Abstract: A surgical drill alignment guide is disclosed that can provide an accurate trajectory for placement of a bone screw along a longitudinal axis of a bone.

Abstract: Methods and apparatuses including apparatuses that can be used for guiding resection of a tibia during a knee replacement surgery procedures are disclosed. According to one example, an apparatus for guiding a tibial bone cut during knee replacement surgery is disclosed. The apparatus can comprise a first portion and a second portion. The first portion can be configured to position the apparatus relative to one or more of a medial condyle of a femur, a lateral condyle of the femur, a medial condyle of a femoral component and a lateral condyle of the femoral component. The second portion can be connected to the first portion and can define one or more slots. The slots can be configured for at least one of a first proximal cut and a first sagittal cut to the tibia.

Abstract: A clot removal system includes a catheter having proximal and distal ends and defining a lumen configured to be filled with a liquid column having a proximal portion, a vacuum pump supplying vacuum, a vent container holding vent liquid, a vent valve configured to fluidically communicate with the vent liquid and with the proximal portion of the liquid column at the proximal end of the catheter, a vacuum valve configured to fluidically communicate with the vacuum and with the proximal portion of the liquid column at the proximal end of the catheter, and a controller configured to carry out a pre-determined pattern of opening and closing the vent and vacuum valves to change a level of vacuum at the distal end and, while changing the level of vacuum at the distal end, to substantially prevent forward flow of the liquid at a distal end of the liquid column.

Abstract: A manipulator includes a pair of flexible operating bodies including a horizontal plate spring, a curved vertical plate spring, a shaft body, and an operation portion. The pair of flexible operating bodies overlaps such that a second flexible operating body on one side is opposite to a first flexible operating body on the other side, and is linked to each other to be rotatable by a pin penetrating respective shaft bodies. In a holder that supports both ends of the pin, a pair of outer horizontal plate springs that has the horizontal plate springs of each of the pair of flexible operating bodies to be interposed in parallel between the holder and extends in the same direction as the horizontal plate spring is integrally formed.

Abstract: Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation. The methods may be performed using an ultrasound ablation catheter. The methods may also include imaging using at least one ultrasound imaging catheter.

Abstract: The present disclosure provides a surgical instrument including an end effector, a drive member movable to effectuate a motion in said end effector, a motor operable to move the drive member to effectuate the motion in the end effector and a bailout assembly operable to perform a mechanical bailout of the surgical instrument in response to a bailout error. The bailout assembly includes a bailout door, a bailout handle accessible through the bailout door. The bailout handle is operable to move the drive member to effectuate a bailout motion in the end effector. A controller includes a memory and a processor coupled to the memory. The processor is configured to detect the bailout error. The processor is programed to stop the motor in response to the detection of the bailout error.

Abstract: The present disclosure relates to an ultrasonic surgical handpiece assembly comprising a surgical handpiece for use with an irrigation sleeve and ultrasonic tip. The surgical handpiece may comprise a piezoelectric transducer disposed within a housing and configured to manipulate the ultrasonic tip. One or more lumens and/or a flex circuit including an antenna may be disposed within the surgical handpiece housing. The lumen(s) may be configured to provide irrigation and/or aspiration to the irrigation sleeve and/or ultrasonic tip. The irrigation sleeve may comprise a second antenna configured to communicate with the ultrasonic handpiece antenna. The irrigation sleeve may further comprise and an alignment and/or coupling feature configured to removably secure the irrigation sleeve to the housing and orient the second antenna relative to the ultrasonic handpiece antenna. The irrigation sleeve may further comprise a lumen for supplying irrigation and/or aspiration to the ultrasonic tip.

Abstract: An intravascular catheter device includes an expandable portion which has a plurality of struts and is secured to a flexible catheter tube. A tip member is attached to a distal portion of a sleeve and a distal portion of the struts. Axial retraction of the tip member moves the expandable portion from a closed position where the struts extend parallel with a centerline of the expandable portion to an opened position where the struts bow outwardly. An incising element is associated with at least one of the struts. The incising element extends parallel with the centerline when the expandable portion is in the closed position.

