Abstract: An infusion catheter has an elongate flexible shaft including a wall and a lumen extending between a proximal end and a distal end. The catheter also has a sealing member within the shaft lumen including a wall and a lumen. The catheter also has a slidable, retractable elongate central axis member extending through the shaft and sealing member lumens connected to an end cap. The catheter also has a plurality of eluting arms extending radially around the central axis member, including lumens fluidly connected to the shaft lumen and the distal end cap. A method for treating a thrombus is also disclosed.

Abstract: An ultrasonic diagnostic imaging system with a two dimensional array transducer performs microbubble-mediated therapy such as sonothrombolysis. The array is formed by dicing into rectilinear elements with the corner elements absent to provide a generally rounded shape that accommodates the temporal windows of the head for cranial therapeutic energy delivery. In several described implementations additional transducer elements are optimized for other specialized functions such as A-line imaging, Doppler flow detection, temporal bone thickness estimation, or cavitation detection. Preferably there are 128 therapeutic elements so that the array probe can be used with standard ultrasound systems having 128-channel beamformers.

Abstract: A surgical instrument includes a housing, a handle, an elongated shaft, an end effector assembly, a drive assembly, a support, a roller, and an extension depending from the handle. The end effector assembly includes a first jaw member and a second jaw member. At least one of the jaw members is movable with respect to the other jaw member. The drive assembly includes a drive bar extending at least partially through the elongated shaft such that longitudinal translation of the drive bar causes movement of the jaw members. The extension includes a proximal surface and a channel defined therein. The proximal surface is configured to contact a portion of the drive assembly such that movement of the handle with respect to the housing causes longitudinal translation of the drive bar. The channel is positioned for mechanical engagement by the roller.

Abstract: A tissue removal device including customizable tips and method of use thereof. The tissue removal device may include an outer shaft having a removable tip attached to the outer shaft and a rotatable inner shaft extending through the outer shaft and having a rotatable cutting portion extending from the inner shaft. Disc material may be cut and removed from a surgical area using an auger-like and/or suction mechanism to facilitate the transfer of removed tissue away from the surgical area.

Abstract: A tissue collection needle with a hollow interior provides two opposing tips with beveled edges on facets that drive tissue toward the hollow interior where the tissue can be gathered and severed from surrounding tissue as the needle advances through a biological specimen. The points and bevels are advantageously formed from a minimal number of cuts amenable to rapid fabrication from readily available hollow needle stock.

Abstract: A medical device may include a snare loop and an elastic member that connects at least two sides of the snare loop. The elastic member is configured to transition from an unexpanded state where the elastic member is in a plane of the snare loop to an expanded state where the elastic member is outside the plane of the snare loop. The snare loop has a same shape when the elastic member is in the unexpanded shape and the expanded shape.

Abstract: A surgical instrument including a shaft including a distal portion and an articulatable portion is disclosed. The articulatable portion, positioned proximal to the distal portion, includes a plurality of joint members. A first articulation cable extends through each first channel of each of the plurality of joint members and a second articulation cable extends through each second channel of each of the plurality of joint members to the distal portion. The first and second articulation cables are transitionable between: (i) an unlocked state, where the first and second articulation cables are free to translate distally and proximally and the plurality of joint members are slidable relative to one another to pivot the distal portion away from a longitudinal axis, and (ii) a locked state, where translation of the first and second articulation cables is locked, causing a position of the distal portion relative to the longitudinal axis to be locked.

Abstract: Guiding tube, in particular a trocar, for receiving and guiding a medical instrument, wherein the guiding tube comprises engaging members for engaging an instrument inside the tube and a substantially spherically shaped ball member provided on an outer surface of said tube, wherein the engaging members are provided movable with respect to the tube in a direction having a radial component, seen with respect to the longitudinal axis of the tube, upon compression of the ball member.

Abstract: This disclosure relates to a cannula for a surgical instrument used for cutting selected tissue in a body cavity while under visual inspection. A kit containing the cannula and methods for performing surgical procedures using the cannula are also described.

Abstract: An apparatus and method for providing surgical access to a body cavity of a living animal through an access port inserted in a wall of the body cavity is disclosed. The apparatus includes a collapsible volume having an opening for sealingly receiving a surgical apparatus. The apparatus also includes an access coupler disposed at a distal end of the collapsible volume, the access coupler being operably configured to sealingly couple to an opening in the access port placing the collapsible volume in fluid communication with the body cavity. The collapsible volume is operably configured to collapse to permit the surgical apparatus to be inserted through the access coupler into the body cavity.

