Abstract: An articulating structure includes a joint unit including a front segment and a rear segment that are connected in series and perform relative rotation with respect to a rotation portion, and an elastic member interposed between the front segment and the rear segment, and a wire that passes through the front segment and the rear segment in a lengthwise direction of the joint unit, wherein the front segment rotates relative to the rear segment in one direction when the wire is pulled rearward, and the elastic member elastically deforms by a pressing force by the rotation of the front segment to provide a force that resists the pressing force.

Abstract: A surgical system includes a drive unit on a support. The drive unit includes motors or other actuators and a plurality of output elements arranged such that operation of each drive unit linearly translates a corresponding one of the output elements. A surgical device has actuation elements extending through an elongate shaft to a distal articulation section, and an input subsystem carried at the proximal end of the shaft. Linear translatable input elements or pistons of the input subsystem are each associated with a corresponding one of the actuation elements. The input and output elements are positioned such that operation of an actuator linearly translates an output element, causing linear translation of a corresponding input element and engagement of an actuation element. A sterile drape is positionable between the input elements and the output elements.

Abstract: Methods and apparatus for performing joint laxity measurement are disclosed. A retractor includes a plurality of spacers, such as plates, that are capable of being moved from a central portion of the retractor by a carriage mechanism. In some cases, the carriage mechanism may press against ramps connected to internal sides of the plates, thereby causing the plates to be displaced outwardly. In other cases, the carriage mechanism may include blades that rotate and press against the internal sides of the plates, thereby causing the plates to be displaced outwardly. The retractor is mounted on a surgical device configured to actuate the carriage mechanism. When the retractor is placed in a joint and the carriage mechanism is actuated, a measurement of the joint laxity may be determined based upon characteristics of the retractor and/or the surgical device.

Abstract: A retractor for use in surgical operations comprises a first blade, a second blade, and a third blade. In operation, the blades are initially in a closed position to assume a low profile during insertion. The blades can be independently translated and independently pivoted, thereby stretching the skin about the incision to form an aperture larger than the incision. In some embodiments, a method of performing an operation on a patient using the disclosed retractor is provided.

Abstract: A self-supporting surgical retractor is provided for retracting soft tissue and anatomy at a spinal surgical site. The retractor includes a tubular base defining an upper rim and a lower rim and a working channel there between the upper and lower rims, in which the base and lower rim are sized and configured to be seated on adjacent vertebral bodies spanning an intervertebral space. At least two elongated legs are provided, each projecting from the upper rim and each including a fixation feature at a free end thereof. Each of the legs has a length sufficient for the fixation feature to be outside the body of a patient when the lower rim is seated on adjacent vertebral bodies of the patient. The retractor is formed of a radio-transparent or radio-lucent material.

Abstract: A tissue retractor having a central body, a posterior housing slidably coupled to the central body via a first two way overrunning clutch, a posterior arm slidably coupled to the posterior housing via a second two way overrunning clutch, a right arm rotatably coupled to the central body via a hinge pin and third two way overrunning clutch and a left arm rotatably coupled to the central body via a hinge pin and fourth two way overrunning clutch.

Abstract: Methods for suspension fixation most applicable for a Latarjet of bone block procedure are performed using an open surgery with an anterior approach. The method passes endobuttons and sutures through the glenoid from posterior without the need of a posterior drill guide and disposable drill/sleeve. As an alternative embodiment, a passing pin with a slot at the advancing end may be used to further reduce surgical steps. The passing pin may be advanced and exit the muscle, and the suture loop may be directly attached to the pin rather than a secondary shuttle suture and then retrieved anteriorly.

