Abstract: A treatment instrument apparatus, which is an endoscopic treatment instrument, includes a sheath having an opening in a distal end; an actuator placed in the sheath and driven by a gas supplied via a tube; a treatment unit connected with the actuator by a wire and placed on a distal end side of the opening of the sheath; and an opening and closing switch, which is an operation portion used for an operation of supplying the gas into the sheath and supplying the gas to the actuator.

Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: An endoscopic surgical blade is disclosed. The blade is of a low-profile design, having a downward angled cutting surface that is radiused at its upper end. The blade is part of an endoscopic knife assembly which also contains a knife tube. The endoscopic knife assembly is for use in endoscopic surgery by insertion of the assembly through a slotted cannula. The knife tube is hollow and allows the insertion of an endoscope for viewing of the surgical procedure. A method for a performing an operative procedure on a target tissue in a subject using an endoscopic knife assembly having a low-profile, downward angled blade is also described.

Abstract: An ultrasonic instrument includes a body and a shaft assembly extending distally from the body. The shaft assembly includes an acoustic waveguide. The instrument further includes an end effector including an ultrasonic blade. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The ultrasonic blade is defined by a solid core shaft of a material or combination of materials. At least a portion of the acoustic waveguide comprises a hollow tubular member coupled with the solid core shaft.

Abstract: A thrombectomy system may include an elongate shaft that defines a high pressure lumen and a low pressure lumen. The high pressure lumen may terminate near an end of the low pressure lumen. An expandable capture basket may be disposed near the end of the low pressure lumen. A thrombectomy apparatus may include an elongate shaft, an evacuation lumen extending within the elongate shaft and a high pressure lumen extending within the elongate shaft. A capture apparatus may be disposed within a wire lumen that extends within the elongate shaft such that the capture apparatus extends distally from the wire lumen.

Abstract: A thrombectomy catheter includes a catheter body having a catheter lumen. An outflow orifice is positioned along a catheter perimeter. A fluid jet emanator communicates with a high pressure tube. The fluid jet emanator includes at least one jet orifice for directing a fluid jet from the fluid jet emanator through the catheter lumen toward the outflow orifice. The fluid jet emanator provides a jet stream from the catheter body through the outflow orifice. The jet stream includes first and second stream portions. An entrainment fluid flow circuit includes at least the first stream portion, and the entrainment fluid flow circuit entrains particulate and macerates the particulate therein. An exhaust fluid flow path includes the second stream portion, and the exhaust fluid flow path draws entrained particulate from the entrainment fluid flow circuit at a location exterior to the catheter body and directs it toward the catheter proximal portion.

Abstract: A surgical cutting tool adapted to be rotatably driven by a motor. The surgical cutting tool includes an elongated shaft defining intermediate and coupling portions. A shape of the intermediate portion defines a primary central axis of the shaft. The coupling portion includes a tang having a tapered cylindrical shape that defines a drive axis. The drive axis is slanted with respect to the primary central axis. When coupled to the motor of a powered handpiece, the tang transmits an input or drive force from the motor to the intermediate portion as a torque about the primary central axis. In some embodiments, the drive axis extends through a centroid of first and second spaced apart cross-sectional planes of the tang, the first and second planes each being perpendicular to the primary central axis.

Abstract: A tool introducer is configured for introduction in an elongated body including a straight tube, wherein the tube encloses a tube lumen opened at its distal end with a tube opening. The tool introducer includes locking means to selectively lock or unlock an interchangeable surgical tool to the tube from displacing axially and/or rotationally in the tube lumen, the locking means being configured such that, at the locking, a tool connector of the tool projects towards the tube opening and is distanced therefrom by at least 3 cm. A method includes positioning the surgical tool introducer such that a distal portion thereof projects in a body cavity, manipulating and/or extending the tool introducer to reach and engage an elongated shaft introduced percutaneously into the body cavity; and inserting the elongated shaft into the tube lumen via the tube opening and connecting the tool to the elongated shaft.

