Abstract: A drill guide arm for providing guidance for placement of a bone tunnel, while protecting against trauma. The guide arm includes a first arm at a proximal end connected at an angle to a second arm, the second arm extending to a distal end. The angle can be within the range of 80°-110°. The second arm extends along a first axis. The guide arm also includes a distal tip extending at a second angle from the second arm at the distal end, and an indicator feature extending from the distal tip toward the first arm. The indicator feature extends along a second axis, the second axis being substantially parallel to the first axis. The guide arm can also include a shield feature of the distal tip. The shield feature has a width wider than the remainder of the distal tip.

Abstract: A balloon guide catheter including a catheter shaft having a reflowable material outer layer. Secured without an adhesive to the catheter shaft is a balloon having a bond interface area with a plurality of punctures defined therein secured about the outer layer of the catheter shaft via seepage of the reflowable material of the outer layer into the plurality of punctures forming a radially outward reflow bond between the catheter shaft and the balloon. Along the bond interface area about the perimeter of the opening in the balloon, a single reflow jacket is secured to the balloon via seepage of the reflowable material of the single reflow jacket into the plural punctures of the balloon forming a radially inward reflow bond. The single reflow jacket is made of a reflowable material and has an opening defined therein aligned with the balloon.

Abstract: Described herein are acoustic-based tissue treatment systems, apparatuses, and methods for use therewith. Certain such apparatuses comprise a catheter sized and shaped for delivery through a radial artery including a catheter shaft having distal and proximal ends, a plurality of lumens extending longitudinally through the catheter shaft between the distal and proximal ends thereof, and an ultrasound transducer distally positioned relative to the distal end of the catheter shaft. A balloon may surround the ultrasound transducer and at least one of the plurality of lumens may be configured to provide a cooling fluid to the balloon at a pressure and flow rate sufficient to protect non-target tissue in the blood vessel wall from thermal injury.

Abstract: A surgical kit includes a handle assembly, an adapter assembly, and at least one end effector. The adapter assembly allows for use of a handle assembly that is configured to affect a function of a relatively long end effector to also be used with a relatively short end effector.

Abstract: Multi-axis pivot joints and surgical instrument drive shafts formed using additive manufacturing methods.

Abstract: Guides for supporting drive shafts across multi-axis articulation joints in surgical instruments.

Abstract: A tissue removal device includes a housing, a catheter extending from the housing and configured to be inserted into the body of a patient, a bending unit including a plurality of bending blocks that is disposed at a front end portion of the catheter and at least one or more wires that control a motion direction of the bending blocks, and a tissue removal unit disposed at the front end portion of the catheter and configured to come in contact with a tissue to be removed.

Abstract: An exhaust tool (50) includes: a flexible body portion (51) extending over substantially an entire length of a cylindrical shaft (30, 90) of an incision energy device (e.g., ultrasonic coagulation incision device 10 or electrocautery device 80) having an energy generation portion (32) for incision provided at a tip thereof; a pair of holding portions (52) provided to the body portion (51) and configured to hold the cylindrical shaft (30, 90); and a flow path formation portion (54) forming therein a flow path (56) for mist generated from the energy generation portion (32). The exhaust tool (50) is allowed to be attached/detached to/from the cylindrical shaft (30, 90) by the pair of holding portions (52) being opened through bending of the body portion (51).

Abstract: Disclosed is a balloon catheter that can prevent or reduce axial rotation and circumferential shift of the elongate body while ensuring good passage of the balloon in the blood vessel. The balloon catheter (100) has a shaft (110); a balloon (120); an elongate body (180) extending along the shaft (110) and having a body tissue contacting part at its distal end part; and an elongate body lumen (130), the elongate body lumen (130) having a first engagement part (131) so that axial rotation angle of the elongate body (180) is 0° to 60°, and the first engagement part (131) being located between the distal end (130d) of the elongate body lumen (130) and a position 30 cm from the distal end of the elongate body lumen (130) toward the proximal side.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A tissue-removing element is mounted on the 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. A motor operatively engages the elongate body for driving rotation of the elongate body and tissue-removing element mounted on the elongate body. A controller is operatively connected to the motor and configured to perform a torque response routine to control a speed of the motor based on a set PWM value of the motor and a detected current applied to the motor during rotation of the elongate body and tissue-removing element.

