Abstract: The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

Abstract: Measuring tool, surgical constructs, and methods for measuring distances between two or more locations. A measuring device allows for simple and accurate intraoperative length measurements to be made. A measuring device has a distal end that can hold a flexible strand in a hole, eyelet, claw, or other suitable means. A shaft of the device has calibration markings on it, with the zero point at the end opposite the distal tip.

Abstract: A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

Abstract: Methods and devices are provided for attaching soft tissue to bone. In general, a deployment device, insertion assembly, and suture anchor are provided. The insertion assembly is coupled between the deployment device and the suture anchor to allow the deployment device to deploy the suture anchor into bone. Each of the various components disclosed herein can be used alone, in combination with one another, or in combination with various other devices.

Abstract: A device for treating a tissue defect including a grasper including a pair of arms movable between a tissue receiving configuration and a tissue gripping configuration, a needle extending longitudinally from a proximal end to a distal end and including a first lumen extending longitudinally therethrough, the needle slidably received between the arms so that the needle is movable between a non-extended configuration, in which the distal end of the needle is proximal the distal ends of the arms, and an extended configuration, in which the distal end of the needle is distal of the distal end of the arms, and a first suture element slidably housed within the first channel and deployable therefrom to be anchored in a first target tissue into which it is inserted, the first suture element including a first cross member attached to a distal end of a first suture.

Abstract: The present disclosure describes devices, systems, and methods for intravascularly delivering an implantable device at the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. The intravascular device is attached at the distal end of the delivery member, and is housed within a distal piece of an outer sheath. A steering catheter is nested within the outer sheath to bend the delivery member into position. A delivery catheter is configured to advance the intravascular device relative to the outer sheath, and a suture catheter includes sutures/tethers which may be coupled to the intravascular device prior to deployment.

Abstract: Various exemplary methods and devices are provided for passing sutures around anatomical structures. In an exemplary embodiment, a suture delivery device is provided that includes a body portion having a suture delivery member disposed therein and configured to pass a suture around an anatomical structure. The suture delivery member can be movable between a retracted configuration in which the suture delivery member is disposed within the body portion and an advanced configuration in which the suture delivery member extends distally beyond the body portion and assumes an arcurate shape. The arcurate shape can correspond to a shape of the anatomical structure and can extend almost all of the way around the anatomical structure, for example at least around 270° of a circle, thus assisting a user in passing the suture around the anatomical structure without having to manually manipulate the suture delivery device at awkward angles around adjacent tissue.

Abstract: Apparatus and methods are provided for treating a tissue opening, for example a trocar opening used in a minimally invasive surgical procedure. In a tissue closure device, a finger guard or shield can be used, handle or holding area or areas can be used, and positioning indicators can be used. A resiliently flexible target material can also be used for reliably holding a suture during the procedure. The resiliently flexible target material may be included as part of a removable mating component for use with a movable wing. Introducers can be used having a suture holder, an alignment indicator and insertion limits.

Abstract: A delivery system for delivering a plurality of helical tissue anchors to repair a wall defect. Coaxially contained within the outer sheath are inner tubular members. The first inner tubular member designed to deploy a first helical tissue anchor, a second inner tubular member designed to deploy a second helical tissue anchor, and a centered inner tubular member contains a cinching mechanism. The two helical tissue anchors are connected to a suture or strap that pull the two helical tissue anchors together to close a tissue defect. A cinching mechanism holds the anchors and tissue defect together and cut the suture or strap.

Abstract: A surgical staple has two movable arms connected by a transverse connection area. Each one of the arms has a pinching area and a fastening end and the transverse connection area is deformable to allow the movable arms to be moved together by bending around the axis of the transverse connection area.

Abstract: A surgical instrument includes a body, a shaft, and an end effector. The shaft extends distally from the body. The end effector is located at a distal end of the shaft. The end effector includes an active feature configured to operate on tissue. The body includes a drive feature operable to drive the active feature of the end effector. The body is operable to selectively couple with a variety of power sources such that the drive feature may receive electrical power form a battery or from a corded power source, based on a user's preference. The body may include a handpiece that has a socket configured to receive a battery or cable adapter. The body may removably receive various kinds of shaft assemblies to provide various operating modalities. The shaft assemblies may include user interface features.

