Abstract: Some disclosed suture securement devices comprise a flat, thin, generally planar body that has one or more suture engagement slots extending into the body from a perimeter inlet for receiving sutures laterally into the device. The slots can be resiliently widened to receive a suture and then released to clamp onto the suture. Some embodiments include two or more such suture engagement slots that independently receive and secure different sutures. Some embodiments include one or more locking tabs that have a closed position that retains the slots against widening and blocks the inlet to the slot. In some embodiment two or more slots are position next to each other on the same side of the device, while in other embodiments slots are positioned on opposite sides of the device. Other types of suture securement devices are also disclosed.

Abstract: A surgical suturing device is disclosed. The surgical suturing device may include a first or a second tissue gap, a first pair of needles configured to be movable across the first tissue gap, a second pair of needles configured to be movable across the second tissue gap, and a first suture having first and second ends. The surgical suturing device also includes a second suture having first and second ends and a needle actuator which selectively engages either: the first pair of needles to drive them through the first tissue gap and into communication with the first end of the first suture and the first end of the second suture, respectively; or the second pair of needles to drive them through the second tissue gap and into communication with the second end of the first suture and the second end of the second suture.

Abstract: A suture attaching station attaches a needle and a suture to form a single combination. The setup of the crimping unit is facilitated by using an offline measuring fixture. The offline measuring fixture is calibrated by placing a precision gage block into the measuring fixture and then zeroing a digital measuring unit. The gage block is then replaced by the desired crimping die and the reading is noted as an offset for the servo drive of the suture attaching station. This offset is used to set the zero point of the crimping die centre.

Abstract: According to one aspect, a medical device including a needle configured for use in suturing tissue is described. The needle may include a cylindrical body having a longitudinal axis extending between first and second ends of the cylindrical body. The needle may also include a lumen extending through the cylindrical body transverse to the longitudinal axis. The needle may further include a first end portion at the first end of the cylindrical body. The first end portion may include a sharp point configured to pierce tissue. An outer surface of the cylindrical body may define a first recess in communication with an opening of the lumen and configured to receive an end of a suture.

Abstract: Aspects of the present disclosure are presented for a surgical instrument having one or more sensors at or a near an end effector and configured to aide in the detection of tissues and other materials and structures at a surgical site. The detections may then be used to aide in the placement of the end effector and to confirm which objects to operate on, or alternatively, to avoid. Examples of sensors include laser sensors used to employ Doppler shift principles to detect movement of objects at the surgical site, such as blood cells; resistance sensors to detect the presence of metal; monochromatic light sources that allow for different levels of absorption from different types of substances present at the surgical site, and near infrared spectrometers with small form factors.

Abstract: A surgical stapling device that comprises an end effector. According to various embodiments, the end effector comprises a circular anvil having a staple forming surface and a plurality of staples facing the staple forming surface of the anvil. The end effector also comprises a staple driver assembly comprising a plurality of staple drivers. Each staple driver supports one of the plurality of staples and is configured such that, when the staple driver assembly is actuated, each staple driver drives the staple into the staple forming surface of the anvil. A first quantity of the plurality of staple drivers has a first height and a second quantity of the plurality of staple drivers has a second height, wherein the first height is less than the second height.

Abstract: A surgical stapling device includes a handle assembly, an elongate body extending distally from the handle assembly, and a tool assembly. The tool assembly is mounted onto the distal portion of the elongate body for articulation and includes a staple cartridge that supports a plurality of staples and pushers. An actuation sled is movable through the staple cartridge to eject staples from the staple cartridge and a clamp member is movable through the tool assembly to move the tool assembly from an open position to an approximated position and to advance the actuation sled through the staple cartridge to eject staples and transect tissue. In order to minimize the space for the firing assembly in the proximal portion of the tool assembly, the actuation sled and clamp member are supported in a nested relationship in a pre-actuated state of the tool assembly. The clamp member is subsequently moved to a position proximal of the actuation sled during a firing stroke of the stapling device.

Abstract: An abdominal closure method and device is disclosed where the device generally includes a first tissue securement member configured for securement to a first tissue region and a second tissue securement member configured for securement to a second tissue region. The first and second tissue securement members are coupled to the connecting member and the connecting member is positionable at a distance from the first and second tissue regions. Additionally, one or more biasing elements may be connected to the first and second tissue securement members to approximate the first and second tissue regions towards one another via respective securement members.

