Abstract: A patella fracture fixation system includes a bone plate that is configured to be implanted along an anterior approach. The bone plate has a fixation hub and a plurality of fixation nodes that are connected to the fixation hub. The fixation hub and the fixation nodes can define respective fixation holes. The bone plate can further include legs that are configured to be bent around respective inferior aspects of the patella.

Abstract: A bone fixation system is configured to be implanted and secured to a bone so as to stabilize a bone. The bone fixation system includes an implant having a plate portion configured to be secured to a first segment of the bone by a first bone anchor, and a second segment of the bone by a second one anchor. The implant further includes a mesh portion configured to abut a third segment of the bone to prevent movement of the third segment relative to both the first segment and the second segment. The implant defining an outer perimeter defined in part by the plate portion and in part by the mesh portion.

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 system for attaching a middle phalanx and a proximal phalanx together may include a middle component and a proximal component. The middle component may have a middle component bone fastener implantable into a first bore formed in the middle phalanx, and a middle component attachment end with a first engagement feature with a first shape. The proximal component may have a proximal bone fastener implantable into a second bore formed in the proximal phalanx, and a proximal component attachment end with a second engagement feature with a second shape. The first engagement feature may be movable into engagement with the second engagement feature along an engagement direction that is generally perpendicular to the middle phalanx and/or the proximal phalanx. The second shape may be complementary to the first shape such that the first engagement feature interlocks with the second engagement feature.

Abstract: A bone graft delivery device, including a dilator sheath arranged to be connected to a first transverse process, the dilator sheath having a first window, a ramp guide removably engageable with the dilator sheath and arranged to be connected to the first transverse process, the ramp guide including a second window and a ramp at least partially connected to the second window, a snake sheath, and a snake arranged to feed the snake sheath through the ramp guide and out of the first and second windows toward a second transverse process, the second transverse process being adjacent to the first transverse process.

Abstract: The present disclosure illustrates an osteotome for treating hard tissue and methods of use. The osteotome embodiments described herein include a shaft with a working end configured to displace hard tissue and a lumen to deliver material through the shaft. The working end may create pathways by selectively transitioning from a linear to a non-linear configuration. The lumen may deliver material through the shaft while the working end is in a linear or a non-linear configuration allowing precise filling of the pathways.

Abstract: In accordance with one aspect of the present disclosure, an instrument for tensioning a surgical cable is provided that includes a rotary tensioner that is rotatable in a tensioning rotary direction to apply tension to the surgical cable. The instrument further includes a body supporting the rotary tensioner, a pawl portion of the body configured to be received at least partially in a recess of a ratchet gear of the rotary tensioner, and a living hinge portion of the body supporting the pawl portion.

Abstract: A surgical guide comprising a body including an inner surface that defines a cavity configured for disposal of a surgical instrument. The body further defining an opening communicating with the cavity. A connector disposable with the opening and engageable with a surgical robot. A release is engageable with the connector. Systems, spinal constructs, implants and surgical instruments are disclosed.

Abstract: A surgical tool for removing a portion of an implant is provided that includes a housing, a motor contained within the housing and coupled to the housing, and an output shaft having a distal end and a proximal end opposite the distal end, wherein the proximal end is coupled to the motor and the distal end has an opening configured to rotateably engage an implant. The surgical tool further includes a counter-torque sleeve extending around the output shaft having a proximal end and a distal end opposite the proximal end, wherein the proximal end is coupled to the housing and the distal end is configured to couple to the implant relative to the counter-torque sleeve. Upon a rotational force to the implant, the forces transmitted by the output shaft and the counter-torque sleeve are balanced by the coupling of the output shaft and counter-torque sleeve through the housing.

Abstract: A method of operating a modular surgical system including a control module, a first surgical module, and a second surgical module is disclosed. The method includes detachably connecting the first surgical module to the control module by stacking the first surgical module with the control module in a stack configuration, detachably connecting the second surgical module to the first surgical module by stacking the second surgical module with the control module and the first surgical module in the stack configuration, powering up the modular surgical system, and monitoring distribution of power from a power supply of the control module to the first surgical module and the second surgical module.

