Abstract: A system and method for providing additional power to a hand-held surgical device from a supplemental DC power supply. The hand-held surgical device includes a generator and an internal power supply. The internal power supply is a battery or a capacitor either which can withstand a high-temperature and/or a low-temperature sterilization procedure while within the hand-held surgical device. The supplemental DC power supply can provide alone or in combination with the internal power supply sufficient power to the generator to perform an electrosurgical procedure. The supplemental DC power supply is connected through a detachable cord to the hand-held surgical device. The DC power supply may be outside a sterile surgical environment.

Abstract: A medical device comprises a tube including a wall with a plurality of slits oriented generally transverse to a longitudinal axis of the tube and defined by opposing surfaces. A pair of force transmission elements is actuatable to alter the tube between a flexible state and a stiffened state. A first force transmission element of the pair is coupled to an opposite side of the tube from the second force transmission element of the pair. The surgical device also includes a plurality of routing members coupled to the wall of the tube and configured to receive and route the force transmission elements along a length of the tube while permitting the length of the tube to flex and compress. Equal tension forces applied to the pair of force transmission elements compress the tube to create the stiffened state by deforming regions of the tube disposed between the plurality of slits.

Abstract: A closure system, assembly and attended method for closing and opening in the tissue of the patient includes first and second closure members each including a biased construction operative for disposition of the closure members into an out of retracted and expanded orientations. A connector is disposed in interconnecting relation with the closure members and structured to establish at least a partial spacing there between. The biased construction and the interconnection of the closure members facilitate con current disposition of the closure members with one another into and through an introductory instrument as well as independent and successive disposition of the first and second closure members into a closing relation to the tissue opening upon exiting the introductory instrument.

Abstract: Various embodiments of a non-metal retractor device having a ratchet arm for retracting an incision and retaining a shunt are described herein.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: Methods and devices are provided for attaching soft tissue to bone. In general, a deployment device, insertion assembly, and suture anchor are provided. The insertion assembly is coupled between the deployment device and the suture anchor to allow the deployment device to deploy the suture anchor into bone. Each of the various components disclosed herein can be used alone, in combination with one another, or in combination with various other devices.

Abstract: First and second arms have first and second retaining members, respectively. A switching mechanism switches a retained state of a first position of a tying medium between first and second states. In the first and second states, the first position is retained by the first and second retaining members at first and second retaining positions, respectively. A loop retaining member retains a loop around the second arm in a path extending from the first retaining position through second and third positions to a fourth position of the tying medium. The second position intersects the third position as a result of the loop such that the third position is closer to the first retaining position than the second position in the path. A moving portion moves the loop relative to the second arm to change a relative positional relationship between the loop and the first position on the path.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: An assembly for joining tissue portions is provided and includes an anvil assembly and a body portion juxtaposed with respect to one another along a shaft and arranged so as to be approximated with respect to one another; and an applicator disposed between the body portion and anvil assembly and configured for retaining a wound treatment material therein. The applicator has channels arranged for dispensing the wound treatment material therefrom onto an interface between the tissue portions. A method of joining the tissue portions is also provided and includes the steps of dispensing the wound treatment material from the applicator so as to distribute wound treatment material onto an interface between a first tissue portion and a second tissue portion; and approximating the anvil assembly and the body portion to one another so that the first and second tissue portions are in contact with one another.

Abstract: Stapling assemblies for use with a surgical stapler and methods for manufacturing the same are provided. Three dimensional adjuncts for use with a surgical stapling assembly and methods for manufacturing the same are also provided.

Abstract: A surgical end effector that includes first and second jaws that are selectively movable between a fully open position and a fully closed position relative to each other. At least one expandable tissue stop is located on one of the first and second jaws and is configured to extend between first and second jaw surfaces on the first and second jaws as the first and second jaws move between the fully open and the fully closed positions.

