Abstract: The devices and methods described herein relate to improved structures for removing obstructions from body lumens. Such devices have applicability in through-out the ho including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Abstract: A tissue specimen retrieval device includes a first shaft and a second shaft telescopically movable relative to the first shaft. The second shaft supports an end effector assembly at a distal end thereof and is movable relative to the first shaft between a retracted position, wherein the end effector assembly is disposed within the first shaft, and a deployed position, wherein the end effector assembly extends from the first shaft in an expanded configuration. The end effector assembly includes a bag brim having a wire support with first and second ends that operably engage the distal end of the second shaft. The bag brim is transitionable from a first collapsed configuration within the first shaft to an expanded configuration upon deployment therefrom. The wire support includes torsion springs disposed between the first and second ends that cooperate to facilitate expansion of the bag brim upon deployment from the first shaft.

Abstract: An ultrasonic instrument comprises a body, a shaft assembly, an ultrasonic blade, and a pivoting member. The shaft assembly extends distally from the body. The ultrasonic blade is positioned distal to the shaft assembly. The pivoting member is pivotable with respect to the blade from an open position to a closed position to thereby clamp tissue between the pivoting member and the blade. One or both of the shaft assembly or the pivoting member comprise a guide feature. The guide feature is configured to provide lateral alignment of the distal portion of the pivoting member with the blade as the pivoting member is pivoted to the closed position.

Abstract: A surgical clip applier comprising a rotatable clip cartridge is disclosed. The surgical clip applier comprises a lockout that at least locks out the crimping drive of the surgical clip applier when the rotatable clip cartridge is empty.

Abstract: A cutting instrument comprising: an outer tube comprising a distal end and a proximal end; an inner tube rotatably disposed within said outer tube, said inner tube comprising a distal end, a proximal end and a region intermediate said distal end and said proximal end, said region comprising a plurality of slits formed in said inner tube so as to render said region of said inner tube flexible; and a bellows disposed adjacent to said plurality of slits so as to render said region of said inner tube fluid-tight.

Abstract: A method of forming a component of an ultrasonic surgical instrument includes accessing a file including a digital model representing the component. The component includes a proximal portion and a distal portion. The proximal portion includes a contact portion. The distal portion includes an ultrasonic blade. The contact portion is configured to transmit ultrasonic vibrations to the ultrasonic blade when the component is acoustically coupled to a complementary portion of an acoustic waveguide of the ultrasonic surgical instrument. The file is used to fabricate the component via an additive manufacturing process. Once the component has been fabricated, the distal portion is secured to a distal end of the complementary portion of the acoustic waveguide.

Abstract: An ultrasonic instrument for use during a surgical procedure includes a body, a shaft assembly, an ultrasonic blade, and an actuation assembly. The body is configured to receive an ultrasonic transducer for selectively generating a first or a second predetermined oscillation. The shaft assembly projects from the body and includes an acoustic waveguide connected to the ultrasonic blade. The actuation assembly includes an activator ring and an activation mechanism. The activator ring is selectively movable along the body such that the activator ring is accessible to be gripped by an operator around an entirety of an outer circumferential surface of the activator ring. The activation mechanism is connected to the activator ring such that the activation mechanism selectively moves along the body in conjunction with the activator ring. At least a portion of the activation mechanism is configured to selectively direct the ultrasonic transducer to oscillate the ultrasonic blade.

Abstract: A surgical instrument is disclosed. The surgical instrument includes a handle assembly that includes a handle housing. The handle housing comprises two asymmetric portions, a first portion configured to support mechanical and electrical components of the surgical instrument and a second portion comprising a removable cover.

