Abstract: Disclosed are embodiments of a removable tip device, which include a bone penetration feature at a distal end and a securing feature that allows the removable tip device to be removably secured to a distal end of various embodiments of a bone coring device. Some embodiments of the removable tip device include features that assist in transmitting torsional loads from the bone coring device to the bone removal feature. In addition, some embodiments of the removable tip device include a protective element that is configured to provide a protective surface for a distal feature of the bone coring device.

Abstract: A device for manipulating a body part, comprises: a) an elongated guide instrument provided with a tip suitable to be positioned in close juxtaposition with a tissue at a desired location of the said body part; and b) a suction channel terminating in or near said tip.

Abstract: The present disclosure relates to a method and a device for treating heart failure by normalizing elevated blood pressure in the left and right atria of a heart of a mammal. The present disclosure includes methods for creating and maintaining an opening in the atrial septum. Tools for making an opening and enlarging the opening are also disclosed. Use of the techniques and tools described herein prolongs the patency of an intra-atrial pressure relief opening.

Abstract: A minimally invasive heart stabilizer includes a guide tube, a revolute joint, a stabilizing end-effector, and a linkage. The guide tube is sized to allow insertion through an endoscopic cannula. The revolute joint is coupled to a distal end of the guide tube. The stabilizing end-effector is coupled to the revolute joint. The linkage has a distal end and a proximal end. The distal end is pivotally connected to the end-effector. The stabilizing end-effector includes two tissue engaging members in parallel alignment with one another. The two tissue engaging members are joined via an arrangement of links.

Abstract: An apron formed from a gel-infused section of foam with a generally pentagonal shape approximately one inch thick with at least one surface exhibiting a coefficient of friction sufficient to releasably adhere the foam to a portion of human anatomy. The section of foam is suspended between four straps extending beyond the periphery of the foam member, each strap defining a length of at least thirty inches and including longitudinally opposing ends relative to the foam member with hook and loop material that permit the releasable attachment of the straps to a proximal mounting substrate, such as the railings of a conventional surgical bed. A method of manipulating a portion of the human anatomy with such an apron is also included.

Abstract: Disclosed herein are devices and methods for introducing a plurality of instruments to a target site through a working channel. The working channel can include a surface adapted to guide one or more instruments into select positions. The working channel can be defined by a portion of a guide tube or tip that may be coupled with an endoscope.

Abstract: Apparatus for securing a first object to a second object, said apparatus comprising: an anchor body which is longitudinally and laterally deformable; and a working suture which is connected to said anchor body; said anchor body and said working suture being configured such that, when at least one of said anchor body and said working suture receives a repair suture which is connected to the first object, and said anchor body is thereafter disposed in a hole in the second object, applying tension to said working suture secures said anchor body to the second object and secures said repair suture to said anchor body without requiring that a knot be tied after said anchor body is disposed in the hole in the second object.

Abstract: A surgical filament snare assembly including an anchor capable of being fixated in bone and having a filament engagement feature. A first filament has a noose on a first portion of at least a first limb and has a second portion connected to the filament engagement feature of the anchor. Preferably, at least one free filament limb, which in some embodiments is a length of the first filament and in other embodiments is a second filament, is capable of being passed through tissue to be repaired and has at least one end passable through the noose to enable incremental tensioning of the tissue after the anchor is fixated in bone. The noose strangulates the free filament limb when tension is applied to at least one of the free filament limb and the noose.

Abstract: A suture anchoring device for fixing a soft tissue to a bone tissue is disclosed that enables the exchange of sutures between anchors after implantation. The suture anchoring device may include a body that is inserted into the bone tissue, a suture exchange fitting situation within a passage formed within the body, and one or more pre-loaded sutures looped through the suture exchange fitting and projecting proximally from a proximal opening formed in the body. Surgical kits and surgical methods for performing various repair procedures using one or more suture anchoring device are also disclosed.

Abstract: An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

Abstract: An apparatus and method for minimally invasive suturing is disclosed. A suturing device for minimally invasive suturing includes proximal section having a proximal end, a distal end, and a longitudinal axis therebetween; a suture head assembly extending from the distal end of the proximal section; a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis approximately perpendicular to a longitudinal axis of the proximal section, wherein the pointed end of the suturing needle is positioned within the suture head assembly prior to and after rotation of the suturing needle; and an actuator extending from the proximal end of the proximal section to actuate a drive mechanism having a needle driver for engaging and rotating the suturing needle.

