Abstract: A vascular closure device configured to seal a puncture site in the vessel wall in a more efficient manner is disclosed. The vascular closure device includes a guide member that extends through a portion of the sealing device and that is removable from the portion the sealing device.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a cannulated suture anchor is provided and it includes a suture-engaging member formed therein and configured to receive a suture therearound such that trailing ends of the suture can extend through the suture anchor. The suture anchor can also include at least a proximal portion having dual threads to facilitate engagement with bone. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: An anchor is provided for placement in or against tissue. The anchor includes a flat fibrous construct having a first end and a second end; and a filament having a first end and a second end passing through the fibrous construct in two locations including a first passing location nearest a first end of the fibrous construct, a second passing location nearest a second end of the fibrous construct, the filament remaining free to slide through the first passing location and the second passing location such that the filament can be removed from the flat fibrous construct from the first end of the fibrous construct and the second end of the fibrous construct. The anchor can be inserted into a bone hole and deployed.

Abstract: Surgical constructs, assemblies and methods of tissue fixation are disclosed. A surgical construct includes a spreadable web attached to a plurality of peripheral strands. The spreadable web may be tensionable and may include one or more flexible filaments or strands. At least one of the filaments is coupled to the peripheral strands. The filaments may extend from the peripheral strands in different directions and/or orientations. The spreadable web is expandable and can be adjusted to various widths. The spreadable web may be knotless. The spreadable web may be tensionable. The surgical construct may be attached to one or more knotted or knotless fixation devices.

Abstract: Suture locking clamps for securing prostheses such as heart valves or annuloplasty rings with sutures and without using knots improve the ease of implantation. The clamps have opposed clamp halves separated by a slot opening to one side and surrounded by a biasing member such as one or more C-clip springs. Sutures pass laterally into the slot which is held open by a retention member positioned between the clamp halves. The locking clamp slides along the sutures into position, the tension of the sutures is adjusted, and the retention member removed to allow the biasing member to clamp the sutures between the clamp halves. A delivery tool used to deliver and deploy the locking clamps contains a number of clamps within a delivery tube in a stack and bonded together for safety and a common retention member. The tool has a longitudinal channel on one side for entry of sutures.

Abstract: A surgical stapling system for stapling the tissue of a patient is disclosed. The stapling system comprises a housing, a shaft extending from the housing, and an end effector extending from the shaft. The end effector comprises a plurality of staples removably stored therein and, also, an anvil configured to deform the staples. The stapling system further comprises a firing mechanism configured to deploy the staples along a staple firing path longer than 60 mm, a camera configured to capture an image of the patient tissue, a display, and a controller configured to generate an image of the staple firing path, wherein the images are displayed on the display.

Abstract: A surgical instrument comprising a surgical end effector that comprises a first jaw and a second jaw that is movably supported relative to the first jaw for selective movement between an open position and closed positions. The surgical instrument further comprises a closure member that is axially movable in response to closing and opening motions. The closure member comprises at least one opening cam that protrudes therefrom to movably engage a corresponding cam surface on the second jaw such that upon application of the opening motion, the at least one opening cam movably engages the corresponding cam surface to move the second jaw to an open position, even when the jaws are under a load.

Abstract: A surgical stapling device includes a tool assembly that includes a drive assembly having a drive member and a working end. The working end of the drive assembly has a I-beam configuration and includes a first beam, a second beam, and a strut interconnecting the first beam and the second beam. The strut defines a slot. The drive member includes a distal portion that is press-fit into the slot in the strut to secure the working end to the drive member.

Abstract: A surgical stapling apparatus includes a housing assembly and an adapter assembly. The adapter assembly defines a longitudinal axis and is selectively attachable to the housing assembly. The adapter assembly includes an end effector and an articulation assembly. The articulation assembly includes an articulation drive screw, an articulation nut threadedly mounted to the articulation drive screw, an articulation yolk coupled to the articulation nut, and an articulation tube that is positioned to move in response to movement of the articulation nut. Movement of the articulation tube causes the end effector to articulate relative to the longitudinal axis.