Abstract: The pneumatic actuator for dispensing surgical staples is a handheld actuator for use with a typical staple cartridge. A source of pressurized fluid is used to automatically drive forward movement of a plunger rod. As in a conventional, manually-driven surgical stapler, the forward movement of the plunger rod is used to actuate the surgical stapler to bend and eject a staple. The pneumatic actuator may be used with any suitable type of surgical staple cartridge, through coupling of the plunger rod thereto. The pneumatic actuator for dispensing surgical staples includes a housing having an upper portion, for receiving the pressurized fluid to drive the plunger rod, and a lower portion, which is configured to act as a gripping handle for the user. A finger-actuated trigger is further provided, allowing for single finger release of the pressurized fluid to reset the pneumatic actuator for a surgical stapler.

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Abstract: An organ anastomosis system 1 includes a pair of disc-shaped magnets 2 and 3 which pinch and compress adjacent organ walls 6a and 6b of an object by magnetically attracting each other with the organ walls 6a and 6b interposed therebetween so as to cause local apoptosis and form a continuous hole and an anastomotic part conglutinating around the peripheral part of the continuous hole are formed, which continuous hole specially connects the organ walls with each other. The side circumferential surfaces of respective disc-shaped magnetic bodies 2a and 3a of the pair of the magnets 2 and 3 are formed as tapered surfaces 2b and 3b which gradually decrease in diameter from one end to the other end in the axial direction of the magnetic bodies 2a and 3a.

Abstract: A system for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system 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 indicator (26) includes an indicator body portion (50), a pivot support member (52), a resilient lever (54) and an anchor (66). The pivot support member (52) has a first end (52a) secured to the indicator body portion (50) and a second end (52b) secured to a first end (54a) of the resilient lever (54). The resilient lever (54) has a second end (54b) secured to the anchor (66). The pivot support member (52) is adapted to be pivotally mounted to a body portion (18) of a surgical device and the anchor (66) is adapted to be secured to the surgical device such that pivotal movement of the indicator body portion (50) from a first position to a second position effects movement of the resilient lever (54) from a relaxed configuration to a stressed configuration. In the stressed configuration, the resilient lever (54) urges the indicator body portion (50) towards the first position. The indicator body portion (50) can be integrally molded of a plastic material to define a single part of unitary construction.

Abstract: Systems, methods and kits for treating hemorrhages within cavities are provided. The methods utilize the application of a rapid spike of pressure to the closed cavity, followed by a steady state pressure or pressures.

Abstract: A vascular embolization device having the function of administering a biochemical active material and also having high flexibility is provided. Specifically, the vascular embolization device includes a coil and a biochemical active material-containing resin wire inserted in the inside of the coil, in which the resin wire is a multilayer strand including a core and at least one outer layer, and the core and the at least one outer layer individually include resin compositions with solubilities different from each other in the same organic solvent.

Abstract: An occlusion device for occluding a body vessel and methods of using the device are disclosed.

Abstract: A system for treating an aneurysm comprises an elongate flexible shaft and an expandable member. An expandable scaffold is disposed over the expandable member and may be expanded from a collapsed configuration to an expanded configuration. A double-walled filling structure is disposed over the scaffold and has an outer wall and an inner wall. The filling structure is adapted to be filled with a hardenable fluid filing medium so that the outer wall conforms to an inside surface of the aneurysm and the inner wall forms a substantially tubular lumen to provide a path for blood flow. In the expanded configuration the scaffold engages the inner wall of the filling structure. A tether is releasably coupled with the filling structure and the flexible shaft thereby constraining axial movement of the structures relative to each other.

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: Injectable embolization particulates (e.g., particles, microstructures, beads) employed in embolization procedures, for facilitating blood vessel occlusion. Exemplary embolization particulates for occluding a blood vessel include a plurality of embolization beads, each bead having a plurality of outwardly protruding portions, wherein, upon a first one and a second one of the beads accumulating against a boundary of the blood vessel, protruding portions of the first bead are configured to intermesh with protruding portions of the second bead, so as to occlude the blood vessel. Also disclosed are compositions of embolization particulates including a plurality of shaped embolization beads, and methods for embolizing or occluding a blood vessel using embolization particulates or compositions thereof.

