Abstract: A single body port or body flange access device and method for performing laparoscopic surgery are disclosed. The device comprises a plurality of crisscrossing conduits through which surgical instruments may be inserted. The instruments are manipulated so that triangulation is obtained using one patient body flange while standard surgical procedures are performed on the patient.

Abstract: Various devices are provided for allowing multiple surgical instruments to be inserted through a single surgical access device at variable angles of insertion, allowing for ease of manipulation within a patient's body while maintaining insufflation. Safety shields and release mechanisms are also provided for use with various surgical access devices.

Abstract: In accordance with aspects of the present invention, a door mechanism is provided. A door mechanism according to some embodiments of the present invention includes a door that includes a sealing part, an arm connected to the sealing part, and a pivot part connected to the arm, the door rotating around a pivot axis at the pivot part; and a lever, the lever engaging the door at the pivot part such that the lever opens the door when engaged but is not affected when the door is opened without the lever.

Abstract: A stage device capable of performing piercing vibration and translational driving by using one actuator, and performing very low-speed driving in the translational driving with high accuracy. The stage device includes an X stage having a vibration actuator that includes an vibration element and a contact body, one of which is a movable body connected to an object to be driven, and drives the object to be driven in an X-axis direction, and a control section that controls driving of the vibration actuator. The control section causes two-phase AC voltages to be applied to an electromechanical energy conversion element to thereby excite predetermined vibrations in the vibration element, to drive the vibration actuator by switching between a movement mode for moving the object to be driven in the X-axis direction and a vibration mode for vibrating the object to be driven in the X-axis direction.

Abstract: The disclosed invention comprises a device that utilizes a manually controlled articulating arm to make a precise, small abrasion on the intrauterine wall prior to ovulation. The preferred embodiment of the invention comprises a handle, an arm having a rigid portion and an articulating tip both of which are covered by a casing having non-irritant properties, wherein the handle is connected to the arm by a connection member that contains a trigger mechanism operable to move the articulating tip by pulling a trigger.

Abstract: A novel posterolateral inter-muscular approach has been developed to access the cervical. spine. The approach includes elevating the splenius capitis and trapezios muscles dorsally to create a window for deep spine access, wherein the window comprises: i) an anterior superior border of the trapezius muscle; ii) an anterior inferior border of the splenius capitis muscle, and iii) a posterior superior border of the levator scapulae muscle. Preferably, a device such as an implant or an instrument is then passed through the window to manipulate the spine.

Abstract: A coupling device includes a first coupling body configured to be coupled to a first bone anchor, a second coupling body configured to be coupled a second bone anchor, and a connection device comprising a first connection member connectable to the first coupling body, a second connection member connectable to the second coupling body, and a length adjustment member positionable between and insertable at least partially into each of the first and second connection members. The first and second connection members are movable relative to the length adjustment member. The length adjustment member can be actuated in a first direction to increase a distance between the first connection member and the second connection member, and in a second direction different from the first direction to decrease the distance between the first connection member and the second connection member.

Abstract: The present invention includes an apparatus, kit and method for providing a bone fixation assembly for attachment to a bone to provide augmented support. The bone fixation assembly includes a screw having a screw head and a threaded shank. A first aperture is positioned about the screw head to receive a first longitudinal member and a first compression member that engages the first aperture to secure the first longitudinal member. The screw head has a second aperture positioned to receive a second longitudinal member and a second compression member that engages the second longitudinal member aperture to secure the second longitudinal member and provide augmented support.

Abstract: Spinal implants and methods of extending pre-existing spinal implant constructs. An extension clamp may be connected to an original spinal implant including an elongated rod attached to a portion of the spine without removal of the original spinal implant. The extension clamp may include a yoke and an extension rod extending from the yoke. The yoke may include a first end and a second end, the first end having first and second rod engaging portions and a channel between the first and second rod engaging portions for encompassing a fastener, and the second end being spaced apart from the first end. The first and second rod engaging portions may be configured and dimensioned to secure the extension clamp to the elongated rod.

