Abstract: A drill guide includes a body, a stabilizing member, a tubular guide sleeve, and an engagement member. The body includes a first channel aligned with a longitudinal axis and a second channel transverse to the longitudinal axis. The first channel is dimensioned to receive the sleeve, while the second channel is dimensioned to receive an engagement member. The engagement member is adapted to move within the second channel between an engaged position, where the engagement member inhibits proximal motion of the sleeve, and a second position, where motion of the sleeve is not inhibited. An alignment member is further mounted to the distal end of the sleeve that includes a distally extending member, spaced from the sleeve. In use, the distally extending member may be employed to exert a force upon a bone or other tissue lateral to the longitudinal axis for improved positioning of the bone or tissue.

Abstract: A surgical template system for use in working on a bone comprises: a tool guide block comprising at least one guide aperture for receiving and guiding a tool to work on a bone; locating means comprising a plurality of locating members, each member having a respective end surface for positioning against a surface of the bone; and attachment means for non-adjustably attaching the tool guide block to the locating means such that, when attached, the member end surfaces are secured in fixed position with, respect to each other, for engaging different respective portions of the surface of the bone, and the at least one guide aperture is secured in a fixed position with respect to the end surfaces. Corresponding methods of manufacturing a surgical template system, methods of manufacturing locating means for a surgical template system, methods of fitting a prosthesis to a bone, surgical methods, and surgical apparatus are described.

Abstract: A surgical template system for use in working on a bone comprises: a tool guide block comprising at least one guide aperture for receiving and guiding a tool to work on a bone; locating means comprising a plurality of locating members, each member having a respective end surface for positioning against a surface of the bone; and attachment means for non-adjustably attaching the tool guide block to the locating means such that, when attached, the member end surfaces are secured in fixed position with, respect to each other, for engaging different respective portions of the surface of the bone, and the at least one guide aperture is secured in a fixed position with respect to the end surfaces. Corresponding methods of manufacturing a surgical template system, methods of manufacturing locating means for a surgical template system, methods of fitting a prosthesis to a bone, surgical methods, and surgical apparatus are described.

Abstract: An ultrasound catheter has an elongate flexible catheter body having a lumen extending longitudinally therethrough, and an ultrasound transmission member extending longitudinally through the lumen of the catheter body. The ultrasound transmission member has a proximal end that is coupled to a separate ultrasound generating device, and a distal tip that is attached to the distal end of the ultrasound transmission member and which is located at the distal end of the catheter body. The ultrasound transmission member is directly attached to the catheter body and/or to a guidewire tube either directly or via an attachment device. The catheter has an additional radiopaque marker positioned on the distal end the catheter.

Abstract: Mechanical thrombectomy apparatuses, and particularly knitted rolling tube mechanical thrombectomy apparatuses configured to have improved tracking for delivery through tortious vessels are described herein. Also described herein are methods of removing clots using a mechanical thrombectomy apparatuses in which the clot is larger than the tractor portion of the mechanical thrombectomy apparatus.

Abstract: Described herein are mechanical inverting tube apparatuses that may be used to remove clot (e.g., thrombectomy), the apparatuses including an inversion support catheter having an expandable funnel-shaped distal end, and a flexible tube that can be continuously rolled over the funnel-shaped distal end and invert into the inner lumen of the inversion support catheter.

Abstract: Embodiments of the invention provide a surgical snare structure in which the material used for the snare and the deployment mechanism of the snare are configured to improve the cutting efficacy of the snare. In particular, the surgical snare structure of the invention may omit the kink or nib present in the loop of known surgical snares and/or may provide a reaction surface against which the cutting action of the snare is effective. The surgical snare of the invention may be a cold, i.e. mechanical-only effect, snare, or may be used in conjunction with radiofrequency (RF) and/or microwave energy to enhance a cutting or coagulation effect.

Abstract: A clot removal device has an expandable treatment member having a distal tip and a proximal end, a delivery wire having a distal end coupled to the proximal end of the expandable treatment member, and a flow restrictor carried along the delivery wire at a location that is separate and proximal from the expandable treatment member. The flow restrictor has a body with a distal section and a proximal section, the distal section being covered and the proximal section being uncovered. The expandable treatment member is moveable relative to the flow restrictor, and can be retracted into the distal section.

