Abstract: A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Abstract: A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves. The shock waves propagate through the liquid and impinge upon the valve to decalcify and open the valve.

Abstract: There is provided herein, a method of attaching a mesh to a loop member, which includes covering a wire with a layer, manipulating the wire along with the layer to form the loop member, wherein the loop member has a shape, placing the mesh over the loop member, wherein portions of the mesh extend beyond a circumference of the loop member, transferring heat to the layer to cause it to partially melt and become tacky, allowing the mesh to fuse with the tacky layer and form a secure bond on cooling, and trimming portions of the mesh extending beyond the circumference of the loop member. A retrieval device formed by the method includes the loop member and attached mesh positioned and longitudinally movable within a tubular sheath. The loop member and mesh are deployed to capture a target object and partially retracted for removal of the object.

Abstract: New devices, systems, and methods are disclosed for preventing, treating, and/or at least minimizing ischemia and/or reperfusion injury by restoring and/or modulating blood flow, particularly in the cerebral vasculature where blood vessels are narrow and tortuous. These devices, systems, and methods make it possible for a clinician to adequately and systematically restore blood flow to ischemic tissue while simultaneously modulating the blood flow to minimize reperfusion injury. New thrombectomy devices and systems, which, for example, expand with greater radial force, further enable improved binding with clots and restoration of blood flow.

Abstract: A lead insertion tool includes a first leg having a first rail element pivotally coupled to the first leg distal end and a second leg having a second rail element pivotally coupled to the second leg distal end. The first rail element and the second rail element are configured to receive a lead. Medical kits and methods of using the same are also disclosed.

Abstract: Systems and method are described for counterbalancing the force required to deform a flexure joint. The system includes an elastically deformable flexure joint, a control joint, and an energy balance system. The control joint is mechanically linked to the flexure joint such that movement of the control joint causes a corresponding deformation of the flexure joint. The energy balance system provides a spring force to aid movement of the control joint and to overcome an elastic force required to deform the flexure joint.

Abstract: A surgical instrument may include a housing, a first actuation member configured; a coupler operatively connected to the first actuation member for imparting a reciprocating action to a portion of the instrument, a second actuation member configured for imparting a rotational action to a portion of the instrument, a first cannula operatively connected to the second actuation member, such that the first cannula is configured for rotational movement with respect to the housing, and a wire member at least partially disposed within the first cannula and fixed to the coupler, the wire member configured to rotate and reciprocate with the coupler.

Abstract: A medical instrument having an elongated shaft, with an elongated outer tube, a first transmission element including a first and second half tube, mutually displaceable in a longitudinal direction in order to operate one first functional element, wherein a second transmission element is in a cavity formed by the first and second half tube. A shaft housing connected to the outer tube is arranged in a proximal end portion of the shaft, and a first hollow tube which is connected to the first half tube is arranged within the shaft housing, and a second hollow tube connected to the second half tube within the first hollow tube, with substantially annular first and second seals. The first and second half tube extend through the shaft housing, a seal is arranged between an inner surface of the shaft housing and the outer surfaces of the first and second half tube.

Abstract: Devices and methods are provided for percutaneously treating atherosclerotic plaques within blood vessels. Atherosclerotic plaques cause significant morbidity and mortality by narrowing the arteries, which adversely affects blood flow, and by acting as a source for thrombi and emboli thus causing acute organ ischemia. Current treatments include open surgery with its inherent drawbacks, and stenting, which is less invasive but leaves the plaque material in the artery, which promotes restenosis. The present invention combines the advantages of both approaches. In general, the invention provides tools that enable percutaneously dissecting the plaque from the arterial wall and removing it from the body.

Abstract: An interventional catheter assembly has an operating head and catheter system that are inserted and navigated within a patient's body while an operator controls the system externally of the operating head. An operating head is positioned at or near a distal end of the catheter system and coupled to a drive shaft and drive system for rotation. A guidewire brake control system interrupt prevents the drive system from being actuated when the guidewire brake is in a released position, and a selectable guidewire brake interrupt override control permits an operator to translate and/or rotate the drive shaft and operating head while the guidewire is simultaneously moved. This allows withdrawal of the guide wire and the operating head from the target site while rotating the operating head.

Abstract: A new process of manufacturing a hybrid cannula may include creating a first part with at least two components, overmolding at least two components of a second part to a channel in each component of the first part, and fixing the components of the first part together. The second part may include various types of features such as thick/thin dams, squirt membranes, and/or duck bill dams inside the hybrid cannula. Each dam may have any number, shape, orientation, and length of slits/openings. The slits/openings may allow passage of an instrument while the dam(s) may prevent fluid from passing through the hybrid cannula. A third part may optionally be overmolded to at least a portion of the first part, at least a portion of the second part, or both. The third part may provide an extension, a flange, or a combination thereof at a distal end of the hybrid cannula.