Abstract: Devices, systems, and methods are provided for managing suture filaments when performing soft tissue repair. One exemplary embodiment of a surgical suture management device is in the form of a suture loop management card. The card can generally be configured to hold open a collapsible loop of suture until a force applied to the loop is greater than a threshold tension. The card can include a number of different features that help to keep the loop open until the threshold tension is achieved, including features designed to prevent the filament from being mistakenly offloaded. The card can be configured to be removably inserted into a handle of an inserter tool for use as a surgical tissue repair system. Other devices, systems, and methods for performing soft tissue repair are also provided.

Abstract: A tissue anchor includes an elongated body having a proximal end and a distal end, and a barb mounted to the elongated body adjacent the proximal end for movement between a retracted position and an extended position in which the barb projects outwardly from the elongated body. An anchoring system includes an implantable device with a tissue contacting surface facing in a proximal direction, the tissue anchor having its distal end engageable with the implantable device and its proximal end adapted to project proximally beyond the tissue contacting surface to grip a living tissue, and a second resilient element that is mounted between the distal end of the anchor and the implantable device, the second resilient element being adapted to bias the anchor distally relative to the implantable device. Tooling and methods of insertion and removal are provided.

Abstract: An apparatus comprises a shaft, an end effector, an articulation joint, and an articulation drive assembly. The shaft has a longitudinal axis. The end effector is operable to staple tissue. The articulation joint couples the shaft with the end effector. The end effector is pivotable at the articulation joint to selectively deflect the end effector away from the longitudinal axis of the shaft. The articulation drive assembly is operable to pivot the end effector at the articulation joint. The articulation drive assembly comprises a first link and a second link. The first link is longitudinally translatable relative to the shaft assembly. The distal end of the first link is pivotably coupled with the proximal end of the second link. The distal end of the second link is pivotably coupled with the end effector. The articulation drive assembly articulates the end effector in response to longitudinal translation of the first link.

Abstract: An applicator instrument for dispensing surgical fasteners includes a handle and an articulating shaft extending from the distal end of the handle. The articulating shaft includes a proximal shaft section, a distal shaft section, and an articulating joint. An articulation control element is coupled with the proximal shaft section for articulating the distal shaft section relative to the proximal shaft section via the articulating joint. The applicator instrument includes an incompressible member interconnecting the proximal and distal shaft sections that maintains a fixed distance between the distal end face of the distal shaft section and the distal end of the handle as the articulating shaft moves between a straight configuration and an articulated configuration to ensure a consistent firing stroke.

Abstract: Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.

Abstract: A surgical instrument has a staple cartridge housing a plurality of staples and an anvil configured to capture tissue therebetween. The surgical instrument also has a firing assembly configured to deploy the plurality of staples into the captured tissue during a firing sequence, and a handle that includes an electric motor operably coupled to the firing assembly, wherein the electric motor is configured to motivate the firing assembly to deploy the plurality of staples into the captured tissue during the firing sequence, and a power pack. The power pack includes rechargeable battery cells configured to power the electric motor, at least one battery-cell health indicator, and an electronic control circuit configured to assess whether a subset of rechargeable battery cells is damaged during the firing sequence based on at least one measurement performed by the at least one battery-cell health indicator.

Abstract: A surgical apparatus includes a handle, an elongate member and a switch actuator. The switch actuator includes an activation link and a switch plunger coupled to the activation link. An electric switch is mounted to the elongate member. A rotatable lock member is mounted to the elongate member and adapted for rotational movement between an unlocked condition and a locked condition. The rotatable lock member includes an actuator stop dimensioned to operatively engage the switch actuator to prevent movement of the switch actuator from a first longitudinal position to a second longitudinal position when in the unlocked condition, and to permit movement of the switch actuator to the second longitudinal position when rotated to the locked condition such that the switch plunger activates the switch. A loading unit is releasably couplable to the rotatable lock member and is secured relative to the elongate member when the rotatable lock member is in the locked condition.

Abstract: Surgical stapling apparatus are disclosed including an anvil having a working surface with a shaped topography; and a staple cartridge, in juxtaposition with the anvil. The staple cartridge includes a working surface with shaped topography which is complementary to the shaped topography of the working surface of the shaped anvil. When the anvil and the staple cartridge are approximated with or toward one another, at least a portion of the working surface of the anvil cooperates with at least a portion of the working surface of the staple cartridge to enhance alignment of the staple cartridge and the anvil in at least one of a transverse and longitudinal direction.

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector including an elongate channel pivotally opposed by an anvil. A firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. A firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples.

