Abstract: Intramedullary fixation device, having an intramedullary rod (2) which is provided for insertion thereof into a bone (1) and consists of a central screw (4) having a first free end comprising a stopper (7) and a second free end with a pre-tensioning nut (8), an alternating series of expanders (3) and bolts (5) being arranged in between, the bolt surfaces in contact with the expanders (3) having a wedge shape. The bolts (5) or expanders (3) may have no, or one or more variations in the dimensions of the different geometric parameters, in accordance with the adjacent expanders, along the length of the implant, and the central screw (4) may have a variable cross section. The device may have different additional components, such as an osteotomic base (9) for fixation of the musculature. The device promotes maximum nailing limited between these elements and produces a controlled peripheral radial deformation.

Abstract: The cephalomedullary nailing system of this invention contributes to solving three main problems: reduce fractures, improve assembly biomechanics to ensure the load axis is favorable as possible for bony fragments and prevent femoral neck collapse as well as offset and limb length loss, hence avoiding the possibility of reduced abductor power. The system is based on specific screw channel geometry and the placement of an additional locking screw, allowing the nail to turn 360° and facilitating nail insertion through the screw.

Abstract: A device for positioning a bone plate includes a body having a first end having a first curved portion and a second end having a second curved portion. Each curved portion terminates at an abutment. Each abutment has a first diameter and the curved portions have a second diameter less than the first diameter. The first end secures the positioning device to a bone plate and the second end secures the positioning device to a soft tissue elevator.

Abstract: A bone plate for implanting in a femur bone having a prosthesis implanted therein includes a shaft portion defining a plurality of holes and a trochanteric portion proximal to the shaft portion having two arms forming a concave shape and defining a plurality of first holes for receiving screws such that when implanted, the two arms at least partially wrap around and attach to the femur bone. The bone plate may include at least one bendable extension positioned between both of the arms. Each of the extensions may define at least one second hole.

Abstract: Embodiments herein employ a flexible orthopedic alignment guide for surgical implantation of flexible bone plates. Specifically, the alignment guide is designed to be used in conjunction with flexible bone plates whereby flexible sections of the alignment guide aid in alignment of drill bits and fasteners with the fastener holes of the bone plate. The flexible guide is designed to flex in a similar manner to the bone plate, thus maintaining positive engagement without compromising hole alignment.

Abstract: A system including a bone punch tool and a needle guide. The bone punch tool can include a support arm having a support arm proximal portion and a support arm distal portion, a pivot arm having a pivot arm proximal portion and a pivot arm distal portion, and an arcuate punch configured to punch through bone. The pivot arm distal portion can be pivotably coupled to the support arm distal portion, such that the pivot arm proximal portion is configured to be moved away from the support arm proximal portion to extend the arcuate punch into a punch position to punch an arcuate hole through bone. The needle guide can be configured to guide a needle through the arcuate hole.

Abstract: A tray includes a plurality of rows, each of which includes a plurality of slots. Each row contains a plurality of screws. Different rows may contain screws of different types, e.g., lengths. Each of one or more rows contains a machine-readable object (e.g., peg) containing data representing properties of the objects in the corresponding rows. Removal of an object from a row is performed by reading data from the machine-readable object in the row and using that data to modify (e.g., decrement or increment) a count of the type of object contained in that row.

Abstract: A bone cement applicator comprising a cartridge with an internal space. The cartridge has a head with a dispensing opening for expulsion of bone cement, a first thread, a dispensing plunger, a threaded tube having a counter thread engaging the first thread, a receptacle mobile in the threaded tube, and a mixing rod with a mixer fastened to it and arranged in the internal space of the cartridge. The mixing rod is detachably connected to the receptacle and is guided through a feedthrough in the dispensing plunger and is supported in the feedthrough so as to be axially mobile. When detached from the receptacle, the mixing rod can be pushed into the receptacle when the receptacle is propelled in the direction of the cartridge head. A method is also disclosed for production of a bone cement using the bone cement applicator.