Abstract: A surgical instrument comprising a first jaw, a second jaw rotatable relative to said first jaw, and jaw drive system is disclosed. The jaw drive system comprises a drive screw and a closure member threadably engaged with the drive screw configured to close the second jaw. The jaw drive system further comprises an opening link connecting the closure member to the second jaw which acts to open the second jaw when the closure member is driven in an opposite direction. In the event that the second jaw is not opened by the closure link, the jaw drive system further comprises a pull member which is pushed by the closure member to dislodge the second jaw into its open position.

Abstract: A stapling assembly comprising an anvil, a staple cartridge, and a tissue cutting knife is disclosed. The staple cartridge comprises a longitudinal slot, a first group of staple cavities, a second group of staple cavities, staple drivers, and staples. The staples comprise a first group of staples positioned in the first group of staple cavities, and a second group of staples positioned in the second group of staple cavities. The first group of staples are deformed against the anvil to a first formed height by the staple drivers during a staple firing stroke. The second group of staples are deformed against the anvil to a second formed height by the staple drivers during the staple firing stroke. The second formed height is different than the first formed height. The tissue cutting knife is movable longitudinally within the longitudinal slot to drive the staple drivers during the staple firing stroke.

Abstract: A surgical stapling device includes a body portion that defines a longitudinal axis and a tool assembly that articulates about an axis transverse to the longitudinal axis. An articulation link assembly is supported in the body portion and is movable between retracted and advanced positions to pivot the tool assembly between a non-articulated position and articulated positions. The articulation assembly supports an articulation lock assembly that is movable from a locked position to an unlocked position in response to longitudinal movement of the articulation assembly to facilitate articulation of the tool assembly. The articulation lock assembly stabilize the articulation link assembly within the body portion when the surgical stapling device is fired to minimize occurrence of tremors in the tool assembly.

Abstract: A surgical stapling device includes cartridge assembly having a replaceable staple cartridge. The replaceable staple cartridge includes a knife having a cutting blade that is movable between a shielded position and an exposed position in response to advancement of a drive assembly of the stapling device. In aspects of the disclosure, the knife is pivotably coupled to an actuation sled of the cartridge assembly and is biased by a resilient finger on the actuation sled to move the cutting blade to the shielded position.

Abstract: Systems and methods for forming an anastomosis between two adjacent walls of a digestive tract are provided. The system can include a first and second magnetic implants that are configured to magnetically couple to each other through the two adjacent walls of the digestive tract to compress a portion of the two adjacent walls therebetween and form a necrotic area that becomes surrounded by a scarred edge following a healing time period. The system can also include a retention member that can extend outwardly from a corresponding one of the first and second magnetic implants, the retention member being configured to retain the first and second magnetic implants in position and prevent passage thereof through the necrotic area during the healing time period.

Abstract: A method of displaying an operational parameter of a surgical system is disclosed. The method includes receiving, by a cloud computing system of the surgical system, first usage data, from a first subset of surgical hubs of the surgical system; receiving, by the cloud computing system, second usage data, from a second subset of surgical hubs of the surgical system; analyzing, by the cloud computing system, the first and the second usage data to correlate the first and the second usage data with surgical outcome data; determining, by the cloud computing system, based on the correlation, a recommended medical resource usage configuration; and displaying, on respective displays on the first and the second subset of surgical hubs, indications of the recommended medical resource usage configuration.

Abstract: A circular stapling device includes an anvil assembly and an adaptor assembly including a shell assembly. The adaptor assembly includes an anvil retainer including an asymmetric tip. The anvil assembly has a center rod, an anvil head supported on the center rod, and an alignment member. The center rod has a proximal portion and a distal portion and defines a channel that extends from the proximal portion to the distal portion. The alignment member is positioned within the channel and is configured to engage the asymmetric trocar tip of the anvil retainer of the adaptor when the anvil assembly is attached to the anvil retainer to properly align the anvil assembly with the shell assembly.

