Abstract: A method of forming an access opening through a psoas muscle to a patient's spine includes laterally inserting a stimulating dilator into the psoas muscle. The stimulating dilator has a stimulation channel formed in an outer surface thereof. An electrical pulse is transmitted via an EMG into the stimulating dilator to locate a positon of a nerve in the patient's psoas muscle. The stimulating dilator is laterally inserted through the psoas muscle and toward the patient's spine in a way that avoids the nerve. A stimulating probe is inserted into the stimulation channel along the outer surface of the stimulating dilator while transmitting an electrical pulse via the EMG into the stimulating probe to verify the position of the nerve.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: In one embodiment, the present invention is a system for repairing a meniscus including: a suture assembly including a first anchor, a second anchor, and a flexible suture connecting the first anchor and the second anchor, the flexible suture including a slide knot between the first anchor and the second anchor; and an inserter including a needle having a longitudinal extending bore and an open distal end, the bore being configured to receive the first anchor and the second anchor, a housing operatively connected to a proximal end of the needle, the housing having a lumen and a slot, the slot including a first portion, a second portion, a first shoulder and a second shoulder and a pusher configured to rotate and slide within the lumen of the housing and the longitudinal extending bore of the needle, the pusher having an extension extending through the slot and configured to be maneuverable through the first portion and second portion and engageable with the first shoulder and second shoulder.

Abstract: An elongate shaft assembly for use with a stitching device includes a hub assembly and an end effector. The hub assembly includes insertion and engaging portions. The insertion portion includes a main rod, a rotatable hub operatively coupled with the main rod such that axial displacement of the main rod rotates the rotatable hub, and first and second arms operatively coupled with the rotatable hub such that rotation of the rotatable hub causes reciprocating axial displacement of the first and second arms. The engaging portion is movable relative to the insertion portion between a reload position in which the rotatable hub is in a distal-most position and rotatable independent of axial displacement of the main rod, and a loaded position in which axial displacement of the main rod rotates the rotatable hub.

Abstract: A system for treatment of tissue includes a fixation apparatus and a delivery tool releasably carrying the fixation apparatus. The fixation apparatus includes first and second anchors and an adjustable band connecting the anchors. The band includes a cinch line and a tether connected to one of the anchors. The delivery apparatus includes a body, a tubular shaft, a displacement rod within the tubular shaft, and an actuator.

Abstract: An attachable clamp for use with a surgical instrument is disclosed. The attachable clamp comprises a body portion, a first jaw member, a second jaw member and an actuation mechanism. The body portion defines a longitudinal axis and has attachment members configured to attach to an elongate portion of a surgical instrument. Each of the first jaw member and second jaw member extends distally from the body portion. The actuation mechanism is disposed in mechanical cooperation with at least one of the first jaw member and the second jaw member. Actuation of the actuation mechanism moves at least one of the first and second jaw members between an approximated position and an open position with respect to the other jaw member.

Abstract: The present invention provides a suturing device to minimize interference and obstructions during intricate surgeries. The curled suture device is significantly shorter than traditional suturing kits by featuring a needle attached to a specially manufactured thread incorporating a stopping mechanism preceding an angular, semi-rigid portion of thread followed by a curled portion of thread arranged in a corkscrew configuration. The stopping mechanism halts the movement of the thread as the needle and thread intermediate the needle and stopping mechanism is pulled through the suture point, securing the remainder of the thread for access. The semi-rigid portion of thread is thereby utilized in conjunction with its curled portion of thread, allowing for the user's unabated access to the corkscrew configuration to form a ready-made knot, minimizing interference and obstruction during surgery. The thread may be manufactured to form an additional semi-rigid and curled portions of thread upon creation of a knot.

Abstract: A surgical stapling device (10) includes a frame (36), a pusher (105), a clamping plate assembly (110), a holder (180), and a stapling plate (220). The pusher (105) is movable in relation to the frame (36) between a retracted position and an advanced position. The pusher (105) is operatively associated with the holder (180), the clamping plate assembly (110), and the stapling plate (220) such that movement of the pusher (105) between the retracted and the advanced positions effects movement of the (105), the clamping plate assembly (110), and the stapling plate (220) to one of their respective retracted or advanced positions.