Abstract: Systems, devices, and methods for endoscopically retracting a target tissue. The device includes a first shaft and a second shaft slidably coupled thereto. An internal member extends in a transverse direction from the first shaft and is configured for advancement through a penetration in the target tissue to atraumatically engage a distal surface of the target tissue after being advanced therethrough. A pair of external members extend from the second shaft generally parallel to the transverse direction. The external members are spaced apart and are configured to atraumatically engage a proximal surface of the target tissue when the internal member is moved longitudinally relative to the external members. The internal member applies traction to the target tissue when retracted past the pair of external members, which apply counter-traction to the target tissue on opposing lateral sides of the internal member, to re-shape the target tissue and enable subsequent suture placement.

Abstract: A suture passer for use in arthroscopic soft tissue repair procedures. The suture passer includes a cannulated needle having a distal tip. A post is slidable within the cannulated needle. A snare is slidable within the cannulated needle between an extended position and a retracted position. In the extended position, the snare extends from the distal tip of the cannulated needle and in the retracted position, the snare extends around the post. The suture passer may have a handle extending proximally from the cannulated needle. In use, suture is passed through an open region between the snare and the post in the extended position. As the snare and, in some cases, the post, are retracted, the snare extends around the post and closes the open region, trapping the suture between the snare and the post in a closed region.

Abstract: An end effector assembly for use with a surgical stapler, comprising a staple cartridge having a tissue contacting surface, an anvil plate having a tissue contacting surface, a buttress material releasably disposed on the tissue contacting surfaces of each of the staple cartridge and the anvil plate, and an epoxy positioned onto the tissue contacting surfaces of each of the staple cartridge and anvil plate defining an attachment zone configured to retain the respective buttress material atop the respective tissue contacting surfaces.

Abstract: The present invention is directed to a surgical instrument with a robotics system, a memory device and an end effector having an elongate channel, knife position sensor(s) and a firing bar coupled to a knife. In response to drive motions initiated by the robotics system, the firing bar may translate within the elongate channel. As the firing bar translates, the sensor(s) transmit a signal to the memory device. The position of the knife may be determined from the output signals and may be communicated to the robotics system or instrument user. The sensors may be Hall Effect sensors.

Abstract: A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

Abstract: An anvil-attachable layer for use with a surgical stapler, or fastening instrument, wherein a proximal end portion of the layer is attached to a staple cartridge assembly, for example. The layer may be attached to the staple cartridge assembly by an adhesive, weld, or a staple-cartridge-based clamp, wherein the attachment is weak enough to allow the layer to pull away from the staple cartridge assembly with stapled tissue. Alternatively, the layer can include two or more lateral slits that define a connector region that can be cut by a knife of a surgical stapler to release the layer.

Abstract: A surgical instrument. The surgical instrument includes an elongated channel configured to support a staple cartridge, an anvil pivotably connected to the elongated channel, a knife mechanically coupled to the staple cartridge, an electric motor and a control circuit electrically connected to the electric motor. The control circuit is configured to change a firing motion a first way based on a first value of a projected peak firing force and a second way based on a second value of the projected peak firing force value.

Abstract: Aspects of the present disclosure are presented for a surgical instrument having one or more sensors at or a near an end effector and configured to aide in the detection of tissues and other materials and structures at a surgical site. The detections may then be used to aide in the placement of the end effector and to confirm which objects to operate on, or alternatively, to avoid. Examples of sensors include laser sensors used to employ Doppler shift principles to detect movement of objects at the surgical site, such as blood cells; resistance sensors to detect the presence of metal; monochromatic light sources that allow for different levels of absorption from different types of substances present at the surgical site, and near infrared spectrometers with small form factors.

Abstract: A surgical stapling device that comprises an end effector. According to various embodiments, the end effector comprises a circular anvil having a staple forming surface and a plurality of staples facing the staple forming surface of the anvil. The end effector also comprises a staple driver assembly comprising a plurality of staple drivers. Each staple driver supports one of the plurality of staples and is configured such that, when the staple driver assembly is actuated, each staple driver drives the staple into the staple forming surface of the anvil. A first quantity of the plurality of staple drivers has a first height and a second quantity of the plurality of staple drivers has a second height, wherein the first height is less than the second height.

