Abstract: A surgical instrument, in particular an arthroscopy punch, with a jaw (22), includes a stationary jaw part (3) and a movable jaw part (10) which, by pivoting of a pivotable grip part (6), is displaceable relative to the stationary jaw part (3), between a closed position and an open position, in a slotted guide (26) along a curved guide path.

Abstract: A robotic surgery method for cutting a bone of a patient includes characterizing the geometry and positioning of the bone and manually moving a handheld manipulator, the handheld manipulator operatively coupled to a bone cutting tool having an end effector portion, to cut a portion of the bone with the end effector portion. The handheld manipulator further comprises a manipulator housing and an actuator assembly movably coupled between the manipulator housing and the bone cutting tool. The method further includes causing the actuator assembly to automatically move relative to the manipulator housing to maintain the end effector portion of the tool within a desired bone cutting envelope in response to movement of the manipulator housing relative to the bone.

Abstract: A surgical procedure of preparing bone holes to fix an implanted tendon to a femur when performing reconstruction of a ligament in a knee joint, includes: bringing a treatment portion of an ultrasonic treatment instrument into contact with the femur in the knee joint, and applying ultrasonic vibration from the treatment portion to the femur, thereby cutting and forming a first bone hole from the inside of the knee joint to the femur in a predetermined depth.

Abstract: Implants, instruments, and methods for connecting and/or stabilizing first and second bone portions relative to one another are presented including fasteners and retainers connectable in axial force transmitting relationship and instruments for their installation. In one example a guide is configured to clamp two bone portions together while a fastener is inserted through at least one of the bone portions to engage a retainer.

Abstract: Implants, instruments, and methods for connecting and/or stabilizing first and second bone portions relative to one another are presented including fasteners and retainers connectable in axial force transmitting relationship and instruments for their installation. In one example a guide is configured to clamp two bone portions together while a fastener is inserted through at least one of the bone portions to engage a retainer.

Abstract: An aspiration catheter can be used to capture and retrieve vascular debris from blood vessels. The aspiration catheter can include a distal segment having ports positioned along its longitudinal length and about its circumference. The distal segment can capture thrombus at least partially on an exterior of the distal segment when aspiration is applied through the ports, and retrieve the thrombus when the elongate member is retracted proximally. The distal segment can be modified from a non-collapsed configuration to a collapsed configuration when aspiration is applied through the ports. The distal segment can have projections arranged along and around its circumference. The projections can be configured to slide distally through a thrombus within a blood vessel and to pull the thrombus when the elongate member is retracted proximally.

Abstract: A clot removal device has an expandable treatment member having a distal tip and a proximal end, a delivery wire having a distal end coupled to the proximal end of the expandable treatment member, and a flow restrictor carried along the delivery wire at a location that is separate and proximal from the expandable treatment member. The flow restrictor has a body with a distal section and a proximal section, the distal section being covered and the proximal section being uncovered. The expandable treatment member is moveable relative to the flow restrictor, and can be retracted into the distal section.

Abstract: A clot removal device has an expandable treatment member having a distal tip and a proximal end, a delivery wire having a distal end coupled to the proximal end of the expandable treatment member, and a flow restrictor carried along the delivery wire at a location that is separate and proximal from the expandable treatment member. The flow restrictor has a body with a distal section and a proximal section, the distal section being covered and the proximal section being uncovered. The expandable treatment member is moveable relative to the flow restrictor, and can be retracted into the distal section.

Abstract: A surgical snare device for engaging an object in a body passage and that employs multiple loops for snaring the object. The loops, which can be made from a single elongated line or separate lines, are positioned at locations that substantially span across the diameter of the body passage. A tubular membrane cap is included which is made from a liner coupled with structural elements made of expandable wire for support. The membrane cap is selectively deployed from a sheath and radially expandable to envelop the captured object so that withdrawing the object is more secure and any sharp edges on the object do not damage walls of the body passage. The loops and membrane cap can be made from a metal, a metal alloy, or polymer. Perforations can be formed in the liner to allow fluid to pass through the membrane cap.

