Abstract: A biopsy device includes a first cannula disposed co-axially with a second cannula. A ratchet drive mechanism is operatively coupled to the first cannula and the second cannula. The ratchet drive mechanism includes a first gear, a second gear and a torsion spring. The first gear is fixedly attached to the first cannula. The second gear is fixedly attached to the second cannula. A second side surface of the second gear is oriented to face a first side surface of the first gear. The torsion spring is interposed between the first gear and the second gear. The torsion spring has a first end portion inserted into a hole of the first gear and has a second end portion inserted into a hole of the second gear. The torsion spring stores energy which when released drivably rotates one of the first gear and the second gear relative to the other.

Abstract: A sealant is provided for sealing a puncture through tissue that includes an elongate first section including a proximal end, a distal end, and a cross-section sized for delivery into a puncture through tissue, and a second section fused to and extending from the distal end of the first section. The first section may be formed from a freeze-dried hydrogel that expands when exposed to physiological fluid within a puncture. The second section may be formed from a solid mass of non-freeze-dried, non-crosslinked hydrogel precursors, the precursors remaining in an unreactive state until exposed to an aqueous physiological, whereupon the precursors undergo in-situ crosslinking with one another to provide an adhesive layer bonded to the first section. Apparatus and methods for delivering the sealant into a puncture through tissue are also provided.

Abstract: A vessel access and closure assist system is used for accessing a vessel to perform a vascular intervention. The system facilitates the delivery of a vessel closure device onto a blood vessel for closing an opening in the wall of the blood vessel. The vessel access and closure assist system includes a procedural introducer sheath that directly couples to a vessel closure device delivery sheath such that the procedural introducer sheath does not have to be exchanged with the vessel closure device delivery sheath.

Abstract: Methods and apparatuses are disclosed for closing a patent foramen ovale. Some of the disclosed apparatuses include an elongate body having a proximal end and a distal end, with first and second suture clasp arms adapted to hold end portions of a suture when in an extended position. A first suture catch mechanism is slidably housed in the elongate body and moves in a proximal-to-distal direction to engage the suture end held by the first suture clasp arm, and a second suture catch mechanism is slidably housed in the elongate body and moves in a distal-to-proximal direction to suture end held by the second suture clasp arm. The first suture clasp arm can be positioned around the septum primum to deliver a suture thereto, and the second suture clasp arm can be positioned around the septum secundum to deliver a suture thereto.

Abstract: A device and a method for sealing an opening in the wall of a blood vessel is provided. The device includes an automatic mechanism, a shaft fixedly connected to the automatic mechanism, a seal assembly attached to the distal end of the shaft, and a pushing rod also engaging the seal assembly, the automatic mechanism moving the pushing rod from a first position to a second position in response to the shaft being pulled distally a predetermined distance.

Abstract: Disclosed are puncture sealing systems and methods of locating a puncture site within a vessel. The systems can include puncture locating dilators and access sheaths that are configured to locate the puncture site within a vessel so that the position of the puncture site relative to a distal end of the access sheath is known during a puncture sealing procedure.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: The present disclosure includes a soft material anchoring system including an elongate, tubular braided soft anchoring implant. The implant has a first elongate state where the implant may easily slide within a bone tunnel, and a second axially compressed state where the implant is wedged within the bone tunnel. The implant also includes at least one suture pathway that extends along and through an implant side wall; this pathway receives at least a portion of a length of suture that is also attached to soft tissue. This length of suture may slide along the suture pathway and transition the implant from the first elongate state to the second compressed state. The system also includes a binding element that at least partially extends within the implant, the binding element having both a first larger binding portion and a second smaller sliding portion.

Abstract: In various examples, a suture anchor includes a sheath including a lumen. A frame member is disposed at least partially within the sheath. The frame member includes at least two suture loops extending from the sheath. The suture loops are configured to receive a suture, wherein tightening of the suture causes compression of the frame member to constrict the lumen of the sheath.