Abstract: A system for removing embolic material from an intravascular site is disclosed. The system includes an elongate, flexible tubular body, having a proximal end, a distal end, and a tubular side wall defining at least one lumen extending axially there through; an axial restraint carried by the side wall and exposed to the lumen; a rotatable core wire extendable through the lumen, the core wire having a distal end; a limit carried by the core wire, the limit having a bearing surface for rotatably engaging the restraint; and an agitator tip on the distal end of the core wire. The limit and the restraint are engageable to permit rotation of the core wire but limit distal advance of the tip relative to the tubular body.

Abstract: A surgical instrument for the removal of frontal nasal recess cells includes an elongate handle, a first arm extending from a first end of the handle and a second arm extending from a second end of the handle. The first and second arms can extend in opposing directions. Each of the arms include a spherical terminal hub on their respective ends. A plurality of cylindrical fingers extend from each terminal hub at an angle, thereby providing an umbrella-like configuration. A spherical cap is attached to a free end of each cylindrical finger.

Abstract: A method of surgically cutting tissue with an ultrasonic instrument that comprises an ultrasonic waveguide that is movable along a longitudinal extent of the ultrasonic instrument comprises the steps of temporarily compressing tissue between two opposing jaws disposed at a distal end of the ultrasonic instrument, applying a resonant ultrasonic wave to the ultrasonic waveguide, and moving the ultrasonic waveguide in a distal direction along the longitudinal extent to advance the ultrasonic waveguide between at least a portion of the jaws to cut and seal the tissue temporarily secured between the jaws.

Abstract: A surgical instrument apparatus for removably receiving an end effector coupled to an elongate control link for actuating the end effector to perform surgical operations is disclosed. The apparatus includes an actuator housing and an elongate shaft extending from the actuator housing and having a bore for receiving the control link. The apparatus also includes an actuator mounted within the actuator housing and includes a clamp aperture disposed to receive the control link while the clamp aperture is being urged into an undamped state by an opening force, the clamp aperture being operably configured to move between the undamped state and a clamped state in response to the opening force being released, the aperture in the clamped state being operable to restrain the control link within the actuator for movement in a longitudinal direction substantially aligned with the elongate shaft.

Abstract: A surgical system for transecting osseous tissue includes an ultrasonic waveform generator, a control unit, an ultrasonic instrument assembly including a electromechanical transducer and an ultrasonic blade, and a robotic system. The ultrasonic instrument assembly is attached to the robotic arm. The surgical system is configured so that the robotic arm moves the ultrasonic blade at a constant forward feed speed through the bone during a cutting operation and so that the forward motion is reduced, and preferably halted automatically upon a reduction in load per unit time or applied power, as monitored by a pickup or sensor.

Abstract: An ultrasonic surgical instrument includes a housing, an ultrasonic transducer and generator assembly disposed in the housing, a shaft extending from a distal end of the housing, and an end effector assembly coupled to the shaft and operatively connected to the ultrasonic transducer and generator assembly. The ultrasonic surgical instrument further includes a handle assembly having a first set of power contacts formed thereon and being removably attachable to the housing, a power receiving mechanism having a second set of power contacts formed thereon, and a power cable electrically connected between the first and second power contacts.

Abstract: Thrombectomy catheter systems, accessory devices, and methods for making and using such devices are disclosed. An example thrombectomy system may include a catheter shaft having a proximal portion, a distal portion, and a lumen extending at least partially through the catheter shaft. A high pressure tube may be disposed within the lumen. The high pressure tube may be designed for communication with a fluid source. A fluid jet emanator may be coupled to the high pressure tube. The fluid jet emanator may have at least one jet orifice. The catheter shaft may include a first orifice disposed proximally of a distal end of the catheter shaft and a second orifice disposed proximally of the first orifice. An accessory device may be disposed within the lumen. The accessory device may include a helical distal region.