Abstract: A basket apparatus is described that assists in removing objects from within a patient. The apparatus includes a number of pull wires, each pull wire physically coupled to a different capstan that individually actuates one of the pull wires. The apparatus also includes an outer support shaft itself including a number of channels through which the pull wires traverse. The portions of the pull wires extending out of the outer support shaft form a basket of adjustable size, shape, and position. The pull wires are attached together at a tip located at a distal end of the basket apparatus. By controlling the actuation of the various pull wires, the basket's shape, position size can be manipulated to reposition the basket around an object located within a patient, independent of or in conjunction with motion of the remainder of the apparatus or an associated endoscope.

Abstract: A method for capturing an object in a cavity in a patient is described. The method includes advancing a ureteroscope into the cavity containing the object. A basket is advanced through a working channel of the ureteroscope. The basket is opened within the cavity and is positioned so as to enclose the object. Then, two actions are performed simultaneously. The basket is collapsed while simultaneously the basket tool is advanced forward so that the object remains within the basket, ideally near the center of the basket, as the basket closes around the object. Once the object is captured, the basket is retracted to remove the object out of the cavity. Further, this process may be automated by having the method carried out by robotic arms acting in tandem, with one or more robotic arms advancing the basket tool or ureteroscope, and another robotic arm collapsing the basket.

Abstract: A method is described for using percutaneous access to a patient to remove an object from a cavity within the patient. The method includes inserting a suction tube into a port created by a percutaneous cut. An endoscope is also advanced into the cavity, however the endoscope passes through a patient lumen rather than through the port. Using a working channel within the endoscope, fluid is irrigated through the cavity. Additionally, a negative pressure is applied to the suction tube, such that the combination of fluid irrigation and negative pressure assist in removing the object from the cavity through the suction tube.

Abstract: A system for dilating a Eustachian tube (ET) of a patient includes a guide member and a dilation catheter. The guide member includes a bent distal portion that is configured to provide access to an opening in the ET. The dilation catheter is slidable relative to the guide member. The dilation catheter includes a shaft, an expandable element, and an actuator. The expandable element is disposed at the distal portion of the shaft. The actuator includes a grasping portion and an actuating member. The expandable element is configured to transition to an expanded configuration in response to actuation of the actuating member. The grasping portion and actuating member are configured to be grasped in a single hand of an operator to enable the operator to advance the dilation catheter relative to the guide member and to transition the expandable element between expanded and unexpanded configurations with the single hand.

Abstract: A knife assembly of a surgical end effector assembly includes a knife body defining a longitudinal axis and having first and second arms. The first arm has a first head including a cutting edge at a distal end thereof and the second arm has a second head. The first head is pivotable relative to the second head to reduce a cutting height during translation of the knife assembly through a knife channel defined within the end effector assembly.

Abstract: A forceps having relative pivoting forceps joined by connectors and jaws retractable by action of a helical spring in a chamber inside the connectors of the two forceps. A passage from the spring chamber outward to the exterior periphery of a first connector and opening in a space between the two jaws of the two forceps when the forceps and their jaws are retracted, permitting entry of cleaning materials into the interior of the forceps. The jaws being shaped and the passage into the interior of the forceps being so located and shaped that the passage into the interior of the forceps is blocked by at least one of the jaws when the forceps are gripped and the jaws are toward each other.

Abstract: A surgical instrument includes a housing, a handle, an elongated shaft, an end effector assembly, a drive assembly, and an extension depending from the handle. The extension includes a proximal surface having a first proximal cam portion defining a first angle with respect to the longitudinal axis and a second proximal cam portion defining a second angle with respect to the longitudinal axis. Initial actuation of the handle from a non-actuated position causes the first proximal cam portion to contact the first portion of the drive assembly causing a first movement of the at least one jaw member, and a subsequent actuation of the handle causes the second proximal cam portion to contact the first portion of the drive assembly causing a second movement of the at least one jaw member.

Abstract: A treatment tool includes: a support portion which is formed in an axial shape; a treatment portion which is disposed at a distal end portion of the support portion; a treatment assisting portion which is disposed at the distal end portion of the support portion, which has an assisting portion, and in which the assisting portion is capable of being moved between a first position and a second position; a driving portion which moves the assisting portion of the treatment assisting portion; an operation detection portion which determines an amount of movement of the support portion, which is inserted into an introducing tool, with respect to the introducing tool, and an orientation of the support portion; an operating portion which is disposed at a proximal end portion of the support portion; and a control portion which controls the driving portion based on a detection result of the operation detection portion.

