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

Abstract: Methods and devices for fixation of soft tissue to bone are provided. In one embodiment, a suture anchor is provided having an elongate cylindrical body with proximal and distal ends and an inner lumen extending therethrough. The elongate body can be configured so that upon partial insertion into a bone hole, it is securely anchored within the bone hole and a suture extending through the inner lumen is freely slidable. It can also configured so that, upon further insertion into the bone hole, at least a portion of the elongate body compresses to lock the suture within the inner lumen such that the suture is prevented from sliding. In another embodiment, a suture anchor is provided having arms that have an open position for receiving a suture therebetween, and a closed position in which the suture is retained but allowed to slide freely.

Abstract: An arthroscopic bone channel forming and suturing system useful following formation of a first and a second generally straight channel in a bone, the second channel not intersecting the first channel, the system including a curved bone puncture needle configured to be insertable into the first channel, a curved needle driving assembly configured to manipulate the curved needle to form a curved junction between the first channel and the second channel, a suture snare wire assembly configured to insert a suture snare wire to a suture snare wire pick-up location via the second channel in the bone and a coordinated multi-function driving assembly operative to operate the curved needle driving assembly and the suture snare wire assembly in coordinated operation to cause the suture snare wire to be pulled from the suture pick up location and through the first channel via the junction.

Abstract: Improved medical suturing devices, systems, and methods for loading a needle in a suturing device, particularly standard surgical needles. An exemplary device includes a body having one or more clamps for grasping a needle and a needle loader supporting the needle in a delivery position suitable for advancing through a minimally invasive aperture and a needle loading position suitable for grasping with a clamp of the device. Preferably, the needle loader includes an elongate body having a rotatable needle holding member and is releasably coupleable with the device body such that the needle is moveable between positions from a proximal portion of the device. Methods includes selecting a standard surgical needle, advancing the needle loader device into a body of a patient, and moving the needle to a needle loading position for grasping and suturing with one or more clamps of the device.

Abstract: A surgical stapler. The surgical stapler includes a drive system, an electric motor, a battery and a control system. The electric motor is mechanically coupled to the drive system. The battery is electrically couplable to the electric motor. The control system is electrically connected to the electric motor and includes an H-bridge circuit, an electrically resistive element and an electrically inductive element. The H-bridge circuit includes a high side and a low side. The low side of the H-bridge circuit includes first and second switching devices. The electrically resistive element is electrically connected in series with the first switching device. The electrically inductive element is electrically connected to the electrically resistive element. The control system is configured to control a force applied to the drive system based on a current downstream of the electrically resistive element.

Abstract: A surgical instrument for use by an operator in a surgical procedure includes an elongate shaft, an end effector extending from the elongate shaft, and a control system. The end effector is articulatable relative to the elongate shaft between a home state position and an articulated position. The control system includes a processor and a memory coupled to the processor to store program instructions. The processor can alert the operator when the end effector reaches the home state position from the articulated position.

Abstract: A method and device for controlling the compression of tissue include clamping tissue between a first clamping member and a second clamping member by driving at least one of the clamping members with an electric motor toward a predetermined tissue gap between the clamping members and, during the clamping, monitoring a parameter of the electric motor indicative of a clamping force exerted to the tissue by the clamping members. The method and device include, during the clamping, controlling the electric motor, based on the monitored parameter, to limit the clamping force to a predetermined maximum limit.

Abstract: An implant insertion device is designed for use with a shape memory implant movable between an unconstrained shape and an insertion shape. The implant insertion device maintains the shape memory implant in its insertion shape until the delivery of the shape memory implant into tissue or bone. Upon the release of the shape memory implant from the implant insertion device, the shape memory implant attempts to move from its insertion shape to its unconstrained shape, thereby releasing mechanical energy into the tissue or bone.

Abstract: The present invention relates to surgical instruments and methods for enhancing properties of tissue repaired or joined by surgical staples and, more particularly to surgical instruments and methods designed to enhance the properties of repaired or adjoined tissue at a target surgical site, especially when sealing an anastomosis between adjacent intestinal sections to improve tissue viability under hypoxia conditions, prevent tissue inflammation, and to prevent leakage. The present invention further relates to hypothermic circular stapling instruments configured to pre-cool the tissues being joined by staples.

Abstract: A suturing system including an elongate distal member, an elongate proximal member proximal the elongate distal member, and a needle guide disposed between the elongate distal member and the elongate proximal member. A plurality of needles with a needle tip of each needle of the plurality of needles are orientated generally proximally toward a single opening in a distal end of the elongate proximal member. When the needle tip of each of the plurality of needles is at least partially disposed within the single opening, a portion of each needle of the plurality of needles, proximal a distal end of the needle guide, being radially separated by a distance less than a diameter of the elongated proximal member.

