Abstract: A surgical stapling instrument (1) comprises a staple fastening assembly (4) in the distal region of said instrument, the staple fastening assembly (4) including a cartridge device (8) which comprises at least one closed row (17, 18) of staples and defines a wavy distal end surface (14), and an anvil (9) which defines a wavy proximal staple forming surface (20) substantially matching the distal end surface (14) and which is adapted to cooperate with the cartridge device (8) for forming the ends of the staples exiting from the cartridge device (8), wherein the distal end surface (14) and the staple forming surface (20) have a globally wavy shape including two opposite peaks (21) and two opposite valleys (22) angularly spaced at about 90° from the adjacent peaks (21) and in that said two-peaks-two-valleys wavy shape is formed by a stepped configuration of said surfaces (14, 20).

Abstract: A circular stapling instrument including a stapling forming assembly that is actuated independently from actuation of the cutting assembly is provided. The instrument includes a handle assembly, an elongate body extending from the handle assembly, a cartridge assembly mounted on a distal end of the elongate body. The cartridge assembly includes a pusher assembly and a knife assembly. The knife assembly is selectively fixed relative to the pusher assembly.

Abstract: An implant for use in orthognathic surgery of a mandible may include a longitudinal plate member and a plurality of pre-configured guides coupled to the plate member. The longitudinal plate member is pre-bent to correspond to the post-operative shape of the mandible; and the guides are pre-configured to align the plate member with the mandible when the implant is positioned against the mandible after the mandible has been separated.

Abstract: Devices are described relating to the retaining of surgical tools within the chuck of a reciprocating surgical instrument, such as a reciprocating saw. A securing chuck is disclosed for securing a surgical tool to a reciprocating surgical instrument that comprises a shaft and a securing member. The shaft defines an axis and has a cylindrical bore extending along the axis. The bore is shaped to receive a substantially rounded tool shank. A pair of transverse slots extends into the shaft along a plane passing through the axis for receiving a substantially flattened tool shank. The transverse slots intersect with the cylindrical bore. The securing member is carried by the shaft and is radially movable relative to the bore both inwardly and outwardly to secure the surgical tool in the chuck.

Abstract: An improved motorized burr instrument for operation on tissue at a desired surgical site surrounding by fluid, the motorized burr instrument being operable with a variable speed motor at a rotary drive coupler with a hub extending therefrom, an outer sheath housing a rotating member extending between the rotary drive coupler and a burr having a cutting edge with at least one radial projection joining a leading and a trailing edge and rotating said fluid through the outer sheath as the cutting edge is rotated.

Abstract: Systems, apparatus, and methods may be adapted for grafting tissue at a tissue site that may include an elongate housing and a plurality of elongate cutting members. The plurality of elongate cutting members may define a cutting surface at a distal end of the elongate housing. The cutting surface may be adapted to contract from a first diameter to a second diameter that is less than the first diameter. The contraction of the cutting surface from the first diameter to the second diameter may define a tapered profile between the first diameter and the second diameter suitable for obtaining a tapered graft.

Abstract: A surgical instrument includes a first member defining an axis and including a cutting surface. A second member includes a cutting surface that is rotatable relative to the first member. A third member includes an outer surface. The cutting surface of the second member is rotatable relative to the outer surface to transfer the cut tissue along the axis. Systems and methods are disclosed.

Abstract: Devices and methods for removing a spinal disc are provided herein. Discectomy instruments are disclosed that can remove a spinal disc in a single-pass, i.e., without repeatedly inserting and removing the instrument from a patient. In an exemplary embodiment, the discectomy instrument includes a distal housing, at least one cutting blade, and a handle. When the distal housing is positioned adjacent to a spinal disc, a handle can be actuated to advance the cutting blade along a substantially arc-shaped path through the disc. In certain aspects, the path of the blade can correspond to the anatomy of the disc and to the approach used to access the spine. A second cutting blade can be advanced through the disc and can intersect with the arc-shaped path, forming a complete cut. The cut disc can be received in the distal housing and removed from the patient.