Abstract: A surgical stapling device that comprises an end effector. According to various embodiments, the end effector comprises a circular anvil having a staple forming surface and a plurality of staples facing the staple forming surface of the anvil. The end effector also comprises a staple driver assembly comprising a plurality of staple drivers. Each staple driver supports one of the plurality of staples and is configured such that, when the staple driver assembly is actuated, each staple driver drives the staple into the staple forming surface of the anvil. A first quantity of the plurality of staple drivers has a first height and a second quantity of the plurality of staple drivers has a second height, wherein the first height is less than the second height.

Abstract: A surgical instrument system can comprise a surgical instrument, a first end effector, and a second end effector, wherein the end effectors are attachable to the surgical instrument. The first end effector can comprise a first set of stored data pertaining to the first end effector, wherein the surgical instrument is configured to ascertain the first set of data and enter a first operating state. The second end effector can comprise a second set of stored data pertaining to the second end effector, wherein the surgical instrument is configured to ascertain the second set of data and enter a second operating state. The surgical instrument is further configured to enter a default operating state if said surgical instrument is unable to ascertain a set of stored data from an end effector.

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

Abstract: A loading unit removably loadable into a surgical instrument positioned within a body of a patient having an elongated member, first and second jaws at a distal portion and a firing mechanism movable within the elongated member to effect firing of fasteners into the tissue clamped between the first and second jaws. The loading unit is insertable into a proximal opening of the instrument and through a lumen in the shaft of the instrument while the instrument is positioned in the body of the patient. The first and second jaws extend distally of the shaft of the instrument and the loading unit is actuable by the instrument. A surgical instrument to receive the loading unit and a method for reloading the instrument are also provided.

Abstract: The present disclosure includes apparatuses for a surgical handle assembly. An example apparatus includes a toothed rack, a movable handle member, a driving pawl configured to engage the toothed rack and advance the toothed rack in a linear distal direction in response to a movable handle member advancing in a proximal direction and a latch configured to engage the toothed rack and advance the toothed rack in a linear proximal direction in response to the movable handle member advancing in a distal direction.

Abstract: A surgical fastener deployment system may include a plurality of coil fasteners having a head and coil body. In one embodiment, the head may be larger in diameter than the coil body. The fasteners may also be mounted on a guide rod or mandrel that passes through a through-hole of the head and the coil body. The shaft may also include a guiding element that contacts and stabilizes the coil body as the fastener is deployed from a distal end of the shaft. When the head approaches and contacts the guiding element, the guiding element may deflect to permit the head to pass.

Abstract: A surgical stapling instrument. Various embodiments include an actuation system for selectively generating a plurality of control motions. A surgical end effector is operably coupled to the actuation system. The actuation system interfaces with an actuation member configured to operably engage rotatable camming members to fire staples within the end effector into forming contact with an anvil portion of the end effector.

Abstract: A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Abstract: A fitting for receiving and fixing at least one sleeve for enforcing an end of a hollow organ so that said end of the hollow organ can be connected with a further end of the hollow organ, the fitting having a cylindrically shaped body, said body being configured to receive and hold two sleeves with turned-over hollow organ ends so that inner sides of the hollow organ ends make contact with one another.

Abstract: Implantable medical devices for connecting tissue layers or occluding body conduits and tissue structures include apposition portions, a central region, and a covering material. The methods of using the devices include endoscopic deployment, and the devices may include self-expanding frameworks that facilitate a secure connection between the tissue structures. In some embodiments, one or more tethers are used to longitudinally contract the device in situ.

Abstract: The present invention relates to a laparoscopic device (1) for locating, mobilising and clamping organs or tubular structures comprising: a hollow introducer element (2), provided with a first end (21) and a second end (22); an elastic element (3) insertable in said introducer element (2) through said first (21) and second end (22) folded upon itself; a fixing element (4), couplable to said introducer element (2), able to block said elastic element (3) in a predetermined position.