Abstract: A debulking catheter includes an advancer for advancing a tissue-removing element, and a linear-force indicator. The linear-force indicator provides feedback to the user based on an amount of linear force being applied to the advancer.

Abstract: An atherectomy system that utilizes an anchoring balloon with a rotary debulker and a crossing balloon to remove or debulk lesions formed on the interior wall surface of a body vessel. The system may include a first balloon coupled to a first tubular member, a rotary debulker coupled to a second tubular member, a second balloon coupled to both the third tubular member and the axially moveable fourth tubular member such that the second balloon is disposed inside the third tubular member. Methods for operating this device are also provided.

Abstract: A medical device that cuts an object in a body lumen includes: a drive shaft; a shaft portion connected to the drive shaft; a cutting portion connected to the shaft portion; and first and second bearings that rotatably support the shaft portion. The first bearing has a ring shape, the second bearing has a ring shape and is spaced from a proximal side of the first bearing. The shaft portion includes a first sliding portion slidably supported by the first bearing, a second sliding portion slidably supported by the second bearing, and an intermediate portion between the first and second sliding portions. The intermediate portion has a protruding portion protruding radially outward, the protruding portion is disposed between the first bearing (81) and the second bearing in an axial direction, and the shaft portion has a passage that communicates from the first sliding portion to the second sliding portion).

Abstract: A surgical access assembly includes a cannula, a valve housing attached to the cannula, and a valve assembly positioned in the valve housing. The valve assembly includes a centering mechanism with a hoop and fingers, a ring with a flange at one end of the ring, a retainer having first and second discs, a guard having a frame and flaps attached to the frame, and a seal with petals attached to a support. The guard is at least partially disposed in the first disc and the seal is at least partially disposed in the second disc.

Abstract: A gas circulation system is disclosed for performing robotically assisted surgical procedures in a surgical cavity of a patient, which includes a multi-lumen tube set including a dual lumen portion having a pressurized gas line and a return gas line, and a single lumen portion having a gas supply and sensing line, a valve sealed access cap for cooperative reception with a first robotic cannula and having an inlet path for communicating with the gas supply and sensing line of the tube set, and a gas sealed access cap for cooperative reception with a second robotic cannula and having an inlet path for communicating with the pressurized gas line of the tube set and an outlet path for communicating with the return gas line of the tube set.

Abstract: An apparatus for delivery of a vascular arteriovenous graft comprises a tubular sleeve defining an interior lumen adapted for being slidably positioned over a tunneling instrument. Once the tunneling instrument has been advanced to a desired subcutaneous anatomical location the shaft is removed while the sleeve remains in the tissue. The sleeve has a linear slit extending from a proximal end to a point intermediate the length of the sleeve. The lumen receives the distal end of the graft and at least a portion of a cannulation chamber such that the end of the sleeve progressively expands along the slit to provide an enlarged diameter for accommodating the cannulation chamber. Longitudinal force to the sleeve during removal of the sleeve from the tissue secures the graft in the sleeve by radial compression of the sleeve for pulling the graft and the sleeve through the tunnel and deploying the vascular graft.

Abstract: A method of performing bunion surgery may involve attaching a bone positioning device to a first metatarsal and to a first cuneiform across a joint separating the first metatarsal from the first cuneiform. Attaching the bone positioning device can include inserting a first fixation pin into one of the first metatarsal or the first cuneiform and inserting a second fixation pin into an other of the first metatarsal or the first cuneiform. The method can involve using the bone positioning device to adjust an alignment of the first metatarsal relative to the first cuneiform; and, after adjusting the alignment of the first metatarsal relative to the first cuneiform using the bone positioning device, fixing a position of the first metatarsal relative to the first cuneiform with a bone connector.

