Abstract: A surgical system which may include a controller, a data entry device, a powered surgical handpiece and a surgical tool adapted to couple to the surgical handpiece. The surgical handpiece can include motor direction control and feedback, safety stop features, stimulation and nerve integrity monitoring, a tool connector assembly configured to retain a variety of surgical tools and optional navigation and/or electric ratcheting features.

Abstract: Disclosed embodiments relate to a membrane closure device (100) for closing a perforation in a membrane (10), comprising: a patch guiding mechanism (110) for guiding at least one expandable patch (120) to a perforation site (12) of a membrane (10); and a fastener delivery mechanism (130, 330) for delivering a fastener (140) to the perforation site (12) and for fastening the at least one expandable patch by the fastener (140) to the membrane (10) to seal the perforation in the membrane (10) by the at least one expandable patch (120).

Abstract: A cannula assembly can allow an operator in an arthroscopic surgical procedure to control both an arthroscope and a surgical tool with a single hand. In some embodiments, for example, a scope tube may be combined with a tool tube to allow such control. The tool may be manipulated, for example, by causing the tool to rotate, and/or to move forward and backward in relation to the cannula assembly.

Abstract: The present disclosure is directed to a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing an intravascular device having a distal portion and a longitudinal axis and inserting the intravascular device into the vascular lumen. The method may further include positioning the distal portion in the vascular wall, rotating the intravascular device about the longitudinal axis, and advancing the intravascular device within the vascular wall.

Abstract: A retractor having an elongated body that provides access to a surgical location within a patient. The elongate body includes a plurality of segments that are connected to one another through a plurality of ratcheting mechanisms. The ratcheting mechanisms permit relative movement of the segments with respect to one another when expander dilators are inserted within the retractor. The segments are surrounded and retained by a resilient elastomeric sleeve or bands. The distal end surfaces of the segments include thin edges that are configured to mobilize, dissect, split and retract the terminal tissues in the surgical area. The retractor may be used in conjunction with a shim.

Abstract: A mechanical cap ring/gel pad assembly useful in surgical access devices and methods for making the same, wherein the cap ring and the gel pad are formed separately and then mechanically attached to form a strong seal without the need for heating, solvents or adhesives.

Abstract: In a first aspect of the subject invention, an iris expander is provided which includes a non-metallic, unitary, multi-segmented body which is expandable from a first state to a second state. The second state defines a larger footprint than the first state with the body being defined by a plurality of segments connected by living hinges. In a further aspect, an iris expander is provided which includes a multi-segmented body that is expandable from a first state to a larger-footprint second state. At least one aperture is formed in the body with a channel extending therefrom embedded in the body such that no portion thereof is exposed externally of the body. The channel is formed to accommodate a portion of an instrument for causing adjustment of the body with avoidance of direct contact of the instrument with the tissue of the iris.

Abstract: An apparatus includes a gripping instrument that includes a first arm and a second arm disposed opposite the first arm. The first arm and the second arm are joined at a joint, where an end of the first arm opposite the joint is configured to move towards an end of the second arm opposite the joint in a gripping direction. The apparatus further includes a blade disposed on the first arm, where the blade is oriented at an angle that is non-parallel to the gripping direction.

Abstract: A system may include a laser configured to output laser light with a wavelength between 600-780 nm, and a radiation delivery device. The radiation delivery device may be configured to output the laser light to a mesh or suture implant so that the mesh or suture implant is exposed to the laser light. The mesh or suture implant is attached to a patient and surrounded at least partially by tissue of the patient. The mesh or suture implant is vaporized by exposure to the laser light while tissue exposed to the laser light is not damaged by the laser light.

Abstract: Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

Abstract: A multiple-firing clip device includes a hollow shaft defining a lateral opening communicating with an environment and a distal shaft portion between the lateral opening and a distal end opening. A shuttle longitudinally moves on the shaft and comprises a shuttle body defining a lumen surrounding the shaft, a snare, and a snare-extender slide defining a snare track to form a snare travel path in which the snare is disposed from the body and through the track and a portion of the body. The slide moves along a given extent defining a slide distance and a distal end and movement of the slide to the distal end shortens the snare travel path to extend the snare portion through the lateral opening, through the distal shaft portion, and distally out from a distal side of the body longer than the given extent to secure a suture with the snare.