Abstract: A minimally invasive occlusion device is disclosed. The minimally invasive occlusion device includes a first link having a first end and a second end, a second link having a first end and a second end; the first end of the second link connected to the first end of the first link by a compensating coupler. Another minimally invasive occlusion device may include a delivery frame or a shaft having an articulating cradle coupled to the shaft. A method of occluding tissue is also disclosed. The method of occluding tissue includes placing a first link of an occlusion device laterally at a base of tissue, placing a second link of an occlusion device on an opposing side of the base of tissue, substantially parallel with the first link, and securing the first link and the second link to fully occlude the base of tissue.

Abstract: An end effector for a surgical clip applier includes an elongate body, first and second jaw members extending out a distal end of the body, and a clip track provided within the body and containing one or more surgical clips, each surgical clip including a crown and a pair of legs extending longitudinally from the crown and diverging from each other at a diverging opening angle. A pre-forming region is defined by the first and second jaw members to receive and deform the one or more surgical clips from a first state, where the pair of legs diverge at the diverging opening angle, and a second state, where the diverging opening angle is minimized and the one or more surgical clips are prepared to be received by the first and second jaw members and crimped.

Abstract: A system and method for sheathing and resheathing a delivery catheter for embolic device are disclosed. An embodiment is directed to an embolic device delivery system that includes a delivery catheter having an embolic device coupler, a locking tube disposed about the delivery catheter, a protective sheath, and a sheath outer component disposed about the protective sheath configured to unsheathe and resheathe the delivery catheter, and smooth transferring of the embolic device into a microcatheter. In one embodiment, the coupler may be an elongated shape having a loop portion for engaging the coil toward the distal end of the delivery catheter. The loop portion of the coupler may be an elastic material or a shape-memory alloy, such as Nitinol or nickel titanium, such that the loop portion is bendable at various angles. Together, the delivery catheter and coupler may be inserted into an artery and carry an embolic device to an aneurysm for placement near an aneurysm.

Abstract: An example system can include a tubular braid, a catheter, and an embolic coil. The tubular braid can have an open end, a pinched end, and a predetermined shape. In the predetermined shape, the tubular braid can have two inversions and a middle segment extending between the two inversions that forms a sack. The tubular braid can be implanted in an implanted shape based on the predetermined shape. A distal end of the catheter can be inserted into the sack when the tubular braid is implanted. The embolic coil can be delivered through the catheter into the sack. The opening to the sack can correspond to a constricted columnar segment of the middle segment when the braid is in the predetermined shape.

Abstract: Disclosed are example embodiments of an endovascular coil having a twisted figure 8 shape. The endovascular coil includes: a first loop; a second loop; and an inflection region where a portion of the first loop transitions into a portion of the second loop. The second loop is rotated about an axis parallel to the longitudinal axis of the first loop to create the twisted figure 8 shape. The twist adds more randomness and variability to the filling behavior of the endovascular coil. The added randomness and variability enables the twisted figure 8 coil to better fill the void of irregular-shaped aneurysms than other conventional embolic coils.

Abstract: The present disclosure relates to a medical compression device (1, 1?) adapted to apply a compression force to a body part (L) of a human or animal. The device comprises one or more strips intended to encircle the body part. The strip comprises a tension indicator (8, 16) adapted to inform a user when a predetermined tension is achieved, the predetermined tension correlating to a predetermined pressure on the body part. The device can be used for therapy or for diagnosis.

Abstract: Disclosed herein is a device and method for reducing or stopping the flow of blood in a patient. The patient may be treated with an intravenous line, such as a central line. The device may have a plunger including a pressure pad that applies pressure to the bleeding vein to reduce or stop the flow of blood in an engaged position of the plunger.

