Abstract: The present embodiments relate generally to ultrasound apparatus with improved heat dissipation and methods for providing same. The ultrasound apparatus may have a housing that encloses a transducer array and at least one integrated circuit (IC) for driving the transducer array during operation. The housing may have an interior surface and an exterior surface, and the housing can be made substantially of metal. A post is disposed between the at least one IC and the interior surface of the housing. The post can be coupled directly to the interior surface of the housing so that heat generated from the at least one IC is transferred via the post to the housing and dissipated via the exterior surface.

Abstract: An ultrasound imaging system includes a processor programmed to identify the type of tissue being imaged and to confirm that one or more system settings and/or the energy of ultrasound imaging signals delivered is set appropriately for such tissue. In one embodiment, an image obtained with the ultrasound imaging system is analyzed to determine if the tissue is ophthalmic (eye) tissue. If so, the system parameter settings and/or the transmit power of the signals produced by the ultrasound system are adjusted or maintained at a level that is appropriate for imaging such tissue.

Abstract: A gut rover traverses the guy and collects samples of the microbiome in a way that permits correlation of samples with particular locations from which they were sampled.

Abstract: Collection devices with valves for liquid specimens are disclosed. In an embodiment, the disclosure provides a collection device including a reservoir having a sealed cavity, the sealed cavity being under a negative pressure; a delivery tube in communication with the sealed cavity of the reservoir and having a delivery inlet, a delivery outlet, and a valve disposed between the delivery inlet and the delivery outlet, the valve being configured to control the communication and blocking between the delivery inlet and the delivery outlet, and an angle being formed by an extension line of the delivery inlet an extension line of the delivery outlet; and a piercing component for piercing a tissue is connected with the delivery inlet of the delivery tube.

Abstract: A moisture-responsive film can include a complexing substrate and an iodine layer applied to the complexing substrate to form the moisture-responsive film. The moisture-responsive film can include a test area formed on a testing surface of the moisture-responsive film.

Abstract: An excisional device for either handheld or stereotactic table use may comprise an outer sheath that may comprise a distal trough shape configured to penetrate and/or cut tissue independently or in concert with work element(s). The articulable work element(s) may comprise articulable beak(s) and may be configured to translate and/or rotate at a first rate and to cut tissue in a direction implied by placement of the trough shaped outer sheath. A first helical element or equivalent assembly may be configured to transport tissue cut by the work element(s) and/or trough, may be co-axially disposed relative to the work element(s) and may be operative to rotate at a second rotation rate that is different than the first rate. A proximal sheath may be co-axially disposed relative to the work element(s) and the first helical element, and may be configured to rotate and actuate the work element(s).

Abstract: A handle for a medical device includes a distal portion extending longitudinally and including a distal channel extending therethrough, the distal end of the distal portion including a connector configured to connect to a proximal end of an endoscope, a central portion slidably connected to the distal portion, the central portion extending longitudinally. The handle also includes a central channel extending therethrough, the distal end of the central portion connected to a sheath, the central portion including an introducer port extending laterally therefrom so that an auxiliary tool inserted through the introducer port is directed through a lumen of the sheath. Further, the handle includes a proximal portion slidably connected to the central portion, the proximal portion extending longitudinally and including a proximal channel extending therethrough, the distal end of the proximal portion connected to a needle so that the needle is passed through the lumen.

Abstract: A device for occluding a vasculature of a patient including a micrograft having an absorbent polymeric structure with a lumen of transporting blood. The micrograft has a series of peaks and valleys formed by crimping. The occluding device is sufficiently small and flexible to be tracked on a guidewire and/or pushed through a microcatheter to a site within the vasculature of the patient. Delivery systems for delivering the micrografts are also disclosed.