Abstract: A bone cement applicator comprising a cartridge with an internal space. The cartridge has a head with a dispensing opening for expulsion of bone cement, a dispensing plunger, a receptacle mobile in the cartridge, and a mixing rod with a mixer fastened to it and arranged in the internal space of the cartridge. The mixing rod is detachably connected, on a side opposite from the mixer, to a front side of the receptacle that faces the cartridge head. When the mixing rod is detached from the receptacle and the receptacle is propelled in the direction of the cartridge head the mixing rod can be pushed into the receptacle. A method is also disclosed for production of a bone cement using the bone cement applicator.

Abstract: Systems, methods, and devices allow intravascular or percutaneous mapping, orientation and/or ablation, in bodily cavities or lumens. A device includes elongate members, moveable between an unexpanded configuration and an expanded or fanned configuration. The elongate members form a stack in the unexpanded configuration to fit through a catheter sheath. The elongate members follow respective arcuate or curvilinear paths as advanced from the sheath into the bent or coiled stack configuration, adopting volute, scroll or rho shapes, and may be nested. The elongated members are fanned or radially spaced circumferentially with respect to one another into the expanded or fanned configuration. Transducer elements carried by elongate members sense various physiological characteristics of or proximate tissue, and/or may apply energy to or proximate tissue. The elongate members are rotatable in groups or as a group in the expanded configuration. The device is retractable.

Abstract: A flexible catheter is inserted into the esophagus to cool or warm the esophagus, particularly during certain procedures which can tend to change the temperature in the area of the esophagus. The catheter is inserted through the mouth and throat to a position, for example, proximate the heart, but within the esophagus. A thermally conductive gel is injected into the esophagus where it is immobilized by the one or more balloons. A coolant is pumped through a coolant tube affixed to the catheter, where it exchanges heat with the conductive gel.

Abstract: A kit for use in cryoablation procedures includes a cryoablation catheter having a cryoballoon positioned about its distal region. A pressure sensor is positioned distally of the cryoballoon. The catheter can be introduced into a patient's left atrium and the cryoballoon inflated. The cryoballoon can then be advanced into contact with a pulmonary vein wall in a manner that occludes the pulmonary vein. Occlusion can be verified by measuring a pressure within the pulmonary vein. Once occlusion is verified, the cryoballoon can be cooled to form a circumferential lesion about the pulmonary vein.

Abstract: An attachment for a gas-assisted electrosurgical device. The attachment has a housing having a channel within it, an electrosurgical blade and an electrical connector. The electrosurgical blade has a conductive member comprising an elongated distal portion and a proximal portion, the distal portion having a width greater than a width of the proximal portion, the width of the distal portion being at least three times the thickness of the distal portion, and a coating on at least a portion of said conductive member.

Abstract: A cold plasma accessory having a hand piece having within in it flexible tubing, wiring, a PCB board connected to the wiring, and a conductive connector tube electrically connected to the PCB board, the conductive connector tube having an inner channel, a rigid tube extending from the distal end of the hand piece, and an electrode within the rigid tube. The electrode comprises a conductive connector having a contact surface contacting the conductive connector tube, a distal end surface facing away from the conductive connector tube, and a channel extending through a center of the conductive connector, the channel being fluidly connected to the flexible tubing, the distal end surface of the conductive connector being outside of the channel in the conductive connector, and a conductive wire connected to the distal end surface of the conductive connector.

Abstract: A bipolar surgical instrument (1) comprises a body (2), first and second opposed jaws (18, 20) located at the distal end of a shaft (10), the first jaw (18) being movable with respect to the second jaw (20) between an open position in which the first and second jaws (18, 20) are spaced apart from one another, and a closed position in which the first and second jaws (18, 20) are adjacent one another. The first and second elongate jaw members (18, 20) have respective first and second electrodes. A controller is operable to determine a mode of operation depending upon a measurement of impedance between the first and second jaws.

