Abstract: An infusion system for sonothrombolysis treatment uses a syringe loaded with a microbubble solution and operated by a syringe pump to deliver the microbubble solution to a subject during sonothrombolysis treatment. To prevent the stratification of the microbubble solution in the barrel of the syringe during treatment, the barrel also contains a plurality of magnetic beads which are agitated into semi-random patterns of motion in the syringe chamber during the procedure. The magnetic beads are moved by magnetic attraction and repulsion from the moving magnets of a magnetic stirrer mounted in proximity to the syringe during treatment.

Abstract: A therapy system includes a therapy source (2) emitting radiation or waves, an ultrasound probe (14), a patient rest as well as a multi-axis positioning system (X, Y, Z) with several drives, by way of which the patient rest and the therapy source (2) can be moved to one another in all three spatial directions. A control device (26) is coupled to the ultrasound probe (14) and configured such that in at least one operating mode, the control device (26) simultaneously activates the drives of the multi-axis positioning system (X, Y, Z) such that the patient rest is moved relative to the therapy source along a selectable movement path (B) which lies within the plane of an ultrasound picture (20) which is currently recorded by the ultrasound probe (14). A method for positioning a patient rest relative to a therapy source is also provided.

Abstract: Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

Abstract: A surgical instrument includes an end effector, a motor for opening and closing the jaws, a sensor configured to detect a tissue compression parameter associated with a tissue between the jaws, and a control circuit. The control circuit is configured to determine a value of the tissue compression parameter via the sensor as the jaws transition from the open configuration to the closed configuration, cause the motor to increase a time to transition the jaws to the closed configuration according to whether the value of the tissue compression parameter is above a first threshold, and provide feedback according to whether the value of the tissue compression parameter is below a second threshold.

Abstract: The ultrasonic treatment instrument for articulations according to the embodiment of the present invention includes, at the distal end of the probe, the treatment section which performs a desired treatment on the treated target part. The treatment portion is provided with an edge which extends in a direction crossing, or a direction parallel to, the longitudinal direction of the probe; a first ultrasonic transducer which generates ultrasonic vibration in a direction crossing the edge; and a second ultrasonic transducer which generates ultrasonic vibration in a direction parallel, to the edge.

Abstract: A grasping treatment instrument includes a grasping piece, and a supporting member opening and closing relative to the grasping piece. A clamp member is provided between the supporting member and the grasping piece in open and close directions of the supporting member, and the clamp member includes an opposed surface opposed to the grasping piece, and a back surface facing to an opposite side of the opposed surface. The grasping treatment instrument includes a cover member made of a material having lower thermal conductivity than the clamp member, and the cover member covers the clamp member from the back surface side in a part on a distal side with respect to a position where the clamp member is pivotally supported.

Abstract: A thrombus treatment device includes a support wire, a body frame portion that is disposed about an axis defined by the support wire, one or more tethers that each have a first end and a second end. Each of the one or more tethers is attached at its first end to the body frame portion, and at its second end to a collar that couples the second end of each of the multiple tethers to the support wire. When the collar is advanced to a position substantially within a region interior of the body frame portion, a rotational actuation of the support wire causes a swiveling motion of the one or more tethers. The swiveling motion of the tethers operates to macerate a thrombus.

Abstract: A surgical apparatus includes a rotatable shaft and a turbine assembly. The rotatable shaft includes a cutter located thereon. The cutter is configured to cut an object when the shaft is rotating about a rotational axis. The turbine assembly includes a turbine and a turbine housing. The turbine housing is configured to receive a fluid that enters the housing parallel to the rotational axis, and to steer the fluid to impinge on the turbine in a direction that is not parallel to the rotational axis. The turbine is configured to rotate the shaft so as to cut the object by the cutter.

Abstract: A system includes a grid-like, breast-receiving pressure plate having a polygonal opening. A prism is configured to match the polygonal opening. The prism includes a first conduit that has a zero first offset from the prism center and a second conduit that has a second offset from the prism center.