Abstract: Devices for closing a passage through tissue communicating with a body lumen. The device may include an elongate body, a sheath disposed at the distal end of the device for disposition within a body lumen, a hollow needle disposed within a needle lumen of the body, the needle being selectively advancable through the needle lumen, a suture-anchor ejection mandrel disposed within the hollow needle that is also selectively advancable through the hollow needle, a suture-anchor and suture disposed within the hollow needle, a distal end of the suture attached to the suture anchor for ejection out the hollow needle by the mandrel. A needle guide disposed between the sheath and proximal end of the body may include a needle port through which the needle can exit. A hemostatic plug is disposed over the needle port so as to be penetrated by the needle upon exiting the port.

Abstract: A sponge-based variable-stiffness support structure for natural orifice surgical instrument is to support the surgical instrument and includes: a variable-stiffness sponge pipeline connected with the natural orifice surgical instrument and configured to support the natural orifice surgical instrument in a natural orifice; a hydrophobic breathable film attached to an outer wall of the variable-stiffness sponge pipeline, and configured to isolate the variable-stiffness sponge pipeline from body fluid in the natural orifice; and a gas delivery assembly connected with the variable-stiffness sponge pipeline, and configured to inject high-pressure air or water vapor into a variable-stiffness sponge pipe of the variable-stiffness sponge pipeline; wherein the variable-stiffness sponge pipeline has a stiffness inversely proportional to content of the water vapor.

Abstract: A surgical device includes a plurality of cameras integrated therein. The view of each of the plurality of cameras can be integrated together to provide a composite image. A surgical tool that includes an integrated camera may be used in conjunction with the surgical device. The image produced by the camera integrated with the surgical tool may be associated with the composite image generated by the plurality of cameras integrated in the surgical device. The position and orientation of the cameras and/or the surgical tool can be tracked, and the surgical tool can be rendered as transparent on the composite image. A surgical device may be powered by a hydraulic system, thereby reducing electromagnetic interference with tracking devices.

Abstract: Bowel retractor devices. In various forms, the bowel retractor devices are configurable from a collapsed position wherein the retractor may be inserted through a trocar cannula or other opening in a patient's body to a second expanded position wherein at least a portion of the patient's bowel may be advantageously supported in a desired position.

Abstract: Suture passers and methods of use. Described herein are suture passers preloaded with suture, including cartridges that couple to a suture passer to form a loaded suture passer that are configured to prevent a length of suture (e.g., already-passed suture) from re-entering the channel of the suture passer jaw and getting recaptured and/or entangled by the tissue penetrator. In particular, described herein are preloaded and automatically re-loading suture passers that are adapted to include a gate, guide or shield on one of the jaws of the suture passer, and methods of operating such suture passers for surgical use including repairing tissue.

Abstract: An adjustable suture locking apparatus includes a lock pin, an outer tube, a handle, and an adjusting device. The lock pin is used to receive or fix a suture. The outer tube defines a receiving cavity. The lock pin is disposed at a distal end of the receiving cavity. The handle includes a fixing portion coupled to a proximal end of the outer tube. The adjusting device is disposed on the fixing portion. The adjusting device is coupled to a proximal end of the suture and operable to adjust tensioning or loosening of the suture.

Abstract: An organization device for maintaining a suspensory graft fixation device (i.e., an implant and suture) in a desired position. The device includes a substrate having top and bottom edges with first and second panels extending therebetween. The device also includes a first central longitudinal axis extending in a direction from the top edge to the bottom edge between the first and second panels. The first and second panels are foldable about the axis between open and closed positions. The device also includes an opening extending through the bottom edge and into the first panel, and a plurality of top slits and bottom slits. The plurality of top slits includes at least one top slit which is aligned with the first opening. The device additionally includes a tabs adjacent the opening. The slits and tabs are configured to maintain suture of a suspensory graft fixation device in an organized manner.

Abstract: Various systems and methods of controlling a surgical instrument are disclosed. The surgical instrument can include one or more sensors that are configured to detect or measure parameters associated with the use of the instrument and a display. A control circuit can be configured to detect whether the instrument is articulating, firing, clamping, and so on according to relationships between the detected parameters. The control circuit can further cause the display to display an image or sequences of images according to the particular operational state of the instrument. The images can provide alerts, instructions on how to use the instrument, or information detected by the one or more sensors, such as the position of the knife during transection.

