Abstract: A device that facilitates the placement of one or more needles and their attached sutures in the body of a surgical patient is disclosed. The device contains one or more needle guide channels in which one or more needles may be backloaded. The device also contains one or more lumens extending though the body of the device. One or more sutures may be coupled to the one or more needles, and threaded through the lumen. The one or more needles may then be advanced out of their respective needle guide channels by pulling on one end of one or more sutures. When one end of a suture is pulled, the attached needle is advanced out of the device and will pierce and be positioned in the tissue that is located adjacent to the device.

Abstract: A medical instrument, such as a surgical device for manipulating and placing a tissue suture and methods of using the same is disclosed. The device comprises a handle, a hollow shaft removably coupled to the handle assembly and a stylet extending within the hollow shaft and longitudinally slideable therein. Preferably, the stylet is not rotationally moveable relative to the shaft. The stylet may be moved between a first position wherein a grasping member formed on the stylet is retracted into a distal end portion of the shaft and a second position wherein the grasping member extends distally beyond the distal end portion of the shaft. Distal movement of an actuation member on the handle correspondingly moves the stylet to the extended position and movement of the actuation member to a proximal position on the handle correspondingly moves the stylet to the retracted position. Lateral movement of the actuation member on the handle does not impart rotational movement of the stylet relative to the shaft.

Abstract: Apparatus and methods for tissue fixation/attachment/reattachment using a knotless tensionable suture construct. The knotless tensionable suture construct is a self-tensioning suture loop that can be tensioned and retensioned after the repair and can be cycled few times. The self-tensioning suture loop is formed of: (i) a simple metal surgical needle with a thin loop off the base of it to allow suture to slide through it; (ii) a single strand of surgical suture which can be of various sizes and colors; (iii) a large knot which is tied to create a large bulge to fix the construct to the device (this can be a knot or secondary piece of material, like a button); (iv) a splice formed by the single strand of suture going back through itself, the splice locking the suture in place; and (v) a suture tail that is pulled to reduce the loop size of the construct and tension the repair.

Abstract: Coupling systems for removably coupling dual rotary drive shafts of a surgical instrument to corresponding driven shafts of a surgical end effector. The surgical instrument may include a first rotary drive shaft that includes a first drive shaft axis and a second rotary drive shaft that includes a second drive shaft axis. The second drive shaft axis may be offset from and parallel with the first drive shaft axis. The coupling systems may facilitate simultaneous operable attachment of the first and second drive shafts of the surgical instrument with corresponding first and second driven shafts of a surgical end effector such that rotation of the first drive shaft rotates the first driven shaft and rotation of the second drive shaft rotates the second driven shaft.

Abstract: A fastener cartridge for creating a flexible fastener line is disclosed. The fastener cartridge includes a plurality of fasteners removably stored therein wherein at least some of the fasteners are oriented in directions which are transverse or oblique to an incision created by a cutting member passing through the fastener cartridge. Once these fasteners are deployed into tissue, the fasteners can translate and/or rotate within the tissue when the tissue is stretched.

Abstract: An end effector and a staple cartridge are disclosed. The staple cartridge includes an array of staples in which at least one staple is angularly-oriented relative to the longitudinal axis of the staple cartridge. The angled staple(s) provide longitudinal flexibility to the stapled tissue. Additionally, the staple cartridge and/or the end effector are configured to provide variable degrees of compression to tissue. For example, the compression of tissue before, during and/or after stapling can be optimized.

Abstract: A locking shipping wedge is provided and generally includes a body portion having an elongate transverse member projecting from the body portion which is engageable with a drive assembly of a loading unit. A locking mechanism is provided on the body portion of the shipping wedge which is engageable with locking structure movably mounted within the loading unit.