Abstract: A membrane removing forceps may include a first forceps jaw having a first forceps jaw distal end and a first forceps jaw proximal end and a second forceps jaw having a second forceps jaw distal end and a second forceps jaw proximal end. The membrane removing forceps may include one or more abrasive surfaces configured to raise a portion of a membrane. A surgeon may raise a portion of a membrane by grazing the portion of the membrane with one or more abrasive surfaces of a membrane removing forceps. The surgeon may grasp the raised portion of the membrane with the first forceps jaw distal end and the second forceps jaw distal end. The surgeon may then remove the membrane by peeling the membrane apart from an underlying tissue.

Abstract: This surgical instrument is provided with: an insertion section; a grasping member provided at a distal end portion of the insertion section and formed in a curved shape; a guide section formed along the curved shape and disposed at the grasping member; a first guided section having a disc shape; a second guided section provided at a proximal side of the guide section closer than the first guided section and having a disc shape; a base to which the first guided member and the second guided member are attached; a blade section fixed to the base and protrudes from the grasping member, the blade section being movably along the curved shape of the grasping member by sliding the first guided member and the second guided member along the guide section.

Abstract: An end effector includes a drive system to rotatably drive a removeable cutting accessory. The cutting accessory defines a bore. The drive system includes a drive member that defines a lumen. A cartridge is provided to deliver liquid from a liquid source, through the lumen of the drive member, through the bore of the cutting accessory, and to a surgical site.

Abstract: The invention describes a single circumcision aid which limits circumcision scar formation and facilitates a fast healing time period. The circumcision aid includes a tubular section having a glans penis locating portion at a first open end region thereof, an opposite second end region and a body therebetween, the body including a threaded portion being received by a screw means. The circumcision aid also includes a framework providing stability to the aid, a crush means and a locking means.

Abstract: A surgical blade includes a region that has a mirror finish such that the blade can reflect an image that can be viewed by a user. A first portion of the blade is a sharpened edge and a second portion of the blade has a mirror. The mirror portion of the blade can be useful in situations where visualization can be facilitated by using a mirror at or near the region where the blade is used. Upon identification or visualization of the region to be incised, a user can create an incision using the first, sharpened portion of the blade.

Abstract: An ultrasound scalpel that may be used for surgical operations is disclosed in this invention. The ultrasound scalpel comprises an ultrasound generator, housing, transducer horn, retaining member and scalpel blade. The device is able to utilize sharp stainless steel surgical blades amenable to being produced as disposable single-use replacement blades. Ultrasonic energy transmitted from transducer horn to surgical blade causes bending waves to be created due to the off-center attachment and/or placement of the surgical blade. This device may be utilized for cutting through skin and/other soft tissues during surgical operations, thereby enhancing cutting efficacy, decreasing and/or eliminating necrosis formation.

Abstract: An ultrasonic surgical instrument for cutting a tissue of a patient includes an end effector projecting from a shaft assembly, which has an acoustic waveguide configured to acoustically couple with an ultrasonic transducer. The end effector includes an ultrasonic blade, a clamp arm, and a first clamp pad. The clamp arm is coupled with the shaft assembly and is configured to selectively move relative to the ultrasonic blade from an open position and toward an ultrasonic blade to a closed position. The clamp arm further includes an abutment configured to engage a portion of the shaft assembly in the closed position thereby inhibiting further movement of the clamp arm toward the ultrasonic blade. The first clamp pad thus remains offset from the ultrasonic blade to prevent the first clamp pad from direct contact with the ultrasonic blade.

Abstract: A treatment tool comprising, a probe including a first surface that carries out incision of the living tissue with the ultrasonic vibrations, a second surface that carries out coagulation of the living tissue, and an insulation portion that covers the first surface, and a jaw which is engageable with the probe and disengageable from the probe, the jaw including a third surface facing the first surface in an engaging state and a fourth surface facing the second surface in the engaging state.

