Abstract: The present disclosure relates to a surgical stapling instrument comprising a handle assembly, an elongated body portion extending from the handle assembly, and an end effector supported on a distal portion of the elongated body portion. The end effector includes a curved housing having a base portion and a jaw portion, a curved anvil assembly supported on the jaw portion, and a curved cartridge assembly supported on the base portion. The cartridge assembly defining first and second arrays of staples receiving slots, the first array of staple receiving slots includes three rows of staples and the second array of staple receiving slots includes two rows of staples. A height of the staples in each of the rows of three rows of staples of the first array of staple receiving slots is different.

Abstract: A surgical stapling device includes a housing assembly that is coupled to a tool assembly by a flexible elongate body that having an outer tube, a middle tube, and an inner cable. Each of the outer tube and the inner cable has a proximal end portion fixedly connected to the housing assembly and a distal end portion that is fixedly connected to the tool assembly. The middle tube is positioned within the outer tube about the inner cable and is movable from a retracted position to an advanced position to operate the tool assembly.

Abstract: An end effector of a surgical stapling apparatus includes an anvil buttress and an anvil assembly. The anvil buttress has a proximal end portion including a strap. The anvil assembly includes an anvil body having a proximal end portion and a distal end portion. The proximal end portion has a tissue stop configured to prevent proximal tissue migration. The tissue stop includes a strap lock. The strap lock is configured to secure the strap of the anvil buttress to the anvil assembly to secure the anvil buttress to the anvil assembly.

Abstract: End effector position set point correction includes an instrument having an end effector and a control unit. In some embodiments, the control unit actuates the end effector to a first position, determines an actuation level, determines an offset based on the actuation level, adjusts a position set point based on the offset, and actuates the end effector to the adjusted position set point. In some embodiments, the control unit actuates the end effector, determines an actuation level, and determines whether the actuation level is above a threshold. In response to determining that the actuation level is above the threshold, the control unit determines a position of the end effector, identifies a nominal position associated with the determined position, determines an offset based on the nominal position and the determined position, adjusts a position set point based on the offset, and actuates the end effector to the adjusted position set point.

Abstract: A surgical instrument includes a staple cartridge that defines a stepped deck. The surgical instrument further includes a staple comprised of seamless unitary structure. The staple is configured to be formed and/or stamped from a sheet of material. The staple includes a base and staple legs. A staple drive surface is integrally formed in the base, and a sled is configured to directly contact the staple drive surface to directly drive the staple.

Abstract: A surgical device comprising a first jaw member, a second jaw member, a clamping member and a clamp apparatus is disclosed. The clamping member is slidably positioned to translate at least partially through the first jaw member. The clamping member engages the first jaw member and the second jaw member, and has a knife blade for cutting tissue. A flange of the clamping member is configured to engage a cam surface to pivot the second jaw member with respect to the first jaw member from an open position toward an approximated position. The clamp apparatus is movable from a retracted position to an advanced position for preventing a gap between proximal portions of the first jaw member and the second jaw member from exceeding a predetermined distance. The clamping member and the clamp apparatus are separately movable.

Abstract: Methods for applying one or more adjuncts to tissue are provided. In one embodiment, the method can include positioning an adjunct, e.g., using an adhesive, on one of first and second jaws of an end effector of a surgical stapler. In one embodiment, an attachment mechanism on the adjunct can prevent stretching of at least a portion of the adjunct. In other aspects, the adjunct can be maintained on the at least one jaw in a first state in which the adjunct is at least partially stretched over the at least one jaw, and actuation of the surgical stapler can cause the adjunct to transition from the first state to a second state such that the adjunct in the second state at least partially separates from the at least one jaw.

Abstract: The present invention aims to provide a staple reinforcement for a surgical stapler that can be used in surgical staplers of various sizes, is easily passed through ports, and is less likely to shift during operation of the surgical stapler. Provided is a staple reinforcement for a surgical stapler, including a fabric layer containing a bioabsorbable material and a sponge layer containing a water-soluble polymer, the fabric layer and the sponge layer being integrally laminated.