Abstract: An adjustable radial and ulnar vascular compression wristband assists in achieving partial or full occlusion of a blood vessel when applied to a patient's wrist during or following a medical procedure. At least two adjustably inflatable non-adjacent balloons on the wristband apply preferential compression to portions of the circumference of the wrist, including in particular those portions overlying the ulnar and radial arteries.

Abstract: A set of surgical instruments for an artificial hip joint implant and, more specifically, a set of improved surgical instruments, can be used in direct anterior approach hip replacement surgery and are capable of minimizing damage, such as muscle damage, which may arise during surgery, by resolving problems that existing surgical instruments possess.

Abstract: The present invention provides a surgical reamer (10), surgical reamer system, and kit including a surgical reamer. The surgical reamer has a domed shell (12) extending from the apex to the rim (13), a rotation axis (1), cutting teeth (14) disposed around the domed shell wherein a first connecting bar (15) having a first longitudinal axis and a first diameter is located on the inside surface of the domed shell, with its first longitudinal axis and a first diameter is located on the inside surface of the domed shell, with its first longitudinal axis being adjacent or closely adjacent to the rim and in which a second connecting bar (16) having a second longitudinal axis and a second diameter is located on the inside surface of the domed shell and spaced apart from the first connecting bar.

Abstract: Methods and apparatus for treating disc herniation provide a conformable device which assumes a first shape associated with insertion and a second shape or expanded shape to occlude the defect which typically follows partial discectomy. The device may take different forms according to the invention, including patches size to cover the defect or plugs adapted to fill the defect. In a preferred embodiment, however, the device is a gel or other liquid or semi-liquid which solidifies to occlude the defect from within the body of the disc itself. In another preferred embodiment, a mesh screen is collapsed into an elongated form for the purposes of insertion, thereby minimizing the size of the requisite incision while avoiding delicate surrounding nerves.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

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

Abstract: The present invention relates to an implant system that comprises an implant, a handle configured to removably receive the implant, and, in some embodiments, a spacer tool configured to be mounted on the implant. In further embodiments, a k-wire is employed to guide the implant to a desired location. The handle has a hole for receiving a first portion of the implant. Using the handle to implant the implant, along with an associated spacer, provides a quick and convenient method for implanting the implant as described herein and in the associated drawings.

Abstract: Disclosed herein are systems and methods for identifying the proper implant for use in an arthroplasty procedure and preparing a bone surface for the placement of such implant. In one embodiment, a centering guide system includes a cannulated post and a translucent surface trial where the cannulated post includes a slit defining legs that flex to engage the post when inserted in a hole of the surface trial. The system is used to confirm a suitable implant size and place a pilot wire in preparation for implant placement. The cannulated post and the translucent surface trial provide comprehensive visibility of the glenoid surface. When inserted into the surface trial, an extension of the cannulated post beyond an articulating surface of the surface trial is minimal or nonexistent. In this way, the congruence of a reamed glenoid surface can be evaluated prior to implantation of the implant.

Abstract: A system and method for attaching tissue to bone are provided. In one embodiment, a system for attaching tissue to bone includes a suture, suture anchor, inserter tool, drill, and drill guide having an outer guide and an inner guide. A method for attaching tissue to bone includes attaching a suture to tissue, nesting the suture in a notch on the distal end of the outer guide, passing the suture through a lumen formed in the outer guide, and inserting an inner guide in a lumen formed in the outer guide. The drill guide protects the suture from rotational movement of the drill and allows a user to maintain alignment between the drill guide and the drilled hole. As a result, a suture anchor can be more easily positioned within the drilled hole.

Abstract: A glenoid device for preparing a shoulder joint of a patient includes a reusable guide holder having a body between an upper surface and a lower surface and a bore passing through the body of the guide holder. The glenoid device also includes a patient-specific glenoid guide having a body with an upper and lower surface. The lower surface of the patient-specific glenoid guide is configured as a negative surface of a glenoid face based on preoperative image scans of the shoulder joint of the patient. The upper face of the patient-specific glenoid guide is configured to be coupled and contact the lower face of the guide holder, such that the bore of the guide holder is aligned along a patient-specific bore through the body of the patient-specific glenoid guide and along a corresponding alignment axis of the patient-specific glenoid guide.

