Abstract: The present invention provides spinous process implant and associated methods. In one aspect of the invention the implant limits the maximum spacing between the spinous processes. In another aspect of the invention, a spacer has at least one transverse opening to facilitate tissue in-growth. In another aspect of the invention, an implant includes a spacer and separate extensions engageable with the spacer. In another aspect of the invention, instrumentation for inserting the implant is provided. In other aspects of the invention, methods for treating spine disease are provided.

Abstract: A battery pack for a use with a powered surgical tool. The battery pack may include a housing with an outer wall and opposing first and second ends. The housing may include an elongated shape that extends between the first and second ends. A first member may extend across the first end of the housing and include a first aperture, and a second end member may extend across the second end of the housing and may include a second aperture. A passage may extend through the housing with a first end that aligns with the first aperture and a second end that aligns with the second aperture. The housing may be sized for a plurality of storage locations positioned between the first and second members and around the passage, and each of the storage locations may be configured to store a power cell.

Abstract: The self-locking screwdriver includes a guide tube inside which a clamping rod is guided and rotatably driven, one end of which is provided with a cavity which allows the rotational drive and tightening of an anchoring screw, ensuring the immobilization of an orthopedic implant against an osseous body of an individual, the screwdriver including, on the one hand, between The guide tube and the clamping rod, a blocking system cooperating with the guide tube in order to prevent the latter from being loosened from the orthopedic implant when the anchoring screw is tightened and, on the other hand, on the outer periphery of the guide tube, a gripping wheel for locking and/or unlocking the blocking system and the rotational drive of the guide tube.

Abstract: The present invention provides a method for stabilizing a fractured bone. The method includes positioning an elongate rod in the medullary canal of the fractured bone and forming a passageway through the cortex of the bone. The passageway extends from the exterior surface of the bone to the medullary canal of the bone. The method also includes creating a bonding region on the elongate rod. The bonding region is generally aligned with the passageway of the cortex. Furthermore, the method includes positioning a fastener in the passageway of the cortex and on the bonding region of the elongate rod and thermally bonding the fastener to the bonding region of the elongate rod while the fastener is positioned in the passageway of the cortex.

Abstract: Illustrative embodiments of orthopedic implants and methods for surgically repairing hammertoe are disclosed. According to at least one illustrative embodiment, an orthopedic implant includes a proximal segment comprising a number of spring arms forming an anchored barb at a first end of the implant, a distal segment extending between the proximal segment and a second end of the implant, and a central segment disposed between the proximal and distal segment.

Abstract: The present invention relates to an intramedullary nail for proximal femoral fractures. The intramedullary nail comprises an elongate body (1) with a longitudinal bore (2). The elongate body (1) includes a proximal portion (5) with an oblique transverse bore (7) for a proximal locking member and a distal portion (6) with at least one transverse bore (8) for a distal locking member. An inlet end of the oblique transverse bore (7) is configured as a recess (9) with a recessed surface (11). The recessed surface (11) is composed of recessed lateral surface portions (15) and a recessed proximal as well as a recessed distal surface portion (16 and 17 respectively). Each of the recessed lateral surface portions (15) is configured with at least one protuberance (18) for preventing or reducing the risk for misalignment of e.g. a reamer and, if misalignment occurs, this will not affect critical parts of the intramedullary nail.

Abstract: A bone screw and a method for using same, the bone screw comprising an elongated shaft including a proximal end, a distal end, a leading portion, and intermediate portion and a trailing portion, the elongated shaft defining a longitudinal axis; a cannula bored completely through said elongated shaft extending from said distal end to said proximal end, the cannula aligned with said longitudinal axis; the leading portion having at least one thread; the intermediate portion being unthreaded; and the trailing portion comprising a threaded tapered head adapted engage a threaded hole at a selectable angle.

Abstract: An orthopedic fixation assembly for connecting to a bone includes a fixation plate having a hole, an insert securable to the hole and a screw securable to the insert. The fixation plate includes a shoulder recessed from its upper surface and an aperture. The insert includes a base portion and a flange extending laterally from an upper end of the base portion. The insert defines an insert central axis extending in a direction generally perpendicular to the flange. The screw has a screw head and the base portion has an insert hole with machined internal threads for engaging the screw. The insert hole defines an insert hole central axis extending in a direction at an offset angle relative to the insert central axis. The aperture of the fixation plate is dimensioned to receive the base portion of the insert and the recessed shoulder is dimensioned to receive the flange.

