Abstract: Apparatus, methods, and systems for hemorrhage control and pelvic stabilization are provided. The hemorrhage control plate includes a baseplate and a bulbous node extending outwardly. The bulbous node is positioned against a patient's body at a location where pressure is desired. The device is used in connection with a tourniquet to occlude blood flow at a hemorrhage site. The device is configured to attach to the tourniquet.

Abstract: A fixing device for a tibia alignment system for knee operations includes a transverse bar, the front end of which can be connected to a main rod of the tibia alignment system. The main rod is configured for an alignment along the tibia. A rear end of the transverse bar has an anchor system with at least one anchor pin that extends obliquely to the transverse bar and can be driven into a knee joint-side end of the tibia. The anchor system has a drive-in anvil into which the anchor pin is integrated and which is designed to transmit impact forces acting on the drive-in anvil from the outside to the anchor pin in order to drive the anchor pin into the tibia. The anchor pin and drive-in anvil are guided in the transverse bar in a longitudinally movable manner.

Abstract: Device and method for reaming bone. In exemplary embodiments, the device may comprise a shaft configured to be rotated about a long axis thereof. The device also may comprise a plurality of cutting members connected to a distal end region of the shaft, rotationally offset from one another about the long axis, and forming a portion of an expandable cutting head. The device further may comprise an inner member configured to be moved with respect to the shaft to change a diameter of the cutting head. In exemplary methods, the device may be utilized to ream a medullary cavity while being pushed or pulled along the medullary cavity.

Abstract: A device for creating a cavity or a channel in bone. First and second steering cables are coupled to a flexible elbow or a tip of a shaft. A control assembly is operably coupled to the first and second steering cables and configured to tension one of the steering cables and slacken another one of the steering cables so as to flex the flexible elbow. The control assembly may include a steering block axially movable within a handle with a knob threadably coupled to the steering block. The steering block may be rotatably fixed within the handle. The first and second steering cables may be anchored to the steering block, such as to opposite sides of the steering block. The first steering cable may extend along a linear path, and the second steering cable may extend along a curved rib of the handle.

Abstract: An orthopedic drill bit that is configurable to form a first bone tunnel having a first bore when inserted through a bone and a second, larger bore as the drill is partially withdrawn from bone to produce a reverse counterbore for accepting an anchor. The drill bit has a shaft with a pivotal cutting tip that is movable from a narrow boring configuration into a wider boring configuration. The drill bit has a body enclosing the shaft that is biased into engagement with the cutting tip. Rotation of the body allow a user to move the cutting tip from the narrower bore configuration used to drill a pilot hole into a wider bore configuration used to drill a reverse counterbore for accepting the anchor.

Abstract: A graft-harvesting instrument and MTP fusion device are disclosed to allow for easy and safe removal of a section of the calcaneus to be used as autograft in the fusion of the MTP joint. The graft-harvesting instrument allows a surgeon to place a barrier between the saw and the vital anatomy on the medial side of the calcaneus. The MTP fusion device allows for the exact placement of the autograft into the MTP joint. The graft-harvesting instrument allows for a very consistent piece of autograft to be harvested. The graft-retaining sleeve component of the MTP fusion device positions that autograft in place for optimum fusion of the MTP joint.

Abstract: An intraosseous access device for accessing an intraosseous space of a patient includes a manual driver and a sternal locator. The handle is connected to an inner penetrator hub, and an inner penetrator extends from the inner penetrator hub. An outer penetrator hub is releasably engaged to the inner penetrator hub. A protective cover is slidably coupled to the handle. The protective cover is operable to move from an extended position where the inner penetrator is covered, to a retracted position where the inner penetrator is exposed. The sternal locator includes a base; a collar extending from a first surface of the base for securing the intraosseous access device to restrict longitudinal separation of the intraosseous access device from the locator. The locator may be removed from the patient while the outer penetrator remains inserted in an intraosseous space of the patient.