Abstract: A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Abstract: Jaw assemblies for a surgical stapler are provided. The jaw assemblies comprise a first jaw having a first clamping surface and a plurality of staples disposed therein and second jaw assembly having a second clamping surface. The jaw assemblies can be actuated from a closed configuration in which the first clamping surface contacts or is adjacent to the second clamping surface to an open configuration in which the second jaw is pivoted away from the first jaw to a stapling position in which the second clamping surface is parallel to the first clamping surface and spaced apart from the first clamping surface. A pivoting link or sliding pivot joint can couple the second jaw to the first jaw to facilitate motion between the closed position, the open position, and the stapling position.

Abstract: An instrument drive connector includes a housing assembly, an elongated shaft extending distally from the housing assembly, and a first drive assembly at least partially disposed within the housing assembly and the elongated shaft. The first drive assembly includes a first drive screw, a first input drive coupler non-rotatably coupled to a proximal end of the first drive screw, a first drive nut threadedly engaged with a threaded body portion of the first drive screw and longitudinally movable relative thereto in response to rotation of the first drive screw, and a locking link. The locking link includes an elongated body having a proximal end portion coupled to the first drive nut and longitudinally movable relative thereto between a proximal non-locking position and a distal locking position, and a distal end portion including a switch actuation assembly including a switch actuating arm biased towards the distal locking position.

Abstract: Various embodiments are directed to a powered surgical instrument for cutting and fastening tissue. The instrument may comprise an end effector comprising a first jaw member and a second jaw member. The second jaw member may be coupled to move relative to the first jaw member from an open position, where the jaw members are apart from one another, to a closed position. The end effector may also comprise a firing bar positioned to fire by translating within the end effector when the first and second jaw members are in the closed position. Additionally, the surgical instrument may comprise a drive device, a clamping trigger and a control circuit. The drive device may be mechanically coupled to the firing bar. The clamping trigger may be mechanically coupled to the end effector such that actuation of the clamping trigger causes the second jaw member to pivot towards the first jaw member. The control circuit may comprise a firing switch, a clamp switch, a latching device and an end-of-stroke sensor.

Abstract: An arteriovenous graft and methods of reducing the risk of graft thrombosis and extending patency of the arteriovenous graft are provided herein. The arteriovenous graft is operable for attaching to a vein at a venous anastomosis. In some aspects, the arteriovenous graft includes a plurality of grooves at a venous anastomosis end of the arteriovenous graft and the venous anastomoses may be arranged such that the arteriovenous graft and the vein meet at an angle of 30° or less.

Abstract: A trocar coupling assembly includes a housing disposable in a tubular shaft of a surgical stapler. The housing has opposed openings defining a passage through the housing that is capable of receiving a trocar assembly therein. A release button is accessible through the tubular shaft for transitioning the trocar coupling assembly between a locked configuration and an unlocked configuration.

Abstract: A surgical system includes an adapter assembly and a tip protector. The adapter assembly includes a tubular housing, and a trocar assembly selectively receivable in the tubular housing. The tip protector includes a housing defining a channel therethrough configured for receipt of the trocar member, a first locking member movably coupled to the housing and configured to selectively engage the trocar member to lock the tip protector to the trocar member, and a second locking member movably coupled to the housing and configured to selectively engage a distal end portion of the tubular housing to lock the tip protector to the tubular housing.

Abstract: Polymeric ligation clips and a clip applier for applying a polymeric ligation clip to tissue are disclosed herein. More particularly, the polymeric ligation clips include separate first and second beams that can be coupled to each other and are movable from a reduced diameter open position in which minimal strain is placed on the ligation clip to a clamped position and to a clip applier for delivering such a ligation clip to a surgical site.

Abstract: A clip unit includes: an arm portion including arms extending from a proximal end portion to a distal end portion so as to be openable and closeable; a holder than can hold the arms in a closed state by accommodating the proximal end portion of the arm portion; and a thread grip attached to at least one of the arms and positioned between the arms. In a state where the arms are spread open, a dimension of the thread grip in the opening/closing direction of the arms is equal to or larger than a distance between the arms in the closed state. The thread can be elastically deformed in the closed state.

