Abstract: Among other things, there are shown embodiments of internal members for closure of vascular wall or other bodily openings, particularly useful in closing larger holes (e.g. larger than 10 French). Embodiments create a better seal or meeting with a vascular or other tissue wall by distributing force outward from the center, and/or by including rib, groove or hinge features that allow the internal member, as it is pulled toward tissue, to close the hole and engage tissue more closely or firmly.

Abstract: An implantable sealing device is disclosed herein and includes an elongated elastic member having distal and a proximal ends, at least one sealing element including braiding having outside and inside faces. The braiding can include of a plurality of fine threads of a memory metal alloy and wherein at least one face of the braiding is coated by a membrane. The braiding can also include a fixing member positioned at one of the distal and proximal ends of the elastic member and being positioned opposite to the braiding.

Abstract: A surgical retractor includes a structure including a plurality of legs and a plurality of joints, each leg being connected to at least one second leg at a joint. The structure has a non-expanded state, and an expanded state in which the structure forms a three dimensional structure having an internal volume. The structure has first and second manipulator arms, each of the manipulator arms being connected to at least two joints of the structure. The manipulator arms may be manipulated by a hand of a user. The retractor also includes a connector that holds the first and second manipulator arms in a crossed position. The connector holds the first and second manipulator arms at a point of intersection. The connector allows a user to move the manipulator arms and cause an angle formed by the manipulator arms to change. Movement of the first and second manipulator arms causes the structure to move between the non-expanded state and the expanded state.

Abstract: A laparoscopic tissue manipulator device includes a handle assembly, an elongate body, and a tool assembly. The tool assembly is supported on the distal portion of the elongate body and includes fingers. Each of the fingers includes a body having an elongate U-shaped configuration with a blunt distal end and an open interior and is secured to a distal portion of the elongate body about a first pivot member. The fingers are pivotable from a contracted position in which the fingers are aligned with each other and with the second longitudinal axis and an expanded position in which the fingers are splayed outwardly from the first pivot member at different angular positions in relation to the second longitudinal axis. A cover is supported on the each of the fingers to cover the open interior of the body of the fingers.

Abstract: Adjustable-length surgical access devices are disclosed herein, which can advantageously allow an overall length of the access device to be quickly and easily changed by the user. The access devices herein can reduce or eliminate the need to maintain an inventory of many different length access devices. In some embodiments, the length of the access device can be adjusted while the access device is inserted into the patient. This can reduce or eliminate the need to swap in and out several different access devices before arriving at an optimal length access device. This can also reduce or eliminate the need to change the access device that is inserted into a patient as the depth at which a surgical step is performed changes over the course of a procedure. Rather, the length of the access device can be adjusted in situ and on-the-fly as needed or desired to accommodate different surgical depths.

Abstract: A construct is disclosed that may be used to repair or replace a natural ligament. The construct may be formed of materials for biocompatibility and/or resorbtion. The construct may be provided or connected to a soft anchor for connection to a bone portion.

Abstract: Methods for repairing a meniscus, and particularly a torn meniscus. A method of repairing a meniscus may include using a suture passer to pass a suturing element from the region between the superior surface of the meniscus and the femoral condyle, through the meniscus tissue, into the region between the inferior surface of the meniscus and the tibial plateau, across the inferior surface of the meniscus, and back to the superior surface of the meniscus, without deeply penetrating the posterior capsular region of the knee. Equivalently, the suture element may be passed from the inferior surface of the meniscus to the superior surface and back to the inferior surface.

Abstract: A knot placement device allows a physician to apply a knot for securing two or more suture ends extending from an incision in a vessel or organ of a patient relative to each other in order to seal an opening in the vessel or organ. The knot placement device has a handle and an elongate shaft and a push rod slidably inserted in said shaft. A knot is disposed in the distal end of the shaft. An actuator on the handle may be depressed to distally advance said push rod relative to said shaft and thereby distally advance said knot. The knot may include a knot body having an inner cavity and a plug sized to fit securely within the inner cavity. In use, the plug may be inserted into the inner cavity of the knot body to fixedly hold two or more suture ends between the knot body and the plug.