Abstract: An ultrasonic surgical instrument that includes a handle assembly including at least one user input feature; an ultrasonic transducer supported by the handle assembly, a shaft assembly configured to removably couple with the handle assembly, and a mechanical lockout assembly. The shaft assembly includes a distal end portion. The shaft assembly further includes an end effector extending distally from the distal end portion, and an ultrasonic waveguide configured to be acoustically coupled with the ultrasonic transducer. The mechanical lockout assembly is configured to move between at least an unlocked configuration and a locked configuration. In the locked configuration, the handle assembly and the shaft assembly are only partially coupled together physically preventing the user from activating the instrument using the user input feature.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body and a tissue-removing element 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. An inner liner is received within the elongate body and coupled to a handle at a proximal end of the inner liner. The inner liner defines a guidewire lumen. The inner liner isolates an interior of the guidewire lumen from the elongate body and tissue-removing element such that rotational and torsional forces are not transferred from the elongate body and tissue-removing element to the interior of the guidewire lumen when the elongate body and tissue-removing element are rotated during operation of the tissue-removing catheter.

Abstract: A needle array guide for a skin graft expansion apparatus includes: a lower side having openings; and guide channels respectively leading to the openings and converging closer toward one another as the guide channels approach the openings, the guide channels configured to receive a plurality of hollow needles, arranged in a needle array and having respective tips to be attachable to minced skin particles obtained from a skin graft, to thereby guide movement of the plurality of hollow needles when the plurality of hollow needles are being protruded from the openings toward the minced skin particles and when the plurality of hollow needles are being retracted toward the openings. The needle array guide may be included as part of a skin graft expansion apparatus that further comprises the needle array. The skin graft expansion apparatus may be included as part of a skin grafting system.

Abstract: Systems, instruments or devices, and methods or procedures are described in which a scalpet array is applied to a target site with the use of a pattern. The scalpet array comprises scalpets positioned on a device. Skin pixels are incised at the target site via application of a load through the scalpet array. A recipient site is prepared by positioning the pattern at the recipient site and applying the scalpet array to generate skin defects. The incised skin pixels are applied at the skin defects of the recipient site.

Abstract: The present invention provides a chest tube introducer which can be inserted without a need of surgical procedures. The chest tube introducer comprises a series of compartmentalized leakproof sealing devices, which is configured for safe introduction of the chest tube introducer minimizing a risk of pneumothorax.

Abstract: A catheter device (1) for providing access to a body cavity of a patient comprises a tube (10) and an inserting shell (11) arranged on the tube (10) and constituted to be fastened to an insertion guide (3) for inserting the catheter device (1) into a body opening (C) of a patient (P). Herein, the inserting shell (11) comprises an opening (111) into which a thread (300) of the insertion guide (3) is insertable for fastening the catheter device (1) to the insertion guide (3). In this way, a catheter device is provided which, in an easy and efficient manner, allows for the fastening to an insertion guide.

Abstract: A lead delivery system having a base for securing a lead delivery device to one or more anatomical structures of a patient and a lead advancer configured to incrementally advance a lead into a patient by a predefined amount.

Abstract: This disclosure relates to a cannula for a surgical instrument used for cutting selected tissue in a body cavity while under visual inspection. A kit containing the cannula and methods for performing surgical procedures using the cannula are also described.

Abstract: A cannula assembly includes a housing supporting a seal assembly, a cannula shaft extending from the housing, and a sleeve positioned about the cannula shaft including an inner fixation device that is supported on a distal end of the cannula shaft. The inner fixation device includes an anchor member that is deployable within a body cavity to obstruct withdrawal of the cannula assembly from within the body cavity. The anchor member is formed of a material that will deactivate or allow removal of the catheter assembly from the body cavity when the anchor member is deployed and an excessive force is applied to the cannula assembly to prevent ripping or tearing of tissue.

Abstract: A dilating cannula includes a radially expandable flange and an expandable shaft. The radially expandable flange is disposed at a proximal end portion of the dilating cannula and includes two or more sectors that are each independently movable. The expandable shaft extends from the proximal end portion to a distal end portion of the dilating cannula and defines an inner passageway of the dilating cannula and includes two or more arms. A first branch of the two or more arms extends from one end of the base section and a second branch of the two or more arms extends from another end of the base section. The first branch is connected to a first sector of the two or more sectors of the radially expandable flange and the second branch is connected to a second, different sector of the two or more sectors of the radially expandable flange.

