Abstract: A tissue collection device including a sheath member that has a first threaded portion on the inner surface of the sheath member and a puncture tube positionable in the interior of the sheath member. The puncture tube is axially movable in distal and proximal directions relative to the sheath member. The puncture tube has a second threaded portion on the outer surface of the puncture tube that threadedly engages with the first threaded portion when the puncture tube is within the interior of the sheath member. At least one of the distal end of the sheath member and the distal end of the puncture tube includes a blade to incise tissue from a living body.

Abstract: Apparatus, comprising: a sheath (22), advanceable through an endoscope (10), and having distal openings comprising a first opening (30a) and a plurality of second openings (30b) surrounding the first opening; a housing (24), coupled to a proximal portion of the sheath; a first needle (28a), extending through the housing and sheath toward the first opening; a plurality of second needles (28b), extending through the housing and sheath toward a respective second opening; a first handle (26a), slidably coupled to the housing along an axis such that the first needle slides through the sheath and a distal tip of the first needle moves with respect to the first opening; and a second handle (26b), slidably coupled to the housing along a different axis such that the second needles slide through the sheath and a distal tip of each second needle moves with respect to its respective second opening.

Abstract: An endoscopic treatment tool includes a sheath; a treatment portion capable of protruding and retracting from a distal end of the sheath; a manipulation main body; a slider which advances and retracts in a longitudinal axis direction to cause the treatment portion to protrude and retract from the sheath; a first locking mechanism which locks the slider at a position at which the distal end of the treatment portion is accommodated in the sheath in accordance with a retracting manipulation of the slider; a second locking mechanism provided at further distal side than the first locking mechanism and restricts advance of the slider by being locked to the manipulation main body; a fixing mechanism provided in the second locking mechanism and fixed to the manipulation main body by sliding; and a restricting portion which restricts fixing of the fixing mechanism to the manipulation main body.

Abstract: A hydrodissector for hydrodissecting a vein, the hydrodissector comprising a handle, a shaft extending from the handle at an angle and including a tip at a distal end thereof, at least one port configured to be coupled to a fluid supply for supplying fluid at a substantially constant pressure, and provided at the distal end of the shaft, and an image capturing assembly configured to provide direct visualization of the vein during hydrodissection. A minimally invasive method for dissecting a greater saphenous vein (GSV) from surrounding tissues using the hydrodissector is also described.

Abstract: The disclosed technology provides a device for sealing an aperture in a tissue of a body lumen. The device comprises a flexible support member having a base having (i) a central portion and (ii) one or more lateral support portions, to engage and/or hold a sealable member of the device against an interior surface of the tissue when the device is in the sealing position. The lateral support portions provide additional support surfaces to engage peripheral portions of the sealable member against the interior surface of the tissue. A cage or shoe engaged with the support member on the exterior surface of the tissue can provide additional support and assist sealing the aperture.

Abstract: A left atrial appendage occluder, including a closure disc and a bracket connected to the closure disc; the closure disc includes a frame; the frame includes a proximal-end disc face and a distal-end disc face; the proximal-end disc face includes flexible proximal-end support rods arranged radially; the distal-end disc face includes flexible distal-end support rods arranged radially; the floating end of each of the flexible proximal-end support rods is connected to the floating end of the adjacent flexible distal-end support rod The flexible proximal-end support rod at the point of largest diameter of the closure disc is arranged independent of the distal-end support rod; thus the degree of freedom of deformation at the point of largest diameter of the closure disc is increased, ensuring that the outer edge of the closure disc may adapt to fit the openings of various irregular left atrial appendages.

Abstract: A surgical delivery instrument for delivering a vascular hole closure device having a hole covering member. The delivery instrument comprises a housing, a plunger and an advancer movable within the housing, the advancer having a first portion and a distal portion hingedly connected to the first portion and forming a casing for supporting the hole covering member. Distal movement of the advancer pivots the casing from an angled position to a more linear position to change the orientation of the covering member from a transverse position to a more aligned position. The plunger is advanceable to advance the covering member into the vessel.

