Abstract: An endoscopic handle attachment is adapted to be secured to an endoscope having a working channel and used in combination with a suture device adapted to extend through the working channel. The attachment includes a backbone adapted to conform to an outer surface of the endoscope and that includes one or more attachment features adapted to enable releasable securement to the endoscope. A primary arm extends radially outwardly from the backbone and includes one or attachment points, at least one of the one or more attachment points adapted to releasably secure a proximal handle of the suture device such that a translation handle may be moved relative to the proximal handle without an operator needing to separately hold the proximal handle.

Abstract: A control handle for use with a suture device operable through an endoscope includes a grip attachment configured to be secured to an endoscope and a control housing operably secured to the grip attachment. A catheter housing is moveably disposed within the control housing and adapted to releasably secure the suture catheter such that translation of the catheter housing causes translation of the suture catheter. A lever is rotatably securable relative to the catheter housing such that rotation of the lever relative to the catheter housing causes the catheter housing to move relative to the control housing. A sliding tab is disposed relative to the lever such that movement of the sliding tab relative to the lever causes the suture catheter to translate relative to the control wire disposed within the suture catheter.

Abstract: A tissue fixation system is provided for dynamic and rigid fixation of tissue. A fastener connected with an elongate fastening member, such as a cable, wire, suture, rod, or tube, is moved through a passage between opposite sides of tissue. A medical device is used to secure the fastener to the elongate fastening member. The medical device includes a tensioning mechanism for tensioning the elongate fastening member. As crimping mechanism is used to secure the fastener to the elongated member, where a cutting mechanism cut the excess portion of the elongated member.

Abstract: An instrument for stretching the skin comprising an elongate, dimensionally stable guide with at last two modules that are disposed on said guide and comprise anchoring means for securing to the skin, wherein at least one of said modules can be moved on the guide in the longitudinal direction thereof, and a non-return device allows movement thereof in a movement direction and blocks movement thereof in the opposite, reverse direction, said non-return device being able to be inverted in terms of the movement direction and the reverse direction.

Abstract: Devices for easily and quickly tying complex suture knots are disclosed. The knot tying accessories described herein provide a means for introducing a complex knot pattern into a bight of suture using a device body and a guide thread. The device body includes system for maintaining the guide thread and suture in a convoluted pathway, either with the use of channels, protrusions, or a combination of both within its interior, on its exterior, or both. The guide thread may include a coupler at one end for holding a suture end while the guide thread leads the suture through the convoluted path defined within the guide body. Pull tabs may also be included to aid with exchanging the guide thread for the suture ends.

Abstract: Devices and methods are provided for stabilizing fasteners post-deployment. Devices and methods are also provided for facilitating ejection of surgical fasteners from a cartridge. Devices and methods are also provided for guiding surgical fasteners. Devices and methods are also provided for facilitating closing and clamping of an end effector of a surgical device. Devices and methods are also provided for securing fasteners and adjunct materials to tissue. Devices and methods are also provided for removably coupling a cartridge to an end effector of a surgical device. Devices and methods are also provided for locking a surgical device based on loading of a fastener cartridge in the surgical device. Devices and methods are provided for adjusting a tissue gap of an end effector of a surgical device. Devices and methods are also provided for manually retracting a drive shaft, drive beam, and associated components.

Abstract: An apparatus for making surgical braids comprises a plurality of bobbin carrier assemblies. An active track engages at least some of the bobbin carrier assemblies. A passive track arranged to selectively engage at least one of the bobbin assemblies, and a gate positioned between the active track and the passive track. The gate defines an inter-track path and an intra-track path. The gate has an open position wherein the inter-track path is aligned between the active and passive tracks. The gate further has a closed position wherein the intra-track path is aligned with the active track.

Abstract: A method of making a surgical braid. The method comprises moving a plurality of bobbins along an active track, the active track being an endless track; and selectively moving a bobbin to a passive track while continuing to move the remaining bobbins along the active track.

Abstract: A system for making surgical braids. The apparatus comprises a braiding machine. The braiding machine comprises a plurality of horn gears and a plurality of bobbin carrier assemblies engaging the plurality of horn gears. A cutting machine is arranged to receive a continuous braid directly from the braiding machine. The cutting machine has a cutter. The braiding machine and cutting machine define a continuous path extending from the bobbin carrier assemblies and through at least a portion of the cutting machine.