Abstract: An apparatus (51) includes a needle placement manipulator (1) and an attachment (52) for the manipulator. The manipulator includes a needle holder and a rotary mechanism. The rotary mechanism (3, 4) has a remote center of motion (RCM: 11) and is configured to position a needle holder (5) such that the axis of the needle holder traces a conical region of coverage (108), the conical region of coverage having the apex thereof at the RCM and the base thereof in a direction towards a subject of needle placement (14). The attachment supports the guide mechanism and is configured to be mounted onto the subject of needle placement. The attachment includes a guide portion (183c) configured to change an inclination of the rotary mechanism with respect to the subject of needle placement such that the axis of the needle holder intersects an insertion target (14) located outside of the conical region of coverage.

Abstract: Disclosed herein is a lifting surgical instrument having a branch point, which is used to insert a thread without a cog and a barb into the skin. The lifting surgical instrument includes a sheath, including: a probe part formed in the tubular shape in which a through hole penetrating in a longitudinal direction is formed, and configured such that the front end thereof may be inserted into the skin; and a body configured to extend from the rear end of the probe part, to have a diameter larger than that of the through hole, to communicate with the through hole, and to include a sheath hole. In this case, a direction guidance portion is provided on the inner surface of the probe part, and the angle at which the needle travels is changed via the direction guidance portion when the needle passes through the through hole.

Abstract: This disclosure provides tools and implant techniques utilizing such tools to gain access to and implant a medical device, such as a medical electrical lead, within extravascular spaces. In one example, this disclosure provides a tool for creating a sub-sternal tunnel in a patient. The tool comprises a relatively straight guide member extending from a first end thereof to a second end thereof, a tunneling member extending from a first end thereof to a tip thereof, the tunneling member extending alongside and coplanar with the guide member, the first end of the tunneling member and the first end of the guide member being joined together, and a handle coupled to the guide member.

Abstract: Disclosed is an automatic hair transplant apparatus including a needle module in which a hair follicle is inserted, a supplying case which has a magazine shape into which the needle module is inserted like a bullet of a gun, a withdrawing case which has a magazine shape into which the needle module is inserted like a bullet of a gun, and a hair transplanter on which the supplying case and the withdrawing case are mounted and which transplants hair follicles into a scalp by sequentially operating needle modules in the supplying case one by one and inserts needle modules from which hair follicles are removed into the withdrawing case.

Abstract: Components, systems and kits for capturing and removing tissue from mammalian bodies include a tissue container that may be introduced into a body cavity and within which a tissue specimen may be placed, cut and removed from the body cavity. Methods of using these components, systems and kits are also described.

Abstract: A uterine manipulator device includes: an elongated cannulated tube having proximal and distal ends, a cervical cup positioned on the elongated cannulated tube with a top distal portion of a first diameter and a base proximal portion of a second smaller diameter, and an occluder assembly comprising an occluder positioned proximally from the cervical cup on the elongated cannulated tube, the occluder having a body with at least one primary rib and at least two secondary ribs, wherein a diameter of at least one secondary rib is smaller than the diameter of the primary rib.

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: Pathology of the human knee can arise from excessive and/or uneven loading of regions within the joint. Methods and apparatus are disclosed that enable displacement of soft tissue around the knee, without displacing or severing bone thereby altering the mechanical load distribution within the joint in a less invasive manner than previous techniques.

Abstract: Provided are a telescoping, adjustable orthopedic strut for use in conjunction with an external bone fixation (EBF) device and an EBF device that employs the strut. The strut includes swivel hinges at each end, wherein each swivel hinge is lockable in any position within a one hundred eighty degree (180°) plane and has a three hundred sixty degree (360°) angle of rotation with respect to an orthopedic plate of the EBF device; an outer sleeve; an inner sleeve configured to slide within the outer sleeve; wherein the inner sleeve and outer sleeve may be positioned and fixed with respect to each other to provide an acute adjustment of the length of the strut; a leadscrew threaded into the inner sleeve, wherein the lead screw can be either rotated or fixed in position; and one or more clamping mechanisms for attaching a EBF element to the strut.

