Abstract: A surgical fastener is provided for various surgical fastening applications, including attaching an implantable prosthesis, such as a soft tissue repair fabric, to tissue and/or muscle. The surgical fastener may include a coil body and a separate head that is attached to the coil body. The head may include an internal thread that is threadably attached to the coil body. The head may also be further secured to the coil body with a compression fit therebetween. A locking feature may prevent back-out of the coil body from the head. The surgical fastener may be assembled by threading the coil body through the head.

Abstract: An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

Abstract: An end effector is provided and includes an outer tube, a coil member, a plurality of fasteners, and an engagement member. The outer tube defines a viewing window and a lockout window. The coil member is disposed within the outer tube. The plurality of fasteners are disposed in the coil member. The engagement member is disposed proximal to the plurality of fasteners and is visible through the viewing window of the outer tube. The engagement member is configured to translate proximal to the plurality of fasteners to provide a count of the plurality of fasteners remaining in the end effector.

Abstract: A side-to-end vascular anastomosis device comprising a diversion conduit coupled to a lower flange which is inserted into the vessel and an upper flange located on the outside of the vessel designed to clamp together to seal the incision into which the lower flange of the device is inserted.

Abstract: A compression assembly for use in compressing tissue comprising a first portion which includes a first compression element and a second portion which comprises a second compression element, at least one support element, at least one spring stopper element, and at least one spring element. Typically the spring stopper element is formed of a bio-degradable or otherwise functionally controllable material. The at least one spring element is in compressive force contact with the second compression element and the tissue to be joined is positioned between the first and second compression elements. A plurality of needles on one of the support elements is operative to pierce the tissue and the first portion of the assembly, holding the first compression element to the second portion of the assembly. The invention is appropriate for joining severed tissue in anastomosis procedures or closing natural or surgically produced tissue perforations.

Abstract: A shroud is provided which includes a rounded atraumatic distal configuration. The shroud is configured and dimensioned to be positioned on the distal end portion of a surgical instrument. The shroud is movable between a first position in which a distal portion of the shroud extends beyond a distal end of a tool assembly of the surgical instrument and a second position in which the distal portion of the shroud is positioned proximal to the distal end of the tool assembly.

Abstract: Disclosed are methods and devices for obtaining patent hemostasis of the radial artery by compressing the uninstrumented ulnar artery to increase radial artery flow. The device comprises a band having an inflatable bladder for applying blunt pressure to the ulnar artery. The method comprises applying a pressure to the homolateral ulnar artery and applying a pressure to the radial artery at the access site to obtain hemostasis at the access site. The method further comprises administering an anticoagulant to a patient at a dose ranging from about 20 units per kg of body weight to about 30 units per kg of body weight.

Abstract: Described herein are composite detachment mechanisms for implantable devices and assemblies comprising these devices. Also provided are methods of using the detachment mechanisms and assemblies.

Abstract: Thermoembolization systems and techniques may provide simultaneous embolization and ablation of bodily tissue. In some embodiments, thermoembolization may be induced, for example, by arterially infusing a viscous liquid carrying an electrophilic material into the feeding vessel(s) of a tumor. The viscous liquid serves to occlude the arterial supply to the tumor while the electrophilic material concurrently undergoes an exothermic reaction when it comes into contact with water present in bodily tissues. In result, thermoembolization induces simultaneous hypoxic and thermal stresses to the tumor, thereby overwhelming tumor cells.

Abstract: Methods, devices and systems are described for treating venous insufficiency in which the vein is compressed at least partially along a treatment zone. A system can be provided including an injection device, such as a glue gun, that is operably connected to a delivery catheter that can be advanced across a treatment zone in the vein. The delivery catheter can be used to deliver one, two, or more boluses of media (e.g., cyanoacrylate) to occlude the vein along different spaced-apart sections of the treatment zone. External compression can also be applied to the vein by a compression element, such as a hand or multifunctional ultrasound transducer, to occlude portions of the vein along the treatment zone prior to or during the introduction of the boluses of media.