Abstract: Methods and devices are provided for promoting wound healing. In general, surgical staplers and stapler components are provided having a coating thereon that is configured to selectively control an interaction between at least one matrix metalloproteinase (MMP) inhibitor and an outer surface of the stapler or stapler component.

Abstract: Surgical methods involving cutting and sealing tissue include affixing a first adjunct material to tissue at a treatment site, such as by stapling the adjunct to tissue. A second adjunct material is applied to at least a portion of the first adjunct material such that the second adjunct material interacts with the first adjunct material to form a seal in an area of the tissue covered by at least one of the first and the second adjunct material. The resulting tissue sealing structure, which includes a combination of the two adjuncts, is believed to be superior to the sealing properties of either adjunct alone.

Abstract: A kit for a powered surgical instrument causes the performance of a homing initiation procedure prior to the connection of a connectable component to the powered surgical instrument. The kit includes a powered surgical instrument, and end effector for coupling to the powered surgical instrument, and a blister pack housing at least the powered surgical instrument.

Abstract: A method of implanting and securing an implantable flow connector in a body of a patient for providing communication of a first space within the body of the patient with a second space within the body of the patient. The method includes providing a flow connector having a lumen having a first orifice and a second orifice, inserting a retention device into the first space within the body, subsequently inserting the flow connector through an opening in the retention device so the second portion of the flow connector extends into the first space within the body and placing the second space within the body over the retention device.

Abstract: An anastomotic coupler is provided. A ring can include a plurality of receiving portions. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. The ring is aligned with the cartridge such that the receiving portions are aligned with the fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure and are received by the receiving portions such that the tubular structure is coupled with the ring.

Abstract: A surgical stapling device includes a reload assembly that includes a dual-detent system to retain a knife carrier of the reload assembly in a retracted position after the stapling device is fired. The dual detent system includes auxiliary and primary detents to improve the retention force of the knife carrier to minimize the likelihood of inadvertent readvancement of the knife carrier and annular knife.

Abstract: The present disclosure relates to adapter assemblies for use with and to electrically and mechanically interconnect electromechanical surgical devices and surgical reloads, and to surgical systems including handheld electromechanical surgical devices and adapter assemblies for connecting surgical reloads to the handheld electromechanical surgical devices.

Abstract: A system including an anoscope having a first channel extending along a longitudinal axis and a second channel positioned at an angle to the first channel. For hemorrhoid treatment, an elastic band ligation device is insertable into the second channel, the elastic band ligation device carrying an elastic band and having an advancer movable in a distal direction to dislodge the elastic band.

Abstract: Systems and methods and devices are provided for treating conditions such as heart failure and/or pulmonary hypertension by at least partially occluding flow through the superior vena cava for an interval spanning multiple cardiac cycles. A catheter with an occlusion device is provided along with a controller that actuates a drive mechanism to provide at least partial occlusion of the patients superior vena cava, which reduces cardiac filling pressures, and induces a favorable shift in the patients Frank-Starling curve towards healthy heart functionality and improved cardiac performance. The occlusion device may include a lumen obstructed by a relief valve that may permit fluid flow through the occlusion device to release an excessive build-up of pressure.

Abstract: Blood flow affecting implant and implantation thereof in superior vena cava, optionally including disintegration of endothelium layer and inducing tissue ingrowth within implant. Implant includes elongated body with optional tubular inner layer forming orifice, shapeable to final orifice diameter for restricting blood flowing therethrough to chosen average flow rate; and/or tubular outer layer provided coaxially around inner layer. Outer layer is formed of second material provided in elastically deformable state for facilitating elastic radial self¬expanding from collapsed diameter up to relaxed maximal expanded diameter greater than diameter of inner wall portion of superior vena cava. Inner layer is formed of first material, in plastically or elastically deformable state.