Abstract: The invention relates to a tissue receiving bag (1) for use in surgery, especially laparoscopic surgery, wherein the bag comprises at least one tissue receiving opening (2) for receiving tissue (T) and/or an instrument opening (3), especially a morcellator opening, wherein the bag comprises at least one further opening (4) into the bag, wherein a flexible tube (5) extends from said further opening having a free end (6) comprising an insertion opening (7) for inserting an instrument (8) into the bag, wherein the bag preferably is inflatable.

Abstract: A surgical system for manipulating tissue. A steerable instrument is at least partially disposed in a deformable conduit. The steering instrument may include a control element and a deflectable portion operatively connected to the control element. The steerable instrument is actuatable to move between at least a substantially straight configuration and a curved configuration when the deflectable portion protrudes from an access cannula positioned within the tissue. The deflectable portion of the steerable instrument moves away from a longitudinal axis of the access cannula in order to deform the deformable conduit so that the deformable conduit occupies a deformed position. The steering instrument is removable from the deformable conduit so as to allow withdrawal of the deflectable portion of the steerable instrument from the deformable conduit without substantially displacing the deformed position of the deformable conduit. Methods of manipulating tissue with the surgical system are also disclosed.

Abstract: Polyaxial pedicle screw with a head in the shape of a ball segment and with a threaded screw shank, wherein a hollow ball segment with a recess for receiving a rod-shaped connector is mounted in the head, in order to permit pivoting movements and rotation movements of the connector, wherein moreover, in the direction of the longitudinal axis of the threaded screw shank, the head in the shape of a ball segment has a cutout with an inner thread in which the rod-shaped connector can be moved in and out and, by means of the inner thread in the cutout, a grub screw can be introduced for blocking the hollow ball segment. According to the invention, a plastic buffer body is fitted in the hollow ball segment and is connected to a ram, wherein the ram has a head which engages in an associated annular groove in the plastic buffer body.

Abstract: A surgical derotator instrument comprises a shaft, a handle and an articulating coupler. The shaft comprises a first end portion having a bone anchor coupling and a second end portion opposite the first end portion. The handle comprises a body portion and a slot extending in the body portion. The articulating coupler connects the shaft and the handle. A method for coupling a plurality of derotator instruments into a series of derotator instruments comprises: attaching a plurality of derotator instruments to a plurality of adjacent bone anchor housings, each derotator instrument comprising: a shaft for connecting to a bone anchor housing, a handle having a slot, and an adjustable coupler connecting the shaft and the handle; adjusting one or more of the adjustable couplers to align at least one of the slots of the series with other slots of the series; and inserting an elongate member through the at least one slots that are aligned.

Abstract: An improved flexible component used for dynamic stabilization of spinal segments for the treatment of vertebrae deformities and injuries and for the replacement of a complete or segment of the body of a vertebra in the spine is described. The flexible component is comprised of a suitable implant material with a longitudinal bore the entire length and an appropriately formed slots that extend spirally around the flexible spinal element either continuously or segmentally. The flexible component can be encapsulated, fully or partially, in a suitable implant grade elastomeric resilient material. When used for a dynamic stabilization device, the element is attached to the vertebral bodies by pedicle screws know to those in the art.

Abstract: A spinal stabilization system including a connecting rod and a bone screw. The connecting rod includes an elongate rounded section, an elongate head portion, and a neck portion connecting the elongate rounded section with the elongate head portion. The bone screw includes a head portion defining a slot, a shank extending longitudinally from the head portion, and a set screw configured to secure the connecting rod in the slot. The head portion includes a pair of radially opposing walls defining the slot therebetween. The head portion includes a trailing end and a leading end. The trailing end includes a guide member defining an aperture configured and dimensioned to receive the set screw therethrough. The aperture is in communication with the slot. In particular, the guide member interconnects the pair of radially opposing walls.

Abstract: A spinal construct comprises a fastener having a head. A member includes an inner surface defining a cavity configured for disposal of the head and a groove configured for disposal of a band. The band is engageable with the head to connect the fastener and the member. A longitudinal element is connectable to the member. A body is disposable with the longitudinal element and defines an implant cavity. A coupling member is engageable with the body. Implants, systems, instruments and methods are disclosed.