Abstract: A motorized surgical handpiece with a chuck. Internal to the chuck are clamping members that releasably hold clamp the shaft of a cutting accessory to a drive shaft so the cutting accessory rotates upon the actuation of the motor. The chuck includes a collar with an opening through which the cutting accessory is inserted. The opening is non-circular in shape. When an accessory shaft with a cross sectional shape that matches the shape of the opening is inserted in the opening, the accessory shaft is appropriate aligned with the chuck clamping members.

Abstract: An implant placement trephine may be used to drill into bone and also to bore a core of bone for purposes of forming an implant channel for implant placement. The trephine generally includes a trephine body with a cutting blade at one end and a spindle extending through the trephine body with a pilot drill at one end extending beyond the cutting blade. The spindle may be adjustably attached to the trephine body to allow the pilot drill to be adjusted relative to the trephine cutting blade. The trephine may be prepackaged with an implant, such as a dental implant, having a corresponding size. The implant placement trephine may be used for different osteotomy applications, for example, to form a channel for dental implants or orthopedic retaining stabilizers. The trephine may also facilitate harvesting bone from the core of bone removed for an autograft at the implant site.

Abstract: An instrument for cutting bone includes a hollow shaft having a sidewall. A cutting element is at least partially housed in the hollow shaft. The cutting element can include one or more cutting blades that are radially expandable through the sidewall. The instrument can also include a piercing tip on a distal end of the hollow shaft is located distally of the one or more cutting blades. In addition, the instrument can include an expansion element for radially expanding the one or more cutting blades through the sidewall.

Abstract: An apparatus is provided for performing spinal surgery having a handle assembly, a screw guide, and a retractor. A shaft is provided with a handle, a neck portion and a connecting portion. The screw guide is provided with a connecting element coupled to the connecting portion of the handle assembly. A retractor for retracting tissue is coupled to the screw guide, wherein the neck portion of the handle assembly is provided with a spring loaded sleeve adapted to engage one of a plurality of holes positioned on a portion of the connecting element. The connecting portion is pivotably coupled to the connecting element.

Abstract: A cut block positioning jig including a first alignment member, a second alignment member, and both first and second guide members. The first alignment member is movable towards and away from a patient's bone to which the positioning jig is mounted to arrange the jig at a predetermined position relative to the bone based on x-rays of the patient. The second alignment member is movable towards and away from the bone to arrange the jig at the predetermined position relative to the bone. The first and second guide members are configured to direct cut block support members to the bone to couple a cut block to the bone to provide the bone with patient-specific cuts.

Abstract: This patent document discloses assemblies, alignment devices and methods for creating a bi-directional path through an occlusion. An alignment device can include a positioning member and a tubular member. The tubular member can be coupled with a distal end portion of the positioning member and can include proximal and distal progressive size-changing shapes separated by a narrow neck passageway. An assembly can include the alignment device, a guide catheter having a lumen in which the alignment device is at least partially positioned, a guidewire, and a specialty catheter for supporting the guidewire. The alignment device and the guide catheter can be advanced in an antegrade direction to a proximal end of the occlusion, and the guidewire and the specialty catheter can be advanced in a retrograde direction to a distal end of the occlusion. The guidewire and the specialty catheter can be manipulated through the occlusion and into the distal end of the tubular member.

Abstract: As may be implemented with various aspects of the present disclosure, a mesh structure is coupled to inner and outer frames that operate with struts to apply pressure to the mesh. Such an approach may involve sealing the mesh around an opening, such as around one or more artery openings along an interior wall of vascular tissue (e.g., in an aortic arch). Accordingly, blood flow can be filtered in a manner that is useful for capturing particulates such as those resulting from surgical operations. In various implementations, the mesh, struts and frames are deployed using a catheter and shaft coupled to the frames. Such an approach can be implemented to apply a spring force from the shaft and through the frames for sealing the mesh.