Abstract: Devices and methods are provided for forming a hole in bone and implanting a suture anchor in the bone hole. The devices and methods disclosed herein allow a suture coupled to tissue to be passed through a shaft that is also configured to receive a drill bit. Exemplary guide devices are provided having a shaft with a cross-sectional shape that allows the suture to be seated in a secondary region that is offset from a primary region that receives the drill bit therethrough. A drill bit can be passed through the shaft without causing any damage to the suture extending through the shaft, and subsequently an anchor can be advanced along the suture through the shaft and guided into the bone hole.

Abstract: A suture anchor comprises a tubular body having an axial bore therethrough and having one or more purchase enhancements on an exterior surface of the body adapted to enhance purchase of the body within a bone hole, such as threads. A lateral port passes through the body from the bore to the exterior surface and is formed of a slot entering the body from its proximal end. A length of suture for attaching soft tissue to bone passes down along the exterior surface over the one or more purchase enhancements, over a distal end of the body, up into the bore through and then back out of the bore and up along the exterior surface over the one or more purchase enhancements.

Abstract: Suture passer systems for tissue suspension and tissue compression, and more particularly for tongue suspension, are described. The system can include at least a first elongate tubular body or shaft, a needle having a lateral bias carried by the elongate body, and a retrieval element operably connected to the elongate tubular body. The needle can have a substantially straight configuration when located within the elongate tubular body, and be configured to exit an opening at or near a distal end of the elongate tubular body and assume a laterally biased or curved shape to form a path through tissue. The needle is configured to carry a suture. The retrieval element can be configured to retrieve the suture carried by the needle after the needle has formed a curved or otherwise angled path through tissue. The system can also include one or more bone anchors to secure the suture loops. Methods of placing one or more suture loops into tissue, such as the base of the tongue, are also described.

Abstract: The present invention relates to micro-sewing devices, specifically a micro-sewing device for percutaneous, endoscopic, laparoscopic and minimally invasive surgical procedures for suturing in small areas. The device allows for sewing-off and stitching in either direction, in very tight spaces.

Abstract: The needle holder includes a primary hollow shaft, a secondary hollow shaft attached to the primary hollow shaft in a generally “T” configuration, a pair of extendible jaws rotatably positioned at a distal end of the primary shaft, a trigger mechanism mounted on the primary shaft for selectively extending the jaws, a first rotation member in the primary shaft, a second rotation member in the secondary shaft, a driven gear attached to the first rotation member, and a drive gear attached to the second rotation member and configured to selectively engage the first gear. The jaws are selectively extendible and rotatable.

Abstract: A surgical instrument includes a shaft assembly, a handle assembly, and a latch system configured to operatively couple the shaft and handle assemblies. The latch system includes shaft and a handle lock members respectively connected to the shaft and handle assemblies for inhibiting operative uncoupling of the shaft and handle assemblies. The latch member has a cam surface and a latch member. The latch member is configured to selectively move from a locked position to a released position such that movement of the latch member causes the shaft and handle lock members to disengage and uncouple the shaft and handle assemblies. The latch member is further configured to selectively move from the released position to a removal position such that further movement of the latch member causes the cam surface of the latch member to engage the cam base and urge the shaft assembly in a removal direction.

Abstract: A surgical stapling instrument includes a handle assembly, an elongate shaft extending distally from the handle assembly, and a tool assembly coupled to a distal end of the elongate shaft. The tool assembly includes a cartridge assembly including a plurality of surgical staples each including a code embedded portion and a first sensor for detecting the position of the surgical staples prior to and during a formation of the staples. The tool assembly further includes an anvil assembly including a second sensor that detects the position of the surgical staples after the formation of the surgical staples.

Abstract: A surgical stapling apparatus (stapler) is provided. The stapler includes a housing, elongated member, and a reload. A cartridge is configured to selectively couple to a first jaw member of the reload and includes one or more resilient members thereon. An anvil operably supported on a second jaw member of the reload is configured to compress one or more fasteners ejected from the cartridge. The anvil includes one or more locking members thereon. A knife is configured to translate through the cartridge and anvil when the first and second jaw members are in a closed configuration. Engagement between the knife and the resilient member(s) causes the resilient member(s) to move from an initial configuration that allows the knife to travel distally past the locking member(s) to a final configuration that allows the locking member(s) to engage the knife.