Abstract: A pedicle screw implant construct kit, comprising at least one pedicle screw, at least one collar comprising a recess for receiving a rod, the collar configured to be coupled to a head of the pedicle screw, an elongated rod for connecting the collar to one more additional collars to couple between the pedicle screw and one or more additional screws, and a locking ring sized to be positioned over at least a distal portion of the collar to restrain relative movement of the screw head and rod by exerting radial compression force onto the collar. In some embodiments, the components of the kit are comprised of carbon reinforced composite material, optionally with no radiation blocking material. In some exemplary embodiments of the invention, the kit includes two locking rings on a collar, optionally both below the rod.

Abstract: A method of inserting a spinal stabilization system into a patient generally comprises inserting a first positioning tool through a first location on a patient's skin and along a path generally toward a first vertebral anchor, coupling an end of the first positioning tool to the first vertebral anchor, positioning at least a portion of a delivery device over a connecting element, and inserting the delivery device and the connecting element through the patient's skin at the first location and along at least a portion of the first positioning tool. The first positioning tool is configured to facilitate directing the delivery device and connecting element generally toward a second vertebral anchor within the patient's body.

Abstract: A spinal fixation construct for aligning vertebral bodies includes a bone screw, a spinal rod, a flexible member, and a fixation member. The spinal rod is disposed within a saddle portion of a housing of the bone screw, and includes an elongated body having a first end and a second end. The spinal rod is formed from a first material having a first modulus of elasticity. The flexible member is coupled to the spinal rod, and includes an elongated body having a first end portion and a second end portion. The flexible member is formed from a second material having a second modulus of elasticity that is different from the first modulus of elasticity. The fixation member includes a threaded body portion and a head portion defining a hole therethrough. A portion of the flexible member extends through the hole of the head portion.

Abstract: A closure for an open headed medical implant, such as a bone screw. The closure having a cylindrical body having an axis of rotation and also having a radially outer surface with a thread or other guide and advancement structure thereon. The body having a plurality of apertures that open onto a top surface of the body and that are parallel to but spaced from the axis of rotation. The closure also has a break-off head centrally attached by a neck to the top surface of the body.

Abstract: A modular polyaxial bone screw includes a poly-axial bone screw, a polyaxial tulip head, and a collet disposed within the tulip head, the collet interacting with the bone screw and tulip head providing an interference fit with the bone screw head to lock orientation of the tulip head on and relative to the bone screw. Inner configurations of the tulip head interact with outer configurations of the collet to lock axial and/or rotational position of the collet within and relative to the tulip head, and thus about the bone screw head. The collet also has a resilient, tapered base with a plurality of slots in and about its end that allow the end to splay outwardly over and upon the head of the bone screw to create a snap or frictional interference fit between the splayed collet and the bone screw head when a spine rod is fixed in the tulip head.

Abstract: A bone anchor having a rod housing including a base that has an internal groove oriented at an angle oblique to the longitudinal axis of the base, a capture ring situated within the groove and oriented at an angle oblique to the longitudinal axis, and a bone fastener extending into the rod housing and including a fastener head situated within the base and having a surface that mates with the capture surface of the capture ring to maintain a connection between the bone fastener and the rod housing.

Abstract: A bone fastener comprises a first member defining an implant cavity and a plurality of adjacent grooves. A first band is configured for disposal within the grooves. A second band is configured for disposal within the grooves. A second member is configured to penetrate tissue and includes a head engageable with the first band to provisionally connect the members. A first part is engageable with a spinal rod disposed with the implant cavity. A second part is attached with the first part and engageable with the second band to dispose the second band adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

Abstract: A polyaxial bone anchor has a locking element shaped and configured to allow an anchoring member (e.g., a screw or hook) to polyaxially rotate at large angles about a central axis of the bone anchor before compression locking the anchoring member within an anchor head.