Abstract: A motorized surgical instrument is disclosed. The surgical instrument includes a displacement member, an energy source, a motor, a control circuit, and a position sensor. The control circuit is configured to initiate firing the displacement member at a predetermined electrical load on the energy source, wherein the predetermined electrical load is applied to the motor to actuate the displacement member, monitor the position of the displacement member via the position sensor, continually sample a voltage of the energy source during a first interval of travel of the displacement member, compare the sampled voltage to a threshold voltage, and continue firing the displacement at the first velocity when the sampled voltage is greater than or equal to the threshold voltage or adjust the first velocity when the sampled voltage is less than the threshold voltage. Techniques for handling motor stall conditions and transitions between velocities also are disclosed.

Abstract: A method of coating a slip ring for use with a surgical instrument is disclosed. The method includes the steps of providing a slip ring including a plurality of conductive elements, and depositing a material less conductive than the conductive elements onto the conductive elements of the slip ring.

Abstract: A robotic stapling system comprising a surgical robot and a surgical instrument is disclosed. The surgical instrument comprises an end effector comprising a first jaw and a second jaw, a replaceable staple cartridge comprising staples, an instrument drive system, and a coupling member movable distally by the instrument drive system. The coupling member comprises a first cam configured to engage the first jaw and a second cam configured to engage the second jaw when the coupling member is moved distally. The coupling member is moved distally a first distance during a first actuation of the instrument drive system and a subsequent distance during a subsequent actuation of the instrument drive system. Staples are ejected from the staple cartridge during the subsequent actuation. The first actuation occurs at a first rate and the subsequent actuation occurs at a second rate which is faster than the first rate.

Abstract: The invention is an implantable magnetic anastomosis device having an exoskeleton that directs self-assembly. The design allows the device to be delivered in a linear configuration using a minimally-invasive technique, such as endoscopy or laparoscopy, whereupon the device self-assembles into, e.g., a polygon. A coupled set of polygons define a circumscribed tissue that can be perforated, or the tissue can be allowed to naturally necrose and perforate. The device can be used to create anastomoses in a variety of tissues, such as tissues found in the gastrointestinal, renal/urinary, and reproductive tracts. New procedures for using anastomoses, e.g., surgical bypass are also disclosed.

Abstract: The subject invention pertains to materials and methods for performing breast neurotization with allogeneic or autologous nerves in breast surgeries, such as reconstructive breast surgery. Certain embodiments of the methods comprise harvesting and implanting one or more allogeneic or autologous intercostal nerves 10 to 12 to one or more of the patient's intercostal nerves 2 and/or 3.

Abstract: An occlusive implant can be delivered into a body vessel using a delivery assembly that can engage with at least a portion of the implant. The assembly can utilize an engagement member and an engagement socket or a catheter or sheath to removably couple the engagement member with the implant. When the implant is advanced to a target location in the body vessel, the implant can be released to restrict flow of a fluid through the vessel and/or promote occlusion of the vessel.

Abstract: Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a resilient self-expanding permeable implant having a radially constrained elongated state configured for delivery within a catheter lumen and an expanded state with a longitudinally shortened configuration, and a plurality of elongate filaments which are woven together. Each of the plurality of elongate filaments may have a diameter between about 0.0005 and about 0.005 inches. The implant includes at least some filaments consisting of nitinol and at least some composite filaments that are drawn filled tube wires comprising an external nitinol tube and a highly radiopaque material concentrically disposed within the external tube. The implant has at least about 40% composite filaments relative to a total number of filaments, and wherein a total number of filaments is about 10 to about 300.

Abstract: A left atrial appendage occluder includes a sealing plate, a fixing plate, and a connection member connecting the sealing plate and the fixing plate. The connection member is a silk woven structure. A radial deformability of the sealing plate is greater than a radial deformability of the fixing plate, and/or an axial deformability of the sealing plate is greater than an axial deformability of the fixing plate. In the left atrial appendage occluder, the fixing plate and the sealing plate are connected via the connection member of the silk woven structure, such that a distance between the fixing plate and the sealing plate and an angle formed thereby are both adjustable to adapt to a left atrial appendage having a large bending angle or requiring the fixing plate to remain at an increased distance to the sealing plate, thereby reducing the risk of failed occlusion.