Abstract: A snare instrument has a snare structure which is formed in one piece from a tube section, by the latter being slit and bent open, and which has a proximal base portion and, extending axially forward from the latter, a distal snaring portion, and which is movable between a snaring position, in which it is moved forward out of an enclosure with the snaring portion folded open, and a securing position, in which it is moved back at least partially into the enclosure with the snaring portion folded in and providing a securing action. The snaring portion, in the folded-open state, has a cup shape with a distal snare opening. For this purpose, a distal end area of the tube section is provided with open axial slits of suitable length introduced from the direction of the distal end of the tube section, and, lying between these, with associated closed axial slits which terminate at a distance in front of the distal end of the tube section and are of greater length than the open axial slits.

Abstract: An endoscopic device for retrieving an object from within a human body is disclosed. The device includes a support assembly, a transmitting assembly, a wire, and a net element. The support assembly has a base and a tubular member. The transmitting assembly includes a handle and a motion transmitting link fixed to the handle and extending through at least a portion of the tubular member. The wire defines a loop portion and two leg portions. A proximal end of each leg portion is secured to the link by a first connection and the two leg portions are secured to each other by at least a second connection distal from the first connection. The net element has a distally protruding portion secured to the loop portion and a proximally protruding portion secured relative to the leg portions.

Abstract: Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

Abstract: A surgical instrument comprising a handle assembly, an elongated shaft, an end effector, a rotation mechanism, and an articulation mechanism is disclosed. The rotation mechanism is disposed in mechanical cooperation with the handle assembly and effects rotation of the end effector about the second longitudinal axis. The articulation mechanism is disposed in mechanical cooperation with the handle assembly and effects movement of the end effector from a first position where the first longitudinal axis is substantially aligned with the second longitudinal axis to a second position where the second longitudinal axis is displaced from the first longitudinal axis. The articulation mechanism comprises a first articulation control disposed in mechanical cooperation with the handle assembly, a first cable and a second cable. Actuation of the first articulation control in a first direction causes the first cable to move distally and causes the second cable to move proximally.

Abstract: Methods and devices are provided for preventing binding between components of a drive assembly of a surgical device. In an exemplary embodiment, a surgical device is provided having a ball-and-socket joint that allows bending of various drive shafts relative to the handle without causing movement of a drive rack disposed within the handle. Since the drive rack does not move in response to bending of the shaft, the drive gear and rack will remain aligned thus preventing jamming of the device.

Abstract: Methods and devices are provided having a locking mechanism configured to selectively prevent actuation of the surgical device, e.g., opening and closing of jaws at a distal end of the device, moving a cutting element of the device, etc. In an exemplary embodiment, a device is provided having a closure lever actuator that can move between an open position and an actuated position, thereby opening and closing, respectively, jaws at the distal end of the device. In addition, the device can include a knife trigger that is configured to move a cutting element through the jaws. The device can further include a knife lockout feature that can prevent actuation of the knife trigger until the closure lever is in the actuated position.

Abstract: The invention relates to a papillotome for percutaneous endoscopic gastrostomy comprising a front opening (11), which is located in a free end region of a catheter (10) and at the outlet of a first lumen (12), a rear opening (9), which is further from a free end (17) than the front opening (11) is and which connects the first lumen (12) to the outside, and a cutting wire (16), which is located in the first lumen (12) in an axially displaceable manner and extends through the front opening (11) and the rear opening (9) and is located on the outside between the front opening (11) and the rear opening (9). When the cutting wire (16) is tensioned, the free end region is deformed in a arc shape and the cutting wire (16) forms a transversely extending cutting edge (15) between the front opening (11) and the rear opening (9). The front opening (11) is arranged at a distance of at least 3 mm from the free end (17). A projection (20) is formed between the free end (17) and the front opening (11).

Abstract: A shield component for an endoscopic surgical blade is disclosed. An endoscopic surgical blade assembly is disclosed. The endoscopic surgical blade assembly contains an endoscopic surgical blade having a distal end, a proximal end, a top edge, a bottom edge and one or more cutting surfaces at the distal end, and a protective shield attached to the blade above the one or more cutting surfaces and extending away from the distal end of the blade. The blade is structurally configured for attachment to the distal end of an endoscope.

