Abstract: A seal shield system protects and preserves seal functionality within a cannula during usage while maintaining existing fluid management and reduced drag. The seal shield system includes an end cap with an aperture extending therethrough, a cannula body extending distally from the end cap, a seal shield connected to the end cap, the seal shield having a first thickness, and one or more seals connected to the seal shield such that the seal shield is connected between the end cap and the one or more seals, one of the one or more seals having a second thickness. The first thickness is smaller than the second thickness.

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: A tissue guard for insertion within an access device disposed within an operating cavity includes a base section defining open proximal and distal ends and a lumen extending therethrough between the open proximal end and the open distal end. The base section includes one or more openings in a side thereof in fluid communication with the lumen. The proximal end of the base section includes an evacuation ring in fluid communication with the lumen. A tissue cuff is configured to encapsulate the base section and is selectively moveable between a distal position for facilitating insertion of the tissue guard within an access device disposed within a tissue opening in an operating cavity and a proximal position wherein the tissue cuff encloses the one or more openings to form an evacuation channel between the one or more openings and the evacuation ring to facilitate fluid evacuation from the operating cavity.

Abstract: A device and method for application of a cervical cerclage suture to a patient's cervix is disclosed. The device includes a housing having a first end and a second end spaced from the first end and defining an internal passageway. The device includes a retractable claw having a shaft slidable in the passageway and comprising a plurality of spaced flexible fingers that hold and release the cerclage suture. Each flexible finger may have a through-hole for receiving the cerclage suture, and may have a radial slit in communication with the through-hole and through which the cerclage suture is releasable from each finger. The claw is movable in the housing between a retracted state and an extended state relative to the housing. The shaft is operatively connected to the claw to move the claw axially relative to the housing.

Abstract: According to some embodiments, a method of treating a skin surface of a subject comprises heating a skin surface, abrading native skin tissue of a subject using a microdermabrasion device, wherein using the microdermabrasion device comprises moving the microdermabrasion device relative to the skin surface while simultaneously delivering at least one treatment fluid to the skin surface being treated and cooling the abraded skin surface.

Abstract: A device, kit, and method for the treatment of anatomical joint dysfunctions, and more particularly, to a spring hinge comprising: a primary coil spring having a helical structure with a central cavity, wherein the primary coil spring forms a plurality of spirals layered against one another when the primary coil spring is in an unexpanded state; wherein the primary coil spring comprises surfaces that are configured to nest against each other to resist translational or shearing movement between adjoining spiral layers.

Abstract: Implants and methods for stabilizing bone fractures are provided. In one embodiment, the implants are spheres. In another embodiment, the implants are rods. The rods can be used to stabilize peripheral portions of a bone fracture. The rods can be shaped and configured to correspond to the shape of a region of bone against which the rod will be deployed. The rods can be provided with surface features for engaging adjacent rods and/or adjacent regions of bone to further stabilize the rods. The spheres can be inserted to fill a remaining volume of the fracture cavity. The implants can be made from orthobiologic materials.

Abstract: The present invention provides a deformable body (2), wherein the deformable body comprises a force application surface (12) opposite a bone contact surface (52) to be pressed against periosteum of a bone surface (52) of a bone such that the bone contact surface adapts its shape to the shape of the bone surface, wherein the deformable body comprises one or more through-going openings (3) and/or one or more fixation locations (34) arranged to receive a fixation element such as as screw (20), and wherein the deformable body comprises an anaesthetic that is released from or through the bone contact surface. The anaesthetic can be bupivicaine, liposome bupivacaine, lidocaine or levobupivacaine. The anaesthetic can be arranged in one or more compartments (6, 7) which have different release rates. The screw can comprise a detent or rim to mate with the deformable body. A sleeve (80) can be arranged in the opening (3) to receive the screw.

