Abstract: A method is described for securing an implanted device within a patient. The overlying skin is lifted away from underlying bone at a selected device fixation location within the patient. Multiple suture anchor locations are then selected around or within the device fixation location. A suture anchor is installed at each of the suture anchor locations, the implanted device is placed at the device fixation location, and suture is connected to the suture anchors so as to securely fix the implanted device at the device fixation location.

Abstract: Surgical devices and methods of surgical repairs using the devices are disclosed. The device and methods aid in surgical repairs by allowing for quick and reproducible repairs to be made. A tensionable knotless fixation device is provided with a tensioning construct (formed of a tensioning strand, a tensionable, adjustable, knotless, self-cinching loop, and a splice adjacent the loop) pre-loaded onto a fixation device. A flexible material (for example, suture or suture tape) may be attached to a fixation device. A flexible material may be threaded through an eyelet of a fixation device.

Abstract: Apparatus and methods for positioning and securing anchors are disclosed herein. The anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism, either within the anchor itself or positioned proximally of the anchor, may allow for the uni-directional translation of the anchor while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This uni-directional anchor locking mechanism facilitates cinching of the tissue plication between the anchors, and it may be utilized in one or several anchors in cinching a tissue fold.

Abstract: Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

Abstract: A surgical tool configured for operation in connection with a robotic system. The surgical tool includes a shaft and an end effector extending distally from the shaft. The end effector comprises a first jaw member and a second jaw member movable relative to the first jaw member from a closed position to an open position in response to at least one axial motion. In addition, the surgical tool includes a motor configured to generate at least one rotational motion and a motion conversion assembly operably coupled to the motor and the second jaw member, wherein the motion conversion assembly is configured to convert the at least one rotational motion to the at least one axial motion.

Abstract: Various systems and methods of controlling a surgical instrument to provide alerts according to the operational state of the instrument and the velocity of a displacement member are disclosed. The surgical instrument includes a displacement member movable between a first position and a second position and a sensor configured to detect a position of the displacement member and provide a signal indicative thereof. The surgical instrument is configured to determine a velocity of the displacement member and, upon the velocity being equal to zero, provide an alert according to the operational state of the instrument and the relative position of the displacement member in its stroke. The alert can include an image that is displayed on the display of the instrument.

Abstract: Various systems and methods of controlling a surgical instrument are disclosed. In one aspect, the surgical instrument includes an end effector that is pivotable between an unarticulated position and an articulated position, a knife bar movable between an unfired position and a fired position. The surgical instrument is configured to determine a firing state according to whether the knife bar is moving between the unfired position and the fired position, determine an articulation state according to whether the displacement member is moving between the first position and the second position, and then initiate a power shutdown mode according to the firing state and the articulation state.

Abstract: Various systems and methods of controlling a surgical instrument are disclosed. The surgical instrument can include one or more sensors that are configured to detect or measure parameters associated with the use of the instrument and a display. A control circuit can be configured to detect whether the instrument is articulating, firing, clamping, and so on according to relationships between the detected parameters. The control circuit can further cause the display to display an image or sequences of images according to the particular operational state of the instrument. The images can provide alerts, instructions on how to use the instrument, or information detected by the one or more sensors, such as the position of the knife during transection.

Abstract: Surgical end effectors are disclosed. The surgical end effectors can include a first jaw, a second jaw rotatably coupled to the first jaw, and a lockout arrangement configured to prevent rotational movement of the second jaw toward the first jaw unless an unfired staple cartridge is positioned in the first jaw. The lockout arrangement can comprise a pivotable lock configured to pivot between a locked orientation and an unlocked orientation, a shiftable lock bar, and/or a spring-loaded lockout lever.