Abstract: The present disclosure provides a clamp composed of four distinct components. The ability to deconstruct the provided clamp into four components as compared to a typical two-part clamp may allow for greater ease in cleaning and sterilization. The provided clamp may include a first arm, a second arm, a cannula block, and a rotary cannula. In some instances, the provided clamp may include a locking feature for locking the rotary cannula to, and releasing it from, the cannula block. The present disclosure also provides a clamp including a scale for bone size determination, a clamp including a scale for determining how much compression force is being applied to a bone between the clamp's jaws, a system including a bushing and a set screw in which the set screw is self-locking, and a drill component system for preparing an opening in bone for a fixation component.

Abstract: A patient specific shoulder guide is provided that includes a hub and a plurality of peripheral members. Each of the peripheral members has a peripheral member height dimension between the patient specific contact surface and a side of the peripheral member opposite the patient specific contact surface. At least one of the peripheral members is a low profile peripheral member in which the peripheral height dimension is less than the peripheral height dimension of at least one other of the peripheral members or is less than the hub height.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. Each aperture may be defined within a radiopaque reinforcing ring embedded within the tubular body. A first set of opposing pairs of reinforcing rings may be separated axially from a second set of opposing pairs of reinforcing rings and may be connected by a flexible hinge section.

Abstract: A system for removing a blood clot includes a first catheter having an inner sheath, the sheath having an interior passage and a plurality of apertures for delivering a drug, and a second catheter having a hollow outer sheath sized to fit over the inner sheath, the second catheter having an agitating element to break apart or loosen the blood clot.

Abstract: Systems for use in blood clot removal can comprise a receiver-supporting element, a self- expanding receiver that includes a frame and a polymer, a first tube connected to the receiver, and a second tube positioned around at least a portion of the receiver. The receiver-supporting element can have a distal end, a proximal end, and a lumen extending proximally from the distal end. At least a portion of the self-expanding receiver can be positioned around at least a portion of a first segment of the receiver-supporting element and the first tube can be positioned around at least a portion of a second segment of the receiver-supporting element. The second tube can include separable portions.

Abstract: A bone clamp (1, 200, 300) for use in fixation of a fractured bone, or prevention of fracture of a bone, the clamp (1, comprising a pair of handles (2a, 2b) joined together at a pivot point (5), the handles (2a, 2b) each having an arcuate jaw (4a 4b), the arcuate jaws (4a, 4b) comprising a first end (7a, 7b) having an opening at a proximal end (12a, 12b) of the jaw (4a, 4b) in communication with a second end (8a, 8b) having an opening at a distal end (14a, 14b) of the jaw (4a, 4b), the first end (7a, 7b) and second end (8a, 8b) in communication via a channel (6a, 6b), in which the channel (6a, 6b) is configured to accommodate a cable, a wire, a suture, a band or other suitable flexible material, and wherein the channel (6a, 6b) is an open channel.

Abstract: The invention involves forceps having rounded grasping tips. The rounded tips are configured to avoid puncturing an amniotic membrane during insertion over an ocular surface for the treatment of dry eye disease and inflammation of the eyes and to avoid injuring the conjunctiva during removal of an amniotic membrane from the ocular surface. The forceps have grasping tips at its distal end, wherein one of the grasping tips has a notch on its inside surface. The dimensions of the notch are configured to permit an eye doctor to securely and safely grasp a lip of an amniotic membrane insert for better insertion and removal from an ocular surface.

Abstract: An apparatus for disrupting tissue in the intervertebral disc space that includes a barrier member having a first configuration for insertion into the disc space and a second configuration when deployed within the disc space. The second configuration of the barrier member is adapted to at least partially define a perimeter of a working region within the disc space. The apparatus also includes a tissue disruption tool configured for insertion into the working region.

Abstract: A method for removing materials from a subject can include inserting an endoscope into the subject through an esophagus of the subject; introducing, through a cavity wall of a stomach of the subject to access a site within the subject outside the stomach, an endoscopic tool coupled with the endoscope; actuating a cutting assembly of the endoscopic tool to cut material at the site, the material associated with at least one of a pancreatic fluid collection in a pancreas of the subject or an extra-pancreatic fluid collection external to the pancreas; and applying suction to a first end of an aspiration channel of the endoscopic tool to remove the material through the aspiration channel, the aspiration channel extending from the first end to a second end at an opening of the cutting assembly.

