Abstract: A surgical system may include tiered-access features. The surgical system may be used to analyze at least a portion of a surgical field. Based on a control parameter, the system may scale up or down various capabilities, such as visualization processing, endocutter communication, endocutter algorithm updates, smart cartridge connectivity, smart motor control for circular stapler, smart energy control, cloud analytics, hub connectivity control, and/or hub visualization and control interactions. The control parameter may include system aspects such as processing capability or bandwidth for example and/or the identification of an appropriate service tier.

Abstract: A surgical instrument that comprises a surgical end effector, a handle that is connected to the surgical end effector and has a controller, and an interchangeable part removably connected to the surgical end effector and having an encryption device in electrical communication with the controller. The encryption device is programmed to authenticate the interchangeable part when the interchangeable part is at the surgical end effector.

Abstract: A surgical device includes a handle assembly having a controller and a motor. The surgical device also includes an adapter assembly having: a tubular housing having a proximal end portion configured to couple to the handle assembly and a distal end portion; and an actuation assembly configured to couple to the motor. The surgical further includes a reload configured to couple to the distal end portion of the adapter assembly; and an anvil assembly including an anvil head pivotally coupled to an anvil shaft, the anvil assembly configured to couple to the actuation assembly and the reload. The controller of the surgical device is configured to control the motor to actuate the actuation assembly to move the anvil assembly in a distal direction for a distance based on a dimension of one of the reload or the anvil head, thereby pivoting the anvil head relative to the anvil shaft while maintaining engagement of the anvil assembly to the reload.

Abstract: A circular stapling device includes structure to position an anvil assembly in proper alignment with a cartridge assembly prior to firing of the stapling device. The stapling device includes an anvil assembly, a cartridge assembly including a staple cartridge and shell housing, and an anvil retainer that has a proximal portion including a longitudinal rib and a distal portion including at least one second longitudinal rib. The first longitudinal rib is received within a slot formed within the shell housing to prevent rotation of the anvil retainer in relation to the shell housing. The at least one second longitudinal rib is received within a longitudinal channel of the anvil assembly to prevent rotation of the anvil assembly in relation to the anvil retainer. The presently disclosed structure obviates the need for splines and the disadvantages associated with the use of splines.

Abstract: A multi-fire clip applier includes an elongate shaft having a lumen and a jaw assembly on a distal end of the shaft. A plurality of surgical ligating clips are positionable within the lumen. A screw member is rotatable within the lumen to sequentially advance the clips towards the jaw assembly.

Abstract: This disclosure relates to a catheter system that for precisely positioning fluid flow restrictors within a blood vessel. In particular, this disclosure provides a catheter system that includes a sheath with a first fluid flow restrictor mounted thereto, and a catheter that is slidably disposed within the sheath and has a second fluid flow restrictor mounted thereto. Inside a blood vessel, the sheath and the catheter are separately slidable, thereby allowing the first and second fluid flow restrictors to be positioned at precise locations within the blood vessel.

Abstract: This disclosure relates to a catheter with a fluid flow restrictor (e.g., a balloon) that includes a flow path. The catheter is useful for creating, and maintaining, an area of reduced pressure within a blood vessel for removing excess fluid from a patient's body. In particular, the catheter is dimensioned for insertion into a blood vessel and includes a fluid flow restrictor that, when deployed, partially occludes the blood vessel. Pressure is reduced within the blood vessel downstream of the occlusion. The flow path allows some blood to flow past the restrictor, which prevents the blood vessel from stretching due to excessive pressure buildup, thereby allowing the area of reduced pressure to be maintained for extended periods of time.

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

Abstract: The invention relates to an occluder for closing the left atrial appendage of a patient, a system having a catheter and an occluder, and a method for providing the system, the occluder having a self-expandable frame, wherein a biological tissue is arranged on the frame on the outside thereof, which tissue covers said frame at least in part, wherein the biological tissue is stabilized by treatment by means of a reticulation method and, in order to make it durable, is wetted with a liquid medium or dried.