Abstract: Devices, systems and methods are provided for subdermal tissue tightening through soft tissue coagulation and for use in cosmetic surgery applications. The devices, systems and methods of the present disclosure may be used for a minimally invasive application of helium-based cold plasma energy to subcutaneous tissue for the purpose of tightening lax tissue.

Abstract: A vitreous enamel coating for an electrosurgical metal cutting blade, the coating having a coefficient of thermal expansion substantially near the coefficient of thermal expansion of the metal cutting blade. Selection of materials having similar coefficients of thermal expansion results in an electrosurgical cutting blade with an improved insulating layer, substantially improved durability, or both.

Abstract: A bipolar surgical instrument comprises a body first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to determine a boiling point for tissue between the jaws using a measure of impedance therebetween.

Abstract: A bipolar surgical instrument comprises a body, first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to detect a short circuit between the first and second electrodes when in use.

Abstract: A bipolar surgical instrument comprises a body, first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to determine a boiling point for tissue between the jaws using a measure of impedance therebetween.

Abstract: A bipolar surgical instrument comprises a body, first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to determine a starting voltage for application to the jaws.

Abstract: An electrosurgical vessel sealing device that can seal biological vessels using a confined microwave field that yields a well-defined seal location with low thermal margin. The device comprises a pair of jaws that are movable relative to each other to grip biological tissue. A blade for cutting the gripped tissue is slidable between the jaws. A coplanar microstrip antenna is mounted on the inner surface of one or both of the pair of jaws to emit microwave energy into the gap therebetween. The device may comprise a separate dissector element to enable fine tissue cutting and dissection to be performed.

Abstract: A surgical instrument is provided and includes a housing having a shaft. An end effector assembly is operatively connected to a distal end of the shaft and has a pair of first and second jaw members that are movable relative to one another. A drive assembly operably couples to a handle assembly associated with the housing and is configured to impart movement of a respective jaw member when the handle assembly is actuated. A spring component operably associated with each of the jaw members is configured to provide a sealing force at the jaw members.

Abstract: In one embodiment, the present disclosure relates to an electrosurgical device that includes an outer body, an inner body disposed partially within the outer body, three plates and an insulator. A first plate of the three plates includes a plurality of apertures and is positioned so that each of two projections extending from the inner body extend through a respective aperture of the plurality of apertures of the first plate. A second plate and a third plate of the three plates are both disposed on the first plate such that each of the two projections extends through an aperture of the second plate or the third plate, the second and third plates being fixed to a respective projection. The insulator is disposed around the inner body and is attached to the outer body at a first end and abuts the first plate at a second end opposite the first end.

Abstract: A catheter has a multifunctional “virtual” tip electrode with a porous substrate and a multitude of surface microelectrodes. The surface microelectrodes are in close proximity to each other and in a variety of configurations so as to sense tissue for highly localized intracardiac signal detection, and high density local electrograms and mapping. The porous substrate allows for flow of conductive fluid for ablating tissue. The surface microelectrodes can be formed via a metallization process that allows for any shape or size and close proximity, and the fluid “weeping” from the porous substrate provides more uniform irrigation in the form of a thin layer of saline. The delivery of RF power to the catheter tip is based on the principle of “virtual electrode,” where the conductive saline flowing through the porous tip acts as the electrical connection between the tip electrode and the heart surface.

Abstract: The invention comprises novel microwave antennas wherein the microwave field profile generated by an antenna is tailored and optimized for a particular clinical application. The antennas disclosed herein incorporate one or more additional elements called shaping elements that use unique properties of microwaves such as interaction of a microwave field with one or more conductive or non-conductive elements to shape or redistribute the microwave field. Such shaping elements may be used to reduce the undesired backward coupling of the emitted microwave field to the transmission line. Such shaping elements may be used to increase the power efficiency of the antenna. The invention also discloses devices and methods for treating tissue with microwave energy emitted from the antennas for use in applications such as destroying a soft tissue by microwave ablation.