Abstract: A surgical stapling system is disclosed. In various embodiments, the system comprises a staple cartridge attachment portion, a first staple cartridge configured to be operably attached to the cartridge attachment portion, wherein the first cartridge comprises a plurality of first staples comprising first staple legs, and a second staple cartridge configured to be operably attached to the cartridge attachment portion in lieu of the first cartridge, wherein the second cartridge comprises a plurality of second staples comprising second staple legs, and wherein the second staples are different than the first staples. The system further comprises an anvil comprising a tissue-engaging surface and a plurality of forming pockets defined in the surface, wherein each pocket comprises a first landing zone configured to receive a leg of a first staple of the first cartridge and a second landing zone configured to receive a leg of a second staple of the second cartridge.

Abstract: A surgical instrument comprises an end effector, a shaft, and a housing extending proximally from the shaft. The surgical instrument includes an articulation assembly configured to articulate the end effector relative to the shaft, a firing assembly configured to fire a plurality of staples, for example, and a locking member movable between a locked configuration and an unlocked configuration. The housing is removably couplable to the shaft when the locking member is in the unlocked configuration and the housing includes a motor configured to drive at least one of the firing assembly and the articulation assembly. The housing also includes a controller in communication with the motor, wherein the controller is configured to activate the motor to reset at least one of the firing assembly and the articulation assembly to a home state when the locking member is moved between the locked configuration and the unlocked configuration.

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. Various embodiments are configured to be operably attached to a robotic system to receive actuation/control motions therefrom.

Abstract: The present invention provides devices for connecting biological structures. The device features a tubular member that includes a tubular body. The tubular member may include a plurality of interwoven lengths configured for reversible radial enlargement and reversible radial contraction of the tubular member. In some aspects the tubular member may include a net design of interconnected cells configured for reversible radial enlargement of the tubular member. The tubular member includes a distal opening, a proximal opening, a central cavity within the tubular member for receiving and retaining a biological structure and a plurality of spaced apart protrusions protruding out from the exterior surface of the body of the device for fixing to the device an end of the biological structure and for fixing a second structure to the device to facilitate connecting the biological structure to the second structure.

Abstract: A system including an anoscope having a first channel extending along a longitudinal axis and a second channel positioned at an angle to the first channel. For hemorrhoid treatment, an elastic band ligation device is insertable into the second channel, the elastic band ligation device carrying an elastic band and having an advancer movable in a distal direction to dislodge the elastic band.

Abstract: IFAK assemblies may include an outer shell having a first outer shell end, a second outer shell end, an outer shell interior extending between the first outer shell end and the second outer shell end, a first shell opening at the first outer shell end and a second shell opening at the second outer shell end. An interior sleeve may be removably deployed in the outer shell interior of the outer shell. The interior sleeve may be selectively removable from a selected one of the first shell opening and the second shell opening. A plurality of first aid items may be carried by the interior sleeve. A left tourniquet sleeve may be carried by a first side of the outer shell. The left tourniquet sleeve may have a left sleeve interior and a left tourniquet retrieval opening corresponding in position to the first outer shell end of the outer shell. A left tourniquet may be deployed in place in the left sleeve interior of the left tourniquet sleeve.

Abstract: Tissue compression devices with a combination of fixation and tension straps and methods of using the same are described herein. The tissue compression devices include a combination of fixation and tension straps that are used together to fix or attach the tissue compression device over selected tissue at a selected location on a patient and to apply pressure to the selected tissue. In one or more embodiments, the fixation straps are sued to fix or attach the tissue compression device and the tension straps are used to provide tension that is converted to pressure on the selected tissue.

Abstract: Systems and methods for performing an osteotomy are presented. Examples include forming a fusion osteotomy at a metatarsocuneiform joint of the first ray of a human foot.

Abstract: Embodiments of the invention include a system for coupling a graft to a bone. A graft preparation tool may be used to place one or more holes in a graft and an offset measurement tool may be used to determine the distance of the one or more holes from an edge of the graft to be aligned with a portion of the bone. One or more complementary holes may then be created in the bone and fasteners applied through the holes to couple the graft to the bone.

Abstract: An instrument for preparing bone. The instrument includes a proximal broach having an outer surface and a canal extending through the length of the proximal broach. The instrument also includes a distal reamer coupled to the proximal broach such that distal reamer is adapted to rotate relative to the proximal broach.