Abstract: An explantation accessory includes a catheter with a steerable head carrying a tubular receptacle adapted to accommodate the proximal portion of the capsule. The explantation accessory further includes a lasso having a flexible wire extending along the catheter to and forming at its distal end a deformable loop. One end of the deformable loop is mobile so as to allow tightening of the loop under the effect of a traction exerted on the flexible wire along the catheter. The free end edge of the tubular receptacle comprises a protruding anterior portion, an axially recessed posterior portion with respect to the anterior portion and located diametrically opposite to the protruding anterior portion, and two beveled edges connecting the protruding anterior portion to the recessed posterior portion.

Abstract: An introducer for a medical lead, the introducer having an arcuate component for creating an arcuate path in a patient. When used to percutaneously implant a medical device such as a medical lead with electrodes, the implanted lead has an arcuate configuration. The implanted lead can be used to at least partially encircle or bracket a region of chronic pain and provide therapeutic electrical signals to the region.

Abstract: Methods and devices for separating an implanted object, such as a pacemaker lead, from tissue surrounding such object in a patient's vasculature system. Specifically, the surgical device includes a handle, an elongate sheath and a circular cutting blade that extends from the distal end of the sheath upon actuating the handle. The circular cutting blade is configured to engage the tissue surrounding an implanted lead and cut such tissue in a coring fashion as the surgical device translates along the length of the lead, thereby allowing the lead, as well as any tissue remaining attached to the lead, to enter the device's elongate shaft. The surgical device has a barrel cam cylinder in the handle assembly that imparts rotation of the blade and a separate cam mechanism in the tip of outer sheath assembly that imparts and controls the extension and retraction of the blade.

Abstract: The present invention relates to egg chambers for use in collection, inspection and selection of eggs for in vitro fertilization (IVF) procedures. The egg chamber, in use, provides an effectively closed and fluid filled system which minimizes the environmental changes that a harvested egg is exposed to, thus maximizing viability. The egg chamber comprises a vessel which can be made airtight, comprising at least one side wall, an upper wall and a lower wall, at least a portion of the upper wall being transparent and at least a portion of the lower wall being light permeable; a first inlet with a sealable port; a first outlet with a sealable port; a filter with a pore size appropriate for egg collection disposed within the vessel between the first inlet and the first outlet and configured to separate the vessel into a first internal chamber and a second internal chamber.

Abstract: A tool for use in fixing the position of an implanted item beneath skin, comprises: a main body, a channel in the main body, the channel defining at least two gripping interfaces for engagement with the skin and around the implanted item, wherein the interfaces are positioned such that, when engaged with the skin, the interfaces retain the implanted item in a known position relative to the engaged skin. Methods of using the tool are also described.

Abstract: Embodiments of the invention provide a fracture fixation device and method for treatment of a bone fracture. The fracture fixation device includes a main body having a recess formed therein, and a compression element is configured to be received in the recess. The compression element has a passage dimensioned to receive a fracture fixation pin. A compressive force is generated across the bone fracture upon the compression element receiving the fracture fixation pin to promote healing of the bone fracture. The fracture fixation device is an external fixator that provides adjustable aspects of compression, rotation, and length in a simple design that facilitates bone healing by compression.

Abstract: According to some embodiments, systems and methods for reshaping bone are provided. The systems may include an implant body, an actuator coupled to the implant body, a sensor configured to detect a parameter indicative of a biological condition, a transceiver, and a controller. The transceiver may be configured to transmit data associated with the parameter to an external remote control and receive instructions from the external remote control. Finally, the controller is configured to move the actuator in response to the instructions from the external remote control, wherein the actuator adjusts the implant body. The methods may include measuring a parameter indicative of a biological condition; transmitting data associated with the parameter from the implantable device to an external remote control; transmitting instructions from the external remote control to the implantable device; and actuating the bone growth device in response to the instructions from the external remote control.

Abstract: A vertebral support device (1) is disclosed, which in various embodiments comprises at least two osseous anchoring implants (2), each designed to be anchored to a vertebra, and at least one linking element (3) fixed to the osseous anchoring implants (2) by fasteners (20) that maintain a fixed angle between the longitudinal axis (L) of the linking element (3) passing through rigid elements (34) of the linking element (3) and the insertion axis (DV) of the implants (2). The linking element (3) includes at least one elastic dampening element (31) that that allows the implant-bearing vertebrae some freedom of movement. The dampening element (31) accommodates the stresses imposed on the linking element (3) during movement of the vertebrae and tends to return the support device (1) to its normal configuration.