Abstract: A spinal prosthesis includes first and second spinal attachment members attachable to first and second spinal structures, respectively. One or more adjustable stopper elements are assembled on one or both of the first and second spinal attachment members. The one or more adjustable stopper elements are formed with a bore through which either of the first and second spinal attachment members is slidable. The one or more adjustable stopper elements include structure that limits relative movement between the one or more adjustable stopper elements and the spinal attachment member on which the one or more adjustable stopper elements are mounted.

Abstract: A polyaxial bone anchor has a locking element shaped and configured to allow an anchoring member (e.g., a screw or hook) to polyaxially rotate at large angles about a central axis of the bone anchor before compression locking the anchoring member within an anchor head.

Abstract: In some embodiments, a method comprises disposing a portion of a flexible fastening band into contact with a first bone portion and into contact with a second bone portion. The portion of the flexible fastening band having a substantially uniform shape configured to substantially compliment a shape of the first bone portion and a shape of the second bone portion. The method further includes inserting the portion of the flexible fastening band into a fastener and advancing the portion of the flexible fastening band through the fastener until the first bone portion and the and the second bone portion are stabilized.

Abstract: The invention relates to an instrument for connecting a correction rod to a bone screw, the instrument having an axial longitudinal direction and comprising an external first housing part, which includes a hollow portion having an internal thread and a portion that is approximately the shape of a half-shell and that forms a first clamp leg. The instrument further includes an external second housing part, which is approximately the shape of a half-shell and forms a second clamp leg that is hinged on the first clamp leg so as to be pivotable about a pivot axis that extends orthogonally to the axial longitudinal direction.

Abstract: Devices, systems, and methods of bone stabilization. The bone stabilization system includes a bone plate having an upper surface and a lower surface configured to be in contact with bone, the bone plate having an opening extending from the upper surface to the lower surface. The opening is configured to receive a fastener, which may be either a locking fastener or a compression fastener. The locking fastener has a threaded head portion configured to engage and lock to the bone plate, and the compression fastener is configured to dynamically compress the bone.

Abstract: Devices, systems, and methods of bone stabilization. The bone stabilization system includes a bone plate having an upper surface and a lower surface configured to be in contact with bone, the bone plate having an opening extending from the upper surface to the lower surface. The opening is configured to receive a fastener, which may be either a locking fastener or a compression fastener. The locking fastener has a threaded head portion configured to engage and lock to the bone plate, and the compression fastener is configured to dynamically compress the bone.

Abstract: Devices, systems, and methods of bone stabilization. The bone stabilization system includes a bone plate having an upper surface and a lower surface configured to be in contact with bone, the bone plate having an opening extending from the upper surface to the lower surface. The opening is configured to receive a fastener, which may be either a locking fastener or a compression fastener.

Abstract: Devices, systems, and methods of bone stabilization. The bone stabilization system includes a bone plate having an upper surface and a lower surface configured to be in contact with bone, the bone plate having an opening extending from the upper surface to the lower surface. The opening is configured to receive a fastener, which may be either a locking fastener or a compression fastener. The locking fastener has a threaded head portion configured to engage and lock to the bone plate, and the compression fastener is configured to dynamically compress the bone.

Abstract: A modular bone fixation linkage includes a plurality of interconnected links that can angulate with respect to an adjacent one of the links in-plane or out-of-plane. The links can further include fixation holes that are configured to receive fixation members that secure the links to an underlying anatomical structure.

Abstract: Devices, systems, and methods for bone stabilization, especially volar distal radius stabilization. The stabilization system may include a bone plate having an elongated portion, an enlarged head portion, and a transition region connecting the elongated portion to the enlarged head portion, and the plate including a plurality of through holes. A plurality of fasteners may be configured to extend through one or more of the plurality of through holes in the bone plate and into the bone. The plate may be used to stabilize a fracture in a long bone, such as a radius.

Abstract: Devices, systems, and methods for bone stabilization, especially volar distal radius stabilization. The stabilization system may include a bone plate having an elongated portion, an enlarged head portion, and a transition region connecting the elongated portion to the enlarged head portion, and the plate including a plurality of through holes. A plurality of fasteners may be configured to extend through one or more of the plurality of through holes in the bone plate and into the bone. The plate may be used to stabilize a fracture in a long bone, such as a radius.