Abstract: A disposable ultrasonic surgical handle includes a disposable handle body defining a battery-holding compartment shaped to receive a battery therein and operable to couple a proximal end of an ultrasonic waveguide to an ultrasonic transducer therethrough. The body has a transducer dock exposed to the environment and interchangeably housing the transducer and a waveguide attachment dock shaped to align and attach the proximal end of the waveguide to the transducer and hold them at the body when the respectively docked at the transducer and attachment docks. A disposable driving-wave generation circuit in the handle body electrically contacts the battery and the transducer when the battery and the transducer are disposed respectively in the battery-holding compartment and the transducer dock. The circuit generates an output waveform sufficient to cause ultrasonic movement along the waveguide by exciting the transducer when the transducer is coupled to the waveguide.

Abstract: A device for introduction into a body vessel includes a shaft, a balloon positioned at the distal end of the shaft, a guidewire disposed longitudinally within the shaft to receive a guidewire during use, a balloon disposed at the distal end of the shaft, and longitudinal scoring wires to score a vascular lesion attached to the distal end of the shaft, disposed over the balloon and disposed within the shaft. The proximal ends are welded or otherwise affixed to a spring mounted in the handle. The balloon expands when fluid is delivered to the balloon through the inflation lumen. This expansion pushes the scoring wires against the vascular lesion.

Abstract: Tissue can be removed from a patient with a catheter or other medical device having a cutting member. A source of suction can be coupled to the device for suctioning removed tissue through a lumen in the device and out of the patient's body.

Abstract: The embodiments herein provide a port apparatus for rectus sheath tunneling. The apparatus comprises a mandarin for creating tissue tract when advanced through patient's body. Mandarin comprises a sharp shaft and a mandarin cap. The shaft is conically tapered at distal end to avoid damage to peritoneum tissues. The proximal end of mandarin is attached with a mandarin cap. A cannula overlaying mandarin is provided for administering medication, inserting surgical instrument or drawing fluids when placed in patient's body. Cannula comprises hollow tube for reaching peritoneal cavity. Cannula comprises head assembly detachably attached to proximal end of hollow tube for providing grasping surface to surgeon. The head assembly comprises cannula cap and cup for holding unidirectional valve for preventing backflow of air. Mandarin extends beyond the length of cannula at distal end for guiding cannula through tissue tract. Mandarin cap prevents complete passage of mandarin through cannula during procedure.

Abstract: According to an exemplary embodiment of the present invention, a trocar is provided. The trocar includes: a sharp end; at least three concave cutting edges extended from the sharp end; and at least three concave cutting surfaces forming the sharp end and the at least three cutting edges.

Abstract: Devices and methods of use for an insertion cannula to insulate a cryoablation probe or other surgical devices are provided. The device comprises an insertion cannula having a proximal end, an exterior surface comprising a distal tip configured to penetrate tissue, and an interior surface that defines an internal passage of the insertion cannula. The internal passage extends along a longitudinal axis of the insertion cannula and is configured to receive an ablation probe. A sealing member contacts the proximal end of the insertion cannula and is configured to provide a fluid seal to prevent fluid from entering or leaving the proximal end of the insertion cannula. Methods for ablating nerve and/or soft tissue utilizing the ablation devices are also provided.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: This disclosure describes various examples of multi-purpose tools and associated methods for safely gaining access to extravascular spaces. The multi-purpose tools described herein are particularly suited for safely gaining access to the sub-sternal space underneath the sternum/ribcage as well as tunneling subcutaneously above the ribcage for the purpose of positioning of a medical electrical lead. This eliminates the need for separate tools for tunneling in different extravascular spaces by providing a single tool capable of the multiple uses.

Abstract: A method is provided for accessing a pericardial space of a subject. The method includes advancing a guide member toward a heart, having (a) a transparent blunt distal end, and (b) a side-facing suction port. During advancing of the guide member, an imaging device disposed in the guide member generates an image of part of the heart. Subsequently to contacting the pericardium with the suction port, the imaging device is retracted proximally in the guide member. Subsequently, a portion of the pericardium is drawn into the guide member through the suction port. Following the drawing of the portion into the guide member, an image of the pericardium disposed within the suction port, is generated. Subsequently, a puncturing element is advanced in the guide member to puncture the portion of the pericardium that is in the guide member. Other applications are also described.

