Abstract: A fibrin adhesive for use in the minimally-invasive treatment of a rupture of a body component formed by hard connective tissue adhesively bonds to that body component. A suitable treatment method features locating the rupture, providing the fibrin adhesive, and supplying the fibrin adhesive at the body component to be treated.

Abstract: In intervertebral operative spinal procedures, using separate or pre-attached spreader blocks to control the directional growth of a distracting balloon.

Abstract: A surgical device includes one or more cameras integrated therein. The view of each of the one or more cameras can be integrated together and provided to a surgeon display and/or an assistant display. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the images generated by the one or more cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as at least partially transparent. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: A surgical access sleeve may include a tubular braid with a closed end pocket at the distal end. The tubular braid is compressible, or it can be shortened, in a longitudinal direction, to force the tubular braid to expand radially outward. A surgical method includes inserting a substantially un-compressed access sleeve partially into an incision or opening in a patient, with the access sleeve comprising a tubular braid. The access sleeve is compressed in a longitudinal direction to force the access sleeve to expand radially outward to dilate or maintain the opening.

Abstract: A bone suture assembly including a flexible sleeve, at least one lockable suture associated with the flexible sleeve and having a series of mutually spaced suture engagement elements extending along at least a portion thereof and at least one suture locking element defining a loop which can be lockably tightened in locking engagement with a corresponding one of the at least one lockable suture by application of tension to the at least one suture locking element, without requiring knotting thereof.

Abstract: Methods and devices are provided for securing tissue to bone. A surgical system can include a guide, a suture anchor including a sheath and a screw, a first driver shaft, and a second driver shaft. The first driver shaft can be configured to be removably received within a lumen of the guide such that an awl tip thereof extends beyond a distal end of the sheath. The sheath and the guide can have first and second side openings, respectively, that can receive at least one suture therethrough. The second driver shaft can be configured to be removably received within the lumen of the guide when the first elongate shaft is removed therefrom, the second driver shaft having a distal driver member configured to be removably received within a proximal channel formed in the screw to drive the screw into mating engagement with the sheath.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include an outer shaft, an elongate inner shaft, and an implantable suture anchor assembly including first and second anchor bodies. The second, more proximal, anchor body has one or more openings extending through a side wall or through opposed side walls thereof. The inner shaft is configured to be received within the outer shaft and through the first and second anchor bodies such that a distal end of the inner shaft protrudes beyond a distal end of the first anchor body. The inner shaft is configured to be removably coupled to the first anchor body such that the inner shaft is configured to be rotated to cause a proximal portion of the first anchor body to move proximally into a lumen extending through the second anchor body and to occlude the opening in the second anchor body.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include a driver device, an elongate shaft receivable within the driver device and having a dilator feature at its distal end, and a capture suture extending through the shaft such that the capture suture's terminal end portions extend to a more proximal position on the driver and the capture suture forms a loop that extends through an opening formed through a side of the shaft. The loop is configured to receive at least one retention suture therethrough and can be tightened by pulling the capture suture's terminal ends, thereby coupling the retention suture with the suture anchor. Once the shaft is inserted into bone and the loop with the retention suture is closed, the suture anchor is driven distally towards the dilator features and into the bone to secure the retaining suture in the bone.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include a driver device, an elongate shaft receivable within the driver device and having a dilator feature at its distal end, and a capture suture extending through the shaft such that the capture suture's terminal end portions extend to a more proximal position on the driver and the capture suture forms a loop that extends through an opening formed through a side of the shaft. The loop is configured to receive at least one retention suture therethrough and can be tightened by pulling the capture suture's terminal ends, thereby coupling the retention suture with the suture anchor. Once the shaft is inserted into bone and the loop with the retention suture is closed, the suture anchor is driven distally towards the dilator features and into the bone to secure the retaining suture in the bone.