Abstract: An embodiment includes a system comprising: a catheter; an optic fiber having a long axis and a short axis that is orthogonal to the long axis; first and second radiopaque elements coupled to the optic fiber; a first wire coupled to the optic fiber and extending from the first radiopaque element to the second radiopaque element; a fluid; wherein (a)(i) the first wire wraps at least partially around an exterior surface of the optic fiber; (a)(ii) an outer diameter of the first wire and an outer diameter of the optic fiber are collectively less than an inner diameter of the catheter, and (a)(iii) the first wire is configured to center the optic fiber within the catheter within a plane orthogonal to the long axis.

Abstract: A surgical clip may be configured to ligate tissue. The surgical clip may include first and second leg members. The first leg member may have a proximal portion, a distal portion, a convex first inner surface, and a convex first outer surface. The first leg member may also include an inner portion at least partially defining the first inner surface and an outer portion at least partially defining the first outer surface. The inner and outer portions may be joined at first and second portions of the first leg member and separated by a channel. The second leg member may include a proximal portion, a distal portion, a second inner surface, and a second outer surface. The first and second leg members may be movable relative to each other between open and closed configurations, and the first and second inner surfaces may be configured to ligate the tissue when in the closed configuration.

Abstract: A device for treating a tissue opening includes a proximal portion including an elongated flexible member, a capsule releasably coupled to a distal end of the flexible member and including a lumen extending therethrough and a clip including a pair of arms movably housed within the capsule. A suture extending along a first one of the pair of arms and including a loop at a distal end thereof extending across an opening extending through the first one of the pair of arms. A suture grabbing element extending laterally from a second one of the pair of arms and including a hook so that, when the pair of arms are moved toward a closed configuration, the hook extends through the opening to grab the loop and draw the distal end of the suture from the first one of the pair of arms toward the second one of the pair of arms.

Abstract: Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

Abstract: A rotatable surgical instrument, system, and method includes an outer tubular member and an inner tubular member contained, at least in part, within the outer tubular member and configured to rotate relative to the outer tubular member. A distal tip is coupled to and configured to rotate with the inner tubular member, the distal tip forming a channel around a portion of the distal tip. A bearing is rotatably positioned within the channel, wherein the channel inhibits radial and axial movement of the bearing, with respect to the distal tip, along a major axis of the outer tubular member and inner tubular member, and wherein the bearing is configured to inhibit deflection of the distal tip from the major axis.

Abstract: Embodiments directed to an apparatus and system of monitoring an instrument with a working tool engaged thereby. In one aspect, an embodiment including a working tool with a machine readable indicium indicative of a working tool attribute. The working tool may be receivable by an instrument such that a corresponding machine readable indicia reader receives an identifier of the working tool. Various attributes and conditions in relation to the instrument and working tool received thereby may be identified to facilitate the provisioning of a response to prompt various corrective actions. In this regard, a controller may provide an output in response to a received identifier of a working tool and an identified instrument operating condition.

Abstract: Disclosed is a system to engage one or more tools. In the system, a drive shaft and collet may be assembled to engage and disengage, selectively, a plurality of tools. A guide may be used with the system to select various features of a procedure, such as depth and position.

Abstract: The present disclosure includes apparatuses for a bone graft harvesting device. An example apparatus includes a blade tip including a proximal end and a distal end, wherein the distal end of the blade tip includes a number of blades configured to morcellate bone in response to being rotated and a lead tip located within the blade tip and configured to maintain the bone graft harvesting apparatus centered on a bone graft punch hole.

Abstract: A system, method and/or reamer driver device provides a fully closed tube which prevents the invasion of debris and minimizes abrasion of soft tissue during use. The reamer device includes a minimum number of component assemblies, so as to permit easy replacement and minimize wear.

Abstract: A tibial alignment device includes an upper part for coupling with a tibial cutting guide and a lower part coupled to the upper part to be vertically slidable, wherein the upper part includes a cutting guide coupling part configured to mount the tibial cutting guide, and a connection part to connect the upper part and the lower part, and the lower part includes an ankle forceps part, wherein the cutting guide coupling part includes a fastening member for coupling to the tibial cutting guide, and a reception member to slidably receive the fastening member, wherein the fastening member includes a coupling part that protrudes to be coupled to the tibial cutting guide, the reception member includes a coupling part that protrudes to be coupled to the tibial cutting guide, and the coupling part of the fastening member is capable of adjusting a gap with respect to the coupling part of the reception member.