Abstract: A fracture reduction device for reducing a fractured bone having a proximal fragment and a distal fragment may include: a proximal attachment member that may be configured to be coaxially attached and fixed into the proximal fragment of the bone; a distal attachment member that may be configured to be laterally attached and fixed to the distal fragment of the bone; and a distracting mechanism that may engage with the proximal attachment member and be coupled with the distal attachment member. The distracting mechanism may be configured to manipulate the proximal fragment and the distal fragment to restore their alignment and orientation.

Abstract: Orthopedic fixation devices and methods of installing the same. The orthopedic fixation device may include a coupling element and a bone fastener, whereby the bone fastener can be loaded into the coupling element through the bottom of a bore in the coupling element.

Abstract: A cervical polyaxial bone anchor includes a longitudinal connecting member receiver structure and a cooperating shank. The shank has a body and an integral head with first and second spherical surfaces of different radii and a plurality of spaced curvate apertures for receiving portions of the longitudinal connecting member to result in a greater angle of inclination of the shank with respect to the receiver. The receiver has an upper channel and a lower cavity that further includes an expansion area and an operational seat for a split retainer ring that captures and fixes the shank head within the receiver.

Abstract: A stiffening device useful for orthopedic stabilization assemblies. The present disclosure provides an apparatus and methods for stiffening the rods and screws typically used for correction of orthopedic defects, such as curvature of the spine. An out-of-plane stiffener is attached to the rods and screws in a plurality of locations, thus reducing the tendency of the rods to move. A stiffener is located in a plane posterior to the rods and screws. The stiffener connects to the rods with adjustable but rigid connections and prevents the rods from bending in the sagittal and coronal planes. This prevents rotation and twisting of the rods and thus the vertebrae into which they are implanted. The stiffeners of the present disclosure may also be attached to pedicle screws only. This helps to correct lordosis and kyphosis bending, as well as scoliosis-type bending. The stiffeners may also be used for cranial and facial applications.

Abstract: A spinal stabilization system and method are provided for treating a patient's spinal column, for maintaining preselected spacing and movement between adjacent vertebrae in a spinal column, and for providing overall stability thereto. The system includes an interlaminar member positioned in the space intermediate a first vertebra and the vertebrae positioned immediately below and adjacent to the first vertebra. The interlaminar member is operatively connected to an adjustable support structure and cooperates therewith to maintain the preselected spacing between adjacent vertebrae and to provide overall stability to the spinal column.

Abstract: Various devices and methods for breaking and retaining surgical reduction tabs are provided. In general, the devices and methods can allow a single surgical instrument to break a plurality of surgical reduction tabs off one or more surgical implants and retain the broken tabs within the instrument. In an exemplary embodiment, a surgical instrument can include an opening at a distal end thereof that is configured to receive a surgical reduction tab therein when the tab is connected to a surgical implant. A retention element at least partially disposed within the instrument can be configured to engage the tab received in the opening so as to hold the tab securely within the instrument. With the tab received in the opening and held by the retention element, the surgical instrument can be configured to be manipulated to break the tab off the surgical implant. The broken tab can be retained within the surgical instrument by being held therein by the retention element.

Abstract: An apparatus, for reinforcing bone and tools for mounting the same, has an implant including a barrel and a device. The implant can be expanded by an expanding apparatus including an outer tube, a base, a hollow body and a handle. The expanding apparatus can be bound to the implant to place the implant into a bone to be treated and adjust the expansion degree. The expanding apparatus can be replaced by an injector apparatus including a container for bone cement and an injecting handle. The injector apparatus can inject a mixture for reinforcing bone (e.g., bone cement) into the bone through an exit, the device, the aperture, the barrel and the window of the barrel, and into the to-be treated area.

Abstract: Medical device locking mechanisms and related methods and systems. In some embodiments, the medical device may comprise an outer surface defining one or more fastener openings configured for receiving one or more fasteners. The one or more fasteners may comprise an upper surface configured to be engaged by a component of the locking system to prevent fastener backout. A plurality of petal structures may be configured to be selectively expanded or contracted to engage the head portion and retain the at least one fastener within the fastener opening to prevent the fastener from backing out of the fastener opening. A biasing member may selectively engage the plurality of petal structures to either expand or contract the plurality of petal structures to facilitate locking the fastener(s) in place within the device.