Abstract: The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

Abstract: The invention is directed to a method and a surgical instrument, typically a surgical stapler that is configured for performing anastomosis of a first gastro-intestinal tract section to a second gastro-intestinal tract section, both gastro-intestinal tract sections comprising a superficial layer and an intermediate layer. Said method comprises contacting the superficial layers of said gastro-intestinal tract sections and compressing the contacted sections between a first pressure area and a second pressure area, wherein the sum of the first pressure area and the second pressure increases during the compression such that the superficial layers are pressed aside and the intermediate layers are contacted.

Abstract: An anvil assembly suitable for trans-oral delivery includes an anvil head configured to receive a retrieval suture that is separable from the anvil head following delivery of the anvil assembly. An anvil delivery assembly includes the anvil assembly, a delivery assembly secured to the anvil assembly, and a retrieval suture selectively secured to the anvil assembly for retrieving the anvil assembly.

Abstract: There is provided a laminate membrane for an implant, comprising: an inner layer having an inner layer thickness; a first covering layer disposed on one side of the inner layer, the first covering layer having a first covering layer thickness; and a second covering layer disposed on another side of the inner layer, the second covering layer having a second covering layer thickness.

Abstract: An implantable device for control over the size of emphysematous bullae in a lung, including: an elongated central region having a fixed axial length; a first end including a first anchor; and a second end including a second anchor.

Abstract: An improved occluding device for occlusion of fluid flow through a lumen of a body vessel includes a main coil having first primary coil windings with a first coil diameter and an end coil having second primary coil windings with a second coil diameter. The main coil is formed into a secondary coil with various shapes. The main coil and the end coil are monolithically formed. A method of manufacturing the occluding device by a continuous process is also provided.

Abstract: Systems and methods for performing an osteotomy are presented. Examples include forming a fusion osteotomy at a metatarsocuneiform joint of the first ray of a human foot.

Abstract: Retro guidewire reamers include a drill having a tubular shaft configured to be disposed over a guidewire and at least one cutting member movably disposed adjacent the distal end of the shaft. A slide actuator is moveably coupled to the shaft and to an actuator wire slidable along the shaft. The actuator wire is operative to move the at least one cutting member between a closed position and a deployed position when the slide actuator is moved along the shaft. The retro guidewire reamers include mechanisms to protect the mechanical joint between the actuator wire and the slide actuator which prevent the actuator wire from disengaging from the slide actuator when the cutting member is obstructed by a guidewire.

Abstract: A portable and passive safety intraosseous device to allow for direct introduction of medications, etc., within the intermedullary space of a subject patient's bone or, if needed, the removal of certain substances from such a subject patient's bone. Such a device permits direct drilling and placement of a cannula within the subject bone with access external to the subject patient's skin, permitting, as well, connection of a tube for such introduction/removal purposes. The ability to provide a passive safety unit allows for facilitated utilization in, for instance, emergency situations with the entire device provided for utilization thereof. The device includes a drilling component with a permanently attached stylet and a removable cannula, a power supply for a single drilling operation, a mechanism to draw the stylet back into the drill component after use and disengagement from the cannula, and an automatic closure that activates with the separation of the cannula.

Abstract: A surgical device may include a tube and a cutting blade movable between a first position in which the cutting blade is concealed inside the tube and a second position in which the cutting blade is exposed through a sidewall of the tube.

Abstract: A thrombosis macerating and aspiration device for macerating and aspirating blood clots and blockages in a blood vessel is disclosed. In some embodiments, the macerating element of the device rotates and creates a partial vacuum to assist in the aspiration of the blood clot of blockage. The macerating element may have a variety of different designs and shapes and in some embodiments, the macerating element is expandable.

Abstract: A stiffening device is disclosed that is adapted to cooperate with a flexible kidney stone extractor. The stiffening device includes a tube having a lumen sized to receive a part of flexible kidney stone extractor; a diversion member having a channel that is configured to receive a part of the flexible kidney stone extractor; and a connector coupled between the tube and the diversion member. The connector allows the channel of the diversion member to communicate with the lumen of the tube. A proximal portion of the connector is connected to the diversion member and a distal portion of the connector is connected to the tube.

Abstract: A device for removing a urinary tract stone from a ureter may include an outer shaft, an inner shaft extending coaxially within the outer shaft, a self-expanding wire basket attached to a basket shaft extending coaxially within the inner shaft, an inflatable balloon and a handle. The balloon main include a rounded distal tip. The handle may include an inversion slider coupled to the inner shaft and configured to actuate the inner shaft, thereby inverting the distal tip of the inflatable balloon to form a pocket adapted to receive a urinary tract stone. The handle may also include a basket slider coupled to the basket shaft and configured to actuate the basket shaft to move the wire basket in and out of the inner shaft.