Abstract: An endoscopic surgical device having a windowed blade case featuring an interior surface that is black or dark, provides improved feasibility and ease of use. Further advantages are achieved by flanging the exterior surface of the blade case, and by providing a scraper tip.

Abstract: Systems, devices and methods for managing surgical instruments throughout their lifecycle include disabling a usage based device lockout and providing notifications for devices nearing a usage based lockout. A device adaptor connected inline between a surgical instrument and a power source can be configured to alter a device EEPROM to allow for additional device usage despite a usage based lockout. Notifications and user prompts may be displayed requiring a user to acknowledge that a usage based device lockout has occurred in order to avoid an attempt to use an expired device in a future procedure.

Abstract: A piezo-driven, vibrating beam is applicable to surgical procedures. A rod of piezoelectric material defines a length with proximal and distal ends. A pattern of electrodes, disposed adjacent to and along the length of the rod of piezoelectric material, is adapted for connection to a generator operative to stimulate the piezoelectric material, causing the rod to assume one or more vibratory states. In preferred embodiments, the proximal end of the rod of piezoelectric material is adapted for coupling to a blocking mass causing the vibratory states to be concentrated at the distal end of the rod of piezoelectric material. The pattern of electrodes may comprise interdigitated fingers, and the system may further include a material encapsulating the rod and the pattern of electrodes. Preferred embodiments may further include a plurality of coextensive, parallel rods forming a basic unit, each rod having a separate pattern of electrodes adjacent thereto.

Abstract: A coupling member for an ultrasonic instrument assembly has a tubular body with a first port at a first end and a second port at a second end opposite the first end. A lumen in the body member extends from the first end to the second end so that the first and the second port communicate with one another. The body member is made of a flexible resilient material such as silicone rubber and at least one reinforcement element is joined to the body member. The reinforcement element is configured so as to at least inhibit a collapse of the body member.

Abstract: An ultrasonic surgical tool system with a tip capable of simultaneously vibrating in plural modes. The system includes a console capable of supplying a drive signal to the tip that includes plural components. Each component has a frequency characteristic that is based in part on the equivalent of current through the mechanical components of the tip. The frequency components are different from each other. Based on the application of drive signal the tip undergoes non-linear vibrations.

Abstract: The present invention relates to a surgical instrument utilizing ultrasonic waves, the surgical instrument comprising: a transmitting rod having a cylindrical bar shape so as to transmit ultrasonic waves generated in a vibrator connected at one end of the transmitting rod to an amputator extending from the other end; a rod cover covering the transmitting rod with a separating distance from the outer circumferential surface thereof; and a contact prevention unit, provided on the inner circumferential surface of the rod cover, for preventing the transmitting rod from coming into contact with the rod cover due to the vibration generated on the transmitting rod during the transmission of the ultrasonic waves.

Abstract: An ultrasonic surgical blade includes a body having a proximal end, a distal end, and an outer surface. The distal end is movable relative to a longitudinal axis in accordance with ultrasonic vibrations applied to the proximal end. At least a portion of the outer surface of the body comprises a lubricious coating adhered thereto. The lubricious coating has a coefficient of friction that is less than the coefficient of friction of the outer surface of the body.

Abstract: An atherectomy device comprising a rotatably motor-driven flexible hollow shaft that is coaxial with a longitudinal axis of the guidewire; an annular distal end of the hollow shaft having a diameter that is only slightly larger than the diameter of the guidewire and configured with cutting surfaces for piercing hardened atherosclerotic plaque! a tubular sleeve secured to a first peripheral surface of the hollow shaft and configured with cutting surfaces for enlarging an opening formed in the plaque; and an asymmetric cutting unit extending between the sleeve and a second peripheral surface of the hollow shaft, to enable eccentric rotation of the hollow shaft for cutting and removing additional occlusive material from the blood vessel to open a chronic total occlusion. In one embodiment, the cutting unit is a helical strand unit having a polygonal cross section with a first side that atraumatically contacts a blood vessel wall.