Abstract: Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting apparatus is configured to engage formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting apparatus is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting apparatus causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The slitting apparatus is supported by a distal end support device configured to lock onto the lead. While supported, a slitting element of the apparatus places fibers of the formed tissue under tension and performs a lifting cut operation. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Abstract: A tissue punch including a barrel defining a first open end, a second open end, and inner diameter, an outer diameter, and a lumen there through. A piston is at least partially disposed within the lumen and pressed against the inner diameter of the barrel, the piston being configured to create negative pressure within the barrel when the piston is retracted. A cutting element defines a proximal end and a distal end, the proximal end of the cutting element being disposed at the second open end of the barrel, the distal end of the cutting element defining a cutting edge, the cutting element is in fluid communication with the barrel. A pushing element is slideably disposed about the outer diameter of the barrel, the pushing element is movable from a biased first position away from the cutting edge to a second position proximate the cutting edge.

Abstract: A tissue punch including a barrel defining a first open end, a second open end, and inner diameter, an outer diameter, and a lumen there through. A piston is at least partially disposed within the lumen and pressed against the inner diameter of the barrel, the piston being configured to create negative pressure within the barrel when the piston is retracted. A cutting element defines a proximal end and a distal end, the proximal end of the cutting element being disposed at the second open end of the barrel, the distal end of the cutting element defining a cutting edge, the cutting element is in fluid communication with the barrel. A pushing element is slideably disposed about the outer diameter of the barrel, the pushing element is movable from a biased first position away from the cutting edge to a second position proximate the cutting edge.

Abstract: A device for intravascular intervention can comprise an intervention element, an elongate manipulation member, and a joining element. The elongate element can comprise a hooked portion extending about a proximal portion of the intervention element. The hooked portion can comprise a bend. The hooked portion can have (i) no substantial surface crack at an interior region of the bend and (ii) a maximum lateral dimension that is less than 0.027 inch. The joining element can substantially permanently attach the hooked portion to the intervention element.

Abstract: Catheters and methods for supporting a guidewire or delivering a radiopaque, diagnostic or therapeutic agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a tip member disposed at a distal end of the shaft body. The shaft body can extend from a proximal end to the distal end and can define an inner lumen. The shaft body can include a liner, a braid member surrounding the liner, a multi-layer coil surrounding the braid member, and a polymer cover surrounding the multi-layer coil. The multi-layer coil can include first and second coil layers wound in opposing directions. An outer surface portion of the polymer cover can include one or more helical threads. In an example, the one or more helical threads are positioned around a distal end portion of the shaft body. The tip member can be made from a metal or a polymer and can also include one or more helical threads around its outer surface.

Abstract: According to one embodiment, a method includes positioning a trocar having a pressure sensor in or on the trocar into a patient cavity such that distension of the patient cavity causes an altitude of the pressure sensor to increase. The method also includes distending the patient cavity by supplying an insufflation gas to the patient cavity, thereby increasing an altitude of the pressure sensor from a first altitude to a second altitude. The method also includes determining a change in pressure at the pressure sensor resulting from increasing the altitude of the pressure sensor from the first altitude to the second altitude and controlling the supply of insufflation gas to the patient cavity in response to the determined change in pressure resulting from increasing the altitude of the pressure sensor from the first altitude to the second altitude.

Abstract: Devices, systems, and methods for delivering a substance within a mammalian luminal organ or area adjacent thereto. In at least one exemplary embodiment of a system of the present disclosure, the system comprises an inner delivery device, comprising an inner portion configured to receive a substance therein, a pock tip at or near a distal end of the inner delivery device, the pock tip configured to deliver the substance from the inner portion, through a pock tip aperture defined within the pock tip, and into a mammalian tissue and/or luminal organ, and an embolus positioned within the inner portion, the embolus configured so that the substance remains distal to the embolus when the substance is positioned within the inner portion.