Abstract: A method of preparing a knee joint for a prosthesis in a patient includes mating a patient-specific three-dimensional curved inner surface of a femoral alignment guide onto a corresponding three-dimensional femoral joint surface of the patient. The patient-specific three-dimensional curved inner surface is preoperatively configured from medical scans of the knee joint of the patient. First and second holes are drilled into an anterior portion of the femoral joint surface through corresponding first and second guiding apertures of the femoral alignment guide.

Abstract: A stemless humeral head replacement system including a base plate and a humeral head implant. The base plate includes a bone facing side, an implant side opposite the bone facing side, a curvate perimeter, at least one fin protruding from the bone facing side a first distance and extending linearly a length along the bone facing side, and an implant engagement structure on the implant side. The humeral head implant includes a curvate implant surface and a base plate engagement structure opposite the curvate implant surface, the base plate engagement structure configured to couple to the implant engagement structure of the base plate.

Abstract: Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.

Abstract: A system for crushing and/or removing body stones, includes a source causing shock waves and/or ultrasonic waves, and a probe, wherein the source and the probe are reversibly connectable to one another via an interface for transmitting the shock waves and/or ultrasonic waves to the probe. The probe includes an identification element for identifying the probe, the identification element being arranged in or on the probe in a sound-protected manner. The identification element is preferably an RFID element.

Abstract: Clot engagement element comprising bundle of unwoven fibers can be assembled to form an acute stroke treatment device. The device has the capability of forming a three dimensional filtration matrix comprising effective pores with a distribution of sizes. The bundle of fiber design allows the device to be effectively delivered into circuitous cerebral arteries to remove clot that causes stroke. The fiber bundle based filtration matrix offers the advantages of conforming to the changing inner perimeter of a blood vessel during a clot removal process and thus the capability to effectively retain and remove a clot in the vessel. The filtration matrix offers the additional advantage to trap any break-off of the clot during the removal process. A plurality of fiber bundles can be combined to form an effective clot engagement element. Supplemental engagement structure as well as mechanical treatment structure can be integrated into the stroke treatment device.

Abstract: A device and a method for increasing or restoring a flow in a body lumen are provided. The device and the method may treat conditions related to a stroke, such as an ischemic stroke, by removing an occlusion from a blood vessel and/or reopen a blood vessel. The device may comprise a tubing compartment, a central wire, and an engaging compartment. The engaging compartment may comprise a distal engaging element and a proximal engaging element. A clot or occlusion present in the body lumen such as an artery may be engaged in and/or between the distal and proximal engaging elements. Further, the positions of one or both of the engaging elements and the distance therebetween can be adjusted to ensure the engagement of the clot or occlusion.

Abstract: The various embodiments disclosed herein relate to arms or forearms of medical devices that are configured to couple with quick-release end effectors, quick-release end effectors for use with such medical devices, and arms or forearms coupled to such quick-release end effectors. Certain forearms and end effectors have magnetic couplings, while others have mechanical couplings, and further implementations have both magnetic and mechanical couplings.

Abstract: A method for attaching a drive rod to a knife includes: forming a knife having proximal and distal ends; forming an aperture within the proximal end of the knife, the aperture including a series of fins disposed therein; weaving a distal end of a knife rod through the series of fins in an alternating manner; and engaging a cap onto the distal end of the knife drive rod to secure the knife drive rod within the aperture of the knife.

Abstract: A surgical instrument includes a shaft defining an axis, an end effector coupled to a distal portion thereof, a fixed handle coupled to a proximal portion thereof, a drive bar, a movable handle, and a linkage. The drive bar is disposed within the shaft and operably coupled to the end effector. The movable handle is movable relative to the fixed handle between open and closed positions and is coupled to the drive bar via a first pin on the axis. The linkage includes a first end portion coupled to the movable handle via a second pin and a second end portion coupled to the shaft via a third pin on the axis. In the closed position of the movable handle, the second pin is disposed in a near-over-center position relative to the axis to reduce a force necessary to maintain the movable handle in the closed position.