Abstract: Adjunct material and methods of using adjunct material to reinforce tissue in proximity to a staple line are provided herein. In general, the adjunct material can be used to maintain a seal in tissue, such as lung tissue, and prevent stapled tissue from tearing. This adjunct material can be coupled to a jaw of a surgical stapler, and can be deployed into tissue along with the staples. In some embodiments, the adjunct material can comprise an outer material encompassing an inner, hydrophilic swellable material. The outer material can be selectively dissolvable and/or absorbable. When the outer material is punctured by staples or otherwise penetrated, moisture is passed to the inner material which then swells and expands to transition to a predetermined shape to seal the tissue and prevent leaks from forming in the tissue. Portions of the inner material around the staple line can transition to a large radius.

Abstract: A tissue closure system includes a sheath and a tissue closure device. The sheath includes a tensioner assembly. The tissue closure device is insertable through and connected to the sheath, and includes an expandable member positionable distal of a distal end of the sheath. Operating the tensioner assembly applies a biasing force to the tissue closure device that withdraws the expandable member.

Abstract: A dispensing device configured to operate with an adhesive backed mesh and backing film for tissue bonding is disclosed. The dispensing device provides for low-friction, low force pay-out of a desired length of an adhesive backed mesh to a wound site. The device prevents or eliminates distortion of the mesh prior to application to the wound site, and includes means for reducing or eliminating binding during use. The dispensing device is configured to operate in a “forward” mode (substrate to which mesh is applied passes beneath applicator after mesh is applied) to provide essentially an unobstructed view of the wound site during use.

Abstract: A fastening device, comprising an inner tube comprising a proximal end and a distal end and at least one fastener positioned within the inner tube and adapted to advance linearly towards the distal end of the inner tube, and an advancing element which converts rotational motion to linear pushing force on the fastener. In some embodiments of the invention, at least one fastener is adapted to not rotate at all or to rotate at a rate not necessarily the same as any other fasteners or any other elements during linear advancement.

Abstract: A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Abstract: A system and method for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system and method utilizes elongate magnetic devices that, when connected across a tissue boundary, necrose tissue until an anastomosis forms and the devices are passed naturally. Despite the elongate shape of the devices, the resulting anastomosis is substantially round. As such, round anastomoses can be formed having increased diameters merely by increasing the lengths of the devices, obviating the need for wider endoscopes.

Abstract: An apparatus applicable for the ligation of internal tissue in a created or natural cavity in animals or in the human body, for example varicose veins in the gullet or a duodenal diverticulum, by means of an elastic band (19) while observing the ligations through an endoscope. The apparatus includes an automatic trigger unit (1) mounted firmly on the handle of the endoscope which can release a number of elastic bands (19) with the aid of a single-stranded trigger cord (11). Only a single elastic band (19) is released for each ligation thereby establishing a one-man-operated apparatus.

Abstract: A method for treating a genetically associated chronic obstructive pulmonary disease. At least one implant is advanced into an airway of a lung having a genetically associated chronic obstructive pulmonary disease. The at least one implant is delivered into the lung to increase tension of the lung and thereby improve breathing function of the lung.

Abstract: Provided is a jaw tool formed from two separable units and which includes a fastening device that attaches the two units together when the jaw tool is in use and which may automatically separate the units after the device performs its function such as clamping and/or cutting. Also provided is a jaw tool having a cutting blade wherein the contours of the device are shaped so that force is concentrated on the cutting bade when the device is closed. The jaw tool may be manufactured from a single injection molded-component that is used in duplicate to form the jaw tool. The jaw tool may be used in various applications in which it may be beneficial to simultaneously clamp and cut an object, such as various medical applications including vascular, gastrointestinal, respiratory, and placental.

Abstract: An intervertebral fusion device comprising inferior and superior fusion cage devices that provide an ability to correct spondylolisthesis via in-situ adjustment.

Abstract: An intervertebral fusion device comprising inferior and superior fusion cage devices that provide an ability to correct spondylolisthesis via in-situ adjustment.