Abstract: An energy module is disclosed. The energy module includes a real time clock and a control circuit coupled to the real time clock. The circuit is configured to detect the presence of a surgical instrument coupled to the energy module, track usage of the surgical instrument in real time based on the real time clock, and deactivate the surgical instrument based on a predetermined total elapsed time based on the real time clock.

Abstract: A tethered system for cryogenic treatment is disclosed in which a hand piece having an elongate probe with a distal tip and a flexible length, at least one infusion lumen positioned through or along the elongate probe, and a liner may be tethered to a base station having a reservoir of a cryoablative fluid via a connection having an elongate flexible body. The connection defines at least one fluid lumen for delivery of the cryoablative fluid from the reservoir and to the infusion lumen within the hand piece.

Abstract: Methods, systems and devices for applying energy to tissue, and more particularly relates to a system for ablating or modifying structures in a body with systems and methods that generate a flow of vapor at a controlled flow rate for applying energy to the body structure.

Abstract: An apparatus and method for sending test signals to an instrument, and checking the resultant and subsequently arriving echo signals in order to detect specific properties and changes of properties on the line, the instrument, the tissue or also on a fluid body, e.g., plasma body, present on an electrode of the instrument, and to control the operation of the supply arrangement accordingly.

Abstract: A treatment system includes a control apparatus having respective first and second output sources that supplies respective high-frequency power defined by a first electrical energy and a second electrical energy. The control apparatus includes a processor configured to acquire a first value based on the first electrical energy and a second value based on the second electrical energy. Based on the first value, the processor determines influence given to the second value by the first electrical energy. Based on the influence given to the second value, the processor adjusts an output instruction value to the second output source by the first electrical energy and the second value based on the second electrical energy. The control apparatus is configured to properly calculate a physical quantity relating to the first and second electrical energies even when an electrical noise is generated in a state in which multiple electrical energies are simultaneously supplied.

Abstract: A method for controlling an output of an energy module of a modular energy system. The energy module can comprise a plurality of amplifiers configured to generate a drive signal at a frequency range and a plurality of ports coupled to the plurality of amplifiers. The method includes determining to which port of the plurality of ports the surgical instrument is connected, selectively coupling an amplifier of the plurality of amplifiers to the port of the plurality of ports to which the surgical instrument is connected, and controlling the amplifier to deliver the drive signal for driving the energy modality to the surgical instrument through the port.

Abstract: An energy module is disclosed. The energy module includes a control circuit and a two wire interface coupled to the control circuit. The two wire interface is configured as a power source and as a communication interface between the energy module and a neutral electrode.

Abstract: Aspects of the present disclosure are presented for providing coordinated energy outputs of separate but connected modules, in some cases using communication protocols such as the Data Distribution Service standard (DDS). In some aspects, there is provided a communication circuit between a header or main device, a first module, and a second module, each including connection to a segment of a common backplane, where the output from a first module can be adjusted by sensing a parameter from a second module. In some aspects, the signal can pass from the first module through the header to the second module, or in other cases directly from the first module to the second module. Aspects of the present disclosure also include methods for automatically activating a bipolar surgical system in one or more of the modular systems using the DDS standard.

Abstract: Aspects of the present disclosure are presented for managing simultaneous outputs of surgical instruments. In some aspects, methods are presented for synchronizing the current frequencies. In some aspects, methods are presented for conducting duty cycling of energy outputs of two or more instruments. In some aspects, systems are presented for managing simultaneous monopolar outputs of two or more instruments, including providing a return pad that properly handles both monopolar outputs in some cases.

Abstract: An energy module for driving electrosurgical and/or ultrasonic surgical instruments is disclosed. The energy module can include an amplifier assembly that is configured to drive a variety of different energy modalities for one or more surgical instruments connected thereto. The energy module can further include a relay assembly for selectively coupling one or more of the amplifiers to different ports to which the surgical instruments are connectable. The amplifier assembly can include amplifiers for driving ultrasonic, bipolar, and/or monopolar energy.

