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 medical device includes an outer tubular member, a middle tubular member received within the outer tubular member, an inner tubular member received within the middle tubular member, and an engagement gear, wherein the inner tubular member is configured to be rotatable in one direction while the middle tubular member is configured to be simultaneously rotatable in an opposite direction through the engagement gear while the outer tubular member is configured to be stationary relative to both the middle tubular member and the inner tubular member.

Abstract: A reservoir of a system for deploying an implantable lead to an extravascular location delivers a flow of fluid through a lumen of one or both of a tunneling tool and an introducer of the system. In some cases, the tunneling tool includes a pressure sensor assembly for monitoring a change in a pressure of the flow through the lumen thereof Alternately, or in addition, a flow-controlled passageway, through which the flow of fluid from the reservoir is delivered to the lumen of the introducer, includes a compliant chamber to hold a reserve of the fluid. Fluid from the reserve may be drawn into the lumen of the introducer as the tunneling tool is withdrawn therefrom. Alternately, the introducer may include a chamber located between two seals, wherein fluid that fills the chamber is drawn distally into the lumen of the introducer, as the tunneling tool is withdrawn therefrom.

Abstract: An adapter configured to receive a drive signal from a control console and to provide the drive signal to an ultrasonic surgical handpiece. The adapter includes a receptacle for receiving the ultrasonic surgical handpiece and providing the drive signal to the ultrasonic surgical handpiece. The adapter includes a module for detecting a presence of the ultrasonic surgical handpiece and a connector to be inserted into a receptacle of the control console to receive the drive signal from the control console. The adapter includes a radio-frequency identification device coupled to the connector and to a memory storing a maximum and minimum frequency for driving the ultrasonic surgical handpiece. The radio-frequency identification device transmits the maximum and minimum frequency from the memory to the control console via the connector using an RFID protocol in response to the module detecting the presence of the ultrasonic surgical handpiece.

Abstract: A surgical instrument includes a body, a shaft assembly, and an end effector. The end effector includes an ultrasonic blade and a clamp arm movably coupled with the shaft assembly. The shaft assembly extends between the body and the end effector and includes an acoustic waveguide, a rotational driver, and a driver wrench. The rotational driver is configured to be received within the rotational drive channel and rotate the shaft assembly relative to the body. The acoustic waveguide includes a notch and the driver wrench includes a key, wherein the first notch of the acoustic waveguide is configured to receive the key.

Abstract: An ultrasonic surgical instrument includes a shaft assembly and an end effector. The end effector extends extending distally from the shaft assembly and includes an ultrasonic blade, a clamp arm, and a clamp pad. The clamp arm is movably secured relative to the ultrasonic blade and includes a mortise longitudinally extending therethrough. The clamp pad is connected to the clamp arm. The clamp arm includes a pad body and a tenon. The pad body extends in a longitudinal direction and is configured to compress a tissue toward the ultrasonic blade. The tenon is secured to the pad body and is received within the mortise. The tenon includes a rail, a support base, and a plurality of openings. The plurality of openings extends through at least one of the support base or the rail such that the tenon has a predetermined transverse spring rate longitudinally along the tenon.

Abstract: A surgical instrument includes a body, a shaft assembly, an end effector, a clamp actuator, and a blade cooling system. The end effector has a clamp arm and an ultrasonic blade coupled with an ultrasonic transducer. The clamp arm is configured to selectively move from a first actuator position toward a second actuator position thereby directing movement of the clamp arm from the open position toward the closed position, respectively. The cooling system is operable to deliver fluid coolant to the ultrasonic blade to thereby cool the ultrasonic blade while the clamp actuator remains in the first actuator position.

Abstract: A system and method for reducing the risk of contamination of interior regions of a needle guide which is disposed on an endocavity transducer, which system includes an elastic membrane forming a pocket which covers a needle exit hole in the needle guide. The pocket is disposed on a sheath which is both; disposed around the endocavity transducer and between the endocavity transducer and the needle guide.

