Abstract: The present disclosure teaches a novel medical device and method of use, employing a unique shape that allows the device to use the lesser (inferior) curve of aortic Arch as a fulcrum of support for a guide catheter, for subsequent prevention of recoil and displacement thereof, while delivering additional catheters or devices into the distal branches of the great vessels. A method for using same.

Abstract: The present disclosure generally relates to a system and method for providing transabdominal gastric surgical access system for medical, endoscopic, and surgical instruments through a percutaneous surgically constructed opening. More particularly, it concerns a delivery system and a surgery system having structures that includes a cannula working channel, an internal and external anchor system, a cap and insertion tool for creating an opening, to provide gastric access through at least one port for the insertion of instruments for medical/surgical procedures.

Abstract: Embodiments include a fiducial deployment system. A fiducial may include dimples to enhance echogenicity and/or to provide for engagement with a delivery cannula or stylet. The needle system may be configured to deliver a plurality of fiducials to a target location in serial fashion, one at a time, when the fiducials are coaxially disposed around a central deployment member that may be embodied as a delivery cannula or stylet. In certain embodiments, echogenic placement of fiducials may present certain advantages. An elongate structure may be included that is configured to distally advance fiducials along the deployment member.

Abstract: A puncture apparatus is disclosed, which can include a first puncture needle having a first needle tip and configured to puncture a living body tissue, a shaft interlocked to the first puncture needle, a second puncture needle having a second needle tip and configured to puncture a living body tissue, the second needle tip being oriented in a direction different from a direction in which the first needle tip is oriented, the second puncture needle being disposed so as to be movable relative to the first puncture needle in a proximal direction of the first puncture needle, and a moving section moving the second puncture needle relative to the first puncture needle in the proximal direction of the first puncture needle.

Abstract: The present invention comprises methods and devices for providing contrast medium for sonography of structures such as ducts and cavities. The invention provides for creation of detectable acoustic variations between two generated phases of a gas and a liquid to make a contrast medium. Sonography is the primary means of imaging but other conventional detection means may also be employed with the present invention.

Abstract: A tool for manipulating a foreign body (e.g., a deployed medical device) can include an operative portion. The operative portion can be used to move the foreign body in the proximal and/or distal directions with respect to the removal/repositioning tool and/or the tissue surrounding the foreign body. In some embodiments, the tool can include a compressing portion that can be used to compress the foreign body as the foreign body is pulled by the operative portion in the proximal direction. The tool can further include a sleeve that can be used to transition the operative portion and/or compressing portion between an opened configuration and a closed configuration. In some embodiments, the tool can be used in conjunction with an endoscope to navigate the tool to the site of a foreign body within the body of a patient.

Abstract: The invention is a point and click method for positioning an external fixator on a patient, in which a surgeon—using a computer mouse or similar device—inscribes lines or points on a computer screen displaying an x-ray or other photographic image of the bones of a patient together with two rings in position adjacent the bones. By inscribing lines on the computer screen, the underlying drawings program detects the x-y coordinates of any point on the screen when the user (the surgeon or other practitioner) clicks on it, and outputs the x-y coordinates of every point identified by the user including the two points defining any desired line. The practitioner thus can, using “point and click” operation, govern the repositioning of two fixator rings on the bones of a patient.

Abstract: An external bone fixation system may include a first semi-circular external fixation member, a second semi-circular external fixation member, four ball collet assemblies attached to the second external fixation member, and four shafts. Each shaft may include a first end attached to the first external fixation member and a second end with a stop member, and each of the four shafts extends slidably through an opening in a ball of one of the four ball collet assemblies. The stop member of each second end prevents each second end from passing through the opening in its respective ball. Each shaft also includes a hinge located closer to the first end than to the second end.