Abstract: A saw gear set comprising a set of saw blades and a saw drive (1), wherein each saw blade of the set is configured to be coupled to the saw drive (1) by means of a coupling mechanism (100), which coupling mechanism (100) is configured to transmit a driving force of the saw drive (1) to the saw blade in a force transmission point, for oscillating the saw blade around a pivot axis (300). Each saw blade of the set is configured to be pivotably borne around the pivot axis (300). In operation, an oscillation angle (?) around the pivot axis (300) is different for each saw blade of the set depending on a pivot distance between the pivot axis (300) and the force transmission point which varies for each saw blade of the set.

Abstract: A cutting guide for spinal osteotomy comprises a main body having a first and a second arm, each provided with a respective through slot. The first and second arm are preferably inclined with respect to each other to substantially form a V shape. The guide also comprises a distal surface and a proximal surface shaped according to the anatomy of the specific patient and a height of each arm is also shaped according to the anatomy of the specific patient.

Abstract: A system (200) and method (600) for identifying cutting tools for use during a surgical procedure are described. For example, the system includes a cutting tool assembly (210) including a shaft (212) having a cutting element (214) and at least one identifying feature (216) that uniquely corresponds to the cutting element. The system further includes a drive assembly (220) including a reference pin (224), a motor (230) mechanically connected to the drive assembly, a control unit (240) configured to activate the motor to move the cutting tool assembly such that the reference pin engages with the at least one identifying feature, a sensor system (226) configured to determine positioning information related to the reference pin when the reference pin engages the at least one identifying feature, and a computing unit (250) configured to receive the positioning information from the sensor system and identify the cutting element based upon the position information.

Abstract: A bone removal device, including: an elongated shaft having a longitudinal axis, a distal end and a proximal end; a bone borer having a distal drilling tip configured to drill into a bone tissue and at least one proximal reamer, wherein the bone borer is movably coupled to a distal end of the elongated shaft, wherein the bone borer is configured to move between a drilling state in which the drilling tip is placed in contact with bone tissue, and reaming states in which the at least one proximal reamer is placed in contact with the bone tissue.

Abstract: Apparatus and methods for removing bone and/or tissue at a target location are disclosed. The apparatus comprises a shaft member having a drive end securable to a rotating drive unit, and a cutting head member at a remaining end of the shaft member distal to the drive end.

Abstract: Embodiments of the invention include implants, instruments, and methods for attaching or reattaching soft tissue (200, 2200) to a bone (100), that enable independent tensioning of multiple connectors such as sutures (60, 160, 2060, 2160) and enable redundant fixation between bone (100) and soft tissue (200, 2200). Some embodiments provide for improved accuracy of the placement of substantially parallel tunnels through which soft tissue (200, 2200) to bone (100) connectors such as sutures (60, 160, 2060, 2160) are passed.

Abstract: An orthopedic device for a shoulder joint includes a patient-specific alignment guide. The alignment guide includes a cap having a three-dimensional engagement surface customized in a pre-operative plan by computer imaging to be complementary and closely mate and conform to a humeral head of a proximal humerus of a patient. The alignment guide includes a tubular element extending from the cap and defining a longitudinal guiding bore for guiding an alignment pin at a patient-specific position and orientation determined in the pre-operative plan, and an orientation feature on the cap. The orientation feature is designed to orient the cap relative to the humeral head when the orientation feature is aligned with a landmark of the proximal humerus.

Abstract: A dual operation grasping forceps for use with an endoscope includes an elongated tube having a control mechanism along a first end, and a grasping section along a second end. The grasping section includes a plurality of resilient wire members each having a loop along a distal end. A cable is positioned through the loops to form a circular or triangular shape snare. The grasping members are independently connected to the control mechanism by a first operating wire, and the cable is independently connected to the control mechanism by a second operating wire. The control mechanism selectively moves the grasping section between a retracted position, an extended position and a closed position.

Abstract: A clot removal device for removal of an occlusion from a lumen in a patient's body is provided. The clot removal device has a lumen, an elongated member positioned within the lumen and extending axially from a proximal end to a distal end of the lumen, a handle attached to the proximal end of the lumen, a first expandable member positioned along a length of the elongated member, a second expandable member positioned along the length of the elongated member, wherein the second expandable member is distal to the first expandable member relative to the handle.