Abstract: A tissue-removing catheter includes a sensor configured to detect a parameter of the catheter during the cutting operation of the catheter when a tissue-removing element is in a tissue-removing position. A locking control circuit is in electrical communication with the sensor and a locking device. During an operational control function, the locking control circuit receives a signal from the sensor based at least in part on the parameter of the catheter detected during the cutting operation of the catheter. The locking control circuit determines whether the received signal is indicative of a tissue-removing element engaging a non-tissue obstruction. The locking control circuit configures the locking device in its locked configuration to inhibit movement of the tissue-removing element from its tissue-removing position to its neutral position if the received signal is indicative of the tissue-removing element engaging a non-tissue obstruction.

Abstract: Embodiments of the present invention provide Dermal Micro-organs (DMOs), methods and apparatuses for harvesting the same. Some embodiments of the invention provide a DMO including a plurality of dermal components, which substantially retain the micro-architecture and three dimensional structure of the dermal tissue from which they are derived. An apparatus for harvesting the DMO may include, according to some exemplary embodiments, a support configuration to support a skin-related tissue structure from which the DMO is to be harvested, and a cutting tool able to separate the DMO from the skin-related tissue structure. Exemplary embodiments of the invention provide a genetically modified dermal micro-organ expressing at least one recombinant gene product. Some embodiments of the invention provide methods and apparatuses for implanting a genetically modified DMO.

Abstract: A method for repairing a fractured bone or a joint of a patient by chemical and/or biological agents, includes the steps of, determining an exact section of the fractured bone or the joint to be repaired, selectively delivering a quantity of an anesthetizing composition into skin surrounding the exact section in order for at least a portion of the anesthetizing composition to be absorbed by one or more tissues in vicinity of one or more nerves responsible for transmitting pain impulses from the exact section to brain of the patient in order to thereby selectively and remotely anesthetize at least a portion of the exact section, supervising the exact section in real-time and delivering one or more chemical and/or biological agents into the exact section, and, applying one or more bandages and/or one or more braces on the exact section for proper alignment and fusion.

Abstract: A bone anchor assembly comprising a shank, receiver, pressure insert, sleeve and closure. The sleeve having a body constructed of deformable material and including a transfer of non deformable material molded into the body of the sleeve to transfer force around the body. The receiver having interior guides and the insert having guide followers that cooperate to align the insert in the receiver and prevent rotation of the insert in the receiver.

Abstract: A coupling assembly for use in surgical constructs includes a first body and a second body. One of the first body and the second body includes a male member and an other of the first body and the second body includes a female member. The male member is sized and shaped to be received within the female member and the female member has an internal bore sized and shaped to receive the male member therein. One of the male member or the female member includes one or more engagement features formed therewith or attached thereto. The engagement features are operable to provide a gripping interface between the male member and the female member to couple the male member and the female member one to another.

Abstract: A bone fixation system with variable z-axis translation is provided. The system includes an outer tulip coupled to a bone fastener via a screw retainer. An inner tulip is coupled to the outer tulip such that the inner tulip is longitudinally movably relative to the outer tulip. The inner tulip includes a lock that provides a seat for a connecting rod. The inner tulip together with a seated rod is permitted to translate along the z-axis inside the outer tulip when in an unlocked position. Also in the unlocked position, the bone fastener is free to angulate relative to the outer tulip. The z-axis position of the inner tulip and rod relative to the outer tulip is fixed in a locked position. Also, in the locked position, the bone fastener is locked with respect to the outer tulip. The system may be adjusted between the locked and unlocked positions by way of a set screw.

Abstract: Disclosed herein are spinal fixation systems that may comprise a screw, a body, and a pressure cap. A screw may comprise a head at a proximal end, a bone connection element at a distal end, and a first mating element disposed on a head of a pedicle screw. A body may comprise a proximal end, a distal end, a mounting rod receiving channel at a proximal end, and a screw head receiving aperture at a distal end. A portion of the mounting rod receiving channel may be operable to receive a compression element. A pressure cap may comprise a proximal end, distal end, and a second mating element on a distal end. A first mating element of the screw may be configured to mate with the second mating element of the pressure cap thereby limiting the pivotal movement of the screw to that of a monoaxial screw.