Abstract: A mandibular fixation device overcomes the low operability of the conventional mandibular fixation device. The mandibular fixation device includes a sleeve, a first screw rod, a second screw rod and two positioning members. The sleeve includes two ends respectively provided with first and second screw holes. The first and second screw holes have opposite spiral directions. The first screw rod has a first threaded portion and a first assembly portion. The first threaded portion is threadedly engaged with the first screw hole, and the first assembly portion is located outside of the sleeve. The second screw rod has a second threaded portion and a second assembly portion. The second threaded portion is threadedly engaged with the second screw hole, and the second assembly portion is located outside of the sleeve. The two positioning members are coupled with the first and second assembly portions, respectively.

Abstract: A bone screw, for drawing first and second bone fragments together, includes a shaft having a distal section and a proximal section. The distal section has a first external male screw thread and a minor diameter. The proximal section has a second external male screw thread. A major diameter of the distal section is larger than a major diameter of the proximal section. The bone screw includes a sleeve that has an internal female screw thread configured to mate with the second male screw thread. A distal portion of the sleeve has an outer diameter. The outer diameter is equal to or smaller than the minor diameter of the distal section of the shaft.

Abstract: An end cap is provided comprising a head with a tool engagement portion and a shaft with a tip, wherein the shaft comprises a threaded conical portion starting from the tip and extending in a direction to the head. The thread may be provided with a constant pitch, i.e. with a constant distance between the turns of the thread.

Abstract: A dynamic fixation medical implant having at least two bone anchors includes a longitudinal connecting member assembly having a core portion made from at least one pre-tensioned flexible member and a cooperating pre-compressed surrounding outer sleeve. The sleeve surrounds the core and is disposed between cooperating rigid end members that are attached to the bone anchors.

Abstract: A bone anchoring device includes a receiving part with a rod receiving portion having a first end, a second end, a recess for the rod, an outer surface, and a first engagement structure on the outer surface that extends farther radially outwardly than other parts of the rod receiving portion, and a flexible head receiving portion for inserting and clamping the head. The bone anchoring device also includes a locking ring configured to be arranged around the head receiving portion for locking the head, the locking ring having an outer surface and a second engagement structure on the outer surface that extends farther radially outwardly than the outer surface of the rod receiving portion. The engagement structures are configured to be engaged by an instrument to move the locking ring from a locking position to a position where the inserted head is pivotable.

Abstract: A polyaxial bone screw for attaching a rod to a vertebra comprises a fastener having a threaded shank and a head. A yoke has a rod receiving channel for receiving the rod. A screw support rotatably attached to the yoke has a cavity articulatingly and rotatably supporting the fastener head, a hole receiving the threaded fastener shank therethrough, and a plurality of slots for maximum screw angulation. A crown has an upper rod receiving surface, a lower surface in contact with the fastener head and a projecting surface in contact with the yoke. A biasing element between the screw support and the yoke applies biasing forces among the fastener, the crown, and the yoke to provide sufficient friction to retain the yoke in a manipulable position relative to the fastener. A set screw is supported by the yoke to overcome the bias and to rigidly secure the components.

Abstract: The bottom loading fastening system that consists of the polyaxial ball and socket joint used in conjunction with a bone screw. The system allows attachment to a bone screw using a retaining ring with a blocker ring to assure proper ring positioning. The retaining ring having a continuous inner surface wall and an outer wall having a notch. Upon installation the retainer wall is expanded causing a break at the notch producing an audible and tactile indication that the sufficient force has been applied to set the retainer and blocker rings locking the bone screw to a U-shaped connecting assembly.

Abstract: A spinal construct comprises a member that defines an axial cavity and includes a transverse rod. The member further defines a groove configured for disposal of a band. A part is disposed with the axial cavity and engageable with the band to provisionally fix the part relative to the member. An implant receiver is disposable with the axial cavity to move the part and engage the band to connect the member with the implant receiver. Implants, systems, instruments and methods are disclosed.

Abstract: A fastener retention system for retaining fasteners within apertures of an orthopedic plate includes a first pocket disposed between two of the apertures in the plate, a blocking member disposed between the two apertures and including a second pocket that forms a cavity with the first pocket, and a spring that expands from a compressed configuration within the first pocket to a decompressed configuration within the cavity.