Abstract: A hemostatic device is provided to stop bleeding at a puncture site on an artery of a patient, the device comprising a transparent flexible band to be wrapped at the site where the bleeding is to be stopped, a curved compression member having an inner peripheral side and possessing a first curved portion in its first half and a second curved portion in its second half, a first balloon provided on the inner peripheral side in the first half of the curved compression member and a second balloon provided on the inner peripheral side in the second half of the curved compression member. The bleeding from a first artery is stopped by compressing the first artery at the puncture site using inflation of the first balloon and blood flow in the first artery is increased by compression of a second artery using inflation of the second balloon.

Abstract: Guides, systems, and methods for maintaining, correcting and/or fusing joint deformities are disclosed. The guide system including a cut guide, an alignment guide, and at least one directional wire. The cut guide including a base portion, an extension member extending away from a bottom surface of the base portion, and at least one arm extending away from an end of the base portion. The alignment guide, including a base portion, a first extension member extending away from a bottom surface of the base portion in a first direction, and a second extension member extending away from the bottom surface of the base portion in a second direction. Methods of using a guide system for maintaining, correcting and/or fusing joint deformities are also disclosed.

Abstract: A method for producing a cutting tool, in particular a drill bit, is specified wherein the cutting tool has a front end (F) at the front and a rear end (R) toward the rear, wherein a tool tip is formed on the front end (F), a point thinning is ground at the tool tip with a grinding tool, the point thinning being ground to be narrower toward the front than toward the rear. The point thinning is ground with a constant point thinning angle (AW). Furthermore, a corresponding cutting tool is specified.

Abstract: A system for drilling a bore in a bone (7) and measuring a depth of the bore during surgery, said system comprising: a drill (5) comprising a drill chuck (6) for holding a drill bit; a drill bit (3) mounted in the drill chuck; at least one sensor (11,12) arranged to produce signals for determining the depth of the bore, preferably comprising a strain gauge (11) arranged to produce a signal representing a force exerted on the system during drilling, and a distance sensor (12) arranged to produce a signal representing a distance between a reference point on the system and the bone surface during drilling; first communication means (19) arranged to communicate said signals to electronic processing means; electronic processing means (16) arranged to receive said signals from said first communication means and to determine a depth of a bore from said signals; second communication means (13a) arranged to communicate said determined depth to output means; output means (2) for outputting information about the determi

Abstract: A method for performing an efficient and thorough percutaneous discectomy includes making into the patient a percutaneous incision, which is a small stab wound, no more than approximately 10 mm in length. A stimulated combination neuro-monitoring dilating probe is passed through an approximately 10 mm or less skin incision and into a patient's disc space to establish a safe path and trajectory through Kambin's Triangle. Once a neuro-monitoring dilating probe is in the disc space, a second dilator is placed over the neuro-monitoring dilating probe and impacted into the disc space. Neuro-monitoring dilating probe may then be removed. An access portal optionally combined with a force dissipation device may then be placed over the second dilator and into the disc space. The second dilator is removed and then discectomy instruments may be placed through the access portal to perform the discectomy.

Abstract: A drilling system includes a guide-hub that includes contact feet configured to be placed against a drilling surface to maintain a fixed angle with the drilling surface. A drilling insert includes a drill bit and a harness. The drilling insert is configured to be inserted into the guide-hub and the harness is configured to detect when the drill bit punctures the drilling surface and automatically prevent further drilling.

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

Abstract: The invention relates to a bone positioning device (1) for use in the repositioning of bone sections relative to each other in case of dysgnathia, comprising a main body (2), which has a bottom side (3), which faces the lower jaw (7) and in which there are recesses (5) for receiving navigating aids (6) fixed to the lower jaw, and an opposite top side (4), which faces the upper jaw and in which there are likewise recesses (5) for receiving navigating aids (6) fixed to the upper jaw, wherein at least one cutting-tool guide device (8) is attached to the main body (2).

Abstract: An orthopaedic surgical instrument is provided having a first customized patient-specific surgical instrument and a second customized patient-specific surgical instrument configured to be removably coupled to the first customized patient-specific surgical instrument. The second customized patient-specific surgical instrument includes a body positioned in a gap defined between posteriorly-extending arms of the first customized patient-specific surgical instrument.