Abstract: A laparoscopic tool sheath for covering a body of a laparoscope, the cover includes an elongated body, having a rubber base; and a highly absorbable top coating; a central passageway extending from a distal end of the elongated body to a proximal end of the elongated body; a distal lens integral to the distal end of the elongated body; the cover is able to quickly and easily be removed from the laparoscopic tool for disposal.

Abstract: A tissue collector includes: an elongated sheath; a bag; a wire bending portion; and an extending portion which is arranged at the distal end portion of the sheath so as to protrude forward from the distal end portion along the longitudinal axis and enter an inside of the bag. The extending portion intersects with the opening surface that is defined by an opening end of the opening portion. The extending portion is configured to be capable of extending inside the bag from an opening surface toward the bottom portion.

Abstract: A surgical retractor assembly is provided having a frame that releasably couples two retractor blades. The retractor blades are coupled to the frame via a pair of mobile carriages that engage a track on the frame. A third retractor blade is configured to be independent of the frame with the first two retractor blades. The independent blade may be fixably positionable in the patient by a direct coupling to a rigid table mount. The retractor assembly may be utilized for creating anterior access to spinal target site while the patient is oriented in the lateral decubitus position.

Abstract: A spinal implant comprises an implant body extending between an anterior surface and a posterior surface, and including a first vertebral engaging surface and a second vertebral engaging surface. The implant body includes an inner surface that defines at least a first cavity and a second cavity. The cavities are oriented to implant fasteners in alignment with an oblique surgical pathway relative to a bilateral axis of a subject body and adjacent an anterior portion of an intervertebral space of the subject body. Systems and methods are disclosed.

Abstract: Method of using a shape-formable apparatus comprising fibrous material. A shape-formable apparatus can include an envelope defining a chamber, a port positioned to fluidly couple the chamber with ambience, and a fibrous material positioned in the chamber. The fibrous material can be substantially less formable when the apparatus is in the second state than when the apparatus is in the first state. The method can include providing the shape-formable apparatus in a first state; forming the apparatus into a desired shape; and reducing the pressure in the chamber to change the apparatus from the first state to a second state in which the apparatus is substantially less formable than in the first state.

Abstract: Circular stapling instruments and anvil assemblies. The anvil assemblies may have collapsible anvil support members that may be inserted through an opening in a patient and then expanded to be attached to an anvil plate assembly that has a staple-forming surface thereon. The anvil support member is attachable to the anvil plate assembly in such a way that when the anvil assembly is coupled to the stapling head of a circular stapler, the staple-forming surface is in substantial registry with the staples supported in the stapling head. A variety of different anvil support members and anvil plate assemblies are disclosed.

Abstract: An exemplary suture anchor system includes a first suture anchor having a central axis, a distal end portion, a proximal end portion, and an internal passage extending along the central axis between the distal end portion and the proximal end portion. The resilient member is at least partially external to the internal passage, and a flexible strand is connected to the resilient member. An exemplary method includes fixating a spring loaded first suture anchor in a first bone, passing a flexible strand from the spring loaded first suture anchor to a second suture anchor, and fixating the second suture anchor in a second bone.

Abstract: Tissue fasteners carried on a tissue piercing deployment wire fasten tissue layers of a mammalian body together. The fasteners include a first member, a second member, and a connecting member extending between the first and second members. The first and second members are substantially parallel to each other. The fasteners may be deployed in limited spaces and in various applications including the restoration of a gastroesophageal flap valve.