Abstract: In some embodiments a PEG feeding device includes a tube sized to bridge a channel between a stomach and an outer abdominal surface; an internal bolster, and an external bolster. Optionally the bolsters are connected to the tube. The internal bolster may be sized to resist movement out of the stomach through the stoma. The external bolster may be sized to resist movement into the stoma from the outer abdominal surface. The external bolster may include an underside which extends from the tube in a radial direction between the external bolster and the outer abdominal surface. The underside of the outer bolster may contact the outer abdominal surface at a distance from an external opening of the stoma. Optionally the distance between the internal bolster and the external bolster is adjustable. Optionally an angle between one or both of the bolsters and the tube is adjustable.

Abstract: A protector is engineered to protect corneal tissue during intraoperative procedures. The protector is a temporary passageway into and optionally through the cornea. The sleeve portion of the protector can be more rigid or less rigid depending on a procedure or surgeon preference. The sleeve is described herein in terms of two examples. The first example is a polymer fabric sleeve that expands and is secured into an incision that will then be the passage for all instruments entering the eye. It will also seal the eye from backflow of liquids and tissue out of the passageway. The second example is a relatively rigid tube with an external bladder that is expandable into the incision to secure it from movement and acts as a valved passage into the eye.

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 retrieval system for a biostimulator, such as a leadless cardiac pacemaker, is described. The biostimulator retrieval system includes a docking cap rotatably coupled to an outer catheter by a bearing. A torque shaft extends through the outer catheter and attaches to the docking cap to transmit torque to the docking cap to cause rotation of the docking cap relative to the outer catheter. The rotating docking cap can transmit torque to an attachment feature of a biostimulator received within the docking cap. The attachment feature can be captured by a snare that extends through the torque shaft. A cincher tube extends through the torque shaft around the snare, and advances over the snare independently from the torque shaft that is attached to the docking cap, to cinch the snare onto the attachment feature. Other embodiments are also described and claimed.

Abstract: A spinal construct comprises a member extending between a first end and a second end and includes a first layer and a second layer. The first layer includes a plurality of interlaced strands that define a first angle. The second layer includes a plurality of interlaced strands that define a second angle. The first angle is smaller than the second angle. Systems, implants, surgical instruments and methods are disclosed.

Abstract: Systems and methods for fixing bone using an intramedullary nail locked to an encircling anchor including a bushing and a locking member. An exemplary system may include any combination of the nail, one or more bushings, one or more locking members, an instrument to guide installation of the bushing, at least one drill, and a driver that attaches to the bushing. The instrument may define a guide axis and be configured to be coupled to a bone such that the guide axis extends across the bone. The instrument may be used to guide a drill, the bushing, and/or the locking member along the guide axis into the bone. The nail may be configured to be placed along the medullary canal of the bone such that the nail extends through the bushing, and the locking member may be configured to lock the nail to the bushing.

Abstract: A modular system is provided for assembling a structure to secure to opposite sides of a fracture in a bone of a subject. The modular system includes a plate with a perimeter including a plurality of openings. The perimeter defines an interior area within the plate. The modular system also includes a link with one or more openings along a linear axis defining the link. The one or more openings of the link include a connector to receive a fastener to be secured in the bone. The plurality of openings of the plate includes a first opening with an inner diameter configured to removably receive an outer diameter of the connector of the link so that the link is rotatably received within the first opening. A method is also provided for assembling the structure using the modular system and securing the assembled structure to opposite sides of the bone fracture.

Abstract: The present invention relates to an implant, to an instrument for implantation of the latter and to a method for manufacturing this implant which includes an elongated body (10) between a free end and a head (18) along a longitudinal axis on the one hand and turns (12) of at least one threading on at least one portion of said body (10) in proximity to the free end, along the longitudinal axis on the other hand, characterized in that the body (10) includes a longitudinal internal conduit (11) in at least one portion to along the longitudinal axis, obtained by at least one first central machining operation parallel to the longitudinal axis and at least one second machining operation in a so-called transverse plane, not parallel to the longitudinal axis and crossing the wall of the body (10) as far as the longitudinal internal conduit (11) by making windows (15) communicating between said longitudinal internal conduit (11) and the outside of the body (10).