Abstract: A powered handheld electromechanical surgical device includes a motor configured to drive extension and retraction of a drive component, a sensor configured to sense force exerted on the drive component during extension of the drive component, and a controller including a processor and a non-transitory computer-readable storage medium storing instructions that, when executed by the processor, cause the processor to receive the sensed force from the sensor, control a speed of the motor during extension of the drive component in accordance with the sensed force, determine a speed profile or a force profile during extension of the drive component, and control a speed of the motor during retraction of the drive component in accordance with the speed profile or the force profile.

Abstract: Described herein are examples of illustrative orthopedic staples, systems and methods. In an illustrative orthopedic staple for fusion of a foot or ankle bone fracture, the staple includes a bridge, a first staple leg and a second staple legs. The bridge of the illustrative staple extends from a first end portion to a second end portion along a first direction. The bridge also includes a step down region located between the first end portion and the second end portion, the step down region having a height along the insertion axis of the staple. In some examples, the first staple leg has a first staple leg height extending from the bridge to the first distal tip and the second staple leg has a second staple leg height extending from the bridge to the second distal tip, and the first staple leg height is greater than the second staple leg height.

Abstract: A surgical instrument. The surgical instrument includes an elongated channel configured to support a staple cartridge, an anvil pivotably connected to the elongated channel, a knife mechanically coupled to the staple cartridge, an electric motor and a control circuit electrically connected to the electric motor. The control circuit is configured to change a firing motion of the surgical instrument based on a combination of events.

Abstract: The present disclosure includes apparatuses for a surgical handle assembly. An example apparatus includes a reloadable cartridge assembly and a surgical handle assembly including an articulation assembly configured to maintain the reloadable cartridge assembly in a first operation position, the articulation assembly comprising a knob in a first knob position coupled to a housing and a spring coupled to the housing configured to bias a sphere radially outward to a first slot of a radial position component.

Abstract: A surgical tool assembly that includes first and second jaws. The second jaw includes a second jaw body portion and a second jaw mounting portion that is movably coupled to the first jaw. A closure member that has at least one opening cam formed thereon is axially movable in response to closing and opening motions. The opening cam is configured to movably engage a corresponding cam surface that is formed on the second jaw body portion to move the second jaw to an open position.

Abstract: An end effector for a surgical instrument is provided that has different types of features for releasably retaining at least one adjunct material. The end effector has a first jaw having a cartridge and a second jaw having an anvil. The attachment feature includes a retaining filament having, an intermediate portion, and first and second ends disposed on opposed sides of the intermediate portion and having end features configured to mate with at least one jaw of the first and second jaws. The attachment feature is arranged to retain the adjunct material such that at least a part of the intermediate portion is disposed over the adjunct material and such that the first and second ends are spaced apart.

Abstract: A circular surgical stapling device includes a reload assembly that is supported on a distal end of an elongate shaft of the stapling device. The reload assembly includes a housing, a pusher assembly movably supported within the housing, a knife carrier movably supported within the pusher assembly, and an annular knife supported on the knife carrier. The elongate body includes a pusher drive member and a knife carrier pusher. The knife carrier includes first engagement structure that is configured to releasably engage second engagement structure formed on the knife carrier pusher to releasably couple the knife carrier pusher to the knife carrier. A reload insert or member is supported on or integrally formed with the housing of the reload assembly. The reload member includes a first portion configured to prevent separation of the first and second engagement structures and a second portion configured to accommodate separation of the first and second engagement structures.

Abstract: A surgical device is disclosed which includes a handle assembly, an elongated member and a disposable loading unit. The handle assembly includes a mode selection mechanism configured to alternate the surgical device between a first grasping mode of operation and a second clamping mode of operation. The handle assembly includes a rotation control member and an articulation lever. The rotation control member is configured to facilitate rotation of the elongated member with respect to the handle assembly. The articulation lever is configured to facilitate articulation of the tool assembly about an axis substantially perpendicular to the longitudinal axis of elongated member. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly configured to clamp and staple tissue in the second clamping mode of operation of the device.