Abstract: A method for securing a suture to bone can include loading the suture in a distal opening of an inserter of an assembly. The suture can be coupled to soft tissue. The assembly can include the inserter, an anchor carried by the inserter, a distal tip and a driver each coupled to the inserter. A hole can be formed in the bone with the distal tip, and the distal opening and a portion of the suture can be positioned in the hole. The driver can be actuated to allow movement relative to the inserter and can be advanced in a first direction to drive the anchor about the inserter into the hole to secure the distal tip, anchor and suture to the bone with an absence of a knot. The driver can be moved in a second direction to remove the inserter from the distal tip, anchor and suture.

Abstract: A method and apparatus for surgically repairing a tear in soft tissue is disclosed. A plurality of collapsible tubes are positioned about the suture. The collapsible tubes are pushed through soft tissue and orthopedic mesh on opposite sides of a tear in soft tissue. When tension is applied to the suture, the tubes are compressed to fix the suture to the soft tissue and draw the soft tissue portions together.

Abstract: Devices and methods for forming and securing a tissue plication are disclosed herein. In one aspect, a tissue manipulation device is described that includes a first jaw member pivotally coupled to a distal end of an elongate shaft and having an articulating portion located distal to the proximal end of the first jaw member. The device also includes a second jaw member pivotally coupled to the first jaw member such that the jaws move in a first plane, and a fastener delivery member attached to the second jaw member. The articulating portion of the first jaw member is configured to move the first and second jaw members between a straight configuration in which a longitudinal axis of the elongate shaft is contained within the first plane and an articulated configuration in which the longitudinal axis of the elongate shaft is transverse to the first plane.

Abstract: A swivel suture anchor for knotless fixation of tissue. The suture anchor includes an anchor tip configured to capture suture, the anchor tip being rotatably received within a fixation device upon advancement of the fixation device over a shaft of the anchor tip. The anchor tip is configured to receive a suture to be anchor in bone without requiring suture knots. The anchor tip can be a conical metal tip which is self-punching and avoids the need for pre-drilling a hole in bone. The anchor tip includes a closed aperture to allow free sliding of a suture strand. The suture is secured in a hole in bone by inserting the anchor tip into bone, and advancing a fenestrated fixation device, such as a cannulated interference screw, over a shaft of the anchor tip.

Abstract: Devices and methods for minimally invasive suturing are disclosed. One suturing device for minimally invasive suturing includes a proximal section a distal end, and an intermediate region therebetween. The device includes a suture head assembly having a suturing needle with a pointed end and a second end. The suturing needle is capable of rotating about an axis approximately perpendicular to a longitudinal axis of the device, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to deployment of guides that are adapted and configured to guide the needle around a circular path when advanced by a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: An apparatus and a method for surgical fastening is disclosed. An illustrative apparatus for tissue suturing includes a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis, a reciprocating needle drive, and an actuator capable of releasably engaging the needle drive to rotate the needle. A method for suturing tissue is provided that includes placing a suturing device having a cartridge containing a suturing needle to span at least one tissue segment, activating an actuator to cause rotational movement of the suturing needle through the at least one tissue segment, and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the at least one tissue segment forming a stitch.

Abstract: A device for cardiac surgery is disclosed, having a) a plurality of pairs of suture guides spaced about the frame; b) a plurality of suture tubes, with one suture tube corresponding to each pair of suture guides; c) a plurality of snares, each corresponding to and passed through one of the plurality of suture tubes so that a handle at one end of the snare protrudes from a proximal end of the corresponding suture tube and a snare loop at another end of the snare protrudes through a distal end of the corresponding suture tube, and wherein the snare loop further protrudes through one of the suture guides in the corresponding pair of suture guides; and d) a plurality of sutures, each corresponding to one of the pairs of suture guides and coupled to the suture guide in the corresponding pair of suture guides which does not have the snare loop passing through it.