Abstract: An adjustable drill depth guide includes a first sleeve, a second sleeve and a stop member. The first sleeve includes a longitudinal axis and defines a helical slot disposed about the longitudinal axis. The second sleeve is concentrically arranged relative to the first sleeve and is axially adjustable relative to the first sleeve for adjusting a length of the adjustable drill depth guide. The stop member extends radially from the second sleeve and is disposed in the helical slot. The stop member is selectively received at various positions along the helical slot to positively locate the second sleeve relative to the first sleeve in the axial direction.

Abstract: A thrombectomy catheter deployment for operation of a thrombectomy catheter may include a stand alone drive unit and a disposable pump/catheter assembly which is manually placed into a carriage assembly in the drive unit. The pump/catheter assembly may have a plurality of preconnected components including a tubular structure and a thrombectomy catheter connected thereto. A barcode reader may sense specific operational data pertaining to an individual pump and may provide an interface for operation of the reciprocating linear actuator.

Abstract: A clot retrieval device, for example to be used in a thrombectomy, is provided including a catheter, an elongated member, and a knitted basket with a proximal end coupled to the catheter and a distal end coupled to the elongated member. The elongated member is movable between an expanded position and a compressed position relative to the catheter and is configured so that the knitted basket expands radially and compresses as the elongated member is moved to the compressed position. The knitted basket is comprised of a plurality of wires coupled together by a plurality of windings. Each winding comprises one of the plurality of the wires twisted about another of the plurality of wires.

Abstract: Catheter-delivered endovascular medical devices are described. The devices may include a pull wire attached to a deployable basket. The basket may include a proximal portion comprising proximal cells defined by a plurality of basket strips and a distal portion comprising a plurality of distal braided mesh openings formed by a plurality of woven linear strands. The proximal and distal portions may overlap with the distal portion being in the proximal portion interior. The distal braided mesh openings may be smaller than the proximal cells when the device is in the relaxed state. Methods of using and making the devices are also described.

Abstract: A surgical instrument for cutting and grasping tissue comprising a handle assembly, an elongated member and first and second jaws. A first movable member moves the second jaw in a first direction about a first pivot axis in a grasping action and a second movable member moves the second jaw in a second direction different than the first direction and about a second pivot axis in a cutting action. A switch is positioned at the proximal portion of the instrument and a selecting member is actuated by movement of the switch, the selecting member movable between a first position to enable movement of the second jaw in the first direction and prohibit movement in the second direction and a second position to enable movement of the second jaw in the second direction and prohibit movement in the first direction.

Abstract: A surgical device is provided. The surgical device includes: a jaw assembly comprising a first jaw and a second jaw moveable relative to the first jaw and an elongated body removably coupled to a proximal end of the jaw assembly. The elongated body includes an actuation bar movable upon engagement of the jaw assembly with the elongated body to secure the jaw assembly thereto; a release button coupled to the actuation bar such that the release button is movable by the actuation bar upon engagement of the jaw assembly with the elongated body and the release button is configured to move the actuation bar to allow for removal of the jaw assembly from the elongated body; and a lockout button in mechanical cooperation with the release button, the lockout button configured to prevent actuation of the release button.

Abstract: A catheter for removing tissue from a body lumen and for providing information relating to the body lumen. The catheter includes a tissue cutting element that rotates relative to the catheter body and is mounted to the drive shaft for imparting rotation to the tissue cutting element. An energy emitting element of the catheter rotates relative to the catheter body and is rotatable independently of the tissue cutting element.

Abstract: A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can further include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can be set such that the sheath can act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath in order to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.

Abstract: A treatment device includes a probe having a treatment portion to treat a biological tissue by using the ultrasonic vibration generated in an ultrasonic transducer; an action portion being able to be close to and away from the treatment portion and including a pressing portion that presses the biological tissue to the treatment portion; and a vibration damping portion disposed in a part of the pressing portion in a state of facing the treatment portion, moving following the treatment portion to which the ultrasonic vibration is transmitted when abutting on the treatment portion in a state where the ultrasonic vibration is transmitted to the treatment portion, and prevented from being grinded by the treatment portion to which the ultrasonic vibration is transmitted.