Abstract: Laminoplasty plates are engageable to at least one portion of a divided lamina to maintain a desired spacing relative to the spinal canal. The laminoplasty plates include a spacer portion having a first end and a second end that spans a gap formed by at least one of a divided lamina portion. The laminoplasty plates can include a lamina engagement portion at one end for engagement with the divided lamina portion.

Abstract: A facet screw system and method includes an implant assembly having a screw with a removable head, a locking nut, and a collet. An insertion instrument is used to insert the screw, compress the facet joint, locks the implant, and breaks off the head of the screw providing a lower profile implant.

Abstract: A spinal treatment system includes a constraint device having an upper tether portion, a lower tether portion and a compliance member coupled therebetween. The upper tether portion is coupled with a superior spinous process of a spinal segment in a patient and the lower tether portion is coupled with an inferior spinous process or sacrum of the spinal segment. The length or tension in the constraint device is adjustable so that the construct of the tether portions and the compliance member provides a force resistant to flexion of the spinal segment. The system also includes a first prosthesis coupled with the spinal segment, wherein the constraint device modulates loads borne by the prosthesis or by tissue adjacent thereto.

Abstract: A method for manipulating a vertebra includes connecting a first bone anchor to a first vertebra, connecting a second bone anchor to a second bone anchor, positioning a spinal rod in a receiving member of the first bone anchor and in a receiving member of the second bone anchor, connecting a first instrument to the receiving member of the first bone anchor, and manipulating the first instrument to rotate first bone anchor and the first vertebra relative to the second vertebra.

Abstract: Orthopedic plating assemblies and methods for bone fixation that include an orthopedic plate and orthopedic anchors that can accommodate subsidence in the vertebral bodies as well as prevent the anchors from “backing out” of their installed position. The orthopedic anchors may be capable of rotating and translating with respect to the plate, and the plate may be able to translate after being fastened to the vertebral bodies.

Abstract: A plate for treating a bone includes a plate body extending along a longitudinal axis from a first end to a second end and being sized, shaped and contoured to be positioned along a desired surface of a bone. The plate also includes a slotted opening extending through the plate body and defined by a first portion sized and shaped to permit a head portion of a bone fixation element fixed to the bone to be passed therethrough and a second elongated portion extending along the longitudinal axis from the first portion in communication with the first portion, the second portion sized to prevent the head portion of the bone fixation element from being passed therethrough so that, when the head portion of the bone fixation element is received through the first portion, the plate is slidable relative thereto such that the second portion engages the head portion of the bone fixation element.

Abstract: A cervical spine plate attachment system includes a bracket and an alignment guide. The bracket is configured to mount to a cervical spine plate. The alignment guide includes a first connector proximate to a first end of the alignment guide, wherein the first connector is configured to attach to a first pin inserted into a first vertebra. The alignment guide also includes a second connector proximate to a second end of the alignment guide, wherein the second connector is configured to attach to a second pin inserted into a second vertebra. The alignment guide further includes a fastener configured to secure the alignment guide to the bracket such that the alignment guide is secured to the cervical spine plate.

Abstract: A method for providing a fractured bone with a bone cerclage according to an exemplary aspect of the present disclosure includes wrapping suture around bone a first time using a suture passer, wrapping the suture around bone a second time using a shuttling suture, and securing the suture to the bone.

Abstract: A fixing pin for orthopedic surgery is provided. The fixing pin for orthopedic surgery includes: an inner fixing pin inserted from one-side cortex of a bone to the opposite-side cortex thereof; an outer fixing pin including a first hole and a first screw portion formed to protrude from a front end thereof, the first hole being penetrated by the inner fixing pin so that front and rear ends of the inner fixing pin protrude, the outer fixing pin being inserted into only one-side cortex of the bone, and the inner fixing pin being fixed to the outer fixing pin; and a sleeve including a second hole and fixed to the outer fixing pin, the second hole being penetrated by the outer fixing pin so that front and rear ends of the outer fixing pin protrude. Therefore, according to the present disclosure, it is possible to perform internal fixation even after reposition of bone fracture has been performed using a fixing pin.