Abstract: Systems and methods for non-serial, substantially simultaneous or simultaneous tissue sampling and placement of multiple markers/fiducials in a non-linear, distributed or three dimensional configuration. The systems and methods can be applicable to other forms and combinations of distributed/3 dimensional/spherical localization which may include a single procedure or combination of procedures that may include 3D biopsy, fiducial placement, brachytherapy seed placement, injection/infusion of bioactive materials (e.g., chemotherapy, small molecules, cellular materials, cells, caustic materials, proteolytics, embolic material, glue, etc.), thermally or electrically derived ablation.

Abstract: An external fixation system and method for realigning, compressing or distracting broken bones has a planar ring element with an adjustable device having a body releasably mounted on the ring element. The adjustable device includes a first member for movement in a direction generally perpendicular to the ring element. A second member is mounted on the first member for movement in a direction parallel to the first member and with respect to a circumference of the planar ring element. The method includes inserting a k-wire through a first piece of bone and affixing the k-wire to the ring element. Then inserting a second k-wire through a second piece of bone and affixing the k-wire to the adjustable device second member. The pieces of bone are realigned, compressed or distracted by adjusting at least one of a first and second adjustable members forming the device.

Abstract: Screw and rod systems include polyaxial and hinge joints which provide independent first and second ranges of motion. The first and second ranges of motion are additive in a direction along the rod, so that the screw has greater angulation relative to the rod along the rod than transverse to the rod.

Abstract: Thoracic/lumbar and cervical spinous process staples which staple/fuse adjacent spinous processes are disclosed. Thoracic/lumbar transverse process staples which staple/fuse adjacent transverse processes are also disclosed. Each embodiment has upper and lower claws connected by a ratchet spring mechanism, along with a multiplicity of bone fastener prongs attached to the upper and lower claws. Two sets of prongs on each staple claw are spaced by a distance approximately equal to the distance separating adjacent spinous or transverse processes so as to facilitate stapling/fusion of two adjacent processes. Also disclosed are staple prongs with multiple perforations which enable incorporation of bone fusion material thereby facilitating stapling/fusion of spinal elements.

Abstract: An interspinous device for arthrodesis, comprising a main body of distraction, inserted between two adjacent spinous processes to provide a relative support; a first and a second pair of lateral stabilizers; support means of each of the pairs of stabilizers slidable with respect to the main body; and a threaded shaft of actuation of the lateral stabilizers, percutaneously operable to determine a rotation and a subsequent translation of the stabilizers with respect to said main body, wherein the overall arrangement is such that each stabilizer is rotatably movable relative to the main body between a first closed configuration and a second open configuration, in which the stabilizers are open wide, and between the second open configuration and a third retaining configuration, in which the open-wide stabilizers of the first pair are longitudinally juxtaposed to respective open-wide stabilizers of the second pair so as to abut a spinous process.

Abstract: A spine immobilization tool that can control the movement of the spine with improved safety as a spine immobilization tool that includes a first covering portion, a second covering portion, and a joint portion. The first covering portion covers at least a part of a vertebral arch of a vertebra at a head-side among the adjacent vertebrae, and thus can be fixed to the vertebra. The second covering portion covers at least a part of a vertebral arch of a vertebra at a buttock side amongst the adjacent vertebrae, and thus can be fixed to the vertebra. The joint portion couples the first covering portion and the second covering portion together while allowing changing relative positions of the first covering portion and the second covering portion.

Abstract: A device for coaptation of bone parts or bone fragments, including an integral plate obtained by molding whereof one portion (1) is made from a first biocompatible polymer including at least one or, preferably, a plurality of areas or inserts (2) provided with a through hole (3), the areas or inserts being made from a second biocompatible polymer which is more malleable than the first polymer, the areas or inserts having mechanical properties allowing a self-tapping of the inner surface of the holes, via screws that can be used for securing the plate to bone tissue, the support portion and the areas or inserts having a partial molecular bond between them.

Abstract: A fastener, for example a bone screw, is sized to pass through a hole of an implant, for example a bone plate, the fastener having a shaft or anchor portion engageable with body tissue, and a head portion. A locking cap secures to the bone plate and covers the head to block the head and inhibit screw back out. Alternatively or additionally, a locking disc located in the plate hole resiliently deflects downward to allow screw insertion, but is blocked to limit or prevent upward deflection so that screw back out is inhibited.