Abstract: A clot removal device for removal of an occlusion from a lumen in a patient's body is provided. The clot removal device has a lumen, an elongated member positioned within the lumen and extending axially from a proximal end to a distal end of the lumen, a handle attached to the proximal end of the lumen, a first expandable member positioned along a length of the elongated member, a second expandable member positioned along the length of the elongated member, wherein the second expandable member is distal to the first expandable member relative to the handle.

Abstract: According to the present disclosure, provided is a surgical instrument in which an actual motion of bending an end tool or performing a surgical treatment intuitively matches a motion of a manipulation portion corresponding thereto. In detail, to this end, provided are an end tool having various degrees of freedom, a manipulation portion having a structure to enable intuitive manipulation of a motion of the end tool, and a driving force transmission portion for transmitting a driving force of the manipulation portion to the end tool so that the end tool operates as manipulated by the manipulation portion.

Abstract: Provided is an end tool including: a first jaw configured to rotate independently; a J11 pulley coupled with the first jaw and configured to rotate around a first axis formed at an end tool hub; a J16 pulley formed at one side of the J11 pulley and configured to rotate around a second axis formed at one side of the first axis; a J12 pulley and a J14 pulley formed at one side of the J16 pulley, and configured to rotate around a third axis formed at a predetermined angle with the first axis. The end tool may further include: a first jaw wire configured to at least partially contact the J12 pulley, the J11 pulley, the J16 pulley, and the J14 pulley; a J16 pulley formed between the J11 pulley and a J12 pulley/a J14 pulley; and the first jaw wire is located on an internal tangent of the J11 pulley and the J16 pulley.

Abstract: Examples herein describes a powered surgical end-effector that may include a controllable jaw configured to operate on a tissue, an updatable memory having stored therein a default actuation algorithm, and and a processor. The processor may be configured to operate in a first mode at a first time, wherein in the first mode the processor may be configured to operate an aspect of the controllable jaw according to the default actuation algorithm. The processor may receive data at a second time, after the first time, that may cause the processor to operate in a second mode, wherein in the second mode the processor may be configured to operate an aspect of the controllable jaw according to an alternative actuation algorithm.

Abstract: A surgical instrument includes a handpiece including a housing and a motor disposed in the housing. An end effector assembly is operably coupled to the handpiece. The motor actuates the end effector assembly. A temperature measurement assembly is in the housing. The temperature measurement assembly measures a temperature of the motor. The temperature measurement assembly includes a printed circuit board (PCB) including an orifice extending through the PCB. An infrared (IR) sensor is on the PCB. The IR sensor transmits IR light to a temperature measurement location of the motor through the orifice of the PCB. The IR sensor detects IR light reflected from the temperature measurement location of the motor to determine a temperature of the temperature measurement location of the motor.

Abstract: Apparatus and methods are described for treatment of a urethra that is constricted due to benign prostatic hyperplasia (BPH). A positioning device is used to determine a location of the area of the urethra that is constricted and is to be treated. An execution device includes a dilation balloon, a cutter, an implant carrier, and an implant, the implant and the implant carrier both being disposed outside the outer surface of the dilation balloon. The urethra is dilated by expanding the dilation balloon, and a cut is formed in the inner surface of the urethra using the cutter. The implant is released into the cut within the inner surface of the urethra subsequent to the cutter forming the cut in the inner surface of the urethra, to thereby maintain the urethra in a dilated state. Other embodiments are also described.

Abstract: An apparatus includes a body, a shaft assembly, an end effector, and a control module. The shaft assembly extends distally from the body and includes an acoustic waveguide. The waveguide is configured to acoustically couple with an ultrasonic transducer. The end effector includes an ultrasonic blade, a clamp arm, an electrode, and a sensor. The ultrasonic blade is in acoustic communication with the waveguide. The clamp arm is operable to compress tissue against the ultrasonic blade. The electrode is operable to apply radiofrequency (RF) electrosurgical energy to tissue. The sensor is operable to sense a condition of tissue contacted by the end effector. The control module is operable to control delivery of ultrasonic power and RF electrosurgical energy through the end effector based on data from the sensor.