Abstract: A method for interosseous ligament reconstruction (e.g., of a scapholunate or lunotriquetral ligament) includes drilling holes through both of the bones to allow for a graft to be placed on the volar and dorsal aspects of the bones, replicating the normal anatomic structure of the interosseous ligament, while requiring only an incision on the dorsal side of the wrist. The method includes using a drill guide that directs the drill to place a drill hole from dorsal to volar (front to back) in the bone, while making sure the drilled hole is within the joint on the volar side. The drill guide includes a hollow guide tube to advance a drill through, the hollow tube movably coupled to a shaft of the drill guide with a distal end that generally aligns with the distal end of the hollow tube.

Abstract: A device for fracturing calcifications in heart valves includes a stabilizer and an impactor movable towards each other. The impactor includes one or more impactor arms, each of which extends distally from a proximal cap. The impactor further includes one or more lever arms each of which is distally coupled to a lever cap and proximally coupled to a corresponding one of the one or more impactor arms. The lever cap slides on a shaft which extends towards the proximal cap. Proximal movement of the lever cap towards the proximal cap causes the one or more lever arms to deform and to push against the one or more impactor arms and to cause the one or more impactor arms to deform.

Abstract: Disclosed herein are systems and methods to remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

Abstract: An endoluminal punch with a penetrating stylet and a vibration generator. The vibration generator is operable to cause vibrations and rapid reciprocation of the distal tip of the stylet to facilitate penetration of the stylet through resistant body tissue such as the fossa ovalis. The vibration generator may also be operable to cause vibration of the distal tip of the punch itself, to facilitate passage of the punch through an initial perforation created by the stylet.

Abstract: A tissue punch including a barrel defining a first open end, a second open end, and inner diameter, an outer diameter, and a lumen there through. A piston is at least partially disposed within the lumen and pressed against the inner diameter of the barrel, the piston being configured to create negative pressure within the barrel when the piston is retracted. A cutting element defines a proximal end and a distal end, the proximal end of the cutting element being disposed at the second open end of the barrel, the distal end of the cutting element defining a cutting edge, the cutting element is in fluid communication with the barrel. A pushing element is slideably disposed about the outer diameter of the barrel, the pushing element is movable from a biased first position away from the cutting edge to a second position proximate the cutting edge.

Abstract: Methods and apparatus are provided to facilitate the minimally invasive removal of tissue and to facilitate the direct approach to anesthetizing a body wall of a patient. A pull-type cutting device also is disclosed to introduce an opening into the body wall to provide access for intra-chest surgical interventions, for example a minimally invasive biopsy technique as also described for excising target tissue from within a patient, including a nodule from within the patient's lung.

Abstract: A medical injection assembly is provided and includes an introducer with a handle, a sheath, a scope lumen configured to receive an endoscope at a first proximal end of the handle and hold the endoscope in a desired position, a cap attached to the distal end of the scope lumen configured to isolate the scope lumen from the external environment, and a cannula lumen configured to receive a cannula at a second proximal end of the handle and hold the cannula in a desired position. The medical injection assembly includes a cannula configured such that the distance between the distal tip of the cannula and the axis defined by the sheath of the introducer increases as the cannula is moved in a distal direction and a syringe.

Abstract: Disclosed herein are apparatuses, kits, and methods for treating skin, such as skin tightening, e.g., reducing skin laxity, for treating conditions that would benefit from tissue area or volume reduction, skin restoration, skin tightening, skin lifting, and/or skin repositioning, and/or for generally improving skin function or appearance. Such apparatuses, kits, and methods include one or more hollow needles each having at least one prong and a mechanism for removing skin tissue portion(s) from the hollow needle(s).

Abstract: A trocar assembly includes a trocar housing that defines a working chamber, and a cannula having a proximal end and a distal end, wherein the cannula is coupled to the trocar housing at the proximal end to facilitate communication between the cannula and the working chamber. A radial support assembly is arranged at or near the distal end and includes a plurality of radial support members that extend radially inward toward a centerline of the cannula to center a surgical tool within the cannula and thereby minimize unintended oscillation and vibration of the surgical tool.