Abstract: An endoscopic resection assembly includes an adaptor configured to adapt to an endoscopic device. A pusher is disposed on the adaptor by inserting the adaptor into the central opening defined by the pusher. A cutting device includes a snare loop and a snare drive cable, and is removably coupled to the pusher. The cutting device is configured to resect a tissue when the snare loop is contracted by activation of the snare driver. A clip for engaging onto the tissue can be loaded onto the adaptor at a position distal to the pusher.

Abstract: An apparatus comprises a body assembly, a shaft assembly, an end effector, an articulation section, and an articulation control assembly. The end effector is located at a distal end of the shaft assembly and comprises an ultrasonic blade. The articulation section is coupled with the shaft assembly and is operable to articulate to thereby deflect the end effector from the longitudinal axis. The articulation control assembly comprises first and second threaded members and an articulation control. The first and second threaded members have respective first and second pitch orientations. The articulation control is rotatable to thereby drive articulation of the articulation section by causing translation of the first and second threaded members along a path that is parallel to the longitudinal axis of the shaft assembly. The axis of rotation of the articulation control is non-parallel with the longitudinal axis of the shaft assembly.

Abstract: Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating one or more abrasive elements within the vessel. The abrasive elements are attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that spirals around the drive shaft in a direction that is opposite to the wind direction of filars of the drive shaft, and opposite to the direction of rotation.

Abstract: Disclosed herein are multiple cannulas defining a lumen sized and dimensioned to receive one or more medical instruments, an inflatable outer membrane attached to an outer surface of the cannula, and at least one activator that reversibly pressurizes a fluid contained in the outer membrane to fill or pressurize the outer membrane.

Abstract: A system for driving an helical anchor into biological tissue including concentric inner and outer drivers defining a driver passageway therebetween for mounting the helical anchor thereinto, the inner and outer drivers being axially rotatable and longitudinally fixed relative to each other. The inner driver includes a protrusion protruding in the driver passageway and configured for engaging the helical anchor to prevent pure translation of the anchor along the inner driver while allowing helical movements of the helical anchor relative to the inner driver. The outer driver is includes a slot extending therealong from an outer driver distal end towards an outer driver proximal end, the slot receiving the anchor protrusion thereinto and allowing movements of the anchor protrusion therealong. An actuator selectively rotates the inner and outer driver relatively to each other.

Abstract: A safe, reliable, reproducible system and method for entry into the pericardial sac. The method and system described generally includes penetration of the subcutaneous tissue with a guide sheath or a relatively blunt stylet contained within a sheath. The stylet is removed from the sheath and a vacuum mechanism is installed. Once in contact with the pericardium, the sheath is engaged with the pericardial tissue, allowing the vacuum mechanism to draw the pericardium away from the heart to create a greater space between the heart and pericardium allowing needle insertion onto the pericardial cavity in a much safer and controlled manner.

Abstract: An apparatus 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 apparatus includes a manual driver and a stabilizer. The manual driver has a handle, an inner penetrator hub, and an outer penetrator hub. The stabilizer has a housing, an outer sleeve coupled to the housing and configured to move from an extended position to a retracted position in the first mode of operation, and a protective shield coupled to the stabilizer housing and configured to move from an exposed position to a shielded position in the first mode of operation. The manual driver is securely engaged to the stabilizer in the first mode of operation, and the manual driver is detached from the stabilizer in the second mode of operation.

Abstract: A retractor, distractor, and camera system with the camera system and/or distractor configured to provide releasable attachment of the camera system to the distractor, and also provide for rotation of the camera assembly relative to the distractor to allow for adjusting the aim of the camera viewing axis to obtain an image of the surgical workspace established by the retractor.

Abstract: A spinal stabilization device that can be used to non-invasively correct spacing and curvature between at least two vertebral structures. The spinal stabilization device includes two telescoping tubes wherein ends of the two tubes can have pedicle screws that can be fastened to two or more vertebral bones. The overall length of the spinal stabilization device can be adjusted by moving the inner tube within the outer tube. Both the outer tube and the inner tube have multiple holes for receiving fasteners, wherein a fastener can be inserted through a hole in the outer tube into a hole in the inner tube for interlocking the inner tube and outer tube. The extension of the fastener into the holes and retraction from the holes can be controlled non-invasively from an external source.