Abstract: A rotation adapter for a minimally invasive surgical apparatus is disclosed. The rotation adapter has a proximal journal and a distal journal. The rotation adapter also has a rotation index coupled between the proximal and distal journals. The rotation adapter further has an actuator input and an effector output. A rotation adapter receiver for a minimally invasive surgical apparatus is also disclosed. The rotation adapter receiver has opposing beams and a proximal bushing coupled between the opposing beams. The rotation adapter receiver also has a distal bushing coupled between the opposing beams. The rotation adapter receiver further has a rotation constraint coupled between the opposing beams and positioned between the proximal and distal bushings.

Abstract: A loading fixture for loading a needle into a suturing device includes a chassis, a clamp assembly and a needle holder. The clamp assembly is connected with the chassis. The needle holder is movably mounted to the chassis. A method of assembling a suturing device includes holding a suturing device. The method further includes inserting a needle having a suture attached thereto through a distal opening into a needle passage of the suturing device. The method also includes maintaining a portion of the suture extending out of the distal opening and outside of the suturing device.

Abstract: A surgical instrument includes a handle portion, a shaft coupled to the handle portion, a pair of jaw members operably coupled to the shaft and a lactate sensor associated with the jaw members. The lactate sensor is configured to measure lactate in tissue disposed between the pair of jaw members.

Abstract: A device for attaching a sheet-like implant to a target tissue. The device includes a fastener push rod including a first portion, a second portion and a force limiting mechanism operably coupled between the first portion and the second portion. A fastener is carried by the second portion of the fastener push rod. The force limiting mechanism transmits longitudinal movement of the first portion to the second portion while the forces applied to the fastener by the fastener push rod are less than a predetermined value such that longitudinal movement of the first portion of the fastener push rod causes substantially equivalent longitudinal movement of the second portion. The force limiting mechanism allows relative longitudinal motion between the first and second portions while the forces applied to the fastener are equal to or greater than the predetermined value such that the application of undue forces to the fastener is prevented.

Abstract: A surgical instrument includes a handle portion, a shaft coupled to the handle portion, a pair of jaw members operably coupled to the shaft, an inflatable member, and a sensor. The inflatable member is associated with one of the jaw members and is configured to apply pressure to tissue disposed between the pair of jaw members. The sensor is associated with one of the jaw members and is configured to measure local perfusion pressure in the tissue disposed between the pair of jaw members.

Abstract: An end effector of a surgical stapler includes first and second jaw members and a buttress material. The first jaw member is moveable relative to the second jaw member. The first jaw member includes a contact surface, a first projection, and a catch. The catch includes first and second fingers distal of the first projection. The second finger is biased toward the contact surface. The buttress material defines a longitudinal axis. The buttress material is releasably secured to the first jaw member. The buttress material defines first, second, and third slots formed therein. The first projection of the first jaw member is received in the first slot of the buttress material. The first finger of the catch is received in the second slot of the buttress material.

Abstract: The present disclosure is directed to systems and methods for operating an electromechanical surgical system. The electromechanical surgical system includes a hand-held surgical instrument including an instrument housing defining a connecting portion for selectively connecting with a shaft assembly. The system also includes an end effector configured to perform at least one function. The shaft assembly is arranged for selectively interconnecting the end effector and the hand-held surgical instrument. The shaft assembly includes a drive member, a flag member configured to translate axially along the drive member, and a sensor disposed about the drive member. The sensor provides a signal indicating that the end effector has reached an end stop when the flag member contacts that sensor.

Abstract: A medical device including a shape-memory metallic body comprising a plurality of closed cells with a plurality of terminal cell ends and a plurality of tissue engaging members extending from the shape-memory metallic body, a shaft of each tissue engaging member extending from the terminal cell end at least approximately in a direction of the long axis of the closed cell in an expanded configuration.