Abstract: An intravascular catheter device for treating atherosclerotic material located within a blood vessel includes an expandable portion is secured to a catheter tube having a centerline. The expandable portion includes a plurality of struts pivotably attached to the expandable portion for movement between a closed position where the struts extend parallel to the centerline and an opened position where the struts splay outwardly at an angle from the centerline. A sharpened edge associated with at least one of struts creates an incision in the atherosclerotic material when the expandable portion is placed in the opened position and retracted axially through the blood vessel.

Abstract: A medical device is disclosed that can help prevent a guide wire from coming into contact with a rotating body in the middle of performing a treatment and achieves improvement in the efficiency of cutting an object by the rotating body. The medical device has a sheath that is insertable into a body lumen, a rotatable hollow rotating body that is disposed to protrude toward a distal side of the sheath, and guide wire lumens into which a guide wire w is insertable in parallel with the sheath. A distal surface of the rotating body has corrugated portions.

Abstract: A non-coring needle for use in accessing an implanted medical device is disclosed. The non-coring needle is configured to include a compact bevel face relative to standard non-coring needles. In one embodiment, the non-coring needle comprises a hollow cannula that defines a lumen and terminates at a sharpened distal tip. The cannula includes a proximal portion and a bent distal portion. The distal portion defines a bevel face extending proximally from the distal tip, and the bevel face includes the lumen distal opening. The bevel face defines an open angle of at least about one degree with respect to a longitudinal axis of the proximal portion of the cannula. The bevel face is also laterally offset from the proximal portion of the cannula by an offset distance of no more than about 0.010 inch. A portion of the bevel face is dulled to prevent access port septum coring.

Abstract: A device selected from microelectrode, temperature sensor, optical sensor, optical fibre, temperature control element, and microdialysis probe for insertion into soft tissue comprises a body with a distal terminal section and a layer of an agent such as gelatin capable of forming a gel with aqueous body fluid on the terminal section. The terminal section and the gel-forming layer have a temperature of more than 30° C. below body temperature during a period of time prior and up to insertion. Also disclosed is method of insertion, an insertion assembly and a use of the device.

Abstract: A penetrator assembly for penetrating a bone and associated bone marrow is provided. The penetrator assembly may include a first connector having a first end and a second end; an outer penetrator extending from the second end of the first connector; the outer penetrator comprising a longitudinal passageway and a first tip; a second connector having a first end and a second end; and an inner penetrator extending from the second end of the second connector, the inner penetrator comprising a second tip. The first connector may be configured to engage the second connector, and the inner penetrator may be disposed in the longitudinal passageway of the outer penetrator when the first connector is engaged with the second connector.

Abstract: An apparatus and method are provided for a syndesmosis treatment construct configured to be placed into a cinched configuration that presses a first bone against a second bone. The syndesmosis treatment construct comprises a proximal fixator to contact the first bone and a distal fixator to contact the second bone. A first suture and a second suture are parallelly looped through the distal fixator. A free splice slidably rides on proximal ends and distal ends of both of the first and second sutures. The distal ends are looped through the proximal fixator and bound within a stitch splice. The proximal ends are passed outside of the stitch splice and through the proximal fixator. The free splices compress and seize the proximal ends during pulling of the proximal ends by a practitioner so as to maintain the cinched configuration.

Abstract: Innovative orthopedic implant assemblies and devices are provided. One example assembly includes two implant devices. An example implant device includes two ends oppositely located with a bulbous portion located at one end and a screw portion located at the opposite end. An example second implant device includes two ends oppositely located with a looped portion defining an aperture located at one end and a nail portion located at the opposite end. The nail portion can include a tip and a smooth or substantially smooth portion. The second implant device can be implanted into a bone by striking the looped portion to facilitate the tip and at least part of the nail portion penetrating the bone.

Abstract: An anchoring system for implanting in bone, the system comprising a first coupling assembly having a first clamp and a first coupling body that receives and holds a first stabilization element; a second coupling assembly that receives and holds a second stabilization element; and a plate that attaches to the first coupling assembly and the second coupling assembly, wherein the first coupling assembly attaches to a bone fastener, and wherein the first coupling body includes a cap retainer that receives a locking cap that applies a directional force to force the first coupling body toward the plate, and applies another directional force to force the first clamp toward the plate, thereby fixedly securing the first coupling body and the first clamp to the plate.