Abstract: A bone plate system for fracture surgery is provided. The bone plate system includes a bone plate and a locking screw. The bone plate includes an upper surface, a lower surface facing a bone, and a locking hole in which an even-number-ridge internal thread is formed. The locking screw is coupled to the locking hole. The locking screw includes a head tapered so that a diameter thereof decreases along a center axis, a shank extending from the head, a double-ridge external thread formed on the head and configured to be tightened to the even-number-ridge internal thread, and an external thread formed on the shank and configured to be fastened to the bone.

Abstract: Embodiments of the invention provide a bone screw device including a bone screw with a temporary encasement. In some embodiments, the temporary encasement comprises a biocompatible material that may be an osteoinductive, a hemostatic and or a bacteriocide. Some embodiments include a temporary encasement including a therapeutic. In some embodiments, the temporary encasement comprises a wax. In some embodiments, the screw head is substantially U-shaped. In some embodiments, the screw includes an extension tip extending from the screw shaft. Some embodiments of the invention include a system for percutaneous implantation of a bone screw including a screwdriver shaft rotatably coupled to a screw that includes a temporary encasement. In some embodiments, the screw shaft can be at least partially rotated by the screwdriver shaft. Some further embodiments further include a retractable sleeve at least partially surrounding the screwdriver shaft and the bone screw.

Abstract: A system for implanting a bone screw into a vertebra of a vertebral column of a patient to help secure an implant within a joint between the vertebra and an adjacent vertebra may include a bone screw, a bone screw delivery mechanism detachably connected to the bone screw, and a guide tube. The guide tube may have a proximal end, a distal end, a lumen configured to receive the bone screw and the bone screw delivery mechanism, and at least one bend disposed nearer the distal end than the proximal end. The bend in the guide tube may change a trajectory of the bone screw and the bone screw delivery mechanism advancing through the lumen from a first trajectory along a longitudinal axis of the guide tube to a second trajectory that is angled relative to the longitudinal axis.

Abstract: A surgical impact tool comprises an electromagnetic impactor hermetically sealed within a sterilizable housing having one or more external mechanical coupling for transmitting an impact to an object external to the tool. The housing also contains an energy storage medium rechargeable through the hermetic seal, and electronic controls operable through the hermetic seal.

Abstract: A thermal surgical tool comprising a conductor having a ferromagnetic material attached thereto is provided. The conductor may include a support of sufficiently high Young's modulus to resist bending when the surgical tool is being used to treat tissue. One or more intervening layers may be disposed between the support and the ferromagnetic material. Each of the intervening layers may be selected for a property that facilitates construction of the surgical tool and/or enhances a functionality of the surgical tool. The thermal surgical tool can be used for separating tissue, coagulation, tissue destruction or achieving other desired tissue effects in numerous surgical procedures.

Abstract: An electrosurgical generator arranged to supply radio frequency (RF) energy to fuse tissue is provided. The generator is arranged to supply RF energy through a removably coupled electrosurgical instrument to fuse tissue grasped by the instrument. The generator monitors a phase angle of the supplied RF energy and adjusts or terminates the supplied RF energy based on the monitored phase angle in comparison to predetermined thresholds and conditions to optimally fuse the tissue. The electrosurgical instrument conducts radio frequency energy to fuse tissue captured between the jaws and a blade to mechanically cut tissue between the jaws. A conductive post positioned on the jaw adjacent to the blade.

Abstract: Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

Abstract: An electrosurgical pencil adapted to receive an electrode controllable by an electrical signal for performing surgical operations. This pencil includes a housing, a circuit, and switch that is activatable from outside the housing for closing the circuit. The housing receives the electrode. The circuit is a flexible circuit and is positioned such that it is in direct contact with the electrode when the electrode is received in the housing.

Abstract: Methods, apparatuses and systems are described for preventing the over-tightening of a furled ablation structure support around an expandable member. An ablation device for treatment of tissue in body lumens with varying sizes is disclosed. The ablation device may include a catheter, an expansion member coupled with a distal portion of the catheter, and an ablation structure support configured to at least partially unfurl or furl around the expansion member as the expansion member expands or contracts. The ablation device may further include a spacer coupled with the catheter and configured to limit a minimum diameter of the ablation structure support when the expansion member is completely contracted.