Abstract: A combination comprises a handle module that is attachable to a detachable shaft module for collectively performing a surgical procedure, a first removable, rechargeable battery pack connectable to the handle module for providing electric power to the handle module during a surgical procedure and a charging station for charging the first battery pack when the battery pack is removed from the handle module and inserted into the charging station. The charging station comprises means for rapidly charging the first battery pack when a rapid charge user input for the battery pack is received by the charging station.

Abstract: An anchor for maintaining a portion of a therapy delivery element within a desired location of a patient has (i) a first opening, (ii) a second opening, (iii) a body member formed of elastic material disposed between the first and second opening, (iv) and a lumen extending though the body member from the first opening to the second opening, and (v) a retention element secured to or integrally formed with the body member for retaining the anchor within a tissue location of a patient. The therapy delivery element has an outer diameter and an outer surface about which the anchor is disposable. The body member has a first inner diameter defined by the lumen in a relaxed state and a second inner diameter defined by the lumen in a radially stretched state. The first inner diameter is smaller than the outer diameter of the therapy delivery element, which is smaller that the second inner diameter. The lumen is configured to be disposed about at least a portion of the therapy delivery element.

Abstract: A surgical instrument comprising a surgical end effector that comprises a first jaw and a second jaw that is movably supported relative to the first jaw for selective movement between an open position and closed positions. The surgical instrument further comprises a closure member that is axially movable in response to closing and opening motions. The closure member comprises at least one opening cam that protrudes therefrom to movably engage a corresponding cam surface on the second jaw such that upon application of the opening motion, the at least one opening cam movably engages the corresponding cam surface to move the second jaw to an open position, even when the jaws are under a load.

Abstract: An end effector is disclosed. The end effector comprises a first jaw, a second jaw, and a staple cartridge assembly. At least one of the first jaw and the second iaw is movable to compress tissue between the first jaw and the second jaw. The staple cartridge assembly comprises a staple cartridge, a plurality of staples, and a first layer. The staple cartridge includes a deck comprising a plurality of staple cavities. The first layer comprises a composite absorbable material including at least two distinct fibrous materials. The first layer is attached to the first jaw by an attachment system comprised of polyglycolic acid that wraps over the first layer in more than two places. The end effector further comprises a second layer comprising a composite absorbable material including at least two distinct fibrous materials. The second layer is attached to the second jaw in more than two places.

Abstract: An end effector includes a mounting portion that mounts to a surgical stapling apparatus, first and second jaw members extending distally from the mounting portion, a drive beam engagable with the first and second jaw members, and a threaded drive screw. The first jaw member includes a first tissue engaging surface and the second jaw member supports a fastener cartridge. The fastener cartridge includes a second tissue engaging surface that defines fastener retaining slots that support fasteners. The drive beam includes a retention foot formed of a first material. The retention foot defines a threaded bore that supports a threaded insert formed of a second material. The threaded drive screw is threadably engaged with the threaded insert and is rotatable to distally advance the drive beam along the threaded drive screw to fire and form the fasteners.

Abstract: The invention concerns delivering paired magnetic anastomosis devices to either side of tissues to be joined. The magnetic anastomosis devices are coupled to a guide element that facilitates delivery and manipulation of the devices when using minimally-invasive techniques such as endoscopy and laparoscopy. Elongated manipulators and guide tubes are also disclosed that improve a user's dexterity with the devices during placement.

Abstract: In an embolization device (1) with a main body (3) and with at least one thrombogenic fiber (2), which main body can be converted from an elongate primary shape to a secondary shape, the at least one thrombogenic fiber (2) is arranged in a configuration wound around the main body. In a method for producing an embolization coil of this kind, a primary coil (30) forming a main body (3) of the embolization coil (1) has at least one thrombogenic fiber (2) wound around it, and the primary coil (30) is converted in shape to a secondary coil.

Abstract: An atrial appendage occlusion apparatus including an inflatable body defining a compression region that is sized and shaped to receive an atrial appendage and a self-sealing valve associated with the inflatable body.