Abstract: A device for treatment of spondylotic disease includes a distractor for distracting vertebral facets of first and second vertebrae located adjacent each other. The distractor includes a first abutment surface for interfacing with an inferior articular facet of the first vertebra. The distractor also includes a second abutment surface for interfacing with the superior articular facet of the second vertebra corresponding to the inferior articular facet of the first vertebra. The first and second abutment surfaces of the distractor engage with each other and are separated by a predetermined distance.

Abstract: Devices, systems and methods for dynamically stabilizing the spine are provided. The devices include an expandable spacer or member having an unexpanded configuration and an expanded configuration, wherein the expandable member in an expanded configuration has a size, volume and/or shape configured for positioning between the spinous processes of adjacent vertebrae in order to distract the vertebrae relative to each other. The systems include one or more expandable members and a mechanical actuation means for expanding the expandable member. The methods involve the implantation of one or more devices or expandable spacers.

Abstract: A device for placing a receiving part of a bone anchoring device onto a head of a bone anchoring element includes a holding portion, a collet configured to be held by the holding portion, the collet having a tubular body extending along a longitudinal axis, and a distal end portion configured to be flexibly expanded and compressed in a radial direction, and a plunger configured to be positioned in the collet. The collet is movable axially relative to the plunger between a first position wherein the distal end portion of the collet is configured to have a first width in a first radial direction and the plunger prevents the distal end portion from assuming a width less than the first width, and a second position wherein the distal end portion of the collet is radially compressible to a second width that is less than the first width.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws.

Abstract: In one general aspect, an orthopaedic fixation device includes an inner core and shaft formed of a multi-layered, fiber-reinforced composite. A sensing element is embedded within the multi-layered, fiber-reinforced composite.

Abstract: A two-part implant insertable in two bone segments that are intended to be fused together, wherein the implant provides built-in axial compressive forces that aid in maintaining the two bone segments in compression against each other so as to facilitate fusion.

Abstract: Systems and methods for intermedullary bone fracture fixation are described herein. The fixation device includes a main body having a flexible state and a rigid state. The fixation device further includes a proximal interface coupled to a proximal end of the main body to anchor the fixation device to an exterior surface of the bone and a distal interface coupled to a distal end of the main body to anchor the fixation device to an interior cavity of the bone. The fixation device further includes a locking interface to configured to convert the main body from the flexible state to the rigid state.

Abstract: A bone plate locking mechanism and methods for utilizing same are disclosed. A bone plate in accordance with the present invention includes a bone screw hole having a plurality of first lips and a plurality of second lips. The first lips are closer to the upper surface than the second lips and the first and second lips are offset around the bone screw hole.

Abstract: A bone plate is dimensioned for securing the rotated cut segment of an upper tibia to the lower portion of the tibia as part of a tibial leveling osteotomy procedure for an animal. The bone plate includes an elongated shaft, a head portion pre-bent with respect to the elongated shaft, and a transition between the elongated shaft and head portion including opposing concave sidewalls. The elongated shaft has a centerline and the pre-bent head portion has a centerline angled with respect to the centerline of the elongated shaft to dispose the elongated shaft collinear or approximately collinear with respect to the lower portion of the tibia and to better fit the head portion to the rotated cut segment of the upper tibia.

Abstract: A bone anchor includes: a main body defining a longitudinal axis and including a head; at least one insertion hole which extends from a first opening formed in the head to a second opening formed in the main body, the at least one insertion hole having an axis which is arranged to be inclined with respect to the longitudinal axis of the main body at an angle, and the insertion hole being configured to receive and guide therethrough a pin-shaped element to be anchored within a bone or bone fragment; and a locking device configured to lock the position of the pin-shaped element inserted within the at least one insertion hole in an axial direction.