Abstract: The present disclosure relates to endoscopic reposable surgical clip appliers having a shaft assembly. The shaft assembly includes a spindle, pusher bar, and a barrel assembly. The spindle and pusher bar are each translatably supported within the shaft assembly. The barrel cam assembly includes a first portion in mechanical communication with the spindle and a second portion in mechanical communication with the pusher bar. Translation of the spindle effectuates rotation of a portion of the barrel cam assembly and the rotation of the portion of the barrel cam assembly effectuates translation of the pusher bar.

Abstract: A surgical loading unit (10) for use with a surgical handle assembly (1000) includes a handle mount (12) dimensioned for mounting to the handle assembly (1000), an outer member (56) extending from the handle mount (12), a staple cartridge assembly (16) mounted to the distal end of the outer member (56), and an anvil assembly (18) couplable relative to the staple cartridge assembly (16). A staple pusher (60) is at least partially disposed within the outer member (56) and operatively coupled to the staple cartridge assembly (16). The staple pusher (60) is adapted for longitudinal movement to eject staples from the staple cartridge assembly (16). An anvil approximator (94) is at least partially disposed within the outer member (56) and is operatively coupled to the anvil assembly (18). The anvil approximator (94) is adapted for movement between first and second positions corresponding to closed and open conditions of the anvil assembly (18) relative to the staple cartridge assembly (16).

Abstract: A bending control mechanism includes a turning power input mechanism, a turning transmission mechanism, a locking mechanism and a linear power output mechanism. The turning power input mechanism and the turning transmission mechanism which are coaxially arranged have a relative rotating angle range in the circumferential direction; the turning power input mechanism sequentially rotates in an angle I, an angle range II and an angle III while rotating relative to the turning transmission mechanism from one end angle to the other end angle of a relative rotating angle range, wherein the angle I or the angle III corresponds to turning; the angle range II corresponds to a locking state. With the adoption of the mechanism, the problem of turning and fixing of the surgical instrument in a human body during surgery is solved, and the risk of surgery is reduced.

Abstract: A staple cartridge assembly comprises a staple cartridge, an anvil and a cutter, wherein the cutter comprises a first end and a second end; the staple cartridge assembly also comprises a rotation shaft and an auxiliary closing member which is connected with the rotation shaft; the staple cartridge assembly is also provided with a driving component capable of driving the rotation shaft to rotate; the driving component drives the rotation shaft to drive the auxiliary closing member to move in the process in which the staple cartridge assembly is converted from an original status to a closed status; when at least the staple cartridge assembly is in the closed status, one end surface of the auxiliary closing member abuts against the anvil to apply a force to the anvil for driving the anvil to be closed towards the staple cartridge.

Abstract: The present teachings provide methods for resizing, reducing, and closing left atrial appendage. Specifically, a percutaneous trans-septal access is first established from outside the body to a patient's LAA. At least two tissue anchors are then implanted inside the LAA chamber and along the tissue wall. At least one anchor is implanted near the opening of the LAA camber. Both tissue anchors are pulled together so that the wall of the LAA chamber collapse. The LAA chamber is therefore resized, reduced, and/or closed off completely. This closure method and system could be used alone in closing LAA chamber. This closure method and system could also be used in addition to other treatment mechanisms, such as filling the LAA chamber with space-filling material, then closing off its opening.

Abstract: Systems and methods are provided for delivering and mechanically detaching embolic coils. The systems disclosed herein comprise a mechanical detachment mechanism to intravascularly release an embolic coil. The methods disclosed herein comprise a various triggering mechanisms to detach embolic coils.

Abstract: A clip cartridge assembly (300) is provided including a clip tray (302), cartridge clip pusher bar (304), and a plurality of surgical clips (C) interposed therebetween. The clip tray (302) is configured to be selectively loadable in a channel assembly (108) of a surgical clip applier (100) and includes a first plurality of distally oriented, deflectable, resilient fingers (302d) projecting from a base wall thereof. The cartridge clip pusher bar (304) is disposed adjacent the clip tray (302) and is slidable relative thereto. The cartridge clip pusher bar (304) includes a second plurality of distally oriented, deflectable, resilient fingers (304e) projecting from a base wall thereof and each terminating in a distal shoulder (304f). A surgical clip applier (100) is also provided.