Abstract: A method of performing a bunion surgery may involve positioning a first portion of a bone positioning device over a first cuneiform and positioning a second portion of the bone positioning device over a first metatarsal with the bone positioning device extending across a joint separating the two bones. The second portion of the bone positioning device can be adjusted relative to the first portion about a first axis and about a second axis. The method may involve moving the second portion of the bone positioning device relative to the first portion of the bone positioning device about the first axis and the second axis, thereby moving the first metatarsal relative to the first cuneiform in a first plane and a second plane. The method may also involve fixing a position of the first metatarsal relative to the first cuneiform with a bone connector.

Abstract: Certain embodiments are directed to a scoliosis treatment device, an internal elastic brace (IEB) for scoliosis, and methods of using or deploying the same to treat scoliosis. The scoliosis treatment device includes various components that are assembled and deployed to provide a compressive force to the convex side of an abnormally curved spine by tethering the ribs on the convex side of the spinal curvature.

Abstract: A system for performing surgical repair of the spine includes a distractor and a permanently implanted bone plate system. A surgical repair methodology is also disclosed that employs an implanted bone plate system with a substantially void internal volume which is attached to adjacent vertebrae subsequent to the distraction and adjustment of curvature of the vertebrae and prior to the excision of disc and/or end plate tissue through the bone plate. The device further facilitates the subsequent delivery of an interbody repair device for the purpose of either fusion or dynamic stabilization, such as by disc arthroplasty. The plate may be permanently implanted, such as when a fusion between the attached vertebral bodies is desired, but it need not be permanently implanted.

Abstract: An aspect of the disclosure relates to an intramedullary device configured for ankle fusion. The intramedullary device for ankle fusion includes: a housing configured to be coupled to a calcaneus bone; and a rod configured to be coupled to a tibia bone, wherein a distal end of the housing includes an external thread. The rod is configured for telescopic movement relative to the housing, and to retract relative to the housing to cause ankle fusion. After fusion is achieved, the rod can be distracted to correct a limb length discrepancy.

Abstract: A distraction screw includes a proximal portion secured to a first vertebra, a distal portion secured to a second vertebra and an intermediate portion. The intermediate portion is coupled to the proximal and distal portions and is positioned in an intervertebral space. The intermediate portion is configured and adapted to enable distraction of the first vertebra relative to the second vertebra.

Abstract: Methods and instruments for placement of orthopedic implants in bones of a patient. The placement may include selective placement of the implant relative to structure of the bone using a measurement system that may detect interfaces between layers of the bone. The orthopedic implants may be engaged by various embodiments of chucks. The chucks may include structure for engaging indexing features of a corresponding orthopedic implant to restrict movement of the implant relative to the chuck along a working axis. The chucks may allow for use of an instrument having a measurement system for accurate and repeatable placement of the implants using the instrument.

Abstract: Described herein are devices and mechanisms for effective and streamlined ratcheting of handheld medical devices, for example, medical ratcheting screwdrivers. In some embodiments, a ratcheting mechanism is included, which comprises a moveable component, which can comprise a plurality of teeth, an engagement component comprising a plurality of protrusions configured to engage with the teeth, and a toggle collar between the moveable component and the engagement component. In some embodiments the toggle collar comprises stops configured to engage the protrusions and configured to toggle the ratcheting mechanism between modes allowing transmission of torque and force in a first rotational direction, but disallowing it in a second rotational direction and a mode allowing transmission of torque and force in the second rotational direction, but disallowing it in the first rotational direction.

Abstract: A bone screw tightening device including a screw driver, the screw driver having along its axis a device for providing for radial bendability and at a same time preserving torsional stiffness along an axis of longitudinal extension of the screw.