Abstract: Implants, systems, and methods for securing multiple cords to bone. The fixation system may be used for correcting scoliosis with a fusionless double corded device. The system may include first and second cords, a single bone fastener, one or more tulip structures configured for receiving one or both of the first and second cords, and one or more locking caps adapted to lock one or both of the first and second cords.

Abstract: Implants, systems, and methods for securing multiple cords to bone. The fixation system may be used for correcting scoliosis with a fusionless double corded device. The system may include first and second cords, a single bone fastener, one or more tulip structures configured for receiving one or both of the first and second cords, and one or more locking caps adapted to lock one or both of the first and second cords.

Abstract: An anchor assembly can be couplable to a bone and can include an anchor and a housing. The anchor can include a shank securable to bone and a head coupled to a proximal portion of the shank. The housing can include a proximal portion including an anchor bore and a distal portion including a secondary bore configured to engage the anchor to limit angulation of the anchor relative to the housing.

Abstract: A two-piece hammertoe compression device is disclosed for the correction of a hammer toe deformity. The two-piece hammertoe compression device provides polyaxial motion between the device components allowing angulation of the joint for fusion. Further, the two-piece hammertoe compression device includes a distal component and a proximal component secured together. The distal component has an externally-threaded anchor with an embedded socket component. The proximal component includes an internally and externally-threaded anchor. Additionally, the embedded socket component has a ball insert component to allow for polyaxial movement and variable angle fixation at the joint.

Abstract: Bone plates for engaging bone members are described herein. The bone plates can receive one or more screws to secure the bone plates to an underlying bone member. The one or more screws can be inserted into bone plate holes that can be considered locking or non-locking. The bone plates described herein can have particular combinations of locking and/or non-locking holes. Additional bone plate holes can be used to accept sutures, K-wire, or other instrumentation.

Abstract: Screw inserter instruments and methods for implanting a bone screw are disclosed herein. In one exemplary embodiment, a screw inserter instrument can include a screw drive assembly having a first handle and a driver shaft coupled to the first handle, and a stylet assembly having a second handle and a stylet extending through the driver shaft. The first handle can have a locked configuration, in which the first handle and the driver shaft are coupled such that the first handle can maintain the driver shaft in a fixed position while the second handle is rotated relative to the first handle, and an unlocked configuration, in which the first handle and the driver shaft can rotate simultaneously in a first direction and the first handle can rotate independent of the driver shaft in a second opposite direction.

Abstract: A modular system for treating a bone includes a main body including a channel extending therethrough. A distal end includes a driving feature sized and shaped to engage a corresponding driving structure of one of first and second bone screws. The system also includes an inner shaft sized and shaped to be inserted into the channel and including a distal end including a retaining feature for engaging a corresponding retaining structure extending within a recess at a proximal end of the first screw. Furthermore, the system includes an outer shaft extending longitudinally and including a channel extending therethrough. The channel of the outer shaft is sized and shaped to slidably receive the main body therein and including a retaining feature extending along a distal end thereof. The retaining feature of the outer shaft engages a retaining structure extending along an exterior surface of the second screw.

Abstract: Introducers for detachably coupling with an ablation probe are described herein. The ablation probe can be a cryoablation probe or other type of ablation probe such as microwave or RF ablation probe. An example introducer includes a hollow member; and a locking mechanism configured to secure the introducer and the ablation probe. An example system includes an ablation probe; and an introducer that is configured to detachably couple with the ablation probe. The introducer includes a hollow member, one or more energy elements arranged along an axial direction of the hollow member, and one or more sensor elements arranged along the axial direction of the hollow member.

Abstract: An electrophysiological catheter and an ablation system comprising a control device, an ablation energy output device and the electrophysiological catheter. The control device controls the ablation energy output device to selectively provide a first fluid or a second fluid that is a frozen liquid to the electrophysiological catheter. When the ablation energy output device provides the first fluid, the control device controls a first heating component on the electrophysiological catheter to work to heat the fluid entering the electrophysiological catheter for spraying a thermal ablation gas onto the inner surface of a balloon; and when the ablation energy output device provides frozen liquid, the control device controls the first heating component not to work to directly spray the frozen liquid to the inner surface of the balloon.