Abstract: A left atrial appendage occluder which includes a closure disc, a mesh anchoring apparatus, and a thin-film body, connected to one another. The anchoring apparatus extends from the closure disc toward the distal end to form a conical part having a distal-end opening, and the conical part extends toward the proximal end and rolls up to form an anchoring part. The thin-film body is fixed on the outside surface of at least one part of the anchoring part, and part or all of it covers the distal-end opening. The left atrial appendage occluder is provided with the thin-film body on the anchoring apparatus, which constrains the deformation of different parts, and accordingly improves the radial supporting force of the occluder so as to prevent it from falling out after implantation.

Abstract: Disclosed are systems and method for effecting the total and partial occlusion of a blood vessel, e.g., the aorta. The systems include a balloon catheter, a reservoir for an inflation fluid, a switch, and a pressure regulator/accumulator. The systems are configured to operate in a first mode and a second mode as established by the switch. During the first mode the balloon is fully inflated by the inflation fluid to completely occlude the blood vessel. During the second mode the balloon is partially inflated so that blood can flow past the balloon in the blood vessel. The pressure regulator/accumulator includes a chamber for receipt of the inflation fluid during the second mode to automatically regulate the pressure within the balloon to a desired operating pressure. The system is configured to operate in a third mode to prime the pressure regulator/accumulator to establish a desired operating pressure in the second mode.

Abstract: The invention relates to a device for closing an atrial appendage, particularly the left atrial appendage, comprising a closing element, designed to be arranged in an atrial appendage entrance and to prevent an entrance of blood into the atrial appendage and/or a leakage of thrombus out of the atrial appendage, which is configured that it does not, in the implanted state, protrude out of the atrial appendage into the atrium of the heart; a first anchoring element, which is arranged adjacent to the closing element and connected to the closing element, wherein the first anchoring element is designed for an anchoring on an atrial appendage tissue wall, a connecting element which is at least in a radial direction flexible and connected to the first anchoring element and a second anchoring element, which is connected to the connecting element and designed for an anchoring on an atrial appendage tissue wall.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

Abstract: A collector used to collect bone includes: a container body defining an interior containment space for receiving and retaining collected bone, and having at least one open end for access and removal of collected bone from the interior containment space; and a cap in covering relation to the open end of the container body such that access to the interior containment space for removal of collected bone is inhibited. The collector includes an intake port defining an opening for receiving therein a distal end of a kerrison rongeur for collecting cut bone from a cutting area thereof, and the cap includes at least one scraper for engaging and dislodging cut bone from the cutting area of a distal end of a kerrison rongeur when received within the intake port. The collector preferably is used with a kerrison-type rongeur for collecting cut bone therefrom.

Abstract: An offset guide can include a body, an arcuate portion, a first fin, and a second fin. The body can have a first surface. The arcuate portion can extend from the body and have a second surface. The first surface and the second surface can define an opening. The first fin can extend from the first surface into the opening. The second fin can extend from the first surface into the opening. A portion of the first surface can be located between the first fin and the second fin and arranged at an angle relative to a longitudinal axis of the offset guide.

Abstract: A lithotripter is provided for fragmenting a stone inside a patient's body. In one form, the lithotripter includes a motor having at least two modes of operation and is configured to produce first and second waveforms. A wave guide shaft is configured to transmit the first and second waveforms to the stone. In one form, at least one of the first and second waveforms is provided to the stone at a frequency that is about equal to a natural frequency of the stone. In a variation, the lithotripter may include an ultrasonic driver configured to produce an ultrasonic frequency waveform and a sonic driver configured to produce a sonic frequency waveform. The sonic driver is mechanically coupled to the ultrasonic driver. The ultrasonic driver and the sonic driver may be disposed within a driver housing. In another variation, the lithotripter may include a brushless DC motor.