Abstract: A method of making a cut braid. The method comprises moving a plurality of bobbins around an endless track in a braiding machine; braiding a plurality of strands from the bobbins into a braid; passing the braid through a take-up mechanism; moving the braid along a continuous path, the continuous path extending from the braiding machine, through a take-up mechanism, and at least partially through a cutting machine; and cutting the braid in the cutting machine to form a cut braid.

Abstract: A medical instrument comprising: (A) a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in an X-Y plane; (B) a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a Y-Z plane perpendicular to the X-Y plane; and, (C) a controller operatively coupled to the first joint and the second joint, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member.

Abstract: There is described a platform device for use in forming an anastomosis and maintaining a desired curvature of a lumen in a desired shape during an anastomosis assistance period. The platform is formed from one or more bioabsorbable or biodegradable polymer filaments. There is also described a method for inserting a platform device for use in creation of an arteriovenous fistula by identifying a candidate artery and a candidate vein and dissecting the candidate vein. Next, inserting a platform device into the vein and creating a breach in the candidate artery at a desired angle and location. Next, introducing the platform device and vein into the candidate artery and forming the platform device into a curvature angle selected to minimize turbulent blood flow in an anastomosis formed by the vein and the artery. The platform May also be used to maintain potency of supply blood vessels and/or organ blood vessels or the lumens daring an organ transplant procedure.

Abstract: An assembly for use in repairing a severed tendon comprises an elongate threading element adapted to transit along a lumen of a tendon sheath, for covering a curved needle and carrying the needle within the lumen. The assembly can also comprise a liner for lining an internal surface of the tendon sheath, defining an internal passage along which a tendon stump coupled to the curved needle can pass. The liner can have a collapsed, rest configuration in which it is adapted to be inserted into the lumen of the tendon sheath, and an expanded, operating configuration, the liner being movable to the expanded configuration by contact with the tendon stump. Once released from the liner, the threading element receives the curved needle, for covering and carrying the curved needle through the liner and along the lumen of the tendon sheath trailing the connected tendon stump.

Abstract: A circular stapler and a staple head assembly thereof are disclosed. The staple head assembly comprises a staple barrel assembly and an anvil assembly. The anvil assembly includes an anvil ring and an anvil shaft which are fixedly connected to each other, where the anvil shaft is capable of sliding along the longitudinal direction in an expansion-stopping tube. The staple barrel assembly includes a staple barrel, a staple pusher piece arranged within the staple barrel and a staple cartridge fixed at a distal end of the staple barrel.

Abstract: An endoscopic cuff having an outer surface configured to allow access of the cuff to tight tissue locations, wherein the cuff has a first collapsed configuration and a second expanded configuration; wherein the expanded configuration is configured to allow passage of one or more endoscopic accessory devices through the at least one longitudinal bore.

Abstract: Methods and devices are used to treat a dorsal vein to reduce blood flow in patients suffering from erectile dysfunction. For example, a clip may be advanced distally across the deep dorsal vein and an anchor on the clip deployed on a proximal side of the Tunica albuginea. The clip can then be pulled back and a distal anchor on the clip deployed to reduce a cross-sectional area of the deep dorsal vein and anchor the deep dorsal vein to the Tunica albuginea. Anchoring of the dorsal vein to the Tunica albuginea further reduces the cross-sectional area of the deep dorsal vein in response to expansion of the patient's corpora cavernosa.

Abstract: An occlusive device for occluding a target area can include an elongate member having opposing first and second side edges extending longitudinally along the member and a member width. The member can have a collapsed configuration in which the first and second side edges are curled toward each other about a longitudinal axis of the member. Further the member can have an expanded configuration in which the member form a series of loops and the first and second side edges uncurl to be spaced apart from each other.

Abstract: Embodiments disclosed herein are directed towards an endovascular clip comprising a proximal anchoring member and a distal self-expanding member. The proximal anchoring member and distal self-expanding member are configured to extend across opposite sides of a neck of an aneurysm.