Abstract: A surgical apparatus for application of surgical clips to body tissue is provided. The surgical apparatus includes a housing, a drive assembly, a trigger, and a shaft assembly. The trigger is operatively connected with the drive assembly. The drive assembly is at least partially positioned within the housing. The shaft assembly extends distally from the housing and has a first tubular member pivotally connected with a second tubular member located distally from the first tubular member. An articulation mechanism is operatively connected between the first and second tubular members, and includes a gear rack, at least one gear, and a gear segment, respectfully connected with each other to pivot the second tubular member about the pivot axis. The gear rack and at least one gear are located within the first tubular member. The gear segment extends proximally from the second tubular member.

Abstract: An apparatus for treating an aneurysm in a blood vessel includes a wire to be advanced within a tube and an occlusion element disposed on the wire. The occlusion element includes a cover and an inner anchoring member. The occlusion element is configured to fit within the tube and slide out of an opening at distal end of the tube in response to movement of the wire. The cover is configured to expand to an expanded configuration when advanced into the aneurysm, wherein the cover comprises a diameter that is greater than the diameter of a neck portion of the aneurysm and is configured such that a first portion of the cover contacts an interior surface of the aneurysm and a second portion covers the neck portion of the aneurysm. The inner anchoring member extends from the cover portion and is configured to contact the interior surface of the aneurysm.

Abstract: Devices, methods and systems are provided for occluding an opening within the tissue of a body, such as a left atrial appendage. In one embodiment, a delivery system for use in occluding an opening in the tissue of a body includes an actuation assembly operatively coupled to a medical device including an anchor portion and an occluder portion. The actuation assembly is configured to move the anchor portion between a deployed state and retracted state while the occluder portion maintains a deployed state. With this arrangement, the deployed occluder portion can be visualized via imaging at a preferred position prior to deploying the anchor portion of the medical device.

Abstract: An epicardial implant having a positioning device that defines an open interior. The positioning device is configured to be detachably coupled with an implant delivery device such that the positioning device may be detached from the implant delivery device after the implant is in place about an atrial appendage. The positioning device has first and second sides with a distal end that couples the first and second sides. The implant includes an expandable cuff coupled with the positioning device. The positioning device is configured to selectively move the expandable cuff toward and away from an atrial appendage to position the expandable cuff in a desired position relative to the atrial appendage. The expandable cuff is expandable into at least a portion of the open interior of the positioning device to physically occlude a base of the atrial appendage following placement of the expandable cuff into the desired position.

Abstract: A medical closure device that is configured to be inserted into a patient's LAA (left atrial appendage) cavity comprises a closure member and at least one fixing member, wherein the closure member comprises a lid part and a body part one following the other in a proximal-distal direction. The lid part comprises a cover portion and a ring portion, the ring portion being configured to be circumferentially disposed along the rim of an individual LAA ostium, thus sealing the LAA ostium completely. The medical closure device is designed individually for each patient. A method of manufacturing the medical closure device includes the step of forming an LAA model based on computer graphic data of the patient. The LAA model is made by 3-D printing and is an exact reproduction of the patient's LAA. The medical closure device is then preformed using the LAA model.

Abstract: Provided is a tourniquet including an internal expansion and contraction portion that includes a gas injection and discharge portion to allow injection and discharge of a gas and expands or contracts according the injection and discharge of the gas and an external accommodation portion that has an incision in a longitudinal direction at one surface to have an accommodation space in which the internal expansion and contraction portion is able to be accommodated.

Abstract: A surgical saw and complementary blade. The blade has lock teeth that are more ductal than the cutting teeth. The saw coupling assembly has an anvil and a press. The saw coupling assembly holds the blade to the saw by compressing the saw lock teeth between the anvil and the press so as to result the coining of the lock teeth.