Abstract: A multi-level compressor/distractor instrument that provides both linear and lordotic/kyphotic induced compression and distraction.

Abstract: A connector includes a first receiver that defines an implant cavity and includes a mating surface. A second receiver attachable with the first receiver via a flexible element, the second receiver defines an implant cavity and includes a mating surface engageable with the mating surface of the first receiver to fix relative orientation of the receivers. A biasing element is disposed adjacent the mating surfaces to space the mating surfaces such that the first receiver is movable relative to the second receiver in operation of the connector. Systems, surgical instruments, implants, spinal constructs and methods are disclosed.

Abstract: A transverse connector system having a first and a second locking head, and a transverse rod that is secured by the first and second locking heads. The first and second locking heads are provided with a first and second pivot arm for engaging and securing first and second elongated rods. The first and second locking heads each simultaneously engage and secure the transverse and elongated rods separately.

Abstract: A spinal plate bender includes an actuation assembly, a collet, and a head portion. The actuation assembly includes a housing, a lever pivotably coupled to the housing, a linkage pivotably coupled to the lever, and an actuation shaft operatively coupled with the linkage. The lever is transitionable between a neutral position and an actuated position, which imparts axial displacement to the actuation shaft. The collet includes a proximal section, a sleeve section extending distally from the proximal section, and a coupling section extending distally from the sleeve section. The head portion is configured to support a spinal plate. The head portion includes an anvil portion coupled to a distal end portion of the actuation shaft. The anvil portion is configured to engage a spinal plate to cause bending of a spinal plate supported in the head portion.

Abstract: A rod reducer designed to deliver a set screw by way of a decoupled ram and driver shaft. The driver shaft secures and delivers the set screw while the ram applies the load to the rod for reduction. By separating the ram and driver, the rod is reduced down below the start of the female threads, allowing for the set screw to be started by the driver, avoiding binding and additional steps.

Abstract: A pedicle screw extraction device that comprises a cannulated shaft and an attached pedicle screw acceptance component secured on the distal end of the shaft, as well as a rod position in and extending outwardly from the distal and proximal ends of the cannulated shaft. The pedicle screw acceptance component comprises a tapered reverse thread for engaging a pedicle screw, while the rod prevents the head of the pedicle screw from rotating during the extraction process. The shaft will have a handle adapter that allows for the attachment of various types and sizes of handles as well as a lateral extrusion on the proximal portion that allows for the maximizing of torque during rotation of the shaft and the attached pedicle screw.

Abstract: Disclosed are devices and methods for stabilizing first and second bone portions relative to one another. In one example, implants, instruments and methods are provided that can be used with minimal exposure of the fractured bone and along curved path.

Abstract: A link for interconnecting with one or more additional, similarly configured links so as to form a linkage for affixation to bone includes a receptacle member having an interior surface that defines a receptacle and further defines a bearing surface and an array of retention features that is arranged around the bearing surface. The link includes an insertion member that extends from the receptacle member and defines an exterior surface that at least partially surrounds a hole. A geometry of the exterior surface is configured to fit within a geometry of the receptacle. The exterior surface defines an annular recess configured to receive a retention member for engaging one or more of the arrayed retention features.

Abstract: A method of shaping a bone screw with an automated device having a CNC unit includes rotating a blank coupled to a spindle about an axis defined by a coordinate system of the CNC unit, advancing a cutting tool proximally through an exterior of the blank at a speed to form a helical thread along a shaft, and reducing the speed to provide a variable, proximally decreasing pitch along at least a portion of the shaft. A first cutting tool is automatically transitioned toward disengagement from the blank when 1) a relative axial position between the first cutting tool and the blank coincides with a first coordinate of a predetermined location, and 2) a relative rotational position between the first cutting tool and the blank coincides with a second coordinate of the predetermined location. The first coordinate is along the axis, the second coordinate is an angular position about the axis, and the first and second coordinates are defined by the coordinate system.