Abstract: A first module configured to engage with a second module in a stacked configuration to define a modular energy system is provided. The first module comprises a first bridge connector portion and a second conductive portion. The first bridge connector portion is configured to engage with a second bridge connector portion of the second module as the first module and the second module are engaged. The first conductive portion is configured to engage with a second conductive portion of the second module as the first module and the second module are engaged, prior to engagement between the first bridge connector portion and the second bridge connector portion.

Abstract: A surgical instrument connectable to a surgical energy module that is configured to provide a first drive signal at a first frequency range for driving a first energy modality and a second drive signal at a second frequency range for driving a second energy modality is provided. The surgical instrument can comprise a surgical instrument component configured to receive power from a direct current (DC) power source, an end effector, and a circuit. The circuit can be configured to convert the first electrical signal to a DC voltage, apply the DC voltage to the surgical instrument component, and deliver the second energy modality to the end effector according to the second drive signal. Alternatively, the circuit can be disposed within a cable assembly configured to connect the surgical instrument to the surgical energy module.

Abstract: Electrosurgical systems and methods are provided for RF nerve ablation, wherein a control console is utilized with a passive or active cable accessory connecting to different of electrode attachments, such as monopolar and bipolar self-grounding types. The control console has multiple RF amplifiers that are associated with multiple channels of the control console and that are energized according to control signals non-simultaneously applied by a controller of the control console. The control console stores and processes identification data and usage data relating to cable accessories and electrode attachments that are connected or have been connected to the control console over time. The control console displays a representation of this processed data on a graphical user interface.

Abstract: A surgical instrument operable to sever tissue includes a body assembly and a selectively coupleable end effector assembly. The end effector assembly may include a transmission assembly, an end effector, and a rotational knob operable to rotate the transmission assembly and the end effector. The body assembly includes a trigger and a casing having a distal aperture configured to receive a portion of the end effector assembly. First and second coupling mechanism portions cooperatively couple the end effector assembly to the body assembly for use. The coupling may mechanically and/or electrically couple the end effector assembly to the body assembly via various coupling mechanisms. For instance, a threaded slip nut may couple to threads within the body assembly. In one configuration, the end effector assembly may have locking tabs that rotate into rotational recesses in the body assembly. The locking tabs may include electrical contacts and/or optically perceivable indicators.

Abstract: Aspects of the present disclosure are presented for a single surgical instrument configured to grasp, seal, and/or cut tissue through application of therapeutic energy, and also detect nerves through application of non-therapeutic electrical energy. A medical device may include two jaws at an end effector, used to apply therapeutic energy and to perform surgical procedures. The therapeutic energy may be in the form of ultrasonic vibrations or higher voltage electrosurgical energy. One of the jaws may be configured to cut tissue through application of the blade. In addition, one or both of the two jaws may be configured to apply nontherapeutic energy for nerve stimulation probing. The application of therapeutic energy may be disabled while the nontherapeutic nerve stimulation energy is applied, and vice versa. The nontherapeutic nerve stimulation energy may be applied to the use of one or more probes positioned near one or both of the jaws.

Abstract: A bipolar dissector includes a handle actuatable by squeezing, a housing extending from and coupled to a distal end of the handle, and a shaft coupled to a proximal end of the handle and extending past the distal end of the handle and through the housing to a distal end of the housing. The shaft includes first and second electrical lines extending from a proximal end to a distal end of the shaft and an insulating material electrically insulating the electrical lines from each other and from the handle and the housing. The bipolar dissector also includes a pair of forceps including a first tine and a second tine. The tines extend from the electrical lines at the distal end of the shaft at the distal end of the housing. Squeezing the handle actuates the forceps in the same direction as the squeezing.

Abstract: A medical instrument comprises a housing and an elongated sheath configured to be attached to the housing. The elongated sheath includes opposed distal end and proximal end along a longitudinal axis. An end effector is configured to be attached to the distal end of the elongated sheath. The end effector includes a pair of grasps. A direction changer is used to change a direction of the end effector with respect to the distal end of the elongated sheath. A first drive shaft movable in the elongated sheath in ganged relation for opening and closing movement of the pair of grasps. A second drive shaft movable in the elongated sheath in ganged relation for angular movement of the end effector by the direction changer with respect to the elongated sheath. An operating member is configured to actuate the second drive shaft between a bent positions and a neutral position.