Abstract: Various surgical devices and methods are disclosed herein. Also disclosed is multi-component prosthesis, which can be used as an ankle prosthesis. One of the disclosed surgical alignment systems includes a guide arm, a ratchet arm frame configured to be coupled slidably to the guide arm, a ratchet arm configured to be coupled to the ratchet arm frame, and a sagittal sizing guide body configured to be coupled to the ratchet arm. The sagittal sizing guide body includes a first radiopaque object disposed at a first position and a second radiopaque object disposed at a second position that is spaced apart from the first position.

Abstract: A novel coplanar X-ray guided method and device for insertion of distal locking screws in intramedullary bone nails. The device has coplanar holes, which allow insertion of protective sleeves. A drill and bone screws can be inserted through the protective sleeves. Radiopaque target markers in the aiming arm enable the easy positioning of an X-ray source such that an X-ray beam is coplanar with the aiming arm transverse holes. After the X-ray source is accurately oriented, a single X-ray snapshot is enough to assess the exact distortion of the implanted intramedullary nail. The X-ray beam need not be coaxial with the intramedullary nail holes. The aiming arm has a mobile portion and a fixed portion fastened to the nail, wherein said aiming arm can be adjusted, displacing the mobile portion over the fixed portion, to compensate for the distortion of the intramedullary nail after implantation.

Abstract: A clot retrieval system comprises a clot retrieval device, a catheter 51, and a tubular shield element 61. The clot retrieval device comprises an elongate member 53 having a proximal end and a distal end, and a clot engaging element 54 at the distal end of the elongate member 53 the clot engaging element 54 having a collapsed delivery configuration and an expanded deployed configuration. The catheter is adapted for placement at a location at which a distal end of the catheter is proximal of the clot engaging element and the tubular shield element 61 extends over the elongate member 53 and is adapted for location between the distal end of the catheter and the proximal end of the clot engaging element 54. The tubular shield element 61 is movable relative to the elongate member 54 when the clot engaging element is in the expanded configuration in that the force that is applied on retraction of the elongate member is spread over the outer surface of the tubular shield element.

Abstract: An instrument that facilitates bending with large degrees of articulation while maintaining ease of manufacturing for medical and surgical applications is discussed.

Abstract: A joint surgical treatment under an arthroscope, includes: excising a treatment object of a synovial membrane, by transmitting an ultrasonic vibration to a treating portion of an ultrasonic device in a state where the treating portion is in contact with the treatment object of the synovial membrane; facing the treating portion to a treatment object of a cartilage, the treating portion being used in excising the treatment object of the synovial membrane; and removing the treatment object of the cartilage, by contacting the treating portion with the treatment object of the cartilage, and by transmitting the ultrasonic vibration to the treating portion in a state where the treating portion is in contact with the treatment object of the cartilage.

Abstract: A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. A delivery sleeve may be selectively provided that is configured to be disposed about the outer cannula for delivery of a variety of devices.

Abstract: A surgical cutting tool includes an elongated shaft and a cutting head. The shaft defines a coupling portion terminating at a proximal end of the shaft, a stem portion, and a distal portion. The stem portion defines a central axis. The coupling portion optionally defines a deflection surface positioned oblique with respect to the central axis and connected with a first driven surface and a second driven surface. Upon insertion into a drive chuck, the deflection surface promotes self-alignment of the cutting tool and the drive chuck.

Abstract: A curette for pituitary adenoma surgery may include a curette having a tubular blade portion. A first cutting edge is formed at a first end of the blade portion, and a protective shell is formed at an outer periphery of the first cutting edge. A first annular ring formed at a first end of the protective shell is located at the same side of the first cutting edge, and a rod portion extended from a surface of the protective shell is configured to provide a handhold for a user. The first annular ring of the protective shell can prevent the first cutting edge of the blade portion from accidentally cutting the meninges or blood vessels during pituitary adenoma surgery. Thus, the curette can improve the efficiency of the surgery and lower surgery time, anesthetic dosage and risk of the surgery.

Abstract: Systems, instruments or devices, and methods or procedures are described in which a scalpet array is applied to a target site with the use of a pattern. The scalpet array comprises scalpets positioned on a device. Skin pixels are incised at the target site via application of a load through the scalpet array. A recipient site is prepared by positioning the pattern at the recipient site and applying the scalpet array to generate skin defects. The incised skin pixels are applied at the skin defects of the recipient site.