Abstract: An occlusion assembly comprising: (a) a tissue occlusion device comprising a first linear clamping portion and a second linear clamping portion, the first and second linear clamping portions oriented to overlap and be parallel to one another in a clamped position, the tissue occlusion device further including a spring concurrently coupled to and interposed by the first and second linear clamping portions to bias the first and second linear clamping portions toward the clamped position; and, (b) an endoscopic rein coupled to the tissue occlusion device and configured to facilitate repositioning of the tissue occlusion device toward an occlusion position where the first and second linear clamping portions are interposed by tissue, where the endoscopic rein includes a flexible wire coupled to the clamping device and configured to facilitate repositioning of the tissue occlusion device toward the occlusion position.

Abstract: A venous tourniquet having a constricting strap which can be placed around a body part, which strap is elastic in the direction of circumference or is provided with at least one elastic portion, and having a closing device by which the constricting strap can be locked into a tightening loop when the strap is positioned around a body part in the tightened state. One embodiment is advantageous if both structure and use is obtained by designing the closing device as a hook-and-loop fastener having two lockingly engaging closing parts.

Abstract: A blade coupling mechanism for a hand-held surgical cutting instrument includes a first coupling member including a first blade-contacting surface and a first outer perimeter sidewall adjacent the first blade contacting surface. It also includes a second coupling member including a second blade-contacting surface facing the first blade-contacting surface of the first coupling member. The second coupling member includes a second outer perimeter sidewall adjacent the second blade contacting surface. The second blade-contacting surface and the second outer perimeter sidewall meet to define an outer edge. The second coupling member including a bore through the second blade contacting surface. The bore and the second blade contacting surface meeting to define an inner edge. Blade-engaging protrusions project from at least one of the first and second blade-contacting surfaces. The protrusions are spaced closer to the outer edge than the inner edge.

Abstract: A cutting block comprises a body having a top surface for guiding a saw blade, and a top plate connected to the body. The top plate can move between a first position in which the top plate is spaced apart from the body and a second position in which the top surface of the top plate is an extension of the top surface of the body. The top plate has first and second resiliently deformable arms extending from it, spaced apart along the top plate, and the body has first and second recesses formed in it extending substantially perpendicularly to the top surface of the body. The first and second arms on the top plate are inserted in the recesses so that the arms and the recesses define the path for movement of the top plate relative to the body between the first and second position.

Abstract: A bone resection guide, which includes a profiling guide. The profiling guide includes a first planar bone contact surface, a first guide surface and at least one outline corresponding to at least a portion of a first implant.

Abstract: A cutting guide assembly comprises a mounting block having a guide surface into which may be mounted an articulated mounting arm. The mounting arm has a first post which is retained in the mounting block and a second post. A cutting tool attachment component is provided to attach the cutting tool to the cutting guide assembly. The cutting tool attachment component has a first surface against which the saw blade can be retained for oscillation around an axis of oscillation, and a shaft which cooperates with the second post such that the longitudinal axis of the shaft is collinear with the axis of oscillation of the saw blade. When the saw blade is retained against the first surface, the plane of oscillation is parallel to, and displaced from, the guide surface of the mounting block.

Abstract: A modular system for total knee arthroplasty includes a modular trial implant assembly. The modular implant assembly includes an elongate shaft configured for insertion into an elongate cavity in a bone, a reamer removably coupleable to the elongate shaft via a connection that allows the reamer to rotate while the elongate shaft remains in a substantially fixed angular orientation. The reamer has an outer surface that tapers toward the distal end configured to form a tapered cavity in an end of a bone in which the reamer is inserted and rotated. The modular trial implant assembly further includes a trial implant removably coupleable to a proximal end of the reamer. A modular final implant assembly includes an elongate stem, a tapered body and an implant body, each having a size and shape that can substantially correspond to a size and shape of the elongate shaft, the reamer and the trial implant, respectively.

Abstract: Instruments and methods for preparing an intervertebral space for receiving an implant. An adjustable trial implant has an adjustable stop mechanism having a stop member connected thereto to vary the distance that a body portion of the trial implant can move into the intervertebral space. Cutting tools for forming cutouts in the adjacent vertebrae use the trial implant and/or a guide to position a cutting tool which may be a burr or a chisel. The chisel cutting tool can be moveable relative to a selected trial implant or the chisel cutting tools can be fixed onto a trial implant shaped body portion.