Abstract: A surgical instrument. The surgical instrument has a force delivery system which communicates a changing force to a user of the surgical instrument when a limit of a surgical function is reached. A sensor senses position of a moving element to communicate a signal to the force delivery system. In various embodiments, the system generates a vibratory force to signal the user.

Abstract: A device for connecting together two opposing leaflets of a valve in a patient's heart, comprising: a first clip having a generally U-shape, comprising a first prong and a second prong, and a first bridge connecting the first prong to the second prong; a second clip having a generally U-shape, comprising a third prong and a fourth prong, and a second bridge connecting the third prong to the fourth prong; a third clip having a generally U-shape, comprising a fifth prong and a sixth prong, and a third bridge connecting the fifth prong to the sixth prong, wherein the third prong has a first elongate axis and the fifth prong has a second elongate axis and the third prong and the fifth prong are positioned to extend adjacent to and parallel with the first prong, and are configured to rotate about the first elongate axis and the fifth elongate axis respectively.

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: A detachable motor-powered surgical instrument. The instrument may include a housing that includes at least one engagement member for removably attaching the housing to an actuator arrangement. A motor is supported within the housing for supplying actuation motions to various portions of a surgical end effector coupled to the housing. The housing may include a contact arrangement that is configured to permit power to be supplied to the motor only when the housing is operably attached to the actuator arrangement.

Abstract: Methods and apparatus for a percutaneous bypass graft system according to various aspects of the present technology include a graft section comprising a dual-sided fixation system at the anastomosis site and a tamper sheath configured to provide enhanced control during installation. The dual-sided fixation system may comprise a plurality of barbs configured to secure the graft section to an internal and external portion of a target vessel. The tamper sheath comprises a cuff at a distal end that is configured to be positioned against an outer surface of the target vessel during the percutaneous procedure.

Abstract: The subject invention pertains to materials and methods for performing breast neurotization with allogeneic or autologous nerves in breast surgeries, such as reconstructive breast surgery. Certain embodiments of the methods comprise harvesting and implanting one or more allogeneic or autologous intercostal nerves 10 to 12 to one or more of the patient's intercostal nerves 2 and/or 3.

Abstract: The present disclosure is directed to kits comprising materials appropriate for treating damaged nerves, such as for reconnecting severed nerves, through the use of fusogenic compounds such as polyethylene glycol (PEG) in combination with antioxidants, calcium-containing and calcium-free solutions.

Abstract: Embodiments of the present invention encompass systems and methods to prevent complications from atrial fibrillation by preventing or reducing the likelihood of blood flow out of the left atrial appendage, to eliminate a possible source of aberrant electrical circuits, or both. Accordingly, techniques are provided for delivering ligature loops or closure means to the left atrial appendage, and to other anatomical structures of a patient which may be desirable in other surgical procedures.

Abstract: An adjustable flow narrow profile balloon device for use in an aorta has a catheter and an adjustable flow device comprising a scaffold having an anchored end fixed to the catheter, a movable end distal to the fixed end and support extending between the anchored end and the movable end, and a flexible tube attached to the support and at least one tension wire attached to the movable end and extending through the catheter such that the at least one tension wire is accessible to move the movable end of the balloon towards the anchored end when the catheter is positioned in the aorta. The adjustable flow device has a collapsed configuration; a fully occluded configuration in which the length of the support lies flat against the catheter and the flexible tube is inflated; and adjustable flow configurations allowing for a desired amount of fluid flow past the device.

Abstract: A sleeve for use with a tourniquet cuff to protect a patient's limb from tourniquet-related injury includes a stretchable body extending longitudinally over a sleeve length between a proximal end and a distal end. The body has a tubular shape, and the sleeve length is greater than a width of the tourniquet cuff. The body tapers from the proximal end to the distal end such that a proximal end circumference is greater than a distal end circumference. The body is formed to apply substantially uniform pressure to the patient's limb from the proximal end of the sleeve to the distal end of the sleeve varying only within a predetermined pressure range.

Abstract: Arthroplasty jigs and related methods are disclosed. Some of the arthroplasty jigs may comprise a jig body that is configured to align with a surface of a bone, and a positioning component. Certain of the methods may comprise providing such an arthroplasty jig, and aligning the jig body with a surface of a bone so that the positioning component provides at least one of a visible, audible, or tactile indication that such alignment has been achieved. Some of the arthroplasty jigs may comprise a jig body that is configured to align with a surface of a bone, and that is marked with identifying information. Certain of the methods may comprise providing an arthroplasty jig comprising a jig body that is configured to align with a surface of a bone, or providing an arthroplasty jig blank, and marking the arthroplasty jig or the arthroplasty jig blank with identifying information.