Abstract: The invention relates to an arthrodesis plate for the stiffening of joints, in particular finger joints, comprising a proximal and distal anchoring region which are connected to one another in a mechanically rigid manner, characterised in that at least one outer contour of one of the two anchoring regions has a cross-section which is undulating, for example roof-shaped, or is provided with alternating crests and troughs by means of coating, and/or has a transversal-sagittal cross-section.

Abstract: An adjustable, knotless button/loop construct for fixation of ankle syndesmosis tibio-fibular diastasis and an associated method of ankle repair using the same. The knotless construct comprises a pair of buttons attached to a flexible, continuous, self-cinching, adjustable loop integrated with two splices that are interconnected. The knotless construct is passed through fibular and tibia tunnels and the buttons are secured on the cortical surfaces of tibia and fibula. One of the buttons (for example, an oblong button) is secured on the medial side of the tibia by passing the button and the flexible, adjustable loop though the fibular and tibia tunnels and then flipping and seating the button outside the tibia. The length of the flexible adjustable loop is adjusted so that the second button (for example, a round button) is appropriately secured on the lateral fibula.

Abstract: A bone screw comprises a main body including a shank portion, a head portion attached to the shank portion, and a cap moveably attached to the head portion. The head portion includes a tool interface structure therein having a closed end portion, an open end portion and sidewall extending therebetween. A tool lock recess is provided in at least one of the sidewalls of the tool interface structure. The tool interface structure is accessible through an opening within an exterior surface of the cap.

Abstract: A self-drilling, self-tapping bone screw is described in which the bone screw has a drill tip free of threads and having a length at least as great as about the thickness of a proximal cortical bone layer, with the drill tip having opposed lands and a helical flute between each of the lands with each of the lands having a cutting edge configured to cut bone as the drill tip is rotated into the bone with the flutes conveying the bone debris away from the drill tip, where a lead thread begins to self-tap internal threads in the proximal cortical bone layer after the drill tip has drilled through the proximal cortical bone layer so as to avoid stripping the threads formed in the bone layer. A method of installation is also disclosed.

Abstract: One aspect relates to a device for the production of a bone cement dough from a monomer liquid and a cement powder comprising a cartridge with an internal space; a cartridge head with a dispensing opening; a conveying plunger that is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a dispensing plunger between the dispensing opening and the conveying plunger that is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a first hollow space, in which the cement powder is arranged; a second hollow space that is bordered by the dispensing plunger and the conveying plunger; a rear-side part of the internal space of the cartridge; and a conducting means that connects the second hollow space to the rear-side part of the internal space of the cartridge such as to bypass the conveying plunger and be permeable to the monomer liquid.

Abstract: One embodiment relates to a device for the production of a bone cement dough from a monomer liquid and a cement powder comprising a cartridge with an internal space; a cartridge head with a dispensing opening; a conveying plunger that is arranged in the internal space of the cartridge and is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a dispensing plunger between the dispensing opening and the conveying plunger that is supported in the internal space of the cartridge such that it is pushable in the direction of the dispensing opening; a first hollow space, in which the cement powder is arranged; a second hollow space that is bordered by the dispensing plunger and the conveying plunger; a fluid opening that is arranged in the conveying plunger; a feedthrough that connects the first hollow space and the second hollow space to each other, and a closure means that is arranged on a rear side of the dispensing plunger.

Abstract: A surgical instrument comprises a first member including a lateral projection having a locking surface that defines an elongated cavity. The locking surface is engageable with a longitudinal member to fix the longitudinal member with the first member. A second member includes at least one mating element being engageable with a spinal construct. The first member is axially translatable relative to the second member in a first direction to tension the longitudinal member and in a second direction to release tension from the longitudinal member. Systems and methods are disclosed.

Abstract: Various aspects of the present invention provide an apparatus and a method of removing an orthopedic implant from a patient. In one embodiment, the method includes cycling the temperature of at least a portion of the orthopedic implant between a first temperature and a second temperature that differs from the first temperature. In one embodiment, the first temperature is above 0° C. and the second temperature is below 0° C. The temperature cycling causes a thermal expansion differential between at least a portion of the orthopedic implant and material in a region contacting the orthopedic implant. In one embodiment, the thermal expansion differential is of an extent sufficient to cause physical separation of at least a portion of the surface of the orthopedic implant from material contacting the surface of the orthopedic implant.