Abstract: Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to a medical device. The device can include an elongate core member having a distal portion configured to be intravascularly positioned at a treatment site within a blood vessel lumen, and an interventional element connected to the distal portion of the elongate core member. The interventional element includes a body that is expandable from a first configuration to a second configuration and an electrically conductive radiopaque marker coupled to the body. An electrically conductive lead has a distal portion electrically coupled to the radiopaque marker and a proximal portion configured to be electrically coupled to a current source.

Abstract: Provided herein are methods, compositions, and devices for occluding cavities or passageways in a patient, in particular cavities or passageways in the cardiovascular system of a patient, such as the LAA of a patient's heart. The methods, compositions, and devices can be used to percutaneously occlude the LAA, decreasing the risk of thromboembolic events associated with AF.

Abstract: A vaso-occlusive device is disclosed herein having a delivery configuration when restrained within a delivery catheter and a deployed configuration when released from the delivery catheter into an aneurysmal sac. The vaso-occlusive device includes a tubular structure and an elongated embolic element. The tubular structure is configured to form at least two nested sacks within the aneurysm, thereby creating a multi-layer scaffolding within the aneurysm sac. The elongate embolic element is coupled to proximal end of the tubular structure and is configured to fill an interior region of the multi-layer scaffolding when deployed into the aneurysmal sac. At least one of the two nested sacks can be inverted upon deployment. The tubular structure can include a tubular braided mesh.

Abstract: An embolization microcatheter is configured to deliver embolization particles to a target area and minimize or prevent embolization of a non-target area. The microcatheter includes a section, located between the distal and proximal ends of the microcatheter, having a skeleton formed of braided wires and a polymeric layer intercalated into and/or overlaying the skeleton. This section includes a plurality of axial slits, each slit having a smallest cross-sectional dimension configured to prevent outflow of the embolization particles.

Abstract: Disclosed is an intelligent femoral artery hemostasis device by compression, including a main body capable of automatic compression. The main body includes a compression mechanism and a pressing plate mechanism successively provided from bottom to top; a lift regulator is provided between the support column and the compression mechanism; the compression mechanism is further provided with a detector for bleeding detection; and the main body is further integrated with a power supply module, an operation module and a central processing module. This invention realizes automatic bleeding detection and automatic pressurizing, and ensures the integration and compactness of the device. The power supply module, the operation module and the central processing module are integrated in the main body, avoiding external connecting wires and making it convenient to use the device when the tourniquet works in a twining working condition.

Abstract: A multilayer smart tourniquet applied about a wound environment or injured tissue. The smart tourniquet can be supplied with sensors and micro heating and cooling units.

Abstract: The saw blade comprising a bar and a blade. The distal end of the bar formed with a distal end opening and a discharge port formed in at least one of the top and bottom faces that opens into the distal end opening, the discharge port for discharging debris. The bar is formed with a geometric feature for receiving a coupling member to hold the bar to the saw, the geometric feature being an opening that extends through the bar. The blade having a blade base disposed in the distal end opening of the bar and a blade crown that extends forward from the blade base and forward of the distal end of the bar.

Abstract: A dynamic trialing method generally allows a surgeon to perform a preliminary bone resection on the distal femur according to a curved or planar resection profile. With the curved resection profile, the distal-posterior femoral condyles may act as a femoral trial component after the preliminary bone resection. This may eliminate the need for a separate femoral trial component, reducing the cost and complexity of surgery. With the planar resection profile, shims or skid-like inserts that correlate to the distal-posterior condyles of the final insert may be attached to the distal femur after the preliminary bone resection to facilitate intraoperative trialing. The method and related components may also provide the ability of a surgeon to perform iterative intraoperative kinematic analysis and gap balancing, providing the surgeon the ability to perform necessary ligament and/or other soft tissue releases and fine tune the final implant positions based on data acquired during the surgery.