Abstract: The invention involves forceps having rounded grasping tips. The rounded tips are configured to avoid puncturing an amniotic membrane during insertion over an ocular surface for the treatment of dry eye disease and inflammation of the eyes and to avoid injuring the conjunctiva during removal of an amniotic membrane from the ocular surface. The forceps have grasping tips at its distal end, wherein one of the grasping tips has a notch on its inside surface. The dimensions of the notch are configured to permit an eye doctor to securely and safely grasp a lip of an amniotic membrane insert for better insertion and removal from an ocular surface.

Abstract: Provided is a treatment tool including an elongated inserting section that is curvable or bendable, a wire that is disposed from an end effector to a proximal end side of the inserting section through the inserting section, the end effector being connected to a tip of the inserting section, and a power input section that is disposed on the proximal end side of the inserting section and configured to input power to a proximal end portion of the wire, and the wire transmits, to the end effector, power to drive the end effector, and the power input section is configured to increase the power to be input into the proximal end portion of the wire in response to displacement of the proximal end portion of the wire in a longitudinal direction, the displacement accompanying a curve or bend of the inserting section.

Abstract: A surgical instrument includes an instrument shaft, two instrument branches that can be positioned relatively to one another in a working position and a rest position, a handle element on which an operating element is movably arranged for positioning the instrument branches, and a coupling mechanism having a translating unit that converts a movement of the operating element, non-linearly, into a relative movement of at least one of the two instrument branches. The coupling mechanism includes at least one bias element that biases the mechanism into the rest position and/or into the working position of the instrument branches.

Abstract: An implant excision aid comprising a first plate comprising an external surface, an internal surface, a top portion, a bottom portion, a right side and a left side, wherein the bottom portion of the first plate is in communication with the patient's skin during use; a second plate comprising an external surface and an internal surface, a top portion, a bottom portion, a right side and a left side, wherein the bottom portion of the second plate is in communication with the patient's skin during use, wherein at least a portion of the bottom portion of the first or second plate or the internal surface of the first plate or second plate comprises a polymer or a metal, wherein the polymer or the metal generates enough friction so that the portion of the bottom of the first or second plate or the internal surface of the first plate or second plate is capable of moving the patient's skin during use; and a hinge wherein the hinge connects the top of the first plate to the top of the second plate.

Abstract: Embodiments of the invention include drive units and other effective types of movement inducing devices that include load sensing mechanisms capable of giving feedback to a user when a force is being applied to the devices during use. The applied force for which monitoring is provided may be one or more of a lateral force transverse to a longitudinal rotating axis of a surgical blade, burr, or other mechanism, a force applied along the longitudinal rotating axis, and other forces.

Abstract: Disclosed herein is a medical device. The medical device includes two coaxially aligned solenoids and a cannulated armature configured to be received within the two coaxially aligned solenoids.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A handle is mounted to the proximal end portion of the elongate body and operable to cause rotation of the elongate body. A tissue-removing element is mounted on the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body and is coupled to the handle at a proximal end portion of the inner liner. The inner liner defines a guidewire lumen. A sensor is arranged with respect to the inner liner and is configured to produce a signal for indicating the presence of a guidewire within the inner liner.

Abstract: A shield component for an endoscopic surgical blade is disclosed. An endoscopic surgical blade assembly is disclosed. The endoscopic surgical blade assembly contains an endoscopic surgical blade having a distal end, a proximal end, a top edge, a bottom edge and one or more cutting surfaces at the distal end, and a protective shield attached to the blade above the one or more cutting surfaces and extending away from the distal end of the blade. The blade is structurally configured for attachment to the distal end of an endoscope.

Abstract: An ultrasonic instrument includes a body, an actuation assembly, a shaft assembly, and an end effector. The actuation assembly includes a mode selection member and an activation member. The shaft assembly extends distally from the body. The shaft assembly includes an acoustic waveguide. The end effector includes an ultrasonic blade. The ultrasonic blade is in acoustic communication with the acoustic waveguide. The end effector is configured to be activated in a first activation mode in response to actuation of the activation member when the mode selection member is in a first position. The end effector is configured to be activated in a second activation mode in response to actuation of the activation member when the mode selection member is in a second position.