Abstract: Methods and apparatus are disclosed for distracting tissue. The devices and methods may include insertion of first and second elongated members into the space between two tissue layers, with an augmenting elongated member at least partially inserted therebetween to form a distraction device between the tissues to be distracted. At least one of the first and second elongated members may be formed of a flexible core member with a plurality of rigid veneer members spaced along the length of the core member. At least one of the elongated members may include a shaping member that automatically moves from a generally linear configuration to a generally less linear configuration. A deployment catheter may include a deformable distal end to allow augmentation of the tissue distraction device during implantation. An injection aid may be provided for introducing a filler material into an interior defined by a deployed tissue distraction device.

Abstract: A device for correcting a compression-type fracture including a housing at a proximal end of the device, a cannula extending from the housing and through a directional balloon, and a tip at a distal end of the cannula, wherein the cannula has an outer tube for supplying fluid to the balloon and an inner tube positioned within the outer tube for supplying cement through at least one opening in the distal end of the cannula. A method of using the device where the device is inserted into a fracture site, the balloon is inflated to elevate fragments of the fracture, cement is injected into the opening created by elevating the fragments of the fracture and the device is removed from the fracture site. The balloon may be deflated before the injection of the cement or simultaneous with the injection of the cement.

Abstract: In specific examples, aspects are directed towards an inner lumen which is at least partially moveable and/or slidable relative an outer lumen. The inner lumen is allowed to extend outside the outer lumen while the outer lumen remains stationary in a relative position to or outside the target tissue site. The inner lumen may then use a gas or liquid to cause a decrease in temperature as it expands with a sudden drop in pressure. This cools the target tissue sufficiently to cryoablate portions of the tissue at various depth.

Abstract: A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Abstract: The heated forceps for Meibomian gland expression disclosed herein may comprise, at least, a forceps and a heating element. The treatment of Meibomian gland dysfunction is benefited by the application of heat to the Meibomian glands during therapeutic manual expression of meibum. The heated forceps for Meibomian gland expression are intended to supply such heat during the manual expression process so as to improve the efficacy of such treatments. The forceps may comprise any appropriate forceps known in the art, and the heating element may be removably attached to the forceps for ease of use and maintenance. In this way the forceps may also be made disposable, while the heating element is reusable.

Abstract: A generator includes first, second, and third inductors and a capacitor. The first inductor is formed by a primary coil of a transformer. The second inductor is formed by a first secondary coil of the transformer. The second inductor is connected between a first contact and a second contact. The first and the second contacts are connected to a surgical instrument. The third inductor is formed by a second secondary coil of the transformer continuously connected to the first secondary coil. The third inductor is connected between the first contact and a third contact. A polarity of the second contact with respect to the third contact coincides with a polarity of the first contact with respect to the second contact of the second inductor. The capacitor is connected between the third contact and ground. An inductance of the third inductor and a capacitance of the capacitor are adjusted.

Abstract: A generator that includes a drive circuit connected to a surgical instrument including a vibration system having a probe and an ultrasonic transducer, which supplies power to the ultrasonic transducer. The control circuit detects a first trigger causing the control circuit to perform a resonance-point search on the vibration system. Upon detecting the first trigger, the control circuit determines a resonance point of a frequency of vibration of the probe by performing the resonance-point search, and upon determining the resonance point, causes the drive circuit to execute a standby operation. The control circuit then detects a second trigger causing the surgical instrument to treat the living tissue, and upon detecting the second trigger, causes the drive circuit to execute an actual output operation by increasing the supply of power to the surgical instrument such that the surgical instrument treats the living tissue.

Abstract: Unitary endoscopic vessel harvesting devices with an elastic force are disclosed. In some embodiments, such devices comprise an elongated body having a proximal end and a distal end, a tip disposed at the distal end of the elongated body. The tip having a visual cue indicating a location of at least one cutting element extending from the elongated body.