Abstract: A threaded fastener for embedment into bone is disclosed. Threads are formed on cylindrical stock. The thread pattern features upper and lower surfaces. The upper surface includes (in section) two facets which intersect to form a “V” shaped contour and a lower surface which is undercut below an upper facet nearest a root of the fastener thread. The fastener includes a self-tapping cutter at a distal extremity and a driving head at its proximal extremity. The cylindrical stock contemplates two variants: it may be hollow from the proximal end to the self-tapping cutter or from the self-tapping cutter to its distal end. The self-tapping cutter is configured to feed bone shards into the hollow.

Abstract: A bone screw including a housing including a threaded opening defined between first and second legs extending from a base portion of the housing, and a threaded closure member configured to be threaded into the threaded opening of the housing between the first and second legs to secure a connecting member in a channel of the housing. The threaded closure member includes a first thread and a second thread intertwined with the first thread, and the threaded opening includes a first discontinuous thread and a second discontinuous thread intertwined with the first discontinuous thread.

Abstract: A distraction screw includes a proximal portion secured to a first vertebra, a distal portion secured to a second vertebra and an intermediate portion. The intermediate portion is coupled to the proximal and distal portions and is positioned in an intervertebral space. The intermediate portion is configured and adapted to enable distraction of the first vertebra relative to the second vertebra.

Abstract: A pedicle anchor device is equipped for being used like a pedicle screw, i.e. for being implanted in the vertebra from dorsal direction (but generally at an angle to the sagittal plane, slightly inward towards the sagittal plane) through the pedicle so that a distal portion of the device protrudes into the vertebral body. The pedicle anchor device includes a pedicle anchor device body with a head portion, a shaft portion and a longitudinal bore that extends from a proximal end of the pedicle anchor device body and has a hole or a plurality of holes from the longitudinal bore outward, for example radially outward.

Abstract: An anchorage in tissue is produced by holding a vibrating element and a counter element against each other such that their contact faces are in contact with each other, wherein at least one of the contact faces includes a thermoplastic material which is liquefiable by mechanical vibration. While holding and then moving the two elements against each other, the vibrating element is vibrated and due to the vibration the thermoplastic material is liquefied between the contact faces, and due to the relative movement is made to flow from between the contact faces and to penetrate tissue located adjacent to outer edges of the contact faces. For liquefaction of the thermoplastic material and for displacing it from between the contact faces, no force needs to act on the tissue surface which is to be penetrated by the liquefied material.

Abstract: A spinal stabilization system may be formed in a patient. In some embodiments, a minimally invasive procedure may be used to form a spinal stabilization system in a patient. Bone fastener assemblies may be coupled to vertebrae. Each bone fastener assembly may include a bone fastener and a collar. Extenders may be coupled to the collar to allow for formation of the spinal stabilization system through a small skin incision. The extenders may allow for alignment of the collars to facilitate insertion of an elongated member in the collars. An elongated member may be positioned in the collars and a closure member may be used to secure the elongated member to the collars. An adjuster may be used in conjunction with the extenders to change a separation distance between the bone fastener assemblies.

Abstract: A balloon catheter (10) has a shaft (12) having an elastically expandable balloon (11) on the distal end side and space provided inside and allowing a fluid to flow into and flow out the balloon (11), a heat generating member (22) provided in the internal space of the balloon (11), and optical fibers (20A, 20B) which are extended up to the internal space of the balloon (11) along the shaft (12) and emit light beams input into the proximal end to the heat generating member (22) from the distal end.

Abstract: A liquid feeder mounted on a treatment instrument, includes: a main tube that is arranged along a long member of the treatment instrument in which a longitudinal axis is defined and that is configured to flow a liquid to an outer circumference of the long member; a connection section that is arranged on a proximal end side of the main tube along the longitudinal axis and that is configured to connect an interior of the main tube and an interior of a liquid feed channel from a liquid source; and a fixing section that is arranged in the connection section and that is configured to fix the connection section to a handle unit arranged at a proximal end of the long member and grasped by a user.