Abstract: The present disclosure provides devices and methods for insufflating abdomens of subjects under direct visualization. Such devices and methods, in some implementations, include features for cleaning the devices, and certain implementations of the methods permit procedures wherein it is not necessary to use a typical obturator to place a cannula, resulting in safer procedures.

Abstract: A connection device attached to one structure includes structures having adjacent slots that are alligned to receive and permit placement of an elongated member, and are subsequently relatively movable to retain the elongated member to restrict or occlude the adjacent slot opening restricting removal, and further provides a sheer force between the structures each having the slot to receive the elongated member, to engage and secure the outer surface of a tubular member received into an aperture common through 2 adjacent members, each member aperture having an axis parallel to and offset from the other, wherein rotation of one of the 2 members causes the surface of the offset aperture and the surface of the non-offset aperture to apply a shear force and/or friction to engage and retain the tubular member. Access to the aperture is provided by slot extending from the aperture to the member periphery.

Abstract: Disclosed are systems, methods, and devices for percutaneous retrieval of objects, such as endovascular devices, from a subject's internal body space. The present inventions have vascular, non-vascular (gastrointestinal), and surgical (laproscopic) applications. The inventions include the use of a retrieval end having one or more compressed states and an expanded state, the retrieval end adopting the expanded state when the retrieval end is deployed into a subject's internal body space, the retrieval end having a mouth through which an object can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state so that the object can be enclosed within the interior space after passing through the mouth of the retrieval end.

Abstract: A method for treating a spine comprising the steps of: connecting at least one first fastener that defines an implant cavity with at least one vertebral level of a first portion of vertebrae; connecting at least one second fastener with at least one vertebral level of a second portion of the vertebrae; manipulating the vertebrae; manipulating a spinal rod to a selected configuration; connecting the spinal rod with the at least one first fastener such that the spinal rod is disposed at a selected position with the implant cavity; connecting a tether to a second fastener and the spinal rod; and reducing the spinal rod to a selected position relative to the second fastener with the tether. Systems, spinal constructs and surgical instruments are disclosed.

Abstract: The present invention generally is directed toward a spinal fixation system whereby a coupling element allows the physician to selectively lock or unlock either the connection between the coupling element and a fastener, such as to allow for repositioning of the coupling element, or the connection between the coupling element and an elongate rod. The locking or unlocking of these connections may be made independently and as desired by the physician.

Abstract: A pivotal bone anchor assembly includes a receiver having a receiver channel configured for receiving an elongate rod, an axial bore with inwardly protruding structures, and horizontally and circumferentially-extending tool engagement grooves formed into upper side outer surfaces of the receiver. The assembly also includes a shank having a proximal capture portion positionable into a lower portion of the axial bore below the inwardly protruding structures. The assembly further includes an insert positionable into the axial bore above the proximal capture portion of the shank, with the insert having an insert channel also configured for receiving the elongate rod, a bottom surface configured for frictional engagement with a partially spherical upper surface of the proximal capture portion, and vertically-elongate grooves formed into outer side surfaces of the insert and configured for receiving the inwardly protruding structures when the insert channel is co-aligned with the receiver channel.

Abstract: Tether clamping assemblies, such as clamping assemblies used to clamp a tether about a spinal feature to assist in spinal fixation, and related methods and systems. In some embodiments, the assembly may comprise a tether configured to engage a bone or other anatomical feature, an inner coupling piece, and an outer coupling piece. A first passage may be at least partially defined by an inner surface of the outer coupling piece and an outer surface of the inner coupling piece. The first passage may be configured such that the tether can be clamped in between the inner surface and the outer surface to allow the tether to move through the first passage in a first direction and lock the tether in place. The inner and outer surfaces preferably differ in surface roughness to facilitate automatic or self-locking of the tether in the assembly.

Abstract: Surgical instruments to properly implant interspinous/interlaminar stabilization devices, and instrumentation kits containing these instruments are provided. These surgical instruments may be configured to be disposable, or for single patient use, and therefore do not require resterilization for reuse, thus reducing risk of infection as a result of reuse and logistical costs associated with these resterilization procedures.