Abstract: A surgical clip applier includes an outer shaft, an end effector assembly, an inner drive sleeve disposed, and a pin. The end effector assembly includes first and second jaw components. The inner drive sleeve is disposed within the outer shaft and about the jaw components. The inner drive sleeve is movable from a proximal position to a distal position to cam about outer surfaces of the jaw components to move first and second jaws from a spaced-apart position to an approximated position to apply a surgical clip. The pin is disposed between the jaw components. Movement of the inner drive sleeve from the distal position back to the proximal position cams the pin about inner surfaces of the jaw components to move the first and second jaws from the approximated position back to the spaced-apart position.

Abstract: An implant delivery system includes an implant and an inserter releasably connectable to the implant. When the inserter is connected to the implant, actuating the inserter moves the implant between a free state and an elastically deformed state. The implant has a body with a bone facing surface and bilaterally protruding connecting means. The inserter has hooks that engage under the connecting means. The hooks and the rest of the inserter are proximal to the bone facing surface so that the implant may be fully seated against a bone surface while connected to the inserter.

Abstract: An apparatus comprises a body, a shaft assembly, an end effector, a cartridge, and a staple driver actuator. The end effector is operable to manipulate tissue. The end effector comprises a lower jaw, a pivotable anvil, and a translating cutter. The translating cutter is operable to translate relative to the lower jaw and the anvil when the anvil is pivoted toward the lower jaw to manipulate tissue. The cartridge is insertable into the lower jaw and includes a plurality of staples. The staple driver actuator is disposed within the cartridge. The staple driver actuator comprises a secondary cutting element. The translating cutter of the end effector is operable to drive the staple driver actuator distally to staple and cut tissue substantially simultaneously.

Abstract: A surgical instrument including a surgical end effector and a threaded rotary input shaft. An actuator member is in operable engagement with the surgical end effector and is in selective threaded engagement with the threaded rotary input shaft such that when the actuator member is in an engaged configuration, rotation of said threaded rotary input shaft causes the actuator member to move axially to impart an actuation motion to the surgical end effector and when the actuator member is in a disengaged configuration, rotation of the threaded rotary input shaft will not be imparted to the actuator member. A switch may be employed for selectively moving the actuator between the engaged and disengaged configurations. A locking system may be employed for preventing axial movement of the actuator member when the actuator member is in the disengaged configuration.

Abstract: A surgical clip includes a pair of opposed arms joined at one end by an integrally formed flexible hinge. A male head element near the free end of one arm is configured to spread tissue when the male head element is urged towards a head mating element near the end of the opposite arm. The clamping side of an arm may include a protruding feature, such as a wedge shape elongated ridge, while the clamping side of the opposite arm includes a corresponding trough or aperture that receives the protruding feature. Clamping surfaces may include non-slip protrusions, such as ribs, ridges, cones or pins. An applicator holding feature, such as a boss, near the hinge prevents the clip from yawing and becoming askew during application. Rectangular alignment features are provided on the distal ends of the arms to maintain clip alignment during application.

Abstract: In a clip treatment tool, a clip locking part brings arms into a closed state after the arms are brought into a closed state in a state where distal ends of the arms of the clip brought into an open state is pressed against a treatment part and the treatment part is ligated to the distal ends of the arms brought into the closed state. After the clip in which the arms are locked to the closed state is separated from the sheath part and indwelled in the treatment part, the clip removal part is indwelled in the treatment part, the locking of the arms locked to the closed state is released, the arms are brought into the open state as the locking is released, and the clip removed from the treatment part is maintained and taken out.

Abstract: An example occlusive implant is disclosed. The example occlusive implant includes an expandable framework configured to shift between a first configuration and an expanded configuration and a fixation member disposed along the expandable framework. The fixation member includes a first engagement portion and an anchor portion. Further, the first engagement portion is designed to be secured to the expandable framework and the anchor portion extends away from an outer surface of the expandable framework.