Abstract: A system for controlling a relationship between first and second bodies and made up of a suture assembly with at least a first suture configured to define a restrictable loop structure with the suture assembly in an operative state. At least first and second restrictable sub-loops cooperatively define a first loop that can be reduced in size to thereby produce a force on the first and second bodies that urges them towards each other. A first loop length has a first sliding portion with a second loop length having a second sliding portion. At least one knot extends around the first and second sliding portions. The first and second sliding portions, upon each being moved within the at least one knot in a tightening sliding direction, cause a size of a respective sub-loop to be reduced.

Abstract: A calibration system for a surgical instrument. The calibration system includes an actuator, such as a motor system and a flexible shaft. The calibration system also includes a surgical instrument actuatable by the actuator. The calibration system also include calibration data corresponding to the surgical instrument. A processor is configured to process the calibration data for determining a position of the surgical instrument. The calibration system may include a sensor configured to provide a signal corresponding to a movement of the actuator, the processor being further configured to process the signal for determining a position of the surgical instrument.

Abstract: Systems and methods for controlling staple firing include an end effector including a first jaw and a second jaw holding staples, a drive system configured to apply a force or torque to cause staple firing to occur, and a processor. The processor is configured to monitor the applied force or torque and control application of the force or torque by the drive system based on a comparison of the applied force or torque to an acceptable range of force or torque. In some embodiments, the processor is further configured to determine one or more of a position of the first jaw and the second jaw or a displacement of the drive system and control application of the force or torque by the drive system based on one or more of the position of the first jaw and the second jaw or the displacement of the drive system.

Abstract: An apparatus includes a housing, an actuator, and a plurality of fasteners. The apparatus is for closing two sides of an incision or cut in skin tissue. The actuator moves into and out of the housing. The plurality of the fasteners are within the housing, and the apparatus is operable to deliver one fastener at a time into each of the two sides of the incision or cut.

Abstract: A fastener delivery tool is disclosed. An example fastener delivery tool comprises a sheath assembly including a sheath and a position retention member and a retraction assembly including a cover and a retractor member. The cover includes a lumen extending therein. The fastener delivery tool also includes and a handle assembly coupled to a proximal end of the sheath assembly, the handle assembly including a housing and an actuation member. Further, the sheath assembly extends through the lumen of the cover and the retractor member is configured to move relative to the handle between a first position in which the sheath assembly is disposed within a distal portion of the cover and a second position in which the sheath assembly extends out of the distal portion of the cover. Additionally, actuation of the actuation member moves the retractor member from the first position to the second position.

Abstract: Surgical instruments are disclosed which comprise improved jaw control. In at least one instance, a surgical instrument is configured to apply an increased clamping force at a distal tip of the instrument. In at least one instance, a surgical instrument is configured to quickly open, or unclamp, a jaw of the instrument.

Abstract: A surgical instrument includes a motor operably coupled to a firing member, wherein the motor is configured to generate at least one rotational motion to motivate the firing member to cause staples to be deployed during a firing stroke. The surgical instrument includes a primary processor configured to determine a first acceleration of the firing member during the firing stroke, and compare the first acceleration to predetermined threshold acceleration. The surgical instrument also includes a secondary processor configured to determine a second acceleration of the firing member during the firing stroke, and compare the second acceleration to the predetermined threshold value.

Abstract: A surgical instrument includes a body portion, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector includes an anvil and a staple cartridge. The anvil has a rigid bent tip configured to contact an angled surface of a nose portion of the staple cartridge. The staple cartridge includes gripping features along a staple deck that assist in gripping tissue during clamping. The staple deck of the cartridge may include multiple levels. The anvil further includes a slot with lateral portions having curved ends for receiving portions of a firing beam to guide the firing beam during a cutting and stapling action.