Abstract: A device including a first member extending along an axis between a first end and a second end. The first end includes a first portion spaced apart from a second portion by a gap extending parallel to the axis. An inner surface of the first portion and an inner surface of the second portion defining a cavity. A pivoting member is movably disposed in the cavity and includes an inner surface defining a passageway. A second member is disposed within the passageway. The pivoting member is movable between a first orientation such that the gap has a first width and the pivoting member is rotatable to a selected trajectory relative to the axis and a second orientation such that the gap has a second width that is less than the first width and the second member is fixed in the selected trajectory. Methods of use are disclosed.

Abstract: Paste application system having a two-component cartridge with two axially shiftable feed plungers; one hollow cylinder with an open front face and an at least partially closed front face, an axially mobile first plunger situated therein with two pestles attached to it; another hollow cylinder that contains a manually shiftable second plunger; and a liquid container, whereby the second hollow cylinder is connected or connectable to the liquid container in liquid-permeable manner by a first conduit means and a first non-return valve, and the first hollow cylinder is connected or connectable to the second hollow cylinder in liquid-permeable manner by a second conduit means and a second non-return valve; whereby the two-component cartridge and the first hollow cylinder, arranged axially adjacent, with the axially mobile pestles are arranged in a pressure container; and the paste application system contains a hollow space and liquid is present in said space.

Abstract: Various forms of a cable fixation device, instrumentation, kit, and methods useful for repairing the skeletal system are introduced. The system utilizes a clamp housing fixing a head end of a surgical cable therein. In an operative configuration the cable is looped around a damaged bone segment and reentered through a lock aperture in the clamp housing then through a multi-part collet and lock cap residing within a lock aperture. The cable loop and each aforementioned component comprise a central axis aligned within a single plane. A sliding interface situated between the lock cap and collet prevent twisting of the surgical cable. The locking mechanism is non-destructive to the cable despite repeated unlocking and relocking of the fixation device. The axis for tensioning of the cable is coincident with the locking axis. A cerclage inserter instrument is disclosed.

Abstract: Instruments and methods for surgical transosseous attachment to a bone include a guide able to guide the formation of intersecting bone tunnels and a passer able to pass a member through the bone tunnels.

Abstract: A bone plate is asymmetric and includes a straight body and a cross arm. The plate has first and second sides, each with the same structure. The body and cross arm include nodes separated by deformable bridges. Each node defines a screw hole, and wings extending laterally therefrom. The wings taper in thickness between the first and second sides. Screw holes are threaded into the nodes. Each of the first and second sides of the body and cross arm define longitudinal channels in the nodes. The plate can be shaped to the bone by deformation at the bridges or removal of portions of the plate at bridges. A pair of benders, each with clamp bracket and clamping bolt threadedly coupled within a threaded hole of the bracket, is also provided for shaping the plate.

Abstract: An orthopedic implant screw driver includes drive shaft. A first gear is operably coupled to the drive shaft and in meshing engagement with a hollow gear which rotates in response to rotation of the drive shaft. The hollow gear includes a passage defining an inwardly facing screw engagement periphery configured to receive and drivingly rotate a threaded portion of the screw. A method of securing an orthopedic implant to a bone includes positioning a screw within the passage which is configured to drivingly engage a threaded portion of the screw and rotating a drive shaft in driving engagement with the gear causing the gear to engage the screw along the threaded portion of the screw and rotatably drive the screw via the threaded portion.

Abstract: An electrosurgical device includes a pair of jaws including a first jaw disposed adjacent to a second jaw. The pair of jaws is movable between open and closed positions. Each jaw comprises an electrode, and each jaw has an active surface. The first jaw active surface is disposed adjacent to the second jaw active surface in the closed position. An actuating member is coupled to one or more of the first and second jaws. The actuating member is configured to move the pair of jaws between the open position and the closed position. In one form, an insulating ring is disposed around the first jaw. In another form, a shield system is disposed on first and second side surfaces of the first jaw and a portion of the first jaw active surface. In yet another form, the shield system forms a lip extending from the first jaw.