Abstract: A suture system including a suture construct having a first reduction construct configured to be selectively arranged in an expanded state and a reduced state. The first reduction construct includes a first locking limb, a first contractible loop, and a first opposed loop disposed generally opposite to the first contractible loop, wherein reduction of the first opposed loop contracts the first contractible loop from the expanded state into the reduced state and secures the suture construct in the reduced state. The suture construct may also include a second reduction construct. Optionally, the suture system includes a first and a second pusher tube defining a first and a second lumen, respectively, wherein each pusher tubes are advanced over portions of opposed loops, respectively, and wherein distal portions of opposed loops extend beyond the pusher tubes, respectively.

Abstract: For a differentiated treatment of individual motion segments of the spine, a plastic rod (41, 42, 46) for the dynamic stabilization of the spine has different degrees of stiffness in its longitudinal direction. The different rod segments are interconnected along an oblique plane (13).

Abstract: A system for flexibly stabilizing a vertebral motion segment of the facet joint by connecting a first vertebra and a second vertebra is disclosed. The system includes an elongate connection element with end portions interconnected by a flexible coupling member. The system includes first and second attachment portions for connecting the connection element to the vertebrae. A first resilient member is positioned between the first end portion and the first attachment portion, and a second resilient member is positioned between the first attachment portion and the second attachment portion.

Abstract: A system for use during a surgical procedure includes a control unit configured to obtain a first anatomical characteristic of a patient; measure a second anatomical characteristic of a patient; create a targeted second anatomical characteristic; and convert at least one of the measured second anatomical characteristic and the targeted second anatomical characteristics to a patient position.

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. The second band is movable for disposal adjacent the first band to fix connection of the members. Implants, systems, instruments and methods are disclosed.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an upper portion with a capture structure thereon, a retaining and articulating structure, a compression structure and a receiver for holding the capture structure, retaining and articulating structure, compression structure and a rod. The receiver includes arms that define a channel for receiving the rod. The arms have inner surfaces with a discontinuous flange form thereon for mating with a cooperating continuous flange form of a closure structure for capturing the rod within the receiver. The shank capture structure and the retaining and articulating structure are threadably attached and secured to one another with a buttress stop. In operation, the compression structure is disposed within the receiver between the shank upper portion and a rod but presses only upon the retaining and articulating structure.

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 vertebral fixation plate assembly for securing adjacent vertebral bodies is provided that is configured to distract or extend along its length, as well as provide multiple degrees of freedom between the fixation points and the vertebral fixation plate in order to accommodate different installation locations, as well as different surgical approaches. Methods of using the vertebral fixation plate assembly are also provided.

Abstract: An articulated fixation device is provided having a high degree of adjustability for securing a plate member thereof to a skull and at least one spinal rod thereof to a vertebral bone. In one form, an adjustable bridge member is provided that is adjustably connected to both the plate member and the spinal rod. The adjustable connections can include an upper and rearward pivot connection between the plate member and the bridge member and a lower and forward pivot connection between the spinal rod and the bridge member.

Abstract: Apparatus and methods for the treatment of abnormal spinal stability and stenosis of the spinal canal. In one embodiment, the apparatus and methods provide treatment via decompression and/or fixation of the spinal canal. One or more implants are used to fixate the posterior column of a spinal segment compromised of the superior and inferior immediately adjacent vertebral bones. In one variant, these disclosed devices are used to fixate the posterior column of a spinal segment while another orthopedic implant is placed into the anterior column of the same spinal segment, thereby providing circumferential decompression.