Abstract: A device for creating a fistula between blood vessels operates in conjunction with a guidewire to locate and position itself so that it straddles both vessels and is able to draw them together. A fixing agent is released either from within the device or from an external needle, or both, into the procedural site. The fixing agent functions to hold the relative position of the two vessels, to seal the surrounding tissue so that any leaks that do occur don't spread into the tissue to create a hematoma, and to limit expansion of the fistula. After the vessels are in close proximity to each other and the fixing agent is applied, the device of the invention employs a cutting mechanism which opens a portal between the two vessels.

Abstract: The device for sutureless repair of an injured (severed) nerve includes a securement band connected by a transparent membrane to form a loop. The band includes two opposing approximation claws that extend into the region of the transparent membrane. An aperture in the transparent membrane is covered by an enclosure having an inlet nozzle and an outlet nozzle. An elongate member having a blade on its bottom end extends through an aperture in the top of the enclosure. The band is strapped around the patient's limb with the transparent membrane adhesively secured over the incision, the severed nerve ends are irrigated with saline and air is evacuated in the process. The blade incises the severed ends of the nerve to expose fresh nerve tissue under vacuum, and the severed ends are approximated. The device is left in place for the severed nerve ends to reunite.

Abstract: Closure devices and methods are provided for ligating tissue, such as the left atrial appendage. Generally, the closure devices include an elongate body, a snare loop assembly comprising a snare and a suture loop, and a shuttle connected to the snare and releasably coupled to the elongate body and retractable therein. In some variations, the shuttle may be configured to fit into the lumen. In other variations, a handle may be attached to the elongate body, and the handle may comprise a track and a snare control coupled to the track. The handle may be configured to release the shuttle from the elongate body and allow movement of the snare control along the track to retract the snare loop and the shuttle into a lumen of the elongate body.

Abstract: A heart treatment device includes an annuloplasty ring for restoring function to a mitral valve, an occluder configured and arranged for implantation within a left atrial appendage and a connector interconnecting the annuloplasty ring and the occluder.

Abstract: A surgical clip applier is provided including a housing, at least one handle pivotably connected to the housing, an outer support channel extending distally from the housing, a drive channel slidably disposed within the outer support channel, a jaw assembly including a first and second pair of jaws extending from an end of the outer support channel in a parallel configuration, and an integrated cutting mechanism disposed within a gap defined between the first and second pair of jaws. The jaw assembly is capable of effectuating formation of a pair of clips disposed within a respective first and second pair of jaws in response to movement of the at least one handle and the cutting mechanism is independently operable of the at least one handle. At least one jaw member of each of the pair or jaws includes a curved distal end. A method of operating same is also provided.

Abstract: Methods and devices 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: A rongeur-type surgical device incorporating a powered rotary cutting tool having a protective distal foot plate portion which protects against injuring non-target tissue enabling the rapid and safe removal of specifically-targeted bone, cartilage, and soft tissue.

Abstract: Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient's positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Abstract: The invention relates to devices and methods for creating a curvilinear cavity within a vertebral body or other body structure. An example method of forming a void in bony structure includes accessing a bony structure with a cannula, inserting a distal end of a combined drill and reaming device through the cannula and into the bony structure, manipulating the distal end of the combined drill and reaming device to create a void in the bony structure, and removing the distal end of the combined drill and reaming device from the cannula.

Abstract: Systems and methods to provide patient-specific cutting blocks that allow for bone resurfacing procedures, such as milling or burring, with simplified devices. A computer assisted surgical cutting block is produced having a surface region that matches with the surface region of a patient's bone to be altered. A cutting tool may be provided having a contoured bone mating surface and a contoured and patient-specific shaped cutting guide surface located in a plane above the bone mating surface. One or more channels are provided in the cutting block, and as the surgeon moves the cutting tool (a milling or burring, for example) in the channels, the tool cuts the bone both laterally along the surface of the bone and vertically into the bone according to the cutting guide surface and other preselected surface features of the cutting block.

Abstract: An orthopedic reamer cutting tool is disclosed that incorporates a second material such as graphene having an increased coefficient of thermal conductivity to remove heat generated at the tissue cutting surface during use. The reamer is constructed having a hemispherical cutting shell that extends from an equatorial base to an apex at a distal end. A plurality of cutting teeth, each having a tissue cutting surface, extend from the exterior of the cutting shell. A reamer driver interface may be positioned spanning the diameter of the reamer base. The second material, having increased thermal conductivity, may be applied to the interior and/or exterior shell surfaces. In addition, the second material may be incorporated within the shell or the driver interface.