Abstract: A guiding device for fixing flexible blades of spinal implants, which includes a guide device for transfixing flexible blades (1) that constitute the platforms (13) and (14), which have a box-shaped side, where the set of flexible blades (3) crosses and slides, and the other side has a hole (16) for its fixation to the double intermediate connector (5), which bears a pedicle screw (7); said set of flexible blades (3) being formed by two blades (4), overlapped, provided with longitudinal openings (9), through which they are joined by means of a fixing device (11), which allow them to slide over each other.

Abstract: Connector assemblies, systems, and methods thereof. One or more modular connectors has a first portion that clamps to a first rod in an existing construct and a second portion that clamps to a second rod in a new construct such that the new construct can be extended from the existing construct.

Abstract: Various embodiments of unilateral implant holders and related methods are disclosed herein. An exemplary unilateral implant holder can include a surgical instrument that includes a unilateral locking mechanism arranged at a distal end of the instrument for rigidly holding onto a unilateral portion of the implant. The locking mechanism can be configured to lock onto a unilateral portion of the implant such that access to the implant is not blocked. By engaging the instrument's locking mechanism with a counterpart locking interface defined in an implant, sufficient clamping force can be applied by the locking mechanism to resist multi-directional forces exerted on the implant during a surgical procedure. The surgical instrument can be a stand-alone unilateral implant holder. The surgical instrument can be configured to perform a surgical task while concurrently holding the implant in place using the unilateral locking mechanism.

Abstract: The present disclosure is directed to a method of surgical repair utilizing a continuous compression staple for an orthopedic injury site having a long bone fracture defining a fracture boundary between a first bone fragment and a second bone fragment. The method can include the steps of aligning the fragments, applying a temporary compressive force to the aligned fragments, inserting a compression staple in a tensioned state into the first and second bone fragments such that it traverses the fracture boundary, releasing tension in the compression staple such that the staple exerts a continuous compressive force to the first and second bone fragments, and securing a neutralization implant to the long bone. The disclosure further includes kits and systems for performing the disclosed surgical methods.

Abstract: A fastener guide that includes a body. The body includes a through-bore configured for receiving a fastener and an end configured for contacting a bone plate. The fastener guide further includes at least one member configured for contacting and retaining the fastener within the body.

Abstract: A driven fastener guide for guiding a fastener into a hole of a bone plate. The driven fastener guide includes an elongated driver configured for connecting to a drill and a fastener guide member operably connected to the elongated driver. The fastener guide member includes a split body and a through-bore configured for receiving the fastener. The fastener guide member is configured for aligning the fastener relative to the hole of the bone plate.

Abstract: In order to apply, with a simple and easy means, proper pressure between bone segments spaced apart as a result of osteotomy or a bone fracture, without lowering the fixing force at the screw meshing portion, without increasing a dead space, and without increasing the thickness of the plate, the present invention provides a bone plate having an upper face, which is to be in contact with bone, a lower face, which is to be in contact with the bone, and a plurality of holes arranged to receive bone screws and connecting the upper face and the lower face. In at least one of the holes, a portion of an edge, on the upper face, of the hole is formed so as to be raised in the form of a protrusion higher than the upper face around the hole.

Abstract: A rib implant securable to first and second rib portions of a rib. The rib implant can include a body, a first porous stem, and a second porous stem. The body can be configured to span a first rib portion of a rib and a second rib portion of the rib. The first porous stem can extend from the body and the first porous stem can be insertable into a first intramedullary canal of the first rib portion. The second porous stem can extend from the body opposite the first porous stem. The second porous stem can be insertable into a second intramedullary canal of the second rib portion to, together with the first porous stem, secure the first rib portion and the second rib portion.

Abstract: The present embodiments include a cable cerclage system and method for the correction of fractures. The system and method can include a cable saddle including first and second loops extending from an upper surface thereof, the first and second loops including apertures extending therethrough and sized and shaped to receive a cerclage cable therethrough. The present embodiments are also directed to a cable cerclage system including at least one cable link, the cable link having a through-hole extending therethrough from a first end to a second end and including a first coupling member at a first and a second coupling member at a second end. The first coupling member of a first cable link is configured to couple to the second coupling member of an adjacent second cable link so that the through-holes of the first and second cable links align to form an elongated cerclage cable passageway.