Abstract: A tissue treatment selection device that has at least one treatment delivery member, a delivery setting circuit that is coupled to the treatment delivery member that is adapted to be deployed into tissue to deliver therapeutic energy to a target tissue zone, and the processing circuit is operable to set treatment parameters in the delivery setting circuit that is operable to set treatment parameters in the delivery setting circuit. The processing circuit is operable to transmit a test signal through the deployed treatment delivery member and to determine deployment status. The treatment selection device has a processing circuit adapted to send a message to a display device that indicates that the deployed treatment delivery member has been determined to be compensable and contains a suggested change in the treatment parameters. Also presented herein is a method of treating a tissue of a patient using the treatment delivery device.

Abstract: A computer-implemented system for delivering energy to tissue having a necrotic threshold may generally comprise an electrode array comprising a plurality of electrodes, a central electrode positioned intermediate the plurality of electrodes, and a controller configured to not only apply a first sequence of electrical pulses to the electrode array to induce thermal heating in the tissue and reduce the necrotic threshold of the tissue but also apply a second sequence of electrical pulses to the central electrode to induce cell necrosis in the tissue by irreversible electroporation. Electrical ablation devices and methods of using the same are also described herein.

Abstract: An electrosurgical generator includes an electrosurgical energy output configured to deliver electrosurgical energy to a bipolar end effector assembly in a conductive fluid environment for treating tissue. A controller having a processor is configured to control a waveform of the electrosurgical energy such that the waveform oscillates between a cut phase for initiating and sustaining tissue cutting, wherein the waveform includes a cut energy greater than the energy needed to create and sustain arcing, and a hemostasis phase, for desiccating/coagulating tissue, wherein the waveform includes a hemostasis energy less than the energy needed to sustain arcing.

Abstract: Described here are devices, systems, and methods for closing the left atrial appendage. The methods described here utilize a closure device for closing the left atrial appendage and guides or expandable elements with ablation or abrading elements to ablate or abrade the left atrial appendage. In general, these methods include positioning a balloon at least partially within the atrial appendage, positioning a closure assembly of a closure device around an exterior of the atrial appendage, inflating the balloon, partially closing the closure assembly, ablating the interior tissue of the atrial appendage with the inflated balloon, removing the balloon from the atrial appendage, and closing the atrial appendage with the closure assembly.

Abstract: A device for resecting undesired tissue from an inner wall of a body cavity, the device having a tip section in a shape of a cylinder's sector, the tip section comprising: a plurality of optical fibers located along an inner surface of the tip section and configured to transmit laser radiation to the undesired tissue; and a cutter having a shape of a cylinder's sector located inwardly or outwardly to the plurality of optical fibers, wherein said cutter is configured to cut through the undesired tissue and thereby detach at least a part of the undesired tissue from the inner wall of the body cavity.

Abstract: Method for generating a shaped laser pulse in a lithotripter characterized in that if the pulse duration is divided into four intervals of equal length, less than 25% of the energy of the pulse is emitted in the first of those intervals, and in that the maximum intensity of the pulse is first reached in the second, third or fourth time interval, and wherein the intensity reached after the start of the third and/or forth interval is at least once the same as or higher than the maximum intensity reached in the second interval.

Abstract: A video headband assembly, having a headband structure, made at least in part of polymeric material, a battery port, a power management network having at least one output lead, and which supplies power from the battery port to the output lead and a multi-pin connector, accessible from outside the headband structure. Also, a video data signal transformation network is supported within the polymeric material of the headband structure and electrically connected to the multi-pin connector. Finally, a first video data signal input to the multi-pin connector is transformed by the video data signal transformation network, which produces a transformed video data signal in response to the first video data signal.

Abstract: A method of manufacturing a surgical kit for cartilage repair in an articulating surface of a joint, comprising the steps of receiving radiology image data representing three dimensional image of a joint; generating a first three dimensional representation of a first surface of the joint in a trainable image segmentation process dependent on a trained segmentation process control parameter set and said radiology image data; generating a set of data representing a geometrical object based on said first surface, wherein said geometrical object is confined by said first surface; generating control software adapted to control a CAD or CAM system to manufacture a surgical kit for cartilage repair dependent on said set of data representing a geometrical object and on a predetermined model of components of said surgical kit.