Abstract: A coupler apparatus for coupling electrical signals between an actuator and an end effector is disclosed. The end effector is disposed at a distal end of an elongate articulated positioner and used to position the end effector for performing surgical operations. The articulated positioner has a central lumen and the apparatus includes an elongate body sized to be slidingly received within the central lumen of the articulated positioner, at least a portion of the body being operable to flex during movement of the articulated positioner. The apparatus also includes a plurality of electrical conductors extending through the body, and a plurality of proximal electrical contacts disposed at a proximal end of the body for removably connecting each of the electrical conductors to respective electrical signal lines at the actuator.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an energy delivery device that avoids coring when it delivers energy to a tissue. The device has a distal face defining an opening, with the distal face including at least one electrically exposed portion and at least one electrically insulated portion. An embodiment of the energy delivery device includes an elongate member defining a lumen structured to receive a fluid, and a distal face defining an aperture in communication with the lumen. The distal face includes an electrically exposed conductive portion and an electrically insulated portion. The electrically exposed conductive portion is configured such that the energy it delivers while the energy delivery device is advanced into a tissue punctures the tissue without the tissue substantially occluding the lumen and without creating embolic particles.

Abstract: Apparatus for radiofrequency neurotomy are disclosed. Needles with deployable filaments capable of producing lesions at target volumes, which include a target nerve, and systems including such needles are disclosed. Ablation of at least a portion of the target nerve may inhibit the ability of the nerve to transmit signals, such as pain signals, to the central nervous system. The lesion may facilitate procedures by directing energy towards the target nerve and away from collateral structures. Example anatomical structures include lumbar, thoracic, and cervical medial branch nerves and rami and the sacroiliac joint.

Abstract: Methods and systems for spinal radio frequency neurotomy. Systems include needles capable of applying RF energy to target volumes within a patient. Such target volumes may contain target medial branch nerves along vertebrae or rami proximate the sacrum. Such procedures may be used to ablate or cauterize a portion of the targeted nerve, thus blocking the ability of the nerve to transmit signals to the central nervous system. Disclosed needles may be operable to asymmetrically, relative to a central longitudinal axis of the needle, apply RF energy. Such asymmetry facilitates procedures where a tip of the needle is placed proximate to anatomical structures for location verification. Then RF energy may be applied in a selectable direction relative to the needle tip to ablate volumes that include the targeted medial branch nerves or rami, thus denervating facet joints or the sacroiliac joint, respectively, to relieve pain in a patient.

Abstract: A catheter having an ablation electrode with at least one microelectrode configured to sense monophasic action potential signals and a force sensor configured to sense contact force of the microelectrode against tissue surface, may be used to acquire pre-ablation MAP signals with monophasic characteristics and post-ablation MAP signals to determine presence or absence of monophasic characteristics in the latter in assessing quality or success of ablation procedure and lesion formation.

Abstract: A method, including performing an ablation of tissue using a first high RF power for a short duration, suspending RF power for a predetermined period, and using a second high RF power for a short duration forming lesions with greater surface area and greater depth through resistive heating and thermal latency. High RF power may range between 75-95 W and short duration may range between 4-5 seconds.

Abstract: A method that includes selectively positioning an ablation catheter system at a treatment site; and ablating tissue at the treatment site with the ablation catheter system using a power setting of approximately 90W applied to tissue for approximately four (4) second increments with a break period of approximately 4 seconds between applications.

Abstract: Medical catheterization is carried out by introducing a catheter into a heart, sliding the catheter through a sheath that encloses a multi-electrode probe into a chamber of the heart. The sheath is retracted to expose the probe. As the sheath is retracted the exposed probe expands into a spiral configuration, and the electrodes contact the endocardial surface of the chamber at multiple contact points.

Abstract: A pigment treatment system includes a handheld apparatus to receive a sub-nanosecond laser beam with a wavelength of about 480 nm to about 550 nm and output a sub-nanosecond laser beam with a wavelength of about 700 nm to about 740 nm. The handheld apparatus includes a monolithic crystal with a first surface coating and a second surface coating to facilitate the change in wavelength of the laser beam through the crystal.