Abstract: A surgical instrument that includes a first jaw and a second jaw that is coupled to the first jaw for selective pivotal travel relative thereto between a fully open position and a fully closed position. An axially movable closure member is selectively axially movable in a closure direction to move the second jaw from the fully open position to the fully closed position and in an axial opening direction to move the second jaw from the fully closed position to the fully open position. The axially movable closure member includes a first jaw opening feature that is configured to apply a first jaw opening motion to the second jaw and a second jaw opening feature is axially spaced from the first jaw opening feature and is configured to apply a second jaw opening motion to the second jaw.

Abstract: In various embodiments, a surgical stapling instrument can comprise a plurality of magnetic elements configured to articulate an end effector of the surgical instrument. The surgical instrument can comprise at least one electromagnet which can be selectively activated, or polarized, to generate a magnetic field sufficient to motivate a second magnetic element, such as a permanent magnet and/or an iron core, for example, mounted to the end effector. In certain embodiments, a surgical stapling instrument can comprise a plurality of magnetic elements configured to open and/or close an end effector of the surgical instrument. In at least one embodiment, a surgical stapling instrument can comprise a plurality of magnetic elements configured to advance and/or retract a firing bar, cutting member, and/or staple sled within the surgical instrument in order to incise and/or staple tissue positioned within an end effector of the surgical instrument.

Abstract: A surgical clip applier is provided including a housing; at least one handle pivotably connected to the housing; a channel assembly extending distally from the housing; a plurality of clips loaded in the clip carrier; a drive channel translatably supported in the housing and the channel assembly, the drive channel being translated upon actuation of the at least one handle; and a counter mechanism supported in the housing, the counter mechanism including indicia visible through the housing, wherein the indicia corresponds to a quantity of clips loaded in the clip applier, wherein the indicia decrements upon each firing of the clip applier resulting in a reduction in the quantity of clips remaining of the plurality of clips.

Abstract: An adapter assembly for selectively interconnecting a surgical end effector including at least one axially translatable drive member and a powered actuator device including at least one rotatable drive shaft is provided. The adapter assembly includes an actuation shaft configured to convert rotation of a first drive shaft of the powered actuator device into an axial translation of a first drive member of the surgical end effector. The adapter assembly further includes an elongate tube configured to convert rotation of a second drive shaft of the powered actuator device into an axial translation of a second drive member of the surgical end effector. The actuation shaft is disposed within the elongate tube, and the actuation shaft and the elongate tube translate axially independent of each other.

Abstract: An apparatus includes a body, an anvil, a firing assembly, and a closure assembly. The firing assembly includes a staple driver, a deck member, and an annular array of staples. The closure assembly includes a trocar, a knob, and a limiting adjustment feature. The trocar is configured to actuate the anvil relative to the body to capture tissue between the anvil and the deck member. The knob is configured to rotate relative to the body to actuate the trocar relative to the body. The limiting adjustment feature is configured to selectively rotate the knob to actuate the trocar and the anvil proximally until tissue captured between the anvil and the deck member is compressed under a predetermined maximum clamping force. The limiting adjustment feature is configured to slip relative to the knob when tissue captured between then anvil and the deck member is compressed over the predetermined maximum clamping force.

Abstract: A circular stapling apparatus includes a staple cartridge, a pusher, and a buttress. The staple cartridge has a tissue contact surface and supports an array of fasteners therein. The pusher is configured to move relative to the staple cartridge to fire the fasteners from the staple cartridge. The buttress is supported on the staple cartridge and selectively pinned to the pusher.