Abstract: A cautery safety controller can include a first input to receive a cautery power signal; a first output coupled to a nerve stimulator system; a second input coupled to receive a nerve detected signal; a zero-crossing detector coupled to receive the cautery power signal via the first input and output a nerve sense enable signal via the first output to the nerve stimulator system in response to detecting a zero crossing of the cautery power signal; and a nerve detection decision unit coupled to receive the nerve detected signal via the second input, generate a stop operation signal, and output the stop operation signal via a second output. A cauterizing pencil can be provided with a tap line for providing the cautery power signal. Alternatively, a cautery pad can be provided with a sense electrode for providing the cautery power signal.

Abstract: Electrosurgical devices including a shaft, a handle and a distal end portion. The distal end portion is formed of an electrically conductive material and includes an electrically insulating material covering a substantial portion of the distal end portion and leaving an exposed portion which acts as an active electrode for delivery of electrical energy to tissue. A conduit in the shaft extending to an opening in the distal end portion facilitates aspiration of tissue and may provide suction simultaneous with delivery of electrical energy. Systems include an electrosurgical device, a source of electrical energy and may optionally include a source of suction and/or a source of fluid delivery or irrigation.

Abstract: An electrically insulated shaft (30) of a microinvasive instrument or for a microinvasive instrument includes an electrically conductive shaft component (40) with an outer surface (44) and an insulation tube (50) formed of an electrically insulating material, which encloses the shaft component (40) and covers the outer surface (44) of the shaft component (40). The insulation tube (50) is melted or welded onto the outer surface (44) of the shaft component (40).

Abstract: A method of manufacturing a surgical instrument that includes an energized feature operable to apply ultrasonic energy or RF energy to tissue. The method includes forming at least one of a microscopic surface pattern or a nanoscopic surface roughness into a base surface of the energized feature to produce at least one recessed portion. The method also includes applying a hydrophobic coating that includes at least one of silicone, titanium nitride, chromium nitride, or titanium aluminum nitride to at least the recessed portion of the energized feature after forming at least one of the microscopic surface pattern or the nanoscopic surface roughness.

Abstract: A treatment device for treatment of overactive bladder conditions operates to suction to grasp and conform a mucosal tissue of the bladder wall to a portion of the tissue treatment device, and deliver energy to non-superficial target tissue at a substantially uniform depth from the mucosal tissue. The tissue treatment device incorporates multiple instruments for different functions needed to treat overactive bladder conditions. The tissue treatment device provides simplified interfaces and mechanisms for operating each of the multiple instruments in a controlled manner. Further, the tissue treatment device is configured to have a low and smooth profile that permits the tissue treatment device to be used without a tubular sheath.

Abstract: In one embodiment, a catheter apparatus is configured to be inserted into a body part of a living subject, and including an elongated deflectable element including a distal end, an expandable basket assembly disposed at the distal end and comprising a plurality of splines and a plurality of electrodes disposed on the splines, an irrigation channel disposed in the elongated deflectable element, and an inflatable balloon disposed in the expandable basket assembly and including a plurality of irrigation holes in fluid connection with the irrigation channel.

Abstract: A sphincterotome device can be used to achieve appropriate positioning within the biliary duct during cannulation. The sphincterotome device enables performance of a “double-wire” or multiple wire procedure without the need for removal and reintroduction of the sphincterotome device, thereby allowing for a shorter procedure.

Abstract: Various catheters are provided herein for recording, mapping, and/or ablating target tissue to reduce or eliminate unwanted electrical impulses. In one embodiment, a catheter can have a handle, an elongate body, and an end effector. The end effector has expanded and contracted configurations and can rotate about the elongate body. A plurality of electrodes can also be disposed on the end effector for recording, mapping, and/or ablating target tissue surrounding the catheter. The handle can guide the end effector through transitioning between the configurations and rotating about the elongate body.