Abstract: A bone closure assembly that includes a buckle and a strap having a first end fixedly attached to the buckle. The strap is configured for looping around bone portions. The bone closure assembly also includes a locking cap removably connected to the buckle. The locking cap is configured for securing the strap within the buckle to secure the bone portions together.

Abstract: An improved cannulated aspiration screw device and method of use thereof for removal of, inter alia, bone marrow from a patient's bone. The cannulated aspiration screw device includes a shaft at its proximate end and a drilling dip section at its distal end and has a removable insert, that when inserted in the cannulated aspiration screw device at is proximate end prevents the flow of materials into and through the cannulated aspiration screw device while the device is being screwed into the bone. Once the cannulated aspiration screw device is screwed in place, the removable insert is removed, and an aspiration device (such as a surgical syringe) is then connected at the proximate end of the cannulated aspiration screw device (generally utilizing a connector) and aspiration is then performed using the aspiration device.

Abstract: A wire tensioner tip includes a body having a first extension and a second extension spaced apart to define a ring slot. An engagement body is disposed within the ring receiving slot. The engagement body includes one or more projections configured to engage an outer surface of a ring positioned within the ring receiving slot. A coupling element extends from the body and is configured to couple the body to a wire tensioner.

Abstract: Disclosed is a system and method for tracking an instrument. The instrument may be tracked with one or more trackable members. The trackable members may be held relative to a handle to which the instrument is attached.

Abstract: A delivery system includes a first instrument having an outer sleeve defining a passageway. The first instrument includes an inner sleeve having a first end disposed in the passageway and a second end including a first mating element. The inner sleeve defines a channel. A second instrument includes a hollow shaft disposed in the channel and a handle coupled to the shaft. The handle includes a body and a second mating element extending from the body. The second mating element is configured to engage the first mating element to secure the second instrument to the first instrument. Methods are disclosed.

Abstract: A surgical instrument comprises a shaft assembly comprising a shaft and an end effector coupled to a distal end of the shaft; a handle assembly coupled to a proximal end of the shaft; a battery assembly coupled to the handle assembly; a radio frequency (RF) energy output powered by the battery assembly and configured to apply RF energy to a tissue; an ultrasonic energy output powered by the battery assembly and configured to apply ultrasonic energy to the tissue; and a controller configured to, based at least in part on a measured tissue characteristic, start application of RF energy by the RF energy output or application of ultrasonic energy by the ultrasonic energy output at a first time.

Abstract: Various embodiments of the present disclosure can include a medical device for providing therapy to heart tissue. The medical device can comprise a balloon, a movable manifold, wherein the movable manifold comprises a first plurality of openings and the movable manifold is inside the balloon and the movable manifold is configured to distribute a fluid within the balloon, an elongate shaft with a proximal end portion and a distal end portion, wherein the distal end portion of the elongate shaft is coupled with the balloon, a central lumen, wherein the movable manifold is movably coupled with the central lumen, and a supply lumen comprising a supply lumen proximal end and a supply lumen distal end, wherein the supply lumen is longitudinally movable and in fluid communication with the movable manifold, wherein the movable manifold is configured to move longitudinally in response to an actuation of the supply lumen proximal end.

Abstract: The instant disclosure relates to electrophysiology catheters for tissue ablation. In particular, the instant disclosure relates to a cryogenic ablation balloon with a catheter handle that interfaces with capital equipment.

Abstract: The instant disclosure relates to electrophysiology catheter for tissue ablation. In particular, the instant disclosure relates to a system controller for facilitating an ablation therapy at a cryogenic ablation balloon.

Abstract: A medical heater includes: a heat generating portion that is made of a material containing nickel, the heat generating portion being configured to generate heat when energized; and a passivation film that is made of nickel fluoride, the passivation film being configured to cover at least a part of a surface of the heat generating portion.