Abstract: A polyaxial fastener is secured within an implant with a retaining ring. The ring is assembled onto a circumferential groove formed in the fastener head. The groove and ring are positionable, when the fastener is installed into an implant, at a wide portion of the mating polyaxial aperture in the implant. The ring is compressible into the groove to form a narrowed diameter, which is passable into a narrow diameter of the aperture, near an entrance to the aperture. The ring is released to expand and increase an overall diameter of the head and ring assembly, thereby rending the assembly too wide to pass by the narrow entrance to the aperture, thereby securing the assembly within the implant.

Abstract: In one embodiment, a bone fixation plate has first and second ends spaced apart along a first direction so as to define a length, and third and fourth ends spaced apart along a second direction so as to define a height that is less than the length. The plate has an inner and outer surface spaced apart along a third direction so as to define a thickness that is less than both the height and length. Openings extend from the inner surface to the outer surface along the third direction and are spaced apart along the first direction. Further, the plate has tangs that are offset from the openings with respect to the second direction, and extend out with respect to the outer surface along the third direction. The tangs are spaced apart from one another along the first direction, and are configured to receive a securement device.

Abstract: Disclosed are methods for correcting hallux varus joint deformity in a foot. The method can include forming a first hole in a first metatarsal of the foot from a medial side to a lateral side of the first metatarsal. A second hole can be formed in a proximal phalanx of a hallux that extends from a medial side to a lateral side of the proximal phalanx. The method includes passing a suture through the first hole, along a lateral side of a first metatarsal phalangeal joint, and through the second hole. The suture can be tensioned between the first and second holes to reduce the hallux to a rectus position relative to the first metatarsal. The suture can be secured within the first and second holes with a first interference screw inserted within the first hole and a second interference screw inserted within the second hole.

Abstract: Apparatus and methods for delivery of an implant at a target site in an interior of a bone. The apparatus may include a plate. The plate may include a bottom surface complementing a surface contour of a bone. The plate may define first holes sized for receiving screws. The plate may define second holes sized for receiving fixation elements. The plate may define an opening. The opening may be sized for providing passage of the implant through the plate. When the bottom surface is seated complementarily against the surface contour, the first holes may point into an interior of the bone and into a volume occupied by the implant in the interior when the implant is positioned at a target site and radially expanded to form a mesh cage.

Abstract: The present invention relates in certain embodiments to medical devices for treating vertebral compression fractures. More particularly, embodiments of the invention relate to instruments and methods for controllably restoring vertebral body height by controlling the flow of bone cement into the interior of a vertebra and the application of forces causes by the cement flow. An exemplary system utilizes Rf energy in combination a conductive bone cement for selectively polymerizing the inflow plume to increase the viscosity of the cement. In one aspect of the invention, the system utilizes a controller to control bone cement flow parameters to either allow or disallow cement interdigitation into cancellous bone. A method of the invention includes pulsing the flows of bone cement wherein high acceleration of the flow pulses can apply expansion forces across the surface of the cement plume to reduce a vertebral fracture.

Abstract: The present disclosure pertains to devices and methods for diagnosis and treatment of biological tissue in which the tissue is accessed by a catheter through a working channel of an endoscope and in which the degree of extension of a distal tip of the catheter beyond a distal tip of the endoscope is controlled.

Abstract: An ablation assembly includes a handle, a catheter assembly and a connector locking assembly. The catheter assembly includes: a catheter shaft, a balloon and a connector at the distal and proximal ends of the catheter shaft, and a delivery tube extending between there between. The connector includes a connector body secured to the proximal end and a plug secured to the delivery tube, the plug and delivery tube movable axially and rotationally. The handle includes an open portion receiving the plug and the connector body. The connector locking assembly includes: means for simultaneously automatically connecting the plug and the connector body to the handle to place the connector in a load state prior to use, and means for automatically releasing the connector body and thereafter the plug from the handle to place the connector in an eject state to permit the connector to be removed from the handle.

Abstract: Methods of ablating endometrial tissue are disclosed. The methods include providing an ablation device that has a catheter with a hollow shaft through which an ablative agent can travel, a first positioning element, and a second positioning element positioned on the catheter distal to the first positioning element. The second positioning element is a disc shaped wire mesh and has a diameter in a range of 0.1 mm to 10 cm.