Abstract: A surgical instrument including a power assist device, and its method of use for deploying surgical fasteners, is disclosed. The surgical instrument may include a handle, an elongated shaft extending from the handle, and a surgical fastener deployment system including a driveshaft. The driveshaft is actuatable between at least a first proximal position and a second distal position. A striker is movable relative to the driveshaft and an impact surface is associated with the driveshaft. The impact surface is constructed and arranged to be struck by the striker member to displace the driveshaft to the second distal position and deploy the surgical fastener.

Abstract: A loading unit includes a shell assembly and a locking collar. The shell assembly has an annular ring that defines a locking slot and a proximal opening. The proximal opening configured to receive a distal end portion of the surgical instrument. The locking collar is rotatably disposed about the annular ring. The locking collar has a body including a flexible tab that has an inwardly extending lock. The locking collar is moveable about the annular ring between a locked and unlocked configuration. In the locked configuration, the lock passes through the locking slot and into the proximal opening of the annular ring. In the unlocked configuration, the body of the locking collar is rotated about the annular ring from the locked configuration to move the lock from within the proximal opening.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

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: An occlusive medical device system may include an elongate shaft having a distal strain relief portion and a lumen extending longitudinally through the elongate shaft, the elongate shaft including a plurality of retaining arms extending distally from the distal strain relief portion; an occlusive medical device including a proximal mounting portion fixed to an expandable occlusive element; and a release wire disposed within the lumen of the elongate shaft. The plurality of retaining arms may extend into the proximal mounting portion. The release wire may be configured to engage the plurality of retaining arms in a distal engagement position, thereby urging the plurality of retaining arms radially outward into releasable engagement with the proximal mounting portion. When the release wire is in a proximal released position, the plurality of retaining arms is deflectable radially inward to disengage from the proximal mounting portion.

Abstract: A system and method for rapidly accessing a tourniquet located in a pouch with a pull-away cover. The tourniquet holder allows users to safely store in a fabric pouch a prepared tourniquet that is quickly accessible and coupled to a removable cover of the pouch. Users are able to fold tourniquet in a manner that allow the tourniquet to be removed from the pouch and used nearly instantaneously.

Abstract: A tourniquet for a limb may include an elongated band with first and second ends, a central portion between the first and second ends, and first and second edges extending between the first and second ends. The elongated band defines an opening between the first and second edges spaced from the first end for receiving the second end and the central portion, thereby forming a loop along the elongated band beginning at the opening and ending at a point on the elongated band passing through the opening.

Abstract: An arthroscopic surgical tool arrangement for performing endoscopic surgical procedures which includes a powered handpiece and a cutting accessory which detachably connects to the handpiece is provided. The cutting accessory has a distal end which defines a cutting head incorporating diamond-grit particles.

Abstract: The present invention is directed to systems, methods, tools and surgical procedures that provide for improved, faster and/or more efficient methods for cleaning bone of soft tissue in preparation for use in bone grafting and surgery, including specific applications particularly useful in fusion procedures and/or other surgeries of the lumbar, cervical, and/or thoracic spine and/or other anatomical locations, desirably allowing for faster and complete healing.

Abstract: The invention relates to a medical aspiration system having a catheter with at least two lumens, wherein a first lumen forms an aspiration lumen which is connected to an aspiration unit for suction removal of substances from a blood vessel through an inlet opening in the aspiration lumen, and a second lumen forms an infusion lumen through which a substance can be supplied to the blood vessel through an outlet opening in the infusion lumen, wherein the outlet opening in the infusion lumen is arranged in a region between the inlet opening of the aspiration lumen and a position proximal to the inlet opening in the aspiration lumen. The invention is characterized in that the infusion lumen is connected to a cooling unit, which supplies a cooled liquid for administration through the infusion lumen.

Abstract: A minimally invasive blood clot capturing invention made of nitinol The nitinol is shaped into a plurality of fingers to form a frame for a basket and funnel to capture and remove blood clots. The basket and funnel being delivered to the blood clot by a catheter. The basket and funnel are capable of being collapsed within a catheter, capable of being deployed into a blood vessel, and capable of being retracted into the catheter for removal from the blood vessel.