Abstract: An apparatus for controlling a needle guide includes a first lever, a second lever, a first cam and a second cam. The first cam is attached to and extends from the first lever to a housing under the needle guide. The second cam is attached to and extends from the second lever to the housing under the needle guide. At least one of the first cam and the second cam is configured to translate rotational movement from the first lever and the second lever to both linear and rotational movement of the needle guide via the housing.

Abstract: A surgical access device includes a tube and a housing coupled to the tube. The housing is configured for passage of a surgical instrument therethrough. The housing includes first and second chambers where the second chamber surrounds the first chamber. A seal is disposed in the first chamber. A port extends from the housing and is in fluid communication with the second chamber. A nozzle is defined between a distal portion of an outer wall of the first chamber and a wall of the housing. The nozzle is configured to direct fluid towards the second chamber.

Abstract: An intraosseous access device is operable to provide access to a sternal intraosseous space in a first mode of operation and operable to provide access to a peripheral intraosseous space in a second mode of operation. The device includes an outer sleeve, an inner penetrator hub, and an outer penetrator hub. A protective shield is telescopically coupled to the outer sleeve. The protective shield is operable to move from an expanded position to a retracted position in both the first and second modes of operation. A bone probe ring is disposed within the protective shield and configured to move between an extended position and a retracted position in both the first and second modes of operation. An actuator is operable to manually move the protective shield and the bone probe ring to the retracted position when in the second mode of operation.

Abstract: A uterine manipulator includes a handle and a central shaft that extends distally from the handle. The central shaft includes a distal end portion supporting a balloon. The central shaft also supports a cervical cup. An occluder shaft is slidably supported on the central shaft. A non-inflatable plug is secured to the occluder shaft and configured to move with the occluder shaft as the occluder shaft slides along the central shaft.

Abstract: A device includes a plurality of rings. Each ring has a first face, a second face, and at least one slot defined by first and second interior edges of the ring on opposing sides of the slot. The at least one slot penetrates from the first face to the second face. The first face of each ring has a first recess adjacent the slot on the first edge and a second recess adjacent the slot on the second edge. A plurality of posts join each one of the plurality of rings to an adjacent one of the plurality of rings.

Abstract: An anchoring assembly for anchoring a rod to a bone or vertebra includes a shank and a receiving part pivotably connected to one another, the receiving part defining a channel for the rod, a pressure element for locking the shank with the receiving part, first and second rods with different diameters configured to be interchangeably received in the channel, and first and second closure elements configured to interchangeably cooperate with the receiving part. The first closure element acts on the selected rod in the receiving part such that the rod exerts pressure on the pressure element to simultaneously lock the shank with the receiving part and fix the rod in the channel. The second closure element cooperates with the receiving part to act on the pressure element to lock the shank with the receiving part, and to act separately on the selected rod to fix the rod in the channel.

Abstract: Implants, systems, and methods for securing a flexible band, thereby providing a desired correction to the spine. The implant may secure the flexible band to patient anatomy without the use of pedicle screws or spinal rods. The implant may include a locking member configured to secure the band. The band may be looped around bony anatomy and tensioned to achieve correction and provide fixation as an alternative to pedicle screws and spinal rods during spinal deformity surgery.

Abstract: A bone anchor based retractor/distractor assembly for simultaneous tissue retraction and disc space distraction utilizing an adjustable, flexible wire to secure the bone anchors during the distraction process. The assembly includes first and second modular retractor/distractor blades that can be detached for securing to the bone anchor. Each blade has a pivot pin and blade connector with a rotatable knob for adjusting of a wire releasably securable to a bone anchor. The blade connectors are attached to the first and second arm elements, each having a stabilizing arm that is movable in relation to each other by a threaded draw rod having an adjustment knob for activating movement. A main body is secured to a medial retraction blade by an arm having a gear member operatively associated with a gear knob for incremental movement of the medial retraction blade.