Abstract: A method is provided for ablating a portion of the myocardium. The method includes inserting an occlusion catheter into a vessel on a heart, occluding the vessel using the occlusion catheter, inserting an ablation catheter into a chamber of the heart, positioning the ablation catheter against the myocardium, and ablating a portion of the myocardium while the vessel is occluded. The system includes an occlusion catheter having a catheter body including a tubular member having a distal portion and a bend located in the distal portion, a balloon located proximal of the bend and configured to contact an inner surface of the CS when positioned therewithin, a plurality of marker bands positioned on the catheter body, and a plurality of electrodes positioned on the catheter body. One or more electrodes or coils can be used as a reference for an electroanatomical system and can be disposed on the occlusion catheter.

Abstract: The volume of a hyperinflated lung compartment is reduced by sealing a distal end of the catheter in an airway feeding the lung compartment. Air passes out of the lung compartment through a passage in the catheter while the patient exhales. A one-way flow element associated with the catheter prevents air from re-entering the lung compartment as the patient inhales. Over time, the pressure of regions surrounding the lung compartment cause it to collapse as the volume of air diminishes. Residual volume reduction effectively results in functional lung volume expansion. Optionally, the lung compartment may be sealed in order to permanently prevent air from re-entering the lung compartment.

Abstract: Devices, methods and systems are provided for occluding an opening within the tissue of a body, such as a left atrial appendage. In one embodiment, a medical device includes an anchor portion and an occluder portion. The anchor portion includes frame segments, each anchor frame segment extending between a first end and a second end such that the second end of each anchor frame segment is coupled to an anchor hub. The occluder portion includes a hub that defines an axis. The occluder portion includes multiple occluder frame segments that extend between a proximal end and a distal end such that the proximal end of the occluder frame segments are pivotably coupled to the hub and the distal end of the occluder frame segments are pivotably coupled to the first end of the anchor frame segments.

Abstract: Disclosed are embodiments of a method for occluding a left atrial appendage (LAA) and other cavities or openings within a body. Some embodiments of the method can include an implant configured to be deployed within the LAA or other cavity, configured to be expanded or moved against a wall portion of the LAA or other cavity, and configured to twist at least a portion of the LAA or other cavity when the implant is rotated. Thereafter, one or more securing elements, staples, sutures, or other fasteners can be implanted in the gathered tissue to hold the tissue in the gathered state, thereby occluding the opening of the LAA or other cavity. In some embodiments, the opening of the LAA or other cavity can be occluded by elongating or otherwise reshaping the opening using an implant device, and securing the opening in the occluded state.

Abstract: A system for treating tissue includes a clip assembly including a pair of clip arms, proximal ends of the clip arms slidably received within a channel of a capsule to be moved between a tissue receiving configuration and a tissue clipping configuration, and an applicator releasably coupleable to the clip assembly to move the clip assembly between the tissue receiving configuration and the tissue clipping configuration, the applicator including a control member having a plurality of nodes extending therealong, each node having a cross-sectional are larger than a cross-sectional area of a remaining portion of the control member and configured to be coupled to the proximal end of the clip arms, a distal-most one of the nodes severable from a next immediately proximal one of the nodes, when a force exerted thereon exceeds a predetermined threshold value, to release the clip assembly from the applicator.

Abstract: Apparatus and methods for delivering a surgical clip to a patient during a minimally invasive surgical procedure are disclosed herein. An exemplary apparatus for isolating an atrial appendage of a patient includes a surgical clip that locks onto the atrial appendage of the patient, and a surgical clip applicator that releasably engages the surgical clip. The surgical clip can include a top portion and a bottom portion. The surgical clip applicator can include a first flexible flap and a second flexible flap. The first and second flexible flaps can be sufficiently rigid to prevent the surgical clip from falling off of the surgical clip applicator when the surgical clip is engaged to the surgical applicator and the surgical clip applicator is in a relaxed state, and sufficiently flexible to facilitate separation of the surgical clip from the surgical clip applicator when the surgical clip is locked onto the atrial appendage.