Abstract: A skin insertion mechanism includes a needle fixedly positioned in a needle holder with a connector (or connective means) to an injection or analysis system having a skin attachment plate coated with an adhesive layer and a spacer mechanism kept in the ready-to-use position, the skin attachment plate is spaced away from a needle support covering the needle. Subcutaneous insertion of the needle is effected by attachment of the adhesive layer to the skin and releasing the spacer mechanism by applying a pre-set trigger point pressure against the skin.

Abstract: Systems and methods for accessing an interior space of a joint such as a hip joint in preparation for arthroscopic surgery are provided. In general, the described techniques utilize a joint access device having a handle and a dilator shaft and/or sheath coupled to a distal end of the handle. The device can be advanced over a guidewire inserted into a joint to a first position and the guidewire can be reversibly locked to the handle. The handle can be associated with an actuator configured to be actuated to cause the dilator shaft and/or sheath to advance distally toward a second position within the joint while simultaneously retracting the guidewire coupled to the handle.

Abstract: A system and method for body piercings using body piercing forceps. The body piercing forceps comprises two arms pivotally hinged to each other. One arm comprises a needle guide at the end of the arm that may be placed externally on the body. The other arm comprises a receiving tube that may be placed into a body orifice. The body piercing forceps allow complete control over the location of a body piercing and prevent dangerous complications that may arise from traditional piercings.

Abstract: An external fixation frame for correcting a bone deformity includes a first fixation ring and a second fixation ring. A posterior adjustable length strut couples a posterior portion of the first fixation ring to a posterior portion of the second fixation ring and has universal joint. Medial and lateral adjustable length struts couple medial and lateral portions of the first fixation ring to medial and lateral portions of the second fixation ring respectively, each of the medial and lateral adjustable length struts including a constrained hinge joint. The fixation frame also includes a half ring coupled to the second fixation ring.

Abstract: The present disclosure relates to an external fixation apparatus comprising a strut having a longitudinal axis defined therein, the strut comprising a strut housing having a housing adjustment aperture, an adjustment sleeve slidably disposed within the strut housing, and a fastener that releasably couples the strut housing with the adjustment sleeve. An embodiment of the adjustment sleeve comprises a first and a second bore extending from a top towards a bottom surface of the adjustment sleeve, a first sleeve member with a proximal end, a distal end, and an axial bore, and a second sleeve member adjoining the first sleeve member. In an embodiment, the second sleeve member comprises a body and a beveled end that is slidably disposed within the axial bore of the first sleeve member. The adjustment sleeve further comprises a biasing mechanism between the first sleeve member and the second sleeve member.

Abstract: A plurality of individual tools is provided where each tool is uniquely configured to perform a step or a portion of a step in a novel procedure associated with the implantation of a stabilizing device (e.g., an interspinous spacer) for stabilizing at least one spinal motion segment. The tools are usable individually, or more preferably as a tooling system in which the tools are collectively employed to implant an interspinous spacer, generally in a minimally invasive manner. For example, each of the tools is arranged with coordinated markings and/or other features to ensure consistent depths of insertion, proper orientation of the tools with respect to each other or an anatomical feature of the patient, and precise delivery of the spacer to maintain safe positioning throughout the implantation procedure.

Abstract: There is provided a spinal implant device for placement between adjacent spinous processes and a pair of opposing facet joints. The spinal implant device includes a fusion cage, first and second fixation plates and a connector for connecting the cage to the plates. The fusion cage includes a superficial face, a deep face, superior and inferior saddle portions, and opposing cage ends. Each cage end defining a facet fusion surface sized and configured to respectively contact the opposing facet joints. The first and second fixation plate are sized and configured to extend along and in contact with the adjacent spinous processes. A method of implanting the device is provided. In another embodiment the device includes the fusion cage.

Abstract: Spinal implants for limiting flexion of the spine are implanted between a superior spinous process and an inferior spinous process or sacrum. The implants include upper straps which are placed over the upper spinous process, while the lower portions of the implant are attached to the adjacent vertebra or sacrum. The attachments may be fixed, for example using screws or other anchors, or may be non-fixed, for example by placing a loop strap through a hole in the spinous process or sacrum.