Abstract: A system and method for managing an occlusion, such as a blood clot, within a lumen or passageway of a patient. More particularly, a system and method for rapidly restoring blood flow through an occlusion including a self-expanding, tubular member through which blood may flow when in an expanded state. The tubular member has a structure configured to engage the occlusive material, thereby allowing for extraction of at least a portion of the occlusive material. The system may further employ a material extraction member that is deployed distally of the tubular member.

Abstract: A medical device, a medical system, and a treatment method are disclosed, which are capable of effectively crushing an object in a body lumen. The medical device can be used after being inserted into a capturing device capturing thrombi in a blood vessel and removing the thrombi to the outside of a body has at least two elongated shaft portions spaced apart from each other side by side and a cutting unit extending to a distal side from distal portions of at least two shaft portions, the cutting unit has linear portions inclined with respect to the shaft portions and a distal continuous portion extending to the distal side from distal portions of at least two linear portions, and at least the linear portions have sharp cutting blades.

Abstract: Aspects of a device are described. One aspect is a device comprising: a housing having a first portion engageable with a scope, and a second portion engageable with a handle of a retrieval device; a platform that is movable relative to the housing, and engageable with a slider of the retrieval device; and a link assembly that is coupled the housing and the platform, and operable to move the platform and slider relative to the housing and handle. Aspects of related devices and systems also are described.

Abstract: An instrument such as a tenaculum comprises a pair of jaws (202, 203) which are pivotal from an open configuration in which the jaws (202, 203) are splayed apart to a closed low profile delivery configuration. The jaws (202, 203) each have tissue engagement features (201). A protector loop (200) for each jaw which may be of a shape memory material such as Nitinol provides a safety protective distal tip which is distal of the tissue engaging features (201). The atraumatic tip does not harm tissue and does not compromise the integrity of a bag which may be used as a containment device in a procedure such as a hysterectomy.

Abstract: A medical clamping instrument includes first and second tubular members pivotally connected together, a first rod member pivotally connected to the second tubular member, a second rod member pivotally connected to the first rod member, first and second claw arms respectively providing first and second clamping portions and first and second connecting portions and respectively pivotally connected to the second tubular member, third and fourth rod members respectively pivotally connected to the first and second connecting portions, a screw nut pivotally connected to the third and fourth rod members, a screw rod threaded into the screw nut and driven by a driving rod via the first universal joint, the fifth rod member and the second universal joint. Thus, operating the driving rod can move the first and second clamping portions, maintaining the clamping force stably.

Abstract: A manipulator includes: an elongated body portion that can be inserted into a body; and an energy treatment mechanism provided at a distal end of the body portion. The energy treatment mechanism is provided with gripping pieces that can grip body tissue and an energy applying part configured to apply energy to the body tissue gripped by the gripping pieces. The body portion is provided with an energy transfer part configured to transfer energy to the energy applying part and a force amplifying mechanism configured to amplify gripping force of the gripping pieces.

Abstract: A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end effector by the clamping member when the clamping member is in a clamped position. The instrument may also comprise a main drive shaft assembly for actuating the cutting instrument in the end effector, a gear drive train connected to the main drive shaft assembly, and a motor for actuating the gear drive train. The instrument may also includes a closure trigger and a firing trigger, separate from the closure trigger, for actuating the motor when the firing trigger is retracted. Also, the instrument may comprise a mechanical closure system connected to the closure trigger and to the clamping member for causing the clamping member to pivot to the clamped position when the closure trigger is retracted.

Abstract: A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end effector by the clamping member when the clamping member is in a clamped position. The instrument may also comprise a main drive shaft assembly for actuating the cutting instrument in the end effector, a gear drive train connected to the main drive shaft assembly, and a motor for actuating the gear drive train. The instrument may also includes a closure trigger and a firing trigger, separate from the closure trigger, for actuating the motor when the firing trigger is retracted. Also, the instrument may comprise a mechanical closure system connected to the closure trigger and to the clamping member for causing the clamping member to pivot to the clamped position when the closure trigger is retracted.