Abstract: In one embodiment, a cutting guide is disclosed for use in a surgical procedure to removed damaged tissue from a patient and form a recipient site configured and dimensioned to receive a donor graft. The cutting guide includes a first aim that abuts a section of the damaged tissue to be removed, and a second arm including a hole and a slot that receives a cutting implement, the first arm and the slot defining a distance therebetween corresponding to a desired dimension of the recipient site. In another embodiment, a cutting guide is disclosed for use in forming a donor graft from donor tissue. The cutting guide includes a body that receives the donor tissue, and a shaping member that is rotatably secured to the body. The shaping member includes at least one vane that shapes the donor tissue so as to form the donor graft.

Abstract: Apparatuses and methods for microfracture (e.g., forming a plurality of microfractures in a bone to encourage cartilage regeneration). Some of the present apparatuses and methods are configured to create microfractures with smaller transverse dimensions (e.g., diameters) and greater depths than previously known. Some of the present apparatuses and methods comprise a penetrator removal tab coupled to the penetrator and configured to retract the penetrator relative to the cannula.

Abstract: Described herein are examples of orthopedic drill bits and methods of preparing a bone of a living being for fixation. An example method includes coupling a drive attachment of a drill bit to a mounting attachment of a driver, and placing a guide at a desired location on the bone. The guide has an opening corresponding to an area of bone to be removed. The guide provides proper positioning and alignment for drilling a hole. With the guide in place, the method further includes aligning the drill bit with the opening on the guide and drilling a hole in the bone. Once the hole is drilled, the method includes de-coupling the drill bit from the driver, and bending the drill bit at the drive attachment while the drill bit is still in the bone. In some examples, additional method steps follow preparation of the hole.

Abstract: A device and method for perforating a dense bone layer. The device includes a vibration generator for generating mechanical vibration, in particular ultrasonic vibration, and an instrument with an elongated shaft and a distal end piece including a perforator. The distal end piece is arranged at a distal end of the shaft and the proximal end of the shaft is connected or connectable to the vibration generator. The perforator has the form of a solid or a hollow cylinder. The vibration generator, the shaft and the distal end piece are adapted to each other for the shaft to transmit, when connected to the activated vibration generator, mechanical vibration from the vibration generator to the distal end piece and for vibrating the perforator in a direction parallel to its cylinder axis.

Abstract: Disclosed is an instrument for balancing a knee. The instrument has a first plate (10) coupled to a second plate (50) by a plurality of adjusters (152A, 152B, 152C). The adjusters are actuatable to vary the gap between the first and second plates. Each adjuster is coupled to the second plate by a joint having at least two degrees of freedom. Also disclosed is an outrigger (300). The outrigger includes a body featuring a connection component configured to be received and held by a slot (34) of the instrument. The slot is arranged to align a blade of a surgical saw with a portion of a knee to be cut. Also disclosed is a method of balancing a knee using the instrument and a method of fabricating the instrument.

Abstract: According to one example, an adjustable cut guide for resecting a bone can include a base, a cam, an actuator, and an insert. The base can include a channel extending between a first end and a second end and a slot intersecting the channel. The cam can extend into the slot, and the cam can be coupled to the base within the slot to rotate between a first position and a. second position. The actuator can be disposed in the slot, where the actuator can be translatable by rotation of the cam between an extended position when the cam is in the first position and a retracted position when the cam is in the second position. The insert can be disposed within the channel of the base and the insert can be secured relative to the base by the actuator when the actuator is in the extended position.

Abstract: A humerus cutting assembly includes a guide frame having an attachment member adapted to be secured to a humerus adjacent to a humeral head. A cutting guide is releasably connected to the guide frame, the cutting guide configured to guide a tool in altering the humeral head. One or more inertial sensor units is on the cutting guide, the inertial sensor unit tracking an orientation of the cutting guide relative to the humerus based on the releasable connection between the cutting guide and the guide frame.

Abstract: Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to a medical device. The device can include an elongate core member having a distal portion configured to be intravascularly positioned at a treatment site within a blood vessel lumen, and an interventional element connected to the distal portion of the elongate core member. The interventional element includes a body that is expandable from a first configuration to a second configuration and an electrically conductive radiopaque marker coupled to the body. An electrically conductive lead has a distal portion electrically coupled to the radiopaque marker and a proximal portion configured to be electrically coupled to a current source.