Abstract: Provided is a catheter including a shaft having a distal end and a loop disposed near the distal end and configured to curl around a tissue and receive, via the shaft, energy for nerve denervation at least a portion of the tissue. The loop includes a body capable of bending to curl around the tissue an electrode disposed on the body and a substrate embedded in the body and separated from the electrode. The nerve denervation is performed at a loop temperature of 48° C. to 65° C. for 70 to 150 seconds.

Abstract: A medical heater includes: a substrate having a first plate surface and a second plate surface; and a conductive portion provided on the first plate surface. The substrate is folded back in a state where the first plate surface forms an outer surface in a longitudinal direction of the substrate, the conductive portion includes: a pair of connecting portions to which wiring members are electrically connected; a heat generating portion; and an electric path portion that is connected from the connecting portions to the heat generating portion, and the heat generating portion has a configuration in which a resistance value of the heat generating portion is higher than resistance values of other parts in the conductive portion, and a thickness measurement of at least a part of the heat generating portion is smaller than thickness measurements of other parts in the conductive portion.

Abstract: An energy generator includes a connector port configured to couple to an electrosurgical instrument including an electrode having a polymeric dielectric coating; a power converter configured to generate energy; and a sensor coupled to the power converter and configured to sense a parameter of the energy. The energy generator also includes a controller coupled to the sensor and the power converter. The controller is configured to: control the power converter to output energy to modify an electrical property of the polymeric dielectric coating; and determine whether the electrical property of the polymeric dielectric coating has been sufficiently modified by the energy.

Abstract: A surgical instrument, system and method for adjusting a compression force applied by a surgical instrument are disclosed. The method includes determining tissue impedance of tissue in contact with an end effector of the surgical instrument, determining a tissue type based on the tissue impedance, selecting a first energy modality to deliver to the surgical instrument, generating a first signal waveform based on the first energy modality, selecting a second energy modality to deliver to the surgical instrument, generating a second signal waveform based on the second energy modality, outputting the first and second signal waveform to deliver energy to the end effector, and adjusting a compression force applied by the end effector by changing a size of a gap between the tissue and the clamp arm based on a proportion of the first signal waveform to the second signal waveform.

Abstract: A method of manufacturing a catheter tip by electroplating a conductive material over an insert comprising a negative to a domelike shape thereby forming a shape of the catheter tip comprising a dome with the domelike shape, selectively positioning a plurality of irrigation holes between outer and inner surfaces of the catheter tip, removing the insert thereby leaving the catheter tip and the plurality of irrigation holes, and electropolishing the catheter tip. In other examples, the insert is not removed and instead the step of electroplating causes the insert to be encapsulated with the conductive material thereby forming the catheter tip.

Abstract: A method of non-thermally ablating undesirable tissue in the body by application of pulsed, bipolar, instant charge reversal electrical fields of sufficient energy to cause complete and immediate cell membrane rupture and destruction. Energy is delivered through radio frequency pulses of particular frequencies, wave characteristics, pulse widths and pulse numbers, such that enhanced physical stresses are placed on the cell membrane to cause its immediate and complete destruction thereby spilling the entire cell content and membrane constituents into, the extracellular space without denaturing proteins so as to enable an immunological response to destroy and remove the target tissue and similarly marked tissue elsewhere in the subject.

Abstract: A method of delivering tumor treating electric fields to a body of a patient. The method includes scanning the body of the patient for identifying at least two tumor-filled areas. The method further includes determining a spatial relationship in between the at least two tumor-filled areas. The method further includes arranging an array of insulated electrode elements on the body of the patient. The method further includes implementing at least two subarray firing configurations for the array of insulated electrode elements to treat the at least two tumor-filled areas depending at least in part upon the spatial relationship in between the at least two tumor-filled areas such that each subarray firing configuration treats a respective tumor-filled area.