Abstract: According to an exemplary embodiment, a cutting block for cutting the femur during knee arthroplasty surgery may be provided. The cutting block may include a cutting guide having a number of slots for guiding a cutter to cut the femur and further comprising a slide extending from the frame of the cutting guide. The cutting block may further include a body that may have a groove with flanges, wherein the space defined by the groove and the flanges may receive the slide extending from the frame of the cutting guide. Further, a feeler gauge may include a support block receiving a pointer arm, wherein the pointer arm may include a pointer that may be configured to make contact with patient bone tissue. A foot including a pair of spaced apart flanges configured to engage the posterior condyles of the patient's femur may also be included in the cutting block.

Abstract: The present invention has a simple structure which is convenient in preparation and easy to use. Moreover, in combination with three-dimensional preoperative analysis and rapid molding technology, the present invention has a high customized precision and clinical applicability, and is cost-effective. Based on the three-dimensional preoperative analysis and 3d printing model, the problems of high technical difficulty and cost of the customized accurate implantation of acetabular cup prosthesis in the total hip arthroplasty can be effectively solved, so that the learning curve of operator can be shortened. The present invention can realize the customized accurate implantation of acetabular cup prosthesis without fitting the positioning guiding module with the articular surface area, so that the assisted positioning and assisted reaming depth determination are realized without removing the guiding module when the acetabulum is being reamed, thus the accuracy of the assisted positioning can be guaranteed.

Abstract: A multifunctional spacer for knee surgery is described comprising a main body configured for use with a single femoral condyle and having an anterior portion of a first height and a posterior portion of a second height, wherein the second height is greater than, equal to or less than the first height. In addition, the anterior portion and/or the posterior portion is provided with an attachment mechanism for selective attachment of a height adjuster.

Abstract: A device for capturing an obstruction in a vasculature can include a first elongated member, an expandable element, an invertible element, and a gap positioned between the expandable element and the invertible element sized to be placed across the obstruction. The expandable element and the invertible element can be positioned near the distal end of the first elongated member. The expandable element can expand from a collapsed delivery configuration to an expanded configuration. The invertible element can expand from a collapsed delivery configuration to an expanded configuration, and the invertible element can invert from the expanded configuration to an inverted configuration, thereby forming a pocket. The pocket can envelope at least a portion of the gap and can thereby capture an obstruction that is in the gap.

Abstract: An embolectomy device includes a pair of elongate spine members extending in a substantially parallel configuration along a longitudinal axis of the device, a first plurality of clot engaging structures having first ends attached to a first one of the spine members and second ends attached to other one of the spine members, and a second plurality of clot engaging structures having first and second ends attached to the respective first and second spine members offset 180° from the first plurality of attached clot engaging structures, such that, when the embolectomy device is unsheathed within in a blood vessel alongside a clot, one of the first and second plurality of the clot engaging structures contact and compress against a wall of the blood vessel to provide a biasing force to facilitate engagement of the other one of the first and second plurality of the clot engaging structures with the clot.

Abstract: An endoscope for removing tissue at a surgical site includes an elongated tubular body insertable within a mammalian cavity of a patient. An instrument channel extends between a first opening at a distal end and a second opening at a proximal end of the tubular body and is sized and configured to receive a surgical cutting assembly that includes an aspiration channel configured to remove material entering the endoscope via a distal end of the surgical cutting assembly. A torque generation component configured to generate torque is positioned within the distal end and configured to provide the generated torque to a coupling component. The coupling component is positioned at the distal end of the elongated tubular member and configured to actuate a cutting component of the surgical cutting assembly responsive to actuation of the torque generation component.

Abstract: An extractor includes a rigid outer cannula forming a lumen extending between a proximal end and an opposing distal end of the outer cannula. An inner cannula is slidably positioned within the lumen of the outer cannula. The inner cannula forms a central passage along a longitudinal axis of the inner cannula extending between a proximal end and an opposing distal end of the inner cannula. A plurality of secondary passages are positioned about the central passage and extend along at least a portion of a length of the inner cannula between the proximal end and the distal end of the inner cannula. An annularly expanding and retracting extraction mechanism at the distal end of the inner cannula is operable to capture and extract kidney stones from within a lumen of a patient.