Abstract: Devices and methods are adapted to permit fixation and stabilization of the bony elements of the skeleton. The devices permit adjustment and maintenance of the spatial relationship between neighboring bones. The motion between adjacent skeletal segments may be maintained, limited or completely eliminated.

Abstract: A resilient core is positioned between bony projections which are offset from a principal load bearing region of a spinal joint. Shaped projections extend from the core, and engage the bony projections by conforming to anatomical landmarks, and may be fastened to the bony projections. During flexion of the joint, the core absorbs some of the force of compression, and limits an extent to which the joint may compress. If the shaped projections are connected to the bony projections, extension of the joint is inhibited by the projections and the core, limiting the extent to which the joint may be distracted. In this manner, healing is fostered, and a weakened or damaged joint is protected from excessive movement.

Abstract: Briefly, the present invention is directed to methods and instrumentation for performing surgery on the spine along its lateral aspect (side) and generally by a lateral, anterior or an anterolateral surgical approach, such that the instruments enter the body from an approach that is other than posterior and make contact with the spine along its lateral aspect. The present invention provides for the entire surgical procedure to be performed through a relatively small incision and may be performed in either the thoracic or lumbar spine.

Abstract: A rod template for determining a curvature and a length of a spinal rod used for joining vertebrae in a spine fusion surgery in advance includes a core, a transparent outer tube, and a transparent filler. The core is made of metal and includes a scale on a surface thereof. The outer tube is made of silicone rubber and covers the core. The filler is made of liquid silicone rubber and inserted in a gap between the outer tube and the core to fill the gap.

Abstract: A clip-on reducer tool assembly for seating a spinal fixation rod in a rod receiving implant, the tool assembly has an outer sleeve. The outer sleeve has a proximal end with a cylindrical portion having a threaded opening, a first leg extension extending therefrom to a distal end, and a second leg extension joined to the first leg extension at an intermediate location between the distal end and proximal end. The second leg extension extends from the distal end toward the proximal end to a lever end spaced from the cylindrical portion. The leg extensions at the distal end have grasping members to engage an outer surface of a rod receiving implant and a fulcrum proximally located near the intermediate location configured to enlarge the space between the leg extension at the distal end as the lever end is depressed inwardly relative to a longitudinal axis of the outer sleeve.

Abstract: A device for bone fixation comprises an expansion part and a covering part. The expansion part has a fixing end and a top end and provides an expansion structure for being adjustable between a state of expansion and contraction. The covering part has a front end and a joining end, wherein the front end thereof is joined to the top end of the expansion part, and the joining end thereof is attached to the fixing end of the expansion part. The covering part is employed to cover the expansion structure. After the expansion part and the covering part are added to the bone, the covering part is unfurled to spread to the expansion state, and the medical filler is injected or pushed into the covering part.

Abstract: System, including methods and apparatus, for hip fixation with load-controlled dynamization. In exemplary embodiments, the system may comprise a fixation element, such as a screw, configured to be placed into a proximal femur of a subject, with a leading end of the fixation element anchored in a head of the proximal femur. The system also may comprise a stop member configured to be connected (e.g., via a nail or plate) to the proximal femur. The system further may comprise a deformable member configured to be irreversibly deformed by compressive force exerted on at least a portion of the deformable member by the fixation element and the stop member in response to a load applied to the proximal femur by the subject, such that the fixation element and the stop member move relative to one another parallel to a long axis of the fixation element.

Abstract: An intramedullary implant has opposite ends inserted into bores in abutting phalanges for correcting hammer toe and for similar arthrodesis procedures. A rear end of the implant may be threaded and is received in a bore in the proximal phalanx. A front end has an asymmetric pointed shape with longitudinally and/or angularly spaced rear-facing gripping flukes. The pointed front end is received in the middle phalanx. The asymmetric pointed shape is self-aligning, enabling entry to begin without first longitudinally aligning the bones. The rear end when screwed into place can be rotated to select the orientation of the asymmetric pointed shape. The pointed front end is inserted and pushed to bring the phalanges into abutment where the implant holds them against retraction or rotational displacement.