Abstract: A bone cutting surgical instrument includes features to mitigate heat generation during use. Excessive heat can be detrimental to bone health as well as to the instrument itself. In one example a liquid dispensing feature provides a flow of cooling liquid to an ultrasonic blade via a lumen in a waveguide of the instrument. In another example, the blade has a serrated edge with a plurality of teeth arranged in a pattern to provide dimension and space during cutting actions. In another example, the blade has an oversize distal portion that creates an oversize slot when cutting to avoid excessive contact between the cut bone and proximal portions of the blade. In another example the blade includes an irrigation slot and also a micro slot in a distal end of the blade that connects with the irrigation slot.

Abstract: Shapeable guide catheters and methods for manufacturing and using such shapeable guide catheters. In one embodiment, the shapeable guide catheter comprises a tubular member having a shapeable region, a malleable shaping member attached to the shapeable region such that, when the shape of the shapeable region is changed from a first shape to a second shape, the shaping member will plastically deform to thereafter substantially hold the shapeable region in the second shape, a tubular outer jacket disposed about the outer surface of the tubular member and a tubular inner jacket disposed within the lumen of the tubular member. The shapeable region of the guide catheter may be manually formed into a desired shape before insertion of the guide catheter into the body. In some embodiments, the guide catheter is sized to be inserted through a nostril of a human patient and used to guide the transnasal insertion of another device (e.g., a guidewire, catheter, etc.

Abstract: A platform of devices for removing obstructions and other objects within a blood vessel or other interior lumen of an animal is provided. The system may be deployed in the lumen from a catheter(s) and the system includes a proximal hub, and a distal basket comprised of a plurality of cells. A number of different baskets designs are disclosed. Methods of manufacturing such baskets out of a single tube of a memory metal without the need for any welding or soldering, and methods of use are also disclosed.

Abstract: A surgical instrument for minimally invasive surgical procedures having a handle portion, an elongated body portion extending distally from the handle portion, an end effector movable between a first position and a second position, and an elongated tissue probe movably positioned within the elongated portion. The probe is movable between a retracted position and an advanced position, wherein movement of the probe moves the end effector from the first position to the second position.

Abstract: A hydrodynamic catheter includes a catheter body with a catheter lumen and an infusion tube extending within the catheter body, the infusion tube configured for coupling with a fluid source near the catheter proximal portion. An inflow orifice and an outflow orifice are positioned at locations along a catheter body perimeter. A fluid jet emanator is in fluid communication with the infusion tube, where the fluid jet emanator includes one or more jet orifices configured to direct one or more fluid jets through the catheter lumen from near the inflow orifice toward the outflow orifice. A pivot cylinder located along the catheter body perimeter is positioned distal relative to one or more of the fluid jet emanator, the inflow orifice, or the outflow orifice.

Abstract: An apparatus includes a body assembly, an acoustic waveguide, an ultrasonic blade, and a liquid dispensing feature. The ultrasonic blade is positioned distally relative to the body assembly. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The liquid dispensing feature is positioned distally relative to the body assembly. The liquid dispensing feature is positioned adjacent to the ultrasonic blade. The liquid dispensing feature is configured to deliver a flow of cooling liquid to the ultrasonic blade.

Abstract: An apparatus includes a body assembly, an acoustic waveguide, an ultrasonic blade, a liquid dispensing feature, and a control module. The liquid dispensing feature is positioned distally relative to the body assembly. The liquid dispensing feature is positioned adjacent to the ultrasonic blade. The liquid dispensing feature is configured to deliver a flow of cooling liquid to the ultrasonic blade. The control module is operable to regulate fluid flow through the liquid dispensing feature.

Abstract: Methods, devices and systems for separating an implanted object, such as a lead attached to a cardiac conduction device, from formed tissue within a blood vessel are provided. The methods, devices and systems for separating a lead from the tissue relate to dilating the tissue surrounding the lead from underneath the tissue and/or between the lead and the tissue.