Abstract: Systems and methods for separating an object such as a pacing lead from a patient tissue involve a flexible and torqueable shaft having an internal lumen sized to receive the object, and a hard separating mechanism for separating the object from the tissue. Typically the shaft and separating mechanism are advanced along or toward the object, and the separating mechanism is contacted with the tissue. The shaft is rotated to effect separation between the object and the tissue. The systems and methods are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: According to one aspect, a medical device may include a luminal element configured for insertion into a natural body lumen. The medical device may further include a tool configured to be received within the luminal element. The tool may include a plurality of operating members. Each of the operating members may include an elongate member and a cutting member. The cutting member may be located at a distal end of the elongate member. Further, the cutting member of a first operating member of the plurality of operating members may be rotatable with respect to the cutting member of a second operating member of the plurality of operating members.

Abstract: A safety neural injection system includes at least a partially hollow cannula having an inside diameter, an outside diameter, a first length, a side port located coaxially along the hollow cannula for fluid communication between the inside and the outside of the hollow cannula, and an open distal end. The safety neural injection system also includes a flexible stylet with a shaped tip. The flexible stylet is capable of being releasably locked in a position within the hollow cannula and extends at least the first length of the hollow cannula. The hollow cannula proximate to the distal end includes a rigid bend so as to facilitate placement of the distal end at the treatment site.

Abstract: A device for allowing passage of a guidewire from a primary blood vessel to an adjacent secondary blood vessel includes a main body having a primary lumen and a secondary lumen, and a piercing member disposed in the secondary lumen, and configured to be moved distally out of the secondary lumen, and to pierce through tissue while being distally moved. A third lumen located within the piercing member is configured to allow placement of a guidewire from the primary blood vessel to the adjacent secondary blood vessel. In one embodiment, the secondary lumen is configured to allow articulation of the distal end of the piercing element. The piercing member has a sharp point on one end to facilitate cutting a small communicating aperture from the primary blood vessel to the secondary blood vessel.

Abstract: Robotic surgical systems and methods of coupling a surgical instrument to a manipulator arm are provided. In one embodiment, a system includes a base; a setup link operably coupled to the base, the setup link locating a remote center of motion for the robotic surgical system; a proximal link operably coupled to the setup link; and a distal link operably coupled to the proximal link. A plurality of instrument manipulators are rotatably coupled to a distal end of the distal link, each of the instrument manipulators including a plurality of actuator outputs distally protruding from a distal end of a frame.

Abstract: A device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field including a base body, which closely surrounds an incision all-side frame-shaped and with at least two webs mounted on the base body, which can be introduced into an intercostal space, by which two ribs arranged next to each other can be moved apart. To create a device for creating an intercostal transcutaneous access to an, in particular endoscopic, operating field which allows individual pressing apart of the ribs, it is proposed according to the invention that the at least two webs are mounted adjustable relative to each other on the base body.

Abstract: A surgical access device including a housing having a nozzle assembly, a gas supply plenum, a gas return plenum, and a pressure sensing plenum, as well as an elongated tubular body that extends from the housing portion and defines a central lumen communicating with the nozzle assembly and the gas return plenum, a telescopic cannula assembly associated with the tubular body and including a proximal section arranged coaxially within the tubular body and a distal section coaxially supported within the proximal section and mounted for movement relative to the proximal section between retracted and extended positions, and an elastomeric sheath associated with the telescopic cannula assembly and having a distal anchor portion for securing the surgical access device during a laparoscopic surgical procedure.

Abstract: An expandable introducer sheath for use in inserting a medical device into a body vessel of a patient includes a body which extends from a proximal end to a distal end along an axis. The body includes an inner layer, an outer layer, and an expandable reinforcement member which is disposed between said inner and outer layers. The expandable reinforcement member is configured to radially expand as the medical device is axially advanced or retracted through said introducer sheath. Once the medical device has exited the introducer sheath, the expandable reinforcement member facilitates a return of the introducer sheath to its original or unexpanded condition.