Abstract: Methods for improving luminal gain when performing angioplasty at a zone of attention located at a blood vessel in a person's vascular system is provided. An intravascular device including an expandable portion secured to a distal portion of a catheter tube is provided. An incising element is provided on the expandable portion. The expandable portion is positioned at a first end of the zone of attention, placed in an expanded position, and moved along at least a portion of the zone of attention such that the incising element contacts at least a portion of atherosclerotic material located therein. An angioplasty device is positioned at the zone of attention and expanded.

Abstract: An arthroscopic or other surgical cutter has features which facilitate fabrication by ceramic molding. The arthroscopic cutter includes a cutter body having a longitudinal axis and a window, an interior channel, and a plurality of cutting edges extending radially outwardly from an outer surface thereof. The features include non-helical, longitudinally aligned cutting edges, controlled thicknesses of the cutting edges, controlled heights of the cutting edges, controlled areas of the windows, controlled diameters of the internal channels, controlled rake angles of the cutting edges, and other parameters.

Abstract: A radially expandable trocar, port or cannula system is provided for use in minimally invasive surgeries. The cannula creates a port access with an initial small internal diameter. The passage of the cannula devices is defined by a plurality of elongate rigid members. A number of mechanisms are provided for expanding the passage of the cannula devices, by moving the plurality of elongate rigid members towards a larger radial location, thereby creating a larger internal diameter for the port. The elongate rigid members can be prevented from unintended movement when the system is at the un-expanded state, during expansion and when it is expanded to the desired larger diameter. Exemplary embodiments include methods of preventing gas loss from the tissue that would occur through the gaps created during expansion.

Abstract: A surgical access assembly including an elongated cannula member having proximal and distal end portions, a cannula housing coupled to the proximal end portion of the elongated cannula member, a balloon anchor coupled to the distal end portion of the elongated cannula member, and a collar disposed along the elongated cannula member and in fluid communication with the balloon anchor. The collar includes a first check valve and a manually actuatable pump. The first check valve is configured to control flow of air into the balloon anchor. The manually actuatable pump is coupled to the first check valve.

Abstract: In one embodiment, a non-invasively adjustable spinal system for treatment of a subject having spondylolisthesis includes a first implantable actuator having at least one anchoring structure, the anchoring structure configured to facilitate securement of the first implantable actuator to a portion of the sacrum of the subject. The non-invasively adjustable spinal system can further include an adjustment element, configured to be coupled to the first implantable actuator, the adjustment element having an engagement structure configured to engage at least one transverse process of a lumbar vertebra of the subject. The non-invasively adjustable spinal system can further include a driving element, wherein remote activation of the driving element causes movement of the adjustment element in relation to the first implantable actuator.

Abstract: An implantable modular plate system for stabilizing adjacent vertebral bodies in a cervical spine includes at least two plate segments aligned or connected together so as to form a connection at and along adjacent ends. At least one of the plate segments includes a flange at an engagement end and at least one of the plate segments including a flange recess at an engagement end, the flange being configured for overlay engagement with the flange recess when the at least two plate segments are engaged. The plate segments are pivotable out of plane with one another at a common axis of rotation traversing overlapping portions of the adjacent ends and are constrained from rotation by the flanges such that the rotation of each plate segment is limited to up to 90 degrees of rotation away from the contact surfaces of the flange and flange recess.

Abstract: An expandable implant system is configured to increase the height of a target bone, for instance that has been subjected to a compression fracture. The expandable implant system includes an implant assembly that can be inserted into the target bone, and subsequently expanded so as to increase the height of the target bone. The expandable implant system further includes an and insertion assembly that is configured to create an insertion channel into the target bone, such that the implant assembly can be inserted in a collapsed configuration into the target bone along the insertion channel, and subsequently expanded.