Abstract: An endoscopic surgical clip applier includes an endoscopic assembly and a handle assembly. The endoscopic assembly includes a shaft assembly and a pair of jaw members. The handle assembly includes a housing, a fixed handle, a trigger, a drive bar, and a ratchet assembly. The ratchet assembly includes a first rack operatively coupled to the drive bar, the first rack defining a plurality of first rack teeth, wherein the first rack includes a first length between a distal end and a proximal end thereof, and a second rack operatively coupled to the drive bar, spaced apart from the first rack, the second rack defining a plurality of second rack teeth, wherein the second rack includes a second length between a distal end and a proximal end thereof, the second length of the second rack being less than the first length of the first rack.

Abstract: A clip counting mechanism for use with a surgical clip applier includes a display gear rotatably supported within a handle housing of the surgical clip applier and including an outer surface having a plurality of numbers disposed thereon, a biasing element in mechanical communication with the display gear and rotatably biasing the display gear, a counter switch reciprocally disposed within the handle housing and defining a cam slot therethrough, and an escapement gear rotatably supported within the handle housing and defining a proximal end portion in mechanical communication with the display gear and a distal end portion in mechanical communication with the cam slot. Translation of the counter switch causes the cam slot to cam the escapement gear and selectively disengage and then re-engage the display gear to enable the display gear to rotate a predetermined angle of rotation.

Abstract: An abdominal aortic tourniquet having one-piece member for the bladder and cover portions and whose bladder has a triangular cross-sectional shape when inflated that significantly increases the amount of point pressure such that the intended artery is properly occluded. The one-piece bladder/cover design provides for a reduction in cost of materials and provides for a more compact piece as compared to prior designs. The abdominal aortic tourniquet uses a single piece of weldable and gas impermeable fabric that is configured in a novel manner to create a three-dimensional, pneumatic piston while also serving as storage/transport cover, attachment structure, and major component of the belt member.

Abstract: A tourniquet apparatus having an optical tourniquet interface for safe personalization, a safe transfer key and a pressure controller. The optical tourniquet interface communicates with the pressure controller and is operable for contactlessly reading and authenticating a machine-readable instrument symbol associated with a tourniquet cuff if it matches stored instrument authentication data and for contactlessly reading machine-readable personalization data associated with the cuff. The optical tourniquet interface presents a personalization parameter value if the machine-readable instrument symbol has been authenticated. The safe transfer key enables the user to selectively transfer the presented value of the personalization parameter to the pressure controller only if the pressure controller is inoperable. The pressure controller is releasably connectable to the tourniquet cuff and responsive to the transferred value of the personalization parameter.

Abstract: A direction adjustable surgical tissue removal device, including: an insert rod having a stopping step at a front end; a slider slidably coupled to the insert rod, moving forward and backward with respect to the stopping step, and having a punching portion forming a jaw in cooperation with the stopping step; a rotary shaft being a hollow member fixed behind the insert rod and rotated by a user; a pushing rod having a front end fixed to the slider sequentially through the rotary shaft and the insert rod and a rear end extending backward; a spring disposed between the rotary shaft and the rear end of the pushing rod and elastically supporting the pushing rod backward; and a handle accommodating a portion of the rotary shaft and moving the pushing rod forward such that the punching portion is pushed toward the stopping step.

Abstract: A surgical system for use in correcting hammer toe or otherwise straightening toes or fusing other bones to one another includes a male drill bit and a female drill bit, as well as an absorbable pin. The male and female drill bits are configured to define complementary features from opposed, or facing, ends of bones that are to be fused to one another. The male and female drill bits may also be configured to define channels through the lengths of the bones that are to be fused to one another, with the channels being configured to align and define a continuous channel through the bones when they are assembled. The absorbable pin, which may be absorbed by a subject's body over time, is configured to be positioned in the continuous channel, and may hold the bones in an assembled relationship before and while they fuse to one another.