Abstract: The disclosure relates to a retrievable intrauterine device which includes a recess suitable for containing one or more elements selected from the group that includes an embryo, male and/or female gametes, a fertilized oocyte, a non-fertilized ovule and a combination of the elements. The recess includes an inner wall made of a biocompatible polymer, the inner wall including at least one perforated portion having perforations with dimensions of between 1 pm and 10 pm, and an outer wall covering the inner wall, the outer wall being made of a biocompatible silicone elastomer and including at least one opening opposite said at least one perforated portion of the inner wall. The use of the device relates to the preimplantation development of gametes and/or embryos.

Abstract: Devices and methods for dermatology and more particularly to fluid enhanced skin treatment system for skin rejuvenation that can use an abrasive probe for removing epidermal layers while contemporaneously providing for the infusion of therapeutic fluids into the skin.

Abstract: Methods of accelerating bone cuts, and the devices used therefore, are disclosed. The methods can involve the use of robotic cutting tools.

Abstract: Reamer instruments and related methods are disclosed herein, e.g., for reaming bone to facilitate in situ assembly of a bone anchor. In some embodiments, the instrument can include a feedback mechanism configured to alert the user when sufficient bone has been removed to facilitate assembly of the bone anchor. The feedback mechanism can be triggered by a movable shaft of the instrument that is displaced by the shank portion of the bone anchor as the surrounding bone is reamed.

Abstract: An external adjustment device includes at least one permanent magnet configured for rotation about an axis with a first handle extending linearly at a first end of the device and a second handle at a second end of the device, the second handle extending in a direction substantially off axis to the first handle. The external adjustment device further includes a motor mounted inside the first handle and a first button located in the proximity to one of the first handle or the second handle, the first button configured to be operated by the thumb of a hand that grips the one of the first handle or second handle. The first button is configured to actuate the motor causing the at least one permanent magnet to rotate about the axis in a first direction.

Abstract: A method of assembly for a bone fastener is provided. The method includes the steps of: engaging a retainer with an implant receiver in a relatively fixed position; translating the retainer relative to the implant receiver to an expandable orientation; and manually engaging a screw shaft with the retainer to connect the implant receiver with the screw shaft. Implants, systems and instruments are disclosed.

Abstract: A rib fixation plate is provided that is can have one or more locking rib hooks that can translate and rotate independently from one another. The one or more locking rib hooks translate and rotate when in an unlocked conformation and are secured from translation and rotation when in a locked conformation. The plate includes a first end and a second end opposite of the first end, the second end having a housing assembly configured to receive a rod. The rod can be secured to a vertebra with a pedicle screw.

Abstract: According to an embodiment, a spinal implant having vertical and horizontal plates with through-holes for receiving a pre-configured square bolt is disclosed. The embodiments of the invention include very long square bolts that can accommodate the height of at least of two vertically stacked plates. When used to reduce spondylolisthesis, a portion of the square bolt can be broken after the desired alignment of the listhetic vertebrae is observed. The square bolts also allow extension of vertical plates above or below an existing fusion by placement of an extension vertical plate on to the previous one without removing it. This makes extension of instrumentation extremely easy.

Abstract: Provided is a spacer apparatus between spinous processes including a spacer disposed between two mutually neighboring spinous processes of vertebrae, a band provided as a pair, bound respectively to the two mutually neighboring spinous processes and fixed to the spacer in end portion thereof to maintain the spacer between the two mutually neighboring spinous processes, a fixing cap coupled to the spacer to fix the end portion of the band to the spacer, and an elastic body mounted on the spacer and maintaining a coupling force between the spacer and the fixing cap.

Abstract: An implantable spacer for placement between adjacent spinous processes is provided. The spacer includes a body and a wing rotatably connected to the body. The wing includes two U-shaped configurations that together define a substantially H-shaped configuration for retaining the spacer between adjacent spinous processes. An actuator assembly is connected to the body and to the wing with the proximal end of the spacer being connectable to a removable driver that is configured to engage the actuator assembly. While connected to the spacer, the driver is rotatable in one direction to deploy the wing from an undeployed to a deployed configuration and in an opposite direction to undeploy the wing. In the deployed configuration, the spacer acts as a space holder opening up the area of the spinal canal, maintaining foraminal height, reducing stress on the facet joints and relieving pain for the patient.