Abstract: Devices and methods for shaping an ablation treatment volume formed in fluid enhanced ablation therapy are provided. The devices and methods disclosed herein utilize the interaction of fluids to create ablation treatment volumes having a variety of shapes. In one embodiment, a method for forming an ablation treatment volume having a desired shape includes delivering therapeutic energy to tissue to form an ablation treatment volume and simultaneously delivering a first fluid and a second fluid to the tissue. The first and second fluids can convect the therapeutic energy in a desired direction such that the ablation treatment volume has a desired shape.

Abstract: A treatment-energy applying structure includes a flexible substrate having a wiring pattern having a heat-generation region and a connection region. A heat transfer plate faces a surface of the flexible substrate, and transfers heat to a body tissue. An adhesive sheet, having heat conductivity, is disposed between the flexible substrate and the heat transfer plate to cover the entirety of the heat-generation region and the heat transfer plate. A region of the adhesive sheet protrudes from the heat transfer plate to cover a region of the connection region. A pair of lead wires connects to the connection region outside of the covered region. The adhesive sheet is longer than the heat transfer plate and shorter than the flexible substrate. A gap between an end of the heat transfer plate and the lead wires is longer than a diameter of the lead wires or a thickness of the heat transfer plate.

Abstract: An electrosurgical generator is disclosed. The electrosurgical generator includes: a power supply configured to output DC power; an inverter coupled to the power supply, the inverter including a plurality of switching elements; and a controller coupled to the inverter and configured to signal the inverter to simultaneously generate based on the DC power a radio frequency heating waveform and an electroporation waveform.

Abstract: A method and device for controlling a treatment procedure includes a treatment tool, an energy source, and a controller. The controller controls the energy source such that in a first treatment phase, power fed into the material to be treated is controlled with an increasing course. An impedance detector determines the impedance course and/or the present impedance of the material to be treated, and recognizes the achievement of an impedance minimum. A timer is started upon recognition of an impedance minimum, and upon recognition of a further impedance minimum within the specific time interval, the timer is reset. If no new impedance minimum is detected within the specific time interval and the time interval expires, the controller switches the power control to constant power or to a power course with an altered gradient. Upon fulfilling a specific criterion, there is a switchover from power control to voltage control.

Abstract: A surgical system for sealing a hollow organ, the surgical system including: a pair of electrodes; a memory storing data which include patterns corresponding to predetermined burst pressure value; an electrosurgical generator configured to generate a high frequency current for sealing the hollow organ; and one or more processors configured to: perform the sealing by application of the high frequency current through the hollow organ; measure impedance of the hollow organ between the pair of electrodes with time during the performing the sealing; subsequent to performing the sealing, classify parameters related to the impedance as one of patterns corresponding to predetermined burst pressure value according to the data; and estimate the burst pressure value of the hollow organ based on the one of patterns.

Abstract: An optimization of electrical characteristics for treatments of tumor or other abnormal cells in culture with sub-microsecond, high-electric field electrical pulses is disclosed. The voltages, pulse widths, and number of pulses are chosen such that the treatment energy is 10-20 J/mL. That is, U=n*?t*V*I/volume is 10-20 J/mL, in which n is the number of pulses, ?t is the duration of each pulse, V is the voltage, I is current, and volume is the area of parallel electrodes times the distance between them. V divided by the distance between the electrodes can be in an effective range of 6 kV/cm to 30 kV/cm, 60 kV/cm, 100 kV/cm, or higher intensities. Rows of needle electrodes, blade electrodes, or other configurations of electrodes can approximate parallel electrodes.

Abstract: Electrosurgical forceps that can provide improved hemostatis and tissue-cutting capabilities during surgical procedures. The electrosurgical forceps include opposing jaw members, each including first and second electrode members. The first and second electrodes included in the respective jaw members are disposed directly opposite one another, the first electrode members included in the respective jaw members are disposed diagonally opposite one another, and the second electrode members included in the respective jaw members are disposed diagonally opposite one another. A first high frequency (HF) electric power source is connectable across the first electrode members, and a second HF electric power source is connectable across the second electrode members, electrically isolating the first electrode members from the second electrode members, and allowing current to flow diagonally through the tissue between one or both of the first electrode members and the second electrode members.