Abstract: Embodiments of the present invention provide a bone fixation assembly that can provide polyaxial fixation. The polyaxial fixation may be provided by fins that protrude from an opening in a bone plate or fins that protrude from a fastener head.

Abstract: The various embodiments disclosed herein relate to bone fixation or fusion devices, including intramedullary fixation or fusion devices that are implanted around the target bone. Certain device embodiments relates to devices that can be bent or otherwise deformed to replicate the natural or desired curve of the bone or joint being treated. In addition, other embodiments relate to implantation devices that can be used to implant or position the bone fixation or fusion devices.

Abstract: An elongated electrode includes a proximal conductor, a tubular member, and a treatment portion. The tubular member defines a channel therethrough and has proximal and distal end portions. The proximal end portion receives the proximal conductor within a portion of the channel and defines a hole through an inner and outer surface of the tubular member in fluid communication with the channel. The treatment portion is coupled to the distal end portion of the tubular member and includes a base and an arm extending distally from the base. The base defines a port in fluid communication with the channel of the tubular member. The arm is in electrical communication with the proximal conductor and is configured to deliver electrosurgical energy to tissue.

Abstract: In a multi-electrode ablation system, method, and controller, a power supply is configured to be coupled to a plurality of electrodes, and a controller is coupled to the power supply. The controller is configured to couple an output voltage of the power supply to the plurality of electrodes, and for each electrode of the plurality of electrodes, measure a temperature associated with the electrode, and determine a thermal gain of each electrode of the plurality of electrodes.

Abstract: The invention provides systems, methods, and apparatus for use in ablation procedures. The invention includes a generator with at least one indifferent lead and at least one catheter lead for connecting an indifferent electrode and a catheter provided with at least one electrode, a charging unit arranged to charge an amount of electrical energy and to discharge an electrical pulse of a predetermined magnitude between the two electrode leads, a power supply arranged to supply electrical energy to the charging unit, an input unit arranged for inputting an indication of the magnitude of the pulse, and a measuring unit arranged between the electrode leads for measuring at least one electrical property between the leads. Numerous additional aspects are provided.

Abstract: An electrosurgical system includes an energy applicator adapted to direct energy to tissue, an electrosurgical power generating source, and a surface-contact detection device. The surface-contact detection device is operably associated with the energy applicator. The surface-contact detection device is communicatively-coupled to the electrosurgical power generating source. The surface-contact detection device includes at least one optical transmitter to generate optical signals, a lens member configured to reflect optical signals generated by the optical transmitter when the lens member is disposed in contact with tissue, and at least one optical receiver to receive optical signals reflected by the lens member. The electrosurgical power generating source is adapted to transmit energy to the energy applicator when it is determined that the lens member is disposed in contact with tissue.

Abstract: A method of transferring a battery assembly to a battery-powered surgical instrument includes releasably engaging a battery jacket with the battery assembly, transferring the battery jacket, having the battery assembly engaged thereto, to a battery-powered surgical instrument, and releasably engaging the battery jacket with a handle of the battery-powered surgical instrument such that the battery assembly is electrically coupled to the battery-powered surgical instrument and such that the battery jacket and the handle cooperate to enclose the battery assembly therein. Aseptic battery jackets for such use are also provided.

Abstract: An electrosurgical instrument includes a housing, a shaft extending from the housing, and an end effector assembly attached at a distal end of the shaft. A handle assembly is coupled to the housing and includes a movable handle for manipulating the end effector assembly. An outer sleeve is disposed about the shaft and selectively translatable relative thereto. An energizable member is operably coupled to the outer sleeve. A deployment mechanism is provided including a lever rotatably coupled to the housing and positioned proximally of the movable handle and at least one link member coupled between the lever and the outer sleeve. The link member(s) couple to the outer sleeve distally of the movable handle. Rotation of the lever translates the outer sleeve distally to move the outer sleeve over the end effector assembly and simultaneously deploy the energizable member distally past the end effector assembly.

Abstract: A method of forming a jaw member of an end effector includes providing a metal support base; engaging a plurality of ceramic stops to the metal support base; and coupling an insulative plate and a sealing plate to the metal support base by aligning the plurality of ceramic stops through a plurality of openings defined in the insulative plate and a plurality of openings defined in the sealing plate.