Abstract: A saw guide for guiding a surgical saw or drill includes a guide portion having one or more guide slots, the one or more guide slot or hole configured to guide a surgical saw or drill. The guide portion has an attachment portion forming a clamping slot between the guide portion and the attachment portion. A clamp locking mechanism is assembled to the guide portion and has one or more cams in contact with the attachment portion. An alignment system for surgical bone cutting procedures is provided that includes bone pins inserted within a virtual plane relative to a cut plane to be created on a subject's bone. One of the aforementioned guides is configured to be received onto the bone pins, one or more guide slots within said guide, said one or more guide slots configured to guide a surgical saw to make surgical cuts on the subject's bone.

Abstract: A drill assembly for creating a reverse counterbore bone tunnel while increasing bone preservation. The drill assembly including a housing having an actuation mechanism and a cannulated shaft connected to the actuation mechanism. The drill assembly also includes a rigid rod extending through the cannulated shaft. Engaging the actuation mechanism moves the cannulated shaft along the rigid rod. The drill assembly additionally includes a distal tip connected to the cannulated shaft and the rigid rod. Proximal movement of the cannulated shaft along the rigid rod causes the distal tip to rotate from a first configuration to a second configuration. In the second configuration, the distal tip extends at an angle relative to the cannulated shaft.

Abstract: The present subject matter relates to a geared instrument. The geared instrument is configured to translate rotation about a first axis to rotation about a second axis. The geared instrument comprises a handle configured to rotate about the first axis. A translation gear is configured to couple to the handle. A stem is coupled to the translation gear and rotates in unison with the translation gear. The translation gear is configured to translate the rotation of the handle about the first axis to rotation of the stem about the second axis. The stem is configured to couple to a modular head.

Abstract: An instrument for establishing orientation of a pelvic prosthesis comprises a hub, a first arm attached to and extending from the hub, and a second arm attached to and extending from the hub. The first and second arms define a nominal plane of the apparatus, and may extend from the hub at an angle relative to each other. Distances between the first and second legs and between the first and third legs are adjustable. The first, second, and third legs have tips, and the tips of the first, second, and third legs define a plane having a predefined geometric relationship to the nominal plane of the apparatus.

Abstract: Implants for the fusion or fixation of two bone segments are described. For example, the implants can be used for the fusion or fixation of the sacroiliac joint. The implants can include fenestrations, have a rectilinear overall cross-sectional area, and have a curvature. Some implants can also be used to rescue failed implants.

Abstract: A number of orthopaedic surgical instruments for use in a surgical procedure to prepare a patient's femur to receive an orthopedic prosthesis. The tools include guide tools, cutting tools, surgical blocks, and other orthopaedic surgical instruments configured to plan and guide the preparation of the patient's femur. A method of using the orthopaedic surgical instruments is also disclosed.

Abstract: A drill guide to facilitate drilling a hole into a bone and inserting an anchor. The drill guide includes a handle extending to a proximal end and a guide shaft extending from the handle to a distal end. A recess extends into the handle at the proximal end. The drill guide also includes a channel extending through the recess and into the guide shaft and a contact surface extending from the recess. The contact surface may be a proximal surface on a ring extending circumferentially within the recess. The contact surface may alternatively be a proximal surface on a protrusion extending from and within the recess. For example, the protrusion is a triangular protrusion extending along the recess toward the channel. The contact surface allows for the use of inserters of varying sizes within the channel of the drill guide.

Abstract: A catheter is provided which includes an outer catheter and an extendable inner catheter. A sealing feature is positioned between the inner catheter and the outer catheter to seal the annular gap between the two while allowing axial translation. The seal may be a compliant protrusion surrounding the inner catheter and may have a chevron-shape for facilitating axial translation. The seal may be a one-way valve configured to allow antegrade flushing but prevent retrograde flow. The seal may be squeegee-like flange on the distal tip of the outer catheter. The seal may be an expandable bulge, which may be mechanically expandable or inflatable or which may be a photosensitive or electrosensitive hydrogel. The seal may include a spring that is radially compressed upon translation or rotation of the inner catheter to transiently break the seal. Also provided is a seal for sealing between the catheter and the vasculature.