Abstract: This invention is an interchangeable hand tool device for surgical and other applications. The device includes an adjustable, interchangeable first jaw; an adjustable, interchangeable second jaw; a base to which the first and second jaws are attached; a central pivot about which one or both jaws can rotate; an interchangeable first handle connected to the base; an interchangeable second handle connected to the base.

Abstract: A rotating cutting head catheter for passage through chronic total occlusions or other refractory atherosclerotic plaque from diseased arteries is disclosed. The catheter's rotating cutting head is designed to reside safely within an outer protective sheath when not in use. The outer protective sheath contains one or more helical grooves or slots, and the cutting head contains protruding blades or projections that fit into these helical grooves or slots. Application of torque to an inner catheter or wire attached to the cutting head applies spin to the cutting head, and the force of the sheath's helical grooves or slots against the cutting head's protruding blades or projections advances the cutting head outward from the protective sheath. Once extended, the cutting head may now rotate freely. The device may use a guidewire to direct the cutting head to the desired position.

Abstract: A cutting device is provided that includes an outer tube. The outer tube includes an inner surface defining a passageway. An inner tube is movably disposed in the passageway such that a distal end of the inner tube extends beyond a distal end of the outer tube. The distal end of the inner tube includes a first cutting element. An inner surface of the inner tube defines a lumen. A shaft is slidably disposed in the lumen. The shaft has a distal end including a second cutting element. A deployment mechanism is coupled to a proximal end of the outer tube. The deployment mechanism includes a body, a push button disposed within the body and a collar disposed about the body. The shaft is fixed relative to the collar and the inner tube is fixed relative to the push button. Systems and methods are disclosed.

Abstract: A method of treatment for a body vessel is provided. The body vessel includes a dissection flap formed from a wall of the body vessel, which longitudinally separates a natural body vessel lumen into a true lumen and a false lumen. One or more cuts are formed in the dissection flap with a cutting device or system. An expandable device is inserted within the true lumen, and expanded to reappose the dissection flap against the wall of the body vessel where the dissection flap was detached from the wall such that the false lumen is closed. A variety of cut patterns are disclosed.

Abstract: A method and system for treatment for a body vessel having a dissection flap formed from a wall of the body vessel, which longitudinally separates a natural body vessel lumen into a true lumen and a false lumen. One or more cuts are formed in the dissection flap with the cutting device or system including cutting blades. An expandable device is inserted within the true lumen, and expanded to reappose the dissection flap against the wall of the body vessel where the dissection flap was detached from the wall such that the false lumen is closed. A variety of cut patterns are disclosed.

Abstract: The present disclosure is directed to a fluid cooled ultrasonic surgical instrument and related systems and methods of use therefor. In some embodiments, the disclosed ultrasonic surgical instrument is adapted for used within an insufflated cavity or pneumoperitoneum of a patient. The instrument includes a housing having an elongate shaft, a waveguide disposed at a distal end of the shaft, a coolant inlet port defined in an outer surface of the housing, and a coolant pump disposed within the housing and configured to move coolant from the coolant inlet port to the waveguide. During use, insufflation gas from within the pneumoperitoneum is drawn into the instrument shaft by the coolant pump, and blown over the waveguide to provide cooling. The delivery of ultrasonic energy and activation of the pump may be controlled by a processor in response to user input and waveguide temperature.

Abstract: A method and a hand-held device for dermaplaning is disclosed that includes a blade assembly which includes a blade, a blade holder and a safety cage. In accordance with an important aspect of the invention, the safety cage limits the amount of penetration of the blade into the facial skin to enable the device to be safely used by non-professionals. The dermaplaning device includes a vibration generator that causes the blade to vibrate at a predetermined frequency. Various embodiments of the hand-held dermaplaning device are disclosed for vibrating the blade.