Abstract: A method includes providing first and second instruments. First and second fasteners are attached with vertebrae. First fasteners are connected with first and second constructs. Second fasteners are connected with a third and fourth constructs. The first construct is connected with a body of the first instrument and the second construct is connected with another body of the first instrument. The third construct is connected with a body of the second instrument and the fourth construct is connected with another body of the second instrument. Joints of the instruments are tightened. At least one of the instruments is selectively distracted. At least one of the instruments is selectively compressed. The spinal constructs are removed from the fasteners. The first fasteners are connected with a first spinal rod. The second fasteners are connected with a second spinal rod. In some embodiments, spinal constructs, implants, systems and kits are disclosed.

Abstract: A system for securing a flexible member to a vertebra includes a flexible member, a fixation member, and an inserter. The flexible member includes two ends. The fixation member includes a head and a shank that defines a longitudinal axis of the fixation member. The head defines a slot that passes through the head orthogonal to the longitudinal axis. The slot receives a portion of the flexible member. The inserter includes a handle and a tubular member that has proximal and distal end portion. The proximal end portion is attached to the handle and the distal end portion extends from the handle. The tubular member defines a passage between the proximal and distal end portions. The distal end portion includes a couple for receiving the head of the fixation member with the portion of the flexible member received in the slot of the flexible member.

Abstract: This disclosure describes example embodiments of rod reduction instrumentation and other rod and vertebrae manipulation instruments. The rod reducers can be used during the installation of a rod based surgical fixation system to help urge the rod into the fixation anchors. The reducers described provide various configurations delivering large reduction distance capabilities, strong controlled reduction coupled with an ability to quickly advance the reducer if desired, and reduction of bulk through the surgical corridor.

Abstract: A device for straightening and stabilizing the vertebral column, particularly for stabilizing broken vertebrae, includes a supporting implant which is plastically expandable by internal pressure. The supporting implant can be placed into the interior of a vertebral body which has been fractured under compression or between adjacent vertebral bodies. A pressure balloon to which pressure fluid can be admitted may be arranged in the interior of the supporting implant for producing the internal pressure.

Abstract: An implant can enable the fixing of at least two adjacent bone elements in a rapid, reliable and low-invasive manner. This implant includes a curved and hollow rod allowing the use of a sealing element. A method for fixing at least two adjacent bone elements implements this implant. This method can be especially suitable for the solidarization of at least two vertebrae for the realization of an arthrodesis.

Abstract: Intramedullary fixation assemblies (4, 8) and intramedullary fixation devices (1, 24) can be used in orthopaedic surgery for the fixation of bone fractures. Also disclosed is an insertion device (30) for inserting an intramedullary fixation device, and a method of fixing a bone fracture. The fixation devices are preferably for addressing fractures of the distal radius, and are preferably styloid nails. The styloid nails preferably have a head portion that can accept up to three bone screws; one of the bone screws is designed to extend across a fracture line between a proximal and a distal bone fragment while the other bone screws are designed to be retained in the distal bone fragment.

Abstract: An orthopaedic implant includes a support body with a first side having a first inner surface and a second side connected to the first side and having a second inner surface and an outer surface. The first inner surface and the second inner surface each have channels formed within that combine to form a reservoir within the support body. A bone ingrowth layer is attached to the outer surface of the second side.

Abstract: A surgical instrument includes an ultrasonic transducer, a shaft extending distally along a shaft axis, a waveguide acoustically coupled with the ultrasonic transducer and extending distally through the shaft, and an end effector at a distal end of the shaft. The end effector includes an ultrasonic blade acoustically coupled with the waveguide. A nodal support element is arranged within a distal portion of the shaft and encircles the waveguide at a distal-most acoustic node of the waveguide. The nodal support element includes a support portion aligned with the distal-most acoustic node, and a sealing portion extending axially from the support portion. The support portion engages an inner surface of the shaft and is configured to support the waveguide in coaxial alignment with the shaft axis. The sealing portion sealingly engages the inner surface of the shaft and is configured to prevent proximal ingress of fluid through the shaft.