Abstract: An electrode assembly (3) is provided for use in a resectoscope, the electrode assembly (3) comprising a pair of arms (4), and a tissue treatment element (9) depending from the arms. The arms (4) are pivotably mounted one to the other such that they are movable between a retracted position in which they lie alongside one another and a deployed position in which they diverge one from another. The electrode assembly (3) includes actuation means for moving the arms between their retracted and deployed positions. The tissue treatment element (9) is disposed at the distal end of each arm such that it is movable between at least two different operating positions.

Abstract: A surgical instrument includes a hand piece having a fixed branch and a displaceable branch for actuating a first tool and/or second tool, a guide device in which a force transmission device is arranged to be displaceable longitudinally and/or rotationally, the force transmission device coupled, on the proximal side, to the fixed branch and/or displaceable branch and coupled, on the distal side, to the first tool and/or second tool, and a connection device on which the guide device can be coupled to the hand piece in an insertable and detachable manner by a coupling simultaneously providing a holding force for holding the guide device in the connection device, a bipolar electrical contact on the distal side of the hand piece for parts of the instrument requiring energy, and degrees of freedom for longitudinal and/or rotational movement of the guide device and/or force transmission device.

Abstract: The inventive ablation element comprises an elongated cannula having a proximal end and a distal end. The cannula defines an internal lumen within the cannula and a cannula axis. A plurality of conductors contained within the lumen, each of the conductors has a proximal end proximate the proximal end of the cannula, and a distal end proximate the distal end of the cannula. A plurality of ablation stylets each has a proximal end and a distal end, and each coupled at the respective proximal end of the stylet to the distal end of a respective conductor, the stylets comprise a deflectable material, the conductors together with their respective stylets being mounted for axial movement. A trocar point defined proximate the distal end of the cannula.

Abstract: A surgical device is disclosed, and includes a probe having a handle assembly and an electrode assembly extending distally therefrom. An optical member is disposed on the probe and has a first set of light transmitting properties corresponding to a first set of physical parameters of the probe. The probe is configured to transition to a second set of physical parameters, the second set of physical parameters being different from the first set of physical parameters. The optical member is configured to transition from the first set of light transmitting properties to a second set of light transmitting properties, the second set of light transmitting properties corresponding to the second set of physical parameters, the second set of light transmitting properties being different from the first set of light transmitting properties.

Abstract: One embodiment of the present invention relates to an electrosurgical handpiece that has a first main body and a second main body. A squeezable handle connects to and across the first main body and the second main body such that, when the handle is unsqueezed, the first main body and the second main body assume a first position relative to one another. When the handle is squeezed, the first main body and the second main body assumes a second position relative to one another. An active electrosurgical electrode is slidingly mounted within the second main body and extends from the second end. A spacer is positioned around and in sliding engagement with the smaller diameter region of the first main body.

Abstract: A tissue resecting device includes a handle, a shaft assembly movably attached to the handle, a housing secured to a distal end of the shaft, and an electrode. The electrode is disposed in the housing to move across a window, and at least one motor in the handle both reciprocates the shaft assembly relative to the handle and drives the electrode across the window.

Abstract: A tissue resecting device includes an elongated shaft having a central axis, a distal end, and a proximal end. A ceramic or other housing is mounted at the distal end of the shaft and has a tissue-receiving window. A movable electrode is configured to be rotationally oscillated or otherwise moved across the window. In one instance, the rotatable moveable electrode may have a dogleg configuration with a free end constrained within an arcuate slot formed near the window. In another instance, the movable electrode may have a U-shaped configuration with a distal end coupled to a pivot in the housing which is aligned with a rotational drive member.

Abstract: A tissue resection device comprises inner and outer coaxial sleeves. The outer sleeve has a cutting window formed therein, and the inner sleeve has a distal cutting end that can be reciprocated past the cutting window. The sleeves comprise electrodes to provide electrosurgical cutting, and an edge portion of the window includes a dielectric material.

Abstract: Systems, device and methods treat target tissue to provide a therapeutic benefit to the patient. A tissue treatment device comprises a tissue treatment element constructed and arranged to treat target tissue, such as duodenal mucosa tissue.