Abstract: A surgical procedure of preparing bone holes to dispose an implanted tendon to a femur when performing reconstruction of a ligament in a knee joint, includes: forming a first bone hole in the femur; and applying ultrasonic vibration from a treatment portion of an ultrasonic treatment instrument to the femur, thereby cutting and expanding the first bone hole from the inside of the knee joint to the first bone hole of the femur along a predetermined depth, and forming a second bone hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive the implanted tendon.

Abstract: An apparatus includes a body, a shaft assembly, and an end effector. The shaft assembly includes an outer tube, an inner tube, and an acoustic waveguide. The end effector includes an ultrasonic blade and a clamp arm. The ultrasonic blade is acoustically coupled with the acoustic waveguide. A first portion of the clamp arm is pivotably coupled with a distal end of the outer tube. A second portion of the clamp arm is pivotably coupled with a distal end of the inner tube. The outer tube and the inner tube are configured to removably couple with the body such that the outer tube, the inner tube, and the clamp arm are configured to removably couple with the body and the remainder of the shaft assembly and end effector as a unit.

Abstract: An ultrasonic instrument includes a body, a shaft assembly, and an end effector. The shaft assembly extends distally from the body. The shaft assembly includes an acoustic waveguide configured to acoustically couple with an ultrasonic transducer. The end effector includes an ultrasonic blade, a clamp arm and a clamp pad. The ultrasonic blade is in acoustic communication with the waveguide. The clamp arm is pivotally coupled with the shaft assembly. The clamp pad is configured to removably couple with the clamp arm while the clamp arm is pivotally coupled to the shaft assembly.

Abstract: A device for introduction into a body vessel includes a shaft, a balloon positioned at the distal end of the shaft, a guidewire disposed longitudinally within the shaft to receive a guidewire during use, a balloon disposed at the distal end of the shaft, and longitudinal scoring wires to score a vascular lesion attached to the distal end of the shaft. The scoring wires are disposed over the balloon and disposed within the shaft. The proximal ends are welded or otherwise affixed to a spring mounted in the handle. The balloon expands when fluid is delivered to the balloon through the inflation lumen. This expansion pushes the scoring wires against the vascular lesion. The scoring wires attach to a source of vibrations. The scoring wires are made of a helical coil.

Abstract: Mechanical atherectomy and/or thrombectomy devices configured to remove obstructions (e.g., plaque material) of different consistencies and/or sizes from blood vessels. The devices may include a tractor comprising a flexible tube of material that inverts as it rolls over itself while being drawn into the open distal end of a catheter in a conveyor-like motion. The flexible tube can include features that facilitate engagement with the obstruction, enhance smooth tractor motion and/or promote movement control of the device within the blood vessel.

Abstract: This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.

Abstract: A needle comprising: (a) a walled lumen having: (i) a proximate end; (ii) a distal end; and (iii) a plurality of zones located between the proximal end and the distal end, the plurality of zones comprising: (1) a first zone with a first stiffness value; (2) a second zone connected to the first zone, the second zone having a second stiffness value; (3) a third zone connected to the second zone, the third zone having a third stiffness value; and (4) a fourth zone connected to the third zone, the fourth zone having a fourth stiffness value; wherein some of the plurality of zones include one or more cut patterns in the walled lumen.

Abstract: The present application relates to a cannula, comprising a cannula body with a cannula tube and a body part attached to the proximal end of the cannula tube, a control clip having a mounting body with at least one control element, said control clip being attachable laterally on the body part to form a first configuration. In addition, the present applications relates to a cannula body, a contact clip and a control clip of a cannula.

Abstract: A cannula seal is presented. The cannula seal includes a cross-slit seal that can include a side wall that includes folded sidewalls; slits that are formed by the folded sidewalls when the cross-slit seal is in a closed position; and a concave end surface at the slits. The cross-slit seal can include energizing ribs formed to close the seal. The instrument guide includes a pyramidal shaped seal that seals against doors when no instrument is inserted and seals against an instrument when the instrument is inserted.

Abstract: A specimen retrieval system is disclosed. The specimen retrieval system includes a first hollow tube including one or more cutting elements on a first end of the first hollow tube, a first gear on a second end of the first hollow tube, a second hollow tube movable relative to the first hollow tube a second gear on a first end of the second hollow tube, a rack coupled to the first gear and the second gear, and a first actuator coupled to the rack. A second end of the second hollow tube may include cutting elements. The specimen retrieval system also includes a rack coupled to the first gear on the first hollow tube and the second gear on the second hollow tube. The specimen retrieval system may also include a geared tenaculum disposed inside the first hollow tube, and a second actuator coupled to the geared tenaculum.