Abstract: An antenna assembly for microwave ablation can include a radiator for emitting a microwave for ablation; a coaxial cable for transmitting the microwave for ablation generated by a microwave generator to the radiator; an annular composite structure is provided around the coaxial cable for inhibiting an electromagnetic wave from propagating backwards along the coaxial cable. In some embodiment, the annular composite structure comprises an annular nonmetallic layer and an annular metallic layer located outside the annular nonmetallic layer. In some embodiments, the annular metallic layer is electrically insulated from the coaxial cable. In some embodiments, the antenna assembly can be used with a microwave ablation needle. The annular composite structure can inhibit the backward propagation of the microwave along the coaxial cable exterior wall. In some embodiments, circulation water enters the radiation zone, to avoid high temperatures of the head the ablation needle.

Abstract: An electrosurgical apparatus for treating fluid-filled biological growths by replacing the fluid within the growth with a substance that assists in delivering treatment energy. The treatment energy may be microwave energy or may be thermal energy derived from microwave energy. The apparatus comprises an instrument having a radiating tip portion, and a fluid delivery mechanism for transporting fluid to and from a treatment zone located around the radiating tip portion. The fluid delivery mechanism comprises a rigid insertion element arranged to extend into the treatment zone, whereby fluid can be aspirated from the treatment zone, and a substance injected into the treatment zone to replace the aspirated fluid. The injected substance has dielectric properties selected to facilitate uniform delivery of treatment energy to biological tissue in the treatment zone.

Abstract: In one aspect, methods of treating a wound are described herein. A method described herein, in some embodiments, comprises treating a wound, such as a chronic wound, by performing a full field laser ablation in a wound bed of the wound and subsequently performing a fractional laser ablation in the wound bed. Additionally, in some cases, the fractional laser ablation step is carried out at substantially the same time as, or immediately following, the full field laser ablation step. In addition, in some instances, a method described herein further comprises performing debridement in the wound bed prior to performing the full field laser ablation in the wound bed.

Abstract: A training system for training a trainee to perform a surgical procedure on an anatomical region. The system includes a physical model of the anatomical region, a physical training instrument, a tracking system configured to track the location and orientation of the physical training instrument relative to the physical model, a display device, and a computer system. The computer system receives from the tracking system information indicating the location and orientation of the physical training instrument and generates and displays an augmented physical model and the physical training instrument. The display is updated based as the trainee manipulates the physical training instrument. After the trainee has completed the surgical procedure, the computer calculates a score based on the performance of the trainee. The score is a measure of the accuracy of the surgical procedure performed by the trainee or the duration of the surgical procedure.

Abstract: This application provides an airway model generation system, including an endoscope apparatus and a computer apparatus, to establish a three-dimensional model of an airway for a patient by using a simultaneous localization and mapping technology. This application further provides an intubation assistance system, to provide assistance to a medical worker during intubation treatment by using three-dimensional models of numerous patients and a machine learning technology.

Abstract: Certain systems, methods, and devices described herein are configured to dynamically model a patient area for surgery and/or other treatment, dynamically identify one or more features and/or characteristics thereon such as the length and/or elasticity of the posterior longitudinal ligament (PLL), dynamically allow modification of the model, dynamically limit and/or assist in modification of the model, and/or dynamically generate guidelines for generation of patient-specific implants and/or treatment kits for a specific patient.

Abstract: The invention relates to a guiding ancillary device designed to cooperate with at least two bone surfaces, and to the method for the production thereof. The invention also relates to a guiding ancillary device for use in orthopedic surgery, and to an assembly comprising a guiding ancillary device and at least one medical device.

Abstract: Devices and methods for performing a surgical step or surgical procedure with visual guidance using an optical head mounted display are disclosed.

Abstract: Methods for aligning bone segments using custom jigs are disclosed. In one technique, bone segments are aligned using interaction elements, imaging, virtual fracture alignment, and a custom jig. The custom jig can be generated using a rapid fabrication method such as via the use of a three-dimensional printer. The methods can be minimally invasive or noninvasive. The interaction elements can be percutaneous interaction pins or noninvasive interaction elements.