Abstract: A system for facilitating changing of a configuration of a bone having: a bone plate with a surface to overlie a surface of a bone; and a spacing assembly configured to be placed together with the bone plate selectively in: a) a cutting state wherein the spacing assembly maintains a gap region between at least a part of the bone plate surface and the bone surface which the bone plate surface is situated to overlie; and b) a second state wherein the at least part of the bone plate surface can be moved closer to the bone surface. A cutting component can be directed fully through a bone and into the gap region with the spacing assembly and bone plate in the cutting state. After the bone is cut, the bone plate and spacing assembly can be changed into the second state whereupon the bone plate can be placed against the bone surface in an operative position.

Abstract: A screw implant is provided for the distraction, fusion, or compression of two adjacent bone structures or two adjacent bone fragments. The implant is a fully threaded screw with a headless proximal end having a drive engagement feature and a blunt distal end for insertion into bone or related tissue. The implant has roughened and porous surfaces throughout and is fully coated with hydroxyapatite and/or tri-calcium phosphate to allow for bone in-growth. The implant may have uniform low pitch cortical threads, or variable pitch threads, with low pitch cortical threads on one end and larger pitch cancellous threads on the other end. The implant may be used for the distraction of spinal vertebrae. The implants may have a cannulation channel and fenestrations.

Abstract: The invention discloses a modular surgical bone screw assembly having a threaded base portion and a screw head adapted to attach a variety of structures to bone. The features of the screw include a modular design for the assembly that separates the function of anchorage to the recipient bone to one of the modules of the device (threaded portion) from the other function of attaching another element (such as bone block, membrane, orthodontic wires, elastics etc) to a second module (the screw head). The design also allows the head to be exchanged after the implant has been placed.

Abstract: Spinal bone anchor attachment device for improving the attachment of a bone screw to skeletal portions of a patient, the device reducing the risk of screw failure, and improving patient outcomes. The device is composed of a biomaterial compatible with bone and provides an enhanced surface area on outer surfaces of the device for engaging the bone, and an enhanced surface area within the device for engaging the bone screw. The device may also have a guiding slanted tip with a bias element for facilitating the placement of the device into bone tissue and rescuing an improper tract. The device may further be used to secure the placement of pedicle screws, and as a component of an intervertebral stabilization system commonly used in spinal fusion surgeries.

Abstract: Tensioner instruments, systems, and methods of tensioning flexible bands in-situ. The tensioner instrument may include first and second pivoting arms with a base for pinching and pulling the flexible band to provide tension. The tensioner instrument system may include a clip inserter and a ratcheting tensioner for tensioning the band through an implant. The instruments may be configured to apply and maintain tension to the flexible band, thereby providing the desired correction to the spine.

Abstract: A traction tensioning apparatus includes a housing that has a first end and a second end. An anchor point is mounted to the housing and is attachable to a first tether is in-line with a traction system and extending away from the housing in a first direction. An urging assembly is engaged with the anchor point. The urging assembly is tension actuated to urge the anchor point toward the second end and releasably actuated to allow the anchor point to move toward the first end. An attachment point is mounted to the housing and is attachable to a second tether in-line with the traction system and extending away from the housing in a second direction. The attachment point is movable in the first and second directions relative to the housing. A biasing member is engaged with the attachment point and biases the attachment point in the first direction.

Abstract: An endosteal guide pin for preparing a guide path for the implantation of a pedicle or orthopaedic screw into a patient's bone. The pin has a head intended to be provisionally implanted in a bone and a guide rod, coaxial with and rigidly secured to the head, ending in a free end intended to be at least level with the skin surface of the patient when the pin is in the implanted position in the bone. The pin has a first coupling part intended at least to secure the pin to and release the pin from at least one portion of a positioning trocar and a second coupling part intended at least to secure the pin to a removal trocar. Also, a trocar for positioning a guide pin, which trocar incorporates the guide pin, and to a trocar for removing the pin.

Abstract: The invention generally relates to systems and methods for providing detection, identification, and precision targeting of specific tissue(s) of interest in a nasal region of a patient for the treatment of a rhinosinusitis condition while minimizing or avoiding collateral damage to surrounding or adjacent non-targeted tissue, such as blood vessels, bone, and non-targeted neural tissue.