Abstract: A suture anchor assembly includes a suture anchor and a suture anchor inserter. The anchor includes a flexible distal tip and a rigid proximal anchor body. The distal tip includes a transverse suture eyelet and a cavity formed in a proximal end of the tip. The anchor body includes a lumen extending between proximal and distal ends of the body. The anchor inserter includes a tubular outer shaft and an inner inserter slidably received therein. The anchor assembly is actuatable to move the anchor tip and inner shaft proximally while the outer shaft and anchor body remain in place, urging the proximal end of the anchor tip against the distal end of the anchor body. The proximal end of the tip is deformable to accommodate at least a portion of the distal end of the anchor body within the anchor tip cavity.

Abstract: A suturing device include a handle, an elongate body, an actuator, and a needle holder. The elongate body connects with the handle. The actuator interacts with the elongate body and is operable between a first operating position and a second operating position. The actuator includes a manually operated member including an operator contact surface. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder includes a distal end section having a distal-most tip and defining a needle passage and a distal opening adjacent the distal-most tip. The needle passage is configured to receive at least a portion of an associated needle when the actuator is in the first operating position. The needle holder and the elongate body are rotatable with respect to the handle about a rotational axis.

Abstract: A suturing device includes an elongate body, a needle holder, an actuator, a needle and a needle retainer. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder includes a distal end section having a distal-most tip, and defines a needle passage and a distal opening adjacent the distal-most tip. The actuator is operable between a first operating position and a second operating position. Movement of the actuator from the first operating position toward the second operating position moves the needle in an advance direction. The needle is in the needle passage. The needle retainer engages the needle holder and the needle when the actuator is in the first operating position and inhibits movement of the needle toward distal opening while the actuator is in the first operating position.

Abstract: Apparatus for attaching a first object to a second object, said apparatus comprising: a distal anchor comprising a generally cylindrical body, a distal end and a proximal end, wherein said distal end comprises an inclined distal end surface, and a vertical bore extending through said generally cylindrical body, perpendicular to the longitudinal axis of said generally cylindrical body; a proximal anchor comprising a generally cylindrical body, a distal end and a proximal end, a top surface and a bottom surface, a first vertical bore extending through said generally cylindrical body from said top surface to said bottom surface, perpendicular to the longitudinal axis of the generally cylindrical body, a second vertical bore spaced distally from said first vertical bore and extending from said top surface to said bottom surface parallel to said first vertical bore, a third vertical bore spaced distally from said second vertical bore and extending from said top surface to said bottom surface parallel to said first

Abstract: The first fixing member and the second fixing member are arranged such that the first clamping surface and the second clamping surface face each other in an axis line direction of the insertion portion. When the manipulation portion is manipulated and the insertion portion and manipulation member is rotated relatively, the first clamping surface and the second clamping surface are configured to approach by screw-fitting with the second fixing member and the first fixing member. When a predetermined manipulation is performed to the manipulation portion, a coupling between the manipulation member and the other is configured to be released.

Abstract: A suturing device includes a needle, a suture, an elongate body, an actuator and a needle holder. The suture connects with the needle. The needle holder extends away from a distal end portion or is provided as part of the distal end portion of the elongate body. The needle holder includes a distal end section having a distal-most tip, and defines a needle passage for holding the needle and a distal opening. At least a portion of the suture extends through the distal opening when the needle is received in the needle passage and the actuator is in a first operating position. At least a portion of the suture extends along the needle passage toward the distal opening between the needle and an inner surface of the needle holder when the needle is received in the needle passage and the actuator is in the first operating position.

Abstract: A fixation device delivery system is described. The system includes a driver and a cooperating fixation element featuring a barb which becomes active upon deployment in the inner abdominal wall.

Abstract: A surgical instrument for applying tacks to tissue includes a handle assembly, an elongated portion, an outer tube, an end effector, a rotation assembly, and a rotation-limiting structure. The rotation assembly is configured to rotate at least a portion of the outer tube about a first longitudinal axis and with respect to the handle assembly. The rotation assembly includes a rotation knob rotationally fixed to a proximal portion of the outer tube. The rotation-limiting structure is disposed in mechanical cooperation with at least one of the rotation assembly and the handle assembly, and is configured to limit an amount of rotation of the outer tube with respect to the handle assembly.