Abstract: A bone fixation device (1) comprises an elongated member (2) and a washer (3) assembled in a manner to prevent relative longitudinal displacement at the same time allowing axial rotation of the washer (3) with respect of the elongated member (2). The elongated member (2) comprises a proximal head (4) and an elongated shaft (5). The proximal head (4) comprises at least a distal spherical portion (8) having a diameter (D) and defining a maximum transversal dimension (Dh) of the proximal head (4). The washer (3) has a central cavity (14) configured to seat the proximal head (4) and comprising a central spherical portion (15) having the same diameter (D) of the distal spherical portion (8) of the proximal head (4). The central spherical portion (15) extends between a distal rim (16) and a proximal rim (17).

Abstract: A cement-directing structure for use in cement-injection bone therapy includes a collapsible, self-restoring braided structure with regions of differential permeability to the bone cement. The regions of differential permeability may be provided by areas where the braided mesh density is greater or lesser than surrounding areas and/or by means of a baffle. After the structure is placed in a void within a bony structure, cement is injected into the interior of the structure then oozes out in preferred directions according to the locations of the regions of differential permeability.

Abstract: A bone cement mixing and delivery device includes a shaft extending along an axis from a first end to a second end and including a passageway. The first end includes an adapter having a first opening that is in communication with the passageway. The second end includes a second opening that is in communication with the passageway. The shaft includes a mixing portion between the first and second ends. A connector includes a central portion that that is coupled to the adapter. The central portion includes a channel that is in communication with the first opening. The connector includes first and second ports that extend from the central portion. The first port includes a first lumen that is in communication with the channel. The second port includes a second lumen that is in communication with the channel. Methods of use are disclosed.

Abstract: Devices, systems, and methods are provided in which movement of a tool is controlled based on sensed parameters. In one embodiment, an electromechanical tool is provided having an instrument shaft and an end effector formed thereon. The electromechanical tool is configured to be mounted on an electromechanical arm, and the electromechanical tool is configured to move with or relative to the electromechanical arm and perform surgical functions. A controller is operatively coupled to the electromechanical arm and the electromechanical tool and is configured to retard advancement of the electromechanical tool toward a tissue surface based on a sensed amount of displacement of a tissue surface, a strain on the tissue of the patient, the temperature of the electromechanical tool, or the like.

Abstract: An endoscopic cutting device for cutting free a probe, provided with a retaining plate, which, within the scope of a percutaneous endoscopic gastrostomy, is arranged in a stomach wall and is overgrown by the gastric mucosa, wherein, for the adjustment of the cutting element provided at a distal end of a tube via a pulling cord, an actuation force of an actuation element can be transmitted to same. In addition, the cutting device includes a cutting wire which is electrically heatable and connected to the pulling cord, and which runs outside the tube via a distal section to form a first diathermy blade. In addition, the distal end of the tube is slanted at an angle to the transverse plane thereof to form a tip, wherein the tip is facing the first diathermy blade. Furthermore, the cutting wire is directed externally around the tip to form a second diathermy blade.

Abstract: A robotic surgical arm includes a puck containing motors to drive an end effector. A tool assembly attached to the puck generates ultrasonic and/or radio frequency energy to apply to tissue disposed between the jaws of the end effector. The tool assembly can include modular components such as a modular shaft that can include an ultrasonic transducer, nonvolatile memory, wireless interface, and/or a power source. The power source allows the modular shaft to communicate wirelessly with the robotic arm. The tool assembly can be moved from one robotic arm to another while remaining powered by the power source. The tool assembly can include sensors to determine a location or movement of the tool assembly after being detached from the robotic surgical arm. The modular shaft can be moved from a robotic arm to a handle manually controlled by a surgeon and back again to the robotic arm.

Abstract: A robotic surgical arm can include a puck containing motors to drive an end effector. A tool assembly attached to the puck generates ultrasonic and/or radio frequency energy to apply between the jaws of the end effector. The tool assembly can include modular components such as a modular shaft that can include an ultrasonic transducer, nonvolatile memory, wireless interface, and/or a power source. The power source allows the tool assembly and modular shaft to communicate wirelessly with the robotic arm.