Abstract: Apparatus, consisting of a hinge, defining a hinge axis, and a pair of opposing jaws terminating at respective proximal regions and distal regions. The proximal regions are connected to the hinge so that at least one of the jaws is configured to rotate about the hinge between a closed state and an open state of the jaws. In addition, the jaws are curved in respective planes parallel to the hinge axis, and terminate in respective narrowed ends at the respective distal regions, wherein in the closed state the jaws are configured to grip one or more sections of vertebrae. The apparatus also has a support structure that is configured to retain the hinge and the pair of opposing jaws. A multiplicity of sharp teeth are disposed on respective inner surfaces of the opposing jaws.

Abstract: An implantable spacer for placement between adjacent spinous processes in a spinal motion segment is provided. The spacer includes a body defining a longitudinal passageway. A first arm and a second arm are connected to the body. Each arm has a pair of extensions and a saddle defining a U-shaped configuration for seating a spinous process therein. An actuator assembly is disposed inside the longitudinal passageway and connected to the body. When advanced, the actuator assembly contacts ramming surfaces of the arms to rotate them from an undeployed configuration to a deployed configuration. In the deployed configuration, the distracted adjacent spinous processes are seated in the U-shaped portion of the arms providing sufficient distraction to open the neural foramen. An insertion instrument is provided for implanting the interspinous process spacer. The system is configured for implantation through a small percutaneous incision employing minimally invasive techniques.

Abstract: A process for introducing a stabilizing element into a vertebral column, in which the stabilizing element is introduced in such a manner that the stabilizing element connects two adjacent vertebral bodies to one another.

Abstract: The invention concerns an implantation assembly comprising a bone-anchoring element comprising a threaded rod provided at one of its ends with a head and an instrument for driving the bone-anchoring element, said instrument comprising a drive spindle removably premounted on the bone-anchoring element.

Abstract: According to some embodiments, an implant for correcting a deformity in or near a joint of a subject includes an implant body having an internal lumen, a suture side hole or window extending through a wall of the implant body and providing access to the internal lumen through an exterior of the implant body, a tension assembly comprising a first bone anchor and a second bone anchor, wherein the first and second bone anchors are configured to be placed on opposite sides of the implant body, and an adjustable suture loop coupling the first bone anchor to the second bone anchor, wherein at least a portion of the at least one adjustable suture loop is positioned within the internal lumen of the implant body.

Abstract: A compression plate for use with treating a fracture on a bone includes a main body portion comprising a pair of opposing ends and a pair of arms. Each arm of the pair of arms extending from a respective end of the pair of opposing ends. The compression plate also includes a bending feature defined in at least one of the main body portion and the arms. The bending feature is configured to enable deflection of at least one of the main body portion and the arms such that the bending feature applies a compression force on the bone.

Abstract: A bone plate and method for use thereof affords use of at least two surgical approaches to attach the bone plate to a fractured bone to facilitate reduction and repair thereof. The bone plate includes two domains extending in different directions from a transition zone. The directions in which each of the two domains extend are generally opposite, and the transition zone is configured to afford portions of the two domains to be substantially disposed in planes that are transverse to one another.

Abstract: The invention provides a device for thermal ablation at a site in a subject. The apparatus comprises an expandable bladder; a displacement chamber having a variable volume; an elongated catheter forming fluid communication between the bladder and the displacement chamber; and a heater for heating the fluid. To obtain an improved pressure control and a reliable structure, the chamber comprises a syringe structure including a piston movable in a cylinder by power driven means for varying the volume of the displacement chamber.

Abstract: Ablation devices, more specifically needle injectors configured to deliver flowable thermal treatment media into an interface with tissue and that can provide a single dose of ablative energy.

Abstract: Systems for nerve and tissue modulation are disclosed. An example system may include an intravascular nerve modulation system including an elongated shaft having a proximal end region and a distal end region. The system may further include one or more ablation electrodes affixed to the distal end region of the elongated shaft. One or more ground pad electrodes may be provided and connected to a processor configured to modulate the impedance of each circuit completed between the ablation electrodes and the ground pads.

