the base to the guide includes an actuating member movable between a coupled configuration wherein the base is coupled to the guide and an uncoupled configuration wherein the base is released from the guide. The actuating member is arranged so that motion of the handle toward the base moves the actuating member from the coupled configuration to the uncoupled configuration.

Abstract: An awl provides for creating an accurate hole in a bone, such as for implantation of a suture anchor. The awl comprises an elongated shaft having a distal tip which terminates in a sharp point adapted to penetrate bone. At least one cutting flute is provided on the shaft and has a longitudinally extending cutting edge formed on the shaft proximal to and adjacent to the sharp point whereby to allow removal of bone via the cutting flute upon rotation of the shaft about a central longitudinal axis thereof inside of the bone.

Abstract: A bone reamer includes a first member having a first hub and a second member having a second hub. The first hub can extend along a first axis and have a pair of elongated cutting arms that are fixed to the first hub. The elongated cutting arms can extend along a second axis that is generally perpendicular relative to the first axis. The first hub can define a track thereon. The second hub can extend along a third axis. The second member can have a second pair of elongated cutting arms that are fixed to the second hub and extend along a fourth axis that is generally perpendicular to the third axis. The second member can have a track follower extending thereon and that is configured to slidably advance along the track causing the first and second members to move between a collapsed position and an expanded position.

Abstract: A power tool includes an output member, a drive mechanism operable to perform work on the output member in one of a first mode or a second mode, and an actuator for activating the drive mechanism in the first mode or the second mode based upon an amount of time the actuator is depressed.

Abstract: A surgical jig assembly that is configured to hold and manipulate a first bone segment and a second bone segment, including: a first member that is configured to be selectively coupled to the first bone segment; a second member coupled to the first member, wherein the second member selectively translates with respect to the first member along a first axis; a third member coupled to the second member, wherein the third member selectively translates with respect to the second member along a second axis, wherein the second axis is perpendicular to the first axis; and a fourth member coupled to the third member, wherein the fourth member selectively translates with respect to the third member along a third axis, wherein the third axis is perpendicular to the first axis and the second axis, and wherein the fourth member is configured to be selectively coupled to the second bone segment.

Abstract: A Lisfranc injury between a second metatarsal and medial cuneiform is repaired by gaining access to the injury site and placing two arm members of a novel drill guide around the two neighboring bones at the injury site, drilling a guide wire through the two bones guided by the drill guide to a desired depth, and measuring the depth of the guide wire for determining proper length for a bone screw for securing the two bones.

Abstract: A catheter includes a tissue-removing element and a tissue-containment chamber configured to receive tissue removed by the tissue-removing element. The tissue-containment chamber has a tissue-removing opening for use in removing tissue from the chamber. A closure component is associated with the tissue-removing opening for selectively opening and closing the opening.

Abstract: An anchoring delivery system for use in an intracranial artery is provided including a tethering device having an elongated tether and an anchor coupled to a distal end of the tether. The anchor is deployable from a low profile configuration to a higher profile configuration to fix the distal end of the tether at an anchoring site in an anchoring vessel. The tethering device is configured to be used with a guide-sheath having a lumen configured to receive the tether. Related devices, systems, and methods are also described.

Abstract: A surgical apparatus for extraction of substances within a body of a human or animal includes an inner cannula, an extraction receptacle secured to the inner cannula, the extraction receptacle being adapted to grip substances to be extracted from the body; and a force sensor including a biasing member, the inner cannula operatively connected to the biasing member at an end of the inner cannula opposite the extraction receptacle, the biasing member exerting a biasing force biasing the inner cannula to pull the extraction receptacle in a direction toward the force sensor, wherein resistive forces on the extraction receptacle during extraction of a substance from the body act against the biasing force and move the biasing member.

Abstract: Flexible expandable treatment devices are disclosed herein. One aspect of the present technology, for example, is directed to an expandable tubular structure formed of an interwoven strand and configured to be positioned in a blood vessel. The interwoven strand may be arranged to form a plurality of cells and a plurality of joints between adjacent cells. At least one of the joints may include a first strand slidably interlocked with a second strand, and at least one of the first strand and the second strand may bend back on itself to form a restriction that limits disengagement of the first strand and the second strand at the joint.

Abstract: A surgical instrument includes a shaft defining a proximal end, a distal end, an interior surface, and an exterior surface. The shaft includes a pair of channels defined in the interior surface thereof towards the distal end of the shaft. A drive member is movably disposed within the shaft. An end effector assembly is pivotably coupled to the shaft towards the distal end of the shaft. A cam pin operably couples the end effector assembly and the drive member such that movement of the drive member relative to the shaft manipulates the end effector assembly. Ends of the cam pin extend outwardly from the end effector assembly and are received within the channels of the shaft to guide movement of the cam pin relative to the shaft in response to movement of the drive member relative to the shaft.

Abstract: A medical scalpel system includes a safety handle and an internal mechanism that permits a blade to be extended and retracted relative to the safety handle.

Abstract: A surgical drive apparatus includes a rotating shaft of a sectioning device and a drive unit having a motor disposed in a motor chamber, in which the motor rotationally couples to the rotating shaft as the rotating shaft extends through an end of the motor chamber. A suction chamber is defined by an interior of a cap, in which the end of the motor chamber is receptive to the cap for sealing engagement with the drive unit, and a rotary tool such as the sectioning device extends through the cap for rotational movement relative to the cap while maintaining fluid communication with the suction chamber. For evacuation of surgical material, an outflow tube is in fluid communication with the suction chamber for providing a fluid path to the suctioning device via the suction chamber. The drive protrudes from the motor chamber which is sealed to allow cleaning and sterilization.