Abstract: Energy delivery devices and methods that have one or more features to measure or estimate the amount of energy dose delivered to a target material. Methods and systems for calculating an energy dose to be delivered to the target material. The devices and methods deliver an accurate energy dose to the target material. Devices, systems and methods using microwave energy delivery devices can calculate the energy dose from returned power measurements. Systems and methods adjusting one or more energy delivery parameters or one or more system components while delivering an energy dose to achieve a desired thermal effect.

Abstract: A cryoablation catheter assembly includes a catheter that defines at least one coolant outtake region and receives a rotatable guide tube and a coolant transfer tube. The coolant transfer tube receives and transfers coolant from a coolant source to a distal end of the coolant transfer tube. An expansion element is coupled to a distal portion of the catheter and defines an inner expansion-element space. The inner expansion-element space is in fluid communication with the at least one coolant outtake region and the distal end of the coolant transfer tube. A distal end of the expansion element couples to the guide tube. A rotation system is coupleable to, or coupled to, a proximal end of the guide tube and rotates the distal end of the expansion element relative to the proximal end of the expansion element by rotating the guide tube relative to the catheter.

Abstract: A method, system, and device for predicting lesion quality. Specifically, lesion quality may be predicted based on an assessment of pulmonary vein occlusion using injection of an impedance-modifying agent and evaluation of changes in impedance measurements recorded by an electrode located distal to an occlusion element of the treatment device used to inject the impedance-modifying agent. The quality of the occlusion may be rated based on the changes in impedance over time within the pulmonary vein. For example, the quality of the occlusion may be rated as being good, fair, or poor. This assessment may be quickly and easily communicated to an operator.

Abstract: The plasma sensor monitors parameters characterizing the condition of the plasma during the treatment phase and/or the change thereof in order to recognize a prefiguring or already occurred interruption of the plasma in this manner and to avoid this interruption and, in the ideal case, avoid this by already changing the voltage form previously. The mentioned mechanisms can be used by the control device (22) also during a pulse packet. The length of each pulse packet is adapted at each change of the voltage form according to their characteristics in order to guarantee a constant average power.

Abstract: Electrosurgical procedures. At least some of the example methods that include: supplying energy to an active electrode of an electrosurgical wand, the supplying energy to the active electrode by an electrosurgical controller; monitoring an electrical parameter associated with the energy; and determining, based on the electrical parameter, the presence of a wand condition of the electrosurgical wand, the wand condition being at least one selected from the group consisting of: a surface area of the active electrode is less than a predetermined threshold surface area; the surface area of the active electrode is approaching the predetermined threshold surface area; and that the electrosurgical wand is affected by a blockage.

Abstract: A technique allows for an electrical connection between a thermal abrasion heating catheter and the energy delivery console that utilizes serial communication. Accordingly, the serial communication allows data such as measured temperature, start/stop status, intended treatment area, device identification, device calibration parameters and/or use history to be conveyed along the same wires that deliver power to a heating element. For example, data can be conveyed along a two wire connection and provided at a frequency that is filtered out so that it is not delivered to a heating feature. In this example, one wire provides power to the heating element, one wire provided communication from the energy delivery console, and a third wire provides a common ground which the heating catheter uses to communicate with the energy delivery console.

Abstract: An electrosurgical system includes an electrosurgical probe connected to a control console, wherein the probe is capable of coagulating and ablating tissue depending on a selected operating mode. Before operating the system, probe-specific data stored in a memory device associated with the probe is read by a processing device in the console. The data includes source impedance values specific to a coagulation or cutting mode of operation. A constant duty cycle value for a modulated cutting mode also is provided. Depending on the operating mode selected, an RF generator adjusted to have a predetermined source impedance value provides a voltage value to the probe. During the duty-cycled mode, the RF generator generates an instantaneous voltage value output for a duty cycle portion that is less than 100% of a time period, which value is no less than a maximum continuous average voltage value for the electrosurgical probe.