Abstract: Aspects of this disclosure pertain to a device with an elongated body having a distal end. The distal end may comprise a port that permits discharge of a laser energy towards a tissue from an optical fiber located in the distal end. An exterior surface of the distal end may include a cauterization portion that permits discharge of a cauterization energy towards the tissue. In some aspects, the device includes an insulative portion that attaches the distal end to the elongated body and limits energy transfer therebetween. Related systems and methods are also disclosed.

Abstract: The present disclosure relates to a system and method for providing laser energy through a catheter towards a second end portion of the catheter. Based on a characteristic of the laser energy multiple types of ablation therapy may be implemented. A first ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a first characteristic. A second ablation therapy is directed at the target site when the laser energy at the second end portion of the laser energy delivery system has a second characteristic. The first ablation therapy may be an optical ablation therapy wherein the laser energy is directed at the target site as optical energy and the second ablation therapy may be a pressure wave ablation therapy wherein pressure waves are directed at the target site as pressure wave energy.

Abstract: A medical manipulator including: an elongated main body that is to be inserted into a body; an arm that is provided so as to be protruded forward from a distal end surface of the main body; and an observation part that is located on the distal end surface of the main body and that has an objective optical system for collecting light coming from a front direction, in which the arm and the observation part are relatively movably provided such that the objective optical system is located at a position equivalent to the position of a distal end of the arm or at a position anterior to the distal end of the arm and is located at a position posterior to the distal end of the arm.

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 method for planning ablation treatment using ultrasound data begins by identify pathology to be treated and one or more blood vessels proximate the treatment site in a medical diagnostic image. Ultrasonic Doppler velocity data is acquired from the flow within the vessels and the Doppler data is used to calculate the volume blood flow through the vessels. The thermal effect of the heat transported by this blood flow is considered in the planning of the ablation treatment.

Abstract: A number of orthopedic surgical instruments are also disclosed. A method, apparatus, and system for fabricating such instruments are also disclosed.

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: A radiographic system may be configured to capture a first radiograph containing a first image of an object with the source and the receiver in a first orientation with respect to one another. The system may store the first radiograph and metadata representing vertical and horizontal positions of the first orientation. At least one of the source and the receiver may be moved so that the source and the receiver are in a second orientation with respect to one another. A second radiograph containing a second image of the object may be captured with the source and the receiver in the second orientation. The second radiograph may be stored in memory along with metadata representing vertical and horizontal positions of the second orientation. Based on the captured radiographs, a magnification of the object of interest, as represented by the first image or the second image, may be determined.

Abstract: A computer-assisted surgery (CAS) navigation assembly comprises a micro-electromechanical sensor (MEMS) navigation unit having one or more MEMS to provide at least orientation data. A support receives the MEMS navigation unit therein, the support being adapted to be mounted on the instrument in a fixed orientation relative to established navigated features of the instrument. At least two mating ball-in-socket features are disposed between the MEMS navigation unit and the support at opposed ends thereof for releasably engaging the MEMS navigation unit in precise orientational alignment within the receptacle, the at least two mating ball-in-socket features comprising catches aligned along an axis extending between the opposed ends, at least one of the catches being a biased catch. A method of connecting a MEMS navigation unit with a mating support fixed to a CAS instrument navigated by the CAS system is also provided.

Abstract: Various exemplary methods, systems, and devices for initializing a surgical tool are provided. In general, a surgical tool can include an end effector, an elongate shaft, and a wrist that couples the end effector to a distal end of the shaft. The wrist can be configured to facilitate movement of the end effector relative to the shaft. The surgical tool can include multiple flexible members configured to move, either individually or as a group including any plural number of the flexible members, to cause the movement of the end effector relative to the shaft by pivoting at the wrist. The movement of the end effector can include movement between an unarticulated position and an articulated position. The surgical tool can also include one or more homing members configured to be selectively actuated to force the end effector into the unarticulated position.

Abstract: Various exemplary surgical tool and robotic surgical system interfaces are provided. In general, a sterile barrier can be positioned between a robotic surgical system and a surgical tool releasably coupled to the robotic surgical system. The surgical tool can be in a sterile environment on one side of the sterile barrier, and the robotic surgical system can be in a non-sterile environment on the other, opposite side of the sterile barrier. The robotic surgical system can be configured to control movement of the surgical tool releasably coupled thereto using a magnetic field that extends across the sterile barrier between the surgical tool and the robotic surgical system.

Abstract: The invention concerns a module for guiding an elongate medical part along an elongation axis for a robotic system comprising: mobile apparatus mounted so as to rotate relative to a base about a rotational axis, and defining a space for receiving the elongate medical part, and comprising a rotational guiding system comprising a passage region for the elongate medical part corresponding to the location of the passage of the elongate medical part through the mobile apparatus, and a plurality of rotary guiding portions distributed about the rotational axis, and access aperture comprising an angular aperture of at least 30°.