Abstract: An ablation catheter comprises an elongated catheter body; at least one ablation element disposed in a distal portion which is adjacent the distal end of the catheter body; an illumination optical element disposed in the distal portion, the illumination optical element being light-transmissive to emit light from the illumination optical element to the targeted tissue region; and a collection optical element disposed in the distal portion, the collection optical element being light-transmissive to collect one or more of returned, backscattered or newly excited light from the targeted tissue region. The illumination or excitation optical element and the collection optical element are axially spaced from one another and axially optically isolated from one another within the distal portion to substantially prevent light from traveling between the illumination optical element and the collection optical element along a path within the distal portion.

Abstract: A catheter and method for the treatment of a patient having atrial flutter or other arrhythmia comprises an elongated catheter body having an outer wall, proximal and distal ends, and at least one lumen extending therethrough. Further it has a distal tip section comprising a flexible tubing having a proximal end and a distal end and a plurality of lumens extending therethrough. The proximal end of the tip section is fixedly attached to the distal end of the catheter body. The tip section further comprises a nitinol tube having slots formed therein which causes the distal tip section to deflect using the same puller-wire action used to cause the deflectable catheter to deflect at a point proximal to the distal tip section.

Abstract: An electrosurgical apparatus having a feed structure comprising a radiofrequency (RF) channel for conveying RF electromagnetic (EM) radiation from an RF signal generator to a probe and a microwave channel for conveying microwave EM radiation from a microwave signal generator to the probe, wherein the RF channel and microwave channel comprise physically separate signal pathways, wherein the feed structure includes a combining circuit having an input connected to the signal pathway on the RF channel, another input connected to the signal pathway on the microwave channel, and an output connected to a common signal pathway for conveying the RE EM radiation and EM radiation separately or simultaneously to the probe, and wherein the microwave channel includes a waveguide isolator connected to isolate the signal pathway on the microwave channel from the RF EM radiation.

Abstract: A device for directing energy to a target volume of tissue includes an inner conductor having a length and an outer conductor coaxially surrounding the inner conductor along the length. The outer conductor has a proximal portion and a distal portion. The distal portion of the outer conductor is provided with a number of apertures N defined therein for radiating energy, where N is an integer greater than 1, each aperture having a size and extending at an angle relative to a longitudinal axis of the outer conductor. At least one of the size and the angle of each aperture is varied in relation to the other apertures N?1 such that the energy radiated along the distal portion is substantially uniform.

Abstract: A skin treatment device comprising a light source providing a light beam for optically treating skin, a wheel with a wheel surface for reflecting the light beam towards the skin, driving means for rotating the wheel and changing an angular position of the wheel, where different angular positions of the wheel correspond to different directions of reflection for the light beam, an angular position detector for detecting the angular position of the wheel, storage means for storing predefined skin-treatment patterns, a relation between the different angular positions of the wheel; and different reflection directions of the light beam, a control circuit coupled to the light source. The light source being controlled in dependence on the detected angular position such that, for each revolution of the wheel, the light beam is controlled to only illuminate the wheel surface in selected angular positions of the wheel to realize a predefined skin-treatment pattern.

Abstract: A support mechanism for a medical device may include an adjustable support that includes a plurality of elongate members movable relative to one another. The support mechanism may also include a bracket coupled to the adjustable support. The bracket may be adapted to be coupled to a first medical device that extends along a longitudinal axis. The support mechanism may also include an instrument holder that extends along a central axis. The instrument holder may be movably coupled to the bracket and adapted to be coupled to a second medical device. The bracket and the instrument holder may be oriented such that central axis of the instrument holder intersects the longitudinal axis at an angle.

Abstract: Embodiments include a system for determining cardiovascular information for a patient. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart, and create a three-dimensional model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create a physics-based model relating to a blood flow characteristic of the patient's heart and determine a fractional flow reserve within the patient's heart based on the three-dimensional model and the physics-based model.

Abstract: Embodiments include a system for determining cardiovascular information for a patient. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart, and create a three-dimensional model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create a physics-based model relating to a blood flow characteristic of the patient's heart and determine a fractional flow reserve within the patient's heart based on the three-dimensional model and the physics-based model.