Abstract: The devices and methods described herein relate to jointless construction of complex structures.

Abstract: A lithotripter is provided that includes a lithotripsy apparatus for treatment of a urinary tract stone by fragmentation. The lithotripsy apparatus includes a lithotripsy wave guide shaft configured to transmit an energy form to at least one urinary tract stone. The lithotripter includes a sensing device configured to provide signal data for determining optimal application of energy during treatment with the lithotripsy apparatus. The lithotripter includes a processor configured to collect the signal data and provide feedback to a user. The processor has a control logic configured to determine at least one of: a) if the lithotripsy wave guide shaft is in contact with a tissue; b) if the lithotripsy wave guide shaft is in contact with a stone; c) type of stone; d) if a user is applying force in excess of a predetermined threshold; and e) physical characteristics of a stone. A method is also provided.

Abstract: Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.

Abstract: Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the removal device. The removal device can have a core assembly that includes a hypotube coupled to a first electrical terminal and a pushwire coupled to a second electrical terminal, the pushwire extending through the hypotube lumen. An insulating layer separates the hypotube and the pushwire, and an interventional element is coupled to a distal end of the pushwire. The interventional element can be disposed adjacent to a thrombus. An electrical signal is delivered to the interventional element to promote adhesion of the thrombus to the interventional element. The electrical signal can optionally be a periodic waveform, and the total energy delivered can be between 0.75-24,000 mJ and the peak current delivered via the electrical signal can be between 0.5-5 mA.

Abstract: According to an aspect, an apparatus includes a handle portion having a first portion and a second portion, a distal portion disposed opposite the handle portion, the distal portion having a first connector contacting portion and a second connector contacting portion, the first connector contacting portion being configured to move with respect to the second connector contacting portion, the distal portion being configured to be disposed in a first configuration and a second configuration, the first connector contacting portion being disposed a first distance from the second connector contacting portion when the distal portion is in the first configuration, the first connector contacting portion being disposed a second distance from the second connector contacting portion when the distal portion is in the second configuration, the second distance being greater than the first distance, and a biasing member configured to bias the distal portion into the first configuration.

Abstract: A suction head for a vacuum-actuated surgical grasper includes a proximal portion, a distal portion extending from the proximal portion, the distal portion being flared so as to have an outer dimension that increases from a proximal end of the distal portion to a distal end of the distal portion, and an inner passage extending through the suction head, the inner passage including a proximal portion that extends through the proximal portion of the suction head and a distal portion that extends through the distal portion of the suction head, wherein the distal portion of the inner passage is also flared so as to have an inner dimension that increases from the proximal end of the distal portion of the suction head to the distal end of the distal portion of the suction head, wherein the distal portion of the inner passage also includes internal ribs configured to grip tissue.

Abstract: Microinvasive applications medical scissors include a first scissor blade (30) with a first cutting edge (35, 36) between a flank surface (33) and a beveled surface (37, 38), a relatively moveable second scissor blade (40) with a second cutting edge (45, 46) between a flank surface (43) and a beveled surface (47, 48), a guiding device (24) for the mechanical guiding such that the second cutting edge touches the first cutting edge at any time in a point of intersection (50). The guiding device is connectable to a shaft (16) of a microinvasive instrument (10). The cutting edges have respective parameters which increases several times and decreases several times along the second cutting edge. The parameters are the wedge angle (?1, ?2,) between the flank surface and the beveled surface or the cutting angle (?1, ?2) or the width (b1, b2) of the beveled surface.

Abstract: A surgical cutting tool for keyhole surgery comprises: a handle 2 at a proximal end of the tool; an elongate member 4 extending from the handle to a distal end of the tool; and a saw 6 at the distal end of the tool, the saw being supported by the elongate member 4. The elongate member 4 has a length allowing for insertion of the saw 6 into the body by a distance of at least 150 mm. The tool is arranged for insertion of the saw 6 into the body during keyhole surgery; and the saw 6 is able to cut bone when pressed against the bone.