Abstract: A dynamic trialing method generally allows a surgeon to perform a preliminary bone resection on the distal femur according to a curved or planar resection profile. With the curved resection profile, the distal-posterior femoral condyles may act as a femoral trial component after the preliminary bone resection. This may eliminate the need for a separate femoral trial component, reducing the cost and complexity of surgery. With the planar resection profile, shims or skid-like inserts that correlate to the distal-posterior condyles of the final insert may be attached to the distal femur after the preliminary bone resection to facilitate intraoperative trialing. The method and related components may also provide the ability of a surgeon to perform iterative intraoperative kinematic analysis and gap balancing, providing the surgeon the ability to perform necessary ligament and/or other soft tissue releases and fine tune the final implant positions based on data acquired during the surgery.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: Embodiments of the invention include devices and methods for implanting arthroplasty devices. Some embodiments include designs that allow for use of x-ray images as the only images used to fully and accurately preoperatively and intraoperatively size and align arthroplasty device components and prepare all necessary tissue.

Abstract: A surgical template system for use in working on a bone comprises: a tool guide block comprising at least one guide aperture for receiving and guiding a tool to work on a bone; locating means comprising a plurality of locating members, each member having a respective end surface for positioning against a surface of the bone; and attachment means for non-adjustably attaching the tool guide block to the locating means such that, when attached, the member end surfaces are secured in fixed position with, respect to each other, for engaging different respective portions of the surface of the bone, and the at least one guide aperture is secured in a fixed position with respect to the end surfaces. Corresponding methods of manufacturing a surgical template system, methods of manufacturing locating means for a surgical template system, methods of fitting a prosthesis to a bone, surgical methods, and surgical apparatus are described.

Abstract: A percutaneous metatarsal fixation guide, including methods of use, is provided. The percutaneous metatarsal fixation guide includes a means for aligning a drill guide bearing a drill sleeve with the central longitudinal axis of a fractured metatarsal, metacarpal, or similar bone. Precise radiographic alignment of the drill sleeve with the long axis of the fractured bone facilitates accurate placement of fixation hardware across the fracture site, allowing for healing in alignment. The fixation bearing two corresponding index wheels is rigidly mounted to a tarsal bone via a temporary threaded K-wire, wherein an index marking on a second index wheel coupled to a drill sleeve may be positioned to correspond with an index marking on first index wheel coupled to an alignment guide, such that the drill sleeve is aligned with the fractured metatarsal. This allows precise placement of fixation hardware, compared to using a conventional “free-hand” technique.

Abstract: A method for creating a custom-fit guide for us in precision application such as orthopedic surgeries. Scanning technology is used to non-invasively create a 3D object of a targeted area. A guide is virtually added to the targeted area and later isolated and used as input to a 3D printer to create a physical guide for use in the procedure.

Abstract: Embodiments of the invention include a multi-lumen catheter for extracting or aspirating a blood clot or thrombus from arterial or veinous sites. Other embodiments are also included herein.

Abstract: A specimen retrieval system for easier tissue removal during endoscopic surgery. The devices include a specimen tube with a main tube, and a mechanism for pulling and everting the distal end of the tube into the tube, or a side channel provided within the tube. The mechanism may include a tether fixed to the distal edge of the tube, or a grasper operable to grasp the distal edge of the tube.

Abstract: In some examples, a medical device includes a flexible elongate member configured for navigation through vasculature of a patient to a target treatment site. A distal portion of the elongate member including a first balloon portion that is inflatable to an expanded state, a second balloon portion that is inflatable to an expanded state, and a cavitation generator. When the balloon portions are in their expanded states within the vasculature, a cavity is defined between the elongate member and the target treatment site and exterior to the first and second balloon portions. The cavitation generator is configured to deliver energy to a fluid within the cavity to cause the fluid to undergo cavitation to generate a pressure pulse wave within the fluid.

Abstract: Apparatus and method for improved cavitation-induced drug delivery is disclosed. In one embodiment, a method for delivering a treatment composition to a target tissue using ultrasound includes: directing ultrasound waveforms toward the target tissue of a patient; generating ultrasound shock fronts at the target tissue of a patient; generating a cavitation inside the target tissue of a patient by the ultrasound shock front; and delivering the treatment composition to the patient. Absorption of the treatment composition by the target tissue is increased by the cavitation inside the target tissue. In some embodiments, the treatment composition may be delivered within a time period of +/?1 week from generating the cavitation.