Abstract: The present invention discloses a low temperature sphincterotome surgical device, system and method. The device includes: a liquid input unit, configured to input liquid to a target object in response to a liquid input signal to form a thin layer of a conductive medium between an emission electrode and a loop electrode; a bipolar electrode socket connector, connected with a high frequency generator through a high frequency cable to receive a first input voltage generated by the high frequency generator; the emission electrode, configured to receive the first input voltage generated by the high frequency generator via the bipolar electrode socket connector and apply a first voltage between the emission electrode and the loop electrode.

Abstract: An electrosurgical forceps includes first and second shaft members pivotably coupled to one another via a pivot member such that pivoting of the first and second shaft members between spaced-apart and approximated positions pivots jaw members thereof between open and closed positions. A knife is translatable between retracted and extended positions. The knife has a stop to prevent distal movement of the knife beyond the extended position.

Abstract: An electrosurgical instrument includes first and second jaw members each including an outer jaw housing, a tissue-treating plate, and a longitudinally-extending knife channel. The electrosurgical instrument also includes a knife actuator and a knife assembly operably coupled to the knife actuator. The knife assembly includes an elongated tube defining a longitudinal lumen and an elongated shaft having a proximal portion coupled to the knife actuator and a distal portion configured to be received through the longitudinal lumen. The distal portion of the elongated shaft includes an enlarged distal end portion configured to prevent movement of the elongated shaft relative to the elongated tube. The knife assembly also includes a knife blade having a pair of opposing lateral sides and a sharpened distal end configured to cut tissue. The elongated tube is configured to be coupled to one of the pair of opposing lateral sides of the knife blade.

Abstract: An electrosurgical instrument includes first and second jaw members each including an outer jaw housing, a tissue-treating plate, and a longitudinally-extending knife channel. The electrosurgical instrument also includes a knife actuator and a knife assembly operably coupled to the knife actuator. The knife actuator is configured to advance at least a portion of the knife assembly through the knife channel to cut tissue. The knife assembly includes an elongated tube defining a longitudinal lumen and an elongated shaft having a proximal portion coupled to the knife actuator and a distal portion configured to be received at least partially within the longitudinal lumen. The knife assembly also includes a knife blade having a pair of opposing lateral sides and a sharpened distal end configured to cut tissue. The elongated tube is configured to be coupled to one of the pair of opposing lateral sides of the knife blade.

Abstract: An endoscopic bipolar forceps includes a housing having a shaft extending therefrom with an end effector disposed at a distal end thereof. The end effector assembly includes a first and second jaw members having cam slots defined therein with distal and proximal sections at different angles relative to a longitudinal axis. Upon initial actuation of a handle, a cam pin engages the distal cam section of the first jaw member causing it to move relative to the second jaw member while the second jaw member remains stationary. Upon continued actuation of the handle, the cam pin engages the proximal cam section of the first jaw member causing the first jaw member to remain stationary while the second jaw member cams relative to the first jaw member to close against tissue disposed between the first and second jaw members.

Abstract: The disclosed technology is directed to a treatment instrument that comprises a sheath main body having opposed respective distal and proximal end regions. The sheath main body includes an outer diameter such that the sheath main body capable of being fit into the channel for insertion of the treatment instrument of the endoscope. The sheath main body includes a lumen extending along a longitudinal axis in the distal end region. A wire-shaped incising portion is configured to engage with the sheath main body so as to protrude from an outer circumferential surface of the sheath main body in the distal end region and extending along the longitudinal axis of the sheath main body. The wire-shaped incising portion is used to incise a tissue. A wire is attached to at least a portion of the sheath main body and having a region in which the wire has different bending resistances.

Abstract: The invention generally relates to systems and methods for therapeutically modulating nerves in or associated with a nasal region of a patient for the treatment of a rhinosinusitis condition.