Abstract: An assembly tool for use with an ultrasonic surgical instrument includes a body portion, a neck, and a head portion. The body portion includes a base and first and second legs extending from the base to define a receiving area therebetween. The neck is attached to the body portion and the head portion is attached to the neck. The head portion defines a central opening. The first and second legs of the body portion are configured to engage a portion of a housing of an ultrasonic surgical instrument received within the receiving area, and the head portion is configured to engage a rotation knob of the ultrasonic surgical instrument received within the central opening to rotationally fix the rotation knob relative to the housing. Kits including the assembly tool and methods of assembling an ultrasonic surgical instrument using the assembly tool are also provided.

Abstract: An ultrasonic electromechanical system for an ultrasonic electromechanical system may include an ultrasonic blade, a clamp arm disposed opposite the ultrasonic blade, an ultrasonic transducer acoustically coupled to the ultrasonic blade, in which the ultrasonic transducer is configured to oscillate the ultrasonic blade in response to a drive signal, and a control circuit coupled to the ultrasonic transducer. The control circuit can be configured to determine a position of a tissue clamped between the ultrasonic blade and the clamp arm, and control an amount of power of the drive signal based at least in part on the position of the tissue.

Abstract: An ultrasound transducer includes a transducer body configured to generate ultrasound vibration to vibrate a treatment portion that treats a living tissue. The transducer body includes a plurality of piezoelectric elements configured to alternately repeat expansion and contraction according to a supplied drive signal. The plurality of piezoelectric elements are integrally fastened in a state where the plurality of piezoelectric elements are stacked along a direction of expansion and contraction. The plurality of piezoelectric elements include a first piezoelectric element configured to expand at a first timing and contract at a second timing, and a second piezoelectric element whose expansion and contraction timings are different from expansion and contraction timings of the first piezoelectric element. The second piezoelectric element is arranged so that a polarization direction of the second piezoelectric element is a same as a polarization direction of an adjacent piezoelectric element.

Abstract: A catheter for dilating and/or destroying a stenosis in a vessel of a patient includes a catheter shaft having a cavity, at least one first active element within the cavity fixedly connected to a wall delimiting the cavity, and at least one radially protruding scoring element arranged on the outside of the catheter shaft at the cavity for exerting a pressure force on a stenosis in a vessel. The at least one first active element is configured to react to an axially movable element by radially expanding the catheter shaft and thereby radially expanding the at least one radially protruding scoring element.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes a tube extending axially along the catheter. A junction box housing is located at a distal end of the tube. An elongate body extends distally from the junction box housing. The elongate body is sized and shaped to be received in the body lumen. A gear assembly is disposed in the junction box housing. The gear assembly engages the elongate body for rotating the elongate body. A tissue-removing element is mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen.

Abstract: A window dressing includes a primary layer having a window for viewing a catheter insertion site. The primary layer includes an adhesive layer on a lower, skin-contacting face of the primary layer. A transparent layer covers the window and adheres to the upper surface of the primary layer. An ultrasonic transmission layer is positioned below the primary layer, where the transmission layer comprises a layer of hydrogel. A support structure has a stiffness that is greater than the primary layer and has an adhesive layer on the lower surface of the support structure. The support structure adhesive layer adheres the support structure to the upper surface of the primary layer.

Abstract: Trocar retractor apparatus and methods for use are described where an apparatus for positioning an instrument may generally include a substrate having a first surface and a second surface opposite to the first surface, an instrument positioning guide projecting from the first surface of the substrate, and one or more suction assemblies positioned along the second surface and in fluid communication with an interior of the substrate. The one or more suction assemblies may be attachable to a tissue region via a vacuum force applied through the one or more suction assemblies. The apparatus may also have the substrate configured to maintain a predetermined configuration when the vacuum force is applied.

Abstract: Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and various stabilizing mechanisms surrounding the tubular body, sized and configured to stabilize and retain the retractor within the orifice. The stabilizing embodiments described herein are useful in all natural orifices and are of particular use in the vaginal surgery.