Abstract: An elongate embolectomy device having a radially constrained configuration and a radially expanded configuration, the embolectomy device being formed out of a plurality of elongate clot engaging structures, each clot engaging structure comprising a plurality of interconnected struts forming an open cell pattern, wherein, when the embolectomy device is in the radially expanded configuration, the clot engaging structures each have a semi-tubular arcuate profile, including a convex face and an concave face facing opposite the convex face, extending along a length of the embolectomy device, the clot engaging structures being longitudinally disposed relative to each other such that the concave faces are facing radially outward, and the convex surfaces are facing radially inward, respectively, relative to a longitudinal axis of the embolectomy device.

Abstract: A waveguide that is configured to focus ballistic shockwaves by harnessing the propagation speed of an acoustic wave through different materials by controlling the geometry and the materials forming the waveguide through which the ballistic shockwave is travelling so as to focus the ballistic shockwaves at a focal zone.

Abstract: A probe attachable to an ultrasonic generator and structured to conduct ultrasonic energy to a surgical site. The probe comprises an elongated body with a sidewall that extends between a proximal end and a distal end. The probe further comprises one projection(s) that extends outwardly from the sidewall and that is structured to remove fat tissue. The body comprises a distal tip disposed between the distal end and the projection(s). The distal tip comprises a substantially conical configuration that diverges continuously from the distal end to the projection(s). The distal tip comprises an apex that is disposed coincident to the distal end, and that comprises a substantially rounded, blunt configuration. The projection(s) comprises a curved configuration and extends transversely, and at least partially, around the sidewall. The distal tip and the projection(s) are structured and dimensioned for movable and removable positioning within the surgical site.

Abstract: An articulating ultrasonic surgical end effector includes a clevis, a transducer housing pivotably coupled to the clevis, an ultrasonic transducer disposed within the transducer housing, a waveguide extending distally from the ultrasonic transducer, an ultrasonic blade disposed at the distal end of the waveguide, a shaft extending distally from the transducer housing about at least a portion of the ultrasonic blade, and a clamp arm pivotably coupled to the shaft and movable relative to the ultrasonic blade between an open position and a clamping position. Ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue therewith.

Abstract: An apparatus is configured to provide hemostasis with tissue removal in order to inhibit one or more of blood loss or tissue drainage. In many embodiments, a nozzle releases a liquid jet in a liquid medium in order to provide cavitation and a plurality of shedding pulses. The liquid jet, its cavitation and the plurality of shedding pulses can affect vascular tissue in order to promote clotting in order to inhibit bleeding. In many embodiments, vessels of the vascular tissue are affected at a distance from a region where cavitation of the water jet contacts the tissue. In many embodiments, the cavitation and plurality of shedding pules are related to a pulsatile shear wave propagating along the blood vessel that is related to clot promoting changes of the blood vessel.

Abstract: A method and article for removing splinters is provided. First a generally flat lancet is removed from its packaging. The disposable lancet is then used to pierce the patients skin and loosening the skin in the area adjacent to the splinter before tearing the skins with a sharp point of the lancet. Then the lancet is bent at bend line located at center between both end points till the points of each end are parallel and aligned so their able grasp objects between the points. The lancet should look and function more so like tweezers after the previous step. The foreign object can now be removed, thereafter the lancet, packaging and splinter is now disposed of.

Abstract: An ultrasonic surgical instrument comprises a cylindrical shaft and a blade at a distal or free end of the shaft, the blade being unitary and continuous with the shaft, without an intervening joint. The shaft has a longitudinal axis and the blade includes a flat or planar blade body with a proximal end eccentrically disposed relative to the shaft axis. Thus, the blade body or at least a proximal end portion thereof is disposed eccentrically relative to the shaft. The blade in its entirely may be inclined relative to the shaft axis or extend parallel thereto.

Abstract: A surgical instrument is disclosed including a transducer configured to produce vibrations along a longitudinal axis at a predetermined frequency and an ultrasonic blade extending along the longitudinal axis coupled to the transducer. The ultrasonic blade includes a body having a proximal end and a distal end. The distal end is movable along the longitudinal axis by the vibrations produced by the transducer. The surgical instrument further includes a protective sheath including a proximal end and a distal end and disposed adjacent to the body. The protective sheath further includes a pad positioned toward the distal end of the protective sheath and located between the body and the distal end of the protective sheath.