Abstract: A probe for ablating tissue comprises an electrosurgical working end configured to provide a first plasma about a first surface location and a second plasma about a second surface location, the first plasma having first ablation parameters and the second plasma having second ablation parameters. The probe has a working end with a thickness below 3 mm and produces a low temperature plasma.

Abstract: An electrosurgical system includes an electrosurgical instrument having an electrode with a polymeric dielectric coating; and an electrosurgical generator, which includes a power converter configured to generate RF energy; a sensor coupled to the power converter and configured to sense a parameter of the RF energy; and a controller coupled to the sensor and the power converter. The controller is configured to control the power converter to output an RF waveform to achieve conductor breakthrough through the polymeric dielectric coating. The controller is further configured to determine whether the conductor breakthrough occurred based on the parameter; and execute a treatment algorithm based on a determination of the conductor breakthrough.

Abstract: A surgical instrument according to an embodiment may include a conductive distal support member, a conductive proximal support member, a sealing mechanism being in contact with the proximal support member and including at least a part thereof having conductivity, and an electric wire. The electric wire includes an end effector-side end portion thereof being connected to the sealing mechanism to supply electrical energy to the end effector through the sealing mechanism, the proximal support body, and the distal support body.

Abstract: The invention generally relates to systems and methods for providing detection, identification, and precision targeting of specific tissue(s) of interest in a nasal region of a patient for the treatment of a rhinosinusitis condition while minimizing or avoiding collateral damage to surrounding or adjacent non-targeted tissue, such as blood vessels, bone, and non-targeted neural tissue.

Abstract: Examples herein describe a surgical instrument that deliver a first energy and a second energy configured to seal the tissue. The first energy may be operated by a first energy algorithm and second energy may be operated by a second energy algorithm. The surgical instrument may include an updatable memory that may store a default control algorithm that may control both the first energy algorithm and the second energy algorithm simultaneously. The surgical instrument may include a processor that may be configured to operate in a first mode at a first time, wherein in the first mode the processor may be configured to operate according to the default control algorithm. The processor may receive data at a second time that may cause the processor to operate in a second mode, wherein in the second mode the processor may be configured to operate according to an alternative control algorithm.

Abstract: An electrosurgical instrument includes a housing having a handle and an elongated shaft extending therefrom supporting an end effector assembly. The end effector assembly includes first and second jaw members each having a jaw housing and an electrically conductive tissue engaging surface. The first jaw member includes a U-shaped proximal flange that defines a cuff having sides configured to support a pivot and also that define cradles for securing a pivot bar. The second jaw member defines a U-shaped cuff for receiving the proximal flange the first jaw member. The cuff includes sides that define cradles for supporting the pivot thereon through the range of motion between first and second jaw members.

Abstract: The invention generally relates to systems and methods for providing detection, identification, and precision targeting of specific tissue(s) of interest in a nasal region of a patient for the treatment of a rhinosinusitis condition while minimizing or avoiding collateral damage to surrounding or adjacent non-targeted tissue, such as blood vessels, bone, and non-targeted neural tissue.

Abstract: The invention generally relates to systems and methods for providing detection, identification, and precision targeting of specific tissue(s) of interest in a nasal region of a patient for the treatment of a rhinosinusitis condition while minimizing or avoiding collateral damage to surrounding or adjacent non-targeted tissue, such as blood vessels, bone, and non-targeted neural tissue.

Abstract: A bipolar electrosurgical device including an outer shaft, an inner shaft, first and second electrode surfaces, and an irrigation channel. The outer shaft defines a lumen, a proximal end and a distal end forming a cutting window. The inner shaft is rotatably disposed within the outer shaft, and defines a distal portion forming a cutting tip. The cutting tip and the cutting window combine to define a cutting implement. The first and second electrode surfaces are electrically isolated, and are formed at the cutting implement. The irrigation channel extends parallel to the outer shaft, and terminates in at least one outlet port. The outlet port is proximally spaced from the cutting window and is located radially outside of the outer shaft. Fluid (e.g., saline) is emitted at the exterior surface of the device near the cutting window and is readily present for interacting with the electrode surfaces.