Abstract: Method and system for treating a patient using an inflatable device. A removal device may be used to remove the inflatable device from the body. The removal device can have at least one manually-actuatable member and at least two opposing jaws at a distal end. At least one of the at least two jaws can be movable by actuation of the at least one manually-actuatable member. At least one of the at least two jaws can have a puncturing member.

Abstract: A medical device is provided. The medical device includes a puncture needle that is inserted into body tissue from outside a body and pierces membranous tissue near pulsating tissue inside the body tissue; a tubular protection member that is disposed on the outer side of the puncture needle; a pulse-information acquisition portion that acquires pulse information of the pulsating tissue; and a driving unit that moves the puncture needle and the protection member relative to each other in synchronization with the pulse information of the pulsating tissue acquired by the pulse-information acquisition portion, in such a manner that a tip of the puncture needle is retracted toward a proximal end from a distal end of the protection member when the pulsating tissue expands and that the tip of the puncture needle is projected farther forward from the distal end of the protection member when the pulsating tissue contracts.

Abstract: Devices, systems, and methods for delivering fluid are provided. Devices include a housing configured for intravaginal deployment and retention, at least one reservoir configured to contain a fluid, and a fluid dispensing mechanism configured to dispense the fluid past the cervix and to the uterus of the subject. Methods include intravaginally deploying and retaining a device in the subject, and dispensing the fluid from the device such that the fluid is driven past the cervix to the uterus of the subject.

Abstract: An osteonsynthesis implant has a plate-shaped base component having at least one hole, at least one axially extending rod-shaped tie rod having a first and a second end and at least one threaded component. The first end of the rod-shaped tie rod can be placed in the hole of the base component. The hole and the first end of the tie rod are formed such that the first end of the tie rod can be locked axially in the hole and is pivoted about an axis of the hole while locked to the plate. The second end of the tie rod is provided with a thread and the threaded component can be screwed onto the thread of the first tie rod. The tie rod can perform a pivoting movement of up to about 20° around the hole axis while locked in the plate hole.

Abstract: A spinal stabilization system includes a connecting rod and a bone screw. The connecting rod includes an elongate rounded section, an elongate head portion, and a neck portion connecting the elongate rounded section with the elongate head portion. The bone screw includes a head portion defining a slot, a shank extending longitudinally from the head portion, and a set screw configured to secure the connecting rod in the slot. The slot includes a leading end portion configured to receive the elongate rounded section of the connecting rod and a trailing end portion configured to threadably engage the set screw, wherein the slot is flared such that elongate rounded section of the connecting rod is pivotable about the leading end portion of the slot.

Abstract: An improved flexible component used for dynamic stabilization of spinal segments for the treatment of vertebrae deformities and injuries and for the replacement of a complete or segment of the body of a vertebra in the spine is described. The flexible component is comprised of a solid, suitable implant material with a longitudinal bore the entire length and an appropriately formed slot which extends spirally around the shaft either continuously or segmentally. The flexible component may be encapsulated, fully or partially, in a suitable implant grade elastomeric resilient material. When used for a dynamic stabilization device, the component is attached to the vertebral bodies by pedicle screws know to those in the art. When used as a vertebral replacement device, attached to the component's opposite ends are members for attachment to the adjacent vertebra that allow for height and angular adjustment.

Abstract: Disclosed herein are a hook with rotating saddle and a rotatable mono axial pedicle screw. In an embodiment, the disclosed hook may include at least one body comprising a hook member and a saddle member. The hook member and saddle member may be rotatably mounted to one another so as to rotate with respect to each other only about a common axis, and the saddle member may be configured for connection to an end of a connecting member. A surgical screw system may include receiver and screw members engagable with one another such that when engaged, only rotation of the receiving member about the longitudinal axis of the screw member and restrain against substantially all other translational or rotational movement.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an upper portion, a receiver member or head, a retaining and articulating structure, and a pressure insert disposed between the shank upper portion and a rod. The receiver has a U-shaped cradle defining a channel for receiving a spinal fixation rod and a receiver cavity. The retaining and articulating structure attaches to the shank and rotates with the shank in the cavity during positioning. The pressure insert presses upon the shank upper portion and not the retaining and articulating structure.