Abstract: Measurement of a leading edge of an instrument passing from a first medium having a first density to a second medium having a second density using a displacement sensor alone. In particular, a displacement signal, a velocity signal, and an acceleration signal measured from or derived from a displacement sensor are analyzed to determine when the leading edge of the instrument passes from the first material to the second material as the leading edge of the instrument is advanced relative to the material. For instance, the measurement may be used to output an occurrence signal that indicates to a user that the instrument has passed from the first medium to the second medium. Additionally, a length measurement of the path of the instrument when passing from the first medium to the second medium may be recorded, and/or the instrument may be controlled (e.g., the instrument may be stopped).

Abstract: An adjustable device for identifying the target location for, and placement of, a bone tunnel wherein the device is capable of measuring a total distance across a region of an anatomic structure. The device may be further configured to engage the anatomic structure at a target distance across the anatomic structure to identify the location for bone tunnel placement. A method for identifying the target location for, and placement of, a bone tunnel such that the method is capable of measuring a total distance across a region of an anatomic structure and capable of engaging the anatomic structure at a target distance across the anatomic structure.

Abstract: A retro guidewire reamer includes a cutting member, and a mechanism for moving the cutting member from a closed position to a deployed position in a single manual motion. Once a desired size of a bone tunnel is established, a surgeon uses the reamer to create a primary bone tunnel over a guidewire from the outside in. The surgeon retracts the guidewire, and activates the mechanism to deploy the cutting member within the bone joint to conform to the size of a tendon graft. The surgeon uses the deployed cutting member to create a counter bore through the bone in a retrograde manner. Once the counter bore is drilled, the surgeon activates the mechanism to close the cutting member, allowing the reamer to be withdrawn through the primary tunnel. The retro guidewire reamer can be used to provide more accurate bone tunnel placement during ligament reconstruction surgery.

Abstract: The present invention includes a method and devices for treating osteonecrosis in, e.g., children, adolescents, and adults comprising: identifying a subject in need of treatment for osteonecrosis; drilling two or more holes into a bone in need of treatment for osteonecrosis; inserting two or more needles or cannulas into the holes in the bone; washing an interior of the bone with a washing fluid introduced through one or more of the needles or cannulas inserted into the bone; and after washing the interior of the bone introducing one or more bone growth promoting materials or cells into the bone.

Abstract: A method may include delivering a first catheter to a location within an arterial vasculature of a subject. The location may include at least one of an internal carotid artery of the subject or a junction between an ophthalmic artery of the subject and the internal carotid artery of the subject. The method also may include moving a second catheter relative to the first catheter so as to reorient a direction of a distal opening of the second catheter, the second catheter being connected to the first catheter at a joint.

Abstract: Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device includes three balloons that are each sized and shaped to fit within a concave portion of a valve cusp when inflated with a liquid and a shock wave source within each of the three balloons. Each balloon is separately and/or independently inflatable, and each shock wave source is separately and/or independently controllable. Methods of treating calcified heart valves using a shock wave device can include advancing a shock wave device having one or more balloons and a shock wave source in each of the balloons to contact a heart valve, inflating the one or more balloons with a liquid such that the balloon is seated within a concave portion of a valve cusp, and activating the shock wave source.

Abstract: A catheter includes a wave guide for transmitting ultrasonic energy from a transducer, and which is also rotated to facilitate enhanced disruption of the concerned obstruction in a transverse direction. Embodiments of waveguide include distal anchors that help focus the energy transmitted to a treatment site, and may also include a deployable filter that may open distal of the obstruction to capture any dislodged debris. Selectively inflatable balloons may cordon off a treatment site, and the wave guide may comprise a tube that may serve the dual purposes of inflating the balloon(s), as well as to transmit ultrasonic energy to an obstruction. A portion of an ultrasonic catheter may include plural curved portions to space an exposed portion of the wave guide away from the catheter body to enhance the vibratory action provided.