Abstract: A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. hi this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde 5 approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion. By appropriately maneuvering each member and applying radiofrequency energy between the proximal and distal ends of the occlusion, a continuous channel is created.

Abstract: Aspects of the present disclosure are presented for systems and methods for identifying characteristics of a return pad in a monopolar electrosurgical system using contact quality monitoring (CQM) and near field communication (NFC) signals. In some aspects, resistance or impedance materials are sensed that may help identify what kind of return pad is being used, including what is the structure of the pad. In some aspects, NFC signals are used to identify characteristics of the return pad. In some aspects, the grounding or return pad may include two separate materials that form an interconnecting or interwoven mesh and both act as non-active electrodes when both contact the patient. A non-zero impedance may separate conductive lines connecting the two separate materials that may be analyzed to obtain a defining signature about that is linked to structural characteristics about the return pad.

Abstract: An electrosurgical return electrode configured for operable association with a transponder detection unit. The return electrode includes a conductive element having an aperture array configured to allow passage of a magnetic, electric, or electromagnetic interrogation signal from the transponder detection unit through the conductive element and through the return electrode. The return electrode is positionable over a transponder detection unit such that the return electrode may be placed upon the transponder detection unit and a patient may be positioned upon the return electrode. The return electrode enables the detection of a transponder located on, within, and/or near the patient without the need for repositioning the patient relative to the return electrode and without the need for positioning an ancillary transponder reader or transmitter above the patient.

Abstract: There is provided a cutting element for use in a hair cutting device. The cutting element includes an optical waveguide having an optical axis and a sidewall, wherein a portion of the sidewall forms a cutting face for contacting hair; wherein the optical waveguide includes a plurality of structures formed along the optical axis, the structures having a refractive index which is different to a refractive index of the optical waveguide. A hair cutting device comprising a cutting element, and a method of manufacturing an optical waveguide cutting element are also disclosed.

Abstract: An Optical fiber with modified distal end and related methods are provided. The optical fiber extends from a proximal end portion to a distal end portion and includes a core, a cladding, a coating, and an optional jacket. The distal end portion comprises a portion with an enlarged outer diameter.

Abstract: A computing device and a three-dimensional printer are disclosed. Data associated with reference anatomical properties is accessed by the computing device to generate a set of 3D printing files. The 3D printing files are compiled using the computing device to generate a printing model defining an anatomic orientation corresponding to the reference anatomical properties. Printing parameters and materials for the printing model are configured referencing experimentally derived datasets that define predetermined settings for the printing parameters and materials that are suitable for constructing a synthetic anatomical model with properties related to the reference anatomical properties. A synthetic model is printed using the printing parameters and materials as configured. The printing parameters and materials may be modified as desired subsequent to biomechanical testing of the model.

Abstract: Systems and methods are disclosed for assessing organ and/or tissue transplantation by estimating blood flow through a virtual transplant model by receiving a patient-specific anatomical model of the intended transplant recipient; receiving a patient-specific anatomical model of the intended transplant donor, the model including the vasculature of the organ or tissue that is intended to be transplanted to the recipient; constructing a unified model of the connected system post transplantation, the connected system including the transplanted organ or tissue from the intended transplant donor and the vascular system of the intended transplant recipient; receiving one or more blood flow characteristics of the connected system; assessing the suitability for an actual organ or tissue transplantation using the received blood flow characteristics; and outputting the assessment into an electronic storage medium or display.

Abstract: A processing system comprises a processor and a memory having computer readable instructions stored thereon. The computer readable instructions, when executed by the processor, cause the system to obtain a reference tree of nodes and linkages based on a reference three dimensional volumetric representation of a branched anatomical formation in a reference state. The computer readable instructions also cause the system to obtain a reference three dimensional geometric model based on the reference tree and detect deformation of the branched anatomical formation due to anatomical motion based on measurements from a shape sensor. The computer readable instructions also cause the system to obtain a deformed tree of nodes and linkages based on the detected deformation and create a three dimensional deformation field that represents the detected deformation of the branched anatomical formation.