Abstract: The invention generally relates to systems and methods for therapeutically modulating nerves in or associated with a nasal region of a patient for the treatment of a rhinosinusitis condition.

Abstract: The invention generally relates to systems and methods for therapeutically modulating nerves in or associated with a nasal region of a patient for the treatment of a rhinosinusitis condition.

Abstract: The invention generally relates to systems and methods for therapeutically modulating nerves in or associated with a nasal region of a patient for the treatment of a rhinosinusitis condition.

Abstract: Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

Abstract: Apparatuses and methods for treating a heart failure patient by ablating a nerve of the thoracic splanchnic sympathetic nervous system to increase venous capacitance and reduce pulmonary blood pressure. A method comprising: inserting a catheter into a vein adjacent the nerve, applying stimulation energy and observing hemodynamic effects, applying ablation energy and observing hemodynamic effects, applying stimulation energy after the ablation and observing hemodynamic effects and monitoring for presence of the lung in the ablation zone. An alternative method comprising: inserting a catheter into a vein adjacent the nerve, detecting that lung tissue is a safe distance from an ablation zone, and delivering ablation energy to the target nerve when lung tissue is a safe distance from the ablation zone.

Abstract: Devices and techniques that enable multiple electrodes to be positioned proximate organic tissue, such as human tissue. In one embodiment, a catheter is provided that includes a shaft and a distal segment. The distal segment includes a plurality of electrodes configured in a plane that is substantially parallel with the longitudinal axis of the shaft.

Abstract: Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Abstract: The present invention relates to an apparatus for treating skin by means of intense pulsed light (IPL). Such apparatus may be used for the treatment of, for example, cosmetic purposes such as hair depilation or dermatological treatment of skin conditions such as acne or rosacea. The present invention provides an improved apparatus that can be used by a non-medical practitioner and comprises a light source comprising a light emitting element for transmitting light energy to the skin and a charge storage device for discharging an energy dose to the light emitting element. There is further provided at least one sensor for measuring a parameter of the skin and a control system configured to determine the treatment energy dose to be delivered. This treatment energy dose is de-rived using the sensor measurement and means of reduction in unwanted time delay associated with charging or discharging of the charge storage device in sole dependence on the current or most recently measured skin parameter.

Abstract: A thermal accelerant is delivered to a tissue site and localized to modulate the shape, extent or other characteristic of RF or microwave-induced hyperthermic tissue ablation. The accelerant may be provided via an image-guided hand piece or via a lumen added to a microwave antenna, and promotes faster heating, more complete ablation and/or a more extensive treatment region to reduce recurrence of treated cancers, overcoming natural limitations, variations in tissue response and drop-off or thermal loss away from the antenna. The accelerant is delivered as a viscous but heat sensitive fluid, and is fixed in place to provide regions of preferential absorption or heating. Shorter exposure times to heat the far field may allow survival of vulnerable tissue such as vessels, and multiple antennae may be used for effective treatment of irregular or large tumors.

Abstract: An insertable catheter device includes a shaft including a proximal end and a distal end, an expandable balloon, and an actuator configured to expand and retract the expandable balloon. The actuator includes a fluid conduit that extends through the shaft and is coupled with the expandable balloon to enable inflation and retraction of the expandable balloon via injection or withdrawal of a fluid to or from the expandable balloon via the fluid conduit. The expandable balloon is displaceably retractable into the shaft and extendable from the shaft. A fluid pump is coupled with the fluid conduit to pump the fluid through the fluid conduit. A patch is positioned to be displaced by the expandable balloon when the expandable balloon is inflated, and the expandable balloon is displaceably retractable into the shaft and displaceably extendable from the shaft.

Abstract: The various examples of the present disclosure are directed towards a multi-physics controller that can predict and monitor ablation procedures. In some examples of the present disclosure, fat saturation images can be used to create custom microwave ablation bioelectric/biothermal models. In some examples of the present disclosure, a deformation correction methodology can be used. Thereby, microwave and mechanics computational models can forecast therapeutic delivery intraoperatively while correcting for deformation.