Abstract: A hemostatic device is disclosed capable of effectively performing hemostasis on a puncture site of a subject without generating over-pressurization compression. The hemostatic device includes a first hemostatic member and a second hemostatic member which is movable relatively close to or away from the first hemostatic member, pinches a skin around the puncture site of the subject between the first hemostatic member and the second hemostatic member when the second hemostatic member moves toward the first hemostatic member, and performs hemostasis on the puncture site.

Abstract: Delivery and detachment of an implant can be enhanced by a retraction mechanism to secure portions of a delivery wire within an interior space of the implant. A delivery system can include an implant having a proximal end portion. A delivery wire can include (i) a detachment zone proximal to the proximal end portion and (ii) a distal region distal to the proximal end portion. An expansion member can be located between the proximal end portion and the distal region of the delivery wire. The expansion member can be biased to move the distal region of the delivery wire distally away from the proximal end portion when severed at the detachment zone.

Abstract: The present disclosure relates to repair devices configured for use in fixing or approximating tissues, such as cardiac valve tissues and particularly the leaflets of a regurgitant mitral valve. The repair device includes a shaft, a pair of proximal elements pivotally coupled to the shaft and extending from the shaft, and a pair of distal elements pivotally coupled to the shaft and extending from the shaft. The proximal and distal elements are configured so that targeted tissue can be grasped therebetween. The distal elements and/or the proximal elements include adjustable arms that can be extended and retracted to adjust the length of the gripping elements to provide more effective grasping of targeted tissues.

Abstract: A device and method is provided herein for esophageal impingement of a patients aorta. The device may be inserted into a patients esophagus and positioned at the location where the esophagus passes over the patients aorta. In this position, an actuation device is used to apply pressure to the patients aorta through their esophagus to impinge or occlude the aorta to stop or significantly reduce hemorrhaging. A manually operable actuator handle enables a physician to manipulate a head assembly of the device through three distinct degrees of freedom of movement so as to control placement and direction of force against the patients esophagus and, in turn, their aorta.

Abstract: An embolus material for inhibiting the inflow of blood into an aortic aneurysm from a branched blood vessel by filling, via a catheter, the inside of the aortic aneurysm joined to the branched blood vessel includes: an elongated filling body that is formed to be narrower than the inside diameter of the catheter; and a shaping section that is provided at a portion of the filling body and that forms a structure larger than the width of the branched blood vessel after exiting from the catheter.

Abstract: A hemostatic device is worn on a hand having a site where bleeding is to be stopped and includes a pressing member that applies a compression force to the site. The hemostatic device further includes a cover configured to be worn on a thumb and a dorsal side of the hand, and a linear member having a first end connected to the cover and configured to secure the cover to the hand when a second end thereof is attached to the cover. The cover has a hole which surrounds a portion of the linear member and the pressing member is disposed on a distal side of the cover relative to a virtual line passing through the hole and the connection portion.

Abstract: A tourniquet is described that includes an outer strap that runs from a first end to a second end having a buckle. An inner strap is routed within the outer strap over a portion of its length and runs through a windlass, which is used to tighten the tourniquet. The inner strap is secured to the outer strap at a position spaced away from the first end of the outer strap and is also secured to the buckle.

Abstract: Surgical instruments for performing osteotomies and particularly, wedge-shaped osteotomies, are disclosed herein. A surgical instrument includes a body with a distal end, a proximal end, a bottom surface, and a top surface including a slope extending upward and along a single plane from the distal end to the proximal end. The surgical instrument further includes multiple cutting burrs positioned on the top surface extending along the slope from the distal end to the proximal end and teeth positioned on the distal end. Further, the body tapers from the distal end to the proximal end. Other surgical instruments include a non-patterned set of cutting burrs along the slope from the distal end to the proximal end or the cutting burrs positioned in multiple rows or columns on the top surface along the slope from the distal end to the proximal end.