Abstract: A system for monitoring electrical activity at an ablation site where the system includes an ablation device having an elongate, flexible shaft and a distal treatment section for delivering ablation energy to target tissue, a first electrode mounted on the distal treatment section, a second electrode mounted on the distal treatment section where the second electrode is spaced from the first electrode a distance (D1), a plurality of conducting elements extending along the distal treatment section and being connected to the first electrode and the second electrode, the plurality of conducting elements for connecting the first electrode and the second electrode to an electrophysiological recording system, a processing device programmed to receive the electrical information from the ablation site from the first electrode and the second electrode, and an electrophysiological recording system.

Abstract: A cryoablation method, system, and device that allows for real-time and accurate assessment and monitoring of PV occlusion and lesion formation without the need for expensive imaging systems and without patient exposure to radiation. The system includes a cryoballoon catheter with a cryoballoon, a distal electrode, a proximal electrode, and a temperature sensor. Impedance measurements recorded by the electrodes may be used to predict ice formation, quality of pulmonary vein occlusion, and lesion formation.

Abstract: An electrosurgical system for tissue cauterization may include a user interface, a front panel display, an electrosurgical generator, a power supply of the electrosurgical generator, a system control of the electrosurgical generator, an RF system of the electrosurgical generator, and a bipolar forceps assembly. The electrosurgical system may be configured to cauterize a tissue. A tissue cauterization may include system activation, tissue impedance analysis, establishment of tissue cauterization parameters, monitoring and adjustment of tissue cauterization, and system deactivation. The establishment of tissue cauterization parameters may include establishing a tissue cauterization curve configured to minimize an amount of time required to cauterize a tissue.

Abstract: A device for compressing a renal artery prior to delivery of radiofrequency ablative energy to the renal nerves. The device includes a stent structure with a focal region that expands outwards to place the RF electrodes located on the stent structure in close proximity to the renal nerves. A covering is applied to the stent structure to prevent intimal hyperplasia.

Abstract: Nanosecond pulsed electric field (nsPEF) treatments of a tumor are adjusted based on a size and type of the tumor to stimulate an immune response against the tumor and other tumors in the subject. Calreticulin expression on tumor cells can be detected to confirm treatment. An immune response biomarker can be measured, and further nsPEF treatments can be performed if needed to stimulate or further stimulate the immune response. Cancers that have metastasized may be treated by directly treating a tumor that is most accessible. The treatment can be combined with CD47-blocking antibodies, doxorubicin, CTLA-4-blocking antibodies, and/or PD-1-blocking antibodies. Electrical characteristics of nsPEF treatments can be based on the size, type, and/or strength of tumors and/or a quantity of tumors in the subject.

Abstract: A method for treating surface tissue of a patient includes: providing an electrode having a contact surface, wherein the contact surface has a curved profile; placing the contact surface in contact with surface tissue of the patient; and sliding the contact surface across and in contact with the surface tissue while applying electrosurgical currents to the surface tissue via the contact surface to thereby vaporize and ablate the surface tissue and form a treated band of the surface tissue.

Abstract: Various forms are directed to systems and methods for dissection and coagulation of tissue. A method for detecting a short circuit in a surgical system configured to apply radio frequency energy and ultrasonic energy to a target surgical site that includes delivering radio frequency (RF) energy to an electrode of a surgical instrument, transitioning from delivering the RF energy to delivering ultrasonic energy to an ultrasonic blade of the surgical instrument, delivering an exploratory ultrasonic pulse to the ultrasonic blade, measuring an ultrasonic property of tissue engaged by the surgical instrument, wherein the ultrasonic property is associated with the exploratory ultrasonic pulse, determining whether the measured ultrasonic property is consistent with a behavior of low impedance tissue, and delivering ultrasonic energy to the ultrasonic blade to cut the tissue upon determining that the measured ultrasonic property is consistent with ultrasonic energy being applied to low impedance tissue.