Abstract: An apparatus for performing a balloon dilation procedure at the site of a stenosis or for deploying a stent in a patient, the apparatus including a single lumen catheter having a proximal end and a distal end, and a high pressure balloon attached to the distal end of the catheter. The high pressure balloon is fabricated from a semi-compliant material that has an average rated burst pressure of between about 15 and about 27 atmospheres of pressure and exhibits a dumbbell-shaped outer periphery when inflated to a first atmospheric pressure and a substantially linear outer periphery when inflated to a second atmospheric pressure.

Abstract: In one exemplary embodiment, an angioplasty device may include a flexible shaft. The angioplasty device may also include an expandable wire mesh structure extending from the flexible shaft. At least one actuator, connected to the expandable wire mesh structure, the actuator being configured to cooperate with the wire mesh structure to transfer angioplasty forces to a vessel obstruction.

Abstract: An ultrasonic surgical probe has an elongate shaft and a probe head that is enlarged to extend laterally or transversely in two opposed directions relative to the shaft The head is formed with a recess or cavity facing laterally in a third direction relative to the shaft and the axis. Where the head lies in a plane, owing to its lateral enlargement or extension, the recess or cavity faces in a direction perpendicular to that plane. The recess or cavity is defined in part by an inclined floor or base surface contiguous at a proximal end with the shaft. The recess or cavity is defined in part by a peripheral wall extending only partway around the recess or cavity, along a distal side and two lateral sides thereof. The cavity or recess is closed on a proximal side by the inclined surface and the shaft.

Abstract: An indwelling device that includes a hollow tubular body having a first end and a second end, and the first end is made of an elastic member.

Abstract: Various embodiments for sustained drug delivery using a needle array are disclosed. A medical instrument and a method associated therewith are described for delivering drugs into tonsillar and other tissue as a way of treating tonsillar hypertrophy or inflammation, as an alternative to tonsillectomy and adenoidectomy (T&A) procedures. In some embodiments, a tonsil-accessible medical instrument is described as including a needle head having needles, or microneedles, disposed therein and capable of introducing a compound, such as a steroid, into tissue. The medical instruments enables for the delivery of various compounds, such as pharmaceuticals, for controlled and sustained release.

Abstract: A forceps includes an end effector assembly having first and second jaw members disposed in parallel orientation relative to one another. One or both of the jaw members is movable along a first axis relative to the other jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween. The first and second jaw members are configured to maintain the parallel orientation therebetween upon movement of the jaw members between the spaced-apart and approximated positions. A drive bar is coupled to one or both of the jaw members. The drive bar is selectively movable along a second axis that is different from the first axis between first and second positions for moving the jaw members between the spaced-apart and approximated positions.

Abstract: The embodiments described herein can be used in a variety of grasping, cutting, and manipulating operations. In some embodiments, an apparatus includes a first joint member, a second joint member, and a flexure. The first joint member includes a first connection portion and a contact surface. The second joint member including a second connection portion. A first end portion of the flexure is coupled to the first connection portion, and a second end portion of the flexure is coupled to the second connection portion. The flexure is configured to deform elastically when the first joint member and the second joint member move from a first configuration to a second configuration. When in the first configuration, the central portion of the flexure is spaced apart from the contact portion. When in the second configuration, the central portion of the flexure contacting the contact portion.

Abstract: Various embodiments of tool assemblies are provided having at least one rotary input coupling and at least one linear input coupling for allowing either a rotary output or a linear output (e.g., from a tool driver on a surgical robot) to activate at least one mechanism of the tool assembly. For example, mechanisms of the tool assembly can include a clamping assembly, a firing assembly, an articulation assembly, and a roll assembly. The clamping assembly can open and close jaws of an end effector, the firing assembly can translate a knife assembly through the end effector to fire staples and cut tissue, the articulation assembly can articulate the end effector, and the roll assembly can rotate the elongate shaft and/or the end effector.

Abstract: The teachings herein provide an instrument comprising a forceps. The forceps comprise a hand piece; a tubular member connected to the hand piece; and a jaw assembly connected to the hand piece. The jaw assembly includes a first jaw element and a second jaw element. The first jaw element includes a gripping section and a flexing section. The flexing section includes an arcuate section. The second jaw element opposes the first jaw element and includes a gripping section. The tubular member is moveable onto the arcuate section of the first jaw element so that the flexing section of the first jaw element is flexed and the jaw assembly is moved into a closed position. The first jaw element, the second jaw element, or both include a stiffening spine so that the jaw assembly is substantially rigid in the closed position.