Abstract: A cylindrical shaft may be gripped with an apparatus including a housing having an axis and an inner surface with multiple asymmetric cam surfaces, a proximal end including a means to rotate the housing, and a distal end having an opening configured to receive the cylindrical shaft, at least two cylindrical gripping members configured to grip the cylindrical shaft, where each cylindrical gripping member contacts a corresponding asymmetric cam surface at a first rest position, and a rotatable frame which holds each pair of cylindrical gripping members at a fixed angular orientation relative to each other. The rotatable frame is configured to rotate upon insertion of the cylindrical shaft into a space defined by the gripping members so that each gripping member moves away from the axis of the housing along a first portion of the corresponding asymmetric cam surface.

Abstract: An electrosurgical instrument includes an end effector comprising two movable jaws for grasping tissue therebetween. The jaws connect to an electrosurgical energy source to deliver energy through tissue between the jaws to effect a seal. The jaws include a knife channel to reciprocate a knife therealong for severing tissue held between the jaws. A two-stage articulation joint is coupled to the end effector and to articulation bands configured to articulate the end effector. The two-stage articulation joint includes an outer cut metal tube comprising a plurality of sections and a solid but flexible inner core positioned within the outer cut metal tube. The electrosurgical instrument also may include a rotatable closure ring and a closure link operatively coupled to the rotatable closure ring, a rotatable coupling joint coupled to the articulation section, and/or a hollow flexible tube coupled to the knife and an active rod extending longitudinally therethrough.

Abstract: A cryoablation temperature control method, system and computer-readable storage medium.

Abstract: A plasma fractionation device having a removable cartridge connected to a handpiece where the removable cartridge includes a plurality of channels or magnetic poles that are filled with an inert gas that can be activated to produce plasma which exits the cartridge through the plurality of channels or magnetic poles. The plasma exiting through the plurality of channels or magnetic poles simultaneously creates a plurality of epidermal wounds.

Abstract: System and method for selectively applying electrical energy to structures within or on the surface of a patient's body and controlling the flow of an electrically conductive fluid from the application site to provide or maintain a desired operating condition of the electrosurgical device. An electrosurgical probe is in communication with a fluid transport apparatus through a fluid transport lumen having an opening at an end proximate the application site and disposed proximate the electrosurgical probe. A controller in communication with the fluid transport apparatus provides control signals to the fluid transport apparatus in response to at least one operating parameter associated with the system. Based on the received control signals, the fluid transport apparatus adjusts a flow rate of the electrically conductive fluid at the application site through the fluid transport lumen in response to at least one operating parameter associated with the system.

Abstract: A computing device for generating and using a graphical user interface (GUI) is disclosed. The computing device includes one or more controllers configured to generate a graphical representation of a plurality of electrodes of an ablation catheter for displaying via the GUI; designate, via the GUI, at least some of the plurality of electrodes to be active electrodes; automatically designate the active electrodes as a source electrode or a sink electrode; assign an amount of energy to each of the designated source electrodes; and estimate an amount of energy associated with each of the designated sink electrodes based at least in part on the assigned energy of the designated source electrodes.

Abstract: In an example, an electrosurgical device includes a housing defining an interior bore. The electrosurgical device also includes a shaft telescopically moveable in the interior bore of the housing. The shaft includes an optical waveguide at a distal end of the shaft, and a smoke evacuation channel circumferentially surrounding the optical waveguide at the distal end of the shaft. The electrosurgical device also includes an electrosurgical electrode coupled to the shaft.

Abstract: An instrument capable of being repeatedly sterilized. The instrument has handle pieces that are configured as a housing. The housing includes housing shells that are joined to one another at butt joints without a gap. The interior of the butt joints may be completely filled with a casting compound.

Abstract: The present application discloses a method and apparatus that use a two-dimensional array or matrix of RF electrodes arranged on a substrate. In one example, the RF electrodes are individually addressable. In another example, the RF electrodes are arranged in addressable clusters. The clusters of the RF electrodes could be non-symmetrical dusters of electrodes.