Abstract: Methods and apparatus for immobilizing a synovial joint, such as a sacroiliac (SI) joint are disclosed. In one form, a multipiece fixation device, such as a dowel, includes multiple expandable fasteners that are configured to fix adjacent bones of a synovial joint with respect to one another. The expandable fasteners include expansion portions that are expanded radially via insertion of another expandable fastener or an expansion device to fix the expandable fasteners to the bone. The fixation device may be configured to provide for compression or distraction of the bones of the synovial joint while at the same time stabilizing the joint.

Abstract: This invention relates to a transdiscal screw capable of following a non-linear trajectory. The screw assembly includes a first screw and second screw coupled at a poly-axial joint. The first screw and the second screw capable of rotating independently of each other. The screw can also include a third screw coupled to the second screw at a poly-axial joint such that the first screw, second screw and third screw can rotate independently of each other.

Abstract: A surgical system is provided that includes a body extending along a longitudinal axis. A first member is rotatably positioned within the body and includes a first threaded surface. A second member is positioned within the body and includes a second threaded surface that engages the first threaded surface. The second member is non-rotatable relative to the body. A third member is positioned within the first member. An inflatable bone tamp includes an outer shaft coupled to the body, a balloon coupled to the outer shaft and an inner shaft coupled to the third member and the balloon. The first member is rotatable relative to the body to translate the third member along the longitudinal axis to move the balloon from a first length to a second length. Kits and methods are disclosed.

Abstract: A system for augmenting a bone structure. A shape memory device includes a deflectable distal segment including temperature-dependent memory metal material. The shape memory device is slidably received within a guide cannula. The deflectable distal segment may include a substantially longitudinally straightened form, such as when subjected to a force from the guide cannula. The deflectable distal segment forms a first deflected shape having a first bend away from said straight longitudinal axis at a first elevated temperature greater than an initial temperature, and forms a second deflected shape having a second bend away from said straight longitudinal axis at a second elevated temperature greater than said first elevated temperature. The shape memory device may create voids within the bone structure with the deflectable distal segment at the first and/or second bends. Methods for positioning a shape memory device within a bone structure are also disclosed.

Abstract: Systems, devices, and methods are provided for a catheter device for use in a medical procedure wherein the interior of the catheter device expands to accommodate longitudinal expansion of the expandable member to compress cancellous bone.

Abstract: Instruments for applying tension to a securing device, such as a cable or wire, for securing bones in place and fastening implants, such as plates, to bones. In some forms, the tensioning instrument is configured with minimal parts for ease of manufacturing and allowing single use applications. The instrument may include a pretensioning mechanism for applying desired preload before connecting a cable to be tensioned to the instrument. The instrument may be sized and configured to remain attached to a tensioned cable while other cables are connected to a bone. In another form, the instrument may be expandable to remove any slack from the securing device and apply tension thereto.

Abstract: A treatment apparatus for treating a body tissue, the treatment apparatus having a drive circuit, an electric resistance pattern, a heat transfer plate, a temperature acquisition circuit, and a controller. The controller controlling the drive circuit to supply power to the electric resistance pattern based on a target temperature of the heat transfer plate and a temperature of the electric resistance pattern acquired by the temperature acquisition circuit.

Abstract: A transporter for controlling the longitudinal movement of an electrode of a urological resectoscope, with a guide tube which is secured lengthwise on the resectoscope and on which a carriage is mounted so as to be longitudinally movable, with a spring mounted at one end on the carriage and at the other end on one of the ends of the guide tube, and with finger supports secured on the carriage and on one of the ends of the guide tube, is characterized in that the spring is formed in one piece with at least one of the finger supports, and wherein the spring is designed as a leaf spring and has portions curved in opposite directions.

Abstract: A surgical instrument is presented that may include a handle assembly, a shaft assembly, an end effector and an articulation joint coupled to the shaft assembly and the end effector. The surgical instrument also may include an articulation control mechanism configured to: control movement of the articulation joint between a first and second maximum articulation angle; determine that the articulation joint has articulated to the first maximum articulation angle; provide a first indication that the articulation joint has articulated to the first maximum articulation angle; determine that the articulation joint has articulated to the second maximum articulation angle; and provide a second indication that the articulation joint has articulated to the second maximum articulation angle.