Abstract: An anchoring system implantable in bone. The anchoring system includes a screw having a screw head, a screw shaft, a plurality of interface elements, each adjacent pair of the interface elements has an interface by-pass channel disposed therebetween, a boring ring that includes cutting teeth and a ring by-pass channel, and a coupling assembly that is adjustable with respect to a longitudinal axis of the screw.

Abstract: A polyaxial bone anchor with a receiver, a shank, a pressure insert, a retainer for holding the shank in the receiver, and a closure. The receiver having at least one vertically aligned guide on a surface of an interior shank and insert receiving chamber. The insert having at least one shoulder that aligns with the guide and both properly positions the insert relative to the receiver during assembly and prevents the insert from axially rotating relative to the receiver.

Abstract: Embodiments disclosed herein include systems for the treatment of spinal deformity in children by harnessing growth modulation without requiring vertebral fusion. In some embodiments, the system uses flexible or moveable elements to selectively apply and tune forces and moments to the spine instead of rigid fixation and vertebral segment fusion.

Abstract: Occipital plate systems are described. The occipital plate systems include an occipital plate having an upper portion and lower portion. The lower portion can include an opening for receiving one or more lateral members therethrough. The lateral members include top and/or side apertures for receiving lateral connectors that are attached to polyaxial screw receiving members. The occipital plate systems can also include low-profile clamping arms that are operably attached to an occipital plate via an extension member and articulating joint member. The clamping arms, along with tension cables attached intermittently along its length, can be used in addition to or instead of screws and hooks to secure an occipital plate system to vertebrae.

Abstract: The present invention concerns an accessory for tensioning an elongate element for attaching an implant to a bone element, comprising a rod having proximal and distal ends and a longitudinal axis L, the distal end of said rod being provided with a bearing device for bearing on the implant. The accessory further comprises a device for tensioning the elongate element, comprising a drum mounted so as to be able to rotate about an axis T, transverse to the axis L, arranged at the proximal end of the rod, the drum comprising a holding portion suitable for cooperating with the elongate element. The tensioning device comprises a device for rotating the drum about the axis T, allowing the elongate element to be tensioned by winding the elongate element around the drum.

Abstract: An instrument for locking and unlocking a head of a bone anchor relative to a receiving part of a polyaxial bone anchoring device includes a tube assembly with an inner tube and an outer tube at least partially around the inner tube, and an actuator assembly including an actuating mechanism movable from a first orientation to a second orientation to displace the inner tube and the outer tube relative to one another between a first axial position configured to unlock the bone anchoring device such that the head is pivotable relative to the receiving part, and a second axial position configured to lock the head. The actuator assembly is adjustable between a first configuration where the tube assembly assumes the first axial position when the actuating mechanism is moved, and a second configuration where the tube assembly assumes the second axial position when the actuating mechanism is moved.

Abstract: A tool set for implanting a rod in a human spine in conjunction with bone screws. The tool set includes a pair of end guide tools that receive opposite ends of the rod in channels and under manipulation by a surgeon facilitate transport of the rod toward the bone screws attached to the guide tools. Intermediate guide tools having guiding pass through slots are utilized to guide intermediate locations along the rod toward associated bone screws. An attachment structure operably connects the guide tools to the bone screws. The guide tools each include a lower guide and advancement structure to allow a closure top with mating structure to be rotated and driven downward against the rod and to cooperate with similar structure in the bone screw to seat and lock the rod therein. A method utilizing the tool set allows a surgeon to percutaneously implant the rod in the patient.

Abstract: Examples of devices and methods for stabilizing a fracture in a bone include a body having an elongate distal portion having an outer surface defining a screw thread and an elongate proximal portion having a non-threaded outer surface.

Abstract: A bone plate and one or more locking assemblies that help prevent screw backout without impinging on therapeutically valuable settling of the screws. In some cases, the locking assembly is configured to be attached to the plate, to be securely but efficiently locked, to be readily unlocked for revision surgery, and/or to reduce the possibility of operator error in installation by providing simplified visible and tactile indicia of the locked and unlocked positions.

Abstract: A locking element is configured to be used with a polyaxial bone anchor. The locking element including a central axis, a bottom side, a top side opposite to the bottom side, and a peripheral surface portion that extending completely around the locking element that has an external thread. The bottom side defines a first recess facing toward the bottom side for accommodating and applying a force in a direction toward the bottom side to at least the portion of the head of the polyaxial bone anchor. The top side defines a second recess having a non-circular cross-section in a plane perpendicular to the central axis for torqueable engagement with a driver.