Abstract: An injectate delivery device for expanding tissue is provided. The injectate delivery device comprises: at least one fluid delivery tube comprising a proximal end, a distal end and a lumen therebetween; at least one fluid delivery element in fluid communication with the at least one fluid delivery tube lumen; a radially expanding element comprising the at least one fluid delivery element; a supply of vacuum constructed and arranged to cause tissue to tend toward the at least one fluid delivery element; and at least one control constructed and arranged to perform a function. The at least one control can be constructed and arranged to expand the radially expandable element and activate the supply of vacuum. Systems and method of injectate delivery are also provided.

Abstract: Described herein is an electrode basket for a catheter system. The electrode basket includes a proximal end and a distal end. A longitudinal axis of the electrode basket extends longitudinally through the proximal end and the distal end. The electrode basket also includes a plurality of splines extending from the proximal end to the distal end, each spline including a proximal portion extending at least partially longitudinally from the proximal end, a distal portion extending at least partially longitudinally from the distal end, a highly pitched region, and a plurality of electrodes. The highly pitched region is oriented more circumferentially than the proximal portion and the distal portion. Each of the plurality of electrodes is located within the highly pitched region such that a high-density circumferential band of electrodes is defined around the electrode basket.

Abstract: A method for creating a conductive junction in a system for performing a diagnostic or therapeutic procedure includes placing a first elongate conductor through a first lumen of an elongate body, creating a hole in a wall of the elongate body adjacent the first lumen at a distal portion of the elongate body, applying an electrically conductive material to a portion of an outer circumference of the elongate body at the distal portion of the elongate body to form an electrode, and electrically coupling the first elongate conductor to the electrode.

Abstract: Provided is a high-frequency treatment tool including: a sheath having an inner hole that passes therethrough in a longitudinal direction; a first electrode portion that is formed in a rod shape, that passes through the inner hole of the sheath to protrude from a distal end of the sheath, and that is configured to apply a high-frequency current; a second electrode portion that is disposed at a position at which the second electrode portion is electrically connected with the first electrode portion; and a power source that uses the first electrode portion as a negative electrode, that uses the second electrode portion as a positive electrode, and that supply a current between the first electrode portion and the second electrode portion so that a state in which attached matter attached to the first electrode portion is lifted from the first electrode portion due to osmosis is created.

Abstract: A catheter device is to be applied to a catheter and includes a tube member and a second handle. The tube member is configured to be inserted through a lumen provided in a catheter shaft of the catheter. The second handle is provided on a base end of the tube member, and includes a deformation operating member. The second handle is provided separately from a first handle provided on a base end of the catheter shaft. Upon bending deformation of a region in the vicinity of a tip end of the tube member in response to an operation of the deformation operating member, the tube member is configured to be pressed against a wall surface of the lumen of the catheter shaft to displace a region in the vicinity of a tip end of the catheter shaft. The second handle is configured to be integrated with the first handle.

Abstract: A deflectable sheath or dilator or catheter used for cardiac procedures; it has a shaft with one or more lumens; an optical fiber for use in channeling light used for visualization of calcification, heart tissue architecture or the progress of the cardiac procedure; the sheath or dilator or catheter includes an additional optical fiber for use as part of an ultrafast laser for calcium removal on or in heart valve tissue or for performing surgical intervention of the heart, or where the optical fiber is configurable for propagating a photon beam as part of an ultrafast laser for removing calcium on or in heart valve tissue or for performing surgical intervention of the heart.

Abstract: The instant invention is comprised of radiographic grids and an adjustable needle guide to facilitate the placement of an introductory needle using a two-dimensional aiming using an imaging needle guide comprising a proximal grid including a body, a top side, a bottom side, one or more radiopaque rings, and a central aperture extending through the body from the top side to the bottom side, a distal grid including a body, a top side, a bottom side, one or more radiopaque rings, and a central aperture extending through the body from the top side to the bottom side, and a needle.