Abstract: A light-based skin treatment device is for treating skin by laser induced optical breakdown of hair or skin tissue. A focusing system has an exit focusing lens for focusing the incident light beam into a focal spot in the hair or skin tissue. This lens has a central aperture. This serves to reduce back-reflectance from the lens surface, which can cause damage to the focusing system.

Abstract: A system for fixing a spatial relationship between medical instruments can include an interlock component including a body defining an aperture to receive and retain a first needle, a head connected to the body and defining a slot extending parallel to the aperture, and a first magnet at least partially surrounded by the head and disposed between the aperture and the slot. The system can also include a handle to receive and retain a second needle, the handle defining a retaining feature for receiving a portion of the interlock component and including a second magnet positioned adjacent to the retaining feature. The second magnet attracts the first magnet to retain the portion of the interlock component in the retaining feature such that the interlock component is oriented in a desired spatial relationship relative to the handle.

Abstract: A spinal correction rod implant manufacturing process includes: estimating a targeted spinal correction rod implant shape based on a patient specific spine shape correction and including spine 3D modeling, one or more simulation loops each including: first simulating an intermediate spinal correction rod implant shape from modeling mechanical interaction between the patient specific spine and: either, for the first simulation, the implant shape, or, for subsequent simulation, if any, an overbent implant shape resulting from the previous simulation loop, a second simulation of an implant shape overbending applied to the targeted spinal correction rod implant shape producing an overbent spinal correction rod implant shape representing a difference between: either, for the first loop, the targeted spinal correction rod implant shape, or, for subsequent loop, if any, the overbent spinal correction rod implant shape resulting from the previous simulation loop, and the intermediate spinal correction rod implant sha

Abstract: A surgical planning computing system and related surgical method include identifying an anatomical landmark of a patient's bony anatomy in a three-dimensional anatomical image and determining positioning criteria for an orthopedic prosthesis to be implanted into the patient's bony anatomy. The positioning criteria may define an alignment between the anatomical landmark and a feature of the orthopaedic prosthesis. A three-dimensional model of the orthopaedic prosthesis is positioned in the three-dimensional model based on the positioning criteria to provide a surgical plan for the implantation of the orthopaedic prosthesis.

Abstract: Systems and methods are provided for generating a high density (HD) map for identifying a location and/or an orientation of an electromagnetic (EM) sensor within an EM volume in which an EM field is generated by way of an antenna assembly. A measured EM field strength at each gridpoint of a set of gridpoints of the EM volume are received from a measurement device. An EM field strength at each gridpoint of a second set of gridpoints of the EM volume is calculated based on a geometric configuration of an antenna of the antenna assembly. The HD map is generated based on the measured EM field strength at each gridpoint of the first set of gridpoints and the calculated EM field strength at each gridpoint of the second set of gridpoints.

Abstract: A system and method for image guided treatment planning utilizing advanced imaging techniques, including multiphase CT scanning, is disclosed. Included is a method for automatically generating a treatment report having the steps of acquiring image data from a patient, extracting patient-specific parameters from the image, analyzing the patient-specific parameters, and generating a report indicating a desired treatment. Treatment recommendations are tailored to each patient.

Abstract: A patient tracking device for insertion into a body cavity includes a flexible conformable sensor housing having a sensor cavity therein. The housing conforms to the body cavity when inserted therein. A sensor is disposed within the housing.

Abstract: A patient tracking device for insertion into an oral cavity includes a sensor housing comprising a first surface shaped to correspond to a pallet within the oral cavity. At least a portion of the first surface affixes the sensor housing to the oral cavity. An electromagnetic sensor is coupled to the sensor housing.