Abstract: An ultrasound catheter includes a hollow body and a plurality of ultrasound sensing regions. The hollow body is made of a flexible circuit board. The ultrasound sensing regions are disposed on a periphery of the hollow body, wherein each of the ultrasound sensing regions has a plurality of channels, and the channels of each ultrasound sensing region are arranged along an axial direction of the hollow body. A medical system using the ultrasound catheter is also provided.

Abstract: A device positionable in a cavity of a bodily organ (e.g., a heart) may discriminate between fluid (e.g., blood) and non-fluid tissue (e.g., wall of heart) to provide information or a mapping indicative of a position and/or orientation of the device in the cavity. Discrimination may be based on flow, or some other characteristic, for example electrical permittivity or force. The device may selectively ablate portions of the non-fluid tissue based on the information or mapping. The device may detect characteristics (e.g., electrical potentials) indicative of whether ablation was successful. The device may include a plurality of transducers, intravascularly guided in an unexpanded configuration and positioned proximate the non-fluid tissue in an expanded configuration. Expansion mechanism may include helical member(s) or inflatable member(s).

Abstract: Diagnostic and therapeutic medical devices and methods that include an elongate shaft, a balloon, a plurality of electrodes carried by the balloon, and electronics to electrically connect the electrodes to a proximal end of the shaft. The devices can include a visualization system within the balloon.

Abstract: Methods for treating polycystic ovary syndrome with therapeutic ovarian neuromodulation and associated systems and methods are disclosed herein. Polycystic ovary syndrome can be associated, for example, with a condition including at least one of oligo/amenorrhea, infertility, hirsutism, obesity, metabolic syndrome, insulin resistance, and increased cardiovascular risk profile. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate an ovarian artery of an ovary of a patient. Sympathetic drive in the patient can thereby be reduced in a manner that treats the patient for the polycystic ovary syndrome. Ovarian sympathetic nerve activity can be modulated along afferent and/or efferent pathways. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly, e.g.

Abstract: A probe for resecting and coagulating tissue comprises an outer sleeve having a tissue cutting window and an inner sleeve having a tissue cutting distal end. And RF cutting region is formed at the distal end of the inner member and an RF coagulation region is formed on an exterior surface of the inner member immediately proximal to the cutting surface. A single power supply providing a single RF energy mode can be connected to both RF applicator regions to simultaneously cut and coagulate tissue.

Abstract: The modular microwave ablation system of the present disclosure includes a microwave instrument, a microwave generator, and one or more auxiliary modules that include circuitry for performing functions related to the operation of the microwave generator. The one or more auxiliary modules are removably connected to the microwave generator. The microwave generator includes a microwave signal generator that generates a microwave signal; a microwave generator controller in communication with the microwave signal generator; one or more terminals that connect to the one or more auxiliary modules, respectively; and a power supply and/or a power distribution module coupled to the microwave signal generator, the microwave generator controller, and the one or more terminals. The one or more terminals provide (1) power from the power supply and/or power distribution module to the one or more respective auxiliary modules and (2) communication signals to and from the one or more respective auxiliary modules.

Abstract: A microwave field-detecting needle assembly includes a needle assembly. The needle assembly includes a distal portion, a proximal portion, and a junction member disposed between the distal portion and the proximal portion. The junction member includes a recess defined therein. The needle assembly also includes a rectifier element disposed in the recess. The rectifier element includes a first terminal electrically coupled to the distal portion and a second terminal electrically coupled to the proximal portion.

Abstract: A medical device to be inserted in a defect blood vessel, body cavity, or body duct for treatment thereof is disclosed, wherein it comprises an essentially cylindrically formed elongated resilient sheath device (2) wherein it has a distal end (3) and a proximal end (4), wherein said sheath device (2) along its circumferential surface in the axial direction is provided with a slotted opening (5) having connection with a first bore (6) arranged in the axial direction of said sheath device (2), said first bore (6) having the ability to house an elongated fiber body (7), wherein said sheath device (2) has the ability to be clamped around a major part of the perimeter of said fiber body (7), and wherein said sheath device (2) in its axial direction also is provided with a second bore (8) having the ability to house an injection means (9), as well as a kit containing said medical device, and a method for treatment of defective blood vessels, body cavities, and body ducts by use of said medical device.