Abstract: The embodiment of the present disclosure provides an optical scale comprising a support and at least three markers, wherein, the markers are fixed on the support; among all the markers, there are at least three markers whose geometric centers are not collinear; any two of the markers are different in at least one of size and shape, and any different markers do not contact each other; the material of the marker and the support enables that in a three-dimensional image obtained by three-dimensional imaging technology, the difference between a gray scale of the marker and a gray scale of the support exceeds a first predetermined value. The embodiment of the present disclosure provides a method for coordinate system registration. The embodiment of the present disclosure further provides a method for coordinate system registration by using the above optical scale.

Abstract: Methods of delivering a prosthetic aortic heart valve are disclosed.

Abstract: A computer implemented medical method of calibrating a cage is presented. In particular, this calibration method calculates a virtual model of the cage based on a cage tip point and a cage end point, acquired by using a pointer tip of a pointing device, and at least one axis, acquired by using a pointer shaft of the pointing device along a side of the cage. This method allows for providing a more detailed virtual model of the cage, while being in compliance with sterility restrictions.

Abstract: A medical apparatus for determining a relative spatial position of a planar marker is provided. The medical apparatus has an illumination device configured to illuminate the marker, a detector configured to detect light steered from the marker to the detector, and an evaluation device configured to determine a direction of a tilt of the marker from an analysis of a first value detected by the detector while the marker is illuminated from a first direction and a second value detected by the detector while the marker is illuminated from a second direction.

Abstract: A camera tracking system is disclosed that is configured to obtain a model defining a tracking volume of a set of tracking cameras relative to pose of the set of tracking cameras, and receive tracking information from the set of tracking cameras indicating pose of an extended reality (XR) headset relative to the set of tracking cameras. The camera tracking system is further configured to generate a graphical representation of the tracking volume from a perspective of the XR headset based on the pose of the XR headset indicated by the tracking information and based the model defining the tracking volume of the set of tracking cameras, and provide the graphical representation of the tracking volume to the XR headset for display to the user.

Abstract: A surgical device for retaining a tool, the surgical device comprises a multi-axis manipulator configured to generate relative movement between a moving end and a stationary end thereof; a housing fixed to the stationary end of the manipulator; a motor configured to rotate the tool by a rotating interface when the tool is retained to the rotating interface; an adaptor connected to the manipulator and in orientational fixation to the moving end of the manipulator, the adaptor being configured to move with the moving end, and the adaptor comprises a tool stopper disposed therein, wherein the tool stopper is configured to catch the tool if the tool is dropped from the rotating interface; a tool head latchless interface exposed to a channel of the adaptor and configured to provide attraction force within the channel for retaining the tool to the rotating interface.

Abstract: A transrectal probe manipulator system includes a probe comprising a biopsy needle and a manipulator. The manipulator includes a base including first and second base support shafts on a base body, a main frame, and a mounting plate. A lower end of the main frame is rotatably connected to the base through a first shaft to define a first degree of freedom. The mounting plate includes first and second mounting plate support shafts and a probe receiver, and is rotatably connected to the main frame through a second shaft to define a second degree of freedom. The probe receiver is rotatable about a central axis to define a third degree of freedom, and linearly moveable along the central axis to define a fourth degree of freedom. The probe is secured to the probe receiver. The manipulator is driven by cables which are attached to the shafts in an actuation assembly.

Abstract: Generally, a sterile adapter for use in robotic surgery may include a frame configured to be interposed between a tool driver and a surgical tool, a plate assembly coupled to the frame, and at least one rotatable coupler supported by the plate assembly and configured to communicate torque from an output drive of the tool driver to an input drive of the surgical tool.

Abstract: A medical cart for use in patient care is provided, the medical cart comprising: a front; a back; sides; four legs which have a distal end, a proximal end and a bore at least partially therebetween terminating in an aperture at the proximal end; a spring plunger mounted on each leg for releasably retaining a pole in the bore; a bracket attached to each leg proximate to the distal end; a caster rotatably attached to each bracket; a lower shelf attached to the legs and extending between the legs; a ballast sleeve below the lower shelf for releasably retaining weight plates; and an upper shelf attached to the legs and extending between the legs, the upper shelf including a recess at the front extending towards the back.