Abstract: An ultrasonic surgical instrument includes a first shaft member, a jaw member extending distally from the first shaft member, a second shaft member, an ultrasonic blade extending distally from the second shaft member and positioned to oppose the jaw member, and a force-limiting hinge assembly operably coupling the shaft members with one another such that movement of the shaft members between a spaced-apart position and an approximated position moves the jaw member and the ultrasonic blade between an open position and a clamping position for clamping tissue therebetween. The force-limiting hinge assembly includes a hinge arm fixedly engaged to one of the shaft members at a first end thereof and pivotably coupled to the other of the shaft members at a second end thereof. The hinge arm is configured to flex to regulate a clamping force applied to tissue clamped between the jaw member and the ultrasonic blade.

Abstract: Surgical devices and systems having rotating end effector assemblies for treating tissue are provided. Methods for using the same are also provided.

Abstract: Rotational atherectomy devices and systems can remove or reduce stenotic lesions in implanted grafts by rotating one or more abrasive elements within the graft. The abrasive elements can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that fully or partially spirals around the drive shaft.

Abstract: Rotational atherectomy devices and systems can remove or reduce stenotic lesions in implanted grafts by rotating one or more abrasive elements within the graft. The abrasive elements can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that fully or partially spirals around the drive shaft.

Abstract: Provided herein in some embodiments is a catheter including an elongate body with a polymeric portion and a metallic portion; a balloon over at least some of the polymeric portion; a coupler formed over or between the polymeric and metallic portions; and one or more scoring wires. The metallic portion can include a spiral-cut portion configured to prevent elongation and kinking of the elongate body. The one or more scoring wires can be fixed to and extend from a tip at a distal end of the elongate body, over the balloon, through the polymeric portion of the elongate body, through the coupler, and to the metallic portion of the elongate body. The one or more scoring wires can be fixed to an internal surface of the spiral-cut portion or formed from the spiral-cut portion.

Abstract: A tissue removing catheter includes an apposition mechanism that selectively imparts an axially compressive load on the catheter body to bend the catheter and urge a tissue-removing element toward a blood vessel wall. The apposition mechanism can include one or more adjustment lines and an adjustment mechanism for selectively tensioning one of the adjustment lines to impart the compressive load on the catheter body. Two adjustment lines can have diametrically opposed positions and be wound onto a spool of the adjustment mechanism in opposite directions so that rotation of the spool simultaneously shortens one adjustment line and lengthens the other. The catheter body can have a more flexible bending segment adjacent the tissue-removing element to promote bending near the tissue-removing element operative to urge the tissue-removing element in apposition with the blood vessel.

Abstract: A medical device for controlling advancement of a needle or other active medical component. An exemplary device includes a needle, a sheath, and a handle. The handle includes an actuator component coupled to a proximal end of the needle and a guide component coupled to a proximal end of the sheath. The guide component slidably receives a portion of the actuator and the guide component allows the actuator to move distally via a plurality of groups of different positions, wherein each of the groups has a different radial value relative to the guide component. The guide component includes a track having a zig-zag pattern.

Abstract: A biopsy needle guide, which has at least two degrees of freedom and can be freely positioned at least in a plane, includes a through-passing opening for passing a biopsy needle through. In an interior of the opening, a fixing structure and a clamping structure are present, and an adapter sleeve is present, which has a continuous opening for passing a biopsy needle through, as well as a stop collar, and which can be pushed into the opening as far as the collar and is rotatable after pushing in as far as the stop. By rotating the adapter sleeve to a first angle at most, a latch structure of the adapter sleeve engages behind the fixing structure of the opening, so that the adapter sleeve is fixed in the axial direction. By rotating the adapter sleeve beyond the first angle, the latch structure interacts with the clamp structure such that a biopsy needle that is introduced in the opening is fixed in the axial direction.