Abstract: Medical devices for renal nerve ablation are disclosed. An example medical device for renal nerve ablation may include a catheter shaft having a distal region. The device may include an expandable member coupled to the distal region, a flexible circuit assembly coupled to the expandable member, and a pressure sensor disposed along the expandable member and positioned adjacent to the flexible circuit assembly. The flexible circuit assembly may include one or more pairs of bipolar electrodes and a temperature sensor.

Abstract: An atrial septostomy device (20) includes a support frame (21) for propping a puncture hole in the atrial septum. The support frame (21) includes an expansion portion (23) for propping the puncture hole, a connecting portion (27) connected to a proximal end of the expansion portion (23), and an extension portion (25) connected to a distal end of the expansion portion (23). A distal end of the extension portion (25) has a converged portion (250) that is parallel to the axis of the support frame (21) or extends towards the axis of the support frame (21). The support frame (21) is provided with an ablation electrode (60) for ablating tissues surrounding the puncture hole.

Abstract: A uterine manipulator including an elongate shaft having a distal portion configured to be inserted into a uterus through a lumen of a cervix, and a return electrode coupled to the elongate shaft. The return electrode is configured to be electrically coupled to an electrosurgical generator.

Abstract: The present disclosure provides systems, devices, and methods for penetrating a biological membrane. The system may comprise a laser unit configured to generate one or more laser beams. The system may comprise a set of targeting optics configured to direct the one or more laser beams to a target region of the biological membrane. The system may comprise a raster scanner operatively coupled to the laser unit and the set of targeting optics. The system may comprise a non-transitory computer readable storage medium comprising a set of instructions. The set of instructions may be configured to control at least one of the laser unit, the set of targeting optics, or the raster scanner to photodisrupt the target region of the biological membrane to a target depth while minimizing damage to one or more blood vessels in proximity to the target region.

Abstract: The present invention relates to a computer-implemented method for a computer-assisted planning of a surgical path. The method includes accessing a data set of a computer-readable three-dimensional visualization medical representation including at least one three-dimensional medical model; loading the data set into and presenting the data set in a three-dimensional surgical path simulator; inserting a virtual three-dimensional object representing for the surgical path and features thereof into the data set; and adjusting a relative position of the virtual three-dimensional object with respect to the at least one three-dimensional medical model.

Abstract: Methods, systems, and devices for the treatment of osteochondral defects (OCDs) are disclosed. The disclosed method and systems include collecting surface data of a joint using image-free methods, generating a three-dimensional (3D) healthy bone model based on the surface data of the joint and a database of healthy bone anatomies, defining of the boundary of the OCD on the joint, generating a 3D implant model based on the 3D healthy bone model and the boundary of the OCD on the joint, manufacturing an implant based on the 3D implant model, generating an implantation plan, resecting the joint according to the implantation plan, and placing the implant into the resected cavity on the joint. The disclosed devices include two or more distinct segments with distinct structures optimized for bone or cartilage growth and configured to receive distinct injectable biologic enhancement for targeted bone or cartilage growth.

Abstract: A method for the spatial mapping of a model of a surgical tool onto a spatial position of the surgical tool includes a) providing a surgical tool having a working part and a marker in the form of a visual image on a surface; b) providing a tool model of the surgical tool; c) providing a viewing device configured to be carried by a user and including a camera configured to capture a view and to generate camera data representative of the view; d) creating a spatial model of a space viewed by the camera; e) bringing the surgical tool within the space viewed b y the camera; f) identifying a representation of the marker in the camera data; g) determining a position and rotation of the representation of the marker with respect to the spatial model, and h) creating a spatial mapping of the tool model in the spatial model.

Abstract: Methods, non-transitory computer readable media, and surgical computing devices are illustrated that improve robotic surgical systems. With this technology, one or more machine learning models are trained based on historical state data obtained for a computer-assisted surgical system (CASS) at each of a plurality of time periods during a plurality of historical knee arthroplasty surgical procedures. One or more of the machine learning models are applied to initial state data for a current knee arthroplasty surgical procedure to generate robotic commands required to achieve one or more future states of the CASS. The initial state data comprises a surgical plan. One or more surgical tools of the CASS are then manipulated based on the robotic commands to achieve the one or more future states of the CASS and thereby carry out at least a portion of the surgical plan.