Abstract: Systems, methods, and devices are provided for assisting or performing guided interventional procedures using. The system uses pre-procedure scans of a patient's anatomy to identify targets and critical structures. A measurement device containing position indicating elements or fiducials is placed in a pre-existing or physician created conduit or lumen whose geometry is known from a scan. During a procedure, the pre-procedure scans may be registered to the patient using the position indicating elements or fiducials and the geometry of the conduit. This registration may be used in an intervention to guide instruments that can obtain diagnostic information or provide therapy to the identified targets.

Abstract: The present disclosure relates to a navigation system for placing a medical device into a patient. The system may include an external unit configured to be disposed on a chest of the patient, the external unit having: a radiating element configured to produce a first radio frequency (“RF”) signal; and a plurality of three-axis sensors configured to receive a second RF signal. The system may also include a medical device such as a catheter. The catheter may have: a first antenna configured to receive the first RF signal and produce an alternating current; a rectifier configured to convert the alternating current into a direct current; a frequency generator configured to produce a second RF signal that is received by the plurality of three-axis sensors. The RF signals received by the plurality of three-axis sensors may be used to determine a position of the catheter relative to the external unit.

Abstract: A high-speed optical tracking with compression and CMOS windowing for tracking applications that require high-speed and/or low latency when delivering pose (orientation and position) data. The high-speed optical tracking with compression and CMOS windowing generally includes an optical tracking system (10) that sense fiducial (22) and by extension markers (20). The markers can either be integrated on tools (20) handled by an operator (e.g. surgeon) (50) or fixed on the subject to track (e.g. patient) (40). The low-level processing (101, 107, 140) is realized within the tracking system to reduce the overall data to be transferred and considerably reduce the processing efforts. Pose data (127) are finally computed and transferred to a PC/monitor (30,31) or to tablet (60) to be used by an end-user application (130).

Abstract: Systems and methods are described to determine joint center of rotation during a procedure. Joint center measurements may be useful to determine other clinically relevant measurements and/or to assist with replacement surgery.

Abstract: A depth-indicating device for determining the depth of insertion of a surgical tool comprising a pair of spaced apart end caps, separated by a compressed spring, with the surgical tool passing through axial openings in both end caps, and firmly attached to one of the end caps, but free to slide through the opening in the other. A guide tube is attached to the second endcap, such that the surgical tool can be guided to its operating position on a body part. The second end cap and guide tube are attached to a location having a known position relative to the body part. A tracking marker is attached to the first end cap such that its longitudinal position can be tracked using a remote racking camera. Since the surgical tool is attached to the first end cap, the tool position is also tracked by the tracking system.

Abstract: Systems, devices and methods are provided that provide assistance in selecting appropriate interventions for treatment of disease and injury to the eye. Systems of the inventive concept provide cloud-based processing and storage of clinical and patient-specific data, which can provide treatment recommendations and projected outcomes to a practitioner using a local device. Systems, devices, and methods can generate interactive physiomechanical models of the eye of a specified individual, which are derived measurements of mechanical properties of structures of the eye. The physiomechanical model is interactive, and can be used to emulate the effects of one or more medical interventions in the eye in order to implement an optimized treatment plan for the individual.

Abstract: A system may include a controller configured to determine a user interface status, wherein the user interface status includes user interaction of a user interface. The controller may also be configured to determine a drive mechanism location relative to a first limit and a second limit and select a clutching location based on the user interface status and drive mechanism location.

Abstract: Methods of collision handling for robotic surgical systems include slipping an input handle of a user interface of the robotic surgical system relative to a pose of a tool of a surgical robot of the robotic surgical system when a portion of the surgical robot collides with an obstruction and an input handle is moved in a direction that corresponds to moving the tool towards the obstruction. The input handle having an offset relative to a desired pose of the tool after the input handle is slipped.

Abstract: A system and method of providing feedback during manual joint positioning includes a computer-assisted device having an articulated structure including a joint and a control unit coupled to the articulated structure. To provide feedback to a user during manual positioning of the joint by a user, the control unit is configured to determine a first target position for the joint, release a brake associated with the joint when the joint is moving toward the first target position, apply the brake when the joint is moving away from the first target position, and change the first target position to a second target position when the joint is at the first target position.