Abstract: Mechanical thrombectomy apparatuses that may be configured to prevent or reduce jamming (e.g., “anti-jamming” thrombectomy devices), grab clot, and/or macerate the thrombus, e.g., clot, being removed. These mechanical thrombectomy apparatuses may include a tractor comprising a flexible tube of material that inverts as it rolls over itself while being drawn into a catheter in a conveyor-like motion. In particular, described herein are mechanical thrombectomy apparatuses having tractors selectably extendable projections that may aid in grabbing and/or macerating a clot. Also described herein are seesawing tractors for mechanical thrombectomy apparatuses.

Abstract: A dilation catheter device and system for dilating an opening in a paranasal sinus and/or other passageways within the ear, nose or throat is disclosed. A dilation catheter device and system is constructed in a manner that facilitates ease of use by the operator and, in at least some cases, allows the dilation procedure to be performed by a single operator. Additionally, the dilation catheter device and system may be useable in conjunction with an endoscope and/or a fluoroscope to provide for easy manipulation and positioning of the devices and real time visualization of the entire procedure or selected portions thereof. In some embodiments, shaft markers are disposed on a shaft of the dilation catheter and have a light color to contrast with a dark color of the dilation catheter shaft. The high contrast between the markers and catheter shaft allows for easy viewing of the markers in low light and operation conditions.

Abstract: In a treatment instrument, one of a pair of jaws is supported by a supporter while being pivot able around the supporter with respect to the supporter. A drive member moves along a longitudinal axis so that the pair of the jaws are closed with respect to each other, thereby applying an axial force onto an elongated member from the drive member by way of the one of the jaws and the supporter in a direction along the longitudinal axis. A contact surface of the elongated member abuts on a housing when the elongated member moves with respect to the housing under the axial force, thereby suppressing rotation of the elongated member around the longitudinal axis with respect to the housing.

Abstract: The disclosure provides a surgical apparatus comprising: a steerable member that is bendable and comprises a plurality of bending segments with channels therein; and a plurality of bending actuation wires that are arranged to pass through the steerable member and cause the steerable member to bend, the steerable member comprising at least one outwardly opening lumen through which the bending actuation wires pass.

Abstract: A treatment tool includes a housing, a sheath rotatable around a predetermined axis of rotation with respect to the housing. An end effector is disposed on a distal-end portion of the sheath and rotatable in unison with the sheath around the axis of rotation. A locking member for restraining rotation of the sheath with respect to the housing by engaging the sheath. A manipulating member is mounted on the housing and moves with respect to the housing for causing the locking member and the sheath to switch between engaging and disengaging positions.

Abstract: A surgical tool that has a pair of transmissions coupled to one another to effect driving of a cutting tool in both an oscillating manner and a reciprocating manner. The transmissions are driven by a motor coupled to one of the transmissions.

Abstract: A catheter for insertion into vasculature of a patient to a target area in the vasculature includes a hollow inner shaft, a non-occluding self-expandable scaffold coupled to the distal end of the inner shaft and disposed at the distal end of the inner shaft, and a hollow outer shaft. The outer shaft is slidable over the inner shaft and scaffold such that the scaffold is in a non-expanded state when the outer shaft is around the scaffold. The outer shaft has a state where the distal end of the outer shaft remains near the target area without the inner shaft and the scaffold being within the outer shaft. The inner shaft and the scaffold are removable through the proximal end of the outer shaft while the distal end of the outer shaft remains near the target area.

Abstract: A scalpel handle sheath includes a body defining a first end and an arm adjacent the first end, the flexible arm having a first boss extending inwardly therefrom and a second boss extending outwardly from the arm. The scalpel handle sheath also includes a shield coupled with the body and slideable between a retracted position and a removal position. The shield defines an edge applying an inward force on the second boss during movement of the shield from the extended position to the removal position and a removal flange extending within the shield and passing the first end of the body during movement of the shield into the removal position.

Abstract: A differential dissecting instrument for differentially dissecting complex tissue is disclosed. The differential dissecting instrument comprises a handle and an elongate member having a first end and a second end, wherein the first end is connected to the handle. The differential dissecting instrument comprises a differential dissecting member configured to be rotatably attached to the second end and further comprises at least one tissue engaging surface. The differential dissecting instrument comprises a mechanism configured to mechanically rotate the differential dissecting member around an axis of rotation, thereby causing the at least one tissue engaging surface to move in at least one direction against the complex tissue. The at least one tissue engaging surface is configured to selectively engage the complex tissue such that the at least one tissue engaging surface disrupts at least one soft tissue in the complex tissue, but does not disrupt firm tissue in the complex tissue.