Abstract: A system for inserting an anchor member into bone includes a receiving member and an anchor member receivable within the receiving member. The receiving member is elongate along a longitudinal axis and has a proximal end and a distal end spaced from the proximal end along the longitudinal axis. The receiving member has an internal surface that defines a transmission element. The anchor member includes an engagement element configured to rotatably engage the transmission element such that the transmission element is configured to drive the anchor member in a distal direction relative to the transmission element so as to rotatably decouple the engagement element from the transmission element. The distal direction extends from the proximal end to the distal end of the receiving member and is parallel with the longitudinal axis.

Abstract: A fixation assembly includes a tapered cannula, a post, and a snap ring. The snap ring is attachable to the post and the tapered cannula. The snap ring is configured to maintain the tapered cannula axially fixed in relation to the post such that the tapered cannula and the post are rotatable relative to each other.

Abstract: Innovative orthopedic implant assemblies, devices, and methods are provided. One example assembly includes two implant devices. An example implant device includes two ends oppositely located with a bulbous portion located at one end and a screw portion located at the opposite end. An example second implant device includes two ends oppositely located with a looped portion defining an aperture located at one end and a nail portion located at the opposite end. The nail portion can include a tip and a smooth or substantially smooth portion. The second implant device can be implanted into a bone by striking the looped portion to facilitate the tip and at least part of the nail portion penetrating the bone.

Abstract: An instrument configured to attach to a bone anchoring element during surgery includes an elongate portion and an end portion having a first side and an opposite second side, where the elongate portion extends away from the first side, and where an opening is defined at the second side to accommodate at least a portion of a head of the bone anchoring element. The opening of the end portion has a first section sized to permit insertion and removal of the head therethrough, and a second section forming a seat for the head. When the head is held in the seat, the seat prevents removal of the head through the opening, while the head is movable unobstructedly from the second section back towards the first section.

Abstract: A stylet screw driver assembly having a screw driver/ratcheting handle assembly which houses a stylet, pre-assembled to a set length based on the screw length in use, fixed in place by a spring loaded button mechanism located on the proximal end of the ratcheting handle. The spring loaded button mates with the stylet assembly, providing various stylet protrusion lengths.

Abstract: A cryoballoon deflation assembly for an intravascular catheter system for use during a cryoablation procedure includes a first deflation initiator and a first deflation initiator inhibitor. The first deflation initiator is configured to automatically activate a vacuum pump to deflate a cryoballoon upon completion of a stage of the cryoablation procedure. The first deflation initiator inhibitor is manually changeable to between an activated and deactivated state. When in the activated state, the first deflation initiator inhibitor is configured to inactivate the first deflation initiator. The cryoballoon deflation assembly can further include a second deflation initiator. The second deflation initiator is manually changeable between an activated and deactivated state. When in the activated state, the second deflation initiator is triggered to activate the vacuum pump to deflate the cryoballoon.

Abstract: Systems, methods, and apparatus for providing power to an electrosurgical instrument.

Abstract: In some embodiments, the inventive subject matter is directed to a multimode electrosurgical system having an electrosurgical instrument with a first electrode configuration that operates in a bipolar mode and second electrode configuration that operates in a monopolar mode. In other embodiments, the inventive subject matter is directed to an instrument and system that provide multiple modes of surgical and/or therapeutic treatments, at least one being an electrosurgical mode of treatment, the instrument including at least one active electrode on a working portion, and the working portion including or supporting at least one non-electrosurgical functional element, the instrument including at least one operational return electrode configuration of selectively variable surface area.

Abstract: An electrosurgical generator and associated methods determine a real part of the impedance of treated tissue. The electrosurgical generator includes an output stage, a plurality of sensors, and a controller that controls the output stage. The controller includes a signal processor that determines an RMS voltage, an RMS current, an average power, and a real part of the impedance of the treated tissue based on measured voltage and current by using a plurality of averaging filters. The controller controls the output stage to generate electrosurgical energy based on at least the determined real part of the impedance.