Abstract: An anchoring delivery system for use in an intracranial artery is provided including a tethering device having an elongated tether and an anchor coupled to a distal end of the tether. The anchor is deployable from a low profile configuration to a higher profile configuration to fix the distal end of the tether at an anchoring site in an anchoring vessel. The tethering device is configured to be used with a guide-sheath having a lumen configured to receive the tether. Related devices, systems, and methods are also described.

Abstract: A implant device delivery system and method is provided employing a sheath with three lumens configured for translation of a shapeable guidewire and a balloon device and an implant such as a cardiac device. The balloon and balloon wire extend from an aperture spaced from the distal end of the sheath and form a rail upon anchoring of the balloon. An extension portion of the sheath is bendable to adjust an angle of deployment of the implant.

Abstract: An ultrasonic surgical probe has an elongate shaft and a probe head that is enlarged to extend laterally or transversely in two opposed directions relative to the shaft The head is formed with a recess or cavity facing laterally in a third direction relative to the shaft and the axis. Where the head lies in a plane, owing to its lateral enlargement or extension, the recess or cavity faces in a direction perpendicular to that plane. The recess or cavity is defined in part by an inclined floor or base surface contiguous at a proximal end with the shaft. The recess or cavity is defined in part by a peripheral wall extending only partway around the recess or cavity, along a distal side and two lateral sides thereof. The cavity or recess is closed on a proximal side by the inclined surface and the shaft.

Abstract: A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves that propagate through the liquid for impinging upon the valve. The shock wave generator is moveable within the balloon to vary shock wave impingement on the valve.

Abstract: Intraluminal devices and methods for removing an obstruction from a blood vessel using an intraluminal device are provided. The intraluminal device can include a flexible shaft and an expandable wire mesh structure extending from the flexible shaft, the wire mesh structure including at least one first expandable section having a first wire arrangement pattern and at least one second expandable section having a second wire arrangement pattern different from the first wire arrangement pattern. In addition, interstices in the at least one first expandable section can differ in size from interstices in the at least one second expandable section.

Abstract: A laparoscopic surgical device comprises an elongate shaft defining a longitudinal axis, the shaft comprising a distal end and a proximal end. A plurality of arms project distally from the distal end of the elongate shaft, the arms each comprising a lateral notch. The arms are axially slideable relative the elongate shaft and are medially deflectable. An elongate pin is positioned medially relative the arms. The elongate pin is axially slideable relative the arms between a locked position preventing medial deflection of the arms and an unlocked position allowing medial deflection of the arms. A surgical end effector is selectively attachable in vivo and detachable in vivo to the mating feature of the arms, the surgical end effector comprising a torque transfer means and tissue contact apparatus that open and close in response to the axial movement of the two arms when attached to the surgical end effector.

Abstract: In an endoscope having a working channel, an inflatable abrading device including an outer flexible sleeve, an auger arranged for controllable rotation within the sleeve, the auger arranged for rotation about a hollow shaft and a balloon having an inner surface and an outer surface, the outer surface coated with abrasive material, the balloon initially disposed within the hollow shaft and connected via a tube to a source of fluid, the balloon arranged to be extendible beyond the hollow shaft and arranged for inflation by the fluid, the tube arranged for controllable rotation.

Abstract: An endoscopic tissue resecting system that includes a reciprocating rotary surgical instrument for cutting tissue that includes a planetary gear assembly to vary rotational speed. A method of cutting and detaching tissue includes positioning an outer member such that tissue is located within a window in the outer member, engaging the tissue with an inner member, and simultaneously rotating at an increased speed relative to a rotary driver and translating the inner member to cut the tissue. A tangential cutting force is applied to the tissue with the inner member to mechanically cut and detach the tissue.

Abstract: Unitary endoscopic vessel harvesting devices are disclosed. In some embodiments, such devices may comprise an elongated body having a proximal end and a distal end. A conical tip may be disposed at the distal end of the elongated body. In addition, the surgical instrument may include one or more surgical instruments moveable in a longitudinal direction along an axis substantially parallel to a central longitudinal axis of the cannula from a retracted position proximally of a distal end of the tip to an advanced position toward the distal end of the tip to seal and cut a blood vessel.