Abstract: A system includes an image guidance system with a memory with computer executable instruction, a processor configured to execute the computer executable instructions, and a display. The computer executable instructions cause the processor to: receive a three-dimensional model of vasculature from an ultrasound imaging system, receive a real-time optical feed of an interior of a cavity from an optical camera-based guidance system, receive a first tracking signal indicative of a first spatial location of a probe of the ultrasound imaging system, receive a second spatial location of the optical camera-based guidance system, and overlay the optical feed with the three-dimensional model based on the first and second tracking signals. The display is configured to visually present the optical feed with the three-dimensional model overlaid thereover.

Abstract: Navigation of an instrument within a luminal network can include image-based airway analysis and mapping. Image-based airway analysis can include detecting one or more airways in an image captured within a luminal network and determining branching information indicative of how the current airway in which the image is captured branches into the detected “child” airways. Image-based airway mapping can include mapping the one or more detected airways to corresponding expected airways of the luminal network in the preoperative model.

Abstract: Systems, methods, software and techniques for generating a milling path for a tool of a surgical system are provided. The milling path is designed to remove a resection volume associated with an anatomical volume. A reference guide is defined with respect to the resection volume. Sections are defined along the reference guide in succession. Each section intersects the reference guide at a different intersection point and is at a specified orientation relative to the reference guide at the intersection point. Each section further intersects the resection volume. A section path is generated to be bounded within each section and defined relative to the resection volume. A plurality of transition segments are generated and each transition segment connects section paths of successive sections along the reference guide.

Abstract: A surgical navigation system for providing computer-aided surgery. The surgical navigation system includes a handheld surgical tool with computer-aided navigation, an imaging device, an alignment module, and a user interface module. The handheld surgical tool includes at least one sensor for measuring a position of the tool in three dimensions, and at least one set key. A processor and at least one display device are associated with the handheld surgical tool and configured to display a target trajectory of the handheld surgical tool for the surgical procedure.

Abstract: The subject matter described herein includes methods, systems, and computer readable media for image guided ablation. One system for image guided ablation includes an ultrasound transducer for producing a real-time ultrasound image of a target volume and of surrounding tissue. The system further includes an ablation probe for ablating the target volume. The system further includes a display for displaying an image to guide positioning of the ablation probe during ablation of the target volume. The system further includes at least one tracker for tracking position and orientation of the ablation probe during the ablation of the target volume. The system further includes a rendering and display module for receiving a pre-ablation image of the target volume and for displaying a combined image on the display, where the combined image includes a motion tracked, rendered image of the ablation probe and an equally motion tracked real-time ultrasound image registered with the pre-ablation image.

Abstract: User input devices (UIDs) for controlling a surgical robotic system are described. A UID can include one or more tracking sensors to generate respective spatial state signals in accordance with a pose of the UID. At least one of the tracking sensors can be a camera. In the case of multiple tracking sensors, the spatial state signals are processed by a sensor fusion algorithm to generate a more robust, single tracking signal and a quality measure. The tracking signal and the quality measure are then used by a digital control system to control motion of a surgical robotic system actuator that is associated with the UID. Other embodiments are also described and claimed.

Abstract: An example method includes displaying, via a visualization device and overlaid on a portion of an anatomy of a patient viewable via the visualization device, a virtual model of the portion of the anatomy obtained from a virtual surgical plan for an orthopedic joint repair surgical procedure to attach a prosthetic to the anatomy; and displaying, via the visualization device and overlaid on the portion of the anatomy, a virtual guide that guides at least one of preparation of the anatomy for attachment of the prosthetic or attachment of the prosthetic to the anatomy.