Abstract: A trocar assembly includes a trocar housing that defines a working chamber, and a cannula having a proximal end and a distal end and defining a lumen that extends between the proximal and distal ends. The cannula is coupled to the trocar housing at the proximal end to facilitate communication between the lumen and the working chamber. A radial biasing device is arranged at or near the distal end of the cannula and includes an annular body coupled to the cannula and a compliant stabilizing member transitionable between a relaxed position and an extended position when acted upon by a surgical tool introduced into the lumen and passing through the compliant stabilizing member.

Abstract: A trocar assembly includes a trocar housing that defines a working chamber, and a cannula having a proximal end and a distal end and defining a lumen that extends between the proximal and distal ends. The cannula is coupled to the trocar housing at the proximal end to facilitate communication between the lumen and the working chamber. A plurality of compliant deflection devices are provided at or near the distal end of the cannula, and each compliant deflection device includes a radial biasing member that extends radially inward toward a centerline of the cannula to center a surgical tool within the lumen and minimize unintended oscillation and vibration of the surgical tool.

Abstract: The present disclosure describes a labor assistance system comprising a perianal support member and grip. The perianal support member includes a contact surface, an inner surface opposing the contact surface, and a rigid compression element. The contact surface has a generally continuous compression surface apex extending from the contact surface in a first direction, oriented to extend from an anterior edge to a posterior edge along a midline axis in a sagittal plane of the patient without substantially interfering with the birthing canal of the patient. The grip is coupled to the inner surface between the anterior edge and the posterior edge of the support member. The present disclosure also describes an intrapartum pelvic floor support device that is applied to tissue in the perianal and/or anococcygeal regions of the patient during an intrapartum period to support the anococcygeal region tissues and at least a portion of the pelvic floor.

Abstract: In one embodiment, a medical device includes an elongate member, a first coupler, and a second coupler. The elongate member has a first end portion, a second end portion, and a side portion. The side portion of the elongate member has a first receiving portion and a second receiving portion. The first receiving portion is configured to receive a first support member. The second receiving portion is configured to receive a second support member. The first coupler is coupled to the elongate member and is configured to engage the first support member to help retain the first support member within the first receiving portion. The second coupler is coupled to the elongate member and is configured to engage the second support member to help retain the second support member within the second receiving portion.

Abstract: According to an embodiment, a spinal implant having vertical and horizontal plates with through-holes for receiving a pre-configured square bolt is disclosed. The embodiments of the invention include very long square bolts that can accommodate the height of at least of two vertically stacked plates. When used to reduce spondylolisthesis, a portion of the square bolt can be broken after the desired alignment of the listhetic vertebrae is observed. The square bolts also allow extension of vertical plates above or below an existing fusion by placement of an extension vertical plate on to the previous one without removing it. This makes extension of instrumentation extremely easy.

Abstract: Disclosed is a dynamically stabilizing intervertebral implant composed of a stabilizing wedge (1), a blocking pin (2), a locking screw (3), and a flexible link in the form of a strap. The stabilizing wedge includes a recess (12) through which the strap can pass. The blocking pin can come into engagement with the wedge by movement inside the recess in the direction of the main axis of the body of the wedge in such a way that the longitudinal axis of the blocking pin firstly coincides with the longitudinal axis of the recess, secondly is perpendicular to the longitudinal axis of the first strap portion inside the recess, and thirdly is parallel to the surface of the first strap portion inside the recess. The strap is immobilized with respect to the stabilizing wedge by being clamped between the blocking pin and the inner wall of the recess.

Abstract: An apparatus and technique for infernally securing a plurality of bone segments together. The device incorporates a plate-like structure stabilizing the fracture and integrated fasteners to attach straps circumscribing the bone segments.