Abstract: An electrosurgical smoke evacuation pencil includes a handle housing having a proximal end portion and a distal end portion, the handle housing defining a first lumen therethrough. The electrosurgical pencil also includes a nozzle disposed within the first lumen and defining a second lumen, the nozzle being movable relative to and within the handle housing and extending proximally past the proximal end portion of the handle housing. The electrosurgical pencil may further include a swivel connector coupled to the distal end portion of the handle housing, the swivel connector configured to couple to a suction source. The electrosurgical pencil includes a hub assembly securedly disposed within the second lumen, the hub assembly including a conductive tube configured to couple to a source of electrosurgical energy, and an electrode slidably disposed within the conductive tube, the electrode being movable relative to and within the conductive tube.

Abstract: An electrosurgical snare, e.g. suitably sized for insertion down the instrument channel of an endoscope, arranged to radiate microwave frequency energy (e.g. having a frequency greater than 1 GHz) from an elongate conductive element within an area encircled by a retractable loop. The elongate conductive element and retractable loop may be independently slidable relative to a snare base at a distal end of a sleeve to provide an appropriate device configuration. By controlling the shape of the emitted microwave field, the risk of collateral thermal damage can be reduced.

Abstract: A preparation instrument comprising an HF-instrument with an electrode that is partially insulated by means of an insulating body, which is combined with a fluid applicator having a channel arranged in the insulating body for the application of a fluid to or into tissue. In some embodiments of the preparation instrument, the electrode is a spatula electrode which is inserted in the insulating body that does not cover sections of the surface of the electrode so that these sections may be in contact with the tissue. The insulating body preferably forms the channel wall that delimits the channel. The insulating body and the electrode may be flexible in order to adapt the form of the insulating body and the electrode, together, to the surgical task.

Abstract: A surgical instrument includes an end effector assembly and a deployment mechanism for deploying a proximal hub associated with an energizable member between proximal and distal positions. The deployment mechanism includes a rotatable shaft, a cord including a proximal end engaged to the rotatable shaft and a distal end engaged to the proximal hub, a biasing member positioned to bias the proximal hub towards the distal position, and a gear assembly operably coupled to the rotatable shaft. The gear assembly is configured to move the proximal hub from the distal position to the proximal position against the bias of the biasing member by rotating the rotatable shaft relative to the cord to at least partially wind-up the cord about the rotatable shaft.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed herein, including an inflatable member for positioning an ablation device within a pulmonary vein ostium. An apparatus can include first and second shafts moveable relative to one another, first and second electrodes configured to generate an electric field for ablating tissue, and an inflatable member disposed between the first and second electrodes. In some embodiments, the inflatable member is configured to transition from an undeployed configuration to a deployed configuration in response to movement of the first and second shafts. In some embodiments, the inflatable member in the deployed configuration can engage a wall of a pulmonary vein ostium and direct the electric field generated by the first and second electrodes toward the wall.

Abstract: A catheter has a distal assembly with at least one loop with ring electrodes. A single continuous puller wire for bidirectional deflection is pre-bent into two long portions and a U-shape bend therebetween. The U-shape bend is anchored at a distal end of a deflectable section which is reinforced by at least one washer having at least two holes, each hole axially aligned with a respective lumen in the deflectable section. Each hole is centered with a lumen so that each puller wire portion therethrough is straight and subjected to tensile force only. A proximal end of the support member is flattened and serrated to provide a better bonding to the distal end of the deflectable section.

Abstract: The present invention provides systems, methods, and devices for electroporation-based therapies (EBTs). Embodiments provide patient-specific treatment protocols derived by the numerical modeling of 3D reconstructions of target tissue from images taken of the tissue, and optionally accounting for one or more of physical constraints or dynamic tissue properties. The present invention further relates to systems, methods, and devices for delivering bipolar electric pulses for irreversible electroporation exhibiting reduced or no damage to tissue typically associated with an EBT-induced excessive charge delivered to the tissue.