Abstract: Instrument and systems for applying ablative energy to epicardial tissue via a subxiphoid access surgical approach. The instrument has a head assembly sized and shaped for a subxiphoid surgical approach to a patient's heart and defines a contact face. The head assembly includes a paddle body, a first ablation electrode, and a second ablation electrode. The ablation electrodes are coupled to the paddle body in a spaced apart, spatially-fixed fashion. The ablation electrodes are exteriorly exposed at the contact face. A tubular member extends from the head assembly and maintains wiring connected to the ablation electrodes. The instrument is manipulable to locate the contact face on epicardial tissue of a patient's heart via a subxiphoid surgical approach, such as between the left and right pulmonary vein junctions of the posterior left atrium.

Abstract: A blade assembly comprising: a tip including two or more tubes, wherein the two or more tubes include at least: an outer tube and an inner tube; and a mechanical enclosure including: a locking spline having a longitudinal axis; and a slide lock; wherein the slide lock slides along the longitudinal axis of the locking spline and over the locking spline forming a locked state so that rotational movement of the locking spline, around the longitudinal axis of the locking spline, is prevented; and wherein the outer tube is coupled to the locking spline so that rotational movement of the outer tube, around the longitudinal axis of the locking spline, is prevented during the locked state.

Abstract: A robotic surgical system is provided that includes an electromechanical tool coupled to a surgical instrument such as an end effector adapted to apply ultrasound energy to tissue when the end effector holds the tissue. The electromechanical tool is mounted on an electromechanical arm and configured to move relative to the arm. A controller operatively coupled to the tool and the arm measures electrical impedance of tissue as ultrasound energy is applied to the tissue by the end effector. The controller determines, based on the tissue impedance measurements, that the tissue is fully cauterized. In response to the detection, the surgical system automatically lifts the end effector, either by lifting the arm to which it is coupled or independently from that arm, thereby the end effector cuts the cauterized tissue to complete the tissue cauterization/cutting. The controller also determines and controls a velocity with which the end effector is lifted.

Abstract: A bipolar forceps may include a first forceps arm having a first forceps arm aperture, a first forceps jaw, and a first forceps arm conductor tip; a second forceps arm having a first forceps arm aperture, a second forceps jaw, and a second forceps arm conductor tip; and an input conductor isolation mechanism having a first forceps arm housing and a second forceps arm housing. The first forceps arm may be disposed in the first forceps arm housing and the second forceps arm may be disposed in the second forceps arm housing. An application of a force to a lateral portion of the forceps arms may be configured to close the forceps jaws. A reduction of a force applied to a lateral portion of the forceps arms may be configured to open the forceps jaws.

Abstract: A boot for an articulable electrosurgical instrument having a conductor is disclosed. The boot has: a first layer having a flexible substantially non-conductive material; a second layer disposed on the first layer, the second layer having a flexible conductive medium configured to be electrically coupled to at least one shield conductor, whereby the boot is configured to transmit normal current and fault current to a reference potential; and a third layer disposed on the second layer, the third layer having a flexible non-conductive material.

Abstract: The present disclosure provides for a device and methods of use to endoluminally heat and/or occlude a body vessel. The method includes a step of contracting the vessel to be treated by a contraction method, such as by delivering an electrical stimulus to induce spasms and decrease the diameter of the vessel. In some embodiments, the electrical stimulus may be a pulsatile electrical stimulus. The device then delivers a heat energy to aid in occlusion of the vessel.

Abstract: A multi-needle point expanding radiofrequency ablation electrode needle, comprising a trocar, one end of which is provided with an opening for extending of needles, a handle portion fixedly arranged on the other end of the trocar and in which a plurality of slidable metallic sliding rods are provided, and a plurality of control sliding blocks that are slidably arranged on a peripheral wall of the handle portion. The present invention can control the number of the expanded needles, the extending direction of the needle and the extending length of the needle, such that an oriented expansion of electrode sub-needles, a complete ablation adapted to a tumor positioned below main vessels or in margin areas of organs and simplicity of operation are implemented.