Abstract: A jaw assembly includes an electrically-conductive tissue-engaging structure, a jaw member including a support base, and a non-electrically conductive member including a first portion configured to engage the electrically-conductive tissue-engaging structure and a second portion configured to engage the support base of the jaw member. The non-electrically conductive member adapted to electrically isolate the electrically-conductive tissue-engaging structure from the jaw member. The electrically-conductive tissue-engaging structure and the non-electrically conductive member cooperatively define a longitudinally-oriented knife channel therethrough.

Abstract: Systems, instruments, and methods are described in which an apparatus comprises a housing including a scalpet device. The scalpet device includes a scalpet array that includes scalpets arranged in a pattern. The scalpets are deployable from the housing to generate incised skin pixels at a target site. The housing is positioned and the scalpet array is deployed into tissue at the target site. Incised skin pixels are generated when the target site is a donor site, and skin defects are generated when the target site is a recipient site. The incised skin pixels are harvested.

Abstract: A medical device utilizing temperature sensing to identify or assess anatomical bodies or structures includes an elongate tubular member, at least one electrode, a thermal sensor, and a temperature response assessment system or component. The at least one electrode may be connected to the distal portion of the elongate tubular member, and the one or more electrode can be configured to provide energy or heat to a portion of an anatomical body or structure. The thermal sensor may be configured to measure the thermal response of the portion of an anatomical body or structure, e.g., tissue or blood pools. The temperature response assessment system or component can be coupled to the thermal sensor. In embodiments, the device may include a lumen and port opening, which may accommodate a tool, such as a needle. Methods for using temperature sensing to identify an anatomical body or structure are also disclosed.

Abstract: An electrode structure and a mechanism for automated or user-selected operation or compensation of the electrodes, for example to determine tissue coverage and/or prevent arcing between bottom electrodes during electrocautery is disclosed.

Abstract: A surgical instrument 10 suitable for sealing tissue includes a tool 15 with at least one branch 16 comprising an electrode unit 35, which consists of a sheet metal part 35. The part 35 is anchored in a positive manner in a plastic body 34. Strip sections 40, 41 of the metal part 35 extend into the plastic body 34, encompassing openings 42, 42 or slits 43, 43a, through which the plastic body 34 extends. A positive anchoring of the sheet metal part 35 in the plastic body 34 and minimizing of the heat introduction into the plastic body 34 is thus attained. The thermal capacity of the sheet metal part 35 and the thermal conductivity of the plastic body 34 are low, so that consistently positive coagulation results are reached even after repeated use in short succession, regardless of the initial temperature of the tissue contact surfaces 36.

Abstract: A surgical system including a cartridge having a first tissue sealing electrode and a surgical instrument including a first jaw and a second jaw, wherein the first jaw comprises a second tissue sealing electrode facing the second jaw, and wherein the second jaw is configured to removably receive the cartridge in a position where the first tissue sealing electrode is opposite the second tissue sealing electrode. The surgical system further includes a cut and seal controller, wherein the cut and seal controller automatically generates a command to the surgical instrument to reduce a clamping force between the first and the second jaws after sensing that tissue sealing is complete.

Abstract: Surgical end effectors with increased stiffness are described herein. Increased stiffness can be accomplished in a variety of manners, including by increasing a height of each jaw member of an end effector. For example, end effector jaw members can include tapered heights that decrease from a proximal end of the jaw member to a distal end thereof. In one embodiment, first and second jaw members can each have a height measured at a proximal end thereof that is greater than half of an overall height of the end effector, while at a distal end thereof a sum of heights of the first and second jaw members can approximately equal the overall height of the end effector. Overlapping or otherwise fitting such jaw members together can create an end effector with greater stiffness that can be used to apply greater compression force to tissue during operation.

Abstract: A forceps includes a housing having a shaft. An end effector assembly operatively connects to a distal end of the shaft and includes a pair of first and second jaw members. One or both of the first and second jaw members is movable relative to the other jaw member from a clamping position to an open position. A resilient member operably couples to the first and second jaw members. The resilient member is configured to bias the first and second jaw members in the clamping position and provide a closure force on tissue disposed therebetween.