Abstract: Systems and methods for robotically preparing a disc space are provided for implantation of an intervertebral prosthetic disc. The system includes three-dimensional modeling to identify positions of vertebrae adjacent a surgical site and a disc selection interface in a computing system to allow the surgeon to select an intervertebral disc prosthesis for implantation. A bone cutting interface allows the surgeon to determine a bone cutting pattern tailored to both the three-dimensional positions of the vertebrae and the selected intervertebral disc. A robot controls a cutting device or guides a cutting device to cut the vertebral bone in the bone cutting pattern.

Abstract: A route selection assistance system, a recording medium on which a route selection assistance program is recorded, a route selection assistance method, and a diagnosis method that enable easy selection of a route of a living body lumen for delivering a medical instrument to a site within a living body via the living body lumen. A route selection assistance system includes: a receiving section configured to receive an input of site information specifying a target site; an image obtaining section configured to obtain image information on a living body of a target patient; a route extracting section configured to extract a plurality of routes of a living body lumen; a ranking assigning section configured to assign rankings to the plurality of routes extracted by the route extracting section; and an output section configured to output the plurality of routes extracted and the rankings assigned by the ranking assigning section.

Abstract: A system and method for registration and coordinated manipulation of augmented reality image components includes registering a model of patient anatomy to a first image of the patient anatomy captured using an imaging device to determine a baseline relationship between the model and the first image, tracking movement of a computer-assisted device used to manipulate the imaging device, updating the baseline relationship based on the tracked movement, and generating a composite image by overlaying the model on a second image of the patient anatomy according to the updated relationship. In some embodiments, the model is semi-transparent. In some embodiments, registering the model to the first image includes adjusting the model relative to the first image based on one or more inputs received from a user and generating a model to image transformation based on the adjustments to the model. The model to image transformation captures the baseline relationship.

Abstract: [Object] To provide a control apparatus, a control method, and a medical observation system. [Solution] A control apparatus including: an acquisition unit configured to acquire dental mirror detection information from a picked up image acquired by an image pickup apparatus; and a control unit configured to, on the basis of the dental mirror detection information, perform at least one of image processing on the picked up image or arm control processing that controls an arm unit that supports the image pickup apparatus.

Abstract: A surgery supporting apparatus capable of performing a manipulation using a surgical instrument to be inserted into a body cavity, comprises a measurement device configured to measure an insertion depth and an insertion angle, with respect to the body cavity, of a shaft of the surgical instrument inserted into the body cavity, as input of the manipulation, wherein the measurement device measures the insertion depth by measuring a sound wave propagating in a space between a transmitter attached to one of the surgical instrument and a position within a predetermined range from a position of insertion to the body cavity, and a receiver attached to the other.

Abstract: Systems and methods are described for functional brain mapping using neuronavigational equipment and additional features. For example, some implementations described combine novel cortical stimulator tools with stereotactic navigation for three-dimensional position tracking of the cortical stimulator tools. In some implementations, the systems and methods described herein can be used on an awake patient. In some implementations, the systems and methods described herein can be used on a patient that is asleep, via motor evoked potentials (MEPs), phase reversal, or electromyography (EMG) monitoring. Accordingly, in some cases sensory and language regions of the brain can be identified in addition to motor regions.

Abstract: A flexible tool includes an optical fiber including a proximal end, a distal end, an intermediate portion between the proximal end and the distal end and an adjustable bend between the proximal end and the intermediate portion. The intermediate portion may be constrained to have a single degree of freedom that is translational substantially along an axis defined by the optical fiber at the intermediate portion. The adjustable bend may be enclosed with a housing that provides space within the housing for the adjustable bend to adjust. The optical fiber may be used to provide shape sensing of the flexible tool.

Abstract: Provided is a robotic system that includes a surgical instrument with a wrist including an elongate shaft extending between a proximal end and a distal end, a wrist extending from the distal end of the elongate shaft, and an end effector extending from the wrist. The end effector may include a first jaw and a second jaw, the first and second jaw being moveable between an open position in which ends of the jaws are separated from each other, and a closed position in which the ends of the jaws are closer to each other as compared to the open position. The surgical instrument may also include a tube extending through the elongate shaft and the wrist, the tube having an outlet in fluid communication with a passage formed by an interior of the first and second jaws when the jaws are in the closed position.

Abstract: Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.