Abstract: A surgical hand piece has a source of ultrasonic energy connected to a one-piece member that transmits the ultrasonic energy. A distal end of the member is a surgical work tip.

Abstract: A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either within the brain. Once positioned at a desired location, the obturator is removed, leaving a distal end of the outer sheath adjacent an area of interest, and creating a working corridor. Interrogation of the area of interest may be performed to evaluate a disorder and/or abnormality, as well as evaluate treatment regimes. Interventional devices may also be introduced to the area of interest, as well as a variety of treatments.

Abstract: An access device for surgical procedures includes an end cap having a rigid body with a flexible support sealingly mounted to the rigid body with at least one separate access port for accommodating introduction of individual surgical instruments into a body of a patient. The at least one access port is sealingly attached to the flexible support and extend in a proximal direction therefrom. The flexible support is of a material more flexible than those of the rigid body and the at least one access port to provide for relative angular movement of the at least one access port to provide flexibility for positioning surgical instruments introduced through the at least one access port.

Abstract: A medical device for transcutaneously inserting an insertable element into a body tissue is disclosed. The medical device includes an insertable element and an insertion cannula for subcutaneously inserting the insertable element. The insertable element includes an in vivo distal end for subcutaneous insertion and an ex vivo proximal end. The insertion cannula has a lumen configured to receive the insertable element that is fully or partially enclosed by a wall of the insertion cannula. The wall comprises at least one shape memory alloy wherein the insertion cannula is stored in a first shape configuration and is configured to be transformable into a second shape configuration for insertion.

Abstract: An access device for surgical procedures includes a multiport end cap having a rigid body with a flexible support sealingly mounted to the rigid body with a plurality of separate access ports for accommodating introduction of individual surgical instruments into a body of a patient. At least one of the access ports is sealingly attached to the flexible support and extends in a proximal direction therefrom. The flexible support is of a material more flexible than those of the rigid body and access ports to provide for relative angular movement of at least one of the access ports to provide flexibility for positioning surgical instruments introduced through the access ports. The flexible support can include at least one flexible bellow.

Abstract: A cochlear implant insertion-assisting device includes a tubular member configured to hold a cochlear implant. The tubular member includes a cut extending in a longitudinal direction. The cochlear implant insertion-assisting device can selectively switch between a first state in which the cochlear implant is held and a second state in which the cochlear implant can be released.

Abstract: A nasal valve implant delivery system includes a delivery tool having a handle and a needle extending distally therefrom and configured to hold an implant therein. When loaded in the needle, the implant proximally abuts or is disposed adjacent to a pusher member disposed partially within the needle. A light source disposed within the delivery tool is coupled to an optical fiber carried within a lumen of the pusher member. The delivery tool includes a moveable needle shuttle disposed in the handle that is coupled to the needle. An actuator disposed in the handle is configured to releaseably engage with the moveable needle shuttle, wherein the needle shuttle is coupled to one or more springs configured to apply a proximal tensioning force on the needle shuttle, wherein actuation of the actuator retracts the needle proximally into the handle and releases the implant.

Abstract: A needleless transseptal device assembly, and associated methods, for accessing the left atrium of a human heart includes a tubular body sized to navigate vasculature, and a dilator having a proximal end and a distal end. The dilator is substantially housed and axially movable within the tubular body. The assembly further includes a guidewire that is substantially housed and axially movable within the dilator. The guidewire includes a flexible proximal section and a flexible distal section, and the flexible distal section has a distal end with rotatable, septal tissue cutting elements. The distal end may be configured with a blunt shape. Further, the tubular body and the dilator may be arranged in a steerable configuration. A torquing member may also be coupled to the proximal section of the guidewire to assist in the rotational movement of the septal tissue cutting elements.

Abstract: In one aspect, a pen needle assembly is provided herein which includes a hub, and a needle fixed to the hub, the needle having proximal and distal ends with a lumen extending therebetween. The needle extends distally from the hub to define an exposed length between the distal end of the needle and the hub in the range of about 5.0 to 9.0 mm. The hub defines a post formed about the needle, the post having a distally-facing first skin engaging surface. The exposed length of the needle extends distally from the first skin engaging surface. The hub also defines a distally-facing second skin engaging surface which at least partially circumscribes the first skin engaging surface. The second skin engaging surface being located proximally of the first skin engaging surface. Advantageously, a pen needle assembly is provided having two skin engaging surfaces which provide stability in achieving subcutaneous injections.