Abstract: The present disclosure provides a human organ movement monitoring method for monitoring human organ movement in a surgical process in real time and a surgical navigation system.

Abstract: Methods and systems for registering a manipulator assembly and independently positionable surgical table are provided herein. In one aspect, methods include reading a fiducial marker on the surgical table with a sensor associated with the manipulator assembly and localizing the manipulator assembly and surgical table with respect to a common reference frame. Methods may further include translating a 3D configuration of the surgical table to a 2D frame of reference so as to estimate a 3D pose of the surgical table relative the manipulator assembly for use in coordinating movements therebetween.

Abstract: A medical system for use in a lithotripsy procedure may include a processor configured to receive input from a first imaging device, wherein the first imaging device may be configured to send image data representative of an image captured in a lumen of a kidney, bladder, or ureter to the processor. The processor may be configured to display the image on a display device coupled to the processor, and analyze the image to sense the presence of an object within the image. If an object was sensed within the image, the processor may analyze the image to estimate a size of the object, and display the estimate on the display device.

Abstract: Medical and/or robotic devices, systems and methods can provide an indicator associated with each manipulator assembly of a multi-arm telerobotic or telesurgical system. The exemplary indicator comprises a multi-color light emitting diode (LED) mounted to a manipulator moving an associated surgical instrument, allowing the indicator to display any of a wide variety of signals. The invention may provide an additional user interface to facilitate communications between the telesurgical system and/or members of a telesurgical team.

Abstract: A robotic actuation system for sensorless force control of an interventional tool (14) having cable driven distal end (e.g., a probe, a steerable catheter, a guidewire and a colonoscope). The system employs a robotic actuator (30) having one or more motorized gears operate the cable drive of the interventional tool (14). The system further employs a robotic workstation (20) to generate motor commands for simultaneous actuation position and contact force control of the interventional tool (14). The motor commands are a function of an actuation position measurement and a motor current measurement of the at least one motorized gear for a desired actuation position of the interventional tool (14).

Abstract: In some aspects, a control algorithm is provided for manipulating a pair of articulation arms configured to control an articulation angle of an end effector of a robotic surgical instrument. Other aspects of the present disclosure focus on the robotic arm system, including the pair of articulation arms coupled to the end effector and guided by independent motors controlled by a control circuit. Each of the articulation arms are designed to exert antagonistic forces competing against each other that are apportioned according to a ratio specified in the control algorithm. The ratio of the antagonistic forces may be used to determine the articulation angle of the head or end effector of the robotic surgical arm.

Abstract: Methods and devices are provided for performing robotic surgery. In general, a surgical system is provided including an electromechanical tool with a first mode of operation in which the electromechanical tool mimics movement of a controller, and a second mode of operation in which the tool mirrors movement of the controller. A hybrid surgical device is also provided including an adapter matable to a handle assembly such that the adapter is electronically coupled to a motor of the handle assembly and is configured to communicate with the motor. A robotic laparoscopic surgical device is also provided including a motion sensor configured to sense movement of an electromechanical tool and an electromechanical arm that assists movement of the tool. A robotic surgical device is also provided including an electromechanical driver associated with a trocar and being configured to rotate and to translate a tool disposed through a passageway.

Abstract: Provided is a surgical manipulator system including: a manipulator provided with a treatment tool having at least one joint and a drive portion that is attached to the treatment tool to drive the treatment tool; a manipulation input portion with which manipulation for causing, by driving the drive portion, the treatment tool to perform a desired operation is input; and a control portion that controls the drive portion on the basis of the manipulation that has been input via the manipulation input portion, wherein the treatment tool is provided with an identification-information retaining portion that retains identification information of the treatment tool, the manipulation input portion is provided with a manipulation-side reading portion that performs short-distance communication with the identification-information retaining portion, thus reading the identification information of the treatment tool, and the control portion controls the drive portion based on the read identification information of the treatm