Abstract: Systems and methods for responding to faults in a robotic system are provided herein. In some embodiments, the system includes an elongate body having a proximal end and a distal end, a backend housing coupled to the proximal end of the elongate body, and a control system. The backend housing includes one or more actuators configured to manipulate the distal end of the elongate body. The control system is configured to control the robotic system by performing operations including: determining an operational state of the medical robotic system, detecting a fault in one or more components of the medical robotic system, classifying the fault according to one or more heuristics, and imposing a fault reaction state on the medical robotic system based on the one or more heuristics to mitigate the fault.

Abstract: Methods and systems for performing robot-assisted surgery, including methods for defining a boundary surface for a robotic surgery system, methods for operating a robotic arm in an image-guided surgery system, methods and systems for providing haptic feedback to a user during robot-assisted surgery, and a robotic arm for use in robot-assisted surgery.

Abstract: A cut guide assembly (600) and a system for mounting assembly on a patient are described. The system includes an ankle clamp (525), an alignment guide (530) configured to be removably attached to the ankle clamp, and the cut guide assembly. The cut guide assembly includes a cut guide (535) and a position tracker (200). The cut guide includes a receiving feature (605) configured to removably attach to at least a portion of the alignment guide, a locking mechanism (610) configured to lock the receiving feature to the at least a portion of the alignment guide, and a plurality of pin receptacles (620), each of the plurality of pin receptacles configured to receive a bone pin (540) configured to affix the cut guide to a patient's bone. The position tracker configured to be affixed to the cut guide when the cut guide is affixed to the patient's bone.

Abstract: Data characterizing a mother video feed acquired by an endoscopic video capture device can be received. The mother video feed can be for characterizing an operative field within a patient. One or more predefined markers can be identified within the mother video feed. Each of the one or more predefined markers can be associated with a surgical instrument in the operative field. Using the data characterizing the mother video feed, a daughter video feed comprising a sub-portion of the mother video feed can be generated. At least one of a location of the daughter video feed within the mother video feed and a zoom of the daughter video feed can be based on the identified one or more predefined markers. The daughter video feed can be provided. Related apparatus, systems, techniques, and articles are also described.

Abstract: Disclosed are systems, methods, and techniques for registering a HMD coordinate system of a head-mounted display (HMD) and a localizer coordinate system of a surgical navigation localizer. A camera of the HMD captures at least one image of a registration device having a registration coordinate system and a plurality of registration markers. The registration markers are analyzed in the at least one image to determine a pose of the HMD coordinate system relative to the registration coordinate system. One or more position sensors comprised in the localizer detect a plurality of tracking markers comprised in the registration device to determine a pose of the registration coordinate system relative to the localizer coordinate system. The HMD coordinate system and the localizer coordinate system are registered using the registration device, wherein positions of the registration markers are known with respect to positions of the tracking markers in the registration coordinate system.

Abstract: A method of registering a real-time image feed from an imaging device inserted into a steerable catheter using a navigation system is provided. The method includes inserting the imaging device into a working channel of the steerable catheter and generating a real-time image feed of one or more reference points, wherein the orientation of the reference points is known. The method further includes orienting a handle of the steerable catheter to a neutral position, displaying the real-time image feed on a display of the navigation system, and registering the real-time image feed to the steerable catheter by rotating the displayed image so that the reference points in the real-time image feed are matched to the known orientation of the reference points.

Abstract: A system and method for navigating to a target site in a patient is provided. The system includes an extended working channel and a tool usable with an electromagnetic navigation system. In particular, the extended working channel and the tool contain an electromagnetic sensor configured to provide location information within a patient of the extended working channel and the tool to the electromagnetic navigation system. The distance from the tool and the target site can then be determined and displayed to a clinician on a display device.

Abstract: A method for displaying guidance information using a graphical user interface during an medical procedure comprises displaying, in a first mode of the graphical user interface, first image data from a perspective corresponding to a distal end of an elongate device. The first image data includes a virtual roadmap. The method also comprises transitioning from the first mode of the graphical user interface to a second mode of the graphical user interface. The transition is based on an occurrence of a triggering condition. The method also comprises displaying, in the second mode of the graphical user interface, second image data from a perspective corresponding to the distal end of the elongate device. The second image data includes a target indicator corresponding to a target location and an alignment indicator corresponding to an expected location of the medical procedure at the target location.