Abstract: A surgical instrument comprising a handle assembly, an elongated shaft, an end effector, a rotation mechanism, and an articulation mechanism is disclosed. The rotation mechanism is disposed in mechanical cooperation with the handle assembly and effects rotation of the end effector about the second longitudinal axis. The articulation mechanism is disposed in mechanical cooperation with the handle assembly and effects movement of the end effector from a first position where the first longitudinal axis is substantially aligned with the second longitudinal axis to a second position where the second longitudinal axis is displaced from the first longitudinal axis. The articulation mechanism comprises a first articulation control disposed in mechanical cooperation with the handle assembly, a first cable and a second cable. Actuation of the first articulation control in a first direction causes the first cable to move distally and causes the second cable to move proximally.

Abstract: A surgical instrument includes a shaft portion which at least partly houses an axially movable cutting element. A handle receives the shaft portion. A trigger element for the cutting element is movably arranged on the handle. The instrument also includes a coupling mechanism which converts a rotation of the trigger element into an axial movement of the cutting element with the interposition of a pinion. The coupling mechanism is designed such that the rotation of the trigger element produces a rotation of the pinion about the central axis thereof and additionally an axial movement of the central axis.

Abstract: A papillotome for percutaneous endoscopic gastrostomy including a front opening located in a free end region of a catheter and at the outlet of a first lumen, a rear opening further from a free end than the front opening and connects the first lumen to the outside, and a cutting wire located in the first lumen in an axially displaceable manner and extends through the front opening and the rear opening and is located on the outside between the front opening and the rear opening. When the cutting wire is tensioned, the free end region is deformed in an arc shape and the cutting wire forms a transversely extending cutting edge between the front opening and the rear opening. The front opening is arranged at a distance of at least 3 mm from the free end. A projection is formed between the free end and the front opening. A cutting tip is formed at the free end of the catheter. The cutting tip is connected to the cutting wire and forms the foremost end of the papillotome.

Abstract: A follicle container for transporting an extracted hair follicle from a follicle extractor and containing the hair follicle for future use includes a receptacle to hold a hair follicle extracted from skin by a follicle extractor; a conduit, coupleable with the follicle extractor, to convey the extracted hair follicle toward the receptacle; and an injector to aerosolize and inject an irrigant into the conduit while the extracted hair follicle travels toward the receptacle. By injecting an irrigant into the conduit, the extracted follicle is less likely to be damaged on its journey to the receptacle. The irrigant lubricates the interior wall of the conduit and thus reduces friction between the extracted follicle and the wall as the follicle travels in the conduit. The irrigant also washes the interior of the conduit and keeps the extracted follicle moist and thus viable and more flexible as the follicle travels through in the conduit.

Abstract: A device for shearing tissue in a human or animal body may include a first member made of a first material and a second member made of a second material. A thread is connected to the first member and to the second member, and the first and second materials show magnetic attraction between one another. A means is provided for pulling the thread between the first and second members.

Abstract: An atherectomy system that utilizes an anchoring balloon with a rotary debulker and a crossing balloon to remove or debulk lesions formed on the interior wall surface of a body vessel. The system may include a first balloon coupled to a first tubular member, a rotary debulker coupled to a second tubular member, a second balloon coupled to both the third tubular member and the axially moveable fourth tubular member such that the second balloon is disposed inside the third tubular member. Methods for operating this device are also provided.

Abstract: Optical systems and methods to track the position of a needle in subsurface structures, such as tissues or organs, and co-register the information with ultrasound are described herein. An optical fiber in a needle catheter is used to transmit light inside of the structure. The light is intensity modulated at sufficiently high frequencies such that the time of arrival of the light can be used to determine the distance of the needle from an optical detector at the tissue surface. The position of the needle can be tracked by combining data obtained using different modulation frequencies and/or wavelengths of light. By using multiple detectors at different positions, the location of the needle in 3D space can be triangulated using light, and the data can be integrated with ultrasound to obtain the anatomical structure.