Abstract: A trocar assembly includes a trocar that includes a trocar housing and a cannula that extends distally from the trocar housing, and an integral seal system positioned within a central passageway extending axially through the trocar and engageable against a surgical tool shaft extended therethrough. The integral seal system includes an asymmetric seal and a duckbill seal arranged distal to the asymmetric seal, and the asymmetric seal defines a diaphragm that complements insertion and extraction drag forces generated by the duckbill seal against the surgical tool shaft such that total insertion and extraction drag forces generated by the integral seal system are equalized.

Abstract: A deformable seal for use together with a laparoscopic port has a deformable body with an upper region, a lower region, and a narrowed waist. A plurality of tool passing channels are individually formed in an axial direction through the deformable body, and each tool passing channel has a tool entrance on a surface of the upper region and a tool exit on a surface of the lower region. The tool passing channels are sufficiently elastic to conform to and seal about a shaft of a laparoscopic tool present in the channel and to close to inhibit leakage of an insufflation gases when the tool is removed from the tool passing channel.

Abstract: An intraosseous device comprises a stylet with a pointed end for penetrating bone and a cannula through which the stylet extends. The stylet has a bent portion which is engaged in a receiver in a handle cover. The cannula has an outwardly extending flare which is engaged in a corresponding seat in a hub. The handle and the hub have formations which interlock with one another when the tip of the stylet is aligned with the tip of the cannula. The interlock formations further assist torque transmission. The configuration ensures that the maximum manual torque can be applied to penetrate bone whilst ensuring that the stylet and cannula are aligned for maximum cutting efficiency and remain fixed to the handle and the hub respectively.

Abstract: A rib fixation plate is provided that is can have one or more locking rib hooks that can translate and rotate independently from one another. The one or more locking rib hooks translate and rotate when in an unlocked conformation and are secured from translation and rotation when in a locked conformation. The plate includes a first end and a second end opposite of the first end, the second end having a housing assembly configured to receive a rod. The rod can be secured to a vertebra with a pedicle screw.

Abstract: A spinal implant comprises a body including an inner surface that defines a cavity configured for disposal of a member. A locking element is engageable with the member within the cavity to fix the member with the body. The body further includes a wall that defines a bay configured for disposal of a longitudinal element being engageable with the wall to fix the longitudinal element with the body independent of the member, Systems and methods are disclosed.

Abstract: An implantation set for implanting a screw in a human or animal body includes a tool and a screw designed to receive the tool. The screw has a tool receiving region into which or onto which a torque transmission region of the tool can be or is inserted or placed to transmit torque. At least one inclined insertion region is formed on the tool receiving region to guide the tool during insertion of the screw. The tool forms at least one centering surface that is matched to the inclined insertion region such that when the centering surface comes into contact with the inclined insertion region, a form fit and force fit is created.

Abstract: This application describes surgical instruments and implants for building a posterior fixation construct across one or more segments of the spinal column. Extension guides are provided that attach to bone anchors implanted within the spine. The extension guides have a guide channel that align with a rod channel in the anchor to help direct the rod to the anchor. Instruments are provided to aid in insertion and positioning or the rod.

Abstract: An apparatus for inserting implants in a bone comprising a frame having a cartridge receiving chamber and a barrel. A cartridge defining a plurality of chambers is positioned in the cartridge receiving chamber so the chambers are selectively alignable with a longitudinal passage of the barrel. At least one instrument is positioned in one of the chambers, and a plurality of implants is positioned in the other chambers. A drive assembly is engageable with the instrument and the implants. The drive assembly is slidably and rotatably disposed in the frame and is moveable between a retracted position, an engaging position wherein the distal end of the drive assembly is positioned to engage the selected one of the instrument and the implants, and an extended position wherein the drive assembly extends through the chamber to transport the selected one of the instrument or the implant from the chamber to the distal end of the barrel.

Abstract: This disclosure describes example embodiments of rod reduction instrumentation and other rod and vertebrae manipulation instruments. The rod reducers can be used during the installation of a rod based surgical fixation system to help urge the rod into the fixation anchors. The reducers described provide various configurations delivering large reduction distance capabilities, strong controlled reduction coupled with an ability to quickly advance the reducer if desired, and reduction of bulk through the surgical corridor.