Abstract: Methods, apparatus, and systems for controlling a telesurgical system are disclosed. In accordance with a method, a first tool connected to a first manipulator of the system, and a second tool connected to a second manipulator of the system, are controlled. A swap of the tools such that the first tool is connected to the second manipulator and the second tool is connected to the first manipulator is then detected. The first tool connected to the second manipulator and the second tool connected to the first manipulator are then controlled.

Abstract: A control unit for a medical device is provided. The control unit includes a palm interface engageable by a palm of a hand, a restraint capable of elastically deforming to apply a restraining force to the dorsum of the hand and a finger interface engageable by one or more fingers of said hand.

Abstract: A drape, such as but not limited to, a drape that can be used to cover a C arm of a medical device is provided. The drape includes material, at least one cuff and at least one adhesive strip. The material has a select property and has a select shape. The at least one cuff is formed along at least one edge of the material. The at least one cuff is configured to allow manipulation of the drape by a user. The at least one adhesive strip is configured to selectively adhere the drape to a surface to be covered by the drape.

Abstract: Various exemplary surgical tool and robotic surgical system interfaces are provided. In general, a sterile barrier can be positioned between a robotic surgical system and a surgical tool releasably coupled to the robotic surgical system. The surgical tool can be in a sterile environment on one side of the sterile barrier, and the robotic surgical system can be in a non-sterile environment on the other, opposite side of the sterile barrier. The robotic surgical system can be configured to control movement of the surgical tool releasably coupled thereto using a magnetic field that extends across the sterile barrier between the surgical tool and the robotic surgical system.

Abstract: In one embodiment, a device for measuring a length of a bone tunnel is provided. The device includes: a gauge comprising an annular shaft coupled to a handle, the handle including a constrained channel configured for receiving a passing pin from the annular shaft and displaying the passing pin in relation to a scale. In another embodiment, a method for measuring length of the bone tunnel is provided. A method and another device are provided.

Abstract: The present invention provides a pivotable optical assembly for a surgical microscope, specifically a zero-degree assistant's device, the assembly comprising: a microscope body interface for mounting the assembly on a microscope body; an assistant's module including an interface for an assistant's tube, the assistant's module being pivotable about a pivot axis relative to the microscope body; and a retaining system that blocks pivoting the assistant's module about the pivot axis. The retaining system comprises: a retaining element being moveable from a locking position into a release position, a biasing member forcing the retaining element into the locking position, and a hand-operable control element acting on the retaining element for moving it from the locking position into the release position, as well as a pivotable optical assembly comprising said retaining system according to the invention, whose retaining element, in its blocking position, blocks pivoting the assistant's module about the pivot axis.

Abstract: The invention relates to a flexible application aid for the treatment of wounds. The application aid can be used in particular for the debridement and/or cleansing of wounds, including the skin surrounding the wound. The application aid according to the invention including a flexible or elastically deformable application wand, facilitates debridement of superficial to deep wounds without the risk of injury to the wound.

Abstract: In a method for printing an RFID tag on an object, a deposition mask is applied to the surface of an object. With the deposition mask on the surface of the object, RFID materials are deposited on at least one portion of the surface exposed by aperture(s) in the deposition mask. In particular embodiments, RFID tags can be deposited on medical instruments.

Abstract: A NiTi alloy root canal file with a flexibility gradient, having a tip, middle portion and rear portion divided along the longitudinal direction. The internal microstructure of the tip is martensite, of the rear portion is austenite, and of the middle portion is a combination of martensite and austenite. The microstructure of martensite is continuously reduced and the microstructure of austenite is continuously increased as the distance from the tip increases. A manufacturing method for the NiTi alloy root canal file with a flexibility gradient. As the internal microstructure of the NiTi alloy root canal file with a flexibility gradient gradually changes along the axial direction and the strength also gradually changes, the flexibility and strength show a gradient change along the axial direction of the root canal file, providing excellent cutting property, high anti-fatigue life and significantly improving operation performance, safety, and life of the root canal files.

Abstract: An orthodontic apparatus for installation in a patient's mouth is disclosed. The orthodontic apparatus includes a first extension wire, a second extension wire, and a palatal archwire. Each of the first and second extension wires includes a proximal portion and a distal portion. The proximal and distal portions and the palatal archwire are manipulatable to apply corrective buccal, labial, and transverse forces on the patient's dento-alveolar complex (DAC), to correct the shape of the patient's palate.