Abstract: An internal intramedullary fixation device for the stabilization of bone in arthrodesis and fractures of the foot and hand is disclosed. During implantation in medullary canals of bones, the device grasps the edges of the canals, stabilizing the bones, internally, during a healing process. The intramedullary fixation device comprises arrow-shaped proximal and distal heads comprising tips and a pairs of wings, the heads being sized to fit within an intramedullary canal of a bone. The intramedullary fixation device also comprises a rigid body defining a longitudinal axis connecting the proximal and distal heads. The rigid body comprises an intermediate portion, a distal neck portion connecting the rigid body to the distal head, and a proximal neck portion connecting the rigid body to the proximal head, the neck portions having a cross-sectional area smaller than a cross-section area of the intermediate portion.

Abstract: Embodiments herein provide a chest wall repair plate device where a central portion of the device is comprised of an elastomer to allow for rapid resection using a standard surgical scalpel should there be a need to quickly re-enter the chest cavity. The elastomeric section adjoins two or more rigid plate sections creating a simple, easily removable sternal stabilization system.

Abstract: A fixation assembly for securing parts of a sternum is provided. The assembly comprises a flexible elongated member and an attachment member. The flexible elongated member includes a locking structure configured to secure the flexible elongated member in a loop around the sternum parts. The attachment member has at least one opening for receiving a bone fastener and is coupled to the flexible elongated member.

Abstract: A polyaxial bone anchoring device includes a receiving part having a longitudinal axis, a channel for receiving a rod, and an accommodation space for pivotably holding a head of a bone anchoring element, and a pressure member configured to be positioned in the receiving part and to exert pressure onto the head to lock the head in the receiving part. The pressure member includes a pressure exerting surface and a deformable portion having a free end, wherein the deformable portion is configured to assume at least a first configuration and a second configuration. The polyaxial bone anchoring device further includes a locking member configured to be inserted into the channel and to exert a force onto the deformable portion.

Abstract: A bone fixation system comprises a first fastener configured to anchor into a first vertebrae, a second fastener configured to anchor into a second vertebrae, and a set screw to retain the second fastener to the first fastener. The first fastener includes a shaft extending along a longitudinal axis and a head. The shaft includes a first cylindrical body. The head of the first fastener includes a second cylindrical body defining a passageway having an interior surface. The passageway defines a longitudinal axis that is different than the longitudinal axis of the shaft. The first cylindrical body of the shaft and the second cylindrical body of the head are angled relative to each other. A head of the second fastener is configured to engage the interior surface of the passageway of the head of the first fastener. The set screw retains the head of the second fastener in the passageway.

Abstract: A dispensing system includes a device having a body extending along a longitudinal axis between opposite proximal and distal ends. The body includes a proximal chamber, a distal chamber and a wall between the chambers. The body includes a first port in communication with the proximal chamber and a second port in communication with the distal chamber. A shaft is movably positioned within the body. The shaft extending through the wall and comprising a proximal plunger positioned within the proximal chamber and a distal plunger positioned within the distal chamber. Wherein pressure introduced through an opening in the proximal end moves the shaft such that the proximal plunger moves a material within the proximal chamber out of the first port and the distal plunger moves a material within the distal chamber out of the second port. Kits and methods of use are disclosed.

Abstract: A kyphoplasty system includes various instruments which can be selectively used in a surgical theater (e.g., during a surgical operation on a patient) or a surgical training environment. The kyphoplasty system can include one or more of a kyphoplasty apparatus, a prone table mat, a connector system, a bone introducer needle, and a biopsy device. The kyphoplasty system may also include a training system for use in the training environment.

Abstract: The cooling system cools a patient's tissue while applying suction to the skin and applying ultrasound waves to the tissue to reduce fat cells. The cooling applicator simultaneously provides suction, cooling, and ultrasound to the treatment area of the patient. The applicator connects to a suction to draw the tissue longitudinally into a cavity of the applicator. Cooling plates located laterally outward from the cavity cool the tissue during the treatment. A transducer located longitudinally above the cavity transmits ultrasound waves longitudinally downward into the cavity and the tissue. The ultrasound provides non-focused treatment such that the transducer transmits the ultrasound waves oriented horizontally and vertically longitudinally downward at the tissue. A treatment pad placed on the patient's skin directly contacts the patient such that the applicator does not directly contact the patient. The treatment pad is constructed from a fabric storing a glycerin gel, deionized water, and fructose.