Abstract: An ankle arthroplasty system may have a talar prosthesis and a tibial prosthesis, each of which has an articular surface and a bone engagement surface. Each bone engagement surface may have an anterior-posterior curvature and a medial-lateral curvature with a convex shape. A burr with a rotatable cutting element may be used to form a prepared surface on the talus or the tibia to receive the corresponding prosthesis. A cutting guide may be used to guide motion of the burr; the cutting guide may include a base and an arm movably coupled to the base. One of the base and the arm may have a guide surface, and the other may have a follower that slides along the guide surface to constrain motion of the burr such that the prepared surface has at least one concave curvature and one convex curvature.

Abstract: In one embodiment of the present invention, a method of applying ultrasonic energy to a treatment site within a patient's vasculature comprises positioning an ultrasound radiating member at a treatment site within a patient's vasculature. The method further comprises activating the ultrasound radiating member to produce pulses of ultrasonic energy at a cycle period T?1 second. The acoustic parameters such as peak power, pulse width, pulse repetition frequency and frequency or any combination of them can be varied non-linearly.

Abstract: A method of treating a thrombus is provided wherein a device is advanced to the vicinity of the thrombus, a thrombolytic agent is applied to the thrombus, and an expandable basket of the device is expanded to capture at least a portion of the thrombus within the expandable basket. The device includes a catheter having a distal portion, a lumen and a plurality of openings on the outer surface of the catheter, through which the thrombolytic agent is supplied. The device further includes a sheath and may include a collar which assists in expanding the expandable basket as the sheath is moved relative to the catheter.

Abstract: A stone extraction fragmentation device of the present invention include: a stone extraction operation section having a first main body and a gripping section; and a fragmentation operation section having a second main body, a moving body which is capable of being connected with the first main body, and a rotating knob which is configured to move the moving body with respect to the second main body, wherein the moving body is configured to move the first main body in a direction away from the second main body by rotation of the rotating knob.

Abstract: A surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the distal ends of the outer tube and the inner rod, the end effector comprising a collet for locking engagement with the distal end of the inner rod. The end effector may further comprise a second collet for locking engagement with the outer tube. The surgical device may further comprise a loader comprising a collet for locking the end effector in the loader.

Abstract: A coupling member for an ultrasonic instrument assembly has a tubular body with a first port at a first end and a second port at a second end opposite the first end. A lumen in the body member extends from the first end to the second end so that the first and the second port communicate with one another. The body member is made of a flexible resilient material such as silicone rubber and at least one reinforcement element is joined to the body member. The reinforcement element is configured so as to at least inhibit a collapse of the body member.

Abstract: Provided is a shock wave focusing device for a shock wave ablation system for coagulating and necrosing cardiac muscle tissue that becomes a cause of arrhythmia. A shock wave generation apparatus (10) comprises: a shock wave focusing device (11) which has a concave surface (11a); an optical fiber (12) which is inserted into the shock wave focusing device (11); a tubular catheter (13) which guides the optical fiber; an enclosure (14) which constitutes a space to be filled with liquid at the tip of the optical fiber (12); and the liquid (L) which is filled into the enclosure (14). The shock wave focusing device (11) is configured from a ring-shaped coupling part (16) provided with a central hole (11b), and 16 blade parts (17) curved outward from the edge of the coupling part (16) toward the front and provided elastically to the edge of the coupling part (16), and can be folded by rotating the blade parts (17) with respect to the coupling part (16).

Abstract: In accordance with an aspect of the present disclosure, the medical device includes a snare member having a proximal portion and a distal portion. The medical device also includes an operating member extending proximally of the snare member. The operating is enabled to extend and retract the snare member from a sheath. The snare member includes a transition portion extending between the proximal portion and the distal portion. The transition portion connects the proximal portion to the distal portion. The distal portion has a different cross-sectional area than the proximal section of the snare member.