Abstract: Systems and methods for controlling an elongate device include an input control console. The console includes a first input control having an infinite length of travel in a first direction, a second input control having an infinite length of travel in more than one direction, one or more transceivers for coupling the console to a control unit for the elongate device, and interface circuits for coupling the first input control and the second input control to the one or more transceivers. The first input control provides a first command suitable for controlling an insertion depth of the elongate device. The second input control provides second commands suitable for controlling steering of a distal end of the elongate device. In some embodiments, the console includes raised rings or bezels within which the input controls are mounted. In some embodiments, pockets of a drape are anchored to the raised rings or bezels.

Abstract: A system comprises a teleoperational assembly including an operator control system and a teleoperational manipulator configured for operation by the operator control system. The teleoperational manipulator is coupled to a medical instrument in a surgical environment. The system also comprises a processing unit including one or more processors. The processing unit is configured to retrieve a user profile for a user. The user profile including a parameter established during a prior teleoperational procedure. The processing unit is also configured to provide instructions to configure an operation of the teleoperational assembly based upon the parameter.

Abstract: A method for controlling a user interface of a modular energy system. The modular energy system comprises a header module and a display screen on which the user interface is displayed. The modular energy system can detect attachment of a first module thereto, control the user interface to display one or more first user interface elements corresponding to the first module, detect attachment of a second module to the modular energy system, control the user interface to resize the one or more first user interface elements to accommodate display of one or more second user interface elements corresponding to the second module, and control the user interface to display the one or more second user interface elements. The various UI elements can correspond to the particular module type that is being connected to the modular energy system.

Abstract: A method for providing a visual expiration indication for a surgical instrument includes holding an indicator body in a first position with a detent mechanism to provide a visual in-service indication for the surgical instrument. The indicator body is engaged with a motor and the indicator body is rotated with the motor from the first position to a second position that provides a visual expired indication. The indicator body is prevented from rotating from the second position to the first position with the detent mechanism. The detent mechanism may hold the indicator body in one of only two positions. The visual indications may be displayed through an aperture fixed to the base of the surgical instrument. The indicator body may be elastically deformed when the indicator body is rotated from the first position to the second position. The motor may be rotated to gain momentum before rotating the indicator body.

Abstract: A system includes a controller communicatively coupled to an illuminator and to a camera configured to capture a scene including tissue. The controller may change the output optical power of the illuminator from a first output optical power to a second output optical power so that a subsequently captured frame is captured by the camera from reflected light, the reflected light being light from the illuminator having the second output optical power prior to being reflected. The controller may determine that an endoscope contacted the tissue if the change of the output optical power of the illuminator results in a change of a reflected luminance that is less than a predetermined threshold, the change of the reflected luminance being a change from a first reflected luminance for the first output optical power to a second reflected luminance for the second output optical power.

Abstract: A teleoperational medical system comprises an input device and a manipulator configured to couple with and move an instrument. The system also comprises a control system including one or more processors. In response to a determination that the instrument is inserted into an instrument workspace in a corresponding direction to a field of view of the workspace, the control system is configured to map movement of the input device to movement of the instrument according to a first mapping. In response to a determination that the instrument is inserted into the instrument workspace in a non-corresponding direction to the field of view, the control system is configured to map movement of the input device to movement of the instrument according to a second mapping. The second mapping includes an inversion of the first mapping for at least one direction of motion of the instrument.

Abstract: A modular energy system including a header module and a module. The header module includes a display screen for displaying a user interface. The header module is configured to receive data, including safety critical data, from the module, control the display screen to cause the UI to display UI content based on the received data, the UI content including safety critical UI content based on the safety critical data, and transmit the displayed safety critical UI content to the module for verification thereby. The module is configured to confirm whether the transmitted safety critical data coincides with the displayed safety critical UI content. In the event that it is determined that they do not coincide, the header module and/or the module can be configured to stop the function(s) of the module, display an alert on the display screen, and take various other actions.