Abstract: A electrosurgical forceps includes a first elongated shaft member including a first handle member and a first jaw member having a first tissue contacting surface, and a second elongated shaft member including a second handle member and a second jaw member having a second tissue contacting surface. At least one of the first and second handle members is movable relative to the other between an open position, a first approximated position where the first and second tissue contacting surfaces are diametrically opposed to one another, and a second approximated position where the first and second tissue contacting surfaces are laterally offset from one another. A handle connector assembly is selectively engageable with the second handle member and is configured to selectively communicate electrosurgical energy between the first and second tissue contacting surfaces when the first and second handle members are disposed in the first approximated position.

Abstract: The invention relates to a clamp for medical use, particularly for use in aesthetic and reconstructive rhinoplasty procedures, said clamp comprising two arms (1) connected at corresponding ends, with a scoop (2) provided at the free end of each arm (1). Each scoop (2) comprises: on one longitudinal edge, a recess (3) with a plurality of through-holes (4), the size of which allows the double pass of a needle; and, on the longitudinal edge opposite the recess (4), respective opposing longitudinal projections (5).

Abstract: The present disclosure relates to a dissecting tip for use in a surgical stapler or instrument.

Abstract: An ultra-sonic medical dissector includes a vibration generator and a wire that defines a cutting loop remote from a first end and a second end. The wire is coupled to the vibration generator in a cutting configuration, and a cutting surface is located on an inner curvature of the cutting loop. A vibration is generated by the vibration generator is transmitted to the cutting loop by the wire when the wire is in tension. The cutting loop can free an embedded end of a vena cava filter from a vessel wall to ease retrieval.

Abstract: Skin treatment systems, handpieces, suction wands, and methods of treatment are disclosed herein. A skin treatment system includes a treatment handpiece with removable tips, a console unit, and a suction assembly. The console unit can have a pressurization device configured to be fluidically coupled to the suction assembly. The suction assembly is configured to hold a subject's skin while the treatment handpiece moves along the epidermis. The tips can replaced any number of times to perform during a treatment session.

Abstract: Assemblies and methods provide for implantation of multiple medical leads to a defined space within the body, such as the epidural space, through a single entry. A catheter having multiple lumens or alternatively a single oblong lumen may be used. A distal end of the catheter enters the defined space through the single entry such that the distal ends of the multiple lumens or the oblong lumen are present in the defined space. Medical leads are introduced through the multiple lumens or the oblong lumen into the defined space. In some cases, the distal end of the catheter may be deflectable to direct the medical leads within the defined space. In other cases, sheaths may be present within each lumen of the catheter where the sheaths may be extended into the defined space and deflect to direct the medical leads that are being passed through a lumen of the sheaths.

Abstract: A medical device is disclosed comprising an elongated needle assembly having a distal end, a proximal end and a longitudinal axis A, the needle assembly comprises a tubular cannula having a sharpened distal end, a proximal cannula portion, and a longitudinal bore along the longitudinal axis A, and a stylet configured to extend through the bore of the cannula, and having a blunt distal end and a proximal stylet portion. The needle assembly is provided with a spring member configured to urge the stylet in a distal direction along the longitudinal axis, such that the stylet is axially spring-biased in said distal direction.

Abstract: The use of stepped cannulas, wherein a step structure creates a backstop to reduce backflow along the cannula body, is known for convection enhanced delivery of agents to the brain and other structures within an animal. Described herein are novel and improved stepped cannula designs wherein the length of the cannula segment between the step and the dispensing outlet is variable and can be controllably adjusted inside the patient during delivery. This advantageously allows the operator to place the cannula step at the optimal position and deliver agents at one or more positions within the target structure.

Abstract: A system and method of accessing a heart of a patient is provided. A cardiac access channel is established through an apical wall of the heart to provide direct access through the apical wall to the left ventricle. A vascular access channel is established through the skin to a peripheral blood vessel. A first end of an elongate member is advanced from the outside of the apical wall through the cardiac access channel and into the left ventricle. A second end disposed opposite the first end remains outside the patient. The elongate member is drawn into and through the vascular access channel to externalize the first end of the elongate member while leaving the second end outside the apical wall of the heart.