Abstract: The present disclosure generally relates to a fixation device for positioning and immobilizing at least two adjacent vertebrae. In particular, in one or more embodiments, the present disclosure relates to an anterior clivus plate that immobilizes at least two adjacent vertebrae.

Abstract: An apparatus for securing a vertebra during healing of a fracture within a pars area of the vertebra is described. In certain embodiments, the apparatus is a plate that has an outer shape similar to a shape of a pedicle and/or lamina of the vertebra, and an inner section that facilitates access to the pars area when the plate is secured to the vertebra.

Abstract: A method for fusing vertebral bodies comprising the steps of: mounting a first engagement member of a fixation member to a pedicle of a first vertebra and a second engagement member of the spinal fixation member to a pedicle of a second vertebra, the first engagement member having a first extension engaged with an expansion ring, the second engagement member having a second extension engaged with the expansion ring; inserting screws through the first and second engagement members and into the pedicles of the respective first and second vertebrae; rotating the expansion ring in a first direction, thereby distracting the first and second vertebrae; implanting an intervertebral implant between the first and second vertebrae after rotating the expansion ring in the first direction; and rotating the expansion ring in a second direction after implanting the intervertebral implant, thereby compressing the first and second vertebrae.

Abstract: The present disclosure generally relates to a device for positioning and immobilizing at least two adjacent vertebrae. In particular, in one or more embodiments, the present disclosure relates to spinous process fusion devices that distract and immobilize the spinous processes of adjacent vertebrae.

Abstract: A rod inserter tool for inserting a rod into a surgical site, and a rod inserter tool assembly is provided. The tool includes a handle disposed at a proximal end of a shaft. An interior rod actuates the rod so as to rotate the rod generally 90 degrees. In one embodiment, the rod inserter tool includes a rack-and-pinion mechanism that is configured to slide out of the shaft and to rotate the rod about an axis orthogonal to the shaft. In another embodiment, the interior rod is rotatably coupled to the rod so as to rotate the rod when driven axially. In one embodiment, the handle is threaded to an interior of the shaft.

Abstract: A spinal rod reduction apparatus including an elongated body member, a pair of arms extending distally from the elongated body member, and first and second elongated slots defined between the pair of arms. The first and second elongated slots are configured to receive a spinal rod therethrough. The first elongated slot is positioned in opposed relation to the second elongated slot and is longer than the second elongated slot.

Abstract: The present invention relates to a nail system for fixation of an olecranon osteotomy or fracture. The nail system of the present invention is securely held in place in the intramedullary canal to ensure proper anatomic reduction of an osteotomy. Further, the invention provides an insertion device and a method for inserting the osteotomy nail system, securing the osteotomy nail system, and fixing the osteotomy.

Abstract: Intramedullary systems, expandable intramedullary nails, expandable anchors, and methods of using the same. The intramedullary system may include an expandable intramedullary nail configured to extend into an intramedullary canal of a long bone and/or one or more expandable anchors configured to extend at an angle transverse to the intramedullary nail. The intramedullary nails and/or anchors may include one or more integrated expansion mechanisms that allow for insertion in a contracted configuration and expansion into a deployed configuration to lock the relative position and prevent axial rotation and translation of the system.

Abstract: An end cap is provided comprising a head with a tool engagement portion and a shaft with a tip, wherein the shaft comprises a threaded conical portion starting from the tip and extending in a direction to the head. The thread may be provided with a constant pitch, i.e. with a constant distance between the turns of the thread.

Abstract: Intramedullary systems, expandable intramedullary nails, expandable anchors, and methods of using the same. The intramedullary system may include an expandable intramedullary nail configured to extend into an intramedullary canal of a long bone and/or one or more expandable anchors configured to extend at an angle transverse to the intramedullary nail. The intramedullary nails and/or anchors may include one or more integrated expansion mechanisms that allow for insertion in a contracted configuration and expansion into a deployed configuration to lock the relative position and prevent axial rotation and translation of the system.