Abstract: An implantable device may be provided. The implantable device may comprise an upper assembly comprising a ramped base and a pair of opposing windows. The pair of opposing windows may extend upward from either lateral side of the ramped base. A gripping assembly may be disposed in each window. The implantable device may further comprise a lower assembly comprising a ramped base and a pair of opposing windows. The pair of opposing windows may extend down from either lateral side of the ramped base. A gripping assembly is disposed in each window. The implantable device may further comprise a ramped actuator assembly disposed between the upper assembly and the lower assembly. The ramped actuator may be configured to transition the implantable device from a collapsed form having a first height to an expanded form having a second height and wherein the second height is greater than the first height.

Abstract: A spinal implant includes an intermediate portion and a first portion extending in a transverse orientation from the intermediate portion. The first portion includes an inner surface connectable with vertebral tissue adjacent a lamina. A second portion is spaced from the first portion and extends in a transverse orientation from the intermediate portion. The second portion includes an inner surface connectable with vertebral tissue adjacent a lamina. At least one of the first portion and the second portion includes an outer surface having a mating element engageable with a mating element of a surgical instrument. Systems, surgical instruments and methods are disclosed.

Abstract: Neurophysiological instruments and techniques are improved through various enhancements. Stimulation of an instrument is possible while it is advancing into the spine or elsewhere, alerting the surgeon to the first sign the instrument or device (screw) may be too near a nerve. A directional probe helps surgeons determine the location of the hole in the pedicle. Electrically insulating sleeves prevent shunting into the soft tissues. According to a different improvement, the same probe to be used to stimulate different devices, such as screws and wires. Electrical impulses may be recorded from non-muscle regions of the body, including the spine and other portions of the central nervous system as opposed to just the extremities.

Abstract: In one embodiment, an intramedullary nail has a nail body that has a proximal end and a distal end that are offset from one another such that the body is elongate from the proximal end to the distal end. The body has an outer surface, and an inner surface. The inner surface defines a cannulation that extends into the proximal end towards the distal end. The body defines a proximal bone-anchor hole that extends into the outer surface and entirely through the nail, and a distal bone-anchor hole that extends into the outer surface and entirely through the intramedullary nail at a location between the proximal bone-anchor hole and the distal end. The nail also defines an access hole extends into the outer surface between the leading portion and the trailing portion. The access hole terminates at the cannulation and is in communication with the cannulation.

Abstract: A bone fracture internal fixator for repairing a bone fracture of a femoral neck that allows load to be applied to the associated bone parts evenly, and increases the connecting strength between the femoral head and femoral shaft while minimizing the risk of the femoral head being torn apart by the inner connecting member by increasing the diameter of the inner fixing member. The central axial line of the femoral head is offset from the central axial line of the intramedullary nail placed in the medullary cavity of the femoral shaft. In order to bring the inner fixing member such as a lag screw configured to be inserted through the femoral neck close to the central axial line of the femoral neck, the central axial line of the through hole for receiving the inner fixing member is offset from the central axial line of the intramedullary nail.

Abstract: A modular bone plate is provided including at least a first and a second member each having a top surface and a bottom surface, the first member comprising a male connection portion with a single hole extending from the top surface to the bottom surface and the second member comprising a female connection portion with a single hole extending from the top surface to the bottom surface, wherein the male connection portion is insertable into the female connection portion such that the holes overlap and wherein an anchor or a plug member is insertable into the holes when they overlap.

Abstract: Instrumentation and methods are provided for orthopedic surgery, including bone distraction. The application describes a bone distraction system that can be used to both distract and retract, or increase and decrease, a gap between first and second bone segments. The instrumentation can include any one of, or any combination of, a distractor, a ratchet, a first footplate, a second footplate, a first torque application instrument, and a second torque application instrument.