Abstract: Unitary endoscopic vessel harvesting devices are disclosed. In some embodiments, such devices comprise an elongated body having a proximal end and a distal end, a tip disposed at the distal end of the elongated body; and a cutting unit having a first cutting portion and a second cutting portion, the first cutting portion and the second cutting portion being moveable in a longitudinal direction relative to the elongated body to capture a blood vessel between the first cutting portion and the second cutting portion, and being rotatable relative to one another circumferentially about the tip to cut the captured blood vessel.

Abstract: A disposable circumcision anastomat includes: an inner ring (2) and an outer ring (1) corresponding to the inner ring (2); wherein the outer ring (1) includes arc sidewalls, and the arc sidewalls are connected to arc blades (7); a loop blade faces inwards; convex structures (8) are repeatedly arranged at internal portion of the outer ring (1) for fixing, and the arc blades (7) form containing spaces (6) with the convex structures (8). With the disposable circumcision anastomat for removing redundant prepuce or phimosis, incision is neat, postoperative bleeding hardly happens, operation is easy, operation time is short, healing is fast, side effects is slight, patients suffer less, and postoperative recovery is fast.

Abstract: The present disclosure is directed to a medical device. Systems and methods are provided for accessing and visualizing the pancreatico-biliary system. The medical device may include a guide catheter with a first lumen and a second lumen. A first elevator may be disposed in the first lumen, wherein the first elevator is movable relative to the first lumen for elevating a first tool insertable into the first lumen. A second elevator may be disposed in the second lumen, wherein the second elevator is movable relative to the second lumen for elevating a second tool insertable into the second lumen.

Abstract: Surgical devices and methods are described herein that provide improved motor control and feedback, thereby combining advantages of manually-operated and powered surgical devices. In one embodiment, a surgical device includes a proximal handle portion that includes a motor, a distal end effector coupled to the handle portion, and a cutting element configured to cut tissue engaged by the end effector, wherein the motor is configured to supply power that moves the cutting element. The device also includes a motor control mechanism configured to cause the amount of the power to dynamically change in response to a manual user input when the cutting element is moving.

Abstract: A medical device may include an insertion device having a proximal end, a distal end, and a lumen extending therethrough. The medical device may further include a snare device configured to transition between a contracted state within the lumen of the insertion device, and an expanded state extending distally of the insertion device. The snare device may include a loop including a pair of legs and a distal tip. The distal tip may include a plurality of stabilizers between the pair of legs.

Abstract: Methods and tool kits for implanting a lead subcutaneously. Examples include tool kits and methods for establishing first and second subcutaneous tunnels at an angle relative to one another to facilitate introduction of a lead to the subcutaneous space. In an example, a first insertion tool is used to establish a first subcutaneous tunnel, and a second insertion tool, with or without the use of a blunt dissector, sheath, guidewire, or steering mechanism, is used to initiate or form the second subcutaneous tunnel. Such methods and tool kits may reduce the number of incisions needed to implant a subcutaneous lead along a subcutaneous path having a curve therein.

Abstract: In an ultrasonic probe a tapered section in which a sectional area perpendicular to a longitudinal axis decreases from a proximal side toward a distal side is provided on the distal side with respect to a probe main body section. When the probe main body section and the tapered section vibrate in an established frequency range, a most distal vibration node positioned most distally among vibration nodes is positioned on the proximal side with respect to a proximal end of the tapered section, and a ? wavelength of the vibration is smaller than a taper dimension from the proximal end the tapered section to a distal end of the tapered section in a longitudinal axis direction.

Abstract: An ultrasonic probe includes a probe main body section; and a curved extending section which is extended in a state of curving relative to the probe main body section toward a first intersecting direction side. The curved extending section includes a first curved outer surface facing the first intersecting direction side, and a second curved outer surface facing a second intersecting direction side. A first curve start position at which the first curved outer surface starts curving relative to the longitudinal axis toward the first intersecting direction side is positioned on the distal side with respect to a second curve start position at which the second curved outer surface starts curving relative to the longitudinal axis toward the first intersecting direction side.

Abstract: A vascular interventional device may comprise a combination of inflatable and cutting elements and embodiments may comprise structures and functionality for dilatation of blood vessels narrowed by diseases, removal of plaque and debris from diseased blood vessels and delivery of drugs for the prevention of re-narrowing of vessel luminal cross-section area as well as to provide scaffolding when needed to keep vessels patent.

Abstract: Systems, methods, and devices for the treatment of acute ischemic stroke that provide immediate blood flow restoration to a vessel occluded by a clot and, after reestablishing blood flow, address the clot itself. Immediate blood flow restoration advantageously can facilitate natural lysis of the clot and also can reduce or obviate the concern for distal embolization due to fragmentation of the clot. Several embodiments of the invention provide for progressive, or modular, treatment based upon the nature of the clot. For example, the progressive treatment can include immediate restoration of blood flow, in-situ clot management, and/or clot removal depending on the particular circumstances of the treatment. The in-situ clot management can include, for example, lysis, maceration, and/or removal.