Abstract: A system for conducting a medical procedure includes a first camera-based 3-D motion sensor configured to generate signals related to the position of a procedure object in the operating room and a controller coupled to the camera-based 3-D motion sensor. The controller is configured to define a predetermined operational plan including positions of a procedure object over time, assign a desired time milestone for each position of the object in the predetermined operational plan, and automatically monitor progress of the procedure based at least in part upon one or more positions of the procedure object over time. The controller is further configured to compare the one or more positions with the desired time milestone, record data relating to an actual time for each position of the object compared with the desired time milestone, and use the data to provide a recommendation for a change to a future predetermined operational plan.

Abstract: A surgical robot system includes a robot. The robot includes a robot base and a robot arm coupled to the robot base. The robot also includes an end-effector coupled to the robot arm. The robot is configured to control movement of the end-effector to perform a surgical procedure. The robot also includes an inertial measurement unit coupled to the robot arm. The surgical robot system also includes camera that is configured to capture one or more pictures or videos used to determine a location of the end-effector. The inertial measurement unit is configured to capture one or more measurements used to determine the location of the end-effector when a view of the camera is occluded.

Abstract: A robotic surgery system includes: (1) a positioning stage and (2) at least one manipulator arm mounted to the positioning stage, wherein the manipulator arm includes a track and a tool carriage moveably mounted to the track, and the tool carriage includes a base and a pair of light emitting devices mounted to the base.

Abstract: Devices, systems, and methods are provided in which movement of a tool is controlled based on sensed parameters. In one embodiment, an electromechanical tool is provided having an instrument shaft and an end effector formed thereon. The electromechanical tool is configured to be mounted on an electromechanical arm, and the electromechanical tool is configured to move with or relative to the electromechanical arm and perform surgical functions. A controller is operatively coupled to the electromechanical arm and the electromechanical tool and is configured to retard advancement of the electromechanical tool toward a tissue surface based on a sensed amount of displacement of a tissue surface, a strain on the tissue of the patient, the temperature of the electromechanical tool, or the like.

Abstract: Medical instruments having a translatable spool are disclosed. In one aspect, a medical instrument configured for use with a robotic system includes an instrument base configured to couple to a robotic drive mechanism of the robotic system and an elongate shaft coupled to the instrument base. The elongate shaft has a distal end. The medical instrument also includes a pull wire fixedly coupled to the distal end of the elongate shaft, the pull wire being configured to actuate the elongate shaft, and a rotatable spool in the instrument base. The rotatable spool is configured to direct the pull wire to the elongate shaft at an angle. The rotatable spool is configured to translate in coordination with actuation of the elongate shaft to control the angle of the pull wire relative to the elongate shaft.

Abstract: A system comprises a medical tool including a shaft having proximal and distal ends and an articulatable distal portion coupled to the distal end of the shaft. The system also comprises a processing unit including one or more processors. The processing unit is configured to determine a target in a medical environment. The articulatable distal portion is directed toward the target. The processing unit is also configured to determine a motion of at least a portion of the shaft, and in response to the determined motion, control a pose of the articulatable distal portion so that the articulatable distal portion remains directed toward the target.

Abstract: Methods and devices are provided for robotic surgery, and in particular for controlling various motions of a tool based on visual indicators. In general, a surgical tool can include an elongate shaft and an end effector coupled to a distal end of the elongate shaft and including first and second jaws. The tool can have at least one visual indicator disposed thereon and configured to indicate a size, position, or speed of movement of the tool or components of the tool.

Abstract: A medical-treatment-tool according to the present invention is provided with: a inserting-portion; a gripping-piece pivots about a shaft orthogonal to a longitudinal axis of the inserting-portion; a driving-portion generates a motive power with which the gripping-piece is driven; a first motive-power transmitting member transmits the motive power to the inserting-portion; a motive-power amplifying mechanism amplifies the motive power; a pulley secured to the shaft of the gripping-piece; a wire-like second motive-power transmitting member wound around the pulley, transmits amplified the motive power to the pulley, and rotates the pulley about the shaft, thus causing the gripping-piece to be pivoted.