Abstract: A surgical device comprising an instrument shaft having a proximal end and a distal end, a control handle connected to the proximal end of the instrument shaft, a surgical end effector connected to the distal end of the instrument shaft at a joint, wherein the surgical end effector is configured to articulate, at the joint and with respect to the instrument shaft, about an articulation axis, and wherein the surgical end effector had a pull-to-release articulation lock configured to retain the joint in a fixed position and the control handle has an articulation lock actuator that is configured to, when actuated, release the articulation lock.

Abstract: The present disclosure relates to medical devices, and methods for producing and using the devices. In embodiments, the medical device may be a buttress including an elongate rectangular body having a proximal portion, a distal portion, and opposing lateral sides running along the elongate rectangular body from the proximal portion to the distal portion. The substrate possesses a therapeutic layer of a therapeutic agent along at least one of its lateral sides. Methods and systems for producing such devices are also provided.

Abstract: A surgical fastener for use with an anastomosis of two tissues includes a base leg and an upright leg. The base leg is selectively deformable and includes a traumatic tip for piecing tissue. The surgical fastener also includes at least one capillary disposed on the base leg which has a reservoir defined therein for retaining a liquid, e.g., bioadhesive, bonding agent, medicament, etc. Each of the capillaries is ruptureable upon deformation of the surgical fastener to dispense the liquid to the anastomosis site.

Abstract: The present disclosure relates to adapter assemblies for use with and to electrically and mechanically interconnect electromechanical surgical devices and surgical loading units, and to surgical systems including hand held electromechanical surgical devices and adapter assemblies for connecting surgical loading units to the hand held electromechanical surgical devices.

Abstract: End effectors with redundant closing mechanisms, and related tools and methods are disclosed. The disclosed end effectors may be particularly beneficial when used for minimally invasive surgery. An example surgical tool comprises an elongate shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a jaw movable relative to the tool body between a clamped configuration and an open configuration, a first actuation mechanism coupled with the jaw and operable to vary the position of the jaw relative to the tool body between the clamped configuration and the open configuration, and a second actuation mechanism coupled with the jaw. The second actuation mechanism has a first configuration where the jaw is held in the clamped configuration and a second configuration where the position of the jaw relative to the tool body is unconstrained by the second actuation mechanism.

Abstract: An end effector for use with a surgical apparatus. The end effector comprising a staple cartridge having a tissue contacting surface defining a central longitudinal slot and an anvil plate having a tissue contacting surface defining a central longitudinal slot. A surgical buttress releasably disposed on the tissue contacting surfaces of each of the staple cartridge and anvil plate. An adhesive tape is disposed over the central longitudinal slot of each of the staple cartridge and anvil plate and configured retain the respective surgical buttress atop the respective tissue contacting surface.

Abstract: A device for closing a tissue opening includes a proximal housing portion having a first portion, a second portion, a third portion, and a fourth portion. The first portion and the fourth portion extending transversely to a longitudinal axis of the proximal housing portion on opposite sides of the proximal housing portion. A distal portion extends from the proximal housing portion. At least the second portion and the third portion are configured to move toward the first portion.

Abstract: An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.

Abstract: Mechanical delivery system for neurovascular embolization apparatus and method of use. A mechanical system for delivery of implants, such as coils for endovascular embolization of intracranial aneurysms and other neurovascular abnormalities such as arteriovenous malformations and ateriovenous fistulae, may include a detachment system for the release of a coil that deforms a detent to release (or eject) the implant.

Abstract: The present application relates to surgical clip appliers having a plurality of clips for applying the clips to body tissues and vessels during surgical procedures and their methods of use and specifically to a reusable counter mechanism for use with a surgical clip applier. The surgical clip applier includes a housing, at least one handle pivotably connected to the housing, a channel assembly extending distally from the housing, a plurality of clips loaded in the channel assembly, a drive channel translatably supported in the housing and the channel assembly and being translatable upon actuation of the at least one handle, and a reusable counter mechanism removably insertable into a counter slot extending into the housing and engagable with the drive channel. The counter mechanism is configured display indicia corresponding to a quantity of clips and to update the indicia upon translation of the drive channel.