Abstract: Embodiments relate to devices, systems, kits and methods for achieving maxillo-mandibular fixation (MMF). In an embodiment, a system comprises a plurality of dental occlusion ties and/or tension band ties (referred to herein as “DO ties” and “TB ties,” respectively). In another embodiment, a system or kit can comprise a plurality of one or both of DO ties and/or TB ties as well as a trimming tool, comfort caps or material, a lip/cheek retractor, and/or an instruction sheet. DO ties and TB ties can simplify the management of mandible fractures and maxilla fractures by helping re-establish precise dental occlusion for MMF.

Abstract: An end effector of an electrosurgical device may include a fluid discharge port, a fluid aspiration port, and at least two electrodes, in which the electrodes are disposed on a surface of a body of the end effector. The end effector body may include channels fluidically coupled to the fluid discharge port. The end effector body may also include channels to receive the electrodes. The electrodes may be helically wound about the end effector body. The electrodes may interdigitate. An electrosurgical device may include the end effector which is fluidically, mechanically, and electrically coupled to a handle assembly by a shaft assembly. The shaft assembly may be bendable and assume a bent configuration upon the application of a force orthogonal to a longitudinal axis of the shaft assembly. The shaft assembly may retain the bent configuration until the application of a countering force.

Abstract: Thermal cutting surgical instruments incorporate a blade incorporating a first substrate of high thermal conductivity material in the heated portion of the blade and a support and, the first substrate of high thermal conductivity material joined to a second substrate of low thermal conductivity material in the support region of the blade; an electrically insulative dielectric layer disposed on the first surface of the first substrate and on the first surface of second substrate; an electrically resistive heating element disposed on the electrically insulative dielectric; electrically conductive power leads and electrically conductive sense leads disposed on the electrically insulative dielectric layer and that are in electrical communication with the electrically resistive heating element; and an electrically insulative dielectric overcoat layer disposed on the electrically resistive heating element and on the distal portion of the electrically conductive power leads and electrically conductive sense leads.

Abstract: A method for assessing a lesion formed between first and second regions of body cavity tissue, the method including using a first probe in contact with the tissue at a stimulus location in the first region, and applying to the tissue or sensing in the tissue a first activation signal having a first activation peak at a first time. Respective second activation signals having respective second activation peaks following the first activation signal are received from a second probe having multiple electrodes in contact with the tissue at respective sensing locations in the second region, and based on a temporal relation between the first and second activation peaks and a spatial relation between the stimulus location and the sensing locations, one of the multiple electrodes proximal to a gap in the lesion is identified. A map of the body cavity is displayed with the identified electrode marked on the map.

Abstract: An end effector of an electrosurgical device may include a discharge port, an aspiration port, two electrodes, and a diverter formed from a porous material. The diverter includes a matrix having voids to receive fluid from the discharge port. A releasable diverter assembly may include an assembly body configured to receive a pair of electrodes and a diverter composed of a porous material. A shaft assembly of an electrosurgical device may include two electrodes and two fluid cannulae. Each cannula may be disposed proximate to a surface of each of the electrodes. An end effector of an electrosurgical device may include a fluid discharge port, two electrodes, and a diverter disposed therebetween. A proximal edge of the diverter may form a secant line with respect to the end of the discharge port so that fluid emitted by the discharge port is disposed on a surface of the diverter.

Abstract: Aspects of the present disclosure include control systems of an electrosurgical system for managing the flow of fluid, such as saline, and rates of aspiration or suction, in response to various states of conditions at a surgical site. The control system(s) may monitor and adjust to impedance at the surgical site, temperature of the surgical tissue, and/or RF current of electrodes, and may account for certain undesirable conditions, such as the electrodes sticking. The control systems may include various automatic sensing scenarios, while also allowing for several manual conditions.

Abstract: Electrical pulses are applied to tissue in a manner which destroys targeted cells such as cancerous cells while sparing non-targeted cells such as nerve cells. The electrical pulses are controlled within ranges for voltage, wattage and duration of application. Multiple pulses or groups of pulses may be applied to obtain a desired result while maintaining any temperature increase below a level which destroys cells.