Abstract: The bone plate (1) has a lower surface (2), an upper surface (3), a thickness T measured between the lower and upper surfaces (2;3), a longitudinal axis (4) and a plurality of plate holes (5) running from the lower surface (2) to the upper surface (3). The bone plate (1) further has a slot (6) extending from the lower surface (2) towards the upper surface (3) and having a width W measured at the lower surface (2) and parallel to the longitudinal axis (4). The slot (6) extends to a maximum distance D measured from the lower surface (2) towards the upper surface (3) of 0.4-0.9 times the thickness T of the bone plate (1). The slot (6) has a width measured parallel to the longitudinal axis (4) which at its maximum extension E is at least 0.8 mm, preferably of at least 3 mm. The slot (6) allows the plate (1) to bend longitudinally—additionally to the intrinsic bendability of the unslotted plate (1)—at most to the amount of 20°, preferably at most to the amount of 10°.

Abstract: A method for force, displacement, and rate control of shape memory material implant. The rate of implant shape change as well as the force exerted on the surrounding tissue of the implant can be controlled by the surgeon and the extent of movement is controlled in circumstances where the bone element is free to move. The invention allows for the first time the fine control of force when fixating osteoporotic bone and rate of bone transport when working near the spinal cord. This heating profile of the implant provides the surgeon to control the extent of microstructure phase transformation so that the rate, force or extent of tissue movement can be controlled individually or together.

Abstract: An expandable screw includes generally a shaft, a head, and a cut pattern. The shaft includes a longitudinal axis, an outer surface including a thread to engage bone, and an expandable region configurable between a first state with a first radius measured from the longitudinal axis to the outer surface and a second state having a second radius measured from the longitudinal axis to the outer surface. The cut pattern on the shaft permits at least partial nesting of a first portion of the expandable region within a second portion of the expandable region in the second state. The central lumen is closed by the abutment of a top portion of the second cut surface with the bottom portion of the first cut surface so as to form a closed structure or fluid seal preventing a bone ingrowth inside the central lumen.

Abstract: The risk of bone cement extravasation can be reduced by delivering a calcium-dependent polymerizing sealant into a bone structure prior to delivery of bone cement into that structure. The polymerization of the sealant in response to the calcium within the bone structure can fill cracks and any other potential cement leakage paths, thereby minimizing the potential for subsequent extravasation. The benefits of the use of a calcium-dependent polymerizing sealant can be provided in any procedure involving the use of bone cement, such as spinal fixation, vertebroplasty, and kyphoplasty, among others.

Abstract: Systems and methods for treating vertebral compression fractures are provided. A kit can include at least one body containing a bone cement precursor to be mixed with at least one other bone cement precursor to form a bone cement. The body or a package containing the body can include at least one sensor. In some embodiments the sensor can be a temperature sensor. In some methods, data from the sensor can be used to determine certain parameters related to a treatment interval involving the bone cement.

Abstract: An operation method of an electric power source device for operating a high-frequency treatment instrument configured to perform a high-frequency treatment on a biological tissue includes causing a high-frequency electric power source circuit to output electric power; acquiring an initial impedance value in a first period from a start of the output; determining an increase rate of an output voltage relative to time; increasing the output voltage of the high-frequency electric power source circuit in accordance with the increase rate in a second period; acquiring the value relating to impedance of the biological tissue in the second period; and terminating the second period after the value relating to the impedance reaches a minimum value.

Abstract: A surgical system includes a power supply, a surgical instrument, and a power and data interface assembly. The power and data interface assembly includes a transformer having a primary winding, to which a first modulator and a second demodulator are coupled, and a secondary winding, to which a second modulator and a first demodulator are coupled. The power supply provides a power signal to the first modulator. The first modulator is configured to modulate, according to a first type of modulation, the power signal based on first data. The modulated power signal is communicated by the first modulator to the first demodulator by way of the transformer. The second modulator is configured to modulate, according to a second type of modulation, a second signal based on second data. The modulated second signal is communicated by the second modulator to the second demodulator by way of the transformer.

Abstract: An adapter element for receiving an HF surgical handpiece is proposed. The adapter element is characterized in that it is possible by receiving the handpiece in the adapter element to form a smoke duct in said adapter element for discharging smoke from a treatment area, at least one stick-, point-, ring-, sphere- or loop-shaped electrode or combinations of the same being attached on the distal end of the adapter element.