Abstract: This disclosure provides design, material, manufacturing method, and use alternatives for medical devices. An example medical device may include a medical device for delivery of a surgical closure member. The medical device includes an elongate tubular member having a proximal end, a distal end and a lumen extending therein. The elongate tubular member is adapted to be delivered through the working channel of an endoscope and the lumen is adapted to receive a surgical closure member. The medical device also includes a tissue support extending from the distal end of the elongate tubular member. The tissue support includes a support surface and the support surface is adapted to support tissue as a surgical closure member engages the tissue thereon.

Abstract: Provided is a device and system for restricting fluid flow in physiological vessels of humans or animals, the device being configurable in a first mode to be passively propellable by fluid flow within a physiological vessel and in a second mode to at least partially occlude a physiological vessel, the device having a first cross-sectional size in the first mode and a second cross-sectional size in the second mode, wherein the second cross-sectional size is greater than the first cross-sectional size. The system comprises: a plurality of the devices described above, a power source for powering the devices; and a controller comprising one or more processors for controlling the devices.

Abstract: A left atrial appendage closure apparatus for obstructing the left atrial appendage, comprises a sealing plate and an anchored plate. The sealing plate is in a mesh structure and arranged with a choke membrane inside, in addition, the sealing plate adopts a tubular member for the distal fixation and is connected with the anchor plate by the tubular member. The proximal end of the sealing plate is fixed with a fastener provided with a structure connecting a convey device, meanwhile, the end of the tubular member at the other side away from the end fixed the sealing plate is arranged with a plurality of supporting rods, which are intersecting radially arranged to form the anchored plate.

Abstract: A hemostatic device includes a band configured to be wrapped around a wrist, and to be secured in a state where the band is wrapped around the wrist, and an inflatable portion that interlocks with the band and that is inflated by injecting gas. The inflatable portion has a first region formed of a thermoplastic material and a second region formed of a thermosetting elastomer whose gas permeability is higher than that of the thermoplastic material. The band has an interlock region which is formed of the thermoplastic material, and with which the inflatable portion interlocks. The first region of the inflatable portion is welded to the interlock region of the band. The compressing force of the inflatable portion can be reduced over time to inhibit vascular occlusion.

Abstract: Disclosed are methods and devices for obtaining patent hemostasis of the radial artery by compressing the uninstrumented ulnar artery to increase radial artery flow. The device comprises a band having an inflatable bladder for applying blunt pressure to the ulnar artery. The method comprises applying a pressure to the homolateral ulnar artery and applying a pressure to the radial artery at the access site to obtain hemostasis at the access site.

Abstract: A hand-wound tourniquet is an apparatus that stops blood flow of an injured appendage as quickly as possible and with minimal effort. The apparatus applies constant pressure against the limb without any manual input. The apparatus includes a housing, a strap, a hook, a reeling shaft, a handle, and a cam-locking mechanism. The reeling shaft traverses into the housing and is rotatably and slidably mounted to the housing. The handle is positioned external to the housing and is torsionally connected to the reeling shaft. The strap traverses into the housing. The cam-locking mechanism is operatively integrated into the torsional connection between the reeling shaft and the handle, wherein the longitudinal motion of the reeling shaft is used to actuate the cam-locking mechanism in order to prevent the rotation of the reeling shaft. The apparatus preferably includes a mount that accommodates the curvature of a limb.