Abstract: Instrument systems for knee arthroplasty provide multiple bone pin holes and/or saw slots for making femoral and tibial resections. The systems are directly or indirectly positioned and oriented with respect to the femoral mechanical axis, distal surface of a femoral condyle, Whiteside's line, proximal tibial plateau, and the tibial mechanical axis.

Abstract: Drivers and drive systems (e.g., off-axis drive systems, pneumatic motors, multi-gear drive systems, and/or the like), and kits comprising drivers with drive systems, such as those, for example, configured to move a drive shaft.

Abstract: Surgical instruments for performing wedge-shaped osteotomies are disclosed herein. One surgical instrument includes a body with a distal end, a proximal end, a bottom surface, and a top surface including a slope extending upward and along a single plane from the distal end to the proximal end. The surgical instrument further includes multiple columns of cutting blades positioned on the top surface in which each of the cutting blades are spaced apart and extend vertically along at least a portion of the slope from the distal end to the proximal end. Another surgical instrument includes the cutting blades positioned in multiple rows of cutting blades on the top surface such that the multiple rows of cutting blades extend along the slope from the distal end to the proximal end and each cutting blade in the plurality of cutting blades extends horizontally across the top surface.

Abstract: Surgical instruments for performing wedge-shaped osteotomies are disclosed herein. One surgical instrument includes a body including a distal end, a proximal end, and a top surface. The top surface includes a slope extending upward and along a single plane from the distal end to the proximal end. Multiple columns of cutting blades positioned on the top surface and each of the cutting blades includes a respective uniform height that extends vertically along at least a portion of the slope. Another surgical instrument includes a top surface including a flat plane. Multiple columns of cutting blades are positioned on the top surface and the columns of cutting blades are spaced apart and positioned on at least a portion of the top surface. Each cutting blade extends horizontally along the top surface and includes an increasing slope extending upward and along a single plane from the distal end to the proximal end.

Abstract: A surgical bur including primary flutes and auxiliary flutes. The primary flutes include (i) first clearance surfaces, and (ii) first rake surfaces with first cutting edges. The primary flutes extend from a proximal end of the surgical bur to a distal end of the surgical bur. The auxiliary flutes are localized in central regions or distal regions of the surgical bur. The auxiliary flutes include (i) second clearance surfaces, and (ii) second rake surfaces with second cutting edges. At least one of the auxiliary flutes is located between a pair of adjacent ones of the primary flutes.

Abstract: Implants, instruments, and methods for connecting and/or stabilizing first and second bone portions relative to one another are presented including fasteners and retainers connectable in axial force transmitting relationship and instruments for their installation. In one example a guide is configured to clamp two bone portions together while a fastener is inserted through at least one of the bone portions to engage a retainer.

Abstract: A novel and improved elbow prosthesis and method of implanting same including a novel aggregate prosthesis having a retaining system in conjunction with a set plate.

Abstract: Described herein are systems and apparatus of surgical instruments engineered for integration with robotic surgical systems to enhance precision in surgical procedures. Also described herein are methods of using such surgical instruments in performing surgical procedures. The use of such surgical instruments reduce complications arising from misalignment during surgery. The disclosed technology assists in stages of a surgical procedure that require a precise trajectory to be followed. Surgical instrument guides are attached to a universal surgical instrument guide, which is engineered to attach directly or indirectly with a robotic arm of a robotic surgical system. Surgical instruments can then be precisely guided along an axis defined by the universal surgical instrument guide. Individual instruments are easily inserted and removed from the channel of the universal surgical instrument guide, thus allowing a range of instruments to be used throughout a procedure while maintaining the surgical trajectory.

Abstract: A device for guiding a surgical instrument at a surgical site, comprising: at least one guide channel sized and fitted to slidingly accommodate a surgical instrument, said guide channel defining a guide longitudinal axis; and at least one guide support leg coupled to said guide and defining a support leg longitudinal axis, wherein an angle (a) of said guide longitudinal axis in respect to a surface of a surgical site is defined by at least one of (i) a length (L) of said support leg, and (ii) an angle (?) between said guide longitudinal axis and said support leg longitudinal axis.