Abstract: An electrosurgical device having a tubular outer shaft and an inner shaft is disclosed. The tubular outer shaft includes an axis and a distal end region. The distal end region includes a distal-most tip and a cutting edge defining a window in the outer shaft proximal along the axis to the distal-most tip. The inner shaft inner shaft coaxially maintained within the outer shaft such that the inner shaft is movable about the axis with respect to the outer shaft and wherein a portion of the inner shaft is exposed in the window of the outer shaft. A first electrode is disposed on the outer shaft in a region proximal along the axis to the window, and a second electrode is electrically isolated from the first electrode and disposed on the inner shaft. The second electrode is exposed in the window of the outer shaft.

Abstract: The subject matter described relates to a coaxial ablation probe and method and system for real time monitoring of ablation progress for percutaneous ablation. The probe includes an anode. The probe further includes a size and shape adjustable cathode cage surrounding the anode, the cathode cage includes a plurality of struts. The anode extends coaxially with respect to the struts that form the cathode cage. The cathode cage defines the treatment volume. Probe insertion and ablation progress will be monitored by a magnetic resonance imaging system.

Abstract: A surgical instrument, such as an electrical ablation device, includes an elongate member having therealong disposed a first electrode extending along an axis. A first expandable portion extends along the axis and defines a first perimeter of the first electrode and has an associated first diameter with respect to the axis. The first expandable portion includes a first framework selectively expandable to transition the first expandable portion from a contracted state to an expanded state. The first framework is selectively contractible to transition the first expandable portion from the expanded state to the contracted state. When the first framework is expanded, the first diameter is expanded and the first expandable portion is transitioned from the contracted state to the expanded state. When the first framework is contracted, the first diameter is contracted and the first expandable portion is transitioned from the expanded state to the contracted state.

Abstract: A method for tissue assessment includes ablating tissue at a site within a body of a living subject using an invasive probe applied to the site. At a first stage in ablation of the tissue, first measurements are made of scattered light intensities from the site at a plurality of different wavelengths. At a second stage in the ablation of the tissue, subsequent to the first stage, second measurements are made of the scattered light intensities from the site at the plurality of different wavelengths. Progress of the ablation is assessed by computing different, respective measures of change in the scattered light intensities at the different wavelengths occurring between the first and second measurements, and comparing the respective measures.

Abstract: Systems and methods for monitoring and performing tissue modulation are disclosed. An example system may include an elongate shaft having a distal end region and a proximal end and having at least one modulation element and one sensing electrode disposed adjacent to the distal end region. The sensing electrode may be used to determine and monitor changes in tissue adjacent to the modulation element.

Abstract: A microwave delivery device, including a coaxial feedline having an inner conductor, an inner dielectric insulator coaxially disposed about the inner conductor, and an outer conductor coaxially disposed about the inner dielectric, and a radiating portion operably coupled to a distal end.

Abstract: A computer-implemented method determines an orientation parameter value of a prosthetic component. The method includes receiving a first desired separation distance between a tibial prosthetic component and a femoral prosthetic component at a first flexion position of a knee joint and estimating a first estimated separation distance between the tibial prosthetic component and the femoral prosthetic component at the first flexion position of the knee joint for at least one potential orientation of the femoral prosthetic component. The method also includes determining a first orientation parameter value of the femoral prosthetic component by comparing the first estimated separation distance to the first desired separation distance and outputting the first orientation parameter value via a user interface.

Abstract: Systems and methods are disclosed for simulating or optimizing hemodialysis access. One method includes receiving a patient-specific anatomic model of a patient's vasculature; computing a pre-treatment hemodynamic characteristic of a pre-treatment geometry of a portion of the anatomic model; simulating a post-treatment geometry of a vascular access in the portion of the anatomic model; computing a post-treatment hemodynamic characteristic of the post-treatment geometry of the portion of the anatomic model having the vascular access; and generating a representation of the pre-treatment hemodynamic characteristic or the post-treatment hemodynamic characteristic.