Abstract: A forceps-type electrosurgical device is disclosed comprising, a fixed elongate body and a pair of moveable tips, arranged for engaging tissue in use, and extending from a forward end of the body. The tips are relatively moveable between a first position in which the tips are spaced apart and a second position in which the tips are brought together. The body further comprising an actuation member moveable relative to the body and connected to the tips such that a user may move the actuation member to result in movement of the tips between the first and second positions. The device may further comprise a suction port proximal to the tips.

Abstract: A multipurpose electrosurgical device is configurable in a bipolar mode and a monopolar mode using a three-conductor electrical input. The device includes a switching mechanism that provides signals corresponding with a first function and a second function in a monopolar mode. The switching mechanism also provides a signal corresponding with a third function in a bipolar mode.

Abstract: Surgical systems can include evacuation systems for evacuating smoke, fluid, and/or particulates from a surgical site. A surgical evacuation system can be intelligent and may include one or more sensors for detecting one or more properties of the surgical system, evacuation system, surgical procedure, surgical site, and/or patient tissue, for example.

Abstract: Medical devices for diagnosis or treatment of tissue in a body. Representative devices include an elongate shaft having a proximal portion and a distal portion configured for movement relative to the proximal portion. A flexible member having a predetermined stiffness is disposed between the proximal and distal portions. One or more coils and an electrically passive element are disposed within the shaft with either the coils or element configured for movement with the distal portion. The element comprises a material effecting an electrical characteristic of the coils. Movement of the distal portion in response to its contact with the tissue and relative movement of the coils and element causes a change in the electrical characteristic in at least one of the coils indicative of at least a contact force magnitude between the distal portion and the tissue. Several embodiments allow determination of both force magnitude and force vector direction.

Abstract: An elongate medical device shaft may comprise an elongate body and an annular electrode disposed on the elongate body. The annular electrode may define a longitudinal axis and have an outer diameter. The outer diameter may be greater at an axial center of the electrode than at an axial end of the electrode. Additionally or alternatively, the elongate body may comprise three longitudinal sections having three wall thicknesses. The middle wall thickness may be less than the proximal and distal wall thicknesses and the distal wall thickness may be less than the proximal wall thickness. Additionally or alternatively, the shaft may comprise an inner cylindrical structure and an outer tube. The outer tube may comprise a first radial layer and a second radial layer that is radially-outward of the first radial layer, the first radial layer, second radial layer, and inner structure having different stiffnesses.

Abstract: A control device controls a surgical instrument including a heater. The control device includes a first power supply, a second power supply, a resistance value calculation section, and an output control circuit. The first power supply outputs a first current having a first frequency and supplied to the heater. The second power supply outputs a second current combined with the first current, supplied to the heater and having a second frequency different from the first frequency. The resistance value calculation section separates a signal component related to the second current from the first and second currents having passed through the heater, and calculates a heater resistance value based on the signal component. The output control circuit controls a temperature of the heater based on the heater resistance value.

Abstract: Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.

Abstract: This disclosure is directed to a method for providing electrical communication with a heart using a catheter having a lasso electrode assembly with a moveable spine. The lasso electrode assembly may have an array of sensing electrodes and may be configured to engage the ostium of the vessel of a patient. The moveable spine may have an ablation electrode and may travel along track around the circumference of the lasso electrode assembly. By adjusting the position of the moveable spine, tissue may be ablated to form lesions around a circumference of the vessel.

Abstract: A sub-microsecond pulsed electric field generator is disclosed. The field generator includes a controller, which generates a power supply control signal and generates a pulse generator control signal, and a power supply, which receives the power supply control signal and generates one or more power voltages based on the received power supply control signal. The field generator also includes a pulse generator which receives the power voltages and the pulse generator control signal, and generates one or more pulses based on the power voltages and based on the pulse generator control signal. In some embodiments, the controller receives feedback signals representing a value of a characteristic of or a result of the pulses and generates at least one of the power supply control signal and the pulse generator control signal based on the received feedback signals.