Abstract: A scalpel handle having knurling on the round shaft in close proximity to the surgical blade for improved precision, improved control, improved safety and reduced hand fatigue. The blade is secured by tension within the collet and is adjustable in length to provide a wide range of exposed positions for use. Embedded flat ruler markings enable accurate measurement of lesions or other tissue areas within the surgical field.

Abstract: Disclosed is an instrument having an elongated shaft, a first member configured in the elongated shaft such that the first member can be deployed from a first portion of the instrument. The first member, when deployed, is configured over a tissue bridge within a heart, the tissue bridge having a clip or suture. A second member is also configured in the elongated shaft such that the second member is deployed from a second portion of the elongated shaft, wherein the second member, when deployed, is configured under the tissue bridge and the clip or suture. The elongated shaft is configured such that the second member, when deployed, moves towards the first member to yield a combined member which receives the tissue bridge and the clip or suture. The elongated shaft receives the combined member. The first member and/or the second member include a signal emitter to cut the tissue bridge.

Abstract: Cutting devices useful for cutting objects or materials are described. Examples of cutting devices useful for creating avulsions in animals, such as human beings, are described. A cutting device includes an elongate main body having proximal and distal ends. A first portion of the main body has a cross-sectional shape that substantially lacks flat surfaces and a second portion of the main body has a cross-sectional shape having one, two or more flat surfaces. The distal end defines a hook having one or more sharpened edges disposed within the notch of the hook. Methods of making cutting devices are also described.

Abstract: A device for cutting polyps via an endoscope lumen, including an over tube arranged to pass through an endoscope, the over tube including (1) a grasping tool arranged to be controlled from a proximal end of the endoscope and to controllably extend from a distal end of the endoscope, and (2) a cutting tool arranged to pass through the endoscope, the cutting tool arranged to be controlled from the proximal end of the endoscope and to controllably extend from the distal end of the endoscope, in which at least one of the grasping tool and the cutting tool is configured to bend away from the other one by including a pre-bent element configured to bend away when extended from the endoscope, and biased to a flat configuration when inside the endoscope, and the cutting tool is coupled to the grasping tool. Related apparatus and methods are also described.

Abstract: A medical device may include a handle having a first portion and a second portion angled with respect to the first portion. The handle may further include a rail extending along the first portion of the handle. The rail may include a groove. The handle may also include a first actuator longitudinally moveable with respect to the handle along the rail and a second actuator rotatable about an axis collinear to a longitudinal axis of the first portion. Further, the handle may include a shaft longitudinally fixed relative to the first actuator.

Abstract: Polypectomy devices and methods for making and using polypectomy devices are disclosed. An example polypectomy device may include an elongate sheath having a proximal end and a distal end. A handle assembly may be coupled to the proximal end. The handle assembly may include a first actuator and a second actuator. A first shaft may extend through the sheath and may be coupled to the first actuator. An end effector may be coupled to the first shaft. A second shaft may extend through the sheath and may be coupled to the second actuator. A retention member may be coupled to the second shaft. The first actuator may be designed to shift the end effector between a housed configuration and a deployed configuration. The second actuator may be designed to shift the retention member between a retracted configuration and a holding configuration.

Abstract: Polypectomy devices and methods for making and using polypectomy devices are disclosed. An example polypectomy device may include an elongate sheath having a proximal end region and a distal end region. A shaft may be slidably disposed within the sheath. A handle may be coupled to the proximal end region of the sheath. The handle may be designed to axially shift the shaft relative to the sheath. A snare may be coupled to the shaft. The snare may include a first region, a traction region, and a distal tip region. The first region may have a non-circular cross-sectional shape. The traction region may include a plurality of traction members. At a position between two adjacent traction members the snare may have a reduced cross-sectional area relative to the first region. The distal tip region may have a circular cross-sectional shape.

Abstract: Balloon angioplasty catheters having cutting or scoring members that are moveable in at least one direction between a stowed position (away from the angioplasty balloon) and an operative position (on the angioplasty balloon). A balloon catheter of the present invention alternately useable to perform balloon dilation of a body lumen with and without concurrent cutting or scoring.