Abstract: A nose knife with good usability and little interference with tools such as an endoscope in nasal cavity surgery is provided, and includes a handle, a shank, and a blade. The shank includes a straight part connected straight to the handle along the same axis, and a curved part integrally connected to the front end of the straight part. The blade is provided at the front end of the curved part. A tip of the blade is angled 65 degrees to 75 degrees inclusive relative to the axis of the straight part.

Abstract: A manipulator includes a flexible actuating body, that includes a rectangular horizontal plate spring, a curved vertical plate spring which stands upright having a plate surface perpendicular to a plate surface of the horizontal plate spring, of which a base end is connected to one end of the horizontal plate spring in a longitudinal direction, which protrudes to one side in a width direction of the horizontal plate spring, which extends along the longitudinal direction of the horizontal plate spring, and of which a tip end in the extending direction is a portion bent in a direction opposite to the protruding direction, a shaft body which is connected to a tip end of the bent portion, and is rotatably supported at a center perpendicular to the plate surface of the horizontal plate spring, and an actuator protruding in a radius direction from an outer circumference of the shaft body.

Abstract: Provided herein are expandable endoscopic devices. In accordance with certain aspects of an embodiment of the invention, an endoscopic expandable device is disclosed that comprises an expandable jaw at the distal tip, a control wire connected to the jaw, a sheath enclosing the control wire, and a handle connected to the sheath or wire having an actuating trigger. The expandable jaw is configured to allow its delivery in a retracted configuration to a target site within a patient's body through the working channel of an endoscope, after which the jaw may reconfigure to an expanded configuration that is larger than the retracted configuration. This allows the expandable jaw to be easily delivered to the target site while allowing an operable jaw size that is larger than would be allowed if limited to size of the working channel. The endoscopic expandable device may have utility as a clip or as forceps.

Abstract: Apparatus, including a tube having a proximal end, and a distal end for insertion into a body cavity including anatomical structures, and a blade mounted at the distal end. The apparatus also includes a handle at the proximal end and including a device which generates sensible outputs upon receiving activation signals, and a position sensor fixed in a predefined disposition relative to the tube. The apparatus additionally includes a processor configured to acquire an image of the cavity, to determine, in the image, locations for each of the structures, to receive, from the sensor, a position signal indicative of a blade location of the blade within the cavity, to determine, based on the blade location and the respective structure locations, a proximity of the blade to a given structure, and to convey, to the warning device, a given activation signal in response to the proximity to the given structure.

Abstract: The devices and methods shown provide for the minimization of extravasation during arthroscopic surgery. The extravasation minimization device allows a surgeon to drain excess fluids from the soft tissue surrounding the surgical field while also providing a stable surgical portal for arthroscopic surgical instruments.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for cutting an opening in a tissue wall. In an illustrative embodiment, an apparatus includes an inner cutting member having a first cylindrical body supporting at least one first cutting surface at a distal end. The first cutting surface faces a first rotational direction relative to an axis of the first cylindrical body and has a first cutting edge at an outer periphery of the first cylindrical body. The apparatus also includes an outer cutting member having a second cylindrical body concentrically disposed around the first cylindrical body and supporting at least one second cutting surface at the distal end. The second cutting surface faces a second rotational direction relative to the axis and has a second cutting edge at an inner periphery of the second cylindrical body.

Abstract: An ultrasonic treatment device includes a first vibration transmitting member and a second vibration transmitting member and being configured to treat a biological tissue by means of vibration transmitted by the first vibration transmitting member and the second vibration transmitting member. At a boundary position between the first vibration transmitting member and the second vibration transmitting member, the first vibration transmitting member has a boundary face including a contacting area that is in contact with the second vibration transmitting member at the face, and a non-contacting area that is not in contact with the second vibration transmitting member.