Abstract: A catheter adapted for mapping and/or ablation in the atria has a basket-shaped electrode array with two or more location sensors with a deflectable expander. The catheter has comprises a catheter body, a basket electrode assembly at a distal end of the catheter body, and a control handle at a proximal end of the catheter body. The basket electrode assembly has a plurality of electrode-carrying spines and an expander that is adapted for longitudinal movement relative to the catheter body for expanding and collapsing the assembly via a proximal end portion extending past the control handle that can be pushed or pulled by a user. The expander is also adapted for deflection in responsive to an actuator on the control handle that allows a user to control at least one puller wire extending through the catheter body and the expander.

Abstract: Apparatus and methods for ablation efficacy are described herein where a hood having a deployable elongated feature can extend beyond a distal face of the hood. The elongated feature can channel the energy to the deeper regions within the tissue (such as trabeculated regions or other tissue structures) such that the energy can be delivered to the target tissue despite small or large irregularities in the target tissue surface (or region) and/or changes in the relative distances between the hood and the target tissue.

Abstract: A conduit assembly for transmitting energy between an electrosurgical energy generator and an energy delivering device comprises a first cable sub-assembly including a cable having a flexibility and an energy attenuation; a second cable sub-assembly including a cable having a flexibility and an energy attenuation; wherein the flexibility of the cable of the first cable sub-assembly is less than the flexibility of the cable of the second cable sub-assembly; and wherein the energy attenuation of the cable of the first cable sub-assembly is less than the energy attenuation of the cable of the second cable sub-assembly.

Abstract: A side-fire laser fiber includes an optical fiber having a distal end and a fiber cap. The fiber cap is coupled to the distal end of the optical fiber and includes a molded reflective surface and a sealed cavity. The molded reflective surface defines a wall of the cavity. Laser energy discharged from the distal end along a central axis of the optical fiber is reflected off the molded reflective surface in a direction that is transverse to the central axis.

Abstract: A method of creating a mass-customized femoral bone base plate comprising: (i) establishing anatomical landmarks across a plurality of bone models of a statistical atlas; (ii) establishing instrument landmarks across the plurality of bone models of the statistical atlas; (iii) establishing definitions for a reference plane calculation across the plurality of bone models of the statistical atlas, where the reference plane represents a boundary of a prosthetic implant; (iv) establishing an attachment site for a mass-customized femoral bone base plate using the anatomical landmarks, the instrument landmarks, and the reference plane; and, (v) fabricating the mass-customized femoral bone base plate configured to be attached to a femur, where the attachment sites of the mass-customized femoral bone base plate are predetermined to avoid impingement with the prosthetic implant when implanted.

Abstract: A method of registering an area of interest luminal network to images of the area of interest luminal network comprising. The method includes generating a model of the area of interest based on images of the area of interest, determining a location of a soft point in the area of interest, tracking a location of the location sensor while the location sensor is navigated within the area of interest, comparing the tracked locations of the location sensor within the area of interest , navigating the location sensor to the soft point, confirming the location sensor is located at the soft point, and updating the registration of the model with the area of interest based on the tracked locations of the location sensor at the soft point.

Abstract: The present invention relates to a redundant reciprocal tracking system composed of at least two trackers 10. A first tracker is able to sense partial or full pose data (orientation and position) of a second tracker in a first reference frame and the second tracker is able to sense partial or full pose data of the first tracker in a second reference frame. Pose data of first and second trackers are further transferred to a central processor 30, which is able to compute the transformation between first and second reference frame. Data generated by the trackers are such designed that they define an over-determined mathematical system (e.g. more than 6 degrees of freedom in a 3D setup). The over-determined information can be used to qualify and/or improve the transformation of the reference frame. In an embodiment of the invention, the tracking system is an optical one and the over-determined information defines an error metric used to check the validity of the transformation.

Abstract: A system and a method for an insertion device positioning guidance system comprising: an electromagnetic field generator configured to generate an electromagnetic field covering a treatment area; a plate sensor configured to be positioned within the treatment area in a location defining an orientation of a subject; a reference sensor configured to be positioned, within the treatment area, on the subject's torso, the reference sensor is configured to define a reference coordinate system representing the position and orientation of the subject's torso relative to said field generator; a registration sensor configured to mark at least a first and a second anatomic locations relative to the reference coordinate system; and a processor configured to operate said field generator, read signals obtained from said the plate sensor, said reference sensor and said registration sensor, calculate a position and orientation thereof relative to said field generator, generate a 3D anatomic map representing the torso of the s