Abstract: A method of treating a lesion in a body lumen to enlarge a passageway in the lumen including providing a cutting member, connecting a tracking member to the cutting member to form an assembly, inserting the connected cutting member and tracking member through a first lumen of a catheter, withdrawing the catheter from the cutting member and tracking member, inserting the catheter over the tracking member and leaving the cutting member outside the catheter, and expanding a portion of the catheter to move the cutting member into cutting contact with the lesion. A device for treating a lesion in a body lumen including a cutting member having a coupler to connect a tracking member is also provided.

Abstract: A protection device includes an elongate body having a distal portion defining a flange, and a proximal portion including a plurality of legs extending proximally from the distal portion. When a distal surface of the flange is positioned on a horizontal surface, the plurality of legs is oriented in a vertical orientation.

Abstract: Two part laparoscopic tools and surgical methods using such tools are presented. The tools and methods enable use of multiple surgical tools each having wide tool heads to be used in a body cavity using a single wide trocar and one or more narrow incisions, thereby reducing surgical risk and enhancing patient comfort and shortening recovery time. Additional instruments for facilitating laparoscopic surgery are also presented.

Abstract: Methods and apparatus for direct visual rhizotomy using an elongated tubular sheath. The sheath includes: a proximal end configured to removably receive a cannula; a distal end; a horizontal shaft having a longitudinal axis extending between the proximal end and the distal end; a first cut-away generally defining a first plane at the distal end, the first cut-away characterized by a first angle relative to a vertical plane; and a second cut-away generally defining a second plane at the distal end, the second cut-away characterized by a second angle relative to a horizontal plane. The sheath further includes an endoscope camera disposed at the distal end, the camera having a line of sight substantially orthogonal to the first plane.

Abstract: An adapter assembly for connecting an end effector to a handle assembly includes a trocar assembly having a flexible trocar member.

Abstract: A biopsy needle assembly includes a mandrel within a cannula, the needle assembly is fired into a target tissue to obtain a tissue sample using a force source imparting movement to the needle assembly. The mandrel and cannula design, and force source characteristics minimize needle deflection, and allow the needle assembly to excise extended length tissue samples. The mandrel forms tissue retention ridges within a tissue sample region to reduce fragmentation of the tissue sample.

Abstract: Embodiments systems and methods for a platform that is configured to hold a medical device. In embodiments, a physician, nurse, medical practitioner, etc. may perform actions to change the positioning and orientation of the medical device while the medical device is secured to the platform. In further embodiments, the platform may include robotic components configured to change the positioning and orientation of the medical device.

Abstract: A method for performing image-guided embryo transfer for in vitro fertilization includes performing a pre-operative magnetic resonance imaging (MRI) scan of a subjects pelvic region to yield a first MRI image dataset. A computer applies a segmentation routine to the first MRI image dataset to yield segment data which is then used by the computer to create an anatomical model of the subjects pelvic region. The computer determines an optimal implant location based on the anatomical model and creates a three-dimensional rendering of the optimal implant location based on the first MRI image dataset.

Abstract: A device to adjust a strip of circular adjustment around the cephalic pole, that is inserted within the delivery channel together with a sleeve and an applicator. The sleeve is flexible, has both ends open, and a fold in its middle where it is fixed, on the inner side of the fold, and where the sleeve has two traction handles on ends of the inner fold, and where the applicator is provided with a butt head, spatulas that fit in the pockets of the sleeve and a guide to indicate the movement of the spatulas with respect to the head butt, and includes: a strip of circular adjustment of flexible material; and at least an adjustment axis with its respective driving mechanism. Also disclosed is a method of using the device.

Abstract: A vented microdermabrasion tip includes a disk-shaped abrasive component coated or configured with a microdermabrasive surface and fixed to a tubular sleeve by a set of annular mounts. The sleeve surrounds an outer periphery of the abrasive component, so that a gap is provided between the abrasive component and an internal air passage through the sleeve. A distal surface of the abrasive component is continuous, free of holes and coated with an abrasive material or formed with an abrasive surface. The distal surface extends beyond the distal end of the sleeve. An end of the mount opposite to the abrasive component is configured for coupling to a channel of a suction apparatus leading to an inlet of an air pump.