Abstract: An arthroscopy system includes both a motorized handpiece and a detachable probe. The motorized handpiece includes a rotating driver which is configured to engage a rotatable drive coupling within a hub of the probe. The probe has a shaft with an articulating distal region, and the rotatable drive coupling is configured to convert the rotary motion of the rotating driver to an articulating motion within the articulating region of the probe.

Abstract: A surgical instrument includes a temperature sensor and a control unit that is operable to deactivate an end effector of the surgical instrument. In some versions the temperature sensor detects the temperature of a transducer, while in others the temperature sensor detects the temperature of the end effector. The surgical instrument may also include a trigger and a trigger position sensor. A force sensor or a position sensor may be included to determine the force and/or position of the transmission assembly. The end effector may also include a force sensor or a micro coil. A surgical instrument having a sensor may be included in a surgical system that includes a control unit and a remote controller. In some instances the remote controller may have one or more force-feedback components. In addition, a device interface and a surgeon interface may be included to remotely adjust the settings of the control unit.

Abstract: A surgical instrument comprises first and second jaws movable relative to each other between open and closed positions, a cutting electrode with a cutting surface for tissue dissection and at least one sealing electrode for sealing or coagulating tissue. The cutting electrode includes one or more insulation layers for securing the cutting electrode to one of the jaws and for protecting the jaws from the heat and energy generated at the cutting surface during operation. An actuator mechanism is coupled to the first and second jaws for moving the jaws between the open and closed positions. At least one portion of the actuator mechanism comprises a conductive pathway for electrically coupling the cutting and/or sealing electrode(s) to a source of energy. Thus, the mechanical components of the actuator mechanism include electrically conductive pathways to reduce the number of conductors extending through the device, thereby providing a more compact and maneuverable instrument.

Abstract: A surgical instrument comprises a controller configured to control application of RF or ultrasonic energy at a low level when displacement or intensity of a button is above a first threshold but below a second threshold higher than the first threshold, and control application of RF or ultrasonic energy at a high level when the displacement or intensity exceeds the second threshold. In another aspect, a surgical instrument comprises a first sensor configured to measure a tissue characteristic at a first location, a second sensor configured to measure the tissue characteristic at a second location, and a controller configured to, based at least in part on the measured tissue characteristic at the first location and the second location, control application of RF or ultrasonic energy.

Abstract: An apparatus includes a body, a shaft assembly, an end effector, and an articulation section. The articulation section is longitudinally interposed between a distal end of the shaft assembly and a proximal end of the end effector. The articulation section is configured to flex to thereby provide deflection of the end effector away from the longitudinal axis of the shaft assembly. The articulation section includes a first frame member, a second frame member, and a sleeve. The proximal end of the second frame member is proximal to the proximal end of the first frame member. The sleeve is disposed about the first and second frame members.

Abstract: A forceps includes a housing having a shaft. An end effector assembly operatively connects to a distal end of the shaft and includes a pair of first and second jaw members. One or both of the first and second jaw members is movable relative to the other jaw member from a clamping position to an open position. A resilient member operably couples to the first and second jaw members. The resilient member is configured to bias the first and second jaw members in the clamping position and provide a closure force on tissue disposed therebetween.

Abstract: A surgical instrument is provided and includes a housing having a shaft. An end effector assembly is operatively connected to a distal end of the shaft and has a pair of first and second jaw members that are movable relative to one another. A drive assembly operably couples to a handle assembly associated with the housing and is configured to impart movement of a respective jaw member when the handle assembly is actuated. A spring component operably associated with each of the jaw members is configured to provide a sealing force at the jaw members.

Abstract: A surgical instrument includes an end effector with opposing jaws that open and close relative to each other. The jaws each include a cam slot for receiving a cam pin. Translation of the pin through the cam slots opens and closes the jaws. The cam slots are shaped such that at least one of the jaws applies a grip force that is substantially proportional to a force applied to the pin to translate the pin through at least a portion of the slots (i.e., the ratio between force input and the resulting force output remains substantially the same as the pin travels through at least one portion of the slots). This design provides a constant mechanical advantage between the force applied to the pin and the force applied by the jaws, thereby allowing a user to more easily regulate the forces applied to tissue held by the jaws.