Abstract: A surgical saw blade for being coupled to a drive hub of a surgical saw assembly. The blade includes an attachment portion configured to be removably coupled to the drive hub and a cutting portion opposite the attachment portion. The cutting portion includes a plurality of teeth. The blade also includes a pivot portion configured to engage a pivot structure of the surgical saw assembly. Additionally, the cutting portion has a follower which engages a blade support of the surgical saw assembly and is configured to limit deflection of the blade during use.

Abstract: Apparatus and methods for bone cavity preparation. Formed broaching members may be supported inside a bone by a rotator. The broaching members may be bowed out inside the bone to create a cavity having a shape determined by the broaching members and bone anatomy.

Abstract: A sleeve pin assembly for fixing a bone piece, and more particularly, a new structure of sleeve pin assembly for fixing a bone piece in which a pin for fixing a plurality of bone pieces that have occurred upon being fractured is coupled to a sleeve with a collet method is provided. The sleeve pin assembly for fixing a bone piece includes: a pin having a fixing portion; a collet portion detachably coupled to the pin; a fastening portion having one end connected to the collet portion and the other end that can be fastened to an electric drill; and a sleeve including an internal receiving space to receive the collet portion.

Abstract: Tools for positioning an implant into the sacroiliac joint. A directional cannula includes a main body having a bore that receives the implant. A cut-out, allowing access to the joint, is formed in a leading end of the main body. A pair of parallel prongs extend from the leading end of the main body in transversely spaced apart relation to one another. A drill guide has a main body of rectangular transverse cross-section and a cylindrical head formed integrally with the main body. A transverse width-reducing step is formed in the main body near its distal end. First and second bores are formed in the cylindrical head and in the main body. Both bores are eccentric relative to the drill guide longitudinal axis of symmetry. The drill guide is rotated 180° after first and second drilling operations, prior to third and fourth drilling operations.

Abstract: Embodiments of the present disclosure are directed to devices and methods for object retrieval in a body lumen. In some embodiments, disclosed herein is a retrieval device including a catheter; a strut shaft; a basket comprising a plurality of struts and a collapsible pouch; and an actuation mechanism.

Abstract: This disclosure relates to systems, devices, and methods for removing clots, e.g., calcified clots, from a blood vessel and/or for removing a calcified clot from a blood vessel wall. The devices include an elongated tubular body including a wall surrounding a central lumen and having proximal and distal ends. The tubular body includes at least one set of two, three, or more elongated cuts through the wall to form a clot engaging member having two, three, or more ribs between the cuts, wherein a first set of elongated cuts is arranged adjacent to the distal end of the body, and wherein the clot engaging member is made of an elastic material configured to cause the ribs to self-expand radially outwardly from the tubular body when the body is in a non-constrained, deployed configuration.

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

Abstract: Disclosed is a surgical instrument that includes a rotatable shaft having an articulation section and an ultrasonic waveguide disposed within the shaft. The ultrasonic waveguide is configured to articulate at the articulation section. The ultrasonic waveguide is disposed within the shaft. A rotatable clamp arm is located distal of the articulation section of the rotatable shaft. The rotatable clamp arm is configured to rotate independently of the rotatable shaft distal of the articulation section.

Abstract: A medical manipulator is disclosed, which includes a multiple-degree freedom arm, which can be mounted with a medical instrument; a memory configured to retain an insertion port position indicating a spatial position of an insertion port for inserting the medical instrument mounted in the multiple-degree freedom arm into a human body; and a controller configured to determine an insertion posture of the medical instrument so as to cause an extended line of a major axis of the medical instrument to pass through the spatial position indicated by the insertion port position, and configured to move the multiple-degree freedom arm to the determined insertion posture.

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 device for intravascular intervention can comprise an intervention element, an elongate manipulation member, and a joining element. The elongate element can comprise a hooked portion extending about a proximal portion of the intervention element. The hooked portion can comprise a bend. The hooked portion can have (i) no substantial surface crack at an interior region of the bend and (ii) a maximum lateral dimension that is less than 0.027 inch. The joining element can substantially permanently attach the hooked portion to the intervention element.