Abstract: A balloon includes a plurality of radial projections formed in a working surface for use in providing a focused force during the angioplasty procedure. The plurality of radial projections may be formed in a wall of the balloon and spaced apart in a longitudinal direction. The projections for use in connection with such a balloon may comprise wires or wire segments, and may also comprise radiopaque materials to facilitate viewing under fluoroscopy during the procedure. Related methods of manufacturing are also disclosed.

Abstract: A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. A second dilator tube may be introduced over the first, advanced along a second longitudinal axis parallel to but offset from the first. A third dilator tube may be introduced over the second, advanced along a third longitudinal axis parallel to but offset from both the first and the second. An access cannula may be introduced over the third dilator tube. With the first, second, and third dilator tubes removed, surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

Abstract: Embodiments of the invention are directed towards a medical device, method and system thereof for the placement or passage of patches, sutures, anchors, tags, tissue sensors and more particularly to a medical device for repairing female pelvic organ or tissue prolapsed region. The device may be used for the placement of stereotactic markers into tissue near joints or tumors for guidance during orthopedic or neurosurgical procedures.

Abstract: A polyaxial bone anchor including a housing, a bone screw, and a retainer for pivotably coupling the head of the bone screw to the housing. The retainer is positioned into the bore of the housing and includes a plurality of alternating tabs and slots circumferentially arranged to define a cavity for receiving the head portion of the bone screw therein. The retainer is axially moveable in the housing from a first position in which the head portion is not passable through the lower opening of the retainer to a second position in which the head portion is passable through the lower opening of the retainer.

Abstract: A bone securement apparatus includes a bone plate configured and dimensioned to be applied across a joint of at least two bones or a space between at least two bone fragments. The bone plate includes first and second openings. A beaming member is configured to pass through the first opening, and the beaming member includes a third opening. A support member is configured to pass through the second opening and the third opening.

Abstract: This disclosure relates to a spinal implant that can provisionally retain a rod in an assembly head without having to first lock the rod relative to the assembly head. The spinal implant has a clip insert structured to retain the rod in the assembly head. The clip insert has a top portion with a cylindrical opening and extending over the cylindrical opening to cover the connection rod in part when the connection rod is engaged in the clip insert. The top portion is deformable by application of force on the connection rod to engage the connection rod with the clip insert. The clip insert and the assembly head are mechanically decoupled and can be fully received within the assembly head. The mechanical forces to which the assembly head is subjected are not transmitted to the clip insert.

Abstract: A polyaxial vertebral assembly that includes a polyaxial vertebral anchor and an articulating connector. The anchor is configured to penetrate and secure to a vertebra, and includes a spherical head end. The connector includes a base, an extension, and a common trajectory split lock. The split lock includes a first lock and a second lock. The first lock is configured to engage rigidly the base in a selected pivotal configuration to the head end along the second axis of the extension, wherein the head end is disposed in the base in the selected pivotal configuration with respect to the first axis of the base. The second lock is configured to engage rigidly a stabilizing rod at selected configurable height and rotational configuration with respect to the polyaxial vertebral anchor along the second axis, wherein the pivotal configuration and the height and rotational configuration are independently adjustable along the second axis.

Abstract: A receiving part for receiving a rod for coupling the rod to a bone anchoring element, the receiving part including: a receiving part body having a channel for receiving a rod and defining an accommodation space for accommodating a head of a bone anchoring element, the accommodation space having an opening for inserting the head; and a pressure element at least partially in the accommodation space, the pressure element including a first portion having a recess to receive the rod, and a second portion having a flexible portion to clamp the head, wherein the pressure element is moveable along a longitudinal axis of the receiving part body from an inserting position to insert the head, to a pre-locking position to clamp the head in the receiving part by a pre-stress exerted by the pressure element, to a locking position to lock the head in the receiving part.

Abstract: An implant having a receiver that is adapted to receive a polyaxial screw in the bore and either an internal or external cap. The cap can be an external or internal cap and the implant further has at least one locking aid in the form of at least one of a tactile feedback, a visual feedback or an enhanced fixation between the cap and a rod that is received in the receiver.