Abstract: Controlling conductive fluid flow during an electrosurgical procedure. At least some of the example embodiments are methods including: flowing conductive fluid from a source lumen to a suction lumen of an electrosurgical wand, the flowing with the electrosurgical wand in a first orientation; sensing a change in orientation of the electrosurgical wand to a second orientation different than the first orientation; and changing a control parameter associated with the conductive fluid flow, the changing responsive to the change in orientation of the electrosurgical wand.

Abstract: This disclosure relates to forming a lesion in a patient's neurological tissue without requiring general anesthesia. The lesion can be either temporary or permanent. In either case, the lesion can be created by a steerable probe that includes a steerable guide, a laser device, and at least one electrode. The steerable guide steers the probe to a target location in the subject's neurological tissue. When the probe reaches the target location, the laser can create the lesion. The at least one electrode can detect a progressive vanishing of neural activity from the portion of the neurological tissue due to the lesion.

Abstract: A surgical instrument includes a housing, a shaft extending distally from the housing, an end effector disposed at a distal end of the shaft, an actuator operably coupled to the housing, an actuation assembly, and a sensor module. The actuation assembly extends through the housing and the shaft and includes a distal end operably coupled to the end effector or a component associated therewith, a proximal end operably coupled to the actuator, and a spring. Actuation of the actuator manipulates the end effector or deploys the component relative thereto. The sensor module is disposed within the housing and configured to sense a property of the spring indicative of an amount the spring has been compressed. The sensor module is further configured, based upon the sensed property, to determine a condition of the end effector or the relative position of the component.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a catheter shaft. An expandable balloon may be coupled to the catheter shaft. The balloon may be capable of shifting between a folded configuration and an expanded configuration. A support structure may be coupled to the balloon. The support structure may be capable of shifting the balloon toward the folded configuration. A plurality of elongate flexible electrode assemblies may be disposed on the balloon. The elongate flexible electrode assemblies may be oriented at an angle relative to a longitudinal axis of the balloon.

Abstract: An ablation device and/or method of ablation may include placing one or more ablation electrodes in contact with a target tissue in a lumen. An electrical insulator may be positioned between the electrode and a lumen fluid and an electrical signal (for example a radio frequency signal) may be conveyed between the electrodes to heat and/or ablate the target tissue. Ablation may be bipolar and/or an in lumen dispersive electrode may be supplied for unipolar ablation. Ablation progress may be sensed and ablation may be adjusted to produce a desired level and/or geometry and/or distribution of ablation.

Abstract: Ablation catheters and systems include coaxial catheter shafts with an inner lumen for delivering an ablative agent and an outer lumen for circulation of a cooling element about the catheter. Induction heating is used to heat a chamber and vaporize a fluid within by wrapping a coil about a ferromagnetic chamber and providing an alternating current to the coil. A magnetic field is created in the area surrounding the chamber which induces electric current flow in the chamber, heating the chamber and vaporizing the fluid inside. Positioning elements help maintain the device in the proper position with respect to the target tissue and also prevent the passage of ablative agent to normal tissues.

Abstract: Techniques for treating a tumor and vaccinating against cancer are described. The techniques include treating the tumor by positioning electrodes over an interface between the tumor and non-tumor tissue and applying sub-microsecond pulsed electric fields. The positioning is facilitated by an imaginary contour line of a threshold value of the electric field. In an example, the imaginary contour line is overlaid over images that include the tumor such that the electrodes are properly positioned over the tumor. The techniques also include vaccinating against cancer by passing sub-microsecond pulsed electric fields through tumor cells of a subject sufficient to cause the tumor cells to express calreticulin on surface membranes. The tumor cells are extracted and introduced with the expressed calreticulin into the subject or another subject, thereby providing a vaccination.