Abstract: A telescopic strut for use with an external fixator comprising an axially extending rod; an axially extending tube moveably recurring the rod for varying the length of the rod and tube combination along a longitudinal axis; the tube having first and second ends, the second end having a pin extending therethrough; a locking system mounted on the tube first end for adjusting the position of the rod in the tube and fixing the length of the rod and tube combination; a coupling element having a tubular sleeve with a threaded outer surface mounted on an outer surface of the second end of the tube, the sleeve having two diametrically opposed slots receiving the pin and an adjustment element threadably mounted on the sleeve outer surface for axial movement along the axis, the adjustment element having a surface contacting the pin to limit the movement of the pin in the slots.

Abstract: The present invention relates to systems and methods for spinal fusion procedures that can allow all components of the spinal fusion procedure to be inserted into the wound of a patient at once, and can thus minimize the number of components that must be separately inserted into a wound. This can be accomplished by providing a intervertebral fixation system that allows an intervertebral cage, vertebral fixation plate, and drill guides to be assembled into a single unit prior to insertion into a patient.

Abstract: An articulating assembly includes a first elongated element for attachment to a first anatomical region, and a second elongated element for attachment to a second anatomical region. In at least one embodiment, a coupling connects the first and second elongated elements. The coupling includes a moveable joint configured to allow polyaxial movement of the first elongated element with respect to the second elongated element. The assembly further includes a locking mechanism. The locking mechanism is operable in an unlocked condition to permit polyaxial movement of the first elongated element with respect to the second elongated element, and a locked condition to immobilize the movable joint and fix the position of the first elongated element with respect to the second elongated element.

Abstract: An anchor assembly for use in spinal fixation to interconnect a longitudinal spinal rod with a patient's vertebra. The anchor assembly preferably includes a bone anchor, a body with a rod-receiving channel, an insert member (preferably a bushing), and a locking cap. The anchor assembly enables in-situ assembly where the bone anchor may be secured to the patient's vertebra prior to being received within the body of the bone anchor assembly. Accordingly, the anchor assembly enables a surgeon to implant the bone anchor without the body to maximize visibility and access around the anchoring site. Once the bone anchor has been secured to the patient's vertebra, the body may be snapped onto the bone anchor and a spinal rod may be inserted into the rod-receiving channel.

Abstract: A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

Abstract: A dynamic fixation medical implant having at least two bone anchors includes a longitudinal connecting member assembly having at least one transition portion and cooperating outer sleeve, both the transition portion and sleeve being disposed between the two bone anchors. The transition portion includes a rigid length or rod having apertures therein and a molded plastic length that extends through the apertures, thus attaching the plastic length to the rigid length. The sleeve surrounds the transition portion and extends between the pair of bone anchors, the sleeve being compressible in a longitudinal direction between the bone anchors.

Abstract: Open implant closure structures include a helically wound guide and advancement flange form having pivot-splay accommodating and splay control surfaces with opposing load flanks in initial non-parallel relation.

Abstract: Devices and methods are provided for immobilizing facet joints of the vertebral column. Embodiments of the invention provide an implant that is inserted in a facet joint from which cartilage has been removed, and which retains the approximate original spacing of the facets in the joint. A retaining arrangement, such as an adhesive, a threaded fastener, or a screw is then used to secure the implant in the joint.

Abstract: A facet fixation device formed from an anchor screw and a collet or facet screw that is secured to adjacent pedicles. The anchor screw has an aperture for receipt of a first end of a guide wire or polyaxial based facet screw. The collet includes a unidirectional attachment mechanism wherein a wire can be drawn to a desired position to fix the distance between the anchor screw and the collet. Excess wire can then be removed.

Abstract: An orthopedic device configured for use as a compressor or a distractor is provided. The device has two arm members and a locking sleeve for securely holding an elongated pin is attached to each of the two arm members. The locking sleeve are hingeably connected to the outer end of each of the two arm members by a biaxial hinge block, wherein the biaxial hinge block is configured to allow the locking sleeve to swivel in two different directions about two orthogonally oriented axes.