Abstract: A method for correcting a spinal deformity is provided. A spinal implant for correcting a spinal deformity includes a multipoint connector that connects to at least one vertebra of a spine at a plurality of locations and a force directing device that applies a force to the vertebra through the multipoint connector. The force directing device may include a rod which extends generally along an axis of the spine and a force directing member which is adjustably coupled to both the rod and the multipoint connector and which applies a corrective force to the at least one vertebra.

Abstract: Instruments, tools, and methods assist in assembling components of a surgical construct, for example, a press-on rod to a pedicle screw. A includes an elongate driving rod having a distal tip adapted to engage and transfer a rotational force to a surgical screw and a driver connection at a proximate end thereof, a first elongate shaft having a distal end, a proximal end, and a generally U-shaped channel adapted to receive the elongate driving rod therein, and a retention mechanism to retain the elongate driving rod in the generally U-shaped channel. A tool includes an elongate hollow rod having a collapsible distal tip, an elongate shaft slidingly disposed within the elongate hollow rod, the elongate shaft having a distal end comprising a driving feature, and a locking mechanism to prevent the distal end of the elongate shaft from being inadvertently removed from the distal tip of the elongate hollow rod.

Abstract: Neurophysiological instruments and techniques are improved through various enhancements. Stimulation of an instrument is possible while it is advancing into the spine or elsewhere, alerting the surgeon to the first sign the instrument or device (screw) may be too near a nerve. A directional probe helps surgeons determine the location of the hole in the pedicle. Electrically insulating sleeves prevent shunting into the soft tissues. According to a different improvement, the same probe to be used to stimulate different devices, such as screws and wires. Electrical impulses may be recorded from non-muscle regions of the body, including the spine and other portions of the central nervous system as opposed to just the extremities.

Abstract: A bone plate includes a first through hole extending through the plate along a first longitudinal axis from a proximal surface of the plate to a bone-facing distal surface thereof which, when the plate is placed on a target portion of bone in a desired orientation, faces the bone. An outer wall of the first through hole includes three wall sections provided with projections for receiving a screw head of a bone screw. The three wall sections are straight or convex.

Abstract: A bone plate sized and shaped for fixation to a phalangeal bone includes a head extending from a first end to a second end and having first, second third and fourth fixation element holes extending therethrough and arranged in a diamond configuration on the head, an outer wall of the head having a diamond shape corresponding to the diamond configuration, a bone contacting surface of the head being contoured to conform to the anatomy of a dorsal surface of a first metacarpal, the contour being curved to be seated over a protuberance at a head of the first metacarpal and a shaft extending from the head, the shaft including an elongated fixation element hole elongated in a direction parallel to a longitudinal axis of the bone plate.

Abstract: A fixation assembly for securing parts of a sternum has a first section having a first attachment structure for securing the first section to a first sternum part. The fixation assembly includes a second section having a second attachment structure for securing the second section to a second sternum part. A mating arrangement is provided defining a mating direction and a predetermined relative position between the first and second sections in a plane perpendicular to the mating direction. At least one holding member is provided for detachably holding the first and second sections in an abutting relationship in the predetermined relative position. This may be achieved in one variant by simultaneous engagement of the first and second sections substantially along the mating direction.

Abstract: A closure system may secure a first bone portion to a second bone portion. The closure system may include a bracket, a band and a tensioning device. The bracket may include a first portion adapted to engage the first bone portion and a second portion adapted to engage the second bone portion. The band may engage the bracket and may be adapted to be looped around the first and second bone portions. The tensioning device may include a body and a threaded member. The threaded member may be received in the body and may engage the band such that rotation of the threaded member relative to the body moves a first end of the band relative to a second end of the band.