Abstract: An electrosurgical cutting tool comprising a pair of pivotable blades that are mechanically operable as scissors or pliers. The blades have electrodes capable of delivery RF and/or microwave energy to cut or coagulate tissue between them. The tool combines the actuation and energy delivery mechanisms in a compact arrangement that enables the tool to be inserted through an instrument channel of a surgical scoping device, such as an endoscope, gastroscope or laparoscope. Each blade may comprise a planar body made of dielectric material that separates a first conductive element from a second conductive element. The blades may rotate relative to each other in the plane of the blades.

Abstract: An electrosurgical instrument includes a needle configured as a first electrode and a coil extending through the needle and configured as a second electrode. The coil movable relative to the needle, and as the needle and the coil are inserted into tissue and energized with an electrical energy source, the needle and the coil apply current to the tissue to coagulate the tissue.

Abstract: An end effector of an electrosurgical device may include a first body, a first electrode on the left side of the first body, and a second electrode on the right side of the first body. The first and second electrodes may be configured to receive electrosurgical energy to treat tissue in a target treatment zone. The end effector may also include a fluid aspiration port in fluid communication with a fluid path. The fluid aspiration port may be configured to remove a material from the target treatment zone.

Abstract: An isolating circuit for electrosurgical generator arranged to produce radiofrequency (RF) energy and microwave energy for treating biological tissue. The generator has an RF channel and a microwave channel which are combined at signal combiner to enable the RF energy and microwave energy to be delivered into tissue along a common feed path. The isolating circuit comprises a tunable waveguide isolator at a junction between the microwave channel and signal combiner, and can include a capacitive structure between a ground conductor of the signal combiner and a conductive input section of the waveguide isolator to inhibit coupling of the RF energy and leakage of the microwave energy. The isolating circuit can combine into a single tunable unit all the necessary components to isolate the microwave and RF channels from one another whilst providing a high withstanding voltage.

Abstract: A shaft assembly for a microwave ablation applicator which includes a shaft assembly and an antenna assembly located within the shaft assembly is disclosed. The shaft assembly comprises an elongate shaft (22) which extends from a first end to a second end thereof, and which defines therein a hollow inner volume and a longitudinal axis of the antenna assembly; and an applicator tip (24) mounted on the second end of the elongate body. The elongate shaft (22) comprises a first shaft portion (44) which extends longitudinally from the first end of the shaft (22) to an engagement region between the first and second ends of the shaft (22), and a second portion (46) which extends longitudinally from the engagement region to the second end of the shaft (22). The first shaft portion (44) is of a carbon reinforced plastics material, and the second shaft portion (46) is of a fibre reinforced plastics material having fibres which are non-electrically conductive.

Abstract: An applicator for cosmetic treatment of skin including one or more sources of light energy and one or more transparent electrode assemblies positioned between the source of light energy and skin to be treated. The transparent electrode assembly supports transmission of light energy from the light source to one or more segments of skin located directly under and in contact with the electrode assembly. The electrode assembly can also include transparent RF electrodes that measure skin impedance (temperature).

Abstract: Disclosed are systems and methods for rapid generation of simulations of a patient's spinal morphology that enable pre-operative viewing of a patient's condition and to assist surgeons in determining the best corrective procedure and with any of the selection, augmentation or manufacture of spinal devices based on the patient specific simulated condition. The simulation is generated by morphing a generic spine model with a three-dimensional curve representation of the patient's particular spinal morphology derived from existing images of the patient's condition.

Abstract: This invention concerns an automated registration method and device for a surgical robot enabling registration between a first three-dimensional location system comprising an optical distance sensor and a second three-dimensional location system comprising optical acquisition means. The method comprises: a first step of intraoperative registration between the first location system and data recorded on an anatomical surface of a patient and; a second step of intraoperative registration of two three-dimensional location systems. The second registration step is performed at the same time as the first registration step by detection, by the optical acquisition means, of at least one point of a point cloud acquired by the optical sensor during the first intraoperative registration.