Abstract: Disclosed herein is a steerable and curvable drill that can be used for various applications including vertebroplasty. The drill can include an elongate, tubular body, having a proximal end, a distal end, and a central lumen extending therethrough; a deflectable zone on the distal end of the tubular body including one or more laser cuts, deflectable through an angular range; an insertable wire insertable into at least a portion of the central lumen of the elongate, tubular body; a handle on the proximal end of the tubular body; a deflection control on the handle; a drill control on the handle; a drive shaft within the elongate tubular body having a proximal end and a distal end; and a boring element on the distal end of the device for creating a cavity within bone. The boring element can be operably connected to the distal end of the drive shaft via a crimping mechanism. Systems and methods involving the drill are also disclosed.

Abstract: A method of fusing a sacroiliac joint including: a) approaching a posterior aspect of a sacroiliac joint space with a joint implant including a body extending a length between a distal end and a proximal end; and b) delivering the joint implant into the sacroiliac joint space such that the joint implant passes through an access region defined between a posterior superior iliac spine and a posterior inferior iliac spine, the joint implant being oriented in the sacroiliac joint space such that a portion of the body of the joint implant is positioned within a joint plane of the sacroiliac joint space, and such that the distal end of the joint implant is positioned posteriorly of an anterior boundary of the sacroiliac joint space.

Abstract: A catheter includes a tissue-removing element and a tissue-containment chamber configured to receive tissue removed by the tissue-removing element. The tissue-containment chamber has a tissue-removing opening for use in removing tissue from the chamber. A closure component is associated with the tissue-removing opening for selectively opening and closing the opening.

Abstract: A clot retrieval device (9501) for removing clot from a blood vessel comprises an inner elongate body (9503) and an outer elongate body (9504) at least partially overlying the inner elongate body (9503). The device also comprises an elongate member or shaft (9502) having a proximal end which extends exterior of a patient so that a user can retrieve the stent-basket device and captured clot by retracting the shaft (9502). The outer elongate body (9504) and the inner elongate body (9503) are connected to the distal end of the shaft (9502) and are expandable relative to the shaft (9502) from a collapsed delivery configuration to an expanded deployed configuration. The outer elongate body (9504) is expandable relative to the inner elongate body (9503) to a radial extent which is greater than the radial extent of the inner body (9503) in the deployed configuration.

Abstract: A clot retrieval apparatus 1 comprises a clot engaging device 2 and a capture basket 3. The clot engaging device 2 has a collapsed delivery configuration and an expanded deployment configuration. The clot engaging device has a proximal end and a distal end and an elongate body between the proximal end and the distal end. The capture basket 3 has a collapsed delivery configuration and an expanded deployment configuration. The capture basket 3 has a proximal mouth which is open when the capture basket 3 is in the deployment configuration. The clot engaging device 2 is axially movable relative to the capture basket for capture of a clot.

Abstract: A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue.

Abstract: A laparoscopic instrument is placed into the abdomen without the creation of a skin incision. The laparoscopic instrument includes a shaft that does not exceed 1.6 mm in diameter. The shaft has a beveled end and is inserted into an abdomen similar to the placement of a needle, without use of a scalpel. Operating instruments are introduced into the abdomen through the umbilical port using a docking device, and are then docked to the beveled end of the shaft after the shaft is introduced through the abdomen. Multiple types of operating instruments can be placed on the beveled end of the shaft during the surgical procedure. Each operating instrument is docked with a holster during introduction into and withdrawal from the umbilical port and is removed from the holster only when in use. When removed from the holster it is locked to the shaft and cannot be dropped.

Abstract: Devices and methods for tissue removal are disclosed herein, including those in which a powered rotary tool actuates a cutting blade to sever tissue and drives an auger to transport the severed tissue proximally through the device. The severed tissue can be collected in an on-board collection chamber for subsequent use as graft material or otherwise (e.g., assay, analysis, post-processing, etc.). Devices of the type disclosed herein can reduce or eliminate the need to move the device in and out of the surgical site, reduce user input force, and provide improved ergonomics and increased user focus.

Abstract: Device and method for puncturing blood vessels while using fluoroscopy. The disclosed device enables improved needle orientation control and avoids direct exposure of the clinician's hand to X-ray during the puncturing procedure.

Abstract: A tissue-removing catheter for removing tissue from a body lumen includes a tissue-removing element. The tissue-removing element may be coupled to a first longitudinal body portion of the catheter body. The first longitudinal body portion may be rotatable along its length and relative to a second longitudinal body portion to adjust the angular position of the first longitudinal body portion relative to the second longitudinal body portion. An angular-positioning mechanism may be operatively connected to the tissue-removing element for rotating the tissue-removing element relative to the second longitudinal body portion about a rotational axis to adjust an angular tissue-removing position of the tissue-removing element, relative to the longitudinal axis of the body lumen, from a first angular tissue-removing position to a second angular tissue-removing position offset from the first angular tissue-removing position.