Abstract: A medical device including an elongate member having a proximal end configured to be electrically coupled to an energy source, and a distal member disposed at a distal end of the elongate member. The distal member may include a plurality of contact elements configured to deliver stimulating energy to innervated tissue, detect a response from the innervated tissue to the stimulating energy, and deliver therapeutic energy to the innervated tissue based on the response from the innervated tissue.

Abstract: Provided is a system including a surgical instrument comprising a handle assembly comprising a handle; a shaft assembly coupled to the handle assembly; and a flexible circuit. The handle assembly comprises a proximal portion of the flexible circuit and the shaft assembly comprises a distal portion of the flexible circuit; the shaft assembly further comprising: an exterior shaft positioned around the distal portion of the flexible circuit and configured to change position while a sub-portion of the distal portion of the flexible circuit remains stationary; and shaft control electronics comprising a stationary portion and a non-stationary portion, the stationary portion coupled to the distal portion of the flexible circuit and the non-stationary portion coupled to the exterior shaft; wherein the stationary portion of the shaft control electronics is configured to measure a distance to the non-stationary portion of the shaft control electronics as the exterior shaft changes position.

Abstract: A tube configured to be mounted on an outer side of a shaft of a treatment instrument includes a tube main body, and a convex portion that is provided along a longitudinal axis of the tube main body and is protruded inwards in a radial direction of the tube main body with respect to an inner peripheral surface of the tube main body.

Abstract: An endoscopic bipolar forceps includes an elongated shaft having opposing jaw members at a distal end thereof. The jaw members are movable relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue therebetween. The forceps also includes a source of electrical energy connected to each jaw member such that the jaw members are capable of conducting energy through tissue held therebetween to effect a seal. A generally tube-like cutter is included which is slidably engaged about the elongated shaft and which is selectively movable about the elongated shaft to engage and cut tissue on at least one side of the jaw members while the tissue is engaged between jaw members.

Abstract: Surgical systems and methods are provided for controlling actuation and movement of various surgical devices.

Abstract: An electroporation apparatus and the method of using same are provided. The apparatus allows for the ablation of an area of tissue of arbitrary volume. The apparatus includes a plurality of conductive electrodes attached to a base plate and electrically connected to a pulse generator to allow individual electrical actuation of the electrodes. In use, the electrodes are inserted into an area of tissue to be ablated, such that the electrodes are in a first position. Predetermined ones of the electrodes are then activated to ablate tissue surrounding the activated electrodes, while leaving other ones of the electrodes un-activated. The electrodes are then moved to a second position which is different than the first position, and predetermined ones of the electrodes are then activated to ablate tissue surrounding the activated electrodes, while leaving other ones of the electrodes un-activated.

Abstract: An excisional device may comprise an introducer comprising a distal trough portion and a cutting assembly. The cutting assembly may comprise an axial hand element configured to selectively bow out of and away from the distal trough portion and to retract into the distal trough portion and a helical cutting element wound around the axial band element. A rotating drum may be provided to cause the cutting assembly to selectively rotate, bow and retract according to a mechanically-driven first cutting profile that is defined by a shape of a channel formed in the drum. An optical guidance projector assembly may be coupled to the excisional device and may be configured to visually indicate when a distal portion of the excisional device is aligned with an imaging plane of an imaging probe and in a desired position.

Abstract: Systems and methods for performing RF ablation while monitoring the procedure using low coherence interferometry (LCI) data are described. A catheter includes a distal section, a proximal section, a multiplexer, and a sheath coupled between the distal section and the proximal section. The distal section includes one or more electrodes configured to apply RF energy to a portion of a sample in contact with the electrode. The distal section also includes a plurality of optical elements configured to transmit one or more beams of exposure radiation away from the distal section of the catheter. The proximal section includes an optical source configured to generate a source beam of radiation and a detector configured to generate depth-resolved optical data. The multiplexer is configured to generate the one or more beams of exposure radiation from the source beam of radiation.