Abstract: In one aspect, the present disclosure pertains to ultrasonic treatment devices that comprise: (a) a flexible elongate body having a proximal end and a distal end, the flexible elongate body being configured for insertion to a target site within a patient; (b) an effector assembly disposed at the distal end of the flexible elongate body, the effector assembly comprising a piezoelectric transducer and an end effector; and (c) flexible electrical conductors in electrical communication with the piezoelectric transducer, the flexible electrical conductors extending along a length of the flexible elongate body, wherein transference of electrical energy to mechanical motion takes place via the piezoelectric transducer at the target site. Other aspects of the present disclosure pertain to systems employing such ultrasonic treatment devices and methods of treatment using such ultrasonic treatment devices.

Abstract: An ultrasonic surgical instrument includes a body, a shaft, an ultrasonic transducer, a waveguide, and an end effector coupled to a distal end of the shaft. A rotation knob is rotatably coupled to the body and is configured to rotate the shaft, the waveguide, and the end effector together relative to the body. A torque transfer structure is positioned radially outwardly of and in direct contact with the waveguide at an acoustic node thereof. The torque transfer structure is rotationally fixed relative to the waveguide and is configured to rotationally couple the waveguide with the shaft and the rotation knob. The waveguide includes a first axial constraining feature defining a distally facing surface, and the torque transfer structure includes a second axial constraining feature defining a proximally facing surface configured to abut the distally facing surface to constrain the waveguide axially relative to the torque transfer structure and the body.

Abstract: A device suitable for use in a body lumen and comprises an elongated control member having a distal and a proximal end, and a radially expansible member disposed at or near the distal end and adapted for collection and/or shearing of matter (i.e. thrombus) from a wall of the body lumen (i.e. a vein or an artery). The radially expansible member has a proximal end and a distal end and is adjustable between a contracted orientation and an expanded orientation. The elongated control member comprising a proximal arm connected at or adjacent to the proximal end of the radially expansible member and a distal arm connected at or adjacent to the distal end of the radially expansible member such that movement of one arm relative to the other arm effects adjustment of the diameter or radial strength of the radially expansible member. The device comprises a control mechanism operatively connected to both arms and adapted to provide resistance to the movement of one arm relative to the other.

Abstract: The disclosed system includes a probe for mechanically cutting tissue Other components of the system include a luminally protective sheath, a microscopic end cauterizing probe, a surgical console, an identification-sensitive self-sealed cassette, and a plurality of flexible tubing lines with pinch valves thereon.

Abstract: Systems, apparatus, and methods are described for forming an incision in tissue for receiving a surgical instrument. A cutting device for forming the incision can be reversibly coupleable to an instrument, e.g., a dilator. The instrument may define a lumen configured to receive a wire that extends or is otherwise extendable through a puncture site. The cutting device can include a cutting element configured to be actuated to form the incision such that the incision extends form the puncture site and is sized to receive the instrument.

Abstract: A flexible cannula device and delivery system for use in arthroscopic surgery. The delivery system engages the flexible cannula from the inside near the distal tip and pushes it into the surgical portal, essentially pulling the proximal portion of the cannula from the distal tip while being pushed from the proximal end with the specialized driver. The delivery system provides for single point engagement at the distal tip as well as a multiplicity of engagement points along the length of the system.

Abstract: A device and system for implanting a hair graft, the device having an elongated body; an intermediate reservoir operably coupled to an anterior end of the elongated body and extending axially therefrom; a skin abutment piece movably coupled to an anterior end of the intermediate reservoir; and a beveled hollow needle operably coupled to an anterior end of the skin abutment piece. The system also includes a source of pressure operably coupled to the device; a hair graft container operably coupled to the device; a vacuum source operably coupled to the device; a differential pressure detector operably coupled to the device; and a controller in communication with the source of pressure, the hair graft container, the vacuum source, and the differential pressure detector.

Abstract: A postpartum balloon system includes a flexible elongate catheter, an inflatable balloon, and a suction member attached to the distal end of the catheter. The system can be delivered into the uterus, where suction is applied to the suction member to anchor the balloon to the internal wall of the uterus. The catheter may include drainage ports both proximal and distal from the balloon. The system may include a stiffening stylet inserted into the drainage lumen of the catheter for aiding in delivery of the balloon. The stiffening stylet can be removed after placement of the balloon. The stiffening stylet can include side passageways that match the drainage ports and a lumen that allows for drainage through the stylet, as well as for administering drugs or other compounds through the drainage ports while the balloon is in place.