Abstract: A guidewire control assembly may hold a guidewire stationary while allowing for rotation of a catheter shaft disposed over the guidewire. The guidewire control assembly may include a housing with a passage for receiving the guidewire, a clutch mechanism connected to the housing and actuatable to selectively grip and release the guidewire disposed in the passage, and an interface rotatably connected to the housing. The interface may receive the catheter hub attached to the catheter shaft and may allow for torquing the catheter hub.

Abstract: A medical device capable of adjusting, while a rotating expandable portion breaks an object, a breaking force of the expandable portion. The medical device for breaking a thrombus in a blood vessel includes a shaft portion, an expandable portion that is provided to the shaft portion, a fixing portion that fixes the expandable portion and the shaft portion, a slide portion that is fixed to the expandable portion and is slidable with the shaft portion, and an outer tube that houses therein the shaft portion, in which the slide portion is movable by being indirectly pressed by the outer tube, and the slide portion is relatively rotatable relative to the outer tube.

Abstract: An integrated clot evacuation device having visualization for use in neurosurgical applications, particularly for the evacuation of clots formed as a result of intracranial hemorrhage (ICH). The device may further include an integrated camera and light for visualizing the interior of the brain and the clot itself. Further, the device is configured to evacuate clots through aspiration and irrigation.

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: Embodiments relate to a microsurgical device for concave topologies. The device enables operators to consistently cut uniform, circular, concentric concave and/or convex tissues. In an embodiment, a device for excising a tissue includes a stem, a suction cup connected to a distal end of the stem, and a cutting ring around an outer surface of the suction cup. The device further includes two suction tubes to provide suction to the suction cup and compress the outer surface of the suction cup against the tissue. The device may be connected to a control console configured to provide suction to the suction cup via the two suction tubes and electrical energy to the cutting element via one or more electrical leads. Through the control console, an operator of the device may control the depth of cut of the tissue by controlling the device parameters, such as the suction and electrical parameters.

Abstract: Provided is a medical device capable of easily changing a position of the device inside a biological lumen and effectively removing a cut object. The medical device for removing the object in the biological lumen has a drive shaft, a cutting portion, a first housing that accommodates the drive shaft to be rotatable, a second housing that is rotatable with respect to the first housing, and a support portion that supports the first housing and the second housing. The second housing and the support portion relatively move along an axis to restrict relative rotation of the first housing and the second housing. The support portion supports the second housing to be rotatable around the axis, and restricts a relative movement and a relative inclination of the second housing and the support portion in a direction intersecting with the axis.

Abstract: An apparatus is provided for assisting breast biopsy. The apparatus includes a biopsy guide, a support system that effects three-dimensional movement of the biopsy guide and a system for registering coordinates of a remote center of motion (RCM) of the biopsy guide with a coordinate system on an image of a breast obtained from a parallel plate radiology imager. The biopsy guide has a mounting plate and a needle gun mount and ultrasound transducer mount on the mounting plate in a common plane. A biopsy needle of a needle gun mounted on the needle gun mount and an image plane of an ultrasound transducer mounted on the ultrasound transducer mount have longitudinal axes in or parallel to the common plane, which intersect at the RCM. The position of the RCM with respect to the biopsy guide is unchanged when the needle gun and/or ultrasound transducer moves on the biopsy guide.

Abstract: An adapter assembly includes a sleeve, a trocar assembly releasably securable within the sleeve, and a retaining mechanism configured to releasably secure the trocar assembly within the sleeve. The retaining mechanism includes a retaining block, a cam wire moveably positioned relative to the retaining block between a lock position and a release position, a retaining block extension for maintaining the cam wire relative to the retaining block, a button member in operable engagement with the cam wire, and a pair of retaining members. The button member includes a center beam moveable from an unflexed position in engagement with a stop tab of the retaining block extension to prevent movement of the button member to a flexed position out of alignment with the stop tab to permit movement of the button member.