Abstract: A medical device includes an electrode shaft and an insulation tip. The electrode shaft is configured to deliver energy to a target site and includes an electrode shaft lumen configured to deliver fluid to the target site. The insulation tip is coupled to a distal tip of the electrode shaft. The insulation tip includes an insulation tip lumen fluidly connected to the electrode shaft lumen and configured to deliver fluid to the target site. The insulation tip covers an entirety of the distal tip of the electrode shaft.

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

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient and including a plurality of electrodes configured to contact tissue within the body. An electrical signal generator applies bipolar trains of pulses having a voltage amplitude of at least 200 V and having a duration of each of the bipolar pulses less than 20 ?s between at least one pair of the electrodes in contact with the tissue, thereby causing irreversible electroporation of the tissue between the at least one pair of the electrodes. One or more electrical sensors sense an energy dissipated between the at least one pair of the electrodes during the trains of the pulses. A controller controls electrical and temporal parameters of the trains of the pulses applied by the electrical signal generator, responsively to the one or more electrical sensors, so that the dissipated energy satisfies a predefined criterion.

Abstract: Methods, apparatus, and systems for medical procedures are disclosed herein and include receiving, at a location agnostic system and at a first time, a first plurality of electronic signals each from a respective plurality of electrodes of a catheter. A subset of electronic signals of the first plurality of electronic signals may be received at a location aware system. The location aware system may determine a location of the catheter within an intra-body organ. The location aware system may determine that the catheter is in contact with the tissue at the location, based on the subset of electronic signals and at least one tissue property at the location. A location agnostic system contact profile for the catheter may be generated based on determining, by the location aware system, that the catheter is in contact with the tissue at the location.

Abstract: An elongate medical device having a device longitudinal axis and a device distal region, the medical device comprising a balloon at the device distal region and having a balloon longitudinal axis, the balloon comprising a balloon inflatable portion with a first length configured to transition from a deflated state to an inflated state and includes a portion of the balloon proximal portion and a portion of the balloon distal portion, a balloon proximal portion with a second length, a balloon distal portion with a third length, wherein, in the inflated state, the balloon is symmetrical about the balloon longitudinal axis and the balloon comprises a first profile shape with a second length and a second profile shape with a third length, and wherein the balloon distal portion comprising the second profile shape comprises a tissue contacting surface where a substantial portion of the tissue contacting surface is concave.

Abstract: An apparatus includes a handle, a catheter, an end effector, and a deflection drive assembly. The end effector includes at least one electrode. The deflection drive assembly includes an input member, a translating assembly coupled to the end effector, and a rack and pinion assembly. The rack and pinion assembly is configured to drive the translating assembly to deflect the end effector away at an angle relative to the longitudinal axis and consists of a rack and a pinion. The rack and pinion assembly is configured to either transfer rotational motion of the pinion from the input member into linear motion of the rack to push distally or pull proximally the translating member; or transfer linear motion of the rack from the input member into rotational motion of the pinion to move a first end of the translating member proximally and a second end of the translating member distally.

Abstract: A flexible circuit including a first segment including a base section of the flexible circuit; a second segment including a lateral wall section; a transition section between the base and lateral wall sections, the transition section being at least partially positioned adjacent a shared region of the base and lateral wall sections; and one or more electrode regions including a respective electrode, the one or more electrode regions being positioned at least partially in the transition section and the second segment.

Abstract: A system and method are adapted for use to reduce the left atrium pressure by creating an inter-atrial shunt (IAS) between the left and right atrium, thereby reducing pulmonary congestion and resulting in a reduction in pulmonary congestion, thereby reducing symptomatic dyspnea and increasing the exercise capacity of treated patients.