Abstract: A multi-movement cosmetic assembly includes a housing defining an interior; a drive system disposed within the housing; a sleeve received within the housing; and a drive shaft positioned in the sleeve. The drive system is operably coupled to the sleeve and the drive shaft such that actuation of the drive system causes (i) the sleeve to move laterally back and forth to oscillate relative to the housing, and (ii) the drive shaft to rotate relative to the housing.

Abstract: A spinal stabilization system including a connecting rod and a bone screw. The connecting rod includes an elongate rounded section, an elongate head portion, and a neck portion connecting the elongate rounded section with the elongate head portion. The bone screw includes a head portion defining a slot, a shank extending longitudinally from the head portion, and a set screw configured to secure the connecting rod in the slot. The head portion includes a pair of radially opposing walls defining the slot therebetween. The head portion includes a trailing end and a leading end. The trailing end includes a guide member defining an aperture configured and dimensioned to receive the set screw therethrough. The aperture is in communication with the slot. In particular, the guide member interconnects the pair of radially opposing walls.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A friction fit compression insert (some with lock and release feature), a planar split retaining ring and a shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled and the receiver and insert may include aligned tool receiving apertures for lock and release of the polyaxial mechanism.

Abstract: A polyaxial bone screw assembly includes a threaded shank body having an integral upper portion receivable in an integral receiver, the receiver having an upper channel for receiving a longitudinal connecting member and a lower cavity cooperating with a lower opening. A friction fit compression insert (some with lock and release feature), a planar split retaining ring and a shank upper portion cooperate to provide for pop- or snap-on assembly of the shank with the receiver either prior to or after implantation of the shank into a vertebra. The shank and receiver once assembled cannot be disassembled and the receiver and insert may include aligned tool receiving apertures for lock and release of the polyaxial mechanism.

Abstract: An implant and method for fixation of long bones. The implant provides rotational, longitudinal, and bending stability. The implant comprises one or more elongated members that span the intramedullary cavity of a long bone, a distal tip that expands radially relative to the long axis of the implant, and a locking mechanism at the proximal end of the implant.

Abstract: The invention relates to a fastening element for preventing unwanted release of a connection between the fastening element and a counter-piece. The fastening element is designed to come into engagement with the counter-piece through a rotary movement of the fastening element about an axis of rotation in a connection direction. Such fastening elements are suitable for use in a wide range of technical fields, for example the automotive industry, household electronics and medical technology, in particular in the field of instruments for implants or prostheses and modular systems of implants or prostheses.

Abstract: A device for treating a bone includes a first clamp member sized and shaped to be mounted over a bone laterally across a fixation plate positioned along a length of the bone. In addition, the device includes a second clamp member coupleable to the first clamp member so that, when the first and second clamp members are coupled together in an operative position, the first and second clamp members extend about at least a portion of a periphery of the bone. The second clamp member includes a spring feature biased toward an initial configuration and deflectable toward a second configuration away from the bone.

Abstract: A device for hydrating particulate bone material is provided. The device comprises a tubular member having an interior surface and an exterior surface. The interior surface is configured to receive the particulate bone material and a hydration fluid. The exterior surface has a plurality of pores configured to allow the hydration fluid to flow into the interior surface of the tubular member and hydrate the particulate bone material. The plurality of pores are smaller in size than the particulate bone material. Methods of dispensing particulate the bone material are also provided.

Abstract: An expandable support device for tissue repair is disclosed. The device can be used to repair hard or soft tissue, such as bone. The expandable support device can have interconnected struts. A method of repairing tissue is also disclosed. The expandable support device can be inserted into a damaged bone and radial expanded. The radial expansion of the expandable support device struts can cause the struts to cut mechanically support and/or the bone.