Abstract: The present invention provides a system and method for treating artery having atherosclerosis. The system comprises a flexible device for wrapping around the diseased artery, at least an imaging fiber and/or an ablation fiber removably adapted on the inner side of the flexible device for imaging and/or treating the said artery and a controller for controlling the process of imaging or treatment on the said artery.

Abstract: The present disclosure relates generally to the use of medical devices for the treatment of vascular conditions. In particular, the present disclosure provides devices and methods for using laser-induced pressure waves created within a sheath to disrupt intimal and medial calcium within the vasculature.

Abstract: A method of generating a patient-specific prosthetic includes receiving anatomic imaging data representative of a portion of a patient's anatomy. A first digital representation of the anatomic imaging data is defined. The first digital representation of the anatomic imaging data is modified. A second digital representation of the portion of the patient's anatomy is defined based on the modifying of the first digital representation of the anatomic imaging data. A patient-specific prosthetic template of the portion of the patient's anatomy is generated based at least in part on the second digital representation of the anatomic imaging data.

Abstract: A system and method utilizing a camera device containing an inertial measuring unit or similar orientation mechanism to calibrate alignment of the camera device according to a primary image such as displayed on an imaging screen, and then utilizing this calibration data to guide the system or user in acquiring a spatially aligned digital image using the camera device. Steps include recording the spatial orientation of the camera in at least two spatial dimensions when aligned with the primary image, and guiding camera alignment relative to the imaging screen when taking a picture.

Abstract: The present invention provides an ergonomic operational system and method thereof for a human operator such as a dental surgeon in image guided implantation. A physical or virtual display in close proximity to, or integrated with, the dental drill shows the information that demands a high frequency of observation from the surgeon. The surgeon is thus able to monitor the drilling site and the display at the same time, without moving his head toward other display not within his field of view. The invention exhibits numerous technical merits such as simplicity of operation, improved operational safety, higher productivity, and enhanced efficiency, among others.

Abstract: A non-sterile device such as, a sensor with a kinematic mount is provided, such that there is a positional relationship between an optical system within the sensor, and the kinematic mount. A sterile drape is provided to allow the introduction of non-sterile devices into the sterile surgical field. The sterile drape has a kinematic mount adapter with a sterile side and a non-sterile side, with a known positional relationship between both sides. The non-sterile side (internal to the drape) is configured to kinematically couple to the non-sterile device and the sterile side (external to the drape) is configured to kinematically couple to an object in the sterile field such that the position and orientation of the object with respect to the non-sterile device is known to a processing unit and can be used to calculate positional measurements.

Abstract: Navigation systems and methods for tracking physical objects near a target site during a surgical procedure. The navigation system comprises a robotic device and an instrument attached to the robotic device. A vision device is attached to the robotic device or the instrument and generates vision data sets. The vision data sets are captured from multiple perspectives of the physical object. A computing system associates a virtual object with the physical object based on one or more features of the physical object identifiable in the vision data sets. The virtual object at least partially defines a virtual boundary for the instrument.

Abstract: A system for verifying a tool for use in a surgical procedure includes a mechanical interface configured to be affixed to a portion of a patient's anatomy, wherein the mechanical interface comprises at least a first portion having a first diameter and a second portion having a second diameter. The system further includes a probe configured to be inserted into the mechanical interface to establish a checkpoint location, and a computing system configured to determine a location of a portion of the probe when the probe is inserted a maximum distance into the mechanical interface, wherein the location of the portion of the probe establishes the checkpoint location. The computing system is further configured to verify a surgical tool by comparing the checkpoint location to a location of a portion of the surgical tool when the surgical tool is inserted a maximum distance into the mechanical interface.

Abstract: A system to control the interaction between a user-interface of a teleoperated surgical system and an input device of the teleoperated surgical system, the system comprising a first master controller communicatively coupled to the teleoperated surgical system, a feedback control communicatively coupled to the first master controller, and a display device communicatively coupled to the teleoperated surgical system and configured to display the user interface. The feedback control is configured to restrict the movement of the first master controller based on a state of the user interface changing from a previous state.

Abstract: A Robotic control system has a wand, which emits multiple narrow beams of light, which fall on a light sensor array, or with a camera, a surface, defining the wand's changing position and attitude which a computer uses to direct relative motion of robotic tools or remote processes, such as those that are controlled by a mouse, but in three dimensions and motion compensation means and means for reducing latency.