Abstract: A surgical scalpel is presented which combines the attributes of cost-effectiveness in design while being ambidextrous and autoclavable. The design of the device affords left handed or right handed medical personnel with the feel, weight and balance of the original metal unguarded scalpel, while maintaining safety through the shielding of the blade during non-use and the ability to dispose of the blade in a safe controlled manner without having to place one's hands near the unguarded sharp. Surgeons of either dexterity are able to learn and operate using similar techniques and instruments heretofore not available to them. No longer must a left handed surgeon be forced into the right handed world to perform surgery. The device is designed to use existing styles of blades currently available without needing costly inventories of specially created blades for the multitude of other such devices on the market.

Abstract: A cannula cap is disclosed. A cannula cap according to some embodiments of the invention includes an instrument guide attachment; a cannula attachment; and a seal captured between the instrument guide attachment and the cannula attachment. In some embodiments, a cannula cap can include a lid; a locking ring; a base; and a cannula seal captured between the lid and the base.

Abstract: A medical tube is disclosed, which is configured to have an elongated implant inserted in the medical tube. The medical tube includes a tube having a proximal end opening where the tube is open at a proximal end of the tube. The tube can include a bent region where an intermediate portion in the longitudinal direction of the tube is bent and where a bent state is maintained, and a connection portion which is provided near the proximal end opening and to which a puncture needle having a sharp needle tip at a distal end of the puncture needle is connected from a needle tip side.

Abstract: The present invention comprises systems, methods and devices for the delivery of compositions for occluding or of means for opening conduits. The implantable occlusive material may be delivered pre-formed or in situ cured and, may be a resorbable material that supports tissue ingrowth that eventually replaces the material leaving little or no original material in place. The delivery system is positioned to allow for placement of the occlusive material into the body conduit. Use of delivery systems, methods and devices for re-opening an occluded body conduit are also included.

Abstract: An assembly includes a catheter that has an insemination lumen for injecting sperm into a uterus. The insemination lumen includes two branches (sub-lumens), one directed toward a left ostium and the other directed to a right ostium of fallopian tubes.

Abstract: Systems and methods are described that may provide an efficient way to retrieve microneedles from tissue. For example, magnetic material may be incorporated into one or more microneedles. The microneedles may be delivered to a region of tissue via a backing material, such as a transdermal patch. The microneedles may provide therapeutic drug delivery and/or diagnostic information about the tissue or, more generally, the body containing the tissue. To retrieve the microneedles, a retrieval magnet may apply a magnetic field to the region of tissue where the microneedles were delivered. The magnetic field may attract the microneedles to aid in extraction of the microneedles from the tissue. In some embodiments, an excitation light source and light sensor may be included in the system and method to determine whether the microneedles were retrieved from the tissue.

Abstract: An implantable orthopedic device. The device includes: a proximal anchor, configured to be implanted inside a first metatarsal; the anchor having a collar larger than the opening in a metatarsal in which the proximal anchor is implanted; the collar preventing cable to bone contact; a distal anchor, configured to be implanted inside a second metatarsal, adjacent to the first metatarsal; the distal anchor having a male thread, a nut threadable onto the male thread of the distal anchor, and a cord mechanically interconnecting the proximal and distal anchors. A shock absorber includes an elongate housing threadedly positioned within the anchor; the shock absorber accommodates a cord holder mechanically connected to the housing via a damping member, the cord holder is freely rotatable within the housing to prevent the cord from twist kinking when the housing is rotated to adjust a tension force.

Abstract: Provided is a novel rod reducing device including a screw jack mechanism that is moveably engaged with an elongated grasping fork assembly, the screw jack mechanism having an elongated threaded portion, the elongated threaded portion being connected at its most distal end to a rod contact member, which is positioned in sliding circumferential contact with each of the two opposing elongated grasping members and the most proximal end of the elongated threaded portion terminating in a controlling member, which can be activated in a measured and controlled manner. A method of using the device is also provided.

Abstract: A spinal implant comprises a fastener including a head and defining a longitudinal axis. A member is configured for disposal of the head and defines an inner groove configured for disposal of a band that is engageable with the head to connect the fastener and the member. The member is moveable relative to the longitudinal axis. The member defines a passageway configured for disposal of a tether. Systems, spinal constructs, surgical instruments and methods are disclosed.