Abstract: A wedge osteotomy method inserts a first wire into a first bone of the foot, distal from tissue to be removed. A second wire is inserted into a second bone, so the tissue to be removed is distal from the second wire. A cut guide is pivoted about the first wire, until a first axis of the cut guide is parallel with a longitudinal axis of the first metatarsal. The cut guide has a slot perpendicular to the first axis for guiding a cutter to cut bone, while the first axis is aligned with the longitudinal axis of the first metatarsal. The cut guide is then pivoted about the second wire, until the first axis is aligned with the longitudinal axis of the talus, and bone is cut through the slot, to form a second planar cut into or through bone material.

Abstract: The present invention provides a catheter for treating occlusions in blood vessels. The catheter includes at least one electrode pair positioned inside of a flexible angioplasty balloon at the distal end of the catheter. In some designs, the electrode pairs are arranged in a low-profile or coplanar configuration, reducing the diameter of the distal end of the device and permitting treatment of tight and hard-to-cross occlusions. The flexible angioplasty balloon has an extremely low profile and does need to be folded before insertion of the catheter into the cardiovascular system. During treatment, the balloon can be expanded a relatively small amount sufficient to immerse the electrode pairs in a conductive fluid before generating shock waves across the electrodes to treat the occlusion. The balloon can be made of material having elastomeric properties such that it returns to its original low profile configuration when it is deflated following treatment.

Abstract: The present disclosure relates generally to thrombectomy devices. An exemplary catheter comprises: an emitter assembly comprising at least one emitter; wherein each emitter comprises an electrode pair, and wherein each emitter is configured to generate a plurality of cavitation bubbles when a voltage is applied to the pair of electrodes; an infusion lumen formed by at least a portion of an outer wall of the catheter, the infusion lumen configured to receive a conductive fluid, wherein the emitter assembly is housed within the infusion lumen, wherein a distal segment of the infusion lumen includes a plurality of holes on the portion of the outer wall of the catheter, and wherein the plurality of holes are configured to release the conductive fluid and the plurality of cavitation bubbles out of the catheter to treat thrombus at a treatment site; an aspiration lumen including aspiration ports at the distal segment thereof.

Abstract: An extracorporeal pressure shock wave device includes a hinge providing a pivotable axis about which a shock wave applicator rotates to provide for adjusting the depth within a targeted body that a shock wave focal volume is produced from the applicator.

Abstract: Acoustic pressure shock waves are applied to a drug delivery structure implanted in tissue of a human or animal body and including one or more pouches that contain at least one drug in fluid form that is releasable from the drug delivery structure when targeted by the acoustic pressure shock waves.

Abstract: The present invention provides for a method for continuously monitoring a coupling quality of a coupling interface between an acoustic energy source of a therapeutic device and a body surface area of a patient, comprising the steps of: (f) obtaining a plurality of images of at least one predetermined first area of the coupling interface; (g) extracting at least one first image characteristic of a predetermined first image of said plurality of images; (h) extracting said at least one first image characteristic of at least one second image of said plurality of images, said at least one second image being temporally spaced apart from said predetermined first image; (i) determining a quantitative parameter corresponding to a difference between said at least one first image characteristic of said predetermined first image and said at least one first image characteristic of said at least one second image, and (j) actuating a signal if said quantitative parameter exceeds a predetermined reference threshold.

Abstract: A surgical instrument apparatus including an elongate tubular body having a proximal end and a distal end and a bore extending through the tubular body is disclosed. The apparatus includes an actuator link extending through the bore and operably configured to move longitudinally and having a first end connected to an actuator at the proximal end of the tubular body and a second end terminating in a coupler. The actuator is operably configured to cause the actuator link to selectively move between an extended state in which the coupler extends beyond the distal end of the tubular body to permit an end effector to be coupled to the coupler, and a retracted state in which the coupler is retracted back into the distal end of the tubular body for operation of the surgical instrument.